The generation of isometric force at the hand can be mediated by activating a few motor modules. Stroke induces alterations in motor modules underlying steady-state isometric force generation in the human upper extremity. However, how the altered motor modules impact task performance remains unclear as stroke survivors develop and converge to the three-dimensional target force. Thus, we tested whether stroke-specific motor modules would be activated from the onset of force generation and also examined how alterations in motor modules would induce (...) changes in force representation. During 3D isometric force development, electromyographic signals were recorded from eight major elbow and shoulder muscles in the paretic arm of 10 chronic hemispheric stroke survivors and both arms of six age-matched control participants. A non-negative matrix factorization algorithm identified motor modules in four different time windows: three “exploratory” force ramping phases and the stable force match phase. Motor module similarity and between-force coupling were examined by calculating the scalar product and Pearson correlation across the phases. To investigate the association between the end-point force representation and the activation of the motor modules, principal component analysis and multivariate multiple linear regression analyses were applied. In addition, the force components regressed on the activation profiles of motor modules were utilized to model the feasible force direction. Both stroke and control groups developed exploratory isometric forces with a non-linear relationship between EMG and force. During the force matching, only the stroke group showed abnormal between-force coupling in medial-lateral and backward-forward and medial-lateral and downward-upward directions. In each group, the same motor modules, including the abnormal deltoid module in stroke survivors, were expressed from the beginning of force development instead of emerging during the force exploration. The PCA and the multivariate multiple linear regression analyses showed that alterations in motor modules were associated with abnormal between-force coupling and limited feasible force direction after stroke. Overall, these results suggest that alterations in intermuscular coordination contribute to the abnormal end-point force control under isometric conditions in the UE after stroke. (shrink)

Uterus transplantation is an emerging technology adding to the arsenal of treatments for infertility; specifically the only available treatment for uterine factor infertility. Ethical investigations concerning risks to uteri donors and transplant recipients have been discussed in the literature. However, missing from the discourse is the potential of uterus transplantation in other groups of genetically XY women who experience uterine factor infertility. There have been philosophical inquiries concerning uterus transplantation in genetically XY women, which includes transgender women and women with (...) complete androgen insufficiency syndrome. We discuss the potential medical steps necessary and associated risks for uterus transplantation in genetically XY women. Presently, the medical technology does not exist to make uterus transplantation a safe and effective option for genetically XY women, however this group should not be summarily excluded from participation in trials. Laboratory research is needed to better understand and reduce medical risk and widen the field to all women who face uterine factor infertility. (shrink)

This paper discusses diverse practices across religions from a universalistic view. Various religions define their beliefs and rituals within an ecological context. Whether it is an Abrahamic, African or humanistic religion, they all have one ritual ground to facilitate their beliefs on. This ground takes the form of environmental or earth-based practices. Religious initiations and the history of spiritual leaders have illustrated that human spirituality is connected to nature and Mother Earth. In addition, Islam views contemplation about natural wonders as (...) an essential pathway to approach God. Despite the variety of religious traditions held, ecology is what universalizes all religions. (shrink)

Europe's largest Muslim population of 4-5 million Muslim resides in France. On February 10, 2004 the French government approved an internationally controversial ban on headscarves, known as the hijab, worn by Muslim women attending public schools. Although the law banned all religious symbols, in this paper I focus on the ramification it has on the Muslim girls adhering to the hijab. The purpose of this paper is to discuss the legislation ban of the hijab in France. Several questions are explored (...) at various stages of the discussion including the following: Is wearing the hijab an expression of culture, religious obligation, or both? Does wearing the hijab jeopardize secularism, as French educational policy suggests? What are the alleged reasons, explicit and underlying, for the French legislation under scrutiny? What do French educators think of the law banning the hijab? Did the legislation take into account the decision's effect on young Muslim women in France, their self-esteem, their educational pursuits, and their identity formation? (shrink)

Reflecting on stressors from a detached perspective – a strategy known as distancing – can facilitate emotional recovery. Researchers have theorised that distancing works by enabling reappraisals of negative events, yet few studies have investigated specifically how distancing impacts stressor appraisals. In this experiment, we investigated how participants’ (N = 355) emotional experience and appraisals of an interpersonal conflict differed depending on whether they wrote event-reflections from a linguistically immersed (first-person) or distanced (second/third-person) perspective. Partly replicating previous findings, distanced reflection (...) predicted increases in positive affect, but not reductions in negative affect, relative to immersed reflection. Linguistic distancing also predicted increases in motivational congruence appraisals (i.e. perceived advantageousness of the event), but did not influence other appraisal dimensions. We discuss how linguistic distancing may facilitate emotional recovery by illuminating the benefits of stressful experiences, enabling people to “see the good in the bad”. (shrink)

