How does it really feel to act together? : Shared emotions and the phenomenology of we-agency

Research on the phenomenology of agency for joint action has so far focused on the sense of agency and control in joint action, leaving aside questions on how it feels to act together. This paper tries to fill this gap in a way consistent with the existing theories of joint action and shared emotion. We first reconstruct Pacherie’s (Phenomenology and the Cognitive Sciences, 13, 25–46, 2014) account on the phenomenology of agency for joint action, pointing out its two problems, namely (1) the necessary trade-off between the sense of self- and we-agency; and (2) the lack of affective phenomenology of joint action in general. After elaborating on these criticisms based on our theory of shared emotion, we substantiate the second criticism by discussing different mechanisms of shared affect—feelings and emotions—that are present in typical joint actions. We show that our account improves on Pacherie’s, first by introducing our agentive model of we-agency to overcome her unnecessary dichotomy between a sense of self- and we-agency, and then by suggesting that the mechanisms of shared affect enhance not only the predictability of other agents’ actions as Pacherie highlights, but also an agentive sense of we-agency that emerges from shared emotions experienced in the course and consequence of joint action.Peer reviewe

Three-dimensional echocardiography: Historical development and current applications

Three-dimensional (3D) echocardiography facilitates spatial recognition of intracardiac structures, potentially enhancing diagnostic confidence of conventional echocardiography. The accuracy of 3D Images has been validated in vitro and in vivo. In vitro, a detail 1.0 mm in dimension and 2 details separated by 1.0 mm can be identified from a volume-rendered 3D image. In vitro SE volume measurements are underestimated by approximately 4.0 mL. In vivo? left ventricular volume measurements correlate highly with both cineventriculography (limits of agreement +/- 18 mL for end diastole and +/- 10 mL for end systole) and magnetic resonance imaging, including measurements for patients with functionally single ventricles. Studies on congenital heart lesions have shown good accuracy and good reproducibility of dynamic "surgical" reconstructions of septal defects, aortoseptal continuity, atrioventricular junction, and both left and right ventricular outflow tract morphology. Transthoratic 3D echocardiography was shown feasible in 81% to 96% of patients with congenital heart defects and provided additional information to that available from conventional echocardiography in 36% of patients, mainly in more detailed description of mitral valve morphology, aortoseptal continuity, and atrial septum. In patients with mitral valve insufficiency 3D echocardiography was shown to be accurate in the quantification of the dynamic mechanism of mitral regurgitation and in the assessment of mitral commissures in patients with mitral stenosis. This includes not only valve tissue reconstruction but also color flow intracardiac jets. Three-dimensional reconstructions of the aortic valve were achieved in 77% of patients, with an accuracy of 90%. In conclusion, the role of 3D echocardiography, which continues to evolve, shows promise in the assessment of congenital and acquired heart disease

Effect of catheter device closure of atrial septal defect on diastolic mitral annular motion

Atrial septal defect closure with the Amplatzer septal occluder has a negative effect on diastolic mitral annulus motion in terms of decreasing longitudinal septal annular motion and changing the relation between the annulus motion and mitral inflow

Personalizing health care: feasibility and future implications

Considerable variety in how patients respond to treatments, driven by differences in their geno- and/ or phenotypes, calls for a more tailored approach. This is already happening, and will accelerate with developments in personalized medicine. However, its promise has not always translated into improvements in patient care due to the complexities involved. There are also concerns that advice for tests has been reversed, current tests can be costly, there is fragmentation of funding of care, and companies may seek high prices for new targeted drugs. There is a need to integrate current knowledge from a payer’s perspective to provide future guidance. Multiple findings including general considerations; influence of pharmacogenomics on response and toxicity of drug therapies; value of biomarker tests; limitations and costs of tests; and potentially high acquisition costs of new targeted therapies help to give guidance on potential ways forward for all stakeholder groups. Overall, personalized medicine has the potential to revolutionize care. However, current challenges and concerns need to be addressed to enhance its uptake and funding to benefit patients