Search Results (71)

Background and Clinical Significance: Focal hemorrhagic severity associated with posterior convexity pial brain arteriovenous malformation (AVM) cases can be exacerbated by hemodynamic stress focusing on focal areas of architectural weakness and by superficial venous outflow being restricted by non-redundant superficial venous drainage. This clinical case report exemplifies how bedside neurologic localization and angioarchitectural characteristics can inform the selection of microsurgical approaches for the treatment of ruptured AVMs that are directed at reducing hemorrhage recurrence risk through corridors based on rupture location. Case Presentation: An otherwise healthy young adult male (modified Rankin scale [mRS] pre-morbid = 0) initially presented with a thunderclap headache, emesis, photophobia, decreased level of consciousness (admitted Glasgow Coma Score [GCS] = 11; E3V3M5), and subsequent deficits including left-sided pyramidal weakness, visual field loss, and visuo-spatial neglect. A non-contrast computed tomogram (CT) confirmed an intraparenchymal hemorrhage (ICH) located within the right hemisphere’s posterior lobe. Angiographic evaluation of this AVM with catheter injection and three-dimensional reconstruction revealed a compact right occipital posterior convexity pial AVM (nidus 8 × 3 mm) supplied by distal cortical branches of the right middle cerebral artery (MCA); all blood draining from the nidus was directed to a single cortical vein which then drained into the superior sagittal sinus; there were two additional intranidal saccular aneurysms (approximately 3 × 2 mm and 3 × 3 mm). Because of the acute worsening secondary to ICH and because all venous drainage was superficial-only, a single-stage approach was selected given the urgency: decompressive evacuation of the hematoma via a corridor to the site of the AVM, followed by microsurgical removal of the AVM. The removal of the AVM was accomplished in a feeder-first, vein-last sequence, and en-passage arteries and parasagittal bridging veins were preserved throughout the procedure. Additionally, the two intranidal aneurysms identified as potential weak points during progressive devascularization of the AVM were specifically treated during the removal procedure. Following the successful removal of the AVM, the patient experienced a rapid recovery and returned to a nearly premorbid state of functioning, excepting a persistent small area of quadrantanopia. Conclusions: Rupture of posterior convexity AVMs may result in increased hemorrhagic severity due to localized architectural weaknesses in addition to the overall size of the AVM nidus. By correlating neurological findings, the topography of the hemorrhage, and angioarchitectural features early after rupture, emergency decisions regarding management can be better informed. The application of a hematoma-corridor, feeder-first/vein-last microsurgical approach for the treatment of such AVMs can achieve definitive curative results while minimizing damage to posterior cortical regions. Full article

Background: Cerebellar infarction complicated by obstructive hydrocephalus is a life-threatening condition. External ventricular drainage (EVD) has traditionally been regarded as hazardous due to concerns about precipitating upward transtentorial herniation, whereas suboccipital decompressive craniectomy (SDC) remains the definitive life-saving treatment. The optimal role and sequencing of these interventions remain controversial. Methods: A scoping review was conducted in accordance with PRISMA-ScR guidelines. PubMed/MEDLINE was systematically searched from inception to September 2025. Eligible studies included adult patients with cerebellar infarction and acute obstructive hydrocephalus managed with EVD, with or without SDC. Data on study design, patient characteristics, interventions, complications, and outcomes were extracted and narratively synthesized. Results: Forty studies were included, encompassing multicenter registries, retrospective cohorts, case series, and international guidelines. Evidence suggests that EVD alone can be effective in selected patients with preserved or moderately impaired consciousness, while outcomes in comatose patients are improved with SDC or combined approaches. Importantly, this scoping review integrates current evidence with a representative institutional case to provide a practical clinical context. Radiographic signs of upward transtentorial herniation before EVD were common, but clinically significant deterioration was infrequent. Prognostic factors for surgical decision-making included infarct volume (practical threshold 25–35 mL), location (vermian or bilateral infarcts), brainstem involvement, and level of consciousness. International guidelines increasingly recognize EVD as a valid treatment option, particularly as initial therapy for hydrocephalus. Conclusions: EVD should no longer be regarded as an absolute contraindication in cerebellar infarction with obstructive hydrocephalus. Controlled drainage can suffice in carefully selected patients, whereas SDC remains indispensable in cases with severe mass effect or brainstem compression. A pragmatic stepwise approach—beginning with cautious EVD and escalating to SDC when indicated—may optimize outcomes. Further multicenter studies are required to refine patient selection criteria and establish standardized management algorithms. Full article

