Overdose deaths involving prescription opioids killed more than 17,000 Americans in 2017, marking a five-fold increase since 1999. High prescribing rates of opioid analgesics have been a substantial contributor to prescription opioid misuse, dependence, overdose and heroin use. There was recognition approximately ten years ago that opioid prescribing patterns were contributing to this startling increase in negative opioid-related outcomes, and federal actions, including Medicare reimbursement reform and regulatory actions, were initiated to restrict opioid prescribing. The current manuscript is a description (...) of those actions, the effect of those actions on opioid prescribing and related patient outcomes. We also describe our proposal of methods of expanding these efforts as an important piece to further reduce opioid-related misuse, dependence, and overdose death. (shrink)

Stiff Person Syndrome is a rare autoimmune disorder associated with antibodies against glutamic acid decarboxylase, the key enzyme in γ -aminobutyric acid synthesis. In order to investigate the role of cerebral benzodiazepinereceptor binding in SPS, we performed [ 11 C]flumazenil positron emission tomography in a female patient with SPS compared to nine healthy controls. FMZ is a radioligand to the postsynaptic central benzodiazepine receptor which is co-localized with the GABA-A receptor. In the SPS patient, we found a global reduction of (...) cortical FMZ binding. In addition, distinct local clusters of reduced radiotracer binding were observed. These data provide first in vivo evidence for a reduced postsynaptic GABA-A receptor availability which may reflect the loss of GABAergic neuronal inhibition in SPS. (shrink)

BackgroundPrenatal and early postnatal choline supplementation reduces cognitive and behavioral deficits in animal models of Fetal Alcohol Spectrum Disorder. In a previously published 9-month clinical trial of choline supplementation in children with FASD, we reported that postnatal choline was associated with improved performance on a hippocampal-dependent recognition memory task. The current paper describes the neurophysiological correlates of that memory performance for trial completers.MethodsChildren with FASD who were enrolled in a clinical trial of choline supplementation were followed for 9 months. Delayed (...) recall on a 9-step elicited imitation task served as the behavioral measure of recognition memory. Neurophysiological correlates of memory were assessed via event-related potentials.ResultsDelayed recall on EI was correlated with two ERP components commonly associated with recognition memory in young children: middle latency negative component and positive slow wave. No significant ERP differences were observed between the choline and placebo groups at the conclusion of the trial.ConclusionAlthough the small sample size limits the ability to draw clear conclusions about the treatment effect of choline on ERP, the results suggest a relationship between memory performance and underlying neurophysiological status in FASD. This trial was registered.1. (shrink)

Plasminogen activator inhibitor‐1 (PAI‐1) is a physiological inhibitor of urokinase (uPA), a serine protease known to promote cell migration and invasion. Intuitively, increased levels of PAI‐1 should be beneficial in downregulating uPA activity, particularly in cancer. By contrast, in vivo, increased levels of PAI‐1 are associated with a poor prognosis in breast cancer. This phenomenon is termed the “PAI‐1 paradox”. Many factors are responsible for the upregulation of PAI‐1 in the tumor microenvironment. We hypothesize that there is a breast cancer (...) predisposition to a more aggressive stage when PAI‐1 is upregulated as a consequence of Metabolic Syndrome (MetS). MetS exerts a detrimental effect on the breast tumor microenvironment that supports cancer invasion. People with MetS have an increased risk of coronary heart disease, stroke, peripheral vascular disease and hyperinsulinemia. Recently, MetS has also been identified as a risk factor for breast cancer. We hypothesize the existence of the “PAI‐1 cycle”. Sustained by MetS, adipocytokines alter PAI‐1 expression to promote angiogenesis, tumor‐cell migration and procoagulant microparticle formation from endothelial cells, which generates thrombin and further propagates PAI‐1 synthesis. All of these factors culminate in a chemotherapy‐resistant breast tumor microenvironment. The PAI‐1 cycle may partly explain the PAI‐1 paradox. In this hypothesis paper, we will discuss further how MetS upregulates PAI‐1 and how an increased level of PAI‐1 can be linked to a poor prognosis. BioEssays 29:1029–1038, 2007. © 2007 Wiley Periodicals, Inc. (shrink)

We outline some ways in which motor neglect (the underutilization of a limb despite adequate strength) and hysterical paralysis (failure to move a limb despite no relevant structural damage or disease) may throw light on the pathophysiology of catatonia. We also comment on the manifold inadequacies of distinguishing too firmly between symptoms of “neurologic origin” and of “psychiatric origin.”.

