Upon separation of the protein from the nucleic acid component of tobacco mosaic virus by phenol, using a fast and gentle procedure, the nucleic acid is infective in assays on tobacco leaves. A series of qualitative and quantitative control experiments demonstrates that the biological activity cannot depend on residual proteins in the preparation, but is a property of isolated nucleic acid which is thus the genetic material of the virus.

Weighing competing obligations and achieving the “greatest balance” of right over wrong guides an individual, an agency or a country in determining what ought to be done in an ethically challenging situation. Conducting controlled human infection model (CHIM) studies in India is one such situation. The ethical challenge in conducting a CHIM study lies in completing the difficult task of introducing standardised, attenuated strains of micro-organisms into normal healthy volunteers, at the same time ensuring the safety of these healthy (...) individuals from potential and completely informed risks in a fashion that is transparent and accountable. The bar is further raised against the background of already fragile public confidence in biomedical research in India; especially when “deliberate” introduction of microbial agents into healthy individuals is involved, with the larger altruistic objective of gain to society as a whole. -/- This paper discusses the uses of CHIM studies with respect to the larger scientific Indian research enterprise of the 21st century. It further explores etic and emic perspectives in conducting such trials in India and seeks to generate an ethical coherence to the justification for conducting CHIM studies in India. The paper deliberates on ethical issues arising out of conducting CHIM studies and reflects on how developing the capacity for CHIM studies in India is likely to strengthen the health research and development sector in the country. -/- . (shrink)

In this paper we make a simple theoretical point using a practical issue as an example. The simple theoretical point is that robustness is not 'all or nothing': in asking whether a system is robust one has to ask 'robust with respect to what property?' and 'robust over what set of changes in the system?' The practical issue used to illustrate the point is an examination of degrees of linkage between sub-networks and a pointed contrast in robustness and fragility between (...) the dynamics of (1) contact infection and (2) information transfer or belief change. Time to infection across linked sub-networks, it turns out, is fairly robust with regard to the degree of linkage between them. Time to infection is fragile and sensitive, however, with regard to the type of sub-network involved: total, ring, small world, random, or scale-free. Aspects of robustness and fragility are reversed where it is belief updating with reinforcement rather than infection that is at issue. In information dynamics, the pattern of time to consensus is robust across changes in network type but remarkably fragile with respect to degree of linkage between sub-networks. These results have important implications for public health interventions in realistic social networks, particularly with an eye to ethnic and socio-economic sub-communities, and in social networks with sub-communities changing in structure or linkage. (shrink)

In order to understand the transmission of a disease across a population we will have to understand not only the dynamics of contact infection but the transfer of health-care beliefs and resulting health-care behaviors across that population. This paper is a first step in that direction, focusing on the contrasting role of linkage or isolation between sub-networks in (a) contact infection and (b) belief transfer. Using both analytical tools and agent-based simulations we show that it is the structure (...) of a network that is primary for predicting contact infection—whether the networks or sub-networks at issue are distributed ring networks or total networks (hubs, wheels, small world, random, or scale-free for example). Measured in terms of time to total infection, degree of linkage between sub-networks plays a minor role. The case of belief is importantly different. Using a simplified model of belief reinforcement, and measuring belief transfer in terms of time to community consensus, we show that degree of linkage between sub-networks plays a major role in social communication of beliefs. Here, in contrast to the case of contract infection, network type turns out to be of relatively minor importance. What you believe travels differently. In a final section we show that the pattern of belief transfer exhibits a classic power law regardless of the type of network involved. (shrink)

Clinical microbiology serves as a partner to clinicians in the diagnosis and treatment of infectious diseases. Antibiotics are prescribed empirically before the availability of antimicrobial susceptibility testing data, especially when the patient's medical status could deteriorate by suspending the treatment. To investigate the impact of antimicrobial susceptibility testing on the management of outpatients with suspected bacterial infection in Libyan patients, a cross-sectional prospective study concluded on microbial microdroplet culture by including outpatients with suspected bacterial infection, who have done (...) antimicrobial susceptibility testing. Thus, 53 Libyan patients with urinary tract infections and 14 Libyan patients with skin infections were included in this study. Before the availability of antimicrobial susceptibility testing data, 25 patients were appropriately treated while 42 patients were inappropriately treated. After the availability of antimicrobial susceptibility testing data, the number of appropriately treated patients increased to 57 patients. Thus, antimicrobial susceptibility testing improved the management of 41 patients by discontinuing an unnecessary antibiotic in four patients, starting necessary antibiotic therapy in 18 patients, and changing to more appropriate antibiotic in 19 patients. However, the antimicrobial susceptibility testing has no impact on the management of 24 patients and has led to the worsening of the management of two patients. The effect of antimicrobial susceptibility testing of antibiotic de-escalation was assessed in 35 patients; however, antibiotic de-escalation occurred in six patients. Thus, data of antimicrobial susceptibility testing has improved the management of Libyan outpatients with bacterial infection but their role in antibiotic de-escalation was slight. (shrink)

Ethical considerations play a key role in the proposed frameworks for COVID-19 vaccine allocation. Based on a set of ethical principles, these frameworks make recommendations on those who should be prioritized for vaccination. WHO Strategic Advisory Group of Experts of Immunization (SAGE)1, the National Academy of Medicine (NAM)2, and the Johns Hopkins Center for Health Security (JHCHS)3 have issued frameworks for allocation and prioritization of COVID-19 vaccination. None of these frameworks have made any recommendations as to the prioritization of those (...) who have not yet been infected with SARS-CoV-2 (non-infected group) over those who have been infected previously (infected group). Does this imply that giving priority to the non-infected group is not justified from the ethical perspective of these frameworks? In the following, we review the ethical foundations of these frameworks and show that prioritization of the non-infected group is not only consistent with, but also implied by, these ethical foundations. (shrink)

