In this essay, I focus on Recanati's treatment of 'What is said' in his book Literal Meaning. I discuss Recanati's conception of Minimalism, his views on propositional completeness, and his understanding of the processes governing the semantic interpretation of meaning-controlled contextuality. In the final sections, I draw some conclusions pertaining to Recanati's assessment of the interface between pragmatic and semantic processes. /// En este ensayo me enfoco en el trato que le da Recanati a "lo que se dice" en (...) su libro Literal Meaning. Discuto su concepción del minimismo, su posición sobre la completud proposicional y su comprensión de los procesos que rigen la interpretación semántica de la contextualidad controlada por el significado. En las secciones finales, extraigo algunas conclusiones acerca de la evaluación que Recanati hace de la interfase entre procesos semánticos y pragmáticos. (shrink)

Although some of the most important figures in the history of philosophy have had something interesting to say about habit, habitual action has been largely neglected in contemporary action theory. An attempt to mitigate the consequences of this neglect has been recently made by Bill Pollard. Pollard’s approach, however, cannot do full justice to the distinctiveness of habitual action with respect to its phenomenology. The reason is that, as with most treatments of habit in the philosophical tradition, it fails to (...) distinguish habit from skill. It is only when this distinction is drawn that certain questions regarding the phenomenology of habit can be properly formulated. (shrink)

AimsThis study evaluates a protocol for early, routine ethics consultation for patients on extracorporeal membrane oxygenation to support decision-making in the context of clinical uncertainty with the aim of mitigating ethical conflict and moral distress.MethodsWe conducted a single-site qualitative analysis of EC documentation for all patients receiving ECMO support from 15 August 2018 to 15 May 2019. Detailed analysis of 20 ethically complex cases with protracted ethics involvement identifies four key ethical domains: limits of prognostication, bridge to nowhere, burden of (...) treatment and system-level concerns. There are three subthemes: relevant contextual factors, the role of EC and observed outcomes. Content analysis of transcripts from interviews with 20 members of the multidisciplinary ECMO team yields supplemental data on providers’ perceptions of the impact of the early intervention protocol.ResultsLimited outcome data for ECMO, unclear indications for withdrawal, adverse effects of treatment and an obligation to attend to programme metrics present significant ethical challenges in the care of this patient population. Upstream EC mitigates ethical conflict by setting clear expectations about ECMO as a time limited trial, promoting consistent messaging among multiple services and supporting surrogate decision-makers. When ECMO becomes a ‘bridge to nowhere’, EC facilitates decision-making that respects patient values yet successfully sets limits on non-beneficial use of this novel therapy.ConclusionData from this study support the conclusion that ECMO poses unique ethical challenges that necessitate a standardised protocol for early, routine EC—at least while this medical technology is in its nascent stages. (shrink)

Introduction: Alcohol approach bias, the tendency to automatically move toward alcohol cues, has been observed in people who drink heavily. However, surprisingly, some alcohol-dependent patients demonstrate an alcohol avoidance bias. This inconsistency could be explained by the clinical or demographic profile of the population studied, yet this has not been examined in approach bias modification trials to date. We aimed to determine the proportion of patients with an approach or avoidance bias, assess whether they differ on demographic and drinking measures, (...) and to examine the clinical correlates of approach bias.Method: These research questions were addressed using baseline data from 268 alcohol-dependent patients undergoing inpatient withdrawal treatment who then went on to participate in a trial of ABM.Results: At trial entry, 155 had an alcohol approach bias and 113 had an avoidance bias. These two groups did not differ on any demographic or relevant drinking measures. Approach bias was significantly and moderately associated with total standard drinks consumed in the past 30 days but no other indices of alcohol consumption or problem severity.Conclusion: Whilst the majority of alcohol-dependent patients showed an alcohol approach bias, those with an avoidance bias did not differ in demographic or clinical characteristics, and the strength of approach bias related only to recent consumption. Further research is needed to develop more accurate and personally tailored measures of approach bias, as these findings likely reflect the poor reliability of standard approach bias measures. (shrink)

The adaptive BCI known as ‘closed-loop deep brain stimulation’ (clDBS) is a device that stimulates the brain in order to prevent pathological neural activity and automatically adjusts stimulation levels based on computational algorithms that detect or predict those pathological processes. One of the prominent ethical concerns raised by clDBS is that, by inhibiting or modulating the undesirable neural states of a cognitive agent automatically, the device potentially undermines her autonomy. It has been argued that clDBS is not a threat because (...) autonomy is fundamentally relational, i.e., it essentially depends on external (e.g., social or cultural) factors. If the relational approach to autonomy includes human-computer interaction, then the mechanisms of clDBS, even if external to the brain and exerting some degree of control over the individual, may support her autonomy. However, DBS applications are substantially different from one another, each involving a specific neurological or psychiatric condition, neural target, mechanism and symptom(s), and therefore at least some of them may not fit into the relational analysis. I examine different clDBS applications for treatment resistant depression and claim that while internal capsule/ventral striatum (VC/VS) clDBS is a case of relational autonomy, subgenual cingulate gyrus (Cg25) clDBS is not. Autonomy (relational or otherwise) requires some degree of self-regulation of our motivational states, which is supported by VC/VS DBS but is absent in Cg25 DBS. In Cg25 DBS the device itself directly influences motivational states, thus substituting or overriding (instead of supporting) the auto-regulatory cognitive processes required for autonomous action. (shrink)

Health professionals faced with refusal of life-saving treatment may wish to override a person's wishes, especially if that person suffers from a mental disorder. Mental illness does not automatically mean a patient is incapable of making decisions of this nature. It is not always clear whether an individual is legally competent to decide whether to undergo treatment or not. This article discusses a clinical example and analyses some of the moral implications.

It is hard to think of a better subject for the exercise of retrospective analysis with which we are here concerned than Robert Boyle, the leading British scientist of his day, and arguably the most significant before Newton. A prolific and influential author, Boyle was lionized in his time both for his scientific achievement and for his piety and philanthropy. Of late, he has been the subject of attention from a variety of viewpoints which, as we shall see, raises the (...) issue of how he is best understood. In particular, I want to argue that, for all his eminence, there are complications about Boyle's personality that cry out for scrutiny, and it is on the implications of these that I will dwell in the latter stages of my paper.Boyle was born into one of the most privileged aristocratic families in England. His father, Richard Boyle, Earl of Cork, was Lord High Treasurer of Ireland before the Civil War, and Robert, the youngest – and, as he himself claimed, favourite – son, was brought up in an opulent, privileged setting, surrounded by servants and with an entrée at the royal court. His elder brothers were suave and active figures, only too ready to be involved in the fighting of the Civil War – in which one, Viscount Kinalmeaky, was killed, though two others, Lords Dungarvan and Broghill, survived to go on to high state office under both Cromwell and Charles II. This background undoubtedly had a significant influence on Boyle, giving him an aristocratic demeanour to which his contemporaries almost automatically deferred. It also made him familiar with the mindless social milieu of landed society, in which it was all too easy to ‘squander away a whole afternoone in tatling of this Ladys Face & tother Lady's Clothes; of this Lords being Drunke & that Lord's Clap; in telling how this Gentleman's horse outrun that other's Mare’. (shrink)

