Twenty-seven health care providers from three nursing homes were interviewed about the autonomy of stroke patients in rehabilitation wards. Data were analysed using the grounded theory method for concept development recommended by Strauss and Corbin. The core category ‘changing autonomy’ was developed, which identifies the process of stroke patients regaining their autonomy (dimensions: self-determination, independence and self-care), and the factors affecting this process (conditions (i.e. circumstances) and strategies of patients; strategies of care providers and families; and the nursing home). Teamwork (...) on increasing patient autonomy is recommended, which can be stimulated by multidisciplinary guidelines and education, and by co-ordination of the process of changing autonomy. (shrink)

This volume includes all Dewey's writings for 1938 except for Logic: The Theory of Inquiry (Volume 12 of The Later Works), as well as his 1939 Freedom and Culture, Theory of Valuation, and two items from Intelligence in the Modern World. Freedom and Culture presents, as Steven M. Cahn points out, the essence of his philosophical position: a commitment to a free society, critical intelligence, and the education required for their advance.

On September 18, 2019, the Cartesian scholar Richard A. Watson, known to his family, friends, and colleagues as "Red," passed away at the age of 88.watson was born in 1930 in new market, Iowa, where he met his wife Patty Jo in middle school. He went on to earn a Ph.D. in philosophy at the University of Iowa, studying under Richard H. Popkin. After a brief stint teaching at the University of Michigan, Watson spent most of his career at Washington (...) University in St. Louis, where Popkin also joined the faculty. Upon his retirement, Red moved to Missoula, Montana, but the final years of his life were spent in Arlington, Massachusetts.Red was a generation's leader in scholarship on early modern philosophy. He was among... (shrink)

This volume includes all Dewey’s writings for 1938 except for _Logic: The Theory of Inquiry _, as well as his 1939 _Freedom and Culture, Theory of Valuation, _and two items from _Intelligence in the Modern World._ __ _Freedom and Culture _presents, as Steven M. Cahn points out, “the essence of his philosophical position: a commitment to a free society, critical intelligence, and the education required for their advance.”.

This volume includes all Dewey's writings for 1938 except for Logic: The Theory of Inquiry, as well as his 1939 Freedom and Culture, Theory of Valuation, and two items from Intelligence in the Modern World. Freedom and Culture presents, as Steven M. Cahn points out, the essence of his philosophical position: a commitment to a free society, critical intelligence, and the education required for their advance.

This volume includes all Dewey’s writings for 1938 except for _Logic: The Theory of Inquiry _, as well as his 1939 _Freedom and Culture, Theory of Valuation, _and two items from _Intelligence in the Modern World._ __ _Freedom and Culture _presents, as Steven M. Cahn points out, “the essence of his philosophical position: a commitment to a free society, critical intelligence, and the education required for their advance.”.

This is a valuable book, jam-packed with learning and insight, cosmopolitan in scope, timely yet classically anchored. An achievement of intellectual beauty. This is how I like to see philosophy conducted. Robert Ginsberg Director, The International Center for the Arts, Humanities, and Value Inquiry. This book contains fifteen essays all seeking to regain the original meaning of philosophy as the love of wisdom. Mythos and Logos are two essential aspects of a quest that began with the ancient Greeks. As concepts (...) fundamental to human experience, Mythos and Logos continue to guide the search for truth in the twenty-first century. (shrink)

The literature on affective determinants of physical activity is growing rapidly. The present paper aims to provide greater clarity regarding the definition and distinctions among the various affect-related constructs that have been examined in relation to PA. Affective constructs are organized according to the Affect and Health Behavior Framework, including: affective response to PA; incidental affect; affect processing; and affectively charged motivational states. After defining each category of affective construct, we provide examples of relevant research showing how each construct may (...) relate to PA behavior. We conclude each section with a discussion of future directions for research. (shrink)

