Lower plasma levels of high-density lipoproteins in adolescents with type 2 diabetes have been associated with a higher pulse wave velocity, a marker of arterial stiffness. Evidence suggests that HDL proteins or particle subspecies are altered in T2D and these may drive these relationships. In this work, we set out to reveal any specific proteins and subspecies that are related to arterial stiffness in youth with T2D from proteomics data. Plasma and PWV measurements were previously acquired from lean and T2D (...) adolescents. Each plasma sample was separated into 18 fractions and evaluated by mass spectrometry. Then, we applied a validated network-based computational approach to reveal HDL subspecies associated with PWV. Among 68 detected phospholipid-associated proteins, we found that seven were negatively correlated with PWV, indicating that they may be atheroprotective. Conversely, nine proteins show positive correlation with PWV, suggesting that they may be related to arterial stiffness. Intriguingly, our results demonstrate that apoA-I and histidine-rich glycoprotein may reverse their protective roles and become antagonistic in the setting of T2D. Furthermore, we revealed two arterial stiffness-associated HDL subspecies, each of which contains multiple PWV-related proteins. Correlation and disease association analyses suggest that these HDL subspecies might link T2D to its cardiovascular-related complications. (shrink)

Drawing on a landscape analysis of existing data-sharing initiatives, in-depth interviews with expert stakeholders, and public deliberations with community advisory panels across the U.S., we describe features of the evolving medical information commons. We identify participant-centricity and trustworthiness as the most important features of an MIC and discuss the implications for those seeking to create a sustainable, useful, and widely available collection of linked resources for research and other purposes.

Presents a plethora of approaches to developing human potential in areas not conventionally addressed. Organized in two parts, this international collection of essays provides viable educational alternatives to those currently holding sway in an era of high-stakes accountability.

This paper argues that professionals who make boundary-related decisions should be guided by relationship-based practice. In our roles as service users and professionals, drawing from our lived experiences of professional relationships, we argue we need to move away from distance-based practice. This includes understanding the boundary stories and narratives that exist for all of us – including the people we support, other professionals, as well as the organisations and systems within which we work. When we are dealing with professional boundary (...) issues, we should centre relationship-building skills that are central to many other aspects of our work. Skills that foster relationships at all levels – between professionals, service users, and services – need to be revalued. Our final recommendation is to create, develop, and foster safer spaces within and outside of organisations, as well as inter-professionally, for the discussion and exploration of boundary-related issues and practice. We are interested in hearing from those with experiences of being marginalised by boundaries so that they can inform a reshaping of our collective ideas around boundary related practices. To foster relationship-based practices in organisations, we have outlined several recommendations here; however, we recognize that these do not go far enough, and that collective action is needed to inform systemic change. (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)

