BackgroundThe rating of perceived exertion scales with respiratory and muscular illustrations are recognized as simple and practical methods to understand individual psychometric characteristics in breathing and muscle exertion during exercise. However, the implementation of respiratory and muscular RPE to quantify training load in futsal training camps has not been examined. This study investigates respiratory and muscular RPE relationships during domestic training camps and overseas training camps in an under 20 futsal national team.MethodsData collected from eleven field (...) players were used for comparison in this study. All players reported Borg CR10 RPE and 7-scales respiratory RPE and muscular RPE after training sessions and matches. Additionally, total distance covered and training impulse were used to quantify external and internal loads via the Polar Team Pro system. Paired-sample t-tests were used to compare the RPECR10, RPErespiration, RPEmuscle, TD, and TRIMP between DTC and OTC. Furthermore, linear regression was performed to determine the relationships among all RPE scales, TD, and TRIMP.ResultsThe RPECR10, TD, and TRIMP showed significant difference between DTC and OTC. Furthermore, linear regression analyses showed significant correlation between RPErespiration and RPEmuscle, RPECR10 and RPErespiration, and RPECR10 and RPEmuscle.ConclusionPictorial RPErespiration or RPEmuscle can be used as an alternative to quantify perceived measures of internal loads during DTC and OTC in futsal players. Interpretation of perceived measures of training load and cardiac-related responses in association with external training loads during short-term training camps would be useful in further understanding the demands of futsal players’ experience in these circumstances. (shrink)

IntroductionRegular exercise has long been shown to positively impact the immune system responsiveness and improve mental well-being. However, the putative links between biomarkers of mental health and immune efficiency in exercising subjects have been scarcely investigated. The aim of this study was to verify the effect of a 14-week combined chair-based exercise program on salivary steroid hormones and anti-microbial proteins, functional fitness, and MWB indexes in pre-frail older women.MethodsThe participant women were randomly divided into the exercising group and (...) the non-exercising control group. The pre/post assessment included: salivary anti-microbial proteins lysozyme; and immunoglobulin-A ; salivary steroid hormones of testosterone and cortisol ; functional fitness ; MWB questionnaires.ResultsSignificant differences with large Cohen’s effect sizes were found on increased salivary TT after exercise intervention. The results revealed a decrease in IgA levels after CEP. The increase in subjective happiness levels and decrease of stress perception and depressive state were found after intervention in the CEP group. Robust statistical differences in gait speed and balance tests were also found in the CEP group. In control, COR increased moderately while no changes were found for the other indicators. Correlation analyses showed inter-dependence between pre–post variations of MWB, biochemical indexes, and fitness function.ConclusionThe CEP program was able to improve functional-fitness performance, decrease feelings of stress, and increase happiness. The CEP also induced clinically relevant hormonal and immune responses, which suggests that chair exercises that combine muscular strength, balance, and gait speed training are promising interventions to improve physical and mental health of older pre-frail adults. (shrink)

This study investigates the Proteus effect from the first-person perspective and during avatar embodiment in actual exercise. In addition to the immediate measurements of the Proteus effect, prolonged effects such as next-day perception and exercise-related outcomes are also explored. We theorized the Proteus effect as altered perceived self-concept and explored the association between virtual reality avatar manipulation and self-concept in the exercise context. While existing studies have mainly investigated the Proteus effect in a non-VR environment or after (...) VR embodiment, we aim to contribute to the literature by addressing this concern to explore how the Proteus effect works in actual VR exercise. Through a 2 × 2 between-subject experiment, the results partially support the Proteus effect. Regarding actual physical activity, embodying an avatar with a six pack during exercise creates fewer body movements. No significant effect was found for perceived exertion. We also explored the role of sex as a potential moderator in the association of the Proteus effect on exercise outcomes. The Proteus effect was supported by immediate and next-day self-efficacy for core-muscle exercise only among female participants. The between-subject design allowed us to probe how avatar manipulation of muscular body shape with a six pack as opposed to normal body shape influences participants’ self-concept and exercise outcomes, as limited VR studies have employed within-subject comparisons. This also contributes to the literature by providing an upward comparison as opposed to the previous downward comparison regarding body fitness. The overall results supported the Proteus effect in the context of core-muscle exercise when comparing normal and ideal body shape avatars. However, the Proteus effect as an altered self-concept and its effects on self-efficacy for exercise were supported among females but not males. Whereas the female participants who embodied avatars with a six pack associated themselves more with the muscular concept than other people, the male participants who embodied avatars with a six pack perceived themselves as more normal than others. Theoretical and practical implications are discussed. (shrink)

