OBJECTIVE: To report and analyse the pattern of end-of-life decision making for terminal Chinese cancer patients. DESIGN: Retrospective descriptive study. SETTING: A cancer clinical trials unit in a large teaching hospital. PATIENTS: From April 1992 to August 1997, 177 consecutive deaths of cancer clinical trial patients were studied. MAIN MEASUREMENT: Basic demographic data, patient status at the time of signing a DNR consent, or at the moment of returning home to die are documented, and circumstances surrounding these events evaluated. RESULTS: (...) DNR orders were written for 64.4% of patients. Patients in pain (odds ratio 0.45, 95% CI 0.22-0.89), especially if requiring opioid analgesia (odds ratio 0.40, 95% CI 0.21-0.77), were factors associated with a higher probability of such an order. Thirty-five patients were taken home to die, a more likely occurrence if the patient was over 75 years (odds ratio 0.12, 95% CI 0.04-0.34), had children (odds ratio 0.14, 95% CI 0.02-0.79), had Taiwanese as a first language (odds ratio 6.74, 95% CI 3.04-14.93), or was unable to intake orally (odds ratio 2.73, 95% CI 1.26-5.92). CPR was performed in 30 patients, none survived to discharge. CONCLUSIONS: DNR orders are instituted in a large proportion of dying Chinese cancer patients in a cancer centre, however, the order is seldom signed by the patient personally. This study also illustrates that as many as 20% of dying patients are taken home to die, in accordance with local custom. (shrink)

The spatial organization of the genome is intimately linked to its biological function, yet our understanding of higher order genomic structure is coarse, fragmented and incomplete. In the nucleus of eukaryotic cells, interphase chromosomes occupy distinct.

The interaction between cavity modes and optical transitions leads to new coupled light-matter states in which the energy is periodically exchanged between the matter states and the optical mode. Here we present experimental evidence of optical strong coupling between modes of individual sub-wavelength metamaterial nanocavities and engineered optical transitions in semiconductor heterostructures. We show that this behaviour is generic by extending the results from the mid-infrared to the near-infrared. Using mid-infrared structures, we demonstrate that the light-matter coupling occurs at the (...) single resonator level and with extremely small interaction volumes. We calculate a mode volume of 4.9 × 10 from which we infer that only ~2,400 electrons per resonator participate in this energy exchange process. (shrink)

Rationale: Deep brain stimulation (DBS) of the hippocampus is proposed for enhancement of memory impaired by injury or disease. Many pre-clinical DBS paradigms can be addressed in epilepsy patients undergoing intracranial monitoring for seizure localization, since they already have electrodes implanted in brain areas of interest. Even though epilepsy is usually not a memory disorder targeted by DBS, the studies can nevertheless model other memory-impacting disorders, such as Traumatic Brain Injury (TBI). Methods: Human patients undergoing Phase II invasive monitoring for (...) intractable epilepsy were implanted with depth electrodes capable of recording neurophysiological signals. Subjects performed a delayed-match-to-sample (DMS) memory task while hippocampal ensembles from CA1 and CA3 cell layers were recorded to estimate a multi-input, multi-output (MIMO) model of CA3-to-CA1 neural encoding and a memory decoding model (MDM) to decode memory information from CA3 and CA1 neuronal signals. After model estimation, subjects again performed the DMS task while either MIMO-based or MDM-based patterned stimulation was delivered to CA1 electrode sites during the encoding phase of the DMS trials. Each subject was sorted (post hoc) by prior experience of repeated and/or mild-to-moderate brain injury (RMBI), TBI, or no history (control) and scored for percentage successful delayed recognition (DR) recall on stimulated vs. non-stimulated DMS trials. The subject’s medical history was unknown to the experimenters until after individual subject memory retention results were scored. Results: When examined compared to control subjects, both TBI and RMBI subjects showed increased memory retention in response to both MIMO and MDM-based hippocampal stimulation. Furthermore, effects of stimulation were also greater in subjects who were evaluated as having pre-existing mild-to-moderate memory impairment. Conclusion: These results show that hippocampal stimulation for memory facilitation was more beneficial for subjects who had previously suffered a brain injury (other than epilepsy), compared to control (epilepsy) subjects who had not suffered a brain injury. This study demonstrates that the epilepsy/intracranial recording model can be extended to test the ability of DBS to restore memory function in subjects who previously suffered a brain injury other than epilepsy, and support further investigation into the beneficial effect of DBS in TBI patients. (shrink)

