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LitCovid-PD-FMA-UBERON

{"project":"LitCovid-PD-FMA-UBERON","denotations":[{"id":"T1","span":{"begin":4613,"end":4618},"obj":"Body_part"},{"id":"T2","span":{"begin":5768,"end":5774},"obj":"Body_part"},{"id":"T3","span":{"begin":10490,"end":10495},"obj":"Body_part"}],"attributes":[{"id":"A1","pred":"fma_id","subj":"T1","obj":"http://purl.org/sig/ont/fma/fma7088"},{"id":"A2","pred":"fma_id","subj":"T2","obj":"http://purl.org/sig/ont/fma/fma264279"},{"id":"A3","pred":"fma_id","subj":"T3","obj":"http://purl.org/sig/ont/fma/fma50801"}],"text":"Part I: The Global Problem\nInfectious diseases, in particular lower respiratory infections, remain the leading cause of death world-wide killing one-third of all people across all economic groups.1 While we acknowledge that the spread of infectious diseases is commonly exacerbated by human behavior, population density, inadequate public health protections, land and water use patterns and violations, increasing trade and travel, viral and bacterial mutations, as well as inappropriate use and increasing resistance to antibiotics, we rarely consider the purposeful lack of governmental leadership as a major factor in both the life and acceleration of preventable outbreaks, epidemics, and pandemics. Societies have experienced the benefits of advancements in public health infrastructure, prevention, and preparedness, yet these protections remain far from being globally understood, available, practiced uniformly, or free of political control.\nWhat is increasingly common since the last one-third of the 20th century is the thread of public health emergencies permeating, and often dominating, the consequences brought on by wars, conflicts, and large-scale disasters.2 Few are aware that wartime public health crises cause more deaths than weapons.3,4 Consistently in war, the public health protective threshold is destroyed and not recovered or maintained.5 Recovery is purposely ignored, resulting in increasing post-crisis mortality and morbidity indices that are characteristically ignored or denied, especially if they negatively impact political, ethnic, or religious groups whose views are contrary to the newly installed autocratic regime.\nRuger reminds us that authoritarian regimes suppress political competition and tend to have an interest in preventing human development, because improved health, education, and economic security mobilizes citizens to advocate for greater participation and more resources.6 Public health protections are literally invisible to populations; they are often taken for granted and applauded as great successes serving as propaganda ploys in public speeches.7 Although there has been scant investment in public health infrastructure and protections in all parts of the world, those countries suffer the most under autocratic regimes, especially where they have failed to keep pace with population growth and density.8 Currently, both the urban and rural environment of the 21st century are being defined by deficient dwellings, aged and inadequate infrastructure, and insufficient capacity to respond to crises, especially in ensuring access to safe water, food, sanitation, and energy. Public health surveillance, the “continuous, systematic collection, and analysis of health-related data serve as an early warning system for impending public health emergencies, but compliance differs remarkably from one country to another.”6,8 Indeed, the direct and indirect mortality and morbidity resulting from these tragedies are the responsibility of the government in power, but are often the first to be ignored. Ecological and environmental protections and preservations, such as the continuous surveillance mandated by the World Health Organization (WHO; Geneva, Switzerland) of wet markets in China that launched SARS (severe acute respiratory syndrome) in 2008, is an example of a critical monitor that was ended prematurely. Only the reporting of three diseases (yellow fever, plague, and cholera) are currently binding under the International Health Regulations, and then some countries are unwilling to notify WHO fearing economic and political consequences.9\n\nStable and Unstable Political Systems\nThe processes of political development, primarily as they apply to stable and unstable political systems and change, have always been dynamic, especially in crisis situations such as outbreaks of infectious diseases in less-developed countries. Crisis situations test the stability of political systems in revealing ways, placing extraordinary demands on the political leadership and the existing public health structure and processes of the country. In the absence of early and effective preparedness, societies may experience social and economic disruption, threats to the continuity of essential services, reduced production, distribution difficulties, and shortages of essential commodities. The WHO emphasizes a “whole-of-society” approach that emphasizes significant roles not only for the health sector, but also by all other sectors, individuals, families, and communities, in mitigating the effects of a pandemic.10 Developing such capacities is at the heart of preparing the whole of society for a pandemic. I assert that it is the loss of the whole of societyʼs concept, thinking, and participation that is systematically destroyed in autocratic regimes that contributes to why these political systems fail. They fail when citizens have no defined ownership, channels of communication, or are allowed to participate in any aspect of the disaster cycle (prevention, preparedness, response, recovery, or rehabilitation). They fail when citizens are not allowed a voice in the implementation of acceptable policies when the political system ceases to be viewed as responsive by individuals and groups making demands on it, and by what is considered inappropriate political behavior.\nInfectious disease outbreaks have the uncanny capacity to question the status quo, catalyze smoldering unrest, and most importantly, reveal population-based public health imperfections.11 The “whole of society” which depends on a form of collaborative governance, which complements public policy, disappears and is seen only as the dictate of one person. Indeed, the negative influence on society, what I refer to a “societal mental health,” is out of proportion to their representation in society.12\nThe 2019 Democracy Index, compiled by the United Kingdomʼs Economist Intelligence Unit (London, UK) and published annually in The Economist, ranks countries according to political and civic freedom using five criteria: whether elections are free and fair, whether governments have checks and balances, whether citizens are included in politics, the level of support for the government, and whether people have freedom of expression. Nations are divided into “full democracies, flawed democracies, hybrid regimes [which include those exhibiting regular electoral frauds], and authoritarian regimes” where “political pluralism has vanished or is extremely limited.”13 The 2019 edition is considered as having the “worst average global score since the Index was introduced in 2006, driven primarily by regressions in Latin America and sub-Saharan Africa.14\nGlobally, this is the first time in the modern era where we have the fewest democracies. By ranking on how functional their political systems are, less than five percent of the worldʼs population live in a “full democracy.”15 Fewer countries can claim free and fair elections, checks, balances, and participation in their governments. Fewer nations offer freedom of expression or political participation in established political cultures. Rapidly established and increasingly prosperous autocratic regimes, many first drawn in by populist claims that enticed the masses of working-class and poor, are now firmly established by an economy ruled by dictators and oligarchs with unfettered political influence. The United States is now categorized as a “flawed democracy,” experiencing both undeniable presidential claims for more authoritarian rule, a population that increasingly claims loss of traditional liberties, and low esteem in which US voters hold their government, elected representatives, and political parties.15\n\nCharacteristics of Autocratic Regime Leadership\nAutocratic leaders demonstrate personality and behavioral characteristics that are remarkably consistent across borders and cultures.16 In great part, this is due to a common fault line from their adolescent development which becomes arrested cognitively and emotionally. While they may, at first glance, seems smart, they are not bright or capable of attaining abstract reasoning.17 This type of reasoning is required to formulate theories and understand multiple meanings crucial for reasoning. It demands generalizations, ideas, the ability to identify the relationship between verbal and nonverbal ideas, and to understand the multiple meanings that underlie an event, statement, or object; an example often cited is: “The Liberty Bell is not just a piece of American history, but is a symbol of freedom.”18 Concrete thinkers misinterpret many concepts like this and are compelled to reinterpret them in their own concrete manner in political speeches and legislative decisions.