Pain, suffering and positive emotions in patients in vegetative state/unresponsive wakefulness syndrome (VS/uws) and minimally conscious states (MCS) pose clinical and ethical challenges. Clinically, we evaluate behavioural responses after painful stimulation and also emotionally-contingent behaviours (e.g., smiling). Using stimuli with emotional valence, neuroimaging and electrophysiology technologies can detect subclinical remnants of preserved capacities for pain which might influence decisions about treatment limitation. To date, no data exist as to how healthcare providers think about end-of-life options (e.g., withdrawal of artificial nutrition (...) and hydration) in the presence or absence of pain in non-communicative patients. Here, we aimed to better clarify this issue by re-analyzing previously published data on pain perception (Prog Brain Res 2009 177, 329–38) and end-of-life decisions (J Neurol 2010 258, 1058–65) in patients with disorders of consciousness. In a sample of 2259 European healthcare professionals we found that, for VS/uws more respondents agreed with treatment withdrawal when they considered that VS/uws patients did not feel pain (77%) as compared to those who thought VS/uws did feel pain (59%). This interaction was influenced by religiosity and professional background. For MCS, end-of-life attitudes were not influenced by opinions on pain perception. Within a contemporary ethical context we discuss (1) the evolving scientific understandings of pain perception and their relationship to existing clinical and ethical guidelines; (2) the discrepancies of attitudes within (and between) healthcare providers and their consequences for treatment approaches, and (3) the implicit but complex relationship between pain perception and attitudes toward life-sustaining treatments. (shrink)

This article explores the trend of increasing automation in law enforcement and criminal justice settings through three use cases: predictive policing, machine evidence and recidivism algorithms. The focus lies on artificial-intelligence-driven tools and technologies employed, whether at pre-investigation stages or within criminal proceedings, in order to decode human behaviour and facilitate decision-making as to whom to investigate, arrest, prosecute, and eventually punish. In this context, this article first underlines the existence of a persistent dilemma between the goal of increasing the (...) operational efficiency of police and judicial authorities and that of safeguarding fundamental rights of the affected individuals. Subsequently, it shifts the focus onto key principles of criminal procedure and the presumption of innocence in particular. Using Article 6 ECHR and the Directive (EU) 2016/343 as a starting point, it discusses challenges relating to the protective scope of presumption of innocence, the burden of proof rule and the _in dubio pro reo_ principle as core elements of it. Given the transformations law enforcement and criminal proceedings go through in the era of algorithms, big data and artificial intelligence, this article advocates the adoption of specific procedural safeguards that will uphold rule of law requirements, and particularly transparency, fairness and explainability. In doing so, it also takes into account EU legislative initiatives, including the reform of the EU data protection _acquis_, the E-evidence Proposal, and the Proposal for an EU AI Act. Additionally, it argues in favour of revisiting the protective scope of key fundamental rights, considering, _inter alia_, the new dimensions suspicion has acquired. (shrink)

This article investigates the role of ‘anarchy’ in state securitisation. First, we discuss state hierarchies’ struggle with active and reactive anarchic networks, theorising a state in existential crisis, which exploits anti-anarchist discourses to respond to network threats. In the second part, we illustrate with examples the use of fear of anarchy in hierarchical productive structures of securitisation. As an ‘antiproduction assemblage’, the state treats logics stemming from the ‘social principle’ as a repressed Real, the exclusion of which underpins its own (...) functioning. The scarcity and fear resulting from state terror ensure responses to this structural violence by reactive networks, while paradoxically also exacerbating reactive tendencies within social movements. In the concluding part, we discuss visions of desecuritising society, breaking away from majoritarian logics of control and the coming of other worlds counterposed to the hierarchies producing and reproducing an eternal loop of state and ne... (shrink)

