Over the past decades, anti-cancer treatments have evolved rapidly from cytotoxic chemotherapies to targeted therapies including oral targeted medications and injectable immunooncology and cell therapies. New anti-cancer medications come to markets at increasingly high prices, and health insurance coverage is crucial for patient access to these therapies. State laws are intended to facilitate insurance coverage of anti-cancer therapies.Using Massachusetts as a case study, we identified five current cancer coverage state laws and interviewed experts on their perceptions of the relevance of (...) the laws and how well they meet the current needs of cancer care given rapid changes in therapies. Interviewees emphasized that cancer therapies, as compared to many other therapeutic areas, are unique because insurance legislation targets their coverage. They identified the oral chemotherapy parity law as contributing to increasing treatment costs in commercial insurance. For commercial insurers, coverage mandates combined with the realities of new cancer medications — including high prices and often limited evidence of efficacy at approval — compound a difficult situation. Respondents recommended policy approaches to address this challenging coverage environment, including the implementation of closed formularies, the use of cost-effectiveness studies to guide coverage decisions, and the application of value-based pricing concepts. Given the evolution of cancer therapeutics, it may be time to evaluate the benefits and challenges of cancer coverage mandates. (shrink)

The proposed volumes are aimed at a multidisciplinary audience and seek to fill the gap between law, semiotics and visuality providing a comprehensive theoretical and analytical overview of legal visual semiotics. They seek to promote an interdisciplinary debate from law, semiotics and visuality bringing together the cumulative research traditions of these related areas as a prelude to identifying fertile avenues for research going forward. Advance Praise for Law, Culture and Visual Studies This diverse and exhilarating collection of essays explores the (...) many facets both historical and contemporary of visual culture in the law. It opens a window onto the substantive, jurisdictional, disciplinary and methodological diversity of current research. It is a cornucopia of materials that will enliven legal studies for those new to the field as well as for established scholars. It is a 'must read' that will leave you wondering about the validity of the long held obsession that reduces the law and legal studies to little more than a preoccupation with the word. Leslie J Moran Professor of Law, Birkbeck College, University of London Law, Culture and Visual Studies is a treasure trove of insights on the entwined roles of legality and visuality. From multiple interdisciplinary perspectives by scholars from around the world, these pieces reflect the fullness and complexities of our visual encounters with law and culture. From pictures to places to postage stamps, from forensics to film to folklore, this anthology is an exciting journey through the fertile field of law and visual culture as well as a testament that the field has come of age. Naomi Mezey, Professor of Law, Georgetown University Law Center, Washington, D.C., USA This highly interdisciplinary reference work brings together diverse fields including cultural studies, communication theory, rhetoric, law and film studies, legal and social history, visual and legal theory, in order to document the various historical, cultural, representational and theoretical links that bind together law and the visual. This book offers a breath-taking range of resources from both well-established and newer scholars who together cover the field of law's representation in, interrogation of, and dialogue with forms of visual rhetoric, practice, and discourse. Taken together this scholarship presents state of the art research into an important and developing dimension of contemporary legal and cultural inquiry. Above all, Law Culture and Visual Studies lays the groundwork for rethinking the nature of law in our densely visual culture: How are legal meanings produced, encoded, distributed, and decoded? What critical and hermeneutic skills, new or old, familiar or unfamiliar, will be needed? Topical, diverse, and enlivening, Law Culture and Visual Studies is a vital research tool and an urgent invitation to further critical thinking in the areas so well laid out in this collection. Desmond Manderson, Future Fellow, ANU College of Law / Research School of Humanities and the Arts, Australian National University, Australia. (shrink)

In this anthology of new and classic articles, fifteen noted feminist philosophers explore contemporary ethical issues that uniquely affect the lives of women. These issues in applied ethics include autonomy, responsibility, sexual harassment, women in the military, new technologies for reproduction, surrogate motherhood, pornography, abortion, nonfeminist women and others. Whether generated by old social standards or intensified by recent technology, these dilemmas all pose persistent, 'nagging,' questions that cry out for answers.

