Several studies have highlighted the role of cross- linguistic influence in determining the over-use of overt subject pronouns in near- native speakers of a null- subject language as Italian. In this work we inquire on the role of other factors, such as age of onset of exposure and dominance with respect to the choice of subject anaphoric devices in two null-subject languages by bilingual speakers. In order to do so we first single out two languages, Italian and Greek, which (...) do not differ significantly as far as subject anaphoric devices are concerned and instantiate thus a suitable language combination to inquire on the role of relevant factors in bilingual speakers of these two languages, in the absence of cross- linguistic influence related effects (Study 1). In Study 2 we compare the productions in Italian of a group of natives speakers and two groups of near- native speakers: Greek- Italian bilinguals from birth and L2ers of Italian with Greek as an L1. Results reveal that age of onset of exposure to Italian is a relevant factor influencing over- use of overt pronouns: while bilinguals from birth do not differ from native speakers, L2ers over-use overt pronouns compared to both native speakers and bilinguals from birth. In order to establish whether dominance is a possible factor determining bilinguals’ choice of subject anaphoric devices, in Study 3 we compare two groups of Greek- Italian bilinguals from birth: bilinguals living in Greece (dominant in Greek) and bilinguals living in Italy (dominant in Italian). Results reveal no effect of dominance with respect to the production of overt subject pronouns. We found however an unexpected effect in the dominant language of one group: bilinguals living in Greece produce significantly more null pronouns and less lexical DPs in Greek compared to bilinguals living in Italy. We interpret this effect as stemming from the need to differentiate the two languages that these bilingual speakers have to handle in everyday life. Interestingly, this effect is found in the dominant language rather than in the non- dominant one, and does not concern overt pronouns. (shrink)

In this paper we investigate whether timing in monolingual acquisition interacts with age of onset and input effects in child bilingualism. Six different morpho-syntactic and semantic phenomena acquired early, late or very late are considered, with their timing in L1 acquisition varying between age 3 (subject-verb agreement) and after age 6 (case marking). Data from simultaneous bilingual children (2L1) whose mean age of onset to German was three months are compared with data from early second language learners of (...) German (eL2) whose mean age of onset to German was 35 months as well as with data from monolingual children. To explore change over time, children were tested twice at the ages of 4;4 years and 5;8 years. The main findings were that 2L1 children had an advantage over their eL2 peers in early acquired phenomena, which disappeared with time, whereas in late acquired phenomena 2L1 and eL2 children did not differ. Moreover, 2L1 children performed like monolingual children in early acquired phenomena but had a disadvantage in the late acquired phenomena with the amount of delay decreasing with time. We conclude that age of onset effects are modulated by effects of timing in monolingual acquisition. Contrary to expectation, input in terms of language dominance, measured as the dominant language used at home, did not affect simultaneous bilingual children’s performance in any of the phenomena. We discuss the implications of our findings for the hypothesis that acquisition of late phenomena is determined by input alone and suggest an alternative concept: the learner’s internal need for time to master a phenomenon, which is determined by its complexity and cross-linguistic robustness. (shrink)

The identification and avoidance of disease susceptibility in embryos is the most common goal of preimplantation genetic diagnosis (PGD). Most jurisdictions that accept but regulate the availability of PGD restrict it to what are characterized as ‘serious’ conditions. Line-drawing around seriousness is not determined solely by the identification of a genetic mutation. Other factors seen to be relevant include: impact on health or severity of symptoms; degree of penetrance (probability of genotype being expressed as a genetic disorder); potential for therapy; (...) rate of progression; heritability; and age of onset. In the original applications of PGD, most, if not all of these factors were seen as necessary but none was seen as sufficient for determining whether a genetic condition was labelled ‘serious’. This, however, is changing as impact on health or severity of symptoms is coming to eclipse the other considerations. This paper investigates how age of onset (primarily in the context of the United Kingdom (UK)) has become considerably less significant as a criterion for determining ethically acceptable applications of PGD. Having moved off the threshold of permitting PGD testing for only fatal (or seriously debilitating), early-onset diseases, I will investigate reasons for why age of onset will not do any work to discriminate between which adult-onset diseases should be considered serious or not. First I will explain the rationale underpinning age of onset as a factor to be weighed in making determinations of seriousness. Next I will challenge the view that later-onset conditions are less serious for being later than earlier-onset conditions. The final section of the paper will discuss some of the broader disability concerns at stake in limiting access to PGD based upon determinations of the ‘seriousness’ of genetic conditions. Instead of advocating a return to limiting PGD to only early-onset conditions, I conclude that the whole enterprise of trying to draw lines of what is to count as a ‘serious’ condition is itself problematic and in certain ways morally misleading. (shrink)

Background: The aim of this study was to investigate associations between demographic and clinical variables and duration of untreated psychosis (DUP) in a sample of cases of psychosis across an adult early intervention in psychosis service and a child and adolescent community team. Method: Cross-sectional baseline data for cases of psychosis across the two teams on the caseload at a given time point were collected, including age of onset, gender, ethnicity, referral route, and DUP. Results: The median DUP across (...) the entire sample was 91 days, while those patients with initial treatment for psychosis from the child and adolescent team had a median DUP of 69 days. Using multiple linear regression, there were two variables that showed a significant association with DUP: referral route (p < .001), and age of onset, with earlier age of onset associated with shorter DUP (p = .015). Conclusion: These findings are discussed in relation to possible explanatory factors, with particular focus on service-level variables and pathways to care. It is suggested that the involvement of child and adolescent teams is vital to the work of early intervention in psychosis services. (shrink)

