Despite extinction-based processes demonstrating efficacy in the animal extinction and human anxiety literatures, extinction for substance use disorders has shown poor efficacy. Reasons for this lack of success include common threats to extinction, such as renewal and reinstatement. In recent decades, research on mindfulness for SUD has flourished, and a key aspect of these mindfulness-based interventions includes teaching individuals to stay present with whatever experience they have, even if unpleasant, without trying to change/escape/avoid it. Similarly, CET teaches individuals to not (...) escape/avoid conditioned responses by engaging in drug use behavior. This paper discusses how mindfulness-based research and practices could positively influence CET through future research, with the long-term goal of improving SUD treatment. (shrink)

BackgroundAlthough the Life-Sustaining Treatment (LST) Decision Act was enforced in 2018 in Korea, data on whether it is well established in actual clinical settings are limited. Hospital-acquired pneumonia (HAP) is a common nosocomial infection with high mortality. However, there are limited data on the end-of-life (EOL) decision of patients with HAP. Therefore, we aimed to examine clinical characteristics and outcomes according to the EOL decision for patients with HAP.MethodsThis multicenter study enrolled patients with HAP at 16 referral hospitals retrospectively from (...) January to December 2019. EOL decisions included do-not-resuscitate (DNR), withholding of LST, and withdrawal of LST. Descriptive and Kaplan–Meier curve analyses for survival were performed.ResultsOf 1,131 patients with HAP, 283 deceased patients with EOL decisions (105 cases of DNR, 108 cases of withholding of LST, and 70 cases of withdrawal of LST) were analyzed. The median age was 74 (IQR 63–81) years. The prevalence of solid malignant tumors was high (32.4% vs. 46.3% vs. 54.3%, P = 0.011), and the ICU admission rate was lower (42.9% vs. 35.2% vs. 24.3%, P = 0.042) in the withdrawal group. The prevalence of multidrug-resistant pathogens, impaired consciousness, and cough was significantly lower in the withdrawal group. Kaplan–Meier curve analysis revealed that 30-day and 60-day survival rates were higher in the withdrawal group than in the DNR and withholding groups (log-rank P = 0.021 and 0.018). The survival of the withdrawal group was markedly decreased after 40 days; thus, the withdrawal decision was made around this time. Among patients aged below 80 years, the rates of EOL decisions were not different (P = 0.430); however, mong patients aged over 80 years, the rate of withdrawal was significantly lower than that of DNR and withholding (P = 0.001).ConclusionsAfter the LST Decision Act was enforced in Korea, a DNR order was still common in EOL decisions. Baseline characteristics and outcomes were similar between the DNR and withholding groups; however, differences were observed in the withdrawal group. Withdrawal decisions seemed to be made at the late stage of dying. Therefore, advance care planning for patients with HAP is needed. (shrink)

Despite the increasing number of studies on user experience and user interfaces, few studies have examined emotional interaction between humans and deformable objects. In the current study, we investigated how the anthropomorphic design of a flexible display interacts with emotion. For 101 unique 3D images in which an object was bent at different axes, 281 participants were asked to report how strongly the object evoked five elemental emotions (e.g., happiness, disgust, anger, fear, and sadness) in an online survey. People rated (...) the object’s shape using three emotional categories: happiness, disgust–anger, and sadness–fear. It was also found that a combination of axis of bending (horizontal or diagonal axis) and convexity (bending convexly or concavely) predicted emotional valence, underpinning the anthropomorphic design of flexible displays. Our findings provide empirical evidence that axis of bending and convexity can be an important antecedent of emotional interaction with flexible objects, triggering at least three types of emotion in users. (shrink)

Kim Dong-ri et Seo Jeong-ju sont deux monuments de la littérature coréenne du XX e siècle. Les deux écrivains nouèrent une profonde amitié à partir des années 1930 et contribuèrent ensemble à la reconstruction du milieu littéraire de la Corée après la période de l’Occupation japonaise. Dans quel contexte le romancier et le poète se sont-ils rencontrés? Quelles sont les caractéristiques de leur lien amical? Comment celui a-t-il résisté aux vicissitudes du temps et au désaccord momentané lié aux circonstances? (...) À partir d’éléments biographiques, autobiographiques et de leurs témoignages réciproques, nous découvrons que la connaissance intime de l’univers de l’un par l’autre et leur inspiration mutuelle se fondent sur les valeurs littéraires et humanistes qu’ils partagent : fins connaisseurs de la littérature du monde, ils valorisent dans leur écriture des éléments proprement coréens. (shrink)

