Trafficking and persistence of fetal microchimeric cells (fMCs) and circulating extracellular vesicles (EVs) have been observed in animals and humans, but their consequences in the maternal body and their mechanistic contributions to maternal physiology and pathophysiology are not yet fully defined. Fetal cells and EVs may help remodel maternal organs after pregnancy‐associated changes, but the cell types and EV cargos reaching the mother in preterm pregnancies after exposure to various risk factors can be distinct from term pregnancies. As preterm delivery‐associated (...) maternal complications are rising, revisiting this topic and formulating scientific questions for future research to reduce the risk of maternal morbidities are timely. Epidemiological studies report maternal cardiovascular risk as one of the major complications after preterm delivery. This paper suggests a potential link between fMCs and circulating EVs and adverse maternal cardiovascular outcomes post‐pregnancies, the underlying mechanisms, consequences, and methods for and how this link might be assessed. (shrink)

Generalisation, universal knowledge claims, and recommendations within disaster studies are problematic because they lead to miscommunication and the misapplication of actionable knowledge. The consequences and impacts thereof are not often considered by experts; forgone as irrelevant to the academic division of labour. There is a disconnect between expert assertions for disaster risk reduction (DRR) and their practical suitability for laypersons. Experts currently assert independently of the context within which protective action measures (PAMs) are to be used, measures unconnected to the (...) people for whom they are developed. This has knock-on effects for DRR: much expert-generated science and policy remains unused, unimplemented, and sometimes misapplied. I use philosophical accounts of assertion and epistemic blame to highlight the epistemic relationship between experts and laypersons. This relationship includes responsibilities and agreements between epistemic agents. Since multilevel DRR knowledge still transfers top-down from experts to laypersons, if experts impair the epistemic relationship, they can be held epistemically blameworthy. To address the pervasiveness of top-down systems, I analyse the epistemic framings and narratives currently shaping DRR, and more specifically PAMs and campaigns. I deconstruct universal perspectives that dominate the epistemic processes of generating, disseminating, and implementing DRR knowledge and specifically for co-seismic landslide PAMs for Nepal. I argue for more inclusive, contextual, and epistemically responsible DRR. Co-production of knowledge should begin from the standpoints of marginalised persons who may have an epistemic advantage due to their socio-politically marginalised positions. Often these epistemic contributions are left out of DRR efforts because marginalised persons are rarely afforded equal, if any, epistemic agency, which results in epistemic gaps and a large pool of relevant knowledge remaining unincorporated and unused in DRR research and policy. (shrink)

Robustness arguments hold that hypotheses are more likely to be true when they are confirmed by diverse kinds of evidence. Robustness arguments require the confirming evidence to be independent. We identify two kinds of independence appealed to in robustness arguments: ontic independence —when the multiple lines of evidence depend on different materials, assumptions, or theories—and probabilistic independence. Many assume that OI is sufficient for a robustness argument to be warranted. However, we argue that, as typically construed, OI is not a (...) sufficient independence condition for warranting robustness arguments. We show that OI evidence can collectively confirm a hypothesis to a lower degree than individual lines of evidence, contrary to the standard assumption undergirding usual robustness arguments. We employ Bayesian networks to represent the ideal empirical scenario for a robustness argument and a variety of ways in which empirical scenarios can fall short of this ideal. (shrink)

For Knox, ‘spacetime’ is to be defined functionally, as that which picks out a structure of local inertial frames. Assuming that Knox is motivated to construct this functional definition of spacetime on the grounds that it appears to identify that structure which plays theoperationalrole of spacetime—i.e., that structure which is actually surveyed by physical rods and clocks built from matter fields—we identify in this paper important limitations of her approach: these limitations are based upon the fact that there is a (...) gap between inertial frame structure and that which is operationally significant in the above sense. We present five concrete cases in which these two notions come apart, before considering various ways in which Knox’s spacetime functionalism might be amended in light of these issues. (shrink)

The value-free ideal for science holds that values should not influence the core features of scientific reasoning. We defend the difference-to-inference model of value-permeation, which holds that value-permeation in science is problematic when values make a difference to the inferences made about a hypothesis. This view of value-permeation is superior to existing views, and it suggests a corresponding maxim—namely, that scientists should strive to eliminate differences to inference. This maxim is the basis of a novel value-free ideal for science. -/- (...) . (shrink)

Most of the large-scale violence in the world will continue to occur within societies rather than between or among states. Yet the international community still has not developed the ethical-legal consensus or the institutions required to manage this terrible problem.

