Motor training to improve walking and balance function is a common aspect of rehabilitation following motor-incomplete spinal cord injury. Evidence suggests that moderate- to high-intensity exercise facilitates neuroplastic mechanisms that support motor skill acquisition and learning. Furthermore, enhancing corticospinal drive via transcranial direct current stimulation may augment the effects of motor training. In this pilot study, we investigated whether a brief moderate-intensity locomotor-related motor skill training circuit, with and without tDCS, improved walking and balance outcomes in persons with MISCI. In (...) addition, we examined potential differences between within-day and between-day effects of MST. Twenty-six adults with chronic MISCI, who had some walking ability, were enrolled in a 5-day double-blind, randomized study with a 3-day intervention period. Participants were assigned to an intensive locomotor MST circuit and concurrent application of either sham tDCS or active tDCS. The primary outcome was overground walking speed measured during the 10-meter walk test. Secondary outcomes included spatiotemporal gait characteristics, peak trailing limb angle, intralimb coordination, the Berg Balance Scale, and the Falls Efficacy Scale-International questionnaire. Analyses revealed a significant effect of the MST circuit, with improvements in walking speed, cadence, bilateral stride length, stronger limb TLA, weaker limb ACC, BBS, and FES-I observed in both the MST+tDCSsham and MST+tDCS groups. No differences in outcomes were observed between groups. Between-day change accounted for a greater percentage of the overall change in walking outcomes. In persons with MISCI, brief intensive MST involving a circuit of ballistic, cyclic locomotor-related skill activities improved walking outcomes, and selected strength and balance outcomes; however, concurrent application of tDCS did not further enhance the effects of MST.Clinical Trial Registration[ClinicalTrials.gov], identifier [NCT03237234]. (shrink)

Obstetricians face difficult decisions when the interests of fetus and mother conflict. An example is the problem of choosing the delivery method when labour begins prematurely and the fetus is breech. Vaginal delivery involves risks for the breech fetus of brain damage or death caused by umbilical cord compression and head entrapment. Caesarean section might avoid these dangers but involves risks for the mother, including infection, haemorrhage and even death in a small percentage of cases. If a caesarean section is (...) performed the infant might die anyway, due to complications of prematurity. Thus, decisions about delivery method involve balancing the risks to mother and fetus. Uncertainty about the frequency of fetal injuries in vaginal breech deliveries adds to the difficulty of these decisions. (shrink)

Umbilical cord blood banking is one of many biomedical innovations that confront pregnant women with new choices about what they should do to secure their own and their child’s best interests. Many mothers can now choose to donate their baby’s umbilical cord blood (UCB) to a public cord blood bank or pay to store it in a private cord blood bank. Donation to a public bank is widely regarded as an altruistic act of civic responsibility. Paying to store UCB may (...) be regarded as a “unique opportunity” to provide “insurance” for the child’s future. This paper reports findings from a survey of Australian women that investigated the decision to either donate or store UCB. We conclude that mothers are faced with competing discourses that force them to choose between being a “good mother” and fulfilling their role as a “good citizen.” We discuss this finding with reference to the concept of value pluralism. (shrink)

The transition of novel and potentially promising medical therapies into their initial human clinical trials can engender conflicting pressures. On the one side, because Phase I trials raise greater ethical and human protection challenges than later stage clinical trials, there is a need to proceed cautiously. This is particularly the case for Phase I trials with a novel therapy being tested in humans for the first time, usually termed first-in-human (FIH) trials, especially if the FIH trial involves significant risks. On (...) the other side, scientists interested in having their research validated, corporations with a financial interest in the field, and potential patients and patient support groups desirous of having .. (shrink)

