BackgroundDiagnostic ultrasound has long been a part of a physician’s armamentarium, but transcranial focused ultrasound (FUS) is an emerging treatment of neurological disorders. Consequently, the literature in this field is increasing at a rapid pace.ObjectiveThis analysis was aimed to identify the top-cited articles on FUS to discern their origin, spread, current trends highlighting future impact of this novel neurosurgical intervention.MethodsWe searched the Web of Science database on 28th May 2021 and identified the top 100 cited articles. These articles (...) were analyzed with various scientometric parameters like the authors, corresponding authors, country of corresponding author, journal of publication, year of publication. Citation based parameters including total citations, mean citations per article and mean citations, citation count, and the citation per year, citations per year and co-authors per document were studied as well in addition to Hirsch h-index, g-index, m-index, Bradford’s Law, Lotka’s law and Collaboration index.ResultsThe 100 top-cited articles were published between 1998 and 2019 in 45 different journals. The average citations per document and citations per document per year were 97.78 and 12.47, respectively. The most prolific authors were Hynynen K (Medical Biophysics—Toronto), Elias WJ (Neurosurgery—Virginia), Zadicario (InSightec). The Journal of Neurosurgery published the most top-cited articles (n = 11), and most articles originated from the United States, followed by Canada. Among individual institutions, the University of Toronto was the most productive.ConclusionFUS is an emerging treatment of neurological disorders. With its increasing application, the FUS literature is increasing rapidly. Eleven countries contributed to the top 100 cited articles, with the top 2 countries (the United States and Canada) contributing to more than half of these articles. (shrink)

We examine pregnant women's experiences with routinised obstetric ultrasound as entailed in their antenatal care during planned pregnancies. This paper highlights the ambiguity of ultrasound technology in the constitution of maternal–foetal connections. Our analysis focusses on Australian women's experiences of the ontological, aesthetic and epistemological ambiguities afforded by ultrasound. We argue that these ambiguities offer possibilities for connecting to the foetus in ways that maintain a kind of unknowability; they afford an openness and ethical responsiveness irrespective of (...) the future of the foetus. This suggests that elucidating women's experience has implications for theorising ethics across maternal–foetal relations and, more specifically, for the ‘moral pioneering’ (Rapp, 2000) that reproductive technologies can demand of women. Moral pioneering cannot be reduced to moments or processes of decision-making; it must allow for greater recognition of the affective commitments entailed in and incited by ultrasound. Furthermore, focussing on experiences of the ambiguity of ultrasound allows for understanding the ways in which affectivity circulates across domains commonly understood as medical or social, public or private. In doing so, it contributes to undermining a series of tensions that currently shape feminist analysis of obstetric ultrasound, often at the expense of the experience of women. (shrink)

This article analyzes the moral relevance of technological artifacts and its possible role in ethical theory, by taking the postphenomenological approach that has developed around the work of Don Ihde into the domain of ethics. By elaborating a postphenomenological analysis of the mediating role of ultrasound in moral decisions about abortion, the article argues that technologies embody morality and help to constitute moral subjectivity. This technological mediation of the moral subject is subsequently addressed in terms of Michel Foucault’s ethical (...) position, in which ethics is about actively co-shaping one’s moral subjectivity. Integrating Foucauldian ethics and postphenomenology, the article argues that the technological mediation of moral subjectivity should be at the heart of an ethical approach that takes the moral dimensions of technology seriously. (shrink)

We ought to treat others’ moral views with respect, even when we disagree. But what does that mean? This paper articulates a moral obligation to make ourselves open to sincere moral persuasion by others. Doing so allows us to participate in valuable relationships of reciprocal respect for agency. Yet this proposal can sound tritely agreeable. To explore its full implications, the paper applies the general obligation to one of the most challenging topics of moral disagreement: the morality of abortion. I (...) consider and reject arguments that abortion decisions have special features exempting them from the obligation to be open to moral persuasion. Further, I argue that viewing fetal ultrasound images can accomplish morally persuasion. Accordingly, in at least some cases a woman seeking abortion has an obligation to view fetal ultrasound images as a means of being open to moral persuasion. However, this conclusion does not support recent laws compelling women seeking abortion to view ultrasound images; such laws are in fact incompatible with the respect for agency that underwrites the obligation to be open to persuasion. (shrink)

