Earlier Approaches Research Articles

Home video review in a pediatric clinical neurophysiology led multidisciplinary team meeting.

Assessment of the value of review of home videos by a pediatric multidisciplinary team (MDT) in a pediatric neurophysiology department. We describe and evaluate the review of home videos alongside clinical history and previous investigations from patients referred to the Evelina pediatric EEG department at a twice-monthly MDT meeting between 01/2021 and 09/2022. We retrospectively analyzed measures of video quality, quantity and duration, time taken from referral to MDT meeting, pre-MDT and post-MDT meeting proposed diagnosis and clinical outcomes. Feedback from referring doctors was obtained by a survey. There were 36 referrals for 34 patients totalling 123 videos. There was a median delay of 10 days between video upload and final report. After the MDT meeting the number of referrals classified as uncertain fell from 15 to 2. The number of referrals classified as non-epileptic events increased from seven to 18. The number classified as infantile spasms fell from six to two. Overall, 26 of 36 referrals had a change in diagnosis and 26 of 36 referrals were triaged away from the video-EEG telemetry (VT) waiting list. Nine out of ten referring doctors reported that MDT discussion improved their understanding of the events. HVR is a useful tool that has been successfully incorporated into our neurophysiology department's workflow. These early results suggest benefits from adopting an MDT meeting may include an early diagnosis and management approach based upon consensus. Using HVR in a pediatric population may help triage urgent cases, conserve specialized neurophysiological investigations and streamline workflows to improve the efficiency of pediatric referrals.

Path-based DEA models in multiplier form and returns-to-scale analysis

AbstractData envelopment analysis (DEA) models appear in envelopment and multiplier forms, which are in a primal-dual relationship. In this paper, we derive the general multiplier form of path-based models, encompassing radial, directional distance function, and hyperbolic distance function models as special cases. We investigate the economic interpretation of the multiplier models and uncover the link between shadow profit inefficiency and technical inefficiency provided by path-based models. Using the optimality conditions for the primal-dual pair, we precisely describe the two-way relationship between the optimal solutions of the multiplier model and the supporting hyperplanes of the technology set at the projection. This relationship serves as a mathematical justification for extending one of the early approaches to measuring returns-to-scale (RTS) onto the entire class of path-based models. Moreover, we demonstrate the eligibility of this method by revealing the fact that the set of all strongly efficient benchmarks for the assessed unit in path-based models does not need to belong to a single strongly efficient face of technology set. This finding changes the view on traditional approaches to RTS measurement that rely on supporting hyperplanes encompassing a single strongly efficient face of the technology set. In this new perspective, we propose two methods for RTS measurement. The first is based on the hyperplanes at the projection, and the second method adapts the minimum face method to be suitable for path-based models. Both methods are fully justified and brought to an algorithmic form.

Evolution of myeloproliferative neoplasms from normal blood stem cells.

Over the course of the last decade, genomic studies in the context of normal human hematopoiesis have provided new insights into the early pathogenesis of myeloproliferative neoplasms (MPN). A preclinical phase of MPN, termed clonal hematopoiesis (CH) was identified and subsequent lineage tracing studies revealed a multi-decade long time interval from acquisition of an MPN phenotypic driver mutation in a hematopoietic stem cell (HSC) to the development of overt MPN. Multiple germline variants associated with MPN risk have been identified through genome-wide association studies (GWAS) and in some cases functional interrogation of the impact of the variant has uncovered new insights into HSC biology and MPN development. Increasingly sophisticated methods to study clonal contributions to human hematopoiesis and measure HSC fitness have helped discern the biology underlying the tremendous clinical heterogeneity observed in MPN. Despite these advances, significant knowledge gaps remain particularly with respect to germline genetic contributors to both MPN pathogenesis and phenotypic diversity, as well as limitations in the ability to prospectively quantify rates of clonal expansion in individual MPN patients. Ultimately, we envisage a personalized approach to MPN care in the future, where an individualized genetic assessment can predict MPN trajectory and this information will be used to inform and guide therapy. MPN is particularly amenable to precision medicine strategies and our increased understanding of the evolution of MPN from normal blood stem cells provides a unique opportunity for early therapeutic intervention approaches and potentially MPN prevention strategies.

