BackgroundIn the Canadian Alliance for Healthy Hearts and Minds (CAHHM) cohort, participants underwent magnetic resonance imaging (MRI) of the brain, heart, and abdomen, that generated incidental findings (IFs). The approach to managing these unexpected results remain a complex issue. Our objectives were to describe the CAHHM policy for the management of IFs, to understand the impact of disclosing IFs to healthy research participants, and to reflect on the ethical obligations of researchers in future MRI studies.MethodsBetween 2013 and 2019, 8252 participants (...) (mean age 58 ± 9 years, 54% women) were recruited with a follow-up questionnaire administered to 909 participants (40% response rate) at 1-year. The CAHHM policy followed a restricted approach, whereby routine feedback on IFs was not provided. Only IFs of severe structural abnormalities were reported.ResultsSevere structural abnormalities occurred in 8.3% (95% confidence interval 7.7–8.9%) of participants, with the highest proportions found in the brain (4.2%) and abdomen (3.1%). The majority of participants (97%) informed of an IF reported no change in quality of life, with 3% of participants reporting that the knowledge of an IF negatively impacted their quality of life. Furthermore, 50% reported increased stress in learning about an IF, and in 95%, the discovery of an IF did not adversely impact his/her life insurance policy. Most participants (90%) would enrol in the study again and perceived the MRI scan to be beneficial, regardless of whether they were informed of IFs. While the implications of a restricted approach to IF management was perceived to be mostly positive, a degree of diagnostic misconception was present amongst participants, indicating the importance of a more thorough consent process to support participant autonomy.ConclusionThe management of IFs from research MRI scans remain a challenging issue, as participants may experience stress and a reduced quality of life when IFs are disclosed. The restricted approach to IF management in CAHHM demonstrated a fair fulfillment of the overarching ethical principles of respect for autonomy, concern for wellbeing, and justice. The approach outlined in the CAHHM policy may serve as a framework for future research studies.Clinical trial registrationhttps://clinicaltrials.gov/ct2/show/nct02220582. (shrink)

Given any collection F of computable functions over the reals, we show that there exists an algorithm that, given any sentence A containing only bounded quantifiers and functions in F, and any positive rational number delta, decides either “A is true”, or “a delta-strengthening of A is false”. Moreover, if F can be computed in complexity class C, then under mild assumptions, this “delta-decision problem” for bounded Sigma k-sentences resides in Sigma k. The results stand in sharp contrast to the (...) well-known undecidability of the general first-order theories with these functions, and serve as a theoretical basis for the use of numerical methods in decision procedures for formulas over the reals. (shrink)

Book reviewed in this article:F.H. Bradley, Collected Works Volumes 1–5.

The Battle of Drepana in 249 b.c. marks the most significant defeat of Roman naval forces at the hands of their Carthaginian opponents during the First Punic War. Attempting to take the Punic fleet in the harbour of Drepana by surprise, the consul P. Claudius Pulcher sailed with his ships from Lilybaeum about midnight, and reached Drepana at dawn. Yet, owing to swift and level-headed counter-measures taken by the Punic commander, Adherbal, the unfolding fight – partly in the harbour, mostly (...) off the shore – turned into a fiasco for the Romans. The consul got away; he returned to Rome, where the Senate instructed him to appoint a dictator. How soon he returned, and by what route, is the question. (shrink)

Kaplan claims that (1) ‘I am here now’, though analytic, is not a necessary truth. But this sentence is not a proposition, in a sense of proposition in which some, but not all, sentences are propositions. Since it is not a proposition, it is not true, and consequently not analytic. It is in fact a fragment of a proposition, the same fragment as ‘he was there then’ in (2) ‘CJFW said in Oxford on 23 September 1991 that he was there (...) then’. Sentences containing indexicals in general owe their sense to the corresponding fragments of sentences containing ‘quasi‐indexicals’(‘then’, for example, is the quasi‐indexical to ‘now’ as indexical). Someone uttering (1) assertively will thereby make a proposition like (2) true. (2) entails (3) ‘CJFW said in Oxford on 23 September 1993 that CJFW was in Oxford on 23 September 1991′. So by uttering (1) in the appropriate circumstances I made it true that I had asserted the proposition (4) ‘CJFW was in Oxford on 23 September 1991′. What is analytic and necessarily true is the proposition ‘If (3) then (4)’. (shrink)

Our study focuses on the correlation of concept map (CMap) structures and learning success tested with short answer tests, taking into particular account the complexity of the subject matter. Novice sixth grade students created CMaps about two subject matters of varying difficulty. The correlation of the complexity of CMaps with the post-test was small but highly significant in both subject matters. The complexity of the CMaps correlated with the long-term knowledge in the difficult subject matter but not in the context (...) of the easy one. Furthermore, the high number of technical errors makes it close to impossible to estimate students? knowledge. In summary, CMaps do not provide an adequate alternative to conventional short answer knowledge tests, but together with them they may offer a better comprehension of a student?s knowledge structure and aid in the preparation of further instruction tailored to individual needs. (shrink)