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)

The spatial organization of the genome is intimately linked to its biological function, yet our understanding of higher order genomic structure is coarse, fragmented and incomplete. In the nucleus of eukaryotic cells, interphase chromosomes occupy distinct.

Current workflows in academic ecology rarely allow an engagement of ecologists with philosophers, or with contemporary philosophical work. We argue that this is a missed opportunity for enriching ecological reasoning and practice, because many questions in ecology overlap with philosophical questions and with current topics in contemporary philosophy of science. One obstacle to a closer connection and collaboration between the fields is the limited awareness of scientists, including ecologists, of current philosophical questions, developments and ideas. In this article, we aim (...) to overcome this obstacle and trigger more collaborations between ecologists and philosophers. First, we provide an overview of philosophical research relevant to ecologists. Second, we use examples to demonstrate that many ecological questions have a philosophical dimension and point to related philosophical work. We elaborate on one example – the debate around the appropriate level of complexity of ecological models – to show in more detail how philosophy can enrich ecology. Finally, we provide suggestions for how to initiate collaborative projects involving both ecologists and philosophers. (shrink)

Rationale: Deep brain stimulation (DBS) of the hippocampus is proposed for enhancement of memory impaired by injury or disease. Many pre-clinical DBS paradigms can be addressed in epilepsy patients undergoing intracranial monitoring for seizure localization, since they already have electrodes implanted in brain areas of interest. Even though epilepsy is usually not a memory disorder targeted by DBS, the studies can nevertheless model other memory-impacting disorders, such as Traumatic Brain Injury (TBI). Methods: Human patients undergoing Phase II invasive monitoring for (...) intractable epilepsy were implanted with depth electrodes capable of recording neurophysiological signals. Subjects performed a delayed-match-to-sample (DMS) memory task while hippocampal ensembles from CA1 and CA3 cell layers were recorded to estimate a multi-input, multi-output (MIMO) model of CA3-to-CA1 neural encoding and a memory decoding model (MDM) to decode memory information from CA3 and CA1 neuronal signals. After model estimation, subjects again performed the DMS task while either MIMO-based or MDM-based patterned stimulation was delivered to CA1 electrode sites during the encoding phase of the DMS trials. Each subject was sorted (post hoc) by prior experience of repeated and/or mild-to-moderate brain injury (RMBI), TBI, or no history (control) and scored for percentage successful delayed recognition (DR) recall on stimulated vs. non-stimulated DMS trials. The subject’s medical history was unknown to the experimenters until after individual subject memory retention results were scored. Results: When examined compared to control subjects, both TBI and RMBI subjects showed increased memory retention in response to both MIMO and MDM-based hippocampal stimulation. Furthermore, effects of stimulation were also greater in subjects who were evaluated as having pre-existing mild-to-moderate memory impairment. Conclusion: These results show that hippocampal stimulation for memory facilitation was more beneficial for subjects who had previously suffered a brain injury (other than epilepsy), compared to control (epilepsy) subjects who had not suffered a brain injury. This study demonstrates that the epilepsy/intracranial recording model can be extended to test the ability of DBS to restore memory function in subjects who previously suffered a brain injury other than epilepsy, and support further investigation into the beneficial effect of DBS in TBI patients. (shrink)

The interaction between cavity modes and optical transitions leads to new coupled light-matter states in which the energy is periodically exchanged between the matter states and the optical mode. Here we present experimental evidence of optical strong coupling between modes of individual sub-wavelength metamaterial nanocavities and engineered optical transitions in semiconductor heterostructures. We show that this behaviour is generic by extending the results from the mid-infrared to the near-infrared. Using mid-infrared structures, we demonstrate that the light-matter coupling occurs at the (...) single resonator level and with extremely small interaction volumes. We calculate a mode volume of 4.9 × 10 from which we infer that only ~2,400 electrons per resonator participate in this energy exchange process. (shrink)

