BackgroundPeople with upper extremity amputations report receiving insufficient information about treatment options. Furthermore, patients commonly report not knowing what questions to ask providers. A question prompt sheet, or list of questions, can support patient-centered care by empowering patients to ask questions important to them, promoting patient-provider communication, and increasing patient knowledge. This study assessed information needs among people with UE amputations about UE vascularized composite allotransplantation and developed a UE VCA-QPS.MethodsThis multi-site, cross-sectional, mixed-methods study involved in-depth and semi-structured interviews with (...) people with UE amputations to assess information needs and develop a UE VCA-QPS. Qualitative data were analyzed by thematic analysis; quantitative data were analyzed by descriptive statistics. The initial UE VCA-QPS included 130 items across 18 topics.ResultsEighty-nine people with UE amputations participated. Most were male, had a mean age of 46 years, and had a unilateral and below-elbow amputation. Participants desired information about UE VCA eligibility, evaluation process, surgery, risks, rehabilitation, and functional outcomes. After refinement, the final UE VCA-QPS included 35 items, across 9 topics. All items were written at a ≤ 6th grade reading level. Most semi-structured interview participants reported being ‘completely’ or ‘very’ likely to use a UE VCA-QPS.ConclusionPeople with UE amputations have extensive information needs about UE VCA. The UE VCA-QPS aims to address patients’ information needs and foster patient-centered care. Future research should assess whether the UE VCA-QPS facilitates patient-provider discussion and informed decision-making for UE VCA. (shrink)

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)

The paper provides a preliminary study of algebraic semantics for modal and superintuitionistic non-monotonic logics. The main question answered is: how can non-monotonic inference be understood algebraically?

In his article, “The Unified Brain-Based Determination of Death Conceptually Justifies Death Determination in DCDD and NRP Protocols,” James Bernat argues that Thoracoabdominal Normothermic Regiona...

In this paper, we study temporal logic for finite linear structures and surjective bounded morphisms between them. We give a characterisation of such structures by modal formulas and show that every pair of linear structures with a bounded morphism between them can be uniquely characterised by a temporal formula up to an isomorphism. As the main result, we prove Kripke completeness of the logic with respect to the class of finite linear structures with bounded morphisms between them.

Research involving recently deceased humans that are physiologically maintained following declaration of death by neurologic criteria—or ‘research involving the recently deceased’—can fill a translational research gap while reducing harm to animals and living human subjects. It also creates new challenges for honouring the donor’s legacy, respecting the rights of donor loved ones, resource allocation and public health. As this research model gains traction, new empirical ethics questions must be answered to preserve public trust in all forms of tissue donation and (...) in the practice of medicine while respecting the legacy of the deceased and the rights of donor loved ones. This article suggests several topics for immediate investigation to understand the attitudes and experiences of researchers, clinical collaborators, donor loved ones and the public to ensure research involving the recently deceased advances ethically. (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 newly revised edition of the International Best-Seller, Making the Brain/Body Connection hit the book stores in June. This book has people raving about its user friendly approach and its solid research based information. Explore and experience how your brain, body and senses interrelate. Sharon Promislow's approach makes the brain research almost fun. Learn about your body's defence mechanism for stress and how you can adapt them to defuse stress instead of allowing it to accumulate into a full blown stress (...) attack. In her lively and entertaining book, Sharon blends cutting edge stress and brain research with practical exercises and techniques that have you moving beyond your current limitations and into a life you only imagined you could have. Her Quick Six stress buster techniques can be used on the street, in the board room, wherever you are when stress hits.Follow along with this step-by-step guide as she leads you through a model for change that unlocks hidden "stress circuits." Clear away mental, emotional and physical blocks to success with simple movements from the 10 Step Change Process, that make change fun. Illustrated with humorus new cartoon characters by Cathrine Levan. (shrink)

Velaquí un libro que fala do home actual e do seu mundo. Da vida como camiño con encrucilladas. Encrucilladas que levan a filosofía actual a buscar na linguaxe unha nova forma de supervivencia. Unha modalidade de encontro no inestable conflito de interpretacións dos múltiples discursos sobre a realidade. Camiñantes aborda os problemas derivados da globalización, a violencia e a soidade do home contemporáneo.

