Hypermnesia and Amnesia: Remembering (with) the Body and Post-Conflict Memorials and Architectures

The article consists of two parts. The first part (§§ 1–2) investigates the indiscriminate and absolute remembering and forgetting of everything, hypermnesia and amnesia as the extreme terms that research has used and uses for the different phenomena of memory, both in individuals and in social and political forms. In the face of these shifts it is thus indispensable to re-establish a critique of the paradoxical effects of memory aids and, at the same time, to seek new forms of remembrance that by mixing an experiential dimension and public sphere refocus the attention on the connection between latency, tension and experiential triggers of involuntary memory and on the ability to break through the fictions of collective memory. On this basis, the second part of the article (§§ 3–4) analyses how the experience of political and racial deportation during World War II drastically changed the idea of memorial architecture. More specifically, the analysis deals with a kind of memorial device that must represent and memorialise persons whose bodies have been deliberately cancelled. The aim is to present and analyse the artistic and architectonic efforts to refer to those forgotten bodies, on the one hand, and on the other hand to point out how for these new kind of memorials the body of the visitor is asked to participate, both physically and emotionally, in this somehow paradoxical search for lost bodies, offering oneself as a substitute.

Increased B Cell Selection Stringency In Germinal Centers Can Explain Improved COVID-19 Vaccine Efficacies With Low Dose Prime or Delayed Boost

The efficacy of COVID-19 vaccines appears to depend in complex ways on the vaccine dosage and the interval between the prime and boost doses. Unexpectedly, lower dose prime and longer prime-boost intervals have yielded higher efficacies in clinical trials. To elucidate the origins of these effects, we developed a stochastic simulation model of the germinal center (GC) reaction and predicted the antibody responses elicited by different vaccination protocols. The simulations predicted that a lower dose prime could increase the selection stringency in GCs due to reduced antigen availability, resulting in the selection of GC B cells with higher affinities for the target antigen. The boost could relax this selection stringency and allow the expansion of the higher affinity GC B cells selected, improving the overall response. With a longer dosing interval, the decay in the antigen with time following the prime could further increase the selection stringency, amplifying this effect. The effect remained in our simulations even when new GCs following the boost had to be seeded by memory B cells formed following the prime. These predictions offer a plausible explanation of the observed paradoxical effects of dosage and dosing interval on vaccine efficacy. Tuning the selection stringency in the GCs using prime-boost dosages and dosing intervals as handles may help improve vaccine efficacies.

Sedation versus General Anesthesia for Cardiac Catheterization in Infants: A Retrospective, Monocentric, Cohort Evaluation

Background: Children with congenital heart disease require repeated catheterization. Anesthetic management influences the procedure and may influence outcome; however, data and recommendations are lacking for infants. We studied the influence of sedation versus general anesthesia (GA) on adverse events during catheterization for children <2 years old. Methods: We conducted a monocentric, retrospective study of all catheterization procedures (2008–2013). High-severity adverse event (HSAE) rates were compared using propensity-score-adjusted models, including pre- and intra-procedural variables. Results: 803 cases (619 patients) (368 (46%) GA, 435 (54%) sedation) with a mean age of 6.9 ± 6.1 months were studied. The conversion rate (GA after sedation) was 18 (4%). Hospital stay was 4.9 ± 4.0 and 4.1 ± 2.5 (p = 0.01) after GA or sedation, respectively. HSAE occurred in 75 (20%) versus 40 (9%) (p < 0.01) in GA versus sedation procedures, respectively. Risk factors (multivariable analysis) were older patients (p = 0.05), smaller weights (p < 0.01), palliated status (OR 3.2 [1.2–8.9], p = 0.02), two-ventricle physiology (OR 7.3 [2.7–20.2], p < 0.01), cyanosis (OR 4.6 [2.2–9.8], p < 0.01), pulmonary hypertension (OR 5.6 [2.0–15.5], p < 0.01), interventional catheterization (OR 1.8 [1.1–3.2], p = 0.02) and procedure-type risk category 4 (OR 28.9 [1.8–455.1], p = 0.02). Sedation did not increase the events rate and decreased the requirement for hemodynamic support (OR 5.2 [2.2–12.0], p < 0.01). Conclusion: Sedation versus GA for cardiac catheterization in children <2 years old is safe and effective with regard to HSAE. Sedation also decreases the requirement for hemodynamic support. Paradoxical effects (older age and two-ventricle physiology) on risk have been found for this specific age cluster.

