Figner, Mackinlay, Wilkening, and Weber (2009) developed the Columbia Card Task (CCT) to measure risk-taking attitudes. This tool consists of two versions: in the COLD version the decision maker needs to state in advance how many cards (out of 32) they want to turn over (so called static risk taking), in the HOT version they have the possibility of turning over all 32 cards one-by-one until they decide to finish (dynamic risk taking). We argue that the HOT version confounds an (...) individual’s willingness to accept risk with their beliefs in trend continuation vs. trend reversal in a prognostic task. In two experimental studies we show that people believing in trend continuation (momentum subjects) turn over more cards than those believing in trend reversal (contrarians) in the HOT version of the task. However, this is not the case in the COLD version. Thus, we provide evidence that, when considered as a dynamic risk propensity measure, the number of turned over cards in the HOT version of the CCT is a contaminated measure and reflects two phenomena: (1) risk preference and (2) the decision-maker’s belief in trend continuation. We speculate that other dynamic risk taking measures can also be biased by a momentum strategy. (shrink)

Background: Patients in a vegetative state pose problems in diagnosis, prognosis and treatment. Currently, no prognostic markers predict the chance of recovery, which has serious consequences, especially in end-of-life decision-making. Objective: We aimed to assess an objective measurement of prognosis using advanced electroencephalography (EEG). Methods: EEG data (19 channels) were collected in 14 patients who were diagnosed to be persistently vegetative based on repeated clinical evaluations at 3 months following brain damage. EEG structure parameters (amplitude, duration and variability within (...) quasi-stationary segments, as well as the spatial synchrony between such segments and the strength of this synchrony) were used to predict recovery of consciousness 3 months later. Results: The number and strength of cortical functional connections between EEG segments were higher in patients who recovered consciousness (P < .05 – P < .001) compared with those who did not recover. Linear regression analysis confirms that EEG structure parameters are capable of predicting (P = .0025) recovery of consciousness 6 months post-injury, whereas the same analysis failed to significantly predict patient outcome based on aspects of their clinical history alone (P = .629) or conventional EEG spectrum power (P = .473). Conclusions: The result of this preliminary study demonstrates that structural strategy of EEG analysis is better suited for providing prognosis of consciousness recovery than existing methods of clinical assessment and of conventional EEG. Our results may be a starting point for developing reliable prognosticators in patients who are in vegetative state, with the potential to improve their day-to-day management, quality of life, and access to early interventions. (shrink)

BackgroundFear of cancer recurrence is an important cause of suffering for cancer survivors, and both empirical evidence and theoretical models suggest that prognostic uncertainty plays a causal role in its development. However, the relationship between prognostic uncertainty and FCR is incompletely understood.ObjectiveTo explore the relationship between prognostic uncertainty and FCR among patients with ovarian cancer.DesignA qualitative study was conducted utilizing individual in-depth interviews with a convenience sample of patients with epithelial ovarian cancer who had completed first-line treatment (...) with surgery and/or chemotherapy. Semi-structured interviews explored participants’ understanding of their prognosis; experiences, preferences, and attitudes regarding prognostic information; and strategies for coping with prognostic uncertainty. Inductive qualitative analysis and line-by-line software-assisted coding of interview transcripts was conducted to identify key themes and generate theoretical insights on the relationship between prognostic uncertainty and FCR.ResultsThe study sample consisted of 21 participants, nearly all of whom reported experiencing significant FCR, which they traced to an awareness of the possibility of a bad outcome. Some participants valued and pursued prognostic information as a means of coping with this awareness, suggesting that prognostic uncertainty causes FCR. However, most participants acknowledged fundamental limits to both the certainty and value of prognostic information, and engaged in various strategies aimed not at reducing but constructing and maintaining prognostic uncertainty as a means of sustaining hope in the possibility of a good outcome. Participants’ comments suggested that prognostic uncertainty, fear, and hope are connected by complex, bi-directional causal pathways mediated by processes that allow patients to cope with, construct, and maintain their uncertainty. A provisional dual-process theoretical model was developed to capture these pathways.ConclusionAmong patients with OC, prognostic uncertainty is both a cause and an effect of FCR—a fear-inducing stimulus and a hope-sustaining response constructed and maintained through various strategies. More work is needed to elucidate the relationships between prognostic uncertainty, fear, and hope, to validate and refine our theoretical model, and to develop interventions to help patients with OC and other serious illnesses to achieve an optimal balance between these states. (shrink)

