Improved Versions: Feminist Poetics and Recent Work by Ulla Hahn and Ursula Krechel

This essay analyzes how Ulla Hahn and Ursula Krechel in their recent poetry and essays have drawn a connection between feminism and their writing. The feminine/feminist outlook they advance is exemplary for their generation of women authors because they have sought to expand the poetic canon by interrogating assumptions made by modernism. A reappraisal of their poetry suggests that interpretations of their work must take account of the feminist poetics of these authors

Cold War Nature: Transforming German Poetry

This essay considers German ‘Naturlyrik’ in terms of factors contributing to the mid-century emergence of political ecopoetry and 21st-century post-pastoral register. Cold War aesthetic experimentation connected with environmental concerns as poets, anthologists, and scholars bridged ideological differences by acknowledging shared values in relation to nature and environment. Material ecocriticism theory provides insight into how during the Cold War the lyric genre became the first to reclaim nature as a place of refuge, then protested the specter of an uninhabitable world, and eventually responded to humanly shaped nature. Work by poets Hans-Jürgen Heise, Peter Huchel, Wulf Kirsten, Ulrike Almut Sandig, and others is discussed

Kaschnitz, Enzensberger, and Sandig: The Ecopoetics of Water Pollution

This ecocritical reading of Marie Luise Kaschnitz’s poetic cycle “Rückkehr nach Frankfurt” ‘Return to Frankfurt’ (1945/46), Hans Magnus Enzensberger’s epic poem Der Untergang der Titanic ‘The Sinking of the Titanic’ (1978), and a 21st-century poem by Ulrike Almut Sandig analyzes key shifts in poetic representations of water pollution. The essay explores underlying cultural and political attitudes about water that define literary depictions of its pollution. It argues that these texts register a conceptual turn away from aesthetic appreciation of water in terms of its culturally rich, purifying properties and toward scientific understanding that emphasizes the social and legal dimensions of water pollution. Ecocritical interpretation of such works, thus, enables deeper understanding of ongoing transformations in the lyric genre. The concluding interpretation of Sandig’s text points to the increasing presence of unnatural elements in representations of the environment as symptomatic of broader literary changes. It argues that developments in German nature poetry since 1945 have increasingly led poets to experiment with expressive possibilities for lyric poetry that foreground cathartic responses to human and environmental history

Borderless Flows in Federspiel’s Die Ballade Von Der Typhoid Mary

Jürg Federspiel’s novel Die Ballade von der Typhoid Mary (1982) offers a fictionalized account of the notorious heroine’s life that ultimately sympathizes with her plight as an immigrant who faced exclusionary cultural barriers. Drawing on Rob Nixon’s concept of “slow violence” and recent approaches developed by material ecocriticism theory, my essay reinterprets this work from an environmental humanities perspective. The interpretation focuses on the interconnection of discourses related to disease, food, and pollution flows. Exploration of these themes leads to the conclusion that Federspiel’s work was prescient in its parallel engagement with both immigration issues and the emerging environmental concerns of its time. Since global migration today is increasingly understood to have climate change as its proximate cause, the novel deserves renewed attention for the insights it offers into the intersection of environment, transnational mobility, and class divides. Beyond illustrating the social tensions present in America during the Gilded Age and in the 1980s, it presents perspectives on historical conditions that remain relevant to debates about migration today

Kaschnitz, Enzensberger, and Sandig: The Ecopoetics of Water Pollution

This ecocritical reading of Marie Luise Kaschnitz’s poetic cycle “Rückkehr nach Frankfurt” ‘Return to Frankfurt’ (1945/46), Hans Magnus Enzensberger’s epic poem Der Untergang der Titanic ‘ The Sinking of the Titanic ’ (1978), and a 21<sup>st</sup>-century poem by Ulrike Almut Sandig analyzes key shifts in poetic representations of water pollution. The essay explores underlying cultural and political attitudes about water that define literary depictions of its pollution. It argues that these texts register a conceptual turn away from aesthetic appreciation of water in terms of its culturally rich, purifying properties and toward scientific understanding that emphasizes the social and legal dimensions of water pollution. Ecocritical interpretation of such works, thus, enables deeper understanding of ongoing transformations in the lyric genre. The concluding interpretation of Sandig’s text points to the increasing presence of unnatural elements in representations of the environment as symptomatic of broader literary changes. It argues that developments in German nature poetry since 1945 have increasingly led poets to experiment with expressive possibilities for lyric poetry that foreground cathartic responses to human and environmental history