The high prevalence of cardiovascular diseases demands a reliable and sensitive risk assessment technique. In order to develop a fast and label-free immunosensor for C-reactive protein, a risk factor for this condition, anti-CRP antibodies were physically adsorbed to the hydrogen -terminated surface of nanocrystalline diamond. An Enzyme-Linked ImmunoSorbent Assay reference technique showed that this was a suitable substrate for antibody-antigen recognition reactions. Electrochemical Impedance Spectroscopy was used to electronically detect CRP recognition. The specificity of the immunosensor was demonstrated by incubation (...) with CRP and plasminogen as reference molecule. A different impedance behavior was observed in real-time after CRP addition as compared to plasminogen addition: the impedance increased only during CRP incubation. Fitting the data showed that this corresponded with a decrease in capacitance of the molecular layer due to its increased thickness by specific CRP recognition. Sensitivity experiments in real-time showed a clear discrimination between 1 μM, 100 nM, and 10 nM of CRP after 10 min at 100 Hz. Since, 10 nM of CRP was still clearly distinguishable from buffer solution, our CRP-directed immunosensor prototype reaches a sensitivity that is within the physiologically relevant concentration range of this biomarker in healthy controls and CVD patients. Moreover, this prototype displayed real-time discriminating power between spiked and unspiked serum, and thus also shows its applicability in this biological matrix. © 2011 Elsevier B.V. All rights reserved. (shrink)

BackgroundPrenatal and early postnatal choline supplementation reduces cognitive and behavioral deficits in animal models of Fetal Alcohol Spectrum Disorder. In a previously published 9-month clinical trial of choline supplementation in children with FASD, we reported that postnatal choline was associated with improved performance on a hippocampal-dependent recognition memory task. The current paper describes the neurophysiological correlates of that memory performance for trial completers.MethodsChildren with FASD who were enrolled in a clinical trial of choline supplementation were followed for 9 months. Delayed (...) recall on a 9-step elicited imitation task served as the behavioral measure of recognition memory. Neurophysiological correlates of memory were assessed via event-related potentials.ResultsDelayed recall on EI was correlated with two ERP components commonly associated with recognition memory in young children: middle latency negative component and positive slow wave. No significant ERP differences were observed between the choline and placebo groups at the conclusion of the trial.ConclusionAlthough the small sample size limits the ability to draw clear conclusions about the treatment effect of choline on ERP, the results suggest a relationship between memory performance and underlying neurophysiological status in FASD. This trial was registered.1. (shrink)

Earlier studies have shown that musically trained individuals may have a benefit in adverse listening situations when compared to non-musicians, especially in speech-on-speech perception. However, the literature provides mostly conflicting results. In the current study, by employing different measures of spoken language processing, we aimed to test whether we could capture potential differences between musicians and non-musicians in speech-on-speech processing. We used an offline measure of speech perception, which reveals a post-task response, and online measures of real time spoken language (...) processing: gaze-tracking and pupillometry. We used stimuli of comparable complexity across both paradigms and tested the same groups of participants. In the sentence recall task, musicians recalled more words correctly than non-musicians. In the eye-tracking experiment, both groups showed reduced fixations to the target and competitor words’ images as the level of speech maskers increased. The time course of gaze fixations to the competitor did not differ between groups in the speech-in-quiet condition, while the time course dynamics did differ between groups as the two-talker masker was added to the target signal. As the level of two-talker masker increased, musicians showed reduced lexical competition as indicated by the gaze fixations to the competitor. The pupil dilation data showed differences mainly in one target-to-masker ratio. This does not allow to draw conclusions regarding potential differences in the use of cognitive resources between groups. Overall, the eye-tracking measure enabled us to observe that musicians may be using a different strategy than non-musicians to attain spoken word recognition as the noise level increased. However, further investigation with more fine-grained alignment between the processes captured by online and offline measures is necessary to establish whether musicians differ due to better cognitive control or sound processing. (shrink)

The Federal Trade Commission has an important role to play in the governmental oversight of mobile health apps, ensuring consumer protections from unfair and deceptive trade practices and curtailing anti-competitive methods. The FTC’s consumer protection structure and authority is outlined before reviewing the recent FTC enforcement activities taken on behalf of consumers and against developers of mhealth apps. The article concludes with identification of some challenges for the FTC and modest recommendations for strengthening the consumer protections it provides.

