scholarly journals Medicine, Court and Logical Sense

2020 ◽  
Vol 2 (3) ◽  
pp. 56-57
Author(s):  
Buttigieg GG ◽  
Stafrace KM

In teaching the rudiments of the 1957 Bolam test as ‘reined’ in by the Bolitho principle, it is invariable for at least one student to ask “is it not obvious that explanations must make logical sense to the Court?” Which invariably raises the point in my mind, “The question should be: The Bolitho principle demands that Bolam oriented statements makes logical sense to whom? Is it to the Court? Is it to any independent observer?”

Sci ◽  
2020 ◽  
Vol 2 (3) ◽  
pp. 73
Author(s):  
Prasanta S. Bandyopadhyay ◽  
Nolan Grunska ◽  
Don Dcruz ◽  
Mark C. Greenwood

We address the need for a model by considering two competing theories regarding the origin of life: (i) the Metabolism First theory and (ii) the RNA World theory. We discuss two inter-related points. (I) Models are valuable tools in understanding both the processes and intricacies of the origin of life issues. (II) Insights from models also help us to evaluate the core objection to origin of life theories called “the inefficiency objection” commonly raised by proponents of both the Metabolism First theory and the RNA World theory against each other. We use Simpson’s paradox as a tool for challenging this objection. We will use models in various senses ranging from taking them as representations of reality to treating them as theories/accounts that provide heuristics for probing reality. In this paper, we will frequently use models and theories interchangeably. Additionally, we investigate Conway’s Game of Life and contrast it with our Simpson’s Paradox (SP)-based approach to emergence of life issues. Finally, we discuss some of the consequences of our view. A scientific model is testable in three senses: (i) a logical sense, (ii) a nomological sense, and (iii) a current technological sense. The SP-based model is testable in the logical sense. It is also testable nomologically. However, it is not currently feasible to test it.


2021 ◽  
Vol 5 (1) ◽  
pp. 1-20
Author(s):  
Isabelle Bloch

Abstract In many domains of information processing, such as knowledge representation, preference modeling, argumentation, multi-criteria decision analysis, spatial reasoning, both vagueness, or imprecision, and bipolarity, encompassing positive and negative parts of information, are core features of the information to be modeled and processed. This led to the development of the concept of bipolar fuzzy sets, and of associated models and tools, such as fusion and aggregation, similarity and distances, mathematical morphology. Here we propose to extend these tools by defining algebraic and topological relations between bipolar fuzzy sets, including intersection, inclusion, adjacency and RCC relations widely used in mereotopology, based on bipolar connectives (in a logical sense) and on mathematical morphology operators. These definitions are shown to have the desired properties and to be consistent with existing definitions on sets and fuzzy sets, while providing an additional bipolar feature. The proposed relations can be used for instance for preference modeling or spatial reasoning. They apply more generally to any type of functions taking values in a poset or a complete lattice, such as L-fuzzy sets.


2017 ◽  
Vol 38 (12) ◽  
pp. 1430-1434 ◽  
Author(s):  
Axel Kramer ◽  
Didier Pittet ◽  
Romana Klasinc ◽  
Stefan Krebs ◽  
Torsten Koburger ◽  
...  

BACKGROUNDFor alcohol-based hand rubs, the currently recommended application time of 30 seconds is longer than the actual time spent in clinical practice. We investigated whether a shorter application time of 15 seconds is microbiologically safe in neonatal intensive care and may positively influence compliance with the frequency of hand antisepsis actions.METHODSWe conducted in vitro experiments to determine the antimicrobial efficacy of hand rubs within 15 seconds, followed by clinical observations to assess the effect of a shortened hand antisepsis procedure under clinical conditions in a neonatal intensive care unit (NICU). An independent observer monitored the frequency of hand antisepsis actions during shifts.RESULTSAll tested hand rubs fulfilled the requirement of equal or even significantly higher efficacy within 15 seconds when compared to a reference alcohol propan-2-ol 60% (v/v) within 30 seconds. Microbiologically, reducing the application time to 15 seconds had a similar effect when compared to 30-second hand rubbing, but it resulted in significantly increased frequency of hand antisepsis actions (7.9±4.3 per hour vs 5.8±2.9 per hour; P=.05).CONCLUSIONTime pressure and workload are recognized barriers to compliance. Therefore, reducing the recommended time for hand antisepsis actions, using tested and well-evaluated hand rub formulations, may improve hand hygiene compliance in clinical practice.Infect Control Hosp Epidemiol 2017;38:1430–1434