Physical activity on prescription for children with obesity: a focus group study exploring experiences in paediatric healthcare

BackgroundInsufficient physical activity is a growing public health concern and is closely linked to obesity in both adults and children. Swedish physical activity on prescription (PAP) is effective in increasing physical activity levels in adults, but knowledge about how PAP is used in paediatric healthcare is lacking. Therefore, this study aimed to explore experiences of working with PAP for children with obesity amongst paediatric staff and managers.MethodsSeven focus group discussions with 26 participants from paediatric outpatient clinics in western Sweden were conducted. Data were analysed both inductively and deductively, framed by the Normalization Process Theory's four core constructs: coherence, cognitive participation, collective action, and reflexive monitoring.ResultsThe PAP work for children with obesity was experienced to be about helping children to become physically active, and less about losing weight. Identified barriers for using PAP were the non-uniform nature of the work and a perceived lack of guidelines. Collaboration with physiotherapists and physical activity organisers outside the organisation was identified as an important facilitator. An important contextual factor for implementing PAP is the collaboration between paediatric clinics and physical activity organisers. In the transition between these stakeholders, maintaining a family-centred approach when working with PAP was experienced as challenging.ConclusionsPAP is a well-known intervention that is inconsistently used for children with obesity. The intervention should include a family-centred approach for this patient group. It also needs to align better with existing collaborations with other healthcare units as well as with new forms of collaboration with physical activity organisers in the community

Model-Informed Target Morning 17α-Hydroxyprogesterone Concentrations in Dried Blood Spots for Pediatric Congenital Adrenal Hyperplasia Patients

Monitoring cortisol replacement therapy in congenital adrenal hyperplasia (CAH) patients is vital to avoid serious adverse events such as adrenal crises due to cortisol underexposure or metabolic consequences due to cortisol overexposure. The less invasive dried blood spot (DBS) sampling is an advantageous alternative to traditional plasma sampling, especially in pediatric patients. However, target concentrations for important disease biomarkers such as 17α-hydroxyprogesterone (17-OHP) are unknown using DBS. Therefore, a modeling and simulation framework, including a pharmacokinetic/pharmacodynamic model linking plasma cortisol concentrations to DBS 17-OHP concentrations, was used to derive a target morning DBS 17-OHP concentration range of 2–8 nmol/L in pediatric CAH patients. Since either capillary or venous DBS sampling is becoming more common in the clinics, the clinical applicability of this work was shown by demonstrating the comparability of capillary and venous cortisol and 17-OHP concentrations collected by DBS sampling, using a Bland-Altman and Passing-Bablok analysis. The derived target morning DBS 17-OHP concentration range is a first step towards providing improved therapy monitoring using DBS sampling and adjusting hydrocortisone (synthetic cortisol) dosing in children with CAH. In the future, this framework can be used to assess further research questions, e.g., target replacement ranges for the entire day

Impaired immunity and high attack rates caused by SARS-CoV-2 variants among vaccinated long-term care facility residents

Introduction: Long-term care facilities (LTCF) residents are at high risk for severe coronavirus disease 2019 (COVID-19), and therefore, COVID-19 vaccinations were prioritized for residents and personnel in Finland at the beginning of 2021. Methods: We investigated COVID-19 outbreaks in two LTCFs, where residents were once or twice vaccinated. After the outbreaks we measured immunoglobulin G (IgG) antibodies to severe acute respiratory syndrome coronavirus 2 spike glycoprotein, neutralizing antibody (NAb) titers, and cell-mediated immunity markers from residents and healthcare workers (HCWs). Results: In LTFC-1, the outbreak was caused by an Alpha variant (B.1.1.7) and the attack rate (AR) among once vaccinated residents was 23%. In LTCF-2 the outbreak was caused by a Beta variant (B.1.351). Its AR was 47% although all residents had received their second dose 1 month before the outbreak. We observed that vaccination had induced lower IgG concentrations, NAb titers and cell-mediated immune responses in residents compared to HCWs. Only 1/8 residents had NAb to the Beta variant after two vaccine doses. Conclusions: The vaccinated elderly remain susceptible to breakthrough infections caused by Alpha and Beta variants. The weaker vaccine response in the elderly needs to be addressed in vaccination protocols, while new variants capable of evading vaccine-induced immunity continue to emerge.Peer reviewe