\nAbstract thinking refers to a cognitive concept involving higher-order, or complex thoughts. To be able to think in an abstract manner implies that one is able to draw conclusions or illustrate relationships among concepts in a manner beyond what is obvious.19 Often the terms “abstract thought” and “concept formation” are used interchangeably. In the past, the term “fluid intelligence” has been used to refer to the ability to reason. The generation of concepts, or abstract ideas, indicates an ability to progress beyond concrete thinking. The concrete interpretation of a concept involves a focus on the salient, obvious characteristics. Progressing beyond the tangible characteristics in order to conceptualize theoretical relationships between items or processes involves abstract thought. Deeper meanings such as “freedom,” “equality,” “charity,” “love,” and “democracy” express ideas, concepts, or qualities that cannot be seen or experienced.20 They are considered only in the concrete sense as it applies to autocratic thinkers. The US Constitution would not be understood in the manner it was originally written as it is an example of a document that requires abstract thought and is either not read, understood, or interpreted concretely by a leadership that is completely self-serving. Concepts such as freedom and equal rights interpreted concretely become self-serving. Studies demonstrate that “persons with different value preferences apply different neurobiological strategies when facing a decision” and can help explain the fixed values that decisions are made that are independent of an actual situation.21 This stubbornness of thought and action is reflected in shared personality disorders of autocratic despots. Brain areas beyond those activated in actual moral dilemma situations were found to be involved. They are psychologically fixed, as illustrated by Muammar Gaddafi when he was being beaten to death by his own people, claiming up to the last minute: “but the people love me!”\nSome of the well-known behaviors include cover-ups, exaggeration, and fabrication; fraud, omission, half-truth, perjury, and lies that come in various types, conveyed to exaggerate oneʼs credentials or get the attention that reflects their universal narcissistic disposition and constant needs. In great part, these behaviors are witnessed between all despots of the world. Despite the bad press lies get, and that many press agencies tally the daily lie numbers, most are ignored by political supporters in every country, particularly the ones that have spoken to avoid conflict, and as a show of collective support. Operationalization of narcissism is “dispositional” which accompany a “grandiose sense of self-importance, exhibitionism, entitlement, interpersonal exploitativeness, and a total lack of empathy.”22 Autocratic leaders:\n[R]etain all power, authority, and control, and reserve the right to make all decisions; distrust their subordinateʼs abilities, closely supervise and control people under them; rarely delegate or empower subordinates; adopt one-way communication, do not consult with subordinates or consider their opinions; create a system of rewards and punishments; use threats and punishments and evoke fear; rarely concern themselves with developmental activities; and take credit for all the accomplishments.23\nIn truth, once in positions of power, only the most emotionally healthy and resilient can avoid the slide into psychopathology. For those with some of the personality attributes of sociopathy or psychopathy, the descent into deeper pathology may be beyond their ability to resist. Even their followers can become pathologically dependent.\nDemocracies characterized by individual freedom and liberty are rare. Throughout history, autocratic governments and tyranny have been the rule. Their lack of conscience and an inability to feel remorse are the underlying factors that are often viewed initially as charming, but soon reveal uncanny skills as master manipulators, skillful at lying and cheating. They have no capacity to feel guilt. Despite an incidence rate of three percent to five percent within the general population, and 25% of prison populations, it sometimes seems that they already rule the most despotic and populated areas of the world.24"}

LitCovid-PD-UBERON

{"project":"LitCovid-PD-UBERON","denotations":[{"id":"T1","span":{"begin":1158,"end":1163},"obj":"Body_part"},{"id":"T2","span":{"begin":4613,"end":4618},"obj":"Body_part"},{"id":"T3","span":{"begin":10490,"end":10495},"obj":"Body_part"}],"attributes":[{"id":"A1","pred":"uberon_id","subj":"T1","obj":"http://purl.obolibrary.org/obo/UBERON_0002542"},{"id":"A2","pred":"uberon_id","subj":"T2","obj":"http://purl.obolibrary.org/obo/UBERON_0000948"},{"id":"A3","pred":"uberon_id","subj":"T3","obj":"http://purl.obolibrary.org/obo/UBERON_0000955"}],"text":"Part I: The Global Problem\nInfectious diseases, in particular lower respiratory infections, remain the leading cause of death world-wide killing one-third of all people across all economic groups.1 While we acknowledge that the spread of infectious diseases is commonly exacerbated by human behavior, population density, inadequate public health protections, land and water use patterns and violations, increasing trade and travel, viral and bacterial mutations, as well as inappropriate use and increasing resistance to antibiotics, we rarely consider the purposeful lack of governmental leadership as a major factor in both the life and acceleration of preventable outbreaks, epidemics, and pandemics. Societies have experienced the benefits of advancements in public health infrastructure, prevention, and preparedness, yet these protections remain far from being globally understood, available, practiced uniformly, or free of political control.\nWhat is increasingly common since the last one-third of the 20th century is the thread of public health emergencies permeating, and often dominating, the consequences brought on by wars, conflicts, and large-scale disasters.2 Few are aware that wartime public health crises cause more deaths than weapons.3,4 Consistently in war, the public health protective threshold is destroyed and not recovered or maintained.5 Recovery is purposely ignored, resulting in increasing post-crisis mortality and morbidity indices that are characteristically ignored or denied, especially if they negatively impact political, ethnic, or religious groups whose views are contrary to the newly installed autocratic regime.\nRuger reminds us that authoritarian regimes suppress political competition and tend to have an interest in preventing human development, because improved health, education, and economic security mobilizes citizens to advocate for greater participation and more resources.6 Public health protections are literally invisible to populations; they are often taken for granted and applauded as great successes serving as propaganda ploys in public speeches.7 Although there has been scant investment in public health infrastructure and protections in all parts of the world, those countries suffer the most under autocratic regimes, especially where they have failed to keep pace with population growth and density.8 Currently, both the urban and rural environment of the 21st century are being defined by deficient dwellings, aged and inadequate infrastructure, and insufficient capacity to respond to crises, especially in ensuring access to safe water, food, sanitation, and energy. Public health surveillance, the “continuous, systematic collection, and analysis of health-related data serve as an early warning system for impending public health emergencies, but compliance differs remarkably from one country to another.”6,8 Indeed, the direct and indirect mortality and morbidity resulting from these