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)

Meaningful relationships are centrally important for human functioning. It remains unclear, however, which aspects of meaningful relationships impact wellbeing the most and whether these differ between psychiatric patients and members of the community. Information about relationship attributes and functions were collected in community members and psychiatric patients. Relationship attributes and functions were examined for differences between groups, their impact on wellbeing and symptoms, and the size of network. Community members reported fewer relationships, higher frequency of contact and less desire for (...) change when compared to the psychiatric patients. Nevertheless, both groups reported relatively high levels of fulfilled functions. Quality of the relationship and investment into the relationship was associated with both wellbeing and symptoms for both the community and the patient group. Almost all functions were associated with wellbeing and symptoms for the community group. However, for the patient group, only few functions were associated with wellbeing and no functions were associated with symptoms. Contrary to our hypotheses, the results show that psychiatric patients do not have a deficit in fulfilling relationships. Most people report a well-functioning network of meaningful, high-quality relationships. Patients benefit from meaningful, function-fulfilling relationships just as much as community members. Results are discussed with respect to how targeting relationships can be used clinically. (shrink)

This book's importance is derived from three sources: careful conceptualization of teacher induction from historical, methodological, and international perspectives; systematic reviews of research literature relevant to various aspects of teacher induction including its social, cultural, and political contexts, program components and forms, and the range of its effects; substantial empirical studies on the important issues of teacher induction with different kinds of methodologies that exemplify future directions and approaches to the research in teacher induction.

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Charm and Speed: Virtuosity in the Performing ArtsAnthony J. PalmerV. A. Howard, Charm and Speed: Virtuosity in the Performing Arts (New York: Peter Lang, 2008)There may be one other book on virtuosity, but nothing that approaches the depth of argument put forth by V. A. Howard in Charm and Speed. As the author states, “[t]his book offers an interpretation, analysis, and reconstruction of the concept of virtuosity (...) which plays so prominent a role in historical, critical, and theoretical discussions of artistic performance.”1 The book is not an easy read, however, because of Howard’s customarily esoteric vocabulary. While the writing is in fine style, there are too many occasions where the reader may be hampered by having to pause to reconsider what was stated, especially in some of the longer sentences, or because a dictionary consultation is warranted.Nevertheless, this is a must-read for voice and instrumental students and their teachers, coaches, and accompanists. Moreover, this book is a must-read for anyone working with performing artists; Howard covers the performance arts broadly, including theatre and dance as well. If you only surmise what virtuosity is, you will become intimately aware of its meaning and all its ramifications.Its casual use suggests that virtuosity can be found everywhere, from auto mechanics to baristas and even include, as Howard describes, cheetahs on the hunt and the kill. And although the cheetah is perfectly suited to find food to feed her [End Page 101] cubs, the intentional development of techniques and a conscious plan to attack her prey is questionable; she acts out of instinct. We can admire various manifestations of excellence, but their qualities do not measure up to the characteristics of virtuosity. Excellence in execution is not by such virtue virtuosic.The fact is performance in the arts requires a special understanding of virtuosity that must be narrowly applied under appropriate conditions. The ten chapters comprising the book deal with every facet of virtuosity in performance and clarify the issues forcefully and accurately. Charm and Speed is a brief treatise of only 134 pages, plus notes and a 3-page appendix. But in those chapters lie explanations to which most professional performers, teachers, and subsidiary personnel may need to give serious consideration. On the other end of the spectrum, for those who may require a less than keenly argued thesis, how much does one really need to know about virtuosity to enjoy fine, but lesser, performance? Some differences do need to be noted, however, and confusing virtuosity with other artistic appellations could be eliminated.At the outset, virtuosity can easily be confused with creativity, but the latter is more general while “a judgment of virtuosity is necessarily grounded in the observables of execution.”2 Howard’s outline of the conditions of virtuosity is carried throughout the discussion. Three parts comprise any consideration: 1) the performing individual or group “inclusive of training and manifest talent,” judged by experts; 2) the domain of the performance—acting, dancing, and playing the violin—must be specified; and 3) the audience comprised of a general audience and “critics, colleagues, and institutions” must render appropriate judgment.3 Virtuosity is not a single state but requires both process and achievement.Howard narrows his discussion on virtuosity to those in the performing arts, “to those who play instruments, or sing or act, dance or conduct,”4 with no other reason or intention but to render the artwork with unique interpretations at the highest level possible. Howard restricts discourse to allographic5 works in the Western tradition, an important distinction that I had considered questionable at first, but came to realize that virtuosity considered on a wider scale could be overly complicated. My experience with Japanese performing art, for example, would have to examine, Nô, Bunraku, Kabuki theatre, and traditional vocal and instrumental performance, among other things, all quite complex in their own right. Can a puppet in Bunraku be a virtuoso, or would it be the puppeteer? Further, Korean art forms such as pansori and African arts, where some cultures are communal rather than performed by superb practitioners, would all have to be considered. When the whole world is examined... (shrink)

T. J. Smiley; XII.—Entailment and Deducibility, Proceedings of the Aristotelian Society, Volume 59, Issue 1, 1 June 1959, Pages 233–254, https://doi.org/10.1093.

