bluuebunny/crossref_metadata_2025 huggingface dataset:
The Niche
Authors: Morowitz Harold J
Published: November 2023

We have from time to time mentioned the concept of “niche.” This ecological construct is a part of the Principle of Competitive Exclusion. We may understand the next group of emergences most easily in terms of the ideas of theoretical ecology. To establish some necessary background, we look back to the 1920s, a time when a prescient group of individuals was laying the foundations of ecological thought.
Hominization and Competitive Exclusion in Hominids
Authors: Morowitz Harold J
Published: November 2023

Among the great apes, a subgroup diverged about five or six million years ago that we designate as the hominids. Our knowledge of this group comes from the lone surviving species Homo sapiens and an array of fossilized bones and some artifacts such as chipped stones, burial items, and other remains that have survived the decay of time.
Analyzing Emergence
Authors: Morowitz Harold J
Published: November 2023

The 28 emergences represent a continuous series going from the reductionist core of particle physics to the most noetic aspect of human thought. The first seven emergences are studied by cosmology, high-energy physics, astrophysics, geophysics, and geochemistry. After each of them, the universe or some part thereof is radically changed. Something novel has happened. There is a surprise. The first is the greatest surprise of all; there is something rather than nothing. It is difficult in the extreme to relate it to other emergences.
Harmonic Productions
Authors: Fontijn Claire
Published: November 2023

In Produzioni armoniche, Antonia Bembo compiled a wide variety of pieces that display her skill in composing music for her own voice, a high soprano, as well as for those that could accompany it. The manuscript’ s table of contents enumeratepieces intended for both sacred and secular performance in a wide range of formal settings and keys King Louis XIV accepted it as a gift for his library, for which it was bound in red leather and stamped with his coat of arms and initial “L”. Today it remains at the Bibliothèque Nationale, preserved as F-Pn Rés. Vm. Bembo collected the pieces at the turn of the century, as deduced from the circumstances of two of its dedicatees: the music celebrating the wedding of the Duke and Duchess of Burgundy dates to December 1697, with that honoring Monsieurthe king’ s brother Philippe, Duke of Orleans—offered prior to his death in June . Produzioni armoniche represents the first in the series of Bembo’ s six music manuscripts.
Development and Aging
Authors: Filley Christopher M
Published: November 2023

The human brain is a dynamic organ that undergoes a constant process of structural change during the life span. As development, maturity, and aging occur, the brain continually remodels both its fine and its gross structure. Microscopically, this remodeling occurs in the gray matter at the level of the synapse, where constant coupling and uncoupling of dendrites takes place in parallel with the processes of learning and cognition. At the macroscopic level, the changes in the brain appear to be more evident in the white matter. Whereas the gray matter remains relatively constant in volume throughout life, white matter volume fluctuates significantly at different stages. This chapter reviews the development and aging of white matter from a neurobiological perspective, with an emphasis on the potential clinical relevance of these phenomena.
Inflammatory Diseases
Authors: Filley Christopher M
Published: November 2023

A diverse group of noninfectious inflammatory diseases can affect the white matter of the brain. These disorders, some of which are referred to as connective tissue or collagen vascular diseases, share the common feature of being autoimmune in nature, by which is meant that the immune system is induced to mount an assault on various tissues of the body. Thus, most of these diseases produce systemic manifestations in addition to those in the nervous system. In the brain, wide¬ spread lesions are typical, usually related to a vasculitic process, but careful perusal of the clinical and neuropathology features of these diseases reveals that prominent damage to white matter occurs and may have significant consequences. The neurobehavioral implications of white matter involvement from inflammatory diseases are largely unknown, but some preliminary data are emerging. The limited available information on this question is reviewed in this chapter.
Toxic Leukoencephalopathies
Authors: Filley Christopher M
Published: November 2023

The nervous system can be damaged by a wide range of toxins, the study of which delimits the scope of neurotoxic ology. Many physical and chemical toxins penetrate the brain and cause adverse effects, and the selective vulnerability of the white matter allows the delineation of a subset of neurotoxic ology called toxic leukoencephalopathy (Filly, 1999). Many of these intoxications have been discovered and characterized by the use of magnetic resonance imaging (MRI), which has the capacity to detect subtle white matter involvement that was previously un¬ appreciated. With the advent of new therapeutic agents for cancer and other dis¬ eases, as well as the appearance of new drugs of abuse, toxic leukoencephalopathies are being increasingly recognized.
Bilateral Lateral Hand Numbness
Authors: Liveson Jay Allan
Published: November 2023

A 6o-year-old woman complained of bilateral hand numbness, maximal in the lateral two digits, progressing for a year. In addition, she had a proximal ache in her arms. Symptoms did not increase significantly at night. She denied neck pain and variation on Valsalva’s maneuver. Medical history revealed radiating low back pain with a magnetic resonance image (MRI) showing “bad discs.” Physical Examination. Cranial nerves were normal. There was minimal thumb abduction weakness bilaterally. Sensation and strength were intact. Phalen’s signs were present bilaterally, manifest as thumb numbness. Deep tendon reflexes (DTRs) were active and symmetric, with no pathologic responses. There was no Homer’s or Tinel’s sign. Nerves were normal to palpation. There was no calf tenderness or hyperpathia.
Crush Injury Of Thigh
Authors: Liveson Jay Allan
Published: November 2023

