AimsThis study evaluates a protocol for early, routine ethics consultation for patients on extracorporeal membrane oxygenation to support decision-making in the context of clinical uncertainty with the aim of mitigating ethical conflict and moral distress.MethodsWe conducted a single-site qualitative analysis of EC documentation for all patients receiving ECMO support from 15 August 2018 to 15 May 2019. Detailed analysis of 20 ethically complex cases with protracted ethics involvement identifies four key ethical domains: limits of prognostication, bridge to nowhere, burden of (...) treatment and system-level concerns. There are three subthemes: relevant contextual factors, the role of EC and observed outcomes. Content analysis of transcripts from interviews with 20 members of the multidisciplinary ECMO team yields supplemental data on providers’ perceptions of the impact of the early intervention protocol.ResultsLimited outcome data for ECMO, unclear indications for withdrawal, adverse effects of treatment and an obligation to attend to programme metrics present significant ethical challenges in the care of this patient population. Upstream EC mitigates ethical conflict by setting clear expectations about ECMO as a time limited trial, promoting consistent messaging among multiple services and supporting surrogate decision-makers. When ECMO becomes a ‘bridge to nowhere’, EC facilitates decision-making that respects patient values yet successfully sets limits on non-beneficial use of this novel therapy.ConclusionData from this study support the conclusion that ECMO poses unique ethical challenges that necessitate a standardised protocol for early, routine EC—at least while this medical technology is in its nascent stages. (shrink)

This article discusses the role of moment-to-moment affect dynamics in mental disorder and aims to integrate recent literature on this topic in the context of complex dynamical system theory. First, we will review the relevance of temporal and contextual aspects of affect dynamics in relation to psychopathology. Related to this, we will discuss recent insights resulting from a network view on affect dynamics in psychopathology. Next, we explore how we can reconcile literature findings from a perspective of complex dynamical system (...) theory. Finally, future directions with regard to personalized assessment of risk and diagnostic use are discussed. (shrink)

We demonstrate that the key components of cognitive architectures (declarative and procedural memory) and their key capabilities (learning, memory retrieval, probability judgment, and utility estimation) can be implemented as algebraic operations on vectors and tensors in a high‐dimensional space using a distributional semantics model. High‐dimensional vector spaces underlie the success of modern machine learning techniques based on deep learning. However, while neural networks have an impressive ability to process data to find patterns, they do not typically model high‐level cognition, and (...) it is often unclear how they work. Symbolic cognitive architectures can capture the complexities of high‐level cognition and provide human‐readable, explainable models, but scale poorly to naturalistic, non‐symbolic, or big data. Vector‐symbolic architectures, where symbols are represented as vectors, bridge the gap between the two approaches. We posit that cognitive architectures, if implemented in a vector‐space model, represent a useful, explanatory model of the internal representations of otherwise opaque neural architectures. Our proposed model, Holographic Declarative Memory (HDM), is a vector‐space model based on distributional semantics. HDM accounts for primacy and recency effects in free recall, the fan effect in recognition, probability judgments, and human performance on an iterated decision task. HDM provides a flexible, scalable alternative to symbolic cognitive architectures at a level of description that bridges symbolic, quantum, and neural models of cognition. (shrink)

Today's modern car is an assemblage of mechanical and digital components, of metal panels that comprise its structure and silicon chips that run its functions. Communication and information studies scholars have interrogated the problematic aspects of the programs that run those functions, revealing serious issues surrounding privacy and security, worker surveillance, and racial, gendered, and class-based bias. This article contributes to that work by taking a step back and asking about the issues inherent not in the software running on these (...) chips, but on the microchips themselves. Using the lens of “chipification”—the process by which a device is rendered capable of reading and processing data through the embedding of microchips—this article explores how the integration of microchips also involves processes that are often borne from, replicate, or create troubling power dynamics of their own. It takes light-duty passenger vehicles as a case study into how chipification is radically reshaping such processes as resource allocation, labor flows, and cultural practices around car manufacture, use, repair, and modification. By naming the process of chipification, this article allows researchers to identify and analyze the ways that integrating data processing capabilities into everyday devices is not a frictionless practice, but rather one that implicates a variety of power dynamics within these massive industries. (shrink)

