Social media has transformed how individuals handle their illnesses. While many patients increasingly use these online platforms to understand embodied information surrounding their conditions, healthcare professionals often frame these practices as negative and do not consider the expertise that patients generate through social media. Through a combination of insights from social epistemology and ignorance studies, this paper problematizes the distinctive understandings of social media between patients and healthcare professionals from a different perspective. A total of four ideas are introduced: (1) (...) healthcare professionals see embodied knowledge that arises from patients’ social media practices as uncomfortable knowledge; (2) healthcare professionals engage in several behaviours to preserve their authority and power in front of embodied knowledge created through these online platforms; (3) failing to consider embodied knowledge can have consequences not only in terms of trust between patients and healthcare professionals but also in connection with epistemological populism and the transition towards patient-centred care; and (4) media and digital health literacy could help healthcare professionals enhance the uses of social media in healthcare. Adopting this framework allows not only to offer valuable insights into how healthcare professionals manage patients’ social media practices, but also opens new avenues to improve healthcare digitisation. (shrink)

This report describes a questionnaire-based study on 309 adult patients attending the Dental Outpatients Department of Bangladesh Medical College and Hospital, Dhaka during December 2000 to March 2001. The aim of the study was to determine the oral health knowledge of the patients in relation to their age, gender, economic and educational status. Almost two third (63.1%) of the subjects correctly said that pan chewing was bad for teeth. Three fourth (78.3%) of the subjects gave correct answer on (...) question of how to prevent teeth decay. When question was asked about cause of teeth decay, bleeding gum and action of fluoride on teeth, only 38.2%, 41.4% and 32.3% could give correct answer respectively. With a few exceptions, knowledge of oral health was comparatively poor among the older generation, females, less educated and less privileged group. (shrink)

In contemporary healthcare, medical image categorization is essential for illness prediction, diagnosis, and therapy planning. The emergence of digital imaging technology has led to a significant increase in research into the use of machine learning (ML) techniques for the categorization of images in medical data. We provide a thorough summary of recent developments in this area in this review, using knowledge from the most recent research and cutting-edge methods.We begin by discussing the unique challenges and opportunities associated (...) with medical image classification, including the complexity of anatomical structures, variability in imaging modalities, and the need for interpretability and reliability in clinical settings. Subsequently, we survey a wide range of ML algorithms and techniques employed for medical image classification, including traditional methods such as support vector machines and k-nearest neighbors, as well as deep learning approaches like convolutional neural networks (CNNs) and recurrent neural networks (RNNs). Furthermore, we examine key considerations in dataset preparation, feature extraction, and model evaluation specific to medical image classification tasks. We highlight the importance of large, annotated datasets, transfer learning, and data augmentation techniques in enhancing model performance and generalization. (shrink)

Abstract: Colon cancer is a prevalent and life-threatening disease, necessitating accurate and timely diagnosis for effective treatment and improved patient outcomes. This research paper presents the development of a knowledge-based system for diagnosing colon cancer using the CLIPS language. Knowledge-based systems offer the potential to assist healthcare professionals in making informed diagnoses by leveraging expert knowledge and reasoning mechanisms. The methodology involves acquiring and structuring medical knowledge specific to colon cancer, followed by the implementation of (...) a knowledge- based system using CLIPS. The system's design integrates relevant medical databases and employs advanced reasoning mechanisms to facilitate accurate diagnosis. Evaluation results demonstrate the system's effectiveness, with high accuracy and sensitivity rates compared to existing methods. The findings highlight the potential of knowledge-based systems in improving clinical practice and patient care. The research contributes to the growing field of medical informatics by demonstrating the feasibility and effectiveness of CLIPS-based knowledge systems for colon cancer diagnosis. Future research can focus on enhancing system performance and expanding its scope to encompass other types of cancer diagnoses. (shrink)

If medical complicity is understood as compliance with a directive to act against the professional's best medical judgment, the question arises whether it can ever be justified. This paper will trace the contours of what would legitimate a directive to act against a professional's best medical judgment (and in possible contravention of her oath) using Joseph Raz's service conception of authority. The service conception is useful for basing the legitimacy of authoritative directives on the ability of the (...) putative authority to enable subjects to comply better with reasons that already apply to them. Hence, the service conception bases the legitimacy of practical authority on a certain kind of greater knowledge or expertise. This helps to focus the conundrum regarding complicity on the clash of expertise between the medical expert and the governing body tasked with coordinating behaviour and otherwise devising rules for the social good. The ethical dilemma presented by a hypothetically legitimate directive to act against a professional's best medical judgment also serves to highlight the moral dimension of one's duty to obey a legitimate authority. (shrink)

The paper offers the concept of reversing the medical humanities. In agreement with the call from Kristeva et al. to recognise the bidirectionality of the medical humanities, I propose moving beyond debates of attitude and aptitude in the application and engagement (either friendly or critical) of humanities to/in medicine, by considering a reversal of the directions of epistemic movement (a reversal of the flow of knowledge). I situate my proposal within existing articulations of the field found in (...) the medical humanities meta-literature, pointing to a gap in the current terrain. I then develop the proposal by unfolding three reasons why we might gain something from exploring a reversed knowledge flow. First, a reversed knowledge flow seems to be an inherent—but still to be articulated—possibility in medical humanities and thus provides an opportunity for more knowledge. Second, the current unidirectionality of the field is founded on an inconsistency in the depiction of the connection between medicine and humanities, which risks creating the very divide that medical humanities set out to bridge. Practising a reversal may help avoid this divide. And third, a reversal might help rebalance the internal epistemic power, so as to motivate less external scepticism and in turn displace more external epistemic power towards medical humanities. I end the paper with a remark on precursors for a reversal, and ideas for where to go from here. (shrink)

The Knowledge Based System for Diagnosing Breast Cancer is used to assist medical students to improve their education on diagnosis and counseling the process of analyzing the biopsy image of the microscope, determining the type of tumor and the treatment method for each case and identifying the disease related questions. According to the Ministry of Health in its annual report in Gaza, between 2009 and 2014 there are 7069 cases of breast cancer, and in 2014 there are 1502 (...) cases of breast cancer . We are now in the age of visual information where 65% of the populations are visual learners; the Knowledge Based System is the easiest way to ensure students remember the information in the long term, using visual and textual information. The Knowledge Based System has an easy-to-use interface to help students diagnose the disease and enhance their information about the disease; the system can be used on smart phones. This Knowledge Based System can be divided into three main parts: The first part is specific questions for the patient, to help student to know questions type. The second part is the process of analyzing the biopsy sample image, to see if the biopsy image is intact or infected. The last part is the video shows ways to treat breast cancer in the form of animation. (shrink)

