Sensibility Research Articles

Management of Pediatric Mild Traumatic Brain Injury Patients: S100b, Glial Fibrillary Acidic Protein, and Heart Fatty-Acid-Binding Protein Promising Biomarkers.

Children are highly vulnerable to mild traumatic brain injury (mTBI). Blood biomarkers can help in their management. This study evaluated the performances of biomarkers, in discriminating between children with mTBI who had intracranial injuries (ICIs) on computed tomography (CT+) and (1) patients without ICI (CT-) or (2) both CT- and in-hospital-observation without CT patients. The aim was to rule out the need of unnecessary CT scans and decrease the length of stay in observation in the emergency department (ED). Newborns to teenagers (≤16 years old) with mTBI (Glasgow Coma Scale > 13) were included. S100b, glial fibrillary acidic protein (GFAP), and heart fatty-acid-binding protein (HFABP) performances to identify patients without ICI were evaluated through receiver operating characteristic curves, where sensitivity was set at 100%. A total of 222 mTBI children sampled within 6 h since their trauma were reported. Nineteen percent (n = 43/222) underwent CT scan examination, whereas the others (n = 179/222) were kept in observation at the ED. Sixteen percent (n = 7/43) of the children who underwent a CT scan had ICI, corresponding to 3% of all mTBI-included patients. When sensibility (SE) was set at 100% to exclude all patients with ICI, GFAP yielded 39% specificity (SP), HFABP 37%, and S100b 34% to rule out the need of CT scans. These biomarkers were even more performant: 52% SP for GFAP, 41% for HFABP, and 39% for S100b, when discriminating CT+ versus both in-hospital-observation and CT- patients. These markers can significantly help in the management of patients in the ED, avoiding unnecessary CT scans, and reducing length of stay for children and their families.

Pilot study GLIM criteria for categorization of a malnutrition diagnosis of patients undergoing elective gastrointestinal operations: A pilot study of applicability and validation.

The Global Leadership Initiative on Malnutrition (GLIM) was proposed to provide a common malnutrition diagnostic framework. The aims of this study were to evaluate the applicability and validity of the GLIM and use machine-learning techniques to help provide the best malnutrition-related variables/combinations to predict complications in patients undergoing gastrointestinal (GI) surgeries. This was a prospective cohort study enrolling surgical patients with GI diseases. Malnutrition prevalence was classified by the GLIM, subjective global assessment (SGA), and various anthropometric parameters. The various combination of the phenotypic criteria generated 10 different models. Sensibility (SE) and specificity (SP) were calculated using SGA as the reference criterion. Machine-learning approaches were used to predict complications. P < 0.05 was set as statistically significant. We evaluated 206 patients. Half of the patients were malnourished according SGA, and 16.5% had postoperative complications. The prevalence of malnutrition using GLIM varied from 10.7% to 41.3% among the whole population, 11.7% and 43.6% in the elderly, from 0 to 24% in overweight non-obese and from 0 to 19.6% in obese patients. SE and SP values varied between 61.2% and 100% and 55.3% and 98.1%, respectively, for the general population. Machine-learning models indicated that midarm circumference, one of the GLIM models, and midarm muscle area were the most relevant criteria to predict complications. The various GLIM combinations provided different rates of malnutrition according to the population. Machine-learning techniques supported the use of common single variables and one GLIM model to predict postoperative complications.

O kafkiano elogio de Abraão

Neste artigo abordamos uma carta de Franz Kafka escrita em 1921, na qual ele apresenta a seu amigo Robert Klopstock sua interpretação do personagem bíblico Abraão. Nosso objetivo é ressaltar o humor presente nessa interpretação kafkiana como uma das marcas pouco analisadas no judeu de Praga. Para tanto apresentaremos primeiramente o Elogio de Abraão proposto por Kierkegaard em seu Temor e Tremor, afim de observar a possível influência do filósofo dinamarquês sobre as conclusões propostas pelo próprio Kafka. Na sequência serão apresentadas as três principais figuras criadas por Kafka, a do Abraão incapaz de realizar sua função, mas que permanece sempre em prontidão; a do Abraão trapaceiro, que não termina suas funções na casa para não ter que realizar o que Deus lhe pede; e a do Abraão inseguro, que ouve o chamado, mas que não acredita que este lhe diga respeito. Ressaltamos nas três figuras kafkianas a intenção primordial dele em produzir uma outra forma de elogio, uma que se adequa melhor à sua sensibilidade permeada pelo humor judaico, que aquela da serenidade cristã proposta por Kierkegaard.

