Background Over the last decade, the return of results (ROR) in precision medicine research (PMR) has become increasingly routine. Calls for individual rights to research results have extended the “duty to report” from clinically useful genetic information to traits and ancestry results. ROR has thus been reframed as inherently beneficial to research participants, without a needed focus on who benefits and how. This paper addresses this gap, particularly in the context of PMR aimed at increasing participant diversity, by providing investigator (...) and researcher perspectives on and questions about the assumed value of ROR in PMR.Methods Semi-structured interviews with a purposive sample of investigators and researchers across federally funded PMR studies in three national consortia, as well as observations of study activities, focused on how PM researchers conceptualize diversity and implement inclusive practices across research stages, including navigating ROR.Results Interviewees (1) validated the value of ROR as a benefit of PMR, while others (2) questioned the benefit of clinically actionable results to individuals in the absence of sufficient resources for translating findings into health care for diverse and disadvantaged populations; (3) expressed uncertainties in applying the presumed value of ROR as a benefit for non-clinical results; and (4) and debated when the promise of the value of ROR may undermine trust in PMR, and divert efforts to return value beyond ROR.Conclusions Conceptualizations of diversity and inclusion among PM researchers and investigators raise unique ethical questions where unexamined assumptions of the value of ROR inform study recruitment efforts to enroll minoritized and under-represented populations. A lack of consideration for resources and infrastructure necessary to translate ROR into actionable information may hinder trustworthy community-research relationships. Thus, we argue for a more intentional interrogation of ROR practices as an offer of benefit and for whom. (shrink)

_341_ _Objectives: _In patients with multivessel disease both the detection of the culprit lesion and the exact allocation are important preconditions for sufficient treatment and improved outcome. In a vessel based approach the combination of quantitative coronary angiography and fractional flow reserve measured by a pressure wire should be advantageous compared to myocardial SPECT, as morphological and functional information is delivered simultaneously. Therefore our aim was to evaluate MS in the detection and allocation of hemodynamically significant stenoses obtained by the (...) combined gold standard QCA plus FFR in patients with multivessel disease. _Methods: _FFR and QCA of 95 vessels in 80 patients have been evaluated. Hemodynamically significant target lesions were defined as intermediate stenoses between 50 and 75% with an FFR. (shrink)

BackgroundReturning neuroimaging incidental findings may create a challenge to research participants’ health literacy skills as they must interpret and make appropriate healthcare decisions based on complex radiology jargon. Disclosing IF can therefore present difficulties for participants, research institutions and the healthcare system. The purpose of this study was to identify the extent of the health literacy challenges encountered when returning neuroimaging IF. We report on findings from a retrospective survey and focus group sessions with major stakeholders involved in disclosing IF.MethodsWe (...) surveyed participants who had received a radiology report from a research study and conducted focus groups with participants, parents of child participants, Institutional Review Board members, investigators and physicians. Qualitative thematic analyses were conducted using standard group-coding procedures and descriptive summaries of health literacy scores and radiology report outcomes are examined.ResultsAlthough participants reported high health literacy skills, 67 % did not seek medical care when recommended to do so; and many participants in the focus groups disclosed they could not understand the findings described in their report. Despite their lack of understanding, participants desire to have information about their radiology results, and the investigators feel ethically inclined to return findings.ConclusionsThe language in clinically useful radiology reports can create a challenge for participants’ health literacy skills and has the potential to negatively impact the healthcare system and investigators conducting imaging research. Radiology reports need accompanying resources that explain findings in lay language, which can help reduce the challenge caused by the need to communicate incidental findings. (shrink)

Despite increasing scientific interest in self-generated thought-mental content largely independent of the immediate environment-there has yet to be any comprehensive synthesis of the subjective experience and neural correlates of affect in these forms of thinking. Here, we aim to develop an integrated affective neuroscience encompassing many forms of self-generated thought-normal and pathological, moderate and excessive, in waking and in sleep. In synthesizing existing literature on this topic, we reveal consistent findings pertaining to the prevalence, valence, and variability of emotion in (...) self-generated thought, and highlight how these factors might interact with self-generated thought to influence general well-being. We integrate these psychological findings with recent neuroimaging research, bringing attention to the neural correlates of affect in self-generated thought. We show that affect in self-generated thought is prevalent, positively biased, highly variable (both within and across individuals), and consistently recruits many brain areas implicated in emotional processing, including the orbitofrontal cortex, amygdala, insula, and medial prefrontal cortex. Many factors modulate these typical psychological and neural patterns, however; the emerging affective neuroscience of self-generated thought must endeavor to link brain function and subjective experience in both everyday self-generated thought as well as its dysfunctions in mental illness. (shrink)

