Tense operators in effect algebras play a key role for the representation of the dynamics of formally described physical systems. For this, it is important to know how to construct them on a given effect algebra $E$ and how to compute all possible pairs of tense operators on $E$ . However, we firstly need to derive a time frame which enables these constructions and computations. Hence, we usually apply a suitable set of states of the effect algebra \( (...) E\) in question. To approximate physical reality in quantum mechanics, we use only the so-called Jauch–Piron states on $E$ in our paper. To realize our constructions, we are restricted on lattice effect algebras only. (shrink)

On the basis of Mackey's axiomatic approach to quantum physics or, equivalently, of a “state-event-probability” (SEVP) structure, using a quite standard “fuzzification” procedure, a set of unsharp events (or “effects”) is constructed and the corresponding “state-effect-probability” (SEFP) structure is introduced. The introduction of some suitable axioms gives rise to a partially ordered structure of quantum Brouwer-Zadeh (BZ) poset; i.e., a poset endowed with two nonusual orthocomplementation mappings, a fuzzy-like orthocomplementation, and an intuitionistic-like orthocomplementation, whose set of sharp elements (...) is an orthomodular complete lattice. As customary, by these orthocomplementations the two modal-like necessity and possibility operators are introduced, and it is shown that Ludwig's and Jauch-Piron's approaches to quantum physics are “interpreted” in complete SEFP. As a marginal result, a standard procedure to construct a lot of unsharp realizations starting from any sharp realization of a fixed observable is given, and the relationship among sharp and corresponding unsharp realizations is studied. (shrink)

Peter John Olivi’s relationship to Bonaventure is intriguing.1 Outwardly, they both appear as the leading figures of two different trends of Franciscan politics: Olivi usually being qualified as a “radical” inspiring the dissidence of the Spirituals, while Bonaventure would represent a central and balanced attitude regarding Franciscan poverty. Likewise, as far as their apocalyptical expectations are concerned, Olivi is certainly an overt and avowed Joachite, whereas Bonaventure supposedly makes a more detached use of Joachim of Fiore’s works. Recent studies of (...) Olivi’s philosophical approaches present him as anticipating themes soon to be developed by Duns Scotus rather than associate him with the Bonaventurian... (shrink)

Two rotational bands have been identified and characterized in the proton-magic N = Z + 1 nucleus Ni-57. These bands complete the systematics of well-and superdeformed rotational bands in the light nickel isotopes starting from doubly magic Ni-56 to Ni-60. High-spin states in Ni-57 have been produced in the fusion-evaporation reaction Si-28(S-32, 2p1n)Ni-57 and studied with the gamma-ray detection array GAMMASPHERE operated in conjunction with detectors for evaporated light charged particles and neutrons. The features of the rotational bands in Ni-57 (...) are compared to those of neighbouring isotopes and interpreted by means of configuration-dependent cranked Nilsson-Strutinsky calculations. The two observed high-spin bands are considered signature partners and assigned to configurations with one 1g(9/2) proton and one 1g(9/2) neutron, resulting in an unambiguous understanding of the energetically favoured signature alpha = -1/2 band but a somewhat less satisfactory description of the signature alpha = +1/2 band. (shrink)

The paper consists of two parts. The first part begins with the problem of whether the original three-valued calculus, invented by J. Łukasiewicz, really conforms to his philosophical and semantic intuitions. I claim that one of the basic semantic assumptions underlying Łukasiewicz's three-valued logic should be that if under any possible circumstances a sentence of the form "X will be the case at time t" is true (resp. false) at time t, then this sentence must be already true (resp. false) (...) at present. However, it is easy to see that this principle is violated in Lukasiewicz's original calculus (as the cases of the law of excluded middle and the law of contradiction show). Nevertheless it is possible to construct (either with the help of the notion of "supervaluation", or purely algebraically) a different three-valued, semi-classical sentential calculus, which would properly incorporate Łukasiewicz's initial intuitions. Algebraically, this calculus has the ordinary Boolean structure, and therefore it retains all classically valid formulas. Yet because possible valuations are no longer represented by ultrafilters, but by filters (not necessarily maximal), the new calculus displays certain non-classical metalogical features (like, for example, nonextensionality and the lack of the metalogical rule enabling one to derive "p is true or q is true" from" 'p ∨ q' is true"). The second part analyses whether the proposed calculus could be useful in formalizing inferences in situations, when for some reason (epistemological or ontological) our knowledge of certain facts is subject to limitation. Special attention should be paid to the possibility of employing this calculus to the case of quantum mechanics. I am going to compare it with standard non-Boolean quantum logic (in the Jauch-Piron approach), and to show that certain shortcomings of the latter can be avoided in the former. For example, I will argue that in order to properly account for quantum features of microphysics, we do not need to drop the law of distributivity. Also the idea of "reading off" the logical structure of propositions from the structure of Hilbert space leads to some conceptual troubles, which I am going to point out. The thesis of the paper is that all we need to speak about quantum reality can be acquired by dropping the principle of bivalence and extensionality, while accepting all classically valid formulas. (shrink)

Background and purpose: The functional understanding and examination of competitive anxiety responses as temporal events that unfold as time-to-competition moves closer has emerged as a topical research area within the domains of sport psychology. However, little is known from an inclusive and interaction oriented perspective. Using the multidimensional anxiety theory as a framework, the present study examined the temporal patterning of competitive anxiety, focusing on the dimensions of intensity, direction, and frequency of intrusions in athletes across gender and skill level. (...) Methods: Elite and semi-elite Table Tennis athletes from the Ghanaian league (N= 90) completed a modified version of Competitive State Anxiety Inventory-2 (CSAI-2) with the inclusion of the directional and frequency of intrusion scales at three temporal phases (7 days, two days and 1 hour) prior to a competitive fixture. Results: MANOVA repeated measures with follow-up analyses revealed significant interactions for between-subjects factors on all anxiety dimensions (intensity, direction and frequency). Notably, elite (international) female athletes were less cognitively anxious, showed more facilitative interpretation towards somatic anxiety symptoms and experienced less frequency of somatic anxiety symptoms than their male counterparts. However, both elite groups displayed appreciable level of self-confidence. For time-to-event effects, both cognitive and somatic anxiety intensity fluctuated whereas self-confidence showed a steady rise as competition neared. Somatic anxiety debilitative interpretation slightly improved 1 hour before competition whereas cognitive anxiety frequencies also increased progressively during the entire preparatory phase. Conclusions: Findings suggest a more dynamic image of elite athletes’ pre-competitive anxiety responses than suggested by former studies, potentially influenced by cultural differences. The use of psychological skills interventions that require effective structure, content, and timing in a composite manner is suggested. (shrink)

Orthomodular lattices with a two-valued Jauch–Piron state split into a generalized orthomodular lattice and its dual. GOMLs are characterized as a class of L-algebras, a quantum structure which arises in the theory of Garside groups, algebraic logic, and in connections with solutions of the quantum Yang–Baxter equation. It is proved that every GOML X embeds into a group G with a lattice structure such that the right multiplications in G are lattice automorphisms. Up to isomorphism, X is uniquely (...) determined by G, and the embedding \\) is a universal group-valued measure on X. (shrink)

