In this Matters Arising article, we outline how the recent article “The impact on patients of objections by institutions to assisted dying: a qualitative study of family caregivers’ perceptions” (White et al., 2023 Mar 13;24(1):22) informed Voluntary Assisted Dying (VAD) implementation in our large Australian public health setting, where objections do not emanate from, but within, the institution. In reporting the harms to patients and caregivers created by institutional objection, White et al. provide an evidenced-based road map for potential potholes (...) or risks associated with VAD implementation. We discuss the complexities emerging from the diverse views of health professionals and the ethical tensions arising from such, especially within certain specialties, and how we developed systemic strategies that support patients, caregivers and staff alike. We highlighted the need to shift from “Do you support VAD?“ to “How can we support you as healthcare professionals to integrate VAD into your practice, in a way that complies with the legislation, meets the needs of patients and caregivers, and feels safe and does not compromise your moral stance?“. (shrink)

Hand function improvement in stroke survivors in the chronic stage usually plateaus by 6 months. Brain-computer interface (BCI)-guided robot-assisted training has been shown to be effective for facilitating upper-limb motor function recovery in chronic stroke. However, the underlying neuroplasticity change is not well understood. This study aimed to investigate the whole-brain neuroplasticity changes after 20-session BCI-guided robot hand training, and whether the changes could be maintained at the 6-month follow-up. Therefore, the clinical improvement and the neurological changes before, immediately after, (...) and 6 months after training were explored in 14 chronic stroke subjects. The upper-limb motor function was assessed by Action Research Arm Test (ARAT) and Fugl-Meyer Assessment for Upper-Limb (FMA), and the neurological changes were assessed using resting-state functional magnetic resonance imaging. Repeated-measure ANOVAs indicated that long-term motor improvement was found by both FMA (F[2,26]= 6.367,p= 0.006) and ARAT (F[2,26]= 7.230,p= 0.003). Seed-based functional connectivity analysis exhibited that significantly modulated FC was observed between ipsilesional motor regions (primary motor cortex and supplementary motor area) and contralesional areas (supplementary motor area, premotor cortex, and superior parietal lobule), and the effects were sustained after 6 months. The fALFF analysis showed that local neuronal activities significantly increased in central, frontal and parietal regions, and the effects were also sustained after 6 months. Consistent results in FC and fALFF analyses demonstrated the increase of neural activities in sensorimotor and fronto-parietal regions, which were highly involved in the BCI-guided training.Clinical Trial Registration:This study has been registered atClinicalTrials.govwith clinical trial registration number NCT02323061. (shrink)

Background Residual dried blood spots (rDBS) from newborn screening programmes represent a valuable resource for medical research, from basic sciences, through clinical to public health. In Hong Kong, there is no legislation for biobanking. Parents’ view on the retention and use of residual newborn blood samples could be cultural-specific and is important to consider for biobanking of rDBS. Objective To study the views and concerns on long-term storage and secondary use of rDBS from newborn screening programmes among Hong Kong Chinese (...) parents. Methods A mixed-method approach was used to study the views and concerns on long-term storage and secondary use of rDBS from newborn screening programmes among Hong Kong Chinese parents of children 0–3 years or expecting parents through focus groups (8 groups; 33 participants) and a survey (n = 1012, 85% mothers) designed with insights obtained from the focus groups. We used framework analysis to summarise the themes as supportive factors, concerns and critical arguments for retention and secondary use of rDBS from focus group discussion. We used multiple logistic regression to assess factors associated with support for retention and secondary use of rDBS in the survey. Results Both in focus groups and survey, majority of parents were not aware of the potential secondary use of rDBS. Overall secondary use of rDBS in medical research was well accepted by a large proportion of Hong Kong parents, even if all potential future research could not be specified in a broad consent. However parents were concerned about potential risks of biobanking rDBS including leaking of data and mis-use of genetic information. Parents wanted to be asked for permission before rDBS are stored and mainly did not accept an “opt-out” approach. The survey showed that parents born in mainland China, compared to Hong Kong born parents, had lower awareness of newborn screening but higher support in biobanking rDBS. Higher education was associated with support in rDBS biobanking only among fathers. Conclusion Long-term storage and secondary use of rDBS from newborn screening for biomedical research and a broad consent for biobanking of rDBS are generally acceptable to Hong Kong parents given their autonomy is respected and their privacy is protected, highlighting the importance of an accountable governance and a transparent access policy for rDBS biobanks. (shrink)

