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This response to critics gives me the opportunity to develop some aspects of the argument in Authoritarian Liberalism and the Transformation of Modern Europe. I do so by foregrounding the concept of political freedom, articulated by Franz Neumann. Authoritarian liberalism operates by suppressing political freedom and democracy. First making its mark in late Weimar, authoritarian liberalism is constructed in a more passive fashion in the decades after the Second Word War. Although it is contested by social movements in the 1960’s and 70’s, it is ultimately reinforced in the turn to neoliberalism. This reaches its apogee at the Treaty of Maastricht, with the de-politicization of economic and monetary union and the deepening and widening of the European Union. German ordoliberalism, which functions as an ideological support to authoritarian liberalism, is instructive, but is only a part of this story; Germany is at most ‘semi-hegemonic’ in Europe. Authoritarian liberalism operates instead through limiting the constitutional imagination in all member states of the Union. I end with some reflections on Walter Benjamin, whose philosophy of history inspired the cover of the book.
To achieve the elimination of the hepatitis C virus (HCV), sustained and sufficient levels of HCV testing is critical. The purpose of this study was to assess trends in testing and evaluate the effectiveness of strategies to diagnose people living with HCV. Data were from 12 primary care clinics in Victoria, Australia, that provide targeted services to people who inject drugs (PWID), alongside general health care. This ecological study spanned 2009–2019 and included analyses of trends in annual numbers of HCV antibody tests among individuals with no previous positive HCV antibody test recorded and annual test yield (positive HCV antibody tests/all HCV antibody tests). Generalised linear models estimated the association between count outcomes (HCV antibody tests and positive HCV antibody tests) and time, and χ2 test assessed the trend in test yield. A total of 44 889 HCV antibody tests were conducted 2009–2019; test numbers increased 6% annually on average [95% confidence interval (CI) 4–9]. Test yield declined from 2009 (21%) to 2019 (9%) (χ2P = <0.01). In more recent years (2013–2019) annual test yield remained relatively stable. Modest increases in HCV antibody testing and stable but high test yield within clinics delivering services to PWID highlights testing strategies are resulting in people are being diagnosed however further increases in the testing of people at risk of HCV or living with HCV may be needed to reach Australia's HCV elimination goals.
The Pinnacle3 Auto-Planning (AP) package is an automated inverse planning tool employing a multi-sequence optimisation algorithm. The nature of the optimisation aims to improve the overall quality of radiotherapy plans but at the same time may produce higher modulation, increasing plan complexity and challenging linear accelerator delivery capability.
Methods and materials:
Thirty patients previously treated with intensity-modulated radiotherapy (IMRT) to the prostate with or without pelvic lymph node irradiation were replanned with locally developed AP techniques for step-and-shoot IMRT (AP-IMRT) and volumetric-modulated arc therapy (AP-VMAT). Each case was also planned with VMAT using conventional inverse planning. The patient cohort was separated into two groups, those with a single primary target volume (PTV) and those with dual PTVs of differing prescription dose levels. Plan complexity was assessed using the modulation complexity score.
Plans produced with AP provided equivalent or better dose coverage to target volumes whilst effectively reducing organ at risk (OAR) doses. For IMRT plans, the use of AP resulted in a mean reduction in bladder V50Gy by 4·2 and 4·7 % (p ≤ 0·01) and V40Gy by 4·8 and 11·3 % (p < 0·01) in the single and dual dose level cohorts, respectively. For the rectum, V70Gy, V60Gy and V40Gy were all reduced in the dual dose level AP-VMAT plans by an average of 2·0, 2·7 and 7·3 % (p < 0·01), respectively. A small increase in plan complexity was observed only in dual dose level AP plans.
The automated nature of AP led to high quality treatment plans with improvement in OAR sparing and minimised the variation in achievable dose planning metrics when compared to the conventional inverse planning approach.
Constitutional pluralism is a theory for the post-sovereign European state. This only makes sense historically, emerging out of postwar European reconstruction through the repression of popular sovereignty and restraining of democracy, including through the project of European integration. It became unsettled at Maastricht and evolved from a series of irritants into a full-blown crisis in the recent decade, with sovereignty claims returning both from the bottom-up and the top-down, to the extent that we can legitimately ask whether we are now moving ‘beyond the post-sovereign state’? Constitutional pluralist literature fails to capture this in that evades material issues of democracy and political economy.
In the period spanning nearly a decade from the beginning of the financial crisis to the present, the constitutional state and state system in Europe has been affected by a series of challenges to its authority and legitimacy. With regard to the European Union, these challenges are fundamental in that they go to the very existence of the project and to the values it professes to be founded on. They seem increasingly interconnected to the EU and the trajectory of integration rather than merely external to it. For the moment, the EU remains relatively resilient; outside of the UK, appetite for ending the experiment mostly inhabits the political fringes, although even in core countries, anti-European pressures are mounting and Eurosceptic parties are on the ascendency. What is clear is that the challenges to the current system go as much to the legitimacy of domestic regimes and their political authority as to the EU itself, not least from the fragmentary pressures on the state from below in the context of subnational claims to autonomy. In short, the crisis of authority is not merely of the EU but of the regional state system and the governing order in Europe.