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23 March 2021: Review Articles
A Systematic Review of Total Thoracic Endovascular Aortic Repair in Treatment of Kommerell Diverticulum Combined with Right-Sided Aortic Arch
Weijian Fan12BCEF, Jinyun Tan3BCD, Weihao Shi3CDE, Jianjie Rong1ABC*, Bo Yu23ABG
1Department of Vascular Surgery, Suzhou Traditional Chinese medicine (TCM) Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, Jiangsu, China (mainland)
2Department of Vascular Surgery, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, China (mainland)
3Department of Vascular Surgery, Huashan Hospital of Fudan University, Shanghai, China (mainland)
*Corresponding Author: Jianjie Rong, e-mail: [email protected]
*Corresponding Author: Bo Yu, e-mail: [email protected]
FLiterature analysis/search
GFunds collection
ABSTRACT: Kommerell diverticulum (KD) combined with right-sided aortic arch (RAA) and aberrant left subclavian artery (ALSA) are rare and limited to a few case reports and small series. Thoracic endovascular aortic repair (TEVAR), which is mini-invasive, is widely utilized in complicated aortic disease. We performed a systematic review of the literature to identify all patients who underwent endovascular repair for KD in terms of technical feasibility and procedural outcomes. Published and accepted studies only in English as well as article reference lists were searched and extracted to assess case series reporting solely TEVAR in KD patients. There were 28 patients with KD/RAA identified from 19 studies. All of them underwent endovascular technique for KD exclusion and the median age was 69 years (range 39–83 years). Hypertension (n=17) was the most common comorbidity in this cohort, followed by diabetes mellitus (n=3), hyperlipidemia (n=3), and smoking (n=3). The presenting symptoms were dysphagia (n=8, 29%), intermittent back pain (n=4, 14%), and acute aortic dissection (n=6, 21%), while asymptomatic was found in 9 patients (n=9, 32%). A technical success rate of 100% was reported associated with various managements of ALSA, proximal embolization (n=19, 68%), in-situ revascularization (n=3, 11%), and left carotid-subclavian bypass (n=3, 11%). All patients survived without severe complications and were discharged home within less than 14 days. The mean follow-up time was 9.3 months, patency was found in all patients, thrombosis and distinct shrinkage of KD aneurysm as indicated by CT-scans were noted (n=20, 71%), and type II endoleak was found in only 4 patients (n=4, 14%). TEVAR appears to be safe and offers favorable results, but it still needs substantial evidence to support routine use in KD. TEVAR is an alternative to open repair in selected cases, but it needs further investigation in a large cohort.
Keywords: Aorta, Thoracic, Aortic Aneurysm, Thoracic, Aortic Arch Syndromes, Embolization, Therapeutic, Endoleak, endovascular procedures, Aged, Aged, 80 and over, Aneurysm, Dissecting, Aortic Diseases, Blood Vessel Prosthesis, Blood Vessel Prosthesis Implantation, Diverticulum, Middle Aged, Retrospective Studies, Stents, Treatment Outcome
Right-sided aortic arch (RAA) is rare and is found in only 0.2–2.5% of autopsy studies; it is genetically associated with 22q11 deletion [1–3]. An extremely rare type of RAA is an aberrant left subclavian artery (ALSA) originating from Kommerell diverticulum (KD), which is a persistent remnant of the fourth primitive dorsal arch, due to the aneurysmal degeneration of the origin of the aberrant subclavian artery (ASA) [4]. Specifically, in patients with KD and RAA, the left dorsal arch diminishes between the subclavian and carotid arteries so that the right subclavian artery eventually originates from the remnant right dorsal arch.
KD was first described by Dr. Friedrich Kommerell in 1936 when he performed a barium swallow examination in a patient with stomach cancer presenting dysphagia lusoria [4]. Specifically, patients with KD are usually asymptomatic, and are discovered incidentally by non-enhanced chest CT scan. When there are symptoms, the most frequent is dysphagia due to compression of the esophagus, followed by asthma and hoarseness due to tracheal compression. Other patients have a long history of intermittent pain in the chest or epigastrium, or sometimes radiating to the back [5].
Given the rarity as well as heterogeneity of RAA combined with KD, there has been no consensus on the treatment. However, Austin et al reported a 19% rate of rupture [6]. Moreover, since the presence of KD mainly predisposes to development of aneurysm and dissection, the highest rate of either rupture or dissection was reported at 53% in a long-term follow-up study [7].
Hence, due to the high rate of rupture and poor prognosis after rupture or dissection, most cardiothoracic surgeons use a surgical approach for both symptomatic and asymptomatic KD patients instead of conservative management [8]. Nonetheless, the treatment of KD varies greatly, and open repair, hybrid repair, and thoracic endovascular aortic repair (TEVAR) were all reported in recent studies [9].
However, open surgery remains a challenging procedure, with extensive incision, considerably higher need for technical dexterity, and relatively higher mortality rate (8% to 26%) [10]. Therefore, with the dramatic advent of minimally invasive procedures, TEVAR has become an attractive option for selected patients, with minimal incision and favorable results. The optimal treatment strategies of endovascular repair applied for KD patients in the present era have not been established, mainly differing in whether the ALSA is reconstructed and the application scenarios (or indications) for it [11]. In-situ fenestration by needle and radio frequency, chimney stenting, and total occlusion of ALSA via coils or plug have emerged but still remain controversial [12,13].
The aim of this study was to evaluate the early and long-term outcomes of different TEVAR strategies in treatment for KD combined with RAA through reviewing the literature, so as to provide better evidence of the efficacy of endovascular repair in treatment and enrollment of KD patients.
The aim of this review was to assess all relevant studies on KD treatment by TEVAR technique. Papers published between 1990 and May 2020 were included. Searches were performed in PubMed, EMBASE, and Web of Science using the terms "Kommerell diverticulum", "Kommerell diverticulum", "Kommerell diverticula", "Kommerell diverticula", "Right-Sided Arch" in combination with "TEVAR", "endovascular" and "endovascular repair". Additional papers were cross-checked from reference lists of included papers.
Studies that solely reported open surgery on thoracic aorta were excluded. Studies reporting hybrid repair or two-staged operation involving ascending aortic replacement were also excluded. Studies were excluded when reporting conservative therapy or best medical treatment (BMT) without endovascular repair. Studies in which data for endovascular repair were not distinguished from data for patients undergoing total arch replacement or hybrid repair without endovascular part were excluded. Data published repeatedly by the same group were excluded; however, papers from the same authors were not excluded when demonstrating further information on different cases, measurements, and consequences. Given the rarity of KD, one-case reports and review articles were all enrolled. Data were assessed for quality independently by 2 researchers. Data were specifically collected on endovascular technique, intraoperative details, postoperative outcomes, and prognosis. Our search strategy conformed to the guidelines in the Preferred Reporting Items for Systematic Reviews (PRISMA) statement standards [14].
IDENTIFIED STUDIES AND POPULATION CHARACTERISTICS:
According to PRISMA protocol, 19 articles were identified from 415 articles that involved "Kommerell diverticulum" or "Kommerell diverticulum". Studies were excluded if they did not contain any information on endovascular therapies. Also, studies were excluded when only comparing endovascular techniques or reporting hybrid repair. In terms of endovascular therapy, articles in which the classification was not KD with coexistent RAA and ALSA were excluded. Among them, mostly were case reports reporting 1 or 2 patients and 1 case cohort containing 10 patients. We analyzed data from 28 patients who were diagnosed with RAA combined with ALSA that originated from KD, and we also assessed data on demographics, details of each patient's clinical presentation, comorbidities, pathologies, management, and follow-up [12,13,15–30].
In this review, 10 patients were female and 18 were male. The median age at presentation was 69 years (range 39–83 years). We analyzed data on comorbidities. We found that the illness frequently coexists with other chronic diseases. According to our research, the majority of patients showed more than 1 comorbidity, with hypertension being most common (n=17). Other comorbidities included diabetes mellitus (n=3), hyperlipidemia (n=3), and smoking (n=3), which are known risk factors for arterial diseases. Chronic renal failure, chronic obstructive pulmonary diseases, and coronary heart diseases were found in 2 patients each. Depression, peripheral arterial diseases, prior stroke, and hypothyroidism were each present in 1 patient.
