Automatic control of physiological variables is one of the most active areas in biomedical engineering. This paper is centered in the prediction of the analgesic variables evolution in patients undergoing surgery. The proposal is based on the use of hybrid intelligent modelling methods. The study considers the Analgesia Nociception Index to assess the pain in the patient and remifentanil as intravenous analgesic. The model proposed is able to make a one-step-ahead prediction of the remifentanil dose corresponding to the current state (...) of the patient. The input information is the previous remifentanil dose, the ANI variable and the electromyogram signal. Modelling techniques used are Artificial Neural Networks and Support Vector machines for Regression combined with clustering methods. Both training and validation were done with a real dataset from different patients. Results obtained show the potential of this methodology to calculate the drug dose corresponding to a given analgesic state of the patient. (shrink)

OBJECTIVES: To analyse the attitudes of medical personnel towards terminally ill patients and their right to be fully informed. DESIGN: Self-administered questionnaire composed of 56 closed questions. SETTING: Three general hospitals and eleven health centres in Granada (Spain). The sample comprised 168 doctors and 207 nurses. RESULTS: A high percentage of medical personnel (24.1%) do not think that informing the terminally ill would help them face their illness with greater serenity. Eighty-four per cent think the patient's own home is the (...) best place to die: 8.9% of the subjects questioned state that the would not like to be informed of an incurable illness. CONCLUSION: In our opinion any information given should depend on the patient's personality, the stage of the illness and family circumstances. Our study confirms that a hospital is not the ideal environment for attending to the needs of the terminally ill and their families. (shrink)

This work focuses on the application of machine learning techniques to assist the clinicians in the administration of analgesic drug during general anaesthesia. Specifically, the main objective is to propose the basis of an intelligent system capable of making decisions to guide the opioid dose changes based on a new nociception monitor, the analgesia nociception index. Clinical data were obtained from 15 patients undergoing cholecystectomy surgery. By means of an off-line study, machine learning techniques were applied to analyse the possible (...) relationship between the analgesic dose changes performed by the physician due to the hemodynamic activity of the patients and the evolution of the ANI. After training different classifiers and testing the results under cross validation, a preliminary relationship between the evolution of ANI and the dosage of remifentanil was found. These results evidence the potential of the ANI as a promising index to guide the infusion of analgesia. (shrink)

Resumen: Este trabajo se propone examinar algunos límites de la célebre descripción merleau-pontiana del cuerpo vivido en términos de “esquema corporal” y “cuerpo habitual”, teniendo en cuenta referencias alternativas del corpus textual del filósofo a ciertas dimensiones de la experiencia corporal que desbordan tal marco. Tras analizar en primer término estas primeras definiciones que esbozan el perfil de un cuerpo hábil y competente correlativo de un entorno pragmático, consideramos seguidamente instancias de comportamientos no teleológicos ni funcionales y espacialidades no objetivas (...) ni instrumentales para concluir mostrando la relación de estos análisis con la tematización merleau-pontiana más amplia de los horizontes naturales de la experiencia. En un segundo plano evaluamos las críticas de exégetas tales como A. Lingis y J. Butler a ciertos déficits de las tesis merleau-pontianas, y relacionamos estas últimas con desarrollos filosóficos que manifiestan ciertas afinidades específicas, tales como los de E. Levinas y R. Caillois.: This paper intends to examine some of the limitations of the well-known MerleauPontian account of the lived body in terms of "body schema" and "habitual body", by taking into account some alternative references of the philosopher’s textual corpus to certain dimensions of corporeal experience that exceed such frames. After analyzing these former definitions that outline the profile of a skillful and competent body correlative of a pragmatic environment, we consider cases of non-teleological and non-functional behaviors and non-objective and non-instrumental spatialities to end up by showing the relationship between these analyses and the wider Merleau-Pontian account of the natural horizons of experience. Secondarily, we evaluate critiques such as A. Lingis’ and J. Butler’s aiming to certain deficits of Merleau-Pontian theses, and we identify certain relations that these theses hold with philosophical developments showing certain specific affinities, such as E. Levinas’ and R. Caillois’. (shrink)

