The debate over the determination of death has been raging for more than fifty years. Since then, objections against the diagnosis of brain death from family members of those diagnosed as dead-have been increasing and are causing some countries to take novel steps to accommodate people’s beliefs and preferences in the determination of death. This, coupled with criticism by some academics of the brain death criterion, raises some questions about the issues surrounding the determination of death. In this paper, we (...) discuss some of the main approaches to death determination that have been theoretically proposed or currently put into practice and propose a new approach to death determination called "weak pluralism" as a reasonable ethical and political alternative to respect diversity in death determination. (shrink)

Luigi Sacco (1769–1863) was the main protagonist of early vaccination campaign in Italy. He found a native source of vaccine lymph: with that, he personally vaccinated more than 500,000 people and furnished all Italy and some Middle East countries too. Starting from the pictures of his books, Sacco proposed to create wax models of real and spurious smallpox pustules in human, cow, sheep and horse; just to permit, not only to doctors, but also to all other health operators, the identification (...) of the right pustules from where to extract active lymph for vaccination. In the Museum of Pathological Anatomy of the Padua University Medical School, we have four anatomical waxes which corresponded exactly to the explicative pictures in 1809 Sacco’s treatise on Vaccine. We have found the same models also at the University of Milan, Pavia and Bologna—the main cities of Cisalpine Republic , the state of North Italy formed at the epoch of Sacco following the Napoleon conquest. The history of the diffusion of these models presented in this text will be a starting point to develop wider questions. In particular, this history could be useful to improve our understanding of the birth of scientific and experimental medicine through XIX and XX Century. (shrink)

Current research in Explainable AI includes post-hoc explanation methods that focus on building transparent explaining agents able to emulate opaque ones. Such agents are naturally required to be accurate and trustworthy. However, what it means for an explaining agent to be accurate and trustworthy is far from being clear. We characterize accuracy and trustworthiness as measures of the distance between the formal properties of a given opaque system and those of its transparent explanantes. To this aim, we extend Probabilistic Computation (...) Tree Logic with operators to specify degrees of accuracy and trustworthiness of explaining agents. We also provide a semantics for this logic, based on a multi-agent structure and relative model-checking algorithms. The paper concludes with a simple example of a possible application. (shrink)

Humanismo básico. Humanismo e historicidad. Humanismo y libertad. Humanismo y díalogo. Lenguaje y verdad. Existencia, fermento de lo trágico.

A cognitive assessment strategy that is not limited to examining a set of summary test scores may be more helpful for early detection of emergent illness such as Alzheimer’s disease (AD) and may permit a better understanding of cognitive functions and dysfunctions in those with AD and other dementia disorders. A revisit of the work already undertaken by Kaplan and colleagues using the Boston Process-Approach provides a solid basis for identifying new opportunities to capture data on neurocognitive processes, test-taking strategies (...) and response styles. Thus, this critical review will combine traditional process-based assessment strategies with support provided or offered by newer technologies that have the potential to add value to data collection and interpretation. There is now considerable interest in neuropsychological test administration using computer/digital technology, both in research and in clinical settings. To add value, any computerized version of an existing cognitive test should respect the administration procedure for which normative data were obtained, should be time-saving in terms of scoring and interpretation, and should, we argue, facilitate gathering information about the processes and strategies followed in test completion. This article will offer an overview of the steps needed when implementing computerization of neuropsychological tests using a Process-Based Approach (PBA) to these technology-based adaptations and will discuss further developments in this area by linking it to future technological developments that may be possible in the area of neuropsychological assessment. Additionally, an overview of neuropsychological tests that may benefit from computerization will be presented, together with suggestions on the specific processes, strategies and features that may be captured with the aid of such computerization. Finally, hypotheses on how virtual reality could be an asset for the future of the PBA to neuropsychological assessment will also be discussed. (shrink)

