There are compelling medical, ethical, and legal arguments that support mandating use of a central institutional review board for the review of clinical trials performed at multiple institutional sites. Progress against serious diseases depends on this.

In aging humans, aerobic exercise interventions have been found to be associated with more positive or less negative changes in frontal and temporal brain areas, such as the anterior cingulate cortex (ACC) and hippocampus, relative to no-exercise control conditions. However, individual measures such as gray-matter (GM) probability may afford less reliable and valid conclusions about maintenance or losses in structural brain integrity than a latent construct based on multiple indicators. Here, we established a latent factor of GM structural integrity based (...) on GM probability assessed by voxel-based morphometry, magnetization transfer saturation, and mean diffusivity. Based on this latent factor, we investigated changes in structural brain integrity during a six-month exercise intervention in brain regions previously reported in studies using volumetric approaches. Seventy-five healthy, previously sedentary older adults aged 63–76 years completed an at-home intervention study in either an exercise group (EG;n= 40) or in an active control group (ACG;n= 35). Measures of peak oxygen uptake (VO2peak) taken before and after the intervention revealed a time-by-group interaction, with positive average change in the EG and no reliable mean change in the ACG. Significant group differences in structural brain integrity changes were observed in the right and left ACC, right posterior cingulate cortex (PCC), and left juxtapositional lobule cortex (JLC). In all instances, average changes in the EG did not differ reliably from zero, whereas average changes in the ACG were negative, pointing to maintenance of structural brain integrity in the EG, and to losses in the ACG. Significant individual differences in change were observed for right ACC and left JLC. Following up on these differences, we found that exercising participants with greater fitness gains also showed more positive changes in structural integrity. We discuss the benefits and limitations of a latent-factor approach to changes in structural brain integrity, and conclude that aerobic fitness interventions are likely to contribute to brain maintenance in old age. (shrink)

We examine the influence of word choices on mathematical practice, i.e. in developing definitions, theorems, and proofs. As a case study, we consider Euclid’s and Euler’s word choices in their influential developments of geometry and, in particular, their use of the term ‘polyhedron’. Then, jumping to the twentieth century, we look at word choices surrounding the use of the term ‘polyhedron’ in the work of Coxeter and of Grünbaum. We also consider a recent and explicit conflict of approach between Grünbaum (...) and Shephard on the one hand and that of Hilton and Pedersen on the other, elucidating that the conflict was engendered by disagreement over the proper conceptualization, and so also the appropriate word choices, in the study of polyhedra. (shrink)

Dans cet article, nous décrivons un schéma et des modèles de représentation développés pour structurer les corpus de communication médiée par ordinateur (CMC) en suivant les recommandations de la Text Encoding Initiative (TEI). Nous considérons le discours CMC comme un échange dialogique entre humains, organisé de manière séquentielle. Nous insistons d’abord sur le fait que de nombreuses caractéristiques de la CMC ne sont pas traitées de manière adéquate par les schémas et les outils actuels d’encodage de corpus. Nous formulons donc (...) un ensemble de recommandations pour représenter la CMC avec des schémas d’encodage, en insistant sur le fait que la TEI nous semble être un cadre particulièrement approprié pour l’encodage des corpus CMC. Nous proposons une modélisation des unités de base de la CMC (énoncés, messages et actions non verbales) ainsi que des structures de niveaux macro- et micro des interactions dans les environnements de la CMC. À partir de ces modèles, nous introduisons le CMC-core, un noyau TEI pour l’encodage des corpus CMC, qui définit un ensemble de traits d’encodage spécifiques à la CMC sur quatre niveaux: (i) éléments, (ii) classes de modèles, (iii) classes d'attributs et (iv) modules de l'infrastructure TEI. La description du noyau proposé est illustrée au moyen d’exemples extraits des corpus des chercheurs du groupe SIG TEI CMC, représentant une grande variété de genres de la CMC (le chat, le wiki talk, le tweet, le blog, les interactions Second Life…). Le matériel décrit, i.e. les schémas, les exemples d’encodage et la documentation, est disponible sur le Wiki du SIG CMC TEI et accompagnera une demande d’enrichissement de la TEI (TEI feature request) au conseil de la TEI à la fin de l’année 2019. (shrink)

