Pragmatic comparative effectiveness randomized controlled trials evaluate the effectiveness of one interventions under real-world clinical conditions. The results of ceRCTs are often directly generalizable to everyday clinical practice, providing information critical to decision-making by patients, clinicians, and healthcare policymakers. The PRECIS-2 framework identifies nine domains that serve to score a trial on a continuum between very explanatory to very pragmatic. According to the framework, pragmatic trials may have one or more of the following features: there are fewer eligibility criteria for (...) participants, in an... (shrink)

The computational genomics community has come increasingly to rely on the methodology of creating annotations of scientific literature using terms from controlled structured vocabularies such as the Gene Ontology (GO). We here address the question of what such annotations signify and of how they are created by working biologists. Our goal is to promote a better understanding of how the results of experiments are captured in annotations in the hope that this will lead to better representations of biological reality through (...) both the annotation process and ontology development, and in more informed use of the GO resources by experimental scientists. (shrink)

In this article, we use the principlist approach to identify, analyse and attempt to solve the ethical problem raised by a pregnant woman's request for cesarean delivery in absence of medical indications.We use two different types of premises: factual (facts about cesarean delivery and specifically attitudes of obstetricians as derived from the EUROBS European study) and value premises (principles of beneficence and non-maleficence, respect for autonomy and justice).Beneficence/non-maleficence entails physicians' responsibility to minimise harms and maximise benefits. Avoiding its inherent risks (...) makes a prima facie case against cesarean section without medical indication. However, as vaginal delivery can have unintended consequences, there is a need to balance the somewhat dissimilar risks and benefits. The principle of autonomy poses a challenge in case of disagreement between the pregnant woman and the physician. Improved communication aimed to enable better informed choice may overcome some instances of disagreement. The principle of justice prohibits unfair discrimination, and broadly favours optimising resource utilisation.Available evidence supports vaginal birth in uncomplicated term pregnancies as the standard of care. The principlist approach offered a useful framework for ethical analysis of cesarean delivery on maternal request, identified the rights and duties of those involved, and helped reach a conclusion, although conflict at the individual level may remain challenging. (shrink)

By drawing on a selection of interviews from the website Engaged Philosophy, this paper highlights the work of philosopher-activists within their classrooms and communities. These philosophers have stepped out of the ivory towers and work directly with media, community and political groups, people in prison; or they encourage their students to engage in activist projects. The variety of approaches presented here shows the many ways philosophically inspired activism can give voice to those who are marginalized, shine a light on injustices, (...) expose the root of social problems, and empower others to seek solutions. This work shows the relevance of philosophy to practical problems and the powerful effects it can have in the world. (shrink)

IntroductionThis study aimed to evaluate, in adults with mild cognitive impairment, the brain atrophy that may distinguish between three AT biomarker-based profiles, and to determine its clinical value.MethodsStructural MRI was employed to evaluate the volume and cortical thickness differences in MCI patients with different AT profiles, namely, A−T−−: normal AD biomarkers; A+T−−: AD pathologic change; and A+T++: prodromal AD. Sensitivity and specificity of these changes were also estimated.ResultsAn initial atrophy in medial temporal lobe areas was found in the A+T−− and (...) A+T++ groups, spreading toward the parietal and frontal regions in A+T++ patients. These structural changes allowed distinguishing AT profiles within the AD continuum; however, the profiles and their pattern of neurodegeneration were unsuccessful to determine the current clinical status.ConclusionsMRI is useful in the determination of the specific brain structural changes of AT profiles along the AD continuum, allowing differentiation between MCI adults with or without pathological AD biomarkers. (shrink)

The deep comprehension of a text is tantamount to the construction of an articulated mental model of that text. The number of correct recollections is an index of a learner's mental model of a text. We assume that another index of comprehension is the timing of the gestures produced during text recall; gestures are simultaneous with speech when the learner has built an articulated mental model of the text, whereas they anticipate the speech when the learner has built a less (...) articulated mental model. The results of four experiments confirm the predictions deriving from our assumptions for both children and adults. Provided that the recollections are correct, the timing of gestures can differ and can be considered a further measure of the quality of the mental model, beyond the number of correct recollections. (shrink)

