Volitional Activity Research Articles

Functional near-infrared spectroscopy: A novel tool for detecting consciousness after acute severe brain injury

Recent advancements in functional neuroimaging have demonstrated that some unresponsive patients in the intensive care unit retain a level of consciousness that is inconsistent with their behavioral diagnosis of awareness. Functional near-infrared spectroscopy (fNIRS) is a portable optical neuroimaging method that can be used to measure neural activity with good temporal and spatial resolution. However, the reliability of fNIRS for detecting the neural correlates of consciousness remains to be established. In a series of studies, we evaluated whether fNIRS can record sensory, perceptual, and command-driven neural processing in healthy participants and in behaviorally nonresponsive patients. At the individual healthy subject level, we demonstrate that fNIRS can detect commonly studied resting state networks, sensorimotor processing, speech-specific auditory processing, and volitional command-driven brain activity to a motor imagery task. We then tested fNIRS with three acutely brain injured patients and found that one could willfully modulate their brain activity when instructed to imagine playing a game of tennis-providing evidence of preserved consciousness despite no observable behavioral signs of awareness. The successful application of fNIRS for detecting preserved awareness among behaviorally nonresponsive patients highlights its potential as a valuable tool for uncovering hidden cognitive states in critical care settings.

TALABALARDA CHET TILLARNI O‘RGANISH JARAYONIDA IRODA KUCHINING NAMOYON BO‘LISHI VA PSIXOLOGIK XUSUSIYATLARI

This article is about the lack of willpower of students, the fact that a person faces internal and external obstacles in the process of voluntary action, and that internal obstacles are characteristic of the person himself and his internal inclinations. The ability of a person to overcome his inner inclinations, control himself and rule over himself is called inner will. External obstacles are found in the surrounding reality. A person’s ability to overcome such external obstacles is called external will. Overcoming external obstacles (external will) and overcoming internal obstacles (internal will) are considered in volitional activity.

Passive exercise provides a simultaneous and postexercise executive function benefit

IntroductionPassive exercise involves limb movement via an external force and is an intervention providing an immediate postexercise executive function (EF) benefit. It is, however, unknown whether EF is improved simultaneous with passive exercise—a salient question given the advent of passive (and active) exercise workstations designed to enhance productivity and wellbeing for individuals engaged in sedentary occupations.MethodsHere, participants (N = 23) completed separate 20-min conditions involving active (i.e., via volitional muscle activation) and passive (i.e., via mechanically driven cycle ergometer) cycle ergometry and a non-exercise control condition. EF was assessed prior to (i.e., preintervention), simultaneous with, and immediately after (post-intervention) each condition via the antipointing task. Antipointing involves a goal-directed limb movement mirror-symmetrical to a target and is an ideal tool for the current investigation given that the task is mediated via EF inhibitory control networks that show response-dependent changes following a single bout of exercise.Results and discussionResults showed that passive exercise produced a simultaneous and post-intervention reduction in antipointing reaction time (RT), whereas active exercise selectively produced a post-intervention—but not simultaneous—RT reduction. Thus, passive and active exercise elicited a postexercise EF benefit; however, only passive exercise produced a simultaneous benefit. That passive—but not active—exercise produced a simultaneous benefit may reflect that the intervention provides the necessary physiological or psychological changes to elicit improved EF efficiency without the associated dual-task cost(s) of volitional muscle activity.

Passive activity enhances residual control ability in patients with complete spinal cord injury.

JOURNAL/nrgr/04.03/01300535-202508000-00024/figure1/v/2024-09-30T120553Z/r/image-tiff Patients with complete spinal cord injury retain the potential for volitional muscle activity in muscles located below the spinal injury level. However, because of prolonged inactivity, initial attempts to activate these muscles may not effectively engage any of the remaining neurons in the descending pathway. A previous study unexpectedly found that a brief clinical round of passive activity significantly increased volitional muscle activation, as measured by surface electromyography. In this study, we further explored the effect of passive activity on surface electromyographic signals during volitional control tasks among individuals with complete spinal cord injury. Eleven patients with chronic complete thoracic spinal cord injury were recruited. Surface electromyography data from eight major leg muscles were acquired and compared before and after the passive activity protocol. The results indicated that the passive activity led to an increased number of activated volitional muscles and an increased frequency of activation. Although the cumulative root mean square of surface electromyography amplitude for volitional control of movement showed a slight increase after passive activity, the difference was not statistically significant. These findings suggest that brief passive activity may enhance the ability to initiate volitional muscle activity during surface electromyography tasks and underscore the potential of passive activity for improving residual motor control among patients with motor complete spinal cord injury.