What are the freedom-relevant conditions necessary for someone to be a morally responsible person? I examine several key authors beginning with Harry Frankfurt that have contributed to this debate in recent years, and then look back to the writings or Søren Kierkegaard to provide a solution to the debate. In this project I investigate the claims of semi-compatibilism and argue that while its proponents have identified a fundamental question concerning free will and moral responsibility—namely, that the agential properties necessary (...) for moral responsibility ascriptions are found in scenarios where the agent acts on her own as opposed to her action resulting from freedom undermining external causes such as manipulation, phobias, etc.—they have failed to show that the freedom-relevant agential properties identified in those actual-sequence scenarios are compatible with causal determinism. My argument is that only a voluntarist-libertarian theory can adequately account for the kinds of cases that the semicompatibilist identify. I argue that there are three freedom-relevant conditions necessary for someone to be a morally responsible person: a hierarchical understanding of human desires [specifically and mental states generally], an incompatibilist (non-deterministic) understanding of human action, and a historical understanding of character development. The ability to reflect critically about one’s own desires and emotions, and thus to have a kind of self-knowledge and understanding with regard to the springs of one’s own actions, is required to make it possible for the agent to be the “source” of her own actions and character. The non-deterministic understanding of human action is needed for a similar reason: if determinism is true, then every action a person performs can be ultimately traced to and exhaustively explained in terms of factors outside the agent’s control, thus making the agent’s responsibility for his actions an illusion. And finally,human nature must be such that, over time, one’s choices leave a dispositional residue self-understanding and motivation in the person’s self, out of which, in mature understanding and motivation, the person acts as a fully responsible agent. (shrink)

Background Noninvasive prenatal testing (NIPT) designed to screen for fetal genetic conditions, is increasingly being implemented as a part of routine prenatal care screening in the United States (US). However, these advances in reproductive genetic technology necessitate empirical research on the ethical and social implications of NIPT among populations underrepresented in genetic research, particularly Black women with sickle cell disease (SCD).Methods Forty (N = 40) semi-structured interviews were conducted virtually with Black women in the US (19 participants with SCD; (...) 21 participants without SCD) from June 2021 to January 2022. We employed a qualitative approach to examine the study participants’ perceptions of the potential advancement of NIPT for screening SCD in the fetus. Data were analyzed using NVivo 12 qualitative software.Results The themes revealed the complexities involving the intersectional lived experiences of SCD, prenatal care, lack of synergy among health providers, and NIPT decision-making. The results further revealed that even when Black women have shared commonalities in their lived experiences while navigating SCD and motherhood, their perceptions of NIPT screening technologies are divergent.Conclusion Expanding the ethical discourse on the social implications of NIPT is critical to fully elucidate how Black women perceive NIPT’s utility, particularly as NIPT advances to screen for SCD in the fetus. Neglecting to include Black women with genetic conditions in empirical studies on NIPT may contribute to ongoing health inequities and limit and constrain reproductive choices among Black women with and without SCD. (shrink)

To what extent, if at all, should a just society adopt public policies that regulate and limit the amount of time people work? Attempts to answer this question face a dilemma: Either, we can adopt a laissez-faire view, according to which governments must refrain from imposing working time policies on the labour market. But this view generates a situation in which many citizens experience deep regret about the balance between work and leisure in their lives. Or, we can endorse an (...) interventionist view that advocates government imposition of working time policies. However, such a view appears to be objectionably perfectionist insofar as it imposes on citizens a particular conception of the ideal balance between work and leisure. This article proposes a way out of this dilemma. It shows that the interventionist view can be defended on the anti-perfectionist grounds that this helps address a collective action problem in the labour market – the working time rat race. Employers often use working time as a proxy for their employees’ productivity and commitment. Those who work particularly long hours are often awarded benefits such as raises or promotions or are spared from dismissals. This makes it individually rational for each worker to work extra hours in an attempt to outcompete colleagues. However, if many workers pursue this strategy, it loses its effectiveness. Workers with preferences for more leisure have a claim to state intervention to remove the rat race when this doesn’t impose disproportionate harm on third parties. (shrink)

Settler-colonialism is founded in environmental racism, and environmental justice is foundational to all forms of decolonialization. Native American groups located in the Gulf Coast Region of the United States are particularly vulnerable to environmental justice issues such as climate change and oil spills due to their geographic location and reliance on the coastal region for economic and social resources. This study used the framework of historical oppression, resilience, and transcendence to explore the historic and contemporary forms of environmental injustice experienced (...) by a Native American tribe in the Gulf Coast region of the United States. This critical ethnography analyzeda series of individual, family, and focus group semi-structured qualitative interviews with a total of 208 participants. Following the critical ethnographic method, data were interpreted through reconstructive analysis using NVivo. Findings of this study reveal the continuing impact of the BP oil spill and difficulty accessing resources following the spill, complicated by the tribe’s lack of federal recognition. Additional themes include the continuing impact of coastal erosion, historical and contemporary land loss, geographic marginalization, and concerns about a loss of tribal identity when tribal members are forced to relocate. Lack of federal tribal recognition has exacerbated all of these issues for this tribe. This study supports national findings that Native American groups experience extensive historic and contemporary environmental injustices and contextualizes these findings for a Native American tribe in the Gulf Coast region of the United States. Recognizing Native American sovereignty is key to addressing the environmental justice issues described. (shrink)

Domestic livestock animals and soils must be considered together as part of an agroecosystem which includes plants. Soil sustainability may be simply defined as the maintenance of soil productivity for future generations. There are both positive and negative aspects concerning the role of animals in soil sustainability. In a positive sense, agroecosystems which include ruminant animals often also include hay forage-or pasture-based crops in the humid regions. Such crops stabilize the soil by decreasing erosion, improving soil structure and usually require (...) fewer chemical inputs. Monogastric animal culture is based on an agroecosystem consisting of mainly grain crops. These crops can result in the soil being exposed to water and wind erosion although soil conservation practices that significantly reduce soil losses may be followed. The management of animal manures is not always compatible with soil conservation practices. Careful management of the nutrients in manure is absolutely necessary to avoid nitrate contamination of ground water or phosphorus loading of streams and lakes. In a negative sense, increases in animal livestock populations in association with human population growth are promoting desertification in the arid and semi-arid regions of the world. The key component for a fully compatible and acceptable association between domestic animals and soil productivity is proper management. Careful management of the components of an animal-based agroecosystem is required if soil productivity and environmental quality are to be maintained. Although we have much to learn, technologies are available to move a considerable way towards this ideal state. (shrink)

In 2004, the agricultural economies of many rural communities in the United States were impacted by the cessation of a price-support and supply-control program for tobacco production. Tobacco was not only an important livelihood, but also was central to social and cultural life. Using a social–ecological systems lens and the adaptive cycle metaphor, we examine the reorganization of agriculture in communities that previously produced tobacco under the program. Specifically, we seek to understand how transitional policy that provided financial support to (...) tobacco farmers interacted with other social, cultural, physical and human capitals to condition system reorganization. We conducted semi-structured interviews with farmers, extension agents, and policy makers in Kentucky as well as examined trends in income and number of farmers before and after the transition as indicators of reorganization. We determined that the financial support was perceived as helpful in supporting the transition and that tobacco farmers reorganized their livelihoods primarily around existing, remnant assets and endogenous capacities. In addition, we determined that though the agricultural system may be reorganizing economically, it is not necessarily supportive of the same social bonds and values that co-existed with tobacco economy. Understanding agricultural economies as part of complex social–ecological systems that consist of interconnected values, identities, ecology and social ties is important for developing policies to support systems and communities through economic transitions. (shrink)

A new axiomatic treatment of equilibrium thermodynamics—thermostatics—is presented. The equilibrium states of a thermal system are assumed to be represented by a differentiable manifold of dimensionn + 1 (n finite). The empirical temperature is defined by the notion of thermal equilibrium. Empirical entropy is shown to exist for all systems with the property that the total work delivered along closed adiabats is zero. Absolute entropy and temperature follow from the additivity of heat and energy for two separate systems in thermal (...) equilibrium considered as a whole. The absolute temperature is defined up to a multiplicative constant. The exterior differentiable calculus of Cartan is introduced and in a subsequent paper its use for the derivation of standard results in thermostatics will be explained. (shrink)