In terms of symptoms, 9 patients (32%) were asymptomatic and most of the other patients were mildly symptomatic. Specifically, the combination of dysphagia, hoarseness, and cough was a common 'typical' symptom due to aneurysmal compression of adjacent structures (29%). Severe chest pain was found in 6 patients who underwent acute aortic dissection (AD) as a destructive consequence of KD (21%). Furthermore, 4 patients had intermittent back pain and mild chest pain and 1 patient had a rupture, which is the most severe emergency complication of KD. Patients were classified into 2 groups depending on their symptoms. Preoperative baseline characteristics are shown in Table 1.
PATHOLOGICAL DETAILS:
The mean diameter of KD was 46.8±11.5 mm. The mean diameter of that in asymptomatic patients was 49.1±12.1 mm, while it was 41.2±10.1 mm in 6 patients who had acute AD or rupture. One patient was not measured due to extensive intramural hemorrhage and hematoma. Acute AD was recorded in 6 patients, all categorized as Stanford type B. Chronic AD and abdominal aortic aneurysm were each found in 1 patient.
ENDOVASCULAR STRATEGIES:
Endovascular repair, which is a minimally invasive and effective treatment, was utilized in all 28 patients and selected for reconstructing KD and RAA. Percutaneous puncture of the common femoral artery (CFA) was normally performed before TEVAR, while CFA exposure was only performed for patients with severe atherosclerosis and calcification. Moreover, various management methods for ALSA were noted. First, TEVAR only without further intervention to ALSA were reported in 3 articles. Moreover, further occlusion of proximal ALSA via left brachial artery was noted in 19 patients and coils were utilized in 14 patients, while plugs were used for 5 patients. Left carotid-subclavian bypass by woven Dacron graft was found in 3 patients and in-situ revascularization through thoracic branched or customized stent grafts were noted in 2 patients. Finally, a new in-situ fenestration technique by radiofrequency and subsequent stenting were reported in 1 article. In terms of device selection, Gore TAG™ and Medtronic Valiant™ were widely utilized for endovascular repair. Grikin and Medtech from China and COOK from the USA were also noted to be used in some individual cases.
PERIOPERATIVE FINDINGS:
General anesthesia was normally performed in most articles while local anesthesia was also noted in some case with full hemodynamic monitoring. Type I endoleak mostly occurred after exclusion and was found in 5 patients. Hoarseness was noticed in 1 patient after left carotid- subclavian bypass probably due to left vocal cord paralysis and recovered after thyroplasty. Mild differences in upper-limb blood pressure were instantly noticed in most of patients after ALSA occlusion. There was no intraoperative stroke or hemorrhage, and intensive care was reported in KD patients with acute dissection. All patients were discharged within 14 days.
MEAN FOLLOW-UP TIME AND PROGNOSIS:
The mean follow-up time was 9.3 months, ranging from 6 weeks to 5 years, and 2 patients were lost to follow-up. In this review, we found that patency was reported in all patients verified by CT-scans at last follow-up. However, type II endoleak was found in 4 patients, while none of them underwent further embolization. Thrombosis and distinct shrinkage of KD aneurysm shown by CT-scans were noted in 20 patients. The symptoms of dysphagia and hoarseness disappeared in 7 patients and were alleviated in 1. There were no migration and fracture of stent grafts in follow-up, and posterior cerebral ischemia was only found in 1 patient. No arm claudication, upper-limb dysfunction and mortality were reported. The specific details for each article are presented in Table 2.
Right-sided aortic arch, normally known as RAA, with an incidence of 0.1%, is reported in case reports and reviews with a small cohort. Kommerell diverticulum originating from aneurysmal degeneration of ASA has a prevalence of 0.04% to 0.4% based on autopsy studies, with a relatively high tendency toward rupture and dissection [4,30]. According to previous studies, KD can be categorized into 5 distinct types. The ALSA originating from RAA, left-sided aortic arch (LAA) or aorto-ductal junction were defined as 3 types. The origin of ALSA arising at the junction of RAA and the descending aorta with mirror image branching was determined as another type, while the extremely rare one involved a diverticulum at the origin of an aberrant right vertebral artery arising distal to the left subclavian artery [31].
KD has been treated by open repair for decades. Total arch replacement of RAA and aberrant left subclavian aneurysm with various exposure ways under deep hypothermic circulatory arrest (DHCA) has been widely accepted [32]. The threshold of surgical option for KD is controversial. Similar to abdominal aortic aneurysm (AAA), the maximum diameter of aneurysm determines the time for operation. Some experts advised intervening when the diameter is greater than 3 cm, while others recommended 5 cm as the point for intervention [33]. Recent research has focused on the ratio of KD diameter and its concomitant ALSA, showing that the KD did not need resection until it was 1.5 times the size of the ALSA [34]. However, KD is an embryological remnant due to failed regression and the tissue is vulnerable. Given that long-term hypertension as well as wall shear stress, KD with its abnormal morphology and angulation ruptures easily and eventually becomes AD [35]. Clearly, for symptomatic patients, troublesome symptoms caused by the compression of mediastinal structures are an indication to intervene. However, owing to a high rate of rupture and dissection, surgical repair was recommended in all KD by some groups [7].
Moreover, surgical indication is feasible when patients experience symptoms from gradual organ compression [36]. Specifically, patients might have a long history of difficulty swallowing and regurgitation due to moderate compression of the esophagus. Chest pain, chest pressure, and retrosternal burning pain in the middle of the night were also illustrated in case reports [37]. Although most patients with KD are asymptomatic, symptoms present in different ways, even in symptomatic patients, due to the correlation of ALSA and adjacent structures. Provided that the ALSA is located behind the esophagus, approximately 80% of patients present with dysphagia to solid food. In the other 2 situations, between the esophagus and trachea (15%) or anterior to the trachea (5%), the symptoms may present as dysphagia, dyspnea, or stridor [38].
Open repair (OR) has been widely used and advocated in the treatment of KD in order to not only prevent sudden rupture or dissection, but also to ameliorate the symptoms arising from moderate compression [39]. OR ordinarily involves diverticulum resection/subclavian arterial reconstruction as well as total arch replacement, using DHCA [40]. However, there still remain some limitations of OR in KD treatments. In treatment of KD using OR, thoracotomy, sternotomy, ligation, aorta cross-clamping, and DHCA are required. The whole procedure remains challenging and it requires high technical dexterity and comprehensive perioperative experience. Therefore, OR carries substantial surgical risks and complications, such as left vocal cord paralysis and right vocal cord edema, as reported by Rosu [41]. Nonetheless, the mortality was 11–25% in different reviews, while the main factors associated with death were massive pulmonary embolism, mediastinitis, hematemesis, and fistula between KD and the esophagus, respectively [4]. Subsequently, increasing experience with TEVAR has paved the way for less invasive hybrid approaches. However, even hybrid repair (HR) still needs thoracotomy or sternotomy and replacement of the ascending aorta, which may still lead to multiple complications due to vast exposure and strict operative conditions during the long surgery [42].
Furthermore, Erben et al reported that 92% of patients with KD were found incidentally and Yu et al indicated that in asymptomatic patients with KD, the morbidity and mortality associated with conventional open intervention outweighed the potential benefit of rupture prevention [5,43]. The mortality and morbidity rates of open repair in KD were not acceptable even though KD with RAA is rare, and treatment is risky and controversial. Compared with postoperative complications like bleeding, nerve injuries, and respiratory failures in OR or HR, the TEVAR technique had illustrated favorable outcomes in aorta reinstitution.
Okada et al first reported endovascular repair in a RAA patient combined with aneurysm. The procedure showed successful isolation of KD and occlusion of ALSA without instant complications and undesirable prognosis [25]. However, TEVAR is not suitable for all KD patients and accurate preoperative clinical and anatomical evaluation is extremely critical for enrollment [15]. The optimal timing for performing TEVAR on KD involves 3 main aspects: (1) the suitability of access vessels for insertion; (2) feasible tortuosity and angulation of the aorta arch; and (3) the availability of a proximal landing zone (PLZ) [44]. The limited landing area for a graft will always lead to type I endoleak as a consequence, along with the possibility of esophagus compression by stents [37]. Therefore, a sufficient PLZ is essential for the success of TEVAR in KD treatment. PLZ was proposed and classified to 3 types according to the modified Hishimaru aortic arch classification. Tinelli et al suggested that a standard thoracic stent graft was feasible for implantation when the PLZ comprised at least 2 cm of healthy aorta [44].