On one hand, Chinese consumers are well known for conspicuous consumption and the adoption of luxury products and named brands. On the other hand, they also have a bad reputation for buying counterfeit products. Their simultaneous preferences for two contrasting types of product present a paradox that has not been addressed in the literature. This study attempts to present an explanation of this paradox by examining the effects of traditional Chinese cultural values and consumer values on consumers’ deontological judgment of (...) pirated CDs and the amount of social benefits they perceive they gain from them. We interviewed 300 Hong Kong Chinese consumers, and found that face consciousness increased materialism and risk aversion, thereby producing a favorable deontological judgment of pirated CDs. Face consciousness also has a direct effect on the amount of social benefits perceived in pirated CDs. Both favorable deontological judgment and perceived social benefits contributed to a strong intention to buy pirated CDs. The results are discussed in a cultural perspective. (shrink)

We consider a setting where a decision maker’s uncertainty is represented by a set of probability measures, rather than a single measure. Measure-by-measure updating of such a set of measures upon acquiring new information is well known to suffer from problems. To deal with these problems, we propose using weighted sets of probabilities: a representation where each measure is associated with a weight, which denotes its significance. We describe a natural approach to updating in such a situation and a natural (...) approach to determining the weights. We then show how this representation can be used in decision making, by modifying a standard approach to decision making—minimizing expected regret—to obtain minimax weighted expected regret. We provide an axiomatization that characterizes preferences induced by MWER both in the static and dynamic case. (shrink)

The menu-dependent nature of regret-minimization creates subtleties when it is applied to dynamic decision problems. It is not clear whether forgone opportunities should be included in the menu. We explain commonly observed behavioral patterns as minimizing regret when forgone opportunities are present. If forgone opportunities are included, we can characterize when a form of dynamic consistency is guaranteed.

Chateauneuf and Faro axiomatize a weighted version of maxmin expected utility over acts with nonnegative utilities, where weights are represented by a confidence function. We argue that their representation is only one of many possible, and we axiomatize a more natural form of maxmin weighted expected utility. We also provide stronger uniqueness results.

This paper compares some key concepts from Buddhism with ideas from different traditions of systems thinking. There appear to be many similarities, suggesting that there is significant potential for dialogue and mutual learning. The similarities also indicate that it may be possible to develop a Buddhist systems methodology to help guide exploration and change within Buddhist organisations.

Rhythm is key to language acquisition. Across languages, rhythmic features highlight fundamental linguistic elements of the sound stream and structural relations among them. A sensitivity to rhythmic features, which begins in utero, is evident at birth. What is less clear is whether rhythm supports infants' earliest links between language and cognition. Prior evidence has documented that for infants as young as 3 and 4 months, listening to their native language supports the core cognitive capacity of object categorization. This precocious link (...) is initially part of a broader template: listening to a non-native language from the same rhythmic class as and to vocalizations of non-human primates provide English-acquiring infants the same cognitive advantage as does listening to their native language. Here, we implement a machine-learning approach to ask whether there are acoustic properties, available on the surface of these vocalizations, that permit infants' to identify which vocalizations are candidate links to cognition. We provided the model with a robust sample of vocalizations that, from the vantage point of English-acquiring 4-month-olds, either support object categorization or fail to do so. We assess whether supervised ML classification models can distinguish those vocalizations that support cognition from those that do not, and which class of acoustic features best support that classification. Our analysis reveals that principal components derived from rhythm-relevant acoustic features were among the most robust in supporting the classification. Classifications performed using temporal envelope components were also robust. These new findings provide in principle evidence that infants' earliest links between vocalizations and cognition may be subserved by their perceptual sensitivity to rhythmic and spectral elements available on the surface of these vocalizations, and that these may guide infants' identification of candidate links to cognition. (shrink)

This paper proposes a novel account of why intertemporal decisions tend to display impatience: People pay more attention to the opportunity costs of choosing larger, later rewards than to the opportunity costs of choosing smaller, sooner ones. Eight studies show that when the opportunity costs of choosing smaller, sooner rewards are subtly highlighted, people become more patient, whereas highlighting the opportunity costs of choosing larger, later rewards has no effect. This pattern is robust to variations in the choice task, to (...) the participant population, and is observed for both incentivized and hypothetical choices. We argue that people are naturally aware of the opportunity costs associated with delayed rewards, but pay less attention to those associated with taking smaller, sooner ones. We conclude by discussing implications for theory and policy. (shrink)