The abstract description of a physical system is developed, along lines originally suggested by Birkhoff and von Neumann, in terms of the complete lattice of propositions associated with that system, and the distinction between classical and quantum systems is made precise. With the help of the notion of state, a propositional system is defined: it is remarked that every irreducible propositional system (of more than three dimensions) is isomorphic to the lattice of all closed subspaces of a Hilbert space (...) constructed on some division ring with involution. The propositional system consisting of a family of separable complex Hilbert spaces is treated as a particular case which is sufficiently general to include both classical and quantum mechanics. The theory of the Galilean particle without spin is given as an illustration. Finally, the basis for the statistical interpretation of wave mechanics is developed with the help of Gleason's theorem. In an appendix, a proof of essentially the first part of Gleason's theorem is given which is a little different (perhaps more geometric) from that originally given by Gleason. (shrink)

The paper proposes a first approach to systems whose language includes two primitives (>+ and >-) as symbols for factual and counterfactual conditionals which are explicit, i.e. that are stated jointly with the truth or falsity of the antecedent clause. In systems based on this language, here called 2-conditional, the standard corner operator may be defined by (Def>) A > B := (A >+ B)∨(A >- B), while in classical conditional systems one could introduce the two symbols for explicit conditionals (...) by the definitions (Def>+) A >+ B := A∧(A>B) and (Def>-) A>- B := ¬A∧(A>B). Two 2-conditional systems, V² and VW², are axiomatized and proved to be definitionally equivalent to the monoconditional systems V and VW. A third system VWTr² is characterized by an axiom stating the transitivity of factual conditionals and is shown to be distinct from V², from VW² and from the 2-conditional version of Lewis’ well-known system VC, here named VC². The same may be said for a fourth system VW²◊ ±, based on an axiom inderivable in VC²: ◊(A >+ B) ⊃ ◊( ¬A >- ¬B). VC² contains what is here called a “semi-collapse” of the operator >+ and it is argued that it is inadequate as a logic for both factual and counterfactual conditionals. The last section shows that several different definitions of the corner operators in terms of >+ and >- may be introduced as an alternative to (Def>). (shrink)

This grounded study investigated the negotiation of authorship by faculty members, graduate student mentors, and their undergraduate protégés in undergraduate research experiences at a private research university in the northeastern United States. Semi-structured interviews using complementary scripts were conducted separately with 42 participants over a 3 year period to probe their knowledge and understanding of responsible authorship and publication practices and learn how faculty and students entered into authorship decision-making intended to lead to the publication of peer-reviewed technical papers. (...) Herein the theoretical model for the negotiation of authorship developed through the analysis of these interviews is reported. The model identifies critical causal and intervening conditions responsible for the coping strategies faculty and students employ, which, in our study, appear to often produce unfortunate consequences for all involved. The undergraduate student researchers and their graduate student mentors interviewed in this study exhibited a limited understanding of authorship and the requirements for authorship in their research groups. The power differential between faculty and students, the students’ limited epistemic development, the busy-ness of the faculty, and the faculty’s failure to prioritize authorship have been identified as key factors inhibiting both undergraduate and graduate students from developing a deeper understanding of responsible authorship and publication practices. Implications for graduate education and undergraduate research are discussed, and strategies for helping all students to develop a deeper understanding of authorship are identified. (shrink)

Background Genuine uncertainty on superiority of one intervention over the other is called equipoise. Physician-investigators in randomized controlled trials need equipoise at least in studies with more than minimal risks. Ideally, this equipoise is also present in patient-participants. In pediatrics, data on equipoise are lacking. We hypothesize that 1) lack of equipoise at enrolment among parents may reduce recruitment; 2) lack of equipoise during participation may reduce retention in patients assigned to a less favoured treatment-strategy. Methods We compared preferences of (...) parents/patients at enrolment, documented by a questionnaire, with preferences developed during follow-up by an interview-study to investigate equipoise of child-participants and parents in the BeSt-for-Kids-study. This trial in new-onset Juvenile Idiopathic Arthritis-patients consists of three strategies. One strategy comprises initial treatment with a biological disease-modifying-antirheumatic-drug, currently not standard-of-care. Semi-structured interviews were conducted with 23 parents and 7 patients, median 11 months after enrolment. Results Initially most parents and children were not in equipoise. Parents/patients who refused participation, regularly declined due to specific preferences. Many participating families preferred the biological-first-strategy. They participated to have a chance for this initial treatment, and would even consider stopping trial-participation when not randomized for it. Their conviction of superiority of the biological-first strategy was based on knowledge from internet and close relations. According to four parents, the physician-investigator preferred the biological-first-strategy, but the majority stated that she had no preferred strategy. In phase 2, preferences tended to change to the treatment actually received. Conclusions Lack of equipoise during enrolment did not reduce study recruitment, mainly due to the fact that preferred treatment was only available within the study. Still, when developing a trial it is important to evaluate whether the physicians’ research question is in line with preferences of the patient-group. By exploring so-called ‘informed patient-group’-equipoise, successful recruitment may be enhanced and bias avoided. In our study, lack of equipoise during trial-participation did not reduce retention in those assigned to a less favoured option. We observed a change for preference towards treatment actually received, possibly explained by comparable outcomes in all three arms. (shrink)

The purpose of this article is to understand how historical oppression has undermined health through environmental injustices that have given rise to food insecurity. Specifically, the article examines ways in which settler colonialism has transformed and contaminated the land itself, impacting the availability and quality of food and the overall health of Indigenous peoples. Food security and environmental justice for Gulf Coast, state-recognized tribes has been infrequently explored. These tribes lack federal recognition and have limited access to recourse and (...) supplemental resources as a result. This research fills an important gap in the literature through exploring the intersection of environmental justice and food insecurity issues for this population. Partnering with a community-advisory board and using a qualitative descriptive methodology, 31 Gulf Coast Indigenous women participated in semi-structured interviews about their healthcare experiences and concerns. Through these interviews, participants expressed concerns about (a) the environmental impacts of pollution on the contamination of food and on the health of tribal members; and (b) the impact of these changes on the land, such as negatively impacting gardening practices. The authors of this study document how environmental changes have compounded these concerns and contribute to the overall pollution of food and water sources and unviability of subsistence practices, severely effecting tribal members’ health. In conclusion, we show how social and environmental justice issues such as pollution, industry exploitation, and climate change perpetuate the goals of settler colonialism through undermining cultural practices and the overall health of Indigenous peoples. (shrink)

Moral distress is a well-documented phenomenon for health care providers (HCPs). Exploring HCPs’ perceptions of participation in moral distress interventions using qualitative and quantitative methods enhances understanding of intervention effectiveness. The purpose of this study was to measure and describe the impact of a two-phased intervention on participants’ moral distress. Using a cross-over design, the project aimed to determine if the intervention would decrease moral distress, enhance moral agency, and improve perceptions about the work environment. We used quantitative instruments and (...) explored participants’ perceptions of the intervention using semi-structured interviews. Participants were from inpatient settings, within three major hospitals of a large, urban healthcare system in the Midwest, United States. Participants included nurses (80.6%) and other clinical care providers. Using generalized linear mixed modeling we assessed the change in each of the outcome variables over time controlling for groups. Interviews were audiotaped and professionally transcribed. The written narratives were coded into themes. The change in scores on study instruments trended in the desired direction however did not meet statistical significance. Qualitative interviews revealed that intervention effectiveness was derived from a combination of learning benefits, psychological benefits, and building community that promoted moral agency. Findings demonstrate a clear link between moral distress and moral agency and suggest that Facilitated Ethics Conversations can enhance the work environment. Findings provide insight for developing evidenced-based approaches to address moral distress of hospital nurses. (shrink)