Este trabajo se propone analizar y confrontar las perspectivas teóricas divergentes de G. Canguilhem y de M. Foucault en torno al estatus pistemológico de las ciencias modernas del cuerpo humano. Ambos filósofos investigaron factores extracientíficos determinantes en la constitución del objeto mismo de la fisiología: aquel cuerpo humano calificado como «normal» que la técnica médica adopta como ideal terapéutico. Sin embargo, Canguilhem apeló en sus análisis a fundamentos subjetivos y biológicos (tales como el padecimiento humano y la «normatividad vital»), mientras (...) que su discípulo otorgó mayor relevancia a los factores políticos de normalización social. (shrink)

As análises aqui propostas enfocam, em primeira instância, a leitura do corpus merleau-pontiano, proposta por R. Barbaras em seu Introduction à une phénoménologie de la vie, segundo a qual os vaivens e ambivalências da reflexão de Merleau-Ponty acerca do corpo se explicam pela desconsideração de seu caráter primordialmente vivente. Em segundo lugar, abordamos a filosofia de Merleau-Ponty a partir do propósito de encontrar no corpo uma modalidade originária e absoluta de movimento como abertura de possibilidades, fundante em relação ao objeto (...) que se move e ao espaço, aberto pelo próprio movimento. Em terceiro lugar, pondo em relevo a noção de nascimento, propomos que esta singular modalidade de movimento buscada por Merleau-Ponty encontra sua caracterização mais apropriada no movimento natural e vital, o que permite conciliar, ao menos parcialmente, as perspectivas de ambos os filósofos. (shrink)

Se examinan de modo sistemático las críticas de Merleau-Ponty, en la Phénoménologie de la perception, a la teoría kantiana de la experiencia, atendiendo al papel de los conceptos en la conformación de la experiencia objetiva, la relación entre la sensibilidad y el entendimiento, así como la redefinición del carácter formal de la sensibilidad. Se discuten posibles objeciones a la interpretación merleau-pontiana de la teoría kantiana y se evalúa, así mismo, el alcance relativo de ciertas referencias positivas de Merleau-Ponty a nociones (...) kantianas tales como afinidad, sinopsis e imaginación. (shrink)

Closed-loop administration of propofol for the control of hypnosis in anesthesia has evidenced an outperformance when comparing it with manual administration in terms of drug consumption and post-operative recovery of patients. Unlike other systems, the success of this strategy lies on the availability of a feedback variable capable of quantifying the current hypnotic state of the patient. However, the appearance of anomalies during the anesthetic process may result in inaccurate actions of the automatic controller. These anomalies may come from the (...) monitors, the syringe pumps, the actions of the surgeon or even from alterations in patients. This could produce adverse side effects that can affect the patient postoperative and reduce the safety of the patient in the operating room. Then, the use of anomaly detection techniques plays a significant role to avoid this undesirable situations. This work assesses different one-class intelligent techniques to detect anomalies in patients undergoing general anesthesia. Due to the difficulty of obtaining real data from anomaly situations, artificial outliers are generated to check the performance of each classifier. The final model presents successful performance. (shrink)

RESUMEN Se examinan de modo sistemático las críticas de Merleau-Ponty, en la Phénoménologie de la perception, a la teoría kantiana de la experiencia, atendiendo al papel de los conceptos en la conformación de la experiencia objetiva, la relación entre la sensibilidad y el entendimiento, así como la redefinición del carácter formal de la sensibilidad. Se discuten posibles objeciones a la interpretación merieau-pontiana de la teoría kantiana y se evalúa, así mismo, el alcance relativo de ciertas referencias positivas de Merleau-Ponty a (...) nociones kantianas tales como afinidad, sinopsis e imaginación. ABSTRACT The article carries out a systematic examination of Merleau-Ponty's critiques of the Kantian theory of experience, in Phénoménologie de la perception, taking into account the role of concepts in shaping objective experience, the relation between sensibility and understanding, and the redefinition of the formal nature of sensibility. It discusses possible objections to Merleau-Ponty's interpretation of Kantian theory and assesses the relative scope of some of Merleau-Ponty's positive references to Kantian notions such as affinity, synopsis, and imagination. (shrink)

