Masks: The Face between Bodies and Networks

Over the past year with increasing intensity an image has occupied the faces featured across media. From the Australian forest fires to the ongoing Covid-19 epidemic, a visual production of emergency, disease, epidemic containment, and security is materialised in a particular piece of protection: the mask. From gas masks to surgical masks, the covered mouth and nose has become a sign of affected bodies. In this short piece we trace the presences and functions of the masks that permeate our contemporary moment as a key proxy of cultural politics centred on the body. The mask articulates tensions between self and other, public and private, identification and obfuscation, contact and containment, inhabitability and uninhabitability, as well as contagion and immunity. The bans against the covered face in Europe are now giving way, acknowledging the medical necessity of covering the face. The emergent political stance to protect breathing must be set against a longer duration of measures of protection and harm, of breathing and denial of breath in ways that amplifies Achille Mbembe’s recent point about the long history of attacking the respiratory tract, having constrained “entire segments of the world population, entire races, to a difficult, panting breath and life of oppression.”[1] Thus, this text argues that it is through contexts of immunity and air – breathability – that we come to understand the broader political stakes of the present as well as the histories in which the mask sits

A Media-Theoretical Armamentarium: From the Pharmakon to Pharmacologies of Media

This essay provides an introductory account of the concept of pharmakon and its uses in different traditions relevant to media theory. First, we chart existing media-theoretical uses of the pharmakon and the main points of reference in this body of work, such as Plato, Jacques Derrida and Bernard Stiegler. Second, we present the alternative genealogies of the pharmakon in reference to material, chemical and medical contexts. Taking the approach Galen developed to the pharmakon in the context of medical practice in Classical antiquity as its guide, this section presents an alternate history of the concept in order to illustrate how else it might be conceived and used. Finally, we introduce the contributions to this special issue which, as a whole, explicate a range of “pharmacologies” and “pharmacologics” available to media theory

Cardiovascular disease treatment among patients with severe mental illness: a data linkage study between primary and secondary care

Background Suboptimal treatment of cardiovascular diseases (CVD) among patients with severe mental illness (SMI) may contribute to physical health disparities. Aim To identify SMI characteristics associated with meeting CVD treatment and prevention guidelines. Design and setting Population-based electronic health record database linkage between primary care and the sole provider of secondary mental health care services in south east London, UK. Method Cardiovascular disease prevalence, risk factor recording, and Quality and Outcomes Framework (QOF) clinical target achievement were compared among 4056 primary care patients with SMI whose records were linked to secondary healthcare records and 270 669 patients without SMI who were not known to secondary care psychiatric services, using multivariate logistic regression modelling. Data available from secondary care records were then used to identify SMI characteristics associated with QOF clinical target achievement. Results Patients with SMI and with coronary heart disease and heart failure experienced reduced prescribing of beta blockers and angiotensin-converting enzyme inhibitor/angiotensin receptor blockers (ACEI/ARB). A diagnosis of schizophrenia, being identified with any indicator of risk or illness severity, and being prescribed with depot injectable antipsychotic medication was associated with the lowest likelihood of prescribing. Conclusion Linking primary and secondary care data allows the identification of patients with SMI most at risk of undertreatment for physical health problems

Development and evaluation of a de-identification procedure for a case register sourced from mental health electronic records

Background: Electronic health records (EHRs) provide enormous potential for health research but also present data governance challenges. Ensuring de-identification is a pre-requisite for use of EHR data without prior consent. The South London and Maudsley NHS Trust (SLaM), one of the largest secondary mental healthcare providers in Europe, has developed, from its EHRs, a de-identified psychiatric case register, the Clinical Record Interactive Search (CRIS), for secondary research. Methods: We describe development, implementation and evaluation of a bespoke de-identification algorithm used to create the register. It is designed to create dictionaries using patient identifiers (PIs) entered into dedicated source fields and then identify, match and mask them (with ZZZZZ) when they appear in medical texts. We deemed this approach would be effective, given high coverage of PI in the dedicated fields and the effectiveness of the masking combined with elements of a security model. We conducted two separate performance tests i) to test performance of the algorithm in masking individual true PIs entered in dedicated fields and then found in text (using 500 patient notes) and ii) to compare the performance of the CRIS pattern matching algorithm with a machine learning algorithm, called the MITRE Identification Scrubber Toolkit – MIST (using 70 patient notes – 50 notes to train, 20 notes to test on). We also report any incidences of potential breaches, defined by occurrences of 3 or more true or apparent PIs in the same patient’s notes (and in an additional set of longitudinal notes for 50 patients); and we consider the possibility of inferring information despite de-identification. Results: True PIs were masked with 98.8% precision and 97.6% recall. As anticipated, potential PIs did appear, owing to misspellings entered within the EHRs. We found one potential breach. In a separate performance test, with a different set of notes, CRIS yielded 100% precision and 88.5% recall, while MIST yielded a 95.1% and 78.1%, respectively. We discuss how we overcome the realistic possibility – albeit of low probability – of potential breaches through implementation of the security model. Conclusion: CRIS is a de-identified psychiatric database sourced from EHRs, which protects patient anonymity and maximises data available for research. CRIS demonstrates the advantage of combining an effective de-identification algorithm with a carefully designed security model. The paper advances much needed discussion of EHR de-identification – particularly in relation to criteria to assess de-identification, and considering the contexts of de-identified research databases when assessing the risk of breaches of confidential patient information

