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Are there limits to the ability of Spinoza’s philosophy to speak to our present? Perhaps his notion of ‘the mind of God’ is too foreign for contemporary sensibilities to contemplate? After offering...

This paper forms part of a larger project which seeks to derive a theory of art from a close reading of Spinoza's work. It focuses on the importance of the aligned terms of ingenium and dispositio,...

In the Preface to Part Four of the Ethics, Spinoza offers the reader an exemplar of human nature. However, Spinoza does not conceive of human nature as a universal in which each human being partici...

Background: Poor balance, lack of neuromuscular control, and movement ability are predictors of performance and injury risk in\ud sports and physical activity participation. The Functional Movement Screen™ (FMS™) and lower quarter Y-Balance Test (YBT) have\ud been used by clinicians to evaluate balance, functional symmetry, and static and dynamic movement patterns, yet little information exists regarding the relationship between the FMS™, YBT, and physical performance tests (e.g. vertical jump) within the high\ud school population.\ud Purpose: The purpose of this study was to investigate the relationship between the FMSTM, dynamic balance as measured by the\ud YBT and physical performance tests (standing long jump, vertical jump, Pro Agility Test) in male and female high school\ud athletes.\ud Study Design: Cohort study.\ud Methods: Fifty-six high school athletes (28 females, 28 males; mean age 16.4 ± 0.1) who participated in organized team sports were\ud tested. Participants performed the FMS™, YBT, and three physical performance tests (standing long jump, vertical jump, Pro Agility\ud Test).\ud Results: Females outperformed males on the FMS™ and YBT, while males outperformed females on the performance tests. In both\ud sexes, the composite FMSTM score was positively correlated with the left and composite YBT scores. Agility was negatively correlated with composite FMSTM in males (p < 0.05) and the left and composite YBT in females (p < 0.05).\ud Conclusions: The FMST M and YBT may evaluate similar underlying constructs in high school athletes, such as dynamic balance\ud and lower extremity power. The results of this study demonstrate the utility of the FMS and YBT to relate multiple constructs of\ud muscular power to an individual’s ability to balance. Furthermore, establishing the need for the utilization and application of\ud multiple field-based tests by sports medicine professionals and strength and conditioning coaches when evaluating an athlete’s\ud movement and physical performance capabilities. Utilization of multiple field-based tests may provide the first step for the development of injury prevention strategies and long-term athlete development programs.

Lyme disease, caused primarily in North America by the bacterium Borrelia burgdorferi sensu stricto, is the most frequently reported vector-borne disease in North America and its geographic extent is increasing in all directions from foci in the northeastern and north central United States. Several southeastern states, including Virginia and North Carolina, have experienced large increases in Lyme disease incidence in the past two decades, with the biggest changes in incidence occurring in the western portion of each state. We tested the hypothesis that B. burgdorferi s.s. was present in western Virginia and North Carolina Peromyscus leucopus populations prior to the recent emergence of Lyme disease. Specifically, we examined archived P. leucopus museum specimens, sampled between 1900 and 2000, for B. burgdorferi s.s. DNA. After confirming viability of DNA extracted from ear punch biopsies from P. leucopus study skins collected between 1945 and 2000 in 19 Virginia counties and 17 North Carolina counties, we used qPCR of two species-specific loci to test for the presence of B. burgdorferi s.s. DNA. Ten mice, all collected from the Eastern Shore of Virginia in 1989, tested positive for presence of B. burgdorferi; all of the remaining 344 specimens were B. burgdorferi-negative. Our results suggest that B. burgdorferi s.s was not common in western Virginia or North Carolina prior to the emergence of Lyme disease cases in the past two decades. Rather, the emergence of Lyme disease in this region has likely been driven by the relatively recent expansion of B. burgdorferi s.s. in southward-moving ticks and reservoir hosts in the mountainous counties of these two states.

Benedict Spinoza (1632–1677) is often characterised in the history of philosophy as the rationalist philosopher par excellence. However, much contemporary critical interpretation of his thought has...

This paper explores the relationship between honour and recognition in the context of normative heterosexuality, and the implications of this relationship for sustaining and transforming problemati...

