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Faithful Form: On Religion and Politics in German Modernist Lyric
No full textExamining the work of four poets-Else Lasker-Schüler, Georg Trakl, Rainer Maria Rilke, and Paul Celan-this dissertation reveals surprising conjunctions between these poets’ sustained engagement with religious images and concepts and their attempt to organize individuals into collective bodies invested with political agency. It thereby uncovers a political valence within those elements of German modernist lyric that draw upon mytho-poetic and religious traditions to model the formation of political communities. Lasker-Schüler’s poetic revisions of the biblical garden myth explore a form of abject subjectivity that seeks to harness anti-authoritarian energy while simultaneously expressing vulnerability and solidarity with the outcasts of society. Trakl’s poetry prophesies the end of Western civilization on the brink of the First World War and develops mystical practices of kenosis (emptying one’s particular will—or in the case of Trakl, the normativity of collective forms—as preparation for receiving the divine) within the social and political sphere as a response to apocalyptic temporality. Rilke’s poetry uses mystical tropes to undermine the authority of institutions and the naturalization of economic relations while establishing poetry as a gathering place for human communities. Celan’s poetry not only confronts personal, but also political trauma, and in doing so ultimately gestures towards the possibility of liturgy as a mode of association, of solidarity with unknown others. More generally, this dissertation considers the way that poetic practices draw on religious operations and images in novel ways to reimagine emancipatory politics
Open versus minimally invasive decompression for low-grade spondylolisthesis: analysis from the Quality Outcomes Database.
No full textOBJECTIVE:Lumbar decompression without arthrodesis remains a potential treatment option for cases of low-grade spondylolisthesis (i.e., Meyerding grade I). Minimally invasive surgery (MIS) techniques have recently been increasingly used because of their touted benefits including lower operating time, blood loss, and length of stay. Herein, the authors analyzed patients enrolled in a national surgical registry and compared the baseline characteristics and postoperative clinical and patient-reported outcomes (PROs) between patients undergoing open versus MIS lumbar decompression. METHODS:The authors queried the Quality Outcomes Database for patients with grade I lumbar degenerative spondylolisthesis undergoing a surgical intervention between July 2014 and June 2016. Among more than 200 participating sites, the 12 with the highest enrollment of patients into the lumbar spine module came together to initiate a focused project to assess the impact of fusion on PROs in patients undergoing surgery for grade I lumbar spondylolisthesis. For the current study, only patients in this cohort from the 12 highest-enrolling sites who underwent a decompression alone were evaluated and classified as open or MIS (tubular decompression). Outcomes of interest included PROs at 2 years; perioperative outcomes such as blood loss and complications; and postoperative outcomes such as length of stay, discharge disposition, and reoperations. RESULTS:A total of 140 patients undergoing decompression were selected, of whom 71 (50.7%) underwent MIS and 69 (49.3%) underwent an open decompression. On univariate analysis, the authors observed no significant differences between the 2 groups in terms of PROs at 2-year follow-up, including back pain, leg pain, Oswestry Disability Index score, EQ-5D score, and patient satisfaction. On multivariable analysis, compared to MIS, open decompression was associated with higher satisfaction (OR 7.5, 95% CI 2.41-23.2, p = 0.0005). Patients undergoing MIS decompression had a significantly shorter length of stay compared to the open group (0.68 days [SD 1.18] vs 1.83 days [SD 1.618], p < 0.001). CONCLUSIONS:In this multiinstitutional prospective study, the authors found comparable PROs as well as clinical outcomes at 2 years between groups of patients undergoing open or MIS decompression for low-grade spondylolisthesis
Quantification of joint mobility limitation in adult type 1 diabetes.