Background Preserving persons’ dignity is integral to nursing. More research is needed to explore how a diversity of patients, particularly those that experience illness from a young age, experience dignity. Aim Describe the characteristics of dignity for persons living with serious illness. Research design Using a secondary data set of twenty audio-recorded interviews, a thematic content analysis was conducted to identify characteristics of dignity. The research team employed van Gennip et al.’s, 2013 “Model of Dignity in Illness” (1) to create (...) a codebook, which the authors utilized to independently code twenty narrative interview transcripts. Participants and research context Twenty persons living with serious illness of heart failure and/or dialysis-dependent renal failure who were admitted in an acute care hospital. Ethical considerations This study was approved on August 26, 2019, by the Colorado Multiple Institutional Review Board (COMIRB) IRB Protocol #19-1874. Findings Early-onset participants expressed markedly different dignity concerns than late-onset participants. In the individual domain, early-onset participants felt that their illness was “normal”; they did not experience the “healthy person to patient” transition described by older onset participants. In the relational domain, early-onset participants expressed that their relationships had already integrated their illness while late-onset participants felt that their illness harmed many of their relationships. In the societal domain, early-onset participants described dignity concerns related to how society impacted their ability to financially support themselves during their illness. Discussion Differences in the dignity experience of early-onset and late-onset participants are informed by Erikson’s “Model of Development” and by Aranda and Jones feminist critique of dignity in healthcare. Conclusions Persons with early-onset illness experience dignity differently. Awareness of the importance of work and financial independence to the experience of dignity for seriously ill patients may enhance persons’ dignity experience. (shrink)

Previous studies have suggested that musical training in childhood is beneficial for sociability. However, it remains unclear how age of onset of group music lessons is associated with the late sociability of children from a long-term perspective. This study investigated associations between group music lessons conducted at a music school and children’s levels of sociability by focusing on the age of onset of the lessons. We conducted a survey of 276 children aged 4–5 years (M = 58.5 months) (...) and 6–7 years (M = 82.7 months) who commenced music lessons at ages 1, 2, 4, and 6 years. We found that (1) the empathy scores of children aged 6–7 years who began lessons when 1-year-old were greater than those who began lessons when 4-years-old, (2) the communication scores of children aged 4–5 years who began lessons when 1-year-old were greater than those who began lessons when older than 1 year, and (3) the empathy and extraversion scores were high in those aged 6–7 years who began lessons in that age range. The results suggest that early onset of music lessons could positively influence children’s sociability; in contrast, after about age 7 years, children who already had high sociability may be more inclined to select group music lessons. By focusing on the impact of regular group music lessons from a very young age on later levels of sociability, these results further elucidate the effects of musical lessons. In sum, participation in group music lessons 2–4 times per month can be effective social training for very young children and foster their later sociability. (shrink)

Many thinkers believe that the next transformational change in human organisation will be the onset of human-level artificial intelligence, and that the most likely method of achieving this will come through brain emulations or "ems": the ability to scan human brains and program their connections into ever faster computers. Taking this as his starting point, Hanson describes what a world dominated by these ems will be like.

To define the determinants of impaired facial emotion recognition (FER) in patients with mesial temporal lobe epilepsy associated with hippocampal sclerosis (MTLE-HS), we examined 76 patients with unilateral MTLE-HS, 36 prior to antero-mesial temporal lobectomy (AMTL) and 40 after AMTL, and 28 healthy control subjects with a FER test consisting of 60 items (20 each for anger, fear, and happiness). Mean percentages of the accurate responses were calculated for different subgroups: right vs. left MTLE-HS, early (age at onset <6 (...) years) vs. late-onset, and before vs. after AMTL. After controlling for years of education, duration of epilepsy and number of antiepileptic drugs (AEDs) taken, on multivariate analysis, fear recognition was profoundly impaired in early-onset right MTLE-HS patients compared to other MTLE patients and control subjects. Happiness recognition was significantly better in post-AMTL MTLE-HS patients compared to pre-AMTL patients while anger and fear recognition did not differ. We conclude that patients with right MTLE-HS with age at seizure onset <6 years are maximally predisposed to impaired fear recognition. In them, right AMTL does not further worsen FER abilities. Longitudinal studies comparing FER in the same patients before and after AMTL will be required to refine and confirm our cross-sectional observations. (shrink)

The current pandemic period has triggered a series of changes in society, at both individual and collective behavioral levels. These changes were perceived as either positive or negative by the impacted bodies, leading to both social change and positive interactions in a tense context. In this paper, the authors will deal with Pandemica Panotpica, subjugation infiltrating all levels of society, and the approach adopted by several countries in trying to find countermeasures to combat the virus' proliferation. Our research scope began (...) at the onset of the pandemic and ended on early January 2021. (shrink)