Lexical semantics has become a major research area within computational linguistics, drawing from psycholinguistics, knowledge representation, computer algorithms and architecture. Research programmes whose goal is the definition of large lexicons are asking what the appropriate representation structure is for different facets of lexical information. Among these facets, semantic information is probably the most complex and the least explored.Computational Lexical Semantics is one of the first volumes to provide models for the creation of various kinds of computerised lexicons for the (...) class='Hi'>automatic treatment of natural language, with applications to machine translation, automatic indexing, and database front-ends, knowledge extraction, among other things. It focuses on semantic issues, as seen by linguists, psychologists, and computer scientists. Besides describing academic research, it also covers ongoing industrial projects. (shrink)

In this paper, I explore the potential of systematically studying the linguistic surface of discourse for the purposes of identifying markers of argumentative moves and other related categories, such as types of arguments and argumentative strategies. Such a list of argumentative markers can prove useful for the (semi)automatic treatment of a large corpus of texts. After reviewing literature on the linguistic realization of argumentative moves as well as literature on the subject of discourse markers, it becomes clear that (...) the search for representative items of argumentative markers cannot be restricted to those elements marking relations but that it should also include elements that signal a certain function that is of pertinence to argumentative analysis. In this view, argumentative markers can be any single or complex lexical expression as well as a discursive configuration whose presence in a given utterance marks that utterance or the one preceding/following it, or a larger piece of discourse as having a certain argumentative function (as an argumentative move, a type of argument or an argumentative strategy). Examples taken from a French corpus on the controversy surrounding the development and applications of nanotechnology currently under study are used to illustrate the different types of argumentative markers proposed. (shrink)

The treatment of the goatherd Melanthius in these lines received remarkably little animadversion from earlier commentators . In contrast, the late Manuel Fernandez-Galiano devoted an extremely full note to the passage. One may wonder, however, whether he was right to base it on the automatic assumption that what we have depicted here is an act of murder. He himself admits that we are not ‘told exactly at what moment the unfortunate Melanthius dies’. :πότομος ατη κα δεινοτάτη ποιν, ξ (...) ς εκς κα θανεν τν Μελάνθιον, ε κα ποιητς κα ατ σιγι. Such lack of specificness would be most unlike Homer, and the removal of hands, feet, ears, nose and genitalia would be a remarkably laborious and uneconomical mode of instantly killing someone. Since we are not told that Melanthius dies I infer that he did not, any more than Eurytion did at Od. 21.300–2, in similarly trying circumstances: ‘they cut off his ears and nostrils with the sharp brass; but he, injured in his feelings, went about, enduring that calamity with a frantic mind’, to quote the translation by Buckley for which Housman was so grateful. (shrink)

Automatized scalable healthcare support solutions allow real-time 24/7 health monitoring of patients, prioritizing medical treatment according to health conditions, reducing medical appointments in clinics and hospitals, and enabling easy exchange of information among healthcare professionals. With recent health safety guidelines due to the COVID-19 pandemic, protecting the elderly has become imperative. However, state-of-the-art health wearable device platforms present limitations in hardware, parameter estimation algorithms, and software architecture. This paper proposes a complete framework for health systems composed of multi-sensor wearable (...) health devices, high-resolution parameter estimation, and real-time monitoring applications. The framework is appropriate for real-time monitoring of elderly patients' health without physical contact with healthcare professionals, maintaining safety standards. The hardware includes sensors for monitoring steps, pulse oximetry, heart rate, and temperature using low-power wireless communication. In terms of parameter estimation, the embedded circuit uses high-resolution signal processing algorithms that result in an improved measure of the HR. The proposed high-resolution signal processing-based approach outperforms state-of-the-art HR estimation measurements using the photoplethysmography sensor. (shrink)

A grandfather clause is a provision whereby an old rule continues to apply to some existing situation while a new rule applies to all future cases. This paper focuses on the use of grandfather clauses in health technology appraisals (HTAs) issued by the National Institute for Health and Care Excellence (NICE) in the United Kingdom. NICE provides evidence‐based guidance on healthcare technologies and public health interventions that influence resource allocation decisions in the National Health Service (NHS) and the broader public (...) sector in England and Wales. In this context, a grandfather clause is included when NICE does not recommend treatment with a given technology. The grandfather clause provides an exemption from the general recommendation for patients who have already started treatment with the technology in question, before the publication of the NICE guidance. In this paper we first lay out the contexts in which grandfather clauses occur in NICE guidance, and then consider ethical arguments against and in support of grandfather clauses and the continuation of treatment. We argue that NICE’s current practice of automatic inclusion of a grandfather clause is ethically problematic and unfair. While the inclusion of a grandfather clause may be appropriate and justified in specific cases, we argue that inclusion of such a clause should be considered as part and parcel of the decision making process on a case by case basis, rather than adopted as the default. (shrink)

Segmentation of post-operative glioblastoma multiforme (GBM) is essential for the planning of Tumor Treating Fields (TTFields) treatment and other clinical applications. Recent methods developed for pre-operative GBM segmentation perform poorly on post-operative GBM MRI scans. In this paper we present a method for the segmentation of GBM in post-operative patients. Our method incorporates an ensemble of segmentation networks and the Kullback–Leibler divergence agreement score in the objective function to estimate the prediction label uncertainty and cope with noisy labels and (...) inter-observer variability. Moreover, our method integrates the surgery type and computes non-tumorous tissue delineation to automatically segment the tumor. We trained and validated our method on a dataset of 340 enhanced T1 MRI scans of patients that were treated with TTFields (270 scans for train and 70 scans for test). For validation, we developed a tool that uses the uncertainty map along with the segmentation result. Our tool allows visualization and fast editing of the tissues to improve the results dependent on user preference. Three physicians reviewed and graded our segmentation and editing tool on 12 different MRI scans. The validation set average (SD) Dice scores were 0.81 (0.11), 0.71 (0.24), 0.64 (0.25), and 0.68 (0.19) for whole-tumor, resection, necrotic-core, and enhancing-tissue, respectively. The physicians rated 72% of the segmented GBMs acceptable for treatment planning or better. Another 22% can be edited manually in a reasonable time to achieve a clinically acceptable result. According to these results, the proposed method for GBM segmentation can be integrated into TTFields treatment planning software in order to shorten the planning process. To conclude, we have extended a state-of-the-art pre-operative GBM segmentation method with surgery-type, anatomical information, and uncertainty visualization to facilitate a clinically viable segmentation of post-operative GBM for TTFields treatment planning. (shrink)

Seeing, Doing, and Knowing is an original and comprehensive philosophical treatment of sense perception as it is currently investigated by cognitive neuroscientists. Its central theme is the task-oriented specialization of sensory systems across the biological domain. Sensory systems are automatic sorting machines; they engage in a process of classification. Human vision sorts and orders external objects in terms of a specialized, proprietary scheme of categories - colours, shapes, speeds and directions of movement, etc. This 'Sensory Classification Thesis' implies (...) that sensation is not a naturally caused image from which an organism must infer the state of the world beyond; it is more like an internal communication, a signal concerning the state of the world issued by a sensory system, in accordance with internal conventions, for the use of an organism's other systems. This is why sensory states are both easily understood and persuasive.Sensory classification schemes are purpose-built to serve the knowledge-gathering and pragmatic needs of particular types of organisms. They are specialized: a bee or a bird does not see exactly what a human does. The Sensory Classification Thesis helps clarify this specialization in perceptual content and supports a new form of realism about the deliverances of sensation: 'Pluralistic Realism' is based on the idea that sensory systems coevolve with an organism's other systems; they are not simply moulded to the external world. The last part of the book deals with reference in vision. Cognitive scientists now believe that vision guides the limbs by means of a subsystem that links up with the objects of physical manipulation in ways that bypass sensory categories. In a novel extension of this theory, Matthen argues that 'motion-guiding vision' is integrated with sensory classification in conscious vision. This accounts for the quasi-demonstrative form of visual states: 'This particular object is red', and so on. He uses this idea to cast new light on the nature of perceptual objects, pictorial representation, and the visual representation of space. (shrink)

In this paper, we distinguish two versions of Curry's paradox: c-Curry, the standard conditional-Curry paradox, and v-Curry, a validity-involving version of Curry's paradox that isn’t automatically solved by solving c-curry. A unified treatment of curry paradox thus calls for a unified treatment of both c-Curry and v-Curry. If, as is often thought, c-Curry paradox is to be solved via non-classical logic, then v-Curry may require a lesson about the structure—indeed, the substructure—of the validity relation itself.

