The translational research community, in general, and the Clinical and Translational Science Awards (CTSA) community, in particular, share the vision of repurposing EHRs for research that will improve the quality of clinical practice. Many members of these communities are also aware that electronic health records (EHRs) suffer limitations of data becoming poorly structured, biased, and unusable out of original context. This creates obstacles to the continuity of care, utility, quality improvement, and translational research. Analogous limitations to sharing objective data in (...) other areas of the natural sciences have been successfully overcome by developing and using common ontologies. This White Paper presents the authors’ rationale for the use of ontologies with computable semantics for the improvement of clinical data quality and EHR usability formulated for researchers with a stake in clinical and translational science and who are advocates for the use of information technology in medicine but at the same time are concerned by current major shortfalls. This White Paper outlines pitfalls, opportunities, and solutions and recommends increased investment in research and development of ontologies with computable semantics for a new generation of EHRs. (shrink)

European Journal of Philosophy, EarlyView.

For Bernard Williams, philosophy and history are importantly connected. His work exploits this connection in a number of directions: he believes that philosophy cannot ignore its own history the way science can; that even when engaging with philosophy’s history primarily to produce history, one needs to draw on philosophy; and that when doing the history of philosophy primarily to produce philosophy, one still needs a sense of how historically distant past philosophers are, because the point of reading them is (...) to confront something different from the present. But Williams also holds that systematic philosophy itself needs to be done historically, engaging not just with its own history, but with that of the concepts it seeks to understand. To explore these different ways in which philosophy and history intertwine, this volume assembles specially commissioned contributions by A. W. Moore, Terence Irwin, Sophie-Grace Chappell, Catherine Rowett, Marcel van Ackeren, John Cottingham, Gerald Lang, Lorenzo Greco, Paul Russell, Carla Bagnoli, Peter Kail, David Owen, Giuseppina D’Oro, James Connelly, Matthieu Queloz, Nikhil Krishnan, John Marenbon, Ralph Wedgwood, Garrett Cullity, Hans-Johann Glock, Geraldine Ng, Ilaria Cozzaglio, Amanda R. Greene, and Miranda Fricker. They critically appraise Williams’s work in and on the history of philosophy as well as his historicist turn and his use of genealogy. The resulting collection uniquely combines substantive discussions of historical figures from Homer to Wittgenstein with methodological discussions of how and why the history of philosophy should be done, and how and why philosophy should draw on history. (shrink)

Wexler and Specker Sullivan (2023) note that, “unbridled speculation can imperil the credibility of neuroethics, generate unrealistic expectations amongst different stakeholders, take up time that...

The number of clinical trials for experimental brain implants continues to grow, and with this growth comes an increased reliance upon patients with treatment-refractory conditions to volunteer as...

Objective: To examine changes in patients’ desired control of the deep brain stimulator and perception of global life control throughout DBS.Methods: A consecutive cohort of 52 patients with Parkinson’s disease was recruited to participate in a prospective longitudinal study over three assessment points. Semi-structured interviews assessing participants’ desire for stimulation control and perception of global control were conducted at all three points. Qualitative data were coded using content analysis. Visual analog scales were embedded in the interviews to quantify participants’ perceptions (...) of control over time.Results: Participants reported significant increases in their perception of global control over time and significant declines in their desired control of the stimulation. These changes were unrelated to improvements in motor symptoms. Improvements in global control were negatively correlated with a decline in desired stimulation control. Qualitative data indicate that participants have changed, nuanced levels of desired control over their stimulators. Increased global life control following DBS may be attributed to increased control over PD symptoms, increased ability to engage in valued activities, and increased overall self-regulation, while other domains related to global control remained unaffected by DBS.Conclusions: There are few empirical data documenting patients’ desire for stimulation control throughout neuromodulation and how stimulation control is related to other aspects of control despite the growing application of neuromodulation devices to treat a variety of disorders. Our data highlight distinctions in different types of control and have implications for the development of patient-controlled neurostimulation devices. (shrink)

