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Dietary intake of dicarbonyl compounds and changes in body weight over time in a large cohort of European adults
- Charlotte Debras, Reynalda Cordova, Ana-Lucia Mayén, Kim Maasen, Viktoria Knaze, Simone J. P. M. Eussen, Casper G. Schalkwijk, Inge Huybrechts, Anne Tjønneland, Jytte Halkjær, Verena Katzke, Rashmita Bajracharya, Matthias B. Schulze, Giovanna Masala, Valeria Pala, Fabrizio Pasanisi, Alessandra Macciotta, Dafina Petrova, Jazmin Castañeda, Carmen Santiuste, Pilar Amiano, Conchi Moreno-Iribas, Yan Borné, Emily Sonestedt, Ingegerd Johansson, Anders Esberg, Elom Kouassivi Aglago, Mazda Jenab, Heinz Freisling
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- British Journal of Nutrition , First View
- Published online by Cambridge University Press:
- 22 February 2024, pp. 1-13
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Dicarbonyl compounds are highly reactive precursors of advanced glycation end products (AGE), produced endogenously, present in certain foods and formed during food processing. AGE contribute to the development of adverse metabolic outcomes, but health effects of dietary dicarbonyls are largely unexplored. We investigated associations between three dietary dicarbonyl compounds, methylglyoxal (MGO), glyoxal (GO) and 3-deoxyglucosone (3-DG), and body weight changes in European adults. Dicarbonyl intakes were estimated using food composition database from 263 095 European Prospective Investigation into Cancer and Nutrition–Physical Activity, Nutrition, Alcohol, Cessation of Smoking, Eating Out of Home in Relation to Anthropometry participants with two body weight assessments (median follow-up time = 5·4 years). Associations between dicarbonyls and 5-year body-weight changes were estimated using mixed linear regression models. Stratified analyses by sex, age and baseline BMI were performed. Risk of becoming overweight/obese was assessed using multivariable-adjusted logistic regression. MGO intake was associated with 5-year body-weight gain of 0·089 kg (per 1-sd increase, 95 % CI 0·072, 0·107). 3-DG was inversely associated with body-weight change (–0·076 kg, −0·094, −0·058). No significant association was observed for GO (0·018 kg, −0·002, 0·037). In stratified analyses, GO was associated with body-weight gain among women and older participants (above median of 52·4 years). MGO was associated with higher body-weight gain among older participants. 3-DG was inversely associated with body-weight gain among younger and normal-weight participants. MGO was associated with a higher risk of becoming overweight/obese, while inverse associations were observed for 3-DG. No associations were observed for GO with overweight/obesity. Dietary dicarbonyls are inconsistently associated with body weight change among European adults. Further research is needed to clarify the role of these food components in overweight and obesity, their underlying mechanisms and potential public health implications.
Psychosis as a potential mental health consequence of racism
- F. B. Lazaridou, A. Heinz
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S910-S911
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Introduction
Evidence shows that racism can have a negative effect on mental health in the lived experiences of Black people and People of Colour. In critical theory discourse including postcolonial and decolonial approaches, racism is suggested to be an everyday phenomenon. Additionally, racism specifically targets the perceived cultural and phenotypic foreignness of Black migrants and migrants Of Colour, as well as the ascribed migrant status attributed to the perceived foreignness of racialized persons who do not actually have any direct migration experiences.
ObjectivesThe stigma associated with severe mental disorders such as psychosis has historically been applied to Black people and People of Colour who have been engaged in anti-racist activism as a form of punishment and social control. Higher incidence rates of psychosis in racialized communities have frequently been conceptualized as cultural differences in family composition and levels of expressed emotion in families. The objective of this study is to sensitively investigate psychosis as a potential mental health consequence of racism.
MethodsThe incidence rates of psychosis - positive symptoms, negative symptoms, non-affective psychosis disorders and first episode psychosis - among migrants by country of migration were compiled in an umbrella review, which offers a summary of meta-analyses. Quantitative research has the limitation of enabling the observation of patterns but not allowing an understanding of the reasons behind them to be theorized through the data. Therefore, qualitative methods complement the quantitative data. Twenty people of diverse genders who self-identified as Black people or People of Colour in Berlin were interviewed about their experiences of racism and sexism and about how those experiences affected their mental health.
ResultsThe umbrella review found an association between migration and psychosis, with migration from the Caribbean and African countries showing the strongest correlation. A constant comparative analysis of the qualitative data suggests that racism contributes to the emergence of a subclinical psychosis symptomatology profile that consists of a sense of differentness, negative self-awareness, paranoid ideation regarding general persecution, and self-questioning with self-esteem instability.
ConclusionsThe findings are interpreted as a situational diagnosis, as coined by the psychiatrist and political philosopher Frantz Fanon in the seminal book ‘Black Skin, White Masks’ (1975). The findings are also contextualized within a critique of institutional racism, both historically and currently, and within an intersectional discussion of the need for structural competency and the provision of safety for racialized groups in clinical settings.
Disclosure of InterestNone Declared
Surveillance for ototoxicity in platinum-based chemotherapy using mobile health audiometry with extended high frequencies
- K Ehlert, B Heinze, M A Graham, D Swanepoel
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- Journal:
- The Journal of Laryngology & Otology / Volume 137 / Issue 1 / January 2023
- Published online by Cambridge University Press:
- 25 May 2022, pp. 61-67
- Print publication:
- January 2023
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Objective
This study investigated mobile health enabled surveillance in ototoxicity.
MethodThis was a longitudinal study of 32 participants receiving chemotherapy. Baseline and exit audiograms that included conventional and extended high frequency audiometry were recorded within the patient's treatment venue using a validated mobile health audiometer.
ResultsAverage hearing thresholds at baseline were within the normal range (81.2 per cent left; 93.8 per cent right), reducing at exit testing (71.9 per cent left; 78.1 per cent right). Half of participants presented with a threshold shift according to ototoxicity monitoring criteria. The frequencies affected the most were between 4000 and 16 000 Hz, with left ears significantly more affected than right ears. Noise levels exceeded the maximum permissible ambient noise levels in up to 43.8 per cent of low frequencies (250–1000 Hz).
ConclusionMobile health supported audiometry proved to be an efficacious tool for ototoxicity monitoring at the treatment venue. Changes in hearing ability over time could be tracked, improving surveillance in patients with full treatment schedules.
