Explores the benefits and negative aspects of using and communicating with social network services.

This paper is divided into two parts. Part I focuses on the manner in which the components of the face recognition system work together so that a perceiver, within several hundred milliseconds after seeing a familiar face, is able to both identify the face of the perceived and recall elements of the history of past encounters with the perceived. Face recognition plays a crucial role in enabling both human and nonhuman primates to interact in collaborative social groups. This critical function is accomplished through the unidirectional coded transfer of informational elements from one component to another. Although these informational elements themselves are not meaningful to the perceiving agent, they do nevertheless contain essential bits of information that are necessary for the final formation of the meaningful message. The structural components of the system are identified and the manner in which informational elements are coded and transferred sequentially from component to component in the brain of the perceiver is described. The independent, physically separated components in the face recognition system are bridged by an additional component, an “adaptor”, that mediates the transfer of informational elements from one component to another. The nature of the independent systems, and the manner by which the bridging or adaptor apparatus enables coded information transfer from one system to another is discussed. Part II focuses on the analysis of recognition in human-designed sign systems such as Braille and Morse code. Recognition in human-designed sign systems is notable for the stability of the link between sign and meaning. Face recognition is characterized as being subjective , indicating that the meaning of a sign (face) to a perceiver is variable and dependent on context , whereas human-devised sign recognition is characterized as being objective , indicating that the meaning of a sign is context independent and invariant. Human-designed sign systems require the presence in brain of a referent world. An example of a referent world is the set of letters of the alphabet. Representations of this set are installed in the brain through social mediated learning. Human-designed sets of signs (e.g., Braille, and written text) are created to correspond, via a code enabling adaptor structure, to referent worlds in the brain. Human-designed sign systems are the foundations for literacy, a capability only found in humans.

Aims: The original Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis I diagnostic algorithms have been demonstrated to be reliable. However, the Validation Project determined that the RDC/TMD Axis I validity was below the target sensitivity of ≥ 0.70 and specificity of ≥ 0.95. Consequently, these empirical results supported the development of revised RDC/TMD Axis I diagnostic algorithms that were subsequently demonstrated to be valid for the most common pain-related TMD and for one temporomandibular joint (TMJ) intra-articular disorder. The original RDC/TMD Axis II instruments were shown to be both reliable and valid. Working from these findings and revisions, two international consensus workshops were convened, from which recommendations were obtained for the finalization of new Axis I diagnostic algorithms and new Axis II instruments. Methods: Through a series of workshops and symposia, a panel of clinical and basic science pain experts modified the revised RDC/TMD Axis I algorithms by using comprehensive searches of published TMD diagnostic literature followed by review and consensus via a formal structured process. The panel’s recommendations for further revision of the Axis I diagnostic algorithms were assessed for validity by using the Validation Project’s data set, and for reliability by using newly collected data from the ongoing TMJ Impact Project—the follow-up study to the Validation Project. New Axis II instruments were identified through a comprehensive search of the literature providing valid instruments that, relative to the RDC/TMD, are shorter in length, are available in the public domain, and currently are being used in medical settings. Results: The newly recommended Diagnostic Criteria for TMD (DC/TMD) Axis I protocol includes both a valid screener for detecting any pain-related TMD as well as valid diagnostic criteria for differentiating the most common pain-related TMD (sensitivity ≥ 0.86, specificity ≥ 0.98) and for one intra-articular disorder (sensitivity of 0.80 and specificity of 0.97). Diagnostic criteria for other common intra-articular disorders lack adequate validity for clinical diagnoses but can be used for screening purposes. Inter-examiner reliability for the clinical assessment associated with the validated DC/TMD criteria for pain-related TMD is excellent (kappa ≥ 0.85). Finally, a comprehensive classification system that includes both the common and less common TMD is also presented. The Axis II protocol retains selected original RDC/TMD screening instruments augmented with new instruments to assess jaw function as well as behavioral and additional psychosocial factors. The Axis II protocol is divided into screening and comprehensive selfreport instrument sets. The screening instruments' 41 questions assess pain intensity, pain-related disability, psychological distress, jaw functional limitations, and parafunctional behaviors, and a pain drawing is used to assess locations of pain. The comprehensive instruments, composed of 81 questions, assess in further detail jaw functional limitations and psychological distress as well as additional constructs of anxiety and presence of comorbid pain conditions. Conclusion: The recommended evidence-based new DC/TMD protocol is appropriate for use in both clinical and research settings. More comprehensive instruments augment short and simple screening instruments for Axis I and Axis II. These validated instruments allow for identification of patients with a range of simple to complex TMD presentations. J Oral Facial Pain Headache 2014;28:6–27. doi: 10.11607/jop.1151

