Objective: Deep brain stimulation targeted to the ventral intermediate nucleus of the thalamus is effective for motor symptoms in essential tremor, but there is limited data on cognitive outcomes. We examined cognitive outcomes in a large cohort of ET DBS patients.Methods: In a retrospective analysis, we used repeated-measures ANOVA testing to examine whether the age of tremor onset, age at DBS surgery, hemisphere side implanted with lead, unilateral vs. bilateral implantations, and presence of surgical complications influenced the cognitive outcomes. Neuropsychological (...) outcomes of interest were verbal memory, executive functioning, working memory, language functioning, visuospatial functioning, and general cognitive function.Results: We identified 50 ET DBS patients; 29 males; the mean age of tremor onset was 35.84 years with a median age of 38 years. The mean age at DBS was 68.18 years. There were 37 unilateral 30 left, seven right, and 13 bilateral brain implantations. In the subgroup analysis, there was a significant interaction between assessment and age of tremor onset ; F = 4.47; p = 0.043 for working memory. The post hoc testing found improvements for younger onset ET. Similarly, there was a significant interaction between assessment and complications vs. no complications subgroups; F = 4.34; p = 0.043 for verbal memory with worsening scores seen for ET patients with complications. The remaining tests were not significant.Conclusion: In this large cohort of ET patients with, DBS was not accompanied by a significant decline in many cognitive domains. These outcomes were possibly related to the selection of patients with normal cognitive functioning before surgery, unilateral DBS implantations for the majority, and selection of patients with optimal response to DBS. (shrink)

This book is structured in a practical, example-driven, manner. The use of VHDL for constructing logic synthesisers is one of the aims of the book; the second is the application of the tools to the design process. Worked examples, questions and answers are provided together with do and don'ts of good practice. An appendix on logic design the source code are available free of charge over the Internet.

According to the universal entropy bound, the entropy (and hence information capacity) of a complete weakly self-gravitating physical system can be bounded exclusively in terms of its circumscribing radius and total gravitating energy. The bound’s correctness is supported by explicit statistical calculations of entropy, gedanken experiments involving the generalized second law, and Bousso’s covariant holographic bound. On the other hand, it is not always obvious in a particular example how the system avoids having too many states for given energy, and (...) hence violating the bound. We analyze in detail several purported counterexamples of this type, and exhibit in each case the mechanism behind the bound’s efficacy. (shrink)

Ian Ayres and Fredrick Vars have done the gun debate a tremendous service in their new book. They have shown that a range of proposals expected to reduce gun death and injury are plausible in our c...

This article traces the roots of the author’s doctoral work to his pre-doctoral experiences in varied realms of professional practice. The research choices made are thus inevitably influenced by these experiences. These include the selection of an interdisciplinary domain to locate his doctoral work, the choice of a “boundary object” as the unit of analysis and the formulation of a methodological mix that reflected the multidimensionality of the research topic. These choices also reflect the researcher’s quest for personal meaningfulness and (...) consequently, a certain degree of irrationality that is characteristic of any human endeavor. The idea of creative research as negotiating the boundary of acceptability is explored and the importance of freedom and tolerance for experimentation to aid this enterprise is highlighted. (shrink)

Attentional control has grown in importance within theoretical and predictive models of psychopathology over past decades. The Attentional Style Questionnaire is a novel measure of internal a...

I propose an experiment that may be performed, with present low temperature and cryogenic technology, to reveal Wheeler’s quantum foam. It involves coupling an optical photon’s momentum to the center of mass motion of a macroscopic transparent block with parameters such that the latter is displaced in space by approximately a Planck length. I argue that such displacement is sensitive to quantum foam and will react back on the photon’s probability of transiting the block. This might allow determination of the (...) precise scale at which quantum fluctuations of space–time become large, and so differentiate between the brane-world and the traditional scenarios of spacetime. (shrink)

We prove the existence of a generalization of Kelvin's circulation theorem in general relativity which is applicable to perfect isentropic magnetohydrodynamic flow. The argument is based on a new version of the Lagrangian for perfect magnetohydrodynamics. We illustrate the new conserved circulation with the example of a relativistic magnetohydrodynamic flow possessing three symmetries.

