This paper analyzes post-Mao China as a complex risk society in which social, economic, and ecological risk syndromes pertaining to highly diverse levels and systems of development are manifested simultaneously. Complex risk society is a theoretical extension of Ulrich Beck’s thesis on risk society, focusing on complex developmental temporalities that are pervasively symptomatic of rapidly but asymmetrically developing political economies. In my earlier study, Korea was defined as a complex risk society (...) in which risk syndromes of developed, undeveloped, and compressively developing societies are concurrently generated. In the current study, post-Mao China is also analyzed as a complex risk society which is, in fact, more complex than Korea. Paradoxically, due to its explosive development in the post-Mao era which even dwarfs Korea, China is now confronted by all of its capitalist neighbour’s risk syndromes. Besides, due to its so-called gradual approach to reform, China is beset with a complicated mix of socialist and post-socialist syndromes of risks. Gradual reform is in practice a sort of peripatetic pluralism in economic and social reform for maximizing developmental utilities of all types of human, material, and institutional resources—a policy line inevitably accompanied by similarly plural sources and factors of social, economic, and ecological risks. The unprecedented temporal and systemic complexity in China’s risk structure has crucial implications for the country’s much deplored tendency for inequalities. In particular, class inequalities and regional disparities seem to be manifest in risk dimensions no less critically than in material dimensions. The state’s developmentalism alone is no solution for risk complexities or inequalities. (shrink)

A growing body of research informs us that an effective, efficient fight against chronic American poverty, producing benefits far exceeding costs, is possible. It begins by protecting children from developmental risks. This book describes those risks, along with the programs and policies we know protect children and families. A policy framework for the pursuit of an intrepid new goal – the purposeful protection of America’s most vulnerable children on a large scale – would end chronic poverty as we know it.

Social decision-making involving risks ideally results in obligations to avoid expected harms or keep them within acceptable limits. Ambitious goals aimed at avoiding or greatly reducing risks might not be feasible, forcing the acceptance of higher degrees of risk (i.e. unrealistic levels of risk reduction are revised to comport with beliefs regarding abilities). In this paper, the philosophical princi- ple ‘ought implies can’ is applied to the management of complex risks, exempli- fied by the risks associated with (...) climate change. In its common interpretation, the principle states that we cannot expect an agent to perform something that lies beyond his or her abilities. However, it is here argued that this principle requires setting thresholds for legitimate claims of inabilities that justify the waiving of normative demands. This paper discuss three claims: (1) that caution is required before revising a risk-reducing goal that is perhaps exceedingly ambitious; (2) that claims on abilities are not only descriptive, but also value-laden; and (3) that the function of a goal has to be clarified before risk-reducing goals are revised. Risk-reducing goals that initially seem unrealistic arguably serve performance- enhancing purposes in risk management. Neglecting such goals could lead to choosing less desirable, but certainly feasible, risk-reducing goals. (shrink)

An extended analysis compared to observations shows that modern “globalised” world civilisation has passed through the invisible “complexity threshold”, after which usual “spontaneous”, empirically driven kind of development (“invisible hand” etc.) cannot continue any more without major destructive tendencies. A much deeper, non-simplified understanding of real interaction complexity is necessary in order to cope with such globalised world development problems. Here we introduce the universal definition, fundamental origin, and dynamic equations for a major related quantity of (systemic) risk characterising (...) real complex system development tendencies at any level of dynamics. Practically important conclusions are derived, opening further detailed applications in economy, finance and development practice. (shrink)

This thesis presents the first comprehensive empirical investigation of ontological instability in complex systems, introducing a novel theoretical framework called Quantitative Ontological Dynamics (QOD) that bridges philosophical ontology with empirical measurement. Through systematic analysis of quantum mechanical systems, biological phase transitions, economic market dynamics, and other complex phenomena, we demonstrate that ontological categories are not fixed but exhibit measurable fluctuations that can be quantified, predicted, and analyzed using rigorous mathematical methods. -/- Our research reveals that traditional fixed ontological (...) positions fail to account for the dynamic nature of reality as observed in complex systems. We introduce five fundamental metrics for measuring ontological instability: fluctuation intensity, correlation dynamics, phase transition indicators, ontological uncertainty, and giant component dynamics. These metrics, combined into a composite Ontological Instability Index (OII), provide unprecedented insight into how the fundamental nature of systems changes over time. -/- The empirical evidence presented demonstrates that ontological instability is not merely a philosophical curiosity but a measurable phenomenon with practical implications for understanding and predicting system behavior. Our analysis of financial market crises, biological phase transitions, and quantum measurement processes reveals consistent patterns of ontological fluctuation that challenge conventional approaches to system analysis and prediction. -/- This work establishes ontological instability as a legitimate subject of scientific inquiry and provides the theoretical and methodological foundation for a new field of quantitative ontology. The implications extend beyond academic philosophy to practical applications in risk assessment, system design, and crisis prediction across multiple domains. (shrink)

