Assessing the commensurability of theories of consciousness: On the usefulness of common denominators in differentiating, integrating and testing hypotheses.

How deep is the current diversity in the panoply of theories to define consciousness, and to what extent do these theories share common denominators? Here we first examine to what extent different theories are commensurable (or comparable) along particular dimensions. We posit logical (and, when applicable, empirical) commensurability as a necessary condition for identifying common denominators among different theories. By consequence, dimensions for inclusion in a set of logically and empirically commensurable theories of consciousness can be proposed. Next, we compare a limited subset of neuroscience-based theories in terms of commensurability. This analysis does not yield a denominator that might serve to define a minimally unifying model of consciousness. Theories that seem to be akin by one denominator can be remote by another. We suggest a methodology of comparing different theories via multiple probing questions, allowing to discern overall (dis)similarities between theories. Despite very different background definitions of consciousness, we conclude that, if attention is paid to the search for a common methological approach to brain-consciousness relationships, it should be possible in principle to overcome the current Babylonian confusion of tongues and eventually integrate and merge different theories.

Selective functionalization of patterned glass surfaces.

Tailored writing and specific positioning of molecules on nanostructures is a key step for creating functional materials and nano-optical devices, or interfaces for synthetic machines in various applications. We present a novel approach for the selective functionalization of patterned glass surfaces with functional probes of any nature. The presented strategy is optimized for imaging fluorophore labeled nanostructures for (single-molecule) fluorescence microscopy. The first step in the protocol is coating a glass surface, here a microscope cover slide, with a 60 nm thick diamond-like carbon film. Subsequently, the pattern is defined by either writing silicon oxide on the coating with a focused electron beam, or by etching the coating with a focused ion beam to expose the glass surface. Finally, the pattern is silanized and functionalized. We demonstrate the selective binding of organic fluorophores and imaging with high contrast, especially in total-internal-reflection mode. The presented approach is flexible and combines bottom-up assembly with high-resolution lithography on glass cover slides to precisely position and image functional molecules of any type.

Linking live animals and products: traceability.

It is rarely possible to successfully contain an outbreak of an infectious animal disease, or to respond effectively to a chemical residue incident, without the use of a system for identifying and tracking animals. The linking of animals at the time they are slaughtered--through the use of identification devices or marks and accompanying movement documentation--with the meat produced from their carcasses, adds further value from the perspective of consumer safety. Over the past decade, animal identification technology has become more sophisticated and affordable. The development of the Internet and mobile communication tools, complemented bythe expanded capacity of computers and associated data management applications, has added a new dimension to the ability of Competent Authorities and industry to track animals and the food they produce for disease control, food safety and commercial purposes.

The prognostic significance of human epidermal growth factor receptor correlations in squamous cell cervical carcinoma.

UNLABELLED: The aim of this study was to investigate the expression and prognostic influence of HER1 (EGFR), HER2 (c-erb-B2), HER3 (c-erb-B3) and HER4 (cerb-B4) in squamous cell cervical carcinomas (SCC) and the importance of receptor correlations. PATIENTS AND METHODS: 78 SCC were stained immunohistochemically for HER1-HER4. HER2 gene amplification was determined using fluorescence in situ hybridization (FISH). Parametric correlations were performed between the four receptors and tumor characteristics. Overall survival was evaluated by uni- and multivariate analyses. RESULTS: Overexpression was found in 63% of SCC for HER1, in 21.8% for HER2, in 74.4% for HER3 and in 79.5% for HER4. Correlations were observed between HER1 and HER4 (p = 0.019). Survival analyses revealed a significant association of HER1 overexpression with favorable outcome (p = 0.016), while overexpression of HER2 and HER3 was associated with poor prognosis (p = 0.006; p = 0.05, respectively). HER1 remained significant in multivariate analysis. CONCLUSION: These data suggest that the prognostic relevance of the different HER receptors is influenced by the balance between the various receptors, especially of HER4.

Impact of community-based education on health care evaluation in patients with acute chest pain syndromes: the Wabasha Heart Attack Team (WHAT) project.

BACKGROUND: Community education programmes focused on raising public awareness of the symptomatology of acute coronary syndromes have had mixed results. OBJECTIVES: The Wabasha Heart Attack Team project, a unique multidisciplinary public education effort in Minnesota, sought to educate area citizens about signs and symptoms of acute myocardial infarction (MI). METHODS: After an intensive 1-month education period, we compared presentations for emergency evaluation of chest pain during the study period with baseline data from the same seasonal period of the preceding year. RESULTS: Visits to the Emergency Room for symptomatic heart disease increased significantly during the study period (56 patients versus 46 patients during the baseline period), as did the percentage of patients presenting with acute MI (18% versus 12%, P < 0.05). Use of emergency medical services for pre-hospital evaluation was significantly increased (41% versus 27%, P < 0.05). CONCLUSION: A community education campaign can significantly increase use of pre-hospital emergency medical service resources and may increase the number of patients presenting with acute chest pain symptoms, including MI.

Current use of HER2 tests.