tragedies are the responsibility of the government in power, but are often the first to be ignored. Ecological and environmental protections and preservations, such as the continuous surveillance mandated by the World Health Organization (WHO; Geneva, Switzerland) of wet markets in China that launched SARS (severe acute respiratory syndrome) in 2008, is an example of a critical monitor that was ended prematurely. Only the reporting of three diseases (yellow fever, plague, and cholera) are currently binding under the International Health Regulations, and then some countries are unwilling to notify WHO fearing economic and political consequences.9\n\nStable and Unstable Political Systems\nThe processes of political development, primarily as they apply to stable and unstable political systems and change, have always been dynamic, especially in crisis situations such as outbreaks of infectious diseases in less-developed countries. Crisis situations test the stability of political systems in revealing ways, placing extraordinary demands on the political leadership and the existing public health structure and processes of the country. In the absence of early and effective preparedness, societies may experience social and economic disruption, threats to the continuity of essential services, reduced production, distribution difficulties, and shortages of essential commodities. The WHO emphasizes a “whole-of-society” approach that emphasizes significant roles not only for the health sector, but also by all other sectors, individuals, families, and communities, in mitigating the effects of a pandemic.10 Developing such capacities is at the heart of preparing the whole of society for a pandemic. I assert that it is the loss of the whole of societyʼs concept, thinking, and participation that is systematically destroyed in autocratic regimes that contributes to why these political systems fail. They fail when citizens have no defined ownership, channels of communication, or are allowed to participate in any aspect of the disaster cycle (prevention, preparedness, response, recovery, or rehabilitation). They fail when citizens are not allowed a voice in the implementation of acceptable policies when the political system ceases to be viewed as responsive by individuals and groups making demands on it, and by what is considered inappropriate political behavior.\nInfectious disease outbreaks have the uncanny capacity to question the status quo, catalyze smoldering unrest, and most importantly, reveal population-based public health imperfections.11 The “whole of society” which depends on a form of collaborative governance, which complements public policy, disappears and is seen only as the dictate of one person. Indeed, the negative influence on society, what I refer to a “societal mental health,” is out of proportion to their representation in society.12\nThe 2019 Democracy Index, compiled by the United Kingdomʼs Economist Intelligence Unit (London, UK) and published annually in The Economist, ranks countries according to political and civic freedom using five criteria: whether elections are free and fair, whether governments have checks and balances, whether citizens are included in politics, the level of support for the government, and whether people have freedom of expression. Nations are divided into “full democracies, flawed democracies, hybrid regimes [which include those exhibiting regular electoral frauds], and authoritarian regimes” where “political pluralism has vanished or is extremely limited.”13 The 2019 edition is considered as having the “worst average global score since the Index was introduced in 2006, driven primarily by regressions in Latin America and sub-Saharan Africa.14\nGlobally, this is the first time in the modern era where we have the fewest democracies. By ranking on how functional their political systems are, less than five percent of the worldʼs population live in a “full democracy.”15 Fewer countries can claim free and fair elections, checks, balances, and participation in their governments. Fewer nations offer freedom of expression or political participation in established political cultures. Rapidly established and increasingly prosperous autocratic regimes, many first drawn in by populist claims that enticed the masses of working-class and poor, are now firmly established by an economy ruled by dictators and oligarchs with unfettered political influence. The United States is now categorized as a “flawed democracy,” experiencing both undeniable presidential claims for more authoritarian rule, a population that increasingly claims loss of traditional liberties, and low esteem in which US voters hold their government, elected representatives, and political parties.15\n\nCharacteristics of Autocratic Regime Leadership\nAutocratic leaders demonstrate personality and behavioral characteristics that are remarkably consistent across borders and cultures.16 In great part, this is due to a common fault line from their adolescent development which becomes arrested cognitively and emotionally. While they may, at first glance, seems smart, they are not bright or capable of attaining abstract reasoning.17 This type of reasoning is required to formulate theories and understand multiple meanings crucial for reasoning. It demands generalizations, ideas, the ability to identify the relationship between verbal and nonverbal ideas, and to understand the multiple meanings that underlie an event, statement, or object; an example often cited is: “The Liberty Bell is not just a piece of American history, but is a symbol of freedom.”18 Concrete thinkers misinterpret many concepts like this and are compelled to reinterpret them in their own concrete manner in political speeches and legislative decisions.\nAbstract thinking refers to a cognitive concept involving higher-order, or complex thoughts. To be able to think in an abstract manner implies that one is able to draw conclusions or illustrate relationships among concepts in a manner beyond what is obvious.19 Often the terms “abstract thought” and “concept formation” are used interchangeably. In the past, the term “fluid intelligence” has been used to refer to the ability to reason. The generation of concepts, or abstract ideas, indicates an ability to progress beyond concrete thinking. The concrete interpretation of a concept involves a focus on the salient, obvious characteristics. Progressing beyond the tangible characteristics in order to conceptualize theoretical relationships between items or processes involves abstract thought. Deeper meanings such as “freedom,” “equality,” “charity,” “love,” and “democracy” express ideas, concepts, or qualities that cannot be seen or experienced.20 They are considered only in the concrete sense as it applies to autocratic thinkers. The US Constitution would not be understood in the manner it was originally written as it is an example of a document that requires abstract thought and is either not read, understood, or interpreted concretely by a leadership that is completely self-serving. Concepts such as freedom and equal rights interpreted concretely become self-serving. Studies demonstrate that “persons with different value preferences apply different neurobiological strategies when facing a decision” and can help explain the fixed values that decisions are made that are independent of an actual situation.21 This stubbornness of thought and action is reflected in shared personality disorders of autocratic despots. Brain areas beyond those activated in actual moral dilemma situations were found to be involved. They are psychologically fixed, as illustrated by Muammar Gaddafi when he was being beaten to death by his own people, claiming up to the last minute: “but the people love me!”