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إدورد سعيد : أماكن الفكر
هذا الكتاب يقدم صورة إدورد سعيد بكل أبعادها، ويكشف الزوايا العديدة لحياته وأعماله التي يجهلها أقرب المقربين له، إن تمثي برنن يعطينا فيه صورة رثائية مرهفة لشخصية من أبعد شخصيات القرن الماضي تأثيرا، كان إدورد سعيد شخصية محبوبة يختلف الناس بشأنها، وكان رائدا لدراسات ما بعد الاستعمار، وناقدا أدبيا واسع الثقافة لاتزال كتبه، ولاسيما کتاب «الاستشراق»، تترك أثرا بليغا في الطلبة والمفكرين في هذه الأيام، كان تمثي برنن تلميذا من تلاميذ سعيد، وبقي صديقا له حتى وفاته في العام 2003، وهو يعطينا في هذا الكتاب أول سيرة كاملة للمشرف على أطروحته، ذلك المشرف الذي يتبين لنا من هذا الكتاب أنه كان مدافعا عن التأثير الذي يتركه الأدب في السياسة والحياة المدنية، يتتبع الكتاب المسار الفكري الذي اتخذه سعید، ويستنتج أنه كان من المحطمين اللامعين للأصنام التقليدية : كان صاحب استراتيجية مخادعة، مفكرا من مفكري نيويورك، وكان يتردد على بيروت، ويعمل على ترتيب الحفلات الموسيقية في فايمار، ويبرع في سرد الحكايات على شاشة التلفزيون القومية، ويفاوض من أجل فلسطين في وزارة الخارجية الأمريكية، ويمثل في أفلام يؤدي فيها دوره في حياته.
BOOK
Fusobacterium nucleatum — symbiont, opportunist and oncobacterium
In this Review, Brennan and Garrett discuss the multifaceted associations of Fusobacterium nucleatum with its human host that range from symbiotic in oral biofilms to potential infectious pathogen at several sites and cancer-promoting member of the microbiota in the gut.
Journal Article
Randomized Trial of Four Financial-Incentive Programs for Smoking Cessation
In this randomized trial of financial incentives in smokers, both reward-based and deposit-based incentive programs were more effective than usual care in achieving smoking cessation. Reward programs were much more commonly accepted than deposit-based programs.
Financial incentives have been shown to promote a variety of health behaviors.
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For example, in a randomized, clinical trial involving 878 General Electric employees, a bundle of incentives worth $750 for smoking cessation nearly tripled quit rates, from 5.0% to 14.7%,
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and led to a program adapted by General Electric for its U.S. employees.
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Although incentive programs are increasingly used by governments, employers, and insurers to motivate changes in health behavior,
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their design is usually based on the traditional economic assumption that the size of the incentive determines its effectiveness. In contrast, behavioral economic theory suggests that incentives . . .
Journal Article
The underestimated role of myopia in uncorrectable visual impairment in the United States
We estimate the US prevalence of uncorrectable visual impairment in 2050 accounting for the changing distribution of both age and myopia. Age projections of the US population (from an estimated total of 379 million in 2050), were taken from the US census website. The distribution of myopia, by severity, was calculated from literature-derived prevalence estimates of 58.4% (≤ − 0.50 D, 2050 projection) and 33.1% (≤ − 1.00 D, 1999–2004 estimate) to provide predicted and conservative estimates, respectively. Uncorrectable visual impairment as a function of age and refractive error was modelled by multiple linear regression. Finally, the likely number of individuals in the US with visual impairment in 2050 was calculated. For a projected myopia prevalence of 58.4%, 222 million are projected to be myopic and 48 million will have high myopia (− 5 D or worse). The projected total number with uncorrectable visual impairment is 11.4 million of which 4.9 million cases (43%) of visual impairment will be directly attributed to increased risk of eye disease associated with myopia. For a projected myopia prevalence of 33.1%, 8.9 million are projected to have uncorrectable visual impairment of which 2.4 million cases (27%) will be directly attributed to myopia. It is predicted that between 27 and 43% of uncorrectable visual impairment in the US population in 2050 will be directly attributable to myopia. Failure to account for the increasing prevalence of myopia among the aging population leads to a substantial underestimate of the prevalence of visual impairment.
Journal Article
Gut microbiota induce IGF-1 and promote bone formation and growth
Appreciation of the role of the gut microbiome in regulating vertebrate metabolism has exploded recently. However, the effects of gut microbiota on skeletal growth and homeostasis have only recently begun to be explored. Here, we report that colonization of sexually mature germ-free (GF) mice with conventional specific pathogen-free (SPF) gut microbiota increases both bone formation and resorption, with the net effect of colonization varying with the duration of colonization. Although colonization of adult mice acutely reduces bone mass, in long-term colonized mice, an increase in bone formation and growth plate activity predominates, resulting in equalization of bone mass and increased longitudinal and radial bone growth. Serum levels of insulin-like growth factor 1 (IGF-1), a hormone with known actions on skeletal growth, are substantially increased in response to microbial colonization, with significant increases in liver and adipose tissue IGF-1 production. Antibiotic treatment of conventional mice, in contrast, decreases serum IGF-1 and inhibits bone formation. Supplementation of antibiotic-treated mice with short-chain fatty acids (SCFAs), products of microbial metabolism, restores IGF-1 and bone mass to levels seen in nonantibiotic-treated mice. Thus, SCFA production may be one mechanism by which microbiota increase serum IGF-1. Our study demonstrates that gut microbiota provide a net anabolic stimulus to the skeleton, which is likely mediated by IGF-1. Manipulation of the microbiome or its metabolites may afford opportunities to optimize bone health and growth.
