Critical Thinking and the Socratic Method

This chapter starts by answering the question, “What is critical thinking?” As it turns out, not everyone agrees on what critical thinking is. Nevertheless, researchers agree that critical thinking allows many people to reason together for solutions to complex problems. Also, in this chapter, the authors look at how computing capabilities enhance Socratic problem solving. A computer-based Socratic problem-solving system can keep problem solvers on track, document the outcome of a problem-solving session, and share those results with participants and a larger audience. In addition, Socrates DigitalTM can also help problem solvers combine evidence about their quality of reasoning for individual problem-solving steps and the overall confidence level for the solution.

A Bayesian Network Concept for Pain Assessment (Preprint)

UNSTRUCTURED Pain is a subjective phenomenon caused/perceived centrally and modified by physical, physiological, or social influences. Currently, the most commonly used approaches for pain measurement rely on self-reporting of pain level on a discrete rating scale. This provides a subjective and only semi-quantitative indicator of pain. This paper presents an approach that combines self-reported pain with pain-related biomarkers to be obtained from biosensors (in development) and possibly other sources of evidence to provide more dependable estimates of experienced pain, a clinical decision support system. We illustrate the approach using a Bayes network, but also describe other artificial intelligence (AI) methods that provide other ways to combine evidence. We also propose an optimization approach for tuning the AI method parameters (opaque to clinicians) so as to best approximate the kinds of outputs most useful to medical practitioners. We present some data from a sample of 379 patients that illustrate several evidence patterns we may expect in real healthcare situations. The majority (79.7%) of our patients show consistent evidence suggesting this biomarker approach may be reasonable. We also found five patterns of inconsistent evidence. These suggest a direction for further exploration. Finally, we sketch out an approach for collecting medical experts’ guidance as to the way the combined evidence might be presented so as to provide the most useful guidance (also needed for any optimization approach). We recognize that one possible outcome may be that all this approach may be able to provide is a quantified measure of the extent to which the evidence is consistent or not, leaving the final decision to the clinicians (where it must reside). Pointers to additional sources of evidence might also be possible in some situations.

Co-occurrence of severe PTSD, somatic symptoms and dissociation in a large sample of childhood trauma inpatients: a network analysis

Co-occurrence of mental disorders including severe PTSD, somatic symptoms, and dissociation in the aftermath of trauma is common and sometimes associated with poor treatment outcomes. However, the interrelationships between these conditions at symptom level are not well understood. In the present study, we aimed to explore direct connections between PTSD, somatic symptoms, and dissociation to gain a deeper insight into the pathological processes underlying their comorbidity that can inform future treatment plans. In a sample of 655 adult inpatients with a diagnosis of severe PTSD following childhood abuse (85.6% female; mean age = 47.57), we assessed symptoms of PTSD, somatization, and dissociation. We analyzed the comorbidity structure using a partial correlation network with regularization. Mostly positive associations between symptoms characterized the network structure. Muscle or joint pain was among the most central symptoms. Physiological reactivation was central in the full network and together with concentrations problems acted as bridge between symptoms of PTSD and somatic symptoms. Headaches connected somatic symptoms with others and derealization connected dissociative symptoms with others in the network. Exposure to traumatic events has a severe and detrimental effect on mental and physical health and these consequences worsen each other trans-diagnostically on a symptom level. Strong connections between physiological reactivation and pain with other symptoms could inform treatment target prioritization. We recommend a dynamic, modular approach to treatment that should combine evidence-based interventions for PTSD and comorbid conditions which is informed by symptom prominence, readiness to address these symptoms and preference.

In the labyrinths of pathogenesis: the environment and metamorphosis of IBD

The purpose of this review is to combine evidence from studies based on environmental impacts on inflammatory bowel disease. The review reflects the environmental factors influencing the incidence of IBD, and also considers the predictors that modify the course of the diseases.

An Overview of Antennal Esterases in Lepidoptera

Lepidoptera are used as a model for the study of insect olfactory proteins. Among them, odorant degrading enzymes (ODEs), that degrade odorant molecules to maintain the sensitivity of antennae, have received less attention. In particular, antennal esterases (AEs; responsible for ester degradation) are crucial for intraspecific communication in Lepidoptera. Currently, transcriptomic and genomic studies have provided AEs in several species. However, efforts in gene annotation, classification, and functional assignment are still lacking. Therefore, we propose to combine evidence at evolutionary, structural, and functional level to update ODEs as well as key information into an easier classification, particularly of AEs. Finally, the kinetic parameters for putative inhibition of ODEs are discussed in terms of its role in future integrated pest management (IPM) strategies.