This book radically simplifies Montague Semantics and generalizes the theory by basing it on a partial higher order logic. The resulting theory is a synthesis of Montague Semantics and Situation Semantics. In the late sixties Richard Montague developed the revolutionary idea that we can understand the concept of meaning in ordinary languages much in the same way as we understand the semantics of logical languages. Unfortunately, however, he formalized his idea in an unnecessarily complex way - two outstanding researchers in (...) the field even compared his work to a `Rube Goldberg machine.' Muskens' work does away with such unnecessary complexities, obtains a streamlined version of the theory, shows how partialising the theory automatically provides us with the most central concepts of Situation Semantics, and offers a simple logical treatment of propositional attitude verbs, perception verbs and proper names. (shrink)

This book constitutes the first treatment of C. S. Peirce’s unique concept of habit. Habit animated the pragmatists of the 19th and early 20th centuries, who picked up the baton from classical scholars, principally Aristotle. Most prominent among the pragmatists thereafter is Charles Sanders Peirce. In our vernacular, habit connotes a pattern of conduct. Nonetheless, Peirce’s concept transcends application to mere regularity or to human conduct; it extends into natural and social phenomena, making cohesive inner and outer worlds. Chapters (...) in this anthology define and amplify Peircean habit; as such, they highlight the dialectic between doubt and belief. Doubt destabilizes habit, leaving open the possibility for new beliefs in the form of habit-change; and without habit-change, the regularity would fall short of habit – conforming to automatic/mechanistic systems. This treatment of habit showcases how, through human agency, innovative regularities of behavior and thought advance the process of making the unconscious conscious. The latter materializes when affordances form the basis for modifications in action schemas and modes of reasoning. Further, the book charts how indexical signs in language and action are pivotal in establishing attentional patterns; and how these habits accommodate novel orientations within event templates. It is intended for those interested in Peirce’s metaphysic or semiotic, including both senior scholars and students of philosophy and religion, psychology, sociology and anthropology, as well as mathematics, and the natural sciences. (shrink)

Unrestricted inferentialism holds both that any collection of inference rules can determine a meaning for an expression and meaning constituting rules are automatically valid. Prior's infamous tonk connective refuted unrestricted inferentialism, or so it is universally thought. This paper argues against this consensus. I start by formulating the metasemantic theses of inferentialism with more care than they have hitherto received; I then consider a tonk language — Tonklish — and argue that the unrestricted inferentialist's treatment of this language is (...) only problematic if it is mistakenly assumed that Tonklish can be homophonically translated into English. Next, I discuss the proper, non-homophonic, translation of Tonklish into English, rebut various objections, and consider several variants of Tonklish. The paper closes by highlighting the philosophical advantages that unrestricted inferentialism has over its competitors once the terrors of tonk have been tamed. (shrink)

In General Relativity in Hamiltonian form, change has seemed to be missing, defined only asymptotically, or otherwise obscured at best, because the Hamiltonian is a sum of first-class constraints and a boundary term and thus supposedly generates gauge transformations. Attention to the gauge generator G of Rosenfeld, Anderson, Bergmann, Castellani et al., a specially _tuned sum_ of first-class constraints, facilitates seeing that a solitary first-class constraint in fact generates not a gauge transformation, but a bad physical change in electromagnetism or (...) General Relativity. The change spoils the Lagrangian constraints, Gauss's law or the Gauss-Codazzi relations describing embedding of space into space-time, in terms of the physically relevant velocities rather than auxiliary canonical momenta. But the resemblance between the gauge generator G and the Hamiltonian H leaves still unclear where objective change is in GR. Insistence on Hamiltonian-Lagrangian equivalence, a theme emphasized by Castellani, Sugano, Pons, Salisbury, Shepley and Sundermeyer among others, holds the key. Taking objective change to be ineliminable time dependence, one recalls that there is change in vacuum GR just in case there is no time-like vector field xi^a satisfying Killing's equation L_xi g_mn=0, because then there exists no coordinate system such that everything is independent of time. Throwing away the spatial dependence of GR for convenience, one finds explicitly that the time evolution from Hamilton's equations is real change just when there is no time-like Killing vector. The inclusion of a massive scalar field is simple. No obstruction is expected in including spatial dependence and coupling more general matter fields. Hence change is real and local even in the Hamiltonian formalism. The considerations here resolve the Earman-Maudlin standoff over change in Hamiltonian General Relativity: the Hamiltonian formalism is helpful, and, suitably reformed, it does not have absurd consequences for change and observables. Hence the classical problem of time is resolved. The Lagrangian-equivalent Hamiltonian analysis of change in General Relativity is compared to Belot and Earman's treatment. The more serious quantum problem of time, however, is not automatically resolved due to issues of quantum constraint imposition. (shrink)

It is widely held that quantum mechanics is the first scientific theory to present scientifically internal, fundamental difficulties for a realistic interpretation (in the philosophical sense). The standard (Copenhagen) interpretation of the quantum theory is often described as the inevitable instrumentalistic response. It is the purpose of the present article to argue that quantum theory doesnot present fundamental new problems to a realistic interpretation. The formalism of quantum theory has the same states—it will be argued—as the formalisms of older physical (...) theories and is capable of the same kinds of philosophical interpretation. This result is reached via an analysis of what it means to give a realistic interpretation to a theory. The main point of difference between quantum mechanics and other theories—as far as the possibilities of interpretation are concerned—is the special treatment given tomeasurement by the “projection postulate.” But it is possible to do without this postulate. Moreover, rejection of the projection postulate does not, in spite of what is often maintained in the literature, automatically lead to the many-worlds interpretation of quantum mechanics. A realistic interpretation is possible in which only the reality ofone (our) world is recognized. It is argued that the Copenhagen interpretation as expounded by Bohr is not in conflict with the here proposed realistic interpretation of quantum theory. (shrink)

