From its inception, genomics has been a speculative endeavor, fixated on a far-off horizon that would deliver on the promise of targeted diagnostics and individualized therapeutics (Fortun 2008). M...

With the growth of precision medicine research on health data and biospecimens, research institutions will need to build and maintain long-term, trusting relationships with patient-participants. While trust is important for all research relationships, the longitudinal nature of precision medicine research raises particular challenges for facilitating trust when the specifics of future studies are unknown. Based on focus groups with racially and ethnically diverse patients, we describe several factors that influence patient trust and potential institutional approaches to building trustworthiness. Drawing on (...) these findings, we suggest several considerations for research institutions seeking to cultivate long-term, trusting relationships with patients: Address the role of history and experience on trust, engage concerns about potential group harm, address cultural values and communication barriers, and integrate patient values and expectations into oversight and governance structures. (shrink)

어떤 만남은 운명이다! 조선시대 전방위 지식인 다산 정약용, 그의 가르침을 따라 평생을 산 단 한 사람, 황상 "부지런하고 부지런하고 부지런하라" "학생은 있지만 제자는 없다"는 탄식의 소리가 높아지고 있다. 존경과 사랑이라는 단어가 무색하게 진정한 스승도 진정한 제자도 드문 요즈음이다. 정민 교수에 의해 200년 전 다산 정약용과 그의 제자 황상 사이에 이어진 도탑고 신실한 사제 간의 정리가 울림이 커다란 의미로 되살아난다.

1. Kwangja chŏngsin e kwanhan kich'ojŏk ihae -- 2. Yuga ŭi kwanggyŏn'gwan -- 3. Toga ŭi kwangŏn kwa kwangja chŏngsin -- 4. Ŭmju munhwa wa Wi-Chin ŭi imt'anjŏk kwang -- 5. Songdae ihakchadŭl ŭi kwangjagwan -- 6. Yangmyŏnghak ŭi kwanggyŏn'gwan -- 7. Chosŏnjo yuhakchadŭl ŭi kwanggyŏn'gwan -- 8. Chosŏnjo yuhakcha ŭi yokki yŏnggwi ihae -- 9. Sŏhwa tot'ongnon kwa kwanggyŏn esŏ chunghaeng ŭro -- 10. Kwanggyŏn mihak ŭi munyejŏk chŏgyong -- 11. Chungguk hoehwa e nat'anan kwanggyŏn mihak -- 12. Chungguk (...) sŏye e nat'anan kwanggyŏn mihak -- 13. Chosŏnjo hoehwa e nat'anan kwanggyŏn mihak -- 14. Chosŏnjo sŏye ŭi kwanggyŏn mihak. (shrink)

che 1-pu. Nolli -- che 2-pu. Kachʻi tʻamgu.

We conducted focus groups to assess patient attitudes toward research on medical practices in the context of usual care. We found that patients focus on the implications of this research for their relationship with and trust in their physicians. Patients view research on medical practices as separate from usual care, demanding dissemination of information and in most cases, individual consent. Patients expect information about this research to come through their physician, whom they rely on to identify and filter associated risks. (...) In general, patients support this research, but worry that participation in research involving randomization may undermine individualized care that acknowledges their unique medical histories. These findings suggest the need for public education on variation in practice among physicians and the need for a collaborative approach to the governance of research on medical practices that addresses core values of trust, transparency, and partnership. (shrink)

The purpose of this study was to investigate the role of perceived vulnerability to disease, emotions (disgust, anger), and perceived norms in predicting moral judgments of anti-COVID-19-preventive behaviors in US and Japan. A total of 442 Japanese and 365 American participants completed an online survey. Disgust and anger mediated the link between perceived vulnerability to disease (germ aversion) and moral judgments of preventive behaviors across both cultures. Perceived social norms among friends and family were associated with harsh judgments of anti-preventive (...) behaviors for Japanese but not for American participants. Overall, our results suggest that effective strategies for promoting preventive behaviors may be culturally valid if they focus on the fear for infectious disease and related aversive affect. We also discussed the possibility that some strategies could be characteristic of collectivistic cultures, warranting further cross-cultural comparisons. (shrink)

