The integration of biomedical terminologies is indispensable to the process of information integration. When terminologies are linked merely through the alignment of their leaf terms, however, differences in context and ontological structure are ignored. Making use of the SNAP and SPAN ontologies, we show how three reference domain ontologies can be integrated at a higher level, through what we shall call the OBR framework (for: Ontology of Biomedical Reality). OBR is designed to facilitate inference across the boundaries of domain ontologies (...) in anatomy, physiology and pathology. (shrink)

_Disaster Psychiatry: Intervening When Nightmares Come True_ captures the state of disaster psychiatry in the aftermath of the terrorist attacks of September 11, 2001. This emergent psychiatric specialty, which is increasingly separated from trauma and grief psychiatry on one hand and military psychiatry on the other, provides psychotherapeutic assistance to victims during, and in the weeks and months following, major disasters. As such, disaster psychiatrists must operate in the widely varying locales in which natural and man-made disasters occur, and they (...) must establish their role among the chaotic array of organizations involved in direct disaster response. Editors Anand Pandya and Craig Katz have captured the challenge and promise of disaster psychiatry through first-person narratives. We hear from psychiatrists who have encountered disasters at various stages of their career and in widely varying social, political, and personal contexts. Accounts of psychiatric involvement with adults and children during and after 9/11 have understandable pride of place in this collection. But they are balanced by richly informative narratives about other domestic and international disasters. Fraught with the drama attendant to the events they describe, these essays delineate the dizzying array of challenges that confront the disaster psychiatrist. They range from the intense emotional responses that are part of the aftermath of any disaster, to the need to legitimize a psychiatric presence within diverse cultural and medical contexts, to the subtle task of providing therapeutic boundaries at a time when all rules seem to be suspended. Special attention is given to the daunting task of working with children whose parents' are disaster victims. What emerges from these testimonies is compelling documentation of skilled and compassionate psychiatrists at the outer limits of their specialty, pursuing their calling into uncharted realms of therapeutic engagement. (shrink)

Two of the most important contributions that Bimal Krishna Matilal made to comparative philosophy are his doctoral dissertation The Navya-Nyāya Doctrine of Negation: The Semantics and Ontology of Negative Statements in Navya-Nyāya Philosophy and his classic: Perception: An Essay on Classical Indian Theories of Knowing. In this essay, we aim to carry forward the work of Bimal K. Matilal by showing how ideas in classical Indian philosophy concerning absence and perception are relevant to recent debates in Anglo-analytic philosophy. In particular, (...) we focus on the recent debate in the philosophy of perception centering on the perception of absence. In her Seeing Absence, Anya Farennikova argues for the thesis that we literally see absences. Her thesis is quite novel within the contexts of the traditions that she engages: analytical philosophy of perception, phenomenology, and cognitive neuroscience. In those traditions there is hardly any exploration of the epistemology of absence. By contrast, this is not the case in classical Indian philosophy where the debate over the ontological and epistemological status of absence is longstanding and quite engaging. In what follows, we engage Farennikova’s arguments, and those of John-Rémy Martin and Jérome Dokic in their response to her work. Using the work of Matilal, Bilimoria and Shaw we show that there are several engaging ideas that can be taken from Indian philosophy into the terrain explored by Farennikova, and Martin & Dokic. Our aim is to provide an updated comparative engagement on absence and its perception for the purposes of enhancing future discussions within global philosophy. However, we do not aim to do this merely by focusing on the history of primary texts or on twentieth century commentary on primary texts. Instead, we hope to show that the living tradition of Indian philosophy that Matilal embodied carries forward in his students and colleagues as they revive, revise, and extend Indian philosophy. (shrink)