The Role of Duplex Ultrasound in Detecting Graft Thrombosis and Endoleak after Endovascular Aortic Repair for Abdominal Aneurysm

To assess the role of duplex ultrasound (DUS) in detecting endoleaks (ELs) and graft thrombosis (GT) in a cohort of patients submitted to endovascular aortic repair (EVAR) for elective infrarenal abdominal aortic aneurysm (AAA) in 2 centers. Data, of all consecutive patients treated in 2 operative units of vascular surgery, from January 01, 2000 to December 31, 2016, were retrospectively collected and evaluated. Follow-up data were analyzed to evaluate survival and device-related complications, both at 30-day and in the midterm. The results of computed tomography angiography (CTA) and DUS which were performed yearly, with a time interval between the 2 examinations lower than 30days, were paired in terms of maximum transverse diameters of the aneurysmal sac, identification of EL, and of GT. Sensibility (SE), specificity (SP), positive predictive value (PPV), negative predictive value (NPV), and accuracy (ACC) of the DUS were calculated with respect to data of each paired CTA and to data of the real clinical diagnosis of either EL or GT. A Student's t-test was performed to compare the aneurysmal sac diameters measured with DUS to those of CTA. "Kappa" coefficient of agreement was also calculated. A P value<0.05 was the level reference for statistical significance. A total of 920 patients (104 female, 11.3%) underwent EVAR for elective infrarenal AAA. Technical success was achieved in 910 cases (98.9%). At 30days, there were 5 deaths (0.5%), no GT, and 3 small type II ELs which did not require any adjunctive procedure. Mean follow-up was 64.8months (range 1-120.3months). Survival and freedom from complications were estimated to be 78.4%±1.9% and 48.3%±1.7%, respectively, at 10years. Seventy-six more ELs and 8GTs were recorded. Considering the CTA as the gold standard, SE, SP, and ACC of DUS in the detection of the EL were 93.2%±5.8%, 98.8%±1.1%, and 97.8%, respectively, with a PPV of 94.5%±5.2% and a NPV of 98.3%±1.4%. Considering, however, the real diagnosis of the EL, SE, SP, and ACC of DUS were slightly lower (89.4%±6.9%, 98.5%±1.3%, and 96.9%, respectively), as well as PPV and NPV (93.1%±5.8% and 97.7%±1.6%, respectively). K coefficient of agreement between the measurements of the sac maximum transverse diameter recorded at DUS and CTA was 0.91, with a little underestimation of the aneurysm diameter at DUS if compared with CTA (mean diameter difference of 2.5mm, 95% confidence interval: 2.25-2.75mm). DUS has proven to be a reliable examination in identifying all GT and most ELs after EVAR, compared with CTA. A good correlation was also observed between the measurements of the sac maximum transverse diameter recorded at DUS and CTA, with a little underestimation of the aneurysm diameter at DUS compared with CTA.

Diagnostic Accuracy of Interleukin-27 between Tuberculous Pleural Effusion and Malignant Pleural Effusion: A Meta-Analysis

Background: The concentration assay of pleural effusion interleukin-27 (IL-27) has raised concern for diagnosing tuberculous pleurisy. Compared with malignant pleural effusion (MPE), the concentration of IL-27 in tuberculous pleural effusion (TPE) increased significantly. Accurate differentiating diagnosis is essential for choosing treatment for pleural effusion. Objective: The present meta-analysis is aimed at determining the accuracy of IL-27 in the differential diagnosis between TPE and MPE. Material and Method: After having retrieved the published studies, we combined the sensibility (SEN), specificity (SPE), positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR) of IL-27 in the diagnosis of TPE compared to MPE using a fixed-effect model. The summary receiver operating characteristic curve was applied to estimate the overall test performance. Results: In total, 550 patients (285 patients with TPE and 265 patients with MPE), included in 7 case-control studies, were enrolled. The summary assessments for IL-27 in the diagnosis between TPE and MPE were: SEN 0.93 (95% CI 0.90–0.96), SPE 0.97 (95% CI 0.94–0.98), PLR 25.88 (95% CI 13.84–48.39), NLR 0.07 (95% CI 0.05–0.11), and DOR 333.26 (95% CI 146.10–760.19), respectively. The maximal joint SEN and SPE was 0.95; the area under the curve was 0.99. Conclusion: IL-27 determination is a relatively accurate test for the diagnosis of TPE, which has very high SEN and SPE for discriminating TPE from MPE. The results of IL-27 assays should be interpreted in parallel with clinical findings and the results of conventional tests.

The Risk Predictive Values of ACG Classification in a Cohort of Colon Ischemia: Refining the Definition of Mild Disease

