BackgroundAlthough the Life-Sustaining Treatment (LST) Decision Act was enforced in 2018 in Korea, data on whether it is well established in actual clinical settings are limited. Hospital-acquired pneumonia (HAP) is a common nosocomial infection with high mortality. However, there are limited data on the end-of-life (EOL) decision of patients with HAP. Therefore, we aimed to examine clinical characteristics and outcomes according to the EOL decision for patients with HAP.MethodsThis multicenter study enrolled patients with HAP at 16 referral hospitals retrospectively from (...) January to December 2019. EOL decisions included do-not-resuscitate (DNR), withholding of LST, and withdrawal of LST. Descriptive and Kaplan–Meier curve analyses for survival were performed.ResultsOf 1,131 patients with HAP, 283 deceased patients with EOL decisions (105 cases of DNR, 108 cases of withholding of LST, and 70 cases of withdrawal of LST) were analyzed. The median age was 74 (IQR 63–81) years. The prevalence of solid malignant tumors was high (32.4% vs. 46.3% vs. 54.3%, P = 0.011), and the ICU admission rate was lower (42.9% vs. 35.2% vs. 24.3%, P = 0.042) in the withdrawal group. The prevalence of multidrug-resistant pathogens, impaired consciousness, and cough was significantly lower in the withdrawal group. Kaplan–Meier curve analysis revealed that 30-day and 60-day survival rates were higher in the withdrawal group than in the DNR and withholding groups (log-rank P = 0.021 and 0.018). The survival of the withdrawal group was markedly decreased after 40 days; thus, the withdrawal decision was made around this time. Among patients aged below 80 years, the rates of EOL decisions were not different (P = 0.430); however, mong patients aged over 80 years, the rate of withdrawal was significantly lower than that of DNR and withholding (P = 0.001).ConclusionsAfter the LST Decision Act was enforced in Korea, a DNR order was still common in EOL decisions. Baseline characteristics and outcomes were similar between the DNR and withholding groups; however, differences were observed in the withdrawal group. Withdrawal decisions seemed to be made at the late stage of dying. Therefore, advance care planning for patients with HAP is needed. (shrink)

Adolescents often create social relationships with their gaming peers who take on the role of offline friends and peer groups. Through collaboration and competition in the games, the social relationships of adolescents are becoming broader and thicker. Although this is a common phenomenon in online games, few studies have focused on the formation and roles of social capital among adolescent gamers. In particular, longitudinal research that examines the role of social capital in terms of influencing gaming time on adolescent gamers’ (...) psychosocial factors has been minimal. This study was designed to fill this gap to see the long-term effect of social capital among adolescent gamers. Specifically, by using the three-year longitudinal data involving 403 adolescents, we analyzed the effect of gaming time on psychological factors with the moderating role of social capital. Results showed that social capital played a crucial moderating role. In the higher social capital group, gaming time enhanced the degree of self-esteem and life satisfaction. However, a vicious circle was found in the lower social capital group: Gaming time increased the degree of depression but decreased self-esteem, which in turn led to increase in gaming time. These results indicate that games work as an important tool for social capital cultivation among adolescent gamers, which imply successful cultivation of social capital is a key to positive gaming effects. Theoretical and practical implications are discussed. (shrink)

Background Conventional consent practices face ethical challenges in continuously evolving digital health environments due to their static, one-time nature. Dynamic consent offers a promising solution, providing adaptability and flexibility to address these ethical concerns. However, due to the immaturity of the concept and accompanying technology, dynamic consent has not yet been widely used in practice. This study aims to identify the facilitators of and barriers to adopting dynamic consent in real-world scenarios. Methods This scoping review, conducted in December 2022, adhered (...) to the PRISMA Extension for Scoping Reviews guidelines, focusing on dynamic consent within the health domain. A comprehensive search across Web of Science, PubMed, and Scopus yielded 22 selected articles based on predefined inclusion and exclusion criteria. Results The facilitators for the adoption of dynamic consent in digital health ecosystems were the provision of multiple consent modalities, personalized alternatives, continuous communication, and the dissemination of up-to-date information. Nevertheless, several barriers, such as consent fatigue, the digital divide, complexities in system implementation, and privacy and security concerns, needed to be addressed. This study also investigated current technological advancements and suggested considerations for further research aimed at resolving the remaining challenges surrounding dynamic consent. Conclusions Dynamic consent emerges as an ethically advantageous method for digital health ecosystems, driven by its adaptability and support for continuous, two-way communication between data subjects and consumers. Ethical implementation in real-world settings requires the development of a robust technical framework capable of accommodating the diverse needs of stakeholders, thereby ensuring ethical integrity and data privacy in the evolving digital health landscape. (shrink)

This is an overview of Davidson's theory of anomalous monism. Objections and replies are also detailed.

