BackgroundIn the Canadian Alliance for Healthy Hearts and Minds (CAHHM) cohort, participants underwent magnetic resonance imaging (MRI) of the brain, heart, and abdomen, that generated incidental findings (IFs). The approach to managing these unexpected results remain a complex issue. Our objectives were to describe the CAHHM policy for the management of IFs, to understand the impact of disclosing IFs to healthy research participants, and to reflect on the ethical obligations of researchers in future MRI studies.MethodsBetween 2013 and 2019, 8252 participants (...) (mean age 58 ± 9 years, 54% women) were recruited with a follow-up questionnaire administered to 909 participants (40% response rate) at 1-year. The CAHHM policy followed a restricted approach, whereby routine feedback on IFs was not provided. Only IFs of severe structural abnormalities were reported.ResultsSevere structural abnormalities occurred in 8.3% (95% confidence interval 7.7–8.9%) of participants, with the highest proportions found in the brain (4.2%) and abdomen (3.1%). The majority of participants (97%) informed of an IF reported no change in quality of life, with 3% of participants reporting that the knowledge of an IF negatively impacted their quality of life. Furthermore, 50% reported increased stress in learning about an IF, and in 95%, the discovery of an IF did not adversely impact his/her life insurance policy. Most participants (90%) would enrol in the study again and perceived the MRI scan to be beneficial, regardless of whether they were informed of IFs. While the implications of a restricted approach to IF management was perceived to be mostly positive, a degree of diagnostic misconception was present amongst participants, indicating the importance of a more thorough consent process to support participant autonomy.ConclusionThe management of IFs from research MRI scans remain a challenging issue, as participants may experience stress and a reduced quality of life when IFs are disclosed. The restricted approach to IF management in CAHHM demonstrated a fair fulfillment of the overarching ethical principles of respect for autonomy, concern for wellbeing, and justice. The approach outlined in the CAHHM policy may serve as a framework for future research studies.Clinical trial registrationhttps://clinicaltrials.gov/ct2/show/nct02220582. (shrink)

Cancer and its treatment pose challenges that affect not only patients but also their significant others, including intimate partners. Accumulating evidence suggests that couples’ ability to communicate effectively plays a major role in the psychological adjustment of both individuals and the quality of their relationship. Two key conceptual models have been proposed to account for how couple communication impacts psychological and relationship adjustment: the social-cognitive processing (SCP) model and the relationship intimacy (RI) model. These models posit different mechanisms and outcomes, (...) and thus have different implications for intervention. The purpose of this project is to test and compare the utility of these models using comprehensive and methodologically rigorous methods. Aims are: (1) to examine the overall fit of the SCP and RI models in explaining patient and partner psychological and relationship adjustment as they occur on a day-to-day basis and over the course of 1 year; (2) to examine the fit of the models for different subgroups (males vs. females, and patients vs. partners); and (3) to examine the utility of various methods of assessing communication by examining the degree to which baseline indices from different measurement strategies predict self-reported adjustment at 1-year follow up. The study employs a longitudinal, multi-method approach to examining communication processes including: standard self-report questionnaires assessing process and outcome variables collected quarterly over the course of 1 year; smartphone-based ecological momentary assessments to sample participant reports in real time; and laboratory-based couple conversations from which we derive observational measures of communicative behavior and affective expression, as well as vocal indices of emotional arousal. Participants are patients with stage II-IV breast, colon, rectal, or lung cancer and their spouses/partners, recruited from two NCI-designated comprehensive cancer centers. Results will be published in scientific journals, presented at scientific conferences, and conveyed to a larger audience through infographics and social media outlets. Findings will inform theory, measurement, and the design and implementation of efficacious interventions aimed at optimizing both patient and partner well-being. (shrink)

What is "critical thinking"? -- What is "law"? : thinking critically about legal perspectives -- Putting critical thinking into legal practice -- Thinking critically about assessments -- Thinking critically in the workplace and beyond.

There appears to be a wide measure of agreement, both amongst biologists and others, that Darwin's theory of evolution marks a major breakthrough in the science of biology; Darwin has even been called ‘Biology's Newton’, the highest term of praise that could be bestowed on a scientist. A. G. N. Flew, considering the matter from a philosophical point of view, says: ‘Yet one of the most important of all scientific theories is that developed by Darwin in his Origin of Species (...) . Covering the entire range of biological phenomena its scope is enormous. While if any scientific theory is interesting philosophically this one is.’ In spite of the testimony of both biologists and philosophers of science to the importance of the theory, it does not appear to play anything like the same role in biology as does Newton's theory in physics. For modern physics would be. (shrink)