Compulsory admissions of patients with mental disorders: State of the art on ethical and legislative aspects in 40 European countries
- D. Wasserman, G. Apter, C. Baeken, S. Bailey, J. Balazs, C. Bec, P. Bienkowski, J. Bobes, M. F. Bravo Ortiz, H. Brunn, Ö. Bôke, N. Camilleri, B. Carpiniello, J. Chihai, E. Chkonia, P. Courtet, D. Cozman, M. David, G. Dom, A. Esanu, P. Falkai, W. Flannery, K. Gasparyan, G. Gerlinger, P. Gorwood, O. Gudmundsson, C. Hanon, A. Heinz, M. J. Heitor Dos Santos, A. Hedlund, F. Ismayilov, N. Ismayilov, E. T. Isometsä, L. Izakova, A. Kleinberg, T. Kurimay, S. Klæbo Reitan, D. Lecic-Tosevski, A. Lehmets, N. Lindberg, K. A. Lundblad, G. Lynch, C. Maddock, U.F. Malt, L. Martin, I. Martynikhin, N. O. Maruta, F. Matthys, R. Mazaliauskiene, G. Mihajlovic, A. Mihaljevic Peles, V. Miklavic, P. Mohr, M. Munarriz Ferrandis, M. Musalek, N. Neznanov, G. Ostorharics-Horvath, I. Pajević, A. Popova, P. Pregelj, E. Prinsen, C. Rados, A. Roig, M. Rojnic Kuzman, J. Samochowiec, N. Sartorius, Y. Savenko, O. Skugarevsky, E. Slodecki, A. Soghoyan, D. S. Stone, R. Taylor-East, E. Terauds, C. Tsopelas, C. Tudose, S. Tyano, P. Vallon, R. J. Van der Gaag, P. Varandas, L. Vavrusova, P. Voloshyn, J. Wancata, J. Wise, Z. Zemishlany, F. Öncü, S. Vahip
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- Journal:
- European Psychiatry / Volume 63 / Issue 1 / 2020
- Published online by Cambridge University Press:
- 24 August 2020, e82
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Background.
Compulsory admission procedures of patients with mental disorders vary between countries in Europe. The Ethics Committee of the European Psychiatric Association (EPA) launched a survey on involuntary admission procedures of patients with mental disorders in 40 countries to gather information from all National Psychiatric Associations that are members of the EPA to develop recommendations for improving involuntary admission processes and promote voluntary care.
Methods.The survey focused on legislation of involuntary admissions and key actors involved in the admission procedure as well as most common reasons for involuntary admissions.
Results.We analyzed the survey categorical data in themes, which highlight that both medical and legal actors are involved in involuntary admission procedures.
Conclusions.We conclude that legal reasons for compulsory admission should be reworded in order to remove stigmatization of the patient, that raising awareness about involuntary admission procedures and patient rights with both patients and family advocacy groups is paramount, that communication about procedures should be widely available in lay-language for the general population, and that training sessions and guidance should be available for legal and medical practitioners. Finally, people working in the field need to be constantly aware about the ethical challenges surrounding compulsory admissions.
Factors associated with the onset of major depressive disorder in adults with type 2 diabetes living in 12 different countries: results from the INTERPRET-DD prospective study
- C. E. Lloyd, N. Sartorius, H. U. Ahmed, A. Alvarez, S. Bahendeka, A. E. Bobrov, L. Burti, S. K. Chaturvedi, W. Gaebel, G. de Girolamo, T. M. Gondek, M. Guinzbourg, M. G. Heinze, A. Khan, A. Kiejna, A. Kokoszka, T. Kamala, N. M. Lalic, D. Lecic-Tosevski, E. Mannucci, B. Mankovsky, K. Müssig, V. Mutiso, D. Ndetei, A. Nouwen, G. Rabbani, S. S. Srikanta, E. G. Starostina, M. Shevchuk, R. Taj, U. Valentini, K. van Dam, O. Vukovic, W. Wölwer
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- Journal:
- Epidemiology and Psychiatric Sciences / Volume 29 / 2020
- Published online by Cambridge University Press:
- 02 June 2020, e134
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Aims
To examine the factors that are associated with changes in depression in people with type 2 diabetes living in 12 different countries.
MethodsPeople with type 2 diabetes treated in out-patient settings aged 18–65 years underwent a psychiatric assessment to diagnose major depressive disorder (MDD) at baseline and follow-up. At both time points, participants completed the Patient Health Questionnaire (PHQ-9), the WHO five-item Well-being scale (WHO-5) and the Problem Areas in Diabetes (PAID) scale which measures diabetes-related distress. A composite stress score (CSS) (the occurrence of stressful life events and their reported degree of ‘upset’) between baseline and follow-up was calculated. Demographic data and medical record information were collected. Separate regression analyses were conducted with MDD and PHQ-9 scores as the dependent variables.
ResultsIn total, there were 7.4% (120) incident cases of MDD with 81.5% (1317) continuing to remain free of a diagnosis of MDD. Univariate analyses demonstrated that those with MDD were more likely to be female, less likely to be physically active, more likely to have diabetes complications at baseline and have higher CSS. Mean scores for the WHO-5, PAID and PHQ-9 were poorer in those with incident MDD compared with those who had never had a diagnosis of MDD. Regression analyses demonstrated that higher PHQ-9, lower WHO-5 scores and greater CSS were significant predictors of incident MDD. Significant predictors of PHQ-9 were baseline PHQ-9 score, WHO-5, PAID and CSS.
ConclusionThis study demonstrates the importance of psychosocial factors in addition to physiological variables in the development of depressive symptoms and incident MDD in people with type 2 diabetes. Stressful life events, depressive symptoms and diabetes-related distress all play a significant role which has implications for practice. A more holistic approach to care, which recognises the interplay of these psychosocial factors, may help to mitigate their impact on diabetes self-management as well as MDD, thus early screening and treatment for symptoms is recommended.
P03-200 - Rct: Oxcarbazepine In Alcohol Relapse Prevention
- B. Croissant, A. Diehl, H. Nakovics, A. Heinz, K. Mann
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- European Psychiatry / Volume 25 / Issue S1 / 2010
- Published online by Cambridge University Press:
- 17 April 2020, 25-E1254
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Objectives
We have compared oxcarbazepine (OXC) with acamprosate (ACP) in relapse prevention in recently withdrawn alcohol dependent patients. Oxcarbazepine blocks voltage-sensitive sodium channels. Its metabolite reduces high-voltage-activated calcium currents in striatal and cortical neurons, thus reducing glutamatergic transmission at corticostriatal synapses. This reduction is of interest in the treatment of alcohol dependence, since acamprosate modulates NMDA receptors, resulting in an inhibition of glutamatergic transmission. Furthermore, OXC has revealed a mood-stabilizing effect in bipolar affective disorders.