The major stakeholder classes in education have three distinct ways by which they judge the quality of knowledge claims. At times this can cause considerable distraction or mis-communication among stakeholders.

This edited collection discusses phenomenological critiques of formalism and their relevance to the problem of responsibility and the life-world. The authors deal with themes of formalisation of knowledge in connection to the life-world, the natural world, the history of science and our responsibility for both our epistemic claims and the world in which we live. Readers will discover critiques of formalisation, the life-world and responsibility, and a collation and comparison of Patočka's and Husserl's work on these themes. Considerable literature on (...) Husserl is presented here and the two themes of epistemic responsibility and the life-world are discussed together. This work specifically emphasises the interrelatedness of these existential aspects of his work - self-responsibility and the crisis - as not only epistemological, but also related to human life. This volume also introduces Jan Patočka to English-speaking readers as a phenomenologist in his own right. Patočka shows us, in particular, the significance of the modern abyss between our thinking and the world. Readers will discover that this abyss is of concern for our everyday experience because it leads to a rupture in our understanding of the world: between the world of our living and its scientific construct. We see that Patočka continually emphasised the relevance of Husserl's work to existential questions relating to human responsibility and the life-world, which he admits is left largely implicit in Husserl's work. This edited collection will spark discussion on the question of responsibility against the backdrop of formalised knowledge which is increasingly inaccessible to human understanding. Despite the complexity of some of the analysed ideas, the authors discuss these themes in a clear and readable way. This work is scholarly, exact in its discussion and authoritative in its reading, but at the same time accessible to anyone motivated to understand these debates. (shrink)

BackgroundFreezing of gait is a disabling burden for Parkinson’s disease patients with poor response to conventional therapies. Combined deep brain stimulation of the subthalamic nucleus and substantia nigra moved into focus as a potential therapeutic option to treat the parkinsonian gait disorder and refractory FoG. The mechanisms of action of DBS within the cortical-subcortical-basal ganglia network on gait, particularly at the cortical level, remain unclear.MethodsTwelve patients with idiopathic PD and chronically-implanted DBS electrodes were assessed on their regular dopaminergic medication in (...) a standardized stepping in place paradigm. Patients executed the task with DBS switched off, conventional STN DBS and combined STN+SN DBS and were compared to healthy matched controls. Simultaneous high-density EEG and kinematic measurements were recorded during resting-state, effective stepping, and freezing episodes.ResultsClinically, STN+SN DBS was superior to conventional STN DBS in improving temporal stepping variability of the more affected leg. During resting-state and effective stepping, the cortical activity of PD patients in STIM OFF was characterized by excessive over-synchronization in the theta, alpha, and high-beta band compared to healthy controls. Both active DBS settings similarly decreased resting-state alpha power and reduced pathologically enhanced high-beta activity during resting-state and effective stepping compared to STIM OFF. Freezing episodes during STN DBS and STN+SN DBS showed spectrally and spatially distinct cortical activity patterns when compared to effective stepping. During STN DBS, FoG was associated with an increase in cortical alpha and low-beta activity over central cortical areas, while with STN+SN DBS, an increase in high-beta was prominent over more frontal areas.ConclusionsSTN+SN DBS improved temporal aspects of parkinsonian gait impairment compared to conventional STN DBS and differentially affected cortical oscillatory patterns during regular locomotion and freezing suggesting a potential modulatory effect on dysfunctional cortical-subcortical communication in PD. (shrink)

Volume 19, Issue 10, October 2019, Page 88-90.

