No Useless Mouth

In the era of the American Revolution, the rituals of diplomacy between the British, Patriots, and Native Americans featured gifts of food, ceremonial feasts, and a shared experience of hunger. When diplomacy failed, Native Americans could destroy food stores and cut off supply chains in order to assert authority. Black colonists also stole and destroyed food to ward off hunger and carve out tenuous spaces of freedom. Hunger was a means of power and a weapon of war. In No Useless Mouth, Rachel B. Herrmann argues that Native Americans and formerly enslaved black colonists ultimately lost the battle against hunger and the larger struggle for power because white British and United States officials curtailed the abilities of men and women to fight hunger on their own terms. By describing three interrelated behaviors—food diplomacy, victual imperialism, and victual warfare—the book shows that, during this tumultuous period, hunger prevention efforts offered strategies to claim power, maintain communities, and keep rival societies at bay. Herrmann shows how Native Americans, free blacks, and enslaved peoples were "useful mouths"—not mere supplicants for food, without rights or power—who used hunger for cooperation and violence, and took steps to circumvent starvation. Her wide-ranging research on black Loyalists, Iroquois, Cherokee, Creek, and Western Confederacy Indians demonstrates that hunger creation and prevention were tools of diplomacy and warfare available to all people involved in the American Revolution. Placing hunger at the center of these struggles foregrounds the contingency and plurality of power in the British Atlantic during the Revolutionary Era. Thanks to generous funding from Cardiff University, the ebook editions of this book are available as Open Access volumes from Cornell Open (cornellpress.cornell.edu/cornell-open) and other repositories

No useless mouth: Waging war and fighting hunger in the American Revolution

In the era of the American Revolution, the rituals of diplomacy between the British, Patriots, and Native Americans featured gifts of food, ceremonial feasts, and a shared experience of hunger. When diplomacy failed, Native Americans could destroy food stores and cut off supply chains in order to assert authority. Black colonists also stole and destroyed food to ward off hunger and carve out tenuous spaces of freedom. Hunger was a means of power and a weapon of war. In No Useless Mouth Rachel B. Herrmann argues that Native Americans and formerly enslaved black colonists ultimately lost the battle against hunger and the larger struggle for power because white British and United States officials curtailed the abilities of men and women to fight hunger on their own terms. By describing three interrelated behaviors—food diplomacy, victual imperialism, and victual warfare—the book shows that, during this tumultuous period, hunger prevention efforts offered strategies to claim power, maintain communities, and keep rival societies at bay. Herrmann shows how Native Americans, free blacks, and enslaved peoples were 'useful mouths'—not mere supplicants for food, without rights or power—who used hunger for cooperation and violence, and took steps to circumvent starvation. Her wide-ranging research on black Loyalists, Iroquois, Cherokee, Creek, and Western Confederacy Indians demonstrates that hunger creation and prevention were tools of diplomacy and warfare available to all people involved in the American Revolution. Placing hunger at the center of these struggles foregrounds the contingency and plurality of power in the British Atlantic during the Revolutionary Era

An 1800 Maroon Treaty

In 1800, an exiled community of Jamaican Maroons migrated from Nova Scotia to the British antislavery colony of Sierra Leone. When they disembarked, Maroon captains met with Sierra Leone Company officials and rapidly negotiated and coauthored a treaty. This treaty is a composite manuscript document scattered throughout the National Archives at Kew (United Kingdom). The diplomatic customs that Maroons and British officials observed at the negotiation—including making speeches, reading script words aloud, and refusing to sign documents—marked the document as a treaty. This essay makes the case that the source is a treaty; explains and contextualizes the negotiation that occurred; and explores the themes of settlement, alliance, and antislavery that changed in Maroon treaties in Jamaica and Sierra Leone in the eighteenth century

Significant increase of patient information and satisfaction with longer initial consultation duration in breast cancer - first results of the WAVES study

