Analyse van de aan de wetenschap ontleende terminologie die de Amerikaanse dichter (1885-1972) in zijn literair-kritisch werk gebruikte.

Mucins are a family of high molecular weight, highly glycosylated glycoproteins found in the apical cell membrane of human epithelial cells from the mammary gland, salivary gland, digestive tract, respiratory tract, kidney, bladder, prostate, uterus and rete testis. Increased synthesis of the core protein and alterations in the carbohydrates attached to these glycoproteins are believed to play important roles in the function and proliferation of tumour cells. Aberrant glycosylation leads not only to the production of novel carbohydrate structures, but also (...) to the exposure of the core peptide. These novel epitopes may be candidates for diagnosis or therapy, by using either synthetic mucin fragments as vaccines, or monoclonal antibody‐based reagents which detect these structures. (shrink)

Periodically, we take stock of SubStance and provide a brief statement regarding initiatives and priorities in the journal's interests. Three years ago, we announced that "Exploring hybrid writing with theoretical impact is at the center of our current preoccupations."1 Since that time, the journal has made significant changes. This issue marks our fourth issue of publishing with Johns Hopkins University Press in a transition that recognizes our new publisher as a leader among university presses.Our plan also expressed our intent to (...) move toward publishing digital work that exemplifies theoretical thinking in nonlinear, experimental forms. In 2018, we launched Digital SubStance, a platform for "hybrid work that... (shrink)

It describes and explains the patient-centered model examining and evaluating qualitative and quantitative research. It comprehensively covers the evolution and the six interactive components of the patient-centered clinical method, taking the reader through the relationships between the patient and doctor and the patient and clinician. All the editors are professors in the Department of Family Medicine at the University of Western Ontario, London, Canada.

Health care is provided in many contexts—not just hospitals, clinics, and community health settings. Different institutional settings may significantly influence the design and delivery of health care and the ethical obligations and practices of health care practitioners working within them. This is particularly true in institutions that are established to constrain freedom, ensure security and authority, and restrict movement and choice. We describe the results of a qualitative study of the experiences of doctors and nurses working within two women’s prisons (...) in the state of New South Wales (NSW), Australia. Their accounts make clear how the provision and ethics of health care may be compromised by the physical design of the prison, the institutional policies and practices restricting movement of prisoners and practitioners, the focus on maintaining control and security, and the very purpose of the prison and prison system itself. The results of this study make clear the impact that context has on professional practice and illustrate the importance of sociology and anthropology to bioethics and to the development of a more nuanced account of professional ethics. (shrink)

The success of assisted reproductive technologies (ARTs) worldwide has led to an accumulation of frozen embryos that are surplus to the reproductive needs of those for whom they were created. In these situations, couples must decide whether to discard them or donate them for scientific research or for use by other infertile couples. While legislation and regulation may limit the decisions that couples make, their decisions are often shaped by their religious beliefs. Unfortunately, health professionals, scientists and policy-makers are often (...) unaware of the way in which faith traditions view ART and decisions concerning the ‘fate’ of surplus embryos. In this paper scholars representing six major religious traditions provide a commentary on a hypothetical case concerning the donation or destruction of excess ART embryos. These commentaries provide a rich account of religious perspectives on the status of the human embryo and an insight into the relevance of faith to health and policy decisions, particularly in reproductive medicine, ART and embryo research. (shrink)

The dissertation's primary task is to discern to what extent the investigations contained in Aristotle's Metaphysics conform to the model of science developed in the Posterior Analytics. It concludes that the Metaphysics substantially follows the model of the Analytics in studying the causes and attributes of a specific nature, although it makes significant departures especially in its conception of the principles of being and substance. ;Two introductory chapters discuss respectively Aristotle's conception of science in the Analytics and the problems one (...) is likely to face in attempting to apply this conception to the Metaphysics . Chapter 3 clarifies the meaning of the phrase "science of being qua being" by reference to the Posterior Analytics, and introduces the concept of pro&d13;v 3&d3;n equivocity. Chapter 4 considers the role of dialectic in metaphysics with particular reference to the principle of noncontradiction. Chapter 5 argues that the second part of Meta. 4.2 introduces a demonstrative science of the per se attributes of being and unity. ;Chapter 6 introduces the investigation into the principles and causes of being and reviews the aporias about the principles . Chapter 7 offers a hypothesis to explain Aristotle's identification of the science of being with first philosophy. The last two chapters argue that Aristotle is pursuing this investigation in the central books of Melaphysics, but his pursuit of the investigation there is incomplete. ;This interpretation provides an alternative to those of T. H. Irwin and Walter Leszl, who argue that metaphysics is a second-order discipline and not a science after the model of the Analytics. It finds explicit support in recent work by Robert Bolton and Alan Code, while widening the range of issues to include the attributes of being and the importance of first philosophy for understanding the nature of being. It supports many of the conclusions of Joseph Owens's, Urbain Dhondt's, and Frede and Patzig's work on the object of metaphysics. There are also substantial discussions of the contributions of G. E. L. Owen, J. G. Stevenson, Theodore Scaltsas, and John Thorp. (shrink)

