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)

In this study, complex dynamics of Briggs–Rauscher reaction system is investigated analytically and numerically. First, the Briggs–Rauscher reaction system is reduced into a new nonlinear parametric oscillator. The Melnikov method is used to derive the condition of the appearance of horseshoe chaos in the cases ω = Ω and ω ≠ Ω. The performed numerical simulations confirm the obtained analytical predictions. Second, the prediction of coexisting attractors is investigated by solving numerically the new nonlinear parametric ordinary differential equation via the (...) fourth-order Runge–Kutta algorithm. As results, it is found that the new nonlinear chemical system displays various coexisting behaviors of symmetric and asymmetric attractors. In addition, the system presents a rich variety of bifurcations phenomena such as symmetry breaking, symmetry restoring, period doubling, reverse period doubling, period-m bubbles, reverse period-m bubbles, intermittency, and antimonotonicity. On the contrary, emerging chaotic band attractors and period-1, period-3, period-9, and period-m bubbles routes to chaos occur in this system. (shrink)

Name der Zeitschrift: Semiotica Jahrgang: 2018 Heft: 225 Seiten: 457-487.

A review of medical ethics literature relating to the importance of the participation of patients in decision-making introduces the role of rights-based mediation as a voluntary process now being developed innovatively in America. This is discussed in relation to the theory of communicative ethics and moral personhood. References are then made to the work of medical ethics committees and the role of mediation within these. Finally it is suggested that mediation is part of an eirenic ethic already being used informally (...) in good patient care, and that there is a case for developing it further. (shrink)

In the course of an immune response, antibodies undergo affinity maturation in order to increase their efficiency in neutralizing foreign invaders. Affinity maturation occurs by the introduction of multiple point mutations in the variable region gene that encodes the antigen binding site. This somatic hypermutation is restricted to immunoglobulin genes and occurs at very high rates. The precise molecular basis of this process remains obscure. However, recent studies using a variety of in vivo and in vitro systems have revealed important (...) regulatory regions, base motifs that are preferred targets of mutation and evidence that transcription may play an active role in hypermutation. BioEssays 20:227–234, 1998. © 1998 John Wiley & Sons, Inc. (shrink)

This book presents Yi Hwang —better known by his pen name, Toegye—Korea’s most eminent Confucian philosopher. It is a pioneering study of Toegye’s moral and religious thought that discusses his holistic ideas and experiences as a scholar, thinker, and spiritual practitioner. This study includes Toegye’s major biographies and letters as well as his famous Jaseongnok and Seonghak sipdo. Edward Chung explains key concepts, original quotations, annotated notes, and thought-provoking comments to bring this monumental thinker and his work to life. Chung (...) also considers comparative and interreligious perspectives and their contemporary relevance. By offering groundbreaking insights into Neo-Confucianism, this book sheds fresh light on the breadth and depth of Toegye’s ethics and spirituality, and is an important source for scholars and students in Korean and Confucian studies and comparative philosophy and religion. (shrink)

This article explores the conceptual and practical gap existing between the developed and developing countries in relation to corporate social responsibility (CSR), or the North-South ' CSR Divide', through the analysis of possible impact on the competitiveness of developing countries' and economies' SMEs and MNEs in globalization. To do so, this article first reviewed the traditional wisdom on the concept of strategic CSR developed in the North and the role that CSR engagement can play in corporate competitiveness, and compare with (...) the impact on the competitive advantage of the South through the supply chains. It points out that among the many factors that could explain the ' CSR Divide', the negative impact of CSR on comparative advantage is the final resort where developing countries are reluctant and defensive toward western-style CSR. It did point out that developing countries are changing their approaches to make CSR work in favor of their competitive position in global trade, such as China who has started to adopt proactive approach by becoming CSR standards-setter. This article concludes with two policy proposals that aim to bridge the CSR gap, the first is to improve CSR standard-setting participation from both sides, and the second to search for solutions in the international investment legal framework which will define corporate obligations in relating to CSR in a more explicit way. (shrink)