The idea that social and political institutions can be designed in order to achieve specific human ends goes back, at least, to Plato’s presentation of the appropriate form of the just city-state i...

Background The complex clinical presentation and progression of Lennox–Gastaut syndrome (LGS) can complicate the accurate diagnosis of this severe, lifelong, childhood-onset epilepsy, often resulting in suboptimal treatment. The Refractory Epilepsy Screening Tool for LGS (REST-LGS) was developed to improve the identification of patients with LGS. Methods Using the Modified Delphi Consensus, a group of experts developed and tested the REST-LGS Case Report Form (CRF) comprising 8 criteria (4 major, 4 minor) considered potentially indicative of LGS. Diagnosis-blinded specialist and nonspecialist raters at 2 epilepsy centers applied the CRF to deidentified patient records, including 1:1 records of patients with drug-resistant epilepsy or confirmed LGS. Interrater reliability was measured by Cohen's κ. Diagnosis was then unblinded to reveal common criteria for LGS or drug-resistant epilepsy. Cronbach's α was used to measure internal consistency between raters for all criteria combined. Results Of 200 patients, 81% to 85% met 1 to 3 major criteria. At both sites, moderate (κ, 0.41–0.60) to good (κ, 0.61–0.80) agreement on most criteria was reached between expert and nonexpert raters. Unblinding revealed that most patients with LGS met 3 major and 2 to 3 minor criteria, while patients with drug-resistant epilepsy met ≤ 1 major and only 1 to 2 minor criteria. Cronbach's α of raters at both sites was 0.64. Conclusions The combined number of major/minor criteria on the CRF may be particularly indicative of LGS. Therefore, the REST-LGS may be a valuable clinical tool in identifying patients requiring further diagnostic evaluation for LGS.

A robust and competitive low-Earth orbit (LEO) economy is vital to continued progress in space. The United States is committed to encouraging and facilitating the growth of the U.S. commercial space sector that supports U.S. needs, is globally competitive, and advances U.S. leadership in the next generation of new markets and innovation-driven entrepreneurship. NASA has developed a long-term vision to achieve this goal where, one day, NASA will become one of many customers in low-Earth orbit. The plan was publicly unveiled on June 7, 2019 at Nasdaq in New York. This plan builds on, uses the capabilities of, and applies the lessons learned from over a decade of work and experience with commercial companies. This plan, entitled NASA's Plan for Commercial LEO Development [1], addresses how NASA will partner with industry to bolster supply of commercial LEO destinations, stimulate demand for new and emerging markets in LEO, and lays out near-term steps to achieve a robust economy in LEO. In the near term, NASA developed and is implementing a five-point plan building on the work of the last two decades. 1)NASA established a commercial use and pricing policy for the International Space Station (ISS) that will enable companies to reduce uncertainty and build business plans as they seek to perform commercial activities, including marketing; 2)NASA has announced the intent to enable flight of private astronauts to the ISS with the first mission as early as 2020, including a solicitation as a mechanism to enable the assessment and approval of these missions; 3)NASA has initiated a process for developing commercial low-Earth orbit destinations, including the overall strategy, timeline, and solicitations for developing commercial destinations using the ISS Node 2 Forward Port, and free-flyer destinations; 4)NASA has laid out a plan to pursue opportunities to stimulate scalable and sustainable demand for LEO destinations including solicitations with calls for in-space manufacturing and regenerative medicine flight demonstrations, as well efforts to expand the pipeline of potential users and seeking innovative approaches to broadly stimulate demand; 5)NASA has updated a white paper quantifying the agency's long-term needs in LEO. This paper provides an overview of NASA's plan and longterm vision for development of the LEO economy, and provides a summary of progress being made in each of the five areas of the plan.

