Johanna Knapstein,1 Daniel Grimm,1 Marcus A Wörns,1 Peter R Galle,1 Hauke Lang,2 Tim Zimmermann111st Department of Internal Medicine, Johannes Gutenberg-University, Mainz, Germany; 2Department of General, Visceral and Transplantation Surgery, Johannes Gutenberg-University, Mainz, GermanyIntroduction: Hepatitis C virus reinfection occurs universally after liver transplantation, with accelerated cirrhosis rates of up to 30% within 5 years after liver transplantation. Dual antiviral therapy with pegylated interferon-2a and ribavirin only reaches sustained virological response rates of ~30% after liver transplantation. With the approval of viral NS3/4A (...) protease inhibitors telaprevir, boceprevir, and simeprevir and the NS5B polymerase inhibitor sofosbuvir, combination therapy offers new therapeutic options for HCV-infected patients, resulting in considerably higher sustained virological response rates in the nontransplant setting. Case presentation: We report three cases of TVR-based triple antiviral therapy in HCV genotype 1 reinfected patients after liver transplantation, of whom a 57-year-old Caucasian female and a 43-year-old Caucasian male were therapy naïve, and a 49-year-old Caucasian male patient was pretreated ineffectively. After 4 weeks of therapy, viral load decreased one to three log10 and became negative in weeks 6 to 8 in the therapy naïve patients. The pretreated patient showed a negative viral load in week 4. TVR was administered over 12 weeks, 750 mg thrice daily. Doses of immunosuppression with cyclosporine were reduced four to six fold. Initial peg-IFN and RBV doses ranged from 135–180 µg/week and 800–1,200 mg/day, according to the patient's body weight. Doses of peg-IFN and RBV were adapted to 90–135 µg/week and 400–800 mg/day after 2 to 12 weeks of protease inhibitor therapy. Dual therapy was continued for 36 weeks with total treatment duration of 48 weeks in the therapy naïve patients leading to a sustained virological response 12 weeks after the end of therapy. In the pretreated patient a breakthrough was detected in week 24 and therapy was discontinued. Overall, antiviral therapy was well tolerated. Side effects included dysgeusia and anemia leading to erythropoietin application and blood transfusions. Conclusion: This case series emphasizes that triple therapy with TVR is an efficient treatment for therapy naïve HCV genotype 1 reinfected patients after liver transplantation. But therapeutic options for pretreated patients require improvement. Keyword: cyclosporine, interferon, ribavirin, hepatitis C, protease inhibitor. (shrink)

In this book, Nugayev makes a clear case against Kuhnian and Lakatosian models. For him the origin of scientific revolutions lies in the clash of theories which are already mature and have triumphed in their respective spheres of action.

Cet article analyse le travail de Patrick Tosani en suivant l’ordre d’apparition des séries afin de souligner l’évolution de la réflexion de l’artiste sur la photographie. Sur le plan méthodologique, l’article privilégie l’analyse des images et des dispositifs mis en place en insistant sur la dimension réflexive du travail. On découvre ainsi comment ce processus en œuvre génère une pensée sur la nature des images produites.

