The nuclear imperialism-necropolitics nexus: contextualizing Chinese-Uyghur oppression in our nuclear age

This paper provides a review of the People’s Republic of China’s (PRC) nuclear warfare and uranium mining programs in the Xinjiang Uyghur Autonomous Region. Its scope spans from the PRC’s first nuclear weapon test in Lop Nor, to contemporary issues surrounding in-situ leach uranium mining in the Yili basin, which now provides a third of PRC’s uranium. By exploring these scenarios, a lens can be placed on the parameters and limitations to Uyghur life within a nuclear state. This paper draws on the work of Achille Mbembe’s necropolitics, whereby power is persistently exercised as violence, to consider the entangled aftermath of nuclear imperialism and its effects to Uyghur bodies, environment and culture. While racialized nuclear imperialism presented Uyghur lives as inconsequential to progress in Xinjiang, post-Cold War necropolitics presents Uyghur culture as a direct threat to the progress and values of the PRC sovereign state. This paper proposes that the ongoing exploitation of nuclear Xinjiang provides an additional motivation for state-imposed necropolitical sanctions upon Uyghur people. This paper also presents anew theoretical contribution, the “nuclear imperialism-necropolitics nexus”, which offers away to consider the entangled legacies of spaces of nuclear activity, from nuclear imperialism to the post-Cold War world

Clinical outcomes five years after POEM for treatment of primary esophageal motility disorders.

BACKGROUND: Peroral endoscopic myotomy (POEM) is a novel operation for the treatment of achalasia and other esophageal motility disorders. While POEM has shown excellent short-term safety and efficacy, the long-term symptomatic outcomes after the procedure are unknown. METHODS: Patients from a single center that underwent POEM for treatment of esophageal motility orders and were greater than 5 years removed from their operation were studied. Patients were contacted to assess current symptoms and encouraged to undergo repeat endoscopy for objective follow-up. RESULTS: Thirty-six patients underwent POEM from October, 2010 to February, 2012 and current symptom scores were obtained from 29 patients at median 65-month follow-up. In the 23 patients with achalasia, Eckardt scores were significantly improved from preoperative baseline (mean current 1.7 vs. preoperative 6.4, p \u3c 0.001). Nineteen patients (83%) with achalasia had a symptomatic success (Eckardt ≤3) and none required retreatment for symptoms. Eckardt scores were dramatically improved at 6 months and maintained at 2 years; however, there was a small but significant worsening of symptoms between 2 and 5-years. Of the five patients with EGJ outflow obstruction, all had current Eckardt scores ≤3 but two needed reintervention for persistent or recurrent symptoms, one with a laparoscopic Heller myotomy and another with an endoscopic cricomyotomy and proximal esophageal myotomy extension. At 6-month follow-up, repeat manometry showed decreased EGJ relaxation pressures and esophagram demonstrated improved emptying. 24-h pH monitoring showed abnormal distal esophageal acid exposure in 38% of patients. Fifteen patients underwent endoscopy at 5-years, revealing erosive esophagitis in two (13%), new hiatal hernia in two, and new non-dysplastic Barrett\u27s esophagus in one. The patient with Barrett\u27s underwent a subsequent laparoscopic hiatal hernia repair and Toupet fundoplication. CONCLUSIONS: POEM resulted in a successful palliation of symptoms in the majority of patients after 5 years, though these results emphasize the importance of long-term follow-up in all patients