This paper develops some modal metatheory for quantified modal logic. In such a theory, the logic of a first-order modal object-language is made sensitive to the modal facts, stated in the metalanguage. This is radically different from possible worlds semantics, which reduces questions of validity to questions of nonmodal set theory. We consider theories which characterize a notion of truth under a second-order interpretation, where an operator for metaphysical necessity is treated homophonically. The form they take is crucially influenced by (...) whether the Barcan formulas are part of the metalogic. The main result is that, with the Barcan formulas, formulating a modal metatheory is easy; principles of classical semantics transfer over smoothly with natural adaptations to the modal setting. Without the Barcan formulas, it seems to be much harder. Several options are considered, but each involves commitments plausibly in tension with the underlying philosophical motivations for rejecting them. (shrink)

_341_ _Objectives: _In patients with multivessel disease both the detection of the culprit lesion and the exact allocation are important preconditions for sufficient treatment and improved outcome. In a vessel based approach the combination of quantitative coronary angiography and fractional flow reserve measured by a pressure wire should be advantageous compared to myocardial SPECT, as morphological and functional information is delivered simultaneously. Therefore our aim was to evaluate MS in the detection and allocation of hemodynamically significant stenoses obtained by the (...) combined gold standard QCA plus FFR in patients with multivessel disease. _Methods: _FFR and QCA of 95 vessels in 80 patients have been evaluated. Hemodynamically significant target lesions were defined as intermediate stenoses between 50 and 75% with an FFR. (shrink)

This book proposes a new theory of the origins of human language ability and presents an original account of the early evolution of language. It explains why humans are the only language-using animals, challenges the assumption that language is a consequence of intelligence, and offers a new perspective on human uniqueness. The author draws on evidence from archaeology, linguistics, cognitive science, and evolutionary biology. Making no assumptions about the reader's prior knowledge he first provides an introductory but critical survey of (...) all sources of evidence for language evolution. He then considers what language itself reveals about its own and human origins and evolution. He shows that certain central aspects of language do not, unexpectedly, reflect what they are used for, are maladapted for their function. He considers why this should be, and argues that these odd aspects of language reveal important clues about its evolutionary origin. The Origins of Complex Language fulfils the promise of its title. In doing so it turns upside down conventional theories about the relation between cognition and expression, truth and reference, and the co-evolution of mind and body. Original in conception, brilliantly executed, stylishly written, this book will attract a wide range of readers interested in the evolution and origins of language. (shrink)

Peter Abelard (1079–1142 ce) was the most wide‐ranging philosopher of the twelfth century. He quickly established himself as a leading teacher of logic in and near Paris shortly after 1100. After his affair with Heloise, and his subsequent castration, Abelard became a monk, but he returned to teaching in the Paris schools until 1140, when his work was condemned by a Church Council at Sens. His logical writings were based around discussion of the “Old Logic”: Porphyry's Isagoge, aristotle'S Categories and (...) On Interpretation and boethius'S textbook on topical inference. They comprise a freestanding Dialectica (“Logic”; probably c.1116), a set of commentaries (known as the Logica [Ingredientibus], c. 1119) and a later (c. 1125) commentary on the Isagoge (Logica Nostrorum Petititoni Sociorum or Glossulae). In a work Abelard called his Theologia, issued in three main versions (between 1120 and c.1134), he attempted a logical analysis of trinitarian relations and explored the philosophical problems surrounding God's claims to omnipotence and omniscience. The Collationes (“Debates,” also known as “Dialogue between a Christian, a Philosopher and a Jew”; probably c.1130) present a rational investigation into the nature of the highest good, in which the Christian and the Philosopher (who seems to be modeled on a philosopher of pagan antiquity) are remarkably in agreement. The unfinished Scito teipsum (“Know thyself,” also known as the “Ethics”; c.1138) analyses moral action. (shrink)

Corballis's claim that the origin of syntax lies in solely gesture is contested. His scenario does not explain why constraints on syntactic “movement” are apparently part of the human biological endowment for language. It also does not pay enough attention to the internal structure of sentences, and how they contrast with other linguistic units such as noun phrases.

