The acquisition and evolution of speech production, discourse and communication can be negatively impacted by brain malformations. We describe, for the first time, a case of developmental dynamic dysphasia (DDD) in a right-handed adolescent boy (subject D) with cortical malformations involving language-eloquent regions (inferior frontal gyrus) in both the left and the right hemispheres. Language evaluation revealed a markedly reduced verbal output affecting phonemic and semantic fluency, phrase and sentence generation and verbal communication in everyday life. Auditory comprehension, repetition, naming, (...) reading and spelling were relatively preserved, but executive function was impaired. Multimodal neuroimaging showed a malformed cerebral cortex with atypical configuration and placement of white matter tracts bilaterally and abnormal callosal fibers. Dichotic listening showed right hemisphere dominance for language and functional magnetic resonance imaging (fMRI) additionally revealed dissociated hemispheric language representation with right frontal activation for phonology and bilateral dominance for semantic processing. Moreover, subject D also had congenital mirror movements (CMM), defined as involuntary movements of one side of the body that mirror intentional movements of the other side. Transcranial magnetic stimulation and fMRI during voluntary unimanual (left and right) hand movements showed bilateral motor cortex recruitment and tractography revealed a lack of decussation of bilateral corticospinal tracts. Genetic testing aimed to detect mutations that disrupt the development of commissural tracts correlating with CMM (e.g., Germline DCC mutations) was negative. Overall, our findings suggest that DDD in subject D resulted from the underdevelopment of the left inferior frontal gyrus with limited capacity for plastic reorganization by its homologous counterpart in the right hemisphere. Corpus callosum anomalies probably contributed to hinder interhemispheric connectivity necessary to compensate language and communication deficits after left frontal involvement. (shrink)

Any theory of information needs to comply with what we call the implementation, formalization, and representation constraints. These constraints are justified by basic considerations concerning scientific modelling and methodology. In the first part of this paper, we argue that the implementation and formalization constraints cannot be satisfied because the relation between Shannon information and IIT must be clarified. In the second part of the paper, we focus on the representation constraint. We argue that IIT cannot succeed in satisfying this constraint (...) for semantic contents without offering models for concepts, conceptual roles, and context sensitivity. In the final part of the paper, further complications are raised with respect to the distinction between consciousness and attention, which apply more specifically to the representation constraint. We conclude with some recommendations as to how IIT may succeed in solving these problems, highlighting the advantages and enormous potential of IIT as a scientific theory. (shrink)

The enormous destructive power of present stocks of nuclear weapons poses the greatest threat to public health in human history. Technical changes in weapons design are leading to an increased emphasis on the ability to fight a nuclear war, eroding the concept of deterrence based on mutually assured destruction and increasing the risk of nuclear war. Medical planning and civil defence preparations for nuclear war have recently been increased in several countries although there is little evidence that they will be (...) of significant value in the aftermath of a nuclear conflict. These developments have raised new ethical dilemmas for those in health professions. If there is any risk of use of weapons of mass destruction, then support for deterrence with these weapons as a policy for national or global security appears to be incompatible with basic principles of medical ethics and international law. The primary medical responsibility under such circumstances is to participate in attempts to prevent nuclear war. (shrink)

Residency training in the Netherlands is to be restructured over the coming years. To this end a general competence profile for medical specialists has been introduced. This profile is nearly the same as the Canadian CanMEDS 2000 model, which describes seven general areas of medical specialist competence, one of which is professionalism. In order to establish a training programme for residents and their instructors based on this competence, it is necessary to develop a vision that does justice to everyday medical (...) practice. The two most prevailing views of professionalism—as personal, or as a behavioural characteristic—fall short of this. Only when professionalism is understood as reflective professionalism does it encompass the fundamental contextuality of medical treatment. This means that the focus of training and assessment must be shifted to accountability for treatment. (shrink)

The removal of water from mines was one of the key issues that former miners had to deal with. Roman colonists brought new technology to the Iberian Peninsula that addressed this problem. However, they did not invent this technology because it had already been applied to the growth of other endeavours in the Hellenistic society throughout the Eastern Mediterranean. In the mine, the Archimedes screw, waterwheels, bucket pulleys, and Ctesibius pumps were the primary drainage systems. In this essay, the primary (...) characteristics, and modes of operation of machines are examined. Without leaving out the most significant finds made in the southwest of the Iberian Peninsula, one of the regions with the longest history of mining exploitation. To serve as a foundation for future research in this field, this work compares the primary mining mechanisms in ancient Huelva on a qualitative and quantitative level by the implementation of a TOPSIS methodology, a multi-criteria decision analysis method. (shrink)