When individuals read literary fiction, contemplate philosophical arguments, view art, or listen to music, they experience emotions that vary in both valence and intensity. Engagement with the humanities can enhance individual emotional intelligence (EI) and well-being. This narrative review proposes links between engagement with literary fiction, moral philosophy, visual art, and music with EI and well-being. The work details the mechanisms by which (i) literary fiction increases the ability to perceive emotions, (ii) moral philosophy improves the use of emotions for (...) ethical decision-making, (iii) visual art elevates the ability to understand emotion, and (iv) music enhances the ability to manage emotions. The concluding section presents theoretical implications and practical suggestions for designing interventions that promote EI and flourishing. (shrink)

The complex hexaploid wheat genome offers many challenges for genomics research. Expressed sequence tags facilitate the analysis of gene-coding regions and provide a rich source of molecular markers for mapping and comparison with model organisms. The objectives of this study were to construct a high-density EST chromosome bin map of wheat homoeologous group 2 chromosomes to determine the distribution of ESTs, construct a consensus map of group 2 ESTs, investigate synteny, examine patterns of duplication, and assess the colinearity with rice (...) of ESTs assigned to the group 2 consensus bin map. A total of 2600 loci generated from 1110 ESTs were mapped to group 2 chromosomes by Southern hybridization onto wheat aneuploid chromosome and deletion stocks. A consensus map was constructed of 552 ESTs mapping to more than one group 2 chromosome. Regions of high gene density in distal bins and low gene density in proximal bins were found. Two interstitial gene-rich islands flanked by relatively gene-poor regions on both the short and long arms and having good synteny with rice were discovered. The map locations of two ESTs indicated the possible presence of a small pericentric inversion on chromosome 2B. Wheat chromosome group 2 was shown to share syntenous blocks with rice chromosomes 4 and 7. (shrink)

This report describes the rationale, approaches, organization, and resource development leading to a large-scale deletion bin map of the hexaploid wheat genome. Accompanying reports in this issue detail results from chromosome bin-mapping of expressed sequence tags representing genes onto the seven homoeologous chromosome groups and a global analysis of the entire mapped wheat EST data set. Among the resources developed were the first extensive public wheat EST collection. Described are protocols for sequencing, sequence processing, EST nomenclature, and the assembly of (...) ESTs into contigs. These contigs plus singletons were used for selection of distinct sequence motif unigenes. Selected ESTs were rearrayed, validated by 5′ and 3′ sequencing, and amplified for probing a series of wheat aneuploid and deletion stocks. Images and data for all Southern hybridizations were deposited in databases and were used by the coordinators for each of the seven homoeologous chromosome groups to validate the mapping results. Results from this project have established the foundation for future developments in wheat genomics. (shrink)

Using the corpus of JSTOR articles, we investigate the role of gender in collaboration patterns across the scholarly landscape by analyzing gender-based homophily--the tendency for researchers to co-author with individuals of the same gender. For a nuanced analysis of gender homophily, we develop methodology necessitated by the fact that the data comprises heterogeneous sub-disciplines and that not all authorships are exchangeable. In particular, we distinguish three components of gender homophily in collaborations: a structural component that is due to demographics and (...) non-gendered authorship norms of a scholarly community, a compositional component which is driven by varying gender representation across sub-disciplines, and a behavioral component which we define as the remainder of observed homophily after its structural and compositional components have been taken into account. Using minimal modeling assumptions, we measure and test for behavioral homophily. We find that significant behavioral homophily can be detected across the JSTOR corpus and show that this finding is robust to missing gender indicators in our data. In a secondary analysis, we show that the proportion of female representation in a field is positively associated with significant behavioral homophily. (shrink)