A 16-year-old adolescent who identifies as transgender wishes to consider fertility preservation prior to the use of gender-affirming hormones. The adolescent’s parents are divorced, and one parent supports fertility preservation while the other does not. This case explores the minor’s future reproductive autonomy and parental decision making in a field where there is limited evidence of known harms and benefits to the use of fertility preservation in the transgender population and about future potential regret from lack of consideration of fertility (...) preservation during the prime window of opportunity. This case is created from a composite of cases seen at multiple institutions. (shrink)

There is paucity in the published literature that provides any ethical guidance guiding gift-giving within the student–patient relationship. This is perhaps because the dynamics of the medical student–patient relationship have not yet been explored as extensively as the doctor–patient relationship. More importantly, however, gift-giving in the doctor–patient relationship has traditionally been from the patient to the doctor and not vice versa. This article examines the literature published in this vicinity reflecting on an encounter with a patient.

In this article, I discuss Gadamer's hermeneutic account of understanding as an alternative to Kuhn's incommensurability thesis. After a brief account of Kuhn's aesthetic account and arguments against it, I argue that the linguistic account faces a paradox that results from Kuhn's objectivist account of understanding, and his lack of historical reflexivity. The statement 'Languages are incommensurable' is not a unique view of language, and is thus subject to contest by incommensurable readings. Resolving the paradox requires an account of incommensurability (...) that is self-referentially consistent, open-ended, and historically reflexive whereby we recognize that our very interest in incommensurability is historically conditioned. By meeting these conditions, Gadamer's account of historical understanding offers a middle ground between two extremes: on the one side is the claim that understanding involves becoming a native of an incommensurable language, and on the other side is the rejection of the prospect of understanding a contextually removed language altogether. Gadamer is discussed as a mediator between Kuhn's epistemic and historical projects, and thus paves the way for a new hermeneutics of science. The notions of traditional horizon, historically effected consciousness, the universality of interpretation, alienation, dialogical openness, and the fusion of horizons are also discussed. (shrink)

The present paper examines the concept of the meaning of life in the Soren Kierkegaard’s view. Kierkegaard sees the concept of "meaning" as "end" and believes in "biology" as the supreme biologist. Based on evidence from his works, he believes that the end is not to be discovered in biology, but it is creatable. There are three witnesses to this: first, the end is, in Kierkegaard''''''''s view, paradoxical, and paradox is not real, but mental. Secondly, Christianity, in his opinion, is (...) anxious, not religious, and religion is unreasonable, and in relation to the mind not connected with the outside, and third, that he does not consider God as an active being, but rather the existence of anxiety, The mind and mind of man. Kierkegaard''''''''s predictions in this evidence include ontological non-reality, individualism, and faith. An analysis of these three presumptions suggests that Kierkegaard believed in the supposition of meaning in life. (shrink)

In this article, we argue that although Bohr's version of the Copenhagen interpretation is in line with several key elements of logical positivism, pragmatism is the closest approximation to a classification of the Copenhagen interpretation, whether or not pragmatists directly influenced the key figures of the interpretation. Pragmatism already encompasses important elements of operationalism and logical positivism, especially the liberalized Carnapian reading of logical positivism. We suggest that some elements of the Copenhagen interpretation, which are in line with logical positivism, (...) are also supported by pragmatism. Some of these elements are empirical realism, fallibilism, holism, and instrumentalism. However, pragmatism goes beyond logical positivism in espousing some other key elements of the Copenhagen interpretation, though imperfectly, such as the correspondence principle, complementarity, and indeterminism. (shrink)

Social media affordances enable us to construct multi-faceted online identities and personal brands that we use to engage and interact with audiences—defined and ambiguous, intended and unintended. There is a need to examine such online identities and associated micro-celebrity practices by users who appeal to multiple audiences through the strategic use of online spaces. In this special issue, we explore performances of our digital selves and the role played by active and interactive audiences in meaning-making within complex socio-political contexts while (...) simultaneously attempting to understand varied positions of media refusal and enactments of digital media resistance. (shrink)

