El problema de una sensibilización del campo de la moralidad en la filosofia trascendental de Kant

La problemática de la investigación se plantea en el contexto de la filosofía trascendental de Kant, en relación al modo en que es en general posible para nosotros representarnos el ámbito de la moralidad. Nuestra comprensión natural o preteórica del funcionamiento del lenguaje parece llevarnos a entender el significado de nuestras palabras en términos de la relación que se establece entre el signo lingüístico y el objeto: nuestros términos lingüísticos están en el lugar del objeto extralingüístico a que refieren y que constituye su significado. A nuestro modo de ver, la afirmación kantiana relativa a que todo nuestro conocimiento comienza con la experiencia, es decir, con aquello que procede de los sentidos, parece estar apuntando a esta intuición fundamental. Ahora bien, la cuestión que cabe plantearse es: de acuerdo con este modelo de significación, ¿cuál es el significado de nuestros términos morales? Si, con Kant, aceptamos que el concepto de deber moral exige el cumplimiento (u omisión) incondicionado de una acción y que, precisamente por las exigencias de universalidad y necesidad que le son inherentes, tal concepto es inderivable de la experiencia, cabe preguntarse cuál es el significado del concepto de deber en sentido moral (y, en general, de los términos morales) y de qué manera somos capaces de representárnoslo. Mi investigación ha pretendido esclarecer precisamente en qué sentido debe entenderse la afirmación kantiana de que en la reflexión sobre la corrección moral de nuestras acciones, para representarnos las exigencias de universalidad y necesidad que son propias del concepto de deber moral, nos servimos analógicamente del concepto de naturaleza, así como analizar la plausibilidad de la propuesta kantiana misma.

Evolutionary genomics and HIV restriction factors.

PURPOSE OF REVIEW: To provide updated insights into innate antiviral immunity and highlight prototypical evolutionary features of well characterized HIV restriction factors. RECENT FINDINGS: Recently, a new HIV restriction factor, Myxovirus resistance 2, has been discovered and the region/residue responsible for its activity identified using an evolutionary approach. Furthermore, IFI16, an innate immunity protein known to sense several viruses, has been shown to contribute to the defense to HIV-1 by causing cell death upon sensing HIV-1 DNA. SUMMARY: Restriction factors against HIV show characteristic signatures of positive selection. Different patterns of accelerated sequence evolution can distinguish antiviral strategies--offense or defence--as well as the level of specificity of the antiviral properties. Sequence analysis of primate orthologs of restriction factors serves to localize functional domains and sites responsible for antiviral action. We use recent discoveries to illustrate how evolutionary genomic analyses help identify new antiviral genes and their mechanisms of action.

Clinical review: practical recommendations on the management of perioperative heart failure in cardiac surgery.

Acute cardiovascular dysfunction occurs perioperatively in more than 20% of cardiosurgical patients, yet current acute heart failure (HF) classification is not applicable to this period. Indicators of major perioperative risk include unstable coronary syndromes, decompensated HF, significant arrhythmias and valvular disease. Clinical risk factors include history of heart disease, compensated HF, cerebrovascular disease, presence of diabetes mellitus, renal insufficiency and high-risk surgery. EuroSCORE reliably predicts perioperative cardiovascular alteration in patients aged less than 80 years. Preoperative B-type natriuretic peptide level is an additional risk stratification factor. Aggressively preserving heart function during cardiosurgery is a major goal. Volatile anaesthetics and levosimendan seem to be promising cardioprotective agents, but large trials are still needed to assess the best cardioprotective agent(s) and optimal protocol(s). The aim of monitoring is early detection and assessment of mechanisms of perioperative cardiovascular dysfunction. Ideally, volume status should be assessed by 'dynamic' measurement of haemodynamic parameters. Assess heart function first by echocardiography, then using a pulmonary artery catheter (especially in right heart dysfunction). If volaemia and heart function are in the normal range, cardiovascular dysfunction is very likely related to vascular dysfunction. In treating myocardial dysfunction, consider the following options, either alone or in combination: low-to-moderate doses of dobutamine and epinephrine, milrinone or levosimendan. In vasoplegia-induced hypotension, use norepinephrine to maintain adequate perfusion pressure. Exclude hypovolaemia in patients under vasopressors, through repeated volume assessments. Optimal perioperative use of inotropes/vasopressors in cardiosurgery remains controversial, and further large multinational studies are needed. Cardiosurgical perioperative classification of cardiac impairment should be based on time of occurrence (precardiotomy, failure to wean, postcardiotomy) and haemodynamic severity of the patient's condition (crash and burn, deteriorating fast, stable but inotrope dependent). In heart dysfunction with suspected coronary hypoperfusion, an intra-aortic balloon pump is highly recommended. A ventricular assist device should be considered before end organ dysfunction becomes evident. Extra-corporeal membrane oxygenation is an elegant solution as a bridge to recovery and/or decision making. This paper offers practical recommendations for management of perioperative HF in cardiosurgery based on European experts' opinion. It also emphasizes the need for large surveys and studies to assess the optimal way to manage perioperative HF in cardiac surgery.

