Due to improvements in medicine, the figures of patients with disorders of consciousness (DoC) are increasing. Diagnostics of DoC and prognostication of rehabilitation outcome is challenging but necessary to evaluate recovery potential and to decide on treatment options. Such decisions should be made by doctors and patients’ surrogates based on medico-ethical principles. Meeting information needs and communicating effectively with caregivers as the patients´ most common surrogate-decision makers is crucial, and challenging when novel tech-nologies are introduced. This qualitative study aims to (...) explore information needs of informal DoC caregivers, how they manage the obtained information and their perceptions and experiences with caregiver-physician communication in facilities that implemented innovative neurodiagnostics studies. In 2021, we conducted semi-structured interviews with nine caregivers of clinically stable DoC patients in two rehabilitation centers in Italy and Germany. Participants were selected based on consecutive purposeful sampling. Caregivers were recruited at the facilities after written informed consent. All interviews were recorded, transcribed verbatim and translated. For analysis, we used reflexive thematic analysis according to Braun & Clarke (2006). Caregivers experienced the conversations emotionally, generally based on the value of the information provided. They reported to seek positive information, comfort and empathy with-in the communication of results of examinations. They needed detailed information to gain a deep understanding and a clear picture of their loved-one’s condition. The results suggest a mismatch between the perspectives of caregivers and the perspectives of medical profession-als, and stress the need for more elaborate approaches to the communication of results of neu-rodiagnostics studies. (shrink)

We introduce a novel modal logic, namely the doxastic μ-calculus with error control (DμCEC), and propose a formalization of probabilistic anonymity and oblivious transfer in the logic, and the validation of these formalizations on implementations formalized in probabilistic CCS. The distinguishing feature of our logic is to provide a combination of dynamic operators for belief (whence the attribute “doxastic”) with a control on the possible error of apprehension of the perceived reality, and for internalized probability. Both operators are dynamic (non-monotonic) (...) thanks to the possibility of combining them with temporal operators, and are parameterized with a lower and upper probability bound (the error control). (shrink)

Artificial intelligence is currently changing many areas of society. Especially in health, where critical decisions are made, questions of control must be renegotiated: who is in control when an automated system makes clinically relevant decisions? Increasingly, the concept of meaningful human control (MHC) is being invoked for this purpose. However, it is unclear exactly how this concept is to be understood in health. Through a systematic review, we present the current state of the concept of MHC in health. The results (...) show that there is not yet a robust MHC concept for health. We propose a broader understanding of MHC along three strands of action: enabling, exercising and evaluating control. Taking into account these strands of action and the established rules and processes in the different health sectors, the MHC concept needs to be further developed to avoid falling into two gaps, which we have described as theoretical and labelling gaps. (shrink)

Can the evidence provided by software systems meet the standard of proof for civil or criminal cases, and is it individualized evidence? Or, to the contrary, do software systems exclusively provide bare statistical evidence? In this paper, we argue that there are cases in which evidence in the form of probabilities computed by software systems is not bare statistical evidence, and is thus able to meet the standard of proof. First, based on the case of State v. Loomis, we investigate (...) recidivism predictions provided by software systems used in the courtroom. Here, we raise problems for software systems that provide predictions that are based on bare statistical evidence. Second, by examining the case of People v. Chubbs, we argue that the statistical evidence provided by software systems in cold hit DNA cases may in some cases suffice for individualized evidence, on a view on which individualized evidence is evidence that normically supports the relevant proposition (Smith, in Mind 127:1193–1218, 2018). (shrink)

With regard to current debates on the ethical implementation of AI, especially two demands are linked: the call for explainability and for ultimate human responsibility. In the medical field, both are condensed into the role of one person: It is the physician to whom AI output should be explainable and who should thus bear ultimate responsibility for diagnostic or treatment decisions that are based on such AI output. In this article, we argue that a black box AI indeed creates a (...) rationally irresolvable epistemic situation for the physician involved. Specifically, strange errors that are occasionally made by AI sometimes detach its output from human reasoning. Within this article it is further argued that such an epistemic situation is problematic in the context of ultimate human responsibility. Since said strange errors limit the promises of explainability and the concept of explainability frequently appears irrelevant or insignificant when applied to a diverse set of medical applications, we deem it worthwhile to reconsider the call for ultimate human responsibility. (shrink)

