Informed consent is a key condition for prenatal screening programmes to reach their aim of promoting reproductive autonomy. Reaching this aim is currently being challenged with the introduction of non-invasive prenatal testing (NIPT) in first-trimester prenatal screening programmes: amongst others its procedural ease—it only requires a blood draw and reaches high levels of reliability—might hinder women’s understanding that they should make a personal, informed decision about screening. We offer arguments for a renewed recognition and use of informed consent compared to (...) informed choice, and for a focus on value-consistent choices and personalized informational preferences. We argue for a three-step counselling model in which three decision moments are distinguished and differently addressed: (1) professionals explore women’s values concerning whether and why they wish to know whether their baby has a genetic disorder; (2) women receive layered medical-technical information and are asked to make a decision about screening; (3) during post-test counselling, women are supported in decision-making about the continuation or termination of their pregnancy. This model might also be applicable in other fields of genetic (pre-test) counselling, where techniques for expanding genome analysis and burdensome test-outcomes challenge counselling of patients. (shrink)

In this paper we defend structural representations, more specifically neural structural representation. We are not alone in this, many are currently engaged in this endeavor. The direction we take, however, diverges from the main road, a road paved by the mathematical theory of measure that, in the 1970s, established homomorphism as the way to map empirical domains of things in the world to the codomain of numbers. By adopting the mind as codomain, this mapping became a boon for all those (...) convinced that a representation system should bear similarities with what was being represented, but struggled to find a precise account of what such similarities mean. The euforia was brief, however, and soon homomorphism revealed itself to be affected by serious weaknesses, the primary one being that it included systems embarrassingly alien to representations. We find that the defense attempts that have followed, adopt strategies that share a common format: valid structural representations come as “homomorphism plus X”, with various “X”, provided in descriptive format only. Our alternative direction stems from the observation of the overlooked departure from homomorphism as used in the theory of measure and its later use in mental representations. In the former case, the codomain or the realm of numbers, is the most suited for developing theorems detailing the existence and uniqueness of homomorphism for a wide range of empirical domains. In the latter case, the codomain is the realm of the mind, possibly more vague and more ill-defined than the empirical domain itself. The time is ripe for articulating the mapping between represented domains and the mind in formal terms, by exploiting what is currently known about coding mechanisms in the brain. We provide a sketch of a possible development in this direction, one that adopts the theory of neural population coding as codomain. We will show that our framework is not only not in disagreement with the “plus X” proposals, but can lead to natural derivation of several of the “X”. (shrink)

Until Process and Reality – An Essay in Cosmology (1929) by Alfred North Whitehead (1861-1947) was translated into Portuguese, four other works had been previously translated, proving Portuguese people had a persistent interest in the thought of a philosopher who is probably the last and most important speculative thinker of the 20th century. Yet, Processo e Realidade – Ensaio de Cosmologia hopefully stands as a turning point in Whiteheadian reception in Portugal; on the hand, it was publishe...

Problems arise when applying the current procedural conceptualization of decision-making capacity to paediatric healthcare: Its emphasis on content-neutrality and rational cognition as well as its implicit assumption that capacity is an ability that resides within a person jeopardizes children’s position in decision-making. The purpose of the paper is to challenge this dominant account of capacity and provide an alternative for how capacity should be understood in paediatric care. First, the influence of developmental psychologist Jean Piaget upon the notion of capacity (...) is discussed, followed by an examination of Vygostky’s contextualist view on children’s development, which emphasizes social interactions and learning for decision-making capacity. In drawing parallels between autonomy and capacity, substantive approaches to relational autonomy are presented that underline the importance of the content of a decision. The authors then provide a relational reconceptualization of capacity that leads the focus away from the individual to include important social others such as parents and physicians. Within this new approach, the outcome of adults’ decision-making processes is accepted as a guiding factor for a good decision for the child. If the child makes a choice that is not approved by adults, the new conceptualization emphasizes mutual exchange and engagement by both parties. (shrink)