MethodsIn a randomized open label pilot study 30 detoxified alcohol dependent patients were followed up for six months to assess treatment outcome in pharmacological relapse prevention. 15 alcoholics were treated with OXC and 15 with ACP. We asked for the time until first and heavy relapse and for drinks on drinking days. We assessed craving (OCDS), the severity of depression (ADS) and the degree of state anxiety (STAI).
ResultsAfter withdrawal, time to severe relapse and time to first consumption of any ethanol by OXC patients was not longer than for ACP patients. Abstinent patients in both study groups showed significantly lower OCDS-G than relapsed patients. No undesired effects occurred when OXC patients consumed alcohol.
While the current sample size clearly limits further conclusions from this pilot study, it is noteworthy that OXC is well tolerated. Thus, in medication-based relapse prevention, OXC could have the potential of a promising alternative for alcoholic patients unable to benefit from ACP or naltrexone or who suffer from affective lability. OXC certainly merits a larger placebo controlled trial.
FC03-02 - Deep Brain Stimulation of the Nucleus Accumbens in Treatment Resistant Alcohol Addiction - a Novel Treatment Option?
- U. Mueller, J. Voges, I. Galazky, M. Heldmann, H.-J. Heinze, V. Sturm, B. Bogerts
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- European Psychiatry / Volume 25 / Issue S1 / 2010
- Published online by Cambridge University Press:
- 17 April 2020, 25-E188
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Introduction
Treatment of alcohol addiction remains challenging, since only half of all patients achieve long-term abstinence by currently available therapies.
ObjectiveIn the last 2 years, there have been promising reports on deep brain stimulation (DBS) of NAc in addiction (animal models, one case report of a patient with severe anxiety disorder and secondary addiction). Our group treated 5 patients with treatment resistant alcohol addiction with DBS so far. Our initial data of the first 3 patients has just been published. However, these very positive results arise from a continuous open stimulation and have not been placebo controlled.
AimsTo assess the impact of discontinuation of bilateral DBS of the NAc on craving for alcohol in patients whose addiction remitted after initiation of DBS.
MethodsCrossover, double-blinded phase of 2 × 4 weeks with sham-stimulation in one and stimulation in the other 4 weeks.
ResultsUntil now, one patient finished the 8 weeks of study (remaining patients will finish experiment in December 2009). In this patient, stimulation was continued in the first and stopped in the latter 4 weeks. While he experienced no changes or side effects in the first part, he showed a massive craving for alcohol one day after discontinuation, which again remitted when the experiment was stopped and the stimulator was turned on again after 3 days.
ConclusionsDBS of NAc seems to selectively alleviate craving for alcohol thus enabling patients to remain abstinent. These results justify clinical studies in larger samples of patients with treatment resistant alcohol addiction.
Dialectical Behavior Therapy for Inpatients with Borderline Personality Disorder and Concomitant Alcohol Dependence: Results of a Pilot Study
- T. Kienast, H. von Hoerner, S. Reiske, B. Renneberg, J. Wrase, A. Heinz
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- European Psychiatry / Volume 24 / Issue S1 / January 2009
- Published online by Cambridge University Press:
- 16 April 2020, 24-E92
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Purpose of study:
Psychotherapy with patients suffering from borderline personality disorder (BPD) and concomitant alcoholism requires an integrative approach. Dialectical Behavioral Therapy (DBT) is an evaluated and effective program for patients with BPD, whereas behavior therapy, commitment therapy and self-help groups have all been found to be effective in the treatment of alcoholism. In this pilot study, we give an initial report of the concept and efficacy of an eight week inpatient therapy program integrating an evaluated therapy of alcoholism with standard DBT. The changes of symptoms were evaluated using the Borderline Symptom List (BSL), the European Addiction Severity Index (EuropASI), Lifetime Parasuicide Count (LPC), and Beck-Depression-Inventory.
Findings:Five case reports were included. All show improvements in various subscores of BSL and EuropASI, and had a decrease in the LPC score.
Summary:With this pilot study we test the efficacy of an extended DBT program for inpatients with BPD and alcoholism who failed outpatient treatment, and found significant improvements in the study in all outcome measures. This promising result points to the necessity for clinical trials that compare standard care with extended DBT in larger cohorts.
Efficacy of oxcarbazepin in alcohol relapse prevention – a pilot study
- B. Croissant, T. Scherle, A. Heinz, K. Mann
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- European Psychiatry / Volume 17 / Issue S1 / May 2002
- Published online by Cambridge University Press:
- 16 April 2020, p. 213s
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2177 – Neuroanatomical Changes Associated With Subthreshold Depression In Adolescents
- H. Vulser, M.-L. Paillere-Martinot, H. Lemaitre, R. Miranda, E. Artiges, R. Goodman, J. Penttilä, M. Struve, T. Fadai, V. Kappel, L. Poustka, P. Conrod, T. Banaschewski, A. Barbot, G.J. Barker, C. Büchel, H. Flor, J. Gallinat, H. Garavan, A. Heinz, B. Ittermann, C. Lawrence, E. Loth, K. Mann, T. Paus, Z. Pausova, M. Rietschel, T.W. Robbins, M. Smolka, G. Schumann, J.-L. Martinot, IMAGEN Consortium
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- European Psychiatry / Volume 28 / Issue S1 / 2013
- Published online by Cambridge University Press:
- 15 April 2020, 28-E1340
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Introduction
Although neuroimaging studies suggest brain regional abnormalities in depressive disorders, it remains unclear whether abnormalities are present at illness onset or reflect disease progression.
ObjectivesWe hypothesized that cerebral variations were present in adolescents with subthreshold depression known to be at high risk for later full-blown depression.
AimsWe examined brain structural and diffusion-weighted magnetic resonance images of adolescents with subthreshold depression.
