Challenges and Suggestions of Ethical Review on Clinical Research Involving Brain-Computer Interfaces

Brain-computer interface(BCI)technology is rapidly advancing in medical research and application.As an emerging biomedical engineering technology,it has garnered significant attention in the clinical research of brain disease diagnosis and treatment,neurological rehabilitation,and mental health.However,BCI also raises several challenges and ethical concerns in clinical research.In this article,the authors investigate and discuss three aspects of BCI in medicine and healthcare:the state of international ethical governance,multidimensional ethical challenges pertaining to BCI in clinical research,and suggestive concerns for ethical review.Despite the great potential of frontier BCI research and development in the field of medical care,the ethical challenges induced by itself and the complexities of clinical research and brain function have put forward new special fields for ethics in BCI.To ensure"responsible innovation"in BCI research in healthcare and medicine,the creation of an ethical global governance framework and system,along with special guidelines for cutting-edge BCI research in medicine,is suggested.

Errata regarding missing Ethical Statements in previously published articles:Part 3

Ethical statements were not included in the published version of the following articles that appeared in previous issues of Journal of Integrative Agriculture.The appropriate statements provided by the Authors are included below.

Errata regarding missing Ethical Statements in previously published articles:Part 5

Ethical statements were not included in the published version of the following articles that appeared in previous issues of Journal of Integrative Agriculture.The appropriate statements provided by the Authors are included below.

Errata regarding missing Ethical Statements in previously published articles:Part 1

Ethical statements were not included in the published version of the following articles that appeared in previous issues of Journal of Integrative Agriculture.The appropriate statements provided by the Authors are included below.

Errata regarding missing Ethical Statements in previously published articles:Part 4

Ethical statements were not included in the published version of the following articles that appeared in previous issues of Journal of Integrative Agriculture.The appropriate statements provided by the Authors are included below.

Errata regarding missing Ethical Statements in previously published articles:Part 2

Ethical statements were not included in the published version of the following articles that appeared in previous issues of Journal of Integrative Agriculture.The appropriate statements provided by the Authors are included below.

Ethical Decision-Making Framework Based on Incremental ILP Considering Conflicts

Humans are experiencing the inclusion of artificial agents in their lives,such as unmanned vehicles,service robots,voice assistants,and intelligent medical care.If the artificial agents cannot align with social values or make ethical decisions,they may not meet the expectations of humans.Traditionally,an ethical decision-making framework is constructed by rule-based or statistical approaches.In this paper,we propose an ethical decision-making framework based on incremental ILP(Inductive Logic Programming),which can overcome the brittleness of rule-based approaches and little interpretability of statistical approaches.As the current incremental ILP makes it difficult to solve conflicts,we propose a novel ethical decision-making framework considering conflicts in this paper,which adopts our proposed incremental ILP system.The framework consists of two processes:the learning process and the deduction process.The first process records bottom clauses with their score functions and learns rules guided by the entailment and the score function.The second process obtains an ethical decision based on the rules.In an ethical scenario about chatbots for teenagers’mental health,we verify that our framework can learn ethical rules and make ethical decisions.Besides,we extract incremental ILP from the framework and compare it with the state-of-the-art ILP systems based on ASP(Answer Set Programming)focusing on conflict resolution.The results of comparisons show that our proposed system can generate better-quality rules than most other systems.

Exploring the intersection of the medical metaverse and healthcare ethics:future considerations and caveats

The medical metaverse and digital twin are set to revolutionise healthcare.Like all emerging technologies their benefits must be weighed against their ethical and social,impacts.If we consider the advances of medical technology as an expression of our values,such as the pursuit of knowledge,cures and healing,an ethical study allows us to align our values and steer the technology towards an agreed goal.However,to appreciate the long-term consequents of a technology,those consequences must be considered in the context of a society already shaped by that technology.This paper identifies the technologies currently shaping society and considers the ethical,and social consequences of the medical metaverse and digital twin in that future society.