Kim Dong-ri et Seo Jeong-ju sont deux monuments de la littérature coréenne du XX e siècle. Les deux écrivains nouèrent une profonde amitié à partir des années 1930 et contribuèrent ensemble à la reconstruction du milieu littéraire de la Corée après la période de l’Occupation japonaise. Dans quel contexte le romancier et le poète se sont-ils rencontrés? Quelles sont les caractéristiques de leur lien amical? Comment celui a-t-il résisté aux vicissitudes du temps et au désaccord momentané lié aux circonstances? (...) À partir d’éléments biographiques, autobiographiques et de leurs témoignages réciproques, nous découvrons que la connaissance intime de l’univers de l’un par l’autre et leur inspiration mutuelle se fondent sur les valeurs littéraires et humanistes qu’ils partagent : fins connaisseurs de la littérature du monde, ils valorisent dans leur écriture des éléments proprement coréens. (shrink)

Computerized relaxation training has been suggested as an effective and easily accessible intervention for individuals with psychological distress. To better elucidate the neural mechanism that underpins the effects of relaxation training, we investigated whether a 10-session computerized relaxation training program changed prefrontal gamma-aminobutyric acid levels and cerebral blood flow in women with psychological distress. We specifically focused on women since they were reported to be more vulnerable to develop stress-related disorders than men. Nineteen women with psychological distress but without a (...) diagnosis of psychiatric disorders received the 10-day computerized relaxation training program that consisted of 30-min cognitive-relaxation training and 10-min breathing-relaxation training per day. At baseline and post-intervention, perceived stress levels, anxiety, fatigue, and sleep quality were assessed by self-report questionnaires. Brain magnetic resonance spectroscopy and arterial spin labeling scans were also performed before and after the intervention to evaluate GABA levels and relative CBF in the prefrontal region. Levels of perceived stress, anxiety, fatigue, and sleep quality improved following 10 sessions of computerized relaxation training, resulting in a significant relief in composite scores of stress-related symptoms. The prefrontal GABA levels decreased, while relative CBF increased after the intervention. In addition, a greater increase in relative prefrontal CBF was associated with better composite scores of stress-related symptoms following the intervention. The current findings suggest that computerized relaxation training may improve stress-related symptoms through modulating the prefrontal GABA levels and CBF in women with psychological distress. (shrink)

Background:While nursing ethics education is commonly provided for undergraduate nursing students in most nursing colleges, consensus on the content and teaching modules for these ethics courses have still not been established.Objectives:This study aimed to examine the effects of nursing ethics education on the moral sensitivity and critical thinking disposition of nursing students in Korea.Research design:A one-group pre- and post-test design was used. Moral sensitivity was measured using the Korean version of the Moral Sensitivity Questionnaire. Critical thinking disposition was measured using (...) the Critical Thinking Disposition Questionnaire.Participants and research context:Participants were 70 undergraduate nursing students who were attending a university located in Seoul, Korea. The nursing ethics education was provided 7 times, from September to December 2010, and comprised 90-min sessions each week.Ethical considerations:This study was conducted in accordance with the Human Subject Research Ethics Committee guidelines.Findings:After the education, the levels for the patient-oriented care, a sub-domain of moral sensitivity, and inquisitiveness, a sub-domain of critical thinking disposition, significantly improved. There were no changes in overall scores for moral sensitivity and critical thinking disposition. There were significant positive correlations between moral sensitivity and critical thinking disposition both pre- and post-intervention.Conclusion:These results reflect the need for ongoing efforts to develop innovative content, structure, and instructional methods for undergraduate nursing ethics education programs. (shrink)

