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)

Given its non-invasive nature, there is increasing interest in the use of transcutaneous vagus nerve stimulation across basic, translational and clinical research. Contemporaneously, tVNS can be achieved by stimulating either the auricular branch or the cervical bundle of the vagus nerve, referred to as transcutaneous auricular vagus nerve stimulation and transcutaneous cervical VNS, respectively. In order to advance the field in a systematic manner, studies using these technologies need to adequately report sufficient methodological detail to enable comparison of results between (...) studies, replication of studies, as well as enhancing study participant safety. We systematically reviewed the existing tVNS literature to evaluate current reporting practices. Based on this review, and consensus among participating authors, we propose a set of minimal reporting items to guide future tVNS studies. The suggested items address specific technical aspects of the device and stimulation parameters. We also cover general recommendations including inclusion and exclusion criteria for participants, outcome parameters and the detailed reporting of side effects. Furthermore, we review strategies used to identify the optimal stimulation parameters for a given research setting and summarize ongoing developments in animal research with potential implications for the application of tVNS in humans. Finally, we discuss the potential of tVNS in future research as well as the associated challenges across several disciplines in research and clinical practice. (shrink)

Early zoological researches by P.S. Pallas and K.E. von Baer in their letters to the zoologists of Berlin. The centenaries which are celebrated in 1991 and 1992 in memory of P.S. Pallas (1791) and K.E. von Baer (born 1792) caused the following studies of hitherto unpublished sources, preserved in the collections of the Museum für naturkunde in Berlin. The earliest zoological works of Pallas are discussed in relation to his last publication on the “Zoographia Rosso-Asiatica” which should have been finished (...) in Berlin. Some years after the death of Pallas, Baer also contacted the Berlin zoologists K.A. Rudolphi and M.H. Lichtenstein, asking for help, when he was going to establish zoology and a zoological museum at the University of Königsberg. (shrink)

The philosophical faculty of the Jesuit Berchmanskolleg in Pullach has long since made its mark in the publishing world, and the new series of philosophical studies from Father Lotz and his associates, of which these two volumes are an auspicious beginning, shows every sign of living up to the high standard we have come to expect. Volume I is a collection of five essays: a comparison between the Thomistic and Kantian theory of knowledge, by Fr. de Vries; the transcendental method (...) in Kant and in Scholasticism, by Fr. Lotz; the Absolute in the Kritik der reinen Vernunft, by Fr. Brugger; formalism in Kant’s ethics, by Dr. Schmucker; and the relationship between Kant and Heidegger, by Fr. Coreth. It concludes with a particularly useful bibliography of scholastic literature on Kant between 1920 and 1955, compiled by Fr. Brugger. After Jansen, Maréchal is the scholastic writer with most published studies on Kant to his credit, and it is not surprising that his influence should make itself felt in the present volume. His monumental Le point de départ de la métaphysique marked a definite turning–point in the scholastic attitude towards Kant, and one has only to read this collection of studies to realise how the atmosphere has changed in the course of the last fifty years. Fr. de Vries devotes almost two–thirds of his essay to what St. Thomas and Kant hold in common with regard to the discursive nature of human understanding, the structure of the sense–image and its relation to the intellectual concept, though he also brings out the fundamental difference between the two on the questions of self–consciousness, natural theology and the reality of the external world. Not only does he show a healthy respect for the many grains of truth in the philosophy of Kant, but he insists that Thomists have much to learn from the German philosopher on the question of strict, critical method. Scholastics of the traditional school were satisfied with what Fr. Lotz describes as the “objective method” and rejected the “subjective” as smacking of subjectivism or idealism. In the longest essay of the five, Fr. Lotz compares the Kantian and Scholastic methods. Kant himself described his Kritik der reinen Vernunft as a “treatise on method rather than a scientific system”, and in the course of the book he condemns the objective approach as dogmatic and uncritical, leaving only the subjective method, which rules out any possibility of metaphysics. Fr. Lotz rightly asserts that even the most modern scholastic cannot dispense with the objective method, but he maintains that it demands to be completed by the subjective. Many scholastics will agree with him on the usefulness of the latter, and indeed an amount of research has been done in this field in recent decades. But how many will agree when he says that scholastic objectivism includes the subjective or transcendental method as the only way, or the only basis on which objectivism can stand? Maréchal’s influence is evident in his treatment of the faculties of the soul. But, however one may quibble at individual points in the book, it nevertheless remains a very valuable contribution to the scholastic literature on Kant. (shrink)

