South Asian Research Articles

Identifying Barriers and Enablers to Cardiac Rehabilitation Participation and Completion Unique to South Asian Individuals: A Qualitative Systematic Review.

South Asian individuals living outside the Indian subcontinent are under-represented in cardiac rehabilitation (CR), despite facing higher rates of cardiac-related mortality and hospitalisations compared to White ethnic groups. Understanding how cultural differences affect CR participation and completion after referral requires the examination of barriers and enablers specific to South Asian populations. This review aims to summarise evidence on barriers and enablers to CR for South Asian minorities outside the Indian subcontinent. A systematic review of six databases (MEDLINE, CINAHL, APA PsycINFO, Cochrane, Scopus, and Web of Science) was conducted in January 2024 (updated November 2024), with no language or date limitations. Studies from countries outside the Indian subcontinent were included. Barriers and enablers were identified, followed by thematic analysis. Thirteen studies (n=384 South Asian participants) from the UK (n=10) and Canada (n=3) were included. Five key themes were generated: 1. communication and knowledge, 2. motivation to attend CR or follow medical advice, 3. religion, 4. program delivery, and 5. practical considerations. Key factors influencing CR participation included language barriers, family support, fatalistic beliefs, and motivation. Each theme encapsulates barriers and enablers and shapes participation at both service and patient level. While some barriers were common across different ethnic groups, they had stronger impact on South Asians due to distinct social determinants of health. Barriers and enablers are closely linked to cultural and societal norms. Recognising these factors enables CR services to better address the needs of underserved populations, ensuring equitable healthcare provision and support.

'I Have my Beliefs, but Then I Have my Reality': Reflections of Black and South Asian Parents Living in England on Screening and Genetic Diagnosis in Pregnancy.

Black and South Asian women in the UK face disproportionately worse pregnancy and maternal outcomes. Yet, they are underrepresented in research. Understanding their attitudes towards prenatal tests (screening tests and diagnostic genetic tests) is critical for offering equitable prenatal care. Focus groups examined attitudes towards prenatal testing amongst Black and South Asian parents. Discussions were analysed using reflexive thematic analysis. Twelve Black and 15 South Asian parents participated in four focus groups. Four themes were identified: 'The desire for information', 'The circle of trust', 'Faith and culture as navigators', and 'Knowledge and understanding of genetics'. Black and South Asian parents were open to prenatal screening tests, valuing the information about their baby's health. However, most opposed invasive testing because of the risks of harm to the baby. Wanting to be prepared, trust in healthcare, family influence and understanding of genetics shaped attitudes. Faith played a significant and varied role, with Muslim and Christian beliefs influencing decision-making. This study underscores the need for culturally respectful prenatal care and the importance of building trust between healthcare services and Black and South Asian communities. It also highlights the value of including people from underrepresented populations in research for supporting health equity.

Interactive and evolutionary effect of CASZ1 gene variants on varicose veins susceptibility in South Asian Indians

BackgroundVaricose veins (VV) are spectrum of common vascular diseases having complex genetic etiology. The Castor Zinc Finger 1 (CASZ1) gene has been involved in vascular development and its variant has shown association with VV in various ethnicities, but CASZ1 susceptibility to VV risk is unexplored in the South Asian Indian population. The objective of this study was to estimate the association of the CASZ1 gene variations and VV susceptibility in the South Asian Indians, and to examine the evolutionary patterns of these variants compared to other populations.MethodologyPopulation based case control analysis was conducted on all CASZ1 variants present in the Global Screening Array, including the established VV variant rs11121615 with a focus on validating and identification of both novel and established genetic markers to capture a full spectrum of population-specific genetic markers unique to studied population group. Linkage disequilibrium patterns and cumulative variant effects were also analyzed, followed by selection pressure assessment using neutrality tests.ResultsThree CASZ1 variants rs72860191 (OR 1.58, 95% CI 1.07–2.32, p = 0.01), rs7519604 (OR 1.43, 95% CI 1.05–1.94, p = 0.01), and rs11121615 (OR 0.69, 95% CI 0.50–0.95, p = 0.02) were observed to be significantly associated with VV. Haplotype analysis identified unique haplotype structure of South Asian Indians compared to other global populations. Moreover, the cumulative OR was observed to be higher than the independently estimated values (OR = 2.41, 95% CI 1.48–3.94), indicating genotypic epistasis of VV associated variants. The neutrality tests revealed balancing selection within CASZ1 in the studied population compared to other populations,ConclusionThe present study identified CASZ1 variants and their epistatic interactions is associated with VV susceptibility supported with evidence of balancing selection, provides crucial insights into the genetic architecture of VV in studied group, highlighting the impact of evolutionary forces on disease susceptibility.