This study used fMRI to investigate the neural substrates of moral cognition in health resource allocation decision problems. In particular, it investigated the cognitive and emotional processes that underpin utilitarian approaches to health care rationing such as Quality Adjusted Life Years. Participants viewed hypothetical medical and nonmedical resource allocation scenarios which described equal or unequal allocation of resources to different groups. In addition, participants were assigned to 1 of 2 treatments in which they either did or did not receive advanced (...) instructions about the principles of utilitarianism. In all cases, participants were asked to judged the proposed allocations as “fair” or “unfair.” More brain activity was observed within the superior parietal lobe, angular gyrus, middle temporal gyrus, and bilateral caudate nucleus when participants viewed scenarios depicting equal divisions of resources. Conversely, unequal resource divisions were associated with more activity in the inferior frontal gyrus and insula cortex. Furthermore, instructions about the principles of utilitarianism led to significant activation differences within the inferior frontal gyrus and the middle frontal gyrus. Significant differences in activity were also found within the inferior frontal cortex and anterior insula between medical and nonmedical scenarios. The implications for cognitive control mechanisms and the cognitive and neural bases of utilitarian ethical judgment are discussed. (shrink)

© 2017. The American Astronomical Society. All rights reserved.We present new observations of the low-mass companion to HD 984 taken with the Gemini Planet Imager as a part of the GPI Exoplanet Survey campaign. Images of HD 984 B were obtained in the J and H bands. Combined with archival epochs from 2012 and 2014, we fit the first orbit to the companion to find an 18 au orbit with a 68% confidence interval between 14 and 28 au, an eccentricity (...) of 0.18 with a 68% confidence interval between 0.05 and 0.47, and an inclination of 119°with a 68% confidence interval between 114°and 125°. To address the considerable spectral covariance in both spectra, we present a method of splitting the spectra into low and high frequencies to analyze the spectral structure at different spatial frequencies with the proper spectral noise correlation. Using the split spectra, we compare them to known spectral types using field brown dwarf and low-mass star spectra and find a best-fit match of a field gravity M6.5 ±1.5 spectral type with a corresponding temperature of K. Photometry of the companion yields a luminosity of log=2.88 ± 0.07 dex with DUSTY models. Mass estimates, again from DUSTY models, find an age-dependent mass of 34 ±1 to 95 ±4 M Jup. These results are consistent with previous measurements of the object. (shrink)

Since January 2004, violent conflicts in the deep South of Thailand have caused 4,453 deaths, 7,239 injuries in 10,386 violent incidents. The numbers are increasing everyday. Myriads of studies, strategies and proposals have been put forth to address and redress this deep-rooted problem. This paper is a modest attempt to find analysis and inspiration from the rich cultural resources of Buddhism to address the question of conflict and conflict transformation in Thai society.The Buddhist “Genesis” or The Agganna-sutta has been analyzed (...) by Thai and Western Buddhist scholars as offering an allegorical tale which details a long, inter-dependent process of human beings’ moral degradation on the one hand, and socio-political evolution on the other. This is considered to be the Buddhist equivalent of the Genesis without God.This paper offers a re-reading of this important sutta as a narrative of conflict and conflict transformation. It argues that the personal conflict of the two young Brahmins aspiring to be fully ordained is transcended and transformed by the Buddha’s allegorical tale of human socio-political evolution. This paper offers an analysis of the narration and demonstrates that in the narrating process, the Buddha was “substituting” the Hindu creation myth with the Discourse on What is Primary (Agganna-sutta). This narrative replacement subverts the deep-rooted cultural force of the Hindu creation myth which serves as a cosmological justification for an hierarchy of classes/castes in the social world. Once the creation Hindu myth is de-mythologized, the structure of meaning for the personal conflict of the two Brahmins evaporates. In this way, the Buddha’s approach to conflict transformation addresses three dimensions simultaneously, namely, the personal, the socio-political and the cosmological.This re-reading is one paradigmatic example of how to revitalize Buddhism to function as an agent of social transformation by offering a Buddhist creative approach to conflict transformation. (shrink)