To characterize human emotions, researchers have increasingly utilized Automatic Facial Expression Analysis (AFEA), which automates the Facial Action Coding System (FACS) and translates the facial muscular positioning into the basic universal emotions. There is broad interest in the application of FACS for assessing consumer expressions as an indication of emotions to consumer product-stimuli. However, the translation of FACS to characterization of emotions is elusive in the literature. The aim of this systematic review is to give an overview of how FACS (...) has been used to investigate human emotional behavior to consumer product-based stimuli. The search was limited to studies published in English after 1978, conducted on humans, using FACS or its action units to investigate affect, where emotional response is elicited by consumer product-based stimuli evoking at least one of the five senses. The search resulted in an initial total of 1,935 records, of which 55 studies were extracted and categorized based on the outcomes of interest including (i) method of FACS implementation; (ii) purpose of study; (iii) consumer product-based stimuli used; and (iv) measures of affect validation. Most studies implemented FACS manually (73%) to develop products and/or software (20%) and used consumer product-based stimuli that had known and/or defined capacity to evoke a particular affective response, such as films and/or movie clips (20%); minimal attention was paid to consumer products with low levels of emotional competence or with unknown affective impact. The vast majority of studies (53%) did not validate FACS-determined affect and, of the validation measures that were used, most tended to be discontinuous in nature and only captured affect as it holistically related to an experience. This review illuminated some inconsistencies in how FACS is carried out as well as how emotional response is inferred from facial muscle activation. This may prompt researchers to consider measuring the total consumer experience by employing a variety of methodologies in addition to FACS and its emotion-based interpretation guide. Such strategies may better conceptualize consumers' experience with products of low, unknown, and/or undefined capacity to evoke an affective response such as product prototypes, line extensions, etc. (shrink)

Winthrop Pickard Bell (1884–1965), a Canadian who studied with Husserl in Göttingen from 1911 to 1914, was arrested after the outbreak of World War I and interred at Ruhleben Prison Camp for the duration of the war. In 1915 or 1916 he presented a lecture titled “Canadian Problems and Possibilities” to other internees at the prison camp. This is the first time Bell’s lecture has appeared in print. Even though the lecture was given to a general audience and (...) thusmakes no explicit reference to Husserl or phenomenology, it is a systematic phenomenological analysis of the national form of group belonging and, as such, makes a substantial contribution to phenomenological sociology and political science, grounding that contribution in phenomenological philosophy. Bell describes the essence of the nation as an organic spiritual unity that grows or develops, and is thus not a product of will, and which becomes a unity by surmounting its parts. This unity is instantiated in a given nation by tradition. The particular character of a nation’s tradition gives it a tendency to act in one way rather than another. (shrink)

This issue of SubStance is the first since 2010 not dedicated to a specific theme or author; it features ten eclectic essays submitted from different disciplines and countries by well-established as well as emerging scholars. We wish to take this opportunity to emphasize the importance of these varia, which illustrate the range of our speculative and critical interests, and to signal directions we anticipate the journal moving in the near future. Beyond its interest in French literature and theory, SubStance has (...) always promoted a dialogue between contemporary theory and a multifaceted outside, an outside where contemporary theory may be used to investigate literary, philosophical, and artistic traditions.. (shrink)

