DBS Think Tank IX was held on August 25–27, 2021 in Orlando FL with US based participants largely in person and overseas participants joining by video conferencing technology. The DBS Think Tank was founded in 2012 and provides an open platform where clinicians, engineers and researchers can freely discuss current and emerging deep brain stimulation technologies as well as the logistical and ethical issues facing the field. The consensus among the DBS Think Tank IX speakers was that DBS expanded in (...) its scope and has been applied to multiple brain disorders in an effort to modulate neural circuitry. After collectively sharing our experiences, it was estimated that globally more than 230,000 DBS devices have been implanted for neurological and neuropsychiatric disorders. As such, this year’s meeting was focused on advances in the following areas: neuromodulation in Europe, Asia and Australia; cutting-edge technologies, neuroethics, interventional psychiatry, adaptive DBS, neuromodulation for pain, network neuromodulation for epilepsy and neuromodulation for traumatic brain injury. (shrink)

We estimate that 208,000 deep brain stimulation (DBS) devices have been implanted to address neurological and neuropsychiatric disorders worldwide. DBS Think Tank presenters pooled data and determined that DBS expanded in its scope and has been applied to multiple brain disorders in an effort to modulate neural circuitry. The DBS Think Tank was founded in 2012 providing a space where clinicians, engineers, researchers from industry and academia discuss current and emerging DBS technologies and logistical and ethical issues facing the field. (...) The emphasis is on cutting edge research and collaboration aimed to advance the DBS field. The Eighth Annual DBS Think Tank was held virtually on September 1 and 2, 2020 (Zoom Video Communications) due to restrictions related to the COVID-19 pandemic. The meeting focused on advances in: (1) optogenetics as a tool for comprehending neurobiology of diseases and on optogenetically-inspired DBS, (2) cutting edge of emerging DBS technologies, (3) ethical issues affecting DBS research and access to care, (4) neuromodulatory approaches for depression, (5) advancing novel hardware, software and imaging methodologies, (6) use of neurophysiological signals in adaptive neurostimulation, and (7) use of more advanced technologies to improve DBS clinical outcomes. There were 178 attendees who participated in a DBS Think Tank survey, which revealed the expansion of DBS into several indications such as obesity, post-traumatic stress disorder, addiction and Alzheimer’s disease. This proceedings summarizes the advances discussed at the Eighth Annual DBS Think Tank. (shrink)

Delineation of the subthalamic nuclei on MRI is critical for deep brain stimulation surgery in patients with Parkinson’s disease. We propose this retrospective cohort study for quantitative analysis of MR signal-to-noise ratio, contrast, and signal difference-to-noise ratio of the STN on pre-operative three-dimensional stereotactic MRI in patients with medication-refractory PD. Forty-five consecutive patients with medication-refractory PD who underwent STN-DBS surgery in our hospital from January 2018 to June 2021 were included in this study. All patients had whole-brain 3D MRI, including (...) T2-weighted imaging, T2-weighted fluid-attenuated inversion recovery, and susceptibility-weighted imaging, at 3.0 T scanner for stereotactic navigation. The signal intensities of the STN, corona radiata, and background noise were obtained after placing regions of interest on corresponding structures. Quantitative comparisons of SNR, contrast, and SDNR of the STN between MR pulse sequences, including the T2WI, FLAIR, and SWI. Subgroup analysis regarding patients’ sex, age, and duration of treatment. We used one-way repeated measures analysis of variance for quantitative comparisons of SNR, contrast, and SDNR of the STN between different MR pulse sequences, and we also used the dependent t-test for the post hoc tests. In addition, we used Mann–Whitney U test for subgroup analyses. Both the contrast and SDNR were highest on FLAIR. The SNR was highest on SWI, and both the SNR and SDNR were lowest on T2WI. Subgroup analyses demonstrated significantly lower SDNR on SWI for patients receiving medication treatment for ≥13 years. In conclusion, on 3D stereotactic MRI of medication-refractory PD patients, the contrast and SDNR for the STN are highest on FLAIR, suggesting the optimal delineation of STN on FLAIR. (shrink)