This study explores the relationship between moral intensity and the use of different sensemaking strategies in military critical incidents. First, narratives of military personnel were used to select prototypical high/low moral intensity critical incidents. In a follow-up, a scenario study was conducted with active duty military personnel to examine the relationship between moral intensity and the use of sensemaking tactics. This study offers three main conclusions. First, the use of sensemaking tactics is strongly tied to the level of moral intensity (...) in the situation. In high-intense situations, the servicemen draw on previous experiences, prediction of consequences, and help of others to recognize and interpret the situation. Less attention goes out to higher level critical thinking. Thus, it seems that in these critical incidents, the servicemen react without giving room for thorough consideration and deliberation. Second, the number of deployments a serviceman experienced influences the perceived seriousness and harmfulness of the situation negatively in low-intense situations. Finally, and in line with earlier studies, the results indicate that the concept of moral intensity is formed out of three rather than the six dimensions originally proposed by Jones. The implications of these findings are discussed. (shrink)

In 1999, da Silva, D'Ottaviano and Sette proposed a general definition for the term translation between logics and presented an initial segment of its theory. Logics are characterized, in the most general sense, as sets with consequence relations and translations between logics as consequence-relation preserving maps. In a previous paper the authors introduced the concept of conservative translation between logics and studied some general properties of the co-complete category constituted by logics and conservative translations between them. In this paper we (...) present some conservative translations involving classical logic, Lukasiewicz three-valued system L3, the intuitionistic system I1 and several paraconsistent logics, as for instance Sette's system P1, the D'Ottaviano and da Costa system J3 and da Costa's systems Cn, 1≤ n≤ω. (shrink)

The introduction of non-invasive prenatal testing in healthcare systems around the world offers an opportunity to reconsider funding policies for prenatal screening. In some countries with universal access healthcare systems, pregnant women and their partners are asked to pay for NIPT. In this paper, we discuss two important rationales for charging women for NIPT: to prevent increased uptake of NIPT and to promote informed choice. First, given the aim of prenatal screening, high or low uptake rates are not intrinsically desirable (...) or undesirable. Using funding policies to negatively affect uptake, however, is at odds with the aim of screening. Furthermore, copayment disproportionally affects those of lower socioeconomic status, which conflicts with justice requirements and impedes equal access to prenatal screening. Second, we argue that although payment models may influence pregnant women’s choice behaviours and perceptions of the relevance of NIPT, the copayment requirement does not necessarily lead to better-informed choices. On the contrary, external influences on women’s personal choices for or against prenatal screening should ideally be avoided. To improve informed decision-making, healthcare systems should instead invest in adequate non-directive, value-focused pretest counselling. This paper concludes that requiring copayments for NIPT in universal access healthcare systems fails to promote reproductive autonomy and is unfair. (shrink)

Like _Beyond All Appearances_,_ _which it supplements, Paul Weiss’s new book is a fundamental work which faces all the hard issues which are not only at the heart of philosophy but at the core of our entire culture. Readers of Mr. Weiss’s phenomenology of religion will need no introduction to this new work which expands and clari­fies many of the issues raised in _Beyond All Appearances. _However, no knowl­edge of Paul Weiss’s previous books is required to understand and appreciate this (...) brilliant new exposition. Weiss’s plain style makes his ideas accessible to all intelligent readers, whether or not they have been trained as professional philosophers. Here in _First Considerations _Mr. Weiss addresses himself to such topics as actuality, internalization, evidence, names, substance, being, natures and possibilities, existence, unity and the cosmos—issues which have engrossed him as a moral philosopher and meta­physician throughout his distinguished career. In his progress through the ideas and issues expounded in this new book Mr. Weiss is concerned with the human condition distinctive of this species of ours. Rigorously applied, his moral philosophy is as complete and thorough as that of any of the major thinkers, and provides as complete a guide as, for example, that of Buddhism. A highly original work, no doubt well in advance of current trends in philosophy, _First Considerations _will provoke further thought and discussion and will be regarded as a seminal work in modern philosophical approaches. (shrink)