According to the results reported above, we found that there were no differences in the mean diameter of KD in asymptomatic and symptomatic patients and no significant difference in mild symptomatic and acute dissection or rupture. Current treatment guidelines for KD are based on a small case series of patients with no clear consensus on the surgical indications. One of the most consistent indications emphasize size, claiming that the KD aneurysm and aortic diameter need to be larger than 3 cm and 5 cm, respectively [33]. However, we found that the size of the KD was not the threshold for intervention because it would lead to disastrous consequences regardless of diameter.
There has been considerable controversy in the literature regarding the feasibility for TEVAR in KD patients. Ota et al argued that there is no volume reduction of the diverticulum after complete exclusion by stent graft, and compression symptoms cannot be attenuated [39]. However, thrombosis and shrinkage of a saccular aneurysm were widely found in this review, so that the compression by KD and corresponding symptoms would be largely alleviated [23]. Also, El Batti et al found that there was ample room between the KD and the esophagus during hybrid repair, which means that the most important aim for KD treatment was preventing rupture, although we assume that a very large KD compression may be a problem [45]. Moreover, Ota et al claimed that a "sharp angle" between the distal arch and descending aorta was an anatomical challenge for transition [39]. It may be taken into consideration in early stage of TEVAR, yet we believe that it is no longer a contraindication due to materials innovation. The introducer sheath of the new stent graft produced by Cordis (USA) is 14-F, with more flexibility compared to the normal 18-F and 24-F sheaths.
Furthermore, no matter which devices are used to treat ALSA, there remain 2 basic techniques: proximal exclusion with/without blood flow reconstruction. Percutaneous coil embolization of the proximal segment of the ALSA was performed by coils or plugs after deployment of the device in some cases [16,21]. However, some researchers were concerned that intentional coverage of the ALSA during TEVAR would increase the risk of upper-extremity subclavian steal syndrome, or possibly of spinal cord ischemia. Rizvi et al reported the need for revascularization need in investigations of cerebral and vertebrobasilar circulation [46]. To avoid arm claudication and vertebrobasilar ischemia, in-situ revascularization and bypass were performed for fear of subclavian steal syndrome [23,24]. However, based on limited cases of KD, more research and observations are needed before reaching a consensus.
KD, usually combined with right-sided aortic arch, is extremely rare and associated with ASA degeneration. Symptoms can be atypical for aneurysms due to persistent compression to adjacent tissues in the mediastinum. Several types of therapies were utilized and reported in the last 50 years, including best medication only, which was not recommended recently, and total arch replacement and debranching of the aortic arch followed with endovascular procedures and total TEVAR. Total arch replacement and debranching for KD under deep hypothermic circulatory arrest are not always required except for severe symptoms or lesions involving the ascending aorta. However, given the increased complexity of and limited experience with conventional surgery in such rare anatomic configurations, with the availability of PLZ, TEVAR is more feasible for KD patients who are asymptomatic or mildly symptomatic. Even in patients who also have acute dissection or rupture, TEVAR still has an acceptable safety profile, and there have been reports of encouraging postoperative outcomes. As the technology continues to improve, TEVAR may become the ideal interventional approach for KD under conditions of preoperative planning, careful delineation of anatomy, and strict patient enrollment.
Table 1. perioperative characteristics of patients divided by symptoms. Table 2. Characteristics of Kommerell diverticulum with right-sided aortic arch via TEVAR technique in the systematic review.
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Goldman Archive | Trotskyist Writers Index | ETOL Main Page
Albert Goldman
TOWARD SOCIALIST CLARITY
From Socialist Appeal, Vol.2 No.12, December 1936, pp.10-12.
Transcribed and Marked up by Damon Maxwell for the Encyclopaedia of Trotskyism On-Line (ETOL).
ON THE CAMPAIGN
OUR PARTY was the only party that pointed out during the election that in the present period of the decline of capitalism there is no alternative for the working class other than socialism. It was primarily because of that factor that left wingers could and did participate in the campaign without being too greatly embarrassed by a platform which, to put it mildly was not all that a revolutionary Socialist platform should be.
It should not be necessary at this time to repeat that what revolutionary Socialists meant, when they said that the fundamental issue of the campaign was socialism versus capitalism, was not that the campaign was to decide that question but that the working class must be taught that the problems confronting them could not be solved in a fundamental manner except through the destruction of the capitalist system; that fighting to retain democracy as against fascism was like struggling to cure the symptoms and not the disease. The Communists of course did their best to distort the meaning of our campaign slogan by attempting to ridicule us for "trying to usher in socialism" in this campaign, thereby showing that the Communist conception of an election campaign is to get something that is practical and achievable.
But we must confess that at times the accusation levelled against our party by the Stalinists to the effect that we made a lifeless abstraction out of the slogan "socialism versus capitalism" struck home. An election campaign must serve as an educational campaign but an educational campaign that is based simply on contrasting the alleged benefits of socialism as against the miseries of capitalism has very little educational value. The campaign must take the fundamental issue as its guiding thread and utilize the current issues of the day for the purpose of mobilizing the masses for struggle and at the same time connecting those current issues with the fundamental issue. One can shout from now till doomsday that socialism; is necessary and that it is better than, capitalism but to educate the advanced workers one must explain the significance of great events that agitate the minds of vast numbers of people.
Enough has been written to convince every left wing Socialist that the party leadership failed miserably in the great task confronting it during the campaign. Its failure to take a correct position (it did not even take any position) on the great events that absorbed the interest of every class conscious worker has been repeatedly mentioned. I shall mention some minor matters which indicate that as far as the party leadership was concerned the central slogan of the campaign was more or less a meaningless accident.
Towards the end of the campaign the National Office of the party flooded the branches with a magazine full of pictures, which were intended to convince the American workers of the superiority of socialism over capitalism. It is not necessary to deal with the character of the pictures although it could be truthfully asserted that some of the dwelling places shown in the pictures would not induce many American workers to struggle for socialism.
Now there is absolutely nothing wrong – in fact quite the contrary – in showing pictures of future apartments under socialism. But a picture book which has as its purpose winning workers over to the socialist movement which does not contain a word about the class struggle and which indicates that all the workers have to do, in order to get these nice things shown in the pictures, is to vote the socialist ticket, is worthy of the worst type of reformism. The Old Guard might have hesitated before issuing such nonsense.
And where did we get the nice picture book? From the British Labor party. And so the most revolutionary party of the Labor and Socialist International must depend for its propaganda on the most decrepitly reformist party of the same International.
"If we only had more money," was the complaint of many a comrade who sought for an excuse why so little literature was given out by the party. Tremendous effort was exerted to collect money but mainly on the plan of a mail order house. Party members and sympathizers were exhorted to contribute but there was very little in the way of literature to show the contributors that their money was used for effective propaganda. A revolutionary party during the period of struggle under the capitalist system will always be short of funds but the lack of money is not an excuse for any failure to bring out good propaganda literature dealing with events of the day. Not only will comrades and sympathizers gladly give their last penny to publish such literature; sufficient money can be derived from its sale to defray the cost of printing. Collecting money is. largely a political task. If a party holds meetings on burning issues; if its speakers give a revolutionary interpretation of those issues, if, in other words, it convinces the advanced workers that it is a revolutionary party, the problem of raising money is more than half solved .