This is an original and stimulating collection of articles by scholars trained in classics, moral philosophy, political science, literature, and intellectual history. Its principal objective is to convey to the modern reader a sophisticated understanding of Homeric and Classical Greek morality and how it differs from our own. Some of the articles focus primarily on Greek value concepts, especially the concept of arete. Others compare those concepts to modern notions of virtue and tolerance, as well as to the work of (...) contemporary literary figures and philosophers, including T.S. Eliot, Alasdair Macintyre, John Wallace, and Philippa Foot. Throughout, the juxtaposition of ancient and modern ideas and the worldviews they presuppose makes these readings both intellectually exciting and revealing. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:BOOK REVIEWS 125 to such a future contingent event, not only does such an event not exist now, it does not even exist in its causes now, and this for the reason that no sufficient causes of the event exist now. Accordingly, if someone were merely to make a guess to the effect that the sea-fight will occur tomorrow, and the fight actually does occur, it still could not (...) be maintained that the original guess at the time it was made was therefore true. It simply could not have been true, because at the time of its assertion there literally was no evidence of any kind that could have rendered it true. Nevertheless, modern logicians have generally been so dead set against the notion that the truth or falsity of a proposition could ever be relative to the time when the proposition was uttered that they seem scarcely to have taken account of a consideration such as the foregoing. Nor is it likely that with the publication of this excellent translation of St. Thomas's commentary, such critics will begin to take account of this Thomistic argument even now. Somehow, one is reminded of Dr. Johnson's purported remark, "Sir, I can only give a man a reason, not an intelligence!" HENRY VEATCtt Northwestern University Pascal e Nietzsche. Scritti di E. Castelli, H. Gouhier, A. del Noce, H. Birault, K. Takeno, K. LSwith, J. D~lhomme, G. Vattimo, R. Boehm, G. Morra. (Padova: Cedam; Casa Editrice Dott. Antonio Milani, 1962. Pp. 218. = Archivio di Filosofia. Organo dell'Istituto di Studi Filosofici. Anno 1962. No 3. L. 2000.) This issue of the Archivio di Filosofia offers essays by the various authors indicated in the title above. Pascal and Nietzsche are here brought together because of what they have in common, that is, suffering, restlessness, dissatisfaction with the human condition, the historical sorrow of post-Copernican man, a paradoxical and chaotic thought. Both Pascal and Nietzsche urge man to measure the real by the possible and not the possible by the real and to risk the present certainties for the uncertainty of the future. They dislodge man from his ordinary seat and launch him on the risky adventure and great experiment of real existence. PA~L T. FUHRMANN Columbia Theological Seminary Pierre Bayle and Voltaire. By H. T. Mason. (Cambridge: Oxford University Press, 1963. Pp. xv -k 163.) Pierre Bayle and Voltaire confronts the ideas of the two philosophers and formulates some prudent conclusions about their relationship. Since Bayle's works run to nine long folio volumes and Voltaire's come to fifty quartos in the Moland edition, one cannot help but be impressed by the magnitude of Professor Mason's undertaking and by his ability to reduce his findings to a book of just over one hundred and fifty pages. In the case of Bayle and Voltaire, the basic facts concerning influence are readily available. We know what works of Bayle's were in the library at Ferney; we can see the pages the Enlightenment philosopher marked as he read; we have almost two hundred references to Bayle in Voltaire's works and letters (listed chronologically by Mason in an appendix); and critical editions, such as Morize's Candide and Lanson's Lettres philosophiques, have disclosed how consistently Voltaire turned to the Dictionnaire historique et critique or other works from Bayle's pen for information. Yet, when dealing with passages that seem to rely on Bayle for factual content, a scholar runs into many hazards. Voltaire may draw his data from Bayle, from Bayle's source, from an intermediary, or from an outside source. We know that he consulted Richard Simon, Spinoza, Dora Calmet, and Dr. Astruc as well as Bayle for his Biblical criticism. Therefore, it is very frequently impossible to be sure just how much Bayle's thinking 126 HISTORY OF PHILOSOPHY contributed to the philosophe'~. Professor Mason, while continually aware of this Uncertainty, lists the numerous cases he has found where Voltaire's source may be Bayle. More significant, of course, are Bayle's seminal ideas and their role in the formation of Voltaire's intellect. The bulk of this book is devoted to chapters on "the... (shrink)

What can well-meaning people do about terror and genocide? The more we fight against systems of violence, the further we seem to sink into them. This book explores the lives and letters of ordinary and intellectual Germans who faced the ethical challenges of the Third Reich. Trained in history, literary criticism, philosophy, and theology, its four authors look at the role of myths, lies, non-conformity, irony, and modeling in cultivating a self. They explain how we might use these ordinary strategies (...) of selfhood to bear the burden of historical responsibility and be happy doing so.". (shrink)

In a recent article in Philosophia Christi, Hugh G. Gauch, Jr., argues for the necessity of “public presuppositions” for Christian apologetics. In the course of his argument, he critiques three tenets of my approach, as given in my book, Covenantal Apologetics. Though all three objections have been lodged and answered in numerous places, I respond to Gauch by arguing that the three tenets are embedded in and consistent with the theology that came out of the Reformation. Thus, I conclude that (...) our apologetic differences have their roots in our theological differences. (shrink)

"The prince and master of all Scholastic doctors," Thomas Aquinas has profoundly impacted thinkers both inside and outside the Roman Catholic Church for more than eight hundred years. Scott Oliphint's unique study focuses on Aquinas's dualistic approach to the natural and revealed knowledge of God and his use of Aristotelian metaphysics. Oliphint provides a response to this methodology in the context of historic Reformed thought and the doctrines of revelation and Scripture. Pastors, theologians, philosophers, and students will benefit from (...) Oliphint's clear, precise, and succint analysis -- as well as from his forceful critique. --. (shrink)

