bluuebunny/crossref_metadata_2025 huggingface dataset:
1074. Surveillance of SARS-CoV-2 variants of concern (VOC) in hospital wastewater (WW) and its correlation with hospitalized cases of COVID-19 and the occurrence of outbreaks
Authors: Acosta Nicole , Chavarriaga Maria Bautista , Waddell Barbara Jean M , McCalder Janine , Du Kristine , Pradhan Puja , Sedaghat Navid , Papparis Chloe , Chen Jianwei , Doorn Jennifer Van , Xiang Kevin , Chan Leslie , Vivas Laura , Low Kashtin , Lu Xuewen , Chekouo Thierry , Dai Xiaotian , Cabaj Jason , Hrudey Steve , Bhatnagar Srijak , Ruecker Norma J , Achari Gopal , Cathryn Ryan M , Clark Rhonda , Pearce Craig , Harrison Joe , Meddings Jon , Leal Jenine , Missaghi Bayan , Kanji Jamil , Larios Oscar , May Elissa Rennert , Kim Joseph , Pang Xiao-Li , Lee Bonita , Frankowski Kevin , Conly John M , Hubert Casey R J , Parkins Michael
Published: December 2022

Background

WW surveillance enables real time monitoring of SARS-CoV-2 burden in defined sewer catchment areas. Here, we assessed the occurrence of total, Delta and Omicron SARS-CoV-2 RNA in sewage from three tertiary-care hospitals in Calgary, Canada.

Methods

Nucleic acid was extracted from hospital (H) WW using the 4S-silica column method. H-1 and H-2 were assessed via a single autosampler whereas H-3 required three separate monitoring devices (a-c). SARS-CoV-2 RNA was quantified using two RT-qPCR approaches targeting the nucleocapsid gene; N1 and N200 assays, and the R203K/G204R and R203M mutations. Assays were positive if Cq< 40. Cross-correlation function analyses (CCF) was performed to determine the time-lagged relationships between WW signal and clinical cases. SARS-CoV-2 RNA abundance was compared to total hospitalized cases, nosocomial-acquired cases, and outbreaks. Statistical analyses were conducted using R.

Results

Ninety-six percent (188/196) of WW samples collected between Aug/21-Jan/22 were positive for SARS-CoV-2. Omicron rapidly supplanted Delta by mid-December and this correlated with lack of Delta-associated H-transmissions during a period of frequent outbreaks. The CCF analysis showed a positive autocorrelation between the RNA concentration and total cases, where the most dominant cross correlations occurred between -3 and 0 lags (weeks) (Cross-correlation values: 0.75, 0.579, 0.608, 0.528 and 0.746 for H-1, H-2, H-3a, H-3b and H-3c; respectively). VOC-specific assessments showed this positive association only to hold true for Omicron across all hospitals (cross-correlation occurred at lags -2 and 0, CFF value range between 0.648 -0.984). We observed a significant difference in median copies/ml SARS-CoV-2 N-1 between outbreak-free periods vs outbreaks for H-1 (46 [IQR: 11-150] vs 742 [IQR: 162-1176], P< 0.0001), H-2 (24 [IQR: 6-167] vs 214 [IQR: 57-560], P=0.009) and H-3c (2.32 [IQR: 0-19] vs 129 [IQR: 14-274], P=0.001).

Conclusion

WW surveillance is a powerful tool for early detection and monitoring of circulating SARS-CoV-2 VOCs. Total SARS-CoV-2 and VOC-specific WW signal correlated with hospitalized prevalent cases of COVID-19 and outbreak occurrence.

Disclosures

All Authors: No reported disclosures.
1103. Virologic and Immunologic Outcomes in People Living with HIV in a Correctional Setting During the SARS-CoV-2 Pandemic
Authors: Patel Dimple , Michienzi Sarah M , Borgetti Scott , Patel Mahesh C , Zheng Anne , Zhu Michael , Badowski Melissa E
Published: December 2022

Background

It is known that the pandemic increased the risk of severe illness from SARS-CoV-2 infection in immunocompromised patients as compared to the general public. To combat this issue, telemedicine was utilized in various settings, but there is very little data on the adequate continuity of care (COC) and sustainability of telehealth throughout the pandemic. There is even less data on the effects of the pandemic in special populations, such as people living with human immunodeficiency virus (PLWH) and within the correctional setting. The purpose of this study was to investigate rates of HIV virologic suppression (VS) and the sustainability of telemedicine throughout the SARS-CoV-2 pandemic.

Methods

This was a retrospective, pre-post cohort study of PLWH who received antiretroviral therapy (ART) within Illinois Department of Corrections (IDOC) / University of Illinois Chicago telemedicine clinic between 3/2019 and 3/2021. Patients who were released from IDOC or reincarcerated during the study period were excluded. The primary endpoint compared the rate of HIV VS pre-, peri- and post-SARS-CoV-2 restrictions. Secondary endpoints included change in immunologic function pre-, peri- and post-SARS-CoV-2 restrictions, incidence of SARS-CoV-2 infection, number of hospitalizations, development of virologic failure, and change in ART post-pandemic. Other factors known to influence COC were also collected.

