This paper describes the application of eight statistical and machine-learning methods to derive computer models for predicting mortality of hospital patients with pneumonia from their findings at initial presentation. The eight models were each constructed based on 9847 patient cases and they were each evaluated on 4352 additional cases. The primary evaluation metric was the error in predicted survival as a function of the fraction of patients predicted to survive. This metric is useful in assessing a model’s potential to assist (...) a clinician in deciding whether to treat a given patient in the hospital or at home. We examined the error rates of the models when predicting that a given fraction of patients will survive. We examined survival fractions between 0.1 and 0.6. Over this range, each model’s predictive error rate was within 1% of the error rate of every other model. When predicting that approximately 30°K of the patients will survive, all the models have an error rate of less than 1.5%. The models are distinguished more by the number of variables and parameters that they contain than by their error rates; these differences suggest which models may be the most amenable to future implementation as paper-based guidelines. (shrink)

Much progress has been made in recent years regarding the mechanisms of targeting of secretory proteins to, and across, the endoplasmic reticulum (ER) membrane. Many of the cellular components involved in mediating translocation across this bilayer have been identified and characterized. Polypeptide domains of secretory proteins, termed signal peptides, have been shown to be necessary, and in most cases sufficient, for entry of preproteins into the lumen of the ER. These NH2‐ terminal segments appear to serve multiple roles in targeting (...) and translocation. The structural features which mediate their multiple functions are currently the subject of intense study. (shrink)

This study was a preliminary exploration of the value changes taking place in the United States since the September 11, 2001 terrorist attack on the World Trade Center in New York, which was a significant emotional event or cultural upheaval. Rokeach told us that "a person's total value system may undergo change as a result of socialization, therapy, or cultural upheaval..." (Rokeach, The Nature of Human Values, 1973, p. 37). The researchers explored the value changes of 500 aviation industry employees (...) before the attack and 500 after the attack. The statistically significant research results showed a total of twenty-seven of thirty-six values changed. Before the attack respondents valued much higher self-esteem and self-actualization values like A Sense of Accomplishment and Self-Respect. After the attack respondents placed a much higher value importance on survival, safety and security values like A World at Peace, Freedom, Family Security, National Security, Mature Love, Salvation, and True Friendship. (shrink)

