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The application of recycled aggregate as a sustainable material in construction projects is considered a promising approach to decrease the carbon footprint of concrete structures. Prediction of compressive strength of environmentally friendly concrete containing recycled aggregate is important for understanding sustainable structures’ concrete behaviour. In this research, the capability of the deep learning neural network approach is examined on the simulation of CS of EF concrete. The developed approach is compared to the well-known artificial intelligence approaches named multivariate adaptive regression (...) spline, extreme learning machines, and random forests. The dataset was divided into three scenarios 70%-30%, 80%-20%, and 90%-10% for training/testing to explore the impact of data division percentage on the capacity of the developed AI model. Extreme gradient boosting was integrated with the developed AI models to select the influencing variables on the CS prediction. Several statistical measures and graphical methods were generated to evaluate the efficiency of the presented models. In this regard, the results confirmed that the DLNN model attained the highest value of prediction performance with minimal root mean squared error. The study revealed that the highest prediction performance could be attained by increasing the number of variables in the prediction problem and using 90%-10% data division. The results demonstrated the robustness of the DLNN model over the other AI models in handling the complex behaviour of concrete. Due to the high accuracy of the DLNN model, the developed method can be used as a practical approach for future use of CS prediction of EF concrete. (shrink)

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Afferent feedback can appreciably alter the pharyngeal phase of swallow. In order to measure the stability of the swallow motor pattern during several types of alterations in afferent feedback, we assessed swallow during a conventional water challenge in four anesthetized cats, and compared that to swallows induced by fixed (20 Hz) and stochastic (1-20Hz) electrical stimulation applied to the superior laryngeal nerve. The swallow motor patterns were evaluated by electromyographic activity (EMG) of eight muscles, based on their functional significance: laryngeal (...) elevators (mylohyoid, geniohyoid, and thyrohyoid); laryngeal adductor (thyroarytenoid); inferior pharyngeal constrictor (thyropharyngeus); upper esophageal sphincter (cricopharyngeus); and inspiratory activity (parasternal and costal diaphragm). Both the fixed and stochastic electrical stimulation paradigms increased activity of the laryngeal elevators, produced short-term facilitation evidenced by increasing swallow durations over the stimulus period, and conversely inhibited swallow-related diaphragm activity. Both the fixed and stochastic stimulus conditions also increased specific EMG amplitudes, which never occurred with the water challenges. Stochastic stimulation increased swallow excitability, as measured by an increase in the number of swallows produced. Consistent with our previous results, changes in the swallow motor pattern for pairs of muscles were only sometimes correlated with each other. We conclude that alterations in afferent feedback produced particular variations of the swallow motor pattern. We hypothesize that specific SLN feedback might modulate the swallow central pattern generator during aberrant feeding conditions (food/liquid entering the airway), which may protect the airway and serve as potentially important clinical diagnostic indicators. (shrink)

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Quantitative assessments of when infectious disease outbreaks end are crucial, as resources targeted towards outbreak responses typically remain in place until outbreaks are declared over. Recent improvements and innovations in mathematical approaches for determining when outbreaks end provide public health authorities with more confidence when making end-of-outbreak declarations. Although quantitative analyses of outbreaks have a long history, more complex mathematical and statistical methodologies for analysing outbreak data were developed early in the 20th century and continue to be refined. Historically, such (...) methodologies focused primarily on factors affecting the early and middle phases of an outbreak, with less attention given to determining how and when outbreaks end. This review discusses mathematical modelling methods from the last 20 years that have been developed for determining the ends of infectious disease outbreaks, and considers factors that affect the accuracy of such determinations. When disease surveillance systems provide timely and representative data to inform models, the timings of end-of-outbreak declarations can be fine-tuned to allow outbreaks to be declared over quickly and with a low risk of being incorrect. Premature declarations that outbreaks are over can undermine earlier achievements in disease control and may result in a resurgence of cases, but unnecessary delays in declaring outbreaks over can cause significant economic and social harm. Appropriate declarations that balance the benefits of relaxing control measures against the risk of a surge in cases allow public health resources to be conserved (and economic and social pressures to be reduced) while limiting the potential for additional transmission. (shrink)

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OBJECTIVE: To report and analyse the pattern of end-of-life decision making for terminal Chinese cancer patients. DESIGN: Retrospective descriptive study. SETTING: A cancer clinical trials unit in a large teaching hospital. PATIENTS: From April 1992 to August 1997, 177 consecutive deaths of cancer clinical trial patients were studied. MAIN MEASUREMENT: Basic demographic data, patient status at the time of signing a DNR consent, or at the moment of returning home to die are documented, and circumstances surrounding these events evaluated. RESULTS: (...) DNR orders were written for 64.4% of patients. Patients in pain (odds ratio 0.45, 95% CI 0.22-0.89), especially if requiring opioid analgesia (odds ratio 0.40, 95% CI 0.21-0.77), were factors associated with a higher probability of such an order. Thirty-five patients were taken home to die, a more likely occurrence if the patient was over 75 years (odds ratio 0.12, 95% CI 0.04-0.34), had children (odds ratio 0.14, 95% CI 0.02-0.79), had Taiwanese as a first language (odds ratio 6.74, 95% CI 3.04-14.93), or was unable to intake orally (odds ratio 2.73, 95% CI 1.26-5.92). CPR was performed in 30 patients, none survived to discharge. CONCLUSIONS: DNR orders are instituted in a large proportion of dying Chinese cancer patients in a cancer centre, however, the order is seldom signed by the patient personally. This study also illustrates that as many as 20% of dying patients are taken home to die, in accordance with local custom. (shrink)