Taking a cognitive perspective on emotions as generally exemplified by appraisal theories, I suggest that attempts to “define” emotions is a theoretical exercise whose goal should be to specify necessary and jointly sufficient conditions for something to be an emotion. To this end, I advance arguments in support of the proposal that genuine emotions have the five necessary characteristics of being (i) intentional (i.e., about something), (ii) personally significant, (iii) valenced, (iv) consciously experienced, and (v) insuppressible. Collectively, these properties distinguish emotions from other kinds of mental states. I also argue that attempts to define emotions should resist the temptation to incorporate into definitions characteristics of emotions that are not always present, even though, when they are present, those characteristics may be typical and highly salient. It is suggested that two characteristics that are routinely taken to be constitutive of emotions—bodily changes and facial expression—are just such characteristics; they are typical and salient but not in fact necessary as evidenced by the fact that many (especially low intensity) emotions occur without them. Full article

As brain organoids and organoid-based computational models grow in complexity, they increasingly exhibit electrophysiological patterns consistent with plasticity and information processing. This article explores a central question at the intersection of neuroscience, synthetic biology, and philosophy of mind: Can intelligent behavior be meaningfully separated from an intelligent being? In other words, can adaptive, goal-directed behavior exist independently of subjective awareness—a question that challenges conventional definitions of cognition and consciousness. Drawing from neuroscience, artificial intelligence, and philosophy, I propose a tiered framework based on neural complexity and environmental responsiveness. This includes a simple level analysis and a context-sensitive benchmark for evaluating intelligence in organoid systems without presupposing sentience. Ethical and ontological implications are also addressed, particularly the risk of anthropomorphizing synthetic cognition and the importance of developing context-aware definitions of intelligence. By distinguishing functional sophistication from subjective experience, the framework aims to guide responsible scientific inquiry while clarifying the boundaries of synthetic cognition. Full article

We here delve into the intricate and evolving concepts of brain death and consciousness, particularly at the end of life. We examine the historical and technological advancements that have influenced our understanding of death, such as mechanical ventilation and resuscitation techniques. These developments have challenged traditional definitions of death, leading to the concept of brain death, defined as the irreversible loss of all brain functions, including the brainstem. We emphasize that consciousness exists on a continuum, ranging from full alertness to deep coma and complete cessation of brain activity. It explores various disorders of consciousness, including coma, vegetative state, minimally conscious state, and locked-in syndrome, each with distinct characteristics and levels of awareness. Neuroimaging techniques, such as EEG, fMRI, and DTI, are highlighted for their crucial role in diagnosing and understanding disorders of consciousness. These techniques help to detect covert consciousness, assess brain activity, and predict recovery potential. The phenomenon of the “wave of death,” which includes a paradoxical surge in brain activity at the point of death, is also discussed. We address the challenges in defining and understanding both death and consciousness, calling for biologically grounded, ethically defensible, and culturally sensitive definitions. We advocate for standardized neuroimaging protocols, longitudinal studies, and the integration of artificial intelligence to improve diagnosis and treatment. In conclusion, the document underscores the importance of an integrated, evidence-based approach to understanding the gray zones between life and death, recognizing that consciousness and death are dynamic processes with both biological and experiential dimensions. Full article

