Background While prenatal surgery historically was performed exclusively for lethal conditions, today intrauterine surgery is also performed to decrease postnatal disabilities for non-lethal conditions. We sought to describe physicians' attitudes about prenatal surgery for lethal and non-lethal conditions and to elucidate characteristics associated with these attitudes. Methods Survey of 1200 paediatric surgeons, neonatologists and maternal–fetal medicine specialists. Results Of 1176 eligible physicians, 670 responded. In the setting of a lethal condition for which prenatal surgery would likely result in the child (...) surviving with a severe disability, most respondents either disagreed or strongly disagreed that they would recommend the surgery. Male physicians were twice as likely to recommend surgery for the lethal condition, as were physicians who believe that abortion is morally wrong. Older physicians were less likely to recommend surgery. For non-lethal conditions, most respondents agreed that they would recommend prenatal surgery, even if the surgery increases the risk of prematurity or fetal death. Compared with MFMs, surgeons were less likely to recommend such surgery, as were physicians not affiliated with a fetal centre, and physicians who were religious. Conclusion Physician’s attitudes about prenatal surgery relate to physicians’ beliefs about disability as well as demographic, cultural and religious characteristics. Given the variety of views, parents are likely to receive different recommendations from their doctors about the preferable treatment choice. (shrink)

Evolutionary developmental biology (evo-devo) has undergone dramatic transformations since its emergence as a distinct discipline. This paper aims to highlight the scope, power, and future promise of evo-devo to transform and unify diverse aspects of biology. We articulate key questions at the core of eleven biological disciplines—from Evolution, Development, Paleontology, and Neurobiology to Cellular and Molecular Biology, Quantitative Genetics, Human Diseases, Ecology, Agriculture and Science Education, and lastly, Evolutionary Developmental Biology itself—and discuss why evo-devo is uniquely situated to substantially improve (...) our ability to find meaningful answers to these fundamental questions. We posit that the tools, concepts, and ways of thinking developed by evo-devo have profound potential to advance, integrate, and unify biological sciences as well as inform policy decisions and illuminate science education. We look to the next generation of evolutionary developmental biologists to help shape this process as we confront the scientific challenges of the 21st century. (shrink)

Scapula mobility complicates upper extremity kinematics assessment. Existing methods are diverse, providing inconsistent results. The current gold standard (bone pins) is prohibitively invasive. The purposes of the current study are to describe a virtual projection alternative to surface markers for video motion capture (VMC) of the scapula and to compare the results of the projection and surface marker methods to the results of similar existing methods. Ten participants were evaluated using VMC. Surface markers were applied to the trunk and arm (...) in accordance with existing guidelines. Three markers were affixed to plastic base on the skin over the acromion process. Other scapular landmarks were digitized in a neutral position. These landmarks’ locations were defined in reference to the acromion cluster and used to generate the projection. Humerothoracic, glenohumeral, and scapulothoracic kinematics were evaluated during shoulder abduction, flexion, and scaption. Joint angles produced by the surface markers and the projection were compared by Bonferroni-adjusted t tests. The results were compared to prior findings in the literature. The projection resulted in greater scapulothoracic upward rotation, internal rotation, and anterior–posterior tilt and less glenohumeral elevation (p <.0055) than did surface markers. The virtual scapula produced greater estimates of scapular mobility than did surface markers, corresponding to pre-existing results from similar methodologies. The result is a noninvasive measurement tool that produces different and superior results than do scapula surface markers. Measuring scapula kinematics via VMC without bone pins will facilitate future investigations into interactions between upper extremity injury, kinematics, and activity performance. (shrink)

The negative emotions generated following stressful life events can increase one’s risk of depressive symptoms and promote higher levels of perceived stress. The process model of emotion regulation can help distinguish between adaptive and maladaptive emotion regulation strategies to determine who may be at the greatest risk of worse psychological health across the lifespan. Heart rate variability may affect these relationships as it indexes aspects of self-regulation, including emotion and behavioral regulation, that enable an individual to dynamically adapt to the (...) changing demands of both internal and external environments. In this study, we expected individual differences in resting vagally mediated HRV to moderate the influence of emotion regulatory strategies among our sample of 267 adults. We found support for the hypothesis that higher vagally mediated HRV buffers against the typical adverse effects of expressive suppression when evaluating depressive symptoms and found weak support when considering perceived stress. There was no evidence for an interaction between cognitive reappraisal and vagally mediated HRV but there was a significant, negative association between cognitive reappraisal and depressive symptoms and perceived stress. Future work may determine if intervening on either emotion regulation strategies or HRV may change these within-persons over time. (shrink)