\nSome of the well-known behaviors include cover-ups, exaggeration, and fabrication; fraud, omission, half-truth, perjury, and lies that come in various types, conveyed to exaggerate oneʼs credentials or get the attention that reflects their universal narcissistic disposition and constant needs. In great part, these behaviors are witnessed between all despots of the world. Despite the bad press lies get, and that many press agencies tally the daily lie numbers, most are ignored by political supporters in every country, particularly the ones that have spoken to avoid conflict, and as a show of collective support. Operationalization of narcissism is “dispositional” which accompany a “grandiose sense of self-importance, exhibitionism, entitlement, interpersonal exploitativeness, and a total lack of empathy.”22 Autocratic leaders:\n[R]etain all power, authority, and control, and reserve the right to make all decisions; distrust their subordinateʼs abilities, closely supervise and control people under them; rarely delegate or empower subordinates; adopt one-way communication, do not consult with subordinates or consider their opinions; create a system of rewards and punishments; use threats and punishments and evoke fear; rarely concern themselves with developmental activities; and take credit for all the accomplishments.23\nIn truth, once in positions of power, only the most emotionally healthy and resilient can avoid the slide into psychopathology. For those with some of the personality attributes of sociopathy or psychopathy, the descent into deeper pathology may be beyond their ability to resist. Even their followers can become pathologically dependent.\nDemocracies characterized by individual freedom and liberty are rare. Throughout history, autocratic governments and tyranny have been the rule. Their lack of conscience and an inability to feel remorse are the underlying factors that are often viewed initially as charming, but soon reveal uncanny skills as master manipulators, skillful at lying and cheating. They have no capacity to feel guilt. Despite an incidence rate of three percent to five percent within the general population, and 25% of prison populations, it sometimes seems that they already rule the most despotic and populated areas of the world.24"}

LitCovid-PD-MONDO

LitCovid-PD-CLO

LitCovid-PD-CHEBI

{"project":"LitCovid-PD-CHEBI","denotations":[{"id":"T1","span":{"begin":368,"end":373},"obj":"Chemical"},{"id":"T2","span":{"begin":521,"end":532},"obj":"Chemical"},{"id":"T3","span":{"begin":2599,"end":2604},"obj":"Chemical"},{"id":"T4","span":{"begin":11604,"end":11609},"obj":"Chemical"}],"attributes":[{"id":"A1","pred":"chebi_id","subj":"T1","obj":"http://purl.obolibrary.org/obo/CHEBI_15377"},{"id":"A2","pred":"chebi_id","subj":"T2","obj":"http://purl.obolibrary.org/obo/CHEBI_33281"},{"id":"A3","pred":"chebi_id","subj":"T3","obj":"http://purl.obolibrary.org/obo/CHEBI_15377"},{"id":"A4","pred":"chebi_id","subj":"T4","obj":"http://purl.obolibrary.org/obo/CHEBI_27007"}],"text":"Part I: The Global Problem\nInfectious diseases, in particular lower respiratory infections, remain the leading cause of death world-wide killing one-third of all people across all economic groups.1 While we acknowledge that the spread of infectious diseases is commonly exacerbated by human behavior, population density, inadequate public health protections, land and water use patterns and violations, increasing trade and travel, viral and bacterial mutations, as well as inappropriate use and increasing resistance to antibiotics, we rarely consider the purposeful lack of governmental leadership as a major factor in both the life and acceleration of preventable outbreaks, epidemics, and pandemics. Societies have experienced the benefits of advancements in public health infrastructure, prevention, and preparedness, yet these protections remain far from being globally understood, available, practiced uniformly, or free of political control.\nWhat is increasingly common since the last one-third of the 20th century is the thread of public health emergencies permeating, and often dominating, the consequences brought on by wars, conflicts, and large-scale disasters.2 Few are aware that wartime public health crises cause more deaths than weapons.3,4 Consistently in war, the public health protective threshold is destroyed and not recovered or maintained.5 Recovery is purposely ignored, resulting in increasing post-crisis mortality and morbidity indices that are characteristically ignored or denied, especially if they negatively impact political, ethnic, or religious groups whose views are contrary to the newly installed autocratic regime.\nRuger reminds us that authoritarian regimes suppress political competition and tend to have an interest in preventing human development, because improved health, education, and economic security mobilizes citizens to advocate for greater participation and more resources.6 Public health protections are literally invisible to populations; they are often taken for granted and applauded as great successes serving as propaganda ploys in public speeches.7 Although there has been scant investment in public health infrastructure and protections in all parts of the world, those countries suffer the most under autocratic regimes, especially where they have failed to keep pace with population growth and density.8 Currently, both the urban and rural environment of the 21st century are being defined by deficient dwellings, aged and inadequate infrastructure, and insufficient capacity to respond to crises, especially in ensuring access to safe water, food, sanitation, and energy. Public health surveillance, the “continuous, systematic collection, and analysis of health-related data serve as an early warning system for impending public health emergencies, but compliance differs remarkably from one country to another.”6,8 Indeed, the direct and indirect mortality and morbidity resulting from these tragedies are the responsibility of the government in power, but are often the first to be ignored. Ecological and environmental protections and preservations, such as the continuous surveillance mandated by the World Health Organization (WHO; Geneva, Switzerland) of wet markets in China that launched SARS (severe acute respiratory syndrome) in 2008, is an example of a critical monitor that was ended prematurely. Only the reporting of three diseases (yellow fever, plague, and cholera) are currently binding under the International Health Regulations, and then some countries are unwilling to notify WHO fearing economic and political consequences.9\n\nStable and Unstable Political Systems\nThe processes of political development, primarily as they apply to stable and unstable political systems and change, have always been dynamic, especially in crisis situations such as outbreaks of infectious diseases in less-developed countries. Crisis situations test the stability of political systems in revealing ways, placing extraordinary demands on the political leadership and the existing public health structure and processes of the country. In the absence of early and effective preparedness, societies may experience social and economic disruption, threats to the continuity of essential services, reduced production, distribution difficulties, and shortages of essential commodities. The WHO emphasizes a “whole-of-society” approach that emphasizes significant roles not only for the health sector, but also by all other sectors, individuals, families, and communities, in mitigating the effects of a pandemic.10 Developing such capacities is at the heart of preparing the whole of society for a pandemic. I assert that it is the loss of the whole of societyʼs concept, thinking, and participation that is systematically destroyed in autocratic regimes that contributes to why these political systems fail. They fail when citizens have no defined ownership, channels of communication, or are allowed to participate in any aspect of the disaster cycle (prevention, preparedness, response, recovery, or rehabilitation). They fail when citizens are not allowed a voice in the implementation of acceptable policies when the political system ceases to be viewed as responsive by individuals and groups making demands on it, and by what is considered inappropriate political behavior.