Quantum set theory and topos quantum theory are two long running projects in the mathematical foundations of quantum mechanics that share a great deal of conceptual and technical affinity. Most pertinently, both approaches attempt to resolve some of the conceptual difficulties surrounding QM by reformulating parts of the theory inside of nonclassical mathematical universes, albeit with very different internal logics. We call such mathematical universes, together with those mathematical and logical structures within them that are pertinent to the physical interpretation, (...) ‘Q-worlds’. Here, we provide a unifying framework that allows us to better understand the relationship between different Q-worlds, and define a general method for transferring concepts and results between TQT and QST, thereby significantly increasing the expressive power of both approaches. Along the way, we develop a novel connection to paraconsistent logic and introduce a new class of structures that have significant implications for recent work on paraconsistent set theory. (shrink)

Neuroscience is a multidisciplinary effort to understand the structures and functions of the brain and brain-mind relations. This effort results in an increasing amount of data, generated by sophisticated technologies. However, these data enhance our descriptive knowledge, rather than improve our understanding of brain functions. This is caused by methodological gaps both within and between subdisciplines constituting neuroscience, and the atomistic approach that limits the study of macro- and mesoscopic issues. Whole-brain measurement technologies do not resolve these issues, but rather (...) aggravate them by the complexity problem. The present article is devoted to methodological and epistemic problems that obstruct the development of human neuroscience. We neither discuss ontological questions nor review data, except when it is necessary to demonstrate a methodological issue. As regards intradisciplinary methodological problems, we concentrate on those within neurobiology and psychology. As regards interdisciplinary problems, we suggest that core disciplines of neuroscience can be integrated using systemic concepts that also entail human-environment relations. We emphasize the necessity of a meta-discussion that should entail a closer cooperation with philosophy as a discipline of systematic reflection. The atomistic reduction should be complemented by the explicit consideration of the embodiedness of the brain and the embeddedness of humans. The discussion is aimed at the development of an explicit methodology of integrative human neuroscience, which will not only link different fields and levels, but also help in understanding clinical phenomena. (shrink)

Institutional suggestions for how to rethink democracy in response to changing state responsibilities and capabilities have been numerous and often mutually incompatible. This suggests that conceptual unclarity still reigns concerning how the normative ideal of democracy as collective self-determination, i.e. ?rule by the people?, might best be brought to bear in a transnational and global context. The aim in this paper is twofold. First, it analyses some consequences of the tendency to smudge the distinction between democratic theory and moral theories (...) of legitimacy and justice. Second, it develops a conceptual framework that distinguishes between necessary conditions, aspects and aims of democracy. On this basis it specifies three objectives of democracy, some of which may also hold for multilevel governance. It is argued that there are in principle at least three reasons to value democratic institutions: they are intrinsically justified to the extent that they distribute fair shares of political influence over decision-making; they are instrumentally justified to the extent that they secure several of our other best interests, one of which is our interest in non-domination; and finally, they are also instrumentally justified insofar as they secure the just distribution of other goods. The aim of this framework is not to develop a specific theory of multilevel governance but to point at important distinctions to be made and normative criteria to be specified. The intention is to take the debate forward by noting some of the issues that any satisfactory account must address. The framework lays out the grounds for analysing the institutional challenges facing legitimate multilevel governance through what is speculatively called ?multiple citizenship?, understood in explorative terms, opening the door for the manifold roles that citizens could and ought to play in multilevel governance, not only as democratic agents, but also as agents of democracy and agents of justice. (shrink)