A proliferation of tests exists for the assessment of auditory-verbal memory processes. However, from a clinical practice perspective, the situation is less clear when it comes to the ready availability of reliable and valid tests for the evaluation of visual/visuo-spatial memory processes. While, at face value, there appear to be a wide range of available tests of visual/visuo-spatial memory, utilizing different types of materials and assessment strategies, a number of criticisms have been, and arguably should be, leveled at the majority (...) of these tests. The criticisms that have been directed toward what are typically considered to be visual/visuo-spatial memory tests, such as the potential for verbal mediation, over-abstraction of stimuli, the requirement of a drawing response, and the lack of sensitivity to unilateral brain lesions, mean that, in reality, the number of readily available valid tests of visual/visuo-spatial memory is, at best, limited. This article offers a critical, historical review on the existing measures and resources for the neuropsychological assessment of visual/visuo-spatial memory, and it showcases some examples of newer tests that have aimed to overcome the challenges of assessing these important aspects of memory. The article also identifies new trends and examples of how technological advances such as virtual reality may add value to overcome previous obstacles to assessment, thereby offering professionals more reliable, accurate means to evaluate visual/visuo-spatial memory in clinical practice. (shrink)

La filosofía de la tecnología es una rama reciente de la filosofía en general. Puede aportar herramientas para problemas derivados de aplicaciones tecnológicas recientes, como la telemedicina. Un problema señalado reiteradamente por la bioética lo constituye la privacidad en general, y las modificaciones que pueden introducirse por el cada vez mayor uso de las tecnologías. Comentando propuestas desde la Asociación Médica Mundial y datos contemporáneo derivados de la pandemia de COVID-19, puede reconocerse que la privacidad es una exigencia ética que (...) requiere regularse a través de su implementación política para su adecuada protección legal. (shrink)

El artículo plantea condiciones clínico-epidemiológicas peculiares cuando la humanidad se enfrente a una zoonosis emergente. El ejemplo que groseramente ha golpeado a la humanidad es la pandemia de Covid-19, enfermedad causada por el coronavirus SARS-CoV-2. Si bien la historia de la humanidad da cuenta de múltiples pandemias ocasionadas por varios agentes infectocontagiosos, es cierto que en el primer momento de afrontar una problemática global de esta naturaleza lo que prima es la incertidumbre. Ante ella, existe la obligación moral de proveer (...) los mejores servicios de salud que sea posible; a la par, debe realizarse una investigación para encontrar medidas farmacéuticas específicas que contengan y mitiguen el daño poblacional (medicamentos específicos y/o vacunas). Mientras tanto, sabiendo que en el caso de la actual pandemia de Covid-19 la principal y más eficiente vía de transmisión es la propagación por gotas de saliva, el distanciamiento físico es crucial. Una consulta médica involucra hablar en el interrogatorio y una proximidad física durante la exploración. Existen datos que indican que la telemedicina tiene un alto grado de recomendación para la protección de la salud, tanto de profesionales como de pacientes. Se recuerda que una declaración de la Asociación Médica Mundial ha tratado el tema de la telemedicina; con su exposición, se indican alcances, limitaciones y proyecciones en el futuro. (shrink)

La celebración de fiestas en honor a los santos patronos de las comunidades andinas es una de las manifestaciones de religiosidad más extendidas desde Colonia. Másallá de entenderla como una manifestación en continuidad directa con las prácticas cúlticas del Tawantinsuyo o la ritualidad católica española, consideramos que esta festividad es un fenómeno emergente que debe ser analizado en su especificidad. El objetivo de este artículo es analizar la figura del santo y su eficacia simbólico-ritual en la fiesta patronal andina desarrollada (...) durante el periodo colonial (XVI-XVII). A partir del análisis de una serie de crónicas coloniales, intentaremos mostrar que las especificidades rituales de la fiesta y de la operación del santo como símbolo icónico dominante permiten comprender su eficacia simbólica, así como también la co-existencia de diversas interpretaciones y escenificaciones rituales que darían cuenta de la agencialidad ritual de la comunidad. The celebration of festivities in honor of the patron saints of the Andean communities is one of the most widespread manifestations of religiosity from the Colony. Beyond understood as a manifestation in direct continuity with the cultic practices of the Catholic ritual Tawantinsuyo or Spanish, we believe that this festival is an emerging phenomenon that must be analyzed in its specificity. The aim of this paper is to analyze the figure of the saint and their efficacy in symbolic ritual Andean fiesta developed during the colonial period (XVI-XVII). From the analysis of a series of colonial chronicles, try to show that the specific rituals of celebration and operation saint as provide insight dominant iconic symbol symbolic effectiveness, as well as the co-existence of different interpretations and stagings rituals give account of agency community ritual. (shrink)