\nInfectious disease outbreaks have the uncanny capacity to question the status quo, catalyze smoldering unrest, and most importantly, reveal population-based public health imperfections.11 The “whole of society” which depends on a form of collaborative governance, which complements public policy, disappears and is seen only as the dictate of one person. Indeed, the negative influence on society, what I refer to a “societal mental health,” is out of proportion to their representation in society.12\nThe 2019 Democracy Index, compiled by the United Kingdomʼs Economist Intelligence Unit (London, UK) and published annually in The Economist, ranks countries according to political and civic freedom using five criteria: whether elections are free and fair, whether governments have checks and balances, whether citizens are included in politics, the level of support for the government, and whether people have freedom of expression. Nations are divided into “full democracies, flawed democracies, hybrid regimes [which include those exhibiting regular electoral frauds], and authoritarian regimes” where “political pluralism has vanished or is extremely limited.”13 The 2019 edition is considered as having the “worst average global score since the Index was introduced in 2006, driven primarily by regressions in Latin America and sub-Saharan Africa.14\nGlobally, this is the first time in the modern era where we have the fewest democracies. By ranking on how functional their political systems are, less than five percent of the worldʼs population live in a “full democracy.”15 Fewer countries can claim free and fair elections, checks, balances, and participation in their governments. Fewer nations offer freedom of expression or political participation in established political cultures. Rapidly established and increasingly prosperous autocratic regimes, many first drawn in by populist claims that enticed the masses of working-class and poor, are now firmly established by an economy ruled by dictators and oligarchs with unfettered political influence. The United States is now categorized as a “flawed democracy,” experiencing both undeniable presidential claims for more authoritarian rule, a population that increasingly claims loss of traditional liberties, and low esteem in which US voters hold their government, elected representatives, and political parties.15\n\nCharacteristics of Autocratic Regime Leadership\nAutocratic leaders demonstrate personality and behavioral characteristics that are remarkably consistent across borders and cultures.16 In great part, this is due to a common fault line from their adolescent development which becomes arrested cognitively and emotionally. While they may, at first glance, seems smart, they are not bright or capable of attaining abstract reasoning.17 This type of reasoning is required to formulate theories and understand multiple meanings crucial for reasoning. It demands generalizations, ideas, the ability to identify the relationship between verbal and nonverbal ideas, and to understand the multiple meanings that underlie an event, statement, or object; an example often cited is: “The Liberty Bell is not just a piece of American history, but is a symbol of freedom.”18 Concrete thinkers misinterpret many concepts like this and are compelled to reinterpret them in their own concrete manner in political speeches and legislative decisions.\nAbstract thinking refers to a cognitive concept involving higher-order, or complex thoughts. To be able to think in an abstract manner implies that one is able to draw conclusions or illustrate relationships among concepts in a manner beyond what is obvious.19 Often the terms “abstract thought” and “concept formation” are used interchangeably. In the past, the term “fluid intelligence” has been used to refer to the ability to reason. The generation of concepts, or abstract ideas, indicates an ability to progress beyond concrete thinking. The concrete interpretation of a concept involves a focus on the salient, obvious characteristics. Progressing beyond the tangible characteristics in order to conceptualize theoretical relationships between items or processes involves abstract thought. Deeper meanings such as “freedom,” “equality,” “charity,” “love,” and “democracy” express ideas, concepts, or qualities that cannot be seen or experienced.20 They are considered only in the concrete sense as it applies to autocratic thinkers. The US Constitution would not be understood in the manner it was originally written as it is an example of a document that requires abstract thought and is either not read, understood, or interpreted concretely by a leadership that is completely self-serving. Concepts such as freedom and equal rights interpreted concretely become self-serving. Studies demonstrate that “persons with different value preferences apply different neurobiological strategies when facing a decision” and can help explain the fixed values that decisions are made that are independent of an actual situation.21 This stubbornness of thought and action is reflected in shared personality disorders of autocratic despots. Brain areas beyond those activated in actual moral dilemma situations were found to be involved. They are psychologically fixed, as illustrated by Muammar Gaddafi when he was being beaten to death by his own people, claiming up to the last minute: “but the people love me!”\nSome of the well-known behaviors include cover-ups, exaggeration, and fabrication; fraud, omission, half-truth, perjury, and lies that come in various types, conveyed to exaggerate oneʼs credentials or get the attention that reflects their universal narcissistic disposition and constant needs. In great part, these behaviors are witnessed between all despots of the world. Despite the bad press lies get, and that many press agencies tally the daily lie numbers, most are ignored by political supporters in every country, particularly the ones that have spoken to avoid conflict, and as a show of collective support. Operationalization of narcissism is “dispositional” which accompany a “grandiose sense of self-importance, exhibitionism, entitlement, interpersonal exploitativeness, and a total lack of empathy.”22 Autocratic leaders:\n[R]etain all power, authority, and control, and reserve the right to make all decisions; distrust their subordinateʼs abilities, closely supervise and control people under them; rarely delegate or empower subordinates; adopt one-way communication, do not consult with subordinates or consider their opinions; create a system of rewards and punishments; use threats and punishments and evoke fear; rarely concern themselves with developmental activities; and take credit for all the accomplishments.23\nIn truth, once in positions of power, only the most emotionally healthy and resilient can avoid the slide into psychopathology. For those with some of the personality attributes of sociopathy or psychopathy, the descent into deeper pathology may be beyond their ability to resist. Even their followers can become pathologically dependent.\nDemocracies characterized by individual freedom and liberty are rare. Throughout history, autocratic governments and tyranny have been the rule. Their lack of conscience and an inability to feel remorse are the underlying factors that are often viewed initially as charming, but soon reveal uncanny skills as master manipulators, skillful at lying and cheating. They have no capacity to feel guilt. Despite an incidence rate of three percent to five percent within the general population, and 25% of prison populations, it sometimes seems that they already rule the most despotic and populated areas of the world.24"}

LitCovid-PD-GO-BP

{"project":"LitCovid-PD-GO-BP","denotations":[{"id":"T3","span":{"begin":291,"end":299},"obj":"http://purl.obolibrary.org/obo/GO_0007610"},{"id":"T4","span":{"begin":2346,"end":2352},"obj":"http://purl.obolibrary.org/obo/GO_0040007"},{"id":"T5","span":{"begin":3501,"end":3512},"obj":"http://purl.obolibrary.org/obo/GO_0065007"},{"id":"T6","span":{"begin":5332,"end":5340},"obj":"http://purl.obolibrary.org/obo/GO_0007610"},{"id":"T7","span":{"begin":9062,"end":9071},"obj":"http://purl.obolibrary.org/obo/GO_0009058"},{"id":"T8","span":{"begin":10787,"end":10796},"obj":"http://purl.obolibrary.org/obo/GO_0007610"},{"id":"T9","span":{"begin":11080,"end":11089},"obj":"http://purl.obolibrary.org/obo/GO_0007610"}],"text":"Part I: The Global Problem\nInfectious diseases, in particular lower respiratory infections, remain the leading cause of death world-wide killing one-third of all people across all economic groups.1 While we acknowledge that the spread of infectious diseases is commonly exacerbated by human behavior, population density, inadequate public health protections, land and water use patterns and violations, increasing trade and travel, viral and bacterial mutations, as well as inappropriate use and increasing resistance to antibiotics, we rarely consider the purposeful lack of governmental leadership as a major factor in both the life and acceleration of preventable outbreaks, epidemics, and pandemics. Societies have experienced the benefits of advancements in public health infrastructure, prevention, and preparedness, yet these protections remain far from being globally understood, available, practiced uniformly, or free of political control.