The U.S. FDA has issued emergency use authorizations for monoclonal antibodies for non-hospitalized patients with mild or moderate COVID-19 disease and for individuals exposed to COVID-19 as post-exposure prophylaxis. One EUA for an oral antiviral drug, molnupiravir, has also been recommended by FDA’s Antimicrobial Drugs Advisory Committee, and others appear likely in the near future. Due to increased demand because of the Delta variant, the federal government resumed control over the supply and asked states to ration doses. As future variants (...) with increased infectivity and/or severity emerge, further rationing may be required. We identify relevant ethical principles and priority groups for access to therapies based on an integrated approach to population health and medical factors. Using priority categories to allocate scarce therapies effectively operationalizes important ethical values. This strategy is preferable to the current approach of categorical rules based on vaccination, immunocompromise status, or older age, or the ad hoc consideration of clinical risk factors. (shrink)

Objective: The objective of this study was to evaluate the clinical efficacy and appropriateness of colistin therapy in patients with hematological malignancies. -/- Methods: Age, gender, type of hematologic malignancy, and potential carbapenem-resistant microorganism risk factors were all noted in this retrospective study. In empirical and agent-specific treatment groups, differences in demographic features, risk factors, treatment responses, and side effects were compared. -/- Results: Sixty-three patients were included, 54% were male, and the median age was 49. In the last (...) three months, the hospitalization rate history was 68%, and four patients had a hospitalization history in the ICU. Carbapenem-resistant K. pneumoniae colonization was present in 22 patients (35%). Gram-negative microorganisms were isolated in 34 patients (54%). The carbapenem, quinolone, and colistin resistance rates were 82%, 76%, and 4% respectively. Clinical and microbiological response rates were 60% and 69%. 7 and 28-day mortality rates were 17% and 35%. There was no significant difference in demographic data and comorbidities in empirical (n=48) and agent-specific (n=15) treatment groups. The rate of carbapenem and glycopeptide treatments before colistin was higher in the empirical treatment group (p = 0.004; p = 0.001). The rate of starting combined antibiotics was higher in the empirical treatment group (p = 0.016). Two of the patients developed renal failure in the first week after treatment. -/- Conclusion: The use of empirical colistin may be unavoidable given the risk considerations. Shortly, colistin-resistant strains may also be a factor affecting treatment success negatively. (shrink)

In this a double-blind study, 17 patients wıth rosacea were treated topically with% 1 ornidazole cream. The other group of 9 patients with rosacea received place-bo cream. Applications were performed twice daily and treatment results were evaluated after one month. The cream was locally well tolerated and no systemic symptoms were noted. Topical ornidazole cream therapy appears to be a safe and efficacious therapy in the treatment of rosacea.

Construction of self and group often incorporates the use of objects associated with "expression," including videos, films, and photographs. In this article, I describe four different sites for construction of groups (group portraiture, courtrooms, video-assisted group therapy, and videoconferencing). I discuss potential aspects of shifts in the way we use and talk about media on what it is like to participate in a group. The eras of video, film, and photography as "silent witnesses" to (...) class='Hi'>group interaction are gradually passing. For example, technology that enables the digital retouching of photographs has afforded means for enhancing or dramatically altering photographic images. Those who employ these media as epistemological companions, supplementing their vision and memories of various events and interactions, are increasingly doing so from a critical (and somewhat cautious) perspective.. (shrink)

Psoriatic arthritis is a chronic, systemic inflammatory disorder. It has been classified in spondyloarthropathies group which shares clinical, radiologic, serologic features, familial and genetic relationship. Up to 5-30% of patients with psoriasis may go on to develop psoriatic arthritis, usually within 5-10 years. Adalimumab (ADA) is the first human monoclonal antibody against TNF-α. ADA is a biologic agent effective in both skin lesions and joint signs. Anti-TNF agents are powerful immunmodulating drugs with potentially side effects. Our case is 38 (...) years old woman complaining about swelling and pain in hand joints. In physical examination she has asymmetrical arthritis in wrist, proximal (PIP) and distal interphalangeal (DIP) hand joints and right knee joint. In laboratory; sedimentation rate: 80 mm/h, C-reactive protein: 17 mg/l, rheumatoid factor (RF): 8.7 IU/ml and HLA B27 was positive. Radiologically, erosions and narrowing were determined in PIP and DIP hand joints and grade 3 sacroiliitis bilaterally. In clinical monitoring, psoriaform lesions progressed in her scalp, so we diagnosed psoriatic artritis. We started ADA therapy 40 mg subcutaneously every two weeks. She developed periorbital infection in left-sided in tertiary month following. Streptococcal proliferation was seen in lesion culture, so we began amoxicillin-clavulanate therapy. She benefit antibiotic therapy, infectious signs regressed. ADA therapy discontinued, instead of it, etanercept 50 mg twice weekly subcutaneous and methylprednisolone 12 mg/daily oral therapy is started. We purposed to declare our case with literature selection. (shrink)

BACKGROUND Patients with chronic pain face significant barriers in finding clinicians to manage long-term opioid therapy (LTOT). For patients on LTOT, it is increasingly common to have them sign opioid treatment agreements (OTAs). OTAs enumerate the risks of opioids, as informed consent documents would, but also the requirements that patients must meet to receive LTOT. While there has been an ongoing scholarly discussion about the practical and ethical implications of OTA use in the abstract, little is known about how (...) clinicians use them and if OTAs themselves modify clinician prescribing practices. OBJECTIVE To determine how clinicians use OTAs and the potential impacts of OTAs on opioid prescribing. DESIGN We conducted qualitative analysis of four focus groups of clinicians from a large Midwestern academic medical center. Groups were organized according to self-identified prescribing patterns: two groups for clinicians who identified as prescribers of LTOT, and two who did not. PARTICIPANTS 17 clinicians from General Internal Medicine, Family Medicine, and Palliative Care were recruited using purposive, convenience sampling. APPROACH Discussions were recorded, transcribed, and analyzed for themes using reflexive thematic analysis by a multidisciplinary team. KEY RESULTS Our analysis identified three main themes: (1) OTAs did not influence clinicians’ decisions whether to use LTOT generally but did shape clinical decision-making for individual patients; (2) clinicians feel OTAs intensify the power they have over patients, though this was not uniformly judged as harmful; (3) there is a potential misalignment between the intended purposes of OTAs and their implementation. CONCLUSION This study reveals a complicated relationship between OTAs and access to pain management. While OTAs seem not to impact the clinicians’ decisions about whether to use LTOT generally, they do sometimes influence prescribing decisions for individual patients. Clinicians shared complex views about OTAs’ purposes, which shows the need for more clarity about how OTAs could be used to promote shared decision-making, joint accountability, informed consent, and patient education. (shrink)

