Johanna Knapstein,1 Daniel Grimm,1 Marcus A Wörns,1 Peter R Galle,1 Hauke Lang,2 Tim Zimmermann111st Department of Internal Medicine, Johannes Gutenberg-University, Mainz, Germany; 2Department of General, Visceral and Transplantation Surgery, Johannes Gutenberg-University, Mainz, GermanyIntroduction: Hepatitis C virus reinfection occurs universally after liver transplantation, with accelerated cirrhosis rates of up to 30% within 5 years after liver transplantation. Dual antiviral therapy with pegylated interferon-2a and ribavirin only reaches sustained virological response rates of ~30% after liver transplantation. With the approval of viral (...) NS3/4A protease inhibitors telaprevir, boceprevir, and simeprevir and the NS5B polymerase inhibitor sofosbuvir, combination therapy offers new therapeutic options for HCV-infected patients, resulting in considerably higher sustained virological response rates in the nontransplant setting. Case presentation: We report three cases of TVR-based triple antiviral therapy in HCV genotype 1 reinfected patients after liver transplantation, of whom a 57-year-old Caucasian female and a 43-year-old Caucasian male were therapy naïve, and a 49-year-old Caucasian male patient was pretreated ineffectively. After 4 weeks of therapy, viral load decreased one to three log10 and became negative in weeks 6 to 8 in the therapy naïve patients. The pretreated patient showed a negative viral load in week 4. TVR was administered over 12 weeks, 750 mg thrice daily. Doses of immunosuppression with cyclosporine were reduced four to six fold. Initial peg-IFN and RBV doses ranged from 135–180 µg/week and 800–1,200 mg/day, according to the patient's body weight. Doses of peg-IFN and RBV were adapted to 90–135 µg/week and 400–800 mg/day after 2 to 12 weeks of protease inhibitor therapy. Dual therapy was continued for 36 weeks with total treatment duration of 48 weeks in the therapy naïve patients leading to a sustained virological response 12 weeks after the end of therapy. In the pretreated patient a breakthrough was detected in week 24 and therapy was discontinued. Overall, antiviral therapy was well tolerated. Side effects included dysgeusia and anemia leading to erythropoietin application and blood transfusions. Conclusion: This case series emphasizes that triple therapy with TVR is an efficient treatment for therapy naïve HCV genotype 1 reinfected patients after liver transplantation. But therapeutic options for pretreated patients require improvement. Keyword: cyclosporine, interferon, ribavirin, hepatitis C, protease inhibitor. (shrink)

On Buddhist metaphsical approach to suffering; a study, with some reference to George Grimm's works.

This article draws from theories of business-government relations and Austrian economics to develop a model relating firm performance to the firm’s market and nonmarket actions. Nonmarket actions represent one mechanism for the implementation of firm strategies. The model is tested using an original data set covering airlines serving international routes in the North Atlantic region. Results suggest that nonmarket actions have a positive and significant impact on performance, measured in three ways: profits, market share, and capacity utilization.

The portrayal of animals in the media is often criticised for instrumentalising, objectifying and anthropomorphising animals :53–79, 1997; Lerner and Kalof in Sociol Q 40:565–586, 1999; Stewart and Cole in Int J Multidiscip Res 12:457–476, 2009). Although we agree with this criticism, we also identify the need for a more substantiated approach to the moral significance of instrumentalisation, objectification and anthropomorphism. Thus, we propose a new framework which is able to address the morally relevant aspects of animal portrayal in the (...) media. We closely examine the normative messages communicated by an unusual TV commercial in which an anthropomorphised piglet advertises organic beef. This serves as a case example to relate the philosophical and ethical concepts of objectification and anthropomorphism to each other and show how they can be applied. We conclude that the commercial conveys a message of animal instrumentalisation as being normatively correct within the constraint of good animal welfare. The depicted form of instrumentalisation is, nonetheless, associated with harm for the animals and thus, needs to overcome cognitive dissonance. To achieve this, animals are directly objectified by a trivialised and de-individualised portrayal. Moreover, animals are indirectly objectified even when they are anthropomorphised as they are granted significance only through being human-like. Thus, objectification and anthropomorphism are not opposing terms in our proposed framework. In addition, objectification, together with the reference to the dominant ideology, and combined with humorous anthropomorphism weakens scrutiny of these normative messages by the viewers. This eventually augments a decrease of moral concern for farmed animals in advertisement employing such portrayals. (shrink)

Community engagement is increasingly promoted as a marker of good, ethical practice in the context of international collaborative research in low-income countries. There is, however, no widely agreed definition of community engagement or of approaches adopted. Justifications given for its use also vary. Community engagement is, for example, variously seen to be of value in: the development of more effective and appropriate consent processes; improved understanding of the aims and forms of research; higher recruitment rates; the identification of important ethical (...) issues; the building of better relationships between the community and researchers; the obtaining of community permission to approach potential research participants; and, the provision of better health care. Despite these diverse and potentially competing claims made for the importance of community engagement, there is very little published evidence on effective models of engagement or their evaluation. (shrink)