Noncommutative geometries generalize standard smooth geometries, parametrizing the noncommutativity of dimensions with a fundamental quantity with the dimensions of area. The question arises then of whether the concept of a region smaller than the scale—and ultimately the concept of a point—makes sense in such a theory. We argue that it does not, in two interrelated ways. In the context of Connes’ spectral triple approach, we show that arbitrarily small regions are not definable in the formal sense. While in the scalar (...) field Moyal–Weyl approach, we show that they cannot be given an operational definition. We conclude that points do not exist in such geometries. We therefore investigate (a) the metaphysics of such a geometry, and (b) how the appearance of smooth manifold might be recovered as an approximation to a fundamental noncommutative geometry. (shrink)

The value-free ideal in science has been criticised as both unattainable and undesirable. We argue that it can be defended as a practical principle guiding scientific research even if the unattainability and undesirability of a value-free end-state are granted. If a goal is unattainable, then one can separate the desirability of accomplishing the goal from the desirability of pursuing it. We articulate a novel value-free ideal, which holds that scientists should act as if science should be value-free, and we argue (...) that even if a purely value-free science is undesirable, this value-free ideal is desirable to pursue. (shrink)

Phase transitions are an important instance of putatively emergent behavior. Unlike many things claimed emergent by philosophers, the alleged emergence of phase transitions stems from both philosophical and scientific arguments. Here we focus on the case for emergence built from physics, in particular, arguments based upon the infinite idealization invoked in the statistical mechanical treatment of phase transitions. After teasing apart several challenges, we defend the idea that phase transitions are best thought of as conceptually novel, but not ontologically or (...) explanatorily irreducible to finite physics; indeed, by looking at ongoing work on “smooth phase transitions” we even suggest that they’re not even conceptually novel. In the case of renormalization group theory, consideration of infinite systems and their singular behavior provides a central theoretical tool, but this is compatible with an explanatory reduction. Phase transitions may be “emergent” in some sense of this protean term, but not in a sense that is incompatible with the reductionist project broadly construed. (shrink)

“At-own-risk discharges” or “self-discharges” evidences an irretrievable breakdown in the patient–clinician relationship when patients leave care facilities before completion of medical treatment and against medical advice. Dissolution of the therapeutic relationship terminates the physician’s duty of care and professional liability with respect to care of the patient. Acquiescence of an at-own-risk discharge by the clinician is seen as respecting patient autonomy. The validity of such requests pivot on the assumptions that the patient is fully informed and competent to invoke an (...) at-own-risk discharge and that care up to the point of the at-own-risk discharge meets prevailing clinical standards. Palliative care’s use of a multidisciplinary team approach challenges both these assumptions. First by establishing multiple independent therapeutic relations between professionals in the multidisciplinary team and the patient who persists despite an at-own-risk discharge. These enduring therapeutic relationships negate the suggestion that no duty of care is owed the patient. Second, the continued employ of collusion, familial determinations, and the circumnavigation of direct patient involvement in family-centric societies compromises the patient’s decision-making capacity and raises questions as to the patient’s decision-making capacity and their ability to assume responsibility for the repercussions of invoking an at-own-risk discharge. With the validity of at-own-risk discharge request in question and the welfare and patient interest at stake, an alternative approach to assessing at-own-risk discharge requests are called for. The welfare model circumnavigates these concerns and preserves the patient’s welfare through the employ of a multidisciplinary team guided holistic appraisal of the patient’s specific situation that is informed by clinical and institutional standards and evidenced-based practice. The welfare model provides a robust decision-making framework for assessing the validity of at-own-risk discharge requests on a case-by-case basis. (shrink)