In this paper we conduct an analysis of the critical narratives of Stardew Valley and compare them to other relevant videogames in order to develop new possibilities for an ecological critique of capitalist extractive econo­mies. Critical narratives of this game are aimed primarily at the alienating conditions of labour and deeply devastating modes of production under capitalism that impact and severely damage the environment. Analysing these narratives, we superimpose the immediate messages of the game with the procedural rhetoric and material (...) conditions of their existence. Over the course of our analysis, we highlight a material-narrative disso­nance which, in the case of Stardew Valley, fails to function as a commu­nicative strategy of the game and remains its mere external contradiction. Although the game’s critical narrative may seem overly utopian and its political imaginary a bit underdeveloped, the game elaborates on concrete ways to tackle the alienation of labour and resolve the ecological crisis. In addition to this, the paper covers the history of the interplay between the video game industry and the field of global ecological crisis research. We compare the attempts to raise awareness of the videogames’ own material­ity that preceded Stardew Valley. We conclude that Stardew Valley utilises the language of sustainable co-existence and wasteless local production, expanding this logic both to the sphere of labour and the spectrum of en­vironmental problems. In the case of ecological critique, some gameplay decisions in Stardew Valley enable us to come up with new strategies aimed at creating critical narratives about the environment in videogames. Thus supplementing Stardew Valley’s findings with critical tropes derived from other games (mainly, Rain World), we were able to gather a set of theoretical instruments that could facilitate the creation of games about ecosystems. Following Donna Haraway’s emphasis on the crucial role of narrative fram­ing (“it matters which stories tell stories”), we highlight new opportunities for the entire medium of videogames. (shrink)

When this work was first published in 1960, it immediately filled a void in Kantian scholarship. It was the first study entirely devoted to Kant's _Critique of Practical Reason_ and by far the most substantial commentary on it ever written. This landmark in Western philosophical literature remains an indispensable aid to a complete understanding of Kant's philosophy for students and scholars alike. This _Critique_ is the only writing in which Kant weaves his thoughts on practical reason into a unified argument. (...) Lewis White Beck offers a classic examination of this argument and expertly places it in the context of Kant's philosophy and of the moral philosophy of the eighteenth century. (shrink)

New arguments against Bayesian regularity and an otherwise plausible domination principle are offered on the basis of rotational symmetry. The arguments against Bayesian regularity work in very general settings.

This paper examines the perceived ethical values of Malaysian managers. It is based on the opinions of 15 hypothetical ethical/unethical business situations from the 81 managers who agreed to participate in the survey. The findings of this study showed that these Malaysian managers have high ethical values. However 53% of the respondents believed that the ethical standards of today are lower than that of 15 years ago. Apparently, this is related to the existence of many unethical business practices prevalent in (...) the modern business world. The behavior of one's immediate superior is the most important factor in influencing managers to commit unethical practices. The results also indicate only a slight variation among the managers in terms of perceived ethical values by virtue of job position, job specialization, type of business activity or the size of the business organization. (shrink)

A law, say, prohibits homosexual conduct or punishes the prostitute for plying her trade. According to some it is a bad law, according to others a necessary one. Those who argue that it is a bad law do so on a variety of grounds—that it is sheer folly to try to change human nature by law, that such legislation can only be effective at the price of the right to privacy, that the punishment of acts arising from compelling desires is (...) cruel and excessive, that the law has no business meddling in what people do to others with their consent. Those who argue that it is a necessary law do so on one ground, that the act in question is immoral, and that what is wrong must be punished, lest the law itself fall into disrepute by failing to carry out a consistent campaign against wrong-doing. (shrink)

Trope theory is a leading metaphysical theory in analytic ontology. One of its classic statements is found in the work of Donald C. Williams who argued that tropes qua abstract particulars are the very alphabet of being. The concept of an abstract particular has been repeatedly attacked in the literature. Opponents and proponents of trope theory alike have levelled their criticisms at the abstractness of tropes and the associated act of abstraction. In this paper I defend the concept of a (...) trope qua abstract particular by rejecting arguments that purport to show that tropes should not be understood as abstract and by arguing that the abstractness of tropes plays an indispensable role in one of our more promising trope-theoretic analyses of universals and of concrete objects. (shrink)

On the life of Mādhava, d. 1386, exponent of Dvaita philosophy.

