An immunizing strategy is an argument brought forward in support of a belief system, though independent from that belief system, which makes it more or less invulnerable to rational argumentation and/or empirical evidence. By contrast, an epistemic defense mechanism is defined as a structural feature of a belief system which has the same effect of deflecting arguments and evidence. We discuss the remarkable recurrence of certain patterns of immunizing strategies and defense mechanisms in pseudoscience and other belief (...) systems. Five different types will be distinguished and analyzed, with examples drawn from widely different domains. The difference between immunizing strategies and defense mechanisms is analyzed, and their epistemological status is discussed. Our classification sheds new light on the various ways in which belief systems may achieve invulnerability against empirical evidence and rational criticism, and we propose our analysis as part of an explanation of these belief systems’ enduring appeal and tenacity. (shrink)

This article is a set of reflections on the question: ‘what is completely new in algorithmic governmentality compared to capitalism and neoliberalism?’ The following text is thus some preliminary, temporary and definitively uncertain intuitions in response to this question.

Abstractabstract:Public health emergencies are fraught by epistemic uncertainty, which raises policy issues of how to handle that uncertainty and devise sustainable public health responses. Among such responses, a herd immunity policy might be an option. Particularly before the development of vaccines, the current COVID-19 pandemic has highlighted the polarized nature of the political debate concerning the ethical feasibility of herd immunity strategies. This article provides a conceptual framework tailored to uncover the ethical rationale behind such strategies. Clarity on (...) this issue is important in order to facilitate the terms of the political debate when tackling future health emergencies. (shrink)

Host‐pathogen arms race is a universal, central aspect of the evolution of life. Most organisms evolved several distinct yet interacting strategies of anti‐pathogen defense including resistance to parasite invasion, innate and adaptive immunity, and programmed cell death (PCD). The PCD is the means of last resort, a suicidal response to infection that is activated when resistance and immunity fail. An infected cell faces a decision between active defense and altruistic suicide or dormancy induction, depending on whether immunity is “deemed” (...) capable of preventing parasite reproduction and consequent infection of other cells. In bacteria and archaea, immunity genes typically colocalize with PCD modules, such as toxins‐antitoxins, suggestive of immunity‐PCD coupling, likely mediated by shared proteins that sense damage and “predict” the outcome of infections. In type VI CRISPR‐Cas systems, the same enzyme that inactivates the target RNA might execute cell suicide, in a case of ultimate integration of immunity and PCD. (shrink)

The current SARS-CoV-2 pandemic has killed thousands across the world. SARS-CoV-2 is the latest but surely not the last such global pandemic we will face. The biomedical response to such pandemics includes treatment, vaccination, and so on. In this paper, though, we argue that it is time to consider an additional strategy: the somatic enhancement of human immunity. We argue for this approach and consider bioethics objections we believe can be overcome.

In the following pages we propose a theory on cognitive systems and the common strategies of perception, which are at the basis of their function. We demonstrate that these strategies are easily seen to be in place in known cognitive systems such as vision and language. Furthermore we show that taking these strategies into consideration implies a new outlook on immune function calling for a new appraisal of the immune system as a cognitive system.

Recent studies suggest that insects use pattern recognition molecules to distinguish prokaryotic pathogens and fungi from “self” structures. Less understood is how the innate immune system of insects recognizes endoparasitic Hymenoptera and other eukaryotic invaders as foreign. Here we discuss candidate recognition factors and the strategies used by parasitoids to overcome host defense responses. We suggest that host–parasitoid systems are important experimental models for studying how the innate immune system of insects recognizes foreign invaders that are phylogenetically more closely (...) related to their hosts. The strategies used by parasitoids suggest that insects may employ “hidden-self” recognition molecules for attacking foreign objects intruding the open circulatory system. BioEssays 23:344–351, 2001. © 2001 John Wiley & Sons, Inc. (shrink)

The COVID-19 pandemic has led a number of countries to introduce restrictive ‘lockdown’ policies on their citizens in order to control infection spread. Immunity passports have been proposed as a way of easing the harms of such policies, and could be used in conjunction with other strategies for infection control. These passports would permit those who test positive for COVID-19 antibodies to return to some of their normal behaviours, such as travelling more freely and returning to work. The introduction (...) of immunity passports raises a number of practical and ethical challenges. In this paper, we seek to review the challenges relating to various practical considerations, fairness issues, the risk to social cooperation and the impact on people’s civil liberties. We make tentative recommendations for the ethical introduction of immunity passports. (shrink)

Cooperative spreading dynamics on complex networks is a hot topic in the field of network science. In this paper, we propose a strategy to immunize some nodes based on their degrees. The immunized nodes disable the synergistic effect of cooperative spreading dynamics. We also develop a generalized percolation theory to study the final state of the spreading dynamics. By using the Monte Carlo method, numerical simulations reveal that immunizing nodes with a large degree cannot always be beneficial for containing (...) cooperative spreading. For small values of transmission probability, immunizing hubs can suppress the spreading, while the opposite situation happens for large values of transmission probability. Furthermore, numerical simulations show that immunizing hubs increase the cost of the system. Finally, all numerical simulations can be well predicted by the generalized percolation theory. (shrink)