Virtual reality is a rapidly developing technology that simulates the real world. However, for some cybersickness-susceptible people, VR still has an unanswered problem—cybersickness—which becomes the main obstacle for users and content makers. Sensory conflict theory is a widely accepted theory for cybersickness. It proposes that conflict between afferent signals and internal models can cause cybersickness. This study analyzes the brain states that determine cybersickness occurrence and related uncomfortable feelings. Furthermore, we use the electroencephalogram microstates and functional connectivity approach based on (...) the sensory conflict theory. The microstate approach is a time–space analysis method that allows signals to be divided into several temporarily stable states, simultaneously allowing for the exploration of short- and long-range signals. These temporal dynamics can show the disturbances in mental processes associated with neurological and psychiatric conditions of cybersickness. Furthermore, the functional connectivity approach gives us in-depth insight and relationships between the sources related to cybersickness. We recruited 40 males, and they watched a VR video on a curved computer monitor for 10 min to experience cybersickness. We recorded the 5-min resting state EEG and 10-min EEG while watching the VR video. Then, we performed a microstate analysis, focusing on two temporal parameters: mean duration and global explained variance. Finally, we obtained the functional connectivity data using eLoreta and lagged phase synchronization. We discovered five sets of microstates, including four widely reported canonical microstates, during baseline and task conditions. The average duration increased in microstates A and B, which is related to the visual and auditory networks. The GEV and duration decreased in microstate C, whereas those in microstate D increased. Microstate C is related to the default mode network and D to the attention network. The temporal dynamics of the microstate parameters are from cybersickness disturbing the sensory, DMN, and attention networks. In the functional connectivity part, the LPS between the left and right parietal operculum significantly decreased compared with the baseline condition. Furthermore, the connectivity between the right OP and V5 significantly decreased. These results also support the disturbance of the sensory network because a conflict between the visual and vestibular system causes cybersickness. Changes in the microstates and functional connectivity support the sensory conflict theory. These results may provide additional information in understanding brain dynamics during cybersickness. (shrink)

Children ranging from 3 to 5 years were introduced to two anthropomorphic robots that provided them with information about unfamiliar animals. Children treated the robots as interlocutors. They supplied information to the robots and retained what the robots told them. Children also treated the robots as informants from whom they could seek information. Consistent with studies of children's early sensitivity to an interlocutor's non-verbal signals, children were especially attentive and receptive to whichever robot displayed the greater non-verbal contingency. Such selective (...) information seeking is consistent with recent findings showing that although young children learn from others, they are selective with respect to the informants that they question or endorse. (shrink)

Climate change and decarbonization raise complex justice questions that researchers and policymakers must address. The distributions of greenhouse gas emissions rights and mitigation efforts have dominated justice discourses within scenario research, an integrative element of the IPCC. However, the space of justice considerations is much larger. At present, there is no consistent approach to comprehensively incorporate and examine justice considerations. Here we propose a conceptual framework grounded in philosophical theory for this purpose. We apply this framework to climate mitigation scenarios (...) literature as proof of concept, enabling a more holistic and multidimensional investigation of justice. We identify areas of future research, including new metrics of service provisioning essential for human well-being. [Can be freely read by clicking the ReadCube link below.]. (shrink)

In written and spoken communications, metaphors are often used as an aid to help convey abstract or less tangible concepts. However, the benefits of using visual metaphors in visualization have so far been inconclusive. In this work, we report an empirical study to evaluate hypotheses that visual metaphors may aid memorization, visual search and concept comprehension. One major departure from previous metaphor-related experiments in the literature is that we make use of a dual-task methodology in our experiment. This design offers (...) an abstraction of typical situations where viewers do not have their full attention focused on visualization (e.g., in meetings and classes). The use of the secondary task introduces “divided attention”, and makes the effects of visual metaphors more observable. In addition, it also serves as additional masking in memory-based trials. The results of this study show that visual metaphors can help participants better remember the information depicted in visualization. On the other hand, visual metaphors can have a negative impact on the speed of visual search. The results also show a complex pattern as to the benefits of visual metaphors in helping participants grasp key concepts from visualization. (shrink)

Background We aimed to examine the ethical concerns Singaporeans have about sharing health-data for precision medicine and identify suggestions for governance strategies. Just as Asian genomes are under-represented in PM, the views of Asian populations about the risks and benefits of data sharing are under-represented in prior attitudinal research. Methods We conducted seven focus groups with 62 participants in Singapore from May to July 2019. They were conducted in three languages and analysed with qualitative content and thematic analysis. Results Four (...) key themes emerged: nuanced understandings of data security and data sensitivity; trade-offs between data protection and research benefits; trust in the public and private sectors; and governance and control options. Participants were aware of the inherent risks associated with data sharing for research. Participants expressed conditional support for data sharing, including genomic sequence data and information contained within electronic medical records. This support included sharing data with researchers from universities and healthcare institutions, both in Singapore and overseas. Support was conditional on the perceived social value of the research and appropriate de-identification and data security processes. Participants suggested that a data sharing oversight body would help strengthen public trust and comfort in data research for PM in Singapore. Conclusion Maintenance of public trust in data security systems and governance regimes can enhance participation in PM and data sharing for research. Contrary to themes in much prior research, participants demonstrated a sophisticated understanding of the inherent risks of data sharing, analysed trade-offs between risks and potential benefits of PM, and often adopted an international perspective. (shrink)