Results

Of 320 patients screened, 225 were included. The majority were Black males (73.7%) and 95.1% had a CD4 T-cell count > 200 cells/mm3 at baseline. Approximately 88% of patients were on a single tablet regimen, with most receiving bictegravir/emtricitabine/tenofovir alafenamide. Rates of HIV VS are summarized in Figure 1 and secondary outcomes are summarized in table 1. Factors associated with disruption of COC included non-adherence to appointments (62.6%) and ART (4.4%). Figure 1Rates of HIV viral suppression (<200 copies/mL), n(%)

Table 1 Secondary outcomes

Conclusion

Results demonstrated that PLWH within IDOC had sustained VS and COC throughout the SARS-CoV-2 pandemic with telemedicine. These results describe how the pandemic impacted PLWH in a correctional setting and future studies could contribute to creating national guidance for telemedicine models to streamline clinical practice.

Disclosures

All Authors: No reported disclosures.
1109. Rise and Fall of COVID-19 Therapies Throughout Different Waves of the Pandemic: Results of a Nationwide Survey
Authors: Mena Lora Alfredo J , Herald Fischer , Lindsey Brenna , Borgetti Scott , Chaisson Lelia H , Burgos Rodrigo M , Bleasdale Susan C
Published: December 2022

Background

The COVID-19 pandemic has caused a major public health crisis and is now a leading cause of death. At the start of the COVID-19 pandemic, treatment was limited to supportive care and off-label use of a variety of agents as we awaited the results of randomized controlled trials (RCTs). Our understanding of the disease has evolved and multiple evidence-based (EBM) treatment strategies supported by RCTs are now approved for use. Interpreting emerging data while responding to the pandemic can been challenging. We seek to understand the use of common medications during the COVID-19 pandemic.

Methods

A survey was developed and disseminated through Infectious Diseases Society of America (IDSA) IDea network, IDSA Antimicrobial Stewardship Centers for Excellence and the Society for Healthcare Epidemiology messaging boards. Data collected included city, therapeutic options including convalescent plasma (CP), hydroxychloroquine (HCQ), baricitinib and tocilizumab during each COVID-19 wave.

Results

A total of 78 responses were collected, representing wide geographic reach in the US (Figure 1). Use of HCQ declined by 96% and use of CP declined by 85% (Figure 2). The decline in CP was gradual each wave despite RCTs showing lack of benefit. Tocilizumab was used in 71% and 76% of hospitals during the first wave, prior to RCT data supporting its use. Baricitinib was used in 42% of hospitals prior to RCT data supporting its use. There was a 90% increase in baricitinib use after RCT data emerged. Figure 1Geographic distribution of hospitals represented in the survey

Figure 2 Use of Hydroxychloroquine, Convalescent Plasma, Tocilizumab and Baricitinib Throughout Different COVID-19 Waves

Conclusion

The use of therapies before proven benefit was common through the pandemic. Similarly, the use of therapies after benefit was in question continued. Hydroxychloroquine was widely used in the first wave and then halted by the majority of hospitals in subsequent COVID-19 surges. IL-6 and JAK-2 inhibitors were commonly used prior to evidence of benefit and were more widely adopted once evidence emerged. Convalescent plasma use was common despite lack of evidence and its use continued despite multiple negative RCTs. Overall, our survey shows a gap between evidence and practice. Communicating evidence-based treatment strategies is a vital priority for major professional societies. Translating evidence into practice remains challenging during public health emergencies like the COVID-19 pandemic.

Disclosures

All Authors: No reported disclosures.
1112. Evaluating the Effects of Casirivimab-Imdevimab in Mild-to-Moderate COVID-19 Disease: A Matched Cohort Study
Authors: Hage Cindy , Martinez Aileen , Dunham Alexis , Mohseni Nathan , Hernandez-Jimenez Jarelys , Cardona Lyssette L
Published: December 2022

Background

In November 2020, the FDA issued an Emergency Use Authorization (EUA) for casirivimab-imdevimab (CAS-IMD) for the treatment of mild to moderate coronavirus disease 2019 (COVID-19) in certain high-risk patients. CAS-IMD is a monoclonal antibody cocktail that binds to COVID-19 spike protein receptor. Delta was the predominant strain in the US at the time.

The purpose of this study is to evaluate if CAS-IMD administration to COVID-19 patients in the emergency department (ED) resulted in fewer hospitalizations and re-admissions.

Methods

A retrospective chart review was conducted at Cleveland Clinic Martin Health which is composed of 3 hospitals and 1 free-standing ED. Patients with COVID-19 who met criteria for CAS-IMD in the ED from June 2021 to December 2021 were randomized into those who received CAS-IMD and those who did not. Patients were excluded if they had COVID-19 symptoms for >10 days or met EUA exclusion criteria for CAS-IMD. Cases and controls were matched by propensity score which was calculated by a logistic regression model including age, body mass index (BMI), sex, race and comorbidities. The primary outcome was the percentage of patients discharged from the ED who were hospitalized for COVID-19-related symptoms within 30 days. Secondary outcomes included number of CAS-IMD infusion-related reactions, ED return rate and subset analyses of severity of illness in the hospitalized. Statistical analyses were performed using two-sample t test or Wilcoxon rank sum test for continuous variables based on distribution, and Chi-square test or Fisher’s exact test for categorical variables. Conditional logistic regression was used to compare the odds of hospitalization between groups.

Results

Patients (N = 176) were matched 1:1 in each group. Eleven (12.5%) of the case group were hospitalized within 30 days of ED discharge vs. 36 (40.9%) in the control group. The odds of hospitalization in the CAS-IMD group were 81% lower than the control group (OR 0.19, 95% CI: 0.081-0.46, p< 0.001). After adjustment of covariates, the adjusted odds ratio remained significant (OR 0.12, 95% CI: 0.025-0.57, p=0.008).

