Thick Evaluation

"We use evaluative terms and concepts every day. We call actions right and wrong, teachers wise and ignorant, and pictures elegant and grotesque. Philosophers place evaluative concepts into two camps. Thin concepts, such as goodness and badness, and rightness and wrongness have evaluative content, but they supposedly have no or hardly any nonevaluative, descriptive content: they supposedly give little or no specific idea about the character of the person or thing described. In contrast, thick concepts such as kindness, elegance and wisdom supposedly give a more specific idea of people or things. Yet, given typical linguistic conventions, thick concepts also convey evaluation. Kind people are often viewed positively whilst ignorance has negative connotations. The distinction between thin and thick concepts is frequently drawn in philosophy and is central to everyday life. However, very few articles or books discuss the distinction. In this full-length study, Simon Kirchin discusses thin and thick concepts, highlighting key assumptions, questions and arguments, many of which have gone unnoticed. Kirchin focuses in on the debate between 'separationists' (those who think that thick concepts can be separated into component parts of evaluative, often very 'thin', content and nonevaluative content) and 'nonseparationists' (who deny this). Thick Evaluation argues for a version of nonseparationism, and in doing so argues both that many concepts are evaluative and also that evaluation is not exhausted by thin positive and negative stances.

Thick Evaluation

"We use evaluative terms and concepts every day. We call actions right and wrong, teachers wise and ignorant, and pictures elegant and grotesque. Philosophers place evaluative concepts into two camps. Thin concepts, such as goodness and badness, and rightness and wrongness have evaluative content, but they supposedly have no or hardly any nonevaluative, descriptive content: they supposedly give little or no specific idea about the character of the person or thing described. In contrast, thick concepts such as kindness, elegance and wisdom supposedly give a more specific idea of people or things. Yet, given typical linguistic conventions, thick concepts also convey evaluation. Kind people are often viewed positively whilst ignorance has negative connotations. The distinction between thin and thick concepts is frequently drawn in philosophy and is central to everyday life. However, very few articles or books discuss the distinction. In this full-length study, Simon Kirchin discusses thin and thick concepts, highlighting key assumptions, questions and arguments, many of which have gone unnoticed. Kirchin focuses in on the debate between 'separationists' (those who think that thick concepts can be separated into component parts of evaluative, often very 'thin', content and nonevaluative content) and 'nonseparationists' (who deny this). Thick Evaluation argues for a version of nonseparationism, and in doing so argues both that many concepts are evaluative and also that evaluation is not exhausted by thin positive and negative stances.

Clinical utility of gadobenate dimeglumine in contrast-enhanced MRI of the breast: a review

Breast magnetic resonance imaging (MRI) is considered the technique with the highest sensitivity for breast cancer detection. Gadobenate dimeglumine is a gadolinium-based contrast agent (GBCA) that is specifically approved in Europe for breast MRI and which has the highest r1 relaxivity among all GBCAs for this indication. In order to improve the diagnostic performance of breast MRI, several intra-individual crossover studies have evaluated gadobenate dimeglumine as a possible GBCA for this application. This review focuses on the role and advantages of gadobenate dimeglumine as a contrast agent for breast MRI by describing the unique properties of this agent and by summarizing published studies

Low radiation dose in computed tomography: the role of iodine

Recent approaches to reducing radiation exposure during CT examinations typically utilize automated dose modulation strategies on the basis of lower tube voltage combined with iterative reconstruction and other dose-saving techniques. Less clearly appreciated is the potentially substantial role that iodinated contrast media (CM) can play in low-radiation-dose CT examinations. Herein we discuss the role of iodinated CM in low-radiation-dose examinations and describe approaches for the optimization of CM administration protocols to further reduce radiation dose and/or CM dose while maintaining image quality for accurate diagnosis. Similar to the higher iodine attenuation obtained at low-tube-voltage settings, high-iodine-signal protocols may permit radiation dose reduction by permitting a lowering of mAs while maintaining the signal-to-noise ratio. This is particularly feasible in first pass examinations where high iodine signal can be achieved by injecting iodine more rapidly. The combination of low kV and IR can also be used to reduce the iodine dose. Here, in optimum contrast injection protocols, the volume of CM administered rather than the iodine concentration should be reduced, since with high-iodine-concentration CM further reductions of iodine dose are achievable for modern first pass examinations. Moreover, higher concentrations of CM more readily allow reductions of both flow rate and volume, thereby improving the tolerability of contrast administration