The fact of the matter is that there was enough money to publish the CALL. And unfortunately that was money thrown away. An awful sensation comes over me when I think of what a wonderful opportunity was completely missed by the national campaign paper of the party. The CALL was alone in the field. It could have harnessed the tremendous enthusiasm of the Yipsels and the revolutionary comrades of the party. Had it dealt with the world-shaking events of the day in a competent manner, from a Marxist point of view; had it given the lead to the comrades on all the perplexing questions confronting them; had it answered the attacks of our enemies vigorously and effectively it would now be sitting on top of the world. Its supremacy as the organ of revolutionary socialism would be unquestioned.
Instead – but what is the use ? Who does not know the pictures, relevant and irrelevant; the dreary, didactic editorials (it must be admitted that they were all against capitalism)? Pictures, sermons on socialism – that is petty bourgeois Utopian socialism.
The Wisconsin Socialist party was swimming in familiar waters during the campaign. Running on the Progressive ticket and burdened only with the "production for use" platform of the Farmer-Labor Progressive Federation about ten members of the party were elected to office and undoubtedly as far as some of them are concerned socialism has been achieved. I have been unable to find out whether there is such a thing as a Socialist .arty in Wisconsin. The party members went into the Farmer-Labor Progressive Federation as individuals and since the platform of the Federation contains the famous "production for use" clause the Wisconsin Socialists are more than satisfied and it is quite certain that they do not see any distinction between the Wisconsin Socialist party and the Federation. And in truth there is none.
Unfortunately the "left" wing of the Wisconsin party was composed of liberal Stalinists with Mrs. Berger as its god-mother and nothing could be expected of such a "left" wing. There must be many a real Socialist in Wisconsin and one of the tasks of the left wing will be to find them; and organize them to struggle for the principles of revolutionary socialism.
SOCIALISTS SUPPORTING SPANISH DEMOCRACY
IN THIS country our party states that not bourgeois democracy but socialism should be the objective of the workers' struggles. Quite correct. It follows that in Spain where the struggle has reached an infinitely higher level than in this country, where the workers are no longer participating in an election campaign with ballots but are deciding questions on the field of civil war, the idea that the workers must struggle for socialism is a thousand times more applicable than here. The Stalinists persist in fighting for bourgeois democracy even in Spain but I presume that the leadership of our party would not accept the Stalinist contention, at least in theory.
Let us see how some of our party comrades who consider themselves left wingers fail to draw necessary conclusions from the theory that our objective must be socialism and not bourgeois democracy. Even before the National Executive Committee resolved to support the North American Committee for the Defense of Spanish Democracy, the question of supporting a meeting held under the auspices of that committee in Chicago came up before the Chicago Executive Committee of the party. Since it is necessary to clear up a great deal of confusion on this point in the minds of loyal left wing Socialists it is necessary to treat this question in some detail.
The Chicago Executive Committee made a peculiar decision on the question. It would not participate officially in the meeting because the committee under whose auspices the meeting was held accepted a political line contrary to the one accepted by revolutionary Socialists. At the same time it permitted individual party members to participate in the Committee and instructed all party members to distribute leaflets for the meeting. So that the party in Chicago was both in and out of the Committee and the meeting.
The confusion arose from the failure to make the simple distinction between a united front on a programmatic basis which we cannot accept unless the program is our program, and a united front for a specific objective.
In the struggle against the Spanish fascists revolutionary Marxists will fight side by side with every other group bourgeois or proletarian; they will offer aid to every group struggling against the fascists. If for reasons of his own a Basque Catholic priest is willing to take a rifle and shoot a Fascist Catholic priest there is no reason in the world why a revolutionary Socialist should refuse to buy the rifle. We aid and fight together with every person involved in the struggle against fascism.
But that is as far as it goes. Our political program is peculiarly our own and we make no compromises with any other group. It is true we are struggling against fascism but with a different purpose; we are struggling to establish a Socialist Spain while other groups are fighting to retain the bourgeois democratic republic. There can be unity of action between these groups but no unity of program.
There is no reason in the world why a joint committee should not be created for the purpose of collecting funds to send arms, clothing and other necessities to the Spanish fighters against fascism. And in that committee could be represented Communists, Socialists, anarchists and even liberals. But the joint committee should have as its purpose the collection of funds and nothing else.
As soon as the committee proclaims it to be its duty to collect funds to defend Spanish bourgeois democracy it enters into the political arena; it thereby formulates a program and one which is absolutely unacceptable to revolutionary Socialists. Under these circumstances revolutionary Socialists (except as a matter of discipline when higher bodies of the party decide) cannot lend their names to and cannot participate in the calling of such a meeting. Called under the auspices of a committee to defend Spanish democracy a meeting has a political character and it is not permissible for revolutionary Socialists to further the cause of such a meeting.
I do not mean that if a Socialist is invited to speak at such a meeting he should refuse to accept. A Socialist should always take advantage of any invitation to speak before a crowd of workers. But he must make his position crystal clear before the audience of workers. There is then no longer a question of a united front but simply one of accepting a chance to educate those who either do not agree with us or else do not know our position.
United front meetings on Spain have only a symbolic significance, representing the unity of the workers in the common struggle against fascism. Of far greater importance are the political meetings on Spain where the workers should be educated in the political significance of that struggle and be informed of the attitude of the various parties in the Spanish civil war. Such meetings can be held only under the auspices of the Socialist party.
And they should be held with much greater frequency than heretofore.
THE DECISION of the National Executive Committee to hold regional conferences for the purpose of discussing the problems of the convention would be of great benefit to the party provided it is carried out properly. To these regional conferences should be invited all active comrades; leading comrades representing different tendencies in the party should be invited to discuss the situation in the party and the tasks confronting the convention, Adequate notice should be given and preparations made for these conferences so that comrades from more distant parts could attend.
I fear however that with the exception of a few states the kind of conferences that will be held will not be very valuable in the sense that the active comrades "will be able to listen to an intelligent discussion of party matters from all viewpoints. I fear that what the party leadership has in mind with reference to these regional conferences are the kind of campaigns which in the Communist party are called "enlightenment campaigns." And by that euphemistic term is meant an attempt to convince the membership that the leadership is correct.
LEON TROTSKY IN MEXICO?
AS WE GO to press the newspapers carry the announcement that the Foreign Office of the Mexican government will grant comrade Trotsky permission to enter Mexico if he applies for entry. The Mexican petty bourgeois government is anxious to show its liberalism by granting asylum to the one revolutionist whom the capitalist class of every country fears more than any other person.
Will Stalin succeed in changing the decision of the Mexican government? That he will try his utmost to do so is certain. The Mexican Stalinists have already begun a vicious campaign and there is no telling what can happen before Trotsky is actually on Mexican soil. Fortunately for Trotsky Stalin cannot exert economic pressure on Mexico as he did on the Norwegian "Labor" government. And the Communists are not such a strong force as to wield a powerful influence on the Mexican government, although they support Cardenas.
The vital interests of the revolutionary movement demand that Trotsky be given political asylum and that he be permitted to instruct the revolutionary workers the world over by his interpretation of the events of the day. The committee which has been recently organized for the defense of Trotsky is not left without work to do. It must continue its existence to guard his rights and to defend him; against the vile calumnies of Stalin and his henchmen.