Mental timing studies may be influenced by powerful cognitive illusions that can produce an asymmetry in their rate of progress relative to neuronal timing studies. Both types of timing research are also governed by a temporal asymmetry, expressed by the fact that the direction of causation must follow time's arrow. Here we refresh our earlier suggestion that the temporal asymmetry offers promise as a means of timing mental activities. We update our earlier analysis of Libet's data within this framework. Then (...) we consider the surprises which often occur on those rare occasions when neural timing experiments parallel mental timing work exactly. Together, these surprises and asymmetries prescribe a relentlessly meticulous and fully transparent exposition of timing methods, terms, and concepts which shuns plausible narratives, even when buttressed by rigorous formal models, unless guided by apposite empirical evidence. (shrink)

In the current political climate, understanding women’s health is necessary to achieve progressive and equitable health care reform. Women access the healthcare system more frequently and in greater numbers than men, and are more likely to vote at the polls.1 Yet politicians, corporations, activists, and patients continue to disagree on the scope and definition of women’s health. In her book Beyond Reproduction: Women’s Health, Activism, and Public Policy, Karen L. Baird offers a retrospective analysis of the women’s health movement in (...) recent decades. She discusses landmark legislation and examines how the movement has evolved in response to a changing social and political landscape. Baird’s text is both timely .. (shrink)

:In this essay I defend an alternative account of why markets are legitimate. I argue that markets have a raison d’être—a potential to be valuable that, if fulfilled, would justify their existence. I characterize this potential in terms of the goods that are promoted by the legal protection of economic agency: resource discretion, contribution esteem, wealth, diffusion of power, and freedom of association. I argue that market institutions deliver these goods without requiring the participants to have shared ends, or shared (...) deliberation about joint ends—indeed, this feature is the source of the market’s distinctive contribution to well-being. I suggest that when markets lack legitimacy, this is because they fail to fulfill their raison d’être, or fail to be recognized as doing so. Thus, the contours of legal protection must be drawn so that these goods are realized together in a recognizable way, without sacrificing one good for the sake of others. Finally, I argue that this account is appealing because it allows regulators to consider a plurality of goods, and because it makes room for the essential role of rhetoric in securing market legitimacy. (shrink)

Karen L. Baird, Beyond reproduction: Women’s health, activism, and public policy, Madison, NJ: Fairleigh Dickinson University Press, 2009, reviewed by Amanda R. Clarke.

In the final chapter of Speech Matters, Seana Shiffrin argues that institutions have especially stringent duties to protect speech freedoms. In this article, I develop a few lines of criticism. First, I question whether Shiffrin’s framework of justified suspended contexts is appropriate for institutional settings. Second, I challenge the presumption that the knowledge-gathering function performed by police is necessarily compromised by insincere practices. Third, I criticize Shiffrin’s characterization of the university as involving a complete repudiation of enforced consensus, and I (...) express doubts about the close connection between education and democratic legitimation that Shiffrin endorses. Finally, I raise a problem with the book’s overall argument: even if one agrees that speech freedoms are necessary for moral development, they also may be threatening to moral development. The upshot is that the protection of speech should be modulated in order to account for the potential conflicts between sincerity and other valuable ends, rather than being oriented above all to sincerity. (shrink)

There is a large body of research on conflict in nonhuman animal groups that measures the costs and benefits of intergroup conflict, and we suggest that much of this evidence is missing from De Dreu and Gross's interesting article. It is a shame this work has been missed, because it provides evidence for interesting ideas put forward in the article.

