bluuebunny/crossref_metadata_2025 huggingface dataset:
Withdrawal Agreement: General Provisions
Authors: Dougan Michael
Published: October 2021

This chapter provides a critical analysis of the overall Withdrawal Agreement reached between the EU and the UK. The focus for discussion is the post-withdrawal, status quo ‘transition period’—during which, for 11 months after formally leaving the EU, the UK was nevertheless treated as if it were still a Member State for a wide range of purposes. Once that transition period expired, a new set of rules was activated under the Withdrawal Agreement, e.g. on winding-up outstanding UK engagements with EU rules, processes and institutions; and on calculating the UK’s financial settlement towards the EU (the so-called ‘divorce bill’). This chapter also explores the rules on governance, interpretation, dispute settlement and internal legal effects of the Withdrawal Agreement.
Concluding Remarks
Authors: Dougan Michael
Published: October 2021

This chapter summarizes the key legal and political forces that shaped the conduct and outcomes of the EU–UK withdrawal negotiations under Article 50 TEU; offers an overall evaluation of the final Withdrawal Package that provided the basis upon which Brexit finally occurred on 31 January 2020; and highlights certain common themes and issues that emerged from the experience of UK departure. This chapter also highlights some of the future issues and research questions that are bound to emerge from Brexit: both for the UK, as regards the long-term process of ‘de-Europeanizing’ the domestic legal system, not only as regards substantive law, but also, e.g. institutional relations, judicial protection, and the UK’s own Internal Market; and also for the EU, as regards the full impacts of British withdrawal from the Union’s institutions, substantive policies, and processes of constitutional reform.
Life-History Evolution in a Changing Environment
Authors: Hutchings Jeffrey A.
Published: October 2021

The underlying current to this chapter is change. Environments are not static. They can shift directionally or exhibit natural variability, sometimes predictably (e.g. seasonal periodicity) but often unpredictably (stochasticity). The chapter begins by exploring how changes in the directionality and variance of environmental conditions can influence life-history evolution. Variability is the key word for the second half of the chapter. In response to environmental unpredictability, organisms have evolved bet-hedging strategies that maximize the geometric mean or long-run fitness. These life histories can involve one or more conservative or diversification bet-hedging traits. For example, under semelparity, selection can favour the germination of seeds or the hatching of diapausing eggs across multiple generations. Under iteroparity, rather than producing the maximum number of offspring that an organism is capable of producing in few breeding episodes, environmental variability can favour the production of fewer offspring per episode but across a greater number of breeding episodes. The chapter closes with a consideration of different forms of stochasticity and how stochastic estimates of fitness can differ from determinant estimates.
Number and Size of Offspring
Authors: Hutchings Jeffrey A.
Published: October 2021

Offspring number and size are two of the most variable life-history traits. Among species, much of this variability can be attributed to genetic, developmental, physiological, or structural constraints. Some trait combinations are not possible because of differences associated with a species’ evolutionary history. Substantial variation in propagule number and size can exist among populations of the same species, generating questions concerning the adaptive significance of this variability. The most influential models are those attributed to Lack on clutch size and to Smith and Fretwell on offspring size. Fundamental to both sets of models is a trade-off between offspring number and parental investment per offspring. When offspring survival or fitness continuously varies with offspring size, the fitness of the parent depends on both offspring size and the number of offspring of that size that the parent can produce. If offspring survival is independent of offspring size, parental fitness is maximized when individuals maximize the production of minimally sized propagules.
Pain
Authors: Benedetti Fabrizio
Published: October 2021

This chapter is dedicated to pain and analgesia, the area where most of the knowledge about the mechanisms of the placebo effect comes from. Expectation of pain reduction plays a crucial role in placebo analgesia. The placebo analgesic effect is mediated by the endogenous opioid systems and antagonized by cholecystokinin (CCK) in some circumstances. In other conditions, the endocannabinoid system is involved. Many brain imaging studies indicate that several areas are involved in placebo analgesia, including the dorsolateral prefrontal cortex and those regions involved in dopaminergic reward mechanisms. The prefrontal lobes are fundamental for a placebo response to occur: if there is no prefrontal control, there is no placebo response. The nocebo hyperalgesic effect is mediated by anxiety, which activates a CCK system that, in turn, facilitates pain transmission. The endogenous pain modulatory descending circuits represent the biological substrate for the action of placebos on pain.
Mental and behavioural disorders
Authors: Benedetti Fabrizio
Published: October 2021

In this chapter some mental disorders are described. For example, in depression, fluoxetine treatment and a placebo treatment affect similar brain regions. In anxiety, patients’ expectations play a crucial role, as covert (unexpected) administration of anti-anxiety drugs is less effective than overt (expected) administration. The disruption of prefrontal executive control in Alzheimer’s disease decreases the magnitude of placebo responses. In addition, expectations appear to be particularly important when associated with the effects of drugs of abuse. Placebo effects appear to be powerful in psychotherapy as well, and the brain areas involved in the psychotherapeutic outcome are different from those involved in the placebo effect. As clinical trials for psychotherapeutic interventions represent a major problem, new recommendations are presented.
Everyday life
Authors: Benedetti Fabrizio
Published: October 2021

