PUERPÉRIO EM BOVINOS -/- INTRODUÇÃO -/- O puerpério é definido como o período entre o parto e a apresentação do primeiro estro fértil. Dois processos ocorrem durante o puerpério: a involução uterina e o início da atividade ovariana pós-parto. Em vacas leiteiras, os cuidados médicos pós-parto são essenciais nos programas de manejo, uma vez que as patologias uterinas são diagnosticadas e tratadas nesse período para que a vaca esteja em ótimas condições para ser inseminada, uma vez terminado o período de (...) espera voluntário. -/- 4.1 Involução uterina -/- O útero após o parto sofre modificações macroscópicas e microscópicas, até atingir as características de um útero não gestante, o que leva de 30 a 45 dias. O peso e o tamanho pós-parto diminuem rapidamente como consequência da atrofia das fibras musculares; por necrose das carúnculas e por eliminação de líquidos. Ao mesmo tempo em que o útero diminui de tamanho, o endométrio passa por um processo regenerativo para poder hospedar uma nova gestação. -/- A involução é promovida pelas contrações uterinas, que facilitam a eliminação de fluidos e dejetos e reduzem o tamanho do útero. As contrações são causadas pela secreção contínua de PGF2α, de origem uterina, e pela ocitocina secretada durante a amamentação. A PGF2α é secretada durante as primeiras 3 semanas pós-parto e seu envolvimento é considerado necessário para que a involução uterina ocorra normalmente. -/- Durante a involução uterina, as secreções conhecidas como lóquios, que são formadas por restos de membranas, carúnculas, fluidos fetais e sangue, são derramadas pela vagina. Essas secreções variam da cor vermelha ao marrom, têm consistência viscosa e são inodoras. A maioria dos lóquios é descartada durante os primeiros 15 dias após o parto e, em seguida, praticamente desaparece, exceto em casos de involução uterina anormal, quando o útero continua a derramar fluidos de consistência, cor e odor diferentes (figura 1). -/- Figura 1: O útero após o parto sofre alterações macroscópicas e microscópicas, até atingir as características de um útero não grávido, o que leva de 30 a 45 dias. -/- Antes do parto, o útero é estéril, pois é protegido da contaminação bacteriana pelo colo do útero ou cérvix. Durante e após o parto, essa barreira física desaparece e o útero é invadido por bactérias que se encontram no meio ambiente, pele e fezes, ou que são introduzidas durante a assistência ao parto. Além disso, a capacidade funcional dos fagócitos uterinos é baixa após o parto, o que contribui para o estabelecimento de infecções. Cerca de 95% das vacas desenvolvem infecções uterinas durante a involução, e uma alta porcentagem de vacas as eliminam por meio de mecanismos naturais. -/- Os mecanismos de defesa uterinos são constituídos pelas barreiras anatômicas (vagina, vulva e cérvix); fatores fisiológicos (produção de muco na vagina e cérvix); fagocitose promovida por neutrófilos, que migram da circulação geral para o útero; pela produção de substâncias inespecíficas, que inibem o crescimento bacteriano e favorecem a eliminação de microrganismos. A capacidade de eliminar bactérias do útero é determinada pelos hormônios ovarianos (progesterona e estrogênios); durante o diestro, a progesterona reduz a migração de neutrófilos, suprime o sistema imunocompetente, fecha o colo do útero e causa atonia uterina, resultando em aumento da suscetibilidade à infecção. Ao contrário, durante a fase folicular do ciclo estral (proestro e estro), o estradiol promove a migração de neutrófilos, abre a cérvix e aumenta o tônus uterino, o que facilita a eliminação de agentes infecciosos. Além disso, a atividade dos neutrófilos é afetada pelas deficiências antioxidantes e pela profundidade do balanço energético negativo. -/- 4.2 Anormalidades do puerpério -/- Após o parto, ocorrem algumas patologias que retardam a involução uterina e, consequentemente, afetam o intervalo entre o parto e o primeiro serviço. -/- 4.2.1 Retenção da placenta -/- A placenta é eliminada dentro de 12 horas após o parto; a retenção da placenta por mais de 24 horas é considerada uma patologia. A retenção placentária (RP) é uma alteração frequente do puerpério, que deve ser considerada como um sinal clínico de várias condições que podem ter origem infecciosa (aborto), metabólica (hipocalcemia, cetose, síndrome do vaca gorda), deficiências nutricionais (selênio e vitamina E) e erros de manejo (demasiada intervenção no parto). -/- A incidência de RP varia de 5 a 15% e depende, em grande parte, do estado de saúde e do manejo do rebanho. A RP é o principal fator de risco para infecções uterinas (metrite puerperal, metrite, endometrite e endometrite subclínica); também causa atraso no período entre o parto e a concepção e está associada à redução do percentual de concepção no primeiro serviço. -/- Em termos econômicos, determinou-se que a RP causa perdas significativas principalmente devido aos custos de serviços médicos, aumento da taxa de eliminação e diminuição da fecundidade. Além disso, vacas com retenção placentária produzem 355 kg a menos de leite durante os primeiros 60 dias do que vacas que não apresentam esta patologia (figuras 2 e 3). -/- 4.2.2 Patogenia -/- A placenta está ligada ao endométrio pelas vilosidades coriônicas, que estão ligadas às carúnculas (junção carúncula-cotilédone). A união entre essas estruturas é favorecida por um fluido adesivo formado por colágeno e outras proteínas. Antes e durante o trabalho de parto, observa-se um aumento da atividade das enzimas proteolíticas (colagenase, talvez a mais importante), que são responsáveis por separar o cotilédone da carúncula. Posteriormente, a placenta é removida mecanicamente por contrações uterinas após o parto do feto. -/- A etiologia e patogênese da retenção placentária não são conhecidas. Uma explicação proposta é que isso se deve a uma falha dos mecanismos proteolíticos responsáveis pela separação do cotilédone da carúncula. Foi observado que a atividade da colagenase no cotilédone é maior em vacas que não retêm placenta do que naquelas que a retêm. Propõe-se que alguns fatores de risco para retenção placentária possam estar atuando na redução da atividade da colagenase. Por outro lado, as condições inflamatórias na junção carúncula-cotilédone de origem infecciosa também impedem a separação da placenta. -/- Figura 3: Vaca com retenção placentária. -/- Figura 2: Vaca com retenção placentária. Em rebanhos comerciais, 5 a 15% das vacas retêm a placenta. -/- 4.2.3 Tratamento -/- Existem vários tratamentos, como a remoção manual da placenta em combinação com a aplicação local de antibióticos (infusões intrauterinas) e a administração de produtos hormonais (ocitócicos e PGF2α). A eficácia desses tratamentos é discutível. -/- A remoção manual da placenta é o tratamento mais popular; entretanto, não é a melhor, pois causa danos ao endométrio, que variam de leve sangramento a hematomas, mesmo quando não há evidências externas. Além disso, a remoção manual diminui a capacidade fagocítica dos leucócitos uterinos, resultando em metrite mais grave, maior atraso na involução uterina e baixo desempenho reprodutivo. -/- Outro tratamento consiste em cortar a placenta ao nível da vulva. Posteriormente, quando a placenta se separa das carúnculas, devido ao processo de decomposição do tecido, uma leve tração da vulva é suficiente para retirá-la, sem consequências. Essas vacas devem ser observadas quanto à febre e imediatamente integradas ao programa de check-up pós-parto, pois certamente desenvolverão metrite ou endometrite. A administração de antibióticos, tanto nos casos de retirada manual como naqueles em que a placenta é cortada, depende do estado geral da vaca. Deve-se sempre ter em mente que a RP é o principal fator de risco para metrite, portanto as vacas devem ser observadas para detectar prontamente aquelas que apresentam febre. Os antibióticos devem ser considerados para inibir a putrefação das membranas fetais, o que pode atrasar sua expulsão. No caso de opção pela administração de antibióticos, deve-se optar pela via parenteral em vez da intrauterina, pois esta causa irritação do endométrio, que está associada à baixa fertilidade (figura 4). -/- Outros tratamentos são baseados na administração de hormônios que estimulam a mobilidade uterina (ocitocina, estrogênios e PGF2α); entretanto, não há evidências clínicas que demonstrem sua eficácia; além disso, a causa menos frequente de RP é a incapacidade mecânica do útero de expelir a placenta. -/- 