Physicians have developed a number of implicit and explicit approaches to complex medical decisions. Decision analysis is an explicit, quantitative method of clinical decision making that involves the separation of the probabilities of events from their relative values, or utilities. Its use can help physicians make difficult choices in a manner that promotes true patient participation. Decision analysis also provides a framework for the incorporation of data from multiple sources and for the assessment of the impact of uncertain data on (...) the final decision. Although this approach is imperfect, it represents a significant advance in clinical decision making. (shrink)

Background Ethical and scientific principles require that clinical trials address an important question and have the resources needed to complete the study. However, there are no clear standards for review that would ensure that these principles are upheld.Methods We conducted semi-structured interviews with a convenience sample of nineteen experts in clinical trial design, conduct, and/or oversight to elucidate current practice and identify areas of need with respect to ensuring the scientific value and feasibility of clinical trials prior to initiation and (...) while ongoing. We used a priori and grounded theory to analyze the data and constant comparative method to induce higher order themes.Results Interviewees perceived determination of scientific value as the responsibility of the investigator and, secondarily, other parties who review or oversee research. Interviewees reported that ongoing trials are rarely reevaluated due to emerging evidence from external sources, evaluation is complex, and there would be value in the development of standards for monitoring and evaluating evidence systematically. Investigators, IRBs, and/or data monitoring committees (DMCs) could undertake these responsibilities. Feasibility assessments are performed but are typically inadequate; potential solutions are unclear.Conclusions There are three domains where current approaches are suboptimal and in which further guidance is needed. First, who has the responsibility for conducting scientific review, whether it be the investigator, IRB, and/or DMC is often unclear. Second, the standards for scientific review (e.g., appropriate search terms, data sources, and analytic plan) should be defined. Third, guidance is needed on the evaluation of ongoing studies in light of potentially new and evolving evidence, with particular reference to evidence from outside the trial itself. (shrink)

There is widespread agreement that the European Union is presently suffering from a lack of social justice. Yet there is significant disagreement about what the relevant injustice consists in: Federalists believe the EU can only remedy its justice deficit through the introduction of direct interpersonal transfers between people living in separate states. Intergovernmentalists believe the justice-related purpose of the EU is to enable states to cooperate fairly, and to remain internally just and democratic in the face of increased global pressure (...) on welfare states. I suggest that despite their fundamental differences, many of the most reasonable and prominent philosophical accounts of social justice in the EU nonetheless converge in their institutional prescriptions. In particular, they may each serve as a justificatory basis for introducing the European social minimum, an EU-wide income support scheme. (shrink)

Juri Lotman. Mask in an artistic world of Gogol, and the masks of Anatoli Kaplan. The paper deals with an intersemiotic problem — how it is possible to represent a verbal image by the means of sculpture. It was written as an afterword for a German edition of N. Gogol’s Dead Souls (illustrated by photos on mask-sculpures by Anatoli Kaplan) thus using a style meant for general reader. However, it includes a deep analysis and several important conclusions about the fancy (...) worlds of Gogol and Kaplan, and about the possibilities to create connections between them. It is stressed that the very artistic illustration is possible only due to its independence, due to the subjective seeing of the author. (shrink)

Spontaneous Infra-Slow Fluctuations of the human EEG were discovered 60 years ago when appropriate amplifiers for their recordings were designed. To avoid skin-related artifacts the recording of EEG-ISFs required puncturing the skin under the electrode. In the beginning of the 21st century the interest in EEG-ISFs was renewed with the appearance of commercially available DC-coupled amplified and by observation of ISFs of the blood oxygen level–dependent functional magnetic resonance imaging signal at a similar frequency. The independent components of irregular EEG-ISFs (...) were shown to correlate with BOLD signals which in turn were driven by changes in arousal level measured by galvanic skin response, pupil size and HRV. There is no consensus regarding the temporal organization of EEG-ISFs: some studies emphasize the absence of peaks on EEG-ISFs spectra, some studies report prominent oscillations with frequency around 0.1 or 0.02 Hz, while some emphasize multiple discrete infraslow oscillations. No studies used parameters of EEG-ISFs as neuromarkers to discriminate psychiatric patients from healthy controls. Finally, a set of working hypotheses is suggested that must be tested in future research to solve the enigma of EEG-ISFs. (shrink)