BackgroundPrognostic uncertainty is a challenge for physicians in the neuro intensive care field. Questions about whether continued life-sustaining treatment is in a patient’s best interests arise in different phases after a severe traumatic brain injury. In-depth information about how physicians deal with ethical issues in different contexts is lacking. The purpose of this study was to seek insight into clinicians’ strategies concerning unresolved prognostic uncertainty and their ethical reasoning on the issue of limitation of life-sustaining treatment in patients (...) with minimal or no signs of neurological improvement after severe traumatic brain injury in the later trauma hospital phase.MethodsInterviews with 18 physicians working in a neurointensive care unit in a large Norwegian trauma hospital, followed by a qualitative thematic analysis focused on physicians’ strategies related to treatment-limiting decision-making.ResultsA divide between proactive and wait-and-see strategies emerged. Notwithstanding the hospital’s strong team culture, inter-physician variability with regard to ethical reasoning and preferred strategies was exposed. All the physicians emphasized the importance of team—family interactions. Nevertheless, their strategies differed: (1) The proactive physicians were open to consider limitations of life-sustaining treatment when the prognosis was grim. They initiated ethical discussions, took leadership in clarification and deliberation processes regarding goals and options, saw themselves as guides for the families and believed in the necessity to prepare families for both best-case and worst-case scenarios. (2) The “wait-and-see” physicians preferred open-ended treatment (no limitations). Neurologically injured patients need time to uncover their true recovery potential, they argued. They often avoided talking to the family about dying or other worst-case scenarios during this phase.ConclusionsDepending on the individual physician in charge, ethical issues may rest unresolved or not addressed in the later trauma hospital phase. Nevertheless, team collaboration serves to mitigate inter-physician variability. There are problems and pitfalls to be aware of related to both proactive and wait-and-see approaches. The timing of best-interest discussions and treatment-limiting decisions remain challenging after severe traumatic brain injury. Routines for timely and open discussions with families about the range of ethically reasonable options need to be strengthened. (shrink)

This paper examines the production and circulation of astrological prognostications regarding the illness and death of kings, princes, and popes in the Italian Renaissance . The distribution and consumption of this type of astrological information was often closely linked to the specific political situation in which they were produced. Depending on the astrological techniques used , and the media in which they appeared these prognostications fulfilled different functions in the information economy of Renaissance Italy. Some were used to legitimise the (...) rule of a political leader, others to do just the opposite. Astrological prorogations and interrogations were often used to plan military and political strategies in case of the illness or death of a political leader, while astrological prognostications were generally written to promote certain political leaders while undermining others. While certainly often partisan to this game, astrologers, for their part, worked within a very well established tradition that gave authority to their forecasts. This paper argues that, as indicators of deeper political tensions otherwise not always explicitly manifest, these prognostications are privileged sources of information providing a better understanding of the political history of the period. (shrink)

Machine Learning (ML) is on the rise in medicine, promising improved diagnostic, therapeutic and prognostic clinical tools. While these technological innovations are bound to transform health care, they also bring new ethical concerns to the forefront. One particularly elusive challenge regards discriminatory algorithmic judgements based on biases inherent in the training data. A common line of reasoning distinguishes between justified differential treatments that mirror true disparities between socially salient groups, and unjustified biases which do not, leading to misdiagnosis and (...) erroneous treatment. In the curation of training data this strategy runs into severe problems though, since distinguishing between the two can be next to impossible. We thus plead for a pragmatist dealing with algorithmic bias in healthcare environments. By recurring to a recent reformulation of William James’s pragmatist understanding of truth, we recommend that, instead of aiming at a supposedly objective truth, outcome-based therapeutic usefulness should serve as the guiding principle for assessing ML applications in medicine. (shrink)

RationaleSurrogates of critically ill patients often have inaccurate expectations about prognosis. Yet there is little research on how intensive care unit clinicians should discuss prognosis, and existing expert opinion-based recommendations give only general guidance that has not been validated with surrogate decision makers.ObjectiveTo determine the perspectives of key stakeholders regarding how prognostic information should be conveyed in critical illness.MethodsThis was a multicenter study at three academic medical centers in California, Pennsylvania, and Washington. One hundred eighteen key stakeholders completed in-depth (...) semistructured interviews. Participants included 47 surrogates of adult patients with acute respiratory distress syndrome; 45 clinicians working in study ICUs, including physicians, nurses, social workers, and spiritual care providers; and 26 experts in health communication, decision science, ethics, family-centered care, geriatrics, healthcare disparities, palliative care, psychology, psychiatry, and critical care.Measurements and main resultsThere was broad support among surrogates for existing expert recommendations, including truthful prognostic disclosure, emotional support, tailoring the disclosure strategy to each family's needs, and checking for understanding. In addition, stakeholders offered suggestions that add specificity to existing recommendations, including: In addition to conveying prognostic estimates, clinicians should help families "see the prognosis for themselves" by showing families radiographic images and explaining the clinical significance of physical manifestations of severe disease at the bedside. Many physicians did not support using numeric estimates to convey prognosis to families, whereas many surrogates, clinicians from other disciplines, and experts believed numbers could be helpful. Clinicians should conceptualize prognostic communication as an iterative process that begins with a preliminary mention of the possibility of death early in the ICU stay and becomes more detailed as the clinical situation develops. Although prognostic information should be initially disclosed by physicians, other members of the multidisciplinary team-nurses, social workers, and spiritual care providers-should be given explicit role responsibilities to reinforce physicians' prognostications and help families process a poor prognosis emotionally.ConclusionsFamily members, clinicians, and experts identified specific communication behaviors that clinicians should use to discuss prognosis in the critical care setting. These findings extend existing opinion-based recommendations and should guide interventions to improve communication about prognosis in ICUs. (shrink)

