In the past, hypothesis testing in medicine has employed the paradigm of the repeatable experiment. In statistical hypothesis testing, an unbiased sample is drawn from a larger source population, and a calculated statistic is compared to a preassigned critical region, on the assumption that the comparison could be repeated an indefinite number of times. However, repeated experiments often cannot be performed on human beings, due to ethical or economic constraints. We describe a new paradigm for hypothesis testing which uses only (...) rearrangements of data present within the observed data set. The token swap test, based on this new paradigm, is applied to three data sets from cardiovascular pathology, and computational experiments suggest that the token swap test satisfies the Neyman Pearson condition. (shrink)

It has been demonstrated that death certificates do not accurately record the actual cause of death in up to one-fourth of cases, as determined from subsequent autopsy findings. The purpose of this study was to explore the use of natural language autopsy data bases as an automated quality assurance mechanism. We translated the account of the major process leading to death, or the primary diagnosis, from all 45,564 narrative autopsy reports obtained at The Johns Hopkins Hospital between May 28, 1889, (...) and June 30, 1987, into the hierarchical system of Medical Subject Heading (MeSH) titles. We obtained a total of 125,772 MeSH title translations, 1,563 of them distinct (average 2.8 per case), ranging in frequency from 6,029 occurrences of LUNG to 1 occurrence apiece of 357 MeSH titles. The natural-language-to-MeSH translations showed expected trends over the past century: fewer infectious diseases; more cardiovascular and neoplastic disease among adults; and more respiratory diseases and congenital malformations in the pediatric age group. The greater availability of autopsy documents in electronic form should increase the value of this resource for quality assurance. (shrink)

An argument is developed at some length to show that any semantical theory which treats superficially nonperformative sentences as being governed by performative prefaces at some level of underlying structure must either leave those sentences semantically uninterpreted or assign them the wrong truth-conditions. Several possible escapes from this dilemma are examined; it is tentatively concluded that such hypotheses as the Ross-Lakoff-Sadock Performative Analysis should be rejected despite their attractions.

The target article misrepresents the foundations of integrated information theory and ignores many essential publications. It, thus, falls to this lead commentary to outline the axioms and postulates of IIT and correct major misconceptions. The commentary also explains why IIT starts from phenomenology and why it predicts that only select physical substrates can support consciousness. Finally, it highlights that IIT's account of experience – a cause–effect structure quantified by integrated information – has nothing to do with “information transfer.”.

In lieu of an abstract, here is a brief excerpt of the content:BOOK REVIEWS El Primer Principia del Obrar Moral y las Normas Especificas en el Pensamiento de G. Grisez y!. Finnis. By AURELIO A.NSALDO. Roma: Pontificia Universita Lateranense, 1990. Pp. xiii+ 255. This unusually excellent and important doctoral dissertation was written in Rome at the Istituto Giovanni Paolo II per Studi su Matrimonio e Famiglia, a component of the Lateran University. The author currently teaches at the Ateneo Romano della (...) Santa Croce in Rome. The volume is of special importance for three reasons: (1) it provides a comprehensive, detailed, and accurate account of the moral theory developed by Germain Grisez and John Finnis over the past quarter century (Joseph Boyle has also made important contributions to this theory, and Ansaldo has noted these); (2) it defends Grisez and Finnis against many of the criticisms which have been unjustly leveled against their thought; and (3) it raises some critically import· ant issues by way of constructive criticism. In what follows I will briefly comment on the first and second features of Ansaldo's work and discuss more fully the third important component of his scholarly study. In the first part of his work (pp. 3-100), Ansaldo offers readers a splendid synthesis of the thought of Grisez and Finnis. He has carefully studied everything written by these authors from 1964 to 1988. He has included important material from Finnis that had escaped even my attention, and I have tried to study everything these authors have written. He has also succeeded in presenting their thought comprehensively and faithfully. He understands what they think, appreciates it, and presents it accurately. In short, he does justice to their thought. In this respect his study is quite superior to another doctoral dissertation, Russell Hittinger's A Critique of the New Natural Law Theory. Hittinger's work has been severely criticized, and rightly so, not only by Grisez but by others (e.g., Robert George and William Marshner) ; it seriously misrepresents the work of Grisez and Finnis. A criticism of this sort cannot be levelled against Ansaldo's work; it provides an accurate and very scholarly account of their thought. In the second part of his study (pp. 103-229) Ansaldo offers a critical assessment of the work of Grisez and Finnis. Here he first shows that many of the criticisms leveled against their thought are unjust and unfounded, particularly those offered by such writers as Veatch, Rittinger, Flicken, Bourke, et al. These writers charge that Grisez and Finnis fail to show how moral principles are rooted in metaphysics and anthropology, that they completely separate ethics from metaphysics, natural law from human nature, etc. Ansaldo, by a patient and thorough BOOK REVIEWS 888 examination of their thought and the thought of St. Thomas, defends Grisez and Finnis from these misguided criticisms. He shows, first of all,,that Grisez and Finnis are correct (and fully in accord with St. Thomas) in holding that our krwwledge of the primary principles of natural law is not derived from our knowledge of metaphysics or of human nature. By referring to appropriate texts of Grisez and Finnis, Ansaldo shows conclusively that these authors explicitly recognize the intimate rela· tionship between ethics and metaphysics, between natural law and human nature. They fully and explicitly recognize that, were our na· ture other than it is, namely, the nature of human beings, the goods pedective of us would be other than what they actually are. When these goods are grasped by practical reason, they serve as starting points or principles of purposeful human action. Nonetheless, our practical krwwledge of these goods, is not epistemologically derived from or dependent upon prior knowledge, speculative in character, of human nature. In short, in contrast to their critics and in conformity with St. Thomas, Grisez and Finnis are correct in holding that our practical understanding of the primary principles of natural law is not dependent upon our prior understanding of metaphysics or human nature. At the same time they explicitly acknowledge and defend the truth that onto· logically ethics is grounded in metaphysics and anthropology. "Our authors," Ansaldo writes, " have always sought not only to respect but even more to defend and explain the fact that the basis... (shrink)

