bluuebunny/crossref_metadata_2025 huggingface dataset:
Conclusion: After the System
Authors: Kapoor Ilan , Zalloua Zahi
Published: October 2021

In theorizing post-capitalism, a universal politics cannot downplay “the power of envy” or engage in a fetishistic disavowal of envy. Envy is to be avowed, acknowledged as a constitutive element of human existence. This is not to naturalize or justify envy. Quite the contrary, the avowal of envy enjoins us to politically confront it, to de-individualize envy’s hold on us—not to transcend it or acquiesce to its presence. Envy registers first and foremost an ontological dissatisfaction, a “glitch” in us, that the current system is all too keen to exploit and manipulate. And this insight must not be lost on a universal politics. The unavoidable implication is that the struggle for emancipation is a never-ending one—it always fails; it always falls short of its objective. Reaching a destination inevitably brings with it killjoys and spoilers, making for new struggles. But this should come as no surprise since universality, after all, is about the very absence of meaning—impossible to reach, possess, or fully realize. Struggle, struggle again, struggle better.
Authority Taming Power
Authors: Fèvre Raphaël
Published: October 2021

From a political perspective, ordoliberals formulated a “new” social question based on the collapse of human freedom and autonomy in the face of the rise of private and public economic powers. Thus ordoliberals regarded the dispersion of economic power within the economic process as the key to overcome the social question. Finding an answer to the social question required the institution and perpetuation of the competitive order. Thus, the ordoliberal economic policy is directed toward the dispersion of economic power. Ordoliberals considered competition as a formidable tool for the disempowering of private economic power and for regulating the social body. Tracing the various manifestations of economic power led the ordoliberals to consider a broad program of economic and social policies that should be politically implemented by a strong state.
Epilogue
Authors: Fèvre Raphaël
Published: October 2021

This last chapter outlines the ordoliberal discourse in the early postwar period (1946–1950) and the way it gained traction on the political stage. The author shows that the ordoliberals sought to establish a continuity between the economic order of the Third Reich and the administration of the Western Allies and thereby confronted political authorities with the fact that proper denazification could succeed only if Nazi planning methods were rejected. This argument has been constructed around various kinds of documentation, including advisory reports, newspaper/magazine articles, and academic publications. Ultimately, the chapter contributes both to a better definition of ordoliberal ideas (especially of their critical scope) and to a better knowledge of competing ideologies in the early Cold War context.
Conclusion
Authors: Fèvre Raphaël
Published: October 2021

After having briefly summarized the content of the book, this concluding chapter uses the definition of ordoliberalism as a political economy of power to discuss what is today called the “ordoliberal core” of European governance. The conclusion shows that the word “ordoliberalism” refers to two separates—and at time conflicting—paradigms: an old form of political economy and a new form of neoliberal orthodoxy. Hence the conclusion investigates the reasons for the political success of ordoliberalism in the immediate aftermath of the war, as well as to what extent the lasting influence of the ordoliberal discourse was accompanied by its transformation: abandoning its original form of a political economy of power to embody the contemporary form of neoliberal orthodoxy in the European Union.
Knowledge from the Outside
Authors: Kornblith Hilary
Published: October 2021

Knowledge may be examined from the third-person perspective, as psychologists and sociologists do, or it may be examined from the first-person perspective, as each of us does when we reflect on what we ought to believe. This chapter takes the third-person perspective. One obvious source of knowledge is perception, and some general features of how our perceptual systems are able to pick up information about the world around us are highlighted. The role of the study of visual illusions in this research is an important focus of the chapter. Our ability to draw out the consequences of things we know by way of inference is another important source of knowledge, and some general features of how inference achieves its successes are discussed. Structural similarities between the ways in which perception works and the ways in which inference works are highlighted.
Milton Friedman’s Corporate Misanthropy
Authors: Lechterman Theodore M.
Published: October 2021

This chapter considers how arguments from previous chapters inform the ethics of corporate philanthropy. It also draws help from an unlikely ally, the libertarian economist Milton Friedman, notorious for his opposition to corporate philanthropy. The chapter argues that this controversial stance can be anchored in a democratic critique of corporate power. Because a firm’s shareholders, managers, and employees are already free to make donations in their individual capacities as citizens, allowing firms to donate in addition can objectionably multiply the public influence of their stakeholders. Furthermore, as firms typically command concentrated wealth, deploying that wealth for social purposes can afford them domineering influence over receiving communities. Finally, an inherent conflict between a commercial firm’s acquisitive and altruistic motives exposes vulnerable beneficiaries to mistreatment. The chapter reveals how corporate philanthropy can overcome this criticism and proposes that new developments in business that blend commercial and nonprofit aims invite further research.
Overthrowing the Tyranny of Generosity
Authors: Lechterman Theodore M.
Published: October 2021