Multiple drug resistant strains of HIV and continuing difficulties with vaccine development highlight the importance of psychologi- cal interventions which aim to in uence the psychosocial and emo- tional factors empirically demonstrated to be significant predictors of immunity, illness progression and AIDS mortality in seropositive persons. Such data have profound implications for psychological interventions designed to modify psychosocial factors predictive of enhanced risk of exposure to HIV as well as the neuroendocrine and immune mechanisms mediating the impact of such factors (...) on disease progression. Many of these factors can be construed as unconscious mental ones, and psychoanalytic self-psychology may be a useful framework for conceptualizing psychic and immune de- fence as well as bodily and self-integration in HIV infection. Al- though further prospective studies and cross-cultural validation of research are necessary, existing data suggest that psychoanalytic insights may be useful both in therapeutic interventions and evaluative research which would require an underlying epistemology of the complementarity of mind and matter. (shrink)

Introduction: There is no study investigating the factors predicting postoperative febrile urinary tract infection (fUTI) in pediatric patients. We aimed to determine the factors predicting postoperative fUTI in pediatric patients who underwent ureterorenoscopic lithotripsy (URS-L). -/- Methods: Pediatric patients who underwent URS-L due to ureter or kidney stones in our clinic between 2012 and 2019 were analyzed retrospectively. The demographic data, stone characteristics, intraoperative and postoperative data of those with and without postoperative fUTI were compared. Univariable and multivariable binary (...) logistic regression analysis was performed to determine predictors of fUTI. -/- Results: A total of 136 patients were included in the study. Postoperative fUTI developed in 17 patients (12.5%). History of stone surgery, history of UTI, presence of nephrostomy/D-J stent, type of surgery, operation time, length of stay, and presence of complication except fUTI were found to be significantly different in the fUTI group. In the univariate analysis, history of stone surgery, history of UTI, presence of nephrostomy/D-J stent, type of surgery, operation time, and presence of complication except fUTI were determined as factors predicting fUTI. In multivariate analysis, only the history of UTI was identified as an independent predictive factor. -/- Conclusion: In pediatric patients, infectious complications constitute the majority of complications after URS-L. History of UTI is the only independent factor that predicts postoperative fUTI after URS-L. (shrink)

Psoriatic arthritis is a chronic, systemic inflammatory disorder. It has been classified in spondyloarthropathies group which shares clinical, radiologic, serologic features, familial and genetic relationship. Up to 5-30% of patients with psoriasis may go on to develop psoriatic arthritis, usually within 5-10 years. Adalimumab (ADA) is the first human monoclonal antibody against TNF-α. ADA is a biologic agent effective in both skin lesions and joint signs. Anti-TNF agents are powerful immunmodulating drugs with potentially side effects. Our case is 38 years (...) old woman complaining about swelling and pain in hand joints. In physical examination she has asymmetrical arthritis in wrist, proximal (PIP) and distal interphalangeal (DIP) hand joints and right knee joint. In laboratory; sedimentation rate: 80 mm/h, C-reactive protein: 17 mg/l, rheumatoid factor (RF): 8.7 IU/ml and HLA B27 was positive. Radiologically, erosions and narrowing were determined in PIP and DIP hand joints and grade 3 sacroiliitis bilaterally. In clinical monitoring, psoriaform lesions progressed in her scalp, so we diagnosed psoriatic artritis. We started ADA therapy 40 mg subcutaneously every two weeks. She developed periorbital infection in left-sided in tertiary month following. Streptococcal proliferation was seen in lesion culture, so we began amoxicillin-clavulanate therapy. She benefit antibiotic therapy, infectious signs regressed. ADA therapy discontinued, instead of it, etanercept 50 mg twice weekly subcutaneous and methylprednisolone 12 mg/daily oral therapy is started. We purposed to declare our case with literature selection. (shrink)

Clinical microbiology serves as a partner to clinicians in the diagnosis and treatment of infectious diseases. Antibiotics are prescribed empirically before the availability of antimicrobial susceptibility testing data, especially when the patient's medical status could deteriorate by suspending the treatment. To investigate the impact of antimicrobial susceptibility testing on the management of outpatients with suspected bacterial infection in Libyan patients, a cross-sectional prospective study concluded on microbial microdroplet culture by including outpatients with suspected bacterial infection, who have done (...) antimicrobial susceptibility testing. Thus, 53 Libyan patients with urinary tract infections and 14 Libyan patients with skin infections were included in this study. Before the availability of antimicrobial susceptibility testing data, 25 patients were appropriately treated while 42 patients were inappropriately treated. After the availability of antimicrobial susceptibility testing data, the number of appropriately treated patients increased to 57 patients. Thus, antimicrobial susceptibility testing improved the management of 41 patients by discontinuing an unnecessary antibiotic in four patients, starting necessary antibiotic therapy in 18 patients, and changing to more appropriate antibiotic in 19 patients. However, the antimicrobial susceptibility testing has no impact on the management of 24 patients and has led to the worsening of the management of two patients. The effect of antimicrobial susceptibility testing of antibiotic de-escalation was assessed in 35 patients; however, antibiotic de-escalation occurred in six patients. Thus, data of antimicrobial susceptibility testing has improved the management of Libyan outpatients with bacterial infection but their role in antibiotic de-escalation was slight. (shrink)

