A Charter on Medical Professionalism (CMA) has just recently been developed internationally, and the Canadian Medical Association is calling for public dialogue on medical professionalism now that reforms in the Canadian system of health care are imminent. We posit that good practices are at issue; we outline the essence of these in general and also specifically in the knowing, teaching and intervening components of practice. We also see challenges not to, but in, medical professionalism – first and foremost in the (...) profession's definition of good practices and the payer's confinement of insurance coverage to these. (shrink)

This book is unique in presenting an interdisciplinary conversation between jurists and logicians. It brings together scholars from both law and philosophy and looks at the application of 'the new logics' to law and legal ordering, in a number of legal systems. The first Part explores the ways in which the new logics shed light on the functioning of legal orders, including the structure of legal argumentation and the rules of evidence. The second addresses how non-classical logics can help us (...) to understand the interactions between multiple legal orders, in a range of contexts including domestic and international law. The final Part examines particular issues in the applicability of non-classical logics to legal reasoning. This book will be of interest to jurisprudence and logic scholars and students who want to deepen their understanding of relationships between law and legal reasoning, and learn about recent developments in formal logic. (shrink)

Adaptive training adjusts a training task with the goal of improving learning outcomes. Adaptive training has been shown to improve human performance in attention, working memory capacity, and motor control tasks. Additionally, correlations have been observed between neural EEG spectral features (4–13 Hz) and the performance of some cognitive tasks. This relationship suggests some EEG features may be useful in adaptive training regimens. Here, we anticipated that adding a neural measure into a behavioral-based adaptive training system would improve human performance (...) on a subsequent transfer task. We designed, developed, and conducted a between-subjects study of 44 participants comparing three training regimens: Single Item Fixed Difficulty (SIFD), Behaviorally Adaptive Training (BAT), and Combined Adaptive Training (CAT) using both behavioral and EEG measures. Results showed a statistically significant transfer task performance advantage of the CAT-based system relative to SIFD and BAT systems of 6 and 9 percentage points, respectively. Our research shows a promising pathway for designing closed-loop BCI systems based on both users' behavioral performance and neural signals for augmenting human performance. (shrink)

Car sickness is a major concern for car passengers, and with the development of autonomous vehicles, increasing numbers of car occupants are likely to be affected. Previous laboratory studies have used EEG measurements to better understand the cerebral changes linked to symptoms. However, the dynamics of motion in labs/simulators differ from those of a real car. This study sought to identify specific cerebral changes associated with the level of car sickness experienced in real driving conditions. Nine healthy volunteers participated as (...) front passengers in a slalom session inducing lateral movements at very low frequency. They were continuously monitored via EEG recordings and subjectively rated their level of symptoms after each slalom, using a 5-point likert scale. Car-sickness symptoms evolved concomitantly with changes in theta and alpha power in the occipital and parietal areas. These changes may reflect altered sensory integration, as well as a possible influence of sleepiness mitigating symptoms. (shrink)

The question of how we apply knowledge from biomedical science to medical and public health practice has been the subject of heated debates about generalizability and related concepts, such as applicability and inductive inference. In this essay, I interpret the term from the perspective of two causal models: determinism and indeterminism. I suggest that theories of generalizability can be formulated on the basis of both models and take the form of testable but unverifiable hypotheses, an attribute that is common to (...) all scientific theories. Nonetheless, there is one noteworthy difference between the two models: determinism allows one to rationalize a decision to treat a certain kind of patient but only indirectly a decision to treat any particular patient, whereas indeterminism accommodates both types of decisions. (shrink)

This paper attempts to analyze the performance of 57 memberstates of the Organization of Islamic Cooperation based on selectedindicators of some sectors namely demography, economics, educationand technology and innovation. Specifically, it aims at firstly portraying anoverview of OIC performance based on six selected indicators followed byanalyzing the relationship between selected development variables withliteracy and exploring the state of OIC performance as indicated by theirachievement based on selected indicators. The study was undertaken vis-àvisthe prevailing theories on modernization and development as well (...) as thewidely asserted underdevelopment of the contemporary Muslim ummah asclaimed by numerous contemporary Muslim scholars. The data were solicitedamong others from the World Bank Database, Statistical, Economic, and SocialResearch and Training, Centre of Islamic Countries of OIC andsome previous studies. They were then analyzed using SPSS with the resultsbeing generated mainly through the use of descriptive statistics. Among others,the study found that there is a positive correlation between Muslim countries’urban population growth and literacy rate, there is a steady decline in thenumber of OIC countries as they are categorized from lower to higher incomecategory placement and the percentage of the scientific publications of all 57OIC countries is far below that of any one single developed nation. (shrink)

