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In their presentation of canonical models for normal systems of modal logic, Hughes and Cresswell observe that some of these models are based on a frame which can be also thought of as a collection of two or more isolated frames; they call such frames ‘non-cohesive’. The problem of checking whether the canonical model of a given system is cohesive is still rather unexplored and no general decision procedure is available. The main contribution of this article consists in introducing a method which is sufficient to show that canonical models of some relevant classes of normal monomodal and bimodal systems are always non-cohesive.

The present article provides a taxonomic analysis of bimodal logics of normative ideality and normative awfulness, two notions whose meaning is here explained in terms of the moral values pursued by a given community. Furthermore, the article addresses the traditional problem of a reduction among deontic concepts: we explore the possibility of defining other relevant normative notions, such as obligation, explicit permission and Hohfeldian relations, in terms of ideality and awfulness. Some proposals in this respect, which have been formulated in the literature over the years, are here improved and discussed with reference to the various logics that we will introduce.

Background: Wireless Vital Parameter Continuous Monitoring (WVPCM) allows the continuous tracking of patient physiological parameters, facilitating the earlier detection of clinical deterioration, especially in low-intensity care settings. The aim of this study is to evaluate the effectiveness of using WVPCM compared to the usual monitoring of critically ill patients hospitalized in Internal Medicine wards. An investigation of the attitude of health professionals towards the use of new technologies in daily practice to improve patient management was also carried out. Methods: The LIght Monitor Study (LIMS) is a prospective, open-label, randomized, multi-center pilot trial comparing WVPCM and conventional nurse monitoring during the first 72 h of hospitalization. A central randomization unit used computer-generated tables to allocate patients to two different types of monitoring. The main outcome was the occurrence of major complications. The study planned to enroll 296 critically ill patients with a Modified Early Warning Score (MEWS) ≥ 3 and/or National Early Warning Score (NEWS) ≥ 5 across two Internal Medicine (IM) Units in Italy. The investigation of the attitude of nurses towards the use of WVPCM was carried out by using a questionnaire and a qualitative survey. Results: Due to the COVID-19 outbreak, the study was interrupted early and only 135 patients (WVPCM = 68; standard care = 67) were randomized. One patient in the control group was excluded from analysis because of drop-out, leaving 134 patients for intention to treat analysis. No statistically significant differences between standard care and WVPCM were observed in terms of major complications (37.5%, vs. 31.2% p = 0.475), in-hospital mortality (17.5% vs. 11.1%, p = 0.309), and median hospital length of stay (9 vs. 10 days, p = 0.463). WVPCM decreased nursing workload compared to the control, as the average time spent by nurses on the detection of vital signs per patient was 0 min per patient per day compared to 24.4 min (p < 0.001) observed in the control group. Twenty-two percent of patients in the WVPCM group (15/68) experienced discomfort with the device, resulting in its removal. The investigation of nurses involved 16 out of 18 people participating in the study. Opinions on the wireless device for patient monitoring were particularly favorable; most of them considered remote monitoring clearly superior to traditional in-person visits and easy to use after a brief practice period. All participants recognized the safety benefits of the system. Conclusions: The reduced sample size of this pilot study does not allow us to draw any conclusions on the superiority of WVPCM compared to standard care in terms of clinical outcomes. However, we observed a positive trend in the reduction of major complications.

The present article employs a model-theoretic semantics to interpret a fragment of the language of the Quantified Argument Calculus (Quarc), a recently introduced logical system whose main aim is capturing the structure of natural language sentences in a closer way than does the language of classical logic. The main contribution is an axiomatization for the set of formulas that are valid in all standard interpretations within the employed semantics.

As a result of improved diagnostic methods and higher cancer patient survival rates, leptomeningeal carcinomatosis is being found in internal medicine departments more frequently. Melanoma, lung cancer, and breast adenocarcinoma are the three cancers that are most commonly associated. When the main tumor diffuses through the bloodstream, cerebrospinal fluid, or direct diffusion and causes multiple focal neurological symptoms, it is known as leptomeningeal involvement; the prognosis is usually not good. Despite multimodal treatment, leptomeningeal carcinomatosis is an advanced form of cancer that frequently results in rapid death. Treatment is typically palliative and consists primarily of intrathecal or systemic radiation and/or chemotherapy. New experimental therapies and immunotherapy are promising means of lowering morbidity and mortality. Clinical cases of leptomeningeal carcinomatosis are reported; both cases were identified at the Ospedale dei Castelli’s Department of Internal Medicine and resulted from primary breast pathology.

