The medical biography of Ludwig van Beethoven remains enigmatic. Some of his health problems, such as his early and eventually profound deafness, are well documented and extensively discussed, although not necessarily well explained . Other medical problems, and his ultimate cause of death, remain unclear. Perhaps unsurprisingly for such an important musical figure, there has been no dearth of speculation about the illnesses that may have befallen Beethoven. Medical historians and physicians have suggested a myriad of illnesses, including but hardly (...) limited to .. (shrink)

Political corruption imposes substantial costs on shareholders in the U.S. Yet, we understand little about the basic factors that exacerbate or mitigate the value consequences of political corruption. Using federal corruption convictions data, we find that firm-level economic rents and monitoring mechanisms moderate the negative relation between corruption and firm value. The value consequences of political corruption are exacerbated for firms operating in low-rent product markets and mitigated for firms subject to external monitoring by state governments or monitoring induced by (...) disclosure transparency. Our results should inform managers and policymakers of the tradeoffs imposed on firms operating in politically corrupt districts. (shrink)

The coronavirus disease 2019 (COVID-19) pandemic has motivated medical ethicists and several task forces to revisit or issue new guidelines on allocating scarce medical resources. Such guidelines are relevant for the allocation of scarce therapeutics and vaccines and for allocation of ICU beds, ventilators, and other life-sustaining treatments or potentially scarce interventions. Principles underlying these guidelines, like saving the most lives, mitigating disparities, reciprocity to those who assume additional risk (eg, essential workers and clinical trial participants), and equal access may (...) compete with one another. We propose the use of a “categorized priority system” (also known as a “reserve system”) as an improvement over existing allocation methods, particularly because it may be able to achieve disparity mitigation better than other methods. (shrink)

In many research studies, tumor biopsies are an unavoidable requirement for achieving key scientific aims. Yet some commentators view mandatory research biopsies as coercive and suggest they should be optional, or at least optional until further data are obtained regarding their scientific usefulness. Further complicating the ethical picture is the fact that some research biopsies offer a potential for clinical benefit to trial participants. We interviewed and surveyed a convenience sample of participants in phase I clinical trials at a single (...) institution. Our primary aim was to describe phase I participants’ understanding of whether a research biopsy offered them the prospect of medical benefit. We also endeavored to describe participants’ views about biopsies—specifically, the benefits of biopsies, if any, and whether biopsies were acceptable, risky, or discouraged trial participation. Finally, we collected data on demographics and attitudes to see if any strong correlations with misunderstanding, acceptability, or riskiness existed. Overall, the respondents tended to view research biopsies as acceptable, though they did not succeed in identifying the lack of benefit of a research biopsy. These findings call for renewed efforts in consent conversations and documents to carefully describe the benefits, or lack thereof, of research biopsies. (shrink)

Is it a mistake to use "true" or "false" in certain contexts? White sets the stage for dealing with this issue by laying out a field of usages. He develops his position by characterizing and criticizing contemporary treatments of these data, moving rapidly from case to case. His numerous summaries and conclusions, obviously based on a wider view of the material than is presented in the text, may leave the uninitiated alternately puzzled, bristling, or suspicious. While White's data (...) are expressed clearly, the goal of his arguments and his organizational principles are frequently less apparent. White's discussions of fiction and modality are of particular historic interest. Here we find Frege and Russell arguing about whether they can argue about the King of France. We meet with Aristotle's ancient problem of the future naval battle, witness latter-day skirmishes over the nature of moral language, and find Leibniz, Hume, and Kant debating the logic of necessity and contingency. Are there really different types of truth which correspond with different modalities and existence presuppositions, as White seems to assume? This question, harking back to books 5 and 6 of Plato's Republic, is passed over by White in his usage-oriented quest for the sense of "truth." Truth will suit both student and researcher alike and is to be recommended for its breadth of concern and for its 18 pages of bibliography.--M. D. P. [[sic]]. (shrink)

Originally published in 1936 as part of the 'Medieval Epics' series for Cambridge Contact Readers, this book contains the stories of the folk heroes Dietrich von Bern and Tannhäuser in German. The text is illustrated with beautiful black and white drawings, and a vocabulary list is provided at the end of the volume. This book will be of value to anyone with an interest in German folklore or the history of German education in Britain.

