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)

Byrne has demonstrated that although subjects can make deductively valid inferences of the modus ponens and modus tollens forms, these valid inferences can be suppressed by presenting an appropriate additional premise “If R then Q” with the original conditional “If P then Q”. This suppression effect challenges the assumption of all syntactic theories of conditional reasoning that formal rules of inference such as modus ponens is part of mental logic. This paper argues that both the syntactic and the mental model (...) accounts of the suppression effect are inadequate because they fail to give a principled account of the critical interpretive component involved in reasoning. In contrast, the relative salience model proposed in this study emphasized the centrality of the interpretative processes with the critical component being the relative salience of premises as judged by subjects on the basis of their prior knowledge activated in particular problem situations. Using 120 undergraduates and 120 policemen as subjects, predictions from the model were tested and confirmed in a suppression paradigm and evidence of convergent validity for the construct of salience were obtained. The results cannot be reconciled with either the syntactic view or the mental model view that have dominated theories of conditional reasoning. (shrink)

Two groups of scientists have just announced what is being described as a leap forward in human stem cell research.1–3 Both have found ways of producing what are being called “induced pluripotent cells” , stem cells that they hope will demonstrate the same key properties of regeneration and unrestricted differentiation that human embryonic stem cells possess, but which are derived from skin cells not from embryos. In simple terms, these scientists have succeeded in reprogramming skin cells to behave like hESCs.Stem (...) cell research has been hailed as one of the most important and exciting areas of science, because it is believed that these types of cells will not only play an important part in regenerative medicine, but also yield valuable scientific information. These latest developments in cell reprogramming represent a milestone for stem cell science. No longer does the paradigm of irreversible cell specialisation hold true; instead, almost any type of cell might have the potential to become any other.The advent of techniques for producing these iPCs has also been hailed as an ethical breakthrough. Up until now, the production of hESCs has required a process which involves the destruction of embryos. Many of these embryos are available as by-products of IVF; but in addition, the process of somatic cell nuclear transfer to produce cloned embryonic stem cells requires a supply of human oocytes, which must currently be harvested from female donors at no insignificant cost. In a nutshell, iPCs seem to enable us to produce “embryo-free” human pluripotent stem cells, and in a “gender-neutral” way—that is, without the need for human oocytes.The response from the scientific community, ethical commentators and the public has, however, reflected an inherent confusion over the ethical significance of this research. The anti-embryo …. (shrink)

We present our method for tackling a legal case retrieval task by introducing our method of encoding documents by summarizing them into continuous vector space via our phrase scoring framework utilizing deep neural networks. On the other hand, we explore the benefits from combining lexical features and latent features generated with neural networks. Our experiments show that lexical features and latent features generated with neural networks complement each other to improve the retrieval system performance. Furthermore, our experimental results suggest the (...) importance of case summarization in different aspects: using provided summaries and performing encoded summarization. Our approach achieved F1 of 65.6% and 57.6% on the experimental datasets of legal case retrieval tasks. (shrink)

Using a nationwide survey of provincial institutional quality and a sample of private manufacturing small and medium scale enterprises, this paper contributes to the literature by considering for the first time the effects of corruption on the financial performance of Vietnamese private SMEs. Interestingly, contrary to previous findings, we find that corruption when measured by a dummy variable, does not affect firms’ financial performance after controlling for heterogeneity, simultaneity and dynamic endogeneity. However, the intensity of bribery and the majority of (...) the forms of corruption were found to have negative impacts on firms’ financial performance. Hence, a typical approach using only a dummy variable for bribery might not adequately evaluate the impact of bribe intensity or even ignores the negative impacts of some types of bribes on firms’ financial performance. The findings suggest that anti-corruption measures are vital for the development of the Vietnamese private SMEs. (shrink)

In this paper, we describe four broad ‘meta-methods’ employed in scientific and philosophical research of qualia. These are the theory-centred metamethod, the property-centred meta-method, the argument-centred meta-method, and the event-centred meta-method. Broadly speaking, the theory-centred meta-method is interested in the role of qualia as some theoretical entities picked out by our folk psychological theories; the property-centred meta-method is interested in some metaphysical properties of qualia that we immediately observe through introspection ; the argument-centred meta-method is interested in the role of (...) qualia in some arguments for non-physicalism; the event-centred metamethod is interested in the role of qualia as some natural events whose nature is hidden and must be uncovered empirically. We will argue that the event-centred metamethod is the most promising route to a comprehensive scientific conception of qualia because of the flexibility of ontological and methodological assumptions it can provide. We also reveal the hidden influences of the different meta-methods and in doing so show why consideration of meta-methods has value for the study of consciousness. (shrink)