The present paper draws on climate science and the philosophy of science in order to evaluate climate-model-based approaches to assessing climate projections. We analyze the difficulties that arise in such assessment and outline criteria of adequacy for approaches to it. In addition, we offer a critical overview of the approaches used in the IPCC working group one fourth report, including the confidence building, Bayesian and likelihood approaches. Finally, we consider approaches that do not feature in the IPCC reports, including three (...) approaches drawn from the philosophy of science. We find that all available approaches face substantial challenges, with IPCC approaches having as a primary source of difficulty their goal of providing probabilistic assessments. (shrink)

The widely accepted supposition that Newton’s De gravitatione was written in 1684/5 just before composing the Principia is examined. The basis for this determination has serious difficulties starting with the failure to examine the numerical estimates for the resistance of aether. The estimated range is not nearly nil as claimed but comparable with air at or near the earth’s surface. Moreover, the evidence provided most likely stems from experiments by Boyle, Hooke, and others in the 1660s and does not use (...) evidence available in the late 1684. The document supports Newton’s contention that the aether medium incorporates very large voids thereby proving that body and space differ but does by no means completely reject its corporeal nature or eliminate its resistance. Newton’s use of the term inertia provides no conclusive evidence for a late date as often claimed and his definition of gravitas is difficult to reconcile with a late one. (shrink)

For the past three decades there has been a substantial amount of scientific evidence supporting the view that attention is necessary and sufficient for perceptual representations to become conscious (i.e., for there to be something that it is like to experience a representational perceptual state). This view, however, has been recently questioned on the basis of some alleged counterevidence. In this paper we survey some of the most important recent findings. In doing so, we have two primary goals. The first (...) is descriptive: we provide a literature review for those seeking an understanding of the present debate. The second is editorial: we suggest that the evidence alleging dissociations between consciousness and attention is not decisive. Thus, this is an opinionated overview of the debate. By presenting our assessment, we hope to bring out both sides in the debate and to underscore that the issues here remain matters of intense controversy and ongoing investigation. (shrink)

Products of particlelike representations of the homogeneous Lorentz group are used to construct the degrees of spin angular momentum of a composite system of protons and neutrons. If a canonical labeling system is adopted for each state, a shell structure emerges. Furthermore the use of the Dirac ring ensures that the spin is characterized by half-angles in accord with the neutron-rotation experiment. It is possible to construct a Clebsch-Gordan decomposition to reduce a state of complex angular momentum into simpler states (...) which can be identified with α and β particles, multipole operators, etc. Finally, ground-state energy levels are calculated for all the even-even nuclei by using a differentiable manifold that is spin-graded and gauge-invariant by construction. It is shown that this manifold is Grassmann. (shrink)

The South African-Dutch research group responsible for this article started its activities in 2012 by looking at religious tolerance as a means of addressing the tendency for religious intolerance, extremism and fundamentalism. While tolerance seemed to be a promising way to counter religious intolerable behaviour, some shortcomings also became apparent. For example, the concept of tolerance includes an aspect of passivity towards others who adhere to another religion. The concept also does not appear to be able to respond to attitudes (...) and values such as respect, human rights and diversity. Accurate investigation of this problem, both conceptually and empirically, led to the understanding that hospitality is a concept that embodies more active adaptation to those who are different. Hospitality, therefore, seems to be a more promising concept than tolerance for reducing religious tension between individuals and groups. The inner contradiction discovered by Derrida in the notion of hospitality does not detract from the concept of being defined from a Biblical point of view. Hospitality can also be taught to young people. Although there are no formal provisions for hospitality in the national curricula, an analysis of the Dutch and South African national curricula shows that there is room for hospitality education. (shrink)