Emerging research shows a strong connection between brain areas governing cognition and motor behavior. Yet, research investigating the negative aftereffects of cognitive control exertion on task performance has not considered the potential role of areas governing motor behavior. The present study investigated the effects of high cognitive control exertion on task self-efficacy and exercise performance in children. A secondary purpose was to investigate whether motor coordination influences the change in exercise performance differently following low versus high cognitive control (...) exertion. Participants (N = 70) performed two isometric handgrip endurance trials separated by a Stroop task, which was either congruent (low cognitive control) or incongruent (high cognitive control). Motor coordination was assessed prior to the first endurance trial. Task self-efficacy for performing the second endurance trial was assessed following the Stroop task. Participants in the high cognitive control condition reported lower task self-efficacy and showed a reduction in endurance exercise performance. Task self-efficacy mediated the cognitive control – performance relationship. Participants scoring lower on motor coordination showed the greatest declines in exercise performance following high cognitive control, whereas motor coordination did not affect performance following low cognitive control. The results of this study provide evidence that task self-efficacy and exercise performance are also negatively affected in children following high cognitive control, and interestingly, these effects are exacerbated among those scoring lower in motor coordination. We recommend future research investigate motor coordination as a potential mechanism for the reductions in both cognitive and physical task performance following the prolonged exertion of high cognitive control. (shrink)

Motor imagery is often used inducing changes in electroencephalographic (EEG) signals for imagery-based brain-computer interfacing (BCI). A BCI is a device translating brain signals into control signals providing severely motor-impaired persons with an additional, non-muscular channel for communication and control. In the last years, there is increasing interest using BCIs also for healthy people in terms of enhancement or gaming. Most studies focusing on improving signal processing feature extraction and classification methods, but the performance of a BCI can also (...) be improved by optimizing the user’s control strategies, e.g., using more vivid and engaging mental tasks for control. We used multichannel EEG to investigate neural correlates of a sports imagery task (playing tennis) compared to a simple motor imagery task (squeezing a ball). To enhance the vividness of both tasks participants performed a short physical exercise between two imagery sessions. EEG was recorded from 60 closely spaced electrodes placed over frontal, central, and parietal areas of 30 healthy volunteers divided in two groups. Whereas Group 1 (EG) performed a physical exercise between the two imagery sessions, Group 2 (CG) watched a landscape movie without physical activity. Spatiotemporal event-related desynchronization (ERD) and event-related synchronization (ERS) patterns during motor imagery (MI) tasks were evaluated. The results of the EG showed significant stronger ERD patterns in the alpha frequency band (8–13 Hz) during MI of tennis after training. Our results are in evidence with previous findings that MI in combination with motor execution has beneficial effects. We conclude that sports MI combined with an interactive game environment could be a future promising task in motor learning and rehabilitation improving motor functions in late therapy processes or support neuroplasticity. (shrink)

Clear explanation and evaluation of fundamental concepts of Hindu thought; historical synopsis of the development of Hindu religious philosophy; detailed descriptions of the psychology and psychoanalysis of yoga, its postures and varieties of breathing; exercises in concentration--even methods by which yogis achieve muscular control over bodily functions. For general readers, students, and practitioners.

Introduction: Congenital myasthenic syndromes refer to a heterogenic group of neuromuscular transmission disorders. CMS-subtypes are diverse regarding exercise intolerance and muscular weakness, varying from mild symptoms to life-limiting forms with neonatal onset. Long-term follow-up studies on disease progression and treatment-response in pediatric patients are rare.Patients and Methods: We analyzed retrospective clinical and medication data in a cohort of 32 CMS-patients including the application of a standardized, not yet validated test to examine muscular strength and endurance in 21 (...) patients at the last follow-up. Findings obtained in our cohort were compared with long-term follow-up studies of CMS-cohorts from the literature by considering the underlying molecular mechanisms. Outcomes of CMS-ST were compared to results of normal clinical assessment.Results: Thirty-two pediatric patients with defects in eight different CMS-genes were followed by a median time of 12.8 years. Fifty-nine percentage of patients manifested with first symptoms as neonates, 35% as infants. While 53% of patients presented a reduced walking distance, 34% were wheelchair-bound. Even under adequate therapy with pyridostigmine and 3,4-diaminopyridine, CHAT-mutations led to the progression of muscular weakness partly in combination with persistent respiratory and bulbar symptoms. RAPSN, CHRND, and CHRNB1 patients with neonatal manifestation, early respiratory problems, and bulbar symptoms showed a good and maintained treatment response. CHAT and CHRNE patients required higher PS dosages, whereas RAPSN patients needed a lower mean dosage at the last follow-up. The benefits of short-term medication and long-term progression of symptoms were highly dependent on the specific genetic defect. CMS-ST was carried out in 17/21 patients, determined affected muscle groups including bulbar and ocular symptoms, some of which were not reported by the patients.Conclusions: Our findings and comparison with the literature- suggest a better treatment-response and less severe progression of symptoms present in patients suffering from mutations in CMS-genes directly associated with receptor deficiency, while patients with defects leading to synaptopathy and presynaptic defects tend to have worse outcomes. Assessment of affected muscular groups and clinical symptoms by CMS-ST may be a useful tool for optimal therapeutic management of the patients, especially for future clinical studies. (shrink)

