Search Results (31)

Artificial intelligence systems increasingly generate conduct that appears intentional. They negotiate, advise, adapt to obstacles, and shape human decision-making. Yet they are not legal persons and lack minds in any conventional sense. We argue that the apparent impasse dissolves once legal intent is understood functionally rather than metaphysically. Across contract, tort, corporate, and criminal law, intent has never been a simple report on inner mental states. It is a normative tool used to gate legal effect, allocate blame, and manage risk, one that is routinely inferred, imputed, and even fictionalized in service of institutional goals. We reframe the AI question accordingly. Instead of treating AI systems as candidate legal subjects, we see them as non-personal agents whose conduct is attributable to identifiable human principals through doctrines of agency, respondeat superior, electronic-agent contracting, and corporate attribution that already do this work. Drawing on experimental evidence of goal persistence and emergent strategy formation in autonomous AI agents, we propose a three-layer framework distinguishing questions of legal status from questions of attribution and governance, and develop a factor-based approach for determining when AI-generated conduct should be treated as intentional for specific doctrinal purposes. We apply this framework to recent litigation, including wrongful death claims against an AI chatbot provider, and contrast U.S. and EU regulatory trajectories. Engaging with the substantial AI personhood literature, we conclude that the agency-attribution route does the practical work that personhood proposals are designed to do without importing their normative freight. Law can treat artificial agency as legally consequential without granting AI systems personhood, consciousness, or moral standing, preserving human responsibility while acknowledging that intention may no longer be exclusively human as a matter of law. Full article

This article rereads Akira Kurosawa’s 1960 film The Bad Sleep Well as a modern Hamlet that relocates Shakespeare’s crisis of action from dynastic succession to postwar bureaucratic and corporate modernity. It shifts attention away from plot fidelity and toward how Hamletian functions—staged revelation, damaged legitimacy, obstructed revenge, and the demand for narrative afterlife—are adopted into a corporate world that delegates authority downward, a reworking the article calls structural-political adaptation. Drawing on Carl Schmitt’s account of sovereignty and the political taboo that gives tragic form its density, it argues that Kurosawa adapts the relation between tragedy and what cannot be directly represented. The film’s highest authority is heard on a telephone and never seen. The power of decision has receded behind a bureaucratic apparatus, where neither the avenger nor the camera can follow it. Death and its consequences change accordingly. Nishi dies without a survivor who can perform Horatio’s public function. The institution records his death as an accident and absorbs it into administrative routine. This article argues that The Bad Sleep Well shows how Hamletian action and death survive under faceless institutional power and are shaped by political taboo. Full article

Background: Accurate diagnosis and cause of death ascertainment are essential for effective disease surveillance and epidemiological research. This study aimed to validate prostate cancer diagnostic accuracy (PCa) and the accuracy of cause of death information among veterans with type 2 diabetes mellitus (T2DM). Methods: We conducted a retrospective cohort study of veterans with T2DM diagnosed during the baseline period (2008–2009) and followed from 2010 to 2019 using data from the Veterans Health Administration (VHA) Corporate Data Warehouse (CDW). Diagnostic codes and cause of death data were obtained from the Prostate Cancer Data Core (PCDC) and the National Death Index (NDI), which served as the gold standards for validating PCa diagnosis and mortality information in the CDW. Concordance between data sources was assessed using Cohen’s Kappa statistic. Results: Among 763,424 veterans with T2DM, 37,048 (4.9%) were diagnosed with PCa in the CDW and 36,861 (4.8%) in the PCDC, with a concordance rate of 36,361 (98.6% of patients diagnosed in the PCDC). Mortality data from the NDI identified 2723 deaths with PCa listed as the underlying cause of death, of whom 75.4% had a corresponding PCa diagnosis recorded in the CDW. For all-cause mortality, 328,165 veterans were identified as deceased in the CDW Vital Status File (VSF), compared with 326,707 deaths recorded in the NDI. Of these, 324,567 deaths were concordant between the two sources, representing 99.3% of NDI-recorded deaths. Compared with the PCDC, the CDW demonstrated high accuracy for identifying incident PCa diagnosis, with a sensitivity of 98.6% and a specificity of 99.9%. Conclusions: The findings demonstrated a high level of concordance in key outcomes, including PCa diagnosis between the CDW and PCDC, and all-cause mortality between the CDW VSF and NDI. Full article

