Stroke continues to be a leading cause of disability. Basic neurorehabilitation research is necessary to inform the neuropathophysiology of impaired motor control, and to develop targeted interventions with potential to remediate disability post-stroke. Despite knowledge gained from basic research studies, the effectiveness of research-based interventions for reducing motor impairment has been no greater than standard of practice interventions. In this perspective, we offer suggestions for overcoming translational barriers integral to experimental design, to augment traditional protocols, and re-route the rehabilitation trajectory (...) toward recovery and away from compensation. First, we suggest that researchers consider modifying task practice schedules to focus on key aspects of movement quality, while minimizing the appearance of compensatory behaviors. Second, we suggest that researchers supplement primary outcome measures with secondary measures that capture emerging maladaptive compensations at other segments or joints. Third, we offer suggestions about how to maximize participant engagement, self-direction, and motivation, by embedding the task into a meaningful context, a strategy more likely to enable goal-action coupling, associated with improved neuro-motor control and learning. Finally, we remind the reader that motor impairment post-stroke is a multidimensional problem that involves central and peripheral sensorimotor systems, likely influenced by chronicity of stroke. Thus, stroke chronicity should be given special consideration for both participant recruitment and subsequent data analyses. We hope that future research endeavors will consider these suggestions in the design of the next generation of intervention studies in neurorehabilitation, to improve translation of research advances to improved participation and quality of life for stroke survivors. (shrink)

Nel corso degli ultimi 20 anni c’è stata una espansione globale in materia di istruzione dottorale e in particolare di ‘dottorati professionali’. Difficoltà nell’avanzamento e nel completamento diventano sempre più il centro dell’attenzione per tutti i tipi di dottorato. È stato riconosciuto che una serie di fattori al di là di quelli prettamente demografici potrebbe influire sulla possibilità di completare gli studi. C’è ancora molto da imparare sul motivo per cui l’avanzamento e il completamento del dottorato sono così impegnativi. In (...) questo articolo vorremmo mettere in evidenza un settore che sembra trascurato dalla ricerca: l’esperienza emotivamente complessa del percorso di dottorato.Offriamo un contributo al dibattito su ciò che è necessario per facilitare il successo e intrinsecamente un soddisfacente avanzamento all’interno di un programma di dottorato professionale. Noi sosteniamo che una maggiore attenzione debba essere prestata al cammino esperienziale di studenti di dottorato dal momento che essi hanno il difficile compito di integrare la loro vita personale, professionale e accademica. Il nostro interesse per le risorse emotive di cui gli studenti possono avvalersi durante il loro percorso di dottorato è iniziato con la progettazione e lo sviluppo del nostro primo dottorato professionale in materia di sanità e cura. Attraverso la nostra iniziale esperienza con due gruppi di studenti, abbiamo riflettuto sullo sviluppo del dottorato professionale, in generale, e trasversalmente a diverse altre discipline, per comprendere meglio come facilitare una buona esperienza di dottorato e una conclusione nei tempi.L’importanza di partecipare all’esperienza emotiva all’interno del complesso percorso di dottorato professionale ci ha portato al concetto di ‘nourished scholarship’ . Si definisce la nozione di ‘nourished scholarship’ come un percorso di apprendimento che lega i valori personali, significativi e attuali, allo sviluppo e al contributo professionale. Tale nutrimento emotivo