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The epilogue considers one possible future incarnation of the idea of progress in medicine, namely progress as achieving sustainability. Despite the fact that environmental concerns have long been associated with reimagined ideas of progress, aspirations for sustainability remain underdeveloped in medicine. Nevertheless, this epilogue discusses the cases in which the concept of medical progress has been coupled with “sustainable” or “green” medicine. Visions of sustainable medical progress tend to presuppose a multidimensional concept of medical progress, call for expanding the time frame in which progress is assessed, and posit environmental limits as constraints on open-ended progress. At the same time, few of these visions engage with the pluralistic nature of medical progress, preferring to understand measures that support a robust natural environment as intrinsically good for the health of individuals and societies, and broadly aligned with the goals of conventional medicine.
In her contribution, Roessler is interested in what digitalization means for the concept of human beings: a specific concept, identifiable, that defies digitalization? A conceptual clarification, she argues, shows that a rather uncontested definition of a human being includes their vulnerability, their finiteness, and their rational self-consciousness. In a next step, she discusses the difference between robots and humans and engages with novels by Ian MacEwan and Kazuo Ishiguro which imagine this difference between humans and robots. Finally, she advocates that a world in which the difference between robots and humans would no longer be recognizable would be an uncanny world in which we would not want to live.
The epilogue returns to the major themes discussed throughout the book. In addition, it examines the contemporaneous nature of Ghana–Russian relations, particularly through the lens of anti-Black violence and Russia’s full-scale invasion of Ukraine in February 2021. It also looks at the continued contestation between Ghanaians abroad and the embassy in Russia and Ghanaians’ use of protest domestically to seek better rights and economic benefits. The epilogue demonstrates that while Nkrumah and the explicit debates and discourses on socialism that consumed Ghana in the 1960s have almost vanished, that their ghosts continue to shape Ghanaian society.
The recirculating flow at the rear of a flat-base three-dimensional body with ground proximity is investigated for different body attitudes defined by the pitch angle varying in the range $-1.5^\circ \lt \alpha \lt +2.6^\circ$ and the yaw angle in the range $0^\circ \lt \beta \lt +12^\circ$. Experiments measuring the three components of the mean velocity field in two perpendicular planes intersecting the recirculation area as well as the base pressure distribution are conducted for 50 different attitudes. They provide a clear correlation between the orientation of the spatially averaged reversed flow and the gradient at the centre of the base pressure distribution. Both vectors are found to be in the same so-called w-plane, that is perpendicular to the base of which the azimuthal position changes with the body attitude due to either the flow orientation at the base separation or sometimes to a ground separation for large nose-up pitch. Numerical simulations of the same geometry realised for 10 attitudes show satisfactory agreement with the force coefficients measured in the experiment. Base flow variations induced by attitude changes are also well captured, particularly that of the w-plane. The full three-dimensional simulation data are used to show that the inner structure of the separation bubble is always a tilted recirculation torus, where the tilt orientation is given by the base pressure gradient. At the bubble closure, a pair of longitudinal vortices symmetrically located on both sides of the w-plane are permanently observed with circulations consistent with the circulation of the dividing streamline separation in the w-plane.
In the 1990s and 2000s, scholars emphasized the transformative power of international human rights and the durability of liberal global governance. Today, that optimism has faded. Human rights norms face sharper constraints, weakened institutions, and their authority challenged. We argue that rising authoritarian power—driven by more countries autocratizing, major powers gaining strength, and coordination in an emboldened bloc—poses a major challenge to the global human rights system, and that the United States’ retreat from human rights leadership is accelerating this threat. Authoritarian regimes are no longer merely resisting pressure; they are reshaping the system itself. Four strategies are driving this transformation: repression of domestic and transnational activism; refuting information and discrediting of critics; re-engineering procedures and coalitions within international organizations; and replacement of existing norms with alternative narratives that redefine human rights in illiberal terms. US disengagement amplifies each strategy by removing funding, normative leadership, and institutional backing that once raised the cost of violations and constrained authoritarian advance. Together, these developments mark a turning point. Where autocracies once played defense, liberal democracies and human rights actors are now on the defensive. If powerful authoritarian states consolidate these gains, they may emerge as models for others, attract new followers, and gravely damage liberal human rights as a global project. Yet the future is not preordained. Resilience may require liberal democracies confronting illiberal backsliding at home, and for European and other consolidated democracies to assume greater external leadership to strengthen the foundations of international human rights.
