Inclusion of children in medical decision making, to the extent of their ability and interest in doing so, should be the default position, ensuring that children are routinely given a voice. However, optimizing the involvement of children in their health care decisions remains challenging for clinicians. Missing from the literature is a stepwise approach to assessing when and how a child should be included in medical decision making. We propose a systematic approach for doing so, and we apply this approach (...) in a discussion of two challenging clinical cases. The approach is informed by a literature review, and is anchored by case studies of teenagers' refusal of clinical care, regulatory requirements for research assent, and the accepted approach to involving cognitively impaired adults in medical decisions. (shrink)

Although informed consent is important in clinical research, questions persist regarding when it is necessary, what it requires, and how it should be obtained. The standard view in research ethics is that the function of informed consent is to respect individual autonomy. However, consent processes are multidimensional and serve other ethical functions as well. These functions deserve particular attention when barriers to consent exist. We argue that consent serves seven ethically important and conceptually distinct functions. The first four functions pertain (...) principally to individual participants: (1) providing transparency; (2) allowing control and authorization; (3) promoting concordance with participants' values; and (4) protecting and promoting welfare interests. Three other functions are systemic or policy focused: (5) promoting trust; (6) satisfying regulatory requirements; and (7) promoting integrity in research. Reframing consent around these functions can guide approaches to consent that are context sensitive and that maximize achievable goals. (shrink)

The integrity of critical ethnography requires engagement in reflexive practice at all phases of the research process. In this discussion paper, I explore the insights and challenges of reflexive practice in an ethnographic study of the recovery experiences of black trauma patients in a Philadelphia hospital. Observation and interviews were conducted with twelve patients who were admitted to trauma‐designated units of the hospital over the course of a year. During fieldwork, I learned the ways that my background as a professional (...) nurse structured my way of being in clinical space and facilitated a particular interpretation of clinical culture. In analysis, reflection on subjectivities through which I designed this ethnographic research allowed me to see beyond my preconceived and theoretically informed perspective to permit unexpected features of the field to emerge. Reflexive practice also guided my reconciliation of key practical and epistemological differences between clinical ethnographic research and the anthropologic tradition in which it is rooted. I conclude that with careful reflection to the subjectivities that influence the research process, interdisciplinary clinically relevant applied interpretations of critical ethnographic work can be used to generate detailed knowledge across contexts in clinical care, nursing practice, and patient experiences. (shrink)

Understandings of urban foodways in Zimbabwe and other African countries have been dominated by food security frameworks. The focus on material scarcity and measurable health outcomes within these frameworks has often obscured the socio-cultural dimension of foodways and the historical and political structures that have shaped, and continue to shape, everyday relationships with food among different groups of urban residents in cities. Addressing these often-overlooked aspects, this paper looks at intergenerational contestations over foodways in a midsized high-density Zimbabwean town. Presenting (...) results of 6-months ethnographic fieldwork involving participant observation and semi-structured interviews, the paper explores meanings and practices of food in a postcolonial urban setting using three generational groups as a point of departure. These groups are youth (aged 15 to 25 years old), a post-independence generation (aged 26 to 43) and a pre-independence middle-aged generation (aged 43 to 65). Findings show that foodways of the three generations, each having experienced Zimbabwe’s (post-)colonial political economy in different ways, are negotiated through postcolonial socio-ecological relations, urban–rural connections and social hierarchies articulated through urban and rural space. The paper concludes that to understand urban food security in a postcolonial setting, urbanites’ generation-specific life experiences and intergenerational negotiations around historically situated spatial and socio-ecological relations should be considered. The findings could inform urban food security policy to make it more targeted towards the needs of different generational groups as well as more attuned to urbanites’ dynamic socio-cultural foodways and the socio-ecological relations that shape these. (shrink)