Shortages of new therapeutics to treat coronavirus disease (COVID-19) have forced clinicians, public health officials, and health systems to grapple with difficult questions about how to fairly allocate potentially life-saving treatments when there are not enough for all patients in need (1). Shortages have occurred with remdesivir, tocilizumab, monoclonal antibodies, and the oral antiviral Paxlovid (2) -/- Ensuring equitable allocation is especially important in light of the disproportionate burden experienced during the COVID-19 pandemic by disadvantaged groups, including Black, Hispanic/Latino and (...) Indigenous communities, individuals with certain disabilities, and low-income persons. However, many health systems have resorted to first-come, first-served approaches to allocation, which tend to disadvantage individuals with barriers in access to care (3). There is mounting evidence of racial, ethnic, and socioeconomic disparities in access to medications for COVID-19 (4, 5). -/- One potential method to promote equitable allocation is to use a weighted lottery, which is an allocation strategy that gives all eligible patients a chance to receive the scarce treatment while also allowing the assignment of higher or lower chances according to other ethical considerations (6). We sought to assess the feasibility of implementing a weighted lottery to allocate scarce COVID-19 medications in a large U.S. health system and to determine whether the weighted lottery promotes equitable allocation. (shrink)

The thymus is a unique primary lymphoid organ that supports the production of self‐tolerant T‐cells essential for adaptive immunity. Intrathymic microenvironments are microanatomically compartmentalised, forming defined cortical, and medullary regions each differentially supporting critical aspects of thymus‐dependent T‐cell maturation. Importantly, the specific functional properties of thymic cortical and medullary compartments are defined by highly specialised thymic epithelial cells (TEC). For example, in the medulla heterogenous medullary TEC (mTEC) contribute to the enforcement of central tolerance by supporting deletion of autoreactive T‐cell (...) clones, thereby counterbalancing the potential for random T‐cell receptor generation to contribute to autoimmune disease. Recent advances have further shed light on the pathways and mechanisms that control heterogeneous mTEC development and how differential mTEC functionality contributes to control self‐tolerant T‐cell development. Here we discuss recent findings in relation to mTEC development and highlight examples of how mTEC diversity contribute to thymus medulla function. (shrink)

During public health crises including the COVID-19 pandemic, resource scarcity and contagion risks may require health systems to shift—to some degree—from a usual clinical ethic, focused on the well-being of individual patients, to a public health ethic, focused on population health. Many triage policies exist that fall under the legal protections afforded by “crisis standards of care,” but they have key differences. We critically appraise one of the most fundamental differences among policies, namely the use of criteria to categorically exclude (...) certain patients from eligibility for otherwise standard medical services. We examine these categorical exclusion criteria from ethical, legal, disability, and implementation perspectives. Focusing our analysis on the most common type of exclusion criteria, which are disease-specific, we conclude that optimal policies for critical care resource allocation and the use of cardiopulmonary resuscitation (CPR) should not use categorical exclusions. We argue that the avoidance of categorical exclusions is often practically feasible, consistent with public health norms, and mitigates discrimination against persons with disabilities. (shrink)

Meyer, Kent and Clifton (MKC) claim to have nullified the Bell-Kochen-Specker (Bell-KS) theorem. It is true that they invalidate KS's account of the theorem's physical implications. However, they do not invalidate Bell's point, that quantum mechanics is inconsistent with the classical assumption, that a measurement tells us about a property previously possessed by the system. This failure of classical ideas about measurement is, perhaps, the single most important implication of quantum mechanics. In a conventional colouring there are some remaining patches (...) of white. MKC fill in these patches, but only at the price of introducing patches where the colouring becomes ``pathologically'' discontinuous. The discontinuities mean that the colours in these patches are empirically unknowable. We prove a general theorem which shows that their extent is at least as great as the patches of white in a conventional approach. The theorem applies, not only to the MKC colourings, but also to any other such attempt to circumvent the Bell-KS theorem (Pitowsky's colourings, for example). We go on to discuss the implications. MKC do not nullify the Bell-KS theorem. They do, however, show that we did not, hitherto, properly understand the theorem. For that reason their results (and Pitowsky's earlier results) are of major importance. (shrink)