Speculative Realism (SR) has often been characterised as a heterogeneous group of thinkers, united almost exclusively in their commitment to the critique of what Quentin Meillassoux terms ‘correlationism’ or what Graham Harman calls the ‘philosophy of (human) access.’ The terms ‘correlationism’ and ‘philosophy of access’ are in turn often treated – at times even by Meillassoux and Harman themselves – as synonymous. In this paper, I seek to analyse these terms to evaluate their similarities, but also possible differences. I shall (...) argue that the difference between the two terms ought to be retained and emphasised, since it hints at important differences between the positions of Harman and Meillassoux. (shrink)

We are immersed within an odorous sea of chemical currents that we parse into individual odors with complex structures. Odors have been posited as determined by the structural relation between the molecules that compose the chemical compounds and their interactions with the receptor site. But, naturally occurring smells are parsed from gaseous odor plumes. To give a comprehensive account of the nature of odors the chemosciences must account for these large distributed entities as well. We offer a focused review of (...) what is known about the perception of odor plumes for olfactory navigation and tracking, which we then connect to what is known about the role odorants play as properties of the plume in determining odor identity with respect to odor quality. We end by motivating our central claim that more research needs to be conducted on the role that odorants play within the odor plume in determining odor identity. (shrink)

Arthur Schopenhauer was one of the greatest writers and German philosophers of the nineteenth century. His work influenced figures as diverse as Wagner, Freud and Nietzsche. Best known as a pessimist, he was one of the few philosophers read and admired by Wittgenstein. In this comprehensive introduction, Julian Young covers all the main aspects of Schopenhauer's philosophy. Beginning with an overview of Schopenhauer's life and work, he introduces the central aspects of his metaphysics fundamental to understanding his work as (...) a whole: his philosophical idealism and debt to the philosophy of Kant; his attempt to answer the question of what the world is; his account of science; and in particular his idea that 'will' is the essence of all things. Julian Young then introduces and assesses Schopenhauer's aesthetics, which occupy a central place in his philosophy. He carefully examines Schopenhauer's theories of the sublime, artistic genius and music, before assessing his ethics of compassion, his arguments for pessimism and his account of 'salvation'. In the final chapter, he considers Schopenhauer's legacy and his influence on the thought of Nietzsche and Wittgenstein, making this an ideal starting point for those coming to Schopenhauer for the first time. (shrink)

We perceive smells as perduring complex entities within a distal array that might be conceived of as smellscapes. However, the philosophical orthodoxy of Odor Theories has been to deny that smells are perceived as having a distal location. Recent challenges have been mounted to Odor Theories’ veracity in handling the timescale of olfactory perception, how it individuates odors as a distal entities, and their claim that olfactory perception is not spatial. The paper does not aim to dispute these criticisms. Rather, (...) what will be shown is that Molecular Structure Theory, a refinement of Odor Theory, can be further developed to handle these challenges. The theory is further refined by focusing on distal perception that requires considering the perceptual object as mereologically complex persisting odor against a background scene conceived of as a smellscape. What will be offered is an expansion of Molecular Structure Theory to account for distal smell perception within natural environments. (shrink)

The Discovery of Evolution explains what the theory of evolution is all about by providing a historical narrative of discovery. Some of the major puzzles that confront anyone studying living things are discussed and it details how these were solved from an evolutionary perspective. Beginning with the emergence of the early naturalists in the seventeenth century, the scientific discoveries that led up to and then flowed from Darwin and Wallace's theory of evolution by natural selection are then discussed, and finally (...) the modern evolutionary studies at the close of the twentieth century are detailed. This new edition of The Discovery of Evolution is fully updated and contains a new chapter on the evolutionary studies of the twentieth century. By approaching the topic of evolution in this way, it is made accessible to the non-specialist and no previous study of biology is required in order to read and understand this book. (shrink)