The understanding of locomotion in neurological disorders requires technologies for quantitative gait analysis. Numerous modalities are available today to objectively capture spatiotemporal gait and postural control features. Nevertheless, many obstacles prevent the application of these technologies to their full potential in neurological research and especially clinical practice. These include the required expert knowledge, time for data collection, and missing standards for data analysis and reporting. Here, we provide a technological review of wearable and vision-based portable motion analysis tools that emerged (...) in the last decade with recent applications in neurological disorders such as Parkinson's disease and Multiple Sclerosis. The goal is to enable the reader to understand the available technologies with their individual strengths and limitations in order to make an informed decision for own investigations and clinical applications. We foresee that ongoing developments toward user-friendly automated devices will allow for closed-loop applications, long-term monitoring, and telemedical consulting in real-life environments. (shrink)

The beneficial effects of physical exercise on physical health and cognitive functioning have been repeatedly shown. However, evidence of its effect on psychosocial functioning in healthy adults is still scarce or inconclusive. One limitation of many studies examining this link is their reliance on correlational approaches or specific subpopulations, such as clinical populations. The present study investigated the effects of a physical exercise intervention on key factors of psychosocial functioning, specifically well-being, stress, loneliness, and future time perspective. We used data (...) from healthy, previously sedentary older adults who participated in a 6-month at-home intervention, either engaging in aerobic exercise or as part of a control group who participated in foreign language-learning or reading of selected native-language literature. Before and after the intervention, comprehensive cardiovascular pulmonary testing and a psychosocial questionnaire were administered. The exercise group showed significantly increased fitness compared to the control group. Contrary to expectations, however, we did not find evidence for a beneficial effect of this fitness improvement on any of the four domains of psychosocial functioning we assessed. This may be due to pronounced stability of such psychological traits in older age, especially in older adults who show high levels of well-being initially. Alternatively, it may be that the well-documented beneficial effects of physical exercise on brain structure and function, as well as cognition differ markedly from beneficial effects on psychosocial functioning. While aerobic exercise may be the driving factor for the former, positive effects on the latter may only be invoked by other aspects of exercise, for example, experiences of mastery or a feeling of community. (shrink)

Despite the recent advances in information and communication technology that have increased our ability to store and circulate information, the task of ensuring that the right sorts of information gets to the right sorts of people remains. We argue that the many efforts underway to develop efficient means for sharing information across healthcare systems and organizations would benefit from a careful analysis of human action in healthcare organizations. This in turn requires that the management of information and knowledge within healthcare (...) organizations be combined with models of resources and processes of patient care that are based on a general ontology of social interaction. The Health Level 7 (HL7) is one of several ANSI-accredited Standards Developing Organizations operating in the healthcare arena. HL7 has advanced a widely used messaging standard that enables healthcare applications to exchange clinical and administrative data in digital form. HL7 focuses on the interface requirements of the entire healthcare system and not exclusively on the requirements of one area of healthcare such as pharmacy, medical devices, imaging or insurance transactions. This has inspired the development of a powerful abstract model of patient care called the Reference Information Model (RIM). The present paper begins with an overview of the core classes of the HL7 (Version 3) RIM and a brief discussion of its “actcentered” view of healthcare. Central to this account is what is called the life cycle of events. A clinical action may progress from defined, through planned and ordered, to executed. These modalities of an action are represented as the mood of the act. We then outline the basis of an ontology of organizations, starting from the theory of speech Acts, and apply this ontology to the HL7 RIM. Special attention is given to the sorts of preconditions that must be satisfied for the successful performance of a speech act and to the sorts of entities to which speech acts give rise (e.g. obligations, claims, commitments, etc.). Finally we draw conclusions for the efficient communication and management of medical information and knowledge within and between healthcare organizations, paying special attention to the role that medical documents play in such organizations. (shrink)