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The authors conducted a baseline survey of baccalaureate and graduate degree health humanities programs in the United States and Canada. The object of the survey was to formally assess the current state of the field, to gauge what kind of resources individual programs are receiving, and to assess their self-identified needs to become or remain programmatically sustainable, including their views on the potential benefits of program accreditation. A 56-question baseline survey was sent to 111 institutions with baccalaureate programs and 20 (...) institutions with graduate programs. Respondents were asked about three areas: (1) program administration (managing unit, paid director, faculty lines, paid staff, funding sources); (2) educational program (curricular structure, CIP code usage, completion rates); and (3) views on accreditation for the field. A clear majority of respondents agreed that some form of accreditation or consultation service could address resource and sustainability issues. Overall, the survey responses to staffing, curricular structure, and support suggest the need for developing a sustainable infrastructure for health humanities. (shrink)

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Abstract: Retama raetam (RR) is a traditional medicinal plant belongs to fabaceae family which grows in North Africa and East Mediterranean region. Locally, RR is used in several diseases including diabetes mellitus and hypertension. Thus, this study aims to investigate certain behavioral and central effects of methanolic extract of RR seeds in experimental animals (male Albino adult mice of 20 – 35 gm). Three exploratory behavioral models are used in this study, open field, elevated plus maze and light-dark box models, (...) in addition, picrotoxin induced seizure model in mice. In elevated plus-maze test of anxiety, a dose of 25 mg/kg of RR induced a significant increase in number of open arms entries and time spent on open arms of the maze compared to the control. In light-dark model, time spent on light area and number of light-dark transitions are significantly increased after treatment with 25 mg/kg RR extract of seeds. Open field model also revealed a significant increase in general motor activity of the mouse after 25 mg/kg of RR. On the other hand, a dose of 50 mg/kg of RR significantly induced a profound central and peripheral analgesic responses. In summary, this study concludes that RR seeds have a profound anxiolytic-like effect and analgesic response with delay in latency time of seizure induced by picrotoxin in mice. (shrink)

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A line of research is emerging investigating the private sector impacts and dependencies on critical biodiversity and ecosystem services, and related business risks and opportunities. While the ecosystem services narrative is being forwarded globally as a key paradigm for promoting business sustainability, there is scarce knowledge of how these issues are considered at managerial level. This study thus investigates managerial views of corporate sustainability after the ecosystem services concept. We analyse interviews conducted with 20 managers from domestic and international forestry (...) companies operating with a plantation-based business model in China. Content analysis was employed to analyse the data, with a focus on four key areas: interviewee familiarity with the ecosystem services concept; their views of corporate dependencies and impacts on ecosystem services; related business risks and opportunities; and viability of existing instruments and practices that can be employed in detecting and addressing business impacts and dependencies on ecosystem services. Through an inductive approach to the empirical findings, we refined a framework that holds operational value for developing company response strategies to ecosystem services impact/dependence assessment, ensuring that all issues are addressed comprehensively, and that related risks and opportunities are properly acknowledged. (shrink)

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We report the identification of a recurrent, 520-kb 16p12.1 microdeletion associated with childhood developmental delay. The microdeletion was detected in 20 of 11,873 cases compared with 2 of 8,540 controls and replicated in a second series of 22 of 9,254 cases compared with 6 of 6,299 controls. Most deletions were inherited, with carrier parents likely to manifest neuropsychiatric phenotypes compared to non-carrier parents. Probands were more likely to carry an additional large copy-number variant when compared to matched controls. The clinical (...) features of individuals with two mutations were distinct from and/or more severe than those of individuals carrying only the co-occurring mutation. Our data support a two-hit model in which the 16p12.1 microdeletion both predisposes to neuropsychiatric phenotypes as a single event and exacerbates neurodevelopmental phenotypes in association with other large deletions or duplications. Analysis of other microdeletions with variable expressivity indicates that this two-hit model might be more generally applicable to neuropsychiatric disease. © 2010 Nature America, Inc. All rights reserved. (shrink)

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Context. The identification of the sources that reionized the Universe and their specific contribution to this process are key missing pieces of our knowledge of the early Universe. Faint star-forming galaxies may be the main contributors to the ionizing photon budget during the epoch of reionization, but their escaping photons cannot be detected directly due to inter-galactic medium opacity. Hence, it is essential to characterize the properties of faint galaxies with significant Lyman continuum photon leakage up to z 4 to (...) define indirect indicators allowing analogues to be found at the highest redshift. Aims. Long gamma-ray bursts explode typically in star-forming regions of faint, star-forming galaxies. Through LGRB afterglow spectroscopy it is possible to detect directly LyC photons. Our aim is to use LGRBs as tools to study LyC leakage from faint, star-forming galaxies at high redshift. Methods. Here we present the observations of LyC emission in the afterglow spectra of GRB 191004B at z = 3:5055, together with those of the other two previously known LyC-emitting LGRB, to determine their LyC escape fraction and compare their properties. Results. From the afterglow spectrum of GRB 191004B we determine a neutral hydrogen column density at the LGRB redshift of og =17:2 0:15, and negligible extinction. The only metal absorption lines detected are C iv and Si iv. In contrast to GRB 050908 and GRB 060607A, the host galaxy of GRB 191004B displays significant Ly emission. From its Ly emission and the non-detection of Balmer emission lines we constrain its star-formation rate to 1 SFR 4:7 M yr. 1. We fit the Ly emission with a shell model and find parameters values consistent with the observed ones. The absolute LyC escape fractions we find for GRB 191004B, GRB 050908 and GRB 060607A are of 0:35+0:10.0:11, 0:08+0:05.0:04 and :20+0:05.0:05, respectively. We compare the LyC escape fraction of LGRBs to the values of other LyC emitters found from the literature, showing that LGRB afterglows can be powerful tools to study LyC escape for faint high-redshift star-forming galaxies. Indeed we could push LyC leakage studies to much higher absolute magnitudes. The host galaxies of the three LGRB presented here have all M1600 >.19:5 mag, with the GRB 060607A host at M1600 >.16 mag. LGRB hosts may therefore be particularly suitable for exploring the ionizing escape fraction in galaxies that are too faint or distant for conventional techniques. Furthermore the time investment is very small compared to galaxy studies. (shrink)

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We report specific heat and μSR measurements on Th and/or B substituted UBe13. The specific heat data show that either Th or B substitution reduces the Kondo temperature TK and increases the entropy at the superconducting transition by almost 20%, indicating an enhanced density of states. However, whereas μSR shows clear evidence for magnetic correlations for Th substitutions, no magnetism is observed for B substitutions. The enhanced specific heat jump in the B-substituted material is associated with a change in the (...) superconducting properties as TK is reduced. (shrink)

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An overview of 20 years of environmental philosophy in the Netherlands.