For decades, health information has been collected and shared for health care delivery and public health purposes. While the “primary use” of patient data for providing direct health care services is the cornerstone of health care practice, health departments rely on data sharing for research and analysis to support disease prevention and health promotion in the population. As the U.S. health system undergoes a digital revolution, health information that was previously captured in paper form now can be captured electronically. Electronic (...) health information has transformed the efficiency, capacity, and functions of the U.S. health system. For this reason, there is increased attention to the “secondary use” of electronic patient data for public health uses, including disease reporting and investigation, syndromic surveillance, and patient-specific or population-level communications about health conditions and their associated risk factors. Secondary uses may also encompass clinical research, licensure, and payment for services. (shrink)

For Knox, ‘spacetime’ is to be defined functionally, as that which picks out a structure of local inertial frames. Assuming that Knox is motivated to construct this functional definition of spacetime on the grounds that it appears to identify that structure which plays the operational role of spacetime—i.e., that structure which is actually surveyed by physical rods and clocks built from matter fields—we identify in this paper important limitations of her approach: these limitations are based upon the fact that there (...) is a gap between inertial frame structure and that which is operationally significant in the above sense. We present five concrete cases in which these two notions come apart, before considering various ways in which Knox’s spacetime functionalism might be amended in light of these issues. (shrink)

Brown and Pooley’s ‘dynamical approach’ to physical theories asserts, in opposition to the orthodox position on physical geometry, that facts about physical geometry are grounded in, or explained by, facts about dynamical fields, not the other way round. John Norton has claimed that the proponent of the dynamical approach is illicitly committed to spatiotemporal presumptions in ‘constructing’ space-time from facts about dynamical symmetries. In this article, I present an abstract, algebraic formulation of field theories and demonstrate that the proponent of (...) the dynamical approach is not committed, in special relativity, to the illicit presumptions to which Norton refers. (shrink)

Supersymmetry (SUSY) is a proposed symmetry between bosons and fermions. The structure of the space of SUSY generators is such that the distinction between internal and spacetime symmetries is blurred. As a result, there are two viable candidates for the correct spacetime setting for a flat supersymmetric field theory---Minkowski spacetime and superspace. an extension of four- dimensional Minkowski spacetime to include (at least) four new dimensions, coordinatised by mathematical objects known as supernumbers. These objects are, in one significant way, quite (...) different from real or complex number---some of them have the property that their order of multiplication makes a difference; in mathematical terms, they are said to have nontrivial commutation properties. This paper argues for two theses: first, that one standard set of arguments, related to universality of symmetry behaviour, that motivate a particular choice of spacetime structure in familiar spacetime theories motivates the choice of superspace as the appropriate spacetime for SUSY field theories. And second, that the metaphysical utility of the concept of spacetime requires more than just the satisfaction of this universality condition; in supersymmetric theories, the spacetime concept is not as useful as in special relativity. (shrink)

Recent work in the physics literature demonstrates that, in particular classes of rotating spacetimes, physical light rays in general do not traverse null geodesics. Having presented this result, we discuss its philosophical significance, both for the clock hypothesis, and for the operational meaning of the metric field.

If we cannot directly empirically test the claims of particular scientific theory, then it would be nice to have some other criteria with which to assess its viability. In his 2013 book, String Theory and the Scientific Method, Richard Dawid aims to develop such criteria, with an eye to vindicating research programs in disciplines where direct empirical data is scant or non-existent. In an accompanying paper, Dawid, Hartmann and Sprenger formalise Dawid’s so-called ‘No Alternatives Argument’ using a generalised Bayesian framework, (...) as a first step towards formalising Dawid’s entire re- search programme. In this paper, I argue that the formalisation of the NAA cannot play the central role in Dawid’s programme as intended. This is based on the observation that not all confirmation is non-negligible confirmation. For Dawid’s programme to be useful, it must demonstrate the viability not just of non-empirical theory confirmation, but of non-negligible non-empirical theory confirmation. I argue that Dawid et al.’s appeal to Bayesian confirmation theory to formalise his NAA cannot guarantee non-negligible confirmation. As a result, I conclude that if Dawid’s overall project is to succeed, it must do so without the NAA formalised in this way. (shrink)

