On staying grounded and avoiding Quixotic dead ends

The 15 articles in this special issue on The Representation of Concepts illustrate the rich variety of theoretical positions and supporting research that characterize the area. Although much agreement exists among contributors, much disagreement exists as well, especially about the roles of grounding and abstraction in conceptual processing. I first review theoretical approaches raised in these articles that I believe are Quixotic dead ends, namely, approaches that are principled and inspired but likely to fail. In the process, I review various theories of amodal symbols, their distortions of grounded theories, and fallacies in the evidence used to support them. Incorporating further contributions across articles, I then sketch a theoretical approach that I believe is likely to be successful, which includes grounding, abstraction, flexibility, explaining classic conceptual phenomena, and making contact with real-world situations. This account further proposes that (1) a key element of grounding is neural reuse, (2) abstraction takes the forms of multimodal compression, distilled abstraction, and distributed linguistic representation (but not amodal symbols), and (3) flexible context-dependent representations are a hallmark of conceptual processing

Determining the Effective Density and Stabilizer Layer Thickness of Sterically Stabilized Nanoparticles.

A series of model sterically stabilized diblock copolymer nanoparticles has been designed to aid the development of analytical protocols in order to determine two key parameters: the effective particle density and the steric stabilizer layer thickness. The former parameter is essential for high resolution particle size analysis based on analytical (ultra)centrifugation techniques (e.g., disk centrifuge photosedimentometry, DCP), whereas the latter parameter is of fundamental importance in determining the effectiveness of steric stabilization as a colloid stability mechanism. The diblock copolymer nanoparticles were prepared via polymerization-induced self-assembly (PISA) using RAFT aqueous emulsion polymerization: this approach affords relatively narrow particle size distributions and enables the mean particle diameter and the stabilizer layer thickness to be adjusted independently via systematic variation of the mean degree of polymerization of the hydrophobic and hydrophilic blocks, respectively. The hydrophobic core-forming block was poly(2,2,2-trifluoroethyl methacrylate) [PTFEMA], which was selected for its relatively high density. The hydrophilic stabilizer block was poly(glycerol monomethacrylate) [PGMA], which is a well-known non-ionic polymer that remains water-soluble over a wide range of temperatures. Four series of PGMA x -PTFEMA y nanoparticles were prepared (x = 28, 43, 63, and 98, y = 100-1400) and characterized via transmission electron microscopy (TEM), dynamic light scattering (DLS), and small-angle X-ray scattering (SAXS). It was found that the degree of polymerization of both the PGMA stabilizer and core-forming PTFEMA had a strong influence on the mean particle diameter, which ranged from 20 to 250 nm. Furthermore, SAXS was used to determine radii of gyration of 1.46 to 2.69 nm for the solvated PGMA stabilizer blocks. Thus, the mean effective density of these sterically stabilized particles was calculated and determined to lie between 1.19 g cm(-3) for the smaller particles and 1.41 g cm(-3) for the larger particles; these values are significantly lower than the solid-state density of PTFEMA (1.47 g cm(-3)). Since analytical centrifugation requires the density difference between the particles and the aqueous phase, determining the effective particle density is clearly vital for obtaining reliable particle size distributions. Furthermore, selected DCP data were recalculated by taking into account the inherent density distribution superimposed on the particle size distribution. Consequently, the true particle size distributions were found to be somewhat narrower than those calculated using an erroneous single density value, with smaller particles being particularly sensitive to this artifact

The Role of Leucoyte-Derived Free Oxygen Radicals in the Pathogenesis of Experimental Acute Pancreatitis

The role of free oxygen radicals in experimental acute pancreatitis induced by common bile duct ligation was investigated by measuring malondialdehyde levels in the rat pancreas. Also, the potential role of leucocytes as the source of free oxygen radicals was tested by inducing leukopenia with methotrexate. The malondialdehyde levels in the control, pancreatitis and pancreatitis + methotrexate groups were 9.6 ± 2.0, 44.8 ± 11.4, and 25.6 ± 5.0 nmol malondialdehyde/ g pancreas tissue respectively. The corresponding histopathological severity scores were 0.5 ± 0.7, 8.1 ± 1.2 and 3.7 ± 1.1. The results suggest that the leucocyte may be an important source of free oxygen radicals in this experimental model

