Prominent tuberculosis (TB) actors are invoking solidarity to motivate and justify collective action to address TB, including through intensified development and implementation (D&I) of technologies such as drugs and diagnostics. We characterize the ethical challenges associated with D&I of new TB technologies by drawing on stakeholder perspectives from 23 key informant interviews and we articulate the ethical implications of solidarity for TB technology D&I. The fundamental ethical issue facing TB technological D&I is a failure within and beyond the TB community (...) to stand in solidarity with persons with TB in addressing the complex sociopolitical contexts of technological D&I. The failure in solidarity relates to two further ethical challenges raised by respondents: skewed power dynamics that hinder D&I and uncertainties around weighing risks and benefits associated with new technologies. Respondents identified advocacy and participatory research practices as necessary to address such challenges and to motivate sustained collective action to accelerate toward TB elimination. We present the first empirical examination of bioethical accounts of solidarity in public and global health. Our study suggests that solidarity allows us better to understand and address the ethical challenges that arrest the D&I of new TB technologies. Solidarity lends credence to policies and practices that address the relational nature of illness and health through collective action. (shrink)

ObjectiveTo identify the ethical challenges associated with the development and implementation of new tuberculosis drugs and diagnostics.MethodsTwenty-three semi-structured qualitative interviews conducted between December 2015 and September 2016 with programme administrators, healthcare workers, advocates, policymakers, and funders based in the Americas, Europe, and Africa. Interviews were analysed using thematic analysis.ResultsDivergent interests and responsibilities, coupled with power imbalances, are a primary source of ethical challenges; the uncertain risk profiles of new drugs present an additional one. Although this challenge can be partially mitigated (...) through stringent pharmacovigilance, respondents highlighted that high-burden countries tend to lack the resources to facilitate safe implementation. Increased advocacy and community engagement are considered an ethical imperative for future TB development and implementation.ConclusionsThis project helps identify some of the ethical challenges of new TB technologies. It demonstrates that investigating ethical challenges through qualitative research is one way to apprehend the difficulty of implementing new TB technologies. Addressing this difficulty will require that those in positions of power reconsider their interests in relation to disempowered communities.Policy implicationsEfforts to build consensus regarding what values should underpin the global governance of TB research, prevention, and care are essential to facilitate the ethical implementation of new TB technologies. (shrink)

Schools have been the main context for physical activity and sedentary behavior interventions among adolescents, but there is inconsistent evidence on whether they also improve dimensions of the health−related quality of life. The aim of this study was to evaluate the effects of a school-based active lifestyle intervention on dimensions of HRQoL. A secondary aim was to verify whether sex, age, and HRQoL at baseline were moderators of the intervention effect. A cluster-randomized controlled trial was conducted at three control and (...) three intervention schools in Florianopolis, Brazil. All students from 7th to 9th grade were invited to participate. A school year intervention, designed primarily to increase PA and reduce SB, included strategies focused on teacher training on PA, SB, and nutrition, and availability of teaching materials related to these contents; environmental improvements ; and education strategies, with the availability of folders and posters regarding PA, SB, and nutrition. Participants and the research staffs were not blinded to group assignment, but a standardized evaluation protocol was applied at baseline and after the intervention using the KIDSCREEN−27 to assess HRQoL across five dimensions. Mixed linear models were performed to evaluate the effect of the Movimente intervention on the five HRQoL dimensions. Of the 921 students who answered the questionnaire at baseline, 300 and 434 completed the study in control and intervention groups, respectively. The results revealed no significant effects of the intervention on any HRQoL dimensions. A reduction of the school environment dimension was observed in both the control and intervention groups. Sensitivity analyses showed that students in the highest baseline tertiles of HRQoL in any dimension had a reduction in their respective scores from pre- to post-intervention in both school groups. In conclusion, our results demonstrated no intervention effect on HRQoL dimensions and those students with the highest levels of HRQoL at baseline on all dimensions reduced from pre to post-intervention.Clinical Trial RegistrationThe trial is registered at the Clinical Trial Registry. (shrink)

A elaboração deste artigo conjunto tem por base a continuidade de um plano editorial do Grupo Kinosophia junto a Revista Inquietude, articulada a um conjunto de aulas do Prof. Früchtl, ministradas em agosto de 2011 na Faculdade de Filosofia da UFG. Sua teoria sobre filosofia do cinema contribuiu para a formação do Grupo de Estudos Kinosophia, ao promover a discussão de suas ideias no exercício de tradução de suas aulas e textos, bem como da revisão da filmografia por ele indicada. (...) Os artigos são, portanto, resultados desta experiência contada em três etapas: 1. Modernidade, subjetividade, Hegel e o Western; 2. O romantismo, o agonístico e o filme de gângster; 3. O hibridismo, Nietzsche e a ficção científica. (shrink)