BackgroundFunctional changes after spinal cord injury are related to changes in cortical plasticity. These changes can be measured with electroencephalography and has potential to be used as a clinical biomarker.MethodIn this longitudinal study participants underwent a total of 30 sessions of robotic-assisted gait training over a course of 6 weeks. The duration of each session was 30 min. Resting state EEG was recorded before and after 30-session rehabilitation therapy. To measure gait, we used the Walking Index for Spinal Cord Injury (...) Scale, 10-Meter- Walking Test, Timed-Up-and-Go, and 6-Min-Walking Test. Balance was measured using Berg Balance Scale.ResultsFifteen participants with incomplete SCI who had AIS C or D injuries based on American Spinal Cord Injury Association Impairment Scale classification were included in this study. Mean age was 35.7 years and the mean time since injury was 17.08 months. All participants showed clinical improvement with the rehabilitation program. EEG data revealed that high beta EEG activity in the central area had a negative correlation with gait and balance measured at baseline, in a way that greater high beta EEG power was related to worse clinical function at baseline. Moreover, improvement in gait and balance had negative correlations with the change in alpha/theta ratio in the parietal area.ConclusionIn SCI, functional impairment and subsequent improvement following rehabilitation therapy with RAGT correlated with the change in cortical activity measured by EEG. Our results suggest that EEG alpha/theta ratio may be a potential surrogate marker of functional improvement during rehabilitation. Future studies are necessary to improve and validate these findings as a neurophysiological biomarker for SCI rehabilitation. (shrink)

Mr. C is a twenty‐two‐year‐old who was flown to a level‐1 trauma center after diving headfirst into shallow water. Prior to this accident, he was in excellent health. At the scene, he had been conscious but was paralyzed and had no sensation below his neck. The emergency medical services team immobilized Mr. C's neck with a cervical collar and intubated him for airway protection before transport. As Mr. C's medical care proceeds, he expresses a desire for extubation, although it was (...) not clear that he had the capacity to make this (or any other) decision. It also was unclear whether this desire reflected his authentic wishes to be allowed to die or stemmed from feelings of discomfort and agitation. Over a period of several days, Mr. C's sedation was lightened, and the psychiatry service conducted a formal decision‐making capacity assessment. Mr. C continues to express a desire to withdraw life‐sustaining medical treatment. However, the psychiatry service is concerned that Mr. C seems to lack adequate insight into what it would mean to die.What does it mean to respect Mr. C's autonomy? (shrink)

This commentary on coderre & katz, wiesenfeld-hallin et al., and dickenson focuses on: (a) the brain as an under-recognized contributor to pain facilitation at the spinal cord; (b) these brain-to-spinal pathways being activated by learning or by body infection/inflammation; and (c) the resultant spinal release of anti-analgesic neuropeptides, activators of the NMDA-NO cascade, and activators of glia.

Gran parte de la filosofía más interesante y original los escolásticos la hacían en la teología. Un buen ejemplo es el dilema en el Siglo de Oro sobre el libre albedrío: ¿cómo podemos actuar libremente si Dios causa y conoce nuestros actos? La discusión incluye varios temas fundamentales como la antinomia entre la libertad y la determinación, la semántica modal, la lógica temporal y la lógica de los estados de cosas contrafácticos. Los jesuitas mexicanos Matías Blanco y Antonio Peralta escribieron (...) libros sobre la cuestión. Se describirá aquí la solución “disyuntiva” que Blanco propuso en su Funiculus triplex, publicado póstumamente en México en 1746. Cuando alguien ha de eligir entre las alternativas B y C, barrunta Blanco, Dios no actualiza ni B ni C, sino su disyunción B-o-C. Blanco propone una tregua en la “guerra” entre las escuelas contrincantes para que consideren su solución– pues cree podría ser aceptable para todos. (shrink)

