A role of perirhinal cortex (PrC) in recognition memory for objects has been well established. Contributions of parahippocampal cortex (PhC) to this function, while documented, remain less well understood. Here, we used fMRI to examine whether the organization of item-based recognition memory signals across these two structures is shaped by object category, independent of any difference in representing episodic context. Guided by research suggesting that PhC plays a critical role in processing landmarks, we focused on three categories of objects that (...) differ from each other in their landmark suitability as confirmed with behavioral ratings (buildings > trees > aircraft). Participants made item-based recognition-memory decisions for novel and previously studied objects from these categories, which were matched in accuracy. Multi-voxel pattern classification revealed category-specific item-recognition memory signals along the long axis of PrC and PhC, with no sharp functional boundaries between these structures. Memory signals for buildings were observed in the mid to posterior extent of PhC, signals for trees in anterior to posterior segments of PhC, and signals for aircraft in mid to posterior aspects of PrC and the anterior extent of PhC. Notably, item-based memory signals for the category with highest landmark suitability ratings were observed only in those posterior segments of PhC that also allowed for classification of landmark suitability of objects when memory status was held constant. These findings provide new evidence in support of the notion that item-based memory signals for objects are not limited to PrC, and that the organization of these signals along the longitudinal axis that crosses PrC and PhC can be captured with reference to landmark suitability. (shrink)

In their article, Navin, Brummett, and Wasserman (2022) advance the idea that there are qualitatively different types of decision-making capacity (DMC) for treatment refusals. Departing from what t...

Volume 20, Issue 8, August 2020, Page 88-90.

Two reports have shown that mammalian artificial chromosomes (MAC) can be constructed from cloned human centromere DNA and telomere repeats, proving the principle that chromosomes can form from naked DNA molecules transfected into human cells. The MACs were mitotically stable, low copy number and bound antibodies associated with active centromeres. As a step toward second-generation MACs, yeast and bacterial cloning systems will have to be adapted to achieve large MAC constructs having a centromere, two telomeres, and genomic copies of mammalian (...) genes. Available construction techniques are discussed along with a new P1 artificial chromosome (PAC)-derived telomere vector (pTAT) that can be joined to other PACs in vitro, avoiding a cloning step during which large repetitive arrays often rearrange. The PAC system can be used as a route to further define the optimal DNA elements required for efficient MAC formation, to investigate the expression of genes on MACs, and possibly to develop efficient MAC-delivery protocols. BioEssays 1999;21:76–83. © 1999 John Wiley & Sons, Inc. (shrink)

This is the second paper in a two-part series describing subject and family perspectives from the CENTURY-S (CENtral Thalamic Deep Brain Stimulation for the Treatment of Traumatic Brain InjURY-Safety) first-in-human invasive neurological device trial to achieve cognitive restoration in moderate to severe traumatic brain injury (msTBI). To participate, subjects were independently assessed to formally establish decision-making capacity to provide voluntary informed consent. Here, we report on post-operative interviews conducted after a successful trial of thalamic stimulation. All five msTBI subjects met (...) a pre-selected primary endpoint of at least a 10% improvement in completion time on Trail-Making-Test Part B, a marker of executive function. We describe narrative responses of subjects and family members, refracted against that success. Interviews following surgery and the stimulation trial revealed the challenge of adaptation to improvements in cognitive function and emotional regulation as well as altered (and restored) relationships and family dynamics. These improvements exposed barriers to social reintegration made relevant by recoveries once thought inconceivable. The study’s success sparked concerns about post-trial access to implanted devices, financing of device maintenance, battery replacement, and on-going care. Most subjects and families identified the need for supportive counseling to adapt to the new trajectory of their lives. (shrink)

