In this paper we present an executable approach to model interactions between agents that involve sensitive, privacy-related information. The approach is formal and based on deontic, epistemic and action logic. It is conceptually related to the Belief-Desire-Intention model of Bratman. Our approach uses the concept of sphere as developed by Waltzer to capture the notion that information is provided mostly with restrictions regarding its application. We use software agent technology to create an executable approach. Our agents hold beliefs about the (...) world, have goals and commitment to the goals. They have the capacity to reason about different courses of action, and communicate with one another. The main new ingredient of our approach is the idea to model information itself as an intentional agent whose main goal it is to preserve the integrity of the information and regulate its dissemination. We demonstrate our approach by applying it to an important process in the insurance industry: applying for a life insurance. In this paper we will: (1) describe the challenge organizational complexity poses in moral reasoning about informational relationships; (2) propose an executable approach, using software agents with reasoning capacities grounded in modal logic, in which moral constraints on informational relatio nships can be modeled and investigated; (3) describe the details of our approach, in which information itself is modeled as an intentional agent in its own right; (4) test and validate it by applying it to a concrete ‘hard case’ from the insurance industry; and (5) conclude that our approach upholds and offers potential for both research and practical application. (shrink)

Background: The Declaration of Helsinki, the World Medical Association’s statement of ethical guidelines regarding medical research, is published in the three official languages of the WMA: English, French and Spanish.Methods: A detailed comparison of the three official language versions was carried out to determine ways in which they differed and ways in which the wording of the three versions might illuminate the interpretation of the document.Results: There were many minor linguistic differences between the three versions. However, in paragraphs 1, 6, (...) 29, 30 and in the note of clarification to paragraph 29, there were differences that could be considered potentially significant in their ethical relevance.Interpretation: Given the global status of the Declaration of Helsinki and the fact that it is translated from its official versions into many other languages for application to the ethical conduct of research, the differences identified are of concern. It would be best if such differences could be eliminated but, at the very least, a commentary to explain any differences that are unavoidable on the basis of language or culture should accompany the Declaration of Helsinki. This evidence further strengthens the case for international surveillance of medical research ethics as has been proposed by the WMA. (shrink)

Positive frequency dependent selection is a natural selection regime where the fitness of a phenotype increases with its frequency in the population. Examples can be typically found in the spread of disease tolerance strategies in a population. A characterizing feature of PFDS is that the focal allele may experience favorable selection only when it becomes more frequent in the population, while being selected against when it is rare. In this paper, by applying a solution concept from evolutionary game theory, we (...) hypothesize that the process of emergence of such alleles triggers selection for silence, where the emergence of alleles that can stay unexpressed for a period of time will be favored by selection forces. We illustrate our hypothesis using a mathematical model of a population of single locus diploid organisms with two alleles where a single mutant of an allele that experiences positive frequency dependent selection appears in a population where the other allele is a dominant. The model results show that the longer the silence interval of the new mutant before its expression, the better its chances of getting fixed in the population. However, this effect will be observable only to a certain limit after which further increase in the interval will not have an effect on the expected fixation rate. Two divergences from the simple scenario are also investigated: the nonsynchronous expression of the focal allele and its emergence in a spatial grid limited by a migration bottleneck. In all cases, it is shown that there is an evolutionary pressure inherent in the dynamics of positive frequency dependent selection on the genes to have a delayed expression. It is hypothesized that the regulation systems of such traits will be under selection for either internal silencing mechanisms or to be triggered by an external environmental condition. (shrink)

The impact of COVID-19 on chronic pain in non-infected vulnerable South American subjects is unknown. Healthcare workers are at increased risk for CP. During the pandemic, many HCWs with CP kept working. Knowing how cognition is affected by CP in these subjects is an important subject for work safety. The attention domain has a pivotal role in cognition. Previously, the Continuous Visual Attention Test was applied to detect specific attention deficits in fibromyalgia patients. The present investigation described CP prevalence in (...) non-infected Brazilian HCWs during the pandemic and assessed HCWs’ attentional performance with the aid of the CVAT. This study was carried out at a reference University Hospital in Rio de Janeiro, Brazil. HCWs of both sexes, aged 20 or older, were interviewed from August to December 2020. A 90-second version of the CVAT was performed. The average reaction time to correct responses and the respective intraindividual reaction time variability for correct responses to target was determined. Omission and commission errors were also calculated. Then, for each participant we calculated the Z-scores of the CVAT variables based on the distribution of CVAT performance of 211 healthy subjects. HCWs with Z-scores > 1.64 were classified as significantly impaired. From the 154 selected HCWs, 72 reported CP during the pandemic. Post hoc ANCOVAs showed that the average correct VRT was significantly higher in the CP group than in the non-CP group. The percentage of participants with impaired VRT performance was 30% in the CP group and 16% in the non-CP group. The difference between these two propositions reached significance. As VRT is associated with the sustained-attention subdomain, our data suggest that this subdomain is disrupted in the CP group. (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)