The extended neoteric ranked set sampling plan proposed by Taconeli and Cabral has proven to outperform many one stages and two stages ranked set sampling plans when estimating the mean and the variance for different populations. Therefore, in this paper, the likelihood function based on ENRSS is proposed and used for estimation of the parameters of the inverted Nadarajah–Haghighi distribution. An extensive Monte Carlo simulation study is conducted to assess the performance of the proposed likelihood function, and the efficiency of (...) the estimated parameters based on ENRSS is compared with the well-known ranked set sampling plan and some of its modifications. These modifications include the extended ranked set sampling plan and the neoteric ranked set sampling plan. The results as foreseeable were very satisfactory and gave similar results to Taconeli and Cabral’s 2019 results. (shrink)

Nowadays, mobile telephony interruptions in our daily life activities are common because of the inappropriate ringing notifications of incoming phone calls in different contexts. Such interruptions may impact on the work attention not only for the mobile phone owners, but also for the surrounding people. Decision tree is the most popular machine-learning classification technique that is used in existing context-aware mobile intelligent interruption management model to overcome such issues. However, a single-decision tree-based context-aware model may cause over-fitting problem and thus (...) decrease the prediction accuracy of the inferred model. Therefore, in this paper, we propose an ensemble machine-learning-based context-aware mobile telephony model for the purpose of intelligent interruption management by taking into account multi-dimensional contexts and name it “E-MIIM”. The experimental results on individuals’ real-life mobile telephony data sets show that our E-MIIM model is more effective and outperforms existing MIIM model for predicting and managing individual’s mobile telephony interruptions based on their relevant contextual information. (shrink)

One of the central problems in philosophy since Kant has been that of the possibility of a science of human culture. Dilthey, Croce and Collingwood devoted their energies to this task, in an atmosphere marked by an intense hostility between positivists, who represented the tradition of naturalism and historicists, who represented the tradition of humanism. The positivists, led by Comte, Buckle, Mill and Taine, argued for a science of man modelled on the prevailing methods of the natural sciences. Typical of (...) this approach was the attempt by the English historian T. H. Buckle:to accomplish for the history of man something equivalent, or at all events analogous, to what has been effected by other inquiries for the different branches of the natural sciences. (shrink)

This study investigated the neuromodulatory effects of transspinal stimulation on soleus H-reflex excitability and electromyographic activity during stepping in humans with and without spinal cord injury. Thirteen able-bodied adults and 5 individuals with SCI participated in the study. EMG activity from both legs was determined for steps without, during, and after a single-pulse or pulse train transspinal stimulation delivered during stepping randomly at different phases of the step cycle. The soleus H-reflex was recorded in both subject groups under control conditions (...) and following single-pulse transspinal stimulation at an individualized exactly similar positive and negative conditioning-test interval. The EMG activity was decreased in both subject groups at the steps during transspinal stimulation, while intralimb and interlimb coordination were altered only in SCI subjects. At the steps immediately after transspinal stimulation, the physiological phase-dependent EMG modulation pattern remained unaffected in able-bodied subjects. The conditioned soleus H-reflex was depressed throughout the step cycle in both subject groups. Transspinal stimulation modulated depolarization of motoneurons over multiple segments, limb coordination, and soleus H-reflex excitability during assisted stepping. The soleus H-reflex depression may be the result of complex spinal inhibitory interneuronal circuits activated by transspinal stimulation and collision between orthodromic and antidromic volleys in the peripheral mixed nerve. The soleus H-reflex depression by transspinal stimulation suggests a potential application for normalization of spinal reflex excitability after SCI. (shrink)