Cyclin-dependent kinase 5 has been implicated in Alzheimer's disease pathogenesis. Here, we demonstrate that overexpression of p25, an activator of cdk5, led to increased levels of BACE1 mRNA and protein in vitro and in vivo. A p25/cdk5 responsive region containing multiple sites for signal transducer and activator of transcription was identified in the BACE1 promoter. STAT3 interacts with the BACE1 promoter, and p25-overexpressing mice had elevated levels of pSTAT3 and BACE1, whereas cdk5-deficient mice had reduced levels. Furthermore, mice with a (...) targeted mutation in the STAT3 cdk5 responsive site had lower levels of BACE1. Increased BACE levels in p25 overexpressing mice correlated with enhanced amyloidogenic processing that could be reversed by a cdk5 inhibitor. These data demonstrate a pathway by which p25/cdk5 increases the amyloidogenic processing of APP through STAT3-mediated transcriptional control of BACE1 that could have implications for AD pathogenesis. (shrink)

Outstanding translations by leading contemporary scholars--many commissioned especially for this volume--are presented here in the first single edition to include the entire surviving corpus of works attributed to Plato in antiquity. In his introductory essay, John Cooper explains the presentation of these works, discusses questions concerning the chronology of their composition, comments on the dialogue form in which Plato wrote, and offers guidance on approaching the reading and study of Plato's works. Also included are concise introductions by Cooper and Hutchinson (...) to each translation, meticulous annotation designed to serve both scholar and general reader, and a comprehensive index. This handsome volume offers fine paper and a high-quality Smyth-sewn cloth binding in a sturdy, elegant edition. (shrink)

Today, intelligence in all walks of life is developing at an unexpectedly fast speed. The complexity of the Internet of Things big data system of intelligent parks is analyzed to unify the information transmission of various industries, such as smart transportation, smart library, and smart medicine, thereby diminishing information islands. The traditional IoT systems are analyzed; on this basis, a relay node is added to the transmission path of the data information, and an intelligent park IoT big data system is (...) constructed based on relay cooperation with a total of three hops. Finally, the IoT big data system is simulated and tested to verify its complexity. Results of energy efficiency analysis suggest that when the power dividing factor is 0.5, 0.1, and 0.9, the energy efficiency of the IoT big data system first increases and then decreases as α0 increases, where the maximum value appears when α0 is about 7 J. Results of outage probability analysis demonstrate that the system’s simulation result is basically the same as that of the theoretical result. Under the same environment, the more hop paths the system has, the more the number of relays is; moreover, the larger the fading index m, the better the system performance, and the lower the outage possibility. Results of transmission accuracy analysis reveal that the IoT big data system can provide a result that is the closest to the actual result when the successful data transmission probability is 100%, and the parameter λ values are between 0.01 and 0.05; in the meantime, the delay of successful data transmission is reduced gradually. In summary, the wireless relay cooperation transmission technology can reduce the outage probability and data transmission delay probability of the IoT big data system in the intelligent park by adding the multihop path, thereby improving the system performance. The above results can provide an experimental basis for exploring the complexity of IoT systems in intelligent parks. (shrink)

Theodor W. Adorno is best known for his contributions to aesthetics and social theory. Critics have always complained about the lack of a practical, political or ethical dimension to Adorno's philosophy. In this highly original contribution to the literature on Adorno, J. M. Bernstein offers the first attempt in any language to provide an account of the ethical theory latent in Adorno's writings. Bernstein relates Adorno's ethics to major trends in contemporary moral philosophy. He analyses the full range of Adorno's (...) major works, with a special focus on Dialectic of Enlightenment, Minima Moralia and Negative Dialectics. In developing his account Bernstein lays particular stress on Adorno's contention that the event of Auschwitz demands a new categorical imperative. This book will be widely acknowledged as the standard work on Adorno's ethics and as such will interest professionals and students of philosophy, political theory, sociology, history of ideas, art history and music. (shrink)

CONSCIOUSNESS AND THE BRAIN SELF-REGULATION PARADOX The relationship of consciousness to biology has intrigued mankind thoroughout recorded history. However, little progress has been made not only in understanding these issues but also in raising fundamental questions central to the problem. As Davidson and Davidson note in their introduction, William James suggested, almost a century ago in his Principles of Psychology, that the brain was the organ of mind and be havior. James went so far as to suggest that the remainder (...) of the Principles was but a "footnote" to this central thesis. This volume brings together diverse biobehavioral scientists who are addressing the various aspects of the mindlbrainlbodylbehavior issue. Although some of the authors have previously published together in other volumes, by and large the particular combination of authors and topics selected by the editors makes this volume unique and timely. Unlike the Consciousness and Self-Regulation series (Schwartz & Shapiro, 1976, 1978), also published by Plenum, this volume is devoted entirely to a psychobiological approach to consciousness. Although readers will differ in their interest in specific chapters, the well-rounded investigator who is concerned with the psychobiology of consciousness will want to become intimately acquainted with all the views presented in this volume. As noted by the individual contributors, the topic of this volume stimulates fundamental questions which, on the surface, may appear trivial, yet, on further reflection, turn out to have deep significance. (shrink)

In this 1974 book a practising scientist and gifted expositor sets forth an exciting point of view on the nature of science and how it works.