Stunting and inequality in Sri Lanka compared to other Low- and middle-income South Asian countries.

This study investigates and measures whether the association of childhood stunting with household socioeconomic position (SEP) differs in Sri Lanka compared to other South Asian countries. Secondary analysis of data of children from the latest available DHS data (survey years, 2016-2018). The exposures (SEP) were maternal education and wealth. The outcome was stunting. Binary logistic regression models incorporated SEP, Country, and SEP-by-Country interaction terms. A nationally representative sample of children from Bangladesh, India, Nepal, Pakistan and Sri Lanka. Mothers/caregivers of children under 36 months (133,491). The prevalence of stunting in Sri Lanka of 19% was much lower than that observed for all the other low to low-middle income South Asian countries (37% in Bangladesh, 36% in India, 31% in Nepal, 30% in Pakistan). The association of SEP with odds of stunting was similar in Sri Lanka compared to other South Asian countries. The only exception was weaker associations of wealth with stunting in Sri Lanka compared to Bangladesh. For example, in Sri Lanka, the poorest group had 2.75 (2.06, 3.67) times higher odds of stunting compared to the richest group, but in Bangladesh, this estimate was 4.20 (3.24, 5.44); the difference between these two estimates being 0.65 (0.44, 0.96) on the odds ratio scale. The lower prevalence of stunting in Sri Lanka is unlikely to be due to less inequality. It is more likely that the lower prevalence of stunting in Sri Lanka is related to there being fewer mothers belonging to the lowest SEP groups.

What Is a Good Death in South Asia? A Systematic Review and Narrative Synthesis.

To deliver palliative care, it is important to understand what a "good death" means to the relevant people. Such studies have mostly occurred in high-income settings that usually live by Western ideals. What matters to people is likely to vary across different regions of the world, influenced by multiple factors. Although there is a great need for palliative care in South Asia, there is a lack of comprehensive understanding of what a good death means in this setting. This study aimed to increase understanding of what is considered a good death in South Asia. Systematic review and narrative synthesis. A systematic search was conducted across eight databases, an Advanced Google search, and a bibliography search of selected articles. A data-based convergent synthesis was performed, along with quality appraisal. Twenty-five empirical studies were selected for analysis from India, Pakistan, Bangladesh, Sri Lanka, and Bhutan. Four themes emerged. Mutual care and connection support a continued sense of self: contributing to others, while receiving connection through relationships and spiritual practices, was important for patients and supported by families and healthcare workers. Freedom to choose-privilege or burden?: the choice to participate in care was necessary for some patients but a burden for others, who preferred the family to lead their care. Severe uncontrolled pain and financial distress precluded choice for some patients, who felt death was the only option. Decisions regarding artificial prolongation of life were complex for patients and healthcare workers. Opportunities in the last days: when actively dying, there was general agreement on the importance of being pain-free, feeling safe, and having family present. Home was not always the preferred place of death. For family, it was critical to perform last rites. After death matters: What happens after death-influenced by leaving a legacy and religious beliefs-affected all parties before, during, and post-death. To our knowledge, this is the first review of what a good death means in South Asia. There is a dearth of research from most South Asian countries. Although the South Asian perspective has similarities with the Western perspective, we note important nuances around decision-making, prolongation of life, prognostic awareness, and wanting to end one's life, moderated by culture, religion, and poverty. We support policies that account for these variations. Ongoing work is required to provide good symptom management, thus increasing opportunities for patient participation in care. Further research is needed in areas of ethics and religion at the end of life in South Asia.

The feasibility of culturally adapted computerised cognitive remediation for first-episode psychosis.