© 2015 Elsevier Inc.Postnatal organogenesis occurs in an immune competent environment and is tightly controlled by interplay between positive and negative regulators. Innate immune cells have beneficial roles in postnatal tissue remodeling, but roles for the adaptive immune system are currently unexplored. Here we show that adaptive immune responses participate in the normal postnatal development of a non-lymphoid epithelial tissue. Since the mammary gland is the only organ developing predominantly after birth, we utilized it as a powerful system to study (...) adaptive immune regulation of organogenesis. We found that antigen-mediated interactions between mammary antigen-presenting cells and interferon-γ -producing CD4+ T helper 1 cells participate in MG postnatal organogenesis as negative regulators, locally orchestrating epithelial rearrangement. IFNγ then affects luminal lineage differentiation. This function of adaptive immune responses, regulating normal development, changes the paradigm for studying players of postnatal organogenesis and provides insights into immune surveillance and cancer transformation. Plaks et al. (shrink)

We study increasing F-sequences, where F is a dilator: an increasing F-sequence is a sequence (indexed by ordinal numbers) of ordinal numbers, starting with 0 and terminating at the first step x where F(x) is reached (at every step x + 1 we use the same process as in decreasing F-sequences, cf. [2], but with "+ 1" instead of "- 1"). By induction on dilators, we shall prove that every increasing F-sequence terminates and moreover we can determine for every dilator (...) F the point where the increasing F-sequence terminates. We apply these results to inverse Goodstein sequences, i.e. increasing (1 + Id) (ω) -sequences. We show that the theorem every inverse Goodstein sequence terminates (a combinatorial theorem about ordinal numbers) is not provable in ID 1 . For a general presentation of the results stated in this paper, see [1]. We use notions and results concerning the category ON (ordinal numbers), dilators and bilators, summarized in [2, pp. 25-31]. (shrink)

In the human sciences, experimental research is used to establish causal relationships. However, the extrapolation of these results to the target population can be problematic. To facilitate extrapolation, we propose to use the statistical technique Latent Class Regression Analysis in combination with the analogical reasoning theory for extrapolation. This statistical technique can identify latent classes that differ in the effect of X on Y. In order to extrapolate by means of analogical reasoning, one can characterize the latent classes by a (...) combination of features, and then compare these features to features of the target. (shrink)

Background Speech understanding may rely not only on auditory, but also on visual information. Non-invasive functional neuroimaging techniques can expose the neural processes underlying the integration of multisensory processes required for speech understanding in humans. Nevertheless, noise (from fMRI) limits the usefulness in auditory experiments, and electromagnetic artefacts caused by electronic implants worn by subjects can severely distort the scans (EEG, fMRI). Therefore, we assessed audio-visual activation of temporal cortex with a silent, optical neuroimaging technique: functional near-infrared spectroscopy (fNIRS). Methods (...) We studied temporal cortical activation as represented by concentration changes of oxy- and deoxy-hemoglobin in four, easy-to-apply fNIRS optical channels of 33 normal-hearing adult subjects and 5 post-lingually deaf cochlear implant (CI) users in response to supra-threshold unisensory auditory and visual, as well as to congruent auditory-visual speech stimuli. Results Activation effects were not visible from single fNIRS channels. However, by discounting physiological noise through reference channel subtraction, auditory, visual and audiovisual speech stimuli evoked concentration changes for all sensory modalities in both cohorts (p<0.001). Auditory stimulation evoked larger concentration changes than visual stimuli (p<0.001). A saturation effect was observed for the audiovisual condition. Conclusions Physiological, systemic noise can be removed from fNIRS signals by reference channel subtraction. The observed multisensory enhancement of an auditory cortical channel can be plausibly described by a simple addition of the auditory and visual signals with saturation. (shrink)

When 47-year-old Simba Abalo, an unemployed retired soldier in Lomé, Togo, found out that he had AIDS in September 2007, he was unable to receive government-supplied antiretroviral drugs: “CAMEG [the state’s central medicines purchasing organization],” he said, “told me they were not taking any new cases for six months because they had run out of drugs.Stocks of antiretrovirals had become depleted after the Global Fund to Fight AIDS, Tuberculosis and Malaria suspended part of its grant to Togo in 2006 and (...) failed to approve a new grant request in 2007, reportedly because of oversight irregularities. “Even if they had the drugs,” said Abalo, “I could not have paid more than US$4 a month since I had just lost my job as a security guard earning US$70 a month.”. (shrink)