Introduction: Although most cases of colon ischemia (CI) are mild and self-limiting, when severe it implies high mortality rates. We aimed to evaluate the risk predictive value of the classification proposed by American College of Gastroenterology (ACG) guidelines (2015), created to provide a management algorithm. Methods: A retrospective multicenter study was conducted on adult patients with definite CI (clinical, endoscopic, pathologic and culture criteria), between 2013 and 2016. Data was collected on clinical presentation, including comorbidities, organ failure, management and outcome. Cases were evaluated according to ACG risk factors (RF) (gender, systolic blood pressure, heart rate, abdominal pain without rectal bleeding, BUN, Hb, LDH, serum sodium, WBC). Cases were classified as mild (0 RF), moderate (1-3 RF) and severe (>3 RF or any of the following: peritoneal signs, pneumatosis or portal venous gas, gangrene, pan-colonic or isolated right-colon ischemia). Results: 349 cases with the clinical diagnosis of IC were analyzed. 193 met inclusion criteria of definitive diagnosis (63% females; mean age 72 years (±13). ACG classification of mild, moderate and severe disease was attributed respectively to 21% of patients (0 intra-hospital deaths), 45% (2 deaths) and 34% (12 deaths). The number of ACG RF was: 40% with 0 RF, 8% with 1, 9% with 2, 15% with 3, 16% with 4, 8% with 15%, 4% with 6 and 1% with 7. No patient with 0 or 1 RF died. Only 1 patient with 2 RF died. The remaining 13 deaths were verified with at least 3 RF. The univariate analysis revealed a statistical correlation between RF and intra-hospital or 30-day mortality as well as the need for surgery (P<0.001, P<0.001, and P=0.006, respectively). ACG classification presented high predictive accuracy for in-hospital and 1-month mortality with an AUROC of 0.78 and 0.79 (P<0.001), respectively. For a cutoff of 2 ACG RF, the sensibility (SE) for death was 100%, specificity (SP) was 52%, with a positive predictive value (PPV) of 14% and negative predictive value (NPV) of 100%. For 3 ACG RF the results were: SE 93%, SP 61%, PPV 16% and NPV 99%. Three or more RF had an OR of 20.2 (95%CI: 2.59-158) for intra-hospital and 18.4 (95% CI: 2.34-144) for 1-month mortality. Conclusion: No patient in this cohort with less than 2 ACG RF died, suggesting that mild disease of ACG classification may include 0 and 1 RF without changing prognosis. Short-term mortality risk increases significantly in patients with at least 3 ACG RF.Figure: ROC curve comparing the sensitivity of prediction of mortality at 1 month using the ACG classification, ACG classification adjusting mild disease until 1 RF and the number of ACG RF.

“He looked quite red”: Persuasion and Austen’s New Man of Feeling

This article reconsiders the status of sensibility in Jane Austen’s Persuasion (1818), focusing on the blushing hero of the novel, Frederick Wentworth. Although literary scholars have often dis cussed the blushing of Austen’s female characters, they have paid scant attention to her blushing heroes. Despite his incon trovertible mascu linity, Went worth is positioned as a new “man of feeling,” who demonstrates sympathy without the sentimental histrionics of his literary predecessors. Looking especially at Wentworth’s chang ing complexion, this article argues that blushing as depicted in Austen’s novel not only demonstrates the com pati bil ity of sensi bility and masculinity, but also participates in Austen’s larger project of realigning social value on the basis of sym pathy rather than gender.

Abstract 217: Analysis Of Aspects Electrocardiographic, Vectorcardiographic And Echocardiographic Of Left Ventricular Hypertrophy In Resistant Hypertension

Introduction: Resistant hypertension (RHTN) defined as the failure to reach goal BP, with at least 3 drugs including a diuretic (JNC-VII). Affects 5-30% HTN, become high risk of developing target organ damage, like LVH rasing morbi-mortality (Framingham Study). Then is necessary a better treatment plan the early diagnosis. The electrocardiogram (ECG) and the vectorcardiogram (VCG), graphic methods (GM), alone, present, in spite of high specificity, have low sensitivity compared with echocardiography (ECHO). Objective: Analyze ECG/VCG for LVH diagnosed by ECHO in RHTN. Methods: Population: 120 RHTN. Excluded diabetic, valve heart, coronary, renal diseases and obese. Study Protocol: After 06 months, between 2008 and 2011, measures BP monthly (JNC-VII) receiving directions, as well as pill counts (Taylor Method) to assess compliance. Underwent ECHO (ASE) then GM. ECG&amp;VCG methods: ECG Criterion: Sokolow-Lyon I(SL-I):SV1+RV5(6)≥3.5mV &amp; II(SL-II):RavL≥1.1mV; Gübner(G):SDI+RDIII≥2.5mV;Cornell(C):RavL+SV3≥2/2.8mV(woman/man);Romhilt-Estes(RE):Point Score≥5points; Perugia(P): RE or C(modify) or Strain. VCG Criterion: Mag Max QRS on Planes horizontal(HP) &amp; frontal(FP): vector≥2mV and right saggital(rSP): vector≥1.6 mV; Defl QRS HP &amp; rSP: angle≥ 330° &amp; ≥150°. Statistical Analysis: Sensibility(SENS), accuracy(ACCU) and specificity(SPEC) to analyse GM. Results: Criterion Sens (%) Accu (%) Spec (%) SL-I 27 (16/60) 61 (73/120) 93 (56/60) G 18 (11/60) 58 (69/120) 97 (58/60) SL-II 18 (11/60) 58 (69/120) 97 (58/60) C 25 (15/60) 59 (71/120) 93 (56/60) RE 32 (19/60) 58 (77/120) 95 (58/60) P 50 (30/60) 68 (81/120) 85 (51/60) Mag Max QRS PH 28 (17/60) 61 (73/120) 93 (56/60) Mag Max QRS PSr 12 (07/60) 52 (62/120) 92 (55/60) Mag Max QRS PF 25 (15/60) 57 (68/120) 88 (53/60) Defl QRS PH 12 (07/60) 52 (62/120) 92 (55/60) Defl QRS PSr 13 (08/60) 50 (60/120) 87 (52/60) COMBINED* 70 (42/60) 76 (91/120) 82 (49/60) Conclusion: ECG: P had the best SENS &amp; ACCU, SL-II and G both showed the best SPEC. VCG: best criteria Mag Max QRS PH. Combined criteria* using best SENS and ACCU of each GM improved SENS &amp; ACCU demonstrated SPEC without injury to LVH in RHTN detection. Can be worn with method in a cost effectiveness ratio and in places where access is difficult to ECHO to be performed.