Objective To assess parental permission for a neonate's research participation using the MacArthur competence assessment tool for clinical research (MacCAT-CR), specifically testing the components of understanding, appreciation, reasoning and choice. Study Design Quantitative interviews using study-specific MacCAT-CR tools. Hypothesis Parents of critically ill newborns would produce comparable MacCAT-CR scores to healthy adult controls despite the emotional stress of an infant with critical heart disease or the urgency of surgery. Parents of infants diagnosed prenatally would have higher MacCAT-CR scores than parents (...) of infants diagnosed postnatally. There would be no difference in MacCAT-CR scores between parents with respect to gender or whether they did or did not permit research participation. Participants Parents of neonates undergoing cardiac surgery who had made decisions about research participation before their neonate's surgery. Methods The MacCAT-CR. Results 35 parents (18 mothers; 17 fathers) of 24 neonates completed 55 interviews for one or more of three studies. Total scores: magnetic resonance imaging (mean 36.6, SD 7.71), genetics (mean 38.8, SD 3.44), heart rate variability (mean 37.7, SD 3.30). Parents generally scored higher than published subject populations and were comparable to published control populations with some exceptions. Conclusions The MacCAT-CR can be used to assess parental permission for neonatal research participation. Despite the stress of a critically ill neonate requiring surgery, parents were able to understand study-specific information and make informed decisions to permit their neonate's participation. (shrink)

There is a great deal of interest in the relation between the status of women and fertility—by humanists, academics and policy-makers concerned with bringing about fertility declines. The three aspects of women's status most frequently linked to fertility are their education, employment and type of husband-wife interaction. Research to date has not given us a clear and consistent explanation of these relationships and has not confirmed causality. The effects of these three factors on fertility vary considerably across national boundaries and (...) even within different sectors of the same society. Some of the assumptions held by both researchers and policymakers must be re-thought in the interests of more useful future research and of sounder policy. (shrink)

There is no agreed minimum standard with regard to what is considered safe, competent nursing care. Limited resources and organizational constraints make it challenging to develop a minimum standard. As part of their everyday practice, nurses have to ration nursing care and prioritize what care to postpone, leave out, and/or omit. In developed countries where public healthcare is tax-funded, a minimum level of healthcare is a patient right; however, what this entails in a given patient’s actual situation is unclear. Thus, (...) both patients and nurses would benefit from the development of a minimum standard of nursing care. Clarity on this matter is also of ethical and legal concern. In this article, we explore the case for developing a minimum standard to ensure safe and competent nursing care services. Any such standard must encompass knowledge of basic principles of clinical nursing and preservation of moral values, as well as managerial issues, such as manpower planning, skill-mix, and time to care. In order for such standards to aid in providing safe and competent nursing care, they should be in compliance with accepted evidence-based nursing knowledge, based on patients’ needs and legal rights to healthcare and on nurses’ codes of ethics. That is, a minimum standard must uphold a satisfactory level of quality in terms of both professionalism and ethics. Rather than being fixed, the minimum standard should be adjusted according to patients’ needs in different settings and may thus be different in different contexts and countries. (shrink)

