_341_ _Objectives: _In patients with multivessel disease both the detection of the culprit lesion and the exact allocation are important preconditions for sufficient treatment and improved outcome. In a vessel based approach the combination of quantitative coronary angiography and fractional flow reserve measured by a pressure wire should be advantageous compared to myocardial SPECT, as morphological and functional information is delivered simultaneously. Therefore our aim was to evaluate MS in the detection and allocation of hemodynamically significant stenoses obtained by the (...) combined gold standard QCA plus FFR in patients with multivessel disease. _Methods: _FFR and QCA of 95 vessels in 80 patients have been evaluated. Hemodynamically significant target lesions were defined as intermediate stenoses between 50 and 75% with an FFR. (shrink)

We used social network analysis to examine how adaptive ER strategies and maladaptive ER strategies predict the creation and maintenance of friendship and conflict relationships within a mixed-gender social group. Participants reported on emotion regulation, friendship, and conflict nominations at two time points. Stochastic actor-oriented models revealed that similarity in endorsement of adaptive ER strategies predicted maintenance of friendship and conflict relationships over time. However, new conflict relationships were more likely to form between those who differed in use of adaptive (...) ER. Finally, more frequent use of maladaptive ER strategies was related to termination of existing conflict ties and the creation of new ones. Deploying social network analysis as a methodology for examining social relationships enables the unpacking the dynamics of multiple social relationships, identifying the role of ER for structuring of social relationships among group members. Although cognitive ER is an intra-individual process, it fundamentally occurs within a social environment and our results advance the knowledge of how ER contributes to how this social environment is created in a first place. (shrink)

Examines the relationship between making objects and knowing nature in Europe from the mid-15th to mid-19th centuries.

The US National Institute of Health’s Human Microbiome Project aims to use genomic techniques to understand the microbial communities that live on the human body. The emergent field of microbiome science brought together diverse disciplinary perspectives and technologies, thus facilitating the negotiation of differing values. Here, we describe how values are conceptualized and negotiated within microbiome research. Analyzing discussions from a series of interdisciplinary workshops conducted with microbiome researchers, we argue that negotiations of epistemic, social, and institutional values were inextricable (...) from the reflective and strategic category work that defined and organized the microbiome as an object of study and a potential future site of biomedical intervention. Negotiating the divergence or tension between emerging scientific and regulatory classifications also activated “values levers” and opened up reflective discussions of how classifications embody values and how these values might differ across domains. These data suggest that scholars at the intersections of science and technology studies, ethics, and policy could leverage such openings to identify and intervene in the ways that ethical/regulatory and scientific/technical practices are coproduced within unfolding research. (shrink)

We conducted focus groups with 47 potential jurors who were presented with diferent scenarios in a hypothetical malpractice case involving failure to order a PSA test. Better documentation that a patient made an informed decision to decline a PSA test appeared to provide more medical-legal protection for physicians, especially with the use of a decision aid.

Screening for prostate cancer with the prostate-specific antigen blood test is controversial, as evidence to date has not demonstrated such screening does more good than harm. While the potential benefit of PSA screening on reducing prostate cancer mortality has not been documented in randomized trials, many risks of PSA screening have been well documented. These risks include a substantially higher risk of a prostate cancer diagnosis over a screenee’s lifetime, false-positive and false-negative test results, possible complications from biopsies done in (...) response to suspicious test results, and substantial risks of side effects from subsequent prostate cancer treatments. Nevertheless, PSA screening is widespread in the United States, and many physicians in a national survey reported supporting routine PSA screening as well as getting PSA tests themselves, despite the lack of evidence. (shrink)

Biomedical research is increasingly globalized with ever more research conducted in low and middle-income countries. This trend raises a host of ethical concerns and critiques. While community engagement has been proposed as an ethically important practice for global biomedical research, there is no agreement about what these practices contribute to the ethics of research, or when they are needed.

