bluuebunny/crossref_metadata_2025 huggingface dataset:
The economic burden of smoking in Belgium: incremental healthcare costs and lost productivity
Authors: Vynckier Pieter , Schmidt Masja , Nayani Sarah , Guariguata Leonor , Devleesschauwer Brecht , Verhaeghe Nick
Published: January 2025

Tobacco use is among the leading behavioural risk factors for morbidity and mortality. These high rates result in a high cost to society. Therefore, the aim of the current study was to provide a contemporary overview of the direct medical and indirect costs attributable to smoking tobacco in Belgium. Data from the Belgian Health Interview Survey (BHIS) was combined with health insurance claims data. Healthcare costs were calculated on individuals’ cigarette smoking patterns (daily, former, and never smokers). Lost productivity costs were calculated by multiplying the number of absence days by the national average wage cost per day. Univariate and multivariable regression analyses with negative binomial distribution and log link were performed to evaluate the average healthcare costs and indirect costs in relation to tobacco use, socio-demographic characteristics, and (behavioural) risk factors. A total of 10 829 individuals were included in the analyses, of which 47.7% were men, with 15% being smokers. Men were more likely to be smokers than women (56.8% vs. 43.2%; P < 0.001). Compared to never smokers, significantly higher direct medical costs were found for daily (20%; P = 0.03) and former smokers (27%; P < 0.001). No significant differences were observed for the indirect costs for the smoking population compared to never smokers. Taking into account that 15% of the Belgian population were daily smokers in 2018, the national cost for daily smokers equates to €533.861.010. Results of our study show that cigarette smoking has higher direct medical costs compared with never smokers.
Excess healthcare utilization and costs linked to chronic conditions: a comparative study of nine European countries
Authors: Polanco Boris , Oña Ana , Gemperli Armin , Pacheco Barzallo Diana
Published: January 2025

The increasing prevalence of chronic conditions is a significant challenge for healthcare systems worldwide, not only from a public health perspective but also for the aggregate cost that these represent. This paper estimates the additional use of healthcare services due to chronic health conditions and their associated costs in nine European countries. We analyzed inpatient and outpatient healthcare utilization using longitudinal data (Survey of Health, Ageing and Retirement in Europe [SHARE]). We implemented a difference-in-differences approach across multiple time periods. Monetary estimates were derived using WHO-CHOICE healthcare service costs. To compare countries, we calculated the healthcare cost burden of chronic conditions as a percentage of total health expenditure. People with chronic conditions require significantly more healthcare services than those without such conditions, averaging three additional outpatient visits and one extra overnight inpatient stay annually. These patterns vary across countries. In Germany, outpatient care usage is particularly high, with an average of four additional visits, while Switzerland leads in inpatient care with two extra overnight stays. The associated costs also differ widely, influenced by variations in healthcare demand, service pricing, and the prevalence of chronic conditions in each country. Chronic conditions significantly increase healthcare utilization, and demographic trends suggest this demand will continue to grow steadily. This rising pressure poses serious challenges for healthcare systems, necessitating a shift toward more efficient service delivery models.
Using feedback in pooled experiments augmented with imputation for high genotyping accuracy at reduced cost
Authors: Clouard Camille , Nettelblad Carl
Published: January 2025

Conducting genomic selection (GS) in plant breeding programs can substantially speed up the development of new varieties. GS provides more reliable insights when it is based on dense marker data, in which the rare variants can be particularly informative. Despite the availability of new technologies, the cost of large-scale genotyping remains a major limitation to the implementation of GS. We suggest to combine pooled genotyping with population-based imputation as a cost-effective computational strategy for genotyping SNPs. Pooling saves genotyping tests and has proven to accurately capture the rare variants that are usually missed by imputation. In this study, we investigate adding iterative coupling to a joint model of pooling and imputation that we have previously proposed. In each iteration, the imputed genotype probabilities serve as feedback input for adjusting the per-sample prior genotype probabilities, before running a new imputation based on these adjusted data. This flexible setup indirectly imposes consistency between the imputed genotypes and the pooled observations. We demonstrate that repeated cycles of feedback can take advantage of the strengths in both pooling and imputation when an appropriate set of reference haplotypes is available for imputation. The iterations improve greatly upon the initial genotype predictions, achieving very high genotype accuracy for both low- and high-frequency variants. We enhance the average concordance from 94.5% to 98.4% at limited computational cost and without requiring any additional genotype testing.
Defining a novel DYRK1A-gp130/IL-6R-pSTAT axis that regulates Th17 differentiation
Authors: Malueg Matthew , Moo Keagan G , Arnett Azlann , Edwards Thomas H , Ruskin Susan L , Lambert Katharina , Subramanyam Aditi , Dufort Matthew J , Gersuk Vivian H , Partridge Rebecca , Buckner Jane H , Khor Bernard
Published: January 2025