This paper argues for global sharing of COVID‐19 treatments during the COVID‐19 pandemic and beyond based on principles of global solidarity. It starts by distinguishing two types of COVID‐19 treatments and models sharing strategies for each in small‐group scenarios, contrasting groups that are solidaristic with those composed of self‐interest maximizers to show the appeal of solidaristic reasoning. It then extends the analysis, arguing that a similar logic should apply within and between nations. To further elaborate global solidarity, the paper (...) distinguishes morally voluntary, sliding‐scale, and mandatory versions. It argues for an all‐hands‐on‐deck approach and gives examples to illustrate. The paper concludes that during the COVID‐19 crisis, global solidarity is a core value, and global sharing of COVID‐19 treatments should be considered a duty of justice, not of charity. (shrink)

Psychedelics are currently being studied intensively for the treatment of various psychiatric disorders. Ayahuasca, a plant-based extract originating from the Amazonian area, is traditionally consumed in ritualistic group events. The related indigenous traditions date back hundreds of years and have amassed vast amounts of knowledge on the therapeutic use of psychedelic and non-psychedelic plant-based substances. -/- These traditions require a prospective ceremony facilitator to undergo years of intensive training to acquire knowledge, mental power or self-confidence, stability, sensitivity, intuitive treatment (...) outcome prediction skills, musical skills, and sufficient physical strength. These qualities of a facilitator, in the presence of integrity and love, largely determine treatment outcomes. -/- In Europe, predominantly in the first decade of the 2000s and in the early 2010s, some individuals began building connections with diverse indigenous groups and syncretic churches of the Amazonia in an attempt to find cures for their treatment-resistant psychiatric conditions. Small circles of other patients in need of similar treatment formed around them. This led to the formation of decentralized, diverse local ceremony cultures that either followed the principles of the traditional lineages of their origin or synthesized various influences. -/- These unofficial ceremony contexts appeared to complement official healthcare systems, offering efficient methods unavailable in the medical context and correcting the consequences of medical malpractice and neglect. These ceremony contexts appeared highly communal, were largely based on volunteering, and contained mechanisms for self-correcting possible emerging issues. They seemed to function as systems for collecting, preserving, storing, and distributing knowledge of psychedelic therapy methods; in other words, systems for knowledge base building and innovation. -/- doi: 10.13140/RG.2.2.27385.85602. (shrink)

The study investigated the effect of cognitive restructuring on junior secondary school mathematics test anxiety in Oshimili south L.G.A of Delta State. Two research questions and two hypotheses tested at 0.05 level of significance guided the study. Quasi-experimental research design was adopted for this study. The population for this study was a total of 1224 students. These comprised of all the JSS 2 students from Oshimili South Local Government Area of Delta State. Research sample consisted of 120 JSS 2 students (...) with high level of mathematics test anxiety selected through purposive sampling technique. The instrument adopted for this study was Maths anxiety rating scale-R. Data collected from the study were analyzed using mean and ANCOVA. Results obtained from the study indicated that Cognitive restructuring therapy (CRT) was effective on mathematics test anxiety of junior secondary school students. The results equally showed that Cognitive restructuring therapy was more effective on the female students’ mathematics anxiety than their male counterparts. Furthermore, the results indicated a significant difference in the post-test mathematics test anxiety mean scores of students treated with CRT and those in the control group. Also, there was significant difference in the post-test mathematics test anxiety mean scores of male and female students treated with CRT. Based on the findings of this study, some recommendations were noted. The researcher recommended, among others that Schools’ Guidance Counselors should be empowered to make good use of the cognitive restructuring technique, in counseling students who find it difficult to comprehend mathematics skills. (shrink)

Metformin is considered the first-line treatment as a monotherapy for patients with type 2 diabetes mellitus. Emerging evidence suggests that metformin may have a renoprotective role; therefore, understanding the impact of metformin dose and therapy duration on renal function may significantly improve renal outcomes in type 2 diabetes patients. This study aims to investigate the renoprotective effects of metformin by analyzing its dose-dependent impacts on the estimated glomerular filtration rate in patients with type 2 diabetes mellitus. A retrospective cross-sectional (...) study design was used from September 2022 to October 2023. Data from 302 type 2 diabetes patients were collected from patient files at the Benghazi Diabetic Center and the Aljabal Al-Alkdar Diabetic Center, including all with type 2 diabetes mellitus patients on varying doses of metformin. The collected data included age, gender, metformin dose, duration of metformin therapy, urea, and creatinine. Exclusion criteria included patients with significant comorbidities such as chronic kidney disease (other than diabetic nephropathy), liver disease, heart failure, or malignancy; those taking nephrotoxic medications; individuals with recent acute illnesses or surgical procedures; pregnant or lactating women; participants with inadequate medical records; and patients who were non-adherent to metformin therapy. Survival analysis was conducted to evaluate the effect of different metformin doses on the estimated glomerular filtration rate. The study analyzed 302 diabetic patients, of whom 46.0% were male and 54.0% were female. The age was 58.3±11.9 years. The HbA1c was 7.7%±1.3%. The duration of diabetes was 11.4±8.1 years. The creatinine was 1.0±0.9 mg/dL, and the urea was 36.7±23.8 mg/dL. Data analysis revealed a statistically significant difference in survival distribution across the dose groups. Different metformin doses significantly impact the estimated glomerular filtration rate, suggesting that dosage plays a crucial role in maintaining renal function. (shrink)

