To what extend is trading ecological validity for experimental control justified in moral research?

In an effort to gain experimental control, most moral studies use simplified, artificial dilemmas purposely disconnected from real life, devoid of all circumstantial and social contexts. A relationship between the type of dilemma, Footbridge or Trolley, and the type of response, deontological or utilitarian, has been consistently found using this reductionist approach, which has led to establishing a proposal of causality between the two. However, our moral sense evolved as a relational process and it might be impossible to disengage moral judgments from an ecological environment and a network, no matter how simple, of social relations; even when this contextual information is never provided in the experimental framework. With an extremely simple experimental manipulation, we here show that to be the case. We found that moral judgments correlate as much with type of dilemma as with the nature of this subjective social context spontaneously generated by the participants, thus introducing a very relevant confounding factor often neglected before, and which could potentially bias results in an unpredictable and hardly quantifiable manner

A new scaling rule for context-dependent moral judgments.

Moral judgments are typically explained by a combination of either deontological considerations about the nature of actions, or quantitative assessments of the consequences of those actions. These proposals, however, have serious limitations such as being insensitive to personal biases and global circumstances. This study presents an alternative approach based on comparative affective evaluations that modulate responses as more contextual information is presented to the choice set. We show that, when we make a moral decision, we do not simply judge the action and/or its consequences, we judge the protagonist performing the action embedded in a given set of circumstances and we normalize their behavior using the same gain control mechanism that operates in other sensory and motor domains. The explanatory power of this novel approach is broader than that provided by traditional paradigms and can be easily applied to more ecologically relevant scenarios

Soundtrack of life: an fMRI study

Most people have a soundtrack of life, a set of special musical pieces closely linked to certain biographical experiences. Autobiographical memories (AM) and music listening (ML) involve complex mental processes ruled by differentiate brain networks. The aim of the paper was to determine the way both networks interact in linked occurrences. We performed an fMRI experiment on 31 healthy participants (age: 32.4 ± 7.6, 11 men, 4 left-handers). Participants had to recall AMs prompted by music they reported to be associated with personal biographical events (LMM: linked AM-ML events). In the main control task, participants were prompted to recall emotional AMs while listening known tracks from a pool of popular music (UMM: unlinked AM-ML events). We wanted to investigate to what extent LMM network exceeded the overlap of AM and ML networks by contrasting the activation obtained in LMM versus UMM. The contrast LMM>UMM showed the areas (at P 20): right frontal inferior operculum, frontal middle gyrus, pars triangularis of inferior frontal gyrus, occipital superior gyrus and bilateral basal ganglia (caudate, putamen and pallidum), occipital (middle and inferior), parietal (inferior and superior), precentral and cerebellum (6, 7 L, 8 and vermis 6 and 7). Complementary results were obtained from additional control tasks. Provided part of tLMM>UMM areas might not be related to ML-AM linkage, we assessed LMM brain network by an independent component analysis (ICA) on contrast images. Results from ICA suggest the existence of a cortico-ponto-cerebellar network including left precuneus, bilateral anterior cingulum, parahippocampal gyri, frontal inferior operculum, ventral anterior part of the insula, frontal medial orbital gyri, caudate nuclei, cerebellum 6 and vermis, which might rule the ML-induced retrieval of AM in closely linked AM-ML events. This topography may suggest that the pathway by which ML is linked to AM is attentional and directly related to perceptual processing, involving salience network, instead of the natural way of remembering typically associated with default mode network

Pancreatic surgery outcomes: multicentre prospective snapshot study in 67 countries

Background: Pancreatic surgery remains associated with high morbidity rates. Although postoperative mortality appears to have improved with specialization, the outcomes reported in the literature reflect the activity of highly specialized centres. The aim of this study was to evaluate the outcomes following pancreatic surgery worldwide.Methods: This was an international, prospective, multicentre, cross-sectional snapshot study of consecutive patients undergoing pancreatic operations worldwide in a 3-month interval in 2021. The primary outcome was postoperative mortality within 90 days of surgery. Multivariable logistic regression was used to explore relationships with Human Development Index (HDI) and other parameters.Results: A total of 4223 patients from 67 countries were analysed. A complication of any severity was detected in 68.7 percent of patients (2901 of 4223). Major complication rates (Clavien-Dindo grade at least IIIa) were 24, 18, and 27 percent, and mortality rates were 10, 5, and 5 per cent in low-to-middle-, high-, and very high-HDI countries respectively. The 90-day postoperative mortality rate was 5.4 per cent (229 of 4223) overall, but was significantly higher in the low-to-middle-HDI group (adjusted OR 2.88, 95 per cent c.i. 1.80 to 4.48). The overall failure-to-rescue rate was 21 percent; however, it was 41 per cent in low-to-middle-compared with 19 per cent in very high-HDI countries.Conclusion: Excess mortality in low-to-middle-HDI countries could be attributable to failure to rescue of patients from severe complications. The authors call for a collaborative response from international and regional associations of pancreatic surgeons to address management related to death from postoperative complications to tackle the global disparities in the outcomes of pancreatic surgery (NCT04652271; ISRCTN95140761)