Thick Evaluation

This is an open access title available under the terms of a CC BY-NC-ND 4.0 International licence. It is free to read at Oxford Scholarship Online and offered as a free PDF download from OUP and selected open access locations. We use evaluative terms and concepts every day. We call actions right and wrong, teachers wise and ignorant, and pictures elegant and grotesque. Philosophers place evaluative concepts into two camps. Thin concepts, such as goodness and badness, and rightness and wrongness have evaluative content, but they supposedly have no or hardly any nonevaluative, descriptive content: they supposedly give little or no specific idea about the character of the person or thing described. In contrast, thick concepts such as kindness, elegance and wisdom supposedly give a more specific idea of people or things. Yet, given typical linguistic conventions, thick concepts also convey evaluation. Kind people are often viewed positively whilst ignorance has negative connotations. The distinction between thin and thick concepts is frequently drawn in philosophy and is central to everyday life. However, very few articles or books discuss the distinction. In this full-length study, Simon Kirchin discusses thin and thick concepts, highlighting key assumptions, questions and arguments, many of which have gone unnoticed. Kirchin focuses in on the debate between 'separationists' (those who think that thick concepts can be separated into component parts of evaluative, often very 'thin', content and nonevaluative content) and 'nonseparationists' (who deny this). Thick Evaluation argues for a version of nonseparationism, and in doing so argues both that many concepts are evaluative and also that evaluation is not exhausted by thin positive and negative stances

Is Drag Morally Objectionable?

We are living through a golden age of drag, with drag kings and queens prominent in our society and media. Drag seems like fun, and a talk about drag in a department seminar may seem as if philosophy is enjoying a jolly time away from more serious topics. However, drag has a serious side. Some critics have recently accused drag of inherent sexism and misogyny, and this has extra bite in an age where concerns about cultural appropriation (and other, similar matters) are high. This talk will detail the challenge and argue that drag is not inherently morally objectionable

Follow-Up of Coiled Cerebral Aneurysms at 3T: Comparison of 3D Time-of-Flight MR Angiography and Contrast-Enhanced MR Angiography

BACKGROUND AND PURPOSE: Our aim was to compare contrast-enhanced MR angiography (CE-MRA) and 3D time-of-flight (TOF) MRA at 3T for follow-up of coiled cerebral aneurysms. MATERIALS AND METHODS: Fifty-two patients treated with Guglielmi detachable coils for 54 cerebral aneurysms were evaluated at 3T MRA. 3D TOF MRA (TR/TE = 23/3.5; SENSE factor = 2.5) and CE-MRA by using a 3D ultrafast gradient-echo sequence (TR/TE = 5.9/1.8; SENSE factor = 3) enhanced with 0.1-mmol/kg gadobenate dimeglumine were performed in the same session. Source images, 3D maximum intensity projection, 3D shaded surface display, and/or 3D volume-rendered reconstructions were evaluated in terms of aneurysm occlusion/patency and artifact presence. RESULTS: In terms of clinical classification, the 2 MRA sequences were equivalent for 53 of the 54 treated aneurysms: 21 were considered fully occluded, whereas 16 were considered to have a residual neck and 16 were considered residually patent at follow-up MRA. The remaining aneurysm appeared fully occluded at TOF MRA but had a residual patent neck at CE-MRA. Visualization of residual aneurysm patency was significantly ( P = .001) better with CE-MRA compared with TOF MRA for 10 (31.3%) of the 32 treated aneurysms considered residually patent with both sequences. Coil artifacts were present in 5 cases at TOF MRA but in none at CE-MRA. No relationship was apparent between the visualization of patency and either the size of the aneurysm or the interval between embolization and follow-up. CONCLUSION: At follow-up MRA at 3T, unenhanced TOF and CE-MRA sequences are similarly effective at classifying coiled aneurysms as occluded or residually patent. However, CE-MRA is superior to TOF MRA for visualization of residual patency and is associated with fewer artifacts

