Indoleamine 2,3‐dioxygenase (IDO) is the rate‐limiting enzyme in conversion of tryptophan to kynurenines, feeding de novo nicotinamide synthesis. IDO orchestrates materno‐foetal tolerance, increasing human reproductive fitness. IDO mediates immune suppression through depletion of tryptophan required by T lymphocytes and other mechanisms. IDO is expressed by alternatively activated macrophages, suspected to play a key role in tuberculosis (TB) pathogenesis. Unlike its human host, Mycobacterium tuberculosis can synthesize tryptophan, suggesting possible benefit to the host from infection with the microbe. Intriguingly, nicotinamide analogues (...) are used to treat TB. In reviewing this field, it is postulated that flux through the nicotinamide synthesis pathway reflects switching between aerobic glycolysis and oxidative phosphorylation in M. tuberculosis‐infected macrophages. The evolutionary cause of such shifts may be ancient mitochondrial behavior related to reproductive fitness. Evolutionary perspectives on the IDO pathway may elucidate why, after centuries of co‐existence with the Tubercle bacillus, humans still remain susceptible to TB disease. (shrink)

Human immunodeficiency virus and other sexually transmitted infections significantly burden youth 13–24 years of age in the United States. Directly engaging youth in sexual health research is a public health priority and urgently needed to develop targeted, youth-friendly, and culturally relevant HIV/sti prevention interventions. Controversies arise, however, regarding informed assent and consent, parental permission or consent, and the definition of “child”/“minor” as it relates to medical, legal, and ethical issues. In this article, we describe challenges in the human subjects review (...) processes that were undertaken before beginning an HIV/sti prevention research project with sexually active youth in an urban setting. These findings provide important contextual information to facilitate youth sexual health research and care, and Institutional Review Board approval processes with fewer delays. (shrink)

Among the distinguished intellectuals of sixteenth-century Italy was Antonio Brucioli, renowned for participating in the gatherings in the garden of the Rucellai in Florence during the second decade of the sixteenth century. Since Delio Cantimori’s fundamental article and Giorgio Spini’s fundamental monograph, Brucioli’s Dialogi have been valued for the insight they afford into the discussions of the Rucellai group. Twice in the Dialogi Brucioli offers a revealing discussion of music. The references reflect intellectual traditions of great significance and longevity and (...) afford valuable insight into the late-Renaissance reception of such venerable doctrines. (shrink)

The opening sentence of Christopher Meyers’ Target Article is “Lying to one’s patient is wrong”. The author continues, “This truism is one that bioethicists have heartedly endorsed fo...

We define organic sets and organically stationary sequences, which generalize tight sets and tightly stationary sequences respectively. We show that there are stationary many inorganic sets and stationary many sets that are organic but not tight. Working in the Constructible Universe, we give a characterization of organic and tight sets in terms of fine structure. We answer a related question posed in [J. Cummings, M. Foreman, M. Magidor, Canonical structure in the universe of set theory: Part two, Ann. Pure Appl. (...) Logic 142 55–75] about the combinatorial principle Coherent Squares. (shrink)

To paraphrase Lewis Carroll’s poem “The Walrus and the Carpenter” from his Through the Looking Glass, “The time has come to talk of many things.” Not as the Walrus did in the nursery rhyme, “of sho...

The opinion of Mr. Justice Francis of the English High Court which denied the parents of Charlie Gard, who had been born with an extremely rare mutation of a genetic disease, the right to take their child to the United States for a proposed experimental treatment occasioned world wide attention including that of the Pope, President Trump, and the US Congress. The case raise anew a debate as old as the foundation of Western medicine on who should decide and on (...) what standard when there is a conflict between a family and the treating physicians over a possible treatment. This paper will explore the different approaches of the British and American courts on the issue and the various proposals from that of John Rawls in his A Theory of Justice to a processed-based approach for resolving such disputes. As carefully crafted as the opinion of Mr Justice Nicholas Francis in the Gard case proved to be, it left commentators unsatisfied. A widespread criticism, captured in an article by Michael Dougherty in The National Review was for the state to ‘get out of the way of the parents trying to act in the best interests of the child’.1 Although he conceded the parents could be adding to the suffering of the child by taking Charlie to America for an experimental therapy and agreed that such a choice ‘may be the wrong decision,’ in Dougherty’s view, it should still be ‘their decision’. Dougherty’s stand was the popular response to the question of ‘Who should decide?’ It fails, however, to propose any rationale for the decision. It provided no norms, no standards and no guidelines for the parents. Their motive could equally well be indifference to the suffering of the child as concern for his well-being. Furthermore, even good, loving parents may make …. (shrink)

This paper examines and critiques the ethical issues in postmortem sperm retrieval and the use of postmortem sperm to create new life. The article was occasioned by the recent request of the parents of a West Point cadet who died in a skiing accident at the Academy to retrieve and use his sperm to honor his memory and perpetuate the family name. The request occasioned national media attention. A trial court judge in New York in a two-page order authorized both (...) the retrieval and use of the postmortem sperm. (shrink)

The children were nestled all snug in their beds.While visions of sugar-plums danced in their heads.Clement Moore's cherished ‘Twas the Night Before Christmas captures the hopes, dreams and visions...