Any case raising the profile of ‘assisted-dying’ and public policy naturally causes consternation, excitement, heated debate and concerns from different parties, worried that the law is unclear, unfair, too conservative, too permissive, neglectful of ‘the vulnerable’ or indifferent to the proper scope of freedom for ‘the competent’. It was unsurprising, then, that much attention focused on the litigation between Debbie Purdy and the Director of Public Prosecutions .1–4 Ms Purdy has muscular sclerosis, and would like to be free, at (...) a time of her choosing, to travel to receive assisted suicide in a jurisdiction that permits this. To do so, she will need the help of her husband. In contrast with the famous Pretty case,5 Ms Purdy did not seek a proleptic immunity from prosecution under the Suicide Act 1961. Rather, she invoked her human right to respect for private and family life, and argued that the DPP should publish guidance detailing the basis on which he exercises his discretion to bring a prosecution for the crime of aiding, abetting, counselling or procuring a suicide in England and Wales. Her case, when heard in the House of Lords, was successful. 3A decision to prosecute cases of assisted suicide pivots on the satisfaction of two key issues: the ‘evidential test’—is there sufficient evidence to justify bringing a prosecution?; and the ‘public interest test’—is it in the public interest to bring a prosecution? Rightly or wrongly, the threshold for meeting the evidential test seems to be set very low.6 Focus tends to fall, therefore, on the public interest aspect of the decision. In September 2009, the DPP published interim guidance, which detailed the offence of ‘assisting a …. (shrink)

Death of motor neurones following invasion of the central nervous system by poliovirus may result in paralysis of specific muscles. Virulence may be tested by injection into monkeys by routes which bypass natural infection. Transmissibility is also very important, but cannot be measured, only inferred. An infection may lead to immunity or paralysis. In epidemics, the highest incidence among children 0-2 years was 2% and among those over 10 years was 25%: these figures fit a model of genetic susceptibility of (...) homozygotes and heterozygotes with phenotypic susceptibility increasing with age. Hypogamma-globulinemics, some neonates and pregnant women are more susceptible than others. Intra-muscular injections may increase the risk of paralysis. Strenuous exercise and IM injections given when poliovirus has already reached the spinal cord can increase the severity of paralysis or convert a non-paralytic attack to paralysis. Although vaccines reduced polio in temperate countries, polio was thought to be no problem in the tropics. Since 1977 polio has been recognised as a massive problem in the third world: because it affects babies and very young children, it is properly infantile paralysis. (shrink)

Contemporary experimental research has emphasised the role of centrally generated signals arising from premotor areas in voluntary muscular force perception. It is therefore generally accepted that judgements of force are based on a central sense, known as the sense of effort, rather than on a sense of intra-muscular tension. Interestingly, the concept of effort is also present in the classical philosophy: to the French philosopher Maine de Biran [Maine de Biran . Mémoire sur la décomposition de la pensée (...) , Vrin, Paris ], the sense of effort is the fundamental component of self-experience, the landmark of the exercise of the will. In the present review, after a presentation of the nature and neurophysiological bases of effort sensation, we will examine its possible involvement in the neurocognitive process of agency. We will further focus on delusions of alien control in schizophrenic patients. Experimental data suggest that these patients have an abnormal awareness of effort caused by cerebral anomalies in the frontal and parietal lobes. (shrink)