This paper analyses the nature of the relationship between risk and responsibility. Since neither the concept of risk nor the concept of responsibility has an unequivocal definition, it is obvious that there is no single interpretation of their relationship. After introducing the different meanings of responsibility used in this paper, we analyse four conceptions of risk. This allows us to make their link with responsibility explicit and to determine if a shift in the connection between risk (...) and responsibility can be outlined. (1) In the engineer’s paradigm, the quantitative conception of risk does not include any concept of responsibility. Their relationship is indirect, the locus of responsibility being risk management. (2) In Mary Douglas’ cultural theory, risks are constructed through the responsibilities they engage. (3) Rayner and (4) Wolff go further by integrating forms of responsibility in the definition of risk itself. Analysis of these four frameworks shows that the concepts of risk and responsibility are increasingly intertwined. This tendency is reinforced by increasing public awareness and a call for the integration of a moral dimension in risk management. Therefore, we suggest that a form of virtue-responsibility should also be integrated in the concept of risk. (shrink)

The subsistence technology of forager communities has varied greatly over space and time. This paper (i) reviews briefly the main causal factors the literature identifies as responsible for this variation; (ii) analyzes in some detail the most prominent idea in the literature on spatial variation:Complex technology is an adaptive response to elevated risks of subsistence failure; (iii) it argues that the alleged empirical support for this hypothesis depends on dubious proxies of risk; (iv) it argues that it fails (...) to explain the subsistence technologies of desert foragers, who generally live with simple technologies in high‐risk environments; (v) it offers an alternative analysis, based on the reduced opportunity costs of complex technologies in highly seasonal environments, on the high value of typical forager targets in those environments and their relatively predictable location in space and time; and (v) the paper concludes with a conjecture about the role of environmental variation in toolkit change over deep time. (shrink)

In his paper, ‘Patients, doctors and risk attitudes’, Makins argues that doctors, when choosing a treatment for their patient, need to follow their risk profile.1 He presents a pair of fictitious diseases facing a patient who either has ‘exemplitis’, which requires no treatment or ‘caseopathy’, which is severe and disabling and for which there is a treatment with unpleasant side effects. The doctor needs to decide whether the patient should pursue the unpleasant treatment, just in case he has (...) caseopathy. Makins believes that rational-choice theory is a productive way to approach this problem. This theory frames all decisions as gambles. Each possible gamble (eg, not to pursue treatment) leads, probabilistically, to a set of outcomes (life with no disease and no side effects, but also, possibly, life with a disabling disease, since no treatment is taken). Utilities of these outcomes and probabilities that they will happen are combined to yield a number—expected utility. One is supposed to gamble—to make a choice—in a way that maximises this expected utility. Makins takes this framework for granted and is focused on an additional complication, the patient’s risk preference. He believes that, in his hypothetical example, even if expected utility were exactly the same, withholding treatment …. (shrink)

The possibility of social and technological collapse has been the focus of science fiction tropes for decades, but more recent focus has been on specific sources of existential and global catastrophic risk. Because these scenarios are simple to understand and envision, they receive more attention than risks due to complex interplay of failures, or risks that cannot be clearly specified. In this paper, we discuss the possibility that complexity of a certain type leads to fragility which can function (...) as a source of catastrophic or even existential risk. The paper first reviews a hypothesis by Bostrom about inevitable technological risks, named the vulnerable world hypothesis. This paper next hypothesizes that fragility may not only be a possible risk, but could be inevitable,and would therefore be a subclass or example of Bostrom’s vulnerable worlds. After introducing the titular fragile world hypothesis, the paper details the conditions under which it would be correct, and presents arguments for why the conditions may in fact may apply. Finally, the assumptions and potential mitigations of the new hypothesis are contrasted with those Bostrom suggests. (shrink)

This paper uses the 5-five-minute high-frequency data of energy-listed companies in China's A-share market to extract the jump of energy stock prices and build a dynamic stock price jump complex network. Then, we analyze the clustering effect of the complex network. The research shows that the energy stock price jump is an important part of stock price volatility, and the complex network of energy stock jump risk has obvious time-varying characteristics. However, the infection problem of stock (...) price jump risks needs specific analysis. China's coal industry has an important influence on the development of China's energy industry. According to the clustering analysis results of the network community, the clustering effect of the network community has time-varying characteristics. After October 2017, the clustering effect of the jumping risk of the coal industry and the new energy industry is obvious. The risk contagion within the new energy industry community is a key point for the development of the new energy industry. (shrink)

The interactions between genetic and environmental risk factors contribute to the aetiology of complex human diseases. Genome‐wide association studies (GWAS) have revealed that most of the genetic variants associated with complex diseases are located in the non‐coding part of the genome, preferentially within enhancers. Enhancers are distal cis‐regulatory elements composed of clusters of transcription factors binding sites that positively regulate the expression of their target genes. The generation of genome‐wide maps for histone marks (e.g., H3K27ac), chromatin accessibility (...) and transcription factor and coactivator (e.g., p300) binding profiles have enabled the identification of enhancers across many human cell types and tissues. Nonetheless, the functional and pathological consequences of the majority of disease‐associated genetic variants located within enhancers seem to be rather minor under normal conditions, thus questioning their medical relevance. Here we propose that, due to the prevalence of enhancer redundancy, the pathological effects of many disease‐associated non‐coding genetic variants might be preferentially (or even only) manifested under environmental stress. (shrink)

