Chinese-speaking older adults usually do not perceive a hearing problem until audiometric thresholds exceed 45 dB HL, and the audiometric thresholds of the average hearing-aid user often exceed 60 dB HL. The purpose of this study was to examine the relationships between cognitive and hearing functions in older Chinese adults with HAs and with untreated hearing loss. Participants were 49 Chinese older adults who used HAs and had moderate to severe HL, and 46 older Chinese who had mild to moderately (...) severe HL but did not use HAs. Multiple linear regression analysis was employed to evaluate how well age, education level, audiometric thresholds, and speech perception in noise were related to performance on general cognitive function, working memory, executive function, attention, and verbal learning tests. Results showed that speech perception in noise alone accounted for 13–25% of the variance in general cognitive function, working memory, and executive function in the UT group, and 9–21% of the variance in general cognitive function and verbal learning in the HA group. Audiometric thresholds did not explain any proportion of the variance in cognitive functioning in the HA or UT group. Thus, speech perception in noise accounts for more variance in cognitive performance than audiometric thresholds, and is significantly associated with different cognitive functions in older Chinese adults with HAs and with untreated HL. (shrink)

Delineation of the subthalamic nuclei on MRI is critical for deep brain stimulation surgery in patients with Parkinson’s disease. We propose this retrospective cohort study for quantitative analysis of MR signal-to-noise ratio, contrast, and signal difference-to-noise ratio of the STN on pre-operative three-dimensional stereotactic MRI in patients with medication-refractory PD. Forty-five consecutive patients with medication-refractory PD who underwent STN-DBS surgery in our hospital from January 2018 to June 2021 were included in this study. All patients had whole-brain 3D MRI, including (...) T2-weighted imaging, T2-weighted fluid-attenuated inversion recovery, and susceptibility-weighted imaging, at 3.0 T scanner for stereotactic navigation. The signal intensities of the STN, corona radiata, and background noise were obtained after placing regions of interest on corresponding structures. Quantitative comparisons of SNR, contrast, and SDNR of the STN between MR pulse sequences, including the T2WI, FLAIR, and SWI. Subgroup analysis regarding patients’ sex, age, and duration of treatment. We used one-way repeated measures analysis of variance for quantitative comparisons of SNR, contrast, and SDNR of the STN between different MR pulse sequences, and we also used the dependent t-test for the post hoc tests. In addition, we used Mann–Whitney U test for subgroup analyses. Both the contrast and SDNR were highest on FLAIR. The SNR was highest on SWI, and both the SNR and SDNR were lowest on T2WI. Subgroup analyses demonstrated significantly lower SDNR on SWI for patients receiving medication treatment for ≥13 years. In conclusion, on 3D stereotactic MRI of medication-refractory PD patients, the contrast and SDNR for the STN are highest on FLAIR, suggesting the optimal delineation of STN on FLAIR. (shrink)

We estimate that 208,000 deep brain stimulation (DBS) devices have been implanted to address neurological and neuropsychiatric disorders worldwide. DBS Think Tank presenters pooled data and determined that DBS expanded in its scope and has been applied to multiple brain disorders in an effort to modulate neural circuitry. The DBS Think Tank was founded in 2012 providing a space where clinicians, engineers, researchers from industry and academia discuss current and emerging DBS technologies and logistical and ethical issues facing the field. (...) The emphasis is on cutting edge research and collaboration aimed to advance the DBS field. The Eighth Annual DBS Think Tank was held virtually on September 1 and 2, 2020 (Zoom Video Communications) due to restrictions related to the COVID-19 pandemic. The meeting focused on advances in: (1) optogenetics as a tool for comprehending neurobiology of diseases and on optogenetically-inspired DBS, (2) cutting edge of emerging DBS technologies, (3) ethical issues affecting DBS research and access to care, (4) neuromodulatory approaches for depression, (5) advancing novel hardware, software and imaging methodologies, (6) use of neurophysiological signals in adaptive neurostimulation, and (7) use of more advanced technologies to improve DBS clinical outcomes. There were 178 attendees who participated in a DBS Think Tank survey, which revealed the expansion of DBS into several indications such as obesity, post-traumatic stress disorder, addiction and Alzheimer’s disease. This proceedings summarizes the advances discussed at the Eighth Annual DBS Think Tank. (shrink)