Sinnott, Nigel I had been looking forward to 29 July 1962 for a very long time. It marked the end often years spent at two English private boarding schools with their ethos of 'muscular Christianity': a proto-fascist mix of semi-monastic living, lots of compulsory sport and relentless Anglican religious indoctrination. I had loathed almost every day I had spent at these schools, as I disliked ball games and strenuous exercise from the outset, and by the time I was (...) ten, or maybe a few months older, I was a staunch atheist. I was by temperament a studious, imaginative and inquiring boy, but I loathed the formality, petty regimentation, narrow conservative mind-set, intolerance and sometimes brutality of the school system in which I found myself. I had spent a decade feeling confined, frustrated, very bored, often cold and sometimes frightened. I resolved that, if I ever had children of my own, they would never be brought up and 'educated' like this. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Know-How of Musical PerformanceStephen DaviesMusicians make music; that is, the performance of music involves applied knowledge or know-how. Can we attain a discursive understanding of what the musician does, and does the attempt to achieve this put at risk the very art it aims to capture? In other words, what can be said of the nature of performance and does what we say turn a living practice into (...) a dead object? In this discussion, I aim to clarify the issues in terms of which these questions can be developed.Consider acquired practical knowledge or'knowing how.'1 It involves a learned skill or capacity to do something-typically, to perform an action-as in "I know how to ride a unicycle."2 'Knowing how'can be subdivided into types. A first variety is always conscious. For most people, mental arithmetic is of this kind. It is not mental arithmetic they are doing if they do not follow an appropriate rule, algorithm, procedure, or principle, even if they fluke the right answer. Many practical skills are of this sort. I know how to fill in tax forms, immigration documents, and hire purchase agreements. In all these cases, the working of the skill and the steps through which it is exercised are held inevitably before my mind. A second type of 'knowing how' might be termed "retrievable." I know how to drive a car. Most of the time, I am not aware of the processes, judgments, and procedures that are [End Page 154] involved. I do not have to think about my driving as I drive. Nevertheless, if I reflect on what I do, I can describe the steps or routines I go through. A third type of 'knowing how' is cognitively impenetrable. Cognitively impenetrable processes are opaque to introspection. Some bit of neurological hardware receives an input, processes it, and outputs some result, but the nature of that processing is not retrievable by consciousness. The skill is learned but the many computational, muscular, kinaesthetic, or other activities involved in the skill's application or execution are not available to the agent's awareness. From my own case, typical examples are of knowing how to walk, how to pick up a glass, and how to speak English.3 When a person intends to perform an action of this kind, he aims at it directly, as it were. He intends to turn his skateboard to the left, say, not to flex this muscle here and so. He can intend to produce a certain action as output, but the intermediate steps and movements involved in this, to the extent that they are controlled in an irretrievable fashion, are not what he can intend. Similarly, where 'knowing how' is retrievable but automatic, the action is intended directly. The intermediary steps and movements are not what are intended so long as the action remains automatic.In what ways is practical knowledge acquired? In some cases it can be learned from verbal descriptions of the appropriate basic actions and their sequences-"put the left leg in and shake it all about"-or of the relevant rules or algorithms-"multiply by π r2." In others, learning is by example, copying, or experimenting. Some procedures work better for some skills than others. Generally speaking, when we encourage children and stroke victims to walk we do not provide them with examples. By contrast, language skills are often conveyed via paradigm instances. And while it is possible to learn to drive a plane from an instruction manual alone, one is more likely to be successful by following and being assisted by an instructor. Always conscious skills are often acquired by memorizing the procedure or rule that must be kept in mind, whereas automatic but retrievable skills, because their application is unconscious, are usually acquired through physical repetition until the routine becomes unthinking. Nevertheless, even cognitively impenetrable skills might be learned by first following written instructions. What makes the skill impenetrable is not the method by which it is acquired but the inability to recall or describe the relevant steps, rules, or procedures when the skill is entrenched.4A given skill might be cognitively impenetrable for... (shrink)

