Hepatocellular carcinoma represents the third leading cause of cancer-related death. Because HCC is multicentric with time, excluding the few transplanted patients, sooner or later it becomes untreatable with loco-regional therapies and, until some years ago, it was not responsive to systemic therapies. In 2005 a randomized trial indicated the efficacy of a product containing stem cell differentiation stage factors taken from zebrafish embryos during the stage in which the totipotent stem cells are differentiating into the pluripotent adult stem cells. In (...) such a trial the patients, with “intermediate” and “advanced” HCC according to Barcelona Clinic Liver Cancer/American Association for the Study of Liver Diseases guidelines, presented benefit in terms of performance status and objective tumoral response, with some cases of complete response, that is, sustained disappearance of the neoplastic areas or blood supply therein, accompanied by normalization of alpha-fetoprotein... (shrink)

On the basis of the evidence that tumor development is suppressed by the embryonic microenvironment, some experiments using the factors taken from Zebrafish embryo at precise stages of cell differentiation were made. These experiments demonstrated a significant growth inhibition on different tumor cell lines in vitro. The observed mechanism of tumor growth inhibition is connected with the key-role cell cycle regulation molecules, such as p53 and pRb, which are modified by transcriptional or post-translational processes. Research on apoptosis and differentiation revealed (...) that treatment with these factors induces caspase-3 with a p73 apoptotic-dependent pathway activation and a concurrent significant normalization of e-cadherin and beta-catenin ratio. Other experiments found a synergistic effect on the colon cancer proliferation curve after the concurrent treatment with these factors and 5-fluorouracil. Finally, a product prepared for human therapy demonstrated 19.8% regression and 16% stable disease in an... (shrink)

BackgroundDiagnosis and treatment of differentiated thyroid carcinomas cause anxiety and depression. Additionally, these patients suffer hormonal alterations that are associated with psychological symptoms. This study aims to evaluate the effectiveness of a psycho-oncological intervention based on counseling to reduce anxiety and depression related to the treatment in patients with DTC.MethodsA non-randomized controlled study, with two groups [experimental group, n = 37, and control group, n = 38] and baseline and posttreatment measures, was designed. Patients in the EG received (...) a psycho-oncological intervention based on counseling in addition to the standard treatment. The independent variable was the assigned group and the dependent one was the evolution of anxiety and depression, which were analyzed separately, and both were evaluated using the Hospital Anxiety and Depression Scale. Other relevant covariables related to the quality of life were also analyzed using Short Form-36 Health Survey and Psychological General Wellbeing Index scales.ResultsThe difference of the posttreatment-baseline variation showed a statistically significant reduction in anxiety and depression in the EG in relation to the CG. The mean of the Psychological General Wellbeing Index scales score increased significantly in the EG and decreased significantly in the CG. All the baseline and the posttreatment scores of the variables evaluated showed a statistically significant improvement in the EG vs. the CG.ConclusionThis study demonstrates significant benefits of psycho-oncological intervention based on counseling in anxiety, depression, QoL, and wellbeing of the patient with differentiated thyroid carcinomas. (shrink)

Adolescents who believe that their parents treat them differently from their siblings have poorer psychosocial well-being than otherwise. This phenomenon, which is known as parental differential treatment or PDT occurs in up to 65% of families. Past studies have examined socio-demographic variables (e.g., child gender, age, and birth order) as predictors of PDT, but these immutable characteristics do little to inform interventions and help these adolescents. Hence, this study extends past research by investigating links among parent empathy, parent (...) perception of PDT, child perception of PDT, child perception of fairness and child well-being (self-esteem, depression, anxiety, and trust in the relationship with parents). Furthermore, this study tests whether adolescent personality (openness, conscientiousness, extraversion, agreeableness and neuroticism), child empathy, and child perception of fairness moderate these links. This study will utilize a two-wave longitudinal design with a one-year lapse. Data will be collected from 760 Chinese adolescents studying from Secondary One to Secondary Three in 18 schools in Hong Kong and from their parents. We test our theoretical model via a multilevel structural equation model. This study both addresses (a) theoretical debates about relations among empathy, PDT, fairness, and psychosocial well-being and (b) focuses on modifiable factors and behaviors, to inform future interventions, such as parent education. (shrink)

The climate regime, comprising the Framework Convention on Climate Change of 1992 and the Kyoto Protocol of 1997, contains elements of prescription for and leadership of developed countries and differentiation in favor of developing countries. The nature and extent of differentiation in favor of developing countries in the climate regime, however, has remained contentious through the years. While there is a shared understanding among states that they have common but differentiated responsibilities in addressing climate change, there is little agreement on (...) the formulae for differentiating between states in doing so. This Article argues that the outcomes of international climate negotiations in recent years, in particular the Copenhagen Accord of 2009 and the Cancun Agreements of 2010, offer a distinctive vision of differential treatment. Through these instruments, the international community appears to be moving from differentiation in favor of developing countries towards differentiation or flexibility for all countries, as well as towards increasing parallelism between developed and developing countries. The Durban Platform of 2011, which launches a new process to negotiate a post-2020 agreement, confirms this trend, setting the scene for the erosion of differential treatment in the future/post-2020 climate regime. This Article explores the nature of differentiation, as it is evolving, in the emerging climate regime, in particular as it relates to mitigation obligations, and the impact this is likely to have on the design, ambition, reach and rigor of the emerging climate regime. (shrink)

In this paper the authors give a survey of biological phenomena , for which the term ‘differentiation’, used in the widest sense, has a meaningful application. The last chapter deals with some general aspects of differentiation and connected phenomena, such as polarity, symmetry, loss of potencies, dedifferentiation, redifferentiation, adifferentiation, regulation and integration.To prevent this article becoming too voluminous, the authors had to refrain from extending the treatment of differentiation to non-living matter and to human society.