BackgroundRadiotherapy is an essential component of cancer treatment, yet many countries do not have adequate capacity to serve all patients who would benefit from it. Allocation systems are needed to guide patient prioritization for radiotherapy in resource-limited contexts. These systems should be informed by allocation principles deemed relevant to stakeholders. This study explores the ethical dilemmas and views of decision-makers engaged in real-world prioritization of scarce radiotherapy resources at a cancer center in Rwanda in order to identify relevant principles.MethodsSemi-structured interviews (...) were conducted with a purposive sample of 22 oncology clinicians, program leaders, and clinical advisors. Interviews explored the factors considered by decision-makers when prioritizing patients for radiotherapy. The framework method of thematic analysis was used to characterize these factors. Bioethical analysis was then applied to determine their underlying normative principles.ResultsParticipants considered both clinical and non-clinical factors relevant to patient prioritization for radiotherapy. They widely agreed that disease curability should be the primary overarching driver of prioritization, with the goal of saving the most lives. However, they described tension between curability and competing factors including age, palliative benefit, and waiting time. They were divided about the role that non-clinical factors such as social value should play, and agreed that poverty should not be a barrier.ConclusionsMultiple competing principles create tension with the agreed upon overarching goal of maximizing lives saved, including another utilitarian approach of maximizing life-years saved as well as non-utilitarian principles, such as egalitarianism, prioritarianism, and deontology. Clinical guidelines for patient prioritization for radiotherapy can combine multiple principles into a single allocation system to a significant extent. However, conflicting views about the role that social factors should play, and the dynamic nature of resource availability, highlight the need for ongoing work to evaluate and refine priority setting systems based on stakeholder views. (shrink)

Ethics is the emphasis of our first-year Introduction to Clinical Medicine-1 course. Introduction to Clinical Medicine-1 uses problem-based learning to involve groups of seven to nine students and two facilitators in realistic clinical cases. The cases emphasize ethics, but also include human behaviour, basic science, clinical medicine, and prevention learning issues. Three cases use written vignettes, while the other three cases feature standardized patients. Groups meet twice for each case. In session one, students read the case introduction, obtain data from (...) the written case or standardized patient, identify the case's ethical problems, formulate learning issues, discuss ways to resolve the moral conflicts, and assign research responsibilities. In session two, students discuss their assigned learning issues and specify and justify clinical actions to address the case's ethical dilemmas. Following three cases, groups write an essay discussing what they learned and describing how they would approach and resolve the case's learning issues. (shrink)

Next SectionObjectives To evaluate the adequacy of paediatric informed consent and its augmentation by a supplemental computer-based module in paediatric endoscopy. Methods The Consent-20 instrument was developed and piloted on 47 subjects. Subsequently, parents of 101 children undergoing first-time, diagnostic upper endoscopy performed under moderate IV sedation were prospectively and consecutively, blinded, randomised and enrolled into two groups that received either standard form-based informed consent or standard form-based informed consent plus a commercial (Emmi Solutions, Inc, Chicago, Il), sixth grade level, (...) interactive learning module (electronic assisted consent). Anonymously and electronically, the subjects' anxiety (State Trait Anxiety Inventory), satisfaction (Modified Group Health Association of America), number of questions asked, and attainment of informed consent were assessed (Consent-20). Statistics were calculated using t test, paired t test, and Mann Whitney tests. Results The ability to achieve informed consent, as measured by the new instrument, was 10% in the control form-based consent group and 33% in the electronic assisted consent group (p<0.0001). Electronically assisting form-based informed consent did not alter secondary outcome measures of subject satisfaction, anxiety or number of questions asked in a paediatric endoscopy unit. Conclusions This study demonstrates the limitations of form-based informed consent methods for paediatric endoscopy. It also shows that even when necessary information was repeated electronically in a comprehensive and standardised video, informed consent as measured by our instrument was incompletely achieved. The supplemental information did, however, significantly improve understanding in a manner that did not negatively impact workflow, subject anxiety or subject satisfaction. Additional study of informed consent is required. Clinical trial registration number ClinicalTrials.gov Identifier NCT00899392. (shrink)

In this paper, the relationship between the e-value of a complex hypothesis, H, and those of its constituent elementary hypotheses, Hj, j = 1… k, is analyzed, in the independent setup. The e-value of a hypothesis H, ev, is a Bayesian epistemic, credibility or truth value defined under the Full Bayesian Significance Testing mathematical apparatus. The questions addressed concern the important issue of how the truth value of H, and the truth function of the corresponding FBST structure M, relate to (...) the truth values of its elementary constituents, Hj, and to the truth functions of their corresponding FBST structures Mj, respectively. (shrink)