Open Compositionality: Towards a Methodology of Language offers a fresh view into human languages as supermodular, highly interactive cognitive capacities allowing for human unique thought and communication. It is a novel account of semantics as decision-making in tandem with the cognition first methodology.

Abstract:This symposium includes thirteen personal narratives from people who have received at least one organ transplant from a living or deceased donor. These narratives foster better understanding of the experiences of life-saving organ recipients and their families, including post-transplant difficulties experienced—sometimes requiring multiple transplants. This issue also includes three commentaries by Macey L. Levan, Heather Lannon, and Vidya Fleetwood, Roslyn B. Mannon & Krista L. Lentine. Dr. Levan is a living kidney donor and associate professor of surgery and (...) population health. She writes and teaches on organ transplant and has expertise and experience in governance at the federal level as a member of the board of directors for the U.S. Organ Procurement and Transplantation Network. Dr. Lannon is a social worker and transplant advocate. Her work and interest in the topic were inspired by her husband who needed a heart transplant. Dr. Fleetwood is a surgeon specializing in liver transplantation, pancreas transplantation, kidney transplantation, as well as living donor nephrectomy. Dr. Mannon is a nephrologist and professor of medicine, pathology and microbiology. Her work focuses on understanding and improving long-term kidney transplant outcomes for patients, donors, and caregivers. Dr. Lentine is a nephrologist specializing in treatment of adult patients with kidney disease. She is a researcher and co-chaired the international work group that developed guidelines for living donor kidney transplantation. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Journal of the History of Ideas 62.3 (2001) 523-541 [Access article in PDF] Antiquarianism, the History of Objects, and the History of Art before Winckelmann Thomas DaCosta Kaufmann [Figures] To the Memory of Franklin LeVan Baumer. In light of postmodernist and poststructuralist trends in the humanities which have contested notions of originality and of authorship, it might seem surprising that one outstanding myth of the eighteenth century has (...) not yet been thoroughly challenged. This is the claim made by Johann Joachim Winckelmann in the foreword to the Geschichte der Kunst des Altertums, originally published in 1764, that he had created a new history of art which was distinct from a history of artists and also different from what had previously been written about antiquities (Altertümer): The history of the art of antiquity, which I have undertaken to write, is no mere account of the chronological order and change of art, but I take the word history in the wider sense, that it has in the Greek language, and my intention is to offer an attempt at a system.... But the essence of art is in every part the most eminent aim, in which the history of artists has little influence, and this [sort of history of artists], which has been compiled by others, is therefore not to be sought here... those who have treated antiquities, examine either only such where erudition was to be applied, or, if they speak of art, this happens in part with common eulogies, or their judgment is built on peculiar, false grounds. 1 [End Page 523]Wolf Lepenies once described this claim as one of the many foundational myths of the Enlightenment and presented instead some parallels between the writing of art history and natural history in the eighteenth century. 2 As interest in the historiography of art has revived, publications have continued to pour forth on Winckelmann. 3 Yet the critique suggested by Lepenies has largely not been followed. Winckelmann's claim to originality remains a starting or major turning point for most accounts of the history of the discipline of art history. 4 [End Page 524]It may be that Winckelmann's claim has remained largely unchallenged because his differentiation of his accomplishment from that of Gelehrsamkeit in particular coincides with and helps to support another distinction made at his time, that between "philosophy," or criticism, and erudition, the latter being at best necessary but inferior. 5 This distinction, which was fostered by the philosophes and their counterparts in other countries, has been frequently heard in scholarly debates, and it is echoed in current discussions where empirical scholarship is disparaged in favor of what is often now called Theory. 6 Thus while in the twentieth century the Enlightenment came in for heavy going starting with at least the critique of Max Horkheimer and Theodor W. Adorno, 7 this is one Enlightenment opinion which, despite the rise of critical theory among other trends in recent scholarship, has gained in fashion, especially in the English-speaking world.But the contrast between philosophy, or critique, and erudition makes a distinction that is ultimately untenable, even if it is also one that has continued to dominate many views of the history of eighteenth-century scholarship. The case at hand suggests that supposed innovations of the eighteenth century in the historiography of art, as in many other fields of study, are much more bound up with late humanism and encyclopedism than their promulgators might have wished to admit. Scholars of a number of disciplines have begun to revise interpretations of the role of the so-called antiquarians of the sixteenth to eighteenth centuries--those who dealt with Altertümer. 8 Some recent studies of the historiography of art have pointed to some connections between the antiquarian tradition and that of the historiography of art. 9 These approaches, however, have primarily dealt with Italian and French writers and, moreover, have left Winckelmann's position largely untouched. 10 Winckelmann's situation in the [End Page 525] broader European historical and geographical context also remains... (shrink)