4.2.4 Prevenção -/- As estratégias de prevenção dessa patologia devem ter como objetivo reduzir a influência dos fatores de risco para RP. Assim, a incidência de abortos deve ser reduzida por meio de programas eficazes de vacinação e biossegurança; deve-se evitar períodos de seca muito longos para que as vacas não cheguem obesas ao parto; intervir o mínimo possível nos partos, e se atendido, deve ser feito com medidas de higiene rígidas; oferecer sais minerais de boa qualidade e administrar antioxidantes antes do parto (vitamina E, selênio e betacarotenos; tabela 1). -/- Figura 4: A placenta não deve ser removida inserindo a mão na vagina. É aconselhável aguardar a autólise (48 horas) e removê-la por leve tração. -/- Tabela 1: Incidência de retenção na membrana fetal (RMF), metrite hemorrágica (HM), metrite purulenta (PM) e puerpério anormal (PA) em vacas leiteiras tratadas com selênio e vitamina E nos dias 60, 21 antes do parto e 30, 90 pós-parto (grupo pré-pós-parto) e 21 dias pré-parto (grupo pré-parto) e testemunhas. -/- Laterais diferentes na mesma coluna indicam diferença estatística (P < 0,05). Adaptado de RUIZ et al., 2008. -/- 4.3 Infecções uterinas -/- Cerca de 95% das vacas desenvolvem infecção uterina durante os primeiros dias pós-parto; no entanto, a maioria elimina infecções por meio de seus mecanismos de defesa e apenas 30 a 50% delas desenvolvem metrite ou endometrite nas primeiras três semanas. As bactérias mais frequentes encontradas em processos inflamatórios no útero são: Arcanobacterium pyogenes (antes Actinomyces pyogenes), Fusobacterium necrophorum e Escherichia coli. Essas três bactérias agem sinergicamente. -/- 4.3.1 Metrite puerperal -/- A metrite puerperal é comum em vacas com retenção placentária. Essa patologia é observada nas três primeiras semanas pós-parto e é caracterizada pela presença de secreções abundantes na luz uterina que são vermelhas ou marrons, aquosas, fétidas e com involução retardada. As vacas afetadas mostram sinais de doença sistêmica (toxemia e febre > 39,5 °C) e diminuição da produção de leite (figura 5). -/- Figura 5: Vaca com metrite puerperal; vacas afetadas apresentam sinais de doença sistêmica. -/- 4.3.2 Metrite clínica -/- Metrite é o processo inflamatório que envolve as diferentes camadas do útero (mucosa, muscular e serosa). Esta condição se apresenta nos primeiros 21 dias pós-parto e é caracterizada por atraso na involução uterina e secreção purulenta, e não há sinais de doença sistêmica (figura 6). -/- 4.3.3 Endometrite clínica -/- Endometrite se refere à inflamação do revestimento uterino; clinicamente, caracteriza-se por retardo na involução uterina e eliminação de exsudato purulento ou mucopurulento. Pode surgir nos primeiros 21 dias pós-parto ou mais, sem apresentar qualquer afetação no estado geral. -/- Figura 6: Vaca com exsudato mucopurulento. Na prática, é difícil estabelecer um diagnóstico diferencial entre endometrite e metrite. Uma vaca com essa secreção pode ser tratada com cefalosporinas intrauterinas ou, se ela já estiver em ciclo, a administração de PGF2a é eficaz. -/- 4.3.4 Endometrite subclínica -/- Apresenta-se entre 21 e 40 dias pós-parto, não apresenta sinais externos e só é diagnosticada pela citologia uterina. Essa condição afeta entre 20 e 30% das vacas. Os fatores de risco identificados são retenção placentária e metrite. -/- 4.4 Diagnóstico -/- O diagnóstico é baseado na avaliação uterina por palpação retal, na qual são verificados o grau de involução e as características das secreções. Além disso, é necessária uma avaliação clínica geral, uma vez que vacas com metrite nos primeiros 10 dias pós-parto desenvolvem febre. Outra forma de estabelecer o diagnóstico é avaliando as secreções uterinas sem palpação retal. Pode ser feito introduzindo a mão por via vaginal, após a limpeza da região; embora este método possa parecer arriscado, a experiência em campo indica que é um método seguro e rápido. Outra possibilidade é por meio da vaginoscopia, esse método permite a avaliação da cérvix e das secreções uterinas. Existe um instrumento (Metricheck) que é inserido pela vagina e possui uma campânula atraumática na extremidade que permite a coleta das secreções uterinas (figuras 7 e 8). -/- 4.5 Impacto das infecções uterinas na reprodução e produção -/- As infecções uterinas (metrite e endometrite) prolongam o período do parto até a concepção; diminuem a porcentagem de concepção no primeiro serviço; a porcentagem de resíduos aumenta; a taxa de vacas inseminadas diminui e a produção diminui (300 kg a menos que vacas não afetadas). Além disso, eles afetam o período do parto à primeira ovulação; em vacas com puerpério anormal, os folículos dominantes são menores em diâmetro e produzem menos estradiol do que vacas saudáveis. Também uma proporção menor dos folículos da primeira onda ovula em comparação com as vacas com puerpério anormal. -/- A endometrite subclínica diminui a taxa de concepção no primeiro serviço e aumenta os dias abertos. Além disso, a metrite ou endometrite pode afetar os ovidutos e causar inchaço, obstrução e aderências (esse processo é mais frequente em vacas que recebem injeções de estrogênio). -/- Figura 8: Outra forma de diagnosticar infecções uterinas é por meio da introdução de um instrumento que possui em sua extremidade uma campânula atraumática que permite a coleta de secreções uterinas (Metricheck). -/- Figura 7: O diagnóstico de infecções uterinas pode ser estabelecido com a introdução da mão por via vaginal, após limpeza da região. -/- 4.6 Tratamentos -/- Para evitar o efeito negativo das infecções uterinas na eficiência reprodutiva, é necessário um diagnóstico e tratamento oportunos. Existem diversos tratamentos para a metrite ou endometrite, como o uso de antibióticos sistêmicos ou intrauterinos, infusões intrauterinas de antissépticos e a administração de hormônios. -/- 4.6.1 Antibióticos -/- Os tratamentos com antibióticos intrauterinos são usados há muitos anos e são uma opção, desde que alguns aspectos sejam considerados: que o útero é um ambiente anaeróbio; que há a presença de exsudatos e tecidos em decomposição e a existência de uma grande diversidade de bactérias, algumas das quais até produzem enzimas que inativam alguns antibióticos. -/- Como o útero é um ambiente anaeróbio, os antibióticos do grupo dos aminoglicosídeos não são ativos, pois precisam de oxigênio. Por outro lado, o acúmulo de exsudato purulento e restos de tecido no útero inibe a atividade das sulfonamidas. Os nitrofuranos são eficazes contra A pyogenes, somente quando doses extremamente altas são usadas; as doses usuais nunca atingem a concentração inibitória mínima no endométrio; além disso, não são ativos na presença de sangue ou exsudato purulento, são irritantes e estão associados a problemas de fertilidade. -/- A penicilina intrauterina ou parenteral é eficaz na cura de infecções entre os dias 25 e 30 após o parto; ou seja, quando for observada uma diminuição na diversidade de espécies bacterianas (menor probabilidade de que algumas bactérias produzam penicilinase) e predomina A pyogenes, que é sensível a este antibiótico. As formulações intrauterinas de cefalosporinas (cefapirina benzatina) são eficazes em vacas com endometrite entre os dias 15-20 pós-parto e não é necessário retirar o leite do mercado. -/- A tetraciclina é o antibiótico mais utilizado devido ao seu amplo espectro e por manter sua atividade nas condições do útero pós-parto; porém, a probabilidade de resistência bacteriana é alta devido ao seu uso contínuo por muitos anos, também causa danos ao endométrio e reduz a fertilidade (figura 9). -/- Em testes de campo, a administração de uma única infusão intrauterina de cefapirina benzatina, em vacas com endometrite entre os dias 15 a 20 pós-parto, produz uma maior taxa de recuperação e não afeta a fertilidade, em comparação com aquelas que foram tratadas com infusões de oxitetraciclina. -/- O problema mais importante na terapia com antibióticos é estabelecer um critério de quais animais realmente precisam. Nos casos de metrite puerperal não há dúvida, essas vacas precisam de tratamento com antibióticos por via sistêmica e intrauterina. Porém, em casos de metrite e endometrite a decisão é difícil, pois muitas vacas se curam sem nenhum tratamento. Na prática, antes que os antibióticos sejam administrados às vacas, deve-se considerar alguns dos fatores: características das secreções uterinas, dias após o parto, início da atividade ovariana, presença