BackgroundClinical genomic professionals are increasingly facing decisions about returning incidental findings (IFs) from genetic research. Although previous studies have shown that research participants are interested in receiving IFs, yet there has been an argument about the extent of researcher obligation to return IFs. We aimed in this study to explore the perspectives of clinical genomics professionals toward returning incidental findings from genomic research.MethodsWe conducted a national survey of a sample (n = 113) of clinical genomic professionals using a convenient sampling. (...) A self-administered questionnaire was used to explore their attitudes toward disclosure of IFs, their perception of the duties to return IFs and identifying the barriers for disclosure of IFs. A descriptive analysis was employed to describe participants' responses.ResultsSixty-five (57.5%) respondents had faced IFs in their practice and 31 (27.4%) were not comfortable in discussing IFs with their research subjects. Less than one-third of the respondents reported the availability of guidelines governing IFs. The majority 84 (80%) and 69 (62.7%) of the study participants indicated they would return the IFs if the risk of disease threat ≥ 50% and 6–49%, respectively and 36 (31.9%) reported they have no obligation to return IFs.ConclusionClinical genomics professionals have positive attitudes and perceptions toward the returning IFs from genomic research, yet some revealed no duty to do so. Detailed guidelines must be established to provide insights into how genomics professionals should be handled IFs. (shrink)

This study analyzes the content of 12th-grade mathematics textbooks and workbooks, based on their inclusion of mathematical discourse components. The mathematics textbooks and workbooks were used in a Saudi Arabian school, where students are transitioning from secondary education to university. The results revealed that Saudi Arabian school textbooks and workbooks did not appropriately include discourse components or discourse skills to help facilitate mathematical learning among students. Furthermore, these textbooks did not exceed level two of the four levels of inclusion. As (...) a result, the inclusion was insufficient in helping students meaningfully understand mathematical concepts, become active students, and develop successful community leadership. This implies that mathematics textbooks and workbooks should be revised to include mathematical discourse so that this inclusion is more student directed than teacher directed. (shrink)

BackgroundPhysician burnout is a growing phenomenon in current health systems worldwide. With the emergence of COVID-19, burnout in healthcare is progressively becoming a serious concern. Increasing emotional exhaustion, depersonalization, and reduced personal accomplishment threaten the effective delivery of healthcare. Compassion fatigue and moral injury are a considerable risk to the doctor-patient relationship. These issues can potentially be mitigated by mindfulness practice, which has shown promising results in reducing burnout, restoring compassion, and preventing moral injury in physicians.MethodologyA scoping review was conducted (...) to investigate the effects of mindfulness practice on physician burnout. High-ranking journals were targeted to analyze high-quality studies and synthesize common themes in the literature. Studies conducted on current practicing physicians were included. Mindfulness practice of varying forms was the main intervention studied. Gray literature and studies conducted only on allied health personnel were excluded from this review.Results31 studies were included in this scoping review. Mindfulness practice decreased emotional exhaustion and depersonalization while improving mood, responses to stress, and vigor. Self-awareness, compassion, and empathy were also increased in study participants. From this review, four themes emerged: innovations in mindfulness practice, mindfulness and positive psychology, the impact of mindfulness on work and patient care, and barriers and facilitators to physician mindfulness practice.ConclusionMindfulness was widely reported to benefit mental health and well-being, but the studies reviewed seemed to adopt a mono focus and omitted key considerations to healthcare leadership, systems-level culture, and practices. Mindfulness practice is a quintessential component of positive psychology and is inherently linked to effective leadership. A mindful and compassionate physician leader will play a crucial role in addressing current practice gaps, prioritizing staff mental health, and providing a supportive platform for innovation. (shrink)

Motivated by the call for more research on students’ perceptions of their ethical development in business education programs, this study examines students’ reflections on how their understanding of ethics was challenged and/or changed, and what facilitated the development of ethical decision-making approaches in a first-year accounting course. The results indicate that students developed more sophisticated and contextualised views of ethical issues in business, government and social contexts including the need to consider their impact on various stakeholders. Students attributed this development (...) to the various elements in the integrated course design including the real cases sourced in current newspaper articles, an ethical decision-making framework with various ethical perspectives, the reflective journal component and the ability to work in groups. These findings have implications for the design of effective ethics education programs in business. (shrink)

BackgroundInstitutional review boards (IRBs) are formally designated to review, approve, and monitor biomedical research. They are responsible for ensuring that researchers comply with the ethical guidelines concerning human research participants. Given that IRBs might face different obstacles that cause delays in their processes or conflicts with investigators, this study aims to report the functions, roles, resources, and review process of IRBs in Saudi Arabia.MethodThis was a cross-sectional self-reported survey conducted from March 2021 to March 2022. The survey was sent to (...) 53 IRB chairpersons and the administration directors (or secretary) across the country through email after receiving verbal consent. The validated survey consisted of eight aspects: (a) organizational aspects, (b) membership and educational training, (c) submission arrangements and materials, (d) minutes, (e) review procedures, (f) communicating a decision, (g) continuing review, and (h) research ethics committee (REC) resources. A total of 200 points indicated optimal IRB functions.ResultsTwenty-six IRBs across Saudi Arabia responded to the survey. Overall, the IRBs in this study scored a total of 150/200 of the points on the self-assessment tool. Relatively newer IRBs (established less than ten years ago) conducted meetings at least once in a month, had annual funding, had more balanced gender representation, tended to score higher than older IRBs. The organizational aspect score was the lowest among all items in the survey (14.3 score difference, p-value < 0.01). The average turnaround time for expedited research from proposal submission to final decision was 7 days, while it was 20.5 days for the full committee review.ConclusionSaudi IRBs performed generally well. However, there is room for focused improvement with respect to extra resources and organizational issues that require closer evaluation and guidance from the regulatory bodies. (shrink)