Este trabajo se propone en primer lugar explicitar el rol fundamental que la reflexión de Merleau-Ponty otorga a los otros sujetos corporales como copartícipes en mi percepción del mundo. Avanzando más allá de esta figura primaria de la alteridad relativa a una comunidad intercorporal anónima, las secciones segunda y tercera pretenderán reconocer el lugar que corresponde en esta filosofía a otras figuras fundadas y derivadas, tales como la del conflicto y la alternancia de los roles del sujeto y el sujeto (...) objetivado y, por último, la de un posible vínculo de reconocimiento recíproco entre sujetos personales, únicos y singulares. In the first place, this paper intends to elucidate the fundamental role that Merleau-Ponty's reflection grants to other corporeal subjects as copartners in my perception of the world. Moving beyond this primary figure of alterity, that of an intercorporeal anonymous community, the second and third sections will aim to recognize the place that this philosophy grants to other founded and secondary figures, such as the conflict and alternation of the roles of the subject and the objectified subject, and finally, a possible relationship of reciprocal recognition between personal, unique and singular subjects. (shrink)

El 8 de septiembre de 2017, con el copatrocinio del Centro de Estudios Constitucionales de la Suprema Corte, el Departamento de Derecho del ITAM invitó a Owen M. Fiss, Profesor Sterling Emérito de la Escuela de Derecho de Yale. El profesor Fiss fue nombrado Profesor Visitante Distinguido del ITAM —la más alta distinción académica otorgada por la universidad— y se celebró un seminario sobre trabajo suyo reciente en el ITAM y en el CEC-SCJN. El programa incluía la presentación y debate (...) público del libro de Fiss sobre la erosión que la llamada “guerra contra el terrorismo” ha tenido sobre los principios más básicos de la Constitución estadounidense... (shrink)

The present study aimed to verify the quarantine’s effects during a serious viral outbreak on the cardiovascular and performance associated with the Yo-Yo test in a sample of professional soccer players. 20 high-level soccer players participated in this study. The intermittent Yo-Yo test was performed pre- and post- COVID-19 quarantine in a random order. During each test, the soccer players’ running performance outcomes were monitored using a portable 5-Hz GPS with a 100 Hz accelerometer and a paired t-test was conducted (...) at a p-value of ≤ 0.05. The main results demonstrated significant differences between pre- versus post-COVID-19 quarantine in the following variables: relative distance, maximal speed, acceleration, deceleration, sprints > 19 km/h [0.8 % >0.5 %], and in high intensity running distance [16.48 m > 0.827 m]. We concluded that COVID-19-related restrictions and quarantine COVID-19 demonstrated adverse effects on professional soccer players’ Yo-Yo tests performance. (shrink)

Background: The magnitude of bullying and harassment among psychiatrists is reportedly high, yet no peer-review published studies addressing this issue could be found. Therefore, it was decided to conduct a pilot study to assess the degree of the problem, the types of bullying/harassment and to provide some insights into the situation.Methods and Principal Findings: Following multiple focus group meetings, a yes/no response type questionnaire was developed to assess the degree and type of bullying and harassment experienced by psychiatrists. Over a (...) 3-month period the questionnaire was administered to a random sample of 60 psychiatrists. 57 out of the 60 psychiatrists reported harassment and bullying. Frequencies of the following response variables are presented in descending order: rumours 40% ; defamation 20% ; passing remarks 20% ; false accusations 15% ; threats 13.3% ; verbal abuse 13.3% ; unjustified complaints 13.3% ; promotion blocked 13.3% ; humiliation 13% ; bad reference given 10% ; credentials questioned 8.3% ; physical attacks 5% ; termination 5% ; derogatory remarks 1.7% and 1.7% were subjected to personal work. As a result of being subjected to harassment, 66.7% of the psychiatrists did not take any action, whereas 33.3% confronted the person they believed responsible. Asked whether the bullying and harassment caused distress, 18.3% of the psychiatrists did not report any effect, 30% reported mild distress, 40% moderate distress and severe distress was reported by 11.7%.Conclusions: It was concluded that the magnitude of bullying and harassment among psychiatrists may be quite high, as evidenced by this pilot study. There is a need for extensive systematic studies on this subject and to establish strategies to prevent and address this issue at a national and regulatory level. (shrink)

