Objective: To review the principles and practice of the use of conscious sedation for IVF.Design: The pertinent literature was reviewed and recommendations are provided.Result(s): Conscious sedation appears to be the most commonly used method of pain relief for transvaginal retrieval of oocytes. Conscious sedation does not require the presence of an anesthesiologist and can be done in freestanding clinics. Agents commonly used include opioids in combination with benzodiazepines. This combination minimizes pain, decreases anxiety, and provides sedation and some amnesia Adjuvants (...) such as promethazine and hydroxyzine can also be used but often are not needed. Conscious sedation is well tolerated by patients and does not require highly specialized equipment. However, there are specific safeguards that should be followed. Only a few toxicity studies have been performed, but they are reassuring because they have not found significant effects on fertilization or cleavage.Conclusion(s): Conscious sedation appears to be a safe and cost-effective method of providing analgesia and anesthesia for transvaginal retrieval of oocytes. (shrink)

The subject matter of Ward’s book is Kant’s view of the nature of morality. Its object is to show that there is a development in Kant’s view, not only from the precritical to the critical stage of his thought, but also within the critical stage of his thought. The occasion for writing this book, it should be noted, is the prevalence of "verdicts" regarding Kant’s view of the nature of morality formed by British scholars on the basis of an acquaintance (...) of only the major critical works of Kant. According to Ward, an adequate understanding of Kant’s view of the nature of morality can come only from a reading of all of Kant’s works, most especially from a reading of his final, posthumously published, notes. In these notes, Kant equates God with practical reason. The significance of this equation is that it finally provides a stable solution to the problem of the foundations of morality, a problem which had occupied Kant since the beginning of his philosophical career. Kant’s precritical works, as well as the critiques, provide only unstable solutions. In his pre-critical works, Kant oscillates between seeking the foundations in knowledge and feeling. In his critiques, Kant seems to find a stable solution by conceiving reason as the source of principles, both theoretical and practical. The instability of this solution lies in the fact that Kant retains, along with the formal principles, a morality the source of which is religion. In the critiques, however, Kant is unable to conceive religion as anything more than a supplement to morality. Not until his final notes, Ward argues, does Kant recognize this instability and rectify it by giving religion an integral place in his conception of morality.—W. A. S. (shrink)

One thing we have found out about logical empiricism, now that people are examining it more closely again, is that it was more a framework for a number of related views than a single doctrine. The pluralism of different approaches among various adherents to the Vienna and Berlin groups has been much emphasized. Some have gone so far as to suggest that the kind of speculative philosophy now often called "continental" (including, say, phenomenology) can be seen as falling within the (...) framework of views shared by the Vienna Circle. Much is made of Felix Kaufmann's membership in the Vienna Circle, for instance, or of its "Austrian" roots in the phenomenology of Brentano. (shrink)

In 1929 Carnap gave a paper in Prague on Investigations in General Axiomatics; a briefsummary was published soon after. Its subject lookssomething like early model theory, and the mainresult, called the Gabelbarkeitssatz, appears toclaim that a consistent set of axioms is complete justif it is categorical. This of course casts doubt onthe entire project. Though there is no furthermention of this theorem in Carnap''s publishedwritings, his Nachlass includes a largetypescript on the subject, Investigations inGeneral Axiomatics. We examine this work here,showing (...) that it provides important insights intoCarnap''s development during this critical period, thetransition from Aufbau to Syntax,especially regarding the nature and motivation ofCarnap''s logicism. Moreover, we show how theAxiomatics influenced Carnap''s student Gödel inreaching the fundamental logical results that soonafterwards undermined Carnap''s project. (shrink)

In Carnap’s autobiography, he tells the story how one night in January 1931, “the whole theory of language structure” in all its ramifications “came to [him] like a vision”. The shorthand manuscript he produced immediately thereafter, he says, “was the first version” of Logical Syntax of Language. This document, which has never been examined since Carnap’s death, turns out not to resemble Logical Syntax at all, at least on the surface. Wherein, then, did the momentous insight of 21 January 1931 (...) consist? We seek to answer this question by placing Carnap’s shorthand manuscript in the context of his previous efforts to accommodate scientific theories and metalinguistic claims within Wittgenstein’s Tractatus theory of meaning. The breakthrough of January 1931 consists, from this viewpoint, in the rejection of the Tractatus theory in favor of the meta-mathematical perspective of Hilbert, Gödel, and Tarski. This was not yet the standpoint of the published Logical Syntax, as we show, but led naturally to the “principle of tolerance” and thus to Carnap’s mature philosophy, in which the inconsistencies between this first view and the principle of tolerance, which survived into the published Syntax, were overcome. (shrink)