Our goal was to explore self‐care practices among men who have sex with men in the context of Mpox in Brazil. This study used qualitative research methods, including interviews and thematic analysis, to collect and analyze data from male participants across the Brazilian territory. The narratives unveil men's perspectives on self‐care, risk reduction, and health beliefs during the Mpox pandemic. Our findings highlight a multifaceted approach to self‐care among men, encompassing hygiene, physical contact management, mask usage, skin lesion vigilance, and (...) adherence to official guidelines. Men's attitudes toward sexual behaviors emphasize the importance of reducing sexual partners, practicing safe sex, and combating misinformation through accurate information dissemination. The development of these behaviors and self‐care practices can be facilitated by nurses guided by Dorothea Orem's Self‐Care Theory, supported by patient‐centered care, with strategies to address and confront the stigma associated with the disease and provide emotional support. Thus, the study underscores the pivotal role of self‐care in mitigating infection risks, especially in the context of emerging infectious diseases. It acknowledges the impact of socio‐cultural factors and healthcare policies on men's preventive measures. However, it also recognizes limitations, such as potential bias due to stigma concerns and a nonrepresentative sample. Ultimately, the research advocates for tailored education, promotion of gender equity, and healthcare empowerment to effectively manage health risks in such contexts. (shrink)

The distinction between propositional and doxastic justification has been of undisputed theoretical importance in a wide range of contemporary epistemological debates. Yet there are a host of intimately related issues that have rarely been discussed in connection with this distinction. For instance, the distinction not only applies to an individual’s beliefs, but also to group beliefs and to various other attitudes that both groups and individuals can take: credence, commitment, suspension, faith, and hope. Moreover, discussions of propositional and doxastic justification (...) have rarely focused on broader meta-epistemological issues, and yet meta-epistemological positions can have important implications for first-order views about this distinction. This volume addresses these and other issues by bringing together 16 essays that advance the state-of-the-art thinking on propositional and doxastic justification and explore how such thinking shapes and is shaped by a range of issues previously neglected in contemporary epistemology. (shrink)

This paper explores the notion of reciprocity in the context of active pulmonary and laryngeal tuberculosis treatment and related control policies and practices. We seek to do three things: First, we sketch the background to contemporary global TB care and suggest that poverty is a key feature when considering the treatment of TB patients. We use two examples from TB care to explore the role of reciprocity: isolation and the use of novel TB drugs. Second, we explore alternative means of (...) justifying the use of reciprocity through appeal to different moral and political theoretical traditions. We suggest that each theory can be used to provide reasons to take reciprocity seriously as an independent moral concept, despite any other differences. Third, we explore general meanings and uses of the concept of reciprocity, with the primary intention of demonstrating that it cannot be simply reduced to other more frequently invoked moral concepts such as beneficence or justice. We argue that reciprocity can function as a mid-level principle in public health, and generally, captures a core social obligation arising once an individual or group is burdened as a result of acting for the benefit of others. We conclude that while more needs to be explored in relation to the theoretical justification and application of reciprocity, sufficient arguments can be made for it to be taken more seriously as a key principle within public health ethics and bioethics more generally. (shrink)

Accelerated changes to the planet have created novel spaces to re-imagine the boundaries and foci of environmental health research. Climate change, mass species extinction, ocean acidification, biogeochemical disturbance, and other emergent environmental issues have precipitated new population health perspectives, including, but not limited to, one health, ecohealth, and planetary health. These perspectives, while nuanced, all attempt to reconcile broad global challenges with localized health impacts by attending to the reciprocal relationships between the health of ecosystems, animals, and humans. While such (...) innovation is to be encouraged, we argue that a more comprehensive engagement with the ethics of these emerging fields of inquiry will add value in terms of the significance and impact of associated interventions. In this contribution, we highlight how the concept of spatial and temporal scale can be usefully deployed to shed light on a variety of ethical issues common to emerging environmental health perspectives, and that the potential of scalar analysis implicit to van Potter’s conceptualization of bioethics has yet to be fully appreciated. Specifically, we identify how scale interacts with key ethical issues that require consideration and clarification by one health, ecohealth, and planetary health researchers and practitioners to enhance the effectiveness of research and practice, including justice and governance. (shrink)

In this note we show that the Axiom of Countable Choice is equivalent to two statements from the theory of pseudometric spaces: the first of them is a well-known characterization of uniform continuity for functions between metric spaces, and the second declares that sequentially compact pseudometric spaces are \—meaning that all real valued, continuous functions defined on these spaces are necessarily uniformly continuous.

