Fourteen healthy children (13.8±2.2 years, range 10 to 16; M:F=5:9) received 30 Hz intermittent theta burst transcranial magnetic stimulation (iTBS) with a stimulation intensity of 70% of resting motor threshold (RMT) with a total of 300 (iTBS300) pulses. All volunteers were free of neurologic, psychiatric and serious medical illnesses, not taking any neuropsychiatric medications, and did not have any contraindications to Transcranial Magnetic Stimulation. Changes in the mean amplitudes of motor-evoked potentials from baseline following iTBS were expressed as a ratio (...) and assessed from 1 to 10 minutes (BLOCK1) and 1 to 30 minutes (BLOCK2) using repeated-measures analysis of variance. All 14 subjects completed iTBS300 over the dominant primary motor cortex (M1) without any clinically reported adverse events. ITBS300 produced significant M1 facilitation (F5,65=3.165, p=0.01) at BLOCK1 and trend level M1 facilitation at BLOCK2 (F10,129=1.69, p=0.089). Although iTBS300 (stimulation duration of 92 seconds at 70% RMT) delivered over M1 in typically developed children was well-tolerated and produced on average significant facilitatory changes in cortical excitability, the post-iTBS300 neurophysiologic response was variable in our small sample. ITBS300-induced changes may represent a potential neuroplastic biomarker in healthy children and those with neuro-genetic or neuro-psychiatric disorders. However, a larger sample size is needed to address safety and concerns of response variability. (shrink)

We estimate that 208,000 deep brain stimulation (DBS) devices have been implanted to address neurological and neuropsychiatric disorders worldwide. DBS Think Tank presenters pooled data and determined that DBS expanded in its scope and has been applied to multiple brain disorders in an effort to modulate neural circuitry. The DBS Think Tank was founded in 2012 providing a space where clinicians, engineers, researchers from industry and academia discuss current and emerging DBS technologies and logistical and ethical issues facing the field. (...) The emphasis is on cutting edge research and collaboration aimed to advance the DBS field. The Eighth Annual DBS Think Tank was held virtually on September 1 and 2, 2020 (Zoom Video Communications) due to restrictions related to the COVID-19 pandemic. The meeting focused on advances in: (1) optogenetics as a tool for comprehending neurobiology of diseases and on optogenetically-inspired DBS, (2) cutting edge of emerging DBS technologies, (3) ethical issues affecting DBS research and access to care, (4) neuromodulatory approaches for depression, (5) advancing novel hardware, software and imaging methodologies, (6) use of neurophysiological signals in adaptive neurostimulation, and (7) use of more advanced technologies to improve DBS clinical outcomes. There were 178 attendees who participated in a DBS Think Tank survey, which revealed the expansion of DBS into several indications such as obesity, post-traumatic stress disorder, addiction and Alzheimer’s disease. This proceedings summarizes the advances discussed at the Eighth Annual DBS Think Tank. (shrink)

Little is known about the biting nuisance of mosquitoes in the UK, despite the high numbers found in some locations. A telephone questionnaire survey was used to determine the perceived nuisance of biting insects on the Isle of Sheppey, Kent, a place notorious for mosquitoes. Two hundred randomly selected individuals were interviewed and asked if they suffered from mosquito bites. If they answered yes, they were asked to describe where and when they were bitten, and what measures they took against (...) mosquitoes. Forty-six per cent of respondents completed the questionnaire. Of those, 50% reported being bitten by mosquitoes, mostly outside during the summer. Seventy per cent said that most biting occurred during the evening and night. Of those respondents who protected themselves against biting (27), most used repellents (70%), with the remainder changing their behaviour to avoid mosquitoes, including closing or screening windows (33%), wearing thicker clothes (7%) and spraying insecticide (4%). One person slept under a bednet in summer (4%). This study provides evidence that on the Isle of Sheppey mosquitoes are considered a major nuisance by a sizeable proportion of the population. Since there is growing interest in the threat posed by new and emerging diseases in the UK, health authorities will need to make substantial efforts to inform and reassure the public about the threats posed by mosquitoes in areas where they are common. (shrink)