redpajama_set_name: RedPajamaCommonCrawl


text:
using System;
using System.Net.Http;
using System.Net.Http.Formatting;
using System.Threading.Tasks;

namespace Antix.Http.Services.Client
{
    public class HttpClientService :
        IHttpClientService
    {
        readonly Func<HttpClient> _getClient;
        readonly MediaTypeFormatter _mediaTypeFormatter;

        public HttpClientService(
            Func<HttpClient> getClient,
            MediaTypeFormatter mediaTypeFormatter)
        {
            _getClient = getClient;
            _mediaTypeFormatter = mediaTypeFormatter;
        }

        public async Task<HttpResponseMessage> ExecuteAsync(
            HttpClientServiceRequest model)
        {
            using (var client = _getClient())
            {
                var requestMessage = new HttpRequestMessage
                {
                    Method = model.Method,
                    RequestUri = new Uri(model.UriString)
                };
                foreach (var header in model.Headers)
                    requestMessage.Headers.Add(header.Key, header.Value);

                if (model.Content != null)
                {
                    requestMessage.Content =
                        new ObjectContent(
                            model.Content.GetType(), model.Content,
                            _mediaTypeFormatter);
                }

                return await client.SendAsync(requestMessage);
            }
        }
    }
}

redpajama_set_name: RedPajamaGithub


text:
Mikhail Pletnev - Klavierabend
Classical concert
With the radicalism of the discoverer, Mikhail Pletnev makes every single piece he plays his own, as if it had been composed for him. The master pianist takes his audience on fascinating journeys of discovery that shed new light on even the best-known works and change listening habits forever.
Mikhail Pletnev performs with the leading orchestras and conductors. In 1989, he founded the Russian National Orchestra (RNO) as the first privately financed orchestra in his homeland. In September 2022, Pletnev and his orchestra broke up. Pletnev then founded a new, free orchestra in Bratislava, bringing together musicians from Russia and around the world: the Rachmaninoff International Orchestra. By choosing Rachmaninoff as the orchestra's namesake, Pletnev also commemorates one of the greatest Russian composers of the 20th century, who was forced to leave his homeland due to the Soviet dictatorship. Pletnev records for the prestigious Deutsche Grammophon label, and his recordings have won numerous awards. Pletnev's compositions are performed by renowned performers and acclaimed by press and public. His piano transcriptions of the ballet suites to "Sleeping Beauty" and "Nutcracker" (Peter I. Tchaikovsky) have long been part of the repertoire of international master pianists. Mikhail Pletnev was born in 1957 in Arkhangelsk in northern Russia and studied at the Moscow Conservatory. Winning First Prize at the International Tchaikovsky Competition in Moscow in 1978 marked the beginning of his international career as a soloist.
www.alteoper.de/


text:
Comments Off on Paul Mitchell – Giving Is My Style Campaign
Fall 2015, Fashion, Holiday Gift Giving Guide, Life, Lifestyle Tips, Wellness
Paul Mitchell - Giving Is My Style Campaign
Christmas and Thanksgiving's right around the corner and everyone likes to give back during this time of the year! Why not participate in a great charity; striving to raise funds for Boys and Girls Club, Waterkeeper Foundation, Morris Animal Foundation, and many more. Paul Mitchell has taken action on social media with the Giving Is My Style Campaign.
Paul Mitchell Mission:
This holiday season, we're celebrating our commitment to live beautifully by giving, because that's our style. Whether that means taking steps toward sustainability, helping families in need or supporting underserved kids, Paul Mitchell® believes in doing good for people, animals and our planet. Join our global family and share why or how you give back on Instagram or Twitter with #GivingIsMyStyle, and we'll donate $1 to one of our favorite charities on your behalf.
Bright Pink: Bright Pink is the only national non-profit organization that focuses on the prevention and early detection of breast and ovarian cancer in young women. We are proud to support their mission to educate, equip and empower women of all ages to be proactive with their health. @BeBrightPink
Waterkeeper Foundation: For more than 10 years, Paul Mitchell has supported Waterkeeper Alliance in their mission to protect rivers, streams, coastlines and other major waterways around the world.@Waterkeeper
Morris Animal Foundation: Morris Animal Foundation is a global leader in supporting scientific research that advances veterinary medicine. We're proud to support the organization's commitment to improving the health and quality of life for dogs, cats, horses and wildlife around the world.@Morris_Animal
Grow Appalachia: In 2010, Paul Mitchell co-founder John Paul DeJoria teamed up with Berea College to establish Grow Appalachia, a non-profit initiative that helps Appalachian families plant a healthy future. Over the last few years, the organization has produced more than 1.1 million pounds of healthy, organic food for thousands of people in five states. @GrowAppalachia
Boys & Girls Club: Paul Mitchell co-founder John Paul DeJoria grew up in an underserved Los Angeles community. During his youth, the local Boys & Girls Club provided a safe place for him to socialize, learn and grow. Today, our company is proud to give back to the Boys & Girls Clubs of America and their efforts to create great futures for young people.@BGCA_Clubs
Reforest'Action: Paul Mitchell Tea Tree proudly supports Reforest'Action, an environmental organization that plants trees worldwide, in the areas where they're needed most. Join The Green Takeover and help us plant 500,000 trees by 2016.
Social Handles
IG: @PaulMitchellUS
Twitter: @PaulMitchellUS
Hashtag: #GivingIsMyStyle
Join us in helping with the cause by sending an IG Message or Tweet with the featured social media handles. I've already started working on the initiative and asking everyone to join me! It's just that easy but can make a big difference this holiday season.
[youtube height="720″ width="1280″]https://www.youtube.com/watch?v=Fs4KCWsnBkI[/youtube]


The hospital romances often fictionalized in romance novels may be fiction in real-life, according to one researcher.
In a recent report, published in a recent issue of The Lancet found that the steamy hospital love affairs just don't happen in the real world. Researcher Brendan Kelly, a senior lecturer in psychiatry at the University of Dublin, who also met his wife of three years while in medical school, studied romance novels where the romantic interests involved those who worked in the medical field together.
Most novels were set in primary care or emergency room settings, including emergency medicine departments and airborne medical teams while the rest where in general hospitals and maternities. The central characters were usually male doctors in emergency, primary care, surgery, obstetrics, neonatology or pediatrics, and the 20 female characters were either doctors or nurses.
Dr. Kelly claims that the picture painted in most of these novels of doctors ripping off their shirts and saving a female patient just doesn't happen. "The real ER is a lot less exciting, I regret to tell you," said Dr. Brendan Kelly, senior lecturer in psychiatry at University College Dublin in Ireland.
However, one doctor, who also met his wife while attending an academic medical center, somewhat disagrees. "The potential for romance is high in emotionally intense settings such as hospitals," said Dr. A. Mark Fendrick, professor of medicine at the University of Michigan. "The dismal record for medical marriage longevity shows once again that fiction does not mimic reality."