More impetus needs to be placed on cord blood donationIn July, the Royal College of Obstetricians and Gynaecologists released a report on the uses and the potential perils of umbilical cord blood collection.1 This report has had the positive effect of drawing attention to what has hitherto been an under addressed topic of medical research and ethics. However, the focus and recommendations of the report say little about one important aspect of cord blood usage—research. Such an omission, although understandable from (...) an organisation primarily concerned with maternal and neonatal health, may nevertheless have implications for the broader applicability of the report’s recommendations, outside the immediate arena of patient care.The RCOG report deals with various aspects of cord blood collection and use—the harvesting procedure itself; cord blood transplantation treatment, either as an autologous cell transplant or as a donation for community use; and whether cord blood banking for personal use should be permitted or encouraged as a privately funded commercial enterprise. It also makes note of some of the legal and ethical issues surrounding cord blood and tissue banking more generally, concerns that will be of increasing importance as more biobanks are established worldwide. A large part of the report deals with concerns on neonatal and maternal safety and whether cord blood collection may pose a risk. These concerns may be valid and certainly, the health of mothers and children should not be compromised. The guidance provided by this report in relation to the collection procedure will undoubtedly assist maternity health professionals in this area.The main relevance of the RCOG …. (shrink)

Questions about sincerity play a central role in our lives. But what makes an assertion insincere? In this paper we argue that the answer to this question is not as straightforward as it has sometimes been taken to be. Until recently the dominant answer has been that a speaker makes an insincere assertion if and only if he does not believe the proposition asserted. There are, however, persuasive counterexamples to this simple account. It has been proposed instead that an insincere (...) assertion that p is one made by a speaker who (a) does not express his belief that p; or (b) does not believe that he believes that p; (c) does not assent to p; or (d) does not express any of these cognitive states. We show that these .. (shrink)

The Humility Thesis is a persistent thesis in contemporary metaphysics. It is known by a variety of names, including, but not limited to, Humility, Intrinsic Humility, Kantian Humility, Kantian Physicalism, Intrinsic Ignorance, Categorical Ignorance, Irremediable Ignorance, and Noumenalism. According to the thesis, we human beings, and any knowers that share our general ways of knowing, are irremediably ignorant of a certain class of properties that are intrinsic to material entities … Continue reading Humility Regarding Intrinsic Properties →.

In this chapter, we aimed at further characterizing the functional neuroanatomy of the human rapid eye movement (REM) sleep at the population level. We carried out a meta-analysis of a large dataset of positron emission tomography (PET) scans acquired during wakefulness, slow wave sleep and REM sleep, and focused especially on the brain areas in which the activity diminishes during REM sleep. Results show that quiescent regions are confined to the inferior and middle frontal cortex and to the inferior parietal (...) lobule. Providing a plausible explanation for some of the features of dream reports, these findings may help in refining the concepts, which try to account for human cognition during REM sleep. In particular, we discuss the significance of these results to explain the alteration in executive processes, episodic memory retrieval and self representation during REM sleep dreaming as well as the incorporation of external stimuli into the dream narrative. (shrink)

The emergency department (ED) is a fast-paced, highly stressful environment where clinicians function with little or suboptimal information and where time is measured in minutes and hours. In addition, death and dying are phenomena that are often experienced in the ED. Current end-of-life care models, based on chronic illness trajectories, may be difficult to apply in the ED. A philosophical approach examining end-of-life care may help us understand how core medical and nursing values are embodied as care practices and as (...) ethical comportment. The integration of Aristotle's notions of phronesis and praxis with Merleau-Ponty's ontological notions of intentional arc and maximum grip in the context of the culture and practices of the ED offers a unique view of clinical and ethical practice at the end-of-life in the emergency setting. Caring for people at the end-of-life calls us to act virtuously based on previous experience, meanings and local practices. The maximum grip of the ultimate particulars of the situation combined with one's experiential and theoretical knowledge opens up situated possibilities for the expert clinician. (shrink)

It is evident, in the face of the COVID-19 pandemic that has physicians confronting death and dying at unprecedented levels along with growing data suggesting that physicians who care for dying patients face complex emotional, psychological and behavioural effects, that there is a need for their better understanding and the implementation of supportive measures. Taking into account data positing that effects of caring for dying patients may impact a physician’s concept of personhood, or “what makes you, ‘you’”, we adopt Radha (...) Krishna’s Ring Theory of Personhood (RToP) to scrutinise the experiences of physicians working in intensive care units (ICU) using a fictional scenario that was inspired by real events. The impact of death and dying, its catalysts, internal constituents, external factors, dyssynchrony, and buffers, specific to ICU physicians, were identified and explored. Such a framework allows for ramifications to be considered holistically and facilitates the curation of strategies for conflict resolution. This evaluation of the RToP acknowledges the experience and wide-ranging effects it has on ICU physicians. As such, our findings provide insight into their specific needs and highlight the importance of support on a personal and organisational level. Although further research needs to be conducted, the RToP could serve as the basis for a longitudinal assessment tool supported by the use of portfolios or mentorship due to their provision of personalised, appropriate, specific, timely, accessible and long-term support. (shrink)