Objective: To assess the adequacy of the process of informed consent for surgical patients at the University Hospital of the West Indies. Method: The study is a prospective, cross-sectional, descriptive study. 210 patients at the University Hospital of the West Indies were interviewed using a standardised investigator-administered questionnaire, developed by the authors, after obtaining witnessed, informed consent for participation in the study. Data were analysed using SPSS V.12 for Windows. Results: Of the patients, 39.4% were male. Of the surgical procedures, (...) 68.6% were scheduled, 7.6% urgent and 23.8% emergency, 35.2% were minor and 64.8% major. Information imparted/received was acceptable in 40% of cases, good in 24% and inadequate (unacceptable) in 36% of cases. Almost all (97.6%) patients stated that they understood why an operation was planned and 93.3% thought that they had given informed consent. Most (95.2%) thought that they had free choice and made up their own mind. A quarter (25.2%) of all patients were told that it was mandatory for them to sign the form. There was a discussion of possible side effects and complications in 56.7% of patients. Conclusions: This study clearly indicates that surgical patients at the University Hospital of the West Indies feel that they have given informed consent. However, it also suggests that more information should be given to patients for consent to be truly informed. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy and Rhetoric 36.1 (2003) 1-21 [Access article in PDF] Did Habermas Cede Nature to the Positivists? Gordon R. Mitchell Jürgen Habermas's "colonization of the lifeworld" thesis (1987, 332-73) posits that many of society's pathologies are due to the tendency of institutions to convert social issues that ought to be sorted out by a debating citizenry into technical problems ripe for resolution by expert bureaucracies, thus pre-empting (...) important public discussion. Habermas has attempted to lay bare the pernicious effects of this colonization process in his analysis of public opinion polling, welfare policy, education, German reunification, immigration, and other social issues (see Habermas 1997, 1994, and 1970; Holub 1992). In each of these contexts, Habermas has publicly challenged the encroachment of scientistic modes of decision-making into spheres where joint communicative action by deliberating citizens would yield more appropriate and legitimate judgments. This critical impulse is also evident in Habermas's methodological reflections on the proper role of academic scholarship, where he has argued vigorously against attempts to graft "objectivating" methods of natural scientific inquiry onto research projects in the social sciences (1971, 304-17).From all of this, one might gather that Habermas's commitment to rolling back the influence of technical forms of reasoning is connected to some intrinsic quarrel he has with the natural sciences. Yet such a sweeping generalization is hard to sustain in light of the fact that Habermas does not oppose technical reasoning per se; he recognizes that the daunting complexity of social life in late capitalism requiresthat certain "steering" tasks be delegated to systems that utilize largely instrumental logics to co-ordinate action. Likewise, he acknowledges that the disciplines of the natural sciences necessarily play important supporting roles in such steering projects.One normative presupposition of Habermas's colonization thesis is that there exists some proper boundary demarcating where the sphere of technical reasoning ends and the realm of communicative rationality begins. [End Page 1] On one side of this boundary, Habermas has provided many details on what he sees as the essential qualities of a properly functioning "public sphere," where "new social movements" continuously reweave the threads of communicative fabric holding society together (1996, 359-87), and where "historico-hermeneutic" academic study reflects on public life, sluicing insight back into the capillaries of democratic deliberations (1987, 374-403).What lies on the other side of the boundary is murkier. The proper role of natural scientific investigation has received relatively scant attention in Habermas's critical theory of society, and this has led to some confusion regarding his account of the natural sciences, as well as debate over whether this account has political purchase. One would think that sympathetic commentators, such as Helen Longino (who bases much of her own coherence theory of scientific truth on Habermas), would have reassuring things to say on this point. Yet her lukewarm assessment that, "in trying to clear a space for an autonomous social and critical theory, [Habermas] has ceded nature to the positivists" (1990, 202), raises questions about the flexibility and scope of Habermas's theory of communicative action as a basis for critique of scientific practice.One way to test Habermas's account of the natural sciences on this count is to put his views in conversation with science studies commentators who share a similar commitment to the idea that dialogue and argumentation are constitutive elements of scientific practice. Such an approach recasts the "ceding to positivism" question into a moment of controversy over the role of dialogue, not only as an essential motor driving the scientific enterprise, but also as a vehicle for democratic decision-making on issues related to the purpose and direction of scientific inquiry in society.Part one of this essay locates discursive norms embedded pragmatically in the notion of scientific objectivity. By bringing a modified version of Habermas's theory of communicative action into conversation with other approaches to science studies that foreground intersubjective dialogue as the key motor driving the scientific enterprise, I develop a foundation for robust criticism of systematically distorted scientific communication. Specific strategies of... (shrink)

We present a formal, mathematical model of argument structure and evaluation, taking seriously the procedural and dialogical aspects of argumentation. The model applies proof standards to determine the acceptability of statements on an issue-by-issue basis. The model uses different types of premises (ordinary premises, assumptions and exceptions) and information about the dialectical status of statements (stated, questioned, accepted or rejected) to allow the burden of proof to be allocated to the proponent or the respondent, as appropriate, for each premise separately. (...) Our approach allows the burden of proof for a premise to be assigned to a different party than the one who has the burden of proving the conclusion of the argument, and also to change the burden of proof or applicable proof standard as the dialogue progresses from stage to stage. Useful for modeling legal dialogues, the burden of production and burden of persuasion can be handled separately, with a different responsible party and applicable proof standard for each. Carneades enables critical questions of argumentation schemes to be modeled as additional premises, using premise types to capture the varying effect on the burden of proof of different kinds of questions. (shrink)