Contains fulltext : 216835pub.pdf (Publisher’s version ) (Closed access) Verbal fluency is commonly used to evaluate cognitive dysfunction in a variety of neuropsychiatric diseases, yet the neurobiology underlying performance of this task is incompletely understood. Electrocorticography (ECoG) provides a unique opportunity to investigate temporal activation patterns during cognitive tasks with high spatial and temporal precision. We used ECoG to study high gamma activity (HGA) patterns in patients undergoing presurgical evaluation for intractable epilepsy as they completed an overt, free-recall verbal fluency task. We examined regions demonstrating changes in HGA during specific timeframes relative to speech onset. Early pre-speech high gamma activity was present in left frontal regions during letter fluency and in bifrontal regions during category fluency. During timeframes typically associated with word planning, a distributed network was engaged including left inferior frontal, orbitofrontal and posterior temporal regions. Peri-Rolandic activation was observed during speech onset, and there was post-speech activation in the bilateral posterior superior temporal regions. Based on these observations in the context of prior studies, we propose a model of neocortical activity patterns underlying verbal fluency. 13 p.

It is common practice for athletes to treat their aches and pain after training with cold-water immersion. The purpose of this study is to determine if cold-water immersion affects an athlete’s postexercise recovery on muscle performance or pain perception. Twenty-two subjects were assessed on measures of pain and muscle performance tests and then randomly assigned to a cryotherapy or control group after performing plyometric exercises. Cryotherapy resulted in substantially less perception of pain 24 hr postexercise compared with the control, however, muscle performance was not substantially effected. Our results demonstrate that cryotherapy may be beneficial for reducing postexercise pain perception.

Objective To examine and describe normative values for an objective, mobile measure of postural stability commonly used in concussion assessments, SWAY Balance (SWAY Medical, Tulsa, Oklahoma). Design Retrospective analysis of baseline balance assessments in a healthy pediatric population. Setting Baseline assessments completed by certified athletic trainers at an outpatient concussion center or sports medicine offices in Philadelphia, PA and surrounding suburban Pennsylvania and New Jersey or during an athletic trainer's baseline assessment of collegiate athletes at a National Collegiate Athletic Association (NCAA) Division-II University in Fort Lauderdale, FL. Participants Test results of a sample of 466 athletes aged 5 to 18 years were included. Interventions The SWAY Balance test was administered using a mobile device on all participants as part of a standard preseason, baseline evaluation, following the standard evaluation protocol. Main outcome measures Baseline SWAY Balance mobile assessment balance and reaction time scores, age and sex effects, were examined. Results Normative scores are described, with results stratified into 4 age groups (5-9, 10-12, 13-17, and 18 years old). Balance scores, overall and within each individual stance score, improved with the age of the participants. Sex effects on balance were only seen in single-leg stances, with females outperforming males. Reaction time was found to be faster in males and improved with age, peaking at 13 to 17 years old and slowing in 18-year-olds. Conclusions Normative, age-specific SWAY Balance test results provided are of clinical use as references in the concussion assessments of pediatric athletes.

This paper reads Mary Shelley’s novel, Frankenstein, through the lens of three themes in Spinoza’s philosophy. First, the bondage of the passions; second, the importance of the imitation of affects...

Did George Eliot’s work as translator of the critical writings on religion of Ludwig Feuerbach and Benedict Spinoza influence her work as a novelist? Did she hold a comprehensive philosophy of religion? Through an examination of her non-fictional and fictional writings this chapter argues that we should take seriously Eliot’s claim that her novels are ‘experiments in life’. Building on the critiques of religion offered by Spinoza and Feuerbach, Eliot’s novels address the philosophical question: is morality possible in a godless world? The capacities necessary to a moral life are imagination, sympathy, and reflection. Her fiction contributes to the reformation of moral consciousness by experimenting with the interplay between these capacities.

Background and Purpose: Nurses’ attitudes play an important role in the consistent practice of safe patient handling behaviors. The purposes of this study were to develop and assess the psychometric properties of a newly developed instrument measuring attitudes of nurses related to the care and safe handling of patients who are obese. Methods: Phases of instrument development included (a) item generation, (b) content validity assessment, (c) reliability assessment, (d) cognitive interviewing, and (e) construct validity assessment through factor analysis. Results: The final data from the exploratory factor analysis produced a 26-item multidimensional instrument that contains 9 subscales. Conclusions: Based on the factor analysis, a 26-item instrument can be used to examine nurses’ attitudes regarding patients who are morbidly obese and related safe handling practices.