In the past decades, an enormous amount of precious information has been collected about molecular and genetic characteristics of cancer. This knowledge is mainly based on a reductionistic approach, meanwhile cancer is widely recognized to be a ‘system biology disease’. The behavior of complex physiological processes cannot be understood simply by knowing how the parts work in isolation. There is not solely a matter how to integrate all available knowledge in such a way that we can still deal with complexity, (...) but we must be aware that a deeply transformation of the currently accepted oncologic paradigm is urgently needed. We have to think in terms of biological networks: understanding of complex functions may in fact be impossible without taking into consideration influences outside of the genome. Systems Biology involves connecting experimental unsupervised multivariate data to mathematical and computational approach than can simulate biologic systems for hypothesis testing or that can account for what it is not known from high-throughput data sets. Metabolomics could establish the requested link between genotype and phenotype, providing informations that ensure an integrated understanding of pathogenic mechanisms and metabolic phenotypes and provide a screening tool for new targeted drug. (shrink)

Ghazālī’s The Incoherence of the Philosophers is an unusual philosophical work for a number of reasons, not the least of which is the author’s explicit disavowalof any of the conclusions contained within it. The present essay examines some of the hermeneutical challenges that face readers of the work and offers anexegetical account of the much-neglected Third Discussion, which examines a key point of Neoplatonic metaphysics. The paper argues that Ghazālī’s maintaining of the incompatibility of metaphysical creationism and Neoplatonic emanationism should (...) not be viewed as simply a rhetorical or dialectical argument, but rather is best understood, to use Ghazālī’s words, as a philosophical “proof.” Essential to this proof in the solution to the argument of the Third Discussion is an implicit theory of metaphorical predication that can be pieced together from several of Ghazālī’s remarks as well as a reductio ad absurdum argument about the very possibility of ethical discourse. (shrink)

This article explores yet another paradox – aside from the privacy paradox – related to the datafication of media: citizens trust least the media they use most It investigates the role that daily life plays in shaping the trust that citizens place in datafied media. The study reveals five sets of heuristics guiding the trust assessments of citizens: characteristics of media organisations, old media standards, context of use and purpose, experiences of datafication and understandings of datafication. The article discusses the (...) use of these heuristics and the value that everyday life holds in assessing trust in datafied media. It concludes that, guided by a partial ‘structure of perception’ and enticed into trusting datafied media in the context of their daily lives, citizens may be highly concerned by the datafication of media but use them nevertheless. (shrink)

Critical educational research offers the researcher a position and an ethos of comfort. Even the declared recognition of the relativity of principles, norms or criteria so characteristic of much critical research does not prevent it from looking immediately for a way out of this uncomfortable situation i.e. to keep to the idea that comfort is needed and desirable. However, we suggest that this uncomfortable condition is constitutive for critical educational research and may be even for education as such. Therefore the (...) article can be considered as a genealogical analysis of this comfortable critical research, in which we show how the birth of the milieu of the modern school goes together with the instauration of two forms of a comfortable research ‘ethos’: a research ethos rooted in a pastoral milieu and a research ethos rooted in a bureaucratic milieu. In the last section of the article we indicate that another ‘experimental’ ethos of research is possible, including the acceptance of discomfort. This is the ethos of a critical researcher as an inhabitant of a coming research community and as being exposed to the present. (shrink)

"The availability of a paperback version of Boyle's philosophical writings selected by M. A. Stewart will be a real service to teachers, students, and scholars with seventeenth-century interests. The editor has shown excellent judgment in bringing together many of the most important works and printing them, for the most part, in unabridged form. The texts have been edited responsibly with emphasis on readability.... Of special interest in connection with Locke and with the reception of Descarte's Corpuscularianism, to students of the (...) Scientific Revolution and of the history of mechanical philosophy, and to those interested in the relations among science, philosophy, and religion. In fact, given the imperfections in and unavailability of the eighteenth-century editions of Boyle’s works, this collection will benefit a wide variety of seventeenth-century scholars." --Gary Hatfield, University of Pennsylvania. (shrink)

The paper consists of a reflexive exercise in which Herbert Simon 's views concerning science are applied to his own research. It argues that what connected his ventures into so many different disciplinary domains was a search for complex, hierarchical systems. In the process, the paper establishes a close connection between Simon 's insights and his focus on simulation. Instead of simulating Simon on a computer, though, it simulates Simon on paper. This exercise is then contrasted with Simon 's own (...) attempts to simulate science. This comparison leads to a reflexive evaluation of Simon 's simulations. (shrink)

Gay marriages (as such) are not as yet allowed anywhere but the demand for them is increasing. Most countries take a liberal attitude towards marriage: few obstacles are put in its way. But objections to gay marriages continue to be raised. These objections are refuted and the case for gay marriage is assessed through the prism of various forms of liberalism. The normative argument for allowing gay marriage is shown to be both strong and consistent with many of the values (...) upheld by the opponents of such unions. (shrink)