One of the most predictable implications of photography consists of the ability to fix some images returning them in a variable timeframe for the observation. In all the major world cities, it is common to incur in some book where recent photos are compared to old ones searching the same point of view in order to make the comparison more accurate and stimulate the critical ability of the observer. An exercise that sometimes stimulates a sort of regret for the (...) past, pointing out a diffused excess of nostalgia for times gone by. Nevertheless, the reality and meaning of modern city images are not always so prosaic. What happens when photographs are evocative of a reality that is completely lost in the collective imaginary even though it still exists and functions, despite being forgotten and buried in the depths of the city? This is the case of very few pictures capable of telling the story of a city, Milan, and its only “real” river, the Olona, whose waters, humiliated and rejected, continue to flow in total amnesia. It is a different story when photography does not have the role of nourishing nostalgia, but the power to make visible and explain the variation of a presence and its progressive obliteration. Some pictures testify to the passage from the bucolic amenity of the river and its banks in a pre-urban context to a muscular urban infrastructure. A rigid channelized river, shown with confidence, is trying to keep its presence, until the moment of its inevitable decline and disappearance. It is in these images that the possibility of reconsidering the Olona as a part of the new project for the city lies. (shrink)

This research topic (RT) focused on the impact of fitness on cognitive function and development in adolescents and elderly adults from the standpoint of lifespan neuroscience. Adolescent brain development is characterized by multimodal integration of brain anatomical features and function, according to accumulating evidence. The elderly, on the other hand, suffer from age-related cognitive deterioration. Fitness may be a major factor influencing brain growth and cognitive performance throughout these two critical times for neurological development. It is a multidimensional notion that (...) includes cardiovascular fitness, muscular strength and endurance, flexibility, and body composition, as well as motor fitness (balance, agility, speed, power, and coordination). Adolescents and older people may be responsive to intervention trials aimed at improving fitness levels, such as outdoor activities, cardiovascular exercise, and mind-body practice since brain network integration and neural efficiency are rapidly altered during this period. This RT investigates how fitness influences structural and functional brain development, particularly cognitive functions, and emotional health in adolescents and elderly people, as well as training strategies that may assist cognitive progress throughout this time. It includes a clinical trial (1) and original research papers (4) on the influence of fitness on cognitive function and development in adolescents and elderly adults from a lifespan neu... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Editors’ NoteJames M. DuBois, Ana S. Iltis, and Heidi A. WalshFrom childhood, David Slakter had undergone tests and invasive procedures to monitor his nephritis. It was not a surprise when in 2015, doctors told him he needed a kidney transplant. The wife of a childhood friend was a close match and gave him one of her kidneys. Before his transplant, aerobic exercise was difficult; a few months after (...) transplant, Slakter could ride his bike, hike, and work out with a personal trainer. He no longer had to weigh food or gauge his potassium consumption, a concern for people with kidney failure. For Slakter, “life post-transplant has been a significant improvement.”Individuals or family members of those who have received an organ transplant from a living or deceased donor share their stories in this issue of Narrative Inquiry in Bioethics. The symposium is titled “Receiving the Gift of Life: Stories from Organ Transplant Recipients.” Organ transplantation can extend an individual’s life by decades. It can also greatly improve an individual’s quality of life, as was Slakter’s experience. At the same time, organ transplantation is expensive and stressful. Recipients can experience complications, including organ rejection, and there are few appealing alternatives.After her heart transplant, author Leilani R. Graham required four open-heart surgeries, ECMO, and an intra-aortic balloon pump. She experienced delirium, necrotizing pneumonia, and severe muscular atrophy that required her to re-learn how to walk. She struggled with weight gain, explosive mood swings, hair loss, and was terrified that her body would reject the new heart. For Graham, “[Transplant] was not the miracle [she] was hoping for.” Graham says she felt unprepared for and inadequately informed about what to expect after her transplant, which left her “battered, beaten, and bruised” with a 12-inch line from neck to navel and “bullet holes” up and down her torso from the chest tubes. When reflecting on her experience post-transplant, Graham says, “It wasn’t the physical trauma that hurt the most. It was that no one seemed surprised [by the aftereffects of transplant].” Seemingly no one, that is except Graham, who calls on transplant providers to “prioritize empathy.”The symposium editors are Jason T. Eberl and Tristan McIntosh. Three commentary articles, written by Macey Leigh Levan, Heather Lannon, and Vidya A. Fleetwood, Roslyn B. Mannon & Krista L. Lentine, offer important insights into the authors’ stories. The editors thank Mid-America Transplant, the UCSF Lung Transplant Program, Donor Connect, William L. Freeman, MD, MPH, MJIL, CIP, Janet Monk, and the individuals who gave anonymous donations to support the publication of this issue, an open-access VOICES edition of the symposium, and accompanying teaching guides.The research article in this issue, “‘A Shell of My Former Self’: Using Figurative Language to Promote Communication about Patient Suffering,” was written by Tyler Tate, Elizabeth Stein, and Robert A. Pearlman. The relief of suffering is a primary goal of medicine. However, the authors note that clinicians often miss or ignore suffering because they focus on the causes rather than the experience of suffering, or the subjective nature of suffering makes it difficult to discuss. The authors believe that “the key to communicating about suffering lies in finding [End Page vii] the right kind of words to describe the experience” and say that figurative language offers a promising approach. In their research, the authors performed qualitative analysis on 52 works of literature and identified 254 excerpts of figurative language with themes of non-physical or psychological suffering. The authors found 13 salient themes: brokenness, diminishment, disorientation, drowning, emptiness, imprisonment, battle, darkness, isolation, invisibility, lifelessness, punishment, and torture. The authors reiterate that developing a shared language of suffering could foster a therapeutic patient-clinician relationship and improve clinicians’ ability to recognize and address a patient’s experience of suffering.María Susana Ciruzzi wrote the first of two case studies included in this issue. “The Sword of King Solomon” addresses a tragic and difficult subject—how to navigate the situation posed by conjoined twins when “any decision will produce damage and suffering.” The case involves two infant male patients born at 37 weeks gestation as omphalo-ischiopagus conjoined twins... (shrink)