We are moving towards a future where Artificial Intelligence (AI) based agents make many decisions on behalf of humans. From healthcare decision-making to social media censoring, these agents face problems, and make decisions with ethical and societal implications. Ethical behaviour is a critical characteristic that we would like in a human-centric AI. A common observation in human-centric industries, like the service industry and healthcare, is that their professionals tend to break rules, if necessary, for pro-social reasons. This behaviour among humans (...) is defined as pro-social rule breaking. To make AI agents more human-centric, we argue that there is a need for a mechanism that helps AI agents identify when to break rules set by their designers. To understand when AI agents need to break rules, we examine the conditions under which humans break rules for pro-social reasons. In this paper, we present a study that introduces a ‘vaccination strategy dilemma’ to human participants and analyzes their response. In this dilemma, one needs to decide whether they would distribute COVID-19 vaccines only to members of a high-risk group (follow the enforced rule) or, in selected cases, administer the vaccine to a few social influencers (break the rule), which might yield an overall greater benefit to society. The results of the empirical study suggest a relationship between stakeholder utilities and pro-social rule breaking (PSRB), which neither deontological nor utilitarian ethics completely explain. Finally, the paper discusses the design characteristics of an ethical agent capable of PSRB and the future research directions on PSRB in the AI realm. We hope that this will inform the design of future AI agents, and their decision-making behaviour. (shrink)

We explore the ethics of deliberately exposing consenting adults to SARS-CoV-2 to induce immunity to the virus (“DEI” for short). We explain what a responsible DEI program might look like. We explore a consequentialist argument for DEI according to which DEI is a viable harm-reduction strategy. Then we consider a non-consequentialist argument for DEI that draws on the moral significance of consent. Additionally, we consider arguments for the view that DEI is unethical on the grounds that, given that large-scale DEI (...) would be highly likely to result in some severe illnesses and deaths, DEI amounts to a form of killing. Our thesis is that incorporating a DEI program alongside the status-quo “calibrate-the-curve” responses could have significant advantages at the early stages of pandemics. These potential advantages mean that, at a minimum, research into DEI would have been justified early in the COVID-19 pandemic, and that DEI programs should be explored as potential additions to our overall approach to emerging pandemics in the future. (shrink)

Physical exercise is seen as the main ally for health promotion, preventing and protecting the organism from several diseases. According to WHO, there is a tendency of constant growth in the elderly population in the coming years. The regular practice of exercises by the elderly becomes relevant to minimize the deleterious effects of the aging process and to increase the fitness index. Recently, the world population started a confrontation against Corona Virus Disease (COVID-19), which is the most significant public health (...) challenge globally. Although social isolation is a reasonable measure in an attempt to stop contamination by COVID-19, this measure has limited the ability of individuals to exercise outdoors or in gyms and health clubs, which increased the risk of developing chronic illnesses related to a sedentary lifestyle. The critical point is that the recent recommendations on exercise prescription to combat the potentially harmful effects of COVID-19 failure to adequately address resistance exercise interventions as home-based exercise strategy. Thus, in this paper, we discussed the physical exercise as medicine if the training status is enough to protect the elderly against COVID-19 infection, about the role of physical activity on immunosuppression. Possible risks for COVID-19 infection, and the old training methods, such as no-load resistance training as possible resistance exercise strategies and high-intensity interval training, as new proposals of home-based exercise interventions, could perform during the current COVID-19 pandemic. (shrink)

It is deemed that the effectiveness of teachers is highly entangled with psycho-emotional constructs, such as critical thinking (CT), emotion regulation (ER), and immunity. Despite the potential roles of CR, ER, and immunity, their possible relationships have remained unexplored in the higher education context of Iran. To fill in this lacuna, this study explored the potential role of CT and ER in university teachers' immunity in the Iranian higher education context. For this purpose, a total of 293 English university teachers (...) were selected using a convenience sampling method. They were invited to fill out the Watson–Glaser Critical Thinking Appraisal-Form, Language Teacher Emotion Regulation Inventory, and Language Teacher Immunity Instrument. The findings of path analysis indicated that the university teachers with higher CT were more productively immunized. Moreover, the results revealed that ER could predict the university teachers' immunity. The findings of the study lead to this implication that higher order thinking skills, emotion regulatory strategies, and immune enhancement should be incorporated into educational programs of higher education. (shrink)

In principle, mandatory vaccination in employment could be justified in certain circumstances. These include: the availability of safe and effective vaccination; if alternative, less coercive strategies did not work; and, the costs to the individual were proportionate. However, in COVID-19, the long term safety of vaccines is yet to be established. Vaccines should be made available by employers, and voluntary vaccination encouraged.

