Rationale, aims and objectives To compare the pharmacotherapeutic approaches to diabetic hypertension of family physicians (FPs) and general practitioners (GPs). Methods A retrospective prescription-based study was conducted in 15 out of a total of 20 health centres, involving 115 primary care physicians – 77 FPs and 38 GPs, representing 74% of the primary care physicians of Bahrain. Prescriptions were collected during May and June 2000 to comprise a study population of 1266 diabetic-hypertensive patients. Results As monotherapy, angiotensin-converting enzyme (ACE) inhibitors (...) (37.9%) and β-blockers (38.3%) were the most commonly prescribed classes of antihypertensives by FPs and GPs, respectively. Calcium channel blockers (CCBs) were ranked third by both categories of physicians. For two-drug combinations, a β-blocker and an ACE inhibitor was the combination of choice for both physician categories. Patients managed by the FPs were more likely to receive a β-blocker–CCB combination (17.4 vs. 14.9%) or a diuretic–ACE inhibitor combination (16.7 vs. 11.4%) and less likely to receive a β-blocker–diuretic combination (11.8 vs. 16.7%) than those managed by the GPs. The proportion of patients receiving antihypertensive combinations was 40.6 and 38.5% for FPs and GPs, respectively. While the GPs prescribed CCB as a monotherapy to the elderly most often, the FPs choice was a β-blocker. Diuretics were less preferred by both FPs and GPs. β-Blocker–ACE inhibitor was again the most preferred combination of both FPs and GPs. FPs prescribed CCB–β-blocker combinations more often than GPs (P = 0.01), whereas CCB–ACE inhibitor combinations were less preferred (P = 0.09). A trend towards excessive use of short-acting nifedipine as monotherapy for elderly patients, both by FPs and by GPs, was noticed. Glibenclamide, alone or in combination with metformin, was the foremost antidiabetic drug prescribed by FPs and GPs. Middle-aged (45–64 years) patients seen by GPs were more likely to receive glibenclamide than those treated by FPs (P = 0.001) and less likely to receive gliclazide (P = 0.01). Combinations of a β-blocker with either glibenclamide or insulin were prescribed considerably more often by GPs.Conclusions Within the same practice setting, a substantial difference was observed between FPs and GPs in terms of preference for different classes of drugs in the management of diabetic hypertension. The compliance of both FPs and GPs was suboptimal; overall, the compliance of the FPs was closer to the recommended guidelines, however. Educational programmes should specifically address these inadequacies in order to improve the quality of health care. (shrink)

Pancreatitis is a complex, progressively destructive inflammatory disorder. Alcohol was long thought to be the primary causative agent, but genetic contributions have been of interest since the discovery that rare PRSS1, CFTR and SPINK1 variants were associated with pancreatitis risk. We now report two associations at genome-wide significance identified and replicated at PRSS1-PRSS2 and X-linked CLDN2 through a two-stage genome-wide study. The PRSS1 variant likely affects disease susceptibility by altering expression of the primary trypsinogen gene. The CLDN2 risk allele is (...) associated with atypical localization of claudin-2 in pancreatic acinar cells. The homozygous CLDN2 genotype confers the greatest risk, and its alleles interact with alcohol consumption to amplify risk. These results could partially explain the high frequency of alcohol-related pancreatitis in men. © 2012 Nature America, Inc. All rights reserved. (shrink)

The COVID-19 pandemic has resulted in more than 524 million cases and 6 million deaths worldwide. Various drug interventions targeting multiple stages of COVID-19 pathogenesis can significantly reduce infection-related mortality. The current within-host mathematical modeling study addresses the optimal drug regimen and efficacy of combination therapies in the treatment of COVID-19. The drugs/interventions considered include Arbidol, Remdesivir, Interferon and Lopinavir/ritonavir. It is concluded that these drugs, when administered singly or in combination, reduce the number of infected cells and viral load. (...) Four scenarios dealing with the administration of a single drug, two drugs, three drugs and all four are discussed. In all these scenarios, the optimal drug regimen is proposed based on two methods. In the first method, these medical interventions are modeled as control interventions and a corresponding objective function and optimal control problem are formulated. In this framework, the optimal drug regimen is derived. Later, using the comparative effectiveness method, the optimal drug regimen is derived based on the basic reproduction number and viral load. The average number of infected cells and viral load decreased the most when all four drugs were used together. On the other hand, the average number of susceptible cells decreased the most when Arbidol was administered alone. The basic reproduction number and viral load decreased the most when all four interventions were used together, confirming the previously obtained finding of the optimal control problem. The results of this study can help physicians make decisions about the treatment of the life-threatening COVID-19 infection. (shrink)