While many "benchtop-to-bedside" research pathways have been developed in "Type I" translational medicine, vehicles to facilitate "Type II" and "Type III" translation that convert scientific data into clinical and community interventions designed to improve the health of human populations remain elusive. Further, while a high percentage of physicians endorse the principle of citizen leadership, many have difficulty practicing it. This discrepancy has been attributed, in part, to lack of training and preparation for public advocacy, time limitation, and institutional resistance. As (...) translational medicine and physician-citizenship implicate social, political, economic and cultural factors, both enterprises require "integrative" research strategies that blend insights from multiple fields of study, as well as rhetorical acumen in adapting messages to reach multiple audiences. This article considers how argumentation theory's epistemological flexibility, audience attentiveness, and heuristic qualities, combined with concepts from classical rhetoric, such as rhetorical invention, the synecdoche, and ethos, yield tools to facilitate translational medicine and enable physician-citizenship. (shrink)

Robust stakeholder engagement in health research requires broad communicative integration, not only of patients but also other stakeholders such as health system leaders, clinicians, and researcher...

Using a sample of 652 college students, we examined several implications of the hypothesis that the shape of the human penis evolved to enable males to substitute their semen for those of their rivals. The incidence of double mating by females appears sufficient to make semen displacement adaptive (e.g., one in four females acknowledge infidelity, one in eight admit having sex with two or more males in a 24-hour period, and one in 12 report involvement in one or more sexual (...) threesomes with two males). We also document several changes in post-ejaculatory behavior (e.g., reduced thrusting, penis withdrawal, loss of an erection) which may have evolved to minimize displacement of the male’s own semen. Consistent with predictions derived from a theoretical model (Gallup and Burch 2006), we discovered that most females report waiting at least 48 hours following an instance of infidelity before resuming sex with their in-pair partners. (shrink)

In a critical discussion, interlocutors can strategically maneuver by shading their expressed degree of standpoint commitment for rhetorical effect. When is such strategic shading reasonable, and when does it cross the line and risk fallacious derailment of the discussion? Analysis of President George W. Bush’s 2002–2003 prewar commentary on Iraq provides an occasion to explore this question and revisit Douglas Ehninger’s distinction between argumentation as coercive correction and argumentation as a person-risking enterprise. Points of overlap between Ehninger’s account and pragma-dialectical (...) argumentation theory suggest avenues for harmonization of rhetorical and dialectical perspectives on argumentation. Out of this conceptual convergence comes theoretical resources for understanding strategic maneuvering, by accounting for ways that discussants exploit gaps between their externalized and actual discussion attitude. As such higher-order strategic maneuvering played a major role in the 2003 Iraq prewar discourse failure, perspicacious understanding of this particular argumentative maneuver carries practical, as well as theoretical import. (shrink)

This volume of essays offers direct comparisons of historic Western and Buddhist perspectives on ethics and metaphysics, tracing parallels and contrasts all the way from Plato to the Stoics, Spinoza to Hume, and Schopenhauer through to contemporary ethicists such as Arne Naess, Charles Taylor and Derek Parfit. It compares and contrasts each Western philosopher with a particular strand in the Buddhist tradition, in some chapters represented by individual writers such as Nagarjuna, Vasubandhu, Santideva or Tsong Khapa. It does so in (...) light of both analytic concerns and themes from the existentialist and phenomenological traditions, and often in an ecumenical spirit that bridges both analytic and continentalist approaches. Some of the deepest questions in ethics, dealing with the scope of agency, value-laden notions of personhood and the nature of value in general, are intertwined with questions in metaphysics. One set of questions addresses how varying conceptions of selfhood relate to moral values ; another set of questions addresses how a conception of oneself or one’s selves should or should not affect how one thinks of happiness, or eudaimonia, or – in classical Indian terms – artha, sukha or nirvana. Western philosophy has featured discussion of both, but some would argue that certain traditions of Asian philosophy have offered a more sustained and even treatment of both sets of questions. The Buddhist tradition in particular has not only featured much discussion on both fronts, but has attracted many contemporary philosophers to its distinctive spectrum of approaches, and to what is – from many ‘Western’ points of view – a seemingly subversive analysis of ego, selfhood and personhood, whether in metaphysical, phenomenological or other incarnations. (shrink)

