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)

Implicit in the scottish tradition is a metaphilosophy of commonsense which deserves as much attention as that recently given to scottish presentative realism and agent causality. The author articulates this metaphilosophy by (a) sketching a systematic metaphilosophy of commonsense, (b) considering to what extent thomas reid fits this pattern, And (c) deciding to what extent asa mahan, One of the ablest of the american realists, Fits it. The result is a characterization of a coherent scottish metaphilosophy still worthy of (...) consideration. He also explores the question whether the metaphilosophy that emerges from (b) and (c) is part of an ongoing tradition. It has been suggested that there are important similarities between the scottish view and g e moore's concept of analysis. While he agrees that there are analogies he stresses the disanalogies as more enlightening about the nature of both. (shrink)

Recovers some of the value in the Wittgensteinian period of philosophy, using certain logical systems: Prior's theory of operators and Hilbert's epsilon calculus. This work applies, discursively, the previous largely technical results published in Prolegomena to Formal Logic (Aldershot, Gower 1989) and Intensional Logic (Aldershot, Ashgate 1994) to resolve matters of current interest in philosophy, logic and linguistics - notably attacking a variety of realisms found in comtemporary cognitive science and the philosophy of mathematics.

Speaking of Professor Geach's belief that pronouns in natural language function like the bound variables in quantification theory, Gareth Evans, in ‘Pronouns, Quantifiers, and Relative Clauses - I’ says :I want to try to show that there are pronouns with quantifier antecedents that function in a quite different way. Such pronouns typically stand in a different grammatical relation to their antecedents, and; in contrast with bound pronouns, must be assigned a reference, so that their most immediate sentential contexts can always (...) be assigned a truth value. The relevant grammatical relation appears to be Klima's relation of ‘in construction with’. When the pronoun is in construction with its antecedent, as in [‘Some man loves his mother’] and [‘No man is happy when he is in love’] the result is a bound pronoun. (shrink)

It seems surprising that this text—or others similar— has been accepted without any serious search for a more meaningful alternative. Even if it be thought that Euripides was capable of adding , in an unusual sense producing an awkward tautology, to , surely this should only be accepted in the absence ofa more credible emendation which departs no further from the manuscripts? Is there such an alternative? In the corresponding last line of the strophe we have : the first syllable (...) of is doubtful; there seems to be no convincing metrical objection to its being a long syllable here. This atonce suggests the maintenance of the manuscripts' to maintain the metrical balance. (shrink)

Brian Wormald provides a fundamental reappraisal of one of the most complex and innovative figures of the late-Elizabethan and Jacobean age. In the centuries since his death, Francis Bacon (1561-1626) has been perceived and studied as a promoter and prophet of the philosophy of science--natural science--but he saw himself also as a clarifier and promoter of what he called "policy" or the study and improvement of the structure and function of civil states. Mr. Wormald shows that Bacon was concerned equally (...) with the knowledge of the world of nature and with that of policy. The junction between the two enterprises was effected by his work in history; and in the end it was Bacon's conception and practice of history that provided the answer to his efforts to advance policy and natural philosophy. (shrink)

The scope of the thermodynamic theory of nonlinear irreversible processes is widened to include the nonlinear stability analysis of system motion. The emphasis is shifted from the analysis of instantaneous energy flows to that of the average work performed by periodic nonlinear processes. The principle of virtual work separates dissipative and conservative forces. The vanishing of the work of conservative forces determines the natural period of oscillation. Stability is then determined by the variations of the dissipative forces with amplitude of (...) oscillation. If the work is a minimum, under certain conditions, the motion is stable. Reduction to linear analysis shows the coincidence with the impedance analysis of electrical circuit theory. The theory is applied to the analysis of temporal interactions of nonlinear irreversible processes in the particular cases of synchronization and hysteresis. Characteristic nonequilibrium phenomena of directional energy transfers, self-excitation, system passivity, wave modulation, and “beat” phenomena are observed. Possible relationships with biological processes are discussed. (shrink)