One of the main limitations of natural language‐based approaches to meaning is that they do not incorporate multimodal representations the way humans do. In this study, we evaluate how well different kinds of models account for people's representations of both concrete and abstract concepts. The models we compare include unimodal distributional linguistic models as well as multimodal models which combine linguistic with perceptual or affective information. There are two types of linguistic models: those based on text corpora and those derived (...) from word association data. We present two new studies and a reanalysis of a series of previous studies. The studies demonstrate that both visual and affective multimodal models better capture behavior that reflects human representations than unimodal linguistic models. The size of the multimodal advantage depends on the nature of semantic representations involved, and it is especially pronounced for basic‐level concepts that belong to the same superordinate category. Additional visual and affective features improve the accuracy of linguistic models based on text corpora more than those based on word associations; this suggests systematic qualitative differences between what information is encoded in natural language versus what information is reflected in word associations. Altogether, our work presents new evidence that multimodal information is important for capturing both abstract and concrete words and that fully representing word meaning requires more than purely linguistic information. Implications for both embodied and distributional views of semantic representation are discussed. (shrink)

While COVID-19 has generated a massive burden of illness worldwide, healthcare workers (HCWs) have been disproportionately exposed to SARS-CoV-2 coronavirus infection. During the so-called ‘first wave’, infection rates among this population group have ranged between 10% and 20%, raising as high as one in every four COVID-19 patients in Spain at the peak of the crisis. Now that many countries are already dealing with new waves of COVID-19 cases, a potential competition between HCW and non-HCW patients for scarce resources can (...) still be a likely clinical scenario. In this paper, we address the question of whether HCW who become ill with COVID-19 should be prioritised in diagnostic, treatment or resource allocation protocols. We will evaluate some of the proposed arguments both in favour and against the prioritisation of HCW and also consider which clinical circumstances might warrant prioritising HCW and why could it be ethically appropriate to do so. We conclude that prioritising HCW’s access to protective equipment, diagnostic tests or even prophylactic or therapeutic drug regimes and vaccines might be ethically defensible. However, prioritising HCWs to receive intensive care unit (ICU) beds or ventilators is a much more nuanced decision, in which arguments such as instrumental value or reciprocity might not be enough, and economic and systemic values will need to be considered. (shrink)

BackgroundClinical Ethics Support (CES) services are offered to support healthcare professionals in dealing with ethically difficult situations. Evaluation of CES is important to understand if it is indeed a supportive service in order to inform and improve future implementation of CES. Yet, methods to measure outcomes of CES are scarce. In 2014, the European Moral Case Deliberation Outcomes Instrument (Euro-MCD) was developed to measure outcomes of Moral Case Deliberation (MCD). To further validate the instrument, we tested it in field studies (...) and revised it. This paper presents the Euro-MCD 2.0 and describes the revision process.MethodsThe revision process comprised an iterative dialogue among the authors as Euro-MCD-project team, including empirical findings from six Euro-MCD field-studies and input from European experts in CES and theory. Empirical findings contained perceptions and experiences of MCD outcomes among healthcare professionals who participated in MCDs in various settings in Norway, Sweden and the Netherlands. Theoretical viewpoints on CES, literature on goals of CES and MCD and ethics theory guided the interpretation of the empirical findings and final selection of MCD outcomes.ResultsThe Euro-MCD 2.0 Instrument includes three domains: Moral Competence, Moral Teamwork and Moral Action. Moral Competence consists of items about moral sensitivity, analytical skills and virtuous attitude. Moral Teamwork includes open dialogue and supportive relationships and Moral Action refers to moral decision-making and responsible care. During the revision process, we made decisions about adding and reformulating items as well as decreasing the number from 26 to 15 items. We also altered the sentence structure of items to assess the current status of outcomes (e.g. ‘now’) instead of an assumed improvement over time (e.g. ‘better’) and we omitted the question about perceived importance.ConclusionsThe Euro-MCD 2.0 is shorter, less complex and more strongly substantiated by an integration of empirical findings, theoretical reflections and dialogues with participants and experts. Use of the Euro-MCD 2.0 will facilitate evaluation of MCD and can thereby monitor and foster implementation and quality of MCD. The Euro-MCD 2.0 will strengthen future research on evaluation of outcomes of MCD. (shrink)