In dementia research evidence is mounting that therapeutic strategies that target moderate and even mild Alzheimer's disease may be missing the ‘therapeutic window’. Given that the neuropathology that leads to Alzheimer's disease probably begins somewhere between 10 and 15 years before symptoms manifest, many believe that the optimal therapeutic strategy would target persons in the earliest phases of disease development or even earlier. This would include, for example, persons with prodromal Alzheimer's and even persons who are deemed at risk. (...) Given the nature of research involving the central nervous system, it is conceivable that some therapeutic investigations may involve an increase over minimal risk. This paper examines how, in dementia research, at-risk persons, although healthy, bring multiple and intersecting vulnerabilities to the prospect of research participation even though they are clinically healthy. Current guidelines for research ethics may not provide adequately for the nuances of ‘healthy individuals’ and their possible vulnerabilities. In the context of neurodegenerative disease, the fact of being ‘at risk’ alters the vulnerability profile in significant ways. While healthy persons who are at risk of developing dementia may not appear to warrant placement in the research category of vulnerable participants (alongside prisoners, pregnant women and children) careful regard for the vulnerabilities that arise as a result of the intersecting circumstances of being healthy and at risk of an incurable disease are worthy of increased attention and consideration, particularly as the research effort for the increasingly prevalent disease of Alzheimer's moves forward. (shrink)

Cardiovascular disease (CVD) and sustained high blood glucose as prediabetes are an established comorbidity. People's experience in reconciling these long‐term conditions requires deeper appreciation if nurses are to more effectively support person‐centred care for people who have them. Our analysis explores the initial experience of people admitted to hospital with CVD who then find they also have sustained high blood glucose. Our methodology is informed by the philosophy of Gadamer and applies interpretive description to develop an interpretation of participant experiences. (...) The major theme emerging from participant interviews was the ‘invisible disequilibrium’ characterised by three subthemes: ‘losing equilibrium’, ‘becoming embattled’ and ‘evolving illness’. This study examines CVD and prediabetes in conjunction with the Gadamerian notion of the ‘whole’, as being in a social and emotional world in which illness is also a component part. We explore how participants lived within an ‘invisible disequilibrium’, with prediabetes frequently remaining unnoticed, while CVD was manifest. To identify multiple conditions and support effective intervention to manage them as part of person‐centric care, nursing practice should explore the ‘whole’ of the person's experience, value people’s knowledge as potential indicators of complex illness, thereby reducing the risk of accelerating complex illness. (shrink)

Evidence suggests that men are more confident and less risk averse in financial decision making. Researchers did not address how men and women respond differently to goals in financial decision situations, however. In the present study, men set more challenging personal goals and risked more resources than women in a complex financial decision task. Men did not report higher self-efficacy versus women. As expected, gender interacted with assigned goals to predict self-efficacy, risk behavior, and personal goals. Results (...) concur with recent financial decision research that suggests men and women differ in their use of externally-provided information such as assigned goals. Suggestions for future research are offered and limitations are discussed. (shrink)

Construction schedules play an important role in construction project management. However, during construction activities, risks may arise due to unexpected schedule changes, resulting in the ineffective delivery of projects. This study aims to reveal the law of schedule change risk propagation and to analyze the effects on the risk propagation through numerical simulations. First, construction projects are represented by activity-on-node networks. A model of risk propagation is then built based on a susceptible-infected model considering the effects of (...) the nodal characteristics on the propagation process. Next, the model is tested on a real-world project to examine cascading failures with varying parameters. The experimental results demonstrate that the model is effective in identifying the activities most capable of affecting a project schedule and evaluating the impact of schedule change risk propagation. This study will provide a basis for enhancing the robustness of AON networks and controlling the propagation of schedule change risks. (shrink)

How do common and rare genetic polymorphisms contribute to quantitative traits or disease risk and progression? Multiple human traits have been extensively characterized at the genomic level, revealing their complex genetic architecture. However, it is difficult to resolve the mechanisms by which specific variants contribute to a phenotype. Recently, analyses of variant effects on molecular traits have uncovered intermediate mechanisms that link sequence variation to phenotypic changes. Yet, these methods only capture a fraction of genetic contributions to phenotype. (...) Here, in reviewing the field, it is proposed that complex traits can be understood by characterizing the dynamics of biochemical networks within living cells, and that the effects of genetic variation can be captured on these networks by using protein–protein interaction (PPI) methodologies. This synergy between PPI methodologies and the genetics of complex traits opens new avenues to investigate the molecular etiology of human diseases and to facilitate their prevention or treatment. (shrink)

