Psychiatry is rapidly adopting digital phenotyping and artificial intelligence/machine learning tools to study mental illness based on tracking participants’ locations, online activity, phone and text message usage, heart rate, sleep, physical activity, and more. Existing ethical frameworks for return of individual research results (IRRs) are inadequate to guide researchers for when, if, and how to return this unprecedented number of potentially sensitive results about each participant’s real-world behavior. To address this gap, we convened an interdisciplinary expert working group, supported by (...) a National Institute of Mental Health grant. Building on established guidelines and the emerging norm of returning results in participant-centered research, we present a novel framework specific to the ethical, legal, and social implications of returning IRRs in digital phenotyping research. Our framework offers researchers, clinicians, and Institutional Review Boards (IRBs) urgently needed guidance, and the principles developed here in the context of psychiatry will be readily adaptable to other therapeutic areas. (shrink)

Highly portable and accessible MRI technology will allow researchers to conduct field-based MRI research in community settings. Previous guidance for researchers working with fixed MRI does not address the novel ethical, legal, and societal issues (ELSI) of portable MRI (pMRI). Our interdisciplinary Working Group (WG) previously identified 15 core ELSI challenges associated with pMRI research and recommended solutions. In this article, we distill those detailed recommendations into a Portable MRI Research ELSI Checklist that offers practical operational guidance for researchers contemplating (...) using this technology. (shrink)

Reason and Sentiment Throughout the long history of philosophy there has appeared from time to time a certain dilemma which is both attractive and fatal. ...

Blaise Pascal began as a mathematical prodigy, developed into a physicist and inventor, and had become by the end of his life in 1662 a profound religious thinker. As a philosopher, he was most convinced by the long tradition of scepticism, and so refused – like Kierkegaard – to build a philosophical or theological system. Instead, he argued that the human heart required other forms of discourse to come to terms with the basic existential questions – our nature, purpose and (...) relationship with God. This introduction to the life and philosophical thought of Pascal is intended for the general reader. Strikingly illustrated, it traces the antithetical tensions in Pascal’s life from his infancy, when he was said to have been placed under the spell of a sorceress, to his final years of extreme asceticism. Pascal stressed both the misery and greatness of humanity, our finitude and our comprehension of the infinite. The book shows how his life, philosophical thought and literary style can best be understood in the light of the paradoxical view of human nature. It covers the methods of argument and the central issues of the Provincial Letters and of the Pensées ; the Introduction places Pascal’s thought in the religious and political climate of seventeenth-century France, and a ‘Chronology of the Life of Pascal’ is also included. (shrink)

This study focuses on mindfulness programs in the corporate world, which are receiving increasing attention from business practitioners and organizational scholars. The workplace mindfulness literature is rapidly evolving, but most studies are oriented toward demonstrating the positive impacts of mindfulness as a state of mind. This study adopts a critical perspective to evaluate workplace mindfulness practice as a developmental process, with a focus on its potential risks that have ethical implications and are currently neglected by both researchers and practitioners. We (...) draw from a Buddhist perspective that understands mindfulness training as an ethics-based, longitudinal, and holistic path. To this end, we develop a four-stage model to illustrate a potential developmental process for participants in workplace mindfulness programs. This model comprises four stages of preliminary concentration, deep concentration, self-transcendence, and reengagement, each of which has its own underlying characteristics and impacts on individual participants and organizations. (shrink)

Introduction The General Bearings of Kant's Third Critique The Critique of Judgment may be broadly viewed as a work of philosophical diplomacy in which Kant ...

Increasingly, professionalism has been recognized as a core competency for health service professionals and is the domain in which vexing competence problems are observed in trainees. We begin by describing manifestations of problems of professionalism in accord with the values that fall within the rubric of this multifaceted construct. We provide an approach for evaluating problems of professionalism and discuss intervention for trainees with mild, moderate, or severe problems in this domain. We propose implications for training focused on enhancing the (...) culture of programs; bolstering the education, guidance, and mentoring provided related to professionalism; and encouraging best practices for addressing trainees with problems of professionalism. We conclude by sharing ideas about defining professionalism, identifying problems of professionalism, strengthening our approach to assessing professionalism and intervening when problems are evident, developing strategies for preventing professionalism problems, and ensuring that psychologists take seriously their responsibility to address professionalism concerns with colleagues. (shrink)