è caratterizzato da una soddisfacente esperienza di scambio tra il sé, l’apprendimento e la comunità di pratica/studio. La nostra opinione è che tale nutrimento emotivo sia una risorsa fondamentale da cui gli studenti attingono al momento di negoziare le sfide complesse del percorso professionale di dottorato. Al fine di illustrare il significato di ‘nourished scholarship’ descriviamo alcune delle sue dimensioni emotive chiave. Queste dimensioni possono essere agevolate in vari modi, ma qui ne segnaliamo uno in particolare: il sostegno reciproco e la supervisione di gruppo facilitata. Al fine di illustrare le dimensioni della ‘nourished scholarship’ quindi noi riflettiamo su un caso specifico, quello di una coorte di studenti di dottorato professionale. Sono state estratte alcune loro esperienze per illustrare sette dimensioni che sono importanti per contribuire all’esperienza di ‘nourished scholarship’ come una risorsa di sostegno:- Sperimentare i benefici di appartenenza- Aiutarsi vicendevolmente a contenere l’ansia- Vivere la crescente fiducia- Accettare comunanza e unicità- Miglioramento personale, identità professionale e accademica attraverso la chiarificazione dei valori- Sperimentare i benefici di relazionarsi ad una più ampia comunità scientifica- Accettare i ritmi dei tempi in cui ricevere dei tempi attivi.Inoltre, in questo articolo si riflette su come la particolare struttura del programma di dottorato è stata in grado di sostenere lo sviluppo di queste risorse. Ci sono state tre caratteristiche chiave che crediamo siano state fondamentali nel modo in cui il programma è stato progettato e realizzato:a) ‘Cohortness’ in cui gli studenti si impegnano con il programma come un gruppo in viaggio.b) Supervisione di coorte: anche se tutti studiavano diversi argomenti, si è formato un gruppo insieme a due facilitatori accademici per discutere il processo, l’esperienza del percorso e il loro apprendimento.c) Una strategia di valutazione flessibile che permette agli studenti di progredire in modo personale e non lineare.Il valore potenziale di questo articolo per i programmi educativi è che fornisce un quadro per focalizzare l’attenzione sull’importanza del percorso emotivo e sui modi per sostenere la motivazione degli studenti e la resilienza. Noi crediamo che questo quadro abbia un potenziale trasferibile ad altre situazioni in cui tali risorse emotive possono essere importanti.During the past 20 years there has been a global expansion in doctoral education and in particular professional doctorates. Difficulties with progression and completion have increasingly become the focus of attention within both academic and professional contexts. It has been acknowledged that a range of factors, beyond demographics, could be influential in whether students are able to sustain their studies to completion. In this paper we stress the importance of conceptualising professional doctoral studies as a personal, professional and academic journey that is sustained by emotional factors that may need more explicit attention. As such, our contribution is the delineation of a phenomenon that we call ‘nourished scholarship’. We wish to illustrate how such ‘nourished scholarship’ functions as a resource for sustaining motivation and integration through the doctoral journey. We offer seven dimensions that a doctoral programme needs to embody in order to facilitate ‘nourished scholarship’: belonging, containing anxiety, growing confidence, commonality and uniqueness, values clarification, scholarly community, and negotiating the rhythms of receptive and active times. We illustrate these dimensions in the context of a professional doctorate programme that emphasises ‘cohort supervision’ as the primary resource for facilitating such nourished scholarship. We believe that this notion has transferable potential to other provisions where such emotional resources may be important. (shrink)