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BackgroundSchool based running programmes, such as The Daily Mile™, positively impact pupils’ physical health, however, there is limited evidence on psychological health. Additionally, current evidence is mostly limited to examining the acute impact. The present study examined the longer term impact of running programmes on pupil cognition, wellbeing, and fitness.MethodData from 6,908 school pupils, who were participating in a citizen science project, was examined. Class teachers provided information about participation in school based running programmes. Participants completed computer-based tasks of inhibition, (...) verbal and visual-spatial working memory, as well as the Children’s Feeling scale and Felt arousal scale to determine subjective wellbeing. A multistage 20-m shuttle run test was used to estimate fitness.ResultsFrom our total sample of 6,908 school pupils, 474 participants had been taking part in a running programme for 3 months); and 5,430 did not take part in a running programme. The Longer Term participation group had higher fitness levels than both other groups and this remained significant when adjusted for age, sex and SES. Moderated regression analysis found that for the Shorter Term participation group, higher shuttle distance was associated with better visual-spatial working memory. Effect sizes were small though.ConclusionWe identified small and selective positive impact of participation in school based running programmes on fitness and cognition. While no long term benefit was identified for cognition or wellbeing, the impact on fitness and short term benefit suggest schools should consider participation. (shrink)

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Amaç: Kanserle yaşayan bireylerin (KYB) bakımında, resmiyette görünür olmayan ve çoğunlukla herhangi bir profesyonel donanıma sahip olmayan, ama sürecin başından sonuna, hasta bireye eşlik eden bakım verenler kritik öneme sahiptir. Baş etmesi zor bir hastalık olan kanserle mücadele eden bireylerin bakımında, bakım verenler fiziksel, zihinsel ve sosyal birtakım zorluklarla karşılaşmaktadır. Bu araştırma, KYB’lere bakım veren, yakınlarının karşılaştıkları zorlukları gündeme getirmeyi ve ihtimam etiği perspektifinden, bakım verenlerin bakımına yönelik öneriler sunmayı amaçlamaktadır. Gereç ve Yöntem: Bu araştırma tanımlayıcı ve kesitsel olup araştırmanın (...) evreni Marmara Üniversitesi Pendik Eğitim ve Araştırma Hastanesi (MÜPEAH) Onkoloji kliniğinde takip edilen, 15 Mart-5 Nisan tarihleri arasında kemoterapi ünitesine ve servis hizmetlerine başvuran KYB’lerin bakım veren yakınlarıdır. KYB’lere bakım verenlerin umutsuzluk derecelerini tespit etmek ve bunu etkileyen faktörleri ölçmek için, veri toplama aracı olarak; sosyodemografik sorular, bakım alan bireyin hastalık derecesine yönelik sorular ve Beck Umutsuzluk Ölçeği sorularından oluşan bir anket elden dağıtılmıştır. Anket bakım verene yönelik sosyodemografik sorular 8, KYB’nin hastalığının durumu ile ilgili sorular 7, Beck Umutsuzluk Ölçeği 20 olmak üzere 35 sorudan oluşmaktadır ve yaklaşık 10 dakikada tamamlanmaktadır. Elde edilen veriler önce Microsoft Excel aracılığıyla dijitalleştirilmiş, ardından IBM SPSS 27.0.1 sürümüyle analiz edilmiştir. Verilerin analizinde Ki-kare, Fisher’s Exact testi ve Pearson Korelasyon analizi kullanılmış, istatistiksel anlamlılık değeri için p<0.05 kabul edilmiştir. Bulgular: Ankete katılan 151 bakım verenin 83’ü (%55,3) kadın, 67’si (%44,7) erkektir. Katılımcıların yaş ortalaması 40,09’dur. Bakım verenlerin %41,1’i umutsuzluk düzeyi ölçeğinde “minimal ya da yok”, %39,7'si "hafif düzeyde", %13.2'si orta düzeyde ve %6’sı “aşırı düzeyde” skorunu almıştır. KYB’lere bakım verenlerin demografik özellikleri ile umutsuzluk düzeyi arasında anlamlı bir ilişki bulunmamıştır. Bakım verenlerin yaşı, cinsiyeti, medeni durumu, gelir durumu ve bakım verme süresi ile umutsuzluk skorları arasında anlamlı bir ilişki bulunmazken, eğitim seviyesi ile umutsuzluk skorları arasında anlamlı bir ilişki bulunmuştur. (p=0,019). Sonuç: Bakım verenlerin, umutsuzluk düzeyleri göz önüne alındığında, önemli psikolojik yükler taşıdığına ve bu yükün, özellikle bakım verenin eğitim seviyesi ile hastanın sağlık durumu arasında belirgin ilişkiler gösterdiğine ulaşılmıştır. Bu bilgiler ışığında, sosyodemografik özelliklerin bakım verenleri önemli ölçüde etkilediği görülmüştür. Bakım verenlerin duygusal yükleri, bakım alıcılarla olan ilişkileri ve bu sürecin hem bireysel hem toplumsal düzeyde getirdiği zorluklar ve sorumluluklar, ihtimam etiği kapsamında ele alınmıştır. Araştırma neticesinde bakım verenlerin karşılaştığı zorluklar ve ihtiyaçlarının daha geniş bir toplumsal ve etik perspektiften ele alınmasının gerekliliği ortaya konmuştur. Bakım verenlerin bakımına yönelik öneriler, duygusal destek; teorik eğitim ve bilgilendirme desteği; pratik ve uygulamalı destek; kaynak erişimi ve tahsisi; tanıma ve doğrulama başlıkları altında sunulmuştur. (shrink)

