Si bien la cirugía es parte fundamental de la medicina y de gran relevancia en la sociedad actual, no ha sido tomada en cuenta por la filosofía de la medicina. Debido a la naturaleza eminentemente práctica de la cirugía, una indagación sistemática nos permitirá, entre otros aspectos, dilucidar rasgos generales de las prácticas científicas en las que el conocimiento tácito es esencial. Por lo que, con la finalidad de integrar a la cirugía dentro del marco general de la filosofía de (...) la medicina, se propone un primer corpus tentativo de problemas en los que puede centrarse la filosofía de la cirugía, que incluyen: cuestiones epistémicas acerca del aprendizaje de las habilidades quirúrgicas y su transformación; la evidencia utilizada en cirugía, así como la forma en la que los cirujanos validan sus intervenciones frente a otras especialidades médicas y si está justificada epistémicamente la falta de ensayos clínicos aleatorizados; finalmente se examina la forma de aprobación de los dispositivos médicos que son ampliamente utilizados en cirugía. Esto, mostrará que la filosofía de la cirugía tiene el potencial para establecerse como un área autónoma dentro de la filosofía de la medicina. (shrink)

Film clips are proven to be one of the most efficient techniques in emotional induction. However, there is scant literature on the effect of this procedure in older adults and, specifically, the effect of using different positive stimuli. Thus, the aim of the present study was to examine emotional differences between young and older adults and to know how a set of film clips works as mood induction procedure in older adults, especially, when trying to elicit attachment-related emotions. To this (...) end, we use this procedure to analyze differences in subjective emotional response between young and older adults. A sample of 57 older adults and 83 young adults watched a film set previously validated in young population. Their responses were studied in an individual laboratory session to elicit 6 target emotions (disgust, fear, sadness, anger, amusement and tenderness) and neutral state. Self-reported emotional experience was measured using the Self-Assessment Manikin (SAM). Our results show that film clips are capable of evoking positive and negative emotions in older adults. Furthermore, older adults experienced more intensely negative emotions than young adults, especially in response to disgust and fear clips. They also reported higher arousal than young adults, especially in the case of sadness, anger and tenderness clips. Nevertheless, the older adults recovered more easily from the effects of the emotion induction. The young adults reported higher arousal ratings than older adults in response to amusement film clips. On the other hand, this study reflects the importance of controlling the baseline state to study the real strength of mood induction. Overall, current data suggests significant differences occur in emotional response in adult age and that film clips are an effective tool for studying positive and negative emotions in aging research. (shrink)

Childhood obesity, linked to a sedentary lifestyle and an unbalanced diet, is one of the main problems in today’s Western societies. In this sense, the aim of the study was to analyze students’ perceived satisfaction in physical education classes with learning strategies and engagement in learning and critical thinking as determinants of healthy lifestyle habits. The study involved 2,439 high school students aged 12–18 years (M= 14.66,SD= 1.78). Structural equation modeling was conducted to analyze the predictive relationships between the study (...) variables. The results showed that teaching, teaching mastery, and cognitive development are precursors to deep thinking on the part of students, indicators of the adoption of healthy lifestyle habits. These results reflect the importance of the methodology adopted by the teacher in order to positively influence the students’ habits. (shrink)

Este escrito presenta el tema del cuerpo y de la corporeidad en la Scienza nuova de Vico, confrontando las dos interpretaciones, que la autora opone, de Alberto M. Damiani y de Giuseppe Patella.Palabras clave: Vico, cuerpo, corporeidad, A. Damiani, G. Patella.This paper focusses on the subject of body and embodiment in Vico’s Scienza nuova, by confronting the interpretations of Alberto M. Damiani and Giuseppe Patella.Keywords: Vico, body, embodiment, A. Damiani, G. Patella.

