Restoring the microcirculation and tissue oxygenation is the ultimate goal of hemodynamic resuscitation. Hand-held vital microscopes enable direct visualization of the sublingual microcirculation of RBC flow through the capillaries and the density of perfused capillaries. The association between alterations of sublingual microvascular parameters and patient outcomes during shock validates that these parameters are clinically relevant for the assessment of patients in shock. Assessment of sublingual microvascular perfusion parameters at the bedside is only conceivable if hand-held vital microscopes are easy to use and if the analysis of the images can be done in real time. Studies have shown that real-time point-of-care assessment by visual inspection of microcirculatory properties at the bedside shows good agreement with off-line evaluation of the microcirculation. The development of automatic microcirculatory analysis software systems will be the next step to obtain high-performance quantitative analysis at the patient’s bedside and for caregivers to adhere to this monitoring technique. Lastly, the impact of sublingual microcirculation on patient outcome remains to be proven during the perioperative setting.

Chapter 7 explores the shrine complex of Aghā-yi Buzurg and its history. Her shrine, known as that of “Qiz Bibi,” is situated near the city of Bukhara. The traditions surrounding the shrine remind visitors of Aghā-yi Buzurg’s superiority in her struggle with her famous enemy, Mīr-i ʿArab. The accounts explored in this final chapter allow us to discern the reinterpretation of the figure of Aghā-yi Buzurg over time, evident in the written narratives and oral materials in which she was turned into a 14-year-old virgin, Qiz Bibi. These sources demonstrate people’s efforts to make sense of Aghā-yi Buzurg’s legacy over a long period of time and shed light on the development of oral history in general.

In the wake of the 2019 COVID-19 pandemic, at-home digital care has expanded. This change has set off a cascade of effects, including new pathways for information flows that include a wider array of direct-to-consumer companies and products. This new landscape requires a reexamination of the implicit and explicit social contract between patients, clinicians, and the health delivery system: Who has access to personal health information? What is the appropriate role of commercial companies? Are people who continue to receive most of their care in clinical settings subject to the new norms of at-home care? This technology and circumstance drive change in health is not a new phenomenon. In this chapter, we examine the emergence of the Michigan BioTrust for Health in 2009 as an instance of renegotiating the social contract between stakeholders in response to cultural and technological changes that made information more available and accessible to a broader community of users. In the case of the BioTrust, Michigan’s four million “legacy” newborn screening bloodspots and the related health information were repurposed to be more widely available, not only for public health, but also for research. Based on prior research on the ethical and policy implications for patients that were part of the legacy system (i.e. those being asked to make the change from old to new systems of care), we review key findings on attitudes about informed consent and notification, partnerships with commercial companies, and trust. We review consumer preferences and expectations in the context of the BioTrust for Health and the expanded use of newborn screening bloodspots and consider their implications for the governance of at-home digital health care.

Chapter 9 is an investigation of mythico-history, with a particular focus on the narrative construction of dictatorship. It tells a disturbing story of how and why, in post-genocide Rwanda, law became “a dramatically enacted thing.” To this end, the chapter analyzes the RPFs media campaign in support of the gacaca courts alongside its assault on international law.

Fluid management is a complex yet fundamental aspect in the care of patients undergoing cardiac surgery, and different to that for patients in general intensive care and other surgical specialties. The underlying cardiac disease and impaired cardiovascular reserve of patients in this high-risk population means that significant hemodynamic alterations can impact adversely on their short- and long-term outcomes. Volume replacement during and after cardiac surgery is not influenced by filling pressures in isolation, but requires a critical balance with vasomotor tone, fluid responsiveness and cardiac contractility. The timing, type, volume and monitoring of fluid administration are important considerations. So far, the evidence does not favor a specific choice of fluid therapy and none of the available fluid therapies has been assessed for comparative endothelial homeostatic potential. This leaves a significant knowledge gap and an incentive for researchers, clinicians and industry to design and test safer and more efficacious choices for clinical use.

The cases of the Maria Theresa and the America were designed, by Hardwicke, Holderness, and Newcastle, to instil confidence in the Dutch government that the Court of Prize Appeal would safeguard the Dutch neutral rights that had been agreed throughout the first part of the war. They were also designed to instil confidence in British privateers and naval captains and ensure that French colonial trade carried in neutral ships could still largely be stopped and condemned as legal prize. This chapter focuses on the two appellate cases and the legal arguments presented. These are then tied to the legal and strategic maritime thinking of Lord Hardwicke and his creation of the Rule of the War of 1756. This rule became the bedrock for how Britain would understand and negotiate neutral rights over the course of the next major European maritime wars. The basic premise of the rule was that trade that was prohibited to a neutral during times of peace would be considered by the British prize court system to be prohibited in times of war. The chapter, through an analysis of Dutch cases in the Court of Prize Appeal, examines how and why Hardwicke developed this rule.

Phonology has generally been neglected as a nexus of philosophical interest despite certain debates within the field both inviting and needing philosophical reflection. Yet, the few who have attempted such inquiry have noted something special about the field and its target. On the one hand, it shares formal and structural aspects with syntax. On the other, it seems to require more literal interpretation in terms of components such as hierarchy and sequential ordering. In this chapter, the nature of the phoneme, the theoretical centrepiece of traditional phonology, comes under scrutiny. The notion, as well as the field itself, is extended to other modalities, such as sign, in accordance with the contemporary trajectory of the field. This extension, and the connections with language and gesture in general, open up the possibility of a philosophical action theory with phonology as its basis. Motor and action theory have been proffered recently in connection with syntax, with little success. However, it’s argued that phonology serves as a better point of comparison. The chapter discusses a range of issues from autosegmental phonology, feature grammar, and sign language, to gestural grammar, motor cognition, and recent 4E approaches to cognition.

Is tragedy choral? Let us return finally to the question of origins, but let us do so while keeping strictly to the poetical, narrative and ritual dimensions. We will now be able to draw some conclusions regarding the pragmatics of the tragic choral voice – both masculine and feminine – as it is orchestrated by the poets who stage, in the service of the city, an action belonging to its heroic past.

This chapter provides a contextual overview of the development and operation of the British prize court system. It then introduces the specific legal rules and precedents, specifically the Rule of the War of 1756, that were developed by Britain during the Seven Years’ War in the pursuit of negotiating neutral rights to Britain’s strategic advantage. The chapter critiques the historiography on the Rule of the War of 1756 and makes the argument that the development of the rule and its influence in subsequent wars can only be understood if its strategic drivers are taken into account. The Rule, in other words, was as much a creation of strategic thinking as it was of legal thinking.

This introductory chapter lays out the historical background of English New World colonization and sketches the argument of the book. It explains the English crown’s formal authority over colonization and introduces the principal–agent perspective as a framework to analyze the crown’s use of that authority. The chapter lays out the concept of contractual imperialism, or the early crown’s policy of early colonization embedded in letters patent to private colonizers, and of regulatory imperialism, or the later crown’s policy of regulating colonial political economies.