2021 ◽  
Vol 9 (2_suppl) ◽  
pp. 2325967121S0000
Author(s):  
Alex Laedermann ◽  
Fayssal Kadri ◽  
Alec Cikes

Objectives: Exercises performed in water have shown to improve strength and range of motion in various joint pathologies. This study aims to identify the best rehabilitation protocol for patients who undergo arthroscopic rotator cuff repair, and the effectiveness of a pool therapy protocol. Methods: Patients who underwent arthroscopic rotator cuff repair for small to medium sized rotator cuff tears, with small to moderate retraction of the affected tendon and who underwent surgery between 2013 and 2016, were randomized in 3 different groups at the time of surgical indication. Groups: 1. Patients who had rehabilitation with physical therapy and no aquatic protocol; The "Dry group", 2. Patients who had rehabilitation with physical therapy, including an aquatic protocol; The "Pool Group", 3. Patients who had self-rehabilitation alone, with no physical therapist. The "Self Group" follow-up: all patients were assessed by an independent observer. The mean outcome measures consisted of pre and postoperative SSV, Constant score, and patient satisfaction. Patients were followed-up at 4, 8 and 12 weeks postoperatively, as well as in 1 and 2 years. Results: Group 1 (Dry group) and Group 2 (Pool group) showed better Constant scores 2 months postoperatively, although this was not statistically significant. However, patients in group 2 (Pool group) showed statistically better Constant scores and overall satisfaction 3 months postoperatively. All the groups had similar results 6 months, 1 year and 2 years postoperatively, with slightly better outcomes for the Dry and Pool groups compared to the Self group. Conclusion: Water therapy after rotator cuff repair provides better early results compared to traditional "dry" rehabilitation or self-exercise therapy. The results remain better for patients who had pool or dry rehabilitation 1 and 2 years postoperatively, although the difference is not statistically significant in the long term.


2018 ◽  
Vol 32 (4) ◽  
pp. 227-240
Author(s):  
Daniel M. Bernhofen ◽  
John C. Brown

Last year marked the 200th anniversary of Ricardo’s famous “four numbers” paragraph on comparative advantage, which is one of the oldest analytical results in economics. Following the lead of James Mill (1821), these four numbers have been interpreted as unit labor coefficients. This interpretation has provided the basis for the development of the ‘Ricardian model’ from John Stuart Mill (1852) to Eaton and Kortum (2002). However, if we accept the labor unit interpretation of these numbers, Ricardo’s exposition in his 1817 Principles of Political Economy and Taxation makes little logical sense. Building on Sraffa’s (1930) interpretation of Ricardo’s numbers as labor embodied in trade, our discussion reveals the amazing simplicity and generality of Ricardo’s comparative advantage formulation and gains-from-trade logic.


2016 ◽  
Vol 41 (7) ◽  
pp. 732-738 ◽  
Author(s):  
J. K. Andersson ◽  
P. Axelsson ◽  
J. Strömberg ◽  
J. Karlsson ◽  
J. Fridén

A total of 20 patients scheduled for wrist arthroscopy, all with clinical signs of rupture to the triangular fibrocartilage complex and distal radioulnar joint instability, were tested pre-operatively by an independent observer for strength of forearm rotation. During surgery, the intra-articular pathology was documented by photography and also subsequently individually analysed by another independent hand surgeon. Arthroscopy revealed a type 1-B injury to the triangular fibrocartilage complex in 18 of 20 patients. Inter-rater reliability between the operating surgeon and the independent reviewer showed absolute agreement in all but one patient (95%) in terms of the injury to the triangular fibrocartilage complex and its classification. The average pre-operative torque strength was 71% of the strength of the non-injured contralateral side in pronation and supination. Distal radioulnar joint instability with an arthroscopically verified injury to the triangular fibrocartilage complex is associated with a significant loss of both pronation and supination torque. Level of evidence: Case series, Level IV.