The clinical relevance of whole-exome sequencing is unquestionable. In the prenatal setting, the standard testing process of reflexing from karyotype to microarray to single-gene disorders may take several weeks, leaving a family in prolonged turmoil and often without answers in time to make a decision about the pregnancy. WES provides a powerful amount of data more quickly and with a higher yield of diagnostic results, allowing a timelier plan for medical management and decision-making. However, while results that pertain specifically to (...) the testing indication can be isolated, the potential for incidental findings or results that are unrelated to the original testing indication is significant. In 2013, ACMG published recommendations for reporting incidental or secondary findings, providing a list of 57 clinically actionable genes for which reporting should be obligatory. These recommendations were updated in 2015 to include the option to opt out of receiving all secondary findings. The list includes childhood-onset conditions, for which medical management would be immediately impacted. However, the list also includes adult-onset conditions such as hereditary breast and ovarian cancer and Lynch syndrome. Historically, decisions regarding genetic testing for these conditions have been left up to the individual until they reach the age of consent. While the 2015 recommendations are an improvement over the 2013 recommendations insofar as they allow an option to opt out of receiving secondary findings, the recommendations continue to have potentially troubling ethical consequences. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Medicine-Based Values?Åge Wifstad (bio)KeywordsEthics committees, judgment, common moralityToulmin's DiagnosisIn his classical article with the unforgettable title "How medicine saved the life of ethics" (Toulmin 1982), Stephen Toulmin claims that medicine saved ethics by giving the philosophers a positive reality check through medical challenges: (1) Ethics in medicine is a serious topic, not just something to discuss at seminars. If, for example, both A and B need treatment and there (...) are only enough resources for one, the fundamental interests of these two people compete against each other. (2) In clinical medicine, the individual case might demand a different approach than that suggested by theory. Similarly, an ethicist who is confronted by a diversity of medical cases becomes aware of the fact that solutions drawn from ethical theory can be irrelevant in practice. (3) The moral philosopher has often focused on the individual and his or her universal commitments. The fact that ethical dilemmas can have deep roots in practical challenges and must be understood within a certain context has been "forgotten." (4) In clinically relevant ethics, it is important to find solutions that all involved parties find reasonable. This revitalizes central Aristotelian schools of thought on, for example, ethical judgment and situational understanding.Today, there is a common understanding that in both the education of doctors and in the implementation of medical knowledge and technology there needs to be ethical guidelines and control. Toulmin wants us to see that the background for this agreement is multifaceted. It was not just the ethicists who saved the doctors. The doctors helped the ethicists to escape their academic isolation.Ethics CommitteesThe establishment of ethics committees is perhaps the most interesting example of this. Here it is especially clear how ethical judgment establishes a basis for decision making: Each case presented to an ethics committee is special because one cannot reference decisions made in similar cases. At the same time, we are expected to handle similar cases equally. Consideration of the concrete, individual case must be balanced with the principle of similar treatment. Second, as a committee member, one must interpret and respect ethical principles that cannot be easily defined. Every principle must be interpreted and implemented within a specific and concrete context. Third, one must consider the law, but seen isolated, the implications of relevant rules can be difficult to determine. Fourth, the status of principles and rules are open for interpretation. The most important example of this is the Declaration of Helsinki, which was established through cooperation between the worlds' doctors unions. The strength and end result of such a document can be discussed. Fifth, multiple but partly conflicting juridical and ethical considerations can be [End Page 179] relevant at the same time. An example: Decisions about confidentiality can prevent data gathering that is crucial in ensuring that a research project is scientifically acceptable. Two important ethical considerations are then put up against one another. As a sixth and final point, it can be mentioned that the ethics committee is expected to make a qualitative, scientific judgment. But what kind of quality judgment and how detailed it should be is up for discussion.Two Definitions of Ethical JudgmentThe fact that the committee must base their holistic decision on ethical judgment means that the committee, in an important sense of the word, stands freely: It can be difficult to refer to specific ethical rules or laws when making an external review of the committee's decision. Unless the committee has clearly not followed known principles and rules, then the committee is able to confront criticism by replying that the decision is based on holistic considerations, where many views have been taken into account. In this way, the usage of ethical judgment makes sure that the committee has freedom to act. The catch here is that the committee's responsibility becomes even more obvious. One cannot simply say that the decision is made based on rules and principles formulated by others, such as the state. The committee must, as a unit, be able to defend their decision.The complexity of the work of the committee can, however, make it more tempting to think about ethics in... (shrink)

A certain kind of externalism—"the view from nowhere"—lies at the heart of evidence-based medicine (EBM). As a consequence, the individual case glides out of focus. However, to judge to what extent external knowledge is applicable to an individual case, the clinician has to rely on some sort of knowledge of the case at hand. The article focuses on the tension between the externalism of EBM and the "internal evidence" one has to presuppose when making clinical judgments.