Reversal of Soleus Muscle Atrophy in Older Adults: A Non-Volitional Exercise Intervention for a Changing Climate.

The World Health Organization recommends that older adults undertake at least 150 minutes of moderate intensity physical activity over the course of each week in order to maintain physical, mental, and social health. This goal turns out to be very difficult for most community dwelling older adults to achieve, due to both actual and perceived barriers. These barriers include personal health limitations, confinement issues, and self-imposed restrictions such as fear of injury. Climate change exacerbates the confinement issues and injury fears among the elderly. To assist older adults in obtaining the benefits of increased physical activity under increasingly challenging climate conditions, we propose a targeted non-volitional intervention which could serve as a complement to volitional physical activity. Exogenous neuro-muscular stimulation of the soleus muscles is a non-invasive intervention capable of significantly increasing cardiac output in sedentary individuals. Long-term daily use has been shown to improve sleep, reduce bone loss, and reverse age-related cognitive decline, all of which are significant health concerns for older adults. These outcomes support the potential benefit of exogenous neuro-muscular stimulation as a complementary form of physical activity which older adults may find convenient to incorporate into their daily life when traditional forms of exercise are difficult to achieve due to barriers to completing traditional physical activities as a result of in-home or in-bed confinement, perceptual risks, or real environmental risks such as those arising from climate change.

ПРАВОВІ ЗАСАДИ ОРГАНІЗАЦІЇ ПРАЦІ ОСІБ, ЯКІ УТРИМУЮТЬСЯ В УСТАНОВАХ ВИКОНАННЯ ПОКАРАНЬ

Ukraine as a democratic, legal social state on the path to European integration, needs to reform all sectors of society. Particular attention in the transformation process is paid to the penitentiary system. The rights of persons who have committed a criminal offense and are held in penitentiary institutions (hereinafter – PIs), along with the rights of other citizens, are protected by the Constitution of Ukraine and international human rights law. Among the fundamental human rights is the right to work. In its turn, the work that convicted persons are involved in is a necessary component of achieving the goal of serving a sentence – the correction of a person and his or her resocialization. Labor is a significant factor in human life. It is a volitional activity aimed at creating material values. Labor as a means of correction and resocialization of a convicted person is defined by the provisions of Article 6 of the Criminal and Executive Code of Ukraine (hereinafter – the CEC). The conscientious performance of their labor duties is taken into account when applying for conditional early release of a convicted person. Therefore, socially useful labor, which convicted persons are involved in, helps to reduce crime. Given the reforms that the penitentiary system in Ukraine has undergone, legal regulation of the organization of work of persons held in PIs is an actual issue of the day. The article highlights the legal basis for organizing labor of persons held in penitentiary institutions. The essence of the constitutional right of a convicted person to work is considered. Labor is defined as a means of correction and resocialization of a convict. The legal basis of socially useful work of convicts is analyzed. The functions of socially useful activities of convicted persons are defined. The principles of involving convicts in socially useful work are defined. The author establishes the working conditions for those convicted to restraint of liberty. The author analyzes the current legislation of Ukraine in terms of the obligation to involve convicted persons in labor; the list of jobs and positions in which it is prohibited to use convicts; requirements for remuneration, working week, and salary; involvement in labor on a free basis; and pension provision for convicted persons. The author draws conclusions about the need for further reform of the penitentiary system in terms of ensuring that convicts have the right to engage in labor activity in accordance with their abilities, desire and fair remuneration. Key words: labor, work of convicts, labor activity, labor contract, penitentiary institution, socially useful work, labor functions, working conditions, involvement in work, remuneration, penitentiary system in Ukraine, European integration.