Short food supply chains have become the focus of considerable research in the last two decades. However, studies so far remain highly localized, and claims about the economic and social advantages of such channels for farmers are not backed by large-scale empirical evidence. Using a web survey of 613 direct-market farmers across Canada, this article explores the potential economic and social benefits that farmers derive from participating in short food supply chains. We used multivariate analysis to test whether a farmer’s (...) degree of involvement in direct food channels is positively correlated with levels of work enjoyment, social satisfaction, and economic satisfaction. The results indicate that, overall, direct-market farmers report high levels of occupational satisfaction, although work-related challenges persist, such as stress, excessive workloads, and competition. Farmer participation in short food chains was also a positive predictor of work enjoyment and economic satisfaction, but not of social satisfaction, as measured by the share of total farm sales attributable to direct selling. Net annual farm revenue, the share of direct food sales involving a middleman, age, and gender also correlated with one or more dimensions of occupational satisfaction. (shrink)

In this paper I defend Kaplan’s claim that the sentence “I am here now” is logically true. A number of counter-examples to the claim have been proposed, including occurrences of the sentence in answerphone messages, written notes left for later decoding, etc. These counter-examples are only convincing if they can be shown to be cases where the correct context with respect to which the utterance should be evaluated is the context in which it is decoded rather than encoded. I argue (...) that this is not the case, and draw on the distinction between force and content to suggest an alternative account of how information is communicated in these cases that is consistent with Kaplan’s semantic theory. (shrink)

It is widely assumed that Russell's problems with the unity of the proposition were recurring and insoluble within the framework of the logical theory of his Principles of Mathematics. By contrast, Frege's functional analysis of thoughts (grounded in a type-theoretic distinction between concepts and objects) is commonly assumed to provide a solution to the problem or, at least, a means of avoiding the difficulty altogether. The Fregean solution is unavailable to Russell because of his commitment to the thesis that there (...) is only one ultimate ontological category. This, combined with Russell's reification of propositions, ensures that he must hold concepts and objects to be of the same logical and ontological type. In this paper I argue that, while Frege's treatment of the unity of the proposition has immediate advantages over Russell's, a deeper consideration of the philosophical underpinnings and metaphysical consequences of the two approaches reveals that Frege's supposed solution is, in fact, far from satisfactory. Russell's repudiation of the Fregean position in the Principles is, I contend, convincing and Russell's own position, despite its problems, conforms to a greater extent than Frege's with common sense and, furthermore, with certain ideas which are central to our understanding of the origins of the analytical tradition. (shrink)

Roughly speaking, classical statistical physics is the branch of theoretical physics that aims to account for the thermal behaviour of macroscopic bodies in terms of a classical mechanical model of their microscopic constituents, with the help of probabilistic assumptions. In the last century and a half, a fair number of approaches have been developed to meet this aim. This study of their foundations assesses their coherence and analyzes the motivations for their basic assumptions, and the interpretations of their central concepts. (...) The most outstanding foundational problems are the explanation of time-asymmetry in thermal behaviour, the relative autonomy of thermal phenomena from their microscopic underpinning, and the meaning of probability. A more or less historic survey is given of the work of Maxwell, Boltzmann and Gibbs in statistical physics, and the problems and objections to which their work gave rise. Next, we review some modern approaches to (i) equilibrium statistical mechanics, such as ergodic theory and the theory of the thermodynamic limit; and to (ii) non-equilibrium statistical mechanics as provided by Lanford's work on the Boltzmann equation, the so-called Bogolyubov-Born-Green-Kirkwood-Yvon approach, and stochastic approaches such as `coarse-graining' and the `open systems' approach. In all cases, we focus on the subtle interplay between probabilistic assumptions, dynamical assumptions, initial conditions and other ingredients used in these approaches. (shrink)