Fléau de nos sociétés contemporaines, l'usage de la drogue, des drogues, n'est pas un phénomène absolument nouveau dans l'humanité. La Bible elle-même en traite, à sa façon sans doute, mais qui est d'abord tributaire des modes de pensée et de représentation comme de l'état des connaissances de l'Antiquité et plus particulièrement du Proche-Orient ancien. La pharmacopée autant que des pratiques que nous jugerions aujourd'hui explicitement superstitieuses entrent dans cette recherche et réception des drogues. S'il n'y a pas de traité biblique (...) ni de classification des drogues, du moins psaumes et prophètes notamment font souvent allusion à ces produits qui n'entrent pas directement dans les biens de subsistance immédiate, pour les entendre de façon symbolique. En bref, la Bible est plutôt discrète sur le sujet. Elle n'en permet pas moins d'amorcer une éthique et déontologie, à quoi la consultation du Talmud et de la Mishna apportent une contribution non négligeable. The use of drugs is a sickness of our contemporaneous society, but not a phenomenon absolutely new for humanity. In its own way, the Bible itself speaks of them, but is dependent on the ways of thinking, representation, and the state of knowledge of Antiquity, especially in the ancient Near East. The pharmacopoeia, as well as the practices that we judge today explicitly superstitions, enters into this research and utilisation of drugs. If there is no biblical treatise nor classification of drugs, at least the Psalms and the prophets often make notable allusions to these products, which are not directly part of the goods of immediate sustenance, understanding them in a symbolic way. In brief, the Bible is particularly discrete on the subject. But we are not prevented from beginning an ethic and deontology. Consultation of the Talmud and the Mishna offers a helpful contribution. (shrink)

Las reflexiones recogidas en este volumen constituyeron, en su mayor parte, el contenido del Seminario de Semántica celebrado en la Universidad de Oviedo, y uno de los textos ("Léxico y cognición: ¿hay términos de base?") formó parte del programa de conferencias de Año Europeo de las Lenguas. Conforme al espíritu de esas jornadas centradas en la pluralidad lingüística, esta publicación se hace simultáneamente en dos lenguas: español y francés. Aunque se tomen como referencia aspectos concretos de dos lenguas concretas, la (...) española y la francesa, los problemas que aquí se suscitan son de índole general, ya que afectan, y de manera crucial, a todas las lenguas. (shrink)

Structured interviews were held with 149 registered nurses in seven countries in America, Asia, Australia and Europe concerning the feeding of severely demented patients who do not accept food. The most common reasons for nurses being willing to change their decision to feed or not to feed were an order from the medical head, a request from the patient's husband and/or the staff meeting. There was a connection between the willingness to feed and the ranking of ethical principles. Nurses who (...) were most prone to feed the patient most often gave a high rank to the ethical principle of sanctity of life, while those who primarily chose not to feed the patient gave a high rank to the ethical principle of autonomy. All nurses stressed the ethical principle of beneficence. Des interviews structurés ont eu lieu avec 149 infirmiers/ères dans sept pays en Amérique, Asie, Australie et Europe concernant l'alimentation des malades gravement dément qui refusent de manger. La raison la plus générale pour des infirmiers/ères d'être prêt à changer leures décisions de donner à manger ou non sont: un ordre du médecin, la demande du mari de la malade ou de la réunion du personnel. Il y avait un lien entre la volonté de nourir et le rang des principes éthiques. Les infirmiers/ères les plus enclins de nourir la malade le plus souvent donnaient un rang supérieur au principe éthique de la sainteté de vie, pendant que ceux et celles qui choisissaient de ne pas nourrir la malade donnaient un rang supérieur au principe éthique de l'autonomie. Tous insistaient sur l'importance du principe éthique de la bienfaisance. Konstruktive Interviews wurden mit 149 ausgebildeten Krankenschwestern und Pfleger in sieben Ländern in Amerika, Asien, Australien und Europa gehalten über die Ernährung von schwer von Dementia praecox leidenden Patienten, die das Essen verweigern. Die gewöhnlichsten Gründe des Pflegepersonals für die Bereitwilligkeit, ihre Entscheidung, zu ernähren oder nicht, zu ändern, waren Anordnungen vom medizinischen Chef, Anfragen vom Ehemann der Patientin und/oder einer Personalsitzung. Es bestand ein Zusammenhang zwischen der Bereitwilligkeit zur Ernährung und dem Rang der ethischen Prinzipien. Die Pflegenden, die sich am meisten neigten, die Patientin zu ernähren, gaben dem ethischen Prinzip der Heiligkeit des Lebens einen hohen Rang, während die, die meistens vorzogen, die Patientin nicht zu ernähren, gaben dem ethischen Prinzip der Autonomie einen hohen Rang. Alle Pflegenden legten grossen Wert auf das ethische Prinzip der Wohltätigkeit. (shrink)