Vocal fold electromyography in patients with endoscopic features of unilateral laryngeal paralysis.

<b><br>Introduction:</b> Electromyography (EMG) of the larynx provides information on the electrophysiological condition of laryngeal muscles and innervation. Integration of information obtained from the EMG exams with the clinical parameters as obtained by other methods for laryngeal assessment (endoscopy, perceptual and acoustic analysis, voice self-assessment) provides a multidimensional picture of dysphonia, which is of particular importance in patients with vocal fold (VF) mobility disorders accompanied by glottic insufficiency.</br> <b><br>Aim:</b> The aim of this study was to evaluate laryngeal EMG records acquired in subjects with unilateral vocal fold immobilization with signs of atrophy and glottic insufficiency.</br> <b><br>Material and methods:</b> From the available material of 74 EMG records of patients referred for the exam due to unilateral laryngeal paralysis, records of 17 patients with endoscopic features suggestive of complete laryngeal muscle denervation were selected. The EMG study of thyroarytenoid muscles of mobile and immobile VFs was evaluated qualitatively and quantitatively at rest and during volitional activity involving free phonation of vowel /e/ [ε].</br> <b><br>Results:</b> In all patients, the EMG records from mobile VFs were significantly different from those from immobile VFs. Despite endoscopic features of paralysis, no VF activity whatsoever was observed in as few as 2 patients so as to meet the neurophysiological definition of paralysis. In 88% of cases, electromyographic activity of the thyroarytenoid muscle was observed despite immobilization and atrophy of the vocal fold. In these patients, neurogenic type of record was observed with numerous high- -amplitude mobility units. On the basis of the results, quantitative features of EMG records indicative of paralysis and residual activity of the thyroarytenoid muscle were determined.</br> <b><br>Conclusions:</b> Qualitative and quantitative analysis of laryngeal EMG records provides detailed information on the condition of vocal fold muscles and innervation. EMG records of mobile vs immobile VFs differ significantly from each other. Endoscopic evaluation does not provide sufficient basis for the diagnosis of complete laryngeal muscle denervation.</br&gt.

The relationship and relevant factors between sleep disturbance and depressive symptoms in adolescents

Depression and sleep difficulties have a strong association. Depression may coexist with long-term sleep difficulties in some people, and vice versa for those who already have depression, they are more likely to develop sleep disturbance. In other words, the development of one symptom can trigger the development of another. Patients must therefore pay close attention to their sleep difficulties. Numerous psychiatric illnesses that are related to sleep difficulties might worsen a patient's overall condition. If the issue of sleep difficulties is not resolved in a timely manner, it may eventually lead to the appearance of other connected psychiatric illnesses, which may make the patient's condition worse overall. Depression is a prevalent mental illness. Clinical symptoms of depression commonly include tiredness, delayed thinking, and diminished volitional activity. Sleep disturbances can arise for a variety of reasons, including physical illnesses and psychological issues. This review can provide some suggestions for the development of prevention and intervention programs for individuals with depression and sleep disturbance.

Endurance exercise preserves physical function in adult and older male C57BL/6 mice: high intensity interval training (HIIT) versus voluntary wheel running (VWR).

Exercise has been shown to improve physical function, mitigate aspects of chronic disease and to potentially alter the trajectory of age-related onset of frailty and sarcopenia. Reliable and valid preclinical models are necessary to elucidate the underlying mechanisms at the intersection of age, exercise, and functional decline. The purpose of this study was to compare, head to head, the effects of two common pre-clinical models of endurance exercise: high intensity interval training (HIIT) and voluntary wheel running (VWR). The hypothesis was that a prescribed and regimented exercise program, HIIT, would prove to be a superior training method to unregulated voluntary exercise, VWR. To investigate this hypothesis, we evaluated adult (n = 24, designated 10m, aged 6 months at the beginning of the study, 10 months at its completion) and older adult (n = 18, designated 26m, aging from 22 months to 26 months over the course of the study) C57BL/6 male mice. These mice were randomly assigned (with selection criteria) to a 13-week program of voluntary wheel running (VWR), high intensity interval training (HIIT), or sedentary control (SED). The functional aptitude of each mouse was determined pre- and post-training using our composite CFAB (comprehensive functional assessment battery) scoring system consisting of voluntary wheel running (volitional exercise and activity rate), treadmill (endurance), rotarod (overall motor function), grip meter (forelimb strength), and inverted cling (whole body strength/endurance). To measure sarcopenia, we tracked body mass, body composition (with EchoMRI), plantar flexor torque (in 10m), and measured muscle wet mass post-training. Overall, adult CFAB scores decreased while body mass and percent body fat increased as they matured; however, exercise significantly mitigated the changes (p < 0.05) compared to SED. Older adults demonstrated preservation of function (CFAB) and reduced body fat (p < 0.05) compared to SED. To conclude, both types of exercise maintained physical function equally in older mice.

