Systemic autoimmune diseases are characterized by the production of antibodies against a broad range of self-antigens. Recent evidence indicates that the majority of these autoantigens are modified in various ways during cell death. This has led to the hypothesis that the primary immune response in the development of autoimmunity is directed to components of the dying cell. In this article, we summarize data on the modification of autoantigens during cell death and the possible consequences of this for autoimmunity. BioEssays 22:627–636, (...) 2000. © 2000 John Wiley & Sons, Inc. (shrink)

This paper addresses several questions related to the nature, production, and use of animal-human (a-h) chimeras. At the heart of the issue is whether certain types of a-h chimeras should be brought into existence, and, if they are, how we should treat such creatures. In our current research environment, we recognize a dichotomy between research involving nonhuman animal subjects and research involving human subjects, and the classification of a research protocol into one of these categories will trigger different ethical standards (...) as to the moral permissibility of the research in question. Are a-h chimeras entitled to the more restrictive and protective ethical standards applied to human research subjects? We elucidate an Aristotelian-Thomistic metaphysical framework in which to argue how such chimeras ought to be defined ontologically. We then examine when the creation of, and experimentation upon, certain types of a-h chimeras may be morally permissible. (shrink)

The number of people who survive critical illness is increasing. In parallel, a growing body of literature reveals a broad range of side-effects following intensive care treatment. Today, more attention is needed to improve the quality of survival. Based on nine individual stories of illness experiences given by participants in two focus groups and one individual interview, this paper elaborates how former critically ill patients craft and recraft their personal stories throughout their illness trajectory. The analysis was conducted from a (...) phenomenological perspective and led to the meaning structure; a quest to find oneself after critical illness. In this structure, illness represented a breakdown of the participants’ lives, forcing them to develop a new understanding of themselves. Despite acute illness, they felt safe in hospital. Coming home, however, meant a constant balancing between health and illness, and being either in or out of control. To gain a deeper understanding of the participants’ narratives of survival, the meaning structure was developed from a phenomenological life world perspective, Heidegger’s concept of homelikeness and Arthur Frank’s typologies of illness narratives. In conclusion listening to and acknowledging the patients’ lived experiences of critical illness may support the patient efforts to establish the newly defined self and hence be vital for recovery. Phenomenology is one approach facilitating care tailored to the patients’ lived experience of critical illness and its aftermaths. (shrink)

The article examines the surprising role of Rousseau in the revival of liberal and humanist thought in contemporary French political thought. The choice of Rousseau as an inspiration and source of humanism is an illuminating indication of a shift in French thought. The authors concentrate on the natural- rights republicanism of Luc Ferry and Alain Renaut and the critical humanism of Tzvetan Todorov. While these thinkers all appeal to Rousseau's definition of humanity in terms of freedom, they draw on different (...) aspects of his thought and his relationship to the philosophic tradition. Their different receptions of Rousseau reveal tensions in the humanist revival and provoke reflection on the relationships among republicanism, liberalism and humanism in contemporary France. (shrink)

It is an interesting fact of our time that some of the best studies of communism and Marxism have been written by Catholic scholars. This book, based on a series of television programs in St. Louis aims at presenting an historical and theoretical understanding of the emergence of Marxism and the development of Communism. Written for the intelligent lay reader as an introduction to a complex subject, the treatment is lucid and balanced.—R. J. B.

A unifying theory of general anesthetic-induced unconsciousness must explain the common mechanism through which various anesthetic agents produce unconsciousness. Functional-brain-imaging data obtained from 11 volunteers during general anesthesia showed specific suppression of regional thalamic and midbrain reticular formation activity across two different commonly used volatile agents. These findings are discussed in relation to findings from sleep neurophysiology and the implications of this work for consciousness research. It is hypothesized that the essential common neurophysiologic mechanism underlying anesthetic-induced unconsciousness is, as with (...) sleep-induced unconsciousness, a hyperpolarization block of thalamocortical neurons. A model of anesthetic-induced unconsciousness is introduced to explain how the plethora of effects anesthetics have on cellular functioning ultimately all converge on a single neuroanatomic/neurophysiologic system, thus providing for a unitary physiologic theory of narcosis related to consciousness. (shrink)