Moral distress has been covered extensively in the nursing literature and increasingly in the literature of other health professions. Cases that cause nurses’ moral distress that are mentioned most frequently are those concerned with prolonging the dying process. Given the standard of aggressive treatment that is typical in intensive care units (ICUs), much of the existing moral distress research focuses on the experiences of critical care nurses. However, moral distress does not automatically occur in all end-of-life circumstances, nor does (...) every critical care nurse suffer its damaging effects. What are the practices of these nurses? What specifically do they do to navigate around or through the distressing situations? The nursing literature is lacking an answer to these questions. This article reports a study that used narrative analysis to explore the reported practices of experienced critical care nurses who are skilled at and comfortable working with families and physicians regarding the withdrawal of aggressive treatment. A major finding was that these nurses did not report experiencing the dam-Moral Agency, Moral Imagination, and Moral Community: Antidotes to Moral Distress Terri Traudt, Joan Liaschenko, and Cynthia Peden-McAlpine Terri Traudt, MBC, MA, is a Communications Consultant specializing in bioethics at the Center for Bioethics at the University of Minnesota, in Minneapolis. [email protected] Joan Liaschenko, PhD, RN, FAAN, is a Professor at the Center for Bioethics and Nursing at the University of Minnesota. Cynthia Peden-McAlpine, PhD, ACNS, BC, is an Associate Professor in the School of Nursing at the University of Minnesota. © 2016 by The Journal of Clinical Ethics. All rights reserved. aging effects of moral distress as described in the nursing literature. The verbal communication and stated practices relevant to this finding are organized under three major themes: (1) moral agency, (2) moral imagination, and (3) moral community. Further, a total of eight subthemes are identified. The practices that constitute these themes and subthemes are further detailed and discussed in this article. Understanding these practices can help mitigate critical care nurses’ moral distress. (shrink)

This paper proposes that the meanings of some natural language expressions should be thought of as functions on their own continuations. Continuations are a well-established analytic tool in the theory of programming language semantics; in brief, a continuation is the entire default future of a computation. I show how a continuation-based grammar can unify several aspects of natural language quantification in a new way: merely stating the truth conditions for quantificational expressions in terms of continuations automatically accounts for scope displacement (...) and scope ambiguity. To prove this claim, I exhibit a simple finite context-free grammar with a strictly compositional semantics in which quantificational NPs are interpreted in situ but take semantic scope over larger constituents. There is no Quantifier Raising (nor any use of a level of Logical Form distinct from overt syntax), no Cooper Storage (or similar mechanisms used in many recent HPSG, Categorial, or Type-logical treatments), and no need for type-shifting (as in Hendriks' Flexible Types account). Continuations also provide a natural account of generalized coordination that does not require either type-shifting or type polymorphism. Compositionality issues are discussed in some detail. (shrink)

1. Introduction. David Malament has described a natural and satisfying resolution of the traditional problems of Newtonian cosmology—natural in the sense that it effects the escape by altering Newtonian gravitation theory in a way that leaves its observational predictions completely unaffected. I am in full agreement with his approach. There is one part of his account, however, over which Malament has been excessively modest. The resolution requires a modification to Newtonian gravitation theory. Malament presents the modification as so straightforward as (...) to be automatic. This trivializes the crucial postulate, which I shall call the “relativity of acceleration.” It is a significant physical statement in its own right and requires careful justification. Moreover the postulate proved easy to overlook for decades of discussion of the paradox. It really only becomes natural from the perspective of the newer geometric methods Malament exploits. There the postulate has become a commonplace. My purpose here is to develop the following: While Newtonian cosmology can be repaired satisfactorily, in its traditional form it remains deeply troubled. These troubles can be expressed most vividly as the paradoxical contradictions indicated below. They persist in both the integral and differential formulations of Newtonian gravitation theory. Malament's careful geometric treatment is necessarily dense. By taking some liberties with precision, his core result can be expressed in a far simpler form. Attempts to avoid the resolution Malament describes do lead to disaster. Therefore this episode can be inverted and used as the strongest extant argument for the relativity of acceleration in Newtonian gravitation theory. (shrink)

Questions concerning the parent/ patient’s autonomy are seen as one of the most important reasons for requesting Ethics Consultations. Respecting parent/ patient’s autonomy also means respecting the patient’s wishes. But those wishes may be controversial and sometimes even go beyond legal requirements. The objective of this case series of 32 ECs was to illustrate ethically challenging parent / patients’ wishes during the first stages of life and how the principle of patient’s autonomy was handled. The case series has a qualitative (...) retrospective approach. A documentary sheet was designed de novo and information was gained from EC minutes and medical charts. The cases originate from the following specialties: reproductive medicine, obstetrics and neonatology as well as two interdisciplinary cases. Through the structured EC minutes aspects of patient / parents’ wishes could be identified explicitly. Overall the patient / parents’ wishes were not supported in 61% of the cases. Central reasons for rejection of patient / parent wishes were mainly the protection of the best interest of the unborn / new-born child as well as the rejection of clinical approaches that were regarded as being substandard treatment. The study shows that treatment decisions in reproductive medicine, obstetrics and neonatology raise substantial ethical questions leading to the request for ethics consultation. The systematic case series presented here gives insight into the ethical reflection carried out to support the clinicians in their decision-making and counselling. It shows that clinicians, after using ethics consultation, make deliberate decisions that do not “automatically” fulfil the treatment requests of the patients and parents. (shrink)

Increasing ethical attention and debate is focusing on whether individuals who take part in clinical trials should be given access to post-trial care. However, the main focus of this debate has been upon drug trials undertaken in low-income settings. To broaden this debate, we report findings from interviews with individuals (n = 24) who participated in a clinical trial of a closed-loop system, which is a medical device under development for people with type 1 diabetes that automatically adjusts blood glucose (...) to help keep it within clinically recommended ranges. Individuals were recruited from UK sites and interviewed following trial close-out, at which point the closed-loop had been withdrawn. While individuals were stoical and accepting of the requirement to return the closed-loop, they also conveyed varying degrees of distress. Many described having relaxed diabetes management practices while using the closed-loop and having become deskilled as a consequence, which made reverting back to pre-trial regimens challenging. Participants also described unanticipated consequences arising from using a closed-loop. As well as deskilling, these included experiencing psychological and emotional benefits that could not be sustained after the closed-loop had been withdrawn and participants reevaluating their pre- and post-trial life in light of having used a closed-loop and now perceiving this life much more negatively. Participants also voiced frustrations about experiencing better blood glucose control using a closed-loop and then having to revert to using what they now saw as antiquated and imprecise self-management tools. We use these findings to argue that ethical debates about post-trial provisioning need to be broadened to consider potential psychological and emotional harms, and not just clinical harms, that may result from withdrawal of investigated treatments. We also suggest that individuals may benefit from information about potential nonclinical harms to help make informed decisions about trial participation. (shrink)

We present a general theory of scope and binding in which both crossover and superiority violations are ruled out by one key assumption: that natural language expressions are normally evaluated (processed) from left to right. Our theory is an extension of Shan’s (2002) account of multiple-wh questions, combining continuations (Barker, 2002) and dynamic type-shifting. Like other continuation-based analyses, but unlike most other treatments of crossover or superiority, our analysis is directly compositional (in the sense of, e.g., Jacobson, 1999). In particular, (...) it does not postulate a level of Logical Form or any other representation distinct from surface syntax. One advantage of using continuations is that they are the standard tool for modeling order-of-evaluation in programming languages. This provides us with a natural and independently motivated characterization of what it means to evaluate expressions from left to right. We give a combinatory categorial grammar that models the syntax and the semantics of quantifier scope and wh-question formation. It allows quantificational binding but not crossover, in-situ wh but not superiority violations. In addition, the analysis automatically accounts for a variety of sentence types involving binding in the presence of pied piping, including reconstruction cases such as Whose criticism of hisi mother did each personi resent? (shrink)