We examine the impact of an ethics education program on reporting behavior using two groups of students: fourth year Masters of Accounting students who just completed a newly instituted ethics education program, and fifth year students in the same program who did not receive the ethics program. In an experiment providing both the opportunity and motivation to misreport for more money, we design two social condition treatments – anonymity and public disclosure – to examine whether or to what extent ethical (...) values are internalized by students. We find that when participants are anonymous, misreporting rates are nearly the same regardless of ethics program participation. However, when their reporting behavior is made public to the cohort, participants who completed the ethics program misreported at significantly lower rates than those who did not receive the ethics program. The results suggest that ethics education does not necessarily result in internalized ethical values, but it can impact ethical behavior. (shrink)

The paper builds on the postulate of “myths we live by,” which shape our imaginative life (and hence our social expectations), but which are also open to reflective study and reinvention. It applies this principle, in particular, to the concepts of love and vulnerability. We are accustomed to think of the condition of vulnerability in an objectifying and distancing way, as something that affects the bearers of specific (disadvantaged) social identities. Against this picture, which can serve as a pretext for (...) paternalist and controlling attitudes to the groups in question – notably to women – Anderson urges us to reimagine our vulnerability as a condition not merely of exposure to violence but of openness to mutual affection, love, and friendship. Hegel’s celebrated image of the owl of Minerva, which takes wing only with the coming of dusk, suggests an association of (philosophical) wisdom with negativity – with the experience of death or loss. Anderson, by contrast, proposes an alternative and more hopeful image of the dawn of enlightenment, in the guise of new ethical dispositions shaped by an emancipatory (and so, no longer an oppressive or sexist) conception of our capacity for love. Her main interlocutors or influences in this piece are Judith Butler (who contributes the idea of a “relational ontology”), Michèle Le Doeuff, and Mary Midgley. (shrink)

Since the early 1980’s, with the clinical advent of in vitro fertilization resulting in so-called “test tube babies,” a wide array of ethical considerations and concerns regarding artificial womb technology (AWT) have been described. Recent breakthroughs in the development of extracorporeal neonatal life support by means of AWT have reinitiated ethical interest about this topic with a sense of urgency. Most of the recent ethical literature on the topic, however, pertains not to the more imminent scenario of a physiologically improved (...) method of neonatal care through AWT, but instead to the remote scenario of “complete ectogenesis” that imagines human gestation occurring entirely outside of the womb. This scoping review of the ethical literature on AWT spans from more abstract concerns about complete ectogenesis to more immediate concerns about the soon-to-be-expected clinical life support of what we term the fetal neonate or fetonate. Within an organizing framework of different stages of human gestational development, from conception to the viable premature infant, we discuss both already identified and newly emerging ethical considerations and concerns regarding AWT and the care of the fetonate. (shrink)

The objective of this study is to evaluate if use of a patient decision aid, when choosing between a repeat cesarean or a trial of labor after a cesarean, reduces medical liability exposure. The authors conclude that use of a PDA conferred liability protection when potential jurors were presented with a hypothetical malpractice claim against an obstetrician following a TOLAC.

In a recent Opinion article, Sui and Humphreys [1] argue that experimental findings suggest self is ‘special’, in that self-reference serves a binding function within human cognitive economy. Contrasting their view with other functionalist positions, chiefly Dennett's [2], they deny that self is a convenient fiction and adduce findings to show that a ‘core self representation’ serves as an ‘integrative glue’ helping to bind distinct types of information as well as distinct stages of psycho- logical processing. In other words, where (...) Dennett regards self as analogous to a center of gravity, a simplification posited by observers, Sui and Humphreys regard self as a function that modulates mental processes. In practice, however, the concept of ‘self’ they employ is not unlike Dennett's. We side with Sui and Humphreys in hold- ing that self-reference modulates mental processes: reference to self during a task can bind memory to source, increase perceptual integration, and link attention to decision making, among other things. What is more, these functions are not reducible to other factors such as semantic coding, familiarity, or reward [3]. But whereas Sui and Humphreys contribute important empirical detail, the binding functions they describe are compatible with Dennett's version of functionalism, which treats self as an artifact of social process. (shrink)

This paper deals with four ethical issues in the development and application of business and management knowledge. The issues examined are: (1) failure to adopt or disclose knowledge with proven value that could benefit individuals, organizations, and society; (2) inappropriate implementation or incomplete disclosure of knowledge with proven potential; (3) use of knowledge for the exclusive benefit of a selected interest group even if harm is done to others; and (4) intentional falsification or misrepresentation of knowledge as something other than (...) what it is known to be. Each of these issues are illustrated with actual case histories and are examined using frequently accepted ethical concepts. (shrink)

We are pleased to present the following Review Forum of Harvey Whitehouse’s book, Arguments and Icons: Divergent Modes of Religiosity. Oxford: Oxford University Press, 2000. 204 pages. ISBN 0-19- 823414-7 (cloth); 0-19-823415-5 (paper). We have given the contributors and the book’s author sufficient space to discuss its themes carefully and thus make a significant contribution to the further analysis of religion and ritual generally.