The spiritual geography of Russian cosmism. General characteristics ; Recent definitions of cosmism -- Forerunners of Russian cosmism. Vasily Nazarovich Karazin (1773-1842) ; Alexander Nikolaevich Radishchev (1749-1802) ; Poets: Mikhail Vasilyevich Lomonosov, (1711-1765) and Gavriila Romanovich Derzhavin (1743-1816) ; Prince Vladimir Fedorovich Odoevsky (1803-1869) ; Aleksander Vasilyevich Sukhovo-Kobylin (1817-1903) -- The Russian philosophical context. Philosophy as a passion ; The destiny of Russia ; Thought as a call for action ; The totalitarian cast of mind -- The religious and spiritual (...) context. The kingdom of god on earth ; Hesychasm: two great Russian saints ; The Third Rome ; Pre-Christian antecedents -- The Russian esoteric context. Early searches for "deep wisdom" ; Popular magic ; Higher magic in the time of Peter the Great ; Esotericism after Peter the Great ; Theosophy and anthroposophy -- Nikolai Fedorovich Fedorov (1829-1903), the philosopher of the common task ; The one idea ; The unacknowledged prince ; The village teacher ; First disciple: Dostoevsky and Tolstoy ; The Moscow librarian ; Last years: Askhabad: the only portrait -- The "common task" ; Esoteric dimensions of the "common task" ; Fedorov's legacy: projectivism, delo, regulation -- The religious cosmists. Vladimir Sergeevich Solovyov (1853-1900) ; Sergei Nikolaevich Bulgakov (1871-1944) ; Pavel Aleksandrovich Florensky (1882-1937) ; Nikolai Aleksandrovich Berdyaev (1874-1948) -- The scientific cosmists. Konstantin Edouardovich Tsiolkovsky (1857-1935) ; Vladimir Ivanovich Vernadsky (1863-1945) ; Alexander Leonidovich Chizhevsky (1897-1964) ; Vasily Feofilovich Kuprevich (1897-1969) -- Promethean theurgy. Life-creation ; Cultural immortalism ; God-building ; Re-aiming the arrows of Eros ; Technological utopianism ; Occultism -- Fedorov's twentieth century followers. Nikolai Pavlovich Peterson (1844-1919) and Vladimir Aleksandrovich Kozhevnikov (1852-1917) ; Svyatogor and the biocosmists ; New wine and the universal task ; Alexander Konstantinovich Gorsky (1886-1943) and Nikolai Alexandrovich Setnitsky (1888-1937) ; Valerian Nikolaevich Muravyov (1885-1932) ; Vasily Nikolaevich Chekrygin (1897-1922) -- Cosmism and its offshoots today. The N.F. Fedorov museum-library ; The Tsiolkovsky museum and Chizhevsky center ; ISRICA - Institute for Scientific Research in Cosmic Anthropoecology ; Lev Nikolaevich Gumilev (1912-1992) and neo-eurasianism ; The hyperboreans ; Scientific immortalism: Igor Vishev, Danila Medvedev ; Conclusions about the Russian cosmists. (shrink)

It is often taken for granted that Paul Hirst’s switch from emphasis on liberal education to a social practices view of education is a radical one. This depends on how we understand the relation between the two views. From the perspective of a ‘weak’ interpretation I argue that Hirst’s later position differs little from his earlier one in the light both of the relation between the forms of knowledge and social practices, and of the rationalistic character of Hirst’s conception of (...) social practices in their connection with education. (shrink)

This is a clear and lucid account of Nietzsche's philosophy of art, combining exegesis, interpretation and criticism in a judicious balance. Julian Young argues that Nietzsche's thought about art can only be understood in the context of his wider philosophy. In particular, he discusses the dramatic changes in Nietzschean aesthetics against the background of the celebrated themes of the death of God, eternal recurrence, and the idea of the Übermensch. Young then divides Nietzsche's career and his philosophy of (...) art into four distinct phases, but suggests that these phases describe a circle. An attempt at world-affirmation is made in the central phases, but Nietzsche is predominantly influenced at the beginning and end of his career by a Schopenhauerian pessimism. At the beginning and end art is important because it 'redeems' us from life. (shrink)

This is the first modern, annotated and scholarly edition of Jean-Baptiste Du Bos’ _Critical Reflections on Poetry and Painting_, one of the seminal works of modern aesthetics in any language.