2018 ◽  
Vol 7 (3) ◽  
pp. e000294
Author(s):  
Matthew Charles Mason ◽  
Rebecca Katie Griggs ◽  
Rachel Withecombe ◽  
Eunice Yun Xing ◽  
Charlotte Sandberg ◽  
...  

National Health Service England published the National Safety Standards for Invasive Procedures (NatSSIP) in 2015. They mandated that individual trusts produce Local Safety Standards for Invasive Procedures (LocSSIPs), a set of safety standards drawn from the NatSSIP that apply to a particular clinical situation in a given department, for all invasive procedures.The project goal was to design and implement the LocSSIP within the endoscopy department. A draft LocSSIP was produced, and a pilot study conducted to gain initial feedback on its use. Version 1 of the checklist was produced and after approval, rolled out for use within the endoscopy department at ‘time out’ and ‘sign out’. A scoring system was developed that allowed the quality of the performance of LocSSIPs to be assessed and recorded as a ‘compliance score’.After 2 months, an independent observer spent a week assessing use of the checklist, recording completion and a compliance score. Analysis of this data led to a number of changes in performing the checklist, wider multidisciplinary team education and integration of the checklist into existing documentation, before reassessing at 12 months.In 2016, ‘time out’ checks were completed in 100% of cases, but full completion was only observed in 68%. ‘Sign out’ checks were completed in 91% of cases, with full completion in 71%. In 2017, ‘time out’ checks were completed in 100% of cases, with full completion in 85%. ‘Sign out’ checks were completed in 100% of cases, with full completion in 91%.The composite score for compliance in 2016 was 57% increasing to 90% in 2017.In conclusion, stronger departmental leadership, broadening education and integration of the checklist into routine documentation to reduce duplication led to significant improvements in compliance with use of the checklist. Ongoing education and assessment is imperative to ensure that compliance is maintained to ensure patient safety.


2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S293-S293
Author(s):  
Jonathan Altamirano ◽  
Grace Tam ◽  
Marcela Lopez ◽  
India Robinson ◽  
Leanne Chun ◽  
...  

Abstract Background While pediatric cases of COVID-19 are at low risk for adverse events, schoolchildren should be considered for surveillance as they can become infected at school and serve as sources of household or community transmission. Our team assessed the feasibility of young children self-collecting SARS-CoV-2 samples for surveillance testing in an educational setting. Methods Students at a K-8 school were tested weekly for SARS-CoV-2 from September 2020 - June 2021. Error rates were collected from September 2020 - January 2021. Clinical staff provided all students with instructions for anterior nares specimen self-collection and then observed them to ensure proper technique. Instructions included holding the sterile swab while making sure not to touch the tip, inserting the swab into their nostril until they start to feel resistance, and rubbing the swab in four circles before repeating the process in their other nostril. An independent observer timed random sample self-collections from April - June 2021. Results 2,590 samples were collected from 209 students during the study period when data on error rates were collected. Errors occurred in 3.3% of all student encounters (n=87). Error rates over time are shown in Figure 1, with the highest rate occurring on the first day of testing (n=20/197, 10.2%) and the lowest in January 2021 (n=1/202, 0.5%). 2,574 visits for sample self-collection occurred during the study period when independent timing data was collected (April - June 2021). Of those visits, 7.5% (n=193) were timed. The average duration of each visit was 70 seconds. Figure 1. Swab Error Rates Over Time Conclusion Pediatric self-collected lower nasal swabs are a viable and easily tolerated specimen collection method for SARS-CoV-2 surveillance in school settings, as evidenced by the low error rate and short time window of sample self-collection during testing. School administrators should expect errors to drop quickly after implementing testing. Disclosures All Authors: No reported disclosures


