Bradford C Bemiss, Chad A WittDepartment of Internal Medicine, Division of Pulmonary and Critical Care Medicine, Washington University School of Medicine, St Louis, MO, USA: Chronic rejection is a major cause of death after the first year following lung transplantation. Bronchiolitis obliterans is the most common pathologic finding on biopsy, characterized by fibrous granulation tissue, which obliterates the lumen of the bronchiole. Clinically, in the absence of tissue for pathology, BO syndrome refers to a progressive irreversible drop in the forced (...) expiratory volume in 1 second. Recently, a broader definition of chronic rejection, termed "chronic lung allograft dysfunction", has been used to encompass a more inclusive definition of posttransplant dysfunction. Recently, the lung transplant community has come to realize that chronic rejection may be the final common result after repetitive epithelial insults. Acute rejection, infection, and alloreactivity to mismatched HLA antigens are a few of these insults that damage the surface of the bronchioles. Recent evidence of autoimmunity to the normally hidden structural proteins collagen V and K-α1 tubulin have been correlated with a BO phenotype as well, perhaps correlating the epithelial damage with a mechanism for developing BO lesions. Many immunomodulatory medications and treatments have been studied for effectiveness for the treatment of chronic lung allograft dysfunction. New drugs, which more precisely target the immune system, are being developed and tested. Further study is required, but recent advances have improved our understanding of the pathogenesis and potential intervention for this common and deadly complication of lung transplantation.Keywords: lung transplant, bronchiolitis obliterans syndrome, rejection. (shrink)

This book offers an introduction to the thought of Robert Holcot, a great and influential but often underappreciated medieval thinker. Holcot was a Dominican friar who flourished in the 1330's and produced a diverse body of work including scholastic treatises, biblical commentaries, and sermons. By viewing the whole of Holcot's corpus, John T. Slotemaker and Jeffrey C. Witt provide a comprehensive account of his thought. Challenging established characterizations of him as a skeptic or radical, they show Holcot to be (...) primarily concerned with affirming and supporting the faith of the pious believer. At times, this manifests itself as a cautious attitude toward absolutist claims about the power of natural reason. At other times Holcot reaffirms, in Anselmian fashion, the importance of rational effort in the attempt to understand and live out one's faith. Over the course of this introduction the authors unpack Holcot's views on faith and heresy, the divine nature and divine foreknowledge, the sacraments, Christ, and political philosophy. They also examine Holcot's approach to several important medieval literary genres, including the development of his unique. (shrink)

Students in an undergraduate legal and ethical issues course continually told the authors that they did not have time to study for the course because they were busy studying for their clinical courses. Faculty became concerned that students were failing to realize the value of legal and ethical concepts as applicable to clinical practice. This led the authors to implement a transformational learning experience in which students applied legal and ethical course content in a high-fidelity human simulation (HFHS) scenario. A (...) preliminary evaluation compared the new HFHS experience with in-person and online student groups using the same case. Based on both student and faculty perceptions, the HFHS was identified as the best of the three approaches for providing a transformational learning experience regarding legal and ethical content. (shrink)

This article offers an introduction to the question of God’s omnipresence as debated within the late medieval scholastic tradition as seen through the lens of Francis of Meyronnes. In Meyronnes’s commentary on distinction 37 of Peter Lombard’s Sentences, he attempts to categorize the various ways one might prove God’s existence in all things through a four-fold classification. In following his classifications, we are able to look back at some of the historical ways earlier scholastics have attempted to prove God’s omnipresence (...) and follow some of the changes in those approaches as the tradition has developed. Likewise, Meyronnes’s fourth and final classification will point us toward the future. His fourth way—interesting and puzzling in and of itself—offers early hints of future debates about God’s omnipresence and his relationship to place that will emerge in the late 14th century and then again in the 15th, 16th, and 17th centuries. (shrink)