Combining information from two or possibly several blocks of data is gaining increased attention and importance in several areas of science and industry. Typical examples can be found in chemistry, spectroscopy, metabolomics, genomics, systems biology and sensory science. Many methods and procedures have been proposed and used in practice. The area goes under different names: data integration, data fusion, multiblock analyses, multiset analyses and a few more. This book is an attempt to give an up-to-date treatment of the most used (...) and important methods within an important branch of the area; namely methods based on so-called components or latent variables. These methods have already obtained an enormous attention in for instance chemometrics, bioinformatics, machine learning and sensometrics and have proved to be important both for prediction and interpretation. The book is primarily a description of methodologies, but most of the methods will be illustrated by examples from the above-mentioned areas. The book is written such that both users of the methods as well as method developers will hopefully find sections of interest. In the end of the book there is a description of a software package developed particularly for the book. This package is freely available in R and covers many of the methods discussed. To distinguish the different type of methods from each other, the book is divided into five parts. Part I is introduction and preliminary concepts. Part II is the core of the book containing the main unsupervised and supervised methods. Part III deals with more complex structures and, finally, Part IV discusses alternative unsupervised and supervised methods. The book ends with Part V discussing the available software. Our recommendation for reading the book are as follows. A minimum read of the book would involve chapters 1, 2, 3, 5 and 7. Chapters 4, 6 and 8 are more specialized and chapters 9 and 10 contain methods we think are more advanced or less obvious to use. We feel privileged to have so many friendly colleagues who were willing to spend their time on helping us to improve the book by reading separate chapters. We would like to express our thanks to: Rasmus Bro, Margriet Hendriks, Ulf Indahl, Henk Kiers, Ingrid MaÌ⁽ge, Federico Marini, AÌ⁽smund Rinnan, Rosaria Romano, Lars Erik Solberg, Marieke Timmerman, Oliver Tomic, Johan Westerhuis and Barry Wise. Of course, the correctness of the final text is fully our responsibility! (shrink)

Word in noise identification is facilitated by acoustic differences between target and competing sounds and temporal separation between the onset of the masker and that of the target. Younger and older adults are able to take advantage of onset delay when the masker is dissimilar to the target word, but only younger adults are able to do so when the masker is similar. We examined the neural underpinning of this age difference using cortical evoked responses to words masked (...) by either Babble or Noise when the masker preceded the target word by 100 or 600 ms in younger and older adults, after adjusting the signal-to-noise ratios to equate behavioural performance across age groups and conditions. For the 100 ms onset delay, the word in noise elicited an acoustic change complex response that was comparable in younger and older adults. For the 600 ms onset delay, the ACC was modulated by both masker type and age. In older adults, the ACC to a word in babble was not affected by the increase in onset delay whereas younger adults showed a benefit from longer delays. Hence, the age difference in sensitivity to temporal delay is indexed by early activity in the auditory cortex. These results are consistent with the hypothesis that an increase in onset delay improves stream segregation in younger adults in both noise and babble, but only in noise for older adults and that this change in stream segregation is evident in early cortical processes. (shrink)

Objectives: This study explored a multidimensional model of the relationships between social media use, gender, peer bullying victimization experiences, and the onset of anxiety symptoms among children. We hypothesized that greater experience of bullying would be associated with greater onset of anxiety. We also expected that gender and social media use would be linked with anxiety among elementary school children. To test this hypothesis, a structural equation modeling approach was used.Methods: A total of 456 elementary children aged 11–13 (...) years from nine schools were recruited for this research. We used two psychological measures: The Screen for Child Anxiety Related Emotional Disorders and the Personal Experience Checklist as well as a sociodemographic questionnaire.Results: The social media usage survey found that all participants used social media. Instagram and YouTube were the platforms most used by the participants. The Structural Equation Model results suggest that bullying victimization and gender predicted the onset of anxiety in elementary school children. The model explained 32.1% of the variance of the outcome with very adequate fit indicators based on most indices, χ2 = 173.56, df = 52, p < 0.001; CFI = 0.92; TLI = 0.94; RMSEA = 0.07. Instagram use was correlated positively with generalized anxiety disorder. Gender was negatively correlated with Instagram use and positively correlated with YouTube use. Girls were found to use Instagram more and boys were found to use YouTube more. It was also found that girls had higher scores onSCARED dimensions, except for school avoidance. Girls were more prone to onset of anxiety than boys, except for school avoidance, which was not related to gender. Boys were found to experience significantly more physical bullying than girls. On the other hand, girls were found to experience more panic disorder, generalized anxiety disorder, separation anxiety disorder, and social anxiety than boys.Conclusion: This study found that bullying victimization significantly influences the onset of anxiety in children. Particular attention should be paid to cyberbullying in this context. This study also found a link between gender and anxiety—girls had a greater tendency to experience the onset of various types of anxiety, including panic disorder, generalized anxiety disorder, separation anxiety disorder, and social anxiety. Gender was also correlated with the form of bullying victimization. The findings of this study suggest that boys were more likely to experience physical bullying than girls. Interestingly, we found that Instagram use was significantly correlated with developing separation anxiety. In particular, children demonstrated school avoidance when experiencing cyberbullying. Limitations and future directions are discussed. (shrink)

The assumption that the onset of puberty is a context-sensitive marker of a reproductive strategy is tested by comparing parental and filial childhood context and somatic development in West and East Germany. Sixty-eight mother-daughter dyads and 35 father-son dyads were taken from two samples of families from Osnabrück in West Germany and Halle in East Germany. According to the observed context discontinuity between the generations in the male dyads, linear regression models show that no indicator of male sexual maturation (...) was influenced significantly by the somatic development of the father. Instead of an inherited timing of maturation, antecedent distal factors like socioeconomic childhood context variables and critical life events lead to an acceleration of male sexual maturation. Finally we test the effect of two different conditions of childhood context continuity on daughter’s age at menarche with maternal age at menarche controlled. Linear regression models show that mother’s age at menarche predicts daughter’s age at menarche only under the condition of contextual continuity between generations, which was the case in the West German sample only. In East Germany, where mother’s age at menarche had no significant effect, the amount of variance explained by childhood context variables was almost the same. These results indicate the context sensitivity of somatic development which seems to follow an evolutionary rationale. (shrink)