This study aimed to explore stakeholders’ perspectives on the ethical considerations for returning individual pharmacogenomics research results to people living with HIV. A qualitative approach to investigation involved five focus group discussions with 30 Community representatives, 12 key informant interviews with researchers, and 12 in-depth interviews with research ethics committee members. In total, 54 stakeholders who were involved in pharmacogenomics research and HIV treatment and care contributed to the data collection between September 2021 and February 2022. The study explored five (...) prominent themes: (i) defining the nature of research results to return to participants; (ii) preparing research participants to receive their results; (iii) obtaining informed consent for the return of results; (iv) opinions on health personnel to return the results to participants; and (v) opinions on how research results should be communicated to participants. Respondents identified various strategies for the return of individual results with minimal ethical risks including the setting up of a diverse and independent committee to undertake a risk-benefit assessment based on local context; ongoing discussions about the possible kinds of results and their implications throughout the study; and employing genetic counsellors to communicate results to participants. The strategies identified in this study should be further studied and independently verified. (shrink)

Since the foundation of the Santa Fe Institute, the new science of complex adaptive systems has seen extraordinary development, breaking with previous, more epistemological, trends in complexity theory. This article makes a critique of CAS as a model of the current global complexity. Its basic model, the cellular automaton, which focuses on the interactive dynamics among components, ignores the nature of any complex system as constructed by the observer/actor and is unable to explain the sociohistorical construction of the (...) agents/subjects and the social structure in which they are located, thus being unable to accurately represent the overall social complexity. (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)

While research is emerging, there remains an inadequate focus upon the experiences of those delivering and receiving care specifically for service users with complex emotional needs (CEN) within Crisis Resolution and Home Treatment (CRHT) settings. This study therefore utilised hermeneutic phenomenology to examine the lived experience of both those providing and receiving care within CRHT settings. Data were gathered via semi‐structured interviews with 14 participants (seven mental health nurses working within CRHT settings and seven service users with CEN who (...) have received CRHT intervention). Transcripts were analysed using van Manen's hermeneutic phenomenological reflective method. A synthesis of participant accounts revealed several areas of convergence across the two groups, thus highlighting those ‘core structures’ of mental health crisis care as lived by participants in these encounters. Fears arising from structural vulnerabilities were illuminated as the eidos (or the ‘essence’) of the crisis encounter in CRHT settings, and at the heart of the crisis encounter, a central phenomenon of reciprocal insecurity is illuminated, whereby both parties' attempts to achieve a sense of personal safety inadvertently threatens that of the other. Findings highlight an urgent need for hermeneutic mediators; structures that provide the space and containment necessary for both parties to feel safe. (shrink)

Today, the risk management of budget challenges throughout the budget process is greater than ever. The process of change has been driven by new information and communication technologies, resulting in e-government. The purpose of this scientific paper is to see whether budgetary challenges have an effect on the performance of e-government in complex financial systems based on factors F1, F2, F3, F4, and F5: lack of information, lack of cooperation, lack of resources and reduction of focus, lack of (...) budget experts and financial stability, and shortcomings and inconsistencies during the budget process. Therefore, this study aims to advance the understanding of how to manage risks from budgetary challenges by focusing on a novel approach to improve e-government performance in complex financial systems. Empirical research was based on three key issues: an approach to e-government, analyzing which variables need more attention to risk, and learning how to meet budgetary challenges to improve performance during governance. For this study, the data were conducted by Kosovo’s public institutions, more specifically at the central level and at the local level. A total of 38 questionnaires were analyzed and divided into three sessions, which were analyzed through three analyses, such as factor analysis, data reliability analysis, and multiple regression analysis, using SPSS version 23.0 for Windows. The research was conducted over the years 2017, 2018, 2019, and 2020, while the analysis involved several processes, where some of the factors were removed in order to make the model acceptable. In this case, 21 variables were tested and divided into 5 factors. The results showed that special attention should be paid to these factors to reduce budgetary challenges and increase the performance of e-government in complex financial systems, such as lack of resources, increasing the focus on risk management even after the transfer of funds from the ministry to the municipality, the selection of programs based on priorities and not on the basis of wishes and policies, having political stability, rule of law, and more control, and having regulations and guidelines from the practices of developed countries as well as taking into account the opinions of budget experts. The implications of this paper have to do with only a considerable number of variables, which were taken in the study as well as only in the municipalities of Kosovo. In this case, for other analyses by other researchers, other variables can be analyzed in other countries by making comparisons. (shrink)

This chapter introduces to the main topic of the volume, namely the influence of the changing nature of warfare on the provision of medical care and the ethical challenges that occur. It presents the main ideas of relevant concepts such as asymmetrical warfare, hybrid warfare, and complex emergencies before illustrating the ethical challenges that new forms of warfare create for military and humanitarian health care providers. Examples of ethical challenges include embedding medical personnel in combating forces, questions regarding the (...) treatment of detainees, the need to uphold medical neutrality, and pitfalls of using medicine to non-medical ends. The chapter concludes with a synopsis of the volume. (shrink)

In this article, a framework is suggested to deal with the analysis of global environmental risk governance. Climate Change is taken as a particular form of contemporary environmental risk, and mobilised to refine and characterize some salient aspects of new governance challenges. A governance framework is elaborated along three basic features: (1) a close relationship with science, (2) an in-built reflexivity, and (3) forms of governmentality. The UNFCCC-centered system is then assessed according to this three-tier framework. While the (...) two-first requisites are largely met, the analysis of governmentality points to some institutional weak spots. (shrink)

