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This thesis argues for the general implausibility of pure determinism by refuting the constitutive logical categories of specific forms of determinism. Pure determinism is understood as the metaphysical thesis that everything is fundamentally externally determined. The underlying categories in question are necessity, causality and objectivity (law). The specific forms of determinism are necessitarian- (or conditional necessity), causal- and metaphysical (or lawful) determinism. The refutation concerning the relevant logical forms or categories is grounded in the systematic conceptual analysis developed in The Science of Logic by G. W. F. Hegel. The second part of the main argument is to show that, although pure or particular forms of determinism may fail, this does not entail that deterministic features as such are thereby dismissed or are unreal. The third part of the argument indicates that such deterministic features are only logically coherent as moments of a structure of self-determination, which means, in turn, that self-determination cannot be fully understood without making explicit its relationship to (other-)determination. While almost nobody theoretically defends the position of determinism, it is invariably used in discussions surrounding freedom, particularly as a contrast or opposition to it. This opposition chiefly takes the positions of compatibilism and incompatibilism. This thesis contends, however, that determinism within such positions remains ill-defined and that, when examined logically, through its constituent categories, there is in fact no consistent concept of determinism one might oppose to freedom. Instead, deterministic features-normally seen to be wholly separate from freedom-form essential moments of it. Hegel's Logic demonstrates, therefore, that external determination or unfreedom is integral to the reality and development of self-determination or freedom as such, whereby the latter is justified through the former, and the former through the latter.

Russon makes engaging connections to a flurry of other thinkers—Derrida, Deleuze, Marx, Foucault, St. Paul, Merleau-Ponty and Laing—expertly showing how Hegel’s major texts (Phenomenology of Spirit, Science of Logic and Philosophy of Right) shed light on the many facets of human experience. Towards the end of the book, Russon further develops themes that he had begun earlier—mutual recognition, conscience, forgiveness, openness, hospitality and oppositional determinacy—but with a focus on how these concepts are actualized in ethical, political and religious domains. Social-political tensions can never be overcome, but instead will always exist as interactions between self-determining exclusive communities and the possibility of their mutual hospitality and dialogue: ‘The site for justice and universality is not found in the establishment of an ideal regime, but is found in the determinacy of our actual situation of opposition’ (203). On Russon’s account, on the other hand, the term ‘absolute knowing’ refers to the ‘experience of ourselves as the agents of the real, as the ones who speak on behalf of the absolute: we are “certain of being all reality” in the sense of recognizing our infinite indebtedness, and recognizing that the absolute must speak here and now’ (21–22).

The gut hormone glucose-dependent insulinotropic polypeptide (GIP) causes postprandial insulin release and inhibits bone resorption assessed by carboxy-terminal collagen crosslinks (CTX). To study if GIP affects bone homeostasis biomarkers independently of insulin release and glycemic level. Randomized, double-blinded, crossover study with 5 study days. Ten male C-peptide-negative patients with type 1 diabetes. On 3 matched days with \"low glycemia\" (plasma glucose in the interval 3 to 7 mmol/L for 120 minutes), we administered intravenous (IV) GIP (4 pmol × kg-1 × min-1), glucagon-like peptide 1 (1 pmol × kg-1 × min-1), or placebo (saline), and on 2 matched days with \"high glycemia\" (plasma glucose 12 mmol/L for 90 minutes), we administered either GIP or saline. CTX, procollagen type 1 N-terminal propeptide (P1NP), and parathyroid hormone (PTH). During low glycemia: GIP progressively suppressed CTX from baseline by up to 59 ± 18% compared with 24 ± 10% during saline infusion (P < 0.0001). Absolute values of P1NP and PTH did not differ between days. During high glycemia: GIP suppressed CTX from baseline by up to 59 ± 19% compared with 7 ± 9% during saline infusion (P < 0.0001). P1NP did not differ between days. GIP suppressed PTH after 60 minutes compared with saline (P < 0.01), but this difference disappeared after 90 minutes. Short-term GIP infusions robustly reduce bone resorption independently of endogenous insulin secretion and during both elevated and low plasma glucose, but have no effect on P1NP or PTH after 90 minutes.

