Decompressive craniectomy is a technically straightforward procedure whereby a large section of the cranium is temporarily removed in cases where the intracranial pressure is dangerously high. While its use has been described for a number of conditions, it is increasingly used in the context of severe head injury. As the use of the procedure increases, a significant number of patients may survive a severe head injury who otherwise would have died. Unfortunately some of these patients will be left severely disabled; (...) a condition likened to the RUB, an acronym for the Risk of Unacceptable Badness. Until recently it has been difficult to predict this outcome, however an accurate prediction model has been developed and this has been applied to a large cohort of patients in Western Australia. It is possible to compare the predicted outcome with the observed outcome at 18 months within this cohort. By using predicted and observed outcome data this paper considers the ethical implications in three cases of differing severity of head injury in view of the fact that it is possible to calculate the RUB for each case. (shrink)

This report describes the rationale, approaches, organization, and resource development leading to a large-scale deletion bin map of the hexaploid wheat genome. Accompanying reports in this issue detail results from chromosome bin-mapping of expressed sequence tags representing genes onto the seven homoeologous chromosome groups and a global analysis of the entire mapped wheat EST data set. Among the resources developed were the first extensive public wheat EST collection. Described are protocols for sequencing, sequence processing, EST nomenclature, and the assembly of (...) ESTs into contigs. These contigs plus singletons were used for selection of distinct sequence motif unigenes. Selected ESTs were rearrayed, validated by 5′ and 3′ sequencing, and amplified for probing a series of wheat aneuploid and deletion stocks. Images and data for all Southern hybridizations were deposited in databases and were used by the coordinators for each of the seven homoeologous chromosome groups to validate the mapping results. Results from this project have established the foundation for future developments in wheat genomics. (shrink)

The rule of rescue describes the powerful human proclivity to rescue identified endangered lives, regardless of cost or risk. Deciding whether or not to perform a decompressive craniectomy as a life-saving or ‘rescue’ procedure for a young person with a severe traumatic brain injury provides a good example of the ethical tensions that occur in these situations. Unfortunately, there comes a point when the primary brain injury is so severe that if the patient survives they are likely to remain severely (...) disabled and fully dependent. The health resource implications of this outcome are significant. By using a web-based outcome prediction model this study compares the long-term outcome and designation of two groups of patients. One group had a very severe injury as adjudged by the model and the other group a less severe injury. At 18 month follow-up there were significant differences in outcome and healthcare requirements. This raises important ethical issues when considering life-saving but non-restorative surgical intervention. The discussion about realistic outcome cannot be dichotomised into simply life or death so that the outcome for the patient must enter the equation. As in other ‘rescue situations’, the utility of the procedure cannot be rationalised on a mere cost–benefit analysis. A compromise has to be reached to determine at what point either the likely outcome would be unacceptable to the person on whom the procedure is being performed or the social utility gained from the rule of rescue intervention fails to justify the utilitarian value and justice of equitable resource allocation. (shrink)

Tüm dünyayı etkisi altına alan koronavirüs pandemisinin siyasi tutumlarla ilişkisini öğrenmek ve siyasetin kriz durumlarında halkın tutum ve davranışlarını yönlendirip yönlendirmediğini öğrenmek amacıyla 767 kişiyle çevrimiçi anket yapılmıştır. Yapılan nicel araştırma sonucunda, alınan önleyici tedbirlere uymanın, bu tedbirlerin yerinde oluşuna/haklılığına olan tutumun, aşı olma niyetinin ve aşının koruyuculuğuna olan inancın siyasi görüşlere göre farklılaştığı bulunmuştur. Ayrıca katılımcıların yapılan Covid-19 açıklamaları bakımından siyasi partilerine, parti temsilcilerinden daha çok güvendikleri, alınan önlem ve tedbirleri kısmen yerinde/haklı buldukları ve çok büyük çoğunluğun bu önlemlere (...) uyduğu görülmüştür. Araştırma sonucunda virüsün kökenine yönelik inançlar bakımından virüsün gerçek olduğuna inanıldığı, ortaya çıkış nedeni bakımından ise ülkelerin ekonomilerini kötüleştirmek ve dünya nüfusunu azaltmak için ortaya çıktığına inanıldığı görülmüştür. Araştırmadan çıkan bir başka sonuç ise katılımcıların televizyon, dergi ve gazetelerin ideolojik nedenlerle ve siyasi yanlılıklarına bağlı olarak virüs haberlerini halka farklı yansıttığını düşündükleridir. Sosyal medyadaki haberlerin ise yanıltıcı, yanlış olduğu görüşündelerdir. Bu çalışma sonucunda salgın hastalık, afet, savaş, ekonomik krizler gibi olağanüstü durumlarda siyasetin, siyasi görüşlerin dikkate alınmasının hem krizin üstesinden gelmede hem de toplumun tüm üyelerini kapsamada önemli bir rol oynayacağı vurgulanmaktadır. (shrink)