Sixteen months prior to examination, the left thigh of an 18-year-old girl was crushed between a truck and a loading platform. Skin was grafted below the knee. Since then, she had loss of sensation distal to the knee, with sparing of the medial leg. In addition, her leg and foot muscles were weak. Medical history was negative. PHYSICAL EXAMINATION. All findings were confined to the left leg. There was skin grafted over the lateral aspect. Decreased sensation extended from the lateral leg to include her foot. All muscles below the knee were weak. Tinel’s sign was elicited at the fibular head with radiation to the dorsum of her foot. There was a decreased left ankle jerk Left plantar response was silent; the right was flexor.
Caveat Doctor!
Authors: Liveson Jay Allan
Published: November 2023

During the course of a year, a 51-year-old man noted gradually progressing neck pain, eventually radiating to the left shoulder. There was no weakness or sensory distortion. Valsalva’s maneuver had no effect, and there was no exacerbation at night. Medical history was limited to hypertension. Physical Examination. Cranial nerves and cerebellar function were intact. No motor or sensory deficits were detected. DTRs were hypoactive but symmetric, with no pathologic reflexes. There was no Homer’s, Phalen’s, or Tinel’s sign.
Serendipity
Authors: Liveson Jay Allan
Published: November 2023

A 78-year-old right-handed semiretired auto mechanic complained of severe wrist “arthritis” progressing over the course of several months. In addition, there were severe paresthesias over the lateral three digits. All symptoms were worse in the left hand. At night, there was marked exacerbation, which the patient relieved by shaking his wrists. Patient denied neck pain, radiation, and increase on Valsalva’s maneuver. Medical history was negative. Physical Examination. Cranial nerves and cerebellar function were intact. He had no motor or sensory deficit. There was no Homer’s, Tinel’s, or Phalen’s sign. DTRs were hypoactive but symmetric, and plantar responses were flexor. There was no calf tenderness, plantar hyperpathia, or nerve enlargement.
Leg Weakness and Twitching
Authors: Liveson Jay Allan
Published: November 2023

A 38-year-old man noticed weakness of his right lower extremity that slowly progressed for 6 months. There was transient fatigability. The patient also noted muscle twitching in upper and lower extremities. He had occasional cramps, especially in his gastrocnemius muscles. He denied sensory changes, bladder symptoms, and speech or swallowing difficulties. Medical history was negative.
Shoulder Dislocation and Weakness
Authors: Liveson Jay Allan
Published: November 2023

During a motorcycle accident, a 45-year-old man sustained a fracture-dislocation of his left humerus. He lost consciousness for several minutes, but had no retrograde amnesia. Closed shoulder reduction was performed the next day. He subsequently noted shoulder weakness. Medical history was limited to gall bladder dysfunction. Physical Examination. The left deltoid was atrophied with weakness of shoulder flexion, abduction, and extension. There was a patch of hypesthesia over the lateral deltoid. Cranial nerve and cerebellar function were normal. DTRs were active and symmetric, with no pathologic reflexes. There was no Homer’s sign.
Radiating Pain and Knee Jerk Decrease
Authors: Liveson Jay Allan
Published: November 2023

The patient was a 57-year-old man who, 2 weeks previously, suddenly felt right hip pain on bending over. It radiated to his toes, accompanied by numbness over his shin. Valsalva’s maneuver had no effect. The patient denied weakness and bladder symptoms. Medical history was negative. Physical Examination. Cranial nerves were intact. There was no weakness. Sensation was decreased over the anterior leg. DTRs were active with a decreased right knee jerk. Plantar responses were flexor. There was no Lasègue’s sign.
Gunshot Wound to Neck
Authors: Liveson Jay Allan
Published: November 2023

A 26-year-old man suffered gunshot wounds to the cheek and neck. He was referred for electrodiagnostic evaluation 9 weeks later. PHYSICAL EXAMINATION. Healed bullet entry sites were evident in the left cheek and lower anterolateral left side of his neck. There was no Homer’s sign and no winging of the scapula. Although the left arm was grossly paralyzed, minimal movement was palpated that could not be reliably localized. Similarly, there was no clear area of preserved sensation. DTRs were absent in the left arm only.
Proximal Weakness and Ache in Sixth Decade
Authors: Liveson Jay Allan
Published: November 2023

For a period of several weeks, a 51-year-old man noted muscle and joint pains. He subsequently developed difficulty climbing stairs and standing from a seated position. There was no dysfunction of his upper extremities. Patient denied family history of similar complaints. Medical history was negative except for transient numbness of his right lower extremity, which followed a lightning accident 20 years ago.
Wrist Weakness with Deviation
Authors: Liveson Jay Allan
Published: November 2023

The patient was a 43-year-old woman who fractured the head of her right radius 6 weeks before this examination. At that time, there was possible weakness of extension of the wrist and fingers (although this may have been caused by pain). The next day, a fragment of bone was excised, but weakness of the hand persisted. At no time did she experience sensory loss. Medical history was negative. Physical Examination. There was weakness of finger and thumb extension at the metacarpophalangeal joints. She was able to extend her wrist but performed this with radial deviation. Other motor and sensory functions were intact. DTRs were active and symmetric. Plantar responses were flexor.
Radiating Thigh Pain and Numbness
Authors: Liveson Jay Allan
Published: November 2023