Chad A Witt, Ramsey R Hachem Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, Washington University School of Medicine, Saint Louis, MO, USA: The role of donor-specific antibodies to human leukocyte antigens and the burden of antibody-mediated rejection in lung transplantation remain enigmatic. Over the past several years, evidence has been emerging that humoral immunity plays an important role in the development of both acute and chronic lung allograft dysfunction. Multiple case reports and case series have (...) identified lung allograft recipients with clinical findings consistent with acute AMR. However, there is currently no widely accepted definition for AMR in lung transplantation, and this has been a significant barrier to furthering our understanding of this form of rejection. Nonetheless, the development of DSA after transplantation has consistently been identified as an independent risk factor for persistent and high-grade acute cellular rejection and CLAD. This has raised the possibility that chronic AMR may be a distinct phenotype of CLAD although evidence supporting this paradigm is still lacking. Additionally, antibodies to lung-restricted self-antigens have been associated with primary graft dysfunction early and the development of CLAD late after transplantation, and emerging evidence underscores significant interactions between autoimmunity and alloimmunity after transplantation. There is currently an active International Society for Heart and Lung Transplantation working group that is developing an operational definition for AMR in lung transplantation. This will be critical to improve our understanding of this form of rejection and conduct clinical trials to identify optimal treatment strategies. This review will summarize the literature on DSA and AMR in lung transplantation and discuss the impact of antibodies to self-antigens on lung allograft dysfunction. Keywords: antibody-mediated rejection, donor-specific antibodies, lung transplantation. (shrink)

This article provides ethical guidance on using race in health research as a variable or in defining the study population. To this end, a plain, non-exhaustive checklist is provided for researchers and research ethics committees, preceded by a brief introduction on the need for justification when using race as a variable or in defining a study population, the problem of exoticism, that distinctions pertain between race, ethnicity and ancestry, the problematic naming of races, and that race does not serve well (...) as a presumed biological construct in genetic research. (shrink)

In this article we conclude, via a comparison of the 19th C. scientific publications concerning the Belgian parliament and the state of parliamentological research of the day, that Belgian writers achieved an international standard. In Belgium, as elsewhere in Europe, parliamentology was pursued from the standpoint of various complementary schools of thought. Modern political history provided very detailed information about the functioning of the parliamentary institution; constitutional law investigated the juridical aspects of it ; political science transcended these juridical boundaries (...) and took account of the political aspects as well ; this method was also pursued in the field of political economy which, from a methodological point of view, can be regarded as the fundamental current of parliamentary sociology.It can be asserted that these writers are the founders of modern parliamentology despite the rather weak methodological foundation of their studies, the relative lack of empirical data-collection and the infiuenceof political commitment. As is still the case today, so also in the 19th C, the formal-juridical approach was dominant ; however, it was also insight-fully recognized that the most important problems of power lay in the mutual relations of the members of parliament themselves and in their relation to the majority, the opposition and the executive power. These studies furnish, therefore, very interesting lines of inquiry for the diachronic treatment of the majority of the problems of contemporary parliamentology. (shrink)

Michael Wedin’s Aristotle’s Theory of Substance provides an interpretation of primary substance in Metaphysics Book Z that is compatible with the ontology of the Categories. The incompatibilist position holds that primary substance in the Categories is the concrete, individual substance, like Socrates, whereas the title of primary substance in Metaphysics Z goes to the eidos, the form or the species. Hence, the ontology of the Categories is incompatible with the ontology of Metaphysics Z. One compatibilist strategy argues that the c-substance (...) remains primary substance in Metaphysics Z. Wedin takes another tack. He argues that c-substances are ontologically primary in both texts, and that Metaphysics Z introduces a new kind of priority, explanatory priority, awarded to the form of c-substances. Since c-substances and their forms are prior in different senses, the incompatibility vanishes. Wedin’s claim is stronger than mere compatibilism, however, since what forms explain are basic features of c-substances. Hence, Metaphysics Z is not only compatible with the Categories, “it is a theory about the theory of the Categories”. Wedin argues for what I call strong compatibilism. (shrink)