The method of morphisms is a well-known application of Dialectica categories to set theory. In a previous work, Valeria de Paiva and the author have asked how much of the Axiom of Choice is needed in order to carry out the referred applications of such method. In this paper, we show that, when considered in their full generality, those applications of Dialectica categories give rise to equivalents of either the Axiom of Choice or Partition Principle —which is a consequence of (...) $\textbf{AC}$ whose precise status of its relationship with$\textbf{AC}$ itself is an open problem for more than a hundred years. (shrink)

This book symposium comprises a précis of Nuno Venturinha’s Description of Situations: An Essay in Contextualist Epistemology together with four critical commentaries on different aspects of the book by Marcelo Carvalho, João Vergílio Gallerani Cuter, Marcos Silva and Darlei Dall’Agnol, and the author’s replies.

The concept of “predatory” publishing, despite many studies of the phenomenon, continues to be unclear. This paper visualizes this topic through an epistemological perspective, claiming that these limitations emerge from an impressionism of idealization, the entrapment of cause and effect induced by a journalology-based perspective, and entrenched fantasized extraction, imagination and divination of what constitutes the truth, in essence, a path never followed by an _epistēmōn_. Reality, proof, verification, recorded observations and their interpretations have been pivoted to fit the theoretical (...) flavor of the day, an entity one day being predatory, the next not. Perhaps ephemeral judgements of predatory have been built on boundless disregard for common sense. Yet, these have led to scientists’ apotheosis, almost oblivious of the intangibility of “valid”, or the infinitesimal continuum of “predatory”. Perhaps their fault-ridden authoritarian argumentative disabilities is at fault. (shrink)

Computer vision research involving street and road detection methods usually focuses on driving assistance and autonomous vehicle systems. In this context, street segmentation occurs in real-time, based on images centered on the street. This work, on the other hand, uses street segmentation for urban planning research to classify pavement types of a city or region, which is particularly important for developing countries. For this application, it is needed a dataset with images from various locations for each street. These images are (...) not necessarily centered on the street and include challenges that are not common in street segmentation datasets, such as mixed pavement types and the presence of faults and holes on the street. We implemented a multi-class version of a state-of-the-art segmentation algorithm and adapted it to perform street pavement classification, handling navigation along streets and angle variation to increase the accuracy of the classification. A data augmentation approach is also proposed to use preliminary results from the test instances as new ground truth and increase the amount of training data. A dataset with more than 300,000 images from 773 streets from a Brazilian city was built. Our approach achieved a precision of 0.93, showing the feasibility of the proposed application. (shrink)

Ion channels are transport proteins present in the lipid bilayers of biological membranes. They are involved in many physiological processes, such as the generation of nerve impulses, hormonal secretion, and heartbeat. Conformational changes in the ion channel-forming protein allow the opening or closing of pores to control the ionic flux through the cell membranes. The opening and closing of the ion channel have been classically treated as a random kinetic process, known as a Markov process. Here the time the channel (...) remains in a given state is assumed to be independent of the condition it had in the previous state. More recently, however, several studies have shown that this process is not random but a deterministic one, where both the open and closed dwell-times and the ionic current flowing through the channel are history-dependent. This property is called long memory or long-range correlation. However, there is still much controversy regarding how this memory originates, which region of the channel is responsible for this property, and which models could best reproduce the memory effect. In this article, we provide a review of what is, where it is, its possible origin, and the mathematical methods used to analyze the long-term memory present in the kinetic process of ion channels. (shrink)

O significado hermenêutico da experiência da obra de arte -- A pertinência hermenêutica da ética aristotélica -- Para uma hermenêutica do cuidado: do mistério da saúde de H.-G. Gadamer aos novos fins da medicina -- A hermenêutica como pensamento de fronteira -- Hermenêutica filosófica e mobilidade cultural: conceitos fundamentais -- A Europa e o destino das ciências humanas -- Para uma hermenêutica da memória -- Tradição, linguagem e jogo -- A missão hermenêutica da filosofia -- Problemas da hermenêutica prática -- (...) O reconhecimento como núcleo da aplicação: de Gadamer a Ricoeur -- A linguagem da polis -- Retórica e hermenêutica. (shrink)