En s'inscrivant dans une problématique posée par Pierre Schaeffer à propos d'une utilisation des moyens de communication au profit de groupes sociaux d'intérêts communs, cet article présente les conditions d'émergence et de fonctionnement des réseaux spécifiques de communication sociale à partir de l'exemple concret de la radio Antélim, et il s'interroge sur une éventuelle préfiguration d'Internet. Dans un premier temps, un rappel des théorisations, recherches et expériences, menées au cours des années 1960-1970, dégagera les conditions d'une communication participative, interactive et (...) multipolaire, modèle alternatif à celui, dominant, des mass média. Puis, l'étude de l'expérimentation d'Antélim menée en France entre 1978 et 1985 avec le milieu de la marine marchande mettra en lumière l'origine du projet, sa mise en oeuvre et présentera une évaluation de l'expérience. Enfin, la question de la préfiguration d'Internet par ces réseaux spécifiques de communication sociale via la radio sera posée pour tenter de définir des parallèles possibles entre ces deux dispositifs.By entering in a problem posed by Pierre Schaeffer about a use of means of communication for the benefit of groups of common interests, this article presents the conditions for the emergence and operation of specific networks of social communication from the example of the radio Antélim, and he wondered about a possible forerunner of the Internet. At first, a reminder of the theories, research and experiments, conducted in the years 1960-1970, will identify the conditions for participatory communication, interactive and multipolar alternative model to the dominant, mass media. Then, the study of Antélim experimentation conducted in France between 1978 and 1985 with the middle of the Merchant will highlight the origin of the project, its implementation and present an evaluation of the experience. Finally, the question of the forerunner of the Internet by these specific networks of social communication via the radio will be asked to try to identify possible parallels between these two devices. (shrink)

The dilemma of whether and how to disclose a diagnosis of cancer or of any other terminal illness continues to be a subject of worldwide interest. We present the case of a 62-year-old Japanese woman afflicted with advanced gall bladder cancer who had previously expressed a preference not to be told a diagnosis of cancer. The treating physician revealed the diagnosis to the family first, and then told the patient: "You don't have any cancer yet, but if we don't (...) treat you, it will progress to a cancer". In our analysis, we examine the role of family consent, communication patterns (including ambiguous disclosure), and advance directives for cancer disclosure in Japan. Finally, we explore the implications for Edmund Pellegrino's proposal of "something close to autonomy" as a universal good. (shrink)

We present a formalization of first-order predicate calculus with equality which, unlike traditional systems with axiom schemata or substitution rules, is finitely axiomatized in the sense that each step in a formal proof admits only finitely many choices. This formalization is primarily based on the inference rule of condensed detachment of Meredith. The usual primitive notions of free variable and proper substitution are absent, making it easy to verify proofs in a machine-oriented application. Completeness results are presented. The example (...) of Zermelo-Fraenkel set theory is shown to be finitely axiomatized under the formalization. The relationship with resolution-based theorem provers is briefly discussed. A closely related axiomatization of traditional predicate calculus is shown to be complete in a strong metamathematical sense. (shrink)

À proprement parler, la première « ontologie » de l’histoire fut publiée en 1606 par Jacob Lorhard, recteur du Gymnasium réformé de Saint-Gall. L’article examine l’ontologie de Lorhard en la replaçant dans son contexte suisse, celui d’une « municipalisation » de la théologie qui concerna aussi la métaphysique. Nous proposons d’abord une caractérisation « macrologique » de l’ontologie scolastique moderne par différence d’avec les voies différentes empruntées par les métaphysiques jésuites du xvi e siècle. Au niveau « micrologique » (...) ensuite, le cas de Saint-Gall permet de comparer les modèles métaphysiques des réformés et ceux des moines de l’Abbaye bénédictine. Les métaphysiques monastiques offrent de nouvelles perspectives à la recherche sur la naissance de l’ontologie à l’époque moderne. (shrink)

Non-Invasive Prenatal Testing is a technology which provides information about fetal genetic characteristics very early in pregnancy by examining fetal DNA obtained from a sample of maternal blood. NIPT is a morally complex technology that has advanced quickly to market with a strong push from industry developers, leaving many areas of uncertainty still to be resolved, and creating a strong need for health policy that reflects women’s social and ethical values. We approach the need for ethical policy-making by studying the (...) use of NIPT and emerging policy in the province of Ontario, Canada. Using an adapted version of constructivist grounded theory, we conducted interviews with 38 women who have had personal experiences with NIPT. We used an iterative process of data collection and analysis and a staged coding strategy to conduct a descriptive analysis of ethics issues identified implicitly and explicitly by women who have been affected by this technology. The findings of this paper focus on current ethical issues for women seeking NIPT, including place in the prenatal pathway, health care provider counselling about the test, industry influence on the diffusion of NIPT, consequences of availability of test results. Other issues gain relevance in the context of future policy decisions regarding NIPT, including funding of NIPT and principles that may govern the expansion of the scope of NIPT. These findings are not an exhaustive list of all the potential ethical issues related to NIPT, but rather a representation of the issues which concern women who have personal experience with this test. Women who have had personal experience with NIPT have concerns and priorities which sometimes contrast dramatically with the theoretical ethics literature. These findings suggest the importance of engaging patients in ethical deliberation about morally complex technologies, and point to the need for more deliberative patient engagement work in this area. (shrink)

