Monica Colvin-Adams,1 Nonyelum Harcourt,1 Robert LeDuc,2 Ganesh Raveendran,1 Yassir Sonbol,3 Robert Wilson,1 Daniel Duprez11Cardiovascular Division, University of Minnesota, Minneapolis, MN, USA; 2Division of Biostatistics University of Minnesota, Minneapolis, MN, USA; 3Cardiovascular Division, St Luke's Hospital System, Sugar Land, TX, USAObjective: Arterial elasticity is a functional biomarker that has predictive value for cardiovascular morbidity and mortality in nontransplant populations. There is little information regarding arterial elasticity in heart transplant recipients. This study aimed to characterize small and large artery elasticity in (...) heart transplant recipients in comparison with an asymptomatic population free of overt cardiovascular disease. A second goal was to identify demographic and clinical factors associated with arterial elasticity in this unique population.Methods: Arterial pulse waveform was registered noninvasively at the radial artery in 71 heart transplant recipients between 2008 and 2010. SAEs and LAEs were derived from diastolic pulse contour analysis. Comparisons were made to a healthy cohort of 1,808 participants selected from our prevention clinic database. Multiple regression analyses were performed to evaluate associations between risk factors and SAE and LAE within the heart transplant recipients.Results: LAE and SAE were significantly lower in heart transplant recipients than in the normal cohort. Female sex and history of ischemic cardiomyopathy were significantly associated with reduced LAE and SAE. Older age and the presence of moderate cardiac allograft vasculopathy were also significantly associated with reduced SAE. Transplant duration was associated with increased SAE.Conclusion: Heart transplants are associated with peripheral endothelial dysfunction and arterial stiffness, as demonstrated by a significant reduction in SAE and LAE when compared with a healthy population. Furthermore, cardiac allograft vasculopathy is associated with a significant reduction in SAE, suggesting a potential use in screening heart transplant recipients at risk for developing this complication.Keywords: heart transplant, endothelial function, arterial elasticity, cardiac allograft vasculopathy. (shrink)

We share Nair-Collins and Joffe's (2023) concern with the accuracy of the “whole brain-death” diagnosis, which fails to take into account current understandings of residual brain function (neurohor...

This study aimed to understand the preserved elements of self-identity in persons with moderate to severe dementia attributable to Alzheimer’s disease. A semi-structured interview was developed to explore the narrative self among residents with dementia in a residential care facility and residents without dementia in an independent living setting. The interviews were transcribed verbatim from audio recordings and analyzed for common themes, while being sensitive to possible differences between the groups. The participants with dementia showed evidence of self-reference even though (...) losses in explicit memory were evident. The most noticeable difference between the two groups was time frame reference. Nonetheless, all participants showed understanding of their role in relationships and exhibited concrete preferences. Our findings suggest that memory loss and other cognitive deficits associated with moderate to severe dementia do not necessarily lead to a loss of “self.”. (shrink)

We agree with Nielsen Busch and Mjaaland’s (2023) assessment that the Dead Donor Rule (DDR) should be viewed as an essential requirement of the organ donation process, and that the essence of the r...

The Human-Animal Boundary shifts the traditional anthropocentric focus of philosophy and literature by combining the question "what is human?" with the question "what is animal?" The objective is to expand the imaginative scope of human-animal relationships by combining perspectives from different disciplines, traditions, and cultural backgrounds.

We welcome and applaud Wilkinson’s impressive and subtle exploration of the possible considerations of frailty as a criterion for triage in times of pandemic-dr...

BackgroundSimilar to many other countries, in Germany patients with alcohol-related liver disease are obliged to prove their abstinence before being accepted on a waitlist for liver transplantation. Health care professionals (HCPs) must both treat patients and ensure that patients have proven their abstinence. The aim of this exploratory study was to develop a deeper understanding of how HCPs deal with this dual role.MethodsThe study used semi-structured interviews as the source of data. 11 healthcare professionals from ten of the 22 German (...) transplant centers were interviewed. After transcription, a qualitative content analysis was performed.ResultsWe found that these HCPs faced an ethical dilemma, as they must balance the roles of being both a treatment provider (the therapist role) and an assessor (the monitoring role). To solve this dilemma, the strategy seems to be a tendency for the HCPs to take on one dominant role amongst these two roles. HCPs who prefer to take on the therapist role seem to feel burdened by the 6-month abstinence rule and the obligation to monitor their patients. HCPs who prefer to take on the monitoring role tend to have negative assumptions about the patients. HCPs also reported the impression that patients perceive HCPs as more involved in monitoring and less open to the therapeutic role. From this it can be deduced that current regulations and structures lead both to stress for HCPs and to suboptimal therapy for those affected.ConclusionsThe results showed that current transplantation guidelines can have a negative impact on both patient care and the burdens on the HCPs. From our point of view, there are various changes that could be made to the current clinical practice that would help solve this dilemma. For instance, integrating other assessment criteria that are more closely adapted to the health status trajectory and psychosocial background of the individual patient would be both possible and would lead to improvements in practice. (shrink)

