Intentions and Creative Insights: a Reinforcement Learning Study of Creative Exploration in Problem-Solving

Insight is perhaps the cognitive phenomenon most closely associated with creativity. People engaged in problem-solving sometimes experience a sudden transformation: they see the problem in a radically different manner, and simultaneously feel with great certainty that they have found the right solution. The change of problem representation is called "restructuring", and the affective changes associated with sudden progress are called the "Aha!" experience. Together, restructuring and the "Aha!" experience characterize insight. Reinforcement Learning is both a theory of biological learning and a subfield of machine learning. In its psychological and neuroscientific guise, it is used to model habit formation, and, increasingly, executive function. In its artificial intelligence guise, it is currently the favored paradigm for modeling agents interacting with an environment. Reinforcement learning, I argue, can serve as a model of insight: its foundation in learning coincides with the role of experience in insight problem-solving; its use of an explicit "value" provides the basis for the "Aha!" experience; and finally, in a hierarchical form, it can achieve a sudden change of representation resembling restructuring. An experiment helps confirm some parallels between reinforcement learning and insight. It shows how transfer from prior tasks results in considerably accelerated learning, and how the value function increase resembles the sense of progress corresponding to the "Aha!"-moment. However, a model of insight on the basis of hierarchical reinforcement learning did not display the expected "insightful" behavior. A second model of insight is presented, in which temporal abstraction is based on self-prediction: by predicting its own future decisions, an agent adjusts its course of action on the basis of unexpected events. This kind of temporal abstraction, I argue, corresponds to what we call "intentions", and offers a promising model for biological insight. It explains the "Aha!" experience as resulting from a temporal difference error, whereas restructuring results from an adjustment of the agent's internal state on the basis of either new information or a stochastic interpretation of stimuli. The model is called the actor-critic-intention (ACI) architecture. Finally, the relationship between intentions, insight, and creativity is extensively discussed in light of these models: other works in the philosophical and scientific literature are related to, and sometimes illuminated by the ACI architecture

Implementations in Machine Ethics: A Survey

Increasingly complex and autonomous systems require machine ethics to maximize the benefits and minimize the risks to society arising from the new technology. It is challenging to decide which type of ethical theory to employ and how to implement it effectively. This survey provides a threefold contribution. First, it introduces a trimorphic taxonomy to analyze machine ethics implementations with respect to their object (ethical theories), as well as their nontechnical and technical aspects. Second, an exhaustive selection and description of relevant works is presented. Third, applying the new taxonomy to the selected works, dominant research patterns, and lessons for the field are identified, and future directions for research are suggested

Cardiac assist devices: Cognitive and behavioral factors among patients awaiting cardiac transplantation

Cognitive functioning and quality of life are salient factors in predicting mortality and morbidity in end-stage heart failure patients receiving cardiac assist devices while awaiting cardiac transplantation. This study focused on cognitive functioning and selfreported quality of life, neurological impairment, and depressive symptoms. Of 103 candidates for cardiac assist devices (HeartMate ThermoCardiosystems, Inc. [TCI] Left Ventricular Devices [LVAD] or Abiomed Biventricular Assist System [Abiomed]) as a bridge to cardiac transplantation at Hahnemann University Hospital, a total of 53 patients completed neuropsychological evaluations. Cognitive factors included visual-spatial andverbal memories, motor speed, grip strength, and cognitive processing speed. Inaddition, a total of 298 end-stage heart failure (ESHF) inpatients completed the same cognitive measures over the past decade. Overall, cognitive functioning for both groups was within the normal range. Not surprisingly, a series of t-tests revealed that ESHF inpatients performed better than MCAD candidates on most cognitive measures. However, MCAD candidates performed better than ESHF inpatients on the Mental Status Exam, Visual Reproduction Immediate subtest of the Wechsler Memory Scale, and grip strength task with the nondominant hand.A total of 23 cardiac assist device candidates completed self-report measures ofgeneral and disease-specific quality of life, depressive symptoms, memory, and selfreported neuropsychological symptoms. Results did not support the hypothesis that depression would mediate the relationship between cognitive functioning and quality of life. There were significant differences in quality of life between the three groups: ESHF, MCAD, and OHT warranting a discussion of the implications of various definitions of quality of life. There were no significant gender differences. Major behavioral findings were 1) these patients are resilient in comparison to the general population; their cognitive functioning was not impaired and they were not depressed and 2) there was a strong relationship between self-report depressive symptoms and self-reportedneurological impairment.Ph.D., Clinical Psychology -- Drexel University, 200

Neuropsychological Outcomes After Cardiac Surgery: A Pilot Feasibility Study

Approximately half of patients who have cardiac surgery will experience deficits in attention, memory, and thinking speed after their operation. Given that heart surgery is one of the most common medical procedures in Canada, it is necessary to better understand the natural history of cognitive impairment after such surgery. Yet, there is no globally accepted method for measuring cognitive function in patients who undergo heart surgery. To address this, we assessed whether it was feasible to use a web-based approach to measure cognition in heart surgery patients before and after their operation. Findings showed that remote administration of cognitive testing was feasible. Relative to healthy age and sex-matched controls, cardiac patients showed impairment on the Creyos battery before and after surgery, specifically on tasks that relied on verbal processing skills. This study will help identify vulnerable patients and inform future interventional trials to promote cognitive recovery and improve patient quality of life