In medical settings, machines are in close proximity with human beings: with patients who are in vulnerable states of health, who have disabilities of various kinds, with the very young or very old, and with medical professionals. Machines in these contexts are undertaking important medical tasks that require emotional sensitivity, knowledge of medical codes, human dignity, and privacy. -/- As machine technology advances, ethical concerns become more urgent: should medical machines be programmed to follow (...) a code of medical ethics? What theory or theories should constrain medical machine conduct? What design features are required? Should machines share responsibility with humans for the ethical consequences of medical actions? How ought clinical relationships involving machines to be modeled? Is a capacity for empathy and emotion detection necessary? What about consciousness? -/- The essays in this collection by researchers from both humanities and science describe various theoretical and experimental approaches to adding medical ethics to a machine, what design features are necessary in order to achieve this, philosophical and practical questions concerning justice, rights, decision-making and responsibility, and accurately modeling essential physician-machine-patient relationships. -/- This collection is the first book to address these 21st-century concerns. (shrink)

Getting physical: Empiricism’s medical History Content Type Journal Article DOI 10.1007/s11016-010-9474-4 Authors John Gascoigne, School of History and Philosophy, University of New South Wales, Sydney, NSW 2056, Australia Journal Metascience Online ISSN 1467-9981 Print ISSN 0815-0796.

Medicine, like law, is a pragmatic, probabilistic activity. Both require that decisions be made on the basis of available evidence, within a limited time. In contrast to law, medicine, particularly evidence-based medicine as it is currently practiced, aspires to a scientific standard of proof, one that is more certain than the standards of proof courts apply in civil and criminal proceedings. But medicine, as Dr. William Osler put it, is an "art of probabilities," or at best, a "science of uncertainty." (...) One can better practice medicine by using other evidentiary standards in addition to the "scientific." To employ only the scientific standard of proof is inappropriate, if not impossible; furthermore, as this review will show, its application in medicine is fraught with bias. Evidence is information. It supports or undermines a proposition, whether a hypothesis in science, a diagnosis in medicine, or a fact or point in question in a legal investigation. In medicine, physicians marshal evidence to make decisions on how to best prevent, diagnose, and treat disease, and improve health. In law, courts decide the facts and render justice. Judges and juries assess evidence to establish liability, to settle custody and medical issues, and to determine a defendant's guilt or innocence. (shrink)

Abstract: The Knowledge-Based System for Diagnosing Breast Cancer aims to support medical students in enhancing their education regarding diagnosis and counseling. The system facilitates the analysis of biopsy images under a microscope, determination of tumor type, selection of appropriate treatment methods, and identification of disease-related questions. According to the Ministry of Health's annual report in Gaza, there were 7,069 cases of breast cancer between 2009 and 2014, with 1,502 cases reported in 2014. In an era dominated by visual (...) information, where 65% of the population are visual learners, the Knowledge-Based System serves as an effective tool to aid long-term information retention by utilizing visual and textual resources. The system features a user-friendly interface, enabling students to diagnose the disease and expand their understanding. Furthermore, it can be accessed via smartphones. The Knowledge-Based System comprises three primary components: Firstly, it provides specific patient-oriented questions to familiarize students with the questioning process. Secondly, it facilitates the analysis of biopsy sample images to determine their integrity and identify potential infections. Lastly, the system incorporates animated videos illustrating various approaches for treating breast cancer. (shrink)

Most people are completely oblivious to the danger that their medical data undergoes as soon as it goes out into the burgeoning world of big data. Medical data is financially valuable, and your sensitive data may be shared or sold by doctors, hospitals, clinical laboratories, and pharmacies—without your knowledge or consent. Medical data can also be found in your browsing history, the smartphone applications you use, data from wearables, your shopping list, and more. At best, data (...) about your health might end up in the hands of researchers on whose good will we depend to avoid abuses of power.2 Most likely, it will end up with data brokers who might sell it to a future employer, or an insurance company, or the government. At worst, your medical data may end up in the hands of criminals eager to commit extortion or identity theft. In addition to data harms related to exposure and discrimination, the collection of sensitive data by powerful corporations risks the creation of data monopolies that can dominate and condition access to health care. -/- This chapter aims to explore the challenge that big data brings to medical privacy. Section I offers a brief overview of the role of privacy in medical settings. I define privacy as having one’s personal information and one’s personal sensorial space (what I call autotopos) unaccessed. Section II discusses how the challenge of big data differs from other risks to medical privacy. Section III is about what can be done to minimise those risks. I argue that the most effective way of protecting people from suffering unfair medical consequences is by having a public universal healthcare system in which coverage is not influenced by personal data (e.g., genetic predisposition, exercise habits, eating habits, etc.). (shrink)

It is unknown to what extent medical researchers generalize study findings beyond their samples when their sample size, sample diversity, or knowledge of conditions that support external validity do not warrant it. It is also unknown to what extent medical researchers describe their results with precise quantifications or unquantified generalizations, i.e., generics, that can obscure variations between individuals. We therefore systematically reviewed all prospective studies (n = 533) published in the top four highest ranking medical journals, (...) Lancet, New England Journal of Medicine (NEJM), Journal of the American Medical Association (JAMA), and the British Medical Journal (BMJ), from January 2022 to May 2023. We additionally reviewed all NEJM Journal Watch clinical research summaries (n = 143) published during the same time. Of all research articles reporting prospective studies, 52.5% included generalizations beyond specific national study populations, with the numbers of articles with generics varying significantly between journals (JAMA = 12%; Lancet = 77%) (p < 0.001, V = 0.48). There was no evidence that articles containing broader generalizations or generics were correlated with larger or more nationally diverse samples. Moreover, only 10.2% of articles with generalizations beyond specific national populations reported external validity strengthening factors that could potentially support such extrapolations. There was no evidence that original research articles and NEJM Journal Watch summaries intended for practitioners differed in their use of broad generalizations, including generics. Finally, from the journal with the highest citation impact, articles containing broader conclusions were correlated with more citations. Since there was no evidence that studies with generalizations beyond specific national study populations or with generics were associated with larger, more nationally diverse samples, or with reports of population similarity that may permit extensions of conclusions, our findings suggest that the generalizations in many articles were insufficiently supported. Caution against overly broad generalizations in medical research is warranted. (shrink)