This chapter provides a critical reflection on an ethnographic approach led by a non-Indigenous researcher in partnership with an Indigenous community-controlled health organization, and a team of Indigenous and non-Indigenous supervisors, advisors, critical friends, and mentors. The chapter explores the way the three interrelated principles of Indigenist research informed the study, as a critical reflection of the methodology’s achievement of a decolonizing research agenda. The flow of Maiwah provides a metaphor for the chapter’s diverse authorship. Maiwah’s tributaries, inlets, and banks (...) represent author voices at different points while the one River flowing represents coming together to form a broader collective story of the research that still respects the authors’ individual positioning. Maiwah’s flow also signifies the dialogical approach of the research – “tricky ground” for non-Indigenous researchers seeking to privilege Indigenous voices while remaining accountable to their own White privilege, particularly given that at its most basic level, research requires the “extraction of ideas” from participants. Yet, the flow of Maiwah also shows us the possibilities of research, where in this case, researcher and participants together cocreated new knowledge in support of their agendas. This process enabled both research outcomes and increased research capacity and confidence in the host agency and researcher. On this account, decolonizing research is perhaps more about relationship and devolving control over the process than it is about particular methods, and the respectful negotiation of epistemological meanings and representation of particular knowledges that can result. (shrink)

Research on the nature of science and science education enjoys a longhistory, with its origins in Ernst Mach's work in the late nineteenthcentury and John Dewey's at the beginning of the twentieth century.As early as 1909 the Central Association for Science and MathematicsTeachers published an article – ‘A Consideration of the Principles thatShould Determine the Courses in Biology in Secondary Schools’ – inSchool Science and Mathematics that reflected foundational concernsabout science and how school curricula should be informed by them. Sincethen (...) a large body of literature has developed related to the teaching andlearning about nature of science – see, for example, the Lederman and Meichtry reviews cited below. As well there has been intensephilosophical, historical and philosophical debate about the nature of scienceitself, culminating in the much-publicised ‘Science Wars’ of recent time. Thereferences listed here primarily focus on the empirical research related to thenature of science as an educational goal; along with a few influential philosophicalworks by such authors as Kuhn, Popper, Laudan, Lakatos, and others. Whilenot exhaustive, the list should prove useful to educators, and scholars in otherfields, interested in the nature of science and how its understanding can berealised as a goal of science instruction. The authors welcome correspondenceregarding omissions from the list, and on-going additions that can be made to it. (shrink)

Death from cancer is usually due to metastasis. Fortunately, most cells that escape from a primary tumor fail to form metastases. Identifying reasons for this failure will help development of anti‐metastatic therapies. Intravital videomicroscopy (IVVM) can be used to observe cancer cells injected into live animals. Co‐injected microspheres can be used to assess cell survival. These techniques have been used to show that circulating tumor cells generally arrest in the microcirculation and may extravasate with high efficiency. While many tumor cells (...) may survive in a secondary site, only a small subset form micrometastases and only a subset of these micrometastases persist to form vascularized macrometastases. Furthermore, solitary tumor cells may remain dormant for long periods of time in secondary sites. These findings suggest that metastatic growth and angiogenesis are prime targets for anti‐metastatic therapy. BioEssays 24:885–893, 2002. © 2002 Wiley Periodicals, Inc. (shrink)

Let HF be the collection of the hereditarily finite well-founded sets and let the primitive language of set theory be the first-order language which contains binary symbols for equality and membership only. As announced in a previous paper by the authors, "Truth in V for ∃*∀∀-sentences is decidable," truth in HF for ∃*∀∀-sentences of the primitive language is decidable. The paper provides the proof of that claim.

The aim of this book is twofold: first, to arrive at a coherent interpretation of Aristotle's account of definition in APo. 2.1-10; and second, to show how what Aristotle says there sheds light on the way in which per se attributes belong to their subjects.