Facing ethical concerns in the age of precise gene therapy:Outlook on inherited arrhythmias

This editorial,comments on the article by Spartalis et al published in the recent issue of the World Journal of Cardiology.We here provide an outlook on potential ethical concerns related to the future application of gene therapy in the field of inherited arrhythmias.As monogenic diseases with no or few therapeutic options available through standard care,inherited arrhythmias are ideal candidates to gene therapy in their treatment.Patients with inherited arrhythmias typically have a poor quality of life,especially young people engaged in agonistic sports.While genome editing for treatment of inherited arrhythmias still has theoretical application,advances in CRISPR/Cas9 technology now allows the generation of knock-in animal models of the disease.However,clinical translation is somehow expected soon and this make consistent discussing about ethical concerns related to gene editing in inherited arrhythmias.Genomic off-target activity is a known technical issue,but its relationship with ethnical and individual genetical diversity raises concerns about an equitable accessibility.Meanwhile,the costeffectiveness may further limit an equal distribution of gene therapies.The economic burden of gene therapies on healthcare systems is is increasingly recognized as a pressing concern.A growing body of studies are reporting uncertainty in payback periods with intuitive short-term effects for insurance-based healthcare systems,but potential concerns for universal healthcare systems in the long term as well.Altogether,those aspects strongly indicate a need of regulatory entities to manage those issues.

Integrating GPT into the Journalism and Communication Industries:The Technological Logic,Ecosystem Reconstruction,and Ethical Chal enges

Generative AI,represented by GPT(Generative Pre-trained Transformer),is now leading the technological revolution and is reconstructing the journalism and communication industries'ecosystems because of its powerful generative capacity and diverse range of outputs.While GPT is busy revolutionizing and innovating the production of news content,working patterns,and operation modes,it has also given rise to ethical concerns in regard to news authenticity,data security,humanistic values,and other related aspects.Therefore,it is imperative to initiate strategies and approaches,such as establishing a mechanism for verifying information authenticity,enhancing data security and privacy regulations,and instituting an ethical supervision and governance framework for AI,in order to facilitate the systematic advancement of AI-based news production while reinstating public trust.

Helping People and Changing the World with CS

What should academic institutions be doing in order to benefit students,the community at large,and society in the new era?Particularly,as computing is impacting all aspects of human society,it also brings many challenges and opportunities for the academic departments of computer science.Some of these challenges include the increasing impact of software on society,issues involving privacy and data abuse,and ethical issues concerning AI.Towards addressing these challenges,the Korea Advanced Institute of Science and Technology(KAIST)leverages its position as an educator in order to train the future computing workforce to be more aware of these issues.To achieve this goal,KAIST mainly adopts three strategies:Combining science&technology and humanities together;putting academy and industry together;training software experts while making them understand people and the world.

From the mathematical model to the patient: The scientific and human aspects of artificial intelligence in gastrointestinal surgery

Recent medical literature shows that the application of artificial intelligence(AI)models in gastrointestinal pathology is an exponentially growing field,with pro-mising models that show very high performances.Regarding inflammatory bowel disease(IBD),recent reviews demonstrate promising diagnostic and prognostic AI models.However,studies are generally at high risk of bias(especially in AI models that are image-based).The creation of specific AI models that improve diagnostic performance and allow the establishment of a general prognostic fo-recast in IBD is of great interest,as it may allow the stratification of patients into subgroups and,in turn,allow the creation of different diagnostic and therapeutic protocols for these patients.Regarding surgical models,predictive models of post-operative complications have shown great potential in large-scale studies.In this work,the authors present the development of a predictive algorithm for early post-surgical complications in Crohn's disease based on a Random Forest model with exceptional predictive ability for complications within the cohort.The pre-sent work,based on logical and reasoned,clinical,and applicable aspects,lays a solid foundation for future prospective work to further develop post-surgical prognostic tools for IBD.The next step is to develop in a prospective and mul-ticenter way,a collaborative path to optimize this line of research and make it applicable to our patients.

