The French Convention on Bioethics (États généraux de la bioéthique, 2009) were a perfect spot to observe new methods of organizing the participants of public debates into a hierarchy. Indeed, a privileged place was given to the citizen, and quite often the expert and the politician were devoid of their usual roles. This article will focus on the analysis of the very role given to the expert and to the expertise, both in the definition of the general framework of (...) the series of meetings and in public debates that took place in (among others) Marseille and Paris. This analysis makes obvious the idea that the major result of those Conventions does not consist in putting forward some original thoughts on biomedicine and its problems, but rather in promoting a new model of governance. In consequence, and if I am right, this promotion is being made precisely by diminishing the role of the expert (the intellectual). (shrink)

On se propose de fédérer les questions relevant de la bioéthique, des générations futures et de l’éthique environnementale autour du thème de la communauté morale. On examinera certains problèmes théoriques posés par l’élargissement de celle-ci. On soutiendra qu’il n’est possible d’y faire face qu’en se ralliant à une forme d’anthropocentrisme. Toutefois, il s’agit d’un anthropocentrisme méta-axiologique, pas d’un anthropocentrisme normatif: il ne saurait être question de soutenir que les intérêts des être humains ont, toujours et partout, priorité sur (...) les intérêts des autres créatures. (shrink)

In rehabilitation, there is a growing interest in ethics. That said, few meta-ethical reflections have been conducted to date. Therefore, a review and critical analysis of the use of the concept of “ethical issue” is warranted. To this end, a systematic and critical review of the literature discussing ethical issues in rehabilitation was conducted. This review, based on the method developed by McCullough and colleagues, identified and analyzed 80 articles. Several characteristics and gaps in the conceptualization of the ethical issue (...) concept were noted. Three main findings emerge from the study: 1) the corpus of texts studied is dominated by descriptive ethics; 2) ethical conceptualisation is marginal, in that ethical concepts are generally stated without being defined; and 3) the corpus is characterized by the use of amalgams and by the multiplication of imprecise ethical concepts that are often used as synonyms while referring to distinct phenomena. These conceptual gaps create conceptual confusion and imprecision that can undermine ethics research, teaching and clinical ethics, and discredit the discipline of ethics. (shrink)

Spasticity and muscle weakness is common in children with cerebral palsy (CP). Spasticity can be treated with Botulinum Neurotoxin-A (BoNT-A), but this drug has also been reported to induce muscle weakness. Our purpose was to describe the effect on muscle strength in the lower extremities after BoNT-A injections in children with cerebral palsy. A secondary aim was to relate the effect of BoNT-A to gait pattern and range of motion. Twenty children with spastic cerebral palsy were included in the study, (...) eight girls and 12 boys (mean age 7.7 years). All were able to walk without support, but with increased muscle tone interfering with motor function and gait pattern. Sixteen children had unilateral spastic CP and four bilateral spastic CP. Twenty-four legs received injections with BoNT-A in the plantar flexor muscles. The children were tested before treatment, around six weeks after at the peak effect of BoNT-A, and at six months after treatment, with measurement of muscle strength, gait analysis and range of motion. There were no differences in muscle strength in plantar flexors of treated legs at peak effect compared to baseline. Six months after treatment, there was still no change in untreated plantar flexor muscles, but an increasing trend in plantar flexor strength in legs treated with BoNT-A. Parents reported positive effects in all children, graded as: small in three children, moderate in eight, and large in nine children. The gait analysis showed a small improvement in knee extension at initial contact, and there was a small increase in passive range of motion for ankle dorsiflexion. Two children had a period with transient weakness and pain. We found that voluntary force production in plantar flexor muscles did not decrease after BoNT-A, instead there was a trend to increased muscle strength at follow-up. The increase may be explained as an effect of the blocking of involuntary nerve impulses, leading to an opportunity to using and training the muscles with voluntary control. Adequate muscle strength is important for maintaining the ability to walk and knowledge of how a treatment affects muscle strength is useful when selecting interventions. (shrink)

(1996). International policy of Albania: 1912–21. The European Legacy: Vol. 1, Fourth International Conference of the International Society for the study of European Ideas, pp. 852-857.