Despite the recent advances in information and communication technology that have increased our ability to store and circulate information, the task of ensuring that the right sorts of information gets to the right sorts of people remains. We argue that the many efforts underway to develop efficient means for sharing information across healthcare systems and organizations would benefit from a careful analysis of human action in healthcare organizations. This in turn requires that the management of information and knowledge within (...) healthcare organizations be combined with models of resources and processes of patient care that are based on a general ontology of social interaction. The Health Level 7 (HL7) is one of several ANSI-accredited Standards Developing Organizations operating in the healthcare arena. HL7 has advanced a widely used messaging standard that enables healthcare applications to exchange clinical and administrative data in digital form. HL7 focuses on the interface requirements of the entire healthcare system and not exclusively on the requirements of one area of healthcare such as pharmacy, medical devices, imaging or insurance transactions. This has inspired the development of a powerful abstract model of patient care called the Reference Information Model (RIM). The present paper begins with an overview of the core classes of the HL7 (Version 3) RIM and a brief discussion of its “actcentered” view of healthcare. Central to this account is what is called the life cycle of events. A clinical action may progress from defined, through planned and ordered, to executed. These modalities of an action are represented as the mood of the act. We then outline the basis of an ontology of organizations, starting from the theory of speech Acts, and apply this ontology to the HL7 RIM. Special attention is given to the sorts of preconditions that must be satisfied for the successful performance of a speech act and to the sorts of entities to which speech acts give rise (e.g. obligations, claims, commitments, etc.). Finally we draw conclusions for the efficient communication and management of medical information and knowledge within and between healthcare organizations, paying special attention to the role that medical documents play in such organizations. (shrink)

Creativity and innovation is very part of human nature (fitrah) which makes human beings different from other beings that are so far found on the planet. The outcome of creativity can be both harmful and beneficial. And most of it depends on the moral standing of those to whom end products of such creativity are available. Islam gives high importance to health and the Muslim civilization that flourished in Bagdad and Spain during the medieval period made original contributions to (...) class='Hi'>medical science. The contributions of the scholars of the age were led by religious ethics and spirit in pursuing, using, and creating knowledge. On the other hand, with the advent of modernity, science has received freedom to a greater extent to be ethics-free, neutral, and value- free. This approach has produced new important innovations in medical science and ways of their applications. Some of these innovations and their applications are beneficial and some others are beneficial too if guarded by appropriate ethics, yet some of the applications are questionable. After discussing the ethical repercussions of these innovations and applications, a general ethical framework on the subject is formulated on Islamic guidelines. (shrink)

In order to develop the ontology of tendencies for use in the representation of medical knowledge, tendencies are compared with other kinds of entities possessing the realizable-realization-structure, specifically: dispositions, propensities, abilities and virtues. The peculiarities of tendencies are discussed and a standard schema of tendency ascription is developed in order to represent the relations between the ascriptions of tendency tokens to particulars and the ascriptions of tendency types to universals. Two non-standard cases and their epistemic variants are discussed.

Background: Dengue Disease is a mosquito-borne tropical disease caused by the dengue virus, symptoms typically begin three to fourteen days after infection. This may include a high fever, headache, vomiting, muscle and joint pains, and a characteristic skin rash. Dengue serology is applied in different settings, such as for surveillance, in health care facilities in endemic areas and in travel clinics in non-endemic areas. The applicability and quality of serological tests in dengue endemic regions has to be judged against a (...) background of potential cross reactivity with other flavi-viruses, difficulties in distinguishing primary from secondary infections and technological problems related to the fact that most dengue endemic regions are relatively poor of resources .Objectives: to help doctors and patients in diagnosing Dengue Disease and give them the information of how to prevent Dengue Disease and to be able to understand the signs and symptoms of Dengue Disease. Methods: We collected all relevant material for Dengue Disease. Then we designed and implemented a knowledge based system for diagnosing Dengue Disease using SL5 Object Language. Results: The knowledge based system was evaluated by a group of Patients and specialized doctors and they found it very friendly and easy to use. (shrink)

Purpose: The objective of this study is to determine the importance of supplementary medical ethics course for resident physicians. In this study, we assessed the current state of their knowledge of medical ethics and aimed to improve and deepen their understanding of clinical scenarios to increase their awareness of the link between the practice of medicine and ethical issues. Methods: The course was held for groups of 10-12 people for 3 days a week for a total of (...) 6 hours. Tests given prior to and following completion of the course were used to assess the effectiveness of a medical ethics training course in which 120 resident physicians completed. The evaluation was made on the basis of the same pre-and post-tests (14 scenarios) and direct observation of participants. Result and Discussion: The average age was 28.23 ± 4.08 and 25% were female and 75% were male. Of the participants, 68.3% were training to be internists, 24.2% were training to be surgeons, and 7.5% were training in laboratory medicine. There was a significant statistical difference between the mean total scores of both tests (p=0.00). After completing the course, residents took into account the medical ethical principles while discussing ethical decisions. Conclusion: After finishing the course, participants defended their responses in regard to issues of medical ethics more carefully and articulated their thoughts more clearly. Our experience demonstrated that the trainees benefited from a structured curriculum in medical ethics. We believe that the development and implementation of our course may serve as a case study for training resident physicians in medical ethics. (shrink)