de febre e condição corporal. -/- Figura 9: As infusões de oxitetraciclina causam irritação do endométrio e diminuem a fertilidade. -/- 4.6.2 Tratamento com infusões de substâncias antissépticas -/- Tratamentos baseados na administração intrauterina de substâncias antissépticas também são usados. O tratamento mais frequente consiste na infusão de soluções de iodo; no entanto, os resultados com esta terapia não são positivos e estão associados a uma diminuição subsequente da fertilidade. Deve-se ter cautela no uso de antissépticos intrauterinos, pois todos causam irritação, afetam os mecanismos de defesa do útero e, em alguns casos, chegam a causar necrose do endométrio. -/- 4.6.3 Tratamentos hormonais -/- Na prática, a administração de estrogênio é comum em casos de metrite, principalmente quando o útero retém muito líquido. Sabe-se que os estrógenos em condições fisiológicas favorecem a contratilidade uterina e auxiliam na eliminação de infecções, porém, em doses farmacológicas o efeito é negativo. A administração de estrogênios pode contribuir para infecções que ascendem aos ovidutos e causam salpingite, aderências ovarianas e infertilidade. -/- A PGF2α desempenha um papel importante no parto e durante a involução uterina. Em vacas com puerpério normal, a duração dos níveis elevados de PGF2α está negativamente correlacionada com o tempo de involução uterina; portanto, quanto mais tempo duram os níveis elevados de PGF2α, menor é o tempo de involução uterina. Além disso, a administração de PGF2α a cada 12 horas, dos dias 3 a 10 pós-parto, encurta o período de involução uterina. Ao contrário, em vacas com puerpério anormal, foi observada uma correlação positiva entre as concentrações de PGF2α e o tempo de involução uterina; portanto, vacas com retenção placentária ou endometrite apresentam níveis mais elevados de PGF2α. -/- Algumas evidências envolvem a PGF2α como parte do mecanismo de eliminação da placenta; ou seja, foi observado que as vacas que normalmente eliminam a placenta apresentaram maiores concentrações de PGF2α na placenta, em comparação com as vacas com retenção placentária. Foi proposto que a falha do processo que leva à separação do cotilédone da carúncula está associada a uma alteração no metabolismo da prostaglandina, resultando em uma diminuição na PGF2α e um aumento na PGE2. Por outro lado, a inibição da síntese de PGF2α após o parto, por meio da injeção de ácido acetilsalicílico (aspirina), causa retenção da placenta. Esse conhecimento motivou estudos nos quais o tratamento com PGF2α após o parto foi avaliado para prevenir a retenção placentária ou reduzir o tempo de involução em vacas com retenção placentária ou metrite. Em alguns estudos, uma única injeção de PGF2α foi administrada nas primeiras horas após o parto com resultados conflitantes. Em outros estudos, a injeção de PGF2α entre os dias 20 a 30 pós-parto foi avaliada e não foi observado um efeito favorável na involução uterina. Porém, a injeção sistemática de PGF2α, a cada 14 dias a partir do 25º dia pós-parto, aumenta a proporção de vacas inseminadas, o que aumenta a taxa de prenhez. A PGF2α causa contrações uterinas e favorece a eliminação de secreções; entretanto, um efeito favorável da PGF2α na involução uterina, sem envolver um corpo lúteo, é questionável. -/- Na prática, um programa é usado com base na administração sistemática de PGF2α a todas as vacas a cada 14 dias, do 25º ao 30º dia pós-parto. Esse tratamento é baseado no encurtamento das fases lúteas, o que favorece a eliminação das infecções. Deve-se observar que cerca de 30% das vacas desenvolvem corpos lúteos longevos (21 a 50 dias) nos primeiros ciclos pós-parto, nessas condições a injeção de PGF2α, a cada 14 dias, encurta o ciclo estral e diminui o risco de persistência de infecções uterinas. -/- 4.7 Piometra -/- Esta patologia se desenvolve em vacas que ovulam nos primeiros 20 dias pós-parto e, concomitantemente, sofrem de infecção uterina. Nessas condições, a progesterona promove a proliferação bacteriana e fecha o colo do útero, causando acúmulo de exsudato purulento no útero. As alterações causadas no endométrio alteram a secreção de PGF2α, resultando na persistência do corpo lúteo e anestro. Vacas com piometra respondem muito bem ao tratamento com PGF2α; uma segunda injeção desse hormônio, 14 dias depois, encurta o período de recuperação (figura 10). -/- Figura 10: A piometra é caracterizada pelo acúmulo de exsudato purulento no útero, colo uterino fechado e presença de corpo lúteo. O diagnóstico é feito por palpação retal e tratado com PGF2α. -/- 4.8 Vaginite em fêmeas gestantes -/- A vaginite em fêmeas grávidas ocorre com baixa frequência; porém, quando há um caso, causa alarme porque é confundido com um aborto. Nesses casos, o veterinário deve fazer um exame retal para determinar se o produto está vivo e se a cérvix está aberta. O diagnóstico é concluído com o exame vaginal com vaginoscópio ou diretamente à mão com luva limpa. -/- No caso de um aborto, o produto geralmente está morto e a cérvix está aberta; nestes casos, o produto deve ser extraído. Ao contrário, se a cérvix estiver fechada e o feto estiver vivo, o prognóstico é favorável e o problema diminui com o tratamento com antibióticos sistêmicos. -/- RESUMO -/- < >O útero após o parto pesa 13 kg e no dia 21 pós-parto, 1 kg. A regeneração do epitélio uterino leva 25 dias. A regeneração das camadas profundas do endométrio leva 42 a 56 dias. 95% das vacas desenvolvem alguma infecção uterina. 30 a 50% das vacas desenvolvem metrite nas primeiras duas semanas após o parto. 15 a 20% persistem como endometrite clínica > 3 semanas após o parto. 18 a 20% têm metrite com efeitos sistêmicos. 20 a 30% das vacas têm endometrite subclínica. 5 a 15% das vacas retêm a placenta. 355 kg de leite são perdidos em vacas com retenção placentária. Em vacas que sofrem de puerpério anormal, a proporção de vacas prenhes é reduzida em 10 por cento no 90º dia pós-parto. No Reino Unido, 192 euros são gastos por cada vaca que tem um puerpério anormal. REFERÊNCIAS BIBLIOGRÁFICAS -/- ANDREWS, Anthony H. et al. (Ed.). Bovine medicine: diseases and husbandry of cattle. John Wiley & Sons, 2008. -/- AZAWI, O. I. Postpartum uterine infection in cattle. Animal reproduction science, v. 105, n. 3-4, p. 187-208, 2008. -/- BEARDEN, Henry Joe et al. Applied animal reproduction. Reston Publishing Company, Inc., 1984. -/- HOLY, Lubos; MARTÍNEZ JÚSTIZ, G. Colab. Biología de la reproducción bovina. Havana: Revolucionária, 1975. -/- HOPPER, Richard M. (Ed.). Bovine reproduction. John Wiley & Sons, 2014. -/- HORTA, António Eduardo Monteiro. Fisiologia do puerpério na vaca. Jornada Internales de Reproductión Animal, v. 8, p. 73-84, 1995. -/- KOZICKI, Luiz Ernandes. Aspectos fisiológicos e patológicos do puerpério em bovinos. Archives of Veterinary Science, v. 3, n. 1, 1998. -/- LEBLANC, S. J. et al. Defining and diagnosing postpartum clinical endometritis and its impact on reproductive performance in dairy cows. Journal of dairy science, v. 85, n. 9, p. 2223-2236, 2002. -/- LEBLANC, S. J. et al. The effect of treatment of clinical endometritis on reproductive performance in dairy cows. Journal of dairy science, v. 85, n. 9, p. 2237-2249, 2002. -/- MARTINS, T. M.; BORGES, A. M. Avaliação uterina em vacas durante o puerpério. Rev. Bras. Reprod. Anim, Belo Horizonte, v. 35, n. 4, p. 433-443, 2011. -/- RADOSTITS, Otto M. et al. Clínica Veterinária: um tratado de doenças dos bovinos, ovinos, suínos, caprinos e eqüinos. Rio de Janeiro: Guanabara Koogan, 2002. -/- RISCO, CARLOS A.; YOUNGQUIST, ROBERT S.; SHORE, M. DAWN. Postpartum uterine infections. In: Current therapy in large animal theriogenology. WB Saunders, 2007. p. 339-344. -/- SHELDON, I. M. et al. Influence of uterine bacterial contamination after parturition on ovarian dominant follicle selection and follicle growth and function in cattle. REPRODUCTION-CAMBRIDGE-, v. 123, n. 6, p. 837-845, 2002. -/- SHELDON, I. M. et al. Mechanisms of infertility associated with clinical and subclinical endometritis in high producing dairy cattle. Reproduction in domestic animals, v. 44, p. 1-9, 2009. -/- SHELDON, I. Martin et al. Uterine diseases in cattle after parturition. The Veterinary Journal, v. 176, n. 1, p. 115-121, 2008. -/- TIXI, C. et al. Factores que afectan el porcentaje de vacas gestantes en el día 90 posparto. In: Memorias del XXXIII Congreso Nacional de Buiatría. Tuxtla Gutiérrez Chiapas. México. pp. 2009. (shrink)