Objective: Patients' satisfaction is one of the most important goals in complete denture therapy, and there are many factors influencing this parameter. This study aimed to determine patient satisfaction with conventional removable complete denture made by clinical year students at the Faculty of Dentistry, Al Azhar University - Gaza. Methods: A sample of 85 patient who had conventional removable complete denture made by clinical year students at the Faculty of Dentistry Al Azhar University - Gaza filled a questionnaire two (...) months after denture insertion. The questionnaire involving four sections including personal information, history, denture evaluation in aspects of mastication, speech, aesthetics and retention, and patient comfort. Results: Of the 85 patient studied, 81% were males, and the mean age was 60.3 years SD+-9.64. The majority (n= 67, 79 %) lost their teeth because of bad oral hygiene. The overall satisfaction level was (92.1%), and patients were more satisfied with their upper denture. A significant association was found between the patient satisfaction and prior denture use experience (p=0.013). No significant correlation was established between the patient satisfaction and their gender (p=0.188), age group (p=0.640) and employment status (p=0.667).Conclusion: The patients have shown a high level of overall satisfaction. A significant association was found between the overall satisfaction level of patients and prior denture use experience. No statistically significant association was observed between the overall satisfaction level of patients and with each of age group, employment status and gender. (shrink)

In various documents the view emerges that contemporary biotechnosciences are currently experiencing a scientific revolution: a massive increase of pace, scale and scope. A significant part of the research endeavours involved in this scientific upheaval is devoted to understanding and, if possible, ameliorating humankind: from our genomes up to our bodies and brains. New developments in contemporary technosciences, such as synthetic biology and other genomics and “post-genomics” fields, tend to blur the distinctions between prevention, therapy and enhancement. An important (...) dimension of this development is “biomimesis”: i.e. the tendency of novel technologies and materials to mimic or plagiarize nature on a molecular and microscopic level in order to optimise prospects for the embedding of technological artefacts in natural systems such as human bodies and brains. In this paper, these developments are read and assessed from a psychoanalytical perspective. Three key concepts from psychoanalysis are used to come to terms with what is happening in research laboratories today. After assessing the general profile of the current revolution in this manner, I will focus on a particular case study, a line of research that may serve as exemplification of the vicissitudes of contemporary technosciences, namely viral biomaterials. Viral life forms can be genetically modified (their genomes can be rewritten) in such a manner that they may be inserted in human bodies in order to produce substances at specific sites such as hormones (testosterone), neurotransmitters (dopamine), enzymes (insulin) or bone and muscle tissue. Notably, certain target groups such as top athletes, soldiers or patients suffering from degenerative diseases may become the pioneers serving as research subjects for novel applications. The same technologies can be used for various purposes ranging from therapy up to prevention and enhancement. (shrink)

Cognitive tests show that identity and symmetry reflect intellect. 'Guess of other guess' creates various symmetries, while only one is right: 'absolute symmetry', which can be outvoted by the majority. Prejudices result from differences between ME (my identity) and others. Unbiased judgement is symmetrical, always in the middle: neither in favor, nor against ME. Intelligence reduces prejudices, but the lack of opportunities can counterbalance it. That's why type of bias differs in various groups: people from war zones, people in (...) class='Hi'>therapy, artists, etc.. "The law of values' equity" is a symmetrical principle redefining utility in economics, when people equate all their values. E.g. 2 children averagely rich, is better than one child rich and another poor. If 'a' is an average richness, and 'x' is a difference in richness, and Utility multiplies all values, then: a * a > (a - x) * (a + x), which is: a² > a² - x². It does not however imply egalitarianism, as it is still better to have both children rich than both average or poor. (shrink)

Objective: In this study, we aimed to identify patients at risk of chemotherapy-induced cardiotoxicity with a simple method like platelet-to-lymphocyte ratio (PLR) before starting therapy. Method: A total of 65 breast cancer patients who completed anthracycline or adjuvant trastuzumab treatment were evaluated retrospectively. Serial PLR calculations, echocardiographic examinations, and cardiac markers before treatment and after follow-up period were analyzed. Cardiotoxicity was determined according to Cardiac Review and Evaluation Committee Criteria. Results: Patients were divided into two groups according to their (...) baseline PLR levels as Group C—PLR < 119 and Group D—PLR 120. The median follow-up of the study was 22.23 (12-42) months. Concomitant disease and baseline characteristics were similar in both groups. Symptomatic cardiotoxicity was not observed in both groups. Cardiotoxicity was occurred in one patient (2.3%) in Group C and in four patients (9.5%) in Group D (P ¼ .005). Average mean left ventricular ejection fraction loss from baseline was 10.7 6 7.0% in Group D vs 2.3 6 6.4% in Group C (P ¼ .008). Interpretation of cardiac markers that were present in nearly half of the patients revealed that serum hs-c-reactive protein and pro-brain natriu¨ retic peptide levels were significantly higher in patients who developed cardiotoxicity compared to who did not develop cardiotoxicity. PLR 120 had 99% sensitivity and 85% specificity in predicting cardiotoxicity. Conclusion: This study’s results showed that high PLR levels were associated with chemotherapy-induced cardiotoxicity. To our best knowledge, this is the first study, examining the impact of whole blood test on chemotherapy-induced cardiotoxicity before starting the therapy and allowing doctors plot a route for these risky patients. (shrink)

This fifth volume on Advances and Applications of DSmT for Information Fusion collects theoretical and applied contributions of researchers working in different fields of applications and in mathematics, and is available in open-access. The collected contributions of this volume have either been published or presented after disseminating the fourth volume in 2015 in international conferences, seminars, workshops and journals, or they are new. The contributions of each part of this volume are chronologically ordered. First Part of this book presents some (...) theoretical advances on DSmT, dealing mainly with modified Proportional Conflict Redistribution Rules (PCR) of combination with degree of intersection, coarsening techniques, interval calculus for PCR thanks to set inversion via interval analysis (SIVIA), rough set classifiers, canonical decomposition of dichotomous belief functions, fast PCR fusion, fast inter-criteria analysis with PCR, and improved PCR5 and PCR6 rules preserving the (quasi-)neutrality of (quasi-)vacuous belief assignment in the fusion of sources of evidence with their Matlab codes. Because more applications of DSmT have emerged in the past years since the apparition of the fourth book of DSmT in 2015, the second part of this volume is about selected applications of DSmT mainly in building change detection, object recognition, quality of data association in tracking, perception in robotics, risk assessment for torrent protection and multi-criteria decision-making, multi-modal image fusion, coarsening techniques, recommender system, levee characterization and assessment, human heading perception, trust assessment, robotics, biometrics, failure detection, GPS systems, inter-criteria analysis, group decision, human activity recognition, storm prediction, data association for autonomous vehicles, identification of maritime vessels, fusion of support vector machines (SVM), Silx-Furtif RUST code library for information fusion including PCR rules, and network for ship classification. Finally, the third part presents interesting contributions related to belief functions in general published or presented along the years since 2015. These contributions are related with decision-making under uncertainty, belief approximations, probability transformations, new distances between belief functions, non-classical multi-criteria decision-making problems with belief functions, generalization of Bayes theorem, image processing, data association, entropy and cross-entropy measures, fuzzy evidence numbers, negator of belief mass, human activity recognition, information fusion for breast cancer therapy, imbalanced data classification, and hybrid techniques mixing deep learning with belief functions as well. (shrink)