2020 ◽  
Vol 11 ◽  
Author(s):  
Deanna Leonard ◽  
Nils Øien

A ship-based mosaic survey of Northeast Atlantic cetaceans was conducted over a 5-year period between 2014–2018. The area surveyed extends from the North Sea in the south (southern boundary at 53oN), to the ice edge of the Barents Sea and the Greenland Sea. Survey vessels were equipped with 2 independent observer platforms that detected whales in passing mode and applied tracking procedures for the target species, common minke whales (Balaenoptera acutorostrata acutorostrata). Here we present abundance estimates for all non-target species for which there were sufficient sightings. We estimate the abundance of fin whales (Balaenoptera physalus) to be 11,387 (CV=0.17, 95% CI: 8,072–16,063), of humpback whales (Megaptera novaeangliae) to be 10,708 (CV=0.38, 95% CI: 4,906–23,370), of sperm whales (Physeter macrocephalus) to be 5,704 (CV=0.26, 95% CI: 3,374–9,643), of killer whales (Orcinus orca) to be 15,056 (CV=0.29, 95% CI: 8,423–26,914), of harbour porpoises (Phocoena phocoena) to be 255,929 (CV=0.20, 95% CI: 172,742–379,175), dolphins of genus Lagenorhynchus to be 192,767 (CV=0.25, 95% CI: 114,033–325,863), and finally of northern bottlenose whales (Hyperoodon ampullatus) to be 7,800 (CV=0.28, 95% CI: 4,373–13,913). Additionally, our survey effort in the Norwegian Sea in 2015 contributed to the 6th North Atlantic Sightings Survey (NASS) and the survey was extended into the waters north and east of Iceland around Jan Mayen island. This NASS extension, along with our Norwegian Sea survey in 2015, was used to estimate the abundance of fin whales, humpback whales, and sperm whales. All estimates presented used mark-recapture distance sampling techniques and were thus corrected for perception bias. Our estimates do not account for additional variance due to distributional shifts between years or biases due to availability or responsive movement.


Author(s):  
YB Tan ◽  
KL Puah ◽  
RWW Chong ◽  
KL Ong ◽  
YJ Lim ◽  
...  

Introduction: Arthroscopic Bankart repair is a widely accepted procedure to treat recurrent shoulder dislocation. This study aims to describe our experience with arthroscopic Bankart repair and its functional outcome. Methods: 107 patients who underwent arthroscopic Bankart repair from 2008 to 2013 were followed up for a minimum of three years and reviewed by an independent observer. 80 consented to being interviewed using the Oxford Shoulder Instability Score (OSIS) and Simple Shoulder Test. Results: 82 shoulders (two bilateral) were studied. Mean age at first dislocation was 19.4 ± 3.4 (12.0–31.0) years. Mean follow-up was 4.4 ± 1.3 (3.0–9.0) years and 2.5 ± 3.0 (0.1–15.4) years elapsed from first dislocation to surgery. 41 (50.0%) patients played overhead or contact sports and 44 (53.7%) played competitive sports before injury; 8 (9.8%) patients reported recurrence of dislocation, which was significantly associated with playing competitive sports before injury (p < 0.039), 5 (6.1%) underwent revision surgery and 22 (26.8%) reported residual instability after surgery. 49 (59.8%) patients returned to playing sports, 75 (91.5%) were satisfied with their surgery and 79 (96.3%) were willing to undergo the surgery again. 74 (90.2%) patients had two-year good/excellent OSIS, which was significantly associated with playing competitive sports before injury (p = 0.039), self-reported stability after surgery (p = 0.017), satisfaction with surgery (p = 0.018) and willingness to undergo surgery again (p = 0.024). Conclusion: Arthroscopic Bankart repair yields good functional outcomes and is associated with high patient satisfaction, although not all patients return to sports.


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