Lament as Transitional Justice

Works of human rights literature help to ground the formal rights system in an informal rights ethos. Writers have developed four major modes of human rights literature: protest, testimony, lament, and laughter. Through interpretations of poetry in Carolyn Forché’s anthology, Against Forgetting, and novels from Rwanda, the United States, and Bosnia, I focus on the mode of lament, the literature of mourning. Lament is a social and ritualized form, the purposes of which are congruent with the aims of transitional justice institutions. Both laments and truth commissions employ grieving narratives to help survivors of human rights trauma bequeath to the ghosts of the past the justice of a monument while renewing the survivors’ capacity for rebuilding civil society in the future. Human rights scholars need a broader, extra-juridical meaning for “transitional justice” if we hope to capture its power

Identification of genetic variants associated with Huntington's disease progression: a genome-wide association study

Background Huntington's disease is caused by a CAG repeat expansion in the huntingtin gene, HTT. Age at onset has been used as a quantitative phenotype in genetic analysis looking for Huntington's disease modifiers, but is hard to define and not always available. Therefore, we aimed to generate a novel measure of disease progression and to identify genetic markers associated with this progression measure. Methods We generated a progression score on the basis of principal component analysis of prospectively acquired longitudinal changes in motor, cognitive, and imaging measures in the 218 indivduals in the TRACK-HD cohort of Huntington's disease gene mutation carriers (data collected 2008–11). We generated a parallel progression score using data from 1773 previously genotyped participants from the European Huntington's Disease Network REGISTRY study of Huntington's disease mutation carriers (data collected 2003–13). We did a genome-wide association analyses in terms of progression for 216 TRACK-HD participants and 1773 REGISTRY participants, then a meta-analysis of these results was undertaken. Findings Longitudinal motor, cognitive, and imaging scores were correlated with each other in TRACK-HD participants, justifying use of a single, cross-domain measure of disease progression in both studies. The TRACK-HD and REGISTRY progression measures were correlated with each other (r=0·674), and with age at onset (TRACK-HD, r=0·315; REGISTRY, r=0·234). The meta-analysis of progression in TRACK-HD and REGISTRY gave a genome-wide significant signal (p=1·12 × 10−10) on chromosome 5 spanning three genes: MSH3, DHFR, and MTRNR2L2. The genes in this locus were associated with progression in TRACK-HD (MSH3 p=2·94 × 10−8 DHFR p=8·37 × 10−7 MTRNR2L2 p=2·15 × 10−9) and to a lesser extent in REGISTRY (MSH3 p=9·36 × 10−4 DHFR p=8·45 × 10−4 MTRNR2L2 p=1·20 × 10−3). The lead single nucleotide polymorphism (SNP) in TRACK-HD (rs557874766) was genome-wide significant in the meta-analysis (p=1·58 × 10−8), and encodes an aminoacid change (Pro67Ala) in MSH3. In TRACK-HD, each copy of the minor allele at this SNP was associated with a 0·4 units per year (95% CI 0·16–0·66) reduction in the rate of change of the Unified Huntington's Disease Rating Scale (UHDRS) Total Motor Score, and a reduction of 0·12 units per year (95% CI 0·06–0·18) in the rate of change of UHDRS Total Functional Capacity score. These associations remained significant after adjusting for age of onset. Interpretation The multidomain progression measure in TRACK-HD was associated with a functional variant that was genome-wide significant in our meta-analysis. The association in only 216 participants implies that the progression measure is a sensitive reflection of disease burden, that the effect size at this locus is large, or both. Knockout of Msh3 reduces somatic expansion in Huntington's disease mouse models, suggesting this mechanism as an area for future therapeutic investigation

A Comparative Study of the Block Characteristics of Spinal Bupivacaine Alone and Spinal Bupivacaine with Dexmedetomidine for Lower Abdominal Surgeries

Background: Spinal anaesthesia with a local anaesthetic alone is often associated with relatively short duration of action. This study investigated the effect of intrathecal dexmedetomidine on duration of spinal bupivacaine during lower abdominal surgeries.Patients and Method: Seventy two patients aged 18 - 55 years and ASA Class I or II scheduled for elective nonobstetric lower abdominal surgeries were recruited into the study. The patients were randomly allocated to receive spinal anaesthesia in sitting position using either 3ml of 0.5% hyperbaric bupivacaine plus 0.5ml sterile water (group B) or same dose of hyperbaric bupivacaine plus 0.5ml of 5ug dexmedetomidine (group D). The haemodynamic parameters, sensory and motor block characteristics, sedation scores and side effects during and immediately after the surgery were assessed and recorded. ·Results: The mean time to reach T7 sensory level and Bromage score 3 were significantly longer among group B patients (6'.2 ± 2.4 and 6.8 ± 4.8 minutes respectively) as compared to group D (3.6 ± 1.2 and 2.9 ± 1.0 minutes respectively); p<0.0001. Time to first request for analgesic in Group 8 and Group D was 210 ± 29.7 and 360.1± 31.0 minutes respectively, p<0.0001. For most of the study period, group D exhibited significantly lower mean blood pressures compared to group B. The differences in the occurrence of adverse etfects were not statistically signiticant in both groups.Conclusion: This study has shown that spinal anaesthesia using hyperbaric bupivacaine plus dexrnedetomid ine provided adequate and prolonged sensory and motor block than hyperbaric bupivacaine alone but it also resulted in lower blood pressure readings during most of the study periods.Key words: Dexmedetomidine, spinal anaesthesia, bupivacaine, lower abdominal surgerie