Since January 2004, violent conflicts in the deep South of Thailand have caused 4,453 deaths, 7,239 injuries in 10,386 violent incidents. The numbers are increasing everyday. Myriads of studies, strategies and proposals have been put forth to address and redress this deep-rooted problem. This paper is a modest attempt to find analysis and inspiration from the rich cultural resources of Buddhism to address the question of conflict and conflict transformation in Thai society.The Buddhist “Genesis” or The Agganna-sutta has been analyzed (...) by Thai and Western Buddhist scholars as offering an allegorical tale which details a long, inter-dependent process of human beings’ moral degradation on the one hand, and socio-political evolution on the other. This is considered to be the Buddhist equivalent of the Genesis without God.This paper offers a re-reading of this important sutta as a narrative of conflict and conflict transformation. It argues that the personal conflict of the two young Brahmins aspiring to be fully ordained is transcended and transformed by the Buddha’s allegorical tale of human socio-political evolution. This paper offers an analysis of the narration and demonstrates that in the narrating process, the Buddha was “substituting” the Hindu creation myth with the Discourse on What is Primary (Agganna-sutta). This narrative replacement subverts the deep-rooted cultural force of the Hindu creation myth which serves as a cosmological justification for an hierarchy of classes/castes in the social world. Once the creation Hindu myth is de-mythologized, the structure of meaning for the personal conflict of the two Brahmins evaporates. In this way, the Buddha’s approach to conflict transformation addresses three dimensions simultaneously, namely, the personal, the socio-political and the cosmological.This re-reading is one paradigmatic example of how to revitalize Buddhism to function as an agent of social transformation by offering a Buddhist creative approach to conflict transformation. (shrink)

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)

Let T be a complete O-minimal theory in a language L. We first give an elementary proof of the result (due to Marker and Steinhorn) that all types over Dedekind complete models of T are definable. Let L * be L together with a unary predicate P. Let T * be the L * -theory of all pairs (N, M), where M is a Dedekind complete model of T and N is an |M| + -saturated elementary extension of N (and (...) M is the interpretation of P). Using the definability of types result, we show that T * is complete and we give a simple set of axioms for T * . We also show that for every L * -formula φ(x) there is an L-formula ψ(x) such that $T^\ast \models (\forall \mathbf{x})(P(\mathbf{x}) \rightarrow (\phi(\mathbf{x}) \mapsto \psi (\mathbf{x}))$ . This yields the following result: Let M be a Dedekind complete model of T. Let φ(x, y) be an L-formula where l(y) = k. Let $\mathbf{X} = \{X \subset M^k$ : for some a in an elementary extension N of M, X = φ (a,y N ∩ M k }. Then there is a formula ψ(y, z) of L such that X = {ψ (y, b) M : b in M}. (shrink)

The "space" of Lascar strong types, on some sort and relative to a given complete theory T, is in general not a compact Hausdorff topological space. We have at least three aims in this paper. The first is to show that spaces of Lascar strong types, as well as other related spaces and objects such as the Lascar group Gal L of T, have well-defined Borel cardinalities. The second is to compute the Borel cardinalities of the known examples as well (...) as of some new examples that we give. The third is to explore notions of definable map, embedding, and isomorphism, between these and related quotient objects. We also make some conjectures, the main one being roughly "smooth if and only if trivial". The possibility of a descriptive set-theoretic account of the complexity of spaces of Lascar strong types was touched on in the paper [E. Casanovas, D. Lascar, A. Pillay and M. Ziegler, Galois groups of first order theories, J. Math. Logic1 305–319], where the first example of a "non-G-compact theory" was given. The motivation for writing this paper is partly the discovery of new examples via definable groups, in [A. Conversano and A. Pillay, Connected components of definable groups and o-minimality I, Adv. Math.231 605–623; Connected components of definable groups and o-minimality II, to appear in Ann. Pure Appl. Logic] and the generalizations in [J. Gismatullin and K. Krupiński, On model-theoretic connected components in some group extensions, preprint, arXiv:1201.5221v1]. (shrink)

This volume provides an overview of issues arising in work on the foundations of decision theory and social choice. The collection will be of particular value to researchers in economics with interests in utility or welfare, but also to any social scientist or philosopher interested in theories of rationality or group decision-making.