Prevention and treatment options for postoperative delirium in the elderly.

PURPOSE OF REVIEW: To review recent findings and developments in strategies for prevention and treatment of postoperative delirium. RECENT FINDINGS: Current advances in the field include improved knowledge about predisposing and precipitating factors, evidence for efficacy of multicomponent prevention programmes, refinement of perioperative procedures, and promising pharmacological approaches for prophylaxis and management of postoperative delirium. SUMMARY: Postoperative delirium is a common and serious complication in elderly patients. Preoperative assessment of risk profiles and tailored multimodal prevention approaches proved effective and should be integrated into clinical practice. Despite promising recent findings, at present, the routine use of pharmacological prophylaxis cannot be recommended. Validated and easy-to-use bedside diagnostic tools are available and should be regularly applied for delirium screening in the first days after surgery. In patients developing delirium, causal conditions and contributing factors need to be identified and addressed. Whereas administration of antipsychotics may represent an option for symptomatic treatment, further studies are needed to evaluate the effects of pharmacological approaches on long-term outcomes in elderly patients with delirium.

Neuromodulation by oxytocin and vasopressin in the central nervous system as a basis for their rapid behavioral effects

The last several years have seen an increasing number of studies that describe effects of oxytocin and vasopressin on the behavior of animals or humans. Studies in humans have reported behavioral changes and, through fMRI, effects on brain function. These studies are paralleled by a large number of reports, mostly in rodents, that have also demonstrated neuromodulatory effects by oxytocin and vasopressin at the circuit level in specific brain regions. It is the scope of this review to give a summary of the most recent neuromodulatory findings in rodents with the aim of providing a potential neurophysiological basis for their behavioral effects. At the same time, these findings may point to promising areas for further translational research towards human applications.

A role for clock genes in sleep homeostasis.

The timing and quality of both sleep and wakefulness are thought to be regulated by the interaction of two processes. One of these two processes keeps track of the prior sleep-wake history and controls the homeostatic need for sleep while the other sets the time-of-day that sleep preferably occurs. The molecular pathways underlying the latter, circadian process have been studied in detail and their key role in physiological time-keeping has been well established. Analyses of sleep in mice and flies lacking core circadian clock gene proteins have demonstrated, however, that besides disrupting circadian rhythms, also sleep homeostatic processes were affected. Subsequent studies revealed that sleep loss alters both the mRNA levels and the specific DNA-binding of the key circadian transcriptional regulators to their target sequences in the mouse brain. The fact that sleep loss impinges on the very core of the molecular circadian circuitry might explain why both inadequate sleep and disrupted circadian rhythms can similarly lead to metabolic pathology. The evidence for a role for clock genes in sleep homeostasis will be reviewed here.

Demyelination as a complication of new immunomodulatory treatments.