Although timely dementia diagnosis is a global healthcare priority, delays between symptom onset and formal recognition remain common, particularly in regions with limited awareness and high stigma. Such delays are associated with worse clinical outcomes, greater caregiver burden and increased healthcare costs. We report the first large-scale study of diagnostic delays in the United Arab Emirates (UAE) and the wider Middle East and North Africa, with findings relevant to other Gulf Cooperation Council countries, given the region’s unique demographic and cultural landscape.
Aims
To investigate the duration between dementia symptom onset and formal diagnosis, and to identify demographic and clinical factors associated with prolonged delays.
Method
We retrospectively analysed 825 patients diagnosed with dementia over 10 years at a major governmental hospital in Abu Dhabi. The duration of undiagnosed symptoms (DUS) was calculated and multivariable regression was performed, adjusting for age, gender, nationality, dementia subtype and presenting symptoms.
Results
The mean DUS was 34.7 months (s.d. = 28.8), with a median of 24 months (interquartile range 12–48 months). Older adults (≥65 years) experienced longer delays than younger patients. Symptom profile strongly influenced DUS: patients presenting with memory complaints (forgetfulness) had the longest delays, whereas those with behavioural or psychiatric symptoms, such as agitation, hallucinations or disinhibition, were diagnosed earlier. In multivariable regression, older age and memory-related presentations remained independent predictors of longer DUS while gender, nationality and dementia subtype were not significant.
Conclusions
Dementia diagnosis in the UAE is delayed by nearly 3 years, driven mainly by age and presenting symptoms. Reducing these delays through public awareness campaigns, clinician training and pilot primary care screening programmes could improve patient outcomes and reduce the growing health economic burden in the region.
A defining feature of the post-1945 international system is the American network of allies and partners that has underpinned its global power. Recent developments within the United States and in the international system have severely strained that alliance network. If it collapses, what is at stake? Existing scholarship in International Relations highlights losses in aggregated military capabilities, reduced diplomatic support, and lost trade. In this essay we review these benefits and another that has been overlooked: ally-enabled access. Access refers to permission from allies and partners to engage in military and intelligence missions within their borders on their territory, through their airspace, or in their territorial waters. Access via America’s allies and security partners has enabled Washington to use foreign sovereign spaces for military logistics, military operations, and foreign surveillance to overcome the tyranny of distance. Examples include permission from allies and partners in the Middle East to allow the US Air Force to fly from their bases to strike targets in Afghanistan and Iraq after 9/11, and US intelligence installations built and operated by permission from Pakistani, Turkish, and Japanese territory during the Cold War. We describe the broad functions of alliances and show how access has been key to projection of American military and intelligence power at a global scale. Perhaps limiting or ending America’s global hegemonic role is desirable; perhaps it is dangerous. We argue that accounting for the contributions of access made by allies and security partners is critical if scholars, policymakers, and publics are to properly assess what is at stake in an American turn away from alliances.
Chapter 2 interrogates the development schemes between Ghana and the Soviet Union – notably the Cotton Textile Factory and the Soviet Geological Survey Team. These engagements were supposed to embody Ghana’s new postcolonial socialist modernity and highlight the benefits, opportunities, and possibilities of Soviet partnership. It demonstrates how pro-Soviet and Eastern bloc stories in the Ghanaian press were not simply intended to offer hagiographic praise or to support Nkrumah’s commitment to geopolitical nonalignment. Instead, they were part of a concentrated movement to dismantle and deconstruct the myth of Western scientific and cultural superiority and anti-Soviet bias, which were introduced and reinforced by Western colonial education and rule. In addition, Chapter 2 focuses on the relationships, expertise, livelihoods, and contestations of the technicians, bureaucrats, and local Ghanaian actors who were essential to overseeing the actual success of Ghana-Soviet relations in tangible ways for the Ghanaian people. It demonstrates how everyday Ghanaians employed Ghana–Soviet spaces to demand rights and protections against ethnic-discrimination and favoritism, and to make citizenship claims.