The theory and practice of advertising self-regulation have been evolving for decades in pursuit of basic standards for advertising quality. In Spain, this discipline was put into practice in 1995, the year the Association for the Self-Regulation of Commercial Communication was created. This article aims to examine in depth the functioning of the Spanish advertising self-regulation system, with special emphasis on the Advertising Jury, and explore to what extent some of the normative requirements of rigour, independence and participation can be (...) considered to have been met. The paper is based on a case study in which interviews with Autocontrol members, Jury members and consumer associations have particular bearing. The results shed light on the achievements of Autocontrol’s self-regulation work and the challenges it still faces. (shrink)

We reported a series of experiments carried out to confront the underlying intuitions of value-based argumentation frameworks (VAFs) with the intuitions of ordinary people. Our goal was twofold. On the one hand, we intended to test VAF as a descriptive theory of human argument evaluations. On the other, we aimed to gain new insights from empirical data that could serve to improve VAF as a normative model. The experiments showed that people’s acceptance of arguments deviates from VAF’s semantics and is (...) rather correlated with the importance given to the promoted values, independently of the perceptions of argument interactions through attacks and defeats. Furthermore, arguments were often perceived as promoting more than one value with different relative strengths. Individuals’ analyses of scenarios were also affected by external factors such as biases and arguments not explicit in the framework. Finally, we confirmed that objective acceptance, that is, the acceptance of arguments under any order of the values, was not a frequent behavior. Instead, participants tended to accept only the arguments that promoted the values they subscribe. (shrink)

L'ouvrage ici presente appartient peut-etre a la derniere periode de la production d'Avicenne. Le Livre des directives et remarques supplee les parties perdues de La philosophie orientale, dernier grand projet avicennien, en ce sens qu'il tend a rearticuler science divine et science universelle, par raport a l'entreprise philosophique du Shifa'. Neanmoins les Directives ne sont aucunement un traite, mais plutot un recueil de notes sur des points controverses. Les liens entre les chapitres sont souvent tenus, parfois meme arbitraires, mais il (...) ressort pourtant de la des modifications importantes par rapport aux philosophes grecs. Les theories d'Avicenne sont ainsi toutes en faveur d'une pensee rationaliste et scientifique. L'avance scientifique des orientaux a, pour lui, ouvert a l'intelligence des voies nouvelles; les methodes grecques de pensee demeurent fondamentales, mais des exigences inconnues de leur temps demandent qu'elles soient depassees. (shrink)

The nature of quantum computation is discussed. It is argued that, in terms of the amount of information manipulated in a given time, quantum and classical computation are equally efficient. Quantum superposition does not permit quantum computers to ''perform many computations simultaneously'' except in a highly qualified and to some extent misleading sense. Quantum computation is therefore not well described by interpretations of quantum mechanics which invoke the concept of vast numbers of parallel universes. Rather, entanglement makes available types of (...) computation processes which, while not exponentially larger than classical ones, are unavailable to classical systems. The essence of quantum computation is that it uses entanglement to generate and manipulate a physical representation of the correlations between logical entities, without the need to completely represent the logical entities themselves. (shrink)

