En matière de liberté d’expression, les normes de forme sont celles, sociales ou juridiques, qui, sans égard au contenu du discours, encadrent les moyens employés pour se faire entendre. L’analyse partira d’un cas spécifique de violation de ces normes : les actes expressifs illégaux, infractions que leurs auteurs présentent comme un exercice de leur liberté d’expression, quoiqu’ils enfreignent la légalité. Que ces infractions soient le plus souvent le fait de voix minoritaires conduit à examiner le lien entre normes de forme (...) et asymétries de pouvoir entre locuteurs sur le « marché des idées », et à proposer un assouplissement des normes de forme au bénéfice des discours minoritaires, tout en soulignant les difficultés de sa mise en œuvre juridique. (shrink)

Definition of the problemA myocardial infarction is often a vitally and emotionally threatening situation for the affected. Unconscious coping mechanisms in dealing with the heart disease may result in, for example, complete denial or emotional decompensation.ArgumentAn understanding of myocardial infarction as a borderline situation may provide theoretical enrichment for clinicians and point to a third coping avenue, described as “posttraumatic growth”. Affected individuals often refer to the event as a “wake-up call”. Clinical knowledge of these different coping mechanisms (...) may in turn lead to a relativization of primarily subjectivist positions and substantively hedonistic or preferentialist notions of good life or “quality of life”. Such a position would in turn be compatible with the deliberative model of physician–patient communication.ConsequencesIn the light of such a broader understanding of disease coping, the task of (psychosomatic) physicians would thus to accompany persons with heart disease, to be aware of the teachable moment and to enable a process of development for the patients. (shrink)

In-vivo phenotyping of genetically engineered mouse models for amyotrophic lateral sclerosis is established by combining BT-MRI and CASL G. Vanhoutte1, E. Storkebaum2, P. Carmeliet2, A. Van der Linden1.

The present work is aimed at investigating the effects of myocardial infarction and ischemia on induction of ventricular fibrillation. Electrophysiologic effects of global and local ischemia (variation of the dispersion of refractory periods as well as conduction velocity) on initiation of reentry mechanisms was studied by means of computer simulations based on a cellular automata model of propagation of activation wave through a ventricular surface element. A local area of ischemia where effects of the dispersion of refractory periods are (...) investigated is then simulated. This is made using a Gaussian distribution characterized by its mean and standard deviation. These simulations show that ischemia is capable of initiating reentry phenomena which propagate through the whole ventricle; they are responsible for ventricular fibrillation which causes sudden cardiac death, even when ischemia only involves limited parts of the myocardium. Statistical study of the probability of reentries as a function of both of the size of ischemic zones and the rate of dispersion of refractory periods shows that the latter parameter is of primary importance in triggering cardiac reentries. (shrink)

Acute myocardial infarction (AMI) is a common disease in the Western world and has been the topic of much research. Conducting clinical trials with patients in the acute phase of a myocardial infarction, however, poses an ethical challenge. As patients are often under extreme stress and require urgent medical attention, the process of informed consent is severely constrained. Furthermore, the very procedure of informed consent, which is supposed to protect eligible patients, may be a cause of harm in (...) itself due to the delay in the provision of therapy which it causes. This paper describes how physicians have dealt with the informed consent process in various AMI trials and summarizes the results from empirical studies of the consent process of such trials. Finally, the ethical issues and their implications for future trials involving this particular group of patients are discussed. (shrink)

Myocardial disarray is the screening tool for HCM (hypertrophy cardiomyopathy). It is also found in hypertension, congenital heart disease, corpulmonale, etc. Many patients died from heart failure due to myocardial disarray. The risk of premature death may be determined by the degree of myocyte disarray. This article reviews the anatomical explanation of myocardial disarray. It also discusses the pathogenesis of the myocardial disorganization that causes heart failure. How to measure myocardial disarray has also been assessed. (...) Therefore, early detection of myocardial disarray is advised to prevent heart failure. (shrink)