Clinical Features, Biochemistry, Imaging, and Treatment Response in a Single-Center Cohort With Coenzyme Q 10 Biosynthesis Disorders

Clinical Features, Biochemistry, Imaging, and Treatment Response in a Single-Center Cohort With Coenzyme Q ₁₀ Biosynthesis Disorders

General and Specific Risk and Protective Factors for Cigarette and Electronic Nicotine Delivery System (ENDS) Use.

Electronic nicotine delivery system (ENDS or e-cigarette) use is at least as common as cigarette use among today's young adults. However, most prevention approaches are based on risk and protective factors (RPFs) that were identified with respect to cigarette use alone. To the extent that RPFs differ for cigarette and ENDS use, tailored approaches are needed to reduce the burden of nicotine use. In the current study, we examined both shared general RPFs and substance-specific RPFs across a developmental period spanning early adolescence to young adulthood, with the goal of identifying upstream preventive intervention targets for cigarette and ENDS use. The current study used data from the Community Youth Development Study (n = 4407) collected at 7 time points from early adolescence (age 12) through young adulthood (age 26). Using longitudinal structural equation modeling, we examined the contributions of adolescent and young adult RPFs to young adult cigarette and ENDS use. We examined general protective factors (e.g., family bonding and peer opportunities for prosocial involvement), cigarette-specific risk (e.g., friends' cigarette use and permissive community norms), and peer polysubstance use. General protective factors assessed in early adolescence had an indirect association with young adult cigarette and ENDS use, mediated through later RPFs. Whereas both cigarette-specific RPFs and peer polysubstance use predicted ENDS use in young adulthood, only cigarette-specific RPFs were related to cigarette use in young adulthood. Our findings suggest that, although addressing known RPFs holds value for preventing ENDS use, additional prevention targets should also be considered. Early prevention approaches might seek to strengthen protective factors, whereas later prevention approaches might target cigarette beliefs for cigarette use and peer polysubstance use for ENDS use.

The ECJ Apple Judgment: A Sour Tarte Tatin

This article comments on the judgment of the ECJ of 10 September 2024 in the so-called Apple case. It analyses how the ECJ approached the Authorised OECD Approach and the arm’s length principle through the lens of the authors, two transfer pricing practitioners. The article also links the Apple case to earlier approaches adopted in judgments rendered in Amazon, Fiat and Engie.

Maternal and Fetal Outcome in Pregnancy with diabetes mellitus: Study in a district hospital, Jamalpur, Bangladesh

Cardiac disease is an important cause of maternal mortality and morbidity in antepartum and postpartum period. Objectives of our study was to determine maternal and fetal outcome in pregnant women in Bangladesh.This was a cross-sectional analytical study was conducted in the department of Obstretics & Gynecology in 250 bedded General Hospital, Jamalpur, Bangladesh during the period from January 2018 to in December 2018. The aim of this study was to find out the maternal and fetal outcome of the pregnancies complicated by pre-gestational and gestational diabetes mellitus. In this study, a total of 225 patients were selected using purposive sampling technique. There were three groups of pre-gestational diabetic, gestational diabetic and non-diabetic control, designated as Group A, Group B, Group C accordingly; and each consists of 75 patients. Information collected from all pregnant women (After 28 weeks of gestation) with diagnosed GDM and Pre-GDM and symptoms signs suggestive of GDM and Pre-GDM later confirmed by relevant investigation (FBS, 2h PPBS & HbA1C) using a questionnaire made for recoding all relevant parameters under study, after proper counseling and taking written consent of the patient or her legal guardian admitted during the study period in obstetric ward in Rangpur Medical College & Hospital, Rangpur. Results: History of GDM was significantly more common among patients with pre-GDM (38%) and GDM (18%) compared to controls. History of abortion, IUFD and congenital anomaly were significantly higher among pre-GDM mothers than GDM mothers and controls (p<0.05). History of deliveries with macrosomia and still birth was distributed similarly across the groups (p>0.05). Pre–GDM and GDM patients had significantly higher number of patients with HbA1C >6.5% than controls. Mean FBS and PPBS was significantly higher in pre-GDM & GDM patients than control (p<0.05). APGAR score was <7 in significantly higher number of pre–GDM and GDM babies than controls (p <0.05). Mean Weight of the babies was significantly lower among pre–GDM patients than GDM patients (p <0.05). Among pre–GDM patients and GDM patient’s cases of birth asphyxia, Hypoglycemia, hyperbilirubinemia and congenital anomalies were significantly higher than controls (p< 0.05). Conclusion: Interventions such as preconception care for women with pre-gestational diabetes, screening for early diagnosis, patient education, multidisciplinary approach and good metabolic control maintained throughout the pregnancy is the key to successful fetomaternal outcome.