Multilaboratory Comparison of Pneumococcal Multiplex Immunoassays Used in lmmunosurveillance of Streptococcus pneumoniae across Europe

Surveillance studies are required to estimate the impact of pneumococcal vaccination in both children and the elderly across Europe. The World Health Organization (WHO) recommends use of enzyme immunoassays (EIAs) as standard methods for immune surveillance of pneumococcal antibodies. However, as levels of antibodies to multiple serotypes are monitored in thousands of samples, a need for a less laborious and more flexible method has evolved. Fluorescent-bead-based multiplex immunoassays (MIAs) are suitable for this purpose. An increasing number of public health and diagnostic laboratories use MIAs, although the method is not standardized and no international quality assessment scheme exists. The EU Pneumo Multiplex Assay Consortium was initiated in 2013 to advance harmonization of MIAs and to create an international quality assessment scheme. In a multilaboratory comparison organized by the consortium, agreement among nine laboratories that used their own optimized MIA was assessed on a panel of 15 reference sera for 13 pneumococcal serotypes with the new WHO standard 007sp. Agreement was assessed in terms of assay accuracy, reproducibility, repeatability, precision, and bias. The results indicate that the evaluated MIAs are robust and reproducible for measurement of vaccine-induced antibody responses. However, some serotype-specific variability in the results was observed in comparisons of polysaccharides from different sources and of different conjugation methods, especially for serotype 4. On the basis of the results, the consortium has contributed to the harmonization of MIA protocols to improve reliability of immune surveillance of Streptococcus pneumoniae

An original phylogenetic approach identified mitochondrial haplogroup T1a1 as inversely associated with breast cancer risk in BRCA2 mutation carriers

Introduction: Individuals carrying pathogenic mutations in the BRCA1 and BRCA2 genes have a high lifetime risk of breast cancer. BRCA1 and BRCA2 are involved in DNA double-strand break repair, DNA alterations that can be caused by exposure to reactive oxygen species, a main source of which are mitochondria. Mitochondrial genome variations affect electron transport chain efficiency and reactive oxygen species production. Individuals with different mitochondrial haplogroups differ in their metabolism and sensitivity to oxidative stress. Variability in mitochondrial genetic background can alter reactive oxygen species production, leading to cancer risk. In the present study, we tested the hypothesis that mitochondrial haplogroups modify breast cancer risk in BRCA1/2 mutation carriers. Methods: We genotyped 22,214 (11,421 affected, 10,793 unaffected) mutation carriers belonging to the Consortium of Investigators of Modifiers of BRCA1/2 for 129 mitochondrial polymorphisms using the iCOGS array. Haplogroup inference and association detection were performed using a phylogenetic approach. ALTree was applied to explore the reference mitochondrial evolutionary tree and detect subclades enriched in affected or unaffected individuals. Results: We discovered that subclade T1a1 was depleted in affected BRCA2 mutation carriers compared with the rest of clade T (hazard ratio (HR) = 0.55; 95% confidence interval (CI), 0.34 to 0.88; P = 0.01). Compared with the most frequent haplogroup in the general population (that is, H and T clades), the T1a1 haplogroup has a HR of 0.62 (95% CI, 0.40 to 0.95; P = 0.03). We also identified three potential susceptibility loci, including G13708A/rs28359178, which has demonstrated an inverse association with familial breast cancer risk. Conclusions: This study illustrates how original approaches such as the phylogeny-based method we used can empower classical molecular epidemiological studies aimed at identifying association or risk modification effects.Peer reviewe