It is pointed out that the Higgs field may be supplanted by an ordinary Klein-Gordon field conformally coupled to the space-time curvature, and with very small, real, rest mass. Provided there is a bare cosmological constant of order of its square mass, this field can induce spontaneous symmetry breaking with a mass scale that can be as large as the Planck-Wheeler mass, but may be smaller. It can thus play a natural role in grand unified theories. In the theory presented (...) here the physical cosmological constant is small, being of order of the squared mass, and can meet observational constraints without having to be cancelled accurately. The physical gravitational constant differs somewhat from the coupling constant in Einstein's equation, and is temperature dependent in the broken symmetry regime. Symmetry restoration occurs at high temperature. (shrink)

Gender‐affirming care is almost exclusively discussed in connection with transgender medicine. However, this article argues that such care predominates among cisgender patients, people whose gender identity matches their sex assigned at birth. To advance this argument, we trace historical shifts in transgender medicine since the 1950s to identify central components of “gender‐affirming care” that distinguish it from previous therapeutic models, such as “sex reassignment.” Next, we sketch two historical cases—reconstructive mammoplasty and testicular implants—to show how cisgender patients offered justifications grounded (...) in authenticity and gender affirmation that closely mirror rationales supporting gender‐affirming care for transgender people. The comparison exposes significant disparities in contemporary health policy regarding care for cis and trans patients. We consider two possible objections to the analogy we draw, but ultimately argue that these disparities are rooted in “trans exceptionalism” that produces demonstrable harm.. (shrink)

This commentary responds to Moti Gorin's article “What Is the Aim of Pediatric ‘Gender‐Affirming’ Care?” We argue that Gorin's case against pediatric gender‐affirming care rests upon numerous false conceptual binaries: female/male, public/private, objective/subjective, and medically necessary/elective. Drawing on feminist bioethics, we show how such dichotomous thinking is both inaccurate and marginalizing of gender minorities.

Upshot: We seek to address several questions and statements made in the commentaries by elaborating on the four main aspects of the M-N-L framework. Before doing so, we discuss the issue of constructivist teaching in the context of schools. We conclude by hypothesizing on what would be lost in the M-N-L framework by taking constructivism out of the picture.

Context: Constructivist teachers who find themselves working within an educational system that adopts a realist epistemology, may find themselves at odds with their own beliefs when they catch themselves paying closer attention to the knowledge authorities intend them to teach rather than the knowledge being constructed by their learners. Method: In the preliminary analysis of the mathematical learning of six low-performing Year 7 boys in a Maltese secondary school, whom one of us taught during the scholastic year 2014-15, we constructed (...) a conceptual framework which would help us analyze the extent to which he managed to be sensitive to constructivism in a typical classroom setting. We describe the development of the framework M-N-L as a viable analytical tool to search for significant moments in the lessons in which the teacher appeared to engage in what we define as “constructivist teaching” during mathematics lessons. The development of M-N-L is part of a research program investigating the way low-performing students make mathematical sense of new notation with the help of the software Grid Algebra. Results: M-N-L was found to be an effective instrument which helped to determine the extent to which the teacher was sensitive to his own constructivist beliefs while trying to negotiate a balance between the mathematical concepts he was expected to teach and the conceptual constructions of his students. Implications: One major implication is that it is indeed possible for mathematics teachers to be sensitive to the individual constructions of their learners without losing sight of the concepts that society, represented by curriculum planners, deems necessary for students to learn. The other is that researchers in the field of education may find M-N-L a helpful tool to analyze CT during typical didactical situations established in classroom settings. (shrink)

This paper conducts a critical examination of the "usual psychopharmacology standards" for clinical research. Four main areas are inspected: What is "it" that is being treated in a clinical drug study? How much is really known concerning the psychological alterations brought about by psychiatric drug treatment? To what extent are sources of bias actually controlled for in "controlled" drug treatment studies? How does the usual "dropout pattern" influence the alleged "clinical findings" of controlled drug treatment studies? The overall conclusion reached (...) is that the "usual standards" cannot produce a realistic picture of either safety or efficacy. Conceptual and methodological reforms are suggested. (shrink)

This interdisciplinary collection of essays highlights the relevance of Buddhist doctrine and practice to issues of globalization. From philosophical, religious, historical, and political perspectives, the authors show that Buddhism—arguably the world’s first transnational religion—is a rich resource for navigating todays interconnected world.

