BackgroundIn the Canadian Alliance for Healthy Hearts and Minds (CAHHM) cohort, participants underwent magnetic resonance imaging (MRI) of the brain, heart, and abdomen, that generated incidental findings (IFs). The approach to managing these unexpected results remain a complex issue. Our objectives were to describe the CAHHM policy for the management of IFs, to understand the impact of disclosing IFs to healthy research participants, and to reflect on the ethical obligations of researchers in future MRI studies.MethodsBetween 2013 and 2019, 8252 participants (...) (mean age 58 ± 9 years, 54% women) were recruited with a follow-up questionnaire administered to 909 participants (40% response rate) at 1-year. The CAHHM policy followed a restricted approach, whereby routine feedback on IFs was not provided. Only IFs of severe structural abnormalities were reported.ResultsSevere structural abnormalities occurred in 8.3% (95% confidence interval 7.7–8.9%) of participants, with the highest proportions found in the brain (4.2%) and abdomen (3.1%). The majority of participants (97%) informed of an IF reported no change in quality of life, with 3% of participants reporting that the knowledge of an IF negatively impacted their quality of life. Furthermore, 50% reported increased stress in learning about an IF, and in 95%, the discovery of an IF did not adversely impact his/her life insurance policy. Most participants (90%) would enrol in the study again and perceived the MRI scan to be beneficial, regardless of whether they were informed of IFs. While the implications of a restricted approach to IF management was perceived to be mostly positive, a degree of diagnostic misconception was present amongst participants, indicating the importance of a more thorough consent process to support participant autonomy.ConclusionThe management of IFs from research MRI scans remain a challenging issue, as participants may experience stress and a reduced quality of life when IFs are disclosed. The restricted approach to IF management in CAHHM demonstrated a fair fulfillment of the overarching ethical principles of respect for autonomy, concern for wellbeing, and justice. The approach outlined in the CAHHM policy may serve as a framework for future research studies.Clinical trial registrationhttps://clinicaltrials.gov/ct2/show/nct02220582. (shrink)

Articles, on metaphysics, originally published in Siḷumiṇa, weekly Sinhalese newspaper and written by Ven. Baḷangoḍa Ānandamaitreya.

For a long period, no attention was paid in our literature to the circumstance that space and time, as fundamental forms of the existence of matter, cannot be reduced to the characteristics of space and time as viewed in physics. Nor was the fact taken into consideration that sociohistorical being is no less real than the existence of physical things, that the activity of human society is no less objective than the physical interactions of the material world.

On fundamentals of Vedanta and science; a study.

The nature of tragedy has always been felt to be a problem, not only by the philosopher, but also, and perhaps even more, by the ordinary man. The question so often asked is: why, if there is so much suffering already in the world, do we want to go to a theatre or read a story describing more suffering? Why indeed should the spectacle of suffering ever be pleasing to us? Yet it is obvious that olarge numbers of ordinary people (...) do like reading or seeing tragedies; and that there are some tragedies which are generally judged to be the most valuable works of literary art ever produced. What then is the nature of the value which we extract from these works? That is the question to which I would like to address myself. (shrink)

Buddhist ethics on environment protection.

Study on Islamic prayers and medical ethics.

Condensed metrical version of Śaṅkarācārya's Śārīrakamīmāṃsābhāṣya, Advaita Vedanta commentary on Bādarāyaṇa's Brahmasūtra; includes Sārasaṅgraha supercommentary of Madhusūdana Sarasvatī.

Condensed metrical version of Śārīraramīmaṃsābhāṣya of Śaṅkarācārya, Advaita comentary on Brahmasūtra; includes supercommentaries.

In a recent article Professor Brunt has made an eloquent plea for greater rigour in handling the remains of non-extant authors. When the original is lost and we depend I upon quotation, paraphrase or mere citation by later authorities, we must first establish the reliability of the source which supplies the fragment. There is obviously a world of difference between the long verbal quotations in Athenaeus and the disjointed epitomes provided by the periochae of Livy. As a general rule, the (...) fuller and more explicit the reproduction in the secondary source, the more confident we can be that it approximates to the original. Our doubts should increase as the references become less precise and resort to paraphrase rather than direct quotation. The wider context is also important. One always needs to know why the secondary author is making his citation and what interest he has in a strictly literal reproduction. These principles are unexceptionable, but they are difficult to maintain in practice. One rarely has the opportunity to make a sustained experiment, checking an author's techniques' of quotation and digest against sources which are now extant. As a result the historian all too often feels constrained to squeeze the last drop of meaning out of testimonia which are by their very nature imprecise. The standard work, Jacoby's Fragmente der griechischen Historiker, is a pitfall for the unwary. It presents all citations, whether full quotations or the vaguest of references, on the same status as ‘fragments’; and the context is necessarily reduced to the barest minimum, so that the reader's attention is focussed directly upon the lost original and diverted from the machinery of transmission. (shrink)

Critical study of of the addresses of Sir Muhammad Iqbal, 1877-1938 from philosophical and religious point of view.