As the number of infections and mortalities from the SARS‐CoV‐2 pandemic continues to rise, the development of an effective therapy against COVID‐19 becomes ever more urgent. A few reports showing a positive correlation between BCG vaccination and reduced COVID‐19 mortality have ushered in some hope. BCG has been suggested to confer a broad level of nonspecific protection against several pathogens, mainly via eliciting “trained immunity” in innate immune cells. Secondly, BCG has also been proven to provide benefits in autoimmune diseases (...) by inducing tolerogenicity. Being an acute inflammatory disease, COVID‐19 requires a therapy that induces early priming of anti‐viral immune responses and regulates aberrant hyperactivity of innate‐immune cells. Here, we hypothesize that BCG can offer reliable spatiotemporal protection from COVID‐19 by triggering trained immunity and tolerogenesis, through multiple cellular pathways. We propose further research on BCG‐mediated immunoprotection, especially in vulnerable individuals, as a strategy to halt the progress of the SARS‐CoV‐2 pandemic. Also see the video abstract here https://youtu.be/P2D2RXfq6Vg. (shrink)

The aim of the study was to compare the strategies of coping with stress during the COVID-19 epidemic in athletes involved in Olympic preparations and students of physical education, and to determine their depending on the variable gender. The research was conducted in the form of an on-line survey in the period of April 7–28 during the COVID-19 pandemic. Four standard psychological questionnaires were used. Elite athletes and physical education students practicing sports most often dealt with the stress of (...) the COVID-19 pandemic using cognitive and behavioral coping strategies. The sports level depended on the strategies of coping with the stress of the COVID-19 pandemic more strongly than gender. The relationship between the sense of coherence and the hope for success treated as a generalized immune resource with coping strategies in the case of the COVID-19 pandemic postulated by Antonovsky was confirmed. (shrink)

Cameron et al ’s1 ethical considerations about the ‘Dualism of Values’ in pandemic response emphasise the need to strike a fair balance between the interests of the less vulnerable to COVID-19 and the interests of the more vulnerable. Those considerations are at the basis of ethical defences of focused protection strategies.2 One example is the proposal put forward in the Great Barrington Declaration. It presented focused protection strategies as more ethical alternatives to lockdowns which would prevent lockdowns’ ‘irreparable (...) damage, with the underprivileged disproportionately harmed’.3 Here we want to suggest that a version of Cameron et al ’s analysis can be applied to the case of vaccines to support a focused protection vaccination strategy. At this stage, we should limit vaccination to the vulnerable and not target children in COVID-19 vaccination strategies. We argue that, given the current state of knowledge about COVID-19, immunity and vaccines, it would be wrong to pose the costs and risks of vaccines on children for three reasons. First, they are unlikely to benefit from COVID-19 vaccination …. (shrink)

Towards the end of Decision Theory with a Human Face, Richard Bradley discusses various ways a rational yet human agent, who, due to lack of evidence, is unable to make some fine-grained credibility judgments, may nonetheless make systematic decisions. One proposal is that such an agent can simply “reach judgments” on the fly, as needed for decision making. In effect, she can adopt a precise probability function to serve as proxy for her imprecise credences at the point of decision, and (...) then subsequently abandon the proxy as she proceeds to learn more about the world. Contra Bradley, I argue that an agent who employs this strategy does not necessarily act like a precise Bayesian, since she is not necessarily immune to sure loss in diachronic, as well as synchronic, settings. I go on to suggest a method for determining a proxy probability function whereby the agent does act like a precise Bayesian, so understood. (shrink)

The affinities of antibodies (Abs) for their target antigens (Ags) gradually increase in vivo following an infection or vaccination, but reach saturation at values well below those realisable in vitro. This ‘affinity ceiling’ could in many cases restrict our ability to fight infections and compromise vaccines. What determines the affinity ceiling has been an unresolved question for decades. Here, we argue that it arises from the strength of the chain of protein complexes that is pulled by B cells during the (...) process of Ag acquisition. The affinity ceiling is determined by the strength of the weakest link in the chain. We identify the weakest link and show that the resulting affinity ceiling can explain the Ab affinities realized in vivo, providing a conceptual understanding of Ab affinity maturation. We explore plausible evolutionary underpinnings of the affinity ceiling, examine supporting evidence and alternative hypotheses and discuss implications for vaccination strategies. (shrink)

Recently, the development of several strategies based on immunotherapy has raised hopes for a more promising way to treat cancer patients. Here, we describe how interleukin (IL)‐10, a seemingly unlikely candidate, stimulates the immune system in a particularly efficacious way. IL‐10, an omnipotent anti‐inflammatory cytokine, delivers an equally potent immune stimulation in the context of CD8+ T cells and tumor immunity. By activation of tumor‐resident, tumor‐specific CD8+ T cells, pegylated IL‐10 can induce rejection of large and metastasizing tumors in (...) mice. Here, we summarize the mechanisms of action of IL‐10, the reasons why the mechanisms may be crucial for the treatment of cancer patients, and the rationale for applying pegylated IL‐10 in the clinic. (shrink)

