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This article advocates a new interpretation of inner experience – the experience that one has of one’s empirical-psychological features ‘from within’ – in Kant. It argues that for Kant inner experience is the empirical cognition of mental states, but not that of a persistent mental substance. The schema of persistence is thereby substituted with the regulative idea of the soul. This view is shown to be superior to two opposed interpretations: the parity view that regards inner experience as empirical cognition of a mental object on a par with outer experience and the disparity view that denies altogether that inner experience is empirical cognition.
The aim of this study was to perform a systematic review and meta-analysis of the diagnostic accuracy of a point-of-care ultrasound exam for undifferentiated shock in patients presenting to the emergency department.
Ovid MEDLINE, Scopus, Cochrane Central Register of Controlled Trials, and research meeting abstracts were searched from 1966 to June 2018 for relevant studies. QUADAS-2 was used to assess study quality, and meta-analysis was conducted to pool performance data of individual categories of shock.
A total of 5,097 non-duplicated studies were identified, of which 58 underwent full-text review; 4 were included for analysis. Study quality by QUADAS-2 was considered overall a low risk of bias. Pooled positive likelihood ratio values ranged from 8.25 (95% CI 3.29 to 20.69) for hypovolemic shock to 40.54 (95% CI 12.06 to 136.28) for obstructive shock. Pooled negative likelihood ratio values ranged from 0.13 (95% CI 0.04 to 0.48) for obstructive shock to 0.32 (95% CI 0.16 to 0.62) for mixed-etiology shock.
The rapid ultrasound for shock and hypotension (RUSH) exam performs better when used to rule in causes of shock, rather than to definitively exclude specific etiologies. The negative likelihood ratios of the exam by subtype suggest that it most accurately rules out obstructive shock.
In spring 1962, 60,000 individuals fled from northern Xinjiang into the Soviet Union. Known as the “Yi–Ta” incident, the mass exodus sparked a major flare up in Sino-Soviet relations. This article draws on declassified Chinese and Russian-language archival sources and provides one of the first in-depth interpretations of the event and its aftermath. It argues that although the Chinese government blamed the Soviet Union for the Yi-Ta incident, leaders in Beijing and Xinjiang also recognized the domestic roots of the disturbance, such as serious material deficits in northern Xinjiang and tensions between minority peoples and the party-state. The Chinese government's diplomatic sparring with Moscow over the mass exodus reflected Mao Zedong's continued influence on Chinese foreign policy, despite claims by scholars that Mao had retreated from policymaking during this period.
Reinforcement learning (RL) can be extremely effective in solving complex, real-world problems. However, injecting human knowledge into an RL agent may require extensive effort and expertise on the human designer’s part. To date, human factors are generally not considered in the development and evaluation of possible RL approaches. In this article, we set out to investigate how different methods for injecting human knowledge are applied, in practice, by human designers of varying levels of knowledge and skill. We perform the first empirical evaluation of several methods, including a newly proposed method named State Action Similarity Solutions (SASS) which is based on the notion of similarities in the agent’s state–action space. Through this human study, consisting of 51 human participants, we shed new light on the human factors that play a key role in RL. We find that the classical reward shaping technique seems to be the most natural method for most designers, both expert and non-expert, to speed up RL. However, we further find that our proposed method SASS can be effectively and efficiently combined with reward shaping, and provides a beneficial alternative to using only a single-speedup method with minimal human designer effort overhead.
Necrotising otitis externa is a severe inflammatory process affecting soft tissue and bone, mostly in diabetic patients. Diabetic patients are also at risk of diabetic foot osteomyelitis, another inflammatory condition involving soft tissue and bone. This review aimed to describe the similarities and differences of these entities in an attempt to further advance the management of necrotising otitis externa.
A PubMed search was conducted using the key words ‘otitis externa’, ‘necrotising otitis externa’, ‘malignant otitis externa’, ‘osteomyelitis’ and ‘diabetic foot’.
Results and conclusion
The similarities regarding patient population and pathophysiology between necrotising otitis externa and diabetic foot osteomyelitis raise basic questions concerning the effects of long-standing diabetes on the external ear. The concordance between local swabs and bone cultures in diabetic foot osteomyelitis is less than 50 per cent. If this holds true also to necrotising otitis externa, the role of deep tissue cultures should be strongly considered. Similar to diabetic foot osteomyelitis, magnetic resonance imaging should be considered in selected necrotising otitis externa subgroups.
Until quite recently the cultural prehistory of Japan has been, like many other areas of Asia, very inadequately known to most American and European students. There is now enough material available to enable me to present to you an outline of the prehistoric cultural development of Japan with a high degree of reliability in its essential validity. Much remains to be done, however, both in the sphere of “dirt archaeology” and in the field of analysis, synthesis, and foreign relationships.
The term “Jomon” has become entrenched as the designation for the entire period of Japanese culture preceding the entrance of the Yayoi people with their bronze-age culture from Korea and the adjacent areas into Kyushu. This migration must have commenced at least as early as the second century B.C. since it is known that Yayoi centers were flourishing in Kyushu and southwest Honshu in the first century B.C. Absolute dates for the earliest cultural manifestations in Japan are lacking but my guess would be about 3000 B.C.