The revised Declaration of Helsinki allows placebo-controlled trials to be used even when there is an established therapy, provided there are adequate ‘methodological’ reasons for doing so. This seems to violate the principle of beneficence: where there is an established therapy, physicians treating patients with a placebo are withholding a known effective therapy. Because of this problem, we hypothesised that clinical researchers may be unwilling to risk violating the principle of beneficence and employ placebo-controlled trials in cases where there is (...) an established therapy. In this paper, we began to investigate this hypothesis. After summarising the arguments for and against using placebo controls in clinical practice, we exploredthe extent to which placebo-controlled trials are used in cases where there is an established therapy. To do this, we conducted as systematic search for all placebo-controlled trials published in 2015 in the five highest impact general medical journals. We identified 70 placebo-controlled trials. Of these, 66 were for indications where there was no established effective therapy. Only four used a placebo control in spite of there being an available effective therapy. The infrequent use of placebo controlled trials where established therapy exists highlights a seeming discrepancy between what the Declaration of Helsinki allows and what clinical investigators believe to be ethically acceptable. The evidence presented in this paper suggests that the Declaration of Helsinki be reconsidered, and perhaps revised, in light of actual practice. (shrink)

This paper discusses the work of Ismat Chughtai (1911–1991), a controversial writer whose long literary career extending over four decades roughly corresponds to the formative stages of the Indian women's movement. It interprets Chughtai's novella The Heart Breaks Free (1966) to forward an anti-teleological enquiry of the women's movement in India. This progressive teleology often suggested by a discussion of the ‘waves’, ‘stages’ or ‘phases’ of the Euro-American women's movement and adopted to postcolonial women's movements, such as those in India, (...) Jamaica and South Africa, is belied by the piecemeal legislative gains won by activist efforts. Some of the questions governing my enquiry are: What lessons can a questioning of teleology teach us about the gains and losses of postcolonial women's movements? If the alternative to teleology is, as I suggest, a genealogy, then what constitutes a genealogical enquiry into the women's movement in India? In face of apparent and self-acknowledged losses and ineffectiveness in recent times, would the movement's apparent unity across religious differences be a way of initiating such an inquiry or is another mode of analysis required? The paper directs attention to the Indian women's movement's attempts at bringing together women of different religious persuasions, legislative, and religious edicts related to Muslim women's right to co-habitation and divorce, and ‘cases’ that serve as testing points of the movement's struggle against religious and state authority. It also points to the neglected factor of economic security for women as a way in which a genealogical inquiry can proceed so as to strengthen the legislation and the movement itself. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The TripletsManeesh BatraI am a neonatologist and for the majority of my clinical time I care for babies and their families at a large University-based referral neonatal intensive care unit (NICU) in the United States. In 2003, I first visited this rural Ugandan hospital shortly after the opening of a special care baby nursery there, and have been involved with development of that program ever since.Uganda is a beautiful, (...) land-locked country in East Africa with a sordid political history. It is a developing country that is poor, mostly rural with a high fertility rate and a life expectancy of 42 years. The government spends $5 per capita per year on healthcare. The district with the hospital has a population of 500,000, the majority of which is rural. Access to health services is poor, even by Ugandan standards, and child mortality is in the higher band in the country.Most people in the region live in extended family clans. A common home is made of earth, with a grass roof, and a jerry can out front for collecting water from the well. It is an exquisitely lush landscape with fecund soil. At the hospital, there is limited electricity, lab support, medications, blood supplies, and health care workers. For the 200 bed hospital (that accommodates upwards of 400 inpatients when necessary, no one is turned away) there are four to seven Ugandan doctors, who do everything from C-sections, to colostomies, to HIV care to resuscitate babies in the NICU. For a ward of 20-80 patients there are one to two nurses, and maybe a nursing aide. Families do the majority of the care in the hospital, even in the NICU. Mum's express breast milk, perform tube feeds, wash the linens, notify staff when an IV infiltrates, and keep babies warm.Day OneAnother beautiful morning, with fresh instant coffee in hand, birds chirping and kids playing outside. It is good to be back. Over the last eight years, I've [End Page 78] made some close friends here and its good to be among them again. Every time I visit and return home, I leave a piece of me here, and bring back something new with me. This morning that feeling is overwhelming me, an incredible inspiration swells. I am not tired and I want to be busy. It is no wonder that this is where I was inspired to pursue caring for babies as my career. Over these years, it has been amazing to see the staff care for the community's babies and mums here. As an outsider, an opinioned one at that, I feel burdened at the thought of these babies dying somewhat needlessly. Is it really no-one's fault? How should one act in the face of scarcity, knowing there is a better standard to be had if only circumstances were different?I walked into the NICU to find triplets had arrived! Born at about 33 weeks they were two months early. Since they weighed around 1.5kg (about 3 lbs) each, they were at very high risk of dying —however, it was absolutely incredible to see the way they were tucked in by the skilled team. Within an hour of delivery—they were in incubators with IVs, having their hypoglycemia corrected, and two out of three were on oxygen (all of them had their O2 saturations checked). The three babies were tucked in so calmly, with the finest skill and expertise neonatal care anywhere has to offer. In stark contrast to the first admissions I witnessed years ago, the nurses now knew exactly what to do and how to do it. As a result, they had saved many lives and restored hope among the mums of the region that there was somewhere to go to get help. This success resulted in a healthy swagger among the staff because they could intervene successfully.These were spontaneous triplets to this young mum, who already had three other children. She looked tired when she walked into the NICU one hour (yes one hour) after delivering the trio, but if I hadn't known prior, there was no way to know... (shrink)