Aim of the study: The "WAVES" study (Widening Aims and giving patients a Voice for Expanded Structures in breast cancer care developed jointly by patients and physicians) aims to illuminate current breast cancer care structures with special focus on physician-patient-communication. Methods: The study is conducted within and funded by the BZKF (Bavarian Center for Cancer Research). Here, we present the results of the first preplanned analysis of the survey designed together with patients and patient advocates with the aim of adequately reflecting patients concerns. It is based on the evaluation of the first 1.000 patients who participated between 05/2022 and 08/2023, focusing on the duration of the first diagnosis consultation. Results: The participants were between 23 and 89 years old (mean: 59.18 years). There was a significant association between longer initial consultation duration and higher patient satisfaction (p < 0.001). When the first consultation lasted 30 minutes or more, patients stated more frequently that they felt better informed (p < 0.001) and had fully or substantially understood the content (p < 0.001). Conclusion: These results demonstrate a significantly higher satisfaction and better preparation of patients with initial breast cancer diagnosis if physicians’ communication lasted 30 minutes or more. Therefore the WAVES study clearly demonstrates the need for improved communication structures in terms of an appropriate time frame for breast cancer patients, which is not reflected in the current reimbursement structures

GestaltMatcher Database - A global reference for facial phenotypic variability in rare human diseases

The most important factor that complicates the work of dysmorphologists is the significant phenotypic variability of the human face. Next-Generation Phenotyping (NGP) tools that assist clinicians with recognizing characteristic syndromic patterns are particularly challenged when confronted with patients from populations different from their training data. To that end, we systematically analyzed the impact of genetic ancestry on facial dysmorphism. For that purpose, we established the GestaltMatcher Database (GMDB) as a reference dataset for medical images of patients with rare genetic disorders from around the world. We collected 10,980 frontal facial images - more than a quarter previously unpublished - from 8,346 patients, representing 581 rare disorders. Although the predominant ancestry is still European (67%), data from underrepresented populations have been increased considerably via global collaborations (19% Asian and 7% African). This includes previously unpublished reports for more than 40% of the African patients. The NGP analysis on this diverse dataset revealed characteristic performance differences depending on the composition of training and test sets corresponding to genetic relatedness. For clinical use of NGP, incorporating non-European patients resulted in a profound enhancement of GestaltMatcher performance. The top-5 accuracy rate increased by +11.29%. Importantly, this improvement in delineating the correct disorder from a facial portrait was achieved without decreasing the performance on European patients. By design, GMDB complies with the FAIR principles by rendering the curated medical data findable, accessible, interoperable, and reusable. This means GMDB can also serve as data for training and benchmarking. In summary, our study on facial dysmorphism on a global sample revealed a considerable cross ancestral phenotypic variability confounding NGP that should be counteracted by international efforts for increasing data diversity. GMDB will serve as a vital reference database for clinicians and a transparent training set for advancing NGP technology.</p

Common variants in Alzheimer’s disease and risk stratification by polygenic risk scores

Funder: Funder: Fundación bancaria ‘La Caixa’ Number: LCF/PR/PR16/51110003 Funder: Grifols SA Number: LCF/PR/PR16/51110003 Funder: European Union/EFPIA Innovative Medicines Initiative Joint Number: 115975 Funder: JPco-fuND FP-829-029 Number: 733051061Genetic discoveries of Alzheimer's disease are the drivers of our understanding, and together with polygenetic risk stratification can contribute towards planning of feasible and efficient preventive and curative clinical trials. We first perform a large genetic association study by merging all available case-control datasets and by-proxy study results (discovery n = 409,435 and validation size n = 58,190). Here, we add six variants associated with Alzheimer's disease risk (near APP, CHRNE, PRKD3/NDUFAF7, PLCG2 and two exonic variants in the SHARPIN gene). Assessment of the polygenic risk score and stratifying by APOE reveal a 4 to 5.5 years difference in median age at onset of Alzheimer's disease patients in APOE ɛ4 carriers. Because of this study, the underlying mechanisms of APP can be studied to refine the amyloid cascade and the polygenic risk score provides a tool to select individuals at high risk of Alzheimer's disease