Objective: Ethical guidelines are designed to ensure benefits, protection and respect of participants in clinical research. Clinical trials must now be registered on open-access databases and provide details on ethical considerations. This systematic survey aimed to determine the extent to which recently registered clinical trials report the use of standard of care and post-trial obligations in trial registries, and whether trial characteristics vary according to setting. Methods: We selected global randomized trials registered on http://www.clinicaltrials.gov and http://www.controlled-trials.com. We searched for intervention (...) trials of HIV/AIDS, malaria, and tuberculosis from 9 October 2004, the date of the most recent version of the Helsinki Declaration, to 10 April 2007. Results: We collected data from 312 trials. Fifty-eight percent (58%, 95% CI = 53 to 64) of trial protocols report informed consent. Fifty-eight percent (58%, 95% CI = 53 to 64) of trials report active controls. Almost no trials (1%, 95% CI = 0.5 to 3) mention post-trial provisions. Most trials measure surrogate outcomes. Twenty percent (20%, 95% CI = 16 to 25) of trials measure patient-important outcomes, such as death; and the odds that these outcomes are in a low income country are five times greater than for a developed country (odds ratio (OR) 5.03, 95% CI = 2.70 to 9.35, p = < 0.001). Pharmaceutical companies are involved in 28% (CI = 23 to 33) of trials and measure surrogate outcomes more often than nonpharmaceutical companies (OR 2.45, 95% CI = 1.18 to 5.09, p = 0.31). Conclusion: We found a large discrepancy in the quality of reporting and approaches used in trials in developing settings compared to wealthier settings. (shrink)

pain' and ┌I think that p┐ express the pain and the thought that p, themselves. The book is most impressive. It is packed with careful argument, and addresses a remarkable range of important issues about the mind. I have very much enjoyed studying it.

These remarks, which span the last eighteen months of Wittgenstein’s life, extend several of his well known themes from his so-called "later" writings. One such theme, which occurs as a unifying leitmotiv in this work, is that philosophical puzzlement arises from a failure to realize the indefiniteness and complexity of our concepts. Herein it takes the form of the claim that we have not one but several concepts of color. In fact, we have as many concepts of color as we (...) have different methods for determining sameness of color. "The indefiniteness in the concept of color lies, above all, in the indefiniteness of the concept of the sameness of colors, i.e., of the methods of comparing colors". E.g., when I say of two objects that they have the same color I could mean, among other things, that they visually appear to be similar or that their surfaces are painted with similarly tinted paints. Another prominent theme, which runs throughout all of his writings, both early and late, is the employment of a linguistic or grammatical theory of necessity for the purpose of refuting claims to have synthetic a priori knowledge. Herein it is phenomenology which is put in its place, its claims turning out to be only an "analysis of concepts that can neither agree with nor contradict physics". The indefiniteness in our concept of color helps spawn the illusion of such exalted knowledge, because it enables us to use a single sentence, on some occasions, to express a norm or convention of language and, on others, to report experience. "Sentences are often used on the borderline between logic and the empirical, so that their meaning changes back and forth and they count now as expressions of norms, now as expressions of experience". Considerable space is devoted to showing that the sentence "A body cannot seem to be both white and transparent" is used in the former way. While Wittgenstein succeeds in saying many interesting and original things about color, his remarks do not give any further clarification to the underlying themes, such as the two above, which he deploys in this area.—R.M.G. (shrink)

