Rationing Health Care and the Role of the 'Acute Principle'

In several works, Hartmut Kliemt has developed an original account on the necessity of rationing health care and on how a rationing policy should be carried out. While I agree on several important points of that view, there is one important aspect of his account that I do not find plausible: his claim that the so-called 'acute principle' (a principle that gives absolute preeminence to rescuing identified lives from dying) should be one of the basic criteria to carry out a rationing policy in a liberal state. After explaining Kliemt's view on rationing health care and, more specifically, the foundations of the acute principle, I argue that the acute principle is not supported by our basic moral intuitions. I then apply the previous argument to the case of rationing, arguing for the necessity of a compromise among intuitions supporting the acute principle and other moral intuitions. Finally, I try to show that a feasible system of public health care services is conceivable. In doing so, I make use, with some relevant modifications, of Kliemt's own ideas.health care, health ethics, rationing in medicine, distributive justice, scarce resources, prioritization, acute principle

Promises, Expectations, and Rights

I address the problem of why promises create obligations. First, I spell out and object the so-called expectational account according to which the duty to keep our promises arises from the fact that, when we promise to do something, we create an expectation in the promisee, which we have the duty not to disappoint. It has been claimed that this account is circular since we can only raise the expectation, in the appropriate sense, if we already have the moral duty to keep our promise. I argue, against Scanlon and others, that such circularity is unavoidable. In the second section, I develop an alternative approach. Based on some ideas by H. Hart, H. Steiner, E. Mack, and others, I hold that the normative force of promises should be explained by its connection to the normative force of rights. Promising to do X should be understood as an act of surrendering our liberty-right not to do X. The central question is, therefore, how we come to have the moral power to limit our liberty-rights. My suggestion is that such power is conceptually linked to the very idea of exercising rights

Promises, Expectations, and Rights

I address the problem of why promises create obligations. First, I spell out and object the so-called expectational account according to which the duty to keep our promises arises from the fact that, when we promise to do something, we create an expectation in the promisee, which we have the duty not to disappoint. It has been claimed that this account is circular since we can only raise the expectation, in the appropriate sense, if we already have the moral duty to keep our promise. I argue, against Scanlon and others, that such circularity is unavoidable. In the second section, I develop an alternative approach. Based on some ideas by H. Hart, H. Steiner, E. Mack, and others, I hold that the normative force of promises should be explained by its connection to the normative force of rights. Promising to do X should be understood as an act of surrendering our liberty-right not to do X. The central question is, therefore, how we come to have the moral power to limit our liberty-rights. My suggestion is that such power is conceptually linked to the very idea of exercising rights

Control del mal de los almácigos causado por Rhizoctonia solani y Sclerotium rolfsii con caldos de cebolla

