Search

CONTEXT/OBJECTIVE: The standard approach is to perform repeat FNAB (rFNAB) in thyroid nodules with non-diagnostic (ND) / insufficient (UNS) cytology. However, due to the nature of these nodules, recurrent FNABs may also be insufficient. Therefore, by comparing the clinical-radiological-pathological parameters of nodules with a definite diagnosis of excision, we questioned the possibility of patient management without rFNAB. METHODS: Clinical-radiological parameters of 275 nodules belonging to 264 patients in the ND/UNS aspiration group with definite pathological diagnosis after surgery were determined. Under the guidance of these parameters, those with and without rFNAB were compared. RESULTS: The incidence of malignancy was found to be significantly higher in nodules without rFNAB compared to nodules with rFNAB (p = 0.036). In addition, the incidence of malignancy in BC-1 nodules without rFNAB was significantly higher than in nodules with rFNAB result also BC-1 (p = 0.009). In all cases, nodule size smaller than 10 mm and border irregularity were found to be statistically significant for malignancy (p

PURPOSE: The purpose of this study is to determine the clinical significance of incidental thyroid 18F-FDG PET/CT uptake in oncology patients with the focus achieving the most appropriate management of this challenging situation. MATERIALS AND METHOD: Two thousand five hundred and eighty 18F-FDG PET/CT studies performed at our institute in the past 4 years were retrospectively reviewed. Patients with incidental FDG uptake in the thyroid gland were further analysed. RESULTS: The prevalence of incidental FDG uptake in thyroid gland was 7.6% (129 patients). 26 patients (20.1%) had diffuse 18F-FDG PET/CT uptake, 103 patients (79.1%) had nodular uptake in thyroid gland. All diffuse uptake patients who were further examined diagnosed to be a benign condition. 53 patients in the nodular uptake group were further examined and the final histopathology examinations revealed an 18.8% malignancy rate. SUV max values ranged from 2 to 21.8 with a significant highness in malignant lesions. CONCLUSION: 18F-FDG PET/CT uptake in the thyroid gland may be diffuse or nodular. Diffuse uptake needs no further examination as it usually accompanied by benign thyroid disorders. Patients with nodular uptake whose general condition is good should be further examined due to high rates of malignancy.

COVID-19 has been called “a disaster for feminism” (Lewis in The coronavirus is a disaster for feminism, 2020) for numerous reasons. In this short piece, we make sense of this claim, drawing on intersectional feminism(s) to understand why an analysis that considers gender alone is inadequate to address both the risks and consequences of COVID-19.

Teilhard de Chardin developed an evolutionary vision of our planetary future, currently developing from a sphere of life, orbiospheretowards a sphere of mind, ornoosphere. As a visionary, Teilhard was not only on the brink of formulating the internet, but he also anticipated current academic efforts to understand globalization, as well as human, cultural and technological evolution. However, his ideas are sources of enduring controversies in both scientific and theological circles. Here I uncover some of the core reasons why his ways of thinking and writing are often problematic, and propose a way forward. This note aims to introduce Teilhard’s central article about the noosphere (The Formation of the Noosphere, 1947), but can also be read as an independent introduction to Teilhard’s system of thought. A detailed exegesis of Teilhard’s article is available as a supplementary document.

In this paper, we analyze some of the policies implemented by Mexico, a country that has not pursued a total lockdown, although it has implemented different partial confinement policies. Such approach to the confinement has been criticized by some authors as morally inappropriate. Our focus is to show that cultural, political and economic conditions shape the governmental response to the pandemic. While these can be judged on the basis of their efficiency, it seems to us that underlying principles are also ethically acceptable.