To entertain an idea is to take it in, pay attention to it, give it breathing room, dwell with it for a time. The practice of entertaining ideas suggests rumination and meditation, inviting us to think of philosophy as a form of hospitality and a kind of mental theatre. In this collection, organized around key words shared by philosophy and performance, the editors suggest that Shakespeare's plays supply readers, listeners, viewers, and performers with equipment for living. In plays ranging from (...) A Midsummer Night's Dream to King Lear and The Winter's Tale, Shakespeare invites readers and audiences to be more responsive to the texture and meaning of daily encounters, whether in the intimacies of love, the demands of social and political life, or moments of ethical decision. Entertaining the Idea features established and emerging scholars, addressing key words such as role play, acknowledgment, judgment, and entertainment as well as curse and care. The volume also includes longer essays on Shakespeare, Kant, Husserl, and Hegel as well as an afterword by theatre critic Charles McNulty on the philosophy and performance history of King Lear. (shrink)

This volume presents a study edition of the lectures delivered by Charles Peirce to the Lowell Institute in Boston in the Fall of 1903. These previously unpublished lectures present a comprehensive and revised statement of his work on the methods of science. Offering mature reflection on a lifetime's thought and work, they represent the culmination of Peirce's research on scientific objectivity. Alongside the Cambridge Conferences Lectures (1898, edited by K. L. Ketner), the Harvard Lectures on Pragmatism (1903, edited by (...) P. A. Turrisi), and the The Logic of Interdisciplinarity (the project of Peirce's Monist Series 1891-1909, edited by E. Bisanz), the Lowell Lectures of 1903 presented here offer significant insights into Peirce's mature phase as an explorer of objective methods in interdisciplinary science. This collection will appeal to anyone interested in the work of this great thinker, the history of science, and the history of American intellectual life. (shrink)

Objectives: Hospital ethics committees increasingly affect medical care worldwide, yet there has been little evaluation of these bodies. Israel has the distinction of having ethics committees legally required by a Patients' Rights Act. We studied the development of ethics committees in this legal environment.Design: Cross-sectional national survey of general hospitals to identify all ethics committees and interview of ethics committee chairpersons.Setting: Israel five years after the passage of the Patients' Rights Act.Main measurements: Patients' rights and informal ethics committee structure and (...) function.Results: One-third of general hospitals have an ethics committee, with committees concentrated in larger facilities. Hospitals without committees tended to lack any structure to handle ethics issues. Committees tend to be interdisciplinary and gender-mixed but ethnic mix was poor. Confidentiality is the rule, however, legal liability is a concern. One-third of patients' rights ethics committees never convened and most committees had considered fewer than ten consults. Access to the consultation process and the consultation process itself varied substantially across committees. Some patients' rights ethics committees attempted to solve cases, others only rendered decisions. Informal committees often refused to consider cases within Patients' Rights Act jurisdiction.Conclusions: Despite statutory requirement, many Israeli patients and clinicians do not have access to ethics committees. The scant volume of cases shows serious discrepancies between practice and Patients' Rights Act regulations, suggesting the need for education or revision of the law. Heterogeneity in committee function demonstrates need for substantial improvement. (shrink)

This article is the first in a series that looks at the technological transformation of Des Moines Public Schools (DMPS). It concentrates on the costs, some financial but mostly human and organizational, that are emerging as the district begins to implement its plans for dramatically increasing computer technology use. The conclusion reached here is that not only ave the costs been greatly underestimated, they may even force a gradual shift of control over the learning environment.

In this groundbreaking new study, Lowell Nissen explores the use of teleological language in the study of subjects such as behaviorism, negative feedback, and natural selection. He argues that all existing analyses fail to explain how teleological language can be used legitimately, and provides his own analysis in terms of intentionality.

Despite the recent advances in information and communication technology that have increased our ability to store and circulate information, the task remains of ensuring that the right sorts of information reach the right sorts of people. In what follows we defend the thesis that efforts to develop efficient means for sharing information across healthcare systems and organizations would benefit from a careful analysis of human action in healthcare organizations, and that the communication of healthcare information and knowledge needs to rest (...) on a sound ontology of social interaction. We illustrate this thesis in relation to the HL7 RIM, which is one centrally important tool for communication in the healthcare domain. (shrink)