Taking wishes and feelings seriously: the views of people lacking capacity in Court of Protection decision-making

The Mental Capacity Act requires that where a person (P) lacks capacity to make a decision her wishes and feelings be taken into account when deciding what is in her best interests. This article considers how the Court of Protection evaluates evidence from P concerning her wishes and feelings. It finds that the Court ignores evidence regarding current wishes and fails to engage with more ambiguous evidence where P desires conflicting outcomes or may be concealing her true feelings. This is unhelpful since it makes the resulting judgment unconvincing to observers. It is legally problematic, since the Court should be following the practices of other decision-makers under the Mental Capacity Act (MCA). And it is ethically problematic since it undermines P's dignity and does not treat P as an actor whose evidence regarding her wishes and feelings has intrinsic status which the Court must make active efforts to engage with or discount rather than ignore

The Jacobian as a measure of planar dose congruence

We propose a new starting point for comparing dose distributions in therapeutic radiation physics using a Jacobian-based measure. The measure is normalization independent, free of tunable parameters, bounded and converges to a unique value when comparing unrelated dose distributions. We present a preliminary demonstration of the sensitivity and general characteristics of this measure.Comment: 9 pages, 2 figure

Enhanced spectral discrimination through the exploitation of interface effects in photon dose data

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/134954/1/mp7731.pd

Multi-stakeholder Perspective on Responsible Artificial Intelligence and Acceptability in Education

This study investigates the acceptability of different artificial intelligence (AI) applications in education from a multi-stakeholder perspective, including students, teachers, and parents. Acknowledging the transformative potential of AI in education, it addresses concerns related to data privacy, AI agency, transparency, explainability and the ethical deployment of AI. Through a vignette methodology, participants were presented with four scenarios where AI's agency, transparency, explainability, and privacy were manipulated. After each scenario, participants completed a survey that captured their perceptions of AI's global utility, individual usefulness, justice, confidence, risk, and intention to use each scenario's AI if available. The data collection comprising a final sample of 1198 multi-stakeholder participants was distributed through a partner institution and social media campaigns and focused on individual responses to four AI use cases. A mediation analysis of the data indicated that acceptance and trust in AI varies significantly across stakeholder groups. We found that the key mediators between high and low levels of AI's agency, transparency, and explainability, as well as the intention to use the different educational AI, included perceived global utility, justice, and confidence. The study highlights that the acceptance of AI in education is a nuanced and multifaceted issue that requires careful consideration of specific AI applications and their characteristics, in addition to the diverse stakeholders' perceptions.Comment: 28 pages, 2 appendices, 3 figures, 5 tables, original researc

Probabilistic Daily ILI Syndromic Surveillance with a Spatio-Temporal Bayesian Hierarchical Model

BACKGROUND: For daily syndromic surveillance to be effective, an efficient and sensible algorithm would be expected to detect aberrations in influenza illness, and alert public health workers prior to any impending epidemic. This detection or alert surely contains uncertainty, and thus should be evaluated with a proper probabilistic measure. However, traditional monitoring mechanisms simply provide a binary alert, failing to adequately address this uncertainty. METHODS AND FINDINGS: Based on the Bayesian posterior probability of influenza-like illness (ILI) visits, the intensity of outbreak can be directly assessed. The numbers of daily emergency room ILI visits at five community hospitals in Taipei City during 2006-2007 were collected and fitted with a Bayesian hierarchical model containing meteorological factors such as temperature and vapor pressure, spatial interaction with conditional autoregressive structure, weekend and holiday effects, seasonality factors, and previous ILI visits. The proposed algorithm recommends an alert for action if the posterior probability is larger than 70%. External data from January to February of 2008 were retained for validation. The decision rule detects successfully the peak in the validation period. When comparing the posterior probability evaluation with the modified Cusum method, results show that the proposed method is able to detect the signals 1-2 days prior to the rise of ILI visits. CONCLUSIONS: This Bayesian hierarchical model not only constitutes a dynamic surveillance system but also constructs a stochastic evaluation of the need to call for alert. The monitoring mechanism provides earlier detection as well as a complementary tool for current surveillance programs

Differences in the Population Structure of Invasive Streptococcus suis Strains Isolated from Pigs and from Humans in the Netherlands

Streptococcus suis serotype 2 is the main cause of zoonotic S. suis infection despite the fact that other serotypes are frequently isolated from diseased pigs. Studies comparing concurrent invasive human and pig isolates from a single geographical location are lacking. We compared the population structures of invasive S. suis strains isolated between 1986 and 2008 from human patients (N = 24) and from pigs with invasive disease (N = 124) in the Netherlands by serotyping and multi locus sequence typing (MLST). Fifty-six percent of pig isolates were of serotype 9 belonging to 15 clonal complexes (CCs) or singleton sequence types (ST). In contrast, all human isolates were of serotype 2 and belonged to two non-overlapping clonal complexes CC1 (58%) and CC20 (42%). The proportion of serotype 2 isolates among S. suis strains isolated from humans was significantly higher than among strains isolated from pigs (24/24 vs. 29/124; P<0.0001). This difference remained significant when only strains within CC1 and CC20 were considered (24/24 vs. 27/37,P = 0.004). The Simpson diversity index of the S. suis population isolated from humans (0.598) was smaller than of the population isolated from pigs (0.765, P = 0.05) indicating that the S. suis population isolated from infected pigs was more diverse than the S. suis population isolated from human patients. S. suis serotype 2 strains of CC20 were all negative in a PCR for detection of genes encoding extracellular protein factor (EF) variants. These data indicate that the polysaccharide capsule is an important correlate of human S. suis infection, irrespective of the ST and EF encoding gene type of S. suis strains