‘Analog horror’ is a subgenre of internet and media horror, beginning c.2015. Its texts use late 20th-century analogue technology as a locus of horror, both narratively and aesthetically, expressing contemporary technophobia and existential anxieties of the first quarter of the 21st century, using a deliberate and anarchic a-historicity to represent concerns surrounding techno-capitalism and its attendant ‘polycrisis’. This irreverent attitude to historical cause and effect, and technological progress, in subgenre texts such as “The Nixonverse” by creator Eve Casanas represents our modern-day conflict between the digital, techno-capitalist online world, and the corporeal crisis events affecting the real world. This diametric in analog horror expresses the central tenet of Mark Fisher’s concept of ‘capitalist realism’, the idea that capitalist ideology makes it appear that there are no viable alternatives to capitalism. In analog horror narratives, analogue–digital hybrid technologies channel techno-organic monster-figures, with the helplessness of the individual and/or groups to defeat these monstrosities being expressive of this capitalist realist impression that capitalism cannot be overcome, and its polycrisis avoided, enacting fantasies of societal destruction to alleviate this suspended state of anxious helplessness, in the tone of Freud’s ‘death drive’ wish fulfilment fantasies. Full article

Background: The care and management of a pregnant woman suffering from end-stage brain cancer is surrounded by medical, legal, and ethical controversies. When this brain pathology leads to brain death (BD), continuation of life-sustaining treatments has been considered futile and unethical. An exception could be the case of pregnancy, in order to deliver a healthy neonate. Aim: The presentation of a pregnant woman with a terminal stage brain astrocytoma, admitted in the intensive care unit (ICU) to support the pregnancy, until optimal fetal viability, after she had neurological deterioration and confirmed BD, and a brief literature review of previously relevant published cases. Case Presentation: A 36-year-old woman with a medical history of brain astrocytoma in the last 2 years was admitted in ICU for the first time due to status epilepticus, six months after she stopped anticonvulsant therapy. Her epilepsy was controlled, and a pregnancy of 14 weeks was confirmed. Two weeks later, she deteriorated. After a multidisciplinary approach, it was decided to mechanically ventilate the patient and support the pregnancy. Brain death was determined after a couple of days. Results: A cesarean section was performed 11 weeks after BD diagnosis (at 27 weeks of gestational age) resulting in the delivery of a live, premature infant, weighing 549 gr. Conclusions: Maternal corporeal support can maximize the chances for survival in the neonate by prolonging the pregnancy of a brain-dead woman. Full article

Snakebite envenoming causes an estimated 138,000 deaths annually worldwide, with approximately 75% of fatalities occurring prior to arrival at definitive medical care. Even in regions where antivenom is available in hospitals, the absence of treatment options before a victim can reach definitive care results in delays of many hours before therapy is initiated. Manufacturing complexity, region-specific products, and the risk of anaphylaxis further limit the availability and use of antivenom in many regions. Reducing the persistently high mortality of snakebite envenoming requires both novel scientific approaches and partnerships that extend beyond traditional disciplinary and funding silos. This article describes the collaboration between Ophirex, a Public Benefit Corporation developing the oral secretory phospholipase A2 (sPLA2) inhibitor varespladib, and the United States military, which has identified a capability gap in snakebite treatment for forward-deployed personnel. The partnership was driven by a shared requirement for a shelf-stable, easy-to-administer, snake-species-agnostic therapy suitable for use prior to definitive medical care. A central insight of the program was that military operational requirements and global public health needs converged around the same product characteristics, enabling a strategically aligned development effort. From early proof-of-concept studies through regulatory pathway definition and advanced development, the Military–Ophirex partnership integrated operational requirements, regulatory planning, and iterative risk mitigation to advance manufacturing, nonclinical, and clinical development. This work provides both practical insights into complex drug development and a case study in how structured partnerships can carry innovation through translation in underfunded and operationally challenging conditions. Full article