This study examines the challenges of humanism and education in the 21st century as addressed by the German philosopher Peter Sloterdijk in his Elmau Speech (1999). In this lecture, titled _Rules for the Human Zoo_, Sloterdijk argues that the traditional notion of humanism, specifically “humanism as a literary society,” has reached its conclusion, necessitating the development of a new humanism appropriate for the contemporary era. However, the new concept of humanism emerging from what Sloterdijk terms the “anthropotechnic turn” appears to (...) align with the discourses surrounding human enhancement that have emerged in the 21st century, thereby influencing the realm of education. The first half of this article reports on the significant concerns and criticisms expressed by the media at that time regarding this new humanism, which seems to be associated with eugenicist ideas. Taking a step further, this study critically examines the nature of the challenges around education implied by Sloterdijk, specifically the conflict between “friend of humans and friend of Übermensch”, and explores the potential roles and responsibilities of education in the latter part of the paper. (shrink)

The meshed control theory assumes that cognitive control and automatic processes work together in the natural attention of experts for superior performance. However, the methods adopted by previous studies limit their capacity to provide in-depth information on the neuromotor processes. This experiment tested the theory with an alternative approach. Twelve skilled golfers were recruited to perform a putting task under three conditions: (1) normal condition, with no focus instruction (NC), (2) external focus of attention condition (EC), and (3) internal focus (...) of attention condition (IC). Four blocks of 10 putts each were performed under each condition. The putting success rate and accuracy were measured and electroencephalographies (EEGs) were recorded. The behavioral results showed that the NC produced a higher putting success rate and accuracy than the EC and IC. The EEG data showed that the skilled golfers’ attentional processes in the NC initially resembled those in the EC and then moved toward those in the IC just before putting. This indicates a switch from more automatic processes to cognitive control processes while preparing to putt. The findings offer support for the meshed control theory and indicate the dynamic nature of neuromotor processes for the superior performance of athletes in challenging situations. (shrink)

This article argues that environmental considerations fall within the scope of medical bioethics, and there are implications specific to medical education. It endorses the need to expand the scope and epistemology of contemporary medical bioethics discourse by including themes related to environmental considerations. Our discussion begins by providing a brief history of environmental bioethics. It then offers a critique of three specific health and environmental issues, namely technology, toxics, and consumption, and discusses how these issues are key to articulating moral (...) considerations of human health and subsequently medicine and its teaching. Lastly, it explores criticisms of including environmental issues into the bioethical debate before providing suggestions of how environmental ethics can be included into the medical curriculum. This article concludes by suggesting theoretical possibilities for environmentally inclusive bioethics, such as reorienting bioethical discussions to its original environmental advocacy and supporting environmental bioethics as a competency in medical education. (shrink)

PurposeWhite matter damage (WMD) was defined as the appearance of rough and uneven echo enhancement in the white matter around the ventricle. The aim of this study was to develop and validate a risk prediction model for neonatal WMD.Materials and MethodsWe collected data for 1,733 infants hospitalized at the Department of Neonatology at The First Affiliated Hospital of Zhengzhou University from 2017 to 2020. Infants were randomly assigned to training (n= 1,216) or validation (n= 517) cohorts at a ratio of (...) 7:3. Multivariate logistic regression and least absolute shrinkage and selection operator (LASSO) regression analyses were used to establish a risk prediction model and web-based risk calculator based on the training cohort data. The predictive accuracy of the model was verified in the validation cohort.ResultsWe identified four variables as independent risk factors for brain WMD in neonates by multivariate logistic regression and LASSO analysis, including gestational age, fetal distress, prelabor rupture of membranes, and use of corticosteroids. These were used to establish a risk prediction nomogram and web-based calculator (https://caowenjun.shinyapps.io/dynnomapp/). The C-index of the training and validation sets was 0.898 (95% confidence interval: 0.8745–0.9215) and 0.887 (95% confidence interval: 0.8478–0.9262), respectively. Decision tree analysis showed that the model was highly effective in the threshold range of 1–61%. The sensitivity and specificity of the model were 82.5 and 81.7%, respectively, and the cutoff value was 0.099.ConclusionThis is the first study describing the use of a nomogram and web-based calculator to predict the risk of WMD in neonates. The web-based calculator increases the applicability of the predictive model and is a convenient tool for doctors at primary hospitals and outpatient clinics, family doctors, and even parents to identify high-risk births early on and implementing appropriate interventions while avoiding excessive treatment of low-risk patients. (shrink)