British South Asians have a greater incidence of psychotic illness, which is associated with cognitive deficits. Computerised cognitive remediation aims to improve cognition. We aimed to culturally adapt computerised cognitive remediation for British South Asians with first-episode psychosis, and assess its feasibility. Qualitative interviews were analysed using thematic analysis to guide cultural adaptation of cognitive remediation, followed by a case series to determine feasibility. Our sample comprised 20 participants: ten in the qualitative interviews and ten in the feasibility evaluation. The sample was generated via purposive sampling from early intervention services in England, and was an entirely Muslim cohort, who were mainly Pakistani and born in the UK. Our intervention was computerised interactive remediation of cognition training for schizophrenia (CIRCuiTS), which was culturally adapted based on formative qualitative interviews and using an established framework. Participants engaged with 40 h of tasks over 12 weeks, with the aim of improving attention, memory and executive functioning. Feasibility was explored by assessing acceptability, engagement and retention in the study, and a range of measures were used to assess impact on cognition and mental state. The cultural adaptation of CIRCuiTS was found to be acceptable, with high levels of engagement and satisfaction. Despite the small sample, the intervention led to improved cognition and mental state. This is the first study to culturally adapt computerised cognitive remediation for British South Asians who are Muslim, and it had high acceptability with good retention, engagement and satisfaction. Future effectiveness testing is recommended.

Strategic Importance of Small South Asian States- Revisiting Pakistan’s Regional Approach

This article examines the growing strategic significance of small South Asian states including Sri Lanka, Nepal, Bhutan and Maldives in the backdrop of Sino-Indian competition for influence over these states. It is argued that the small states of South Asia have attained autonomy by not formally joining any balancing efforts by India or China, while at the same time these states are receiving economic benefits from both sides. It also argues that Pakistan remains the least integrated country of South Asia due to its inward looking and India centric approach towards the region. Therefore, this article proposes that as stated in National Security Policy of Pakistan (NSP), Pakistan needs to shift its diplomatic focus from geopolitics to geo-economics in South Asia. This could be achieved if Pakistan re-evaluates its regional approach by increasing engagement with the small South Asian states. Moreover, the article also conducts an in-depth analysis of Pakistan’s historical and current relationship with each of the stated small states of South Asia and identifies potential areas of cooperation. Findings of this paper suggest that Pakistan can bolster its diplomatic, economic, and political position in the region by enhancing cooperation with the smaller states of South Asia. The paper also recommends policy measures for Pakistan that could help achieve increased trade and cooperation with the small states of South Asia.

Work, Motherhood, and Nutrition: Investigating the Association of Maternal Employment on Child Nutritional Status in South Asia—A Systematic Review

Background/Objectives: Malnutrition in children is a challenge in South Asian countries, and understanding its relation with variety of social and economic conditions is imperative. The present systematic review examined the association between maternal employment and the nutritional status of children up to twelve years old from South Asia. Methods: An electronic search for research articles published in the English language between January 2011 and December 2024 was conducted in PubMed, Science Direct, and Web of Science databases. Results: A total of 10,247 articles from five South Asian countries were screened, resulting in the inclusion of 19 studies in the review based on well-defined inclusion and exclusion criteria. The findings showed that the association between maternal employment and children’s nutritional status was context-dependent, with adverse effects in children (stunting, wasting, and growth failure) when mothers worked in unskilled sectors—in low-paying jobs. Children of urban mothers had poor nutritional status, often exacerbated by the lack of or limited childcare support and financial assistance during their work absences. Additionally, many South Asian countries implemented maternal and paternal leave policies and benefits; however, the implementation challenges reduced maternal access to these benefits and predominantly favored mothers working in formal sectors. Conclusions: This systematic review underscores the necessity to strengthen the employment benefit programs for working women in South Asian countries, especially for mothers working in informal sectors. The provision of childcare assistance and supplementary financial benefits to women employed in informal sectors is essential to improve the child nutritional outcomes.

