Deep brain stimulation of the subthalamic nucleus or the globus pallidus is an established treatment for Parkinson’s disease that yields a marked and lasting improvement of motor symptoms. Yet, DBS benefit on gait disturbances in PD is still debated and can be a source of dissatisfaction and poor quality of life. Gait disturbances in PD encompass a variety of clinical manifestations and rely on different pathophysiological bases. While gait disturbances arising years after DBS surgery can be related to disease progression, (...) early impairment of gait may be secondary to treatable causes and benefits from DBS reprogramming. In this review, we tackle the issue of gait disturbances in PD patients with DBS by discussing their neurophysiological basis, providing a detailed clinical characterization, and proposing a pragmatic programming approach to support their management. (shrink)

The social aspects of causality in medicine and healthcare have been emphasized in recent debates in the philosophy of science as crucial factors that need to be considered to enable, among others, appropriate interventions in public health. Therefore, it seems central to recognize the bearing of social causes (broadly understood, e.g., social inequalities and socio-economic status) in bringing about certain concrete pathologies. Being aware of the relevance of social causes in medicine and healthcare is particularly important in the face of (...) the role that artificial intelligence-based systems (such as machine learning algorithms) are increasingly playing in these high-stakes fields. In fact, these systems bear the dangerous potential of concealing relevant social causes. This is highly problematic not only because it reinforces issues of distributive injustice but also because it can pave the way for issues of epistemic injustice. The central aim of this chapter is to make a first effort to point out possible connections between the importance of recognizing social causes in medicine and healthcare and forms of epistemic injustice. (shrink)

The advancement of AI-based technologies, such as machine learning (ML) systems, for implementation in healthcare is progressing rapidly. Since these systems are used to support healthcare professionals in crucial medical practices, their role in medical decision-making needs to be epistemologically and ethically assessed. However, a central issue at the intersection of the ethics and epistemology of ML has been largely neglected. This pertains to the careful scrutiny of how ML systems can degrade individuals’ epistemic standing as receivers and conveyors of (...) knowledge and, thereby, perpetrate epistemic injustice. Since ML systems are powerful epistemic entities that are not easily contestable, and their decision-making rationale is often inaccessible, it is crucial to consider their role in creating imbalances in patients’ disfavor and the ways to mitigate such imbalances. This is especially important when it comes to interactions between patients and physicians, in which questions of credibility, trust, and understanding are central. Against this background, the overarching purpose of this dissertation is to fill this research gap by providing a framework to identify and, on occasion, mitigate epistemic injustices that are _ML-induced_, i.e., that emerge specifically due to the role that ML systems play in patient-physician interactions. (shrink)

The current ecological and global crises call us to reexamine our understanding of ourselves, our relationships, and the world in which we live together as well as the values that shape and determine our mutual participation within this shared world process. This article engages the dynamic relationship between the thought and writings of C. G. Jung and A. N. Whitehead, two insightful contemplative visionaries, exploring the philosophical and spiritual vision that arises from this interaction, with special attention to the emergence (...) of principles and values that might serve as guides for reflection, evolution, and mutual understanding. (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)

Giorgia Pozzi’s feature article1 on the risks of testimonial injustice when using automated prediction drug monitoring programmes (PDMPs) turns the spotlight on a pressing and well-known clinical problem: physicians’ challenges to predict patient behaviour, so that treatment decisions can be made based on this information, despite any fallibility. Currently, as one possible way to improve prognostic assessments of patient behaviour, Machine Learning-driven clinical decision support systems (ML-CDSS) are being developed and deployed. To make her point, Pozzi discusses ML-CDSSs (...) that are supposed to deliver physicians an accurate estimation of the likelihood of narcotic, sedative and stimulant opioid misuse by a given patient (like, e.g., ‘NarxCare’). Regarding cases of deviating assessment between human evaluators and automated systems, the medico-ethical discussion has so far mainly focused on disagreement between clinicians and Machine Learning (ML) algorithms,2 for example in ‘second opinions’ that have been reconstructed as disagreements between physician testimony and ML-CDSS testimony.3 Examples such as those of PDMPs, by contrast, draw attention to situations in which patient testimony potentially contradicts ML-CDSS testimony. Pozzi examines decision-making situations in which ML-CDSS testimony factually overrides the testimony of the person affected. Thus, in the presented case of patient Kathryn, the testimony of her own physical and mental condition was insufficient to overturn the unfavourable outcome for …. (shrink)