The development of empathy and positive attitudes are essential elements of professional education. This study explored the nature of empathy and its association with attitudes about, and exposure to older patients in a sample of dental students. Students completed an adapted version of the Jefferson Scale of Physician Empathy (JSPE), the Aging Semantic Differential (ASD) and answered questions about their exposure to older people. Factor analysis was used to identify four factors: (1) Empathy is Valuable, (2) Empathy is Demonstrated, (3) Empathy is not Influential, and (4) Empathy is Difficult to Accomplish. Higher empathy scores were related to the ASD subscale attitude of acceptability of aging and to greater exposure to older adults outside of clinical practice. There were no demographic predictors of higher empathy scores.

Part 1IntroductionThis special issue is an extension of a project begun in 2010 when I sent out a call forpapers forananthology dedicatedto exploringthebiological origins andevolutionarydevelopment of organic mindedness. I expected a dozen or so submissions andreceived over 60. Some of those were published in Origins of Mind (Springer2012), some appear in this special issue and more are forthcoming in a second specialissue dedicated to the topic. It became clear to me that the question of how minded-ness evolved or emerged in the natural world and why is important to researchersacross philosophy and the bio-, neuro-, and medical sciences. What I have aimed todo in the origins of mind project, which includes this special issue, is collect a varietyof novel, thought-provoking, and intuitively plausible accounts of the where, when,why, and how of organic mindedness in the natural world.An important historical fact of the history of philosophy is that the majority of 20thcentury philosophy of mind, dominated as it was by the analytic tradition, enjoyed arobust existence completely insulated from discoveries and insights generated in thebio-, neuro-, and medical sciences. It did, of course, engage with computer science inthat the then reigning philosophy of mind, functionalism, was based on comparisonsbetween machine functionality and human consciousness. Though artificial intelli-gence is an important historical paradigm that has generated insights into whatmindedness might be and what it is not, my own project in philosophy of mind hasbeen to work toward a naturalistic (i.e., consistent with evolutionary theory) accountof organic mindedness that will have implications for medicine, mental and physicalhealth, and our species’ understanding of itself.

The egg behaves as a prospective cell sustaining the developmental processes of the future embryo. In biosemiotic terms, this apparent teleonomic behaviour can be accounted for without referring to the exclusive causal role played by its genetic makeup. We envision two different processes that are uniquely found in the oocyte: (1) the first involves the mechanisms by which large amounts of mRNA accumulate in the ooplasm to establish the embryo axes prior to fertilization; (2) the second involves transfer of an excess of maternally supplied ribosomes to the oocyte to provide the future embryo with newly synthesized proteins. In this paper, we argue that the information required to sustain embryonic development is not due to any physical properties of the zygotic DNA and the maternal mRNAs, but to their spatially and temporally ordered relationship in the zygote’s internal space.

Face recognition depends upon the uniqueness of each human face. This is accomplished by the patterns formed by the unique relationship among face features. Unique face-patterns are produced by the intrusion of random factors into the process of biological growth and development. Processes are described which enable a unique face-pattern to be represented as a percept in the visual sensory system. The components of the face recognition system are analyzed as is the manner in which the precept is connected through microcircuits to a memory file so that the history of a perceiver’s encounters with a familiar face enables the perceiver to access a memory store that is a record of the outcome of past encounters with the perceived. The importance of the face recognition system in enabling humans to individuate members the social group is discussed, as well as the importance of face recognition in the development of the individual’s social identity and ability to be a collaborative member of the social groups to which it belongs. The role of prosopagnosia—the inability to recognize familiar faces—in furthering an understanding of the face recognition system is examined, as is its importance in demonstrating the crucial nature of face recognition in human social functions. It is proposed that human face recognition is not a unique phenomenon but is an elaboration of processes existing in nonhuman primates as well as in lower animals.