Psychological morbidity and facial volume in HIV lipodystrophy: quantification of treatment outcome

INTRODUCTION HIV-associated facial lipoatrophy is a stigmatizing condition associated with significant psychological morbidity. The condition may be treated with soft tissue fillers, although quantification of objective and patient- reported outcomes is lacking. The primary aim of this study was to evaluate change in facial volume and psychological morbidity following treatment for HIV lipodystrophy with autologous fat transfer, Newfill and Bio-alcamid. An additional aim of the study was to compare psychological characteristics between HIV seropositive patients with lipodystrophy (HIV LD) and without lipodystrophy (HIV non -LD) and HIV seronegative men who have sex with men (MSM).METHODS HIV LD patients were treated with autologous fat, Newfill or Bio- alcamid based on a clinical assessment in a prospective, observational study. The Colemnan technique of fat transfer was utilised. Newfill injections were carried out at monthly intervals using 1 vial per cheek. Bio- alcamid was injected subcutaneously under aseptic technique to achieve the desired cheek augmentation. 3 -D images were obtained pre- operatively then at 2, 6 and 12 months post -operatively using the DI3D system. Volume changes in treated areas were measured using DI3D software. The DAS -24 and HADS were used to assess psychological morbidity at similar time intervals. An additional case -control study was conducted to measure psychological morbidity in HIV LD, HIV non -LD and MSM groups utilising the Derriford Appearance Scale (DAS -24) and Hospital Anxiety and Depression Scale (HADS). Data was analyzed using appropriate statistical tests.RESULTS ANOVA tests demonstrated significantly higher DAS -24 scores in the HIV -LD group compared to the HIV non -LD and MSM groups. No difference in HADS -A scores was seen between groups. 48 patients with HIV LD were treated: 16 patients had Bio- alcamid augmentation, 20 patients received Newfill injections and 12 patients underwent fat transfer. The mean injected volume of Bio- alcamid was 25.5cc The Wilcoxin test demonstrated no significant difference in mean volume change relative to zero at 2, 6 and 12 months. The mean injected volume of fat was 20.1cc, which did not differ from the measured volumes at 2 months (1)= 0.15). There was a mean reduction in measured volume of 7.3cc at 6 months and 9cc at 12 months (p <0.001). For Newfill, the mean volume change compared to baseline was 8.7cc at 2months, increasing to 12.6cc at 6 months and 12.3cc at 12 months. ANOVA tests demonstrated no difference in psychological outcomes between groups. There was a significant improvement in DAS -24 scores compared too baseline for all 3 groups throughout follow -up. For Bio- alcamid, a significant improvement in HADS -A and HADS -D scores were seen at 2 months but mean scores increased at 6 and 12 months. In the fat group, some improvement in HADS -A and HADS -D scores were seen at follow -up, although values only reached significance at 6 months. In the Newfill group, small improvements in both HADS -A and HADS -D were demonstrated in the post -treatment scores, although these did not reach significance. No correlation between change in facial volume and psychological measures was demonstrated.CONCLUSIONS The case control study demonstrated that patients with HIV lipodystrophy have greater distress relating to body image and depression compared to HIV-seropositive patients without lipodstrophy and HIV-seronegative MSM control groups. The prospective study of the HIV LD treatment cohort demonstrated a change in 3 -D measured facial volume for all 3 groups. Bio-alcamid produced the greatest, permanent volume change but was associated with the most complications. Newfill was associated with a moderate, delayed volume augmentation but was insufficient for some patients with severe lipoatrophy. Volume enhancement with autologous fat was good immediately post-operatively but variable degrees of fat resorption occurred. Treatment was associated with improved body image perception. However, initial improvements in anxiety and depression symptoms were not maintained in the long term

Implant-prosthetic therapy failure in smoker and nonsmoker patients

Introduction: Implant-prosthetic therapy has predictable success, and the complications are associated with a lot of factors. Smoking cigarettes is reason for different oral diseases, bone loss, loss of soft tissue and teeth, appearance of periimplantitis and implant loss. The corellation of smoking and implant-prosthetic therapy failure was examined in the clinical study. Materials and method: Fifty patients with FDP on 61 implants in frontal and molar region were investigated. They were divided in two groups: smokers and nonsmokers. Thirty four patients were smokers, and sixteen didn’t smoke cigarettes in the last two years. Criteria data for the success of the therapy were mobility of the implant, pain, peri-implant bone loss higher than 1.5 mm, absence of technical complications and function and aesthetics appeal. Control checkups were made after six months, one and two years. Patients had questionnaires, clinical examination and X-ray. Results: There is a statistically significant difference between smokers and nonsmokers in the failure rates of dental implants. During first year 0,5 mm of bone was lost around eleven implants, and 0,05 mm next years.Total seven implants failed, five in smoker group at the beginning of the first year, and 2 in nonsmoker group during second year. Conclusion: Results showed that smoking habit can increase the risk of early implants loss two times more often in smokers. For some complications like periimplantitis, local factors have greater influence. Smoking does not increase the risk of late implant loss, but the implants at patients with smoking habit, in correlation with several different local risk factors, is contraindicated. Early complications are results of smoking, while quality and quantity of surrounding bone are responsible for late complications.The results from the investigation, also give informations for proper treatment planning, and patient education for quiting their harmfull habit. Keywords Implants, therapy failure, smoking, periimplantitis

