Symposium: 19th Amendment at 100: Many Pathways to Suffrage, Other Than the 19th Amendment

When the Nineteenth Amendment to the U.S. Constitution appears in historical memory as the intended objective in the long march of woman suffragists, the complexity of changing voting rights is obscured. This essay looks at a variety of ways that women tried to break through the male monopoly of political power in the nineteenth and early twentieth centuries. In the earliest days of agitation, women took for granted that qualifications for voting were set solely by the states. Their earliest political pleas were made to state constitutional conventions. The last state victories were won in 1918. After the Civil War, the Fourteenth and Fifteenth Amendments opened a new road to votes for women by indicating a federal interest in who voted. Even then, a constitutional amendment was only one way to go. Attempts were made to win suffrage through the federal courts on grounds that citizenship and voting rights were coextensive, a route closed by the Supreme Court’s decision in Minor v. Happersett (1875). Virginia and Francis Minor, plaintiff and attorney in that case, were barely slowed by the adverse opinion. With their guidance, campaigns for federal suffrage got underway in 1891. Maybe a federal amendment was not required, maybe Congress could under Article I require by legislation that women must be considered eligible voters in any federal election. It was predicted that no state would retain its male-only restrictions if it meant running separate elections for state and federal offices. Among suffragists in the Jim Crow South, federal suffrage appealed because it limited the extent of federal interference in the disfranchisement of African Americans

Is There a Story in Those Notes?

Is there a story in those notes? Let me answer that in the affirmative. Drawing on the Selected Papers of Elizabeth Cady Stanton and Susan B. Anthony, I can tell you that there are many, many stories in those notes. But I should explain the question. Certainly there are stories behind the notes: the serendipitous moments of discovery, the slogging through barren sources, or the comeuppance when a research strategy proves terribly wrong. Stories behind the notes also encompass stories that are left behind, chipped off or sanded away as the editor trims her knowledge down to precisely the kernel needed to explicate the text. Stories in the notes are offered to the reader as aids in reading the texts well. Unlike the note that explicates an isolated reference or image, these notes weave and link together the edition\u27s various narratives to complement its plot. Arising from the text, they reflect the editor\u27s mastery of the documents and their context after it is filtered through the discipline of editing. While proofreading our third volume, I have been asking myself questions: what is it we do? why do we seem to have so many stories in our notes? are there patterns? why do our notes seem so bloody long even after I\u27ve whittled and whittled away at them? And those questions led me back to another puzzle I chewed on for awhile: how do historical editors get themselves caught between, on the one hand, the Jerry Georges of the world who say the NHPRC will not fund scholarship, and, on the other hand, colleagues who regard editions as not scholarly enough? I rephrased the questions: how do I use historical research in annotation? To find balance between editorial restraint and good historical research, we need to articulate (or confess) activity that sounds anything but restrained and consider not only the dichotomy of restraint and temptation but also the dichotomy between restraint and superficiality. It is quite easy to keep the annotation in check if the editors don\u27t know anything about their subject

Institutional development and poverty reduction

The persistence of poverty in sub-Saharan Africa cannot be attributed to a single cause; its roots are multiple, complex and inter-related. Institutions, as formal organizations, informal community groups and networks, or the rules and traditions that guide the actions which affect the lives of the poor, are influential, however. They may help preserve the status quo or they may be a powerful force for change – and their role is crucial in the implementation of poverty reduction programmes and policies. The focus of this paper is the development of organizations to enhance their capacity to include the rural poor

Critical appraisal of CRP measurement for the prediction of coronary heart disease events: new data and systematic review of 31 prospective cohorts.