This contribution explores Gilles Personne de Roberval’s 1644 Aristarchi Samii de mundi systemate, partibus, & motibus eiusdem, libellus. I focus on the complex circumstances of publication, the intellectual context of the polemics of Copernicanism within the scientific community, as well as the natural philosophy of the treatise. Roberval’s strategy of publication provides a very sophisticated example of authorship in early modern natural philosophy. The strategy lies at the conflux of certain specific motivations. I contextualize these motivations by accounting for the (...) delicate debates around the motion of the Earth in mid-seventeenth century Europe, the institutional communities of the Collège Royal and Mersenne’s circle, and the disciplinary bounds of Roberval’s professional authority. Weighing in all the elements, I argue that Roberval’s publication is an interesting intellectual game, playing with the notion of ancient authority and humanistic recovery. By this somewhat libertine attitude, Roberval takes a stance in a complicated debate around heliocentrism and the status of hypothetical cosmology. Roberval’s position is supported by his natural philosophical speculations, which I situate in the contemporary debates of the community. Roberval borrows from many philosophers, but he aims at achieving a highly systematic speculative cosmology. One of the functions of this system is to confirm Copernicanism, while maintaining a very pessimistic attitude on the prospects of precise astronomical knowledge and, among others, prognostication issues. (shrink)

Machine‐learning algorithms have the potential to revolutionise diagnostic and prognostic tasks in health care, yet algorithmic performance levels can be materially worse for subgroups that have been underrepresented in algorithmic training data. Given this epistemic deficit, the inclusion of underrepresented groups in algorithmic processes can result in harm. Yet delaying the deployment of algorithmic systems until more equitable results can be achieved would avoidably and foreseeably lead to a significant number of unnecessary deaths in well‐represented populations. Faced with this (...) dilemma between equity and utility, we draw on two case studies involving breast cancer and melanoma to argue for the selective deployment of diagnostic and prognostic tools for some well‐represented groups, even if this results in the temporary exclusion of underrepresented patients from algorithmic approaches. We argue that this approach is justifiable when the inclusion of underrepresented patients would cause them to be harmed. While the context of historic injustice poses a considerable challenge for the ethical acceptability of selective algorithmic deployment strategies, we argue that, at least for the case studies addressed in this article, the issue of historic injustice is better addressed through nonalgorithmic measures, including being transparent with patients about the nature of the current epistemic deficits, providing additional services to algorithmically excluded populations, and through urgent commitments to gather additional algorithmic training data from excluded populations, paving the way for universal algorithmic deployment that is accurate for all patient groups. These commitments should be supported by regulation and, where necessary, government funding to ensure that any delays for excluded groups are kept to the minimum. We offer an ethical algorithm for algorithms—showing when to ethically delay, expedite, or selectively deploy algorithmic systems in healthcare settings. (shrink)

ABSTRACTThis paper situates the discourse of the Occupy movement within the context of radical political philosophy. Our analysis takes place on two levels. First, we conduct an empirical analysis of the ‘official’ publications of Occupy Wall Street and Occupy London. Operationalising core concepts from the framing perspective within social movement theory, we provide a descriptive-comparative analysis of the ‘collective action frames’ of OWS and OL. Second, we consider the extent to which radical political philosophy speaks to the discourse of Occupy. (...) Our empirical analysis reveals that both movements share diagnostic frames, but there were notable differences in terms of prognostic framing. The philosophical discussion suggests that there are alignments between anarchist, post-anarchist and post-Marxist ideologies at the level of both identity and strategy. Indeed, the absence of totalising anti-capitalist or anti-statist positions in Occupy suggests that – particularly with Occupy London – alignments are perhaps not so distant from typically social democratic demands. (shrink)