We consider several puzzles of bounded rationality. These include the Allais- and Ellsberg paradox, the disjunction effect, and related puzzles. We argue that the present account of quantum cognition—taking quantum probabilities rather than classical probabilities—can give a more systematic description of these puzzles than the alternate treatments in the traditional frameworks of bounded rationality. Unfortunately, the quantum probabilistic treatment does not always provide a deeper understanding and a true explanation of these puzzles. One reason is that quantum approaches introduce (...) additional parameters which possibly can be fitted to empirical data but which do not necessarily explain them. Hence, the phenomenological research has to be augmented by responding to deeper foundational issues. In this article, we make the general distinction between foundational and phenomenological research programs, explaining the foundational issue of quantum cognition from the perspective of operational realism. This framework is motivated by assuming partial Boolean algebras. They are combined into a uniform system via a mechanism preventing the simultaneous realization of perspectives. Gleason’s theorem then automatically leads to a distinction between probabilities that are defined by pure states and probabilities arising from the statistical mixture of pure states. This formal distinction relates to the conceptual distinction between risk and ignorance. Another outcome identifies quantum aspects in dynamic macro-systems using the framework of symbolic dynamics. Finally, we discuss several ideas that are useful for justifying complementarity in cognitive systems. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Josiah Royce on RaceIssues in ContextJacquelyn Ann K. KegleyAll philosophy, whether or not we want to admit it, is done in a context, filtered through lenses that are personal, intellectual, historical, cultural, social, and political. Thus to fairly treat and fully understand Royce's views on race, we must set a situational framework. First, Royce's 1906 article entitled "Race Questions and Prejudices" is the lead piece in a collection that (...) implements his philosophy of loyalty. It applies his principle of loyalty to what he considers one of the most significant social/political issues of his time—the race question. As we discuss Royce and race issues, the philosophy of loyalty must be in the background as a point of reference. Indeed, Royce tells us that he will address the various questions in his article "Race Questions and Prejudices" by calling attention to "a few principles which seem to me to be serviceable to any one who wants to look at race questions fairly and humanely" (6).Secondly, except for W. E. B. DuBois and Jane Addams, no other major figure associated with pragmatic philosophy substantially addressed issues of race and racism in their written work, nor did anyone so early in the twentieth century as did Royce. DuBois's The Souls of Black Folk, which came out in 1903, immediately preceded Royce's article. Jane Addams briefly touched on race issues in her 1915 Democracy and Social Ethics. Alain Locke, who sought to study with Royce at Harvard but could not because of Royce's premature death, gave his "Lectures on the Theory and Practice of Race" in 1915, but they were published posthumously. John Dewey's "Race Prejudice and Friction" appeared in 1922. There is an absence of treatment of race issues in George Herbert Mead, Charles Sanders Peirce, and Alfred North Whitehead. Thus Shannon Sullivan and I agree that Royce stands out in the history of classical American philosophy in taking an antiracist focus on race questions when very few philosophers—especially white male philosophers—took scholarly time to think about these issues.1 [End Page 1]Another important context for Royce's article is the political climate of the time. Royce identifies the era as one in which there were "more ways and places in which men find themselves in the presence of alien races with whom they have to live in the same social order" (4). It was a time of "white anxiety." In 1905, Theodore Roosevelt gave his famous "On American Motherhood" speech in which he warned of white "race suicide" if white families continued to reproduce at a slower rate than other races. Thus, Royce was speaking and writing against racism in a time of anti-immigration and proimperialism sentiment due to white anxiety in the United States about the possible decline of global white supremacy. It is in this setting that Royce highlights the color line as a significant problem.Royce states the problem as follows:This is the problem of dealing with the men who seem to us somehow very widely different from ourselves in physical constitution, in temperament, in all their deeper nature, so that we are temped to think of them as natural strangers to our souls, while nevertheless we find that they are stubbornly there in our world and that they are men as much determined to live as we are, and are men who, in turn, find us as incomprehensible as we find them.(5)With increased contact among different populations, the age-old problem of how to deal with people who seem different from one's own group intensifies. There will be, says Royce, numerous questions including those of superiority-inferiority, power and sovereignty, and a new assessment of the ways in which these "different" people might be helpful or perilous to one's own group interests. Royce notes that one cannot assume an automatic answer. He asks, "Is it a ‘yellow peril,' or a ‘black peril,' or perhaps after all, is it not rather some form of ‘white peril' which threatens the future of humanity in this day of great struggles and of complex issues?" (6). With the question posed in this... (shrink)

A recent challenge to statist arguments defending the right of states to exclude prospective immigrants maintains that such statist arguments prove too much. Specifically, the challenge argues that statist arguments, insofar as they are correct, entail that states may permissibily exclude current members' newcomers by birth, which seems to violate a widely held intuition that members' newcomers by birth ought automatically to be granted membership rights. The basic claim is that statist arguments cannot account for the differntial treatment between (...) prospective immigrants and newcomers by birth. Call this the newcomer-by-birth objection. This article rejects the newcomer-by-birth rejection. It begins by sketching the precise extent to which the objection applies to statist arguments. It then examines the case of newcomers by birth and argues for a principled basis for treating them differentially from prospective immigrants such that a right to exclude prospective immigrants need not entail a right to exclude newcomers by birth. But this distinction holds only in most cases, not all, and therefore the newcomer-by-birth objection is not entirely defeated. With respect to the cases in which the objection does hold, it is argued that such cases are morally akin to international adoption, and thus morally benign. All considered, statist arguments easily survive the newcomer-by-birth objection. (shrink)

This paper argues that Sulmasy and Sugarman have not succeeded in showing a moral difference between withholding and withdrawing treatment. In particular, they have misunderstood historical entitlement theory, which does not automatically prefer a first occupant by just acquisition.

Wilkinson’s discussion of the individual and family consent to organ and tissue donation is to be welcomed because it draws attention to the “incoherent hybrid” of the current position.1 I wish to highlight some areas of his discussion and propose that, in a situation of posthumous organ and tissue donation, the cadaver has no individual rights and family rights should under no circumstances automatically outweigh the potential transplant recipients’ right to a life-saving treatment.Transplant immunobiology and clinical transplantation is a (...) revolutionary area of medicine and has saved thousands of lives. In the UK, between 1 April 2004 and 31 March 2005, organs from 752 people who died were used to save or dramatically improve many people’s lives through 2242 transplants.2 In the US, 23 506 transplants were performed between January and October 2005 from 12 084 donors.3 Information from available databases shows that demand for organs, cells and tissues has outstripped the supply. As of 18 January 2006, 6553 people are still waiting for transplants in the UK and there are 90 636 waiting list transplant candidates in the US.2,3 As of 01 January 2006, there are 15 977 people active on the Eurotransplant waiting list.4 It is likely that non-compulsory posthumous donation of organs has resulted in the loss of many thousands, possibly many …. (shrink)

Although depression is characterized as a mood disorder it turns out that, like moods in general, it cannot be explained independently of a theory of emotion. In this paper I outline one promising theory of emotion and show how it deals with the phenomenon of depressive mood. An important aspect of MAT is the role it assigns to peripheral information processing systems in setting up emotional responses. The operations of these systems are automatic and opaque to consciousness, but they (...) represent information about the significance of the environment for the subject, bias cognition and behaviour, and have a characteristic phenomenology. I show how understanding the nature of peripheral appraisal provides a principled way to link neurochemistry and mood via an information processing theory of the circuitry targeted by antidepressant treatment. The discussion is organized around Matthew Ratcliffe's distinction between pre-intentional and intentional feelings and suggests that the MAT might provide a way to link phenomenological and mechanistic accounts of feeling states characteristic of depression. (shrink)