Retroviruses replicate by inserting their proviral DNA into host cell chromosomes, usually in cells of the immune system. Nevertheless, an efficacious and safe subunit recombinant vaccine has been prepared against the feline leukemia retrovirus of cats. Because of high rates of morbidity and mortality, particularly in the developing world, the development of a vaccine against human immunodeficiency virus type I (HIV-I) has become very important. The very high rate of mutation or variation of lentiviruses, such as HIV-I, makes a vaccine (...) against this virus particularly difficult. Active research must be encouraged to design a modified envelope vaccine molecule of gp120 subtype E or C for trials in appropriate developing country settings. (shrink)

Many male traits are well explained by sexual selection theory as adaptations to mating competition and mate choice, whereas no unifying theory explains traits expressed more in females. Anne Campbell's “staying alive” theory proposed that human females produce stronger self-protective reactions than males to aggressive threats because self-protection tends to have higher fitness value for females than males. We examined whether Campbell's theory has more general applicability by considering whether human females respond with greater self-protectiveness than males to other threats (...) beyond aggression. We searched the literature for physiological, behavioral, and emotional responses to major physical and social threats, and found consistent support for females' responding with greater self-protectiveness than males. Females mount stronger immune responses to many pathogens; experience a lower threshold to detect, and lesser tolerance of, pain; awaken more frequently at night; express greater concern about physically dangerous stimuli; exert more effort to avoid social conflicts; exhibit a personality style more focused on life's dangers; react to threats with greater fear, disgust, and sadness; and develop more threat-based clinical conditions than males. Our findings suggest that in relation to threat, human females have relatively heightened protective reactions compared to males. The pervasiveness of this result across multiple domains suggests that general mechanisms might exist underlying females' unique adaptations. An understanding of such processes would enhance knowledge of female health and well-being. (shrink)

Study of the multiplicity of interactions between invertebrate hosts and their parasites helps to define the aspects of the host immune systems that have ecological and evolutionary significance. Such study, however, reveals how much is yet unknown. For instance, the costs of mounting an immune response, the nature of the long-lasting protection sometimes attained, and the high degree of specificity observed in certain hosts are phenomena that still await full explanation. An additional puzzle is the high degree of specificity achieved (...) in light of the apparent low degree of specificity in the recognition and effector mechanisms of insect immune systems. Furthermore, while protective immunity is typically associated with vertebrate adaptive immune systems, invertebrates may have analogous capacities, whose nature is still largely unknown. This review will illustrate how the traditional host-centred view of immune defence can be usefully extended by taking account of parasite immune evasion strategies and the variation that such strategies create in the observed outcomes of infection. BioEssays 27:1026–1034, 2005. © 2005 Wiley Peiodicals, Inc. (shrink)

Schistosoma mansoni is one of several species of trematode helminths responsible for schistosomiasis, a major parasitic infection of man. Genetic analysis in mice has revealed that the protective immunity induced against this parasite by an attenuated larval vaccine is strongly influenced by genes regulating the activation of macrophage effector cells. The latter finding suggests that the induction of cell‐mediated immunity may be a successful strategy for a non‐living vaccine against the human infection.

Studies of the activation of the behavioral immune system triggered by the coronavirus disease-2019 pandemic have demonstrated that evolutionary explanations of individual differences in self-protection should not be based only on parental investment and sexual selection theory. An evolutionary model must also incorporate individual differences that arise within each sex as a result of life history strategies and attachment patterns.

Presenilin‐1 (PS1) is thought to regulate cell differentiation and survival by modulating the Notch signaling pathway. Mutations in PS1 have been shown to cause early‐onset inherited forms of Alzheimer's disease (AD) by a gain‐of‐function mechanism that alters proteolytic processing of the amyloid precursor protein (APP) resulting in increased production of neurotoxic forms of amyloid β‐peptide. The present article considers a second pathogenic mode of action of PS1 mutations, a defect in cellular calcium signaling characterized by overfilling of endoplasmic reticulum (ER) (...) calcium stores and altered capacitive calcium entry; this abnormality may impair synaptic plasticity and sensitize neurons to apoptosis and excitotoxicity. The calcium signaling defect has also been documented in lymphocytes, suggesting a contribution of immune dysfunction to the pathogenesis of AD. A better understanding of the calcium signaling defect resulting from PS1 mutations may lead to the development of novel preventative and therapeutic strategies for disorders of the nervous and immune systems. BioEssays 23:733–744, 2001. © 2001 John Wiley & Sons, Inc. (shrink)

