A mode of production flux: the transformation and reproduction of rural class relations in lowland Nepal and North Bihar

The Eastern Gangetic Plains of South Asia represents a peripheral region far from the centers of global capitalist production, and this is all the more apparent in Mithilanchal, a cultural domain spanning the Nepal/Bihar border. The agrarian structure can be considered ‘semi-feudal’ in character, dominated by landlordism and usury, and backed up by political and ideological processes. Paradoxically, Mithilanchal is also deeply integrated into the global capitalist market and represents a surplus labor pool for the urban centers of Western India as well as the Persian Gulf in a classic articulation between pre-capitalist and capitalist modes of production. A review of the changes in the agrarian structure over recent decades in the context of globalisation, out-migration and climate stress, shows that while landlordism remains entrenched, the relationship between the marginal and tenant farmer majority and the landed classes has changed, with the breakdown of ideological ties and reduced dependence on single landlords. The paper thus ends on a positive note, as the contemporary juncture represents an opportune moment for new avenues of political mobilization among the peasantry

Bringing history (back) into international business

We argue that the field of international business should evolve its rhetoric from the relatively uncontroversial idea that ‘history matters’ to exploring how it matters. We discuss four conceptual channels through which history matters, illustrating each with a major example. First, historical variation is at least a worthy complement to contemporary cross-sectional variation in illuminating conceptual issues. As an example, we show that conclusions reached by the literature on contemporary emerging market business groups are remarkably similar to independently reached conclusions about a very similar organizational form that was ubiquitous in the age of empire. Second, historical evidence avoids spurious labeling of some phenomena as ‘new’, and by so doing may challenge current explanations of their determinants. Whereas some firm types today were also present earlier, some types have disappeared, some have appeared, and some have disappeared and reappeared later. Third, history can allow us to move beyond the oft-recognized importance of issues of path dependence to explore the roots of Penrosian resources. We argue that the choices made by Jardine's and Swire's in Asia today, for example, are an outgrowth of strategic choices first in evidence more than a century ago. These would remain obscured absent an historical analysis. Fourth, there are certain issues that are unaddressable, except in the really long (that is, historical) run. Exploring the causal relationship (if any) between foreign direct investment, a staple of the international business literature, and long-run economic development provides one important example. Throughout, we advocate embracing rigorous methods for analyzing small-sample and qualitative data when conventional regression techniques do not apply. That is, we suggest that re-embracing history in the mainstream is not tantamount to sacrificing methodological rigor. Journal of International Business Studies (2006) 37,, 453–468. doi:10.1057/palgrave.jibs.8400198

Rivaroxaban or aspirin for patent foramen ovale and embolic stroke of undetermined source: a prespecified subgroup analysis from the NAVIGATE ESUS trial

Background: Patent foramen ovale (PFO) is a contributor to embolic stroke of undetermined source (ESUS). Subgroup analyses from previous studies suggest that anticoagulation could reduce recurrent stroke compared with antiplatelet therapy. We hypothesised that anticoagulant treatment with rivaroxaban, an oral factor Xa inhibitor, would reduce the risk of recurrent ischaemic stroke compared with aspirin among patients with PFO enrolled in the NAVIGATE ESUS trial. Methods: NAVIGATE ESUS was a double-blinded, randomised, phase 3 trial done at 459 centres in 31 countries that assessed the efficacy and safety of rivaroxaban versus aspirin for secondary stroke prevention in patients with ESUS. For this prespecified subgroup analysis, cohorts with and without PFO were defined on the basis of transthoracic echocardiography (TTE) and transoesophageal echocardiography (TOE). The primary efficacy outcome was time to recurrent ischaemic stroke between treatment groups. The primary safety outcome was major bleeding, according to the criteria of the International Society of Thrombosis and Haemostasis. The primary analyses were based on the intention-to-treat population. Additionally, we did a systematic review and random-effects meta-analysis of studies in which patients with cryptogenic stroke and PFO were randomly assigned to receive anticoagulant or antiplatelet therapy. Findings: Between Dec 23, 2014, and Sept 20, 2017, 7213 participants were enrolled and assigned to receive rivaroxaban (n=3609) or aspirin (n=3604). Patients were followed up for a mean of 11 months because of early trial termination. PFO was reported as present in 534 (7·4%) patients on the basis of either TTE or TOE. Patients with PFO assigned to receive aspirin had a recurrent ischaemic stroke rate of 4·8 events per 100 person-years compared with 2·6 events per 100 person-years in those treated with rivaroxaban. Among patients with known PFO, there was insufficient evidence to support a difference in risk of recurrent ischaemic stroke between rivaroxaban and aspirin (hazard ratio [HR] 0·54; 95% CI 0·22–1·36), and the risk was similar for those without known PFO (1·06; 0·84–1·33; pinteraction=0·18). The risks of major bleeding with rivaroxaban versus aspirin were similar in patients with PFO detected (HR 2·05; 95% CI 0·51–8·18) and in those without PFO detected (HR 2·82; 95% CI 1·69–4·70; pinteraction=0·68). The random-effects meta-analysis combined data from NAVIGATE ESUS with data from two previous trials (PICSS and CLOSE) and yielded a summary odds ratio of 0·48 (95% CI 0·24–0·96; p=0·04) for ischaemic stroke in favour of anticoagulation, without evidence of heterogeneity. Interpretation: Among patients with ESUS who have PFO, anticoagulation might reduce the risk of recurrent stroke by about half, although substantial imprecision remains. Dedicated trials of anticoagulation versus antiplatelet therapy or PFO closure, or both, are warranted. Funding: Bayer and Janssen