Cristofano Bertelli’s companion broadsheets, printed in Modena in the 1560s, represent a failed attempt to introduce a new iconographic theme to the Italian print market. Contrary to the vibrant success of transalpine prints representing the Steps of Life with animal analogies, Bertelli’s initiative did not stimulate Italian visual culture to produce the multiple copies, imitations and derivations long enjoyed by this motif in areas north of the Alps. The only other, comparable images to appear in the peninsula in the course (...) of the sixteenth century would seem to be Titian’s allegorical triple portrait, and a pair of large, anonymous woodcuts from the later Cinquecento, possibly made in Venice. The recalcitrance of Counter-Reformation Italy towards this imported topos is difficult to account for, especially when a retail vogue for a similar genre—the multi-vignette moralising broadsheet— was trending in local print markets. There is no direct explanation for the apparent indifference met by Bertelli’s attempt at iconographic innovation. Nonetheless, a cluster of factors relative to print culture and animal lore North and South of the Alps provides indirect but ample evidence to account for the ‘flop’ of Bertelli’s broadsheets. Among these, the Christian visual tradition features prominently, contributing to viewer diffidence towards serial analogies between humans and animals. The market for illustrated books on animals is also considered, as it testifies to a transalpine divide with regard to moralised natural history and, in Italy, an inhospitable cultural climate for the Steps of Life motif. (shrink)

In Arnauld’s view, a fruitful clarification of the nature of knowledge is possible if only one pays close attention to “ce qui se passe en nous,” in such a fashion “de n’y rien mêler dont nous ne soyons certains.” In support of his position, he cites not only Descartes’ testimony but also that of St. Augustine. Consequently, he treats—first of all—of the things that any one can know about his own soul upon consulting with himself with a little attention, and (...) by so doing Arnauld shows once again his faithfulness to the spirit of Cartesianism. Yet he does more, for he is among the first thinkers fully to appreciate the value of a truly descriptive method in philosophy. (shrink)

In the present study of Descartes’ epistemological investigations, I have tried to show that his renowned principle of clarity and distinctness is not, in fact, one but two axioms. Most interpreters and critics have taken the two formulations of such a principle here considered as successive moments of it. At best, this position is insufficient, for each “version” of the principle of clarity and distinctness guarantees different kinds of cognitive content. Moreover, while the validity of one “version” is not dependent (...) on the thesis of God’s veracity, no such thing can be asserted of the validity of the other. These two formulations of the principle of clarity and distinctness are: 1. Whatever is clearly and distinctly perceived is true; 2. whatever we perceive clearly and distinctly as belonging to the nature of something can indeed be predicated of the thing in question. The fust formula corresponds to what I have characterized as “presentative” knowledge; the second one expresses the guarantee of “representative” knowledge. This distinction is all-important for solving the question of whether Descartes’ proofs of God’s existence and veracity---both the a priori and the a posteriori proofs that we find in the Cartesian corpus-are circular. On the basis of such a distinction, it is possible to argue that at least the ontological argument---and possibly as well the proof “par les effets”---is not at all dependent on the principle of clarity and distinctness, which in turn draws its ultimate validity from God’s faithfulness. In other words, as suggested above, only the second “version” needs to be guaranteed by God’s veracity. On the other hand, the first “version” has no normative value, for it merely describes what is the case whenever a clear and distinct cognition occurs. An example of this is our knowledge of God as the most perfect being. (shrink)

In the present study of Descartes’ epistemological investigations, I have tried to show that his renowned principle of clarity and distinctness is not, in fact, one but two axioms. Most interpreters and critics have taken the two formulations of such a principle here considered as successive moments of it. At best, this position is insufficient, for each “version” of the principle of clarity and distinctness guarantees different kinds of cognitive content. Moreover, while the validity of one “version” is not dependent (...) on the thesis of God’s veracity, no such thing can be asserted of the validity of the other. These two formulations of the principle of clarity and distinctness are: 1. Whatever is clearly and distinctly perceived is true; 2. whatever we perceive clearly and distinctly as belonging to the nature of something can indeed be predicated of the thing in question. The fust formula corresponds to what I have characterized as “presentative” knowledge; the second one expresses the guarantee of “representative” knowledge. This distinction is all-important for solving the question of whether Descartes’ proofs of God’s existence and veracity---both the a priori and the a posteriori proofs that we find in the Cartesian corpus-are circular. On the basis of such a distinction, it is possible to argue that at least the ontological argument---and possibly as well the proof “par les effets”---is not at all dependent on the principle of clarity and distinctness, which in turn draws its ultimate validity from God’s faithfulness. In other words, as suggested above, only the second “version” needs to be guaranteed by God’s veracity. On the other hand, the first “version” has no normative value, for it merely describes what is the case whenever a clear and distinct cognition occurs. An example of this is our knowledge of God as the most perfect being. (shrink)

