Sport-related concussion research agenda beyond medical science: culture, ethics, science, policy.

The Concussion in Sport Group guidelines have successfully brought the attention of brain injuries to the global medical and sport research communities, and has significantly impacted brain injury-related practices and rules of international sport. Despite being the global repository of state-of-the-art science, diagnostic tools and guides to clinical practice, the ensuing consensus statements remain the object of ethical and sociocultural criticism. The purpose of this paper is to bring to bear a broad range of multidisciplinary challenges to the processes and products of sport-related concussion movement. We identify lacunae in scientific research and clinical guidance in relation to age, disability, gender and race. We also identify, through multidisciplinary and interdisciplinary analysis, a range of ethical problems resulting from conflicts of interest, processes of attributing expertise in sport-related concussion, unjustifiably narrow methodological control and insufficient athlete engagement in research and policy development. We argue that the sport and exercise medicine community need to augment the existing research and practice foci to understand these problems more holistically and, in turn, provide guidance and recommendations that help sport clinicians better care for brain-injured athletes.

The indispensability of race in medicine.

A movement asking to take race out of medicine is growing in the US. While we agree with the necessity to get rid of flawed assumptions about biological race that pervade automatic race correction in medical algorithms, we urge caution about insisting on a blanket eliminativism about race in medicine. If we look at racism as a fundamental cause, in the sense that this notion has been introduced in epidemiological studies by Bruce Link and Jo Phelan, we must conclude that race is indispensable to consider, investigate, and denounce the health effects of multilevel racism, and cannot be eliminated by addressing more specific risk factors in socially responsible epidemiology and clinical medicine. This does not mean that realism about human races is vindicated. While maintaining that there are no human races, we show how it is that a non-referring concept can nonetheless turn out indispensable for explaining real phenomena.

A reconsideration of the role of self-identified races in epidemiology and biomedical research.

A considerable number of studies in epidemiology and biomedicine investigate the etiology of complex diseases by considering (self-identified) race as a relevant variable and focusing on the differences in risk among racial groups in the United States; they extensively draw on a genetic hypothesis--viz. the hypothesis that differences in the risk of complex diseases among racial groups are largely due to genetic differences covarying with genetic ancestry--that appears highly problematic in the light of both current biological evidence and the theory of human genome evolution. Is this reason for dismissing self-identified races? No. An alternative promising use of self-identified races exists, and ironically is suggested by those studies that investigate the etiology of complex diseases without focusing on racial differences. These studies provide a large amount of empirical evidence supporting the primacy of the contribution of non-genetic as opposed to genetic factors to the risk of complex diseases. We show that differences in race--or, better, in racial self-identification--may be critically used as proxies for differences in risk-related exposomes and epigenomes in the context of the United States. Self-identified race is what we need to capture the complexity of the effects of present and past racism on people's health and investigate risk-related external and internal exposures, gene-environment interactions, and epigenetic events. In fact patterns of racial self-identifications on one side, and patterns of risk-related exposomes and epigenomes on the other side, constantly coevolve and tend to match each other. However, there is no guarantee that using self-identified races in epidemiology and biomedical research will be beneficial all things considered: special attention must be paid at balancing positive and negative consequences.

Active and passive-touch during interpersonal multisensory stimulation change self-other boundaries.

In the "enfacement" illusion seeing an unfamiliar face being touched at the same time as one's own face evokes changes in self-face recognition. We investigated the contribution of proprioceptive and motor signals derived from self-generated actions in the sensory-driven malleability of self-other boundaries during the "enfacement" illusion. Changes in self-face recognition during active- and passive-touch interpersonal visuo-tactile stimulation were quantified by means of psychophysical and psychometric tasks. Active- and passive-touch evoked comparable changes in the categorical boundaries of self-other distinction, changing the extent to which the other is assimilated into the mental self-representation. Actively touching or simply feeling touch on one's own face with concurrent observed touch on someone else's face seems to elicit comparable changes in self-recognition, suggesting that afferent input might be sufficient for updating one's body-image, although some components of the experience of self-identification seem to be more affected by passive- than by active-touch.

The justification of race in biological explanation.

In medicine, racial differences are frequently presented as part of the best explanation of differences in the risk of diseases. The problem of using racial classification in biomedical research has become important because of its ethical consequences in society. However, the biological relevance of the concept of race cannot be established by any ethical argument and the epistemological role of racial categorisation requires clarification. In this paper, different issues related to the concept of race are considered. This paper analyses the semantic problem concerning the definition of race, considers the ontological problem of race, drawing attention to the biological evidence for genetic differences among human groups, and presents a promising epistemological approach to the problem of race. The purpose of the paper is to examine whether, or when, racial categories belong in biological explanations. It shows that the concept of race cannot be justified in biology because it does not lead to successful predictions, and that genetic discontinuities are sufficient to explain differences in diseases but not needed in the explanation. The biomedical field should search for genetic patterns related to diseases, and should not assume racial discontinuities among human groups and use racial clusters as proxies for undetected genetic patterns.

Visual judgments of kinship: an alternative perspective.

Following other researchers, we investigated the premise that visual judgment of kinship might be modelled as a signal-detection task, strictly related to similar facial features. We measured subjects' response times to face-pair stimuli while they performed visual judgments of kinship, similarity, or dissimilarity, and examined some priming effects involved. Our results show that kinship judgment takes longer on average than either similarity or dissimilarity judgment-which is compatible with existing models, yet might also suggest that kinship judgments are of a more complex character. In our priming study we observed selective suppression/enhancement of the efficacy of dissimilarity judgments whenever they followed similarity and kinship judgments. This finding confounds the notion, inherent in previous models, of resemblance cues signalling for kinship, since similarity and dissimilarity cannot be considered just as opposite concepts, and observed priming effects need to be explicitly modelled, including dissimilarity cues. To model kinship judgments across faces that are perceived as dissimilar, a new framework may be required, perhaps accepting the perspective of a task-driven use of the visual cues, modulated by experience and cultural conditioning.

Clustering humans: on biological boundaries.

We inquire into the notions of 'boundary' and 'cluster' in the fields of medical genetics, pharmacogenetics, and population genetics. First we show that the two notions are not well discussed in literature. Then we propose a promising explication of them, in which we argue that clustering is always 'property laden', that is, fundamentally dependent on decisions about the properties to be taken into account. In particular we suggest three different kinds of properties (main properties, investigating properties, and catalyzing properties) that have a role in these decisions. That is, we conclude that boundaries and clusters among humans depend on our way of considering nature. Concepts of 'race' and 'ethnic group' are discussed too, since they are the most used clusters among humans.