Obstetric ultrasound has become a significant tool in obstetric practice, however, it has been argued that its increasing use may have adverse implications for women’s reproductive freedom. This study aimed to explore Australian obstetricians’ experiences and views of the use of obstetric ultrasound both in relation to clinical management of complicated pregnancy, and in situations where maternal and fetal health interests conflict.

This paper explores the rhetoric of obstetric ultrasound technology as it relates to the abortion debate, specifically the interpretation given to ultrasound images by opponents of abortion. The tenor of the anti-abortion approach is precisely captured in the videotape, Ultrasound:A Window to the Womb. Aspects of this videotape are analyzed in order to tease out the assumptions about the (female) body and about the access to truth yielded by scientific technology (ultrasound) held by militant opponents of (...) abortion. It is argued that the ultrasound images do not offer transparent confirmation of the ontological status of the embryo and fetus. Rather, the window of ultrasound is constructed through a complex combination of visual and verbal devices: ultrasound images, photographic images, verbal argument, and emotional appeal. (shrink)

As several studies, along with a book and movie depicting the true story of a former clinic director, have recently brought to the public’s attention, fetal ultrasound images dramatically impact some viewers’ normative judgments: a small but non-negligible proportion of viewers attribute increased moral status to fetal humans and even form the belief that abortion is impermissible. I consider three types of psychological explanation for a viewer’s shift in beliefs: increased bonding or empathy, various forms of cognitive bias, and (...) type of cognitive processing involved. I consider the normative implications of each explanation, arguing that in each case the viewer’s judgment is presumptively rational. (shrink)

Requiring that a woman who is seeking an abortion be given the opportunity to view an ultrasound of her fetus has spread from anti-abortion “pregnancy resource centers” to state laws. Proponents of these laws claim that having access to the ultrasound image is necessary for a woman to make a medically informed decision. In this paper, we argue that ultrasound examinations frame fetuses visually and linguistically as persons and interpellate pregnant women as mothers, with all of the (...) cultural meaning invested in those two normative concepts. Presenting these judgments as medical information is misleading. Because women are being subjected to these cultural expectations unknowingly, mandatory ultrasound laws in fact undermine women’s autonomy. Fully informed consent would include a critical engagement with social norms around femininity and a recognition that such laws are meant to advance the state’s interest in preserving potential life. (shrink)

Despite FDA recommendations against the practice, keepsake fetal imaging centers have become more common in the United States. U.S. ultrasound regulations construct keepsake imaging in relation to medical practice, yet these centers blur the boundary between medical and nonmedical. Analyzing keepsake imaging centers in two U.S. states demonstrates how centers both appeal to medical expertise to promote their services and extend an intensive mothering ideal to the prenatal stage. To understand keepsake ultrasound, we must account for the role (...) of consumerism in creating pregnant mothers and how keepsake centers constitute ultrasound as a means of expressing mother-love before birth. (shrink)

This paper proposes a synthetic presentation of the proof construction paradigm, which underlies most of the research and development in the so-called “logic programming” area. Two essential aspects of this paradigm are discussed here: true non-determinism and partial information. A new formulation of Focussing, the basic property used to deal with non-determinism in proof construction, is presented. This formulation is then used to introduce a general constraint-based technique capable of dealing with partial information in proof construction. One of the baselines (...) of the paper is to avoid to rely on syntax to describe the key mechanisms of the paradigm. In fact, the bipolar decomposition of formulas captures their main structure, which can then be directly mapped into a sequent system that uses only atoms. This system thus completely “dissolves” the syntax of the formulas and retains only their behavioural content as far as proof construction is concerned. One step further is taken with the so-called “abstract” proofs, which dissolves in a similar way the specific tree-like syntax of the proofs themselves and retains only what is relevant to proof construction. (shrink)

