Imagining Evil

It is in a way easier to imagine evil actions than we often suppose, but what it is thus relatively easy to do is not what we want to understand about evil. To argue for this conclusion I distinguish between imagining why someone did something and imagining how they could have done it, and I try to grasp partial understanding, in part by distinguishing different imaginative perspectives we can have on an act. When we do this we see an often unnoticed asymmetry: we do not put the same demands on our understanding of wrongdoing as on that of most everyday, morally acceptable, actions. Il est relativement facile d’imaginer des actes maléfiques, plus facile que ce que nous sommes prêts à supposer. Mais ce qui est ainsi facile à imaginer n’est pas ce que nous souhaitons comprendre à propos des actes maléfiques. Pour étayer cette conclusion, je distingue entre comprendre pourquoi quelqu'un fait ce qu'il fait et imaginer comment cette personne aurait fait une telle chose; j'essaie aussi de saisir ce qu'est la compréhension partielle, du moins en partie, en distinguant entre elles les différentes perspectives imaginaires d’un même acte. C’est ainsi qu’apparaît une asymétrie qui passe souvent inaperçue: nous n'imposons pas les mêmes exigences à l'égard de notre compréhension d’actes répréhensibles qu'à l’égard d’actions quotidiennes moralement acceptables.

Statistiques appliquées en chirurgie cardiaque adulte : analyses de survie et applications du “propensity score”

L'objectif principal de ce travail est d’étudier en profondeur certaines techniques biostatistiques avancées en recherche évaluative en chirurgie cardiaque adulte. Les études ont été conçues pour intégrer les concepts d'analyse de survie, analyse de régression avec “propensity score”, et analyse de coûts. Le premier manuscrit évalue la survie après la réparation chirurgicale de la dissection aigüe de l’aorte ascendante. Les analyses statistiques utilisées comprennent : analyses de survie avec régression paramétrique des phases de risque et d'autres méthodes paramétriques (exponentielle, Weibull), semi-paramétriques (Cox) ou non-paramétriques (Kaplan-Meier) ; survie comparée à une cohorte appariée pour l’âge, le sexe et la race utilisant des tables de statistiques de survie gouvernementales ; modèles de régression avec “bootstrapping” et “multinomial logit model”. L'étude a démontrée que la survie s'est améliorée sur 25 ans en lien avec des changements dans les techniques chirurgicales et d’imagerie diagnostique. Le second manuscrit est axé sur les résultats des pontages coronariens isolés chez des patients ayant des antécédents d'intervention coronarienne percutanée. Les analyses statistiques utilisées comprennent : modèles de régression avec “propensity score” ; algorithme complexe d'appariement (1:3) ; analyses statistiques appropriées pour les groupes appariés (différences standardisées, “generalized estimating equations”, modèle de Cox stratifié). L'étude a démontrée que l’intervention coronarienne percutanée subie 14 jours ou plus avant la chirurgie de pontages coronariens n'est pas associée à des résultats négatifs à court ou long terme. Le troisième manuscrit évalue les conséquences financières et les changements démographiques survenant pour un centre hospitalier universitaire suite à la mise en place d'un programme de chirurgie cardiaque satellite. Les analyses statistiques utilisées comprennent : modèles de régression multivariée “two-way” ANOVA (logistique, linéaire ou ordinale) ; “propensity score” ; analyses de coûts avec modèles paramétriques Log-Normal. Des modèles d’analyse de « survie » ont également été explorés, utilisant les «coûts» au lieu du « temps » comme variable dépendante, et ont menés à des conclusions similaires. L'étude a démontrée que, après la mise en place du programme satellite, moins de patients de faible complexité étaient référés de la région du programme satellite au centre hospitalier universitaire, avec une augmentation de la charge de travail infirmier et des coûts.

