Fuzzy argumentation for trust

In an open Multi-Agent System, the goals of agents acting on behalf of their owners often conflict with each other. Therefore, a personal agent protecting the interest of a single user cannot always rely on them. Consequently, such a personal agent needs to be able to reason about trusting (information or services provided by) other agents. Existing algorithms that perform such reasoning mainly focus on the immediate utility of a trusting decision, but do not provide an explanation of their actions to the user. This may hinder the acceptance of agent-based technologies in sensitive applications where users need to rely on their personal agents. Against this background, we propose a new approach to trust based on argumentation that aims to expose the rationale behind such trusting decisions. Our solution features a separation of opponent modeling and decision making. It uses possibilistic logic to model behavior of opponents, and we propose an extension of the argumentation framework by Amgoud and Prade to use the fuzzy rules within these models for well-supported decisions

The roles of general health and COVID-19 proximity in contact tracing app usage: cross-sectional survey study

Background: Contact tracing apps are considered useful means to monitor SARS-CoV-2 infections during the off-peak stages of the COVID-19 pandemic. Their effectiveness is, however, dependent on the uptake of such COVID-19 apps. Objective: We examined the role of individuals’ general health status in their willingness to use a COVID-19 tracing app as well as the roles of socioeconomic characteristics and COVID-19 proximity. Methods: We drew data from the WageIndicator Foundation Living and Working in Coronavirus Times survey. The survey collected data on labor market status as well as the potential confounders of the relationship between general health and COVID-19 tracing app usage, such as sociodemographics and regular smartphone usage data. The survey also contained information that allowed us to examine the role of COVID-19 proximity, such as whether an individual has contracted SARS-CoV-2, whether an individual has family members and colleagues with COVID-19, and whether an individual exhibits COVID-19 pandemic–induced depressive and anxiety symptoms. We selected data that were collected in Spain, Italy, Germany, and the Netherlands from individuals aged between 18 and 70 years (N=4504). Logistic regressions were used to measure individuals’ willingness to use a COVID-19 tracing app. Results: We found that the influence that socioeconomic factors have on COVID-19 tracing app usage varied dramatically between the four countries, although individuals experiencing forms of not being employed (ie, recent job loss and inactivity) consistently had a lower willingness to use a contact tracing app (effect size: 24.6%) compared to that of employees (effect size: 33.4%; P Conclusions: Current public health policies aim to promote the use of smartphone-based contact tracing apps during the off-peak periods of the COVID-19 pandemic. Campaigns that emphasize the health benefits of COVID-19 tracing apps may contribute the most to the uptake of such apps. Public health campaigns that rely on digital platforms would also benefit from seriously considering the country-specific distribution of privacy concerns

Cost-effectiveness of shifting breast cancer surveillance from a hospital setting to a community-based national screening programme setting

Background: In the Netherlands, breast cancer surveillance after breast conserving surgery (BCS) takes place in a hospital setting for at least five years to detect possible recurrences in early stage. As breast cancer incidence rises and mortality decreases, surveillance expenses increase. This study explores the effectiveness and cost-effectiveness of BCS surveillance as delivered in a hospital setting versus providing BCS surveillance as part of the community-based National Breast Cancer Screening Program (NBCSP). We hypothesise that the NBCSP-based strategy leads to lower costs and a lower proportion of true test results (TTR) compared to the hospital-based strategy and determine to what extent potential lower effectiveness may be balanced with expected cost savings. Materials and Methods: Both strategies are compared on effectiveness and cost-effectiveness in a decision tree from a healthcare perspective over a 5-year time horizon. Women aged 50–75 without distant metastases that underwent BCS in the years 2003–2006 with complete 5 year follow-up were selected from the Netherlands Cancer Registry (n = 14,093). Key input variables were mammography sensitivity and specificity, risk of loco regional recurrence (LRR), and direct healthcare costs. The primary outcome measure was the overall predictive value (measured in true test results). Secondary effectiveness measures were the positive predictive value (PPV) (LRRs detected or true positive test results) and the negative predictive value (NPV) (true negative test results) detected within five years post-treatment. Results are presented for low and high risk patients separately and expressed in incremental cost-effectiveness ratios (ICERs). Results: For low risk patients (with grade 1 tumours, no node involvement, and hormonal treatment), the PPV and NPV for the NBCSP strategy were 3.31% and 99.88%, and 2.74% and 99.95% for the hospital strategy respectively. For high risk patients (grade 3 tumours, over three nodes involved, without hormonal treatment), the PPV and NPV for the NBCSP strategy were 64.1% and 98.9%; and 51.0% and 99.7% for the hospital strategy respectively. For low risk patients the NBCSP saves €202 per patient leading to an ICER of €109/accurate test result. For high risk patients the cost savings are €72 per patient, leading to an ICER of €43/accurate test result. Conclusion: Although the NBCSP-based strategy is cheaper, it cannot replace the hospital-based strategy, since it leads to only half of the accurate test results compared to hospital-based strategy. This contradicts the goal of early detection of LRRs and improving outcomes

Maternal Prenatal Distress, Maternal Pre- and Postnatal Bonding and Behavioral and Emotional Problems in Toddlers. A Secondary Analysis of the IRIS Study