There is a middle ground of imperfect knowledge in fields like medicine and the social sciences. It stands between our day-to-day relatively certain knowledge obtained from ordinary basic observation of regularities in our world and our knowledge from well-validated theories in the physical sciences. -/- The latter enable reliable prediction a great deal of the time of the happening of events never before experienced. The former enable prediction only of what has happened before and beyond that of (...) educated guesses which may sometimes prove right and others not when we test them. -/- The imperfection of our knowledge between those limits is a consequence of complexity. -/- Reductionist empiricism fails when faced with complexity but we all still have to live in a complex world where reductionist science cannot help us devise reliable theories from which we can predict the behaviour of the world around us. We cannot predict reliably. We can only monitor actively and manage actively the world around us if we want to try to control our environment. We have a limited prediction horizon. -/- Science and empiricism work well if we want to send Voyager I and II over 3 billion miles away but not for most other things. -/- In medicine how and when to apply probabilistic, conjectural, incomplete medical theories and explanations requires professional expertise, intuition and judgement (non scientific knowledge) which is essential. Medical diagnosis is a skill of predicting from knowledge of what has happened before that the past will recur in the current patient applying expertise and intuition from knowledge and experience of prior cases and probabilistic medical research and theory. The physician is left to an educated guess as to how the future will develop for the particular individual patient the focus of his or her current attention. (shrink)

Prescription drug misuse has emerged as a significant problem over the past decade, particularly topical corticosteroids for skin lightening. This study aimed to assess the misuse of topical corticosteroids among the female population in southern Libya; to determine prevalence, awareness, attitude, and practice regarding this drug misuse. A descriptive, cross-sectional questionnaire was distributed on January 2022 to females aged between 16-45 years old in southern Libya. Out of 200 distributed questionnaires, 155 were returned with a response rate of 77.5%. The (...) majority of the participants were aged 16-25 years (n=138, 89.0%) and over two-thirds of participants, said they obtained lightening products containing cortisone from pharmacies (n=107, 69.0%) while 36 participants indicated they obtained these products from cosmetic shops (23.2%). More than three-quarters of the participants said they were aware that they should read product ingredients (n=120, 77.4%). Just over one-quarter of respondents indicated they used the product on their face almost daily (n=41, 26.5%) while 28 participants denied using it (18.1%). The most common source of information about topical corticosteroids among participants was the Internet (n=51, 32.9%), followed by dermatologists (n=41, 26.5%), and pharmacists (n=31, 20.0%). Almost half of respondents were aware that topical corticosteroids can cause harmful effects (n=75, 48.4%). The most common indications reported for using topical corticosteroids were whitening (23.3%), and acne treatment (54.2%). Over two-thirds of participants, declared they would not use topical lightening products if they contained corticosteroids (n=107, 69.0%). In a similar attitude, nearly a third of participants stated that they would never use corticosteroid medications again if they knew about the negative effects of whitening (n=51, 32.9%). The majority of females, (87.7%), concur that only pharmacies should be able to sell and prescribe topical corticosteroid medications. The study's findings indicate that topical corticosteroids are frequently misused and that to lessen contraindications, especially for prolonged use, it is imperative to provide basic care to females who continue using topical corticosteroids in public or unlicensed marketing settings. (shrink)

Abstract: This article explores the medical theories of the Dutch philosopher and physician Henricus Regius (1598-1679), who sought to provide clearer notions of medicine than the traditional theories of Jean Fernel, Daniel Sennert and Vopiscus Plempius. To achieve this, Regius overtly built upon the natural philosophy of René Descartes, in particular his theories of mechanical physiology and the corpuscular nature of matter. First, I show that Regius envisaged a novel partitioning of medicine, intended to make it independent in exposition (...) but conceptually grounded in natural philosophy. This served his overall purpose of making medicine a ‘clearer’ discipline. To this end Regius detaches the general notion of physiology as the study of the human body (which pertains to natural philosophy) from a medical physiology that concerns only health. Secondly, I show that Regius’s notions of health, disease, temperament and medicaments were the product of a Cartesian interpretation of traditional concepts, which was influenced by Santorio Santorio’s project of practicing medicine without occult elements. As a consequence, Regius’s classification of these notions is largely traditional. In conclusion, I show that Regius’s method of investigation in the area of natural philosophy consisted of a problem-solving procedure based on sensorial ideas. This approach can be traced back to Descartes, but was grounded on a purely empirical theory of knowledge, by which he rejected Descartes’s metaphysics. Regius’s order of exposition in natural philosophy and medicine, on the other hand, proceeds by definitions and divisions, and omits proofs. The reasons why Regius adopted this order were: 1) his rejection of Descartes’s metaphysical interpreta-tion of physics, and 2) his wish to emphasize the conceptual clarity and continuity of natural philosophy and medicine. (shrink)

Lung cancer is a serious and deadly disease that affects the lungs, which are responsible for taking in oxygen and expelling carbon dioxide from the body. The disease can develop in any part of the lungs and is usually caused by smoking or exposure to certain chemicals. The main Objective: of this expert system is to provide an accurate diagnosis of lung cancer and the appropriate treatment options. In this paper, Methods: we present the design and implementation of an expert (...) system that can assist physicians in diagnosing lung cancer and determining the best course of treatment. The system provides an overview of the disease, its causes, symptoms, diagnosis, and treatment, along with relevant medical information. Results: The system was developed using the Clips expert system language and evaluated by medical professionals who found it to be an effective tool for diagnosing and treating lung cancer. Conclusion: The proposed expert system has the potential to improve patient outcomes and reduce healthcare costs associated with the treatment of lung cancer. (shrink)

Some of the duties of individuals and organisations involve responsiveness to need. This requires knowledge of need, so the epistemology of need is relevant to practice. The prevailing contention among philosophers who have broached the topic is that one can know one’s own needs (as one can know some kinds of desires) by feeling them. The article argues against this view. The main positive claims made in the article are as follows. Knowledge of need, in both first‐person and (...) second‐person cases, is a type of knowledge‐that with no basic epistemological source. Needs, like medical conditions, have signs and symptoms. Knowledge of these, with inference, results in knowledge of need. Finally, it is argued that need is akin to, but not a special case of, metaphysical necessity de re. Some implications of this for the epistemology of need are explained. (shrink)

Background and Aim: Global trends and national policies have made internationalization and paying attention to the international markets of higher education inevitable on the one hand and becoming a legal requirement of Iranian medical sciences universities on the other hand. Therefore, the main goal of this article was to show, by examining the experience of international marketing of higher education in Tehran University of Medical Sciences, what are the futures of international marketing of higher education in medical (...) sciences? Materials and methods: in this documented data and the views, knowledge and lived experiences of the beneficiaries of the University of Medical Sciences were the basis of the study, and in the following, the methods of documentary studies, trend analysis, brainstorming, expert panel, theme analysis and scenario planning were used. Results: The most important achievement of this article is that among the challenges facing the international marketing of higher education in the University of Medical Sciences, two driving forces have the highest importance and uncertainty in shaping the future of this issue, including: sustainable security and cultural development. Conclusion: The normalization of political and economic relations with the world along with appropriate cultural development inside and outside the university and acceptance of cultural, racial, religious, intellectual, ethnic and gender differences strengthens the marketing process of higher education. In such a situation, the risk of investing in providing international higher education will be reduced. Therefore, the most expensive and the most important uncertainty facing the country's universities in international marketing is the attitude and approach of science and technology governance to the relations and structure governing the international system. (shrink)