Combining the conceptual approach of racial formation and racial projects with the Foucauldian concept of governmentality, Jeong-eun Rhee theorizes the “neoliberal racial project” (NRP) and examines contemporary meanings and operations of race and racism in relation to neoliberalism. She analyzes Amy Chua's popular parenting memoir, Battle Hymn of the Tiger Mother, as a specific case of the NRP, and demonstrates how in this text race is pressed to work in new — neoliberal — ways, re/generating different kinds of categories (...) and meanings, yet also continuously drawing upon old categories and meanings, to effect and rationalize social arrangements of power and exploitation, violence and expropriation. What is noteworthy is the way in which racial neoliberalism builds silently on the structural conditions of racism while disabling the very categories of their recognizability. Consequently, Rhee argues for new, historically bounded theories that can articulate how the meanings, categories, and concepts of races are constantly being reconfigured. (shrink)

Electroencephalogram has been widely utilized in emotion recognition. Psychologists have found that emotions can be divided into conscious emotion and unconscious emotion. In this article, we explore to classify subliminal emotions with EEG signals elicited by subliminal face stimulation, that is to select appropriate features to classify subliminal emotions. First, multi-scale sample entropy, wavelet packet energy, and wavelet packet entropy of EEG signals are extracted. Then, these features are fed into the decision tree and improved random forest, respectively. The classification (...) accuracy with Ei and WpEn is higher than MSpEn, which shows that Ei and WpEn can be used as effective features to classify subliminal emotions. We compared the classification results of different features combined with the decision tree algorithm and the improved random forest algorithm. The experimental results indicate that the improved random forest algorithm attains the best classification accuracy for subliminal emotions. Finally, subliminal emotions and physiological proof of subliminal affective priming effect are discussed. (shrink)

ObjectivePrevious studies have demonstrated altered brain activity in strabismic amblyopia. In this study, low-frequency repetitive transcranial magnetic stimulation was applied in children with strabismic amblyopia after they had undergone strabismus surgery. The effect of rTMS was investigated by measuring the changes of brain features using the amplitude of low-frequency fluctuation.Materials and MethodsIn this study, 21 SA patients were recruited based on their age, weight, and sex. They all had SA in their left eyes and they received rTMS treatment one month (...) after strabismus surgery. Their vision before and after surgery were categorized as pre-rTMS and post-rTMS. All participants received rTMS treatment, underwent magnetic resonance imaging, and their data were analyzed using the repeated measures t-test. The team used correlation analysis to explore the relationship between logMAR visual acuity and ALFF.ResultsPre- versus post-rTMS values of ALFF were significantly different within individuals. In the POT group, ALFF values were significantly decreased in the Angular_R, Parietal_Inf_L, and Cingulum_Mid_R while ALFF values were significantly increased in the Fusiform_R and Frontal_Inf_Orb_L compared to the PRT stage.ConclusionOur data showed that ALFF recorded from some brain regions was changed significantly after rTMS in strabismic amblyopes. The results may infer the pathological basis of SA and demonstrate that visual function may be improved using rTMS in strabismic amblyopic patients. (shrink)

Feminist epistemology aims to propose epistemic reasons for increasing the representation of women or socially subordinated people in science. This is typically done—albeit often only implicitly—by positing a causal mechanism through which the representation of sociodemographic minorities exerts a positive effect on scientific advancement. Two types of causal theories can be identified. The “epistemic diversity thesis” presents a causal path from sociodemographic diversity to scientific progress mediated by epistemic diversity. The “thesis of epistemic advantage” proposes a causal path from social (...) subjugation to capacity for inquiry. The latter theory is defined with substantial ambiguity in the existing literature, and I present an explicit causal reformulation that disambiguates it. The epistemic diversity thesis focuses on the effect of group composition on collective epistemic performance and is largely silent about what kind of characteristics lead to individual epistemic excellence. On the other hand, the thesis of epistemic advantage seeks to identify sociodemographic background conditions that make certain epistemic agents strictly better knowers or inquirers than others and pays little attention to the synergistic effects of diverse group composition. Such a difference in the causal structure reflects the diverging political characteristics of the two theories. (shrink)