Dysregulated differentiation of naïve CD4+ T cells into T helper 17 (Th17) cells is likely a key factor predisposing to many autoimmune diseases. Therefore, better understanding how Th17 differentiation is regulated is essential to identify novel therapeutic targets and strategies to identify individuals at high risk of developing autoimmunity. Here, we extend our prior work using chemical inhibitors to provide mechanistic insight into a novel regulator of Th17 differentiation, the kinase dual-specificity tyrosine phosphorylation-regulated kinase 1A (DYRK1A). We generated a conditional knockout mouse model to validate DYRK1A as a regulator of Th17 differentiation that acts in a dose-dependent fashion at least in part by modulating interleukin (IL)-6 signaling through multiple mechanisms. We identified a new role for DYRK1A in regulating surface expression of IL-6 receptor subunits in naïve CD4+ T cells, consistent with DYRK1A’s impact on Th17 differentiation. Physiologic relevance is supported by findings in people with Down syndrome, in which increased expression of DYRK1A, encoded on chromosome 21, is linked to increased IL-6 responsiveness. Our findings highlight DYRK1A as a druggable target of broad therapeutic and prognostic interest in autoimmunity and immune function.
Metagenomic analyses of gut microbiome composition and function with age in a wild bird; little change, except increased transposase gene abundance
Authors: Lee Chuen Zhang , Worsley Sarah F , Davies Charli S , Silan Ece , Burke Terry , Komdeur Jan , Hildebrand Falk , Dugdale Hannah L , Richardson David S
Published: January 2025

Studies on wild animals, mostly undertaken using 16S metabarcoding, have yielded ambiguous evidence regarding changes in the gut microbiome (GM) with age and senescence. Furthermore, variation in GM function has rarely been studied in such wild populations, despite GM metabolic characteristics potentially being associated with host senescent declines. Here, we used 7 years of repeated sampling of individuals and shotgun metagenomic sequencing to investigate taxonomic and functional changes in the GM of Seychelles warblers (Acrocephalus sechellensis) with age. Our results suggest that taxonomic GM species richness declines with age and in the terminal year, with this terminal decline occurring consistently across all ages. Taxonomic and functional GM composition also shifted with host age. However, the changes we identified occurred linearly with age (or even mainly during early years prior to the onset of senescence in this species) with little evidence of accelerated change in later life or during their terminal year. Therefore, the results suggest that changes in the GM with age are not linked to senescence. Interestingly, we found a significant increase in the abundance of a group of transposase genes with age, which may accumulate passively or due to increased transposition induced as a result of stressors that arise with age. These findings reveal taxonomic and functional GM changes with age, but not senescence, in a wild vertebrate and provide a blueprint for future wild functional GM studies linked to age and senescence.
O01 Rapid respiratory microbiological POCTs and antibiotic use in primary care: the RAPID-TEST RCT
Authors: Hay Alastair , Abbs Samantha , Ridd Matthew , Granier Stephen , Lane Athene , Muir Peter , Taylor Jodi , Young Grace , Eastwood Kathy , Dash Hayly , Bradshaw Lynne , Clarke Rebecca , Lui Mandy , Bridgeman Emma , Brierley Rachel , Brown Emily , Thornton Hannah , Yardley Lucy , Metcalfe Chris
Published: January 2025

Background

Antibiotics are prescribed for over 50% of RTIs in primary care, despite good evidence most patients do not benefit. Rapid multiplex microbiological point-of-care-tests (POCTRM) determine the presence/ absence of respiratory pathogens in 15 min. Whether POCTRM reduce antibiotic prescribing without worsening patient outcomes is not known.

Objectives

To investigate whether POCTRM can (i) reduce same-day antibiotic prescribing for children and adults presenting to primary care with RTIs; and (ii) change symptom severity on Days 2 to 4.

Methods

Patients 12+ months with a RTI where the clinician and/or patient believed antibiotic treatment was, or may have been necessary, presenting to 16 GP practices in SW England. Patients individually randomized to BioFire® FilmArray® Torch 1 testing for 19 viruses and four atypical bacteria; or usual care.

Results

Recruitment opened December 2022 and ended April 2024. A total of 552 participants were randomized: 63% female; 86% aged 16+ years; 95% self-reported white ethnicity; 26% had chronic lung disease; 5% reported a temperature >38°C; 14% reported tachycardia (age-adjusted); 8% reported tachypnoea (age-adjusted); 1% had oxygen saturation <94%. Ninety-five percent provided a dual throat and nasal swab, and clinician diagnoses included: acute cough (17%); common cold (14%); acute pharyngitis/ tonsillitis (13%); acute lower RTI (11%); chest infection (9%); sore throat (9%); and infective exacerbation of chronic lung disease (7%). Outcome data completeness: 548 (99%) with antibiotic prescribing; 414 (76%) with Day 2 to 4 symptom severity.