Damping off is a frequent disease that kills seedlings. Cultural control is the only tool in organic crops to manage this disease, and only empirical information is available on the efficiency of plant preparations. This work evaluates the effects of fermented onion decoctions on the growth of Rhizoctonia solani and Sclerotium rolfsii and disease incidence. Broth (B) and sterilized broth (SB) were respectively obtained by boiling chopped yellow onions in water, and incubating for 14 days at room temperature, with or without subsequent sterilization. The pathogens were grown on PDA supplemented with B and SB at 1.7, 3.3, 8.3, 16.7 and 25% (v/v). Their growth was reduced by B at 8.3, 16.7 and 25%. Production of sclerotia by S. rolfsii was diminished by B, but stimulated by SB. Penicillium purpurogenum, P. simplicissimum and Aspergillus niger obtained from B behaved as antagonistic against both pathogens, showing antibiosis, competition and hyperparasitism in dual confrontations with them. Broth and SB at 10 and 50% were sprayed on chard (Beta vulgaris), tomato (Solanum lycopersicum), pepper (Capsicum annuum) and eggplant (Solanum melongena) seedlings cultivated in pathogen-colonized soil. Damping off incidence in B treatments at 50% was markedly lower than the observed for SB. It is concluded that B antifungal activity depends on its dilution and mycota. Broth sprays should be considered as a tool to control damping off in low-environment-impact crop production. Further studies are needed for a complete understanding of B chemical and microbiological components, as well as their changes during fermentation.El mal de los almácigos causa muerte de plántulas. Los controles cultural y biológico constituyen las únicas herramientas orgánicas para su manejo. Acerca de la eficiencia de preparaciones vegetales, sólo se encuentra información de divulgación. Este trabajo evalúa el efecto de caldos fermentados de cebolla sobre el crecimiento de Rhizoctonia solani y Sclerotium rolfsii y la incidencia de la enfermedad. Se obtuvieron caldo (B) y caldo esterilizado (SB), respectivamente, mediante hervido de trozos de cebollas y fermentación a temperatura ambiente, con o sin esterilización posterior. Se cultivaron los patógenos en APG suplementado con B y SB diluidos 1,7; 3,3; 8,3; 16,7 y 25%. Su crecimiento decreció con B al 8,3, 16,7 y 25%. La producción de esclerocios por S. rolfsii disminuyó con B, pero aumentó con SB. Penicillium purpurogenum, P. simplicissimum y Aspergillus niger aislados de B evidenciaron antibiosis, competencia e hiperparasitismo respecto de ambos patógenos. B y SB diluidos 10 y 50% fueron aplicados en almácigos de acelga (Beta vulgaris), tomate (Solanum lycopersicum), pimiento (Capsicum annuum) y berenjena (Solanum melongena) infestados. La pérdida de plántulas fue menor en el tratamiento con B al 50%, en relación al tratamiento con SB. Se concluye que la actividad antifúngica de B depende de su dilución y de su micota. La utilización de caldos de cebolla debería ser contemplada como alternativa para el manejo fitosanitario de bajo impacto ambiental. Se requiere continuar los estudios para completar el conocimiento acerca de los componentes químicos y microbiológicos de los caldos, y sus posibles cambios durante la fermentación.Fil: Rivera, Marta Carolina. Universidad de Buenos Aires. Facultad de Agronomia; ArgentinaFil: Wright, Eduardo Roberto. Universidad de Buenos Aires. Facultad de Agronomia; ArgentinaFil: Fabrizio, Maria del Carmen. Universidad de Buenos Aires. Facultad de Agronomia; ArgentinaFil: Freixá, G.. Universidad de Buenos Aires. Facultad de Agronomia; ArgentinaFil: Cabalini, R.. Universidad de Buenos Aires. Facultad de Agronomia; ArgentinaFil: Lopez, Silvia Edith. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Biodiversidad y Biología Experimental; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentin

Erectile Dysfunction in People with HIV – A Scoping Review

Objetivo: Exponer los factores que han sido asociados al desarrollo de disfunción eréctil (DE) en las personas con virus de la inmunodeficiencia humana (VIH) y cuál es la prevalencia de la disfunción eréctil en esta población. Métodos: Se realizó una revisión de alcance utilizando las siguientes bases de datos: MEDLINE, CENTRAL, Embase, Scopus, Lilacs, y Psycinfo. Los artículos incluidos debían tener cualquier información relacionada con la DE en personas con VIH, su prevalencia, y posibles factores asociados. Se filtraron un total de 2.726 artículos por título y resumen, y, de estos, se seleccionaron 22 referencias para revisión de texto completo y análisis. Resultados: Se encontró que las personas con VIH tienen una mayor probabilidad de presentar DE en comparación con las personas sin VIH. Algunos estudios han establecido una asociación entre la DE y trastornos psicológicos o factores orgánicos, como la lipodistrofia, la hipertensión arterial, la hipercolesterolemia, la diabetes mellitus, la depresión, la ansiedad, y el hipogonadismo. La ingesta de terapia antirretroviral (TARV), más específicamente los inhibidores de la proteasa, sigue siendo cuestionada como causante de DE en pacientes con VIH. Conclusiones: Ante un paciente con diagnóstico de VIH, se debe ahondar sobre DE con el fin de recomendar e iniciar conductas terapéuticas que aseguren un mejoramiento en su calidad de vida.Q4Hombres con Virus de la Inmunodeficiencia Humana (VIH)Aim: To present factors that have been associated with the development of erectile dysfunction (ED) in people with human immunodeficiency virus (HIV) and the frequency of erectile dysfunction among this population. Methods: We performed a scoping review on the following databases: MEDLINE, CENTRAL, Embase, Scopus, Lilacs, and Psycinfo. The articles included information related to ED in people with HIV, its frequency, and possible associated factors. A total of 2,726 articles were filtered by title and abstract, and, from these, 22 references were selected for full-text review and analysis. Results: People with HIV were found to be more likely to have ED compared to people without HIV. Some studies have established an association between ED and psychological disorders or organic factors, such as lipodystrophy, high blood pressure, hypercholesterolemia, diabetes mellitus, depression, anxiety, and hypogonadism. The intake of antiretroviral therapy (ART), more specifically protease inhibitors, continues to be questioned as a cause of ED in patients with HIV. Conclusions: In HIV-positive men, we recommend to actively seek ED in order to initiate therapeutic conducts that can ensure an improvement in their quality of life.https://orcid.org/0000-0002-1416-3201https://orcid.org/0000-0003-3355-2816https://orcid.org/0000-0002-2914-429Xhttps://orcid.org/0000-0002-0885-7960https://orcid.org/0000-0002-5895-3029Revista Nacional - IndexadaCN