BACKGROUND: Non-uniform reporting of relevant relationships and metrics hampers critical appraisal of the clinical utility of C-reactive protein (CRP) measurement for prediction of later coronary events. METHODS: We evaluated the predictive performance of CRP in the Northwick Park Heart Study (NPHS-II) and the Edinburgh Artery Study (EAS) comparing discrimination by area under the ROC curve (AUC), calibration and reclassification. We set the findings in the context of a systematic review of published studies comparing different available and imputed measures of prediction. Risk estimates per-quantile of CRP were pooled using a random effects model to infer the shape of the CRP-coronary event relationship. RESULTS: NPHS-II and EAS (3441 individuals, 309 coronary events): CRP alone provided modest discrimination for coronary heart disease (AUC 0.61 and 0.62 in NPHS-II and EAS, respectively) and only modest improvement in the discrimination of a Framingham-based risk score (FRS) (increment in AUC 0.04 and -0.01, respectively). Risk models based on FRS alone and FRS + CRP were both well calibrated and the net reclassification improvement (NRI) was 8.5% in NPHS-II and 8.8% in EAS with four risk categories, falling to 4.9% and 3.0% for 10-year coronary disease risk threshold of 15%. Systematic review (31 prospective studies 84 063 individuals, 11 252 coronary events): pooled inferred values for the AUC for CRP alone were 0.59 (0.57, 0.61), 0.59 (0.57, 0.61) and 0.57 (0.54, 0.61) for studies of 10 years follow up, respectively. Evidence from 13 studies (7201 cases) indicated that CRP did not consistently improve performance of the Framingham risk score when assessed by discrimination, with AUC increments in the range 0-0.15. Evidence from six studies (2430 cases) showed that CRP provided statistically significant but quantitatively small improvement in calibration of models based on established risk factors in some but not all studies. The wide overlap of CRP values among people who later suffered events and those who did not appeared to be explained by the consistently log-normal distribution of CRP and a graded continuous increment in coronary risk across the whole range of values without a threshold, such that a large proportion of events occurred among the many individuals with near average levels of CRP. CONCLUSIONS: CRP does not perform better than the Framingham risk equation for discrimination. The improvement in risk stratification or reclassification from addition of CRP to models based on established risk factors is small and inconsistent. Guidance on the clinical use of CRP measurement in the prediction of coronary events may require updating in light of this large comparative analysis

Rehabilitation Therapy in Older Acute Heart Failure Patients (REHAB-HF) trial: Design and rationale.

BACKGROUND: Acute decompensated heart failure (ADHF) is a leading cause of hospitalization in older persons in the United States. Reduced physical function and frailty are major determinants of adverse outcomes in older patients with hospitalized ADHF. However, these are not addressed by current heart failure (HF) management strategies and there has been little study of exercise training in older, frail HF patients with recent ADHF. HYPOTHESIS: Targeting physical frailty with a multi-domain structured physical rehabilitation intervention will improve physical function and reduce adverse outcomes among older patients experiencing a HF hospitalization. STUDY DESIGN: REHAB-HF is a multi-center clinical trial in which 360 patients ≥60 years hospitalized with ADHF will be randomized either to a novel 12-week multi-domain physical rehabilitation intervention or to attention control. The goal of the intervention is to improve balance, mobility, strength and endurance utilizing reproducible, targeted exercises administered by a multi-disciplinary team with specific milestones for progression. The primary study aim is to assess the efficacy of the REHAB-HF intervention on physical function measured by total Short Physical Performance Battery score. The secondary outcome is 6-month all-cause rehospitalization. Additional outcome measures include quality of life and costs. CONCLUSIONS: REHAB-HF is the first randomized trial of a physical function intervention in older patients with hospitalized ADHF designed to determine if addressing deficits in balance, mobility, strength and endurance improves physical function and reduces rehospitalizations. It will address key evidence gaps concerning the role of physical rehabilitation in the care of older patients, those with ADHF, frailty, and multiple comorbidities

The first NINDS/NIBIB consensus meeting to define neuropathological criteria for the diagnosis of chronic traumatic encephalopathy.