Therapeutic privilege is a defence that may be available to doctors who fail to disclose to the patient relevant information when seeking informed consent for treatment if they have a reasonable belief that providing that information would likely cause the patient concerned serious physical or mental harm. In a landmark judgement, the Singapore Court of Appeal introduced a novel interpretation of TP, identifying circumstances in which it might be used with patients who did not strictly lack capacity but might be (...) inclined to refuse recommended treatments. In this paper, we explore the conceptual and practical challenges of this novel interpretation of TP. We propose that more emphasis should be placed on forms of shared and supported decision-making that foster the autonomy of patients with compromised mental capacity while being mindful of the need to safeguard their well-being. The kind of privilege that doctors might need to invoke is one of time and supportive expertise to ensure a flexible, responsive approach calibrated to the individual patients’ needs. The provision of such service would extinguish the need for the novel TP proposed by the Singapore Court of Appeal. (shrink)

Beginning with Einstein's special and general theories of relativity, the authors give a detailed mathematical description of fundamental astrophysical radiation processes, including Compton scattering of electrons and photons, synchrotron radiation of particles in magnetic fields, and much more.

The American Journal of Bioethics, Volume 12, Issue 7, Page 53-54, July 2012.

Phase transitions are an important instance of putatively emergent behavior. Unlike many things claimed emergent by philosophers (e.g., tables and chairs), the alleged emergence of phase transitions stems from both philosophical and scientific arguments. Here we focus on the case for emergence built from physics, in particular, arguments based upon the infinite idealization invoked in the statistical mechanical treatment of phase transitions. After teasing apart several challenges, we defend the idea that phase transitions are best thought of as conceptually novel, (...) but not ontologically or explanatorily irreducible to finite physics; indeed, by looking at ongoing work on “smooth phase transitions” we even suggest that they’re not even conceptually novel. In the case of renormalization group theory, consideration of infinite systems and their singular behavior provides a central theoretical tool, but this is compatible with an explanatory reduction. Phase transitions may be “emergent” in some sense of this protean term, but not in a sense that is incompatible with the reductionist project broadly construed. (shrink)

Purpose Digital transformation leverages digital technologies to change current processes and introduce new processes in any organisation’s business model, customer/user experience and operational processes. Artificial intelligence plays a significant role in achieving DT. As DT is touching each sphere of humanity, AI led DT is raising many fundamental questions. These questions raise concerns for the systems deployed, how they should behave, what risks they carry, the monitoring and evaluation control we have in hand, etc. These issues call for the need (...) to integrate ethics in AI led DT. The purpose of this study is to develop an “AI led ethical digital transformation framework”. Design/methodology/approach Based on the literature survey, various existing business ethics decision-making models were synthesised. The authors mapped essential characteristics such as intensity and the individual, organisational and opportunity factors of ethics models with the proposed AI led ethical DT. The DT framework is evaluated using a thematic analysis of 23 expert interviews with relevant AI ethics personas from industry and society. The qualitative data of the interviews and opinion data has been analysed using MAXQDA software. Findings The authors have explored how AI can drive the ethical DT framework and have identified the core constituents of developing an AI led ethical DT framework. Backed by established ethical theories, the paper presents how DT pillars are related and sequenced to ethical factors. This research provides the potential to examine theoretically sequenced ethical factors with practical DT pillars. Originality/value The study establishes deduced and induced ethical value codes based on thematic analysis to develop guidelines for the pursuit of ethical DT. The authors identify four unique induced themes, namely, corporate social responsibility, perceived value, standard benchmarking and learning willingness. The comprehensive findings of this research, supported by a robust theoretical background, have substantial implications for academic research and corporate applicability. The proposed AI led ethical DT framework is unique and can be used for integrated social, technological and economic ethical research. (shrink)