Purpose: Despite the prevalent use of the golden ratio in the environment design for autistic users, there is no experimental research that explains their desired space ratio. This study aims to find the desired ratio in the learning environment, like an occupational therapy room for autistic users, while considering effective variables on their choices. Methodology: Based on McAllister's (2012) study, a scale model inspired by a dollhouse has been chosen to work and play with autistic children directly and find (...) their desired space ratio. Meanwhile, the furniture configuration and the access type in the environment could also define the ratio for interviewees. Accordingly, the scale model was designed with six different scale rooms containing three ratios and two spatial access types represented by the furniture arrangement. 50 autistic children of different ages, genders, and disorders in the moderate and medium spectrum have been randomly sampled. Then, they were asked to choose their desired ratio by playing with the scale model and putting the doll in their preferred room. This study also included 50 non-autistic children as a control group with different genders and defined ages. Result: After interviewing both groups, the chi-square test with Cramer's V calculation analyzed the result to find the statistically significant correlation between control variables, among which two independent variables had a statistically significant correlation with the chosen ratio for all the interviewees. First, being autistic significantly impacted their desired ratio choice as autistic children went for a ratio of 2:5, and no autistic ones had a high tendency toward the golden ratio (1:1.6). The chi-square test also showed that the access type in the scale model was the effective variable for both groups when choosing their desired ratio. Conclusion: The access type of the room with its furniture configuration impacted how users perceived the room's ratio, as well as being autistic or non-autistic users. (shrink)

The theoretical underpinnings and practical worth of content-based, intentional, or "folk" psychology have been challenged by three distinct groups of philosophical critics in the past 15 years or so. The first group, comprised by Hilary Putnam, Tyler Burge, and other advocates of "wide" or "externalist" theories of meaning, claims that traditional psychologists have been mistaken in assuming that our beliefs, desires, and other content-laden states supervene on or inhere in our individual minds or brains. The other two groups are (...) both "eliminative materialists," who charge that the intentional approach is inadequate and that it can or will be replaced by a completely non-interpretive discipline: either neuropsychology, in the view of Patricia and Paul Churchland, or a strictly syntactic computational psychology, according to Stephen Stich. ;This dissertation defends "notional world" or narrow intentional psychology against these charges, primarily on the strength of its practical merits, in contrast to the limitations and adverse effects of the proposed alternatives. Psychology is at least partly an applied science with a mandate to help understand and treat concrete psychological problems such as Post Traumatic Stress Disorder and depression, I argue, so any theorist who proposes to reconfigure or phase out existing approaches must be prepared to take over these duties with at least equal facility. However, whereas various "narrow" schools of psychotherapy such as Cognitive Therapy are fairly successful in this regard and show every indication of continuing to be needed for the foreseeable future, the Syntactic Theory seems to show very poor promise of being able to help relieve the distress of people with psychological disturbances, while a purely neurobiological approach is inappropriate in many cases, and tends to cause a variety of untoward and dangerous side-effects. As for the "wide" theorists with their emphasis upon the social and environmental contributions to meaning: they must acknowledge that a good deal of content is in the head; and, more importantly, by focusing on the role of the "experts" in a society's language-game, they miss the whole point of a psychological attribution, which is to understand an individual's reasons--however idiosyncratic--for acting as he or she does. (shrink)

Epileptogenesis involves an increase in excitatory synaptic strength in the brain in a manner similar to synaptic potentiation. In the present study we investigated the mechanisms of short-term synaptic potentiation in patients with focal epilepsy by using 5 Hz repetitive transcranial magnetic stimulation (rTMS), a non invasive neurophysiological technique able to investigate the mechanisms of synaptic plasticity in humans. Ten patients with focal idiopathic cortical epilepsy were studied. 5 Hz-rTMS (10 stimuli-trains, 120% of motor threshold, RMT) was delivered over the (...) first dorsal interosseus (FDI) motor area of both (affected and unaffected) hemispheres. Changes in the motor evoked potential (MEP) size in the FDI muscle during the trains and the RMT were measured and compared between the hemispheres. 5 Hz-rTMS was also delivered in a group of healthy subjects over both hemispheres. 5 Hz-rTMS in patients elicited a reduced MEP facilitation compared to normal subjects. The reduced MEP amplitude was more evident in the affected hemisphere than in the unaffected hemisphere. RMT in the affected hemisphere was higher than in the unaffected hemisphere and in healthy subjects. Our findings showing a decreased response to 5 Hz-rTMS over the affected hemisphere, differently from the expected results suggest a reduced cortical excitability in epileptic patients. We hypothesize an altered balance between excitatory and inhibitory circuits in epileptic patients under chronic therapy. (shrink)

Objective: The aim of this study was to compare oral Artemether-Lumefantrine to intravenous Quinine by exploring its effectiveness in cerebral malaria in hospitalized patients. Materials and Methods: A randomized prospective study was conducted among 64 hospitalized cases of cerebral malaria. One group of patients was treated with intravenous Quinine and another group was treated with oral Artemether-Lumefantrine. Response in clinical, laboratory parameters and outcome of treatment were noted every eight hours. Results: Oral Artemether-Lumefantrine showed almost similar response in (...) clinical and laboratory parameters with median temperature (101º F), pulse rate (102 b/m), systolic BP (110mmHg), GCS (12), hemoglobin (9.8 g/dl), WBC (9000/μl), platelet (130000/μl), B. glucose (101 mg/dl), S. creatinine (1.8 mg/dl), ALT (32 U/L), mean disappearance time of parasite from blood (40 hours), and mean time for regaining full consciousness (30 hours). Final outcome was also similar in both drugs with only 1 death (3.1%) reported in each group. Conclusion: In cerebral malaria intravenous Quinine or oral Artemether-Lumefantrine therapy does not have any statistically significant difference in terms of clinical parameter, laboratory parameter and final outcome. (shrink)