Four sequential, sub-processes are identified as the fundamental steps in the processing of signals by big-brained animals. These are, Detection of the signal, its Representation in correlated sensory brain structure, the Interpretation of the signal in another part of the brain and the Expression of the receiver’s response. We label this four-step spatiotemporal process DRIE. We support the view that when the context within which such signals are produced and received is relatively constant, the DRIE process can be ultimately assimilated into the genome, with the Interpretation sub-phase is markedly decreased in duration as speed and efficiency are maximized. With frequent repetition and learning, an analogous result can be attained epigenetically as exemplified in human word and text recognition, allowing tasks critical to primate social function to be accomplished with rapidity and accuracy.

A unique aspect of human communication is the utilization of sets of well-delineated entities, the morphology of which is used to encode the letters of the alphabet. In this paper, we focus on Braille as an exemplar of this phenomenon. We take a Braille cell to be a physical artifact of the human environment, into the structure of which is encoded a representation of a letter of the alphabet. The specific issue we address in this paper concerns an examination of how the code that is embedded in the structure of a Braille cell is transferred with fidelity from the environment through the body and into the Braille reader’s brain. We describe four distinct encoding steps that enable this transfer to occur.

I read with interest Dr. Barry Smith and colleagues’ October JADA editorial, “Ontology and the Future of Dental Research Informatics” (Smith B, Goldberg LJ, Ruttenberg A, Glick M. JADA 2010;141[10]:1173–1175). It was fascinating, reassuring, surprising and a little disappointing all at the same time. MORE ABOUT ONTOLOGY: Authors’ responseThe Journal of the American Dental AssociationVol. 142Issue 3PreviewDr. Schleyer and his group are responsible for some of the most important contributions to dental informatics, and we are thus honored by the strong support expressed in their letter for the idea of an Ontology for Dental Research (ODR). We welcome his letter also because it gives us the opportunity to specify more precisely our thinking as it concerns the criteria for membership in the ODR consortium. Full-Text PDF MORE ABOUT ONTOLOGY: Response from ADA’S Product Development and Sales DepartmentThe Journal of the American Dental AssociationVol. 142Issue 3PreviewThe American Dental Association developed Current Dental Terminology (CDT) to be a comprehensive language having a consistent format to help dentists record and report the treatments they provide their patients in an accurate, standardized and appropriately detailed way that can be clearly understood by other dentists as well as by others in the health care community. On Aug. 17, 2000, the Code was named as a HIPAA (Health Insurance Portability and Accountability Act) standard code set. Full-Text PDF

This study was an extension of a previous study that considered dental student attitudes about older adults. In the current study, the association of student interactions with older adults, in both the dental school clinic and daily life, with their attitudes about this group was evaluated using the Aging Semantic Differential. A total of 311 dental students across all four years of academic standing were included in the study. The results showed that students' interactions with older adults outside the clinic did not relate to positive attitudes; however, even after controlling for the age of the student and the frequency, type of individual, and context of interactions with older adults outside the dental clinic, the number of older adult patients seen in the clinic showed a significant positive relationship with attitudes towards older adults. These results reinforce the conclusions drawn in a previous study that dental students' general attitudes about older adults may be changed, but that it is the exposure to older adults in a clinical setting that seems to be more critical in shaping these attitudes.

We present an ontology of pain and of other pain-related phenomena, building on the definition of pain provided by the International Association for the Study of Pain (IASP). Our strategy is to identify an evolutionarily basic canonical pain phenomenon, involving unpleasant sensory and emotional experience based causally in localized tissue damage that is concordant with that experience. We then show how different variant cases of this canonical pain phenomenon can be distinguished, including pain that is elevated relative to peripheral trauma, pain that is caused neuropathically (thus with no necessary peripheral stimulus), and pain reports arising through deception either of self or of others. We describe how our approach can answer some of the objections raised against the IASP definition, and sketch how it can be used to support more sophisticated discrimination of different types of pain resulting in improved data analysis that can help in advancing pain research. 1 Background: The Physical Basis of Disease Increasingly, ontologies are being used to support the retrieval, integration and analysis of a variety of different kinds of biomedical data. Ontology-based technology has been successful especially in support of data-driven research in the basic biological sciences and in model organism studies, and efforts are now being made to extend these successes to the domain of human disease and diagnosis. The most successful ontologies, above all the Gene Ontology [Bodenreider 2008], rest on objective classifications of biological phenomena primarily at the molecular and cellular levels, and we face difficulties in applying the same approach where we are dealing with clinical data pertaining to pain and to other symptoms of human disease marked by the feature of subjectivity. The goal of this communication is to provide the beginnings of an ontological account of pain and of those phenomena closely related to pain that are commonly described as pain in patient reports. Because pain has subtly complex characteristics, we believe that its examination will have heuristic value for ontological accounts of symptoms (such as feelings of nausea, fatigue, depression) more generally.