FOR women, it is supposed to trigger one of the most intense orgasms imaginable, with waves of pleasure spreading out across the whole body. If the "G spot orgasm" seems semi-mythical, however, that's because there has been scant evidence of its existence. Now for the first time gynaecological scans have revealed clear anatomical differences between women who claim to experience vaginal orgasms involving a G spot and those who don't. It might mean that there is a G spot, after all. (...) What's more, a simple test could tell you if it's time to give up the hunt, or if your partner just needs to try harder. (shrink)

Prenatal ultrasound use is skyrocketing despite limited evidence of improved outcomes. One factor driving this trend is the widely recognized psychological appeal of real-time fetal imaging. Meanwhile, considering imperfect safety evidence, U.S. professional guidelines dictate that prenatal ultrasound—a screening test—should be governed by expected clinical benefits—an opportunity for intervention. However, when women’s healthcare professionals themselves are pregnant, their access to ultrasound technology permits informal, personal use that may deviate from standard-of-care, e.g., for reassurance. Highlighting a poignant case (...) wherein a pregnant obstetrician’s personal ultrasound use had unforeseen negative consequences, we explore this issue within context of professional ethics and informal medical care. We discuss how women’s health professionals’ self-care may influence and inform prenatal care at large. We advocate curtailing informal prenatal ultrasound use, but also potentially broadening accepted indications for or relaxing proscriptions against ultrasounds for patients. Further research and updated, evidence-based, ethically-sound guidelines are needed. (shrink)

Feminist scholarship has demonstrated the importance of sustained critical engagement with ultrasound visualizations of pregnant women’s bodies. In response to portrayals of these images as “objective” forms of knowledge about the fetus, it has drawn attention to the social practices through which the meanings of ultrasound are produced. This article makes a novel contribution to this project by addressing an empirical context that has been neglected in the existing feminist literature concerning ultrasound, namely, its use during pregnancies (...) that women decide to terminate. Drawing on semi-structured interviews with women concerning their experiences of abortion in England, I explore how the meanings of having an ultrasound prior to terminating a pregnancy are discursively constructed. I argue that women’s accounts complicate dominant representations of ultrasound and that in so doing, they multiply the subject positions available to pregnant women. (shrink)

In recent years, a number of US states have adopted laws that require pregnant women to have an ultrasound examination, and be shown images of their foetus, prior to undergoing a pregnancy termination. In this paper, I examine one of the basic presumptions of these laws: that seeing one’s foetus changes the ways in which one might act in regard to it, particularly in terms of the decision to terminate the pregnancy or not. I argue that mandatory ultrasound (...) laws compel women into a position of moral spectatorship and require them to recognise the foetus as a being for whom they are responsible, particularly through empathic responses to ultrasound images. The approach I propose extends the project of a bioethics of the image and highlights the need for a critical analysis of the political mobilization of empathy in discussions of abortion. (shrink)

Foetal images have been central to the medicalized abortion debate since the 1960s. Feminists have extensively analysed such pictures, arguing that the pregnant body is separated from the foetus and erased from view, and that the rights of women and foetuses are set in opposition. In this article I introduce the latest image in this debate, the 3D sonogram, which is widely reported as new evidence for a reduction in the gestational time limit. Through close analysis of two examples, I (...) argue that the rhetorical use of these images can be characterized by a conflation of knowing with seeing. With the new clarity of sonograms to the untrained eye, image producers are legitimated by a discourse of public information and concerned citizens are called upon to exercise their rights to see/know. For feminist theory, this implies the need for continued analysis of the epistemology of foetal images and renewed focus on the subject position of the viewer. (shrink)