Conclusion

CAS-IMD use for mild-to-moderate COVID-19 infection in ED patients was associated with a lower incidence of hospitalization.

Disclosures

All Authors: No reported disclosures.
1121. Does Anti-Vaccine Equal Anti-Antibody? Differing Rates of Veteran Acceptance of Monoclonal Antibody Therapies for COVID-19 By Prior Vaccination Status
Authors: Brennan Martha , Shumaker Amy Hirsch , Stiefel Usha
Published: December 2022

Background

We assessed correlation between prior acceptance of COVID-19 vaccination and acceptance of monoclonal antibody (MAb) treatment for mild-to-moderate COVID-19.

Methods

Adult outpatients evaluated for treatment with MAb between August 31st, 2021 and April 23, 2022 in a large tertiary care VA healthcare system were included. MAb therapies administered over the period included casirivimab-imdevimab, sotrovimab, and bebtelovimab. All patients were screened by a small central clinician team with experience discussing COVID therapies under Emergency Use Authorization (EUA). Baseline characteristics, rationale for not offering MAb, and rates of vaccination and acceptance of therapy were recorded. In addition, rates of acceptance for the initial 4 months were compared to rates during the second 4 months of the program, using Chi-square or Fisher’s exact test.

Results

203 patients (mean age 68, 91% male) with early COVID-19 were screened for MAb. 68% were vaccinated. 158 (78%) of those screened were offered MAb. The most common reason MAb was not offered was duration of illness longer than specified by EUA (65%). 112 (71%) patients offered MAb accepted, and 94 (84%) received MAb. Of 106 vaccinated patients offered MAb, 81 (76%) accepted. In contrast, of 52 unvaccinated patients offered MAb, only 31 (60%) accepted (Chi-square p = 0.046). However, when analyzed over time, unvaccinated patients were significantly more likely to accept MAb during the second 4 months of the program (7/7 patients, 100%) than during the first 4 months of the program (24/45 patients, 53%, Fisher’s exact p = 0.033). This disparity was not seen in vaccinated patients, who accepted MAb at a rate of 73% during the first half of the program, and 88% during the second half (Chi-square p = 0.19).

Conclusion

Vaccinated patients were significantly more likely to accept MAb therapy for COVID-19 than unvaccinated patients, suggesting that willingness to accept COVID-19 vaccination predicts willingness to accept other COVID-19 therapeutics. However, disparity in acceptance rates in our population is significantly attenuating over time, suggesting a “late-adopter,” phenomenon that has implications for continued efforts to encourage therapeutics and vaccines for COVID-19.

Disclosures

All Authors: No reported disclosures.
1124. Effect of High-Dose versus Standard-Dose Dexamethasone on Mortality Among Mechanically Ventilated COVID-19 Patients
Authors: Kale-Pradhan Pramodini , Pacitto Regina , Krumm Lauren , Hejnar Anna , Giuliano Christopher , Johnson Leonard B
Published: December 2022

Background

Anti-inflammatory agents like dexamethasone (DEX) have become a mainstay of treatment for COVID-19. Despite randomized trials demonstrating that a 6 mg daily dose of DEX improved patient outcomes in hospitalized COVID-19 patients receiving oxygen, clinicians often prescribe higher doses of corticosteroids without evidence to support this practice. The purpose of this study was to compare outcomes of ventilated COVID-19 patients who received standard dose (SD) versus high dose (HD) DEX.

Methods

This was a multi-site, retrospective, observational study of ventilated COVID-19-positive patients who received at least three days of DEX between June 1, 2020 and January 31, 2022. Sample size was calculated based on a 3:1 high:standard-dose prescribing pattern ratio. The primary outcome of this study was the association between mortality and SD (<6mg daily) versus HD ( >10mg daily) DEX in ventilated COVID-19 patients. Secondary outcomes included average blood glucose (BG), number of BG readings above 200, incidence of bacterial nosocomial infection, ventilator-free days, length of stay (LOS) and ICU LOS.

Results

Of 322 patients screened, 110 were excluded primarily for average daily DEX dose of > 6 to ≤ 10mg. Of the 212 included patients, 53 (25%) received SD DEX and 159 (75%) received HD DEX. Data demonstrate no significant effect of DEX dose on mortality, number of BG readings > 200, incidence of nosocomial infections, LOS, or ventilator-free days (p >0.05). After controlling for confounding factors no difference in mortality persisted (OR 1.45 95% CI 0.66- 3.20). Average daily BG and ICU LOS were significantly greater in the HD group compared to the SD group (p = 0.003, p = 0.019 respectively).

Conclusion

There is no association between HD DEX and mortality among ventilated COVID-19 patients compared to SD DEX. Moreover, HD DEX is associated with detrimental effects such as prolonged ICU LOS and higher average daily BG. This study supports the use of SD DEX in ventilated COVID-19 patients.