How we come to know the external world has intrigued thinkers throughout the history of philosophy. Medieval philosophers understood that a theory of perception requires an account of the categorization of sensory information: to perceive things as being dangerous or beneficial and even as being individuals that belong to certain kinds (e.g., 'this is a dog'). A key question is whether this requires the intervention of rational cognitive capacities, cooperating with sensory ones in normal instances of perception. The contributions to (...) this volume investigate how thinkers from the thirteenth and fourteenth centuries answer this and other related questions about human perception. Contributors are Fabrizio Amerini, Joel Biard, Veronique Decaix, Christian Kny, Lydia Schumacher, Josee Filipe Silva, and Jorg Alejandro Tellkamp. (shrink)

Progressive supranuclear palsy is a movement disorder with prominent tau neuropathology. Brain diseases with abnormal tau deposits are called tauopathies, the most common of which is Alzheimer's disease. Environmental causes of tauopathies include repetitive head trauma associated with some sports. To identify common genetic variation contributing to risk for tauopathies, we carried out a genome-wide association study of 1,114 individuals with PSP and 3,247 controls followed by a second stage in which we genotyped 1,051 cases and 3,560 controls for the (...) stage 1 SNPs that yielded P ≤ 10-3. We found significant previously unidentified signals associated with PSP risk at STX6, EIF2AK3 and MOBP. We confirmed two independent variants in MAPT affecting risk for PSP, one of which influences MAPT brain expression. The genes implicated encode proteins for vesicle-membrane fusion at the Golgi-endosomal interface, for the endoplasmic reticulum unfolded protein response and for a myelin structural component. © 2011 Nature America, Inc. All rights reserved. (shrink)

Mucopolysaccharidosis type I (MPS I) is a rare lysosomal storage disorder treated with bone marrow transplantation or enzyme replacement therapy with laronidase, a high-cost orphan drug. Laronidase was approved by the US Food and Drug Administration and the European Medicines Agency in 2003 and by the Brazilian National Health Surveillance Agency in 2005. Many Brazilian MPS I patients have been receiving laronidase despite the absence of a governmental policy regulating access to the drug. Epidemiological and treatment data concerning MPS I (...) are scarce. This study aims to present a demographic profile of Brazilian patients with MPS I, describe the routes of access to laronidase in Brazil, and discuss associated ethical issues relating to public funding of orphan drugs. (shrink)

The amygdala is a key brain area regulating responses to stress and emotional stimuli, so improving our understanding of how it is regulated could offer novel strategies for treating disturbances in emotion regulation. As we review here, a growing body of evidence indicates that the gut microbiota may contribute to a range of amygdala-dependent brain functions from pain sensitivity to social behavior, emotion regulation, and therefore, psychiatric health. In addition, it appears that the microbiota is necessary for normal development of (...) the amygdala at both the structural and functional levels. While further investigations are needed to elucidate the exact mechanisms of microbiota-to-amygdala communication, ultimately, this work raises the intriguing possibility that the gut microbiota may become a viable treatment target in disorders associated with amygdala dysregulation, including visceral pain, post-traumatic stress disorder, and beyond. Also see the video abstract here: https://youtu.be/O5gvxVJjX18 The amygdala plays a central role in regulating many aspects of behavior in rodents and humans, from pain responding to social interaction and psychiatric function. Accumulating evidence suggests microbiota-to-amygdala communication along the gut-brain axis is a key modulator of these amygdala-dependent behaviors, with critical implications for health and disease. (shrink)

IntroductionTranscranial magnetic stimulation is a consolidated procedure for the treatment of depression, with several meta-analyses demonstrating its efficacy. Theta-burst stimulation is a modification of TMS with similar efficacy and shorter session duration. The geriatric population has many comorbidities and a high prevalence of depression, but few clinical trials are conducted specifically for this age group. TBS could be an option in this population, offering the advantages of few side effects and no pharmacological interactions. Therefore, our aim is to investigate the (...) efficacy of TBS in geriatric depression.Clinical trial registration[https://clinicaltrials.gov/ct2/], identifier [NCT04842929]. (shrink)