Today, the risk management of budget challenges throughout the budget process is greater than ever. The process of change has been driven by new information and communication technologies, resulting in e-government. The purpose of this scientific paper is to see whether budgetary challenges have an effect on the performance of e-government in complex financial systems based on factors F1, F2, F3, F4, and F5: lack of information, lack of cooperation, lack of resources and reduction of focus, lack of budget experts (...) and financial stability, and shortcomings and inconsistencies during the budget process. Therefore, this study aims to advance the understanding of how to manage risks from budgetary challenges by focusing on a novel approach to improve e-government performance in complex financial systems. Empirical research was based on three key issues: an approach to e-government, analyzing which variables need more attention to risk, and learning how to meet budgetary challenges to improve performance during governance. For this study, the data were conducted by Kosovo’s public institutions, more specifically at the central level and at the local level. A total of 38 questionnaires were analyzed and divided into three sessions, which were analyzed through three analyses, such as factor analysis, data reliability analysis, and multiple regression analysis, using SPSS version 23.0 for Windows. The research was conducted over the years 2017, 2018, 2019, and 2020, while the analysis involved several processes, where some of the factors were removed in order to make the model acceptable. In this case, 21 variables were tested and divided into 5 factors. The results showed that special attention should be paid to these factors to reduce budgetary challenges and increase the performance of e-government in complex financial systems, such as lack of resources, increasing the focus on risk management even after the transfer of funds from the ministry to the municipality, the selection of programs based on priorities and not on the basis of wishes and policies, having political stability, rule of law, and more control, and having regulations and guidelines from the practices of developed countries as well as taking into account the opinions of budget experts. The implications of this paper have to do with only a considerable number of variables, which were taken in the study as well as only in the municipalities of Kosovo. In this case, for other analyses by other researchers, other variables can be analyzed in other countries by making comparisons. (shrink)

This article by Juri Lotman from the third volume of Trudy po znakovym sistemam (Sign Systems Studies) in 1967, deals with the problem of artistic modelling. The general working questions are whether art displays any characteristic traits that are common for all modelling systems and which could be the specific traits that can distinguish art from other modelling systems. Art is seen as a secondary modelling system, more precisely, as a play-type model, which is characterised simultaneously by practical and conventional (...) behaviour and constant awareness of the possibility of alternate meanings to the one that is currently being perceived. At the same time art has play-like elements but is not the same as play, since play is inherently rule-bound, whereas art is a more flexible model thepurpose of which is truth. Art is a special type of modelling system, since it is on one hand suitable for storing very large amount of complex information, but onthe other hand it can increase the stored information and transform the consumer. (shrink)

The aim of this article is to argue that the principle of “publicity” constitutes a fundamental idea in Kant’s political thought. Publicity provides a central insight that binds together various strands of Kant’s political writings (on issues as diverse as the question of Enlightenment, the right of revolution, historical teleology, reflective judgment, cosmopolitan citizenship, democratic peace, and republican government), and moreover, it offers a much-needed cornerstone for a systematic exposition of his nonexistent political philosophy. Apart from some eminent examples, publicity (...) has been a rather neglected topic in the ever-expanding literature on Kant’s political ideas. Revisiting this notion will make us more attentive to his evocation of the “spirit of republicanism” over and above the letter of the law, and might prompt us to reconsider Kant’s reputation as a classical representative of liberal political thought. Indeed, it should inspire us to situate Kant’s appeal for the “public use of reason” in the vicinity of the republican ideal of political liberty. (shrink)

This article aims through a study of the epigraphy of Pope Damasus, to reconstruct the ideal society that was shown to the pilgrim who went to the loca sanctorum in the Urbs. Taking into account the pastoral, political and ideological elements of Damasian epigraphy, it shows that the choice of martyrs and subjects which were celebrated responded to the increasing numbers of nobles within Roman Christian society after the peace of Constantine. Damasus tried to accommodated himself to the sensibilities of (...) the minor aristocracy of Rome and the emerging clergy, without renouncing its hierarchical organization of the Church in line with the social and ecclesial tendencies of the second half of the fourth century, when Roma christiana came into being. (shrink)

El presente trabajo esboza la doctrina suareciana sobre el ejercicio del poder soberano en el contexto ideológico de la llamada Escuela de Salamanca, haciendo foco en la factibilidad de la resistencia al mismo, en los casos de tiranía y vinculando tal resistencia a la clave fundamental de la comunidad política que es el bien común, al cual está ordenada la potestad soberana. Nos interesa confrontar esta doctrina con la de un autor contemporáneo a Suárez y clásico por sus aportes a (...) la noción de soberanía de la República como lo fue Jean Bodin, con sus Seis Libros de la República. (shrink)

