BackgroundThe preferable position of Deep Brain Stimulation electrodes is proposed to be located in the dorsolateral subthalamic nucleus to improve general motor performance. The optimal DBS electrode localization for the post-operative improvement of balance and gait is unknown.MethodsIn this single-center, retrospective analyses, 66 Parkinson’s disease patients were assessed pre- and post-operatively by using MDS-UPDRS, freezing of gait score, Giladi’s gait and falls questionnaire and Berg balance scale. The clinical outcome was related to the DBS electrode coordinates in x, y, z (...) plane as revealed by image-based reconstruction. Binomial generalized linear mixed models with fixed-effect variables electrode asymmetry, parkinsonian subtype, medication, age class and clinical DBS induced changes were analyzed.ResultsSubthalamic nucleus-deep brain stimulation improved all motor, balance and FoG scores in MED OFF condition, however there were heterogeneous results in MED ON condition. DBS electrode reconstructed coordinates impacted the responsiveness of axial symptoms. FoG and balance responders showed slightly more medially located STN electrode coordinates and less medio-lateral asymmetry of the electrode reconstructed coordinates across hemispheres compared to non-responders.ConclusionDeep brain stimulation electrode reconstructed coordinates, particularly electrode asymmetry on the medio-lateral axis affected the post-operative responsiveness of balance and FoG symptoms in PD patients. (shrink)

BackgroundFreezing of gait is a disabling burden for Parkinson’s disease patients with poor response to conventional therapies. Combined deep brain stimulation of the subthalamic nucleus and substantia nigra moved into focus as a potential therapeutic option to treat the parkinsonian gait disorder and refractory FoG. The mechanisms of action of DBS within the cortical-subcortical-basal ganglia network on gait, particularly at the cortical level, remain unclear.MethodsTwelve patients with idiopathic PD and chronically-implanted DBS electrodes were assessed on their regular dopaminergic medication in (...) a standardized stepping in place paradigm. Patients executed the task with DBS switched off, conventional STN DBS and combined STN+SN DBS and were compared to healthy matched controls. Simultaneous high-density EEG and kinematic measurements were recorded during resting-state, effective stepping, and freezing episodes.ResultsClinically, STN+SN DBS was superior to conventional STN DBS in improving temporal stepping variability of the more affected leg. During resting-state and effective stepping, the cortical activity of PD patients in STIM OFF was characterized by excessive over-synchronization in the theta, alpha, and high-beta band compared to healthy controls. Both active DBS settings similarly decreased resting-state alpha power and reduced pathologically enhanced high-beta activity during resting-state and effective stepping compared to STIM OFF. Freezing episodes during STN DBS and STN+SN DBS showed spectrally and spatially distinct cortical activity patterns when compared to effective stepping. During STN DBS, FoG was associated with an increase in cortical alpha and low-beta activity over central cortical areas, while with STN+SN DBS, an increase in high-beta was prominent over more frontal areas.ConclusionsSTN+SN DBS improved temporal aspects of parkinsonian gait impairment compared to conventional STN DBS and differentially affected cortical oscillatory patterns during regular locomotion and freezing suggesting a potential modulatory effect on dysfunctional cortical-subcortical communication in PD. (shrink)

Problem: Visions of technology, future scenarios, guiding visions represent imaginations of future states of affairs that play a functional role in processes of technological research, development and innovation—e.g. as a means to create attention, communication, coordination, or for the strategic exertion of influence. Since a couple of years there is a growing attention for such imaginations of futures in politics, the economy, research and the civil society. This trend concerns technology assessment as an observer of these processes and a consultant (...) on the implications of technology and innovation. TA faces increasing demands to assess imaginations of futures that circulate in the present and to participate in shaping these through scenarios or foresights. More than ever, this raises the question, which propositions can be made based on these imaginations by TA and how this can be used in advisory practices. Imaginations of futures are relevant for TA not as predictions but in their significance and effectiveness in the present, which need to be understood and assessed.Contents: This discussion paper outlines how present significance and effects of imagined futures in technological research and innovation processes can be conceived and analyzed. In this paper, all forms of imaginations of technology futures will be called “socio-technical futures” because within them technological developments and social changes are interwoven and inseparably interrelated. In this paper, we discuss why TA should analyze socio-technical futures, how such analyses can grasp the societal conditions that are expressed in the imagined futures and how these become effective in processes of technology development, communication, decision making etc. We raise the question which self-reflexive positioning or possible realignment of TA is needed as a response to its increased concern with assessing and even co-producing socio-technical futures. The latter is often demanded regarding the growing attention by politics and publics to imaginations of futures with wide temporal and spatial reach.Addressee of this paper is the TA community in a broader sense. The aim is to sensitize colleagues for the topic and its challenges, to consolidate discussions and to provide theoretical and methodical suggestions for research in TA and related advisory practices with respect to socio-technical futures. This paper has been originally initiated during the workshop “The present of technological futures-theoretical and methodical challenges for Technology Assessment”, in which all of the paper’s authors participated. The contents of this discussion paper are preliminary results that shall initiate and guide further discussions. (shrink)

First published in 1968. Aesthetics is a living debate of issues concerning the concepts involved in speaking about the arts and the appreciation and creation of art works. But contemporary aesthetics is seriously impoverished if it forgets to take issue or come to terms with its own past. Discovering how problems first arose, and tracing their subsequent careers, can suggest perspectives for contemporary analysis in aesthetics. This book by Eva Schaper examines the views of Plato and Aristotle at the (...) very beginning of philosophical reflection on the nature and purpose of art. Both thinkers, in raising questions and offering solutions, contributed formative ideas which are still an essential part of our common stock of aesthetic notions. This title will be of interest to students of philosophy. (shrink)

