1,515 research outputs found

    Virtue perspectivism, externalism, and epistemic circularity

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    Virtue perspectivism is a bi-level epistemology according to which there are two grades of knowledge: animal and reflective. The exercise of reliable competences suffices to give us animal knowledge; but we can then use these same competences to gain a second-order assuring perspective, one through which we may appreciate those faculties as reliable and in doing so place our first-order (animal) knowledge in a competent second-order perspective. Virtue perspectivism has considerable theoretical power, especially when it comes to vindicating our external world knowledge against threats of scepticism and regress. Prominent critics, however, doubt whether the view ultimately hangs together without succumbing to vicious circularity. In this paper, I am going to focus on circularity-based criticisms of virtue perspectivism raised in various places by Barry Stroud, Baron Reed and Richard Fumerton, and I will argue that virtue perspectivism can ultimately withstand each of them

    Dynamic risk control by human nucleus accumbens

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    Real-world decisions about reward often involve a complex counterbalance of risk and value. Although the nucleus accumbens has been implicated in the underlying neural substrate, its criticality to human behaviour remains an open question, best addressed with interventional methodology that probes the behavioural consequences of focal neural modulation. Combining a psychometric index of risky decision-making with transient electrical modulation of the nucleus accumbens, here we reveal profound, highly dynamic alteration of the relation between probability of reward and choice during therapeutic deep brain stimulation in four patients with treatment-resistant psychiatric disease. Short-lived phasic electrical stimulation of the region of the nucleus accumbens dynamically altered risk behaviour, transiently shifting the psychometric function towards more risky decisions only for the duration of stimulation. A critical, on-line role of human nucleus accumbens in dynamic risk control is thereby established

    Elgin on understanding:How does it involve know-how, endorsement and factivity?

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    In Chapter 3 of True Enough, Elgin (2017) outlines her view of objectual understanding, focusing largely on its non-factive nature and the extent to which a certain kind of know-how is required for the “grasping” component of understanding. I will explore four central issues that feature in this chapter, concentrating on (1) the role of know-how, (2) the concept of endorsement, (3) Elgin’s critique of the factivity constraint on understanding, and (4) how we might use aspects of Elgin’s framework to inform related debates on the norm of assertion

    Sosa on Knowledge, Judgment and Guessing

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    In Chapter 3 of Judgment and Agency, Sosa (Judgment and Agency, 2015) explicates the concept of a fully apt performance. In the course of doing so, he draws from illustrative examples of practical performances and applies lessons drawn to the case of cognitive performances, and in particular, to the cognitive performance of judging. Sosa’s examples in the practical sphere are rich and instructive. But there is, I will argue, an interesting disanalogy between the practical and cognitive examples he relies on. Ultimately, I think the source of the disanalogy is a problematic picture of the cognitive performance of guessing and its connection to knowledge and defeat. Once this critical line of argument is advanced, an alternative picture of guessing, qua cognitive performance, is articulated, one which avoids the problems discussed, and yet remains compatible with Sosa’s broader framework

    Alcohol Production as an Adaptive Livelihood Strategy for Women Farmers in Tanzania and Its Potential for Unintended Consequences on Women's Reproductive Health.

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    Although women occupy a central position in agriculture in many developing countries, they face numerous constraints to achieving their full potential including unequal access to assets and limited decision-making authority. We explore the intersection of agricultural livelihoods, food and economic security, and women's sexual and reproductive health in Iringa Region, Tanzania. Our goal was to understand whether the benefits of supporting women in the agricultural sector might also extend to more distal outcomes, including sexual and reproductive health. Using the Sustainable Livelihoods Framework to guide data collection, we conducted 13 focus group discussions (FGD) with female (n = 11) and male farmers (n = 2) and 20 in-depth interviews with agricultural extension officers (n = 10) and village agro-dealers (n = 10). Despite providing the majority of agricultural labor, women have limited control over land and earned income and have little bargaining power. In response to these constraints, women adopt adaptive livelihood strategies, such as alcohol production, that allow them to retain control over income and support their households. However, women's central role in alcohol production, in concert with the ubiquitous nature of alcohol consumption, places them at risk by enhancing their vulnerability to unsafe or transactional sex. This represents a dangerous confluence of risk for female farmers, in which alcohol plays an important role in income generation and also facilitates high-risk sexual behavior. Alcohol production and consumption has the potential to both directly and indirectly place women at risk for undesirable sexual and reproductive health outcomes. Group formation, better access to finance, and engaging with agricultural extension officers were identified as potential interventions for supporting women farmers and challenging harmful gender norms. In addition, joint, multi-sectoral approaches from health and agriculture and alternative income-generating strategies for women might better address the complexities of achieving safe and sustainable livelihoods for women in this context

