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The capacious companion: law, lawyers and the legal on ethics advisory groups
No full textThis article asks whether and how law matters in ethics advisory work in the fields of health, medicine and science, and whether it is law or legal knowledge, or both, that matters. Written from the perspective of four law professors, each with first-hand experience of ethics advisory groups, it examines the framing of academic legal expertise on ethics advisory groups and explains why this framing requires ongoing negotiation
Multi-agent reinforcement learning in designing the low-dropout regulator circuits
No full textLow-dropout regulator (LDO) circuit, whose function is to provide a power supply robust to variations in process, voltage, and temperature (PVT), is an essential part in any system-on-chip. Therefore, the design of this circuit must satisfy various intricate specifications, rendering the design process generally perceived as tedious and lengthy. As a result, previous research has been conducted to explore the use of machine learning, particularly reinforcement learning, in speeding up and automating the LDO design process, especially the sizing phase. However, the results of these works are limited in terms of the number of design variables and specifications handled by the automation engine. This study presents the application of single-agent proximal policy optimization (PPO) and multi-agent proximal policy optimization (MAPPO), including both parameter-separated and parameter-sharing methods, to address the LDO sizing automation problem. The experimental result shows that the PPO- and MAPPO-based implementation in LDO sizing automation outperforms that of the classical particle swarm optimization algorithm. We demonstrate that the parameter-separated MAPPO features the most effective learning process compared with other PPO-based benchmarks, resulting in a design result that is competitive to that of a well-known commercial tool
Comment by European Alzheimer's Disease Consortium (EADC) investigators on the negative recommendation of the CHMP on the marketing authorization of donanemab for early Alzheimer' s disease
No full textTranslating knowledge(s) across time and space: audiovisual translation of “Traditional Chinese medicine and culture” Open Course (a case study)
No full textThe audiovisual translation (AVT) of online courses plays a crucial role in the rapidly evolving global education landscape. This means that Massive Open Online Courses become massive translation sites, in which complex linguistic, cultural, and epistemological challenges are negotiated. Taking a cue from the EPISTRAN international research project, this article takes a close look at a hugely popular MOOC devoted to Traditional Chinese Medicine and Culture to identify both challenges as well as elements of good practice. One of the key findings is that integrating a translational perspective early into the design process, rather than viewing translation as an extra linguistic layer added at the end, helps minimise conceptual mismatches, maximise participant engagement, and encourage constant revision and updating of knowledge. MOOCs offered by world-renowned educational institutions to a broad range of multilingual and multicultural audiences powerfully showcase translation in its knowledge-making role
Scientists' warning to humanity: the need to begin teaching critical and systems thinking early in life
No full textWe live in a time of global crises: a deteriorating environment that is struggling to provide all the resources and services we demand of it, changing climate and its consequences for the biosphere, its habitats, inhabitants and biodiversity, conflicts‐divisive ideologies‐competition for resources, increasing societal inequalities and human deprivations, and a youth mental health pandemic, to name but just a few. Most of these crises are self‐made, the result of human decisions, and their acceptance/toleration by society. Policies and practices at all levels of society that created, exacerbate and launch new crises are, at worst, self‐serving and, at best, faulted through a lack of understanding. In democracies, citizens can hold decision‐makers to account but, to do this, they must understand the issues and be able to imagine better policies. We also live in a digital world in which a flood of mostly inconsequential information and misinformation pollutes our brains, enhancing pre‐existing biases and creating new ones, and numbing our mental ability to think clearly and reach sensible decisions. But sensible decisions are urgently needed at all levels to fix problems and reduce future self‐harm. Sensible decisions require sourcing the best available relevant information, and a process to convert information into understanding, understanding into clear decision options, and the choice of a decision option that leads to an action that represents best practice. Critical thinking is the enabling cognitive process of this decision pathway, because it selects the best available information through demanding evidence‐basing, seeks critical discourse between experts and stakeholders that agnostically