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"Buchanan, Roderick D"
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Darwin's \Mr. Arthrobalanus\: Sexual Differentiation, Evolutionary Destiny and the Expert Eye of the Beholder
Darwin's Cirripedia project was an exacting exercise in systematics, as well as an encrypted study of evolution in action. Darwin had a long-standing interest and expertise in marine invertebrates and their sexual arrangements. The surprising and revealing sexual differentiation he would uncover amongst barnacles represented an important step in his understanding of the origins of sexual reproduction. But it would prove difficult to reconcile these findings with his later theorizing. Moreover, the road to discovery was hardly straightforward. Darwin was both helped and hindered by the tacit expectations generated by his transformist theorizing, and had to overcome culturally-embedded assumptions about gender and reproductive roles. Significant observational backtracking was required to correct several oversights and misapprehensions, none more so than those relating to the chronically misunderstood \"Mr. Arthrobalanus.\" With careful attention to chronology, this paper highlights some curious and overlooked aspects of Darwin's epic project.
Journal Article
Darwin’s Delay
The suggestion that Darwin delayed publishing his species theory has long occupied a central part of his biographical storyline. The notion of a fretful delay reached a melodramatic apogee in Adrian Desmond and James Moore’s best-selling 1991 biography. Janet Browne’s acclaimed work downplayed the pathos but depicted a somewhat hesitant Darwin. In 2007 John van Wyhe upended this tableau, arguing that there was no evidence to support a secretive, fear-based delay. Contrary to van Wyhe, this essay suggests that Darwin was only selectively and strategically open about his belief in transmutation prior to his barnacle project. The 1844 appearance of the anonymously published Vestiges of the Natural History of Creation was one in a series of blows that prompted Darwin to reappraise the evidential requirements of his species theory. Nonetheless, much depends on how one interprets the barnacle project. Darwin’s decision to take on the whole group guaranteed its lengthy duration and effectively delayed his species work. The barnacle project could not be considered a necessary preparation, since it was not undertaken to address species theory problems. The evidence and insights Darwin gained from it were largely incidental and came after his decision to tackle the whole group. However, the credentialing motivations behind it were driven by field-generated self-doubts that are difficult to separate from fear. Darwin gained much-needed confidence from it and was far more open about his species theorizing afterward. The project helped Darwin become the authoritative figure he needed to be.
Journal Article
Epilogue: The Redux of Postmodernity
The essays in this topical issue illustrate the changing cultural form and function of the biopsyche disciplines – disciplines that are both sciences and technologies of selfhood. To varying degrees, each essay actively engages Paul Forman's thesis on modern and postmodern cultural valuations of science and technology. Forman invites those who read his work to view the cultural space framing science and technology in new ways (Forman 2007; idem 2010).
Journal Article
Ink Blots or Profile Plots: The Rorschach versus the MMPI as the Right Tool for a Science-Based Profession
When a strange new test of perceptual style called the Rorschach reached the New World in the 1920s, it became almost immediately popular. Developed as a psychoanalytic \"X ray\" of the psyche, it succeeded because American psychologists wanted and needed it to do so, and to do so as that kind of test. Over a decade later, the MMPI was constructed as a more orthodox personality inventory geared to traditional psychiatric categories. While this medical legacy was soon removed or obscured, success was more gradual. After the war, clinical psychologists adopted a professional identity independent of psychiatry. Their personality assessment tools, and what counted as success, came to reflect a reclaimed disciplinary genealogy. Standardized mappings and rule-by-numbers tended to displace a trust in experience and expert judgment. In this context, \"proper\" Rorschach use came to be seen as indulgent or sadly mistaken. Supporters of the MMPI were, in contrast, able to claim both science and efficiency on their side and colonized the field. The history of these tests clearly illustrates the process of co-production, of how the right tool can become very wrong as networks dissipate and professional time goes by.
Journal Article
The impact of non-alcoholic fatty liver disease and liver fibrosis on adverse clinical outcomes and mortality in patients with chronic kidney disease: a prospective cohort study using the UK Biobank
Background
Chronic kidney disease (CKD) and non-alcoholic fatty liver disease (NAFLD) frequently co-exist. We assess the impact of having NAFLD on adverse clinical outcomes and all-cause mortality for people with CKD.