Conclusions

Full results will be available for conference. This globally original RCT will provide important evidence regarding the role of rapid multiplex microbiological point-of-care-tests in primary care.
A novel detoxification strategy of Bombyx mori (Lepidoptera: Bombycidae) to dimethoate based on gut microbiota research
Authors: Tian Chao , Tang Jie , Zhu Qingyu , Guo Xiqian , Shu Qilong , Gu Zhiya , Li Fanchi , Li Bing
Published: January 2025

Bombyx mori (L.) (Lepidoptera: Bombycidae) is an important economic insect, and Exorista sorbillans (W.) (Diptera: Tachinidae) is an endoparasitic pest of larval B. mori. Dimethoate is less toxic to B. mori than E. sorbillans and is used in sericulture to controlling E. sorbillans. To investigate the effects of dimethoate treatment on the gut microorganisms and physiological functions of B. mori, 16S rRNA sequencing was used to analyzed the composition and structure of the gut microbiota. This study investigated their role in enhancing silkworm resistance by screening dominant populations after dimethoate treatment. The results indicated that dimethoate did not alter the composition of the dominant gut bacterial groups in silkworm; however, it significantly increased the abundance of the gut bacteria Methylobacterium and Aureimonas, and decreased the abundance of Enterobacterales, Bifidobacterium, Blautia, Collinsella, Faecalibacterium, and Prevotella. Eleven strains of dimethoate-resistant bacteria were selected through in vitro culture, all of which were unable to grow when dimethoate was used as a carbon source. Additionally, a germ-free silkworm model was established to assess detoxifying enzyme activity in the midgut. The results revealed that the gut symbiotic microbiota can enhance dimethoate resistance by increasing detoxification enzyme activity. This study identifies a novel pathway for silkworm resistance to dimethoate based on gut microbiota, providing new insights into the role of symbiotic gut bacteria in insecticide metabolism.
Accommodating family diversity and social parenthood within constitutional conservatism: A comparative analysis of Irish and Polish Law
Authors: Harding Maebh , Pawliczak Jakub
Published: January 2025

Recognition of family diversity in Polish law is limited. Many children are cared for by adults to whom they are legally strangers but who act as social parents. In contrast, Ireland has recently extended the definition of legal parentage to include LGBT+ families and has allowed social parents to become legal guardians of children. In both jurisdictions, tensions arise between conservative constitutional framing of the family and constitutional protection of respect for family life and the rights of children. The authors assert that the law should prioritise the best interests of the child in a functioning family where circumstances so require, even at the cost of infringing the traditional rights or status of the birth parents. This requires flexibility in legal provisions determining parentage and allocation of parental responsibilities and rights. Ideally, family law should directly recognize connections between children and their caregivers, regardless of biological relationship or the structure of the family in which they live. As a first step, recognizing social parenthood through established hierarchies of legal caregivers, as Irish law has done, is a good model for Poland to follow as a politically safe way to embrace diversity in family law.
Positive sputum fungal culture, fungal sensitisation, and airway microbial diversity in asthmatic children
Authors: Seear Paul J , Welsh Kathryn G , Satchwell Jack , Patel Deepa , Pashley Catherine H , Wardlaw Andrew J , Gaillard Erol A
Published: January 2025

Sensitisation to thermotolerant fungi such as Aspergillus fumigatus and Candida albicans, which can colonise the airways, is associated with poor lung function in children with asthma. Dysbiosis of bacteria and fungi in the airway microbiome has been reported between health and asthma but has yet to be characterised for fungal-sensitised asthmatic children. We investigated if microbial diversity of the airways is altered in fungal-sensitised school-age asthmatic children. Sputum samples from children with asthma who were fungal sensitised (n = 22) and non-fungal sensitised (n = 17) along with children without asthma (n = 15), aged 5–16 years were profiled by traditional microbiological culture, modified fungal culture, bacterial 16S, and fungal ITS2 next-generation sequencing. Microbiota were compared between groups using alpha/beta diversity and differential abundance analysis. Bacterial alpha diversity was significantly lower in asthma compared to disease controls and in stable compared to acute asthma. Fungal alpha and beta diversity did not change between asthma states and disease controls, but alpha diversity was significantly lower in asthma samples from patients with positive A. fumigatus culture. Children sensitised to fungi had similar microbial diversity compared to non-sensitised children. However, in children not sensitised to fungi, those with a positive airway fungal culture had significantly lower fungal alpha diversity and bacterial beta differences compared to children with negative fungal culture. Fungal sensitisation did not alter bacterial or fungal microbiota in the airways of asthmatic children. However, positive airway fungal culture was associated with significant changes in microbial diversity, particularly in non-fungal sensitised children with asthma.
Exploring psychological impact of hand-arm vibration syndrome (HAVS)
Authors: Bezanson S , Ruco A , Howse M , Budd D , House R , Khakpour M , Holness D L
Published: January 2025

Background

Hand-arm vibration syndrome (HAVS) is an occupational disease associated with long-term exposure to power tools leading to hand-transmitted vibration exposure. Prior research has focussed on physical manifestations with little known about the psychological impacts of HAVS.

Aims

To examine if HAVS severity and/or functional impairment is associated with psychological outcomes.

Methods

We conducted a cross-sectional study collecting data through a survey and retrospective chart review of workers being assessed for HAVS at an occupational medicine clinic. We collected information on demographics, work conditions, disease characteristics and physical and psychological outcomes as measured through validated instruments (SF-12, QuickDASH, GAD-2, PHQ-2). Descriptive statistics and bivariate analyses were followed by multivariable models to explore associations between mental health outcomes and predictor variables.