An important inconsistency currently exists in the literature on oral cancer. Reviewing this literature, one finds that the term oral cancer is defined and described with great variation. In a search in PubMed, at least 17 different terms were found for titles of papers reporting data on oral cancer. The variability of the terms used for designating anatomic regions and type of malignant neoplasms for reporting oral cancer has hampered the ability of researchers to effectively retrieve information concerning oral cancer. Therefore, it is sometimes extremely difficult to provide meaningful comparisons among various studies of oral cancer. Recently, a new ontological strategy that is rooted in consensus-based controlled vocabularies has been proposed to improve the consistency of data in dental research (Smith et al. in J Am Dent Assoc 141:1173–1175, 2010). In this paper, we analyzed the terminology dilemma on oral cancer and explained the current situation. We proposed a possible solution to the dilemma using an ontology-based approach. The advantages for applying this strategy are also discussed.

In this paper we address the interrelated questions of why and how certain features of an organism’s environment become meaningful to it. We make the case that knowing the biology is essential to understanding the foundation of meaning-making in organisms. We employ Miguel Nicolelis et al’s seminal research on the mammalian somatosensory system to enrich our own concept of brain-objects as the neurobiological intermediary between the environment and the consequent organismic behavior. In the final section, we explain how brain-objects advance the ongoing discussion of what constitutes a biosemiotic system. In general, this paper acknowledges Marcello Barbieri’s call for biology to make room for meaning, and makes a contribution to that end.