DBS Think Tank IX was held on August 25–27, 2021 in Orlando FL with US based participants largely in person and overseas participants joining by video conferencing technology. The DBS Think Tank was founded in 2012 and provides an open platform where clinicians, engineers and researchers can freely discuss current and emerging deep brain stimulation technologies as well as the logistical and ethical issues facing the field. The consensus among the DBS Think Tank IX speakers was that DBS expanded in (...) its scope and has been applied to multiple brain disorders in an effort to modulate neural circuitry. After collectively sharing our experiences, it was estimated that globally more than 230,000 DBS devices have been implanted for neurological and neuropsychiatric disorders. As such, this year’s meeting was focused on advances in the following areas: neuromodulation in Europe, Asia and Australia; cutting-edge technologies, neuroethics, interventional psychiatry, adaptive DBS, neuromodulation for pain, network neuromodulation for epilepsy and neuromodulation for traumatic brain injury. (shrink)

Background: Freezing of gait is a common symptom in Parkinson’s disease and can be difficult to treat with dopaminergic medications or with deep brain stimulation. Novel stimulation paradigms have been proposed to address suboptimal responses to conventional DBS programming methods. Burst-cycling deep brain stimulation delivers current in various frequencies of bursts, while maintaining an intra-burst frequency identical to conventional DBS.Objective: To evaluate the safety and tolerability of BCDBS in PD patients with FOG.Methods: Ten PD subjects with STN or GPi DBS (...) and complaints of FOG were recruited for this single center, single blinded within-subject crossover study. For each subject, we compared 4, 10, and 15 Hz BCDBS to conventional DBS during the PD medication-OFF state.Results: There were no serious adverse events with BCDBS. It was feasible and straightforward to program BCDBS in the clinic setting. The benefit was comparable to conventional DBS in measures of FOG, functional mobility and in PD motor symptoms. BCDBS had lower battery consumption when compared to conventional DBS.Conclusions: BCDBS was feasible, safe and well tolerated and it has potential to be a viable future DBS programming strategy. (shrink)

IntroductionDeep brain stimulation (DBS) is increasingly used to treat the symptoms of various neurologic and psychiatric conditions. People can undergo the procedure during reproductive years but the safety of DBS in pregnancy remains relatively unknown given the paucity of published cases. We thus conducted a review of the literature to determine the state of current knowledge about DBS in pregnancy and to determine how eligibility criteria are approached in clinical trials with respect to pregnancy and the potential for pregnancy.MethodsA literature (...) review was conducted in EMBASE to identify articles involving DBS and pregnancy. Two reviewers independently analyzed the articles to confirm inclusion. Data extracted for analysis included conditions treated, complications at all stages of pregnancy, neonatal/pediatric outcomes, and DBS target. A second search was then conducted using www.clinicaltrials.gov. The same two reviewers then assessed whether each trial excluded pregnant individuals, lactating individuals, or persons of childbearing age planning to conceive. Also assessed was whether contraception had to be deemed adequate prior to enrollment.ResultsThe literature search returned 681 articles. Following independent analysis and agreement of two reviewers, 8 pregnancy related DBS articles were included for analysis. These articles described 27 subjects, 29 pregnancies (2 with subsequent pregnancies), and 31 infants (2 twin pregnancies). There was 1 preterm birth at 35 weeks, and 3 patients who experienced discomfort from the DBS battery (i.e., impulse generator) placement site. All 27 patients had a DBS device implanted before they became pregnant, which remained in use throughout their pregnancy. There was exclusion of pregnant individuals from 68% of 135 interventional trials involving DBS. Approximately 44% of these trials excluded persons of childbearing age not on “adequate contraception” or wishing to conceive in the coming years. Finally, 22% excluded breastfeeding persons.ConclusionThe data from 29 pregnancies receiving DBS treatment during pregnancy was not associated with unexpected pregnancy or post-partum complication patterns. Many clinical trials have excluded pregnant individuals. Documentation of outcomes in larger numbers of pregnancies will help clarify the safety profile and will help guide study designs that will safely include pregnant patients. (shrink)