Does the Ship of Theseus present a genuine puzzle about persistence due to conflicting intuitions based on “continuity of form” and “continuity of matter” pulling in opposite directions? Philosophers are divided. Some claim that it presents a genuine puzzle but disagree over whether there is a solution. Others claim that there is no puzzle at all since the case has an obvious solution. To assess these proposals, we conducted a cross-cultural study involving nearly 3,000 people across twenty-two countries, speaking eighteen (...) different languages. Our results speak against the proposal that there is no puzzle at all and against the proposal that there is a puzzle but one that has no solution. Our results suggest that there are two criteria—“continuity of form” and “continuity of matter”— that constitute our concept of persistence and these two criteria receive different weightings in settling matters concerning persistence. (shrink)

BackgroundAlthough the Life-Sustaining Treatment (LST) Decision Act was enforced in 2018 in Korea, data on whether it is well established in actual clinical settings are limited. Hospital-acquired pneumonia (HAP) is a common nosocomial infection with high mortality. However, there are limited data on the end-of-life (EOL) decision of patients with HAP. Therefore, we aimed to examine clinical characteristics and outcomes according to the EOL decision for patients with HAP.MethodsThis multicenter study enrolled patients with HAP at 16 referral hospitals retrospectively from (...) January to December 2019. EOL decisions included do-not-resuscitate (DNR), withholding of LST, and withdrawal of LST. Descriptive and Kaplan–Meier curve analyses for survival were performed.ResultsOf 1,131 patients with HAP, 283 deceased patients with EOL decisions (105 cases of DNR, 108 cases of withholding of LST, and 70 cases of withdrawal of LST) were analyzed. The median age was 74 (IQR 63–81) years. The prevalence of solid malignant tumors was high (32.4% vs. 46.3% vs. 54.3%, P = 0.011), and the ICU admission rate was lower (42.9% vs. 35.2% vs. 24.3%, P = 0.042) in the withdrawal group. The prevalence of multidrug-resistant pathogens, impaired consciousness, and cough was significantly lower in the withdrawal group. Kaplan–Meier curve analysis revealed that 30-day and 60-day survival rates were higher in the withdrawal group than in the DNR and withholding groups (log-rank P = 0.021 and 0.018). The survival of the withdrawal group was markedly decreased after 40 days; thus, the withdrawal decision was made around this time. Among patients aged below 80 years, the rates of EOL decisions were not different (P = 0.430); however, mong patients aged over 80 years, the rate of withdrawal was significantly lower than that of DNR and withholding (P = 0.001).ConclusionsAfter the LST Decision Act was enforced in Korea, a DNR order was still common in EOL decisions. Baseline characteristics and outcomes were similar between the DNR and withholding groups; however, differences were observed in the withdrawal group. Withdrawal decisions seemed to be made at the late stage of dying. Therefore, advance care planning for patients with HAP is needed. (shrink)

Chinese mind-body exercises are positively associated with executive function, but their effects on EF, from synthesized evidence using systematic and meta-analytic reviews, have not been conducted. Therefore, the present systematic review with meta-analysis attempted to determine whether CMBEs affect EF and its sub-domains, as well as how exercise, sample, and study characteristics moderate the causal relationship between CMBEs and EF in middle-aged and older adults. Seven electronic databases were searched for relevant studies published from the inception of each database through (...) June 2020. Randomized controlled trials with at least one outcome measure of CMBEs on EF in adults of mean age ≥ 50 years with intact cognition or mild cognitive impairment and with or without chronic diseases were included. A total of 29 studies ultimately were included in this study. The results indicated that CMBEs improved overall EF, as well as its sub-domains of working memory and shifting. The beneficial effects of CMBEs on EF occurred regardless of type, frequency of group classes, session time, total training time, and length of the CMBEs, in addition to that more frequent participation in both group classes and home practice sessions resulted in more beneficial effects. The positive effects of CMBEs on EF were also demonstrated, regardless of participants mean age, sex, and cognitive statuses, health status, as well as training mode and study language. This review thus suggests that CMBEs can be used as an effective method with small to moderate and positive effects in enhancing EF, and that more frequent group classes and home practice sessions may increase these effects. However, certain limitations, including strictly design studies, limited ES samples for specific variables, and possible biased publications, required paying particular attention to, for further exploring the effects of CMBEs on EF. (shrink)

Despite the prevailing discourses on the importance of top management ethical leadership, related theoretical and empirical developments are lacking. Drawing on institutional theory, we propose that top management ethical leadership contributes to organizational outcomes by promoting firm-level ethical and procedural justice climates. This theoretical framework was empirically tested using multi-source data obtained from 4,468 employees of 147 Korean companies from various industries. The firm-level analysis shows that top management ethical leadership significantly predicts ethical climate, which then results in procedural justice (...) climate that fully mediates the effects of top management ethical leadership on two organizational outcomes, namely, firm-level organizational citizenship behavior and firm financial performance. The present study provides a plausible theoretical account and empirical validation of a mechanism through which top management ethical leadership enhances organizational performance. (shrink)

This paper reports our analysis of the ELSI Virtual Forum: 30 Years of the Genome: Integrating and Applying ELSI Research, an online meeting of scholars focused on the ethical, legal, and social implications (ELSI) of genetics and genomics.