The author has made this treatise on Madhva’s realistic school of Ved?nta philosophy convincing to the modern mind by employing western logical apparatus in substantiating Madhva’s ideas. Following the Indian classical tradition, the author has examined the validity of Advaitaved?nta, the Absolute Monism of ?a?kara and Bh?skara as P?rvapak?a, and logically proved its inconsistencies. He has then established the Dvaitasiddh?nta i.e., the Monotheistic Dualism of Madhva. He has successfully brought out the nuances of the realistic school of Indian philosophical thought (...) in this work. A Modern Introduction to M?dhva Philosophy is Prof B H Kotabagi’s posthumous publication. (shrink)

A simple random walk model has been shown by Gaveauet al. to give rise to the Klein-Gordon equation under analytic continuation. This absolutely most probable path implies that the components of the Dirac wave function have a common phase; the influence of spin on the motion is neglected. There is a nonclassical path of relative maximum likelihood which satisfies the constraint that the probability density coincide with the quantum mechanical definition. In three space dimensions, and in the presence of electromagnetic (...) interaction, the Lagrangian for this optimal, nonclassical path coincides with the Lagrangian of the Dirac particle. The nonrelativistic, or diffusion, limit is shown to be a formal consequence of Einstein's dynamical equilibrium condition; the continuity equation reduces to the same diffusion equation derived from Schrödinger's equation. The relativistic, massless limit, which would describe a neutrino, is comparable (in the sense of analytic continuation) to a nonviscous liquid whose molecules possess internal degrees of freedom. (shrink)

It is shown that: (i) the Onsager-Machlup postulate applies to nonlinear stochastic processes over a time scale that, while being much longer than the correlation times of the random forces, is still much shorter than the time it takes for the nonlinear distortion to become visible; (ii) these are also the conditions for the validity of the generalized Fokker-Planck equation; and (iii) when the fine details of the space-time structure of the stochastic processes are unimportant, the generalized Fokker-Planck equation can (...) be replaced by the ordinary Fokker-Planck equation. (shrink)

The thermodynamics of averaged motion treats the asymptotic spatiotemporal evolution of nonlinear irreversible processes. Dissipative and conservative actions are associated with short and long spatiotemporal scales, respectively. The motion of asymptotically stable systems is slow, monotonic, and continuous, so that the microscopic state variable description of rapid motion can be supplanted by an analysis of the macroscopic variable equations of motion of amplitude and phase. Rapid motion is associated with instability, and the direction of system motion is determined by thermodynamic (...) criteria, in place of an analysis of the microscopic equations of motion. The characteristic structural configurations, deduced from the extremum principles of partial differential equations, are compared with the thermodynamic criteria. As a result of the nature of asymptotic motion, variational principles exist which characterize the asymptotic states of the system. (shrink)

This paper starts by criticising some olderaccounts of conditionals based on the so-called `Ramsey Test', and ends by proposing their replacement, in part with a material account, in part with a probabilistic account using epsilon terms. The combined replacement is in fact closer to Ramsey's ideas. But there is also a resemblance between the latter and a more recent account of conditionals, which relates some of them to causality. The comparison provides a basis for assessment of the proposed replacement.

Background Informed consent confers upon participants the right to decline or accept participation in a study in equal measure. Consent declines can be used as a potential metric to assess the adequacy of the informed consent process. Limited literature is available on the reporting of consent declines in Clinical Research. We evaluated randomized controlled trials published in three high-impact factor journals for consent declines to assess the extent of exertion of autonomy by research participants. Methods CONSORT flow charts in RCTs (...) published in New England Journal of Medicine, The Lancet and Journal of the American Medical Association between 2012 and 2015 were evaluated. The total and per journal proportion of RCTs reporting consent declines was calculated. Percentage of consent declines was also compared based on number of centers and type of setting. Between-groups analysis was done using Chi Square, Chi Square for trend and a Crude odds ratio [95% C.I] were calculated. Results Only 3.7% of the published articles were RCTs. Of the 1103 RCTs, only 532 reported consent declines. JAMA had the highest RCTs reporting consent declines, the Lancet [129,150/781,924, 16.5%] had the most participants declining consent. Difference was significant using Chi square for linear trend [ p < 0.00001]. Consent decline rate was higher in developed countries relative to developing countries [cOR: 2.27, p < 0.000001] and in single centric versus multicentric studies [cOR : 3.63, p < 0.0000001]. Conclusion Both authors and journal editors need to ensure better reporting of consent declines. (shrink)