The origin of marine invertebrate larvae has been an area of controversy in developmental evolution for over a century. Here, we address the question of whether a pelagic “larval” or benthic “adult” morphology originated first in metazoan lineages by testing the hypothesis that particular gene co-option patterns will be associated with the origin of feeding, indirect developing larval forms. Empirical evidence bearing on this hypothesis is derivable from gene expression studies of the sea urchin larval gut of two closely related (...) but differently developing congenerics, Heliocidaris tuberculata (feeding indirect-developing larva) and H. erythrogramma (nonfeeding direct developer), given two subsidiary hypotheses. (1) If larval gut gene expression in H. tuberculata was co-opted from an ancestral adult expression pattern, then the gut expression pattern will remain in adult H. erythrogramma despite its direct development. (2) Genes expressed in the larval gut of H. tuberculata will not have a coordinated expression pattern in H. erythrogramma larvae due to loss of a functional gut. Five structural genes expressed in the invaginating archenteron of H. tuberculata during gastrulation exhibit substantially different expression patterns in H. erythrogramma with only one remaining endoderm specific. Expression of these genes in the adult of H. erythrogramma and larval gut of H. tuberculata, but not in H. erythrogramma larval endoderm, supports the hypothesis that they first played roles in the formation of adult structures and were subsequently recruited into larval ontogeny during the origin and evolution of feeding planktotrophic deuterostome larvae. (shrink)

American health policy today faces dual problems of too little coverage at too high a cost. The mix of private and public financing leaves about one seventh of the population without any insurance coverage. At the same time, the coverage Americans do have costs an ever-larger share of our country’s productive capacity. The U.S. pays well above what other countries pay and what many people, health plans, businesses, and governments want to pay. This “paradox of excess and deprivation” results from (...) the incremental approach the U.S. has taken to promoting incompatible policy goals of increasing health insurance coverage and medical quality while trying to control costs, without squarely confronting tradeoffs. This essay examines the record of incremental developments and draws lessons for current efforts at reform. (shrink)

ABSTRACTThe contention that abortion harms women constitutes a new strategy employed by the pro‐life movement to supplement arguments about fetal rights. David C. Reardon is a prominent promoter of this strategy. Post‐abortion syndrome purports to establish that abortion psychologically harms women and, indeed, can harm persons associated with women who have abortions. Thus, harms that abortion is alleged to produce are multiplied. Claims of repression are employed to complicate efforts to disprove the existence of psychological harm and causal antecedents of (...) trauma are only selectively investigated. We argue that there is no such thing as post‐abortion syndrome and that the psychological harms Reardon and others claim abortion inflicts on women can usually be ascribed to different causes. We question the evidence accumulated by Reardon and his analysis of data accumulated by others. Most importantly, we question whether the conclusions Reardon has drawn follow from the evidence he cites. (shrink)

The goal of this paper is to sketch an account of Kant’s signature metaphysical doctrine (transcendental idealism) that (a) has no supporters – as far as I am aware – in the contemporary literature, and (b) draws its primary motivation (as interpretation) from considerations regarding our practical situation and needs as agents. -/- The consideration I focus on here is that people not only have mental and moral features, but they also appear to us – in our daily experience – (...) to have such features: “[w]e can perceive virtue in our experience (Wir können in der Erfahrung wohl Tugend wahrnehmen)” (24: 906). The same presumably goes for vice: When I see you casually torturing a cat, you appear to me to be brown-haired, wearing jeans, moving your arms, laughing, and so on, but you also appear to me to be vicious and cruel. Your character shines through in your actions. I can then make a defeasible inference from those appearances to the moral reality. -/- Such appearances and inferences play a central role in our practices of praise, blame, forgiveness, and punishment. An interpretation of transcendental idealism that gives primacy to the practical will thus seek to analyze the concepts of experience, acquaintance, and appearance/phenomenon in a capacious-enough way that they can apply to mental and moral features too. If successful, such an interpretation would have a clear practical advantage over those that leave us merely conjecturing from experiences of bodies, gestures, and secondary qualities to moral features that do not appear, or even to the non-appearing features of a distinct set of things. (shrink)