Wynn's claims are, in principle, entirely reasonable; although, as always, the devil is in the details. With respect to Wynn's discussion of the cultural evolution of artifactual symmetry, we provide a few more arguments for the utility of mirror symmetry and extend the enquiry into the tacit and explicit processing of natural and artifactual symmetry.

Excerpt from Uebersicht ber das Aristotelische Lehrgeb ude und Er rterung der Lehren Seiner N chsten Nachfolger: Als Uebergang zur Dritten Entwickelungsperiode der Griechischen Philosophie Sci) bergebe hie $erbattnifie 111e cbe hie @d einnng biefe8 %anbe8 meiner (R)efcbicbte n1eljr brei Sabre lang ber3ogert haben; bie @1'm bnnng befiel en m rbe mir fcbn1er3; I11I) unb fiir ben 8efer ohne 8'nterefie fein. S'huen finh fie befannt nnb (c)ie werben ben (c)pnren ber (R)tin1n1nngen, 111 Innen MB 931119 gefcf;rieben ift, 351e 9tacbficbt nicht (...) verfagen. About the Publisher Forgotten Books publishes hundreds of thousands of rare and classic books. Find more at www.forgottenbooks.com This book is a reproduction of an important historical work. Forgotten Books uses state-of-the-art technology to digitally reconstruct the work, preserving the original format whilst repairing imperfections present in the aged copy. In rare cases, an imperfection in the original, such as a blemish or missing page, may be replicated in our edition. We do, however, repair the vast majority of imperfections successfully; any imperfections that remain are intentionally left to preserve the state of such historical works. (shrink)

ABSTRACTIn the present study, attentional bias was investigated as a potential predisposing mechanism for the contamination-related subtype of obsessive-compulsive disorder. Fifty healthy participants with varying degrees of subclinical C-OC symptoms performed a visual search task to measure differential attentional biases elicited by neutral, disgust-, and fear-specific pictorial material. Participants had to find a target picture within five neutral distractor pictures randomly presented on different locations in an array. The task was to decide whether the array contained an unpleasant target picture (...) or not. In randomly-selected emotional trials, participants were further asked about the content of the picture and the confidence of their answer. The results show that the reaction times significantly differed between the emotional and neutral pictures. Participants were significantly more confident in answering questions referring to fear compared to disgust pictures. This effect was mar... (shrink)

Otto Pöggeler is among the most distinguished living German scholars. He is the coeditor of the new critical edition of the works of Hegel published by the Deutsche Forschungsgemeinschaft. In addition he is the author of what many regard as the book on Heidegger. He has access to documents that Heidegger makes available to only a few and is considered to have an acquaintance with the pre-Sein und Zeit period that is matched by none. This latest volume--a collection of important (...) articles that have appeared in European periodicals on Heidegger, and offered on the occasion of his 80th birthday--is exactly what one would expect of Pöggeler. The contributions are most distinguished. To name a few: Löwith on Heidegger and Protestant theology; Schulz's famous article on the place of Heidegger in the history of Philosophy; Gadamer on Heidegger and Marburg theology; Beda Allemann on Heidegger's engagement with the National Socialists; Tugendhat on Heidegger's idea of truth; and finally an article by Pöggeler on Heidegger's hermeneutics. Pöggeler also provides a 38-page introduction entitled "Heidegger Today." In addition to a helpful index, there is a tripartite bibliography including not only Heidegger's works and the important secondary literature but also the works of independent thinkers who think out of the context and under the influence of Heidegger--such as Binswanger, Bultmann, Fink, Löwith et al.--J. D. C. (shrink)