Grodzinsky associates Broca's area with three kinds of deficit, relating to articulation, comprehension (involving trace deletion), and production (involving “tree pruning”). Could these be special cases of one deficit? Evidence from research on language evolution suggests that they may all involve syllable structure or those aspects of syntax that evolved through exploiting the neural mechanisms underlying syllable structure.

Translating ethical theories into clinical practice presents a perennial challenge to educators. While many suggestions have been put forth to bridge the theory-practice gap, none have sufficiently remedied the problem. We believe the ascendance of hospital medicine, as a dominant new force in medical education and patient care, presents a unique opportunity that could redefine the way clinical ethics is taught. The field of hospital medicine in the United States is comprised of more than 50,000 hospitalists—specialists in inpatient medicine—representing the (...) fastest growing subspecialty in the history of medicine, and its members have emerged as a dominant new force around which medical education and patient care pivot. This evolution in medical education presents a unique opportunity for the clinical ethics community. Through their proximity to patients and trainees, hospitalists have the potential to teach medical ethics in real time on the wards, but most hospitalists have not received formal training in clinical ethics. We believe it is time to strengthen the ties between hospital medicine and medical ethics, and in this article we outline how clinical ethicists might collaborate with hospitalists to identify routine issues that do not rise to the level of an “ethics consult,” but nonetheless require an intellectual grounding in normative reasoning. We use a clinical vignette to explore how this approach might enhance and broaden the scope of medical education that occurs in the inpatient setting: A patient with an intra-abdominal abscess is admitted to the academic hospitalist teaching service for drainage of the fluid, hemodynamic support, and antimicrobial therapy. During the initial encounter with the hospitalist and his team of medical students and residents, the patient reports night sweats and asks if this symptom could be due to the abscess. How should the hospitalist approach this question? (shrink)

The goal of this study was to assess the relationships between computational approaches to analyzing constructed responses made during reading and individual differences in the foundational skills of reading in college readers. We also explored if these relationships were consistent across texts and samples collected at different institutions and texts. The study made use of archival data that involved college participants who produced typed constructed responses under thinking aloud instructions reading history and science texts. They also took assessments of vocabulary (...) knowledge and proficiency in comprehension. The protocols were analyzed to assess two different ways to determine their cohesion. One approach involved assessing how readers established connections with themselves. The other approach involved assessing connections between the constructed responses and the texts that were read. Additionally, the comparisons were made by assessing both lexical and semantic comparisons. The result showed that both approaches for analyzing cohesion and making the comparisons were correlated with vocabulary knowledge and comprehension proficiency. The implications of the results for theory and practice are discussed. (shrink)

At the beginning of Aeneid 12, a truce is agreed so that Aeneas and Turnus can fight each other in single combat. But this truce is violated through the instigation of Turnus’ sister Juturna, who in turn has been instigated by Juno. The Italian Tolumnius casts a spear that kills an Etruscan warrior. Aeneas pleads for calm and the maintenance of the truce, but he in turn is wounded by an arrow. Turnus, seeing the Trojans in disarray, rushes into battle, (...) and a general engagement ensues. So Turnus, even if he did not instigate the breach, does nothing to heal it, and for that reason alone is a criminal, who deserves his ultimate death at the hands of Aeneas. (shrink)

We describe the results of an experiment testing for the presence of strong altruism among Christians in New Zealand. The study examined anonymous participant generosity to cohort. We found that in modified dictator games, anonymous Christians in New Zealand gave significantly more to Canadian Christians than anonymous New Zealand citizens gave to their fellow citizens. The gifting opportunities occurred after anonymous benefactors observed recipients willingly undertake costly acts of group commitment. We found that mean gifting after witnessing a fellow group (...) member metaphorically "fall on a hand grenade" to punish a member of an out-group was almost four times greater in the Christian group than it was in the New Zealand control. Our data support the hypothesis that religious altruism exists and is especially strong among Christians in New Zealand. The data also weakly support a multi-level selection hypothesis for the evolution of religious altruism. (shrink)

