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This paper addresses the generality problem arising for the use of spatial figures in geometry by emphasizing Kant’s notion of the schema of a geometrical concept (in contrast to an individual figure falling under that concept). It then relates this notion of schema to space as a form of intuition by connecting geometrical constructions (examples of Kantian schemata) with the possible perspectives of the perceiving subject within space as the form of outer intuition. And it uses this relationship between geometrical schemata and what I thus call "perceptual space" (the form of outer intuition) to develop a new interpretation of the relationship between the understanding and sensibility in section 26 of the Transcendental Deduction. The result is a reading of Kant on space and geometry that shows how geometrical, perceptual, and physical space are necessarily related to one another.
In patients with β-lactam allergies, administration of non–β-lactam surgical prophylaxis is associated with increased risk of infection. Although many patients self-report β-lactam allergies, most are unconfirmed or mislabeled. A quality improvement process, utilizing a structured β-lactam allergy tool, was implemented to improve the utilization of preferred β-lactam surgical prophylaxis.
Immune system markers may predict affective disorder treatment response, but whether an overall immune system marker predicts bipolar disorder treatment effect is unclear.
Bipolar CHOICE (N = 482) and LiTMUS (N = 283) were similar comparative effectiveness trials treating patients with bipolar disorder for 24 weeks with four different treatment arms (standard-dose lithium, quetiapine, moderate-dose lithium plus optimised personalised treatment (OPT) and OPT without lithium). We performed secondary mixed effects linear regression analyses adjusted for age, gender, smoking and body mass index to investigate relationships between pre-treatment white blood cell (WBC) levels and clinical global impression scale (CGI) response.
Compared to participants with WBC counts of 4.5–10 × 109/l, participants with WBC < 4.5 or WBC ≥ 10 showed similar improvement within each specific treatment arm and in gender-stratified analyses.
An overall immune system marker did not predict differential treatment response to four different treatment approaches for bipolar disorder all lasting 24 weeks.
This chapter recommends a broad range of public policy changes to promote increased life expectancy and quality of life among older adults with schizophrenia and other serious, long-term psychotic conditions. Needed changes include: (1) comprehensive efforts to reduce the mortality gap, (2) securing the future of the Social Security Trust Fund, (3) expanded community housing and non-institutional residential care, (4) expanded capacity to provide high-quality, integrated behavioral health and medical services, as well as recovery-oriented psychosocial interventions, (5) restructuring Medicaid and Medicare to assure funding is available for psychosocial interventions - especially housing, outreach and engagement, off-site services, rehabilitation, case management, and family support - as well as for traditional treatment interventions, (6) addressing problems of capacity and quality among service providers including the VA, (7) enhancing public education and anti-stigma campaigns, (8) addressing workforce inadequacies in both size and competence, (9) increasing and diversifying research to emphasize improving services and translating evidence-based practices into reality, and (10) enhancing coordination and geriatric mental health leadership of federal and state agencies and other systems that serve this population.
The Permo-Carboniferous eurynotiforms show conspicuous modifications to postcranial and cranial morphology relative to primitive actinopterygian conditions, and represent an important early example of functional experimentation within ray-finned fishes. Although eurynotiforms are represented by abundant articulated fossil material, the internal anatomy of the group is not well known. Microcomputed tomography (μCT) of Eurynotus crenatus from the early Carboniferous (Viséan) Wardie Shales Member of the Gullane Formation of Wardie, Scotland provides detailed information on the jaws, palate and dentition. The lower jaw is deep and bears a well-developed convex dental plate on the prearticular/coronoids. The dentary bears a dorsally directed posterior process and lacks any obvious marginal dentition. The prearticular bears a low coronoid process. Apart from the first and second dermopalatines, and a likely accessory vomer, bones of the palate are tightly sutured or fused. The upper dental plate comprises a longitudinal, concave horizontal dental surface that occludes with the convex lower toothplate, and a more vertical region consisting of anastomosing ridges. The parasphenoid has a narrow anterior corpus and a broad posterior stalk that bears a pronounced midline notch. The smooth, irregularly punctated surfaces of the dental plates are formed by closely packed teeth with conjoined crowns, providing clues to the evolution of the more monolithic toothplates of Amphicentrum from the peg-like teeth reported in the earliest and most anatomically generalised eurynotiforms. The feeding apparatus shows many qualitative and quantitative features consistent with the processing of hard prey items. Eurynotus and its relatives show the first clear example of jaw and dental structures consistent with durophagy among actinopterygians. The origin of the group in the early Carboniferous is suggestive of diversification into newly available ecological roles in the aftermath of the end-Devonian extinction.