Comprehensing the role of serum GGT in colorectal carcinoma: cancer risk, prognostic and diagnostic significance.

Effective biomarkers are necessary for early diagnosis, prognosis, and therapy monitoring of colorectal cancer (CRC), a disease that continues to be a major worldwide health problem. Due to a potential connection to colorectal cancer, serum gamma-glutamyl transferase (GGT), an important enzyme in metabolism of glutathioneand cellular stress response, has drawn attention. GGT is an essential component of the antioxidant system that protects against oxidative stress. It is mostly found in organs such as the liver, kidneys, and biliary tract. Numerous health problems, such as metabolic disorders, liver illnesses, and several types of cancer, are linked to elevated blood GGT levels. This review aims to clarify the function of serum GGT in colorectal cancer by examining clinical research conducted over the past 20years. A comprehensive analysis of pertinent literature identifies associations between high blood GGT levels and carcinoma of the colon risk, prognosis, and diagnostic potential. Increased GGT and a higher risk of colorectal cancer are positively correlated, according to epidemiological data consistently. The predictive capacity of GGT for colorectal adenomas underscores its use in early identification and preventive approaches. Additional clinical evidence indicates that higher GGT levels in CRC patients are associated with poorer outcomes, such as invasion of lymph nodes, advanced tumour stages, and decreased overall survival. Furthermore, changes in GGT levels after therapy offer information about patient survival and treatment effectiveness, highlighting its importance in therapy monitoring. In summary, this review underscores the multifaceted role of serum GGT in CRC, offering insights into its value as a biomarker for risk assessment, prognosis, and therapeutic monitoring, while emphasizing the need for further research to validate its clinical utility.

Multi-order attributes information fusion via hypergraph matching for popular fashion compatibility analysis

Popular fashion compatibility modeling aims to quantitatively assess the compatibility of a set of wearable items for everyday pairings and clothing purchases to assist human decision-making, which has garnered extensive academic attention. Earlier approaches that studied garments as a whole could only discern loose relationships between items, resulting in low accuracy and poor interpretability. Although existing state-of-the-art methods attempt to reveal the mechanism of garment compatibility at a fine-grained level by quantifying pairwise attribute compatibility, they overlook the fact that multi-attribute combinations between apparel items tend to play a more salient role in compatibility. Considering the complex and high-order characteristics of compatibility data, we propose a network named MAIF to deeply mine and reveal the intricate compatibility mechanisms of clothing by fusing multi-order attributes compatibility information through hypergraph matching. Specifically, we use the compatibility modeling of top-item and bottom-item as an example. First, we construct an adaptive hypergraph representation module to model the multi-attribute association combinations of individual clothing items and fuse single-attribute variable information to form multi-order attribute association information. Second, we learn the multi-order compatibility information of attributes between clothing items through spatial similarity matching. Considering the varying compatibility impacts caused by different attribute combinations, we construct a dynamic cross-plot matching mechanism to model the impact weights of multi-order attribute compatibility information. Finally, personalized ranking loss is designed to optimize the model parameters using fashion context information. Experimental and user survey studies conducted on the FashionVC and Polyvore-Maryland datasets verified the validity and superiority of MAIF in accurately assessing apparel compatibility, demonstrating its ability to interpret multi-order attribute compatibility information.

Extracellular Matrix as a Target in Melanoma Therapy: From Hypothesis to Clinical Trials.

Melanoma is a malignant, highly metastatic neoplasm showing increasing morbidity and mortality. Tumor invasion and angiogenesis are based on remodeling of the extracellular matrix (ECM). Selective inhibition of functional components of cell-ECM interaction, such as hyaluronic acid (HA), matrix metalloproteinases (MMPs), and integrins, may inhibit tumor progression and enhance the efficacy of combination treatment with immune checkpoint inhibitors (ICIs), chemotherapy, or immunotherapy. In this review, we combine the results of different approaches targeting extracellular matrix elements in melanoma in preclinical and clinical studies. The identified limitations of many approaches, including side effects, low selectivity, and toxicity, indicate the need for further studies to optimize therapy. Nevertheless, significant progress in expanding our understanding of tumor biology and the development of targeted therapies holds great promise for the early approaches developed several decades ago to inhibit metastasis through ECM targeting.

