In many research studies, tumor biopsies are an unavoidable requirement for achieving key scientific aims. Yet some commentators view mandatory research biopsies as coercive and suggest they should be optional, or at least optional until further data are obtained regarding their scientific usefulness. Further complicating the ethical picture is the fact that some research biopsies offer a potential for clinical benefit to trial participants. We interviewed and surveyed a convenience sample of participants in phase I clinical trials at a single (...) institution. Our primary aim was to describe phase I participants’ understanding of whether a research biopsy offered them the prospect of medical benefit. We also endeavored to describe participants’ views about biopsies—specifically, the benefits of biopsies, if any, and whether biopsies were acceptable, risky, or discouraged trial participation. Finally, we collected data on demographics and attitudes to see if any strong correlations with misunderstanding, acceptability, or riskiness existed. Overall, the respondents tended to view research biopsies as acceptable, though they did not succeed in identifying the lack of benefit of a research biopsy. These findings call for renewed efforts in consent conversations and documents to carefully describe the benefits, or lack thereof, of research biopsies. (shrink)

(1982). Sex‐ and Age‐Related Differences in the Musical Behaviour, Interests and Attitudes Towards Music of 232 Secondary School Students. Educational Studies: Vol. 8, No. 2, pp. 131-139.

Background In Switzerland, right-to-die organisations assist their members with suicide by lethal drugs, usually barbiturates. One organisation, Dignitas, has experimented with oxygen deprivation as an alternative to sodium pentobarbital. Objective To analyse the process of assisted suicide by oxygen deprivation with helium and a common face mask and reservoir bag. Method This study examined four cases of assisted suicide by oxygen deprivation using helium delivered via a face mask. Videos of the deaths were provided by the Zurich police. Dignitas provided (...) protocol and consent information. Results One man and three women were assisted to death by oxygen deprivation. There was wide variation in the time to unconsciousness and the time to death, probably due to the poor mask fit. Swiss law prevented attendants from effectively managing the face mask apparatus. Purposeless movements of the extremities were disconcerting for Dignitas attendants, who are accustomed to assisting suicide with barbiturates. None of the dying individuals attempted self-rescue. Conclusions The dying process of oxygen deprivation with helium is potentially quick and appears painless. It also bypasses the prescribing role of physicians, effectively demedicalising assisted suicide. Oxygen deprivation with a face mask is not acceptable because leaks are difficult to control and it may not eliminate rebreathing. These factors will extend time to unconsciousness and time to death. A hood method could reduce the problem of mask fit. With a hood, a flow rate of helium sufficient to provide continuous washout of expired gases would remedy problems observed with the mask. (shrink)

The third volume in a projected library of contemporary Soviet thought called 'Sovietica' is of particular interest because it makes available to non-Russian readers a condensed German translation of the most recent Summa of Soviet thought, Osnovy marksistskoj filosofii. The text, organised under two main headings, Dialectical and Historical Materialism, is a catechism of Soviet dogmata which ranges from questions of space, time and perception to those of scientific socialism, class war and social consciousness. One of the aims of the (...) editor, as stated in the preface, is to demonstrate that the current Soviet version of 'Marxism' fails to express young Marx's overriding concern for the human being, and the phenomenon of estrangement.--K. R. D. (shrink)

Initial responses to questionnaires used to assess participants' understanding of informed consent for malaria vaccine trials conducted in the United States and Mali were tallied. Total scores were analyzed by age, sex, literacy (if known), and location. Ninety-two percent (92%) of answers by United States participants and 85% of answers by Malian participants were correct. Questions more likely to be answered incorrectly in Mali related to risk, and to the type of vaccine. For adult participants, independent predictors of higher scores (...) were younger age and female sex in the United States, and male sex in Mali. Scores in the United States were higher than in Mali (P = 0.005). Despite this difference participants at both sites were well informed overall. Although interpretation must be qualified because questionnaires were not intended as research tools and were not standardized among sites, these results do not support concerns about systematic low understanding among research participants in developing versus developed countries. (shrink)

In this book, a Woodbridge Lecture, Professor Dennes assesses the formulations of naturalism given by such philosophers as John Dewey and J. E. Woodbridge, and finds them open to certain fundamental circularities of argument. The critique centers its attention on the questions of meaning and morals, and in each area seeks to lay bare the 'restriction metaphysics' to which naturalistic explanation is inevitably tied down.--K. R. D.

