Background Genuine uncertainty on superiority of one intervention over the other is called equipoise. Physician-investigators in randomized controlled trials need equipoise at least in studies with more than minimal risks. Ideally, this equipoise is also present in patient-participants. In pediatrics, data on equipoise are lacking. We hypothesize that 1) lack of equipoise at enrolment among parents may reduce recruitment; 2) lack of equipoise during participation may reduce retention in patients assigned to a less favoured treatment-strategy. Methods We compared preferences of (...) parents/patients at enrolment, documented by a questionnaire, with preferences developed during follow-up by an interview-study to investigate equipoise of child-participants and parents in the BeSt-for-Kids-study. This trial in new-onset Juvenile Idiopathic Arthritis-patients consists of three strategies. One strategy comprises initial treatment with a biological disease-modifying-antirheumatic-drug, currently not standard-of-care. Semi-structured interviews were conducted with 23 parents and 7 patients, median 11 months after enrolment. Results Initially most parents and children were not in equipoise. Parents/patients who refused participation, regularly declined due to specific preferences. Many participating families preferred the biological-first-strategy. They participated to have a chance for this initial treatment, and would even consider stopping trial-participation when not randomized for it. Their conviction of superiority of the biological-first strategy was based on knowledge from internet and close relations. According to four parents, the physician-investigator preferred the biological-first-strategy, but the majority stated that she had no preferred strategy. In phase 2, preferences tended to change to the treatment actually received. Conclusions Lack of equipoise during enrolment did not reduce study recruitment, mainly due to the fact that preferred treatment was only available within the study. Still, when developing a trial it is important to evaluate whether the physicians’ research question is in line with preferences of the patient-group. By exploring so-called ‘informed patient-group’-equipoise, successful recruitment may be enhanced and bias avoided. In our study, lack of equipoise during trial-participation did not reduce retention in those assigned to a less favoured option. We observed a change for preference towards treatment actually received, possibly explained by comparable outcomes in all three arms. (shrink)

BackgroundMeasurement of tinnitus-related distress and treatment responsiveness is key in understanding, conceptualizing and addressing this often-disabling symptom. Whilst several self-report measures exist, the heterogeneity of patient populations, available translations, and treatment contexts requires ongoing psychometric replication and validation efforts.ObjectiveTo investigate the convergent validity and responsiveness of the German versions of the Tinnitus Questionnaire [TQ], Tinnitus Handicap Inventory [THI], and Tinnitus Functional Index [TFI] in a large German-speaking sample of patients with chronic tinnitus who completed a psychologically anchored 7-day Intensive Multimodal (...) Treatment Programme.MethodsTwo-hundred-and-ten patients with chronic tinnitus completed all three questionnaires at baseline and post-treatment. Intraclass correlation coefficients determined the convergent validity of each questionnaire’s total and subscale scores. Treatment responsiveness was investigated by [a] comparing treatment-related change in responders vs. non-responders as classified by each questionnaire’s minimal clinically important difference-threshold, and [b] comparing agreement between the questionnaires’ responder classifications.ResultsThe total scores of all three questionnaires showed high agreement before and after therapy. All total scores changed significantly with treatment yielding small effect sizes. The TQ and TFI yielded comparable and the THI higher responder rates. The TQ | THI and TQ | TFI showed fair, and the THI | TFI moderate agreement of responder classifications. Independent of classification, responders showed significantly higher change rates than non-responders across most scores. Each questionnaire’s total change score distinguished between responders and non-responders as classified by the remaining two questionnaires.ConclusionThe total scores of all three questionnaires show high convergent validity and thus, comparability across clinical and research contexts. By contrast, subscale scores show high inconsistency. Whilst the TFI appears well suited for research purposes, the THI may be better suited to measure psychological aspects of tinnitus-related distress and their changes with accordingly focused treatment approaches. (shrink)