Recently, John Doe, an undocumented immigrant who was detained by United States Immigration and Customs Enforcement, was admitted to a hospital off-site from a detention facility. Custodial officers accompanied Mr. Doe into the exam room and refused to leave as physicians examined him. In this analysis, we examine the ethical dilemmas this case brings to light concerning the treatment of patients in immigration detention and their rights to privacy. We analyze what US law and immigration detention standards allow regarding immigration (...) enforcement or custodial officers’ presence in medical exams and documentation of detainee health information. We describe the ethical implications of the presence of officers in medical exam rooms, including its effects on the quality of the patient-provider relationship, patient privacy and confidentiality, and provider's ability to provide ethical care. We conclude that the presence of immigration enforcement or custodial officers during medical examination of detainees is a breach of the right to privacy of detainees who are not an obvious threat to the public. We urge ICE and the US Department of Homeland Security to clarify standards for and tighten enforcement around when officers are legally allowed to be stationed in medical exam rooms and document detainees’ information. (shrink)

In response to the continued expansion of “red flag” laws allowing broader classes of people to petition a court for the removal of firearms from individuals who exhibit dangerous conduct, this paper argues that state laws should adopt a double-filter provision that balances individual rights and government public safety interests. The main component of such a provision is a special statutory category — “reporting party” — that enables a broader social network, such as co-workers or school administrators, to request that (...) a law enforcement officer file a petition for an Extreme Risk Protection Order. A double-filter provision would not give reporting parties a right to file a court petition directly. Instead, parties would file a request for petition with law enforcement officers, who must seek an ERPO from the court if they find the reporting party's information credible. That information is then transmitted to the court as a sworn affidavit of the reporting party. The goal is to facilitate a balanced policy model that widens the reporting circle in order to feed more potentially life-saving information into the system, mitigates the risk of erroneous deprivation of constitutionally protected due process and Second Amendment rights. (shrink)

Objectives: To examine associations of changing employment conditions, specifically switching to working from home or job loss, with mental health, using data collected during the COVID-19 pandemic.Methods: Data from 2,301 US adults in employment prior to COVID-19 were collected April 3rd−7th, 2020. Participants reported whether their employment remained unchanged, they were WFH when they had not been before, or they had lost their job due to the pandemic. Outcomes were symptoms of depression, anxiety, stress, loneliness, and positive mental health assessed (...) using validated questionnaires. Linear regression quantified associations of employment changes with mental health outcomes, controlling for age, sex, race, BMI, smoking status, screen time, physical activity, marital status, chronic conditions, and current COVID-19 containment strategies being followed.Results: Compared to participants whose employment remained unchanged, those who switched to WFH did not differ in any measures of mental health. Participants who had lost their job reported higher symptoms of depression, anxiety, and stress, and lower PMH. Loneliness did not differ between groups.Conclusion: This study demonstrates that concerns around potential adverse mental health effects, particularly increases in loneliness, should not preclude WFH in the general population, while considering each individual's personal circumstances, and the acute adverse association of job loss with mental health. Tailored and sensitive interventions may be required to prevent deteriorations in mental health associated with job loss during periods of societal stress. (shrink)

The aim of this exploratory study was to examine client demographics and expectations, reasons for use, sensations during treatment, and perceived outcomes of Pranic Healing, an energy healing system lacking in scientific documentation but whose use in the general population is becoming more widespread internationally. This study consisted of a cross-sectional survey of adults (18+ years of age) receiving care from 12 Pranic Healing practices in four different states in the U.S. (N = 179) completing online questionnaires. Closed-ended response sets (...) were analyzed descriptively, while qualitative data were analyzed using content analysis. Reasons to use the therapy included physical, mental/emotional, and metaphysical issues, dissatisfaction with conventional care, and overall well-being. Expectations of care included enhanced abilities, cure or relief, or unsure. Respondents were more likely to cite a specific problem from which they needed alleviation than to cite overall health or wellness as their goal. Sensations experienced were reported to be of a relaxing nature and not, as was hypothesized, of an energizing nature. Results show that those who use Pranic Healing fit the sociodemographic profile of CAM (complementary and alternative medicine) users in the United States, that their reasons for use are not homogeneous, and that preliminary descriptive data from a selective subsample of respondents indicated that some respondents are experiencing positive outcomes attributed to this modality. (shrink)

Recent reports of CRISPR/Cas9 genome editing in parasitic helminths open up new avenues for research on these dangerous pathogens. However, the complex morphology and life cycles inherent to these parasites present obstacles for the efficient application of CRISPR/Cas9‐targeted mutagenesis. This is especially true with the trematode flukes where only modest levels of gene mutation efficiency have been achieved. Current major challenges in the application of CRISPR/Cas9 for study of parasitic worms thus lie in enhancing gene mutation efficiency and overcoming issues (...) involved in host passage so that mutated parasites survive. Strategies developed for CRISPR/Cas9 studies on Caenorhabditis elegans, protozoa and mammalian cells, including novel delivery methods, the choice of selectable markers, and refining mutation precision represent novel tactics whereby these impediments can be overcome. Furthermore, employing CRISPR/Cas9‐mediated gene drive to interfere with vector transmission represents a novel approach for the control of parasitic worms that is worthy of further exploration. (shrink)

Jennifer Blumenthal-Barby (2024) argues that “[i]t is time for bioethics to end talk about personhood” (11). The author calls on the field to ask different kinds of normative questions about the mo...

