63 research outputs found

    Scientism recognizes evidence only of the quantitative/general variety

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    Rationale, aims and objectivesMcHugh and Walker introduced a model of knowledge to demonstrate that EBM is a form of scientism that ignores important sources of knowledge thereby impairing the practice of medicine. We study the development of this model and explore additional applications.MethodsReview of the relevant literature and identification of possible areas for fruitful application.ResultsWe show that the McHugh and Walker model is closely related to the model of evidence considered earlier by Upshur et al. We also indicate that the utility of this model is not limited to showing scientism distorts clinical practice. Several representative applications are identified, including psychotherapy, the Salk polio vaccine trial, and the placebo effect.ConclusionsPriority should be given to Upshur et al for the development of a model that has far‐reaching application to medical epistemology. It is shown that all four of the types of evidence considered—qualitative/personal, qualitative/general, quantitative/general, and quantitative/personal—are required to adequately characterize epistemology in medical research and practice.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/154650/1/jep13330_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/154650/2/jep13330.pd

    prM-reactive antibodies reveal a role for partially mature virions in dengue virus pathogenesis

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    Cleavage of the flavivirus premembrane (prM) structural protein during maturation can be inefficient. The contribution of partially mature flavivirus virions that retain uncleaved prM to pathogenesis during primary infection is unknown. To investigate this question, we characterized the functional properties of newly-generated dengue virus (DENV) prM-reactive monoclonal antibodies (mAbs) in vitro and using a mouse model of DENV disease. Anti-prM mAbs neutralized DENV infection in a virion maturation state-dependent manner. Alanine scanning mutagenesis and cryoelectron microscopy of anti-prM mAbs in complex with immature DENV defined two modes of attachment to a single antigenic site. In vivo, passive transfer of intact anti-prM mAbs resulted in an antibody-dependent enhancement of disease. However, protection against DENV-induced lethality was observed when the transferred mAbs were genetically modified to inhibit their ability to interact with FcÎł receptors. These data establish that in addition to mature forms of the virus, partially mature infectious pr

    Biodiversity of Fusarium species in Mexico associated with ear rot in maize, and their identification using a phylogenetic approach

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    Fusariumproliferatum, F. subglutinans, and F. verticillioides are known causes of ear and kernel rot in maize worldwide. In Mexico, only F. verticillioides and F. subglutinans, have been reported previously as causal agents of this disease. However, Fusarium isolates with different morphological characteristics to the species that are known to cause this disease were obtained in the Highland-Valley region of this country from symptomatic and symptomless ears of native and commercial maize genotypes. Moreover, while the morphological studies were not sufficient to identify the correct taxonomic position at the species level, analyses based in the Internal Transcribed Spacer region and the Nuclear Large Subunit Ribosomal partial sequences allowed for the identification of F. subglutinans, F. solani, and F. verticillioides, as well as four species (F. chlamydosporum, F. napiforme, F. poae, and F. pseudonygamai) that had not previously been reported to be associated with ear rot. In addition, F. napiforme and F. solani were absent from symptomless kernels. Phylogenetic analysis showed genetic changes in F. napiforme, and F. pseudonygamai isolates because they were not true clones, and probably constitute separate sibling species. The results of this study suggest that the biodiversity of Fusarium species involved in ear rot in Mexico is greater than that reported previously in other places in the world. This new knowledge will permit a better understanding of the relationship between all the species involved in ear rot disease and their relationship with maize

    Pavlovian Reward Prediction and Receipt in Schizophrenia: Relationship to Anhedonia

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    Reward processing abnormalities have been implicated in the pathophysiology of negative symptoms such as anhedonia and avolition in schizophrenia. However, studies examining neural responses to reward anticipation and receipt have largely relied on instrumental tasks, which may confound reward processing abnormalities with deficits in response selection and execution. 25 chronic, medicated outpatients with schizophrenia and 20 healthy controls underwent functional magnetic resonance imaging using a Pavlovian reward prediction paradigm with no response requirements. Subjects passively viewed cues that predicted subsequent receipt of monetary reward or non-reward, and blood-oxygen-level-dependent signal was measured at the time of cue presentation and receipt. At the group level, neural responses to both reward anticipation and receipt were largely similar between groups. At the time of cue presentation, striatal anticipatory responses did not differ between patients and controls. Right anterior insula demonstrated greater activation for nonreward than reward cues in controls, and for reward than nonreward cues in patients. At the time of receipt, robust responses to receipt of reward vs. nonreward were seen in striatum, midbrain, and frontal cortex in both groups. Furthermore, both groups demonstrated responses to unexpected versus expected outcomes in cortical areas including bilateral dorsolateral prefrontal cortex. Individual difference analyses in patients revealed an association between physical anhedonia and activity in ventral striatum and ventromedial prefrontal cortex during anticipation of reward, in which greater anhedonia severity was associated with reduced activation to money versus no-money cues. In ventromedial prefrontal cortex, this relationship held among both controls and patients, suggesting a relationship between anticipatory activity and anhedonia irrespective of diagnosis. These findings suggest that in the absence of response requirements, brain responses to reward receipt are largely intact in medicated individuals with chronic schizophrenia, while reward anticipation responses in left ventral striatum are reduced in those patients with greater anhedonia severity

