This paper describes the application of eight statistical and machine-learning methods to derive computer models for predicting mortality of hospital patients with pneumonia from their findings at initial presentation. The eight models were each constructed based on 9847 patient cases and they were each evaluated on 4352 additional cases. The primary evaluation metric was the error in predicted survival as a function of the fraction of patients predicted to survive. This metric is useful in assessing a model’s potential to assist (...) a clinician in deciding whether to treat a given patient in the hospital or at home. We examined the error rates of the models when predicting that a given fraction of patients will survive. We examined survival fractions between 0.1 and 0.6. Over this range, each model’s predictive error rate was within 1% of the error rate of every other model. When predicting that approximately 30°K of the patients will survive, all the models have an error rate of less than 1.5%. The models are distinguished more by the number of variables and parameters that they contain than by their error rates; these differences suggest which models may be the most amenable to future implementation as paper-based guidelines. (shrink)

Much progress has been made in recent years regarding the mechanisms of targeting of secretory proteins to, and across, the endoplasmic reticulum (ER) membrane. Many of the cellular components involved in mediating translocation across this bilayer have been identified and characterized. Polypeptide domains of secretory proteins, termed signal peptides, have been shown to be necessary, and in most cases sufficient, for entry of preproteins into the lumen of the ER. These NH2‐ terminal segments appear to serve multiple roles in targeting (...) and translocation. The structural features which mediate their multiple functions are currently the subject of intense study. (shrink)

This study was a preliminary exploration of the value changes taking place in the United States since the September 11, 2001 terrorist attack on the World Trade Center in New York, which was a significant emotional event or cultural upheaval. Rokeach told us that "a person's total value system may undergo change as a result of socialization, therapy, or cultural upheaval..." (Rokeach, The Nature of Human Values, 1973, p. 37). The researchers explored the value changes of 500 aviation industry employees (...) before the attack and 500 after the attack. The statistically significant research results showed a total of twenty-seven of thirty-six values changed. Before the attack respondents valued much higher self-esteem and self-actualization values like A Sense of Accomplishment and Self-Respect. After the attack respondents placed a much higher value importance on survival, safety and security values like A World at Peace, Freedom, Family Security, National Security, Mature Love, Salvation, and True Friendship. (shrink)

Objective: To assess the adequacy of the process of informed consent for surgical patients at the University Hospital of the West Indies. Method: The study is a prospective, cross-sectional, descriptive study. 210 patients at the University Hospital of the West Indies were interviewed using a standardised investigator-administered questionnaire, developed by the authors, after obtaining witnessed, informed consent for participation in the study. Data were analysed using SPSS V.12 for Windows. Results: Of the patients, 39.4% were male. Of the surgical procedures, (...) 68.6% were scheduled, 7.6% urgent and 23.8% emergency, 35.2% were minor and 64.8% major. Information imparted/received was acceptable in 40% of cases, good in 24% and inadequate (unacceptable) in 36% of cases. Almost all (97.6%) patients stated that they understood why an operation was planned and 93.3% thought that they had given informed consent. Most (95.2%) thought that they had free choice and made up their own mind. A quarter (25.2%) of all patients were told that it was mandatory for them to sign the form. There was a discussion of possible side effects and complications in 56.7% of patients. Conclusions: This study clearly indicates that surgical patients at the University Hospital of the West Indies feel that they have given informed consent. However, it also suggests that more information should be given to patients for consent to be truly informed. (shrink)

Using a sample of 652 college students, we examined several implications of the hypothesis that the shape of the human penis evolved to enable males to substitute their semen for those of their rivals. The incidence of double mating by females appears sufficient to make semen displacement adaptive (e.g., one in four females acknowledge infidelity, one in eight admit having sex with two or more males in a 24-hour period, and one in 12 report involvement in one or more sexual (...) threesomes with two males). We also document several changes in post-ejaculatory behavior (e.g., reduced thrusting, penis withdrawal, loss of an erection) which may have evolved to minimize displacement of the male’s own semen. Consistent with predictions derived from a theoretical model (Gallup and Burch 2006), we discovered that most females report waiting at least 48 hours following an instance of infidelity before resuming sex with their in-pair partners. (shrink)

Robust stakeholder engagement in health research requires broad communicative integration, not only of patients but also other stakeholders such as health system leaders, clinicians, and researcher...