This paper aims to propose an improved learning algorithm for feature selection, termed as binary superior tracking artificial bee colony with dynamic Cauchy mutation. To enhance exploitation capacity, a binary learning strategy is proposed to enable each bee to learn from the superior individuals in each dimension. A dynamic Cauchy mutation is introduced to diversify the population distribution. Ten datasets from UCI repository are adopted as test problems, and the average results of cross-validation of BSTABC-DCM are compared with other seven (...) popular swarm intelligence metaheuristics. Experimental results demonstrate that BSTABC-DCM could obtain the optimal classification accuracy and select the best representative features for the UCI problems. (shrink)

St, what did the word nien itself mean? There are five retations. The first holds that it referred to a place people congregated. Ch'a K'uei's "Lun An-hui li-chih" [On ficer System in Anhwei] states,1 "They carried swords and ed into units by the tens and hundreds. … The places they gathered were known as nien-tzu; the large nien-tzu red several hundred people." In 1814, T'ao Chu, the Im- Censor wrote,2 "They gather and commit improprieties ad daylight. Each group is known (...) as a nien. A small onsists of from several to several dozen persons. A nien includes from one to two hundred people.". (shrink)

In lieu of an abstract, here is a brief excerpt of the content:398 Feminist Studies 46, no. 2. © 2020 by Feminist Studies, Inc. Becky Thompson In the Slip Between Coasts Every morning the sea announces the day intimate crashing against the high stone wall we scan the waves for black dots floating becoming new moons and then arms waving rafts carrying the world Cartography in Greece after Zeina Hashem Beck’s “To Hamra” Here is the Oleander bush where a family (...) hid before their walk up the hill from Eftalou to Molyvos after eating eggs and croissants in my seaside room thirteen pairs of shoes lined up on the patio slate Here is seaweed beach where one raft landed in perched sea another behind carrying the elders and children Becky Thompson 399 stalled, taking in saltwater coast guard delayed in Petra sea ten, twenty, fifty minutes shouting and prayer finally a rescue exhaustion lining every pore They say memories fade, mine multiply, a cacophony tossing Here is the beach where the Syrian man strapping muscles and whimsical eyes gave me his salmon shirt with a finely made collar his friends ordered selfies called home saying yes began the climb to Mytilini defiant, alive There were moments of freedom jubilation in the air rest on the beach with dates and cool water children tossing stones into the sea lovers sitting close, feet in Europe cell phones that worked, telegraphing safety What does it mean to miss the intimacy of disaster? Now rescue teams mechanic pick-ups intercept rafts before shore whisk people away to Skala Sikamia then Moria no time to touch sand rest with the breeze Here is life jacket graveyard next to the dump perched between two hills above the seacoast 400 Becky Thompson a German couple toots up on a scooter taking photographs while eating nine-grain toast academics from the US talking postmodern flight a film crew from Barcelona picking through jackets amid ashes and twisted plastic crows memorize the wind as two garbage trucks trudge up the road bringing old fish and more jackets I wave at the sheepherder as I walk down the hill Save the people, bury the dead, photograph the remains, repeat Here is the hotel by the beach in Petra where children would run to the iron swing set let the arc carry them then jump off dance in the sprinklers the owner emerging mumbling generations handing us apricots and bottles of water Here is the computer store where the young Greek tells me he can’t copy my poems since he sees Arabic words menacing the page Here is my patience as I sit in his smoke ask him about his family and dancing Becky Thompson 401 eye his automatic weapon perched next to a wooden door Down the highway is a new bar next to Moria. Of course. Here is barbed wire that doubles as a fence a clothesline for diapers space to toss out rotten food Here is the highway lined with pickups and two-door sedans young Greek employment guarding people in tents Here is a baby carriage a young mother pushes that seconds as a grocery cart and shade for her five-year-old a step up from before when babies were in arms toddlers walking Here is the refugee people center where they built a strong swing set men lifting weights growing rings around their arms women stretching out in a new room eyeing the Lesvos sky Here are the streets of Mytilini looking like Beirut the Greeks who ran from Turkey the Turks who kicked out Afghans the Afghans who wish they were Syrian 402 Becky Thompson Syrians joined by Congolese— teachers, holy seers, and men selling hats. The sidewalk sparkles an atlas in transit.... (shrink)