Disclosures

All Authors: No reported disclosures.
1134. Lenzilumab Treatment in COVID-19 Pneumonia Reduces Circulating Cytokines and Markers of Systemic Inflammation
Authors: Chappell Dale , Kilcoyne Adrian , Cerasoli Frank , Lukas John , Durrant Cameron , Temesgen Zelalem , Polk Christopher , Baker Jason , Marconi Vincent
Published: December 2022

Background

Coronavirus disease 2019 (COVID-19) results from SARS-CoV-2-induced hyperinflammatory immune response, orchestrated by granulocyte-macrophage colony-stimulating factor (GM-CSF). GM-CSF increases interleukin-6 (IL-6) levels, ultimately leading to increased C-reactive protein (CRP). The LIVE-AIR trial demonstrated that lenzilumab, the GM-CSF neutralizing antibody, improved the likelihood of survival without invasive mechanical ventilation (IMV) in hospitalized COVID-19 patients requiring supplemental oxygen but not IMV. This sub-analysis correlated levels of cytokines before and after lenzilumab treatment.

Methods

LIVE-AIR was a phase 3, randomized, double-blind, placebo-controlled trial (NCT04351152). Patients hospitalized with COVID-19 pneumonia, requiring only supplemental oxygen, were randomized to receive lenzilumab (1800 mg in three equally divided doses of 600 mg, q8h) or placebo IV infusion, in addition to standard of care which included remdesivir and corticosteroids. Blood taken at baseline (BL) and subsequent to treatment through day 10 (D10) were obtained and analyzed by high sensitivity enzyme immunoassay for GM-CSF, IL-6, and CRP.

Results

Baseline IL-6 levels (Loge-transformed for all cytokines and biomarkers) were linearly correlated with higher baseline GM-CSF levels (slope=0.60, p< 0.001). Baseline CRP levels were linearly correlated with higher baseline IL-6 levels (slope=0.29, p < 0.001). GM-CSF levels decreased with lenzilumab treatment on day 1 (D1) which persisted through D10 (Table). In contrast, GM-CSF increased with placebo treatment. IL-6 levels decreased only with lenzilumab treatment. CRP following lenzilumab or placebo treatment decreased on D1 to similar levels and further decreased on D10 only with lenzilumab treatment.

Cytokine Levels Associated with Lenzilumab Treatment

Conclusion

Lenzilumab decreased GM-CSF as well as downstream cytokines and systemic biomarkers of inflammation during the hyperinflammatory immune response of COVD-19.

Disclosures

Dale Chappell, MD, MBA, Humanigen, Inc: Employee|Humanigen, Inc: Ownership Interest Adrian Kilcoyne, MD, Humanigen, Inc: Employee Frank Cerasoli, PhD, Humanigen, Inc: Advisor/Consultant John Lukas, PhD, Humanigen, Inc: Advisor/Consultant Cameron Durrant, MD, Humanigen, Inc: Employee|Humanigen, Inc: Ownership Interest Zelalem Temesgen, MD, Gilead: unrestricted educational grant (to the institution)|Humanigen, Inc: Grant/Research Support|Merck: unrestricted educational grant (to the institution)|ViiV: Advisor/Consultant Christopher Polk, MD, Gilead: Advisor/Consultant Jason Baker, MD, Gilead: Grant/Research Support|Humanigen, Inc: Grant/Research Support Vincent Marconi, MD, Gilead: Grant/Research Support.
1141. Phase 3 Trial (in progress) of the SYK Inhibitor Fostamatinib in Patients Hospitalized with COVID-19: Protocol and Study Implementation Updates
Authors: Yan Lucy , Mallat Ziad , Lobo Suzana Margareth , Malik Anuj , Dummer Wolfgang
Published: December 2022

Background

Immune dysregulation associated with COVID-19 includes immune cell activation, inflammatory cytokine release, and neutrophil extracellular trap release (NETosis), which are mediated by spleen tyrosine kinase (SYK) (Fig 1). Fostamatinib, an oral spleen tyrosine kinase (SYK) inhibitor, was approved for immune thrombocytopenia (ITP) in 2018, and the Phase 3 trials showed a lower than expected rate of thrombosis.1 Clinical studies showed a reduction in IL-6 in patients with rheumatoid arthritis.2 The active metabolite of fostamatinib (R406) protected against LPS-induced acute lung injury and thrombosis in mice3,4 and reduced MUC1 in a mouse model of ALI.5 Fostamatinib demonstrated abrogation of the hyperimmune response caused by anti-spike IgG,6 including reduction in hyperactivation of platelets7 and NETosis in neutrophils8 in in vitro studies using plasma from patients with severe COVID-19.

A phase 2 study (NCT04579393) evaluated fostamatinib vs. placebo (all received standard of care [SOC]) in 59 hospitalized patients with COVID-19 and demonstrated reduction in mortality, ordinal scale scores, and number of days in the intensive care unit (ICU) as well as meeting the primary endpoint of safety.9 A phase 3 clinical study (NCT04629703) of fostamatinib for the treatment of COVID-19 is underway. Figure 1.Mechanism of Disease (COVID-19) and Role of SYK inhibition

Methods

A Phase 3, randomized, double-blind, placebo-controlled, adaptive design, multi-center study (NCT04629703) is underway to evaluate fostamatinib in 308 adult patients hospitalized with COVID-19 and on oxygen without intubation (Fig 2). Patients will receive fostamatinib 150 mg BID or placebo for 14 days; both arms receive SOC. At baseline, the clinical status score (8-point ordinal scale) had to be 5 or 6. Patients ≥ 65 years had to have ≥ 1 risk factor for severe disease and adults < 65 had to have ≥ 3. The primary outcome is days on oxygen (Day 1 to 29). Other endpoints include change in clinical status score, days in the ICU, time to hospital discharge, all-cause mortality, oxygen-free status and safety. Fostamatinib is investigational for COVID-19.