This is the first article in a two-part series describing subject and family perspectives from the central thalamic deep brain stimulation for the treatment of traumatic brain injury using the Medtronic PC + S first-in-human invasive neurological device trial to achieve cognitive restoration in moderate to severe traumatic brain injury, with subjects who were deemed capable of providing voluntary informed consent. In this article, we report on interviews conducted prior to surgery wherein we asked participants about their experiences recovering from (...) brain injury and their perspectives on study enrollment and participation. We asked how risks and benefits were weighed, what their expectations and fears were, and how decisions were reached about trial participation. We found that informed consent and enrollment decisions are fraught. Subjects and families were often split, with subjects more focused on putative benefits and families concerned about incremental risk. Both subjects and families viewed brain injury as disruptive to personal identity and relationships. As decisions were made about study enrollment, families struggled with recognizing the re-emergent agency of subjects and ceding decision-making authority to subjects who had previously been dependent upon them for protection and guidance. Subjects and family members reported a hope for the relief of cognitive disabilities, improved quality of life, normalization of interpersonal interactions, and a return to work or school as reasons for study participation, along with altruism and a desire to advance science. Despite these aspirations, both subjects and families appreciated the risks of the intervention and did not suffer from a therapeutic misconception. A second essay to be published in the next issue of Cambridge Quarterly of Healthcare Ethics—Clinical Neuroethics will describe interviews conducted after surgery, the effects of cognitive restoration for subjects, families, and challenges presented to the social structures they will call upon to support them through recovery. This subsequent article will be available online prior to its formal publication in October 2023. (shrink)

Persons with dementia often prefer to participate in decisions about their health care, but may be prevented from doing so because healthcare decision-making law facilitates use of advance directives or surrogate decision makers for persons with decisional impairments such as dementia. Federal and state disability law provide alternative decision-making models that do not prevent persons with mild to moderate dementia from making their own healthcare decisions at the time the decision needs to be made. In order to better promote autonomy (...) and wellbeing, persons with dementia should be accommodated and supported so they can make their own healthcare decisions. (shrink)

Shavelson and colleagues (2023) describe how medical aid-in-dying laws in the United States prohibit assistance in administering aid-in-dying medication. This prohibition distinguishes aid in dying...

The study examined the influence of the Pond Report on the teaching of medical ethics in the London medical schools. A questionnaire was given to both medical students and college officers. All medical colleges reported that ethics was included in the curriculum. However, from students' replies, it seems that attendance of optional courses is low and that not all current final year medical students have had any formal teaching in medical ethics. Stronger guidelines are necessary to ensure appropriate ethical training (...) in London medical schools. (shrink)

Philosophy as a way of life (PWOL) places investigations of value, meaning, and the good life at the center of philosophical investigation, especially of one’s own life. This essay argues that PWOL is compatible with general introductory philosophy courses, further arguing that PWOL‐based general introductions have several philosophical and pedagogical benefits. These include the ease with which high‐impact practices, situated skill development, and students’ ability to “think like a disciplinarian” may be incorporated into such courses, relative to more traditional introductory (...) courses, as well as the demonstration of philosophy’s value to students by explicitly tying philosophical investigation to students’ own lives. (shrink)

As improvements in neuroscience have enabled a better understanding of disorders of consciousness as well as methods to treat them, a hurdle that has become all too prevalent is the denial of coverage for treatment and rehabilitation services. In 2011, a settlement emerged from a Vermont District Court case, Jimmo v. Sebelius, which was brought to stop the use of an “improvement standard” that required tangible progress over an identifiable period of time for Medicare coverage of services. While the use (...) of this standard can have deleterious effects on those with many chronic conditions, it is especially burdensome for those in the minimally conscious state, where improvements are unpredictable and often not manifested through repeatable overt behaviors. Though the focus of this paper is on the challenges of brain injury and the minimally conscious state, which an estimated 100,000 to 200,000 individuals suffer from in the United States, the post-Jimmo arguments presented can and should have a broad impact as envisioned by the plaintiffs who brought the case on behalf of multiple advocacy groups representing patients with a range of chronic care conditions. (shrink)

Functionalists about truth employ Ramsification to produce an implicit definition of the theoretical term _true_, but doing so requires determining that the theory introducing that term is itself true. A variety of putative dissolutions to this problem of epistemic circularity are shown to be unsatisfactory. One solution is offered on functionalists' behalf, though it has the upshot that they must tread on their anti-pluralist commitments.

Discussion of supported decision making has been dominated by legal scholars, philosophers, and advocates for persons with disabilities. Peterson et al.’s primary contribution is introducing...

This is the first scholarly study of Atlas Shrugged, covering in detail the historical, literary, and philosophical aspects of Ayn Rand's magnum opus. Topics explored in depth include the history behind the novel's creation, publication, and reception; its nature as a romantic novel; and its presentation of a radical new philosophy.

The essays in this collection treat historical, literary, and philosophical topics related to Ayn Rand's Anthem, an anti-utopia fantasy set in the future. The first book-length study on Anthem, this collection covers subjects such as free will, political freedom, and the connection between freedom and individual thought and privacy.