Numerical Feasibility Study for Treated Wastewater Recharge as a Tool to Impede Saltwater Intrusion in the Coastal Aquifer of Gaza – Palestine

The ongoing depletion of the coastal aquifer in the Gaza strip due to groundwater overexploitation has led to the process of seawater intrusion, which is continually becoming a serious problem in Gaza, as the seawater has further invaded into many sections along the coastal shoreline. As a first step to get a hold on the problem, the artificial neural network (ANN)-model has been applied as a new approach and an attractive tool to study and predict groundwater levels without applying physically based hydrologic parameters, and also for the purpose to improve the understanding of complex groundwater systems and which is able to show the effects of hydrologic, meteorological and anthropogenic impacts on the groundwater conditions. Prediction of the future behaviour of the seawater intrusion process in the Gaza aquifer is thus of crucial importance to safeguard the already scarce groundwater resources in the region. In this study the coupled three-dimensional groundwater flow and density-dependent solute transport model SEAWAT, as implemented in Visual MODFLOW, is applied to the Gaza coastal aquifer system to simulate the location and the dynamics of the saltwater–freshwater interface in the aquifer in the time period 2000-2010. A very good agreement between simulated and observed TDS salinities with a correlation coefficient of 0.902 and 0.883 for both steady-state and transient calibration is obtained. After successful calibration of the solute transport model, simulation of future management scenarios for the Gaza aquifer have been carried out, in order to get a more comprehensive view of the effects of the artificial recharge planned in the Gaza strip for some time on forestall, or even to remedy, the presently existing adverse aquifer conditions, namely, low groundwater heads and high salinity by the end of the target simulation period, year 2040. To that avail, numerous management scenarios schemes are examined to maintain the ground water system and to control the salinity distributions within the target period 2011-2040. In the first, pessimistic scenario, it is assumed that pumping from the aquifer continues to increase in the near future to meet the rising water demand, and that there is not further recharge to the aquifer than what is provided by natural precipitation. The second, optimistic scenario assumes that treated surficial wastewater can be used as a source of additional artificial recharge to the aquifer which, in principle, should not only lead to an increased sustainable yield of the latter, but could, in the best of all cases, revert even some of the adverse present-day conditions in the aquifer, i.e., seawater intrusion. This scenario has been done with three different cases which differ by the locations and the extensions of the injection-fields for the treated wastewater. The results obtained with the first (do-nothing) scenario indicate that there will be ongoing negative impacts on the aquifer, such as a higher propensity for strong seawater intrusion into the Gaza aquifer. This scenario illustrates that, compared with 2010 situation of the baseline model, at the end of simulation period, year 2040, the amount of saltwater intrusion into the coastal aquifer will be increased by about 35 %, whereas the salinity will be increased by 34 %. In contrast, all three cases of the second (artificial recharge) scenario group can partly revert the present seawater intrusion. From the water budget point of view, compared with the first (do nothing) scenario, for year 2040, the water added to the aquifer by artificial recharge will reduces the amount of water entering the aquifer by seawater intrusion by 81, 77and 72 %, for the three recharge cases, respectively. Meanwhile, the salinity in the Gaza aquifer will be decreased by 15, 32 and 26% for the three cases, respectively.

Enfoque del paciente con sospecha de neuroinfección en urgencias

Las infecciones del sistema nervioso son importantes fuentes de morbilidad y mortalidad en el mundo, debido a diferentes factores como son el amplio uso de antibióticos que aunque contribuyen con éxito al manejo de infecciones, pero el mal uso por automedicación o tratamientos incompletos favorecen la emergencia de organismos resistentes y la existencia de “mimos infecciosos” que incluyen el síndrome de reconstitución inflamatoria (IRIS). Adicionalmente el crecimiento de las poblaciones inmunocomprometidas por el síndrome de inmunodeficiencia adquirida (SIDA) y por tratamientos agresivos para trasplante sólido o hematopoyético han mejorado la sobrevida de diferentes tipos de malignidades y alteraciones reumatológicas pero son poblaciones que tienen más susceptibilidad a contraer infecciones y encefalitis mediadas inmunológicamente, como son la encefalomielitis diseminada aguda (ADEM) o la encefalitis contra el receptor de N-metil-D aspartato (NMDA).

