General Approval Research Articles

Perceptual axioms are irreconcilable with Euclidean geometry.

There are different definitions of axioms, but the one that seems to have general approval is that axioms are statements whose truths are universally accepted but cannot be proven; they are the foundation from which further propositional truths are derived. Previous attempts, led by David Hilbert, to show that all of mathematics can be built into an axiomatic system that is complete and consistent failed when Kurt Gödel proved that there will always be statements which are known to be true but can never be proven within the same axiomatic system. But Gödel and his followers took no account of brain mechanisms that generate and mediate logic. In this largely theoretical paper, but backed by previous experiments and our new ones reported below, we show that in the case of so-called 'optical illusions', there exists a significant and irreconcilable difference between their visual perception and their description according to Euclidean geometry; when participants are asked to adjust, from an initial randomised state, the perceptual geometric axioms to conform to the Euclidean description, the two never match, although the degree of mismatch varies between individuals. These results provide evidence that perceptual axioms, or statements known to be perceptually true, cannot be described mathematically. Thus, the logic of the visual perceptual system is irreconcilable with the cognitive (mathematical) system and cannot be updated even when knowledge of the difference between the two is available. Hence, no one brain reality is more 'objective' than any other.

International multi-stakeholder consensus statement on clinical trial integrity

ObjectiveTo prepare a set of statements for randomised clinical trials (RCT) integrity through an international multi-stakeholder consensus.MethodsThe consensus was developed via multi-country multidisciplinary stakeholder group composition and engagement; evidence synthesis of 55 systematic reviews concerning RCT integrity; anonymized two-round modified Delphi survey with consensus threshold based on the average percentage of majority opinions; and a final consensus development meeting. Prospective registrations: (https://osf.io/bhncy, https://osf.io/3ursn).ResultsThere were 30 stakeholders representing 15 countries from five continents including trialists, ethicists, methodologists, statisticians, consumer representatives, industry representatives, systematic reviewers, funding body panel members, regulatory experts, authors, journal editors, peer reviewers and advisors for resolving integrity concerns. Delphi survey response rate was 86.7% (26/30 stakeholders). There were 111 statements (73 stakeholder-provided, 46 systematic review-generated, 8 supported by both) in the initial long list, with eight additional statements provided during the consensus rounds. Through consensus the final set consolidated 81 statements (49 stakeholder-provided, 41 systematic review-generated, 9 supported by both). The entire RCT life cycle was covered by the set of statements including general aspects (n = 6), design and approval (n = 11), conduct and monitoring (n = 19), reporting of protocols and findings (n = 20), post-publication concerns (n = 12) and future research and development (n = 13).ConclusionImplementation of this multi-stakeholder consensus statement is expected to enhance RCT integrity.

DNV issues GASA to HD Hyundai for ‘world-first’ hybrid super-strength support structure

DNV has presented HD Hyundai with a general approval for ship application (GASA) for a new high-strength composite hybrid support system for independent tanks on liquefied gas carriers.

Scientism, trust, value alignment, views of nature, and U.S. public opinion about gene drive mosquitos.

Gene drive could be a powerful tool for addressing problems of conservation, agriculture, and human health caused by insect and animal pests but is likely to be controversial as it involves the release of genetically modified organisms. This study examined the social determinants of opinion of gene drive. We asked a representative sample of the U.S. public to respond to a description of a hypothetical application of a gene-drive mosquito to the problem of malaria and examined the relationship of these responses with demographic and ideological beliefs. We found strong general approval for the use of gene-drive mosquitos to address malaria, coinciding with the concern about a possible environmental impact of modified mosquitos and that gene drives represent "too much power over nature." Among the determinants we measured, respondent acceptance of scientism and trust that scientists are advancing the public's interest were the greatest predictors of views of gene drive.