FRI0462 Nasal Mucosa Narrow Band Imaging (NBI) in Granulomatosis with Poliangiitis (Wegener Granulomatosis): A Preliminary Study

BackgroundGranulomatosis with polyangiitis, former Wegener's (GPA) is a systemic vasculitis characterized by necrotizing granulomatous inflammation and necrotizing vasculitis classically affecting the ear, nose and throat (ENT) district, the lower respiratory...

Pertinence du bilan préoperatoire dans l’évaluation du risque de métastases ganglionnaires d’un cancer endométrial

PurposeTo assess the relevance of MRI, endometrial biopsy and curettage in the diagnosis of endometrial cancer at high risk of lymph node metastasis. Patients and methodsA retrospective study on continuous series of patients treated for endometrial cancer limited to the uterus between 2004 and 2008, results of preoperative evaluation of tumor stage using MRI, histological type and grade by endometrial curettage and biopsies were compared to final histological examination. ResultsOne hundred and sixty-nine patients were included in the study. Ninety (53.3%) had MRI, 112 (66.2%) curettage and 61 (36.6%) endometrial biopsy using Pipelle de Cornier®. Sensibility (SN), specificity (SP), positive (PPV) and negative predictive values (NPV) of MRI, in the diagnosis of endometrial cancer at high risk of lymph nodes metastases were of 65.6%, 87.2%, 77.7%, 79.2%. For EB and curettage SN, SP, PPV and NPV were of 42.9%, 96.9%, 85%, 79.5%; 80.6%, 98.3%, 96.2% and 90.6% respectively. 37.8% of cancers diagnosed to be at low risk of lymph node metastasis were at high risk in definitive histologic examination. Discussion and conclusionPreoperative evaluation by MRI, endometrial curettage and biopsy has good diagnostic value in the identification of endometrial cancer susceptible to benefit from lymphadenectomy. Underestimation, however, is encountered in approximately one third of cases.

Aphra Behn’s Black Body: Sex, Lies and Narrativity in Oroonoko

This paper traces the peculiar relationship between Aphra Behn, a 17 th century novelist, poet, playwright and translator (by all accounts the first professional writer in English, let alone the first woman to make her living by her pen) and the hero of her novel Oroonoko (an African prince enslaved in Surinam). Although Behn ennobles the young man in the tradition of Rousseau’s “noble savage,” educating him above his owners and marrying him to a similarly “pure” African maiden, certain discrepancies stand out, among them the facial features of the two slaves (clearly European), the couple’s prim and almost-Victorian sensibil ity, and the Christian brutality of the white slavelords, intent upon destroying Oroonoko for a sacrifice beyond their comprehension. Previous research addresses Oroonoko’s value as an abolitionist work, remarking upon the romance between “lesser” equals as among Europeans, or makes political comparisons between the visage of the noble prince and the English monarchs. Neglected in the literary appreciations is Behn’s evident passion for her subject, in its colonial context of illicit interracial love and possession. Is Oroonoko a courageous celebration of racial difference itself, in the only conceivable means of presentation available to a 17 th century woman? Does Oroonoko stand in as a metaphor for an encounter of yet another kind, the trespass of race, class and gender? Couched in the poetic similes of Restoration art and artifice, Oroonoko is a story of strangled violence. It is the tale of a woman writer translating desire and meaning into flesh – black flesh, publicly consumed. Behn’s authorial “I” is transgressive, transformative. Artfully concealed between covers, Behn projects her bound English body into forbidden territories: foreign darkness, black otherness, and desires too dangerous for words.

P2-141 Definition and validation of an algorithm to identify COPD patients from administrative databases

IntroductionAdministrative databases are increasingly used to identify patients with chronic conditions, however the optimal methodology for Chronic Obstructive Pulmonary Disease (COPD) is still debated.ObjectiveTo develop and validate an algorithm to...

Can Poetry Matter?