In lieu of an abstract, here is a brief excerpt of the content:On the NoseDavid F. Bell (bio)I recently underwent a COVID test. As the technician inserted the rather ominous cotton-tipped probe into my nostril, she told me that it was going to feel as if she were tickling my brain. Indeed… This experience, shared by many during the past three years, and likely multiple times, prompted me to think about my nose. Not since cocaine reentered American mainstream culture (...) in the 1970s and '80s—and found its way into countless movies that reflect the trend—has the nose been so central to a certain state of public life. It's difficult to find a film dealing with American culture from that period and beyond, from Scarface to The Wolf of Wall Street, in which there is not a scene depicting characters snorting the obligatory line or spoon of cocaine. Yes, snorting, sniffing, sneezing, ingesting the line through the nose and finishing leftover dust by collecting it with a moist finger, rubbing it lovingly against the front gum of the mouth. Freud's "Über Coca" looms ominously in the background, the work of a phase in Freud's professional career complicated by his obscure relationships with Parke-Davis (now a subsidiary of Pfizer) and Merck, pharmaceutical companies that supplied him with early samples to tickle his nose (Freud; Merkel). The Sacklers of the moment. In our day, Pfizer wants to transform our noses into defenses against the virus rather than conduits toward mind-altering dreams. In the wake of the Freud and William Halsted cocaine addictions chronicled by Howard Merkel, the irony of the contemporary link between Pfizer and the nose is patent.The nose: that orifice through which the virus creeps, the first stage in breathing, the first filter for air-borne pollutants. Recently, important immunological analyses of COVID have focused on the question of viral load, how much virus is necessary to overcome the nose's filtering function and reach the deeper airways leading to the lungs. The processes triggered by any of the major vaccines prepare antibody blueprints and actual antibodies that can be dispatched to the linings of the nose to counter the virus as soon as the body detects its presence. The Delta, Omicron, and subsequent variants remind us that the virus has mechanisms to challenge this response, namely, increased viral load that intensifies transmissibility and the potential to overwhelm antibodies. It seems, however, that [End Page 231] so-called breakthrough infections are still well controlled by the body's vaccinated immune system. Hysteria about the dangers of such incursions is partially a product of biased and often incorrect or incomplete media coverage of the COVID vaccine, which has terrified the vaccinated and fueled the skepticism of the unvaccinated.The virus tries to overpower and confuse the filtering nose in another way, more immediately apparent to our conscious selves. As many as eighty-five percent of COVID infections result in the loss of smell, generally recovered in about two to three weeks in sickened people who overcome the infection. About five percent of COVID victims, however, have not recovered their sense of smell six months or more after they have shed the virus.1 What might it mean to lose one's sense of smell? In our vision-oriented culture, both sound (the ear) and smell (the nose) have been less recognized as primary defense mechanisms than in other cultures. When one hears a sound, the first reaction is to prepare for a threat, before the sonic source is seen or understood. Orientation in the world, knowing from which direction the sound emanates, is key to preparing the body for an encounter with an unknown phenomenon: "To sound (an alarm) means to warn. Isn't any emerging sound understood as a warning? Any unexpected sonic occurrence is seen as an indication of something that is to come and that must be clarified rapidly" (Deshays 34). By the same token, to sample surroundings by sniffing what is in the air signals whether one should inhale or somehow try to hold one's breath in search of cleaner, more palatable air. Without olfaction, we are at potentially heightened risk of asphyxiation. We are more likely to... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Pairing breaths:Rabah Ameur-Zaïmech's Terminal Sud (2019)Marion Froger (bio)Translated by David F. BellAsphyxiaNever had I felt such a sense of suffocation watching a film by Rabah Ameur-Zaïmeche.1 The poisoned atmosphere of Terminal Sud (2019) recalls the atmosphere of the Algerian War (1955-1962) and that of the decade of darkness (1991-2002) in that country. The filmmaker chose not to make a historical film, however, but rather a dystopia that fuses together (...) periods and places. The story appears to be contemporary, in a country bathed in the colors of southern France, apparently in the grip of all the violence that French and Algerian memories are nowhere near forgetting.2 Bandits wearing combat uniforms, policemen wearing outfits sporting an acronym that strangely resembles one used by Islamist Algerian groups,3 and generals evoking the French putschists of 1961 all fight against each other—ransoming, threatening, kidnapping, killing, and torturing the local population. Meanwhile, out in the countryside, guerrillas (maquisards4) try to care for their dying leader, like North African freedom fighters (fellagas) were doing before them, and this in turn evokes French Resistance fighters in the 1940s. The film's work on confused memories, which, according to Thierry Kuntzel, is related to the condensation, overdetermination, and displacement of dreamwork, transforms being out of breath into a symptom that hounds the doctor, played by Ramzy Bédia ("Inhale…Exhale…Inhale again…Hold your breath…Exhale"), a state of the world in the form of a trap that threatens to suffocate him—and launches the quest for a filmic poetics of calm through the pairing of breaths.Peeling façades with tightly closed doors, lowered metal shop shutters, narrow and tense streets: the doctor, his wife Hazia, and their family slip outside in fear of kidnapping and gunfire, climb up stairs breathing heavily, anxiously await by the window, their bodies obscured in starkly contrasting shadows cast by glaring light, hug each other with endless sighs. As they share their grief, they have barely enough breath left to sing to the memory of someone who has disappeared,5 as if after an argument, [End Page 244] when everything has been said and all that remains is a strangled sob serving as last farewell.The film opens with an attack on a minivan used for public transportation: bandits, who could be soldiers, steal everything from the passengers and driver. The doctor sees his patients in a rundown hospital, treats a woman whose breathing is raucous, her voice taut with anxiety, and who speaks about the disappearance of her husband. Back home, he finds anonymous letters containing death threats and, to calm down, he searches for his breath by taking a deep drag from a cigarette and a swig of whiskey. "I can't take it any longer, I can't even stand up, I can't do anything, I'm at the end of my rope, I'm tired […] Is that what our country has become?" he confides to a friend several hours before losing, in the emergency room, his wife's brother, a journalist assassinated in front of his house. "Stay with me," he says as he runs beside the stretcher calling for help, "Breathe, breathe."The spasmodic breathing of Ramzy Bédia, provoked by the fear, effort, and pain that define his character, intensifies as the film progresses. He barely breathes in the car taking him to treat the rebel leader; he is running out of breath beside the leader's bed as we hear the death rattle and as Bédia shouts to the leader's comrades, "Give him some air, everyone get out!" Later, one of the policemen standing guard at the entrance to the hospital will be mortally wounded by a kamikaze attack and will die on the operating table despite the doctor's exhausting reparatory manipulations. Asphyxia will ultimately directly threaten the doctor after his arrest. Tied to an old bedspring, he will be tortured by electroshock,6 will attempt one last time to justify himself to a soldier who wants to know everything about the rebel leader the doctor has treated, and will nearly suffocate in his... (shrink)