El presente trabajo se enfocó a profundizar sobre el tema de las economías verdes y la Responsabilidad Social Empresarial. A través de una investigación documental, se logró evidenciar que las economías verdes siguen estando muy poco desarrolladas en todas partes del mundo, donde Europa es la que más avances posee en dicho tema, quedándose Latinoamérica rezagada al respecto por problemas tecnológicos y de desarrollo. Sobre la responsabilidad social se pudo entender que la misma representa una piedra angular para el desarrollo (...) de las naciones y una de las vías más relevantes para alcanzar la sostenibilidad, reduciéndose problemas como la pobreza y el impacto medioambiental. Se concluyó que la importancia de estos trabajos de investigación radica en la amplitud del análisis que proponen, lo que sirve como un elemento referencial de gran calado desde el cual partir para otras investigaciones. Palabras Clave: Sostenibilidad, Responsabilidad, Sociedad, Desarrollo. Referencias [1]M. Mordt, «Soluciones ambientales sostenibles y economía verde e inclusiva: América Latina en la senda del cambio,» 2019. [2]A. Martínez y A. Porcelli, «Reflexiones sobre la economía verde. El New Deal Ecológico Mundial,» Revista LEX, vol. 15, nº 19, pp. 361-408, 2017. [3]Global Green Growth Institute, «Green Growth Index Concept,» 2019. [4]J. F. Cajiga Calderón, «El concepto de responsabilidad social empresarial,» Ciudad de México, 2007. [5]J. A. Cortés y E. Flores, Responsabilidad social, Centro de Investigación y Desarrollo Ecuador, 2017. [6]J. M. Araque Ramírez, «Responsabilidad Social del Ingeniero,» San José de Cúcuta, 2016. (shrink)

The objective of this research is to develop accurate forecasting models for chlorophyll-α concentrations at various depths in El Mar Menor, Spain. Chlorophyll-α plays a crucial role in assessing eutrophication in this vulnerable ecosystem. To achieve this objective, various deep learning forecasting techniques, including long short-term memory, bidirectional long short-term memory and gated recurrent uni networks, were utilized. The models were designed to forecast the chlorophyll-α levels with a 2-week prediction horizon. To enhance the models’ accuracy, a sliding window method (...) combined with a blocked cross-validation procedure for time series was also applied to these techniques. Two input strategies were also tested in this approach: using only chlorophyll-α time series and incorporating exogenous variables. The proposed approach significantly improved the accuracy of the predictive models, no matter the forecasting technique employed. Results were remarkable, with |$\overline{\sigma}$| values reaching approximately 0.90 for the 0.5-m depth level and 0.80 for deeper levels. The proposed forecasting models and methodologies have great potential for predicting eutrophication episodes and acting as decision-making tools for environmental agencies. Accurate prediction of eutrophication episodes through these models could allow for proactive measures to be implemented, resulting in improved environmental management and the preservation of the ecosystem. (shrink)

A continuoxis t- norm is a continuous map * from [0, 1]² into [0,1] such that is a commutative totally ordered monoid. Since the natural ordering on [0,1] is a complete lattice ordering, each continuous t-norm induces naturally a residuation → and becomes a commutative naturally ordered residuated monoid, also called a hoop. The variety of basic hoops is precisely the variety generated by all algebras, where * is a continuous t-norm. In this paper we investigate the structure of the (...) variety of basic hoops and some of its subvarieties. In particular we provide a complete description of the finite subdirectly irreducible basic hoops, and we show that the variety of basic hoops is generated as a quasivariety by its finite algebras. We extend these results to Hájek's BL-algebras, and we give an alternative proof of the fact that the variety of BL-algebras is generated by all algebras arising from continuous t-norms on [ 0,1] and their residua. The last part of the paper is devoted to the investigation of the subreducts of BL- algebras, of Gödel algebras and of product algebras. (shrink)

The legal requirements and justifications for collecting patient-identifiable data without patient consent were examined. The impetus for this arose from legal and ethical issues raised during the development of a population-based disease register. Numerous commentaries and case studies have been discussing the impact of the Data Protection Act 1998 and Caldicott principles of good practice on the uses of personal data. But uncertainty still remains about the legal requirements for processing patient-identifiable data without patient consent for research purposes. This is (...) largely owing to ignorance, or misunderstandings of the implications of the common law duty of confidentiality and section 60 of the Health and Social Care Act 2001. The common law duty of confidentiality states that patient-identifiable data should not be provided to third parties, regardless of compliance with the DPA1998. It is an obligation derived from case law, and is open to interpretation. Compliance with section 60 ensures that collection of patient-identifiable data without patient consent is lawful despite the duty of confidentiality. Fears regarding the duty of confidentiality have resulted in a common misconception that section 60 must be complied with. Although this is not the case, section 60 support does provide the most secure basis in law for collecting such data. Using our own experience in developing a disease register as a backdrop, this article will clarify the procedures, risks and potential costs of applying for section 60 support. (shrink)