Humans, animals, and the environment face a universal crisis: antimicrobial resistance. Addressing AR and its multi-disciplinary causes across many sectors including in human and veterinary medicine remains underdeveloped. One barrier to AR efforts is an inconsistent process to incorporate the plenitude of stakeholders about what AR is and how to stifle its development and spread—especially stakeholders from the animal agriculture sector, one of the largest purchasers of antimicrobial drugs. In 2019, The Wellcome Trust released Reframing Resistance: How to communicate about (...) antimicrobial resistance effectively, which proposed the need to establish a consistent and harmonized messaging effort that describes the AR crisis and its global implications for health and wellbeing across all stakeholders. Yet, Reframing Resistance does not specifically engage the animal agriculture community. This study investigates the gap between two principles recommended by Reframing Resistance and animal agriculture stakeholders. For this analysis, the research group conducted 31 semi-structured interviews with a diverse group of United States animal agriculture stakeholders. Participants reported attitudes, beliefs, and practices about a variety of issues, including how they defined AR and what entities the AR crisis impacts most. Exploration of Reframing Resistance’s Principle 2, “explain the fundamentals succinctly” and Principle 3, “emphasis that this is universal issue; it can affect anyone, including you” reveals disagreement in both the fundamentals of AR and consensus of “who” the AR crisis impacts. Principle 2 may do better to acknowledge that animal agriculture stakeholders espouse a complex array of perspectives that cannot be summed up in a single perspective or principle. As a primary tool to combat AR, behavior change must be accomplished first through outreach to stakeholder groups and understanding their perspectives. (shrink)

Background There are intense discussions about the ethical and societal implications of biomedical engineering, but little data to suggest how scientists think about the ethics of their work. The aim of this study is to describe how scientists frame the ethics of their research, with a focus on the field of molecular systems engineering.Methods Semi-structured qualitative interviews were conducted during 2021–2022, as part of a larger study. This analysis includes a broad question about how participants view ethics as related (...) to their work, with follow up probes about the topics they consider most important. Interviews were transcribed, inductively coded by two researchers to consensus, and analyzed thematically.Results Twenty-four scientists participated in the study. Interviewees hold positions as professors, principal investigators, and senior staff researchers in universities or research institutes in the United States and Europe. Among those scientists who reported reflecting on ethical considerations in their work, many equated ethics with research ethics topics (e.g., safety, replicability), or with regulation and guidelines. Participants expressed the view that ethical issues are primarily relevant for clinical trials of bioengineered products, or for those working with animal or human subjects. Scientists described their research as “too early” or “not examining anything living” with regard to ethical reflection. Finally, many felt that ethics is seen as territory for experts and therefore beyond scientists’ competencies.Conclusions Molecular systems engineering scientists currently focus on regulatory aspects as the framework for their ethical analyses. They describe using a framework to define when life arises, as a means to determine when further ethical engagement is warranted. Further research is needed to investigate how scientists relate to the ethics of their scientific work, and build consensus around concepts of life, autonomous behavior, and physiological relevance of bioengineered systems. (shrink)

BackgroundKeeping the patients well and fully informed about diagnosis, prognosis, and treatments is one of the patient’s rights in any healthcare system. Although all healthcare providers have the same viewpoint about rendering the truth in treatment process, sometimes the truth is not told to the patients; that is why the healthcare staff tell “white lie” instead. This study aimed to explore the nurses’ experience of white lies during patient care.MethodsThis qualitative study was conducted from June to December 2018. Eighteen hospital (...) nurses were recruited with maximum variation from ten state-run educational hospitals affiliated to Tehran University of Medical Sciences. Purposeful sampling was used and data were collected by semi-structured interviews that were continued until data saturation. Data were classified and analyzed by content analysis approach.ResultsThe data analysis in this study resulted in four main categories and 11 subcategories. The main categories included hope crisis, bad news, cultural diversity, and nurses’ limited professional competences.ConclusionResults of the present study showed that, white lie told by nurses during patient care may be due to a wide range of patient, nurse and/or organizational related factors. Communication was the main factor that influenced information rendering. Nurses’ communication with patients should be based on mutual respect, trust and adequate cultural knowledge, and also nurses should provide precise information to patients, so that they can make accurate decisions regarding their health care. (shrink)

In recent years, the biopharmaceutical industry has seen an increase in the development of so-called orphan drugs for the treatment of rare and neglected diseases. This increase has been spurred on by legislation in the United States, Europe, and elsewhere designed to promote orphan drug development. In this article, we examine the drivers of corporate social responsibility (CSR) activities in orphan drug markets and the extent to which biopharmaceutical firms engage in these activities with a strategic orientation. The unique context (...) of orphan drugs constitutes a research opportunity to test the applicability of existing theoretical perspectives on CSR and strategic CSR. Using Schwartz and Carroll’s (Bus Ethics Q, 13(4):503–530, 2003) three-domain approach to CSR and the literature on strategic CSR as a theoretical background, we employ a combination of semi-structured interviews and a quantitative website content analysis to study practices of biopharmaceutical firms in the United States and European Union. Our findings show that both US- and EU-based companies engaged in orphan drugs development perceive their involvement as a responsible business activity beyond the economic dimension of CSR. However, for the majority of these companies their CSR activities do not qualify as strategic according to the criteria established in the literature. We also find significant differences between larger and smaller firms in their use of CSR. Based on these findings, we make several suggestions regarding orphan drug legislation and other measures that might help firms exploit strategic CSR benefits. (shrink)

We address the old question whether a logical understanding of Quantum Mechanics requires abandoning some of the principles of classical logic. Against Putnam and others (Among whom we may count or not E. W. Beth, depending on how we interpret some of his statements), our answer is a clear "no". Philosophically, our argument is based on combining a formal semantic approach, in the spirit of E. W. Beth's proposal of applying Tarski's semantical methods to the analysis of physical theories, with (...) an empirical-experimental approach to Logic, as advocated by both Beth and Putnam, but understood by us in the view of the operationalrealistic tradition of Jauch and Piron, i. e. as an investigation of "the logic of yes-no experiments" (or "questions"). Technically, we use the recently-developed setting of Quantum Dynamic Logic (Baltag and Smets 2005, 2008) to make explicit the operational meaning of quantum-mechanical concepts in our formal semantics. Based on our recent results (Baltag and Smets 2005), we show that the correct interpretation of quantum-logical connectives is dynamical, rather than purely propositional. We conclude that there is no contradiction between classical logic and (our dynamic reinterpretation of) quantum logic. Moreover, we argue that the Dynamic-Logical perspective leads to a better and deeper understanding of the "non-classicality" of quantum behavior than any perspective based on static Propositional Logic. (shrink)

I define sublaltices of quantum propositions that can be taken as having determinate (but perhaps unknown) truth values for a given quantum state, in the sense that sufficiently many two-valued maps satisfying a Boolean homomorphism condition exist on each determinate sublattice to generate a Kolmogorov probability space for the probabilities defined by the slate. I show that these sublattices are maximal, subject to certain constraints, from which it follows easily that they are unique. I discuss the relevance of this (...) result for the measurement problem, relating it to an early proposal by Jauch and Piron for defining a new notion of state for quantum systems, to a recent uniqueness proof by Clifton for the sublattice of propositions specified as determinate by modal interpretations of quantum mechanics that exploit the polar decompostion theorem, and to my own previous suggestions for interpreting quantum mechanics without the projection postulate. (shrink)