BackgroundCommunity engagement is increasingly promoted as a marker of good, ethical practice in the context of international collaborative research in low-income countries. There is, however, no widely agreed definition of community engagement or of approaches adopted. Justifications given for its use also vary. Community engagement is, for example, variously seen to be of value in: the development of more effective and appropriate consent processes; improved understanding of the aims and forms of research; higher recruitment rates; the identification of important ethical (...) issues; the building of better relationships between the community and researchers; the obtaining of community permission to approach potential research participants; and, the provision of better health care. Despite these diverse and potentially competing claims made for the importance of community engagement, there is very little published evidence on effective models of engagement or their evaluation.MethodsIn this paper, drawing upon interviews with the members of a Community Advisory Board on the Thai-Myanmar border, we describe and critically reflect upon an approach to community engagement which was developed in the context of international collaborative research in the border region.Results and conclusionsDrawing on our analysis, we identify a number of considerations relevant to the development of an approach to evaluating community engagement in this complex research setting. The paper also identifies a range of important ways in which the Community Advisory Board is in practice understood by its members to have morally significant roles and responsibilities beyond those usually associated with the successful and appropriate conduct of research. (shrink)

In his paper ‘Has the Ontological Argument Been Refuted?’, 97–110) William F. Vallicella argues that my attempt to show that the Ontological Argument begs the question is unsuccessful. 1 I believe he is wrong about this, but before endeavouring to vindicate my position I must first make clear what precisely is the point at issue between us. The Ontological Argument is not a single argument, but a family of arguments. Newly devised formulations of the argument are frequently put forward by (...) philosophers in an effort to avoid difficulties that have been pointed out in previous versions. As a consequence there is no possibility of a conclusive proof that every form of the argument embodies the same fallacy. Nevertheless, one can, I believe, prove that all the standard versions of the argument embody a certain fallacy and that, given the nature of the argument, it is therefore unlikely that the argument can be formulated in such a way as to avoid this difficulty. What I tried to show in my paper is that the six best-known versions of the argument all beg the question and that they do so at the same point in the argument, namely when it is asserted that it is possible that an absolutely perfect being exists. It is difficult to see how an ontological argument could be formulated without including this claim as one of its premises, since the distinguishing badge of the argument is the inference from the possibility of an absolutely perfect being to its actuality. It must be unlikely then, if my criticism of these six versions is correct, that there is any way of formulating the argument that avoids this fallacy. (shrink)

Theism, according to David O'Connor, has in recent centuries been on trial for its life, the charge being that the existence of so much evil in the world is incompatible with belief in a benevolent creator. But this trial, he claims is incapable of producing a reasoned verdict.

Religion and the external world -- Projection, religion, and the external world -- The senses, reason and the imagination -- Realism, meaning and justification : the external world and religious belief -- Modality, projection and realism -- 'Our profound ignorance' : causal realism, and the failure to detect necessity -- Spreading the mind : projection, necessity and realism -- Into the labyrinth : persons, modality, and Hume's undoing -- Value, projection, and realism -- Gilding : projection, value and secondary qualities (...) -- The gold : good, evil, belief and desire -- The golden : relational values, realism and a moral sense. (shrink)

This new edition offers expanded selections from the works of Kongzi, Mengzi, Zhuangzi, and Xunzi ; two new works, the dialogues _Robber Zhi_ and _White Horse_; a concise general introduction; brief introductions to, and selective bibliographies for, each work; and four appendices that shed light on important figures, periods, texts, and terms in Chinese thought.

The Religious Openness Hypothesis argues that traditional religions have resources for integrating intellect with faith. In a test of this hypothesis, Hindu graduate students in India responded to Hindu religious reflection, attitudes toward Hinduism, religious schema, religious orientation, and psychological openness scales. Faith and intellect oriented religious reflection correlated positively with each other and with the all three religious schemas, which also correlated directly. Linkages with attitudes toward Hinduism and intrinsic and extrinsic personal religious orientations documented the compatibility of religious (...) reflection and schema with Hindu commitments. Associations with greater openness to experience and need for cognition confirmed their psychological openness as well. Interactions between attitudes toward Hinduism and the intrinsic orientation suggested that Hinduism had more positive influences in those who were more sincerely religious. These data from India most importantly supported the Religious Openness Hypothesis. (shrink)

The metaphysical problem of individuation requires an answer to two different but intimately related questions: 1) How are we to characterize individuality ontologically? To what ontological category or logical type does individuality belong? 2) What sort of distinction is there between the individuality and nature of an individual, e.g., a real distinction, a modal distinction, a distinction of reason, or some other distinction My purpose in this article is to clarify a bare particular account of individuation and respond to objections (...) that have been raised against bare particulars as individuators. (shrink)