Purpose of review: This review discusses demyelinating events of the nervous system that have been associated with new immunomodulatory treatments, in particular monoclonal antibodies (mAbs). Recent findings: Natalizumab, a mAb targeting the alpha-4 integrins, which is efficient in relapsing-remitting multiple sclerosis, has been associated with progressive multifocal leukoencephalopathy (PML). We will review the putative mechanisms linking natalizumab with JC virus, the agent of PML. Efalizumab, a mAb targeting a member of the integrin family, CD11a, was approved for the treatment of psoriasis, but had to be withdrawn in 2009 because of the occurrence of three cases of PML. Rituximab, an anti-CD20 mAb, is used in different neoplastic and autoimmune diseases and may soon enter the pharmacopeia of multiple sclerosis. It has been suggested that rituximab is a risk factor for PML; however, evidence of such a link is unclear. Antitumor necrosis factor-alpha agents are used in several autoimmune diseases. Several cases of demyelinating events of the nervous system have been reported, prompting a heightened surveillance of treated patients. Recent data are reassuring, suggesting that the incidence of such events is relatively low. Summary: Neurologists must become familiar with neurological complications of new immunomodulatory treatments, a field situated at the interface of neurology, immunology and infection.

General Practitioners' willingness to pay for continuing medical education in a fee-for-service universal coverage health care system

Background: Sponsoring of physicians meetings by life science companies has led to reduced participation fees but might influence physician's prescription practices. A ban on such sponsoring may increase participation fees. We aimed to evaluate factors associated with physicians' willingness to pay for medical meetings, their position on the sponsoring of medical meetings and their opinion on alternative financing options. Methods: An anonymous web-based questionnaire was sent to 447 general practitioners in one state in Switzerland, identified through their affiliation to a medical association. The questionnaire evaluated physicians' willingness to pay for medical meetings, their perception of a bias in prescription practices induced by commercial support, their opinion on the introduction of a binding legislation and alternative financing options, their frequency of exchange with sales representatives and other relevant socioeconomic factors. We built a multivariate predictor logistic regression model to identify determinants of willingness to pay. Results: Of the 115 physicians who responded (response rate 26%), 48% were willing to pay more than what they currently pay for congresses, 79% disagreed that commercial support introduced a bias in their prescription practices and 61% disagreed that it introduced a bias in their colleagues' prescription practices. Based on the multivariate logistic regression, perception of a bias in peers prescription practices (OR=7.47, 95% CI 1.65-38.18) and group practice structure (OR=4.62, 95% CI 1.34-22.29) were significantly associated with an increase in willingness to pay. Two thirds (76%) of physicians did not support the introduction of a binding legislation and 53% were in favour of creating a general fund administered by an independent body. Conclusion: Our results suggest that almost half of physicians surveyed are willing to pay more than what they currently pay for congresses. Predictors of an increase in physicians' willingness to pay were perception of the influence of bias in peers prescription practices and group practice structure. Most responders did not agree that sponsoring introduced prescribing bias nor did they support the 2 introduction of a binding legislation prohibiting sponsoring but a majority did agree to an independent body that would centrally administer a general fund.

Emotional intelligence: On definitions, neuroscience, and marshmallows

In his timely article, Cherniss offers his vision for the future of "Emotional Intelligence" (EI). However, his goal of clarifying the concept by distinguishing definitions from models and his support for "Emotional and Social Competence" (ESC) models will, in our opinion, not make the field advance. To be upfront, we agree that emotions are important for effective decision-making, leadership, performance and the like; however, at this time, EI and ESC have not yet demonstrated incremental validity over and above IQ and personality tests in meta-analyses (Harms & Credé, 2009; Van Rooy & Viswesvaran, 2004). If there is a future for EI, we see it in the ability model of Mayer, Salovey and associates (e.g, Mayer, Caruso, & Salovey, 2000), which detractors and supporters agree holds the most promise (Antonakis, Ashkanasy, & Dasborough, 2009; Zeidner, Roberts, & Matthews, 2008). With their use of quasi-objective scoring measures, the ability model grounds EI in existing frameworks of intelligence, thus differentiating itself from ESC models and their self-rated trait inventories. In fact, we do not see the value of ESC models: They overlap too much with current personality models to offer anything new for science and practice (Zeidner, et al., 2008). In this commentary we raise three concerns we have with Cherniss's suggestions for ESC models: (1) there are important conceptual problems in both the definition of ESC and the distinction of ESC from EI; (2) Cherniss's interpretation of neuroscience findings as supporting the constructs of EI and ESC is outdated, and (3) his interpretation of the famous marshmallow experiment as indicating the existence of ESCs is flawed. Building on the promise of ability models, we conclude by providing suggestions to improve research in EI.