Coping after myocardial infarction. The mediational effects of positive and negative emotions The aim of the study was to examine mediational effects of positive and negative emotions on the relationship between cognitive appraisal and coping after myocardial infarction. Subjects were 163 patients assessed a few days after their first MI episode for cognitive appraisal using the Situation Appraisal Questionnaire developed by Wrześniewski and based on the Lazarus theory. The participants' current emotional state and coping strategies were evaluated with (...) Polish versions of the PANAS and CISS-S, respectively. The data were analyzed using the boostrapping procedure. Resultant models turned out to be similar for threat and loss appraisal, where PEs mediated task-oriented coping, while NEs were found to mediate emotion-oriented coping. A different relationship was found for challenge. Due to a significant intercorrelation among appraisals, mediational models for threat and loss were re-analyzed when controlling for challenge. Nevertheless, even if a situation is perceived as highly stressful, both positive and negative emotions can emerge, resulting in strategies that serve different functions to meet external and internal demands. (shrink)

This study aimed to investigate the status and risk factors of post-traumatic stress disorder in patients with acute myocardial infarction after emergency percutaneous coronary intervention in acute and convalescence phases. A longitudinal study design was used. Two questionnaire surveys were conducted in the acute stage of hospitalization, and 3 months after onset in patients. Logistic regression was used to analyze the risk factors for PTSD in AMI patients. The incidence of PTSD was 33.1 and 20.4% in acute and convalescent (...) patients, respectively. The risk factors related to PTSD were door-to-balloon time, left ventricular ejection fraction, smoking, anxiety, and depression. AMI patients after PCI had PTSD in the acute and convalescent stage. The findings indicate that tailored measures should be developed and carried out to prevent PTSD and improve the mental health of patients with AMI after undergoing PCI. (shrink)

The present study sought to determine the extent to which individuals'' ethical ideologies, as measured by Forsyth''s (1980) Ethics Position Questionnaire (EPQ), impacted the degree of punishment they advocated for differing ethical infractions, as well as their selection of non-ethics related variables that might be used to modify judgments of disciplinary action. The data revealed that individual ideology does impact both advocated punishment and choice of non-ethics related variables, but only in some measures. The data are discussed in terms of (...) potential moderating variables that could be examined in future studies. (shrink)

A misconception regarding the ultrastructural basis of myocardial failure has been observed in laboratory studies involving medical students and practicing physicians, in medical textbooks, and in clinical instruction of students. This misconception attributes heart failure to overextension of individual cardiac muscle fibres and their sarcomeres, resulting in a mechanically based decline in contractile force production. The basis of the misconception is a set of component misconceptions which interact in reciprocally supportive ways. The interlocking nature of the component misunderstandings strengthens (...) the overall misconception, making it difficult to undermine. A contributor to many aspects of the faulty account of heart failure is a tendency toward oversimplification of complex phenomena in learning, instruction, and scientific research. Implications for medical education are considered. (shrink)

The article presents the results of research on the relationship between social support and self-care of people with myocardial infarction. 127 patients treated in a rehabilitation centre participated in the study. The Inventory of Socially Supportive Behaviours and the Self-care Questionnaire developed by the author, were used. The findings suggest that persons receiving little support are characterised by lower level of self-care than people with medium and high level of support. No such difference was noted between people with medium (...) and high support level. This suggests that social support is of considerable importance for the changes in the level of self-care only in the case of people previously receiving little support. The research also indicates that informational support is related to higher level of self-care whereas instrumental support is related to lower level of self-care. Emotional support was significant only for the care for social functioning. (shrink)

A misconception regarding the ultrastructural basis of myocardial failure has been observed in laboratory studies involving medical students and practicing physicians, in medical textbooks, and in clinical instruction of students. This misconception attributes heart failure to overextension of individual cardiac muscle fibres and their sarcomeres, resulting in a mechanically based decline in contractile force production. The basis of the misconception is a set of component misconceptions which interact in reciprocally supportive ways. The interlocking nature of the component misunderstandings strengthens (...) the overall misconception, making it difficult to undermine. A contributor to many aspects of the faulty account of heart failure is a tendency toward oversimplification of complex phenomena in learning, instruction, and scientific research. Implications for medical education are considered. Keywords: mental models, knowledge representation, reductionism, myocardium, heart failure, physiology CiteULike Connotea Del.icio.us What's this? (shrink)