Prompt-guided bidirectional deep fusion network for referring image segmentation

Referring image segmentation involves accurately segmenting objects based on natural language descriptions. This poses challenges due to the intricate and varied nature of language expressions, as well as the requirement to identify relevant image regions among multiple objects. Current models predominantly employ language-aware early fusion techniques, which may lead to misinterpretations of language expressions due to the lack of explicit visual guidance of the language encoder. Additionally, early fusion methods are unable to adequately leverage high-level contexts. To address these limitations, this paper introduces the Prompt-guided Bidirectional Deep Fusion Network (PBDF-Net) to enhance the fusion of language and vision modalities. In contrast to traditional unidirectional early fusion approaches, our approach employs a prompt-guided bidirectional encoder fusion (PBEF) module to promote mutual cross-modal fusion across multiple stages of the vision and language encoders. Furthermore, PBDF-Net incorporates a prompt-guided cross-modal interaction (PCI) module during the late fusion stage, facilitating a more profound integration of contextual information from both modalities, resulting in more accurate target segmentation. Comprehensive experiments conducted on the RefCOCO, RefCOCO+, G-Ref and ReferIt datasets substantiate the efficacy of our proposed method, demonstrating significant advancements in performance compared to existing approaches.

Exploring 17q12 Deletion Syndrome: A Case Report of Neurodevelopmental, Endocrine, and Genital Anomalies

Objective − 17q12 deletion syndrome is a rare genetic disease characterized by neurodevelopmental disorders, genital and renal abnormalities, and maturity-onset diabetes of the young type 5 (MODY5).Case Report − This case report details the case of a 13-year-old female with moderate intellectual disability, Mayer-Rokitansky-Küster-Hauser syndrome, multicystic dysplastic kidneys, and MODY5. Genetic testing revealed a 1.52-megabase heterozygous deletion on chromosome 17q12, encompassing the HNF1B and LHX1 genes, which was found to be inherited from the mother. Conclusion − This case underscores the importance of early genetic testing and multidisciplinary approach in managing the multisystemic manifestations of 17q12 deletion syndrome. Early diagnosis and appropriate management are crucial for improving the outcomes and quality of life for affected individuals.

Endoscopic Findings of 'Salmon Roe-like Nodular Lesions' in a Case of Severe Disseminated Strongyloidiasis in a Foreign Resident in Japan.

A Southeast Asian man in his 30s residing in Japan developed severe disseminated strongyloidiasis during long-term steroid therapy. Initially misdiagnosed as gastroenteritis, his condition was later identified as strongyloidiasis by fecal smears and endoscopy. An endoscopic examination revealed salmon roe-like nodular lesions, indicating an advanced stage. Despite treatment, the patient died of the illness. This case underscores the importance of considering the patient's geographical background and immunosuppressive history in medical assessments. It further highlights the need for early and proactive diagnostic approaches, such as stool testing and gastrointestinal endoscopy, to effectively detect and treat imported infectious diseases.

Aberrant intrinsic brain activities in functional gastrointestinal disorders revealed by seed-based d mapping with permutation of subject images.

Functional gastrointestinal disorders (FGIDs) are characterized by complex interactions between the gut and brain, leading to altered brain function and symptom manifestation. We used neuroimaging meta-analytic techniques in order to analyze the correlation between FGIDs and aberrant brain activity. A systematic review was performed to ascertain resting-state functional magnetic resonance imaging (rs-fMRI) studies examining brain function in FGIDs. Pooled meta-analyses by seed-based d mapping with permutation of subject images (SDM-PSI) were performed to assess variations in regional brain activity, and sensitivity analyses were applied to evaluate the robustness of findings. Meta-regression analyses were then carried out to examine possible links between demographic factors and neuroimaging changes. Our meta-analysis revealed significant changes in regional brain activities among FGIDs patients compared to healthy controls (HC). Increased brain activation was observed in several regions including the postcentral gyrus, calcarine fissure/surrounding cortex, superior frontal gyrus, and insula, while decreased activity was noted in the left posterior cingulate gyrus, right median cingulate/paracingulate gyri, and the left caudate nucleus. Furthermore, meta-regression analyses indicated negative associations between disease duration and alterations in specific brain regions. These findings underscored the intricate interplay between gut dysfunction and aberrant brain activity in FGIDs. Early intervention and multidisciplinary approaches addressing both gastrointestinal symptoms and associated emotional distress are crucial for improving the quality of life of the patients.