Fully modernised and extended, this spacious property is situated in the village of St Brides Major offering local facilities including primary schools, village store and village pub. The village of St Brides is a short drive from the beautiful Heritage Coast and the popular towns of Cowbridge and Bridgend. The property accommodation comprises: Entrance hallway to spacious open plan lounge/diner and fitted kitchen with oven, hob and hood, separate utility and cloakroom/WC. Three double bedrooms and shower room. Gas fired central heating. UPVC double glazing. Gardens to front and rear and driveway.
With coast hairdressers on your left hand side, follow that road and take the next right signposted Southerndown. Kyneton is along that road on the right hand side.


Newsom's statement came one week after he unveiled a new health care agenda aimed at enhancing affordability in the years ahead and building on the Patient Protection and Affordable Care Act as a pathway to universal coverage.
Covered California Executive Director Peter V. Lee, who was in Los Angeles Monday to promote open enrollment, said time is of the essence.
Lee praised the governor's proposals to enhance affordability by increasing subsidies in the future for middle-income Californians.
Gov. Newsom urged Californians to visit CoveredCA.com for more information.
"Covered California is the only place you can go to see if you qualify for financial help that can take hundreds of dollars off the price of your insurance premium," he said. "An estimated 1.1 million Californians are eligible for quality health care coverage, either through Covered California or Medi-Cal, so do not miss this chance to get coverage that will protect you and your family," he said.
Open enrollment is the one time of the year when consumers can sign up for coverage without needing to meet any conditions. California's previous open-enrollment period ran through January, but a state law established that open enrollment would run from Oct. 15 through Jan. 15 each year.
Covered California made a stop in Los Angeles on Monday to promote enrollment with longtime partner Asian Americans Advancing Justice. The event culminated a bus tour that traveled more than 2,000 miles, with stops in cities across the state.
The tour will feature individuals who have been enrolled through Covered California since the exchange first opened its doors. Local dance crews will also be depicting the idea that life can change in an instant, which ties to Covered California's award-winning advertising campaign that features ads showing individuals slipping down stairs, falling off a ladder, getting in a bicycle accident and cutting their hand in the kitchen.
There will be two performances in Los Angeles, at the headquarters of Asian Americans Advancing Justice. Both dances will be performed by the world-famous GRV dance crew. The crew and the choreographers, Eileen Kim and David Lim, are all based in Los Angeles. Both Kim and Lim have spent years dancing, teaching and touring the world with their performances.