"No matter who you are or what you aim to achieve, power determines whether you succeed or fail. But while power dynamics permeate every interaction in the workplace, the concept is very poorly understood or managed in practice. Everyone has influence over some people and is under the influence of others, and must choose how to deal with these realities in daily interactions. This book offers a comprehensive and applied understanding of power in a professional scenario: where it comes from, (...) how it moves and what that means in practice for how professionals work together. Drawing on numerous recent case studies, this book offers a toolbox that anyone can apply, including explanations of the different forms of power, the two ways power can move between parties, the perils of power, how to create accountability, the intersection of power and ethics, and tools for maintaining power relationships with both superiors and subordinates. It provides employers and employees alike the means to understand, manage, and exert the power necessary to control their own circumstances."-Provided by publisher. (shrink)

The advent of population-specific genomic research has prompted calls for invention of informed consent protocols that would treat entire social groups as research subjects as well as endow such groups with authority as agents of consent. Critics of such an unconventional ethical norm of group consent fear the rhetorical effects of approaching social groups with offers to participate in dialogues about informed consent. Addressing a specific population as the collective subject of genomic research, on this logic, adds currency to the (...) potentially dangerous public opinion that such a group is bound by genetic ties. The paper considers the problem of group and individual identity within the rhetorical dynamics of the discourse and politics of consent. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy and Rhetoric 36.1 (2003) 1-21 [Access article in PDF] Did Habermas Cede Nature to the Positivists? Gordon R. Mitchell Jürgen Habermas's "colonization of the lifeworld" thesis (1987, 332-73) posits that many of society's pathologies are due to the tendency of institutions to convert social issues that ought to be sorted out by a debating citizenry into technical problems ripe for resolution by expert bureaucracies, thus pre-empting (...) important public discussion. Habermas has attempted to lay bare the pernicious effects of this colonization process in his analysis of public opinion polling, welfare policy, education, German reunification, immigration, and other social issues (see Habermas 1997, 1994, and 1970; Holub 1992). In each of these contexts, Habermas has publicly challenged the encroachment of scientistic modes of decision-making into spheres where joint communicative action by deliberating citizens would yield more appropriate and legitimate judgments. This critical impulse is also evident in Habermas's methodological reflections on the proper role of academic scholarship, where he has argued vigorously against attempts to graft "objectivating" methods of natural scientific inquiry onto research projects in the social sciences (1971, 304-17).From all of this, one might gather that Habermas's commitment to rolling back the influence of technical forms of reasoning is connected to some intrinsic quarrel he has with the natural sciences. Yet such a sweeping generalization is hard to sustain in light of the fact that Habermas does not oppose technical reasoning per se; he recognizes that the daunting complexity of social life in late capitalism requiresthat certain "steering" tasks be delegated to systems that utilize largely instrumental logics to co-ordinate action. Likewise, he acknowledges that the disciplines of the natural sciences necessarily play important supporting roles in such steering projects.One normative presupposition of Habermas's colonization thesis is that there exists some proper boundary demarcating where the sphere of technical reasoning ends and the realm of communicative rationality begins. [End Page 1] On one side of this boundary, Habermas has provided many details on what he sees as the essential qualities of a properly functioning "public sphere," where "new social movements" continuously reweave the threads of communicative fabric holding society together (1996, 359-87), and where "historico-hermeneutic" academic study reflects on public life, sluicing insight back into the capillaries of democratic deliberations (1987, 374-403).What lies on the other side of the boundary is murkier. The proper role of natural scientific investigation has received relatively scant attention in Habermas's critical theory of society, and this has led to some confusion regarding his account of the natural sciences, as well as debate over whether this account has political purchase. One would think that sympathetic commentators, such as Helen Longino (who bases much of her own coherence theory of scientific truth on Habermas), would have reassuring things to say on this point. Yet her lukewarm assessment that, "in trying to clear a space for an autonomous social and critical theory, [Habermas] has ceded nature to the positivists" (1990, 202), raises questions about the flexibility and scope of Habermas's theory of communicative action as a basis for critique of scientific practice.One way to test Habermas's account of the natural sciences on this count is to put his views in conversation with science studies commentators who share a similar commitment to the idea that dialogue and argumentation are constitutive elements of scientific practice. Such an approach recasts the "ceding to positivism" question into a moment of controversy over the role of dialogue, not only as an essential motor driving the scientific enterprise, but also as a vehicle for democratic decision-making on issues related to the purpose and direction of scientific inquiry in society.Part one of this essay locates discursive norms embedded pragmatically in the notion of scientific objectivity. By bringing a modified version of Habermas's theory of communicative action into conversation with other approaches to science studies that foreground intersubjective dialogue as the key motor driving the scientific enterprise, I develop a foundation for robust criticism of systematically distorted scientific communication. Specific strategies of... (shrink)