The novel coronavirus disease is regarded as one of the most imminent disease outbreaks which threaten public health on various levels worldwide. Because of the unpredictable outbreak nature and the virus’s pandemic intensity, people are experiencing depression, anxiety, and other strain reactions. The response to prevent and control the new coronavirus pneumonia has reached a crucial point. Therefore, it is essential—for safety and prevention purposes—to promptly predict and forecast the virus outbreak in the course of this troublesome time to have (...) control over its mortality. Recently, deep learning models are playing essential roles in handling time-series data in different applications. This paper presents a comparative study of two deep learning methods to forecast the confirmed cases and death cases of COVID-19. Long short-term memory and gated recurrent unit have been applied on time-series data in three countries: Egypt, Saudi Arabia, and Kuwait, from 1/5/2020 to 6/12/2020. The results show that LSTM has achieved the best performance in confirmed cases in the three countries, and GRU has achieved the best performance in death cases in Egypt and Kuwait. (shrink)

Twitter integrates with streaming data technologies and machine learning to add new value to healthcare. This paper presented a real-time system to predict breast cancer based on streaming patient’s health data from Twitter. The proposed system consists of two major components: developing an offline building model and an online prediction pipeline. For the first component, we made a correlation between the features to determine the correlation between features and reduce the number of features from the Breast Cancer Wisconsin Diagnostic dataset. (...) Two feature selection algorithms are recursive feature elimination and univariate feature selection algorithms which are applied to features after correlation to select the essential features. Four decision trees, logistic regression, support vector machine, and random forest classifier have been used on features after correlation and feature selection. Also, hyperparameter tuning and cross-validation have been applied with machine learning to optimize models and enhance accuracy. Apache Spark, Apache Kafka, and Twitter Streaming API are used to develop the second component. The best model with the highest accuracy obtained from the first component predicts breast cancer in real time from tweets’ streaming. The results showed that the best model is the random forest classifier which achieved the best accuracy. (shrink)

This paper analyzes the rhetoric surrounding the profession’s presentations of auditor independence. We trace the evolution of thecharacter of the auditor from Professional Man in the early years of the twentieth century to the more public and abstract figures of Judicial Man and Economic Man. The changing character of the auditor in the profession’s narratives of legitimation reflects changes in the role of auditing, in the economic environment, and in the values of American society. Economic man is a self-interested and (...) shallow character who offered the auditing profession little protection against involvement in corporate scandals. In the wake of recent accounting scandals, the profession is calling for a return to the character of Professional Man to restore trust in audits and the financial markets.We also analyze the philosophical bases of the metaphors surrounding auditor independence. These metaphors, particularly the metaphor of independence as separation, create problems in conceptualizing independence concepts. How can you discuss appropriate relationships when your basic concept is one of separation, or no relationship? On the other hand, relational concepts of independence are also flawed if they are not based on a firm moral foundation. We suggest how the profession can act to rebuildits moral foundation through recognition of collective responsibility. (shrink)

This book tackles the most difficult and profound open questions about life and its origins from an information-based perspective.

The sequences produced by the cryptographic sequence generator known as the shrinking generator can be modelled as the output sequences of linear elementary cellular automata. These sequences are composed of interleaved m-sequences produced by linear structures based on feedback shifts. This profitable characteristic can be used in the cryptanalysis of this generator. In this work we propose an algorithm that takes advantage of the inherent linearity of these CA and the interleaved m-sequences. Although irregularly decimated generators have been conceived and (...) designed as non-linear ones, in practice they can be easily analysed in terms of simple linear structures. (shrink)

Los modelos epistemológicos tradicionales clasifican el conocimiento en disciplinas separadas con objetos de estudio distintos y técnicas específicas, incluso proponiendo esquemas jerárquicos. Según pensadores como John Holland o Teilhard de Chardin, el avance de la ciencia implica una convergencia entre sus disciplinas. Esta convergencia puede estudiarse de maneras distintas, como el impacto de diferentes autores fuera de su equipo o la manera en la que colaboran. Aunque estos estudios están generando ideas interesantes, no son capaces de mostrar la convergencia de (...) los distintos temas que se tratan en un cuerpo de trabajos. Este artículo intenta estudiar esta pregunta desde un punto de vista cuantitativo, buscando evidencias que apoyen la idea de convergencia en el contenido de las ciencias en sí mismas. Empleamos Latent Dirichlet Analysis, una técnica que analiza textos y estima las contribuciones relativas de los temas que los generan. Aplicamos esta técnica al corpus de artículos publicados por el Instituto de Santa Fe, que describe trabajos relacionados con las Ciencias de la Complejidad entre 1989 y 2015. Analizamos la cercanía entre las diferentes áreas, la aparición y desaparición de temas de investigación y, en general, la posible convergencia entre disciplinas. Combinando la estructura obtenida de la historia de las publicaciones de SFI con técnicas de inferencia de jerarquía y clustering, reconstruimos la perspectiva de una comunidad científica dinámica que experimenta tendencias, temas recurrentes y cambios en la cercanía de las diferentes disciplinas. Nuestros resultados muestran que hay evidencias de convergencia y que la aplicación de métodos cuantitativos puede proporcionar nuevos elementos de comprensión que ayuden a los investigadores a estructurar una literatura científica cada vez más amplia y compleja, así como a identificar áreas potenciales para nuevas colaboraciones. (shrink)