ObjectivesMany older adults with visual impairment also have significant hearing loss. The aim was to investigate the effectiveness of a newly developed Dual Sensory Loss protocol on communication and wellbeing of older persons with DSL and their communication partners in the Netherlands and Belgium.MethodsParticipants and their communication partners were randomized in the “DSL-protocol” intervention group or a waiting-list control group. The intervention took 3 to 5 weeks. Occupational therapists focused on optimal use of hearing aids, home-environment modifications and effective communication (...) strategies. The primary outcome was the Communication Strategies domain of the Communication Profile for the Hearing Impaired. Secondary outcomes measured in participants were the Low Vision Quality Of Life Adjustment subscale, the Center for Epidemiological Studies - Depression Scale, De Jong Gierveld Loneliness Scale and the Fatigue Assessment Scale. The Hearing Handicap and Disability Inventory - Reaction of Others subscale and the Care-related Quality of Life - 7 Dimensions was measured in communication partners. Measurements were taken at baseline and 3-month follow-up. Linear mixed models were used to analyze effects between groups over time for every outcome measure.ResultsIntention-to-treat analyses showed a significant effect of the DSL-protocol on the use of verbal strategies in favor of the control group, however, this effect was non-significant after adjustment for confounding. Effect sizes of other outcomes varied between −0.23 [−0.57, 0.12] and 0.30 [−0.05, 0.64]. The LMM showed a significant effect on the HHDI-Reaction of others scale in favor of communication partners in the treatment group, however, the effect did not remain significant at a 0.01 significance level and the effect size was very small and non-significant 0.12, 95% CI [−0.27 to 0.51]. Adjusted analyses did not reveal treatment effects.ConclusionThe DSL-protocol did not clearly contribute to the enhancement of communication and wellbeing in DSL-patients. Possible reasons for the lack of effects are OTs not being comfortable giving advice on communication and psychosocial issues or the short-term treatment and follow-up period. Further study is warranted to find out how the protocol may be adapted or whether it is necessary to involve mental healthcare professionals.Clinical Trial Registrationwww.ClinicalTrials.gov, identifier NTR2843. (shrink)

Introduction: Uncertainty is omnipresent in cancer care, including the ambiguity of diagnostic tests, efficacy and side effects of treatments, and/or patients' long-term prognosis. During second opinion consultations, uncertainty may be particularly tangible: doubts and uncertainty may drive patients to seek more information and request a second opinion, whereas the second opinion in turn may also affect patients' level of uncertainty. Providers are tasked to clearly discuss all of these uncertainties with patients who may feel overwhelmed by it. The aim of (...) this study was to explore how oncologists communicate about uncertainty during second opinion consultations in medical oncology.Methods: We performed a secondary qualitative analysis of audio-recorded consultations collected in a prospective study among cancer patients who sought a second opinion in medical oncology. We purposively selected 12 audio-recorded second opinion consultations. Any communication about uncertainty by the oncologist was double coded by two researchers and an inductive analytic approach was chosen to allow for novel insights to arise.Results: Seven approaches in which oncologists conveyed or addressed uncertainty were identified: specifying the degree of uncertainty, explaining reasons of uncertainty, providing personalized estimates of uncertainty to patients, downplaying or magnifying uncertainty, reducing or counterbalancing uncertainty, and providing support to facilitate patients in coping with uncertainty. Moreover, oncologists varied in their choice of words/language to convey uncertainty.Discussion: This study identified various approaches of how oncologists communicated uncertain issues during second opinion consultations. These different approaches could affect patients' perception of uncertainty, emotions provoked by it, and possibly even patients' behavior. For example, by minimizing uncertainty, oncologists may consciously steer patients toward specific medical decisions). Future research is needed to examine how these different ways of communicating about uncertainty affect patients. This could also facilitate a discussion about the desirability of certain communication strategies. Eventually, practical and evidence-based guidance needs to be developed for clinicians to optimally inform patients about uncertain issues and support patients in dealing with these. (shrink)