ESSAY Can Poetry Matter? Margaret Randall Margaret Randall isa feminist poet, writer, photographer, and social activist. She firstread the following essay at the Stir Poetry Festival inAlbuquerque, New Mexico, inSeptember 2008. The panel was organized by Albuquerque poet Lisa Gill,who titled it inhonor ofDana Gioia's 1991 essay by the same name. All poets and readers of poetry ask the question: Can poetry matter? We may pose thisquestion indifferent ways. We may ask ifpoetry canmatter in thewider world, if ithas thepower to change or even impact how we think or feel,what we believe, how we act, what we want for ourselves and others.Will it win my lover's heart?Keep my children safe?Can it reverse climate change, feed thehungry, effec tively support justice or reverse injustices, end war? Can poetry bring about lastingpeace? The question is not whether an individual poem or series of poems have been important to people throughout history. They have been, and powerfully. Such diverse poets as Sappho, Basho, Nguyen Du,1 Mevlana Rumi, C?sar Vallejo, Pablo Neruda, N?zim Hikmet, R. M. Rilke, Ho Chi Mirth,Walt Whitman, Czeslaw Milosz, Allen Ginsberg, Adrienne Rich, June Jordan, and Joy Harjo are only a few of thosewhose work contin ues to change lives. The question is:Can poetry as process and product?as genre?matter? And ifso, how? We may ask more intimate questions about poetry, less ambitious perhaps but clearlymean ingful for our human community. For example: Can poetry nurture hope, can itmake us aware, teach, comfortus in times of grief,heal, inspire? What is poetry's responsibility to language? Can it revealmysteries, solve problems? Can it shock us to awareness and action, help us negotiate or persuade? What about oral tradition, everyday conversation, accent, inflection, color, risk? How does poetry enrich culture, help write history, retrieve or preserve memory, provide vision and perspective? Inwhat ways does itsupplement or perhaps even replace the lies thatcome down tous inhistorybooks written by thevictors, biography, essays, even the most thoughtfuljournalism? Poetrymattered to my friendCary Herz. Just a couple ofweeks before her death fromovarian cancer, she senta goodbye email toher friends.She ended hermessage with aMary Oliver poem, her parting gift. The poem was "Blackwater Woods," and some of the lines thatcontinue to sustainme are "Look, the trees/ are turning/ theirown bod ies / intopillars // of light... everything / Ihave ever learned //in my lifetime/ leadsme back to this: the fires/ and theblack riverof loss /whose other side // is salvation,whose meaning / none of us will ever know ..." The gift allowed us to breathe when we received it,and liftedus in recognitionwhen the rabbi read it at Cary's graveside. That poem con tinues to remind us of our friend, her gentle sensi bility,meaningful photography, fierce resistance, and gracious farewell.But itdoes much more than that.The lessons itholds move on many levels. I can think ofmany such instanceswhen a par ticularpoem or group ofpoems tempered sorrow, imbuedme with courage, flashed an unexpected image, or simply expressed an idea or emotion as nothing else could. Poems have been smuggled out of prisons, shared on battlefields, passed fromhand tohand and generation to generation, scratched on walls, written in diaries and recipe books, distributed on street corners, and carried cross-county by hobos riding the freighttrainsof the 1930s. They have inhabited public spaces and been whispered 201World Literature Today in ears, bringing otherwise indescribable events and people to life in stunningways. Their humor makes us laugh. Their truthcan take our breath away. Their concise complexity may transmit more, and more powerfully, than any piece of prose. Their ability to evoke emotion oftenmakes thempurveyors of experience inways thatmore expository writing cannot. It is obvious that poetry changes language. Cultural change influences what is permissible, what may be judged redundant or acceptable. What startles or reinvents later nestles securely in the lexicon. It is also clear that each new commu nicative tool?the telegraph, telephone, computer, cell phone, iPod, Blackberry, Kindle, and other constantly evolving electronic devices?can reju venate poetry. Chatting, twittering, and text mes saging push language toward brevity?urge us to say what we mean, and now. But they also do more. Typographical layout and rhythmemerge fromhow...

Diagnostic Role of Flow Cytometry Analysis of Bioptical Samples in the Diagnosis of Lymphoid Tumors