To investigate whether people can implicitly learn regularities in a social context, we developed a new implicit sequence learning task combining elements from classic false belief and serial reaction time tasks. Participants learned that protagonists were offered flowers at four locations. The protagonists' beliefs concerning the flowers were true or false, depending on their orientation, respectively, toward the scene or away from it. Unbeknown to the participants, there was a fixed belief-related sequence involving three dimensions. Participants had to indicate as (...) fast as possible where the flowers were located, or how many flowers were given according to the protagonists. Experiment 1 combined perceptual and motor processes, whereas Experiment 2 unconfounded the sequence and motor responses, allowing to investigate pure perceptual implicit learning. For reasons of comparison, two non-social conditions were created in Experiment 2 by replacing the protagonists with two non-social objects—colored cameras or shapes. Results revealed significant implicit sequence learning of all belief-related dimensions in Experiment 1, and of true-false belief orientation in Experiment 2, even without a motor confound. Importantly, there were faster reaction times and stronger sequence learning effects in the social than in the non-social conditions. The present findings demonstrate for the first time that people are able to implicitly learn belief-related sequences. (shrink)

BackgroundExperience with open disclosure and its study are restricted to certain western countries. In addition, there are concerns that open disclosure may be less suitable in non-western countries. The present study explored and compared the in-depth perceptions of the general public and physicians regarding open disclosure in Korea.MethodsWe applied the COREQ checklist to this qualitative study. We conducted 20 in-depth interviews and four focus group discussions with 16 physicians and 18 members of the general public. In-depth interviews and focus group (...) discussions were performed according to semi-structured guidelines developed according to a systematic review of open disclosure. We conducted a directed content analysis by analyzing the verbatim transcripts and field notes in accordance with the predetermined guidelines.ResultsOpen disclosure perceptions were summarized in terms of the “five Ws and one H”. All physician and general public participants acknowledged the normative justifiability of open disclosure. The participants mostly agreed on the known effects of open disclosure, but the physicians had negative opinions on its expected effects, such as decreased intention of the general public to file lawsuits and increased credibility of medical professionals. Generally, the participants thought that open disclosure is required for medical errors causing major harm. However, the physicians and general public had conflicting opinions on the need for open disclosure of near misses. Most physicians did not know how to conduct open disclosure and some physicians had bad experiences due to inappropriate or incomplete open disclosure.ConclusionPhysicians and the general public in Korea acknowledge the need for open disclosure. Guidelines according to the type of patient safety incident are required to encourage physicians to more readily conduct open disclosure. Furthermore, hospitals need to consider organizing a dedicated team and hiring experts for open disclosure. (shrink)

Theories of grounded and embodied cognition offer a range of accounts of how reasoning and body‐based processes are related to each other. To advance theories of grounded and embodied cognition, we explore the cognitive relevance of particular body states to associated math concepts. We test competing models of action‐cognition transduction to investigate the cognitive relevance of directed actions to students’ mathematical reasoning in the area of geometry. The hypotheses we test include (1) that cognitively relevant directed actions have a direct (...) effect on performance (direct cognitive relevance hypothesis), (2) that cognitively relevant directed actions lead to more frequent production of gestures during explanations, which leads to improved performance (mediated cognitive relevance hypothesis), and (3) that performance effects of directed actions are influenced by the presence or absence of gesture production during mathematical explanations (moderated cognitive relevance hypothesis). We explore these hypotheses in an experiment where high school students (N = 85) evaluated the truth of geometry conjectures after performing cognitively relevant or cognitively irrelevant directed actions while playing a movement‐based video game. Contrary to the direct and mediated cognitive relevance hypotheses, we found no overall differences in performance or gesture production between relevant and irrelevant conditions. Consistent with the moderated cognitive relevance hypothesis, cognitive relevance influenced mathematical performance, as measured by the accuracy of students’ intuitions, insights, and the validity of their proofs, provided that students produced certain kinds of gestures during mathematical explanations (i.e., with explanatory gestures as the moderator). Implications for theories of grounded and embodied cognition and the design of embodied forms of educational interventions are discussed. (shrink)