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This study aimed to compare long-term audiological outcomes of diode laser stapedotomy, microdrill stapedotomy and combined potassium titanyl phosphate laser–microdrill stapedotomy, and to identify predictors of surgical success.
Methods
Surgical, audiological and complications data were collected. Surgical success was analysed via the measurement of post-operative air–bone gap, air conduction gain.
Results
A total of 615 patients were included; median follow-up was 16 months (range 1–1319). Overall, the 94.3 per cent achieved surgical success (air–bone gap < 15 dB). Median air–bone gap closure was 5 dB (interquartile range: 2.50–8.12), and median air conduction gain was 27.5dB (interquartile range: 19.37–36.25).
Compared across techniques, success rates were similar; however, post-operative air–bone gap was significantly better with laser techniques than with microdrill alone (p = 0.016). Longer prostheses were associated with improved outcomes.
Conclusion
All the examined techniques showed excellent audiological results. Laser use was associated with better post-operative air–bone gap than stapedotomy with microdrill only.
The Computational Theory of Mind says that the mind is a computing system. It has a long history going back to the idea that thought is a kind of computation. Its modern incarnation relies on analogies with contemporary computing technology and the use of computational models. It comes in many versions, some more plausible than others. This Element supports the theory primarily by its contribution to solving the mind-body problem, its ability to explain mental phenomena, and the success of computational modelling and artificial intelligence. To be turned into an adequate theory, it needs to be made compatible with the tractability of cognition, the situatedness and dynamical aspects of the mind, the way the brain works, intentionality, and consciousness.
Where does a probabilistic language-of-thought (PLoT) come from? How can we learn new concepts based on probabilistic inferences operating on a PLoT? Here, I explore these questions, sketching a traditional circularity objection to LoT and canvassing various approaches to addressing it. I conclude that PLoT-based cognitive architectures can support genuine concept learning; but, currently, it is unclear that they enjoy more explanatory breadth in relation to concept learning than alternative architectures that do not posit any LoT.
Bruineberg and collaborators distinguish three philosophical positions about the status of Markov blankets in the context of active inference modelling, namely: literalism, realism, and instrumentalism. They criticize the first two positions and suggest that instrumentalism is “less problematic but also less interesting” (sect. 6.1.2, para. 5) Here, I sketch how literalists and realists might reply to Bruineberg et al.'s criticisms, and I explain why instrumentalism is more interesting and contentious than what Bruineberg and collaborators suggest.
An unprecedented wave of patients with acute respiratory failure due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease 2019 (COVID-19) hit emergency departments (EDs) in Lombardy, starting in the second half of February 2020. This study describes the direct and indirect impacts of the SARS-CoV-2 outbreak on an urban major-hospital ED.
Methods:
Data regarding all patients diagnosed with COVID-19 presenting from February 1 to March 31, 2020, were prospectively collected, while data regarding non-COVID patients presenting within the same period in 2019 were retrospectively retrieved.
Results:
ED attendance dropped by 37% in 2020. Two-thirds of this reduction occurred early after the identification of the first autochthonous COVID-19 case in Lombardy, before lockdown measures were enforced. Hospital admissions of non-COVID patients fell by 26%. During the peak of COVID-19 attendance, the ED faced an extraordinary increase in: patients needing oxygen (+239%) or noninvasive ventilation (+725%), transfers to the intensive care unit (+57%), and in-hospital mortality (+309%), compared with the same period in 2019.
Conclusions:
The COVID-19 outbreak determined an unprecedented upsurge in respiratory failure cases and mortality. Fear of contagion triggered a spontaneous, marked reduction of ED attendance, and, presumably, some as yet unknown quantity of missed or delayed diagnoses for conditions other than COVID-19.
Veissière and collaborators ground their account of culture and social norms in the free-energy principle, which postulates that the utility (or adaptive value) of an outcome is equivalent to its probability. This equivalence would mean that their account entails that complying with social norms has always adaptive value. But, this is false, because many social norms are obviously maladaptive.
Obsessive-compulsive disorder (OCD) and tic disorder (TD) represent highly disabling, chronic and often comorbid psychiatric conditions. While recent studies showed a high risk of suicide for patients with OCD, little is known about those patients with comorbid TD (OCTD). Aim of this study was to characterize suicidal behaviors among patients with OCD and OCTD.
Methods
Three hundred and thirteen outpatients with OCD (n = 157) and OCTD (n = 156) were recruited from nine different psychiatric Italian departments and assessed using an ad-hoc developed questionnaire investigating, among other domains, suicide attempt (SA) and ideation (SI). The sample was divided into four subgroups: OCD with SA (OCD-SA), OCD without SA (OCD-noSA), OCTD with SA (OCTD-SA), and OCTD without SA (OCTD-noSA).
Results
No differences between groups were found in terms of SI, while SA rates were significantly higher in patients with OCTD compared to patients with OCD. OCTD-SA group showed a significant male prevalence and higher unemployment rates compared to OCD-SA and OCD-noSA sample. Both OCTD-groups showed an earlier age of psychiatric comorbidity onset (other than TD) compared to the OCD-SA sample. Moreover, patients with OCTD-SA showed higher rates of other psychiatric comorbidities and positive psychiatric family history compared to the OCD-SA group and to the OCD-noSA groups. OCTD-SA and OCD-SA samples showed higher rates of antipsychotics therapies and treatment resistance compared to OCD-noSA groups.
Conclusions
Patients with OCTD vs with OCD showed a significantly higher rate of SA with no differences in SI. In particular, OCTD-SA group showed different unfavorable epidemiological and clinical features which need to be confirmed in future prospective studies.
Lieder and Griffiths introduce resource-rational analysis as a methodological device for the empirical study of the mind. But they also suggest resource-rationality serves as a normative standard to reassess the limits and scope of human rationality. Although the methodological status of resource-rational analysis is convincing, its normative status is not.
What's the evidential impact of learning that something is a mystery? To answer this question, we first explicate the notion of a mystery in terms of unexplainability. After distinguishing different ways in which something can be unexplainable, we develop a test to evaluate the evidential impact of two distinct types of unexplainables: symmetrical and asymmetrical unexplainables. We argue that only asymmetrical unexplainables have evidential impact. We finally clarify how our explication of mysteries as unexplainables complements existing accounts of abduction and contributes to the literature on the mystery of consciousness.
Modularity is one of the most important concepts used to articulate a theory of cognitive architecture. Over the last 30 years, the debate in many areas of the cognitive sciences and in philosophy of psychology about what modules are, and to what extent our cognitive architecture is modular, has made little progress. After providing a diagnosis of this lack of progress, this article suggests a remedy. It argues that the theoretical framework of network science can be brought to bear on the traditional modularity debate, facilitating our progress in articulating a good theory of the human cognitive architecture.
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