Abstract Context Gut hormones seem to play an important role in postprandial bone turnover, which also may be affected by postprandial plasma glucose excursions and insulin secretion. Objective To investigate the effect of an oral glucose tolerance test (OGTT) and an isoglycemic intravenous glucose infusion (IIGI) on bone resorption and formation markers in individuals with type 1 diabetes and healthy controls. Methods This observational case-control study, conducted at the Center for Clinical Metabolic Research, Gentofte Hospital, Hellerup, Denmark, included 9 individuals with C-peptide negative type 1 diabetes and 8 healthy controls matched for gender, age, and body mass index. Subjects underwent an OGTT and a subsequent IIGI. We analyzed changes in bone resorption assessed by measurements of carboxy-terminal type I collagen crosslinks (CTX) and in bone formation as assessed by procollagen type I N-terminal propeptide (PINP) concentrations. Results Baseline CTX and PINP levels were similar in the 2 groups. Both groups exhibited significantly greater suppression of CTX during OGTT than IIGI. PINP levels were unaffected by OGTT and IIGI, respectively, in healthy controls. Participants with type 1 diabetes displayed impaired suppression of CTX-assessed bone resorption and inappropriate suppression of PINP-assessed bone formation during OGTT. Conclusion Our data suggest the existence of a gut-bone axis reducing bone resorption in response to oral glucose independently of plasma glucose excursions and insulin secretion. Subjects with type 1 diabetes showed impaired suppression of bone resorption and reduced bone formation during OGTT, which may allude to the reduced bone mineral density and increased fracture risk characterizing these individuals.

Background The global prevalence of type 2 diabetes-related complications is not well described. We assessed prevalence of vascular complications at baseline in DISCOVER (NCT02322762; NCT02226822), a global, prospective, observational study program of 15,992 patients with type 2 diabetes initiating second-line therapy, conducted across 38 countries. Methods Patients were recruited from primary and specialist healthcare settings. Data were collected using a standardized case report form. Prevalence estimates of microvascular and macrovascular complications at baseline were assessed overall and by country and region, and were standardized for age and sex. Modified Poisson regression was used to assess factors associated with the prevalence of complications. Results The median duration of type 2 diabetes was 4.1 years (interquartile range [IQR]: 1.9–7.9 years), and the median glycated hemoglobin (HbA 1c ) level was 8.0% (IQR: 7.2–9.1%). The crude prevalences of microvascular and macrovascular complications were 18.8% and 12.7%, respectively. Common microvascular complications were peripheral neuropathy (7.7%), chronic kidney disease (5.0%), and albuminuria (4.3%). Common macrovascular complications were coronary artery disease (8.2%), heart failure (3.3%) and stroke (2.2%). The age- and sex-standardized prevalence of microvascular complications was 17.9% (95% confidence interval [CI] 17.3–18.6%), ranging from 14.2% in the Americas to 20.4% in Europe. The age- and sex-standardized prevalence of macrovascular complications was 9.2% (95% CI 8.7–9.7%), ranging from 4.1% in South-East Asia to 18.8% in Europe. Factors positively associated with vascular complications included age (per 10-year increment), male sex, diabetes duration (per 1-year increment), and history of hypoglycemia, with rate ratios (95% CIs) for microvascular complications of 1.14 (1.09–1.19), 1.30 (1.20–1.42), 1.03 (1.02–1.04) and 1.45 (1.25–1.69), respectively, and for macrovascular complications of 1.41 (1.34–1.48), 1.29 (1.16–1.45), 1.02 (1.01–1.02) and 1.24 (1.04–1.48), respectively. HbA 1c levels (per 1.0% increment) were positively associated with microvascular (1.05 [1.02–1.08]) but not macrovascular (1.00 [0.97–1.04]) complications. Conclusions The global burden of microvascular and macrovascular complications is substantial in these patients with type 2 diabetes who are relatively early in the disease process. These findings highlight an opportunity for aggressive early risk factor modification, particularly in regions with a high prevalence of complications. Trial registration ClinicalTrials.gov; NCT02322762. Registered 23 December 2014. https://clinicaltrials.gov/ct2/show/NCT02322762 . ClinicalTrials.gov; NCT02226822. Registered 27 August 2014. https://clinicaltrials.gov/ct2/show/NCT02226822

Researchers have argued that leadership is one of the most important determinants of team effectiveness. The present study examined the extent to which the perceived quality of athlete leadership was related to the effectiveness of elite sports teams. Three professional football teams (N=135) participated in our study during the preparation phase for the Australian 2016 season. Players and coaching staff were asked to assess players’ leadership quality in four leadership roles (as task, motivational, social, and external leader) via an online survey. The leadership quality in each of these roles was then calculated in a social network analysis by averaging the indegree centralities of the three best leaders in that particular role. Participants also rated their team’s performance and its functioning on multiple indicators. As hypothesized, the team with the highest-quality athlete leadership on each of the four leadership roles excelled in all indicators of team effectiveness. More specifically, athletes in this team had a stronger shared sense of the team’s purpose, they were more highly committed to realizing the team’s goals, and they had a greater confidence in their team’s abilities than athletes in the other teams. Moreover, this team demonstrated a higher task-involving and a lower ego-involving climate, and excelled on all measures of performance. High-quality athlete leadership is positively related to team effectiveness. Given the importance of high-quality athlete leadership, the study highlights the need for well-designed empirically-based leadership development programs.