How do we find what is clinically significant in the swarms of data being generated by today's diagnostic technologies? As electronic records become ever more prevalent—and digital imaging and genomic, proteomic, salivaomics, metabalomics, pharmacogenomics, phenomics and transcriptomics techniques become commonplace— different clinical and biological disciplines are facing up to the need to put their data houses in order to avoid the consequences of an uncontrolled explosion of different ways of describing information. Fortunately, a new strategy to advance the consistency of data in the dental research community is emerging. The strategy is based on the idea that existing systems for data collection in dental research will continue to be used, but proposes a methodology in which past, present and future data will be described using a consensus-based controlled structured vocabulary called the Ontology for Dental Research (ODR). The ODR initiative is modeled on a series of existing biomedical ontology projects and will adopt best-practice principles that already have been thoroughly tested in areas such as molecular biology, model organism research, proteomics and genetic disease.1 An “ontology,” in this context, is a controlled, logically structured vocabulary created by experts in a given area as a strategy for promoting consistency in the way primary data (for example, in the form of experimental results or clinical records) are described. Specialist biocurators create “annotations” in the form of HTML tags linking such primary data to expressions in the ontology, thereby making the data available to search and to algorithmic processing. Each ontology contains a taxonomy at its heart, and its logical structure is built around the hierarchy defined by its taxonomic (subtype) relation. But an ontology contains also definitions of its terms, along with additional relations such as parthood, connection and participation, as well as functional relations. These additional relations make the data searchable not only through the use of terms in the ontology, but also through logically related terms. Thus, the ontology can be used to retrieve data associated with terms referring to parts of specific anatomical entities, to anatomical entities immediately connected to specific anatomical entities, or to biological processes in which specific anatomical entities participate. We can conceive ODR, in the first place, as providing an evolving standard set of key words for all aspects of dental research. Initially, these key words can be used to annotate both published literature and existing research databases. Such annotation will enable easier access to research results and allow also first steps toward the semantically enhanced publishing of the future.2 The long-term goals of ODR, however, are much more ambitious. ODR will include not only English-language definitions of its terms for human use and for human quality control of the ontology, but also logical definitions for use by computers. With the latter, ODR then can be used as a computational resource for enhanced search and integration of data, and for reasoning—not only with dental research data but also with data annotated using other biological and bio-medical ontologies with which ODR will be linked logically. The key idea behind ODR is rooted in 10 years of experience using ontologies in support of biomedical research. Ontologies in biomedicine began in the model organism community, which faced a problem of inconsistency in the ways in which the results of functional genomics experiments on different kinds of organisms were being described. To address these problems, a group of leading model organism databases came together in 1999 to create the Gene Ontology (GO), a controlled structured vocabulary for describing different attributes of gene products.3 The GO is designed to be species neutral. It provides a set of some 30,000 common terms for describing different kinds of cellular constituents, biological processes and molecular functions in all kinds of organisms— terms such as “mitochondrion” or “cell division” or “binding.” Since its inception, more than $100 million has been invested in the use of the GO to annotate references to gene products in databases and in the scientific literature. There are more than 11 million annotations relating gene products described in the UniProt, Ensembl and other databases and in more than 50,000 scientific journal articles to terms in the GO.4 The information in huge numbers of dispersed resources is hereby being made accessible through resources such as AmiGO and GOPubMed. Increasingly, the availability of this huge body of integrated information also is having an influence on clinical research, and a simple PubMed search on “gene ontology” reveals a variety of different ways in which the GO and the data annotated in its terms are being used in support of research on human health and disease. Important features of ODR include the following: It will be built to work with the GO and with other high-quality ontologies developed by the biomedical community. This means that ODR will follow the best practices identified through 10 years of testing by the GO and by its sister ontologies participating in the Open Biomedical Ontologies (OBO) Foundry initiative.5 It will be built with terms used by dental researchers, and it will be created and managed by the dental research community itself. The more an ontology is used, the more the ontology and the data described in its terms increase in value, and the more research groups in the future will be motivated to use the ontology in describing their data. The key to ontology success, therefore, is incentivizing users, and to this end it is important that potential users feel that they have ownership of the ontology, that the ontology is populated using the terms that they need and uses definitions that conform to their understanding of these terms. ODR is being initiated by the leading informatician groups within the dental research community in such a way that it will, from the very start, be in a position to serve as an attractor for multiple expanding groups of users whose members will have strong incentives not only to invest resources directed toward ensuring that it is developed in ways that keep pace with scientific advance, but also to recommend it to other users—thereby increasing the value of their own investment in the resource. It can be corrected easily in light of new research discoveries. One key presupposition for the success of an ontology project is its ability to integrate previously annotated data with new terms and relations brought to light by ongoing scientific discovery. This process ensures that previously annotated (legacy) data do not lose their value. To this end, the biomedical ontology community has developed a methodology based on careful versioning of ontologies and annotations, combined with software tools to ensure consistent updating of existing annotation resources with each new version of the ontology. It can be extended easily to incorporate new kinds of data. The organization of OBO ontologies is based on the use of a simple and highly flexible treelike hierarchy structure. This can be extended at will to comprehend new domains of entities as science evolves, and thereby allow the annotation of new kinds of data in ways consistent with existing annotations. The ODR will benefit the research community in a number of ways: It is designed to work well with existing ontologies in all areas of clinical and translation-al science, and thus allows dental research data to be easily integrated with other kinds of data. It is designed to work well with the Semantic Web, providing access to all data resources through unique Web URLs associated with each ontology term.6 It provides a pretested and well-defined set of terms, selections from which can be used in the design of new databases. It can incorporate, where needed, sets of synonyms deriving from legacy term sets and nomenclatures such as the Systematized Nomenclature of Medicine–Clinical Terms and Systematized Nomenclature of Dentistry vocabularies.7,8 To ensure high quality and continued maintenance, the ODR controlled vocabulary will be subject to a process of governance and peer review. Organizations such as the National Institutes of Health are requiring definitions of common standards to ensure that the results obtained through funded research are more easily accessible to external groups. ODR will be created in such a way that its use will meet these common standards. It is designed also to allow information presented in its terms to be usable in satisfying regulatory purposes—submissions to the U.S. Food and Drug Adminis -tration, for example. ORD will contain several subontology components, including the Salivaomics Ontology, 9 a Dental Anatomy Ontology based on the Foundational Model of Anatomy10 and an Oral Pathology Ontology. In addition, vocabulary resources are being developed, based on the Ontology for General Medical Science (OGMS)11 and the Ontology for Biomedical Investigations,12 to represent dental disease and dental procedures, and to allow a seamless connection between the use of ODR in the dental domain and the use of existing ontology resources developed in other areas of medicine. The use of ODR to describe data will be entirely voluntary. However, we anticipate that over time, more and more researchers will see the value of employing a common resource both in annotating their data and, progressively, in designing new databases in which to capture their research results.