About 6% of women in the world live in countries that ban all abortions, and 34% in countries that only allow abortion to preserve maternal life or health. In the USA, over the last decades—even before Dobbs v. Jackson Women’s Health Organization overturned the federal right to abortion—various states have sought to restrict abortion access. Often times, this legislation has been advanced based on legislators’ personal moral values. At the bedside, in contrast, provision of abortion care should adhere to the (...) normative principles of medical ethics and reproductive justice, centreing patients and their individual reproductive intentions and desires. Abortion regulations, through their influence on patients and providers, may facilitate or impede such ethical care at the bedside. In this paper, we present a framework to model how abortion legislation should fit into the patient–provider relationship and to clarify the dynamics by which legislation may affect healthcare encounters. Our proposed framework serves as a tool to analyse the ethical impact of abortion regulations. We propose a model for assessing abortion policies based not on legislators’ or advocates’ individual moral claims, but on the shared, normative framework of clinical medical ethics. Through contrasting case studies, we demonstrate how a robust normative ethical framework can recentre patients and their reproductive needs. Our model is one way to account for—and safeguard—patients’ diverse viewpoints and needs in the development of abortion policy, and it can serve to ground narratives for advocacy by healthcare workers and their professional organisations. (shrink)

Wood, Kressel, Joshi, and Louie thoroughly evaluate the evidence for menstrual cycle shifts in ratings of several male characteristics and conclude that their analyses fail to provide supportive evidence for consistent cycle effects. The topic of menstrual cycle shifts in mate preferences has been strongly debated, with disagreements over both scientific content and practice. Here, we attempt to take a step back from these acrimonious exchanges and focus instead on how to interpret menstrual cycle shifts in mate preference tasks, independently (...) from the question of when, or if, task performance varies with cycle stage. A greater consideration of domain-general mechanisms could provide an opportunity for investigating how evolved predispositions interact with socially transmitted information in biasing women’s responses on mate preference tasks. (shrink)

Background: Since the passage of the Patient Self-Determination Act, numerous policy mandates and institutional measures have been implemented. It is unknown to what extent those measures have affected end-of-life care, particularly with regard to the do-not-resuscitate order.Methods: Retrospective cohort study to assess associations of the frequency and timing of DNR orders with advance directive status, patient demographics, physician’s specialty and extent of documentation of discussion on end-of-life care.Results: DNR orders were more frequent for patients on a medical service than on (...) a surgical service and were made earlier in the hospital stay for medicine than for surgical patients . 22.18% of all patients had some form of an advance directive in their chart, yet this variable had no impact on the frequency or timing of DNR ordering. Documentation of DNR discussion was significantly associated with the frequency of DNR orders and the time from DNR to death .Conclusions: The physician’s specialty continues to have a significant impact on the frequency and timing of DNR orders, while advance directive status still has no measurable impact. Additionally, documentation of end-of-life discussions is significantly associated with varying DNR ordering rates and timing. (shrink)

This paper proposes a new definition of vocation that honors the concept’s ancient roots, is consistent with how the term is used in modern contexts, and also expands the concept for greater versatility. We discuss the centrality of service in the concept of vocation locating it as part of the bridge between a student’s core values and their embodiment in community life. The commitment to one’s profession begins before independent status as a practitioner of that profession. It begins in training (...) during which service-learning is a laudable and increasingly popular way to connect to the charitable aspects of professionalism. We further discuss how the concept of vocation is especially appropriate in the context of citizenship. Citizenship is a way of belonging to a community. It is a relationship that requires giving and taking. Service-learning is an ideal way to practice good citizenship on a local scale, and prepare future professionals for understanding their communities and commitments morebroadly. We discuss how these concepts are being emphasized in the medical informatics master’s degree program at Saint Louis University through the incorporation of a service-learning module. We describe the module, discussing how it can be applied to curricula at other institutions and modified for inclusion in other types of courses. (shrink)