We live in layers of mixed realities with continuous conflicts, negotiation and becoming. I find it interesting to look at our situation as a continuous struggle in the fusion of virtual/actual presences, and machine/human. However, we seem to be far from understanding these relationships. Maybe the problem lies in the questions themselves, promoting unidirectional preconceptions. By reversing the questions, we might be able to identify something that has been missing in previous discussions: Can we talk about disconnection to further discuss (...) connection? Can we talk about distancing to further discuss the process of becoming? Can we talk about love impossible, to further discuss love? This paradoxical journey would maintain us in the continuum of struggle and massive doubts, and encounter deep aspects of human being. In this article, I examine the Korean cultural psyche called han in the context of a paradoxical state of consciousness and the story of love impossible, and argue that han is a driving force of transformative ritual in human consciousness. Beyond cultural boundaries, this article also positions han in a microscopic view of contemporary life. han underlies paradoxical human relationships with objects, and with my virtual puppets, in the context of distance, disconnection and love impossible. (shrink)

This paper explores differences in national responses to foodborne disease outbreaks, addressing both the sources of policy divergence and their implications for public health and coordinated emergency response. It presents findings from a comparative study of two multi-state E. coli outbreaks, one in the United States and one in Germany, demonstrating important differences in how risk managers understood and responded to each nation’s first major outbreak associated with fresh produce. Drawing on a qualitative analysis of 36 semi-structured interviews (...) with key stakeholders and hundreds of archival documents, this paper traces how social constructions of the E. coli risk interacted with organizational dynamics among state and industry actors to produce divergent policy outcomes: the U.S. outbreak was understood primarily as an agricultural problem that led to an industry-led agricultural solution, whereas the German outbreak was understood as a human disease problem that did not result in a substantial policy response once the acute health crisis passed. The paper concludes by discussing how these policy processes generate partial solutions to foodborne contamination that expose modern societies to systemic vulnerabilities. (shrink)

Movements tend to employ instituent practices and to acquire constitutive characteristics when they set up the material foundations of their collective autonomy, i.e. when they establish socially reproductive commons, democratically producing forms of life that respond to basic needs of the participants to the commons. The legal recognition of the sphere of the commons and the freedom of people to share, co-establish and self-regulate whole infrastructures of their social production is therefore not a negligible change but a complete reversal of (...) the logic currently underlying our legal order. It is, therefore, clear that to the end of multiplying and expanding the sphere of the commons we need to invent a new theory of a law of the commons and a hybrid and transitional semi-state ius communis, which will be capable of incorporating the acquis of social movements and receptive to emerging forms of life of the oppressed. (shrink)

RESUMO Este artigo propõe pensar sobre as vicissitudes do cuidado na rede pública de atenção psicossocial e sobre a fundamentação de uma perspectiva ético-dialógica de trabalho a partir de contribuições bakhtinianas. A reflexão se entretece na análise de impasses e possibilidades para a práxis em um Centro de Atenção Psicossocial da Região Metropolitana I do Estado do Rio de Janeiro. O estudo é resultado da pesquisa de mestrado vinculada ao Programa de Pós-graduação em Saúde Pública da Escola Nacional de Saúde (...) Pública Sergio Arouca da Fundação Oswaldo Cruz. Foram realizadas entrevistas semiestruturadas com os profissionais e observação participante no cotidiano da instituição. A partir das análises realizadas sob o prisma do Construcionismo Social e do recurso de análise de práticas discursivas e produção de sentidos, verificamos a presença de posicionamentos contraditórios expressos em percepções que se mostraram ao mesmo tempo consonantes e conflitantes com pressupostos ético-dialógicos. ABSTRACT This paper proposes to think about the vicissitudes of care in the public psychosocial care network and about the fundamentals of an ethical-dialogical perspective of work with grounds in the Bakhtinian contributions. The reflection is interwoven in the analysis of the impasses and possibilities for the praxis in one Centro de Atenção Psicossocial - [Psychosocial Care Center - PCC] in the metropolitan area of the State of Rio de Janeiro, Brazil. The study is the result of a Master’s Degree research, linked to the Public Health Postgraduate Program of the Sergio Arouca National Public Health School of the Oswaldo Cruz Foundation. Semi-structured interviews and participant observation were carried out with professionals during the institutional routine. From the analyses performed under the perspective of Social Constructionism and using the resource of analysis of discursive practices and meaning production, we verified the presence of contradicting positions expressed in perceptions that are both aligned and conflicting with dialogical ethics assumptions. (shrink)

O presente artigo analisa as ligações entre a Cáritas Brasileira e a Economia Popular Solidária a partir do trabalho do Agente de Cáritas. A problemática central do artigo remete às representações sociais que esses Agentes constroem em seus relatos sobre os princípios da Teologia da Libertação que norteiam os projetos em economia solidária da referida instituição religiosa. A metodologia de base qualitativa e etnográfica consistiu na realização da revisão bibliográfica, consulta a materiais institucionais, observação in loco e entrevistas semiestruturadas com (...) Agentes que atuam na Economia Popular Solidária no estado do Ceará. A análise das representações sinaliza que a própria noção de “Reino de Deus” na terra pressupõe a vinculação profunda entre religião e economia, mística e movimentos sociais, religião e Estado, configurando, dessa forma, um projeto de sociedade contra hegemônico que se vislumbra mediante a transformação radical da base econômica e moral do tecido social contrapondo individualismo à solidariedade. Palavras-chave: Cáritas Brasileira. Economia Popular Solidária. Caridade Libertadora. Teologia da Libertação.This article examines the links between Brazilian Caritas and Popular Solidarity Economy from the work of Caritas Agent. The central issue of the article refers to the social representations that these agents build in his histories about the principles of Liberation Theology that guide the projects in solidarity economy of that religious institution. The basic methodology used was qualitative and ethnographic; It consisted in literature review, consultation to institutional materials, observation in loco and semi-structured interviews with agents who act in the Popular Solidarity Economy in the state of Ceará. The analysis of representations indicates that the very notion of "Kingdom of God" on earth presupposes deep linking between religion and economics, mystic and social movements, religion and state configuring a project of a counter hegemonic society who sees through the radical transformation of the economic and moral base of the social tissue opposing solidarity to individualism. Keywords : Brazilian Caritas. Popular Solidarity Economy. Liberating Charity. Liberation. (shrink)

The starting point for studying the Croatian constitutional democracy is the adoption of the Constitution of the Republic of Croatia on 22 December 1990. The said Constitution defines the system of government as semi-presidential and its authors state as their model the Constitution of the Fifth Republic. However, the importing, in 1990, of French constitutional provisions was not neutral since the original French constitutional text was stripped of institutional obstacles, constitutional institutions for opposing the will of the President (...) of the Republic, constitutional-law conditions for the Prime Minister's primacy in the political system in case of co-habitation and discrepancies between the parliamentary and the presidential majority. The text was complemented by constitutional norms unknown to the original. French constitutional norms had to be put to good use, interpreted in line with and legally adapted to the desired political goal, i.e., the establishment of an effective state government in which the primacy of the President of the Republic would assert itself over both the Government and the legislature. The myth on the semi-presidential system was drawn on for both the adoption of the provisions regulating the organisation of government in the 1990 Constitution of the Republic of Croatia and their amendment in 2000. (shrink)

The mathematical description of the three distinct fundamental notions of “individual sample” of “preparing procedure,” and of “Piron's state” of a physical entity are precisely introduced in the framework of the Piron's “preparation-question structure” (without specific axioms C, P, A) based on Ludwig's “selection structure.” We compare our realization of the above notions with a similar use of the standard terminology of the “Geneva School” adopted by Pykacz and Santos in a recent paper.

