ObjectiveCochlear explantation for purely elective (e.g. psychological and emotional) reasons is not well studied. Herein, we aim to provide data and expert commentary about elective cochlear implant (CI) removal that may help to guide clinical decision-making and formulate guidelines related to CI explantation.Data sourcesWe address these objectives via three approaches: case report of a patient who desired elective CI removal; review of literature and expert discussion by surgeon, audiologist, bioethicist, CI user and member of Deaf community.Review methodsA systematic review using (...) three scientific online databases was performed. Included articles addressed the benefits and/or complications of cochlear implantation in young children, CI explantation with or without revision surgery and the ethical debate between the medical and Deaf communities on cochlear implantation and explantation.ConclusionsThe medical and audiological perspectives identify a host of risks related to implant removal without reimplantation, including risk from surgery, general anaesthesia, cochlear ossification and poor audiometric outcomes. The member of the deaf community and bioethicist argue that physicians need to guide the principles of beneficence, non-maleficence and patient autonomy. Taken together, patient desires should be seen as paramount, if the patient is otherwise fit for surgery and well informed.Implications for practiceSimilar to the case of device implantation, device explantation should be a multidisciplinary and collaborative decision with the patient and the family’s desires at the centre. While every case is different, we offer a CI explantation discussion to assist in clinical decision-making, patient counselling and education. (shrink)

Recent advances in molecular biology and microanatomy have supported homologies of body parts between vertebrates and extant invertebrate chordates, thus providing insights into the body plan of the proximate ancestor of the vertebrates. For example, this ancestor probably had a relatively complex brain and a precursor of definitive neural crest. Additional insights into early vertebrate evolution have come from recent discoveries of Lower Cambrian soft body fossils of Haikouichthys and Myllokunmingia (almost certainly vertebrates, possibly related to modern lampreys) and Yunnanozoon (...) and Haikouella (evidently stem-group vertebrates). The earliest vertebrates had an unequivocally marine origin, probably evolved mineralised pharyngeal denticles before the dermal skeleton, and evidently utilised elastic recoil of the visceral arch skeleton for suction feeding. Moreover, the new data emphasise that the advent of definitive neural crest was supremely important for the evolutionary origin of the vertebrates. BioEssays 23:142–151, 2001. © 2001 John Wiley & Sons, Inc. (shrink)

Increasing complexity and specialisation of modern sciences has led to increasingly collaborative publications, as well as the involvement of commercial services. Modern integrative taxonomy likewise depends on many lines of evidence and is increasingly complex, but the trend of collaboration lags and various attempts at ‘turbo taxonomy’ have been unsatisfactory. We are developing a taxonomic service in the Senckenberg Ocean Species Alliance to provide fundamental data for new species descriptions. This will also function as a hub to connect a global (...) network of taxonomists, assembling an alliance of scientists working on potential new species to tackle both the extinction and inclusion crises we face today. The current rate of new species descriptions is simply too slow; the discipline is often dismissed as old fashioned, and there is a crisis level need for taxonomic descriptions to come to grips with the scale of Anthropocene biodiversity loss. Here, we envision how the process of describing and naming species would benefit from a service supporting the acquisition of descriptive data. Also see the video abstract here: https://youtu.be/E8q3KJor_F8. (shrink)

A large proportion of nursing home residents in developed countries come from ethnic minority groups. Unmet care needs and poor quality of care for this resident population have been widely reported. This systematic review aimed to explore social conditions affecting ethnic minority residents' ability to exercise their autonomy in communication and care while in nursing homes. In total, 19 studies were included in the review. Findings revealed that ethno‐specific nursing homes create the ideal social condition for residents to express their (...) care needs and preferences in a language of choice. In nonethno‐specific nursing homes, staff cultural competence and nursing home commitment to culturally safe care are crucial social conditions that enable this group of residents to fulfil their autonomy in communicating and in participating in their care. In contrast, social conditions that undermine residents' ability to express their care needs and preferences include low levels of staff cultural awareness and cultural desire, negative attitudes towards residents and limited organisational support for staff to improve culturally responsive and culturally safe care. In conclusion, it is important to optimise the social conditions to support ethnic minority residents to communicate their care needs and preferences. (shrink)

