The rapid rise of international collaborative science has enabled access to genomic data. In this article, it is argued that to move beyond mapping genomic variation to understanding its role in complex disease aetiology and treatment will require extending data sharing for the purposes of clinical research translation and implementation.
Randomized controlled clinical trials play an important role in the development of new medical therapies. There is, however, an ethical issue surrounding the use of randomized treatment allocation when the patient is suffering from a life threatening condition and requires immediate treatment. Such patients can only benefit from the treatment they actually receive and not from the alternative therapy, even if it ultimately proves to be superior. We discuss a novel new way to analyse data from such clinical trials based (...) on the use of the recently developed theory of imprecise probabilities. This work draws an explicit distinction between the related but nevertheless distinct questions of inference and decision in clinical trials. The traditional question of scientific interest asks 'Which treatment offers the greater chance of success?' and is the primary reason for conducting the clinical trial. The question of decision concerns the welfare of the patients in the clinical trial, asking whether the accumulated evidence favours one treatment over the other to such an extent that the next patient should decline randomization and instead express a preference for one treatment. Consideration of the decision question within the framework of imprecise probabilities leads to a mathematical definition of equipoise and a method for governing the randomization protocol of a clinical trial. This paper describes in detail the protocol for the conduct of clinical trials based on this new method of analysis, which is illustrated in a retrospective analysis of data from a clinical trial comparing the anti-emetic drugs ondansetron and droperidol in the treatment of postoperative nausea and vomiting. The proposed methodology is compared quantitatively using computer simulation studies with conventional clinical trial designs and is shown to maintain high statistical power with reduced sample sizes, at the expense of a high type I error rate that we argue is irrelevant in some specific circumstances. Particular emphasis is placed on describing the type of medical conditions and treatment comparisons where the new methodology is expected to provide the greatest benefit. (shrink)
This article argues that a close reading of friendship practices in the plays of Plautus, in light of the relevant social science and anthropological literature on friendship, can help us establish the parameters, discourse, and behaviors associated with Roman friendship. Application of a new analytical framework for studying such relationships in ancient literature (a "processual model of friendship interaction") to the plays of Plautus increases our understanding of Roman amicitia in that it marks the relationship as a precious and all (...) too rare social bond, fraught with paradox and ambivalence, and generative of tensions, anxieties, and asymmetries. (shrink)
Philip Burton explores Augustine's treatment of language in his Confessions - a major work of Western philosophy and literature, with continuing intellectual importance. One of Augustine's key concerns is the story of his own encounters with language: from his acquisition of language as a child, through his career as schoolboy orator then star student at Carthage, to professor of rhetoric at Carthage and Rome. Having worked his way up to the eminence of Court Orator to the Roman Emperor at Milan, (...) Augustine rediscovered the catholic Christianity of his childhood - and decided that this was incompatible with his rhetorical profession. Over the next ten years, he gradually reinvents himself as a different sort of language professional: a Christian intellectual, commentating on Scripture and preaching to his flock. (shrink)