Strong Turing Determinacy, or ${\mathrm {sTD}}$, is the statement that for every set A of reals, if $\forall x\exists y\geq _T x (y\in A)$, then there is a pointed set $P\subseteq A$. We prove the following consequences of Turing Determinacy ( ${\mathrm {TD}}$ ) and ${\mathrm {sTD}}$ over ${\mathrm {ZF}}$ —the Zermelo–Fraenkel axiomatic set theory without the Axiom of Choice: (1) ${\mathrm {ZF}}+{\mathrm {TD}}$ implies $\mathrm {wDC}_{\mathbb {R}}$ —a weaker version of $\mathrm {DC}_{\mathbb {R}}$.(2) ${\mathrm {ZF}}+{\mathrm {sTD}}$ implies that every (...) set of reals is measurable and has Baire property.(3) ${\mathrm {ZF}}+{\mathrm {sTD}}$ implies that every uncountable set of reals has a perfect subset.(4) ${\mathrm {ZF}}+{\mathrm {sTD}}$ implies that for every set of reals A and every $\epsilon>0$ :(a)There is a closed set $F\subseteq A$ such that $\mathrm {Dim_H}(F)\geq \mathrm {Dim_H}(A)-\epsilon $, where $\mathrm {Dim_H}$ is the Hausdorff dimension.(b)There is a closed set $F\subseteq A$ such that $\mathrm {Dim_P}(F)\geq \mathrm {Dim_P}(A)-\epsilon $, where $\mathrm {Dim_P}$ is the packing dimension. (shrink)

Having remarked that "competing and mutually contradictory philosophies may be formulated in different languages," Landesman concludes that "the generalization that the speaking of a given language by a given philosopher is either a necessary or sufficient condition for the formulation of his explicit philosophy would seem to be false." I do not believe that the conclusion follows. Elsewhere, I have tried to show that what I call the "strong interpretation" of the Sapir-Whorf hypothesis can be assimilated to the notion of (...) "untranslatability" in such a way that it becomes equivalent to the denial of the position held by Roman Jakobson that "All cognitive experience and its classification is conveyable in any existing language." To deny Jakobson's thesis is equivalent to the assertion that there is at least one language for which there is at least one other language such that the first cannot translate the second. Letting "Txy" stand for "x translates y," and "Lx" for "x is a language," Jakobson's thesis goes over in symbols as. (shrink)

Childhood adversity is associated with altered or dysregulated stress reactivity; these altered patterns of physiological functioning persist into adulthood. Evidence from both preclinical animal models and human neuroimaging studies indicates that early life experience differentially influences stressor-evoked activity within central visceral neural circuits proximally involved in the control of stress responses, including the subgenual anterior cingulate cortex (sgACC), paraventricular nucleus of the hypothalamus (PVN), bed nucleus of the stria terminalis (BNST) and amygdala. However, the relationship between childhood adversity and the (...) resting-state connectivity of this central visceral network remains unclear. To this end, we examined relationships between childhood threat and childhood socioeconomic deprivation, the resting-state connectivity between our regions of interest (ROIs), and affective symptom severity and diagnoses. We recruited a transdiagnostic sample of young adult males and females (n= 100; mean age = 27.28,SD= 3.99; 59 females) with a full distribution of maltreatment history and symptom severity across multiple affective disorders. Resting-state data were acquired using a 7.2-min functional magnetic resonance imaging (fMRI) sequence; noted ROIs were applied as masks to determine ROI-to-ROI connectivity. Threat was determined by measures of childhood traumatic events and abuse. Socioeconomic deprivation (SED) was determined by a measure of childhood socioeconomic status (parental education level). Covarying for age, race and sex, greater childhood threat was significantly associated with lower BNST-PVN, amygdala-sgACC and PVN-sgACC connectivity. No significant relationships were found between SED and resting-state connectivity. BNST-PVN connectivity was associated with the number of lifetime affective diagnoses. Exposure to threat during early development may entrain altered patterns of resting-state connectivity between these stress-related ROIs in ways that contribute to dysregulated neural and physiological responses to stress and subsequent affective psychopathology. (shrink)