I examine social capital’s impact on financial reports. Based on the social capital literature, I predict that the quality of the financial reports is higher when a firm is headquartered in a region with high social capital. Consistent with this prediction, I find that the firms that are headquartered in this type of region in the USA have a lower probability of committing fraud by misrepresenting financial information. Further, I find that the firms in regions with high social capital have (...) lower levels of discretionary accruals and much more readable annual reports. (shrink)

When weighing up which inhaler to prescribe, a doctor may prioritise a patient’s preferences over the expected harms from the associated carbon emissions. Parker argues that this is wrong.1 Doctors have a pro-tanto duty to switch from a high-carbon metered-dose inhaler (MDI) to a low-carbon dry-powdered inhaler (DPI)—even though this provides no direct patient benefit—unless switching would undermine trust or significantly worsen a patient’s health. He goes on to state that even if DPIs are more expensive for the National Health (...) Service (NHS) then this is justified so long as it does not ‘significantly threaten’ the NHS’ ability to protect and promote health. This may appear to be a radical proposal, challenging the ethical principles of autonomy, health entitlements and justly distributed resources. However, we will claim that it is only radical in so far as one perceives (A) patient autonomy and healthcare entitlements as existing within a vacuum, unrelated to other foundational ethics concerns and (B) the health consequences of a given healthcare budget are limited solely to the designated recipients rather than all affected parties. Here, we test the claim that our responsibility for promoting patient autonomy …. (shrink)

The Unified Medical Language System and the Gene Ontology are among the most widely used terminology resources in the biomedical domain. However, when we evaluate them in the light of simple principles for wellconstructed ontologies we find a number of characteristic inadequacies. Employing the theory of granular partitions, a new approach to the understanding of ontologies and of the relationships ontologies bear to instances in reality, we provide an application of this theory in relation to an example drawn from the (...) context of the pathophysiology of hypertension. This exercise is designed to demonstrate how, by taking ontological principles into account we can create more realistic biomedical ontologies which will also bring advantages in terms of efficiency and robustness of associated software applications. (shrink)

The hard problem of consciousness arises in most incarnations of present day physicalism. Why should certain physical processes necessarily be accompanied by experience? One possible response is that physicalism itself should be modified in order to accommodate experience: But, modified how? In the present work, we investigate whether an ontology derived from quantum field theory can help resolve the hard problem. We begin with the assumption that experience cannot exist without being accompanied by a subject of experience (SoE). While people (...) well versed in Indian philosophy will not find that statement problematic, it is still controversial in the analytic tradition. Luckily for us, Strawson has elaborately defended the notion of a thin subject—an SoE which exhibits a phenomenal unity with different types of content (sensations, thoughts etc.) occurring during its temporal existence. Next, following Stoljar, we invoke our ignorance of the true physical as the reason for the explanatory gap between present day physical processes (events, properties) and experience. We are therefore permitted to conceive of thin subjects as related to the physical via a new, yet to be elaborated relation. While this is difficult to conceive under most varieties of classical physics, we argue that this may not be the case under certain quantum field theory ontologies. We suggest that the relation binding an SoE to the physical is akin to the relation between a particle and (quantum) field. In quantum field theory, a particle is conceived as a coherent excitation of a field. Under the right set of circumstances, a particle coalesces out of a field and dissipates. We suggest that an SoE can be conceived as akin to a particle—a SelfOn—which coalesces out of physical fields, persists for a brief period of time and then dissipates in a manner similar to the phenomenology of a thin subject. Experiences are physical properties of selfons with the constraint (specified by a similarity metric) that selfons belonging to the same natural kind will have similar experiences. While it is odd at first glance to conceive of subjects of experience as akin to particles, the spatial and temporal unity exhibited by particles as opposed to fields and the expectation that selfons are new kinds of particles, paves the way for cementing this notion. Next, we detail the various no-go theorems in most versions of quantum field theory and discuss their impact on the existence of selfons. Finally, we argue that the time is ripe for a rejuvenated Indian philosophy to begin tackling the three-way relationship between SoEs (which may become equivalent to jivas in certain Indian frameworks), phenomenal content and the physical world. With analytic philosophy still struggling to come to terms with the complex worlds of quantum field theory and with the relative inexperience of the western world in arguing the jiva-world relation, there is a clear and present opportunity for Indian philosophy to make a worldcentric contribution to the hard problem of experience. (shrink)

