scholarly journals A note on Huemer’s Claim to immortality

Author(s):  
Inge-Bert Täljedal

According to Huemer (2019), existence is evidence of immortality, provided past time is infinite. The argument is based on, inter alia, an alleged contradiction between the fact of one’s existence now and its improbability. I suggest that Huemer’s argument is flawed in equating the infinitesimally small with its limit value, and in assuming a philosophically significant difference between the a priori probability of the occurrence of a unique incarnation and that of anyone among an infinite number.

1977 ◽  
Vol 8 (5) ◽  
pp. 385-389
Author(s):  
Robert C. Clark

In the classical decision-making model, the experimenter seeks to demonstrate a difference between the distributions of two or more samples (or a sample and a population) for some parameter. A null hypothesis is stated that there is no “significant” difference between the distributions, and probabilistic models are used to determine the probability that any difference is due to chance. Philosophically, the researcher decides in advance that he is only willing to accept a probability less than a given size for making the error of assuming that the difference is real when it is actually due to chance. The a priori probability of such an error (Type I) is designated α. But the possibility of another error exists: the error of failing to reject a null hypothesis when the difference is real. (The a priori probability of such an error is designated β.) Whereas the probability of a Type I error has been controlled by the choice of a significance criterion, the Type II error (failing to reject a false null hypothesis) has seldom been controlled. However, the use of the technique of power analysis now makes it possible to control the probability of a Type II error with little more difficulty than the technique used to control the probability of a Type I error.


2019 ◽  
Vol 54 (4) ◽  
pp. 351-358 ◽  
Author(s):  
Katy Stephens ◽  
Jamie L. Miller ◽  
Teresa V. Lewis ◽  
Stephen Neely ◽  
Peter N. Johnson

Background: Intravenous (IV) sulfamethoxazole/trimethoprim (SMX/TMP) has been associated with hyponatremia in adults. Objective: The primary objective was to identify the number of patients with a serum sodium <135 mEq/L. Secondary objectives between the hyponatremic versus nonhyponatremic groups included demographic comparisons, median serum sodium concentrations, SMX/TMP cumulative dose, number of diuretics, and other medications causing hyponatremia. Methods: This was a retrospective study of children <18 years receiving IV SMP/TMX. Comparisons were conducted via Mann-Whitney-Wilcoxon and Mantel-Haenszel χ2 tests with an a priori P value <0.05. Results: Sixty-one patients received 66 total courses; 20 courses (30.3%) were associated with hyponatremia with a decrease in the median nadir serum sodium concentration of 133 and 138 mEq/L in the hyponatremic and nonhyponatremic groups, respectively ( P<0.001). The median age (interquartile range) was lower in the hyponatremic versus nonhyponatremic group, but this was not statistically significant: 0.6 (0.1-5.5) versus 3.9 (0.3-11.0) years; P=0.077. There was no significant difference in the median cumulative dose (mg/kg) between groups; P=0.104. In addition, there was a significant difference in the number of children in the hyponatremic versus nonhyponatremic groups receiving diuretics (16 [80.0%] vs 23 [50.0%], P=0.023) and other medications that cause hyponatremia (7 [35.0%] vs 5 [10.9%], P=0.034), respectively. Furosemide was noted to be the medication most associated with hyponatremia. Conclusion and Relevance: Approximately one-third administered IV SMX/TMP developed hyponatremia. Concomitant furosemide administration was one of the most common risk factors. Clinicians should be aware of this potential adverse event when initiating IV SMX/TMP in children.


2018 ◽  
Vol 5 (1) ◽  
pp. 23 ◽  
Author(s):  
Vincent Bounes, MD ◽  
Jean Louis Ducassé, MD ◽  
Annie Momo Bona, MD ◽  
Florent Battefort, MD ◽  
Charles-Henri Houze-Cerfon, MD ◽  
...  