The acquisition of genetic information (GI) confronts both the affected individuals and healthcare providers with difficult, ambivalent decisions. Genetic responsibility (GR) has become a key concept in both ethical and socioempirical literature addressing how and by whom decision-making with respect to the morality of GI is approached. However, despite its prominence, the precise meaning of the concept of GR remains vague. Therefore, we conducted a systematic literature review on the usage of the concept of GR in qualitative, socioempirical studies, to (...) identify the main interpretations and to provide conceptual clarification. The review identified 75 studies with primarily an Anglo-American setting. The studies focused on several agents: the individual, the family, the parent, the healthcare professional, and the institution and refer to the concept of GR on the basis of either a rational/principle-oriented approach or an affective/relational approach. A subtype of the rational/principle-oriented approach is the reactive approach. The review shows how the concept of GR is useful for analyzing and theorizing about socioempirical findings within qualitative socioempirical studies and also reveals conceptual deficits in terms of insufficient theoretical accuracy and heterogeneity, and in the rarity of reflection on cultural variance. The vagueness and multiplicity of meanings for GR in socioempirical studies can be avoided by more normative-theoretical explication of the underlying premises. This would provide a higher degree of differentiation of empirical findings. Thereby, the complex findings associated with the individual and social implications of genetic testing in empirical studies can be better addressed from a theoretical point of view and can subsequently have a stronger impact on normative and policy debates. (shrink)

Commercial genetic testing offered over the internet, known as direct-to-consumer genetic testing (DTC GT), currently is under ethical attack. A common critique aims at the limited validation of the tests as well as the risk of psycho-social stress or adaption of incorrect behavior by users triggered by misleading health information. Here, we examine in detail the specific role of advertising communication of DTC GT companies from a medical ethical perspective. Our argumentative analysis departs from the starting point that DTC GT (...) operates at the intersection of two different contexts: medicine on the one hand and the market on the other. Both fields differ strongly with regard to their standards of communication practices and the underlying normative assumptions regarding autonomy and responsibility. Following a short review of the ethical contexts of medical and commercial communication, we provide case examples for persuasive messages of DTC GT websites and briefly analyze their design with a multi-modal approach to illustrate some of their problematic implications. We observe three main aspects in DTC GT advertising communication: (1) the use of material suggesting medical professional legitimacy as a trust-establishing tool, (2) the suggestion of empowerment as a benefit of using DTC GT services and (3) the narrative of responsibility as a persuasive appeal to a moral self-conception. While strengthening and respecting the autonomy of a patient is the focus in medical communication, specifically genetic counselling, persuasive communication is the normal mode in marketing of consumer goods, presuming an autonomous, rational, independent consumer. This creates tension in the context of DTC GT regarding the expectation and normative assessment of communication strategies. Our analysis can even the ground for a better understanding of ethical problems associated with intersections of medical and commercial communication and point to perspectives of analysis of DTC GT advertising. (shrink)

Epistemic curiosity as the desire to acquire new knowledge and ideas is considered as an important attribute for successful entrepreneurs among practitioners, yet there is lacking empirical evidence of epistemic curiosity having an effect on entrepreneurial outcomes. This study aims to put a spotlight on epistemic curiosity as a predictor for entrepreneurial intentions and orientation. We found that epistemic curiosity has a stronger influence on entrepreneurial outcomes in comparison to the Big Five personality trait openness to experience, which is a (...) widely used and conceptually related predictor for entrepreneurship. Furthermore, we found evidence for a mediating role of entrepreneurial alertness which gives further insights about how personality influences the ability to recognize business opportunities and leads to the formation of entrepreneurship orientation and intentions. Our findings contribute to the field of entrepreneurship research by emphasizing that epistemic curiosity may be one of the most important personality indicators for the emergence of entrepreneurial intentions and behavior. (shrink)

Learning is a central component of human life and essential for personal development. Therefore, utilizing new technologies in the learning context and exploring their combined potential are considered essential to support self-directed learning in a digital age. A learning environment can be expanded by various technical and content-related aspects. Gamification in the form of elements from video games offers a potential concept to support the learning process. This can be supplemented by technology-supported learning. While the use of tablets is already (...) widespread in the learning context, the integration of a social robot can provide new perspectives on the learning process. However, simply adding new technologies such as social robots or gamification to existing systems may not automatically result in a better learning environment. In the present study, game elements as well as a social robot were integrated separately and conjointly into a learning environment for basic Spanish skills, with a follow-up on retained knowledge. This allowed us to investigate the respective and combined effects of both expansions on motivation, engagement and learning effect. This approach should provide insights into the integration of both additions in an adult learning context. We found that the additions of game elements and the robot did not significantly improve learning, engagement or motivation. Based on these results and a literature review, we outline relevant factors for meaningful integration of gamification and social robots in learning environments in adult learning. (shrink)

Philosophical aesthetics is an area in which many strands of contemporary philosophical thinking meet. The contributors to this volume are aware of the wider logical, epistemological, moral and metaphysical implications raised by conceptual problems specific to aesthetics. Three themes recur and are taken up from different angles in several of the papers: pleasure – its nature and role in the experience of art and beauty; preference – figuring prominently in aesthetic appraising, appreciating and judging; and value – aesthetic value in (...) particular, and the status of value in general. As these themes interweave, the complexities of aesthetics bring into focus some of the central issues in the philosophy of mind. The authors argue their cases with professional expertise and perceptive understanding of the arts, making significant and original contributions. This book should be of interest not only to philosophers but also to the readers who know, care and theorise about the arts. All the essays were commissioned for this volume, which is part of an informal series of books emerging from meetings sponsored by the Thyssen Foundation. (shrink)