The focus of this study was to analyze the content, distribution, and comparative genome relationships of 996 chromosome bin-mapped expressed sequence tags accounting for 2266 restriction fragments on the homoeologous group 3 chromosomes of hexaploid wheat. Of these loci, 634, 884, and 748 were mapped on chromosomes 3A, 3B, and 3D, respectively. The individual chromosome bin maps revealed bins with a high density of mapped ESTs in the distal region and bins of low density in the proximal region of the (...) chromosome arms, with the exception of 3DS and 3DL. These distributions were more localized on the higher-resolution group 3 consensus map with intermediate regions of high-mapped-EST density on both chromosome arms. Gene ontology classification of mapped ESTs was not significantly different for homoeologous group 3 chromosomes compared to the other groups. A combined analysis of the individual bin maps using 537 of the mapped ESTs revealed rearrangements between the group 3 chromosomes. Approximately 232 of the consensus mapped ESTs matched sequences on rice chromosome 1 and revealed large- and small-scale differences in gene order. Of the group 3 mapped EST unigenes ∼21 and 32% matched the Arabidopsis coding regions and proteins, respectively, but no chromosome-level gene order conservation was detected. (shrink)

A total of 944 expressed sequence tags generated 2212 EST loci mapped to homoeologous group 1 chromosomes in hexaploid wheat. EST deletion maps and the consensus map of group 1 chromosomes were constructed to show EST distribution. EST loci were unevenly distributed among chromosomes 1A, 1B, and ID with 660, 826, and 726, respectively. The number of EST loci was greater on the long arms than on the short arms for all three chromosomes. The distribution of ESTs along chromosome arms (...) was nonrandom with EST clusters occurring in the distal regions of short arms and middle regions of long arms. Duplications of group 1 ESTs in other homoeologous groups occurred at a rate of 35.5%. Seventy-five percent of wheat chromosome 1 ESTs had significant matches with rice sequences, where large regions of conservation occurred between wheat consensus chromosome 1 and rice chromosome 5 and between the proximal portion of the long arm of wheat consensus chromosome 1 and rice chromosome 10. Only 9.5% of group 1 ESTs showed significant matches to Arabidopsis genome sequences. The results presented are useful for gene mapping and evolutionary and comparative genomics of grasses. (shrink)

Medium- and high-spin states of Pr-134 were populated using the Cd-116(Na-23, 5n) reaction and studied with the GAMMASPHERE spectrometer. Several new bands have been found in this nucleus, one of them being linked to the previously observed chiral-candidate twin-band structure. The ground state of Pr-134 could be determined through establishing a level structure that connects the two previously known long-lived isomeric states. Unambiguous spin-parity assignments for the excited states could be performed based on the known 2(-) spin-parity of the ground (...) state combined with the present experimental data. Intrinsic single-particle configurations have been assigned to the newly observed bands on the basis of the measured B(M1)/B(E2) ratios, alignments, band-crossing frequencies, bandhead spins, the observed single-particle configurations in the neighboring nuclei, and taking into account the predictions of total Routhian surface and tilted-axis cranking calculations. (shrink)