This concluding chapter summarizes and reflects on the arguments of the book. Even when philanthropy comes with noble intentions, just aims, and rigorous methods, it can objectionably privatize matters that all of us have equal interests in deciding, augment the power of the richer at the expense of the poorer, empower the dead at the expense of the living, and perpetuate structural inequalities between donors and recipients. But democracy’s contribution to the ethics of philanthropy isn’t merely critical. The chapter insists that reflection on the value of democracy shows how philanthropy can be consistent with, and facilitative of, the democratic ideal. When sensitively regulated and conducted, philanthropy provides a valuable vehicle for individual liberty that complements and strengthens democratic institutions. The chapter goes on to clarify the arguments’ practical upshots, note some of the topics and questions left outstanding, and propose issues for further research.
Treating Dominant Digital Platforms as Public Trustees
Authors: Napoli Philip M.
Published: October 2021

This chapter outlines a rationale for digital platform regulation that involves treating platforms as public trustees, and the massive aggregations of user data that serve as the foundation of these platforms’ business models as a public resource. In developing this argument, the first section of this chapter provides an overview of the public trustee concept and its application in policymaking. The second section argues for the applicability of the public trustee concept to large aggregators of user data such as social media platforms and search engines. The third section delineates key limitations and boundaries in terms of how this public trustee framework would be applied. The concluding section offers some preliminary thoughts on possible public interest obligations for dominant digital platforms.
The Architectonic of Reason
Authors: Ypi Lea
Published: October 2021

The Architectonic of Pure Reason, one of the most important sections of Kant’s first Critique, raises three fundamental questions. What can I know? What should I do? What may I hope? Taken together these questions converge on a fourth one, which is at the centre of philosophy as a whole: what is the human being? This book suggests that the answer to this question is tied to a particular account of the unity of reason—one that stresses its purposive character. By focusing on the sources, evolution, and function of Kant’s concept of purposiveness, the book shows that the idea of purposiveness that Kant endorses in the Critique of Pure Reason is a concept of purposiveness as intelligent design, quite different from the concept of purposiveness as normativity that will become central to his later works. wIn the case of purposiveness as normativity, it is anchored to the concept of reflexive judgment, and grounded on transcendental freedom. Understanding this shift has important implications for some of the most difficult questions that confront the Kantian system: the passage from the system of nature to that of freedom, the relation between faith and knowledge, the philosophical defence of progress in history, and the role of religion. It is also crucial to shed light on the way in which Kant’s critique has shaped the successive German philosophical tradition.
The Nature of Knowledge: Avenarius and Schlick
Authors: Textor Mark
Published: October 2021

The Criticist project, as articulated by Riehl, is to draw the limits of knowledge. If knowledge is properly delimited, we can see that the alleged knowledge of metaphysics lies beyond these limits. So what is the nature of knowledge? Schlick General Theory of Knowledge found the key to an answer to this question in Avenarius’ two-term view of knowledge. The chapter introduces the basic concepts and theses of Schlick’s epistemology as it is presented in his General Theory of Knowledge. He argued that every cognition must have two terms, and that in the case of scientific knowledge at least one of the terms will be a precise concept. While endorsing the two-term view, Schlick disagreed with Avenarius and Mach about the economy of thought. The chapter will outline how Schlick reconfigured the idea that the aim of all cognition is to save intellectual expenditure and how he tried to argue for the two-term view of judgement against Brentano.
Drawing the Limits of Knowledge
Authors: Textor Mark
Published: October 2021

Metaphysicians hold that there are two kinds of real things: those that are truly real and those that are less real. The former are the grounds of the latter. Metaphysics is supposed to be knowledge of the truly real things; the reality that underlies appearances. Schlick argued (i) that metaphysics so understood needs to have a special source of knowledge distinct from the sources of knowledge on which science and common sense rely and (ii) that there is no such source of knowledge. Hence, even if there are truly real objects and facts, they are beyond the limits of knowledge. Schlick concludes that there are no differences in degrees of being: all being is on a par. The chapter gives an overview of the metaphysicians attacked by Schlick and reconstructs his argument against metaphysical knowledge that is based on the two-term view of cognition.
Housing for the People
Authors: Sillars Stuart
Published: October 2021

The inter-war years great housing innovation and expansion. As a result, a new kind of publication, the book detailing structures and layouts of buildings, became popular. Earlier illustrated texts had explored housing problems and their solutions, but all were too technical or lacked impact. The Illustrated London News and The Graphic, as well as books by Jack London, and photographs of slum houses, began a tradition of verbal-visual discussion, although lacking practical advice and immediate impact. By contrast, the Tudor Walters Report of 1919, on housing for working people, made highly effective use of diagrams and floor plans with brief, precise prose descriptions. Walters, himself an architect, also designed buildings combining traditional and modern materials. Richard Reiss’s The Home I Want explored similar concerns. All prepared the way for later publications that made the housing debate visibly accessible, becoming an art form in itself.
Some Uses of Imagery
Authors: Sillars Stuart
Published: October 2021

