944 resultados para Thomas, David S. G.
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Published by request.
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The illuminated manuscript has title: Horae Beatae Virginis Mariae secundum usum romanum, cum calendario.
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Mode of access: Internet.
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Mode of access: Internet.
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David Hume belonged to the consecuencialist philosophical tendency, in which is included utilitarianism. This tendency was opposed to the normativism philosophy, in which is enrolled contractualism. This article analyzes the critique made by David Hume, from the utilitarianism perspective, against contractualism. The major philosophers of contractualism are Thomas Hobbes, John Locke and Jean Jacques Rousseau. Hume implemented three arguments in opposition to them: 1) historic: the social contract does not have any practical testing. Therefore it could not be presented as the foundation of the state; 2) philosophical: it is not the duty, but the interest that moves men to seek the formation of the political authority; 3) social: in the consciousness of the people, there is no trace of the social contract.Utilitarianism was one of the philosophical tendencies that finished the theoretical hegemony that contractualism had during the XVII and the XVIII centuries. Nonetheless from the historical and social point of view, the liberalization movements in many parts of the world, at that time, were inspired by contractualism. It means that from the theoretical point of view, utilitarianism, certainly, stressed the empirical origins of the state but not the rational justification of the political Authority. Hume was unable to understand the normative force that contractualism owns, which inspires human action.
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The diagnosis of intraductal carcinoma (IDC) of the prostate remains subjective because 3 sets of diagnostic criteria are in use. An internet survey was compiled from 38 photomicrographs showing duct proliferations: 14 signed out as high-grade prostatic intraepithelial neoplasia (HGPIN), 17 IDC, and 7 invasive cribriform/ductal carcinoma. Each image was assessed for the presence of 9 histologic criteria ascribed to IDC. Thirty-nine respondents were asked to rate images as (1) benign/reactive, (2) HGPIN, (3) borderline between HGPIN and IDC, (4) IDC, or (5) invasive cribriform/ductal carcinoma. Intraclass correlation coefficient was 0.68. There was 70% overall agreement with HGPIN, 43% with IDC, and 73% with invasive carcinoma (P < .001, χ(2)). Respondents considered 19 (50%) of 38 cases as IDC candidates, of which 5 (26%) had a two-thirds consensus for IDC; two-thirds consensus for either borderline or IDC was reached in 9 (47%). Two-thirds consensus other than IDC was reached in the remaining 19 of 38 cases, with 15 supporting HGPIN and 4 supporting invasive carcinoma. Findings that differed across diagnostic categories were lumen-spanning neoplastic cells (P < .001), 2× benign duct diameters (P < .001), duct space contours (round, irregular, and branched) (P < .001), papillary growth (P = .048), dense cribriform or solid growth (both P = .023), and comedonecrosis (P = .015). When the 19 of 38 images that attained consensus for HGPIN or invasive carcinoma were removed from consideration, lack of IDC consensus was most often attributable to only loose cribriform growth (5/19), central nuclear maturation (5/19), or comedonecrosis (3/19). Of the 9 histologic criteria, only 1 retained significant correlation with a consensus diagnosis of IDC: the presence of solid areas (P = .038). One case that attained IDC consensus had less than 2× duct enlargement yet still had severe nuclear atypia and nucleomegaly. Six fold nuclear enlargement was not significant (P = .083), although no image had both 6× nuclei and papillary or loose cribriform growth: a combination postulated as sufficient criteria for IDC. Finally, 20.5% of respondents agreed that an isolated diagnosis of IDC on needle biopsy warrants definitive therapy, 20.5% disagreed, and 59.0% considered the decision to depend upon clinicopathologic variables. Although IDC diagnosis remains challenging, we propose these criteria: a lumen-spanning proliferation of neoplastic cells in preexisting ducts with a dense cribriform or partial solid growth pattern. Solid growth, in any part of the duct space, emerges as the most reproducible finding to rule in a diagnosis of IDC. Comedonecrosis is a rarer finding, but in most cases, it should rule in IDC. Duct space enlargement to greater than 2× the diameter of the largest, adjacent benign spaces is usually present in IDC, although there may be rare exceptions.