This chapter aims to stimulate further research on placebo-like effects outside the healing setting, thus involving the area of social psychology. Halo effects can be considered, at least in part, similar to placebo effects because the context plays a crucial role in both. Whereas placebo effects have to do with the evaluation of symptoms, halo effects have to do with judgements of a person’s quality and personality. The approach to placebo and halo effects is somehow related to expectations. If one expects pain reduction, he may experience a real analgesic effect. Likewise, if one expects either positive or negative qualities in a person, he may be misled to give either positive or negative judgements, respectively. Another example in everyday life is represented by the role of expectations and mindset in the generation of hunger and satiety.
Social Interaction in Early and Middle Childhood
Authors: Lecce Serena , Devine Rory T.
Published: October 2021

This chapter examines the cognitive basis of social interaction by assessing the claim that children’s ability to understand the minds of others (or ‘Theory of Mind’ [ToM]) matters for their successful social interactions. To this end, it critically examines available research on the relation between ToM and social interaction during early and middle childhood, both within and outside the family. The chapter introduces ToM in a social context framework that considers the processes through which ToM has an impact on children’s social outcomes, and the circumstances under which an association between ToM and social interaction should be apparent. It sets an agenda for future research by emphasizing (1) the mediating role of intentional social interaction behaviours in explaining the relations between ToM and social outcomes in early and middle childhood; and (2) the moderating role of partner-related variables (including familiarity, the nature and quality of the relationship, and the level of partner ToM ability) and of social context in strengthening or attenuating the relations between ToM and social interaction.
The Netherlands: Traditions and Practices
Authors: Weller Patrick , Grube Dennis C. , Rhodes R. A. W.
Published: October 2021

The chapter stresses the ‘polder’ tradition that emphasizes the importance of cooperation in government. The Netherlands has a long tradition of consociational government. Within a parliamentary structure where a system of proportional representation ensures that no one party will hold a majority, coalitions and collaboration are essential. The prime ministers are seen as weak with limited power, although they have a growing institutional and media presence that is generated by the new media demands, regular participation as head of the government in the European Union, and crisis management. Dutch cabinet government is driven through the networks at the centre of government where prime ministers are the key linking figures for parties, civil service, and parliament.
The Policy Dilemma
Authors: Weller Patrick , Grube Dennis C. , Rhodes R. A. W.
Published: October 2021

The chapter considers the dilemmas that underpin policy debates: the civil service argument for evidence-based policy, the need for ministers to balance good policy and good politics, and the advisers’ challenge to manage the politics of issues. Friction is an inherent part of the policy dilemma in all cabinet systems as evidence-based assessments of the ‘best’ policy solution have to be filtered through the many layers of politics and negotiation that surround cabinet decision making. It involves ‘puzzling’ through to imperfect solutions in order to mitigate and manage political risk.
The Leadership Dilemma
Authors: Weller Patrick , Grube Dennis C. , Rhodes R. A. W.
Published: October 2021

How leaders develop cohesion and direction within a cabinet will depend on institutional and conventional traditions. All leaders will necessarily work through persuasion but there are also levers that can be pulled. There are several imperatives: the need to survive electorally; vulnerability to internal revolt; the means by which ministers can be persuaded to collaborate; and the capacity to set agenda and processes. The levels of support differed from one system to another. The chapter shows how these processes work and the extent to which they can assist leaders. It also examines the importance and form of both bureaucratic and political advice across the different systems.
The Transcendent Dimension
Authors: Briggs Andrew , Reiss Michael J.
Published: October 2021

For most of us, there are times when we feel transported beyond the everyday, when we feel a burst of joy or a sense that there is great meaning to life, that everything is connected or that, somehow, all is well. This is an appreciation of the transcendent. Some describe their experience of the transcendent in terms of their relationship with God. Nietzsche explored the idea of self-transcendence, which he saw as self-perfection. The transcendent can be experienced in various ways. Feelings of ecstasy are associated with the production of endorphins. The assertion that what can be studied by science constitutes the only reality is known as scientism, a relation of reductionism. In contradistinction to this, many religions see the transcendent as pointing towards a world to come.
Human Flourishing in an Age of Technology
Authors: Briggs Andrew , Reiss Michael J.
Published: October 2021

For many years, tools were thought to be one of the defining characteristics of humans. Jane Goodall’s work with the chimpanzees of Gombe in Tanzania changed that. Nevertheless, humans use technology in ways that are not just quantitatively but qualitatively different from other species. New technologies can be greeted with overenthusiasm or categorical rejection, often both at the same time. Issues of human flourishing need to be addressed early in the development of a new technology, just as safety should be considered early in the design of any new engineering project. We explore the implications for human flourishing of artificial intelligence and gene technologies. We also examine the implications of COVID-19 for human flourishing and for the place of scientific insight and spiritual wisdom in addressing the disease.
Revolutions, 1685–9
Authors: Smith Hannah
Published: October 2021