Impacte visual aeri a Argentona

Treball de recerca realitzat per un alumne d'ensenyament secundari i guardonat amb un Premi CIRIT per fomentar l'esperit cientí­fic del Jovent l'any 2009. Aquest treball té com a finalitat millorar l'entorn aeri d'Argentona, un poble situat a la comarca del Maresme. Els elements que creen més impacte visual aeri són les antenes en desús i el cablejat no soterrat. S'han buscat propostes per canviar aquesta situació: la retirada de les antenes, aprofitant l'arribada de la TDT, i el soterrament del cablejat aeri. Donat que ambdues accions afectarien al municipi i a la seva població, s'ha considerat necessari incloure una enquesta, per a conèixer l'opinió dels argentonins, i dues entrevistes, a l'alcalde i a l'enginyer municipal, per conèixer la postura oficial.

La història es repeteix?: estudi comparatiu de la crisi del 29 amb l'actual

Treball de recerca realitzat per un alumne d'ensenyament secundari i guardonat amb un Premi CIRIT per fomentar l'esperit científic del Jovent l'any 2009. L’objectiu d’aquest treball ha estat donar pautes de reflexió sobre la crisi i el moment econòmic actual. Es volia valorar si era certa la idea que la situació econòmica dels nostres dies té certs paral•lelismes amb la crisi que va patir el món occidental el 1929. Per tal d’establir la veracitat de la hipòtesi plantejada es va dissenyar un model d’investigació basat en les entrevistes i en el recull i buidatge d’articles de premsa relacionats amb el tema, durant un període de temps no gaire extens, període que correspon als tres mesos a partir dels quals s’evidencia la situació de crisi. Al mateix temps era interessant copsar l’opinió de dos grans mestres en l’estudi de l’economia del nostre país, el Dr. Fabià Estapé i el Dr. Anton Costas, mestre i deixeble respectivament.. Sense esperar massa sorpreses, la crisi actual presenta molts punts de similitud amb el procés inciat l’any 1929. Ambdós esdeveniments econòmics tenen molts punts de connexió i les mesures proposades per solucionar o per pal•liar les conseqüències són també similars. En tots dos casos la figura de l’economista britànic John Maynard Keynes és cabdal per part dels diversos governs a l’hora de reconduir i adreçar la situació econòmica.

High magnification cystoscopy in the primary diagnosis of bladder tumors.

Purpose of reviewIn bladder cancer, discrimination between benign and malignant tissue may remain tricky with current endoscopic tools. On the basis of our recent experience with high-magnification cystoscopy, compared with other tools such as optical coherence tomography or confocal laser endomicroscopy, it is suggested here that this discrimination may well be feasible endoscopically. The clinical potential of these systems that are being developed as complementary tools to the current endoscopic equipment is reviewed.Recent findingsAt present, white-light cystoscopy, either assisted by fluorescence cystoscopy or narrow-band imaging, is proposed for the global cystoscopic examination of bladder cancer patients. Both techniques compete to help to reduce the recurrence rate by improving exophytic tumor detection, and the extent of carcinoma in situ and high-grade dysplasia. All of which are important prognosis factors for disease progression. In addition, recent findings on neoangiogenesis that accompanies early stage bladder cancer show that this may also be an important observable switch in bladder cancerogenesis, as it is found very early in tumor development. The high magnification cystoscopy as a complementary tool to fluorescence cystoscopy allows classification of the vessel patterns on fluorescence positive sites, and thus facilitates the discrimination between cancerous and noncancerous lesions. This information may be useful to reduce the false positive rate of fluorescence cystoscopy.SummaryEmerging technologies aiming at a real-time in-situ discrimination between benign and malignant tissue during endoscopic bladder exploration is a promising development for the monitoring of bladder cancer patients.