In the so-called ‘Iliadic’Aeneid, Dido is scarcely mentioned. At first sight, Aeneas’ dalliance at Carthage is forgotten when he gets down to the serious business of establishing the Trojans in Italy. But the poem's last mention of Dido is enmeshed in a network of parallel passages elsewhere in theAeneidrelating to tunics and adoption. In the light of similarities between Aeneas and the superficially unimportant Trojan warrior Nisus, these passages bear crucially on the contrast between Aeneas’ public and privatepietas: his obedience (...) to imposed commitments and to chosen ones. In this way, Virgil provides guidance on what motivates Aeneas’ fury in Books 10 and 12. (shrink)

The frame/content theory suggests that chewing was tinkered into speaking. A simple extrapolation of this approach suggests that syllable structure may have been tinkered into syntax. That would explain the widely noted parallels between sentence structure and syllable structure, and also the otherwise mysterious pervasiveness of the grammatical distinction between sentences and noun phrases.

Clahsen shows that “combinatorial” inflection is processed differently from “irregular” inflection. However, combinatorially regular affixes need not coincide with “class-default” affixes, that is, affixes shared by more than one inflection class and all of whose rivals are peculiar to one class. This creates a tension that may help to explain the persistence of inflection class systems.

Hurford claims that empty variables antedated proper names in linguistic (not merely logical) predicate-argument structure, and this had an effect on visual perception. But his evidence, drawn from proper names and the supposed inability of nonhumans to recognise individual conspecifics, is weak. So visual perception seems less relevant to the evolution of grammar than Hurford thinks.

Matteo Ricci (1552-1610) was an Italian Jesuit and one of the first Christian missionaries to China in the modern era. He was a genuine polymath—a translator, cartographer, mathematician, astronomer, and musician. Above all, Ricci was a missionary for the gospel. As we briefly examine his 1603 seminal work, The True Meaning of the Lord of Heaven, our hope is that we, as evangelical educators, will perceive some of the deeper principles necessary for our own missionary work among unreached people.

A 47-year-old woman with a history of anxiety disorder is admitted to the hospital for shortness of breath. On the third day of hospitalization, she asks her physician for a copy of all documents pertaining to her care. What expectation should she have for full disclosure? Are there limits on her access to her medical records and do her physician's concerns about professional privilege matter?The virtues of transparency in medicine have been well described. As proponents of transparency, we favor patient (...) access to their medical records, but we are increasingly troubled by the ease and extent of disclosure in current practice as technology advances and... (shrink)

Yagisawa (2005) considers two old arguments against the existence requirement. Both arguments are significantly less appealing than Yagisawa suggests. In particular, the second argument, first given by Kaplan (1989: 498), simply assumes that existence is contingent (§1). Yagisawa’s ‘new’ argument shares this weakness. It also faces a dilemma. Yagisawa must either treat ‘at @’ as a sentential operator occupying the same grammatical position as ‘∼’ or as supplying an extra argument place. In the former case, Yagisawa’s argument faces precisely the (...) problems he concedes that Kaplan’s argument does (§2). In the latter case, though the argument does not face these problems, it renders the sense in which things exist contingently no threat to (E) properly understood (§3). (shrink)

Intelligent humanoid robots (IHRs) are becoming likely to be integrated into nursing practice. However, a proper integration of IHRs requires a detailed description and explanation of their essential capabilities, particularly regarding their competencies in replicating and portraying emotive functions such as empathy. Existing humanoid robots can exhibit rudimentary forms of empathy; as these machines slowly become commonplace in healthcare settings, they will be expected to express empathy as a natural function, rather than merely to portray artificial empathy as a replication (...) of human empathy. This article works with a twofold purpose: firstly, to consider the impact of artificial empathy in nursing and, secondly, to describe the influence of Affective Developmental Robotics (ADR) in anticipation of the empathic behaviour presented by artificial humanoid robots. The ADR has demonstrated that it can be one means by which humanoid nurse robots can achieve expressions of more relatable artificial empathy. This will be one of the vital models for intelligent humanoid robots currently in nurse robot development for the healthcare industry. A discussion of IHRs demonstrating artificial empathy is critical to nursing practice today, particularly in healthcare settings dense with technology. (shrink)