Sustainable Personalized Home Care for Pandemic Management: A Service-Oriented Approach

The COVID-19 pandemic has shown us how a viral disease originating in one part of the world rapidly spread the entire globe in just a few weeks, causing a complete shutdown of socio-economic activities in almost all countries. We have seen that during vaccine unavailability, social distancing, rigorous contact tracing, and case isolation are found to be the most effective strategies to contain the disease outbreak. For effective management of home-based isolation, patient care should not be limited to the illness but should also take into account other factors that are related to the needs and sustenance of patients and their dependents. In this paper, we first present retrospective case studies of South Asian countries, discuss the strategies and technological interventions employed to fight the pandemic, and underscore the significant issues that persist and require action. Second, building upon the insights from these case studies, we propose an integrated service-oriented system that supports seamless interfacing and information sharing with the functional systems of service providers/ caregivers to develop, manage, and monitor care plans for patients undergoing home isolation. The viability of our proposed framework is demonstrated by providing a proof-of-concept implementation. Further, we discuss the technical issues and policy considerations for practical and sustainable deployment of such system(s).

Brampton, Browntown, or Bramladesh? A Critique of the Hate Speech Used Against Racialized Spaces in Canada

This study investigates the online hate narratives around South Asian citizens in Canada. The value of this research is that it challenges the perception of Canadian multiculturalism and by addressing the reality of multiculturalism, it reveals the racial hierarchical structure within ‘equal’ multicultural state like Canada. In this study we connect early 20th century history of recently arrived South Asian migrants to British Columbia to the literature of white nationalism and white fantasy, the myths of multiculturalism and the racist nature of online platforms to expose a shift towards the perspective and acceptance of South Asian people in Canada. Here, the study compiles 120 comments identified as hate speech and organized the comments into categories of general South Asian hate, specific Punjabi hate, specific Indian hate, commentary on social space, insult towards linguistic abilities and claims advocating for deportation from Canada and when relevant, the comments are categorized into subcategories of ‘Becoming India’, white replacement theory and loss of Canadian culture. The results of this coding showcase that the most prevalent narrative found in the YouTube comments were commentary on social space and more precisely commentary on white replacement theory. The implication of this dominant narrative is that it signals to a growing resistance to racialized spaces in Canada. This implication allows for the argument that online platforms such as YouTube should be viewed as an extension to the body of the dominant white nationalist structure in colonial society because these platforms are able to encourage and sustain a white fantasy and white power structures through the platforms structural racist nature that encourage the growth of hate narratives online.

The genetic footprint of the European Roma diaspora: evidence from the Balkans to the Iberian Peninsula

Abstract The Roma people have a complex demographic history shaped by their recent dispersal from a South Asian origin into Europe, accompanied by continuous population bottlenecks and gene flow. After settling in the Balkans around 1,000 years ago, the Roma gradually dispersed across Europe, and approximately 500 years ago, they established in the Iberian Peninsula what is now one of the largest Roma populations in Western Europe. Focusing specifically on the Iberian Roma, we conducted the most comprehensive genome-wide analysis of European Roma populations to date. Using allele frequency and haplotype-based methods, we analysed 181 individuals to investigate their genetic diversity, social dynamics, and migration histories at both continental and local scales. Our findings demonstrate significant gene flow from populations encountered during the Roma’s dispersal and confirm their South Asian origins. We show that, between the 14th and 19th centuries, the Roma spread westward from the Balkans in various waves, with multiple admixture events. Furthermore, our findings refute previous hypotheses of a North African dispersal route into Iberia and genetic connections to Jewish populations. The Iberian Roma exhibit ten times greater genetic differentiation compared to non-Roma Iberians, indicating significant regional substructure. Additionally, we provide the first genetic evidence of assortative mating within Roma groups, highlighting distinct mating patterns and suggesting a gradual shift towards increased integration with non-Roma individuals. This study significantly enhances our understanding of how demographic history and complex genetic structure have shaped the genetic diversity of Roma populations, while also highlighting the influence of their evolving social dynamics.

Demographic, socioeconomic and regional disparities in the coverage of water, sanitation and hygiene facilities in four South Asian Countries.

