Related Works: Part II: C. T. Chong, Yue Yang. $\Sigma_2$ Induction and Infinite Injury Priority Argument, Part II: Tame $\Sigma_2$ Coding and the Jump Operator. Ann. Pure Appl. Logic, vol. 87, no. 2, 103--116. Mathematical Reviews : MR1490049 Part III: C. T. Chong, Lei Qian, Theodore A. Slaman, Yue Yang. $\Sigma_2$ Induction and Infinite Injury Priority Argument, Part III: Prompt Sets, Minimal Paries and Shoenfield's Conjecture. Mathematical Reviews : MR1818378.
The immune system against tumors acts through a complex dynamical process showing a dual role. On the one hand, the immune system can activate some immune cells to kill tumor cells, such as cytotoxic T lymphocytes and natural killer cells, but on the other hand, more evidence shows that some immune cells can help tumor escape, such as regulatory T cells. In this paper, we propose a tumor immune interaction model based on Tregs-mediated tumor immune escape mechanism. When helper T (...) cells’ stimulation rate by the presence of identified tumor antigens is below critical value, the coexistence equilibrium is always stable in its existence region. When HTCs stimulation rate is higher than the critical value, the inhibition rate of effector cells by Tregs can destabilize the coexistence equilibrium and cause Hopf bifurcations and produce a limit cycle. This model shows that Tregs might play a crucial role in triggering the tumor immune escape. Furthermore, we introduce the adoptive cellular immunotherapy and monoclonal antibody immunotherapy as the treatment to boost the immune system to fight against tumors. The numerical results show that ACI can control TCs more, while MAI can delay the inhibitory effect of Tregs on ECs. The result also shows that the combination of both immunotherapies can control TCs and reduce the inhibitory effect of Tregs better than a single immunotherapy can control. (shrink)
Although many philosophers argue that making and revising moral decisions ought to be a matter of deliberating over reasons, the extent to which the consideration of reasons informs people’s moral decisions and prompts them to change their decisions remains unclear. Here, after making an initial decision in 2-option moral dilemmas, participants examined reasons for only the option initially chosen(affirming reasons), reasons for only the option not initially chosen (opposing reasons), or reasons for both options. Although participants were more likely to (...) change their initial decisions when presented with only opposing reasons compared with only affirming reasons, these effect sizes were consistently small. After evaluating reasons, participants were significantly more likely not to change their initial decisions than to change them, regardless of the set of reasons they considered. The initial decision accounted for most of the variance in predicting the final decision, whereas the reasons evaluated accounted for a relatively small proportion of the variance in predicting the final decision. This resistance to changing moral decisions is at least partly attributable to a biased, motivated evaluation of the available reasons: participants rated the reasons supporting their initial decisions more favorably than the reasons opposing their initial decisions, regardless of the reported strategy used to make the initial decision.Overall, our results suggest that the consideration of reasons rarely induces people to change their initial decisions in moral dilemmas. (shrink)
Children's utterances from late infancy to 3 years of age were examined to infer their conception of knowledge. In Study 1, the utterances of two English-speaking children were analysed and in Study 2, the utterances of a Mandarin-speaking child were analysed – in both studies, for their use of the verb know. Both studies confirmed that know and not know were used to affirm, query or deny knowledge, especially concerning an ongoing topic of conversation. References to a third party were (...) rare. By implication, 2-year-olds have a conception of knowledge that underpins their exchange of information in conversation. Implications for the child's developing theory of mind are discussed. (shrink)
Lachlan observed that any nonzero d.c.e. degree bounds a nonzero c.e. degree. In this paper, we study the c.e. predecessors of d.c.e. degrees, and prove that given a nonzero d.c.e. degree , there is a c.e. degree below and a high d.c.e. degree such that bounds all the c.e. degrees below . This result gives a unified approach to some seemingly unrelated results. In particular, it has the following two known theorems as corollaries: there is a low c.e. degree isolating (...) a high d.c.e. degree [S. Ishmukhametov, G. Wu, Isolation and the high/low hierarchy, Arch. Math. Logic 41 259–266]; there is a high d.c.e. degree bounding no minimal pairs [C.T. Chong, A. Li, Y. Yang, The existence of high nonbounding degrees in the difference hierarchy, Ann. Pure Appl. Logic 138 31–51]. (shrink)