Immunological theories, particularly the sickness syndrome theory, may explain psychopathology in mood disorders. However, no clinical trials have investigated the association between overall immune system markers with a wide range of specific symptoms including potential gender differences.
We included two similar clinical trials, the lithium treatment moderate-dose use study and clinical and health outcomes initiatives in comparative effectiveness for bipolar disorder study, enrolling 765 participants with bipolar disorder. At study entry, white blood cell (WBC) count was measured and psychopathology assessed with the Montgomery and Aasberg depression rating scale (MADRS). We performed analysis of variance and linear regression analyses to investigate the relationship between the deviation from the median WBC, and multinomial regression analysis between different WBC levels. All analyses were performed gender-specific and adjusted for age, body mass index, smoking, race, and somatic diseases.
The overall MADRS score increased significantly for each 1.0×109/l deviation from the median WBC among 322 men (coefficient=1.10; 95% CI=0.32–1.89; p=0.006), but not among 443 women (coefficient=0.56; 95% CI=−0.19–1.31; p=0.14). Among men, WBC deviations were associated with increased severity of sadness, inner tension, reduced sleep, reduced appetite, concentration difficulties, inability to feel, and suicidal thoughts. Among women, WBC deviations were associated with increased severity of reduced appetite, concentration difficulties, lassitude, inability to feel, and pessimistic thoughts. Both higher and lower WBC levels were associated with increased severity of several specific symptoms.
Immune system alterations were associated with increased severity of specific mood symptoms, particularly among men. Our results support the sickness syndrome theory, but furthermore emphasise the relevance to study immune suppression in bipolar disorder. Due to the explorative nature and cross-sectional design, future studies need to confirm these findings.
A wide range of diseases can present to the ED with headache as the major or only symptom. Infectious diseases, inflammatory diseases, autoimmune diseases, and malignancy can cause headache. Processes that raise or lower intracranial pressure can also result in headache. In this chapter, we discuss the epidemiology, pathophysiology, diagnosis, and treatment of other secondary headaches including brain tumor headache, post-traumatic headache, high- and low-pressure headache, cervicogenic headache, trigeminal neuralgia, and headaches attributed to infection, Chiari malformation, arteritis, disorders of the eye, substances or withdrawal headache, and autonomic dysreflexia. In this chapter we also discuss primary (idiopathic) stabbing headache.
Critical to the development of improved HIV elimination efforts is a greater understanding of how social networks and their dynamics are related to HIV risk and prevention. In this paper, we examine network stability of confidant and sexual networks among young black men who have sex with men (YBMSM). We use data from uConnect (2013–2016), a population-based, longitudinal cohort study. We use an innovative approach to measure both sexual and confidant network stability at three time points, and examine the relationship between each type of stability and HIV risk and prevention behaviors. This approach is consistent with a co-evolutionary perspective in which behavior is not only affected by static properties of an individual's network, but may also be associated with changes in the topology of his or her egocentric network. Our results indicate that although confidant and sexual network stability are moderately correlated, their dynamics are distinct with different predictors and differing associations with behavior. Both types of stability are associated with lower rates of risk behaviors, and both are reduced among those who have spent time in jail. Public health awareness and engagement with both types of networks may provide new opportunities for HIV prevention interventions.
