Living donation provides important access to organ transplantation, which is the optimal therapy for patients with end-stage liver or kidney failure. Paired exchanges have facilitated thousands of kidney transplants and enable transplantation when the donor and recipient are incompatible. However, frequently willing and otherwise healthy donors have contraindications to the donation of the organ that their recipient needs. Trans-organ paired exchanges would enable a donor associated with a kidney recipient to donate a lobe of liver and a donor associated with (...) a liver recipient to donate a kidney. This article explores some of the ethical concerns that trans-organ exchange might encounter including unbalanced donor risks, the validity of informed consent, and effects on deceased organ donation. (shrink)

S'il est un point que les réflexions contemporaines sur le temps ont mis en relief et inscrit profondément dans notre conscience, c'est que l'avenir qu'on espère dépend directement du présent qu'on réalise. Telle est notre attitude en face du présent, telle elle sera inéluctablement en face de l'avenir; et donc l'avenir lui-même, puisque ce dernier n'est rien sinon un présent caché encore, au cœur d'un présent déjà actuel, et explicite. Il est en effet de l'essence même de notre condition humaine (...) d'avoir un présent structuré et comme stratifié. Certes on peut imaginer le présent comme un point sans épaisseur, comme la limite évanescente entre un segment de ligne qui marque le passé à jamais révolu, et l'avenir qui se meut vers nous pour basculer inexorablement vers le non-être en franchissant ce présent. Mais cette image, utile pour bien des tâches, ne correspond d'aucune manière à la réalité vivante de la conscience humaine et des activités qui lui sont propres. Nous sommes dans le présent ce que nous sommes et ce que, en un sens, nous croyons pouvoir dire que nous avons été. Une grande partie de ce que nous appelons le passé, notre passé personnel et sans doute notre passé spécifique, est présent, non seulement à titre de souvenir, pouvant être, ou non, évoqué, mais à titre de schéma dynamique modifiant notre être-au-monde, notre présente réaction au réel le plus réel, à la situation où nous avons à déployer notre activité. (shrink)

Au moment où il entreprend d'élaborer une preuve de l'existence de Dieu dont la force soit susceptible d'entraîner l'adhésion de tout esprit qui entend le sens des mots utilisés, s. Anselme veut faire appel à une notion de Dieu admise par tout le monde. Que signifie en effet ce mot Dieu, sinon, ce par rapport à quoi on ne saurait rien concevoir de plus parfait? La notion de Dieu et celle de la perfection la plus grande possible sont done, à (...) ses yeux, si intimement unies qu'on peut les employer l'une pour l'autre. Penser Dieu et penser 1'être le plus parfait possible, ce serait une seule et même chose. (shrink)

PurposeTo explore the mindfulness practice, its long-term effects, facilitators and barriers, in clinical clerkship students 2 years after participation in an 8-week mindfulness-based stress reduction training.MethodA qualitative study was performed by semi-structured in-depth interviews with 16 clinical clerkship students selected by purposive sampling. Students had participated in a MBSR training 2 years before and were asked about their current mindfulness practice, and the long-term effects of the MBSR training. Thematic analysis was conducted using the constant comparison method. Data saturation was (...) reached after 16 interviews.ResultsMost interviewees were still engaged in regular, predominantly informal, mindfulness practice, although some discontinued mindfulness practice and reported an “unchanged lifestyle.” Three main themes came forward; “focused attention and open awareness” during daily activities as core elements of long-term mindfulness practice; “changes in behavior and coping” that resulted from taking a pause, reflecting, recognizing automatic behavioral patterns and making space for a conscious response; “integration in personal and professional life” by enhanced enjoyment of daily activities, improved work-life-balance and making different career choices. Barriers and facilitators in starting and maintaining mindfulness practice were understanding and intention as “pre-conditions”; practical, personal, and professional factors of students in maintaining practice.ConclusionTwo years after participation in a MBSR training, many interviewees were still engaged in mindfulness practice contributing to both personal and professional changes. In light of the high clerkship demands, MBSR training could be a valuable addition to medical curricula, supporting medical students in developing necessary competencies to become well-balanced professionals. (shrink)

Marcel Beaufils fut un pedagogue exceptionnel qui exerca une influence decisive sur l'evolution de l'esthetique musicale en France, a partir des annees 50. Or, parmi ses ouvrages, Musique du son, musique du verbe est tres certainement celui qui porte le plus fortement la marque de son activite d'enseignant au Conservatoire National Superieur de Musique de Paris ; cette mission, il semblait l'entendre davantage comme celle d'un declencheur d'idees, catalyseur, plutot que du transmetteur d'un savoir fige une fois pour toutes. Bouleversant (...) toute tentative de classification academique, toute certitude acquise, ce livre laisse des pointilles ; un grand souffle traverse son ecriture. N'en deplaise aux musicographes, il s'agit la d'un ouvrage de creation, qui nous rappelle que Marce Beaufils etait egalement un ecrivain qui savait manier le verbe a la fois en tant que dramaturge et en tant que poete. (shrink)

In recent years, to protect the rights and welfare of human subjects, institutions in the USA have begun to set up programmes to monitor ongoing medical research. These programmes provide routine, onsite oversight, and thus go beyond existing oversight such as investigating suspected misconduct or reviewing paperwork provided by investigators. However, because of a lack of guidelines and evidence, institutions have had little guidance in setting up their programmes. To help institutions make the right choices, we used interviews and document (...) analysis to study how and why 11 US institutions have set up their monitoring programmes. Although these programmes varied considerably, we were able to distinguish two general types. ‘Compliance’ programmes on the one hand were part of the institutional review board office and set up to ensure compliance with regulations. Investigators’ participation was mandatory. Monitors focused on documentation. Investigators could be disciplined, and could be obliged to take corrective actions. ‘Quality-improvement’ programmes on the other hand were part of a separate office. Investigators requested to be monitored. Monitors focused more on actual research conduct. Investigators and other parties received feedback on how to improve the research process. Although both types of programmes have their drawbacks and advantages, we argue that if institutions want to set up monitoring programmes, quality improvement is the better choice: it can help foster an atmosphere of trust between investigators and the institutional review board, and can help raise the standards for the protection of human subjects. (shrink)

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