A phenomenological model is developed as an alternative to current analyses of the imagination in sport philosophy, heirs to an Enlightenment notion that conceptualizes imaginings as abstract, eidetic, and representational. EC describes how Eidetic and Corporeal Imaginings phenomenologically structure our imaginative undertakings. EIs keep the ‘ideal’ aspect, but CIs—enacted, corporeal, non-representational—are more fundamental and foundational. Sports are particularly suited to express CIs’ muscular imaginings, which result in novel performances. An enactive framework theorizes CIs as non-representational interactions.

A phenomenological model is developed as an alternative to current analyses of the imagination in sport philosophy, heirs to an Enlightenment notion that conceptualizes imaginings as abstract, eidetic, and representational. EC describes how Eidetic and Corporeal Imaginings phenomenologically structure our imaginative undertakings. EIs keep the ‘ideal’ aspect, but CIs—enacted, corporeal, non-representational—are more fundamental and foundational. Sports are particularly suited to express CIs’ muscular imaginings, which result in novel performances. An enactive framework theorizes CIs as non-representational interactions.

Muscular dystrophies are associated with mutations in genes encoding several classes of proteins. These range from extracellular matrix and integral membrane proteins to cytoskeletal proteins, but also include a heterogeneous group of proteins including proteases, nuclear proteins, and signalling molecules. Muscular dystrophy phenotypes have also become evident in studies on various knockout mice defective in proteins not previously considered or known to be mutated in muscular dystrophies. Some unifying themes are beginning to emerge from all of these (...) data. This review will consider recent advances in our understanding of the molecules involved and bring together data that suggest a role for the cytoskeleton and cell adhesion in muscular dystrophies. BioEssays 24:542–552, 2002. © 2002 Wiley Periodicals, Inc. (shrink)

Although the precise function of utrophin at the postsynaptic membrane of the neuromuscular junction still remains unclear, despite recent genetic ‘knockout’ experiments(1,2), a separate study in a transgenic mouse model system for Duchenne muscular dystrophy (DMD) has nonetheless shown that overexpression of utrophin into extrasynaptic regions of muscle fibers can functionally compensate for the lack of dystrophin and alleviate the muscle pathology(3). In this context, the next step is to identify the mechanisms presiding over expression of utrophin at the (...) neuromuscular synapse in attempts to induce its expression throughout DMD muscle fibers. In fact, additional studies have shown that an important DNA element contained with the utrophin promoter may confer synapse‐specific expression to the utrophin gene(4,5). Identification of the events culminating in the transaction of the utrophin gene within synaptic myonuclei should provide important cues for the development of an effective therapeutic strategy for DMD. (shrink)

A survey of members of the Japan Muscular Dystrophy Association , including patients and families, was conducted in October 1995. Some of the same questions that were included in a 1992 survey were included to allow comparisons. During the 1994 Annual Meeting in Kyoto a special session on fetal diagnosis and bioethics was included, attended by over 500 persons, which may have been a cause for increased awareness of genetic diagnosis seen in this survey. 60% of patients and 71% (...) of families said they would receive fetal diagnosis. 10% of patients and 24% of families could remember DNA diagnosis of themselves, and most had some type of consent or information. (shrink)