Current technology has dramatically increased the prevalence of studies to establish the genetic correlates of a wide variety of human characteristics, including not only the physical attributes that determine what we look like and the risk of physiological disease but also the psychological and cognitive characteristics that often define who we are as individuals. Perhaps one of the most deeply personal and often controversial characteristics is the concept of general intelligence, known in the psychological literature as “g.” As with (...) the genetic study of any complex trait, the first step in studying the genetics of g is to carefully define the characteristic of interest. For g, this entails establishing what intelligence means and providing a clear operational definition for how it will be measured. In this paper, we provide a brief historical and theoretical overview of the construct of general intelligence, describe its relationship to the contemporary measurement of intelligence, and discuss these concepts in light of the challenges associated with defining g as a characteristic in the study of genetics. (shrink)

As a bioethicist focused on designing interventions to mitigate the impact of language barriers on healthcare quality, communication and care and a researcher who has tested a complex intervention...

In a context of accelerated change and interlinked systems we are facing the challenge to build a strategic planning that can be resilient in different future scenarios, in order to be prepared for emerging risks and opportunities. In this work we study an approach to manage emerging risks and opportunities for strategic purposes in conditions of uncertainty and complexity.Frequently a classic risk management approach for assessment cannot be sufficient because probability models could be unsuccessful. It is necessary to recognize (...) the uncertainty and complexity in emerging risks and to address both with suitable methodologies that allow a holistic view.Emerging risks that involve complex systems and entangled cause-and-effect relationships require adequate methodologies that allow the assessment of the degree of exposure to risks and a holistic and integrated vision. In order to avoid a compartmental view and see the global picture, we need to overcome the focus on single parts. It’s necessary to evolve from bidimensional to tridimensional models introducing the concept of interconnections between each bidimensional structure. As we are exposed to risks with insufficient knowledge or imprecise data, a fuzzy approach can be useful. In our study we explore the combination of fuzzy logic with other models such as decision trees and artificial neural networks to propose a possible theoretical framework. (shrink)

BackgroundThe 11th revision of the International Classification of Diseases included two distinct trauma-related diagnoses—Posttraumatic Stress Disorder and Complex Posttraumatic Stress Disorder. The initial diagnostic factor for both disorders is exposure to a traumatic event. This study aimed to explore whether exposure to different traumatic experiences distinguish risk for PTSD and CPTSD.MethodsThe study sample comprised 158 trauma-exposed participants, Mage = 33.61. The Life Events Checklist-Revised was used to evaluate trauma exposure, and the International Trauma Questionnaire was used to assess (...) risk for ICD-11 PTSD and CPTSD. Multinomial logistic regression was used to determine traumatic events as predictors of risk for PTSD and CPTSD.ResultsAnalysis revealed that sexual abuse experienced in childhood or adulthood was associated with both PTSD and CPTSD. History of other unwanted sexual experiences and childhood physical abuse predicted CPTSD compared to PTSD, whereas exposure to natural disasters predicted PTSD compared to CPTSD.ConclusionsThe results showed that experiences of certain traumatic events, such as sexual trauma, childhood physical abuse or natural disasters, might help distinguish risk for PTSD and CPTSD. Nevertheless, future studies on specific aspects of trauma exposure are necessary. (shrink)

The paper explores the basis for decision?making and policy with regard to the Environment. Clearly these should be based on knowledge of possible consequences and accompanying risk assessments involving the linked behaviour of the many interacting human actors within a socio?economic system and the ecological, and physical systems in which they are embedded. The paper describes the Complex Systems approach to these problems, showing the kind of models that are required in order to obtain whatever limited knowledge is (...) possible about the co?evolution of the human and environmental systems involved. Several practical examples are described and the models briefly presented. These are shown as examples of what should be required for the creation of the necessary basis for making policy and decision explorations with an integrated view of the system as a whole, instead of separate parts studied in detail by experts of specific disciplines. This provides a framework for making real use of the ?knowledge? of disciplinary experts, and linking their narrow views to the overall, practical consequences in the real world of possible policy options. (shrink)

The Malnutrition-Inflammation Score was initially proposed to evaluate malnutrition-inflammation complex syndrome in end-stage renal disease patients. Although MICS should be routinely evaluated to reduce the hospitalization and mortality rate of ESRD patients, the inconvenience of the MIS might limit its use. Cerebral complications in ESRD, possibly induced by MICS, were previously assessed by using spectral electroencephalography via the delta/theta ratio and microstate analysis. Correspondingly, EEG could be used to directly assess MICS in ESRD patients, but the relationships among MICS (...) and these EEG features remain inconclusive. Thus, we aimed to investigate the delta/theta ratio and microstates in ESRD patients with high and low risks of MICS. We also attempted to identify the correlation among the MIS, delta/theta ratio, and microstate parameters, which might clarify their relationships. To achieve these objectives, a total of forty-six ESRD subjects were willingly recruited. We collected their blood samples, MIS, and EEGs after receiving written informed consent. Sixteen women and seven men were allocated to low risk group. Additionally, high risk group contains 15 women and 8 men. Here, we discovered that delta/theta ratio and most microstate parameters were significantly different between subject groups. We also found that the delta/theta ratio was not correlated with MIS but was strongly with the average microstate duration ; hence, we suggested that the average microstate duration might serve as an alternative encephalopathy biomarker. Coincidentally, we noticed positive correlations for most parameters of microstates A and B and stronger negative correlations for all microstate C parameters. These findings unveiled a novel EEG biomarker, the MIC index, that could efficiently distinguish ESRD patients at high and low risk of MICS when utilized as a feature in a binary logistic regression model. We expected that the average microstate duration and MIC index might potentially contribute to monitor ESRD patients in the future. (shrink)