MethodsThe participants were extracted from the European IMAGEN study cohort of healthy adolescents recruited at age 14. Subthreshold depression was defined as a distinct period of abnormally depressed or irritable mood, or loss of interest, plus two or more depressive symptoms but without diagnosis of Major Depressive Episode. Comparisons were performed between adolescents meeting these criteria and control adolescents within the T1-weighted imaging modality (118 and 475 adolescents respectively) using voxel-based morphometry and the diffusion tensor imaging modality (89 ad 422 adolescents respectively) using tract-based spatial statistics. Whole brain analyses were performed with a statistical threshold set to p< 0.05 corrected for multiple comparisons.
ResultsCompared with controls, adolescents with subthreshold depression had smaller gray matter volume in caudate nuclei, medial frontal and cingulate cortices; smaller white matter volume in anterior limb of internal capsules, left forceps minor and right cingulum; and lower fractional anisotropy and higher radial diffusivity in the genu of corpus callosum.
ConclusionsThe findings suggest that adolescents with subthreshold depression have volumetric and microstructural gray and white matter changes in the emotion regulation frontal-striatal-limbic network.
Auditory verbal hallucinations in first episode psychosis – an fMRI symptom capture study
- T. Dunne, P. Mallikarjun, M. Broome, B. Farmah, K. Heinze, R. Reniers, S. Wood, F. Oyebode, R. Upthegrove
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- European Psychiatry / Volume 41 / Issue S1 / April 2017
- Published online by Cambridge University Press:
- 23 March 2020, p. S194
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Introduction
Neurobiological models of auditory verbal hallucination (AVH) have been advanced by symptom capture functional magnetic resonance imaging (fMRI), where participants self-report hallucinations during scanning. To date, regions implicated are those involved with language, memory and emotion. However, previous studies focus on chronic schizophrenia, thus are limited by factors, such as medication use and illness duration. Studies also lack detailed phenomenological descriptions of AVHs. This study investigated the neural correlates of AVHs in patients with first episode psychosis (FEP) using symptom capture fMRI with a rich description of AVHs. We hypothesised that intrusive AVHs would be associated with dysfunctional salience network activity.
MethodsSixteen FEP patients with frequent AVH completed four psychometrically validated tools to provide an objective measure of the nature of their AVHs. They then underwent fMRI symptom capture, utilising general linear models analysis to compare activity during AVH to the resting brain.
ResultsSymptom capture of AVH was achieved in nine patients who reported intrusive, malevolent and uncontrollable AVHs. Significant activity in the right insula and superior temporal gyrus (cluster size 141 mm3), and the left parahippocampal and lingual gyri (cluster size 121 mm3), P < 0.05 FDR corrected, were recorded during the experience of AVHs.
ConclusionsThese results suggest salience network dysfunction (in the right insula) together with memory and language processing area activation in intrusive, malevolent AVHs in FEP. This finding concurs with others from chronic schizophrenia, suggesting these processes are intrinsic to psychosis itself and not related to length of illness or prolonged exposure to antipsychotic medication.
Disclosure of interestThe authors have not supplied their declaration of competing interest.
Assessing failure in epitaxially encapsulated micro-scale sensors using micro and nano x-ray computed tomography
- Lizmarie Comenencia Ortiz, David B. Heinz, Ian B. Flader, Anne L. Alter, Dongsuk D. Shin, Yunhan Chen, Thomas W. Kenny
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- Journal:
- MRS Communications / Volume 8 / Issue 2 / June 2018
- Published online by Cambridge University Press:
- 12 April 2018, pp. 275-282
- Print publication:
- June 2018
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Millions of micro electro mechanical system sensors are fabricated each year using an ultra-clean process that allows for a vacuum-encapsulated cavity. These devices have a multi-layer structure that contains hidden layers with highly doped silicon, which makes common imaging techniques ineffective. Thus, examining device features post-fabrication, and testing, is a significant challenge. Here, we use a combination of micro- and nano-scale x-ray computed tomography to study device features and assess failure mechanisms in such devices without destroying the ultra-clean cavity. This provides a unique opportunity to examine surfaces and trace failure mechanisms to specific steps in the fabrication process.
The NorthGRIP deep drilling programme
- Dorthe Dahl-Jensen, Niels S. Gundestrup, Heinz Miller, Okitsugu Watanabe, Sigfús J. Johnsen, Jørgen P. Steffensen, Henrik B. Clausen, Anders Svensson, Lars B. Larsen
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- Annals of Glaciology / Volume 35 / 2002
- Published online by Cambridge University Press:
- 14 September 2017, pp. 1-4
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The North Greenland Icecore Project (NorthGRIP) was initiated in 1995 as a joint international programme involving Denmark, Germany, Japan, Belgium, Sweden, Iceland, the U.S.A., France and Switzerland. the main goal was to obtain undisturbed high-resolution information about the Eemian climatic period (115–130 kyr BP). the records from the Greenland Icecore Project (GRIP) and Greenland Ice Sheet Project 2 (GISP2) in central Greenland are different and disturbed down in the ice covering this period. Internal radio-echo sounding layers show that NorthGRIP, placed 325 km north-northwest of GRIP at the Summit of the Greenland ice sheet, is located on a gently sloping ice ridge with very flat bedrock and internal layers found so high that an undisturbed Eemian record is possible. Internal layers much farther above bedrock than their apparent counter parts at GRIP suggest that conditions are favourable for recovery of an undisturbed Eemian record. So far, a 1351 mdeep ice core (NorthGRIP1) and a 3001 mdeep ice core (NorthGRIP 2) have been recovered. the ice thickness is expected to be 3080 m, and the ice temperature at 3001 m is –5.6°C, so we expect basal melting at the bedrock. Most of the Eemian ice will be melted away, leaving only the last part and the transition between the Eem and the Last Glacial Period. At 3001 m the age of the ice is 110 kyr BP and the annual layers are of the order 1 cm.With modern methods the annual layers can be resolved, resulting in detailed information on the decline of the warm Eemian period into the Last Glacial Period.
A comparison of radio-echo sounding data and electrical conductivity of the GRIP ice core
- Ludwig Hempel, Franz Thyssen, Niels Gundestrup, Henrik B. Clausen, Heinz Miller
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- Journal of Glaciology / Volume 46 / Issue 154 / 2000
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- 08 September 2017, pp. 369-374
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The depth of reflecting layers in Arctic ice sheets has been determined by electromagnetic echo sounding, using a varying distance between transmitter and receiver to determine the radar wave velocity. The depth of the radar reflecting layers is compared with a profile of electrical conductivity measurements (ECMs) from the Greenland Ice Core Project (GRIP) ice core, in order to determine the velocity of the radar waves in the ice cap. By using several reflecting layers, it is possible to isolate the firn correction of the wave velocity and to estimate the accuracy of the calculated electromagnetic wave velocity. The measured firn correction is compared with the correction calculated from the density profile, and a comparison between the depth profiles of ECM and radar based on the corrected electromagnetic wave velocity is presented. This profile shows that acid layers, which originate from major volcanic eruptions, show up as reflecting radar horizons.