    Socioeconomic determinants of organic cotton adoption in Benin, West Africa

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    Organic cotton relies on ecological processes and the use of natural resources to sustain the production system, unlike conventional cotton, mainly characterized by massive utilization of synthesis chemicals. In West Africa, where rural livelihoods are particularly vulnerable, organic cotton is expected to contribute not only to poverty reduction but also to strengthen households’ resilience. The objective of this study was to assess institutional and socioeconomic factors determining farmers’ decisions to adopt organic cotton. For this purpose, we applied a probit model on empirical data collected from producers of the Centre and the Northern parts of Benin. Overall, we found that organic cotton adoption is mainly determined by farmers’ socioeconomic characteristics, the physical distance between farm and house, and contact with extension and advisory services. Organic farming is more attractive to women compared to conventional farming. This because such type of cotton farming enables women to hold a separate cotton farm and thus increase their economic independence, whereas with the conventional system they depend mainly on the farm of the (male) head of the household. Older, less educated and low-income farmers who express environmental concern are more likely to adopt organic cotton. Subsequently, organic cotton should be considered as a prospective policy option to reach the poor and strengthen their livelihoods conditions while contributing to preserve the environment and natural resources. Furthermore, farmers who have their farm near home are more likely to adopt organic farming than those who have the farm far from their home. It also came out that organic farmers have more contacts with advisory and extension services. Finally, the study noted that there is still a need to enhance the extension system by: (1) exploring, designing, and upgrading innovative pedagogic tools such as videos and mobile phone technology to foster learning; and (2) strengthening organic farmer’s organizations and the linkage with agricultural research organizations for technology development

    Seropositivity to Cytomegalovirus, Inflammation, All-Cause and Cardiovascular Disease-Related Mortality in the United States

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    Studies have suggested that CMV infection may influence cardiovascular disease (CVD) risk and mortality. However, there have been no large-scale examinations of these relationships among demographically diverse populations. The inflammatory marker C-reactive protein (CRP) is also linked with CVD outcomes and mortality and may play an important role in the pathway between CMV and mortality. We utilized a U.S. nationally representative study to examine whether CMV infection is associated with all-cause and CVD-related mortality. We also assessed whether CRP level mediated or modified these relationships., 2006 (N = 14153) in the National Health and Nutrition Examination Survey (NHANES) III (1988–1994). Cox proportional hazard models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for all-cause and CVD-related mortality by CMV serostatus. After adjusting for multiple confounders, CMV seropositivity remained statistically significantly associated with all-cause mortality (HR 1.19, 95% CI: 1.01, 1.41). The association between CMV and CVD-related mortality did not achieve statistical significance after confounder adjustment. CRP did not mediate these associations. However, CMV seropositive individuals with high CRP levels showed a 30.1% higher risk for all-cause mortality and 29.5% higher risk for CVD-related mortality compared to CMV seropositive individuals with low CRP levels.CMV was associated with a significant increased risk for all-cause mortality and CMV seropositive subjects who also had high CRP levels were at substantially higher risk for both for all-cause and CVD-related mortality than subjects with low CRP levels. Future work should target the mechanisms by which CMV infection and low-level inflammation interact to yield significant impact on mortality

    Review of the projected impacts of climate change on coastal fishes in southern Africa

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    The coastal zone represents one of the most economically and ecologically important ecosystems on the planet, none more so than in southern Africa. This manuscript examines the potential impacts of climate change on the coastal fishes in southern Africa and provides some of the first information for the Southern Hemisphere, outside of Australasia. It begins by describing the coastal zone in terms of its physical characteristics, climate, fish biodiversity and fisheries. The region is divided into seven biogeographical zones based on previous descriptions and interpretations by the authors. A global review of the impacts of climate change on coastal zones is then applied to make qualitative predictions on the likely impacts of climate change on migratory, resident, estuarine-dependent and catadromous fishes in each of these biogeographical zones. In many respects the southern African region represents a microcosm of climate change variability and of coastal habitats. Based on the broad range of climate change impacts and life history styles of coastal fishes, the predicted impacts on fishes will be diverse. If anything, this review reveals our lack of fundamental knowledge in this field, in particular in southern Africa. Several research priorities, including the need for process-based fundamental research programs are highlighted
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