The prime objective of this paper is to conduct phoneme categorization experiments for Indian languages. In this direction a major effort has been made to categorize Hindi phonemes using a time delay neural network (TDNN), and compare the recognition scores with other languages. A total of six neural nets aimed at the major coarse of phonetic classes in Hindi were trained. Evaluation of each net on 350 training tokens and 40 test tokens revealed a 99% recognition rate for vowel classes, (...) 87% for unvoiced stops, 82% for voiced stops, 94.7% for semi vowels, 98.1% for nasals and 96.4% for fricatives. A new feature vector normalisation technique has been proposed to improve the recognition scores. (shrink)

Objectives To conduct an independent evaluation of the first phase of the Health Foundation’s Safer Patients Initiative (SPI), and to identify the net additional effect of SPI and any differences in changes in participating and non-participating NHS hospitals. Design Mixed method evaluation involving five substudies, before and after design. Setting NHS hospitals in the United Kingdom. Participants Four hospitals (one in each country in the UK) participating in the first phase of the SPI (SPI1); 18 control hospitals. Intervention The SPI1 (...) was a compound (multi-component) organisational intervention delivered over 18 months that focused on improving the reliability of specific frontline care processes in designated clinical specialties and promoting organisational and cultural change. Results Senior staff members were knowledgeable and enthusiastic about SPI1. There was a small (0.08 points on a 5 point scale) but significant (P<0.01) effect in favour of the SPI1 hospitals in one of 11 dimensions of the staff questionnaire (organisational climate). Qualitative evidence showed only modest penetration of SPI1 at medical ward level. Although SPI1 was designed to engage staff from the bottom up, it did not usually feel like this to those working on the wards, and questions about legitimacy of some aspects of SPI1 were raised. Of the five components to identify patients at risk of deterioration—monitoring of vital signs (14 items); routine tests (three items); evidence based standards specific to certain diseases (three items); prescribing errors (multiple items from the British National Formulary); and medical history taking (11 items)—there was little net difference between control and SPI1 hospitals, except in relation to quality of monitoring of acute medical patients, which improved on average over time across all hospitals. Recording of respiratory rate increased to a greater degree in SPI1 than in control hospitals; in the second six hours after admission recording increased from 40% (93) to 69% (165) in control hospitals and from 37% (141) to 78% (296) in SPI1 hospitals (odds ratio for “difference in difference” 2.1, 99% confidence interval 1.0 to 4.3; P=0.008). Use of a formal scoring system for patients with pneumonia also increased over time (from 2% (102) to 23% (111) in control hospitals and from 2% (170) to 9% (189) in SPI1 hospitals), which favoured controls and was not significant (0.3, 0.02 to 3.4; P=0.173). There were no improvements in the proportion of prescription errors and no effects that could be attributed to SPI1 in non-targeted generic areas (such as enhanced safety culture). On some measures, the lack of effect could be because compliance was already high at baseline (such as use of steroids in over 85% of cases where indicated), but even when there was more room for improvement (such as in quality of medical history taking), there was no significant additional net effect of SPI1. There were no changes over time or between control and SPI1 hospitals in errors or rates of adverse events in patients in medical wards. Mortality increased from 11% (27) to 16% (39) among controls and decreased from 17% (63) to 13% (49) among SPI1 hospitals, but the risk adjusted difference was not significant (0.5, 0.2 to 1.4; P=0.085). Poor care was a contributing factor in four of the 178 deaths identified by review of case notes. The survey of patients showed no significant differences apart from an increase in perception of cleanliness in favour of SPI1 hospitals. Conclusions The introduction of SPI1 was associated with improvements in one of the types of clinical process studied (monitoring of vital signs) and one measure of staff perceptions of organisational climate. There was no additional effect of SPI1 on other targeted issues nor on other measures of generic organisational strengthening. (shrink)

"By combining recent advances in the physical sciences with some of the novel ideas, techniques, and data of modern biology, this book attempts to achieve a new and different kind of evolutionary synthesis. I found it to be challenging, fascinating, infuriating, and provocative, but certainly not dull."--James H, Brown, University of New Mexico "This book is unquestionably mandatory reading not only for every living biologist but for generations of biologists to come."--Jack P. Hailman, Animal Behaviour , review of the first (...) edition "An important contribution to modern evolutionary thinking. It fortifies the place of Evolutionary Theory among the other well-established natural laws."--R.Gessink, TAXON. (shrink)