BackgroundIn the context of translational research, researchers have increasingly been using biological samples and data in fundamental research phases. To explore informed consent practices, we conducted a retrospective study on informed consent documents that were used for CARPEM’s translational research programs. This review focused on detailing their form, their informational content, and the adequacy of these documents with the international ethical principles and participants’ rights.MethodsInformed consent forms (ICFs) were collected from CARPEM investigators. A content analysis focused on information related to (...) biological samples and data treatment (context of sampling and collect, aims, reuse, consent renewal), including the type of consent. An automatic assessment of the readability of the ICFs were performed with the IT program “Flesch Score”.Results29 ICFs from 25 of 49 studies were analyzed after selection criteria were applied. Three types of consent were identified: 11 broad consents, six specific consents, and two opt-out consents. The Flesch Scores showed that most of the documents were too complex to be fully understood by most of the potential research participants. Most of the biological samples were collected during the healthcare routine, but the information content about secondary use of biological samples varied between ICFs. All documents mentioned personal data treatment but information about their reuse was not standardized in the ICFs.ConclusionsOur review of current IC procedures of CARPEM showed that practices could be improved considering new translational research methods. “Old fashion written ICFs” should be adapted to the translational research approach, to better respect individual rights and international research ethics principles. In this context, theoretically, a digital tool allowing dynamic information and consent of participants, through an electronic interactive platform may be a good way to promote more active participation in research. Nevertheless, its feasibility in the complex environment of biological samples and data research remains to prove. The way of a combination of a broad consent followed by dynamic information may be alternatively tested. (shrink)

Over the last decade, attention has crawled from out of the shadows into the philosophical limelight with several important books and widely read articles. Carolyn Dicey Jennings has been a key player in the attention revolution, actively publishing in the area and promoting awareness. This book was much anticipated by insiders and does not disappoint. It is in no way redundant with respect to other recent monographs, covering both a different range of material and developing novel positions throughout. The book (...) might have been called The Attending Self, since Jennings defines attention as mental prioritization controlled by the self. This invocation of the self is among her central innovations, and may prove to be the main source of controversy. I will highlight points of contention here, but want to emphasize at the outset that the book is essential reading for anyone interested in attention. Jennings also contributes to a range of other debates, which will help a broader audience appreciate the importance this topic.After a brief introduction, Jennings provides “a philosophical landscape” of attention (chap. 2), tracing the concept through history. This is an invaluable achievement that will be welcomed by both newcomers and veterans. Jennings exhibits enormous breadth, covering areas that contemporary philosophers of mind tend to neglect: medieval philosophy, Buddhist thought, and phenomenology, to name a few. We also get perspectives on attention from core figures in the Western canon, such as Descartes, Locke, and Kant, as well as thinkers who gave the topic a more political inflection: Mary Wollstonecraft and W. E. B. DuBois. Jennings surveys contemporary literature as well, locating recent work in these older lineages. Some authors get more treatment later in the book (e.g., William James and Wayne Wu). Overall, Jennings provides the best overview of this history I have seen. She proves that attention is not a new topic, but one with deep roots and one that can inform current debates; Jennings draws on these roots throughout. I would love to see a companion piece surveying scientific theories, including “gain control” and “biased competition,” which get little airtime in the book. Some recent philosophical theories are under-explored as well, including Chris Mole’s concept of cognitive unison (Jennings discusses other aspects of his view), Carlos Montemayor and Harry Haladjian’s exploration of attention’s diversity (we get a touch of this), and my own proposal that attention is a gateway to working memory (not mentioned here). That said, no extant survey is more complete.Chapter 3 begins with the empirical claim that attention is regulated by slow brainwaves, and then takes up two issues. The first is mental causation. Endorsing moderate emergentism, Jennings argues that slow brain waves are causally efficacious even though they are not reducible to lower-level processes. (The metaphysics and neuroscience are presented accessibly, aided by three appendixes.) Second, Jennings argues that these slow brain waves indicate that attention is controlled by the self. As someone who was never moved by the mental causation problem—I don’t think overdetermination threatens efficacy—I would have welcomed more development of this second issue. For one thing, in linking attention to subjective control, Jennings eschews the idea that there can be purely “bottom-up” attention driven by stimulus features alone. This goes against the orthodoxy in attention science, and makes it hard for her to accommodate phenomena such as “pop-out,” or the commonsense idea that attention can be “captured” by a sudden flash or loud sound. For another thing, I wanted to hear more on why Jennings relates slow brain waves to the self. Does this include the slow waves that occur during deep sleep? Is there even such a thing as the self? Is there one self or many? How do slow brain waves reflect our interests, projects, values, self-conceptions, autobiographical narratives, or social identities? Does the social self invoked by Wollstonecraft and DuBois gain a foothold here? The whole chapter campaigns against metaphysical reductionism, but arrives at a perspective on the self that will strike some readers as highly reductive.In the fourth chapter, Jennings sheds further light on her conjecture that attention involves the self by advancing the thesis that attention endows sensory information with meaning. On the face of it, this may sound implausible. Object recognition, reading, and many other meaning-involving processes can take place outside of attention and outside of consciousness. But Jennings has a richer notion of “meaning” in mind. She develops the idea of “subject unity,” which is imposition of structure on perception that reflects the interests of the perceiving subject. This, she claims, is what brings perception into the space of reasons. Along the way, she has interesting observations about binding, feature integration, and demonstrative reference. The material is highly original, and Jennings’s postulation of interest-based perceptual organization is compelling. At the same time, one might wonder whether interests are really relegated to the ambit of attentional control. Consider the cocktail party effect, wherein one’s own name captures attention. This implies a preattentive filter that reflects our interests. Emotionally charged words, facial expressions, and dangerous objects also work this way, and social biases can operate preattentively as well. If these reflect our interests, then meaning may arise outside attention.Jennings’s fifth chapter explores the relationship between attention and consciousness. Some authors have argued that attention is necessary and sufficient for consciousness. Jennings focuses primarily on the necessity claim. She does not systematically review the empirical literature here, but she addresses some of the key findings, and effectively rebuts studies that allege to find consciousness outside attention. She does not rest her case there, however. Instead, she identifies a new class of examples that purport to establish the possibility of consciousness without attention. Her central example she calls “conscious entrainment,” which is what we experience when engaged in habitual or skilled activities. Other possible examples touched on in the chapter include hypervigilance in individuals with attention deficit hyperactivity disorder (ADHD), passive movie watching, dreaming, and “attentional neglect.” These states all involve intense focus, Jennings admits, but not attention. To some readers this may sound contradictory. Isn’t focus a kind of attention? Don’t these states of absorption involve stimulus selection and enhancement of relevant features, suppression of distractors, and other hallmarks of attention? Jennings says none of this is tantamount to attention. Recall that she thinks attention is controlled by the self. In these cases, we are invited to imagine that the self takes a passive role: control is either ceded to the world (movie watching) or to previously mastered routines (skills and habits). Thus, Jennings’s claim that there is no attention in these cases hangs on her contentious thesis that attention requires a controlling self. One might also push back by arguing that, in some of Jennings’s allegedly selfless examples, the self remains involved. Skilled activities and hypervigilance, for example, can reflect personal interests.Skills and hypervigilance get more airtime in chapter 6. There, Jennings turns to questions of responsibility—a neglected topic in attention research. The chapter begins with a manslaughter trial in which the teenage plaintiff was given a light sentence because the judge evidently believed that the teen’s ADHD compromised his ability to control his actions. The example may be a bit triggering for people who have a personal relationship with this diagnosis, but, putting that aside, Jennings uses it to introduce the important concept of attention-based control. With reduced control, Jennings argues, comes reduced responsibility. I am inclined to see ADHD as involving dysregulation of attention (difficulty disengaging and dividing attention, for example) rather than diminished attention, but that can still be characterized as an issue with control of attention; therefore ADHD still illustrates Jennings’s point that there is a link between responsibility and control of attention. This, it turns out, is only half of her story. Having argued for this link, one might expect Jennings to follow Wayne Wu, who contends that attention is necessary for action, and hence for responsibility. She does not. Instead, she says argues that responsibility can also arise in cases of “strategic automaticity.” This brings us back to skills. When skills are deployed, action is governed by learned pairings between stimuli and responses. The choice to exercise a skill requires attention, so attention is needed for being a responsible agent, but once a skill kicks in, attention is no longer required, and one can be held responsible for actions performed skillfully—thus attention is not required for responsibility tout court. Jennings addresses an opposing view (defended by Wu, Ellen Fridland, and Barbara Montero), according to which skills involve “automatic attention” rather than no attention. Jennings worries that this move will collapse the distinction between attention and other kinds of selection and filtering that occur throughout the nervous system, including the retina. She says that the attentional interpretation of skilled action is at odds with the lack of top-down reweighing of sensory inputs, regulated by lateral frontal cortex. These objections to automatic attention warrant response. My own view is that attention involves broadcasting to working memory, so retinal filtering is ruled out. Jennings’s insistence on top-down reweighing will not move those who believe attention can be purely bottom-up. For all that, I side with Jennings in wanting to allow for responsibility without attentional control. I think we can be responsible for implicit biases, for example. I also think attentional control is insufficient for responsibility, as when we act under duress.Jennings offers fresh perspective on the nature of attention, and its role in meaningful perception, consciousness, action, and responsibility. Each chapter can be read separately, but they hang together well, and each reflects her thesis that attention is essentially linked to the self. Though I am skeptical of that strong claim, we would do well to follow Jennings in regarding attention as interest-laden interface between mind and world. I look forward to a sequel in which attention is related to richer conceptions of identity, and where the political consequences of this link are actively explored. Meanwhile, one can hardly fault Jennings for covering too little. She tackles a remarkable range of topics, from metaphysics to ethics. Her arguments throughout demand response, repay careful study, and propel the field forward. (shrink)