During preparation for early abortion in Norway, an ultrasound examination is usually performed to determine gestation and viability. This article aims to provide a deeper understanding of women’s and health care personnel’s experiences with ultrasound viewing during abortion preparation in the first trimester. Qualitative in-depth interviews with women who had been prepared for early abortion and focus group interviews with HCP from gynaecological units were carried out. A hermeneutic-phenomenological analysis, inspired by van Manen, was chosen. Thirteen women who (...) were pregnant and considering abortion in their first trimester and 20 HCP, namely, 19 registered nurses and one medical doctor, were recruited from gynaecological units at six hospitals. The study was approved by the ethics committee. The essential meaning structure of ‘autonomy under pressure’ consisted of two themes that expressed the different experiences of both the women and the HCP, namely, expectations versus precautions and choice versus protection. The women and HCP expressed different attitudes before the consultation that affected their experiences of the ultrasound examination. While the women had expectations of a clarification based on their choice to either see or not see the ultrasound image, HCP seemed to be more concerned with predetermined rules that they believed would protect the women. Consequently, the basis for dialogue was not optimal, and women’s autonomy was under pressure. Health care personnel are ethically challenged during preabortion ultrasound examinations. Meeting the individual woman’s needs and respecting her autonomy during preparation for abortion requires sensitivity, involvement, and dialogue skills by health personnel. According to the woman’s desire to be informed about the possibility of viewing the image during the abortion preparations, a dialogue that is focused in this direction should arise before the examination. (shrink)

A focussed issue of The Reasoner on the topic of 'Infinitary Reasoning'. Owen Griffiths and A.C. Paseau were the guest editors.

The purpose of this study is to elucidate various practices for the structuring of images on an ultrasound monitor during prenatal ultrasound examinations. This study focuses on the practices that healthcare providers employ to invite pregnant women to differentiate a gray-tone image on the ultrasound monitor from the image’s background. In sequential environments in which pregnant women display difficulty in differentiating an image on the screen in response to the healthcare provider’s invitation, the healthcare provider employs practices (...) that require additional bodily involvement to structure the images on the screen. Furthermore, on certain occasions, the healthcare provider also points to a particular abdominal location with the ultrasound transducer, which is held against the abdomen to produce the very image being differentiated. This study demonstrates that the image on the ultrasound monitor is intrinsically embodied and spatially and modally distributed. In addition, the study suggests an interaction-organizational ground for an aspect of the ‘personification of the fetus’ through obstetric ultrasound. (shrink)

Since the introduction of ultrasound technology in the 1960s as a tool to visibly articulate the interiors of the pregnant body, feminist scholars across disciplines have provided extensive critique regarding the visual culture of fetal imagery. Central to this discourse is the position that fetal images occupy- as products of a visualizing technology that at once penetrates and severs pregnant and fetal bodies. This visual excision, feminist scholars describe, has led not only to an erasure of the female body (...) from fetal images but also to an erasure of the pregnant body in social, political, and biomedical discourses. Vital to feminist scholarship is, thereby, an engagement with fetal images in ways that reinscribe the pregnant body onto fetal images and into political discourses pertaining to reproductive rights. In this paper, similar to the feminist aim, I am interested in engaging with fetal images as way to gain agency for pregnant women and their bodies. The critical question that I ask is: Can we conceive of medical technology in an embodied way -one that interacts organically, dynamically, and through multisensory dimensions with pregnant bodies? In attempting to answer this question, I turn to Bruno Latour and Gilles Deleuze’s articulations of how bodies and machines interact to produce visual fact. (shrink)

In this commentary, I discuss three aspects of Monique Deveaux’s account. First, the method of Grounded Normative Theorizing she adopts to engage directly with the contexts and views of those experiencing poverty fits within a range of proposals to enhance the methodology of moral and political philosophy, and I would call on all philosophers working in this space to further develop these innovative methodologies. Second, Deveaux extends the capabilities approach by focusing on the group-based character of poverty and making the (...) case for building the collective capabilities of poor-led social movements. While I do not substantially disagree with this argument (in practice), I argue that we should be careful to avoid normative collectivism (as a theoretical assumption). Finally, Deveaux discusses political solidarity with people experiencing poverty. I argue that this should be based on esteeming each other’s various contributions in more diverse ways than only in narrow economic terms. Treating people in poverty and poor-led social movements as agents of justice, as Deveaux advocates, is a significant step in this endeavour. (shrink)