No full textAimsDiabetic cheiroarthropathies limit hand mobility due to fibrosis and could be markers of a global profibrotic trajectory. Heterogeneity in definitions and lack of a method to measure it complicate studying associations with organ involvement and treatment outcomes. We measured metacarpophalangeal (MCP) joint extension as a metric and describe magnetic resonance (MR) imaging determinants of MCP restriction.MethodsAdults with type 1 diabetes were screened for hand manifestations using a symptom questionnaire, clinical examination, and function [Duruoz hand index (DHI) and grip strength]. Patients were segregated by mean MCP extension (60°) for MR imaging (MRI) scanning. Patients in the four groups were compared using ANOVA for clinical features and MRI tissue measurements (tenosynovial, skin, and fascia thickness). We performed multiple linear regression for determinants of MCP extension.ResultsOf the 237 patients (90 men), 79 (33.8%) with cheiroarthropathy had MCP extension limitation (39° versus 61°, p ConclusionJoint mobility limitation was quantified by restricted mean MCP extension and had structural correlates on MRI. These can serve as quantitative measures for future associative and interventional studies
Multisector Mitigation of Plastic Pollution: Approaches from Biology, Policy, Law and Industry
No full textPlastic pollution is ubiquitous in the ocean. Researchers are actively determining how plastic pollution harms marine animals and which measures should be used to reduce pollution. I use the four pathways to global sustainability (created by Folke et al., 2021) as a guiding framework for this dissertation because this framework outlines how society can develop sustainable practices to address environmental challenges, in this case, plastic pollution. I identify risks posed by plastic pollution to marine animals and characterize government and corporate responses to plastic pollution. My overarching goal is to use these results to inform stakeholders of gaps or mismatches in plastics governance and chart a path toward global plastics sustainability. In Chapter 1, I investigate plastic consumption in marine animals, using the sea anemone as a model animal. I find that anemones readily consume plastic (polyethylene and polyvinyl chloride) pellets and can extract metallic additives, specifically lead and tin, from plastic. More broadly, this research suggests that plastic pollution may be a novel pathway for heavy metals to enter the marine food web. In Chapter 2, I examine government responses to plastic pollution by qualitatively analyzing public policies at all levels of government, from local to international, adopted between the years 2000 and 2019. I show that governments are increasingly adopting policies over time. Policies frequently target plastic bags and macroplastics and infrequently target microplastics. In Chapter 3, I qualitatively analyze voluntary commitments to reduce plastic pollution made by the world’s largest companies. I report that most companies are aware of the unsustainability of plastic and responding, albeit insufficiently given the scope of the challenges. Company commitments often lack concrete deadlines and frequently focus on recycling, despite low global recycling rates, which obscures corporate accountability. In Chapter 4, I provide insight into the role that emerging technologies may play in plastics sustainability. I synthesize literature on the use of plastic waste in road construction and highlight key knowledge gaps such as plastic additive leaching, microplastic and nanoplastic generation, and road recyclability at end-of-life. The dissertation closes with Chapter 5, which summarizes articles from the special issue “Emerging Challenges and Solutions to Plastic Pollution,” published in Frontiers in Marine Science, and contextualizes my dissertation findings in the broader scientific literature. I close Chapter 5 by synthesizing key dissertation findings and suggesting areas of future research. I highlight that societal responses to plastic pollution have not prioritized addressing the plastics that pose the greatest risks to aquatic ecosystems, resulting in negative environmental consequences. This dissertation contributes to the field by demonstrating the harms posed by plastic pollution to sea anemones and qualitatively characterizes public and private sector measures aiming to reduce plastic pollution. More broadly, I highlight the role of interdisciplinary research in environmental problem-solving and charting a path toward global plastics sustainability.</p
Analysis of Advocacy Methods for Promoting and Passing State Electric School Bus Policies
No full textNatural history of lower urinary tract symptoms in treatment-seeking women with pelvic organ prolapse; the Symptoms of Lower Urinary Tract Dysfunction Research Network (LURN).