Results

Blinded data from this trial in progress are as of 2 December 2021. See Fig 3.

Conclusion

Final results of this Phase 3 trial are anticipated in 2022.

Disclosures

Lucy Yan, MD, PhD, Rigel Pharmaceuticals: Employee|Rigel Pharmaceuticals: Stocks/Bonds Ziad Mallat, MD, PhD, Rigel Pharmaceuticals: Advisor/Consultant Suzana Margareth Lobo, MD, PhD, Rigel Pharmaceuticals: Grant/Research Support Anuj Malik, MD, MS, Rigel Pharmaceuticals: Grant/Research Support Wolfgang Dummer, MD, PhD, Rigel Pharmaceuticals: Employee|Rigel Pharmaceuticals: Stocks/Bonds.
1162. A data-driven approach to predict plasma leakage using explainable machine learning
Authors: Marandi Ramtin Zargari , Leung Preston , Sigera Chathurani , Murray Daniel Dawson , Weeratunga Praveen , Fernando Deepika , Rodrigo Chaturaka , Rajapakse Senaka , MacPherson Cameron
Published: December 2022

Background

Dengue could cause complications with an estimated 10,000 deaths per annum. It mostly affects low- and middle-income countries such as Sri Lanka with limited healthcare resources to handle seasonal outbreaks. A third of dengue patients usually have a critical phase characterized by plasma leakage with increased risk of life-threatening complications. A data-driven approach was required to find early predictors of plasma leakage that are usually available in routine care from a resource limited setting, as means of triaging patients for hospital admission.

Methods

We utilized a prospective cohort (The Colombo dengue study in Sri Lanka) that recruits patients meeting the clinical case definition of dengue fever. The cohort includes 4,781 instances of clinical signs, symptoms, and in-hospital laboratory tests from N=877 patients (60.3% patients infected by Dengue) recorded in first four days of fever. By excluding incomplete patient instances, the data was randomly split to a development set (N=378) and a test set (N=144). From the development set, five most informative features were identified using the minimum description length (MDL) algorithm. Logistic regression was used to create a prediction model using the development set. Shapley analysis was used to explain the model on the test set extracting the extent by which each predictor contributed to the predictions.

Results

The MDL algorithm revealed that hemoglobin (HGB), hematocrit (HCT), aspartate aminotransferase (AST), age, and gender to be the most informative predictors of plasma leakage. The logistic regression model predicted plasma leakage with (AUC = 0.76) on the test set (Fig 1). The HGB appeared to contribute the most to the predictions with the higher values associated with higher predicted risk of plasma leakage and vice versa (Fig 2).

Figure 2 SHAP decision plot for the logistic regression model on the test set. The features are sorted from top to bottom by their mean absolute SHAP values (higher interpreted as more contributing). Feature values are normalised to [0 1] by the min-max normalisation method and colour-coded (grey points are missing values), outliers were squished to the range using Hampel filter. For gender, male is indicated by red and female by blue. The colour of each line is the same as the value of the feature connected to in downwards direction.

Conclusion

Our results give support to the predictability of plasma leakage in patients suspected of Dengue fever in their first four days of fever onset. The study also underlines the relevance of the machine learning approach to identify the predictors and the practicality of the prediction model as reflected by the prediction performance to triage patients for hospital admission in resource limited settings.

Disclosures

All Authors: No reported disclosures.
Half-hearted Support to Pluralist Curriculum Building: The Case of Religion
Authors: Temperman Jeroen
Published: December 2022

This article makes two claims, one explanatory, one normative. The former aims at explaining why pluralist religion teaching, be it teaching in the style advocated by the OSCE Toledo Guiding Principles on Teaching about Religions and Beliefs in Public Schools or other forms of pluralist religion teaching or religious literacy teaching, has not become an overwhelming success in Europe. To that effect, the article identifies a number of incentives and disincentives contained in (interpretations of) international human rights law that serve to perpetuate confessional teaching models. The normative claim advanced in this article challenges international human rights monitoring bodies’ ‘claw-back-clause’ reading of educational and religious rights of pupils and parental liberties. Specifically, the article concludes that advances in socio-legal science show that opt-outs are no remedy for the risks emanating from confessional religion teaching within public schools—rather, opt-outs are part of the problem.
The Welfare State Begins at Home
Authors: Chettiar Teri
Published: December 2022

Chapter 2 explores how the wartime discovery of widespread emotional “deprivation” in children—and fears attached to its long-term psychological effects—transformed post-WWII British political culture by making it a basic duty of the modern state to ensure citizens’ emotional health. This chapter reveals how concerns about Britain’s future after 1945 became tied to the developmental futures of British children. Alongside its agenda of eliminating poverty and guaranteeing full employment, Britain’s new welfare state was tasked with ensuring that all children be reared within “family-like” environments and given the best possible shot at emotional health. Concern for children’s emotional development framed the government’s approach to adoption, foster care, daycare provision, and children’s in-patient treatment in hospitals. The protection and promotion of family intimacy came to be seen as one of the functions of the new welfare state. This not only helped reinvent the family as first and foremost a set of intimate relationships, it also introduced a new emotional component to the rights and responsibilities of modern democratic citizenship.
Pursuing Connection
Authors: Chettiar Teri
Published: December 2022