A 43-year-old woman had a history of chronic low back pain related to bowling. Four weeks previously, the pain started to radiate to the left buttock and lateral thigh. For 1 week, the lateral thigh became numb. She denied an effect with Valsalva’s maneuver, weakness, and bladder symptoms. Medical history was negative. Physical Examination. Cranial nerve, cerebellar, motor, and sensory functions were intact. DTRs were active and symmetric, with no pathologic responses. There was no Lasègue’s sign.
Calcaneal Fracture and Foot Numbness
Authors: Liveson Jay Allan
Published: November 2023

Five months previously, a 39-year-old woman fractured her left calcaneus. This was treated conservatively, with a cast in place for 6 weeks. After removal, she noted paresthesias of the lateral foot when wearing slippers. She denied weakness and back pain effect from Valsalva’s maneuver. Medical history was negative. Physical Examination. Tenderness was elicited on palpation of the left lateral malleolus. The plantar aspect of the left foot had abnormal touch sensation; the heel was spared. Reflexes were symmetric. Plantar responses were flexor. There was no Lasègue’s sign.
Progressive Diplopia in a Twenty-One-Year-Old Woman
Authors: Liveson Jay Allan
Published: November 2023

A 21-year-old woman was told by her friends that her right eye was “wandering” 4 months previously. One month later, she developed diplopia in all directions of gaze. It was worse on awaking and did not improve by resting her eyes. She had no other symptoms or related family history. Physical Examination. Patient had ptosis of the right lid and moderate weakness of all extraocular muscles. Cranial nerves were otherwise intact. There were no cerebellar, motor, or sensory findings. DTRs were hyperactive, with plantar responses normal.
Asymmetric Leg Weakness and Diabetes
Authors: Liveson Jay Allan
Published: November 2023

A 56-year-old diabetic woman developed gait difficulty over a 7-month period. She denied pain but had occasional hand numbness. There was a medical history of hypertension. Physical Examination. Cranial nerves and cerebellar and sensory function were normal. There was isolated weakness and atrophy of the left quadriceps. DTRs were active and symmetric, except for absence of the left knee jerk. Plantar responses were normal.
Rapid Proximal Weakness in a 10-Year-Old
Authors: Liveson Jay Allan
Published: November 2023

A 10-year-old boy developed rapidly progressive weakness over the previous 4 years. Birth and development were normal until that point, when walking became difficult, then climbing stairs. By this time, he became wheelchair-bound. There was no family history for this condition. Physical Examination. Cranial nerves and cerebellar function were intact. Sensation was normal. Patient’s muscles were hypotonic, and his calves were enlarged. He was diffusely weak, with proximal predominance. He walked (with assistance) on his toes because of heel-cord tightness. There was a severe lordosis. DTRs were hypoactive and symmetric with no pathologic reflexes.
Mees’ lines and Distal Numbness
Authors: Liveson Jay Allan
Published: November 2023

Two months previously, an 18-year-old boy accidentally ingested an arsenic compound that he was using for taxidermy. His immediate symptoms were nausea and vomiting. Subsequently, he developed weakness of his legs and numbness distal to his knees. Family and personal medical history were negative. Physical Examination. Transverse white stria were present above the lunula of several nails (Mees’ lines). There was no weakness revealed by muscle testing. Sensation to all modalities was abnormal below his knees (including touch, vibration, and joint position). DTRs were symmetric and active in the upper extremities and absent in the lower extremities. Plantar responses were flexor. Nerves were normal to palpation.
Sacral Growth and Incontinence
Authors: Liveson Jay Allan
Published: November 2023

A 25-year-old man with an external growth at the base of his spine, present since birth, was referred for premarital evaluation. A tap to this region would produce a tingling radiating to both posterior thighs. Sensation was otherwise intact. Patient was incontinent of urine, wearing a collecting device. Bowel function, erections, and ejaculations were normal, although his sperm count and motility were low. Medical history was otherwise normal. Physical Examination. A large midline sacral growth extended to include part of the right buttock. He was wearing a bag device. He had bilateral pes cavus, but no scoliosis. Pain sensation was decreased over the posterior thighs. Cranial nerves and cerebellar function were normal, and no motor impairment could be found. Knee jerks were hypoactive, with absence of all other DTRs. Plantar responses were flexor.
Scapular Winging Increased on Flexion
Authors: Liveson Jay Allan
Published: November 2023

A 38-year-old man experienced right scapular pain radiating to his shoulder and elbow for 3 weeks. He became aware of abnormal prominence of his right scapula. There was no numbness or cervical pain. Medical history was negative. Physical Examination. At rest, the right scapula was winged with slight medial translocation and medial rotation of the inferior angle. The winging was accentuated by f01ward flexion of the arm and decreased on lateral abduction. There was no sensory loss. DTRs were hypoactive, symmetric, with no pathologic reflexes. There was no Homer’s sign.
Postlaminectomy Recurrence of Pain
Authors: Liveson Jay Allan
Published: November 2023