Perspectives on care and communication involving incurably ill Turkish and Moroccan patients, relatives and professionals: a systematic literature review

<p>Abstract</p> <p>Background</p> <p>Our aim was to obtain a clearer picture of the relevant care experiences and care perceptions of incurably ill Turkish and Moroccan patients, their relatives and professional care providers, as well as of communication and decision-making patterns at the end of life. The ultimate objective is to improve palliative care for Turkish and Moroccan immigrants in the Netherlands, by taking account of socio-cultural factors in the guidelines for palliative care.</p> <p>Methods</p> <p>A systematic literature review was undertaken. The data sources were seventeen national and international literature databases, four Dutch journals dedicated to palliative care and 37 websites of relevant national and international organizations. All the references found were checked to see whether they met the structured inclusion criteria. Inclusion was limited to publications dealing with primary empirical research on the relationship between socio-cultural factors and the health or care situation of Turkish or Moroccan patients with an oncological or incurable disease. The selection was made by first reading the titles and abstracts and subsequently the full texts. The process of deciding which studies to include was carried out by two reviewers independently. A generic appraisal instrument was applied to assess the methodological quality.</p> <p>Results</p> <p>Fifty-seven studies were found that reported findings for the countries of origin (mainly Turkey) and the immigrant host countries (mainly the Netherlands). The central themes were experiences and perceptions of family care, professional care, end-of-life care and communication. Family care is considered a duty, even when such care becomes a severe burden for the main female family caregiver in particular. Professional hospital care is preferred by many of the patients and relatives because they are looking for a cure and security. End-of-life care is strongly influenced by the continuing hope for recovery. Relatives are often quite influential in end-of-life decisions, such as the decision to withdraw or withhold treatments. The diagnosis, prognosis and end-of-life decisions are seldom discussed with the patient, and communication about pain and mental problems is often limited. Language barriers and the dominance of the family may exacerbate communication problems.</p> <p>Conclusions</p> <p>This review confirms the view that family members of patients with a Turkish or Moroccan background have a central role in care, communication and decision making at the end of life. This, in combination with their continuing hope for the patient’s recovery may inhibit open communication between patients, relatives and professionals as partners in palliative care. This implies that organizations and professionals involved in palliative care should take patients’ socio-cultural characteristics into account and incorporate cultural sensitivity into care standards and care practices<it>.</it></p

Neonatal Hypoglycemia in Diabetic Mothers: a Systematic Review

Hypoglycemia occurs in approximately 8-30% of neonates born to mothers with diabetes. The full extent of the individual and contextual risk factors of hypoglycemia remains unclear and no systematic review of the available studies exists to date. We identified published studies using PubMed and EBSCO host search engines. A modified STROBE statement was used to assess studies\u27 strengths, weaknesses, and generalizability. A total of 16 articles were eligible for full text review. The clinical risk factors in these studies were broadly classified into two: infant-related and mother-related risk factors. The identified infant-related risk factors were SGA, macrosomia, prematurity, lower cord blood glucose, ponderal index and male sex. On the other hand, mother-related risk factors includes maternal hyperglycemia, ethnic origin, diabetes diagnosed prior to 28 weeks of gestation, pre-pregnancy BMI of ≥ 25 kg/m², blood glucose, maternal diabetes type and maternal HbA1c. Irrespective of diabetes type, infants born to diabetic mothers appear to have a higher risk of developing hypoglycemia compare to those born to normal mothers. The overall evidence suggested that these studies mainly focus on the clinical characteristics of infants and mothers. Future research should focus on the identification of risk factors at the individual and contextual levels that can independently predict neonatal hypoglycemia. Appropriate emphasis should also be given to better define neonatal hypoglycemia