Background Ethical reasoning and sensitivity are always important in public health, but it is especially important in the sensitive and complex area of public health emergency preparedness. Here, we explored the ethical challenges, and dilemmas encountered by frontline health workers amid the coronavirus disease-19 (COVID-19) pandemic in Ethiopia. Methods A nationwide survey was conducted amongst the frontline health workers from nineteen public hospitals. Health workers were invited to respond to a self-administered questionnaire. Data were weighted and analyzed using descriptive (...) statistics. Results Of the 285 frontline health workers to whom questionnaires were distributed, 217 of them gave their responses (response rate 76.1%). Respondents frequently reported encountering rationing dilemmas on health commodities directly used for the prevention and treatment of COVID-19. Most (83.9%) of the health workers agreed that they encountered ethical challenges very frequently or frequently. Almost all [215(99.1%)] claimed that the limitation of resources was directly used for the treatment and prevention of COVID-19. The frequency of difficulty in the provision of essential clinical services varied between 77% and 98.7% for different services. More than half of the study participants reported that they had encountered difficulty in the provision of clinical care on a daily or weekly basis. Regarding rationing strategies, isolating COVID-19 treatment units and limiting admission were the most frequent rationing strategies used by two-thirds of health workers on a daily or weekly basis. Conclusion Front-line health workers encountered numerous ethically challenging situations during COVID-19. More than half of health workers reported that they encountered ethical challenges in rationing the resources and delivery of different clinical services such as family planning services, maternal and childcare, immunization, and chronic care. With limited resources such as ventilators and hospital beds, healthcare providers have been faced with the difficult task of deciding who gets access to these resources and who doesn't. Overall, the COVID-19 pandemic has presented numerous ethical challenges for healthcare providers, highlighting the importance of ethical considerations in healthcare delivery. By being aware of these dilemmas and having policies in place to address them, healthcare providers can ensure that they are providing the best possible care to their patients while upholding ethical standards. (shrink)

Stratified biomedicalization (Clarke et al., 2003, 2010) is a notion derived from Science and Technology Studies (STS) that refers to the complex ways in which biomedical implementations are distributed, often unintentionally, in an uneven manner between people because of their social class, gender, ethnicity, or race, which aggravates health inequities. Hence, although it is suggestive, the category is inadequate when considering the Global South. In this chapter I point out the limitations of this notion and suggest the concept of (...) aspirational biomedicalization with the purpose of showing how stratification joins the aspirations of the government to apply public policies from the Global North, which affect those who receive said policies. This conceptual proposal stems from my empirical work done in Mexico about the sociotechnical complexities of the implementation of public policies regarding preventive vaccination against human papillomavirus (HPV) and pre-exposure prophylaxis (PrEP) to prevent human immunodeficiency virus (HIV). Thus, in this text I offer a theoretical alternative to critically consider the way in which social contexts of the Global South can contribute to the creation of new concepts for STS. (shrink)

Heritable genome editing is officially here. ‘Lulu’ and ‘Nana’, born in China, are the first children whose genomes have been intentionally modified. A third gene edited baby may have already been born. Scientists in Russia are planning similar applications.1 We recently argued that HGE should be judged by the same ethical standards that we apply to other technologies.2 There is a moral imperative to improve the health of future generations, to reduce inequalities and improve standards of living. If we can (...) use HGE to achieve these aims, we should. We want to thank Sarah Chan, Peter Mills, Rachel Horton and Anneke Lucassen for their thoughtful criticisms of our paper. We would also like to thank the editors of the Journal of Medical Ethics for helping facilitate this detailed discussion. The moral questions posed by HGE, are complex, multifaceted and difficult. They required focused attention, which formats like this encourage. Our responses to each of the commentaries are detailed below We agree with the following points made in Horton and Lucassen’s paper ‘ The moral argument for heritable genome editing requires an inappropriately deterministic view of genetics ’.3 These are some of the reasons why we say HGE targeting polygenic diseases is likely decades away.2 The technical challenges seem daunting. But science can move quickly, and often does so in bounds. Our capacity to capture and analyse genetic data is rapidly expanding. Over the next 5 years, genomic …. (shrink)