Background The use of lengthy, detailed, and complex informed consent forms is of paramount concern in biomedical research as it may not truly promote the rights and interests of research participants. The extent of information in ICFs has been the subject of debates for decades; however, no clear guidance is given. Thus, the objective of this study was to determine the perspectives of research participants about the type and extent of information they need when they are invited to participate in (...) biomedical research. Methods This multi-center, cross-sectional, descriptive survey was conducted at 54 study sites in seven Asia-Pacific countries. A modified Likert-scale questionnaire was used to determine the importance of each element in the ICF among research participants of a biomedical study, with an anchored rating scale from 1 to 5. Results Of the 2484 questionnaires distributed, 2113 were returned. The majority of respondents considered most elements required in the ICF to be ‘moderately important’ to ‘very important’ for their decision making. Major foreseeable risk, direct benefit, and common adverse effects of the intervention were considered to be of most concerned elements in the ICF. Conclusions Research participants would like to be informed of the ICF elements required by ethical guidelines and regulations; however, the importance of each element varied, e.g., risk and benefit associated with research participants were considered to be more important than the general nature or technical details of research. Using a participant-oriented approach by providing more details of the participant-interested elements while avoiding unnecessarily lengthy details of other less important elements would enhance the quality of the ICF. (shrink)

Although it is generally acknowledged that the coming of age of analytical philosophy of history as a flourishing enterprise in contemporary philosophical circles is due chiefly to the pioneering work of R.G. Collingwood, what Collingwood had to say about history in particular and the scientific study of it has sometimes been obscured by a concern with larger questions, such as whether Collingwood’s writings can be viewed as a single system or as successive but ultimately incompatible attempts at elaborating such a (...) system, whether and to what extent he was an old-fashioned idealist, and whether his thought did or did not undergo a radical conversion from idealism to historicism. In History as Re-Enactment, W. H. Dray attempts to re-examine Collingwood’s philosophy of history with a view to clarifying precisely what his contribution to this field amounts to, and where it fits in Collingwood’s lifelong attempt to achieve a rapprochement between philosophy and history. (shrink)

Statistical distributions have great applicability for modeling data in almost every applied sector. Among the available classical distributions, the inverse Weibull distribution has received considerable attention. In the practice of distribution theory, numerous methods have been studied and suggested/introduced to increase the flexibility level of the traditional probability distributions. In this paper, we implement different distribution methods to obtain five new different versions of the inverse Weibull model. The new modifications of the inverse Weibull model are called the logarithm transformed-inverse (...) Weibull, a flexible reduced logarithmic-inverse Weibull, the weighted TX-inverse Weibull, a new generalized-inverse Weibull, and the alpha power transformed extended-inverse Weibull distributions. To illustrate the flexibility and applicability of the new modifications of the inverse Weibull model, a biomedical data set is analyzed. The data set consists of 108 observations and represents the mortality rate of the COVID-19-infected patients. The practical application shows that the new generalized-inverse Weibull is the best modification of the inverse Weibull distribution. (shrink)

Rationale, aims and objectives Given the increasing prevalence of cataract and demand for cataract extraction surgery, patients must often wait to undergo this procedure. We validated a previously developed priority scoring system in terms of clinical variables, pre-intervention health status, appropriateness of surgery and gain in visual acuity (VA) and health-related quality of life (HRQoL).Methods Explicit prioritization criteria for cataract extraction created by a variation of the Research and Development (RAND) and University of California Los Angeles appropriateness methodology were retrospectively (...) applied to a prospective cohort of 5257 patients on waiting lists to undergo cataract by phacoemulsification at 17 hospitals in Spain. Demographic data, clinical data and data related to surgical technique were collected by trained ophthalmologists. Patients were evaluated by their ophthalmologist before the intervention and 6 weeks afterward. They also completed, by mail, the Visual Function Index (VF-14) before the intervention and 3 months afterward.Results High-priority patients experienced greater improvement in VA and HRQoL than those classified as intermediate or low-priority (P < 0.0001), even after adjusting by VA and the VF-14 score at baseline. The time to intervention was the same for high-priority patients as it was for intermediate and low-priority patients.Conclusions The priority score we developed identified patients most likely to experience the greatest improvements from cataract extraction. Use of this tool could provide a fairer and more rational way to prioritize patients for cataract extraction. (shrink)