Chinese-speaking older adults usually do not perceive a hearing problem until audiometric thresholds exceed 45 dB HL, and the audiometric thresholds of the average hearing-aid user often exceed 60 dB HL. The purpose of this study was to examine the relationships between cognitive and hearing functions in older Chinese adults with HAs and with untreated hearing loss. Participants were 49 Chinese older adults who used HAs and had moderate to severe HL, and 46 older Chinese who had mild to moderately (...) severe HL but did not use HAs. Multiple linear regression analysis was employed to evaluate how well age, education level, audiometric thresholds, and speech perception in noise were related to performance on general cognitive function, working memory, executive function, attention, and verbal learning tests. Results showed that speech perception in noise alone accounted for 13–25% of the variance in general cognitive function, working memory, and executive function in the UT group, and 9–21% of the variance in general cognitive function and verbal learning in the HA group. Audiometric thresholds did not explain any proportion of the variance in cognitive functioning in the HA or UT group. Thus, speech perception in noise accounts for more variance in cognitive performance than audiometric thresholds, and is significantly associated with different cognitive functions in older Chinese adults with HAs and with untreated HL. (shrink)

IntroductionDeep brain stimulation (DBS) is increasingly used to treat the symptoms of various neurologic and psychiatric conditions. People can undergo the procedure during reproductive years but the safety of DBS in pregnancy remains relatively unknown given the paucity of published cases. We thus conducted a review of the literature to determine the state of current knowledge about DBS in pregnancy and to determine how eligibility criteria are approached in clinical trials with respect to pregnancy and the potential for pregnancy.MethodsA literature (...) review was conducted in EMBASE to identify articles involving DBS and pregnancy. Two reviewers independently analyzed the articles to confirm inclusion. Data extracted for analysis included conditions treated, complications at all stages of pregnancy, neonatal/pediatric outcomes, and DBS target. A second search was then conducted using www.clinicaltrials.gov. The same two reviewers then assessed whether each trial excluded pregnant individuals, lactating individuals, or persons of childbearing age planning to conceive. Also assessed was whether contraception had to be deemed adequate prior to enrollment.ResultsThe literature search returned 681 articles. Following independent analysis and agreement of two reviewers, 8 pregnancy related DBS articles were included for analysis. These articles described 27 subjects, 29 pregnancies (2 with subsequent pregnancies), and 31 infants (2 twin pregnancies). There was 1 preterm birth at 35 weeks, and 3 patients who experienced discomfort from the DBS battery (i.e., impulse generator) placement site. All 27 patients had a DBS device implanted before they became pregnant, which remained in use throughout their pregnancy. There was exclusion of pregnant individuals from 68% of 135 interventional trials involving DBS. Approximately 44% of these trials excluded persons of childbearing age not on “adequate contraception” or wishing to conceive in the coming years. Finally, 22% excluded breastfeeding persons.ConclusionThe data from 29 pregnancies receiving DBS treatment during pregnancy was not associated with unexpected pregnancy or post-partum complication patterns. Many clinical trials have excluded pregnant individuals. Documentation of outcomes in larger numbers of pregnancies will help clarify the safety profile and will help guide study designs that will safely include pregnant patients. (shrink)

Background: Freezing of gait is a common symptom in Parkinson’s disease and can be difficult to treat with dopaminergic medications or with deep brain stimulation. Novel stimulation paradigms have been proposed to address suboptimal responses to conventional DBS programming methods. Burst-cycling deep brain stimulation delivers current in various frequencies of bursts, while maintaining an intra-burst frequency identical to conventional DBS.Objective: To evaluate the safety and tolerability of BCDBS in PD patients with FOG.Methods: Ten PD subjects with STN or GPi DBS (...) and complaints of FOG were recruited for this single center, single blinded within-subject crossover study. For each subject, we compared 4, 10, and 15 Hz BCDBS to conventional DBS during the PD medication-OFF state.Results: There were no serious adverse events with BCDBS. It was feasible and straightforward to program BCDBS in the clinic setting. The benefit was comparable to conventional DBS in measures of FOG, functional mobility and in PD motor symptoms. BCDBS had lower battery consumption when compared to conventional DBS.Conclusions: BCDBS was feasible, safe and well tolerated and it has potential to be a viable future DBS programming strategy. (shrink)