This chapter examines James VII and II’s relationship with his army as he started on political and religious reforms to promote Catholicism. James’s unruly army defended him during Monmouth’s Rebellion in 1685 and supported his policies, sparking civil–military conflict. The king’s military reviews on Hounslow Heath were the biggest public spectacle of his reign and suggested his military power over his international and domestic enemies. But the king’s subjects scrutinized the army for tantalizing signs that its members might ultimately be the preservers, rather than the destroyers, of Protestantism and parliament. Throughout his reign, James could not rely on the unanimous backing of army officers and soldiers and by 1688, a group of his most senior army officers was conspiring with William of Orange to support the Dutch invasion which would dethrone James and bring about the Revolution of 1688–9.
Oligarchy and Opposition, 1714–50
Authors: Smith Hannah
Published: October 2021

The interactions between the Crown, its ministers, the army, and parliament during the years of the Whig Oligarchy are the focus of this chapter. Parliament remained concerned about standing armies for many of the same reasons as its forebears. But the British army’s victories during the War of the Spanish Succession had transformed the army’s political as well as military reputation and army veterans could convincingly pose as patriotic defenders of the nation’s liberties. Nevertheless, fears over the abuse of military power arose again in the late 1740s and early 1750s. George II’s son and captain-general, the duke of Cumberland, had crushed the ’45 Rebellion and the Jacobite cause at the battle of Culloden. However, Cumberland’s popularity in the aftermath of the ’45 soon waned amidst allegations that he aimed at military government.
King of Macedon
Authors: Waterfield Robin
Published: October 2021

I begin by reconstructing the operations in the northern Aegean that enabled Antigonus to keep Antiochus of Asia at bay while he attempted to recover Macedon. At first, he was defeated by Ptolemy Ceraunus, but he returned. It took several attempts, but he did eventually succeed. In this he was aided by the peace accord reached with Antiochus, and by a stroke of luck: he came upon a band of marauding Celts, and by defeating them in the battle of Lysimachea could represent himself as the savior of Macedon. Once he had eliminated a few pretenders, the throne was his. He married Phila, the daughter of Antiochus. I discuss his elevation of the god Pan to major status. But his seat on the throne was not yet stable, and Pyrrhus of Epirus took back most of the country for a couple of years, before Antigonus was able to eliminate him in southern Greece. I then turn to how Antigonus stabilized his country and his reign by a program of reform, by which he devolved some of the power of the throne to high-ranking individuals and to the towns and cities of Macedon. I end with some speculations on Antigonus’s finances.
Antigonus and the Greeks
Authors: Waterfield Robin
Published: October 2021

Antigonus lacked any institutional means of controlling the Greeks, such as the League of Corinth, so he resorted to more repressive measures. Even under the kings, the Greek states had considerable local freedom, and the pace of local political life scarcely slackened in the third century. But many of the states were impoverished, so that they became dependent on handouts from the kings, and came also to rely on their wealthy citizens to supply money and hold political offices. Antigonus’s measures were focused largely on the Peloponnese, where he imposed or supported sole rulers (“tyrants”), and installed military garrisons as well. Much of the Peloponnese became effectively occupied territory. At the same time, he was attacking Ptolemaic possessions in Asia Minor. But resentment built up in Greece, and an alliance between Ptolemy, Athens, and the Peloponnesians led to the Chremonidean War (268-262). I go into as much detail as can be recovered about this war, which Antigonus resoundingly won, and the naval battle of Cos against Ptolemy that followed and limited Egyptian encroachment on the Aegean. In celebration, Antigonus enhanced the sacred island of Delos with festivals and a magnificent stoa.
Moral Motivation in Plato’s Republic?
Authors: Sheffield F. C. C.
Published: October 2021

Against the view that knowledge of the Good motivates philosophers in Plato’s Republic to rule, this paper argues that philosophers are ‘dependent rational animals’ (MacIntyre), whose education fosters a widespread sense of mutual interdependence in the community. The recognition of this dependency is a bond of philia, the cultivation of which ensures that citizens care for one another and assist each other to their mutual advantage. Ruling is how philosophers express the reciprocity characteristic of friendship, make a return for benefits received, and show care for others in their service. By tracking the language of ‘nurture’, ‘sharing’, and ‘community’ in Socrates’ replies to Glaucon’s concern and showing how it is embedded within this sense of mutual interdependence and philia, I argue that philia, a certain kind of affective bond, or love, motivates philosophers’ willingness to rule and preserves the integrity of the eudaemonist framework of the Republic.
Breaking New Ground
Authors: Escobar-Lemmon Maria C. , Hoekstra Valerie J. , Kang Alice J. , Kittilson Miki Caul
Published: October 2021