The advent of population-specific genomic research has prompted calls for invention of informed consent protocols that would treat entire social groups as research subjects as well as endow such groups with authority as agents of consent. Critics of such an unconventional ethical norm of group consent fear the rhetorical effects of approaching social groups with offers to participate in dialogues about informed consent. Addressing a specific population as the collective subject of genomic research, on this logic, adds currency to the (...) potentially dangerous public opinion that such a group is bound by genetic ties. The paper considers the problem of group and individual identity within the rhetorical dynamics of the discourse and politics of consent. (shrink)

When individuals learn from what others tell them, the information is subject to transmission error that does not arise in learning from direct experience. Yet evidence shows that humans consistently prefer this apparently more unreliable source of information. We examine the effect this preference has in cases where the information concerns a judgment on others’ behaviour and is used to establish cooperation in a society. We present a spatial model confirming that cooperation can be sustained by gossip containing a high (...) degree of uncertainty. Accuracy alone does not predict the value of information in evolutionary terms; relevance, the impact of information on behavioural outcomes, must also be considered. We then show that once relevance is incorporated as a criterion, second-hand information can no longer be discounted on the basis of its poor fidelity alone. Finally we show that the relative importance of accuracy and relevance depends on factors of life history and demography. (shrink)

The central claim of this book is that, early and late, Wittgenstein modelled his approach to existential meaning on his account of linguistic meaning. A reading of Nietzsche’s The Birth of Tragedy sets up Bearn’s reading of the existential point of Wittgenstein’s Tractatus. Bearn argues that both books try to resolve our anxiety about the meaning of life by appeal to the deep, unutterable essence of the world. Bearn argues that as Wittgenstein’s and Nietzsche’s thought matured, they both separately came (...) to believe that the answer to our existential anxiety does not lie beneath the surfaces of our lives, but in our acceptance—Nietzsche’s “Yes”—of the groundless details of those surfaces themselves: the wonder of the ordinary. (shrink)

In 2000, US Secretary of Health and Human Services Secretary Tommy Thompson mobilized the US public health infrastructure to deal with escalating trends of excess body weight. A cornerstone of this effort was a report entitled The Surgeon General's Call to Action to Prevent and Decrease Overweight and Obesity. The report stimulated a great deal of public discussion by utilizing the distinctive public health terminology of an epidemic to describe the growing prevalence of obesity in the US population. We suggest (...) that the ensuing controversy was fueled in part by the report's ambiguous usage of the evocative term “epidemic.” In some passages, the report seems to use “epidemic” in a literal sense, suggesting that rising prevalence of excess body weight should be defined technically as a disease outbreak. Other passages of the report present the same key term metaphorically, leaving readers with the impression that the epidemic language is invoked primarily for rhetorical effect. Here, we explore dynamics and implications of both interpretations. This analysis sheds light on the ongoing public argument about the appropriate societal response to steadily increasing body sizes in the US population; likewise, it capitalizes on the accumulated knowledge that the field of public health has garnered from combating diverse historic epidemics. Our interdisciplinary approach deploys critical tools from the fields of rhetoric, sociology and epidemiology. In particular, we draw from metaphor theory and public address scholarship to elucidate how the Call to Action frames public deliberation on obesity. We turn to the applied public health literature to develop a reading of the report that suggests a novel approach to the problem—application of the Epidemic Investigation protocol to streamline the public health response and reframe the public argument about obesity. (shrink)

Apparent design breakthroughs in short-range missile defense systems such as Theater High-Altitude Air Defense have prompted questions about the legality of such systems under the 1972 Antiballistic Missile Treaty. Prominent physicists have used computer “footprint” methodology to prove that if engineered to specifications, THAAD might exceed ABM Treaty performance limits banning highly effective missile defense systems. In response, missile defense officials commissioned Sparta, Inc. to conduct secret research casting doubt on the validity of such findings. The substantial diplomatic issues at (...) stake and the interesting rhetorical dynamics involved in this dispute warrant close scholarly analysis. Attention to the iterative relationship between the interpenetrating spheres of public argument and scientific practice in this case yields novel insight about the processes in which technical knowledge of defense systems is forged and raises fresh issues for the “closure project” in science and technology controversy studies. (shrink)