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Diyanet İşleri Başkanlığı teşkilatı kurumsal olarak Türk medyasında en çok tartışılan kurumlar arasında yer almaktadır. Bu çerçevede Diyanet teşkilatının kamuoyunda nasıl algılandığı ve nasıl bir imaja sahip olduğu önem arz etmektedir. Çalışmada köşe yazarlarının yazdığı yazılar üzerinden Diyanet İşleri Başkanlığı’nın imajının medyada nasıl algılandığı araştırılmıştır. Nicel içerik analizi yönteminin kullanıldığı çalışmada iki aşamalı akış kuramı temelinde köşe yazarları kanaat önderi olarak ele alınmıştır. Araştırma, 2013-2022 yıllarını kapsayan 10 yıllık bir veri setinde kota örneklemesi ve maksimum çeşitlilik örneklemesi uygulanarak Diyanet İşleri (...) Başkanlığı’nı en çok konu edinen 20 yayın organı üzerinden gerçekleştirilmiştir. Çalışmanın bulgularına göre kurumun genel imajına bakıldığında köşe yazılarında Diyanet İşleri Başkanlığı’nın olumsuz olarak algılandığı belirlenmiştir. Türkiye’deki siyasi kutuplaşmanın bir yansıması olarak Diyanet kurumuna bakış açısı da keskinleşmektedir. Diyanet’in yaygın eğitim anlamında topluma ulaşma araçlarından olan hutbe ve vaazların, diğer taraftan sosyal hayatı din ölçeğinde yorumlama ve yönlendirme işlevi olan fetva mekanizmasının çıktılarının olumsuz algılanması yaygın din eğitiminde kullanılan din dili ve gündelik ihtiyaçlar ile dinî metinler arasındaki uyumu sağlama konusunda uygulanan yöntemlerin gözden geçirilmesi gerektiğini göstermektedir. Cinsiyet dağılımı ve temaların ele alınış biçimi bakımından Diyanet hakkında kaleme alınan yazılarda erkek egemen bir bakış açısının hâkim olduğu belirtilebilir. Bu durum, din merkezli tartışmalara da eril bir söylem ve yorumun hâkim olduğu şeklinde yorumlanabilir. Yazılar incelendiğinde Diyanet kurumunun ekonomik faaliyetleri de olumsuz olarak algılanmaktadır. Yayın organlarının Diyanet’e bakış açılarının genel olarak ideolojik eksende değil siyasi eksende farklılaştığı görülmektedir. (shrink)

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Kur’an-ı Kerim, dili ve üslubu açısından diğer kitaplardan farklı bir özelliğe sahip olması münasebetiyle hicrî ilk asırdan itibaren çeşitli araştırmalara konu olmuştur. Özellikle kime veya neye delalet ettiği belirsiz olan müphem hususların ve zamirlerin tayininde tefsirin sistemleşme döneminden itibaren eserler telif edilmiştir. Söz konusu belirsizlikler, tefsir ilminin gelişim sürecinden sistemleşme dönemine kadar özel bir ilgi alanı olarak ortaya çıkmış ve tarihi süreç içerisinde artan bir ilgi görmüştür. Ancak, bu alandaki araştırmaların daha sağlıklı sonuçlar verebilmesi için klasik yöntem ve kaynakların yanında (...) bağlamsal bilgiyi dikkate alan yöntemler ve okumalar da gereklidir. Kur’an ilimlerinde müphem hususların konusu olan zamirlerin mercii sorunu da bu çerçevede ele alınabilir. Araştırmamızın konusunu oluşturan Bakara sûresinin 146. ayeti ve En‘âm sûresinin 20. ayetinde bulunan zamirlerdeki belirsizlik bu konudaki örnekler arasında sayılabilir. Her iki ayetin de bizim araştırmamıza konu olan kısmı, aynı ifadelerle zikredilmektedir. Bu ayetlerdeki müphemlik, Ehl-i kitabın kendi evlatlarını bildikleri gibi aynı şekilde tanıyıp bildikleri şeyin belirsizliğidir. Mealen “Onu çok iyi bilmektedirler” ifadesinde geçen zamirin tam olarak neye atıfta bulunduğu konusunda müfessirler arasında farklı görüşler ve gerekçelendirmeler ortaya çıkmıştır. Bu görüşlerin ve yorumların dayanakları, tefsir geleneğinde bir taraftan müphemlik kültürünün mümkün kıldığı anlam zenginliğine katkıda bulunurken, diğer taraftan tercih zorluğunu ortaya çıkaran ikilemlere neden olmuştur. Çalışmada, müfessirlerin zamirlerin referans noktasına dair görüşleri sadece sınıflandırılmakla yetinilmemiş, aynı zamanda Bakara ve En‘âm sûrelerinde geçen söz konusu ifadelerin aynı manaya gelme imkanı tartışılmıştır. Zira zikredilen zamirlerin içerisinde bulunduğu her iki ayet de aynı ifadelerden oluşmaktadır. Lafzî müteşâbih olarak adlandırılan bu durum, zamirlerin de aynı mercii karşılayabileceği ihtimalini barındırmaktadır. Bu yüzden makalede müfessirlerin görüşleri tercihlerin gerekçeleri bakımından da incelenmektedir. Aynı şekilde tefsir kitâbiyatında var olan bu görüşler, müfessirlerin kronolojisi dikkate alınarak liste halinde sunulmuştur. Bu sayede zamirlerin anlamına dair tercihlerde tefsir tarihinin farklı dönemlerinde kronolojik değişimlerin var olup olmadığı ortaya konulmuştur. Ayrıca zamirlerin isnadının belirlenmesinde ya da ihtilafları oluşturan görüşlerin gerekçelendirilmesinde bağlamsal bilgilerin nasıl bir rol oynadığı da örneklerle ele alınmaktadır. Bu sayede çalışmada genelde Kur’an’ı anlamada daha özelde ise zamirlerin isnadının tespitinde bağlam bilgisinin fonksiyonu somut bir şekilde görülebilecektir. (shrink)