Currently, an emphasis is being placed on the integration of ethical issues into the business curriculum. This paper investigates the viability of using student group interaction to induce an upward movement in the stages of moral development as advanced by Kohlberg. The results of a classroom experiment using graduate business law students suggest that formulating groups that mix stages of moral development can provide a robust environment for upward movement. In addition, the results suggest strategies for formulating effective groups, based (...) upon entry levels as measured by the Defining Issues Test. (shrink)

Background Psychiatric electroceutical interventions (PEIs) use electrical or magnetic stimulation to treat mental disorders and may raise different ethical concerns than other therapies such as medications or talk therapy. Yet little is known about stakeholders’ perceptions of, and ethical concerns related to, these interventions. We aimed to better understand the ethical concerns of a variety of stakeholder groups (patients with depression, caregivers of patients, members of the public, and psychiatrists) regarding four PEIs: electroconvulsive therapy (ECT), repetitive transcranial magnetic stimulation (rTMS), (...) deep brain stimulation (DBS), and adaptive brain implants (ABI).Methods We conducted a national survey of these four stakeholder groups, using an embedded video vignette experiment depicting a patient with treatment-resistant depression and her psychiatrist discussing the possibility of treatment with one of the four PEIs.Results Participants’ ethical concerns varied by stakeholder group, by PEI, and by the interaction of the two. The three non-clinician groups tended to have similar ethical concerns, but to differ from psychiatrists. Similar concerns were raised with regard to the two implantable technologies, DBS and ABI. Overall, there was relatively little concern about the involuntary use of PEIs, though some expressed concern about the adequacy of information provided during the consent process. There was also significant concern that patients may not receive helpful therapies.Conclusions To our knowledge, this is the first national survey that includes multiple stakeholder groups and multiple PEI modalities. A better understanding of the ethical concerns of stakeholders can help to shape clinical practice and health care policy regarding PEIs. (shrink)

We report the results of a randomized trial to assess the impact of an innovative ethics curriculum on the knowledge and confidence of 85 medical house officers in a university hospital programme, as well as their responses to a simulated clinical case. Twenty-five per cent of the house officers received a lecture series, 25 per cent received lectures and case conferences, with an ethicist in attendance, and 50 per cent served as controls. A post-intervention questionnaire was administered. Knowledge scores did (...) not differ among the groups. Confidence regarding ethical issues was significantly greater in the aggregate intervention group compared to the control group. Confidence regarding procedural issues related to ethics was significantly higher for the EI group than for the controls. Responses to a simulated case showed that significantly fewer house officers in the EI group would intubate a patient for whom such therapy would be futile. We conclude that ethics education can have an impact on house officers' confidence and their responses to a simulated case, and that the EI was more effective than the LI. Such results have implications regarding the implementation of ethics education during residency. (shrink)

In Bester’s article (2018) challenging the use of the harm principle and advocating sole reliance on the use of a best interest standard (BIS) in pediatric decision-making, we believe that the auth...

[D. H. Mellor] Kant's claim that our knowledge of time is transcendental in his sense, while false of time itself, is true of tenses, i.e. of the locations of events and other temporal entities in McTaggart's A series. This fact can easily, and I think only, be explained by taking time itself to be real but tenseless. /// [J. R. Lucas] Mellor's argument from Kant fails. The difficulties in his first Antinomy are due to topological confusions, not the tensed nature (...) of time. Nor are McTaggart' s difficulties due to the tensed nature of time. The ego-centricity of tensed discourse is an essential feature of communication between selves, each of whom refers himself as 'I', and is required for talking about time as well as experience and agency. Arguments based on the Special Theory are misconceived. Some rest on a confused notion of 'topological simultaneity'. In the General Theory a cosmic time is defined, as also in quantum mechanics, where a natural present is defined by a unique hyperplane of collapse into eigen-ness. (shrink)

The Greeks attributed to Thales a great many discoveries and achievements. Few, if any, of these can be said to rest on thoroughly reliable testimony, most of them being the ascriptions of commentators and compilers who lived anything from 700 to 1,000 years after his death—a period of time equivalent to that between William the Conqueror and the present day. Inevitably there ilso accumulated round the name of Thales, as round that of Pythagoras , a number of anecdotes of varying (...) degrees of plausibility and of no historical worth whatsoever. These and the achievements credited to Thales have, of course, been painstakingly brought together by Hermann Diels in Der Fragmente der Vorsokratiker. Useful and necessary as this work undoubtedly is, it nevertheless has probably contributed as much as any other book to the exaggerated and false Aew of Thales which we meet in so many modern histories of science or philosophy, and which it is the purpose of this article to combat. (shrink)