Yi Hwang, better known by his pen name T'oegye, is generally considered Korea's preeminent Neo-Confucian scholar. The Ten Diagrams on Sage Learning is his final masterpiece, a distillation of the learning and practice of a lifetime, and one of the most important works of Korean Neo-Confucianism. In it he crystallized the essence of Neo-Confucian philosophy and spiritual practice in ten brief chapters that begin with the grand vision of the universe and conclude with a description of a well-lived day. In (...) To Become a Sage, Michael Kalton supplements a superb translation of this pivotal text with useful commentary that will greatly enhance its value and interest to the lay reader. The Ten Diagrams is the first complete primary text of Korean Neo-Confucianism to be translated into English. Korea's Yi Dynasty, the only East Asian regime founded exclusively under Neo-Confucian auspices, was unique in its allegiance to the orthodox Ch'eng Chu school, predominant in China, Korea, and Japan. Although the Ten Diagrams is a relatively short work, it fully presents the entire vision of Neo-Confucianism as framed in that school. Kalton provides a brief history of Neo-Confucianism in China and Korea as well as commentary that includes extensive passages from T'oegye's voluminous personal correspondence. These annotations expand the meaning distilled in each chapter. They help the uninitiated reader understand the basic elements of the complex Ch'eng Chu school of Neo-Confucianism, while enabling the scholar to distinguish characteristic aspects of Korean Neo-Confucianism as presented in the thought of the nation's leading philosopher of the time. (shrink)

While much has been said about what ought to be done about the statues and monuments of racist, colonial, and oppressive figures, a significantly undertheorised aspect of the debate is the aesthetics of commemorations. I believe that this philosophical oversight is rather unfortunate. I contend that taking the aesthetic value of commemorations seriously can help us a) better understand how and the extent to which objectionable commemorations are objectionable, b) properly formulate responses to aesthetic defences of objectionable commemorations, and c) (...) help us explore aesthetic solutions—for example, artistic interventions as counterspeech—to objectionable commemorations. Here, I propose that the aesthetic value of objectionable commemorations can amplify the force of the objectionable messages conveyed, and the moral disvalue of objectionable commemorations can hinder our appreciation of their aesthetic value. These two considerations shall help us answer the practical question of what to do about objectionable commemorations of apparently good aesthetic value. Both, I shall argue, give us further reason to remove, replace, recontextualise, or even vandalise objectionable commemorations. Sometimes we need to save the art from its own immorality to best respect its aesthetic value. (shrink)

Sit-ins, blockades, and lock-ons are common protest tactics. They work partly because continuing the operation or attempting quickly to remove activists risks injuring or killing them. Injuring or killing the activists is morally wrong, so the targets of the protest must (temporarily) yield to the activists. This appears to be a case of moral blackmail: The blackmailer makes it so that the blackmailed must either do what the blackmailer wants or do something morally wrong. Here, protestors appear to exploit the (...) targets’ tendency to be moral. Can such tactics be justified? I contend that they can insofar as such activists merely add further reason to what their targets already have decisive reason to do. The problem of moral blackmail, however, complicates the morality of primarily communicative civil disobedience. (shrink)

This detailed and sympathetic, but not uncritical, study of On Liberty' argues for the general consistency and coherence of Mill's defence of individual liberty, but maintains that there are significant non-utilitarian elements in his arguments.

In the 1970s “bioethics” emerged as a new interdisciplinary discourse on medicine, health care, and medical technologies, primarily in Western, developed countries. The main focus was on how individual patients could be empowered to cope with the challenges of science and technology. Since the 1990s, the main source of bioethical problems is the process of globalization, particularly neo‐liberal market ideology. Faced with new challenges such as poverty, inequality, environmental degradation, hunger, pandemics, and organ trafficking the bioethical discourse of empowering individuals (...) is no longer sufficient. Global bioethics nowadays is concerned with applying and implementing a universal ethical framework. Islamic bioethics has contributed to creating such framework (exemplified in the UNESCO Universal Declaration on Bioethics and Human Rights) while at the same time it is continuously articulating and interpreting this framework in specific settings and contexts. (shrink)