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BackgroundObtaining informed consent for intravenous thrombolysis in acute ischemic stroke can be challenging, and little is known about if and how the informed consent procedure is performed by neurologists in clinical practice. This study examines the procedure of informed consent for intravenous thrombolysis in acute ischemic stroke in high-volume stroke centers in the Netherlands.MethodsIn four high volume stroke centers, neurology residents and attending neurologists received an online questionnaire concerning informed consent for thrombolysis with tissue-type plasminogen activator (tPA). The respondents were (...) asked to report their usual informed consent practice for tPA treatment and their considerations on whether informed consent should be obtained.ResultsFrom the 203 invited clinicians, 50% (n = 101) completed the questionnaire. One-third of the neurology residents (n = 21) and 21% of the neurologists (n = 8) reported that they always obtain informed consent for tPA treatment. If a patient is not capable of providing informed consent, 30% of the residents (n = 19) reported that they start tPA treatment without informed consent. In these circumstances, 53% of the neurologists (n = 20) reported that the resident under their supervision would start tPA treatment without informed consent. Most neurologists (n = 21; 55%) and neurology residents (n = 45; 72%) obtained informed consent within one minute. None of the respondents used more than five minutes for informed consent. Important themes regarding obtaining informed consent for treatment were patients’ capacity, and medical, ethical and legal considerations.ConclusionThe current practice of informed consent for thrombolysis in acute ischemic stroke varies among neurologists and neurology residents. If informed consent is obtained, most clinicians stated to obtain informed consent within one minute. In the future, a shortened information provision process may be applied, making a shift from informed consent to informed refusal, while still considering the patient’s capacity, stroke severity, and possible treatment delays. (shrink)

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Continuous recordings of brain electrical activity were obtained from a group of 176 patients throughout surgical procedures using general anesthesia. Artifact-free data from the 19 electrodes of the International 10/20 System were subjected to quantitative analysis of the electroencephalogram (QEEG). Induction was variously accomplished with etomidate, propofol or thiopental. Anesthesia was maintained throughout the procedures by isoflurane, desflurane or sevoflurane (N = 68), total intravenous anesthesia using propofol (N = 49), or nitrous oxide plus narcotics (N = 59). A set (...) of QEEG measures were found which reversibly displayed high heterogeneity of variance between four states as follows: (1) during induction; (2) just after loss of consciousness (LOC); (3) just before return of consciousness (ROC); (4) just after ROC. Homogeneity of variance across all agents within states was found. Topographic statistical probability images were compared between states. At LOC, power increased in all frequency bands in the power spectrum with the exception of a decrease in gamma activity, and there was a marked anteriorization of power. Additionally, a significant change occurred in hemispheric relationships, with prefrontal and frontal regions of each hemisphere becoming more closely coupled, and anterior and posterior regions on each hemisphere, as well as homologous regions between the two hemispheres, uncoupling. All of these changes reversed upon ROC. Variable resolution electromagnetic tomography (VARETA) was performed to localize salient features of power anteriorization in three dimensions. A common set of neuroanatomical regions appeared to be the locus of the most probable generators of the observed EEG changes. (shrink)

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Next SectionBackground: Publication bias and discrimination are increasingly recognised in medicine. A survey was conducted to determine if medical journals were more likely to publish research reports from members of their own than a rival journal’s editorial board. Methods: A retrospective review was conducted of all research reports published in 2006 in the four competing medical journals within five medical specialties. Only three journals were willing to divulge the authorship of reports that had been rejected. Results: Overall, 4460 research reports (...) were published in 2006 by the 20 journals from five subspecialties (mean 223 (SD = 164) reports per journal; median 176; interquartile range 108–238). On average, 17.2 (7.7%) reports were from a journal’s own editorial board (SD = 10.7; median 15; interquartile range 10–23; n = 20), and 6.3 (2.8%) reports were from a member of the editorial board of one of the three rival journals within the specialty (SD = 7.3; median 3.5; interquartile range 1–8; n = 60). There was a statistically significant excess of publications from the journal’s own editorial board in 14 of the 20 journals (p<0.05). Journals were almost three times more likely to publish reports from their own editorial board than from one of the three rivals within their subspecialty (p<0.0001; median difference 11; Mann–Whitney U test; power for 5% significance >99.99%). Conclusions: There was a significant excess of publications from medical journals’ own editorial boards, although it is not possible to determine whether this is due to bias in the peer review process or selective submission by editors. (shrink)

