A Quagmire of Religion, Politics, and Violence : The Political Causes and Consequences of Militarized Religious Movements

Men never do evil so completely and cheerfully as when they do it from religious conviction. - Blaise Pascal While sitting in the living room of my upper-middle class Muslim Egyptian host family, settling down for the evening, the mother of the family pulled out a shoebox and sat down next to me, clearly indicating it was time for me to put away the homework and learn an authentic lesson about Egyptian culture. Inside the shoebox were photos of her family over the decades, some dating even back to the 1930s. What appeared striking to my limited perspective was that in pictures all the way through the 1960s, the women were all wearing sleeveless dresses and attending what looked like cocktail parties. Also noticeable was the fact that the city was clean, and the traffic appeared orderly in every picture. In response to my surprise at the foreignness and beauty of the Cairo I saw in the pictures, she placed her hand on her heart and uttered the words that have inspired much of the research that follows: Kara, my heart mourns the Cairo that uneducated fundamentalists have robbed me of

Initial Laparotomy Versus Peritoneal Drainage in Extremely Low Birthweight Infants With Surgical Necrotizing Enterocolitis or Isolated Intestinal Perforation: A Multicenter Randomized Clinical Trial.

ObjectiveThe aim of this study was to determine which initial surgical treatment results in the lowest rate of death or neurodevelopmental impairment (NDI) in premature infants with necrotizing enterocolitis (NEC) or isolated intestinal perforation (IP).Summary background dataThe impact of initial laparotomy versus peritoneal drainage for NEC or IP on the rate of death or NDI in extremely low birth weight infants is unknown.MethodsWe conducted the largest feasible randomized trial in 20 US centers, comparing initial laparotomy versus peritoneal drainage. The primary outcome was a composite of death or NDI at 18 to 22 months corrected age, analyzed using prespecified frequentist and Bayesian approaches.ResultsOf 992 eligible infants, 310 were randomized and 96% had primary outcome assessed. Death or NDI occurred in 69% of infants in the laparotomy group versus 70% with drainage [adjusted relative risk (aRR) 1.0; 95% confidence interval (CI): 0.87-1.14]. A preplanned analysis identified an interaction between preoperative diagnosis and treatment group (P = 0.03). With a preoperative diagnosis of NEC, death or NDI occurred in 69% after laparotomy versus 85% with drainage (aRR 0.81; 95% CI: 0.64-1.04). The Bayesian posterior probability that laparotomy was beneficial (risk difference <0) for a preoperative diagnosis of NEC was 97%. For preoperative diagnosis of IP, death or NDI occurred in 69% after laparotomy versus 63% with drainage (aRR, 1.11; 95% CI: 0.95-1.31); Bayesian probability of benefit with laparotomy = 18%.ConclusionsThere was no overall difference in death or NDI rates at 18 to 22 months corrected age between initial laparotomy versus drainage. However, the preoperative diagnosis of NEC or IP modified the impact of initial treatment