Objectives: To quantify the use of do-not-resuscitate orders in a tertiary-care children’s hospital and to characterise the circumstances in which such orders are written.Design: Retrospective study conducted in a 500-bed children’s hospital in Taiwan.Patients: The course of 101 patients who died between January 2002 and December 2005 was reviewed. The following data were collected: age at death, gender, disease and its status, place of death and survival. There were 59 males and 42 females with a median age of 103 months (...) . 50 children had leukaemias, and 51 had malignancies other than leukaemia. The t test and the χ2 test were applied as appropriate.Results: The study found that 44% of patient deaths occurred in the paediatric oncology ward; 29% of patient deaths occurred in the intensive care unit; and 28% of patients died in their home or at another hospital. Other findings included the following: 46 of 101 patients died after attempted cardiopulmonary resuscitation and 55 died with a DNR order in effect. The mean age at death was 9.8 years in both groups with or without DNR orders.Conclusions: From the study of patient deaths in this tertiary-care children’s hospital, it was concluded that an explicit DNR order is now the rule rather than the exception, with more DNR orders being written for patients who have been ill longer, who have solid tumours, who are not in remission and who are in the ward. (shrink)
Social Trinitarianism is a family of views that bear some resemblance to each other in a way that distinguishes them from other Trinitarian accounts. In this paper, we address recent objections by Carl Mosser against ST, objections which have not received much attention by defenders of ST. Mosser claims that proponents of ST offer a narrative that is historically inaccurate, employs concepts of personhood and perichoresis that are incompatible, upholds dubious hermeneutical assumptions, and is unable to preclude Mormon theology within (...) its fold. We argue that all four criticisms fail, especially for a specific version of ST: Perichoretic Monotheism. (shrink)
We give a survey of the study of nonstandard models in recursion theory and reverse mathematics. We discuss the key notions and techniques in effective computability in nonstandard models, and their applications to problems concerning combinatorial principles in subsystems of second order arithmetic. Particular attention is given to principles related to Ramsey’s Theorem for Pairs.
Two isolated Neogene carbonate platforms have developed in the rifted uplifts since the Early Miocene. A large-scale submarine canyon system, the Zhongjian Canyon, has developed in the tectonic depression between the two platforms since the Middle Miocene. High-resolution bathymetry data and 2D and 3D seismic data reveal the existence of the ZJC on the present seafloor, as well as in Neogene intervals. It exhibits typical characteristics of deepwater canyons that cut the surrounding rocks and indicate strong erosional features. The ZJC (...) resulted from northwest–southeast strike-slip fault activities during synrift and postrift stages, and it periodically grew during the development of carbonate platforms since the Middle Miocene. We identified four cycles of parallel to subparallel high amplitude and dim reflectors in seismic data, which we interpreted as alternating canyon fill, based on the interpretation of seismic facies. Thus, the sedimentary evolution of the ZJC can be divided into four typical stages, which were in the Middle Miocene, Late Miocene, Early Pliocene, and Pleistocene. Considering the tectonic background of the carbonate platforms, as well as the on-going igneous activities, the sediment filling the canyon could be derived from a mixture of carbonate clasts, igneous clasts, mud, and silt. The laminar high-amplitude reflectors and dim-reflector package represented a fining-upward sedimentary cycle. The coarse-grained sediment in canyon fillings could be turbidites, carbonate debrites, and even igneous clasts. In contrast, the fine-grained sediment is likely to be dominated by pelagic to hemipelagic mud, and silt. This case study describes a deepwater canyon under a carbonate-dominated sedimentary environment and has significant implications for improving our knowledge of periplatform slope depositional processes. Furthermore, the insight gained into periplatform slope depositional processes can be applied globally. (shrink)
We study the minimal enumeration degree problem in models of fragments of Peano arithmetic () and prove the following results: in any model M of Σ2 induction, there is a minimal enumeration degree if and only if M is a nonstandard model. Furthermore, any cut in such a model has minimal e-degree. By contrast, this phenomenon fails in the absence of Σ2 induction. In fact, whether every Σ2 cut has minimal e-degree is independent of the Σ2 bounding principle.