This study is a continuation of the work of Professor Kazimierz Wrześniewski. It concerns the role of curiositytrait in the dynamics of changes in coping and quality of life after a heart attack. The study was attended by 222 people after a heart attack, of whom 140 participated in the three stages of the study: at the beginning and at the end of cardiac rehabilitation and a year after leaving the resort. The participants aged 24-64 years. Curiosity-trait was measured by (...) Spielberger and Wrześniewski’s STPI questionnaire. To assess coping strategies a modified version of the COPE by Carver et al., was used. The specific and general quality of life were measured by the Polish adaptations of MacNew and NHP questionnaires. The level of curiosity-trait significantly differentiated changes in the dynamics of positive reinterpretation, problem solving and resignation, but did not affect the change in quality of life within the year after a heart attack. (shrink)

From the very first scene of The Good Place, monumental duplicity is at work. Everything is contrived and everyone is lying, both to themselves and to one another. The Good Place raises the issue of how to determine whether a person is ethical or not. Both Eleanor and Tahani struggle with significant feelings of inadequacy, compelling them to commit ethical infractions to land them in “The Good Place”. Although Tahani and Eleanor come from divergent social stations, they share a common (...) legacy of familial abuse that deeply affected their sense of self‐worth, causing them to relentlessly exploit and abuse others in their attempts to gain a positive self‐image. The Good Place reminds that in our lives we are constantly confronted by ethical dilemmas that challenge us to make choices, and all we have for guidance are flawed, often conflicting ideals that we pick up along the way. (shrink)

In the past decade, the availability of genetically modified animals has enabled the discovery of interesting roles for phosphatidylinositol 3‐kinase‐γ (PI3Kγ) and ‐δ (PI3Kδ) in different cell types orchestrating innate and adaptive immune responses. Therefore, these PI3K isoforms appear to be attractive drug targets for the treatment of diseases caused by unrestrained immune reactions. Currently, pharmacological targeting of PI3Kγ and/or PI3Kδ represents one of the most promising challenges for companies interested in the development of novel safe treatments for inflammatory diseases. (...) In this review we provide a general outline of PI3Kγ‐ and PI3Kδ‐specific functions in distinct subsets of inflammatory cells. We also discuss the therapeutic impact of novel compounds targeting PI3Kγ, PI3Kδ or both, in mouse models of autoimmune disorders (systemic lupus erythematosus (SLE) and rheumatoid arthritis), respiratory diseases (allergic asthma and chronic obstructive pulmonary disease) and cardiovascular dysfunctions (atherosclerosis and myocardial infarction). (shrink)

BackgroundAcute myocardial infarction (AMI) research is challenging as it requires enrollment of acutely ill patients. Patients are generally in a suboptimal state for providing informed consent. Patients’ understanding to verbal assents have not been previously examined in AMI research. Patients Acceptance and Comprehension to Written and Verbal Consent (PAC–VC) compared patients’ understanding and attitudes to verbal and written consents in AMI RCTs.MethodsPAC–VC recruited patients from 3 AMI trials using both verbal N = 12 and written N = 6 consents. (...) We compared patients’ understanding using two survey questionnaires. The first questionnaire used open-ended questions with multiple choice answers. The second questionnaire used a 5-point Likert scale to measure patients understanding and attitudes to the consent process. Overall answers average scores were categorized into three groups: Adequate understanding (71–100) %, Partial understanding (41–70)% and Inadequate understanding (0–40)%.ResultsResponses showed patients with verbal assent had adequate understanding to most components of informed consent, close to those of written consent. Most patients did not read written information entirely and believed that it is not important to make a final decision. Patients favoured to have written information be part of the consent but not necessarily presented during the initial consent process. Patients felt less pressured in the verbal assent arm than those of written consent.ConclusionPatients had adequate understanding to most components of verbal assent and comparable to those of written consent. Utilizing verbal assents in the acute care setting should be further assessed in larger trials. (shrink)

Ca2+ transients in myocardial cells are modulated by cyclic AMP‐dependent phosphorylation of a protein in the sarcoplasmic reticulum. This protein, termed phospholamban, serves to regulate the Ca2+ pump ATPase of this membrane, thus altering the mode of Ca2+ transients and the myocardial contractile response. Elucidating the structure of phospholamban and its intimate interaction with the Ca2+ pump ATPase should provide the basis for understanding, at the molecular level, how the cAMP system contributes to excitation‐contraction coupling in muscle cells.

