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The gut microbiome is impacted by certain types of dietary fibre. However, the type, duration and dose needed to elicit gut microbial changes and whether these changes also influence microbial metabolites remain unclear. This study investigated the effects of supplementing healthy participants with two types of non-digestible carbohydrates (resistant starch (RS) and polydextrose (PD)) on the stool microbiota and microbial metabolite concentrations in plasma, stool and urine, as secondary outcomes in the Dietary Intervention Stem Cells and Colorectal Cancer (DISC) Study. The DISC study was a double-blind, randomised controlled trial that supplemented healthy participants with RS and/or PD or placebo for 50 d in a 2 × 2 factorial design. DNA was extracted from stool samples collected pre- and post-intervention, and V4 16S rRNA gene sequencing was used to profile the gut microbiota. Metabolite concentrations were measured in stool, plasma and urine by high-performance liquid chromatography. A total of fifty-eight participants with paired samples available were included. After 50 d, no effects of RS or PD were detected on composition of the gut microbiota diversity (alpha- and beta-diversity), on genus relative abundance or on metabolite concentrations. However, Drichlet’s multinomial mixture clustering-based approach suggests that some participants changed microbial enterotype post-intervention. The gut microbiota and fecal, plasma and urinary microbial metabolites were stable in response to a 50-d fibre intervention in middle-aged adults. Larger and longer studies, including those which explore the effects of specific fibre sub-types, may be required to determine the relationships between fibre intake, the gut microbiome and host health.
This study investigates the impact of primary care utilisation of a symptom-based head and neck cancer risk calculator (Head and Neck Cancer Risk Calculator version 2) in the post-coronavirus disease 2019 period on the number of primary care referrals and cancer diagnoses.
Methods
The number of referrals from April 2019 to August 2019 and from April 2020 to July 2020 (pre-calculator) was compared with the number from the period January 2021 to August 2022 (post-calculator) using the chi-square test. The patients’ characteristics, referral urgency, triage outcome, Head and Neck Cancer Risk Calculator version 2 score and cancer diagnosis were recorded.
Results
In total, 1110 referrals from the pre-calculator period were compared with 1559 from the post-calculator period. Patient characteristics were comparable for both cohorts. More patients were referred on the cancer pathway in the post-calculator cohort (pre-calculator patients 51.1 per cent vs post-calculator 64.0 per cent). The cancer diagnosis rate increased from 2.7 per cent in the pre-calculator cohort to 3.3 per cent in the post-calculator cohort. A lower rate of cancer diagnosis in the non-cancer pathway occurred in the cohort managed using the Head and Neck Cancer Risk Calculator version 2 (10 per cent vs 23 per cent, p = 0.10).
Conclusion
Head and Neck Cancer Risk Calculator version 2 demonstrated high sensitivity in cancer diagnosis. Further studies are required to improve the predictive strength of the calculator.
Non-technical summary. As we consider a transition to a low-carbon future, there is a need to examine the mineral needs for this transformation at a scale reminiscent of the Green Revolution. The efficiency gains of the agrarian transition came at ecological and social costs that should provide important lessons about future metal sourcing. We present three options for a Mineral Revolution: status quo, incremental adaption and revolutionary change. We argue that a sustainable Mineral Revolution requires a paradigm shift that considers wellbeing as a purpose and focuses on preserving natural capital.
Technical summary. As we consider a transition to a low-carbon future, there is a need to examine the mineral needs for this transformation at a scale reminiscent of the Green Revolution. The efficiency gains of the agrarian transition came at ecological and social costs that can also provide important lessons about the Mineral Revolution. We lay out some of the key ways in which such a mineral revolution can be delineated over temporal scales in a paradigm shift that considers wellbeing as a purpose and focuses on preserving natural capital. These prospects are conceptually presented as three pathways that consider the status quo, incremental adaption and revolutionary change as a means of planning more effectively for a low-carbon transition.
