Difficult moral questions: may a husband end all care of his permanently unconscious wife?
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This essay describes the effects of Zionist ideology on research into human population genetics carried out in Israel during the 1950s and early 1960s. I argue that the internalization of the dominant Zionist narrative is reflected in the articles that were written by Israeli geneticists and physicians during these years. My claim is based on a comparison of articles about human population genetics written and published by Israeli scientists between 1951 and 1963 with similar articles written by non-Israelis. The comparison reveals that during this period the Israeli human geneticists and physicians emphasized the sociological and historical aspects of their research and used their work, among other things, as a vehicle for establishing a national identity and confirming the Zionist narrative.
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BACKGROUND: Learning during anaesthesia has been demonstrated, but little is known about the circumstances under which it may occur. This study investigated the hypothesis that learning during anaesthesia occurs during, but not before, surgical stimulation. METHODS: Words were played through headphones to 64 day-surgery patients during propofol anaesthesia. Fourteen words were played repeatedly (15 times) for 1 min each either before (n=32) or during (n=32) surgical stimulation. The depth of anaesthesia was estimated using the bispectral index (BIS). Heart rate, ventilatory frequency, mean arterial pressure, end-tidal carbon dioxide concentration, and infusion rate of propofol were recorded at 1 min intervals during word presentation. On recovery, memory was assessed using an auditory word stem completion test and word recognition test. RESULTS: The mean BIS, arterial pressure, end-tidal carbon dioxide and heart rate during word presentation did not differ between the groups. The infusion rate of propofol and the ventilatory frequency were significantly greater in the during-surgical stimulation group. There was no evidence for explicit recall or recognition, nor of awareness during anaesthesia (median mean-BIS=38 in the before-surgical stimulation group and 42 in the during-surgical stimulation group). Only patients who were played words during surgical stimulation showed significant implicit memory on recovery (mean score=0.08, P<0.02) However, their scores were not significantly higher than those of the before-surgical stimulation group (mean score=0.01). CONCLUSIONS: Learning during anaesthesia seems more likely to occur during rather than before surgical stimulation at comparable anaesthetic depth. We hypothesize that surgical stimulation facilitates learning during anaesthesia, independently of its effects on anaesthetic depth.
Visual extinction is a sign classically associated with right parietal damage. The patient can see a single stimulus presented in the ipsilesional or contralesional visual field, but is characteristically unaware of the same contralesional stimulus during simultaneous stimulation of both fields. The ipsilesional stimulus is said to 'extinguish' the contralesional stimulus from awareness during bilateral stimulation, perhaps due to a pathological bias in attention towards the ipsilesional side. Recent psychophysical evidence suggests that, although extinguished stimuli are not consciously seen, they may undergo residual processing and exert implicit effects on performance. However, the neural structures mediating such residual processing for extinguished stimuli remain unknown. Here we studied the neural activity evoked by an extinguished visual stimulus, using event-related functional MRI (fMRI), in a patient with circumscribed right inferior parietal damage and profound left-sided extinction. Monochrome objects (faces or houses) were presented in the left or right field, either unilaterally or bilaterally on each trial, with the patient indicating by button press whether he saw an object on the left, the right or on both sides. He usually saw only the right object on bilateral trials, yet the fMRI data showed activation of visual cortex contralateral to the extinguished left stimulus on these trials (compared with right-only stimulation), in both striate and early extrastriate areas of the right hemisphere. This activity had a similar location and time-course to that resulting from a single stimulus in the left versus right visual field. Cortical pathways involved in the normal processing of a single seen stimulus can thus still be activated by an unseen, extinguished stimulus after right parietal damage. Comparison of fMRI responses for faces versus houses revealed some category-specific activation for extinguished stimuli in right fusiform regions, but only at low statistical threshold. These results are discussed in terms of theoretical accounts for parietal extinction and, more generally, for the neural substrates of visual awareness.
A systematic approach in the differential diagnosis of the comatose patient, based on the pathophysiological classification of the various disorders causing coma and the clinical neurological examination, is outlined. This approach appears useful in that in most instances a clinical diagnosis suggesting the pathophysiological abnormality producing coma can be made. Appropriate laboratory tests can then be selected to establish a definitive etiological diagnosis. Such a systematic approach to the evaluation of the comatose patient hastens definitive therapy in a disorder where time in which to institute therapy is often short.
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The human chemosignal, Delta 4,16-androstadien-3-one modulates psychological state without being consciously discernible as an odor. This study demonstrates that Delta 4,16-androstadien-3-one (androstadienone) alters cerebral glucose utilization both in subcortical regions and in areas of the neocortex not exclusively associated with olfaction. These widely distributed changes are consistent with modulation of an integrated neural network for regulation of emotional and attentional states. This is the first study to demonstrate the effects of a sustained chemosignal on brain metabolism and to show that they are similar to those of long acting chemical substances that affect psychological states. Moreover, this provides the first evidence that a human chemosignal has distributed effects on cortical processes and brain metabolism even when it is not detected consciously.
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