Sentiment analysis of U.S. News & World Report Best Children's Hospital urology rankings: A difference in positivity between the public and academic worlds

Initiated in 2009, the U.S. News & World Report (USNWR) pediatric urology rankings aim to guide patients and families towards high-quality urologic care. Despite this, the pediatric urology community remains divided, with significant debate over the rankings' accuracy, utility, and potential for misleading information. While some professionals argue for a collective opt-out from these rankings, citing these concerns, others highlight their positive impact on patient care, hospital benchmarking, and financial support. Recognizing the lack of formal evaluation on how these rankings are viewed beyond the pediatric urology community, this research endeavors to fill the gap through sentiment analysis of public news articles and academic publications. We captured news articles from Google News and academic papers from Ovid Medline and Embase, focusing specifically on content related to the USNWR pediatric urology rankings from 2009 to 2023. Sentiment analysis was conducted using the Valence Aware Dictionary and Sentiment Reasoner (VADER) package on both news and academic texts, aiming to capture the overall sentiment through a compound score derived from the presence of sentiment-laden words. Sensitivity analysis was performed using TextBlob Pattern Analyzer tool. The analysis revealed a significant divergence in sentiment between news articles and academic literature. News articles exhibited a predominantly positive sentiment, with an average compound score of 0.681, suggesting a general approval or celebration of the rankings in the public sphere. Conversely, academic literature showed a more moderate sentiment, with an average score of 0.534, indicating a nuanced perspective that includes both positive views and critical reflections on the rankings. Sensitivity analysis confirmed this observation (Figure). This difference may reflect the distinct nature of news media and academic discourse. While news outlets may prioritize celebratory narratives that align with public interest and institutional pride, academic discussions tend to offer a balanced view that critically assesses both the merits and limitations of the rankings. This discrepancy underscores the complexity of interpreting and acting upon the rankings within the pediatric urology community. While the USNWR pediatric urology rankings are generally received positively by the public, as reflected in news media, the academic community presents a more reserved sentiment. These findings suggest the need for ongoing dialogue and research to understand the implications of these rankings fully. It also calls for a strategic approach to address the concerns and perceptions of healthcare professionals, aiming to leverage the rankings in a way that truly benefits patient care and informed decision-making.

O konceptualizacji pojęcia odličan w języku serbskim: analiza synonimii i budowy wewnętrznej wyrazu

The word odličan ‘excellentʼ is used to express a positive evaluation and has a large number of synonyms, but for many of them the lexicographic sources do not provide information about the possibility of using them for expressing evaluation. Moreover, although the inner word-form of the word odličan speaks only of general standing out from other objects, the word itself is used only in a positive sense. The inner word-form semantic analysis gives the answer to the question why all the analyzed synonyms can be used for giving a positive evaluation. The article draws attention to a deep conceptual relationship between words with the meaning of dobar ‘goodʼ and odličan ‘excellentʼ, because the same basic conceptual metaphors are used in their synonyms (dobar / odličan is up / big). It was also established that words with a positive connotation are found in the inner word-form of synonyms of odličan or in their definitions, including those that indicate a relationship between a positive general assessment and a positive aesthetic assessment. The meaning of odličan differs from “ordinary” objects in such a way that it can be conceptually associated with realm of the fantastic or unreal, which in turn triggers an emotional reaction in the observer. The language reveals that objects that are evaluated positively are treated in a unique way: they are set apart from others, they function as a topic of conversation, they acquire general approval and obtain a special status in society.

Abiotic stress treatment reveals expansin like A gene OfEXLA1 improving salt and drought tolerance of Osmanthus fragrans by responding to abscisic acid

Sweet osmanthus (Osmanthus fragrans) is a having general approval aromatic tree in China that is widely applied to landscaping and gardening. However, the evergreen tree adaptability is limited by many environmental stresses. Currently, limited information is available regarding the genetic analysis and functional identification of expansin genes in response to abiotic stress in sweet osmanthus. In this study, a total of 29 expansin genes were identified and divided into four groups by genome-wide analysis from the sweet osmanthus genome. Transcriptome and quantitative Real-time PCR analysis showed that the cell wall-localized protein expansin-like A (OfEXLA1) gene was significantly induced by salt and drought treatment. Histochemical GUS staining of transgenic Arabidopsis lines in which GUS activity was driven with the OfEXLA1 promoter, GUS activity was significantly induced by salt, drought, and exogenous abscisic acid (ABA). In yeast, we found OfEXLA1 overexpression significantly improved the population of cells compared with wild-type strains after NaCl and polyethylene glycol (PEG) treatment. Additionally, OfEXLA1 overexpression not only promoted plant growth, but also improved the salt and drought tolerance in Arabidopsis. To gain insight into the role of ABA signaling in the regulation of OfEXLA1 improving abiotic tolerance in sweet osmanthus, four differentially expressed ABA Insensitive 5 (ABI5)-like genes (OfABL4, OfABL5, OfABL7, and OfABL8) were identified from transcriptome, and dual-luciferase (dual-LUC) and yeast one hybrid (Y1H) assay showed that OfABL4 and OfABL5 might bind to OfEXLA1 promoter to accumulate the OfEXLA1 expression by responding to ABA signaling to improve abiotic tolerance in sweet osmanthus. These results provide the information for understanding the molecular functions of expansin-like A gene and molecular breeding of sweet osmanthus in future.