Background: Chronic myeloid leukemia (CML) is a hematopoietic stem cell disease, associated with a reciprocal translocation between chromosomes 9 and chromosome 22, lead to the formation of the BCRABL fusion gene (Philadelphia chromosome). This fusion gene is believed to play golden role in the initial development of CML with constitutive tyrosine kinase activation. Successful use of tyrosine kinase inhibiters (TKIs) play a role in improve survival and increase prevalence of CML, but un fortunately mutations in the BCR-ABL kinase domain may (...) cause, or contribute to increase, resistance to TKIs in CML patients. . Objective: This study was designed to assess the association of five most common BCR-ABL kinase domain mutations (T315I, M351T, E255K, M244V and E255V) with resistance state of CML patients on TKIs in Iraqi Middle Euphrates region. Patients and methods: A retrospective case-control study in which 85 patients with chronic myeloid leukemia in chronic phase (45 patients as cases group and 40 patient as control group) were selected from three hemato-oncology centers in middle Euphrates in Iraq during the period from January 2016 till October 2016 out of a total of 240 CML patients (108 male and 132 female) who were registered during this period in these three centers and all patients on TKI (Imatinib and Nilotinib). Venous blood sampling done for BCRABL kinase domain mutations screening. Results: four patients from cases group (4/45) were carriers of one of five selected ABL kinase domain mutations and no one of control group. T315I mutation was detected in 3/45 (6.6 %) of resistant patients, with a significant risk association to develop resistance to TKI therapy (odd ratio and C. I.) (6.67, 0.3340 - 133.2255). E255V was detected in 1/45 (2.2 %) and also had significant risk association to develop resistance to TKIs (odd ratio, C.I.) (2.73, 0.1081 -68.9424). No one of these mutations had significance correlation with demographic or hematological features. M351T, E255K and M244V were not detected in any one of our study groups CML patients. Conclusions: T315I and E255V among five ABL kinas domain mutations were detected in our CML patients with resistance to TKIs. All of them may play a role in development variable degree of resistance to first and second generation TKIs weather primary or secondary.T315I mutation is most common mutation within BCR-ABL domain kinase gene. (shrink)

Abstract: -/- In this paper we discuss how through our bi-weekly Socratic dialogue groups with inmates at the Metropolitan Correctional Center downtown San Diego, we were able to bring the inmates to a sense of aporia or puzzlement. Not only did the dialogues help to uncover assumptions, uncovering the dots, so to speak, but also to help reconnect the dots and see their world from a different perspective. It allowed them to question their lives in a safe and non-judgmental environment. (...) They felt empowered by these dialogues to become their own life’s judges, freeing themselves from feeling oppressed by the judgments of others. (shrink)

Background: In response to the pandemic caused by COVID-19, World Health Organization (WHO), together with International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC), developed research protocols facilitating global collaboration and accelerating the understanding of the disease, to identify the potential symptoms and persistent sequelae in infected individuals, which can be used in different areas of health, that is, in primary care, at a hospital or outpatient level, both public and private. Objective: To describe the International Severe Acute Respiratory and (...) Emerging Infection Consortium (ISARIC) protocol as a new global collaborative platform for global clinical trials targeting post-COVID-19 patients. Methods: The standardized forms were developed from the COVID-19 Clinical Characterization Protocol (PCC) by the ISARIC/WHO working group composed of specialist researchers with experience in clinical research in different areas of medicine and public health, especially outbreaks and infectious diseases. Conclusion: It is expected that the creation of a database composed of different populations from all over the world will help in the characterization of risk factors, in the best form of clinical intervention and in the best prevention strategies for physical, neurological and psychosocial sequelae in the medium and long term in post-COVID-19 patients. (shrink)

The International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC) COVID-19 dataset is one of the largest international databases of prospectively collected clinical data on people hospitalized with COVID-19. This dataset was compiled during the COVID-19 pandemic by a network of hospitals that collect data using the ISARIC-World Health Organization Clinical Characterization Protocol and data tools. The database includes data from more than 705,000 patients, collected in more than 60 countries and 1,500 centres worldwide. Patient data are available from acute (...) hospital admissions with COVID-19 and outpatient follow-ups. The data include signs and symptoms, pre-existing comorbidities, vital signs, chronic and acute treatments, complications, dates of hospitalization and discharge, mortality, viral strains, vaccination status, and other data. Here, we present the dataset characteristics, explain its architecture and how to gain access, and provide tools to facilitate its use. (shrink)

Are groups ever capable of bearing responsibility, over and above their individual members? This chapter discusses and defends the view that certain organized collectives – namely, those that qualify as group moral agents – can be held responsible for their actions, and that group responsibility is not reducible to individual responsibility. The view has important implications. It supports the recognition of corporate civil and even criminal liability in our legal systems, and it suggests that, by recognizing group (...) agents as loci of responsibility, we may be able to avoid “responsibility gaps” in some cases of collectively caused harms for which there is a shortfall of individual responsibility. The chapter further asks whether the view that certain groups are responsible agents commits us to the view that those groups should also be given rights of their own and gives a qualified negative answer. (shrink)

Ronald Dworkin argued that Advance Directives informed by a principle of autonomy ought to guide decisions in relation to the treatment of those in care for dementia. The principle of autonomy in play presupposes a form of competence that is tied to the individual person making the Directive. This paper challenges this individualist assumption. It does so by pointing out that the competence of a patient is inherently relational, and the key illustrative case to make this point is the case (...) of music therapy. In music therapy, a relatively recent treatment modality in aged care, patients previously thought to be permanently unresponsive are shown on the contrary to be capable of significant levels of social agency. The conclusion to draw is that Advance Directives that fail to acknowledge the real possibility of such relational competence are misapplied. (shrink)

The paper clarifies therapeutic ideas about philosophical method which Wittgenstein puts forward in his "Big Typescript". It does so by analysing how Wittgenstein treats the question 'What is meaning?', in that part of the same work from which the opening sections of his "Philosophical Investigations" derive. On this basis, the paper explains why Wittgenstein set himself a therapeutic goal, why this is reasonable, and how he sought to attain that goal without 'pronouncing new truths about the subject of the investigation', (...) viz. meaning. (shrink)