A large and growing empirical literature documents that privatization, deregulation, financialization, and under-regulation of harmful industries are associated with adverse health outcomes in the United States. However, this evidence remains fragmented across sectors and rarely articulates a unifying causal framework. This paper advances the literature by integrating findings across health care, harmful-product industries, and economic and social policy to demonstrate that corporate profit maximization functions as a cross-cutting driver of health disparities and premature mortality in the United States. We synthesize evidence showing that profit-driven incentives shape insurance markets, hospital and physician practice ownership, pharmaceutical marketing, and the aggressive promotion of tobacco, alcohol, ultra-processed foods, opioids, firearms, and fossil fuels—together contributing to more than one million deaths annually. We further document how corporate influence over public policy has increased poverty, economic inequality, and discrimination, all of which are powerful social determinants of health. In contrast to sector-specific analyses, this paper presents a unified, systems-level account of how profit-first governance undermines population health. We conclude by describing how a social movement to achieve a single payer system that provides Medicare for All would not only vastly improve public health, it would be a catalyst for numerous other reforms that enhance the general wellbeing. Full article

This study examines Sylvia Plath’s literary corpus through a biopolitical lens, analyzing how her representations of embodiment—particularly aging, decay, disease, and institutionalization—function as sites of contestation against institutional power. Moving beyond traditional biographical and psychoanalytic interpretations, this research study applies theoretical frameworks from Foucault, Agamben, and Esposito to illuminate how Plath’s work engages with and resists biopolitical structures. Through close readings of “The Bell Jar”, “The Colossus”, and “Ariel”, this study demonstrates how Plath’s aesthetic strategies transform embodied vulnerability into forms of resistance. The analysis explores four key dimensions: the institutionalized body and medical authority; aesthetic politics and the anxiety of aging; the biopolitics of reproduction and maternity; and death as both boundary and transcendence. This study reveals Plath’s corporeal poetics as a sophisticated engagement with the political dimensions of embodiment in the mid-twentieth century, establishing a literary tradition that influences contemporary understandings of bodies as sites of political contestation. Comparative analysis with other confessional poets highlights Plath’s distinctive and systematic approach to biopolitical themes, positioning her work as particularly significant for subsequent feminist theorizations of embodied resistance. Full article

In October 2024, a DANA (Isolated Depression at High Levels) triggered torrential rains across the Valencian Community, causing 227 deaths, severe infrastructure damage, and economic losses estimated at €17.8 billion. In this context of crisis, startups, despite having fewer resources and less experience than large corporations, played a significant role in crisis communication, shaping public perception and operational continuity. This study explores the communication strategies adopted by startups during and after the disaster, focusing on their activity on Instagram, TikTok, and Facebook between October 2024 and January 2025. Using a mixed-methods approach, we conducted a quantitative analysis of digital discourse through the Fanpage Karma tool, assessing metrics such as engagement, reach, and posting frequency. Sentiment analysis was performed using GPT-4, an advanced natural language processing model, and in-depth interviews with startup representatives provided qualitative insights into reputational impacts. The findings reveal that startups which aligned their discourse with the social context, prioritizing transparency and emotional proximity, enhanced their visibility and credibility. These results underscore how effective crisis communication not only mitigates reputational risk but also strengthens the local entrepreneurial ecosystem through trust-building and social responsibility. Full article

Antibiotic resistance is a public health emergency, with ten million deaths estimated annually by the year 2050. Water systems are an important medium for the development and dissemination of antibiotic resistance from a variety of sources, explored in this perspective review. Hospital wastewater and wastewater systems more broadly are breeding grounds for antibiotic resistance because of the nature of their waste and how it is processed. Corporations from various sectors contribute to antibiotic resistance in many direct and indirect ways. Pharmaceutical factory runoff, agricultural antibiotic use, agricultural use of nitrogen fertilizers, heavy metal pollution, air pollution (atmospheric deposition, burning of oil and/or fossil fuels), plastic/microplastic pollution, and oil/petroleum spills/pollution have all been demonstrated to contribute to antibiotic resistance. Mitigation strategies to reduce these pathways to antibiotic resistance are discussed and future directions hypothesized. Full article