Oxygen isotopes of bovid teeth as archives of paleoclimatic variations in archaeological deposits of the Ganga plain, India
- Shikha Sharma, Michael M Joachimski, Heinz J Tobschall, Indra B Singh, Devi P Tewari, Rakesh Tewari
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- Quaternary Research / Volume 62 / Issue 1 / July 2004
- Published online by Cambridge University Press:
- 20 January 2017, pp. 19-28
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Oxygen isotope analysis was performed on enamel phosphate of mammalian teeth from archaeological sites Kalli Pachchhim and Dadupur in the central Ganga plain and Charda in the northern Ganga plain. The bulk oxygen isotopic compositions of enamel phosphate from third molars (M3) of Bos indicus individuals belonging to different cultural periods were used to understand the climatic changes during the past 3600 cal yr B.P. Oxygen isotope ratios indicate humid conditions around 3600 cal yr B.P., followed by a trend toward drier conditions until around 2800 cal yr B.P. Then from 2500 to 1500 cal yr B.P. there is a trend toward higher humidity, followed by the onset of a dry period around 1300 cal yr B.P. The study of intratooth δ18O variations in teeth from different periods demonstrates that the monsoon seasonality was prominent. Spatial changes in the amount of annual rainfall are also reflected in the δ18O values. Teeth derived from areas with intense rainfall have lighter isotope ratios compared to teeth from regions receiving less rain, but they show similar seasonal patterns. The long-term paleoclimatic variations reflected by fluctuations in bulk δ18Op values from M3 teeth match well with the regional paleoenvironmental records and show a good correlation to the cultural changes that took place during this time span in Ganga plain.
Patient and caregiver characteristics related to completion of advance directives in terminally ill patients
- Grace W.K. Ho, Lauren Skaggs, Gayane Yenokyan, Anela Kellogg, Julie A. Johnson, Mei Ching Lee, Katherine Heinze, Mark T. Hughes, Daniel P. Sulmasy, Joan Kub, Peter B. Terry, Alan B. Astrow, Jing Zheng, Lisa Soleymani Lehmann, Marie T. Nolan
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- Palliative & Supportive Care / Volume 15 / Issue 1 / February 2017
- Published online by Cambridge University Press:
- 30 May 2016, pp. 12-19
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Objective:
There is a growing body of literature describing the characteristics of patients who plan for the end of life, but little research has examined how caregivers influence patients' advance care planning (ACP). The purpose of this study was to examine how patient and caregiver characteristics are associated with advance directive (AD) completion among patients diagnosed with a terminal illness. We defined AD completion as having completed a living will and/or identified a healthcare power of attorney.
Method:A convenience sample of 206 caregiver–patient dyads was included in the study. All patients were diagnosed with an advanced life-limiting illness. Trained research nurses administered surveys to collect information on patient and caregiver demographics (i.e., age, sex, race, education, marital status, and individual annual income) and patients' diagnoses and completion of AD. Multivariate logistic regression was employed to model predictors for patients' AD completion.
Results:Over half of our patient sample (59%) completed an AD. Patients who were older, diagnosed with amyotrophic lateral sclerosis, and with a caregiver who was Caucasian or declined to report an income level were more likely to have an AD in place.
Significance of results:Our results suggest that both patient and caregiver characteristics may influence patients' decisions to complete an AD at the end of life. When possible, caregivers should be included in advance care planning for patients who are terminally ill.
Pre-diagnostic meat and fibre intakes in relation to colorectal cancer survival in the European Prospective Investigation into Cancer and Nutrition
- Heather A. Ward, Teresa Norat, Kim Overvad, Christina C. Dahm, H. Bas Bueno-de-Mesquita, Mazda Jenab, Veronika Fedirko, Fränzel J. B. van Duijnhoven, Guri Skeie, Dora Romaguera-Bosch, Anne Tjønneland, Anja Olsen, Franck Carbonnel, Aurélie Affret, Marie-Christine Boutron-Ruault, Verena Katzke, Tilman Kühn, Krassimira Aleksandrova, Heiner Boeing, Antonia Trichopoulou, Pagona Lagiou, Christina Bamia, Domenico Palli, Sabina Sieri, Rosario Tumino, Alessio Naccarati, Amalia Mattiello, Petra H. Peeters, Elisabete Weiderpass, Lene Angell Åsli, Paula Jakszyn, J. Ramón Quirós, María-José Sánchez, Miren Dorronsoro, José-María Huerta, Aurelio Barricarte, Karin Jirström, Ulrika Ericson, Ingegerd Johansson, Björn Gylling, Kathryn E. Bradbury, Kay-Tee Khaw, Nicholas J. Wareham, Magdalena Stepien, Heinz Freisling, Neil Murphy, Amanda J. Cross, Elio Riboli
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- Journal:
- British Journal of Nutrition / Volume 116 / Issue 2 / 28 July 2016
- Published online by Cambridge University Press:
- 19 May 2016, pp. 316-325
- Print publication:
- 28 July 2016
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Improvements in colorectal cancer (CRC) detection and treatment have led to greater numbers of CRC survivors, for whom there is limited evidence on which to provide dietary guidelines to improve survival outcomes. Higher intake of red and processed meat and lower intake of fibre are associated with greater risk of developing CRC, but there is limited evidence regarding associations with survival after CRC diagnosis. Among 3789 CRC cases in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort, pre-diagnostic consumption of red meat, processed meat, poultry and dietary fibre was examined in relation to CRC-specific mortality (n 1008) and all-cause mortality (n 1262) using multivariable Cox regression models, adjusted for CRC risk factors. Pre-diagnostic red meat, processed meat or fibre intakes (defined as quartiles and continuous grams per day) were not associated with CRC-specific or all-cause mortality among CRC survivors; however, a marginal trend across quartiles of processed meat in relation to CRC mortality was detected (P 0·053). Pre-diagnostic poultry intake was inversely associated with all-cause mortality among women (hazard ratio (HR)/20 g/d 0·92; 95 % CI 0·84, 1·00), but not among men (HR 1·00; 95 % CI 0·91, 1·09) (Pfor heterogeneity=0·10). Pre-diagnostic intake of red meat or fibre is not associated with CRC survival in the EPIC cohort. There is suggestive evidence of an association between poultry intake and all-cause mortality among female CRC survivors and between processed meat intake and CRC-specific mortality; however, further research using post-diagnostic dietary data is required to confirm this relationship.