Recent discussions of emergence in physics have focussed on the use of limiting relations, and often particularly on singular or asymptotic limits. We discuss a putative example of emergence that does not fit into this narrative: the case of phonons. These quasi-particles have some claim to be emergent, not least because the way in which they relate to the underlying crystal is almost precisely analogous to the way in which quantum particles relate to the underlying quantum field theory. But there (...) is no need to take a limit when moving from a crystal lattice based description to the phonon description. Not only does this demonstrate that we can have emergence without limits, but also provides a way of understanding cases that do involve limits. (shrink)

In this paper we will examine the influence digital media has had on political dialogue in the public sphere. We will explore the phenomenon through an example case, namely the global feminist #MeToo movement which started in 2017. Within the framework of the #MeToo Movement, we introduce and examine the challenges digital media poses to the political dialogue in the public sphere. We start by going through concepts and theories utilized in this research paper. Then we will discuss the relationship (...) between digital media and #MeToo, after which we will assess the negative and positive outcomes of the #MeToo movement. Finally, an overall assessment concerning the movement and phenomenon around it is given. Our main argument is that while making the public sphere more inclusive, digital media has also made public debate and political discussion more polarized and antagonistic. (shrink)

Enhancement technologies may someday grant us capacities far beyond what we now consider humanly possible. Nick Bostrom and Anders Sandberg suggest that we might survive the deaths of our physical bodies by living as computer emulations.­­ In 2008, they issued a report, or “roadmap,” from a conference where experts in all relevant fields collaborated to determine the path to “whole brain emulation.” Advancing this technology could also aid philosophical research. Their “roadmap” defends certain philosophical assumptions required for this technology’s success, (...) so by determining the reasons why it succeeds or fails, we can obtain empirical data for philosophical debates regarding our mind and selfhood. The scope ranges widely, so I merely survey some possibilities, namely, I argue that this technology could help us determine (1) if the mind is an emergent phenomenon, (2) if analog technology is necessary for brain emulation, and (3) if neural randomness is so wild that a complete emulation is impossible. (shrink)

ABSTRACTThis article addresses the question of whether certain experiences that originate in causes other than bereavement are properly termed ‘grief’. To do so, we focus on widespread experiences of grief that have been reported during the Covid-19 pandemic. We consider two potential objections to a more permissive use of the term: grief is, by definition, a response to a death; grief is subject to certain norms that apply only to the case of bereavement. Having shown that these objections are unconvincing, (...) we sketch a positive case for a conception of grief that is not specific to bereavement, by noting some features that grief following bereavement shares with other experiences of loss. (shrink)

Discussions concerning whether there is a natural right to health care may occur in various forms, resulting in policy recommendations for how to implement any such right in a given society. But health care policies may be judged by international standards including the UN Universal Declaration of Human Rights. The rights enumerated in the UDHR are grounded in traditions of moral theory, a philosophical analysis of which is necessary in order to adjudicate the value of specific policies designed to enshrine (...) rights such as a right to health care. We begin with an overview of the drafting of the UDHR and highlight the primary influence of natural law theory in validating the rights contained therein. We then provide an explication of natural law theory by reference to the writings of Thomas Aquinas, as well as elucidate the complementary “capabilities approach” of Martha Nussbaum. We conclude that a right to health care ought to be guaranteed by the state. (shrink)

During his Jena period, Fichte endorses a curious dictum: ‘the kind of philosophy one chooses depends on the kind of person one is’. How can Fichte’s dictum support a vindication of German idealism over Spinozism, which he also calls ‘dogmatism’? I will show that the answer to this seemingly straightforward question reveals a rather complex series of metametaphysical objections that shape the development of the entire German idealist tradition. Ultimately, as I will suggest, the series of metametaphysical questions that shape (...) the German idealist tradition must culminate in the question of how to understand the relation between philosophy and its presuppositions. I will conclude by briefly considering a hermeneutical response to this question. (shrink)

Biological evolution is a complex blend of ever changing structural stability, variability and emergence of new phe- notypes, niches, ecosystems. We wish to argue that the evo- lution of life marks the end of a physics world view of law entailed dynamics. Our considerations depend upon dis- cussing the variability of the very ”contexts of life”: the in- teractions between organisms, biological niches and ecosys- tems. These are ever changing, intrinsically indeterminate and even unprestatable: we do not know ahead of (...) time the ”niches” which constitute the boundary conditions on selec- tion. More generally, by the mathematical unprestatability of the ”phase space”, no laws of mo- tion can be formulated for evolution. We call this radical emergence, from life to life. The purpose of this paper is the integration of variation and diversity in a sound concep- tual frame and situate unpredictability at a novel theoretical level, that of the very phase space. Our argument will be carried on in close comparisons with physics and the mathematical constructions of phase spaces in that discipline. The role of symmetries as invariant preserving transformations will allow us to under- stand the nature of physical phase spaces and to stress the differences required for a sound biological theoretizing. In this frame, we discuss the novel notion of ”enablement”. Life lives in a web of enablement and radical emergence. This will restrict causal analyses to differential cases. Mutations or other causal differ- ences will allow us to stress that ”non conservation princi- ples” are at the core of evolution, in contrast to physical dynamics, largely based on conservation principles as sym- metries. Critical transitions, the main locus of symmetry changes in physics, will be discussed, and lead to ”extended criticality” as a conceptual frame for a better understanding of the living state of matter. (shrink)

Background Several jurisdictions, including Singapore, Australia, New Zealand and most recently Ireland, have a public interest or public good criterion for granting waivers of consent in biomedical research using secondary health data or tissue. However, the concept of the public interest is not well defined in this context, which creates difficulties for institutions, institutional review boards and regulators trying to implement the criterion. Main text This paper clarifies how the public interest criterion can be defensibly deployed. We first explain the (...) ethical basis for requiring waivers to only be granted to studies meeting the public interest criterion, then explore how further criteria may be set to determine the extent to which a given study can legitimately claim to be in the public interest. We propose an approach that does not attempt to measure magnitude of benefit directly, but rather takes into account metrics that are more straightforward to apply. To ensure consistent and justifiable interpretation, research institutions and IRBs should also incorporate procedural features such as transparency and public engagement in determining which studies satisfy the public interest requirement. Conclusion The requirement of public interest for consent waivers in secondary biomedical research should be guided by well-defined criteria for systematic evaluation. Such a criteria and its application need to be periodically subject to intra-committee and intra-institution review, reflection, deliberation and amendment. (shrink)

This paper argues that McDowell wrongly assumes that “terror”, Cavell’s reaction to the radical contingency of our shared modes of knowing or our “attunement”, expresses a skepticism that is antinomically bound to an equally unacceptable dogmatism because Cavell rather regards terror as a mood that reveals the “truth of skepticism”, namely, that there is no conclusive evidence for necessary attunement on pain of a category error, and that a precedent for McDowell’s misunderstanding is Hegel’s argument for necessary attunement in a (...) system of knowing, whose refutation Schelling holds it is the “merit of skepticism” to provide. (shrink)

While the idea that philosophy requires self-transformation is historically pervasive, it exerts considerable influence on the post-Kantians who first aim to systematize Kant’s idealism by grounding it on a first principle. In the 1790s, Fichte and Schelling offer competing accounts of the self-transformation that they regard as essential to positing a first principle. Their accounts raise two central questions. First, what makes this kind of self-transformation possible? Second, are there different possible expressions of philosophical self-transformation? In what follows, I will (...) articulate the Fichtean and Schellingian answers to these central questions. For Fichte, the one who summons me to posit a first principle makes possible my philosophical self-transformation, although the latter has an exclusively idealist expression in that I can only genuinely posit the I as first principle, which is to say that philosophical self-transformation depends on mutual recognition and vindicates precisely one philosophical system (Section 1). For Schelling, a brute act of will makes possible my philosophical self-transformation, although the latter has either an idealist or a realist expression in that I can genuinely posit either the I or the not-I as first principle, which is to say that philosophical self-transformation does not depend on mutual recognition and vindicates one of two possible philosophical systems (Section 2). Thus, whereas Fichtean self-transformation is recognitive and non-pluralistic, Schellingian self-transformation is pluralistic and non-recognitive. I conclude with a discussion of how Jacobi poses a challenge to Fichte’s and Schelling’s answers to the two central questions (Section 3). (shrink)