ZusammenfassungDer ca. 1445 von Nikolaus von Kues verfasste Dialog »De Deo abscondito« widmet sich der erkenntnistheoretischen Frage, ob Gott und was von ihm erkannt werden kann. Damit führt der Kusaner seine Überlegungen insbesondere aus seinem Hauptwerk »De docta ignorantia« fort. Wie dort, so kommt er auch in diesem Dialog zu dem Schluss, Gott als derjenige, der alle Gegensätze in sich vereinige, könne weder via positionis noch via negationis erkannt und beschrieben werden. Vielmehr sei Gott vor aller sagbaren Wahrheit und mehr (...) noch: vor allem Gedanken, der über ihn gedacht werden könne. Darin übertrifft der Kusaner den Anselm'schen Gottesbeweis. Gerade in der Nichterkennbarkeit erweise sich die Existenz Gottes und liege der Grund, ihn anzubeten. Das Wesen Gottes bleibt für den Menschen in der absconditas. Die Frage, ob die Rede vom verborgenen Gott bei Nikolaus von Kues auf Luther gewirkt habe, lässt sich historisch nicht eindeutig klären, dürfte aber eher unwahrscheinlich sein. Theologisch liegt jedenfalls keine Beeinflussung vor, da Luthers Rede vom deus absconditus kein erkenntnistheoretisches Problem lösen will, sondern in den Kontext des Willens Gottes im Gegenüber zum menschlichen Willen gehört und damit eine soteriologische Frage, von der Offenbarung in Christus aus gedacht, beantwortet.SummaryThe dialogue “De Deo abscondito”, composed by Nicolas of Cues in ca. 1445, is dedicated to the epistemological problem whether and to what extent God can be known. Nicolas is continuing here the train of thought of his most important work “De docta ignorantia”. In both works, Nicolas comes to the conclusion that God can neither be known and described via positionis nor via negationis. Rather, God precedes any expressible truth and, what is more, any thought that could be thought about him. Thus, Nicolas goes beyond Anselm's argument for God's existence. The existence of God and the reason for worshipping him is manifested exactly by the impossibility of knowing or proving that existence. For human beings, the essence of God remains absconditas. The question whether the conception of the hidden God in Nicolas of Cues has influenced Luther cannot be definitely solved historically; a direct influence is rather improbable. At any rate, there is no theological parallel between the two, as Luther's concept of the Deus absconditus does not respond to an epistemological problem. It rather concerns the divine will in its opposition to the human will and responds to a soteriological problem in the light of the revelation in Christ. (shrink)

■ Evidence from functional neuroimaging studies on resting state suggests that there are two distinct anticorrelated cortical systems that mediate conscious awareness: an “extrinsic” system that encompasses lateral fronto-parietal areas and has been linked with processes of external input (external awareness), and an “intrinsic” system which encompasses mainly medial brain areas and..

Marie-Aure´lie Bruno,1 Jan L Bernheim,2 Didier Ledoux,1 Fre´de´ric Pellas.

Different sort of people are interested in personal identity. Philosophers frequently ask what it takes to remain oneself. Caregivers imagine their patients’ experience. But both philosophers and caregivers think from the armchair: they can only make assumptions about what it would be like to wake up with massive bodily changes. Patients with a locked-in syndrome suffer a full body paralysis without cognitive impairment. They can tell us what it is like. Forty-four chronic LIS patients and 20 age-matched healthy medical professionals (...) answered a 15-items questionnaire targeting: global evaluation of identity, body representation and experienced meaning in life. In patients, self-reported identity was correlated with B and C. Patients differed with controls in C. These results suggest that the paralyzed body remains a strong component of patients’ experienced identity, that patients can adjust to objectives changes perceived as meaningful and that caregivers fail in predicting patients’ experience. (shrink)