High-dose chemotherapy and autologous stem cell transplantation is used to treat some advanced malignancies. It is a traumatic procedure, with a high complication rate and significant mortality. ASCT patients and their carers draw on many sources of information as they seek to understand the procedure and its consequences. Some seek information from beyond orthodox medicine. Alternative beliefs and practices may conflict with conventional understanding of the theory and practice of ASCT, and ‘contested understandings’ might interfere with patient adherence to the (...) strict and demanding protocols required for successful ASCT.The present study, conducted in Sydney, Australia, examines narrative-style interviews with 10 sequentially recruited ASCT patients and nine of their carers conducted at the time of transplant and three months later. Transcripts were read for instances of mention of alternative advice, and for instances of contested understanding of information relevant to the transplant.Patients and carer pairs expressed closely concordant views about alternative advice. Five pairs were consulting alternative practitioners. Contested understanding was expressed in four domains—understandings of the transplant itself and its underlying theory, of the relationship between the components of the ‘transplant’, of the nature and role of stem cells, and of beliefs about bodily function and life-style. Contested understandings of the transplant treatment were expressed as predominantly personal interpretations of orthodox informationPatients and carers seemed to recognise that alternative and conventional systems were discordant, yet they were able to separate the two, and adhere to each practice without prejudicing their medical treatment. A single case of late, post-transplant repudiation of Western medicine is discussed to emphasise some of the possible determinants of dissonance when it does occur. (shrink)

Peer review is a widely accepted instrument for raising the quality of science. Peer review limits the enormous unstructured influx of information and the sheer amount of dubious data, which in its absence would plunge science into chaos. In particular, peer review offers the benefit of eliminating papers that suffer from poor craftsmanship or methodological shortcomings, especially in the experimental sciences. However, we believe that peer review is not always appropriate for the evaluation of controversial hypothetical science. We argue that (...) the process of peer review can be prone to bias towards ideas that affirm the prior convictions of reviewers and against innovation and radical new ideas. Innovative hypotheses are thus highly vulnerable to being “filtered out” or made to accord with conventional wisdom by the peer review process. Consequently, having introduced peer review, the Elsevier journal Medical Hypotheses may be unable to continue its tradition as a radical journal allowing discussion of improbable or unconventional ideas. Hence we conclude by asking the publisher to consider re-introducing the system of editorial review to Medical Hypotheses. (shrink)