When forced treatment in mental health care is under consideration, two approaches guide clinicians in their actions: the dominant rights-based approach and the relational ethical approach. We hypothesized that nurses with bachelor's degrees differentiate better between the two approaches than nurses without a degree. To test this hypothesis a survey was performed in major Slovenian health institutions. We found that nurses emphasize the importance of ethics and personal values, but 55.4% of all the nurse participants confused the two approaches. (...) The results confirmed our hypothesis and indicate the importance of nurses' formal education, especially when caring for patients with mental illness. (shrink)

Adolescents are routinely treated differently to adults, even when they possess similar capacities. In this article, we explore the justification for one case of differential treatment of adolescents. We attempt to make philosophical sense of the concurrent consents doctrine in law: adolescents found to have decision-making capacity have the power to consent to—and thereby, all else being equal, permit—their own medical treatment, but they lack the power always to refuse treatment and so render it impermissible. Other (...) parties, that is, individuals who exercise parental responsibility or a court, retain the authority to consent on an adolescent’s behalf. We explore four defences of the doctrine. We reject two attempts to defend the asymmetry in the power to consent to and refuse medical treatment by reference to transitional paternalism. We then consider and reject a stage of life justification. Finally, we articulate a justification based on the distinctiveness of adolescent well-being. (shrink)

The literature on multiculturalism currently splits parties into two camps : those favorable to the uniform treatment of cultural differences and those favorable to their differential treatment. Brian Barry, perhaps of the most influential present supporters of the first camp, has recently developed a severe criticism of the second approach. I intend in this paper to examine the scope and limits of Barry’s own uniform treatment approach. First, I will present the grounds Barry has for supporting (...) it. Second, I will examine one of its most important difficulties, that of excluding the particular treatment of cultural differences on the grounds that they are a matter of choice. (shrink)

Cellular pattern formations of some epithelia are believed to be governed by the direct lateral inhibition rule of cell differentiation. That is, initially equivalent cells are all competent to differentiate, but once a cell has differentiated, the cell inhibits its immediate neighbors from following this pathway. Such a differentiation repeats until all non-inhibited cells have differentiated. The cellular polygonal patterns can be characterized by the numbers of undifferentiated cells and differentiated ones. When the differentiated cells become large in size, the (...) polygonal pattern is deformed since more cells are needed to enclose the large cell. An actual example of such a cellular pattern was examined. The pupal wing epidermis of a butterfly Pieris rapae shows a transition of the equivalent-size cell pattern to the pattern involving large cells. The process of the transition was analyzed by using the method of weighted Voronoi tessellation that is useful for treatment of irregularly sized polygons. The analysis supported that the pattern transition of the early stage of the pupal wing epidermis is governed by the lateral inhibition rule. The differentiation takes place in order of largeness, but not smallness, of the apical polygonal area in the differentiating region of the pupal wing. (shrink)

In the big data era, sequencing technology has produced a large number of biological sequencing data. Different views of the cancer genome data provide sufficient complementary information to explore genetic activity. The identification of differentially expressed genes from multiview cancer gene data is of great importance in cancer diagnosis and treatment. In this paper, we propose a novel method for identifying differentially expressed genes based on tensor robust principal component analysis, which extends the matrix method to the processing of (...) multiway data. To identify differentially expressed genes, the plan is carried out as follows. First, multiview data containing cancer gene expression data from different sources are prepared. Second, the original tensor is decomposed into a sum of a low-rank tensor and a sparse tensor using TRPCA. Third, the differentially expressed genes are considered to be sparse perturbed signals and then identified based on the sparse tensor. Fourth, the differentially expressed genes are evaluated using Gene Ontology and Gene Cards tools. The validity of the TRPCA method was tested using two sets of multiview data. The experimental results showed that our method is superior to the representative methods in efficiency and accuracy aspects. (shrink)

Arginine vasopressin (AVP) is a powerful regulator of various social behaviors across many species. However, seemingly contradictory effects of AVP have been found in both animal and human studies, e.g., promoting aggression on one hand and facilitating social bonding on the other hand. Therefore, we hypothesize that the role of AVP in social behaviors is context-dependent. To this end, we examined the modulatory effect of AVP on male’s behavioral and neural responses to infant and adult cues. After intranasal and double-blind (...) treatment of AVP or placebo, male participants were asked to rate their subjective approaching willingness to infant and adult faces in specific contexts informed by cue words while EEG recording. Our results showed that AVP treatment increased approaching ratings to neutral and positive other-gender adult faces compared to emotional matched same-gender adult faces, and to negative girl faces compared to negative boy faces. Furthermore, compared to placebo treatment, AVP treatment induced larger N1 amplitudes to neutral cues associated with both adults and infants, whereas AVP treatment only sustained pronounced late positive potential (LPP) amplitudes to neutral cues of infants but not adults. Those findings implicate differential roles of AVP in the processing of adult- and infant-related cues and thus lend support to the context-dependent account. (shrink)