Disorders of consciousness (DOC) raise profound scientific, clinical, ethical, and philosophical issues. Growing knowledge on fundamental principles of brain organization in healthy individuals offers new opportunities for a better understanding of residual brain function in DOCs. We here discuss new perspectives derived from a recently proposed scheme of brain organization underlying consciousness in healthy individuals. In this scheme, thalamo-cortical networks can be divided into two, often antagonistic, global systems: (i) a system of externally oriented, sensory-motor networks (the ‘‘extrinsic’’ system); and (...) (ii) a system of inward-oriented networks (the ‘‘intrinsic’’ or default system). According to this framework, four distinct mental states would be possible that could be relevant for understanding DOCs. In normal healthy volunteers and locked-in syndrome patients, a state of high functionality of both the extrinsic and intrinsic or default systems is expected — associated with full awareness of environment and self. In this case, mental imagery tasks combined with fMRI can be used to detect covert awareness in patients that are unable to communicate. According to the framework, two complementary states of system imbalance are also possible, in which one system is in a hyperfunctional state, while the other is hypoactive. Extrinsic system hyperfunction is expected to lead to a state of total sensory-motor ‘‘absorption’’ or ‘‘lost self.’’ In contrast, intrinsic or default system hyperfunction is expected to lead to a state of complete detachment from the external world. A state where both extrinsic and intrinsic systems are hypofunctional is predicted to lead to markedly impaired consciousness as seen in DOCs. Finally, we review the potential use of ultra-slow fluctuations in BOLD signal as a tool for assessing the functional integrity of extrinsic and intrinsic systems during ‘‘resting state’’ fMRI acquisitions.. (shrink)

Name der Zeitschrift: Jahrbuch für Wissenschaft und Ethik Jahrgang: 19 Heft: 1 Seiten: 147-162.

Pain, suffering and positive emotions in patients in vegetative state/unresponsive wakefulness syndrome (VS/UWS) and minimally conscious states (MCS) pose clinical and ethical challenges. Clinically, we evaluate behavioural responses after painful stimulation and also emotionally-contingent behaviours (e.g., smiling). Using stimuli with emotional valence, neuroimaging and electrophysiology technologies can detect subclinical remnants of preserved capacities for pain which might influence decisions about treatment limitation. To date, no data exist as to how healthcare providers think about end-of-life options (e.g., withdrawal of artificial nutrition (...) and hydration) in the presence or absence of pain in non-communicative patients. Here, we aimed to better clarify this issue by re-analyzing previously published data on pain perception (Prog Brain Res 2009 177, 329–38) and end-of-life decisions (J Neurol 2010 258, 1058–65) in patients with disorders of consciousness. In a sample of 2259 European healthcare professionals we found that, for VS/UWS more respondents agreed with treatment withdrawal when they considered that VS/UWS patients did not feel pain (77%) as compared to those who thought VS/UWS did feel pain (59%). This interaction was influenced by religiosity and professional background. For MCS, end-of-life attitudes were not influenced by opinions on pain perception. Within a contemporary ethical context we discuss (1) the evolving scientific understandings of pain perception and their relationship to existing clinical and ethical guidelines; (2) the discrepancies of attitudes within (and between) healthcare providers and their consequences for treatment approaches, and (3) the implicit but complex relationship between pain perception and attitudes toward life-sustaining treatments. (shrink)

A target question for the scientific study of consciousness is how dimensions of consciousness, such as the ability to feel pain and pleasure or reflect on one’s own experience, vary in different states and animal species. Considering the tight link between consciousness and moral status, answers to these questions have implications for law and ethics. Here we point out that given this link, the scientific community studying consciousness may face implicit pressure to carry out certain research programs or interpret results (...) in ways that justify current norms rather than challenge them. We show that because consciousness largely determines moral status, the use of nonhuman animals in the scientific study of consciousness introduces a direct conflict between scientific relevance and ethics—the more scientifically valuable an animal model is for studying consciousness, the more difficult it becomes to ethically justify compromises to its well-being for consciousness research. Finally, in light of these considerations, we call for a discussion of the immediate ethical corollaries of the body of knowledge that has accumulated and for a more explicit consideration of the role of ideology and ethics in the scientific study of consciousness. (shrink)

Although much has been written globally about the key issues of corporate governance in REITs, there are not enough studies inspired by the systematic literature review method. This study reviews the literature on corporate governance in real estate investment trusts (REITs) published after 2004 and addresses three interrelated research questions. We examined 77 peer-reviewed journal articles using a systematic literature review approach. We found that there has been a rise in studies since 2010, with a brief decrease in 2015 and (...) 2017 before increasing again in 2016. Moreover, the vast majority of the studies were published in the areas of economics/econometrics/finance and business/management/accounting. In addition, most of the papers are single-country studies, and the minority are multi-country. The majority of the papers are focused on the USA and Asia. Similarly, the majority of these analyses concentrate on developed countries and ignore emerging and frontier markets.Keywordscorporate governance, real estate investment trusts, REITs, systematic literature review, SLR. (shrink)