Background: The vascular depression hypothesis emphasizes the significance of vascular lesions in late-life depression. At present, no meta-analytic model has investigated whether a difference in hyperintensity burden compared to controls between late-life and late-onset depression is evident. By including a substantial number of studies, focusing on a meaningful outcome measure, and considering several moderating and control variables, the present meta-analysis investigates the severity of hyperintensity burden in major depressive disorder (MDD) and bipolar disorder (BD). A major focus of the (...) present meta-analysis refers to the role of age at illness onset. It is analyzed whether late-onset rather than late-life depression characterizes vascular depression. Method: In total, 68 studies were included in the meta-analysis and a multilevel random effects model was calculated using Hedges’ g as the effect size measure. Results: The severity of hyperintensity burden was significantly greater in the patient group compared to the control group. This effect was evident regarding the whole patient group (g = 0.229) as well as both depression subgroups, with a significantly greater effect in BD (g = 0.374) compared to MDD (g = 0.189). Hyperintensity burden was more pronounced in late-onset depression than in early-onset depression or late-life depression. A considerable heterogeneity between the included studies was observed, which is reflected by the large variability in effects sizes. Conclusion: In conclusion, the present meta-analysis underscores the association of hyperintensities with MDD and BD. Especially late-onset depression is associated with an increased hyperintensity burden, which is in line with the vascular depression hypothesis. The results suggest that it might be more feasible to confine the concept of vascular depression specifically to late-onset depression as opposed to late-life depression. Further research is needed to understand the causal mechanisms that might underlie the relation between hyperintensity burden and depression. (shrink)

This article examines the current state of end-of-life care in internal medicine wards in Israel, through an analysis of medical practice and the existing legal framework. The authors demonstrate the processes that lead chronically ill, elderly patients to perceive death as an unexpected phenomenon that is to be avoided at all costs. This perception stems, among other things, from the lack of public debate on questions relating to the end of life and the dominant cultural expectation that physicians provide curative (...) interventions. This results in a dearth of palliative care for the elderly along with a growing number of medical interventions that are of questionable value. The authors propose an alternative approach that highlights individual well-being and that demonstrates the potential areas of intervention by which death can be transformed into an expected and acceptable occurrence for the old and infirm. This approach allows patients to avoid unnecessary interventions and to reduce the burden of responsibility on family members and physicians, who are currently being called on to make end-of-life choices under exigent circumstances. We present these dilemmas by focusing on typical cases of incompetent elderly patients when there is no clear documentation of their wishes regarding treatment, and when their families do not have a coherent perception of what they may have wanted or of the care that would be most appropriate for them. We conclude with a call to action that highlights the need for greater awareness—through public discourse and private discussions—of end-of-life medical choices before the onset of ill-health and incompetence. (shrink)

One of the characteristics of all somatic cells is a finite life span. Cells may proliferate until they reach a point after which, although they are metabolically active, they can no longer produce daughter cells. This observation is central to the clonal exhaustion hypothesis, a mechanism cited to explain age-associated immune dysfunction. In this hypothesis, repeated division of lymphocytes leads to a replicative limit, after which they enter the senescent phase but are not lost from the pool of T cells. (...) Advancing age would then be associated with an increase in the number of T cells that are unable to proliferate to a stimulus which induces a proliferative response in T cells from younger individuals. This hypothesis seems both logical and reasonable and is supported by data from both humans and mice with the demonstration of an age-related accumulation of senescent T cells in both species. However, there is an apparent paradox. The paradox arises because the onset of immunosenescence appears to be more closely linked to the life span of the animal rather than the life span of the lymphocyte. BioEssays 21:519–524, 1999. © 1999 John Wiley & Sons, Inc. (shrink)

Change can be difficult to achieve, and system inertia may be considered relevant. There is a tendency for dynamic systems to enter into specific states characterized by stabilizing factors. The present work attempts to define inertia processes and explores these with regard to pro-environmental behaviour and decision-making. Inertia processes can be considered both within an organizational context and from the level of the individual, and may involve a number of psychological processes and aspects of the decision-making process. A few suggestions (...) for research are also presented. (shrink)

Age‐related and cancer‐related epigenomic modifications have been associated with enhanced cell‐to‐cell gene expression variability that characterizes increased cellular stochasticity. Since gene expression variability appears to be highly reduced by—and epigenetic and phenotypic stability acquired through—direct or long‐range cellular interactions during cell differentiation, we propose a common origin for aging and cancer in the failure to control cellular stochasticity by cell–cell interactions. Tissue‐disruption‐induced cellular stochasticity associated with epigenetic drift would be at the origin of organ dysfunction because of an increase in (...) phenotypic variation among cells, ultimately leading to cell death and organ failure through a loss of coordination in cellular functions, and eventually to cancerization. We propose mechanistic research perspectives to corroborate this hypothesis and explore its evolutionary consequences, highlighting a positive correlation between the median age of mass loss onset (a proxy for the onset of organ aging) and the median age at cancer diagnosis. (shrink)