Repetition plays a significant, productive role in the work of both Derrida and Deleuze. But the difference between these two philosophers couldn''t be greater: it is the difference between negation and affirmation, between Yes and No. In Derrida, the productive energy of repetition derives from negation, from the necessary impossibility of supplementing an absence. Deleuze recognizes the kind of repetition which concerns Derrida, but insists that there is another, primary form of repetition which is fully positive and affirmative. I will (...) argue that there is nothing in Derrida''s philosophy to match the affirmative, primary form of repetition articulated by Deleuze. Moreover, it is precisely this difference that accounts for the most exciting features of Deleuze''s work: the possibility of breaking through to the other side of representation, beyond authenticity and inauthenticity, becoming-becoming. (shrink)

The past 50 years have seen an accumulation of evidence suggesting that associative learning depends on high-level cognitive processes that give rise to propositional knowledge. Yet, many learning theorists maintain a belief in a learning mechanism in which links between mental representations are formed automatically. We characterize and highlight the differences between the propositional and link approaches, and review the relevant empirical evidence. We conclude that learning is the consequence of propositional reasoning processes that cooperate with the unconscious processes involved (...) in memory retrieval and perception. We argue that this new conceptual framework allows many of the important recent advances in associative learning research to be retained, but recast in a model that provides a firmer foundation for both immediate application and future research. (shrink)

The Pleadings Game is a normative formalization and computational model of civil pleading, founded in Roberty Alexy''s discourse theory of legal argumentation. The consequences of arguments and counterarguments are modelled using Geffner and Pearl''s nonmonotonic logic,conditional entailment. Discourse in focussed using the concepts of issue and relevance. Conflicts between arguments can be resolved by arguing about the validity and priority of rules, at any level. The computational model is fully implemented and has been tested using examples from Article Nine of (...) the Uniform Commercial Code. (shrink)

The common view of the transition between subitizing and numerosity estimation regimes is that there is a hard bound on the subitizing range, and beyond this range, people estimate. However, this view does not adequately address the behavioral signatures of enumeration under conditions of attentional load or in the immediate post-subitizing range. The possibility that there might exist a numerosity range where both processes of subitizing and estimation operate in conjunction has so far been ignored. Here, we investigate this new (...) proposal, that people strategically combine the processes of subitizing and estimation to maximize accuracy and precision, given time or attentional constraints. We present a process-level account of how subitizing and estimation can be combined through strategic deployment of attention to maximize the precision of perceived numerosity given time constraints. We then describe a computational model of this account and apply it in two experimental simulations to demonstrate how it can explain key findings in prior enumeration research. While recent modeling work has argued that the behavioral signatures of enumeration can best be explained through a single numerosity system with a single form of representation, we argue that our model demonstrates how the traditional two-systems view of numerical representation accounts for behavioral data through coordination with a unified attentional mechanism, rather than a unified representation. (shrink)

The essay characterizes an anthropological impasse of political philosophy dividing those in a more liberal tradition from those in a more Hegelian tradition, and then it proceeds to sketch a political philosophy without any human or anthropological content. I rely on Foucault’s notion of parrhesia to activate such a political philosophy, and I rely on the philosophical life of the Cynic to make parrhesia possible. Finally by invoking exercises of ascent and of descent, I suggest that this kind of political (...) philosophy can not only solve the anthropological impasse of political philosophy, but also in practice, it can cool hateful passions and warm cold hearts. (shrink)