\nWhat is increasingly common since the last one-third of the 20th century is the thread of public health emergencies permeating, and often dominating, the consequences brought on by wars, conflicts, and large-scale disasters.2 Few are aware that wartime public health crises cause more deaths than weapons.3,4 Consistently in war, the public health protective threshold is destroyed and not recovered or maintained.5 Recovery is purposely ignored, resulting in increasing post-crisis mortality and morbidity indices that are characteristically ignored or denied, especially if they negatively impact political, ethnic, or religious groups whose views are contrary to the newly installed autocratic regime.\nRuger reminds us that authoritarian regimes suppress political competition and tend to have an interest in preventing human development, because improved health, education, and economic security mobilizes citizens to advocate for greater participation and more resources.6 Public health protections are literally invisible to populations; they are often taken for granted and applauded as great successes serving as propaganda ploys in public speeches.7 Although there has been scant investment in public health infrastructure and protections in all parts of the world, those countries suffer the most under autocratic regimes, especially where they have failed to keep pace with population growth and density.8 Currently, both the urban and rural environment of the 21st century are being defined by deficient dwellings, aged and inadequate infrastructure, and insufficient capacity to respond to crises, especially in ensuring access to safe water, food, sanitation, and energy. Public health surveillance, the “continuous, systematic collection, and analysis of health-related data serve as an early warning system for impending public health emergencies, but compliance differs remarkably from one country to another.”6,8 Indeed, the direct and indirect mortality and morbidity resulting from these tragedies are the responsibility of the government in power, but are often the first to be ignored. Ecological and environmental protections and preservations, such as the continuous surveillance mandated by the World Health Organization (WHO; Geneva, Switzerland) of wet markets in China that launched SARS (severe acute respiratory syndrome) in 2008, is an example of a critical monitor that was ended prematurely. Only the reporting of three diseases (yellow fever, plague, and cholera) are currently binding under the International Health Regulations, and then some countries are unwilling to notify WHO fearing economic and political consequences.9\n\nStable and Unstable Political Systems\nThe processes of political development, primarily as they apply to stable and unstable political systems and change, have always been dynamic, especially in crisis situations such as outbreaks of infectious diseases in less-developed countries. Crisis situations test the stability of political systems in revealing ways, placing extraordinary demands on the political leadership and the existing public health structure and processes of the country. In the absence of early and effective preparedness, societies may experience social and economic disruption, threats to the continuity of essential services, reduced production, distribution difficulties, and shortages of essential commodities. The WHO emphasizes a “whole-of-society” approach that emphasizes significant roles not only for the health sector, but also by all other sectors, individuals, families, and communities, in mitigating the effects of a pandemic.10 Developing such capacities is at the heart of preparing the whole of society for a pandemic. I assert that it is the loss of the whole of societyʼs concept, thinking, and participation that is systematically destroyed in autocratic regimes that contributes to why these political systems fail. They fail when citizens have no defined ownership, channels of communication, or are allowed to participate in any aspect of the disaster cycle (prevention, preparedness, response, recovery, or rehabilitation). They fail when citizens are not allowed a voice in the implementation of acceptable policies when the political system ceases to be viewed as responsive by individuals and groups making demands on it, and by what is considered inappropriate political behavior.\nInfectious disease outbreaks have the uncanny capacity to question the status quo, catalyze smoldering unrest, and most importantly, reveal population-based public health imperfections.11 The “whole of society” which depends on a form of collaborative governance, which complements public policy, disappears and is seen only as the dictate of one person. Indeed, the negative influence on society, what I refer to a “societal mental health,” is out of proportion to their representation in society.12\nThe 2019 Democracy Index, compiled by the United Kingdomʼs Economist Intelligence Unit (London, UK) and published annually in The Economist, ranks countries according to political and civic freedom using five criteria: whether elections are free and fair, whether governments have checks and balances, whether citizens are included in politics, the level of support for the government, and whether people have freedom of expression. Nations are divided into “full democracies, flawed democracies, hybrid regimes [which include those exhibiting regular electoral frauds], and authoritarian regimes” where “political pluralism has vanished or is extremely limited.”13 The 2019 edition is considered as having the “worst average global score since the Index was introduced in 2006, driven primarily by regressions in Latin America and sub-Saharan Africa.14\nGlobally, this is the first time in the modern era where we have the fewest democracies. By ranking on how functional their political systems are, less than five percent of the worldʼs population live in a “full democracy.”15 Fewer countries can claim free and fair elections, checks, balances, and participation in their governments. Fewer nations offer freedom of expression or political participation in established political cultures. Rapidly established and increasingly prosperous autocratic regimes, many first drawn in by populist claims that enticed the masses of working-class and poor, are now firmly established by an economy ruled by dictators and oligarchs with unfettered political influence. The United States is now categorized as a “flawed democracy,” experiencing both undeniable presidential claims for more authoritarian rule, a population that increasingly claims loss of traditional liberties, and low esteem in which US voters hold their government, elected representatives, and political parties.15\n\nCharacteristics of Autocratic Regime Leadership\nAutocratic leaders demonstrate personality and behavioral characteristics that are remarkably consistent across borders and cultures.16 In great part, this is due to a common fault line from their adolescent development which becomes arrested cognitively and emotionally. While they may, at first glance, seems smart, they are not bright or capable of attaining abstract reasoning.17 This type of reasoning is required to formulate theories and understand multiple meanings crucial for reasoning. It demands generalizations, ideas, the ability to identify the relationship between verbal and nonverbal ideas, and to understand the multiple meanings that underlie an event, statement, or object; an example often cited is: “The Liberty Bell is not just a piece of American history, but is a symbol of freedom.”18 Concrete thinkers misinterpret many concepts like this and are compelled to reinterpret them in their own concrete manner in political speeches and legislative decisions.