Partisanship, attribution and approval in a public health shock

Political scientists have long agreed that partisanship can bias how voters evaluate government performance and attribute responsibility. However, less is known about how – and to what extent – these biases work across different types of voters, or how they respond to positive or non-partisan policy outcomes. In this research note we address these questions, focusing on how voters respond to a positive, non-partisan public health shock: the successful early rollout of Covid-19 vaccinations in England. Through a pre-registered information experiment embedded in the British Election Study (N > 6000), we test how voters respond to claims that the quasi-independent National Health Service, rather than the government, deserved credit for the success of the programme. On average, subjects do attribute less responsibility to government, but this has no downstream effect on general approval. Exploratory heterogeneity analyses suggest that government and opposition supporters, as well as historic swing voters, respond homogeneously to our intervention. Our findings are not fully explained by rational or selective frameworks of responsibility attribution, and add nuance to existing experimental work on the political effects of the pandemic.

Diagnostic lymphangiography with therapeutic effect: Since more than 70 years Lipiodol is used as an off-label standard of care for chylothorax - why not convert to on-label use?

Purpose: The use of Lipiodol as a diagnostic agent and off-label therapeutic agent has been investigated in well over 395 publications listed in Pubmed under the key words: lymphangiography and chylothorax in the time period between 1921-2021. While Lipiodol® ultra-fluid has been approved for use as a diagnostic agent in most countries, it can only be used off-label as a therapeutic agent for chylothorax, cholascos, and lymphatic leaks and fistulas. The therapeutic effects in chylothorax and the question why Lipiodol® ultra-fluid is still not approved for on-label use in the treatment of chylothorax are reviewed. Background: Lipiodol was synthesized as iodized poppy seed oil by the French pharmacist Marcel Guerbet and first described by him in 1901. Over the past 12 decades, it has proven to be a reliable and versatile clinical theranostic agent. Lipiodol® ultra-fluid has been used (a) as a diagnostic contrast agent alone in the clarification and (b) so far only in off-label use as a therapeutic agent for chylothorax or cholascos, e.g. in cases of postoperative lymph leakages. Lipiodol® ultra-fluid has, to our knowledge, only very limited approvals as a therapeutic agent, in Switzerland only for transarterial chemo-embolization (TACE) for liver cancer. For decades and in numerous countries, Lipiodol® ultra-fluid has been in use as first-line treatment of chylothorax, cholascos, lymphatic leakage or lymphatic fistulae, avoiding additional interventions or surgery. This review aims to assess in which countries Lipiodol® ultra-fluid is approved (a) as a primary diagnostic tool and (b) as a first line therapeutic agent. This review wants to reassess why the general therapeutic approval still lacks, and what could be done to achieve it.

International multi-stakeholder consensus statement on clinical trial integrity.

To prepare a set of statements for randomised clinical trials (RCT) integrity through an international multi-stakeholder consensus. The consensus was developed via: multi-country multidisciplinary stakeholder group composition and engagement; evidence synthesis of 55 systematic reviews concerning RCT integrity; anonymised two-round modified Delphi survey with consensus threshold based on the average percentage of majority opinions; and, a final consensus development meeting. Prospective registrations: (https://osf.io/bhncy, https://osf.io/3ursn). There were 30 stakeholders representing 15 countries from five continents including triallists, ethicists, methodologists, statisticians, consumer representatives, industry representatives, systematic reviewers, funding body panel members, regulatory experts, authors, journal editors, peer-reviewers and advisors for resolving integrity concerns. Delphi survey response rate was 86.7% (26/30 stakeholders). There were 111 statements (73 stakeholder-provided, 46 systematic review-generated, 8 supported by both) in the initial long list, with eight additional statements provided during the consensus rounds. Through consensus the final set consolidated 81 statements (49 stakeholder-provided, 41 systematic review-generated, 9 supported by both). The entire RCT life cycle was covered by the set of statements including general aspects (n=6), design and approval (n=11), conduct and monitoring (n=19), reporting of protocols and findings (n=20), post-publication concerns (n=12), and future research and development (n=13). Implementation of this multi-stakeholder consensus statement is expected to enhance RCT integrity.