Results

Participants (N = 94; 56% response rate) were male with a mean age of 48.2 years. The majority (62%) worked in the mining sector, and 27% of participants reported feeling depressed and 35% reported showing little interest in or pleasure in doing things, while 28% reported clinically significant anxiety symptoms. In multivariable models, the QuickDASH, a measure of upper-extremity function and disability, was the only significant predictor of psychological outcomes.

Conclusions

Workers with HAVS have poorer mental health and physical functioning outcomes in comparison to the general population. Employers should consider tailored policies and interventions to address the mental health of workers with HAVS.
Preliminary Discourse on the Nature, Foundation, Utility, and Tools of the Philosophical History
Authors: Catana Leo
Published: January 2025

This chapter contains a translation of the introductory text to the Historia, namely the ‘Dissertatio praeliminaris’ (‘Preliminary Discourse’), which formulates the aim, nature, methodology, mechanisms of inclusion and exclusion, and periodization of his history of philosophy. In the ‘Preliminary Discourse’ Brucker explains his methodological precepts in the form of fifteen precautions, his scholarly and religious motivations for writing the Historia, his stance towards earlier models for narrating past philosophy, his criterion of inclusion and exclusion, and the scheme of the entire work and its underlying periodization. The ‘Preliminary Discourse’ is of value to any reader interested in his methodology, partly because it is relevant to his exposition of singular philosophers or periods exposed in his Historia, and partly because his methodology has been very influential up till at least the first half of the twentieth century, in some cases even longer. In addition, the chapter provides a translation of ‘De schola socratica’ (‘On the Socratic School’), illustrating how his methodological precepts were put into practice in the case of Socrates and his school. This text illustrates to an exceptional degree several of the precautions listed in the ‘Preliminary Discourse’, in particular the ones concerned with textual criticism. Moreover, in the ‘Preliminary Discourse’, Brucker himself pointed out Socrates’ philosophical method as an ideal way of philosophizing. Lastly, the understanding and evaluation of Socrates in eighteenth-century Germany is under-examined among modern Socrates scholars, and the text ‘On the Socratic School’ provides insight into this eighteenth-century debate about Socrates.
Interventionist Causal Exclusion and the Challenge of Mixed Models
Authors: Hoffmann-Kolss Vera
Published: January 2025

Whether the interventionist approach to causation can deal with variables occurring at different levels has been the subject of lively debate. According to an argument by Baumgartner, variables standing in supervenience relations to each other lead to a particularly detrimental version of the classical exclusion problem. However, many authors seem to agree that this problem can be efficiently avoided if variables standing in supervenience relations are given special treatment in the context of interventionist causal models. This chapter argues that the interventionist exclusion problem cannot be easily fixed, since the standard approach to avoiding it implies that the confounding factors for the causal relations described by a model are not adequately taken into account. Furthermore, it argues that multilevel causal structures can only be captured in a causal modelling framework if causal models are required to satisfy aptness conditions that rely on metaphysically ‘thick’ notions, such as the distinction between metaphysical and nomological modality, the grounding relation, or the assumption that properties can be ordered in terms of their degree of naturalness.
Explanatory Levels in Living Organisms
Authors: Bechtel William
Published: January 2025

This paper examines two notions of levels that are invoked in biology—levels of mechanisms and levels of control—and demonstrates that both notions of level are defined only locally. Neither generates to a general stratification of biological entities. This, however, does not present a problem for either the practices of biologists or of philosophers seeking to understand biology. In terms of locally characterized levels, researchers can develop multilevel mechanistic explanations and philosophers can explicate what is intended by claims of both bottom-up and top-down causation. Likewise, biologists can understand how a distinctive type of mechanism, a control mechanism, operates on and alters the operation of other mechanisms. Control is often understood hierarchically, but in biology control is often heterarchical. The result is that control processes are not neatly stratified. Nonetheless, levels of control can be identified locally. Defining mechanistic levels and levels of control locally suffices for the explanatory purposes of biology.
Levels Worth Having
Authors: Knox Eleanor
Published: January 2025

Accounts of theoretical levels range from very weak to very strong. Very weak accounts do not offer articulated level structure or underpin ontological claims. Very strong accounts are at odds with our understanding of reduction in physics. This chapter proposes a mid-strength account of theoretical levels based on accounts of novelty and autonomy in physics. Accounts in the philosophy of physics literature often hold novelty and autonomy to be the hallmarks of weak emergence but focus on autonomy at the expense of novelty. The chapter suggests that an account of novelty based on the importance of variable changes in inter-theoretic relations might underpin an appropriate conception of levels. The result is a local, system-specific, and sparse (but not unrealistically sparse) levels structure that can underpin modest ontological commitments.
Explanation in Descriptive Set Theory
Authors: Antos Carolin , Colyvan Mark
Published: January 2025