© 2016 Regents of the University of California.The Review summarizes much of particle physics and cosmology. Using data from previous editions, plus 3,062 new measurements from 721 papers, we list, evaluate, and average measured properties of gauge bosons and the recently discovered Higgs boson, leptons, quarks, mesons, and baryons. We summarize searches for hypothetical particles such as supersymmetric particles, heavy bosons, axions, dark photons, etc. All the particle properties and search limits are listed in Summary Tables. We also give numerous (...) tables, figures, formulae, and reviews of topics such as Higgs Boson Physics, Supersymmetry, Grand Unified Theories, Neutrino Mixing, Dark Energy, Dark Matter, Cosmology, Particle Detectors, Colliders, Probability and Statistics. Among the 117 reviews are many that are new or heavily revised, including those on Pentaquarks and Inflation. The complete Review is published online in a journal and on the website of the Particle Data Group. The printed PDG Book contains the Summary Tables and all review articles but no longer includes the detailed tables from the Particle Listings. A Booklet with the Summary Tables and abbreviated versions of some of the review articles is also available. (shrink)

Socialist courts are supposed to apply the law, not make it, and socialist legality denies judicial decisions any precedential status. In 2011, the Chinese Supreme People’s Court designated selected decisions as Guiding Cases to be referred to by all judges when adjudicating similar disputes. One decade on, the paucity of citations to Guiding Cases has been taken as demonstrating the incongruity of case-based adjudication and the socialist legal tradition. Citations are, however, an imperfect measure of influence. Reproduction of language uniquely (...) traceable to Guiding Cases can also be evidence of their impact on judicial decision-making. We employ a local alignment tool to detect unattributed text reuse of Guiding Cases in local court decisions. Our findings suggest that Guiding Cases are more consequential than commonly assumed, thereby complicating prevailing narratives about the antagonism of socialist legality to case law. (shrink)

Human behavior depends on the ability to effectively introspect about our performance. For simple perceptual decisions, this introspective or metacognitive ability varies substantially across individuals and is correlated with the structure of focal areas in prefrontal cortex. This raises the possibility that the ability to introspect about different perceptual decisions might be mediated by a common cognitive process. To test this hypothesis, we examined whether inter-individual differences in metacognitive ability were correlated across two different perceptual tasks where individuals made judgments (...) about different and unrelated visual stimulus properties. We found that inter-individual differences were strongly correlated between the two tasks for metacognitive ability but not objective performance. Such stability of an individual’s metacognitive ability across different perceptual tasks indicates a general mechanism supporting metacognition independent of the specific task. (shrink)

The current system of ethical review for medical research in the United Kingdom is changing from the current system involving large committees of 7–18 members reviewing every individual application to a system involving pre-review by small sub-committees of National Research Ethics Officers , who have a remit to approve studies if they believe there are no material ethical issues imposed by the research. The reliability of this new system depends on the reliability of the NREAs and in particular the ability (...) of small groups to effectively identify and appropriately assess the seriousness of all the material ethical issues that may be posed by an application. There is anecdotal evidence to suggest that many individual research ethics committee members have had experience of believing that a study presents no material ethical concerns, then on reaching the committee and discussing the application they realise that the committee feels it does present significant ethical concerns. If this is the case then this casts doubt on the reliability of NREAs or small groups to effectively identify ethically problematic research and appropriately respond to this to protect research participants. In this paper we describe a small questionnaire based piece of research carried out to assess how common this and other relevant experiences are. (shrink)

The purpose of this study was to investigate how the subjective impression of English speech would change when pause duration at punctuation marks was varied. Two listening experiments were performed in which written English speech segments were rated on a variety of evaluation items by both native-English speakers and non-native speakers. The ratings were then subjected to factor analysis. In the first experiment, the pauses in three segments were made into the same durations, from 0.075 to 4.8 s. Participants rated (...) the segments on 23 evaluation items on a rating scale from 1 to 10. A varimax rotation after PCA led to two factors that were related to speech style. These two factors could be interpreted as representing speech naturalness and speech rate. Speech segments with a pause duration of 0.6 s received the highest naturalness evaluation, while perceived speech rate decreased as the physical pause duration increased, without any changes in utterance segments. In the second experiment, a full-factorial design of pause durations within and between sentences, i.e., for commas and for periods, was implemented in two speech segments. The original speech segments and speech segments without any pauses were also included as control conditions. From ratings on 12 evaluation items, similar to Experiment 1, two factors representing speech naturalness and speech rate were obtained. The results showed again that the perceived speech rate decreased with an increase only in pause duration. As for speech naturalness, the highest evaluations occurred when pause durations were 0.6 s within sentences, and either 0.6 or 1.2 s between sentences. This recommends fixing all pause durations to 0.6 s as a practical way to train non-native speakers to make their spoken English appear more natural. (shrink)