Speech unfolds over time, and the cues for even a single phoneme are rarely available simultaneously. Consequently, to recognize a single phoneme, listeners must integrate material over several hundred milliseconds. Prior work contrasts two accounts: (a) a memory buffer account in which listeners accumulate auditory information in memory and only access higher level representations (i.e., lexical representations) when sufficient information has arrived; and (b) an immediate integration scheme in which lexical representations can be partially activated on the basis of early (...) cues and then updated when more information arises. These studies have uniformly shown evidence for immediate integration for a variety of phonetic distinctions. We attempted to extend this to fricatives, a class of speech sounds which requires not only temporal integration of asynchronous cues (the frication, followed by the formant transitions 150–350 ms later), but also integration across different frequency bands and compensation for contextual factors like coarticulation. Eye movements in the visual world paradigm showed clear evidence for a memory buffer. Results were replicated in five experiments, ruling out methodological factors and tying the release of the buffer to the onset of the vowel. These findings support a general auditory account for speech by suggesting that the acoustic nature of particular speech sounds may have large effects on how they are processed. It also has major implications for theories of auditory and speech perception by raising the possibility of an encapsulated memory buffer in early auditory processing. (shrink)

Communication is an important component in the construction of workplace identities, including leader and group identities. Micro-level analysis of everyday workplace discourse provides valuable insights into the way leadership is constructed and how workplace culture is created, maintained, and changed. In this context, leaders and managers are inevitably significant and influential participants, with a crucial impact on workplace culture. Drawing on audio and video data collected in 12 meetings of an IT department, the analysis demonstrates ways in which two leaders, (...) who succeed each other in the role of Director, reinforce and shape the culture of the workplace in which they operate. While both leaders claim teamwork as an important cultural value for their teams, their respective instantiations of teamwork are rather different. To explore the leaders' effect on the culture of their department, this investigation of leadership change examines ways in which the leaders manage regular workplace meetings and how they contribute to workplace humour. The analysis provides detailed evidence of the ways in which a change in leadership style can create the conditions for a change in the culture of a community of practice. (shrink)

There are clear associations between the overall quantity of input children are exposed to and their vocabulary acquisition. However, by uncovering specific features of the input that matter, we can better understand the mechanisms involved in vocabulary learning. We examine whether exposure to wh-questions, a challenging quality of the communicative input, is associated with toddlers' vocabulary and later verbal reasoning skills in a sample of low-income, African-American fathers and their 24-month-old children. Dyads were videotaped in free play sessions at home. (...) Videotapes were transcribed and reliably coded for sheer quantity of fathers' input as well as the number of wh-questions fathers produce. Children's productive vocabulary was measured at 24 months using the McArthur Bates Communicative Development Inventory MCDI, and children's verbal reasoning skills were measured 1 year later using the Bayley Scales of Infant Development. Results indicate that the overall quantity of father talk did not relate to children's vocabulary or reasoning skills. However, fathers' use of wh-questions related to both vocabulary and reasoning outcomes. Children's responses to wh-questions were more frequent and more syntactically complex, measured using the mean length of utterance, than their responses to other questions. Thus, posing wh-questions to 2-year-olds is a challenging type of input, which elicits a verbal response from the child that likely helps build vocabulary and foster verbal reasoning abilities. (shrink)