Endosteal stem cells are a subclass of bone marrow skeletal stem cell populations that are particularly important for rapid bone formation occurring in growth and regeneration. These stem cells are strategically located near the bone surface in a specialized microenvironment of the endosteal niche. These stem cells are abundant in young stages but eventually depleted and replaced by other stem cell types residing in a non‐endosteal perisinusoidal niche. Single‐cell molecular profiling and in vivo cell lineage analyses play key roles in (...) discovering endosteal stem cells. Importantly, endosteal stem cells can transform into bone tumor‐making cells when deleterious mutations occur in tumor suppressor genes. The emerging hypothesis is that osteoblast‐chondrocyte transitional identities confer a special subset of endosteal stromal cells with stem cell‐like properties, which may make them susceptible for tumorigenic transformation. Endosteal stem cells are likely to represent an important therapeutic target of bone diseases caused by aberrant bone formation. (shrink)

This paper discusses the issue of whether we have responsibilities to future generations with respect to genetic screening, including for purposes of selective abortion or discard. Future generations have been discussed at length among scholars. The concept of ‘Guardianfor Future Generations’ is tackled and its main criticisms discussed. Whilst germ-line cures, it is argued, can only affect family trees, genetic screening and testing can have wider implications. If asking how this may affect future generations is a legitimate question and since (...) we indeed make retrospective moral judgements, it would be wise to consider that future generations will make the same retrospective judgements on us. Moreover such technologies affect present embryos to which we indeed can be considered to have an obligation. (shrink)

: The member states of the United Nations Educational, Scientific and Cultural Organization (UNESCO) decided in 2002 that ethics is one of the five priority areas of the organization. This article describes three categories of past and current activities in the ethics of science and technology, in particular bioethics. The first category is the global standard setting with the Universal Declaration on Bioethics and Human Rights as the most recently adopted normative instrument. The second category focuses on capacity building in (...) order to enable member states to apply the provisions of the declarations, through, for example, the establishment of national bioethics committees, the introduction of ethics teaching programs, and drafting of legislation and guidelines. The final category of activities is awareness raising through publications, events, and conferences. The challenges and difficulties UNESCO may face in its various activities are highlighted. (shrink)

This paper gives a selective overview of studies in 'medical ethnomethodology'. It starts with the 1967 contributions by Garfinkel and Sudnow, which focus on medical action as accountable Then it discusses the many CA-inspired studies of doctor-patient inter-action published during the 1980s. Finally, it points to scattered studies that suggest several ways in which this latter approach can be deepened and enlarged. In this way, it formulates the contours of a program for ethnomethodological studies in the medical field.

Commonsense reasoning about the physical world, as exemplified by "Iron sinks in water" or "If a ball is dropped it gains speed," will be indispensable in future programs. We argue that to make such predictions (namely, envisioning), programs should use abstract entities (such as the gravitational field), principles (such as the principle of superposition), and laws (such as the conservation of energy) of physics for representation and reasoning. These arguments are in accord with a recent study in physics instruction where (...) expert problem solving is related to the construction of physical representations that contain fictitious, imagined entities such as forces and momenta (Larkin 1983). We give several examples showing the power of physical representations. (shrink)

This paper presents a study of the effect of working memory load on the interpretation of pronouns in different discourse contexts: stories with and without a topic shift. We discuss a computational model (in ACT-R, Anderson, 2007) to explain how referring expressions are acquired and used. On the basis of simulations of this model, it is predicted that WM constraints only affect adults' pronoun resolution in stories with a topic shift, but not in stories without a topic shift. This latter (...) prediction was tested in an experiment. The results of this experiment confirm that WM load reduces adults' sensitivity to discourse cues signaling a topic shift, thus influencing their interpretation of subsequent pronouns. (shrink)