Family involvement in healthcare decision-making for competent patients occurs to varying degrees in many communities around the world. There are different attitudes about who should make treatment decisions, how and why. Legal and professional ethics codes in most jurisdictions reflect and support the idea that competent patients should be enabled to make their own treatment decisions, even if others, including their healthcare professionals, disagree with them. This way of thinking contrasts with some cultural norms that put more emphasis on the (...) family as a decision-making entity, in some circumstances to the exclusion of a competent patient. Possible tensions may arise between various combinations of patient, family members and healthcare professionals, and healthcare professionals must tread a careful path in navigating family involvement in the decision-making process. These tensions may be about differences of opinion about which treatment option is best and/or on who should have a say or influence in the decision-making process. While some relevant cultural, legal and policy considerations vary from community to community, there are ethical issues that healthcare professionals need to grapple with in balancing the laws and professional codes on decision-making and the ethical principle of respecting patients and their autonomy. This paper will highlight and propose that a partial resolution to these issues may lie in relational understandings of autonomy, which in principle justify interventions by healthcare professionals and family that support patients in decision-making. (shrink)

Recent work in the physics literature demonstrates that, in particular classes of rotating spacetimes, physical light rays in general do not traverse null geodesics. Having presented this result, we discuss its philosophical significance, both for the clock hypothesis (and, in particular, a recent purported proof thereof for light clocks), and for the operational meaning of the metric field. 1Introduction 2Fletcher's Theorem 2.1Maudlin on the clock hypothesis in special relativity 2.2Fletcher’s result in special relativity 2.3Fletcher’s theorem in general relativity 3Electromagnetism and (...) the Geometrical-Optical Limit 3.1Maxwell’s equations in curved spacetime 3.2The geometrical-optical limit 3.3Rotating spacetimes 3.4Aren’t Gödel spacetimes unphysical? 4The Clock Hypothesis and Chronogeometry 4.1Natural and mathematical observations 4.2Clock registry discord 4.3Chronogeometry 5Conclusion. (shrink)

This volume brings together the primary challenges for 21st century cognitive sciences and cultural neuroscience in responding to the nature of human identity, self, and evolution of life itself. Through chapters devoted to intricate but focused models, empirical findings, theories, and experiential data, the contributors reflect upon the most exciting possibilities, and debate upon the fundamental aspects of consciousness and self in the context of cultural, philosophical, and multidisciplinary divergences and convergences. Such an understanding and the ensuing insights lie in (...) the cusp of philosophy, neurosciences, psychiatry, and medical humanities. In this volume, the editors and contributors explore the foundations of human thinking and being and discuss both evolutionary/cultural embeddedness, and the self-orientation, of consciousness, keeping in mind questions that bring in the interdisciplinary complexity of issues such as the emergence of consciousness, relation between healing and agency, models of altered self, how cognition impacts the social self, experiential primacy as the hallmark of consciousness, and alternate epistemologies to understand these interdisciplinary puzzles. (shrink)

In a recent article, Halvorson and Manchak (Br J Philos Sci, Forthcoming) claim that there is no basis for the Hole Argument, because (in a certain sense) hole isometries are unique. This raises two important questions: (a) does their argument succeed?; (b) how does this formalist response to the Hole Argument relate to other recent responses to the Hole Argument in the same tradition—in particular, that of Weatherall (Br J Philos Sci 69(2):329–350, 2018)? In this article, _ad_ (a), we argue (...) that Halvorson and Manchak’s claim does not go through; _ad_ (b), we argue that although one _prima facie_ plausible reading would see Halvorson and Manchak as filling an important hole (no pun intended) in Weatherall’s argument, in fact this reading is implausible; there is no need to supplement Weatherall’s work with Halvorson and Manchak’s results. (shrink)