Objective: To evaluate the efficacy and safety of inhaled morphine delivered in patients experiencing severe acute pain in an emergency setting.Patients and Methods: Patients were eligible for inclusion if they were aged 18 years or older, with a severe acute pain defined by a numerical rating scale (NRS) score of 60/100 or higher. The intervention involved administering a single dose of 0.2 mg/kg morphine nebulized using a Misty-Neb nebulizer system. NRSs were recorded and were repeated at 1, 3, 5, and 10 minute after the end of inhalation (T10). The protocol-defined primary outcome measure was pain relief (defined by an NRS score of 30/100 or lower) at T10. Secondary outcomes included differences between pain scores at baseline and at T10 and incidence of adverse events.Results: A total of 28 patients were included in this study. No patient experienced pain relief 10 minutes after the end of inhalation, and no adverse effects were recorded. Respective initial and final median NRS scores were 80 (70-90) and 70 (60-80), p < 0.0001. Despite achieving statistical significance, the value of this point estimate is less than the 14 NRS difference that was defined a priori as representing a minimum clinically significant difference in pain severity.Conclusion: 0.2 mg/kg nebulized morphine is not effective in managing acute pain in an emergency setting. In spite of the potential advantages of the pulmonary route of administration, opioids should be intravenous prescribed at short fixed intervals to control severe acute pain in an emergency setting.


Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 293-293
Author(s):  
Ambuj Kumar ◽  
Heloisa Soares ◽  
Benjamin Djulbegovic

Abstract Background: Randomized clinical trials (RCT) remain the primary mean for advancement of new treatments for the prevention and cure of hematological malignancies. However, if a RCT fails to show a significant difference between the treatment and the control group, is it because treatment is not effective (evidence of absence of treatment effect) or the results were inconclusive (absence of evidence of treatment effect). Methods: We identified 143 studies related to hematological malignancies out of 566 trials conducted by 6 NCI sponsored cooperative groups (RTOG, COG, GOG, ECOG, NSABP and NCCTG). Data were extracted from the original research articles and protocols. Quality of trials was high. To determine whether non-significant trial findings were true negatives or inconclusive, we compared the a priori effect size used in the power calculation for the trial’s pre-defined primary outcome to the confidence intervals (CIs) of the non-significant trial results. Trial results were construed as true negative if the effect size and the 95%CIs were entirely outside the limits of equivalence and inconclusive if the 95%CIs crossed the line of no effect and one or both limits of equivalence (BMJ2004;328:476–477). Results: 71% of studies resulted in non significant outcome (102/143, missing data for 11 studies). Comparing the calculated CI to the a priori specified effect size 48% (44/91) of studies resulted in true negative results (evidence of no effect) and 52% (47/91) were inconclusive (no evidence of effect). Most of the studies (73%, 66/91) had conducted a power analysis before the commencement of trials. The range of expected effect size for experimental treatments in this set of trials ranged from as low as 9% to high as 200% (improvement in survival). Conclusion: High-quality RCTs conducted by the most prestigious institutions often result in inconclusive or negative findings. Unrealistic expectation in treatment effect size appears to be a major culprit for continuing conduct of underpowered trials.


2018 ◽  
Vol 6 (8) ◽  
pp. 232596711879151 ◽  
Author(s):  
Brandon J. Erickson ◽  
Peter N. Chalmers ◽  
Jon Newgren ◽  
Marissa Malaret ◽  
Michael O’Brien ◽  
...  

Background: The Kerlan-Jobe Orthopaedic Clinic (KJOC) shoulder and elbow outcome score is a functional assessment tool for the upper extremity of the overhead athlete, which is currently validated for administration in person. Purpose/Hypothesis: The purpose of this study was to validate the KJOC score for administration over the phone. The hypothesis was that no difference will exist in KJOC scores for the same patient between administration in person versus over the phone. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: Fifty patients were randomized to fill out the KJOC questionnaire either over the phone first (25 patients) or in person first (25 patients) based on an a priori power analysis. One week after the patients completed the initial KJOC on the phone or in person, they then filled out the score via the opposite method. Results were compared per question and for overall score. Results: There was a mean ± SD of 8 ± 5 days between when patients completed the first and second questionnaires. There were no significant differences in the overall KJOC score between the phone and paper groups ( P = .139). The intraclass correlation coefficient comparing paper and phone scores was 0.802 (95% CI, 0.767-0.883; P < .001), with a Cronbach alpha of 0.89. On comparison of individual questions, there were significant differences for questions 1, 3, and 8 ( P = .013, .023, and .042, respectively). Conclusion: The KJOC questionnaire can be administered over the phone with no significant difference in overall score as compared with that from in-person administration.


