Brock Macdonald1, Evi Vakiani2, Rhonda K Yantiss3, Jun Lee4, Robert S Brown Jr5, Samuel H Sigal61Division of Gastroenterology, Department of Medicine, University of California-San Francisco, San Francisco, CA, 2Department of Pathology, Memorial Sloan–Kettering Cancer Center, New York, NY, 3Department of Pathology and Laboratory Medicine, New York Weill Cornell Medical College, New York, NY, 4Division of Nephrology, Department of Medicine, Weill Cornell Medical College, New York, NY, 5Division of Gastroenterology, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, (...) NY, 6Division of Gastroenterology and Hepatology, Department of Medicine, New York University, New York, NY, USA: The use of sirolimus as an alternative to calcineurin inhibitors for posttransplant immunosuppression is associated with a variety of inflammatory conditions. In this report, we describe the case of a 34-year-old man who developed abnormal liver tests 6 years after live-donor kidney transplantation and 5 years after initiation of sirolimus-based immunosuppression. Elevated aminotransferase levels persisted after withdrawal of potentially hepatotoxic medications, and serologic evaluation for viral hepatitis, autoimmune disease, and genetic disorders was unrevealing. Liver biopsy revealed prominent hepatocellular injury associated with a mixed inflammatory infiltrate and liver tests normalized within 2 weeks of discontinuation of sirolimus. In this report, we review previous reports of sirolimus hepatotoxicity and propose a unifying hypothesis for the various inflammatory conditions that have been attributed to sirolimus.Keywords: sirolimus, immunosuppression, transplant, inflammatory conditions, hepatotoxicity. (shrink)

Richard Janko's acclaimed translation of Aristotle's _Poetics_ is accompanied by the most comprehensive commentary available in English that does not presume knowledge of the original Greek. Two other unique features are Janko's translations with notes of both the _Tractatus Coislinianus_, which is argued to be a summary of the lost second book of the Poetics, and fragments of Aristotle’s dialogue On Poets, including recently discovered texts about catharsis, which appear in English for the first time.

It is often alleged that liberalism and nationalism are mutually antagonistic in theory and practice. Max Weber is a good example, the dominant interpretation maintains, as his political thought betrays its liberal foundation by embracing an ardent nationalism that was popular in Wilhelmine Germany. Weber was, in short, a nationalist, and thus illiberal, political thinker. Against this conventional wisdom I argue that Weber's liberal nationalism cannot be placed squarely in the authoritarian, ethnic tradition of German nationalism, and its idiosyncrasy becomes (...) evident once Weber's twofold political project of revivifying a robust civil society while imbuing it with the spirit of public citizenship is foregrounded more clearly. Thus recast, Weber's political thought reveals a strong affinity with that of Tocqueville and Mill, especially in their similar concern with moral personality and political maturity in a mass democracy. (shrink)

Rationing healthcare is a difficult task, which includes preventing patients from accessing potentially beneficial treatments. Proponents of implicit rationing argue that politicians cannot resist pressure from strong patient groups for treatments and conclude that physicians should ration without informing patients or the public. The authors subdivide this specific programme of implicit rationing, or “hidden rationing”, into local hidden rationing, unsophisticated global hidden rationing and sophisticated global hidden rationing. They evaluate the appropriateness of these methods of rationing from the perspectives of (...) individual and political autonomy and conclude that local hidden rationing and unsophisticated global hidden rationing clearly violate patients’ individual autonomy, that is, their right to participate in medical decision-making. While sophisticated global hidden rationing avoids this charge, the authors point out that it nonetheless violates the political autonomy of patients, that is, their right to engage in public affairs as citizens. A defence of any of the forms of hidden rationing is therefore considered to be incompatible with a defence of autonomy. (shrink)

This inclusive, cross-cultural study rethinks the nexus between engineering, development, and culture. It offers diverse commentary from a range of disciplinary perspectives on how the philosophies of today’s cultural triumvirate—American, European and Chinese—are shaped and given nuance by the cross-fertilization of engineering and development. Scholars from the humanities and social sciences as well as engineers themselves reflect on key questions that arise in this relational context, such as how international development work affects the professional views, identities, practice and ethics of (...) engineers. The first volume to offer a systematic and collaborative study that cuts across continental boundaries, the book delineates the kinds of skills and competences that tomorrow’s engineering success stories will require, and analyzes fascinating aspects of the interplay between engineering and philosophy, such as how traditionally Chinese ways of thinking can influence modern engineering practice in the world’s most populous country. China’s problematic mix of engineering woes and wonders, from the high-profile crash on its high-profile rail network to its ‘bird’s nest’ Olympic stadium, adds to the urgency for reform, while Europe’s Enlightenment-informed legal frameworks are contrasted with Chinese mechanisms in their governance of the field of nanotechnology, a crucial element of future technical evolution. Fascinating and compelling in equal measure, this volume addresses one of the topics at the leading edge of humanity’s quest to survive, and to thrive.​. (shrink)

Nurses and midwives are part of health care in all the stages of our lives from preconception to death. Recent scientific advances have introduced new techniques of screening and diagnosis linked to stem cell isolation and therapies. These could affect us at any age and therefore nurses will be involved as carers and patients advocates for these techniques. In this article stem cell techniques and therapies are outlined, as well as some of the ethical challenges faced by various nursing groups, (...) whether in adult, learning difficulties, mental health, paediatric, primary care, public health or health visiting areas. Nurses have to understand the ethical issues and the rights of all parties (donor, recipient and families), which may conflict with each other, to be able to weigh up the benefits and costs to each group involved. Answers have to be found on a case-by-case basis within local moral frameworks and law. Nurses represent all parties in these therapies and act as advocates for every patient group. They need to act in an interprofessional environment to promote the best interests of all their clients, both clinically and ethically. (shrink)

It is shown that the jet mechanism derivable from the Lorentz deformation picture leads to a nearly constant average jet transverse momentum. It is pointed out that this is consistent with the high-energy experimental data. It is pointed out further that this result strengthens the physical basis for the minimal time-energy uncertainty combined covariantly with Heisenberg's space-momentum uncertainty relation.

Why do good people suffer? Does fate control the events that come our way? What is the difference between the reactions of men and women when a disaster occurs? Why did Jewish mothers kill their children in Ashkenazi countries? How did the Jews of Yemen tell about the deportation they were sentenced to? What explanation did the Hasidic Rebbe provide for what happened in the Holocaust? This is an unexpected journey through the Jewish bookcase - sometimes it is amusing, sometimes (...) horrifying, but always fascinating. A journey following one question and many answers, which expresses the human need to give meaning and meaning to the enigma of existence. (shrink)