Background:The severity of the Coronavirus pandemic has led to lockdowns in different countries to reduce the spread of the infection. These lockdown restrictions are likely to be detrimental to mental health and well-being in adolescents. Physical activity can be beneficial for mental health and well-being; however, research has yet to examine associations between adolescent physical activity and mental health and well-being during lockdown.Purpose:Examine the effects of adolescent perceived Coronavirus prevalence and fear on mental health and well-being and investigate the extent (...) to which physical activity can be a protective factor against these concerns.Methods:During United Kingdom lockdown restrictions, 165 participants (100 female, aged 13–19) completed an online questionnaire assessing perceived Coronavirus prevalence and fear, physical activity, and indicators of mental health and well-being (stress, anxiety, depression, fatigue, vitality, and perceived health). Separate hierarchical multiple linear regression analyses (with age, gender, perceived Coronavirus prevalence, and fear entered in step 1, and physical activity in step 2) were run to predict each well-being outcome.Results:Regression analyses indicated that in general, while Coronavirus fear was a negative predictor, physical activity was a positive and stronger predictor of enhanced mental health and well-being outcomes.Conclusion:Findings suggest that physical activity during the Coronavirus pandemic can counteract the negative effects of Coronavirus fear on adolescent mental health and well-being. Therefore, physical activity should be promoted during lockdown to support good mental health and well-being. (shrink)

Pickering, Newton-Howes, and Young assert that the traditional view of decisional capacity, premised on assessing patients’ abilities to communicate, understand, appreciate,...

Here, Bob Hale and Crispin Wright assemble the key writings that lead to their distinctive neo-Fregean approach to the philosophy of mathematics. In addition to fourteen previously published papers, the volume features a new paper on the Julius Caesar problem; a substantial new introduction mapping out the program and the contributions made to it by the various papers; a section explaining which issues most require further attention; and bibliographies of references and further useful sources. It will be recognized as the (...) most powerful presentation yet of a neo-Fregean program. (shrink)

Although it’s sometimes thought that pluralism about truth is unstable—or, worse, just a non-starter—it’s surprisingly difficult to locate collapsing arguments that conclusively demonstrate either its instability or its inability to get started. This paper exemplifies the point by examining three recent arguments to that effect. However, it ends with a cautionary tale; for pluralism may not be any better off than other traditional theories that face various technical objections, and may be worse off in facing them all.

Incapacitated adults with a legally appointed guardian or conservator may be recruited for or involved with medical, behavioral, or social science research. Much of the research in which such persons participate is aimed at evaluating medical interventions for them, or contributing to general knowledge about disorders from which they may suffer. In this paper we will consider how the appointment of guardians for patients with disorders of consciousness —severe brain injuries that affect a patient’s level of arousal and ability to (...) interact —impacts such patients’ access to research.Such persons may be under guardianship because they have lost decisional capacity (i.e., those in a coma or... (shrink)

This article proposes a theological emphasis to the definition of προσλαμβάνω in Romans 14–15. Previous accounts have emphasised the domestic and social implication of Paul's imperative—‘welcome one another’ (Rom. 15:7a). The result has been that what Paul might have meant by God's and Christ's ‘welcome’ (Rom. 14:3 and 15:7b) has been governed by the ethical imperative. In order to investigate the ‘welcome’ of God and Christ, this article proposes a context of three important Septuagintal antecedents as yet unconsidered: 1 Samuel (...) 12, Psalm 18, and Psalm 65: In this context, God's and Christ's ‘welcome’ in Rom. 14–15 incorporates notions of justification, election, salvation, and unified worship. A theological reading of προσλαμβάνω, using these intertextual resources, therefore provides a stronger position from which to understand Paul's imperative—‘welcome one another’. (shrink)

A growing body of empirical research suggests that people's concrete‐case intuitions are unstable—i.e., vulnerable to biasing influences—with no way of anticipating the instability. This has led some to challenge the use of intuitions in philosophical practice. In this chapter, I consider responses to this challenge. One is that the empirical research cited has no bearing on the epistemic status of intuitions because it fails to actually test intuitions. While this is a worry worth taking seriously, there is another response available—namely, (...) that even if we grant that these studies successfully elicited intuitions, in the midst of the instability uncovered there was also a fair amount of stability. And an investigation into the features of unstable vs. stable judgments, and the contexts within which they are generated, suggests that the instability in question may not actually be intuitional. (shrink)