IntroductionGeneralized Anxiety Disorder is a prevalent emotional disorder associated with increased dysfunctionality, which has a lasting impact on the individual’s quality of life. Besides medication, Cognitive-Behavioral Therapy represents the golden standard psychotherapeutic approach for GAD, integrating multilevel techniques and various delivery formats that enable the development of tailored treatment protocols. The objective of this study was to compare the efficiency of a standard CBT protocol targeting worries, dysfunctional beliefs, and intolerance of uncertainty with an integrative and multimodal CBT intervention (...) augmented with Virtual Reality.Materials and methodsThis study included 66 participants with moderate GAD symptoms that were randomized to the standard CBT group and the Integrative and Multimodal CBT augmented with VR group. The interventions comprised 10 weekly sessions conducted by trained CBT therapists, including cognitive restructuring, problem-solving, behavioral exposure, and relaxation techniques. Baseline and post-assessments were conducted with both groups. Primary outcome measures included the Hamilton Anxiety Rating Scale and Penn-State Worry Questionnaire to evaluate the severity of GAD symptoms and worries, respectively. Secondary outcomes involved the administration of Automatic Thoughts Questionnaire, Dysfunctional Attitudes Scale and Unconditional Self-Acceptance Questionnaire.ResultsBoth interventions determined statistically significant effects on both primary and secondary outcomes in the expected direction. However, CBTs was associated with higher effect sizes for anxiety and worries, in contrast to IM-VRCBT. Also, secondary analyses revealed positive correlations between changes in anxiety and worries level and the reduction of dysfunctional cognitive processes.ConclusionThis research emphasized the effectiveness of CBT interventions for treating adults with moderate GAD symptomatology. Specifically, both interventions were efficient for reducing anxiety symptomatology present at individuals with GAD. However, regarding cognitive dysfunctions like worries, the standard CBT protocol performed better, as compared to the IM-VRCBT. In addition, we conclude that VR could be integrated within CBT interventions in a single protocol for GAD treatment. (shrink)

BackgroundInformation and communication technology solutions have the potential to support active and healthy aging and improve monitoring and treatment outcomes. To make such solutions acceptable, all stakeholders must be involved in the requirements elicitation process. Due to the COVID-19 situation, alternative approaches to commonly used face-to-face methods must often be used. One aim of the current article is to share a unique experience from the Pharaon project where due to the COVID-19 outbreak alternative elicitation methods were used. In addition, (...) an overview of common functional, quality, and emotional goals identified by six pilot sites is presented to complement the knowledge about the needs of older adults.MethodsOriginally planned face-to-face co-creation seminars were impossible to carry out, and all pilot sites chose alternative requirements elicitation methods that were most suitable in their situation. The elicited requirements were presented in the form of goal models. In one summary goal model, we provide an overview of common functional, quality, and emotional goals.ResultsDifferent elicitation methods were combined based on the digital literacy of the target group and their access to digital tools. Methods applied without digital technologies were phone interviews, reviews of literature and previous projects, while by means of digital technologies online interviews, online questionnaires, and virtual co-creation seminars were conducted. The combination of the methods allowed to involve all planned stakeholders. Virtual and semi-virtual co-creation seminars created collaborative environment comparable to face-to-face situations, while online participation helped to save the time of the participants. The most prevalent functional goals elicited were “Monitor health,” “Receive advice,” “Receive information.” “Easy to use/comfortable,” “personalized/tailored,” “automatic/smart” were identified as most prevalent quality goals. Most frequently occurring emotional goals were “involved,” “empowered,” and “informed.”ConclusionThere are alternative methods to face-to-face co-creation seminars, which effectively involve older adults and other stakeholders in the requirements elicitation process. Despite the used elicitation method, the requirements can be easily transformed into goal models to present the results in a uniform way. The common requirements across different pilots provided a strong foundation for representing detailed requirements and input for further software development processes. (shrink)

This paper analyses the arguments for and against what we have called automatic organ procurement model in relation to the organs of the deceased. For this purpose, this work provides empirical evidence to assess the potential impact of this model on donation rates and on public opinion. Specifically, we examine first the reasons supporting this model, with special reference to utilitarian and justice arguments. On the other hand, we analyse both the approaches based on the violation of pre mortem (...) and post mortem interests opposing this theoretical model and the rejection the model would generate in the population. Finally, we point out the aspects that, in our opinion, should be exhaustively regulated if this model were implemented. In particular, we refer to the legal status of the human body, the treatments for end-of-life patients, the incentives for health professionals and the recognition of the right to conscientious objection. (shrink)