I thought the paper by Kai-yee Wong and Chris Fraser was fascinating and insightful. Two things I especially appreciated are the clarity with which they summarize my views. I think they are quite fair and accurate. Second, I appreciate their suggestion that the way to deal with the practical problem of weakness of will has much to do with the role of the Background in shaping our actions. I think they are especially on the right track when they say (...) that the improvement of Background skills may actually narrow the range of real options for action, (p. 21) nonetheless, they do not decrease freedom. As they say, “It is a process of strengthening the self, and the agent is likely to experience the concomitant restriction of ‘live’ options not as a limitation but as strength of character.” (p. 21). That seems to me very much on the right track. What they are suggesting, and it is a powerful addition to my own writings, is that we should not just think of the Background as facilitating languages, games and social practices generally, but for morality as well (p. 23). (shrink)

The following framework of theses, roughly hewn, shapes contemporary discussion of the problem of mental causation: (1) Non-Identity of the Mental and the Physical Mental properties and states cannot be identified with specific physical properties and states. (2) Causal Closure (Completeness) of the Physical The objective probability of every physical event is fixed by prior physical events and laws alone. (This thesis is sometimes expressed in terms of explanation: In tracing the causal history of any physical event, one need not (...) advert to any non-physical events or laws. To the extent that there is any explanation available for a physical event, there is a complete explanation available couched entirely in physical vocabulary. We prefer the probability formulation, as it should be acceptable to any physicalist, though some reject the explanation formulation.) (3) Causal Exclusion There is at most one complete and wholly independent explanation for any given event or sequence of events. (shrink)

What is the significance of bodily awareness for bodily action? The orthodox philosophical account from O'Shaughnessy claims that bodily awareness is necessary for bodily action. Whilst O'Shaughnessy's account appears to be consonant with the phenomenology of ordinary agency, it falls afoul to empirical counterexamples. The failure of O'Shaughnessy's account and its cousins might suggest that bodily action does not depend on bodily awareness. On the contrary, I argue that the contrast between the character of afferented and deafferented agency shows that (...) bodily awareness is crucial to explaining the distinctive character of bodily action in neurologically normal agents. In particular, the capacity to feel one's body ‘from the inside’ appears to be a condition on the capacity to act with one's body in a way that is not like remote control. This dependency of capacities is at once empirically adequate and in tune with the phenomenology of ordinary agency. (shrink)

There are a number of recent attempts to introduce Confucian values to the ethical analysis of technology. These works, however, have not attended sufficiently to one central aspect of Confucianism, namely Ritual (‘Li’). Li is central to Confucian ethics, and it has been suggested that the emphasis on Li in Confucian ethics is what distinguishes it from other ethical traditions. Any discussion of Confucian ethics for technology, therefore, remains incomplete without accounting for Li. This chapter aims to elaborate on the (...) concept of Confucian Li and discuss its relevance to ethics of technology. Particularly, by referring to Li’s communicative, formative, and aesthetic function, I formulate an approach to ethics of technology with an emphasis on community, performance, and the aesthetic and demonstrate how this approach proceeds with the ethical analysis of technology. In doing so, I attempt to answer the question: why Confucianism matters in ethics of technology. (shrink)

The essence of the associated-proposition strategy is to distinguish the necessary proposition _expressed by_ a sentence.