Why do some invertebrates store so much carotenoids in their tissues? Storage of carotenoids may not simply be passive and dependent on their environmental availability, as storage variation exists at various taxonomic scales, including among individuals within species. While the strong antioxidant and sometimes immune-stimulating properties of carotenoids may be beneficial enough to cause the evolution of features improving their assimilation and storage, they may also have fitness downsides explaining why massive carotenoid storage is not universal. Here, the functional and (...) ecological implications of carotenoid storage for the evolution of invertebrate innate immune defenses are examined, especially in crustaceans, which massively store carotenoids for unclear reasons. Three testable hypotheses about the role of carotenoid storage in immunological (resistance and tolerance) and life-history strategies (with a focus on aging) are proposed, which may ultimately explain the storage of large amounts of these pigments in a context of host–pathogen interactions. (shrink)

In the atavistic model of cancer progression, tumor cell dedifferentiation is interpreted as a reversion to phylogenetically earlier capabilities. The more recently evolved capabilities are compromised first during cancer progression. This suggests a therapeutic strategy for targeting cancer: design challenges to cancer that can only be met by the recently evolved capabilities no longer functional in cancer cells. We describe several examples of this target‐the‐weakness strategy. Our most detailed example involves the immune system. The absence of adaptive immunity in immunosuppressed (...) tumor environments is an irreversible weakness of cancer that can be exploited by creating a challenge that only the presence of adaptive immunity can meet. This leaves tumor cells more vulnerable than healthy tissue to pathogenic attack. Such a target‐the‐weakness therapeutic strategy has broad applications, and contrasts with current therapies that target the main strength of cancer: cell proliferation. (shrink)

The paper looks at the idea of grounding human freedom in selfhood, with particular attention to the strategies of “denaturalizing” time, resulting in its separation into different modalities. The perspective of practical philosophy, interested in accounting for and making legitimate the spontaneous first person assumption of being a free agent, is enriched with some historical references to different ontological and anthropological attempts at inscribing verticality or transcendence into the human self in order to secure to this self what is (...) called here inalienable freedom. The paper focuses on some elements of Henri Bergson’s thought and tries to reinterpret them in terms of an example modern, anti-reductionist “immunization” of the triad freedom – self – humanity. It also emphasizes the emancipatory potential and the novelty of Bergson’s conception of the human self. (shrink)

Microbes can influence host physiology and behavior in many ways. Here we review evidence suggesting that some microbes can contribute to host stress (and other microbes can contribute to increased resilience to stress). We explain how certain microbes, which we call “stress microbes,” can potentially benefit evolutionarily from inducing stress in a host, gaining access to host resources that can help fuel rapid microbial replication by increasing glucose levels in the blood, increasing intestinal permeability, and suppressing the immune system. Other (...) microbes, which we term “resilience microbes,” can potentially benefit from making hosts more resilient to stress. We hypothesize that “stress microbes” use a fast life history strategy involving greater host exploitation while “resilience microbes” use a slow life history strategy characterized by more aligned evolutionary interests with the host. In this paper, we review the evidence that microbes affect host stress and explain the evolutionary pressures that could lead microbes to manipulate host stress, discuss the physiological mechanisms that are known to be involved in both stress and microbial activity, and provide some testable predictions that follow from this hypothesis. (shrink)

Vaccine hesitancy is a growing threat to public health. The reasons are complex but linked inextricably to a lack of trust in vaccines, expertise and traditional sources of authority. Efforts to increase immunization uptake in children in many countries that have seen a fall in vaccination rates are two-fold: addressing hesitancy by improving healthcare professional-parent exchange and information provision in the clinic; and, secondly, public health strategies that can override parental concerns and values with coercive measures such as mandatory (...) and presumptive vaccination. It is argued that such conflicting, parallel approaches seriously risk undermining trust that is crucial for sustaining herd immunity. Although public health strategies can be ethically justified in limiting freedoms, a parent-centered approach seldom acknowledges how it is impacted by contemporaneous coercive measures. In addition, the clinical encounter is not well suited to helping parents consider the public dimensions of vaccination, despite these being important for trust formation and informed decision-making. Efforts to address vaccine hesitancy require more consistent engagement of parental and citizen views. Along with evidence-based information, debates need to be informed by ethical support that equips parents and professionals to respond to the private and public dimensions of vaccination in a more even-handed, transparent manner. Efforts to address vaccine hesitancy need to avoid simple reliance on either parental values or coercive public policies. To do this effectively requires increasing citizen engagement on vaccination to help inform a parent-centered approach and legitimize public policy measures. In addition, cultivating a more ethically consistent strategy means moving beyond the current silos of health ethics - clinical and public health ethics. (shrink)