Saunkeah et al. argue convincingly that although respect for Tribal sovereignty is often invoked as a core justification for Tribal research protections, an expanded ethical framework is req...

In [3], two different effective versions of Borel embedding are defined. The first, called computable embedding, is based on uniform enumeration reducibility, while the second, called Turing computable embedding, is based on uniform Turing reducibility. While [3] focused mainly on computable embeddings, the present paper considers Turing computable embeddings. Although the two notions are not equivalent, we can show that they behave alike on the mathematically interesting classes chosen for investigation in [3]. We give a “Pull-back Theorem”, saying that if (...) Φ is a Turing computable embedding of K into K’, then for any computable infinitary sentence φ in the language of K’, we can find a computable infinitary sentence φ* in the language of K such that for all. (shrink)

Leading scholars from psychology, neuroscience, and philosophy present theories and findings on understanding how individuals infer such complex mental states ...

To stimulate research and innovation (R&I), to contribute to the solution of societal challenges and to align R&I with societal values, the European Commission has launched the governance framework of Responsible Research and Innovation (RRI). RRI figures in many high-level EU policies as a means to promote smart growth, and a growing community of R&I practitioners from both the public and private sectors appears committed to it. Although debates on what RRI precisely entails have not reached closure yet, RRI provides (...) an interesting avenue to explore ways of making R&I more societally germane. While recognizing the usefulness of keeping critical reflection on RRI’s meaning alive, we suggest that to make the step from theorizing to implementation, RRI could benefit from a clearer conceptualization. This chapter presents the iterative trajectory in conceptualizing RRI followed as part of RRI Tools, one of a number of EC-funded research projects and support acts aimed at fleshing out what RRI can and should be, and the conceptualization of RRI that this led to. It suggests that RRI is best captured if in R&I governance attention is paid to the five p’s of Purpose, Products, Processes, Preconditions and People, and that further elaborations on the meaning of RRI should happen in dialogue with attempts at practicing RRI. (shrink)

The dual-code proposal of number representation put forward by Cohen Kadosh & Walsh (CK&W) accounts for only a fraction of the many modes of numerical abstraction. Contrary to their proposal, robust data from human infants and nonhuman animals indicate that abstract numerical representations are psychologically primitive. Additionally, much of the behavioral and neural data cited to support CK&W's proposal is, in fact, neutral on the issue of numerical abstraction.

Biological evolution provides a creative fount of complex and subtle adaptations, often surprising the scientists who discover them. However, because evolution is an algorithmic process that transcends the substrate in which it occurs, evolution’s creativity is not limited to nature. Indeed, many researchers in the field of digital evolution have observed their evolving algorithms and organisms subverting their intentions, exposing unrecognized bugs in their code, producing unexpected adaptations, or exhibiting outcomes uncannily convergent with ones in nature. Such stories routinely reveal (...) creativity by evolution in these digital worlds, but they rarely fit into the standard scientific narrative. Instead they are often treated as mere obstacles to be overcome, rather than results that warrant study in their own right. The stories themselves are traded among researchers through oral tradition, but that mode of information transmission is inefficient and prone to error and outright loss. Moreover, the fact that these stories tend to be shared only among practitioners means that many natural scientists do not realize how interesting and lifelike digital organisms are and how natural their evolution can be. To our knowledge, no collection of such anecdotes has been published before. This paper is the crowd-sourced product of researchers in the fields of artificial life and evolutionary computation who have provided first-hand accounts of such cases. It thus serves as a written, fact-checked collection of scientifically important and even entertaining stories. In doing so we also present here substantial evidence that the existence and importance of evolutionary surprises extends beyond the natural world, and may indeed be a universal property of all complex evolving systems. (shrink)