This is part of a three-volume collection of most of David Lewis' papers in philosophy, except for those that previously appeared in his Philosophical Papers (Oxford University Press, 1983 and 1986). They are now offered in a readily accessible form. This second volume is devoted to Lewis' work in metaphysics and epistemology. The purpose of this collection, and the volumes that precede and follow it, is to disseminate more widely the work of an eminent and influential contemporary philosopher. The volume (...) will serve as a useful work of reference for teachers and students of philosophy. (shrink)

The traditional “realist” conception of physics, according to which human concepts, laws and theories can grasp the essence of a reality in our absence , seems incompatible with quantum formalism and it most fruitful interpretation. The proof rests on the violation by quantum mechanical formalism of some fundamental principles of the classical ontology. We discuss if the conception behind Einstein’s idea of a reality in our absence, could be still maintained and at which price. We conclude that quantum mechanical formalism (...) is not formulated on those terms, leaving for a separated paper the discussion about the terms in which it could be formulated and the onto-epistemological implications it might have. (shrink)

Judgment aggregation theory, which concerns the translation of individual judgments on logical propositions into consistent group judgments, has shown that group consistency generally cannot be guaranteed if each proposition is treated independently from the others. Developing the right method of abandoning independence is thus a high-priority goal. However, little work has been done in this area outside of a few simple approaches. To fill the gap, we compare four methods based on distance metrics between judgment sets. The methods generalize the (...) premise-based and sequential priority approaches to judgment aggregation, as well as distance-based preference aggregation. They each guarantee group consistency and implement a range of distinct functions with different properties, broadening the available tools for social choice. A central result is that only one of these methods (not previously considered in the literature) satisfies three attractive properties for all reasonable metrics. (shrink)

The same research proposal was submitted to 24 district health authority (DHA) research ethics committees in different parts of the country. The objective was to obtain permission for a multi-centre research project. The study of neonatal care in different types of unit (regional, subregional and district), required that four health authorities were approached in each of six widely separated health regions in England. Data were collected and compared concerning aspects of processing, including application forms, information required, timing and decision-making. The (...) key finding was that ethics committees received and processed the applications variably, reflecting individual factors and local problems. To improve consensus and facilitate multicentre studies, standard forms and instructions are suggested and the establishment of a national committee or advisory group advocated. (shrink)

It is sometimes suggested that expressivism in meta-ethics is to be criticized on grounds which do not themselves concern meta-ethics in particular, but which rather concern philosophy of language more generally. Frank Jackson and Philip Pettit (1998; see also Jackson and Pettit 1999, and Jackson 2001) have recently advanced a novel version of such an argument. They begin by noting that expressivism in its central form makes two claims—that ethical sentences are not truth evaluable, and that to assert an ethical (...) sentence is to express one’s desires or feelings rather than to report a fact. They then argue that, given some plausible premises in the philosophy of language emanating mainly from Locke, the two central claims of expressivism are contradictory: when combined with the plausible premises, they say, the second claim refutes the first. The purpose of this paper is to formulate Jackson and Pettit’s Lockean argument, and to suggest that it fails. (shrink)