Ayahuasca, a hallucinogen with profound consciousness- altering properties, has been increasingly utilized in recent studies (e.g., Strassman, 2001; Shanon, 2002a,b). However, other than Shanon's recent work, there has been little attempt to examine the effects of ayahuasca on perceptual, affective and cognitive experience, its relation to fringe consciousness or to pertinent personality variables. Twenty-one volunteers attending a seminar on ayahuasca were administered personality measures and a semi-structured interview about phenomenal qualities of their experience. Ayahuasca ingestion was associated with profound (...) alterations of temporal- spatial experiences including expansive space and slowed time. Ayahuasca use was also associated with positive emotional states, higher levels of fantasy proneness and psychological absorption and a greater openness to mystical experiences. Conversely, quickened time was associated with negative emotionality. The results are discussed within a multi-faceted model of fringe consciousness with a particular emphasis on Hunt's (1995) models of cross-modal translation as the basis for higher-order symbolic cognition and support James' (1890/1950) contention that fringe consciousness is essential to human cognition. (shrink)

In this short note we provide an example of a semi-linear group G which does not admit a semi-linear affine embedding; in other words, there is no semi-linear isomorphism between topological groups f:G→G′Mm, such that the group topology on G′ coincides with the subspace topology induced by Mm.

Brunner, Austin Farrer, W.M. Horton, Pierre Maury.

Three issues related to Feldman and Levin's treatment of biological variability are discussed. We question the usefulness of the indirect component of δλ. We suggest that trade-offs between speed and accuracy in aimed movements support identification of δλ, rather than λ, as a control variable. We take issue with the authors' proposal for resolving redundancy in multi-joint movements, given recent data.

The article presents some of the results of the research project Lúdica y juego en la educación infantil: construcción conceptual–Play and Games in Early Childhood Education: A Conceptual Construct–financed by the Vicerrectoría de Investigaciones of the Universidad Pedagógica y Tecnológica de Colombia, Tunja, Boyacá, Colombia. The aim was to identify and explore the conceptions of what the Campamento Filosófico (Philosophy Camp) represents for its participants within the framework of the project Filosofía e infancia (Philosophy and Childhood). This study takes a (...) qualitative approach, for which semi-structured interviews were used as an instrument for data collection. Also, Atlas.ti 8® software was used for data analysis. An open, axial and selective coding was carried out, in which the emerging categories of the analysis were “experience,” “encounter,” “learning,” “self-care” and “body”. As a result of this conceptualization, it was found that philosophy camps are scenarios that make possible a relationship between university learning environments and primary, elementary and middle school educational contexts. They also enable an experience of the dialogic encounter between different perspectives on the same philosophical topic. Through the Philosophy Camp, philosophy is brought to the school, and the encounter with childhood - as a state, attitude and possibility - fosters spaces for thought, friendship and interaction. (shrink)