No full textBackgroundThe association of pelvic organ prolapse with overactive bladder and other lower urinary tract symptoms, and the natural history of those symptoms are not well characterized. Previous cross-sectional studies demonstrated conflicting relationships between prolapse and lower urinary tract symptoms.ObjectiveThis study primarily aimed to determine the baseline association between lower urinary tract symptoms and prolapse and to assess longitudinal differences in symptoms over 12 months in women with and without prolapse. Secondary aims were to explore associations between lower urinary tract symptoms and prolapse treatment. We hypothesized that: (1) prolapse is associated with the presence of lower urinary tract symptoms, (2) lower urinary tract symptoms are stable over time in patients with and without prolapse, and (3) prolapse treatment is associated with lower urinary tract symptom improvement.Study designWomen enrolled in the Symptoms of Lower Urinary Tract Dysfunction Research Network Observational Cohort Study with adequate 12-month follow-up data were included. Prolapse and lower urinary tract symptom treatment during follow-up was guided by standard of care. Outcome measures included the Lower Urinary Tract Symptoms Tool total severity score (in addition to overactive bladder, obstructive, and stress urinary incontinence subscales) and Urogenital Distress Inventory-6 Short Form. Prolapse (yes or no) was defined primarily when Pelvic Organ Prolapse Quantification System points Ba, C or Bp were >0 (beyond the hymen). Mixed-effects models with random effects for patient slopes and intercepts were fitted for each lower urinary tract symptom outcome and prolapse predictor, adjusted for other covariates. The study had >90% power to detect differences as small as 0.4 standard deviation for less prevalent group comparisons (eg, prolapse vs not).ResultsA total of 371 women were analyzed, including 313 (84%) with no prolapse and 58 (16%) with prolapse. Women with prolapse were older (64.6±8.8 vs 55.3±14.1 years; P.05 for all regression interaction coefficients). The Lower Urinary Tract Symptoms Tool obstructive severity score had a statistically significant positive association with Pelvic Organ Prolapse Quantification System Ba, Bp, and point of maximum vaginal descent. The Lower Urinary Tract Symptoms Tool total severity scale had a statistically significant negative association with Pelvic Organ Prolapse Quantification System Ba and point of maximum vaginal descent. No other associations between prolapse and lower urinary tract symptoms were significant (P>.05 for all regression coefficients). Symptom differences between prolapse groups were small: all regression coefficients (interpretable as additive percentage change in each score) were between -5 and 5 (standard deviation of outcomes ranged from 14.0-32.4).ConclusionAmong treatment-seeking women with urinary symptoms, obstructive symptoms were positively associated with prolapse, and overall lower urinary tract symptom severity was negatively associated with prolapse. Lower Urinary Tract Symptoms Tool scores improved over 12 months regardless of prolapse status, including in those with treated prolapse, untreated prolapse, and without prolapse
Effects of winter temperatures, spring degree-day accumulation, and insect population source on phenological synchrony between forest tent caterpillar and host trees
No full textGlobal climate change has the potential to dramatically alter multiple ecosystem processes, including herbivory. The development rates of both plants and insects are highly sensitive to temperature. Although considerable work has examined the effects of temperature on spring phenologies of plants and insects individually, few studies have examined how anticipated warming will influence their phenological synchrony. We applied elevated temperatures of 1.7 and 3.4. °C in a controlled chamberless outdoor experiment in northeastern Minnesota, USA to examine the relative responses in onset of egg eclosion by forest tent caterpillar (. Malacosoma disstria Hübner) and budbreak of two of its major host trees (trembling aspen, Populus tremuloides Michaux, and paper birch, Betula papyrifera Marshall). We superimposed four insect population sources and two overwintering regimes onto these treatments, and computed degree-day models. Timing of egg hatch varied among population source, overwintering location, and spring temperature regime. As expected, the development rates of plants and insects advanced under warmer conditions relative to ambient controls. However, budbreak advanced more than egg hatch. The degree of phenological synchrony between M. disstria and each host plant was differentially altered in response to warming. The interval by which birch budbreak preceded egg hatch nearly doubled from ambient to +1.7 °C. In the case of aspen, the sequence changed from egg hatch preceding, to following, budbreak at +3.4 °C. Additionally, under temperature regimes simulating future conditions, some insect populations currently south of our study sites became more synchronous with the manipulated hosts than did currently coexisting insect populations. These findings reveal how climate warming can alter insect-host plant interactions, through changes in phenological synchrony, possibly driving host shifts among tree species and genotypes. They also suggest how herbivore variability, both among populations and within individual egg masses, may provide opportunities for adaptation, especially in species that are highly mobile and polyphagous
The associations between prognostic awareness and health-related quality of life among patients with advanced cancer: A systematic review.