Throughout the period, book design and typography developed to improve clarity of presentation and idea, and page design became much clearer, in principles described by G. Wren Howard. This was matched by the use of many kinds of illustration within a wide range of books. Crime thrillers, increasingly popular, used illustrations rarely, perhaps because they intruded with the readers’ own construction of scenes that they could share. Illustrations on other books covered many styles. This chapter discusses the range of uses to which illustrations are put, and other ways in which they relate to the written texts alongside which they appear.
Sightseeing
Authors: Hawes Greta
Published: October 2021

This chapter begins from the premise that reading Pausanias is an experience, one that is shaped by what a reader might have before her eyes, and already hold in her head. It comprises two case studies: an examination of Pausanias’ Thebes that seeks to understand how topographical description and spatial awareness function within the Periegesis; and a survey of Heracles’ appearances which tests the relationship between required and acquired mythic knowledge. It argues that the experiential facets of Pausanias’ work create almost infinite possibilities for idiosyncratic interpretation while simultaneously instilling in the reader a set of normative habits for approaching both travel and travel literature.
The UK's Withdrawal from the EU
Authors: Dougan Michael
Published: October 2021

Following a national referendum on 23 June 2016, the UK announced its intention to end its decades-long membership of the EU. That decision initiated a process of complex negotiations, governed by Article 50 of the Treaty on European Union, with a view to making the arrangements required for an ‘orderly Brexit’. This book explores the UK’s departure from the EU from a legal perspective. As well as analysing the various constitutional principles relevant to ‘EU withdrawal law’, and detailing the main issues and problems arising during the Brexit process itself, the book provides a critical analysis of the final EU–UK Withdrawal Agreement—including dedicated chapters on the future protection of citizens’ rights, the border between Ireland and Northern Ireland, and the prospects for future EU–UK relations in fields such as trade and security.
Epilogue
Authors: Warren James
Published: October 2021

This final chapter presents brief look at some of the later, especially early Christian, developments of the notion of metameleia, focussing on a passage in Paul, 2 Corinthians 7. Here there is an important distinction to be made between repentance (metanoia) and regret (metameleia). Paul both looks back to the earlier ancient philosophical accounts and also introduces new dimensions to the treatment of regret. He initially regretted sending a letter that caused its recipients pain but then, recognising that this led them to repentance, finds he no longer regrets what he did. Repentance can never be a source of regret.
Emergence and development of scientific medicine
Authors: Benedetti Fabrizio
Published: October 2021

This chapter 2 describes how scientific medicine has evolved over the centuries, representing an important point if we want to investigate the doctor–patient relationship and placebo effects from a neuroscientific perspective. The transition from the shaman to the modern physician, and from shamanism (i.e. a spiritual-based notion of disease) to scientific medicine (i.e. an anatomophysiological-based concept of disease), was a slow process that took many centuries to develop. With the advent of psychoimmunology, modern medicine recognizes that the brain may play an important role in the pathophysiology of many illnesses. It is important to underscore that, although medical approaches vary across different cultures, the interaction between the doctor and his patient does not change very much, as it is always characterized by four steps: feeling sick, seeking relief, meeting the therapist, receiving the therapy.
Feeling sick
Authors: Benedetti Fabrizio
Published: October 2021

This chapter sets the stage for a better understanding of how different placebo effects are related to different psychological factors taking part in the perception of a symptom, particularly nociception, whereby psychological modulation plays a crucial role in the global experience of pain. Interoceptive sensibility is at the very heart of the process of feeling sick. The insular cortex and the anterior cingulate cortex are key regions in interoceptive processing and in awareness. Different emotional states, such as anxiety and depression, or different cognitive tasks, like attention and distraction, may have profound effects on interoceptive awareness, such that perceptions can be reported in different ways from time to time. Pain is a representative symptom and is better understood compared with other symptoms, like nausea and fatigue. Overall, the process of feeling sick is an intricate combination of bottom-up and top-down processes.
The Cognitive Basis of Social Interaction Across the Lifespan
Authors: Ferguson Heather J.
Published: October 2021

This chapter sets the scene of the book by providing key definitions of the concepts that underlie social interaction, and highlighting the importance of a lifespan approach. Traditionally, research on social interaction has focused on a very narrow age-range between 2 and 7 years old, when these skills are known to develop in typically developing children. However, over the last few years new paradigms and methodological advances have facilitated an exciting new body of research that has examined social interaction in infancy and beyond childhood. This chapter presents key theoretical models of social interaction, and considers the predictions that each makes about development across the lifespan, noting a particular role for cognitive mechanisms. It also introduces a range of methodological approaches that have been used to study social interaction, emphasizing the challenges that researchers face in applying these methods across the lifespan, and the opportunities that lie ahead thanks to new paradigms and technologies that enable more implicit and ecologically-valid research on this topic.
Social Interactions in Old Age
Authors: Brunsdon Victoria E. A. , Bradford Elisabeth E. F. , Ferguson Heather J.
Published: October 2021