The discipline of knowledge translation (KT) emerged as a way of systematically understanding and addressing the challenges of applying health and medical research in practice. In light of ongoing and emerging critique of KT from the medical humanities and social sciences disciplines, KT researchers have become increasingly aware of the complexity of the translational process, particularly the significance of culture, tradition and values in how scientific evidence is understood and received, and thus increasingly receptive to pluralistic notions (...) of knowledge. Hence, there is now an emerging view of KT as a highly complex, dynamic, and integrated sociological phenomenon, which neither assumes nor creates knowledge hierarchies and neither prescribes nor privileges scientific evidence. Such a view, however, does not guarantee that scientific evidence will be applied in practice and thus poses a significant dilemma for KT regarding its status as a scientific and practice-oriented discipline, particularly within the current sociopolitical climate. Therefore, in response to the ongoing and emerging critique of KT, we argue that KT must provide scope for relevant scientific evidence to occupy an appropriate position of epistemic primacy in public discourse. Such a view is not intended to uphold the privileged status of science nor affirm the “scientific logos” per se. It is proffered as a counterbalance to powerful social, cultural, political and market forces that are able to challenge scientific evidence and promote disinformation to the detriment of democratic outcomes and the public good. (shrink)

A newborn baby is an infant within the first 28 days of birth. Diagnosis and treatment of infant diseases require specialized medical resources and expert knowledge. However, there is a shortage of such professionals globally, particularly in low-income countries. To address this challenge, a knowledge-based system was designed to aid in the diagnosis and treatment of neonatal diseases. The system utilizes both machine learning and health expert knowledge, and a hybrid data mining process model was used (...) to extract knowledge from a clinical dataset. The PART algorithm achieved the highest performance result with 98.06% accuracy under 10-fold cross-validation, and the generated rules were used to develop the knowledge-based system. The system achieved 90.9% accuracy in system performance testing and 89.2% in user acceptance testing, and is intended to serve as an assistant tool for healthcare experts. (shrink)

Diagnosing flatulence involves a thorough assessment of an individual's symptoms, medical history, and, if necessary, the use of diagnostic tests. Healthcare providers gather information about the patient's medical background and conduct a physical examination to identify any signs of gastrointestinal issues. Dietary habits are evaluated, and potential triggers are identified through an elimination diet. Diagnostic tests such as breath tests, stool analysis, or imaging studies may be performed to further investigate the underlying causes of excessive flatulence. Accurate diagnosis (...) is crucial for effective management and treatment of flatulence, enabling individuals to gain control over their symptoms and address any underlying conditions. (shrink)

Introduction: The purpose of this study was to assess dental care professionals' drug prescription knowledge, practices, and reporting of adverse drug reactions (ADRs). -/- Methods: A cross-sectional exploratory study was conducted by using a face-to-face survey administered to a sample of dentists from tertiary care hospitals in Adana, Türkiye. A questionnaire consisted of six sections with closed-ended items including sociodemographic characteristics, knowledge about drugs, patient history information, counseling practices during prescribing, source of information and ADR reporting. -/- Results: (...) The study included 180 dentists, with a 95.3% response rate. More than half of the dentists (50.6%) stated their level of knowledge about drug price/cost as low. Most of the dentists (50.6%;n=91) claimed that they never/rarely asked about health insurance during patient history information. Moreover, most of the participants reported that they never/rarely and sometimes counsel the patients regarding drug mechanism of action, side effects of the drug, interaction of prescribed drug with other drugs/nutrients. It was determined that the dentists learned about the drugs from Vademecum (Turkish Medication Guidebook: 70%;n=126) and the internet (55%;n=99). A higher proportion (85.5%) of the dentists indicated that they did not report ADR during their clinical practice. -/- Conclusion: This study showed a general improvement in dentists prescribing knowledge and practices, although they reported some lack of knowledge regarding drug cost, discussion about the possible side effect of a drug/interaction with other drugs/nutrients with patients and under-reporting of ADRs. Periodic education and training for dentists are critical to overcoming any problem related to prescribing errors and potential ADRs. (shrink)

Bradford Hill (1965) highlighted nine aspects of the complex evidential situation a medical researcher faces when determining whether a causal relation exists between a disease and various conditions associated with it. These aspects are widely cited in the literature on epidemiological inference as justifying an inference to a causal claim, but the epistemological basis of the Hill aspects is not understood. We offer an explanatory coherentist interpretation, explicated by Thagard's ECHO model of explanatory coherence. The ECHO model captures the (...) complexity of epidemiological inference and provides a tractable model for inferring disease causation. We apply this model to three cases: the inference of a causal connection between the Zika virus and birth defects, the classic inference that smoking causes cancer, and John Snow’s inference about the cause of cholera. (shrink)

In recent years, the opioid crisis in the United States has sparked significant discussion on doctor–patient interactions concerning chronic pain treatments, but little to no attention has been given to investigating the vocal aspects of patient talk. This exploratory sociolinguistic study intends to fill this knowledge gap by employing prosodic discourse analysis to examine context-specific linguistic features used by the interlocutors of two distinct medical interactions. We found that patients employed both low pitch and creak as linguistic resources (...) when describing chronic pain, narrating symptoms and requesting opioids. The situational use of both features informs us about the linguistic ways in which patients frame fraught issues like chronic pain in light of the current opioid crisis. This study expands the breadth of phonetic analysis within the domain of discourse analysis, serving to illuminate discussions surrounding the illocutionary role of the lower vocal tract in expressing emotions. (shrink)