This case study aims to problematise concepts of equine and human co-relational agency in the context of ‘mis-re-presentations’ in the Australian media of harms experienced by the Anglo Arab stallion, Cambridge, following his development of laminitis and his consequent confinement at a leading national Equestrian centre. Autoethnographic narrative is used to retrospectively and selectively narrate the evolving relationship between Cambridge and his owners, farrier, and treating veterinarians within the dominant housing and veterinary practices and welfare paradigms in equestrian culture of 1990’s Australia. Structured author/owner autoethnographic vignettes are framed by newspaper and internet reportage to highlight a productive tension between the public mediation of the case, and what it means to be fully embodied in relationship with an equine companion agent within a particular, racialised, gendered, and biopoliticised location. Adopting a phenomenologically informed intersectional feminist ethics of care perspective, a counternarrative to the gendered, racialised and essentialising rights-based judgements about Cambridge’s illness and eventual death that dominated the popular media is provided. Crucially, the autoethnographic vignettes are chosen to capture the corporeal reciprocity and rapport of forces that produced a co-created agentivity that characterised the horse’s birth, training, and treatment. The embodied interspecies knowledge that informs the training and care of equines (and all animal species) is always historically situated within permeable, dynamic worlds of self and other that are fluid, contextual, and always in relation. It is suggested that the case of Cambridge illustrates how competing stakeholder investments in animal welfare can play out in the public mediation of particular cases in ways that exclude their historical and interspecies situatedness and serve to reinforce dominant ideologies governing human and animal relationships. Full article

Background: Bacterial superinfections are common complications during viral infections, but the impact of multidrug-resistant (MDR) pathogens in critically ill patients affected by coronavirus disease 2019 (COVID-19) is still debated. Methods: This is an observational, monocentric, and prospective study designed to investigate the incidence, risk factors, and outcomes of MDR bacterial superinfections in COVID-19 patients admitted to the intensive care unit (ICU). Results: A high incidence of superinfections (66%, 159/241) was observed: ventilator-associated pneumonia (VAP) (65%, 104/159) and bloodstream infection (BSI, 32%, 51/159) were the most common. Superinfections, Extra-Corporeal Membrane Oxygenation (ECMO) support, and prone positioning increased the risk of death five, four, and more-than-two times, respectively (OR = 5.431, IC 95%: 1.637–18.014; 4.462, IC 95%: 1.616–12.324 and 2.346, IC 95%: 1.127–4.883). MDR bacteria were identified in 61% of patients with superinfection, with a cumulative incidence of 37.2% at day 14. Carbapenem-resistant Acinetobacter baumannii (CR-AB) and CR-Klebsiella pneumoniae (CR-KP) were the most common causative agents (24.3% and 13.7%). CR-AB was found to significantly increase both ICU and in-hospital mortality (76.4% and 78.2%), whereas CR-KP had no direct impact on mortality. Prior rectal colonization (p < 0.0001), mechanical ventilation (p = 0.0017), a prolonged ICU stay (p < 0.0001), the use of iNO (p = 0.0082), vasopressors (p = 0.0025), curarization (p = 0.0004), and prone positioning (p = 0.0084) were found to be risk factors for CR-AB. Conclusions: Critically ill COVID-19 patients are at high risk of developing MDR superinfection. While CR-KP had no direct impact on mortality, CR-AB appeared to increase ICU and in-hospital mortality. Full article

Background/Objectives: This study evaluated comparative overall survival (OS) of United States veterans with unresectable hepatocellular carcinoma (uHCC) receiving first-line (1L) atezolizumab plus bevacizumab vs. sorafenib or lenvatinib, overall and across racial and ethnic groups. Methods: In this retrospective study, patients with uHCC who initiated atezolizumab plus bevacizumab (post-2020) or sorafenib or lenvatinib (post-2018) were identified from the Veterans Health Administration National Corporate Data Warehouse (1 January 2017–31 December 2022). Patient characteristics were evaluated in the year prior to 1L treatment initiation. Kaplan–Meier and multivariable Cox regression methods were used to compare OS starting from treatment between cohorts, both overall and by race and ethnicity. Results: Among the 1874 patients included, 405 (21.6%) received 1L atezolizumab plus bevacizumab, 1016 (54.2%) received sorafenib, and 453 (24.2%) received lenvatinib, with a median follow-up time of 8.5, 7.6, and 8.2 months, respectively. Overall, patients receiving atezolizumab plus bevacizumab had longer unadjusted median OS (12.8 [95% CI: 10.6, 17.1] months) than patients receiving sorafenib (8.0 [7.1, 8.6] months) or lenvatinib (9.5 [7.8, 11.4] months; both log-rank p < 0.001). After adjustment, atezolizumab plus bevacizumab was associated with a reduced risk of death by 30% vs. sorafenib (adjusted HR: 0.70 [95% CI: 0.60, 0.82]) and by 26% vs. lenvatinib (0.74 [0.62, 0.88]; both p < 0.001). OS trends in the White, Black, and Hispanic patient cohorts were consistent with that of the overall population. Conclusions: Atezolizumab plus bevacizumab was associated with improved survival outcomes compared with sorafenib and lenvatinib in patients with uHCC, both overall and across racial and ethnic subgroups. Full article