Particular visions of urban development are often codified in multi-year resource management policies. These policies, and the negotiations leading to them, are based in specific problem frames and narratives with long legacies. As conditions change and knowledge improves, there is often a need to revisit how problems, opportunities, and development pathways were defined historically, and to consider the viability of alternative pathways for development. In this article, we examine the case of agriculture near Metropolitan Phoenix, in the Central Arizona region, (...) to highlight how frames and narratives embedded in policy can reinforce particular development pathways, even as information, conditions, and values evolve. Using expert interviews and secondary data, we document alternative frames and narratives that may offer different pathways for development and sustainability in the region. By highlighting alternative narratives, we demonstrate the uncertainties and limitations associated with all narratives about development pathways, and explore the possibilities that narrative shifts can alter future outcomes. (shrink)

In 1885, during initial discussions of J. C. Maxwell's celebrated thermodynamic demon, Whiting (1) observed that the demon-like velocity selection of molecules can occur in a gravitationally bound gas. Recently, a gravitational Maxwell demon has been proposed which makes use of this observation [D. P. Sheehan, J. Glick, and J. D. Means, Found. Phys. 30, 1227 (2000)]. Here we report on numerical simulations that detail its microscopic phase space structure. Results verify the previously hypothesized mechanism of its paradoxical behavior. This (...) system appears to be the only example of a fully classical mechanical Maxwell demon that has not been resolved in favor of the second law of thermodynamics. (shrink)

This essay asks: How do the realities of embodied trauma inflicted by racism interface with virtue theory? This question illuminates two lacunae in virtue theory. The first is attention to race. We argue that the contemporary academic virtue literature performs largely as a White space, failing to address virtue theory’s role in the social construction of race, ignoring the rich and vibrant resources on virtue ethics alive within the Black theological tradition that long antedates Alasdair MacIntyre’s After Virtue, and (...) segregating the emerging literature on race and virtue from the broader discourse. The second is lack of attention to embodiment. More precisely, contemporary virtue theory, informed largely by Aristotle, Aquinas, and MacIntyre, has no conceptual space to theorize the body’s role acquiring and deploying virtue and vice. To explore this nexus, we draw on racial trauma therapist Resmaa Menakem, Katie Walker Grimes, and Howard Thurman’s Jesus and the Disinherited to challenge contemporary virtue theory and open new possibilities for a robustly corporate, enfleshed theological virtue ethic. (shrink)

It is a familiar fact that dreams are hard to recall. Because of this, memory alone is not a reliable indication of what they are like. Consider the following examples. Some people claim that they never dream. The truth is, psychologists assure us, that they do not remember having dreamt. Researchers say that they can tell when someone is dreaming, by his rapid eye movements and a certain pattern of brain waves recorded on an electroencephalograph . When a sleeper's eyes (...) move rapidly, and he registers the appropriate pattern of brain-waves on the EEG, and then he is awakened, he almost always reports a dream. By this test, no one has yet been discovered who does not dream at all. In fact, psychologists have established that the average person has four to six periods of dreaming each night. Some people say that they always dream in black and white, never in colour. Again, however, they have apparently forgotten the colours that occur in dreams, as is shown by the fact that most often, if we wake a sleeper in the middle of a dream, when it is still fresh in his mind, he then can report colours. Another claim that some people make is that dreams never last more than a few seconds. This also seems to be a case of forgetting dreams, since periods of REM, together with EEG readings, indicate that dreams take longer than this; in fact they may last as long as thirty-five minutes. Finally, it is a piece of folk wisdom that eating rich foods just before sleep causes nightmares. According to scientists, however, all that eating such foods can do is to cause a person enough bodily discomfort to wake him often during the night. This leads him to remember more of his dreams—and therefore more of their vividness and strangeness—than he usually does. (shrink)

In 1885, during initial discussions of J. C. Maxwell's celebrated thermodynamic demon, Whiting(1) observed that the demon-like velocity selection of molecules can occur in a gravitationally bound gas. Recently, a gravitational Maxwell demon has been proposed which makes use of this observation [D. P. Sheehan, J. Glick, and J. D. Means, Found. Phys. 30, 1227 (2000)]. Here we report on numerical simulations that detail its microscopic phase space structure. Results verify the previously hypothesized mechanism of its paradoxical behavior. This system (...) appears to be the only example of a fully classical mechanical Maxwell demon that has not been resolved in favor of the second law of thermodynamics. (shrink)