CONTEXT: SARS-CoV-2 infection was declared a pandemic in 2020 and affected millions of people worldwide. Angiotensin-converting enzyme-2 receptors, through which coronavirus enters the cells of different organs, have been detected in the thyroid gland. The most common cause of thyrotoxicosis is Graves’ disease in which thyroid-receptors antibodies (TRAb) stimulate the TSH receptor, increasing thyroid hormone production and release. CASE PRESENTATION: A 22-year-old woman had symptoms of palpitation, tremor, muscle weakness, anxiety and sleep disturbance. 3 weeks before the onset of these symptoms, the patient suffered from COVID-19, which lasted 14 days and was characterized by a course of moderate severity with fever up to 38(°)C, general weakness without shortness of breath. The patient had no pre-existing thyroid problems. Her TSH was

Research, innovation, and progress in the life sciences are increasingly contingent on access to large quantities of data. This is one of the key premises behind the “open science” movement and the global calls for fostering the sharing of personal data, datasets, and research results. This paper reports on the outcomes of discussions by the panel “Open science, data sharing and solidarity: who benefits?” held at the 2021 Biennial conference of the International Society for the History, Philosophy, and Social Studies of Biology (ISHPSSB), and hosted by Cold Spring Harbor Laboratory (CSHL).

Ageism has unfortunately become a salient phenomenon during the COVID-19 pandemic. In particular, triage decisions based on age have been hotly discussed. In this article, I first defend that, although there are ethical reasons (founded on the principles of benefit and fairness) to consider the age of patients in triage dilemmas, using age as a categorical exclusion is an unjustifiable ageist practice. Then, I argue that ageism during the pandemic has been fueled by media narratives and unfair assumptions which have led to an ethically problematic group homogenization of the older population. Finally, I conclude that an intersectional perspective can shed light on further controversies on ageism and triage in the post-pandemic future.

The COVID-19 pandemic poses extraordinary public health challenges. In order to respond to such challenges, most democracies have relied on so-called ‘evidence-based’ policies, which supposedly devolve to science the burden of their justification. However, the biomedical sciences can only provide a theory-laden evidential basis, while reliable statistical data for policy support is often scarce. Therefore, scientific evidence alone cannot legitimise COVID-19 public health policies, which are ultimately based on political decisions. Given this inevitable input on policy-making, the risk of arbitrariness is ubiquitous and democratic scrutiny becomes essential to counter it. During the COVID-19 pandemic, the standards of scientific and democratic scrutiny have been, as a matter of fact, substantially lowered. This erosion potentially damages democracy.

Although every emerging infectious disease occurs in a unique context, the behaviour of previous pandemics offers an insight into the medium- and long-term outcomes of the current threat. Where an informative historical analogue exists, epidemiologists and policymakers should consider how the insights of the past can inform current forecasts and responses.

This short paper aims to present some philosophical considerations about the relationship between credibility and the uses of evidence. The point of view regarding evidence and scientific and political decisions in this paper focuses on the current world situation of the COVID-19.

COVID-19 has revealed that science needs to learn how to better deal with the irreducible uncertainty that comes with global systemic risks as well as with the social responsibility of science towards the public good. Further developing the epistemological principles of new theories and experimental practices, alternative investigative pathways and communication, and diverse voices can be an important contribution of history and philosophy of science and of science studies to ongoing transformations of the scientific enterprise.

Ageing is one of the main risk factors for Covid-19. In this paper, we delineate four alternative conceptualisations of ageing, each of which determines different understandings of its causal role to the susceptibility to Covid-19 as well as to the severity of its symptoms and adverse health outcomes.

RNA is central to the COVID-19 pandemic—it shapes how the SARS Coronavirus 2 (SARS-CoV-2) behaves, and how researchers investigate and fight it. However, RNA has received relatively little attention in the history and philosophy of the life sciences. By analysing RNA biology in more detail, philosophers and historians of science could gain new and powerful tools to assess the current pandemic, and the biological sciences more generally.