Background: Discussions about medical errors facilitate professional learning for physicians and may provide emotional support after an error, but little is known about physicians’ attitudes and practices regarding error discussions with colleagues.Methods: Survey of faculty and resident physicians in generalist specialties in Midwest, Mid-Atlantic and Northeast regions of the US to investigate attitudes and practices regarding error discussions, likelihood of discussing hypothetical errors, experience role-modelling error discussions and demographic variables.Results: Responses were received from 338 participants . In all, 73% of (...) respondents indicated they usually discuss their mistakes with colleagues, 70% believed discussing mistakes strengthens professional relationships and 89% knew at least one colleague who would be a supportive listener. Motivations for error discussions included wanting to learn whether a colleague would have made the same decision , wanting colleagues to learn from the mistake and wanting to receive support . Given hypothetical scenarios, most respondents indicated they would likely discuss an error resulting in no harm , minor harm or major harm . Fifty-seven percent of physicians had tried to serve as a role model by discussing an error and role-modelling was more likely among those who had previously observed an error discussion .Conclusions: Most generalist physicians in teaching hospitals report that they usually discuss their errors with colleagues, and more than half have tried to role-model discussions. However, a significant number of these physicians report that they do not usually discuss their errors and some do not know colleagues who would be supportive listeners. (shrink)

Wisdom is a multi-component trait that is important for mental health and well-being. In this study, we sought to understand gender differences in relative strengths in wisdom. A total of 659 individuals aged 27–103 years completed surveys including the 3-Dimensional Wisdom Scale and the San Diego Wisdom Scale. Analyses assessed gender differences in wisdom and gender’s moderating effect on the relationship between wisdom and associated constructs including depression, loneliness, well-being, optimism, and resilience. Women scored higher on average on the 3D-WS (...) but not on the SD-WISE. Women scored higher on compassion-related domains and on SD-WISE Self-Reflection. Men scored higher on cognitive-related domains and on SD-WISE Emotion Regulation. There was no impact of gender on the relationships between wisdom and associated constructs. Women and men have different relative strengths in wisdom, likely driven by sociocultural and biological factors. Tailoring wisdom interventions to individuals based on their profiles is an important next step. (shrink)

Steve Awodey and A. W. Carus. How Carnap Could Have Replied to Gödel.

Steve Awodey and A. W. Carus. The Turning Point and the Revolution: Philosophy of Mathematics in Logical Empiricism from Tractatus on Logical Syllogism.

Objectives The objectives of the study are to understand the current practice of informed consent in medical research in public hospitals in Shanghai, and to share our views with other countries, especially developing countries. Methods In the study, 145 consent forms (CFs) of the selected research projects in eight public hospitals with ethics committees in Shanghai were audited, and the principle investigators (PIs) of these research projects and 40 student subjects who had participated in clinical drug tests were surveyed by (...) questionnaires. Results The CFs of medical researches in public hospitals with ethics committees in Shanghai were generally acceptable. However, there were some defects in the CFs. Although most of the surveyed PIs had correct recognition of informed consent, some processes of informed consent were not in accordance with generally accepted requirements. A large number of the PIs considered the greatest difficulty with informal consent was lack of correct recognition of subjects or legally authorised representatives on medical research. Discussion Informed consent in medical research should consider the research ethics, the background of potential subjects, the local resources and culture of medical research. In addition, special protection is needed for student subjects in informed consent as well as efforts for building and restoring the public's trust in biomedical research. Conclusion The informed consent in Shanghai's public hospitals with ethics committees was generally acceptable and the achievement of adequate informed consent is influenced by many factors. (shrink)

Objectives The objective of this research was to develop ethics accreditation standards for hospitals. Research design Our research methods included a literature review, an expert focus group, the Delphi technique and a hospital survey. The entire process was separated into two stages: (1) the development of a draft of hospital ethics accreditation standards; and (2) conducting a nationwide hospital survey of the proposed standards. Results This study produced a tentative draft of hospital ethics accreditation standards comprised of six chapters and (...) 62 standards based on the expert focus group and Delphi technique. The six chapters are: Medical ethics policies, regulations and leadership; The establishment and operation of a medical ethics committee; The establishment and operation of research-related ethics committees; Medical ethics education; Organisational ethical climate; and Respect for patients' rights and establishment of good hospital-patient relationships. The hospital survey indicated that the concept of an organisational ethical climate was new to most hospital managers, most hospitals disliked the idea of having a separate hospital ethics accreditation system, and small hospitals were concerned about their ability to comply with all of the standards. Conclusions Regardless of whether hospital ethics accreditation can be a stand-alone accreditation or just part of existing hospital accreditation programmes, we hope this draft can serve as a good reference for future endeavours by hospital accreditation authorities. (shrink)

The target article retains the traditional account of saccades as conjugate eye movements. However, recent single-unit recordings of premotor cells in the saccade pathway (excitatory burster neurons [EBNs]) found that they do not encode conjugate eye velocity, but rather, monocular eye velocity. These data argue against the traditional concept of saccades as inherently conjugate. Instead, they suggest a monocular mechanism in the sensorimotor transformation stage of saccade generation. This commentary will discuss the implications of these data for the saccade generation (...) model proposed in Findlay & Walker's target article. (shrink)

Volume 20, Issue 5, June 2020, Page 38-40.