A new journal issued in connection with the Hegel-Kommission der Deutschen Forschungsgemeinschaft, which is preparing a new critical-historical collection of Hegel's works. The first volume contains critical editions of certain Hegel fragments, essays on Hegel, and reviews of Hegel literature.--K. R. D.

The author divides present ideological tendencies into three groups: Christian, Communist, and agnostic. Subsequent chapters attempt to outline a "small-1 liberal" theology designed to provide a "reason for living" through "the present chaos."--K. R. D.

A selection of articles originally written in English for the New York Tribune and here edited with an eye to proving the tantalizing thesis "that for Karl Marx antagonism between capital and labor took second place to the eternal duel between East and West, in which his sympathies... lay unequivocally with the West." Although these articles, dealing mainly with the Crimean War, merit greater attention than they have thus far received, this edition is misleading in two critical aspects: 1) Many (...) of the articles signed by Marx in the New York Tribune, especially those dealing with military affairs, were actually written by Engels. The crucial document for distinguishing them, a notebook kept by Marx's wife, is acknowledged to be in Moscow, but the editor makes no mention of this. 2) The editor also gives no hint of Marx's many other statements on Russia, especially in his preface to the second edition of Capital and in his correspondence with Vera Zasulich.--K. R. D. (shrink)

A significant advance toward a more objective understanding of western philosophy in Soviet philosophical circles. Unlike the off-hand condemnations of western philosophers which so often fill the pages of Voprosy Filosofii, this Georgian philosopher presents a well documented historical development of twentieth century analytic philosophy from Russell's atomism, through Wittgenstein's Tractatus, logical positivism, and recent trends in English analysis. The "moral" of the story is that western thinkers are gradually coming to see the poverty of their philosophical perspective; linguistic analysis (...) must give way to the "precise vision of historical materialism."--K. R. D. (shrink)

A useful edition of some political and strategic writings, together with all the significant philosophical essays of Mao Tse-tung, who is described as the "most influential" contemporary Marxist philosopher. Except for the 1957 "Hundred Flowers" speech, all the translations and footnotes are from International Publishers' four volume Selected Works. Miss Fremantle's forty-one page introduction is largely a paraphrased abridgment of Edgar Snow's well known biography, Red Star over China. For the general reader, this Mentor paperback probably provides the best low (...) priced introduction to the thought of Mao Tse-tung.--K. R. D. (shrink)

The fourth volume of the 'Sovietica' series is chiefly composed of a collection in German translation of four papers read at a Moscow conference in 1958. The theme of the conference was 'The Question of Dialectical Contradiction in the Light of Contemporary Science and Practice.' Included are a brief excerpt from the official Soviet textbook, Osnovy marksistkoj filosofii and a noteworthy paper by A. I. Kolman.--K. R. D.

At the age of eighty-six, Professor Hocking has contributed a treatise on our times which shares the rarely combined merits of youthful adventure and mature insight. The central theme of "strength" is pitted at once against the theories of ideological intransigeance and appeasement. The main body of this work is devoted to an investigation of the present contrasts, the common values, and the possible paths toward a creative reconciliation of the guiding educational, economic, legal, moral, political, and esthetic ideas of (...) US and Soviet society.--K. R. D. (shrink)

Advances in life-saving technologies in the past few decades have challenged our traditional understandings of death. Traditionally, death was understood to occur when a person stops breathing, their heart stops beating and they are cold to the touch. Today, physicians determine death by relying on a diagnosis of ‘total brain failure’ or by waiting a short while after circulation stops. Evidence has emerged, however, that the conceptual bases for these approaches to determining death are fundamentally flawed and depart substantially from (...) the established biological conception of death. We argue that the current approach to determining death consists of two different types of unacknowledged legal fictions. These legal fictions were developed for practices that are largely ethically legitimate but need to be reconciled with the law. The considerable debate over the determination of death in the medical and scientific literature has not informed the public that vital organs are being procured from still-living donors and it seems unlikely that this information can remain hidden for long. Given the instability of the status quo and the difficulty of making the substantial legal changes required by complete transparency, we argue for a second-best policy solution: acknowledging the legal fictions involved in determining death to move in the direction of greater transparency. This may someday result in more substantial legal change to directly confront the challenges raised by life-sustaining and life-preserving technologies without the need for fictions. (shrink)