Cyclin-dependent kinase 5 has been implicated in Alzheimer's disease pathogenesis. Here, we demonstrate that overexpression of p25, an activator of cdk5, led to increased levels of BACE1 mRNA and protein in vitro and in vivo. A p25/cdk5 responsive region containing multiple sites for signal transducer and activator of transcription was identified in the BACE1 promoter. STAT3 interacts with the BACE1 promoter, and p25-overexpressing mice had elevated levels of pSTAT3 and BACE1, whereas cdk5-deficient mice had reduced levels. Furthermore, mice with a (...) targeted mutation in the STAT3 cdk5 responsive site had lower levels of BACE1. Increased BACE levels in p25 overexpressing mice correlated with enhanced amyloidogenic processing that could be reversed by a cdk5 inhibitor. These data demonstrate a pathway by which p25/cdk5 increases the amyloidogenic processing of APP through STAT3-mediated transcriptional control of BACE1 that could have implications for AD pathogenesis. (shrink)

Today, intelligence in all walks of life is developing at an unexpectedly fast speed. The complexity of the Internet of Things big data system of intelligent parks is analyzed to unify the information transmission of various industries, such as smart transportation, smart library, and smart medicine, thereby diminishing information islands. The traditional IoT systems are analyzed; on this basis, a relay node is added to the transmission path of the data information, and an intelligent park IoT big data system is (...) constructed based on relay cooperation with a total of three hops. Finally, the IoT big data system is simulated and tested to verify its complexity. Results of energy efficiency analysis suggest that when the power dividing factor is 0.5, 0.1, and 0.9, the energy efficiency of the IoT big data system first increases and then decreases as α0 increases, where the maximum value appears when α0 is about 7 J. Results of outage probability analysis demonstrate that the system’s simulation result is basically the same as that of the theoretical result. Under the same environment, the more hop paths the system has, the more the number of relays is; moreover, the larger the fading index m, the better the system performance, and the lower the outage possibility. Results of transmission accuracy analysis reveal that the IoT big data system can provide a result that is the closest to the actual result when the successful data transmission probability is 100%, and the parameter λ values are between 0.01 and 0.05; in the meantime, the delay of successful data transmission is reduced gradually. In summary, the wireless relay cooperation transmission technology can reduce the outage probability and data transmission delay probability of the IoT big data system in the intelligent park by adding the multihop path, thereby improving the system performance. The above results can provide an experimental basis for exploring the complexity of IoT systems in intelligent parks. (shrink)

Imagine that you are given access to an AI chatbot that compellingly mimics the personality and speech of a deceased loved one. If you start having regular interactions with this “thanabot,” could this new relationship be a continuation of the relationship you had with your loved one? And could a relationship with a thanabot preserve or replicate the value of a close human relationship? To the first question, we argue that a relationship with a thanabot cannot be a true continuation (...) of your relationship with a deceased loved one, though it might support one’s continuing bonds with the dead. To the second question, we argue that, in and of themselves, relationships with thanabots cannot benefit us as much as rewarding and healthy intimate relationships with other humans, though we explain why it is difficult to make reliable comparative generalizations about the instrumental value of these relationships. (shrink)

ABSTRACT Imagine that you are given access to an AI chatbot that compellingly mimics the personality and speech of a deceased loved one. If you start having regular interactions with this “thanabot,” could this new relationship be a continuation of the relationship you had with your loved one? And could a relationship with a thanabot preserve or replicate the value of a close human relationship? To the first question, we argue that a relationship with a thanabot cannot be a true (...) continuation of your relationship with a deceased loved one, though it might support one’s continuing bonds with the dead. To the second question, we argue that, in and of themselves, relationships with thanabots cannot benefit us as much as rewarding and healthy intimate relationships with other humans, though we explain why it is difficult to make reliable comparative generalizations about the instrumental value of these relationships. (shrink)

Language tests for overseas registered nurses (ORN) working outside their home country are essential for patient safety, as communication competency needs to be established in any workforce. We argue that the current employment of existing language tests is structurally and institutionally racist and disadvantages ORNs from non‐European Union (EU) and non‐White countries seeking to work in the United Kingdom. Using Critical Race Theory (CRT), we argue that existing English language tests for ORNs seeking registration in the United Kingdom are discriminatory (...) due to the UK's racist migration policies and a regulatory body for nursing and midwifery that fails to acknowledge and understand its own institutionally racist practices. (shrink)