Social relationships play an important role in healthy ageing, with positive social interaction experiences predicting better mental and physical health. Research into social-cognitive abilities has often focused on the development of these abilities in childhood. This chapter will look at the other end of the lifespan, examining changes in social cognition abilities in older individuals as a result of healthy ageing. In particular, it focuses on several social processes, including Theory of Mind, empathy, emotion recognition, action understanding, and imitation, looking at reported changes in these abilities as a result of advancing age, and factors that may influence these changes across individuals. It also discusses potential intervention protocols aimed at reducing social-cognitive declines in older age, and how these reported abilities influence day-to-day functioning in the social world.
The Origins of Gandersheim
Authors: Greer Sarah
Published: October 2021

The establishment of the convent of Gandersheim c.852 is often seen as an origin point for its founding family as well, denoting the Liudolfings’ first use of a memorial centre to build up their power and political influence en route to securing the royal title. Consequently, studies of the origins of Gandersheim are often coloured by the later success of the Ottonian dynasty and the monastery’s role as a royal foundation. This chapter instead sets the early history of Gandersheim and its external relationships firmly in its late-Carolingian context. It uses the contemporary works written for the community of Gandersheim by Agius of Corvey to argue that there was considerable ambiguity around the monastery’s relationship to the Liudolfings after the death of the first abbess, Hathumoda.
The Origins of Quedlinburg
Authors: Greer Sarah
Published: October 2021

The foundation of a new convent at Quedlinburg fundamentally altered the history of Saxon female monasticism. However, the early years of the convent, from its establishment in 936 down to the accession of its first Ottonian abbess in 966, have often been overlooked. This chapter moves beyond seeing the convent as the pet project of the widowed Queen Mathilda to instead set the monastery back into the context of Otto I’s early reign. It argues that Quedlinburg was founded by Otto I himself over his father’s body as an aggressive attempt to prevent his brothers from claiming royal power for themselves. The monastery immediately became a place of incredible memorial significance within Ottonian politics. Its rule by Ottonian abbesses was not, however, a feature of its early history. Rather, it was only the result of a broader reorientation of the Ottonian family from 955 onwards that we see Ottonian daughters first enter convents to become their rulers.
Introduction
Authors: Sumner Andy
Published: October 2021

This book is about stalled industrialization, the spectre of premature deindustrialization, and tertiarization in the developing world. It discusses development since the 1960s/1970s and particularly since the 1990s. Four great transformations framing the evolution of the global system are presented, followed by a set of accompanying myths of economic development. The book culminates in the challenge that developing countries face in the ‘tertiary trilemma’ and the pursuit of national and equitable economic development in the years ahead. This introductory chapter sets out the rationale for the book, the existing literature, the intended contribution of the book, the methodology and analytical approach taken in the book, and the structure of the book.
The Two New Middles
Authors: Sumner Andy
Published: October 2021

This chapter sets the scene in a panoramic discussion of changes in the developing world, in particular the substantial economic growth since the 1990s. In doing so, the chapter focuses on the first great transformation outlined. It is argued that there is a new polarization in the developing world and that two new precarious ‘middles’—one of countries and one of people—that have emerged since the end of the Cold War. Both are threatened by stalled industrialization and the spectre of deindustrialization. The chapter discusses the related myth emerging from this first transformation—that economic development is ahistorical. The chapter focuses on why late development remains a crucial concept in understanding contemporary development.
A Critical Juncture
Authors: Calvo-Gonzalez Oscar
Published: October 2021

This chapter zeroes in on a series of events that helped Spain achieve a much higher degree of political stability than in previous decades. Having sided with the Axis, the end of World War II posed great danger to the regime of Spain’s dictator, General Franco. Yet as the Cold War intensified, the geostrategic value of Spain increased, helping shift American foreign policy interests. After the Korean War broke out, the US sought and achieved agreements with Spain to set up a series of military bases in its territory. The agreements helped solidify the Franco regime in power. The chapter shows how the achievement of political stability in Spain was unlikely, fast, and externally facilitated. Crucially, it also led to a significant increase in economic confidence among the business community in the country.
More Than Macro Stability
Authors: Calvo-Gonzalez Oscar
Published: October 2021

For economic growth to accelerate, as it did in Spain in the decade after 1950, requires more than just increased political stability. This chapter documents the drastic turnaround in economic policymaking that took place, from an autarkic and statist orientation to a more open and market-friendly one. It also provides a counterfactual exercise to help us gauge the impact of economic reforms. The analysis makes clear two important conclusions. First and foremost, the growth dividend from improving economic policies in Spain was large. The most impactful reforms were those that implied removing excesses that were causing large distortions, such as the misalignment in the exchange rate. The second conclusion is that this improved performance was the result of a decade-long reform process. The results from the counterfactual exercise suggest that the early reforms undertaken before 1959 played almost as much of a role as the 1959 Plan did in stoking growth. This finding is in contrast with most of the literature which, with few exceptions, has focused perhaps too much on the importance of the 1959 Stabilization Plan. This finding also raises important questions why reforms were undertaken and puts in doubt the existing mainstream view that a desperate economic situation had prompted the adoption of the 1959 Stabilization Plan.
Openness
Authors: Calvo-Gonzalez Oscar
Published: October 2021