Timing Matters: A Comprehensive Meta-Analysis on the Optimal Period for Cranioplasty After Severe Traumatic Brain Injury

BACKGROUND AND OBJECTIVES: Craniectomy is a commonly performed procedure in severe traumatic brain injury (TBI) to control intracranial hypertension and reduce mortality. The optimal timing for cranioplasty after craniectomy remains a topic of debate. The aim of this study was to investigate the ideal timing for cranioplasty after severe TBI, focusing on complications associated with temporal aspects and materials used in cranioplasty. METHODS: Multiple databases, including PubMed, Embase, Cochrane, and Web of Science, were searched for studies reporting on the subject. Inclusion criteria involved randomized and observational studies comparing early and late cranioplasty procedures. Quality assessment was performed using the Methodological Index for Non-Randomized Studies scale. Results were pooled in a single-arm meta-analysis and presented as mean and 95% confidence interval. RESULTS: Early cranioplasty was associated with a lower likelihood of subdural effusion (odds ratio [OR] 0.3735 [0.1643; 0.8490], P = .0187). However, no differences were detected for the presence of infection between both groups (OR 0.7460 [0.2065; 2.6945], P = .6548). Cranioplasties performed within or equal to 3 months from the TBI incident were associated with a reduced likelihood of minor complications (OR 0.4471 [0.2467; 0.8102], P = .0080). Paradoxically, this time frame exhibited an elevated risk of hydrocephalus (OR 3.2035 [1.4860; 6.9059], P = .0030), as well as total complications (OR 1.4190 [1.0453; 1.9262] P = .0248). CONCLUSION: This comprehensive review highlights the current lack of consensus on the optimal timing for cranioplasty after severe TBI. Early cranioplasty, within 35 days, showed a reduced risk of subdural effusion, but no disparity in the odds of infection was found. A reduced incidence of minor complications was observed in the earlier approach, however with an elevated risk for hydrocephalus and total complications. The association between timing and complications, including hydrocephalus, highlights the need for further research and standardization in this critical aspect of TBI management.

A Simplified Two-Fluid Model Based on Equilibrium Closure for a Dilute Dispersion of Small Particles

Two-fluid formalisms that fully account for all complex inter-phase interactions have been developed based on a rigorous ensemble-averaging procedure. Here, we apply equilibrium approximation to particle velocity to simplify two-phase flow equations for the case of a dilute dispersion of particles much smaller than the flow scales. First, we extend an earlier approach to consider the rotational motion of the particles and seek an equilibrium approximation for the angular velocity of the particulate phase. The resulting explicit knowledge of the particulate phase translational and rotational velocities in terms of fluid velocity eliminates the need to consider the momentum equations for the particulate phase. The equilibrium approximations also provide precise scaling for various terms in the governing equations of the two-fluid model, based on which a simplified set of equations is obtained here. Three different regimes based on the relative strength of gravitational settling are identified, and the actual form of the simplified two-phase flow equations depends on the regime. We present two simple examples illustrating the use of the simplified two-fluid formalism.

Abstract 4137718: Coronary Artery Calcium for Risk Stratification of Heart Failure Mortality

Background: There is increasing interest in predicting heart failure (HF), a major cause of morbidity and mortality that exerts a significant financial burden. The role of coronary artery calcium (CAC), an accessible and inexpensive test, in predicting long-term HF mortality amongst asymptomatic adults remains unknown. Objectives: To determine if CAC burden is associated with HF-related mortality in the primary prevention population. Methods: The study included 66,636 primary prevention patients from the Coronary Artery Calcium Consortium. Multivariable competing risks regression was used to assess the association between CAC and HF-related mortality adjusting for demographics and traditional risk factors. Results: The mean age was 54.4 years, 67% male, 89% white, and 55% had CAC >0. A total of 260 HF-related mortality events were observed during a median follow up of 12.5 years, 75.3% of which occurred among those with a baseline CAC score >100. Compared with a CAC = 0, there was a stepwise higher risk (P < 0.005) of HF mortality for CAC 1-100 (subdistribution hazard ratio [SHR]: 2.27; 95% CI: 1.3-3.99), 100-400 (SHR: 3.68; 95% CI 2.1-6.43), and >400 (SHR: 7.05; 95% CI 4.05-12.29). This increasing risk of HF mortality across higher CAC scores persisted across age groups, sex, and in the intermediate and high-risk groups as calculated by the pooled cohort equation (PCE) and the PREVENT equation. Conclusions: Higher CAC is associated with increasing incidence of long-term HF-related mortality in the primary prevention population, particularly intermediate and high-risk patients. Early preventive approaches in patients with high CAC must focus on preventing heart failure and ASCVD with lifestyle changes and medications.