\nAbstract thinking refers to a cognitive concept involving higher-order, or complex thoughts. To be able to think in an abstract manner implies that one is able to draw conclusions or illustrate relationships among concepts in a manner beyond what is obvious.19 Often the terms “abstract thought” and “concept formation” are used interchangeably. In the past, the term “fluid intelligence” has been used to refer to the ability to reason. The generation of concepts, or abstract ideas, indicates an ability to progress beyond concrete thinking. The concrete interpretation of a concept involves a focus on the salient, obvious characteristics. Progressing beyond the tangible characteristics in order to conceptualize theoretical relationships between items or processes involves abstract thought. Deeper meanings such as “freedom,” “equality,” “charity,” “love,” and “democracy” express ideas, concepts, or qualities that cannot be seen or experienced.20 They are considered only in the concrete sense as it applies to autocratic thinkers. The US Constitution would not be understood in the manner it was originally written as it is an example of a document that requires abstract thought and is either not read, understood, or interpreted concretely by a leadership that is completely self-serving. Concepts such as freedom and equal rights interpreted concretely become self-serving. Studies demonstrate that “persons with different value preferences apply different neurobiological strategies when facing a decision” and can help explain the fixed values that decisions are made that are independent of an actual situation.21 This stubbornness of thought and action is reflected in shared personality disorders of autocratic despots. Brain areas beyond those activated in actual moral dilemma situations were found to be involved. They are psychologically fixed, as illustrated by Muammar Gaddafi when he was being beaten to death by his own people, claiming up to the last minute: “but the people love me!”\nSome of the well-known behaviors include cover-ups, exaggeration, and fabrication; fraud, omission, half-truth, perjury, and lies that come in various types, conveyed to exaggerate oneʼs credentials or get the attention that reflects their universal narcissistic disposition and constant needs. In great part, these behaviors are witnessed between all despots of the world. Despite the bad press lies get, and that many press agencies tally the daily lie numbers, most are ignored by political supporters in every country, particularly the ones that have spoken to avoid conflict, and as a show of collective support. Operationalization of narcissism is “dispositional” which accompany a “grandiose sense of self-importance, exhibitionism, entitlement, interpersonal exploitativeness, and a total lack of empathy.”22 Autocratic leaders:\n[R]etain all power, authority, and control, and reserve the right to make all decisions; distrust their subordinateʼs abilities, closely supervise and control people under them; rarely delegate or empower subordinates; adopt one-way communication, do not consult with subordinates or consider their opinions; create a system of rewards and punishments; use threats and punishments and evoke fear; rarely concern themselves with developmental activities; and take credit for all the accomplishments.23\nIn truth, once in positions of power, only the most emotionally healthy and resilient can avoid the slide into psychopathology. For those with some of the personality attributes of sociopathy or psychopathy, the descent into deeper pathology may be beyond their ability to resist. Even their followers can become pathologically dependent.\nDemocracies characterized by individual freedom and liberty are rare. Throughout history, autocratic governments and tyranny have been the rule. Their lack of conscience and an inability to feel remorse are the underlying factors that are often viewed initially as charming, but soon reveal uncanny skills as master manipulators, skillful at lying and cheating. They have no capacity to feel guilt. Despite an incidence rate of three percent to five percent within the general population, and 25% of prison populations, it sometimes seems that they already rule the most despotic and populated areas of the world.24"}

LitCovid-sentences

LitCovid-PD-HP

{"project":"LitCovid-PD-HP","denotations":[{"id":"T1","span":{"begin":68,"end":90},"obj":"Phenotype"},{"id":"T2","span":{"begin":3420,"end":3425},"obj":"Phenotype"},{"id":"T3","span":{"begin":8362,"end":8371},"obj":"Phenotype"},{"id":"T4","span":{"begin":10445,"end":10466},"obj":"Phenotype"}],"attributes":[{"id":"A1","pred":"hp_id","subj":"T1","obj":"http://purl.obolibrary.org/obo/HP_0011947"},{"id":"A2","pred":"hp_id","subj":"T2","obj":"http://purl.obolibrary.org/obo/HP_0001945"},{"id":"A3","pred":"hp_id","subj":"T3","obj":"http://purl.obolibrary.org/obo/HP_0001344"},{"id":"A4","pred":"hp_id","subj":"T4","obj":"http://purl.obolibrary.org/obo/HP_0012075"}],"text":"Part I: The Global Problem\nInfectious diseases, in particular lower respiratory infections, remain the leading cause of death world-wide killing one-third of all people across all economic groups.1 While we acknowledge that the spread of infectious diseases is commonly exacerbated by human behavior, population density, inadequate public health protections, land and water use patterns and violations, increasing trade and travel, viral and bacterial mutations, as well as inappropriate use and increasing resistance to antibiotics, we rarely consider the purposeful lack of governmental leadership as a major factor in both the life and acceleration of preventable outbreaks, epidemics, and pandemics. Societies have experienced the benefits of advancements in public health infrastructure, prevention, and preparedness, yet these protections remain far from being globally understood, available, practiced uniformly, or free of political control.\nWhat is increasingly common since the last one-third of the 20th century is the thread of public health emergencies permeating, and often dominating, the consequences brought on by wars, conflicts, and large-scale disasters.2 Few are aware that wartime public health crises cause more deaths than weapons.3,4 Consistently in war, the public health protective threshold is destroyed and not recovered or maintained.5 Recovery is purposely ignored, resulting in increasing post-crisis mortality and morbidity indices that are characteristically ignored or denied, especially if they negatively impact political, ethnic, or religious groups whose views are contrary to the newly installed autocratic regime.\nRuger reminds us that authoritarian regimes suppress political competition and tend to have an interest in preventing human development, because improved health, education, and economic security mobilizes citizens to advocate for greater participation and more resources.6 Public health protections are literally invisible to populations; they are often taken for granted and applauded as great successes serving as propaganda ploys in public speeches.7 Although there has been scant investment in public health infrastructure and protections in all parts of the world, those countries suffer the most under autocratic regimes, especially where they have failed to keep pace with population growth and density.8 Currently, both the urban and rural environment of the 21st century are being defined by deficient dwellings, aged and inadequate infrastructure, and insufficient capacity to respond to crises, especially in ensuring access to safe water, food, sanitation, and energy. Public health surveillance, the “continuous, systematic collection, and analysis of health-related data serve as an early warning system for impending public health emergencies, but compliance differs remarkably from one country to another.”6,8 Indeed, the direct and indirect mortality and morbidity resulting from these tragedies are the responsibility of the government in power, but are often the first to be ignored. Ecological and environmental protections and preservations, such as the continuous surveillance mandated by the World Health Organization (WHO; Geneva, Switzerland) of wet markets in China that launched SARS (severe acute respiratory syndrome) in 2008, is an example of a critical monitor that was ended prematurely. Only the reporting of three diseases (yellow fever, plague, and cholera) are currently binding under the International Health Regulations, and then some countries are unwilling to notify WHO fearing economic and political consequences.9\n\nStable and Unstable Political Systems\nThe processes of political development, primarily as they apply to stable and unstable political systems and change, have always been dynamic, especially in crisis situations such as outbreaks of infectious diseases in less-developed countries. Crisis situations test the stability of political systems in revealing ways, placing extraordinary demands on the political leadership and the existing public health structure and processes of the country. In the absence of early and effective preparedness, societies may experience social and economic disruption, threats to the continuity of essential services, reduced production, distribution difficulties, and shortages of essential commodities. The WHO emphasizes a “whole-of-society” approach that emphasizes significant roles not only for the health sector, but also by all other sectors, individuals, families, and communities, in mitigating the effects of a pandemic.10 Developing such capacities is at the heart of preparing the whole of society for a pandemic. I assert that it is the loss of the whole of societyʼs concept, thinking, and participation that is systematically destroyed in autocratic regimes that contributes to why these political systems fail. They fail when citizens have no defined ownership, channels of communication, or are allowed to participate in any aspect of the disaster cycle (prevention, preparedness, response, recovery, or rehabilitation). They fail when citizens are not allowed a voice in the implementation of acceptable policies when the political system ceases to be viewed as responsive by individuals and groups making demands on it, and by what is considered inappropriate political behavior.