Like mother, like daughter? Analyzing maternal influences upon women’s entrepreneurial propensity

Within the phenomenon of entrepreneurship, the extant literature suggests that the normative actor is embodied by and through stereotypical masculinized characteristics. In this paper,we contextualize entrepreneurship as self-employment in order to explore how such stereotypical characterizations might influence women’s attitudes toward this activity. However, rather than analyzing the confirmatory effects of stereotypes, we critically evaluate the effect of counterstereotypical characterizations upon women’s propensity for self-employment. Drawing upon life-span data, we explore whether self-employed mothers disconfirm masculinized stereotypes and so act as positive role models for their daughters.As hypothesized, we found that maternal self-employment has a counterstereotypical effect and so positively influences daughters to become self-employed. These data indicate, however, that this effect is tempered by personal stereotypes held by daughters; moreover, it is shaped by significant life events (marriage, parenthood, education, and prior managerial experience). By using a robust data set, this paper contributes to our understanding of how stereotypes and role expectations influence women’s propensity toward entrepreneurial activity.

What Happens When IKEA Comes to Town?

Using data from 2000-2011, the effects of a new IKEA store on retail revenues, employment, and inflow of purchasing power in the entry municipalities, as well as in neighboring municipalities were investigated. A propensity score matching method was used to find non IKEA entry municipalities that were as similar as possible to the entry municipalities based on the situation before entry. Our results indicate that IKEA-entry increased entry-municipality durable-goods revenues by about 20% and employment by about 17%. Only small and, in most cases, statistically insignificant effects were found in neighboring municipalities.

Evaluation of fungal adherence to plasma-modified polymethylmethacrylate

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Ovarian response to porcine FSH in association with ablation-induced or spontaneous follicular wave development during the estrous cycle in crossbred and Brazilian Warmblood mares

The primary objective of this study was to examine the follicular and ovulatory responses following treatment with pFSH in association with ablation-induced or spontaneous follicular wave emergence or follicle deviation during diestrus in crossbred (Mangalarga × Arabian) and Brazilian Warmblood mares with a propensity for spontaneous multiple ovulations; secondary considerations were given to the collection of embryos In Experiment 1, crossbred mares were administered (im) saline (control, n= 7) or pFSH (25 mg) when the largest follicle of the ablation-induced follicular wave reached ≥13 mm (n= 7) or ≥20 mm (n= 7) or, after pre-treatment ovulation (Day 0) on Day 6 (n= 7) In Experiment 2, crossbred mares were administered (im) saline (control, n= 10) or a larger dose of pFSH (50 mg, n= 7) when the largest follicle of the ablation-induced follicular wave reached ≥13 mm In Experiment 3, Brazilian Warmblood mares were administered (im) saline (control, n= 7), pFSH (25 mg, n= 7 or 50 mg, n= 5) or EPE (12.5 mg, n= 7) as a positive control on Day 6 Ultrasonic technology was used to ablate all follicles ≥8 mm and to monitor follicular development and detect ovulation Treatment with pFSH or EPE was done twice daily until the largest follicle reached ≥32 mm; thereafter, hCG (2500 IU) was administered (iv) when the largest follicle reached ≥35 mm Artificial insemination was done 12 h after hCG and embryo collections were done 8 d after post-treatment ovulations In Experiments 1 and 2, treatment of crossbred mares with pFSH post-ablation in association with the expected time of wave emergence or follicle deviation did not (P> 0.05) enhance the follicular or ovulatory responses or collection of embryos compared to controls In Experiment 3, although the enhanced ovulatory response of mares to EPE at the expected time of spontaneous wave emergence was not different (P> 0.05) from controls, it was greater (P< 0.05) than the response to pFSH In conclusion, the novelty of using follicle ablation prior to pFSH treatment at the time of wave emergence or follicle deviation did not enhance the follicular or ovulatory responses or collection of embryos to treatment in crossbred mares In addition, the hypothesis that Brazilian Warmblood mares with a greater propensity for spontaneous multiple ovulations are as responsive to pFSH compared to EPE was not supported Thus, the combined experimental results of the present study continue to support the general consensus that pFSH is relatively ineffective for follicular superstimulation/superovulation in mares © 2012 Elsevier B.V.