The effects of striatal dopamine (DA) on behavior have been widely investigated over the past decades, with “phasic” burst firings considered as the key expression of a reward prediction error responsible for reinforcement learning. Less well studied is “tonic” DA, where putative functions include the idea that it is a regulator of vigor, incentive salience, disposition to exert an effort and a modulator of approach strategies. We present a model combining tonic and phasic DA to show how different outflows triggered (...) by either intrinsically or extrinsically motivating stimuli dynamically affect the basal ganglia by impacting on a selection process this system performs on its cortical input. The model, which has been tested on the simulated humanoid robot iCub interacting with a mechatronic board, shows the putative functions ascribed to DA emerging from the combination of a standard computational mechanism coupled to a differential sensitivity to the presence of DA across the striatum. (shrink)

In “Body, Cyborgs and the Politics of Incarnation,” Bruno Latour recounts the story of Professor Paul Churchland, his colleague, carrying a portrait of his wife. “Nothing unusual in this,” Latour writes. “No, except that this picture was an image produced by computed tomography, a CT scan of his wife’s inner brain, in full colour”. The image of Professor Church-land proudly showing off a full-color CT of his wife’s beautiful brain has a wonderful sense of absurdity to it, and its punch (...) line depends on the reader being jolted by the strangeness of medical imagery standing in place of portraiture—no matter how stunning the cerebellum.However.. (shrink)

Iris Marion Young’s classic paper on the phenomenology of pregnancy chronicles the alienating tendencies of technology-ridden maternal care, as the mother’s subjective knowledge of the pregnancy gets overridden by the objective knowledge provided by medical personnel and technological apparatuses. Following Fredrik Svenaeus, the authors argue that maternal care is not necessarily alienating by looking specifically at the proper attention paid by sonographers in maternal care when performing ultrasound examinations. Using Martin Heidegger’s philosophy as a theoretical lens, the authors argue (...) that sonographers who cultivate technical mastery, build patient rapport, explain the process and significance of the ultrasound, and understand the patient’s world are able to provide excellent patient care. The authors utilize Hans-Georg Gadamer’s hermeneutics to show how sonographers can frame the ultrasound in a way that acknowledges both the subjective knowledge of the mother and the objective data obtained by the sonographer through the use of technology. Ultimately, the authors argue that the common practice of framing the ultrasound as the chance to “meet the baby” is inappropriate, as it exacerbates the tendency to regard objective knowledge as the only legitimate knowledge in medical contexts. They recommend a more balanced approach that elicits a fusion of horizons between the patient’s subjective knowledge and the objective data that is obtained by the sonographer via the ultrasound, thus respecting and bolstering patient autonomy. (shrink)

The development of four-dimensional ultrasound pre-natal scans carries with it an intriguing range of philosophical questions. While ultrasound in pregnancy is a medical test for detecting foetal abnormalities, it has also become a social ritual in Western culture. The scan has become embedded within a discourse of the parent’s ante-relationships with their future child as much as it is a screening function. Within such a scene, the advance of technology – the move, for example, the increasing addition of (...) dimensions to pre-natal imaging, from 2D to 3D and 4D – is inextricably merged with the spatial rhetoric of the foetus. Drawing on both Heidegger’s insights into the relationship between the human and technology, and debates within feminist cultural theory, this paper explores how these spatial and temporal rhetorics of the foetal ultrasound relate to the philosophical motifs around self, knowledge, gender and the technical image. It charts these relationships through an analysis of two classic images of the foetal self, before considering how the fourth dimension of ultrasound – that of real-time image streaming of a foetal scan – enhances, develops and critiques these motifs. (shrink)