Objectives: Evidence based patient choice seems based on a strong liberal individualist interpretation of patient autonomy; however, not all patients are in favour of such an interpretation. The authors wished to assess whether ideals of autonomy in clinical practice are more in accordance with alternative concepts of autonomy from the ethics literature. This paper describes the development of a questionnaire to assess such concepts of autonomy.Methods: A questionnaire, based on six moral concepts from the ethics literature, was sent to aneurysm (...) patients and their surgeons. The structure of the questionnaire was assessed by factor analysis, and item reduction was based on reliability.Results: Ninety six patients and 58 surgeons participated. The questionnaire consisted of four scales. Two of the scales reflected the paternalistic and consumerist poles of the liberal individualist model, one scale reflected concepts of Socratic autonomy and of procedural independence, and the fourth scale reflected ideals of risk disclosure.Discussion: The Ideal Patient Autonomy Scale is a 14 item normative instrument. It is clearly distinct from the generally used psychological preference questionnaires that assess preferences for physician-patient roles. (shrink)

Adrian Viens, Guest Editor of this Olivieri symposium, and Julian Savulescu, the Editor of JME, set the scene for the symposium."In failing...[her] when she needed them most, it is now clear that some members of the University’s Faculty of Medicine heard her muffled cries of academic freedom from the back room, yet their response was to serve another round of drinks and turn the music up louder. With the bombshell revelations in the...affair, the plug may have been pulled on this (...) business sponsored party, and hopefully a sober re-examination of the university’s neglected role and responsibility toward independent inquiry and academic freedom can begin.1" "These guys don’t get one thing—we’re not going away. This isn’t a personal vendetta. This is something I want patients to be protected from when I’m dead, fifty years from now.2" "[The Olivieri affair is] not a mystery novel, but instead the latest skulduggery at Toronto’s Hospital for Sick Children.1" "The legal assaults which you have endured in your battle against the drug company, and in your battle against the medical establishment appear to have been fought with the type of uncommon bravery that is rarely seen. It is for this reason that our trustees have unanimously chosen to recognise you for this most prestigious award.3" "[The Olivieri affair resulted from] a fundamental misreading of the issue as a mere contractual and scientific dispute...[it is] Canada’s worst academic and research scandal in decades...[Since 1998, Olivieri has been] demoted, then restored, then harassed. She has been smeared with allegations attacking her competence, integrity, sanity and personality....4"The Olivieri affair is one of the most important events to occur in research ethics. From its dominance in the Canadian and international news media, to changes in the governance of public health, academic medicine, …. (shrink)

This paper examines the use of case studies in ethics education. While not dismissing their value for specific purposes, the paper shows the limits of their use. While agreeing that case studies are narratives, although rather thin stories, the paper argues that the claim that case studies could represent reality is difficult to sustain. Instead, the paper suggests a way of using stories in ethics teaching that could be more real for students, while also giving them a way of thinking (...) about their own professional practices. The paper shows how the method can be used to develop a more critical and reflective practice for students in the health care professions. Some immediate problems with the method are discussed. (shrink)

Informed consent enjoys an unassailable position in both clinical and research situations as a safeguard of patients’ rights. Keeping the patient involved in the decision making process is easier when there is direct communication with the individual. The Pakistani milieu offers challenges to this process because crucial decision making is often done by family members or is left entirely up to the attending physician. There seems to be a general acceptance of this shifting of focus from the individual to other (...) players. This also raises certain ethical dilemmas for physicians who may feel uncomfortable with communication which excludes the patient or in accepting a paternalistic primary decision making role. The objective of this informal qualitative study was to ascertain physicians’ perceptions regarding the process of information delivery to the patient in the Pakistani context and the various influences acting upon it. (shrink)

Parents’ freedom to choose infant male circumcision is the correct policyIndividuals and groups lobbying to have infant male circumcision prohibited or restricted often argue that the practice of routinely circumcising infants is unjustified. For instance, in this issue of the journal, John Hutson argues that it is virtually impossible to justify a policy in which the medical establishment should be able to embark on a “mass circumcision” campaign of 100% of the infant male population [see page 238].1Indeed, I would be (...) hard pressed to find anyone who could rationally disagree with this contention. However, this is because no one is currently arguing for the enactment of a policy that stipulates that all healthy male infants should be routinely circumcised . Arguments seeking to support a prohibition of “routine infant circumcision”, such as the one by Hutson, are arguing against a straw man—and a pitiful one at that.2 Such arguments only serve to misconstrue the debate and avoid engaging in the real and pressing issues concerning the legitimacy of the provision of this procedure.The questions that should be considered, and the ones which I shall be interested in discussing here, are what reasons are justifiable for allowing parents to choose to have their son circumcised? After well informed and careful deliberation should parents have the freedom to choose to have their son circumcised? These are the most relevant questions to be considered because there is a growing collection of citizens, medical practitioners, and lawyers who are currently lobbying for the practice of infant male circumcision to be outlawed—for example, there is a bioethicist who argues that the criminal law should be used …. (shrink)