Purpose. The aim of the article is to clarify the content of the concept of culture as an explication of vitality within the philosophy of life and its further modifications in current problems of contemporary. The analysis performed standing from the point, that contrasting of nature and culture is irrelevant, since culture does not contradict natural determinants and patterns, but rather qualitatively alters them. So, are justified the idea of culture as a phenomenon that exist accordingly and in proportion to (...) nature, need to form its potential and content and not contradict the axioms and values of life. Theoretical basis. In the theoretical field of philosophy of life, the local development of the problem of culture as an explication of vitality produces grounds for analytical and prognostic activity concerning meaningful transformations in a separate historical and social horizon. The fundamental categories of culture: spirit, value, symbol, freedom, justice and harmony receive the requested content and meaning. The idea of the constancy and super-naturality of cultural universals is illusory and dangerous. The consequences of such a "non-cosmological" justification of freedom and will, and the assertion of values, that contradict the logic of life, are the global environmental, economic and social crisis of our time. Originality. The originality of the authors’ thought lies in the interpretation of the essence of culture as an explication of vitality, as a logical and natural extension of life. In this formulation of the problem of culture, the possibility of reconciling the natural, social and value determinants of human life is formed. Theorists of the philosophy of life substantiated the primacy and supremacy of the values of life over the values and meanings of culture. The position of authors position consists in the need to understand culture as an environmentally appropriate and dimensional phenomenon, the content and strategies of which are determined by a single ontology. Conclusions. The analysis let authors understand the voluntarily chaotic element of life. Culture in its philosophical analysis took on a clearer anthropomorphic dimension: the immanent logic of being in substantiating the essence and purpose of man and the value of his being localized the universe of transcendence in the concept of "living world", "inhabited space", "human, too human". Accordingly, the range of cultural evaluations has been polarized: from the approving statement of its vital essence, to the disparaging calls for its reform. The chaotic state of voluntarily acts is transformed into cultural codes and stereotypes by rationalization. The modern global nature of crisis phenomena, both in the worldview, in the social, and in the ecological dimension, requires reformatting the understanding of culture as a continuation of nature, and not its antipode. (shrink)

Amid the current COVID-19 crisis, everyone has been called upon to offer assistance. What can historians contribute? One obvious approach is to draw on our knowledge of the history of epidemics and proclaim the lessons of history. But does history offer clear lessons? To make their expertise relevant, some historians assert that there are enduring patterns in how societies respond to all epidemics that can inform our experiences today. Others argue that there are informative analogies between specific past epidemics and (...) our present crisis, for instance between COVID-19 and prior outbreaks of SARS or influenza. Both strategies can be pursued, but each must be done with care. It is certainly possible to map COVID-19 onto the classic dramatic structure of an epidemic, but we cannot yet know how it will end, a failure of prognostication that constrains the advice we can offer. It is likewise possible to draw on the history of medical therapeutics and public health interventions to identify the risks we face of both underuse and overuse of our remedies, but we cannot yet judge whether our current commitment to heroic social distancing is warranted. While historians can offer insight, we must temper our contributions with humility. (shrink)

Long-standing psychiatric practice confirms the pervasive use of pharmacological therapies for treating severe mental disorders. In many circumstances, drugs constitute the best allies of psychotherapeutic interventions. A robust scientific literature is oriented on finding the best strategies to improve therapeutic efficacy through different modes and timing of combined interventions. Nevertheless, we are far from triumphal therapeutic success. Despite the advances made by neuropsychiatry, this medical discipline remains lacking in terms of diagnostic and prognostic capabilities when compared to other (...) branches of medicine. An ethical principle remains as the guidance of therapeutic interventions: improving the quality of life for patients. Unfortunately, psychotropic drugs and psychotherapies do not always result in an efficient remission of symptoms. In this paper I corroborate the idea that therapists should provide drug-resistant patients with every effective and available treatment, even if some of such interventions could be invasive, like Electroconvulsive Therapy (ECT). ECT carries upon its shoulders a long and dramatic history that should be better investigated to provide new insights. In fact, ECT has attracted renewed interest in recent years. This is due to the fact that antidepressant drugs in younger patients show often scarce effectiveness and unpleasant side-effects. Moreover, I show that, thanks to modern advances, ECT may work as a successful form of treatment for specific and rare cases, such as severe depression (with suicide attempts) and catatonia. (shrink)

Findings about the desire for health-risk information are heterogeneous and sometimes contradictory. In particular, they seem to be at variance with established psychological theories of information-seeking behavior.The present paper posits the decision about treating illness with medicine as the causal determinant for the expected net value of information, and attempts to explain idiosyncrasies in information-seeking behavior by using the notion of decision sensitivity to incoming information.Furthermore, active information avoidance is explained by modeling the expected emotional distress potentially brought about by (...) “bad news” as a disutility factor in pay-off maximization.In this context two notions of uncertainty are distinguished: an epistemic uncertainty related to the prognostic probability assigned to the risk, and an emotional uncertainty related to the expected damage. Health-risk information can both reduce epistemic and increase emotional uncertainty, giving rise to idiosyncratic processing strategies. (shrink)