Survival and swimming performance in small-sized South European Cypriniformes tagged with passive integrated transponders

A fundamental assumption in animal telemetry is that the behavior and performance of tagged animals do not substantially deviate from that of untagged animals. For fish, swimming behavior is fundamental for every part of a fish post-hatch life, influencing predator-prey interactions, movement ecology, and habitat choice. Here, we study the effects of PIT-tagging on survival and a range of swimming behaviors for South European nase (Protochondrostoma genei) and brook barbel (Barbus caninus), two small-sized, stream-dwelling cypriniforms native to the Italian peninsula. Effects on volitional swimming activity (sustained swimming) and maximum swimming speed (escape response; burst swimming) were tested in arena trials. Tagging effects on the prolonged swimming performance were tested in South European nase in an increasing velocity time-to-fatigue test, while a barrier passage test was designed to further investigate tagging effects in brook barbel. Both species displayed very high survival (95–100%), with no difference between tagged and control fish. No fish lost a tag during the 64 days of the study, and no tagging effect on swimming activity, prolonged swimming performance, barrier passage rate, or escape response was detected. Our results indicate that PIT-telemetry is a suitable tool to study the tested fish species.

Machine-learning-based coordination of powered ankle-foot orthosis and functional electrical stimulation for gait control.

This study proposes a novel gait rehabilitation method that uses a hybrid system comprising a powered ankle-foot orthosis (PAFO) and FES, and presents its coordination control. The developed system provides assistance to the ankle joint in accordance with the degree of volitional participation of patients with post-stroke hemiplegia. The PAFO adopts the desired joint angle and impedance profile obtained from biomechanical simulation. The FES patterns of the tibialis anterior and soleus muscles are derived from predetermined electromyogram patterns of healthy individuals during gait and personalized stimulation parameters. The CNN-based estimation model predicts the volitional joint torque from the electromyogram of the patient, which is used to coordinate the contributions of the PAFO and FES. The effectiveness of the developed hybrid system was tested on healthy individuals during treadmill walking with and without considering the volitional muscle activity of the individual. The results showed that consideration of the volitional muscle activity significantly lowers the energy consumption by the PAFO and FES while providing adaptively assisted ankle motion depending on the volitional muscle activities of the individual. The proposed system has potential use as an assist-as-needed rehabilitation system, where it can improve the outcome of gait rehabilitation by inducing active patient participation depending on the stage of rehabilitation.

Obesity worsens mitochondrial quality control and does not protect against skeletal muscle wasting in murine cancer cachexia.