Abstract:In this paper, we explore challenges in conveying the culturally constructed meanings of local Indigenous musics and the worldviews they manifest to students in K-12 school music classes, when foundational aspects of the English language, historical and current discourse, and English language habits function to thwart the transmission of those meanings. We recount how, in settler colonial societies in North America, speakers of the dominant English language have historically misrepresented, discredited, and obscured cultural meanings that inhere in local Indigenous musics. (...) First, we examine three ways in which the use of English has distorted the cultural meanings of those musics. Next, we explain how historical discourses in English have intentionally undervalued or discredited the values intrinsic to those musics, also describing how some current music education discourse in English might work against the embedding of Indigenous meanings in school music education settings. We then consider additional factors distinguishing Indigenous languages from European languages (especially English) to show how a people’s “language habits” influence their perception of and thus their relationship with their natural environment. We conclude by considering the role of music education in revitalizing local Indigenous languages and musics and advancing the cultural values of their originating communities. (shrink)

The paper defends the thesis that institutional virtue is properly modeled as a ‘‘consensual’’ property, along the lines of the Lehrer–Wagner model of consensus (LWC). In a first step, I argue that institutional virtue is not exhausted by duty-fulfilling, since institutions, contrary to natural individuals, are designed to fulfill duties. To avoid the charge of vacuity, virtue, if attributed to institutions, must be able to motivate supererogatory action. In a second step, I argue against dis- continuity of institutional virtue (...) with individual virtue. Two main arguments for discontinuity of collective properties display serious shortcomings when applied to virtues of institutions. Given that motivation for supererogatory action is neither inferred from statutory duties nor accommodates a right of reprobation, modeling institutional virtue on collective rationality or explaining it in terms of joint com-mitment both prove problematic. In a third step, I argue that LWC has the explanatory potential to account for institutional virtue. Due to its main features,iteration and evaluation, it provides a non-trivial analysis of continuity and thereby satisfies basic constraints on the notion of genuine institutional virtue. (shrink)

Barion, J. Was es heisst, ein Philosoph zu sein.--Flach, W. Die Objektivität der Erkenntnis.--Schmidt, G. Die Transzendentalität des Seingedankens.--Winterhager, E. Das Sich-Haben des Subjekts.--Hartmann, K. Analytische und kategoriale Transzendentalphilosophie.--Marx, W. Systemidee und die Problematik ihrer Begründung.--Röd, W. Transzendentalphilosophie und deskriptive Philosophie als wissenschaftliche Theorien.--Vuillemin, J. Caractères et fonctions des signes.--Ritzel, W. Zur Theorie praktischer Wissenschaft.--Hufnagel, E. Relationen--zum Streit um die pädagogische Anthropologie.--Derbolav, J. Politik und Moral.--Wolandt, G. Standpunkte der Kunstphilosophie.

If K is a field of finite Morley rank, then for any parameter set $A \subseteq K^{eq}$ the prime model over A is equal to the model-theoretic algebraic closure of A. A field of finite Morley rank eliminates imaginaries. Simlar results hold for minimal groups of finite Morley rank with infinite acl( $\emptyset$ ).

The seven contributors present the reader with a set of perspectives on the subsequent histories of the central ideas of these great thinkers. The essays focus on the ways in which these ideas were caught up in social movements and had been taken up by others who used them to support programs for radical historical changes, thereby subjecting them to distortions and perversions. The whole book reflects the feeling that history itself has purged away the dross which lay within the (...) original ideas, and that what now remains is either pure gold or later perversions illicitly smuggled in under the cover of various "isms."--K. P. F. (shrink)

The seven contributors present the reader with a set of perspectives on the subsequent histories of the central ideas of these great thinkers. The essays focus on the ways in which these ideas were caught up in social movements and had been taken up by others who used them to support programs for radical historical changes, thereby subjecting them to distortions and perversions. The whole book reflects the feeling that history itself has purged away the dross which lay within the (...) original ideas, and that what now remains is either pure gold or later perversions illicitly smuggled in under the cover of various "isms."--K. P. F. (shrink)