Ensuring an adequate water, sanitation, and hygiene (WASH) is crucial for upholding public health and achieving Sustainable Development Goals (SDG-6). The main goal of this study was to review the existing WASH facilities, mapping for regional comparisons, and identify the significant socioeconomic and demographic factors associated with WASH facilities in Afghanistan, Bangladesh, Nepal, and Pakistan. This study employed a quantitative research design using the most recent Multiple Indicator Cluster Survey (MICS) data from Afghanistan (2022-23, n = 23,213), Bangladesh (2019, n = 61,242), Nepal (2019, n = 12,655), and Pakistan (2017-19, n = 96,105). Data analysis was done using descriptive statistics and multivariate logistic regression model. Besides, spatial mapping was used for regional comparison, the Generalized Variance Inflation Factor (GVIF) was applied for checking multicollinearity, and the Receiver Operating Characteristic (ROC) curve was used to evaluate model performance. This study revealed substantial disparities in the coverage of WASH facilities across four countries. Nepal had the highest coverage (75.33%), followed by Pakistan (59.47%), Bangladesh (50.28%) and Afghanistan (33.54%). Wealthier households were associated with higher odds of WASH facilities compared to the poor: Afghanistan (aOR = 7.83; 95% CI: 6.58-9.32; p < 0.001), Bangladesh (aOR = 5.75; 95% CI: 5.34-6.20; p < 0.001), Nepal (aOR = 5.80; 95% CI: 4.52-7.44; p < 0.001), and Pakistan (aOR = 9.64; 95% CI: 8.79-10.58; p < 0.001). In addition, place of residence, education of household head, access to the media, age of household head, and family size emerged as significant determinants of WASH facilities across all four countries. The findings suggest that wealthier households, those with educated heads, and those in urban areas have higher coverage of WASH facilities. To ensure adequate WASH facilities, policymakers should focus on rural areas, lower-income groups, less educated household heads, and should conduct awareness campaigns.

Ideally, the biryani that brings us all together

This Exposition is a brief ironic comment on the ongoing degradation, commodification, and colonisation of food and its many dimensions — recipes, ingredients, context — and a reflection on the territorial definitions that shape identity, in this case of South Asians and the Global South, once bound together as a people and still united in the brieftopian world of the Author’s Greatest Biryani: an amalgamative dish of political and cultural reproductions, drenched in time, where old and new contest identity. Through a conversational, autoethnographic lens, the exposition blends historical, colonial, and territorial reflections, using Biryani as both departure point and metaphor for shared identity and dislocation. Visual collages — archival, familial, and sourced — act as probes connecting memory, culture, and belonging. Ultimately, the work offers the Author’s Greatest Biryani as a living document of generational knowledge and a utopian gesture, inviting both insiders and outsiders to gather around a dish transcending borders and time. keywords: food, food studies, recipes, food as appropriation, food design, colonialism, colonial memory, memory practice, archives, Archival Research, Indian Subcontinent, Biryani

Unveiling the nexus of shadow economy and economic growth through the lens of Hofstede’s cultural dimensions: a case of emerging nations

The present study seeks to investigate the impact of the shadow economy on the economic growth of the South Asian countries. Additionally, the study also explores the moderating influence of Hofstede’s national culture dimensions on the shadow economy-economy growth nexus. In order to achieve the aforementioned objectives, the study employs robust econometric tools based on panel data from South Asian countries. The empirical estimate indicates that the shadow economy has a negative influence on the economic growth of the South Asian countries. Moreover, the study further reveals that power distance, masculinity, and uncertainty avoidance have a negative impact on economic growth, while individualism and long-term orientation positively influence the economic growth of South Asian countries. Furthermore, in context to the moderating variables, the study reveals that cultural dimensions such as power distance, masculinity, and uncertainty avoidance exacerbate the negative impact of the shadow economy on economic growth, while individualism and long-term orientation help moderate this negative impact. Finally, the Dumitrescu and Hurlin panel causality test reveals bidirectional causality between the shadow economy and economic growth and unidirectional causality between cultural factors, economic growth, and the shadow economy. The study assists to comprehend how cultural factors affect the relationship between the shadow economy and economic growth and offer several policy recommendations.