Should we be worried that the concept of trust is increasingly used when we assess non-human agents and artefacts, say robots and AI systems? Whilst some authors have developed explanations of the concept of trust with a view to accounting for trust in AI systems and other non-agents, others have rejected the idea that we should extend trust in this way. The article advances this debate by bringing insights from conceptual engineering to bear on this issue. After setting up a (...) target concept of trust in terms of four functional desiderata (trust-reliance distinction, explanatory strength, tracking affective responses, and accounting for distrust), I analyze how agential vs. non-agential accounts can satisfy these. A final section investigates how ‘non-ideal’ circumstances—that is, circumstances where the manifest and operative concept use diverge amongst concept users—affect our choice about which rendering of trust is to be preferred. I suggest that some prominent arguments against extending the language of trust to non-agents are not decisive and reflect on an important oversight in the current debate, namely a failure to address how narrower, agent-centred accounts curtail our ability to distrust non-agents. (shrink)

Since Popper and Lakatos, the demarcation line between science and non-science has been considered one of the fundamental issues of the philosophy of science. According to Lakatos, pseudoscience is a non-science, which appears as science, using science's public authority. Since then, mountains of texts have been published on how non-sciences, such as astrology, are not sciences. -/- But the enemy is not on the other side of the border. The enemy is in our midst. Science has been institutionalized. The best (...) way to do the pseudoscience is to fuss inside the big enterprise recognized as a science. (shrink)

Tõde või eimiski [= Truth or Nothingness]. A collection of philosophical essays 1990-2021. In Estonian. -/- Kogumikku hoolikalt valitud tekstid on ühelt poolt loomingulised, lugejat intrigeerivad ning interdistsiplinaarsed – kõige rohkem põimitakse filosoofilisi arutlusi psühholoogilistega. Kuid teisest küljest on esseed filosoofiliselt ranged, demonstreerides oskust jääda ka rakenduslikes teemaarendustes üdini filosoofiks. Raamatus leidub nii filosoofia olemuse üle arutlevaid tekste, kaasahaaravaid filosoofia suurkujude tõlgendusi, põhjalikult käsitletakse ka praktilise filosoofia alla kuuluvaid teemasid kuni meie kaasaja poliitilise olukorra diagnoosi ja kriitikani välja. Raamatu lõpus (...) on intervjuu väljaandjaga. (shrink)

This contribution investigates a specific agricultural protest movement that emerged towards the end of the Second World War in Western Switzerland. In the spring of 1945, dissatisfied farmers in the French-speaking part of Switzerland founded the “Union Romande des Agriculteurs” (URA), a peasant opposition movement that struggled against both the increasing power of the state and the existing farmers’ organizations in regulating agriculture and the disintegrating impact of industrial capitalism on the livelihoods and way of life of farming communities. In (...) the fall of 1945 and 1947, the URA organized two milk delivery strikes to mobilize fellow farmers to join the URA’s resistance. They also founded their own journal, tellingly called _Le Paysan Enchâiné_ – “The Chained Peasant.” The leaders of the movement were later brought to the courts and condemned to harsh punishments for their non-compliance with the milk delivery obligations that emanated from the war economy regime and that were still in force after the war. The story of the URA’s milk delivery strikes and its suppression by the state and the official farmers’ organizations is also a story of farmers’ use of symbolic practices with which they forged their identity as an opposition movement and by which they demanded political legitimacy for their claims. By taking a closer look at the activities of this movement and investigating the performance of the URA’s protests, as well as the symbolic meanings they attached to them, this article attempts to decipher the often-intangible political symbolism and ritual character that shaped their protesting, at the crossroads of long-standing traditions of peasant resistance and the new challenges farmers were facing in the transformation of mid-20th century agriculture. (shrink)

Although Van de Vliert presented an entertaining story containing several original observations, an implicit assumption that climate affects human society identically through the history is not realistic. If almost everything is explained by cold winters or hot summers, then nothing is explained. Ignoring rival explanations does not make the proposed theory more convincing.

It is shown that the product of finitely many sequential, CLP-compact spaces is CLP-compact.

It is shown to be consistent that the reals are covered by ℵ1 meagre sets yet there is a Baire class 1 function which cannot be covered by fewer than ℵ2 continuous functions. A new cardinal invariant is introduced which corresponds to the least number of continuous functions required to cover a given function. This is characterized combinatorially. A forcing notion similar to, but not equivalent to, superperfect forcing is introduced.

Nakba is ignored in Western philosophy encyclopedias, and the notion of genocide is rarely explained. In turn, there is much talk about the Holocaust.

To any metric space it is possible to associate the cardinal invariant corresponding to the least number of rectifiable curves in the space whose union is not meagre. It is shown that this invariant can vary with the metric space considered, even when restricted to the class of convex subspaces of separable Banach spaces. As a corollary it is obtained that it is consistent with set theory that any set of reals of size ℵ 1 is meagre yet there are (...) ℵ 1 rectifiable curves in R 3 whose union is not meagre. The consistency of this statement when the phrase "rectifiable curves" is replaced by "straight lines" remains open. (shrink)