Autumn Fiester's “Neglected Ends: Clinical Ethics Consultation and the Prospects for Closure” (2015) demonstrates how a focus on recommendations in clinical ethics consultations (CECs) can fail to...

Sen’s capabilities approach offers a radical generalisation of the conventional approach to welfare economics. It has been highly influential in development and many researchers are now beginning to explore its implications for health care. This paper contributes to the emerging debate by discussing two examples of such applications: first, at the individual decision making level, namely the right to die, and second, at the social choice level. For the first application, which draws on Nussbaum’s list of capabilities, it is argued (...) that many capabilities are ambiguously or indirectly related to the right to die, but the ability to form a concept of the good life and plan one’s own life provides a direct justification for such a right. In the second application, the focus is specifically on healthcare rationing and it is argued that, although not committed to age based rationing, the capabilities approach provides a more natural justification of age related access to health care than the fair innings argument, which is often used to justify the alleged ageism inherent in quality adjusted life years maximisation. (shrink)

Recently, Kit Fine's (1994) view that modal truths aretrue in virtue of,grounded in, orexplained byessentialist truths has been under attack. In what follows we offer two responses to the wave of criticism against his view. While the first response is pretty straightforward, the second is based on the distinction between, what we call,Reductive Finean EssentialismandNon-Reductive Finean Essentialism. Engaging the work of Bob Hale onNon-Reductive Finean Essentialism, we aim to show that the arguments against Fine's view are unconvincing, while we acknowledge (...) the presence of a deep standoff between the two views. (shrink)

Many medicines currently available on the market are simply too expensive for millions around the world to afford. Many medicines available in the developing world are only available to a small percentage of the population due to economic inequities. The profit-seeking behavior of pharmaceutical companies exacerbates this problem. In most cases, the price reductions required to make drugs affordable to a broader class of people in the developing world are not offset by the resultant increase in sales volume. Simply stated, (...) in most of the developing world, it is more profitable to sell drugs to the very wealthy at high prices than it is to sell cheaper drugs to a greater number of people. As a result, medicines remain unaffordable for the vast majority of people in many parts of the world. While this might be an acceptable outcome for certain commodities, such as luxury goods, it is completely unacceptable for life-saving medicines. Therefore, in order to effectively address the global lack of access to medicines, the role pharmaceutical companies play in the international intellectual property regime must be critically examined. (shrink)

Approximately two billion people lack access to medicines globally. People living with HIV, cancer patients, those suffering from tuberculosis or malaria, and other populations in desperate need of life-saving medicines are increasingly unable to access existing preventative, curative, and life-prolonging treatments. In many cases, treatment may be unavailable or inaccessible for even some of the most common and readily treatable health concerns, such as hypertension. In the developing world, many of the factors that contribute to making the world’s most vulnerable (...) and marginalized populations particularly susceptible to illness also operate to restrict their access to medicines. As a result of dramatic economic inequities and widespread poverty, it is not profitable for most originator pharmaceutical companies to develop new medicines for sale in developing markets or to lower the cost of existing drugs so that they are affordable for the majority of these populations. (shrink)

The Norwegian Oil Fund (‘Government Pension Fund – Global’) is worth over NOK 10.6 trillion (USD 1.15 USD trillion)1 making it the largest sovereign wealth fund in the world (Norges Bank Investment...