This study investigates the relative importance of trait anger and trait anxiety in financial decision-making. Given the disparate economic, cultural and social environments within an emerging market, this study focuses on South Africa to provide unique insights. The use of a student experimental cohort and hypothetical scenarios allows for the assessment of prima facie evidence of the merits of future research using more experienced participants and more realistic scenarios. Gender and race are incorporated as explanatory variables given the history of (...) South Africa and the disparate opportunities amongst individuals of different races. Both variables are also notable indicators of financial behaviour and decision-making. A questionnaire was completed by 288 university students which measured Trait anxiety and Trait anger using the Anxiety Inventory and Anger Expression Inventory-2. Using multinomial logistic regressions, the results showed that White participants and those individuals with higher levels of anger are more inclined to invest in equity. Alternatively, Women and individuals with higher levels of anxiety were found to be more risk averse. These findings are relevant to financial advisers as most of the predictive outcomes relate to risk which is vital in making investment decisions. While prior research has shown the relevance of personality traits on investment performance, the added dimension of gender and race adds practicality to the findings. It also highlights the necessity of including demographic variables when assessing personality traits. (shrink)

Algorithmic biases, or algorithmic unfairness, have been a topic of public and scientific scrutiny for the past years, as increasing evidence suggests the pervasive assimilation of human cognitive biases and stereotypes in such systems. This research is specifically concerned with analyzing the presence of discursive biases in the text generated by GPT-3, an NLPM which has been praised in recent years for resembling human language so closely that it is becoming difficult to differentiate between the human and the algorithm. The (...) pertinence of this research object is substantiated by the identification of race, gender and religious biases in the model’s completions in recent research, suggesting that the model is indeed heavily influenced by human cognitive biases. To this end, this research inquires: How does the Natural Language Processing Model GPT-3 replicate existing social biases?. This question is addressed through the scrutiny of GPT-3’s completions using Critical Discourse Analysis (CDA), a method which has been deemed as amply valuable for this research as it is aimed at uncovering power asymmetries in language. As such, the analysis is specifically centered around the analysis of gender and race biases in the model’s generated text. Research findings suggest that GPT-3’s language generation model significantly exacerbates existing social biases while replicating dangerous ideologies akin to white supremacy and hegemonic masculinity as factual knowledge. (shrink)

Introduction: Early recognition of prediabetes may prevent progression to diabetes, yet not all adults are aware of their prediabetes risk. To reach all adults unaware of their risk, additional risk assessment strategies are warranted. Objectives: The objective of this study was to evaluate the potential scope of benefit from prediabetes risk assessment in the dental care setting and to identify characteristics of dental patients likely to unknowingly have prediabetes or diabetes. Methods: Data from 10,472 adults in the National Health and (...) Nutrition Examination Survey from 2013 to 2014 and 2015 to 2016 were analyzed for associations among prediabetes/diabetes risk factors, health care use, and hemoglobin A1C levels according to chi-square tests and multivariate logistic regression. Results: A total of 7.73% of US adults had seen a dentist but not a medical provider in the past 12 mo. The composition of this subpopulation was significantly different from that who saw a medical provider, in ways that might affect their diabetes risk. In addition, 31.27% of this subpopulation would be identified as being at high risk for prediabetes according to the CDC Prediabetes Screening Test, and 15.83% had hemoglobin A1C levels indicative of undiagnosed prediabetes or diabetes. Screening in a dental setting would have the highest odds of identifying someone unaware of his or her diabetes risk among those who were non-White, obese, or ≥45 y old. Conclusion: Extrapolation from this analysis indicates that screening for prediabetes at dental visits has the potential to alert an estimated 22.36 million adults of their risk for prediabetes or diabetes. Incorporating prediabetes or diabetes risk assessment into routine dental visits may enable 1) those with prediabetes to take action to decrease their risk of developing diabetes and 2) those with diabetes to engage in treatment to decrease their risk of diabetes-related complications. Knowledge Transfer Statement: Screening for prediabetes and diabetes during dental visits has the potential to raise patients’ awareness of diabetes risk and prevent prediabetes from progressing to diabetes. For some patients, the dental visit may be the only point of contact with the health care system, which heightens the importance of including diabetes risk assessment for patient well-being. (shrink)