In this paper we investigate explanatory proofs in mathematics. We do this via an extended case study from descriptive set theory. The aim is to shed light on what makes explanatory proofs explanatory. Building on earlier work, we argue that there may be more than one notion of explanation in operation in mathematics: there does not seem to be a single account that ties together the different explanatory proofs we find in the various areas of mathematics. We then attempt to give a characterisation of the different notions of explanation in play and how these sit with accounts of explanation found elsewhere.
The Explanatory Role Argument and the Metaphysics of Deterministic Chance
Authors: Emery Nina
Published: January 2025

One common reason for thinking that there are non-trivial objective probabilities in worlds where the fundamental laws are deterministic is that such probabilities play an important explanatory role. According to this line of thought, it is vital to have probabilistic explanations of certain higher-level, macrophysical patterns, even if the underlying microphysical states can be explained in a purely deterministic way. This chapter examines this argument in detail and shows that insofar as it is successful, it places significant constraints on the further metaphysical theory that we give of deterministic chance. In particular, it is not clear how one can reconcile the explanatory role that deterministic chances are supposed to play with a Humean account of how deterministic chances are related to what is fundamental.
François Rabelais and the Renaissance Physiology of Invention
Authors: Garrod Raphaële
Published: January 2025

François Rabelais and the Renaissance Physiology of Invention explores the medical poetics of inventive, embodied thinking or ingenuity instantiated in episodes from Rabelais’s Gargantua and, mostly, his Quart livre. It unsettles established dichotomies in Rabelaisian scholarship between Rabelais’s ‘lowly’ laugher and ‘high’ erudite message and reassesses the Rabelaisian grotesque by highlighting its debts to grotesque ornament, this marginal yet omnipresent Renaissance visual art. Bodily functions are a trademark of Rabelais’s poetics. Scholarship has read them as signs of carnivalesque inversion and satirical degradation pitting the ‘lowly’ against the ‘high’, the ‘belly’ against the ‘head’. Yet for a physician like Rabelais, the ‘head’ or brain, the chest, belly and nether regions as sites of cognition, breathing, nutrition, and generation are all integrated physiological systems of animation. From this medical perspective, Rabelais’s fictions testify to his reflexive investigation into how culture results from natural, physiological processes. These underpin the animation of human ingenia—wits conditioned by biological natures—made manifest in pedagogical, artistic, mechanical, and spiritual ‘inventions’. While ingenia might be idiosyncratic, their animation is environmentally fuelled and shaped by the food we eat, the air we breathe, the places we inhabit, the company we keep. In this respect Rabelaisian fiction is grotesque in a period sense. With its emphasis on hybrid forms capturing the metamorphoses of animation, grotesque ornament reflexively commented on the embodied, inventive processes grounding Renaissance mimesis. Similarly, Rabelais’s fictions forefront the inventive powers of ingenious animation and articulate reflexive, often ironic alternatives to the (often transcendent) humanist views they alter: a thoroughly embodied anthropology, a naturalist genealogy of cultural production and transmission.
Groignet, the Slashing Tailor
Authors: Garrod Raphaële
Published: January 2025

This aside elucidates an anecdote from the Papimanes episode: that of Groignet the tailor, who misused a parchment of Canon Law to cut his clothes on; he found himself turning courtly clothes into papal garb and ended up ruined. Rabelais stages a grotesque trophy denouncing the anti-French political agenda of the Vatican Stanze and the conception of Church history they promote. He counters them by alluding to the forgotten fortune of Groignet de Vassé: former soldier for Guillaume du Bellay in Piemont, he turned unwitting agent of papal politics and later struggled to obtain a Church benefice. Like grotesque ornament itself, Groignet’s sartorial trophy of papal clothes is a critical reflection from the margins of real, individual histories ruled by chance on the grand historical designs of the Stanze, which unmasks their coherent providential logic as the illusionistic ‘picture in the clouds’ of papal propaganda.
Ingenuity and the Needful, Illiberal Roots of Order
Authors: Garrod Raphaële
Published: January 2025

This second aside compares, on the one hand, Rabelais’s grotesque trophies in Pantagruel XXVII and his gastric myth of violent cultural production in the Quart livre and, on the other hand, Dürer’s 1532 Treatise on Measurements and 1535 On the Construction and Fortifications of Castles, Cities and Camps. The first was prefaced by Rabelais’s friend Amaury Bouchard, the second was dedicated to Guillaume du Bellay, who faced the very real demands of warfare urban planning in Turin from 1537 to 1542 to prevent food shortages and control civil unrest. Rabelais and Dürer debunk the trophy’s epic mode and its related aristocratic ethics, highlighting satirically instead its funerary and spoliative dimension. Dürer’s geometry in his plan for a besieged fortified city in On the Construction turns grotesque in the Treatise’s peasant column as it highlights the illiberal violent order rooted in need that geometry codifies, chiming in with Rabelais’s Gaster episode.
En Fin. Rabelais and Renaissance Grotesque Ornament
Authors: Garrod Raphaële
Published: January 2025