Eleven days before his initial examination, while working, a 57-year-old man developed sudden low back pain radiating to his right leg. He complained of knee weakness with numbness distal to it. There was no exacerbation on Valsalva’s maneuver. Medical history revealed left chest and arm pain, a negative cardiac evaluation, and a kidney problem requiring diuretics. Physical Examination. Cranial nerve and cerebellar function were normal. He had weakness of right knee extension and hip adduction, with touch sensation decreased over the lateral thigh, medial leg, and foot. The right knee jerk was absent, with other DTRs active. Plantar responses were flexor. Lasègue’s sign was present on the right.
Intrinsic Weakness Related to Stapling
Authors: Liveson Jay Allan
Published: November 2023

Over the previous year, a 35-year-old woman developed left wrist pain related to repeated pounding on a stapler. In the region exposed to this repeated trauma, the medial volar wrist, there was tenderness to pressure. In addition, she complained of multiple joint pain and finger weakness in that hand. She denied neck and elbow pain and change with Valsalva’s maneuver. Medical history was of low back pain only.
Painful Eruption and Weak Hip
Authors: Liveson Jay Allan
Published: November 2023

A 74-year-old woman suffered from right low back pain radiating to her right thigh over the previous several months. She denied numbness and change on Valsalva’s maneuver. Weakness was evident only on crossing her right leg over the left. Bed rest for 2 weeks had no effect. Several weeks prior to this examination, a mildly painful vesicular eruption developed over the right thigh and buttock. Medical history revealed atrophy of the left arm since birth.
Positive “Dropped Ann Test”
Authors: Liveson Jay Allan
Published: November 2023

Eight months previously, a 73-year-old woman fractured the humeral lip of her left shoulder during a fall. Since then, she was unable to raise the arm above the horizontal plane. She had shoulder pain extending to her left trapezius muscle but no sensory loss. Her medical history was limited to angina, hypertension, and a benign tumor removed 2 years earlier.
Scapular Winging After Neck Tumor Excision
Authors: Liveson Jay Allan
Published: November 2023

Four months previously, a 60-year-old man awoke with “total paralysis” of his left arm. This resolved gradually in a proximal-to-distal pattern, clearing completely in 3 months. Shortly thereafter, a small tumor was noted on the left side of his neck. The growth was removed and found to be benign. Postoperatively, he immediately had difficulty in flexing and abducting his left arm. Medical history included a heart attack several years before.
Quadrilateral Space Lesion
Authors: Liveson Jay Allan
Published: November 2023

Seven weeks previously, an 80-pound piece of plywood fell 35 feet, striking the left shoulder of a 28-year-old construction worker. This resulted in slight separation of the glenohumeral joint, but no fracture. Initially, his fingers were paralyzed, with numbness from the medial upper arm to the medial two fingers. Function returned except for weakness of elbow extension. He denied neck pain or effect from Valsalva’s maneuver. Medical history was limited to splenectomy several years earlier because of a car accident.
Slow Evolution of Proximal Weakness
Authors: Liveson Jay Allan
Published: November 2023

A 26-year-old man developed progressively severe leg weakness since the age of 10. No perinatal or infancy problems were noted. He had difficulty climbing stairs by 13 and needed a cane by the age of Patient had a 10th-grade education and was unable to hold a job because of his weakness and intellectual limitations. Three out of his four brothers had similar motor abnormalities. His four sisters and his parents were spared.
Thoracic Outlet Syndrome “Recurrence”
Authors: Liveson Jay Allan
Published: November 2023

During the previous 4 years, a 51-year-old man complained of pain in his right arm with distal paresthesias. He developed curling of his fourth and fifth digits, and difficulty with fine finger movement. His pulse was decreased on that side. A diagnosis of thoracic outlet syndrome was made and scalenotomy performed. This was followed by transient improvement. Gradually, however, he noted cramping and progressive weakness with atrophy evident for 6 months. Elevation of his hand above his head occasionally led to numbness of his arm. There was no effect from Valsalva’s maneuver.
Gluteal Injection and Radiating Pain
Authors: Liveson Jay Allan
Published: November 2023

Two months previously, a 47-year-old woman was undergoing cervical traction for left arm pain. An intramuscular left gluteal injection caused immediate local soreness with radiation to the inguinal area, lateral thigh, and leg. Valsalva’s maneuver had no effect. She had weakness of the left knee. Medical history was limited to a benign right ovarian tumor. Physical Examination. Cranial nerve and cerebellar function were normal. There was no sensory or motor deficit. DTRs were active and symmetric, with no pathologic reflexes. There was no Lasègue’s sign.
Abdominal Pain with No Abdominal Pathology
Authors: Liveson Jay Allan
Published: November 2023

Patient is a 75-year-old woman with an 8-month history of upper abdominal pain, originally on the right but extending to the left. There was no skin eruption. Medical history included gall stones, pyelonephritis, right-sided sciatica (3 years ago), and collapsed vertebrae. Physical Examination. Cranial nerve and cerebellar function were intact. There was no weakness or sensory loss. DTR.s were hypoactive and symmetric, with no pathologic reflexes. Patient did not have Lasègue’s or Beevor’s sign.
Diabetes with Asymmetric Weakness
Authors: Liveson Jay Allan
Published: November 2023