The low rates of regular exercise and overall physical activity (PA) in the general population represent a significant public health challenge. Previous research suggests that, for many people, exercise leads to a negative affective response and, in turn, reduced likelihood of future exercise. The purpose of this paper is to examine this exercise–affect–adherence relationship from an evolutionary perspective. Specifically, we argue that low rates of physical exercise in the general population are a function of the (...) evolved human tendency to avoid unnecessary physical exertion. This innate tendency evolved because it allowed our evolutionary ancestors to conserve energy for physical activities that had immediate adaptive utility such as pursuing prey, escaping predators, and engaging in social and reproductive behaviors. The commonly observed negative affective response to exercise is an evolved proximate psychological mechanism through which humans avoid unnecessary energy expenditure. The fact that the human tendencies toward negative affective response to and avoidance of unnecessary physical activities are innate does not mean that they are unchangeable. Indeed, it is only because of human-engineered changes in our environmental conditions (i.e., it is no longer necessary for us to work for our food) that our predisposition to avoid unnecessary physical exertion has become a liability. Thus, it is well within our capabilities to reengineer our environments to once again make PA necessary or, at least, to serve an immediate functional purpose. We propose a two-pronged approach to PA promotion based on this evolutionary functional perspective: first, to promote exercise and other physical activities that are perceived to have an immediate purpose, and second, to instill greater perceived purpose for a wider range of physical activities. We posit that these strategies are more likely to result in more positive (or less negative) affective responses to exercise, better adherence to exercise programs, and higher rates of overall PA. (shrink)

The World Medical Association (WMA), the global representation of the medical profession, first adopted the International Code of Medical Ethics (ICoME) in 1949 to outline the professional duties of physicians to patients, other physicians and health professionals, themselves and society as a whole. The ICoME recently underwent a major 4-year revision process, culminating in its unanimous adoption by the WMA General Assembly in October 2022 in Berlin. This article describes and discusses the ICoME, its revision process, the controversial and uncontroversial (...) issues, and the broad consensus achieved among WMA constituent members, representing over 10 million physicians worldwide. The authors analyse the ICoME, including its response to contemporary changes and challenges like ethical plurality and globalisation, in light of ethical theories and approaches, reaching the conclusion that the document is a good example of international ethical professional self-regulation. (shrink)

This full-color, user-friendly book features simple meridian exercises that combine breathing, movement, stretching, and focused attention to improve overall balance and flexibility. The book identifies specific meridian exercises to alleviate common ailments, including headaches, colds, and the flu, as well as more serious conditions, such as high blood pressure, diabetes, and thyroid disorders. Meridian exercise is a technique developed and perfected over the course of thousands of years in the Asian healing arts traditions. This book includes the following features: (...) Low-impact, time-efficient exercises that relieve stress, restore physical health, and rebalance the mind Step-by-step instructions with accompanying photos for dozens of exercises specifically designed for common symptoms Breathing and relaxation techniques to awaken innate healing power and. (shrink)

“Exercise starts and ends in the brain”: this was the title of a review article authored by Dr. Bengt Kayser back in 2003. In this piece of work, the author highlights that pioneer studies have primarily focused on the cardiorespiratory-muscle axis to set the human limits to whole-body exercise tolerance. In some circumstances, however, exercise cessation may not be solely attributable to these players: the central nervous system is thought to hold a relevant role as the ultimate (...) site of exercise termination. In fact, there has been a growing interest relative to the “brain” response to exercise in chronic cardiorespiratory diseases, and its potential implication in limiting the tolerance to physical exertion in patients. To reach these overarching goals, non-invasive techniques, such as near-infrared spectroscopy and transcranial magnetic stimulation, have been successfully applied to get insights into the underlying mechanisms of exercise limitation in clinical populations. This review provides an up-to-date outline of the rationale for the “brain” as the organ limiting the tolerance to physical exertion in patients with cardiorespiratory diseases. We first outline some key methodological aspects of neuromuscular function and cerebral hemodynamics assessment in response to different exercise paradigms. We then review the most prominent studies, which explored the influence of major cardiorespiratory diseases on these outcomes. After a balanced summary of existing evidence, we finalize by detailing the rationale for investigating the “brain” contribution to exercise limitation in hitherto unexplored cardiorespiratory diseases, an endeavor that might lead to innovative lines of applied physiological research. (shrink)

In my paper I will argue for the thesis that spiritual exercises are an essential part of every philosophical life. My arguments are partly historical, partly conceptual in their nature. First, I show that philosophy at each stage of its history was accompanied by spiritual exercises. Next, I provide a definition of spiritual exercises as genuinely philosophical activity. Then I show that the philosophical life cannot be complete if it does not include spiritual exercises.