Integrative Neurology

Over the past decade, there has been increasing interest in alternative methods of treatment for many diseases. Physicians have recognized the limitations in the conventional use of pharmaceuticals and surgical intervention. Integrative approaches to patient care combine evidence-based conventional care with the best of evidence-based alternative care. Neurologists, in particular, manage many patients who have difficult-to-treat symptoms and disorders and can greatly benefit from integrative medicine. Many neurologists in practice have been incorporating alternative means of treatment in conjunction with current standards of care and experiencing improved patient response and satisfaction. This text covers some of the more commonly seen disease states in neurology and discusses integrative approaches to treatment and management. It also addresses the importance of self-care for the neurologist as stress and burnout are problematic for neurologists, further impairing patient care and the critical patient–doctor relationship.

From Electricity to Fuels: Descriptors for C1 Selectivity in Electrochemical CO2 Reduction

Electrochemical reduction of carbon dioxide (CO₂) over transition metals follows a complex reaction network. Even for products with a single carbon atom (C₁ products), two bifurcated pathways exist: initially between carboxyl (COOH*) and formate (HCOO*) intermediates and the COOH* intermediate is further bifurcated by pathways involving either formyl (CHO*) or COH*. In this study, we combine evidence from the experimental literature with a theoretical analysis of energetics to rationalize that not all steps in the reduction of CO₂ are electrochemical. This insight enables us to create a selectivity map for two-electron products (carbon monoxide (CO) and formate) on elemental metal surfaces using only the CO and OH binding energies as descriptors. In the further reduction of CO^*, we find that CHO* is formed through a chemical step only whereas COH* follows from an electrochemical step. Notably on Cu(100), the COH pathway becomes dominant at an applied potential lower than −0.5V vs. RHE. For the elemental metals selective towards CO formation, the variation of the CO binding energy is sufficient to further subdivide the map into domains that predominantly form H₂, CO, and ultimately more reduced products. We find Cu to be the only elemental metal capable of reducing CO₂ to products beyond 2e⁻via the proposed COH pathway and we identify atomic carbon as the key component leading to the production of methane. Our analysis also rationalizes experimentally observed differences in products between thermal and electrochemical reduction of CO₂ on Cu.

From Electricity to Fuels: Descriptors for C1 Selectivity in Electrochemical CO2 Reduction

Electrochemical reduction of carbon dioxide (CO₂) over transition metals follows a complex reaction network. Even for products with a single carbon atom (C₁ products), two bifurcated pathways exist: initially between carboxyl (COOH*) and formate (HCOO*) intermediates and the COOH* intermediate is further bifurcated by pathways involving either formyl (CHO*) or COH*. In this study, we combine evidence from the experimental literature with a theoretical analysis of energetics to rationalize that not all steps in the reduction of CO₂ are electrochemical. This insight enables us to create a selectivity map for two-electron products (carbon monoxide (CO) and formate) on elemental metal surfaces using only the CO and OH binding energies as descriptors. In the further reduction of CO^*, we find that CHO* is formed through a chemical step only whereas COH* follows from an electrochemical step. Notably on Cu(100), the COH pathway becomes dominant at an applied potential lower than −0.5V vs. RHE. For the elemental metals selective towards CO formation, the variation of the CO binding energy is sufficient to further subdivide the map into domains that predominantly form H₂, CO, and ultimately more reduced products. We find Cu to be the only elemental metal capable of reducing CO₂ to products beyond 2e⁻via the proposed COH pathway and we identify atomic carbon as the key component leading to the production of methane. Our analysis also rationalizes experimentally observed differences in products between thermal and electrochemical reduction of CO₂ on Cu.

Using Agent-Based Modeling to Understand the Emergence and Reproduction of Social Inequalities in Health

Studies on social inequalities in health present contradictory findings when they attempt to describe and identify the complex societal mechanisms that give rise to poor health outcomes and health inequalities. This work aims to study the mechanism of reproduction of health inequalities among different population groups using agent-based modeling. We combine evidence-based knowledge and survey data to set the simulation model. Our initial findings show that the combination of the most adverse contextual conditions (i.e., negative environmental exposure and the absence of health-care provision) combined with extreme social inequalities in health might increase mortality drastically. The model suggests that, although poor health outcomes may emerge through the action of individual determinants, social inequalities generally emerge and reproduce through non-linear associations and complex multivariate data structures.