Purpose The pilot study purpose was to determine the effects of a new standardized oral care protocol (intervention) to usual care practices (control) in poststroke patients. Design This study is a randomized controlled clinical trial. Method Fifty-one subjects were enrolled. Subjects in the intervention group received oral care twice a day including tooth brushing, tongue brushing, flossing, mouth rinse, and lip care while control patients received usual oral care. Findings Subjects in the control and intervention groups showed improvement in their oral health assessments, swallowing abilities and oral intake. There were no significant differences between the two groups. Although not statistically significant, overall prevalence of methicillin-resistant Staphylococcus aureus and methicillin-sensitiveStaphylococcus aureus colonization in the control group almost doubled (from 4.8% to 9.5%), while colonization in the intervention group decreased (from 20.8% to 16.7%). Conclusions/Clinical Relevance These findings demonstrate the importance of oral care in the poststroke patient with dysphagia.

Module extraction is the task of computing, given a description logic ontology and a signature ∑ of interest, a subset (called a module) such that for certain applications that only concern ∑ the ontology can be equivalently replaced by the module. In most applications of module extraction it is desirable to compute a module which is as small as possible, and where possible a minimal one. In logic-based approaches to module extraction the most popular way to define modules is using inseparability relations, the strongest and most robust notion of this being model ∑-inseparability, where two ontologies are called ∑-inseparable iff the ∑-reducts of their models coincide. Then, a ∑-module is defined as a ∑-inseparable subset of the ontology. Unfortunately deciding if a subset of an ontology is a minimal ∑-module, over ontologies formulated in even moderately expressive logics, is of perpetually high complexity and often undecidable, and for this reason approximation algorithms are required. Instead of computing a minimal ∑-module one computes some ∑-module and the main research task is to minimise the size of these modules --- to compute an approximation of a minimal ∑-module. This thesis considers research surrounding approximations based on the model ∑-inseparability relation including: improving and extending existing approximation algorithms, providing a highly-optimised implementations, and the introduction a new methodology to evaluate just how well approximations approximate minimal modules, all supported by a significant empirical investigation.

Through a critical reading of Maxine Hong Kingston’s novel, Woman Warrior, this paper addresses Amy Allen’s criticism that Seyla Benhabib’s conception of narrative agency involves the idea of a gender-neutral core self. Allen’s criticism of Benhabib is found wanting and the notion of an ungendered self is judged incoherent. Rather, gender is one of a number of markers at work in the open-ended narrative construction of identity.

With the extension of the International Space Station (ISS) operations until at least 2024, NASA and its partners have the opportunity to leverage the orbiting laboratory to conduct research and validate systems in microgravity that will better prepare humans and systems for future missions, farther into deep space. Beyond 2024, it is vitally important to ensure that the infrastructure and capabilities that have been developed over the past three decades in low Earth orbit (LEO) do not languish, and in fact are used to enable sustainable commercial activity in LEO beyond the ISS. This paper will explore the opportunities and challenges in developing the commercial market in LEO through the ISS program while at the same time continuing to use the ISS as a testbed to enable human missions into deep space. System and technology capability gaps requiring demonstrations on the ISS will be discussed in detail. NASA's strategic plan for leveraging the ISS to enable commercial markets and stimulate commercial supply of LEO services will be summarized, along with initial steps and progress. The intersection between NASA's needs beyond LEO and commercial LEO platforms will be explored. Finally, the paper will discuss preliminary measures that will indicate when a transition from ISS to the Proving Ground is appropriate.

Spinoza took it to be an important psychological fact that belief cannot be compelled. At the same time, he was well aware of the compelling power that religious and political fictions can have on the formation of our beliefs. I argue that Spinoza allows that there are ‘good’ and ‘bad’ fictions. His complex account of the imagination and fiction, and their disabling or enabling roles in gaining knowledge of Nature, is a site of disagreement among commentators. The novels of George Eliot (who translated Spinoza's works) represent a significant development for those who aim to resolve such disagreement in favour of the epistemic value of the imagination and fiction. Although Eliot agreed with Spinoza that belief cannot be compelled, she nevertheless affirmed the potential of certain kinds of fiction to be not only compelling but also edifying. The parallel reading of Eliot and Spinoza offered here raises the question of whether his philosophy can accommodate a theory of art in which the artist is seen to be capable of attaining and imparting dependable knowledge.