The patient was a 76-year-old woman with a 4-month history of weak grasp, especially on the right. She also felt finger numbness worse at night. For 7 years, she was paraparetic with distal pain and numbness. Medical history was of severe diabetes mellitus. Physical Examination. Intrinsic right hand muscles were atrophied, with decreased sensation of the medial three digits to the midpalm. On the left hand, the lateral thenar muscles were atrophied with sensory loss of the second digit. The lower extremities had proximal weakness and distal paralysis. All sensation was decreased in a stocking pattern with sparing of the lateral right thigh and leg. No DTRs could be elicited. Plantar responses were silent. The patient had no calf tenderness or plantar hyperpathia. Her nerves were normal to palpation.
Gunshot Wound of Leg
Authors: Liveson Jay Allan
Published: November 2023

Seven months ago, a 41-year-old man was wounded in the left leg. Shotgun pellets entered his medial calf in the posterior-to-anterior direction, with many remaining in situ. Skin grafts were required. Subsequently, he developed paresthesias of the fifth toe. Percussion at the wound elicited Tinel’s sign, which radiated to the plantar surfaces of the other toes. He also had difficulty curling his toes. Medical history included hip arthritis treated by left hip pinning, and attacks of low back pain radiating to the lateral left thigh, leg, and ankle.
Fractured Ankle Bone and Focal Atrophy
Authors: Liveson Jay Allan
Published: November 2023

Two years previously, a 34-year-old teacher hit the dorsum of her right ankle on her desk, fracturing a “small bone” between the maleoli. Several weeks later, her ankle was placed in a cast for 3 weeks. Since then, she noted dorsolateral foot pain distal to the maleolus. She denied weakness, numbness, back pain, or exacerbation by Valsalva’s maneuver. Medical history was negative.
Ear Pain, Hoarseness, and Facial Weakness
Authors: Liveson Jay Allan
Published: November 2023

Through an interpreter, a 69-year-old Chinese man described an itching sensation that evolved over the previous 4 weeks into left ear pain. Over the next several days, he developed hoarseness and facial weakness. He lost the ability to close his left eye and had difficulty swallowing (especially solids). Hiccoughs developed, and buzzing in his ear, decreased hearing, dizziness on arising, and leg weakness. There were no other prior medical problems.
Difficulty Relaxing Grip
Authors: Liveson Jay Allan
Published: November 2023

As far back as he could recall, a 32-year-old man had difficulty relaxing his grip. This was intensified by exercise and cold but was unrelated to sleep or meals. By 17, he developed frontal baldness. No family history of precocious baldness, cataracts, or motor disease. Physical Examination. Patient’s strength and sensation were normal, with no notable atrophy. His DTRs were active, symmetric. Plantar responses were flexor. On percussion, his tongue remained ridged and thenar relaxation was delayed. He had difficulty releasing a handshake quickly. He had frontal baldness, but no cataracts or testicular abnormality.
HIV and Progressing Weakness
Authors: Liveson Jay Allan
Published: November 2023

Five weeks previously, a 35-year-old HIV-positive homosexual man developed respiratory symptoms and was found to have tuberculosis. He was placed on multiple antibiotics for 3 weeks but developed difficulty walking, numbness of his feet, and shaking in his hands after 1 week of therapy.
Proximal Weakness and Frequent Pneumonia
Authors: Liveson Jay Allan
Published: November 2023

A 28-year-old man had a 10-year history of progressive proximal weakness. He was normal until his midteens and even played team football. At the age of 15, however, during a hospitalization for schizophrenia, he started suffering calf cramps, which were treated with quinine. During the following years, his exercise tolerance decreased and proximal weakness progressed, especially in his hips. In the previous 4 years, he had four episodes of pneumonia, and pulmonary function tests documented decreased static lung volume. Family history was noncontributory.
Flail Anesthetic Posttraumatic Arm
Authors: Liveson Jay Allan
Published: November 2023

Three years previously, a 26-year-old cyclist was struck by a car. Initially, he was drowsy and confused, his right arm flail. CT scan indicated a left frontoparietal contusion. He became alert over the next several days on short-term steroid therapy. His right arm, however, remained flaccid and paralyzed. Electrodiagnostic studies at that time showed no motor function from C5 through T1 on volition and on peripheral stimulation. He later developed left focal seizures treated with phenobarbital, and lower gastrointestinal bleeding of unknown cause. Medical history prior to all this was negative.
Sudden Flaccid Hemiplegia
Authors: Liveson Jay Allan
Published: November 2023

Four weeks previously, a 63-year-old right-handed man suddenly developed right-sided paralysis. There was no associated headache, loss of consciousness, pain, or loss of feeling. Medical history was negative. Physical Examination. There was a mild expressive aphasia. The patient was unperturbed but aware of his motor loss consisting of total flaccid right hemiplegia. There was no facial weakness and no hemianopsia. Sensation was intact. DTRs were active and symmetric, with plantar response flexor on the left and silent on the right. There was no cervical rigidity or Kernig’s sign. The heart rate was normal and regular, and the patient was normotensive. No cervical bruits were audible.
Paraplegia After Tethered Cord Surgery
Authors: Liveson Jay Allan
Published: November 2023