Understanding the functional mechanisms underlying genetic signals associated with complex traits and common diseases, such as cancer, diabetes and Alzheimer's disease, is a formidable challenge. Many genetic signals discovered through genome‐wide association studies map to non‐protein coding sequences, where their molecular consequences are difficult to evaluate. This article summarizes concepts for the systematic interpretation of non‐coding genetic signals using genome annotation data sets in different cellular systems. We outline strategies for the global analysis of multiple association intervals and the (...) in‐depth molecular investigation of individual intervals. We highlight experimental techniques to validate candidate (potential causal) regulatory variants, with a focus on novel genome‐editing techniques including CRISPR/Cas9. These approaches are also applicable to low‐frequency and rare variants, which have become increasingly important in genomic studies of complex traits and diseases. There is a pressing need to translate genetic signals into biological mechanisms, leading to prognostic, diagnostic and therapeutic advances. (shrink)

For a long time, leading European thinkers have denied systematic, theoretical and rational nature of Chinese traditional thinking, unpretentiously reading it as banal moralizing, not supported by any proper philosophical discourse. However, the habitual socioethical label conceals a much deeper problematic of strategic thinking. At its center, there is the question of choosing all sorts of strategies: from everyday life to special technical ones, from personal existential choice to fateful state decisions. The concept of a winning strategy is emblematized (...) by the dramatic plot of a deadly risk but under certain conditions with guaranteed happy end. The strategy of harmony, which is miraculous in its effectiveness, is proposed as a exemplary strategy. It allows you to “step on the tiger’s tail” with impunity. From the point of view of strategic thinking, the criterion of cognitive value of reasoning is its effectiveness, and the most effective is unmistakable prediction, i.e. the ability to predict the outcome of future developments with the help of reasoning. In the ideal case, prognostic reasoning becomes not just plausible but 100% reliable that is an apodictic true inference. Therefore, the highest cognitive status in the Chinese intellectual tradition is endowed with guaranteed error-free prognostic reasoning. This type of reasoning, where the reliability of foresight is guaranteed by the implementation of a certain winning strategy, can be called the prognostic form of deduction. As a result, the dynamism of Chinese logic, which relies on a deliberate staging of the future, is strikingly different from the static nature of the classical image of logic, where logic is no more than a static guardian of correctness of reasoning. On the contrary, the Chinese concept of logic focuses on deriving consequences from strategic considerations regarding the future, actively and purposefully shaped by the subject who at the same time constructing both himself and the world around him. (shrink)

Aim: To elicit preferences for prognostic information, attitudes towards withdrawal of life-sustaining treatment (WLST) and perspectives on acceptable quality of life after post-anoxic coma within the adult general population of Germany, Italy, the Netherlands and the United States of America. Methods: A web-based survey, consisting of questions on respondent characteristics, perspectives on quality of life, communication of prognostic information, and withdrawal of life-sustaining treatment, was taken by adult respondents recruited from four countries. Statistical analysis included descriptive analysis and (...) chi2-tests for dierences between countries. Results: In total, 2012 respondents completed the survey. In each country, at least 84% indicated they would prefer to receive early prognostic information. If a poor outcome was predicted with some uncertainty, 37-54% of the respondents indicated that WLST was not to be allowed. A conscious state with severe physical and cognitive impairments was perceived as acceptable quality of life by 17–44% of the respondents. Clear differences between countries exist, including respondents from the U.S. being more likely to allow WLST than respondents from Germany (OR = 1.99, p < 0.001) or the Netherlands (OR = 1.74, p < 0.001) and preferring to stay alive in a conscious state with severe physical and cognitive impairments more than respondents from Italy (OR = 3.76, p < 0.001), Germany (OR = 2.21, p < 0.001), or the Netherlands (OR = 2.39, p < 0.001). Conclusions: Over one-third of the respondents considered WLST unacceptable when there is any remaining prognostic uncertainty. Respondents had a more positive perspective on acceptable quality of life after coma than what is currently considered acceptable in medical literature. This indicates a need for a closer look at the practice of WLST based on prognostic information, to ensure responsible use of novel prognostic tests. (shrink)

An adolescent’s last moment of life is an emotionally and medically complex time. Children may grapple with understanding the things happening to them and with grief of a future lost; caregivers struggle to simultaneously balance deep sorrow, hope, and love; and healthcare providers fight to maintain sound medical and ethical decision making. Increased discussion regarding adolescent end-of-life care is needed so that clinicians may better understand how to engage in ethically based medical management during these events. This holds particularly true (...) in situations where potentially conflicting ideas exist between clinicians and family members. We describe the case of an acutely and terminally ill adolescent who remained cognitively intact but with rapidly advancing multiple organ failure and whose parents requested that he remain uninformed of his critical illness and prognosis. (shrink)