explores solution space to find plausible options, and whittles down options inter alia through plausibility, due diligence, bottleneck analysis, cost‐benefit analysis, and benchmarking filtering. Crucially, it rejects biases, influencing factors, and other constraints on options, and is an effective barrier to the information flood. The problem is that critical thinking capacity is not widely available among either decision makers or stakeholders. There is an urgent need to rapidly roll out effective education programmes in which critical thinking teaching is solidly embedded. Since biases accumulate with age, the teaching of critical thinking must begin with the very young. However, the very young are not able to comprehend the complex abstract issues underpinning critical thinking. Embedding the teaching of critical thinking in a suitable educational context, and integrating it into curricula, is another challenge. To address these two challenges, the International Microbiology Literacy Initiative is developing a storytelling programme for children, called the Critical Thinking MicroChats Gallery, within the curriculum of societally relevant microbiology it is creating. MicroChats illustrate the principal practical elements of critical thinking, like bottlenecks, cost: benefit, benchmarking, the need for discussions and other points of view, employing readily relatable, relevant microbially centric scenarios. MicroChats suggest class discussion topics to encourage children to imagine the application of each element in other contexts to reinforce principles and hone critical thinking skills. Critical thinking, and especially the cultivation of the habit of asking ‘why’ and requiring plausible justification for policies/actions, is a shield against bias, prejudice, propaganda, misinformation and the incessant pressures of social media. It promotes a healthy mind and the attainment of the developmental potential of individuals. Increasing critical thinking in society will raise the quality of decision making at all levels and thereby improve sustainability/reduce the human footprint on our planet, and promote the individual sense of responsibility and global citizenship necessary for the improvement of the condition of humanity and its relationship with Planet Earth
Patient preferences for adverse effects of intraocular pressure-lowering eye drops. Results from a Danish large-scale discrete choice experiment: These adverse effects matter to the patients
No full textAssessment of patient preferences for local adverse effects (AEs) of intraocular pressure (IOP)-lowering eye drops. A total of 10 000 eye drop-treated patients aged 40-75 years were sampled from the Danish national registries. A discrete choice experiment (DCE) was distributed to each patient to elicit preferences for distinct levels of five representative local AE attributes of IOP-lowering drops: acute discomfort, persistent discomfort, blurred vision, non-persistent cosmetic changes, and persistent cosmetic changes. Preference weights were computed using conditional logistic regression and normalised using profile-based normalisation. The mildest severity levels were used as a reference. Heterogeneity analyses were conducted across patient covariates to examine variation in preference patterns. A total of 2445 patients (24% response rate; 55% male; median age: 67 years) completed the DCE, with 2096 providing additional covariate data. 95% reported a diagnosis of glaucoma or ocular hypertension. More females than males reported currently experiencing AEs (48% vs. 35%). 25% had previously discontinued treatment with IOP-lowering eye drops due to AEs. The DCE revealed significant differences in the patients' preferences for avoiding AEs. Severe blurred vision, persistent cosmetic changes, and persistent discomfort exhibited the highest levels of disutility. Moderate acute discomfort and non-persistent cosmetic changes were least important. The patients' preferences varied notably by age and gender. This study provides novel insight into patients' preferences for AEs of IOP-lowering eye drops by identifying the characteristics that most strongly influence treatment choices. These insights support future clinical studies and shared decision-making, facilitating personalised care that can improve adherence, quality of life, and long-term patient outcomes
Predicting risk of morbidities associated with oral corticosteroid prescription for asthma