Noninvasive brain stimulation technique is an interesting tool to investigate the causal relation between cortical functioning and autonomic nervous system (ANS) responses. The objective of this report is to evaluate whether anodal transcranial direct current stimulation (tDCS) over the temporal cortex influences short-period temporal ventricular repolarization dispersion and cardiovascular ANS control in elderly subjects. In 50 healthy subjects (29 subjects younger than 60 years and 21 subjects older than 60 years) matched for gender, short-period RR and systolic blood pressure spectral variability, QT variability index (QTVI), and noninvasive hemodynamic data were obtained during anodal tDCS or sham stimulation. In the older group, the QTVI, low-frequency (LF) power expressed in normalized units, the ratio between LF and high-frequency (HF) power, and systemic peripheral resistances decreased, whereas HF power expressed in normalized units and α HF power increased during the active compared to the sham condition ( <0.05). In healthy subjects older than 60 years, tDCS elicits cardiovascular and autonomic changes. Particularly, it improves temporal ventricular repolarization dispersion, reduces sinus sympathetic activity and systemic peripheral resistance, and increases vagal sinus activity and baroreflex sensitivity.

Who is responsible when an AI machine causes something to go wrong? Or is there a gap in the ascription of responsibility? Answers range from claiming there is a unique responsibility gap, several different responsibility gaps, or no gap at all. In a nutshell, the problem is as follows: on the one hand, it seems fitting to hold someone responsible for a wrong caused by an AI machine; on the other hand, there seems to be no fitting bearer of responsibility for this wrong. In this article, we focus on a particular (aspect of the) AI responsibility gap: it seems fitting that someone should bear the legal consequences in scenarios involving AI machines with design defects; however, there seems to be no such fitting bearer. We approach this problem from the legal perspective, and suggest vicarious liability of AI manufacturers as a solution to this problem. Our proposal comes in two variants: the first one has a narrower range of application, but can be easily integrated in current legal frameworks; the second one requires a revision of current legal frameworks, but has a wider range of application. The latter variant employs a broadened account of vicarious liability. We emphasise strengths of the two variants and finally highlight how vicarious liability offers important insights for addressing a moral AI responsibility gap.

QT and T(peak)-T(end) (Te) intervals are associated with sudden cardiac death in patients with chronic heart failure (CHF). We studied age-dependent influence on short-term temporal dispersion of these two variables in patients with postischemic CHF. We grouped 75 CHF and 53 healthy control subjects into three age subsets: ≤ 50 years, >50 years and ≤ 65 years, and >65 years. We then calculated the following indices: QT and Te variability index (QTVI and TeVI), the ratio between the short-term variability (STV) of QT or Te, and the STV of resting rate (RR) (QT/RR STV and Te/RR STV). In all different age subgroups, patients with CHF showed a higher level of QTVI than age-matched control subjects (≤ 50 years: P < 0.0001; >50 years and ≤ 65 years: P < 0.05; >65 years: P < 0.05). Patients with CHF < 50 years old also had all repolarization variability indices higher than normal age-matched controls (TeVI, P < 0.05; QT/RR STV, P < 0.05; Te/RR STV, P < 0.05), whereas we did not find any difference between the two older classes of subjects. Both QTVI (r²: 0.178, P < 0.05) and TeVI (r²: 0.433, P < 0.001) were positively related to age in normal subjects, even if the first correlation was weaker than the second one. Our data showed that QTVI could be used in all ages to evaluate repolarization temporal liability, whereas the other indices are deeply influenced by age. Probably, the age-dependent increase in QTVI was more influenced by a reduction of RR variability reported in older normal subjects.

Vicarious responsibility is a notoriously puzzling notion in normative reasoning. In this article we will explore two fundamental issues, which we will call the “explication problem” and the “justification problem”. The former issue concerns how vicarious responsibility can plausibly be defined in terms of other normative concepts. The latter issue concerns how ascriptions of vicarious responsibility can be justified. We will address these two problems by combining ideas taken from legal theory and moral philosophy. Our analysis will emphasise the importance of the voluntary involvement of the normative parties considered liable in a relation with other normative parties who causally contributed to a prohibited state-of-affairs.