According to moral testimony pessimists, the testimony of moral experts does not provide non-experts with normative reasons for belief. Moral testimony optimists hold that it does. We first aim to show that moral testimony optimism is, to the extent such things may be shown, the more natural view about moral testimony. Speaking roughly, the supposed discontinuity between the norms of moral beliefs and the norms of non-moral beliefs, on careful reflection, lacks the intuitive advantage that it is sometimes supposed to (...) have. Our second aim is to highlight the difference in the nature of the pragmatic reasons for belief that support moral testimony optimism and moral testimony pessimism, setting out more clearly the nature and magnitude of the challenge for the pessimist. (shrink)

A thirty-year-old single mother with recurrent, metastatic, treatment-refractory cancer presents to the emergency room with severe difficulty breathing due to an obstructive tumor in her neck, compounded by progressive disease in her lungs and a new pulmonary embolism. She cannot be safely intubated and would require an emergent awake tracheotomy. Even if the airway can be successfully secured surgically, the likelihood that she will be able to be weaned from mechanical ventilation is very low. The surgeon, a young mother too, (...) appreciates the patient's desire for more time with her toddler. But the surgeon knows the significant risk of surgery, the massive responsibility she would accept in trying to get the patient through it, and the emotional toll of an intraoperative death on surgical staff. And she can imagine the second-guessing that will come during the inevitable morbidity and mortality conference if the patient should die in the perioperative window. Yet the surgeon does not want to take the “easy” way out; after all, critically ill patients undergo aggressive resuscitation all the time. What should she do? (shrink)

In this volume, Simona Goi and Frederick M. Dolan gather stimulating arguments for the indispensability of fiction_including poetry, drama, and film_as irreplaceable sites for wrestling with nature, meaning, shortcomings, and the future of modern politics.

BackgroundHIV prevention research in resource-limited countries is associated with a variety of ethical dilemmas. Key amongst these is the question of what constitutes an appropriate standard of health care (SoC) for participants in HIV prevention trials. This paper describes a community-focused approach to develop a locally-appropriate SoC in the context of a phase III vaginal microbicide trial in Mwanza City, northwest Tanzania.MethodsA mobile community-based sexual and reproductive health service for women working as informal food vendors or in traditional and modern (...) bars, restaurants, hotels and guesthouses has been established in 10 city wards. Wards were divided into geographical clusters and community representatives elected at cluster and ward level. A city-level Community Advisory Committee (CAC) with representatives from each ward has been established. Workshops and community meetings at ward and city-level have explored project-related concerns using tools adapted from participatory learning and action techniques e.g. chapati diagrams, pair-wise ranking. Secondary stakeholders representing local public-sector and non-governmental health and social care providers have formed a trial Stakeholders' Advisory Group (SAG), which includes two CAC representatives.ResultsKey recommendations from participatory community workshops, CAC and SAG meetings conducted in the first year of the trial relate to the quality and range of clinic services provided at study clinics as well as broader standard of care issues. Recommendations have included streamlining clinic services to reduce waiting times, expanding services to include the children and spouses of participants and providing care for common local conditions such as malaria. Participants, community representatives and stakeholders felt there was an ethical obligation to ensure effective access to antiretroviral drugs and to provide supportive community-based care for women identified as HIV positive during the trial. This obligation includes ensuring sustainable, post-trial access to these services. Post-trial access to an effective vaginal microbicide was also felt to be a moral imperative.ConclusionParticipatory methodologies enabled effective partnerships between researchers, participant representatives and community stakeholders to be developed and facilitated local dialogue and consensus on what constitutes a locally-appropriate standard of care in the context of a vaginal microbicide trial in this setting.Trial registrationCurrent Controlled Trials ISRCTN64716212. (shrink)

We study the degrees of bi-hyperhyperimmune sets. Our main result characterizes these degrees as those that compute a function that is not dominated by any ∆02 function, and equivalently, those that compute a weak 2-generic. These characterizations imply that the collection of bi-hhi Turing degrees is closed upwards.