The article deals with the concept of metaparasite in the cultural and communicative sphere. Relying on the memetic theory of R. Dawkins and the cognitive framework proposed by K. Anokhin, the authors explore the dynamics of metaparasitism and the ability of the metaparasite to change its environment beyond the original context. The article also considers the challenges that have emerged in the post-truth era, embodied in such phenomena as fake news, etc., and emphasizes the need to find effective responses to (...) threats to psychological and sociocultural security. The article formulates a set of communicative techniques aimed at ensuring safety for both the communicator and the recipient, and presents the feedback system as a key component of any rational system. Based on the results of the study, the authors propose a strategy aimed at protecting society against the harmful effects of metaparasites. (shrink)

Background: In prevalence studies of sexually transmitted infections (STIs), investigators often provide syndromic management for symptomatic participants, but may not provide specific treatment for asymptomatic individuals with positive laboratory test results due to the delays between sample collection and availability of results as well as logistical constraints in recontacting study participants. Methods: To characterize the extent of this issue, 80 prevalence studies from the World Health Organization’s Report on global sexually transmitted infection surveillance, 2018, were reviewed. Studies were classified (...) as to whether clinically relevant positive results were returned or if this was not specified. Results: More than half (56%) of the cited studies did not specify if participants were notified of clinically relevant positive STI test results. The percentages were similar for low- and middle-income country populations (57%) and high-income country populations (53%). Conclusions: The absence of documentation of the provision of test results raises the possibility that in some instances, results may not have been communicated, with potential negative effects for participants, their sexual partners, and newborns. From an ethical perspective, clinically relevant results should be returned to study participants and treating clinicians in a timely fashion to ensure appropriate management of identified infections. Study authors should document if they returned test results to study participants and report on numbers lost to follow-up. (shrink)

Background: In response to the pandemic caused by COVID-19, World Health Organization (WHO), together with International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC), developed research protocols facilitating global collaboration and accelerating the understanding of the disease, to identify the potential symptoms and persistent sequelae in infected individuals, which can be used in different areas of health, that is, in primary care, at a hospital or outpatient level, both public and private. Objective: To describe the International Severe Acute Respiratory (...) and Emerging Infection Consortium (ISARIC) protocol as a new global collaborative platform for global clinical trials targeting post-COVID-19 patients. Methods: The standardized forms were developed from the COVID-19 Clinical Characterization Protocol (PCC) by the ISARIC/WHO working group composed of specialist researchers with experience in clinical research in different areas of medicine and public health, especially outbreaks and infectious diseases. Conclusion: It is expected that the creation of a database composed of different populations from all over the world will help in the characterization of risk factors, in the best form of clinical intervention and in the best prevention strategies for physical, neurological and psychosocial sequelae in the medium and long term in post-COVID-19 patients. (shrink)

Abstract: A complex parasite such as human Plasmodium is likely to generate a variety of substances that injure the hosts directly or cause immunopathology. In malaria, a blood concentration of anti-inflammatory cytokines, such as interleukin (IL-10) is increased. The present study was performed to analyze IL-10 levels in patients with malaria falciparum and healthy controls individuals and correlate with malaria density infection as well as age groups. It is a cross sectional study was carried out in Khartoum state /Sudan, (...) a total of 70 febrile patients and 20 healthy volunteers as controls were included in this study. Blood samples were collected from both patients and control candidates in (EDTA) containers for parasitological and immunological tests. Immunochromatography test and microscopic examination for both thick and thin blood films were used to detect the positive samples for Plasmodium falciparum. Enzyme linked Immunosorbant Assay (ELISA), was used for the determination of IL-10 levels. The result showed that of IL-10 levels in malaria patients were 1598.50 and SD 4771.64 while the levels in healthy participants the level was 10.39 and SD was 124.33 the difference was found to be statistically significant (P= 0.007). The levels of cytokines mentioned above were observed to be raised in malaria individual compared to healthy control candidates. (shrink)

Introduction The major burden of the COVID-19 pandemic has been mainly on healthcare workers (HCWs) and as a result many of them have been afflicted with the disease thus far. -/- Purpose The present study was an effort to investigate Tehran University of Medical Sciences HCWs' experiences of COVID-19 during the pandemic in Tehran, Iran. -/- Methods This study is essentially a conventional qualitative content analysis. Twenty-six HCWs (including 7 physicians, 16 nurses, and 3 physiotherapists) were purposefully selected to participate (...) in the study. The data were collected from April 2020 to January 2021 through semi-structured face-to-face interviews. The interviews were transcribed and then analyzed based on the Graneheim and Lundman method using MAXQDA 12. -/- Results Based on the qualitative content analysis which resulted in 364 initial codes, three themes and eight subthemes were extracted. The extracted themes were “support,” “control,” and “improvement.” -/- Conclusions HCWs are in close contact with COVID-19 patients as part of their professional careers and the provision of quality patient care in times of crises is unattainable unless HCWs enjoy support and their own health is maintained. Making institutional, national, and international preparations for their protection is an obligation. (shrink)

