About one third of patients with epilepsy have seizures refractory to the medical treatment. Electrical stimulation mapping is the gold standard for the identification of “eloquent” areas prior to resection of epileptogenic tissue. However, it is time-consuming and may cause undesired side effects. Broadband gamma activity recorded with extraoperative electrocorticography during cognitive tasks may be an alternative to ESM but until now has not proven of definitive clinical value. Considering their role in cognition, the alpha and beta bands could further (...) improve the identification of eloquent cortex. We compared gamma, alpha and beta activity, and their combinations for the identification of eloquent cortical areas defined by ESM. Ten patients with intractable focal epilepsy participated in a delayed-match-to-sample task, where syllable sounds were compared to visually presented letters. We used a generalized linear model approach to find the optimal weighting of each band for predicting ESM-defined categories and estimated the diagnostic ability by calculating the area under the receiver operating characteristic curve. Gamma activity increased more in eloquent than in non-eloquent areas, whereas alpha and beta power decreased more in eloquent areas. Diagnostic ability of each band was close to 0.7 for all bands but depended on multiple factors including the time period of the cognitive task, the location of the electrodes and the patient’s degree of attention to the stimulus. We show that diagnostic ability can be increased by 3–5% by combining gamma and alpha and by 7.5–11% when gamma and beta were combined. We then show how ECoG power modulation from cognitive testing can be used to map the probability of eloquence in individual patients and how this probability map can be used in clinical settings to optimize ESM planning. We conclude that the combination of gamma and beta power modulation during cognitive testing can contribute to the identification of eloquent areas prior to ESM in patients with refractory focal epilepsy. (shrink)

O presente trabalho busca evidenciar a concepção moral do Direito na doutrina do Direito de Kant, distinguindo as ideias que conceituam a diferença entre leis jurídicas e leis éticas, a partir das leis morais para tratar da concepção e o reconhecimento dos direitos de equidade e o de necessidade, por um lado, e a não realização desses direitos, por outro. O intuito do presente trabalho é mostrar a efetivação e validade do direito, tendo a base em Kant. PALAVRAS-CHAVE: Direito. Moral. (...) Kant. Validade do Direito. (shrink)

In this paper I will briefly discuss flourishing and freedom, relating them to health and disease; discuss the tensions between flourishing and freedom; and exemplify how those discussions are relevant to chronic disease suffering. The concept of freedom has significant connections with the concepts of health, disability and disease. Understanding disease and disability in terms of the loss of aspects of freedom may help our understanding of the suffering that arises from chronic disease. On the other hand, flourishing may require (...) a degree of adversity. Therefore disability and disease may be conducive to flourishing. Flourishing may be understood as subordinated to freedom, as a path to freedom, or as transcending freedom. It is suggested that freedom and flourishing are expressed as mutually enhancing cycles, actualized according to the personal circumstances that will ground their expression. In a distant horizon of innocent spontaneous self-expression, flourishing and freedom may become coincident. Regarding chronic disease as a constraint on ‘species-typical’ abilities to fulfill one’s significant life interests, as well as an unwanted intrusion into the patient’s life, presents chronic disease suffering as a loss of both positive and negative freedom. The conceptual relation between flourishing and freedom will thus organise the possibilities the sufferer sees as open to their self. (shrink)

Throughout about three decades of incessant research, the Austrian phenomenologist Alfred Schutz tried to specify the concept of meaning presented in an insufficient way by Max Weber in his famous definition of subjective action. Quickly, Schutz exceeded the methodological questions related with the foundation of Social Sciences, developing an elaborated reflection on the relations between Communication and Society. Along this text, are presented some particularly significant moments of this intellectual journey, such as the schtuzian reflection on intersubjectivity; the question of (...) communication as condition of possibility of the life-world, and, finally, the analysis of appresentational reference and the set of linguistic artefacts (marks, indications, signs and symbols) that allows man to deal with the experience of transcendence. (shrink)