Respiratory infections are the major cause of death from infectious disease worldwide. Multiplexed diagnostic approaches are essential as many respiratory viruses have indistinguishable symptoms. We created self-assembled DNA nanobait that can simultaneously identify multiple short RNA targets. The nanobait approach relies on specific target selection via toehold-mediated strand displacement and rapid readout via nanopore sensing. Here we show that this platform can concurrently identify several common respiratory viruses, detecting a panel of short targets of viral nucleic acids from multiple viruses. Our nanobait can be easily reprogrammed to discriminate viral variants with single-nucleotide resolution, as we demonstrated for several key SARS-CoV-2 variants. Last, we show that the nanobait discriminates between samples extracted from oropharyngeal swabs from negative- and positive-SARS-CoV-2 patients without preamplification. Our system allows for the multiplexed identification of native RNA molecules, providing a new scalable approach for the diagnostics of multiple respiratory viruses in a single assay. Polymerase-chain-reaction-based methods used in clinic to identify respiratory viral infections cannot simultaneously detect multiple viruses or viral variants. Here nanopore nucleic acid sensing is coupled to programmable ribonuclease to simultaneously identify specific short RNA sequences of multiple viruses, without predetection steps such as sample purification or preamplification.

The present article provides a comprehensive examination of the relationship between playing position and leadership in sport. More particularly, it explores links between leadership and a player's interactional centrality-defined as the degree to which their playing position provides opportunities for interaction with other team members. This article examines this relationship across different leadership roles, team sex, and performance levels. Study 1 (N = 4443) shows that athlete leaders (and the task and motivational leader in particular) are more likely than other team members to occupy interactionally central positions in a team. Players with high interactional centrality were also perceived to be better leaders than those with low interactional centrality. Study 2 (N = 308) established this link for leadership in general, while Study 3 (N = 267) and Study 4 (N = 776) revealed that the same was true for task, motivational, and external leadership. This relationship is attenuated in sports where an interactionally central position confers limited interactional advantages. In other words, the observed patterns were strongest in sports that are played on a large field with relatively fixed positions (e.g., soccer), while being weaker in sports that are played on a smaller field where players switch positions dynamically (e.g., basketball, ice hockey). Beyond this, the pattern is broadly consistent across different sports, different sexes, and different levels of skill. The observed patterns are consistent with the idea that positions that are interactionally central afford players greater opportunities to do leadership-either through communication or through action. Significantly too, they also provide a basis for them to be seen to do leadership by others on their team. Thus while it is often stated that \"leadership is an action, not a position,\" it is nevertheless the case that, when it comes to performing that action, some positions are more advantageous than others.

Leadership has been suggested to be a key factor in gaining a competitive advantage as a team, with shared leadership being a better predictor of team functioning than vertical leadership. Although the benefits of shared leadership are well-documented, evidence about how to implement a shared leadership structure remains sparse. This leaves coaches with three key challenges: (1) identifying the best leaders; (2) defining what roles those leaders should fulfill; and (3) developing their leadership skills. Solutions to these challenges have been proposed in the 5R Shared Leadership Program (5RS) — a leadership development program that seeks to implement an effective structure of shared leadership within sports teams. To test the effectiveness of 5RS program, we conducted an experimental-comparison group intervention in which eight national-level basketball teams (N = 96) completed a questionnaire at two points in time (i.e., pre- and posttest). The teams in the intervention condition completed the 5RS program, in which we identified the leadership structure in their teams (through Shared Leadership Mapping), appointed the best leaders in their leadership role, and then developed their identity leadership skills. The results revealed that the 5RS program was successful in strengthening athlete leaders’ identity leadership skills, and as a result also team members’ identification with their team. Furthermore, in contrast to athletes in the comparison condition, athletes in the 5RS condition were able to maintain their levels of intrinsic motivation and commitment to team goals, while also reporting improved well-being. The present study provides encouraging evidence that, by implementing a structure of shared leadership and by promoting athlete leaders’ identity leadership skills, the 5RS program is able to improve the team’s functioning and the well-being of its members.