Professor R. J. Getty has drawn attention to a tenth- or early eleventh-century manuscript of Statius’ Thebaid, hitherto examined only in Book I, namely Turonensis . Dr. Klotz, in his Teubner edition of 1908, gave citations from Book I, and wrote , ‘dolendum est sane de hoc codice primum tantum librum innotuisse, sed cum Roffensis libri maxime affinis accuratiorem notitiam haberemus, collatione quamvis -aegre careri posse nobis visum est.’ I have collated both T and Roffensis in full, and find firstly (...) that the citations of r by Klotz are far from accurate, especially in the last six books, and secondly that while it is indeed true thatT and r are very closely related, T is a much better representative than r of their common source. (shrink)

Hauptsächlich erstmalige Übersetzung der 3 Texte Kants ins Englische R & O messen den Texten keine große Bedeutung bei.

Clinical biobanks processing data of participants in the European Union fall under the scope of the General Data Protection Regulation, which among others includes requirements for consent. These requirements are further specified by the Article 29 Working Party —an EU advisory body currently known as the European Data Protection Board. Unfortunately, their guidance is cause for some confusion. While the GDPR allows participants to give broad consent for research when specific research purposes are still unknown, the WP29 guidelines suggest that (...) additional consent for specific uses should be obtained in addition to broad consent when this becomes applicable. This discrepancy elicits the question whether clinical biobanks can fail the requirement of consent if they obtain broad consent, but not a specific consent for each biomedical study. We analysed this discrepancy within the framework of contextual integrity, in order to describe the context-relative informational norms that govern information flows in clinical biobanks. However, our analysis demonstrates that there is no uniform set of norms that can be applied to all clinical biobanks. As such, neither the GDPR nor the WP29 guidance can act as a “one size fits all” approach to all clinical biobanks. Rather, differences between clinical biobanks—especially regarding the scientific aims and patient populations—make the case for context-relative norms that determine the appropriate type of consent. (shrink)

Screening programmes are becoming increasingly popular since prevention is considered 'better than cure'. While earlier diagnosis may result in more effective treatment for some, there will be consequent harm for others due to anxiety, stigma, side-effects etc. A screening test cannot guarantee the detection of all 'abnormal' cases, therefore there will be false reassurance for some. A proper consideration of the potential benefit and harm arising from screening may lead to the conclusion that the programme should not be offered. A (...) modified utilitarian approach may be used for allocation of scarce resources in health care. Ethics has an important role in this evaluation. (shrink)

R. Renehan's ingenious solutions to the problems of Symphosius 42. 1 and Anth. Lat. 207 in this journal , 471 f.) are much to be welcomed. On the other hand, I do not think that his defence of the manuscript reading in Anth. Lat. 24. 3 marcent post rorem violae, rosa perdit odorem holds water. Taking rorem as = rorem marinum he explains that ‘the poet is not presenting us with a piece of botanical information about the relative seasons of (...) the violet and rosemary; he means rather that all flowers wither and fade’. Actually, however, the poet on this showing does present information; and whether the information is botanically correct or not , that is an odd way to make his point. Stranger still is his choice of rosemary out of all the fading flowers of field and garden. It was bound to be I misunderstood. As Renehan indicates, ros = ros marinus is supported only by Virg. Georg. 2. 212–13, where the identity has been doubted, and Plin. HN 24. 100, where ex rore supra dicto refers back to ros marinum in 99. Renehan may well be the first reader not to take rorem as dew. And an evergeen shrub makes a singularly unfortunate illustration of floral decay, even though the shrub does produce a flower. Pliny classes it with herbs. (shrink)

The characteristics of inductivist historiography of science, as practised by earlier scientist/historians, and Whig historiography, as practised by earlier political historians, are described, according to the accounts of Agassi and Butterfield. It is suggested that the writings of Geikie on the history of geology allow us to characterize him as a Whig/inductivist historian of science who formulated anachronistic judgements. It is further suggested that his writings have had a considerable long-term effect on interpretations of the history of geology. The character (...) of Geikie's historiography is related to his social, political and religious views, his historicism, and his romantic enthusiasm for Nature. His methodological pronouncements are examined: he believed that the present is the key to the past, and also that the past is the key to the present. He was an empiricist and inductivist. These epistemological and methodological views impinged on his historiography of science. If one attempts to criticize Geikie's historiography, though one may try to judge his work according to the norms of his own day and age, historical anachronism cannot be avoided entirely and one may oneself be charged with acting ‘Whiggishly’. Historians of science, in the process of professionalization, have accepted the historiographical norms of general historians , but in so doing have inherited a problem that arises whenever they contemplate earlier historical writings. It is suggested that there may be more room for Whiggish historiography of science than is presently deemed acceptable. Alternatively, one may wish to draw a careful distinction between science and its meta-discipline, the historiography of science. Whig historiography conflates the two, and the work of Geikie provides a good illustration of this. (shrink)