The conclusion investigates Rabelais’s debt to Renaissance grotesque ornament in his explicit uses of the term and his implicit reference to it (the Gargantua prologue), before interpreting grotesque prints by Androuet du Cerceau as reflections on spirited coction, quick-wittedness, and diffuse animation. Grotesque ornament allowed artists to showcase their ingenious, inventive designs and to articulate an alternative to orderly mimesis. This alternative highlighted the contradictions inherent in the architectonic and anatomical understanding (both Vitruvian and Galenic) of anatomical beauty as fitness to functions made manifest in harmony and symmetry. In Xenophon’s Symposium, Socrates/Silenus ironically emphasized that fitness to functions could actually warrant ugliness. Galen took note, and Rabelais after him. Furthermore, Galenic functions are rooted in the unseen: the spirited physiology of ingenuity. The reflexive logic of grotesque ornament, with its emphasis on the licence of ingenuity as embodied thinking, reaches for it, as do Rabelais’s grotesque poetics.
Decision-making when there is uncertainty
Authors: Hauer Julie
Published: January 2025

This chapter provides a comprehensive and detailed approach to decision-making with uncertainty, with emphasis on the process that generates certainty in the decision made. The likelihood that a chronic problem without cure is more or less likely to be modified and improved is analysed, with considerations for when and how to review using an iterative framework. This process aids in the direction phase of the ABCD tool in Chapter 1. Parental perspective and preference is key in this process, which is foundational to building and maintaining trust, and informs our understanding of a child’s level of thriving. Specific topics include decisional readiness and regret, advance care planning, anticipating versus experiencing a life-threatening event, surgical decisions, resuscitation, futility versus potentially inappropriate interventions, and chronic critical illness that results in being ‘stuck’ in the hospital. The chapter provides a framework that is relevant to decision-making circumstances in subsequent chapters.
Ottoman Sacred Kingship
Authors: Hagen Gottfried
Published: January 2025

This chapter draws attention to political ritual as a medium for the enunciation of the sacred character of kingship, focusing on the preservation, veneration, and display of the relics of the Prophet Muḥammad that the Ottomans acquired in the sixteenth century. It is widely accepted that in the Ottoman political imaginary the king or sultan possessed qualities that set him apart from normal human beings. Max Weber would have described this quality as charisma; more recently historians have adopted the term “sacred kingship” to describe this phenomenon. So far, however, such arguments have mostly rested on discursive textual sources and as a result have been primarily concerned with Ottoman claims to the caliphate. The cult of the relics, by contrast, has not been theorized in Ottoman religio-political writing, yet emerges as a crucial venue to articulate ideas of kingship and government. Specifically, it helped the Ottoman kings to assert “cosmic kingship” in order to extricate themselves from the encroachment of the scripturalist elite onto their domain. None of this, however, happened as part of a long-term strategic design; nor was the outcome a clear ideological pronouncement. Instead, the cult of the rituals added new contradictions and complications to the history of Ottoman political thought and mentality.
Political Power and Lawmaking in the Ottoman Empire
Authors: Atçıl Abdurrahman
Published: January 2025

Delineating the authority to define and implement sharia has been an essential question in the historical practice of Islamic societies. Generally speaking, during the pre-Ottoman period, ʿulamāʾ (Muslim scholars), as specialists of scriptural sources and sharia knowledge, and rulers, as the holders of political power, competed for primacy in this sphere. This chapter starts with the Ottoman institutional development in the fifteenth and sixteenth centuries that gradually transformed ʿulamāʾ from being independent interpreters of scriptural sources and producers of sharia to being agents of the Ottoman government, scholar-bureaucrats. It argues that this institutional development inaugurated a decisive new chapter in the configuration of political and lawmaking authority in Islamic history, one in which the executive authority and ʿulamāʾ were positioned not as rivals but instead as partners in the exercise of political power, harnessing the coercive power of the state to make binding laws from sharia knowledge.
Uncovering Ottoman Political Thought in Political Actors Who Did Not Write
Authors: Darling Linda T.
Published: January 2025

This chapter explores how Ottoman documentary sources reveal the political thought of people who did not express themselves through political literature, from sultans through officials and military men to peasants and townsmen. It argues against the notion that political thought is what is contained in the literature of political thought, or that its authors were accurate and reflected the thinking of most people of their day. It asks two questions: who thought Ottoman political thought but did not write it, and what sources depict what that political thought must be. The first question is addressed from prior research, while the second, due to COVID-19, is explored in published documentary sources such as mühimme and ahkâm registers, grand viziers’ telhis, and kadı sicills. The chapter concludes that “political literature” is woefully incomplete in depicting Ottoman political thought.
Hybrid Justice
Authors: Ainley Kirsten , Kersten Mark
Published: January 2025