In March 2012, Joshua Foer presented a TED Talk to a mesmerized audience. As he began, Foer asked the audience members to close their eyes, and he proceeded to describe a scenario in which a series of striking images appeared as he talked his spectators through various architectural spaces in a house they were to imagine as their own. First, a group of nude bicyclists materialized at the front door, crashing before the very eyes of the bemused beholders, sending bicycle (...) pieces flying in all directions. An encounter with Sesame Street’s Cookie Monster in the entrance foyer ensued, during which salient details of the Muppet’s appearance were described down to the smell of his... (shrink)

Dear Jacques Derrider,Today is my birthday. I received a considerable number of messages, almost all written and sent by computer programs. Because most of my contacts have died, or else they are too busy to write me.I'm not bothered by the fact that these letters were written by programs. I am troubled, however, when they remind me of all of those who have died. And especially when I am no longer able to distinguish between the programs that speak for the (...) living and those that speak for the dead.These digital mummies are called necrobots. The archive of conversations of the deceased person serves as a training database for a neural network. Once it is deployed in the email and social network accounts of the... (shrink)

The Brethren of Purity, the anonymous adepts of a tenth-century esoteric fraternity, hold an eminent position in the history of science and philosophy in Islam due to the wide reception and assimilation of their monumental encyclopaedia, the Rasa 'il Ikhwan al-Safa'. Its fifty-two epistles offer synoptic accounts of the classical sciences and philosophies of the age; divided into four classificatory parts, it treats themes in mathematics, logic, natural philosophy, psychology, metaphysics, and theology, in addition to didactic fables. Epistles 43-45 are (...) some of the richest and most diverse in the corpus of the Brethren of Purity. This volume includes anecdotes and visions of paradise, Qur'anic quotations and interfaith references, as well as Platonic motifs. The prevailing theme of the immortality of the soul is considered in detail, along with the necessity of co-operation in this world in order for the soul to be able to break free of it. (shrink)

This monograph examines the domain of classical political economy using the methodologies developed in recent years both by the new discipline of econo-physics and by computing science. This approach is used to re-examine the classical subdivisions of political economy: production, exchange, distribution and finance. The book begins by examining the most basic feature of economic life – production – and asks what it is about physical laws that allows production to take place. How is it that human labour is able (...) to modify the world? It looks at the role that information has played in the process of mass production and the extent to which human labour still remains a key resource. The Ricardian labour theory of value is re-examined in the light of econophysics, presenting agent based models in which the Ricardian theory of value appears as an emergent property. The authors present models giving rise to the class distribution of income, and the long term evolution of profit rates in market economies. Money is analysed using tools drawn both from computer science and the recent Chartalist school of financial theory. Covering a combination of techniques drawn from three areas, classical political economy, theoretical computer science and econophysics, to produce models that deepen our understanding of economic reality, this new title will be of interest to higher level doctoral and research students, as well as scientists working in the field of econophysics. (shrink)

This monograph examines the domain of classical political economy using the methodologies developed in recent years both by the new discipline of econo-physics and by computing science. This approach is used to re-examine the classical subdivisions of political economy: production, exchange, distribution and finance. The book begins by examining the most basic feature of economic life – production – and asks what it is about physical laws that allows production to take place. How is it that human labour is able (...) to modify the world? It looks at the role that information has played in the process of mass production and the extent to which human labour still remains a key resource. The Ricardian labour theory of value is re-examined in the light of econophysics, presenting agent based models in which the Ricardian theory of value appears as an emergent property. The authors present models giving rise to the class distribution of income, and the long term evolution of profit rates in market economies. Money is analysed using tools drawn both from computer science and the recent Chartalist school of financial theory. Covering a combination of techniques drawn from three areas, classical political economy, theoretical computer science and econophysics, to produce models that deepen our understanding of economic reality, this new title will be of interest to higher level doctoral and research students, as well as scientists working in the field of econophysics. (shrink)

“I don’t believe what people say to me, I believe the way they say it,” Christian Bobin said. “This is where the sonic is located, in the manner of speaking, in the way in which bodies move and silences occur.”It would be hard to argue that sound is something the public or professionals, whose work is to create sound, actually think about carefully and consciously, as strange as this might seem. Sound in film is rarely addressed from a theoretical perspective. (...) Few books are dedicated to it beyond purely technical works, and those do not often consider the aesthetic conditions of sound production. The question of the existence of sound is abandoned in favor of normalizing procedures for producing it, absent any... (shrink)

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)