The prospect of using cell-based interventions to treat neurological conditions raises several important ethical and policy questions. In this target article, we focus on issues related to the unique constellation of traits that characterize CBIs targeted at the central nervous system. In particular, there is at least a theoretical prospect that these cells will alter the recipients' cognition, mood, and behavior—brain functions that are central to our concept of the self. The potential for such changes, although perhaps remote, is cause (...) for concern and careful ethical analysis. Both to enable better informed consent in the future and as an end in itself, we argue that early human trials of CBIs for neurological conditions must monitor subjects for changes in cognition, mood, and behavior; further, we recommend concrete steps for that monitoring. Such steps will help better characterize the potential risks and benefits of CBIs as they are tested and potentially used for treatment. (shrink)

A total of 1918 loci, detected by the hybridization of 938 expressed sequence tag unigenes from 26 Triticeae cDNA libraries, were mapped to wheat homoeologous group 4 chromosomes using a set of deletion, ditelosomic, and nulli-tetrasomic lines. The 1918 EST loci were not distributed uniformly among the three group 4 chromosomes; 41, 28, and 31% mapped to chromosomes 4A, 4B, and 4D, respectively. This pattern is in contrast to the cumulative results of EST mapping in all homoeologous groups, as reported (...) elsewhere, that found the highest proportion of loci mapped to the B genome. Sixty-five percent of these 1918 loci mapped to the long arms of homoeologous group 4 chromosomes, while 35% mapped to the short arms. The distal regions of chromosome arms showed higher numbers of loci than the proximal regions, with the exception of 4DL. This study confirmed the complex structure of chromosome 4A that contains two reciprocal translocations and two inversions, previously identified. An additional inversion in the centromeric region of 4A was revealed. A consensus map for homoeologous group 4 was developed from 119 ESTs unique to group 4. Forty-nine percent of these ESTs were found to be homoologous to sequences on rice chromosome 3, 12% had matches with sequences on other rice chromosomes, and 39% had no matches with rice sequences at all. Limited homology was found between wheat ESTs on homoeologous group 4 and the Arabidopsis genome. Forty-two percent of the homoeologous group 4 ESTs could be classified into functional categories on the basis of blastX searches against all protein databases. (shrink)

The objectives of this study were to develop a high-density chromosome bin map of homoeologous group 7 in hexaploid wheat, to identify gene distribution in these chromosomes, and to perform comparative studies of wheat with rice and barley. We mapped 2148 loci from 919 EST clones onto group 7 chromosomes of wheat. In the majority of cases the numbers of loci were significantly lower in the centromeric regions and tended to increase in the distal regions. The level of duplicated loci (...) in this group was 24% with most of these loci being localized toward the distal regions. One hundred nineteen EST probes that hybridized to three fragments and mapped to the three group 7 chromosomes were designated landmark probes and were used to construct a consensus homoeologous group 7 map. An additional 49 probes that mapped to 7AS, 7DS, and the ancestral translocated segment involving 7BS also were designated landmarks. Landmark probe orders and comparative maps of wheat, rice, and barley were produced on the basis of corresponding rice BAC/PAC and genetic markers that mapped on chromosomes 6 and 8 of rice. Identification of landmark ESTs and development of consensus maps may provide a framework of conserved coding regions predating the evolution of wheat genomes. (shrink)

On the theory of meaning and reference (semantics) as interpretated by W.V. Quine; a study.

