Short-term limb immobilization results in skeletal muscle decline, but the underlying mechanisms are incompletely understood. This study aimed to determine the neurophysiologic basis of immobilization-induced skeletal muscle decline, and whether repetitive Transcranial Magnetic Stimulation could prevent any decline. Twenty-four healthy young males underwent unilateral limb immobilization for 72 h. Subjects were randomized between daily rTMS using six 20 Hz pulse trains of 1.5 s duration with a 60 s inter-train-interval delivered at 90% resting Motor Threshold, or Sham rTMS throughout immobilization. (...) Maximal grip strength, EMG activity, arm volume, and composition were determined at 0 and 72 h. Motor Evoked Potentials were determined daily throughout immobilization to index motor excitability. Immobilization induced a significant reduction in motor excitability across time. The rTMS intervention increased motor excitability at 0 h. Despite daily rTMS treatment, there was still a significant reduction in motor excitability, loss in EMG activity, and a loss of maximal grip strength after immobilization. Interestingly, the increase in biceps and posterior forearm skinfold thickness with immobilization in Sham treatment was not observed following rTMS treatment. Reduced MEPs drive the loss of strength with immobilization. Repetitive Transcranial Magnetic Stimulation cannot prevent this loss of strength but further investigation and optimization of neuroplasticity protocols may have therapeutic benefit. (shrink)

Despite tributes paid to Fuller as an intellectual father of ADR, little attention has been paid within the ADR field to the broader interactionist vision that underlies Fuller’s discussion about process. A closer reading of Fuller’s study of mediation, however, reveals that he intended that study to substantiate his interactionist thesis about the nature of social ordering. He understood ordering to be generated by and to reflect a particular experience of social interaction. Fuller’s interactionist vision recognizes the creative, choice-making and (...) purposive dimensions of human reality, emphasizes participation as a normative criterion for institutional design, and gives rise to a pluralistic notion of power arrangements. It appears in Fuller’s thinking about process as a kind of dialectic and integrative mindset that pervades his means-ends analysis, functional analytical approach and his emphasis on institutional design. This interactionist vision has particular relevance for the practice and research of ADR, for example, in helping to develop a more integrative approach to process pluralism. (shrink)

It is traditionally believed that cerebral activation (the presence of low voltage fast electrical activity in the neocortex and rhythmical slow activity in the hippocampus) is correlated with arousal, while deactivation (the presence of large amplitude irregular slow waves or spindles in both the neocortex and the hippocampus) is correlated with sleep or coma. However, since there are many exceptions, these generalizations have only limited validity. Activated patterns occur in normal sleep (active or paradoxical sleep) and during states of anesthesia (...) and coma. Deactivated patterns occur, at times, during normal waking, or during behavior in awake animals treated with atropinic drugs. Also, the fact that patterns characteristic of sleep, arousal, and waking behavior continue in decorticate animals indicates that reticulo-cortical mechanisms are not essential for these aspects of behavior. (shrink)

The ectoplasmic specialization (ES) is a testis‐specific, actin‐based hybrid anchoring and tight junction. It is confined to the interface between Sertoli cells at the blood–testis barrier, known as the basal ES, as well as between Sertoli cells and developing spermatids designated the apical ES. The ES shares features of adherens junctions, tight junctions and focal contacts. By adopting the best features of each junction type, this hybrid nature of ES facilitates the extensive junction‐restructuring events in the seminiferous epithelium during spermatogenesis. (...) For instance, the α6β1‐integrin–laminin 333 complex, which is usually limited to the cell–matrix interface in other epithelia to facilitate cell movement, is a putative apical ES constituent. Furthermore, JAM‐C and CAR, two tight junction integral membrane proteins, are also components of apical ES involving in spermatid orientation. We discuss herein the mechanisms that maintain the cross‐talk between ES and blood–testis barrier to facilitate cell movement and orientation in the seminiferous epithelium. BioEssays 29: 36–48, 2007. © 2006 Wiley Periodicals, Inc. (shrink)

Bob Solomon used to inveigh against William James’ theory of emotions, but he eventually arrived at a rapprochement with James and James’s recent successors. In particular, James suggested that emotions are initiated by the “automatic, instinctive” appraisals that register important information in the body and are recorded by body-mapping brain areas. In recent work Solomon describes the judgments he thinks constitute emotions as felt bodily appraisals in similar fashion.

In this study, we investigated endorsement of two types of prescriptive views of aging, namely active aging and altruistic disengagement. The study comprised a large international sample of middle-aged and older adults, covering the age range from 40 to 90 years. Participants rated their personal endorsement of prescriptive views of active aging and altruistic disengagement targeting older adults in general. Findings showed that endorsement was higher for prescriptions for active aging than for prescriptions for altruistic disengagement. Age groups in the (...) sample differed regarding their endorsement of both prescriptive views of active aging and altruistic disengagement with older adults showing higher endorsement than middle-aged adults did. Prescriptive views of active aging and altruistic disengagement related positively to each other and to the superordinate social belief that older adults should not become a burden, which attests to their functional similarity. In contrast, prescriptive views of active aging and altruistic disengagement were associated with psychological adjustment in opposite ways, with endorsement of active aging being related to better adjustment outcomes such as life satisfaction and subjective health. Our findings highlight the internalization of prescriptive views of aging in older people and their implications for their development and well-being. (shrink)

This book gives a descriptive analysis of specific Madhyamika texts. It compares the ideology of Kumarajiva (a translator of the four Madhyamika treatises 400 A.D.) with the ideologies of the three Chinese contemporaries - HuiYuan, Seng-Jui and Seng-Chao. It envisages an intercultural transmission of religious and philosophical ideas from India to China.