Ethicists have tended to treat the psychology of attributing mental states to animals as an entirely separate issue from the moral importance of animals’ mental states. In this paper I bring these two issues together. I argue for two theses, one descriptive and one normative. The descriptive thesis holds that ordinary human agents use what are generally called phenomenal mental states to assign moral considerability to animals. I examine recent empirical research on the attribution of phenomenal states and agential states (...) to argue that phenomenal mental states are the primary factor, psychologically, for judging an animal to be morally considerable. I further argue that, given the role of phenomenal states in assigning moral considerability, certain theories in animal ethics will meet significant psychological resistance. The normative thesis holds that ethicists must take the psychology of attributing mental states into account when constructing moral ideals concerning animals. I draw from the literature in political philosophy on ideal and non-ideal theory to argue that non-ideal theories for animals must account for human psychology because—like current social and political conditions—human psychology limits the achievement of moral ideals. (shrink)

Background Biobank participants often do not understand much of the information they are provided as part of the informed consent process, despite numerous attempts at simplifying consent forms and improving their readability. We report the first assessment of biobank enrollees’ comprehension under an "integrated consent” process, where patients were asked to enroll in a research biobank as part of their normal healthcare experience. A number of healthcare systems have implemented similar integrated consent processes for biobanking, but it is unknown how (...) much patients understand after enrolling under these conditions. Methods: We recruited patients who enrolled in a biobank while in a healthcare setting when receiving ordinary care. We assessed knowledge of consent materials using 11 true/false questions drawn from a well-known biobank knowledge test. After reviewing the results from 114 participants, we revised the consent form and repeated the knowledge assessment with 144 different participants. Results: Participants scored poorly on the knowledge test in both rounds, with no significant differences in overall scores or individual items between the rounds. In Phase 1, participants answered 53% of the questions correctly, 25% incorrectly, and 22% “I don’t know.” In Phase 2, participants answered 53% of questions correctly, 24% incorrectly, and 23% “I don’t know.” Participants scored particularly poorly on questions about data sharing and accessing medical records. Conclusions: Enrollees under an integrated consent model had significant misunderstandings that persisted despite an attempt to improve information specifically about those topics in a consent form. These results raise challenges for current approaches that attribute misunderstanding to overly complex consent forms. They also suggest that the pressures of the clinic may compound other problems with patient understanding of biobank consent. As health systems increasingly blend research and care, they may need to rethink their approach to educating patients about participation in a biobank. (shrink)

Recent highly publicized privacy breaches in health care and genomics research have led many to question whether current standards of data protection are adequate. Improvements in de-identification techniques, combined with pervasive data sharing, have increased the likelihood that external parties can track individuals across multiple databases. This paper focuses on the communication of identifiability risks in the process of obtaining consent for donation and research. Most ethical discussions of identifiability risks have focused on the severity of the risk and how (...) it might be mitigated, and what precisely is at stake in pervasive data sharing. However, there has been little discussion of whether and how to communicate the risk to potential donors. We review the ethical arguments behind favoring different types of risk communication in the consent process, and outline how identifiability concerns can be incorporated into either a detailed or simplified method of communicating risks during the consent process. (shrink)

Some philosophers have thought that life could only be meaningful if there is no God. For Sartre and Nagel, for example, a God of the traditional classical theistic sort would constrain our powers of self-creative autonomy in ways that would severely detract from the meaning of our lives, possibly even evacuate our lives of all meaning. Some philosophers, by contrast, have thought that life could only be meaningful if there is a God. God and the Meanings of Life is interested (...) in exploring the truth in both these schools of thought, seeking to discover what God could and couldn't do to make life meaningful (as well as what he would and wouldn't do). Mawson espouses a version of the 'amalgam' or 'pluralism' thesis about the issue of life's meaning – in essence, that there are a number of different legitimate meanings of 'meaning' (and indeed 'life') in the question of life's meaning. According to Mawson, God, were he to exist, would help make life meaningful in some of these senses and hinder in some others. He argues that whilst there could be meaning in a Godless universe, there could be other sorts of meaning in a Godly one and that these would be deeper. (shrink)

Consistent application of dialectical materialism leads Marxism-Leninism to the assertion that matter is infinite in its properties. However, the history of physics shows that the various levels of matter possess geometric dimensions that originate at the lowest level and continue through the others. The search for absolute natural constants -- which Planck called the most pleasant task of physics -- shows the conviction of the physicists that there is a limit to the parameters, a limit beyond which matter is no (...) longer divisible. (shrink)

How do we think about animals? How do we decide what they deserve and how we ought to treat them? Subhuman takes an interdisciplinary approach to these questions, drawing from research in philosophy, neuroscience, psychology, law, history, sociology, economics, and anthropology. Subhuman argues that our attitudes to nonhuman animals, both positive and negative, largely arise from our need to compare ourselves to them.

This article reviews and corrects frequent misunderstandings of somaesthetics, the multidisciplinary field of study of the lived body conceived by Richard Shusterman. After responding to an article published in Contemporary Pragmatism, I extend the discussion to cover larger topics of discussion related to somaesthetics and misapprehensions by its critics, including the nature of somatic experience, the role of pleasure, and the relevance of culture. In rectifying mistakes of understanding, it is hoped the effort will foster better understanding and better critique.

Beskow and Weinfurt (2019) present an excellent and timely discussion of how to respond to evidence that individuals do not fully understand a biobank consent form. We faced similar challenges afte...

This note addresses briefly the difficulties associated with the personalities named in the epigram Anth. Lat. 109.8 ShB and their roles before suggesting that tibi should be read rather than mihi in line 8.