High-Resolution Steady State Magnetic Resonance Angiography of the Carotid Arteries: Are Intravascular Agents Necessary? Feasibility and Preliminary Experience With Gadobenate Dimeglumine

Purpose: To prospectively evaluate the potential of gadobenate dimeglumine for high-resolution steady-state (SS) contrast-enhanced magnetic resonance angiography (CE-MRA) of the carotid arteries as an adjunct to conventional first-pass (FP) MRA, with computed tomography angiography (CTA) and digital subtraction angiography (DSA) as reference. Materials and Methods: Institutional ethics committee approval and written informed consent were obtained. Forty consecutive patients underwent conventional FP MRA with 15 mL gadobenate dimeglumine, using a conventional 3D FLASH sequence (14 see acquisition time). Immediately afterward, SS images were obtained using a high resolution coronal 3D FLASH sequence (240 see acquisition time). All patients also underwent CTA and conventional DSA within 8 +/- 3 days. Three experienced radiologists assessed FP and SS image quality and calculated sensitivity, specificity, accuracy, and predictive values for stenosis grade and length, plaque morphology, and tandem lesions using DSA as reference. Detected stenoses were quantified and compared (Spearman rank correlation coefficient, [R(s)]. McNemar test) with DSA and CTA findings. Inter-read variability was assessed using kappa (kappa) statistics. The impact of SS acquisitions on diagnostic confidence and patient management was assessed. Results: MRA FP and SS image quality was excellent in 63 (78.8%) and 46 (57.5%) vessels, adequate in 11 (13.8%) and 20 (25.0%) vessels, and poor in 6 (7.5%) and 14 (17.5%) vessels, respectively. Area under the curve analysis revealed no significant differences between MRA FP, MRA FP + SS, and CTA for the grading of stenoses (P = 0.838; accuracy values of 97.4% 97.4%, and 98.7%, respectively). Greater accuracy (P < 0.001) was noted for FP + SS images over FP images alone for the assessment of plaque morphology (96.1% for FP + SS images vs. 83.3% for FP). Increased diagnostic confidence was noted for 49 (61.3%) vessels because of additional SS images whereas an impact on final diagnosis was noted in 8 (10%) cases. Good correlation was noted between SS image quality and impact on final diagnosis (R(s) = 0.7; P < 0.0001). Conclusion: SS imaging of the carotid arteries is feasible with gadobenate dimeglumine. The increased spatial resolution attainable allows improved evaluation of stenoses and plaque irregularity, yielding comparable diagnostic performance to that of CTA and DSA

A protocol for developing, disseminating, and implementing a core outcome set for stress urinary incontinence.

INTRODUCTION: Randomized trials evaluating interventions for stress urinary incontinence (SUI) have been using variable outcome measures, reporting a variety of outcomes. Alongside this variation across studies, outcome-reporting flaws contribute to a limited use of research to inform clinical practice. The development and use of core outcome sets (COSs) in future trials would ensure that outcomes important to different stakeholders and primarily women with SUI are reported more consistently and comprehensively. METHODS: An international steering group including healthcare professionals, researchers, and women with urinary incontinence will guide the development of this COS. Potential outcomes will be identified through comprehensive literature reviews. These outcomes will be entered into an international, multiperspective online Delphi survey. All key stakeholders, including healthcare professionals, researchers, and women with urinary incontinence, will be invited to participate. The modified Delphi method encourages stakeholder group convergence toward collective agreement, also referred as consensus, core outcomes. DISCUSSION: Dissemination and implementation of the resulting COS within an international context will be promoted and reviewed. Embedding the COS for SUI within future clinical trials, systematic reviews and clinical practice guidelines could make a significant contribution to advancing the value of research in informing clinical practice, enhancing patient care and improving outcomes. The infrastructure created by developing a COS for SUI could be leveraged in other settings, for example, selecting research priorities and clinical practice guideline development