This chapter examines the launching of counseling and befriending services by British queer activist organizations at the height Britain’s so-called sexual revolution. Seeking to remedy the many serious social and emotional problems that homosexual, bisexual, and trans populations faced, supporters of homosexual law reform and queer liberation activists alike saw in counseling a promising solution to the harmful psychological effects of social exclusion and internalized homo- and transphobia. However, as this chapter demonstrates, although the meaning and markers of psychological “health” were expanded and revised, many features of Britain’s dominant constellation of sexual values were retained as goals and even internalized by social reformers themselves. This chapter reveals that British counseling aimed at queer people, in its pursuit of resolving the emotional suffering uniquely experienced by sexual minorities, focused on cultivating clients’ psychological capacity to choose and sustain lasting intimate relationships.
The Right to Visit (I)
Authors: Huber Jakob
Published: December 2022

This chapter turns to Kant’s discussion of cosmopolitan right, where the argument from earth dwellership reappears. Starting with the ‘constraining’ dimension of the cosmopolitan right to visit, it makes sense of Kant’s anticolonialism against the background of his grounded cosmopolitanism. The primary systematic question is on which juridical basis Kant can radically curtail the comportment of Western emissaries abroad, denying them in particular a right to force non-state peoples to enter the civil condition, for instance by simply settling in their vicinity. The chapter argues that it is their shared earth dwellership which constrains travellers to cautious offers for interaction and exchange even in the absence of a shared property practice. Construing a regress from the property argument to the more fundamental domain of earth dwellership, I show how Kant is able to conceptualise a distinctly juridical critique of colonialism as wrongful comportment. The chapter thus highlights that Kant’s grounded cosmopolitanism is a cosmopolitanism of self-constraint vis-à-vis distant strangers or unfamiliar forms of collective life and political association.
The Right to Visit (II)
Authors: Huber Jakob
Published: December 2022

This chapter addresses the permissive aspect of cosmopolitan right, which is concerned with global mobility. I argue that individuals have a right to roam the earth’s surface in their capacity as earth dwellers. As cosmopolitan agents ‘on the move’, they create the conditions for lawful peace among the entire cosmopolitan plurality, including both states and non-state peoples. Earth dwellership thus limits exclusive claims to land or territory to the conditions of global mobility, which is a fundamental precondition for transforming the disjunctive community of original common possession into a juridical community of legal subjects. Both dimensions of the cosmopolitan right to visit are integrated in that they spell out the conditions for realising a cosmopolitan political order in the future under conditions where such an order can neither be brought about nor maintained by force.
Progress, Hope, and the Cosmopolitan State
Authors: Huber Jakob
Published: December 2022

Approaching the project of bringing the community of disjunctive possession under law from a perspective of historical time, the chapter zooms in on Kant’s conception of cosmopolitan progress. It distinguishes two dimensions of political progress in Kant, which concern the perfection and the creation of political institutions respectively. These two domains intersect in the idea of a cosmopolitan state, i.e., a state that contributes to cosmopolitan progress by binding itself and its citizens to rightful comportment towards other states and non-state peoples. The path to a global institutional order proceeds via radically reformed states. If we do our part in establishing a condition of peace, we may reasonably hope for the willingness of other states and non-state peoples to reciprocate our efforts, such that the idea of a perpetual peace does not remain an empty wish.
Conclusion
Authors: Huber Jakob
Published: December 2022

The ‘Conclusion’ transcends the book’s primarily exegetical ambition by pointing to some of the ways in which Kant’s grounded cosmopolitanism is of continuing relevance, foregrounding two aspects in particular. On the one hand, the relational (yet practice-independent) nature of Kant’s global thinking contrasts with recent global justice theorising, which remains largely focused on distributive questions. This has implications for a number of normative debates around migration, membership or colonialism. On the other hand, the reflexivity enshrined in what I call the global standpoint provides a novel perspective on the perennial question how to accommodate diversity and difference. Kant’s community of earth dwellers is not a homogenous community of individuals already united in shared principles or institutions, but it is made up of a plurality of perspectives in disjunctive relation. This not only provides a timely reminder against the philosophical impatience that continues to characterise global justice debates, Kant’s focus on cosmopolitan activity within the state also transcends the traditional dichotomy between statism and cosmopolitanism.
Theoretical Framework
Authors: Bobić Ana
Published: December 2022

This chapter sets out the theoretical framework for analysis of the interactions between the Court of Justice and national constitutional/supreme courts. It provides a detailed literature review of constitutional pluralism as it was developed in the context of EU constitutional theory. It briefly presents the development of the general theory of legal pluralism in order to zoom into its application to the context of the European Union. Finally, this chapter presents the main criticisms directed to the theory from its inception and in respect of the most recent rule of law crisis in the EU.
Identity Review
Authors: Bobić Ana
Published: December 2022

This chapter examines the function of the national identity clause enshrined in Article 4(2) TEU and how it has been used by the national level in protecting national constitutional particularities. This head of review gained prominence in recent years as a source for contestation of EU law, and its use in the rule of law backsliding in a number of Member States. In this context, this chapter offers an analysis of the national constitutional jurisprudence and its approach to constitutional identity. In so doing, it presents the wide range of national approaches to safeguarding constitutional identity: the German unconditional take on constitutional identity as a limit to the principle of primacy of EU law; the Polish shift from constructive to destructive use of constitutional identity; and finally other Member States that envisage some identity-based limits to primacy, while at the same time offering a range of reconciliatory options should a conflict arise. The chapter further explores the case law of the Court of Justice, by looking at the different ways in which Article 4(2) TEU has featured in its decisions on free movement. The chapter concludes with suggesting a pluralist interpretation of the national identity clause that would accommodate both national constitutional concerns and the requirements of the principle of primacy of EU law.
The Interplay between Delegitimation and Legitimation
Authors: Gregoratti Catia , Uhlin Anders
Published: December 2022