Negative prognostic communication is often delayed in intensive care units, which limits time for families to prepare for end‐of‐life. This descriptive study, informed by ethnographic methods, was focused on exploring critical care physician communication of negative prognoses to families and identifying timing influences. Prognostic communication of critical care physicians to nurses and family members was observed and physicians and family members were interviewed. Physician perception of prognostic certainty, based on an accumulation of empirical data, and the perceived (...) need for decision‐making, drove the timing of prognostic communication, rather than family needs. Although prognoses were initially identified using intuitive knowledge for patients in one of the six identified prognostic categories, utilizing decision‐making to drive prognostic communication resulted in delayed prognostic communication to families until end‐of‐life (EOL) decisions could be justified with empirical data. Providers will better meet the needs of families who desire earlier prognostic information by separating prognostic communication from decision‐making and communicating the possibility of a poor prognosis based on intuitive knowledge, while acknowledging the uncertainty inherent in prognostication. This sets the stage for later prognostic discussions focused on EOL decisions, including limiting or withdrawing treatment, which can be timed when empirical data substantiate intuitive prognoses. This allows additional time for families to anticipate and prepare for end‐of‐life decision‐making. (shrink)

Background: Cognitive Training may contribute to the maintenance and even enhancement of cognitive functions in healthy older adults. However, the question who benefits most from multi-domain CTs is still highly under-investigated.Objective: The goal is to investigate prognostic factors and models for changes in cognitive test performance in healthy older adults after a multi-domain CT.Methods: The data bases MEDLINE, Web of Science Core Collection, CENTRAL, and PsycInfo were searched up to July 2019. Studies investigating prognostic factors and/or models on (...) cognitive outcomes after conducting a multi-domain CT in healthy older adults were included. Risk of Bias was assessed using the QUIPS and the PROBAST tool.Results: 23 prognostic factor and model studies were included. Results indicate a high heterogeneity regarding the conducted multi-domain CTs, the investigated prognostic factors, the investigated outcomes, and the used statistical approaches. Age and neuropsychological performance at study entry were the most investigated predictors, yet they show inconsistent results.Conclusion: Data on prognostic factors and models of changes after multi-domain CT are still too rare and inconsistent to draw clear conclusions due to statistical shortcomings and low reporting quality. Approaches for future research are outlined.Registration:https://www.crd.york.ac.uk/prospero/, ID: CRD42020147531. (shrink)

The article presents social simulation from theoretical and philosophical perspectives as a prognostic tool for researching, analysing and anticipating communication and other processes in social environments. The first part discusses the phenomena of ontological and epistemological simulation, treating social simulation processes as epistemological ones. The second part analyses the attitude of the French sociologist and media philosopher Jean Baudrillard towards social simulation, which he himself treats as ontological one. The counterarguments to introduce Baudrillard’s unidentified distinction between ontological and epistemological (...) simulation processes are presented. The third part deals with the principles of the functioning of social simulations as a prognostic tool and provides analytical possibilities for various social environments, communication and other processes. At the end of the article, it is concluded that Baudrillard’s concept of ontological simulation, which annihilates classical Western metaphysics, erroneously reduces the difference between ontos and epistēmē. (shrink)

This book offers an analysis of the status and function of the Anglo-Saxon prognostics in their manuscript context, a study of their introduction to and transmission in Anglo-Saxon England, and, for the first time, a comprehensive edition of prognostics in Old English and Latin.

Linguistic theories often suffer from the dilemma that their explanatory power is based on extra-linguistic assumptions. The book delineates the essence of linguistic theory and linguistic explanation and, in doing so, proposes a solution to the dilemma. Simultaneously, the book is one of the first attempts to profile the philosophy of linguistics as a distinct sub-discipline of the contemporary philosophy of science.

In the United States, at least 6% of all hospital beds are in the intensive care unit or coronary care unit. The cost of treating a patient in an intensive care unit averages from $2,000 to $3,500 per day. At least 10–40% of intensive care patients will not survive to hospital discharge. Today, every major category of disease may be found in the modern ICU; common diagnoses are septicemia, postsurgical complications, cerebrovascular accidents, gastrointestinal bleeding, neoplasia, and respiratory failure. ICUs employ (...) some of the most sophisticated medical technology, routinely monitoring the cardiopulmonary performance of patients and often providing assisted ventilation. ICUs are high intensity in terms of their staffing, involving 24-hour physician supervision and nurse:patient ratios from 1:3 to 1:1. (shrink)

Two strategies to infinity are equally relevant for it is as universal and thus complete as open and thus incomplete. Quantum mechanics is forced to introduce infinity implicitly by Hilbert space, on which is founded its formalism. One can demonstrate that essential properties of quantum information, entanglement, and quantum computer originate directly from infinity once it is involved in quantum mechanics. Thus, thеse phenomena can be elucidated as both complete and incomplete, after which choice is the border between them. (...) A special kind of invariance to the axiom of choice shared by quantum mechanics is discussed to be involved that border between the completeness and incompleteness of infinity in a consistent way. The so-called paradox of Albert Einstein, Boris Podolsky, and Nathan Rosen is interpreted entirely in the same terms only of set theory. Quantum computer can demonstrate especially clearly the privilege of the internal position, or “observer”, or “user” to infinity implied by Henkin’s proposition as the only consistent ones as to infinity. (shrink)