How is it possible that beginning from the negation of rational thoughts one comes to produce knowledge? This problem, besides its intrinsic interest, acquires a great relevance when the representation of a knowledge is settled, for example, on data and automatic reasoning. Many treatment ways have been tried, as in the case of the non-monotonic logics; logics that intend to formalize an idea of reasoning by default, etc. These attempts are incomplete and are subject to failure. A possible (...) solution would be to formulate a logic of the irrational, which offers a model for reasoning permitting to support contradictions as well as to produce knowledge from such situations. An intuition underlying the foundation of such a logic consists of the da Costa's paraconsistent logics presenting however, a different deduction theory and a whole distinct semantics, called here "the semantics of possible translations". The present proposing, following our argumentation, intends to enlight all this question, by a whole satisfactory logical point of view, being practically applicable and philosophically acceptable.Como é possível que a partir da negação do racional se possa obter conhecimento adicional? Esse problema, além de seu interesse intrínseco, adquire uma relevância adicional quando o encontramos na representação do conhecimento em bases de dados e raciocínio automático, por exemplo. Nesse caso, diversas tentativas de tratamento têm sido propostas, como as lógicas não-monotônicas, as lógicas que tentam formalizar a ideia do raciocínio por falha . Tais tentativas de solução, porém, são falhas e incompletas; proponho que uma solução possível seria formular uma lógica do irracional, que oferecesse um modelo para o raciocínio permitindo não só suportar contradições, como conseguir obter conhecimento, a partir de tais situações. A intuição subjacente à formulação de tal lógica são as lógicas paraconsistentes de da Costa, mas com uma teoria da dedução diferente e uma semântica completamente distinta . Tal proposta, como pretendo argumentar, fornece um enfoque para a questão que é ao mesmo tempo completamente satisfatório, aplicável do ponto de vista prático e aceitável do ponto de vista filosófico. (shrink)

In the case of magnetic resonance imaging (MRI) imaging, image processing is crucial. In the medical industry, MRI images are commonly used to analyze and diagnose tumor growth in the body. A number of successful brain tumor identification and classification procedures have been developed by various experts. Existing approaches face a number of obstacles, including detection time, accuracy, and tumor size. Early detection of brain tumors improves options for treatment and patient survival rates. Manually segmenting brain tumors from a (...) significant number of MRI data for brain tumor diagnosis is a tough and time-consuming task. Automatic image segmentation of brain tumors is required. The objective of this study is to evaluate the degree of accuracy and simplify the medical picture segmentation procedure used to identify the type of brain tumor from MRI results. Additionally, this work suggests a novel method for identifying brain malignancies utilizing the Bagging Ensemble with K-Nearest Neighbor (BKNN) in order to raise the KNN’s accuracy and quality rate. For image segmentation, a U-Net architecture is utilized first, followed by a bagging-based k-NN prediction algorithm for classification. The goal of employing U-Net is to improve the accuracy and uniformity of parameter distribution in the layers. Each decision tree is fitted on a little different training dataset during classification, and the bagged decision trees are effective since each tree has minor differences and generates slightly different skilled predictions. The overall classification accuracy was up to 97.7 percent, confirming the efficiency of the suggested strategy for distinguishing normal and pathological tissues from brain MR images; this is greater than the methods that are already in use. (shrink)

Deep Brain Stimulation (DBS) is an effective treatment for advanced Parkinson’s disease. However, identifying stimulation parameters, such as contact and current amplitudes, is time-consuming based on trial and error. Directional leads add more stimulation options and render this process more challenging with a higher workload for neurologists and more discomfort for patients. In this study, a sweet spot-guided algorithm was developed that automatically suggested stimulation parameters. These suggestions were retrospectively compared to clinical monopolar reviews. A cohort of 24 Parkinson’s (...) disease patients underwent bilateral DBS implantation in the subthalamic nucleus at our center. First, the DBS’ leads were reconstructed with the open-source toolbox Lead-DBS. Second, a sweet spot for rigidity reduction was set as the desired stimulation target for programming. This sweet spot and estimations of the volume of tissue activated were used to suggest (i) the best lead level, (ii) the best contact, and (iii) the effect thresholds for full therapeutic effect for each contact. To assess these sweet spot-guided suggestions, the clinical monopolar reviews were considered as ground truth. In addition, the sweet spot-guided suggestions for best lead level and best contact were compared against reconstruction-guided suggestions, which considered the lead location with respect to the subthalamic nucleus. Finally, a graphical user interface was developed as an add-on to Lead-DBS and is publicly available. With the interface, suggestions for all contacts of a lead can be generated in a few seconds. The accuracy for suggesting the best out of four lead levels was 56%. These sweet spot-guided suggestions were not significantly better than reconstruction-guided suggestions (p = 0.3). The accuracy for suggesting the best out of eight contacts was 41%. These sweet spot-guided suggestions were significantly better than reconstruction-guided suggestions (p < 0.001). The sweet spot-guided suggestions of each contact’s effect threshold had a mean error of 1.2 mA. On an individual lead level, the suggestions can vary more with mean errors ranging from 0.3 to 4.8 mA. Further analysis is warranted to improve the sweet spot-guided suggestions and to account for more symptoms and stimulation-induced side effects. (shrink)

The aim of this study is to look at the the syntactic calculus of Bar-Hillel and Lambek, including semantic interpretation, from the point of view of constructive type theory. The syntactic calculus is given a formalization that makes it possible to implement it in a type-theoretical proof editor. Such an implementation combines formal syntax and formal semantics, and makes the type-theoretical tools of automatic and interactive reasoning available in grammar.In the formalization, the use of the dependent types of constructive (...) type theory is essential. Dependent types are already needed in the semantics of ordinary Lambek calculus. But they also suggest some natural extensions of the calculus, which are applied to the treatment of morphosyntactic dependencies and to an analysis of selectional restrictions. Finally, directed dependent function types are introduced, corresponding to the types of constructive type theory. (shrink)

How is it possible that beginning from the negation of rational thoughts one comes to produce knowledge? This problem, besides its intrinsic interest, acquires a great relevance when the representation of a knowledge is settled, for example, on data and automatic reasoning. Many treatment ways have been tried, as in the case of the non-monotonic logics; logics that intend to formalize an idea of reasoning by default, etc. These attempts are incomplete and are subject to failure. A possible (...) solution would be to formulate a logic of the irrational, which offers a model for reasoning permitting to support contradictions as well as to produce knowledge from such situations. An intuition underlying the foundation of such a logic consists of the da Costa's paraconsistent logics presenting however, a different deduction theory and a whole distinct semantics, called here "the semantics of possible translations". The present proposing, following our argumentation, intends to enlight all this question, by a whole satisfactory logical point of view, being practically applicable and philosophically acceptable.Como é possível que a partir da negação do racional se possa obter conhecimento adicional? Esse problema, além de seu interesse intrínseco, adquire uma relevância adicional quando o encontramos na representação do conhecimento em bases de dados e raciocínio automático, por exemplo. Nesse caso, diversas tentativas de tratamento têm sido propostas, como as lógicas não-monotônicas, as lógicas que tentam formalizar a ideia do raciocínio por falha. Tais tentativas de solução, porém, são falhas e incompletas; proponho que uma solução possível seria formular uma lógica do irracional, que oferecesse um modelo para o raciocínio permitindo não só suportar contradições, como conseguir obter conhecimento, a partir de tais situações. A intuição subjacente à formulação de tal lógica são as lógicas paraconsistentes de da Costa, mas com uma teoria da dedução diferente e uma semântica completamente distinta. Tal proposta, como pretendo argumentar, fornece um enfoque para a questão que é ao mesmo tempo completamente satisfatório, aplicável do ponto de vista prático e aceitável do ponto de vista filosófico. (shrink)