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Background: Informed consent is fundamental to the autonomous decision-making of patients, yet much is still unknown about the process in the clinical setting. In an evolving healthcare landscape, nurses must be prepared to address patient understanding and participate in the informed consent process to better fulfill their well-established role as patient advocates. Research objective: This study examines hospital-based nurses’ experiences and understandings of the informed consent process. Research design: This qualitative descriptive study utilized a semi-structured interview approach identifying thematic concerns, (...) experiences, and knowledge of informed consent across a selected population of clinically practicing nurses. Participants and research context: In all, 20 baccalaureate prepared registered nurses practicing in various clinical settings (i.e. critical care, oncology, medical/surgical) at a large northeastern academic medical center in the United States completed semi-structured interviews and a demographic survey. The mean age of participants was 36.6 years old, with a mean of 12.2 years of clinical experience. Ethical considerations: Participation in this study involved minimal risk and no invasive measures. This study received Institutional Review Board approval from the University of Pennsylvania. All participants voluntarily consented. Findings: The majority of participants (N = 19) believe patient safety is directly linked to patient comprehension of the informed consent process. However, when asked if nurses have a defined role in the informed consent process, nearly half did not agree (N = 9). Through this qualitative approach, three major nursing roles emerged: the nurse as a communicator, the nurse as an advocate, and the clerical role of the nurse. Discussion and conclusion: This investigation contributes to the foundation of ethical research that will better prepare nurses for patient engagement, advance current understanding of informed consent, and allow for future development of solutions. Nurses are at the forefront of patient–provider interactions and they are often presented opportunities to learn about and engage in the informed consent process. (shrink)

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In lieu of an abstract, here is a brief excerpt of the content:GENDER AND THE PRIESTHOOD OF CHRIST: A THEOLOGICAL REFLECTION BENEDICT M. ASHLEY, 0.P. Aquinas Institute of Theology St. Louis, Missouri I. Does "Patriarchy" Explain the Tradition? HE CONGREGATION for the Doctrine of the Faith, n its 1976 Declaration on the Question of the Admission f Wonien to the Ministerial Priesthood, based its negative response primarily on tradition.1 For many this argument 1 Inter Insigniores (Oct. 15, 1976, AAS 69 (...) [1977]), Origins 6, 33 (Feb. 3, 1977) : 518-531. For a general bibliography on women's studies see Patricia K. Ballou, Women: A Bibliography of Bibliographies, 2nd ed. (Boston: G. K. Hall, 1986). For select bibliography pro and con on the present topic see note 92, p. 560 of my Theologies of the Body: Humanist and Christian (St. Louis: Pope John Center, 1985) and Wendell E. Langley, S.J. and Rosemary J ermann, " Women and the ministerial priesthood: An annotated bibliography," Theology Digest 29 :329-42 (Winter '81). Strong cases against ordination are made by Louis Bouyer, W onzan in the Church, tr. by Marilyn Techert [Epilogue by Hans Urs von Balthasar and Essay by C. S. Lewis, "Priestesses in the Church"] (San Francisco: Ignatius Press, 1979) ; Manfred Hauke, Women in the Priesthood? A Systematic Analysis in the Light of the Order of Creation and Redemption, tr. by David Kipp (San Francisco: Ignatius Press, 1988); L. Ligier, "Women and the ministerial priesthood," Origins, 7:694-702 (April 20, 1978); and Patrick Dunn, Priesthood: A Re-Examination of the Roman Catholz'.c Theology of the Presbyterate (Staten Island, NY: Alba House, 1990), pp. 173-196. Strong cases for ordination are made by Ida Raming, The Exclusion of Women from Priesthood: Divine Law or Sex Discrimination, tr. by Norman R. Adams (Meutchen, NJ: Scarecrow Press, 1976) ; Haye von der Meer, Women Priests in the Catholic Chitrch: A Theological -Historical Investigation, tr. by Arlene and Leonard Swidler (Philadelphia : Temple University Press, 1973) ; George Tavard, Woman in Christian Tradition (Notre Dame: University of Notre Dame Press, 1973) ; Karl Raimer, "Priestertum der Frau," Stimmen der Zeit, 195 :291-301 (May 1977) ; Joseph Komonchak, " Theological Questions on the Ordination of Women," Catholic Mind 75 CJan. 1977) : 13-28; Carroll Stuhlmueller, C. P., ed., Women and Priesthood: Future Directions (Collegeville, MN: Liturgical Press, 1978); and Elizabeth Schussler Fiorenza, In Memory of Her: A Feminist Theological Reconstruction of Christian Origins (New York: Crossroad, 1983). 343 344 BENEDICT Mo ASHLEY, OoPo fails to persuade" It seems obvious to them that this " tradition " merely reflects the " patriarchalism " of the Jewish and pagan milieu of the early Church" The Declaration anticipated this objection when it pointed out (a) that Jesus was counter-cultural in many respects, especially in his attitude toward women; (b) a better explanation for the tradition can be found in the reality (res) which the sacrament of ordination symbolizes, namely, that the priest acts ini persona Christi capitis ecclesiae" Thus the essential role of a Christian priest is to represent Christ present and acting in his Church as its male Head" The Congregation formulated its conclusion cautiously: "The Church, in fidelity to the example of the Lord, does not consider herself authorized to admit women to priestly ordination." 2 Thus no other opinion may be followed in practice, and if bishops or theologians raise questions about the meaning of the tradition they must not trivialize its importance nor arouse illusory expectations of change. Final judgment on the matter can only pertain to the magisterium. In what follows I will not explore the argument from tradition as such, but only the supporting argument from symbolism, in an attempt to fill in certain steps which it seems to me the Declaration passed over. Nor will I deal here with other secondary arguments against the Declaration's conclusion, particular the pragmatic argument that since Christians have a right to the Eucharist, the decline of male priestly vocations in many secularized countries justifies the ordination of women" H the Church has no power to ordain women validly, obviously that argument, however practically attractive, is beside the point2 2 Inter Insigniores, last paragraph of the Introduction. 3 The members of a local church have a " right " to the Eucharist only if they... (shrink)