The concept of facticity denotes conditions of experience whose necessity is not logical yet whose contingency is not empirical. Although often associated with Heidegger, Fichte coins ‘facticity’ in his Berlin period to refer to the conclusion of Kant’s metaphysical deduction of the categories, which he argues leaves it a contingent matter that we have the conditions of experience that we do. Such rhapsodic or factical conditions, he argues, must follow necessarily, independent of empirical givenness, from the I through a process (...) of ‘genesis.’ I reconstruct Fichte’s argument by tracing the origin of his neologism, presenting his Jena critique of Kant’s rhapsodic appeal to the forms of judgment, and illustrating the Jena period’s continuity with the Berlin period’s genetic method, while noting a methodological shift whereby Fichte directs his critique against his own doctrine of intellectual intuition in order to eliminate its ‘factical terms.’. (shrink)

A precursor to the hard problem of consciousness confronts nihilism. Like physicalism, nihilism collides with the first-personal fact of what perception and action are like. Unless this problem is solved, nature’s inclusion of conscious experience will remain, as Chalmers warns the physicalist, an “unanswered question” and, as Jacobi chides the nihilist, “completely inexplicable". One advantage of Kant’s Copernican turn is to dismiss the question that imposes this hard problem. We need not ask how nature is accompanied by the first-person standpoint (...) because “I think” is an apperceptive form of thinking that must be able to accompany any cognition of nature. Kant’s formal conception of apperception worries Fichte in his Nova Methodo lectures. This conception arguably cannot exhaust the ground of experience, for it does not show why we posit objects “at all". For Fichte, it is our agency that first opens a world of objects, viz., as subjects, means, ends, and obstacles. In what follows, I argue that, for Fichte, the I poses no hard problem because it collides exclusively with nihilistic views like Spinozism, which are refuted by a properly transcendental idealist conception of apperception, according to which the first-person standpoint is the absolute ground of our experience of nature. If transcendental idealism refutes nihilism, nature is no more explicable than that there is something it is like for me to perceive and act. In Section 1, I show why Kantian apperception is necessary for possible experience. In Section 2, I reconstruct Fichte’s argument that a modified conception of apperception refutes guises of nihilism, thereby solving the hard problem of consciousness. In Section 3, I suggest that transcendental idealism undermines Chalmers’ proposed solution to and Dennett’s dismissal of this problem. (shrink)

Mitochondrial replacement therapy requires oocytes of women whose mitochondrial DNA will be transmitted to resultant children. These techniques are scientifically, ethically and socially controversial; it is likely that some women who donate their oocytes for general in vitro fertilisation usage would nevertheless oppose their genetic material being used in MRT. The possibility of oocytes being used in MRT is therefore relevant to oocyte donation and should be included in the consent process when applicable. In present circumstances, specific consent should be (...) obtained. However, once MRT becomes more routine, such consent could be incorporated into the general consent process for oocyte donation. The reported lack of proper consent for MRT from the oocyte donor in the first baby born via the technique is an ethical failing and should be corrected in any future practice of MRT. (shrink)

Fichte assigns ‘intellectual intuition’ a new meaning after Kant. But in 1799, his doctrine of intellectual intuition is publicly deemed indefensible by Kant and nihilistic by Jacobi. I propose to defend Fichte’s doctrine against these charges, leaving aside whether it captures what he calls the ‘spirit’ of transcendental idealism. I do so by articulating three problems that motivate Fichte’s redirection of intellectual intuition from being to acting: (1) the regress problem, which states that reflecting on empirical facts of consciousness leads (...) only to further facts and so cannot yield a first principle; (2) the rhapsody problem, which states that the categories form a haphazard set and so lack necessity unless they derive from a first principle; and (3) the nihilism problem, which states that a first principle cannot lie outside our cognition of it, lest it be the cause of our cognition and, being first, the cause of all our actions, reducing us to machines. Crucially, Fichte’s three motivating problems are in fact aspects of a single problem. Leaving any aspect unsolved spoils putative solutions to the other two. Consequently, Fichte requires a single unified solution to all three, which his doctrine of intellectual intuition provides. (shrink)

Meillassoux defines “correlationism” as the view that we can only access the mutual dependence of thought and being—specifically, subjectivity and objectivity—which he attributes to Heidegger. This attribution is inapt. It is only by accessing being—via existential analysis—that we can properly distinguish beings like subjects and objects. I propose that Meillassoux’s misattribution ignores the ontological difference that drives Heidegger’s project. First, I demonstrate the inadequacy of Meillassoux’s account of correlationism as a criticism of Heidegger and dispense with an objection. Second, I (...) argue that Meillassoux’s neglect of the ontological difference stems from a question-begging appeal to transcendental realism, which is at odds with Heidegger’s twin claims for a variety of transcendental idealism in Being and Time. Third, I offer a reflection on three general marks of transcendental idealism. (shrink)

Organisms that share the capability of storing information about experiences in the past have an actively generated background resource on which they can compare and evaluate more recent experiences in order to quickly or even better react than in previous situations. This is an essential competence for all reaction and adaptation purposes of living organisms. Such memory/learning skills can be found from akaryotes up to unicellular eukaryotes, fungi, animals and plants, although until recently, it had been mentioned only as a (...) capability of higher animals. With the rise of epigenetics, the context-dependent marking of experiences at both the phenotype and the genotype level is an essential perspective to understand memory and learning in all organisms. Both memory and learning depend on a variety of successful communication processes within the whole organism. (shrink)

The current prevailing view is that participation in biomedical research is above and beyond the call of duty. While some commentators have offered reasons against this, we propose a novel public goods argument for an obligation to participate in biomedical research. Biomedical knowledge is a public good, available to any individual even if that individual does not contribute to it. Participation in research is a critical way to support an important public good. Consequently, all have a duty to participate. The (...) current social norm is that individuals participate only if they have a good reason to do so. The public goods argument implies that individuals should participate unless they have a good reason not to. Such a shift would be of great aid to the progress of biomedical research, eventually making society significantly healthier and longer lived. (shrink)

It is commonplace to observe that digital technologies facilitate our access to information on a scale unimaginable in previous eras, leading many to call this the “Information Age.” The vaunted advantages of unprecedented data flow obscure a dark corollary: the more modes of engaging with data are available to a people, the more modes are available for manipulating them. Whether through social media, blogs, email, newspaper headlines, or doctored images and videos, the public is indeed bombarded by information, and much (...) of it is misleading or outright false. Much of it, in fact, is propaganda. As the methods for manipulating mass audiences continue to multiply, a clear understanding of the concept of propaganda has never been more relevant. -/- This Article constructs a precise, novel account of propaganda, incorporating notable scholarly insights into the concept as well as the overlooked lessons of the law’s fragmented efforts to regulate it. To bring this new theoretical framework into focus and demonstrate its importance in the Information Age, the Article connects the underlying theory to contemporary communications practices, many of which are enhanced by the availability of new technology. Notably, in doing so, the Article also develops the first systematic account of political gaslighting, which properly understood (and counterintuitively, perhaps) constitutes a form of propaganda. (shrink)

A rapidly growing body of scholarship embraces virtue jurisprudence, a series of (often ad hoc) attempts to incorporate the philosophical tradition of virtue ethics into legal theory. Broadly understood, virtue ethics describes an approach to moral questions that emphasizes the importance of developing and embodying various virtues, often as manifestations of human flourishing. Scholars typically contrast virtue ethics with deontological and consequentialist moral theories, tracing virtue-centered analysis to ancient Greek philosophers, and in particular to Aristotle. Virtue ethics has experienced a (...) revival over the past 65 years; but, long before that, it proved especially influential in Catholic moral thought, particularly through the work of Aquinas. Perhaps relatedly, scholars have seized on virtue jurisprudence to defend a range of politically conservative positions, such as originalist constitutional interpretation and the propriety of utilizing the law to regulate ostensibly “private” immoralities. This Article reveals the radically underappreciated progressive promise of virtue jurisprudence. Virtue jurisprudence requires no religious commitments whatsoever, but a strong version entails acceptance of the moral significance of developing one’s character—both within and without the law. On a compelling understanding of the virtues, rejecting a state of perpetual disadvantage under the law is a meaningful marker of the virtue of self-respect, and a repudiation of the vice of servility that would otherwise be imposed by the legal system itself. Thus, contrary to the predominant tenor of research on the subject, virtue jurisprudence can ground significant resistance to—and even defiance of—the law. In making this argument, the Article also draws novel connections between virtue jurisprudence and literature on (inter alia) race, feminism, and sexual orientation to reveal the unnoticed potential of virtue jurisprudence to push forward work in those and related areas. At a time when massive and widespread protests across the United States reflect a groundswell of support for overturning certain long-standing, legally-ingrained, systemic disadvantages of people of color, many might be surprised to learn that virtue jurisprudence can serve as a potent theoretical ally. (shrink)