Increasingly, national governments across the globe are prioritizing investments in neuroscience. Currently, seven active or in-development national-level brain research initiatives exist, spanning four continents. Engaging with the underlying values and ethical concerns that drive brain research across cultural and continental divides is critical to future research. Culture influences what kinds of science are supported and where science can be conducted through ethical frameworks and evaluations of risk. Neuroscientists and philosophers alike have found themselves together encountering perennial questions; these questions are (...) engaged by the field of neuroethics, related to the nature of understanding the self and identity, the existence and meaning of free will, defining the role of reason in human behavior, and more. With this Perspective article, we aim to prioritize and advance to the foreground a list of neuroethics questions for neuroscientists operating in the context of these international brain initiatives. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Hume Studies Volume XX, Number 2, November 1994, pp. 261-287 Collingwood's Understanding of Hume S. K. WERTZ What was David Hume's reception in the British idealistic tradition? In this paper, I shall contribute a short chapter on this question by examining Hume's place in R. G. Collingwood's thought.1 Such an examination has been lacking in the literature, so what follows is a comprehensive study of Collingwood's use of Hume (...) throughout all of R.G.'s writings. I shall mainly focus on two main, unrelated discussions of Hume: first is the theory of the imagination which primarily occurs in The Principles of Art, and second is the set of relations between human nature and human history which is principally found in The Idea of History. These sections will be followed by a section on minor discussions and omissions and a conclusion. It is a common misconception that Collingwood (1889-1943) has little to offer Hume scholarship, and I wish to amend that here. Actually, Collingwood has good insights into the nature of the imagination and its role in human understanding, besides instructive thoughts on Hume on human nature and history, even though his discussion of the latter is flawed. This essay serves both historical and philosophical purposes. It is to sample Hume's place in early twentieth century British idealism at a time when he began to emerge as an important philosophical figure worthy of careful study. (By "idealism," I mean the philosophical movement which takes ideas to be an irreducible part of the world and whose program is opposed to both materialism and realism.) So Collingwood's portrait is historically interesting. But over and above this, it carries significant philosophical amendments, S. K. Wertz is at the Department of Philosophy, Texas Christian University, Box 30781, Fort Worth, TX 76129 USA. e-mail: [email protected] 262 S. K. Wertz criticisms, and suggestions about Hume's thought and the eighteenth century intellectual climate. Collingwood has mostly been studied as a philosopher of history or as an aesthetician, but not in toto from the perspective of one of the historical figures to whom he is deeply indebted. Such a view affords a portrait of Hume that is instructive and rewarding. The comparison of Hume and Collingwood lead us to finer appreciation of both philosophers. Let us first look at Collingwood's positive contribution. Imagination Collingwood begins his analysis by declaring his intentions: I shall...try to show that there are such things, to be with what Hume (whose account of them I shall take as my starting-point) called 'ideas' as distinct from 'impressions'. I shall try to show that there is a special activity of mind correlative to them, and that this is what we generally call imagination, as distinct from sensation on the one hand and intellect on the other. (PA 170-71, emphasis added) Why would Collingwood start with Hume's distinction between impressions and ideas? Undoubtedly, this means that Collingwood is willing to accept the validity of the distinction and to build on it. Isn't this a strange place for an idealist to begin? Not really. When we look at British philosophy at the turn of this century, we find idealists preoccupied with the distinction,2 so it is not extraordinary to find Collingwood utilizing it to some extent. Like most Oxford students of the time, Collingwood read Locke, Berkeley, and Hume in his undergraduate program. Consequently we find them in the problems he addresses. "It was Hume who first perceived the [Lockean] problem [of confusing sensation with imagination]," Collingwood attributes, "and tried to solve it by distinguishing ideas from impressions" (PA 200). In detail: He [Hume] was right when he laid it down that the immediate concern of thought is not with impressions but with ideas; that it is ideas, not impressions, that are associated with one another and thus built up into the fabric of knowledge; and that ideas, though 'derived' from impressions, are not mere relics of them like an after-taste of onions or an after-image of the sun (as Lockeans like Condillac supposed), but something different in kind: different, if not in what he... (shrink)

Objective: The objectives of this study are to understand the current functions, structure and operation of hospital ethics committees (HECs) in Shanghai and to facilitate their improvement. Methods: (1) A questionnaire survey, (2) interviews with secretaries and (3) on-site document reviews of HECs in Shanghai were used in the study, which surveyed 33 hospitals. Results: In Shanghai, 57.56% of the surveyed hospitals established HECs from 1998 to 2005. Most HECs used bioethical review of research involving human subjects as well as (...) bioethical review or consultation regarding medical care services and administrative decision- making. Of the surveyed HECs, 14.3% did not provide any formal bioethical training to the HECs’ members and many HECs had no standard operating procedures. Some HECs had no clear definition of what was “conflict of interest” that should be considered by the HECs, while 44.4% of the HECs did not perform continuing review. Discussion: After the issues of related national regulations, more and more hospitals established HECs in Shanghai, but the functions of HECs need to be further developed and formal training on bioethics should be provided to HEC members. To assure the independence and good performance of HECs, the conflict of interest procedure, the standard operating procedures and bioethical review should be improved. Conclusion: HECs in Shanghai had developed in the preceding 10 years and they played great roles in protecting the rights and welfare of human subjects and patients; some areas need improvement. (shrink)