This volume contains the minutes of a seminar which was held on Heraclitus in the University of Freiburg under the joint direction of Heidegger and Fink. The seminar was to be conducted over a series of semesters, but since only the Winter Semester in 1966-1967 proved feasible, the current work is in Fink's words "a fragment on the Fragments." The text takes the form of a dialogue between "Heidegger," "Fink," and "Participant," Using the fragments of Heraclitus as (...) a point of departure, the dialogue partners cover a terrain by now familiar to readers of Heidegger: the hermeneutic circle, metaphysics, the "mortals" and the "gods," Hegel's idea of Logic. Heidegger clearly leads the discussion and hence his unique reading of the pre-Socratic philosopher is always the central theme. As Fink says, not the philological problematic, as important as that may be, but rather the attempt to think through the thought of Heraclitus is the issue in this seminar. Fink usually opens the discussion with a preliminary interpretation of Heraclitus in order to provide a common basis for the participants which will be more familiar to them. The volume is frequently punctuated with insights into Heraclitus' text, as anyone who has learned to stay with Heidegger's thoughtful dialogue with classical sources has discovered.--J. D. C. (shrink)

La pensée de Eugen Fink s’est formée sous la double influence de Husserl et de Heidegger, mais c’est dans l’œuvre de ce dernier qu’il a trouvé les prémisses de la problématique originale qu’il a développée par la suite, celle d’une phénoménologie cosmologique post-métaphysique dont le modèle opératoire est le jeu. Or c’est chez Nietzsche, auquel il consacre en 1960 un long essai, qu’il retrouve la conjonction de ces deux phénomènes, le monde et le jeu. Il entreprend ainsi de montrer (...) que, contrairement à ce qu’affirme Heidegger, la philosophie de Nietzsche, dans la mesure où il a été capable de penser l’être et le devenir comme jeu, ne fait plus partie de la métaphysique moderne de la subjectivité. (shrink)

Qu'est-ce que la phénoménologie de la phénoménologie de E Fink, dont la Sixième méditation cartésienne constitue l'exposition principale? Au lieu d'aborder la Sixième méditation à partir de sa genèse textuelle ou à partir de la collaboration avec E Husserl dont elle est issue, l'auteur la prend à partir de son problème directeur. Ce dernier est mis au jour à travers une confrontation approfondie avec la phénoménologie husserlienne du temps, ce qui est devenu récemment possible, d'une part, grâce à la (...) publication des Manuscrits de Bernau et des Manuscrits C, d'autre part, grâce à la publication des notes de recherches de Fink. De là, la division de l'ouvrage en trois moments. Le premier analyse le problème directeur de la phénoménologie de la phénoménologie linkienne dans sa forme de base : comment la temporalisation originaire, qui est à l'origine du flux immanent, se phénoménalise-t-elle? Le deuxième approfondit le problème de la phénoménalisation de la temporalisation originaire dans ses multiples formes : comme problème de la phénoménalisation de l'origine des essences immanentes, de la langue, de l'intersubjectivité et enfin de la science de l'immanence. Le troisième considère le problème de la phénoménalisation de la temporalisation originaire dans l'unité de ses multiples formes et notamment, comme problème de l'attestation phénoménologique de la temporalisation originaire. Ce parcours permet de reconstruire et de problématiser la "métaphysique phénoménologique" que Fink considérait comme le couronnement de sa phénoménologie de la phénoménologie. (shrink)

Actes d’un colloque qui s’est tenu à Copenhague en 2007, l’ouvrage veut combler un manque : traiter du développement de la dialectique de Platon à Aristote, non pas en se focalisant sur la méthode et l’ontologie, mais en se fondant sur le cadre du débat dialectique. Selon J. Fink (p. 2), la dialectique ici signifie d’abord et avant tout argumentation adressée à un interlocuteur. La pratique de l’argumentation dialectique et son extension dans la forme littéraire du dialogue constituent le (...) cœu... (shrink)