This volume of essays offers direct comparisons of historic Western and Buddhist perspectives on ethics and metaphysics, tracing parallels and contrasts all the way from Plato to the Stoics, Spinoza to Hume, and Schopenhauer through to contemporary ethicists such as Arne Naess, Charles Taylor and Derek Parfit. It compares and contrasts each Western philosopher with a particular strand in the Buddhist tradition, in some chapters represented by individual writers such as Nagarjuna, Vasubandhu, Santideva or Tsong Khapa. It does so in (...) light of both analytic concerns and themes from the existentialist and phenomenological traditions, and often in an ecumenical spirit that bridges both analytic and continentalist approaches. Some of the deepest questions in ethics, dealing with the scope of agency, value-laden notions of personhood and the nature of value in general, are intertwined with questions in metaphysics. One set of questions addresses how varying conceptions of selfhood relate to moral values ; another set of questions addresses how a conception of oneself or one’s selves should or should not affect how one thinks of happiness, or eudaimonia, or – in classical Indian terms – artha, sukha or nirvana. Western philosophy has featured discussion of both, but some would argue that certain traditions of Asian philosophy have offered a more sustained and even treatment of both sets of questions. The Buddhist tradition in particular has not only featured much discussion on both fronts, but has attracted many contemporary philosophers to its distinctive spectrum of approaches, and to what is – from many ‘Western’ points of view – a seemingly subversive analysis of ego, selfhood and personhood, whether in metaphysical, phenomenological or other incarnations. (shrink)

In a critical discussion, interlocutors can strategically maneuver by shading their expressed degree of standpoint commitment for rhetorical effect. When is such strategic shading reasonable, and when does it cross the line and risk fallacious derailment of the discussion? Analysis of President George W. Bush’s 2002–2003 prewar commentary on Iraq provides an occasion to explore this question and revisit Douglas Ehninger’s distinction between argumentation as coercive correction and argumentation as a person-risking enterprise. Points of overlap between Ehninger’s account and pragma-dialectical (...) argumentation theory suggest avenues for harmonization of rhetorical and dialectical perspectives on argumentation. Out of this conceptual convergence comes theoretical resources for understanding strategic maneuvering, by accounting for ways that discussants exploit gaps between their externalized and actual discussion attitude. As such higher-order strategic maneuvering played a major role in the 2003 Iraq prewar discourse failure, perspicacious understanding of this particular argumentative maneuver carries practical, as well as theoretical import. (shrink)

This paper presents a formalization of informal logic using the Carneades Argumentation System, a formal, computational model of argument that consists of a formal model of argument graphs and audiences. Conflicts between pro and con arguments are resolved using proof standards, such as preponderance of the evidence. CAS also formalizes argumentation schemes. Schemes can be used to check whether a given argument instantiates the types of argument deemed normatively appropriate for the type of dialogue.

While many "benchtop-to-bedside" research pathways have been developed in "Type I" translational medicine, vehicles to facilitate "Type II" and "Type III" translation that convert scientific data into clinical and community interventions designed to improve the health of human populations remain elusive. Further, while a high percentage of physicians endorse the principle of citizen leadership, many have difficulty practicing it. This discrepancy has been attributed, in part, to lack of training and preparation for public advocacy, time limitation, and institutional resistance. As (...) translational medicine and physician-citizenship implicate social, political, economic and cultural factors, both enterprises require "integrative" research strategies that blend insights from multiple fields of study, as well as rhetorical acumen in adapting messages to reach multiple audiences. This article considers how argumentation theory's epistemological flexibility, audience attentiveness, and heuristic qualities, combined with concepts from classical rhetoric, such as rhetorical invention, the synecdoche, and ethos, yield tools to facilitate translational medicine and enable physician-citizenship. (shrink)

Argument invention is a method that can be used to help an arguer find arguments that could be used to prove a claim he needs to defend. The aim of this paper is to show how argumentation systems recently developed in artificial intelligence can be applied to the task of argument invention. One such system called Carneades is featured. Carneades can be used to analyze arguments, evaluate arguments, to make an argument diagram, and to construct arguments from a database. Using (...) some simple examples, the paper explains how Carneades works as a system of argument invention. (shrink)

This paper compares the features and methods of the two leading implemented systems that offer a tool for helping a user to find or invent arguments to support or attack a designated conclusion, the Carneades Argumentation System and the IBM Watson Debater tool. The central aim is to contribute to the understanding of scholars in informal logic, rhetoric and argumentation on how these two software systems can be useful for them. One contribution of the paper is to explain to these (...) potential users how the two tools are applicable to the task of inventing arguments by using some simple illustrative examples. Another is to redefine the structure of argument invention as a procedure. (shrink)