OBJECTIVE: To report and analyse the pattern of end-of-life decision making for terminal Chinese cancer patients. DESIGN: Retrospective descriptive study. SETTING: A cancer clinical trials unit in a large teaching hospital. PATIENTS: From April 1992 to August 1997, 177 consecutive deaths of cancer clinical trial patients were studied. MAIN MEASUREMENT: Basic demographic data, patient status at the time of signing a DNR consent, or at the moment of returning home to die are documented, and circumstances surrounding these events evaluated. RESULTS: (...) DNR orders were written for 64.4% of patients. Patients in pain (odds ratio 0.45, 95% CI 0.22-0.89), especially if requiring opioid analgesia (odds ratio 0.40, 95% CI 0.21-0.77), were factors associated with a higher probability of such an order. Thirty-five patients were taken home to die, a more likely occurrence if the patient was over 75 years (odds ratio 0.12, 95% CI 0.04-0.34), had children (odds ratio 0.14, 95% CI 0.02-0.79), had Taiwanese as a first language (odds ratio 6.74, 95% CI 3.04-14.93), or was unable to intake orally (odds ratio 2.73, 95% CI 1.26-5.92). CPR was performed in 30 patients, none survived to discharge. CONCLUSIONS: DNR orders are instituted in a large proportion of dying Chinese cancer patients in a cancer centre, however, the order is seldom signed by the patient personally. This study also illustrates that as many as 20% of dying patients are taken home to die, in accordance with local custom. (shrink)

Evidence suggests divergent thinking is the cognitive basis of creative thoughts. Neuroimaging literature using resting-state functional connectivity has revealed network reorganizations during divergent thinking. Recent studies have revealed the changes of network organizations when performing creativity tasks, but such brain reconfigurations may be prolonged after task and be modulated by the trait of creativity. To investigate the dynamic reconfiguration, 40 young participants were recruited to perform consecutive Alternative Uses Tasks for divergent thinking and two resting-state scans were used for mapping (...) the brain reorganizations after AUT. We split participants into high- and low-creative groups based on creative achievement questionnaire and targeted on reconfigurations of the two brain networks: default-mode network and the network seeded at the left inferior frontal gyrus because the between-group difference of AUT-induced brain activation located at the left IFG. The changes of post-AUT RSFCs indicated the prolonged effect of divergent thinking. More specifically, the alterations of RSFCIFG−AG and RSFCIFG−IPL in the high-creative group had positive relationship with their AUT performances, but not found in the low-creative group. Furthermore, the RSFC changes of DMN did not present significant relationships with AUT performances. The findings not only confirmed the possibility of brain dynamic reconfiguration following divergent thinking, but also suggested the distinct IFGN reconfiguration between individuals with different creativity levels. (shrink)

1. Michael A PetersBeijing Normal UniversityChatGPT is an AI chatbot released by OpenAI on November 30, 2022 and a ‘stable release’ on February 13, 2023. It belongs to OpenAI’s GPT-3 family (genera...

In The Pragmatics of Text Messaging: Making Meaning in Messages Michelle A. McSweeney seeks to explore the meaning to be found in the labyrinth of text messaging language, and offers explanations b...