Patient narratives from two investigational deep brain stimulation trials for traumatic brain injury and obsessive‐compulsive disorder reveal that injury and illness rob individuals of personal identity and that neuromodulation can restore it. The early success of these interventions makes a compelling case for continued post‐trial access to these technologies. Given the centrality of personal identity to respect for persons, a failure to provide continued access can be understood to represent a metaphorical identity theft. Such a loss recapitulates the pain of (...) an individual's initial injury or illness and becomes especially tragic because it could be prevented by robust policy. A failure to fulfill this normative obligation constitutes a breach of disability law, which would view post‐trial access as a means to achieve social reintegration through this neurotechnological accommodation. (shrink)

In this paper, I use insights from post-structuralist anarchism to consider the relationship between a sense of the future, or “futurity”, and the notion of utopia for anarchist movements. At issue is whether anarchism requires a vision or sense of the future at all and, if so, whether that futurity should be utopian. Drawing from the post-structuralist anarchism of Todd May, Saul Newman, and Lewis Call, I consider the problems with utopia, as well as the potential irrelevance or impossibility of (...) even thinking the future. I then argue for the necessity of both and contend that post-structuralist anarchism does not preclude either futurity or provisional forms of utopia. I conclude by sketching the outlines of a utopia that would be acceptably post-structuralist and acceptably anarchist. (shrink)

The present study applies a new method for investigating dynamic unconscious processes. The method consists of selection of words from patient interview and test protocols that in the clinicians' judgments capture the patients' conscious symptom experience and the hypothetical unconscious conflict related to the symptom, subliminal and supraliminal presentation of these words, signal analysis of event-related potentials obtained to the word presentations. Eight phobics and three patients suffering from pathological grief reactions served as subjects. A time-frequency ERP analysis revealed that (...) subjects' ERPs classified the unconscious conflict words better subliminally than supraliminally, while the reverse was true for the conscious symptom words = 2.82, p = .011). The relationship between frequency and latency revealed a similar mirror image pattern for the unconscious conflict and conscious symptom words . This method demonstrated that objective, brain-based evidence for unconscious conflict can be obtained. (shrink)

We discuss arguments against the thesis that the world itself can be vague. The first section of the paper distinguishes dialectically effective from ineffective arguments against metaphysical vagueness. The second section constructs an argument against metaphysical vagueness that promises to be of the dialectically effective sort: an argument against objects with vague parts. Firstly, cases of vague parthood commit one to cases of vague identity. But we argue that Evans' famous argument against will not on its own enable one to (...) complete the reductio in the present context. We provide a metaphysical premise that would complete the reductio, but note that it seems deniable. We conclude by drawing general morals from our case study. (shrink)

Scientific authorship serves to identify and acknowledge individuals who “contribute significantly” to published research. However, specific authorship norms and practices often differ within and across disciplines, labs, and cultures. As a consequence, authorship disagreements are commonplace in team research. This study aims to better understand the prevalence of authorship disagreements, those factors that may lead to disagreements, as well as the extent and nature of resulting misbehavior. Methods include an international online survey of researchers who had published from 2011 to (...) 2015. Of the 6673 who completed the main questions pertaining to authorship disagreement and misbehavior, nearly half reported disagreements regarding authorship naming; and discipline, rank, and gender had significant effects on disagreement rates. Paradoxically, researchers in multidisciplinary teams that typically reflect a range of norms and values, were less likely to have faced disagreements regarding authorship. Respondents reported having witnessed a wide range of misbehavior including: instances of hostility, undermining of a colleague’s work during meetings/talks, cutting corners on research, sabotaging a colleague’s research, or producing fraudulent work to be more competitive. These findings suggest that authorship disputes may contribute to an unhealthy competitive dynamic that can undermine researchers’ wellbeing, team cohesion, and scientific integrity. (shrink)

Infants have been described as 'statistical learners' capable of extracting structure (such as words) from patterned input (such as language). Here, we investigated whether prior knowledge influences how infants track transitional probabilities in word segmentation tasks. Are infants biased by prior experience when engaging in sequential statistical learning? In a laboratory simulation of learning across time, we exposed 9- and 10-month-old infants to a list of either disyllabic or trisyllabic nonsense words, followed by a pause-free speech stream composed of a (...) different set of disyllabic or trisyllabic nonsense words. Listening times revealed successful segmentation of words from fluent speech only when words were uniformly disyllabic or trisyllabic throughout both phases of the experiment. Hearing trisyllabic words during the pre-exposure phase derailed infants' abilities to segment speech into disyllabic words, and vice versa. We conclude that prior knowledge about word length equips infants with perceptual expectations that facilitate efficient processing of subsequent language input. (shrink)