We present the first systematic literature review on stress and burnout in K−12 teachers during the COVID-19 pandemic. Based on a systematic literature search, we identified 17 studies that included 9,874 K−12 teachers from around the world. These studies showed some indication that burnout did increase during the COVID-19 pandemic. There were, however, almost no differences in the levels of stress and burnout experienced by K−12 teachers compared to individuals employed in other occupational fields. School principals' leadership styles emerged as (...) an organizational characteristic that is highly relevant for K−12 teachers' levels of stress and burnout. Individual teacher characteristics associated with burnout were K−12 teachers' personality, self-efficacy in online teaching, and perceived vulnerability to COVID-19. In order to reduce stress, there was an indication that stress-management training in combination with training in technology use for teaching may be superior to stress-management training alone. Future research needs to adopt more longitudinal designs and examine the interplay between individual and organizational characteristics in the development of teacher stress and burnout during the COVID-19 pandemic and beyond. (shrink)

As systems based on opaque Artificial Intelligence (AI) continue to flourish in diverse real-world applications, understanding these black box models has become paramount. In response, Explainable AI (XAI) has emerged as a field of research with practical and ethical benefits across various domains. This paper not only highlights the advancements in XAI and its application in real-world scenarios but also addresses the ongoing challenges within XAI, emphasizing the need for broader perspectives and collaborative efforts. We bring together experts from diverse (...) fields to identify open problems, striving to synchronize research agendas and accelerate XAI in practical applications. By fostering collaborative discussion and interdisciplinary cooperation, we aim to propel XAI forward, contributing to its continued success. Our goal is to put forward a comprehensive proposal for advancing XAI. To achieve this goal, we present a manifesto of 27 open problems categorized into nine categories. These challenges encapsulate the complexities and nuances of XAI and offer a road map for future research. For each problem, we provide promising research directions in the hope of harnessing the collective intelligence of interested stakeholders. (shrink)

In today’s world, Artificial Intelligence plays a central role in many decision-making processes. However, its use can lead to structural and epistemic injustices—especially in the context of healt...

Between-subject variability in cognitive performance has been related to inter-individual differences in functional brain networks. Targeting the dorsal attention network we questioned whether resting-state functional connectivity within the DAN can predict individual performance in spatial attention tasks and whether there is short-term adaptation of DAN-FC in response to task engagement. Twenty-seven participants first underwent resting-state fMRI, they subsequently performed different tasks of spatial attention [including visual search ] and immediately afterwards received another rs-fMRI. Intra- and inter-hemispheric FC between core hubs (...) of the DAN, bilateral intraparietal sulcus and frontal eye field, was analyzed and compared between PRE and POST. Furthermore, we investigated rs-fMRI-behavior correlations between the DAN-FC in PRE/POST and task performance parameters. The absolute DAN-FC did not change from PRE to POST. However, different significant rs-fMRI-behavior correlations were revealed for intra-/inter-hemispheric connections in the PRE and POST run. The stronger the FC between left FEF and IPS before task engagement, the better was the learning effect in VS. And the faster the VS, the stronger was the FC between right FEF and IPS after task engagement. To conclude, DAN-FC relates to the individual performance in spatial attention tasks supporting the view of functional brain networks as priors for cognitive ability. Despite a high inter- and intra-individual stability of DAN-FC, the change of FC-behavior correlations after task performance possibly indicates task-related adaptation of the DAN, underlining that behavioral experiences may shape intrinsic brain activity. However, spontaneous state fluctuations of the DAN-FC over time cannot be fully ruled out as an alternative explanation. (shrink)

BackgroundCurrently, intensive care medicine strives to define a generally accepted way of dealing with end-of-life decisions, therapy limitation and therapy discontinuation.In 2006 a new advance directive legislation was enacted in Austria. Patients may now document their personal views regarding extension of treatment. The aim of this survey was to explore Austrian intensive care physicians' experiences with and their acceptance of the new advance directive legislation two years after enactment (2008).MethodsUnder the aegis of the OEGARI (Austrian Society of Anaesthesiology, Resuscitation and (...) Intensive Care) an anonymised questionnaire was sent to the medical directors of all intensive care units in Austria. The questions focused on the physicians' experiences regarding advance directives and their level of knowledge about the underlying legislation.ResultsThere were 241 questionnaires sent and 139 were turned, which was a response rate of 58%. About one third of the responders reported having had no experience with advance directives and only 9 directors of intensive care units had dealt with more than 10 advance directives in the previous two years. Life-supporting measures, resuscitation, and mechanical ventilation were the predominantly refused therapies, wishes were mainly expressed concerning pain therapy.ConclusionA response rate of almost 60% proves the great interest of intensive care professionals in making patient-oriented end-of-life decisions. However, as long as patients do not make use of their right of co-determination, the enactment of the new law can be considered only a first important step forward. (shrink)