En este artículo, se aborda, desde una óptica Spinoziana, el problema de la libertad. Spinoza rechaza la libertad como el libre albedrío. Sin embargo, considera que podemos tener agencia (libertad) en tanto, guiados por el conocimiento de las causas de nuestros afectos, actuemos en favor de nuestro conatus. Esta investigación está dividida en tres capítulos: En el primero, se reconstruye, someramente, la posición de Spinoza sobre el libre albedrío; en el segundo, se desarrolla su propuesta de agencia; finalmente, en el (...) tercero, se busca reactualizar las consideraciones de Spinoza en torno a la discusión contemporánea sobre problema de la libertad. (shrink)

Requiring family authorization for apnea testing subtracts health professionals control over death determination, a procedure that has traditionally been considered a matter of clinical expertise alone. In this commentary, we first provide evidence showing that health professionals’ (HPs) disposition to act on death determination without family’s prior consent could be much lower than that referred to by Berkowitz and Garrett (2020). We hypothesize that HPs may have reservations about their own expertise as regards death, and may thus hesitate to impose (...) their views on patients’ families. We then address the theoretical question of clinical expertise in death determination by distinguishing judgments about facts (e.g., the presence or absence of spontaneous breathing) from interpretations given of these facts (i.e., their meaning for the vital status of an individual). We argue that, while clinicians may claim some expert authority on the former, they hold no particular authority on the latter. (shrink)

Altruism and solidarity are concepts that are closely related to organ donation for transplantation. On the one hand, they are typically used for encouraging people to donate. On the other hand, they also underpin the regulations in force in each country to different extents. They are often used indistinctly and equivocally, despite the different ethical implications of each concept. This paper aims to clarify to what extent we can speak of altruism and solidarity in the predominant models of organ donation. (...) It also raises the ethical question of whether these categories are adequate as a basis for such models, bearing in mind that organs are a scarce resource and that a shortage of them may mean that fewer lives are saved or improved. (shrink)

Background: This research explores how public awareness and attitudes toward donation and transplantation policies may contribute to Spain's success in cadaveric organ donation. Materials and Methods: A representative sample of 813 people residing in Andalusia (Southern Spain) were surveyed by telephone or via Internet between October and December 2018. Results: Most participants trust Spain's donation and transplantation system (93%) and wish to donate their organs after death (76%). Among donors, a majority have expressed their consent (59%), and few nondonors have (...) expressed their refusal (14%). Only a minority are aware of the presumed consent system in force (28%) and feel sufficiently informed regarding the requirements needed to be an organ donor (16%). Participants mainly consider that relatives should represent the deceased's preferences and be consulted when the deceased's wishes are unknown, as is the case in Spain. Conclusion: Public trust in the transplant system may contribute to Spain's high performance in organ donation. High levels of societal support toward organ donation and transplantation do not correspond with similar levels of public awareness of donation and transplantation policies in Spain. (shrink)

El presente artículo apunta a discutir cómo los actos cívicos o los monumentos actuaron en los albores del siglo XX como mecanismos de articulación dinámica de la “chilenización” en el desierto tarapaqueño, particularmente en el puerto de Iquique. Se reflexiona desde una perspectiva sociohistórica en torno a las fiestas públicas como rituales simbólicos donde se materializa la integración y/o pertenencia a la comunidad nacional; eventos cívicos que no dejaron de ser menos persuasivos como otras formas mas “violentas” de implantar y (...) promover el sentido de la Nación en los nuevos territorios anexados al Estado chileno. (shrink)

This article presents a two level hierarchical forecasting model developed in a consulting project for a Brazilian magazine publishing company. The first level uses a VARMA model and considers econometric variables. The second level takes into account qualitative aspects of each publication issue, and is based on polynomial networks generated by Genetic Programming (GP).