Low serum potassium levels increase the infectious-caused mortality in peritoneal dialysis patients: a propensity-matched score study

Background and ObjectivesHypokalemia has been consistently associated with high mortality rate in peritoneal dialysis. However, studies investigating if hypokalemia is acting as a surrogate marker of comorbidities or has a direct effect in the risk for mortality have not been studied. Thus, the aim of this study was to analyze the effect of hypokalemia on overall and cause-specific mortality.Design, Setting, Participants and MeasurementsThis is an analysis of BRAZPD II, a nationwide prospective cohort study. All patients on PD for longer than 90 days with measured serum potassium levels were used to verify the association of hypokalemia with overall and cause-specific mortality using a propensity match score to reduce selection bias. In addition, competing risks were also taken into account for the analysis of cause-specific mortality.ResultsThere was a U-shaped relationship between time-averaged serum potassium and all-cause mortality of PD patients. Cardiovascular disease was the main cause of death in the normokalemic group with 133 events (41.8%) followed by PD-non related infections, n=105 (33.0%). Hypokalemia was associated with a 49% increased risk for CV mortality after adjustments for covariates and the presence of competing risks (SHR 1.49; CI95% 1.01-2.21). In contrast, in the group of patients with K < 3.5mEq/L, PD-non related infections were the main cause of death with 43 events (44.3%) followed by cardiovascular disease (n=36; 37.1%). For PD-non related infections the SHR was 2.19 (CI95% 1.52-3.14) while for peritonitis was SHR 1.09 (CI95% 0.47-2.49).ConclusionsHypokalemia had a significant impact on overall, cardiovascular and infectious mortality even after adjustments for competing risks. The causative nature of this association suggested by our study raises the need for intervention studies looking at the effect of potassium supplementation on clinical outcomes of PD patients.

A Spatial Propensity Score Matching Evaluation of the Social Impacts of Sugarcane Growing on Municipalities in Brazil

The expansion of sugarcane growing in Brazil, spurred particularly by increased demand for ethanol, has triggered the need to evaluate the economic, social, and environmental impacts of this process, both on the country as a whole and on the growing regions. Even though the balance of costs and benefits is positive from an overall standpoint, this may not be so in specific producing regions, due to negative externalities. The objective of this paper is to estimate the effect of growing sugarcane on the human development index (HDI) and its sub-indices in cane producing regions. In the literature on matching effects, this is interpreted as the effect of the treatment on the treated. Location effects are controlled by spatial econometric techniques, giving rise to the spatial propensity score matching model. The authors analyze 424 minimum comparable areas (MCAs) in the treatment group, compared with 907 MCAs in the control group. The results suggest that the presence of sugarcane growing in these areas is not relevant to determine their social conditions, whether for better or worse. It is thus likely that public policies, especially those focused directly on improving education, health, and income generation/distribution, have much more noticeable effects on the municipal HDI.

ROLAND BARTHES AND THE STRUGGLE BETWEEN GOOD AND EVIL

This article begins at Barthes lecture of Tolstoy's War and Peace, to understand some writing moves observed at the manuscript of his novel "Vita Nova". To reach this purpose, we find an element in Tolstoy's book he intended to develop in his novel: the fight of Good and Evil, developed in the last text by written Barthes before dying.