This paper takes issue with what seem to be standard practices of at least some organizations that use models in their ad campaigns. These organizations know that many of their models have had drug problems but refuse either to tolerate this or to help them. Some organizations have, allegedly in the name of a responsibility for the health of their customers, rather opted for a firm condemnation of the practices in which models such as Kate Moss apparently engage. This raises (...) questions about hypocrisy. The paper uses Levinas's concept of the face critically to describe what might be going on in the conflict between Moss and some of the companies she worked for. Moss is arguably understood by these companies as a role model who should not engage with drugs or street life. Against these more or less patronizing tendencies, the paper claims that it is not so much the face but processes of defacement that should trouble us from a moral perspective. The face, it is maintained, is not only ethical but also has a materiality. In opposition to what is maintained by at least some scholars of Levinas, art, literature and history have alerted us over and over again that the face is anything but indelible. Some examples from art show us the versatility and vulnerability of the face. The gossip and hype about what came to be known as the Kate Moss affair stands, it is argued, in a long misogynic tradition of defacement. (shrink)

Constitutionalism and the Rule of Law are related ideas about how the powers of government and of state officials are to be limited. The two ideas are sometimes equated. But constitutionalism, generally understood, usually refers to various constitutional devices and procedures, such as the separation of powers between the legislature, the executive and the judiciary, the independence of the judiciary, due process or fair hearings for those charged with criminal offences, and respect for individual rights, which are partly constitutive of (...) a liberal democratic system of government. The Rule of Law, on the other hand, embodies certain standards that define the characteristic virtues of a legal system as such. (shrink)

In today’s competitive business market, firms that collaborate on a coopetition basis face obstacles in the form of decision-making, dependency, and trust in their competitor partners. This current study is the only one that has examined the relationship between coopetition and firm performance; yet, this relationship appears to be unclear due to the impact of trust and dependency on coopetition. This study investigates the impact of coopetition on firm performance by examining the mediating effects of decision-making and open innovation on (...) firm performance. There are 230 sets of data that were collected from the employees of Chinese small- and medium-sized enterprises through the survey method, and the data were analyzed using Partial Least Square-Structural Equation Modeling. The findings of this study indicated that open innovation has a significant mediation effect between coopetition and firm performance, and that decision-making is also an important mediating effect in bridging the relationship between coopetition and firm performance. By considering these mediators, the findings revealed that the coopetition has a significant impact on firm performance through decision-making and has a significant effect on firm performance through increasing open innovation. The findings also revealed that decision-making played a significant role in mediating the relationship between coopetition and firm performance, which in turn specified a statistically significant positive rel... (shrink)

This essay is a critical theological and pastoral study of the Working Document of the Second African Synod. The article engages the articles in the document which deal with the theme of reconciliation. This essay begins by exploring the Christological and ecclesiological foundations for an African theology of reconciliation as found in the working document. While engaging the significant aspects of the working document which relate to articulating an African theology of reconciliation, this essay shows the limitations of the document (...) in its historical and cultural analysis of the situation in Africa. Drawing from a phenomenological hermeneutical engagement with African history, cultural grammar, and Christ‐centered African Christian imagination, the essay widens the scope of theological engagement with the task of reconciliation in Africa. It does a theological aesthetics of reconciliation in Africa, by integrating diverse cultural, ontological, and Christological symbols within the African world on vital participation and vital union. Through the inculturation of vital participation as analogous to Trinitarian Communion, the essay shows how the Church in Africa can deal with the ever‐revolving cycle of violence, conflicts, and divisions in the churches and political institutions which have all hampered the mission of building relationship and God's kingdom in Africa. The essay concludes by recommending four pastoral approaches through which the Catholic Church in Africa can be both a reconciled community and an instrument for reconciliation in Africa. (shrink)

Filial Piety and Business Ethics: A Confucian Reflection.

Filial Piety and Business Ethics: A Confucian Reflection.