Linkage between Southeast and South Asian Summer Monsoons: Relative Roles of the Pacific–Japan Pattern and El Niño–Southern Oscillation

Abstract The various regional summer monsoons over Asia have been known to be highly interactive, but their interrelationships are still under debate. The current study investigates the linkage between the South Asian summer monsoon (SASM) and the Southeast Asian summer monsoon (SEASM) and the involved physical mechanisms. A robust positive correlation is found between the first empirical orthogonal function (EOF) modes of SASM and SEASM precipitations. However, asymmetric features emerge between the mutually enhanced (ME) and mutually weakened (MW) SEASM–SASM cases. Apparent Pacific–Japan pattern occurs in the ME SEASM–SASM cases under a relatively weak sea surface temperature (SST) background, causing a southwest–northeast precipitation dipole with a positive center over the northern Bay of Bengal and a negative center over the eastern Arabian Sea and southern India induced by westerly anomalies with anticyclonic curvature associated with the anomalous heating over the tropical western North Pacific and cooling over the Maritime Continent. While in the MW SEASM–SASM cases, the El Niño–Southern Oscillation–related SST anomalies (i.e., a transition from the equatorial eastern Pacific warming in winter to cooling in summer) are substantial, which cause simultaneous weakening of the first modes of SEASM and SASM through anomalous western North Pacific anticyclone induced by the Pacific SST anomalies and the capacitor effects of other tropical oceans. In addition, intensified diabatic heating over the Maritime Continent driven by the anomalous zonal circulation related to the eastern Pacific cooling can enhance the precipitation over the eastern Arabian Sea and southern India via the westward-propagating Rossby wave. Significance Statement The South Asian summer monsoon (SASM) and the Southeast Asian summer monsoon (SEASM) can be independent from each other at one time but interactive with each other at another time. However, many features of their relationship remain unclear. This study is aimed at better understanding their linkage and the involved physical mechanisms. A robust positive correlation exists between the first modes of SASM and SEASM precipitations, but asymmetric features emerge between the mutually enhanced (ME) and mutually weakened (MW) SEASM–SASM cases. The Pacific–Japan pattern and El Niño–Southern Oscillation play a relatively important role in the ME and MW situations, respectively. A better understanding of the SEASM–SASM linkage can provide useful theoretical basis for improving seasonal prediction of Asian summer climate.

Poetry of the depressed or symphony of hope: South Asian poetry on COVID-19

ABSTRACT Covid-19 ensued in a planetary precarity that surpassed all types of existing precarities. During these precarious times, poetry became a representative literary genre because of the outpouring of pandemic-related poetry [Dera, J. (2021). Evaluating poetry on COVID-19: Attitudes of poetry readers toward corona poems. Journal of Poetry Therapy, 34(2), 77–94] for the immediacy of expression as well as poetry’s power to heal through a flight of imagination. South Asian poets also expressed their feelings about the paranoia and trauma caused by the uncanny times. This paper explores how South Asian poets responded to the pandemic precarity by analyzing their poems published in the Poetry and Covid Anthology. Whether most of them felt depressed or new vistas of imagination rendered hope through creativity is explored through the interplay of precarity and hope motifs. The diversity (if any) in the treatment of the pandemic, both thematic and stylistic, due to regional and cultural variations, has also been hyphenated. The study concludes that poetry acts as a catalyst for recuperating hope for South Asian poets confronted with unyielding despair promoted by the pandemic precarity.

Tropical Futurisms: Thinking Futures

Tropical Futurisms situates the reading of futures in the shared yet multiple modalities of this geo-climatic zone, acknowledging the social and political complexities, technological engagements, multispecies vitalities, and cosmological plurality within tropical regions. This first part of the double Special Issue emphasizes the diversity that comes from thinking about futures by positioning them back in material ecological experiences in this time of escalating climate crisis. This issue seeks solidarity in the tropics via imagining the future together in plural forms. This praxis of tropical futurisms encompasses envisioning decolonial tropics not only by archiving the past-future but also by rebuilding worlds, including Indigenous and multispecies knowledge and experience that is conventionally not seen as belonging to the future. Considering the vibrancy of Indigenous, Caribbean and Latin American, Afro and African, South Asian, Southeast Asian, Pacific and Tropical Australian futures, we are also interested in the ways they intersect in the tropics creating new rich and complex forms of theorizing and storytelling.