The advent of new genetic and genomic technologies may cause friction with the principle of respect for autonomy and demands a rethinking of traditional interpretations of the concept of informed consent. Technologies such as whole‐genome sequencing and micro‐array based analysis enable genome‐wide testing for many heterogeneous abnormalities and predispositions simultaneously. This may challenge the feasibility of providing adequate pre‐test information and achieving autonomous decision‐making. At a symposium held at the 11th World Congress of Bioethics in June 2012 (Rotterdam), organized by (...) the International Association of Bioethics, these challenges were presented for three different areas in which these so‐called ‘new genetics’ technologies are increasingly being applied: newborn screening, prenatal screening strategies and commercial personal genome testing. In this article, we build upon the existing ethical framework for a responsible set‐up of testing and screening offers and reinterpret some of its criteria in the light of the new genetics. As we will argue, the scope of a responsible testing or screening offer should align with the purpose(s) of testing and with the principle of respect for autonomy for all stakeholders involved, including (future) children. Informed consent is a prerequisite but requires a new approach. We present preliminary and general directions for an individualized or differentiated set‐up of the testing offer and for the informed consent process. With this article we wish to contribute to the formation of new ideas on how to tackle the issues of autonomy and informed consent for (public) healthcare and direct‐to‐consumer applications of the new genetics. (shrink)

Introducing and implementing corporate sustainability poses many challenges to business organizations. In this longitudinal, inductive study, we focus on how such challenges are handled in a Dutch bank that is developing its sustainability policies. We examine why there is such a high degree of tension and conflict within the organization and identify how the development of these policies is affected by the interplay between subcultures and institutional logics. We show how different subcultures affect the enactment of logics by infusing the (...) rational and mindful behavior coming from logics with (sub)cultural values, beliefs, and assumptions. In turn, conflicting logics amplify subcultural characteristics between groups by shaping different behavior and practices. Together, this leads to a magnification of subcultural differences while, at the same time, logics are increasingly being perceived as incompatible. (shrink)

In the light of partial (mis)understanding, we examine the thesis that concepts are individuated in terms of possession conditions and show that adherents face a fatal dilemma: Either concept‐individuating possession conditions include cases of partially (mis)understood concepts or not. If yes, possession conditions do not individuate concepts. If no, the thesis is too restricted and lacks a minimally satisfactory level of generalization.

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)

In recent years, functional connectivity in the developmental science received increasing attention. Although it has been reported that the anatomical connectivity in the preterm brain develops dramatically during the last months of pregnancy, little is known about how functional and effective connectivity change with maturation. The present study investigated how effective connectivity in premature infants evolves. To assess it, we use EEG measurements and graph-theory methodologies. We recorded data from 25 preterm babies, who underwent long-EEG monitoring at least twice during (...) their stay in the NICU. The recordings took place from 27 weeks postmenstrual age until 42 weeks PMA. Results showed that the EEG-connectivity, assessed using graph-theory indices, moved from a small-world network to a random one, since the clustering coefficient increases and the path length decreases. This shift can be due to the development of the thalamocortical connections and long-range cortical connections. Based on the network indices, we developed different age-prediction models. The best result showed that it is possible to predict the age of the infant with a root mean-squared error equal to 2.11 weeks. These results are similar to the ones reported in the literature for age prediction in preterm babies. (shrink)