More than 650 million people are obese (BMI>30) worldwide, which increases their risk for several metabolic diseases and cancer. While cachexia and obesity are at opposite ends of the weight spectrum, leading many to suggest a protective effect of obesity against cachexia, mechanistic support for obesity's benefit is lacking. Given that obesity and cachexia are both accompanied by metabolic dysregulation, we sought to investigate the impact of obesity on skeletal muscle mass loss and mitochondrial dysfunction in murine cancer cachexia. Male C57BL/6 mice were given a purified high fat or standard diet for 16weeks before being implanted with 106 Lewis lung carcinoma (LLC) cells. Mice were monitored for 25days, and hindlimb muscles were collected for cachexia indices and mitochondrial assessment via western blotting, high-resolution respirometry and transmission electron microscopy (TEM). Obese LLC mice experienced significant tumour-free body weight loss similar to lean (-12.8% vs. -11.8%, P=0.0001) but had reduced survival (33.3% vs. 6.67%, χ2 =10.04, P=0.0182). Obese LLC mice had reduced muscle weights (-24%, P<0.0354) and mCSA (-16%, P=0.0004) with similar activation of muscle p65 (P=0.0337), and p38 (P=0.0008). ADP-dependent coupled respiration was reduced in both Obese and Obese LLC muscle (-30%, P=0.0072) consistent with reductions in volitional cage activity (-39%, P<0.0001) and grip strength (-41%, P<0.0001). TEM revealed stepwise reductions in intermyofibrillar and subsarcolemmal mitochondrial size with Obese (IMF: -37%, P=0.0009; SS: -21%, P=0.0101) and LLC (IMF: -40%, P=0.0019; SS: -27%, P=0.0383) mice. Obese LLC mice had increased pAMPK (T172; P=0.0103) and reduced FIS1 (P=0.0029) and DRP1 (P<0.0001) mitochondrial fission proteins, which were each unchanged in Lean LLC. Further, mitochondrial TEM analysis revealed that Obese LLC mice had an accumulation of damaged and dysfunctional mitochondria (IMF: 357%, P=0.0395; SS: 138%, P=0.0174) in concert with an accumulation of p62 (P=0.0328) suggesting impaired autophagy and clearance of damaged mitochondria. Moreover, we observed increases in electron lucent vacuoles only in Obese LLC muscle (IMF: 421%, P=0.0260; SS: 392%, P=0.0192), further supporting an accumulation of damaged materials that cannot be properly cleared in the obese cachectic muscle. Taken together, these results demonstrate that obesity is not protective against cachexia and suggest exacerbated impairments to mitochondrial function and quality control with a particular disruption in the removal of damaged mitochondria. Our findings highlight the need for consideration of the severity of obesity and pre-existing metabolic conditions when determining the impact of weight status on cancer-induced cachexia and functional mitochondrial deficits.

Comparison of filtering methods for real-time extraction of the volitional EMG component in electrically stimulated muscles

ObjectiveRecorded electromyograms (EMG) of electrically stimulated muscles can contain both an exogenous-evoked potential (M-wave) and an endogenous, or volitional, component. This study evaluated the effectiveness of three filtering methods (i.e., high-pass, adaptive, and comb), commonly used in neurorehabilitation, in extracting the volitional component of simulated and experimental EMG during upper-limb tasks. MethodsVolitional EMG and M-wave were simulated through a physiological model of muscle recruitment, comprising of a motor neuron pool and associated muscle fibres, superimposed to a stimulation artefact. Experimental EMG data during different levels of volitional muscle contraction in isometric and dynamic tasks were recorded from five unimpaired individuals. Electrical stimulation artefact was removed with different techniques (i.e., none, removing samples, blanking, and interpolation) to assess filter performance across time and frequency domains, and information content (i.e., Kolmogorov-Smirnov D-value). ResultsThe experimental results agreed with the simulations, wherein the adaptive filter outperformed the other filters when using no artefact removal or removing artefact samples from the signal, while for the blanking and interpolation artefact removal methods, the adaptive and comb filters outperformed the high-pass filter. ConclusionThe adaptive and comb filters best estimated volitional muscle activity in electrically stimulated muscles. SignificanceResults from this study will enable the enhanced design of real-time neuroprosthesis control.

Rules of the organization of effective justice (guidelines) a tool for the application of judicial discretion and the exercise of discretionary powers of the court