The COVID-19 pandemic revealed numerous weaknesses in pandemic preparedness and response, including underfunding, inadequate surveillance, and inequitable distribution of countermeasures. To overcome these weaknesses for future pandemics, WHO released a zero draft of a pandemic treaty in February, 2023, and subsequently a revised bureau's text in May, 2023. COVID-19 made clear that pandemic prevention, preparedness, and response reflect choices and value judgements. These decisions are therefore not a purely scientific or technical exercise, but are fundamentally grounded in ethics. The latest (...) treaty draft reflects these ethical considerations by including a section entitled Guiding Principles and Approaches. Most of these principles are ethical—they establish core values that undergird the treaty. Unfortunately, the treaty draft's set of principles are numerous, overlapping, and show inadequate coherence and consistency. We propose two improvements to this section of the draft pandemic treaty. First, key guiding ethical principles should be clearer and more precise than they currently are. Second, the link between ethical principles and policy implementation should be clearly established and define boundaries on acceptable interpretation, ensuring that signatories abide by these principles. (shrink)

En este texto presentamos el modelo que se ha diseñado para implementar la evaluación por colegas pares en la Universidad del Rosario. Explicamos los principios que lo guían y las etapas y procedimientos para realizar esta evaluación; además, exponemos algunos aprendizajes que ha dejado su implementación en dos facultades en los últimos años, y presentamos algunos retos y desarrollos que enfrenta el modelo a futuro.

Fichte argues that the conclusion of Kant’s transcendental deduction of the categories is correct yet lacks a crucial premise, given Kant’s admission that the metaphysical deduction locates an arbitrary origin for the categories. Fichte provides the missing premise by employing a new method: a genetic deduction of the categories from a first principle. Since Fichte claims to articulate the same view as Kant in a different, it is crucial to grasp genetic deduction in relation to the sorts of deduction that (...) Kant offers. I propose to interpret genetic deduction as the simultaneous fulfillment of two tasks: answering the question quid facti by deriving the categories from the I and answering the question quid juris by establishing our entitlement to the categories as conditions of experience. While the second task represents Fichte’s agreement with Kant’s transcendental deduction, the first reflects his correction of Kant’s metaphysical deduction. (shrink)

It has recently been argued that reproductive genetic manipulation technologies like mitochondrial replacement and germline CRISPR modifications cannot be said to save anyone’s life because, counterfactually, no one would suffer more or die sooner absent the intervention. The present article argues that, on the contrary, reproductive genetic manipulations may be life-saving (and, from this, have therapeutic value) under an appropriate population health perspective. As such, popular reports of reproductive genetic manipulations potentially saving lives or preventing disease are not necessarily mistaken, (...) though such terminology still requires further empirical validation. (shrink)

Throughout his career, Schelling assigns knowledge of the absolute first principle of philosophy to intellectual intuition. Schelling's doctrine of intellectual intuition raises two important questions for interpreters. First, given that his doctrine undergoes several changes before and after his identity philosophy, to what extent can he be said to “hold onto” the same “sense” of it by the 1830s, as he claims? Second, given that his doctrine of intellectual intuition restricts absolute idealism to what he calls a “science of reason”, (...) which he says cannot prove the absolute’s existence, what other doctrine does he require in order to prove this? I will answer these questions by tracing the shifts in Schelling’s doctrine of intellectual intuition from the 1790s to the 1830s and drawing out its evolving methodological role within his science of intelligibility. (shrink)

Resumo A criação de bezerras está entre as atividades mais importantes da pecuária leiteira, pois reflete a genética e a produção do rebanho. Um bom manejo nutricional de novilhas durante a fase recria é essencial para o desenvolvimento ponderal adequado, pois melhora da função imunológica e precocidade reprodutiva. Este estudo teve como objetivo avaliar a relação do peso de novilhas holandesas com a idade na primeira inseminação artificial, primeiro parto e volume de leite produzido na primeira lactação. Foram utilizados os (...) registros de 200 novilhas holandesas submetidas a inseminação artificial em tempo fixo (IATF) em uma fazenda leiteira na região de Lagoa Formosa, MG, no período de janeiro a dezembro de 2020 a 2023, considerando informações sobre de ganho de peso no período de recria até o primeiro serviço idade na IATF e idade ao primeiro parto, produção de leite (em litros) e tempo de lactação. Os registros com as informações foram tabelados no software Exel® e avaliados. As novilhas foram divididas em três (3) grupos de acordo com o ganho de peso alcançado até a primeira inseminação, sendo: grupo A (GA) acima de 390 kg, grupo B (GB) de 360 a 389 kg e grupo C (GC) abaixo de 359 kg. O GA apresentou menor idade na primeira inseminação e no primeiro parto e maior produção de leite, porém a duração da lactação foi menor em relação aos demais grupos. O escore corporal se mostrou determinante para o bom desempenho na reprodução, na produção e na geração de renda ao produtor. -/- Abstract Raising calves is among the most important activities in dairy farming, as it reflects the genetics and production of the herd. Good nutritional management of heifers during the rearing phase is essential for adequate weight development, as it improves immune function and reproductive precocity. This study aimed to evaluate the relationship between the weight of Holstein heifers and age at first artificial insemination, first calving and volume of milk produced in the first lactation. We used the records of 200 Holstein heifers submitted to fixed-time artificial insemination (FTAI) on a dairy farm in the region of Lagoa Formosa, MG, from January to December 2020 to 2023, considering information on weight gain in the period from rearing to first service age at TAI and age at first calving, milk production (in liters) and lactation time. The records with the information were tabulated in the Exel® software and evaluated. The heifers were divided into three (3) groups according to the weight gain achieved until the first insemination, being: group A (GA) above 390 kg, group B (GB) from 360 to 389 kg and group C (GC) below 359 kg. The GA showed a younger age at first insemination and first birth and higher milk production, but the duration of lactation was shorter compared to the other groups. Body score proved to be decisive for good performance in reproduction, production and income generation for the producer. -/- Resumen La cría de terneros es una de las actividades más importantes en la ganadería lechera, ya que refleja la genética y la producción del rebaño. Un buen manejo nutricional de las novillas durante la fase de cría es esencial para un adecuado desarrollo del peso, ya que mejora la función inmune y la precocidad reproductiva. Este estudio tuvo como objetivo evaluar la relación entre el peso de las vaquillonas Holstein y la edad a la primera inseminación artificial, primer parto y el volumen de leche producida en la primera lactancia. Se utilizaron los registros de 200 novillas Holstein sometidas a inseminación artificial en tiempo fijo (FTAI) en una granja lechera de la región de Lagoa Formosa, MG, de enero a diciembre de 2020 a 2023, considerando información sobre ganancia de peso en el período de recría a primera edad de servicio en TAI y edad al primer parto, producción de leche (en litros) y tiempo de lactancia. Los registros con la información fueron tabulados en el software Exel® y evaluados. Las vaquillonas se dividieron en tres (3) grupos de acuerdo a la ganancia de peso lograda hasta la primera inseminación, siendo: grupo A (GA) por encima de 390 kg, grupo B (GB) de 360 a 389 kg y grupo C (GC) por debajo de 359 kg. El AG mostró una menor edad a la primera inseminación y al primer parto y mayor producción de leche, pero la duración de la lactancia fue menor en comparación con los otros grupos. La puntuación corporal resultó ser determinante para un buen desempeño en la reproducción, la producción y la generación de ingresos para el productor. (shrink)

As opposed to a ‘one size fits all’ approach, precision medicine uses relevant biological, medical, behavioural and environmental information about a person to further personalize their healthcare. This could mean better prediction of someone’s disease risk and more effective diagnosis and treatment if they have a condition. Big data allows for far more precision and tailoring than was ever before possible by linking together diverse datasets to reveal hitherto-unknown correlations and causal pathways. But it also raises ethical issues relating to (...) the balancing of interests, viability of anonymization, familial and group implications, as well as genetic discrimination. This article analyses these issues in light of the values of public benefit, justice, harm minimization, transparency, engagement and reflexivity and applies the deliberative balancing approach found in theEthical Framework for Big Data in Health and Research to a case study on clinical genomic data sharing. Please refer to that article for an explanation of how this framework is to be used, including a full explanation of the key values involved and the balancing approach used in the case study at the end. Our discussion is meant to be of use to those involved in the practice as well as governance and oversight of precision medicine to address ethical concerns that arise in a coherent and systematic manner. (shrink)

