A New Subform? Fast-Progressing, Severe Neurological Deterioration Caused by Spinal Epidural Lipomatosis

Spinal epidural lipomatosis (SEL) is a rare condition caused by hypertrophic growth of epidural fat. The prevalence of SEL in the Western world is approximately 1 in 40 patients and is likely to increase due to current medical and socio-economic developments. Rarely, SEL can lead to rapid severe neurological deterioration. The pathophysiology, optimal treatment, and outcome of these patients remain unclear. This study aims to widen current knowledge about this “SEL subform” and to improve its clinical management. A systematic literature review according to the PRISMA guidelines using PubMed, Scopus, Web of Science, and Cochrane Library was used to identify publications before 7 November 2021 reporting on acute/rapidly progressing, severe SEL. The final analysis comprised 12 patients with acute, severe SEL. The majority of the patients were male (9/12) and multimorbid (10/12). SEL mainly affected the thoracic part of the spinal cord (11/12), extending a median number of 7 spinal levels (range: 4–19). Surgery was the only chosen therapy (11/12), except for one critically ill patient. Regarding the outcome, half of the patients regained independence (6/11; = modified McCormick Scale ≤ II). Acute, severe SEL is a rare condition, mainly affecting multimorbid patients. The prognosis is poor in nearly 50% of the patients, even with maximum therapy. Further research is needed to stratify patients for conservative or surgical treatment.

Changing operating room practices: the effect on postoperative endophthalmitis rates following cataract surgery

PurposeTo determine whether four new operating room (OR) protocols instituted because of COVID-19 reduced the cataract surgical postoperative endophthalmitis rate (POE).DesignRetrospective, sequential, clinical registry study.Methods85 552 sequential patients undergoing cataract surgery at the Aravind Eye Hospitals between 1 January 2020 and 25 March 2020 (56 551 in group 1) and 3 May 2020 and 31 August 2020 (29 011 in group 2). In group 1, patients were not gowned, surgical gloves were disinfected but not changed between cases, OR floors were not cleaned between every case, and multiple patients underwent preparation and surgery in the same OR. In group 2, each patient was gowned, surgical gloves were changed between each case, OR floors and counters were cleaned between patients, and only one patient at a time underwent preparation and surgery in the OR.ResultsGroup 1 was older, had slightly more females, and better preoperative vision. More eyes in group 2 underwent phacoemulsification (p=0.18). Three eyes (0.005%) in group 1 and 2 eyes (0.006%) in group 2 developed POE (p=0.77). Only one eye that underwent phacoemulsification developed POE; this was in group 1. There was no difference in posterior capsule rupture rate between the two groups.ConclusionsAdopting a set of four temporary OR protocols that are often mandatory in the Western world did not reduce the POE rate. Along with previously published studies, these results challenge the necessity of these common practices which may be needlessly costly and wasteful, arguing for the reevaluation of empiric and potentially unnecessary guidelines that govern ophthalmic surgeries.

Creating Autonomy in the Advance of Teacher and Moral Educator Development

The demand for character development in many of the Western World’s public schools is increasing. Yet there are substantive steps being taken beyond manipulating student behavior in rigidly constructed contexts. Unfortunately manipulating behavior only develops self-interest as the measure of all good and might makes right the legitimation of authority. Yet as any anthropologist can explain it is role-modeling family and village elders that decides which of two instincts will dominate human development: self-interest or cooperation (Tomasello, 2019). As Aristotle famously observed, it makes no small difference what habits humans develop rather, it makes all the difference. But to be truly conducive to moral development those habits must reflect autonomous conviction to develop organizational well-being over the pandemonium self-interest leads towards. The Moral Self-assessment Protocol discussed herein creates the conditions for teacher and other leaders to track their own moral development to role model for those growing into organization membership, in schools, cities, states, countries and businesses.

John Osborne’s Luther: An Islamic Interpretation for Boosting Human Fraternity

The fictional world John Osborne builds up in Luther (1961) dramatizes Martin Luther’s spiritual journey from rooted Catholicism to emerging Protestantism. Throughout the journey, Martin’s religious tendency varies according to the belief he adheres to. This paper examines if the aspects of the Christian doctrine Martin is fed with at first and the initiatives he undertakes later on can be reinterpreted through the lens of Islam. The study tries to prove that drama can be used as a platform that enhances religious and multicultural proximity rather than distance between the western world and the Muslim community. It analyzes the Christian tenets in Luther to demonstrate how the religious values embedded in Osborne’s representation can be brought close to the principles of the Islamic doctrine. Hence, another endeavour for boosting human fraternity is presented based on picking up a modern English drama that was written sixty years ago and analyzing some of its aspects from an Islamic perspective.