David Hume fancied himself the Newton of the mind, aiming to reinvent the study of human mental life in the same way that Newton had revolutionized physics. And it was his view that the novel account of belief he proposed in his Treatise of Human Nature was one of that work’s central philosophical contributions. From the earliest responses to the Treatise forward, however, there was deep pessimism about the prospects for his account. It is easy to understand the source of (...) this pessimism: The constraints he employed in theorizing stem from his Newtonian ambitions. Constraints such as his copy principle and his decision to rely only on variations in “force and vivacity” for differentiating types of mental states severely limit his available explanatory resources. However, it is one thing to regard an account as untenable, and quite another to understand where it fails. In this paper, I focus on one long-standing objection to Hume’s account — the objection that Hume cannot offer an account of negative belief or denial — as presented by Hume’s contemporary Thomas Reid, as well as more recently by Barry Stroud, and defend Hume from this objection. I argue that Hume both should and does endorse an account of negative belief based in relations of contrariety between contents, rather than between mental activities, and survey the different options available to Hume for spelling out an account of contrary contents. (shrink)

The coronavirus disease 2019 pandemic caused by severe acute respiratory syndrome coronavirus 2 is challenging the dental community to an unprecedented degree. Knowledge of the increased risk of infection in dental settings has been disseminated to the public and guidelines have been formulated to assist dental attendance decision-making. However, dental attendance behaviors incompatible with treatment need is not uncommon in clinical settings. Important gaps remain in the knowledge about how psychological factors are affecting dental attendance behaviors during the COVID-19 (...) epidemic. In this cross-sectional study, a questionnaire survey was performed during February and March 2020. A total of 342 and 294 dental patients who attended and avoided dental visits, respectively, were included. The participants were classified into four groups based on dental attendance behavior and emergent/urgent dental treatment need. Bivariate analysis was performed to investigate factors associated with dental attendance. Multivariable logistic regression based on principal component scores was performed to identify major psychological constructs associated with unnecessary dental avoidance and attendance. Among all the factors explored, inability to wear masks during dental treatment was most closely associated with the overall pattern of dental attendance among participants. Multivariable regression suggested that unnecessary dental avoidance was associated with perceived risk of infection in general and in dental settings, perceived impact of COVID-19 and dental problems on general health, and personal traits such as trust and anxiety. Unnecessary dental attendance was associated with optimism toward the epidemic and trust. Multidisciplinary efforts involving dental and medical professionals as well as psychologists are warranted to promote more widespread adoption, among the general public, of dental attendance behaviors compatible with dental treatment need during the COVID-19 epidemic. (shrink)

In this paper I criticize the claim that fair trade entails a commitment to an ideal of formal equality according to which all members of the trade regime are to receive and offer equal, or uniform, treatment. I first elaborate on the idea of formal equality and its rationales, identify several positive arguments for departing from formal equality, and respond to a number of objections to “special and differential treatment” for poor countries. I then consider in more (...) detail one specific element of formal equality in the trade regime, namely, the principle of reciprocity. Several distinct reciprocity principles are identified, none of which, I argue, should be regarded as a requirement of fairness. Next I consider a more recent interpretation of formal equality that requires trading countries to “harmonize” domestic laws and policies. I argue that harmonization is not required by fairness. (shrink)

Humans' voice offers the widest variety of motor phenomena of any human activity. However, its clinical evaluation in people with movement disorders such as Parkinson's disease lags behind current knowledge on advanced analytical automatic speech processing methodology. Here, we use deep learning-based speech processing to differentially analyze voice recordings in 14 people with PD before and after dopaminergic medication using personalized Convolutional Recurrent Neural Networks and Phone Attribute Codebooks. p-CRNN yields an accuracy of 82.35% in the binary classification of ON (...) and OFF motor states at a sensitivity/specificity of 0.86/0.78. The PAC-based approach's accuracy was slightly lower with 73.08% at a sensitivity/specificity of 0.69/0.77, but this method offers easier interpretation and understanding of the computational biomarkers. Both p-CRNN and PAC provide a differentiated view and novel insights into the distinctive components of the speech of persons with PD. Both methods detect voice qualities that are amenable to dopaminergic treatment, including active phonetic and prosodic features. Our findings may pave the way for quantitative measurements of speech in persons with PD. (shrink)

Sex selection and disability avoidance receive opposed treatment in bioethics literature, legislative practice and public opinion. However, some theorists question this state of affairs by drawing analogies between the harmful consequences of these practices. This paper shares their disapproval of gender selection and disability avoidance, but bases its resistance to these practices on an examination of the concepts of gender and disability. Here it identifies conceptual confusions as another cause of approval of sex selection and disability avoidance. Further, in (...) clarifying the nature of the concepts at issue, and their relationship with the subjects that they apply to, this discussion highlights the existence of relevant analogies between the concepts of gender and disability. Here the social construction and universality of gender and disability allow their differential treatment to be resisted at the conceptual level, creating a strong foundation for more consequentialist arguments against sex selection and disability avoidance. (shrink)