Engagement with genomic medicine and research has increased globally during the past few decades, including rapid developments in Sri Lanka. Genomic research is carried out in Sri Lanka on a variety of scales and with different aims and perspectives. However, there are concerns about participants' understanding of genomic research, including the validity of informed consent. This article reports a qualitative study aiming to explore the understanding, knowledge, and attitudes of the Sri Lankan public towards genomic medicine and to inform the (...) development of an effective and appropriate process for informed consent in that setting. Purposive sampling was employed. Participants were recruited from a sub-group of the public in Colombo, Sri Lanka who had either consented or refused to donate genetic material for a biobank. Data were collected using face-to-face semi-structured interviews. Interview data were transcribed verbatim and translated into English. Conventional content analysis was used. The analysis developed three key themes: a) ‘Scientific literacy’ describes an apparent lack of scientific knowledge that seems to affect a participant’s ability to understand the research, b) ‘Motivation’ describes narratives about why participants chose (not) to take part in the research, despite not understanding it, and c) ‘Trust’ describes how trust served to mitigate the apparent ethical deficit created by not being fully informed. In this article, we argue that informed trust is likely an acceptable basis for consent, particularly in settings where scientific literacy might be low. However, researchers must work to be worthy of that trust and ensure that misconceptions are actively addressed. (shrink)

Context The attitudes of medical professionals towards physician assisted dying have been widely discussed. Less explored is the level of agreement among physicians on the possibility of ‘rational suicide’—a considered suicide act made by a sound mind and a precondition of assisted dying legislation. Objective To assess attitudes towards rational suicide in a representative sample of senior doctors in England and Wales. Methods A postal survey was conducted of 1000 consultants and general practitioners randomly selected from a commercially available database. (...) The main outcome of interest was level of agreement with a statement about rational suicide. Results The corrected participation rate was 50%; 363 questionnaires were analysed. Overall 72% of doctors agreed with the possibility of rational suicide, 17% disagreed, and 11% were neutral. Doctors who identified themselves as being more religious were more likely to disagree. Some doctors who disagreed with legalisation of physician assisted suicide nevertheless agreed with the concept of rational suicide. Conclusions Most senior doctors in England and Wales feel that rational suicide is possible. There was no association with specialty. Strong religious belief was associated with disagreement, although levels of agreement were still high in people reporting the strongest religious belief. Most doctors who were opposed to physician assisted suicide believed that rational suicide was possible, suggesting that some medical opposition is best explained by other factors such as concerns of assessment and protection of vulnerable patients. (shrink)

The subject matter of Ward’s book is Kant’s view of the nature of morality. Its object is to show that there is a development in Kant’s view, not only from the precritical to the critical stage of his thought, but also within the critical stage of his thought. The occasion for writing this book, it should be noted, is the prevalence of "verdicts" regarding Kant’s view of the nature of morality formed by British scholars on the basis of an acquaintance (...) of only the major critical works of Kant. According to Ward, an adequate understanding of Kant’s view of the nature of morality can come only from a reading of all of Kant’s works, most especially from a reading of his final, posthumously published, notes. In these notes, Kant equates God with practical reason. The significance of this equation is that it finally provides a stable solution to the problem of the foundations of morality, a problem which had occupied Kant since the beginning of his philosophical career. Kant’s precritical works, as well as the critiques, provide only unstable solutions. In his pre-critical works, Kant oscillates between seeking the foundations in knowledge and feeling. In his critiques, Kant seems to find a stable solution by conceiving reason as the source of principles, both theoretical and practical. The instability of this solution lies in the fact that Kant retains, along with the formal principles, a morality the source of which is religion. In the critiques, however, Kant is unable to conceive religion as anything more than a supplement to morality. Not until his final notes, Ward argues, does Kant recognize this instability and rectify it by giving religion an integral place in his conception of morality.—W. A. S. (shrink)

The fulfillment of the pedagogical intention of this work takes the form of developing a specific conception of metaphysics. The author’s conception is not the original one in terms of the object of metaphysics, but one that encompasses as well the various philosophical developments that affect the original conception of it, including critiques of it. The author conceives metaphysics in terms of "motives" of thought, originally articulated by Plato, namely, 1) the knowledge of principles of being; 2) the standard of (...) true knowledge; and 3) the way in which this knowledge is attained. According to the author, the first definitive treatment of the first of these themes is given by Aristotle, in the conception of the essences of things as the principles of being. In subsequent treatments, these themes undergo various transformations, which are presented by the author as being the result of critical reflections on prior treatments. In fact, they are the result of shifts in perspective, the most fundamental of which is, as the author himself notes, the introduction of perspectivity as a category in the sense of a condition of knowledge. The author traces the function of this category in the thought of various philosophers from Augustine to Nietzsche, suggesting, though not explicitly establishing, its theological origin. (shrink)