In 1928 a ‘friendship testimonial’ in the form of an obelisk was erected in the Japanese town of Onjuku in Chiba (see Figure P.1). The obelisk stands at the presumed site where the Spanish colonial official Don Rodrigo de Vivero (1564–1636) stepped ashore after being rescued from a shipwrecked journey from the Philippines to Mexico in 1609. This Prefectural Historic Monument, known as the Mexico Commemorative Tower, manifests historical ties with Chiba’s sister city Acapulco across the Pacific. A year after the construction of the obelisk, historian Murakami Naojirō (村上直次郎, 1868–1966) published a Japanese translation of Vivero’s memories of Japan.
The liberal international trading system has underpinned decades of unprecedented globalization. Yet the imposition of across-the-board and country- and sector-specific tariffs by the second Trump administration in early 2025 has reignited debates over the system’s survival. We challenge the notion that the regime is on the brink of collapse. Drawing on historical patterns of United States trade policy, we argue that US engagement with global commerce has mostly been eclectic, characterized by the coexistence of protectionist and liberal impulses. We show that the system has demonstrated resilience and an ability to adapt to challenges resulting from this eclecticism. While current US trade actions are unprecedented since World War II, we present three reasons to expect a return to the traditional US approach to trade policy. We therefore argue that, despite the protectionist turn and the disruptions created by current US trade policy, predictions about the death of the system underestimate its adaptive flexibility and are thus premature.
This chapter presents Murakami Naojirō’s multifaceted life in chronological order. Providing details about Murakami’s educational background, career stages, and publication history, this chapter traces his imperial agendas and epistemological impact in East and Southeast Asia. It emphasizes the entangled nature of his life and work as a translator historian and scholar diplomat who held influential academic positions during the Japanese Empire, as well as his rehabilitation in Jesuit-led Christian history circles toward the end of his life. A variety of genres have been consulted to develop a comprehensive understanding of Murakami’s professional life across archives, universities, and government offices and how his various posts shaped the global circulation of knowledge.
The movement of capital across borders has never been easier, as evidenced by the recent proliferation of offshore financial services. But these services are a double-edged sword: while boosting economic efficiency, they can also facilitate illicit financial activity. In this paper, we discuss the symbiotic relationship between financial liberalization and the pursuit of financial anonymity by secrecy-seeking actors. We examine a hide-and-seek dynamic between governments increasing monitoring of international finance and actors seeking anonymity via offshore financial centers. Under what conditions can international financial monitoring have the unintended consequence of increasing the use of poorly regulated and opaque offshore financial services? We examine this dynamic in the context of US targeted sanctions. Using the Office of Foreign Asset Control’s Specially Designated Nationals data and the International Consortium of Investigative Journalists Offshore Leaks Database, we show that increases in US targeted sanctions provoke firms and individuals from targeted countries to seek low-supervision offshore financial centers.
This article considers people’s relations with ruins in the Mesoamerican past from the perspective of two approaches within the ontological turn. The first examines ruins drawing on Indigenous ontologies, while the second involves the application of a new materialist perspective that incorporates Peircean semiotics. Both approaches view matter as animate and share a relational, nonbinary, and nonessentializing position. Research drawing on ethnographic and ethnohistoric accounts of Native American perspectives considers ruins as living entities often inhabited by divinities, ancestors, or pre-Sunrise beings, which could require propitiation and reverence or provoke denigration and erasure. A new materialist perspective allows archaeologists to better recognize what ruins did beyond holding meanings imposed on them by people. Ruins in ancient Mesoamerica had the vibrancy and power to gather people, offerings, shrines, and the dead in ways that constituted community and temporality, contested or legitimated authority, and invoked the cosmic creation.
Roessler and Steeves, in their introduction, underscore the urgency of the debate about being human in an increasingly digitalized society. In a further step, they outline the theoretical background with regard to the concept of a human being, as well as with regard to the theoretical approaches of postmodernism and transhumanism, to situate the volume within earlier discussions about the digital human. They conclude with a helpful overview of the volume’s contributions.