State-of-the-art three-dimensional analysis of soft tissue changes following Le Fort I maxillary advancement

We describe the comprehensive 3-dimensional analysis of facial changes after Le Fort I osteotomy and introduce a new tool for anthropometric analysis of the face. We studied the cone-beam computed tomograms of 33 patients taken one month before and 6-12 months after Le Fort I maxillary advancement with or without posterior vertical impaction. Use of a generic facial mesh for dense correspondence analysis of changes in the soft tissue showed a mean (SD) anteroposterior advancement of the maxilla of 5.9 (1.7) mm, and mean (SD) minimal anterior and posterior vertical maxillary impaction of 0.1 (1.7) mm and 0.6 (1.45) mm, respectively. It also showed distinctive forward and marked lateral expansion around the upper lip and nose, and pronounced upward movement of the alar curvature and columella. The nose was widened and the nostrils advanced. There was minimal forward change at the base of the nose (subnasale and alar base) but a noticeable upward movement at the nasal tip. Changes at the cheeks were minimal. Analysis showed widening of the midface and upper lip which, to our knowledge, has not been reported before. The nostrils were compressed and widened, and the lower lip shortened. Changes at the chin and lower lip were secondary to the limited maxillary impaction

The protective effect of ischemic preconditioning on rat testis

This is an Open Access article distributed under the terms of the Creative Commons Attribution Licens

Heme oxygenase-1 and carbon monoxide in pulmonary medicine

Heme oxygenase-1 (HO-1), an inducible stress protein, confers cytoprotection against oxidative stress in vitro and in vivo. In addition to its physiological role in heme degradation, HO-1 may influence a number of cellular processes, including growth, inflammation, and apoptosis. By virtue of anti-inflammatory effects, HO-1 limits tissue damage in response to proinflammatory stimuli and prevents allograft rejection after transplantation. The transcriptional upregulation of HO-1 responds to many agents, such as hypoxia, bacterial lipopolysaccharide, and reactive oxygen/nitrogen species. HO-1 and its constitutively expressed isozyme, heme oxygenase-2, catalyze the rate-limiting step in the conversion of heme to its metabolites, bilirubin IXα, ferrous iron, and carbon monoxide (CO). The mechanisms by which HO-1 provides protection most likely involve its enzymatic reaction products. Remarkably, administration of CO at low concentrations can substitute for HO-1 with respect to anti-inflammatory and anti-apoptotic effects, suggesting a role for CO as a key mediator of HO-1 function. Chronic, low-level, exogenous exposure to CO from cigarette smoking contributes to the importance of CO in pulmonary medicine. The implications of the HO-1/CO system in pulmonary diseases will be discussed in this review, with an emphasis on inflammatory states

Containing the Mask, Governing the Emergency:The Case of Turkey

The security bill that was proposed by the Justice and Development Party (AKP) government in 2014 has sparked controversy both within and outside the Parliament of Turkey. Yet, with AKP’s majority, the bill – which includes an anti-masking regulation for protests – was passed in spring 2015. In this article, first I demonstrate a partial mapping of the rhetoric employed by mainstream politics in Turkey, to underline that any oppositional political activity on the streets has the potential to be labeled a ‘terrorist’ one – and most have been. Then, by taking one of the most prominent examples of these events, the Gezi uprising, I discuss the affirmative biopolitical potentialities of the uses of masks that the law criminalizes. Lastly, I situate the law globally in relation to the protest movements, on the one hand, and anti-masking laws on the other. </jats:p

Evaluation of facial soft tissue changes and surgical outcome of orthognathic surgery

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