Intellectual interest in epistemic bubbles and echo chambers has grown exponentially over the past two decades. This is largely because many assume, in light of recent events, that these phenomena are morally, socially, politically, and epistemically problematic. But are we justified in simply assuming that epistemic bubbles and echo chambers are inherently epistemically problematic? Perhaps surprisingly, numerous philosophers have recently argued that epistemic bubbles and echo chambers are not intrinsically epistemically problematic. Nevertheless, I argue, this trend is mistaken. Epistemic bubbles (...) and echo chambers are all intrinsically epistemically problematic, such that we should try to escape them, if we find ourselves in them. Crucially, there are two senses in which we might identify epistemic bubbles and echo chambers as being intrinsically epistemically problematic, as opposed to “good.” After distinguishing between these senses, I demonstrate that, even if there is a sense in which epistemic bubbles can in principle be “good,” all epistemic bubbles are epistemically problematic in the sense that is ultimately relevant to the question of whether we ought to stay in epistemic bubbles or to try to get out of them. (shrink)

A review of the literature on corporate governance serves to demonstrate the applicability of many governance solutions to the university setting. Based on a review of university scandals, most of which are recent but some of which took place decades ago, it is possible to categorize them as follows: sex scandals, drugs, cheating, hazing, admissions and diplomas, on-the-job consumption, athletics, and murder. Several examples are provided in the paper, along with their impact on various stakeholders. The paper then discusses a (...) variety of solutions designed to either preempt the activities potentially leading to scandal, to deter them or to punish perpetrators. Some of these involve structural changes, institutional policies and procedures, fines, terminations, and sanctions. The paper emphasizes the proactive safeguards which govern and monitor to make sure that universities do not suffer on the back end and that their reputations do not suffer into the future. (shrink)

A classic problem in cognitive science concerns how listeners perceive and understand speech as comprised of discrete words. We propose a Syllable Inference account of spoken word recognition and segmentation, under which alternative hierarchical models of syllables, words, and phonemes are dynamically posited from cues that include current and past speech rate, with a goal of maximal prediction of sensory input. Three experiments using the Visual World eye‐tracking paradigm provide evidence supporting our proposal.

Understanding female sexuality and mate choice is central to evolutionary scenarios of human social systems. Studies of female sexuality conducted by sex researchers in the United States since 1938 indicate that human females in general are concerned with their sexual well-being and are capable of sexual response parallel to that of males. Across cultures in general and in western societies in particular, females engage in extramarital affairs regularly, regardless of punishment by males or social disapproval. Families are usually concerned with (...) marriage arrangements only insofar as those arrangements are economically or politically advantageous, but females most often have a voice in arranged marriages. Extended families also concentrate on a couple’s future reproduction rather than on sexual exclusivity. Although marriage for females is often compromised by male or family reproductive interests (which may not in fact differ from female interests), females appear to exercise their sexuality with more freedom than has previously been suggested. Notions of human females as pawns in the male reproductive game, or as traders of sex for male services, should be dispelled. (shrink)

Despite being assailed for decades by disability activists and disability studies scholars spanning the humanities and social sciences, the medical model of disability—which conceptualizes disability as an individual tragedy or misfortune due to genetic or environmental insult—still today structures many cases of patient–practitioner communication. Synthesizing and recasting work done across critical disability studies and philosophy of disability, I argue that the reason the medical model of disability remains so gallingly entrenched is due to what I call the “ableist conflation” of (...) disability with pain and suffering. In an effort to better equip healthcare practitioners and those invested in health communication to challenge disability stigma, discrimination, and oppression, I lay out the logic of the ableist conflation and interrogate examples of its use. I argue that insofar as the semiosis of pain and suffering is structured by the lived experience of unwelcome bodily transition or variation, experiences of pain inform the ableist conflation by preemptively tying such variability and its attendant disequilibrium to disability. I conclude by discussing how philosophy of disability and critical disability studies might better inform health communication concerning disability, offering a number of conceptual distinctions toward that end. (shrink)