Plastic changes in spinal cord function like neuronal wind-up and increased receptive field are too short-lived to explain chronic pain without structural changes. It is possible that learning could be a mechanism for longlasting changes in nociceptive regulation. A learning process localized to the spinal cord has been shown to be important for the development of tolerance to the analgetic effect of ethanol, suggesting that nociceptive control systems may be changed by learning. Long term potentiation (LTP) is regarded as a (...) useful model of learning and memory. LTP-like changes have been observed in invitro preparations from the spinal cord and in spinal cord field potentials. Recently a long term increase in spinal A-[beta] and C-fibre evoked responses after painful stimulation has been observed. [coderre & katz, dickenson, wiesenfeld-hallin et al.]. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Two NarractsAntoine Volodine (bio)1. DögbruzDögbruz dépassa le dernier lampadaire de l'avenue et il s'arrêta pour calmer sa respiration haletante. Derrière lui, la ville semblait déserte. La nuit était tombée depuis des heures, de longues heures, un grand nombre d'heures, et, alors que cette idée prenait naissance dans l'esprit de Dögbruz, la phrase bourgeonna et devint quelque chose d'inquiétant, une réflexion qui n'appartenait pas totalement à notre monde : la (...) nuit, pensa soudain Dögbruz. Elle est tombée depuis plusieurs jours.Plusieurs jours sans soleil ni lune, sans crépuscule, plusieurs longues tranches noires de vingt-quatre heures. La noirceur n'avait connu aucune interruption.– Je... Mais qu'est-ce que... bougonna Dögbruz.L'air était tiède, le sol sous ses pieds était chaud, de temps en temps une ombre minuscule voletait en silence autour de sa tête, puis disparaissait. Un flocon charbonneux. Une mouche, pensa-t-il. Elle est épuisée ou déjà morte, pensa-t-il.– Non, non, pas ça, murmura-t-il, effrayé par ce qui faisait des allées et venues entre sa sous-conscience et sa conscience, des images et des expressions qui avaient rompu avec la logique du réel.Il avait besoin de bouger les lèvres et les cordes vocales pour les chasser, ces images et ces expressions désagréables.– Non, pas morte, cette sale bestiole, corrigea-t-il à voix basse. Très fatiguée, peut-être. Comme moi, très, très fatiguée. Mais pas encore morte. Autrement elle serait au sol. Elle ne pourrait pas voler.Comme moi, pensa-t-il. Moi aussi je suis au sol. Et, s'il y a au moins une certitude ici cette nuit, c'est que je ne vole pas.Il resta quelques minutes immobile, sans rien faire d'autre que combattre les petites intuitions délirantes qui traversaient les couches inférieures de son intelligence et montaient sans hâte, comme des bulles de méthane cherchant, dans un marécage, la surface de la vase. Il reprenait son souffle en observant l'avenue, devant et derrière lui : une vallée d'obscurité monotone, deux parois de maisons non éclairées, quelques arbres qui agonisaient sous la poussière, des palmiers en phase terminale, quatre ou cinq, dans la distance, et, pour le reste, une vilaine coulée [End Page 60] de bitume, qui donnait l'impression d'avoir pour origine le ciel sans la moindre étoile, d'une épaisseur et d'une opacité repoussantes. Les lampadaires étaient rares. À la fin de l'image, rien ne brillait. Pas d'horizon, pas de séparation entre le monde des nuages et le ruban bitumeux, les maisons noyées dans le rien, plus de différence entre la nuit du haut et la nuit du bas.Il s'aperçut soudain qu'il ne respirait plus et il s'empressa de mettre un terme à ce moment d'apnée indésirable.– Saletés de poumons de merde, jura-t-il.De nouveau, ses sacs pulmonaires se gonflaient et se dégonflaient. Certes. Mais il devait y veiller, leur donner l'ordre de s'emplir puis de se vider. Sans cesse il devait contrôler cela. Il haussa les épaules au bout d'une minute.– Tu parles d'un organisme pourri, protesta-t-il, s'adressant à lui-même, ou plutôt à on ne sait quelle divinité familière qu'il associait à son destin, une divinité camarade et, face à l'adversité, aussi impuissante que lui.Alors qu'il essayait de confier son alimentation en oxygène à des réflexes qui fonctionnaient avec réticence, il distingua au bout de l'avenue une forme que d'abord il se refusa à identifier, puis qu'il fut bien obligé de reconnaître. C'était loin, à plus de cent cinquante mètres, noyé d'obscurité, mais le doute n'était pas possible. Non, non, je ne peux pas me tromper, pensa-t-il.Un lama.L'univers ici est en noir et blanc, pensa-t-il. Aucune couleur et presque aucune nuance de gris. Mais... (shrink)