We introduce a new and time-efficient memory-encoding paradigm for functional magnetic resonance imaging. This paradigm is optimized for mapping multiple contrasts using a mixed design, using auditory and visual stimuli. We demonstrate that the paradigm evokes robust neuronal activity in typical sensory and memory networks. We were able to detect auditory and visual sensory-specific encoding activities in auditory and visual cortices. Also, we detected stimulus-selective activation in environmental-, voice-, scene-, and face-selective brain regions. A subsequent recognition task allowed the detection (...) of sensory-specific encoding success activity in both auditory and visual cortices, as well as sensory-unspecific positive ESA in the hippocampus. Further, sensory-unspecific negative ESA was observed in the precuneus. Among others, the parallel mixed design enabled sustained and transient activity comparison in contrast to rest blocks. Sustained and transient activations showed great overlap in most sensory brain regions, whereas several regions, typically associated with the default-mode network, showed transient rather than sustained deactivation. We also show that the use of a parallel mixed model had relatively little influence on positive or negative ESA. Together, these results demonstrate a feasible, versatile, and brief memory-encoding task, which includes multiple sensory stimuli to guarantee a comprehensive measurement. This task is especially suitable for large-scale clinical or population studies, which aim to test task-evoked sensory-specific and sensory-unspecific memory-encoding performance as well as broad sensory activity across the life span within a very limited time frame. (shrink)

One of the common domains in health care in which the concept of vulnerability is used is end-of-life care, including euthanasia and assisted suicide (EAS). Since different uses and implications of the notion have been recognised in the literature on EAS, this paper aims to analyse them and reflect on who is the most vulnerable in the context of EAS. A prior exploratory review of the literature has served as a starting point for the discussion. We concluded that vulnerability is (...) a complex, multi-perspective and multi-layered concept, which implies the vulnerability of different stakeholders involved in EAS practices and vulnerability in different aspects of being human (i.e., physical, mental, moral, social and spiritual). A comprehensive understanding of the notion of vulnerability, which balances as well as complements the concept of autonomy, seems to be an indispensable element of the discourse on EAS. (shrink)

This Open Access book offers a synthetic reflection on the authors’ fieldwork experiences in seven countries within the framework of ‘Authoritarianism in a Global Age’, a major comparative research project. It responds to the demand for increased attention to methodological rigor and transparency in qualitative research, and seeks to advance and practically support field research in authoritarian contexts. Without reducing the conundrums of authoritarian field research to a simple how-to guide, the book systematically reflects and reports on the authors’ combined (...) experiences in getting access to the field, assessing risk, navigating ‘red lines’, building relations with local collaborators and respondents, handling the psychological pressures on field researchers, and balancing transparency and prudence in publishing research. It offers unique insights into this particularly challenging area of field research, makes explicit how the authors handled methodological challenges and ethical dilemmas, and offers recommendations where appropriate. This book is open access under a CC BY 4.0 license. (shrink)

El presente volumen incluye la edición crítica, acompañada de un completo estudio introductorio, del Arte de bien morir, texto en prosa sin autor declarado, y de La contienda del cuerpo y alma, una composición en verso firmada por Antón López de Meta. Ambas obras integraban un mismo libro destinado a preparar al hombre para enfrentar su tránsito final hacia la vida eterna y forman parte de la tradición del Memento mori.

In controlled human infection (CHI) studies, investigators deliberately infect healthy individuals with pathogens in order to study mechanisms of disease or obtain preliminary efficacy data on investigational vaccines and medicines. CHI studies offer a fast and cost‐effective way of generating new scientific insights, prioritizing investigational products for clinical testing, and reducing the risk that large numbers of people are exposed to ineffective or harmful substances in research or in practice. Yet depending on the pathogen, CHI studies can involve significant risks (...) or burdens for participants, pose risks to individuals or communities not involved in the research, and lead to public controversy. It is therefore essential to ensure that the risks of CHI studies are justified by their social value—that is, their potential to generate benefits for society—and that public trust can be maintained. In this paper, we aim to clarify how research sponsors, research ethics committees and other reviewers should judge the social value of CHI studies. We develop a list of relevant considerations for making social value judgments based on the standard view of social value. We then use this list to discuss the example of potentially conducting dengue virus CHI studies in endemic settings. We argue that dengue virus CHI studies in endemic settings would fall on the higher end of the spectrum of social value, mostly because of their potential to redirect all fields of future dengue research. Drawing on this discussion, we derive several general recommendations for how reviewers should judge the social value of CHI studies. (shrink)