Objectif Le traitement des anevrysmes de l’aorte thoraco-abdominale (AATA) est un challenge technique. L’essor du traitement endovasculaire des anevrysmes combine avec la realisation de pontages vers les arteres digestives ou renales a permis la realisation d’un traitement hybride endovasculaire de ces anevrysmes. Le but de cette etude etait d’evaluer la maniere dont le nombre de reconstructions d’arteres digestives ou renales, les materiaux ou le sexe modifiaient les resultats. Methodes Tous les patients ayant l’association d’un pontage destine aux arteres digestives et renales et du traitement endovasculaire d’un anevrysme aortique ont ete etudies prospectivement dans un registre vasculaire et revus retrospectivement entre les annees 2004 et 2009. Les patients ayant le traitement conventionnel ouvert d’un AATA et ceux ayant une reconstruction des troncs supra aortiques associee a une exclusion endovasculaire d’un anevrysme thoracique ont ete exclus de cette analyse. Les patients ont ete divises en deux groupes bases sur le nombre de vaisseaux pontes. Le groupe 1 ( n = 9) comprenait des patients necessitant un ou deux pontages tandis que le groupe 2 ( n = 15) comprenait les patients necessitant trois ou quatre pontages. Resultats Un total de 64 AATA a ete traite. Vingt-deux patients ayant un traitement hybride avec reconstruction des troncs supra aortiques et 18 patients ayant un traitement conventionnel d’un AATA ont ete exclus de cette analyse. Un total de 24 (38%) patients ayant un traitement endovasculaire hybride a ete evalue dans cette etude. La mortalite a 30 jours etait de 12,5% (3/24) et l’incidence de complications medullaires etait de 8,3% (2/24). Les comorbidites pre operatoires et les scores de l’American Society of Anesthesia (ASA) etaient identiques dans les deux groupes. Compares au groupe 2, les patients du groupe 1 etaient plus jeunes (69,7 ± 10,6 vs. 76,0 ± 5,7 ans [ p = 0,074]), avaient des pertes sanguines moindres (1200 ± 1088 mL vs. 3119 ± 2188 mL, [ p = 0,06]), necessitaient moins de transfusions sanguines (5,33 ± 2,31 vs. 9,09 ± 7,06 culots globulaires (CG) [ p = 0,39]) et avaient une duree de sejour plus courte (11,4 ± 5,6 vs. 21,9 ± 15,1 jours, [ p = 0,090]). Il n’y a pas eu de difference concernant les taux de mortalite a 30 jours entre les deux groupes. Les taux de morbidite peri operatoire incluant l’ischemie intestinale (11%[1/9] vs. 27% [4/15], [ p = 0,39]), l’infarctus du myocarde (11% [1/9] vs. 13% [2/15], [ p = 0,88]), l’infection de plaie operatoire (0% vs. 27% [4/15], [ p = 0,09]) et de pneumopathie (11% [1/9] vs. 40% [6/15], [ p = 0,14]) etaient plus faibles dans le groupe 1 que dans le groupe 2, mais ces differences n’etaient pas significatives. Les patients ayant trois ou quatre pontages necessitaient significativement davantage de soins infirmiers ou de transfert en unite de rehabilitation a la sortie (79% [11/14] vs. 29% [2/7], p = 0,026). Il n’y a pas eu de difference statistiquement significative de resultats en fonction du type de materiau choisi (autogene ou prothetique) ou le sexe. Les resultats d’une reduction proportionnelle de Cox ont montre que l’ischemie intestinale etait la seule complication post operatoire associee a une diminution de la survie ( p = 0,037, intervalle de confiance [0,1328-4,3075]). Conclusions Le traitement hybride des anevrysmes aortiques comporte un risque significatif de morbidite mais une mortalite acceptable chez des patients consideres comme etant a haut risque pour le traitement conventionnel de l’anevrysme thoraco-abdominal. Il existe une tendance a un plus faible taux de complications post operatoires et a une reduction de la duree de sejour chez les patients necessitant un nombre plus faible de reconstruction des arteres digestives ou renales. De plus, la necessite de soins infirmiers apres la sortie de l’hopital est significativement diminuee. L’ischemie intestinale est associee avec un pronostic significativement plus pejoratif qui justifie de plus grands efforts destines a eviter cette complication et son traitement agressif.