THE TITLE OF THIS PAPER calls for clarification. Not only are there several senses in which something may be said to "be," there are also many nuances to the terms "categorial" and "intuition." Taking Aristotle as a guide, let us focus upon the primary sense of "being," that is, substance considered both as first substance and second substance. We may then take "categorial" as referring to what Aristotle calls the "figures of predication," the ways in which predicates characterize subjects, indicating (...) "what" the subject is, its quality, quantity, relation, its "where," its "when," and so forth. The term "intuition" expresses something too primitive to be defined, but Edmund Husserl's metaphorical contrast between the "emptiness" of thought and speech and the "fullness" of intuition successfully highlights its essential characteristic. A couple of examples should suffice to grasp the import of Husserl's distinction. Consider the difference, for instance, between first entertaining vague plans of visiting a foreign city and then experiencing the fulfillment of actually strolling through its streets, or the difference between first reading a manual of instructions for performing some task and then actually executing the task skillfully. Taking Husserl as a guide, let us therefore characterize intuition broadly as the presentation of something in its fullness, as opposed to thinking or talking about it in an empty way. Finally, combining Husserlian and Aristotelian terminologies, we may describe categorial intuition as the presentation of figures of predication. Rather than presenting some particular thing, say a red chair, categorial intuition presents the chair's being red, the red quality's belonging to the chair. In short, categorial intuition makes present the modes of presentation of things. (shrink)

The rapid expansion of Big Tech companies into various societal domains (e.g., health, education, and agriculture) over the past decade has led to increasing concerns among governments, regulators, scholars, and civil society. While existing theoretical frameworks—often revolving around privacy and data protection, or market and platform power—have shed light on important aspects of Big Tech expansionism, there are other risks that these frameworks cannot fully capture. In response, this editorial proposes an alternative theoretical framework based on the notion of sphere (...) transgressions, which draws on political philosopher Michael Walzer's theory of justice. The editorial not only introduces the sphere transgressions framework, but it also highlights its potential to generate novel research questions. Furthermore, this editorial introduces eight articles and one commentary from a group of interdisciplinary scholars that critically examine Big Tech expansionism by reflecting on this expansionism from the perspective of different societal spheres or by engaging with the sphere transgressions framework itself. (shrink)

The aim of this article is to analyse the relation between the second law of thermodynamics and the so-called arrow of time. For this purpose, a number of different aspects in this arrow of time are distinguished, in particular those of time-reversal (non-)invariance and of (ir)reversibility. Next I review versions of the second law in the work of Carnot, Clausius, Kelvin, Planck, Gibbs, Caratheodory and Lieb and Yngvason, and investigate their connection with these aspects of the arrow of time. It (...) is shown that this connection varies a great deal along with these formulations of the second law. According to the famous formulation by Planck, the second law expresses the irreversibility of natural processes. But in many other formulations irreversibility or even time-reversal non-invariance plays no role. I therefore argue for the view that the second law has nothing to do with the arrow of time. (shrink)

Helmuth Plessner’s Levels of Organic Life and the Human [Die Stufen des Organischen und der Mensch, 1928] is one of the founding texts of twentieth century philosophical anthropology (understood as philosophical reflection on the fundamental characteristics of the human lifeform). It is argued that Plessner’s work demonstrates the fundamental indispensability of the qualitative humanities vis-à-vis the natural-scientific study of man. Plessner’s non-reductionist, emergentist naturalism allots complementary roles to the causal and functional investigations of the life sciences and the phenomenological and (...) hermeneutic interpretation of the phenomenon of life in its successive levels and stages. Within this context, human agency can be understood as a higher-order property of organic life, which act by the selective activation of lower-level psychophysical powers. Plessner’s three ‘anthropological laws’ are used to situate the notion of practical self-understanding in between two extremes: deterministic views that deny human freedom and responsibility and views that ascribe an unrealistic amount of autonomy to human beings. (shrink)