We reviewed flow cytometric immunophenotyping (FCI) data of 470 tissue suspensions suspected of being involved by lymphoma (371 lymph nodes, 263 surgical biopsies and 108 fine needle aspirations,16 spleens, 6 tonsils, and 77 other tissues) and we have compared corresponding histologic diagnosis. The screening panel of FCI (CD45, CD19, CD3, CD4, CD8, and sIgκ/sIgλ ratio) identified three main groups:239 cases with demonstrable light chain restriction (sIgκ/sIgλ ratio ≤ 0.5 or ≥4);37 cases with demonstrable T cell proliferation and polyclonal B cell population;194 cases with polyclonal B cell and normal T cell populations (146 cases) or with not detectable CD45 reactivity and other leucocyte markers (48 cases).In group 1, 235 cases were then evaluated by means of the following markers: CD5, CD10, CD11a, CD11c, CD20, CD22, CD23, CD30, CD38, CD43, CD79a–b, CD103, CD138, FMC7, and, in group 2, 30 cases were evaluated by means of the following markers: CD1a, CD2, CD5, CD7, CD16, CD26, CD43, CD56, CD57, CD45RA/RO, anti-TCR-ab gd. The complete analysis identified in group 1 four main diagnostic subsets: A (26 cases) characterized by CD5+, CD23+/±, sIg dim (CLL-like); B (36 cases) characterized by CD5+, sIg bright (MCL/CLLv); C (89 cases) characterized by heterogeneous expression of Ig, CD20 and CD43 (lymphoproliferative syndromes CD5−, excluding hairy cell leukemia); D (84 cases) characterized by CD10+, CD20 bright, CD43− (follicular NHL like). In cluster B, FISH analysis for t(11;14) resulted positive in 15/27 cases; in cluster D, FISH analysis for t(14;18) resulted positive in 60/60 cases. Histologic analysis convalidated FCI data in 23 cases of subset A (88%), in 29 cases of subset B (80%) and in 60 cases of subset D (71%). Subset C included 39 cases of LCL and 15 cases of MZL. In group 2, all cases studied expressed an aberrant T phenotype but, with the exception of 1 case of NK proliferation, 1 case of likely Sezary syndrome/Micosis Fungoides (CD4+CD7−CD26−) and 1 case of T lymphoblastic lymphoma (CD3cy+TdT+), in the other 34 cases was not possible identify other peculiar subset. In this group, histologic analysis included 19 cases of NHL T (63%). Considering NHL vs no NHL, sensibility (SE) and specificity (SP) of FCI analysis resulted 88% and 92%, respectively; positive predictive value (PPV) was 96% and negative predictive value (NPV 78%). Considering B-cell NHL only, SE was 91%, SP 95%, PPV 97% and NPV 84%. Even if histology is the basis for the diagnosis of lymphoid tumors, however our study supports that FCI can play an important role mainly in B-NHL diagnosis, combining rapidity of analysis with a multiparametric analysis, also in presence of size limitated samples.

Julia Hoffman and the Arts and Crafts Society of Portland: An Aesthetic Response to Industrialization

RICHARD S. CHRISTEN Julia Hoffman and the Arts and Crafts Society of Portland An Aesthetic Response toIndustrialization ON OCTOBER 9, 1907, NEARLY 150 people met at the Portland Art Museum to adopt a constitution, elect officers, and enlist members for a new organization: theArts and Crafts Society of Portland.1 Among those present was JuliaHoffman, one of Portland's leading citizens and perhaps itsmost avid craftsperson. More than any other individual, Hoffman had generated an interest in handicrafts in the city. She also helped draft the new society's constitution and by-laws and, as one of its original trustees, its second president, and itsprimary spokesperson for nearly thirtyyears, infused the institution with her vision of the arts and crafts. Despite her responsibility for its existence, theArts and Crafts Society of Portland was more than Julia Hoffman's personal creation. Like similar groups that appeared in cities across theUnited States during the late nineteenth and early twentieth centuries, the Portland society was part of an arts and crafts movement thatflourished from the i88os to the 1920s inEngland, theUnited States, and to a lesser degree, the European continent. At its core, the arts and craftsmovement was a response to industrial ization? a loose network of individuals and institutions committed not somuch to a specific artistic style or method as to an attitude and sensi bility that something was amiss in themodern, industrial world.2 Attacks leveled by English designer, poet, and socialist William Morris against the nineteenth-century industrial revolution originally inspired themovement. Machines had undoubtedly increased efficiency, freed humans frommuch drudgery, and multiplied the quantity of consumer goods, but according 510 OHQ vol. 109, no. 4 ? 2008 Oregon Historical Society Courtesy of the Oregon College ofArt andCraft In itsearlyyears, the Arts and CraftsSociety ofPortland oftenheld classes, likethis onephotographed byJuliaHoffman, in thehomes of its mostlymiddle class and affluent patrons. The societyeventuallyopened a schooldowntown. toMorris, the cost had been unacceptable. Product quality and beauty had declined as cheap, poorly designed objects flooded themarket. The shift from craftsperson tomachine operator drained industrial workers of creativity and separated themfrom theirmaterials, products, and customers. Laborers took littlepride or pleasure indemeaning toil and suffered dramatic losses in social and financial status.3 Building on the insights of JohnRuskin and other Romantics, Morris countered industrializations harmful effectswith what historian Eileen Boris refers to as "the craftsman ideal."4This archetype fused two particular notions that Morris believed had been trampled by the factory system: first, an aesthetic ideal ? that natural beauty, simplicity, and usefulness should characterize all objects and permeate everyday life; and second, a theory of labor ? a commitment towork that brings joy, dignity, and personal satisfaction to laborers.Morris believed pre-industrial artisans had embodied both notions. Because theirwork combined design and creation, he argued, itwas stimulating, pleasurable, and respected within the community; their products, created for specific purposes and people, were original, practical, and the epitome of elegant beauty. Hop Christen, Julia Hoffman and theArts and Crafts Society of Portland 511 ML'Mifafi* Hi i ^^MgB^M /w/ia Hoffman was thedrivingforce behind thearts and crafts movement in early twentieth-century Portland. She created thisself-portraitin 1885,a few years afterhermove toPortlandfrom Salt Lake City. ing to return to these conditions, Morris's answer to industrializa tion looked backward rather than forward. His was a reactionary conviction that attention to pre industrial tools, processes, and design would reverse two of the most nefarious effects of the fac tory system. He was convinced that, iffreed from the slavery of machines, laborers would again make beautiful things and per form work "worth doing ... of itselfpleasant to do, and ... done under such conditions as would make it neither over-wearisome nor over-anxious."5 Hoffman and other leaders of theArts and Crafts Society of Portland possessed Morris's desire to cultivate an appreciation for craftsmanship and handicrafts, but they had little of his enthu siasm for fundamental economic and social change. Like that of its counterparts inBoston and other American cities, the Portland society's goal was aesthetic rather than social or economic; they wished to counter theunsightliness of the city's commercial and industrial growth without slowing itsgrowth or challenging the status quo. To achieve thisaim, the...