Injury to the central or peripheral nervous system is often associated with persistent pain. After ischemic injury to the spinal cord, rats develop severe mechanical allodynia-like symptoms, expressed as a pain-like response to innocuous stimuli. In its short-lasting phase the allodynia can be relieved with the [gamma]-aminobutyric acid (GABA)-B receptor agonist baclofen, which also reverses the hyperexcitability of dorsal horn interneurons to mechanical stimuli. Furthermore, there is a reduction in GABA immunoreactivity in the dorsal horn of allodynic rats. Clinical neuropathic (...) pain of peripheral and central origin often cannot be relieved by opiates at doses that do not cause side effects. The loss of sensitivity to opiates may be associated with the up-regulation of endogenous antiopioid substances, such as the neuropeptide cholecystokinin (CCK). CCK and its receptor (CCK-R) protein is normally not detectable in rat dorsal root ganglion cells. After peripheral nerve section, both CCK and CCK-R are up-regulated in the dorsal root ganglia. Furthermore, CI 988, an antagonist of the CCK-B receptor, chronically coadministered with morphine, reduces autotomy, a behavior that may be a sign of neuropathic pain following peripheral nerve section. Thus, opiate insensitivity may be due to the release of CCK from injured primary afferents. Similarly, in the chronic phase of the spinal ischemic model of central pain, the allodynia-like symptom is not relieved by systemic morphine, but is significantly reversed by the CCK-B antagonist. Consequently, up-regulation of CCK and CCK-R in the CNS may also underlie opiate drug insensitivity following CNS injury. Thus, dysfunction of central inhibition involving GABA and endogenous opioids may be a factor underlying the development of sensory abnormalities and/or pain following injury to neural tissue. (shrink)

As a member of the BRAIN Neuroethics Subgroup, which drafted the Neuroethics Roadmap, I am proud of our work. The Roadmap is the result of many hours of thoughtful discussion, and reflects strong l...

In lieu of an abstract, here is a brief excerpt of the content:VIOLENCE AND NONVIOLENCE IN HINDU RELIGIOUS TRADITIONS Francis X. Clooney, SJ. Boston College Outline I.Violence, Sacrifice and Ritual 1. Some basic attitudes toward the killing of animals 2.Resolving the problem of sacrificial violence by internalization 3.Substitutions 4.Renunciation and nonviolence: an elite pathway 5.Violence andnonviolenceinrelation to vegetarianism: Hans Schmidt's theses?. Traditional Hindu Theorizations of Violence in Mimamsa Ritual Theory and Vedanta Theology 1. The ritual analysis (at Mimamsa Sutra 1.1.2) (...) of the Shyena rite which is performed in order to harm enemies 2.The Vedanta analysis (at Uttara Mimamsa Sutra 3.1.25) of ritual violence in relation to the prohibition of violence??. Violence in the Life of the State HOFrancis X. Clooney, S.J. 1. The royal power to punish (danda) 2.The synthesis of the ideals of brahmin and king a..The distribution and management of violence in the Laws ofManu (1st century CE) b. Policy toward warfare in the Arthashastra of Kautilya 3.The collapse of the brahmanical synthesis—and the emergence of a (seemingly) more nonviolent Hinduism 4.A comment on Gandhi (1 869-1948) and the contemporary emergence of post-Gandhian Hindu perspectives IV.Alternate Views from Outside the Sanskritic Tradition 1. Tamil Wisdom on Violence and Nonviolence: a.Tirukkural (c. 2nd century CE) b.Cilappatikaram (5th century CE) 2.Blood and Goddesses 3.From a Village Perspective a. Some Trouble with Cows b.Mahasweta Devi and the Literary Exposure of Violence V.The Question of a Christian Perspective on the Hindu Treatment of Violence and Religion: Are Victims Necessary? Some Presuppositions: • The following reflections, complex as they are, are governed by a reluctance to simplify Hindu teaching. I seek to avoid the view that the Hindu traditions had only one view of violence and nonviolence. • I use the term "Hindu" loosely and as a shorthand, without claiming that there is a single Hindu tradition, or a single creed shared by all Hindus, or a single attitude toward violence. But neither do I claim that there are simply many traditions without any common elements which justify the appellation "Hindu." • I am reluctant to idealize the Hindu traditions as if nonviolence must necessarily be taken as the epitome ofHindu thought. India's traditions are complex, and require complex treatment. • A serious artificiality of this paper is that I treat Hinduism without simultaneously lookinginto Buddhist andJain materials, though both were traditions with important and enduring commitments to nonviolence. Particularly with respect to the renunciant, marginal components of traditions, one ought not to make overly neat or decisive distinctions Violence and Nonviolence in Hindu Religious Traditions 1 1 1 between the Hindu, Buddhist, and Jain theories and practices related to violence and nonviolence. • I attempt to give preference to indigenous discussions ofissues related to violence and nonviolence; the context and mode of thinking are important, notjust the conclusions drawn. I therefore avoid simply mining Hindu texts for an answer to a contemporary question, "What is the Hindu attitude toward violence and nonviolence?" • In most ofwhat follows we must distinguish contexts where "violence" indicates "physical action which causes pain to some living being," from contexts where "violence" indicates "an intention, rooted in anger or malice, to hurt someone." I use the word "violence" for both in order to highlight the complex issues of distinction involved. In considering the Sanskrit formulations, one likewise has to distinguish himsa as "causing pain" from himsa as "intending to harm." • It is often difficult to date ancient texts, and even when one narrows down a date—within 200-300 years—its significance still depends on other, often equally broadly stated dates. Nevertheless, I do offer dates throughout, as summarized here: •ancient Vedic sacrificial practices, from before 1200 BCE •Vedic ritual analyses and reformulations of sacrifices as ritualized acts, in the Brahmanas, from after 1000 BCE •the Upanishadic exploration of the deeper meanings of ritual and interiorized alternatives to ritual, from after 900 BCE •the Buddha, c. 500 BCE •key texts in the theorization of royal power, The Laws of Manu (beginning of Common Era) and Arthashastra (c. 150 CE) •the Tamil wisdom text Tirukkural (100 CE) •Goddess texts as evidenced in Sanskrit formulations, from after 500 CE... (shrink)