The World Health Organization has issued international instructions for certification and classification (coding) of the coronavirus disease (COVID-19) as cause of death. Central to these instructions is the selection of the underlying cause of death for a public health preventive purpose. This article focuses on two rules for this selection: (1) that a death due to COVID-19 should be counted independently of pre-existing conditions that are suspected of triggering a severe course of COVID-19 and (2) that COVID-19 should not be considered as due to anything else. The article argues that observance of the first rule may not always lead to an optimal selection from a preventive point of view and that in the future the ascertainment of an animal source of the coronavirus (SARS-CoV-2) would make it possible to reconceptualize ‘COVID-19′ and create a zoonotic classification code by means of which a factor of a greater preventive value could be selected than what is currently possible.

Sitting on the fine line between pathogen ‘transmissibility’ and ‘severity’, the Behavioural Immune System (BIS) is responsible for activating behaviours that minimise infection risks and maximise fitness. To achieve self-preservation, the BIS also fuels social and political attitudes. We aim to explain societal changes that may be sparked by COVID-19 by highlighting links between human evolutionary history and our psychological faculties mediated by the BIS.

Three interdependent factors are behind the current Covid-19 pandemic distorted narrative: (1) science´s culture of “publish or perish”, (2) misinformation spread by traditional media and social digital media and (3) distrust of technology for tracing contacts and its privacy-related issues. In this short paper, I wish to tackle how these three factors have added up to give rise to a negative public understanding of science in times of a health crisis, such as the current Covid-19 pandemic and finally, how to confront all these problems.

I begin with my impressions of a narrative of redemption that is caught up in the formation of new environmental, social, and political aspirations for the aftermath of the COVID-19 pandemic. I then reflect on, first, pre-pandemic scholarship on “biosecurity” and, second, taking up a variation of the syndemic approach to understanding the COVID-19 pandemic. I end by arguing that we should not expect to live with “new normals” for living in a post-COVID-19 world that leaves intact “old normals” that have historically contributed to the rise of anthropogenic environmental harms and inegalitarian social arrangements in the world today.

The establishment of international sanitary institutions, which took place in the context of rivalry among the great European powers and their colonial expansion in Asia, allowed for the development of administrative systems of international epidemiological surveillance as a response to the cholera epidemics at the end of the nineteenth century. In this note, I reflect on how a historical analysis of the inception of international epidemiological surveillance and pandemic management helps us to understand what is happening in the COVID-19 pandemic today.

Calls for evidence-based approaches to COVID-19 have sparked up discussions on the use of evidence for policy. In this note, we expand these discussions: while the debate has mostly focused on the types of evidence to be used for policy, we argue that the assessment of judgments involved in data practices and evidence production should play a central role in evaluating policy.

Although fear and anxiety have gradually become a shared experience in the time of COVID-19, few studies have examined its content from historical, cultural, and phenomenological perspectives concerning the self-awareness and alterity. We discuss the development of the ubiquitous nature of Taijin-kyōfushō (TKS), a subtype of social anxiety disorder (SAD) originated and considered culturally-bound in the 1930s Japan involving fear of offending or displeasing other people. Considering the historical processes of disease classification, advances in cognitive neurosciences, and the need to better understand the content of suffering, psychiatric nosology for SAD still appears controversial and requires further investigations.

COVID-19 presents many challenges, both clinical and philosophical. In this paper we discuss a major lacuna that COVID-19 revealed in our philosophy and understanding of medicine. Whereas we have some understanding of how physician-scientists interrogate the world to learn more about medicine, we do not understand the epistemological costs and benefits of the various ways clinicians acquire new knowledge in their fields. We will also identify reasons this topic is important both when the world is facing a pandemic and when it is not.

The COVID-19 crisis has called into question the utilitarianism-oriented human-wildlife relations and the legitimacy of wildlife protection regime in China. The pandemic has triggered significant, swift, and encompassing changes in policies. Drawing on insights from historical institutionalism, we argue that COVID-19 constitutes a critical juncture in China’s wildlife protection policy.

