The development of gene expression profiling and next-generation sequencing technologies have steered oncogenomics to the forefront of precision medicine. This created a need for harmonious cooperation between clinicians and researchers to increase access to precision oncology, despite multiple implementation challenges being encountered. The aim is to apply personalised treatment strategies early in cancer management, targeting tumour subtypes and actionable gene variants within the individual’s broader clinical risk profile and wellbeing. A knowledge-generating database linked to the South African Medical Research Council’s (...) Genomic Centre has been created for the application of personalised medicine, using an integrated service and research approach. Insights gained from patient experiences related to tumour heterogeneity, access to targeted therapies and incidental findings of pathogenic germline variants in tumour DNA, provided practice-changing evidence for the implementation of a cost-minimisation pathology-supported genetic testing strategy. Integrating clinical care with genomic research through data sharing advances personalised medicine and maximises precision oncology benefits. (shrink)

Background: Spirometry for early detection of chronic obstructive pulmonary disease and smoking cessation is criticised because of the potential negative effects of labelling with disease. Aim: To assess the effects of opinions of smokers with mild to moderate COPD on the effectiveness of spirometry for smoking cessation, the justification of early detection of airflow limitation in smokers and the impact of confrontation with COPD. Design: Qualitative study with data from a randomised controlled trial. Setting: General population of Dutch and Belgian (...) Limburg. Methods: Semistructured ethical exit interviews were conducted with 205 smokers who were motivated to quit smoking and had no prior diagnosis of COPD but were detected with airflows limitation by means of spirometry. They received either counselling, including labelling with COPD, plus with nortriptyline for smoking cessation, counselling excluding labelling with COPD, plus nortriptyline for smoking cessation or care as usual for smoking cessation by the general practitioner, without labelling with COPD. Results: Of the participants, 177 agreed or completely agreed that it is justified to measure lung function in heavy smokers. These participants argued that measuring lung function raises consciousness of the negative effects of smoking, helps to prevent disease or increases motivation to stop smoking. Most of the 18 participants who disagreed argued that routinely measuring lung function in smokers would interfere with freedom of choice. Conclusions: Labelling with disease is probably a less important issue in the discussion about the pros and cons of early detection of COPD. (shrink)

Both unipolar and bipolar depression have been linked with impairments in executive functioning. In particular, mood symptom severity is associated with differences in common EF, a latent measure of general EF abilities. The relationship between mood disorders and EF is particularly salient in adolescence and young adulthood when the ongoing development of EF intersects with a higher risk of mood disorder onset. However, it remains unclear if common EF impairments have associations with specific symptom dimensions of mood pathology such as (...) blunted positive affect, mood instability, or physiological arousal, or if differences in common EF more broadly relate to what is shared across various symptom domains, such as general negative affect or distress. To address this question, bifactor models can be applied to simultaneously examine the shared and unique contributions of particular mood symptom dimensions. However, no studies to our knowledge have examined bifactor models of mood symptoms in relation to measures of common EF. This study examined associations between common EF and general vs. specific symptom dimensions using structural equation modeling in adolescents and young adults with varying severity of mood symptoms. A General Depression factor capturing shared variance across symptoms statistically predicted lower Common EF. Additionally, a factor specific to physiological arousal was associated with lower Common EF. Anhedonia-specific and Mania-specific factors were not significantly related to Common EF. Altogether, these results indicate that deficits in common EF are driven by, or reflect, general features of mood pathology that are shared across symptom dimensions but are also specifically associated with physiological arousal. (shrink)

This article provides ethical guidance on using race in health research as a variable or in defining the study population. To this end, a plain, non-exhaustive checklist is provided for researchers and research ethics committees, preceded by a brief introduction on the need for justification when using race as a variable or in defining a study population, the problem of exoticism, that distinctions pertain between race, ethnicity and ancestry, the problematic naming of races, and that race does not serve well (...) as a presumed biological construct in genetic research. (shrink)

Various claims have been made, recently, that Darwin's argumentation in the Origin instantiates and so supports some general philosophical proposal about scientific theorizing, for example, the "semantic view". But these claims are grounded in various incorrect analyses of that argumentation. A summary is given here of an analysis defended at greater length in several papers by the present author. The historical and philosophical advantages of this analysis are explained briefly. Darwin's argument comprises three distinct evidential cases on behalf of natural (...) selection, cases, that is, for its existence, its adequacy and its responsibility. Theorizing, today, about evolution by natural selection involves a similar structure of evidential and explanatory concerns. (shrink)