-- 22.03.2024 -- Intervention held at the conference entitled "In the Memory of Giuseppe Cantillo a Year from his Disappearance" at the ”Banner’s room” of the Municipality of Salerno, Italy -- -/- Giuseppe Cantillo's philosophy suggests a combination between Jaspersian criticism of modernity and the Masullian path through Hegel's dialectical ontology. The "duality" of the Cure that Aldo Masullo talks about allows in fact to rebalance and fluidify the existentialist-teleological approach typical of Jaspers' philosophy. This happens in the terms of (...) a recognition of the individual as irreducibly unique and at the same time always belonging to the social being. This allows for a dialectical interpretation of the relationship between the ego and the other. The result is a theoretical perspective capable of re-establishing the already fragile link between individual and social being, exhuming its transformative and critical potential. Such a system is rooted in Marxian intuition, which assumes the objective nature of pathicity as the condition that unites historical subjects. (shrink)

This chapter aims to illuminate ways in which hope was significant in the philosophy of classical Greece. Although ancient Greek philosophies contain few dedicated and systematic expositions on the nature of hope, they nevertheless include important remarks relating hope to the good life, to reason and deliberation, and to psychological phenomena such as memory, imagination, fear, motivation, and pleasure. After an introductory discussion of Hesiod and Heraclitus, the chapter focuses on Plato and Aristotle. Consideration is given both to Plato’s direct (...) comments on hope and to the narrative contexts of his dialogues, with analysis of Plato’s positive and negative representations of hope, hope’s relationship to reason, and Plato’s more psychological approach in the Philebus, where hope finds a place among memory, recollection, pleasure, and pain. The chapter then reviews Aristotle’s discussions of confidence, hope, and courage, observing that although Aristotle does not mention hope as a virtue, he does note its importance to human agency and deliberation and as a foundation for the further development of virtue. The chapter concludes that discussions surrounding hope in ancient Greek philosophy are rich and challenging and can serve as a lively stimulus to further exploration of the concept of hope. (shrink)

In the Freedom essay, Schelling charges that (1) idealism fails to grasp human freedom’s distinctiveness and that (2) this failure undermines idealism's attempt to refute pantheism, as exemplified by Spinoza. This raises two questions, which I will answer in turn: what, for Schelling, is distinctive of human freedom; and how does the idealists’ failure to grasp it render them unable to refute pantheism? To answer these questions, I will reconstruct Schelling’s argument that freedom has the distinctness of being the unconditioned (...) condition of the world’s intelligibility. My reconstruction will illustrate how Schelling’s notion of freedom as primal will grounds the alleged primacy of practical reason as Kant and Fichte conceive it. I will then consider three objections to Schelling’s argument. Throughout, I will develop the Schellingian idea that freedom is enacted in an unprethinkable decision that cannot be anticipated by any law or principle. (shrink)

It is generally unquestioned that human subjects research review boards should assess the ethical acceptability of protocols. It says so right on the tin, after all: they are explicitly called research ethics committees in the UK. But it is precisely those sorts of unchallenged assumptions that should, from time to time, be assessed and critiqued, in case they are in fact unfounded. John Stuart Mill's objection to suppressers of dissent is instructive here: “If the opinion is right, they are deprived (...) of the opportunity of exchanging error for truth: if wrong, they lose, what is almost as great a benefit, the clearer perception and livelier impression of truth, produced by its collision with error”.1 Andrew Moore and Andrew Donnelly's compelling article, “The job of ‘ethics committees’”, is just this sort of challenge to conventional wisdom, a rejection of the notion that review boards should be considering ethical matters at all.2 If true, we should be substantially reforming our research ethics policies. And if false, rebuttals would help strengthen and ground the otherwise unquestioned assumption of the role of ethics committees. As it happens, I will argue that their critiques fall into the second category. While mistaken, they present a valuable opportunity to clarify the role of ethics committees and their relationship to relevant codes. In particular, I will defend a hybrid account where codes have strict primacy, but leave significant room for review boards …. (shrink)

In debates over the regulation of communication related to dual-use research, the risks that such communication creates must be weighed against against the value of scientific autonomy. The censorship of such communication seems justifiable in certain cases, given the potentially catastrophic applications of some dual-use research. This conclusion however, gives rise to another kind of danger: that regulators will use overly simplistic cost-benefit analysis to rationalize excessive regulation of scientific research. In response to this, we show how institutional design principles (...) and normative frameworks from free speech theory can be used to help extend the argument for regulating dangerous dual-use research beyond overly simplistic cost-benefit reasoning, but without reverting to an implausibly absolutist view of scientific autonomy. (shrink)

This chapter intervenes in recent debates in Kant scholarship about the possibility of a general logical alien. Such an alien is a thinker whose laws of thinking violate ours. She is third-personal as she is radically unlike us. Proponents of the constitutive reading of Kant’s conception of general logic accordingly suggest that Kant rules out the possibility of such an alien as unthinkable. I add to this an often-overlooked element in Kant’s thinking: there is reason to think that he grants—and (...) in fact presupposes—the possibility of a transcendental logical alien. Such an alien is a knower whose laws of experience purport to violate ours. She is first-personal as she is radically like us. In other words, she is us, insofar as we are alienated from ourselves and our experience. I go on to draw an analogy between her, a dogmatist, and another transcendental alien, an evil agent. Just as a dogmatist is alienated from her (our) experiential laws, an evil agent is alienated from her (our) moral law. These forms of theoretical and practical self-conceit require self-knowledge in the form of a critique of speculative or practical reason. In bringing this point out, I aim to shift from the question of whether logical laws constitute our thinking to the question of whether grasping our experiential and moral laws as our laws constitutes our reason. (shrink)

The study investigated the effect of cognitive restructuring on junior secondary school mathematics test anxiety in Oshimili south L.G.A of Delta State. Two research questions and two hypotheses tested at 0.05 level of significance guided the study. Quasi-experimental research design was adopted for this study. The population for this study was a total of 1224 students. These comprised of all the JSS 2 students from Oshimili South Local Government Area of Delta State. Research sample consisted of 120 JSS 2 students (...) with high level of mathematics test anxiety selected through purposive sampling technique. The instrument adopted for this study was Maths anxiety rating scale-R. Data collected from the study were analyzed using mean and ANCOVA. Results obtained from the study indicated that Cognitive restructuring therapy (CRT) was effective on mathematics test anxiety of junior secondary school students. The results equally showed that Cognitive restructuring therapy was more effective on the female students’ mathematics anxiety than their male counterparts. Furthermore, the results indicated a significant difference in the post-test mathematics test anxiety mean scores of students treated with CRT and those in the control group. Also, there was significant difference in the post-test mathematics test anxiety mean scores of male and female students treated with CRT. Based on the findings of this study, some recommendations were noted. The researcher recommended, among others that Schools’ Guidance Counselors should be empowered to make good use of the cognitive restructuring technique, in counseling students who find it difficult to comprehend mathematics skills. (shrink)

Aristotle argued that you need some wealth to live well. The Stoics argued that you could live well with or without wealth. But the Cynics argued that wealth is a hinderance. For the Cynics, a good life consists in self-sufficiency, or being able to rule and help yourself. You accomplish this by living simply and naturally, and by subjecting yourself to rigorous philosophical exercises. Cynics confronted people to get them to abandon extraneous possessions and positions of power to live better. (...) And while the Cynics were experts in living in this way, their ascetic lifestyles made their message curious to some audiences. This paper reflects on Cynic ascetic practices and the ways others perceived them. (shrink)

Two attitudes are possible: one, that the world is an absolute jungle and that the exercise of coercive power by rulers is only a manifestation of this; and the other, that it is both necessary and right that there should be this exercise of power, that through it the world is much less of a jungle than it could possibly be without it, so that one should in principle be glad of the existence of such power, and only take exception (...) to its unjust exercise. (shrink)

Business resilience is the ability to quickly recover from difficulties and continue operating by applying innovative strategies. The article aims to document the resilience level of micro, small, and medium enterprises (MSMEs) in the Pacific towns of Southern Leyte, Philippines, and capture its causal determinants amid the health crisis using descriptive correlational research design. Using a research-made questionnaire, cross-sectional and primary data were collected from a random sample of MSMEs and were summarized using statistical measures. The significant determinants of the (...) resilience of MSMEs were determined using the Chi-square test for independence via cross-tabulation of categorical data. Results depicted that, on average, MSMEs during the pandemic are "resilient", particularly in their situational awareness, keystone vulnerabilities, and adaptive capacity as they combat the disruption of the health crisis. The Chi-square test reveals that age, civil status, business job position of the MSMEs' personnel, and the estimated monthly income of the enterprise are the highly significant factors that affect the resilience of MSMEs during the health crisis. In particular, younger age, single status, and owner of the enterprise are more active and creative in digital business technology, which increases their resilience in response to challenges brought about by the pandemic. Moreover, enterprises with lower incomes do adopt innovative business strategies that improve economic resilience and profit. Furthermore, the study suggests that enterprises must consider strategic plans and goals to enhance their capability in risk management as they will face future crises. (shrink)

