In a situation of peer disagreement, peers are usually assumed to share the same evidence. However they might not share the same evidence for the epistemic system used to process the evidence. This synchronic complication of the peer disagreement debate suggested by Goldman (In Feldman R, Warfield T (eds) (2010) Disagreement. Oxford University Press, Oxford, pp 187–215) is elaborated diachronically by use of a simulation. The Hegselmann–Krause model is extended to multiple epistemic systems and used to investigate the role of (...) consensus and difference splitting in peer disagreement. I find that the very possibility of multiple epistemic systems downgrades the epistemic value of consensus and makes difference splitting a suboptimal strategy. (shrink)

Current theories of the division of cognitive labor are confined to the “context of justification,” assuming exogenous theories. But new theories are made from the same labor that is used for developing existing theories, and if none of this labor is ever allocated to create new alternatives, then scientific progress is impossible. A unified model is proposed in which theories are no longer given but a function of the division of labor in the model itself. The interactions of individuals balancing (...) the exploitation of existing theories and the exploration of new theories results in a robust cyclical pattern. (shrink)

Kuhn wanted to install a new research agenda in philosophy of science. I argue that the tools are now available to better articulate his paradigm and let it guide philosophical research instead of itself remaining the object of philosophical debate.

Background: Critically ill patients often require complex clinical care by highly trained staff within a specialized intensive care unit (ICU) with advanced equipment. There are currently limited data on the costs of critical care in low-and middle-income countries (LMICs). This study aims to investigate the direct-medical costs of key infectious disease (tetanus, sepsis, and dengue) patients admitted to ICU in a hospital in Ho Chi Minh City (HCMC), Vietnam, and explores how the costs and cost drivers can vary between the (...) different diseases. -/- Methods: We calculated the direct medical costs for patients requiring critical care for tetanus, dengue and sepsis. Costing data (stratified into different cost categories) were extracted from the bills of patients hospitalized to the adult ICU with a dengue, sepsis and tetanus diagnosis that were enrolled in three studies conducted at the Hospital for Tropical Diseases in HCMC from January 2017 to December 2019. The costs were considered from the health sector perspective. The total sample size in this study was 342 patients. -/- Results: ICU care was associated with significant direct medical costs. For patients that did not require mechanical ventilation, the median total ICU cost per patient varied between US$64.40 and US$675 for the different diseases. The costs were higher for patients that required mechanical ventilation, with the median total ICU cost per patient for the different diseases varying between US$2,590 and US$4,250. The main cost drivers varied according to disease and associated severity. -/- Conclusion: This study demonstrates the notable cost of ICU care in Vietnam and in similar LMIC settings. Future studies are needed to further evaluate the costs and economic burden incurred by ICU patients. The data also highlight the importance of evaluating novel critical care interventions that could reduce the costs of ICU care. (shrink)