Higher-Order Logic (HOL) is a proof development system intended for applications to both hardware and software. It is principally used in two ways: for directly proving theorems, and as theorem-proving support for application-specific verification systems. HOL is currently being applied to a wide variety of problems, including the specification and verification of critical systems. Introduction to HOL provides a coherent and self-contained description of HOL containing both a tutorial introduction and most of the material that is needed for day-to-day work (...) with the system. After a quick overview that gives a "hands-on feel" for the way HOL is used, there follows a detailed description of the ML language. The logic that HOL supports and how this logic is embedded in ML, are then described in detail. This is followed by an explanation of the theorem-proving infrastructure provided by HOL. Finally two appendices contain a subset of the reference manual, and an overview of the HOL library, including an example of an actual library documentation. (shrink)

Carneades is an open source argument mapping application and a programming library for building argumentation support tools. In this paper, Carneades’ support for argument reconstruction, evaluation and visualization is illustrated by modeling most of the factual and legal arguments in Popov v Hayashi.

In lieu of an abstract, here is a brief excerpt of the content:Effecting AffectionThe Corporeal Ethics of Gins and ArakawaGordon C. F. Bearn (bio)No one has yet determined what the body can do …—Spinoza, Ethics, 1677, Part III, proposition 2, ScholiumWhat could be the educational relevance of an architecture designed to make its inhabitants live forever? At first, it is hard to take seriously that Madeline Gins and Arakawa, in their work Architectural Body, are trying to escape mortality. Many are (...) those who smile and say that what they call "the architectural surrounds" that they have designed and built for what they call "organisms that person" are intriguing enough, but this idea of slipping death's grip… Really. They say. Hmmm. And they clear their throats. But is it really that unusual to think that what inspires philosophical thinking is death? And insofar as death has inspired philosophy, hasn't it inspired escape—and if not escape from death itself then at least escape from its terrors? Plato's Phaedo is an early instance of this, and Wittgenstein's Tractatus is a more recent one, no less explicit in its discussion of death. Gins and Arakawa are therefore part of a long and traditional line of philosophers who's thinking never quite loses sight of death. But why are philosophers concerned with death?The reason is simple. By and large, philosophers don't like it here. They would rather be somewhere else. And what don't they like about it here? Often, almost invariably, it is becoming that bothers them. Becoming. And they don't like becoming both for existential and metaphysical reasons. Existentially, "becoming" means change. Today's friends may betray you tomorrow, or the next day. And even if they don't, they will die. And be gone. You too. Soon enough. Dead. Existentially, change and becoming ruin everything we care about—people and projects. Metaphysically, "becoming" is a threat to the dream of understanding, the dream of forming a precise [End Page 40] picture of the world. I learned this from the opening pages of Deleuze's Logic of Sense. On top of the cake, beautifully marked in currants, are the words "EAT ME," and Alice did. She ate the cake and grew taller. And what, you may wonder, is the problem with that? It happens at children's parties every day, even after eating normal cake.Common sense assumes that at any moment Alice will be a certain height, and that as the moments pass her height will increase. But this is just as if we had taken an egg-slicer to her becoming taller, turning becoming into a succession of unchanging slices of being. This egg-sliced reality is good enough for ordinary work, and it is good enough, by means of the calculus, for science and for physics. But it is not good enough for metaphysics. If at a given moment Alice is really becoming taller, then at that moment, while she is becoming, she must paradoxically be both a definite height h, and also not h. If there is becoming, then the world cannot be completely conceptually represented. And if everything is becoming, then nothing can be conceptually represented. That is the metaphysical difficulty with becoming, and so philosophers run from becoming. They run both from death and from what is beyond representation.They tend to go in either of two directions. Up or down. Either up to eternity if you are drawn to the transcendent, or down to the rough ground, the earth, if you are drawn to the ordinary. In either case, the negation implicit in becoming, whether it is the negation of life or the negation of our dreams of conceptual representation, both of these negations are themselves negated. It is the old philosophical gambit: backing by double negation into an ersatz affirmation. Gins and Arakawa join neither of these two ways of escaping becoming. But first let us see why these two negations are disappointing.Take the way up first. This is famously the technique of Plato's Phaedo. Worried that your lover or your mother or you yourself is going to die, Plato's Socrates carves out room for the eternity of the form of human... (shrink)