Twentieth-century developments in quantum physics, together with an emerging science of consciousness, have created the need for a new cosmology, or model of the universe. The theory of process contained in THE REFLEXIVE UNIVERSE places consciousness within the context of contemporary science. One of the central themes of this extraordinary work is that each successive organization of matter, from fundamental particles in physics to living organisms, expresses a particular stage in the evolution of mind. Starting with the photon, the basic (...) unit of light, and moving through atomic physics, molecular chemistry, the morphology of plants and animals and finally to levels of human evolution, Young develops his theory in vivid step-by-step detail. Consciousness, in his point of view, is not isolated from the material universe. It exists in a continuum, one in which physical and nonphysical realms can be linked and the teachings of mythology and religion can be integrated. To order: FAX: 415-883-9280; e-mail: [email protected]; or write: Anodos Foundation, c/o Publishers Services, P.O. Box 2510, Novato, CA 94948. Visa and MasterCard only. Trade STOP orders 40% plus postage. (shrink)

In Graham Harman’s Object-Oriented Ontology (OOO), an apparent tension arises between his pursuit of a self-proclaimed “new theory of everything,” or general ontology, and his assertion that any ontology must be able to account for distinctions among various regions of being. This paper delves into this tension between universality and specificity, particularly concerning the question of animal ontology, and examines the potential for constructing an object-oriented animal ontology. By juxtaposing Harman’s perspectives with those of Matthew Calarco and other scholars, I (...) aim to demonstrate the feasibility of developing an animal ontology using the framework of OOO. (shrink)

SignificanceElectrical burns can cause severe damage to the nervous system, resulting in autonomic dysfunction with reduced cerebral perfusion. However, few studies have investigated these consequences.AimTo elucidate changes in prefrontal cerebral hemodynamics using functional near-infrared spectroscopy (fNIRS) during the head-up tilt table test (HUT) for patients with electrical burns.ApproachWe recruited 17 patients with acute electrical burns within 1 week after their accidents and 10 healthy volunteers. The NIRS parameters acquired using an fNIRS device attached to the forehead were analyzed in five (...) distinct HUT phases.ResultsBased on their HUT response patterns, patients with electrical burns were classified into the group with abnormal HUT results (APG, n = 4) or normal HUT results (NPG, n = 13) and compared with the healthy control (HC, n = 10) participants. We found trends in hemodynamic changes during the HUT that distinguished HC, NPG, and APG. Reduced cerebral perfusion and decreased blood oxygenation during the HUT were found in both the NPG and APG groups. Patients with electrical burns had autonomic dysfunction compared to the HC participants.ConclusionsUsing fNIRS, we observed that acute-stage electrical burn injuries could affect cerebral perfusion. (shrink)

This book uses rare pathologies to inform questions on topics such as consciousness and rationality. Rather than trying to answer these by inventing far-fetched scenario or 'thought experiments', it is better to utilize a rich but under-used clinical resource.

What can we learn about the nature of technology by studying practices of maintenance and repair? This volume addresses this question by bringing together scholarship from philosophers of technology working at the forefront of this emerging and exciting topic. -/- The chapters in this volume explore how attending to maintenance and repair can challenge and complement existing ways of thinking about technology focused on use and design and introduce new philosophical perspectives on the relationship between technology, time and human practice. (...) They examine the significance of maintenance and repair practices at different scales in relation to a diverse range of philosophical traditions and a wide variety of technologies, from urban infrastructure such as bridges and buildings to data technologies such as servers and software systems. Together, the contributions highlight common themes in the philosophical study of maintenance, including the role of skill, the significance of social values and the potential of these practices to transform the technologies to which they are applied. By reflecting on the different ways in which we keep technologies going, from the devices we use in our homes to the large technical systems which surround us, this volume reveals the philosophical significance of practices of maintenance, not only as a source of new insights but also as a resource for enriching our understanding of a variety of existing topics in philosophy. -/- Maintenance and Philosophy of Technology will appeal to scholars and advanced students working in philosophy of technology, philosophy of engineering and science & technology studies. (shrink)