ABSTRACT I argue that this examination and appreciation for the shift to abductive reasoning should be extended to the intersection of neuroscience and novel brain-computer interfaces too. This paper highlights the implications of applying abductive reasoning to personalized implantable neurotechnologies. Then, it explores whether abductive reasoning is sufficient to justify insurance coverage for devices absent widespread clinical trials, which are better applied to one-size-fits-all treatments. INTRODUCTION In contrast to the classic model of randomized-control trials, often with a large number of (...) subjects enrolled, precision medicine attempts to optimize therapeutic outcomes by focusing on the individual.[i] A recent publication highlights the strengths and weakness of both traditional evidence-based medicine and precision medicine.[ii] Plus, it outlines a tension in the shift from evidence-based medicine’s inductive reasoning style (the collection of data to postulate general theories) to precision medicine’s abductive reasoning style (the generation of an idea from the limited data available).[iii] The paper’s main example is the application of precision medicine for the treatment of cancer.[iv] I argue that this examination and appreciation for the shift to abductive reasoning should be extended to the intersection of neuroscience and novel brain-computer interfaces too. As the name suggests, brain-computer interfaces are a significant advancement in neurotechnology that directly connects someone’s brain to external or implanted devices.[v] Among the various kinds of brain-computer interfaces, adaptive deep brain stimulation devices require numerous personalized adjustments to their settings during the implantation and computation stages in order to provide adequate relief to patients with treatment-resistant disorders. What makes these devices unique is how adaptive deep brain stimulation integrates a sensory component to initiate the stimulation. While not commonly at the level of sophistication as self-supervising or generative large language models,[vi] they currently allow for a semi-autonomous form of neuromodulation. This paper highlights the implications of applying abductive reasoning to personalized implantable neurotechnologies. Then, it explores whether abductive reasoning is sufficient to justify insurance coverage for devices absent widespread clinical trials, which are better applied to one-size-fits-all treatments.[vii] ANALYSIS I. The State of Precision Medicine in Oncology and the Epistemological Shift While a thorough overview of precision medicine for the treatment of cancer is beyond the scope of this article, its practice can be roughly summarized as identifying clinically significant characteristics a patient possesses (e.g., genetic traits) to land on a specialized treatment option that, theoretically, should benefit the patient the most.[viii] However, in such a practice of stratification patients fall into smaller and smaller populations and the quality of evidence that can be applied to anyone outside these decreases in turn.[ix] As inductive logic helps to articulate, the greater the number of patients that respond to a particular therapy the higher the probability of its efficacy. By straying from this logical framework, precision medicine opens the treatment of cancer to more uncertainty about the validity of these approaches to the resulting disease subcategories.[x] Thus, while contemporary medical practices explicitly describe some treatments as “personalized”, they ought not be viewed as inherently better founded than other therapies.[xi] A relevant contemporary case of precision medicine out of Norway focuses on the care of a patient with cancer between the ventricles of the heart and esophagus, which had failed to respond to the standard regimen of therapies over four years.[xii] In a last-ditch effort, the patient elected to pay out-of-pocket for an experimental immunotherapy (nivolumab) at a private hospital. He experienced marked improvements and a reduction in the size of the tumor. Understandably, the patient tried to pursue further rounds of nivolumab at a public hospital. However, the hospital initially declined to pay for it given the “lack of evidence from randomised clinical trials for this drug relating to this [patient’s] condition.”[xiii] In rebuttal to this claim, the patient countered that he was actually similar to a subpopulation of patients who responded in “open‐label, single arm, phase 2 studies on another immune therapy drug” (pembrolizumab).[xiv] Given this interpretation of the prior studies and the patient’s response, further rounds of nivolumab were approved. Had the patient not had improvements in the tumor’s size following a round of nivolumab, then pembrolizumab’s prior empirical evidence in isolation would have been insufficient, inductively speaking, to justify his continued use of nivolumab.[xv] The case demonstrates a shift in reasoning from the traditional induction to abduction. The phenomenon of ‘cancer improvement’ is considered causally linked to nivolumab and its underlying physiological mechanisms.[xvi] However, “the weakness of abductions is that there may always be some other better, unknown explanation for an effect. The patient may for example belong to a special subgroup that spontaneously improves, or the change may be a placebo effect. This does not mean, however, that abductive inferences cannot be strong or reasonable, in the sense that they can make a conclusion probable.”[xvii] To demonstrate the limitations of relying on the abductive standard in isolation, commentators have pointed out that side effects in precision medicine are hard to rule out as being related to the initial intervention itself unless trends from a group of patients are taken into consideration.[xviii] As artificial intelligence (AI) assists the development of precision medicine for oncology, this uncertainty ought to be taken into consideration. The implementation of AI has been crucial to the development of precision medicine by providing a way to combine large patient datasets or a single patient with a large number of unique variables with machine learning to recommend matches based on statistics and probability of success upon which practitioners can base medical recommendations.[xix] The AI is usually not establishing a causal relationship[xx] – it is predicting. So, as AI bleeds into medical devices, like brain-computer interfaces, the same cautions about using abductive reasoning alone should be carried over. II. Responsive Neurostimulation, AI, and Personalized Medicine Like precision medicine in cancer treatment, computer-brain interface technology similarly focuses on the individual patient through personalized settings. In order to properly expose the intersection of AI, precision medicine, abductive reasoning, and implantable neurotechnologies, the descriptions of adaptive deep brain stimulation systems need to deepen.[xxi] As a broad summary of adaptive deep brain stimulation, to provide a patient with the therapeutic stimulation, a neural signal, typically referred to as a local field potential,[xxii] must first be detected and then interpreted by the device. The main adaptive deep brain stimulation device with premarket approval, the NeuroPace Responsive Neurostimulation system, is used to treat epilepsy by detecting and storing “programmer-defined phenomena.”[xxiii] Providers can optimize the detection settings of the device to align with the patient’s unique electrographic seizures as well as personalize the reacting stimulation’s parameters.[xxiv] The provider adjusts the technology based on trial and error. One day machine learning algorithms will be able to regularly aid this process in myriad ways, such as by identifying the specific stimulation settings a patient may respond to ahead of time based on their electrophysiological signatures.[xxv] Either way, with AI or programmers, adaptive neurostimulation technologies are individualized and therefore operate in line with precision medicine rather than standard treatments based on large clinical trials. Contemporary neurostimulation devices are not usually sophisticated enough to be prominent in AI discussions where the topics of neural networks, deep learning, generative models, and self-attention dominate the conversation. However, implantable high-density electrocorticography arrays (a much more sensitive version than adaptive deep brain stimulation systems use) have been used in combination with neural networks to help patients with neurologic deficits from a prior stroke “speak” through a virtual avatar.[xxvi] In some experimental situations, algorithms are optimizing stimulation parameters with increasing levels of independence.[xxvii] An example of neurostimulation that is analogous to the use of nivolumab in Norway surrounds a patient in the United States who was experiencing both treatment-resistant OCD and temporal lobe epilepsy.[xxviii]Given the refractory nature of her epilepsy, implantation of an adaptive deep brain stimulation system was indicated. As a form of experimental therapy, her treatment-resistant OCD was also indicated for the off-label use of an adaptive deep brain stimulation set-up. Another deep brain stimulation lead, other than the one implanted for epilepsy, was placed in the patient’s right nucleus accumbens and ventral pallidum region given the correlation these nuclei had with OCD symptoms in prior research. Following this, the patient underwent “1) ambulatory, patient-initiated magnet-swipe storage of data during moments of obsessive thoughts; (2) lab-based, naturalistic provocation of OCD-related distress (naturalistic provocation task); and (3) lab-based, VR [virtual reality] provocation of OCD-related distress (VR provocation task).”[xxix] Such signals were used to identify when to deliver the therapeutic stimulation in order to counter the OCD symptoms. Thankfully, following the procedure and calibration the patient exhibited marked improvements in their OCD symptoms and recently shared her results publicly.