In this paper we consider an intuitionistic variant of the modal logic S4 (which we call IS4). The novelty of this paper is that we place particular importance on the natural deduction formulation of IS4— our formulation has several important metatheoretic properties. In addition, we study models of IS4— not in the framework of Kirpke semantics, but in the more general framework of category theory. This allows not only a more abstract definition of a whole class of models but also (...) a means of modelling proofs as well as provability. (shrink)

Drawing its strength from the UN Charter and UDHR, human rights ethics is a beacon of hope and a promise that requires continuous reaffirmation during these turbulent times. These two documents, with their unwavering faith in ‘fundamental human rights, in the dignity and worth of the human person, in the equal rights of men and women and of nations large and small,’ have shaped our understanding of human rights as global and universal ethics. However, this faith is now being severely (...) tested by four countercurrents: extremism, exclusionism, selectivism, and populism. These countercurrents pose significant and urgent human rights threats that activists, academics, and policymakers must confront by reasserting the basic core values of the UN Charter and UDHR. (shrink)

We investigate the problem of “wave packet reduction” in quantum mechanics by solving the Schrödinger equation for a system composed of a model measuring apparatusM interacting with a microscopic objects. The “instrument” is intended to be somewhat more realistic than others previously proposed, but at the same time still simple enough to lead to an explicit solution for the time-dependent density matrix. It turns out that,practically, everything happens as if the wave packet reduction had occurred. This is a consequence of (...) the fact that the apparatus is made up of a very large number of microsystems interacting withs. More precisely, our model shows that the “macroscopic size” of a measuring apparatus can lead by itself to a density matrix for the systemM + s which is physically equivalent to the density matrix of a statistical mixture corresponding to the reduced wave packet. (shrink)

BackgroundCRISPR-Cas9, a technology enabling modification of the human genome, is developing rapidly. There have been calls for public debate to discuss its ethics, societal implications, and governance. So far, however, little is known about public attitudes on CRISPR-Cas9. This study contributes to a better understanding of public perspectives by exploring the various holistic perspectives Dutch citizens have on CRISPR-Cas9.MethodsThis study used Q methodology to identify different perspectives of Dutch citizens (N = 30) on the use of CRISPR-Cas9. The Q-sort method (...) aims at segmenting audiences based on the structural characteristics of their perspectives. Participants individually ranked 32 statements about CRISPR-Cas9 and discussed their rankings in small groups. By-person factor analysis was performed using PQMethod. Participants’ contributions to the discussions were used to further make sense of the audience segments identified.ResultsFive perspectives on CRISPR-Cas9 were identified: (1) pragmatic optimism (2) concerned scepticism; (3) normative optimism; (4) enthusiastic support; and (5) benevolent generalism. Each perspective represents a unique position motivated by different ranking rationales. Sorting rationales included improving health, preventing negative impacts on society, and fear of a slippery slope. Overall, there is broad, but not universal support for medical uses of CRISPR-Cas9.ConclusionsResearch on CRISPR-Cas9 should prioritise the broadly supported applications of the technology. Research and public debates on CRISPR-Cas9, its uses, its broader implications, and the governance of CRISPR-Cas9 are recommended. A discourse that includes all perspectives can contribute to the embedding of future uses of CRISPR-Cas9 in society. This study shows that Q methodology followed by group discussions enables citizens to contribute meaningfully to discourses about research. (shrink)