Authorship is commonly used as the basis for the measurement of research productivity. It influences career progression and rewards, making it a valued commodity in a competitive scientific environment. To better understand authorship practices amongst collaborative teams, this study surveyed authors on collaborative journal articles published between 2011 and 2015. Of the 8364 respondents, 1408 responded to the final open-ended question, which solicited additional comments or remarks regarding the fair distribution of authorship in research teams. This paper presents the analysis (...) of these comments, categorized into four main themes: disagreements, questionable behavior, external influences regarding authorship, and values promoted by researchers. Results suggest that some respondents find ways to effectively manage disagreements in a collegial fashion. Conversely, others explain how distribution of authorship can become a “blood sport” or a “horror story” which can negatively affect researchers’ wellbeing, scientific productivity and integrity. Researchers fear authorship discussions and often try to avoid openly discussing the situation which can strain team interactions. Unethical conduct is more likely to result from deceit, favoritism, and questionable mentorship and may become more egregious when there is constant bullying and discrimination. Although values of collegiality, transparency and fairness were promoted by researchers, rank and need for success often overpowered ethical decision-making. This research provides new insight into contextual specificities related to fair authorship distribution that can be instrumental in developing applicable training tools to identify, prevent, and mitigate authorship disagreement. (shrink)

Gilbert and colleagues point out the discrepancy between the limited empirical data illustrating changes in personality following implantation of deep brain stimulating electrodes and the vast number of conceptual neuroethics papers implying that these changes are widespread, deleterious, and clinically significant. Their findings are reminiscent of C. P. Snow’s essay on the divide between the two cultures of the humanities and the sciences. This division in the literature raises significant ethical concerns surrounding unjustified fear of personality changes in the context (...) of DBS and negative perceptions of clinician-scientists engaged in DBS. These concerns have real world implications for funding future innovative, DBS trials aimed to reduce suffering as well as hampering true interdisciplinary scholarship. We argue that the philosophical tradition of pragmatism and the value it places on empirical inquiry, experiential knowledge, and inter-disciplinary scholarship – reflecting diverse ways of knowing – provides a framework to start to address the important questions Gilbert and colleagues raise. In particular, we highlight the importance of expert clinician knowledge in contributing to the neuroethical questions raised by Gilbert and colleagues. Finally, we provide illustrative examples of some of our interdisciplinary empirical research that demonstrate the iterative cycle of inquiry characteristic of pragmatism in which conceptual neuroethics questions have led to empirical studies whose results then raise additional conceptual questions that give rise to new empirical studies in a way that highlights the contributions of the humanities and the sciences. (shrink)

Gilbert and colleagues point out the discrepancy between the limited empirical data illustrating changes in personality following implantation of deep brain stimulating electrodes and the vast number of conceptual neuroethics papers implying that these changes are widespread, deleterious, and clinically significant. Their findings are reminiscent of C. P. Snow’s essay on the divide between the two cultures of the humanities and the sciences. This division in the literature raises significant ethical concerns surrounding unjustified fear of personality changes in the context (...) of DBS and negative perceptions of clinician-scientists engaged in DBS. These concerns have real world implications for funding future innovative, DBS trials aimed to reduce suffering as well as hampering true interdisciplinary scholarship. We argue that the philosophical tradition of pragmatism and the value it places on empirical inquiry, experiential knowledge, and inter-disciplinary scholarship – reflecting diverse ways of knowing – provides a framework to start to address the important questions Gilbert and colleagues raise. In particular, we highlight the importance of expert clinician knowledge in contributing to the neuroethical questions raised by Gilbert and colleagues. Finally, we provide illustrative examples of some of our interdisciplinary empirical research that demonstrate the iterative cycle of inquiry characteristic of pragmatism in which conceptual neuroethics questions have led to empirical studies whose results then raise additional conceptual questions that give rise to new empirical studies in a way that highlights the contributions of the humanities and the sciences. (shrink)