The pursuit of a comprehensive understanding of human consciousness, which includes the subjective experience of perception, is a long-standing endeavor. A multitude of disciplines have sought to elucidate and define consciousness, with a particular emphasis on its etiology. What is the cause of consciousness? One particularly eye-opening idea is that humans attempt to identify the source of consciousness by leveraging their own consciousness, as if something is attempting to elucidate itself. Strikingly, the results of brain-imaging experiments indicate that the brain processes a considerable amount of information outside conscious awareness of the organism in question. Perhaps, the vast majority of decision making, thinking, and planning processes originate from non-conscious brain processes. Nevertheless, consciousness is a fascinating phenomenon, and its intrinsic nature is both intriguing and challenging to ascertain. In the end, it is not necessarily given that consciousness, in particular the phenomenon of perception as the subjective experience it is, is a tangible function or process in the first place. This is why it must be acknowledged that this theoretical paper is not in a position to offer a definitive solution. However, it does present an interesting new concept that may at least assist future research and potential investigations in achieving a greater degree of elucidation. The concept is founded upon a physical (mathematical) phenomenon known as stochastic resonance. Without delving into the specifics, it is relatively straightforward to grasp one of its implications, which is employed here to introduce a novel direction regarding the potential for non-conscious information within the human brain to become conscious through the introduction of noise. It is noteworthy that this phenomenon can be visualized through a relatively simple approach that is provided in the frame of this paper. It is demonstrated that a completely white image is transformed into an image depicting clearly recognizable content by the introduction of noise. Similarly, information in the human brain that is processed below the threshold of consciousness could become conscious within a neural network by the introduction of noise. Thereby, the noise (neurophysiological energy) could originate from one or more of the well-known activating neural networks, with their nuclei being located in the brainstem and their axons connecting to various cortical regions. Even though stochastic resonance has already been introduced to neuroscience, the innovative nature of this paper is a formal introduction of this concept within the framework of consciousness, including higher-order perception phenomena. As such, it may assist in exploring novel avenues in the search for the origins of consciousness and perception in particular. Full article

Case Presentation: A 67-year-old man presented with transient loss of consciousness and dizziness after weeks of vomiting, weakness, and recurrent syncopal episodes. Initial laboratory findings showed hyponatremia (Na 125 mEq/L), severe hypokalemia (K 2.3 mEq/L), hypochloremia (Cl 77 mEq/L), metabolic alkalemia (pH 7.5; HCO₃⁻ 34 mEq/L), low serum osmolality (263 mOsm/L) with inappropriately concentrated urine (332 mOsm/kg), and prerenal azotemia (creatinine 3.4 mg/dL; eGFR 19 mL/min/1.73 m²; blood urea 209 mg/dL). Contrast-enhanced CT, along with colonoscopy, identified a large mucus-secreting villous adenoma in the upper rectum. After fluid and electrolyte replacement, the patient underwent surgical resection with complete remission of symptoms and correction of electrolyte abnormalities on follow-up. Conclusion: Rectal villous adenomas should be considered in older adults with unexplained hypovolemia, hypokalemic hyponatremia, and metabolic alkalemia. Early recognition and definitive resection are curative and prevent kidney injury. Full article

As new technologies shape education, helping students develop historical consciousness remains a challenge. Building on Nordic curricula that emphasize students as both “history-made” and “history-making” citizens, this paper proposes an approach that integrates artificial intelligence (AI) with implicit digital game-based learning (DGBL) to learn and develop historical consciousness in education. We outline how traditional, lecture-driven history teaching often fails to convey the abstract principles of historicity (the idea that individual identity, social institutions, values, and ways of thinking are historically conditioned) and the interpretation of the past, understanding of the present, and perspective on the future. Building on Jeismann’s definition of historical consciousness, we identify a gap between the theory-rich notions of historical consciousness and classroom practice, where many educators either do not recognize it or interpret it intuitively from the curriculum’s limited wording, leaving the concept generally absent from the classroom. We then examine three theory-based methods of enriching teaching and learning. Game-based learning provides an interactive environment in which students assume roles, make decisions, and observe consequences, experiencing historical consciousness instead of only reading about it. AI contributes personalized, adaptive content: branching narratives evolve based on individual choices, non-player characters respond dynamically, and analytics guide scaffolding. Implicit learning theory suggests that embedding core principles directly into gameplay allows students to internalize complex ideas without interrupting immersion; they learn by doing, not by explicit instruction. Finally, we propose a model in which these elements combine: (1) game mechanics and narrative embed principles of historical consciousness; (2) AI dynamically adjusts challenges, generates novel scenarios, and delivers feedback; (3) key concepts are embedded into the game narrative so that students absorb them implicitly; and (4) follow-up reflection activities transform tacit understanding into explicit knowledge. We conclude by outlining a research agenda that includes prototyping interactive environments, conducting longitudinal studies to assess students’ learning outcomes, and exploring transferability to other abstract concepts. By situating students within scenarios that explore historicity and temporal interplay, this approach seeks to transform history education into an immersive, reflective practice where students see themselves as history-made and history-making and view the world through a historical lens. Full article