THE MOST SACRED FREEDOM includes eight essays that were first presented at the 2014 A.V. Elliott Conference on Great Books and Ideas, the seventh annual conference sponsored by Mercer Universitys Thomas C. and Ramona E. McDonald Center for Americas Founding Principles. Together, these essays explore the great principle of religious liberty by charting its development in the Western tradition and reconsidering its place at Americas founding. The book begins with a comparison between the flood accounts in Genesis and the Mesopotamian (...) Atra-Has's and advances all the way to the 2014 Supreme Court case Burwell v. Hobby Lobby. The intervening chapters examine the contributions of figures such as Emperor Julian, Roger Williams, Cecilius Calvert, John Locke, Jean-Jacques Rousseau, and the American Founders. Contributors to the volume are Steven Grosby, Jeremiah H. Russell, Maura Jane Farrelly, Daniel Cullen, John Witte, Jr., Scott Yenor, David Ramsey, and Michael Novak. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Journal of the History of Philosophy 41.2 (2003) 276-277 [Access article in PDF] Wiep Van Bunge. From Stevin to Spinoza: An Essay on Philosophy in the Seventeenth-Century Dutch Republic. Leiden: Brill, 2001. Pp. xii + 217. Cloth, $80.00 By 1660 there were probably more followers of Descartes in the Dutch Republic, population 1.4 million, than in France, population 20 million. Protestantism and prosperity encouraged high rates of literacy and (...) the universities of Leiden and Utrecht were among the liveliest in the world. This vibrancy infused the metaphors that Descartes put into his great Discours de la methode published first in Leiden in 1637. In it he spoke about the beauty of cities that looked as if they had been built by a single architect and of the freedom to be found among people so busy with their business as to leave thinkers to their pursuits. Indirectly he spoke about his adopted homeland where he found many followers—some more eager than loyal. By the 1640s disputes raged in the Republic and the anti-Cartesian forces were led by the Aristotelian and anti-Copernican Gisbertus Voetius. What has been missing in our scholarship up to now has been any convincing account as to why these disputes occurred, and how they resonated within the Dutch context. Wiep Van Bunge's book takes a big step toward closing that knowledge gap.Van Bunge convincingly argues that the vibrancy of the stadtholder-less period up to 1672 produced a willingness to entertain new ideas. It also did not hurt to have Descartes on the scene and active on behalf of his mechanical philosophy, even to the point of addressing the Utrecht magistrates publicly and asking that his critics be chastised. What is remarkable—especially given the resistance to Descartes seen at Oxford and Cambridge—was the speed with which Cartesian ideas entered the Dutch classrooms where as many as a third of the students came from abroad. Again Van Bunge provides context when he starts with the Dutch engineer Simon Stevin and demonstrates the vitality of mathematics for a commercial society but also for a militant one. (The Netherlands was at war with Spain up to 1609.) A recent exhibition at the J. Paul Getty Museum in Los Angeles, April to July 2002, also illustrates another aspect of mathematics in the Republic. Precisely in the 1630s when Descartes was putting the finishing touches on his Discours, Pieter Saenredam applied geometry to the interiors of the elegant Utrecht churches so as to give his paintings a regularity and precision worthy of the Cartesian dream of order and clarity. The Dutch commitment to discipline and order also made their army one of the most accomplished in the world. It was perhaps over-determined that Descartes, who had trained with it, would find such a sympathetic audience in the Republic.One of the more fascinating aspects of Van Bunge's detailed study, first of Cartesianism and then of Spinozism in the Republic, concerns the political and ideological meanings to be extracted from the new philosophy. Hobbes also finds a place in the narrative, surprisingly taken up by republicans eager to construct a state that could control the passions. Abraham van Berkel, who put Hobbes's Leviathan into Dutch in 1667, gave the allegiance of his text and himself to Jan de Witt and the cause of the regents and the estates. We can only wonder what Hobbes would have made of the association. The republican affiliations of the mechanical philosophy in the Republic provide a distinctively Dutch context to the [End Page 276] political writings of Spinoza, the most famous and outrageous Cartesian of the century. Van Bunge is especially deft in finding Spinozists and providing far more evidence than I could back in 1981 when I argued for a radical enlightenment within the late seventeenth-century Dutch context (see The Radical Enlightenment. Pantheists, Freemasons and Republicans [London: 1981]). None of these positions with their deeply heretical implications could be taken lightly or without danger. Men lost... (shrink)