text:
Marx and Engels on India and the 1857 Indian Mutiny
– ( Choppa Morph )
Revolutions and war in the world and in Europe 1419, 1649, 1776
Bourgeois revolutions had been shaking the world for centuries before the English took power over the whole of the Indian subcontinent. Great milestones were the pre-Reformation peasants' commune in Tabor in Bohemia (1419-1434), the English Revolution, which beheaded Charles the First in 1649 and set up a Republic, and the American Revolution of 1776. All these revolutions were part of bloodthirsty wars between classes and nations.
The impact of the bourgeois French Revolution on history and philosophy
The high point of this rising tide of bourgeois revolution was the French Revolution of 1789, which finally broke the back of aristocratic rule in Europe and the world. By this time the European bourgeoisie had already made most of the world subservient to its commercial requirements, colonizing America, Africa and Asia. The removal of feudal and Papal fetters on thought and expression allowed this expanding material world to be reflected in new and bold ideas – scientific, historical and philosophical. The German philosopher Hegel assimilated all this contradictory ferment in his idealistic system, smashing all previous moulds of thought – including, ironically, his own! The way was prepared for humanity to move beyond the limits of bourgeois society that had been reached and surpassed both materially and intellectually by 1830.
The proletarian revolutions of 1848 and the Communist Manifesto'
The bourgeoisie itself had produced the social force that was to transcend its world – the working class. And this rising class made its first independent appearance on the stage of history in the pan-European revolutionary upsurge of 1848, and the accompanying initial fanfare of world socialist power – the Communist Manifesto of Marx and Engels.
Marx succeeded in assimilating the conquests of Hegel's thought without being sucked into the empty idealism of the World Spirit and just as importantly without losing any of the breadth, depth or power of Hegel's perspectives or penetrating intellectual insights.
Marx's first series of articles on India
Simultaneously with the revolutions of 1848, England finally gained control of the whole of Greater India by defeating the Sikh Empire in the Punjab and Sindh in 1849. Marx and Engels always followed world events avidly, but did so even more attentively when they went into exile in England after the defeat of the 1848 revolutions, as England was the heart of the most powerful political, military and economic power in the world in the mid-19th century.
In the 1850s they contributed many articles to American journals on English and world events, and in 1853 they produced a series of articles on the history of India and the impact England had on it. The articles were prompted by the consideration by parliament in London of the India Act, to deal with new and unprecedented challenges facing English rule in India.
The India Act
In 1784 the East India Company which had previously been pretty much a law unto itself, was put under tighter government control. The greater its power, and the richer its pickings, the bigger the say the government wanted in its affairs. The Company's power and pickings grew very fast in the following sixty year, but the government was unable to radically change the Charter defining the Company's privileges because whenever the Charter came up for renewal, Britain was completely occupied by other more urgent business, like the Napoleonic Wars in 1813 and later the Reform Act in 1833. This allowed the Company to use English arms and money to extend its control over the whole subcontinent.
In 1853 however further delay was impossible. The Company had long since ceased to be a commercial enterprise, and had assumed military and territorial powers the government could no longer allow free rein. Thus the Company was turned into an empty shell, but still a very lucrative one for its stockholders, bureaucrats and government accomplices.
English industrialists also craved unrestricted access to the Indian market and Indian manufacturing potential, in opposition to the old oligarchs and plutocrats who were content to live off stolen landed estates and monopoly profits.
A final incentive to legislate for greater parliamentary control was the crisis in Indian finances.
Marx details these preconditions for the India Act in his June 1853 article "The East India Company – Its History and Results". In another article he writes of "the double government of India" – ie the Company and the Crown, and sarcastically lists the "five points of the East Indian Charter": "a permanent financial deficit, a regular over-supply of wars, and no supply at all of public works, an abominable system of taxation, and a no less abominable state of justice and law".
How well parliament was able to resolve these problems was shown in the following few years.
From the East India Company to the Raj
We must never forget that India as a united entity of a modern kind, as an integral part of the bourgeois world market, only dates from 1849. British domination was qualitatively different from all previous rule in India. Marx writes in "The British Rule in India" (June 1853) that "the misery inflicted by the British on Hindustan is of an essentially different and infinitely more intensive kind than all Hindustan had to suffer before". What the rule of Britain in the guise of the East India Company achieved between 1700 and 1850 was a prodigy of creative destruction – with the destruction outweighing the creativity…
First and foremost Marx emphasizes that the foundation of Indian civilization from time immemorial – the "village system" of virtually autonomous isolated rural communities, self-sufficient in hand-spinning, hand-weaving and hand-tilling – was smashed. High above this ancient system various warring dynasties had ruled, but their only contact with the villages was the more or less tolerable collection of tribute. Except that the rulers had always taken care to provide public works such as irrigation, without which no crops would grow and which individual villages were incapable of creating for themselves.
The British, like earlier rulers, made war and exacted tribute – but unlike their predecessors they wilfully neglected the provision of public works, with easily predictable results. Marx quotes official statistics for 1851-52 showing that of a total Indian revenue of £19,800,000, only £166,300 were spent on public works – less than one per cent.
And unlike earlier rulers the English destroyed all traditional forms of land tenure and replaced them with mongrel bourgeois-aristocratic hybrids of their own creation. Rapacious rent-collectors and tax-gatherers (the zemindari) were forced on some regions, and uneconomically small plots of land were chopped up for rich and poor natives alike in others (the ryotwari).
As for the condition of the small cultivators, Marx notes that "the ryots – and they form 11/12ths of the Indian population – have been wretchedly pauperized".
Finally, the condition of India after its incorporation under the British Crown in 1849 could be epitomized by its main sources of revenue – two thirds coming from the land, and one ninth from the hated salt tax (a factor that precipitated both the French Revolution of 1789, and powered much of the Indian independence movement of the mid-20th century). The third main source, amounting to one seventh of the total was derived from opium cultivation and commerce.
Opium brings in the international setting of India's historical relationship with England. England forced India to grow and prepare the drug, and then forced China to consume it. So India was used as a battering ram to break down the protective walls of Chinese isolation and allow the English to profit from Chinese silk and tea.
The opposed challenges of China and Russia forced England into very expensive strategic wars to safeguard the profits from the one (the Burmese wars) and to ward off encroachment by the other (the Persian and Afghan wars).
The articles of 1857-58
The unification of India and the native army were preconditions of the 1857 Mutiny
The outbreak of the great Indian Mutiny in 1857 – less than 10 years after England had brought all India under its sway, comes as no big surprise against the background given by Marx in his 1853 articles. After unification all the pressures increased with explosive force. Not only was there a ruinous financial situation whipping the English to tax India to starvation point, not only were there no public works but only endless wars, not only was there permanent injustice and disregard for law, but all this was compounded by English arrogance and contempt for the Indians.
This arrogance and contempt for Indian dignity finally sparked the conflagration. And since the contempt made no distinction between Hindu or Muslim, or even rich or poor, the Indian nation as such rose against the English tyrants. The last straw was forcing native soldiers to bite into cartridges greased with fat from cows (sacred to Hindus) and pigs (taboo for Muslims). But the rising was not religious.
In their articles on the development of the mutiny Marx and Engels show their skill as political and military analysts. They build on the understanding shown in the 1853 articles to give a clear-sighted straight-from-the-shoulder commentary on events as they unfold.
The motto for their coverage of the Mutiny could well be Marx's words from his July 1853 article "The Future Results of the British Rule in India":
"The native army, organized and trained by the British drill-sergeant, was the sine qua non of Indian self-emancipation, and of India ceasing to be the prey of the first foreign intruder."
The articles, written from June 1857 to July 1858 for the New-York Daily Tribune, follow the initial victories and the final defeat of the rising, from the first outbreaks of disobedience in Bengal, via the taking of Delhi to the British looting of Lucknow and the annexation of Oudh. Although most of the articles are signed by Marx, the strategic military understanding of Engels, known as "the General" to his comrades in the Marxist Second International, is present in every line – partly because he wrote a lot of these articles for Marx, and partly because of the constant exchange of ideas and analyses between the two men. The articles speak for themselves – they are brief, clear, and enlightening. They are particularly clear on the respective strengths and weaknesses of the combatants.
British weaknesses
The major weakness of the British in an emergency of this kind was the mirror image of a great strength in "stable" times. 40,000 English troops controlled a native army of 200,000 (with English officers) which in turn controlled a population of 200,000,000 Indians. Once the Indian troops ventured to turn their rifles on their officers, the English were overwhelmed by their sheer numbers. "Ye are many, they are few", as Shelley writes.
A great military weakness of the English is one shared by all tyrannical soldiery – arrogance coupled with contempt. A permanent blindness to the capabilities of a supposedly inferior enemy. This is coupled with institutional cowardice, which refuses to fight unless in a position of overwhelming strength – a contemporary equivalent is US aggression in Iraq and even more so in Afghanistan, and the blood-chilling cowardice of the Israeli state relentlessly bombing Gaza and destroying people, houses, and business and public premises.
The British were at a great disadvantage when forced to fight in the murderous heat of the Indian summer. More were killed by the sun and disease than by enemy action.
And they found it very difficult to travel or bring in supplies because of the complete lack of suitable roads and communications.
Indian strengths
The Indian strengths lay in their numbers, and in their ability to cope with the climate and conditions. They also knew the terrain far better than the English. And had the support of the people.
The also had the advantage of fighting for their own cause and their own freedom. One soldier fighting for his own cause is worth at least ten mercenaries.
Indian weaknesses
But although the Indians now formed part of a unified army, they were still confined to lower ranks and lacked the tactical and strategic skills of trained officers. Marx and Engels are scathing about their tactical and strategic blunders, as in the occupation of and the fighting around Delhi. They also lacked military equipment, artillery etc and the skills required to use them effectively.
The crucial weakness however was the lack of social cohesion in the Indian rebellion. The mutineers were initially supported by the expropriated, impoverished and humiliated feudals, but this solidarity didn't last.
British strengths
The British had three great strengths. One was military knowledge (regardless of how ignorant and brutish most of the officers were). Given time and space to consider strategy and tactics, they were able to plan and execute coordinated and effective manoeuvres that the mutineers were unable to counter. Another was what must have appeared to the Indians to be limitless material resources. And the third was political and diplomatic cunning. Using every means available, by hook or by crook, they were able to divide the Indians and gradually win back power. In effect they bought off the feudal princes by offering them concessions such as better conditions of land tenure and lower taxes.
Indian Empire to Indian independence and partition
After the defeat of the Mutiny the British consolidated their rule and misrule of Greater India. Two decades later, in 1877, Britain proclaimed the Indian Empire and Queen Victoria was declared Empress of India.
But already two decades before Independence was won in 1947 India became practically ungovernable and the whole nation rose like a tide against British tyranny.
Great as the achievement of independence was, however, the irony of history in the form of the pro-imperialist bourgeois policies of Gandhi and others, allowed British political and diplomatic cunning to leave its cancerous poison of divide and rule as an enduring legacy to the subcontinent. The catastrophe of Partition along communal lines kept British and later US imperialist influence much stronger than it would otherwise have been, and has delayed the socialist transformation of South Asia by decades.
The lesson of the Indian Mutiny for today is that united resolute militant rebellion can shake the most apparently immovable tyranny to its core – we are seeing this daily right now in February 2011 in North Africa and the Middle East. The ultimate failure of the Mutiny also serves to warn us that such rebellion is not in itself sufficient for full social and economic emancipation.
Our post-October 1917 Bolshevik-Leninist perspective teaches us that you also need an internationalist Marxist leadership of the working class in alliance with the poor peasantry and the poor rural and urban masses to carry such a revolt through to a permanent revolutionary socialist victory. Only with such a leadership will we be capable of overthrowing bourgeois capitalist society and creating a non-capitalist workers state capable of building a new socialist society
Filed under Reports and General Articles Tagged with 1857, Engels, Great Indian rebellion, Marx, Sepoy


Since its inception back in 1999, the San Antonio institution known as PuroSlam has called many venues home — from bygone haunts like Re:Verb, the Wild Club, El Toro and the Korova to still-active mainstays like Sam's Burger Joint, Southtown 101 and the Mix — while staying true to its roots as a platform for outspoken, envelope-pushing spoken word. Founded by Benjamin Ortiz and in the hands of wordsmith Jason "Shaggy" Gossard since 2000, the Tuesday night tradition follows a steadfast format: anyone can sign up to compete, poets are given three minutes onstage to spit strictly original material, random audience members help judge performances, prizes are awarded, DJ Donnie Dee spins during the breaks — and booze and heckling are both part of the overall equation. "There is a reason I hold [the] slam so late and at a bar — I want it to have that punk-rock atmosphere," Gossard explained to the Current in 2014. Unsurprisingly, PuroSlam's irreverent, uncensored spirit hasn't gone unnoticed at the National Poetry Slam (NPS), a roving championship tournament the group nearly won as a fresh force to be reckoned with back in 2000. (Boos and hisses reportedly punctuated PuroSlam's offerings at NPS in 2013.) For the last seven months, PuroSlam poets have been duking it out at weekly slams in hopes of scoring high enough to land in a group of 10 who'll compete for just four coveted spots on a team bound for this year's NPS in Oakland. So far, confirmed competitors include 2014 San Antonio Grand Slam Poetry Champion Christopher "Rooster" Martinez, 2017 San Antonio Grand Slam Poetry Champion Chibbi, 2018 San Antonio Grand Slam Poetry Champion Diamond Mason, 2018 NPS team member Mandy Lynn, multi-year NPS team member Travis and rookie George Lee. It's safe to say nerves will be running high as the special guest judge for the qualifying event is none other than San Antonio Poet Laureate Octavio Quintanilla.