An important strand of current experimental philosophy promotes a new kind of methodological naturalism. This chapter argues that this new ‘metaphilosophical naturalism’ is fundamentally consistent with key tenets of Wittgenstein’s metaphilosophy, and can provide empirical foundations for therapeutic conceptions of philosophy. Metaphilosophical naturalism invites us to contribute to the resolution of philosophical problems about X by turning to scientific findings about the way we think about X – in general or when doing philosophy. This new naturalism encourages us to use (...) resources from psychology that can empirically vindicate precisely some of the most controversial aspects of Wittgenstein’s conception of philosophy: They can establish the need, and provide key tools, for something worth calling ‘therapy’, in philosophy. As ‘pudding proof’ this chapter shows how methods and findings from psycholinguistics motivate and facilitate a therapeutic approach to a characteristically philosophical problem: ‘the problem of perception’. (shrink)

In this paper, I introduce the emerging theory of judgment aggregation as a framework for studying institutional design in social epistemology. When a group or collective organization is given an epistemic task, its performance may depend on its ‘aggregation procedure’, i.e. its mechanism for aggregating the group members’ individual beliefs or judgments into corresponding collective beliefs or judgments endorsed by the group as a whole. I argue that a group’s aggregation procedure plays an important role in (...) determining whether the group can meet two challenges: the ‘rationality challenge’ and the ‘knowledge challenge’. The rationality challenge arises when a group is required to endorse consistent beliefs or judgments; the knowledge challenge arises when the group’s beliefs or judgments are required to track certain truths. My discussion seeks to identify those properties of an aggregation procedure that affect a group’s success at meeting each of the two challenges. (shrink)

Groups behave in a variety of ways. To show that this behavior amounts to action, it would be best to fit it into a general account of action. However, nearly every account from the philosophy of action requires the agent to have mental states such as beliefs, desires, and intentions. Unfortunately, theorists are divided over whether groups can instantiate these states—typically depending on whether or not they are willing to accept functionalism about the mind. But we can avoid this debate. (...) I show how a more general view of action captures what is central to action without mentioning mental states, and I argue that a group’s members can fulfill the role in group action that mental states play in our actions. Group behavior is explicable in terms of reasons, regardless of whether the group itself cognizes those reasons. After discussing the kind of reasons at issue and arguing that groups can act in light of them without minds, I assess how this account bears on the question of group responsibility. (shrink)

Desire is an important philosophical topic that deeply impacts everyday life. Philosophical practice is an emerging trend that uses philosophical theories and methods as a guide to living a eu‐ daimonic life. In this paper, we define desire philosophically and compare different theories of desire in specific Eastern and Western traditions. Based on the Lacanian conceptual–terminological triad of “Need‐Demand‐Desire”, the research of desire is further divided into three dimensions, namely, the subject of desire, the object of desire, and the desire (...) itself. The concept of desire is then an‐ alyzed from this triad and these three dimensions through different philosophical theories. This paper selects Buddhism as the representative of Eastern tradition, and Stoicism as the representative of the West, paying special attention to Stoicism’s “spiritual exercises” following Pierre Hadot. By exploring and comparing the Buddhist paths to liberation from suffering (i.e., the Four Noble Truths and the Noble Eightfold Path) and the two theoretical pillars in Stoicism (i.e., the notions of “living according to nature” and “the dichotomy of control”), practical guidance is then provided for un‐ derstanding and regulating desire in times of crisis. This understanding and regulation of desire constitutes a philosophical therapy for today’s troubles, particularly those caused by excessive or irrational desires. (shrink)

Sports physicians are continuously confronted with new biotechnological innovations. This applies not only to doping in sports, but to all kinds of so-called enhancement methods. One fundamental problem regarding the sports physician's self-image consists in a blurred distinction between therapeutic treatment and non-therapeutic performance enhancement. After a brief inventory of the sports physician's work environment I reject as insufficient the attempts to resolve the conflict of the sports physician by making it a classificatory problem. Followed by a critical assessment of (...) some ideas from the US President's Council on Bioethics, the formulation of ethical codes and attempts regarding a moral topography, it is argued that the sports physician's conflict cannot be resolved by the distinction between therapy and enhancement. Instead, we also have to consider the possibility that the therapy-based paradigm of medicine cannot do justice to the challenges of the continuously increasing technical manipulability of the human body and even our cognitive functions as well. At the same time we should not adhere to transhumanist ideas, because non-therapeutic interventions require clear criteria. Based on assistive technologies an alternative framework can be sketched that allows for the integration of therapeutic and non-therapeutic purposes. After a thorough definition of standards and criteria, the role of the sports physician might be defined as that of an assistant for enhancement. Yet the process of defining such an alternative framework is a societal and political task that cannot be accomplished by the sports physicians themselves. Until these questions are answered sports physicians continue to find themselves in a structural dilemma that they partially can come to terms with through personal integrity. (shrink)

In this opinion piece we propose the investigation of psychedelic-assisted psychotherapy for the treatment of body dysmorphic disorder (BDD). BDD is a psychiatric disorder characterised by appearance-based preoccupations and accompanying compulsions. While safe and effective treatments for BDD exist, non-response and relapse rates remain high. Therefore, there is a need to investigate promising new treatment options for this highly debilitating condition. Preliminary evidence suggests safety, feasibility, and potential efficacy of psychedelic treatments in disorders that share similar psychopathological mechanisms with BDD. (...) Drawing on this evidence, as well as on relevant qualitative reports and theoretical proposals, we argue that it would be worthwhile to conduct a phase 2a study aimed at assessing the safety and feasibility of psychedelic-assisted psychotherapy in BDD. We also offer some suggestions for how future research ought to proceed. (shrink)

A group is lying when it makes a statement that it believes to be untrue but wants the addressee(s) to believe. But how can we distinguish statements that the group believes to be untrue from honest group statements based on mistaken beliefs or confusion within the group? I will suggest anarrative constraintfor honest group statements, made up of two components.Narrative coherencerequires that a new group statement should not conflict with group knowledge on the (...) matter, or beliefs of relevant operative subgroups, unless a coherent rationale is given.Narrative intentionlooks at the process of gathering new evidence on the area of expertise of the group and requires that the group position behind the statement is formed in good faith. The narrative constraint will help to distinguish group lies from more innocent erroneous statements of group beliefs when there is an internal disagreement within the group, including in cases involving spokespersons. (shrink)