Obesity is a particularly vexing public health challenge, since it not only underlies much disease and health spending but also largely stems from repeated personal behavioral choices. The newly enacted comprehensive health reform law contains a number of provisions to address obesity. For example, insurance companies are required to provide coverage for preventive-health services, which include obesity screening and nutritional counseling. In addition, employers will soon be able to offer premium discounts to workers who participate in wellness programs that emphasize (...) behavioral choices. These policies presume that government intervention to reduce obesity is necessary and justified. Some people, however, argue that individuals have a compelling interest to pursue their own health and happiness as they see fit, and therefore any government intervention in these areas is an unwarranted intrusion into privacy and one's freedom to eat, drink, and exercise as much or as little as one wants. This paper clarifies the overlapping individual, employer, and social interest in each person's health generally to avoid obesity and its myriad costs in particular. The paper also explores recent evidence on the impact of government interventions on obesity through case studies on food labeling and employer-based anti-obesity interventions. Our analysis suggests a positive role for government intervention to reduce and prevent obesity. At the same time, we discuss criteria that can be used to draw lines between government, employer, and individual responsibility for health, and to derive principles that should guide and limit government interventions on obesity as health reform's various elements (e.g., exchanges, insurance market reforms) are implemented in the coming years. (shrink)
The drive for cost-effective use of medical interventions has advantages, but can also be challenging in the context of end-of-life palliative treatments. A quality-adjusted life-year (QALY) provides a common currency to assess the extent of the benefits gained from a variety of interventions in terms of health-related quality of life and survival for the patient. However, since it is in the nature of end-of-life palliative care that the benefits it brings to its patients are of short duration, it fares poorly (...) under a policy of QALY-maximization. Nevertheless, we argue that the goals of palliative care and QALY are not incompatible, and optimal integration of palliative care into the calculation of QALY may reveal a mechanism to modify considerations of how optimal quality of life can be achieved, even in the face of terminal illness. The use of QALYs in resource allocation means that palliative care will always compete with alternative uses of the same money. More research should be conducted to evaluate choices between palliative care and more aggressive therapies for the terminally ill. However, current limited data show that investing in palliative care makes more sense not only ethically, but also financially. (shrink)
Recently, in this journal, Jeremy Gwiazda has offered a critique of our separationist view of hell. His objection relies on two key assumptions, and we show in our reply that both assumptions can be denied.
Nurse practitioners can ease increased pressure on primary care shortage while providing a cost-effective and high-quality alternative to certain physician services. However, scope-of-practice laws are restrictive and their modification remains a source of controversy. Clearly, there is a need for new thinking around the scope of practice debate. This article conducted a review of literature and laws concerning the nursing scope of practice, as well as the outcomes of nurse-led care coordination models. It also examined different manifestations of the controversy (...) that arises in scope of practice debates. We argue that improved care coordination is necessary to improve outcomes and “bend the cost curve downward.” Allowing nurse practitioners and other providers to practice to the full extent of their licenses will result in improved care coordination. This can be accomplished by expanding nursing and other providers' scopes of practice. But any health care reform strategy, particularly with respect to chronic care management, must also serve to activate the patient herself as the keystone in the coordinated care process. Focusing first on the patient's need for coordinated care may be what is necessary to move beyond the existing impasse between physicians and nurses on scope of practice expansion. (shrink)
Objectives The objective of this research was to develop ethics accreditation standards for hospitals. Research design Our research methods included a literature review, an expert focus group, the Delphi technique and a hospital survey. The entire process was separated into two stages: (1) the development of a draft of hospital ethics accreditation standards; and (2) conducting a nationwide hospital survey of the proposed standards. Results This study produced a tentative draft of hospital ethics accreditation standards comprised of six chapters and (...) 62 standards based on the expert focus group and Delphi technique. The six chapters are: Medical ethics policies, regulations and leadership; The establishment and operation of a medical ethics committee; The establishment and operation of research-related ethics committees; Medical ethics education; Organisational ethical climate; and Respect for patients' rights and establishment of good hospital-patient relationships. The hospital survey indicated that the concept of an organisational ethical climate was new to most hospital managers, most hospitals disliked the idea of having a separate hospital ethics accreditation system, and small hospitals were concerned about their ability to comply with all of the standards. Conclusions Regardless of whether hospital ethics accreditation can be a stand-alone accreditation or just part of existing hospital accreditation programmes, we hope this draft can serve as a good reference for future endeavours by hospital accreditation authorities. (shrink)
As the baby boomer generation ages, the need for laws to enhance quality of life for the elderly and meet the increasing demand for family caregivers will continue to grow. This paper reviews the national family leave laws of nine major OECD countries (Canada, Denmark, France, Germany, Italy, Japan, Netherlands, Spain, and the United Kingdom) and provides a state-by-state analysis within the U.S. We find that the U.S. has the least generous family leave laws among the nine OECD countries. With (...) the exception of two states (California and New Jersey), the U.S. federal Family Medical Leave Act of 1993 provides no right to paid family leave for eldercare. We survey the current evidence from the literature on how paid leave can impact family caregivers' employment and health outcomes, gender equality, and economic arguments for and against such laws. We argue that a generous and flexible family leave law, financed through social insurance, would not only be equitable, but also financially sustainable. (shrink)
We give a survey of the study of nonstandard models in recursion theory and reverse mathematics. We discuss the key notions and techniques in effective computability in nonstandard models. and their applications to problems concerning combinatorial principles in subsystems of second order arithmetic. Particular attention is given to principles related to Ramsey's Theorem for Pairs.