The other mother: ancient and early Byzantine approaches to wet-nursing and mothering

Abstract In premodernity, a time when human milk was the only safe means of infant nutrition, and in societies, such as those of classical antiquity and early Byzantium, where breastfeeding was considered servile work, wet-nursing was both a necessary and widespread occupation. Despite the social demand for the profession, public discourses around wet nurses were mostly negative, while their work was treated with both admiration and scorn. In an attempt to understand ancient and early Byzantine approaches to the wet nurse, this article takes a matricentric perspective. It investigates various discourses (rhetorical, moralist, philosophical, theological, hagiographical, medical and contractual) which establish the wet nurse as an essential part of the institution of motherhood, as a social and moral category whose work, way of life and behaviour are constantly defined, controlled and regulated. These discourses nevertheless tell us much more about the anxieties and preoccupations of the societies that produced them and much less about actual contemporary wet nurses. The choice of an investigation encompassing antiquity up to early Byzantium, an extension rarely seen in existing studies, further illuminates the mechanics and dynamics of the ideologies around the wet nurse, as these are preserved or evolve in time.

An Observational Study of Patients Presenting in Hypotension and Shock to Emergency Room by Applying RUSH Protocol

Introduction: Care of the patient with shock can be one of the most challenging issues in emergency medicine. The early use of ultrasound at the bedside in such emergency is a very valuable tool to determine the type of shock. Rapid Ultrasound in SHock (RUSH) protocol done by emergency physicians is one such protocol which is being underused. Hence, we conducted this study to assess the effectiveness of the RUSH protocol for patients presenting with undifferentiated hypotension and shock. Materials and methods: This was prospective observational study done on a total of 100 patients presented with hypotension and shock. We performed an early bedside sonographic examination for participants based on RUSH protocol and type of shock was determined. Then the definitive interventions were performed as per the type of shock. The outcome measures were determined either till the survival to discharge from the hospital or till the in-hospital death of the patient. The data was analysed using SPSS version25. Results: In this study, the type of shock most commonly found overall was hypovolemic shock (40%) followed by cardiogenic shock (27%) and distributive shock (17%). Contractility of left ventricle, size of right ventricle, inferior venacava caliber, hemoperitoneum, pneumothorax, hemothorax, pulmonary edema, pleural effusion and lungs consolidation were statistically significant in determining the type of shock except cardiac tamponade, abdominal aortic aneurysm/dissection and deep vein thombosis. Majority of the interventions performed were fluid resuscitation (41%), vasopressors and inotropes (28%) and laparotomy (9%) and were statistically significant (p=0.001). Among all patients, 73% survived and 27% died. The outcome was statistically significant (p=0.002). Conclusion: RUSH protocol used for undifferentiated hypotension and shock is an effective tool at the bedside as an early approach to diagnose the type of shock. It will also help in determining early definitive interventions in shock states and thereby having better patient outcomes.

“America is a Land of Censored Opportunity”: The Daily Worker Obscenity Case of 1927–1928

ABSTRACT In March 1927, the Communist Party’s newspaper, the Daily Worker, published a poem, “America” by David Gordon, that compared the United States to a “neat whore house.” For more than a year, state and federal prosecutors pursued obscenity cases against Gordon, the paper, and its editors, which resulted in the paper paying a $500 fine, Gordon being sentenced to an indefinite term in the state reformatory, and two editors spending time in jail. The saga demonstrates the legal persecution that the Communist Party faced in the 1920s, and the way that the organization defended itself. It also allows us to examine how the obscenity laws were used to pursue political prosecution, and, finally, offers a glimpse at early Communist aesthetic approaches.