Mit dem «Catalogue raisonné» von Oskar Wulff: „Altchristliche und mittelalterliche Bildwerke“ (1909 bzw. 1911) war die Erforschung und Präsentation der in den Staatlichen Museen zu Berlin gesammelten einschlägigen Kunst seinerzeit mit einem Schlage in die vorderste Reihe wissenschaftlicher Kataloge in Europa gerückt worden. Abgesehen von einer Neubearbeitung durch Wolfgang Fritz Volbach (1950) ist entsprechend Umfassendes für die ehemalige „Frühchristlich-Byzantinische Sammlung“ der Berliner Museen seither nicht wieder geleistet worden. Mit dem beträchtlichen zeitlichen Abstand zu den älteren Katalogen erscheint es verständlich und (...) begrüßenswert, wenn – nach der Zusammenführung der seit 1945 zwischen Ost und West geteilten musealen Bestände – eine neue Bestandsaufnahme unternommen wird. Das anspruchsvolle, dem Geleitwort von Arne Effenberger zufolge auf 10 Bände (mit Unterteilungen) angelegte Vorhaben verspricht noch umfassender und auf seine Art vorbildlich zu werden, wie es die Kataloge von Wulff waren. Inzwischen ist ein erster Teil von Band 1 über die Textiliensammlung erschienen. Wie dieser ist auch der 2. Band über „Werke der Alltagskultur“ auf mehrere Teilbände angelegt, deren eben erschienener erster Part ausschließlich den sog. Menasampullen gewidmet ist. Es handelt sich dabei um die bekannten Pilgerandenken aus dem unweit Alexandria in der Mariotis gelegenen Wüstenheiligtum des hl. Menas. Es geht freilich nicht um die erste Bearbeitung dieser kleinformatigen, auch von Privatsammlern hochgeschätzten Objekte: es sei verwiesen auf ältere Arbeiten von C.M. Kaufmann, dem Ausgräber von Abu Mina, sowie aus jüngster Zeit auf die Veröffentlichungen von C. Metzger zu den Sammlungen des Louvre (1981) und G. Kaminski-Menssen zu den Beständen des Liebieg-Hauses in Frankfurt (1997). Berlin nimmt mit 63 Menas-Ampullen immerhin einen bedeutenden Platz ein. (shrink)

Aristotle's defense of Dunamis -- Power and potentiality -- Rational and nonrational powers -- The priority of actuality -- Ontological hierarchy, normativity, and gender.

In the inter-war period physicians elaborated numerous ‘biotherapies’ grounded in the complex interactions between physiology, bacteriology and immunology. The elaboration of these non-specific biological treatments was stimulated by the theory of generalized anaphylaxis that linked the violent reaction to a foreign protein to a broad array of chronic diseases, from asthma and urticaria to rheumatism or chronic colitis. Such diseases were perceived as the result of an ‘abnormal reactivity’ to a sensitisation of tissues and organs by bacteria and by foreign (...) proteins, a view that provided an effective bridge between new concepts derived from bacteriology and immunology and the long-standing pathological tradition. Accordingly, physicians attempted to treat these conditions through specific desensitisation and non-specific biological therapies: peptone treatment, protein therapy, haemotherapy, ‘antivirus’ or ‘opotherapy’. Therapies that attempted to neutralise the harmful effects of chronic infections through ‘desensitisation’ were not seen as marginal medical practices, but were promoted by leading advocates of the ‘Pasteurian sciences’, such as Richet, Widal, Vallery-Radot, Wright and Fleming. They also led to development of new products by the pharmaceutical industry. (shrink)

Although the principle of fair subject selection is a widely recognized requirement of ethical clinical research, it often yields conflicting imperatives, thus raising major ethical dilemmas regarding participant selection. In this paper, we diagnose the source of this problem, arguing that the principle of fair subject selection is best understood as a bundle of four distinct sub-principles, each with normative force and each yielding distinct imperatives: (1) fair inclusion; (2) fair burden sharing; (3) fair opportunity; and (4) fair distribution of (...) third-party risks. We first map out these distinct sub-principles, and then identify the ways in which they yield conflicting imperatives for the design of inclusion and exclusion criteria, and the recruitment of participants. We then offer guidance for how decision makers should navigate these conflicting imperatives to ensure that participants are selected fairly. (shrink)

Feminist work in the history of philosophy has come of age as an innovative field in the history of philosophy. This volume marks that accomplishment with original essays by leading feminist scholars who ask basic questions: What is distinctive of feminist work in the history of philosophy? Is there a method that is distinctive of feminist historical work? How can women philosophers be meaningfully included in the history of the discipline? Who counts as a philosopher? This collection is a unique (...) collaboration among philosophers from North America and the Nordic Countries, including papers written from both analytic and continental philosophical perspectives and discussing both ancient and modern philosophers. Feminist Reflections on the History of Philosophy will be of interest to historians of philosophy, feminist theorists, women's studies faculty and students, and humanists interested in canon formation and transformation. (shrink)