BackgroundCommunity engagement within biomedical research is broadly defined as a collaborative relationship between a research team and a group of individuals targeted for research. A Community Advisory Board is one mechanism of engaging the community. Within genomics research CABs may be particularly relevant due to the potential implications of research findings drawn from individual participants on the larger communities they represent. Within such research, CABs seek to meet instrumental goals such as protecting research participants and their community from research-related risks, (...) as well as intrinsic goals such as promoting the respect of participants and their community. However, successful community engagement depends on the degree to which CABs legitimately represent and engage with communities targeted for research. Currently, there is little literature describing the use of CABs in genomics research taking place in developing countries, and even less in the field of genomics research relating to mental illness. The aim of this article is to describe and consider the contributions made by a researcher-driven, population-specific CAB in a genomics of schizophrenia research project taking place in South Africa, from the perspective of the research team.DiscussionFour broad discussion topics emerged during the CAB meetings namely: 1) informed consent procedures, 2) recruitment strategies, 3) patient illness beliefs and stigma experiences, and 4) specific ethical concerns relating to the project. The authors consider these discussions in terms of their contributions to instrumental and intrinsic goals of community engagement.SummaryThe CAB gave valuable input on the consent processes and materials, recruitment strategies and suggested ways of minimizing the potential for stigma and discrimination. All of these contributions were of an instrumental nature, and helped improve the way in which the research took place. In addition, and perhaps more importantly, the CAB made a unique and important contribution relating to intrinsic functions such as promoting the respect and dignity of research participants and their community. This was particularly evident in ensuring sensitivity and respect of the community’s traditional beliefs about schizophrenia and its treatment, and in this way promoting a respectful relationship between the research team and the participants. (shrink)

In recent years, functional connectivity in the developmental science received increasing attention. Although it has been reported that the anatomical connectivity in the preterm brain develops dramatically during the last months of pregnancy, little is known about how functional and effective connectivity change with maturation. The present study investigated how effective connectivity in premature infants evolves. To assess it, we use EEG measurements and graph-theory methodologies. We recorded data from 25 preterm babies, who underwent long-EEG monitoring at least twice during (...) their stay in the NICU. The recordings took place from 27 weeks postmenstrual age until 42 weeks PMA. Results showed that the EEG-connectivity, assessed using graph-theory indices, moved from a small-world network to a random one, since the clustering coefficient increases and the path length decreases. This shift can be due to the development of the thalamocortical connections and long-range cortical connections. Based on the network indices, we developed different age-prediction models. The best result showed that it is possible to predict the age of the infant with a root mean-squared error equal to 2.11 weeks. These results are similar to the ones reported in the literature for age prediction in preterm babies. (shrink)

The advent of new genetic and genomic technologies may cause friction with the principle of respect for autonomy and demands a rethinking of traditional interpretations of the concept of informed consent. Technologies such as whole‐genome sequencing and micro‐array based analysis enable genome‐wide testing for many heterogeneous abnormalities and predispositions simultaneously. This may challenge the feasibility of providing adequate pre‐test information and achieving autonomous decision‐making. At a symposium held at the 11th World Congress of Bioethics in June 2012 (Rotterdam), organized by (...) the International Association of Bioethics, these challenges were presented for three different areas in which these so‐called ‘new genetics’ technologies are increasingly being applied: newborn screening, prenatal screening strategies and commercial personal genome testing. In this article, we build upon the existing ethical framework for a responsible set‐up of testing and screening offers and reinterpret some of its criteria in the light of the new genetics. As we will argue, the scope of a responsible testing or screening offer should align with the purpose(s) of testing and with the principle of respect for autonomy for all stakeholders involved, including (future) children. Informed consent is a prerequisite but requires a new approach. We present preliminary and general directions for an individualized or differentiated set‐up of the testing offer and for the informed consent process. With this article we wish to contribute to the formation of new ideas on how to tackle the issues of autonomy and informed consent for (public) healthcare and direct‐to‐consumer applications of the new genetics. (shrink)

The blackbody radiation field is studied from different points of view. The existence of zero-point fluctuations is shown to be crucial in determining the form of the thermal part of the spectrum. The notion of a continuous field is seen to be compatible with a discrete structure for its interaction: The description normally used in the quantum context does not refer to the field but to its interaction with atomic systems, which involves statistically independent elementary acts of absorption and emission. (...) The same classical field has different effects on absorption and on emission, and these are conveniently, but not necessarily, described in terms of non-commuting operators. (shrink)

This edition of Giraldus Odonis' Logica for the first time gives access to an important and original treatise, which has unduly been neglected since the author's death. It is also important in that it gives evidence of interesting achievements in the field of logic outside the anti-metaphysical circle surrounding Ockham.

This work presents the concepts of translation and conservative translation between logics. By using algebraic semantics we introduce several conservative translations involving the classical propositional calculus and the many-valued calculi of Post and Lukasiewicz.