As documented by Darwin 150 years ago, emotion expressed in human faces readily draws our attention and promotes sympathetic emotional reactions. How do such reactions to the expression of emotion affect our goal-directed actions? Despite the substantial advance made in the neural mechanisms of both cognitive control and emotional processing, it is not yet known well how these two systems interact. Here, we studied how emotion expressed in human faces influences cognitive control of conflict processing, spatial selective attention and inhibitory (...) control in particular, using the Eriksen flanker paradigm. In this task, participants viewed displays of a central target face flanked by peripheral faces and were asked to judge the gender of the target face; task-irrelevant emotion expressions were embedded in the target face, the flanking faces, or both. We also monitored how emotion expression affects gender judgment performance while varying the relative timing between the target and flanker faces. As previously reported, we found robust gender congruency effects, namely slower responses to the target faces whose gender was incongruent with that of the flanker faces, when the flankers preceded the target by 0.1 s. When the flankers further advanced the target by 0.3 s, however, the congruency effect vanished in most of the viewing conditions, except for when emotion was expressed only in the flanking faces or when congruent emotion was expressed in the target and flanking faces. These results suggest that emotional saliency can prolong a substantial degree of conflict by diverting bottom-up attention away from the target, and that inhibitory control on task-irrelevant information from flanking stimuli is deterred by the emotional congruency between target and flanking stimuli. (shrink)

From the perspective of the system of systems development, system-level functional testing is required for designing subsystems. This study utilizes modeling and simulation techniques to analyze the operational behaviors of the subsystems and confirm data communication between them. The targeted system in the study is a naval combat system, which is a typical type of defense cyber-physical system. Three types of models were designed for the simulation testing of the NCS: a combat-management model for simulating the overall computational activities, physical (...) models to confirm the intrasubsystem behaviors, and data integration models to test the intersubsystem communications. These models are realized with the Model-View-ViewModel design pattern, which strongly facilitates graphical user interfaces being decoupled from model logic and data. We consider underwater combat scenarios as an application. Six significant physical subsystems within the NCS are simulated and tested: a ship-steering system, an inertial navigation system, a global navigation satellite system, a periscope, sonar systems, and a plotting board. We expect that the proposed work will play a principal role when analyzing the behaviors and communications of defense CPSs and providing an environment for functional testing as a digital twin. (shrink)

With the growing amount of clinical research, regulations and research ethics are becoming more stringent. This trend introduces a need for quality assurance measures for ensuring adherence to research ethics and human research protection beyond Institutional Review Board approval. Audits, one of the most effective tools for assessing quality assurance, are measures used to evaluate Good Clinical Practice and protocol compliance in clinical research. However, they are laborious, time consuming, and require expertise. Therefore, we developed a simple auditing process and (...) evaluated its feasibility and effectiveness. The screening audit was developed using a routine audit checklist based on the Severance Hospital’s Human Research Protection Program policies and procedures. The measure includes 20 questions, and results are summarized in five categories of audit findings. We analyzed 462 studies that were reviewed by the Severance Hospital Human Research Protection Center between 2013 and 2017. We retrospectively analyzed research characteristics, reply rate, audit findings, associated factors and post-screening audit compliance, etc. Investigator reply rates gradually increased, except for the first year. The studies were graded as “critical,” “major,” “minor,” and “not a finding”, based on findings and number of deficiencies. The auditors’ decisions showed fair agreement with weighted kappa values of 0.316, 0.339, and 0.373. Low-risk level studies, single center studies, and non-phase clinical research showed more prevalent frequencies of being “major” or “critical”. Inappropriateness of documents, failure to obtain informed consent, inappropriateness of informed consent process, and failure to protect participants’ personal information were associated with higher audit grade. We were able to observe critical GCP violations in the routine internal audit results of post-screening audit compliance checks in “non-responding” and “critical” studies upon applying the screening audit. Our screening audit is a simple and effective way to assess overall GCP compliance by institutions and to ensure medical ethics. The tool also provides useful selection criteria for conducting routine audits. (shrink)