Issues related to controlled human infection studies using Schistosoma mansoni (CHI-S) were explored to ensure the ethical and voluntary participation of potential CHI-S volunteers in an endemic setting in Uganda. We invited volunteers from a fishing community and a tertiary education community to guide the development of informed consent procedures. Consultative group discussions were held to modify educational materials on schistosomiasis, vaccines and the CHI-S model and similar discussions were held with a test group. With both groups, a mock consent (...) process was conducted. Fourteen in-depth key informant interviews and three group discussions were held to explore perceptions towards participating in a CHI-S. Most of the participants had not heard of the CHI-S. Willingness to take part depended on understanding the study procedures and the consenting process. Close social networks were key in deciding to take part. The worry of adverse effects was cited as a possible hindrance to taking part. Volunteer time compensation was unclear for a CHI-S. Potential volunteers in these communities are willing to take part in a CHI-S. Community engagement is needed to build trust and time must be taken to share study procedures and ensure understanding of key messages. (shrink)

“Meta-argument allegations” consist of protestations that an interlocutor’s speech is wrongfully offensive or will trigger undesirable social consequences. Such protestations are meta-argument in the sense that they do not interrogate the soundness of an opponent’s argumentation, but instead focus on external features of that argument. They are allegations because they imply moral wrongdoing. There is a legitimate place for meta-argument allegations, and the moral and epistemic goods that can come from them will be front of mind for those levelling such (...) allegations. But I argue there is a dark side to such allegations, and their epistemic and moral costs must be seriously weighed. Meta-argument allegations have a concerning capacity to derail discussions about important topics, stymieing argumentational interactions and the goods they provide. Such allegations can license efforts to silence, punish and deter—even as they provoke the original speaker to retaliate in kind. Used liberally, such allegations can escalate conflicts, block open-mindedness, and discourage constructive dialogues. In response, I defend “argumentational tolerance”—a principled wariness in employing meta-argument allegations—as a virtue of ethical argument. (shrink)

O Katulu vemo zelo malo zanesljivega in celo večino tega je treba razbrati iz njegovega lastnega literarnega dela. To je vedno tvegan pristop, ki mu kritika danes večinoma nasprotuje (četudi je kritika vedno spremenljiva in znaki teh sprememb so že v zraku). Toda po drugi strani vemo kar precej o zadnjem stoletju rimske republike, o času torej, v katerem je Katul preživel svoje kratko, a intenzivno življenje, in o številnih javnih osebnostih, tako iz sveta književnosti kot politike, ki jih je (...) štel med svoje prijatelje ali sovražnike. Tako kot Byron, ki je bil Katulu v nekaterih pogledih podoben, se je gibal v krogih visoke družbe, imel je radikalna stališča, ne da bi se aktivno politično udejstvoval, ter je pisal poezijo, ki daje vtis, da je nastala kot odziv na družbeno dogajanje, literarne tokove ali zasebne škandale takratne aristokracije. (shrink)

Accumulating evidence indicates that simulated natural settings can engage mechanisms that promote health. Simulations offer alternatives to actual natural settings for populations unable to travel outdoors safely; however, few studies have contrasted the effects of simulations of natural settings to their actual outdoor counterparts. We compared the impacts of simulated and actual natural settings on positive and negative affect (mood) levels using a pooled sample of participants enrolled in extant experimental studies. Relevant articles were identified from a review of research (...) published/in press by March 2020 and updated during the peer review of the current study. Of 16 articles identified, 6 met the inclusion criteria and administered a single cross-cutting, standardized instrument [the Positive and Negative Affect Schedule (PANAS)] before and after exposure. Random effects meta-analysis of pooled effects showed that positive affect increased in the actual settings but not in their simulated counterparts (Hedge's g = 0.87; 95% CI, 0.54, 1.20). We observed little difference in effects on negative affect change scores ( g = −0.28; 95% CI, −0.62, 0.06), with studies generally showing reductions in negative affect in both settings. Further research with additional populations, settings, antecedent conditions, and durations would provide a more robust understanding of differences in effects between these two ways to enhance mood by viewing nature. (shrink)