The terms complexity, complex adaptive systems, and sciences of complexity are found often in recent scientific literature, reflecting the remarkable growth in collaborative academic research focused on complexity from the origin and dynamics of organisms to the largest social and political organizations. One of the great challenges in this field of research is to discover which features are essential and shared by all of the seemingly disparate systems that are described as complex. Is there sufficient synthesis to suggest the possibility (...) of an overarching science of complexity? This report describes current views on this subject held by various eminent scholars associated with the Santa Fe Institute.The physical sciences have traditionally been concerned with “simple” systems whose dynamics can be described in mathematical terms with precision and certainty. In contrast, the biological and social sciences are inevitably concerned with self-organized or social “complex” systems whose detailed behaviors appear to be unpredictable. The two categories differ greatly in size and diversity, prompting the late mathematician Stanislaus Ulam to remark that research on complex systems might be compared to the study of non-elephants. Nevertheless, certain integrative themes have begun to emerge.Rising activity in this field of research runs completely counter to the trend toward increasing fragmentation and specialization in the sciences. It has stimulated a resurgence of interest in a broad synthesis involving mathematics, computational science, physics, chemistry, biology, neuroscience, and the social sciences. The growth of effort in this very extended field has been greatly stimulated by the development of new computational tools that are capable of dealing with vast, interrelated databases. Many of the participants in complexity research feel that it is now time to reintegrate the fragmented interests of much of the academic community. The reader is encouraged to consider whether such views are sparking a historic renaissance of scholarship or represent a passing scientific diversion. (shrink)

Extant attempts to incorporate _intensionality_ into the grammar either systematically over-generate, or systematically under-generate. In this paper, building on Keshet (Linguist and Philos 33(4):251–283, 2011), we aim to reconcile a scopal account of _de re_ with the possibility of _de re_ readings out of scope islands. By adapting compositional techniques for dealing with exceptionally scoping indefinites (Charlow, in On the semantics of exceptional scope, PhD thesis, Rutgers University, 2014; The scope of alternatives: indefiniteness and islands. Linguist and Philos 43(4):427–472, 2020), (...) we develop an intensional grammar in which exceptional _de re_ is achieved via _cyclic scope_. World-sensitive expressions are converted into scope-takers via a constrained inventory of type-flexible operators. Type flexibility _explains_ the possibility of apparently island-violating _de re_ by predicting the possibility of cyclic scope-taking. We argue that the resulting theory—which we dub the _flexible scope theory_—is sufficiently expressive to address the under-generation issues of current accounts, while still capturing constraints on _de re_ in an explanatory fashion. (shrink)

Collection of essays on the connection between medicine and literature and how novelists and physicians are both, in a sense, diagnosticians; the book focuses, in particular, on Walker Percy, a writer who had trained as a pathologist.

A phylogeny that allows for lateral gene transfer (LGT) can be thought of as a strictly branching tree (all of whose branches are vertical) to which lateral branches have been added. Given that the goal of phylogenetics is to depict evolutionary history, we should look for the best supported phylogenetic network and not restrict ourselves to considering trees. However, the obvious extensions of popular tree-based methods such as maximum parsimony and maximum likelihood face a serious problem—if we judge networks by (...) fit to data alone, networks that have lateral branches will always fit the data at least as well as any network that restricts itself to vertical branches. This is analogous to the well-studied problem of overfitting data in the curve-fitting problem. Analogous problems often have analogous solutions and we propose to treat network inference as a case of model selection and use the Akaike Information Criterion (AIC). Strictly tree-like networks are more parsimonious than those that postulate lateral as well as vertical branches. This leads to the conclusion that we should not always infer LGT events whenever it would improve our fit-to-data, but should do so only when the improved fit is larger than the penalty for adding extra lateral branches. (shrink)

One of the remarkable developments in the contemporary study of Paul is the dramatic interest in his thought amongst European philosophers. This collection of insights from leading scholars makes accessible a discussion often elusive to those not already conversant in the categories of European philosophy"--Publisher description.