This article examines the discursive construction of a specific letter-style multilingual crisis message released by local governmental institutions during China’s battle against the COVID-19 pandemic. Based on a sociocognitive analysis of a collection of 33 English-language messages, the analysis revealed the structural features of the message and the discursive strategies in constructing and negotiating the identities of the message’s addresser and the addressee. It was found that the discursive relationship between the addresser and the addressee was established on an ingroup-outgroup (...) distinction mediated by neutralising strategies to reduce authoritative imposition and image-enhancing strategies to promote a responsible government. The findings suggest that multilingual crisis communication is a multivocal, complex social practice shaped by genre, textual, media and contextual factors. These findings will provide insights into the crisis discourse as an emerging topic of interest and help inform multilingual communication strategies in and beyond the context of a public health emergency. (shrink)

This gritty and compelling ethnography examines the darker side of American education through chronicling the course of Peachtree Alternative School's tenth and final year.. It exposes punitive school policy, demonstrates the prison-industrial complex, and reveals school board corruption. In addition, it pinpoints quality teaching of chronically disruptive youth. As ethnographic nonfiction, The Forgotten Room breaks down the walls between social science and literature.

Complex systems are difficult to manage, operate and maintain. This is why we see teams of highly specialised engineers in industries such as aerospace, nuclear and subsurface. Condition based monitoring is also employed to maximise the efficiency of extensive maintenance programmes instead of using periodic maintenance. A level of automation is often required in such complex engineering platforms in order to effectively and safely manage them. Advances in Artificial Intelligence related technologies have offered greater levels of automation but (...) this potentially pivots the weight of decision making away from the operator to the machine. Implementing AI or complex algorithms into a platform can mean that the Operators’ control over the system is diminished or removed altogether. For example, in the Boeing 737 Air Max Disaster, AI had been added to a platform and removed the operators’ control of the system. This meant that the operator could not then move outside the extremely reserved, algorithm defined, “envelope” of operation. This paper analyses the challenges of AI driven condition based monitoring where there is a potential to see similar consequences to those seen in control engineering. As the future of society becomes more about algorithm driven technology, it is prudent to ask, not only whether we should implement AI into complex systems, but how this can be achieved ethically and safely in order to reduce risk to life. (shrink)

It is widely recognized that our social and moral environments influence our actions and belief formations. We are never fully immune to the effects of cultural membership. What is not clear, however, is whether these influences excuse average moral agents who fail to scrutinize conventional norms. In this paper, I argue that the lack of extensive public debate about factory farming and, its corollary, extreme animal suffering, is probably due, in part, to affected ignorance. Although a complex phenomenon because (...) of its many manifestations, affected ignorance is morally culpable because it involves a choice not to investigate whether some practice in which one participates in might be immoral. I contend further that James Montmarquet’s set of intellectual virtues can provide a positive account of what it means to act as a responsible moral agent while immersed in a meat eating culture; they also represent the moral and epistemic framework for the kind of public discourse that should be taking place. (shrink)

Legal dispute resolution hinges on the weighing of evidence and arguments across parties, yet human biases and bounded rationality can influence outcomes. Simulating this process with large language models can clarify both the capabilities and the anthropomorphic behavior. Most existing studies focus on algorithmic support for adjudication, such as online courts, risk assessment, and sentencing tools. At the same time, the role of AI agents in mediation and conciliatory negotiation remains largely untested. To address this gap, the study designs (...) six scenario types and evaluates them on a multi-agent platform. It addresses two questions: (i) To what extent can LLM agents produce realistic simulations from a juridical perspective? We find that LLMs can reproduce diverse dispute scenarios, but performance varies by role; in particular, judge agents sometimes commit serious legal errors when interpreting clauses and may infer property rights rather than apply the correct rules. (ii) Do sensitive factors and intrinsic properties affect legal dispute resolution? Sensitivity analyses across model-level configurations, framework design choices, and procedural settings confirm the robustness of our findings; we further observe irrational patterns yielding mechanical or unexpected decisions and measurable effects from intrinsic properties. These findings show strengths in fact-heavy money bargaining and mixed remedies, while highlighting limits where careful discretion and normative justification are required. Code and scenarios are publicly available for replication (https://github.com/TOM-ZHOUch/Legal_Dispute_Resolution). (shrink)

Complex, risk-generating and predicament-laden patterns of global interdependence pose significant imperatives for radically reframing the purposes and provision of higher education. Changes already ongoing in higher education reflect and respond to global dynamics that are intensifying interdependence and, at the same time, deepening inequalities both within and among societies. Recognizing this is to recognize the need to question whether the arcs of change in higher education should remain passively entrained with globalization-driven magnifications and multiplications of difference, or whether (...) higher education can and should play a unique and critical role in reorienting the dynamics of global interdependence. This paper argues that if current trends toward both institutional and epistemic differentiation can be inflected toward enhancing diversification—rather than mere variation—21st-century higher education can come to serve as a global relational commons crucial to realizing ever more deeply shared and equitable expressions of global flourishing and public good. (shrink)