Introduction: An ethnographer among the anthropologists -- The world at hand: between scientific and literary inquiry -- A method of experience: reading, writing, teaching, fieldwork -- For the humanity yet to come: politics, art, fiction, ethnography -- Coda: The anthropologist as critic.

The sixteenth-century Marathi poet-saint Eknāth is better known for his devotional songs and allegorical drama-poems than his “philosophical” writings. These writings include commentaries on and distillations of Sanskrit texts that feature a highly localized form of Advaita, or non-dualist Vedānta. Rather than consider them vernacular translations of the classical traditions of Advaita, I propose to read Eknāth’s philosophical works as embedded in a local context of non-dualist thought that filtered into the elite world of Sanskrit knowledge-systems. I provide examples from (...) his Marathi commentary on the Sanskrit Hastāmalaka Stotra, a brief versified teaching on Advaita Vedānta. I also look at the para-textual material bracketing the content and some of the accompanying manuscript record, in order to understand the context for circulation and transmission of this material among Eknāth’s various readers over generations. My general attempt is to understand how ideas and practices belonging to local, vernacular networks filter into elite Sanskrit systems of knowledge—that is, not just into flexible genres like purāṇa but into disciplines, like Vedānta, that are generally viewed as impervious to the world around them. From my perspective, all knowledge is local, even that articulated in such cosmopolitan languages as Sanskrit. In Eknāth’s vernacular Advaita, we find evidence for a much wider scope for the movement of ideas, one that moves not from top-down but bottom-up. (shrink)

There are three theories in the epistemology of modality that have received sustained attention over the past 20 years: conceivability-theory, counterfactual-theory, and deduction-theory. In this paper we argue that all three face what we call the problem of modal epistemic friction. One consequence of the problem is that for any of the three accounts to yield modal knowledge, the account must provide an epistemology of essence. We discuss an attempt to fend off the problem within the context of the internalism (...) versus externalism debate about epistemic justification. We then investigate the effects that the PMEF has on reductive and non-reductive theories of the relation between essence and modality. (shrink)

It is widely understood that protein functions can be exhaustively described in terms of no single parameter, whether this be amino acid sequence or the three-dimensional structure of the underlying protein molecule. This means that a number of different attributes must be used to create an ontology of protein functions. Certainly much of the required information is already stored in databases such as Swiss-Prot, Protein Data Bank, SCOP and MIPS. But the latter have been developed for different purposes and the (...) separate data-structures which they employ are not conducive to the needed data integration. When we attempt to classify the entities in the domain of proteins, we find ourselves faced with a number of cross-cutting principles of classification. Our question here is: how can we bring together these separate taxonomies in order to describe protein functions? Our proposed answer is: via a careful top-level ontological analysis of the relevant principles of classification, combined with a new framework for the simultaneous manipulation of classifications constructed for different purposes. (shrink)

"A rough spade for a rugged landscape" : on savage selves and more civil places -- "What remains of the harvest when the fence grazes the crop?" : on the proper violence of agrarian citizenship -- "The life of the thief leaves the belly always boiling" : on the nature and restraint of the criminal animal -- "Millets sown yield millets, evil sown yields evil" : on the moral returns of agrarian toil -- "Let the water for the paddy also (...) irrigate the grass" : on the sympathies of an aqueous self. (shrink)

Outcomes research in healthcare has been a topic much addressed in recent years. Efforts in this direction have been supplemented by work in the areas of guidelines for clinical practice and computer-interpretable workflow and careflow models.In what follows we present the outlines of a framework for understanding the relations between organizations, guidelines, individual patients and patient-related functions. The derived framework provides a means to extract the knowledge contained in the guideline text at different granularities, in ways that can help us (...) to assign tasks within the healthcare organization and to assess clinical performance in realizing the guideline. It does this in a way that preserves the flexibility of the organization in the adoption of the guidelines. (shrink)