Nanoparticles have been used in numerous fields, various branches of science and engineering. These were used as a modification and to enhance the activity such as dentistry and oral investigation. The current survey uncovers that graphene oxide has been used to set up a variety of functionalized nanoparticles and progressed nanocomposites carriers. Graphene oxide shows potential in a variety of research examinations, for instance, tooth bleaching, antimicrobial activity, tooth erosion, teeth implants, toothaches, drug delivery at a specific site. All these (...) usages of graphene oxide to biomedicine are excellent, and consoling Graphene oxide use in dental science has given amazing outcomes in antimicrobial activity, bone tissue building, regenerative dental, advancing dentistry biological materials, and in the treatment of oral cancer. The biocompatibilities of graphene oxide and its nanomaterial make them approaching units in bone regeneration, osseointegration, and cell multiplication. Furthermore, its antibiofilm and antiadhesion action encouraged researchers to formulate graphene oxide for biofilm. Nanostructures are utilized advancements or exploration of dentistry, and nanocomposite is employed for oral ailment preventive drugs, prostheses, and teeth implantation. Nanomaterials are further utilized as an oral liquid, mouth wash, or medication, forestalling and facilitating some oral malady and keep up oral wellbeing. (shrink)

Physicians, so it will be argued have by virtue of their profession a weightier obligation than patients to disclose their HIV infection, and also have a duty to refrain from performing exposure-prone invasive procedures. This argument supports both the AMA and CDC guidelines on HIV infected health care workers (HCWS), while undermining the recommendations against disclosure suggested by the National Commission on AIDS (NCA). The argument is divided into three parts. First, a distinction is made between entrenched and fuzzy (...) roles. Second, the physician-patient relationship is described as essentially fiduciary rather than businesslike or merely contractual. Third, the conflict between patients' and physicians' right to know is portrayed as one between patients' and physicians' right to life. Last, given the the probability of infection from seropositive patients to seronegative physicians, and, conversely, is roughly the same, it is recommended as a fair social policy that whenever an invasive procedure occurs, both physicians and patients have a duty to disclose any serious infection that may jeopardize their lives. (shrink)

Hospital acquired infections (HAIs), especially ventilator associated respiratory infection (VARI) cause significant morbidity and mortality, and disproportionally so in low and middle-income countries (LMICs), including Vietnam, where infection control in hospitals is often neglected. The management of HAIs in these settings is challenging because of the high proportions of antimicrobial drug resistance and limitations of laboratory diagnostics, financial and human resources in terms of knowledge and skills for antimicrobial stewardship and infection prevention and control.

Microbial biofilm created huge burden in treatment of both community and hospital infections. A biofilm is complex communities of bacteria attached to a surface or interface enclosed in an exopolysaccharide matrix and protected from unfavorable conditions such as presence of antibiotics, host defense or oxidative stresses. Biofilms are often considered hot spot for horizontal gene transfer among same or different bacterial species. Furthermore, bacteria with increased hydrophobicity facilitate biofilm formation by reducing repulsion between the extracellular matrix and the bacterium. There (...) is a marked increase in the rate of persons nonresponsive to antibiotic therapy for infections of the Urinary Tract (UTIs), burns and upper respiratory tract due to biofilm formations. It is estimated that 90% of nosocomial infections are mediated by biofilm. The role of biofilm in infections has become so great that the treatment of such antibiotic resistance infections is proving difficult and costly to health care systems. The biofilm related infections varied from dental plaque, destruction of prosthetic valve to death of cystic fibrosis patients. This review aims to provide a summary of role of bacterial biofilm and its clinical implications for the patients. (shrink)

Within the sedimentation diagram of infective RNA preparations isolated from Tobacco Mosaic Virus, undegraded molecules form a sharp peak with a molecular weight corresponding to the total RNA content of the virus particle. Degradation kinetics by ribonuclease is of the linear, single-target type, indicating that the RNA is single-stranded. The intact RNA of a virus particle thus forms one big single-stranded molecule. Quantitative evaluation of the effect degradation by RNA-ase on the infectivity of the RNA shows that the integrity of (...) the entire molecule is required for its biological activity. (shrink)

Beyond belief change and meme adoption, both genetics and infection have been spoken of in terms of information transfer. What we examine here, concentrating on the specific case of transfer between sub-networks, are the differences in network dynamics in these cases: the different network dynamics of germs, genes, and memes. Germs and memes, it turns out, exhibit a very different dynamics across networks. For infection, measured in terms of time to total infection, it is network type rather (...) than degree of linkage between sub-networks that is of primary importance. For belief transfer, measured in terms of time to consensus, it is degree of linkage rather than network type that is crucial. Genes model each of these other dynamics in part, but match neither in full. For genetics, like belief transfer and unlike infection, network type makes little difference. Like infection and unlike belief, on the other hand, the dynamics of genetic information transfer within single and between linked networks are much the same. In ways both surprising and intriguing, transfer of genetic information seems to be robust across network differences crucial for the other two. (shrink)

Music can infect us. In the dominant approach, music contaminates listeners through emotional mimicry and independently of value appraisal, just like when we catch other people’s feelings. Musical contagion is thus considered fatal to the mainstream view of emotions as cognitive evaluations. This paper criticizes this line of argument and proposes a new cognitivist account: the value metaphor view. Non-cognitivism relies on a contentious model of emotion transmission. In the competing model (social appraisal), we catch people’s emotions by appraising value (...) through their emotional expressions. Social appraisal debunks the main motivation for non-cognitivism and offers fruitful insights into musical contagion. Combining it with metaphor theory, I claim that musical contagion involves experiencing the music as a metaphor for emotions and values. Just like people infect us as we appraise value through their emotional expressions, music contaminates listeners because they hear it metaphorically-as some emotional expression and hereby appraise it metaphorically-as some value. As infectious music “sounds like” emotions and values, cognitivism is safe. (shrink)