2016 ◽  
Author(s):  
Peter Zotter ◽  
Hanna Herich ◽  
Martin Gysel ◽  
Imad El-Haddad ◽  
Yanlin Zhang ◽  
...  

Abstract. Black carbon (BC) measured by a multi-wavelength Aethalometer can be apportioned to traffic and wood burning. The method is based on the differences in the dependence of aerosol absorption on the wavelength of light used to investigate the sample, parameterized by the source-specific Ångström absorption exponent (α). While the spectral dependence (defined as α values) of the traffic-related BC light absorption is low, wood smoke particles feature enhanced light absorption in the blue and near ultraviolet. Source apportionment results using this methodology are hence strongly dependent on the α values assumed for both types of emissions: traffic αTR, and wood burning αWB. Most studies use a single αTR and αWB pair in the Aethalometer model, derived from previous work. However, an accurate determination of the source specific α values is currently lacking and in some recent publications the applicability of the Aethalometer model was questioned. Here we present an indirect methodology for the determination of WB and αTR by comparing the source apportionment of BC using the Aethalometer model with 14C measurements of the EC fraction on 16 to 40 h filter samples from several locations and campaigns across Switzerland during 2005–2012, mainly in winter. The data obtained at eight stations with different source characteristics also enabled the evaluation of the performance and the uncertainties of the Aethalometer model in different environments. The best combination of αTR and αWB (0.9 and 1.68, respectively) was obtained by fitting the Aethalometer model outputs (calculated with the absorption coefficients at 470 nm and 950 nm) against the fossil fraction of EC (ECF/EC) derived from 14C measurements. Aethalometer and 14C source apportionment results are well correlated (r = 0.81) and the fitting residuals exhibit only a minor positive bias of 1.6 % and an average precision of 9.3 %. This indicates that the Aethalometer model reproduces reasonably well the 14C results for all stations investigated in this study using our best estimate of a single αWB and αTR pair. Combining the EC, 14C and Aethalometer measurements further allowed assessing the dependence of the mass absorption cross section (MAC) of BC on its source. Results indicate no significant difference in MAC at 880 nm between BC originating from traffic or wood burning emissions. Using ECF/EC as reference and constant a priori selected αTR values, αWB was also calculated for each individual data point. No clear station-to-station or season-to-season differences in αWB were observed, but αTR and αWB values are interdependent. For example, an increase in αTR by 0.1 results in a decrease in αWB by 0.1. The fitting residuals of different αTR and αWB combinations depend on ECF/EC such that a good agreement cannot be obtained over the entire ECF/EC range using other α pairs. Additional combinations of αTR = 0.8, and 1.0 and αWB = 1.8 and 1.6, respectively, are possible but only for ECF/EC between ~ 40 % and 85 %. Applying α values previously used in literature such as αWB of ~ 2 or any αWB in combination with αTR = 1.1 to our data set results in large residuals. Therefore we recommend to use the best α combination as obtained here (αTR = 0.9 and αWB = 1.68) in future studies when no or only limited additional information like 14C measurements are available. However, these results were obtained for locations impacted by BC mainly from traffic consisting of a modern car fleet and residential wood combustion with well-constrained combustion efficiencies. For regions of the world with different combustion conditions, additional BC sources or fuels used further investigations are needed.


1970 ◽  
Vol 8 (5) ◽  
pp. 317-320 ◽  
Author(s):  
Arthur I. Schulman ◽  
Gordon Z. Greenberg

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