Suppose COVID-19 is the runaway tram in the famous moral thought experiment, known as the “Bystander at the Switch.” Consider the two differentiated responses of governments around the world to this new threat, namely the option of quarantine/lockdown and herd immunity. Can we contrast the hypothetical with the real scenario? What do the institutional decisions and strategies for dealing with the virus, in the beginning of 2020, signify in a normative moral framework? This paper investigates these possibilities in order (...) to highlight the similarities and, more importantly, the differences that exist between utilitarianism and Kantian ethics. Analysis shows that the hypothetical scenario can never be fully compared to the complex multifactorial nature of the real world. But if a comparison is attempted, the most obvious difference between the two governmental strategies is the concept of duty within the Kantian perspective. Ultimately, it is a matter of comparing freedom and life. Attributing a moral “priority ticket” to one or the other can be analysed through interpersonal aggregation. (shrink)

Targeted hypermutation has proven to be a useful survival strategy for bacteria under severe stress and is also used by multicellular organisms in specific instances such as the mammalian immune system. This might appear surprising, given the generally observed deleterious effects of poor replication fidelity/high mutation rate. A previous theoretical model designed to explore the role of replication fidelity in the origin of life was applied to a simulated hypermutation scenario. The results confirmed that the same model is useful for (...) analyzing hypermutation and can predict the effects of the same parameters (survival probability, replication fidelity, mutation effect, and others) on the survival of cellular populations undergoing hypermutation as a result of severe stress. (shrink)

Much of the fear and uncertainty around Zika epidemics stem from potential association between Zika virus complications on infected pregnant women and risk of their babies being born with microcephaly and other neurological abnormalities. However, much remains unknown about its mode of transmission, diagnosis and long-term pathogenesis. Worries of these unknowns necessitate the need for effective and efficient psychosocial programs and medical-legal strategies to alleviate and mitigate ZIKV related burdens. In this light, local and global efforts in maintaining fundamental (...) health principles of moral, medical and legal decision-making policies, and interventions to preserve and promote individual and collectiveHuman Rights, autonomy, protection of the most vulnerable, equity, dignity, integrity and beneficence that should not be confused and relegated by compassionate humanitarian assistance and support. This paper explores the potential medical and ethical-legal implications of ZIKV epidemics emergency response packages and strategies alongside optimizing reproductive and mental health policies, programs and best practice measures. Further long-term cross-borders operational research is required in elucidating Zika-related population-based epidemiology, ethical-medical and societal implications in guiding evidence-based local and global ZIKV maternal-child health complications related approaches and interventions. Core programs and interventions including future Zika safe and effective vaccines for global Zika immunization program in most vulnerable and affected countries and worldwide should be prioritized. (shrink)

Much of the fear and uncertainty around Zika epidemics stem from potential association between Zika virus complications on infected pregnant women and risk of their babies being born with microcephaly and other neurological abnormalities. However, much remains unknown about its mode of transmission, diagnosis and long-term pathogenesis. Worries of these unknowns necessitate the need for effective and efficient psychosocial programs and medical-legal strategies to alleviate and mitigate ZIKV related burdens. In this light, local and global efforts in maintaining fundamental (...) health principles of moral, medical and legal decision-making policies, and interventions to preserve and promote individual and collectiveHuman Rights, autonomy, protection of the most vulnerable, equity, dignity, integrity and beneficence that should not be confused and relegated by compassionate humanitarian assistance and support. This paper explores the potential medical and ethical-legal implications of ZIKV epidemics emergency response packages and strategies alongside optimizing reproductive and mental health policies, programs and best practice measures. Further long-term cross-borders operational research is required in elucidating Zika-related population-based epidemiology, ethical-medical and societal implications in guiding evidence-based local and global ZIKV maternal-child health complications related approaches and interventions. Core programs and interventions including future Zika safe and effective vaccines for global Zika immunization program in most vulnerable and affected countries and worldwide should be prioritized. (shrink)

Zusammenfassung Die Einführung von Impfprogrammen bei einer immun-naiven Bevölkerung in Europa spielte eine wesentliche Rolle für den Verlauf der COVID-19 Pandemie. Vor allem zu Beginn waren Impfprogramme jedoch durch einen Mangel an Impfdosen gekennzeichnet. Bei einer Zuteilung geringer Dosen an Krankenhäuser in der Initialphase, waren Krankenhausleitungen durch eine möglichst faire Verteilung dieser Impfdosen unter dem Krankenhauspersonal gefordert. Der Beitrag dokumentiert das Vorgehen im ersten Quartal 2021 an fünf deutschen Krankenhäusern in einem Klinikverbund. Wir berichten über einen regel-konsequentialistischen Ansatz auf der (...) strategischen Ebene, der durch einen egalitären Ansatz auf der taktischen Ebene ergänzt wurde. Es erfolgte die ethisch begleitete Entwicklung eines hybriden Schemas unter Verzicht auf klassische Verteilungsmuster, wie dem First-Come-First-Served Schema. Die Kombination des strategischen regel-konsequentialistischen Schemas mit egalitärer Verteilung auf der taktischen Ebene war vollständig funktional und unter den Mitarbeitenden des Klinikverbundes gut akzeptiert. In Zeiten von Pandemien und knappen Ressourcen spielt die Verteilung von medizinischen Gütern für die Funktionalität medizinischer Einrichtungen eine wichtige Rolle. Die Verteilung von Gütern, die durch den Staat bereitgestellt werden, bedarf jedoch einer Anpassung an die jeweiligen Gegebenheiten der Institutionen. Dieser Bericht zeigt eine mögliche Option für die Verteilung knapper Impfdosen auf, die nicht nur unter Personen der Zielgruppe verteilt wurden, sondern die auch die Funktionalität der medizinischen Versorgung in einer Region sicherte. (shrink)