Vacuolar ATPases (V‐ATPases, V1Vo‐ATPases) are rotary motor proton pumps that acidify intracellular compartments, and, when localized to the plasma membrane, the extracellular space. V‐ATPase is regulated by a unique process referred to as reversible disassembly, wherein V1‐ATPase disengages from Vo proton channel in response to diverse environmental signals. Whereas the disassembly step of this process is ATP dependent, the (re)assembly step is not, but requires the action of a heterotrimeric chaperone referred to as the RAVE complex. Recently, an alternative pathway (...) of holoenzyme disassembly was discovered that involves binding of Oxidation Resistance 1 (Oxr1p), a poorly characterized protein implicated in oxidative stress response. Unlike conventional reversible disassembly, which depends on enzyme activity, Oxr1p induced dissociation can occur in absence of ATP. Yeast Oxr1p belongs to the family of TLDc domain containing proteins that are conserved from yeast to mammals, and have been implicated in V‐ATPase function in a variety of tissues. This brief perspective summarizes what we know about the molecular mechanisms governing both reversible (ATP dependent) and Oxr1p driven (ATP independent) V‐ATPase dissociation into autoinhibited V1 and Vo subcomplexes. (shrink)

Figurines de terre cuite (H. Aurigny, Fr. Croissant) Tous les fragments sont désormais enregistrés dans la base FileMakerPro, terminée pour l’essentiel en 2013 et complétée en 2015. La mission prévue en 2014 ayant été annulée par l’École française d’Athènes pour raisons budgétaires, un réexamen à distance de l’ensemble du matériel avait néanmoins permis d’en esquisser à distance le classement typologique et d’élaborer quelques hypothèses, qui ont pu être vérifiées et affinées sur place en mai...

The essays collected together in this volume originated with a symposium which addressed a variety of issues associated with the publications of Professor W.H. Dray in the philosophy of history. In this expanded version of the original symposium, to which Professor Dray has provided a critical response, a group of prominent philosophers and historians address the central questions posed by contemporary philosophy of history - such as, the logic and methodology of historical explanation, the selection and uses of evidence, the (...) fact/value relationship, the nature of historical causation, the question of conflicting interpretations and their possible resolution, the idea of history as a school of practical wisdom, and the question whether history has any discernable pattern or meaning. These issues are approached from the experience of both historians and philosophers and represent an important increment to the long-standing and continuing debates concerning the nature and aims of the practice and philosophy of history. (shrink)

Moral distress (MD) is well-documented within the nursing literature and occurs when constraints prevent a correct course of action from being implemented. The measured frequency of MD has increased among nurses over recent years, especially since the COVID-19 Pandemic. MD is less understood among nurse leaders than other populations of nurses. A qualitative systematic review was conducted with the aim to synthesize the experiences of MD among nurse leaders. This review involved a search of three databases (Medline, CINAHL, and APA (...) PsychINFO) which resulted in the retrieval of 303 articles. PRISMA review criteria guided authors during the article review and selection process. Following the review, six articles were identified meeting review criteria and quality was assessed using the Critical Appraisal Skills Programme (CASP) Checklist for qualitative studies. No ethical review was required for this systematic review. The six studies included in this review originated from the United States, Brazil, Turkey, and Iran. Leadership roles ranged from unit-based leadership to executive leadership. Assigned quality scores based upon CASP criteria ranged from 6 to 9 (moderate to high quality). Three analytical themes emerged from the synthesis: (1) moral distress is consuming; (2) constrained by the system; and (3) adapt to overcome. The unique contributors of MD among nurse leaders include the leadership role itself and challenges navigating moral situations as they arise. The nurse leader perspective should be considered in the development of future MD interventions. (shrink)

Book Information Epistemology: Classic Problems and Contemporary Responses. By Laurence BonJour. Rowman and Littlefield. Lanham MD. 2002. Pp. viii + 289. Hardback, US$75. Paperback, US$23.95.