Evaluation of the ‘Jumping to conclusions’ bias in different subgroups of the at-risk mental state: from cognitive basic symptoms to UHR criteria
- F. Rausch, S. Eisenacher, H. Elkin, S. Englisch, S. Kayser, N. Striepens, M. Lautenschlager, A. Heinz, Y. Gudlowski, B. Janssen, W. Gaebel, T. M. Michel, F. Schneider, M. Lambert, D. Naber, G. Juckel, S. Krueger-Oezguerdal, T. Wobrock, A. Hasan, M. Riedel, S. Moritz, H. Müller, J. Klosterkötter, A. Bechdolf, M. Zink, M. Wagner
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- Journal:
- Psychological Medicine / Volume 46 / Issue 10 / July 2016
- Published online by Cambridge University Press:
- 20 April 2016, pp. 2071-2081
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Background
Patients with psychosis display the so-called ‘Jumping to Conclusions’ bias (JTC) – a tendency for hasty decision-making in probabilistic reasoning tasks. So far, only a few studies have evaluated the JTC bias in ‘at-risk mental state’ (ARMS) patients, specifically in ARMS samples fulfilling ‘ultra-high risk’ (UHR) criteria, thus not allowing for comparisons between different ARMS subgroups.
MethodIn the framework of the PREVENT (secondary prevention of schizophrenia) study, a JTC task was applied to 188 patients either fulfilling UHR criteria or presenting with cognitive basic symptoms (BS). Similar data were available for 30 healthy control participants matched for age, gender, education and premorbid verbal intelligence. ARMS patients were identified by the Structured Interview for Prodromal Symptoms (SIPS) and the Schizophrenia Proneness Instrument – Adult Version (SPI-A).
ResultsThe mean number of draws to decision (DTD) significantly differed between ARM -subgroups: UHR patients made significantly less draws to make a decision than ARMS patients with only cognitive BS. Furthermore, UHR patients tended to fulfil behavioural criteria for JTC more often than BS patients. In a secondary analysis, ARMS patients were much hastier in their decision-making than controls. In patients, DTD was moderately associated with positive and negative symptoms as well as disorganization and excitement.
ConclusionsOur data indicate an enhanced JTC bias in the UHR group compared to ARMS patients with only cognitive BS. This underscores the importance of reasoning deficits within cognitive theories of the developing psychosis. Interactions with the liability to psychotic transitions and therapeutic interventions should be unravelled in longitudinal studies.
Evolution of generic flight vehicle design synthesis
- B. Chudoba, W. Heinze
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- Journal:
- The Aeronautical Journal / Volume 114 / Issue 1159 / September 2010
- Published online by Cambridge University Press:
- 03 February 2016, pp. 549-567
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When defining a new product like an aircraft, space access vehicle or space mission, the Advanced Projects Group evaluates the available design space and compares it with the design space required to accomplish the specified mission. As with any product development process, the general life-cycle characteristics are established first during the conceptual design (CD) phase, clearly before a design proposal can be released to the follow-on design phases such as preliminary design (PD), detail design (DD), flight test (FT), and finally operation and disposal. As a rule of thumb, it can be assumed that around 80% of the flight vehicle configuration and mission tandem are determined during the CD phase alone, which is the key phase where the initial brainstorming has to take place. Clearly, it is the responsibility of the CD team to simulate the entire life-cycle of the project from ‘cradle to grave’ where the focus is on correctness rather accuracy in order to identify the design space and offer an overall proof of design convergence. Currently, the important primary aerospace vehicle and mission design decisions at CD level are still made using extremely simple analysis and heuristics. A reason for this scenario is the difficulty in synthesising the range of individual design disciplines for both, classical and novel aerospace vehicle conceptual designs, in more than an ad hoc fashion. Although the CD segment is seen as the most important step in the product development phase due to its pre-defining function, it is the least well understood part of the entire product evolution process due to its level of abstraction. This paper presents the roadmap towards the next generation of aerospace life-cycle synthesis systems, a software and management process capable to immediately calculate cost and time implications while simultaneously linking design, manufacturing, testing, and operation. A historical review of how design has been accomplished until today is presented. The design approaches are categorised and the characteristics of today’s state-of-the-art design synthesis systems are discussed. A specification for the new class of intelligent generic design synthesis systems is presented capable of satisfying the demands imposed by the new breed of high-performance aircraft, space access vehicles, space missions, and others. Finally, the development status of the next generation aerospace vehicle design synthesis (AVDS-PrADO) simulation-based acquisition environment is presented.