This chapter analyzes the interplay between one behavioral delegitimation practice—civil society protest—and global governance institution (GGI) legitimation practices. It demonstrates how the type of protest (diffuse or specific) and the extent to which protesters are recognized by the targeted GGI determine when and how civil society protest triggers legitimation responses by GGIs. Empirically, it investigates four cases of civil society protest against three different types of GGIs active in the field of economic policy: the regional intergovernmental organization ASEAN, the World Bank as a global intergovernmental organization, and the transgovernmental network G20. The chapter shows that diffuse protests, challenging the overall authority of the G20, led to symbolic legitimation when the chair (Australia) recognized protesters as a relevant audience but ignored them when the successive chair (Turkey) did not recognize civil society protesters. Protests against specific policies of the World Bank led to substantial legitimation in the form of real policy change as this particular GGI recognized protesters as significant actors. In contrast, specific protests against the ASEAN, which did not grant the same recognition to civil society protesters, were ignored.
Outsourcing the Border Within
Authors: Zedner Lucia
Published: December 2022

The policing of borders is a core state function that cannot be delegated without detriment to its legitimate authority, yet many states not only contract out to private security, but also co-opt private citizens as agents of immigration control. Under the notorious ‘Hostile Environment’ policy, the UK government created a network of citizen border agents by obliging health workers, teachers, employers, landlords, and charitable organisations working with migrants, the poor, and the homeless to check immigration status and report so-called ‘illegals’. This creation of a ‘border within’ disperses controls across the territory of the nation state, and makes private citizens complicit in policing migration. Although the UK government formally ended the Hostile Environment policy in 2017, its successor, the ‘Compliant Environment’, continues to co-opt private citizens as collaborators in immigration control. Legal challenges by civil society organisations and others have questioned whether citizens act as agents of the state or as private actors and, if as agents, on whose authority they police, but they have had limited success in resisting the trend. This chapter explores the origins, aims, and implications for state sovereignty of outsourcing state responsibility to police immigration. It explores the legal and ethical implications of co-opting citizens to argue that it makes police of private citizens and creates suspects not only of non-citizens but of those in minority communities. In so doing, it undermines social trust, civil order, and delegitimises the authority of the sovereign state to police its borders.
Introduction
Authors: Adams Zoe
Published: December 2022

This introductory chapter introduces the Marxian inspired theoretical and methodological framework underpinning the book. It begins by explaining the book’s focus on work, and the law’s conception of work more specifically. The chapter moves from here to set out the basic theoretical and methodological premises underpinning the book, introducing the reader to the author’s structural approach to labour law. It then goes on to tease out the political implications of this approach, and to explain how a comprehensive study of the law’s concept of work might contribute to our understanding of the law’s role in struggles for structural transformation. The chapter ends by providing a brief outline of each of the book’s chapters in turn.
A History of Management
Authors: Adams Zoe
Published: December 2022

This chapter explores how legal conceptions of work and working time influence, and have been influenced by, managerial practices. The chapter explains the distinctiveness of management in capitalism, emphasizing its inherently political nature and its inseparability from questions of exploitation and resistance. It traces the evolution of management throughout the nineteenth and twentieth centuries, before discussing certain modern trends, most specifically the shift towards ‘cultural control’ from the 1970s, and, more recently, experimentations in algorithmic management. It also briefly discusses some of the limitations of the regulatory frameworks harnessed to respond to some of these management trends, most specifically data-protection law.
Academic Work
Authors: Adams Zoe
Published: December 2022

This chapter develops a case study of the labour performed by academics in the context of the UK higher education system. It traces the evolution of Academic work, showing the significance of the legal reforms to the sector that have taken place since the 1980s under the guise of neoliberalism. The second half of the chapter presents findings from an empirical study carried out at the University of Cambridge, with a view to shedding new light on academics’ experiences and understandings of work and its relationship with the legal frameworks through which it is performed. In so doing, it sheds light on how neoliberalism, and associated developments—such as the introduction and increase of student fees, the spread of consumerism, and the introduction of the Research Excellence Framework—have impacted on academic work and the experiences of academics, particularly when it comes to matters such as over-work and casualization.
Conclusion
Authors: Adams Zoe
Published: December 2022

This chapter draws together insights from Parts I, II, and III. It begins by summarizing some of the unique insights provided by the analysis, while situating them in the wider literature. It then demonstrates the practical contribution that the book can make when it comes to furthering the political agenda normatively implied by the analysis presented, teasing out some of its strategic implications. It explains how the Marxian-inspired theoretical understanding of law and work presented throughout the book can provide guidance when it comes to formulating, and advancing, concrete reform proposals, as well as when it comes to thinking about what sort of reforms might contribute to the longer-term pursuit of structural change. Reform proposals discussed include proposals for sector-level collective bargaining, and various changes to the working time and wage regulation framework, all of which are intended to create space for the development of capacities for collective organization and resistance, while simultaneously navigating some of the limits, identified throughout the book, in the law’s conception of work.
Against Bare Urges and Good-Independent Desires
Authors: Moss Jessica
Published: December 2022