This study examined the influence of sex and racial discrimination on academic alienation among Iranian university students. Two groups of 60 girls and 60 boys were sampled through multi-stage cluster sampling from among first-year Tabriz University students in Tabriz, Iran. All participants, between18 and 22, were asked to respond on an academic alienation questionnaire. The findings of a two-way ANOVA revealed that girls and Turkish speakers had higher levels of academic alienation compared to boys and Persian speakers. An investigation of (...) interactional effects indicated that Turkish girls demonstrated the highest levels of academic alienation, with no significant effects in the powerlessness dimension. Finally, the effects of the factors relevant to academic alienation were discussed. (shrink)

When the first r lower extreme order statistics of a sample of large size n, 1 < r < s < n, are observed, asymptotic predictive intervals of the future extreme order statistic with a rank s are constructed. The only assumption that we adopt is that the first failure time is attracted to the Weibull distribution. In addition, we suggest an efficient point estimator of its shape parameter and then a confidence interval is constructed for it. Moreover, new interesting (...) asymptotic properties of the distributions that belong to the minimum domain of attraction of the Weibull distribution are revealed. Furthermore, extensive simulation studies are conducted to demonstrate the efficiency of the proposed methods. Two real datasets are analyzed to illustrate and corroborate the obtained results. The main results concern large samples. (shrink)

When the first r lower extreme order statistics of a sample of large size n, 1 < r < s < n, are observed, asymptotic predictive intervals of the future extreme order statistic with a rank s are constructed. The only assumption that we adopt is that the first failure time is attracted to the Weibull distribution. In addition, we suggest an efficient point estimator of its shape parameter and then a confidence interval is constructed for it. Moreover, new interesting (...) asymptotic properties of the distributions that belong to the minimum domain of attraction of the Weibull distribution are revealed. Furthermore, extensive simulation studies are conducted to demonstrate the efficiency of the proposed methods. Two real datasets are analyzed to illustrate and corroborate the obtained results. The main results concern large samples. (shrink)

Medical paternalism has long been a common medical practice. However, patient autonomy in healthcare has been recently adopted by doctors and patients alike. This study explored whether doctors and patients in a tertiary care hospital in Saudi Arabia preferred autonomy or paternalism in shared decision‐making. A total of 118 participants (51 patients requiring total knee replacement, owing to stages 3–4 of osteoarthritis, and 67 doctors) from the Eastern province, Saudi Arabia. responded to a 17‐question category‐based questionnaire involving four scales of (...) autonomy. Descriptive statistics and chi‐square test results revealed that in this hospital, patients preferred a paternalistic approach toward their medical care along with a full disclosure of the risks related to surgical procedures. We recommend health education regarding the specific autonomy subscales (doctor knows best, patient should decide, right to non‐participation, and obligatory risk information), and the implementation of protocols that protect patients' rights and enhance personal autonomy. (shrink)

The experience of emotion is a fundamental part of human consciousness. Think, for example, of how different our conscious lives would be without such experiences as joy, anger, fear, disgust, pity, anxiety, and embarrassment. It is uncontroversial that these experiences typically have an intentional content. Anger, for example, is normally directed at someone or something. One may feel angry at one=s stock broker for provid- ing bad advice or angry with the cleaning lady for dropping the vase. But it is (...) not un- controversial that emotional experiences are always intentional. John Searle, for exam- ple, remarks, AMany conscious states are not Intentional, e.g., a sudden sense of elation...@. Moreover, many animals experience emotions and it is natural to sup- pose that such emotions lack the sophistication of beliefs or thoughts. When a dog ex- periences delight in seeing its master after an absence of several days, the suggestion that at least part of the dog=s experience of delight is a belief that its master has returned home seems to import into the experience something that at best is associ- ated with it and perhaps is not really a state to which the dog is subject at all. And even in the case of human beings, emotional experience often does not seem to involve thought. Consider the experience of disgust, to take one obvious example.1 Nor is a sali- ent belief required. One may have a strong fear of spiders and yet not believe that spi- ders typically pose any risk to humans. But if emotional experiences need not involve beliefs or thoughts, then just how are they intentional?2. (shrink)