Contributors
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- By Mitchell Aboulafia, Frederick Adams, Marilyn McCord Adams, Robert M. Adams, Laird Addis, James W. Allard, David Allison, William P. Alston, Karl Ameriks, C. Anthony Anderson, David Leech Anderson, Lanier Anderson, Roger Ariew, David Armstrong, Denis G. Arnold, E. J. Ashworth, Margaret Atherton, Robin Attfield, Bruce Aune, Edward Wilson Averill, Jody Azzouni, Kent Bach, Andrew Bailey, Lynne Rudder Baker, Thomas R. Baldwin, Jon Barwise, George Bealer, William Bechtel, Lawrence C. Becker, Mark A. Bedau, Ernst Behler, José A. Benardete, Ermanno Bencivenga, Jan Berg, Michael Bergmann, Robert L. Bernasconi, Sven Bernecker, Bernard Berofsky, Rod Bertolet, Charles J. Beyer, Christian Beyer, Joseph Bien, Joseph Bien, Peg Birmingham, Ivan Boh, James Bohman, Daniel Bonevac, Laurence BonJour, William J. Bouwsma, Raymond D. Bradley, Myles Brand, Richard B. Brandt, Michael E. Bratman, Stephen E. Braude, Daniel Breazeale, Angela Breitenbach, Jason Bridges, David O. Brink, Gordon G. Brittan, Justin Broackes, Dan W. Brock, Aaron Bronfman, Jeffrey E. Brower, Bartosz Brozek, Anthony Brueckner, Jeffrey Bub, Lara Buchak, Otavio Bueno, Ann E. Bumpus, Robert W. Burch, John Burgess, Arthur W. Burks, Panayot Butchvarov, Robert E. Butts, Marina Bykova, Patrick Byrne, David Carr, Noël Carroll, Edward S. Casey, Victor Caston, Victor Caston, Albert Casullo, Robert L. Causey, Alan K. L. Chan, Ruth Chang, Deen K. Chatterjee, Andrew Chignell, Roderick M. Chisholm, Kelly J. Clark, E. J. Coffman, Robin Collins, Brian P. Copenhaver, John Corcoran, John Cottingham, Roger Crisp, Frederick J. Crosson, Antonio S. Cua, Phillip D. Cummins, Martin Curd, Adam Cureton, Andrew Cutrofello, Stephen Darwall, Paul Sheldon Davies, Wayne A. Davis, Timothy Joseph Day, Claudio de Almeida, Mario De Caro, Mario De Caro, John Deigh, C. F. Delaney, Daniel C. Dennett, Michael R. DePaul, Michael Detlefsen, Daniel Trent Devereux, Philip E. Devine, John M. Dillon, Martin C. Dillon, Robert DiSalle, Mary Domski, Alan Donagan, Paul Draper, Fred Dretske, Mircea Dumitru, Wilhelm Dupré, Gerald Dworkin, John Earman, Ellery Eells, Catherine Z. Elgin, Berent Enç, Ronald P. Endicott, Edward Erwin, John Etchemendy, C. Stephen Evans, Susan L. Feagin, Solomon Feferman, Richard Feldman, Arthur Fine, Maurice A. Finocchiaro, William FitzPatrick, Richard E. Flathman, Gvozden Flego, Richard Foley, Graeme Forbes, Rainer Forst, Malcolm R. Forster, Daniel Fouke, Patrick Francken, Samuel Freeman, Elizabeth Fricker, Miranda Fricker, Michael Friedman, Michael Fuerstein, Richard A. Fumerton, Alan Gabbey, Pieranna Garavaso, Daniel Garber, Jorge L. A. Garcia, Robert K. Garcia, Don Garrett, Philip Gasper, Gerald Gaus, Berys Gaut, Bernard Gert, Roger F. Gibson, Cody Gilmore, Carl Ginet, Alan H. Goldman, Alvin I. Goldman, Alfonso Gömez-Lobo, Lenn E. Goodman, Robert M. Gordon, Stefan Gosepath, Jorge J. E. Gracia, Daniel W. Graham, George A. Graham, Peter J. Graham, Richard E. Grandy, I. Grattan-Guinness, John Greco, Philip T. Grier, Nicholas Griffin, Nicholas Griffin, David A. Griffiths, Paul J. Griffiths, Stephen R. Grimm, Charles L. Griswold, Charles B. Guignon, Pete A. Y. Gunter, Dimitri Gutas, Gary Gutting, Paul Guyer, Kwame Gyekye, Oscar A. Haac, Raul Hakli, Raul Hakli, Michael Hallett, Edward C. Halper, Jean Hampton, R. James Hankinson, K. R. Hanley, Russell Hardin, Robert M. Harnish, William Harper, David Harrah, Kevin Hart, Ali Hasan, William Hasker, John Haugeland, Roger Hausheer, William Heald, Peter Heath, Richard Heck, John F. Heil, Vincent F. Hendricks, Stephen Hetherington, Francis Heylighen, Kathleen Marie Higgins, Risto Hilpinen, Harold T. Hodes, Joshua Hoffman, Alan Holland, Robert L. Holmes, Richard Holton, Brad W. Hooker, Terence E. Horgan, Tamara Horowitz, Paul Horwich, Vittorio Hösle, Paul Hoβfeld, Daniel Howard-Snyder, Frances Howard-Snyder, Anne Hudson, Deal W. Hudson, Carl A. Huffman, David L. Hull, Patricia Huntington, Thomas Hurka, Paul Hurley, Rosalind Hursthouse, Guillermo Hurtado, Ronald E. Hustwit, Sarah Hutton, Jonathan Jenkins Ichikawa, Harry A. Ide, David Ingram, Philip J. Ivanhoe, Alfred L. Ivry, Frank Jackson, Dale Jacquette, Joseph Jedwab, Richard Jeffrey, David Alan Johnson, Edward Johnson, Mark D. Jordan, Richard Joyce, Hwa Yol Jung, Robert Hillary Kane, Tomis Kapitan, Jacquelyn Ann K. Kegley, James A. Keller, Ralph Kennedy, Sergei Khoruzhii, Jaegwon Kim, Yersu Kim, Nathan L. King, Patricia Kitcher, Peter D. Klein, E. D. Klemke, Virginia Klenk, George L. Kline, Christian Klotz, Simo Knuuttila, Joseph J. Kockelmans, Konstantin Kolenda, Sebastian Tomasz Kołodziejczyk, Isaac Kramnick, Richard Kraut, Fred Kroon, Manfred Kuehn, Steven T. Kuhn, Henry E. Kyburg, John Lachs, Jennifer Lackey, Stephen E. Lahey, Andrea Lavazza, Thomas H. Leahey, Joo Heung Lee, Keith Lehrer, Dorothy Leland, Noah M. Lemos, Ernest LePore, Sarah-Jane Leslie, Isaac Levi, Andrew Levine, Alan E. Lewis, Daniel E. Little, Shu-hsien Liu, Shu-hsien Liu, Alan K. L. Chan, Brian Loar, Lawrence B. Lombard, John Longeway, Dominic McIver Lopes, Michael J. Loux, E. J. Lowe, Steven Luper, Eugene