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In this study, a 20-item questionnaire was used to elicit undergraduates’ (N = 93) ethical judgment and behavioral intention regarding a number of behaviors involving computers and internet usage. Machiavellianism was found to be uncorrelated with both ethical judgment and behavioral intention. Gender was found to be negatively correlated with both ethical judgment and behavioral intention, such that females judged the behaviors as being less ethical than males, and were less likely to engage in the behaviors than males. A disconnect (...) was found between ethical judgment and behavioral intention, for both males and females, such that the ethical judgment mean for a number of issues was significantly lower (towards the “unethical” end of the continuum) than the behavioral intention mean (towards the “more likely to engage in” end of the continuum). The study raises questions regarding ethical awareness of technology-related issues, and the authors make suggestions for future research. (shrink)

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The essential role of creativity has been highlighted in several human knowledge areas. Regarding the neural underpinnings of creativity, there is evidence about the role of left dorsolateral prefrontal cortex (DLPFC) and left inferior frontal gyrus (IFG) on divergent thinking (DT) and convergent thinking (CT). Transcranial stimulation studies suggest that the left DLPFC is associated with both DT and CT, whereas left IFG is more related to DT. However, none of the previous studies have targeted both hubs simultaneously and compared (...) transcranial direct current stimulation (tDCS) and random noise stimulation (tRNS). Additionally, given the relationship between cognitive flexibility and creativity, we included it in order to check if the improvement in creativity may be mediated by cognitive flexibility. In this double-blind, between-subjects study, 66 healthy participants were randomly assigned to one of three groups (N = 22) that received a transcranial direct current stimulation (tDCS), transcranial random noise stimulation (tRNS), or sham for 20 min. The tDCS group received 1.5 mA with the anode over the left DLPFC and cathode over the left IFG. Locations in tRNS group were the same and they received 1.5 mA of high frequency tRNS (100–500 Hz). Divergent thinking was assessed before (baseline) and during stimulation with unusual uses (UU) and picture completion (PC) subtests from Torrance Creative thinking Test, whereas convergent thinking was evaluated with the remote association test (RAT). Stroop test was included to assess cognitive flexibility. ANCOVA results of performance under stimulation (controlling for baseline performance) showed that there were significant differences in PC (F = 3.35, p = 0.042, np2 = 0.10) but not in UU (F = 0.61, p = 0.546) and RAT (F = 2.65, p = 0.079) scores. Post-hoc analyses showed that tRNS group had significantly higher scores compared to sham (p = 0.004) in PC. More specifically, tRNS showed higher performance in fluency (p = 0.012) and originality (p = 0.021) dimensions of PC compared to sham. Regarding cognitive flexibility, we did not find any significant effect of any of the stimulation groups (F = 0.34, p = 0.711). Therefore, no further mediation analyses were performed. Finally, the group that received tDCS reported more adverse effects than sham group (F = 3.46, p = 0.035). Altogether, these results suggest that tRNS may have some advantages over tDCS in DT. (shrink)

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A core symptom of anxiety disorders is the tendency to interpret ambiguous information as threatening. Using EEG and BOLD-MRI, several studies have begun to elucidate brain processes involved in fear-related perceptual biases, but thus far mainly found evidence for general hypervigilance in high fearful individuals. Recently, multi-voxel pattern analysis (MVPA) has become popular for decoding cognitive states from distributed patterns of neural activation. Here, we used this technique to assess whether biased fear generalization, characteristic of clinical fear, is already present (...) during the initial perception and categorization of a stimulus, or emerges during the subsequent interpretation of a stimulus. Individuals with low spider fear (LSF, n = 20) and high spider fear (HSF, n = 18) underwent functional MRI scanning while viewing series of schematic flowers morphing to spiders. In line with previous studies, individuals with high fear of spiders were behaviorally more likely to classify ambiguous morphs as spiders than individuals with low fear of spiders. Univariate analyses of BOLD-MRI data revealed stronger activation towards spider pictures in high fearful individuals compared to low fearful individuals in numerous areas. Yet, neither average activation, nor support vector machine classification (i.e. a form of MVPA) matched the behavioral results - i.e., a biased response towards ambiguous stimuli - in any of the regions of interest. This may point to limitations of the current design, and to challenges associated with classifying emotional and neutral stimuli in groups that differ in their judgment of emotionality. Improvements for future research are suggested. (shrink)

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Current report assessed measurement reproducibility and reliability of magnetic resonance spectroscopy (1H-MRS) at 3 Tesla in left and right posterior insular, pregenual and anterior midcingulate subdivisions. 10 healthy male volunteers aged 20 to 30 years were tested on four different days, of which 9 were included in the data analysis. Intra- and inter-subject variability of myo-Inositol (mI), Creatine (Cre), Glutamate (glu), total-Choline (tCho), total-N-acetylaspartate (tNAA) and combined Glutamine-Glutamate (Glx) were calculated considering the influence of movement parameters, age, daytime of measurements (...) and tissue composition. Overall mean intra-subject variability revealed small mean coefficients of variation (CV) across the four regions: 5.3% in aMCC, 6.6% in pgACC, 7.3% in pIL and 8.2% in pIR. For all neurochemicals combined, mean inter-subject variability demonstrated mean CVs of 9.05% (aMCC), 8.84% (pgACC), 10.00% (pIL) and 10.55% (pIR). Head movement, tissue composition and day time revealed no significant explanatory variance contribution suggesting a negligible influence on data. A strong correlation between Cramer-Rao Lower Bounds (CRLB; a measure of fitting errors) and the mean intra-subject CV (r=0.799, p<0.001) outlined the importance of low CRLB in order to obtain robust and finally meaningful 1H-MRS measures. The present findings confirm 1H-MRS as a reliable tool to measure brain neurochemistry in small subregions of the human brain. (shrink)