Gilbert and colleagues point out the discrepancy between the limited empirical data illustrating changes in personality following implantation of deep brain stimulating electrodes and the vast number of conceptual neuroethics papers implying that these changes are widespread, deleterious, and clinically significant. Their findings are reminiscent of C. P. Snow’s essay on the divide between the two cultures of the humanities and the sciences. This division in the literature raises significant ethical concerns surrounding unjustified fear of personality changes in the context (...) of DBS and negative perceptions of clinician-scientists engaged in DBS. These concerns have real world implications for funding future innovative, DBS trials aimed to reduce suffering as well as hampering true interdisciplinary scholarship. We argue that the philosophical tradition of pragmatism and the value it places on empirical inquiry, experiential knowledge, and inter-disciplinary scholarship – reflecting diverse ways of knowing – provides a framework to start to address the important questions Gilbert and colleagues raise. In particular, we highlight the importance of expert clinician knowledge in contributing to the neuroethical questions raised by Gilbert and colleagues. Finally, we provide illustrative examples of some of our interdisciplinary empirical research that demonstrate the iterative cycle of inquiry characteristic of pragmatism in which conceptual neuroethics questions have led to empirical studies whose results then raise additional conceptual questions that give rise to new empirical studies in a way that highlights the contributions of the humanities and the sciences. (shrink)

Research has shown that adults can engage in cognitive offloading, whereby internal processes are offloaded onto the environment to help task performance. Here, we investigate an application of this approach with children, in particular children with poor working memory. Participants were required to remember and recall sequences of colors by placing colored blocks in the correct serial order. In one condition the blocks were arranged to facilitate cognitive offloading (i.e., grouped by color), whereas in the other condition they were arranged (...) randomly. Across two experiments (total N = 166) the ordered condition improved task performance for children with low working memory ability. In addition, participants in Experiment 2 rated the difficulty of the two arrangements and performed a further condition in which they were given an opportunity to freely arrange the blocks before completing the task. Despite performing better in the ordered condition, children with low working memory ability did not rate the ordered arrangement as easier, nor did they choose an ordered arrangement when given the opportunity to do so. This research shows that cognitive offloading can also be a useful process in populations other than typical adults, and the implications of this work for supporting children with poor working memory are discussed. (shrink)

In recent years, multivariate pattern analysis has been hugely beneficial for cognitive neuroscience by making new experiment designs possible and by increasing the inferential power of functional magnetic resonance imaging, electroencephalography, and other neuroimaging methodologies. In a similar time frame, “deep learning” has produced a parallel revolution in the field of machine learning and has been employed across a wide variety of applications. Traditional MVPA also uses a form of machine learning, but most commonly with much simpler techniques based on (...) linear calculations; a number of studies have applied deep learning techniques to neuroimaging data, but we believe that those have barely scratched the surface of the potential deep learning holds for the field. In this paper, we provide a brief introduction to deep learning for those new to the technique, explore the logistical pros and cons of using deep learning to analyze neuroimaging data – which we term “deep MVPA,” or dMVPA – and introduce a new software toolbox intended to facilitate dMVPA for neuroscientists everywhere. (shrink)

The Mental Health Act 2007 introduced Deprivation of Liberty safeguards into the Mental Capacity Act 2005 with potentially far reaching resource implications. There appears to be no scientific data regarding the prevalence of deprivation of liberty in clinical settings such as hospitals and nursing homes. We examined how many patients across a whole Trust area in Wales were subject to some lack of capacity, how well documented this was and how many were potentially deprived of their liberty. We found that (...) no patient was deprived of their liberty, but 8% lacked capacity to make either basic or complex decisions; another 5% lacked capacity to make complex decisions. Documentation was good in mental health and community directorates, but there were gaps in documentation (not practice) in the medical and surgical directorates. Routine collection of data improved documentation regarding deprivation of liberty criteria. There is a high likelihood that senior nursing staff underestimate the number of patients who lack capacity. (shrink)