The use of head-mounted displays (HMD) for virtual reality (VR) application-based purposes including therapy, rehabilitation, and training is increasing. Despite advancements in VR technologies, many users still experience sickness symptoms. VR sickness may be influenced by technological differences within HMDs such as resolution and refresh rate, however, VR content also plays a significant role. The primary objective of this systematic review and meta-analysis was to examine the literature on HMDs that report Simulator Sickness Questionnaire (SSQ) scores to determine the impact (...) of content. User factors associated with VR sickness were also examined. A systematic search was conducted according to PRISMA guidelines. Fifty-five articles met inclusion criteria, representing 3,016 participants (mean age range 19.5-80; 41% female). Findings show gaming content recorded the highest total SSQ mean 34.26 (95%CI 29.57-38.95). VR sickness profiles were also influenced by visual stimulation, locomotion and exposure times. Older samples (mean age ≥35 years) scored significantly lower total SSQ means than younger samples, however, these findings are based on a small evidence base as a limited number of studies included older users. No sex differences were found. Across all types of content, the pooled total SSQ mean was relatively high 28.00 (95%CI 24.66-31.35) compared with recommended SSQ cut-off scores. These findings are of relevance for informing future research and the application of VR in different contexts. (shrink)

My topic is the old debate between moral realists and moral expressivists. Although I will eventually adopt a Pyrrhonian position, as usual, my main goal is neither to argue for this position nor to resolve this debate but only to explore some new options that mix together realism and expressivism in various ways. Nothing that I say will be conclusive, but I hope that some of it will be suggestive.

This study systematically analyzes the factors that affect consumers’ green purchase intention. Through a comprehensive literature review, the influencing factors of consumers’ green purchase intention are organized into three categories: cognitive factors, consumer individual characteristics, and social factors. Next, a meta-analysis of 54 empirical papers was conducted using Comprehensive Meta-Analysis 3.0 software to quantitatively assess these relationships. The results revealed that green perceived value, attitude, and green trust have a significant positive influence on green purchase intention. Perceived behavior control, perceived (...) consumer effectiveness, and subjective norm also has a strong positive impact on green purchase intention. Collectivism has a positive effect on green purchase intention. Green perceived risk has a significant negative impact on green purchase intention. The study’s findings provide references for enterprises engaged in green product diffusion and organizations responsible for environmental protection. (shrink)

Objectives: The present study aimed to systematically analyze the effects of physical activity on executive function, working memory, cognitive flexibility, and activities of daily living in Alzheimer's disease patients and to provide a scientific evidence-based exercise prescription.Methods: Both Chinese and English databases were used as sources of data to search for randomized controlled trials published between January 1980 and December 2019 relating to the effects of physical activity on executive function, working memory, cognitive flexibility, and ADL issues in AD patients. (...) Sixteen eligible RCTs were ultimately included in the meta-analysis.Results: Physical activity had significant benefits on executive function [standard mean difference = 0.42, 95% confidence interval 0.22–0.62, p < 0.05], working memory, cognitive flexibility, and ADLs among AD patients. Subgroup analysis indicated that, for executive function issues, more than 60 min per session for 16 weeks of moderate-to-high-intensity dual-task exercises or multimodal exercise had a greater effect on AD patients. For working memory and cognitive flexibility issues, 60–90 min of moderate-intensity dual-task exercises 1–4 times/week was more effective. For ADL issues, 30–90 min of multimodal exercise at 60–79% of maximal heart rate 3–4 times/week had a greater effect on AD patients.Conclusions: Physical activity was found to lead to significant improvements in executive function, working memory, cognitive flexibility, and ADLs in AD patients and can be used as an effective method for clinical exercise intervention in these patients. However, more objective, scientific, and effective RCTs are needed to confirm this conclusion. (shrink)