This paper presents the findings of an ultrasound study of ten New Zealand English and ten Tongan -speaking trombone players, to determine whether there is an influence of native language speech production on trombone performance. Trombone players’ midsagittal tongue positions were recorded while reading wordlists and during sustained note productions. After normalizing to account for differences in vocal tract shape and ultrasound transducer orientation, we used generalized additive mixed models (GAMMs) to estimate average tongue shapes used by the (...) players from the two language groups when producing notes at different pitches and intensities, and during the production of the monophthongs in their native languages. The average midsagittal tongue contours predicted by our models show a statistically robust difference at the back of the tongue distinguishing the two groups, although tongue shape during playing does not directly map onto vowel tongue shapes as prescribed by the pedagogical literature. While the New Zealand English-speaking participants employed a playing tongue position approximating the neutral vowel schwa and vowel used in the word ‘lot’, the Tongan participants used a tongue shape loosely patterning with the back vowels /o/ and /u/. We argue that these findings represent evidence for native language influence on brass instrument performance; however, this influence seems to be secondary to more basic constraints of brass playing related to airflow requirements and acoustical considerations, with the vocal tract configurations observed across both groups satisfying these conditions in different ways. Our findings furthermore provide evidence for the functional independence of various sections of the tongue and indicate that speech production, itself an acquired motor skill, can influence another skilled behavior via motor memory of vocal tract gestures forming the basis of local optimization processes to arrive at a suitable tongue position for sustained note production. (shrink)

This article explores the ways in which ultrasound screening influences the temporal dimensions of prevention in the obstetrical management of pregnancy. Drawing on praxeographic perspectives and empirically based on participant observation of ultrasound examinations in obstetricians’ offices, it asks how ultrasound scanning facilitates anticipatory modes of pregnancy management, and investigates the entanglement of different notions of time and temporality in the highly risk-oriented modes of prenatal care in Germany. Arguing that the paradoxical temporality of prevention—acting now in (...) the name of the future—is intensified by ultrasound screening, I show how the attribution of risk regarding foetal growth in prenatal check-ups is based on the fragmentation of procreative time and ask how time standards come into play, how pregnancy is located in calendrical time, and how notions of foetal time and the everyday life times of pregnant women clash during negotiations between obstetricians and pregnant women about the determination of the due date. By analysing temporality as a practical accomplishment via technological devices such as ultrasound, the paper contributes to debates in feminist STS studies on the role of time in reproduction technologies and the management of pregnancy and birth in contemporary societies. (shrink)

Medical imaging is predominantly a visual field. In this context, prenatal ultrasound images assume intense social, ethical, and psychological significance by virtue of the subject they represent: the fetus. This feature, along with the sophistication introduced by three-dimensional ultrasound imaging that allows improved visualization of the fetus, has contributed to the common impression that prenatal ultrasound scans are like photographs of the fetus. In this article we discuss the consistency of such a comparison. First, we investigate the (...) epistemic role of both analogic and digital photographic images as visual information-providing representations holding a high degree of objectivity. Second, we examine the structure and process of production of ultrasound scans and argue that a comparison between two-dimensional ultrasound and photography is justified. This is in contrast to 3D ultrasound images that, due to the intensive mathematical processing involved in their production, present some structural issues that obfuscate their ontological and epistemic status. (shrink)

Since 1994, when the first fetal imaging boutique appeared in Texas, many sites have been established around the country for parents to receive nonmedical fetal imaging using three- and four-dimensional ultrasound machines. These businesses boast the benefits they offer to parental-fetal bonding, but the medical community objects to the use of ultrasound machines for nonmedical purposes. In this article, I present the statements released by the medical community, highlighting the alarmist strategies used to paint boutique ultrasounds as bad (...) science and elevate the medical use of ultrasounds. Through a close reading of the statements, it is shown that the medical community's primary concern is not the health of the fetus or the woman but rather their place as the sole users of fetal ultrasounds. This detailed analysis reveals a medical community fearful that its authority is being usurped and is therefore responding with statements meant to denigrate boutique fetal ultrasounds. (shrink)