Why women first joined high courts (supreme courts, constitutional courts, and high appellate courts) when they did is the topic of chapter 2. Drawing on the book’s cross-national data set, this chapter explains why women broke the judicial glass ceiling sooner on some courts than others. To consider the influence of multiple factors on the timing of the first woman and given that some courts have never appointed women, the chapter uses an event history model. The cross-national analysis reveals that the more women completing tertiary education relative to men, the faster the first woman is appointed. Further, the results make clear that the judicial glass ceiling is not broken in a domestic vacuum: after other high courts in the geographic region have a woman justice, the faster the appointment of the first woman, and the first woman high court judge is appointed sooner the more advocacy organizations are connected to the international women’s movement.
AI in Medicine
Authors: Kerasidou Angeliki , Kerasidou Xaroula (Charalampia)
Published: October 2021

This chapter explores the use of artificial intelligence in medicine. AI promises major benefits for healthcare. But along with the benefits come risks. Not so much the risk of powerful super-intelligent machines taking over, but the risk of structural injustices, biases, and inequalities being perpetuated in a system that cannot be challenged because nobody actually knows how the algorithms work. Or the risk that there might be no doctor or nurse present to hold your hand and reassure you when you are at your most vulnerable. There are many initiatives to come up with ethical or trustworthy AI and these efforts are important. Yet we should demand more than this. Technological solutionism and the urge to “move fast and break things” often dominate the tech industry but are inappropriate for the healthcare context and incompatible with basic healthcare values of empathy, solidarity, and trust.
Mind-Reading and Morality
Authors: Rainey Stephen
Published: October 2021

This chapter evaluates the prospects, promises, and perils of neurotechnology that aims to reveal our thoughts by recording brain activity. There are mind reading risks from the advance of neurotechnologies. This is especially centred upon how data processing works in technologies developed outside of clinical and scientific research. Neurotechnologies will begin amassing ever growing databases of brain recordings. Meanwhile, technology companies will continue developing algorithms capable of discerning patterns that no human data analyst could spot. In combination, these will amount to a great many opportunities for predicting things about brains, and inferring things about minds. We may be entering a world of neuroprofiling — judgements being made about persons, on the basis of data, beyond relationships and credit ratings. Thus, it is important to think now about whether this is something we want to undergo, or something over which we should demand control.
Artificial Wombs
Authors: Wilkinson Dominic , Stefano Lydia Di
Published: October 2021

This chapter addresses the possibility of artificial wombs. The technology of developing a fetus from embryo to birth in an artificial environment is sometimes called “ectogenesis.” Ectogestation, if it comes to fruition, might offer the extraordinary possibility of saving or improving the lives of babies born extremely early, barely halfway through a normal pregnancy. It could also free women from various forms of gender oppression and liberate people from the constraints of anatomy. On the other hand, some feminists worry that this potential technology could undermine the importance of motherhood, render natural child-bearing a luxury, and diminish the value of women’s lives. Like many advances in reproductive medicine and neonatal care, ectogestation is sure to be accompanied by challenging ethical questions. The chapter then considers the ethical implications of ectogestation in neonatal ethics and abortion.
Posthumans
Authors: Sandberg Anders
Published: October 2021

This chapter evaluates human enhancement, looking at the concepts of transhumans and posthumans. It might be useful to call enhancements things that improve the functions we already have while extensions add new functions. Somebody who is much enhanced compared to us current humans can be called a “transhuman”; they are clearly better at a lot of things, even if they are not better people in a moral sense. Being a moral or good person seems to be a thing we should always try to achieve — even if it means installing an ethical co-processor in the brain. But could we turn ourselves into a new species, a post-human species? What if enhancement makes us not ourselves? Not everybody agrees on what changes would change how we evaluate ourselves. In fact, people differ enormously in what they regard as defining their own existence, so a change that is fine for one person may be too radical for someone else. The best we can do is to respect different choices, making sure they are well considered and informed.
Obstetrics
Authors: Setna Zeryab
Published: October 2021

Obstetrics, like all fields of medicine, continues to evolve at a rapid pace, and keeping up-to-date with the latest literature, guidelines, and protocols can be a daunting task. This chapter contains 26 questions that encompass all of the important areas of this subject, with detailed explanations. Unique to this series, questions are rated by difficulty and are cross-referenced to the eleventh edition of Oxford Handbook of Clinical Specialties to track revision progress and revise effectively.
Gynaecology and genitourinary medicine
Authors: Hayes Kevin
Published: October 2021

Gynaecological practices are changing constantly, with more emphasis on management in primary care, conservative, rather than surgical, management of conditions, and an increase in sub-specialization such as gynaecological oncology and urogynaecology. This chapter contains 29 questions that encompass all of the important areas of this subject, with detailed explanations. Unique to this series, questions are rated by difficulty and are cross-referenced to the eleventh edition of Oxford Handbook of Clinical Specialties to track revision progress and revise effectively.
Dermatology
Authors: Simcox Gemma
Published: October 2021