This volume brings together Nussbaum's published papers on the relationship between literature and philosophy, especially moral philosophy. The papers, many of them previously inaccessible to non-specialist readers, deal with such fundamental issues as the relationship between style and content in the exploration of ethical issues; the nature of ethical attention and ethical knowledge and their relationship to written forms and styles; and the role of the emotions in deliberation and self-knowledge. Nussbaum investigates and defends a conception of ethical understanding which (...) involves emotional as well as intellectual activity, and which gives a certain type of priority to the perception of particular people and situations rather than to abstract rules. She argues that this ethical conception cannot be completely and appropriately stated without turning to forms of writing usually considered literary rather than philosophical. It is consequently necessary to broaden our conception of moral philosophy in order to include these forms. Featuring two new essays and revised versions of several previously published essays, this collection attempts to articulate the relationship, within such a broader ethical inquiry, between literary and more abstractly theoretical elements. (shrink)

Kant makes a much-unexpected confession in a much-unexpected place. In the Criticism of the third paralogism of transcendental psychology of the first Critique Kant accepts the irrefutability of the Heraclitean notion of universal becoming or the transitory nature of all things, admitting the impossibility of positing a totally persistent and self-conscious subject. The major Heraclitean doctrine of panta rhei makes it impossible to conduct philosophical inquiry by assuming a self-conscious subject or “I,” which would potentially be in constant motion like (...) other thoughts. For it rules out the possibility of completely detached reasoning which necessitates an unchanging state of mind. In this paper, Kaplama uses panta rhei to critically examine the philosophical shortcomings and contradictions of Kantian and Enlightenment ethics. In his examination, he specifically focuses on the teleological nature of Kant’s principle of freedom and ideal of moral autonomy which have dominated the Enlightenment thought. By doing so, he argues that it is essentially inaccurate to posit Überlegenheit (the state of being superior to nature) as the foundation of philosophical inquiry mainly because this would contradict the Enlightenment’s claim to constitute a rupture from classic and medieval metaphysics and would render Enlightenment a mere extension of Christian metaphysics. As in Christianity, Überlegenheit presupposes two separate realms, the actual (contingent) and ideal (pure) realms of thought and assumes that the transcendence commences from the level of the late metaphysical/teleological construction of the ‘subject’ who is completely persistent, self-conscious and immune to change. He then substantiates these points with reference to the philosophical roots of ethnic prejudice displayed by the post-Enlightenment colonialists and the missionaries in Fiji and the Pacific. This brief critical examination of the post-Enlightenment ethnocentrism will be conducted under the following three points: a) On the Enlightenment’s teleological and universalistic understanding of humanity and the concept of progress versus the Fijian concepts of the continuity of life, regeneration, and reproduction b) On the Enlightenment’s ideal of the free-willing and independent individual subject versus the Fijian ideas of 'the cord', reciprocity, and vanua, and c) On the Enlightenment’s (and Christianity’s) strict dualism between physics and metaphysics, nature and human mind, body and soul versus the Fijian bio-centrism, the sanctity of vanua and the cosmological concept of mana. (shrink)

This reconsideration of Hume’s classic essay “Of Miracles” via the lens of American pragmatist ways of thinking about history and power shifts our attention from Hume’s epistemic concerns about the legitimacy of witnesses and testimony to his distaste for sacred history, his critical stance regarding the social force of revelation, and his disdain for religious authority. To view Hume’s essay both as an articulation of a critical philosophy of history and as an exercise in moral dynamism (social power or, authority, (...) is a result of epistemic transactions), is to intervene in both Hume studies and Contemporary Pragmatism. (shrink)

What is post-truth? -- Science denial as a road map for understanding post-truth -- The roots of cognitive bias -- The decline of traditional media -- The rise of social media and the problem of fake news -- Did post-modernism lead to post-truth? -- Fighting post-truth.