Much of the growth dividend from policy reforms stemmed from increased openness. This chapter explores the way in which Spain became increasingly open to the world economy. The chapter discusses not only trade but also inflows of foreign capital as well as tourism and migrants’ remittances—all of which combined made possible a sharp rise in imports of equipment and machinery that embodied more updated technology. The increased interactions with the external world led not merely to technological adoption and catch-up but also to an increased outward orientation. Spanish businesses, from shoemakers to engineering firms, were able to build on their contacts with the international market to explore opportunities and achieve exporting success. From a comparative perspective, the economy experienced a fast and substantial diversification of exports, a remarkable development that had until recently been somewhat hidden due to the lack of comparable data across countries.
Introduction
Authors: Gribben Crawford
Published: October 2021

This introductory chapter provides an overview of the history of Christianity in Ireland. Since the arrival of Palladius in Ireland in the year 431, the ‘land of saints and scholars’ has had a long and complex relationship with its dominant religion. Ireland's social, political and intellectual history has always been integrated with its experience of Christianity, for the religion that began to organize in 431 has shaped in powerful ways the island's cultures and languages, as well as its people's conceptions of what it means to be an individual, a family, a community, and a nation. Over one-and-a-half millennia, the Christian faith fashioned ideas about Irish-ness and Ireland, just as Irish missionaries, theologians, ideas, and experiences shaped Christianity as it expanded around the world. Nevertheless, the dominance of Christianity in Ireland was never complete and has never been uncontested.
Conversions
Authors: Gribben Crawford
Published: October 2021

This chapter discusses the gradual expansion of the Christian movement into Ireland. Despite widespread fears, the fall of the Roman empire did not herald the end of Christianity. Instead, it encouraged its expansion. Christian missionaries in Ireland worked to ensure that an island with an unfamiliar language and culture beyond the edge of the western empire would accept Christianity more than 100 years before the Anglo-Saxons, and centuries before other northern European peoples. For the fall of Rome and the crisis of imperial Christianity were contexts for the emergence in Ireland, and elsewhere, of a new kind of faith. From the early fifth century, and over several hundred years, the Irish converted to Christianity, shaping their new faith, exporting their theological and missionary cultures, and working for the conversion of the Picts, the Northumbrians, and Anglo-Saxons, as their Christian culture expanded throughout Europe, saving souls, if not ‘saving civilization’, at the end of the Roman world.
Foundations
Authors: Gribben Crawford
Published: October 2021

This chapter examines the foundation of the Irish church. Irish monasteries did a great deal to protect Roman traditions of learning, as Roman power contracted. And, as a consequence, the Irish church grew in wealth and prestige, with Irish preachers, theologians and biblical scholars doing much to lead movements of evangelism and reform throughout western and central Europe. This work developed as the Irish church faced unprecedented threats. Among the most serious of these threats was the competition between monastic federations, as well as the arrival of the earliest Scandinavian pirates and the English invasion and partial conquest in the eleventh and twelfth centuries. Deeper cultural changes were also afoot. Nevertheless, the Irish church was held together by its differences. At the end of the fifteenth century, there was no sign of religious discontent. The reformation that began before the invasion and accelerated in its aftermath consolidated the cultures of Christian Ireland.
Western Jihadism
Authors: Klausen Jytte
Published: October 2021

This book tells the story of how Al Qaeda grew in the West. In compelling detail, Jytte Klausen traces how Islamist revolutionaries exiled in Europe and North America in the 1990s helped create and control the world’s deadliest terrorist movement - and how, after the near-obliteration of the organization in the aftermath of the 9/11 attacks, they helped to rebuild it. She shows that the diffusion of Islamist terrorism to Europe and North America was driven, not by local grievances of Western Muslims, but by the strategic priorities of the international Salafi-jihadist revolutionary movement. That movement nevertheless adapted to Western repertoires of protest even as it agitated for armed insurrection and religious revivalism in the name of a warped version of Islam. The jihadists—Al Qaeda and the Islamic State, and their many affiliates and associates— also proved to be amazingly resilient. Again and again, the movement recovered from major setbacks. Appealing to disaffected Muslims of immigrant origin and alienated converts to Islam, Jihadist groups continue to recruit new adherents in Europe and North America, street-side in neighborhoods, in jails, and online through increasingly clandestine platforms. Taking a comparative and historical approach, deploying cutting-edge analytical tools, and drawing on her unparalleled database of up to 6,500 Western jihadist extremists and their networks, Klausen has produced the most comprehensive account yet of the origins of Western jihadism and its role in the global movement.
Hitler's First Hundred Days
Authors: Fritzsche Peter
Published: October 2021