text:
Chinese Company Expands in Swansea
Thursday, February 23rd, 2017 12:00am
Economy Secretary Ken Skates with Acerchem International Chairman Frank Chen.
Acerchem creates 38 R&D jobs at university
Acerchem International - a leading Chinese health and nutraceutical group with links to Swansea University - is to establish its European HQ and R&D and manufacturing centre in the city, creating 38 high calibre skilled jobs.
The news was announced today by Economy Secretary Ken Skates who is in China on a trade mission and meeting Acerchem International Chairman Frank Chen, Strategic Director Ms Nancy Wu and Global Vice President Ken Li at a business reception in Shanghai this evening.
Mr Skates said: "It's great news that Acerchem International has chosen to set up its European Headquarters in Wales and is to open a manufacturing and Research and Development centre here, creating a significant number of skilled jobs.
"The company has a long standing Research collaboration with Swansea University which clearly illustrates the importance of building international academic links with business and industry.
"This investment, which is supported by the Welsh Government, can only serve to strengthen the ties between our two countries. China is an extremely important market for Wales and our trade mission this week builds on the strong economic and cultural links that have been developed over a number of years."
The investment by Acerchem International is backed by £600,000 from the Welsh Government and will create 38 highly skilled, well paid jobs, primarily working in R&D. The company plans to establish its R&D facility in the Institute of Life Science at Swansea University.
Acerchem International Chairman Frank Chen said: "We very much look forward to building up the business in Wales and developing even closer links with Swansea University.
"Support from the Welsh Government helped fast track this project and was vital in bringing it to Wales and we value the support we have had from Welsh Government officials in Shanghai and in Cardiff.
"Opening this new HQ and R&D centre in Wales marks an exciting new development for the group and a great opportunity to develop and grow the business."
CEO Jeff Jiang founded Acerchem International in Shanghai in 2007 which has grown into a multi million pound business and a leading group in the health and nutraceutical sectors. The company exports to over 40 countries with sales offices in Wales - at the Institute of Life Science, Swansea University - in Japan, the Netherlands and Spain.
Its product range includes nutritional supplements, functional foods and beverages, beauty care and animal nutrition supplements.
The company provides a diversified portfolio of fermented ingredients and has developed a sophisticated extraction and purification business unit using natural ingredients, giving products better absorption and stability.
With an R&D centre in Shanghai, and working alongside Swansea University, it has developed its own formulations which include premix, blends, tablets, soft-gels, and others. It plans to invest significantly in R&D working with Welsh Universities and increase its business with existing customers in Wales that could also lead to additional jobs being created.
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text:
OpinionUS news
This article is more than 1 year old
We can prevail over Omicron. We just need to use the tools we have
Eric Topol
Masks, vaccines, boosters, rapid tests and anti-Covid pills will all be essential in the months ahead
'Beyond mitigation and vaccination, we soon will have potent pills, when taken early in the first few days of a Covid infection, one with around 90% efficacy, to prevent hospitalizations and deaths.' Photograph: Kim Ludbrook/EPA
Wed 1 Dec 2021 06.19 EST Last modified on Wed 22 Dec 2021 07.15 EST
Last week, we learned from virus sequencing and rapid reporting by South African scientists that there is a new variant with 50 mutations compared with the original Wuhan strain. It quickly was named Omicron and categorized as a variant of concern by the World Health Organization, a designation that hasbeen used for only four previous variants (Alpha, Beta, Gamma, Delta) among thousands of variants noted in the evolution of the Sars-CoV-2 virus.
We do know a few things about Omicron, namely its sequence and the site of its abundant mutations, far more than previous variants of concern, and some at spots in the virus RNA that may substantially affect transmission or impair our immune system (or vaccine-induced immunity) to respond. That is all theoretical, since there have been other mutation-laden variants in the past that were picked up but turned out to be void of any clinical consequence.
We also can deduce that Omicron must have originated from an immunocompromised host to have such an extensive number of mutations (from an initial Alpha variant lineage) to rapidly evolve in the person's body. That phenomenon has been demonstrated with multiple previous cases whereby there are unrestrained virus mutations inside a person's body due to an inadequate immune system defense. And the individual's chronic infection subsequently transmits to other people.
The other thing we know is that there has been an outbreak in the Gauteng province in South Africa and, after Omicron was flagged for the rest of the world, more than 15 countries have confirmed new cases, predominantly from travelers but now multiple community transmissions have been documented.
To date, the pattern of hospitalizations in Guateng is the same as with the prior waves, no worse or better. It is likely that Omicron has been around for months, but only recently was there the first sign of a sudden rise in one place. Fortunately, it was diagnosed quickly, and the rest of the world was forewarned, far better than for the previous variants of concern.
It remains unclear whether the proliferation of cases is related to high transmission, like Delta, or immune evasion, like Beta. Most likely because of the extensive mutations or what is known as "antigen drift", it will behave more like Beta, with some immune evasion properties. The extent of that will be sorted out in the next couple of weeks by lab studies that look at the virus in culture and sera from people who are vaccinated to see how their neutralizing antibodies fare against Omicron.
But no matter the results of these lab studies and what tracking of new cases around the world show, we have all the tools to prevail over Omicron. That includes mitigation measures like masks, especially medical grade ones, physical distancing, ventilation and air filtration.
We have remarkably potent vaccines with 95% efficacy against symptomatic infections, hospitalizations and deaths. And even though these mRNA vaccines have some waning of effectiveness over five to six months, their efficacy is fully restored to 95% with a third shot (booster).
Moreover, that third shot induces remarkably high neutralizing antibodies, much higher than the second vaccine dose, and much broader activity against variants. Furthermore, the T-cell response to vaccines are far less variant sensitive than neutralizing antibodies, which puts us in good stead for fully vaccinated people to reduce the risk of severe disease.
We are better positioned to defend against Omicron than we would have been earlier in the pandemic
Beyond mitigation and vaccination, we soon will have potent pills, when taken early in the first few days of a Covid infection, one with about 90% efficacy, to prevent hospitalizations and deaths. The protective benefit of pills such as Paxlovid is not expected to be affected by Omicron in any substantive way.
There are many fully validated rapid antigen tests that should be made freely available as in many other countries to help diagnose infectiousness in people with or without symptoms, which can promote early use of treatments, such as anti-Covid pills. Accordingly, we are better positioned to defend against Omicron than we would have been earlier in the pandemic. We are also probably on the cusp of developing pan-sarbecovirus vaccines, which may protect against all future variants, and just needs a global prioritized, coordinated and funded effort to accelerate the process. Yet the paramount thing holding us back is human behavior: the unwillingness and resistance to use all these tools.
Although Omicron is a source of concern, our problem now is lack of containment of Delta in the United States, with more than 90,000 new cases a day and more than 50,000 hospitalizations. We are the number one source of new infections in the world, and they are now all Delta. Had we managed to vaccinate more than 80% of our total population, as several countries have done, and used third shots to prevent any significant waning, we would have Delta contained. Our problem now is not Omicron, but rather not using the tools we have, which are getting better and better over time.
Eric Topol is the founder and director of the Scripps Research Translational Institute, professor of molecular medicine, and executive vice-president of Scripps Research