This chapter contains 37 questions that encompass all of the important areas of dermatology, with detailed explanations. The questions in this chapter will test your knowledge of the skin problems that are frequently encountered in non-specialist clinical practice. Other more rare skin disorders are also covered, either because they are potentially life-threatening or because they are a sign of systemic disease. The questions are designed to improve your ability to recognize the morphology and distribution of cutaneous physical signs. Unique to this series, questions are rated by difficulty and are cross-referenced to the eleventh edition of Oxford Handbook of Clinical Specialties to track revision progress and revise effectively.
Trauma
Authors: Davies Nev , Vusirikala Anuhya
Published: October 2021

This chapter contains 19 questions that encompass all of the important areas of trauma, with detailed explanations. The questions highlight the important principles of trauma care and aim to help the reader comprehend the management of a seriously injured trauma patient. Unique to this series, questions are rated by difficulty and are cross-referenced to the eleventh edition of Oxford Handbook of Clinical Specialties to track revision progress and revise effectively.
The Ageing Writer
Authors: Castro São Luís , Abreu Regina
Published: October 2021

As a demanding task that requires the orchestration of multiple processes, writing is an adept candidate to the ravages of old age. Yet writing is also an overlearned skill of which some components are especially resistant to use and decay. This chapter focuses on the ageing writer in health and disease. It reviews age-related changes in writing and examines how executive control plays a role in these changes. Linguistic-level (lexicon, syntax, discourse) and output (handwriting, typing) characteristics of older persons’ writing are outlined, and models explaining how writing performance depends on the integrity of executive functions are presented. The scope of the chapter is expanded by reviewing how writing outcomes can provide markers of dementia and, on a final positive note, how writing interventions can contribute to brace executive functions in older ages.
Healthcare Activism, Marketization, and the Collective Good
Authors: Geiger Susi
Published: October 2021

This introductory chapter charts the book’s trajectory by engaging with three interlinked key dynamics of contemporary healthcare—marketization, digitalization, and individualization. It draws on several theoretical frameworks to conceptualize notions of the common, collective, or public good and to consider how healthcare activism may play into defining and defending the collective good when faced with the outlined societal, economic, and scientific dynamics. Presenting contemporary examples from the Covid-19 pandemic, the chapter argues that the way activists define and defend the collective good can only fully be understood by grasping how this good is shaped by other, often more dominant, stakeholders in healthcare: governmental institutions, professional experts, scientists, and private industry—the latter being a focal point of concern for this current volume.
War on Diseases
Authors: Rabeharisoa Vololona , Doganova Liliana
Published: October 2021

Why and how do patient organizations intervene into debates on the pricing of drugs? This chapter refreshes our understanding of these two questions by situating patient organizations’ participation in drug pricing discussions into the broader dynamics of patient activism. That patient organizations look for a “fair price” is undisputable. From their point of view, though, a “fair price” is not necessarily a “low price.” Patient organizations reflect on whether or not the prices of drugs account for individual and collective concerns they deem important to count. That patient organizations are eager to defend patients’ interests is equally out of doubt. However, patient organizations are not mere lobbies but play a vital epistemic role: they intervene into therapeutic development, tackle its economic impediments, and explore solutions they feel desirable or “fair” for patients and society at large.
Introduction
Authors: Klausen Jytte
Published: October 2021

This Introduction explains how the book addresses issues around the Western wing of the global jihadist movement. It is based on an extensive data collection relating to about 6,400 Western residents and citizens from twenty countries who committed terrorism-related crimes or died fighting with Al Qaeda or an aligned foreign terrorist group since the early 1990s. The Introduction argues that the diffusion of jihadist extremism in Western democracies was driven by the strategic objectives of Osama Bin Laden and the global movement he spearheaded rather than, as is often said, by local grievances of Western Muslims. Bin Laden was a political entrepreneur. His singular accomplishment was to give extremist Islamism a new strategic direction by focusing on a war against the “far enemy,” the United States and its Western allies, on the assumption that relentless terrorism against American and Western targets would compel the United States to withdraw support from the Muslim world and leave Muslim governments vulnerable to the jihadist insurgents. The chapter reviews a range of ideas about the causes of terrorism and outlines a theory of networked social contagion that explains how jihadism has made inroads in Western democracies.
Mystery Tour
Authors: Fritzsche Peter
Published: October 2021

This chapter examines how the National Socialist German Workers' Party charged into a position of power in the years between 1930 and 1932. No party in the Weimar Republic had managed to gain a foothold in as many precincts as quickly as the Nazis did, and no party could match their diverse electorate, which mostly comprised middle-class Protestants, farmers, shopkeepers, and civil servants but also included the “bourgeoisie of education and property” as well as workers and Catholics. The Nazis campaigned tirelessly to court such support. In cities, Adolf Hitler himself attracted audiences that numbered in the tens of thousands. The Nazi leader appealed to popular fears and resentments and transformed them into final judgments and the promise of direct remedial action.
Introduction
Authors: McHugh James
Published: October 2021