This book details the story of how Germans came to embrace the Third Reich. Germany in early 1933 was a country ravaged by years of economic depression and increasingly polarized between the extremes of left and right. Over the spring of that year, Germany was transformed from a republic, albeit a seriously faltering one, into a one-party dictatorship. The book examines the pivotal moments during this fateful period in which the Nazis apparently won over the majority of Germans to join them in their project to construct the Third Reich. It scrutinizes the events of the period—the elections and mass arrests, the bonfires and gunfire, the patriotic rallies and anti-Jewish boycotts—to demonstrate both the terrifying power that the National Socialists came to exert over ordinary Germans and the powerful appeal of the new era that they promised.
Between Deflationism and Inflationism: A Moderate View on Truth and Reference
Authors: Moore Graham Seth
Published: October 2021

This essay argues for a two-part thesis concerning the deflationist theories of truth and reference. First, I identify two points of contrast between the deflationist theories and their traditional inflationary opponents: (1) they each employ different orders of explanation for the variety of semantic phenomena, and (2) the inflationist is typically taken to be beholden to a reductive explanation of reference, whereas the deflationist is doubtful of this project. Secondly, I argue that these two points of contrast need not come together to exhaust the space of possible views. There is room for a plausible middle ground: a moderate version of inflationism. My moderate inflationism will reject the deflationist's order of explanation, so it counts as genuinely inflationary. However, it also rejects the reductionist ambitions of the earlier inflationists, so it isn’t an apt target for deflationary scepticism.
Lie–Nijenhuis Bialgebroids
Authors: Drummond Thiago
Published: October 2021

We introduce Lie–Nijenhuis bialgebroids as Lie bialgebroids endowed with an additional derivation-like object. They give a complete infinitesimal description of Poisson–Nijenhuis (PN) groupoids, and key examples include PN manifolds, holomorphic Lie bialgebroids and flat Lie bialgebra bundles. To achieve our goal we develop a theory of ‘generalized derivations’ and their duality, extending the well-established theory of derivations on vector bundles.
Prothrombin complex concentrates in cardiac surgery: where are we?
Authors: Santana Jeans M. , Brovman Ethan Y.
Published: October 2021

Purpose of review

Major bleeding in cardiac surgery is commonly encountered, and, until recently, most frequently managed with fresh frozen plasma (FFP). However, a Cochrane review found this practice to be associated with a significant increase in red blood cell (RBC) transfusions and costs. These findings have led to off-label uses of prothrombin complex concentrates (PCCs) in cardiac surgery. The purpose of this review is to compare and contrast the use of FFP and PCC, review the components, limitations and risks of different types of PCCs, and discuss the latest evidence for the use of PCC versus FFP in cardiac surgery.

Recent findings

A recent review and meta-analysis suggests that PCC administration in cardiac surgery is more effective than FFP in reducing RBC transfusions and costs.

The current data supports the use of 4F-PCC instead of FFP as the primary hemostatic agent in cases of major bleeding in cardiac surgery. The use of PCCs is associated with reduced rates of RBC transfusions while maintaining a favorable safety profile. Clear advantages of PCC over FFP include its smaller volume, higher concentration of coagulation factors and shorter acquisition and administration times.
The Modified 11-Item Frailty Index and Postoperative Outcomes in Patients Undergoing Lateral Lumbar Interbody Fusion
Authors: Jung Jong-myung , Chung Chun Kee , Kim Chi Heon , Yang Seung Heon , Ko Young San
Published: October 2021

Study Design.

Retrospective cohort study.

Objective.

The aim of this study was to analyze postoperative complications and recovery patterns in different modified 11-item frailty index (mFI-11) groups after lateral lumbar interbody fusion (LLIF) surgery.

Summary of Background Data.

The relationship between the mFI-11 score and LLIF surgery has not been previously reported.

Methods.

A single-center, consecutive series of patients who underwent LLIF with at least two years of follow-up were retrospectively reviewed. Complications after LLIF surgery were recorded. Clinical outcomes, including the visual analog scale (VAS) for back/leg pain and the Oswestry Disability Index (ODI), were evaluated preoperatively and at 1 and 2 years postoperatively. The proportions of patients who achieved substantial clinical benefit (SCB) for the VAS-B, VAS-L, and ODI were also analyzed.

Results.

One hundred fifty-two patients included in the present study were grouped according to their mFI-11 score: 0 (n = 39), 0.09 (n = 69), 0.18 (n = 31), and ≥0.27 (n = 13). An mFI-11 score ≥0.27 was a significant predictor of urinary complications (adjusted odds ratio: 3.829, P = 0.013). At 2 years postoperatively, patients in all frailty categories experienced improvements in the VAS for back pain, VAS for leg pain, and ODI, without significant differences between the four groups (p = 0.182, 0.121, and 0.804, respectively). There were also no significant differences in the proportions of patients achieving SCB for back/leg pain and the ODI between the four groups (P = 0.843, 0.957, and 0.915, respectively).

Conclusion.

An mFI-11 score was found to be independently associated with urologic complications in patients who underwent LLIF. Patients in all frailty categories experienced significant improvements in back pain, leg pain, and the ODI at 1 year and 2 years postoperatively. LLIF surgery may be useful for patients with high frailty index.