A 45-year-old paraplegic patient was referred for complete neurologic evaluation by his lawyer several years after three lumbar laminectomies. For many years he had noticed insidious progression of gait difficulty and development of urinary incontinence. On evaluation, he was found to have a tethered spinal cord associated with a cystic lipoma. Three laminectomies were performed (between the ages of 39 and 40) with removal of the lipoma and freeing of the cord. Postoperatively, the patient was completely paraplegic and incontinent of urine. There were only patches of preserved touch in his legs and penis.
Postshunt Evaluation for Syringomyelia
Authors: Liveson Jay Allan
Published: November 2023

A 52-year-old woman had insidiously progressive right hemiparesis and hemianesthesia over several years. A diagnosis of syringomyelia was made and a shunt inserted surgically 1 year previously. Since then, there was no improvement in her status, although she complained of a heat sensation over her face. Medical history was otherwise negative.
Situation Theory and Causation
Authors: Koons Robert C
Published: November 2023

In their seminal book Situations and Attitudes (Barwise and Perry (1983)), Jon Barwise and John Perry introduced the basic elements of situation theory. These elements included: the existence of concrete parts of the world, called situations or situation-tokens, a realistic attitude toward abstract situation-types, and the use of a partial, non-classical semantics for the relationship between situation tokens and situation-types. Barwise and Perry made use of the strong Kleene tables of three-valued logic, making use of the three values true, false, and undefined.
An Overview
Authors: Koons Robert C
Published: November 2023

The notions of natural teleology and biological function play an increasingly significant role in contemporary philosophy, especially in recent theories of con tent and of knowledge. The twentieth century has been characterized by an intensifying of efforts at clarifying the logic, semantics, and metaphysics of teleology, rectifying the unfortunate neglect of the topic in modern philosophy since Leibniz. One of the most influential and attractive accounts was that of Charles Taylor, in his 1964 The Explanation of Behavior (Taylor (1964)).
Teleological Reliabilism
Authors: Koons Robert C
Published: November 2023

Gettier’s seminal article on justified true belief (Gettier (1963)) forced a re thinking of the conditions of knowledge. So-called external factors and analyses came to the fore. The distinction between knowledge and mere true opinion turns on the way in which the belief was formed and how it is sustained. If the formation and maintenance of the belief reliably tracks the truth, then the belief constitutes knowledge. Knowledge is reliably formed and maintained belief (Goldman (1979)).
Eudaemonism and the Objectivity of Value
Authors: Koons Robert C
Published: November 2023

The objective reality of value is a given of human experience. The task of philosophy is not to explain away the objectivity of value, but to reconcile the objective existence of value with four apparent problems. These four problems include two forms of “queerness” about objective values noted by J. L. Mackie, plus the problems of semantics and epistemology. Mackie argued that objective values would be queer, incapable of being integrated into a rationally coherent ontology, because, unlike all other facts, they (1) provide categorical reasons for acting, and (2) are intrinsically motivating. Many have noticed the philosophical problems inherent in postulating objective values, since they seem to be imperceptible and without definite location. Finally, the most serious problem of all is the semantic one: given that there are objective values, how do our thoughts and words become linked to one rather than another?
A Coherent Realism Is a Comprehensive Realism
Authors: Koons Robert C
Published: November 2023

A comprehensive form of realism, as exemplified by Plato, Aristotle, and Boethius, was the dominant school in Western philosophy from the time of Augustine until that of Scotus. Today, a comprehensive form of anti-realism, as exemplified by Rorty, Foucault, or Derrida, is at or near dominance in the academy. The transition from the first state to the last took place in four great waves: Occam, Bacon, Hume and the post-modernists. These waves correspond to the dismantling, one by one, of Aristotle’s four causes: formal, final, efficient, and material.
Introduction
Authors: Levin Susan B
Published: November 2023

Plato’s middle dialogues have received an extraordinary amount of attention, and much work has been done to illuminate his engagement with other philosophers and the sophists as he articulates a range of doctrines therein. Socrates, Parmenides, and Heraclitus are regularly identified as the key influences on Plato’s theory of Forms. According to the standard account, Plato continues Socrates’ quest—undertaken in opposition to the sophists—to articulate what objective standards in the arena of values consist in, and adds to this emphasis on values a strong concern with other entities, particularly those in the domain of mathematics. In addition, as Aristotle emphasizes, Plato departs from his teacher by insisting on the separate existence of the objective standards in question.
World Without End or Beginning
Authors: Kermode Frank
Published: November 2023

It is worth remembering that the rise of what we call literary fiction happened at a time when the revealed, authenticated account of the beginning was losing its authority. Now that changes in things as they are change beginnings to make them fit, beginnings have lost their mythical rigidity. There are, it is true, modern attempts to restore this rigidity. But on the whole there is a correlation between subtlety and variety in our fictions and remoteness and doubtfulness about ends and origins. There is a necessary relation between the fictions by which we order our world and the increasing complexity of what we take to be the ‘real’ history of that world.
Solitary Confinement
Authors: Kermode Frank
Published: November 2023