What drives Chinese MNEs’ global CSR integration and local CSR responsiveness? Drawing on institutional theory, we argue that both antecedents reflecting globally isomorphic patterns of adaptation and antecedents mirroring the distinct characteristics of China’s institutional context are relevant. We support our argument using fuzzy-set qualitative comparative analysis on a sample of 29 of China’s globally most influential companies. We find that state influence and global CSR associations affect global CSR integration, whereas presence in the West and internationalization through mergers and (...) acquisitions predict local CSR responsiveness. Our study thus suggests that home-country characteristics are an important co-determinant of the CSR approaches of emerging-market MNEs. We further find that multicultural experience in top management teams is associated with both global CSR integration and local CSR responsiveness, supporting notions of transnational CSR. (shrink)

An adequate theory of rights ought to forbid the harming of animals to promote trivial interests of humans, as is often done in the animal-user industries. But what should the rights view say about situations in which harming some animals is necessary to prevent intolerable injustices to other animals? I develop an account of respectful treatment on which, under certain conditions, it’s justified to intentionally harm some individuals to prevent serious harm to others. This can be compatible with recognizing the (...) inherent value of the ones who are harmed. My theory has important implications for contemporary moral issues in nonhuman animal ethics, such as the development of cultured meat and animal research. (shrink)

Introduction : kith, kin, and family / Sally Haslanger and Charlotte Witt Adoption and its progeny : rethinking family law, gender, and sexual difference / Drucilla Cornell Open adoption is not for everyone / Anita L. Allen Methods of adoption : eliminating genetic privilege / Jacqueline Stevens Several steps behind : gay and lesbian adoption / Sarah Tobias A child of one’s own : property, progeny, and adoption / Janet Farrell Smith Family resemblances : adoption, personal identity, and genetic (...) essentialism / Charlotte Witt Being adopted and being a philosopher : exploring identity and the "desire to know" differently / Kimberly Leighton Real othering : the metaphysics of maternity in children’s literature / Shelley Park Accidents and contingencies of love / Songsuk Hahn ; comments by Harry Frankfurt Abuse and neglect, foster drift, and the adoption alternative / Elizabeth Bartholet Feminism, race, and adoption policy / Dorothy Roberts Racial randomization / Hawley Fogg-Davis You Mixed?: racial identity without racial biology / Sally Haslanger. (shrink)

Value capture occurs when an agent’s values are rich and subtle; they enter a social environment that presents simplified — typically quantified — versions of those values; and those simplified articulations come to dominate their practical reasoning. Examples include becoming motivated by FitBit’s step counts, Twitter Likes and Re-tweets, citation rates, ranked lists of best schools, and Grade Point Averages. We are vulnerable to value capture because of the competitive advantage that such crisp and clear expressions of value have in (...) our private reasoning and our public justification. There is, however, a price. In value capture, we take a central component of our autonomy — our ongoing deliberation over the exact articulation of our values — and we outsource it. And the metrics to which we outsource usually engineered for the interests of some external force, like a large-scale institution’s interest in cross-contextual comprehensibility and quick aggregability. That outsourcing cuts off one of the key benefits to personal deliberation. In value capture, we no longer adjust our values and their articulations in light of own rich experience of the world. Our values should often be carefully tailored to our particular selves or our small-scale communities, but in value capture, we buy our values off the rack. In some cases – like decreasing CO2 emissions – the costs of non-tailored values are outweighed by the benefit of precise collective coordination. In other cases, like in our aesthetic lives, they are not. This suggests that we should want different values suited to different scales. We should want value federalism. Some values are perhaps best pursued at the largest-scale level, others at smaller scales. The problem occurs when we exhibit an excess preference for the largest-scale values – when we consistently let the universal metrics swamp our quieter interests. (shrink)

Review of Substance and Essence in Aristotle: an Interpretation of Metaphysics VII-IX, by Charlotte Witt (Cornell University Press: 1989).