Feminist Pedagogy in the STEM Research Laboratory: an Intersectional Approach

The research laboratory is a crucial and indispensable classroom for STEM education. It is where we practice science as a craft and test the ideas that awaken our curiosity, allowing us to create knowledge. It is also a space where challenges await and struggles are imminent. Thus, supporting mentees through their traineeship in a research lab requires an intersectional approach and lens to provide equitable mentorship and guidance. The concept of intersectionality, initially devised by Black feminist professor Kimberlé W. Crenshaw, can be employed to generate practices and frameworks that democratize laboratory culture and provide trainees with a space in which they shape the laboratory culture while helping them recognize their positionality. This critical commentary provides insights and experiences when incorporating feminist frameworks to sustain equitable working environments in the research lab setting, specifically in leading a research group composed predominantly of Puerto Rican women

Data-driven historical characterization of epilepsy-associated genes.

Many epilepsy-associated genes have been identified over the last three decades, revealing a remarkable molecular heterogeneity with the shared outcome of recurrent seizures. Information about the genetic landscape of epilepsies is scattered throughout the literature and answering the simple question of how many genes are associated with epilepsy is not straightforward. Here, we present a computationally driven analytical review of epilepsy-associated genes using the complete scientific literature in PubMed. Based on our search criteria, we identified a total of 738 epilepsy-associated genes. We further classified these genes into two Tiers. A broad gene list of 738 epilepsy-associated genes (Tier 2) and a narrow gene list composed of 143 epilepsy-associated genes (Tier 1). Our search criteria do not reflect the degree of association. The average yearly number of identified epilepsy-associated genes between 1992 and 2021 was 4.8. However, most of these genes were only identified in the last decade (2010–2019). Ion channels represent the largest class of epilepsy-associated genes. For many of these, both gain- and loss-of-function effects have been associated with epilepsy in recent years. We identify 28 genes frequently reported with heterogenous variant effects which should be considered for variant interpretation. Overall, our study provides an updated and manually curated list of epilepsy-related genes together with additional annotations and classifications reflecting the current genetic landscape of epilepsy

Sistema de enfoque basado en dos espejos elípticos y un espejo plano rotatorio para un radar a 300 GHz

A focusing system for a 300 GHz radar with two target distances (5m and 10m) is proposed, having 1cm resolution in both cases. The focusing system is based on a gaussian telescope scheme and it has been designed using gaussian beam quasi-optical propagation theory with a homemade Matlab analysis tool. It has been translated into a real focusing system based on two elliptical mirrors and a plane mirror in order to have scanning capabilities and validated using the commercial antenna software GRAS

Molecular cloning of the gene promoter encoding the human CaVγ2/Stargazin divergent transcript (CACNG2-DT): characterization and regulation by the cAMP-PKA/CREB signaling pathway

CaVγ2 (Stargazin or TARPγ2) is a protein expressed in various types of neurons whose function was initially associated with a decrease in the functional expression of voltage-gated presynaptic Ca2+ channels (CaV) and which is now known to promote the trafficking of the postsynaptic α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid receptors (AMPAR) towards the cell membrane. Alterations in CaVγ2 expression has been associated with several neurological disorders, such as absence epilepsy. However, its regulation at the transcriptional level has not been intensively addressed. It has been reported that the promoter of the Cacng2 gene, encoding the rat CaVγ2, is bidirectional and regulates the transcription of a long non-coding RNA (lncRNA) in the antisense direction. Here, we investigate the proximal promoter region of the human CACNG2 gene in the antisense direction and show that this region includes two functional cAMP response elements that regulate the expression of a lncRNA called CACNG2-DT. The activity of these sites is significantly enhanced by forskolin, an adenylate cyclase activator, and inhibited by H89, a protein kinase A (PKA) antagonist. Therefore, this regulatory mechanism implies the activation of G protein-coupled receptors and downstream phosphorylation. Interestingly, we also found that the expression of CACNG2-DT may increase the levels of the CaVγ2 subunit. Together, these data provide novel information on the organization of the human CACNG2-DT gene promoter, describe modulatory domains and mechanisms that can mediate various regulatory inputs, and provide initial information on the molecular mechanisms that regulate the functional expression of the CaVγ2 protein