Classical temples in ancient Greece show two deterministic illusionistic principles of architecture, which govern their functional design: geometric proportionalism and a set of illusion-strengthening rules in the proportionalism's stochastic margin. Animal morphology, in its mechanistic-deductive revival, applies just one architectural principle, which is not always satisfactory. Whether a Greek Classical situation occurs in the architecture of living structure is to be investigated by extreme testing with deductive methods.Three deductive methods for explanation of living structure in animal morphology are proposed: the (...) parts, the compromise, and the transformation deduction. The methods are based upon the systems concept for an organism, the flow chart for a functionalistic picture, and the network chart for a structuralistic picture, whereas the optimal design serves as the architectural principle for living structure. These methods show clearly the high explanatory power of deductive methods in morphology, but they also make one open end most explicit: neutral issues do exist. (shrink)

In the article "The Epistemological Nature of Information Modeling" [Gnoseologicheskaia priroda informatsionnogo modelirovaniia], Voprosy filosofii, 1963, No. 10, Academician V. M. Glushkov examines two important methodological aspects of the modeling of natural objects and phenomena in the contemporary natural sciences. The first consists of the informational nature of the models created, and the second of their dynamism. The dynamic nature of today's models in the natural sciences means that it is not so much the material structure of the object that (...) is modeled as its behavior and functions in some sphere of natural phenomena. In this sense, the models under examination may also be termed functional, as distinct from the structural models pertaining to a static description of objects. (shrink)

Car driving is considered a very complex activity, consisting of different concomitant tasks and subtasks, thus it is crucial to understand the impact of different factors, such as road complexity, traffic, dashboard devices, and external events on the driver’s behavior and performance. For this reason, in particular situations the cognitive demand experienced by the driver could be very high, inducing an excessive experienced mental workload and consequently an increasing of error commission probability. In this regard, it has been demonstrated that (...) human error is the main cause of the 57 % of road accidents and a contributing factor in most of them. In this study, 20 young subjects were involved in a real driving experiment, performed under different traffic conditions (rush hour and not) and along different road types (main and secondary streets). Moreover, during the driving tasks different specific events, in particular a pedestrian crossing the road and a car entering the traffic flow just ahead of the experimental subject, were acted. A Workload Index based on the Electroencephalographic (EEG), i.e. brain activity, of the drivers has been employed to investigate the impact of the different factors on the driver’s workload. Eye-Tracking technology and subjective measures were also employed in order to have a comprehensive overview of the driver’s perceived workload and to investigate the different insights obtainable from the employed methodologies. The employment of such EEG-based Workload index confirmed the significant impact of both traffic and road types on the drivers’ behavior (increasing their workload), with the advantage of being under real settings. Also, it allowed to highlight the increased workload related to external events while driving, in particular with a significant effect during those situations when the traffic was low. Finally, the comparison between methodologies revealed the higher sensitivity of neurophysiological measures with respect to Eye-Tracking and subjective ones. In conclusion, such an EEG-based Workload index would allow to assess objectively the mental workload experienced by the driver, standing out as a powerful tool for research aimed to investigate drivers’ behavior and providing additional and complementary insights with respect to traditional methodologies employed within road safety research. (shrink)

Social and neurocognitive research suggests that thinking about one’s own thinking and thinking about the thinking of others—termed ‘mindreading’, ‘metacognition’, ‘social cognition’ or ‘mentalizing’ are not identical activities. The ability though to think about thinking in the first person is nevertheless related to the ability to think about other’s thoughts in the third person. Unclear is how these phenomena influence one another. In this review, we explore how self-reflection and autobiographical memory influence the capacity to think about the thoughts and (...) emotions of others. We review studies suggesting that the more individuals are able to reflect on and retrieve episodes from their life narratives, the more they are likely to grasp others’ thoughts and emotions. We discuss evidence supporting this possibility including studies of the neurocognitive bases of empathy and self-awareness and how different aspects of self-reflection may impact on mindreading. We also draw from clinical reports how improved self-reflection may result in a more nuanced mindreading, namely persons suffering from schizophrenia and narcissistic personality disorder. We finally discuss the implications for research and practice and consider whether there are conditions in which the reverse is true, where self-reflection might impair mindreading or in which mindreading may facilitate self-reflection. (shrink)

La autora de esta obra desarrolla un estudio en el que se analizan los derechos del individuo en contraposición con los del profesional de las ciencias de la vida, parte de los preceptos de la bioética, que ofrece el sustento ético-teórico, y el Derecho, que constituye el sistema normativo. Contempla temas referentes a cuestiones bioéticas y jurídicas relacionadas con el tratamiento y manipulación del embrión, apropiación indebida de material genético, responsabilidad civil en la transmisión de enfermedades congénitas y genéticas derivadas (...) de la reproducción asistida, anencefalia, clonación, entre otros aspectos relacionados con el genoma humano. (shrink)