This study aimed to understand the expressions of fear in the journeys of health professionals who worked in the confrontation of coronavirus disease 2019 (COVID‐19), in the city of Manaus, in the Brazilian Western Amazon. This is an exploratory qualitative study that adopts interpretive description as a method to generate informed knowledge responsive to the needs of the practice. We included 56 participants, comprising 23 health managers and 33 health workers (middle and higher level) of different professional categories. The results (...) revealed three circles of experience: (1) knowledge and professional experience in dealing with the disease (unknown–known–experienced); (2) the growing proximity to death and loss (predicted–witnessed–suffered); and (3) the involvement and proximity to whatever affects the individual, their emotions, and personal transformations in the face of the threat (the collective, the neighbor, and oneself). Our results suggest that health professionals who worked during the COVID‐19 pandemic in Manaus experienced insecurity, dread, and fear, illustrating the complexity of developing their activities in the front line of care and management during the different phases of the pandemic. A contribution of the study is precisely that of capturing this complexity, which suggests the impossibility of analyzing fear only in its simple manifestation, or in each circle of experience. (shrink)

Ontologies have been successfully used to assign semantics in the Semantic Web context, to support integration of data from different systems or different sources, and to enable reasoning. However, building ontologies is not a trivial task. Ontology reuse can help in this matter. The search and selection of ontologies to be reused should consider the alignment between their scope and the scope of the ontology being developed. In this paper, we discuss how goal modeling can be helpful in this context (...) and we present GO-FOR, a framework in which goals are the central elements to promote ontology reuse. GO-FOR comprises a conceptual architecture, a goal-oriented ontology development process and a supporting tool. In GO-FOR we introduce Goal-Oriented Ontology Patterns as a new type of pattern to be applied to develop ontologies in a goal-oriented approach. Results of the use of GO-FOR to build an ontology used to integrate patient examination data are also shown in this paper. (shrink)

Fake news has been the focus of debate, especially since the election of Donald Trump (2016), and remains a topic of concern in democratic countries worldwide, given (a) their threat to democratic systems and (b) the difficulty in detecting them. Despite the deployment of sophisticated computational systems to identify fake news, as well as the streamlining of fact-checking methods, appropriate fake news detection mechanisms have not yet been found. In fact, technological approaches are likely to be inefficient, given that fake (...) news are based mostly on partisanship and identity politics, and not necessarily on outright deception. However, as disinformation is inherently expressed linguistically, this is a privileged room for forensic linguistic analysis. This article builds upon a forensic linguistic analysis of fake news pieces published in English and in Portuguese, which were collected since 2019 from acknowledged fake news outlets. The preliminary empirical analysis reveals that fake news pieces employ particular linguistic features, e.g. at the levels of typography, orthography and spelling, and morphosyntax. The systematic identification of these features, which will allow mapping linguistic resources and patterns used in those contexts, contributes to scholarship, not only by enabling a streamlined development of computational detection systems, but more importantly by permitting the forensic linguistics expert to assist criminal investigations and give evidence in court. (shrink)

Background There are intense discussions about the ethical and societal implications of biomedical engineering, but little data to suggest how scientists think about the ethics of their work. The aim of this study is to describe how scientists frame the ethics of their research, with a focus on the field of molecular systems engineering.Methods Semi-structured qualitative interviews were conducted during 2021–2022, as part of a larger study. This analysis includes a broad question about how participants view ethics as related to (...) their work, with follow up probes about the topics they consider most important. Interviews were transcribed, inductively coded by two researchers to consensus, and analyzed thematically.Results Twenty-four scientists participated in the study. Interviewees hold positions as professors, principal investigators, and senior staff researchers in universities or research institutes in the United States and Europe. Among those scientists who reported reflecting on ethical considerations in their work, many equated ethics with research ethics topics (e.g., safety, replicability), or with regulation and guidelines. Participants expressed the view that ethical issues are primarily relevant for clinical trials of bioengineered products, or for those working with animal or human subjects. Scientists described their research as “too early” or “not examining anything living” with regard to ethical reflection. Finally, many felt that ethics is seen as territory for experts and therefore beyond scientists’ competencies.Conclusions Molecular systems engineering scientists currently focus on regulatory aspects as the framework for their ethical analyses. They describe using a framework to define when life arises, as a means to determine when further ethical engagement is warranted. Further research is needed to investigate how scientists relate to the ethics of their scientific work, and build consensus around concepts of life, autonomous behavior, and physiological relevance of bioengineered systems. (shrink)