I thought the paper by Kai-yee Wong and Chris Fraser was fascinating and insightful. Two things I especially appreciated are the clarity with which they summarize my views. I think they are quite fair and accurate. Second, I appreciate their suggestion that the way to deal with the practical problem of weakness of will has much to do with the role of the Background in shaping our actions. I think they are especially on the right track when they say (...) that the improvement of Background skills may actually narrow the range of real options for action, (p. 21) nonetheless, they do not decrease freedom. As they say, “It is a process of strengthening the self, and the agent is likely to experience the concomitant restriction of ‘live’ options not as a limitation but as strength of character.” (p. 21). That seems to me very much on the right track. What they are suggesting, and it is a powerful addition to my own writings, is that we should not just think of the Background as facilitating languages, games and social practices generally, but for morality as well (p. 23). (shrink)

Untruthfulness is surprisingly common in the U.S. military even though members of the profession are loath to admit it. Further, much of the deception and dishonesty that occurs in the profession of arms is actually encouraged and sanctioned by the military institution. The end result is a profession whose members often hold and propagate a false sense of integrity that prevents the profession from addressing -- or even acknowledging -- the duplicity and deceit throughout the formation. It takes remarkable courage (...) and candor for leaders to admit the gritty shortcomings and embarrassing frailties of the military as an organization in order to better the military as a profession. Such a discussion, however, is both essential and necessary for the health of the military profession"--Publisher's web site. (shrink)

Neuropsychiatrist Michael T. H. Wong argues that the notions of soul, mind, brain, self and consciousness are no longer adequate on their own to explain humanity. He formulates a “third discourse” that brings philosophy neuroscience theology and psychiatry together as an innovative multilayered narrative for the person in the twenty-first century.

The view defended is one sense externalist on the relation between moral reasons and motivation: A's having a moral reason to do X does not necessarily imply that A has a motivation that would support A's doing X via some appropriate deliberative route. However, it is in another sense externalist in holding that there are the kind of moral reasons there are only if the relevant motivational capacities are "generally present" in human beings, if not in all individuals. The process (...) of socialization is an attempt to embed the recognition of what we have moral reason to do in the intentional content of one's feelings. E.g., learning that about others' suffering embeds their suffering as a reason to help in the intentional content of incipient compassionate feelings. This endows the reason with motivational efficacy while conferring further direction to the feelings in ways that shape us for social cooperation. (shrink)

Algorithms can now identify patterns and correlations in the (big) datasets, and predict outcomes based on those identified patterns and correlations with the use of machine learning techniques and big data, decisions can then be made by algorithms themselves in accordance with the predicted outcomes. Yet, algorithms can inherit questionable values from the datasets and acquire biases in the course of (machine) learning, and automated algorithmic decision-making makes it more difficult for people to see algorithms as biased. While researchers have (...) taken the problem of algorithmic bias seriously, but the current discussion on algorithmic fairness tends to conceptualize ‘fairness’ in algorithmic fairness primarily as a technical issue and attempts to implement pre-existing ideas of ‘fairness’ into algorithms. In this paper, I show that such a view of algorithmic fairness as technical issue is unsatisfactory for the type of problem algorithmic fairness presents. Since decisions on fairness measure and the related techniques for algorithms essentially involve choices between competing values, ‘fairness’ in algorithmic fairness should be conceptualized first and foremost as a political issue, and it should be (re)solved by democratic communication. The aim of this paper, therefore, is to explicitly reconceptualize algorithmic fairness as a political question and suggest the current discussion of algorithmic fairness can be strengthened by adopting the accountability for reasonableness framework. (shrink)

Emergence is a notorious philosophical term of art. A variety of theorists have appropriated it for their purposes ever since George Henry Lewes gave it a philosophical sense in his 1875 Problems of Life and Mind. We might roughly characterize the shared meaning thus: emergent entities (properties or substances) ‘arise’ out of more fundamental entities and yet are ‘novel’ or ‘irreducible’ with respect to them. (For example, it is sometimes said that consciousness is an emergent property of the brain.) Each (...) of the quoted terms is slippery in its own right, and their specifications yield the varied notions of emergence that we discuss below. There has been renewed interest in emergence within discussions of the behavior of complex systems and debates over the reconcilability of mental causation, intentionality, or consciousness with physicalism. (shrink)