Next SectionThe principle of respect for autonomy has shaped much of the bioethics' discourse over the last 50 years, and is now most commonly used in the meaning of respecting autonomous choice. This is probably related to the influential concept of informed consent, which originated in research ethics and was soon also applied to the field of clinical medicine. But while available choices in medical research are well defined, this is rarely the case in healthcare. Consideration of ordinary medical practice (...) reveals that the focus on patient choice does not properly grasp the moral aspects involved in healthcare. Medical decisions are often portrayed as if doctors and patients in confidence confront specific decisions about examinations or treatment, yet the reality often involves many different participants, with decisions being made over time and space. Indeed, most of the decisions are never even presented to patients, as it would be unethical to suggest something that is not medically justifiable. The options patients do confront are somewhat arbitrarily constructed within the narrow framework of both what is deemed to be medically appropriate and how the healthcare system is organised practically. While the autonomy discourse has proven valuable, a failure to distinguish between the fields of medical research and clinical medicine has generated a focus on patient choice that does not reflect what is really at stake in healthcare settings. This is alarming, because the current discourse misrepresents medical practice in a way that actually contributes to bioethical self-delusion. (shrink)

The main aim of this study is to test the validity of the Motivation, Engagement, and Thriving in User Experience model in higher education. We propose a process model in which we investigate how the need-satisfaction of digital learning tools within the interface sphere and task sphere accounts for engagement, learning, and well-being. A total of 426 higher education students drawn from two subsamples participated in this cross-sectional study. A structural equation model shows that interface autonomy and competence satisfaction positively (...) predict task autonomy and competence. Task competence, in turn, negatively predicts focused attention and positively predicts perceived usability and well-being. Task autonomy positively predicts perceived usability and reward. Based on our results, we provide some initial support for the METUX model in higher education. However, more validation work is needed to improve the scale that measures need-satisfaction in the interface and task spheres. Moreover, we find no support for the effect of task sphere on learning. Further investigations are needed into how METUX can be used in domain- and situation-specific contexts to account for increases in engagement, learning, and well-being. Finally, future studies need to include all aspects of the METUX model in order to fully test its validity. (shrink)

Over the past 25 years, no religious institution in America has done more to explore the link between the environment and spirituality than the Cathedral of St. John the Divine. Now, for the first time, a selection of the finest of the Cathedral's ecological sermons appears in a single volume.

Early-Onset Schizophrenia (EOS) and Attention Deficit-Hyperactivity Disorder (ADHD) are early- onset neurodevelopmental disorders associated with cognitive deficits. The current study represents the first attempt to compare these groups on a comprehensive cognitive test battery in a longitudinal design over 25 years in order to enhance our knowledge of particular patterns resulting from the interaction between normal maturational processes and different illness processes of these disorders. In the baseline study, 19 adolescents with schizophrenia were compared to 20 adolescents with (...) ADHD and 30 healthy controls (HC), all between 12 and 18 years of age. After 13 years (T2) and after 25 years (T3) they were re-evaluated with the cognitive test battery. A cognitive Composite Score was used in a linear mixed model. The EOS group had a significant cognitive stagnation or deterioration from T1 to T2 compared to HC. However, the EOS group had the most positive change from T2 to T3, supporting a stable level of cognitive performance over the 25 year span. The ADHD group improved or had similar development as the HC group from T1 to T2. They continued to improve significantly compared to the HC group from T2 to T3. Individuals in the EOS group performed more impaired on the cognitive composite score compared to the HC group and the ADHD group at all three time points. Results might indicate a neurodevelopmental pathway of EOS with subnormal cognitive development specific in adolescence. In comparison, the ADHD group had a more consistent cognitive maturation supporting a maturational delay hypothesis of ADHD. (shrink)

BackgroundBurnout is a syndrome that results from stressors in the work environment that have not been successfully managed. The prevalence of burnout among schoolteachers was always controversial. COVID-19 pandemic added more stressors to teachers since they had to change their working styles in response to the pandemic lockdowns or curfews. In Saudi Arabia, the prevalence and determinants of burnout among school teachers were not measured by any other group during the COVID-19 pandemic stressors.MethodsA cross-sectional survey was conducted among 879 teachers (...) in the Jazan region, Saudi Arabia, using the Maslach Burnout Inventory, during April 2021. Multistage cluster random sampling was used.ResultsThe mean age of the participants was 41.4 years. Male teachers represented 52.6% of the participants while females represented 47.4%. Most teachers showed burnout symptoms. Consequences of burnout were observed, such as using psychotropic medications, absenteeism, lack of job satisfaction, and changing schools. Using the MBI scale, most teachers showed medium or high emotional exhaustion, low depersonalization, and low personal accomplishment.ConclusionMost teachers showed symptoms of burnout during the COVID-19 pandemic. Being an expert and ability to adapt to technology during the COVID-19 pandemic proved to effectively reduce burnout symptoms. Increasing incentives, early detection, and improving the work environment is recommended to diminish burnout consequences. (shrink)