We suggest that there is confusion between why consciousness developed and what additional functions, through continued evolution, it has co-opted. Consider episodic memory. If we believe that episodic memory evolved solely to accurately represent past events, it seems like a terrible system—prone to forgetting and false memories. However, if we believe that episodic memory developed to flexibly and creatively combine and rearrange memories of prior events in order to plan for the future, then it is quite a good system. We (...) argue that consciousness originally developed as part of the episodic memory system—quite likely the part needed to accomplish that flexible recombining of information. We posit further that consciousness was subsequently co-opted to produce other functions that are not directly relevant to memory per se, such as problem-solving, abstract thinking, and language. We suggest that this theory is compatible with many phenomena, such as the slow speed and the after-the-fact order of consciousness, that cannot be explained well by other theories. We believe that our theory may have profound implications for understanding intentional action and consciousness in general. Moreover, we suggest that episodic memory and its associated memory systems of sensory, working, and semantic memory as a whole ought to be considered together as the conscious memory system in that they, together, give rise to the phenomenon of consciousness. Lastly, we suggest that the cerebral cortex is the part of the brain that makes consciousness possible, and that every cortical region contributes to this conscious memory system. (shrink)

This collection explores, in Adorno's description, `philosophy directed against philosophy'. The essays cover all aspects of Benjamin's writings, from his early work in the philosophy of art and language, through to the concept of history. The experience of time and the destruction of false continuity are identified as the key themes in Benjamin's understanding of history.

People’s concept of free will is often assumed to be incompatible with the deterministic, scientific model of the universe. Indeed, many scholars treat the folk concept of free will as assuming a special form of nondeterministic causation, possibly the notion of uncaused causes. However, little work to date has directly probed individuals’ beliefs about what it means to have free will. The present studies sought to reconstruct this folk concept of free will by asking people to define the concept (Study (...) 1) and by confronting them with a neuroscientific claim that free will is an illusion (Study 2), which invited them to either reconcile or contrast free will with determinism. The results suggest that the core of people’s concept of free will is a choice that fulfills one’s desires and is free from internal or external constraints. No evidence was found for metaphysical assumptions about dualism or indeterminism. (shrink)

The main thrust of my argument was that ad hoc su gge s ti ons of ch a ri ty cannot replace a systematic and theoreti c a lly inform ed approach to poverty rel i ef . Ch a ri t a ble don a ti on som eti m e s h elps—and som etimes harm s — but is no general solution to global poverty, and can be po s i tively dangerous wh en pre s en (...) ted as such. We need to consider, and often choose, other routes to helping the poor—including ethical to u rism and fair trade in lu x u ry goods. We will not be able to invest in such feasible routes if we give away all our extra income, as Singer recommends. Sticking to donation above all, when a combination of other strategies is necessary, is highly likely to harm the poor. Si n ger doe s n’t re a lly en ga ge my argumen t . In s te ad , he cari c a tu res our “f u n d a m ental disa greem en t” :a pp a ren t ly, Si n ger rej ects va ri o u s policies because he takes into account the “f act s” ; wh ereas Ku per is the one seeking a “f a i t h ,” a “po l i tical ph i l o s ophy. . . i m mune to ref ut a ti on on the basis of evi den ce .” Anyon e who has re ad my arti cle (pp. 1 07 - 2 0) must fin d this puzzling. The arti cle explains at len g t h wh i ch kinds of b ack ground theories help us to d i s cern and re s pon s i bly con s i der the rel eva n t f act s . I show that Si n ger sel ects and uses fact s u n c ri ti c a lly prec i s ely because he has no po l i tical econ omy, no po l i tical soc i o l ogy, and no t h eory of ju s ti ce . We are seri o u s ly misled if we do not draw adequ a tely on the wi s dom and.. (shrink)