Jurgen Habermas' construction of a critical social theory of society grounded in communicative reason is one of the very few real philosophical inventions of recent times that demands and repays extended engagement. In this elaborate and sympathetic study which places Habermas' project in the context of critical theory as a whole past and future, J. M. Bernstein argues that despite its undoubted achievements, it contributes to the very problems of ethical dislocation and meaninglessness it aims to diagnose and remedy. Bernstein (...) further argues that the precise character of the failures of Habermas' program demonstrate the necessity for a return to the first generation critical theory of Adorno. Reading across nearly the whole range of Habermas' corpus, Recovering Ethical Life traces the development of the theory of communicative reason from its inception in Knowledge and Human Interests through its elaboration in The Theory of Communicative Action and into its defense against postmodernism in The Philosophical Discourse of Modernity . In separate chapters Habermas' readings of Freud, Durkheim amd Mead, Adorno and Foucault, Castoriadis and Taylor are critically examined. The focus of Bernstein's analyses, however, is always problem centered and thematic rather than textual psychoanalytic theory as an account of self knowledge, the competing claims of ethical identity and moral reason, the place of judgment in practical reason, and the debate between philosophies of language based communities versus those oriented towards world-disclosure. Critical theory is unique among current philosophies in engaging with the problems of social injustice and nihilism by siding with an abstract moral reason that forfeits the processes of intersubjective recognition it intended to salvage. Even in the fine grain of Habermas' account of performative contradictions and the theory of discourses of application, Bernstein perceives a squandering of the resources of an ethical life in need of transfiguration. (shrink)

Language tests for overseas registered nurses (ORN) working outside their home country are essential for patient safety, as communication competency needs to be established in any workforce. We argue that the current employment of existing language tests is structurally and institutionally racist and disadvantages ORNs from non‐European Union (EU) and non‐White countries seeking to work in the United Kingdom. Using Critical Race Theory (CRT), we argue that existing English language tests for ORNs seeking registration in the United Kingdom are discriminatory (...) due to the UK's racist migration policies and a regulatory body for nursing and midwifery that fails to acknowledge and understand its own institutionally racist practices. (shrink)

Philosophical discussion tends to converge on the view that narratives are at the center of the emotion of grief. In this article, I expand on this kind of view. On the one hand, I argue that key strands of phenomenological and neuroscientific studies suggest that grief consists in a complex emotional process of disconfirmation-and-updating of the narrative self-model. By heuristically drawing on an analogy between binocular rivalry and grief, I show that certain salient aspects of the phenomenology of grief, such (...) as self-alienation and ambiguity, are straightforwardly reflected by this account. On the other hand, I argue that this hierarchical approach has the resources to: (i) show that both narratable and unnarratable experiences of personal loss are both instances of grief; and (ii) differentiate between narratable and unnarratable experiences of grief, without compromising the view that self-constituting narratives are at the center of the phenomenon. (shrink)

The familiar issue of corporate social responsibility takes on a new topic. Added to the list of concerns from affirmative action and environmental integrity is their growing contributions to education. At first glance, the efforts may appear to be ordinary gestures of communal good will in terms of providing computers, sponsoring book covers, and interactive materials provided by Scholastic Magazine. A closer view reveals a targeted market of student life who are vulnerable to commercials placed in these formats. Among the (...) most effective corporate intervention is Channel One News. It offers a newsworthy show but with mandatory commercial viewing. This increasing trend of corporations intervening to assist schools that need more money and/or equipment is disingenuous.In this essay, I present the background of this commercialization of education and demonstrate the violations against student autonomy and integrity. Although there may be utilitarian merits to some interventions, I argue that these infringe upon the moral value of personhood. Advertising in schools in its current practice is immoral on deontological grounds. (shrink)