This investigation examined age-related differences in auditory-visual integration as reflected on perceptual judgments of temporally misaligned AV English sentences spoken by native English and native Spanish talkers. In the detection task, it was expected that slowed auditory temporal processing of older participants, relative to younger participants, would be manifest as a shift in the range over which participants would judge asynchronous stimuli as synchronous. The older participants were also expected to exhibit greater declines in speech recognition for asynchronous AV stimuli (...) than younger participants. Talker accent was hypothesized to influence listener performance, with older listeners exhibiting a greater narrowing of the AV simultaneity window and much poorer recognition of asynchronous AV foreign-accented speech compared to younger listeners. Participant groups included younger and older participants with normal hearing and older participants with hearing loss. Stimuli were video recordings of sentences produced by native English and native Spanish talkers. The video recordings were altered in 50 ms steps by delaying either the audio or video onset. Participants performed a detection task in which they judged whether the sentences were synchronous or asynchronous, and performed a recognition task for multiple synchronous and asynchronous conditions. Both the detection and recognition tasks were conducted at the individualized signal-to-noise ratio corresponding to approximately 70% correct speech recognition performance for synchronous AV sentences. Older listeners with and without hearing loss generally showed wider AV simultaneity windows than younger listeners, possibly reflecting slowed auditory temporal processing in auditory lead conditions and reduced sensitivity to asynchrony in auditory lag conditions. However, older and younger listeners were affected similarly by misalignment of auditory and visual signal onsets on the speech recognition task. This suggests that older listeners are negatively impacted by temporal misalignments for speech recognition, even when they do not notice that the stimuli are asynchronous. Overall, the findings show that when listener performance is equated for simultaneous AV speech signals, age effects are apparent in detection judgments but not in recognition of asynchronous speech. (shrink)

As the median age of practicing physicians increases, ethical dilemmas due to age-related cognitive decline among clinicians will become ever more pressing. Compelling data show that despite acknowledgement of their duty to protect the public, physicians often fail to report themselves, their colleagues, or their physician-patients when cognitive decline appears to impact medical practice adversely. As such, efforts to educate physicians about ethical obligations and various tactful methodologies to report themselves or others seem ineffective. Illustrated by a case report of (...) age-related cognitive decline in a practicing physician, practical recommendations are made both to develop and validate cognitive screening in middle-aged physicians, presumably before the onset of age-related cognitive decline. (shrink)

This volume contains the first critical edition of the Scriptum super III-VIII libros Politicorum by Peter of Auvergne as well as a pragmatical edition of Books III-VIII of the medieval Latin translation of Aristotle's Politics. Intended as the continuation of Aquinas' unfinished commentary on the first three books of the Politics, the Scriptum became-together with Aquinas' commentary-the commentary on the Politics. From its appearance in the late thirteenth century to the end of the sixteenth century, the Scriptum represented the most (...) authoritative and influential interpretation of Books III-VIII of the Politics.The introduction to the volume provides both an overview of Peter's political thought and a case study of the production and dissemination of a university text. An examination of the manuscripts traces the preparation of the text from its first transcription and revision by a scribe close to the author-if not the author himself-to the preparation of the finished exemplar and its diffusion through the system of peciae. The introduction also explains how the text was adapted to fit the standards of humanistic Latin when it was first printed in the fifteenth century: its language was adjusted to humanistic standards, many formulations were reshaped, and passages were suppressed. These changes were subsequently preserved in all later editions of the text. Freed from this humanistic patina with which it has been transmitted since the early age of printing age, the Scriptum is now restored to its original version. (shrink)

Compared with the large number of studies on reading of children with hearing loss in alphabetic languages, there are only a very limited number of studies on reading of Chinese-speaking children with HL. It remains unclear how phonological, orthographic, and semantic skills contribute to reading fluency of Chinese school-age children with HL. The present study explored this issue by examining the performances of children with HL on reading fluency and three linguistic skills compared with matched controls with normal hearing. Specifically, (...) twenty-eight children with HL and 28 chronological-age-matched children with NH were tested on word/sentence reading fluency, phonological awareness which was composed of onset/vowel/lexical tone awareness, orthographic knowledge, and semantic competence which comprised animal word identification, pseudo-homophone detection, and word segmentation. Results showed that children with HL lagged behind their peers with NH in WRF/SRF and most of the phonological, orthographic, and semantic subskills except onset awareness and pseudo-homophone detection. Furthermore, the significant contributors to WRF differed between the two groups with PA being the significant contributor in the children with NH while OK being the significant contributor in the children with HL. However, the significant contributor to SRF did not differ between the two groups with SC being the only significant contributor. These results revealed not only between-group differences but also similarities in the relative contributions of PA, OK, and SC to reading fluency at both word and sentence levels, which has practical implications for developing better training programs to improve reading for children with HL. (shrink)

The mobility restrictions related to COVID-19 pandemic have resulted in the biggest disruption to individual mobilities in modern times. The crisis is clearly spatial in nature, and examining the geographical aspect is important in understanding the broad implications of the pandemic. The avalanche of mobile Big Data makes it possible to study the spatial effects of the crisis with spatiotemporal detail at the national and global scales. However, the current crisis also highlights serious limitations in the readiness to take the (...) advantage of mobile Big Data for social good, both within and beyond the interests of health sector. We propose two strategical pathways for the future use of mobile Big Data for societal impact assessment, addressing access to both raw mobile Big Data as well as aggregated data products. Both pathways require careful considerations of privacy issues, harmonized and transparent methodologies, and attention to the representativeness, reliability and continuity of data. The goal is to be better prepared to use mobile Big Data in future crises. (shrink)