Attention Restoration Theory proposes that exposure to natural environments helps to restore attention. For sustained attention—the ongoing application of focus to a task, the effect appears to be modest, and the underlying mechanisms of attention restoration remain unclear. Exposure to nature may improve attention performance through many means: modulation of alertness and one’s connection to nature were investigated here, in two separate studies. In both studies, participants performed the Sustained Attention to Response Task before and immediately after viewing a meadow, (...) ocean, or urban image for 40 s, and then completed the Perceived Restorativeness Scale. In Study 1, an eye-tracker recorded the participants’ tonic pupil diameter during the SARTs, providing a measure of alertness. In Study 2, the effects of connectedness to nature on SART performance and perceived restoration were studied. In both studies, the image viewed was not associated with participants’ sustained attention performance; both nature images were perceived as equally restorative, and more restorative than the urban image. The image viewed was not associated with changes in alertness. Connectedness to nature was not associated with sustained attention performance, but it did moderate the relation between viewing the natural images and perceived restorativeness; participants reporting a higher connection to nature also reported feeling more restored after viewing the nature, but not the urban, images. Dissociation was found between the physiological and behavioral measures and the perceived restorativeness of the images. The results suggest that restoration associated with nature exposure is not associated with modulation of alertness but is associated with connectedness with nature. (shrink)

This article presents evidence supporting the claim that ethical reasoning is a skill that can be taught and assessed. We propose a working definition of ethical reasoning as 1) the ability to identify, analyze, and weigh moral aspects of a particular situation, and 2) to make decisions that are informed and warranted by the moral investigation. The evidence consists of a description of an ethical reasoning education program—Ethical Reasoning in Action —designed to increase ethical reasoning skills in a variety of (...) situations and areas of life. ERiA is housed at a public, major comprehensive U.S. university—James Madison University—and assessment of the program focuses on interventions delivered prior to and during orientation for incoming first-year students. Findings indicate that the interventions measurably enhance the ability of undergraduate students to reason ethically. ERiA’s competency-targeted program and positive student learning outcomes offers a promising model for higher education ethics programs seeking to connect classroom learning in ethics to decision-making in everyday life. (shrink)

This article explores the plausibility of some intuitions and counter intuitions about the anti-corruption efforts of MDBs and international organizations leveraging the power of the private sector. Regulation of a sizable percentage of global private sector actors now falls into a new area of international governance with innovative institutions, standards, and programs. We wrestle with the role and value of private sector partnerships and available informal and formal social controls. Crafting proportional informal controls (e.g., monitoring, evaluations, and sanctions) and proper (...) incentives to cooperative games across networks are the lynchpins of successful collective action programs. Ambivalence with informal social controls or effective incentives, we argue, risks far too much deference to private sector interests. (shrink)

Despite the salient experience of encoding threatening events, these memories are prone to distortions and often non-veridical from encoding to recall. Further, threat has been shown to preferentially disrupt the binding of event details and enhance goal-relevant information. While extensive work has characterised distinctive features of emotional memory, research has not fully explored the influence threat has on temporal memory, a process putatively supported by the binding of event details into a temporal context. Two primary competing hypotheses have been proposed; (...) that threat can impair or enhance temporal memory. We analysed two datasets to assess temporal memory for an in-person haunted house experience. In study 1, we examined the temporal structure of memory by characterising memory contiguity in free recall as a function of individual levels of heart rate as a proxy of threat. In study 2, we replicated marginal findings of threat-related increases in memory contiguity found in study 1. We extended these findings by showing threat-related increases in recency discriminations, an explicit test of temporal memory. Together, these findings demonstrate that threat enhances temporal memory regarding free recall structure and during explicit memory judgments. (shrink)

At the forefront of international concerns about global legislation and regulation, a host of noted environmentalists and business ethicists examine ethical issues in consumption from the points of view of environmental sustainability, economic development, and free enterprise.

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

This chapter outlines David Lewis's favored foundational account of linguistic representation, and outlines and briefly evaluates variations and modifications. It gives an opinionated exegesis of Lewis's work on the foundations of reference: his interpretationism. The author looks at the way that the metaphysical distinction between natural and non‐natural properties came to play a central role in his thinking about language. Lewis's own deployment of this notion has implausible commitments. The chapter briefly considers a buck‐passing strategy involving fine‐grained linguistic conventions. Lewis (...) was no fan of primitive intentionality. Much of the Lewisian framework remains attractive. The overall select‐and‐project method, with its promise to deal even‐handedly with all linguistic intentionality, and its epistemic tractability, should be retained. Post‐Lewisian interpretationism results from emphasizing and retaining some of the virtues of Lewis's original proposal promises (e.g. universality and epistemic tractability), while compromising on others (e.g. metaphysical principle). (shrink)