Task-unrelated thought (TUT) occurs frequently in our daily lives and across a range of tasks, but we know little about how this phenomenon arises during and influences the way we communicate. Conversations also provide a novel opportunity to assess the alignment (or divergence) in TUT during dyadic interactions. We conducted a study to determine: (a) the frequency of TUT during conversation as well as how partners align/diverge in their rates of TUT, (b) the subjective and behavioral correlates of TUT and (...) TUT divergence during conversation, and (c) if perceived social group identity impacts TUT and TUT divergence during conversation. We used a minimal groups induction procedure to assign participants (N = 126) to either an ingroup, outgroup, or control condition. We then asked them to converse with one another via a computer-mediated text chat application for 10 min while self-reporting TUTs. On average, participants reported TUT about once every 2 min; however, this rate was lower for participants in the ingroup condition, compared to the control condition. Conversational pairs in the ingroup condition were also aligned more in their rates of TUT compared to the outgroup condition. Finally, we discuss subjective and behavioral correlates of TUT and TUT divergence in conversations, such as valence, turn-taking ratios, and topic shifts. (shrink)

Source [1] Andrew E. P. Mitchell, Federica Galli, Sondra Butterworth. (2023). Editorial: Equality, diversity and inclusive research for diverse rare disease communities. Front. Psychol., vol. 14. doi:10.3389/fpsyg.2023.1285774. "It is also important to recognize that certain mental health disorders are classified as rare conditions and have their own cultural concepts of distress, as defined in the DSM-5 (American Psychiatric Association, 2013)" and require “equal attention and support for individuals and their families, both physically and emotionally”. [1].

According to previous research, threatening people’s belief in free will may undermine moral judgments and behavior. Four studies tested this claim. Study 1 used a Velten technique to threaten people’s belief in free will and found no effects on moral behavior, judgments of blame, and punishment decisions. Study 2 used six different threats to free will and failed to find effects on judgments of blame and wrongness. Study 3 found no effects on moral judgment when manipulating general free will beliefs (...) but found strong effects when manipulating the perceived choice capacity of the judged agent. Study 4 used pretested narratives that varied agents’ apparent free will and found that perceived choice capacity mediated the relationship between free will and blame. These results suggest that people’s general beliefs about whether free will exists have no impact on moral judgments but specific judgments about the agent’s choice capacity do. (shrink)

This paper shows that strict evidentialism about normative reasons for belief is inconsistent with taking truth to be the source of normative reasons for belief. It does so by showing that there are circumstances in which one can know what truth requires one to believe, yet still lack evidence for the contents of that belief.

The concepts of being and order are the basic notions in all and every philosophical reflection and investigation into reality. The intention of this study is to examine the mutual relationships between order and being as found in the philosophy of Thomas Aquinas, but against the background of the age-old dispute regarding the unity and plurality of being(s) as initiated by Heraclitus and Parmenides, and developped by Plato and Aristotle, Duns Scotus and Ockham, Descartes and some contemporary metaphysicians, e.g. Heidegger (...) and Whitehead. Being and Order is the first volume of the series «Catholic Thought from Lublin». (shrink)

_An original philosophical account of relational ontology drawing on the work of Descartes, Kant, Fichte, Hegel, and Heidegger._.

In this paper I introduce an objection to normative evidentialism about reasons for belief. The objection arises from difficulties that evidentialism has with explaining our reasons for belief in unstable belief contexts with a single fixed point. I consider what other kinds of reasons for belief are relevant in such cases.

We conduct an experiment with 459 nonprofessional investors to examine whether they evaluate companies differently based on management’s stated purpose for undertaking corporate social responsibility activities in the presence versus absence of a company-specific negative event. Specifically, we vary whether or not management intends to achieve financial returns from CSR activities in addition to promoting social good. We address investors’ decision processes by investigating whether their judgments are mediated by perceptions of future cash flows and/or the underlying ethical culture of (...) the company. Results show that absent a negative event, investment judgments are stronger when CSR activities are intended to achieve financial returns, through expectations of higher future cash flows. However, when a negative event occurs, we find a moderating effect of independent assurance of CSR disclosures. When disclosures are not assured, investors prefer CSR undertaken only for societal benefit, mediated by perceptions of a stronger ethical culture. However, when disclosures are assured, ethical culture is viewed similarly regardless of management’s intention to achieve financial returns from CSR activities. This suggests that management’s willingness to obtain independent assurance on disclosures is viewed as a positive ethical signal. Thus, assurance complements disclosure of CSR activities by contributing to protection against the impact of negative events. (shrink)