Research integrity in randomized clinical trials: A scoping umbrella review.

Randomized clinical trials (RCTs) are experiencing a crisis of confidence in their trustworthiness. Although a comprehensive literature search yielded several reviews on RCT integrity, an overarching overview is lacking. The authors undertook a scoping umbrella review of the research integrity literature concerning RCTs. Following prospective registration (https://osf.io/3ursn), two reviewers independently searched PubMed, Scopus, The Cochrane Library, and Google Scholar, without language or time restrictions, until November 2021. The authors included systematic reviews covering any aspect of research integrity throughout the RCT lifecycle. The authors assessed methodological quality using a modified AMSTAR 2 (A Measurement Tool to Assess Systematic Reviews) tool and collated the main findings. A total of 55 relevant reviews, summarizing 6001 studies (median per review, 63; range, 8-1106) from 1964 to 2021, had an overall critically low quality of 96% (53 reviews). Topics covered included general aspects (15%), design and approval (22%), conduct and monitoring (11%), reporting (38%), postpublication concerns (2%), and future research (13%). The most common integrity issues covered were ethics (18%) and transparency (18%). Low-quality reviews identified various integrity issues across the RCT lifecycle, emphasizing the importance of high ethical standards and professionalism while highlighting gaps in the integrity landscape. Multistakeholder consensus is needed to develop specific RCT integrity standards.

(218–220) Proposals to authorize binding decisions to be implemented upon General Committee approval of a recommendation, subject to ratification by a later International Botanical Congress

(218–220) Proposals to authorize binding decisions to be implemented upon General Committee approval of a recommendation, subject to ratification by a later International Botanical Congress

General and Case-Specific Approval of Coercion in Psychiatry in the Public Opinion.

Psychiatric patients are subjected to considerable stigmatization, in particular, because they are considered aggressive, uncontrollable, and dangerous. This stigmatization might influence the approval of coercive measures in psychiatry by the public and healthcare professionals and might have an influence on the clinical practice of coercive measures. We examined whether the general approval of coercive measures for psychiatric patients with dangerous behaviors differs from case-specific approval. We conducted a representative survey of the general population (n = 2207) in the canton of Basel-Stadt, Switzerland. In total, 1107 participants assessed a case vignette depicting a fictitious character with a mental illness and indicated whether they would accept coercive measures (involuntary hospitalization, involuntary medication, and seclusion) for the person in the vignette. It was explicitly stated that within the last month, the fictitious character displayed no dangerous behavior (Vignette ND) or dangerous behavior (Vignette D). Another 1100 participants were asked whether they would approve coercive measures (involuntary hospitalization, involuntary medication, and seclusion) for psychiatric patients with dangerous behavior in general (General D), i.e., without having received or referring to a specific case vignette. The logistic regression model containing all variables explained 45% of the variance in approval of any type of coercive measures. Assessment of case vignettes without dangerous behavior (Vignette ND) was associated with significantly reduced approval of coercive measures compared to assessment of a case vignette with dangerousness (Vignette D), while approval for coercive measures in a person with mental health disorder with dangerous behavior in general (General D) was significantly higher than for the case vignette with dangerousness. The general approval of coercive measures for people with mental disorders seems to differ depending on if the respondents are asked to give a general assessment or to examine a specific and detailed clinical case vignette, indicating an increased role of stigmatization when asking about generalized assessments. This may contribute to diverging findings on the acceptance of coercive measures in the literature and should be considered when designing future studies.