The aim of the study is to rethink the ethics of advanced motherhood. In the literature, delayed childbearing is usually discussed in the context of reproductive justice, and in relationship to ethical issues associated with the use and risk of assisted reproductive technologies. We aim to go beyond these more “traditional” ways in which reproductive ethics is framed by revisiting ethics itself through the lens of the figure of the so-called “older” mother. For this purpose, we start by exploring some (...) of the deep seated socio-cultural discourses in the context of procreation: ageism, ableism and the widespread bias towards geneticism and pronatalism. Afterwards, we provide a critical overview of the key arguments against or in support of advanced motherhood. We then briefly discuss how entrenchment by both sides has produced an impasse in the debate on the ethics of advanced motherhood and proceed by arguing that it is fundamental to bring about a change in this narrative. For this purpose, we will revisit the feminist usage of the concept of vulnerability which will allow us both to criticize culturally prescribed norms about motherhood and to address the painful reality of age-related fertility decline. In the last section, we argue that instead of defining “older” motherhood as an ethical problem, we should problematize the fact that female reproductive ageing is an understudied and ill-sourced topic. We believe that allocating resources to research to better understand female reproductive ageing is not only ethically permissible, but might even be ethically desirable. (shrink)

This paper discusses the view that subjectifications are primarily motivated by speakers’ need for self-expression. Approaching the issue from the perspective of animal signalling, we propose that semantic subjectifications are at least equally likely to reflect evaluations and attitudes read into utterances by listeners who attempt to read speakers’ minds. We compare speaker-based and listener-based theories with regard to their predictions, sketch ways in which they can be tested and report findings from first attempts at doing so. First, we report (...) evidence from diachronic corpora. Second, we describe a game-theoretic model that relates listener’s interest in speaker intentions to the average degree of speaker-honesty in a population. Third, we report preliminary results of an experiment in which we tested if listeners were more likely to interpret an utterance as indexing speaker subjectivity when they perceived speakers as more powerful. We conclude that the listener-based hypothesis of subjectification is solid enough to warrant further investigation. (shrink)

A scoping review was conducted to explore the metaphors and related expressions older adults use to describe extremely stressful events that may lead to Post-Traumatic Stress Disorder (PTSD), Complex PTSD (CPTSD), Prolonged Grief Disorder (PGD), or Adjustment Disorder (AjD). Relevant databases from psychology, gerontology, and related fields were searched. In addition, relevant references found in included papers were considered. Inclusion criteria were: qualitative study, sample of older adults (age 65+), and focus on maladaptive rather than adaptive psychological aspects. Eleven studies (...) focusing on PTSD, 5 on CPTSD, 13 on PGD, and 10 on AjD were included. Metaphors and other expressions related to extremely stressful events were then extracted and analyzed. Multiple linguistic expressions to describe extremely stressful events and stress-related symptoms were identified. Metaphors and related expressions often referred to the body and the theme of moving on with one’s life. (shrink)