No full textBackgroundPrognostic awareness among patients with advanced cancer is important for better palliative and end-of-life care. However, the relationships between prognostic awareness and patient health-related quality of life outcomes remain inconsistent across studies. Critically synthesizing empirical literature will allow for a better understanding of these associations.AimTo investigate the associations between prognostic awareness and health-related quality of life outcomes among patients with advanced cancer.DesignThis study was a systematic review, prospectively registered on PROSPERO (CRD42020177228).Data sourcesSeven databases (PubMed/Medline, Embase, Scopus, Cochrane Central, PsycINFO, CINAHL, and Web of Science) were searched in March 2022. Cross-sectional and longitudinal empirical studies in English were included regardless of cancer type or publication date.ResultsWe identified 1338 articles and included 36 for review. A substantial proportion of patients remained prognostically unaware (50%). Prognostic awareness was either not significantly associated (48%) or associated with worsened (40%) outcomes. These associations were found to vary (e.g., be differently associated with improved, worsened, or non-significant health-related quality of life outcomes) based on the definition of prognostic awareness used and the population sampled (Asian vs Western). Few structured, validated questionnaires were used and only three studies investigated how the associations evolved over time.ConclusionsTo facilitate better understanding of the relationships between prognostic awareness and health-related quality of life, future research must focus on developing a standardized, "gold standard" measurement of prognostic awareness. Research should also examine the influence of culture and the evolution of these relationships longitudinally
Suitability of Automated Writing Measures for Clinical Trial Outcome in Writer's Cramp.
No full textBackgroundWriter's cramp (WC) dystonia is a rare disease that causes abnormal postures during the writing task. Successful research studies for WC and other forms of dystonia are contingent on identifying sensitive and specific measures that relate to the clinical syndrome and achieve a realistic sample size to power research studies for a rare disease. Although prior studies have used writing kinematics, their diagnostic performance remains unclear.ObjectiveThis study aimed to evaluate the diagnostic performance of automated measures that distinguish subjects with WC from healthy volunteers.MethodsA total of 21 subjects with WC and 22 healthy volunteers performed a sentence-copying assessment on a digital tablet using kinematic and hand recognition softwares. The sensitivity and specificity of automated measures were calculated using a logistic regression model. Power analysis was performed for two clinical research designs using these measures. The test and retest reliability of select automated measures was compared across repeat sentence-copying assessments. Lastly, a correlational analysis with subject- and clinician-rated outcomes was performed to understand the clinical meaning of automated measures.ResultsOf the 23 measures analyzed, the measures of word legibility and peak accelerations distinguished subjects with WC from healthy volunteers with high sensitivity and specificity and demonstrated smaller sample sizes suitable for rare disease studies, and the kinematic measures showed high reliability across repeat visits, while both word legibility and peak accelerations measures showed significant correlations with the subject- and clinician-rated outcomes.ConclusionsNovel automated measures that capture key aspects of the disease and are suitable for use in clinical research studies of WC dystonia were identified. © 2022 International Parkinson and Movement Disorder Society
The children's brain tumor network (CBTN) - Accelerating research in pediatric central nervous system tumors through collaboration and open science.
No full textPediatric brain tumors are the leading cause of cancer-related death in children in the United States and contribute a disproportionate number of potential years of life lost compared to adult cancers. Moreover, survivors frequently suffer long-term side effects, including secondary cancers. The Children's Brain Tumor Network (CBTN) is a multi-institutional international clinical research consortium created to advance therapeutic development through the collection and rapid distribution of biospecimens and data via open-science research platforms for real-time access and use by the global research community. The CBTN's 32 member institutions utilize a shared regulatory governance architecture at the Children's Hospital of Philadelphia to accelerate and maximize the use of biospecimens and data. As of August 2022, CBTN has enrolled over 4700 subjects, over 1500 parents, and collected over 65,000 biospecimen aliquots for research. Additionally, over 80 preclinical models have been developed from collected tumors. Multi-omic data for over 1000 tumors and germline material are currently available with data generation for > 5000 samples underway. To our knowledge, CBTN provides the largest open-access pediatric brain tumor multi-omic dataset annotated with longitudinal clinical and outcome data, imaging, associated biospecimens, child-parent genomic pedigrees, and in vivo and in vitro preclinical models. Empowered by NIH-supported platforms such as the Kids First Data Resource and the Childhood Cancer Data Initiative, the CBTN continues to expand the resources needed for scientists to accelerate translational impact for improved outcomes and quality of life for children with brain and spinal cord tumors