Social media summary. Sourcing metals sustainably will require to consider wellbeing as a purpose and to preserve natural capital.
Over the last twenty years or so several new waves of research on the history of liberalism have emerged. The novelty of this should not be exaggerated as broad scholarly interest in liberalism has in fact been increasing at a remarkable rate since the 1980s. Nevertheless, it is clear that the historiography of liberalism has broken much new ground since around the turn of the century. This has been driven partly by the influence of larger developments in the humanities and social sciences. The global and post-colonial turns, for instance, have helped to reshape the historiography of liberalism by provoking debates over the extent of its complicity in slavery and colonialism, while also drawing attention to the contribution of theorists from the global south. But even much of this ‘normal’ innovation has been driven at least indirectly by a growing sense that liberalism is in crisis. The War on Terror, the financial meltdown of 2008 and the global rise of populist authoritarianism are the obvious staging posts in liberalism's journey from post-Cold War triumphalism to contemporary fears for its imminent demise. And it is not a coincidence that the end of the end of history has seen the beginning of a new historiography of liberalism. Since the early 2000s the emergence of new sub-fields like the histories of ‘Cold War liberalism’, human rights and neoliberalism can all be seen in different ways as responding to liberalism's unfolding crisis.
The introduction begins with a critical biographical overview of Aron’s career as a whole. This overview, which opens with an account of Aron’s emergence in the 1970s as an anti-totalitarian icon, serves as a point of entry into the larger questions addressed throughout the book. Both the 'French liberal revival' and Aron’s specific contribution to it have, it is argued, previously been treated more in laudatory evaluative terms than critical analytical ones. While the liberal status of Aron’s political thought has been largely taken for granted, the French liberal renaissance has been analysed on its own terms such that its claims for the historical illiberality of French political culture in particular have often been taken at face value. These points lead into a brief historiographical review which links the literature on Aron and the liberal revival to recent debates around the history of French and European liberalism more broadly.
This chapter focuses on Aron’s interpretation of Montesquieu and Tocqueville and his influential self-description as their ‘belated descendant’ in his book Main Currents of Sociological Thought. It argues, firstly, that in this book Aron’s invention of a ‘French school of political sociology’ represented by these liberal forbears was part of wider efforts among sociologists to rewrite their discipline’s history at a time when it was becoming unprecedentedly popularised and institutionalised. It shows that the decline of Durkheimian hegemony at this juncture had opened up a consensus gap between French sociologists, some of whom - including Aron - responded by rewriting the discipline’s past to legitimate their competing visions of its future. The chapter also shows how Aron read Montesquieu and Tocqueville through the lens of his earlier philosophical writings in an attempt to revise the epistemological basis of his political thought. Ironically, this project was substantially indebted to previous readings of Montesquieu and Tocqueville by some of the same Durkheimian colleagues against whom Aron defined himself and the ‘French school of political sociology’ in Main Currents.
This chapter considers Raymond Aron’s position in the intellectual history of liberalism from several angles. It argues that in relation to the Dreyfusard liberalism of his teachers’ generation his attitude was mostly critical but that he played a crucial role in the formulation of what has since come to be known as cold war liberalism. The chapter also offers a critique of the notion of a ‘French liberal revival’ and concludes by considering the implications of Aron’s oeuvre for the crisis of liberalism in the early twenty-first century.
This chapter offers a new interpretation of Raymond Aron’s doctoral thesis, Introduction à la philosophie de l’histoire (1938). Described by Aron as having established the basis of all his subsequent political thought, the Introduction contains a pluralist critique of Marx’s philosophy of history which doubles as a normative justification for political liberalism. Anticipating the ‘epistemology of doubt’ characteristic of later cold war liberalism, the book also served as the philosophical basis for Aron’s ethic of intellectual responsibility. Yet the extent to which the Introduction’s historical relativism undermines its ethical and normative arguments has been widely debated. Through an analysis of Aron’s previously under-explored interpretations of Dilthey and Heidegger, the chapter argues that scholarly disagreement on this issue reflects the Introduction’s ambiguous epistemological agnosticism. The chapter concludes with a discussion of the influence of the Introduction to the Philosophy of History on Jean-Paul Sartre's Critique of Dialectical Reason.