According to Marr, a computational-level theory consists of two elements, the what and the why. This article highlights the distinct role of the Why element in the computational analysis of vision. Three theses are advanced: that the Why element plays an explanatory role in computational-level theories, that its goal is to explain why the computed function is appropriate for a given visual task, and that the explanation consists in showing that the functional relations between the representing cells are similar to (...) the “external” mathematical relations between the entities that these cells represent. (shrink)

The apolipoprotein E gene plays an important role in the pathogenesis of Alzheimer's disease , and amyloid plaque comprised mostly of the amyloid-beta peptide ) is one of the major hallmarks of AD. However, the relationship between these two important molecules is poorly understood. We examined how A treatment affects APOE expression in cultured cells and tested the role of the transcription factor NF-B in APOE gene regulation. To delineate NF-B's role, we have characterized a 1098 nucleotide segment containing the (...) 5'-flanking region of the human APOE gene . Sequence analysis of this region suggests the presence of two potential NF-B elements. To demonstrate promoter activity, the region was cloned upstream of a promoterless luciferase gene. This segment was able to drive expression of luciferase in transient transfections of human fetal glial cells. Promoter activity was stimulated twofold by A treatment. Pretreatment with double-stranded DNA decoy oligonucleotides against NF-B reduced A stimulation. Deletion and mutagenetic analyses demonstrated that the distal NF-B element was functional and showed a strong DNA-protein complex band in gel shift analysis, similar to that from control NF-B consensus element. An anti-inflammatory and anti-NF-B drug, sodium salicylate, significantly blocked A-induced APOE promoter function. Our data provide evidence that upregulation of APOE by A in astroglial cells is mediated by an NF-B-element present in the 5'-flanking region of the APOE gene. (shrink)

Many scientists and doctors hope that affordable genome sequencing will lead to more personalized medical care and improve public health in ways that will benefit children, families, and society more broadly. One hope in particular is that all newborns could be sequenced at birth, thereby setting the stage for a lifetime of medical care and self‐directed preventive actions tailored to each child's genome. Indeed, commentators often suggest that universal genome sequencing is inevitable. Such optimism can come with the presumption that (...) discussing the potential limits, cost, and downsides of widespread application of genomic technologies is pointless, excessively pessimistic, or overly cautious. We disagree. Given the pragmatic challenges associated with determining what sequencing data mean for the health of individuals, the economic costs associated with interpreting and acting on such data, and the psychosocial costs of predicting one's own or one's child's future life plans based on uncertain testing results, we think this hope and optimism deserve to be tempered.In the analysis that follows, we distinguish between two reasons for using sequencing: to diagnose individual infants who have been identified as sick and to screen populations of infants who appear to be healthy. We also distinguish among three contexts in which sequencing for either diagnosis or screening could be deployed: in clinical medicine, in public health programs, and as a direct‐to‐consumer service. Each of these contexts comes with different professional norms, policy considerations, and public expectations. Finally, we distinguish between two main types of genome sequencing: targeted sequencing, where only specific genes are sequenced or analyzed, and whole‐exome or whole‐genome sequencing, where all the DNA or all the coding segments of all genes are sequenced and analyzed.In a symptomatic newborn, targeted or genome‐wide sequencing can help guide other tests for diagnosis or for specific treatment that is urgently needed. Clinicians use the infant's symptoms (or phenotype) to interrogate the sequencing data. These same complexities and uncertainties, however, limit the usefulness of genome‐wide sequencing as a population screening tool. While we recognize considerable benefit in using targeted sequencing to screen for or detect specific conditions that meet the criteria for inclusion in newborn screening panels, use of genome‐wide sequencing as a sole screening tool for newborns is at best premature. We conclude that sequencing technology can be beneficially used in newborns when that use is nuanced and attentive to context. (shrink)