As a transitional economy, Vietnam has undergone tremendous changes over recent decades within a ‘fusion’ context that blends both traditional and modern values from its complex history. However, few studies have explored how contemporary issues in the context of Vietnam have brought both obstacles and skillful initiatives to managerial approaches to doing business. We draw on the concepts of social trust and institutional theory to explore how informal institutions such as religious forces can contribute to the development of individual trust (...) and whether individuals are willing to extend trust beyond familial networks. We contribute to the notion of a moral conception of trust by exploring how Buddhism in particular has initiated distinctive managerial approaches in the context of Vietnam, in response to dilemmas of social trust. Our findings highlight that as an informal institution, engaged Buddhism yields significant impact on the formation of social trust. We carried out in-depth interviews in Vietnam with 33 organizational leaders who were Buddhist practitioners, using thematic analysis to elucidate our findings and arguments. The study reveals how the incorporation of Buddhist principles has fostered context-sensitive, non-extreme, and reflexive managerial approaches to enhance morality as a response to social trust issues. (shrink)

This paper argues that the principles of spiritual traditions provide normative ‘standards of goodness’ within which practitioners evaluate meaningful work. Our comparative study of practitioners in the Buddhist and Quaker traditions provide a fine-grained analysis to illuminate, that meaningfulness is deeply connected to particular tradition-specific philosophical and theological ideas. In the Buddhist tradition, meaningfulness is temporal and rooted in Buddhist principles of non-attachment, impermanence and depending-arising, whereas in the Quaker tradition, the Quaker testimonies and theological ideas frame meaningfulness as eternal. (...) Surprisingly, we find that when faced with unethical choices and clashes between organizational normativity and spiritual normativity, Buddhist practitioners acknowledge the temporal character of meaningfulness and compromise their moral values, whereas in contrast, Quaker practitioners morally disengage from meaningless work. Our study highlights how normative commitments in different spiritual traditions can influence different levels of adaptability in finding work meaningful and stresses the central importance of normative commitments in meaningful work. Our study concludes with practical implications and future pathways for inter-disciplinary research. (shrink)

This study explores the role of an informal institution—engaged Buddhism—in leadership responses to issues of bribery at the firm level in the context of Vietnam. In-depth interviews were carried out in Vietnam with 26 organizational leaders who were Buddhist practitioners. The leaders expressed a Buddhist-enacted utilitarian approach based on three context-associated mechanisms: karmic consequences, community and social well-being, and total detachment. These mechanisms manifest in leadership approaches based on the Middle Way, Skillful Means, and Emptiness. They are involved in forming (...) leaders’ perceptions about bribery issues and their enacting of contextual approaches to balance organizational means and ends in tackling ethical issues associated with bribery. The study also sheds light on moral struggles involved in the process of shaping and enacting a Buddhist-enacted utilitarian approach. (shrink)

O objetivo deste artigo é descrever o grau de parentesco existente entre várias famílias de origem chinesa que se estabeleceram em Nicoya e analisar como isso influenciou suas contribuições para o desenvolvimento socioeconômico da cidade e seus padrões de mobilidade em todo o Pacífico da Costa Rica desde final do século XIX até meados do século XX. Os participantes do estudo são descendentes de imigrantes que se enraizaram em Nicoya entre 1880 e 1950, que possuíam duas peculiaridades: pertenciam aos mesmos (...) clãs familiares, apesar dos diferentes sobrenomes com os quais estavam registrados ou eram da mesma área geográfica e, às vezes, até da mesma aldeia, que desenvolveu laços de afinidade tão fortes quanto laços consanguíneos. Isso lhes permitiu apoiar-se mutuamente para alcançar o desenvolvimento coletivo do grupo de imigrantes chineses em Nicoya. (shrink)

In this sequel of my previous publication, I will continue my discussion of the word tian as it appears in the Guodian texts. I shall argue that, from natural order arises xing, human’s distinctive potentiality, which is endowed by heaven to follow and be guided by the heavenly principle. I thereafter will elaborate the sages’ role as cultural creators. The distinct roles of heaven and humanity are further deepened when tian and ming are perceived as the determinants of an individual’s (...) success or failure. I will go on to show how the word tian can be understood as the source or underlying pattern that brings about coincidental or synchronous events and experiences. (shrink)

On the philosophy of Jiddu Krishnamurti, 1895-1986, Indian philosopher.

China’s phenomenal economic development since 1979 has caught the attention and envy of the rest of the world. 500 million Chinese have been lifted out of poverty since then.1 Yet, it has come with a huge price which threatens not only China but the rest of the world. These challenges include corruption, environmental issues, social inequalities and a rapidly aging population. If China is not able to overcome any of these, then its development will not be sustainable and the impact (...) will be immensely negative just as its development over the last three decades have been positive on the rest of the world. The purpose of this article is to show that there is a little-known transformation happening in China which may address the above issues. It is the thesis of the author that China’s present developmental challenges are fundamentally a problem of misplaced values, i.e. unsustainable priorities. And the little known transformation is that tens of millions of Chinese are quickly embracing a new set of values and accepting a biblical worldview.2 Rodney Stark, socialogist and popular author, has shown through his many works, such as For the Glory of God: How Monotheism Led to Reformations, Science, Witch-Hunts, and the End of Slavery,3 that societies which have espoused the monotheistic belief system are able to successfully overcome similar social challenges and remain viable. (shrink)