Introduction: Congenital myasthenic syndromes refer to a heterogenic group of neuromuscular transmission disorders. CMS-subtypes are diverse regarding exercise intolerance and muscular weakness, varying from mild symptoms to life-limiting forms with neonatal onset. Long-term follow-up studies on disease progression and treatment-response in pediatric patients are rare.Patients and Methods: We analyzed retrospective clinical and medication data in a cohort of 32 CMS-patients including the application of a standardized, not yet validated test to examine muscular strength and endurance in 21 patients at the (...) last follow-up. Findings obtained in our cohort were compared with long-term follow-up studies of CMS-cohorts from the literature by considering the underlying molecular mechanisms. Outcomes of CMS-ST were compared to results of normal clinical assessment.Results: Thirty-two pediatric patients with defects in eight different CMS-genes were followed by a median time of 12.8 years. Fifty-nine percentage of patients manifested with first symptoms as neonates, 35% as infants. While 53% of patients presented a reduced walking distance, 34% were wheelchair-bound. Even under adequate therapy with pyridostigmine and 3,4-diaminopyridine, CHAT-mutations led to the progression of muscular weakness partly in combination with persistent respiratory and bulbar symptoms. RAPSN, CHRND, and CHRNB1 patients with neonatal manifestation, early respiratory problems, and bulbar symptoms showed a good and maintained treatment response. CHAT and CHRNE patients required higher PS dosages, whereas RAPSN patients needed a lower mean dosage at the last follow-up. The benefits of short-term medication and long-term progression of symptoms were highly dependent on the specific genetic defect. CMS-ST was carried out in 17/21 patients, determined affected muscle groups including bulbar and ocular symptoms, some of which were not reported by the patients.Conclusions: Our findings and comparison with the literature- suggest a better treatment-response and less severe progression of symptoms present in patients suffering from mutations in CMS-genes directly associated with receptor deficiency, while patients with defects leading to synaptopathy and presynaptic defects tend to have worse outcomes. Assessment of affected muscular groups and clinical symptoms by CMS-ST may be a useful tool for optimal therapeutic management of the patients, especially for future clinical studies. (shrink)

AimThe functional prognosis of patients after coma following either cardiac arrest or acute structural brain injury is often uncertain. These patients are associated with high mortality and disability. N20 and N70 somatosensory evoked potentials are used to predict prognosis. We evaluated the utility of SSEP as an early indicator of long-term prognosis in these patients.MethodsThis was a retrospective cohort study of patients admitted to the intensive care unit with a diagnosis of coma after CA or ABI. An SSEP study was (...) performed, including N20 and N70 at 24–72 h, after coma onset. Functional recovery was assessed 6–12 months later using the modified Glasgow scale. The study was approved by our local research ethics committee.ResultsIn the CA and ABI groups, the absence of N20 or N70 was a strong indicator of poor outcome. Conversely, the presence of N70 was an indicator of a good outcome.ConclusionSomatosensory evoked potentials are useful early prognostic markers with high specificity and sensitivity. Moreover, N70 has additional potential value for improving the prediction of good long-term functional outcomes.Clinical Trial Registration:[https://clinicaltrials.gov/], identifier [2018/01/001]. (shrink)

Previous research in Explainable Artificial Intelligence (XAI) suggests that a main aim of explainability approaches is to satisfy specific interests, goals, expectations, needs, and demands regarding artificial systems (we call these “stakeholders' desiderata”) in a variety of contexts. However, the literature on XAI is vast, spreads out across multiple largely disconnected disciplines, and it often remains unclear how explainability approaches are supposed to achieve the goal of satisfying stakeholders' desiderata. This paper discusses the main classes of stakeholders calling for explainability (...) of artificial systems and reviews their desiderata. We provide a model that explicitly spells out the main concepts and relations necessary to consider and investigate when evaluating, adjusting, choosing, and developing explainability approaches that aim to satisfy stakeholders' desiderata. This model can serve researchers from the variety of different disciplines involved in XAI as a common ground. It emphasizes where there is interdisciplinary potential in the evaluation and the development of explainability approaches. (shrink)

Cultural norms may dictate how grief is displayed. The present study explores the display behaviours and rules in the bereavement context from a cross-cultural perspective. 86 German-speaking Swiss and 99 Chinese bereaved people who lost their first-degree relative completed the adapted bereavement version of the Display Rules Assessment Inventory. Results indicated that the German-speaking Swiss bereaved displayed more emotions than the Chinese bereaved. The Chinese bereaved, but not the German-speaking Swiss bereaved, thought that bereaved people should display more emotions than (...) they actually did when they were with their close others (but not when they were alone). Bereaved people endorsed more emotional expression “when alone” than “when with close others”, demonstrating a social disconnection tendency, which was more evident in the Chinese sample. Bereaved people endorsed more expression of positive emotions (e.g. affection/love) and less expression of powerful negative emotions (e.g. blame/guilt, anger) across cultures. Compared to their Chinese counterparts, the German-speaking Swiss sample indicated more actual expressions for most emotion types (i.e. joy/happiness, affection/love, sadness, anger, and denial) but thought bereaved people should express more joy/happiness and less blame/guilt. The results suggest that bereaved people’s display behaviours and rules are influenced by culture, situation, and type of emotion. (shrink)