Understanding the dynamics of information is crucial to many areas of research, both inside and outside of philosophy. Using computer simulations of three kinds of information, germs, genes, and memes, we show that the mechanism of information transfer often swamps network structure in terms of its effects on both the dynamics and the fitness of the information. This insight has both obvious and subtle implications for a number of questions in philosophy, including questions about the nature of information, whether there (...) is genetic information, and how to arrange scientific communities. (shrink)

“The Ethics of Infection Challenges in Primates,” by Anne Barnhill, Steven Joffe, and Franklin Miller, is an exceptionally timely contribution to the literature on animal research ethics. Animal research has long been both a source of high hopes and a cause for moral concern. When it comes to infection challenge studies with nonhuman primates, neither the hope—to save thousands of human lives from such diseases as Ebola and Marburg—nor the concern—the conviction that primates deserve especially strong protections—could be (...) much higher. Coming just a few years after the National Institutes of Health adopted the Institute of Medicine's recommendations regarding chimpanzees, Barnhill and colleagues attempt to nudge the clarification and specification—one might say the evolution—of NHP research ethics and regulation. They assert that NHP challenge studies “are not justified by marginal gains in human safety or by efficacy gains that are unlikely to translate directly into saving human lives or preventing morbidity.” How, in turn, is their standard—which, although stringent, does permit causing NHPs to suffer and die for human benefit—to be justified? (shrink)

COVID-19 infects cities, here grasped as quasi-living functioning systems, and the changes inflicted can poetically open us to certain things. Drawing on ecological psychology, we maintain that this brings people into contact with different realities depending on their overall wellbeing, arguing that the aesthetic experience of cities accordingly varies. We then consider iterations of these ideas in dystopian cinema, which portrays global threats altering human relations with technology, art, and the world.

Placebo-trials on HIV-infected pregnant women in developing countries like Thailand and Uganda have provoked recent controversy. Such experiments aim to find a treatment that will cut the rate of vertical transmission more efficiently than existing treatments like zidovudine. This scenario is first stated as generally as possible, before three ethical principles found in the Belmont Report, itself a sharpening of the Helsinki Declaration, are stated. These three principles are the Principle of Utility, the Principle of Autonomy and the Principle of (...) Justice. These are taken as voices of moral imperative. But although each has intuitive appeal, it can be shown that there are possible scenarios in which they give conflicting prescriptions. To achieve consistency, one must be subordinate to the others. The voice of utility is taken as subordinate to those of justice and autonomy and it is shown that given plausible assumptions about the level of poverty and education in the developing country targeted, the experiment is ruled morally wrong in the name of both justice and autonomy. Moreover, it is argued that no justification can be found for the inclusion of a placebo group, when strictly defined. By contrast, a ‘no- treatment’ control arm might be justified, but only when the demands of autonomy are satisfied, demands that are more stringent than they might appear. A utilitarian defence of the experiment is examined, namely that the would-be participants are in a no-loss situation, and it is shown that this defence is seriously flawed. Finally, it is concluded that there is no justification for amending the Declaration of Helsinki. (shrink)

A comprehensive understanding of the ethics of the COVID-19 pandemic priorities must be sensitive to the influence of social inequality. We distinguish between ex-ante and ex-post relevance of social inequality for COVID-19 disadvantage. Ex-ante relevance refers to the distribution of risks of exposure. Ex-post relevance refers to the effect of inequality on how patients respond to infection. In the case of COVID-19, both ex-ante and ex-post effects suggest a distribution which is sensitive to the prevalence social inequality. On this (...) basis, we provide a generic fairness argument for the claim that welfare states ought to favour a healthcare priority scheme that gives particular weight to protecting the socially disadvantaged. (shrink)

Knowledge has almost always been treated as good, better than mere true belief, but it is remarkably difficult to explain what it is about knowledge that makes it better. I call this “the value problem.” I have previously argued that most forms of reliabilism cannot handle the value problem. In this article I argue that the value problem is more general than a problem for reliabilism, infecting a host of different theories, including some that are internalist. An additional problem is (...) that not all instances of true belief seem to be good on balance, so even if a given instance of knowing p is better than merely truly believing p, not all instances of knowing will be good enough to explain why knowledge has received so much attention in the history of philosophy. The article aims to answer two questions: What makes knowingp better than merely truly believing p? The answer involves an exploration of the connection between believing and the agency of the knower. Knowing is an act in which the knower gets credit for achieving truth. What makes some instances of knowing good enough to make the investigation of knowledge worthy of so much attention? The answer involves the connection between the good of believing truths of certain kinds and a good life. In the best kinds of knowing, the knower not only gets credit for getting the truth but also gets credit for getting a desirable truth. The kind of value that makes knowledge a fitting object of extensive philosophical inquiry is not independent of moral value and the wider values of a good life. (shrink)

Research in infection biology aims to understand the complex nature of host–pathogen interactions. While this knowledge facilitates strategies for preventing and treating diseases, it can also be intentionally misused to cause harm. Such dual-use risk is potentially high for highly pathogenic microbes such as Risk Group-3 (RG3) bacteria and RG4 viruses, which could be used in bioterrorism attacks. However, other pathogens such as influenza virus (IV) and enterohemorrhagic Escherichia coli (EHEC), usually classified as RG2 pathogens, also demonstrate high dual-use (...) risk. As the currently approved therapeutics against these pathogens are not satisfactorily effective, previous outbreaks of these pathogens caused enormous public fear, media attention and economic burden. In this interdisciplinary review, we summarize the current perspectives of dual-use research on IV and EHEC, and further highlight the dual-use risk associated with evolutionary experiments with these infectious pathogens. We support the need to carry out experiments pertaining to pathogen evolution, including to gain predictive insights on their evolutionary trajectories, which cannot be otherwise achieved with stand-alone theoretical models and epidemiological data. However, we also advocate for increased awareness and assessment strategies to better quantify the risks-versus-benefits associated with such evolutionary experiments. In addition to building public trust in dual-use research, we propose that these approaches can be extended to other pathogens currently classified as low risk, but bearing high dual-use potential, given the particular pressing nature of their rapid evolutionary potential. (shrink)