The article analyzes the essence of the concepts of «discretionary powers» and «judicial discretion», their correlation; the essence of the concept of «guidelines», their legal nature and role as a tool for the application of judicial discretion in exercising discretionary powers by the court are defined. On the basis of a comparative analysis of the legal norms of civil and criminal procedural laws, the limits of the court's discretion, limits and direction of the judge's discretion are determined. It has been established that none of judicial proceeding can do without discretionary norms, and therefore without judicial discretion, however, the limits of discretion vary depending on the type of judicial proceeding and the stage of consideration of the case. This conclusion was made on the basis of a comparative analysis of the norms of civil and criminal procedural laws in terms of court evaluation of evidence. Thus, the difference in the discretionary powers of the court is due to the higher standard of proof in criminal proceedings, compared with civil ones. On the basis of the analysis of the functions of punishment and the principle of its individualization, a conclusion was made about the direction of judicial discretion in the exercise of discretionary powers during the imposition of punishment and, thus, it was demonstrated that discretionary powers are a specific means of legal protection. Discretionary powers and judicial discretion are independent concepts. In procedural codes, discretion begins with issues of recusals/self-recusals and ends with the imposition of punishment (in criminal proseedings). On the basis of the analysis of the provisions of procedural norms (civil and criminal), which determine the grounds for the removal of a judge, in particular, «the presence of other circumstances that raise doubts about the judge's impartiality», a conclusion was made about the possibility of such an interpretation that would allow arbitrariness, abuse and even corruption risks. The unpredictability and lack of understanding of the grounds for recusal in the absence of unanimous practice of national courts may call into question the guarantees provided for in Article 6 of the European Convention on Human Rights, namely the right to a fair trial. The essence of the guidelines comes down to the fact that judges, having determined the range of issues that cause the most controversy and in respect of which the legislation allows wide discretion, formulate a certain set of rules, how they generally interpret the corresponding «discretionary norms». The range of issues, the solution of which can be unified by including them in guidelines, can be as follows: valid reasons for postponing the trial; establishment of regulations for the speeches of the participants; order of calls and notifications of the parties; the procedure for agreeing the dates of court sessions, etc. The advantages of guidelines are named. Thus, discretionary powers are defined as the legislative basis for the application of judicial discretion – the intellectual and volitional activity of a judge, the direction of which is determined by the observance of the rule of law. Guidelines are rules of soft law that determine how judges apply judicial discretion to the discretionary powers granted to them. Key words: rules of the organization of effective justice, guidelines, judicial discretion, discretionary powers, standart of proof, rule of law

Conserved multi-tissue transcriptomic adaptations to exercise training in humans and mice

Physical activity is associated with beneficial adaptations in human and rodent metabolism. We studied over 50 complex traits before and after exercise intervention in middle-aged men and a panel of 100 diverse strains of female mice. Candidate gene analyses in three brain regions, muscle, liver, heart, and adipose tissue of mice indicate genetic drivers of clinically relevant traits, including volitional exercise volume, muscle metabolism, adiposity, and hepatic lipids. Although ∼33% of genes differentially expressed in skeletal muscle following the exercise intervention are similar in mice and humans independent of BMI, responsiveness of adipose tissue to exercise-stimulated weight loss appears controlled by species and underlying genotype. We leveraged genetic diversity to generate prediction models of metabolic trait responsiveness to volitional activity offering a framework for advancing personalized exercise prescription. The human and mouse data are publicly available via a user-friendly Web-based application to enhance data mining and hypothesis development.

Research progress in the brain area responsible for depression

Depression is one of the main types of affective disorders, which is extremely harmful to the physical and mental health of patients. The typical clinical symptoms of depression include decreased volitional activity, retardation of thinking, low spirits, and cognitive impairment. The pathogenesis of depression is very complex, including multiple factors such as biological, psychological and environmental factors. Researchers at home and abroad have carried out research on depression in many fields. In neuroscience, it has been concluded that the dysfunction of the frontal lobe, hippocampus, temporal lobe, striatum, amygdala and other brain of patients with depression can contribute to depression. Besides, the abnormal connections between these brain regions may also result in depression. Herein, we mainly introduced the current research of the above-mentioned responsible brain regions and related neural circuits for depression, and further summarized the current knowledge about the diagnosis and treatment of depression. Finally, we briefly discussed the feasibility of using rodents as animal models to explore depression.

Нарушения саморегуляции у молодых людей с аффективными расстройствами в условиях пандемии COVID-19

The purpose of the empirical study is assessment or the correlation among disorders of operational level of self-regulation with psychological security parameters, psychological defense mechanisms, and personality traits of young people with affective disorders during the COVID-19 pandemic. The study involved 60 people aged 20-25, 30 of which had affective disorders. In the test group regulative dysfunctions of processes of modelling, programming, results and independence evaluation are due to non-adaptive defense mechanisms of projection, regression, and substitution, security basis views bias as well as self-criticism. People with affective disorders satisfy their security need looking for supportive external environment rather than their intellectual and volitional activity.