AimThe functional prognosis of patients after coma following either cardiac arrest or acute structural brain injury is often uncertain. These patients are associated with high mortality and disability. N20 and N70 somatosensory evoked potentials are used to predict prognosis. We evaluated the utility of SSEP as an early indicator of long-term prognosis in these patients.MethodsThis was a retrospective cohort study of patients admitted to the intensive care unit with a diagnosis of coma after CA or ABI. An SSEP study was (...) performed, including N20 and N70 at 24–72 h, after coma onset. Functional recovery was assessed 6–12 months later using the modified Glasgow scale. The study was approved by our local research ethics committee.ResultsIn the CA and ABI groups, the absence of N20 or N70 was a strong indicator of poor outcome. Conversely, the presence of N70 was an indicator of a good outcome.ConclusionSomatosensory evoked potentials are useful early prognostic markers with high specificity and sensitivity. Moreover, N70 has additional potential value for improving the prediction of good long-term functional outcomes.Clinical Trial Registration:[https://clinicaltrials.gov/], identifier [2018/01/001]. (shrink)

As societies become increasingly technologised, the need for careful and critical assessment rises. However, attempts to assess or normatively evaluate technological development invariably meet with an antinomy: both structurally and historically, technologies display multistable possibilities regarding uses, effects, side effects and other outcomes. Philosophers, usually expected to play applied ethics roles, often come to the scene after these effects are known. But others who participate at the research and development stages find even more difficulties with prognosis. Recent work on ‘revenge’ (...) effects (Tenner) and negative side effects (Kevles) are examined, as well as several cases of philosophers in ‘R&D’ roles. After sketching the antinomy,I outline a heuristic pragmatics of prognosis that addresses this quandary. (shrink)

While firms' engagement with Corporate Social Responsibility has been associated with positive performance impacts, little is known about the incorporation of the United Nations 2030 Agenda into business practices. Precisely, although the literature suggests that firms are pursuing the Sustainable Development Goals (SDGs), there are limited insights on their strategy to implement them in the context of developing countries. To address this gap, we conducted a comprehensive large-scale investigation of 2030 Agenda adoption by Brazilian companies. Accordingly, the analysis of our (...) multicase study reveals (1) variations on the business opportunities brought by the SDGs depending on the firm position in the value chain, (2) which SDGs and target stakeholders are addressed through corporate policies and practices, (3) the different ways firms embrace the SDGs to pursue ambidexterity. Our findings clarify how firms in the developing countries interpret the institutional pressures and assemble their internal resources to respond to the SDGs challenges. Boundary conditions and policy implications are further discussed. (shrink)

Strategies are mentioned across a variety of domains, from business ethics, to the philosophy of war, philosophy of sport, game theory, and others. However, despite their wide use, very little has been said about how to think about what strategies are or how they relate to other prominently discussed concepts. In this article, I probe the close connection between strategies and plans, which have been much more thoroughly characterized in the philosophy of action. After highlighting the challenges (...) of analyzing strategies in terms of plans, I show how the work done on the connection between plans and intentions can inspire further questions about the nature of strategy. I conclude by showing how one particular innovation in the understanding of plans—how they can be more or less partial—can be used to help us to mark what makes for a good strategy. (shrink)

The human brain has some capabilities that the brains of other animals lack. It is to these distinctive capabilities that our species owes its dominant position. Other animals have stronger muscles or sharper claws, but we have cleverer brains. If machine brains one day come to surpass human brains in general intelligence, then this new superintelligence could become very powerful. As the fate of the gorillas now depends more on us humans than on the gorillas themselves, so the fate of (...) our species then would come to depend on the actions of the machine superintelligence. But we have one advantage: we get to make the first move. Will it be possible to construct a seed AI or otherwise to engineer initial conditions so as to make an intelligence explosion survivable? How could one achieve a controlled detonation? To get closer to an answer to this question, we must make our way through a fascinating landscape of topics and considerations. Read the book and learn about oracles, genies, singletons; about boxing methods, tripwires, and mind crime; about humanity's cosmic endowment and differential technological development; indirect normativity, instrumental convergence, whole brain emulation and technology couplings; Malthusian economics and dystopian evolution; artificial intelligence, and biological cognitive enhancement, and collective intelligence. (shrink)

An immunizing strategy is an argument brought forward in support of a belief system, though independent from that belief system, which makes it more or less invulnerable to rational argumentation and/or empirical evidence. By contrast, an epistemic defense mechanism is defined as a structural feature of a belief system which has the same effect of deflecting arguments and evidence. We discuss the remarkable recurrence of certain patterns of immunizing strategies and defense mechanisms in pseudoscience and other belief systems. Five (...) different types will be distinguished and analyzed, with examples drawn from widely different domains. The difference between immunizing strategies and defense mechanisms is analyzed, and their epistemological status is discussed. Our classification sheds new light on the various ways in which belief systems may achieve invulnerability against empirical evidence and rational criticism, and we propose our analysis as part of an explanation of these belief systems’ enduring appeal and tenacity. (shrink)