This chapter considers Raymond Aron’s role in the ‘liberal moment’ of the 1970s and 1980s, when a significant broadening of interest in liberalism occurred among French intellectuals. It begins by considering the significance of intellectual anti-totalitarianism in these years. Rather than reducing late twentieth-century French intellectual anti-totalitarianism to anti-communist politics, the chapter shows how French intellectuals’ preoccupations with the problem of totalitarianism informed significant innovations in historiography and political theory. It also shows how the notion of ‘the political’ entered into widespread use among intellectuals in these years and considers Aron’s influence on this development. On the broadening of interest in liberalism the chapter argues for the existence of two main strands to the French liberal moment: one associated with Aron that emerged in hostile opposition to the events of May ’68 and another associated with Claude Lefort that viewed the events and legacy of 1968 in an altogether more positive light.
This chapter explores the origins, development and applications of Aron’s theory of totalitarianism from the 1930s to the 1950s. It begins by discussing how Aron’s earliest theorisations of totalitarianism and political religion emerged from critical dialogues with the works of Élie Halévy and Carl Schmitt such that by the eve of the Second World War Aron had arrived at an understanding of totalitarianism as a pathology of modern democracy. The chapter then considers how Aron’s theory of totalitarianism developed with the onset of the Cold War and how this impacted on his understanding of the meaning of modern democracy as a constitutional, pluralist, multi-party regime. It concludes with a discussion of Aron’s theory of totalitarianism in relation to that of Hannah Arendt, explaining how and why Aron came to de-emphasise notions of totalitarianism and secular religion in his work following the death of Stalin in 1953.
This chapter focuses on Aron's contribution to ‘end of ideology’ theory. Aron played an important role in reorienting the Congress for Cultural Freedom towards this theme in 1955. But, as this chapter shows, the possibility of a post-ideological politics had interested him since the late 1920s. The chapter thus begins by explaining how and why Aron came to be preoccupied with this theme via his involvement in the overlapping peripheries of neosocialist and neoliberal thinktanks in the interwar years. It then considers how his involvement in these circles informed Aron’s writings on the theme of post-war economic planning in some of his writings in the 1940s. After discussing Aron’s involvement in the ‘end of ideology’ debate within the Congress for Cultural Freedom, the chapter considers the implications of this debate for Aron’s views on decolonization, challenging the view that Aron was the theorist of a ‘liberal retreat from empire’. Finally, it considers how Aron’s dissatisfaction with the end of ideology, together with the emergence of the New Left, led him to become increasingly concerned with the need for a revival of normative political theory in the later 1950s.
This chapter examines the development of Raymond Aron’s distinctive understanding of the intellectual’s role in public life. In contrast to existing accounts of Aron’s intellectual development, it shows that his earliest political engagements as a student had a lasting impact on his intellectual ethic of responsibility. The chapter explains how Aron’s involvement in revisionist socialist and pacifist movements during the late 1920s and early 1930s informed his understanding of political realism. Situating Aron within the context of broader debates over intellectual responsibility and irresponsibility involving authors such as Julien Benda, Paul Nizan, and Max Weber, it then examines Aron’s response to the crisis of French democracy in the 1930s. Here the chapter shows Aron to have been a staunch critic of organised intellectual anti-fascism who was sympathetic to the radical right’s critique of French democracy. Thc chapter concludes by explaining how Aron’s politics in the 1920s and 1930s shared many of the anti-liberal characteristics of the nonconformist milieu in which he was politicised, while at the same time he adopted the reconciliatory historical vision characteristic of the French liberal tradition.