Legislation on Disability/ Functional Diversity in Spain has experimented a great advance since 1982 to 2013, leaving the initial orientation, based on care and rehabilitation, toward another one based on rights and social inclusion as main objectives. However, this legislation has not been effective because in the same lap of time another transformation made it useless: the suppression of social rights that came from Keynesian politics and the progressive neoliberal ideology implantation. The evolution of People with Disability/ Functional Diversity labour (...) situation illustrates the imposition of what we name neoliberal “ableisment” over PFD labour rights. (shrink)

In classical Greek poetry there is a familiar distinction between verse which repeats line upon line, and that which forms patterns liable to closure at intervals, in stanzas or lyric sections. This is often equated with the distinction between spoken and sung verse, but the equation is only approximate. At an earlier stage all verse had some musical accompaniment—so much can be deduced from a number of passages in Homer, and is in any case implicit in the nature of quantitative (...) verse. By Hellenistic times it seems that, in new composition, the more complex lyric structures had died out, while of the simpler ones more and more were being taken over as spoken verse. In the fifth century—and this can probably be extended to at least the late sixth and most of the fourth—only two kinds of verse are known to have dispensed with music altogether in performance: the heroic hexameter and the iambic trimeter. (shrink)

In classical Greek poetry there is a familiar distinction between verse which repeats line upon line, and that which forms patterns liable to closure at intervals, in stanzas or lyric sections. This is often equated with the distinction between spoken and sung verse, but the equation is only approximate. At an earlier stage all verse had some musical accompaniment—so much can be deduced from a number of passages in Homer, and is in any case implicit in the nature of quantitative (...) verse. By Hellenistic times it seems that, in new composition, the more complex lyric structures had died out, while of the simpler ones more and more were being taken over as spoken verse. In the fifth century—and this can probably be extended to at least the late sixth and most of the fourth—only two kinds of verse are known to have dispensed with music altogether in performance: the heroic hexameter and the iambic trimeter. (shrink)

Text, interpretation and metre present a tangled problem in this threnody, and the solutions of editors differ widely. The chief function of detailed metrical study in such corrupt passages of lyric is to weight the scales in favour of—or more often against—certain methods of handling the text. The positive results of this present attempt to apply metrical criteria are necessarily modest and tentative; negatively they are, I think, sometimes decisive.

It is known from work of P. Young that there are recursively enumerable sets which have optimal orders for enumeration, and also that there are sets which fail to have such orders in a strong sense. It is shown that both these properties are widespread in the class of recursively enumerable sets. In fact, any infinite recursively enumerable set can be split into two sets each of which has the property under consideration. A corollary to this result is that there (...) are recursive sets with no optimal order of enumeration. (shrink)

"Forster was the first to lay the foundation of the world view that has now become dominant thanks to the progress of positive knowledge. He rebelled with all the power of his thought against the philosophical systems then in favor and counterposed to the subjective speculations of philosophy the logic of experience and the direct witness of common sense." This was the characterization of Georg Forster given by D. I. Pisarev. Upon reading the works of Forster one cannot but agree (...) that their author was possessed of an extraordinary intellect and that he ranks with the outstanding materialist philosophers. A passionate striving to remake the existing order of things characterized his entire life and activity. He took an active part in the French Revolution, and was one of the organizers of the commune in Mainz. Forster was the author of a number of philosophical works that had an enormous influence upon his contemporaries and upon the development of philosophical thought in general. (shrink)