Gender equality mainstreaming and the Australian academy: paradoxical effects?

Australian Universities consistently rank highly on lists that celebrate the most gender equal higher education institutions in the world. Despite participation in institutional frameworks for gender equity accreditation, what often lies beneath the outward display of gender equality is a lived experience of inequality. Whilst there is relative gender equality amongst academics employed at universities overall, men continue to dominate appointments at the professorial or senior executive levels. At the same time, gender asymmetries make women’s access to the opportunities and resources that are highly valued by the sector difficult. Women who experience intersections with care, mothering, race, sexual identity, class, and ability face additional obstacles. In this paper, three women in Australian academia attempt to disrupt the dominant masculine ideology and value system by sharing our lived experience of gender (in)equality in the academy.

Bureaucracy, Democracy and Westminster: The Quest for Political Control

<p>This thesis argues that a Weberian process of bureaucratisation poses a serious threat in itself to the central values and ideals of liberal democracy. Such a threat arises not only from the bureaucratic pathology of 'goal displacement' of substantive ends by instrumental means, but also, because of this pathology, its tendency to mask and embed ideological challenges to liberal democracy. An effective liberal political constitution is therefore necessary to maintain the democratic control of bureaucracy while exploiting the efficiency benefits of bureaucratic administration. Such a political constitution is in fact contained in the Westminster tradition of liberal constitutionalism, based on the principles of parliamentary sovereignty, ministerial responsibility and political neutrality. Through this theoretical lens, the thesis proceeds to examine the trajectory of public sector reforms against the changing political contexts in New Zealand over the past 20 years and its constitutional implications. The NPM reforms in New Zealand, whether intended or unintended, displaced the political and constitutional safeguards implicit in the traditional model of public service with managerial norms which simultaneously serve to embed the neoliberal ideology. Despite the claim of NPM reformers to control bureaucracy, the paradoxical effects of the reform have been to accelerate the process of bureaucratisation and attenuate democratic control. Recent initiatives aimed to address some apparent weaknesses of NPM, have not changed the fundamentals of the managerial system, and thus fail to reverse this trend of declining democratic control of bureaucratic power. A reassertion of the fundamental norms of the Westminster system is recommended to arrest this decline of liberal democracy.</p>

Bureaucracy, Democracy and Westminster: The Quest for Political Control

<p>This thesis argues that a Weberian process of bureaucratisation poses a serious threat in itself to the central values and ideals of liberal democracy. Such a threat arises not only from the bureaucratic pathology of 'goal displacement' of substantive ends by instrumental means, but also, because of this pathology, its tendency to mask and embed ideological challenges to liberal democracy. An effective liberal political constitution is therefore necessary to maintain the democratic control of bureaucracy while exploiting the efficiency benefits of bureaucratic administration. Such a political constitution is in fact contained in the Westminster tradition of liberal constitutionalism, based on the principles of parliamentary sovereignty, ministerial responsibility and political neutrality. Through this theoretical lens, the thesis proceeds to examine the trajectory of public sector reforms against the changing political contexts in New Zealand over the past 20 years and its constitutional implications. The NPM reforms in New Zealand, whether intended or unintended, displaced the political and constitutional safeguards implicit in the traditional model of public service with managerial norms which simultaneously serve to embed the neoliberal ideology. Despite the claim of NPM reformers to control bureaucracy, the paradoxical effects of the reform have been to accelerate the process of bureaucratisation and attenuate democratic control. Recent initiatives aimed to address some apparent weaknesses of NPM, have not changed the fundamentals of the managerial system, and thus fail to reverse this trend of declining democratic control of bureaucratic power. A reassertion of the fundamental norms of the Westminster system is recommended to arrest this decline of liberal democracy.</p>

Telemedicine and Remote Monitoring as an Adjunct to Medical Management of Bronchiectasis

The limited resources and the practice of social distancing during the COVID pandemic create a paradigm shift in the utilization of telemedicine in healthcare. However, the implementation of best practices is hampered in part by a lack of literature devoted to telehealth in bronchiectasis. In this commentary, we examine multiple approaches to structuring of telemedicine care for patients with bronchiectasis, highlight current evidence-based interventions that can be incorporated into the management of bronchiectasis, and describe our experience with telemedicine at the University of Connecticut Center for Bronchiectasis Care during the COVID-19 pandemic. The structural model must be adapted to different local dynamics and available technologies with careful attention to patient characteristics and access to technology to avoid the potential paradoxical effects of increasing patients’ burden and healthcare disparities in underserved populations.