This paper proposes a new definition of vocation that honors the concept’s ancient roots, is consistent with how the term is used in modern contexts, and also expands the concept for greater versatility. We discuss the centrality of service in the concept of vocation locating it as part of the bridge between a student’s core values and their embodiment in community life. The commitment to one’s profession begins before independent status as a practitioner of that profession. It begins in training (...) during which service-learning is a laudable and increasingly popular way to connect to the charitable aspects of professionalism. We further discuss how the concept of vocation is especially appropriate in the context of citizenship. Citizenship is a way of belonging to a community. It is a relationship that requires giving and taking. Service-learning is an ideal way to practice good citizenship on a local scale, and prepare future professionals for understanding their communities and commitments morebroadly. We discuss how these concepts are being emphasized in the medical informatics master’s degree program at Saint Louis University through the incorporation of a service-learning module. We describe the module, discussing how it can be applied to curricula at other institutions and modified for inclusion in other types of courses. (shrink)

1 Evidence-based policy requires researchers to provide the answers to ecological questions that are of interest to policy makers. To find out what those questions are in the UK, representatives from 28 organizations involved in policy, together with scientists from 10 academic institutions, were asked to generate a list of questions from their organizations. 2 During a 2-day workshop the initial list of 1003 questions generated from consulting at least 654 policy makers and academics was used as a basis for (...) generating a short list of 100 questions of significant policy relevance. Short-listing was decided on the basis of the preferences of the representatives from the policy-led organizations. 3 The areas covered included most major issues of environmental concern in the UK, including agriculture, marine fisheries, climate change, ecosystem function and land management. 4 The most striking outcome was the preference for general questions rather than narrow ones. The reason is that policy is driven by broad issues rather than specific ones. In contrast, scientists are frequently best equipped to answer specific questions. This means that it may be necessary to extract the underpinning specific question before researchers can proceed. 5 Synthesis and applications. Greater communication between policy makers and scientists is required in order to ensure that applied ecologists are dealing with issues in a way that can feed into policy. It is particularly important that applied ecologists emphasize the generic value of their work wherever possible. (shrink)

This chapter describes the potential far‐reaching consequences of contemplative higher education for the fields of science and medicine.

In recent years, we have seen a new concern with ethics training for research and development professionals. Although ethics training has become more common, the effectiveness of the training being provided is open to question. In the present effort, a new ethics training course was developed that stresses the importance of the strategies people apply to make sense of ethical problems. The effectiveness of this training was assessed in a sample of 59 doctoral students working in the biological and social (...) sciences using a pre–post design with follow-up and a series of ethical decision-making measures serving as the outcome variable. Results showed not only that this training led to sizable gains in ethical decision making but also that these gains were maintained over time. The implications of these findings for ethics training in the sciences are discussed. (shrink)

‘Menander has set up a confrontation between this law [the law about epikleroi] and love… He wants the audience to regard the law as stupid and wrong… Surely one of Menander's purposes in writing this play was to make the Athenians consider seriously whether the law ought to be changed.’ Thus Professor D. M. MacDowell in the concluding paragraph of his article ‘Love versus the Law: an Essay on Menander's Aspis’. A similar view was already implicit in E. Karabelias' treatment (...) of the play as indicative of the general attitude to this law in Athens in Menander's day: ‘A n'en point douter, l'épiclérat est ressenti, á l'epoque de Ménandre, comme une anomalie intolérable pour les mceurs de la societe athénienne à la fin du ive s.av.n.è L'épiclérat est odieux et ridicule… L'hostilité envers l'épiclérat est done un signe des temps’. And Professor E. G. Turner has written: ‘it is hard to imagine that the institution of the epiclerate emerged in good standing from this derisory treatment’. (shrink)

We report the identification of a recurrent, 520-kb 16p12.1 microdeletion associated with childhood developmental delay. The microdeletion was detected in 20 of 11,873 cases compared with 2 of 8,540 controls and replicated in a second series of 22 of 9,254 cases compared with 6 of 6,299 controls. Most deletions were inherited, with carrier parents likely to manifest neuropsychiatric phenotypes compared to non-carrier parents. Probands were more likely to carry an additional large copy-number variant when compared to matched controls. The clinical (...) features of individuals with two mutations were distinct from and/or more severe than those of individuals carrying only the co-occurring mutation. Our data support a two-hit model in which the 16p12.1 microdeletion both predisposes to neuropsychiatric phenotypes as a single event and exacerbates neurodevelopmental phenotypes in association with other large deletions or duplications. Analysis of other microdeletions with variable expressivity indicates that this two-hit model might be more generally applicable to neuropsychiatric disease. © 2010 Nature America, Inc. All rights reserved. (shrink)