Linked with existence of the almighty, the operation of division by zero which is considered as undefined or indeterminate or infinite sometimes, has been a topic of serious altercation among mathematicians and philosophers for so long. History is evident of the various attempts made to clearly define the algebra of zero, including the idea of division by zero. This includes the evolution of the idea of zero division and various insights from mathematicians like Euler, Craig and more. The realm of (...) the paper contains all such significant attempts and it deals with the idea of the history that wishes to explore the evolution of infinity and undefined. The prime aim of this paper is to clearly distinguish the three concepts of Undefined, Indeterminate and Infinity, along with the concept of division by zero. It strives to provide a notation to undefined expressions, along with citing justifications and results with the help of unpretentious examples from key branches. (shrink)

Public health emergencies, including infectious disease outbreaks and natural disasters, are issues faced by every community. To address these threats, it is critical for all jurisdictions to understand how law can be used to enhance public health preparedness, as well as improve coordination and collaboration across jurisdictions. As sovereign entities, Tribal governments have the authority to create their own laws and take the necessary steps to prepare for, respond to, and recover from disasters and emergencies. Legal preparedness is a key (...) component of public health preparedness. This article first explains legal preparedness and Tribal sovereignty and then describes the relationship between Tribal Nations, the US government, and states. Specific Tribal concerns with respect to emergency preparedness and the importance of coordination and collaboration across jurisdictions for emergency preparedness are discussed. Examples of collaborative efforts between Tribal and other governments to enhance legal preparedness are described. (shrink)

Vol. presents a method for critically evaluating relevance in arguments based on case studies & a new relevance theory incorporating techniques of argumentation theory, logic & artificiaI intelligence. For scholars/students in argumentation & rhetoric.

The Stanford Encyclopedia of Philosophy is an open access, dynamic reference work designed to organize professional philosophers so that they can write, edit, and maintain a reference work in philosophy that is responsive to new research. From its inception, the SEP was designed so that each entry is maintained and kept up to date by an expert or group of experts in the field. All entries and substantive updates are refereed by the members of a distinguished Editorial Board before they (...) are made public. (shrink)

A "slippery slope argument" is a type of argument in which a first step is taken and a series of inextricable consequences follow, ultimately leading to a disastrous outcome. Many textbooks on informal logic and critical thinking treat the slippery slope argument as a fallacy. Walton argues that used correctly in some cases, they can be a reasonable type of argument to shift a burden of proof in a critical discussion, while in other cases they are used incorrectly. Walton identifies (...) and analyzes four types of slippery slope argument. Walton presents guidelines that show how each type of slippery slope argument can be used correctly or incorrectly, using over fifty case studies of argumentation on controversial issues. These include abortion, medical research on human embryos, euthanasia, the decriminalization of marijuana, pornography, and censorship, and banning of American flag burning. (shrink)

Cloud computing paradigm is growing rapidly, and it allows users to get services via the Internet as pay-per-use and it is convenient for developing, deploying, and accessing mobile applications. Currently, security is a requisite concern owning to the open and distributed nature of the cloud. Copious amounts of data are responsible for alluring hackers. Thus, developing efficacious IDS is an imperative task. This article analyzed four intrusion detection systems for the detection of attacks. Two standard benchmark datasets, namely, NSL-KDD and (...) UNSW-NB15, were used for the simulations. Additionally, this study highlights the proliferating challenges for the security of sensitive user data and gives useful recommendations to address the identified issues. Finally, the projected results show that the hybridization method with support vector machine classifier outperforms the existing techniques in the case of the datasets investigated. (shrink)

Volume 19, Issue 11, November 2019, Page 29-31.