Background: Only data of published study results are available to the scientific community for further use such as informing future research and synthesis of available evidence. If study results are reported selectively, reporting bias and distortion of summarised estimates of effect or harm of treatments can occur. The publication and citation of results of clinical research conducted in Germany was studied.Methods: The protocols of clinical research projects submitted to the research ethics committee of the University of Freiburg in 2000 were (...) analysed. Published full articles in several databases were searched and investigators contacted. Data on study and publication characteristics were extracted from protocols and corresponding publications.Results: 299 study protocols were included. The most frequent study design was randomised controlled trial , followed by uncontrolled studies , laboratory studies and non-randomised studies . 182 were multicentre studies including 97 international collaborations. 152 of 299 had commercial funding and 46 non-commercial funding. 109 of the 225 completed protocols corresponded to at least one full publication ; the publication rate was 48%. 168 of 210 identified publications were cited in articles indexed in the ISI Web of Science. The median was 11 citations per publication .Conclusions: Results of German clinical research projects conducted are largely underreported. Barriers to successful publication need to be identified and appropriate measures taken. Close monitoring of projects until publication and adequate support provided to investigators may help remedy the prevailing underreporting of research. (shrink)

On conduct of life and ethics of Islamic seminarians.

BackgroundKeeping the patients well and fully informed about diagnosis, prognosis, and treatments is one of the patient’s rights in any healthcare system. Although all healthcare providers have the same viewpoint about rendering the truth in treatment process, sometimes the truth is not told to the patients; that is why the healthcare staff tell “white lie” instead. This study aimed to explore the nurses’ experience of white lies during patient care.MethodsThis qualitative study was conducted from June to December 2018. Eighteen hospital (...) nurses were recruited with maximum variation from ten state-run educational hospitals affiliated to Tehran University of Medical Sciences. Purposeful sampling was used and data were collected by semi-structured interviews that were continued until data saturation. Data were classified and analyzed by content analysis approach.ResultsThe data analysis in this study resulted in four main categories and 11 subcategories. The main categories included hope crisis, bad news, cultural diversity, and nurses’ limited professional competences.ConclusionResults of the present study showed that, white lie told by nurses during patient care may be due to a wide range of patient, nurse and/or organizational related factors. Communication was the main factor that influenced information rendering. Nurses’ communication with patients should be based on mutual respect, trust and adequate cultural knowledge, and also nurses should provide precise information to patients, so that they can make accurate decisions regarding their health care. (shrink)

Encyclopedic dictionary of Yogasūtra of Patañjali.

Монография посвящена теории и практике очеловечивания человека. Уделено внимание факторам, способствующим укреплению здоровья и восхождению человека к своей истинной природе, или, наоборот, способствующим его деградации.