It is widely held that in the argument for soul-division in Republic IV, Plato commits himself to the view that appetites are bare urges: they are limited to generic objects like “drink itself” because the appetitive part of the soul is too primitive to grasp features like hot or cold, let alone good or bad. I argue that this misunderstands the argument badly. Plato appeals to “thirst itself” simply to show that one can desire an object even though one believes it to have some quality to which one is averse, and he could just as well have illustrated his point by appeal to a generic rational desire—for example, the desire for “wisdom itself.” His argument is thus consistent with appetites being quite sophisticated, and indeed good-dependent. Plato does of course think that there are important differences between appetites and rational desires, but he is not explaining that difference here.
Comments on Raphael Woolf, ‘Courage and Pleasure in Aristotle’s Ethics’
Authors: Broadie Sarah
Published: December 2022

The ‘courage problem’ in Aristotle’s Ethics is this: (1) courage is a virtue; (2) doctrinally, the exercise of virtue is supposed to be pleasant; and (3) typical exercises of courage are painful and dangerous. Aristotle makes moves to solve the difficulty. But what exactly is his solution, and does it work? In response to Raphael Woolf’s interpretation of Aristotle’s solution, according to which the courageous person merely recognizes fearful things as fearful, but does not experience the feeling of fear himself, this chapter argues that the courageous person can really be feeling fear as well as intellectually recognizing the fearfulness of his situation. Neither of these psychological conditions, separately or together, undermines his claim to courage if he does not let either of them get the better of him. An alternative solution to the courage problem is to take the ‘pleasantness’ of virtuous action, in this context, to mean no more than that the virtuous agent is thoroughly identified with his actions and choices, even when they involve grim and painful situations and feelings.
Memory, Anticipation, Pleasure
Authors: Warren James
Published: December 2022

We can remember an experience with pleasure or look forwards to an experience with trepidation. Our memories and anticipations can be pleasant or painful and what we remember and anticipate was or will be pleasant or painful too. We humans, in short, have ways of looking forwards and backwards within a life and bringing to mind in the present some non-present personal event. Our capacity to do so allows us access to a wide range of affective experiences. This phenomenon is itself not a trivial observation and it attracted the attention of thoughtful ancient writers. Here I briefly explore some of what they had to say about it. I suggest that we can distinguish in their writings two broad ways of thinking about the fact that we can take pleasure in and be pained by our memories and our anticipations.
Petrarchan Love and the English Renaissance
Authors: Braden Gordon
Published: December 2022

This book surveys English love poetry, primarily though not exclusively sonnets and sonnet sequences showing the influence of Petrarch, from the early sixteenth century up to the publication of Mary Wroth’s Pamphilia to Amphilanthus in 1621. There has been no comprehensive study of this well-defined episode in English literature for over 30 years; this project incorporates a range of new scholarship and thinking into a circumstantial narrative history with local focus on particular poets (Thomas Wyatt, George Gascoigne, Philip Sidney, Fulke Greville, Samuel Daniel, Wroth, Walter Ralegh, Shakespeare) and particularly notable poems (“They flee from me,” “Gascoigne’s Woodmanship,” “The Ocean’s Love to Cynthia”). In general, the self-absorption of Petrarchan lyricism is brought into a more populous environment, keyed to the ambitious and intense world of the English court, within or in sight of which many of these poets lived and worked. During the reign of Queen Elizabeth, the Petrarchan theme of love for a powerful but distant woman is literalized in the politics of the realm, in ways that the queen herself recognized and exploited. A final chapter offers a new model for the implied narrative of Shakespeare’s sonnets, which when seen in the context of the tradition as a whole has more coherence than it has generally been given credit for. The concluding disillusion of that sequence gives a major theme of that tradition especially acute expression.
Introduction
Authors: Barlow Richard Alan
Published: December 2022

This section examines the emergence of Irish-Scottish studies over the last few decades, the deep connections between Irish and Scottish histories and cultures, and the long development of the concepts ‘Celt’ and ‘Celtic’ in history, theory, and literature. The evolving attitudes towards Celtic languages and Celtic peoples in European thought from ancient times onwards are also discussed here. Special attention is paid to the development of scholarly Celtology and the cultural discourse of Celticism, with analysis of the work of the nineteenth century theorists Ernest Renan and Matthew Arnold. The introduction also explores the late nineteenth/early twentieth century Celtic Revivals of Ireland and Scotland in their respective political contexts and considers the gender politics of Celticism.
Joyce and Scott
Authors: Barlow Richard Alan
Published: December 2022

There are important similarities between Walter Scott and James Joyce as authors—both were fascinated by the histories of their respective nations, in the relationship between their home country and English power, and in the historical development of societies. Furthermore, Joyce owned some of Scott’s poetry and prose, and there is a network of intertextual links between Scott’s work and Joyce’s texts Dubliners (1914), A Portrait of the Artist as a Young Man (1916), Ulysses (1922), and Finnegans Wake (1939). Chapter 3 studies Joyce’s reading of Scott and examines allusions and references to Scott and his work in Joyce’s texts. Special attention is paid to the links between Scott, incest, and masturbation in Joyce’s work, as well as to the different conceptions of history offered by these two writers—Scott’s quasi-Smithian view of history is contrasted to Joyce’s interest in the theories of Giambattista Vico.