Methods
A total of 18,073 UK Biobank participants identified to have CKD (eGFR < 60 ml/min/1.73 m
2
or albuminuria > 3 mg/mmol) were prospectively followed up by electronic linkage to hospital and death records. Cox-regression estimated the hazard ratios (HR) associated with having NAFLD (elevated hepatic steatosis index or ICD-code) and NAFLD fibrosis (elevated fibrosis-4 (FIB-4) score or NAFLD fibrosis score (NFS)) on cardiovascular events (CVE), progression to end-stage renal disease (ESRD) and all-cause mortality.
Results
56.2% of individuals with CKD had NAFLD at baseline, and 3.0% and 7.7% had NAFLD fibrosis according to a FIB-4 > 2.67 and NFS ≥ 0.676, respectively. The median follow-up was 13 years. In univariate analysis, NAFLD was associated with an increased risk of CVE (HR 1.49 [1.38–1.60]), all-cause mortality (HR 1.22 [1.14–1.31]) and ESRD (HR 1.26 [1.02–1.54]). Following multivariable adjustment, NAFLD remained an independent risk factor for CVE overall (HR 1.20 [1.11–1.30],
p
< 0.0001), but not ACM or ESRD. In univariate analysis, elevated NFS and FIB-4 scores were associated with increased risk of CVE (HR 2.42 [2.09–2.80] and 1.64 [1.30–2.08]) and all-cause mortality (HR 2.82 [2.48–3.21] and 1.82 [1.47–2.24]); the NFS score was also associated with ESRD (HR 5.15 [3.52–7.52]). Following full adjustment, the NFS remained associated with an increased incidence of CVE (HR 1.19 [1.01–1.40]) and all-cause mortality (HR 1.31 [1.13–1.52]).
Conclusions
In people with CKD, NAFLD is associated with an increased risk of CVE, and the NAFLD fibrosis score is associated with an elevated risk of CVE and worse survival.
Journal Article
Outcomes for Women With Ductal Carcinoma-in-Situ and a Positive Sentinel Node: A Multi-Institutional Audit
A positive sentinel lymph node (SLN) has been reported in 6% to 13% of patients with ductal carcinoma in situ (DCIS). Although it is well established that nodal status for invasive disease is prognostically important, the clinical relevance of a positive SLN in patients with DCIS remains undetermined.
SLN biopsy was performed on 470 high-risk patients with DCIS (22% of all patients with DCIS) at 3 institutions. Of these, 43 (9%) had SLN metastases. Pathology findings of positive cases were reviewed, and follow-up was obtained. At 2 of the 3 institutions, data were also collected on DCIS patients who had negative findings on SLN biopsy. For these 414 patients, univariate analyses of tumor characteristics were performed to identify factors associated with node positivity.
Extensive disease requiring mastectomy (p = 0.02) and the presence of necrosis (p = 0.04) were associated with an increased risk of nodal positivity. Three (7%) of the 43 SLN-positive patients had macrometastases (pN1), 4 (9%) had micrometastases (pN1mi), and 36 (84%) had single tumor cells or small clusters (pN0(i+)). Of the 25 women that underwent completion axillary dissection, one was found to have a macrometastasis. On pathological review of the primary lesion, 2 (5%) of 43 patints were found to have microinvasion, and 2 (5%) lymphovascular invasion. Nine of 43 (21%) high-risk DCIS patients with a positive SLN and 9/470 (2%) of all high-risk DCIS patients were upstaged to AJCC stage I or II as a result of the SLN biopsy. At a median (range) follow-up of 27 (3-88) months, 1 patient had developed hepatic metastases. This patient had immunohistochemistry detected isolated tumor cells in her SLN (N0(i+)), and upon pathologic review, was found to have high-grade DCIS with microinvasion.
SLN biopsy for high-risk DCIS patients is a mean of detecting those who may have unrecognized invasive disease and therefore are at risk for distant disease.
Journal Article