The End of Monogamy? An Exploration of Non-monogamous Relationship Dynamics

Although monogamy is the dominant relationship style in the Western world, there are alternative options for non-monogamous relationship dynamics. This paper works to explore how the roots of how monogamy became the dominant structure, the hidden drawbacks of monogamy, how those who assert monogamy to be compulsory hold a stigma against those who partake in other dynamics, and how this stigma can work to oppress. It also explores what those dynamics are, who participates in them, and a myriad of benefits that non-monogamous relationships can have. Overall coming to the conclusion that everyone should be able to make an informed decision, free of societal judgment, to partake in whatever dynamic they may choose.

Nation-state and Islamic Government Theoretical and Factual studies

The concept of nation state presented by the West at its core is the idea of humanism. In which man was given a central position and freed from the concept of God. Denied everything that was not observed. Therefore, man expelled religion in all matters of life. The logical consequence of which was that the head of human unity was scattered. The slogan of nationalism was used to unite man in the struggle for unity. Which eventually manifested itself in the formation of nation-states the western colonial powers ruled the world in the form of the United Nations change the way of life in the Western World and especially in Muslim society. Which has a profound effect on the Islamic system of government. Islam envisioned divine sovereignty in the system of government. Today the Muslim rulers have forgotten it, and the Western system considered its survival in democracy. The article explains what the core concern of the nation state and Islamic Government is and whether it is based on its own ideas in modern times has been considered.

Buddhist Pragmatism or Pragmatic Buddhism: What is the relationship between Buddhism and Pragmatism?

With the rise of modernity, the Western world fell into a deep spiritual crisis which forced Comte to Dewey, and Einstein to Whitehead to synthesize a cosmic or humanistic religion. Similarly, the rise of modern science increased western interest in Eastern religions. Because of the ontological resemblance,they further enquired to Buddhism by assuming that would be a religion of their ideal. They began interpreting Buddhism through the lenses of modern philosophies. As a result, Buddhism appeared so diverse that sometimes its positioning is confusing and ambivalent- e.g. 'ethical idealism', 'atheism', 'empiricism', etc. As an attempt of resolving the contradictory positioning, both the original nikayas translated in English by PTS and commentary texts of Buddhism authored by both eastern and western scholars were carefully reviewed. These texts suggested that Buddhism is mostly close to 'ethical pragmatism. To present this closeness, the article at the first describes the cardinal principles of pragmatism, which are- multiple truths, verification of truths, changeability of truth; and then discusses how these principles are embedded in the teaching of Buddha. It also claims that Buddha’s efforts on developing new doctrine, constituting a Sangha, practicing sainthood, and defending against rival doctrines and organizations were just strategies of social reform via cultivating ethics rather than the objectives in themselves. This knowledge contributes to the understanding of both pragmatism and Buddhism from each other's perspectives, and at the same time, draws its educational implication in developing critical thinking, and ethical values.

Dispositional Mindfulness and Positive Mindset in Emerging Adult College Students: The Mediating Role of Decentering

Emerging adulthood is often recognized as a time of uncertainty, confusion, pressure, and stress. This time period also coincides in the Western world with attending college. Many emerging adults arrive at this developmental stage feeling the pressure and obligation for success, but lack the interpersonal resources needed to make required choices. The purpose of this study was to provide insight into the psychological and mental state of this particular group by focusing on mechanisms of self-awareness and its connection to psychological health. The present study examines whether an indirect path could explain the relationships between mindfulness, positive thinking, and positive affect. Path analysis was used to test whether decentering fosters positive thinking and positive affect. Participants were surveyed for dispositional mindfulness, frequency of positive and negative feelings, positive thinking, and rumination. Results show decentering mediates between mindfulness and positive affect but does not mediate between mindfulness and positive thinking. Rumination counteracts the effects of mindfulness and predicts negative affect.

Surgery and Catheter Ablation for Atrial Fibrillation: History, Current Practice, and Future Directions

Atrial fibrillation (AF) is the most common of all cardiac arrhythmias, affecting roughly 1% of the general population in the Western world. The incidence of AF is predicted to double by 2050. Most patients with AF are treated with oral medications and only approximately 4% of AF patients are treated with interventional techniques, including catheter ablation and surgical ablation. The increasing prevalence and the morbidity/mortality associated with AF warrants a more aggressive approach to its treatment. It is the purpose of this invited editorial to describe the past, present, and anticipated future directions of the interventional therapy of AF, and to crystallize the problems that remain.