Lateral temporal measures of the auditory evoked potential including the T-complex, as well as an earlier negative peak index maturation of auditory/speech processing. Previous studies have shown that these measures distinguish neural processing in children with typical language development from those with disorders and monolingual from bilingual children. In this study, bilingual children with Turkish as L1 and German as L2 were compared with monolingual German-speaking children with developmental language disorder and monolingual German-speaking children with TD in order to disentangle (...) effects of limited language input vs. reduced perceptual abilities in the processing of speech and non-speech stimuli. Sensory processing reflected by the T-complex was compared in response to a German vowel and a sine-wave tone in the three groups of children, ages 5 through 6 years. Stimuli were presented while children watched a muted video. Auditory evoked potentials were time-locked to the vowels and tones. AEPs to the frequent stimuli within an oddball paradigm were analyzed at the left and right temporal electrode sites.The results revealed language status, stimulus, and language test measures all influenced the T-complex amplitudes. Particularly, the peak amplitude of Ta was modulated by language status and stimulus type. Bilingual children had significantly more negative Ta responses than the monolingual children with TD for both vowels and tones while DLD children differed from TD children only for the vowel stimulus. The amplitude of the T-complex was overall more negative at the left than at the right site. The Na peak latency was longer for the bilingual group than that observed for the two monolingual groups. The Tb latency was shorter for DLD and bilingual groups than that for TD children in the vowel condition, but no such latency difference between DLD and bilingual children was found. We suggest that the attenuated T-complex for bilingual children indicates continued plasticity of the auditory cortex to allow for learning of novel, second-language speech sounds. (shrink)

Public health law research reveals significant complexities underlying the use of law as an effective tool to improve health outcomes across populations. The challenges of applying public health law in practice are no easier. Attorneys, public health officials, and diverse partners in the public and private sectors collaborate on the front lines to forge pathways to advance population health through law. Meeting this objective amidst competing interests requires strong practice skills to shift through sensitive and sometimes urgent calls for action (...) to address known threats to the health of individuals and the community. It also necessitates objective, timely information and national and regional legal support. (shrink)

In Leszek Kolakowski's title essay, "My Correct Views on Everything", the former Communist "High Priest" accounts for his apostasy from communism and explains why communism had to fail. Next, in a number of scholarly articles, he explains why communism assumed the pernicious form it had. The two other sections of the book, on Christianity and Liberal ideologies, are equally prescient. Each is both a pointed, incisive, often humorous exposition, even indictment, and yet each offers an intimate portrait of Kolakowski's spiritual (...) and intellectual development. Included also are two interviews with the author. Far from believing that the author has "correct views on everything," the reader is likely to be convinced that Kolakowski is right on more than one point. One's rejection of Marxist ideology does not have to lead, he implicitly suggests, to the dismissal of the Marxist dream of a world without greed. Being criticial of this or that item in the Church's politics should not have to make one reject Jesus's teaching. Finally, being concerned with liberalism's inability to generate moral values should not lead us past the compelling reason to accept the liberal state as the only viable political alternative both to the political and cultural follies of our times and the dangers of religious theocratic temptations. What Kolakowski offers in this wonderful collection of essays is, in short, a "catechism" for non-ideological Marxists, Christians, liberals, and conservatives alike. Book jacket. (shrink)