Background Thoracoabdominal aortic aneurysm (TAAA) repairs are technically challenging. The advent of endovascular aneurysm repair in combination with visceral/renal artery bypasses has allowed for hybrid endovascular repair of these aneurysms. The purpose of this study was to evaluate whether outcomes were affected by the number of visceral/renal artery reconstructions, conduit, or gender. Methods All patients who underwent visceral/renal bypass associated with an endovascular aortic aneurysm repair were prospectively studied in a vascular registry and retrospectively reviewed between the years 2004 and 2009. Patients undergoing standard open TAAA repair and those with aortic arch branch vessel reconstructions associated with thoracic endovascular repair were excluded from this analysis. Patients were segregated into two groups on the basis of number of vessels bypassed. Group 1 ( n = 9) consisted of patients who required one or two bypasses, whereas group 2 ( n = 15) consisted of patients who required three or four bypasses. Results A total of 64 TAAA repairs were performed. In all, 22 patients with hybrid repair and aortic arch vessel reconstructions and 18 patients with open TAAA repair were excluded from this analysis. A total of 24 (38%) patients with hybrid endovascular repair were evaluated in this study. The 30-day mortality was found to be 12.5% (3/24) and the incidence of spinal cord ischemia was 8.3% (2/24). Preoperative comorbidities and American Society of Anesthesia (ASA) scores were reported to be similar between the two groups. As compared with group 2, patients in group 1 were reported to be younger (69.7 ± 10.6 vs. 76.0 ± 5.7 years [ p = 0.074]), had less blood loss (1,200 ± 1,088 mL vs. 3,119 ± 2,188 mL, [ p = 0.06]), required fewer blood transfusions (5.33 ± 2.31 vs. 9.09 ± 7.06 units packed red blood cells (PRBC) [ p = 0.39]), and had a shorter length of stay (11.4 ± 5.6 vs. 21.9 ± 15.1 days, [ p = 0.090]). There was no difference in 30-day mortality rates between the two groups. The incidence of perioperative morbidity, including bowel ischemia (11%[1/9] vs. 27% [4/15], [ p = 0.39]), myocardial infarction (11% [1/9] vs. 13% [2/15], [ p = 0.88]), wound infection (0% vs. 27% [4/15], [ p = 0.09]), and pneumonia (11% [1/9] vs. 40% [6/15], [ p = 0.14]) was found to be less in group 1 than group 2, but this difference was not significant. Patients with three or four bypasses had a significantly greater requirement for a skilled nursing facility or a rehabilitation facility after discharge (79% [11/14] vs. 29% [2/7], p = 0.026). There were no statistically significant differences in postoperative outcomes when comparing choice of conduit (autogenous or prosthetic) or gender. Results from the Cox-proportional hazards regression showed that bowel ischemia was the only postoperative complication associated with decreased survival ( p = 0.037, confidence interval [0.1328-4.3075]). Conclusions Hybrid aortic aneurysm repair carries a significant risk of patient morbidity with an acceptable mortality for patients considered to be at a high risk for standard thoracoabdominal repair. In patients requiring fewer visceral/renal reconstructions, there is a trend toward fewer postoperative complications and a significantly shorter length of stay. Moreover, there is a significantly lower need for skilled nursing facility requirements after discharge from the hospital. Bowel ischemia is associated with significantly worse outcome and better attempts at avoiding this complication and aggressive management is indicated.

Conserving biodiversity in the southeastern United States begins with documenting the distribution and natural history of all taxa. Using pitfall traps between March 2005 and January 2006, we collected the first Sorex fumeus (Smoky Shrew) specimens (44) from Alabama on the Cumberland Plateau in the northeastern portion of the state. Body size of specimens was generally smaller than reported for other populations. We recommend additional surveys throughout the Cumberland Plateau region in Alabama to better document this species' range in the state.