Lure of the Fallen Seraphim: Sovereignty and Sacrifice in James Joyce and Georges Bataille

For Georges Bataille, sovereignty and sacrifice are inextricable. The passage to sovereignty requires overcoming the fear of death and a transgressive accession to the un-knowledge (non-savoir) of being.1 Joyce's Finnegans Wake allegorizes a simi lar transgression, with the reviving Finnegan rising from his bier and demanding whiskey for himself, in the impossible ontological maneuver of drinking to his own demise. For Bataille, in one of his only references to Joyce, the ritualized revelry of the wake is paradig matic both of that gaiety-in-armihilation that distinguishes the sover eign and of the need to confront death while remaining conscious: In order for man to be revealed to himself he must die, but he must do it while living (12:336). I contend that the blithe demise of Finnegan is but the final, though greatest, term in an ethos of sovereignty and sacrifice that spans Joyce's entire oeuvre, from the first pages of Dubliners to the final lines of Finnegans Wake, whose consonance with Bataille's mythology of loss furnishes an interpretative tool for understanding the Irishman's artistic trajectory. Although Bataille claimed that Joyce had no influ ence on his work (8:615), the contiguity of their artistic motifs and thematic concerns is sufficient to justify a comparative investigation into their respective texts. Beyond the passing references to the Wake, Bataille's formalized ethos of sovereignty is too close to that of Joyce to ignore. Indeed, it is easy to speculate on the early historical and biographical parallels that might be behind this. As young men, for example, both considered the priesthood. Joyce questioned and final ly abandoned his faith at the same age that Bataille converted. Both men carried with them a profound and unorthodox religious sensibil ity and a debt to Thomas Aquinas, which found repeated expression through their work. It is highly unlikely that the two writers ever met, but both were in Paris during the 1930s?the son of the blind madman with an abortive career in medicine, on the one hand, and the older, near-blind ex-medical student with the schizophrenic texts and a mad daughter on the other2?forging their own artistic praxis along

The Sacred Heart of Jesus, Thérèse of Lisieux, and the Transformation of U.S. Catholic Piety, 1865-1940

A vote of confidence from a friend can change a person's life, and in my case, one such vote came from David O'Brien. Upon graduation from Holy Cross in 1996,1 received a letter from O'Brien suggesting graduate school: even if land ing an academic job might be tricky, he said, I would never regret passing my twenties in the company of thoughtful, creative scholars. He then argued the need for young Catholic intellectuals who possessed a critical understanding of American life: only if we appreciate our cultural context, recognizing its potentials and pitfalls, only then can we realize the kind of fruitful, mutually beneficial dialogue between Church and culture envisioned at Vatican II (1962-65). Reading O'Brien's Isaac Hecker: An American Catholic drove home this point by illuminating a distinctly American Catholic sensibil ity emerging in the second half of the nineteenth century?a sensibility as much defined by confidence in American democracy as it was by faith in God's abiding presence in human history.1 I was persuaded by the need for a critical, historical understanding that could contextualize this kind of engagement, and in the end, I did get a job. This present essay builds from O'Brien's argument for engagement, and it offers perspective on the historical relationship between Catholicism and American culture. Moreover, it demonstrates how examining devotional literature can produce a longer, more accurate view of the transition from a pre-conciliar (before 1962) to a post-con ciliar (after 1965) Church. Such a view highlights how piety and democratic culture were mutually supportive, and it clarifies changes that predated Vatican II, helping account for widespread lay appreciation of conciliar reforms. When considered alongside the popular practice of intercessory prayer to saints, the popularization of

Cultural Landscape Studies: Reception and the Social Mediation of Meaning

Research Article| March 01 2006 Cultural Landscape Studies: Reception and the Social Mediation of Meaning Richard Schein Richard Schein Search for other works by this author on: This Site PubMed Google Scholar Journal of the Society of Architectural Historians (2006) 65 (1): 17–18. https://doi.org/10.2307/25068232 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn MailTo Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Richard Schein; Cultural Landscape Studies: Reception and the Social Mediation of Meaning. Journal of the Society of Architectural Historians 1 March 2006; 65 (1): 17–18. doi: https://doi.org/10.2307/25068232 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu toolbar search search input Search input auto suggest filter your search All ContentJournal of the Society of Architectural Historians Search This content is only available via PDF. Copyright 2006 The Society of Architectural Historians Article PDF first page preview Close Modal You do not currently have access to this content.