Hybrid robotic and electrical stimulation assistance can enhance performance and reduce mental demand.

Combining functional electrical stimulation (FES) and robotics may enhance recovery after stroke, by providing neural feedback with the former while improving quality of motion and minimizing muscular fatigue with the latter. Here, we explored whether and how FES, robot assistance and their combination, affect users' performance, effort, fatigue and user experience. 15 healthy participants performed a wrist flexion/extension tracking task with FES and/or robotic assistance. Tracking performance improved during the hybrid FES-robot and the robot-only assistance conditions in comparison to no assistance, but no improvement is observed when only FES is used. Fatigue, muscular and voluntary effort are estimated from electromyographic recording. Total muscle contraction and volitional activity are lowest with robotic assistance, whereas fatigue level do not change between the conditions. The NASA-Task Load Index answers indicate that participants found the task less mentally demanding during the hybrid and robot conditions than the FES condition. The addition of robotic assistance to FES training might thus facilitate an increased user engagement compared to robot training and allow longer motor training session than with FES assistance.

Human Nature as a Source of Moral Normativity: Reflections on the Naturalist Approach in P. Foot’s Work Natural Goodness

This article considers aspects of Philippa Foot’s theory of naturalist realist metaethics. It addresses the question of whether human nature can function as a direct source of normativity or whether it is more of a metanormative framework that is open to norm-creation based on the agent’s rational volitional activity. This gives rise to the question of whether the source of moral normativity is not in fact the agent’s practical rationality since natural facts may conflict and therefore cannot constitute a direct guide for the articulation of moral norms. Our interpretation is based primarily on Foot’s Natural Goodness, and identifies the tensions between the broader and narrower meanings of the conception of human nature. In the first step we discuss the broader meaning of human nature. In the second we consider the narrower meaning of human nature, practical rationality. In conclusion we show that in its broader sense human nature cannot function as a proper source of moral normativity; rather, it is a metanormative framework for making moral judgements. Within this framework practical rationality operates as human nature in the narrower sense and only it can be considered the source of moral normativity.

Physical activity and relationship to physical function, quality of life, and cognitive function in older patients with acute decompensated heart failure

Volitional physical activity level is predictive of a variety of health outcomes, but has not been examined in patients recently hospitalized for acute decompensated HF (ADHF). Ten to 14 days after index hospitalization for ADHF, 93 participants wore a wrist-mounted triaxial accelerometer (ActiGraph GT3X+) to objectively quantify sedentary behavior, light physical activity, and moderate-to-vigorous physical activity. Levels were compared to 2 groups of age-matched NHANES participants: healthy and chronic, stable HF. The relationship between physical activity levels and physical function [Short Physical Performance Battery (SPPB)], HF-specific quality-of-life (QOL) [Kansas City Cardiomyopathy Questionnaire (KCCQ)], and cognition [Montreal Cognitive Assessment (MOCA)] were examined. ADHF participants accumulated a median 1,008 (IQR 896, 1,109) minutes of sedentary time, 88 (57, 139) minutes of light physical activity, and 10 (6, 25) minutes of moderate-to-vigorous physical activity per day. Sedentary time, light physical activity, or moderate-to-vigorous activity did not differ by sex or EF subtype. ADHF participants spent only 9% of awake time nonsedentary, compared to 34% and 27% for healthy adults and adults with chronic, stable HF, respectively. Among ADHF participants, SPPB, KCCQ, and MOCA scores did not differ among quartiles of total physical activity. Older patients recently hospitalized for ADHF have very low levels of physical activity and high levels of sedentary time, both of which may be potential targets for interventions in this high-risk population. Physical activity level was not significantly associated with objectively measured physical function, QOL, or cognition, suggesting that this measure provides independent information regarding the patient experience of living with HF. NCT02196038, https://clinicaltrials.gov/ct2/show/NCT02196038.