‘Menander has set up a confrontation between this law [the law about epikleroi] and love… He wants the audience to regard the law as stupid and wrong… Surely one of Menander's purposes in writing this play was to make the Athenians consider seriously whether the law ought to be changed.’ Thus Professor D. M. MacDowell in the concluding paragraph of his article ‘Love versus the Law: an Essay on Menander's Aspis’. A similar view was already implicit in E. Karabelias' treatment (...) of the play as indicative of the general attitude to this law in Athens in Menander's day: ‘A n'en point douter, l'épiclérat est ressenti, á l'epoque de Ménandre, comme une anomalie intolérable pour les mceurs de la societe athénienne à la fin du ive s.av.n.è L'épiclérat est odieux et ridicule… L'hostilité envers l'épiclérat est done un signe des temps’. And Professor E. G. Turner has written: ‘it is hard to imagine that the institution of the epiclerate emerged in good standing from this derisory treatment’. (shrink)

Aggleton & Brown argue that a hippocampal-anterior thalamic system supports the “recollection” of contextual information about previous events, and that a separate perirhinal-medial dorsal thalamic system supports detection of stimulus “familiarity.” Although there is a growing body of human literature that is in agreement with these claims, when recollection and familiarity have been examined in amnesics using the process dissociation or the remember/know procedures, the results do not seem to provide consistent support. We reexamine these studies and describe the (...) results of an additional experiment using a receiver operating characteristic (ROC) technique. The results of the reanalysis and the ROC experiment are consistent with Aggleton & Brown's proposal. Patients with damage to both regions exhibit severe deficits in recollection and smaller, but consistent, deficits in familiarity. (shrink)

This article is part of a For-Discussion-Section of Methods of Information in Medicine about the paper "Biomedical Informatics: We Are What We Publish", written by Peter L. Elkin, Steven H. Brown, and Graham Wright. It is introduced by an editorial. This article contains the combined commentaries invited to independently comment on the Elkin et al. paper. In subsequent issues the discussion can continue through letters to the editor.