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The Greeks and Romans have been charged with destroying the ecosystems within which they lived. In this book, however, M. D. Usher argues rather that we can find in their lives and thought the origin of modern ideas about systems and sustainability, important topics for humans today and in the future. With chapters running the gamut of Greek and Roman experience – from the Presocratics and Plato to Roman agronomy and the Benedictine Rule – Plato's Pigs brings together unlikely bedfellows, (...) both ancient and modern, to reveal surprising connections. Lively prose and liberal use of anecdotal detail, including an afterword about the author's own experiments with sustainable living on his sheep farm in Vermont, add a strong authorial voice. In short, this is a unique, first-of-its-kind book that is sure to be of interest to anyone working in Classics, environmental studies, philosophy, ecology, or the history of ideas. (shrink)

In the past decades, an enormous amount of precious information has been collected about molecular and genetic characteristics of cancer. This knowledge is mainly based on a reductionistic approach, meanwhile cancer is widely recognized to be a ‘system biology disease’. The behavior of complex physiological processes cannot be understood simply by knowing how the parts work in isolation. There is not solely a matter how to integrate all available knowledge in such a way that we can still deal with complexity, (...) but we must be aware that a deeply transformation of the currently accepted oncologic paradigm is urgently needed. We have to think in terms of biological networks: understanding of complex functions may in fact be impossible without taking into consideration influences outside of the genome. Systems Biology involves connecting experimental unsupervised multivariate data to mathematical and computational approach than can simulate biologic systems for hypothesis testing or that can account for what it is not known from high-throughput data sets. Metabolomics could establish the requested link between genotype and phenotype, providing informations that ensure an integrated understanding of pathogenic mechanisms and metabolic phenotypes and provide a screening tool for new targeted drug. (shrink)

Two rotational bands have been identified and characterized in the proton-magic N = Z + 1 nucleus Ni-57. These bands complete the systematics of well-and superdeformed rotational bands in the light nickel isotopes starting from doubly magic Ni-56 to Ni-60. High-spin states in Ni-57 have been produced in the fusion-evaporation reaction Si-28(S-32, 2p1n)Ni-57 and studied with the gamma-ray detection array GAMMASPHERE operated in conjunction with detectors for evaporated light charged particles and neutrons. The features of the rotational bands in Ni-57 (...) are compared to those of neighbouring isotopes and interpreted by means of configuration-dependent cranked Nilsson-Strutinsky calculations. The two observed high-spin bands are considered signature partners and assigned to configurations with one 1g(9/2) proton and one 1g(9/2) neutron, resulting in an unambiguous understanding of the energetically favoured signature alpha = -1/2 band but a somewhat less satisfactory description of the signature alpha = +1/2 band. (shrink)

Given an argumentation network we associate with it a modal formula representing the ‘logical content’ of the network. We show a one-to-one correspondence between all possible complete Caminada labellings of the network and all possible models of the formula.

There is no way literally to measure health, because health is multi-dimensional, and there is no metric whereby one person who is healthier than a second with respect to one dimension but less healthy with respect to another counts as healthier, less healthy or equally healthy overall. Health analysts instead measure how good or bad health states are in some regard. If these values are measures of health states, then identical health states must have identical values. But in different circumstances, (...) the same health state may have different values. It may be better or worse. Uniform values can nevertheless be assigned to kinds of health states, either as a weighted average of the values of their tokens or as the value of the performance in a standard environment of the capacity the health state constitutes. These uniform values are not well suited for some of the purposes for which summary measures of population health have been intended, and a set of non-evaluative indicators may be an attractive alternative. (shrink)

In 1792 Dugald Stewart published Elements of the philosophy of the human mind. In its section on abstraction he declared himself to be a nominalist. Although a few scholars have made brief reference to this position, no sustained attention has been given to the central role that it played within Stewart’s early philosophy of mind. It is therefore the purpose of this essay to unpack Stewart’s nominalism and the intellectual context that fostered it. In the first three sections I aver (...) that his nominalism emanated from his belief that objects of the mind—qualities, ideas and words—were signs that bore no necessary relation to the external objects that they were meant to represent. More specifically, it was these signs that were arranged into systems of thought by the ‘operations of the mind’. The next three sections suggest that his treatment of words as signs most probably originated in his views on language and medicine and that his nominalistic philosophy of mind could also be extended to systems that sought to classify the natural world. I conclude by suggesting several avenues of enquiry that could be pursued by future scholars interested in excavating Stewart’s thought. (shrink)