This book provides a highly original approach to the writings of the twentieth-century German philosopher Walter Benjamin by one of his most distinguished readers. It develops the idea of "working with" Benjamin, seeking both to read his corpus and to put it to work - to show how a reading ofBenjamin can open up issues that may not themselves be immediately at stake in his texts.The defining elements in Benjamin's writings that Andrew Benjamin isolates - history, experience, translation, technical reproducibility (...) and politics - are put to work; that is, their utility is established in engaging the works of others. The question is how utility is understood. As AndrewBenjamin argues, utility involves demonstrating the different ways in which Benjamin is a central thinker within the project of understanding the nature of modernity. This is best achieved by noting connections and points of differentiation between his work and the writings of Adorno and Heidegger.However, the more demanding project is that "working with" Benjamin necessitates deploying the implicit assumptions within his writings as well as demanding of his formulations more than is provided by their initial presentation. What is at stake is not the application of Benjamin's thought. Ratherwhat counts is its use.Working with Benjamin engages with the themes central to Benjamin's work with deftness, daring and critical insight while at the same time situating those themes within current academic and cultural debates. (shrink)

In this paper it is argued that the buck-passing analysis (BPA) of final value is not a plausible analysis of value and should be abandoned. While considering the influential wrong kind of reason problem and other more recent technical objections, this paper contends that there are broader reasons for giving up on buck-passing. It is argued that the BPA, even if it can respond to the various technical objections, is not an attractive analysis of final value. It is not attractive (...) for two reasons: the first being that the BPA lacks the features typical of successful conceptual analyses and the second being that it is unable to deliver on the advantages that its proponents claim for it. While not offering a knock-down technical refutation of the BPA, this paper aims to show that there is little reason to think that the BPA is correct, and that it should therefore be given up as an analysis of final value. (shrink)

Andrew Youpa offers an original reading of Spinoza's moral philosophy, arguing it is fundamentally an ethics of joy. Unlike approaches to moral philosophy that center on praiseworthiness or blameworthiness, Youpa maintains that Spinoza's moral philosophy is about how to live lovingly and joyously. His reading expands to examinations of the centrality of education and friendship to Spinoza's moral framework, his theory of emotions, and the metaphysical foundation of his moral philosophy.

It is important to note that certain mental health disorders are classified as rare conditions, and they have their own ‘cultural concepts of distress’ as defined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM 5). Cultural concepts of distress are a recent attempt to understand psychological distress influenced by culture, separate from biomedical diagnoses that require equal attention and support for individuals and their families, both physically and emotionally. [1].

As a result of increased interest in global health, more and more medical students and trainees from the.

L’imamat et l’occultation selon l’imamisme: Étude bibliographique et histoire des textes. By Hassan Ansari. Islamic History and Civilization, vol. 134. Leiden: Brill, 2017. Pp. xx + 310 + 268. $245, €204.

Lamberth’s “Introduction” sets forth with clarity the purposes and plan of the text. In the chapters that follow he never loses sight of these purposes. Moreover, the plan of investigation is followed and developed in meticulous detail without becoming tedious.

Centuries of scientific progress have been devoted to reducing uncertainty. Newtonian physics, introduced over 300 years ago, allowed for precise prediction of planetary and tidal motion, falling bodies and infinitely more, in addition to allowing the construction of the material world. The 20th century witnessed a revolution in our understanding of organ and cellular function and dysfunction, elucidation of pathways, mediators, receptors, and molecular interactions, and breakthroughs in the characterization of replication, transcription, and translation, all of which has been integral (...) to our understanding of human physiology and pathophysiology. Clinical epidemiology has had a revolutionary impact on our .. (shrink)

Recent research (Latham, Miller and Norton, forthcoming) reveals that a majority of people represent actual time as dynamical. But do they, as suggested by McTaggart and Gödel, represent time as essentially dynamical? This paper distinguishes three interrelated questions. We ask (a) whether the folk representation of time is sensitive or insensitive: i.e., does what satisfies the folk representation of time in counterfactual worlds depend on what satisfies it actually—sensitive—or does is not depend on what satisfies it actually—insensitive, and (b) do (...) those who represent actual time as dynamical, represent time in all possible worlds as dynamical—what we call insensitive dynamism—or do they represent time in all possible worlds as dynamical only conditional on the actual world in fact being dynamical—what we call sensitive dynamism and (c) do dynamists and non-dynamists deploy two different representations of time, or deploy the same representation, but disagree about what actually satisfies that representation? We found no evidence that the folk representation of time is sensitive, or that the folk representation of time is essentially dynamical in either sense, though we did find evidence of a shared representation, on which dynamical features are sufficient, but not necessary, for time. (shrink)