Background Moral distress has negative effects on physical and mental health. However, there is little information about nurses’ coping strategies reducing moral distress. Aim The purpose of this study was to investigate the coping strategies of intensive care unit nurses reducing moral distress in Iran. Study design This is a qualitative study with a content analysis approach. Participants and research context The research sample consisted of nurses working in intensive care units of teaching hospitals affiliated to Tehran University (...) of Medical Sciences. Samples were selected among eligible nurses by purposive sampling. Data were obtained through 17 in-depth, individual, and semi-structured interviews with 17 nurses. Graneheim and Lundman’s (2004) 6-step content analysis method was used to analyze the data. Data management was also performed by MAXQDA software version 20. The COREQ checklist was used to report the study. Ethical considerations This project was approved by the Ethics Committee of Tehran University of Medical Sciences. All ethical guidelines in research were followed. Finding The data analysis resulted in the formation of two main categories of desirable coping strategies (with two subcategories of compensation and rejuvenation) and less desirable coping strategies (with three subclasses of indifference over time, escape and concealment). Discussion The intensive care unit nurses in dealing with ethical problems first try to solve the problem through discussion, but when they fail to resolve it peacefully, they resort to several coping strategies. Factors, such as increasing experience, lack of support from hospital managers and officials, poor communication between colleagues, the need to maintain hierarchy, fear of reprimand, and a sense of powerlessness, changed the nurses’ preferred strategies. It is important for managers to provide a blame/punishment-free atmosphere for expression of ethical experiences; a supportive atmosphere in which staff can engage in ethical discussions without fear of punishment. They should also provide opportunities for rest, rejuvenation, and adequate training for their employees. (shrink)

In the 1950s and 1960s, an interfield interaction between molecular biologists and biochemists integrated important discoveries about the mechanism of protein synthesis. This extended discovery episode reveals two general reasoning strategies for eliminating gaps in descriptions of the productive continuity of mechanisms: schema instantiation and forward chaining/backtracking. Schema instantiation involves filling roles in an overall framework for the mechanism. Forward chaining and backtracking eliminate gaps using knowledge about types of entities and their activities. Attention to mechanisms highlights salient features (...) of this historical episode while providing general reasoning strategies for mechanism discovery. (shrink)

Until recently, scientific consensus held firm that genetically manipulated embryos created through methods including Mitochondrial Replacement Therapy or human germline genome editing should not be used to initiate a pregnancy. In countries that have relevant laws pertaining to heritable human germline modifications, the vast majority prohibit or restrict this practice. In the last several years, scholars have observed a transformation of scientific and policy restrictions with insistent calls for creating a regulatory pathway. Multiple stakeholders highlight the role of social consensus (...) and public engagement for governance of heritable human germline modifications. However, in the drive to gain public acceptance and lift restrictions, some proponents provide distorted or misleading narratives designed to influence public perception and incrementally shift the consensus. This article describes eight discrete strategies that proponents employ to influence framing, sway public opinion, and revise policymaking of human germline modifications in a manner that undermines honest engagement. (shrink)

This chapter explores the ideological dimension of dehumanization in the context of National Socialism, focusing on the connection between concepts of humanity and dehumanizing images. NS regarded itself as a political revolution, realizing a new concept of humanity. Nazi ideologues undergirded the self-understanding of NS by developing racist anthropologies. I examine two major strands of Nazi ideology, focusing on their diverging strategies of dehumanization, and arguing that they were dependent on different anthropological frameworks. Richard Walther Darré held a naturalistic (...) concept of humanity and advanced biologistic forms of dehumanization. Alfred Rosenberg developed a dualistic anthropology that combined metaphysical and natural features. He dehumanized certain groups of people by reducing them to being human in a natural sense only. Moreover, I aim to show that the key motifs of these racist worldviews were prevalent in the scientific and philosophical debates on anthropology in early-twentieth-century Germany. I thus explore the general orientation of both the naturalistic and the anti-naturalistic strand in anthropological thought, unfold the animalizing tendencies of these views, and emphasize their conformity with the key motifs of Nazi ideology. The case of NS should thus exemplify the dehumanizing potential of anthropological theories. (shrink)

Discovery proceeds in stages of construction, evaluation, and revision. Each of these stages is constrained by what is known or conjectured about what is being discovered. A new characterization of mechanism aids in specifying what is to be discovered when a mechanism is sought. Guidance in discovering mechanisms may be provided by the reasoning strategies of schema instantiation, modular subassembly, and forward/backward chaining. Examples are found in mechanisms in molecular biology, biochemistry, immunology, and evolutionary biology.