The period from Plato's birth to Aristotle's death (427-322 BC) is one of the most influential and formative in the history of Western philosophy. The developments of logic, metaphysics, epistemology, ethics and science in this period have been investigated, controversies have arisen and many new theories have been produced. But this is the first book to give detailed scholarly attention to the development of dialectic during this decisive period. It includes chapters on topics such as: dialectic as interpersonal debate between (...) a questioner and a respondent; dialectic and the dialogue form; dialectical methodology; the dialectical context of certain forms of arguments; the role of the respondent in guaranteeing good argument; dialectic and presentation of knowledge; the interrelations between written dialogues and spoken dialectic; and definition, induction and refutation from Plato to Aristotle. The book contributes to the history of philosophy and also to the contemporary debate about what philosophy is. (shrink)

Authentic objects are those that have a historical link to a person, event, time, or place of some significance. The current study examines everyday beliefs about authentic objects, with three primary goals: to determine the scope of adults' evaluation of authentic objects, to examine such evaluation in two distinct cultural settings, and to determine whether a person's attachment history predicts evaluation of authentic objects. We found that college students in the UK and the USA consistently evaluate a broad range of (...) authentic items as more valuable than matched control objects, more desirable to keep, and more desirable to touch, though only non-personal authentic items were judged to be more appropriate for display in a museum. These patterns were remarkably similar across the two cultural contexts. Additionally, those who had an attachment object as a child evaluated objects more favorably, and in particular judged authentic objects to be more valuable. Altogether, these results demonstrate broad endorsement of "positive contagion" among college-educated adults. (shrink)

Background: Clinical research nurses experience unique challenges in the context of their role that can lead to conflict and moral distress. Although examined in many areas, moral distress has not been studied in clinical research nurses. Research aim: The aim of this study was to examine moral distress in clinical research nurses and the relationship between moral distress scores and demographic characteristics of clinical research nurses. Research design: This was a descriptive quantitative study to measure moral distress in clinical research (...) nurses using the Measure of Moral Distress – Healthcare Professionals (MMD-HP) administered electronically. Demographic data were also collected. Participants and research context: Registered nurses working in the clinical research nurse role ( N = 322) were recruited through use of social media, emails, digital flyers, and snowball recruitment. Data was analyzed using SPSS. Pearson’s correlation, independent t-test, and one-way ANOVA were performed to explore differences among the demographic variables. Ethical considerations: This study was approved by the Institutional Review Board at Texas Woman’s University. A consent statement was included, and completion of the questionnaire was construed as consent. Findings/results: Analysis revealed a mean overall moral distress score of 79.58 (SD = 64.27) and median of 67, with a range of 0–354. Moral distress scores were negatively correlated with clinical research nurse age ( r = 0-.156, p < 0.05). Reliability of the MMD-HP was demonstrated with a Cronbach’s alpha of 0.93. Conclusions: The findings demonstrate that clinical research nurses do experience moral distress and revealed a wide range of scores. Further research is necessary to determine potential patient impact due to moral distress and to develop processes to minimize moral distress in the clinical research setting. This study was conducted during the COVID-19 pandemic, and the digital recruitment methods proved effective in recruiting a wide range of clinical research nurses, both nationally and internationally. (shrink)

Existenz und Coexistenz č l'opera in cui Eugen Fink espone la sua filosofia sociale in base ai presupposti dell'ontologia del "Mondo" che egli sviluppa a partire dal secondo dopoguerra. Cosě come questa ontologia si compone di piani di analisi differenti, anche la struttura della socialitÀ si rivela complessa e stratificata, tesa fra la descrizione fenomenologica e l'approfondimento speculativo. L'obiettivo del saggio č di esaminare tanto le premesse metodiche e teoriche dell'indagine finkiana, quanto le sue componenti strutturali, al fine di (...) ricostruire la risposta fornita dal pensatore alla questione della coesistenza, nonché la sua originale definizione del rapporto fra individuo e comunitÀ. (shrink)

Eugen Fink is considered one of the clearest interpreters of phenomenology and was the preferred conversational partner of Edmund Husserl and Martin Heidegger. In Play as Symbol of the World, Fink offers an original phenomenology of play as he attempts to understand the world through the experience of play. He affirms the philosophical significance of play, why it is more than idle amusement, and reflects on the movement from "child's play" to "cosmic play." Well-known for its non-technical, literary (...) style, this skillful translation by Ian Alexander Moore and Christopher Turner invites engagement with Fink's philosophy of play and related writings on sports, festivals, and ancient cult practices. (shrink)