When individuals learn from what others tell them, the information is subject to transmission error that does not arise in learning from direct experience. Yet evidence shows that humans consistently prefer this apparently more unreliable source of information. We examine the effect this preference has in cases where the information concerns a judgment on others’ behaviour and is used to establish cooperation in a society. We present a spatial model confirming that cooperation can be sustained by gossip containing a high (...) degree of uncertainty. Accuracy alone does not predict the value of information in evolutionary terms; relevance, the impact of information on behavioural outcomes, must also be considered. We then show that once relevance is incorporated as a criterion, second-hand information can no longer be discounted on the basis of its poor fidelity alone. Finally we show that the relative importance of accuracy and relevance depends on factors of life history and demography. (shrink)

Argument invention is a method that can be used to help an arguer find arguments that could be used to prove a claim he needs to defend. The aim of this paper is to show how argumentation systems recently developed in artificial intelligence can be applied to the task of argument invention. One such system called Carneades is featured. Carneades can be used to analyze arguments, evaluate arguments, to make an argument diagram, and to construct arguments from a database. Using (...) some simple examples, the paper explains how Carneades works as a system of argument invention. (shrink)

In 2000, US Secretary of Health and Human Services Secretary Tommy Thompson mobilized the US public health infrastructure to deal with escalating trends of excess body weight. A cornerstone of this effort was a report entitled The Surgeon General's Call to Action to Prevent and Decrease Overweight and Obesity. The report stimulated a great deal of public discussion by utilizing the distinctive public health terminology of an epidemic to describe the growing prevalence of obesity in the US population. We suggest (...) that the ensuing controversy was fueled in part by the report's ambiguous usage of the evocative term “epidemic.” In some passages, the report seems to use “epidemic” in a literal sense, suggesting that rising prevalence of excess body weight should be defined technically as a disease outbreak. Other passages of the report present the same key term metaphorically, leaving readers with the impression that the epidemic language is invoked primarily for rhetorical effect. Here, we explore dynamics and implications of both interpretations. This analysis sheds light on the ongoing public argument about the appropriate societal response to steadily increasing body sizes in the US population; likewise, it capitalizes on the accumulated knowledge that the field of public health has garnered from combating diverse historic epidemics. Our interdisciplinary approach deploys critical tools from the fields of rhetoric, sociology and epidemiology. In particular, we draw from metaphor theory and public address scholarship to elucidate how the Call to Action frames public deliberation on obesity. We turn to the applied public health literature to develop a reading of the report that suggests a novel approach to the problem—application of the Epidemic Investigation protocol to streamline the public health response and reframe the public argument about obesity. (shrink)

The central claim of this book is that, early and late, Wittgenstein modelled his approach to existential meaning on his account of linguistic meaning. A reading of Nietzsche’s The Birth of Tragedy sets up Bearn’s reading of the existential point of Wittgenstein’s Tractatus. Bearn argues that both books try to resolve our anxiety about the meaning of life by appeal to the deep, unutterable essence of the world. Bearn argues that as Wittgenstein’s and Nietzsche’s thought matured, they both separately came (...) to believe that the answer to our existential anxiety does not lie beneath the surfaces of our lives, but in our acceptance—Nietzsche’s “Yes”—of the groundless details of those surfaces themselves: the wonder of the ordinary. (shrink)

Background Population based genetics studies are dependent on large numbers of individuals in the pursuit of small effect sizes. Recruiting and consenting a large number of participants is both costly and time consuming. We explored whether an online consent process for large-scale genetics studies is acceptable for prospective participants using an example online genetics study. Methods We conducted semi-structured interviews with 42 members of the public stratified by age group, gender and newspaper readership (a measure of social status). Respondents were (...) asked to use a website designed to recruit for a large-scale genetic study. After using the website a semi-structured interview was conducted to explore opinions and any issues they would have. Responses were analysed using thematic content analysis. Results The majority of respondents said they would take part in the research (32/42). Those who said they would decline to participate saw fewer benefits from the research, wanted more information and expressed a greater number of concerns about the study. Younger respondents had concerns over time commitment. Middle aged respondents were concerned about privacy and security. Older respondents were more altruistic in their motivation to participate. Common themes included trust in the authenticity of the website, security of personal data, curiosity about their own genetic profile, operational concerns and a desire for more information about the research. Conclusions Online consent to large-scale genetic studies is likely to be acceptable to the public. The online consent process must establish trust quickly and effectively by asserting authenticity and credentials, and provide access to a range of information to suit different information preferences. (shrink)