Los cuidados paliativos buscan ofrecer una atención holística para brindar una mejor calidad de vida a los enfermos, especialmente cuando se aproximan al fin de su existencia. Profundizar en la dimensión espiritual de la persona humana resulta atractivo puesto que ofrece respuestas al sentido de la vida. Se ha constatado que la atención espiritual aporta grandes beneficios para el paciente. Es por eso que en este trabajo hemos querido profundizar en la importancia de la dimensión espiritual en los cuidados paliativos; (...) se destaca la actitud de la escucha como pieza clave de dicha atención espiritual, lo que evidencia que el burnout de los médicos es el principal obstáculo para potenciar la escucha como una adecuada disposición que resulte consoladora y sanadora. (shrink)

En un mundo que enfrenta cada día un mayor número de problemáticas ambientales, el presente trabajo busca demostrar la creciente necesidad de proveeduría en el sector de bienes y servicios ambientales en las distintas regiones, además, busca dar un panorama general de la competitividad y el crecimiento de las pymes en la Ciudad de Chihuahua, México, enfocadas en este sector. Con base en la construcción de un sector de estudio por medio de datos estadísticos, el análisis de las regulaciones de (...) políticas para pymes y la perspectiva de actores que forman parte de la región. (shrink)

Objective: To assess the psychological distress of healthcare providers working in the field of obstetrics during the coronavirus disease 2019 pandemic and to identify factors associated with psychological distress at the individual, interpersonal, and organizational level.Design: Cross-sectional survey study.Setting: Four University hospitals in Italy.Participants: HCPs working in obstetrics, including gynecologists, residents in gynecology and obstetrics, and midwives.Methods: The 104-item survey Impatto PSIcologico COVID-19 in Ostetricia was created by a multidisciplinary expert panel and administered to HCPs in obstetrics in May 2020 (...) via a web-based platform.Main Outcome Measures: Psychological distress assessed by the General Health Questionnaire-12 included in the IPSICO survey.Results: The response rate to the IPSICO survey was 88.2%, and that for GHQ-12 was 84.4%. Just over half of the GHQ-12 respondents reported a clinically significant level of psychological distress. Psychological distress was associated with either individual, interpersonal, and organizational factors in dealing with the pandemic.Conclusions: Results confirm the need for monitoring and assessing the psychological distress for HCPs in obstetrics. Interventions at the individual, interpersonal, and organizational level may relieve the psychological distress during the COVID-19 pandemic and foster resilience skills in facing emotional distress. (shrink)

Clearing algorithms are at the core of modern payment systems, facilitating the settling of multilateral credit messages with (near) minimum transfers of currency. Traditional clearing procedures use batch processing based on MILP - mixed-integer linear programming algorithms. The MILP approach demands intensive computational resources; moreover, it is also vulnerable to operational risks generated by possible defaults during the inter-batch period. This paper presents TORC3 - the Token-Ring Clearing Algorithm for Currency Circulation. In contrast to the MILP approach, TORC3 is a (...) real time heuristic procedure, demanding modest computational resources, and able to completely shield the clearing operation against the participating agents’ risk of default. (shrink)

Este artículo analiza el rol de la escuela chilena en la comunidad andina y las demandas locales por un sistema educativo permanente. Dentro de este contexto, se realiza una discusión en torno al Estado, la construcción de la nación y la utilización de la escuela como instrumento disciplinador de la sociedad. Asimismo, se analiza la experiencia histórica de la escuela en el sur peruano, como parte de un proceso que antecede a la instauración del modelo educativo nacional chileno, relevando la (...) praxis política que las propias comunidades asumen en torno diversos petitorios por la presencia de profesores y de establecimientos educacionales en los sectores cordilleranos andinos. (shrink)