Continuing the dialogue: postcolonial feminist scholarship and Bourdieu — discourses of culture and points of connection Postcolonial feminist theories provide the analytic tools to address issues of structural inequities in groups that historically have been socially and economically disadvantaged. In this paper we question what value might be added to postcolonial feminist theories on culture by drawing on Bourdieu. Are there points of connection? Like postcolonial feminists, he puts forward a position that aims to unmask oppressive structures. We argue that, (...) while there are points of connection, there are also epistemologic and methodologic differences between postcolonial feminist perspectives and Bourdieu's work. Nonetheless, engagement with different theoretical perspectives carries the promise of new insights — new ways of ‘seeing’ and ‘understanding’ that might enhance a praxis‐oriented theoretical perspective in healthcare delivery. (shrink)

In this unflinching look at the experience of suffering and one of its greatest manifestations—torture—J.M. Bernstein critiques the repressions of traditional moral theory, showing that our morals are not immutable ideals but fragile constructions that depend on our experience of suffering itself. Morals, Bernstein argues, not only guide our conduct but also express the depth of mutual dependence that we share as vulnerable and injurable individuals. Beginning with the attempts to abolish torture in the eighteenth century, and then sensitively examining (...) what is suffered in torture and related transgressions, such as rape, Bernstein elaborates a powerful new conception of moral injury. Crucially, he shows, moral injury always involves an injury to the status of an individual as a person—it is a violent assault against his or her dignity. Elaborating on this critical element of moral injury, he demonstrates that the mutual recognitions of trust form the invisible substance of our moral lives, that dignity is a fragile social possession, and that the perspective of ourselves as potential victims is an ineliminable feature of everyday moral experience. (shrink)

This 2002 volume brings together major works by German thinkers, writing just prior to and after Kant, who were enormously influential in this crucial period of aesthetics. These texts include the first translation into English of Schiller's Kallias Letters and Moritz's On the Artistic Imitation of the Beautiful, together with translations of some of Hölderlin's most important theoretical writings and works by Hamann, Lessing, Novalis and Schlegel. In a philosophical introduction J. M. Bernstein traces the development of aesthetics from its (...) still rationalist and mimetic construction in Lessing, through the optimistic construal of art and/or beauty as the appearance of human freedom in the work of Schiller, to Hölderlin's darker vision of art as the memory of a lost unity, and the variations of that theme - of an impossible striving after the lost ideal - which are found in the work of Schlegel and Novalis. (shrink)

This 2002 volume brings together major works by German thinkers, writing just prior to and after Kant, who were enormously influential in this crucial period of aesthetics. These texts include the first translation into English of Schiller's Kallias Letters and Moritz's On the Artistic Imitation of the Beautiful, together with translations of some of Hölderlin's most important theoretical writings and works by Hamann, Lessing, Novalis and Schlegel. In a philosophical introduction J. M. Bernstein traces the development of aesthetics from its (...) still rationalist and mimetic construction in Lessing, through the optimistic construal of art and/or beauty as the appearance of human freedom in the work of Schiller, to Hölderlin's darker vision of art as the memory of a lost unity, and the variations of that theme - of an impossible striving after the lost ideal - which are found in the work of Schlegel and Novalis. (shrink)

Malthus did not leave us with a systematic treatment of colonization, but from remarks scattered throughout his publications and correspondence it is possible to assemble a fairly coherent account of his views on the advantages and disadvantages of colonies, and on the reasons why some have failed and others succeeded. Included in these scattered remarks are some comparisons between his own views on colonies and those of Adam Smith. The question of the relationship between Malthus and Adam Smith is a (...) rather complex and subtle one, and cannot be given the full consideration it deserves in one short paper. But, as a general summary, it can be said that Malthus had a high regard for Smith and considered himself a follower and disciple of Smith, by contrast with Ricardo, James Mill, and McCulloch etc., whom he considered as exponents of a ‘New System of Political Economy”. His own Principles of Political Economy was conceived as a collection of ‘tracts or essays”, not as a new systematic treatise replacing the Wealth of Nations, Joseph Gamier in his article ‘Malthus” in the Dictionnaire de l'Economie Politique, 1852, saw that the title of the Principles was in fact a misnomer: ‘Malgré son titre, le livre sur les Principes n'est point un traité complet, mais seulement une collection de dissertations.” In what was probably intended as a criticism of Ricardo's Principles of Political Economy and Taxation, 1817, Malthus stated that the ‘present period … seems to be unpropitious to the publication of a new systematic treatise on political economy”, and, referring to Smith's work, stated that ‘the treatise which we already possess is still of the very highest value”. Nevertheless, despite professing his affiliation, Malthus did not hesitate to criticize Smith when he disagreed with him. He recognized that the Wealth of Nations contained ‘controverted points” and that it would require some ‘additions … which the more advanced stage of the science has rendered necessary”. (shrink)