Numerous eukaryotic DNA processing enzymes, such as DNA polymerases and ligases, bind the processivity factor PCNA, which acts as a platform to recruit and regulate the binding of enzymes to their DNA substrate. Multiple PCNA‐interacting motifs (PIPs) are present in these enzymes, but their individual structural and functional role has been a matter of debate. Recent cryo‐EM reconstructions of high‐fidelity DNA polymerase Pol δ (Pol δ), translesion synthesis DNA polymerase κ (Pol κ) and Ligase 1 (Lig1) bound to a DNA (...) substrate and PCNA demonstrate that the critical interaction with PCNA involves the internal PIP proximal to the catalytic domain. The ancillary PIPs, located in long disordered regions, are instead invisible in the reconstructions, and appear to function as flexible tethers when the enzymes fall off the DNA. In this review, we discuss the recent structural advancements and propose a functional hierarchy for the PIPs in Pol δ, Pol κ, and Lig1. (shrink)

One in three university students experiences mental health problems during their study. A similar percentage leaves higher education without obtaining the degree for which they enrolled. Research suggests that both mental health problems and academic underperformance could be caused by students lacking control and purpose while they are adjusting to tertiary education. Currently, universities are not designed to cater to all the personal needs and mental health problems of large numbers of students at the start of their studies. Within the (...) literature aimed at preventing mental health problems among students (e.g., anxiety or depression), digital forms of therapy recently have been suggested as potentially scalable solutions to address these problems. Integrative psychological artificial intelligence (AI) in the form of a chatbot, for example, shows great potential as an evidence-based solution. At the same time, within the literature aimed at improving academic success, the online life-crafting intervention in which students write about values and passions, goals, and goal-attainment plans has shown to improve the academic performance and retention rates of students. Because the life-crafting intervention is delivered through the curriculum and doesn’t bear the stigma that is associated with therapy, it can reach larger populations of students. But life-crafting lacks the means for follow-up or the interactiveness that online AI-guided therapy can offer. In this paper, we propose to integrate the current literature on chatbot interventions aimed at the mental health of students with research about a life-crafting intervention that uses an inclusive curriculum-wide approach. When a chatbot asks students to prioritize both academic as well as social and health-related goals and provides personalized follow-up coaching, this can prevent -often interrelated- academic and mental health problems. Right on-time delivery, and personalized follow-up questions enhance the effects of both -originally separated- intervention types. Research on this new combination of interventions should use design principles that increase user-friendliness and monitor the technology acceptance of its participants. (shrink)

Heinrich Rickert fut, avec Windelband et Lask, l’un des principaux représentants de l’école néokantienne de Heidelberg, qui se différencie essentiellement de l’école de Marbourg par la façon dont elle redéfinit l’idéalisme transcendantal à partir de la problématique de la validité, héritée notamment de la philosophie de Lotze.Les six articles réunis ici, publiés par Rickert dans la revue Logos entre 1911 et 1932, dessinent les grandes lignes d’une philosophie systématique des valeurs qui ne se veut pas seulement une théorie transcendantale du (...) valoir dans son opposition à l’être, mais aussi, en tant que doctrine des visions du monde, l’élaboration d’une réponse philosophique à la question du sens de la vie. À côté de recherches architectoniques portant sur la détermination et l’articulation des différents domaines axiologiques, mais aussi sur les problèmes généraux liés à la définition de la philosophie comme doctrine des valeurs, ces articles entretiennent une constante polémique à l’endroit de tout intuitionnisme et de toute « philosophie de la vie ». Contre le biologisme qui fait du vivant la valeur absolue et contre la dénonciation intuitionniste de la science comme intellectualisme, l’affirmation de la transcendance des valeurs garantit pour Rickert le droit d’une philosophie scientifique et critique de la culture, qui en appréhende la vie propre en rendant compte de l’articulation des valeurs et de l’effectivité empirique au sein d’un système des valeurs qui reste ouvert sur l’infinie nouveauté et l’inépuisable richesse du monde historique. (shrink)