On the current existence of a coccidial line of development in the malaria parasites: a theory

Most opinion favors the origin of the malaria parasites from a coccidial ancestor. It is assumed that whatever the process through which the coccidia differentiated into a Plasmodium this phenomenon very probably occured millions of year ago, and during that differentiation process the original coccidia vanished. Therefore it has never repeated. At the light of some experiments the existence, at the present time, of a coccidial cycle of development in the malaria parasites, is proposed. The conection routes and mechanisms through which the malaria parasite changes to a coccidial life, and the routes in reverse are exposed. Transmission of the malaria-coccidial forms is suggested.

The Enigma of the Silent Closing of Acts (28,16-31)

(Résumé de l'ouvrage) In the first volume of this long-anticipated collection by Moessner and Tiede, seventeen leading scholars of antiquity present an amazing "sea change" of opinion that Luke is indeed the interpreter of Israel. The book represents an unprecedented international consensus that the Hellenistic author Luke composed a carefully crafted narrative in two parts to claim Jesus of Nazareth as Israel's true heritage and enduring legacy to the world. Part One explores the nature of Luke's prologues and his intention to write a narrative of "events brought to fruition," using the narrative conventions and audience expectations of the Greco-Roman milieu. Part Two illuminates the relation of Luke's second "volume" to the first by inquiring about the consistency and coherence of his narrative-thematic strategies in retelling the story of Israel's legacy of "the Christ." Whether Luke completed Acts, the larger role of Paul and, most significantly, the meaning of Israel by the end of Acts are approached from new perspectives and charged with provocative insights. In addition to the volume editors, the contributors include L. Alexander, D. Schmidt, V. Robbins, C. Thornton, R. Pervo, W. Kurz, C. Holladay, G. Sterling, D. Balch, E. Plmacher, Charles H. Talbert, J.H. Hayes, D. Marguerat, M. Wolter, R. Tannehill, and I. H. Marshall.

Sectes, médias, fin des temps

(Résumé de l'ouvrage) Durant toute l'Europe, et au-delà, on a assisté ces dernières années à un grand débat sur les sectes, leur nature, leur nombre, leur influence, leur rôle. Des événements tragiques comme les suicides collectifs ont confirmé dans leurs convictions ceux qui pensent que les sectes sont un fléau pour la société qui les tolère et pour les individus qui s'y engagent. D'autres, au contraire, mettent en garde contre la nouvelle « chasse aux sorcières » qu'on risque de déclencher et en appellent au respect du droit à la liberté religieuse. Ne faut-il pas compléter les analyses classiques de Max Weber et d'Ernst Troeltsch, qui distinguent entre le type « Église » et le type « Secte » ? Plusieurs études sur des groupes controversés (le tristement célèbre Ordre du Temple Solaire, les Témoins de Jéhovah, la Soka Gakkaï, les Loubavitch... ou les mouvances accusées de dérives sectaires) illustrent les évolutions contrastées du paysage religieux aujourd'hui. On assiste d'ailleurs à une mondialisation de ces phénomènes. Les auteurs reviennent longuement sur le débat de société autour des sectes, sur leur nocivité réelle ou supposée, sur leur stigmatisation légitime ou irraisonnée dans les médias et l'opinion publique. Les sectes interrogent la laïcité de l'État et le droit : entrent-elles dans le droit commun des religions ou faut-il créer une législation « anti-sectes » spécifiques ?