Objective: Long-term C-arm fluoroscopy exposes medical personnel to substantial radiation doses. Preventing this exposure requires protective equipment and radiation safety. This study examined anesthesia students' using fluoroscopy and preventive knowledge. -/- Methods: This descriptive and cross-sectional study included 139 Vocational High School Anesthesia students. The "Healthcare Professional Knowledge of Radiation Protection" scale and a 13-question survey collected data. The scale was designed with a Likert scale and three sub-factors. If the total and sub-dimension item average score of (...) the scale is below 5, it indicates that the level of knowledge of radiation protection among medical personnel is low, and if it is above 5, it indicates that the level of knowledge is high. -/- Results: More than half of the students (59.8%) heard the radiation from the fluoroscopy device, the vast majority (82.7%) did not receive radiation protection training, 58.3% stayed away from the device while it was operating, and 70.5% stated that it is crucial to stay away from the device while it was operating. It was determined that there was a statistically significant difference (p<0.05) in the "Radiation Physics, Biology, and Radiation Usage Principles" sub-dimension of students who were male, in their second year of education, received radiation protection training, and offered reliable answers to a number of questions measuring their level of radiation knowledge. In addition, the research revealed a positive and highly significant correlation between the scale and its subdimensions. -/- Conclusion: Although the scale scores of the students who received radiation protection training and had a high level of radiation knowledge were substantially higher than those of the other students, the average score of the students was less than 5. This indicates that students have an inadequate understanding of radiation protection. To prevent the negative biological effects of radiation on the human body, it is necessary to conduct epidemiological research, educate health care professionals and anesthesiology students about the effects and processes of this radiation on human cells, and provide frequent training. Radiation, radiation's biological effects, and radiation protection should be included in health students' curricula. (shrink)

In this paper I describe a novel application of contemplative techniques to software engineering with the goal of augmenting the intellectual capabilities of knowledge workers within the field in four areas: flexibility, attention, creativity, and trust. The augmentation of software engineers’ intellectual capabilities is proposed as a third complement to the traditional focus of methodologies on the process and environmental factors of the software development endeavor. I argue that these capabilities have been shown to be open to improvement through (...) the practices traditionally used in spiritual traditions, but now used increasingly in other fields of knowledge work, such as in the medical profession and the education field. Historically, the intellectual capabilities of software engineers have been treated as a given within any particular software development effort. This is argued to be an aspect ripe for inclusion within software development methodologies. (shrink)

Education on authorship was delivered and evaluated by pre test and post test questionnairen on 30 post graduate medical students at the Department of Anestheology, Dhaka Medical College, Bangladesh between January and June 2019 to understand the knowledge, skill and attitude of post graduate medical students on authorship. Result: Before intervention, majority (60%) of the students felt that who perform the research work should be the author of the article. But 40% students were divided and felt (...) that who advised the design of the research (20%), who provided the grants (10%) and Chief/Head of the division (10%) should be the author of the article respectively. Maximum (70%) respondents did not know the order of authorship. Of 40% respondent felt that the PI should be always the first author and 40% don’t know the answer. Half of the students (50%) felt that keeping honorary author increased the opportunity of acceptance of publication. Of 36.7% and 13.3% of students felt that keeping honorary author increased the article’s value and made good relation to them to get some extra facility from them respectively. Of 20% participants were pressurized by lab head/head of department for inclusion of their name as an author. Half of the (56.7 %) respondents felt that the author’s contribution should be stated in the article. Only few 4 (13.3%) respondents said that their institute had guideline for authorship. However, after education 100% of students felt that who perform the research work should be only the author of the article. All (100%) respondents understood the order of authorship. Most of the students (86%) felt that PI should be always the first author. Of 100% respondent felt supervisor of the research should be the last author. All students (100%) felt author’s contribution should be mentioned in the article. All (100%) students did not want to include as author those who help in research design and secured grant; and they did not like to keep honorary author in their article. All (100%) students expressed that their institute had no guideline for authorship. After intervention, three groups of students were asked to write one page of article on Anesthesiology. Interestingly, they did not include any name in the author by line who were not participate or had any contribution in the writing. Conclusion: The comparative data between pre- and post-text have highlighted a general lack of understanding of the basic concept of authorship ethics which significantly improved after the intervention. The results also indicate that the education on authorship improved the awareness of postgraduate medical students in a particular centre. (shrink)

Williams Syndrome provides a striking test case for discourses on disability, because the characteristics associated with Williams Syndrome involve a combination of “abilities” and “disabilities”. For example, Williams Syndrome is associated with disabilities in mathematics and spatial cognition. However, Williams Syndrome individuals also tend to have a unique strength in their expressive language skills, and are socially outgoing and unselfconscious when meeting new people. Children with Williams are said to be typically unafraid of strangers and show a greater interest in (...) contact with adults than with their peers. This apparently keen social knowledge is a counterexample to the discussion of disability among academic philosophers, especially philosophers of the early modern period. Locke infamously used the example of disability to claim that Descartes’ arguments in favor of innate ideas were incorrect. On the contrary, Williams Syndrome may stand as an example of innate social knowledge; something that could benefit current discourse in philosophy, disability theory, and medical ethics. (shrink)

I shall argue that where a coercive public health policy is backed by a clear medical consensus, appropriately reconsidered in the light of claims of doubters, there is sometimes a moral obligation on the part of the public to defer to the experts. The argument will be geared to the continuing controversy in the UK over the safety of the measles/mumps/rubella (MMR) vaccine. vaccine.

A cross-sectional, descriptive study was done at a rural high school in Zakiganj Upazila of Sylhet District, Bangladesh, between January and December of 2014, to determine knowledge and practice of oral health and hygiene and oral health status among school going adolescents. Students from three classes: class VIII, IX and X, and aged 12-16 years were taken for the study. Study samples were collected by using simple random sampling technique. A total of 90 students were divided into two age (...) groups: 12-14 years and 15-16 years. A pre-designed, self-administered questionnaire was used for demographic survey and knowledge of oral health and hygiene (a 10-point questionnaire) and practice (a 7-point questionnaire). Then a plane mouth mirror and periodontal probe was used for examining oral health status in those school children. Oral hygiene status was measured by simplified Green and Vermillion Oral Hygiene Index. The mean age of the respondents was 14.37±0.50 years. Females were 68 (75.6%) and males were 22 (24.4%). 31 (34.4%) were from class VIII, 30 (33.3%) from class IX and 29 (32.2%) were from class X. 33.3% of the respondents have scored below the mean of the total knowledge score while 66.7% has scored above the mean (6.86±2.05). Pearson’s correlation coefficient (+0.342) revealed that an increase in knowledge score would lead to increase in practice score. The younger group had higher mean knowledge score than older group (7.15+1.35 vs. 6.58+2.54; P=0.017); however, no significant difference was found between males and females (6.90±1.74 vs. 6.85±2.15; P=0.432). There was no significant difference in Debris Index (DI), Calculous Index (CI) and Oral Health Index (OHI) scores in between age groups and genders. On educational status, significant difference was observed only in OHI score (P=0.001) among those three classes of students. Overall, only 31% had good oral hygiene, while 59% respondents had fair and 10% had poor oral hygiene status. (shrink)