BackgroundStudies and meta-analyses found individual, meso and micro-social factors that are associated with individual well-being, as well as a positive socio-emotional climate or collective well-being.AimThis article simultaneously studies and examines these factors of well-being.MethodWell-Being is measured as a dependent variable at the individual and collective level, as well as the predictors, in three cross-sectional and one longitudinal studies. Education and social intervention workers from Chile, Spain and Uruguay participate; a subsample of educators from the south central Chile and from Chile, (...) Uruguay and Spain ; workers from organizations in Latin America and Southern Europe, military cadets from Argentina ; and teams from Spanish companies.ResultsIndividual and collective well-being indicators were related, suggesting that the emotional climate as a context improves personal well-being. Individual factors, psychosocial factors were positively associated with personal well-being in education and social intervention context. Organizational dynamic or transformational culture is directly and indirectly associated with individual well-being through previously described psychosocial factors. Group processes such as internal communication and safe participation, task orientation or climate of excellence as well as leadership style that reinforces participation and belonging, were positively associated with collective well-being in labor and military context and predict team work socio-emotional climate in a longitudinal study- but were unrelated to individual well-being. Transformational leadership plays a mediating role between functional factors and social-emotional climate in work teams. Organizational role autonomy, functional organizational leadership, integration and resources were associated with collective well-being in organizations. Organizational leadership moderates the relationship between task orientation and collective well-being in military context.ConclusionIndividual and microsocial factors influence personal well-being. Meso level factors favorable to well-being through processes which reinforce social belonging, influence directly collective well-being and indirectly personal well-being. Leadership that reinforces participation and belonging play a central role for emotional climate. Stress and emotional climate playing an important pivotal role for psychological well-being. (shrink)

Dos místicos relativamente contemporáneos: Etty Hillesum y Benjamín González Buelta; dos estilos, dos contextos y una coincidencia establecida desde sus experiencias espirituales, en profunda conexión con la realidad, en medio de la vida y sus desafíos. Hillesum no habla propiamente de la experiencia mística, sin embargo, su proceso personal existencial en el duro contexto de guerra que le tocó vivir, la condujo a descubrirse profundamente habitada. Su experiencia de Dios le hizo posible comprender y gestionar el dolor en medio de (...) la guerra, así como la necesidad de ‘hacerse bálsamo sobre las heridas’ de sus hermanos judíos. Etty es una mística de ojos abiertos. Benjamín González Buelta ha profundizado en la comprensión de la mística, describiéndola y analizándola desde la experiencia de Dios en el contexto latinoamericano. Su reflexión permite hoy leer a Etty Hillesum desde la perspectiva del místico de ojos abiertos. (shrink)

Nella sua straordinaria opera scientifica, Franco Selleri si è sempre opposto alla rinuncia alla comprensione della struttura della realtà e della natura degli oggetti fisici, che egli considera come l’elemento caratterizzante delle principali teorie della fisica del Novecento e che è stata stigmatizzata da Karl Popper come tesi della “fine della strada in fisica”. Sin dalla fine degli anni ’60, egli ha sviluppato quella riflessione critica nei confronti delle teorie fondamentali della fisica moderna, in particolar modo della teoria delle particelle (...) elementari e della meccanica quantistica, e in un secondo tempo delle teorie relativistiche, che contraddistingue il suo programma di ricerca. Nel corso della sua intensa e infaticabile attività scientifica, Selleri è entrato in proficuo contatto con molti grandi fisici e filosofi della scienza, instaurando un intenso dialogo critico con Louis de Broglie, John Bell e Karl Popper. Le sue originali e non convenzionali ricerche lo hanno portato a risultati significativi non solo nell’ambito dei fondamenti della fisica, ma anche della storia e della filosofia della fisica. Per questo abbiamo voluto dedicare un numero speciale di Isonomia al nostro impareggiabile amico e collega, sia per la sua passione instancabile e la sua profonda conoscenza dei fondamenti formali, concettuali e filosofici delle teorie della fisica contemporanea, sia e forse ancor più come maestro di una prospettiva perennemente critica che egli ha sempre seguito e proposto con particolare rigore ed estrema determinazione. (shrink)