BackgroundFor many decades, the debate on children’s competence to give informed consent in medical settings concentrated on ethical and legal aspects, with little empirical underpinnings. Recently, data from empirical research became available to advance the discussion. It was shown that children’s competence to consent to clinical research could be accurately assessed by the modified MacArthur Competence Assessment Tool for Clinical Research. Age limits for children to be deemed competent to decide on research participation have been studied: generally children of 11.2 (...) years and above were decision-making competent, while children of 9.6 years and younger were not. Age was pointed out to be the key determining factor in children’s competence. In this article we reflect on policy implications of these findings, considering legal, ethical, developmental and clinical perspectives.DiscussionAlthough assessment of children’s competence has a normative character, ethics, law and clinical practice can benefit from research data. The findings may help to do justice to the capacities children possess and challenges they may face when deciding about treatment and research options. We discuss advantages and drawbacks of standardized competence assessment in children on a case-by-case basis compared to application of a fixed age limit, and conclude that a selective implementation of case-by-case competence assessment in specific populations is preferable. We recommend the implementation of age limits based on empirical evidence. Furthermore, we elaborate on a suitable model for informed consent involving children and parents that would do justice to developmental aspects of children and the specific characteristics of the parent-child dyad.SummaryPrevious research outcomes showed that children’s medical decision-making capacities could be operationalized into a standardized assessment instrument. Recommendations for policies include a dual consent procedure, including both child as well as parents, for children from the age of 12 until they reach majority. For children between 10 and 12 years of age, and in case of children older than 12 years in special research populations of mentally compromised patients, we suggest a case-by-case assessment of children’s competence to consent. Since such a dual consent procedure is fundamentally different from a procedure of parental permission and child assent, and would imply a considerable shift regarding some current legislations, practical implications are elaborated. (shrink)

We studied the role of social dynamics in moral decision-making and behavior by investigating how physical sensations of dirtiness versus cleanliness influence moral behavior in leader–subordinate relationships, and whether a leader’s self-interest functions as a boundary condition to this effect. A pilot study revealed that when participants imagined rewarding unethical behavior of a subordinate, they felt more dirty. Our main experiment showed that directly manipulating dirtiness by allowing leaders to touch a dirty object led to more positive evaluations of, and (...) higher bonuses for, unethical subordinates than touching a clean object. This effect, however, only emerged when the subordinate’s unethical behavior did not serve the leader’s own interest. Hence, subtle cues such as bodily sensations can shape moral decision-making and behavior in leader–subordinate relationships, but self-interest, as a core characteristic of interdependence, can override the influence of such cues on the leader’s moral behavior. (shrink)

Anna Smajdor’s proposal of whole body gestational donation (WBGD) states that female patients diagnosed as brain-dead should be considered for use as gestational donors. In this response, Smajdor’s proposal is rejected on four different accounts: (a) the debated acceptability of surrogacy despite women's autonomy, (b) the harm to dead women ́s interests, (c) the interests of the descendants, and (d) the symbolic value of the body and interests of relatives. The first part argues that WBGD rests on a particular conception (...) of the instrumentalization of bodies that cannot be circumvented simply by the patient’s consent and relinquished autonomy. The second part argues the importance of avoiding any harm to dead women’s interests. The third part identifies the importance of the interest of the foetus in the light of Procreative-Beneficence principle that Smajdor overlooks. And finally, the fourth part considers the symbolic value of the human body and the interest of relatives. The main goal of this commentary is not to show that WBGD cannot be implemented; rather, it is to show that there are not any good arguments in favour of doing so. (shrink)

This paper analyses the way in which discourse and argumentation may vary depending on participants’ educational level and gender. Men and women from three different educational levels (literacy, advanced level and university students) participated in discussion groups that debated about women and work, the sharing of housework and the way in which girls and boys are educated. The results showed important differences depending on participants’ educational level and gender. In general, the main differences were related to educational level, while gender (...) tended to interact with educational level, as a moderating factor. (shrink)

In this paper we consider an intuitionistic variant of the modal logic S4 (which we call IS4). The novelty of this paper is that we place particular importance on the natural deduction formulation of IS4— our formulation has several important metatheoretic properties. In addition, we study models of IS4— not in the framework of Kirpke semantics, but in the more general framework of category theory. This allows not only a more abstract definition of a whole class of models but also (...) a means of modelling proofs as well as provability. (shrink)