In school education, teaching-learning interaction is deemed as a core process in the classroom. The fundamental neural basis underlying teaching-learning interaction is proposed to be essential for tuning learning outcomes. However, the neural basis of this process as well as the relationship between the neural dynamics and the learning outcomes are largely unclear. With non-invasive technologies such as fNIRS, hyperscanning techniques have been developed since the last decade and been applied to the field of educational neuroscience for simultaneous multi-brain scanning. (...) Hyperscanning studies suggest that the interpersonal neural synchronization during teaching-learning interaction might be an ideal neural biomarker for predicting learning outcomes. To systematically evaluate such a relationship, this meta-analysis ran on a random-effects model on 16 studies with 23 independent samples. Further moderator analyses were also performed to examine the potential influences of the style, mode, content, and the assessment method of learning outcomes. The random-effects modeling results confirmed a robust positive correlation between INS and learning outcomes. Subsequent analyses revealed that such relationship was mainly affected by both interaction style and mode. Therefore, the present meta-analysis provided a confirmatory neurocognitive foundation for teaching-learning interaction, as well as its relation to the learning outcomes, consolidated future learning and teaching studies in various disciplines including second language education with a firm methodological reference. (shrink)

ObjectivesThe purpose of this study was to identify risk factors for delirium after total joint arthroplasty and provide theoretical guidance for reducing the incidence of delirium after TJA.MethodsThe protocol for this meta-analysis is registered with PROSPERO. We searched PubMed, the Cochrane Library and Embase for observational studies on risk factors for delirium after TJA. Review Manager 5.3 was used to calculate the relative risk or standard mean difference of potential risk factors related to TJA. STATA 14.0 was used for quantitative (...) publication bias evaluation.ResultsIn total, 25 studies including 3,767,761 patients from 9 countries were included. Old age has been widely recognized as a risk factor for delirium. Our results showed that the main risk factors for delirium after TJA were patient factors, comorbidities, surgical factors and drug factors.ConclusionsMultiple risk factors were associated with delirium after TJA. These results may help doctors predict the occurrence of delirium after surgery and determine the correct treatment.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier: CRD42020170031. (shrink)

Background: The pregnancy and psychological status of infertile couples has always been a concern, but there is no clear evidence for the efficacy of psychotherapy for infertile couples. This study aimed to summarize the current evidence of the effects of psychotherapy on psychological and pregnancy outcomes for infertile couples. Method: We searched Ovid MEDLINE, Ovid EMbase, The Cochrane Library, and Web of Science for articles published from 1946 to June 26, 2020. The pregnancy outcomes, psychological outcomes, and acceptability were involved (...) in the study. Results: Overall, 29 studies with a combined total of 3,522 adult participants were included in the meta-analysis. Compared with a placebo, psychotherapy was associated with the pregnancy rate [risk ratio = 1.43, 95% CI [1.07, 1.93]], total psychological scales associated with infertility [standardized mean difference = −0.33 95% CI [−0.63, −0.02]], subsymptoms of psychological scores using the 28-item version of GHQ, and the integrative body–mind–spirit ; total psychological scales associated with infertility using other treatments and more than a month; and anxiety using BMS had significant statistical significance. The funnel plots of all outcomes were approximately symmetrical, and no significant publication bias was found. Conclusions: The study showed that psychotherapy can lead to improvements in the pregnancy rate for infertile patients, especially for patients receiving assisted fertility. In addition, it may help improve total psychological scales associated with infertility and depression. CBT and BMS play an important role in improving rate of pregnancy, and BMS is associated with reducing anxiety. Although psychological interventions had limited effects on the pregnancy outcomes of infertility, our study still recommended that psychotherapies, in particular CBT and BMS, were applied to the therapeutic regimen for infertility, especially for patients receiving assisted fertility. (shrink)