Assessment of candidemia-attributable mortality in critically ill patients using propensity score matching analysis

[EN] Introduction: Candidemia in critically ill patients is usually a severe and life-threatening condition with a high crude mortality. Very few studies have focused on the impact of candidemia on ICU patient outcome and attributable mortality still remains controversial. This study was carried out to determine the attributable mortality of ICU-acquired candidemia in critically ill patients using propensity score matching analysis. Methods: A prospective observational study was conducted of all consecutive non-neutropenic adult patients admitted for at least seven days to 36 ICUs in Spain, France, and Argentina between April 2006 and June 2007. The probability of developing candidemia was estimated using a multivariate logistic regression model. Each patient with ICU-acquired candidemia was matched with two control patients with the nearest available Mahalanobis metric matching within the calipers defined by the propensity score. Standardized differences tests (SDT) for each variable before and after matching were calculated. Attributable mortality was determined by a modified Poisson regression model adjusted by those variables that still presented certain misalignments defined as a SDT > 10%. Results: Thirty-eight candidemias were diagnosed in 1,107 patients (34.3 episodes/1,000 ICU patients). Patients with and without candidemia had an ICU crude mortality of 52.6% versus 20.6% (P < 0.001) and a crude hospital mortality of 55.3% versus 29.6% (P = 0.01), respectively. In the propensity matched analysis, the corresponding figures were 51.4% versus 37.1% (P = 0.222) and 54.3% versus 50% (P = 0.680). After controlling residual confusion by the Poisson regression model, the relative risk (RR) of ICU- and hospital-attributable mortality from candidemia was RR 1.298 (95% confidence interval (CI) 0.88 to 1.98) and RR 1.096 (95% CI 0.68 to 1.69), respectively. Conclusions: ICU-acquired candidemia in critically ill patients is not associated with an increase in either ICU or hospital mortality.

Rag2-/-;gammac-/- immunodeficient mice, a new preclinical model to study antitumor approaches

Animal models have been relevant to study the molecular mechanisms of cancer and to develop new antitumor agents. Anyway, the huge divergence in mouse and human evolution made difficult the translation of the gained achievements in preclinical mouse based studies. The generation of clinically relevant murine models requires their humanization both concerning the creation of transgenic models and the generation of humanized mice in which to engraft a functional human immune system, and reproduce the physiological effects and molecular mechanisms of growth and metastasization of human tumors. In particular, the availability of genotypically stable immunodepressed mice able to accept tumor injection and allow human tumor growth and metastasization would be important to develop anti-tumor and anti-metastatic strategies. Recently, Rag2-/-;gammac-/- mice, double knockout for genes involved in lymphocyte differentiation, had been developed (CIEA, Central Institute for Experimental Animals, Kawasaki, Japan). Studies of human sarcoma metastasization in Rag2-/-; gammac-/- mice (lacking B, T and NK functionality) revealed their high metastatic efficiency and allowed the expression of human metastatic phenotypes not detectable in the conventionally used nude murine model. In vitro analysis to investigate the molecular mechanisms involved in the specific pattern of human sarcomas metastasization revealed the importance of liver-produced growth and motility factors, in particular the insulin-like growth factors (IGFs). The involvement of this growth factor was then demonstrated in vivo through inhibition of IGF signalling pathway. Due to the high growth and metastatic propensity of tumor cells, Rag2-/-;gammac-/- mice were used as model to investigate the metastatic behavior of rhabdomyosarcoma cells engineered to improve the differentiation. It has been recently shown that this immunodeficient model can be reconstituted with a human immune system through the injection of human cord blood progenitor cells. The work illustrated in this thesis revealed that the injection of different human progenitor cells (CD34+ or CD133+) showed peculiar engraftment and differentiation abilities. Experiments of cell vaccination were performed to investigate the functionality of the engrafted human immune system and the induction of specific human immune responses. Results from such experiments will allow to collect informations about human immune responses activated during cell vaccination and to define the best reconstitution and experimental conditions to create a humanized model in which to study, in a preclinical setting, immunological antitumor strategies.

Coronary collateral function in the transplanted heart: propensity score matching with coronary artery disease

The function of the coronary collateral circulation in heart transplant patients has not been investigated in a controlled fashion. Since it partly belongs to the microcirculation, which is affected by transplant vasculopathy, the hypothesis was tested that the coronary collateral circulation in heart transplant recipients is less developed than in coronary artery disease (CAD) patients.