Confucian Ethics in Western Discourse brings Chinese philosophers into dialogue with contemporary moral philosophers, identifying how ancient Chinese philosophy can contribute to Western discussions of moral philosophy. Covering the characteristics and significance of the Confucian ethical tradition, this study introduces the main concepts, discusses differing perspectives of moral dilemmas and closely examines whether Confucian ethics should be considered as virtue ethics in the Western tradition. Through analysis of the meaning of virtues in Confucian ethics it draws comparison with virtues in (...) Aristotlelian moral philosophy, and offers an in-depth review of the thought of Cheng Brothers in the Song Dynasty, shedding light on current ethical issues. With careful textual studies and philosophical perceptiveness, Confucian Ethics in Western Discourse connects ancient Chinese thought and contemporary problems in Western philosophy. (shrink)

I understand (MR) as meaning that there is a way the world is that is independent of our minds or representations. One may also state (MR) in terms of ‘A description/language independent world/reality’ or ‘a conceptual scheme independent world/reality’. For our purposes, we need not distinguish these variants of formulation.

The following framework of theses, roughly hewn, shapes contemporary discussion of the problem of mental causation: (1) Non-Identity of the Mental and the Physical Mental properties and states cannot be identified with specific physical properties and states. (2) Causal Closure (Completeness) of the Physical The objective probability of every physical event is fixed by prior physical events and laws alone. (This thesis is sometimes expressed in terms of explanation: In tracing the causal history of any physical event, one need not (...) advert to any non-physical events or laws. To the extent that there is any explanation available for a physical event, there is a complete explanation available couched entirely in physical vocabulary. We prefer the probability formulation, as it should be acceptable to any physicalist, though some reject the explanation formulation.) (3) Causal Exclusion There is at most one complete and wholly independent explanation for any given event or sequence of events. (shrink)

This title is part of UC Press's Voices Revived program, which commemorates University of California Press’s mission to seek out and cultivate the brightest minds and give them voice, reach, and impact. Drawing on a backlist dating to 1893, Voices Revived makes high-quality, peer-reviewed scholarship accessible once again using print-on-demand technology. This title was originally published in 1984.

Since the announcement and establishment of the Oversight Board (OB) by the technology company Meta as an independent institution reviewing Facebook and Instagram’s content moderation decisions, the OB has been subjected to scholarly scrutiny ranging from praise to criticism. However, there is currently no overarching framework for understanding the OB’s various strengths and weaknesses. Consequently, this article analyses, organises, and supplements academic literature, news articles, and Meta and OB documents to understand the OB’s strengths and weaknesses and how it can (...) be improved. Significant strengths include its ability to enhance the transparency of content moderation decisions and processes, to effect reform indirectly through policy recommendations, and its assertiveness in interpreting its jurisdiction and overruling Meta. Significant weaknesses include its limited jurisdiction, limited impact, Meta’s control over the OB’s precedent, and its lack of diversity. The analysis of a recent OB case in Ethiopia shows these strengths and weaknesses in practice. The OB’s relationship with Meta and governments will lead to challenges and opportunities shaping its future development. Reforms to the OB should improve the OB’s control over its precedent, apply OB precedent to currently disputed cases, and clarify the standards for invoking OB precedent. Finally, these reforms provide the foundation for an additional improvement to address the OB’s institutional weaknesses, by involving users in determining whether the OB’s precedent should be applied to decide current content moderation disputes. (shrink)

In this book, David B. Wong defends an ambitious and important new version of moral relativism. He does not espouse the type of relativism that says anything goes, but he does start with a relativist stance against alternative theories such that there need not be only one universal truth. Wong proposes that there can be a plurality of true moralities existing across different traditions and cultures, all with one core human question as to how we can all live (...) together. (shrink)