This paper describes the perspectives of stakeholders within the North American dairy industry on key issues affecting the welfare of dairy cattle. Five heterogeneous focus groups were held during a dairy cattle welfare meeting in Guelph, Canada in October 2012. Each group contained between 7 and 10 participants and consisted of a mix of dairy producers, veterinarians, academics, students, and dairy industry specialists. The 1-h facilitated discussions were audio-recorded and transcribed verbatim. Content analysis of the resulting transcripts showed that participants (...) across all stakeholder categories identified lameness as the most important welfare issue facing dairy cattle. Other prominent issues of concern included cow comfort, disease, on-farm mortality, stockmanship, painful procedures, injuries, cull cow management, calf management, and restriction of behavioural freedoms. Participants typically gave several reasons for why they considered issues problematic. Underlying reasons were grouped according to animal-centered concerns [at both the individual and at the herd level ] and industry-centered concerns . This analysis identified areas of shared concern among diverse stakeholder groups, which should aid in the development of standards and policies that satisfy stakeholders within and external to the dairy industry. (shrink)

We apply an online optimization process based on machine learning to the production of Bose-Einstein condensates. BEC is typically created with an exponential evaporation ramp that is optimal for ergodic dynamics with two-body s-wave interactions and no other loss rates, but likely sub-optimal for real experiments. Through repeated machine-controlled scientific experimentation and observations our ’learner’ discovers an optimal evaporation ramp for BEC production. In contrast to previous work, our learner uses a Gaussian process to develop a statistical model of the (...) relationship between the parameters it controls and the quality of the BEC produced. We demonstrate that the Gaussian process machine learner is able to discover a ramp that produces high quality BECs in 10 times fewer iterations than a previously used online optimization technique. Furthermore, we show the internal model developed can be used to determine which parameters are essential in BEC creation and which are unimportant, providing insight into the optimization process of the system. (shrink)

بالحرف نفهم الوجود، ونكتشفُ مُعَمَّيَاتِه وملابساته.فالوجود حرف، والحرف وجود، فهما معا يتماهيان، وهما معا يتبادلان الأدوار في مرآة الحياة والذاكرة والدين والأسطورة و المخيال، وفي فضاء الترميز بالقوة القَوَوِيَّةِ والتجريد المتعالي. وإذا كانت حبة الرمل تختزن الصحراء وتؤشر عليها، وقطرةُ الماء تختزل البحرَ وتومئ إليه، ونبضةُ العِطر تحوز الأزهارَ وتدل عليها، فإن الحرف هو كذلك يمثِّل كثافة الوجود في أعالي أعاليها، فهو الشجرة الرامزة إليه أونطولوجيا. إذْ من هذه الشجرة خرج الأمر الإلهي، فصار كونا ووجودا هو عبارة عن شجرة الكون (...) التي يُجَسِّد كل جزء من أجزائها حرَكِيَّةَ الوجود، وتوهجَ اختلافاته، وتناغمَ إيقاعاته، وتشابكَ دلالاته. إن الوجود حرف لا تكون الكتابة إلا به، والخلْق كتابة، والكتابة غرْسٌ، والغرس نفْسٌ، والنفْس وجود.وهكذا تبتدئ دائرة الوجود بالحرف وتنتهي به وإليه، فخلْقُ آدم وتركيبُه له دلالة على هذا المَنْحَى، فهو وسلالته يشبهان رمزيا في حياتهما حروفَ الأبجدية في بدايتها ونهايتها، فهما يدخلان إلى هذه الحياة على شكل ألِفٍ، ويخرجان منها على شكل ياءٍ.فالعِلم بالأسماء موضوع في قلب آدم، وتصْويرُها في صدره، وتعبيرها فيما بين حلْقه إلى شفتيه، فالقلبُ طَرَفٌ للعلْم، والصدر طَرَفٌ للتصاوير، والفم طَرَفٌ للتعبير. فالعالمُ في أول ظهورٍ له كان على صورة الإنسان، وصورة الإنسان هي صورة الحق. فصورتُه التي على صورة الحق تُؤَهِّلُه لمعرفة الحق من خلال معرفته لذاته الإنسانية. (shrink)