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BackgroundThere is evidence that direct journal endorsement of reporting guidelines can lead to important improvements in the quality and reliability of the published research. However, over the last 20 years, there has been a proliferation of reporting guidelines for different study designs, making it impractical for a journal to explicitly endorse them all. The objective of this study was to investigate whether a decision tree tool made available during the submission process facilitates author identification of the relevant reporting guideline.MethodsThis was (...) a prospective 14-week before–after study across four speciality medical research journals. During the submission process, authors were prompted to follow the relevant reporting guideline from the EQUATOR Network and asked to confirm that they followed the guideline (‘before’). After 7 weeks, this prompt was updated to include a direct link to the decision-tree tool and an additional prompt for those authors who stated that ‘no guidelines were applicable’ (‘after’). For each article submitted, the authors’ response, what guideline they followed (if any) and what reporting guideline they should have followed (including none relevant) were recorded.ResultsOverall, 590 manuscripts were included in this analysis—300 in the before cohort and 290 in the after. There were relevant reporting guidelines for 75% of manuscripts in each group; STROBE was the most commonly applicable reporting guideline, relevant for 35% (n = 106) and 37% (n = 106) of manuscripts, respectively. Use of the tool was associated with an 8.4% improvement in the number of authors correctly identifying the relevant reporting guideline for their study (p< 0.0001), a 14% reduction in the number of authors incorrectly stating that there were no relevant reporting guidelines (p< 0.0001), and a 1.7% reduction in authors choosing a guideline (p = 0.10). However, the ‘after’ cohort also saw a significant increase in the number of authors stating that there were relevant reporting guidelines for their study, but not specifying which (34 vs 29%; p = 0.04).ConclusionThis study suggests that use of a decision-tree tool during submission of a manuscript is associated with improved author identification of the relevant reporting guidelines for their study type; however, the majority of authors still failed to correctly identify the relevant guidelines. (shrink)

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As the federal government continues to expand upon and improve its data sharing policies over the past 20 years, complex challenges remain. Our interviews with U.S. academic genetic researchers (n=23) found that the burden, translation, industry limitations, and consent structure of data sharing remain major governance challenges.

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Some people have supposed that utility is good in itself, non-in-strumentally good, as distinct from good because conducive to other good things. And in modern versions of this view, utility often means want-satisfaction, as distinct from pleasure or happiness. For your want that p to be satisfied, is it necessary that you know or believe that p, or sufficient merely that p is true? However that question is answered, there are problems with the view that want-satisfaction is a non-instrumental good. (...) What if you want something only because you have a false belief? What if the time at which you want that p is fifty or five hundred years before the time to which p itself refers? To meet these difficulties, qualifications have to be introduced, and much has been written about how exactly these qualifications are to be framed.1 There is however what may be a rather more serious objection to the view that want-satisfaction is a non-instrumental good, or rather to the combination of that view with the principle that it is sufficient for your want that p to be satisfied simply that p is true. The objection is that this combination forces you to give undue weight to the mere acquisition of desires when you come to make judgements about changes in the value of things. It forces you to say that for any true proposition p, which initially you do not want to be true, your mere acquisition of a desire that p will, other things being equal, make the world better. Non-instrumental value can be increased merely by multiplying desires, even though everything else remains the same. Surely, however, improving the world is not as easy as that. (shrink)

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Background Payment of research participants helps to increase recruitment for research studies, but can pose ethical dilemmas. Research ethics committees (RECs) have a centrally important role in guiding this practice, but standardisation of the ethical approval process in Ireland is lacking. Aim Our aim was to examine REC policies, experiences and concerns with respect to the payment of participants in research projects in Ireland. Method Postal survey of all RECs in Ireland. Results Response rate was 62.5% (n=50). 80% of RECs (...) reported not to have any established policy on the payment of research subjects while 20% had refused ethics approval to studies because the investigators proposed to pay research participants. The most commonly cited concerns were the potential for inducement and undermining of voluntary consent. Conclusions There is considerable variability among RECs on the payment of research participants and a lack of clear consensus guidelines on the subject. The development of standardised guidelines on the payment of research subjects may enhance recruitment of research participants. (shrink)

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The self is one of the perennial topics in philosophy, and also one of the most debated. Its existence has been both defended and contested in equal measure by philosophers including Descartes and Hume. A Map of Selves: Beyond Philosophy of Mind proposes an original and compelling defense of selfhood. N. M. L. Nathan argues that the self is an enduring substance with a unique quality not shared with any other substance. He criticizes the panpsychist theory that material objects are (...) composed of selves analogous to ours and argues for the existence of at least one transcendent self, whose activity explains both our own existence and the existence of the natural world. He concludes by considering how the world would be for us if such selves did not exist, and we were, as some philosophers think we are, not selves, but, e.g., brains or simply sequences of mental events. A radical and innovative philosophical theory of the self, A Map of Selves: Beyond Philosophy of Mind will be of interest to those working on the philosophy of self and personal identity, philosophy of mind and metaphysics. (shrink)

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"Since the end of the last century," Walter Benjamin wrote, "philosophy has made a series of attempts to lay hold of the 'true' experience as opposed to the kind that manifests itself in the standardized, denatured life of the civilized masses. It is customary to classify these efforts under the heading of a philosophy of life. Towering above this literature is Henri Bergson's early monumental work, Matter and Memory."Along with Husserl's Ideas and Heidegger's Being and Time, Bergson's work represents one (...) of the great twentieth-century investigations into perception and memory, movement and time, matter and mind. Arguably Bergson's most significant book, Matter and Memory is essential to an understanding of his philosophy and its legacy.This new edition includes an annotated bibliography prepared by Bruno Paradis.Henri Bergson was awarded the Nobel Prize in 1927. His works include Time and Free Will, An Introduction to Metaphysics, Creative Evolution, and The Creative Mind. (shrink)

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