To reduce sex differences in employment outcomes, we must examine them in the context of the sex-gender hierarchy. The conventional explanation for wage gap—job segregation—is incorrect because it ignores men's incentive to preserve their advantages and their ability to do so by establishing the rules that distribute rewards. The primary method through which all dominant groups maintain their hegemony is by differentiating the subordinate group and defining it as inferior and hence meriting inferior treatment. My argument implies that neither (...) sex-integrating jobs nor implementing comparable worth will markedly improve women's employment status because men can subvert these mechanisms or even change the rules by which rewards are allocated. As evidence, I show that occupational integration has failed to advance women appreciably, and I argue that comparable worth is not likely to be much more effective. Instead, we must seek political analyses and political solutions. (shrink)

River water pollution by wastewater can cause significant negative impact on the aquatic sustainability. Hence, accurate modeling of this complicated system and its cost-effective treatment and reuse decision is very important because this optimization process is related to economic expenditure, societal health, and environmental deterioration. In order to optimize this complex system, we may consider three treatment or reuse options such as microscreening filtration, nitrification, and fertilization-oriented irrigation on top of two existing options such as settling and biological (...) oxidation. The objective of this environmental optimization is to minimize the economic expenditure of life cycle costs while satisfying the public health standard in terms of groundwater quality and the environmental standard in terms of river water quality. Particularly, this study improves existing optimization model by pinpointing the critical deficit location of dissolved oxygen sag curve by using analytic differentiation. Also, the proposed formulation considers more practical constraints such as maximal size of irrigation area and minimal amount of filtration treatment process. The results obtained by using an evolutionary algorithm, named a parameter-setting-free harmony search algorithm, show that the proposed model successfully finds optimal solutions while conveniently locating the critical deficit point. (shrink)

Experiments carried out on different tumor cell lines showed a significative growth reduction of all treated lines due to the administration of zebrafish embryo extracts withdrawn at different stem cells differentiation stages. Research conducted in order to establish which molecular events were involved in control and downregulation of cancer cell lines demonstrated a transcriptional regulation of the key cell cycle onco-supressor gene, like p53 and a post-translational modification of molecules, like pRb. Research on apoptosis and differentiation processes showed that stem (...) cells differentiating factors induce caspase-3 activation, mainly through E2F-1 gene regulation, thus hyper expressing c-Myc and activating a p73-dependent apoptotic pathway. Moreover, we demonstrated a concurrent and significative normalization of the e-cadherin/β-catenin expression, with an e-cadherin rise. Administration of SCDF in an open clinical randomized clinical trail conducted on 179 patients affected by interme... (shrink)

The current major models of coexistence of species on the same resources are briefly summarized. It is then shown that analysis of supposedly competitive systems in terms of the physical four dimensions of phase-space is sufficient to understand the causes for coexistence and for competitive exclusion. Thus, the multiple dimensions of niche theory are reduced to factors which define the magnitudes of the phase-spatial system, in particular the boundaries of population spaces and of periods of activity. Excluding possible cooperative interaction (...) between consumers, it appears that coexistence of species on thesame kind of limiting resource is possible only in cases of compartmentalization either in space, or in time, of resource consumption, i.e. if each consumer species disposes of a separate resource supply. Three criteria were found to be decisive for successful compartmentalization (i.e. for coexistence): 1. the vector of the resource flow; 2. relative mobility between consumers and resource units; 3. dependence or independence of resource flow on previous consumption. The traditional terminology of niche theory and of competition theory in general proved to be inadequate for analytical treatment of problems of coexistence. (shrink)

IntroductionThe Managing Cancer and Living Meaningfully therapy for patients with advanced cancer was tested against a supportive psycho-oncological counseling intervention in a randomized controlled trial. We investigated whether CALM was delivered as intended ; whether CALM therapists with less experience in psycho-oncological care show higher adherence scores; and whether potential overlapping treatment elements between CALM and SPI can be identified.MethodsTwo trained and blinded raters assessed on 19 items four subscales of the Treatment Integrity Scale covering treatment domains (...) of CALM. A random sample of 150 audio recordings were rated on a three-point Likert scale with 1 = “adherent to some extent,” 2 = “adherent to a sufficient extent,” 3 = “very adherent.”ResultsAll 19 treatment elements were applied, but in various frequencies. CALM therapists most frequently explored symptoms and/or relationship to health care providers and allowed expression of sadness and anxiety about the progression of disease. The exploration of CALM treatment element SC_1 was most frequently implemented in a satisfactory or excellent manner, whereas the treatment element SMP_4: Therapist promotes acknowledgment that some life goals may no longer be achievable was not implemented in a satisfactory manner. In terms of treatment differentiation, no treatment elements could be identified which were applied significantly more often by CALM therapists than by SPI therapists.ConclusionResults verify the application of CALM treatment domains. However, CALM therapists’ adherence scores indicated manual deviations. Furthermore, raters were not able to significantly distinguish CALM from SPI, implying that overlapping treatment elements were delivered to patients. (shrink)

Dr. Hauptman provides us with a wonderful clinical vignette, the richness of which is measured in the range of responses it can evoke. My response will be that of a career-long psychiatric educator who has served as a clinical supervisor to many residents over the years. In this role, residents like Dr. Hauptman present their clinical work and their questions. I, in turn, try to help them to learn from their patients, improve their clinical skills, and seek answers to their (...) questions. My task at the outset is to help the resident develop a differential diagnosis, a biopsychosocial formulation of the patient’s difficulty, and a treatment plan. In other words, I work with the resident to understand who... (shrink)