The women’s liberation movements that emerged in Britain in the late 1960s are rarely thought of through their relationship with technology and technical knowledge. To overlook this is to misunderstand the movement’s social, cultural and economic interventions; it also understates how the technical environment conditioned the emergence of autonomous, women-centred politics. This article draws on archival evidence to demonstrate how the autonomous women’s liberation movement created experimental social contexts that enabled de-skilled, feminised social classes to confront their technical environment and (...) the deficits they experienced within it. The context for forging such politics was the workshop. More than a one-off, skill-sharing event, the workshop was a mobile habitus, adapted from a Marxist craft politics that prioritised the distribution of collective knowledge and responsibility and enabled the realisation of women's self-determination and autonomy. The workshop was discursively extended through women-authored publications in the 1970s and 1980s and designated a specific orientation within knowledge that supported women to practise a range of technical knowledge and gain expertise. An important, and largely forgotten political legacy of women's liberation is its world-making activisms: how it created social contexts that supported de-skilled, feminised classes to substantially intervene, shape and re-build their environments. Such histories can inspire how we practise politics today within an environment characterised, some theorists claim, by dramatic scales of de-skilling and dispossession. (shrink)

Objective: To analyse medical students’, graduate students’ and doctors’ and medical teachers’ perceptions of research contributions as criteria for authorship in relation to the authorship criteria defined by the International Committee of Medical Journal Editors .Design: Medical students with or without prior instruction on ICMJE criteria, graduate students/doctors and medical teachers rated the importance of 11 contributions as authorship qualifications. They also reported single contributions eligible for authorship, as well as acceptable combinations of two or three qualifying contributions.Results: Conception and (...) design, Analysis and interpretation and Drafting of article formed the most important cluster in all four groups. Students without prior instruction rated Critical revision and Final approval lower than the other three groups. “Final approval” was a part of the least important cluster in all groups except among students with instruction.Conclusions: Conception and design, Analysis and interpretation and Drafting of article were recognised as the most important of the ICMJE criteria by all participants. They can be considered independent of previous instruction or experience. Final approval and Critical revision should be actively taught as important authorship criteria to future scientists. (shrink)

No speech in Attic tragedy has made a stronger impression on later generations than Medea's farewell to her children. Four changes of mind and two displays of maternal affection lay bare the depths of a tortured soul; ‘there, in a short space, arelove and hatred, firmness and hesitation, fierce joy and unfathomable sorrow’.

Discusses the metaphysics of the iterative conception of set.

A number of recent studies have examined the effects of phonological variation on the perception of speech. These studies show that both the lexical representations of words and the mechanisms of lexical access are organized so that natural, systematic variation is tolerated by the perceptual system, while a general intolerance of random deviation is maintained. Lexical abstraction distinguishes between phonetic features that form the invariant core of a word and those that are susceptible to variation. Phonological inference relies on the (...) context of surface changes to retrieve the underlying phonological form. In this article we present a model of these processes in speech perception, based on connectionist learning techniques. A simple recurrent network was trained on the mapping from the variant surface form of speech to the underlying form. Once trained, the network exhibited features of both abstraction and inference in its processing of normal speech, and predicted that similar behavior will be found in the perception of nonsense words. This prediction was confirmed in subsequent research (Gaskell & Marslen-Wilson, 1994). (shrink)