Transcranial magnetic stimulation (TMS) of the visual cortex can induce phosphenes as can non-diagnostic ultrasound, the latter while participants have closed their eyes during Stimulation. Here we sought to study potential alteration of a visual target (a white crosshair) due to application of diagnostic ultrasound to the visual cortex. We applied a randomized series of actual or sham diagnostic ultrasound to the visual cortex of healthy participants while they stared at a visual target, with the ultrasound (...) device placed where TMS elicited phosphenes. These participants observed percepts 7 out of 10 times, consisting of extra or extensions of lines relative to the original crosshair, and additional colors. Observation of a percept occurred an average of 53.7 +/- 2.6% of the time over the course of the experiment for these participants. In contrast, 7 out of 10 participants exposed to sham-only diagnostic ultrasound observed comparable percepts an average of 36.3 +/ 1.9% of the time, a statistically significant difference (p < 0.00001). Moreover, on average, participants exposed to a combination of sham and actual ultrasound reported a net increase of 47.9 percentage points in the likelihood that they would report a visual effect by the end of the experiment. Our experiment demonstrated that a random combination of sham-only and actual diagnostic ultrasound applied to the visual cortex of participants increased the likelihood that they would observe visual effects, but not the type of effects, with that likelihood increasing over the course of the experiment. From this we conclude that repeated exposures by diagnostic ultrasound made the visual cortex more responsive to stimulation of their visual cortex by the visual target. These observations, consistent with other’s observation of effects of diagnostic ultrasound stimulation of human motor cortex and amygdala, as well as the FDA approved nature of diagnostic ultrasound, may lead to increased study of diagnostic ultrasound applied to human brain. (shrink)

Obstetric ultrasound is the well-recognized prenatal test used to visualize and determine the condition of a pregnant woman and her fetus. Apart from the clinical application, some businesses have started promoting the use of fetal ultrasound machines for nonmedical reasons. Non-medical fetal ultrasound (also known as ‘keepsake’ ultrasound) is defined as using ultrasound to view, take a picture, or determine the sex of a fetus without a medical indication. Notwithstanding the guidelines and warnings regarding (...) class='Hi'>ultrasound safety issued by governments and professional bodies, the absence of scientifically proven physical harm to fetuses from this procedure seems to provide these businesses with grounds for rapid expansion. However, this argument is too simplistic because current epidemiological evidence is not synchronous with advancing ultrasound technology. As non-medical fetal ultrasound has aroused very significant public attention, a thorough ethical analysis of this topic is essential. Using a multifaceted approach, we analyse the ethical perspective of non-medical fetal ultrasound in terms of the expectant mother, the fetus and health professionals. After applying four major theories of ethics and principles (the precautionary principle; theories of consequentialism and impartiality; duty-based theory; and rights-based theories), we conclude that obstetric ultrasound practice is ethically justifiable only if the indication for its use is based on medical evidence. Non-medical fetal ultrasound can be considered ethically unjustifiable. Nevertheless, the ethical analysis of this issue is time dependent owing to rapid advancements in ultrasound technology and the safety issue. The role of health professionals in ensuring that obstetric ultrasound is an ethically justifiable practice is also discussed. (shrink)