When making decisions, humans can observe many kinds of information about others' activities, but their effects on performance are not well understood. We investigated social learning strategies using a simple problem-solving task in which participants search a complex space, and each can view and imitate others' solutions. Results showed that participants combined multiple sources of information to guide learning, including payoffs of peers' solutions, popularity of solution elements among peers, similarity of peers' solutions to their own, and relative payoffs from (...) individual exploration. Furthermore, performance was positively associated with imitation rates at both the individual and group levels. When peers' payoffs were hidden, popularity and similarity biases reversed, participants searched more broadly and randomly, and both quality and equity of exploration suffered. We conclude that when peers' solutions can be effectively compared, imitation does not simply permit scrounging, but it can also facilitate propagation of good solutions for further cumulative exploration. (shrink)

I advance a variety of intellectualism about knowing-how that is, paradoxically, suggested by Ryle's positive discussions of that phenomenon. I discuss the roots of the view in Ryle's work, its affinity with John Hyman's () view of factual knowledge, and important points of contrast with Stanley and Williamson's () proposal. Drawing on work by Cath () and Wiggins () I also discuss conditions on knowing practically, in ‘the executive way’, as an alternative to appealing to practical modes of presentation.

단국대 학생들의 교책과목으로 집필된 책.단국대학교의 역사와 한민족의 가치관,미래부터 교육과 인간화까지 전체 15장에 엮었다.

Mathematical pluralism can take one of three forms: (1) every consistent mathematical theory consists of truths about its own domain of individuals and relations; (2) every mathematical theory, consistent or inconsistent, consists of truths about its own (possibly uninteresting) domain of individuals and relations; and (3) the principal philosophies of mathematics are each based upon an insight or truth about the nature of mathematics that can be validated. (1) includes the multiverse approach to set theory. (2) helps us to understand (...) the significance of the distinguished non‐logical individual and relation terms of even inconsistent theories. (3) is a metaphilosophical form of mathematical pluralism and hasn't been discussed in the literature. In what follows, I show how the analysis of theoretical mathematics in object theory exhibits all three forms of mathematical pluralism. (shrink)

First-2d ed. published under title: Manual de introduccion a la ciencia del derecho.

Science provides us with representations of atoms, elementary particles, polymers, populations, genetic trees, economies, rational decisions, aeroplanes, earthquakes, forest fires, irrigation systems, and the world’s climate. It's through these representations that we learn about the world. This entry explores various different accounts of scientific representation, with a particular focus on how scientific models represent their target systems. As philosophers of science are increasingly acknowledging the importance, if not the primacy, of scientific models as representational units of science, it's important to (...) stress that how they represent plays a fundamental role in how we are to answer other questions in the philosophy of science (e.g. the scientific realism debate). This entry begins by disentangling ‘the’ problem of scientific representation, before critically evaluating the current options available in the literature. (shrink)

The so-called ergodic hierarchy (EH) is a central part of ergodic theory. It is a hierarchy of properties that dynamical systems can possess. Its five levels are egrodicity, weak mixing, strong mixing, Kolomogorov, and Bernoulli. Although EH is a mathematical theory, its concepts have been widely used in the foundations of statistical physics, accounts of randomness, and discussions about the nature of chaos. We introduce EH and discuss its applications in these fields.

EDITORS' INTRODUCTION B he Vedas tell of a conversation between a young man, Shvetaketu, and his father concerning what the son had learned in his education ...

인간의 이성적 의식과 법의 관계를 밝히고 법의 해석 과 판단에 인간의 의식이 어떻게 작용하는가를 고찰 한 저술. 제1부에서는 법의 형이상학적인 측면에서 법의 실체, 그리스의 법, 데카르트의 법, 로크와 법, 칸트와 법, 헤겔과 법, 아담스미스의 법의 경제, 중국의 도덕과 법사상을 다루었다. 제2부에서는 심리학적 분석으로 헌법의 심리학적 해석, 법의 판결절차, 증거법, 형법과 죄, 청소년과 가족법, 조세법, 플라톤의 법, 칸트의 도덕론의 경험적 확인, 헤겔의 자아와 노동법, 법의 4차원에 대해 다뤘다.

This book identifies 25 argumentation schemes for presumptive reasoning and matches a set of critical questions to each.