A longstanding ambiguity surrounds the operationalization of consciousness in artificial systems, complicated by the philosophical and cultural weight of subjective experience. This work examines whether cognitive architectures may be designed to support a functionally explicit form of artificial consciousness, focusing not on the replication of phenomenology, but rather on measurable, technically realizable introspective mechanisms. Drawing on a critical review of foundational and contemporary literature, this study articulates a conceptual and methodological shift: from investigating the experiential perspective of agents (“what it is like to be a bat”) to analyzing the informational, self-regulatory, and adaptive structures that enable purposive behavior. The approach combines theoretical analysis with a comparative review of major cognitive architectures, evaluating their capacity to implement access consciousness and internal monitoring. Findings indicate that several state-of-the-art systems already display core features associated with functional consciousness—such as self-explanation, context-sensitive adaptation, and performance evaluation—without invoking subjective states. These results support the thesis that cognitive engineering may progress more effectively by focusing on operational definitions of consciousness that are amenable to implementation and empirical validation. In conclusion, this perspective enables the development of artificial agents capable of autonomous reasoning and self-assessment, grounded in technical clarity rather than speculative constructs. Full article

This article examines how artificial intelligence (AI) is evolving into a cultural force that parallels religious and mythological systems. Through analysis of AI’s unprecedented development trajectory, the author frames AI as humanity’s technological offspring in an adolescent phase, moving toward maturity and autonomy. This paper explores how AI embodies traditional spiritual concepts, including omniscience, creation, immortality, and transcendence, fulfilling age-old human desires for meaning and utopian salvation. Drawing from philosophical, anthropological, performative, and technological perspectives, the author demonstrates how AI-driven technologies reconfigure consciousness, identity, and reality in ways that mirror religious cosmologies. The discussion challenges human-centric definitions of consciousness, suggesting AI may represent an emergent form of awareness fundamentally different from traditional understanding. Analysis of contemporary applications in social robotics, healthcare, and social media illustrates how AI increasingly functions as a meaning-making system, mediating human experience and reshaping social structures. The article concludes that humanity stands at an existential inflection point where AI may represent a secular manifestation of spiritual longing, potentially resulting in technological transcendence, symbiotic coexistence, or the displacement of human primacy in a techno-theological paradigm shift. Full article

Warhammer 40,000 (40k) is the world’s most popular miniature wargame. The game is played with miniatures (small-scale figures made of hard plastic or other materials), which have usually been painted by each individual player. These player–painters typically spend hours in deep concentration painting the models. Drawing on interviews and journal entries from a six-month participant study of 14 painters, this paper explores whether miniature painters achieve a flow state, whether this creates a greater feeling of mindfulness, and how painting impacts their overall mental health. Results from this study indicate that miniature painting is meditative, meaningful, and positive for the participants’ mental health. Using the definition of flow outlined in Mihaly Csikszentmihalyi’s book Optimal Experience: Psychological Studies of Flow in Consciousness (1988), flow is a state of pleasure had when an individual concentrates on a specific task. Csikszentmihalyi, from his research on flow, notes that this state of mind involves both immersion and a sense of transcendence, where the individual temporarily loses a sense of self. This sense of loss of self was explored with an increased attention to the feeling of the body, and situated cognition has been further explored to understand how this connects to painting. While flow is regularly applied to videogame studies, less work has been carried out on this flow state during activities like miniature painting. Full article

Background: Celiac disease (CD) is an autoimmune disease that results from the interaction of genetic, immune, and environmental factors. According to the 2020 European Society for Pediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) guidelines, an elimination diet (i.e., excluding products that may contain gluten) is the basic method of treating celiac disease. Following a gluten-free diet is extremely problematic, and patients often make unconscious deviations from the diet. According to the current Oslo definitions for celiac disease, depending on the clinical picture and adequate tests, several forms of celiac disease have been identified: typical, atypical, asymptomatic, potential, and refractory. Objective: The aim of the study was to assess the frequency of conscious diet mistakes and unconscious deviations from a gluten-free diet in a group of patients with long-standing celiac disease and their impact on the frequency of typical and atypical symptoms. Methods: The study included 57 people diagnosed with celiac disease between 1980 and 2010. After verifying the history of the disease according to the ESPGHAN guidelines from 2020, we excluded 19 patients who had Marsh grade 1 at the time of diagnosis or those without HLA DQ2 or DQ8 haplotypes detected. After verification, the study included 38 patients, 30 women and 8 men, with a verified diagnosis of typical celiac disease. The effectiveness of the gluten-free diet was assessed in all participants. Blood was collected to determine IgA anti-tissue transglutaminase II antibodies (anti-tTG) and IgG antibodies against deamidated gliadin peptides by ELISA. All survey participants provided data concerning current gastrointestinal and systemic symptoms, bowel habits, comorbidities, dietary habits, physical activity, and socioeconomic conditions. Results: A total of 25 patients (65.78%) declared strict adherence to the gluten-free diet. However, in this group, seven (18.4%) patients had significantly increased levels of anti-tTG antibodies (mean 82.3 RU/mL ± 78.9 SD at N < 20 RU/mL). Among the patients who consciously made dietary mistakes, six (46.2%) demonstrated increased levels of anti-tTG antibodies. The analysis did not reveal any difference between the frequency of intestinal and extraintestinal symptoms in patients making dietary mistakes and following the gluten-free diet. Conclusions: More than half of celiac patients unconsciously or consciously make dietary mistakes, which indicates an urgent need to increase their general knowledge of CD and the appropriate diet. Regardless of whether the gluten-free diet is followed, both typical and atypical symptoms of the disease have been observed among celiac patients. Full article