Scientific developments take place in a socio-political context but scientists often ignore the ways their innovations will be both interpreted by the media and used by policy makers. In the rush to neuroscientific discovery important questions are overlooked, such as the ways: (1) the brain, environment and behavior are related; (2) biological changes are mediated by social organization; (3) institutional bias in the application of technical procedures ignores race, class and gender dimensions of society; (4) knowledge is used to the (...) advantage of the powerful; and (5) its applications may reinforce existing structures of power that pose ethical questions about distributive justice. The case of crime, deception and functional Magnetic Resonance Imaging (fMRI) shows the complexity, and the political and ethical challenges that confront those who seek to use neuroscience to explain the etiology of crime, and who base policy on its findings. An ethically grounded neuroscience needs to take account of existing structures of power and difference, and to develop a public neuropolitical consciousness that ensures that those subject to risk by the application of science and technology are participants in the decision-making processes involving the implementation of policies that affect them. (shrink)

Risk assessment tools are increasingly used in policing to enhance decision-making accuracy and objectivity; yet their implementation has raised significant ethical concerns regarding issues of bias, transparency, and governance. This paper examines the ethical complexities of risk assessment tools through an analysis of four instruments: the Harm Assessment Risk Tool (HART), previously developed and used by Durham Constabulary; the Active Risk Management System (ARMS), used across all police forces in England and Wales; the Offender Assessment System (...) (OASys), used to profile risk of reoffending by probation services in the UK; and the Correctional Offender Management Profiling for Alternative Sanctions (COMPAS), a widely researched tool deployed in US corrections contexts whose ethical challenges are directly relevant to tools now entering policing practice. A thematic framework identifies 10 key challenges for the field, including disparities in accuracy metrics, fairness trade-offs, bias linked to demographics and social identity, and retraining. The paper contextualises these issues within influential roles, including tool developers, decision-makers, and oversight committees. The credible risk of ethical harms arising from the use of risk assessment tools underscores the need for rigorous validation, transparency, and adaptive governance to minimise these risks. This paper arises from a meeting of an interdisciplinary working group convened at Ethox, University of Oxford, comprising academics in philosophy, law, psychology, psychiatry, and criminology, as well as police stakeholders. (shrink)

The paper explores how the framework of systemic risks can help govern the risks imposed through solar climate engineering research. The central argument is that a systemic perspective of risk is a useful tool for analysing and assessing the risks imposed through Stratospheric Aerosol Injection (SAI) research. SAI is a form of climate engineering that could cool the planet by enhancing its albedo through the injection of aerosols into the stratosphere. Researching such a technology creates systemic risks with a (...) strong sociotechnical component. This component consists of the potential societal harm that a developing or new technology might cause to existing norms, values, institutions, and politics. The systemic risk framework is a valuable heuristic for this case, given the complex interdependencies of societal systems, infrastructures, markets, etc. At the same time, the systemic risk framework can be enhanced through the inclusion of a more robust and reflected ethical considerations on technological risks. Consequently, this article seeks to supplement the systemic risk governance framework with insights from technology ethics. Specifically, the paper offers an ethically reflective conception of societal value dynamism and stakeholder engagement and participation, tying it to existing systemic risk governance approaches. (shrink)

Leaders are faced with ethical and moral dilemmas daily, like those within the military who must span from large-scale combat operations to security cooperation and deterrence. For businesses, these dilemmas can include social and environmental impact such as those in mining; and for governments, the social and economic impact of their decision-making in their response to COVID-19. The move by Western defence forces to align their foundational principles, policies, and “soldier” dispositions with the changing values of the countries they serve (...) are starkly illustrative of challenges faced by all leaders. While admirable, such changes face the apparent contradiction of enhancing individual moral agency within a hierarchical organization that maintain enforceable codes of conduct. Ethical leadership theory provides aspirational goals, but lacks empirically based guidance on how to implement policies that facilitate values-based behavior. Using a discourse theory analysis of a moral dilemma vignette with Royal Australian Air Force personnel, this research identifies important aspects of agency and subject position that must be addressed if such policies are to succeed. These findings show that the potential contradiction can be addressed by acknowledging the contrasting tendency to bureaucratic process by leaders at upper levels, while lower-level leaders address moral issues by incorporating their subjectivity and making a conscious deontological choice between humanity and comrade loyalty. (shrink)

Dietary changes can alter the human microbiome with potential detrimental consequences for health. Given that environment, health, and evolution are interconnected, we ask: Could diet‐driven microbiome perturbations have consequences that extend beyond their immediate impact on human health? We address this question in the context of the urgent health challenges posed by global climate change. Drawing on recent studies, we propose that not only can diet‐driven microbiome changes lead to dysbiosis, they can also shape life‐history traits and fuel human evolution. (...) We posit that dietary shifts prompt mismatched microbiome‐host genetics configurations that modulate human longevity and reproductive success. These mismatches can also induce a heritable intra‐holobiont stress response, which encourages the holobiont to re‐establish equilibrium within the changed nutritional environment. Thus, while mismatches between climate change‐related genetic and epigenetic configurations within the holobiont increase the risk and severity of diseases, they may also affect life‐history traits and facilitate adaptive responses. These propositions form a framework that can help systematize and address climate‐related dietary challenges for policy and health interventions. (shrink)