The unborn healthy foetus is looked upon as a blessing by one and all. A plethora of thoughts arise in the brains of expectant parents. But what goes on in the brain of the yet unborn still remains a mystery. 'Foetal mind' is a reflection of functions of its organs of sense, an instrument of knowledge that may even be reduced to machine to demonstrate the effect of sense organs and brain contact. Testimony to this fact are the various waveform (...) patterns obtained non-invasively from the foetal Middle Cerebral Artery (MCA) by using Colour Doppler Ultrasound. Our study, conducted for evaluating the foetal MCA in a rural obstetric population in Maharashtra, India, explains how the MCA - a major artery supplying foetal brain, can give abundant information about foetal heart and foetal stress. When only the foetal heart is stressed by the presence of arrhythmias or ectopic beats, these changes are manifest in the foetal MCA velocity waveform pattern as seen on Colour Doppler study. When the entire foetus is under stress, as in cases of intra uterine growth retardation (IUGR), changes again manifest in the foetal MCA velocity waveform pattern and are designated as the foetal Brain Sparing Effect. Thus scientific evaluation of foetal MCA waveform can objectively demonstrate that the overtly non-communicating foetal brain indeed remains an internal organ of sense and a vital instrument of knowledge to clarify the various effects of sense organs and brain contact. Although the brain parenchyma or cerebral metabolism has not been studied here, cerebral vessels serve as a window to cerebral metabolism, as auto regulatory function of brain leads to changes in haemodynamics of cerebral vessels. Also, like other vessels, MCA mirrors foetal distress and IUGR; but unlike other vessels, e.g. the umbilical or uterine artery, which show these changes in the form of reduction or even reversal of diastolic flow, MCA shows an increase in diastolic component due to brain sparing effect. The unique connection between physical changes in the foetal heart, brain and mental operations are thus critically clarified to some extent, and this helps untangle and comprehend the lattice of mental operations. Although this preliminary study has its limitations, it still carries forward the present corpus of knowledge on the strength of its evidential and critical enquiry and helps unravel the concept of foetal consciousness. (shrink)

By law, women seeking abortions in some US states must undergo compulsory ultrasound viewing. This article examines the moral significance of this practice, especially as understood by pro-life religious groups, in light of Foucault’s recently published lectures on ‘The Will to Know’ and the place of the aesthetic. How does the larger abortion-debate strategy of ‘showing’ and ‘seeing’ images—whether of living or dead fetuses—work as an aesthetic form of argument that intends to evoke a moral response in the absence (...) of reason-giving? The article draws on recent, parallel debates regarding disgust before concluding with a theological response to the priority of will over knowledge and vision over action as commentary on the future of abortion debate and law, especially in the United States. (shrink)

Evolutionary pressure selects for the most efficient way of information processing by the brain. This is achieved by focussing neuronal processing onto essential environmental objects, by using focussing devices as pointers to different objects rather than reestablishing new representations, and by using external storage bound to internal representations by pointers. Would external storage increase the capacity of cognitive processing?

Alterations in dural venous sinus hemodynamics have recently been suggested as the major contributing factors in venous pulsatile tinnitus. Nevertheless, little is known about the association between real-time alterations in hemodynamics and the subjective perception of venous PT. This study aimed to investigate the hydroacoustic correlations among diverticular vortices, mainstream sinus flow, and PT using various Doppler ultrasound techniques. Nineteen venous PT patients with protrusive diverticulum were recruited. The mainstream sinus and diverticular hemodynamics before and after ipsilateral internal jugular (...) vein compression were investigated using an innovative retroauricular color-coded Doppler method to examine the correlation between the disappearance of PT and hemodynamic alterations. To reveal the hydroacoustic characteristics of disparate segments of venous return, a computational fluid dynamics technique combined with the transcranial color-coded Doppler method was performed. When the ipsilateral IJV was compressed, PT disappeared, as the mean velocity of mainstream sinus flow and diverticular vortex decreased by 51.2 and 50.6%, respectively. The vortex inside the diverticulum persisted in 18 of 19 subjects. The CFD simulation showed that the flow amplitude generated inside the transverse–sigmoid sinus was segmental, and the largest flow amplitude difference was 20.5 dB. The difference in flow amplitude between the mainstream sinus flow and the diverticular flow was less than 1 dB. In conclusion, the sensation of PT is closely associated with the flow of kinetic energy rather than the formation of a vortex, whereby the amplitude of PT is correlated to the magnitude of the flow velocity and pressure gradient. Additionally, the range of velocity reduction revealed by the RCCD method may serve as a presurgical individual baseline curative marker that may potentially optimize the surgical outcomes. (shrink)