In lieu of an abstract, here is a brief excerpt of the content:Zen Pathways: An Introduction to the Philosophy and Practice of Zen Buddhism (禅道の千路) by Bret W. Davis (review)Steve G. LoftsBret W. Davis, Zen Pathways: An Introduction to the Philosophy and Practice of Zen Buddhism (禅道の千路)There is no shortage of books on Zen from almost every imaginable angle. And so, what makes Zen Pathways: An Introduction to the Philosophy and Practice of Zen Buddhism (禅道の千路) by Bret W. Davis (...) unique enough to take up and read, and even re-read? And who should read it? The answers to these questions depend on who you are and what you are looking for. If you are simply curious about what Zen philosophy and practice is or is not, a student, a professor looking for a textbook on Zen Buddhism for your course, or a practitioner seeking to deepen your understanding of what it is that you are practicing, then you will almost certainly enjoy and profit greatly from this book. Davis brings to the page over thirty years of active engagement with Zen Buddhism as a practitioner, teacher of philosophy and Zen Buddhism, and scholar. Davis provides his reader with an accessible, comprehensive, and well-documented introduction to the teachings and practices of Zen Buddhism. What makes this introduction stand out and be particularly effective is that Davis provides us with a scholarly and philosophical account of Zen Buddhism that is animated by his personal experience as a long-term practitioner in Japan at the Rinzai Zen monastery of Shōkokuji and as a teacher and director of the Heart of Zen Meditation Group at Loyola University Maryland. However, as the Japanese subtitle of this work, 禅道の千路, makes clear, there are “a thousand paths of the way of Zen,” and Davis is careful to show us the paths he has traveled while leaving it to the reader to find their own paths along the way.In the course of the book’s twenty-four chapters, Davis provides his reader with a clear account and philosophical interpretation of [End Page 159] the core teachings of Buddhism (the four noble truths, impermanence, the no-self doctrine, co-origination and interconnection of the one and the many, nirvana and samsara, the great death, and so on), always relating his theoretical explanations to the concrete perspective of the practice of Zen Buddhism. His account of Zen Buddhism situates it in the historical tradition of Buddhism as it was transplanted from India to China, from China to Japan, and today from Japan to other places in the world. Davis connects these teachings to the practice of Zen, providing readers with a concrete and firsthand introduction to such Zen practices as zazen (seated meditation), kinhin (walking meditation), sanzen (interviews with a teacher), koān work, and samu (meditative work), and to the Zen practice of cultivating naturalness (jinen) in and through such art forms as karate and flower arrangement (ikebana), the Japanese aesthetics of “cut-continuance” and wabi-sabi, as well as Zen-inspired gardens, painting, and music. The book also explores a number of classical and contemporary philosophical issues from the standpoint of Zen Buddhism: the problem of the one and the many, the ethical relation to the other, the problem of evil, the nature of love, freedom and determinacy, what is God, our relation to nature, and so on. Finally, the presentation of the core teachings of Zen Buddhism and the discussion of philosophical issues is undertaken in and through an intercultural and interreligious dialogue in which the similarities and dissimilarities between different cultural and faith traditions are explored and used to help illustrate the unique standpoint of Zen Buddhism. One can mention here Chapter 12 titled “Dying to Live: Zen, Pure Land Buddhism, and Christianity.” This synoptic view of Zen Buddhism is presented in an elegant, personal style that is clear, concise, and expresses a genuine passion and spirit of openness. In copious endnotes, Davis has also provided the reader with a wealth of material for further study that has been judiciously selected from good English translations of readings in the classical works as well as contemporary scholarship. Finally, with an eye to the use of this text in a classroom or in study groups, Davis has... (shrink)

The harmful impact of an adverse event ripples beyond injured patients and their families to affect physicians, nurses, and other health care staff that are involved. These “Second Victims” may experience intense feelings of anxiety, guilt, and fear. They may doubt their clinical competence or ability to continue working at all. Some go on to suffer post-traumatic stress disorder and depression.Medical institutions long ignored this problem, preferring to believe that adverse events, or “errors,” occur due to incompetence — the unfortunate (...) work of a few “bad” practitioners who deserve, if anything, a reprimand for their negligence. Study after study has rejected this attribution and shown that adverse events in health care stem primarily from systemic flaws, not “bad apples.” Devastating errors, in other words, can, do, and always will happen in the care of competent, well-trained, and caring practitioners. (shrink)

Access to legal information is fundamental to access to justice. Yet accessibility refers not only to making legal documents available to the public, but also rendering legal information comprehensible to them. A vexing problem in bringing legal information to the public is how to turn formal legal documents such as legislation and judgments, which are often highly technical, to easily navigable and comprehensible knowledge to those without legal education. In this study, we formulate a three-step approach for bringing legal knowledge (...) to laypersons, tackling the issues of navigability and comprehensibility. First, we translate selected sections of the law into snippets (called CLIC-pages), each being a small piece of article that focuses on explaining certain technical legal concept in layperson’s terms. Second, we construct a _Legal Question Bank_, which is a collection of legal questions whose answers can be found in the CLIC-pages. Third, we design an interactive _CLIC Recommender_. Given a user’s verbal description of a legal situation that requires a legal solution, CRec interprets the user’s input and shortlists questions from the question bank that are most likely relevant to the given legal situation and recommends their corresponding CLIC pages where relevant legal knowledge can be found. In this paper we focus on the technical aspects of creating an LQB. We show how large-scale pre-trained language models, such as GPT-3, can be used to generate legal questions. We compare machine-generated questions against human-composed questions and find that MGQs are more scalable, cost-effective, and more diversified, while HCQs are more precise. We also show a prototype of CRec and illustrate through an example how our 3-step approach effectively brings relevant legal knowledge to the public. (shrink)