OBJECTIVES: Cognitive and sensory difficulties frequently jeopardize informed consent of frail elderly patients This study is the first to test whether preliminary research experience could enhance geriatric patients' capacity to consent. DESIGN/SETTING: A step-wise consent procedure was introduced in a study on fluid balance in geriatric patients. Eligible patients providing verbal consent participated in a try-out of a week, during which bioelectrical impedance and weight measurements were performed daily. Afterwards, written informed consent was requested. Comprehension, risk and inconvenience scores (ranges: (...) 0-10) were obtained before and after the try-out by asking ten questions about the study's essentials and by asking for a risk and inconvenience assessment on a ten-points rating scale. SUBJECTS AND RESULTS: Seventy of the 78 eligible subjects started the try-out and 53 (68%) provided written consent. The comprehension score increased from 5.0 (+/- 2.3) to 7.0 (+/- 1.9) following the try-out (P < 0.001). The number of subjects capable of weighing risks and inconveniences increased from 32 to 48 (P < 0.001). CONCLUSIONS: Research experience improved the capacity to consent, still enabling an acceptable participation rate. Therefore, experienced consent seems a promising tool to optimize informed consent in frail elderly subjects. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Participation and Immersion in Walton and CalvinoM. Carleton SimpsonThe novel begins in a railway station, a locomotive huffs, steam from a piston covers the opening of the chapter, a cloud of smoke hides part of the first paragraph... The pages of the book are clouded like the windows of an old train, the cloud of smoke rests on the sentences.1Part of Kendall Walton's theory of psychological participation, explicated in (...) Mimesis as Make-Believe, is that representations that display or draw attention to their fictionality discourage participation; part of our enjoyment of representational art is our psychological participation with the representation. The activity of participating comprises the game world, while the material representation comprises the work world. We play games of make-believe with representations, much as children play games with toys or other props. For Walton, the fullest psychological participation arises from the fullest immersion in the game world. Immersion means ignoring or being unaware of the materiality of the work world, attending only to the fictional reality of the work world. It is to "look past" the painted surface, or to become engrossed in the novel's narrative.To the extent that we consider the material of the work, we are distracted from participating in the game prescribed by the work: we do either the one or the other. So, Walton claims "One obvious way in which works sometimes discourage participation is by prominently declaring or displaying their fictionality, betraying their own pretense" (p. 275).2 For example, "The conspicuous brush strokes of Van Gogh's Starry Night call attention to themselves and to their record of the process by which paint was applied to the canvas, possibly intruding on the viewer's participation in his game... One can ignore the brush [End Page 321] strokes enough to lose oneself in the fictional world" (p. 277). In response to prodding by Patrick Maynard, Walton tempers this position: "Prominent brush strokes, as in many of Vincent van Gogh's paintings, can have an inhibiting effect, especially if the observer isn't used to such. Then they not only constitute a plain indication that what one is seeing is a mere painted canvas, but force this fact on the viewer's attention" (italics added).3Ernst Gombrich endorsed this position in Art and Illusion, attributing it to Kenneth Clark.4 Gombrich tells of Clark attempting to see both the brush strokes and the representation, and his failure to "observe what went on when the brush strokes and dabs of pigment on the canvas transformed themselves into a vision of transfigured reality as he stepped back" (p. 6). Walton intends his theory of psychological participation to be widely applicable to the representational arts; he argues that what holds for visual representations holds also for verbal representations. When reading a novel our ability to participate in the story is diminished to the extent the novel draws attention to its fictionality. We either immerse ourselves in the fictional world of the novel or attend to the historical production or materiality of the novel.Attending is contained in Walton's notion of appreciation. Appreciation without participation results when some representations "positively discourage participation, especially the psychological participation that would constitute the experience of being caught up in the story" (p. 274). Works like these employ a variety of strategies, "deliberately 'distancing' the appreciator from the fictional world... For if one does not imagine a proposition, it is unlikely to be fictional that one knows or believes it; and if one imagines it with minimal vivacity, one is unlikely to have the experience of fictionally being concerned or upset or relieved or frightened or overjoyed by the fact that it is true" (p. 274). Just as children imagine themselves to be participants in games of make-believe, more mature imaginings require us to imagine we are participants, not simply observers. Reflexive imagining is central to Walton's theory, and is a point he extensively develops.I argue against this disjunction of activities. My thesis is that participation need not arise from immersion at the expense of awareness. I am also critical of Walton's distinction between appreciation and participation—they are... (shrink)