In a recent editorial, Raymond Spier expresses skepticism over claims that climate change is driven by human actions and that humanity should act to avoid climate change. This paper responds to this skepticism as part of a broader review of the science and ethics of climate change. While much remains uncertain about the climate, research indicates that observed temperature increases are human-driven. Although opinions vary regarding what should be done, prominent arguments against action are based on dubious factual and ethical (...) positions. Thus, the skepticisms in the recent editorial are unwarranted. This does not diminish the general merits of skeptical intellectual inquiry. (shrink)

Scientific endeavor is the pursuit of knowledge with the aim of advancing the welfare of all human beings. This endeavor is built on the ideology of science; thus, society relies on the integrity of the practice of science and of scientists themselves. The responsible conduct of research is the essence of good science; however, many of the pedagogical approaches used to instill integrity in science accentuate the negative rather than exemplify ideal professionalism. This paper makes an argument for the inculcation (...) of the appropriate conduct of research via a positive approach. We address the acclimation to the culture of science that supersedes diverse cultural backgrounds of students. We suggest techniques for the implementation of positive strategies and reinforce the benefit of approaching the teaching of ethical behavior as a competitive advantage. We highlight ways in which this approach can empower the individual scientist and the scientific community as a whole. Transmission of the culture of scientific professionalism formalizes the aims of an ideal scientific professional and encourages assimilation and identification as a member of the scientific profession. We purport that instilling scientific professionalism will spur responsible conduct of research. (shrink)

Throughout an illustrious career of teaching and writing that spans five decades, philosopher Needleman has always tackled the "big questions" of life. In this collection of six feature interviews that began in the 1980s, Miller and Needleman discuss "Making Sense of Mysticism, The Secrets of Time and Love, The Meanings of Money, Searching for the Soul of America, Meeting God without Religion, " and "The Need for Philosophy.".

Possible worlds, concrete or abstract as you like, are irrelevant to the truthmakers for modality—or so I shall argue in this paper. First, I present the neo-Humean picture of modality, and explain why those who accept it deny a common sense view of modality. Second, I present what I take to be the most pressing objection to the neo-Humean account, one that, I argue, applies equally well to any theory that grounds modality in possible worlds. Third, I present an alternative, (...) properties-based theory of modality and explore several specific ways to flesh the general proposal out, including my favored version, the powers theory. And, fourth, I offer a powers semantics for counterfactuals that each version of the properties-based theory of modality can accept, mutatis mutandis. Together with a definition of possibility and necessity in terms of counterfactuals, the powers semantics of counterfactuals generates a semantics for modality that appeals to causal powers and not possible worlds. (shrink)

D. M. Armstrong famously claims that deterministic laws of nature are contingent relations between universals and that his account can also be straightforwardly extended to irreducibly probabilistic laws of nature. For the most part, philosophers have neglected to scrutinize Armstrong’s account of probabilistic laws. This is surprising precisely because his own claims about probabilistic laws make it unclear just what he takes them to be. We offer three interpretations of what Armstrong-style probabilistic laws are, and argue that all three interpretations (...) are incompatible either with some feature of Armstrong’s broader metaphysics or with essential features of his account of laws (or both). (shrink)

The paper develops a preliminary framework for confronting poverty within the Eastern Orthodox Christian tradition. In the first section, I draw on St. Gregory of Nazianzus’s Oration 14 to discuss what is called the stigma of poverty. Although stigmatization is not essentially linked to everyday economic poverty, poor people as such are often subjected to stigmatization. For example, disaffiliation grounded in social rejection was often a distinguishing mark between pôtchos and penês. Moreover, stigmatization in itself constitutes its own form of (...) poverty since those who are stigmatized are imputed to be fundamentally impoverished or defective as person. In the second section, I focus on the writings of St. John Chrysostom and argue that the central problem for Chrysostom is not poverty but wealth, or more properly the ways in which we acquire and use wealth and the ends to which it is put. Put simply, for Chrysostom, a critical, engaged and spiritual response to poverty presupposes a critical and spiritual response to wealth. (shrink)