:In a recent paper in Cambridge Quarterly of Healthcare Ethics on the necessary conditions for morally responsible animal research David DeGrazia and Jeff Sebo claim that the key requirements for morally responsible animal research are an assertion of sufficient net benefit, a worthwhile-life condition, and a no-unnecessary-harm condition. With regards to the assertion of sufficient net benefit, the authors claim that morally responsible research offers unique benefits to humans that outweigh the costs and harms to humans and animals. In this (...) commentary we will raise epistemic, practical, and ethical challenges to DeGrazia and Sebo’s emphasis on benefits in the prospective assessment of research studies involving animals. We do not disagree with DeGrazia and Sebo that, at the theoretical level, the benefits of research justify our using animals. Our contribution intends to clarify, at the practical level, how we should understand benefits in the prospective assessment and moral justification of animal research. We argue that ASNB should be understood as an assessment of Expectation of Knowledge Production in the prospective assessment and justification of animal research. EKP breaks down into two further claims: that morally responsible research generates knowledge worth having and that morally responsible research is designed and executed to produce generalizable knowledge. We understand the condition called knowledge worth having as scientists’ testing a hypothesis that, whether verified or falsified, advances an important interest, and production of generalizable knowledge in terms of scientific integrity. Generalizable knowledge refers to experimental results that generalize to a larger population beyond the animals studied. Generalizable scientific knowledge is reliable, replicable, and accurately descriptive. In sum, morally responsible research will be designed and carefully executed to successfully test a hypothesis that, whether verified or falsified, advances important interests. Our formulation of EKP, crucially, does not require further showing that an experiment involving animals will produce societal benefits. (shrink)

It is the impression of neurologists who deal with cancer patients that the incidence of neurologic complications of cancer is increasing (Posner 1995). ...

In this article, an ethical analysis of an educational programme on renal replacement therapy options for patients and their social network is presented. The two main spearheads of this approach are: (1) offering an educational programme on all renal replacement therapy options ahead of treatment requirement and (2) a home-based approach involving the family and friends of the patient. Arguments are offered for the ethical justification of this approach by considering the viewpoint of the various stakeholders involved. Finally, reflecting on (...) these ethical considerations, essential conditions for carrying out such a programme are outlined. The goal is to develop an ethically justified and responsible educational programme. (shrink)

The current study investigated the adaptations which occur in visual search behaviour as a function of expertise in rugby union players when completing attacking scenarios. Ten experienced players and ten novice players completed 2 vs. 1 attacking game scenarios. Starting with the ball in hand and wearing a mobile eye tracker throughout, participants were required to score a try against a defender. The scenarios allowed for a pass to their supporting player or trying to run past the defender. No between (...) group differences were found in fixating on the supporting attacking player. However, EP increased the length and frequency looking at the area immediately ahead of the supporting player, particularly when executing a spin pass. NP fixated longer and more frequently at the defender, whilst EP fixated more frequently in the space the supporting player would run into in Switch and Dummy Switch scenarios. More successful passes were completed and tries scored by EP compared to NP. Differences in visual search behaviour between experienced and NP suggest that the experts extract information from areas directly related to guiding the motor action; the space immediately ahead of the support player to pass the ball in. Contrastingly, novices use a more allocentric perspective where the actions from the defender are used to guide their motor actions. (shrink)

Hume's 'Natural History of Religion' offers a naturalized account of the causes of religious thought, an investigation into its 'origins' rather than its 'foundation in reason'. Hume thinks that if we consider only the causes of religious belief, we are provided with a reason to suspend the belief. I seek to explain why this is so, and what role the argument plays in Hume's wider campaign against the rational acceptability of religious belief. In particular, I argue that the work threatens (...) a form of fideism which maintains that it is rationally permissible to maintain religious belief in the absence of evidence or of arguments in its favour. I also discuss the 'argument from common consent', and the relative superiority of Hume's account of the origins of religious belief. (shrink)

Multidisciplinary healthcare committees meet regularly to discuss patients’ candidacy for emerging functional neurosurgical procedures, such as Deep Brain Stimulation . Through debate and discussion around the surgical candidacy of particular patients, functional neurosurgery programs begin to mold practice and policy supported both by scientific evidence and clear value choices. These neurosurgical decisions have special considerations not found in non-neurologic committees. The professional time used to resolve these conflicts provides opportunities for the emergence of careful, ethical practices simultaneous with the expansion (...) of therapy applications. (shrink)

This paper discusses the metaphor of projection in relation to Hume’s treatment of causal necessity. I argue that the best understanding of projection shows it to be compatible with taking Hume to be a ‘sceptical realist’ about causal necessity, albeit an agnostic one.