In this lecture, which is my last, I shall try to touch upon most of the themes proposed in the earlier ones, though I do not hope to provide in it the marvellous clue that would make all the rest useful and systematic. I could only do that if I were the master described in the poem, that ‘more severe, More harassing master’I have his programme but not his powers. ‘Life / As it is, in the intricate evasions of as’ is what I am talking about, as best I can; and I am glad that it was in my most recent talk that I discussed Sartre, who knew that fictions, though prone to absurdity, are necessary to life, and that they grow very intricate because we know so desolately that as and is are not really one. None of our fictions is a supreme fiction.
Instrumental Music, Charisma, and Church Leadership
Authors: Lange Barbara Rose
Published: November 2023

During one of the first services I attended at the IG, Brother Horváth declared, “We have a healthy, unified congregation. Now there are more of us ... thereis the problem of an assistant [helyettes ].” Commenting that “the Holy Spirit is not a municipal official,” he read Acts 13:r-5, which describes how God had distinguished Barnabas and Paul out of the Antioch congregation.
Conclusion
Authors: Lange Barbara Rose
Published: November 2023

As the IG congregations were meeting in the 1990s, an atmosphere of conflict permeated society. The violence in the Balkans to the south caused Hungarians to worry about ethnic tensions in their own country. Introducing a free market had drastic effects; when Roma became unemployed, some Magyars, impoverished themselves, objected to the fact that they got welfare payments from the government. The sociologist Zsuzsa Ferge warned that Hungary could become like the United States, where “society eventually divides in two.
Gender: Identifying and Managing Relevant Differences
Authors: Buckey Jay C
Published: November 2023

Although Mary Cleave was a fully trained and capable astronaut, she could not do extravehicular activity (EVA): There were no EVA suits small enough to fit her [1]. Similarly, although astronaut Wendy Lawrence was ready to go to the Mir space station on the Soyuz capsule, she wasn’t tall enough to fit safely within the capsule [2]. This problem, however, has not been limited to women. NASA astronaut Scott Parazynski also was ready to go to the Mir space station, but he was too big for the Soyuz capsule. Size and strength sometimes matter in the space program, and gender can influence both.
Preflight Preparation and Postflight Recovery: Preparation and Rehabilitation
Authors: Buckey Jay C
Published: November 2023

When the Greek explorer Odysseus returned from his long-duration voyage, only his dog recognized him. Even though his loved ones had yearned for a reunion with him, when Odysseus finally arrived home, his reentry into his previous life was not smooth. Odysseus had to work hard to establish a relationship with his son and dispose of the suitors who were pursuing his wife. He literally had to fight his way back to his former position.
Some Catholic Notions
Authors: Fort Timothy L
Published: November 2023

In Richard Attenborough’s film Gandhi, the title character is on his way to negotiate with Muslim leaders in conjunction with India’s freedom from Great Britain. That freedom lifted the lid off the simmering hatreds between Muslims and Hindus. Gandhi was preparing to negotiate a power-sharing arrangement to prevent Muslim secession (which eventually became Pakistan). As Gandhi began to drive past Hindus protesting these negotiations, he scolded the protesters claiming that he (Gandhi) was a Muslim and a Christian and a Jew: all this from a devout Hindu. His example is a model for a commitment to a particular identity and simultaneously profound openness to others. His commitment is not simply one of tolerance but of integration and openness. This is the orientation produced by a nonnative mediating institution.
The Right Hemisphere, lnterhemispheric Communication, and Consciousness
Authors: Devinsky Orrin , D’esposito Mark
Published: November 2023

7 believe it then to be entirely unphilosophical, and tending to important errors, to speak of the cerebrum as one organ . . . The two hemispheres of the brain are really . . . two distinct and entire organs . . . os fully perfect in all its parts . . . 05 the two eyes. The corpus callosum, and the other commissures between them, can with no more justice be said to constitute the two hemispheres into one organ than the optic commissure can be called an union of the two eyes into one organ.
Executive Function and the Frontal Lobes
Authors: Devinsky Orrin , D’esposito Mark
Published: November 2023

At one time, the most anterior portion of the frontal lobes, the prefrontal cortex, was considered “silent” because moderate-sized lesions of this region produced few or no abnormalities on the neurological examination and electrical stimulation rarely altered behavior. Moreover, following prefrontal resections of the dominant hemisphere, patients had normal memory and an intelligence quotient (IQ) of 150 or more. Although behavioral and cognitive changes challenge clinical measurement at the bedside, most families of patients with bilateral frontal lobe damage recognize them as “very different.” For example, these patients may drive past stop signs, fail to show concern when a kettle is boiling over, become slovenly and unkempt, joke about someone’s physical deformity in front of him or her, become violent after a minor provocation and quickly return to their previous calm state, urinate on the street, or leave a baby unattended to watch television.
Functional Pulmonary Anatomy
Authors: Hlastala Michael P , Berger Albert J
Published: November 2023