The Significant Interest view entails that even if there were no medical reasons to have access to genetic knowledge, there would still be reason for prospective parents to use an identity-release donor as opposed to an anonymous donor. This view does not depend on either the idea that genetic knowledge is profoundly prudentially important or that donor-conceived people have a right to genetic knowledge. Rather, it turns on general claims about parents’ obligations to help promote their (...) children’s well-being and the connection between a person’s well-being and the satisfaction of what I call their “worthwhile significant subjective interests.” To put this view simply, the fact that a donor-conceived person—who knows she is donor-conceived—is likely to be very interested in acquiring genetic knowledge gives prospective parents a weighty reason to use an identity-release donor. This is because parents should promote their children’s well-being through the satisfaction of their children’s worthwhile significant interests. (shrink)

A diagnosis based exclusively on the so-called scientifi c evidence does not take into account the problem of the theoryladenness, widely debated in Twentieth Century epistemology. The theory of knowledge developed by Ludwik Fleck, physician and philosopher active in the 30s, can still be useful for shedding light on how psychiatric diagnoses are infl uenced by a specifi c thought style that directs the observations and affects the development of knowledge and the formation of connections between concepts.

This paper explores how a set of observations on the weight of lead were interpreted and assessed between the 1540s and the 1630s across three different interconnecting disciplines: medicine, mineralogy and chemistry. The epistemic import of these discussions will be demonstrated by showing: 1) the changing role and articulation of experience and quantification in the investigation of metals; and 2) the notions associated with weight in different disciplinary frameworks. In medicine and mineralogy, weight was not considered as a specific subject (...) of inquiry in itself, but as a “sign” indicating other relevant properties of metals. In contrast, the chemistry tradition was increasingly concerned with the specific investigation of weight as a property of matter, as seen in the debates that took place in the “chemical revolution.” In addition, this study will reveal the versatility, polysemy, and parallel purposes of the recourse to experiential knowledge in different contexts, where the same “facts” operate within different disciplines. (shrink)

The central hypothesis of the collaboration between Language and Computing (L&C) and the Institute for Formal Ontology and Medical Information Science (IFOMIS) is that the methodology and conceptual rigor of a philosophically inspired formal ontology will greatly benefit software application ontologies. To this end LinKBase®, L&C’s ontology, which is designed to integrate and reason across various external databases simultaneously, has been submitted to the conceptual demands of IFOMIS’s Basic Formal Ontology (BFO). With this, we aim to move beyond the (...) level of controlled vocabularies to yield an ontology with the ability to support reasoning applications. (shrink)

"When we imagine the future of reproductive technology, it is usually a future of more and more choice. A future where it is increasingly possible to exorcise yourself from many of the risks that have thus far been inextricable from the process of bringing someone into being. In a way, I felt as if I were living involuntarily within this future. But it was a half-formed, incomplete future, where I was left terrified in a range of new ways, but not (...) quite protected. A time on the brink of knowledge, but without knowledge.". (shrink)

Synthetic biologists aim to generate biological organisms according to rational design principles. Their work may have many beneficial applications, but it also raises potentially serious ethical concerns. In this article, we consider what attention the discipline demands from bioethicists. We argue that the most important issue for ethicists to examine is the risk that knowledge from synthetic biology will be misused, for example, in biological terrorism or warfare. To adequately address this concern, bioethics will need to broaden its scope, (...) contemplating not just the means by which scientific knowledge is produced, but also what kinds of knowledge should be sought and disseminated. (shrink)

Rationale, aims, and objectives: One of the sectors challenged by the COVID-19 pandemic is medical research. COVID-19 originates from a novel coronavirus (SARSCoV- 2) and the scientific community is faced with the daunting task of creating a novel model for this pandemic or, in other words, creating novel science. This paper is the first part of a series of two papers that explore the intricate relationship between the different challenges that have hindered biomedical research and the generation of scientific (...) knowledge during the COVID-19 pandemic. Methods: During the early stages of the pandemic, research conducted on hydroxychloroquine (HCQ) was chaotic and sparked several heated debates with respect to the scientific methods used and the quality of knowledge generated. Research on HCQ is used as a case study in both papers. The authors explored biomedical databases, peer-reviewed journals, pre-print servers, and media articles to identify relevant literature on HCQ and COVID-19, and examined philosophical perspectives on medical research in the context of this pandemic and previous global health challenges. Results: This paper demonstrates that a lack of prioritization among research questions and therapeutics was responsible for the duplication of clinical trials and the dispersion of precious resources. Study designs, aimed at minimising biases and increasing objectivity, were, instead, the subject of fruitless oppositions. The duplication of research works, combined with poor-quality research, has greatly contributed to slowing down the creation of novel scientific knowledge. Conclusions: The COVID-19 pandemic presented challenges in terms of (1) finding and prioritising relevant research questions and (2) choosing study designs that are appropriate for a time of emergency. (shrink)