BackgroundPrevious studies on voxel-based morphometry have found that there were gray matter alterations in patients with hepatic encephalopathy. However, the reported results were inconsistent and lack a quantitative review. Therefore, this study aims for a quantitative meta-analysis of VBM analysis on patients with HE.MethodsThe studies in our meta-analysis were collected from Pubmed, Web of Science, and Embase, which were published from January 1947 to October 2021. The seed-based d mapping method was applied to quantitatively estimate the regional gray matter abnormalities (...) in patients with HE. A meta-regression analysis was applied to evaluate the relationship between plasma ammonia and gray matter alteration.ResultsThere were nine studies, with sixteen datasets consisting of 333 participants with HE and 429 healthy controls. The pooled and subgroup meta-analyses showed an increase in gray matter volume in the bilateral thalamus and the calcarine fissure but a decrease in the GMV in the bilateral insula, the basal ganglia, the anterior cingulate gyrus, and the cerebellum. The meta-regression showed that plasma ammonia was positively associated with the GMV in the left thalamus but was negatively associated with the GMV in the cerebellum and the bilateral striatum.ConclusionGray matter volume in patients with HE largely varied and could be affected by plasma ammonia. The findings of this study could help us to better understand the pathophysiology of cognitive dysfunction in patients with HE. (shrink)

In recent years a debate has developed over the ties between Friedrich Nietzsche’s ideas and transhumanism. This article clarifies some issues at the meta-level of the discussion. Firstly, the author provides a scientometric analysis of research trends to show the relevance of the topic. Secondly, he distinguishes between two analytical perspectives, which he calls ‘noumenal’ and ‘phenomenal.’ Thirdly, by taking the phenomenal perspective, the author shows that transhumanism can be classified into four different categories, namely: quasi-Nietzschean, Nietzschean, a-Nietzschean, and anti-Nietzschean. (...) Finally, he provides historical examples of each single type of transhumanism. This way, the article also contributes to the history of transhumanist thought. (shrink)

Chalmers (2018) maintains that even if we understood every physical process in the brain we could still wonder why these processes give rise to conscious experience. The meta-problem is the challenge of explaining why we think this 'hard problem' exists. This response to the target paper endorses illusionist accounts of three 'problem intuitions' about consciousness: duality, presentation, and revelation. Subject–object duality is explained in terms of a clash between two compelling but contradictory convictions about consciousness. Phenomenal presence is understood in (...) relation to the configurational features of sensory experiences. And intuitions of revelation are explained as due to an unfounded belief in introspective ontological access. These illusionist analyses are used to bolster the case for physicalist realism rather than to support 'strong' illusionism. In addition to addressing the meta-problem they suggest a promising approach to the hard problem as wel. (shrink)

The article examines the new discourse on medical professionalism and responsibility through the prism of conflicts among moral values, especially with regard to truth-telling. The discussion is anchored in the renaissance of English-language writing on medical ethics in the 18th century, which paralleled the rise of humanitarianism and the advent of the word “responsibility”. Following an analysis of the meanings of the value of responsibility in general and in medical practice in particular, it is argued that, similarly to the Aristotelian (...) notion of equity, responsibility of care is a second-order value, which corrects virtues, laws and norms in exceptional circumstances. Virtues and practices of the second order, such as responsibility and deliberation, bear especially on professional doctoring, which includes a commitment to give priority to the good of the patient over one’s own good. It is argued that, in situations of conflict, and particularly conflicts between personal moral identity and the good of patients, the fundamental professional commitment is to critical and rational deliberation and to the cultivation of psycho-moral flexibility. This leads indirectly to moral growth and strengthening of professional character. (shrink)

“Pós-humano” se tornou um termo guarda-chuva para se referir à variedade de escolas de pensamento e diferentes movimentos, incluindo o pós-humanismo filosófico, cultural e crítico; transumanismo ; a abordagem feminista dos novos materialismos; o panorama heterogêneo do anti-humanismo, meta-humanismo, meta-humanidades e pós-humanidades. Tal uso genérico e abrangente do termo criou confusões metodológicas e teóricas entre especialistas e não especialistas. Este ensaio irá explorar as diferenças entre esses movimentos, focando particularmente nas áreas de significação compartilhadas pelo pós-humanismo e transumanismo. Ao apresentar (...) essas duas filosofias independentes, ainda que relacionadas, o pós-humanismo pode-se provar um ponto de vista mais compreensível para refletir sobre futuros possíveis. (shrink)