“She should get her own cat”: Parent‐child conversations about ownership and sharing

The present study uses a book-reading method to investigate how parents and young children discuss property interactions. 64 parent-child dyads considered 10 stories about different kinds of property interactions. 32 dyads included 2-year-olds and 32 included 4-year-olds. Dyads were of American, majority White, and a higher SES background. We discovered trade-offs in parent-child talk, wherein some property scenarios (e.g., trick-taking) promoted more talk about ownership, whereas others (e.g., borrowing) promoted more talk about sharing. We also document, for potentially the first time, which interactions elicit parent-child talk about the non-obvious history of possessions. Throughout their conversations, parents and children conversations revealed how successful reasoning about property interactions relies on a multi-part construal that includes not only the owner and their rights, but also the nature of the object, and the broader socio-moral context. Finally, we found that parents were more likely to discuss ownership concepts with younger children than older children, and that 4-year-olds were more sensitive to how different property interactions violated (or did not violate) owners’ rights than 2-year-olds. We suggest that 2-year-olds’ general approval of most exchanges may have led parents to highlight the ways different exchanges affected the owner. Together, these findings shed light on how parents and children engage with complex social-moral issues surrounding property interactions.

Health data privacy through homomorphic encryption and distributed ledger computing: an ethical-legal qualitative expert assessment study

BackgroundIncreasingly, hospitals and research institutes are developing technical solutions for sharing patient data in a privacy preserving manner. Two of these technical solutions are homomorphic encryption and distributed ledger technology. Homomorphic encryption allows computations to be performed on data without this data ever being decrypted. Therefore, homomorphic encryption represents a potential solution for conducting feasibility studies on cohorts of sensitive patient data stored in distributed locations. Distributed ledger technology provides a permanent record on all transfers and processing of patient data, allowing data custodians to audit access. A significant portion of the current literature has examined how these technologies might comply with data protection and research ethics frameworks. In the Swiss context, these instruments include the Federal Act on Data Protection and the Human Research Act. There are also institutional frameworks that govern the processing of health related and genetic data at different universities and hospitals. Given Switzerland’s geographical proximity to European Union (EU) member states, the General Data Protection Regulation (GDPR) may impose additional obligations.MethodsTo conduct this assessment, we carried out a series of qualitative interviews with key stakeholders at Swiss hospitals and research institutions. These included legal and clinical data management staff, as well as clinical and research ethics experts. These interviews were carried out with two series of vignettes that focused on data discovery using homomorphic encryption and data erasure from a distributed ledger platform.ResultsFor our first set of vignettes, interviewees were prepared to allow data discovery requests if patients had provided general consent or ethics committee approval, depending on the types of data made available. Our interviewees highlighted the importance of protecting against the risk of reidentification given different types of data. For our second set, there was disagreement amongst interviewees on whether they would delete patient data locally, or delete data linked to a ledger with cryptographic hashes. Our interviewees were also willing to delete data locally or on the ledger, subject to local legislation.ConclusionOur findings can help guide the deployment of these technologies, as well as determine ethics and legal requirements for such technologies.

Results of Parliamentary Elections in Hungary on April 3, 2022 and Prospects of Ukrainian-Hungarian Relations (Part 1)

Results of Parliamentary Elections in Hungary on April 3, 2022 and Prospects of Ukrainian-Hungarian Relations (Part 1)

Results of Parliamentary Elections in Hungary on April 3, 2022 and Prospects of Ukrainian-Hungarian Relations (Part 2)

Results of Parliamentary Elections in Hungary on April 3, 2022 and Prospects of Ukrainian-Hungarian Relations (Part 2)

Historical Society of the United Methodist Church

Historical Society of the United Methodist Church

Humor in radiological breast cancer screening: a way of improving patient service?