The spatial organization of the genome is intimately linked to its biological function, yet our understanding of higher order genomic structure is coarse, fragmented and incomplete. In the nucleus of eukaryotic cells, interphase chromosomes occupy distinct.

Jian Zhou,* Weiqiang Ju,* Xiaopeng Yuan, Xiaofeng Zhu, Dongping Wang, Xiaoshun HeOrgan Transplant Center, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China *These authors contributed equally to this work: Hyperosmolar nonketotic hyperglycemic coma is a serious, rare complication induced by methylprednisolone pulse therapy for acute rejection after orthotopic liver transplantation. Herein, we report an unusual case of a 58-year-old woman who experienced acute rejection at 30 months after OLT, only one case in which HNKHC resulted in MP (...) pulse therapy for acute rejection in all 913 recipients in our center. The general morbidity of HNKHC was 1.09‰ in this study. HNKHC is characterized by rapid onset, rapid progression, and a lack of specific clinical manifestations. High-dose MP management was a clear risk factor. The principle of treatment included rapid rehydration, low-dose insulin infusion, and correcting disorders of electrolytes and acidosis. In conclusion, clinicians considering MP pulse therapy after OLT should be alert to the occurrence of HNKHC. Keywords: liver transplantation, complications, hyperosmolar nonketotic hyperglycemic coma, methylprednisolone pulse therapy, principle of treatment. (shrink)

The microstructures of cryogenically ball-milled Cu were investigated by high-resolution electron microscopy. It was found that the grain-size reduction is a dislocation-controlled continuous process which consists of the formation of small-angle grain boundaries , a gradual increase in misorientations as a result of accumulation of more dislocations and, finally, the formation of large-angle GBs. The GBs were generally curved, wavy or faceted, and heavily strained, which are typical characteristics of nanostructured materials. In addition, extrinsic dislocations were found in many GBs, (...) indicating that most are in a high-energy non-equilibrium configuration, which is consistent with observations in equal-channel angular pressing processed Cu, Ni, and Al-Mg, repetitive corrugation and straightening processed Cu and room-temperature ball-milled Cu. These results support a still-disputed concept that GBs in nanostructured metals processed by severe plastic deformation are mostly in non-equilibrium states. (shrink)

One proposed explanation for a particular kind of temporal preference lies in a disparity between the emotional intensity of memory compared to anticipation. According to the memory/anticipation disparity explanation, the utility of anticipation of a particular event if that event is future, whether positive or negative, is greater than the utility of retrospection of that same event if it is past, whether positive or negative, and consequently, overall utility is maximised when we prefer negative events to be located in the (...) past rather than the future, and positive ones in the future rather than the past. To have this preference is to be (at least apparently) future biased. If this explanation is correct, it would tend to confer rational justification upon these preferences. This paper empirically investigates this explanation. Our results suggest that, at most, this explanation might be a partial one of some people’s preferences some of the time, rather than a general explanation of future bias. In turn, this lends some indirect support to a competing explanation that appeals to temporal asymmetries in emotion and attention. Since that explanation would arguably tend not to confer rational justification upon (apparently) future-biased preferences, we argue that our findings provide some reason to be sceptical that these preferences are, in general, rationally justified. (shrink)