With the Liberal International Order (LIO) in decline, scholars have focused increasingly on the possible return to a Westphalian great power system marked by sovereigntist claims and balancing among states. The actions of the Trump administration, however, raise a number of significant puzzles for such accounts—the US seems willing to sign deals with traditional adversaries including Russia and China, while targeting long-standing allies like Canada and Denmark. At the same time, transactional politics often serve narrow personalist interests rather than national objectives. In short, a Westphalian lens focused on states and sovereignty may generate intellectual blinders that misreads the emerging international order. To overcome these limitations, we propose an alternative account, which we label neo-royalism. The neo-royalist order centers on an international system structured by a small group of hyper elites, which we term cliques. Such cliques seek to legitimize their authority through appeals to their exceptionalism in order to generate durable material and status hierarchies based on the extraction of financial and cultural tributes. This short paper lays out the key elements of the neo-royalist order, differentiating it from the Westphalian and Liberal International Orders, and applies its insights to better grapple with the emerging system being promoted by the United States under Donald J. Trump. For policymakers and scholars, the neo-royalist approach clarifies recent events in US foreign policy. Theoretically, the field should take contending ideas of international order seriously, and establish a research agenda beyond a backward looking view to the Westphalian moment.
This article builds on the recommendations of the United Nations Working Group on Business and Human Rights to argue for the integration of access-to-remedy clauses into international investment agreements (IIAs). It contends that international investment law (IIL) exhibits imperialist tendencies, privileging corporate interests while neglecting rightsholders and thereby entrenching systemic injustice. Using the framework of legal imperialism, the article highlights how existing investment regimes create structural imbalances that deny victims’ meaningful redress. Moving beyond proposals limited to procedural reform within IIL, it advances a normative case for incorporating remedy clauses into IIAs, particularly to enable rightsholders to pursue claims in host states where harms occur. Drawing on examples from the Global South, it identifies persistent barriers such as jurisdictional hurdles and enforcement gaps. The article’s contribution lies in reframing IIAs not merely as instruments of investor protection but as potential vehicles for systemic correction, capable of moving transnational law towards equitable remedies.
Ice shelves that spread into the ocean can develop rifts that can trigger iceberg calving and enhance ocean-induced melting. Fluid mechanically, this system is analogous to an extensionally dominated radial spreading of a non-Newtonian fluid into a relatively inviscid and denser ambient fluid. Laboratory experiments have shown that rift patterns can emerge when the spreading fluid is shear thinning. Linear stability analysis supports these findings, predicting that while the instability mechanism is active in Newtonian fluids, it is suppressed by stabilising secondary-flow cellular vortices. Here, we explore the fully nonlinear evolution of a radially spreading Newtonian fluid, assessing whether large-amplitude perturbations could drive an instability. We use a quasi-three-dimensional numerical simulation that solves the full nonlinear shallow-shelf approximation, tracing the evolving fluid front, and validate it with known axisymmetric solutions and predictions from linear-stability theory. We find that large-amplitude perturbations induce nonlinear effects that give rise to non-axisymmetric patterns, including cusp-like patterns along the fluid front and complex secondary-flow eddies, which have neither been predicted theoretically nor observed experimentally. However, despite these nonlinear effects, large-amplitude perturbations alone are insufficient to induce rift-like patterns in Newtonian fluids. Strain-rate peaks at the troughs of the fluid front suggest that shear-thinning fluids may become more mobile in these regions, potentially leading to rift formation. This coincides with the likely weakening of stabilising forces as the fluid becomes more shear-thinning. These findings elucidate the critical role of nonlinear viscosity on the formation of rift-like patterns, which is the focus of Part 2 of this study.
Akbari describes what it means to have a human body in the digital age and argues that datafication has transformed the materiality of the body in its very flesh and bone. This transformation is especially dangerous in uncertain spaces, such as borders and refugee camps, where identity becomes crucial and only certain categories of human bodies can pass. The consequences to those experiencing datafication of their bodies at the border are harsh and severe. However, the deliberate unruliness of the border paves the way for these spaces to become technological testing grounds, as evidenced by the development of technologies to track fleeing populations for the purposes of contact tracing during the COVID-19 pandemic. Akbari’s text oscillates deliberately between academic thinking, autobiographical accounts, pictures, and poetry, thus clearly denoting the discomfort of the human being living in a Code|Body.