Level of Evidence: 4
A Review of Commercially Available Cellular-based Allografts
Authors: Pinter Zachariah W. , Elder Benjamin D. , Kaye I. David , Kepler Christopher K. , Wagner Scott , Freedman Brett A. , Sebastian Arjun S.
Published: October 2021

Study Design:

This was a narrative review.

Objective:

This review discusses our current knowledge regarding cellular-based allografts while highlighting the key gaps in the literature that must be addressed before their widespread adoption.

Summary of Background Data:

Iliac crest bone graft is the gold-standard bone graft material but is associated with donor site morbidity. Commonly utilized bone graft extenders such as demineralized bone matrix and bone morphogenetic protein have conflicting data supporting their efficacy and lack the osteogenic potential of new cellular-based allograft options.

Methods:

An extensive literature review was performed. The literature was then summarized in accordance with the authors’ clinical experience.

Results:

There is not widespread evidence thus far that the addition of the osteogenic cellular component to allograft enhances spinal fusion, as a recent study by Bhamb and colleagues demonstrated superior bone formation during spine fusion in an aythmic rat model when demineralized bone matrix was used in comparison to Osteocel Plus. Furthermore, the postimplantation cellular viability and osteogenic and osteoinductive capacity of cellular-based allografts need to be definitively established, especially given that a recent study by Lina and colleagues demonstrated a paucity of bone marrow cell survival in an immunocompetent mouse posterolateral spinal fusion model.

Conclusions:

This data indicates that the substantially increased cost of these cellular allografts may not be justified.

Level of Evidence:

Level V.
The Health and Economic Benefits of Tests That Predict Future Progression to Tuberculosis Disease
Authors: Menzies Nicolas A. , Shrestha Sourya , Parriott Andrea , Marks Suzanne M. , Hill Andrew N. , Dowdy David W. , Shete Priya B. , Cohen Ted , Salomon Joshua A.
Published: October 2021

Background:

Effective targeting of latent tuberculosis infection (LTBI) treatment requires identifying those most likely to progress to tuberculosis (TB). We estimated the potential health and economic benefits of diagnostics with improved discrimination for LTBI that will progress to TB.

Methods:

A base case scenario represented current LTBI testing and treatment services in the United States in 2020, with diagnosis via. interferon-gamma release assay (IGRA). Alternative scenarios represented tests with higher positive predictive value (PPV) for future TB but similar price to IGRA, and scenarios that additionally assumed higher treatment initiation and completion. We predicted outcomes using multiple transmission-dynamic models calibrated to different geographic areas and estimated costs from a societal perspective.

Results:

In 2020, 2.1% (range across model results: 1.1%–3.4%) of individuals with LTBI were predicted to develop TB in their remaining lifetime. For IGRA, we estimated the PPV for future TB as 1.3% (0.6%–1.8%). Relative to IGRA, we estimated a test with 10% PPV would reduce treatment volume by 87% (82%–94%), reduce incremental costs by 30% (15%–52%), and increase quality-adjusted life years by 3% (2%–6%). Cost reductions and health improvements were substantially larger for scenarios in which higher PPV for future TB was associated with greater initiation and completion of treatment.

Conclusions:

We estimated that tests with better predictive performance would substantially reduce the number of individuals treated to prevent TB but would have a modest impact on incremental costs and health impact of TB prevention services, unless accompanied by greater treatment acceptance and completion.
Orthokeratology Lenses Versus Administration of 0.01% Atropine Eye Drops for Axial Length Elongation in Children With Myopic Anisometropia
Authors: Ji Na , Niu Yan , Qin Jian , Fu Ai-Cun , Cui Can
Published: October 2021

Objective:

To investigate the effect of orthokeratology (OK) lenses and that of 0.01% atropine eye drops on axial length (AL) elongation in children with myopic anisometropia.

Methods:

Ninety-five children with myopic anisometropia who used OK lenses (N=49) or 0.01% atropine eye drops (N=46) were enrolled in this retrospective 1-year study. For all children, the eyes with higher spherical equivalent refractive error (SER) were assigned to the H-eye subgroup, whereas the fellow eyes with lower SER were assigned to the L-eye subgroup.

Results:

After 1-year treatment, the mean change in the AL of H eyes and L eyes in the OK lenses group was 0.18±0.16 mm and 0.24±0.15 mm, respectively (P=0.15), and 0.28±0.20 mm and 0.25±0.18 mm, respectively (P=0.48), in the 0.01% atropine group. Multivariate regression analyses showed significant differences in AL change between H and L eyes after treatment with OK lens (P=0.03), whereas no significant difference in the 0.01% atropine (P=0.22). The change in the AL in the H-eye group was less with OK lenses than with 0.01% atropine (P=0.04), whereas there was no significant difference between the change in AL in the L-eye group between treatment with OK lens and 0.01% atropine (P=0.89).