[xxx] In both cases, there is a similar level of abductive justification for the efficacy of the delivered therapy. In the case study in which the patient was treated with adaptive deep brain stimulation, they at least had their neural activity tested in various settings to determine the optimum parameters for treatment to avoid them being based on guesswork. Additionally, the adaptive deep brain stimulation lead was already placed before the calibration trials were conducted, meaning that the patient had already taken on the bulk of the procedural risk before the efficacy could be determined. Such an efficacy test could have been replicated in the first patient’s cancer treatment, had it been biopsied and tested against the remaining immunotherapies in vitro. Yet, in the case of cancer with few options, one previous dose of a drug that appeared to work on the patient may justify further doses. However, as the Norwegian case presents, corroboration with known responses to a similar drug (from a clinical trial) could be helpful to validate the treatment strategy. (It should be noted that both patients were resigned to these last resort options regardless of the efficacy of treatment.) There are some elements of inductive logic seen with adaptive deep brain stimulation research in general. For example, abductively the focus could be that patient X’s stimulation parameters are different from patient Y’s and patient Z’s. In contrast, when grouped as subjects who obtained personalized stimulation, patients X, Y, and Z demonstrate an inductive aspect to this approach’s safety and/or efficacy. The OCD case holds plenty of abductive characteristics in line with precision medicine’s approach to treating cancer and as more individuals try the method, there will be additional data. With the gradual integration of AI into brain-computer interfaces in the name of efficacy, this reliance on abduction will continue, if not grow, over time. Moving forward, if a responsive deep brain stimulation treatment is novel and individualized (like the dose of nivolumab) and there is some other suggestion of efficacy (like clinical similarities to other patients in the literature), then it may justify insurance coverage for the investigative intervention, absent other unrelated reasons to deny it. III. Ethical Implications and Next Steps While AI’s use in oncology and neurology is not yet as prominent as its use in other fields (e.g., radiology), it appears to be on the horizon for both.[xxxi] AI can be found in both the functioning of the neurotechnologies as well as the implementation of precision medicine. The increasing use of AI may serve to further individualize both oncologic and neurological therapies. Given these implications and the handful of publications cited in this article, it is important to have a nuanced evaluation of how these treatments, which heavily rely on abductive justification, ought to be managed. The just use an abductive approach may be difficult as AI infused precision medicine is further pursued. At baseline, such technology relies on a level of advanced technology literacy among the general public and could exclude populations who lack access to basic technological infrastructure or know-how from participation.[xxxii] Even among nations with adequate infrastructure, as more patients seek out implantable neurotechnologies, which require robust healthcare resources, the market will favor patient populations that can afford this complex care.[xxxiii] If patients already have the means to pay for an initial dose/use of a precision medicine product out of pocket, should insurance providers be required to cover subsequent treatments?[xxxiv] That is, if a first dose of a cancer drug or a deep brain stimulator over its initial battery life is successful, patients may feel justified in having the costs of further treatments covered. The Norwegian patient’s experience implies there is a precedent for the idea that some public insurance companies ought to cover successful cancer therapies, however, insurance companies may not all see themselves as obligated to cover neurotechnologies that rely on personalized settings or that are based on precision/abductive research more than on clinical trials. CONCLUSION The fact that the cases outlined above rely on abductive style of reasoning implies that there may not be as strong a justification for coverage by insurance, as they are both experimental and individualized, when compared to the more traditional large clinical trials in which groups have the same or a standardized protocol (settings/doses). If a study is examining the efficacy of a treatment with a large cohort of patients or with different experimental groups/phases, insurance companies may conclude that the resulting symptom improvements are more likely to be coming from the devices themselves. A preference for inductive justification may take priority when ruling in favor of funding someone’s continued use of an implantable neurostimulator. There are further nuances to this discussion surrounding the classifications of these interventions as research versus clinical care that warrant future exploration, since such a distinction is more of a scale[xxxv] than binary and could have significant impacts on the “right-to-try” approach to experimental therapies in the United States.[xxxvi] Namely, given the inherent limitations of conducting large cohort trials for deep brain stimulation interventions on patients with neuropsychiatric disorders, surgically innovative frameworks that blend abductive and inductive methodologies, like with sham stimulation phases, have traditionally been used.[xxxvii] Similarly, for adaptive brain-computer interface systems, if there are no large clinical trials and instead only publications that demonstrate that something similar worked for someone else, then, in addition to the evidence that the first treatment/dose worked for the patient in question, the balance of reasoning would be valid and arguably justify insurance coverage. As precision approaches to neurotechnology become more common, frameworks for evaluating efficacy will be crucial both for insurance coverage and for clinical decision making. ACKNOWLEDGEMENT This article was originally written as an assignment for Dr. Francis Shen’s “Bioethics & AI” course at Harvard’s Center for Bioethics. I would like to thank Dr. Shen for his comments as well as my colleagues in the Lázaro-Muñoz Lab for their feedback. - [i] Jonathan Kimmelman and Ian Tannock, “The Paradox of Precision Medicine,” Nature Reviews. Clinical Oncology 15, no. 6 (June 2018): 341–42, https://doi.org/10.1038/s41571-018-0016-0. [ii] Henrik Vogt and Bjørn Hofmann, “How Precision Medicine Changes Medical Epistemology: A Formative Case from Norway,” Journal of Evaluation in Clinical Practice 28, no. 6 (December 2022): 1205–12, https://doi.org/10.1111/jep.13649. [iii] David Barrett and Ahtisham Younas, “Induction, Deduction and Abduction,” Evidence-Based Nursing 27, no. 1 (January 1, 2024): 6–7, https://doi.org/10.1136/ebnurs-2023-103873. [iv] Vogt and Hofmann, “How Precision Medicine Changes Medical Epistemology,” 1208. [v] Wireko Andrew Awuah et al., “Bridging Minds and Machines: The Recent Advances of Brain-Computer Interfaces in Neurological and Neurosurgical Applications,” World Neurosurgery, May 22, 2024, S1878-8750(24)00867-2, https://doi.org/10.1016/j.wneu.2024.05.104. [vi] Mark Riedl, “A Very Gentle Introduction to Large Language Models without the Hype,” Medium (blog), May 25, 2023, https://mark-riedl.medium.com/a-very-gentle-introduction-to-large-language-models-without-the-hype-5 f67941fa59e. [vii] David E. Burdette and Barbara E. Swartz, “Chapter 4 - Responsive Neurostimulation,” in Neurostimulation for Epilepsy, ed. Vikram R. Rao (Academic Press, 2023), 97–132, https://doi.org/10.1016/B978-0-323-91702-5.00002-5. [viii] Kimmelman and Tannock, 2018. [ix] Kimmelman and Tannock, 2018. [x] Simon Lohse, “Mapping Uncertainty in Precision Medicine: A Systematic Scoping Review,” Journal of Evaluation in Clinical Practice 29, no. 3 (April 2023): 554–64, https://doi.org/10.1111/jep.13789. [xi] Kimmelman and Tannock, “The Paradox of Precision Medicine.” [xii] Vogt and Hofmann, 1206. [xiii] Vogt and Hofmann, 1206. [xiv] Vogt and Hofmann, 1206. [xv] Vogt and Hofmann, 1207. [xvi] Vogt and Hofmann, 1207. [xvii] Vogt and Hofmann, 1207. [xviii] Vogt and Hofmann, 1210. [xix] Mehar Sahu et al., “Chapter Three - Artificial Intelligence and Machine Learning in Precision Medicine: A Paradigm Shift in Big Data Analysis,” in Progress in Molecular Biology and Translational Science, ed. David B. Teplow, vol. 190, 1 vols., Precision Medicine (Academic Press, 2022), 57–100, https://doi.org/10.1016/bs.pmbts.2022.03.002. [xx] Stefan Feuerriegel et al., “Causal Machine Learning for Predicting Treatment Outcomes,” Nature Medicine 30, no. 4 (April 2024): 958–68, https://doi.org/10.1038/s41591-024-02902-1. [xxi] Sunderland Baker et al., “Ethical Considerations in Closed Loop Deep Brain Stimulation,” Deep Brain Stimulation 3 (October 1, 2023): 8–15, https://doi.org/10.1016/j.jdbs.2023.11.001. [xxii] David Haslacher et al., “AI for Brain-Computer Interfaces,” 2024, 7, https://doi.org/10.1016/bs.dnb.2024.02.003. [xxiii] Burdette and Swartz, “Chapter 4 - Responsive Neurostimulation,” 103–4; “Premarket Approval (PMA),” https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpma/pma.cfm?id=P100026. [xxiv] Burdette and Swartz, “Chapter 4 - Responsive Neurostimulation,” 104. [xxv] Burdette and Swartz, 126. [xxvi] Sean L. Metzger et al., “A High-Performance Neuroprosthesis for Speech Decoding and Avatar Control,” Nature 620, no. 7976 (August 2023): 1037–46, https://doi.org/10.1038/s41586-023-06443-4. [xxvii] Hao Fang and Yuxiao Yang, “Predictive Neuromodulation of Cingulo-Frontal Neural Dynamics in Major Depressive Disorder Using a Brain-Computer Interface System: A Simulation Study,” Frontiers in Computational Neuroscience 17 (March 6, 2023), https://doi.org/10.3389/fncom.2023.1119685; Mahsa Malekmohammadi et al., “Kinematic Adaptive Deep Brain Stimulation for Resting Tremor in Parkinson’s Disease,” Movement Disorders 31, no. 3 (2016): 426–28, https://doi.org/10.1002/mds.26482. [xxviii] Young-Hoon Nho et al., “Responsive Deep Brain Stimulation Guided by Ventral Striatal Electrophysiology of Obsession Durably Ameliorates Compulsion,” Neuron 0, no. 0 (October 20, 2023), https://doi.org/10.1016/j.neuron.2023.09.034. [xxix] Nho et al. [xxx] Nho et al.; Erik Robinson, “Brain Implant at OHSU Successfully Controls Both Seizures and OCD,” OHSU News, accessed March 3, 2024, https://news.ohsu.edu/2023/10/25/brain-implant-at-ohsu-successfully-controls-both-seizures-and-ocd. [xxxi] Awuah et al., “Bridging Minds and Machines”; Haslacher et al., “AI for Brain-Computer Interfaces.” [xxxii] Awuah et al., “Bridging Minds and Machines.” [xxxiii] Sara Green, Barbara Prainsack, and Maya Sabatello, “The Roots of (in)Equity in Precision Medicine: Gaps in the Discourse,” Personalized Medicine 21, no. 1 (January 2024): 5–9, https://doi.org/10.2217/pme-2023-0097. [xxxiv] Green, Prainsack, and Sabatello, 7. [xxxv] Robyn Bluhm and Kirstin Borgerson, “An Epistemic Argument for Research-Practice Integration in Medicine,” The Journal of Medicine and Philosophy: A Forum for Bioethics and Philosophy of Medicine 43, no. 4 (July 9, 2018): 469–84, https://doi.org/10.1093/jmp/jhy009. [xxxvi] Vijay Mahant, “‘Right-to-Try’ Experimental Drugs: An Overview,” Journal of Translational Medicine 18 (June 23, 2020): 253, https://doi.org/10.1186/s12967-020-02427-4. [xxxvii] Michael S. Okun et al., “Deep Brain Stimulation in the Internal Capsule and Nucleus Accumbens Region: Responses Observed during Active and Sham Programming,” Journal of Neurology, Neurosurgery & Psychiatry 78, no. 3 (March 1, 2007): 310–14, https://doi.org/10.1136/jnnp.2006.095315. (shrink)

In this note we show: Let R = 〈R, <, +, 0, …〉 be a semi-bounded o-minimal expansion of an ordered group, and G a group definable in R of linear dimension m . Then G is a definable extension of a bounded definable group B by 〈Rm, +〉.