The Introduction summarizes the history of hybrid courts, accounts for their recent resurgence, and sets out the conceptual framework that the authors of the subsequent chapters will work within. Proponents of hybrid justice claim that hybrid courts can underwrite a stable peace, strengthen institutions and the rule of law, and enhance human rights protections, that is, increase societal resilience. Critics note the susceptibility of hybrids to political inference if they lack authority and resources, that is, if they are not resilient themselves. Resilience is therefore operationalized in two ways within the book: internal resilience is understood to mean the extent to which the design of hybrid mechanisms enables them to function robustly and with legitimacy in the face of external pressures from donors, host states, states which oppose the mechanism, and other interested parties. Societal resilience is the extent to which hybrid mechanisms enable post-conflict societies to heal, reconcile, strengthen, and address the root causes of prior conflict. The authors use this framing to analyse the creation, practices, innovations, and impacts of hybrid courts. The Introduction sets out the main arguments of the chapters and considers contemporary challenges to hybrid justice.
In Whose Name? Mapping the Constitutional Legitimacy of Hybrid International Criminal Courts
Authors: Schmidt Dennis R.
Published: January 2025

Hybrid courts (or tribunals) are typically portrayed as the most advanced version of international criminal law (ICL) mechanisms, with the structural ability to collapse the artificial boundary between the international and the domestic. A court may be hybrid in its origins (created through domestic and international processes), its mandate (splicing together domestic and international law), or its composition (combining domestic and international members). The way in which the international–domestic distinction has been collapsed varies significantly in that the institutional structure and operation of particular hybrids never represent a mid-point between two jurisdictions. Instead, past hybrids and internationalized criminal courts have moved along a spectrum ranging at the one end, from purely international criminal courts, such as the International Criminal Court (ICC), to purely domestic courts at the other. What is the ideal weight of each element in the composition and design of a hybrid court? How international or domestic should a hybrid court be, or should a ‘perfect’ merger of the two be aimed for? This chapter addresses these questions by placing the international–domestic distinction within an area in which the hybrid model is claimed to hold significant advantages over alternative ICL mechanisms—legitimacy. While the ‘legitimacy promise’ has seen some evaluation since the completion of the first round of hybrids, there has been little theoretical engagement with the deeper-seated sources of hybrids’ legitimacy. The chapter concludes by offering some more general observations about legitimacy and hybrid courts that may help to improve their institutional design and implementation.
Valuing the Defence
Authors: Ashraph Sareta
Published: January 2025

At the outset of the fledgling systems of the hybrid tribunals, there often appeared to be no proper provision for the defence. Starting with the Special Panels of the District Courts of Dili, and tracing its way through the Special Court for Sierra Leone (SCSL), the Iraqi High Criminal Court (IHT), the Special Tribunal for Lebanon, to today’s Kosovo Specialist Chambers (KSC), this chapter looks at the development of the defence within the structures of the hybrid tribunals. The chapter recounts that, while the need for prosecutors, judges, and even prison officers has always been recognized, each iteration of the hybrid courts appears to have been taken by surprise at the need to fund defence counsel, and/or to have an office within the Court’s structure dedicated to defence rights. It traces the impulses—ideological, financial, cosmetic—that first motivated the creation of defence offices and other support to defence teams and looks at how the approach to the defence has evolved. Finally, the chapter examines whether hybrid justice systems have finally learned to value the defence.
Hybrid Investigatory Mechanisms and Other Hybrid Justice Initiatives
Authors: Sánchez Nelson Camilo
Published: January 2025

Hybrid tribunals have not generally been used in Latin America, with ordinary domestic criminal courts favoured to provide accountability in transitions. However, in recent years, domestic justice systems—especially in Central America—have struggled with successfully linking longstanding contexts of corruption and impunity with macro criminality patterns and specific crimes. Against that backdrop, hybrid investigatory mechanisms and other hybrid justice initiatives have gained attention in the past decade. These include the UN-backed International Commission against Impunity in Guatemala (CICIG), the Mission to Support the Fight against Corruption and Impunity in Honduras (MACCIH), and the Inter-American Commission on Human Rights’ ‘Interdisciplinary Group of Experts’. This chapter focuses on these new hybrid investigatory mechanisms and other innovative hybrid justice initiatives. The chapter first summarizes the main traits of modern hybrid justice mechanisms. This assessment includes not only the aforementioned Latin American commissions but also other arrangements of the type such as the International Impartial Independence Mechanism to assist the investigation and prosecution of serious crimes in Syria (IIIM) and the Joint Investigation Team (JIT) established to conduct the criminal investigation of the Malaysia Airlines flight MH17 brought down over eastern Ukraine in 2014. The chapter then uses the Latin American commissions and the context in which they operate to test some of the main questions of the book: how they are failing/succeeding in resisting political pressure; how they have increased their legitimacy; and what their expected contributions to delivering accountability are.
Conclusion
Authors: Ainley Kirsten , Kersten Mark
Published: January 2025

This conclusion draws the chapters into conversation around the design, function, and evaluation of hybrid mechanisms, highlighting the most important findings of the authors. It draws on the Dakar Guidelines on the Establishment of Hybrid Courts to knit together the implications of these for the practical tasks of establishing and operating hybrid mechanisms. It considers what needs to be learned from the book’s chapters by those working in hybrid courts operating now and those likely to be established in the future, and discusses the possible future of hybrid justice in response to the wide-scale commission of war crimes in Ukraine from 2022 and Gaza from 2023.
“Had to Eat”
Authors: Riccardi Ricky
Published: January 2025