Much forensic inference based upon DNA evidence is made assuming Hardy-Weinberg Equilibrium (HWE) for the genetic loci being used. Several statistical tests to detect and measure deviation from HWE have been devised, and their limitations become more obvious when testing for deviation within multiallelic DNA loci. The most popular methods-Chi-square and Likelihood-ratio tests-are based on asymptotic results and cannot guarantee a good performance in the presence of low frequency genotypes. Since the parameter space dimension increases at a quadratic rate on (...) the number of alleles, some authors suggest applying sequential methods, where the multiallelic case is reformulated as a sequence of “biallelic” tests. However, in this approach it is not obvious how to assess the general evidence of the original hypothesis; nor is it clear how to establish the significance level for its acceptance/rejection. In this work, we introduce a straightforward method for the multiallelic HWE test, which overcomes the aforementioned issues of sequential methods. The core theory for the proposed method is given by the Full Bayesian Significance Test (FBST), an intuitive Bayesian approach which does not assign positive probabilities to zero measure sets when testing sharp hypotheses. We compare FBST performance to Chi-square, Likelihood-ratio and Markov chain tests, in three numerical experiments. The results suggest that FBST is a robust and high performance method for the HWE test, even in the presence of several alleles and small sample sizes. (shrink)

Intentional sampling methods are non-probabilistic procedures that select a group of individuals for a sample with the purpose of meeting specific prescribed criteria. Intentional sampling methods are intended for exploratory research or pilot studies where tight budget constraints preclude the use of traditional randomized representative sampling. The possibility of subsequently generalize statistically from such deterministic samples to the general population has been the issue of long standing arguments and debates. Nevertheless, the intentional sampling techniques developed in this paper explore pragmatic (...) strategies for overcoming some of the real or perceived shortcomings and limitations of intentional sampling in practical applications. (shrink)

Statistical tests that detect and measure deviation from the Hardy-Weinberg equilibrium (HWE) have been devised but are limited when testing for deviation at multiallelic DNA loci is attempted. Here we present the full Bayesian significance test (FBST) for the HWE. This test depends neither on asymptotic results nor on the number of possible alleles for the particular locus being evaluated. The FBST is based on the computation of an evidence index in favor of the HWE hypothesis. A great deal of (...) forensic inference based on DNA evidence assumes that the HWE is valid for the genetic loci being used. We applied the FBST to genotypes obtained at several multiallelic short tandem repeat loci during routine parentage testing; the locus Penta E exemplifies those clearly in HWE while others such as D10S1214 and D19S253 do not appear to show this. (shrink)

The Autism Spectrum Disorder (ASD) represents a set of life-long disorders. In particular, subjects with ASD can display momentary behaviors of acute agitation and aggressiveness called crisis behaviors. These events are problematic for the subject and care providers but little is known about their occurrence, namely, possible relations among intensity, frequency, and duration. A group of ASD subjects (n=33) has been observed for 12 months reporting data on each crisis ( n = 1137 crises). Statistical analysis did not find significant (...) results, while the relation between crisis duration and frequency showed a good fit to a “power law” curve, suggesting the application of Self-Organized Criticality (SOC) model. The SOC is used to describe natural phenomena as earthquakes, bank failures of rivers, mass extinctions, and other systems where a type of “catastrophic events” is necessary to maintain a critical equilibrium. In a sense, subjects at risk of crisis behavior seem to fit the same model as seismic zones at risk of earthquakes. The employment of the same strategies, as those successfully developed for known SOC systems, could lead to important insights for ASD management. Moreover, the SOC model offers possible interpretations of crisis behavior dynamics suggesting that they are unpredictable and, in a sense, necessary. (shrink)

ABSTRACT The article deals with the early career of the literary critic Alberto Asor Rosa, one of the founders of the operaismo movement, a Marxist tendency advocating the management of factories by workers through bottom-up councils. It outlines the role he assigned to literature and culture, investigating his criticism first against the non-revolutionary cultural politics of the Italian Communist Party, notoriously through his book Scrittori e popolo and his writings for the periodical classe operaia, then identifying a transition from (...) a destructive approach against any culture based on values to the use of cultural disciplines purely as techniques. The article posits that this instrumental understanding of culture depended on Asor Rosa’s political choice to take the perspective of the working class, in order to use culture itself for social analysis. In the second half of the decade, contributing to the periodicals Angelus novus and Contropiano, he still considered culture ineffective as a way towards revolution, but he began to value the great works of ʻbourgeois’ literature for their ability to penetrate the middle-class spirit and undermine capitalist society. The article concludes that, despite his changing idea of culture, Asor Rosa’s opinions on the intellectual’s task fit the traditional concept of it. (shrink)