Personhood is ascribed on others, such that someone who is recognized to be a person is bestowed with certain civil rights and the right to decision making. A rising question is how severely brain-injured patients who regain consciousness can also regain their personhood. The case of patients with locked-in syndrome is illustrative in this matter. Upon restoration of consciousness, patients with LIS find themselves in a state of profound demolition of their bodily functions. From the third-person perspective, it can be (...) expected that LIS patients might experience a differential personal identity and may lose their status as persons. However, from the patients’ perspective, it is uncontested that they retain their personal identity and that they consider themselves to be persons. We here include results from a survey with patients with LIS aimed at identifying the primary expectations of patients for their care by non-medical professionals. Based on these first-hand reports, we argue that personhood in LIS is progressively regained as the widening circle of others recognizes them as persons. (shrink)

The paper presents the main preliminary findings of GEITONIA research project (Growing and Enabling of Information Technologies for Online Neighborhoods: Implications and Applications). Focusing on the development of a local social network for neighborhoods of Nea Smyrni community in Attica (Greece), the main results of an exploratory mixed methods research study, are discussed. The local social network is a non-commercial social medium that operates as a mobile application. Residents of the local community will have the opportunity to use the application (...) for a pilot period, create their virtual neighborhoods, interact with other neighbors, and expand local social ties in a continuum of physical and virtual spatialities. Moreover, taking into consideration residents’ perceptions, demands and visions, regarding a local social network for their neighborhoods, the research project aims to enhance the rule that sets the focus on the users, as co-creators and co-producers of communication technologies. (shrink)

Activating Transcription Factor-2 is a sequence-specific DNA-binding protein that belongs to the bZIP family of proteins and plays diverse roles in the mammalian cells. In response to stress stimuli, it activates a variety of gene targets including cyclin A, cyclin D and c-jun, which are involved in oncogenesis in various tissue types. ATF-2 expression has been correlated with maintenance of a cancer cell phenotype. However, other studies demonstrate an antiproliferative or apoptotic role for ATF-2. In this review, we summarize the (...) signaling pathways that activate ATF-2, as well as its downstream targets. We examine the role of ATF-2 in carcinogenesis with respect to other bZIP proteins, using data from studies in human cancer cell lines, human tumours and mouse models, and we propose a potential model for its function in carcinogenesis, as well as a theoretical basis for its utility in anticancer drug design. (shrink)

Personhood is ascribed on others, such that someone who is recognized to be a person is bestowed with certain civil rights and the right to decision making. A rising question is how severely brain-injured patients who regain consciousness can also regain their personhood. The case of patients with locked-in syndrome is illustrative in this matter. Upon restoration of consciousness, patients with LIS find themselves in a state of profound demolition of their bodily functions. From the third-person perspective, it can be (...) expected that LIS patients might experience a differential personal identity and may lose their status as persons. However, from the patients’ perspective, it is uncontested that they retain their personal identity and that they consider themselves to be persons. We here include results from a survey with patients with LIS aimed at identifying the primary expectations of patients for their care by non-medical professionals. Based on these first-hand reports, we argue that personhood in LIS is progressively regained as the widening circle of others recognizes them as persons. (shrink)