Adenosine transport in cultured human umbilical vein endothelial cells (HUVEC) was characterized and shown to be mediated by a single facilitated diffusion mechanism. Initial rates of adenosine influx at 22 degrees C were saturable [apparent Michaelis constant, 69 +/- 10 mu M; maximum velocity (V-max), 600 +/- 70 pmol.10(6) cells(-1).s(-1)] and inhibited by nitrobenzylthioinosine (NBMPR). Formycin B had an unusually high affinity [inhibitory constant K-i), 18 +/- 4.3 mu M], whereas inosine had a low affinity (K-i, 440 +/- 68 mu (...) M) and nucleobases were without effect on adenosine influx. The number of transporters (1.2 x 10(6) sites/cell) was estimated by NBMPR equilibrium binding (apparent dissociation constant, 0.11 +/- 0.01 nM; maximum binding, 2.0 +/- 0.15 pmol/10(6) cells). In addition, we compared these endothelial cells with those obtained from cords from pregnancies complicated by diabetes (HUVEC-D), since embriopathy may occur in these conditions. HUVEC-D exhibited a 2.3-fold reduction in both the V-max for adenosine influx and the maximum number of NBMPR binding sites (260 +/- 40 pmol.10(6) cells(-1).s(-1) and 0.86 +/- 0.08 pmol/10(6) cells, respectively). However, the turnover number for each nucleoside transporter in normal and diabetic HUVEC was similar (approximate to 300 adenosine molecules/s). Adenosine metabolism at 10 mu M in HUVEC-D was modified compared with normal cells. Intracellular phosphorylation (> 90%) was the predominant pathway in normal HUVEC, whereas in HUVEC-D, substantial levels of adenine and adenosine were detected. The present results demonstrate therefore the downregulation of the NBMPR-sensitive nucleoside transporter and changes in adenosine metabolism in HUVEC from diabetic pregnancies. (shrink)

First published in 2002. Routledge is an imprint of Taylor & Francis, an informa company.

Ivancovsky et al. propose a novelty-seeking model linking curiosity to creativity. This commentary suggests integrating their work with a stage-based creativity model for additional insights. It also encourages readers to address knowledge gaps identified by the authors, including factors that trigger the pursuit of creative solutions. We aim to refine theory and direct future research to clarify the complex curiosity–creativity relationship.

This book critically assesses arguments for the existence of the God of classical theism, develops an innovative account of objects’ persistence, and defends new arguments against classical theism. The authors engage the following classical theistic proofs: Aquinas’s First Way, Aquinas’s De Ente argument, and Feser’s Aristotelian, Neo-Platonic, Augustinian, Thomistic, and Rationalist proofs. The authors also provide the first systematic treatment of the ‘existential inertia thesis’. By connecting the thesis to relativity theory and recent developments in the philosophy of physics, and (...) by developing a variety of novel existential-inertia-friendly explanations of persistence, they mount a formidable new case against classical theistic proofs. Finally, they defend new arguments against classical theism based on abstract objects and changing divine knowledge. The text appeals to students, researchers, and others interested in classical theistic proofs, the existence and nature of God, and the ultimate explanations of persistence, change, and contingency. (shrink)

Neuroscientists are searching for the engram within the conceptual framework established by John Locke's theory of mind. This framework was elaborated before the development of information theory, before the development of information processing machines and the science of computation, before the discovery that molecules carry hereditary information, before the discovery of the codon code and the molecular machinery for editing the messages written in this code and translating it into transcription factors that mark abstract features of organic structure such as (...) anterior and distal. The search for the engram needs to abandon Locke's conceptual framework and work within a framework informed by these developments. The engram is the medium by which information extracted from past experience is transmitted to the computations that inform future behavior. The information-conveying symbols in the engram are rapidly generated in the course of computations, which implies that they are molecules. (shrink)

Just as humans can draw conclusions responsibly or irresponsibly, so too can computers. Machine learning systems that have been trained on data sets that include irresponsible judgments are likely to yield irresponsible predictions as outputs. In this paper I focus on a particular kind of inference a computer system might make: identification of the intentions with which a person acted on the basis of photographic evidence. Such inferences are liable to be morally objectionable, because of a way in which they (...) are presumptuous. After elaborating this moral concern, I explore the possibility that carefully procuring the training data for image recognition systems could ensure that the systems avoid the problem. The lesson of this paper extends beyond just the particular case of image recognition systems and the challenge of responsibly identifying a person’s intentions. Reflection on this particular case demonstrates the importance (as well as the difficulty) of evaluating machine learning systems and their training data from the standpoint of moral considerations that are not encompassed by ordinary assessments of predictive accuracy. (shrink)