The first book of a projected two-volume set which construes the diverse tendencies of contemporary political thought within the tradition of classical political philosophy. In two very closely argued sections, Brecht examines the degree to which modern logic and scientific method may be said to necessitate "scientific value relativism," and the actual rise of relativism among Europeans and Americans of the late nineteenth and twentieth centuries. The final section, "At the Borderline of Metaphysics,"- is an eloquent argument designed to demonstrate (...) the relevance of belief in God to the question of universal values. Brecht's challenging thesis is developed with unusual care and vast scholarship.--K. R. D. (shrink)

A free and lucid translation of Scheler's first mature work on social and ethical theory. It represents an imaginative reinterpretation of Nietzsche's concept of "ressentiment," the structural key to the phenomenon of "slave morality." Generously sprinkled with apt illustrations, Ressentiment is a sustained attack on the notions of "work" and the "universal love of mankind" as ultimate sources of value. Such ressentiment-laden social tendencies are seen to form the faulty cornerstone of modern morality, both bourgeois and socialist.--K. R. D.

A translation of an early work by Aron which has become- almost a classic. First published in 1938, it is one of the best discussions of the limitations of objective historical knowledge. Analyzing man as both the subject and object of historical knowledge, Aron argues against the reduction of human history to natural history. There are also some brilliant chapters on the epistemological and sociological problems of historical knowledge.--K. R. D.

The first systematic study printed in the recently inaugurated "Sovietica" series, edited by J. M. Bochenski. In this volume, the author examines the basic theses of dialectical materialism and reviews the efforts of Soviet philosophers and physicists to accomodate their official philosophical framework to the challenge of Einstein's special relativity theory. The excellent handling of this subject owes much to the author's masterly grasp of physics, philosophy, and Russian.--K. R. D.

Alzheimer's disease is characterized by amyloid-beta peptide -loaded plaques in the brain. Abeta is a cleavage fragment of amyloid-beta protein precursor and over production of APP may lead to amyloidogenesis. The regulatory region of the APP gene contains consensus sites recognized by the transcription factor, specificity protein 1 , which has been shown to be required for the regulation of APP and Abeta. To understand the role of SP1 in APP biogenesis, herein we have characterized the relative distribution and localization (...) of SP1, APP, and Abeta in various brain regions of rodent and primate models using immunohistochemistry. We observed that overall distribution and cellular localization of SP1, APP, and Abeta are similar and neuronal in origin. Their distribution is abundant in various layers of neocortex, but restricted to the Purkinje cell layer of the cerebellum, and the pyramidal cell layer of hippocampus. These findings suggest that overproduction of Abeta in vivo may be associated with transcriptional pathways involving SP1 and the APP gene. (shrink)

Context. The identification of the sources that reionized the Universe and their specific contribution to this process are key missing pieces of our knowledge of the early Universe. Faint star-forming galaxies may be the main contributors to the ionizing photon budget during the epoch of reionization, but their escaping photons cannot be detected directly due to inter-galactic medium opacity. Hence, it is essential to characterize the properties of faint galaxies with significant Lyman continuum photon leakage up to z 4 to (...) define indirect indicators allowing analogues to be found at the highest redshift. Aims. Long gamma-ray bursts explode typically in star-forming regions of faint, star-forming galaxies. Through LGRB afterglow spectroscopy it is possible to detect directly LyC photons. Our aim is to use LGRBs as tools to study LyC leakage from faint, star-forming galaxies at high redshift. Methods. Here we present the observations of LyC emission in the afterglow spectra of GRB 191004B at z = 3:5055, together with those of the other two previously known LyC-emitting LGRB, to determine their LyC escape fraction and compare their properties. Results. From the afterglow spectrum of GRB 191004B we determine a neutral hydrogen column density at the LGRB redshift of og =17:2 0:15, and negligible extinction. The only metal absorption lines detected are C iv and Si iv. In contrast to GRB 050908 and GRB 060607A, the host galaxy of GRB 191004B displays significant Ly emission. From its Ly emission and the non-detection of Balmer emission lines we constrain its star-formation rate to 1 SFR 4:7 M yr. 1. We fit the Ly emission with a shell model and find parameters values consistent with the observed ones. The absolute LyC escape fractions we find for GRB 191004B, GRB 050908 and GRB 060607A are of 0:35+0:10.0:11, 0:08+0:05.0:04 and :20+0:05.0:05, respectively. We compare the LyC escape fraction of LGRBs to the values of other LyC emitters found from the literature, showing that LGRB afterglows can be powerful tools to study LyC escape for faint high-redshift star-forming galaxies. Indeed we could push LyC leakage studies to much higher absolute magnitudes. The host galaxies of the three LGRB presented here have all M1600 >.19:5 mag, with the GRB 060607A host at M1600 >.16 mag. LGRB hosts may therefore be particularly suitable for exploring the ionizing escape fraction in galaxies that are too faint or distant for conventional techniques. Furthermore the time investment is very small compared to galaxy studies. (shrink)