“At-own-risk discharges” or “self-discharges” evidences an irretrievable breakdown in the patient–clinician relationship when patients leave care facilities before completion of medical treatment and against medical advice. Dissolution of the therapeutic relationship terminates the physician’s duty of care and professional liability with respect to care of the patient. Acquiescence of an at-own-risk discharge by the clinician is seen as respecting patient autonomy. The validity of such requests pivot on the assumptions that the patient is fully informed and competent to invoke an (...) at-own-risk discharge and that care up to the point of the at-own-risk discharge meets prevailing clinical standards. Palliative care’s use of a multidisciplinary team approach challenges both these assumptions. First by establishing multiple independent therapeutic relations between professionals in the multidisciplinary team and the patient who persists despite an at-own-risk discharge. These enduring therapeutic relationships negate the suggestion that no duty of care is owed the patient. Second, the continued employ of collusion, familial determinations, and the circumnavigation of direct patient involvement in family-centric societies compromises the patient’s decision-making capacity and raises questions as to the patient’s decision-making capacity and their ability to assume responsibility for the repercussions of invoking an at-own-risk discharge. With the validity of at-own-risk discharge request in question and the welfare and patient interest at stake, an alternative approach to assessing at-own-risk discharge requests are called for. The welfare model circumnavigates these concerns and preserves the patient’s welfare through the employ of a multidisciplinary team guided holistic appraisal of the patient’s specific situation that is informed by clinical and institutional standards and evidenced-based practice. The welfare model provides a robust decision-making framework for assessing the validity of at-own-risk discharge requests on a case-by-case basis. (shrink)

This article tracks the journeys made by the term ‘gender’ in India. From its beginnings in the 1970s as a feminist contribution to public discourse, destabilizing the biological category of ‘sex’, we find that gender has taken two distinct forms since the 1990s. On the one hand, gender as an analytical category is being used to challenge the notion of ‘woman’ as the subject of feminist politics. This challenge comes from the politics of caste and sexuality. On the other hand, (...) gender is mobilized by the state to perform a role in discourses of development, to achieve exactly the opposite effect; that is, gender becomes a synonym for ‘women’. Thus, the first trend threatens to dissolve, and the second to domesticate, the subject of feminist politics. This article explores the implications of both journeys in terms of a feminist horizon. (shrink)

In current trends in cognitive sciences, the discussion on body crosses the classical divide between the body and the self in terms of nature and function. Embodiment theories have helped to bring in the importance of the role of subjective experiences to understand cognition, and place the process of knowing in a cultural and social context. This article is a critique of the growing trend in cognitive sciences, particularly in affective neurosciences, and approaches, to reduce the experiential self to a (...) nonentity. It is shown that though the apparent goal is to highlight the inner qualitative nature of experience, what is happening in the background is a role reversal. The outer body becomes the inner self. The inner self becomes the outer body. The nature and functions of the self are founded on the body by theorizing embodiment as an alternate to neural reductionism. This article argues that one of the negative consequences of embodiment theories is that age-old concepts of freewill, character and moral choices become flimsy and fleeting in the process of embodying cognition. (shrink)

This book discusses consciousness from the perspectives of neuroscience, neuropsychiatry and philosophy. The author argues that the central issue in brain studies is to explain the unity, continuity, and adherence of experience, whether it is sensory or mental awareness, phenomenal- or self-consciousness. The fascinating discussion that this book presents is: How do the brain and the self create the conspiracy of experience where the physicality of the brain is lost in the subjectivity of the self?

Objective To document the legal guardian-related barriers to consent procurement, and their stated reasons for non-participation in a paediatric critical care research study.Study design A multicentre, prospective, cohort study.Participants Legal guardians of children who participated in a multicentre study on adrenal insufficiency in paediatric critical illness. Data were collected on all consent encounters in the main study.Methods Screening data, reasons for consent not being obtained, paediatric risk of mortality scores and age were collected on all 1707 patients eligible for participation (...) in the Adrenal Insufficiency Study.Results The main barriers to approaching legal guardians for consent were lack of availability of the legal guardians and language barriers . Legal guardians of 917 patients were approached with an overall consent rate of 42% . 81% of the 528 legal guardians who declined consent provided an unsolicited reason for refusal. The three most commonly stated reasons were: being overwhelmed , not wanting anything else done to their child and not wanting an additional medication . In addition, 14.2% cited research-related concerns as the reason for their non-participation.Conclusions Barriers to consent procurement in a non-therapeutic paediatric critical care study appear to occur at many levels with lack of availability of legal guardians, and legal guardians feeling overwhelmed, being the most commonly recorded reasons. Further research into the impact of these findings on the validity and generalisability of the results of such studies is necessary prior to the development and study of future consent models. (shrink)