Reluctance to endorse mask wearing to slow transmission of SARS-Cov-2 has been rationalized by the failure of randomized control trials (RCTs) to provide supportive evidence. In contrast, a mechanism-based approach suggests that mask wearing should be expected to reduce transmission: so that contrary evidence from RCTs likely reflects the need to focus policy attention on addressing interacting or mediating factors that offset the basic positive effect. The differing conclusions that result from these two approaches reflect the limitations of RCT-based approaches that are compounded in scenarios, such as pandemics, where urgent decisions are required with limited evidence.

How can we explain the divergence of social commitment to mass masking as public health measures in the global response to COVID-19? Rather than searching for deep-rooted cultural norms, this essay views the contemporary practice as a reenactment of multiple layers of accumulated socio-material conditions. This perspective will allow us to pursue a comparative study of the social history of mask-wearing around the world.

COVID-19 epidemic models raise important questions for science and philosophy of science. Here I provide a brief preliminary exploration of three: what kinds of predictions do epidemic models make, are they causal models, and how do different kinds of epidemic models differ in terms of what they represent?

As cases of COVID-19 continue to rise, some countries, including the US, Chile, and Germany, have considered issuing "immunity passports." This possibility has raised concerns and debate regarding their potential social, political and economic ramifications, especially for marginalized communities. This paper contributes to that debate by exposing that ways in which immunoprivilege already exists and operates within our present system of structural inequalities.

This note introduces a framework incorporating multiple sources of evidence into the response to COVID-19 to overcome the neglect of social and psychological causes of illness. By using the example of psychological research on loneliness and its effects on physical and mental health with particular focus on aging and disability, I seek to open further inquiry into how relevant psychological and social aspects of health can be addressed at policy level.

During the COVID-19 pandemic, blood and convalescent plasma donors are dearly needed. There is a need to modify donor recruitment strategies in order to stimulate these donors. Financial stimulants though, cannot be possibly used. This paper will analyze, from an ethical perspective, the possible consequences regarding the blood and plasma donor system by a simple shift of attention from the voluntary unpaid donor to the paid one or the blood seller.

The Covid-19 pandemic has intensified interest in animals with superior antiviral defences. I argue that the role of such animals in biomedical research contrasts with the role of disease models.

Even before it had been developed there had already been skepticism among the general public concerning a vaccine for COVID-19. What are the factors that drive this skepticism? While much has been said about how political differences are at play, in this article I draw attention to two additional factors that have not received as much attention: witnessing the fallibility of the scientific process play out in real time, and a perceived breakdown of the distinction between experts and non-experts.

In this short paper we analyse some paradoxical aspects of France’s Foucauldian heritage: (1) while several French scholars claim the COVID-19 pandemic is a perfect example of what Foucault called biopolitics, popular reaction instead suggests a biopolitical failure on the part of the government; (2) One of these failures concerns the government’s inability to produce reliable biostatistical data, especially regarding health inequalities in relation to COVID-19. We interrogate whether Foucaldianism contributed, in the past as well today, towards a certain myopia in France regarding biostatistics and its relation to social inequalities in health. One might ask whether this very data could provide an appropriate response to the Foucauldian question: What kind of governance of life is the pandemic revealing to us?

Many governments have seen digital health technologies as promising tools to tackle the current COVID-19 pandemic. A much-talked example in this context involves the recent deluge of digital contact tracing apps (DCT) aimed at detecting Covid-19 exposure. In this short contribution we look at the bio-political justification of this phenomenon and reflect on whether DCT apps constitute, as it is often argued, a serious potential breach of our right to privacy. Despite praising efforts attempting to develop legal and ethical frameworks for DCT apps' usage; we argue that such endeavours are not sufficient to tackle the more fundamental problem of mass surveillance, which will remain largely unaddressed unless we deal with the biopolitical arguments presented and resort to a technical and structural defence.

Seeing the entwinement of social and epistemic challenges through COVID, we discuss the perils of simplistic appeals to ‘follow the science’. A hardened scientism risks excarbating social conflict and fueling conspiracy beliefs. Instead, we see an opportunity to devise more inclusive medical knowledge practices through endorsing experiential knowledge alongside traditional evidence types.