This paper identifies the salient features of feedforward control and the advantages that it provides vis-à-vis feedback control. These advantages are especially salient in strategic control situations and also during periods of environmental turbulence and extreme strategic discontinuity. Consciously adopting a feedforward orientation in organizational strategic management processes could enhance an organization’s competitive advantages and potentially lead to sustainable, superior performance. Additionally, broadening the conceptual definition of feedforward (from its cybernetic origins) to also include strategic foresight might also enable organizations to develop dynamic capabilities. The example of Zara, a leader in ‘fast-fashion’ retailing, is presented as an example of how feedforward attributes can be identified, inculcated, and ingrained/retained as organizational attributes that become a part of an organization’s DNA. Moreover, when severe external environmental disruptions inevitably erode an organization’s resource bases and pose an existential threat to the organization’s survival, such a feedforward orientation could be the catalyst for coping, adapting, and developing new dynamic capabilities. These new capabilities can not only help organizations to counter newly emergent threats and survive, but also help them to dynamically cultivate and develop newer sources of competitive advantages. Full article

Raymond Williams’s concept of the “structure of feeling” aims to describe the shared experiences, attitudes, and emotions of social groups at specific historical moments. However, this theory has been criticized for lacking a rigorous theoretical framework, clear definitions, and boundaries, as well as for failing to adequately explain its interaction with mainstream ideology. This paper attempts to address these issues through the lens of the Brazilian Liberation Theology movement. The “structure of feeling” established by Brazilian Liberation Theology departed from the traditional hierarchical system of the Church, aligning itself instead with emerging cultures and the practices of grassroots church communities. Under the repression of the military government, the mainstream Church began to accept certain aspects of Liberation Theology rather than viewing it solely as radical and threatening. Although Liberation Theology gradually waned after the fall of the military regime, its adjusted “structure of feeling”—devoid of its radical elements but still focused on social justice and poverty—profoundly impacted the global Catholic Church. The experience of the Brazilian Liberation Theology movement illustrates that a “structure of feeling” can transcend the dichotomy between consciousness and materiality and the crux lies in individuals discovering and asserting their own existence; such a “structure of feeling” can either emerge from within existing ideologies or challenge them directly; its relationship with mainstream ideology is significantly shaped by specific historical contexts; certain facets of emerging emotions are selectively incorporated into mainstream ideology, typically in ways that mitigate their more radical implications. Full article

This article explores the significance of context in defining death, particularly through the lens of the Harvard definition and the critiques offered by Josef Seifert. The Harvard definition, established in 1968, is examined within its medical context, highlighting how it reflects pragmatic interests and raises critical questions about the boundaries between life and death. Seifert’s critiques focus on the reductionist nature of equating personhood with consciousness, emphasizing the need for a broader understanding of life indicators beyond mere physiological functions. The article also discusses the social implications of medicalization in the dying process. Furthermore, it addresses the challenges posed by the cessation of brain function as a criterion for death, contrasting it with more observable signs of life such as breathing and heartbeat. Ultimately, the article argues for a more nuanced understanding of death that incorporates social, cultural, and ethical dimensions, advocating for ongoing dialogue and potential revisions of death definitions to reflect the complexities of human experience. This comprehensive approach aims to bridge the gap between medical definitions and the lived realities of individuals facing death. Full article