Speakers often judge the sentence “Lois Lane believes that Superman flies” to be true and the sentence “Lois Lane believes that Clark Kent flies” to be false. If Millianism is true, however, these sentences express the very same proposition and must therefore have same truth value. “Pragmatic” Millians like Salmon and Soames have tried to explain speakers’ “anti-substitution intuitions” by claiming that the two sentences are routinely used to pragmatically convey different propositions which do have different truth values. “Non-Pragmatic” Millians (...) like Braun, on the other hand, have argued that the Millian should not appeal to pragmatics and opt instead for a purely psychological explanation. I will present two objections against Non-Pragmatic Millianism. The first one is that the view cannot account for the intuitions of speakers who accept the identity sentence “Superman is Clark Kent”: applying a psychological account in this case, I will argue, would yield wrong predictions about speakers who resist substitution with simple sentences. I will then consider a possible response from the non-pragmatic Millian and show that the response would in fact require an appeal to pragmatics. My conclusion will be that Braun’s psychological explanation of anti-substitution intuitions is untenable, and that the Millian is therefore forced to adopt a pragmatic account. My second objection is that Non-Pragmatic Millianism cannot account for the role that certain commonsense intentional generalizations play in the explanation of behavior. I will consider a reply offered by Braun and argue that it still leaves out a large class of important generalizations. My conclusion will be that Braun’s non-pragmatic strategy fails, and that the Millian will again be forced to adopt a pragmatic account of intentional generalizations if he wants to respond to the objection. In light of my two objections, my general conclusion will be that non-pragmatic versions of Millianism should be rejected. This has an important consequence: if Millianism is true, then some pragmatic Millian account must be correct. It follows that, if standard objections against pragmatic accounts succeed, then Millianism must be rejected altogether. (shrink)

A standard understanding of abstraction principles elicits two opposite readings: Intolerant Reductionism, where abstractions are seen as reducing talk of abstract objects to talk about non-problematic domains, and Robustionism, where newly introduced terms genuinely refer to abstract objects. Against this dichotomy between such “austere” and “robust” readings, Dummett suggested ways to steer intermediate paths. We explore different options for intermediate stances, by reviewing metaontological strategies and semantic ones. Based on Dummett’s and Picardi’s understanding of the Context Principle, the paper acknowledges (...) that Frege’s Grundlagen are open to several interpretations of contextual definitions, and argues that the prospects for broadly Fregean intermediate views are all but foreclosed. (shrink)

Introduction: bearing politics -- Abortion, sin, and the state -- A history of the abortion debate -- Conceiving the nation: representations of abortion in Thailand -- Corrupt girls, victims of men, desperate women: representations of women who abort -- 'A small sin': everyday acts -- 'The truth of our day by day lives': situational ethics -- Global debates, local dilemmas.

Originally presented as the author's thesis (doctoral--Gregorian University).

The aim of the present paper is to examine the contribution of evaluative conditioning (EC) to attitude formation theory in social psychology. This aim is pursued on two fronts. First, evaluative conditioning is analysed for its relevance to social psychological research. We show that conditioned attitudes can be acquired through simple co‐occurrences of a neutral and a valenced stimulus. Moreover, we argue that conditioned attitudes are not confined to direct contact with a valenced stimulus, but can be formed and dynamically (...) reformed indirectly, through association chains. Second, social research is examined in an effort to identify evaluative learning mechanisms. We suggest that several important phenomena in social psychology (e.g., ingroup favouritism, prejudice, name letter effect) are at least partly due to simple mechanisms of evaluative learning. The implications for attitude formation theory and for applied settings are discussed. (shrink)