Conclusions:

In myopic anisometropic children, AL differences between 2 eyes decrease by wearing OK lenses but do not change after administration of 0.01% atropine eye drops. The increased effect of OK lenses, but not 0.01% atropine, in reducing axial elongation at 1 year in the eye with higher SER in anisometropic children warrants further investigation.
Cerebrospinal Fluid Shunt Infections in Children: Do Hematologic and Cerebrospinal Fluid White Cells Examinations Correlate With the Type of Infection?
Authors: Buonsenso Danilo , Bianchi Federico , Scoppettuolo Giancarlo , Frassanito Paolo , Massimi Luca , Caldarelli Massimo , Salvatelli Niccolò , Ferro Valentina , Valentini Piero , Tamburrini Gianpiero
Published: October 2021

Background:

Cerebrospinal fluid (CSF) shunt infections in children represent an increasing problem in clinical practice. However, comprehensive clinical, laboratory and microbiologic data are scarce in pediatric age.

Methods:

We conducted a 10-year retrospective study to (1) analyze clinical, laboratory and microbiologic parameters associated with infections in children; (2) analyze results according to the type of catheter (medicated or not), type of infection (first or relapses), type of hydrocephalus (acquired and congenital), presence or not of bacteriemia; (3) describe antibiotic susceptibilities and their evolution during the study period.

Results:

Eighty-seven children with shunt infection and 61 children with mechanical shunt malfunction were enrolled. Fever, vomit, leukocytosis and elevated C-reactive protein were more frequent in the infected group (P < 0.001), while neurologic symptoms developed more frequently in the noninfected group (10.3% vs. 27.87%; P = 0.006). Local signs of inflammation and abdomen distension were similarly reported in the 2 groups. Children with medicated shunts had lower cell count in the CSF (12/mm3) compared with those with nonmedicated shunts (380/mm3; P < 0.0001). Gram-negative bacteria were more common in the not-medicated catheters (90.91% vs. 50% of cultures; P = 0.04). Gram-negative bacteria were identified in 50.67% of CSF cultures, Gram-positive bacteria in 53.33% and fungi were observed in 5.33%. Sixteen children (18.4%) had also a positive blood culture. Enterococci isolation was associated with relapsed infections (37.50% vs. 15.25%; P = 0.05).

Conclusions:

Our study shows that the diagnosis and management of children with shunt infections are challenging. Prospective studies with a comprehensive approach focusing on patient, medical, microbiologic and surgical risk factors for first infection are urgently needed.
Reducing Occupational Sitting While Working From Home
Authors: Mailey Emily L. , Rosenkranz Richard , Rosenkranz Sara K. , Ablah Elizabeth , Talley Mia , Biggins Anna , Towsley Alissa , Honn Allison
Published: October 2021

Objective:

This study examined the individual and combined effects of a height-adjustable desk and an online behavioral intervention on sedentary behavior and health among university employees working from home.

Methods:

Participants (N = 95) were randomly assigned to one of four conditions: Desk Only, Program Only, Desk + Program, or Control. Desk participants received a height-adjustable desk; program participants received a 12-week web-based intervention. Outcomes measured at baseline and post-intervention included workday sitting and cardiometabolic health outcomes.

Results:

Reductions in sitting were largest in the Desk + Program condition (−206 min/workday; d = 1.84), followed by the Desk Only condition (−122 min/workday; d = 0.98), and the Program Only condition (−96 min/workday; d = 1.13). There were no significant changes in the health outcomes assessed.

Conclusions:

Both a height-adjustable desk and an online behavioral intervention effectively reduced occupational sitting, and a combined approach was most effective.
Mechanisms of Blood pH Changes in Venovenous Extracorporeal Membrane Systems: Roles of Hemoglobin-Ion Binding and Donnan Equilibrium
Authors: Wolf Matthew B.
Published: October 2021

An equilibrium model was developed to understand interrelated, physicochemical mechanisms leading to blood pH and electrolyte distribution changes in patients because of venovenous extracorporeal membrane oxygenation (ECMO) and carbon dioxide removal. The model consists of plasma and red cell compartments between which water and small ions can move to establish an equilibrium state. Governing forces are as follows: 1) ionic electroneutrality in each compartment; 2) osmotic equilibrium between compartments; 3) mass balance of small ions other than bicarbonate; 4) oxygen (O2)-dependent hemoglobin (Hb)-Cl binding in red cells; 5) albumin binding to Cl−, Ca2+, and Mg2+ in plasma; and 6) chemical equilibria of carbonates and phosphates in each compartment. The model was constructed and validated using recent clinical ECMO inlet and exit blood-pH and electrolyte concentration data. The model closely described pH and electrolyte concentration changes in both states, which validated the model. The model was then used to predict CO2 and O2 saturation–induced changes in pH and electrolyte concentrations. It was found that O2-dependent Hb-Cl binding had a much lesser effect on blood acid–base status changes and electrolyte shifts during ECMO than previously thought. The model showed that the Cl-shift and Gibbs-Donnan equilibrium effects, characterized by pH and electrolyte distribution changes during ECMO, were primarily caused by changes in pH-induced electrical charge on mainly Hb and other constrained ions in red cells. These insights can improve understanding of the same factors acting when blood traverses the lung.