Cognition or higher brain activity is sometimes seen as a phenomenon greater than the sum of its parts. This viewpoint however is largely dependent on the state of the art of experimental techniques that endeavor to characterize morphology and its association to function. Retinal ganglion cells are readily accessible for this work and we discuss recent advances in computational techniques in identifying novel parameters that describe structural attributes possibly associated with specific function. These parameters are based on calculating wavelet gradients (...) from cell images followed by the extraction of meaningful measures including 2nd wavelet moment, entropy of orientation, and curvature. For the three cell types analyzed, the mean 2nd wavelet moment, which relates to the field of influence of the dendritic-tree segments was significantly different. cells had the highest mean 2nd wavelet moment, followed by the and cells (134 ± 22, 93 ± 19 and 63 ± 12, respectively). There was no significant difference between cells for entropy of orientation, indicating no class with a preferential orientation of their dendritic tree. Curvature provided similar results to the 2nd wavelet moment with cells having the highest curvature followed by and the cells (mean ± SD: 161 ± 15; 134 ± 22; 121 ± 15). Our feature space analysis also indicated a difference between these cell types. No difference was found between the and cell types and their physiological counterparts the Y and X cells based on wavelet analysis. Both the X and Y cells can be divided into two subtypes, the ON- and OFF-center cells based on the stratification level of the dendritic tree within the retina. Using 2nd wavelet moment, a difference in their morphological attributes, not reported previously, was noted for these subtypes. The 2nd wavelet moment and curvature are further discussed with respect to explaining regularity of spacing and coverage associated with retinal ganglion cell mosaics. (shrink)

The rôle of mathematical models in growth studies is discussed and a distinction made between the structural and descriptive aspects of a mathematical formulation. A simple scheme is set up to represent in broad outline the simultaneous growth and interaction of larval and adult systems inMyrmica rubra and is matched against observed results.

The paper addresses the use of heterogeneous ensembles of intelligent unmanned vehicles in such a perspective field of innovations as an unmanned fishery. The issues of joint activity of unmanned vehicles of different types in fishing operations based on intelligent technologies are investigated. The “smart fishing” approach based on the joint fishing operation model is proposed. The operational framework that includes missions, roles, and activity scenarios embedded in the discretized spatial model is presented. The scenario activities are considered as the (...) sequences of pentad that determine executing specific functions concerning the specified waypoint, timepoints, and the states of vehicles. The definition of the plan as the scenario prototype that needs adjusting to the conditions of the situational context is proposed. The coordination problem regarding the joint activities of the unmanned vehicles and their scenarios is defined and the coordination framework based on the distributed common board model and coordination primitives is presented. The prototype of the intelligent scenario-based system including the implementation of both operational and coordination frameworks developed for the control of unmanned vehicles is described. This system makes unmanned vehicles capable to absorb all the latest advances in intelligent technologies to perform smart fishing operations jointly in a large heterogeneous group. The proposed approach to smart fishing using intelligent technologies makes it possible to detach fishermen from the fishing activities dangerous to their life and health, to reduce significantly poaching and illegal fishing, to increase the overall efficiency of fishing operations, and even to save the marine ecosystem. (shrink)

The debate about constructivism in physics has led to different kinds of questions that can be conventionally framed in two classes. One concerns the mathematics that is considered for the theoretical development of physics. The other is concerned with the experimental parts of physical theories. It is unnecessary to observe that the intersection between our two classes of problems is far from being empty. In this paper we will mainly deal with topics belonging to the second class. However, let us (...) briefly mention some important problems that have been debated in the framework of our first class. For instance, the following: to what extent do the undecidability and incompleteness results of classical mathematics affect fragments of physical theories, in such way as to have a “real physical meaning”? are the mathematical arguments that seem to be essential for physics justifiable in the framework of traditional mathematical constructivism?The first question has recently been investigated by Pitowski, Penrose, da Costa, Doria, Mundici, Svozil and others. As expected by most logicians, one can construct undecidable sentences whose physical meaning seems to be hardly questionable. This happens both in classical and in quantum mechanics. (shrink)