Some basic problems of the probabilistic treatment of fields are considered, proceeding from the fundamentals of the complete probability theory. Two essentially equivalent definitions of random fields related to continuous objects are suggested. It is explained why the conventional classical probabilistic treatment generally is inapplicable to fields in principle. Two types of finite-dimensional random variables created by random fields are compared. Some general regularities related to Lagrangian and Hamiltonian partial equations, obtainable proceeding from the corresponding sets of ordinary (...) differential equations, are revealed by using the functional derivative defined anew. It is shown that Hamiltonian random fields give rise to two types of Hamiltonian random variables, variables of the second type being those considered in the author's previous paper and immediately suited to the quantum approach. The results obtained are illustrated by some general examples. Critical remarks concerning second quantization are made, demonstrating the artificiality of this method. It is emphasized that the given probabilistic consideration of fields cannot be directly applied to, for instance, the electromagnetic field, which needs a special treatment. (shrink)

Bioethicists often present ‘saving lives’ as a goal distinct from, and competing with, that of extending lives by as much as possible. I argue that this usage of the term is misleading, and provides unwarranted rhetorical support for neglecting the magnitudes of the harms and benefits at stake in medical allocation decisions, often to the detriment of the young. Equal concern for all persons requires weighting equal interests equally, but not all individuals have an equal interest in ‘life-saving’ treatment.

Historically, studies of the role of endogenous hormones in developmental differentiation of the sexes have suggested that mammalian sexual differentiation is mediated primarily by testicular androgens, and that exposure to androgens in early life leads to a male brain as defined by neuroanatomy and behavior. The female brain has been assumed to develop via a hormonal default mechanism, in the absence of androgen or other hormones. Ovarian hormones have significant effects on the development of a sexually dimorphic cortical structure, the (...) corpus callosum, which is larger in male than in female rats. In the females, removal of the ovaries as late as Day 16 increases the cross-sectional area of the adult corpus callosum. Treatment with low-dose estradiol starting on Day 25 inhibits this effect. Female callosa are also enlarged by a combination of daily postnatal handling and exogenous testosterone administered prior to Day 8. The effects of androgen treatment are expressed early in development, with males and testosterone-treated females having larger callosa than control females as early as Day 30. The effects of ovariectomy do not appear until after Day 55. These findings are more consistent with other evidence of a later sensitive period for ovarian feminization as compared to androgenic masculinization. (shrink)

This paper provides an economic justification for the exemption from liability for omissions in torts and for the exceptions to this exemption. It interprets the differential treatment of acts and omissions under tort law as a proxy for a more fundamental distinction between harms caused by multiple injurers, where each one can single-handedly prevent the harm, and harms caused by a single injurer. Since the overall cost to which a group of injurers is exposed is constant, attributing liability (...) to many injurers reduces the part each has to pay and, consequently, reduces each one’s incentives to take precautions. Broad exemption from liability for omissions is a way of carving a simple, practical rule to distinguish between the typical cases in which an agent can be easily selected and provided with sufficient incentives and cases in which there is a serious problem of dilution of liability. The exceptions to the rule exempting from liability for omissions are explained in terms of efficiency. The imposition of liability for omissions depends on the ability to identify a salient agent, i.e., to single out one or few liable agents and differentiate their role from that of others. Tort law designs three types of "salience rules." It either creates salience directly, or it can exploit salience created "naturally," or it can induce injurers to create salience voluntarily. (shrink)

It is argued that the assessment of the strength of the evidence for the Darwinian theory of evolution by natural selection offered by Michael Ruse in the Philosophy of Biology is in one respect too weak and in the other too strong. His claim that artificial selection provides at best analogical evidence for the theory is shown to rest on a spurious distinction between artificial and natural selection. His argument that Darwinian theory, unlike its competitors, accounts for the cytological and (...) genetic data is demonstrated to be unwarranted and fails to differentiate the actual degrees of evidential support provided by cytology and genetics for parts of differing and competing theories of evolution. The evidentially secure foundations of Darwin's theory are not challenged in this paper, only Ruse's account of their nature. (shrink)

Neurofibromatosis type 1 is associated with peripheral and central nervous system tumors. It is noteworthy that the regions in which these tumors frequently arise are the optic pathways and the brainstem. Thus, we decided to trace the procedure of diffusion Magnetic Resonance Imaging alterations along with Short-Wavelength Automated Perimetry examinations of the OPs after surgery and chemotherapy over 1 year, which enabled us to evaluate chemotherapy's efficacy in an NF1 patient with an OP tumor. In this study, a 25-year-old woman (...) with NF1 and left optic radiation glioma underwent surgery to remove the glioma. Immunohistochemistry revealed a Pilocytic Astrocytoma WHO grade I. Post-operation chemotherapy done using nine treatment cycles of administering Temozolomide for 5 days every 4 weeks. Applying the region of interest differential tractography method and SWAP four times every 3 months allowed us to follow the patient's visual acuity alterations longitudinally. The differential deterministic tractography method and statistical analyses enabled us to discover the white matter tracts anisotropy alterations over time. Furthermore, statistical analyses on the SWAP results along time illustrated possible alterations in visual acuity. Then, we could compare and associate the findings with the SWAP examinations and patient symptoms longitudinally. Statistical analyses of SWAP tests revealed a significant improvement in visual fields, and longitudinal differential tractography showed myelination and dense axonal packing in the left OR after 1 year of treatment. In this study, we examined an old hypothesis suggesting that chemotherapy is more effective than radiotherapy for NF1 patients with OP gliomas because of the radiation side effects on the visual field, cognition, and cerebrovascular complications. Our longitudinal clinical case study involving dMRI and SWAP on a single NF1-OPG patient showed that chemotherapy did not suppress the OP myelination over time. However, it should be noted that this is a clinical case study, and, therefore, the generalization of results is limited. Future investigations might focus on genetic-based imaging, particularly in more cases. Further, meta-analyses are recommended for giving a proper Field Of View to researchers as a subtle clue regarding precision medicine. (shrink)