Remiantis prancūzų sociologo Pierre Bourdieu sociologine teorija, laukas ir habitus sąvokomis, straipsnyje sociologiniu požiūriu analizuojama judėjimo negalios paliesta paauglystė, paauglio habitus formavimasis šeimos socialiniame lauke.Judėjimo negalios apsunkintas kūnas ne tik riboja judėjimo negalią turinčių paauglių fizinę laisvę, bet ir turi reikšmingos įtakos paauglio socializacijos procesui šeimoje bei šeimos narių tarpusavio santykiams. Judėjimo negalią turintys paaugliai dažnai dėl savo negalios ribojamų fizinių galimybių laikomi silpnesniais. Jais stengiasi pasirūpinti tėvai, globėjai ar kiti sveiki šeimos nariai. Negalią turintys paaugliai dažniau nei suaugusieji yra (...) veikiami aktyvios neigimo psichologijos, kai akcentuojama, kad jis negali, nemoka, nesugeba. Tai lemia jo savistigmatizaciją, trukdančią atskleisti, įvertinti bei realizuoti savo turimas realias galimybes. Paauglio negalia kelia daugybę iššūkių visai šeimai. Ji paveikia ne tik šeimos sistemos schemą, bet tėvo ir motinos kaip poros egzistenciją. Užmirštami bendri poros ir asmeniniai siekiai, koncentruojamasi tik į vaiko negalią, globos ir pagalbos teikimą jam. Paauglio negalia turi įtakos ne tik jo, bet ir šeimoje augančių sveikų vaikų socializacijos procesui. Kai tėvai, giminaičiai daugiau dėmesio skiria negalią turinčiam paaugliui, kiti (sveiki) vaikai dažniau jaučiasi atstumti, mažiau mylimi.Patirtas judėjimo neįgalumas itin paveikia paauglio socializaciją. Jei socializacijos pradžioje įgimtas neįgalumas vaiko suvokiamas kaip savaime suprantamas, tai vėliau, išėjus už šeimos lauko ribų, susiduriama su neįgalumo stigmatizacija, ir trauma ar liga drastiškai nutraukia socializacijos procesą. Ypač skausmingas pokytis, nubraukiantis besikaupiančią gyvenimišką patirtį, įvyksta patyrus negalią paauglystėje, kai skyla habitus. (shrink)

It has recently been argued that Harvey Brown and Oliver Pooley’s ‘dynamical approach’ to special relativity should be understood as what might be called an ontologically and ideologically relationalist approach to Minkowski geometry, according to which Minkowski geometrical structure supervenes upon the symmetries of the best-systems dynamical laws for a material world with primitive topological or differentiable structure. Fleshing out the details of some such primitive structure, and a conception of laws according to which Minkowski geometry could so supervene, has (...) been referred to by some as the ‘constructivist project’. Here, it is explained that Nick Huggett’s work on ‘regularity relationalism’ provides a framework for such an approach, and a relativistic version of Huggett’s regularity relationalism is outlined for that purpose. Finally, by way of examples, it is shown that this approach fails in the simplest cases. Still, reasons are given for which this should not necessarily discourage an advocate of this interpretation of the dynamical approach. _1_ Introduction to the Dynamical Approach _2_ Huggett’s Regularity Relationalism _3_ The Dynamical Approach as a Form of Regularity Relationalism _4_ A Simple Way to Set the Stage _5_ A First Attempt _5.1_ Complex-valued planewave solutions _5.2_ Real-valued planewave solutions _6_ More General Solutions _7_ Summary and Reflections. (shrink)

Studies of group selection have been done with both natural and manipulated populations using plants, insects and birds. Group selection occurred in all studies and often the strength of group selection was equal to that of individual selection. Laboratory selection experiments resulted in the opposite response to individual selection than that predicted. Selection with plants for high leaf area resulted in plants with smaller leaf area and selection for high emigration rate in beetles produced lines with lower rates. The selected (...) traits included interactions among individuals. Theoretical studies have shown that genetically based interactions among individuals can interfere with individual selection. Evolution can be partitioned into selection and the response to selection. A response to selection requires genetic variation. Properties of group genetic structure for the natural populations are discussed. The experimental populations had controlled group structure and demonstrate that populations can respond to group selection under some genetic structures. (shrink)

