Individual autonomy as a moral trend in the context of a social crisis

The article analyzes the emergence of a philosophical problem of separating a person from the social world through the formation of an individual value model that presupposes an autonomous spiritual existence of an individual. The political and moral prerequisites of avoiding civic participation are considered. The study focuses on Seneca’s moral theory, revealing the interaction of an individual with society in the context of the transformation of values during a social crisis. The goal of this study is 1) to determine the mutual influence between social inversions and changes in the value models of citizen behavior in society during a social crisis; 2) to formulate the main components of the concept ‘individual autonomy’, presented as part of the ancient tradition; 3) to specify and substantiate moral views of individual alienation from social community; and 4) to find out the features of this trend’s development in the history of social philosophy. The method of historical and comparative analysis and the system method, which allows correlating historical facts and moral interpretations of social events proposed by the Roman authors, are used as a means of reaching the abovementioned goals. The evidence of interrelation between the ancient tradition and subsequent forms of individual autonomy is proposed. Forms of communication with society as part of the self-isolation model of an individual from social activities are presented. The moral contradiction between the official paradigm of morality and a personal perception of social reality is put forward as the basis of social isolation

Institution of higher education transformation and society’s response to distance learning during the Covid 19 pandemic

The article analyzes the transformation of the institution of higher education and traditional education during the epidemiological crisis, due to which distance learning was introduced in universities on a federal scale. The authors focus not only on the effect of the introduction of online technologies into the higher education system, but emphasize the uniqueness of the situation in the context of the need to use these tools in order to minimize social communications when it comes to the viral threat. The authors’ use of cybermetric analysis, big data mining, and media monitoring using the Medialogia analysis system allowed to analyze the information agenda in the federal media space, to determine how the traditional education changed in the context of the Covid 19 pandemic. The specificity of perception of distance learning by Russian society is noted. It was revealed through analysis of the media space concerning the activities of the Ministry of Science and Higher Education of the Russian Federation from February to June 2020. The article emphasizes that the discussion on digitalization of the educational process will continue. The authors draw attention to the fact that joint efforts of the state and civil society can contribute to the development of an adequate model of higher education, based on the convergence of traditional and digital educational forms, taking into account the interests of all the participants in the higher educational process

Ticagrelor in patients with diabetes and stable coronary artery disease with a history of previous percutaneous coronary intervention (THEMIS-PCI) : a phase 3, placebo-controlled, randomised trial

Background: Patients with stable coronary artery disease and diabetes with previous percutaneous coronary intervention (PCI), particularly those with previous stenting, are at high risk of ischaemic events. These patients are generally treated with aspirin. In this trial, we aimed to investigate if these patients would benefit from treatment with aspirin plus ticagrelor. Methods: The Effect of Ticagrelor on Health Outcomes in diabEtes Mellitus patients Intervention Study (THEMIS) was a phase 3 randomised, double-blinded, placebo-controlled trial, done in 1315 sites in 42 countries. Patients were eligible if 50 years or older, with type 2 diabetes, receiving anti-hyperglycaemic drugs for at least 6 months, with stable coronary artery disease, and one of three other mutually non-exclusive criteria: a history of previous PCI or of coronary artery bypass grafting, or documentation of angiographic stenosis of 50% or more in at least one coronary artery. Eligible patients were randomly assigned (1:1) to either ticagrelor or placebo, by use of an interactive voice-response or web-response system. The THEMIS-PCI trial comprised a prespecified subgroup of patients with previous PCI. The primary efficacy outcome was a composite of cardiovascular death, myocardial infarction, or stroke (measured in the intention-to-treat population). Findings: Between Feb 17, 2014, and May 24, 2016, 11 154 patients (58% of the overall THEMIS trial) with a history of previous PCI were enrolled in the THEMIS-PCI trial. Median follow-up was 3·3 years (IQR 2·8–3·8). In the previous PCI group, fewer patients receiving ticagrelor had a primary efficacy outcome event than in the placebo group (404 [7·3%] of 5558 vs 480 [8·6%] of 5596; HR 0·85 [95% CI 0·74–0·97], p=0·013). The same effect was not observed in patients without PCI (p=0·76, p interaction=0·16). The proportion of patients with cardiovascular death was similar in both treatment groups (174 [3·1%] with ticagrelor vs 183 (3·3%) with placebo; HR 0·96 [95% CI 0·78–1·18], p=0·68), as well as all-cause death (282 [5·1%] vs 323 [5·8%]; 0·88 [0·75–1·03], p=0·11). TIMI major bleeding occurred in 111 (2·0%) of 5536 patients receiving ticagrelor and 62 (1·1%) of 5564 patients receiving placebo (HR 2·03 [95% CI 1·48–2·76], p<0·0001), and fatal bleeding in 6 (0·1%) of 5536 patients with ticagrelor and 6 (0·1%) of 5564 with placebo (1·13 [0·36–3·50], p=0·83). Intracranial haemorrhage occurred in 33 (0·6%) and 31 (0·6%) patients (1·21 [0·74–1·97], p=0·45). Ticagrelor improved net clinical benefit: 519/5558 (9·3%) versus 617/5596 (11·0%), HR=0·85, 95% CI 0·75–0·95, p=0·005, in contrast to patients without PCI where it did not, p interaction=0·012. Benefit was present irrespective of time from most recent PCI. Interpretation: In patients with diabetes, stable coronary artery disease, and previous PCI, ticagrelor added to aspirin reduced cardiovascular death, myocardial infarction, and stroke, although with increased major bleeding. In that large, easily identified population, ticagrelor provided a favourable net clinical benefit (more than in patients without history of PCI). This effect shows that long-term therapy with ticagrelor in addition to aspirin should be considered in patients with diabetes and a history of PCI who have tolerated antiplatelet therapy, have high ischaemic risk, and low bleeding risk