The major function of the lung is to exchange gas between the outside environment and blood. This requires an intricate structure that provides for optimal matching of blood flow and ventilation to allow efficient gas exchange with minimal energy cost. The study of respiratory physiology elucidates the many mechanisms that optimize gas exchange during health and that deteriorate in lung disease. In the lungs, gas exchange occurs via passive diffusion along a partial pressure gradient. The barrier between gas and blood is extremely thin and large in area so that this diffusive gas exchange can take place even under severe demands such as heavy exercise. Inhaled air passes along a branching network of progressively narrower, shorter, and more numerous airways that end in small air sacs called alveoli. Blood flows through an intricate network of blood vessels that eventually perfuse the very small alveolar capillaries lying on the opposite side of the alveolar wall from the air. The relative thinness (about 0.1 to 0.5 µm) of the alveolocapillary “barrier” allows for easy gas exchange.
Chemical Control of Breathing
Authors: Hlastala Michael P , Berger Albert J
Published: November 2023

Hypoxia, hypercapnia, and acidosis are important stimulants to breathing. In this chapter sensory mechanisms that enable the body to detect each of these stimuli are described, and the overall ventilatory response to each stimulus is discussed. The respiratory control system responds with increased ventilation following the challenge of decreased P1O2 and the consequent fall in PaO2 The ventilatory response to hypoxia is due to the sensing of a reduction in PaO2 by sensory organs located on the arterial side of the circulation. Increased sensory nerve activity is transmitted to the brain stem where, following neural processing, this leads to an increase in discharge activity in nerves to the respiratory muscles. Ultimately, this increased discharge causes an increase in the output from respiratory muscles, thereby stimulating ventilation (Fig. 9.1). In this section we discuss this homeostatic feedback control system.
Promising: Stits, claims, and strategies
Authors: Belnap Nuel , Perloff Michael , Xu Ming
Published: November 2023

To promise is generally to speak; certainly all promisors are speakers, and one supposes that all fully competent speakers are promisors. The work on “speech acts” dating back to Austin’s work in the 1940s and 1950s (Austin 1961, 1975) and deepened especially by Searle and Vanderveken (see, e.g., Searle and Vanderveken 1985, Vanderveken 1990, and Vanderveken 1991) has exploited the fact that promising can be located among the many things one can do with words. But promises are not always made by means of speech (they are not always “speech acts”), nor is speaking words such as “I promise” always to promise. What are we to conclude from this combination of “generally but not always”? We suggest that while the truth of the “generally” warrants the extended consideration of promising as a “speech act” such as one finds in the work of Searle and Vanderveken, the double failure of the “always” also warrants looking for a complementary “speech-independent” account.
Indexical semantics under indeterminism
Authors: Belnap Nuel , Perloff Michael , Xu Ming
Published: November 2023

Prior chapters of this book have offered bits and pieces of a description of agency in our indeterministic world. This chapter brings us to the topic of the semantics of a language taken to be used by those (ourselves) who live in such a world. Just to have a label, we sometimes call this topic either “the semantics of indeterminism” or “indeterministic semantics.”
Conditional obligation, deontic paradoxes, and stit
Authors: Belnap Nuel , Perloff Michael , Xu Ming
Published: November 2023

Consider the following argument, which is adapted from Castaneda 1981.* Alchourr6n is obligated to do the following: If Bulygin sends him the draft of their latest joint paper, revise it. Bulygin has sent Alchourrón the draft of their latest joint paper.
Decidability of many-agent deliberative-stit theories
Authors: Belnap Nuel , Perloff Michael , Xu Ming
Published: November 2023

In this chapter we give an axiomatization, Ldm, for the basic dstit logic, and prove its completeness and decidability by way of the finite model property. It is surely very natural to combine dstit theory with indeterminist tense logics, especially when we consider deliberative seeing to something to be connected with what the future will be like. In carrying out some basic technical work in dstit theory, however, we will use a formal language without tense operators, though we will use the historical necessity operator Sett:, §8F.4, as a primitive. In our formal language, we will introduce Chellas’s cstit operator, §8G.2, as an abbreviation, just as in §llA. The reader familiar with modal logic can easily see that the Chellas 1992 theory of cstit is decidable, since Chellas did not propose any condition concerning the relation among different agents.
Authenticity and Musical Ensembles
Authors: Romero Raul R
Published: November 2023

The relationship between the assimilation of the clarinet and the saxophone and the impact of modernity in the lives of the people of the Mantaro Valley can be noticed in the many legends about how the saxophone was introduced in the valley. The following story was told to me in 1985 by the widow of Teodoro Rojas Chucas, a well-known musician from the valley. This narrative tells about a North American man who accidentally hit a child with his car. He was carrying a saxophone with its case and wanted to sell it to pay for the damages. Then Teodoro Chucas, who happened to be nearby, bought the instrument for 300 soles (Peruvian currency). He brought the instrument to Acolla, where nobody had heard about the saxophone, and began to play it on June 24 at the Festival of the Tu nantada. From then on, many orchestras were founded that featured the saxophone. This is similar to other stories told around the region but with different names and other variations. However, the common ground among all of them seems to be the sudden, abrupt introduction of the saxophone into the region and the responsibility for its appearance almost always attributed to a particular musician who acquired it through trade, barter, or sale from a foreign, in this case North American, source.