Intensive care sedation: the past, present and the future

Despite the universal prescription of sedative drugs in the intensive care unit (ICU), current practice is not guided by high-level evidence. Landmark sedation trials have made significant contributions to our understanding of the problems associated with ICU sedation and have promoted changes to current practice. We identified challenges and limitations of clinical trials which reduced the generalizability and the universal adoption of key interventions. We present an international perspective regarding current sedation practice and a blueprint for future research, which seeks to avoid known limitations and generate much-needed high-level evidence to better guide clinicians' management and therapeutic choices of sedative agents.

Consciousness, Meaning and the Future Phenomenology

Phenomenological states are generally considered sources of intrinsic motivation for autonomous biological agents. In this paper we will address the issue of exploiting these states for robust goal-directed systems. We will provide an analysis of consciousness in terms of a precise definition of how an agent “understands” the informational flows entering the agent. This model of consciousness and understanding is based in the analysis and evaluation of phenomenological states along potential trajectories in the phase space of the agents. This implies that a possible strategy to follow in order to build autonomous but useful systems is to embed them with the particular, ad-hoc phenomenology that captures the requirements that define the system usefulness from a requirements-strict engineering viewpoint.

The biotic crisis and the future of evolution

The biotic crisis overtaking our planet is likely to precipitate a major extinction of species. That much is well known. Not so well known but probably more significant in the long term is that the crisis will surely disrupt and deplete certain basic processes of evolution, with consequences likely to persist for millions of years. Distinctive features of future evolution could include a homogenization of biotas, a proliferation of opportunistic species, a pest-and-weed ecology, an outburst of speciation among taxa that prosper in human-dominated ecosystems, a decline of biodisparity, an end to the speciation of large vertebrates, the depletion of “evolutionary powerhouses” in the tropics, and unpredictable emergent novelties. Despite this likelihood, we have only a rudimentary understanding of how we are altering the evolutionary future. As a result of our ignorance, conservation policies fail to reflect long-term evolutionary aspects of biodiversity loss.

The past and the future fate of the universe and the formation of structure in it

The history and the ultimate future fate of the universe as a whole depend on how much the expansion of the universe is decelerated by its own mass. In particular, whether the expansion of the universe will ever come to a halt can be determined from the past expansion. However, the mass density in the universe does not only govern the expansion history and the curvature of space, but in parallel also regulates the growth of hierarchical structure, including the collapse of material into the dense, virialized regions that we identify with galaxies. Hence, the formation of galaxies and their clustered distribution in space depend not only on the detailed physics of how stars are formed but also on the overall structure of the universe. Recent observational efforts, fueled by new large, ground-based telescopes and the Hubble Space Telescope, combined with theoretical progress, have brought us to the verge of determining the expansion history of the universe and space curvature from direct observation and to linking this to the formation history of galaxies.

Nitrogen management and the future of food: Lessons from the management of energy and carbon

The food system dominates anthropogenic disruption of the nitrogen cycle by generating excess fixed nitrogen. Excess fixed nitrogen, in various guises, augments the greenhouse effect, diminishes stratospheric ozone, promotes smog, contaminates drinking water, acidifies rain, eutrophies bays and estuaries, and stresses ecosystems. Yet, to date, regulatory efforts to limit these disruptions largely ignore the food system. There are many parallels between food and energy. Food is to nitrogen as energy is to carbon. Nitrogen fertilizer is analogous to fossil fuel. Organic agriculture and agricultural biotechnology play roles analogous to renewable energy and nuclear power in political discourse. Nutrition research resembles energy end-use analysis. Meat is the electricity of food. As the agriculture and food system evolves to contain its impacts on the nitrogen cycle, several lessons can be extracted from energy and carbon: (i) set the goal of ecosystem stabilization; (ii) search the entire production and consumption system (grain, livestock, food distribution, and diet) for opportunities to improve efficiency; (iii) implement cap-and-trade systems for fixed nitrogen; (iv) expand research at the intersection of agriculture and ecology, and (v) focus on the food choices of the prosperous. There are important nitrogen-carbon links. The global increase in fixed nitrogen may be fertilizing the Earth, transferring significant amounts of carbon from the atmosphere to the biosphere, and mitigating global warming. A modern biofuels industry someday may produce biofuels from crop residues or dedicated energy crops, reducing the rate of fossil fuel use, while losses of nitrogen and other nutrients are minimized.

Distance Education and the Evolution of Online Learning in the United States

Online education is no longer a trend, rather it is mainstream. In the Fall of 2012, 69.1% of chief academic leaders indicated online learning was critical to their long-term strategy and of the 20.6 million students enrolled in higher education, 6.7 million were enrolled in an online course (Allen & Seaman, 2013; United States Department of Education, 2013). The advent of online education and its rapid growth has forced academic institutions and faculty to question the current styles and techniques for teaching and learning. As developments in educational technology continue to advance, the ways in which we deliver and receive knowledge in both the traditional and online classrooms will further evolve. It is necessary to investigate and understand the progression and advancements in educational technology and the variety of methods used to deliver knowledge to improve the quality of education we provide today and motivate, inspire, and educate the students of the 21st century. This paper explores the atioevolution of distance education beginning with correspondence and the use of parcel post, to radio, then to television, and finally to online education.

Human Rights in the Democratic People's Republic of Korea and the Future of the Troubled State after Kim Jong-Il

Since 2008, international speculation about the viability of Kim Jong-Il's leadership in North Korea has been at the forefront of diplomatic discussions. North Korea is known to be a secretive state where human rights violations abound. This paper discusses the history of leadership and government in North Korea since World War II, the current human rights situation in the country, the role of China, and potential successors to Kim Jong-Il. The ramifications of impending regime change are discussed in terms of North Korea's human rights issues and economic problems. While current efforts at diplomacy have proved ineffective, the need for concerned nations, intergovernmental organizations, and non-governmental organizations to be prepared to engage North Korea after Kim Jong-Il is imperative.

The puzzle in the bits: Cybersecurity, digital warfare and the future of Internet governance. CEPS Commentary, 26 June 2013

CEPS Senior Research Fellow Andrea Renda persuasively shows in this new CEPS Commentary the extent to which the global economy has become heavily reliant on the Internet, but observes that this phenomenon is becoming increasingly insidious. It is efficient, no doubt: but he asks whether it is also secure?