The ethics of the Flexibility In duty hour Requirements for Surgical Trainees trial have been vehemently debated. Views on the ethics of the FIRST trial range from it being completely unethical to wholly unproblematic. The FIRST trial illustrates the complex ethical challenges posed by cluster randomised trials of policy interventions involving healthcare professionals. In what follows, we have three objectives. First, we critically review the FIRST trial controversy, finding that commentators have failed to sufficiently identify and address many of the (...) relevant ethical issues. The 2012 Ottawa Statement on the Ethical Design and Conduct of Cluster Randomized Trials provides researchers and research ethics committees with specific guidance for the ethical design and conduct of CRTs. Second, we aim to demonstrate how the Ottawa Statement provides much-needed clarity to the ethical issues in the FIRST trial, including: research participant identification; consent requirements; gatekeeper roles; benefit-harm analysis and identification of vulnerable participants. We nonetheless also find that the FIRST trial raises ethical issues not adequately addressed by the Ottawa Statement. Hence, third and finally, we raise important questions requiring further ethical analysis and guidance, including: Does clinical equipoise apply to policy interventions with little or no evidence-base? Do healthcare providers have an obligation to participate in research? Does the power-differential in certain healthcare settings render healthcare providers vulnerable to duress and coercion to participant in research? If so, what safeguards might be implemented to protect providers, while allowing important research to proceed? (shrink)

Preoperative mapping of language and declarative memory functions in temporal lobe epilepsy patients is essential since they frequently encounter deterioration of these functions and show variable degrees of cerebral reorganization. Due to growing evidence on language and declarative memory interdependence at a neural and neuropsychological level, we propose the GE2REC protocol for interactive language-and-memory network mapping. GE2REC consists of three inter-related tasks, sentence generation with implicit encoding and two recollection memory tasks: recognition and recall. This protocol has previously been validated (...) in healthy participants, and in this study, we showed that it also maps the LMN in the left TLE. Compared to healthy controls, left TLE showed widespread inter- and intra-hemispheric reorganization of the LMN through reduced activity of regions engaged in the integration and the coordination of this meta-network. We also illustrated how this protocol could be implemented in clinical practice individually by presenting two case studies of LTLE patients who underwent efficient surgery and became seizure-free but showed different cognitive outcomes. This protocol can be advantageous for clinical practice because it is short and easy to perform; allows brain mapping of essential cognitive functions, even at an individual level; engages language-and-memory interaction allowing to evaluate the integrative processes within the LMN; provides a more comprehensive assessment by including both verbal and visual modalities, as well as various language and memory processes. Based on the available postsurgical data, we presented preliminary results obtained with this protocol in LTLE patients that could potentially inform the clinical practice. This implies the necessity to further validate the potential of GE2REC for neurosurgical planning, along with two directions, guiding resection and describing LMN neuroplasticity at an individual level. (shrink)

ObjectiveIndividuals with an evening chronotype prefer to sleep later at night, wake up later in the day and perform best later in the day as compared to individuals with morning chronotype. Thus, college students without ADHD symptoms with evening chronotypes show reduced cognitive performance in the morning relative to nighttime. In combination with symptoms presented in attention deficit hyperactivity disorder, we predicted that having evening chronotype renders impairment in attention during the morning, when students require optimal performance, amplifying desynchrony.MethodFour hundred (...) college students were surveyed for evening chronotype and symptoms of ADHD. Of those surveyed, 43 students with evening chronotype performed laboratory attention tasks and were queried about fatigue during morning and evening sessions.ResultsStudents with ADHD symptoms demonstrated a greater decrement in sustained attentional vigilance when abstaining from stimulants and asked to perform cognitive tests at times misaligned with natural circadian rhythms in arousal compared to their non-ADHD counterparts with the same chronotype. While individuals with ADHD symptoms had slower reaction-times during sustained attention tasks in the morning session compared to those without symptoms, there was no significant group difference in working memory performance, even though both groups made more errors in the morning session compared to the evening session.ConclusionThese findings suggest that evening chronotype students with ADHD symptoms are at a greater disadvantage when having to perform sustained attention tasks at times that are not aligned to their circadian rhythm compared to their neuro-typical peers. The implications of this finding may be useful for the provision of disability accommodations to college age students with ADHD when they are expected to perform tasks requiring sustained attention at times misaligned with their circadian rhythms. (shrink)

We study logical systems for reasoning about equations involving recursive definitions. In particular, we are interested in "propositional" fragments of the functional language of recursion FLR [18, 17], i.e., without the value passing or abstraction allowed in FLR. The "pure," propositional fragment FLR$_0$ turns out to coincide with the iteration theories of [1]. Our main focus here concerns the sharp contrast between the simple class of valid identities and the very complex consequence relation over several natural classes of models.