Eddy induced cross-shelf exchanges in the Black Sea

Cross-shelf exchanges in the Black Sea were investigated using remote sensing data and an ocean circulation model to which an eddy-tracking algorithm and Lagrangian particle tracking model was applied. An anticyclonic eddy in 1998 and a cyclonic eddy in 2000 were investigated in detail. Eddy-induced cross-shelf transport of low salinity and high Chl-a waters reached a maximum in the presence of filaments associated with these eddies. The daily mean volume transport by the eddies was comparable with the previously documented transport by eddies of similar size in the north-western shelf region. Lagrangian particle tracking results showed that 59% of particles initially released over the shelf were transported offshore within 30 days by the 1998 anticyclone and 27% by the 2000 cyclone. The net volume transport across the Black Sea shelf-break reached the maxima in winter, coinciding with the increase in wind stress curl and mean kinetic energy that is a measure of the intensity of the boundary current. Ekman transport directly influences the cross-shelf exchanges in the surface layer. The south-eastern Black Sea is presented as an important area for cross-shelf transport. The total cross-shelf transport can be divided into its “large-scale” and “eddy-induced” components. Eddy-induced transport was 34% and 37% of the total cross-shelf transport (1998–2014) in the Black Sea in the off-shelf and on-shelf directions, respectively, but these values ranged between 25% and 65% depending on the eddy activity over time

The Impact of the COVID-19 Pandemic on the Psychological Well-Being of Caregivers of People with Dementia or Mild Cognitive Impairment: A Systematic Review and Meta-Analysis

The aim of this systematic review was to investigate the effects of the COVID-19 lockdown on the psychological well-being of caregivers of people with dementia or mild cognitive impairment (PwD/MCI). Electronic databases were searched from inception to August 2022 for observational studies investigating the COVID-19 lockdown and psychological well-being of caregivers of PwD/MCI. Summary estimates of standardized mean differences (SMD) in psychological well-being scores pre- versus during COVID-19 were calculated using a random-effects model. Fifteen studies including 1702 caregivers (65.7% female, mean age 60.40 ± 12.9 years) with PwD/MCI were evaluated. Five studies found no change in psychological well-being parameters, including depression, anxiety, distress, caregiver burden, and quality of life. Ten studies found a worsening in at least one parameter: depression (six studies, n = 1368; SMD = 0.40; 95%CI: 0.09–0.71; p = 0.01, I2 = 86.8%), anxiety (seven studies, n = 1569; SMD = 1.35; 95%CI: 0.05–2.65; I2 = 99.2%), caregiver distress (six studies, n = 1320, SMD = 3.190; 95%CI: 1.42–4.95; p &lt; 0.0001; I2 = 99.4%), and caregiver burden (four studies, n = 852, SMD = 0.34; 95%CI: 0.13–0.56; p = 0.001; I2 = 54.1%) (p &lt; 0.05). There was an increase in depression, anxiety, caregiver burden, and distress in caregivers of PwD/MCI during the lockdown in the COVID pandemic. This could have longer term consequences, and it is essential that caregivers’ psychological well-being is assessed and supported, to benefit both themselves and those for whom they care

Interoperable E-Health System Using Structural and Semantic Interoperability Approaches in CAREPATH

Technical and semantic interoperability are broadly used components of interoperability technology in healthcare. Technical Interoperability provides interoperability interfaces to enable data exchange within different healthcare systems, despite any underlying heterogeneity. Semantic interoperability make different healthcare systems understand and interpret the meaning of the data that is exchanged, by using and mapping standardized terminologies, coding systems, and data models to describe the concept and structure of data. We propose a solution using Semantic and Structural Mapping techniques within CAREPATH; a research project designed to develop ICT solutions for the care management of elderly multimorbid patients with mild cognitive impairment or mild dementia. Our technical interoperability solution supplies a standard-based data exchange protocol to enable information exchange between local care systems and CAREPATH components. Our semantic interoperability solution supplies programmable interfaces, in order to semantically mediate different clinical data representation formats and incorporating data format and terminology mapping features. The solution offers a more reliable, flexible and resource efficient method across EHRs.</p