AimWhite matter changes in individuals at ultra-high risk for psychosis (UHR) may be involved in the transition to psychosis. Sleep-wake disturbances commonly precede the first psychotic episode and predict development of psychosis. We examined associations between white matter microstructure and sleep-wake disturbances in UHR individuals compared to healthy controls (HC), as well as explored the confounding effect of medication, substance use, and level of psychopathology.MethodsSixty-four UHR individuals and 35 HC underwent clinical interviews and diffusion weighted imaging. Group differences on (...) global and callosal mean fractional anisotropy (FA) was tested using general linear modeling. Sleep-wake disturbances were evaluated using the subjective measures disturbed sleep index (DSI) and disturbed awakening index (AWI) from the Karolinska Sleep Questionnaire, supported by objective sleep measures from one-night actigraphy. The primary analyses comprised partial correlation analyses between global FA/callosal FA and sleep-wake measures. Secondary analyses investigated multivariate patterns of covariance between measures of sleep-wake disturbances and FA in 48 white matter regions of interest using partial least square correlations.ResultsUltra-high risk for psychosis individuals displayed lower global FA (F = 14.56, p < 0.001) and lower callosal FA (F = 11.34, p = 0.001) compared to HC. Subjective sleep-wake disturbances were significantly higher among the UHR individuals (DSI: F = 27.59, p < 0.001, AWI: F = 36.42, p < 0.001). Lower callosal FA was correlated with increased wake after sleep onset (r = −0.34, p = 0.011) and increased sleep fragmentation index (r = −0.31, p = 0.019) in UHR individuals. Multivariate analyses identified a pattern of covariance in regional FA which were associated with DSI and AWI in UHR individuals (p = 0.028), but not in HC. Substance use, sleep medication and antipsychotic medication did not significantly confound these associations. The association with objective sleep-wake measures was sustained when controlling for level of depressive and UHR symptoms, but symptom level confounded the covariation between FA and subjective sleep-wake measures in the multivariate analyses.ConclusionCompromised callosal microstructure in UHR individuals was related to objectively observed disruptions in sleep-wake functioning. Lower FA in ventrally located regions was associated with subjectively measured sleep-wake disturbances and was partly explained by psychopathology. These findings call for further investigation of sleep disturbances as a potential treatment target. (shrink)

This article examines mixed ℋ -infinity and passivity synchronization of Markovian jumping neutral-type complex dynamical network models with randomly occurring coupling delays and actuator faults. The randomly occurring coupling delays are considered to design the complex dynamical networks in practice. These delays complied with certain Bernoulli distributed white noise sequences. The relevant data including limits of actuator faults, bounds of the nonlinear terms, and external disturbances are available for designing the controller structure. Novel Lyapunov–Krasovskii functional is constructed to verify (...) the stability of the error model and performance level. Jensen’s inequality and a new integral inequality are applied to derive the outcomes. Sufficient conditions for the synchronization error system are given in terms of linear matrix inequalities, which can be analyzed easily by utilizing general numerical programming. Numerical illustrations are given to exhibit the usefulness of the obtained results. (shrink)

Michigan is a critical agricultural state, and small family farms are a crucial component of the state’s food sector. This paper examines how the race/ethnicity of the family farm owners/operators is related to farm characteristics, financing, and impacts of the pandemic. It compares 75 farms owned/operated solely by Whites and 15 with People of Color owners/operators. The essay examines how farmers finance their farm operations and the challenges they face doing so. The article also explores how the Coronavirus-19 pandemic affected (...) farming operations, the financial viability of farms, and how farmers responded to the challenges posed by the pandemic. The study found that People of Color farm owners/operators were younger than White farm owners/operators. The People of Color farm owners/operators tended to manage smaller farms for shorter periods than White farm owners/operators. Though two-thirds of the Farmers of Color owned their farms, they were more financially vulnerable than White farm owners/operators. The farmers studied had difficulty obtaining loans to finance their farms. Farmers reported increasing requests from people for food assistance during the pandemic. Farmers responded to the pandemic by participating in government programs such as the Farm to Families Food Box Program that purchased their produce. It allowed farmers to supply emergency food assistance programs with products from their farms. The products went to families receiving food assistance from soup kitchens, food banks, and other community-based nonprofits. (shrink)

If stem cell-based therapies are developed, we will likely confront a difficult problem of justice: for biological reasons alone, the new therapies might benefit only a limited range of patients. In fact, they might benefit primarily white Americans, thereby exacerbating long-standing differences in health and health care.

This white paper outlines the plans of the History Philosophy Culture Working Group of the Next Generation Event Horizon Telescope Collaboration.