In this paper, we examine the metaphilosophical relevance of the phenomenon of sleep, suggesting that it has the potential to not only enrich the analysis of limit cases but also to test some of the ideas concerning the possibility of naturalizing phenomenology and its limits. Insofar as sleeping allows for both a first personal and a third personal description and challenges the usual primacy of the first-person point of view, exploring sleeping under the prism of its import for the phenomenological (...) method allows to illuminate the relationships between a first personal transcendental phenomenology and a third personal naturalized one. We do this by examining Husserl’s treatment of sleep as a limit-case, and the problem of accounting for deep sleep from a first-personal perspective. Drawing from a Heidegger-inspired account of sleep, we argue that sleep demands for a type of approach that can be fairly described as ontological, and which reveals a new understanding of subjectivity as a dynamic unity of different modes of being. Although this approach challenges a first-personal based approach, it does not, however support the naturalization of phenomenology or undermine the project of a transcendental philosophy of experience. (shrink)

Spinal muscular atrophy (SMA) is the most common genetic disease that causes infant mortality. Its treatment and prevention represent the paradigmatic example of the ethical dilemmas of 21st‐century medicine. New therapies (nusinersen and AVXS‐101) hold the promise of being able to treat, but not cure, the condition. Alternatively, genomic analysis could identify carriers, and carriers could be offered in vitro fertilization and preimplantation genetic diagnosis. In the future, gene editing could prevent the condition at the embryonic stage. How should (...) these different options be evaluated and compared within a health system? In this paper, we discuss the ethical considerations that bear on the question of how to prioritize the different treatments and preventive options for SMA, at a policy level. We argue that despite the tremendous value of what we call ‘ex‐post’ approaches to treating SMA (such as using pharmacological agents or gene therapy), there is a moral imperative to pursue ‘ex‐ante’ interventions (such as carrier screening in combination with prenatal testing and preimplantation genetic diagnosis, or gene editing) to reduce the incidence of SMA. There are moral reasons relating to autonomy, beneficence and justice to prioritize ex‐ante methods over ex‐post methods. (shrink)

Concerns over the carbon footprint resulting from the manufacturing, usage and disposal of hardware have been growing. The right-to-repair legislation was introduced to promote sustainable utilisation of hardware by encouraging stakeholders to prolong the lifetime of products, such as electronic devices. As there is little empirical evidence from a consumer perspective on exercising the right to repair, this study aims firstly to examine the factors that underpin consumers’ intention to repair their hardware and secondly to investigate the perceived outcomes of (...) repair practices. Based on 510 responses, the results showed that intention to repair is dependent on three groups of factors, namely the facilitators of pro-environmental behaviour, repair-related factors and beliefs about legislation. If consumers have a stronger intention to repair, they have a stronger feeling of emotional self-assurance, satisfaction with the repair decision and the technology manufacturer, an intention to engage with the manufacturer and a positive perception of a repaired device’s performance. The findings contribute to the literature on sustainable behaviour and the right to repair, offering insight for policymakers and manufacturers about the strategies facilitating the wider adoption of repair practices. (shrink)

If _presentism_ is true, then no wholly non-present events exist. If _absence orthodoxy_ is true, then no absences exist. I discuss a well-known causal argument against presentism, and develop a very similar argument against absence orthodoxy. I argue that solutions to the argument against absence orthodoxy can be adopted by the presentist as solutions to the argument against presentism. The upshot is that if the argument against absence orthodoxy fails, then so does the argument against presentism.

Spinal muscular atrophy (SMA) type 1 is a genetic neuromuscular disease in children that leads to degeneration of spinal cord motor neurons. This sometimes results in severe muscular paralysis requiring mechanical ventilation to sustain the child’s life. The onset of SMA type 1, the most severe form of the disease, is during the first year of life. These children become severely paralysed, but retain their intellectual capacity. Ethical concerns arise when mechanical ventilation becomes necessary for survival. When professionals (...) assess the resulting life for the child and family, they sometimes fear it will result in unreasonably excessive care. The aim of this article is to present an analysis of ethical arguments that could support or oppose the provision of invasive ventilation in this population. This examination is particularly relevant as France is one of the few countries performing tracheotomies and mechanical ventilation for this condition. (shrink)