Mental health problems start early in life. However, the majority of adolescents fulfilling the criteria for mental health disorders do not receive treatment, and half of those who do get treatment drop out. This begs the question of what differentiates helpful from unhelpful treatment processes from the perspective of young clients. In this study, we interviewed 12 young people who entered mental health care reluctantly at the initiative of others before the age of 18. Their journeys through (...) mental health care varied significantly despite sharing the same starting point. Our analyses resulted in a model of three trajectories. We describe relational and structural facilitators and obstacles within each trajectory and have formulated narratives highlighting core experiences differentiating them. Trajectory 1 was characterized by a rapid loss of hope, leading the adolescents to conclude that mental health care was not worth the investment. Trajectory 2 was characterized by a lingering hope that never materialized into a constructive therapeutic process despite prevailing efforts by both therapists and adolescents. Trajectory 3 was characterized by genuine meetings, allowing the therapist to transform from an unsafe stranger into a safe, competent, and benevolent adult. We discuss how our results have implications for understanding agency displayed by adolescent clients in therapy, therapist flexibility and authenticity, service organization, and attributional processes influencing clinical judgment and therapeutic processes when adolescent psychotherapy has a difficult starting point. (shrink)

Jonathan Schaffer has provided three putative counterexamples to the transitivity of grounding, and has argued that a contrastive treatment of grounding is able to provide a resolution to them, which in turn provides some motivation for accepting such a treatment. In this article, I argue that one of these cases can easily be turned into a putative counterexample to a principle which Schaffer calls differential transitivity. Since Schaffer's proposed resolution rests on this principle, this presents a dilemma (...) for the contrastivist: either he dismisses the third case, which weakens the motivation for accepting his treatment of grounding, or else he accepts it, in which case he is faced with a counterexample to a principle that his proposed resolution to the original cases depends on. In the remainder of the article, I argue that the prima facie most promising strategy the contrastivist could take, which is to place some restriction on which contrastive facts are admissible so as to rule out the purported counterexample to differential transitivity, faces some important difficulties. Although these difficulties are not insurmountable, they do pose a substantial challenge for the contrastivist. (shrink)

The aim of this study was to investigate the level of posttraumatic growth of cancer patients post-treatment in the context of selected sociodemographic characteristics, clinical markers, and psychological variables (positive and negative emotions, anxiety and depressive symptoms, gratitude, forgiveness, hope, importance of the spiritual aspect of life and the practice of religious faith). The study sample consisted of 110 patients post-treatment aged 22-79 years and with an average time since the completion of the last treatment ranging from (...) 5 to 396 months. The Posttraumatic Growth Inventory, the Positive and Negative Affect Schedule, screening methods to measure anxiety (General Anxiety Dis- order-7) and depression (Patient Health Questionnaire-9), and questionnaires to measure dispositional gratitude (Gratitude Questionnaire GQ-6), dispositional hope (Adult Dispositional Hope Scale), and forgiveness (Heartland Forgiveness Scale) were used to measure the psychological variables. There were no differences in the level of posttraumatic growth in terms of sociodemographic characteristics and clinical markers. Partner status, employment status, presence of recurrence, and comorbidities did not differentiate its level either. The rate of posttraumatic growth was related to the experience of positive emotions, gratitude, the importance of the spiritual aspect of life, and the practice of religious faith. In the regression model that explained 21.90% of the variance in posttraumatic growth, only the level of positive emotions was a significant predictor. The results of the present research point suggest that the level of posttraumatic growth is associated with several areas of emotional experience and cognitive adjustment of cancer patients post-treatment. (shrink)

Biological and epidemiological phenomena are often measured with error or imperfectly captured in data. When the true state of this imperfect measure is a confounder of an outcome exposure relationship of interest, it was previously widely believed that adjustment for the mismeasured observed variables provides a less biased estimate of the true average causal effect than not adjusting. However, this is not always the case and depends on both the nature of the measurement and confounding. We describe two sets of (...) conditions under which adjusting for a non-deferentially mismeasured proxy comes closer to the unidentifiable true average causal effect than the unadjusted or crude estimate. The first set of conditions apply when the exposure is discrete or continuous and the confounder is ordinal, and the expectation of the outcome is monotonic in the confounder for both treatment levels contrasted. The second set of conditions apply when the exposure and the confounder are categorical. In all settings, the mismeasurement must be non-differential, as differential mismeasurement, particularly an unknown pattern, can cause unpredictable results. (shrink)