We show that for every computable limit ordinal α, there is a computable structure A that is $\Delta _\alpha ^0 $ categorical, but not relatively $\Delta _\alpha ^0 $ categorical (equivalently. it does not have a formally $\Sigma _\alpha ^0 $ Scott family). We also show that for every computable limit ordinal a, there is a computable structure A with an additional relation R that is intrinsically $\Sigma _\alpha ^0 $ on A. but not relatively intrinsically $\Sigma _\alpha ^0 $ (...) on A (equivalently, it is not definable by a computable $\Sigma _\alpha $ formula with finitely many parameters). Earlier results in [7], [10], and [8] establish the same facts for computable successor ordinals α. (shrink)

The COVID-19 pandemic is a health issue leading older adults to an increased vulnerability to unfavorable outcomes. Indeed, the presence of physical frailty has recently led to higher mortality due to SARS-CoV-2 infection. However, no longitudinal studies have investigated the role of neuropsychogeriatric factors associated with lockdown fatigue in healthy cognitive aging. Eighty-one healthy older adults were evaluated for their neuropsychological characteristics, including physical frailty, before the pandemic. Subsequently, 50 of them agreed to be interviewed and neuropsychologically re-assessed during the (...) lockdown and immediately after it. Moreover, during another home confinement, they performed a psychological screening to evaluate possible mood changes and fatigue. According to Fried's frailty criteria, at T0, 63% of the sample was robust, 34.5% pre-frail, and only 2.5% frail. Significantly, these subjects presented a decrease in handgrip strength and walking speed. Results from Principal Component Analyses and multiple regression models highlighted the contribution of “cognitive” and “psychological” factors in explaining handgrip strength and gait speed. At T3, lockdown fatigue was explained by higher scores on the Beck Depression Inventory and lower scores on the Trail Making Test part A. Results from a moderated-mediation model showed that the effect of psychomotor speed on lockdown fatigue was mediated by depression, with a moderating effect of gait speed. Our findings highlight the complex interrelationship between cognitive, psychological, and physical factors in the emergence of pandemic fatigue in a carefully selected older population. (shrink)

We report the identification of a recurrent, 520-kb 16p12.1 microdeletion associated with childhood developmental delay. The microdeletion was detected in 20 of 11,873 cases compared with 2 of 8,540 controls and replicated in a second series of 22 of 9,254 cases compared with 6 of 6,299 controls. Most deletions were inherited, with carrier parents likely to manifest neuropsychiatric phenotypes compared to non-carrier parents. Probands were more likely to carry an additional large copy-number variant when compared to matched controls. The clinical (...) features of individuals with two mutations were distinct from and/or more severe than those of individuals carrying only the co-occurring mutation. Our data support a two-hit model in which the 16p12.1 microdeletion both predisposes to neuropsychiatric phenotypes as a single event and exacerbates neurodevelopmental phenotypes in association with other large deletions or duplications. Analysis of other microdeletions with variable expressivity indicates that this two-hit model might be more generally applicable to neuropsychiatric disease. © 2010 Nature America, Inc. All rights reserved. (shrink)

The current trend in knowledge revision in the Dynamic Epistemic Logic tradition focuses on the addition of new knowledge, rather than the possibility of losing knowledge. Yet there are natural situations, such as an agent who does not want another agent to know that she knows a certain piece of information, where there is a need to be able to model the retraction of a proposition from a knowledge base. One situation where this is systematically required is the variant of (...) the medieval theory of obligationes known as dubitatio, where one of the agents in the dialogue is obliged to hold the initial proposition, the dubitatum, as doubtful, regardless of what other propositions she may concede or deny during the disputation. In this paper, we use dubitatio as a motivation for studying deceitful agents, and we discuss various ways that an agent can move from a model where f is known to one where f is not known. (shrink)

In, Kosterec attempts to provide ``model-theoretic proofs'' of certain theses involving the normal modal operators $\Diamond$ and $\square$ and the truth-in-fiction operator $F$ which he then goes on to show have counterexamples in Kripke models. He concludes from this that the embedding of modal logic under the truth-in-fiction operator is unsound. We show instead that it is the ``model-theoretic proofs'' that are themselves unsound, involving illicit substitution, a subtle error that nevertheless allows us to draw an important conclusion about intensional (...) contexts and semantic equivalences. (shrink)