Straipsnyjc svarstornas Algio Micklino atsakas huscrliSkosios fcnorncnologijos kritikarns. Autorius iSrySkina tris svarbiausius IJusscrlio kritikq argurnen- tus: 1 .IHusscrlio fcnorncnologija yra toli graiu nc "rnohlas bc jokiq ikankstiniy prielaidq", ji suponuo- ja dckartiSkqj teiginj, jog bliti rciSkia "hliti paiintu". 2.1-Tusserlio tciginj apic fcnorncnologines duotics apo- diktiSkurnq susilpnina jo patics patcikiarni tokios duo- tics apra5yrnai. IS ju, prieSingai Husserlio ketinirnarns. i6aiSkcja fenorncnologincs rcflcksijos ncpajcgurnas "susidoroti" tiek su retencine 1;iikines patirties di- rncnsija, tiek su radikalia Kito patirtics kitokybe. 3.Husscrlio rnctodui ir rnqstyrnui apskritai (...) budingas eurocentrizrnas ir episterninis irnpcrializrnas - visus kultlirinius ir istorinills skirturnus jis susurnuojn savo fenornenologijoje, kuriy traktuoja kaip slaptq graiko- curopictiSko.jo irnogaus llikcsi.iij iksipildyrnn. Algiui Micktinui svarbiausias klausirnns yra Sis: Koclkl reiketq intcrpretuoti Husserli blitent iitaip? Micktinas, Husscrlio rnokiniy Eugcno Finko ir Lud- wigo Landgrebe's rnokinys, gcrai suvokc, jog ypa- tingas Husscrlio raSyrno stilius nesyk yra veikiau su- trrlkdes nei pacle,jysvisu radikalurnu atsiskleisti svar- biausiorns Mol\qto.jo @valgorns ir atradirnarns. Tatiau jam Sis triikurnas visuornct atrodes ncrciksrningas ly- ginant su rniliiniiku potcncialu, kuris Siuosc atradi- rnuose gltidi. laukdarnas tolcsnio iiplctojirno. Hus- scrlio filosofija Micktinui yra tarsi jminirno laukiantis rnjsliy rinkinps, ir Si jrninirnq jis laiko prasrningesniu uidaviniu ui pastangas padcrnonstruoti huserliSkos fenornenologijos nenuoscklurnus ir silpnqsiasvietas. Savo darbuose Micktinas parodo. jog, ncpaisant kri- tikq iipuoliu, Husscrlio fcnorncnologinio rnctodo vi- suotinurnas ir fundamentalurnas iilicka ncpancigti. Raktiniai iodiiai: fi.nornenologija, refleksijn, skirtis, jk~~orner~ns, ~~~~enntnn.spn.snrrli.s, pntirtis. (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)

Although argumentation plays an essential role in our lives, there is no integrated area of research on the psychology of argumentation. Instead research on argumentation is conducted in a number of separate research communities that are spread across disciplines and have only limited interaction. With a view to bridging these different strands, we first distinguish between three meanings of the word ?argument?: argument as a reason, argument as a structured sequence of reasons and claims, and argument as a social exchange. (...) All three meanings are integral to a complete understanding of human reasoning and cognition. Cognitive psychological research on argumentation has focused mostly on the first and second of these meanings, so we present perspectives on argumentation from outside of cognitive psychology, which focus on the second and third. Specifically, we give anoverview of the methods, goals, and disciplinary backgrounds of research on the production, the analysis, and the evaluation of arguments. Finally, inintroducing the experimental studies included in this special issue, which were conducted by researchers from a range of theoretical backgrounds, weunderline the breadth of argumentation research as well as stress opportunities for mutual awareness and integration. (shrink)

INTRODUCTION ". . . a universe unfinished, with doors and windows open to possibilities uncontrollable in advance." A possibility which William James would ...

It has been a longstanding problem to show how the irreversible behaviour of macroscopic systems can be reconciled with the time-reversal invariance of these same systems when considered from a microscopic point of view. A result by Lanford shows that, under certain conditions, the famous Boltzmann equation, describing the irreversible behaviour of a dilute gas, can be obtained from the time-reversal invariant Hamiltonian equations of motion for the hard spheres model. Here, we examine how and in what sense Lanford’s theorem (...) succeeds in deriving this remarkable result. Many authors have expressed different views on the question which of the ingredients in Lanford’s theorem is responsible for the emergence of irreversibility. We claim that these interpretations miss the target. In fact, we argue that there is no time-asymmetric ingredient at all. (shrink)