The dominant paradigm of experiments in the social and behavioral sciences views an experiment as a test of a theory, where the theory is assumed to generalize beyond the experiment's specific conditions. According to this view, which Alan Newell once characterized as “playing twenty questions with nature,” theory is advanced one experiment at a time, and the integration of disparate findings is assumed to happen via the scientific publishing process. In this article, we argue that the process of integration is (...) at best inefficient, and at worst it does not, in fact, occur. We further show that the challenge of integration cannot be adequately addressed by recently proposed reforms that focus on the reliability and replicability of individual findings, nor simply by conducting more or larger experiments. Rather, the problem arises from the imprecise nature of social and behavioral theories and, consequently, a lack of commensurability across experiments conducted under different conditions. Therefore, researchers must fundamentally rethink how they design experiments and how the experiments relate to theory. We specifically describe an alternative framework, integrative experiment design, which intrinsically promotes commensurability and continuous integration of knowledge. In this paradigm, researchers explicitly map the design space of possible experiments associated with a given research question, embracing many potentially relevant theories rather than focusing on just one. Researchers then iteratively generate theories and test them with experiments explicitly sampled from the design space, allowing results to be integrated across experiments. Given recent methodological and technological developments, we conclude that this approach is feasible and would generate more-reliable, more-cumulative empirical and theoretical knowledge than the current paradigm – and with far greater efficiency. (shrink)

Commentaries on the target article offer diverse perspectives on integrative experiment design. Our responses engage three themes: (1) Disputes of our characterization of the problem, (2) skepticism toward our proposed solution, and (3) endorsement of the solution, with accompanying discussions of its implementation in existing work and its potential for other domains. Collectively, the commentaries enhance our confidence in the promise and viability of integrative experiment design, while highlighting important considerations about how it is used.

This volume contains thirteen papers that were presented at the 2017 Annual Meeting of the Canadian Society for History and Philosophy of Mathematics/Société canadienne d’histoire et de philosophie des mathématiques, which was held at Ryerson University in Toronto. It showcases rigorously reviewed modern scholarship on an interesting variety of topics in the history and philosophy of mathematics from Ancient Greece to the twentieth century. A series of chapters all set in the eighteenth century consider topics such as John Marsh’s techniques (...) for the computation of decimal fractions, Euler’s efforts to compute the surface area of scalene cones, a little-known work by John Playfair on the practical aspects of mathematics, and Monge’s use of descriptive geometry. After a brief stop in the nineteenth century to consider the culture of research mathematics in 1860s Prussia, the book moves into the twentieth century with an examination of the historical context within which the Axiom of Choice was developed and a paper discussing Anatoly Vlasov’s adaptation of the Boltzmann equation to ionized gases. The remaining chapters deal with the philosophy of twentieth-century mathematics through topics such as an historically informed discussion of finitism and its limits; a reexamination of Mary Leng’s defenses of mathematical fictionalism through an alternative, anti-realist approach to mathematics; and a look at the reasons that mathematicians select specific problems to pursue. Written by leading scholars in the field, these papers are accessible to not only mathematicians and students of the history and philosophy of mathematics, but also anyone with a general interest in mathematics. (shrink)

Experiential evidence shows that pain is associated with common meanings. These include a meaning of threat or danger, which is experienced as immediately distressing or unpleasant; cognitive meanings, which are focused on the long-term consequences of having chronic pain; and existential meanings such as hopelessness, which are more about the person with chronic pain than the pain itself. This interdisciplinary book - the second in the three-volume Meanings of Pain series edited by Dr Simon van Rysewyk - aims to better (...) understand pain by describing experiences of pain and the meanings these experiences hold for the people living through them. The lived experiences of pain described here involve various types of chronic pain, including spinal pain, labour pain, rheumatic pain, diabetic peripheral neuropathic pain, fibromyalgia, complex regional pain syndrome, endometriosis-associated pain, and cancer-related pain. Two chapters provide narrative descriptions of pain, recounted and interpreted by people with pain. Language is important to understanding the meaning of pain since it is the primary tool human beings use to manipulate meaning. As discussed in the book, linguistic meaning may hold clues to understanding some pain-related experiences, including the stigmatisation of people with pain, the dynamics of patient-clinician communication, and other issues, such as relationships between pain, public policy and the law, and attempts to develop a taxonomy of pain that is meaningful for patients. Clinical implications are described in each chapter. This book is intended for people with pain, their family members or caregivers, clinicians, researchers, advocates, and policy makers. (shrink)