Workplace incivility has gotten a lot of attention in recent decades. Researchers have looked at many forms of aggressive conduct in the workplace and their negative impacts on individuals and businesses. The goal of this study was to see how incivility among supervisors leads to work withdrawal and when this link might be mitigated. We argued that supervisor incivility indirectly influences work withdrawal behavior through job insecurity, and that emotional intelligence moderates this connection. This study attempted to evaluate the influence (...) of supervisor incivility on the job withdrawal behavior of personnel working in several banks Lahore by drawing on affective events theory and conservation of resource theory. Data were gathered from 350 workers of banks in Lahore, Gujranwala, and Sheikhupura to test our assumptions, and SPSS 24 was used to generate and analyze data with Hayes Process. The findings revealed a strong link between supervisor incivility and job insecurity but no link between supervisor incivility and work withdrawal behavior. The idea of moderation was validated, since emotional intelligence moderates the relationship between job insecurity and job withdrawal behavior. There are also suggestions for more empirical studies and theoretical and practical ramifications. (shrink)

Quality and service improvement (QSI) research employs a broad range of methods to enhance the efficiency of healthcare delivery. QSI research differs from traditional healthcare research and poses unique ethical questions. Since QSI research aims to generate knowledge to enhance quality improvement efforts, should it be considered research for regulatory purposes? Is review by a research ethics committee required? Should healthcare providers be considered research participants? If participation in QSI research entails no more than minimal risk, is consent required? The (...) lack of consensus on answers to these questions highlights the need for ethical guidance. Three distinct approaches to classifying QSI research in accordance with existing ethical principles and regulations can be found in the literature. In the first approach, QSI research is viewed as distinct from other types of healthcare research and does not require regulation. In the second approach, QSI research falls within regulatory guidelines but is exempt from research ethics committee review. In the third approach, QSI research is deemed to be part of the learning healthcare system and, as such, is subject to a different set of ethical principles entirely. In this paper, we critically assess each of these views. While none of these approaches is entirely satisfactory, we argue that use of the ethical principles governing research provides the best means of addressing the numerous questions posed by QSI research. (shrink)

Developing country efforts to enforce basic public health standards are often hindered by limited agency resources and poorly designed enforcement mechanisms, including excessive reliance on slow and erratic judicial systems. Traditional public health regulation can therefore be difficult to implement. This article examines innovative approaches to the implementation of public health regulations that have emerged in recent years within the OECD countries. These approaches aim to improve compliance with health standards among the different actors while reducing dependence on the legal (...) system and the administrative resources of public health agencies in developing countries. Developing countries may find some useful lessons from these approaches that can be adapted for use in their own institutional settings. (shrink)

Der Mensch, das Bild Gottes? Zum Gedanken einer Sonderstellung des Menschen im Alten Testament und in weiteren altorientalischen Quellen. By Annette Schellenberg. Zurich: Theologischer Verlag, 2011. Pp. 474. €64.80.

In the paper “Categoricity in abstract elementary classes with no maximal models”, we address gaps in Saharon Shelah and Andrés Villavecesʼ proof in [4] of the uniqueness of limit models of cardinality μ in λ-categorical abstract elementary classes with no maximal models, where λ is some cardinal larger than μ. Both [4] and [5] employ set theoretic assumptions, namely GCH and Φμ+μ+).Recently, Tapani Hyttinen pointed out a problem in an early draft of [3] to Villaveces. This problem stems from the (...) proof in Shelah and Villavecesʼ [4] that reduced towers are continuous. Residues of this problem also infect the proof of Proposition II.7.2 in VanDieren [5]. We respond to the issues in Shelah and Villaveces [4] and VanDieren [5] with alternative proofs under the strengthened assumption that the abstract elementary class is categorical in μ+. (shrink)