\nInfectious disease outbreaks have the uncanny capacity to question the status quo, catalyze smoldering unrest, and most importantly, reveal population-based public health imperfections.11 The “whole of society” which depends on a form of collaborative governance, which complements public policy, disappears and is seen only as the dictate of one person. Indeed, the negative influence on society, what I refer to a “societal mental health,” is out of proportion to their representation in society.12\nThe 2019 Democracy Index, compiled by the United Kingdomʼs Economist Intelligence Unit (London, UK) and published annually in The Economist, ranks countries according to political and civic freedom using five criteria: whether elections are free and fair, whether governments have checks and balances, whether citizens are included in politics, the level of support for the government, and whether people have freedom of expression. Nations are divided into “full democracies, flawed democracies, hybrid regimes [which include those exhibiting regular electoral frauds], and authoritarian regimes” where “political pluralism has vanished or is extremely limited.”13 The 2019 edition is considered as having the “worst average global score since the Index was introduced in 2006, driven primarily by regressions in Latin America and sub-Saharan Africa.14\nGlobally, this is the first time in the modern era where we have the fewest democracies. By ranking on how functional their political systems are, less than five percent of the worldʼs population live in a “full democracy.”15 Fewer countries can claim free and fair elections, checks, balances, and participation in their governments. Fewer nations offer freedom of expression or political participation in established political cultures. Rapidly established and increasingly prosperous autocratic regimes, many first drawn in by populist claims that enticed the masses of working-class and poor, are now firmly established by an economy ruled by dictators and oligarchs with unfettered political influence. The United States is now categorized as a “flawed democracy,” experiencing both undeniable presidential claims for more authoritarian rule, a population that increasingly claims loss of traditional liberties, and low esteem in which US voters hold their government, elected representatives, and political parties.15\n\nCharacteristics of Autocratic Regime Leadership\nAutocratic leaders demonstrate personality and behavioral characteristics that are remarkably consistent across borders and cultures.16 In great part, this is due to a common fault line from their adolescent development which becomes arrested cognitively and emotionally. While they may, at first glance, seems smart, they are not bright or capable of attaining abstract reasoning.17 This type of reasoning is required to formulate theories and understand multiple meanings crucial for reasoning. It demands generalizations, ideas, the ability to identify the relationship between verbal and nonverbal ideas, and to understand the multiple meanings that underlie an event, statement, or object; an example often cited is: “The Liberty Bell is not just a piece of American history, but is a symbol of freedom.”18 Concrete thinkers misinterpret many concepts like this and are compelled to reinterpret them in their own concrete manner in political speeches and legislative decisions.\nAbstract thinking refers to a cognitive concept involving higher-order, or complex thoughts. To be able to think in an abstract manner implies that one is able to draw conclusions or illustrate relationships among concepts in a manner beyond what is obvious.19 Often the terms “abstract thought” and “concept formation” are used interchangeably. In the past, the term “fluid intelligence” has been used to refer to the ability to reason. The generation of concepts, or abstract ideas, indicates an ability to progress beyond concrete thinking. The concrete interpretation of a concept involves a focus on the salient, obvious characteristics. Progressing beyond the tangible characteristics in order to conceptualize theoretical relationships between items or processes involves abstract thought. Deeper meanings such as “freedom,” “equality,” “charity,” “love,” and “democracy” express ideas, concepts, or qualities that cannot be seen or experienced.20 They are considered only in the concrete sense as it applies to autocratic thinkers. The US Constitution would not be understood in the manner it was originally written as it is an example of a document that requires abstract thought and is either not read, understood, or interpreted concretely by a leadership that is completely self-serving. Concepts such as freedom and equal rights interpreted concretely become self-serving. Studies demonstrate that “persons with different value preferences apply different neurobiological strategies when facing a decision” and can help explain the fixed values that decisions are made that are independent of an actual situation.21 This stubbornness of thought and action is reflected in shared personality disorders of autocratic despots. Brain areas beyond those activated in actual moral dilemma situations were found to be involved. They are psychologically fixed, as illustrated by Muammar Gaddafi when he was being beaten to death by his own people, claiming up to the last minute: “but the people love me!”\nSome of the well-known behaviors include cover-ups, exaggeration, and fabrication; fraud, omission, half-truth, perjury, and lies that come in various types, conveyed to exaggerate oneʼs credentials or get the attention that reflects their universal narcissistic disposition and constant needs. In great part, these behaviors are witnessed between all despots of the world. Despite the bad press lies get, and that many press agencies tally the daily lie numbers, most are ignored by political supporters in every country, particularly the ones that have spoken to avoid conflict, and as a show of collective support. Operationalization of narcissism is “dispositional” which accompany a “grandiose sense of self-importance, exhibitionism, entitlement, interpersonal exploitativeness, and a total lack of empathy.”22 Autocratic leaders:\n[R]etain all power, authority, and control, and reserve the right to make all decisions; distrust their subordinateʼs abilities, closely supervise and control people under them; rarely delegate or empower subordinates; adopt one-way communication, do not consult with subordinates or consider their opinions; create a system of rewards and punishments; use threats and punishments and evoke fear; rarely concern themselves with developmental activities; and take credit for all the accomplishments.23\nIn truth, once in positions of power, only the most emotionally healthy and resilient can avoid the slide into psychopathology. For those with some of the personality attributes of sociopathy or psychopathy, the descent into deeper pathology may be beyond their ability to resist. Even their followers can become pathologically dependent.\nDemocracies characterized by individual freedom and liberty are rare. Throughout history, autocratic governments and tyranny have been the rule. Their lack of conscience and an inability to feel remorse are the underlying factors that are often viewed initially as charming, but soon reveal uncanny skills as master manipulators, skillful at lying and cheating. They have no capacity to feel guilt. Despite an incidence rate of three percent to five percent within the general population, and 25% of prison populations, it sometimes seems that they already rule the most despotic and populated areas of the world.24"}

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PMC:7156578 / 2191-15247 JSON TXT