The Adverse Outcome Pathway (AOP) concept is a knowledge assembly and communication tool to facilitate the transparent translation of mechanistic information into outcomes meaningful to the regulatory assessment of chemicals. The AOP framework and associated knowledgebases (KBs) have received significant attention and use in the regulatory toxicology community. However, it is increasingly apparent that the potential stakeholder community for the AOP concept and AOP KBs is broader than scientists and regulators directly involved in chemical safety assessment. In this paper we (...) identify and describe those stakeholders who currently—or in the future—could benefit from the application of the AOP framework and knowledge to specific problems. We also summarize the challenges faced in implementing pathway-based approaches such as the AOP framework in biological sciences, and provide a series of recommendations to meet critical needs to ensure further progression of the framework as a useful, sustainable and dependable tool supporting assessments of both human health and the environment. Although the AOP concept has the potential to significantly impact the organization and interpretation of biological information in a variety of disciplines/applications, this promise can only be fully realized through the active engagement of, and input from multiple stakeholders, requiring multi-pronged substantive long-term planning and strategies. (shrink)

While environmental claims are increasingly used by companies to appeal consumers, they also attract greater scrutiny from independent parties interested in consumer protection. Consumers are now able to compare corporate environmental claims against external, often disconfirming, information to form their brand attitudes and purchase intentions. What remains unclear is how the level of information specificity of both the environmental claims and external disconfirming information interact to influence consumer reactions. Two experiments address this gap in the CSR communication literature. When specific (...) claims are countered by specific external information, consumers report more negative brand attitudes and lower purchase intentions. The effect is serially mediated by skepticism toward the claims and lack of corporate credibility. We conclude by discussing strategies that firms can utilize to avoid information dilution and ensure that external disconfirming information percolates to consumers as specific. (shrink)

The concept of rectifying names [cheng-ming] is a familiar one in the Confucian Analects. It occupies an important, if not central, position in the political philosophy of Confucius. Since, according to Confucius, the rectification of names is the basis of the establishment of social harmony and political order, one might suspect that later political theories of Confucian-ists should be traced back to the Confucian doctrine of rectifying names. It need not be added that the theory of rectifying names, as developed (...) by Hsün Tzu in the third century B. C., served the double purpose of strengthening his political doctrine of government on the one hand and repudiating doctrines of names on the other. (shrink)

Three experiments examined repetition priming for meaningful environmental sounds in a sound stem identification paradigm using brief sound cues. Prior encoding of target sounds together with their associated names facilitated subsequent identification of sound stems relative to nonstudied controls. In contrast, prior exposure to names alone in the absence of the environmental sounds did not prime subsequent sound stem identification performance at all . Explicit and implicit memory were dissociated such that sound stem cued recall was higher following semantic than (...) nonsemantic encoding, whereas sound priming was insensitive to manipulations of depth encoding . These results extend the findings of long-term repetition priming into the auditory nonverbal domain and suggest that priming for environmental sounds is mediated primarily by perceptual processes. (shrink)

In response to the increasingly popular manipulation argument against compatibilism, some have argued that libertarian accounts of free will are vulnerable to parallel manipulation arguments, and thus manipulation is not uniquely problematic for compatibilists. The main aim of this article is to give this point a more detailed development than it has previously received. Prior attempts to make this point have targeted particular libertarian accounts but cannot be generalized. By contrast, I provide an appropriately modified manipulation that targets all libertarian (...) accounts of freedom and responsibility—an especially tricky task given that libertarian accounts are a motley set. I conclude that if manipulation arguments reveal any theoretical cost then it is one borne by all accounts according to which we are free and responsible, not by compatibilism in particular. (shrink)

Cultural ethical dilemmas occur when ethical research practices, as prescribed by the research ethics codes of Western research institutions, conflict with the cultural and social norms of non-Western researchers and their participants. Thus, insider-researchers working with participants from similar cultural backgrounds may experience ethical dilemmas that result in disconcerting cultural estrangement from their communities. Using reflexive narratives, the author identifies moments of cultural ethical dilemmas that necessitate a choice between two competing sets of values. Working out of a Western university, (...) the narratives reflect on cultural ethical dilemmas relating to non-coercion, confidentiality, and beneficence, encountered during interviews in the researcher’s community. Analyzed through the lens of Confucian social and ethical behavior, the paper asks whether there is a need for East–west polarization, or whether research ethics codes based on Western worldviews can be reconciled with Confucian worldviews. The paper suggests the “Middle Way” approach to reconciling and integrating the diverse worldviews of ethics, through the use of an ethical reflexive process that engenders trust in the research process and resolves cultural ethical dilemmas. (shrink)