Journal Article
The human gut bacterial genotoxin colibactin alkylates DNA
The bacterial toxin colibactin causes double-stranded DNA breaks and is associated with the occurrence of bacterially induced colorectal cancer in humans. However, isolation of colibactin is difficult, and its mode of action is poorly understood. Wilson et al. studied Escherichia coli that contain the biosynthetic gene island called pks , which is associated with colibactin production (see the Perspective by Bleich and Arthur). They identified the DNA adducts that resulted from incubating pks + E. coli in human cells. To overcome the lack of colibactin for direct analysis, mimics of the pks product were synthesized. From the resulting synthetic adenine-colibactin adducts, it became evident that alkylation via a cyclopropane “warhead” breaks the DNA strands. Similar DNA adducts were then identified in the gut epithelia of mice infected with pks + E. coli. Science , this issue p. eaar7785 ; see also p. 689 DNA adducts in cells and animals exposed to colibactin-producing gut microbes shed light on the mode of action of a cancer-linked genotoxin. Certain Escherichia coli strains residing in the human gut produce colibactin, a small-molecule genotoxin implicated in colorectal cancer pathogenesis. However, colibactin’s chemical structure and the molecular mechanism underlying its genotoxic effects have remained unknown for more than a decade. Here we combine an untargeted DNA adductomics approach with chemical synthesis to identify and characterize a covalent DNA modification from human cell lines treated with colibactin-producing E. coli . Our data establish that colibactin alkylates DNA with an unusual electrophilic cyclopropane. We show that this metabolite is formed in mice colonized by colibactin-producing E. coli and is likely derived from an initially formed, unstable colibactin-DNA adduct. Our findings reveal a potential biomarker for colibactin exposure and provide mechanistic insights into how a gut microbe may contribute to colorectal carcinogenesis.
Journal Article
The transformation of American health insurance : on the path to medicare for all
Can American health insurance survive?
In The Transformation of American Health Insurance, Troyen A. Brennan traces the historical evolution of public and private health insurance in the United States from the first Blue Cross plans in the late 1930s to reforms under the Biden administration. In analyzing this evolution, he finds long-term trends that form the basis for his central argument: that employer-sponsored insurance is becoming unsustainably expensive, and Medicare for All will emerge as the sole source of health insurance over the next two decades.
After thirty years of leadership in health care and academia, Brennan argues that Medicare for All could act as a single-payer program or become a government-regulated program of competing health plans, like today's Medicare Advantage. The choice between these two options will depend on how private insurers adapt and behave in today's changing health policy environment.
This critical evolution in the system of financing health care is important to employers, health insurance executives, government officials, and health care providers who are grappling with difficult strategic choices. It is equally important to all Americans as they face an inscrutable health insurance system and wonder what the future might hold for them regarding affordable coverage.
eBook
ACG Clinical Guideline: Diagnosis and Management of Biliary Strictures
A biliary stricture is an abnormal narrowing in the ductal drainage system of the liver that can result in clinically and physiologically relevant obstruction to the flow of bile. The most common and ominous etiology is malignancy, underscoring the importance of a high index of suspicion in the evaluation of this condition. The goals of care in patients with a biliary stricture are confirming or excluding malignancy (diagnosis) and reestablishing flow of bile to the duodenum (drainage); the approach to diagnosis and drainage varies according to anatomic location (extrahepatic vs perihilar). For extrahepatic strictures, endoscopic ultrasound-guided tissue acquisition is highly accurate and has become the diagnostic mainstay. In contrast, the diagnosis of perihilar strictures remains a challenge. Similarly, the drainage of extrahepatic strictures tends to be more straightforward and safer and less controversial than that of perihilar strictures. Recent evidence has provided some clarity in multiple important areas pertaining to biliary strictures, whereas several remaining controversies require additional research. The goal of this guideline is to provide practicing clinicians with the most evidence-based guidance on the approach to patients with extrahepatic and perihilar strictures, focusing on diagnosis and drainage.
Journal Article
Effect of egg white protein and soy protein isolate addition on nutritional properties and in-vitro digestibility of gluten-free pasta based on banana flour
The effects of egg white protein and soy protein isolate addition on the nutritional and digestibility of gluten-free pasta based on banana flour were studied. The level of protein additions (soy protein or egg white protein) were 0, 5, 10 and 15% of banana flour (w/w). Pasta made from 100% durum wheat semolina was used as a control. Soy protein isolate inclusion into banana pasta increased total phenolic content (TPC) and antioxidant capacities, while egg white protein decreased the TPC and antioxidant capacities with the increasing level of addition. Starch digestibility was affected by the type of protein addition. Egg white protein lowered starch digestibility compared to soy protein isolate. Protein inclusion in banana pasta also altered protein digestibility, amino acid profiles and protein digestibility-corrected amino acid score (PDCAAS). Soy protein isolate increased protein digestibility of gluten-free pasta compared to egg white protein. Protein enrichment gave better amino acid profiles of banana pasta compared to semolina pasta with egg white protein and performed a better PDCAAS compared to soy protein isolate. These results showed that soy protein isolate and egg white protein addition enhanced nutritional qualities and digestibility properties of gluten-free banana pasta.
Journal Article