The present study investigates the dynamics of emotional processing and awareness using an affective facial priming paradigm in conjunction with a multimodal assessment of awareness. Key facial primes are visually masked, and are presented for brief and extended durations. Using a preference measure, we examine whether the effects of the primes differ qualitatively . We show that: unconscious affective priming with faces emerges strongly in initial presentations and diminishes rapidly with repetition; conscious affective priming also emerges strongly in initial presentations, (...) however it persists in strength with repetition; and in contrast to other reports on the salience of negative stimuli, happy faces appear more salient than sad faces when presented outside awareness. We discuss the limits and extensions of unconscious affective priming with faces, and consider several methodological and conceptual questions concerning emotional processing out of awareness. (shrink)

Recently, amid growing awareness that computer algorithms are not neutral tools but can cause harm by reproducing and amplifying bias, attempts to detect and prevent such biases have intensified. An approach that has received considerable attention in this regard is the Value Sensitive Design (VSD) methodology, which aims to contribute to both the critical analysis of (dis)values in existing technologies and the construction of novel technologies that account for specific desired values. This article provides a brief overview of the key (...) features of the Value Sensitive Design approach, examines its contributions to understanding and addressing issues around bias in computer systems, outlines the current debates on algorithmic bias and fairness in machine learning, and discusses how such debates could profit from VSD-derived insights and recommendations. Relating these debates on values in design and algorithmic bias to research on cognitive biases, we conclude by stressing our collective duty to not only detect and counter biases in software systems, but to also address and remedy their societal origins. (shrink)

A closer look at the theories and questions in philosophy of technology and ethics of technology shows the absence and marginality of non-Western philosophical traditions in the discussions. Although, increasingly, some philosophers have sought to introduce non-Western philosophical traditions into the debates, there are few systematic attempts to construct and articulate general accounts of ethics and technology based on other philosophical traditions. This situation is understandable, for the questions of modern sciences and technologies appear to be originated from the West; (...) at the same time, the situation is undesirable. The overall aim of this paper, therefore, is to introduce an alternative account of ethics of technology based on the Confucian tradition. In doing so, it is hoped that the current paper can initiate a relatively uncharted field in philosophy of technology and ethics of technology. (shrink)

Political liberals assume an accessibility requirement, which means that, for ensuring civic respect and non-manipulation, public officials should offer accessible reasons during political advocacy. Recently, critics have offered two arguments to show that the accessibility requirement is unnecessary. The first is the pluralism argument: Given the pluralism in evaluative standards, when officials offer non-accessible reasons, they are not disrespectful because they may merely try to reveal their strongest reason. The second is the honesty argument: As long as officials honestly confess (...) their beliefs after offering non-accessible reasons, disrespect and non-manipulation do not occur. This paper defends the accessibility requirement and asserts that these two arguments overlook a unique feature of the political domain. While all citizens collectively own political power as a corporate body, an official does not privately own her political power. Instead, she is a trustee who has a duty to act on behalf of the corporate body, that is, she has to make decisions on grounds that are accessible to others. This duty explains why, despite pluralism, the accessibility requirement is necessary. Moreover, given that political decisions are profoundly influential to each person, requiring people to be honest is ineffective in discouraging disrespectful and manipulative acts. (shrink)

This chapter contains sections titled: Defining the Term “Citizens Labeled with Cognitive Disabilities” The Scope of Moral Personhood: The Potentiality View The Fully Cooperating Assumption How Are the Two Moral Powers Acquired? The Enabling Conditions Personhood as Requiring Enabling Conditions Blocking Developmental Pathways to Moral Personhood The Causal Relationship Between Epistemic Claims and the Concrete Lives of People with Disabilities First Objection: Responding to the Epistemic Difficulty Second Objection: The Argument from Marginal Cases Conclusion Acknowledgments References.

The burgeoning literature on the ethical issues raised by climate engineering has explored various normative questions associated with the research and deployment of climate engineering, and has examined a number of responses to them. While researchers have noted the ethical issues from climate engineering are global in nature, much of the discussion proceeds predominately with ethical framework in the Anglo-American and European traditions, which presume particular normative standpoints and understandings of human–nature relationship. The current discussion on the ethical issues, therefore, (...) is far from being a genuine global dialogue. The aim of this article is to address the lack of intercultural exchange by exploring the ethics of climate engineering from a perspective of Confucian environmental ethics. Drawing from the existing discussion on Confucian environmental ethics and Confucian ethics of technology, I discuss what Confucian ethics can contribute to the ethical debate on climate engineering. (shrink)