Prescriptive rules guide human behavior across various domains of community life, including law, morality, and etiquette. What, specifically, are rules in the eyes of their subjects, i.e., those who are expected to abide by them? Over the last sixty years, theorists in the philosophy of law have offered a useful framework with which to consider this question. Some, following H. L. A. Hart, argue that a rule’s text at least sometimes suffices to determine whether the rule itself covers a case. (...) Others, in the spirit of Lon Fuller, believe that there is no way to understand a rule without invoking its purpose — the benevolent ends which it is meant to advance. In this paper we ask whether people associate rules with their textual formulation or their underlying purpose. We find that both text and purpose guide people’s reasoning about the scope of a rule. Overall, a rule’s text more strongly contributed to rule infraction decisions than did its purpose. The balance of these considerations, however, varied across experimental conditions: In conditions favoring a spontaneous judgment, rule interpretation was affected by moral purposes, whereas analytic conditions resulted in a greater adherence to textual interpretations. In sum, our findings suggest that the philosophical debate between textualism and purposivism partly reflects two broader approaches to normative reasoning that vary within and across individuals. Keywords: , the concept of law, rules, legal psychology, Hart, Fuller. (shrink)

The editors of scholarly journals have a duty to uphold and promote the highest standards of ethical conduct of research. They also have a responsibility to maintain the integrity of the literature, and to promote transparency and honesty in reporting research findings. In the process of screening manuscripts they receive for possible publication, editors have the obligation to report infractions to the institutions of offending authors, and request an investigation. Since editors can reject a paper on ethical grounds, they can (...) be considered to be the guardians of ethics who should express high ethical standards in conducting and publishing their own research. An examination of several publishers’ websites reveals no such requirement or clear selection criteria for journal editors. Therefore, we aim to discuss the factors that publishers, in a broad sense, should consider when selecting editors for scholarly journals and believe that such criteria should be made public to ensure accountability. This would restore some of the eroding public trust in disseminated research, fortify confidence in the composition and qualification of members of an editorial board, and help to protect the reputations of publishers and editors. (shrink)

I describe how our understanding of some of the central principles long held dear by most criminal theorists may have to be interpreted in light of the need to devise lenient responses for low-level offenders. Several of the most plausible suggestions for how to deal with minor infractions force us to take seriously some ideas that many legal philosophers have tended to resist elsewhere. I briefly touch upon four topics: whether informal can substitute for or count against the appropriate state (...) sanction; the significance of repeat offending for sentencing; whether punishment for culpable public wrongdoing has intrinsic value; and the scope of police powers in a liberal democratic state. The context for this discussion is R. A. Duff’s insightful examination of whether and under what conditions we should criminalize a public wrong or respond to it in some other manner. (shrink)

Clinical trials for acute conditions such as myocardial infarction and stroke pose challenges related to informed consent due to time limitations, stress, and severe illness. Consent processes shou...

RésuméL’«Épître sur le savoir divin» d'Averroès présente quatre dialogues differents sur deux niveaux textuels. Ces dialogues, leur structure syllogistique ainsi que l'emploi des contradictions indiquent que l’«Épître» est structurée presque entièrement en accord avec les descriptions de la dialectique se trouvant dans les commentaires d'Averroès aux Topiques d'Aristote. Ainsi, la solution d'Averroès à la question de savoir comment Dieu peut avoir une connaissance universelle des particuliers passe par un compte rendu dialectique de la distinction entre le savoir divin et celui (...) des humains. De surcroît, à un point crucial de l’«Épître» Averroès se réfère à Métaphysique Β d'Aristote, qu'il considère être une exposition dialectique des questions sur la métaphysique. Cette référence suggère que l’«Épître sur le savoir divin» est, selon Averroès, une sorte d'enquête dialectique visant à répondre aux questions qui se présentent dès qu'on aborde l’étude de la métaphysique. Il en ressort que si on peut voir en l’«Épître» une interprétation dialectique de Coran LXVII, 14, son but primaire est d'introduire ses lecteurs a la spéculation métaphysique. Ainsi, il n'y a pas d'infraction de la prohibition légale d'Averroès, dans le Discours décisif, sur l'usage des interprétations dialectiques dans les oeuvres ouvertes au public général. (shrink)