In this book, David B. Wong defends an ambitious and important new version of moral relativism. He does not espouse the type of relativism that says anything goes, but he does start with a relativist stance against alternative theories such that there need not be only one universal truth. Wong proposes that there can be a plurality of true moralities existing across different traditions and cultures, all with one core human question as to how we can all live (...) together. (shrink)

The view defended is one sense externalist on the relation between moral reasons and motivation: A's having a moral reason to do X does not necessarily imply that A has a motivation that would support A's doing X via some appropriate deliberative route. However, it is in another sense externalist in holding that there are the kind of moral reasons there are only if the relevant motivational capacities are "generally present" in human beings, if not in all individuals. The process (...) of socialization is an attempt to embed the recognition of what we have moral reason to do in the intentional content of one's feelings. E.g., learning that about others' suffering embeds their suffering as a reason to help in the intentional content of incipient compassionate feelings. This endows the reason with motivational efficacy while conferring further direction to the feelings in ways that shape us for social cooperation. (shrink)

This paper is to inform the recent situations of work by the foreign domestic workers (FDWs) in Hong Kong through the lens of Covid-19. Through the interviews with seven informants — two employers and five FDWs, stories describing the changes in their working conditions, rights and entitlement, and the contextual environment related to the impacts of Covid-19 were collected. They were analysed through three theoretical tools — visibility/invisibility, mobility/immobility, and work boundary. The findings show that under the Covid-19 crisis, the (...) FDWs experienced more hardships and struggles in both the home country and host country. The paradoxes of visibility/invisibility and mobility/immobility together with blurred work boundary were found in their experience of work, rights and entitlement, and the contextual environment. On one hand, the employers’ power of controlling FDWs has increased, but the agency to resist by the FDWs has decreased making them to turn to more passive means of resistance which could harm the FDWs’ physical and mental health and wellbeing. (shrink)

The Art of War application to education is about solving problems to improve student and school success. The Art of War describes the significance of a leader and his knowledge and prudent application of the strategies. At the core of theses strategies is the non-negotiable moral purpose of the leader to be reinforced by other fine qualities as wisdom, commitment, discipline, and courage.

I argue that there is an important analogy between sex selection and selective abortion of fetuses diagnosed with Down syndrome. There are surprising parallels between the social construction of Down syndrome as a disability and the deeply entrenched institutionalization of sexual difference in many societies. Prevailing concepts of gender and mental retardation exert a powerful influence in constructing the sexual identities and life plans of people with Down syndrome, and also affect their families' lives.1.

: I argue that there is an important analogy between sex selection and selective abortion of fetuses diagnosed with Down syndrome. There are surprising parallels between the social construction of Down syndrome as a disability and the deeply entrenched institutionalization of sexual difference in many societies. Prevailing concepts of gender and mental retardation exert a powerful influence in constructing the sexual identities and life plans of people with Down syndrome, and also affect their families' lives.

Based on a newly conceptualized notion of the dialogical self, achieved by integrating Bakhtin's philosophical anthropology and Karmiloff-Smith's Representational Redescription model into the existing notion proposed by Hermans and colleagues, the present study focuses on examining the role of The Ox-Herding Pictures in cultivating the dialogical self. Methodologically, this study adopted the cultural-historical perspective and microdevelopmental approach of Vygotsky. In-depth case studies consisting of six interrelated phases of interviews and written responses were conducted. The results show that such a unique (...) cultural sign had different mediation effects upon subjects of different backgrounds. Two examples of considerable mediation effects are presented in more detail. A hermeneutical examination of this cultural object switched to a kind of self-representation in all cases, while the self-representation of all subjects developed from a less explicit to a more explicit level. Development of the dialogical self was characterized by its diversity in form and richness regarding content. (shrink)

Using a classical conditioning technique, this study investigated whether nonconscious associative learning could be indexed by event-related brain activity . There were three phases. In a preconditioning baseline phase, pleasant and unpleasant facial schematics were presented in awareness . A conditioning phase followed, in which stimuli were presented outside awareness , with an unpleasant face linked to an aversive shock and a pleasant face not linked to a shock. The third, postconditioning phase, involved stimulus presentations in awareness . Evidence for (...) acquisition of a conditional response was sought by comparing suprathreshold pre- and postconditioning phases, as well as in the subthreshold conditioning phase itself. For the pre-postconditioning phase analyses, significant ERP component differences differentiating CS+ and CS− were observed for N1, P2, and especially P3. For the conditioning phase, significant differences were observed in the 100–400 ms. post-stimulus region reflecting a CS+ processing negativity. Brain activity does indeed index the acquisition of a conditional response to subthreshold stimuli. Associative learning can occur outside awareness. (shrink)