Bullying often results in negative coping in victims, including an increased consumption of alcohol. Recently, however, an increase in alcohol use has also been reported among perpetrators of bullying. The factors triggering this pattern are still unclear. We investigated the role of empathy in the interaction between bullying and alcohol use in an adolescent sample (IMAGEN) at age 13.97 (±0.53) years (baseline (BL), N = 2165, 50.9% female) and age 16.51 (±0.61) years (follow-up 1 (FU1), N = 1185, 54.9% female). (...) General empathic distress served as a significant moderator of alcohol use in perpetrators (F9, 493 = 17.978, p < 0.01), which was specific for males and FU1. Male perpetrators, who are generally less sensitive to distress, might thus be more vulnerable to alcohol abuse. (shrink)

Systematic study of the intersection of ethics consultation services and solid organ transplants and recipients can identify and illustrate ethical issues that arise in the clinical care of these patients, including challenges beyond resource allocation. This was a single-centre, retrospective cohort study of all adult ethics consultations between January 1, 2007, and December 31, 2017, at a large academic medical centre in the north-eastern United States. Of the 880 ethics consultations, sixty (6.8 per cent ) involved solid organ transplant, thirty-nine (...) (65.0 per cent) for candidates and twenty-one (35.0 per cent ) for recipients. Ethics consultations were requested for 4.3 per cent of heart, 4.9 per cent of lung, 0.3 per cent of liver, and 0.3 per cent of kidney transplant recipients over the study period. Nurses were more likely to request ethics consultations for recipients than physicians (80.0 per cent vs 20.0 per cent, p = 0.006). The most common reason for consultation among transplant candidates was discussion about intensity of treatment or goals of care after the patient was not or was no longer a transplant candidate. The most common reason for ethics consultation among transplant recipients was disagreement between transplant providers and patients/families/non-transplant healthcare professionals over the appropriate intensity of treatment for recipients. Very few consultations involved questions about appropriate resource allocation. Ethics consultants involved in these cases most often navigated communication challenges between transplant and non-transplant healthcare professionals and patients and families. (shrink)

Critical care society guidelines recommend that ethics committees mediate intractable conflict over potentially inappropriate treatment, including Do Not Resuscitate status. There are, however, limited data on cases and circumstances in which ethics consultants recommend not offering cardiopulmonary resuscitation despite patient or surrogate requests and whether physicians follow these recommendations. This was a retrospective cohort of all adult patients at a large academic medical center for whom an ethics consult was requested for disagreement over DNR status. Patient demographic predictors of ethics (...) consult outcomes were analyzed. In 42 of the 116 cases, the patient or surrogate agreed to the clinician recommended DNR order following ethics consultation. In 72 of 74 of the remaining cases, ethics consultants recommended not offering CPR. Physicians went on to write a DNR order without patient/surrogate consent in 57 of those cases. There were no significant differences in age, race/ethnicity, country of origin, or functional status between patients where a DNR order was and was not placed without consent. Physicians were more likely to place a DNR order for patients believed to be imminently dying. The median time from DNR order to death was 4 days with a 90-day mortality of 88.2%. In this single-center cohort study, there was no evidence that patient demographic factors affected ethics consultants’ recommendation to withhold CPR despite patient/surrogate requests. Physicians were most likely to place a DNR order without consent for imminently dying patients. (shrink)

In recent years ethical discussion has centred round the problem of the relation between the idea of right and the idea of good. Previously it had been more or less generally assumed that moral philosophy was principally concerned with the idea of good, and followed its course by asking such questions as: What is the meaning of good? or, What are the characteristics which anything must have in order to be good? or even, What things are good? The idea of (...) right was generally regarded as subordinate, and it was perhaps more often implied than stated that an action was right if by it something good was realized. (shrink)

Modern ethics has been chiefly concerned with the analysis of the conditions and principles of morality; and, in particular, one of its most important achievements has been the further elucidation of the Kantian dictum that “I ought” implies that I can. On the face of it Kant's contention seems perfectly straightforward, but, on examination, it becomes apparent that the simple word “can” covers a somewhat complicated ambiguity. When it is said that I ought to do act A, it may rightly (...) be taken that I can do act A; but the question arises whether or not this in turn involves that I am aware that I can do act A. There is clearly some significance in the assertion that I can do many acts which, however, never occur to me, either because I am ignorant of certain facts or because I have a mistaken opinion about the facts. On the other hand, it may quite properly be said that I cannot perform any act of the possibility of which I am unaware. The problem then is to determine and examine the sense of the word “can” which is a pre-condition of moral obligation. (shrink)