The introduction briefly frames the project in terms of the study of drugs, alcohol, and altered states of consciousness in South Asian history and religions. What sort of evidence exists for writing a history of alcohol in India and what are the limits of this archive? What are the methodological and philological difficulties to be overcome in writing this sort of history of India? This chapter also presents a brief survey of previous scholarship on this topic and raises the question of whether this book should be considered controversial or offensive. The chapter concludes with an outline of the book and an explanation for the organization of topics within the book.
Luxurious, Erotic Drinking in Literary Texts
Authors: McHugh James
Published: October 2021

A more poetic, literary style goes hand in hand with more elite drinking. Chapter 4 explores a range of texts on such drinking, which often involves servants, privacy, precious vessels, imported wine, erotic encounters, intense literary moods, and perfumed betel. Again, the conventions of genre are very much in evidence here, so this chapter is more a guide to those features of literature than a study of practice. The chapter also considers representations of ancient Indian “wine talk” and presents some didactic passages on how to drink properly, including a few from the Kāmasūtra. Additionally, the chapter examines the small number of Sanskrit texts devoted primarily to the pleasures and purposes of drinking.
Surā Regained
Authors: McHugh James
Published: October 2021

Chapter 8 presents a brief, simplified account of how drink was used in a selection of Tantric rituals, mainly as presented in some (though by no means all) Hindu Tantras, and in particular in the writings of the Kashmiri author Abhinavagupta. Additionally, this chapter explores a later text that contains a spectacular description of the personified goddess of liquor: Surā (and her nine cups): a mythological account of how humans came to have access to all the intoxicating substances they now possess. This text also mentions cannabis, which is discussed here along with opium, considering some ways in which new substances were incorporated into Indian religious and intellectual traditions.
How Kant was Never a Wolffian, or Estimating Forces to Enforce Influxus Physicus
Authors: Goldenbaum Ursula
Published: October 2021

This chapter aims to show that Kant has never been a Wolffian but started his career precisely from the core problem of the Pietists to secure the influxus physicus and thereby liberum arbitrium. I will first present the battle of Pietist and other Lutheran theologians against Wolffianism as a theological-political battle, which explains its extension as well as its fierceness. Then I will explain how a metaphysical hypothesis such as Leibniz’s pre-established harmony could become the subject of a theological-political debate in the Protestant area of the Empire lasting for decades. Only in the third section I will situate Kant’s very first, but quite lengthy book in this context and contrast his declared intention to solve the controversy between Leibnizians and Cartesians about the estimation of forces with his actual metaphysical approach to save influxus physicus. It will be shown that Kant’s approach lacks any familiarity with modern mechanics and mathematics. Finally, I will point to the contemporary reception of Kant’s first book which confirms my evaluation.
Breaking with Rationalism
Authors: Watkins Eric
Published: October 2021

This chapter focuses on another aspect of the development of Kant’s thought in the pre-Critical period: the influence of Christian August Crusius. While Crusius’s emphasis on a libertarian notion of freedom and his restriction to the principle of sufficient reason are relatively well known, it is here argued that scholars have overlooked the fundamental importance of Crusius’s distinction between essence and existence and that Kant’s reaction to it constitutes both a fundamental break with the Leibnizians and a crucial enduring fixture of his own thought, extending through to his Critical period.
Kant’s Theory of Divine and Secondary Causation
Authors: Hogan Desmond
Published: October 2021

This chapter examines Kant’s theory of the relation between God’s causal activity in the world and so-called “secondary” causation, the causality of created beings. The central question he faces here is the traditional one for a theistic metaphysics: How does the activity of God viewed as primordial creator and conserver of the world relate in general to the causal activity, if any, of created beings? His own evolving account of the divine causal role is shaped by his ongoing engagement with three competing theories of divine causation distinguished in late scholastic philosophy, and vigorously debated in the modern period by Malebranche and Leibniz. It is shown here that the most significant milestone in the emergence of Kant’s mature account does not lie in his transition from pre-Critical to Critical philosopher, but in an earlier one from necessitarian to libertarian on human agency.
Intravenous bisphosphonates do not improve knee pain or bone marrow lesions in people with knee osteoarthritis: a meta-analysis
Authors: Zhang Xu , Cai Guoqi , Jones Graeme , Laslett Laura L
Published: October 2021

Objective

To summarize effects of intravenous bisphosphonates (IVBP) in patients with symptomatic knee OA and bone marrow lesions (BMLs), using a meta-analysis of randomized controlled trials (RCTs).

Methods

Literature databases were searched for placebo-controlled RCTs of IVBPs for knee OA from inception, and included validated pain and function scales, BML size and incidence of adverse events. Efficacy was compared using standardized mean differences (SMD) and risk ratios (RR) with fixed-effect or random-effects models. Methodological quality was assessed using the Cochrane risk of bias tool, heterogeneity was assessed by I2 statistics.