Open peer commentary on the article “The Autopoiesis of Social Systems and its Criticisms” by Hugo Cadenas & Marcelo Arnold. Upshot: The authors claim that it is justified to extend the concept of autopoiesis from its biological origin to other disciplines, predominately those that have a social character. However, the authors do not lay strong enough conceptual grounds to justify this extension of autopoiesis because it is unclear what concept of autopoiesis it is that would achieve this objective, or why (...) the concept of autopoiesis itself should be crucial to this endeavor. (shrink)

Introduction: Early recognition of prediabetes may prevent progression to diabetes, yet not all adults are aware of their prediabetes risk. To reach all adults unaware of their risk, additional risk assessment strategies are warranted. Objectives: The objective of this study was to evaluate the potential scope of benefit from prediabetes risk assessment in the dental care setting and to identify characteristics of dental patients likely to unknowingly have prediabetes or diabetes. Methods: Data from 10,472 adults in the National Health and (...) Nutrition Examination Survey from 2013 to 2014 and 2015 to 2016 were analyzed for associations among prediabetes/diabetes risk factors, health care use, and hemoglobin A1C levels according to chi-square tests and multivariate logistic regression. Results: A total of 7.73% of US adults had seen a dentist but not a medical provider in the past 12 mo. The composition of this subpopulation was significantly different from that who saw a medical provider, in ways that might affect their diabetes risk. In addition, 31.27% of this subpopulation would be identified as being at high risk for prediabetes according to the CDC Prediabetes Screening Test, and 15.83% had hemoglobin A1C levels indicative of undiagnosed prediabetes or diabetes. Screening in a dental setting would have the highest odds of identifying someone unaware of his or her diabetes risk among those who were non-White, obese, or ≥45 y old. Conclusion: Extrapolation from this analysis indicates that screening for prediabetes at dental visits has the potential to alert an estimated 22.36 million adults of their risk for prediabetes or diabetes. Incorporating prediabetes or diabetes risk assessment into routine dental visits may enable 1) those with prediabetes to take action to decrease their risk of developing diabetes and 2) those with diabetes to engage in treatment to decrease their risk of diabetes-related complications. Knowledge Transfer Statement: Screening for prediabetes and diabetes during dental visits has the potential to raise patients’ awareness of diabetes risk and prevent prediabetes from progressing to diabetes. For some patients, the dental visit may be the only point of contact with the health care system, which heightens the importance of including diabetes risk assessment for patient well-being. (shrink)

oscula suspensis instabant carpere palmis oscula et alterna ferre supina fuga. It has been held that ferre is here to be taken for Φέρεσθαι oscula ferre is a fairly common phrase; I have met with it in twenty-two other passages down to Apuleius, in eighteen of which the meaning dare oscula is certain and in two more it is appropriate. The two exceptions are Ov. Her. 15. 101 non tecutn lacrimas, non oscula nostra tulisti and ibid 16. 253 f. oscula (...) si natae dederas, ego protinus ilia / Hermiones tenero laetus ab ore tuli. Neither offers a true parallel to the use attributed to Propertius , and in both the sense ‘bear away’ is made unmistakable by other words . As a matter of usage, then, it is justifiable to assume the meaning ‘give a kiss’ for this phrase, unless something else is plainly indicated. Further, the Propertian lines gain in point by the contrast between carpere ‘snatch’ and ferre ‘bring’. (shrink)

‘He was of Rutulian blood, born of a Saguntine mother; but he had Greek blood too, and by his two parents he combined the seed of Italy with that of Dulichium’. So Duff, and Ruperti's ‘Murrus matre Graia et patre Romano progenitus’ is not the whole story. To Silius Saguntine = Greek because, as Duff says, ‘men of Zacynthos had taken part in founding Saguntum’. prole = ‘with his children’—van Veen's Itala may well be right.