Chairman Hua emphasized in his speech last year at the opening ceremony of the Central Party School that: "Chairman Mao instructed us over and over that ‘the integration of theory and practice is the most fundamental principle of Marxism.’ Chairman Mao fought all his life against the evil work style of boasting and of separating theory from practice. … Political swindlers such as Lin Biao, Chen Boda, and the "gang of four" have messed up many basic theoretical issues and damaged (...) our Party's good learning style. We must make a tremendous effort to correct that.". (shrink)

What is the criterion of truth? This is a question that was resolved long ago by the revolutionary teachers of the proletariat. But as a result of damage done by the "Gang of Four" and a mass of distorted propaganda in the media under their control, it has become muddled beyond compare in recent years. In order to deepen the criticism of the "Gang of Four" and eradicate the remnants of their poison and influence, it is very important to clear (...) this up and sort it out. (shrink)

The ipsilesional arm of stroke patients often has functionally limiting deficits in motor control and dexterity that depend on the side of the brain that is lesioned and that increase with the severity of paretic arm impairment. However, remediation of the ipsilesional arm has yet to be integrated into the usual standard of care for upper limb rehabilitation in stroke, largely due to a lack of translational research examining the effects of ipsilesional-arm intervention. We now ask whether ipsilesional-arm training, tailored (...) to the hemisphere-specific nature of ipsilesional-arm motor deficits in participants with moderate to severe contralesional paresis, improves ipsilesional arm performance and generalizes to improve functional independence. We assessed the effects of this intervention on ipsilesional arm unilateral performance [Jebsen–Taylor Hand Function Test ], ipsilesional grip strength, contralesional arm impairment level [Fugl–Meyer Assessment ], and functional independence [Functional independence measure ]. Intervention occurred over a 3 week period for 1.5 h/session, three times each week. All sessions included virtual reality tasks that targeted the specific motor control deficits associated with either left or right hemisphere damage, followed by graded dexterity training in real-world tasks. We also exposed participants to 3 weeks of sham training to control for the non-specific effects of therapy visits and interactions. We conducted five test-sessions: two pre-tests and three post-tests. Our results indicate substantial improvements in the less-impaired arm performance, without detriment to the paretic arm that transferred to improved functional independence in all three posttests, indicating durability of training effects for at least 3 weeks. We provide evidence for establishing the basis of a rehabilitation approach that includes evaluation and remediation of the ipsilesional arm in moderately to severely impaired stroke survivors. This study was originally a crossover design; however, we were unable to complete the second arm of the study due to the COVID-19 pandemic. We report the results from the first arm of the planned design as a longitudinal study. (shrink)

Although there has been critical analysis of how the informed consent process functions in relation to participation in research and particular ethical 'dilemmas', there has been little examination of consenting to more routine medical procedures. We report a qualitative study of 25 women who consented to surgery. Of these, nine were ambivalent or opposed to having an operation. When faced with a consent form, women's accounts suggest that they rarely do anything other than obey professionals' requests for a signature. An (...) interactionist analysis suggests that women's capacity to act is reduced by the hospital structure of tacit, socially-imposed rules of conduct. Bourdieu's concepts of habitus, capital and symbolic power/violence show how the practical logic that women apply confers a 'sense of place' relative to professionals. Women experience deficits in capital that constrain their ability to exercise choice. This work demonstrates the weakness of the consent process as a safeguard of autonomy. (shrink)

Chronic stroke survivors with severe contralesional arm paresis face numerous challenges to performing activities of daily living, which largely rely on the use of the less-affected ipsilesional arm. While use of the ipsilesional arm is often encouraged as a compensatory strategy in rehabilitation, substantial evidence indicates that motor control deficits in this arm can be functionally limiting, suggesting a role for remediation of this arm. Previous research has indicated that the nature of ipsilesional motor control deficits vary with hemisphere of (...) damage and with the severity of contralesional paresis. Thus, in order to design rehabilitation that accounts for these deficits in promoting function, it is critical to understand the relative contributions of both ipsilesional and contralesional arm motor deficits to functional independence in stroke survivors with severe contralesional paresis. We now examine motor deficits in each arm of severely paretic chronic stroke survivors with unilateral damage to determine whether hemisphere-dependent deficits are correlated with functional independence. Clinical evaluation of contralesional, paretic arm impairment was conducted with the upper extremity portion of the Fugl-Meyer assessment. Ipsilesional arm motor performance was evaluated using the Jebsen-Taylor Hand Function Test, grip strength, and ipsilesional high-resolution kinematic analysis during a visually targeted reaching task. Functional independence was measured with the Barthel Index. Functional independence was better correlated with ipsilesional than contralesional arm motor performance in the left hemisphere damage group [JTHFT: [r = −0.73, p = 0.017]; grip strength: [r = 0.64, p = 0.047]], and by contralesional arm impairment in the right hemisphere damage group [UEFM: [r = 0.66, p = 0.040]]. Ipsilesional arm kinematics were correlated with functional independence in the left hemisphere damage group only. Examination of hemisphere-dependent motor correlates of functional independence showed that ipsilesional arm deficits were important in determining functional outcomes in individuals with left hemisphere damage only, suggesting that functional independence in right hemisphere damaged participants was affected by other factors. (shrink)