In their recent article, Koplin, Gyngell and Savulescu (2019) assess the viability of the precautionary principle as a decision-making tool to determine whether and under what circumstances germline gene editing should proceed. While their survey of different forms of the precautionary principle is illuminating, the most novel contribution is a new account of the precautionary principle, what they dub the Sufficientarian Precautionary Principle (SPP). SPP is meant to avoid several problems with existing accounts, while comporting with at least some of (...) the intuitive force behind the general idea of the precautionary principle. However, as it is only one subsection of a larger paper, SPP is not fully worked out. In this brief response, I will flesh out some problems with SPP as a decision-making tool – particularly that there is a lack of adequate normative justification for adopting it. While this does not constitute a decisive refutation of the approach, SPP needs considerable refinement and clarification before it can be considered viable for use in decision-making. (shrink)

An English translation of Leibniz's fragment "Horizon rerum humanarum... " in which he announces a plan to demonstrate "that the number of truths or falsehoods enunciable by humans as they are now is limited; and also that if the present condition of humanity persisted long enough, it would happen that the greatest part of what they would communicate in words, whether by talking or writing, would have to coincide with what others have already communicated in the past; and moreover that (...) new humans would lead an entire life that appears thoroughly the same to the senses as lives that others have already led." . (shrink)

Scholars agree that Schelling’s critique of Hegel consists in charging reason with an inability to account for its own possibility. This is not an attack on reason’s project of constructing a logical system, but rather on the pretense of doing so with complete justification and so without presuppositions, as if it were obvious why there is a logical system or why there is anything meaningful at all. Scholars accordingly cite the question ‘why is there something rather than nothing’ as emblematic (...) of Schelling’s critique and the source of his claim against Hegel that reason is bounded by something other than itself. But what sort of claim is this? For what sort of argument could it be the conclusion? On these questions, the literature is lacking. I propose that the question ‘why something’ motivates Schelling to give a transcendental argument to the effect that past and future are a priori conditions of the possibility of reason. As I reconstruct it from the Weltalter, this argument construes the past as the pre-rational decision to construct a logical system, while the future represents the purpose that guides the construction of the same. Schelling’s claim against Hegel that reason is bounded by something other is thus the discovery of inescapable presuppositions that condition the possibility of reason as such. (shrink)

Given the sordid history of injustices linking genetics to race and ethnicity, considerations of justice are central to ensuring the responsible development of precision medicine programmes around the world. While considerations of justice may be in tension with other areas of concern, such as scientific value or privacy, there are also tensions between different aspects of justice. This paper focuses on three particular aspects of justice relevant to this precision medicine: social justice, distributive justice and human rights. We describe the (...) implications of each for the use of race and ethnicity in precision medicine, and also how they intersect and potentially conflict with each another. By attending to these intersections, we aim to enrich and add nuance to debates over how best to proceed with precision medicine initiatives. (shrink)

Our understanding of Schelling’s internal critique of German idealism, including his late attack on Hegel, is incomplete unless we trace it to the early “Philosophical Letters on Dogmatism and Criticism,” which initiate his engagement with the problem of systematicity—that judgment makes deriving a system of a priori conditions from a first principle necessary, while this capacity’s finitude makes this impossible. Schelling aims to demonstrate this problem’s intractability. My conceptual aim is to reconstruct this from the “Letters,” which reject Fichte’s claim (...) that the Wissenschaftslehre is an unrivalled system. I read Schelling as charging Fichte with misrepresenting a system’s livability or commensurability with our finitude. My historical aim is to provide a framework for understanding Schelling’s Freiheitsschrift, which argues that a system’s liveability depends on its incompleteness or limitation by our finitude. On my reading, Schelling is early and continually committed to systematicity within the bounds of human finitude. (shrink)

In the Vocation of Man, Fichte makes the striking claim that life is eternal, rational, our true being, and the final cause of nature in general and of death in particular. How can we make sense of this claim? I argue that the public lectures that compose the Vocation are a popular expression of Fichte’s pre-existing commitment to what I call immortalism, the view that life is the unconditioned condition of intelligibility. Casting the I as an absolutely self-active or living (...) power enables his philosophical account of both the intelligibility of objects and of what it means to die. This explains his characterization of the Wissenschaftslehre as a system in which ‘all is act, movement, and life’. In Sect. 1, I explain the context of Jacobi’s use of ‘caput mortuum’ as a term for the thing in itself. In Sects. 2 and 3, I reconstruct two immortalist arguments from Fichte’s Jena period. The first is that the I’s self-activity rules out the existence of the thing in itself and thereby vanquishes ‘death’s head’. The second is that, insofar as the I charges us with the moral perfection of nature, it is the final cause of our entire life, including its end. This is to say that the I puts our every moment into question, even our last. In Sect. 4, I use these immortalist arguments to interpret the striking claim from the Vocation. (shrink)

Some have objected to human enhancement on the grounds that it violates the autonomy of the enhanced. These objections, however, overlook the interesting possibility that autonomy itself could be enhanced. How, exactly, to enhance autonomy is a difficult problem due to the numerous and diverse accounts of autonomy in the literature. Existing accounts of autonomy enhancement rely on narrow and controversial conceptions of autonomy. However, we identify one feature of autonomy common to many mainstream accounts: reasoning ability. Autonomy can then (...) be enhanced by improving people’s reasoning ability, in particular through cognitive enhancement; given how valuable autonomy is usually taken to be, this gives us extra reason to pursue such cognitive enhancements. Moreover, autonomy-based objections will be especially weak against such enhancements. As we will argue, those who are worried that enhancements will inhibit people’s autonomy should actually embrace those enhancements that will improve autonomy. (shrink)

Kant’s critique/doctrine distinction tracks the difference between a canon for the understanding’s proper use and an organon for its dialectical misuse. The latter reflects the dogmatic use of reason to attain a doctrine of knowledge with no antecedent critique. In the 1790s, Fichte collapses Kant’s distinction and redefines dogmatism. He argues that deriving a canon is essentially dialectical and thus yields an organon: critical idealism is properly a doctrine of science or Wissenschaftslehre. Criticism is furthermore said to refute dogmatism, by (...) which Fichte means Spinozism. Schelling repudiates Fichte’s position in his Philosophical Letters by reviving Kant’s distinction. First, ‘critique’ for Schelling names a canon that is valid for all systems—including Spinozism—and thus favours none—not even the Wissenschaftslehre. Second, Schelling coins ‘dogmaticism’ to refer to what Kant calls ‘dogmatism’: reason’s uncritical claim to doctrine. Hence, he says all systems—even Fichte’s—are susceptible to the ‘enthusiasm’ of mistaking themselves for doctrines or ‘objects of knowledge’, instead of subjectively valid ‘objects of freedom’. I reconstruct Schelling’s argument for reviving Kant’s distinction, while noting two consequences for German idealism. First, if criticism favours no system, a system’s origin cannot be an act of knowledge, e.g., intellectual intuition, but only an act of endorsement. Second, if dogmaticism entails enthusiasm, a system’s goal cannot be absolute knowledge, but only infinite striving. Hence, by retrieving Schelling’s notion of dogmaticism, we can both gain a better understanding of the Letters and register the impact of a core Kantian distinction on the German idealist project. (shrink)

Moral enhancement is an ostensibly laudable project. Who wouldn’t want people to become more moral? Still, the project’s approach is crucial. We can distinguish between two approaches for moral enhancement: direct and indirect. Direct moral enhancements aim at bringing about particular ideas, motives or behaviors. Indirect moral enhancements, by contrast, aim at making people more reliably produce the morally correct ideas, motives or behaviors without committing to the content of those ideas, motives and/or actions. I will argue, on Millian grounds, (...) that the value of disagreement puts serious pressure on proposals for relatively widespread direct moral enhancement. A more acceptable path would be to focus instead on indirect moral enhancements while staying neutral, for the most part, on a wide range of substantive moral claims. I will outline what such indirect moral enhancement might look like, and why we should expect it to lead to general moral improvement. (shrink)

Volume 19, Issue 7, July 2019, Page 28-30.

With the recent report of a live birth after use of Mitochondrial replacement therapy, sometimes called ‘Three-parent IVF’, the clinical application of the technique is fast becoming a reality. While the United Kingdom allows the procedure under regulatory scrutiny, it remains effectively outlawed in many other countries. We argue that such prohibitions may violate individuals’ procreative rights, grounded in individuals’ interest in genetic affinity. The interest in genetic affinity was recently endorsed by Singapore’s highest court, reflecting an emphasis on the (...) importance of biological ties found across the globe. We apply that reasoning to make the case for a right to ‘Three-parent IVF’. (shrink)