Results

We included 428 patients in four RCTs of 2–24 months duration; most patients (84%) received zoledronic acid (ZA). Risk of bias was low-moderate. IVBP had large effect sizes on pain within 3 months [SMD = −2.33 (95% CI: −3.02, −1.65)] mainly driven by neridronate (resulting in substantial heterogeneity, I2 = 92%) with no effect for ZA alone. Differences in knee function were statistically significant at 3 months [SMD = −0.22 (−0.43, −0.01), I2 = 0.2%]. Effect sizes for pain did not reach statistical significance at any other time point. IVBPs improved a semi-quantitative measure of BML size within 6 months [SMD = −0.52 (−0.89, −0.14), I2 = 0%] but not at 12 months or two years. Adverse events [RR = 1.19 (1.00, 1.41) I2 = 52%], occurred more frequently with IVBP.

Conclusion

ZA has no effect on knee pain, possibly a short-term effect on BML size and higher rates of adverse events. Neridronate may improve pain in the short term, but this is based on a single trial.
Does environmental message framing impact proportional reach and sample representativeness related to motivational characteristics?
Authors: Wilson Kathryn E , Estabrooks Paul A
Published: October 2021

Physical activity (PA) promotion messages are commonly used to engage target populations in PA programs. However, little is known about how recruitment messages impact program reach. Evidence suggests that framing messages to be congruent with individuals’ motivational orientation can maximize effectiveness. This congruency effect has not been tested in the context of brief PA promotion messages used in a recruitment environment. It is plausible that framed messages attract certain individuals, while deterring others. The purpose of this study was to determine whether message framing influences representativeness of a sample recruited for a PA program with regards to motivational factors. Three messaging conditions (gain-framed, neutral, loss-framed) were counterbalanced across days of data collection in a primary care waiting room. Patients were asked to complete a questionnaire including surveys on personality and PA, and basic demographic questions. Respondents were offered the chance to participate in a low-burden PA program. Interested respondents were instructed to provide contact information. The proportion and representativeness, with respect to motivational orientation, of individuals volunteering for program participation was assessed using chi-squared tests, and two-way (condition × group) ANOVAs, respectively. After controlling for demographic and behavioral covariates, there was no effect of message framing on the motivational orientation of the resultant samples. Results did not support a congruency effect of a covert message-framing manipulation. More work should aim to understand how recruitment materials and strategies influence motivational characteristics of the resulting sample to maximize intervention outcomes, and target individuals who are more likely to engage in risky health behaviors.
Minimum 2-Year Outcomes Following Arthroscopic Hip Labral Reconstruction in Adolescents and Young Adults
Authors: Maldonado David R. , Glein Rachel M. , Saks Benjamin R. , Jimenez Andrew E. , Sabetian Payam W. , Lall Ajay C. , Domb Benjamin G.
Published: October 2021

Background:

Labral repair is generally preferred when facing labral tears. When an irreparable labral tear in the context of femoroacetabular impingement syndrome is present, arthroscopic labral reconstruction has been proven to be a valid option for labral restoration. However, data on this procedure for the adolescent population is scarce. The purpose of the present study was to report minimum 2-year follow-up patient-reported outcome measures (PROMs) on adolescents and young adults following arthroscopic acetabular labral reconstruction.

Methods:

Data were prospectively collected and retrospectively reviewed on adolescents and young adults who underwent hip arthroscopy between March 2009 and June 2018. Inclusion criteria were labral reconstruction, baseline and minimum 2-year follow-up PROMs. Patients were excluded if they were unwilling to participate in the study, had Tönnis grade >1, or dysplasia.

Results:

Twenty-three hips (22 patients) that underwent labral reconstruction were included. Ten hips (10 patients) underwent primary labral reconstruction, and 13 hips (12 patients) underwent revision reconstruction. The mean age was 19.3 years and 56.5% of patients were males. All patients improved significantly at minimum 2 years for all PROMs (P<0.001) with high satisfaction. Patients in both groups demonstrated improvement for all PROMs, patient satisfaction, and a rate of achieving the minimal clinically important difference.

Conclusion:

Arthroscopic labral reconstruction in adolescents and young adults demonstrated significant improvement and high patient satisfaction at minimum 2-year follow-up in the setting of irreparable labral tear. Favorable outcomes, high patient satisfaction, and high achievement rate for the minimal clinically important difference were obtained following labral reconstruction in this population the primary and revision scenarios.

Level of Evidence:

Level IV, case-series.
Use of Recombinant Human Bone Morphogenetic Protein-2 With Iliac Crest Bone Graft Instead of Iliac Crest Bone Graft Alone in Lumbar Spondylolysis
Authors: Meng Hao , Gao Yuan , Zhao Guangmin , Sun Tiansheng , Li Fang
Published: October 2021

Study Design:

A retrospective study.

Objective:

The aim of this study was to evaluate the clinical and radiographic effect of recombinant human bone morphogenetic protein-2 (rhBMP-2) in pars repair of lumbar spondylolysis.

Summary of Background Data:

BMP-2 is a growth factor that plays a role in the formation of bone and promotes bone healing. However, few studies of using rhBMP-2 in pars repair have been reported.