Background The use of lengthy, detailed, and complex informed consent forms is of paramount concern in biomedical research as it may not truly promote the rights and interests of research participants. The extent of information in ICFs has been the subject of debates for decades; however, no clear guidance is given. Thus, the objective of this study was to determine the perspectives of research participants about the type and extent of information they need when they are invited to participate in (...) biomedical research. Methods This multi-center, cross-sectional, descriptive survey was conducted at 54 study sites in seven Asia-Pacific countries. A modified Likert-scale questionnaire was used to determine the importance of each element in the ICF among research participants of a biomedical study, with an anchored rating scale from 1 to 5. Results Of the 2484 questionnaires distributed, 2113 were returned. The majority of respondents considered most elements required in the ICF to be ‘moderately important’ to ‘very important’ for their decision making. Major foreseeable risk, direct benefit, and common adverse effects of the intervention were considered to be of most concerned elements in the ICF. Conclusions Research participants would like to be informed of the ICF elements required by ethical guidelines and regulations; however, the importance of each element varied, e.g., risk and benefit associated with research participants were considered to be more important than the general nature or technical details of research. Using a participant-oriented approach by providing more details of the participant-interested elements while avoiding unnecessarily lengthy details of other less important elements would enhance the quality of the ICF. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Art's DetourA Clash of Aesthetic TheoriesS. K. Wertz (bio)Both John Dewey1 and Martin Heidegger2 thought that art's audience had to take a detour in order to appreciate or understand a work of art. They wrote about this around the same time (mid-1930s) and independently of one another, so this similar circumstance in the history of aesthetics is unusual since they come from very different philosophical traditions. What was it (...) about the climate of the times that led them to such an idea? Is it still viable today? Both philosophers thought that art's audience is not in a position to immediately appreciate works of art—that we are missing something for a direct appreciation or apprehension—so we must take a detour. Why the detours and what are they? Are the detours similar? And are Dewey and Heidegger right about this? The essay that unfolds below attempts to answer these questions.First a definition is in order so we know what the term "detour" means when I use it. What is a detour? It is a deviation from a direct course or the usual procedure; a roundabout way temporarily replacing part of a route; in other words, a bypass or a roundabout way to some destination. The Little Oxford Dictionary adds a different twist on my characterization: "a course that leaves and rejoins [the] direct route."3 Applying this idea to art, we can say that a detour describes an audience who ordinarily perceives an artwork is a legitimate beginning for an appreciation of it, but that course must be bypassed for another (conception) before it can rejoin the direct route (perception). In other words, perceptions in the aesthetic experience must be aided by conceptions—a decidedly Kantian stance taken by Dewey and Heidegger. Their illustrations make my interpretation plausible.One of Heidegger's examples is Van Gogh's painting of a pair of peasant boots.4 He selects this painting to illustrate his metaphysics, which centers around the notion of "equipment." Peasant boots are equipment in [End Page 100] the sense that they are worn or used; the mere thing (like shoes or boots in a store [exhibited] or a closet [in storage]) disappears in use and becomes equipment. Between equipment and mere things—these two categories of being—are artworks. They are pictorial representations of equipment (in Heidegger's illustration; a pair of shoes as mere things could be a pictorial representation, like an advertisement, but it wouldn't be the same). Through the painted boots, a world comes into focus—a network of meaning. The world Heidegger sees in the Van Gogh painting is captured in the following descriptions: "In the vicinity of the [art]work we were suddenly somewhere else than we usually tend to be…. The art work let us know what shoes are in truth" (ATCR 233). So the nature of art is still a question about the nature of representation for Heidegger: it is what the shoes disclose to us about human existence. As he says, it is not just merely a pair of shoes portrayed but shoes "from the dark opening of the worn insides … the toilsome tread of the worker stares forth" (ATCR 232). In other words, we see the difficult labor that this particular owner toiled with in her daily chores.In Tralbaut's book, he quotes Heidegger in a caption alongside the painting: "Engraving in the intimate obscurity of the hollow of a boot is the weariness of the steps of work. The rough and solid weight of the clog tells of the slow and obstinate trudge across the fields."5 Heidegger continues in the same vein:In the stiffly rugged heaviness of the shoes there is the accumulated tenacity of her slow trudge through the far-spreading and ever-uniform furrows of the field swept by a raw wind. On the leather lie the dampness and richness of the soil. Under the soles slides the loneliness of the field-path as evening falls. In the shoes vibrates the silent call of the earth, its quiet gift of the ripening grain and its unexplained self-refusal in the fallow desolation of... (shrink)