Background: Since the passage of the Patient Self-Determination Act, numerous policy mandates and institutional measures have been implemented. It is unknown to what extent those measures have affected end-of-life care, particularly with regard to the do-not-resuscitate order.Methods: Retrospective cohort study to assess associations of the frequency and timing of DNR orders with advance directive status, patient demographics, physician’s specialty and extent of documentation of discussion on end-of-life care.Results: DNR orders were more frequent for patients on a medical service than on (...) a surgical service and were made earlier in the hospital stay for medicine than for surgical patients . 22.18% of all patients had some form of an advance directive in their chart, yet this variable had no impact on the frequency or timing of DNR ordering. Documentation of DNR discussion was significantly associated with the frequency of DNR orders and the time from DNR to death .Conclusions: The physician’s specialty continues to have a significant impact on the frequency and timing of DNR orders, while advance directive status still has no measurable impact. Additionally, documentation of end-of-life discussions is significantly associated with varying DNR ordering rates and timing. (shrink)

Rita Bottino,1 Santosh Nagaraju,2 Vikas Satyananda,2 Hidetaka Hara,2 Martin Wijkstrom,2 Massimo Trucco,1 David KC Cooper2 1Institute of Cellular Therapeutics, Allegheny Health Network, 2Thomas E Starzl Transplantation Institute, Department of Surgery, University of Pittsburgh, Pittsburgh, PA, USA: Diabetes mellitus is increasing worldwide. Type 1 diabetes can be treated successfully by islet allotransplantation, the results of which are steadily improving. However, the number of islets that can be obtained from deceased human donors will never be sufficient to cure more than a very (...) small percentage of patients who might benefit from transplantation. Although there are some differences in glucose metabolism between pigs and humans, the use of pigs could provide an unlimited supply of islets, and the insulin produced would undoubtedly control glucose levels. Transplantation of islets into the portal vein results in islets residing in the liver; however, an early inflammatory response and rejection remain problematic, even when the recipient is receiving immunosuppressive therapy. In the long term, immunosuppressive drugs may exhibit toxicities to patients and specifically harm the islet cells. In contrast, encapsulation techniques provide islets with a physical barrier that prevents antibodies binding to the islet graft while still allowing insulin to be released into the recipient's circulation; in theory, patients receiving encapsulated grafts might not require exogenous immunosuppressive therapy. Nonhuman primates with encapsulated pig islet transplants have remained insulin-independent for several weeks, but long-term efficacy remains uncertain. Furthermore, techniques are now available to knock out genes from the pig and/or insert human genes, thus rendering the antigenic structure of pigs closer to that of humans, and providing protection from the human immune response. Islet transplantation from genetically engineered pigs has been followed by insulin independence in a small number of nonhuman primates for greater than 1 year. Neonatal islets have some advantages over adult islets in that they are easier to isolate and culture, and have the ability to proliferate during the first few months after transplantation. In 2009, the International Xenotransplantation Association set up a group to encourage and advise on clinical trials of pig islet xenotransplantation; this group's guidelines are discussed. Clinical trials of encapsulated pig islets are already under way. Keywords: diabetes, islets, pancreatic, pig, xenotransplantation. (shrink)