The increasing use of pharmacotherapy raises specific ethical concerns for psychologists working with vulnerable populations. Due to a shortage of trained specialists, professionals without training in mental health, such as primary care providers, are increasingly prescribing and monitoring psychotropic medications. Vulnerable populations face additional barriers to mental health treatment and are at heightened risk when these factors intersect. Hence, these patients experience unique barriers to receiving optimal psychopharmacological care and are differentially vulnerable to deleterious outcomes associated with misdiagnosis and (...) overmedication. Taken together, these factors fuel inequities in the access, quality, and utilization of mental health care. Psychologists working with these patients are ethically mandated to protect patients from harm and ensure equitable care across patient populations. Specifically, psychologists must respond to the dilemma of how to effectively treat patients within these vulnerable populations who have been misdiagnosed or poorly medicated while remaining within the bounds of their competence. This article recommends pathways to address these dilemmas through education, training, research, and advocacy. (shrink)

A two strain HIV/AIDS model with treatment which allows AIDS patients with sensitive HIV-strain to undergo amelioration is presented as a system of non-linear ordinary differential equations. The disease-free equilibrium is shown to be globally asymptotically stable when the associated epidemic threshold known as the basic reproduction number for the model is less than unity. The centre manifold theory is used to show that the sensitive HIV-strain only and resistant HIV-strain only endemic equilibria are locally asymptotically stable when (...) the associated reproduction numbers are greater than unity. Qualitative analysis of the model including positivity, boundedness and persistence of solutions are presented. The model is numerically analysed to assess the effects of treatment with amelioration on the dynamics of a two strain HIV/AIDS model. Numerical simulations of the model show that the two strains co-exist whenever the reproduction numbers exceed unity. Further, treatment with amelioration may result in an increase in the total number of infective individuals (asymptomatic) but results in a decrease in the number of AIDS patients. Further, analysis of the reproduction numbers show that antiretroviral resistance increases with increase in antiretroviral use. (shrink)

Multiple Sclerosis is a debilitating chronic autoimmune disease of the central nervous system that results in lower quality of life. Medication adherence is important for reducing relapse, disease progression, and MS-related symptoms, particularly during the early stages of MS. However, adherence may be impacted by negative emotional states. Therefore, it is important to identify protective factors. Past research suggests that the ability to discriminate between negative emotional states, also known as negative emotion differentiation, may be protective against enactment of maladaptive (...) risk-related behaviors. However, less is known as to how NED may promote adaptive health behaviors such as medication adherence. Utilizing weekly diaries, we investigated whether NED moderates the association between negative affect and medication adherence rates across 58 weeks among patients newly diagnosed with MS. Results revealed that NED significantly moderated the relationship between negative affect and medication adherence. Specifically, greater negative affect was associated with lower adherence only for individuals reporting low NED. However, this link disappeared for those reporting moderate to high NED. Building upon past research, our findings suggest that NED may promote adaptive health behaviors and have important clinical implications for the treatment and management of chronic illness. (shrink)

This paper examines the ethical conundrum between a hospital's ethos of relieving distress, investigation and treatment, and its concurrent duties under English law to administer tests of decision-making capacity and safeguarding protection where it believes the patient may lack this capacity. Delirium, characterised by a precipitous decline in mental functioning exhibiting the shared symptomology of recoverable depressive disorders and terminal dementia, is not uncommon after emergency admission of elderly patients into acute medical hospital wards. The use of functional capacity (...) testing as a benchmark for decision-making capacity for post-discharge residence has been criticised as outdated, conceptually floored, subjective, lacking central guidance, transparent process, and accountability. A study of patient experience demonstrates the potential for hospital misuse of capacity testing, the failure of functional testing to differentiate decision making capacity from the disability of partial cognitive impairment, and how hospital capacity processes can interact and amplify patient pathology thereby decreasing recovery prospects. Prioritisation of mental capacity obligations above thorough investigation of emergent mental pathology and relief of patient anguish, results in extended detention in medical wards lacking bespoke facilities. Further understanding of patient experience is needed to inform policy with interventions tailored to avoid harm and increase wellbeing. (shrink)

The limbus is a narrow band of tissue that encircles the cornea, the transparent ‘window’ into the eye. The outermost layer of the cornea is the epithelium, which is necessary for clear vision. The limbus acts as a ‘reservoir’ for limbal stem cells which maintain and regenerate the corneal epithelium. It also functions as a barrier to the conjunctiva and its blood vessels. Limbal stem cell deficiency is a general term for diseases which are characterised by the impairment of the (...) limbus, limbal stem cells and their ability to replenish the corneal epithelium through proliferation and differentiation. Consequently, sufferers experience chronic pain and progressive blindness. This paper will highlight the salient milestones of limbal stem cell biology and potential future treatments for limbal stem cell deficiency. (shrink)

Analysis of the debate concerning the appropriate way of researching the effects of complementary and alternative medicine (CAM) treatments highlights the controversial issue of the mind–body bond in medical research. The article examines a range of approaches, extending from outright opposition to CAM research, through the demand to employ only rigorous trials, to suggestions to use a hierarchy of evidence, up to practice‐based research proposals. These diverse approaches are analysed using theoretical concepts from the field of sociology of science and (...) knowledge. The article uses the concept of “hybrid knowledge” to denote the knowledge being constructed in late modern CAM discourse—knowledge that hybridises differentiated and even contradictory modern categories of knowledge. The article suggests that the different approaches taken by sociologists of science and knowledge, such as strong anti‐dualism and the assertion that there are differences in our understanding of the natural and the cultural–social terrain, are all useful and are not necessarily mutually exclusive. The article seeks to clarify the debate concerning the appropriate way of researching CAM and to contribute to the ongoing development and application of sociology of knowledge. (shrink)