The recent discovery of microRNAs (miRNAs) in unicellular eukaryotes, including miRNAs known previously only from animals or plants, implies that miRNAs have a deep evolutionary history among eukaryotes. This contrasts with the prevailing view that miRNAs evolved convergently in animals and plants. We re‐evaluate the evidence and find that none of the 73 plant and animal miRNAs described from protists meet the required criteria for miRNA annotation and, by implication, animals and plants did not acquire any of their respective miRNA (...) genes from the crown ancestor of eukaryotes. Furthermore, of the 159 novel miRNAs previously identified among the seven species of unicellular protists examined, only 28 from the algae Ectocarpus and Chlamydomonas, meet the criteria for miRNA annotation. Therefore, at present only five groups of eukaryotes are known to possess miRNAs, indicating that miRNAs have evolved independently within eukaryotes through exaptation of their shared inherited RNAi machinery. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Republicanism, Religion, and Machiavelli’s Savonarolan MomentMarcia L. ColishMachiavelli’s readers often take at face value his claim that Christianity has weakened Italy’s civic spirit and martial valor, leaving it open to priestcraft and foreign invasion. Some scholars see this critique of Christianity as an expression of the irreligious, immoral, neopagan, or scientific Machiavelli, making it the chief index of his modernity. 1 One subset within this group treats Machiavelli’s [End (...) Page 597] anthropology as a secularized version of Augustine on original sin, absent an Eden behind it and a redemption before it. 2 Another view of Machiavelli on religion sees him as treating religion, whatever its teachings, functionally, as an instrument promoting desirable political behavior. 3 This is why they regard [End Page 598] Machiavelli as original and modern; although Maury D. Feld notes rightly that Machiavelli is here simply imitating the ancient Roman historians, who all treat religion in just this way. 4 For some proponents of the functionalist interpretation, it does not preclude Christian belief on Machiavelli’s part. For them his brief is not against Christianity itself but against clericalism, the papacy, and Christianity as it is currently interpreted. 5 Still others recognize Machiavelli’s acceptance of signs and portents, saintly behavior and miracles, and other indices of God’s existence and action in human history. They also note Machiavelli’s praise of biblical leaders seen as divinely inspired and his inclusion of them among the founders of religions and states who head his list of heroes. 6 Going farther, some scholars argue that Machiavelli was a conventional, if not an ardent or impeccable, Christian, who joined a religious confraternity before which he preached his Exhortation to Penitence, and the apparent recipient of the last rites of his church after a deathbed confession. 7 [End Page 599]Can these conflicting assessments of Machiavelli and religion be integrated? To some extent, yes. Once, that is, we consider a number of issues not always brought to bear on this question. Machiavelli recognizes that the foreigners who have overrun Italy and deprived Florence of the republic he had served are as Christian as the Italians. At home and abroad, their Christianity has not undermined their military strength or the civic virtue Machiavelli associates with republics. Within contemporary Florence there were three kinds of republicanism on offer, for those unhappy with the Medici restoration of 1512. One group sought to restore the pre-Medici governo stretto constitution dominated by the ottimati. Their opponents defended governo largo republicanism. Machiavelli advocated this type of polity, informed by his reading of ancient history and his assessment of human nature. But another, competing version of governo largo was put forth by Girolamo Savonarola during the Dominican friar’s stormy career as de facto head of the Florentine state from 1494 to 1498. Savonarola’s republican theory combined a number of ideas that Machiavelli loathed: the appeal to the Venetian Great Council as a model, the wish to purge Florence of her sins so that she could serve as the New Jerusalem in the coming apocalypse, and the notion that governo largo was a means to these religious ends, since the more broad-based the government, the more readily could it legislate and enforce moral reform. And, far from self-destructing after the friar’s ashes had been strewn on the Arno, Savonarolan republicanism continued to draw support from a diverse and substantial group of Florentines. Equally alarming, the agents [End Page 600] of this protracted Savonarolan moment seemed to have preempted Machiavelli’s own anticlerical, antipapal, antioligarchic, and antiMedicean positions, as well as a theory of governo largo. If we foreground Machiavelli’s desire to defend his own version of republicanism by undermining the Savonarolan alternative and if we recall that he treats Christianity positively in other contexts, it becomes possible to read those passages where he criticizes Christianity as practiced in Italy as texts with an antiSavonarolan subtext. Read this way, they are not incompatible with his acceptance of Christianity as true or as politically constructive elsewhere. In approaching this topic, we should also remember the longstanding associations that bound Christianity to politics and warfare.Addressing this last point... (shrink)