The present study investigates the dynamics of emotional processing and awareness using an affective facial priming paradigm in conjunction with a multimodal assessment of awareness. Key facial primes are visually masked, and are presented for brief and extended durations. Using a preference measure, we examine whether the effects of the primes differ qualitatively . We show that: unconscious affective priming with faces emerges strongly in initial presentations and diminishes rapidly with repetition; conscious affective priming also emerges strongly in initial presentations, (...) however it persists in strength with repetition; and in contrast to other reports on the salience of negative stimuli, happy faces appear more salient than sad faces when presented outside awareness. We discuss the limits and extensions of unconscious affective priming with faces, and consider several methodological and conceptual questions concerning emotional processing out of awareness. (shrink)

This is a critical discussion of Paul Humphreys's fusion view of emergence, focusing on the basal loss feature of his ontology. The discussion yields some general morals for special science ontology.

The practice of covertly administering medication is controversial. Although condemned by some as overly paternalistic, others have suggested that it may be acceptable if patients have permanent mental incapacity and refuse needed treatment. Ethical, legal, and clinical considerations become more complex when the mental incapacity is temporary and when the medication actually serves to restore autonomy. We discuss these issues in the context of a young man with schizophrenia. His mother had been giving him antipsychotic medication covertly in his soup. (...) Should the doctor continue to provide a prescription, thus allowing this to continue? We discuss this case based on the “four principles” ethical framework, addressing the conflict between autonomy and beneficence/non-maleficence, the role of antipsychotics as an autonomy restoring agent, truth telling and the balance between individual versus family autonomy. (shrink)

Using a classical conditioning technique, this study investigated whether nonconscious associative learning could be indexed by event-related brain activity . There were three phases. In a preconditioning baseline phase, pleasant and unpleasant facial schematics were presented in awareness . A conditioning phase followed, in which stimuli were presented outside awareness , with an unpleasant face linked to an aversive shock and a pleasant face not linked to a shock. The third, postconditioning phase, involved stimulus presentations in awareness . Evidence for (...) acquisition of a conditional response was sought by comparing suprathreshold pre- and postconditioning phases, as well as in the subthreshold conditioning phase itself. For the pre-postconditioning phase analyses, significant ERP component differences differentiating CS+ and CS− were observed for N1, P2, and especially P3. For the conditioning phase, significant differences were observed in the 100–400 ms. post-stimulus region reflecting a CS+ processing negativity. Brain activity does indeed index the acquisition of a conditional response to subthreshold stimuli. Associative learning can occur outside awareness. (shrink)

The aim of this paper is to situate the early Indian (Nikāya) Buddhist notion of karmic causation within the mental causation discourse in the Western analytic tradition, which concerns causal transactions involving mental events, such as desires, beliefs, and intentions, whether the transactions are between mental events, or between mental events and physical events. Karmic causation involves actional causes, in concert with non-actional causes, and their experiential effects on the actor, in concert with non-experiential effects. The problems generated by karmic (...) causation in Buddhism overlap with those generated by mental causation in the Western analytic tradition. They include how the mental aspects relate to the physical aspects of the self, sense perception, and action, as well as how the mental and physical aspects of an actional cause relate to the experiential and non-experiential aspects of an effect on the actor. -/- To make sense of mental causation, it is crucial to understand a cluster of associated concepts such as causation, the self, sense perception, and action. Similarly, to make sense of karmic causation, it is crucial to understand a cluster of associated concepts such as dependent arising (paṭiccasamuppāda), the fivefold laws of nature (pañca-niyāma), the five aggregates (pañca-khandha), the six sense bases (Saḷayatana), action (karma), and results (vipāka). I shall discuss these concepts under the headings of causation, the self, sense perception, and action before I move on to address karmic causation in the context of the mental causation debate. (shrink)