Novel Research in Sexuality and Mental Health

Sexuality is considered as a great human value related to happiness and satisfaction, but unfortunately, when affecting mental disorders, they tend to be associated with second level human functions. Nevertheless, sexual dysfunction often accompanies psychiatric disorder, intensely influencing compliance, quality of life and human relationships. Sexuality could be influenced either by a mental disorder itself, difficulties to get and maintain couple relationships or by the use of psychotropic treatments. Treatment-related adverse events are unfortunately under-recognized by clinicians, scarcely spontaneously communicated by patients, and rarely investigated in clinical trials. The most frequent psychotropic compounds that could deteriorate sexuality and quality of life include antidepressants, antipsychotics and mood regulators. There are important differences between them related to some variations in mechanisms of action including serotonin, dopamine and prolactin levels. Little is known about the relevance of sexuality and its dysfunctions in chronic and frequent mental and neurological disorders, such as psychosis, mood disorders, anxiety, phobias, eating disorders, alcohol or drug dependencies, epilepsy and childhood pathology. Poor sexual life, low satisfaction and more frequent risky sex behavior than in the general population are associated with severe mental diseases. There is a need for increasing research in this field, including epidemiological, psychological, neurophysiological, neuroanatomical and genetic variables related to sexual life to get a better understanding of the implicated mechanisms. To increase the sensibility of clinicians, the identification and management of sexual disturbances after the onset of any mental disorder should be highlighted. This would avoid unnecessary suffering and deterioration of quality of life

Psychological and biological factors in acute coronary heart disease.

Psychosocial factors are thought to contribute to the long term development of coronary artery disease (CAD), to the triggering of cardiac events in people with advanced disease, and to adaptation following acute coronary syndromes (ACS). My thesis presents three studies addressing different aspects of the relationship between emotional factors and CAD, using different methodologies. They focus on the role of negative emotions in vulnerability to myocardial ischaemia in daily life, the influence of acute emotional triggers of ACS on long term quality of life, and the effect of depression following ACS on a particularly important aspect of adaptation, namely return to work. The first study, called the Silent Ischaemia Study (SIS) investigated 88 out-patients with suspected CAD who underwent 24 hour ambulatory electrocardiogram (ECG) monitoring, together with saliva sampling and characterisation of daily life by a new method called the Day Reconstruction Method (DRM). The results indicated that in patients with definite CAD, depressed mood was associated with reduced high frequency and increased low frequency heart rate variability (HRV), suggestive of parasympathetic withdrawal. The Cortisol slope over the day was flatter in more depressed patients with CAD. Episodes of transient ischaemia and/or arrhythmia were also associated with increased negative affect, but their incidence was low, primarily because most patients were medicated with beta blockers. The second and third studies derive from the ACCENT (Acute Coronary Syndrome, Emotion and Triggers) study, exploring long term adaptation following ACS. Analyses showed that the likelihood of returning to work was negatively associated with depression immediately following ACS, independently of clinical and demographic factors, and that emotional triggers predicted elevated anxiety and poor mental health status at 12 and 36 months independently of covariates. In combination, these studies suggest that negative emotional status contribute both to the onset of acute cardiac events, and to adaptation following ACS

Voices from Below—Africa’s Contribution to the Development of the Norm of Corporate Responsibility to Respect Human Rights

The long conversations about corporate responsibility predominantly take place in forums and conferences in the Global North. Yet, the majority of the human rights abuses and their impacts are felt by peasants, farmers, children, and women in local communities in the Global South who do not have a voice in the institutionalized governance systems that animate global affairs. This thesis answers the question of how norms and human rights institutions in Africa can influence the corporate responsibility to respect (CR2R) norm as embedded in pillar II of the United Nations Guiding Principles on Business and Human Rights. Through the theory of social constructivism, this thesis examines how the CR2R norm is changing the dominant narrative that MNCs do not have human rights responsibilities in international law. In light of the CR2R norm’s status as a social and (growing) legal norm, this thesis asks how norms and human rights institutions in Africa can contribute to the interpretation and application of the CR2R norm. The central argument is that international law-making, especially in human rights, should be an inclusive process that promotes an exchange of norms and ideas between the Global North and South divide. The ultimate goal of this thesis is to generate conversations about the potential role that norms and human rights institutions in Africa can play in the development of the CR2R norm. As a start, this thesis puts Africans at the center of the CR2R norm development discussion in terms of the inclusion of their views to affect the prescriptive and policy implications of emergent human right norms and principles