Ethics of Human Resources Management in the Cameroonian Health System, Medical Nomadism and the Ineffectiveness of the Fight against High Blood Pressure

Context/objectives: The fight against Chronic Non-Communicable Diseases (NCDs) is a long-term undertaking, which requires available, motivated and well-managed human resources (HR). The administrative management of skills on both qualitative and quantitative levels is one of the essential functions of a health system. To better implement policies of fight against High Blood Pressure (HBP) and other chronic diseases, it is important to establish strategies to retain health personnel. This loyalty requires favorable working conditions and consideration of the contribution-reward couple. Good working conditions are likely to reduce the phenomenon of medical nomadism;conversely, poor HR management can contribute to their exodus towards exotic “green pastures”, thus leading to an additional crisis in the Cameroonian health system. The fight against HBP is a complex, multifaceted and multifactorial reality that requires appropriate management model for all types of resources mainly HR. The main objective of this research is to show the impact of poor management of human resources in Cameroon health system on medical nomadism and the ineffectiveness of the fight against High Blood Pressure. Method: A cross-sectional descriptive survey among five hundred (500) health facilities in the center region of Cameroon has been conducted. A stratified probabilistic technique has been used, and the number of health facilities to be surveyed has been determined using the “sample size estimation table” of Depelteau. The physical questionnaires have been printed and then distributed to data collectors. After data collection, the latter were grouped during processing in Excel sheets. The Chi-square test was used for data with a qualitative value and that of Kolmogorov-Sminorf for data with a quantitative value to assess the normality and reliability of data. The Crochach’s Alpha reliability test allowed us to have a summary of the means and variances and then to search for intragroup correlations between variables. Descriptive analysis was possible with the XLSTAT 2016 software. Results: 43.60% of Health Facilities (HF) managers were unqualified. 82.20% of HF managers have staff in a situation of professional insecurity. They are mainly contractual (49.00), decision-making agents (24.40%), casual agents (08.80). The proportion of unstable personnel is average of 22.00% and very unstable, 12.00%.

Community Needs Assessment for a Professional University Health Counselling Course in Cambodia

Developing health and counselling professionals remains an important part of supporting mental health services in Cambodia.This paper aims to identify how the key stakeholders and mental health experts in Cambodia consider how a university level health counselling course could contribute to addressing the needs/treatment gap for mental health services in Cambodia.In order to do this,the study consists of semi-structured interviews with stakeholders,community needs assessment,and community resource mapping.The data were drawn from 15 NGOs,various profit and not-for-profit organizations as well as two key government stakeholders.The participants were invited to take part in a stakeholders/expert semi-structured interview that lasted between 30-60 minutes at the participants’organizations.The findings revealed that all participants believe that a university level health counseling course was crucial in Cambodia to address pressing mental health issues in the country.Most participants believed that a graduate or post-graduate level program such as a B.A.or M.A.was necessary to train qualified counsellors.The program should be internationally benchmarked,with a Cambodian context.Topics should include psychopathology,professional ethics and competencies,counselling theories and interventions,trauma treatment,as well as emotional intelligence and addiction.Other topics might need to include parenting,support system for suicidal patients,self-care,staff wellbeing programs,and school counselor programs.

Ethical framework for artificial intelligence in healthcare research:A path to integrity

The integration of Artificial Intelligence(AI)into healthcare research promises unprecedented advancements in medical diagnostics,treatment personalization,and patient care management.However,these innovations also bring forth significant ethical challenges that must be addressed to maintain public trust,ensure patient safety,and uphold data integrity.This article sets out to introduce a detailed framework designed to steer governance and offer a systematic method for assuring that AI applications in healthcare research are developed and executed with integrity and adherence to medical research ethics.

The Ethical Choice of Business English Interpreters under Chesterman’s Model of Translation Ethics

This paper explores the ethical challenges encountered by business English interpreters using Chesterman’s Model of Translation Ethics,set against the context of economic globalization and the“Belt and Road”initiative.With the increasing demand for interpreters,the paper delves into the ongoing discussion about the role of AI in translation and its limitations,especially concerning cultural subtleties and ethical issues.It highlights the importance of human interpreters’cross-cultural understanding and the ethical principles that inform their work,such as the Ethics of Representation,Service,Communication,Norm-based Ethics,and Commitment.Moreover,the paper examines how these ethical models are applied in practical business situations,including business banquets,business negotiations,business talks and business visits,etc.,and investigates the cultural misunderstandings that may occur during these interactions.The study concludes that although AI provides efficiency and cost savings,human interpreters are essential for their capacity to handle the intricacies of cross-cultural communication with cultural awareness and ethical discernment.