We present an ontology of pain and of other painrelated phenomena, building on the IASP definition of pain. Our strategy is to distinguish an evolutionarily basic pain phenomenon, involving unpleasant sensory and emotional experience along with causality by and awareness of localized tissue damage that is concordant with the pain experience. We then show how different variant cases of this canonical case of pain can be distinguished, including pain that is elevated relative to peripheral trauma, pain that is caused neuropathically (thus with no peripheral stimulus), and pain reports arising for example through deception. We describe how our approach can answer some of the objections raised against the IASP definition, and sketch how it might be used to support more sophisticated data analysis in advancing pain research, especially as concerns pain with no identifiable tissue damage. Background: The Physical Basis of Disease Increasingly, ontologies are being used to support the retrieval, integration and analysis of a variety of different kinds of biomedical data. Ontology-based technology has been successful especially in support of data-driven research in the basic biological sciences and in model organism studies, and efforts are now being made to extend these successes to the domain of human disease and diagnosis. The most successful ontologies, above all the Gene Ontology [1], rest on objective classifications of biological phenomena primarily at the molecular and cellular levels, and we face difficulties in applying the same approach where we are dealing with clinical data pertaining to pain and to other symptoms of human disease marked by the feature of subjectivity. The goal of this communication is to provide the beginnings of an ontological account of pain and of those phenomena closely related to pain that are commonly described as pain in patient reports. Because pain has subtly complex characteristics, its examination may have heuristic value for ontological accounts of symptoms more generally. Our strategy is to pursue a view of pain as resting in every case on some physical basis perhaps as yet unknown. This is part of a more general strategy, defended in [2], which views all clinically relevant phenomena on the side of the patient as having some physical basis within the organism. When, for example, there is a persistent pain in a patient’s left temporomandibular joint (TMJ), then this is because some physical structure or substance in the organism is disordered (for example, the TMJ is deformed because of arthritis, or that part of the somatosensory cortex that serves as the projection of the left TMJ is disordered). As a result of this disorder, the organism acts in a certain abnormal way. By ‘physical basis’ we understand any configuration of one or more physical components within the organism at any level of granularity, from a single nucleotide to an arthritically deformed joint. Where they are non-disordered – which means: such as to reflect the coordinated expression of the corresponding structural genes for an organism of the given type [3] – such configurations support those dispositions in the organism which are realized (manifested) in normal (= ordered) functioning. Where disordered, such configurations support dispositions to abnormal functioning, one family of which is manifested in experiences of pain. ‘Symptom’, as we here use this term, covers a restricted family of phenomena (including pain, nausea, anger, drowsiness), which are of their nature experienced in the first person. Symptoms can be reported to, and associated behaviors and bodily qualities can be observed by, the clinician; but the symptoms themselves cannot be observed or objectively measured. The IASP Definition of Pain Pain is defined by the International Association for the Study of Pain (IASP) as follows: pain (IASP) =def. an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage [4]. This definition has proved to be of considerable value, having led to 50 years of highly productive fundamental research on pain. On the other hand it has certain problems, as recently reflected by From: M. Okada (ed.), Proceedings of the Conference on Ontology and Analytical Metaphysics, Tokyo: Keio University Press, 2011, 23-36. significant discussion by an IASP task force [5]. The definition ascribes a common phenomenology (‘unpleasant sensory and emotional experience’) to all instances of pain, together with the recognition of three distinct subtypes of pain involving, respectively: 1. actual tissue damage, 2. what is called ‘potential tissue damage’, 3. a description involving reference to tissue damage. Clause 3. may be interpreted to mean that a mere description of a certain sort provides sufficient evidence that pain is present. The intent, as we understand it, is to assign those patient reports of pain that are not sufficiently grounded in observable manifestations of tissue damage