The exact process that leads to the eruption of autoimmune reactions against β cells and the evolution of diabetes is not fully understood. Macrophages and T cells may launch an initial immune reaction against the pancreatic islets of Langerhans, provoking inflammation and destructive insulitis. The information on the molecular mechanisms of the emergence of β cell injury is controversial and points to possibly important roles for the perforin–granzyme, Fas–Fas-ligand (FasL) and tumor-necrosis-factor-mediated apoptotic pathways. FasL has several unique features that make (...) it a potentially ideal immunomodulatory tool. Most important, FasL is selectively toxic to cytotoxic T cells and less harmful to regulatory T cells. This review discusses the intrinsic sensitivity of β cells to FasL-mediated apoptosis, the conditions that underlie this β cell sensitivity, and the feasibility of using FasL to arrest autoimmunity and prevent islet allograft rejection. In both the autoimmune and transplant settings, it is imperative to progress from the administration of nonspecific immunosuppressive therapy to the concept of β-cell-specific immunomodulation. FasL evolves as a prime candidate for antigen-specific immunomodulation. BioEssays 28: 211–222, 2006. © 2006 Wiley periodicals, Inc. (shrink)

The exact process that leads to the eruption of autoimmune reactions against β cells and the evolution of diabetes is not fully understood. Macrophages and T cells may launch an initial immune reaction against the pancreatic islets of Langerhans, provoking inflammation and destructive insulitis. The information on the molecular mechanisms of the emergence of β cell injury is controversial and points to possibly important roles for the perforin–granzyme, Fas–Fas-ligand (FasL) and tumor-necrosis-factor-mediated apoptotic pathways. FasL has several unique features that make (...) it a potentially ideal immunomodulatory tool. Most important, FasL is selectively toxic to cytotoxic T cells and less harmful to regulatory T cells. This review discusses the intrinsic sensitivity of β cells to FasL-mediated apoptosis, the conditions that underlie this β cell sensitivity, and the feasibility of using FasL to arrest autoimmunity and prevent islet allograft rejection. In both the autoimmune and transplant settings, it is imperative to progress from the administration of nonspecific immunosuppressive therapy to the concept of β-cell-specific immunomodulation. FasL evolves as a prime candidate for antigen-specific immunomodulation. BioEssays 28: 211–222, 2006. © 2006 Wiley periodicals, Inc. (shrink)

This paper offers an epistemological discussion of self-validating belief systems and the recurrence of ?epistemic defense mechanisms? and ?immunizing strategies? across widely different domains of knowledge. We challenge the idea that typical ?weird? belief systems are inherently fragile, and we argue that, instead, they exhibit a surprising degree of resilience in the face of adverse evidence and criticism. Borrowing from the psychological research on belief perseverance, rationalization and motivated reasoning, we argue that the human mind is particularly susceptible (...) to belief systems that are structurally self-validating. On this cognitive-psychological basis, we construct an epidemiology of beliefs, arguing that the apparent convenience of escape clauses and other defensive ?tactics? used by believers may well derive not from conscious deliberation on their part, but from more subtle mechanisms of cultural selection. (shrink)

What is wrong with ad hoc hypotheses? Ever since Popper’s falsificationist account of adhocness, there has been a lively philosophical discussion about what constitutes adhocness in scientific explanation, and what, if anything, distinguishes legitimate auxiliary hypotheses from illicit ad hoc ones. This paper draws upon distinct examples from pseudoscience to provide us with a clearer view as to what is troubling about ad hoc hypotheses. In contrast with other philosophical proposals, our approach retains the colloquial, derogative meaning of adhocness, and (...) calls attention to the way in which the context of a theoretical move bears on the charge of adhocness. We also discuss the role of motivations implicit in the concept of adhocness, and the way ad hoc moves draw on theory-internal rationalizations. (shrink)