Appearing in the “Cairo Declaration on Human Rights in Islam” as an undefined referent for the limits on freedom of expression in Islam, Shariah is still to be chased as an indefinable referent which restricts freedom of the expression in the Islamic Republic of Iran. Iran’s Press Law as well as Constitution unveil Shariah’s referent to be a person: the Jurist-Ruler around whom a cult of personality is legalized in terms of “Imamate” and around whom all the limits on freedom (...) of expression revolve. Interpretation of Shariah is not a solution but part of the problem in Iran. Such problem can be dealt in terms of three modes of self-expression which were invented by the Iranian Reformists to avoid self-censorship. The notion of master-signifier can be the key to unraveling the problem of self-referentiality in freedom of expression and its Reformist solution in Iran’s legal system. (shrink)

In this paper I want to examine the notion of desert, which seems to have been neglected by contemporary philosophers. Apartfrom its interest in its own right, it is important to be clear about the meaning of the word if there is to be any understanding of the idea of punishment. And that we are confused over the whole issue of punishment is obvious both from the remarks of professional philosophers and from the comments of the ‘man in the street’. (...) Because of this confusion, the discussion of any actual punishment seems to take place between two parties who never get to grips with the arguments of the other, as in the whole debate over the death penalty. To one set of people, it is obvious that the retention of hanging depends to a large extent on the question of its effectiveness in deterring murderers; to another it is equally obvious that the murderer ‘deserves’ to hang, and that there is no more to be said about the matter. Capital punishment is not a good starting-point for a discussion of punishment in general, for death is clearly unique among penalties; in addition, the topic gives rise inevitably to much sentimentality and resulting muddle-headedness. (shrink)

Consent transforms an otherwise illegitimate act into a legitimate one. To be valid, however, it must be adequately informed. The legal requirement is vague and provides little assistance in predicting when it will be satisfied. This is particularly so when a patient consents to a procedure and the physician subsequently varies one of the components of that procedure. Using three legal judgments and one General Medical Council decision as a springboard, I have explored the concept of a medical procedure within (...) the context of consent and developed a theoretical model to elucidate a more predictable and consistent informational requirement. (shrink)

Few people would care to deny, whether within India or without, that Buddha is the greatest Indian of all times. Whether from the standpoint of the purity of his life, the daring originality and novelty of his thought, or the extent of his influence in shaping the culture of the world, it would be hard to beat the record of Buddha. Even making every allowance for the common idea that no man is a prophet in his own land, it is (...) difficult to believe that for the last thousand years Buddha has been practically an exile from the land of his birth. It is nothing short of an irony of history, and nothing short of a tragedy for India, that the great unifying force that he represented in his time and does represent even to-day has been allowed to run waste and the great moral stamina that he sought to supply failed in its historic mission. (shrink)

The concept of instantiation is realized differently across a variety of metaphysical theories. A certain realization of the concept in a given theory depends on what roles are specified and associated with the concept and its corresponding term as well as what entities are suited to fill those roles. In this paper, the classic realization of the concept of instantiation in a one-category ontology of abstract particulars or tropes is articulated in a novel way and defended against unaddressed objections.

On the example of the online game Akinator, the basic principles on which programs of this type are built are considered. Effective technics have been proposed by which artificial intelligence systems can build logical inferences that allow to identify an unknown subject from its description. To confirm the considered hypotheses, the terminological analysis of definition of the program "Akinator" offered by the author is carried out. Starting from the assumptions given by the author's definition, the article complements their definitions presented (...) by other researchers and analyzes their constituent theses. Finally, some proposals are made for the next steps in improving the program. The Akinator program, at one time, became one of the most famous online games using artificial intelligence. And although this was not directly stated, it was clear to the experts in the field of artificial intelligence that the program uses the techniques of expert systems and is built on inference rules. At the moment, expert systems have lost their positions in comparison with the direction of neural networks in the field of artificial intelligence, however, in the case considered in the article, we are talking about techniques using both directions – hybrid systems. Games for filling semantics interact with the user, expanding their semantic base and use certain strategies to achieve the best result. The playful form of such semantics filling programs is beneficial for researchers by involving a large number of players. The article examines the techniques used by the Akinator program, and also suggests possible modifications to it in the future. This study, first of all, focuses on how the knowledge base of the Akinator program is built, it consists of incomplete sets, which can be filled and adjusted as a result of further iterations of the program launches. It is important to note our assumption that the order of questions used by the program during the game plays a key role, because it determines its strategy. It was identified that the program is guided by the principles of nonmonotonic logic – the assumptions constructed by the program are not final and can be rejected by it during the game. The three main approaches to acquisite semantics proposed by Jakub Šimko and Mária Bieliková are considered, namely, expert work, crowdsourcing and machine learning. Paying attention to machine learning, the Akinator program using machine learning to build an effective strategy in the game presents a class of hybrid systems that combine the principles of two main areas in artificial intelligence programs – expert systems and neural networks. (shrink)