How could the initial, drastic decisions to implement “lockdowns” to control the spread of COVID-19 infections be justifiable, when they were made on the basis of such uncertain evidence? We defend the imposition of lockdowns in some countries by first, and focusing on the UK, looking at the evidence that undergirded the decision, second, arguing that this provided us with sufficient grounds to restrict liberty given the circumstances, and third, defending the use of poorly-empirically-constrained epidemiological models as tools that can (...) legitimately guide public policy. (shrink)

We think we have lots of substantial knowledge about the future. But contemporary wisdom has it that indeterminism prevails in such a way that just about any proposition about the future has a non-zero objective chance of being false.2, 3 What should one do about this? One, pessimistic, reaction is scepticism about knowledge of the future. We think this should be something of a last resort, especially since this scepticism is likely to infect alleged knowledge of the present and past. (...) One anti-sceptical strategy is to pin our hopes on determinism, conceding that knowledge of the future is unavailable in an indeterministic world. This is not satisfying either: we would rather not be hostage to empirical fortune in the way that this strategy recommends. A final strategy, one that we shall explore in this paper, is one of reconciliation: knowledge of a proposition is compatible with a subject’s belief having a non-zero objective chance of error.4 Following Williamson, we are interested in tying knowledge to the presence or absence of error in close cases, and so we shall explore the connections between knowledge and objective chance within such a framework. We don’t want to get tangled up here in complications involved in attempting to formulate a necessary and sufficient condition for knowledge in terms of safety. Instead, we will assume the following rough and ready necessary condition: a subject knows P only if she could not easily have falsely believed P.5 Assuming that easiness is to be spelt.. (shrink)

During the Covid-19 pandemic, a considerable amount of people seem to have been lured into believing in conspiracy theories. These people deliberately disregard expert advice by virologists and physicians concerning social behaviour that is aimed at reducing the number of new infections. Disregarding traditional experts and their advice is just one example of what, in the philosophy of science, is referred to as a crisis of expertise – the phenomenon whereby people seem to have lost their trust in traditional expert (...) advice and are looking for alternatives. In the following paper, the trend to use Internet technology as an epistemic alternative will be analysed in detail by investigating the question of whether the Internet really allows people to become epistemically more autonomous. The focus will be on the epistemic and moral vulnerability of people resorting to new media tools instead of relying on traditional expert opinion. It will be shown that some important presuppositions about the Internet and, in particular, social media tools as alternative ways to collect information and find emotional support in a group of like-minded people cannot be maintained. (shrink)

Background: Dengue Disease is a mosquito-borne tropical disease caused by the dengue virus, symptoms typically begin three to fourteen days after infection. This may include a high fever, headache, vomiting, muscle and joint pains, and a characteristic skin rash. Dengue serology is applied in different settings, such as for surveillance, in health care facilities in endemic areas and in travel clinics in non-endemic areas. The applicability and quality of serological tests in dengue endemic regions has to be judged against (...) a background of potential cross reactivity with other flavi-viruses, difficulties in distinguishing primary from secondary infections and technological problems related to the fact that most dengue endemic regions are relatively poor of resources .Objectives: to help doctors and patients in diagnosing Dengue Disease and give them the information of how to prevent Dengue Disease and to be able to understand the signs and symptoms of Dengue Disease. Methods: We collected all relevant material for Dengue Disease. Then we designed and implemented a knowledge based system for diagnosing Dengue Disease using SL5 Object Language. Results: The knowledge based system was evaluated by a group of Patients and specialized doctors and they found it very friendly and easy to use. (shrink)

This chapter introduces the main research schools and paradigms along which the field of evolutionary biology has been developing. Evolutionary thinking was originally founded upon the Neo-Darwinian paradigm that combines the teachings of traditional Darwinism with those of the Modern Synthesis. The Neo-Darwinian paradigm has since further diversified into the Micro-, Meso-, and Macroevolutionary schools, and it has also started to integrate the school of Ecology. Together, these schools establish the paradigm called Ecological Evolutionary Developmental Biology (Eco-Evo-Devo). A final school (...) studies Reticulate Evolution as it occurs by means of symbiosis, symbiogenesis, lateral gene transfer, infective heredity, and hybridization. This chapter reviews the major tenets and points of differentiation that exist between these distinct evolution schools. The chapter ends by looking into how evolution can be defined and how distinct units, levels, and mechanisms underlie theorizing on evolutionary hierarchies and evolutionary causation. The following chapter examines how the different evolution schools are implemented into the symbolic sciences. (shrink)

There are two concepts of causes, property causation and token causation. The principle I want to discuss describes an epistemological connection between the two concepts, which I call the Connecting Principle. The rough idea is that if a token event of type Cis followed by a token event of type E, then the support of the hypothesis that the first event token caused the second increases as the strength of the property causal relation of C to E does. I demonstrate (...) the principle, illustrate its application to phylogenies, infections, and rumours, and discuss its consequence for the conceptual distinctness of causal processes from the events they connect. Although I am by no means confident that the Connecting Principle is ultimately correct, it seems to be a useful point of departure into an important aspect of the epistemology of causality. (shrink)