In two experiments, subjects’ task was to decide whether a binocularly viewed target word was evaluatively good (e.g., fame, comedy, rescue) or bad (e.g., stress, detest, malaria) in meaning. Just prior to this target word, a priming word was presented to the nondominant eye, and masked by an immediately following presentation of a letter—fragment pattern to the dominant eye. (Masking effectiveness was demonstrated by subjects’ failure to discriminate the left vs. right position of a test series of words.) In Experiment (...) 1, which used evaluatively positive or negative words as priming stimuli, judgment latency for the evaluative decision task was facilitated by primes that agreed in evaluation with targets, and was retarded by primes that disagreed in evaluation with targets. This result demonstrated that the evaluative meaning of priming stimuli was processed under conditions that prevented subjects from detecting their presence. Primes in Experiment 2 were 2-word strings for which the evaluative meaning of individual words was orthogonal to the evaluative sentence meaning (e.g., the two evaluatively negative words, "enemy fails,“ make up an evaluatively positive sentence). Results of Experiment 2 indicated that masked priming effects were influenced by the evaluative meanings of individual words, but not by their sentence meanings. This result supported the conclusion that the processing of undetected, dichoptically masked words is limited to analyses that are not powerful enough to extract sentence meanings. (shrink)

Managing the interplay of private information within families creates challenges, especially when the information involves member identity, a complex and emotionally charged issue. Ravelingien and...

Introduction While quizzing during informed consent for research to ensure understanding has become commonplace, it is unclear whether the quizzing itself is problematic for potential participants. In this study, we address this issue in a multinational HIV prevention research trial enrolling injection drug users in China and Thailand. Methods Enrolment procedures included an informed consent comprehension quiz. An informed consent survey followed. Results 525 participants completed the informed consent survey (Heng County, China=255, Xinjiang, China=229, Chiang Mai, Thailand=41). Mean age was (...) 33 and mean educational level was 8 yrs. While quizzing was felt to be a good way to determine if a person understands the nature of clinical trial participation (97%) and participants did not generally find the quiz to be problematic, minorities of respondents felt pressured (6%); anxious (5%); bored (5%); minded (5%); and did not find the questions easy (13%). In multivariate analysis, lower educational level was associated with not minding the quizzing (6–10 yrs vs 0–5 yrs: OR=0.27, p=0.03; more than 11 yrs vs 0–5 yrs: OR=0.18, p=0.03). There were also site differences (Heng County vs Xinjiang) in feeling anxious (OR=0.07; p=<0.01), not minding (OR=0.26; p=0.03), being bored (OR=0.25; p=0.01) and not finding the questions easy (OR=0.10; p=<0.01). Conclusions Quizzing during the informed consent process can be problematic for a minority of participants. These problems may be associated with the setting in which research takes place and educational level. Further research is needed to develop, test and implement alternative methods of ensuring comprehension of informed consent. Trial Registration clinicaltrials.gov number NCT00270257. (shrink)

This is the first of an ongoing series of review essays in which the authors of significant new works of philosophy engage their readers. These inaugural two readings discuss Rein Raud’s important new reassessment of contemporary ontology, Being in Flux: A Post-Anthropocentric Ontology of the Self. They consider its accomplishments, both on its own terms and with reference to its East Asian and South Asian precursors. Raud then offers a response.

This article explores the ethics of migrant marketers in Guangzhou. Data were collected from 357 migrant marketers who lived in Guangzhou. A model of Ethical Action has been developed to test the antecedents and outcomes of the ethical decision-making process. It measured moral intention using four ethical scenarios. The results show that the egoistic schema had a positive effect on their intention to act unethically, while the legislative schema exerted a negative effect. The results confirm that moral intention was a (...) strong predictor of an individual's subsequent actual behavior, and it fully mediated the influence of the legislative schema on actual behavior. This study adds to ethics literature by incorporating the construct of social identity and found a moderating effect between the legislative schema and moral intention. The relationships were stronger for individuals who were lower rather than higher in social identity. Analysis of these results lead to a discussion of the implications for marketing ethics in China. (shrink)

Mengzi is known for his sophisticated views on human nature and moral psychology. These essays explore a range of philosophical ideas at the core of his moral philosophy and relate them to both traditional Chinese and current Western philosophical concerns. The introduction provides historical background and philosophical context, and discusses each of the selections alongside Mengzi's work as a whole.