The gaze cueing effect is characterized by faster attentional orienting to a gazed-at than a non-gazed-at target. This effect is often enhanced when the gazing face bears an emotional expression, though this finding is modulated by a number of factors. Here, we tested whether the type of task performed might be one such modulating factor. Target localization and target discrimination tasks are the two most commonly used gaze cueing tasks, and they arguably differ in cognitive resources, which could impact how (...) emotional expression and gaze cues are integrated to orient attention. In a within-subjects design, participants performed both target localization and discrimination gaze cueing tasks with neutral, happy, and fearful faces. The gaze cueing effect for neutral faces was greatly reduced in the discrimination task relative to the localization task, and the emotional enhancement of the gaze cueing effect was only present in the localization task and only when this task was performed first. These results suggest that cognitive resources are needed for gaze cueing and for the integration of emotional expressions and gaze cues. We propose that a shift toward local processing may be the mechanism by which the discrimination task interferes with the emotional modulation of gaze cueing. The results support the idea that gaze cueing can be greatly modulated by top-down influences and cognitive resources and thus taps into endogenous attention. Results are discussed within the context of the recently proposed EyeTune model of social attention. (shrink)

A major intellectual shift between Copernicus and the mid-17th century was the rejection of Aristotelian assertions concerning the relationship of mathematics to physical nature. Aristotle asserted that “The minute accuracy of mathematics is not to be demanded in all cases, but only in the case of things which have no matter. Therefore its method is not that of natural science; for presumably all nature has matter.” Thus, he pulled out the rug from under the feet of the aspiration to a (...) mathematically based natural sciences, asserting that: “And at the same time not even this is true, that mensuration deals with perceptible and perishable magnitudes; for then it would have perished, when they perished. And astronomy also cannot be dealing with perceptible magnitudes nor with this heaven above us. For neither are perceptible lines such lines as the geometer speaks of, nor are the movement and complex orbits in the heaven like those which astronomy treats, nor have geometrical points the same nature as the actual stars.”. (shrink)

In many research studies, tumor biopsies are an unavoidable requirement for achieving key scientific aims. Yet some commentators view mandatory research biopsies as coercive and suggest they should be optional, or at least optional until further data are obtained regarding their scientific usefulness. Further complicating the ethical picture is the fact that some research biopsies offer a potential for clinical benefit to trial participants. We interviewed and surveyed a convenience sample of participants in phase I clinical trials at a single (...) institution. Our primary aim was to describe phase I participants’ understanding of whether a research biopsy offered them the prospect of medical benefit. We also endeavored to describe participants’ views about biopsies—specifically, the benefits of biopsies, if any, and whether biopsies were acceptable, risky, or discouraged trial participation. Finally, we collected data on demographics and attitudes to see if any strong correlations with misunderstanding, acceptability, or riskiness existed. Overall, the respondents tended to view research biopsies as acceptable, though they did not succeed in identifying the lack of benefit of a research biopsy. These findings call for renewed efforts in consent conversations and documents to carefully describe the benefits, or lack thereof, of research biopsies. (shrink)

Over the past generation, the rise of East Asia and especially China, has brought about a sea change in the economic and political world order. At the same time, global warming, environmental degradation, food and water shortages, population explosion, and income inequities have created a perfect storm that threatens the very survival of humanity. It is clear now that the Westphalian model of individual sovereign states seeking their own self-interest will not be able to respond effectively to this win-win or (...) lose-lose crisis. In this volume, a cadre of distinguished scholars comes together to reflect on Confucianism and Deweyan pragmatism as possible resources for a new geopolitics that begins from an ontology of interdependence and recognizes the irreducibly ecological nature of the human experience at every level. Both Confucian and Deweyan traditions emphasize the primacy of experience, the importance of vital relationality, and the moral roots of good governance. The potential benefits of conceptually blending the two are many. Indeed, the contemporary Chinese philosopher Tang Junyi provides us with a cosmological understanding of the "idea" of Confucianism that, in parallel to Dewey's "idea" of democracy, can enable us to anticipate the core values, if not the specific contours, of a "Confucian democracy." Just as Dewey's "idea" of democracy is his vision of the flourishing communal life made possible by the contributions of the uniquely distinguished persons that constitute it, Tang Junyi's Confucianism is a pragmatic naturalism directed at achieving the most highly integrated cultural, moral, and spiritual growth for the individual-in-community. In both, we find an affirmation of communal harmony as a process "starting here and going there" through which those involved learn together to do ordinary things in extraordinary ways. Just such a cosmological understanding of democracy is one way of describing what will be needed to address the many predicaments characterizing the environmental, cultural, socioeconomic, and political dynamics of the twenty-first century. (shrink)