If individual knowledge and justification can be vanquished by epistemic defeaters, then the same should go for group knowledge. Lackey (2014) has recently argued that one especially strong conception of group knowledge defended by Bird (2010) is incapable of preserving how it is that (group) knowledge is ever subject to ordinary mechanisms of epistemic defeat. Lackey takes it that her objections do not also apply to a more moderate articulation of group knowledge--one that is embraced widely (...) in collective epistemology--and which she does not challenge. This paper argues that given certain background premises that are embraced by orthodox thinking in collectivist epistemology, the more moderate account of group knowledge cannot make sense of either psychological or normative epistemic defeaters. I conclude by offering some suggestions for how the more moderate proposal might avoid this result. (shrink)

Group metacognition involves a collective understanding of cognitive processes and collaborative problem-solving mechanisms within a group. This study, conducted through a systematic review of 54 studies, aims to present the evolutionary trajectory of research on group metacognition in (predominantly) online and face-to-face learning environments. It explores the definitional shifts, methodological trends, and potential connections between the quality of collaboration and studies on group metacognition in online learning environments. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (...) (PRISMA) was used to report the study's results. In investigating determinants influencing group metacognition, the research examined the distribution of effective variables such as group size, composition, task complexity, and time constraints. This systematic review provides an overview of the evolutionary path for definitions of the group metacognition concept, accumulated methodological approaches, and key insights into studies that may be associated with group metacognition. Thus, it underscores the importance of customized interventions that appropriately consider variables that could affect group metacognition effectively. (shrink)

Group agents can act, and they can have knowledge. How should we understand the species of collective action which aims at knowledge? In this paper, I present an account of group inquiry. This account faces two challenges: to make sense of how large-scale distributed activities might be a kind of group action, and to make sense of the kind of division of labour involved in collective inquiry. In the first part of the paper, I argue that existing (...) accounts of group action face problems dealing with large-scale group actions, and propose a minimal alternative account. In the second part of the paper, I draw on an analogy between inquiry and conversation, arguing that work by Robert Stalnaker and Craige Roberts helps us to think about the division of labour. In the final part of the paper I put the accounts of group action and inquiry together, and consider how to think about group knowledge, deep ignorance, and the different kinds of division of labour. (shrink)

The aim of this exploratory paper is to review an under-appreciated parallel between group agency and artificial intelligence. As both phenomena involve non-human goal-directed agents that can make a difference to the social world, they raise some similar moral and regulatory challenges, which require us to rethink some of our anthropocentric moral assumptions. Are humans always responsible for those entities’ actions, or could the entities bear responsibility themselves? Could the entities engage in normative reasoning? Could they even have rights (...) and a moral status? I will tentatively defend the (increasingly widely held) view that, under certain conditions, artificial intelligent systems, like corporate entities, might qualify as responsible moral agents and as holders of limited rights and legal personhood. I will further suggest that regulators should permit the use of autonomous artificial systems in high-stakes settings only if they are engineered to function as moral (not just intentional) agents and/or there is some liability-transfer arrangement in place. I will finally raise the possibility that if artificial systems ever became phenomenally conscious, there might be a case for extending a stronger moral status to them, but argue that, as of now, this remains very hypothetical. (shrink)

Can groups really be agents or is group agency just a fiction? Christian List and Philip Pettit argue influentially for group-agent realism by showing how certain groups form and act on attitudes in ways they take to be unexplainable at the level of the individual agents constituting them. Group agency is therefore considered not a fiction or a metaphor but a reality we must account for in explanations of certain social phenomena. In this paper, I challenge this (...) defence of group-agent realism by showing how it is undermined by individual-level analysis of how individuals interact within groups. While group agency can be a useful fiction, real agents are at the individual level, not the collective level. (shrink)

Aggregating individuals’ consistent attitudes might produce inconsistent collective attitudes. Some groups therefore need the capacity to form attitudes that are irreducible to those of their members. Such groups, group-agent realists argue, are agents in control of their own attitude formation. In this paper, however, I show how group-agent realism overlooks the important fact that groups consist of strategically interacting agents. Only by eliminating group agency from our social explanations can we see how individuals vote strategically to gain (...) control of their groups and produce collective attitudes we cannot make sense of if we treat groups as agents. (shrink)

Discussions of group knowledge typically focus on whether a group’s knowledge that p reduces to group members’ knowledge that p. Drawing on the cumulative reading of collective knowledge ascriptions and considerations about the importance of the division of epistemic labour, I argue what I call the Fragmented Knowledge account, which allows for more complex relations between individual and collective knowledge. According to this account, a group can know an answer to a question in virtue of members (...) of the group knowing parts of that answer, when the whole answer is available to group-level action. I argue that this account explains a swathe of central cases of group knowledge, as well as explaining some central features of group knowledge. (shrink)

It is natural to think that social groups are concrete material particulars, but this view faces an important objection. Suppose the chess club and nature club have the same members. Intuitively, these are different clubs even though they have a common material basis. Some philosophers take these intuitions to show that the materialist view must be abandoned. I propose an alternative explanation. Social groups are concrete material particulars, but there is a psychological explanation of nonidentity intuitions. Social groups appear coincident (...) but nonidentical because they are perceived to be governed by conflicting social norms. (shrink)

Jennifer Lackey (2018) has developed an account of the primary form of group assertion, according to which groups assert when a suitably authorized spokesperson speaks for the group. In this paper I pose a challenge for Lackey's account, arguing that her account obscures the phenomenon of group silencing. This is because, in contrast to alternative approaches that view assertions (and speech acts generally) as social acts, Lackey's account implies that speakers can successfully assert regardless of how their (...) utterances are taken up by their audiences. What reflection on group silencing shows us, I argue, is that an adequate account of group assertion needs to find a place for audience uptake. (shrink)

An introductory text describing the author’s approach to epistemology in terms of self-referential argumentation and self-validating proofs. The text emphasizes a skill-based, rather than content-based, approach to the study of epistemology. The book is a simply stated, basic text whose purpose is to introduce students to the technical approach to epistemology developed by the author in other publications. ●●●●● -/- 2022 UPDATE: The approach of this book has been updated and developed further in the author’s 2021 book _Critique of Impure (...) Reason: Horizons of Possibility and Meaning_. The book is available both in a printed edition (under ISBN 978-0-578-88646-6 from Barnes & Noble, Amazon, and other booksellers) and an Open Access eBook edition (available through Philpapers under the book’s title and other philosophy online archives). (shrink)