C. Luschei, William G. Lycan, David Lyons, David Macarthur, Danielle Macbeth, Scott MacDonald, Jacob L. Mackey, Louis H. Mackey, Penelope Mackie, Edward H. Madden, Penelope Maddy, G. B. Madison, Bernd Magnus, Pekka Mäkelä, Rudolf A. Makkreel, David Manley, William E. Mann (W.E.M.), Vladimir Marchenkov, Peter Markie, Jean-Pierre Marquis, Ausonio Marras, Mike W. Martin, A. P. Martinich, William L. McBride, David McCabe, Storrs McCall, Hugh J. McCann, Robert N. McCauley, John J. McDermott, Sarah McGrath, Ralph McInerny, Daniel J. McKaughan, Thomas McKay, Michael McKinsey, Brian P. McLaughlin, Ernan McMullin, Anthonie Meijers, Jack W. Meiland, William Jason Melanson, Alfred R. Mele, Joseph R. Mendola, Christopher Menzel, Michael J. Meyer, Christian B. Miller, David W. Miller, Peter Millican, Robert N. Minor, Phillip Mitsis, James A. Montmarquet, Michael S. Moore, Tim Moore, Benjamin Morison, Donald R. Morrison, Stephen J. Morse, Paul K. Moser, Alexander P. D. Mourelatos, Ian Mueller, James Bernard Murphy, Mark C. Murphy, Steven Nadler, Jan Narveson, Alan Nelson, Jerome Neu, Samuel Newlands, Kai Nielsen, Ilkka Niiniluoto, Carlos G. Noreña, Calvin G. Normore, David Fate Norton, Nikolaj Nottelmann, Donald Nute, David S. Oderberg, Steve Odin, Michael O’Rourke, Willard G. Oxtoby, Heinz Paetzold, George S. Pappas, Anthony J. Parel, Lydia Patton, R. P. Peerenboom, Francis Jeffry Pelletier, Adriaan T. Peperzak, Derk Pereboom, Jaroslav Peregrin, Glen Pettigrove, Philip Pettit, Edmund L. Pincoffs, Andrew Pinsent, Robert B. Pippin, Alvin Plantinga, Louis P. Pojman, Richard H. Popkin, John F. Post, Carl J. Posy, William J. Prior, Richard Purtill, Michael Quante, Philip L. Quinn, Philip L. Quinn, Elizabeth S. Radcliffe, Diana Raffman, Gerard Raulet, Stephen L. Read, Andrews Reath, Andrew Reisner, Nicholas Rescher, Henry S. Richardson, Robert C. Richardson, Thomas Ricketts, Wayne D. Riggs, Mark Roberts, Robert C. Roberts, Luke Robinson, Alexander Rosenberg, Gary Rosenkranz, Bernice Glatzer Rosenthal, Adina L. Roskies, William L. Rowe, T. M. Rudavsky, Michael Ruse, Bruce Russell, Lilly-Marlene Russow, Dan Ryder, R. M. Sainsbury, Joseph Salerno, Nathan Salmon, Wesley C. Salmon, Constantine Sandis, David H. Sanford, Marco Santambrogio, David Sapire, Ruth A. Saunders, Geoffrey Sayre-McCord, Charles Sayward, James P. Scanlan, Richard Schacht, Tamar Schapiro, Frederick F. Schmitt, Jerome B. Schneewind, Calvin O. Schrag, Alan D. Schrift, George F. Schumm, Jean-Loup Seban, David N. Sedley, Kenneth Seeskin, Krister Segerberg, Charlene Haddock Seigfried, Dennis M. Senchuk, James F. Sennett, William Lad Sessions, Stewart Shapiro, Tommie Shelby, Donald W. Sherburne, Christopher Shields, Roger A. Shiner, Sydney Shoemaker, Robert K. Shope, Kwong-loi Shun, Wilfried Sieg, A. John Simmons, Robert L. Simon, Marcus G. Singer, Georgette Sinkler, Walter Sinnott-Armstrong, Matti T. Sintonen, Lawrence Sklar, Brian Skyrms, Robert C. Sleigh, Michael Anthony Slote, Hans Sluga, Barry Smith, Michael Smith, Robin Smith, Robert Sokolowski, Robert C. Solomon, Marta Soniewicka, Philip Soper, Ernest Sosa, Nicholas Southwood, Paul Vincent Spade, T. L. S. Sprigge, Eric O. Springsted, George J. Stack, Rebecca Stangl, Jason Stanley, Florian Steinberger, Sören Stenlund, Christopher Stephens, James P. Sterba, Josef Stern, Matthias Steup, M. A. Stewart, Leopold Stubenberg, Edith Dudley Sulla, Frederick Suppe, Jere Paul Surber, David George Sussman, Sigrún Svavarsdóttir, Zeno G. Swijtink, Richard Swinburne, Charles C. Taliaferro, Robert B. Talisse, John Tasioulas, Paul Teller, Larry S. Temkin, Mark Textor, H. S. Thayer, Peter Thielke, Alan Thomas, Amie L. Thomasson, Katherine Thomson-Jones, Joshua C. Thurow, Vzalerie Tiberius, Terrence N. Tice, Paul Tidman, Mark C. Timmons, William Tolhurst, James E. Tomberlin, Rosemarie Tong, Lawrence Torcello, Kelly Trogdon, J. D. Trout, Robert E. Tully, Raimo Tuomela, John Turri, Martin M. Tweedale, Thomas Uebel, Jennifer Uleman, James Van Cleve, Harry van der Linden, Peter van Inwagen, Bryan W. Van Norden, René van Woudenberg, Donald Phillip Verene, Samantha Vice, Thomas Vinci, Donald Wayne Viney, Barbara Von Eckardt, Peter B. M. Vranas, Steven J. Wagner, William J. Wainwright, Paul E. Walker, Robert E. Wall, Craig Walton, Douglas Walton, Eric Watkins, Richard A. Watson, Michael V. Wedin, Rudolph H. Weingartner, Paul Weirich, Paul J. Weithman, Carl Wellman, Howard Wettstein, Samuel C. Wheeler, Stephen A. White, Jennifer Whiting, Edward R. Wierenga, Michael Williams, Fred Wilson, W. Kent Wilson, Kenneth P. Winkler, John F. Wippel, Jan Woleński, Allan B. Wolter, Nicholas P. Wolterstorff, Rega Wood, W. Jay Wood, Paul Woodruff, Alison Wylie, Gideon Yaffe, Takashi Yagisawa, Yutaka Yamamoto, Keith E. Yandell, Xiaomei Yang, Dean Zimmerman, Günter Zoller, Catherine Zuckert, Michael Zuckert, Jack A. Zupko (J.A.Z.)
- Edited by Robert Audi, University of Notre Dame, Indiana
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- The Cambridge Dictionary of Philosophy
- Published online:
- 05 August 2015
- Print publication:
- 27 April 2015, pp ix-xxx
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