This paper discusses the announcement by a team of researchers that they identified a genetic influence for a range of “antisocial” behaviours in the New Zealand Māori population (dubbed the “warrior gene”). The behaviours included criminality, violence, gambling and alcoholism. The reported link between genetics and behaviour met with much controversy. The scientists were described as hiding behind a veneer of supposedly “objective” western science, using it to perpetuate “racist and oppressive discourses”. In this paper we examine what went wrong (...) in the dissemination of the research. We chose as our framework the debate around the “internal/external” responsibilities of scientists. Using this discourse we argue that when the researchers ventured to explain their research in terms of social phenomena, they assumed a duty to ensure that their findings were placed “in context”. By “in context”, we argue that evidence of any genetic influence on behavioural characteristics should not be reported in isolation, but instead presented alongside other environmental, cultural and socio-economic influences that may also contribute to the studied behaviour. Rather than imposing a new obligation on scientists, we find this duty to contextualise results is in keeping with the spirit of codes of ethics already in place. Lessons from the “warrior gene” controversy may assist researchers elsewhere to identify potential areas of conflict before they jeopardise research relationships, or disseminate findings in a manner that fuels misleading and/or potentially discriminatory attitudes in society. (shrink)

In Bangladesh, due to economic growth and greater access to education, more girls and women are veiling, even as they are also more likely to be in school or employed. Some scholars identify this trend of women appearing both “more modern” and “more religious” as paradoxical. On the basis of 114 in-depth interviews with Bangladeshi migrant workers in Saudi Arabia, Qatar, Singapore, and South Korea and their wives in rural Bangladesh, I claim that Muslim women in middle-class Bengali families who (...) veil are cultivating symbolic boundaries guided by an accountability structure of middle-class religiosity and gender conservatism. The increasing tendency of middle-class Muslim women to appear both “more modern” and “more religious” can be explained by examining the role that veiling plays in signaling class status through conspicuous consumption, moral superiority, and respectable femininity, differentiating them from lower class women. I conclude that “doing gender” through veiling must be understood as also “doing middle-class difference” in Bengali Muslim families in rural Bangladesh. (shrink)

_The purpose _of the article is to introduce into scientific circulation works by Ukrainian scholar Taras Zakydalsky on the philosophy of Hryhorii Skovoroda. Taras Zakydalsky is a representative of the Ukrainian diaspora, philosopher, and member of Canadian NTSh (Shevchenko Scientific Society of Canada). _Theoretical basis._ We consider the uniqueness of H. Skovoroda’s philosophy, which stimulates not only intellectually but also spiritually enlightens the reader. The reasons for the complex perception and interpretation of Hryhorii Skovoroda’s philosophy are highlighted. We have verified (...) the main methods of its interpretation given in the works by Dmytro Chyzhevskyi. The influence of philosophical thought of thinkers of Antiquity and the Middle Ages: Aristotle, Epicurus, the Church Fathers, and Tertullian has been studied. We have comprehended H. Skovoroda’s interpretation of the Bible as a two-layer existence, the symbolic world that makes the foundation of his philosophy. The peculiarity of the thinker’s division of the heart into "internal" and "external" is analyzed. Hryhorii Skovoroda’s position on the Good and the evil is stated. The Good is identified with God, and the evil – with the real world, the man can choose between the two. Much attention is paid to the understanding of man as a microcosm – rational thinking, and thought is the fundamental cause of human activity, which generates all existence. Hryhorii Skovoroda’s philosophy of metaphysics as the existence of three worlds is highlighted: the first is the macrocosm (the whole surrounding world), the second is the microcosm (the man), and the third is the symbolic world (the Bible). "Monodualism" as a characteristic feature of H. Skovoroda’s work is analyzed. We have highlighted H. Skovoroda’s attitude to the transcendence of God, which is not separated from the world but is present in it directly. The understanding of faith as a forced act of self-love is analyzed because by loving ourselves we love God. The criteria for true and false faith have been clarified. The significance of H. Skovoroda’s aphorism that _what is necessary is useful, and not useful is unnecessary_ is considered. Examples of ethical principles in H. Skovoroda’s philosophy are considered. Peculiarities of the concept HAPPINESS are revealed. This concept is a universal means of existence of the Good, its source is gratitude to God. _Originality_ of the article is in the systematic presentation of the philosophy of the heart by Hryhorii Skovoroda and the analysis of the integrity of the "inner man", the true meaning of life as interpreted by Taras Zakydalsky. _Conclusions_ summarize the "anthropological pragmatism" of the philosopher, whose main idea is to apply practical skills for the benefit of society. (shrink)