    High Sensitivity C Reactive Protein in Patients with Rheumatoid Arthritis Treated with Antibodies against IL-6 or Jak Inhibitors: A Clinical and Ultrasonographic Study

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    Background: We examined whether high-sensitivity CRP (hsCRP) reflected the inflammatory disease status evaluated by clinical and ultrasound (US) parameters in RA patients receiving IL-6 receptor antibodies (anti-IL-6R) or JAK inhibitors (JAKi). Methods: We conducted a cross-sectional study of patients with established RA receiving anti-IL-6R (tocilizumab, sarilumab) or JAKi (tofacitinib, baricitinib). Serum hsCRP and US synovitis in both hands were measured. Associations between hsCRP and clinical inflammatory activity were evaluated using composite activity indices. The association between hsCRP and US synovitis was analyzed. Results: 63 (92% female) patients (42 anti- IL-6R and 21 JAKi) were included, and the median disease duration was 14.4 (0.2–37.5) years. Most patients were in remission or had low levels of disease. Overall hsCRP values were very low, and significantly lower in anti-IL-6R patients (median 0.04 mg/dL vs. 0.16 mg/dL). Anti-IL-6R (82.4%) patients and 48% of JAKi patients had very low hsCRP levels (≤0.1 mg/dL) (p = 0.002). In the anti-IL-6R group, hsCRP did not correlate with the composite activity index or US synovitis. In the JAKi group, hsCRP moderately correlated with US parameters (r = 0.5) but not clinical disease activity, and hsCRP levels were higher in patients with US synovitis (0.02 vs. 0.42 mg/dL) (p = 0.001). Conclusion: In anti-IL-6R RA-treated patients, hsCRP does not reflect the inflammatory disease state, but in those treated with JAKi, hsCRP was associated with US synovitis

    Imaging Findings in Patients with Immune Checkpoint Inhibitor-Induced Arthritis

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    Immune checkpoint inhibitor (ICI)-induced arthritis is an increasingly recognized adverse event in patients with oncologic disease during immunotherapy. Four patterns are well described, including rheumatoid arthritis (RA)-like, polymyalgia rheumatica (PMR)-like, psoriatic arthritis (PsA)-like, and oligo-monoarthritis, among others. Despite better clinical recognition of these syndromes, information about the main imaging findings is limited. Methods: We conducted a retrospective observational study including all adult patients referred to the Rheumatology Department of a single-center due to ICI-induced arthritis who underwent imaging studies [ultrasound (US), magnetic resonance imaging (MRI), and (18)F-FDG PET/CT)] between January 2017 and January 2022. Results: Nineteen patients with ICI-induced arthritis with at least one diagnostic imaging assessment were identified (15 US, 4 MRI, 2 (18)F-FDG PET/CT). Most patients were male (84.2%), with a median age at inclusion of 73 years. The main underlying diagnoses for ICI treatment were melanoma in five cases. The distribution of ICI-induced arthritis was as follows: PMR-like (5, 26.2%), RA-like (4, 21.1%), PsA-like (4, 21.1%), and others (6, 31.6%). All RA-like patients had US findings indistinguishable from conventional RA patients. In addition, 3/5 (60%) of PMR-like patients had significant involvement of the hands and wrists. Abnormal findings on MRI or PET-CT were reported by clinical symptoms. No erosions or myofascitis were seen. Conclusions: ICI-induced arthritis patients present inflammatory patterns on imaging studies similar to conventional inflammatory arthropathies, and therefore these syndromes should be followed carefully and treated according to these findings

    An enhanced void-crack based Rousselier damage model for ductile fracture with the XFEM

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    This work presents a modelling strategy for ductile fracture materials by implementing the Rousselier damage model with the extended finite element method (XFEM). The implicit integration scheme and consistent tangent modulus based on a radial return mapping algorithm for this constitutive model are developed by the user-defined material subroutine UMAT in ABAQUS/Standard. To enhance the modelling of the crack development in the materials, the XFEM is used that allows modelling of arbitrary discontinuities, where the mesh does not have to be aligned with the boundaries of material interfaces. This modelling strategy, so-called Rousselier-UMAT-XFEM (RuX) model, is proposed to connect both concepts, which gives an advantage in predicting the material behaviour of ductile material in terms of voids and crack relation. This is the first contribution where XFEM is used in ductile fracture analysis for micromechanical damage problems. The results indicate that the RuX model is a promising technique for predicting the void volume fraction damage and crack extension in ductile material, which shows a good agreement in terms of stress–strain and force–displacement relationships
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