It took nearly two thousand years for society to recognize the Hippocratic insistence that “the doctor knows best”1 was an inadequate approach to medical decisionmaking. Today, patient-centered medicine has come to understand that the individual patient has a significant role in the decisionmaking process.2.

Volume 19, Issue 12, December 2019, Page 49-51.

One enduring legacy of the twentieth century will be the slow, certain transformation of the world from insular civilizations to interactive societies enmeshed in global systems of electronic communication, economics, and politics. Financial news from Thailand or Brazil is often more important globally than political events in the old centers of power. Some bemoan the uncertainty and flux of all this. However, the mutual definition of the world’s societies presents an extraordinary opportunity to humanize a situation that all too quickly (...) could degenerate into a Weberian ‘iron cage’ of truly global proportions. What contribution can the world’s great philosophical traditions make toward humanity’s common task of civilizing the rise of globalization? Here the ancient concept of paideia walks upon the stage of the twenty-first century. (shrink)

One enduring legacy of the twentieth century will be the slow, certain transformation of the world from insular civilizations to interactive societies enmeshed in global systems of electronic communication, economics, and politics. Financial news from Thailand or Brazil is often more important globally than political events in the old centers of power. Some bemoan the uncertainty and flux of all this. However, the mutual definition of the world’s societies presents an extraordinary opportunity to humanize a situation that all too quickly (...) could degenerate into a Weberian ‘iron cage’ of truly global proportions. What contribution can the world’s great philosophical traditions make toward humanity’s common task of civilizing the rise of globalization? Here the ancient concept of paideia walks upon the stage of the twenty-first century. (shrink)

One enduring legacy of the twentieth century will be the slow, certain transformation of the world from insular civilizations to interactive societies enmeshed in global systems of electronic communication, economics, and politics. Financial news from Thailand or Brazil is often more important globally than political events in the old centers of power. Some bemoan the uncertainty and flux of all this. However, the mutual definition of the world’s societies presents an extraordinary opportunity to humanize a situation that all too quickly (...) could degenerate into a Weberian ‘iron cage’ of truly global proportions. What contribution can the world’s great philosophical traditions make toward humanity’s common task of civilizing the rise of globalization? Here the ancient concept of paideia walks upon the stage of the twenty-first century. (shrink)

Objective: To determine whether the marks in the third year Objective Structured Clinical Examination were affected by the collusion reported by the students themselves on an electronic discussion board.Design: A review of the student discussion, examiners’ feedback and a comparison of the marks obtained on the 2 days of the OSCE.Participants: 255 third year medical students.Setting: An OSCE consisting of 15 stations, administered on three sites over 2 days at a UK medical school.Results: 40 students contributed to the discussion on (...) the electronic discussion board. The main points raised were perceived inequity between students who did, or did not, have prior knowledge of the station content, and the lack of honesty and professionalism of their peers. Most contributors claimed to have received, or knew of others receiving, prior knowledge, but none confessed to passing on information. No significant difference was observed in the overall mark for the OSCE on day 1 ) and day 2 ). On day 2, marks were considerably greater for four stations and markedly lower for three stations. It was not obvious why collusion should affect these station marks. A clear indication of the effects of collusion could only be obtained from a single subsection of an individual station where 82 students on day 2 incorrectly gave the diagnosis from day 1.Conclusion: Marks do not provide a sound inference of student collusion in an OSCE and may mask the aspects of professional development of students. (shrink)

The healthcare industry generates significant waste and carbon emissions that negatively impact the environment. Intensive care units are a major contributor to the production of waste, due t...

Volume 20, Issue 7, July 2020, Page 147-150.

Recent neuroscience research makes it clear that human biology is cultural biology - we develop and live our lives in socially constructed worlds that vary widely in their structure values, and institutions. This integrative volume brings together interdisciplinary perspectives from the human, social, and biological sciences to explore culture, mind, and brain interactions and their impact on personal and societal issues. Contributors provide a fresh look at emerging concepts, models, and applications of the co-constitution of culture, mind, and brain. Chapters (...) survey the latest theoretical and methodological insights alongside the challenges in this area, and describe how these new ideas are being applied in the sciences, humanities, arts, mental health, and everyday life. Readers will gain new appreciation of the ways in which our unique biology and cultural diversity shape behavior and experience, and our ongoing adaptation to a constantly changing world. (shrink)

This book introduces Robert Corrington’s “ecstatic naturalism,” a new perspective in understanding “sacred” nature and naturalism, and explores what can be done with this philosophical thought. This is an excellent resource for scholars of Continental philosophy, philosophy of religion, and American pragmatism.

We prove a number of consistency results complementary to the ZFC results from our paper [J. Cummings, M. Foreman, M. Magidor, Canonical structure in the universe of set theory: part one, Annals of Pure and Applied Logic 129 211–243]. We produce examples of non-tightly stationary mutually stationary sequences, sequences of cardinals on which every sequence of sets is mutually stationary, and mutually stationary sequences not concentrating on a fixed cofinality. We also give an alternative proof for the consistency of the (...) existence of stationarily many non-good points, show that diagonal Prikry forcing preserves certain stationary reflection properties, and study the relationship between some simultaneous reflection principles. Finally we show that the least cardinal where square fails can be the least inaccessible, and show that weak square is incompatible in a strong sense with generic supercompactness. (shrink)