Significant scientific and technological advances in intensive care have been made. However, patients in the intensive care unit may experience discomfort, loss of control, and surreal experiences. This has generated relevant debates about how to humanize the intensive care units and whether humanization is necessary at all. This paper aimed to explore how humanizing intensive care is described in the literature. A scoping review was performed. Studies published between 01.01.1999 and 02.03.2020 were identified in the CINAHL, Embase, PubMed, and Scopus (...) databases. After removing 185 duplicates, 363 papers were screened by title and abstract. Full-text screening of 116 papers led to the inclusion of 68 papers in the review based on the inclusion criteria; these papers mentioned humanizing or dehumanizing intensive care in the title or abstract. Humanizing care was defined as holistic care, as a general attitude of professionals toward patients and relatives and an organizational ideal encompassing all subjects of the healthcare system. Technology was considered an integral component of intensive care that must be balanced with caring for the patient as a whole and autonomous person. This holistic view of patients and relatives could ameliorate the negative effects of technology. There were geographical differences and the large number of studies from Spain and Brazil reflect the growing interest in humanizing intensive care in these particular countries. In conclusion, a more holistic approach with a greater emphasis on the individual patient, relatives, and social context is the foundation for humanizing intensive care, as reflected in the attitudes of nurses and other healthcare professionals. Demands for mastering technology may dominate nurses’ attention toward patients and relatives; therefore, humanized intensive care requires a holistic attitude from health professionals and organizations toward patients and relatives. Healthcare organizations, society, and regulatory frameworks demanding humanized intensive care may enforce humanized intensive care. (shrink)

This paper examines folk theories of algorithmic recommendations on Spotify in order to make visible the cultural specificities of data assemblages in the global South. The study was conducted in Costa Rica and draws on triangulated data from 30 interviews, 4 focus groups with 22 users, and the study of “rich pictures” made by individuals to graphically represent their understanding of algorithmic recommendations. We found two main folk theories: one that personifies Spotify and another one that envisions it as a (...) system full of resources. Whereas the first theory emphasizes local conceptions of social relations to make sense of algorithms, the second one stresses the role of algorithms in providing a global experience of music and technology. We analyze why people espouse either one of these theories and how these theories provide users with resources to enact different modalities of power and resistance in relation to recommendation algorithms. We argue that folk theories thus offer a productive way to broaden understanding of what agency means in relation to algorithms. (shrink)

In den letzten zehn Jahren sind, angestossen durch Debatten in der Religions-und Kulturwissenschaft, auch in der Altorientalistik, in der Agyptologie, in der Bibelwissenschaft, in der Klassischen Altertumswissenschaft und in der Judaistik neue Aspekte zur Anthropologie der Antike und ihrer europaischen Nachgeschichte in den Vordergrund getreten, die sich in die integrative Formel vom ganzen Menschen fassen lassen. Diese Formel wendet sich gegen eine dichotomische bzw. trichotomische Anthropologie und nimmt damit den bereits in der Anthropologie der Aufklarung formulierten Protest gegen die Trennung (...) von Geist und Korper auf. Die Geschichte und Absicht dieser Formel wird vom Herausgeber einleitend erlautert. Der Band dokumentiert diese neuen Diskussionen und erganzt sie um die klassischen Beitrage von E. Brunner-Traut und J.-P. Vernant.". (shrink)

W artykule podjęto kwestię dotyczącą tożsamości filozofii przyrody w kontekście trzech współcześnie wymienianych charakterystycznych cech tej dyscypliny, a mianowicie jej różnorodności metodologicznej, interdyscyplinarności oraz swoistej dynamiki rozwojowej. Analizowane są zagrożenia dla tożsamości filozofii przyrody, wynikające z takiego zestawu cech, w szczególności z różnorodności metodologicznej filozofii przyrody. Jednocześnie podjęto próbę obrony wymienionych cech jako powodujących nie tylko zagrożenia, ale również wzmacniających tożsamość filozofii przyrody. Całość analiz odnosi się do metafilozoficznej charakterystyki dziedziny filozofii. --------------- Zgłoszono: 13/08/2021. Zrecenzowano: 06/09/2021. Zaakceptowano do publikacji: 14/10/2021.