There is too much that we do not know about COVID-19. The longer we take to find it out, the more lives will be lost. In this paper, we will defend a principle of risk parity: if it is permissible to expose some members of society (e.g. health workers or the economically vulnerable) to a certain level of ex ante risk in order to minimize overall harm from the virus, then it is permissible to expose fully informed volunteers to a (...) comparable level of risk in the context of promising research into the virus. We apply this principle to three examples of risky research: skipping animal trials for promising treatments, human challenge trials to speed up vaccine development, and low-dose controlled infection or “variolation.” We conclude that if volunteers, fully informed about the risks, are willing to help fight the pandemic by aiding promising research, there are strong moral reasons to gratefully accept their help. To refuse it would implicitly subject others to still graver risks. (shrink)

Warts and verrucas are common skin conditions caused by the human papillomavirus (HPV) infection. They present as raised, rough, or bumpy growths on the hands, feet, or other areas subjected to friction or pressure. Plantar warts exhibit a rough surface with small black dots, while genital warts have a cauliflower-like appearance. Pain or itchiness may accompany these lesions. Factors such as close contact with infected individuals and immune compromise can impact the severity and spread of warts. Diagnosis is primarily (...) based on clinical examination, and referral to a dermatologist may be necessary for uncertain cases. Treatment options range from over-the-counter remedies to professional interventions. Persistent or symptomatic lesions should be evaluated by a healthcare professional. Improved understanding and effective management of warts and verrucas are essential for optimal patient outcomes. (shrink)

Different chemical species are often cited as paradigm examples of structurally delimited natural kinds. While classificatory monism may thus seem plausible for simple molecules, it looks less attractive for complex biological macromolecules. I focus on the case of proteins that are most plausibly individuated by their functions. Is there a single, objective count of proteins? I argue that the vagaries of function individuation infect protein classification. We should be pluralists about macromolecular classification.

During the coronavirus pandemic, communities have faced shortages of important healthcare resources such as COVID-19 vaccines, medical staff, ICU beds and ventilators. Public health officials in the U.S. have had to make decisions about two major issues: which infected patients should be treated first, and which people who are at risk of infection should be inoculated first. Following Beauchamp and Childress’s principlism, adopted guidelines have tended to value both whole lives and life-years. This process of collective moral reasoning has (...) revealed our common commitment to both Kantian and utilitarian principles. For Kant, respecting people’s rights entails that we ought to value whole lives equally. Therefore we ought to allocate resources so as to maximise the number of patients who survive to discharge. By contrast, the principle of utility has us maximise life-years so that people can satisfy more of their considered preferences. Although people are treated impartially in the utilitarian calculus, it does not recognise their equal worth. Subjecting Kantian ethics and utilitarianism to the process of reflective equilibrium lends support to the idea that we need a pluralistic approach that would accommodate our moral intuitions regarding both the equal value of whole lives and the additive value of life-years. (shrink)

Many epidemics consist in individuals spreading infection to others. From the population perspective, they also have population characteristics important in modeling, explaining, and intervening in epidemics. I analyze epidemiology’s contemporary population perspective through the example of epidemics by examining two central principles attributed to Geoffrey Rose: a distinction between the causes of cases and the causes of incidence, and between “high-risk” and “population” strategies of prevention. Both principles require revision or clarification to capture the sense in which they describe (...) distinct perspectives on the same phenomenon, each perspective capturing a different level of contrastive analysis. (shrink)

Abstract: The Knowledge-Based System for Diagnosing Breast Cancer aims to support medical students in enhancing their education regarding diagnosis and counseling. The system facilitates the analysis of biopsy images under a microscope, determination of tumor type, selection of appropriate treatment methods, and identification of disease-related questions. According to the Ministry of Health's annual report in Gaza, there were 7,069 cases of breast cancer between 2009 and 2014, with 1,502 cases reported in 2014. In an era dominated by visual information, where (...) 65% of the population are visual learners, the Knowledge-Based System serves as an effective tool to aid long-term information retention by utilizing visual and textual resources. The system features a user-friendly interface, enabling students to diagnose the disease and expand their understanding. Furthermore, it can be accessed via smartphones. The Knowledge-Based System comprises three primary components: Firstly, it provides specific patient-oriented questions to familiarize students with the questioning process. Secondly, it facilitates the analysis of biopsy sample images to determine their integrity and identify potential infections. Lastly, the system incorporates animated videos illustrating various approaches for treating breast cancer. (shrink)

Objectives -/- Surveys in various countries suggest 17% to 80% of doctors prescribe ‘placebos’ in routine practice, but prevalence of placebo use in UK primary care is unknown. Methods -/- We administered a web-based questionnaire to a representative sample of UK general practitioners. Following surveys conducted in other countries we divided placebos into ‘pure’ and ‘impure’. ‘Impure’ placebos are interventions with clear efficacy for certain conditions but are prescribed for ailments where their efficacy is unknown, such as antibiotics for suspected (...) viral infections. ‘Pure’ placebos are interventions such as sugar pills or saline injections without direct pharmacologically active ingredients for the condition being treated. We initiated the survey in April 2012. Two reminders were sent and electronic data collection closed after 4 weeks. Results -/- We surveyed 1715 general practitioners and 783 (46%) completed our questionnaire. Our respondents were similar to those of all registered UK doctors suggesting our results are generalizable. 12% (95% CI 10 to 15) of respondents used pure placebos while 97% (95% CI 96 to 98) used impure placebos at least once in their career. 1% of respondents used pure placebos, and 77% (95% CI 74 to 79) used impure placebos at least once per week. Most (66% for pure, 84% for impure) respondents stated placebos were ethical in some circumstances. Conclusion and implications -/- Placebo use is common in primary care but questions remain about their benefits, harms, costs, and whether they can be delivered ethically. Further research is required to investigate ethically acceptable and cost-effective placebo interventions. (shrink)