David Lewis's modal realism claims that nothing can exist in more than one world or time, and that statements about how something would have been are to be analysed in terms of its counterpart. I first explain why the counterpart relation depends on de re modal statements in an intensional language, so that intuitive properties of similarity relations cannot be used to show that the counterpart relation is not an equivalence relation. I then look at test sentences in (the intensional) (...) natural language, and show that none of them provide compelling evidence that a counterpart semantics is needed. (shrink)

In an individualistic society and in the increasingly competitive business environment people do not seem inclined to forgive others their trespasses. One is more likely to choose to ignore the virtue of forgiveness as a way of handling personnel situations involving intense conflict or mild disagreements, favoring instead the negative feelings of resentment, anger, revenge or retaliation. Business people seem less concerned with growth in virtue and character; interestingly they allow their character and ultimately their work relationships to deteriorate because (...) they hold onto feelings of anger and resentment. Is there a place for forgiveness in our interpersonal relationships in general and in corporate life in particular? I believe there is. A study of the virtue of forgiveness shows that it is a misunderstood virtue, but one that deserves attention. In this article I will examine the virtue of forgiveness, defining what forgiveness is and is not, and will illustrate how it might be situated as an essential human resource management strategy. (shrink)

Médecins Sans Frontières is not morally required to continue providing the same therapeutic and preventative interventions for lead poisoning in Nigeria in the face of conditions that negatively impact on the achievement of their objectives. Nevertheless, Médecins Sans Frontières may have reasons to revise their objectives and adopt different interventions or methods.

The issue of energy and its potential localizability in general relativity has challenged physicists for more than a century. Many non-invariant measures were proposed over the years but an invariant measure was never found. We discovered the invariant localized energy measure by expanding the domain of investigation from space to spacetime. We note from relativity that the finiteness of the velocity of propagation of interactions necessarily induces indefiniteness in measurements. This is because the elements of actual physical systems being measured (...) as well as their detectors are characterized by entire four-velocity fields, which necessarily leads to information from a measured system being processed by the detector in a spread of time. General relativity adds additional indefiniteness because of the variation in proper time between elements. The uncertainty is encapsulated in a generalized uncertainty principle, in parallel with that of Heisenberg, which incorporates the localized contribution of gravity to energy. This naturally leads to a generalized uncertainty principle for momentum as well. These generalized forms and the gravitational contribution to localized energy would be expected to be of particular importance in the regimes of ultra-strong gravitational fields. We contrast our invariant spacetime energy measure with the standard 3-space energy measure which is familiar from special relativity, appreciating why general relativity demands a measure in spacetime as opposed to 3-space. We illustrate the misconceptions by certain authors of our approach. (shrink)

Due to the growth of neo-liberalism with its emphasis on “market-driven courses,” the humanities, of which philosophy is a part, find themselves disparaged and under-funded. As a result, some African philosophers have yielded to the temptation to deploy the empirical methodology of the natural and social sciences in a bid to illustrate the practical value of their discipline, thereby eroding philosophy’s distinctive characteristic, namely, reflection. Consequently, drawing from the contemporary discourse on methodology in African philosophy, this article argues that in (...) order to preserve the distinctive character of their discipline, philosophers who inquire into indigenous African thought ought to treat the collection of empirical data on the subject as a preliminary step to the core task of philosophical reflection that deploys such techniques as criticism, linguistic analysis, and systematic speculation. Only then will African philosophy make its proper contribution to the interdisciplinary field of African studies. (shrink)

Multinational companies (MNCs) can have positive and negative impacts on the human rights situation of a country. More and more MNCs have made a commitment to respect human rights. So far, little research has been done on how MNCs can embed their commitment and which factors determine its success. This paper therefore aims to describe and learn from the process of embedding human rights in six subsidiaries of the multinational oil company Royal Dutch Shell (in short, Shell), operating in different (...) parts of the world. It develops an approach based on the model of Tatiana Kostova. Using a specific tool called the Human Rights Compliance Assessment, the paper concludes that, despite differences in local context, the process requirements of embedding global standardscan be the same. (shrink)

In On the Origin of Species, Charles Darwin put forward his theory of natural selection. Conventionally, Darwin's argument for this theory has been understood as based on an analogy with artificial selection. But there has been no consensus on how, exactly, this analogical argument is supposed to work – and some suspicion too that analogical arguments on the whole are embarrassingly weak. Drawing on new insights into the history of analogical argumentation from the ancient Greeks onward, as well as on (...) in-depth studies of Darwin's public and private writings, this book offers an original perspective on Darwin's argument, restoring to view the intellectual traditions which Darwin took for granted in arguing as he did. From this perspective come new appreciations not only of Darwin's argument but of the metaphors based on it, the range of wider traditions the argument touched upon, and its legacies for science after the Origin. (shrink)