Die vorliegende Abhandlung ist die erste systematische Darstellung einer wissenschaftstheoretischen Konzeption, die ich in den Jahren 1976-1978 an der Fakultat fur Linguistik und Literaturwissenschaft der Universitat Biele­ feld entwickelt habe. Zweck dieser Arbeit war es, die Konstruktionsphase einer empirischen Theorie der Literatur, und damit einer empirischen Wis­ senschaft liber Literatur, von einer Reihe von Inadaquatheiten, Vorurteilen und Irrationalismen zu befreien, die nach meiner Ansicht den bekannten Grundlagenstreit der Literaturwissenschaftler belasten, aber auch in man­ chen Arbeiten zur konzeptionellen Innovation der Literaturwissenschaft (...) zu finden sind. Ich wlirde es als Erfolg ansehen, wenn es mir gelungen ware zu zeigen, daB die Entwicklung des empirischen Paradigmas der Literatur­ wissenschaft tatsachlich mit jenem "Gestalt-Switch" einhergeht, den Thomas Kuhn fur die Struktur einer die normalen Pfade wissenschaftlicher Ent­ wicklung verlassenden Forschung beschrieben hat. Das Maa an wissenschaft­ licher Toleranz, das dabei der Mehrheit der Literaturwissenschaftler abver­ langt wird, ist ohne Zweifel ganz erheblich. Der zentrale Gedanke dieser Abhandlung ist der, daB die wissenschaftstheo­ retische Rationalitat nirgends so gebraucht wird wie in den fruhen, vorpara­ digmatischen Phasen der Entwicklung einer neuen Konzeption, und daa die libliche Wissenschaftstheorie nirgends so versagt wie gerade dort. Ich ver­ suche daher, die Grundlagen einer Konzeption zu umreiBen, die ich einen "Konstruktiven Funktionalismus" nenne, und ihre Brauchbarkeit als eine intradisziplinare Wissenschaftstheorie der empirischen Literaturwissen­ schaft zu demonstrieren. Das Bild der Literaturwissenschaft, das durch die Brille dieser Konzeption sichtbar wird, ist das einer nicht unwesentlich veranderten Disziplin. (shrink)

Introduction All of us have experienced quite dramatic social changes in our lifetimes. Our families differ greatly from those of our parents, ...

Die schnell anwachsende Hinneigung zur Existentialanalytik, zur Lebensphilosophie und zur Ontologie am Anfang der 30er Jahre zwang Edmund Husserl dazu, die ursprungliche, als transzendentale ausgereifte Phanomenologie in methodischer und systematischer Hinsicht von diesen neuen Tendenzen scharf abzugrenzen. In den Jahren 1930 bis 1932 entwarf Eugen Fink im Auftrag seines Lehrers eine Reihe von Texten zur Phanomenologie, die grundlegende Bedeutung haben sollten fur ein Systematisches Werk der Phanomenologie bzw. als neue Meditations cartesiennes fur das deutsche Publikum gedacht waren. Diese Entwurfe (...) Eugen Finks kulminierten in der VI. Cartesianischen Meditation (1932), die u. a. von Gaston Berger, Maurice Merleau-Ponty und Tran Duc Thao in Frankreich rezipiert wurde, bevor Fink sie im Jahre 1946 als Habilitationsschrift an der Freiburger Universitat einreichte. Der vorliegende Band, der in chronologischer Reihenfolge die im Auftrag Husserls verfassten Entwurfe Finks aus den Jahren 1930-32 veroffentlicht, schliesst unmittelbar an die Bande 1 (Studien zur Phanomenologie) und 3 (Phanomenologische Werkstatt) der Eugen Fink Gesamtausgabe an. In diesen Texten gewinnt Finks origineller Beitrag zur Phanomenologie Husserls in der Freiburger Zeit eine Konturenscharfe, die von Sartre und Merleau- Ponty fruh erkannt wurde. (shrink)