Hypocretin regulates brain reward function and cocaine consumption in rats. The hypocretinergic (Hcrt) system is implicated in energy homeostasis, feeding and sleep regulation. Hypocretinergic cell bodies are located in the lateral hypothalamus (LH) and project throughout the brain. The aim of the present studies was to investigate the role of the Hcrt system in regulating brain reward function and the reinforcing properties of cocaine in rats. Intracranial self-stimulation (ICSS) thresholds provide an accurate measure of brain reward function in rats. Here (...) we show that a single injection of Hcrt-1 (5 µg icv) induced persistent, long-lasting elevations in ICSS thresholds in drug-naïve rats. Indeed, Hrct-1 elevated ICSS thresholds for 36 h, with peak elevations between 6 and 12 hours after injection. Hrct-1-induced threshold elevations were attenuated by an antibody known to neutralize the binding of hcrt-1 to its receptors. Taken together, these observations suggest that Hrct-1 negatively regulates brain reward function in rats. Because Hrct-1 negatively regulates brain reward function, we hypothesized that it may attenuate the increased brain reward function usually observed after cocaine consumption, and thereby alter cocaine self-administration behavior. A daily injection of Hrct-1 (1 µg icv), for 4 consecutive days, slightly increased cocaine self-administration (0.25 mg/infusion) in rats. Overall, these data demonstrate that Hrct-1 negatively regulates brain reward function, and as such may indirectly alter cocaine self-administration. Given the well-established role of hypocretin neurons in regulating feeding behavior and sleep, we hypothesize that hypocretinergic regulation of brain reward function may provide a mechanism by which appropriate and competing behaviors (e.g. sleep or feeding) may be engaged to maintain energy homeostasis. (shrink)

Elevations in brain stimulation reward (BSR) thresholds have been observed in rats undergoing nicotine withdrawal and have been proposed as a sensitive measure of the negative affective state associated with nicotine withdrawal. mGluR are presynaptic autoreceptors that decrease glutamate release when stimulated. The aim of this study was to examine the role of glutamate neurotransmission in nicotine dependence. The mGluR agonist LY314582 (2.5–7.5 mg/kg) precipitated nicotine withdrawal as measured by elevations in BSR thresholds in nicotine-treated rats but not in controls. (...) It was hypothesized that LY314582 precipitated nicotine withdrawal by decreasing glutamatergic tone at postsynaptic glutamate receptors. Therefore, the effects of MPEP (0.5–2 mg/kg), an mGluR antagonist, and MK-801 (0.01–1 mg/kg), an NMDA receptor antagonist, were examined. MPEP elevated BSR thresholds by an equal magnitude in control and nicotine-treated rats. At low doses, MK-801 (0.01–0.2 mg/kg) lowered BSR thresholds to a similar extent in control and nicotine-treated rats. At higher doses, MK-801 (0.25–1 mg/kg) disrupted performance in nicotine-treated and control rats. These data indicate that mGluR and NMDA receptors regulate BSR in opposite directions in non-dependent animals, and chronic nicotine treatment does not alter these effects. Most importantly, the data demonstrate that the mGluR is involved in nicotine dependence, but mGluR and NMDA receptors do not mediate mGluR actions in nicotine dependence. (shrink)

Human-Computer Interaction and games set a new domain in understanding people’s motivations in gaming, behavioral implications of game play, game adaptation to player preferences and needs for increased engaging experiences in the context of HCI serious games. When the latter relate with people’s health status, they can become a part of their daily life as assistive health status monitoring/enhancement systems. Co-designing HCI-SGs can be seen as a combination of art and science that involves a meticulous collaborative process. The design elements (...) in assistive HCI-SGs for Parkinson’s Disease patients, in particular, are explored in the present work. Within this context, the Game-Based Learning design framework is adopted here and its main game-design parameters are explored for the Exergames, Dietarygames, Emotional games, Handwriting games, and Voice games design, drawn from the PD-related i-PROGNOSIS Personalized Game Suite holistic approach. Two main data sources were involved in the study. In particular, the first one includes qualitative data from semi-structured interviews, involving 10 PD patients and four clinicians in the co-creation process of the game design, whereas the second one relates with data from an online questionnaire addressed by 104 participants spanning the whole related spectrum, i.e., PD patients, physicians, software/game developers. Linear regression analysis was employed to identify an adapted GBL framework with the most significant game-design parameters, which efficiently predict the transferability of the PGS beneficial effect to real-life, addressing functional PD symptoms. The findings of this work can assist HCI-SG designers for designing PD-related HCI-SGs, as the most significant game-design factors were identified, in terms of adding value to the role of HCI-SGs in increasing PD patients’ quality of life, optimizing the interaction with personalized HCI-SGs and, hence, fostering a collaborative human-computer symbiosis. (shrink)