Despite the declarations of international documents on minority language rights, provision is patchy for supporting minority languages in the UK, where since the 1980s governments have deliberately or unwittingly greatly raised the profile and comparative standing of English. The partial exception to this trend has been the treatment of indigenous/regional minority languages, stimulated by policies of devolution intended to revive or create a sense of national identity, and to redress perceived historic linguistic injustices. In a multicultural state or region (...) these apparently reasonable goals appear to conflict with current views of citizenship that argue for inclusiveness and equal treatment for all under the law. In particular, the question arises why indigenous minority languages should receive official support and funding that is denied to speakers of minority ethnic languages. In this article, I examine various justifications offered for this, including higher population levels, the geographical concentration of indigenous speakers, the long historical ties between regional language and culture, and the notion of promotional rights. I attempt to show each argument lacks force and ignores the fact of natural language change. I argue for an approach to indigenous languages that weights support and funding according to a range of factors including the number of minority speakers, their perceived need and the benefits that would flow from funding. Support from the local community and private sources could also be encouraged. (shrink)

More than 15 million people have been affected by coronavirus disease 2019 (COVID‐19) and it has caused 640 016 deaths as of July 26, 2020. Currently, no effective treatment option is available for COVID‐19 patients. Though many drugs have been proposed, none of them has shown particular efficacy in clinical trials. In this article, the relationship between the Adrenergic system and the renin‐angiotensin‐aldosterone system (RAAS) is focused in COVID‐19 and a vicious circle consisting of the Adrenergic system‐RAAS‐Angiotensin converting enzyme (...) 2 (ACE2)‐severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) (which is referred to as the “ARAS loop”) is proposed. Hyperactivation of the ARAS loop may be the underlying pathophysiological mechanism in COVID‐19, and beta‐adrenergic blockers are proposed as a potential treatment option. Beta‐adrenergic blockers may decrease the SARS‐CoV‐2 cellular entry by decreasing ACE2 receptors expression and cluster of differentiation 147 (CD147) in various cells in the body. Beta‐adrenergic blockers may decrease the morbidity and mortality in COVID‐19 patients by preventing or reducing acute respiratory distress syndrome (ARDS) and other complications. Retrospective and prospective clinical trials should be conducted to check the validity of the hypothesis. Also see the video abstract here https://youtu.be/uLoy7do5ROo. (shrink)

Unilateral spatial neglect is a disorder characterized by the failure to report, respond to, or orient toward the contralateral side of space to a brain lesion. Current assessment methods often fail to discover milder forms, cannot differentiate between unilateral spatial neglect subtypes and lack ecological validity. There is also a need for treatment methods that target subtypes. Immersive virtual reality systems in combination with eye-tracking have the potential to overcome these shortcomings, by providing more naturalistic environments and tasks, with (...) sensitive and detailed measures. This systematic review examines the state of the art of research on these technologies as applied in the assessment and treatment of USN. As we found no studies that combined immersive VR and ET, we reviewed these approaches individually. The review of VR included seven articles, the ET review twelve. The reviews revealed promising results. All included studies found significant group-level differences for several USN measures. In addition, several studies found asymmetric behavior in VR and ET tasks for patients who did not show signs of USN in conventional tests. Particularly promising features were multitasking in complex VR environments and detailed eye-movement analysis. No VR and only a few ET studies attempted to differentiate USN subtypes, although the technologies appeared appropriate. One ET study grouped USN participants using individual heatmaps, and another differentiated between subtypes on drawing tasks. Regarding ecological validity, although no studies tested the prognostic validity of their assessment methods, VR and ET studies utilized naturalistic tasks and stimuli reflecting everyday situations. Technological characteristics, such as the field of view and refresh rate of the head-mounted displays, could be improved, though, to improve ecological validity. We found no studies that utilized VR or ET technologies for USN treatment up until the search date of the 26th of February 2020. In conclusion, VR-ET-based systems show great potential for USN assessment. VR-ET holds great promise for treatment, for example, by monitoring behavior and adapting and tailoring to the individual person’s needs and abilities. Future research should consider developing methods for individual subtypes and differential diagnostics to inform individual treatment programs. (shrink)

This article enumerates and critically examines the potential grounds on which we might treat the case of a patient with an advance directive who attempted suicide, differently from one whose injuries were the result of an accident. Grounds for differentiation are distilled into two potential justifications. The first addresses the concern that withholding or withdrawing care from a patient with self-inflicted injuries would be aiding and abetting suicide. The second examines concerns about the patient’s decisionmaking capacity. Ultimately, it is argued (...) that while there might be legitimate reasons to hold the advance directive of a suicidal patient to a different standard of scrutiny, the fact that the patient’s medical state was self-inflicted should not, in and of itself, necessarily invalidate the guidance of the directive. Finally, four practical recommendations are offered for negotiating similar cases. (shrink)