Context: Radical constructivism (RC) is seen as a fruitful way to teach innovation, as Ernst von Glasersfeld’s concepts of knowing, learning, and teaching provide an epistemological framework fostering processes of generating an autonomous conceptual understanding. Problem: Classical educational approaches do not meet the requirements for teaching and learning innovation because they mostly aim at students’ competent performance, not at students’ understanding and developing their creative capabilities. Method: Analysis of theoretical principles from the constructivist framework and how they can be used (...) as a foundation for designing a course in the field of innovation. The empirical results are based on qualitative journal entries that were coded and categorized according to Charmaz’s grounded theory approach. Results: It is shown that there is a close relationship between learning and innovation processes. The proposed investigated course design based on RC incorporates the following concepts: the course setting is understood as a framework to guide understanding; students work in teams and are subjective constructors of their own knowledge; instructors take on the role of coaches, guiding students through an innovation process as co-creators. Such a framework facilitates dynamic processes of assimilation and accommodation, as well as perturbation through the “other,” which potentially lead to novel, and viable, conceptual structures crucial for sustainable innovation. Constructivist Content: The paper argues in favor of RC principles in the context of teaching and learning. The proposed course setting is oriented at von Glasersfeld’s understanding of knowing, learning, and teaching (vs. training. It outlines theoretical and practical aspects of these principles in the context of a course design for innovation. Furthermore, it shows the importance of von Glasersfeld’s concept of intersubjectivity for processes of accommodation and the generation of (novel) autonomous conceptual structures. The interplay between creating coherence, perturbation, and irritation through interacting with the “other” (in the form of co-students and instructors) is assumed to be vital for such processes, as it leads to the creation of not only novel but also viable conceptual structures, therefore re-establishing a relative equilibrium critical for sustainable innovation. (shrink)

The macroscopic properties of a many-particle quantum system are revealed by an embedding of the macroscopic classical into the microscopic quantum description of the system. Such an embedding is based on the assumption that the experiments to which the classical theory applies may also be described quantum mechanically. It results from the existence of an injective trajectory observable. For photon quantum systems with a finite number of modes an embedding is explicitly constructed using the well- known phase space observable for (...) quantum systems of finite degrees of freedom. For the general case of photon quantum fields the existence of a phase space observable is shown which, restricted to a finite number of modes, coincides with the mentioned one. (shrink)

_The purpose _of the article is to introduce into scientific circulation works by Ukrainian scholar Taras Zakydalsky on the philosophy of Hryhorii Skovoroda. Taras Zakydalsky is a representative of the Ukrainian diaspora, philosopher, and member of Canadian NTSh (Shevchenko Scientific Society of Canada). _Theoretical basis._ We consider the uniqueness of H. Skovoroda’s philosophy, which stimulates not only intellectually but also spiritually enlightens the reader. The reasons for the complex perception and interpretation of Hryhorii Skovoroda’s philosophy are highlighted. We have verified (...) the main methods of its interpretation given in the works by Dmytro Chyzhevskyi. The influence of philosophical thought of thinkers of Antiquity and the Middle Ages: Aristotle, Epicurus, the Church Fathers, and Tertullian has been studied. We have comprehended H. Skovoroda’s interpretation of the Bible as a two-layer existence, the symbolic world that makes the foundation of his philosophy. The peculiarity of the thinker’s division of the heart into "internal" and "external" is analyzed. Hryhorii Skovoroda’s position on the Good and the evil is stated. The Good is identified with God, and the evil – with the real world, the man can choose between the two. Much attention is paid to the understanding of man as a microcosm – rational thinking, and thought is the fundamental cause of human activity, which generates all existence. Hryhorii Skovoroda’s philosophy of metaphysics as the existence of three worlds is highlighted: the first is the macrocosm (the whole surrounding world), the second is the microcosm (the man), and the third is the symbolic world (the Bible). "Monodualism" as a characteristic feature of H. Skovoroda’s work is analyzed. We have highlighted H. Skovoroda’s attitude to the transcendence of God, which is not separated from the world but is present in it directly. The understanding of faith as a forced act of self-love is analyzed because by loving ourselves we love God. The criteria for true and false faith have been clarified. The significance of H. Skovoroda’s aphorism that _what is necessary is useful, and not useful is unnecessary_ is considered. Examples of ethical principles in H. Skovoroda’s philosophy are considered. Peculiarities of the concept HAPPINESS are revealed. This concept is a universal means of existence of the Good, its source is gratitude to God. _Originality_ of the article is in the systematic presentation of the philosophy of the heart by Hryhorii Skovoroda and the analysis of the integrity of the "inner man", the true meaning of life as interpreted by Taras Zakydalsky. _Conclusions_ summarize the "anthropological pragmatism" of the philosopher, whose main idea is to apply practical skills for the benefit of society. (shrink)

Was the above-named bill, which was brought forward in 122 b.c. by the tribune M. Liuius Drusus, and provided that the Latins should under all circumstances be exempt from the penalty of scourging, duly passed by the Roman Assembly and entered upon the statute-book?