Apparent design breakthroughs in short-range missile defense systems such as Theater High-Altitude Air Defense have prompted questions about the legality of such systems under the 1972 Antiballistic Missile Treaty. Prominent physicists have used computer “footprint” methodology to prove that if engineered to specifications, THAAD might exceed ABM Treaty performance limits banning highly effective missile defense systems. In response, missile defense officials commissioned Sparta, Inc. to conduct secret research casting doubt on the validity of such findings. The substantial diplomatic issues at (...) stake and the interesting rhetorical dynamics involved in this dispute warrant close scholarly analysis. Attention to the iterative relationship between the interpenetrating spheres of public argument and scientific practice in this case yields novel insight about the processes in which technical knowledge of defense systems is forged and raises fresh issues for the “closure project” in science and technology controversy studies. (shrink)

Repetition plays a significant, productive role in the work of both Derrida and Deleuze. But the difference between these two philosophers couldn''t be greater: it is the difference between negation and affirmation, between Yes and No. In Derrida, the productive energy of repetition derives from negation, from the necessary impossibility of supplementing an absence. Deleuze recognizes the kind of repetition which concerns Derrida, but insists that there is another, primary form of repetition which is fully positive and affirmative. I will (...) argue that there is nothing in Derrida''s philosophy to match the affirmative, primary form of repetition articulated by Deleuze. Moreover, it is precisely this difference that accounts for the most exciting features of Deleuze''s work: the possibility of breaking through to the other side of representation, beyond authenticity and inauthenticity, becoming-becoming. (shrink)

This paper presents a formalization of informal logic using the Carneades Argumentation System, a formal, computational model of argument that consists of a formal model of argument graphs and audiences. Conflicts between pro and con arguments are resolved using proof standards, such as preponderance of the evidence. Carneades also formalizes argumentation schemes. Schemes can be used to check whether a given argument instantiates the types of argument deemed normatively appropriate for the type of dialogue.

This paper shows how the critical questions matching an argumentation scheme can be mod-eled in the Carneades argumentation system as three kinds of premises. Ordinary premises hold only if they are supported by sufficient arguments. Assumptions hold, by default, until they have been questioned. With exceptions the negation holds, by default, until the exception has been supported by sufficient arguments. By “sufficient arguments”, we mean arguments sufficient to satisfy the applicable proof standard.

The past 50 years have seen an accumulation of evidence suggesting that associative learning depends on high-level cognitive processes that give rise to propositional knowledge. Yet, many learning theorists maintain a belief in a learning mechanism in which links between mental representations are formed automatically. We characterize and highlight the differences between the propositional and link approaches, and review the relevant empirical evidence. We conclude that learning is the consequence of propositional reasoning processes that cooperate with the unconscious processes involved (...) in memory retrieval and perception. We argue that this new conceptual framework allows many of the important recent advances in associative learning research to be retained, but recast in a model that provides a firmer foundation for both immediate application and future research. (shrink)

We present a formal, mathematical model of argument structure and evaluation, taking seriously the procedural and dialogical aspects of argumentation. The model applies proof standards to determine the acceptability of statements on an issue-by-issue basis. The model uses different types of premises (ordinary premises, assumptions and exceptions) and information about the dialectical status of statements (stated, questioned, accepted or rejected) to allow the burden of proof to be allocated to the proponent or the respondent, as appropriate, for each premise separately. (...) Our approach allows the burden of proof for a premise to be assigned to a different party than the one who has the burden of proving the conclusion of the argument, and also to change the burden of proof or applicable proof standard as the dialogue progresses from stage to stage. Useful for modeling legal dialogues, the burden of production and burden of persuasion can be handled separately, with a different responsible party and applicable proof standard for each. Carneades enables critical questions of argumentation schemes to be modeled as additional premises, using premise types to capture the varying effect on the burden of proof of different kinds of questions. (shrink)

Five errors that fit under the category of jumping to a conclusion are identified: (1) arguing from premises that are insufficient as evidence to prove a conclusion (2) fallacious argument from ignorance, (3) arguing to a wrong conclusion, (4) using defeasible reasoning without being open to exceptions, and (5) overlooking/suppressing evidence. It is shown that jumping to a conclusion is best seen not as a fallacy itself, but as a more general category of faulty argumentation pattern underlying these errors and (...) some related fallacies. (shrink)