Background In neonatal intensive care, a child's death is often preceded by a medical decision. Nurses, social workers and pastors, however, are often excluded from ethical case deliberation. If multiprofessional ethical case deliberations do take place, participants may not always know how to perform to the fullest. Setting A level-IIID neonatal intensive care unit of a paediatric teaching hospital in the Netherlands. Methods Structured multiprofessional medical ethical decision-making (MEDM) was implemented to help overcome problems experienced. Important features were: all professionals (...) who are directly involved with the patient contribute to MEDM; a five-step procedure is used: exploration, agreement on the ethical dilemma/investigation of solutions, analysis of solutions, decision-making, planning actions; meetings are chaired by an impartial ethicist. A 15-item questionnaire to survey staff perceptions on this intervention just before and 8 months after implementation was developed. Results Before and after response rates were 91/105 (87%) and 85/113 (75%). Factor analysis on the questionnaire suggested a four-factor structure: participants' role; structure of MEDM; content of ethical deliberation; and documentation of decisions/conclusions. Effect sizes were 1.67 (p<0.001), 0.69 (p<0.001) and 0.40 (p<0.01) for the first three factors respectively, but only 0.07 (p=0.65) for the fourth factor. Nurses' perceptions of improvement did not significantly exceed those of physicians. Conclusion Professionals involved in ethical case deliberation perceived that the process of decision-making had improved; they were more positive about the structure of meetings, their own role and, to some extent, the content of ethical deliberation. Documentation of decisions/conclusions requires further improvement. (shrink)

This book constitutes the thoroughly refereed post-conference proceedings of the 10th International Conference on Quantum Interaction, QI 2016, held in San Francisco, CA, USA, in July 2016. The 21 papers presented in this book were carefully reviewed and selected from 39 submissions. The papers address topics such as: Fundamentals; Quantum Cognition; Language and Applications; Contextuality and Foundations of Probability; and Quantum-Like Measurements.

The aim of this article is to take relational ethics concepts and apply them to the context of application to research ethics committees for approval to carry out research. The process of a multinational qualitative research application is described. The article suggests that a relational ethics approach can address two issues: how qualitative proposals are interpreted by research ethics committees and how this safeguards potentially vulnerable respondents. In relational terms, the governance of a research project may be enhanced by shared (...) ownership and willingness to engage in mutual dialogue. This challenges both researchers and research ethics committees to reframe their understanding of roles and functions in the assessment of research protocols, particularly those of a qualitative nature and those that address end-of-life issues. (shrink)

People’s beliefs about their ability to control their emotions predict a range of important psychological outcomes. It is not clear, however, whether these beliefs are playing a causal role, and if so, why this might be. In the current research, we tested whether avoidance-based emotion regulation explains the link between beliefs and psychological outcomes. In Study 1, a perceived lack of control over emotions predicted poorer psychological health outcomes, and avoidance strategies indirectly explained these links between emotion beliefs and psychological (...) health. In Study 2, we experimentally manipulated participants’ emotion beliefs by leading participants to believe that they struggled or did not struggle with controlling their emotions. Participants in the low regulatory self-efficacy condition reported increased intentions to engage in avoidance strategies over the next month and were more likely to avoid seeking psychological help. When asked if they would participate in follow-up studies, these participants were also more likely to display avoidance-based emotion regulation. These findings provide initial evidence for the causal role of emotion beliefs in avoidance-based emotion regulation, and document their impact on psychological health-related outcomes. (shrink)

Juan Huarte de San Juan (1529–88) was a physician of the Spanish Renaissance. He wrote the Examen de Ingenios para las Ciencias, translated as The Trial of Men’s Wits (1989[1575–94]), a book that has been acknowledged as a precursor of educational psychology, organizational psychology, behaviorism, neuropsychology and psychiatry. Huarte suggested that before beginning a course of study, students’ intellectual capabilities (i.e. ingenio) should be matched up with the professional studies that best suit their aptitudes. His book had a great impact (...) in Europe from the late 16th century to the mid-18th century. The influence of the Trial spread throughout many areas including philosophy, politics, linguistics and literature. Although there has been a growing interest in Huarte’s work in recent years, biographical studies have been rare; as a result, the information about Huarte’s life is currently incomplete, scattered and sometimes inaccurate. This study presents a systematic archival research on Spanish original sources. We present a reconstruction of Huarte’s life-story based on 32 original documents (1549–c.1650), some of them first discovered during the present survey. Documents are described according to the General International Standard of Archival Description, ISAD(G). The documents uncovered allow for a reappraisal of Huarte’s biography. (shrink)