BackgroundSocial cognitive impairments adversely affect social functioning in patients with schizophrenia. Although pharmacological interventions have been suggested to provide some benefits on social cognition, little information is available on the comparative efficacy of pharmacotherapy. Thus, the aim of this planned systematic review and network meta-analysis is to perform a quantitative comparison of the effects of various psychotropic drugs, including supplements, on social cognition disturbances of schizophrenia.MethodsThe literature search will be carried out using the PubMed, Embase, Cochrane Central Register of Controlled (...) Trials, PsycINFO, ClinicalTrials.gov, and International Clinical Trials Registry Platform databases from inception onward. Randomized controlled trials that examined the efficacy of drugs in social cognitive disturbances will be included, based on the most recent studies and the broader literature than previously searched. This protocol defines a priori the methods that will be used for study selection, data collection, quality assessment, and statistical syntheses.DiscussionThe findings this work are expected to help promote the development of better therapeutics of social cognitive impairments in schizophrenia and related psychiatric conditions.Systematic Review Registration[www.crd.york.ac.uk/prospero], identifier [CRD42021293224]. (shrink)

Cet article analyse les rapports entre politique et bioéthique. La politique s’appuie sur la bioéthique pour justifier des obligations et des interdictions ; et la bioéthique s’appuie sur la politique pour légitimer l’importance de son discours. Toutefois, la politique, inventée pour régler le vivre ensemble, et la bioéthique, inventée pour préserver la dignité humaine, ont récemment pris le dessus sur l’individualité de l’homme.

This commentary examines the synergy between meta-learned models of cognition and integrative learning in enhancing animal and human learning outcomes. It highlights three integrative learning modes – holistic integration of parts, top-down reasoning, and generalization with in-depth analysis – and their alignment with meta-learned models of cognition. This convergence promises significant advances in educational practices, artificial intelligence, and cognitive neuroscience, offering a novel perspective on learning and cognition.

Background: Pembrolizumab, an inhibitory anti-PD-1 antibody, has led to significantly meaningful improvements in advanced melanoma. This meta-analysis discusses and presents the efficacy and safety of pembrolizumab versus control treatments in randomized controlled trials. Methods: Electronic databases were searched systematically for RCTs using pembrolizumab in advanced melanomas. Pooled estimates were calculated under random-effect models for overall response rates, PFS, OS, and TRAEs. Results: Nine RCTs including 5132 patients were analyzed. Pembrolizumab significantly realized better results in ORR, PFS and OS HR 0.62, (...) 95% CI 0.54, 0.71, P < 0.001 and HR 0.70, 95% CI 0.63, 0.78, P < 0.001 for control. PFS and OS were consistently better in first, second, and further lines and in groups stratified for PD-L1 status. Grade 3–5 TRAEs were lower with pembrolizumab than with chemotherapy 13.3% vs. 25.9% and ipilimumab 16.9% vs. 27.3%. Conclusions: Pembrolizumab monotherapy meaningfully improves ORRs, delays progression, and prolongs survival in advanced melanoma compared to current standard regimens, with the latter given its favorable toxicity profile. As such, pembrolizumab should be considered the new standard of care for treatment-naïve and previously treated subjects. (shrink)

Thirty years ago the American philosopher Holmes Rolston published a seminal article in Ethics announcing the birth of a new sub‐discipline in philosophy: environmental ethics. However, while environmental ethicists focused on meta‐ethical questions, the public needed answers to many political questions and dilemmas. This gave rise to some fascinating works in environmental political theory. This essay analyses their achievement – what has been solved and what still remains to be studied – focusing on three main topics: justice and the environment, (...) democracy and the environment, and globalism and the environment. (shrink)