In a recent article, Corey Wrenn argues that in order to adequately address injustices done to animals, we ought to think systemically. Her argument stems from a critique of the individualist approach I employ to resolve a moral dilemma faced by animal sanctuaries, who sometimes must harm some animals to help others. But must systemic critiques of injustice be at odds with individualist approaches? In this paper, I respond to Wrenn by showing how individualist approaches that take seriously the notion (...) of group responsibility can be deployed to solve complicated dilemmas that are products of injustice. Contra Wrenn, I argue that to adequately address injustice, acting individually, often within groups, is significantly more important than thinking systemically. (shrink)

What proper role should considerations of risk, particularly to research subjects, play when it comes to conducting research on human enhancement in the military context? We introduce the currently visible military enhancement techniques (1) and the standard discussion of risk for these (2), in particular what we refer to as the ‘Assumption’, which states that the demands for risk-avoidance are higher for enhancement than for therapy. We challenge the Assumption through the introduction of three categories of enhancements (3): therapeutic, preventive, (...) and pure enhancements. This demands a revision of the Assumption (4), alongside which we propose some further general principles bearing on how to balance risks and benefits in the context of military enhancement research. We identify a particular type of therapeutic enhancements as providing a more responsible path to human trials of the relevant interventions than pure enhancement applications. Finally, we discuss some possible objections to our line of thought (5). While acknowledging their potential insights, we ultimately find them to be unpersuasive, at least provided that our proposal is understood as fully non-coercive towards the candidates for such therapeutic enhancement trials. (shrink)

This article explores the significance that environments play in terms of the learning process. In the United States, the legacy of John Dewey's intellectual efforts left a theoretical understanding that views the architectural composition of learning environments as instrumental mediums which house the educational process. This understanding of learning environments is precipitated by a separation of human agents as subjects and their environments as objects. By contrast, Martin Heidegger's theory of ontology, and its reconfiguration of the subject and object relationship, (...) lends itself to an understanding of the architectural composition of learning environments as dwellings. (shrink)

Philosophers now treat the relationship between Classical Mendelian Genetics and molecular biology as a paradigm of nonreduction and this example is playing an increasingly prominent role in debates about the reducibility of theories ranging from macrosocial science to folk psychology. Patricia Churchland (1986), for example, draws an analogy between the alleged elimination of the “causal mainstay” of classical genetics and her view that today’s psychological theory will be eliminated by neuroscience. Patricia Kitcher takes an autonomous rather than eliminativist view of (...) the reported nonreduction in genetics and reasons that psychology will retain a similar autonomy from lower level sciences (1980 and 1982). Although Churchland and Kitcher offer different interpretations of the apparent failure of molecular biology to reduce classical genetics, they agree that this failure will help illuminate theoretical relations between psychology and lower level sciences. The appearance of the Mendelian example along side the usual ones from physics and chemistry marks a turning point in philosophy of science. (shrink)

The authors present a case study involving truth telling responsibilities in the setting of nonepileptic seizures. Specifically, over the course of several suspected nonepileptic seizures, a patient’s seizures stopped after he received a saline flush meant to precede the administration of anti-seizure medication. The patient and his surrogate believed he had received the medication each time, and the team wondered whether they should disclose the truth. Some worried that disclosure would reinforce the suspected psychogenic behavior, exacerbating the patient’s condition. In (...) this way, the case study presents a twist on the traditional truth telling archetype. While most truth telling cases center on navigating cultural differences or worries about emotional harm, this case presented concerns about medical harm in the form of exacerbating the patient’s condition. The authors describe the complex patient-family-team dynamic that preceded this ethical dilemma, describe the case, analyze the ethical issue, and describe the outcome. (shrink)

First published in 2000. Routledge is an imprint of Taylor & Francis, an informa company.