While numerous studies show that brain signals contain information about an individual’s current state that are potentially valuable for smoothing man-machine interfaces, this has not yet lead to the use of brain computer interfaces (BCI) in daily life. One of the main challenges is the common requirement of personal data that is correctly labelled concerning the state of interest in order to train a model, where this trained model is not guaranteed to generalize across time and context. Another challenge is (...) the requirement to wear electrodes on the head. We here propose a BCI that can tackle these issues and may be a promising case for BCI research and application in everyday life. The BCI uses EEG signals to predict head rotation in order to improve images presented in a Virtual Reality (VR) headset. When presenting a 360° video to a headset, Field-of-View approaches only stream the content that is in the current field of view and leave out the rest. When the user rotates the head, other content parts need to be made available soon enough to go unnoticed by the user which is problematic given the available bandwidth. By predicting head rotation, the content parts adjacent to the currently viewed part could be retrieved in time for display when the rotation actually takes place. Eleven participants generated left- and rightward head rotations while head movements were recorded using the headsets motion sensing system and EEG sensors. We trained neural network models to distinguish EEG epochs preceding rightward, leftward and no rotation. Applying these models to streaming EEG data that was withheld from the training showed that 400 ms before rotation onset, the probability ‘no rotation’ started to decrease and the probabilities of an upcoming right- or leftward rotation started to diverge in the correct direction. In the proposed BCI scenario, users already wear a device on their head allowing for integrated sensors. Moreover, it is possible to acquire accurately labeled training data on the fly, and continuously monitor and improve the model’s performance. The BCI can be harnessed if it will improve imagery and therewith enhance immersive experience. (shrink)

Reductionism as a scientific methodology has been extraordinarily successful in biology. However, recent developments in molecular biology have shown that reductionism is seriously inadequate in dealing with the mind-boggling complexity of integrated biological systems. This title presents an appropriate balance between science and philosophy and covers traditional philosophical treatments of reductionism as well as the benefits and shortcomings of reductionism in particular areas of science. Discussing the issue of reductionism in the practice of medicine it takes into account the holistic (...) and integrative aspects that require the context of the patient in his biological and psychological entirety. The emerging picture is that what first seems like hopeless disagreements turn out to be differences in emphasis. Although genes play an important role in biology, the focus on genetics and genomics has often been misleading. The consensus view leads to pluralism: both reductionst methods and a more integrative approach to biological complexity are required, depending on the questions that are asked. * An even balance of contributions from scientists and philosophers of science - representing a unique interchange between both communities interested in reductionism. (shrink)

This article provides ethical guidance on using race in health research as a variable or in defining the study population. To this end, a plain, non-exhaustive checklist is provided for researchers and research ethics committees, preceded by a brief introduction on the need for justification when using race as a variable or in defining a study population, the problem of exoticism, that distinctions pertain between race, ethnicity and ancestry, the problematic naming of races, and that race does not serve well (...) as a presumed biological construct in genetic research. (shrink)

The South African government’s COVID-19 pandemic risk mitigation strategies significantly limited social contact, which necessitated a novel approach to existing face-to-face career guidance practices. The Grade 9 Career Guidance Project, originally developed as a group-based career development intervention, required radical adaptation into a self-directed, manualized format to offer career guidance to Grade 9 learners from low-income communities amid a global pandemic. The adaptation and continuation of the project was deemed essential as secondary school learners in low-income communities have limited career (...) guidance support. Furthermore, a close collaboration with the teachers at eight resource-constrained South African secondary schools was vital for successful implementation. To assess the success of the adaptation to a self-directed format, a mixed-methods design was employed, and Life Orientation teachers’ evaluative feedback was solicited. Favorable quantitative results were obtained; majority of teachers agreed that learners enjoyed the booklet and that it was deemed an adequate substitute to the previous contact-based format of the Career Guidance Project. This was also confirmed by the qualitative findings revealing teachers’ satisfaction with the booklet’s content, specifically that the booklet is complementary to the Life Orientation curriculum. Qualitative findings identified specific contextual barriers that contributed to some learners struggling to use the booklet optimally. The results suggest that it is feasible and acceptable to implement a self-directed career guidance intervention among secondary school learners amid a global pandemic. Teachers recommended ways to integrate the booklet, resources, and contact sessions as a preferred way forward. These findings have important implications for similar resource-constrained settings that may not have readily access to in-person career guidance and counseling human development. (shrink)

Harrowing stories reported in the media describe Covid‐19 ravaging through families. This essay reports professional experiences of this phenomenon, family clustering, as encountered during the pandemic's spread across Southern California. We identify three ethical challenges following from it: Family clustering impedes shared decision‐making by reducing available surrogate decision‐makers for incapacitated patients, increases the emotional burdens of surrogate decision‐makers, and exacerbates health disparities for and the suffering of people of color at increased likelihood of experiencing family clustering. We propose that, in (...) response to these challenges, efforts in advance care planning be expanded, emotional support offered to surrogates and family members be increased, more robust state guidance be issued on ethical decision‐making for unrepresented patients, ethics consultation be increased in the setting of conflict following from family clustering dynamics, and health care professionals pay more attention to systemic and personal racial biases and inequities that affect patient care and the surrogate experience. (shrink)

Genomic research results and incidental findings with health implications for a research participant are of potential interest not only to the participant, but also to the participant's family. Yet investigators lack guidance on return of results to relatives, including after the participant's death. In this paper, a national working group offers consensus analysis and recommendations, including an ethical framework to guide investigators in managing this challenging issue, before and after the participant's death.