Socrates on the Moral Mischief of Misology

In Plato’s dialogues, the Phaedo, Laches, and Republic, Socrates warns his interlocutors about the dangers of misology. Misology is explained by analogy with misanthropy, not as the hatred of other human beings, but as the hatred of the logos or reasonable discourse. According to Socrates, misology arises when a person alternates between believing an argument to be correct, and then refuting it as false. If Socrates is right, then misanthropy is sometimes instilled when a person goes from trusting people to learning that others sometimes betray our reliance and expectations, and finally not to placing any confidence whatsoever in other people, or, in the case of misology, in the correctness or trustworthiness of arguments. A cynical indifference to the soundness of arguments generally is sometimes associated with Socrates’ polemical targets, the Sophists, at least as Plato represents Socrates’ reaction to these itinerant teachers of rhetoric, public speaking and the fashioning of arguments suitable to any occasion. Socrates’ injunctions against misology are largely moral, pronouncing it ‘shameful’ and ‘very wicked’, and something that without further justification we must ‘guard against’, maintaining that we will be less excellent persons if we come to despise argument as lacking the potential of leading to the truth. I examine Socrates’ moral objections to misology which I show to be inconclusive. I consider instead the problem of logical coherence in the motivations supposedly underlying misology, and conclude that misology as Socrates intends the concept is an emotional reaction to argumentation on the part of persons who have not acquired the logical dialectical skills or will to sort out good from bad arguments. We cannot dismiss argument as directed toward the truth unless we have a strong reason for doing so, and any such argument must itself presuppose that at least some reasoning can be justified in discovering and justifying belief in interesting truths. The relevant passages from Socrates’ discussion of the soul’s immortality in the Phaedo are discussed in detail, and set in scholarly background against Socrates’ philosophy more generally, as represented by Plato’s dialogues. I conclude by offering a suggestive list of practical remedies to avoid the alienation from argument in dialectic with which Socrates is concerned.

Spot drug-eluting stenting for long coronary stenoses: long-term results of a randomized clinical study

Preliminary results of a randomized trial have suggested that total lesion coverage with drug-eluting stents (DES) is not necessary in the presence of diffuse disease of nonuniform severity. In the present study, we report long-term results of this trial.

Comparison of long versus short ("spot") drug-eluting stenting for long coronary stenoses

We compared spot drug-eluting stenting (DES) to full stent coverage for treatment of long coronary stenoses. Consecutive, consenting patients with a long (>20 mm) coronary lesion of nonuniform severity and indication for percutaneous coronary intervention were randomized to full stent coverage of the atherosclerotic lesion with multiple, overlapping stenting (full DES group, n = 90) or spot stenting of hemodynamically significant parts of the lesion only (defined as diameter stenosis >50%; spot DES group, n = 89). At 1-year follow-up, 14 patients with full DES (15.6%) and 5 patients (5.6%) with spot DES had a major adverse cardiac event (MACE; p = 0.031). At 3 years, MACEs occurred in 18 patients with full DES (20%) and 7 patients (7.8%) with spot DES (p = 0.019). Cox proportional hazard model showed that the risk for MACEs was almost 60% lower in patients with spot DES compared to those with full DES (hazard ratio 0.41, 95% confidence interval 0.17 to 0.98, p = 0.044). This association remained even after controlling for age, gender, lesion length, and type of stent used (hazard ratio 0.42, 95% confidence interval 0.17 to 1.00, p = 0.05). In conclusion, total lesion coverage with DES is not necessary in the presence of diffuse disease of nonuniform severity. Selective stenting of only the significantly stenosed parts of the lesion is an appropriate therapeutic alternative in this setting, offering a favorable clinical outcome.

A cardiovascular mathematical model of graded head-up tilt

A lumped parameter model of the cardiovascular system has been developed and optimized using experimental data obtained from 13 healthy subjects during graded head-up tilt (HUT) from the supine position to [Formula: see text]. The model includes descriptions of the left and right heart, direct ventricular interaction through the septum and pericardium, the systemic and pulmonary circulations, nonlinear pressure volume relationship of the lower body compartment, arterial and cardiopulmonary baroreceptors, as well as autoregulatory mechanisms. A number of important features, including the separate effects of arterial and cardiopulmonary baroreflexes, and autoregulation in the lower body, as well as diastolic ventricular interaction through the pericardium have been included and tested for their significance. Furthermore, the individual effect of parameter associated with heart failure, including LV and RV contractility, baseline systemic vascular resistance, pulmonary vascular resistance, total blood volume, LV diastolic stiffness and reflex gain on HUT response have also been investigated. Our fitted model compares favorably with our experimental measurements and published literature at a range of tilt angles, in terms of both global and regional hemodynamic variables. Compared to the normal condition, a simulated congestive heart failure condition produced a blunted response to HUT with regards to the percentage changes in cardiac output, stroke volume, end diastolic volume and effector response (i.e., heart contractility, venous unstressed volume, systemic vascular resistance and heart rate) with progressive tilting.