This chapter explains how Louis Armstrong received a chance to prove himself in a brass band setting when Joe Oliver suggested him as a replacement in the Tuxedo Brass Band. It notes that Armstrong was present for Oliver’s departure. Armstrong’s whole life had seemingly been building up to the moment Kid Ory offered him a spot in his band. The chapter notes that World War I was raging overseas and that Armstrong’s draft registration card identified him as a musician instead of a coal cart driver. As the war raged on, the government turned to New Orleans for help, erecting its great Army Supply Depot at Poland and Dauphine Streets, where Armstrong worked.
“They Loved Us”
Authors: Riccardi Ricky
Published: January 2025

This chapter discusses how Louis Armstrong joined Fate Marable’s band. In the spring of 1919, Louis Armstrong showed up at Co-operator’s Hall on North Liberty Street for one of his regular weekly gigs with Kid Ory’s band. Armstrong could not have known that this supposedly normal night with the Ory band was an audition for one of the biggest opportunities of his career. The chapter notes that Armstrong’s repetition of the phrase “they Loved us” signifies that this was another major event in his life. Armstrong admired Ory but was not ready to go to California following his offer and was content to remain with Marable.
Dopamine Agonists for RLS
Authors: Spector Andrew R.
Published: January 2025

For the past two decades, dopamine agonists, primarily ropinirole and pramipexole, have been considered first-line medications for RLS. They are inexpensive and readily available. Dopamine agonists are also highly effective. However, their benefits tend to wear off due to tolerance, and complications such as tolerance, augmentation, and impulse control disorders can set in. Augmentation cause RLS symptoms to worsen with ongoing use of the medications. Impulse control disorders, typically compulsive eating, shopping, gambling, or pornography use, can occur, particularly with higher doses of dopamine agonists. Discontinuing dopamine agonists requires a taper. The speed of the taper can be quick and difficult with a more rapid recovery, or slower and more controlled with a delayed recovery. Rapid discontinuation of dopamine agonists can result in dopamine agonist withdrawal syndrome.
RLS in Vulnerable Populations
Authors: Spector Andrew R.
Published: January 2025

Vulnerable populations in the health care setting include those groups who are at higher risk of disease or of receiving inadequate medical care. Geography plays a large role as rural patients can be a great distance from their health care providers. In urban areas, low-income patients tend to be most vulnerable. In the United States, racial and ethnic minority populations along with sexual and gender minorities are also vulnerable to inadequate health care and higher disease burdens. Finally, those with physical and cognitive disabilities face barriers to care as well. The expansion of telehealth and high-speed internet connections, drug discount programs, campaigns to end mental health stigma, and improvements in drug availability are ways of combatting these vulnerabilities.
Unanswered Questions and the Future of RLS Management
Authors: Spector Andrew R.
Published: January 2025

There is still much that is unknown about RLS. Knowledge of the causes of RLS, such as genetics and iron deficiency, is incomplete. Inflammation worsens RLS, but it’s not known why or how. While there is a basic understanding of the roles of dopamine, adenosine, and glutamate, the roles of other neurotransmitters, such as serotonin, histamine, and melatonin, are still debated. Likewise, opioids are the most effective drugs for RLS, but the role of the natural opioids in the brain is unknown. Diagnosing RLS is currently based on symptoms, but developing an objective test for RLS could advance understanding of its causes. Once diagnosed, it is not known how to optimize or personalize medications for people suffering from RLS. The best therapies might not even be medications.
New England in Flames
Authors: Tuininga Matthew J.
Published: January 2025

This chapter describes the disastrous consequences following the attack on the Narragansetts. Reinforced by the Narragansetts, Indians devastated colonial town after colonial town, including Lancaster, Medfield, and Groton. They took many captives, including Mary Rowlandson and her three children. Rowlandson was sold to the Narragansett leader Quinnapin and taken northward where she eventually met Philip. When the colonies launched a counteroffensive, it floundered. Angry colonists lashed out against praying Indians and their advocates, and more Indians were sent to Deer Island. In March Indians launched further devastating attacks at Rehoboth, Providence, and other towns.
Melodic Refusal and Racialized Anxiety in Mitski’s “Your Best American Girl”
Authors: Momii Toru
Published: January 2025

This essay offers an analysis of the sound recording and music video of Japanese American singer-songwriter Mitski’s song “Your Best American Girl,” the lead single from her 2016 album Puberty 2. The song has generated an outpouring of reviews and social media posts by Asian American fans on its themes of heartbreak, racial identity, and self-acceptance. Commentaries on the song frequently discuss Asian Americans’ fraught relationship with whiteness and the contradictory experience of seeking approval and attention from whiteness even while facing rejection from it. Building upon these recurring narratives, this essay demonstrates how music analysis can reveal the racialized anxieties that undergird commonly identified themes of self-acceptance and empowerment in “Your Best American Girl.” Through an analysis of cadential patterns in Mitski’s vocal melody, the essay argues that the song expresses the difficulty of overcoming one’s own internalized desire for white approval—a desire that is inseparable from processes of Asian American racialization.