Humans have a flexible and accurate ability to coordinate their movement in time with external rhythms. However, it remains unclear when and how, during their development, human children acquire the ability to adjust tempo and control the timing of their movement toward others. A previous study suggested that such self-regulation of coordination develops at around 18 and 30 months after birth. In this study, we investigated the performance of 24-month-old children and compared their data with those of 18- and 30-month-olds (...) provided in our previous study. In the joint-drumming task, each child was enticed to drum under four conditions [partner: mother or robot; speed: 400 or 600 ms inter-stimulus-interval ]. The most pivotal test condition was the 600 ms ISI speed condition. We found that from the age of 24 months, children try to slow down their drumming tempo toward the 600 ms ISI speed condition, regardless of the drumming partner. On the other hand, significant timing control toward the onset of the 600 ms ISI condition was observed from the age of 30 months. This implies that both motor and cognitive mechanisms are required for flexible tempo adjustment and accurate synchronization and that these develop gradually among 18-, 24-, and 30-month-olds. (shrink)

While certain substantial moral dilemmas in health care have been given much attention, like abortion, euthanasia or gene testing, doctors rarely reflect on the moral implications of their daily clinical work. Yet, with its aim to help patients and relieve suffering, medicine is replete with moral decisions. In this qualitative study we analyse how doctors handle the moral aspects of everyday clinical practice. About one hundred consultations were observed, and interviews conducted with fifteen clinical doctors from different practices. It turned (...) out that the doctors’ approach to clinical cases followed a rather strict pattern across specialities, which implied transforming patients’ diverse concerns into specific medical questions through a process of ‘essentialising’: Doctors broke the patient’s story down, concretised the patient’s complaints and categorised the symptoms into a medical sense. Patients’ existential meanings were removed, and the focus placed on the patients’ functioning. By essentialising, doctors were able to handle a complex and ambiguous reality, and establish a medically relevant problem. However, the process involved a moral as well as a practical simplification. Overlooking existential meanings and focusing on purely functional aspects of patients was an integral part of clinical practice and not an individual flaw. The study thus questions the value of addressing doctors’ conscious moral evaluations. Yet doctors should be aware that their daily clinical work systematically emphasises beneficence at the expense of others—that might be more important to the patient. (shrink)

Critical cellular functions, including stem cell maintenance, fate determination, and cellular behavior, are governed by canonical Wnt signaling, an evolutionarily conserved pathway whose intracellular signal is transduced by β‐catentin. Emerging evidence suggests that canonical Wnt signaling influences cellular aging, indicating that increases in Wnt signaling delay age‐related deficits.1 However, recent Science papers suggest that Wnt signaling accelerates the onset of aging.2,3 In an attempt to resolve this paradox and clarify how Wnt signaling affects aging, we provide a selective review (...) of research relevant to Wnt signaling and aging. BioEssays 30:102–106, 2008. © 2008 Wiley Periodicals, Inc. (shrink)

There are indications that simple reaction time might have slowed in Western countries, based on both cohort- and multi-study comparisons. A possible limitation of the latter method in particular is measurement error stemming from methods variance, which results from the fact that instruments and experimental conditions change over time and between studies. We therefore set out to measure the simple auditory reaction time (SRT) of 7,081 individuals (2,997 males and 4,084 females) born in Sweden 1959-1985 (subjects were aged between 27 (...) and 54 years at time of measurement). Depending on cut-offs and adjustment for ageing related slowing on SRT, the data suggest that SRT has increased between 3 and 16 ms in the 27 birth years covered in the present sample. The slowing is unlikely to be explained by attrition, as evaluated by comparing the general intelligence × birth-year interactions and standard deviations for both male participants and dropouts, utilizing military conscript cognitive ability data. The present result is consistent with previous studies employing alternative methods, and may result from several synergistic factors, such as possible recent micro-evolutionary trends favouring lower g in Sweden and the effects of industrially produced neurotoxic substances on peripheral nerve conduction velocity. (shrink)

SummaryEarly onset of menarche has been shown to be associated with breast cancer and ischaemic heart disease. Studies on age at menarche of the Malaysian population are poorly documented. This study aimed to determine the influence of anthropometric and socio-demographic factors on the age at menarche of university students in Malaysia. Data were obtained in 2010–11 from 961 students between the ages of 18 and 25 years from the University of Malaya using stratified sampling, and multiple regression analysis was (...) applied. Sixty-three per cent of students reached menarche at the age of 12 or 13 years, with the mean and median of age at menarche being 12.45±1.17 and 12.01 years, respectively. Menarcheal age was positively associated with height and negatively associated with BMI. Students from urban areas attained menarche earlier than those from rural areas. Students from small-sized families attained menarche earlier than those from larger families. First-born students experienced menarche earlier than those who were seventh-born or later. Obese and overweight students reached menarche earlier than students who were underweight or of normal weight. The variations in age at menarche among the Malaysian ethnic groups were statistically insignificant. The results suggest that heavier and first-born students from small families are more likely to attain menarche earlier than their counterparts. (shrink)