BackgroundBreast cancer screening is essential in detecting breast tumors, however, the examination is stressful. In this study we analyzed whether humor enhances patient satisfaction.MethodsIn this prospective randomized study 226 patients undergoing routine breast cancer screening at a single center during October 2020 to July 2021 were included. One hundred thirty-two were eligible for the study. Group 1 (66 patients) received an examination with humorous intervention, group 2 (66 patients) had a standard breast examination. In the humor group, the regular business card was replaced by a self-painted, humorous business card, which was handed to the patient at the beginning of the examination. Afterwards, patients were interviewed with a standardized questionnaire. Scores between the two study groups were compared with the Mann-Whitney U test or Fisher’s exact test. P-values were adjusted with the Holm’s method. Two-sided p-values < 0.05 were considered significant.ResultsOne hundred thirty-two patients, 131 female and 1 male, (mean age 59 ± 10.6 years) remained in the final study cohort. Patients in the humor group remembered the radiologist’s name better (85%/30%, P < .001), appreciated the final discussion with the radiologist more (4.67 ± 0.73–5;[5, 5] vs. 4.24 ± 1.1–5;[4, 5], P = .017), felt the radiologist was more empathetic (4.94 ± 0.24–5;[5, 5] vs.4.59 ± 0.64–5;[4, 5], P < .001), and rated him as a humorous doctor (4.91 ± 0.29–5;[5, 5] vs. 2.26 ± 1.43–1;[1, 4], P < .001). Additionally, patients in the humor group tended to experience less anxiety (p = 0.166) and felt the doctor was more competent (p = 0.094).ConclusionHumor during routine breast examinations may improve patient-radiologist relationship because the radiologist is considered more empathetic and competent, patients recall the radiologist’s name more easily, and value the final discussion more.Trial registrationWe have a general approval from our ethics committee because it is a retrospective survey, the patient lists for the doctors were anonymized and it is a qualitative study, since the clinical processes are part of the daily routine examinations and are used independently of the study. The patients have given their consent to this study and survey.

„Nicht mehr raus können!“ Validität und Differenzierung der Konzepte Hausgebundenheit, Rollstuhlgebundenheit und Bettlägerigkeit: eine Delphi-Studie

IntroductionBeing place-bound, including the dimensions of being homebound, wheelchair-bound and bedridden, has multifactorial consequences and carries an increased risk of mortality. The prevalence of being homebound and bedridden is high. Valid concepts are necessary to recognize the dimensions of being place-bound in practice and to act preventively or reductively. In preliminary studies, literature-based concept analyses of being homebound, wheelchair-bound and bedridden were carried out and a conceptual model with the following six characteristics was developed: life‐space confinement, in need of help, powerlessness, mobility limitation, endurance, weakness. The aim of this study was to test the concept by differentiating and validating the dimensions of the model with regard to characteristics, antecedents, and risk factors. MethodConcept testing was carried out employing the Delphi method based on Fehring’s DDV (Differential Diagnostic Validation) model. The CREDES guideline was used for reporting. ResultsApart from the characteristic of endurance in connection with being wheelchair-bound, general approval was achieved for all six characteristics. Mobility limitation and weakness are the main characteristics of differentiation. Antecedents (physiological instability, physical immobility) and risk factors (illness, complexity, stress, endogenous/exogenous booster) were also consented. Regarding the concepts of being wheelchair-bound and bedridden, there was little consensus on the antecedents of physiological instability. The antecedents of physical immobility through hand strength and hand use received no consensus in any of the dimensions. The German terms of the dimensions, originally coined in English, were confirmed: Hausgebundenheit (being homebound) 78.26%, Rollstuhlgebundenheit (being wheelchair-bound) 60%, Bettlägerigkeit (being bedridden) 80%. DiscussionWith a few exceptions, a high level of consensus regarding the approval/rejection of the characteristics, antecedents, and risk factors of the dimensions of being homebound and bedridden is shown. This unambiguity is not evident in the dimension of wheelchair-boundness. One possible cause is the ambiguity of the term itself (active/passive/permanent/temporary wheelchair use). The rejection of physical immobility through hand strength/use is to be seen critically since this is essential in independent movement of the wheelchair and when turning/sitting down in bed. The fact that bedridden people, on the one hand, need a wheelchair to move and, on the other hand, cannot maintain a sitting position, must also be questioned. If an upright sitting position can be maintained, this must be promoted to support orthostatic stability, which would correspond to being wheelchair-bound. ConclusionThe validity of the dimensions of the model of being place-bound is an essential contribution to evidence-based health care and provides a basis for the development of nursing and interdisciplinary interventions to prevent and reduce being place-bound. Mobility does not only have a major impact on the individual quality of life, but also on the resources of the health care system. Therefore, a valid concept is not only important for science and research, but also for health economy and health policy. However, further studies on validity testing in clinical settings including those affected are necessary.