No full textBackground: Oral corticosteroids (OCS) are commonly used to treat asthma but increase the risks for multiple morbidities; reducing OCS exposure may benefit patients. We analysed independent risk factors and longitudinal changes in OCS usage among patients with asthma to predict future risks of OCS-related adverse outcomes.Methods: Optimum Patient Care Research Database United Kingdom primary care electronic medical records (EMR) from January 1990 to June 2021 were used to select adults (18– 93 years) with asthma who had follow-up data from ≥ 2 years before to ≥ 3 years after an index visit for active symptoms; this date was defined by the largest pre-visit to post-visit change in mean annual OCS use. OCS usage during every follow-up year was categorised as none, low (mean < 2 prescriptions/year), or high (mean ≥ 2 prescriptions/year). Pre-index to post-index changes between usage categories were calculated. Risk modelling selected cohorts without 17 morbidities (documented pre-index) reported to be associated with OCS exposure, including type 2 diabetes, osteoporosis, hypertension, and pneumonia. Cox regression analyses selected published risk factors associated with each condition and available in EMR for inclusion in proportional hazards models.Results: The pre-index to post-index OCS usage category remained unchanged in 38.6% of patients, increased in 39.2%, and decreased in 22.2%, with 20.7% having no further OCS prescriptions. In models, the risks of all adverse outcomes increased with projected categoric OCS use; for example, hazard ratios for a one-category increment (none to low, low to high) were 1.55 (1.42– 1.69) for type 2 diabetes, 1.56 (1.36– 1.78) for post-menopausal osteoporosis, 1.05 (1.00– 1.10) for hypertension, and 1.67 (1.52– 1.83) for pneumonia (all p < 0.001).Conclusion: OCS exposure in this primary care asthma population usually continued longitudinally. Our models predict increased risk of multiple morbidities with higher projected OCS exposure. These findings support early initiation of strategies to minimise OCS use in asthma. was defined by the largest pre-visit to post-visit change in mean annual OCS use. OCS usage during every follow-up year was categorised as none, low (mea
The neural contributions to reactive balance control: a scoping review of EEG, fNIRS, MRI, and PET Studies
No full textBackground/Objectives: Rapid postural reactions are critical for preventing falls, yet the neural systems supporting these responses are not fully understood, particularly with respect to aging and neurological disorders. Understanding how the brain detects, interprets, and responds to balance disturbances is essential for developing new interventions. This scoping review aimed to synthesize evidence from neuroimaging studies to identify the cortical and subcortical mechanisms underlying reactive balance and to characterize how these mechanisms are altered by aging and pathology. Methods: A structured search of EMBASE, PubMed, and CINAHL (7 November 2024) identified studies examining neural activity during experimentally induced balance perturbations. Sixty-one studies met inclusion criteria (EEG n = 45; MRI n = 9; fNIRS n = 8; PET n = 1) and were analyzed for patterns of regional activation and age- or disease-related differences. Results: Evidence converges on a distributed network supporting reactive balance. Sensorimotor, premotor, supplementary motor, and prefrontal cortices show consistent involvement, while cerebellar, brainstem, and basal ganglia structures contribute to rapid, automatic responses. Aging and neurological conditions commonly heighten cortical activation, suggesting reduced automaticity and increased reliance on compensatory control. Conclusions: Reactive balance emerges from coordinated activity across cortico-subcortical systems that are altered by aging and pathology. Further research incorporating multimodal imaging approaches and more ecologically realistic perturbation paradigms is needed to clarify mechanistic pathways and inform precision-based fall-prevention strategies
Pinching-antenna systems (PASS): power radiation model and optimal beamforming design
No full textPinching-antenna systems (PASS) improve wireless links by configuring the locations of activated pinching antennas along dielectric waveguides, namely pinching beamforming. In this paper, a novel adjustable power radiation model is proposed for PASS, where power radiation ratios of pinching antennas can be flexibly controlled by tuning coupling spacing between pinching antennas and waveguides. The closed-form coupling spacings are derived to achieve flexible and equal-power radiation. Based on the commonly-assumed equal-power radiation, a practical PASS framework relying on discrete activation is considered, where pinching antennas can only be activated among a set of predefined locations. A transmit power minimization problem is formulated, which jointly optimizes the transmit beamforming, pinching beamforming, and the numbers of activated pinching antennas, subject to each user’s minimum rate requirement. (1) To obtain globally optimal solutions of the resulting highly coupled mixed-integer nonlinear programming (MINLP) problem, branch-and-bound (BnB)-based algorithms are proposed for both single-user and multi-user scenarios. (2) A low-complexity many-to-many matching algorithm is further developed. Combined with the Karush-Kuhn-Tucker (KKT) theory, locally optimal and pairwise-stable solutions are obtained within polynomial-time complexity. Simulation results demonstrate that: (i) PASS significantly outperforms conventional multi-antenna architectures, particularly when the number of users and the spatial range increase; and (ii) The proposed matching-based algorithm achieves near-optimal performance, resulting in only a slight performance loss while significantly reducing computational overheads. Code is available at https://github.com/xiaoxiaxusummer/PASS_Discrete