Governmental reactions to crises like the COVID-19 pandemic can be seen as ethics communication. Governments can contain the disease and thereby mitigate the detrimental public health impact; allow the virus to spread to reach herd immunity; test, track, isolate, and treat; and suppress the disease regionally. An observation of Sweden and Finland showed a difference in feasible ways to communicate the chosen policy to the citizenry. Sweden assumed the herd immunity strategy and backed it up with health utilitarian arguments. This (...) was easy to communicate to the Swedish people, who appreciated the voluntary restrictions approach and trusted their decision makers. Finland chose the contain and mitigate strategy and was towards the end of the observation period apparently hesitating between suppression and the test, track, isolate, and treat approach. Both are difficult to communicate to the general public accurately, truthfully, and acceptably. Apart from health utilitarian argumentation, something like the republican political philosophy or selective truth telling are needed. The application of republicanism to the issue, however, is problematic, and hiding the truth seems to go against the basic tenets of liberal democracy. (shrink)

This Perspective adapts the ViolEx Model, a framework validated in several clinical conditions, to better understand the role of expectations in the recovery and/or maintenance of musculoskeletal pain. Here, particular attention is given to the condition in which dysfunctional expectations are maintained despite no longer being supported by confirmatory evidence. While the ViolEx Model suggests that cognitive immunization strategies are responsible for the maintenance of dysfunctional expectations, we suggest that such phenomenon can also be understood from a Bayesian Brain (...) perspective, according to which the level of precision of the priors is the determinant factor accounting for the extent of priors’ updating. Importantly, this Perspective translates the theory behind these two frameworks into clinical suggestions. Precisely, it is argued that different strategies should be implemented when treating MSK pain patients, depending on the nature of their expectations. (shrink)

As an empirical example of introspective conditions in which the normal sense of self is disrupted, the delusion of thought insertion is of special interest to philosophers investigating the epistemic and phenomenological structures of introspection. A common strategy is to use immunity to error through misidentification as a tool with which to pick apart the implications of thought insertion for our understanding of the faculty of introspection. In this paper I turn that strategy on its head: I draw on our (...) understanding of introspection and of thought insertion to make two correctives to the literature on immunity to error through misidentification. The first is the identification of a formal distinction between two phenomena sometimes conflated under the rubric of misidentification errors. The second is a weakening of the presumed significance of claims to immunity to error through misidentification. With these tightenings to the notion of immunity to error through misidentification in hand, we will be in a better position to turn again to questions about the epistemic and phenomenological nature of introspection. (shrink)

The 2013 Ebola virus outbreak in West Africa, as of writing, is declining in reported human cases and mortalities. The resulting devastation caused highlights how health systems, in particular in West Africa, and in terms of global pandemic planning, are ill prepared to react to zoonotic pathogens. In this paper we propose One Health as a strategy to prevent zoonotic outbreaks as a shared goal: that human and Great Ape vaccine trials could benefit both species. Only recently have two phase (...) 2/3 Ebola human vaccine trials been started in West Africa. This paper argues for a conceptual change in pandemic preparedness. We first discuss the ethics of One Health. Next, we focus on the current Ebola outbreak and defines its victims. Third, we present the notion of a ‘shared benefit’ approach, grounded in One Health, and argue for the vaccination of wild apes in order to protect both apes and humans. We believe that a creation of such inter-species immunity is an exemplar of One Health, and that it is worth pursuing as a coextensive public health approach. (shrink)

Disgust is reasoned to operate in conjunction with the immune system to help protect the body from illness. However, less is known about the factors that impact the degree to which individuals invest in pathogen avoidance (disgust) versus pathogen management (prophylactic immunological activity). Here, we examine the role that one’s control over pathogen contact plays in resolving such investment trade-offs, predicting that (a) those from low control environments will invest less in pathogen-avoidance strategies and (b) investment in each of (...) these two strategies will occur in a compensatory fashion (i.e. they will be traded off with one other). Across four studies, we found support for these predictions, using a variety of manipulations and measures. By providing novel insights into how one’s control over pathogen exposure influences disgust sensitivity and immune system activity, the current research poses an important contribution to the literature on disgust, pathogen avoidance, and the immune system. (shrink)

Human papillomavirus (HPV) infection is the world’s most common sexually transmitted infection. It is a prerequisite for cervical cancer, the second most common cause of death in cancer among women worldwide, and is also believed to cause other anogenital and head and neck cancers. Vaccines that protect against the most common cancer-causing HPV types have recently become available, and different countries have taken different approaches to implementing vaccination. This paper examines the ethics of alternative HPV vaccination strategies. It devotes (...) particular attention to the major arguments for and against one strategy: voluntary, publicly funded vaccination for all adolescent boys and girls. This approach seems attractive because it would protect more people against cervical cancer and other HPV-related cancers than less inclusive alternatives, without the sacrifice of autonomy that a comparably broad compulsory programme would require. Also, the herd immunity that it would likely generate would protect those who remain unvaccinated, a major advantage from a justice perspective. However, there is a possibility that a HPV vaccination programme targeting all adolescents of both sexes is not considered sufficiently cost-effective. Also, it might pose more difficulties for achieving informed consent than comparable vaccination programmes against other diseases. Ultimately, society’s choice of HPV vaccination strategy requires careful consideration not only of the values at stake but also of available and emerging scientific evidence. (shrink)