Pandemics like COVID-19 confront us with decisions about life and death that come with great uncertainty, factual as well as moral. How should policy makers deal with such uncertainty? We suggest that rather than to deliberate until they have found the right course of action, they better do moral experiments that generate relevant experiences to enable more reliable moral evaluations and rational decisions.

A pandemic of misinformation is said to spread alongside the COVID-19 pandemic. The need to properly inform the public is stronger than ever in the fight against misinformation, but what ‘properly’ means in this context is a quite controversial issue. In what follows, I discuss the challenges we face in communicating COVID-19 health information to the public, with the aim to shed light on some ethical and policy issues emerging in science (communication) in times of crises. © 2021, Springer Nature Switzerland AG.

Agent-based models (ABMs) are one of the main sources of evidence for decisions regarding mitigation and suppression measures against the spread of SARS-CoV-2. These models have not been previously included in the hierarchy of evidence put forth by the evidence-based medicine movement, which prioritizes those research methods that deliver results less susceptible to the risk of confounding. We point out the need to assess the quality of evidence delivered by ABMs and ask the question of what is the risk that assumptions entertained in ABMs do not include all the key factors and make model predictions susceptible to the problem of confounding.

CONTEXT: Sodium-glucose co-transporter 2 inhibitors (SGLT2-I) are a new class of oral antidiabetic drugs. OBJECTIVE: Side effects of drugs are frequently encountered with increasing use in clinical practice. DESIGN/SUBJECTS AND METHODS: We present a case with an unidentified body odor that has not been described yet in the literature as an adverse effect of SGLT2-I. RESULTS: A 49-year-old female patient with Type 2 DM was applied to our clinic for routine control. She had been receiving sitagliptin/metformin 50/1000 mg b.i.d. Her fasting plasma glucose was 160 mg/dL and HbA1c was 8%. Empagliflozin 10 mg/day was added to therapy. The patient noticed that two weeks after starting empagliflozin treatment, she began to smell herself and felt a bad/foul odor was released from her body. The patient associated these complaints with the new drug(empagliflozin) stopped two weeks ago. She also stated that all these complaints had disappeared one week after stopping the medication and there were no complaints at the moment. CONCLUSIONS: Here we report an unidentified body odor as a potential empagliflozin-associated adverse event. There was a close temporal relationship between empagliflozin intake and the development and the occurrence of the described odor.

During the COVID-19 pandemic, scientific experts advised governments for measures to be promptly taken; they also helped people to understand the situation. They carried out this role in the face of a worldwide emergency, when scientific understanding was still underway. Public scientific disputes also arose, creating confusion among people. This article highlights the importance of experts' epistemic stance under these circumstances. It suggests they should embrace the intellectual virtue of epistemic humility, regulating their epistemic behavior and communication accordingly. In so doing, they would also favour the functioning of the broad network of knowledge-based experts, which is required to properly address all the aspects of the global pandemic.

This article discusses the role of human-created rules in our collective adapting to Covid-19 and our survival in its wake. Rules that make sense become institutionalised and play a dual role in our response to the pandemic: they provide a guide for individual behavior and they provide a mechanism for coordinating all our behaviors.

In the era of increasingly defined ontological insecurity and uncertainty driven by the ravages of COVID-19, urban informal settlement has emerged as a source of resilience. Indeed, the effects of a pandemic transcends its epidemiological characteristics to political economy and societal resilience. If resilience is the capacity of a system to adapt successfully to significant challenges that threaten the function or development of the human society, then ontological insecurity is about the lack of such capacity. Drawing on Keith Hartian's understanding of 'informality' of spaces, this policy brief attempts to identify and frame a research agenda for the future. The agenda would assist future researchers and policymakers provide responses that appropriately recognize groups and actors that define the urban informal space.