In this chapter I identify three problems affecting the plausibility of group privacy and argue in favour of their resolution. The first problem concerns the nature of the groups in question. I shall argue that groups are neither discovered nor invented, but designed by the level of abstraction (LoA) at which a specific analysis of a social system is developed. Their design is therefore justified insofar as the purpose, guiding the choice of the LoA, is justified. This should remove (...) the objection that groups cannot have a right to privacy because groups are mere artefacts (there are no groups, only individuals) or that, even if there are groups, it is too difficult to deal with them. The second problem concerns the possibility of attributing rights to groups. I shall argue that the same logic of attribution of a right to individuals may be used to attribute a right to a group, provided one modifies the LoA and now treats the whole group itself as an individual. This should remove the objection that, even if groups exist and are manageable, they cannot be treated as holders of rights. The third problem concerns the possibility of attributing a right to privacy to groups. I shall argue that sometimes it is the group and only the group, not its members, that is correctly identified as the correct holder of a right to privacy. This should remove the objection that privacy, as a group right, is a right held not by a group as a group but rather by the group’s members severally. The solutions of the three problems supports the thesis that an interpretation of privacy in terms of a protection of the information that constitutes an individual—both in terms of a single person and in terms of a group—is better suited than other interpretations to make sense of group privacy. (shrink)

In his article Banicki proposes a universal model for all forms of philosophical therapy. He is guided by works of Martha Nussbaum, who in turn makes recourse to Aristotle. As compared to Nussbaum’s approach, Banicki’s model is more medical and less based on ethical argument. He mentions Foucault’s vision to apply the same theoretical analysis for the ailments of the body and the soul and to use the same kind of approach in treating and curing them. In his interpretation (...) of philosophical therapy, there are, however, some controversial issues, to which we would like to call attention: -/- Is restoring health by a philosophical method of treatment – health understood as a person’s ability to reach his/her vital goals – a convincing explication of philosophical therapy in general? In order to answer this question, it may be useful to look at Plato. It is not only Platonism (and especially Neo-platonism since Plotinus) that questions the idea that therapy is necessarily connected with „vital goals“. Buddhist and Gnostic philosophies are questioning „the vital“ in general. The immense effort in the history of philosophy to liberate the mind from the body casts doubt on the project to explain philosophical therapy solely in analogy to medical therapy. -/- According to Banicki a therapeutic philosophy has to identify the diseases it attempts at curing. There are, however, reasons for associating the term therapy with suffering/risk rather than disease. If a therapy aims at reducing the fear of death, as for example many classical philosophical therapies do, then there is no disease to be cured. A model based on chances and risks also has the advantage that the Buddhist and Stoic reinterpretation of desires/emotions as “diseases” can be dropped in contemporary philosophical therapy. -/- Banicki mentions the comparison of therapies as one of the primary goals of modelling. Methods should be verified by a statistical correlation between method and therapeutic success and/or by a theory which justifies the method. Some forms of therapies, however, avoid theory-specific terms and concepts in favor of an unprejudiced interpretation of the patient’s statements. Others share the (Nietzschean) aspiration to explore and change measures of value. If the therapeutic process is seen as a unique phenomenon, then there can be no theory and no statistics with co-occurrences. -/- According to Banicki philosophical therapy has to describe techniques which qualify as genuinely philosophical. Techniques like maieutics and hermeneutics, however, are antique philosophical “inventions”, which were later adopted by psychotherapy. If meditation is accepted as a therapeutic tool – as it was in ancient times – then there is not only a methodical but also an emotional relation to religion. If finally, the Socratic search for a good life is seen as one of the characteristics of philosophical therapy, then delimitation even turns into a criterion for non-philosophical therapies. The search for a good life requires an interdisciplinary approach. -/- For the concretization of the formal structure, we suggest a typology of therapies, which is based on chances and risks. Such a typology has the advantage, that it can model conflicting (and even opposing) forms of therapies. The variety of therapeutic goals and methods is a consequence of the historical development towards conceptual freedom. (shrink)

In this paper, we apply the perspective of intra-organismal ecology by investigating a family of ecological models suitable to describe a gene therapy to a particular metabolic disorder, the adenosine deaminase deficiency (ADA-SCID). The gene therapy is modeled as the prospective ecological invasion of an organ (here, bone marrow) by genetically modified stem cells, which then operate niche construction in the cellular environment by releasing an enzyme they synthesize. We show that depending on the chosen order (a choice (...) that cannot be made on \textit{a priori} assumptions), different kinds of dynamics are expected, possibly leading to different therapeutic strategies. This drives us to discuss several features of the extension of ecology to intra-organismal ecology. (shrink)

If a group is modelled as a single Bayesian agent, what should its beliefs be? I propose an axiomatic model that connects group beliefs to beliefs of group members, who are themselves modelled as Bayesian agents, possibly with different priors and different information. Group beliefs are proven to take a simple multiplicative form if people’s information is independent, and a more complex form if information overlaps arbitrarily. This shows that group beliefs can incorporate all information (...) spread over the individuals without the individuals having to communicate their (possibly complex and hard-to-describe) private information; communicating prior and posterior beliefs sufices. JEL classification: D70, D71.. (shrink)

Groups, like individuals, can communicate. They can issue statements, make promises, give advice. Sometimes, in doing so, they lie and deceive. The goal of this paper is to offer a precise characterisation of what it means for a group to make an assertion and to lie. I begin by showing that Lackey’s influential account of group assertion is unable to distinguish assertions from other speech acts, explicit statements from implicatures, and lying from misleading. I propose an alternative view, (...) according to which a group asserts a proposition only if it explicitly presents that proposition as true, thereby committing to its truth. This proposal is then put to work to define group lying. While scholars typically assume that group lying requires (i) a deceptive intent and (ii) a belief in the falsity of the asserted proposition, I offer a definition that drops condition (i) and significantly broadens condition (ii). (shrink)

In this chapter, a new type Hyper groups are defined, corresponding basic properties and examples for new type Hyper groups are given and proved. Moreover, new type Hypergroups groups and are compared to hyper groups and groups. New type Hyper groups are shown to have a more general structure according to Hyper groups and groups. Also, new type SuperHyper groups are defined, corresponding basic properties and examples for new type SuperHyper are given and proved. Furthermore, we defined neutro-new type SuperHyper (...) groups. (shrink)