“I began to think more like a Canadian”: how second-generation south Asian and Chinese Canadians confront racism by becoming conservative voters

ABSTRACT This study demonstrates how voting for a right-wing party that represents the interests of white, wealthy citizens can be a way for second-generation South Asian and Chinese Canadians to seek acceptance in a society where power is linked to race. Drawing on 50 in-depth interviews with the children of immigrants, I show how white-adjacent groups contending with the model minority stereotype may support right-wing politics in an effort to embody the traits and behaviours of the privileged. Paradoxically, then, excluded groups may seek inclusion not by favouring but by rejecting inclusionary political platforms because this rejection signals proximity to whiteness and, concomitantly, distance from racialized foreignness. The study thus illustrates a powerful mechanism contributing to the political reproduction of inequality.

Dystopian Mumbai: Futurism in Varun Thomas Mathew’s The Black Dwarves of the Good Little Bay

Dystopian science fiction narratives often serve as a powerful medium for imagining the post-apocalyptic scenarios of contemporary socio-political realities. In the context of South Asia, the intersection of multinational capitalism and corrupt politics within a dystopian setting provides a poignant commentary on the region’s vulnerabilities and systemic injustices. Varun Thomas Mathew’s The Black Dwarves of the Good Little Bay (2019) is set in the year 2041, where the tropical city of Mumbai is seen to be recuperating in the aftermath of a massive flood that has led to the rehabilitation of its city-dwellers into ‘Bombadrome’, a towering structure developed by the state-corporate alliance. This paper situates the novel within the framework of South Asian Futurisms, exploring how colonial histories and environmental precarity shape dystopian imaginaries of this tropical region. The book presents a cityscape that becomes a contested space for extrapolating and interrogating narratives of past(s) and future(s), a recurring theme in contemporary speculative fiction. This paper focuses on representations of environmental change and techno-capitalist ideologies that emerge as recent Anglophone Indian literature takes a dystopic turn. The reading explores new thematic possibilities within dystopian literature, positioning Mathew’s novel within a broader discourse on tropical speculative fiction.

Genetic and Demographic Determinants of Fuchs Endothelial Corneal Dystrophy Risk and Severity

Understanding the pathogenic mechanisms of Fuchs endothelial corneal dystrophy (FECD) could contribute to developing gene-targeted therapies. To investigate associations between demographic data and age at first keratoplasty in a genetically refined FECD cohort. This retrospective cohort study recruited 894 individuals with FECD at Moorfields Eye Hospital (London) and General University Hospital (Prague) from September 2009 to July 2023. Ancestry was inferred from genome-wide single nucleotide polymorphism array data. CTG18.1 status was determined by short tandem repeat and/or triplet-primed polymerase chain reaction. One or more expanded alleles (≥50 repeats) were classified as expansion-positive (Exp+). Expansion-negative (Exp-) cases were exome sequenced. Association between variants in FECD-associated genes, demographic data, and age at first keratoplasty. Within the total cohort (n = 894), 77.3% of patients were Exp+. Most European (668 of 829 [80.6%]) and South Asian (14 of 22 [63.6%]) patients were Exp+. The percentage of female patients was higher (151 [74.4%]) in the Exp- cohort compared to the Exp+ cohort (395 [57.2%]; difference, 17.2%; 95% CI, 10.1%-24.3%; P < .001). The median (IQR) age at first keratoplasty of the Exp + patients (68.2 years [63.2-73.6]) was older than the Exp- patients (61.3 years [52.6-70.4]; difference, 6.5 years; 95% CI, 3.4-9.7; P < .001). The CTG18.1 repeat length of the largest expanded allele within the Exp+ group was inversely correlated with the age at first keratoplasty (β, -0.087; 95% CI, -0.162 to -0.012; P = .02). The ratio of biallelic to monoallelic expanded alleles was higher in the FECD cohort (1:14) compared to an unaffected control group (1:94; P < .001), indicating that 2 Exp+ alleles were associated with increased disease penetrance compared with 1 expansion. Potentially pathogenic variants (minor allele frequency, <0.01; combined annotation dependent depletion, >15) were only identified in FECD-associated genes in 13 Exp- individuals (10.1%). In this multicenter cohort study among individuals with FECD, CTG18.1 expansions were present in most European and South Asian patients, while CTG18.1 repeat length and zygosity status were associated with modifications in disease severity and penetrance. Known disease-associated genes accounted for only a minority of Exp- cases, with unknown risk factors associated with disease in the rest of this subgroup. These data may have implications for future FECD gene-targeted therapy development.