Rationale, aims and objectives: The COVID-19 pandemic has impacted every facet of society, including medical research. This paper is the second part of a series of articles that explore the intricate relationship between the different challenges that have hindered biomedical research and the generation of novel scientific knowledge during the COVID-19 pandemic. In the first part of this series, we demonstrated that, in the context of COVID-19, the scientific community has been faced with numerous challenges with respect to (...) (1) finding and prioritizing relevant research questions and (2) choosing study designs that are appropriate for a time of emergency. Methods: During the early stages of the pandemic, research conducted on hydroxychloroquine (HCQ) sparked several heated debates with respect to the scientific methods used and the quality of knowledge generated. Research on HCQ is used as a case study in both papers. The authors explored biomedical databases, peerreviewed journals, pre-print servers and media articles to identify relevant literature on HCQ and COVID-19, and examined philosophical perspectives on medical research in the context of this pandemic and previous global health challenges. Results: This second paper demonstrates that a lack of research prioritization and methodological rigour resulted in the generation of fleeting and inconsistent evidence that complicated the development of public health guidelines. The reporting of scientific findings to the scientific community and general public highlighted the difficulty of finding a balance between accuracy and speed. Conclusions: The COVID-19 pandemic presented challenges in terms of (3) evaluating evidence for the purpose of making evidence-based decisions and (4) sharing scientific findings with the rest of the scientific community. This second paper demonstrates that the four challenges outlined in the first and second papers have often compounded each other and have contributed to slowing down the creation of novel scientific knowledge during the COVID-19 pandemic. (shrink)

ABSTRACT: Abstract Most modern knowledge is not science. The physical sciences have successfully validated theories to infer they can be used universally to predict in previously unexperienced circumstances. According to the conventional conception of science such inferences are falsified by a single irregular outcome. And verification is by the scientific method which requires strict regularity of outcome and establishes cause and effect. -/- Medicine, medical research and many “soft” sciences are concerned with individual people in complex heterogeneous populations. (...) These populations cannot be tested to demonstrate strict regularity of outcome in every individual. Neither randomised controlled trials nor observational studies in medicine are science in the conventional conception. Establishing and using medical and other “soft science” theories cannot be scientific. It requires conceptually different means: requiring expert judgement applying all available evidence in the relevant available factual matrix. -/- The practice of medicine is observational. Prediction of outcomes for the individual requires professional expertise applying available medical knowledge and evidence. Expertise in any profession can only be acquired through experience. Prior cases are the fundament of knowledge and expertise in medicine. Case histories, studies and series can provide knowledge of extremely high reliability applicable to establishing reliable general theories and falsifying others. Their collation, study and analysis should be a priority in medicine. Their devaluation as evidence, the failure to apply their lessons, the devaluation of expert professional judgement and the attempt to emulate the scientific method are all historic errors in the theory and practice of modern medicine. (shrink)

Our present day knowledge in the area of medicine in Ancient Egypt has been severally sourced from medical papyri several of which have been deduced and analyzed by different scholars. For educational purposes it is always imperative to consult different literature or sources in the teaching of ancient Egypt and medicine in particular. To avoid subjectivity the author has found the need to re-engage the efforts made by several scholars in adducing evidences from medical papyri. In the (...) quest to re-engage the efforts of earlier writers and commentaries on the medical papyri, we are afforded the opportunity to be informed about the need to ask further questions to enable us to construct or reconstruct both past and modern views on ancient Egyptian medical knowledge. It is this vocation the author sought to pursue in the interim, through a preliminary review, to highlight, comment and reinvigorate in the reader or researcher the need for a continuous engagement of some pertinent documentary sources on Ancient Egyptian medical knowledge for educational and research purposes. The study is based on qualitative review of published literature. The selection of those articles as sources was based on the focus of the review, in order to purposively select and comment on articles that were published based either on information from a medical papyrus or focused on medical specialization among the ancient Egyptians as well as ancient Egyptian knowledge on diseases and medicine. It was found that the Egyptians developed relatively sophisticated medical practices covering significant medical fields such as herbal medicine, gynecology and obstetrics, anatomy and physiology, mummification and even the preliminary form of surgery. These practices, perhaps, were developed as remedies for the prevailing diseases and the accidents that might have occurred during the construction of their giant pyramids. It must be stated that they were not without flaws. Also, the key issues raised from these literatures are but a few among the Egyptian medical corpus across the academic and publishing world. It should therefore afford researchers, students and readers the opportunity to continue the educational dialogue on the medical practices of the Ancient Egyptians. (shrink)

Advanced medical imaging, such as CT, fMRI and PET, has undergone enormous progress in recent years, both in accuracy and utilization. Such techniques often bring with them an illusion of immediacy, the idea that the body and its diseases can be directly inspected. In this paper we target this illusion and address the issue of the reliability of advanced imaging tests as knowledge procedures, taking positron emission tomography in oncology as paradigmatic case study. After individuating a suitable notion (...) of reliability, we argue that PET is a highly theory-laden and non-immediate knowledge procedure, in spite of the photographic-like quality of the images it delivers; the diagnostic conclusions based on the interpretation of PET images are population-dependent; PET images require interpretation, which is inherently observer-dependent and therefore variable. We conclude with a three-step methodological proposal for enhancing the reliability of advanced medical imaging. (shrink)

This abstract is a synopsis of the paper "An Expert System for Diagnosing Whooping Cough Using CLIPS." The bacterium Bordetella pertussis causes whooping cough, a highly infectious respiratory ailment with several phases of symptoms. An accurate and timely diagnosis is critical for effective treatment and the avoidance of future transmission. The construction of an expert system for detecting whooping cough using the CLIPS (C Language Integrated Production System) architecture is highlighted in this abstract. The expert system provides standardized and systematic (...) evaluation, which reduces the chance of misdiagnosis and improves patient outcomes. Maintenance and upgrades are required to keep the system current with growing medical knowledge. More study in this area has the potential to advance expert systems in identifying and managing a variety of medical disorders. (shrink)

The UN Convention against Torture defines torture as “any act by which severe pain or suffering, whether physical or mental, is intentionally inflicted on a person” by someone acting in an official capacity for purposes such as obtaining a confession or punishing or intimidating that person.1 It is unethical for healthcare professionals to participate in torture, including any use of medical knowledge or skill to facilitate torture or allow it to continue, or to be present during torture.2-7 Yet (...) medical participation in torture has taken place throughout the world and was a prominent feature of the US interrogation practice in military and Central Intelligence Agency (CIA) detention facilities in the years after the attacks of 11 September 2001.8-11 Little attention has been paid, however, to how a regime of torture affects the ability of health professionals to meet their obligations regarding routine clinical care for detainees. -/- The 2016 release of previously classified portions of guideline from the CIA regarding medical practice in its secret detention facilities sheds light on that question. These show that the CIA instructed healthcare professions to subordinate their fundamental ethical obligations regarding professional standards of care to further the objectives of the torturers. (shrink)