Helmet use among bike-share users is low. We sought to characterize helmet-use patterns, barriers to helmet use, and cycling safety practices among bike-share users in Toronto.
A standardized survey of public bike-share program (PBSP) users at semi-random distribution of PBSP stations was undertaken. By maintaining a ratio of one helmet-wearer (HW): two non-helmet-wearers (NHW) per survey period, we controlled for location, day, time, and weather.
Surveys were completed on 545 (180 HW, 365 NHW) unique users at 48/80 PBSP locations, from November 2012 to August 2013. More females wore helmets (F: 41.1%, M: 30.9%, p=0.0423). NHWs were slightly younger than HWs (NHW mean age 34.4 years vs HW 37.3, p=0.0018). The groups did not differ by employment status, education, or income.
Helmet ownership was lower among NHWs (NHW: 62.4% vs HW: 99.4%, p<0.0001), as was personal bike ownership (NHW: 65.8%, vs HW: 78.3%, p=0.0026). NHWs were less likely to always wear a helmet on personal bikes (NHW: 22.2% vs HW: 66.7%, p<0.0001), and less likely to wear a helmet always or most of the time on PBSP (NHW: 5.8% vs HW: 92.3%, p<0.0001). Both groups, but more HWs, had planned to use PBSP when leaving their houses (HW: 97.2% vs NHW: 85.2%, p<0.0001), primarily to get to work (HW: 88.3% vs NHW: 84.1%, p=0.19). NHWs were more likely to report that they would wear a helmet more (NHW: 61.4% vs HW: 13.9%, p<0.0001), and/or cycle less (NHW: 22.5% vs HW: 4.4%) if helmet use was mandatory.
PBSP users surveyed appear to make deliberate decisions regarding helmet use. NHWs tended to be male, slightly younger, and less likely to use helmets on their personal bikes. As Toronto cyclists who do not wear helmets on PBSP generally do not wear helmets on their personal bikes, interventions to increase helmet use should target both personal and bike-share users. Legislating helmet use and provision of rental helmets could improve helmet use among bike-share users, but our results suggest some risk of reduced cycling with legislation.
The project of transcendental philosophy, as originally conceived by Kant, essentially involved an explanation of how purely intellectual concepts can necessarily apply to our (human) sense experience of the natural world. Kant's project also involved an explanation of how pure mathematical concepts can necessarily apply to this same experience, where such an explanation is conceived in a distinctive way. The pure intellect, for Kant, is modelled on the Leibnizian conception of logic, whereas the faculty of pure sensibility is modelled on the Newtonian conception of space and time. Mathematics then necessarily applies to our sense experience in so far as the pure forms of our sensibility – space and time – are themselves the primary sources of pure mathematical knowledge. However, this does not yet show that all natural objects presented to us within these forms of sensibility are also necessarily subject to both pure mathematics and the pure concepts of the understanding; and it is precisely this, for Kant, which is shown in the Transcendental Deduction by demonstrating that there is a necessary harmony or interdependence between the pure intellect, on the one side, and both pure and empirical intuition, on the other. It is only this necessary harmony between two initially independent faculties that fully explains how synthetic a priori knowledge is possible, for Kant, and, in particular, how mathematical natural science (Newtonian physics) is possible.
Yet a rejection of Kant's sharp separation of the faculties of the mind into understanding and sensibility is characteristic of post-Kantian German idealism – as well as of the Marburg School of neo-Kantianism founded by Hermann Cohen and developed, especially, by Ernst Cassirer. This was part and parcel, as is well known, of a more general effort to overcome all of Kant's most fundamental dichotomies or ‘dualisms’, including the notorious dichotomy between phenomena and noumena. How this effort is implicated in the ongoing attempts to revise Kant's philosophy of natural science in the light of the revolutionary new developments in the sciences themselves throughout the nineteenth and the early twentieth centuries is the main topic of this essay.