In this paper, a discrete-time dynamic duopoly model, with nonlinear demand and cost functions, is established. The properties of existence and local stability of equilibrium points have been verified and analyzed. The stability conditions are also given with the help of the Jury criterion. With changing of the values of parameters, the system shows some new and interesting phenomena in terms to stability and multistability, such as V-shaped stable structures and different shape basins of attraction of coexisting attractors. The eye-shaped (...) structures appear where the period-doubling and period-halving bifurcations occur. Finally, by utilizing critical curves, the changes in the topological structure of basin of attraction and the reason of “holes” formation are analyzed. As a result, the generation of global bifurcation, such as contact bifurcation or final bifurcation, is usually accompanied by the contact of critical curves and boundary. (shrink)

Introduction to the thinking of Greek, Roman, Jewish, Christian and Islamic theologians and philosophers, including short, characterizing fragments from their works.

Taking regular walks when living with Parkinson’s disease has beneficial effects on movement and quality of life. Yet, patients usually show reduced physical activity compared to healthy older adults. Using auditory stimulation such as music can facilitate walking but patients vary significantly in their response. An individualized approach adapting musical tempo to patients’ gait cadence, and capitalizing on these individual differences, is likely to provide a rewarding experience, increasing motivation for walk-in PD. We aim to evaluate the observance, safety, tolerance, (...) usability, and enjoyment of a new smartphone application. It was coupled with wearable sensors and delivered individualized musical stimulation for gait auto-rehabilitation at home. Forty-five patients with PD underwent a 1-month, outdoor, uncontrolled gait rehabilitation program, using the BeatWalk application. The music tempo was being aligned in real-time to patients’ gait cadence in a way that could foster an increase up to +10% of their spontaneous cadence. Open-label evaluation was based on BeatWalk use measures, questionnaires, and a six-minute walk test. Patients used the application 78.8% of the prescribed duration and enjoyed it throughout the program. The application was considered “easy to use” by 75% of the patients. Pain, fatigue, and falls did not increase. Fear of falling decreased and quality of life improved. After the program, patients improved their gait parameters in the six-minute walk test without musical stimulation. BeatWalk is an easy to use, safe, and enjoyable musical application for individualized gait rehabilitation in PD. It increases “walk for exercise” duration thanks to high observance.Clinical Trial Registration: ClinicalTrials.gov Identifier: NCT02647242. (shrink)

Jensen’s inequality is one of the fundamental inequalities which has several applications in almost every field of science. In 2003, Mercer gave a variant of Jensen’s inequality which is known as Jensen–Mercer’s inequality. The purpose of this article is to propose new bounds for Csiszár and related divergences by means of Jensen–Mercer’s inequality. Also, we investigate several new bounds for Zipf–Mandelbrot entropy. The idea of this article may further stimulate research on information theory with the help of Jensen–Mercer’s inequality.

ZusammenfassungDie rechtliche Regelung der Fortpflanzungsmedizin ist dringend reformbedürftig. Das Embryonenschutzgesetz von 1990 erfasst die neuesten technischen Entwicklungen nicht, ist in manchen Bereichen unstimmig und lückenhaft, setzt die betroffenen Frauen, Paare und Kinder unnötigen gesundheitlichen Risiken aus, erschwert paradoxerweise die Durchsetzung von Kinderrechten und erzeugt Gerechtigkeitsprobleme und Rechtsunsicherheit für die betroffenen Paare und die behandelnden Ärztinnen und Ärzte.Das Embryonenschutzgesetz enthält zudem nur strafrechtliche Verbote. Diese erlauben keine angemessene Reaktion auf die medizinische Entwicklung und den gesellschaftlichen Wandel und werden der Komplexität der (...) Materie nicht gerecht.Diese Probleme müssen gelöst werden. Der Bundesgesetzgeber verfügt seit mehr als 20 Jahren über die Kompetenz zur Regelung der Fortpflanzungsmedizin. Er sollte in der kommenden Legislaturperiode ein umfassendes Fortpflanzungsmedizingesetz schaffen. (shrink)

本书收入论文17篇,从宏观上探讨宗教伦理及基督教伦理问题,根据圣经探讨基督教的伦理道德观,关注基督教的生态伦理问题,以及神学问题的研究。.