One method for investigating the neurobiology of consciousness is to experimentally manipulate consciousness as a variable and then visualize the resultant functional brain changes with advanced imaging techniques. To begin investigation into this area, healthy volunteers underwent positron emission tomography scanning while listening to randomized word lists in both conscious and unconscious conditions. Following anaesthesia, subjects had no explicit memories. Nonetheless, subjects demonstrated implicit memory on a forced-choice test . These subsequent memory scores were correlated with regional brain metabolism measured (...) during encoding. Conscious recall and unconscious recognition memory demonstrated considerable anatomic overlap in correlating significantly with relative glucose metabolism in auditory verbal memory areas. However, only conscious recall correlated with mediodorsal thalamic nucleus activity; unconscious recognition memory did not. These findings suggest that conscious versus unconscious memory distinctions may depend on the presence or absence of correlated thalamic activity, and directly implicate the thalamus in the neurobiology of consciousness. (shrink)

In this article, we propose the Fair Priority Model for COVID-19 vaccine distribution, and emphasize three fundamental values we believe should be considered when distributing a COVID-19 vaccine among countries: Benefiting people and limiting harm, prioritizing the disadvantaged, and equal moral concern for all individuals. The Priority Model addresses these values by focusing on mitigating three types of harms caused by COVID-19: death and permanent organ damage, indirect health consequences, such as health care system strain and stress, as well as (...) economic destruction. It proposes proceeding in three phases: the first addresses premature death, the second long-term health issues and economic harms, and the third aims to contain viral transmission fully and restore pre-pandemic activity. -/- To those who may deem an ethical framework irrelevant because of the belief that many countries will pursue "vaccine nationalism," we argue such a framework still has broad relevance. Reasonable national partiality would permit countries to focus on vaccine distribution within their borders up until the rate of transmission is below 1, at which point there would not be sufficient vaccine-preventable harm to justify retaining a vaccine. When a government reaches the limit of national partiality, it should release vaccines for other countries. -/- We also argue against two other recent proposals. Distributing a vaccine proportional to a country's population mistakenly assumes that equality requires treating differently situated countries identically. Prioritizing countries according to the number of front-line health care workers, the proportion of the population over 65, and the number of people with comorbidities within each country may exacerbate disadvantage and end up giving the vaccine in large part to wealthy nations. (shrink)

In this paper, the ethical and legal issues raised by the deactivation of implantable cardioverter-defibrillators in patients with terminal cancer is considered. It is argued that the ICD cannot be well described either as a treatment or as a non-treatment option, and thus raises complex questions regarding how rules governing deactivation should be framed. A new category called “integral devices” is proposed. Integral devices require their own special rules, reflecting their position as a “halfway house” between a form of treatment (...) and a part of the body. The practical problems faced by doctors working in palliative medicine with regard to the deactivation of ICDs are also considered. (shrink)

As the commentaries reveal, cognitive neuroscience's first steps toward a theory of development are marked by vigorous debate, ranging from basic points of definition to the fine details of mechanism. In this Response, we present the neural constructivist position on this broad spectrum of issues, from basic questions such as what sets constructivism apart from other theories (particularly selectionism) to its relation to behavioral theories and to its underlying mechanisms. We conclude that the real value of global theories at this (...) stage of cognitive neuroscience is not just their answers but the new set of research questions they pose. (shrink)

We tested the hypothesis that perception of an alternative image in ambiguous figures would be manifest as high-frequency (gamma) components that become synchronized over multiple scalp sites as a ''cognitive binding'' process occurs. For 171 combinations of data from 19 electrodes, obtained from 17 subjects and 10 replicate stimuli, we calculated the difference in correlation between the response to first seeing an ambiguous figure and when the alternative percept for that figure became consciously realized (cognitively bound). Numerous statistically significant correlation (...) differences occurred in all frequency bands tested with ambiguous-figure stimulation, but not in two kinds of control data (a reaction-time test to sound stimuli and a no-task, mind-wandering test). Statistically significant correlation changes were widespread, involving frontal, parietal, central, and occipital regions of both hemispheres. Correlation changes were evident at each of five frequency bands, ranging up to 62.5 Hz. Most of the statistically significant correlation changes were not between adjacent sites but between sites relatively distant, both ipsilateral and contralateral. Typically, these correlation changes occurred in more than one frequency band. These results suggest that cognitive binding is a distinct mental state that is reliably induced by ambiguous-figure perception tasks. Coherent oscillations at multiple frequencies may reflect the mechanism by which such binding occurs. Moreover, different coherent frequencies may mediate different components of the total cognitive-binding process. (shrink)