Biobanks and biomarkers:Their current and future role in biomedical research

The importance and utility of biobanks has increased exponentially since their inception and creation.Initially used as part of translational research,they now contribute over 40%of data for all cancer research papers in the United States of America and play a crucial role in all aspects of healthcare.Multiple classification systems exist but a simplified approach is to either classify as population-based or disease-oriented entities.Whilst historically publicly funded institutions,there has been a significant increase in industry funded entities across the world which has changed the dynamic of biobanks offering new possibilities but also new challenges.Biobanks face legal questions over data sharing and intellectual property as well as ethical and sustainability questions particularly as the world attempts to move to a low-carbon economy.International collaboration is required to address some of these challenges but this in itself is fraught with complexity and difficulty.This review will examine the current utility of biobanks in the modern healthcare setting as well as the current and future challenges these vital institutions face.

Can propensity score matching replace randomized controlled trials?

Randomized controlled trials(RCTs)have long been recognized as the gold standard for establishing causal relationships in clinical research.Despite that,various limitations of RCTs prevent its widespread implementation,ranging from the ethicality of withholding potentially-lifesaving treatment from a group to relatively poor external validity due to stringent inclusion criteria,amongst others.However,with the introduction of propensity score matching(PSM)as a retrospective statistical tool,new frontiers in establishing causation in clinical research were opened up.PSM predicts treatment effects using observational data from existing sources such as registries or electronic health records,to create a matched sample of participants who received or did not receive the intervention based on their propensity scores,which takes into account characteristics such as age,gender and comorbidities.Given its retrospective nature and its use of observational data from existing sources,PSM circumvents the aforementioned ethical issues faced by RCTs.Majority of RCTs exclude elderly,pregnant women and young children;thus,evidence of therapy efficacy is rarely proven by robust clinical research for this population.On the other hand,by matching study patient characteristics to that of the population of interest,including the elderly,pregnant women and young children,PSM allows for generalization of results to the wider population and hence greatly increases the external validity.Instead of replacing RCTs with PSM,the synergistic integration of PSM into RCTs stands to provide better research outcomes with both methods complementing each other.For example,in an RCT investigating the impact of mannitol on outcomes among participants of the Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial,the baseline characteristics of comorbidities and current medications between treatment and control arms were significantly different despite the randomization protocol.Therefore,PSM was incorporated in its analysis to create samples from the treatment and control arms that were matched in terms of these baseline characteristics,thus providing a fairer comparison for the impact of mannitol.This literature review reports the applications,advantages,and considerations of using PSM with RCTs,illustrating its utility in refining randomization,improving external validity,and accounting for non-compliance to protocol.Future research should consider integrating the use of PSM in RCTs to better generalize outcomes to target populations for clinical practice and thereby benefit a wider range of patients,while maintaining the robustness of randomization offered by RCTs.

Tackling the Existential Threats from Quantum Computers and AI

Although AI and quantum computing (QC) are fast emerging as key enablers of the future Internet, experts believe they pose an existential threat to humanity. Responding to the frenzied release of ChatGPT/GPT-4, thousands of alarmed tech leaders recently signed an open letter to pause AI research to prepare for the catastrophic threats to humanity from uncontrolled AGI (Artificial General Intelligence). Perceived as an “epistemological nightmare”, AGI is believed to be on the anvil with GPT-5. Two computing rules appear responsible for these risks. 1) Mandatory third-party permissions that allow computers to run applications at the expense of introducing vulnerabilities. 2) The Halting Problem of Turing-complete AI programming languages potentially renders AGI unstoppable. The double whammy of these inherent weaknesses remains invincible under the legacy systems. A recent cybersecurity breakthrough shows that banning all permissions reduces the computer attack surface to zero, delivering a new zero vulnerability computing (ZVC) paradigm. Deploying ZVC and blockchain, this paper formulates and supports a hypothesis: “Safe, secure, ethical, controllable AGI/QC is possible by conquering the two unassailable rules of computability.” Pursued by a European consortium, testing/proving the proposed hypothesis will have a groundbreaking impact on the future digital infrastructure when AGI/QC starts powering the 75 billion internet devices by 2025.

Tragic Beauty of Faulkner’s Villain Characters

This paper applies the theory of“Sphinx Factor”to examine the characters such as Sutpen,Emily and Jason in Faulkner’s fiction who are filled with brutal elements.It is found that although these characters are generally considered evil,cruel and violent,they also possess tragic beauty.