Background: Individuals with serious mental illness (SMI) experience barriers to accessing and engaging with healthcare, which may have been exacerbated during the emergence of the global pandemic and the rapid shift to telemedicine platforms, substantially decreasing healthcare utilization for non-COVID-19 disorders. Important repercussions on morbidity and mortality may be seen in the months and years to come, which may disproportionately affect high-risk populations, such as patients with SMI, with reduced access to technology platforms. In this study, we explored the impact of the pandemic on healthcare utilization and all-cause mortality rate in SMI compared to non-SMI individuals for the months of March–September 2020 and the same two quarters in 2019. Methods: Data were obtained from the VA Corporate Data Warehouse (CDW), a data repository from clinical and administrative VA systems. The sample included veterans with ≥1 outpatient clinical encounter nationally between 1 January 2019 and 31 December 2020. Results: The cohort for this study included 1,018,047 veterans receiving care through the Veterans Health Administration between 2019 and 2020. Of those, 339,349 had a diagnosis of SMI. Patients with SMI had a significantly larger pre–post-pandemic decrease in outpatient (49.7%, p < 0.001), inpatient (14.4%, p < 0.001), and ED (14.5%, p < 0.001) visits compared to non-SMI patients. Overall, 3752 (1.59%) veterans without SMI and 4562 (1.93%) veterans with SMI died during our observation period. Veterans without SMI who died during the observation period were more likely to have had a positive COVID-19 test compared to veterans with SMI. Unadjusted analyses showed that veterans with SMI were approximately 2.5 times more likely to die than veterans without SMI during the first 6 months of the pandemic, compared to the same two quarters of the previous year. However, after adjustment by pertinent covariates, the predictors associated with an increased risk of death from SMI were older age, being male, a higher CAN score, more inpatient stays in the pre period compared to post, and a positive COVID-19 test. Discussion: Consistent with our initial hypothesis, all the indices of healthcare utilization, namely the number of outpatient, inpatient, and ED visits, significantly decreased between pre- and post-pandemic and did more so for veterans with SMI, despite having more chronic medical illnesses and being prescribed more medications than veterans without SMI. On the other hand, while mortality was greater post-pandemic, factors such as age, morbidity, and having a positive COVID-19 test predicted mortality above and beyond having an SMI diagnosis. Full article

In 1900, Fiedler first reported autopsy cases with peculiar inflammation of the myocardium, which he named interstitial myocarditis. He postulated an isolated cardiac inflammation of the myocardium in the absence of multiorgan involvement and with a poor prognosis due to invisible microorganisms, which years later would have been identified as viruses. The revision of original histologic sections by Schmorl showed cases with lymphocytes and others with giant-cell inflammatory histotypes. The in vivo diagnosis of myocarditis became possible thanks to right cardiac catheterization with endomyocardial biopsy (EMB). The gold standard for diagnosis was achieved with the employment of immunohistochemistry and molecular investigation by Polymerase Chain Reaction (PCR), which allows for the detection of viruses as causal agents. Both RNA and DNA were revealed to be cardiotropic, with a common receptor (CAR). A protease, coded by coxsackie virus, disrupts the cytoskeleton and accounts for cell death. Unfortunately, vaccination, despite having been revealed to be effective in animal experiments, has not yet entered the clinical field for prevention. Cardiac Magnetic Resonance turned out to be a revolutionary tool for in vivo diagnosis through the detection of edema (inflammatory exudate). Myocarditis may be fulminant in terms of clinical presentation but not necessarily fatal. The application of ExtraCorporeal Membrane Oxygenation (ECMO) allows for relieving the overloaded native heart. Full article