Methods:

Direct pars repair and pedicle screw fixation was performed, which were added with 1 mg of rhBMP-2 and iliac crest bone graft in the study group (rhBMP-2 group, n=32) and iliac crest bone graft alone in the autograft group (n=36). Patients completed the visual analog scale and the Oswestry Disability Index preoperation, 3, 6, and 12 months after the operation. Computed tomography scans with axial and sagittal reconstructions were performed at 6, 9, 12, 18, and 24 months postoperatively.

Results:

Baseline demographic data showed no significant difference between 2 groups. There were significant differences for the Oswestry Disability Index score at 3 and 6 months postoperatively, which were higher in the autograft group. There was no significant difference between the groups with respect to the overall union status. As for union speed, the trabecular bone appeared earlier and union rates were higher in rhBMP-2 group than in the autograft group at 9, and 12 months postoperatively. No complications were identified in either group. One case in the rhBMP-2 group and 2 cases in the autograft group underwent revision surgery.

Conclusion:

Compared with iliac crest bone graft alone, the use of rhBMP-2 can accelerate fusion in pars repair for young patients with spondylolysis. The union rates were significantly different at 9 and 12 months after surgery. This study showed no clinical difference when adding rhBMP-2 compared with iliac crest bone graft alone.
Cardiovascular risk profile and clinical characteristics of diabetic patients: a cross-sectional study in China
Authors: Lyu Fang , Cai Xiaoling , Lin Chu , Hong Tianpei , Zhang Xiaomei , Lu Juming , Guo Xiaohui , Wang Zhufeng , Xing Huifang , Zong Guizhi , Ji Linong
Published: October 2021

Background:

Cardiovascular (CV) disease is the leading cause of morbidity and mortality in adults with type 2 diabetes (T2D). The aim of this study was to determine the CV risk in Chinese patients with T2D based on the 2019 European Society of Cardiology (ESC) and the European Association for the Study of Diabetes (EASD) guidelines on diabetes, pre-diabetes, and CV diseases.

Methods:

A total of 25,411 patients with T2D, who participated in the study of China Cardiometabolic Registries 3B study, were included in our analysis. We assessed the proportions of patients in each CV risk category according to 2019 ESC/EASD guidelines.

Results:

Based on the 2019 ESC/EASD guidelines, 16,663 (65.6%), 1895 (7.5%), and 152 (0.6%) of patients were included in “very high risk,” “high risk,” and “moderate risk” categories, respectively. The proportions of patients in each category varied based on age, sex, body mass index, and duration. While 58.7% (9786/16,663) of elderly patients were classified to “very high risk” group, 89.6% (3732/4165) of patients with obesity were divided into “very high risk” group. Almost all patients with a duration of diabetes >10 years had “very high risk” or “high risk.” However, 6701 (26.4%) of Chinese T2D patients, who had shorter duration, and one or two risk factors, could not be included in any category (the “unclear risk” category).

Conclusions:

In China, most patients with T2D have “very high” or “high” CV risk based on 2019 ESC/EASD guidelines. However, the risk of patients in “unclear risk” group needs to be further classified.
Investigation of the anti-inflammatory effects of stigmasterol in mice: insight into its mechanism of action
Authors: Morgan Letícia Vidor , Petry Fernanda , Scatolin Mikaela , de Oliveira Patrícia Viera , Alves Bianca Oliveira , Zilli Gabriela Adriany Lisboa , Volfe Carolin Roberta Bueno , Oltramari Amanda Rebonatto , de Oliveira Débora , Scapinello Jaqueline , Müller Liz Girardi
Published: October 2021

Stigmasterol is a phytosterol that presents pharmacologic properties. However, its anti-inflammatory mechanism and antinociceptive effect are not yet elucidated. Thus, the present study aimed to investigate the anti-inflammatory and antinociceptive activities of stigmasterol and its mechanism of action in mice. The antinociceptive activity was assessed by the acetic acid-induced writhing test, formalin test, and hot plate test. The anti-inflammatory activity was investigated by carrageenan-induced peritonitis and paw edema induced by arachidonic acid. The involvement of glucocorticoid receptors in the mechanism of stigmasterol anti-inflammatory action was investigated by molecular docking, also by pretreating mice with RU-486 (glucocorticoid receptor antagonist) in the acetic acid-induced writhing test. Mice motor coordination was evaluated by the rota-rod test and the locomotor activity by the open field test. The lowest effective dose of stigmasterol was standardized at 10 mg/kg (p.o.). It prevented abdominal writhes and paw licking, but it did not increase the latency time in the hot plate test, suggesting that stigmasterol does not show an antinociceptive effect in response to a thermal stimulus. Stigmasterol decreased leukocyte infiltration in peritonitis assay and reduced paw edema elicited by arachidonic acid. Molecular docking suggested that stigmasterol interacts with the glucocorticoid receptor. Also, RU-486 prevented the effect of stigmasterol in the acetic-acid abdominal writhing test, which might indicate the contribution of glucocorticoid receptors in the mechanism of stigmasterol action. Stigmasterol reduced the number of crossings but did not impair mice’s motor coordination. Our results show that stigmasterol presents anti-inflammatory effects probably mediated by glucocorticoid receptors.