The Wilderness of Henry Bugbee

The concept of wilderness bears an unusual share of the philosophical burden assumed by Henry Bugbee in The Inward Morning. This ambi tious book in fact trades on two senses of wilderness, which, though certainly related, are by no means identical. On the one hand, Bugbee regularly appeals to a sense of wilderness that resonates familiarly with popular appreciations of the North American Western frontier. Readers are likely to find themselves very much at home in the wilderness set tings he so eloquently describes and in the yearnings for spiritual com munion they evoke. On the other hand, Bugbee also trades on a sense of wilderness that bespeaks a distinctly Eastern provenance and sensi bility. This sense of wilderness discloses reality as a depthless mystery, which calls to us and conveys the unresolved fluency of our existence. This latter sense of wilderness is likely to strike many readers as for eign, especially since Bugbee does not exclusively associate it with places and spaces that are typically recognized as wild. As we shall see, in fact, he does not restrict this latter sense of wilderness to any

Henry James and the Grammar of the Modern

Henry James and the Grammar of the Modern by Mary Cross, University of Delaware We move In literature through a world of different values and relations, a blest world In which we know nothing except by style, but In which also everything Is saved by It, and In which the Image Is thus always superior to the thing Itself. —Henry James Part I Syntax as Technology Ezra Pound once remarked that "only after a long struggle will poetry attain such a degree of development, or, If you will, modernity, that It will vitally concern people who are accustomed, In prose, to Henry James." As the antennae of the race, he said, artists like James point the way by their struggle "to create means of communication" which would "recognize differences, the right of differences to exist, and'the Interest In finding things different." Pound admired James for his "searching analysis of things," his "rich, banked-up perception," his "concern for mental temperatures." For Pound, James's "subtly graded atmospheres" were "his subject": "If one were advocate Instead of critic, one would definitely claim that these atmospheres, nuances, Impressions of personal tone and quality are his subject; that In these he gets certain things that almost no one else had done before him." "We find no trace," he continued, "of such degree of awareness ... until the novels of [Wyndhaml Lewis and Joyce." That awareness was born of a language and a style which made James, for Pound and Gertrude Stein and a I I the other writers seeking to reinvent the terms of reality between the two wars, "simply the great true recorder." As Gertrude herself remarked, "The others all stayed where they were. It was where they had come but Henry James knew he was on his way. ... And so although they did In a way the same thing, his had a future feeling and theirs an ending." "Poetry must be as well written as prose," said Pound, who spoke of his "Hugh Selwyn Mauberley" as "an attempt to condense a James novel." If Pound was learning his Henry James, so too were Proust and Joyce and Eliot and, eventually, Ernest Hemingway.' For James's modernity consists In just this, that he was able to devise a literary language which could truly record the "timbres and tonalities," the complex, subjective reality which was just then becoming the consciousness of a race of poets as It had already of painters. The lesson of the master for modern literatura was a style that worked like synecdoche to capture "multiple and multivalent reflections" of reality, to record In Its Intrlcate structures of language the density of psychological experience, and to give, by pattern and placement, by stress and repetition and fragmentation, a new awareness of the words upon the page, all apart from meaning.2 By a verbal artfulness which draws attention to the surface of the text, James's later style, In Its elaborately self-focusing design, foregrounds the language of literature. To the extent that It emphasizes syntax, word order and design, 1. "A Retrospect," In The Literary Essays of Ezra Pound, ed. T. S. Eliot (Norfolk, Conn.: New Directions, 1954), p. 9; Pound, "Henry James," In The Literary Essays of Ezra Pound, pp. 298, 324, 339; Stein, "What Is English Literature," Lectures In America (1935; reprint, Boston: Beacon Press, 1953), p. 52; Pound, Selected Letters, 1907-41, ed. D. D. Paige (New York, 1950), pp. 48-49, 180. 2. Erich Auerbach, Mimesis (1946; rpt., Princeton: Princeton UnIv. Press, 1953), p. 551. THEHENRYJAMESREVIEW 33 FALL, 1981 his language liberates itself from mere reference to portray meaning in terms of its own associative patterning; it becomes a kind of abstraction. For modernism may be seen as basically a syntax--or perhaps, asyntax—an arrangement of parts, whether words or paint or musical notes, which challenges our notions of order and connection. By juxtaposition rather than juncture, by confrontation rather than synthesis, by fragmentation rather than completion of the pattern, the modernist syntax reflects a new order of consciousness, a sensibil ity that comes through primarily as a way of seeing something, transforming what has already been seen in a new way. So the...