Students in two classes in the fall of 2004 making extensive use of online courseware were logged as they visited over 500 different “learning pages” which varied in length and in difficulty. We computed the time spent on each page by each student during each session they were logged in. We then modeled the time spent for a particular visit as a function of the page itself, the session, and the student. Surprisingly, the average time a student spent on learning (...) pages was of almost no value in predicting how long they would spend on a given page, even controlling for the session and page difficulty. The page itself was highly predictive, but so was the average time spent on learning pages in a given session. This indicates that local considerations, e.g., mood, deadline proximity, etc., play a much greater role in determining student pace and attention than do intrinsic student traits. We also consider the average time spent on learning pages as a function of the time of semester. Students spent less time on pages later in the semester, even for more demanding material. (shrink)

A 28-year-old female-to-male transgender patient presents to the emergency room with one day of pleuritic chest pain and shortness of breath. The patient is found to have an acute pulmonary embolus and is admitted is to the academic hospitalist teaching service for further management.The transgender population is diverse in gender identity, expression, and sexual orientation. Although estimates vary, one study suggests that 0.3% of adults identify as transgender. The U.S. National Transgender Discrimination Survey revealed that 28% of transgender adults have (...) experienced harassment in medical settings, 19% reported being refused care, and 28% postponed care because of discrimination... (shrink)

The contingency/inevitability (C/I) problem consists in questions about the extent to which science is contingent or inevitable, what parts of it are contingent or inevitable, and whether alternative scientific trajectories might be just as successful as the one we have. It is relatively new as a well-delineated object of philosophical inquiry, dating to Ian Hacking’s observation in The Social Construction of What? (1999) that the social construction movement raises questions about contingency and inevitability that can be understood as distinct from, (...) and perhaps more promising than, longstanding debates about scientific realism and anti-realism. In the years since Hacking defined the key terms of the C/I problem, a group of scholars has coalesced around the questions he posed. Those questions motivated, for example, a 2009 workshop at the Fondation Des Treilles in Tourtour, France, and this book synthesizes its results. (shrink)

BackgroundCommunity engagement is a key component in health research. One of the ways health researchers ensure community engagement is through Community Advisory Boards (CABs). The capacity of CABs to properly perform their role in clinical research has not been well described in many resource limited settings. In this study, we assessed the capacity of CABs for effective community engagement in Uganda.MethodsWe conducted a cross sectional study with mixed methods. We used structured questionnaires and key informant interviews (KII) to collect data (...) from CAB members, trial investigators, and community liaison officers. For quantitative data, we used descriptive statistics while for qualitative data we used content analysis.ResultsSeventy three CAB members were interviewed using structured questionnaires; 58.9% males, median age 49 years (IQR 24–70), 71.2% had attained tertiary education, 42.5% never attended any research ethics training, only 26% had a training in human subject protection, 30.1% had training in health research, 50.7% never attended any training about the role of CABs, and 72.6% had no guidelines for their operation. On the qualitative aspect, 24 KIIs cited CAB members to have some skills and ability to understand and review study documents, offer guidance on community norms and expectations and give valuable feedback to the investigators. However, challenges like limited resources, lack of independence and guidelines, and knowledge gaps about research ethics were cited as hindrances of CABs capacity.ConclusionThough CABs have some capacity to perform their role in the Ugandan setting, their functionality is limited by lack of resources to facilitate their work, lack of independence, lack of guidelines for their operations and limited knowledge regarding issues of research ethics and protection of the rights of trial participants. (shrink)