Inspired by the Studies on authoritarian personality and based on contemporary research on authoritarianism in Brazil, we will analyze the construction of the idol aura surrounding former president Bolsonaro, which allowed the far right to be elected and remain in power until the last elections in 2022. We see his rise as mostly due to the digital violence that largely benefited his campaign and was directed against the block of left-wing candidates. So as to clarify this issue, we will revisit (...) the sociohistorical and psycho-political fundamentals of the antidemocratic and ethnocentric behaviors spurred by that leadership that became idolized. We will also outline an emancipatory, antiracist, culturally relevant and decolonial education, as a way to provide what Adorno regarded as being the antidote to the reemergence of a regressive barbarism. In the case of Brazil, barbarism refers to the remnants of the slave system implemented in the country for three and a half centuries, whose destructive potential was awakened under Bolsonaro’s government, given the latent antidemocratic and authoritarian tendencies in our society. (shrink)

This text, commissioned by the OSUN Global Observatory of Academic Freedom, discusses how the concept of academic freedom is codified in Colombian Law and regulations of public and private higher education institutions. It also explores common conceptions of academic freedom among Colombian scholars, as well as commonly observed threats to it.

L'auteur a l'intuition que Descartes avait directement lu, autant, voire plus que les thomistes, saint Augustin ; mieux, malgré ou en vertu de sa réticence à l'avouer, il en avait aussi subi l'influence indirecte, sous le poids des débats théologiques et philosophiques de son temps. Une série de rapprochements entre les textes canoniques de Descartes et certains passages de saint Augustin.

Ethical leadership matters in the context of organizational change due to the need for followers to trust the integrity of their leaders. Yet, there have been no studies investigating ethical leadership and organizational change. To fill this gap, we introduce a model of the moderating role of involvement in change. Organizational change and involvement in change are proposed as context-level moderators in the relationships of ethical leadership and work-related attitudes and performance. We employ a sample of 199 supervisor–subordinate pairs from (...) a wide variety of organizations. Results support a three-way interaction (ethical leadership, organizational change, and involvement in change) for performance and OCBs. Our results have important implications for organizational change since ethical leadership appears to complement follower involvement when change is happening. (shrink)

This chapter focuses on the golden era and proposes an exercise of creativity whereby we imagine Diana, the Amazon, becoming Wonder Woman in order to overthrow Man's World. Through Wonder Woman's story, we can build a feminist epic that depicts women who fight patriarchy. In the novel Lesbian Peoples: Material for a Dictionary, Wittig and Zeig describe the Amazons as the warriors thanks to whom we have been able to enter the Golden Age, an age without patriarchy or sex differences. (...) Diana, by becoming Wonder Woman and by fighting against heteropatriarchal injustice, leads the war toward the destruction of this dualistic division. The connection between Amazons and Guerrilleres, between two generations of fighters against patriarchy, aims to inspire our sorority and union in this fight against heteronormative, oppressive structures that affect us all, especially women and other subjects with alternative sexual and gender identities. (shrink)

Amid now extensive debates about cosmopolitanism in political theory, this article explores the implications of Axel Honneth’s recognition theory for issues in international justice, not least the dire situation of poverty in the world. In contrast with a purely resource-distributive approach, the essay turns particularly to Honneth’s recent revival of the Lukácsian concept of reification as a process of self-distancing from the elementary humanity of others. Specifically, Honneth re-formulates reification as a failure of an elementary or ‘antecedent’ form of recognition. (...) From the perspective of his theory, reification connotes the forgetfulness of others’ fundamental humanity. While Honneth takes such forgetfulness to become most readily apparent in dramatic violations such as the Holocaust, the article interprets his theory to explain, and eventually to challenge, the passive acceptance by many of dire material injustices. The article develops the implications of this challenge by interpreting from Honneth’s framework a duty to question international policies which tend to reify and objectify the least well off in the world, whilst remaining cognizant of the limits of de-reification to the more extensive, meaningful alleviation of poverty globally. (shrink)