What do humility, intellectual humility, and open-mindedness mean in the context of inter-group conflict? We spend most of our time with ingroup members, such as family, friends, and colleagues. Yet our biggest disagreements —— about practical, moral, and epistemic matters —— are likely to be with those who do not belong to our ingroup. An attitude of humility towards the former might be difficult to integrate with a corresponding attitude of humility towards the latter, leading to smug tribalism that masquerades (...) as genuine virtue. These potentially conflicting priorities have recently come to the fore because “tribal epistemology” has so thoroughly infected political and social discourse. Most research on these dispositions focuses on individual traits and dyadic peer-disagreement, with little attention to group membership or inter-group conflict. In this chapter, we dilate the social scale to address this pressing philosophical and social problem. (shrink)

One of the most unpredictable things the pandemic brought to our societies was the closure of hospitals and other health services to visitors. Preventing the spread of infection was the main reason for these decisions in the early days of the pandemic when there was no clarity about the means of transmission and the origin of the virus. However, in view of the persistence of the restrictions to date and the numerous negative consequences they have had on the professional (...) and personal quality of life of doctors, nurses, patients and carers, the aim of this article is to analyse in depth the reasons why these decisions have been and, above all, are still being applied, also considering the hypothesis that the choices made so far in the training of health professionals should be questioned. The persistence of restrictions, the constant reduction of human and economic resources in the face of an increase in the demand for care have exacerbated the distance between health professionals and users, to the point of escalating into actual acts of violence and aggression. According to the Critical Pedagogy approach, educators can play a central role in activating formative and collaborative strategies, such as maieutic groups, to rebuild an alliance between those who today find themselves on opposite sides: health professionals on the one hand, and patients and families on the other. (shrink)

The COVID-19 global pandemic has shone a light on several important ethical questions, ranging from fairness in resource allocation to the ethical justification of government mandates. In addition to these institutional issues, there are also several ethical questions that arise at the interpersonal level. This essay focuses on several of these issues. In particular, I argue that, despite the insistence in public health messaging that avoiding infecting others constitutes ‘saving lives’, virus transmission that results in death constitutes an act of (...) killing. Whether this killing is wrongful depends on several factors. I consider one intuitively plausible view—namely, that in many cases, killing via unintentional transmission is not wrongful, because the parties in question have implicitly waived their rights against this harm, often via reciprocal risk imposition. I argue that this view is mistaken, but that its central insight can be better captured by identifying the appropriate standards of blame that we ought to apply during a pandemic. I conclude by showing how these conclusions can be fruitfully applied to certain institutional questions, such as helping to justify restricting government mandates. (shrink)

Those of us who take skepticism seriously typically have two relevant beliefs: (a) it’s plausible (even if false) that in order to know that I have hands I have to be able to epistemically neutralize, to some significant degree, some skeptical hypotheses, such as the brain-in-a-vat (BIV) one; and (b) it’s also plausible (even if false) that I can’t so neutralize those hypotheses. There is no reason for us to also think (c) that the BIV hypothesis, for instance, is plausible (...) or probably true. In order to take skepticism seriously it’s sufficient to hold (a) and (b); one need not hold (c). Indeed, philosophers who accept (a) and (b) never endorse (c). Show me a philosopher who suspects that he is a brain in a vat and I’ll show you someone who is deranged! That’s one thing that bothers undergraduates in philosophy. They object: why on earth do some philosophers take the BIV hypothesis to pose any threat at all to our beliefs given that those very same philosophers think that there’s no real chance that the BIV hypothesis is true? Sure, the BIV hypothesis is formally inconsistent with my belief that I have hands, so if the former is true then my belief is false. But so what? Why should that bare inconsistency matter so much? Is this strange attitude amongst philosophers the result of some logic fetish infecting the philosophical community? It is sometimes said that the skeptical hypotheses are not only inconsistent with our beliefs but are explanatory of our experiences, which is supposed to make them more of a threat. But students aren’t fooled: although the skeptical hypotheses may attempt to explain why our experience is as it is, it’s the kind of attempt appropriate for science fiction movies that are all special effects and virtually no plot. No one with any sense of reality will take the evil demon hypothesis to be even tenuously explanatory. (shrink)

In this chapter, I offer an overview of current scholarly debates on Plato's Lysis. I also argue for my own interpretation of the dialogue. In the Lysis, Socrates argues that all love is motivated by the desire for one’s own good. This conclusion has struck many interpreters as unattractive, so much so that some attempt to reinterpret the dialogue, such that it either does not offer an account of interpersonal love, or that it offers an account on which love is, (...) in fact, an other-regarding state. Others, notably Vlastos, criticize Socrates’ theory as implausibly and repellently egoistic. I maintain, against the first group, that Socrates is indeed offering an egoistic theory of love. I argue, against the second, that, while Socrates’ theory may be repellent, it possesses considerable explanatory power and avoids certain weaknesses which infect contemporary approaches to love. (shrink)