to some other (for example psychological) realm. Problems arise, then, in the classification of cases of malingering. (Example: a patient presenting with pain and associated tissue damage was prescribed pain relief medication. While moderate tissue damage remains, the medication is effective, so that there is no longer pain. But because the patient has become addicted, he claims that there is still pain in order to obtain more medication.) Such cases are not pain; yet as we shall see they will often be so classified by the clinician. Strategy for Defining Pain In providing a modified version of the IASP definition in what follows we define, first, what we shall call ‘pain with concordant tissue damage’, which we hold to be the canonical (normal, prototypical) and evolutionarily most basic case of pain, followed by a number of variant phenomena which are defined in terms of, and involve specific kinds of departures from, this canonical case. We distinguish the following five different sorts of cases of pain and of pain-related phenomena (see Table 1): PCT: pain with concordant tissue damage: the patient experiences pain of the evolutionarily most basic sort, which is to say: pain in response to and in concordance with tissue damage; PNT: pain with peripheral trauma but discordant (elevated) relative to tissue damage: there is peripheral trauma, but the patient is experiencing pain of an intensity that is discordant therewith; NN: neuropathic nociception: there is no peripheral trauma, but the patient is experiencing pain in result of a neuropathic disorder to the nociceptive system. An example is phantom limb pain, where painsystem components in the brain which had been laid down through the PCT pain experiences activated earlier by tissue damage in the once present limb are re-activated. In addition, we distinguish two related cases of nonpain-phenomena: PBWP: pain behavior without pain: there is, for example, a mere report, and no pain is being experienced (a fact which may or may not be detectable by an external observer). TWP: Tissue-damage without pain: tissue damage normally of the sort to cause pain does not activate the pain system. In a full account, we would need to distinguish also various combination cases, for example where the patient experiences canonical (PCT) pain in conjunction with neuropathic nociception; as well as multiple subtypes. In particular, we would need to take account of the fact that pain is divided into two broad subtypes along the temporal dimension: subtype 1. consists of pains of short duration: a cut, a local burn, an abrasion; each involves a brief duration stimulus and evokes a brief, intense experience of pain with accompanying reflex withdrawal that moves the body away from the stimulus. Following the injury there is a prolonged experience of usually less intense pain associated with inflammation that gradually recedes as healing occurs. Subtype 2. is chronic pain, a long-lasting sequence of experiences of pain, which may extend over many years without relief, and which may involve the patient visiting many specialists (ENT, headache, neurologist, TMD, psychologist) with no positive results. Our strategy is comparable to the way in which the results of genetic mutations or injuries affecting, for example, the human hand, are most effectively described in terms of specific kinds of departures from the anatomical structure of the normal human hand (with its 5 fingers, 10 metacarpal bones, etc.). This strategy has been pioneered by the Foundational Model of Anatomy (FMA) Ontology, a scientifically well-established reference ontology of human (and more generally of mammalian) anatomy [3]. Pain as an Evolutionarily Basic Mechanism The canonical pain phenomenon reflects the fact that mammals have components of their brains that are associated with signals to the organism indicating that some part of their structure is damaged or is in danger of being damaged. Such signals result in various consistent outcomes on the side of the organism. This is the sensory signalling system for pain. It is canonical to have pain in a joint when the joint is inflamed. Coordination between pain and tissue damage is then part of the core orienting function of pain, which is to protect the organism from harm. A patient can thus usually direct the clinician to a particular site on or in the body where the pain is experienced. The resultant definition of this evolutionary most basic, ‘canonical’ type of pain reads: pain with concordant tissue damage (PCT) =def. an unpleasant sensory and emotional experience on the part of a human subject S that is caused by damage to tissue located in a certain region of the body of S, and that is of a type that can be experienced as being caused by damage to tissue in this region, and that is of an intensity that is concordant with the tissue damage. This definition is formulated in such a way that small children and even