Reliable detection of HER2 overexpression is important for the success of trastuzumab (Herceptin) therapy. Several methods are available for measuring HER2 expression at the DNA, RNA or protein level. The method most frequently employed is immunohistochemical (IHC) detection of the HER2 receptor in paraffin sections. Advantages include the precise localization of the HER2 protein, the availability of paraffin material and the ease of the procedure. However, IHC can be influenced by the sensitivity/specificity of the antibody, tissue treatment and, in particular, subjective assessment. These disadvantages do not exist in the detection of gene amplification by fluorescence in situ hybridization (FISH) or polymerase chain reaction. However, FISH requires expensive equipment that is not widely available in pathology laboratories. Another approach quantitates shed HER2 antigen in the serum by an enzyme-linked immunosorbent assay. The key advantage of this method is the ease of sampling blood, however, serum HER2 concentrations do not accurately reflect the tumor status. Furthermore, this method does not register single-cell expression, which is important for therapeutic decision making. For routine diagnostics, the combination of IHC and FISH is useful. In addition to improving the accuracy and comparability of HER2 assays, these optimized protocols may further enhance the efficacy of trastuzumab therapy by selecting those patients most likely to respond.

Transient nerve damage following intubation for trans-sphenoidal hypophysectomy.

PURPOSE: To describe a case of transient lingual and hypoglossal nerve damage following intubation for a trans-sphenoidal hypophysectomy. CLINICAL FEATURES: A 56-yr-old acromegalic man was scheduled for trans-sphenoidal hypophysectomy. He had been treated with octreotide six months previously which had reduced the swelling of the tongue to an acceptable degree to the patient. During the anesthetic procedure there were no problems. The intubation was performed without any difficulty, no force had been used to place the endotracheal tube, a throat pack was inserted and, before extubation, an oro-gastric tube was inserted. Three days after surgery the patient complained of numbness and swelling of the left side of the tongue, he had difficulty in moving the tongue, speaking difficulties and problems in swallowing food were noted. Also taste was lost on this side of the tongue. Left lingual and hypoglossal nerve damage was diagnosed, which was confirmed by the neurologist. After four months of intensive physiotherapy and speech therapy, the symptoms disappeared. CONCLUSION: This is a report of a very rare complication of lingual and hypoglossal nerve damage in an acromegalic patient. This incident suggests forceful laryngoscopy, hyperextension of the head and the throat pack (tightly packed in the oropharynx) can result in injury of the lingual and the hypoglossal nerves.

When there is no benchmark: designing a primary care-based chronic pain management program from the scientific basis up.

Managed care has been accused of ignoring the patient with pain. The challenge for a health maintenance organization (HMO) was not just how to deliver state-of-the-art care, but how to deliver it to the 40,000 members who experience chronic pain at a reasonable cost and with enduring outcomes. This article describes how one managed care organization set about improving the care of patients with chronic pain. The article includes the design process, the model implemented, and some suggestions for transfer of this technology to others who might want to explore developing a similar model.

The identity of clones.

A common concern with respect to cloning is based on the belief that cloning produces identical individuals. This is a fundamental misunderstanding of what type of identity-relation cloning involves. The concept "identity" is ambiguous, and the statement that cloning produces "identical" individuals is not meaningful unless the notion of identity is clarified. This paper distinguishes between numerical and qualitative; relational and intrinsic: logical and empirical identity, and discusses the empirical individuation of clones in terms of genetics, physiology, perception, cognition and personality. I argue that the only relation of identity cloning involves is qualitative, intrinsic and empirical: genetic indiscernibility, unlikely to include identity under other aspects mentioned. A popular argument against cloning claims our "right" to a "unique identity". This objection either implies (absurdly) the right not to be an identical twin, or assumes (incorrectly) that cloning involves identity other than genetic. Either way, the argument is untenable.

Estimating the non-heart-beating donor potential at a trauma center.

The number of people awaiting a life-saving transplant far outweighs the number of organs available for transplantation. Our organ procurement organization sought to identify the non-heart-beating donor potential at a large urban level 1 trauma center. We modified the death-record reviews for a 2-year period and determined that a total of 23 patients who expired were suitable for non-heart-beating donation. Therefore, it can be hypothesized that if all large urban level 1 trauma centers participated in non-heart-beating donation, more organs would be available for transplantation.

Longitudinal changes in stages of change for condom use in women.

PURPOSE: This study identifies how women naturally progress through the Transtheoretical Model stages of condom use over a 1 year period, using the longitudinal dynamic methodology of latent transition analysis (LTA). DESIGN: As part of a larger study of human immunodeficiency virus risk in women, participants were assessed for their stage of condom use two times, 1 year apart. SUBJECTS: A total of 491 women who completed both assessments of the study were included in this analysis. MEASURES: Stage of condom use was assessed using two questions, which placed women into one of five stages of change for condom use (alpha = .90). RESULTS: Latent transition analysis identified the best-fitting model of naturalistic stage progression, which included both forward and backward movement. Precontemplation and maintenance were found to be the most stable stages (more than 50% of the participants remaining in that stage 1 year later), and the action stage was the least stable (15% remaining in this stage). Transition probabilities for all stages showed a high rate of relapse in the sample. CONCLUSIONS: A high proportion of women will remain within their stage of condom use over a 1-year period if no intervention is introduced. Interventions that are aimed at increasing condom use in women need to incorporate relapse prevention. In addition, the transition probabilities for the stages will help establish reasonable rates of change for intervention programs.

Patient attitude as a function of disease state in multiple sclerosis.

The present study investigated the attitude of 243 patients with Multiple Sclerosis (MS) as a function of their perceived disease state. Data was collected via a closed-format questionnaire developed through the Fishbein and Ajzen [1-3] Theory of Reasoned Action. Results indicated clearly that patients with MS are not an homogenous group and vary in characteristics across disease states and that disease state differentially affects the psycho-social attitudes of patients. Results also indicated that persons in remission were more positive in their attitude associated with their disease state than persons with a chronic progressive form of the disease.