Chronic traumatic encephalopathy (CTE) is a neurodegeneration characterized by the abnormal accumulation of hyperphosphorylated tau protein within the brain. Like many other neurodegenerative conditions, at present, CTE can only be definitively diagnosed by post-mortem examination of brain tissue. As the first part of a series of consensus panels funded by the NINDS/NIBIB to define the neuropathological criteria for CTE, preliminary neuropathological criteria were used by 7 neuropathologists to blindly evaluate 25 cases of various tauopathies, including CTE, Alzheimer's disease, progressive supranuclear palsy, argyrophilic grain disease, corticobasal degeneration, primary age-related tauopathy, and parkinsonism dementia complex of Guam. The results demonstrated that there was good agreement among the neuropathologists who reviewed the cases (Cohen's kappa, 0.67) and even better agreement between reviewers and the diagnosis of CTE (Cohen's kappa, 0.78). Based on these results, the panel defined the pathognomonic lesion of CTE as an accumulation of abnormal hyperphosphorylated tau (p-tau) in neurons and astroglia distributed around small blood vessels at the depths of cortical sulci and in an irregular pattern. The group also defined supportive but non-specific p-tau-immunoreactive features of CTE as: pretangles and NFTs affecting superficial layers (layers II-III) of cerebral cortex; pretangles, NFTs or extracellular tangles in CA2 and pretangles and proximal dendritic swellings in CA4 of the hippocampus; neuronal and astrocytic aggregates in subcortical nuclei; thorn-shaped astrocytes at the glial limitans of the subpial and periventricular regions; and large grain-like and dot-like structures. Supportive non-p-tau pathologies include TDP-43 immunoreactive neuronal cytoplasmic inclusions and dot-like structures in the hippocampus, anteromedial temporal cortex and amygdala. The panel also recommended a minimum blocking and staining scheme for pathological evaluation and made recommendations for future study. This study provides the first step towards the development of validated neuropathological criteria for CTE and will pave the way towards future clinical and mechanistic studies

Widespread Hydrogenation of the Moons South Polar Cold Traps

The study shows widespread evidence that the Moons permanently shadowed regions (PSR) are enhanced in hydrogen, likely in the form of water ice, as compared to non-permanently shadowed region locations (non-PSRs), to 79deg S. Results are consistent with the original findings of Watson et al, 1961. We use a novel method to aggregate the hydrogen response from all PSR, greater than 2 km wide pixels. Poleward of 79deg S, the PSR have a consistent hydrogen spatial response, which is enhanced in PSR (where the PSRs area density is highest) and diminishes with distance from any PSR (where the PSR area density is lowest). A correlation between the PSRs diameters and their observed hydrogen, is induced by the instrumental blurring of relatively hydrogenated PSR areas. An anomalously enhanced hydrogen concentration observed at Cabeus-1 PSR suggests a second hydrogen budget process at that location. Linear correlations, derived from the PSRs hydrogen observations, from two independent latitude bands, closely predict the hydrogen observation at Shoemaker, the largest area PSR, 1) 75deg to 83deg S, 2) 83deg to 90deg S. Results are consistent with ongoing processes that introduce volatiles to the surface including outgassing, solar wind production with regolith silicates, and mixing from small-scale meteor impacts and diurnal temperature variation. Results are derived from the Collimated Sensor for EpiThermal Neutrons (CSETN), which part of the Lunar Exploration Neutron Detector (LEND), onboard the Lunar Reconnaissance Orbiter (LRO).Comment: 27 pages, 14 Figure

Does sticky blood predict a sticky end? Associations of blood viscosity, haematocrit and fibrinogen with mortality in the West of Scotland

There is increasing evidence that blood viscosity and its major determinants (haematocrit, plasma viscosity and fibrinogen) are associated with an increased risk of incident cardiovascular events; however, their associations with mortality are not established. We therefore studied the associations of these variables with cardiovascular events and total mortality in 1238 men and women aged 25-64 years, followed for 13 years in the first North Glasgow MONICA (MONItoring CArdiovascular disease) survey and West of Scotland centres in the Scottish Heart Health Study. After adjustment for age and sex, increasing whole blood viscosity, plasma viscosity, haematocrit and fibrinogen (analysed by both von Clauss and heat precipitation assays) were significantly associated with mortality. Only the association for fibrinogen (von Clauss assay) remained significant after adjustment for major cardiovascular risk factors. We conclude that clottable fibrinogen may be independently associated with mortality. However, the significance of this association, and the extent to which viscosity is associated with mortality, remain to be established in larger studies and meta-analyses