ABSTRACT The First British New Left formed around two journals, The New Reasoner edited by E.P.Thompson and John Saville, and the Universities and Left Review edited by Stuart Hall, Gabriel Pearson, Raphael Samuel and Charles Taylor. Both sought a ‘new’ socialism which, based on a loose concept of socialist humanism, restored the role of the individual and revitalised a popular left movement. Early commentators critiqued its lack of robust theory and organisational structure. More recently, others have proposed that, particularly amongst (...) the ULR cohort, with this ‘new’ socialism emerged a ‘new’ activist politics. Building on this, I examine the ULR’s activism as a performative politics which stressed active participation over theory and dissolved any distinction between means and ends. Whilst Thompson and Hall have tended to be considered the main protagonists in shaping this, I argue that it was Samuel, an experienced organiser, who was most responsible for shaping their early agenda. His role has been neglected because he wrote no ‘position piece’ but, appropriately for an activist politics, expressed his ideas through his actions. ‘Reading’ his performances, then, illuminates more fully both the scope and the limits of this activist politics. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:242 HISTORY OF PHILOSOPHY his political and religious predispositions prodded him to demonstrate that the roots of modern science were in the Christian Middle Ages. Sarton's particular foibles are best understood by referring them to his pacifist commitments and the moralistic assumption that the values of science are transferable to other human endeavors. Categories such as inductivism, conventionalism and Popperianism are of little help in gaining historical understanding. For (...) this, they are in fact Platonic ideals which have little heuristic value. I would venture that a truly historical historiography of science would aid us in spotting errors in the past and help us in the future. My guess is that a good analysis would reveal a major source of trouble to have stemmed from preconceived notions which the history of science was meant to illustrate. Surely some of them have been philosophical in character, and even Baconian or conventionalist. But until recent times, most of these preconceptions have stemmed from religious, nationalistic, or personal motivations, or from scientists who wanted support for a particular concept. I agree with Agassi only in the suggestion that a parti pris was at the root of our troubles. Why, then, substitute a Popperian preconception for a conventionalist one? Why not, on the contrary, combat their distorting influence and reduce their impact? This is in fact what has happened in recent times. As the history of science has fallen into the hands of a gradually organized profession, the blatant motivations --of any type--which colored past historical writings have slowly receded. By a constant and critical confrontation of opposing views among specialists, the purpose for examining the history of science has slowly been transformed. The older external motivations have given way to an interest in the subject for its own sake and a gradual transformation has been in the making for the last few decades. As happens in other human endeavors, professionalization has already raised the standards in the discipline and there is every reason to think it will continue to do so in the future. We need not really be as pessimistic as Agassi, nor embrace his particular salvation. ROGEa HAm~ University o] Cali]ornia, Berkeley A MEDIEVAL ANALYSIS OF INFINITY IN THE COURSEof arguing that time must have had a beginning, St. Bonaventure (1221-74) put forward a demonstration which in some ways seems to anticipate Cantor's definition of infinity.1 Bonaventure pointed out that, if the world were infinitely old, then there would have been an infinite number of annual revolutions of the sun around the ecliptic. But during each such period there occur (roughly) twelve revolutions of the moon, i.e. lunar months or lunations. Thus there would be one infinity which was twelve times another--which, says Bonaventure, is impossible. This attempted proof might be formulated as the following For other adumbrationsof this definition,see I. Thomas,"A TwelfthCentury Paradoxof the Infinite,"Journal o] Symbolic Logic, XXIII (1958), 133-134, and W. & M. Kneale, The Development of Logic (Oxford,1962),p. 440. NOTES AND DISCUSSIONS 243 reductio ad absurdum, in which a revolution of the sun is specified as the period between successive vernal equinoxes. If there could be an infinite set of past lunations, then clearly it could be put in a one-to-one correspondence with a proper sub-set of itself--viz., with the set of past lunar months during which vernal equinoxes occurred. But this consequence is preposterous; no set could be so correlated with its own sub-set. Therefore the set of past lunar months cannot be infinite, and the world must have had a beginning. The passage, which is found in Bonaventure's commentary on the Sentences of Peter Lombard, reads as follows :2 Si mundus est aeternus, revolutiones solis in orbe suo sunt infmitae ; rursus, pro una revolutions solis necesse est fuisse duodecim ipsius lunae: ergo plus revoluta est luna quam sol; et sol infinities: ergo infinitorum ex ea parle, qua infinita sunt, est reperire excessum. Hoe autem est impossibile : ergo etc. PA~-r~asoN BROWN Harpur College, State University o] New York Sententiarum L/b. H, Dist. I, P.I, Art. I, Quaest. II, as found in S. Bonaventurme, Opera Omnla... (shrink)

Boghossian has argued that Putnam's externalism is incompatible with privileged access, i.e., the claim that a subject can have nonempirical knowledge of her thought contents ('What the externalist can know a priori', PAS 1997). Boghossian's argument assumes that Oscar can know a priori that (1) 'water' aims to name a natural kind; and (2) 'water' expresses an atomic concept. However, I show that if Burge's externalism is correct, then these assumptions may well be false. This leaves Boghossian with two options: (...) (a) (heroically) to show that Burge's externalism is false; or (b) to reformulate the argument such that it does not require the two assumptions in question. I suggest one way of reformulating the argument. (shrink)

© 2017. The American Astronomical Society. All rights reserved.We present new observations of the low-mass companion to HD 984 taken with the Gemini Planet Imager as a part of the GPI Exoplanet Survey campaign. Images of HD 984 B were obtained in the J and H bands. Combined with archival epochs from 2012 and 2014, we fit the first orbit to the companion to find an 18 au orbit with a 68% confidence interval between 14 and 28 au, an eccentricity (...) of 0.18 with a 68% confidence interval between 0.05 and 0.47, and an inclination of 119°with a 68% confidence interval between 114°and 125°. To address the considerable spectral covariance in both spectra, we present a method of splitting the spectra into low and high frequencies to analyze the spectral structure at different spatial frequencies with the proper spectral noise correlation. Using the split spectra, we compare them to known spectral types using field brown dwarf and low-mass star spectra and find a best-fit match of a field gravity M6.5 ±1.5 spectral type with a corresponding temperature of K. Photometry of the companion yields a luminosity of log=2.88 ± 0.07 dex with DUSTY models. Mass estimates, again from DUSTY models, find an age-dependent mass of 34 ±1 to 95 ±4 M Jup. These results are consistent with previous measurements of the object. (shrink)