Maternal prenatal distress (i.e., anxiety and depressive symptoms) increases the risk for childhood behavioral and emotional problems. So far, the potential role of maternal bonding in this association still needs further study. Maternal prenatal distress can affect the development of maternal bonding from pregnancy onwards. Maternal prenatal and postnatal bonding in turn have been shown to predict child behavioral functioning. We aimed to investigate whether maternal prenatal and postnatal bonding mediate the association between maternal prenatal distress and toddlers’ internalizing and externalizing problems. Data from a Dutch prospective longitudinal sample (N = 666) were used to conduct single and multiple mediation models. Mothers reported prenatal anxiety (State Anxiety Inventory) and prenatal depressive symptoms (Edinburgh Postnatal Depression Scale) at 24 weeks’ gestation and maternal prenatal bonding (Maternal Antenatal Attachment Scale) at 32 weeks’ gestation. At 6 weeks and 6 months postpartum mothers completed questionnaires to assess maternal postnatal bonding (Maternal Postnatal Attachment Scale). Mothers reported child internalizing and externalizing problems (Child Behavior Checklist) at 28 months postpartum. Maternal prenatal and postnatal bonding mediated the link between maternal prenatal anxiety and child externalizing problems but not internalizing problems. Only maternal bonding 6 months postpartum mediated the link between maternal prenatal depressive symptoms and child internalizing problems but not externalizing problems. Our study showed that maternal postnatal bonding more consistently mediated links between measures of maternal prenatal distress and child behavioral and emotional problems than maternal prenatal bonding. Interventions reducing maternal prenatal distress and promoting maternal bonding should be developed.</p

Maternal Prenatal Distress, Maternal Pre- and Postnatal Bonding and Behavioral and Emotional Problems in Toddlers. A Secondary Analysis of the IRIS Study

Maternal prenatal distress (i.e., anxiety and depressive symptoms) increases the risk for childhood behavioral and emotional problems. So far, the potential role of maternal bonding in this association still needs further study. Maternal prenatal distress can affect the development of maternal bonding from pregnancy onwards. Maternal prenatal and postnatal bonding in turn have been shown to predict child behavioral functioning. We aimed to investigate whether maternal prenatal and postnatal bonding mediate the association between maternal prenatal distress and toddlers’ internalizing and externalizing problems. Data from a Dutch prospective longitudinal sample (N = 666) were used to conduct single and multiple mediation models. Mothers reported prenatal anxiety (State Anxiety Inventory) and prenatal depressive symptoms (Edinburgh Postnatal Depression Scale) at 24 weeks’ gestation and maternal prenatal bonding (Maternal Antenatal Attachment Scale) at 32 weeks’ gestation. At 6 weeks and 6 months postpartum mothers completed questionnaires to assess maternal postnatal bonding (Maternal Postnatal Attachment Scale). Mothers reported child internalizing and externalizing problems (Child Behavior Checklist) at 28 months postpartum. Maternal prenatal and postnatal bonding mediated the link between maternal prenatal anxiety and child externalizing problems but not internalizing problems. Only maternal bonding 6 months postpartum mediated the link between maternal prenatal depressive symptoms and child internalizing problems but not externalizing problems. Our study showed that maternal postnatal bonding more consistently mediated links between measures of maternal prenatal distress and child behavioral and emotional problems than maternal prenatal bonding. Interventions reducing maternal prenatal distress and promoting maternal bonding should be developed.</p

Аксиологоческое пространство культуры

Introduction. This study was performed to assess the applicability of the WHO Maternal Near Miss Tool (MNM Tool) and the organ dysfunction criteria in a high-income country. Material and methods. The MNM tool was applied to 2552 women who died of pregnancy-related causes or sustained severe acute maternal morbidity between August 2004 and August 2006 in one of the 98 hospitals with a maternity unit in the Netherlands. Fourteen (0.6%) cases had insufficient data for application. Each case was assessed according to the three main "MNM categories" specified in the MNM tool and their subcategory criteria: five disease-, four intervention- and seven organ dysfunction-based criteria. Potentially life-threatening conditions (disease-based inclusions) and life-threatening cases (organ dysfunction-based inclusions) were differentiated according to WHO methodology. Outcomes were incidence of all (sub)categories and case-fatality rates. Results. Of the 2538 cases, 2308 (90.9%) women fulfilled disease-based, 2116 (83.4%) intervention-based and 1024 (40.3%) organ dysfunction-based criteria. Maternal death occurred in 48 women, of whom 23 (47.9%) fulfilled disease-based, 33 (68.8%) intervention-based and 31 (64.6%) organ dysfunction-based criteria. Case-fatality rates were 23/2308 (1.0%) for cases fulfilling the disease-based criteria, 33/2116 (1.6%) for intervention-based criteria and 31/1024 (3.0%) for women fulfilling the organ dysfunction-based criteria. Conclusions. In the Netherlands, where advanced laboratory and clinical monitoring are available, organ dysfunction-based criteria of the MNM tool failed to identify nearly two-thirds of sustained severe acute maternal morbidity cases and more than one-third of maternal deaths. Disease-based criteria remain important, and using only organ dysfunction-based criteria would lead to underestimating severe acute maternal morbidity