Indian Ocean salinity build-up primes deglacial ocean circulation recovery.

The Indian Ocean provides a source of salt for North Atlantic deep-water convection sites, via the Agulhas Leakage, and may thus drive changes in the ocean's overturning circulation1-3. However, little is known about the salt content variability of Indian Ocean and Agulhas Leakage waters during past glacial cycles and how this may influence circulation. Here we show that the glacial Indian Ocean surface salt budget was notably different from the modern, responding dynamically to changes in sea level. Indian Ocean surface salinity increased during glacial intensification, peaking in glacial maxima. We find that this is due to rapid land exposure in the Indonesian archipelago induced by glacial sea-level lowering, and we suggest a mechanistic link via reduced input of relatively fresh Indonesian Throughflow waters into the Indian Ocean. Using climate model results, we show that the release of this glacial Indian Ocean salinity via the Agulhas Leakage during deglaciation can directly impact the Atlantic Meridional Overturning Circulation and global climate.

Empowerment: Freud, Canguilhem and Lacan on the ideal of health promotion.

Empowerment is a prominent ideal in health promotion. However, the exact meaning of this ideal is often not made explicit. In this paper, we outline an account of empowerment grounded in the human capacity to adapt and adjust to environmental and societal norms without being completely determined by those norms. Our account reveals a tension at the heart of empowerment between (a) the ability of self-governance and (b) the need to adapt and adjust to environmental and societal norms. We address this tension by drawing from the work of Freud, Canguilhem, and Lacan. First, we clarify through a discussion of Freud's notion of sublimation that it is difficult to assess empowerment independent of any social valuations, but also that it is no less problematic to make it dependent on social valuations alone. Second, we draw from the work of Canguilhem to show how empowerment can be understood in terms of the individual's capacity to tolerate the aggressions of a multiplicity of environments. Third, using Lacan, we show how empowerment requires incorporation of social and symbolic norms, without necessarily rendering ourselves a mere product of these norms. Finally, we demonstrate how the views of these authors can complement one another, resulting in a more sophisticated understanding of empowerment.

Milankovitch-paced erosion in the southern Central Andes.

It has long been hypothesized that climate can modify both the pattern and magnitude of erosion in mountainous landscapes, thereby controlling morphology, rates of deformation, and potentially modulating global carbon and nutrient cycles through weathering feedbacks. Although conceptually appealing, geologic evidence for a direct climatic control on erosion has remained ambiguous owing to a lack of high-resolution, long-term terrestrial records and suitable field sites. Here we provide direct terrestrial field evidence for long-term synchrony between erosion rates and Milankovitch-driven, 400-kyr eccentricity cycles using a Plio-Pleistocene cosmogenic radionuclide paleo-erosion rate record from the southern Central Andes. The observed climate-erosion coupling across multiple orbital cycles, when combined with results from the intermediate complexity climate model CLIMBER-2, are consistent with the hypothesis that relatively modest fluctuations in precipitation can cause synchronous and nonlinear responses in erosion rates as landscapes adjust to ever-evolving hydrologic boundary conditions imposed by oscillating climate regimes.

Living in the Flesh: Technologically Mediated Chiasmic Relationships (in Times of a Pandemic).

During the Corona pandemic, it became clear that people are vulnerable to potentially harmful nonhuman agents, as well as that our own biological existence potentially poses a threat to others, and vice versa. This suggests a certain reciprocity in our relations with both humans and nonhumans. In his The Visible and the Invisible, Merleau-Ponty introduces the notion of the flesh to capture this reciprocity. Building on this idea, he proposes to understand our relationships with other humans, as well as those with nonhuman beings as having a chiasmic structure: to sense, or perceive another entity in a particular way simultaneously implies to be sensed or perceived in a particular way by this other entity. In this paper, we show how a postphenomenological perspective expands on Merleau-Ponty: first, it more radically interprets Merleau-Ponty's notion of flesh by not only considering it to be a medium that is the condition of possibility for vision but as pointing to the constitution of an intercorporeal field in which entities-both human and nonhuman-mutually sense one another. Second, it augments Merleau-Ponty's thought by drawing attention to how technologies mediate chiasmic relations. This is clarified through the example of the facemask, which (1) reveals the chiasmic structure of our relation with nonhuman entities, and (2) shows that technologies co-constitute interpersonal relationships by making humans present to one another in a particular way. We suggest that these aspects are not unique to the facemask, but point to a general technologically mediated chiasmic structure of human-world relations.

Bringing disgust in through the backdoor in healthy food promotion: a phenomenological perspective.

Obesity has been pointed out as one of the main current health risks leading to calls for a so-called "war on obesity". As we show in this paper, activities that attempt to counter obesity by persuading people to adjust a specific behavior often employ a pedagogy of regret and disgust. Nowadays, however, public healthcare campaigns that aim to tackle obesity have often replaced or augmented the explicit negative depictions of obesity and/or excessive food intake with the positive promotion of healthy food items. In this paper, we draw on a phenomenological perspective on disgust to highlight that food-related disgust is connected to the character and behavior of a perceived individual even in the context of promoting healthy food items. We argue that the focus on "making the healthy food choice the easy choice" might be an important step towards the de-stigmatization of people that are affected by obesity. However, so we suggest, this focus threatens to bring back an image of individuals affected by obesity as disgusting "through the backdoor". It does so not by portraying bodies with overweight as disgusting, but instead by implying that lifestyle choices, character and habits of people that are affected by obesity are markers of a lack of control. We argue that the close relationship between disgust and the perception of self-control in the context of obesity should be taken into consideration in the context of assessing the implications of new health promotion strategies to minimize the risk of stigmatizing people.

Co-designing diagnosis: Towards a responsible integration of Machine Learning decision-support systems in medical diagnostics.

RATIONALE: This paper aims to show how the focus on eradicating bias from Machine Learning decision-support systems in medical diagnosis diverts attention from the hermeneutic nature of medical decision-making and the productive role of bias. We want to show how an introduction of Machine Learning systems alters the diagnostic process. Reviewing the negative conception of bias and incorporating the mediating role of Machine Learning systems in the medical diagnosis are essential for an encompassing, critical and informed medical decision-making. METHODS: This paper presents a philosophical analysis, employing the conceptual frameworks of hermeneutics and technological mediation, while drawing on the case of Machine Learning algorithms assisting doctors in diagnosis. This paper unravels the non-neutral role of algorithms in the doctor's decision-making and points to the dialogical nature of interaction not only with the patients but also with the technologies that co-shape the diagnosis. FINDINGS: Following the hermeneutical model of medical diagnosis, we review the notion of bias to show how it is an inalienable and productive part of diagnosis. We show how Machine Learning biases join the human ones to actively shape the diagnostic process, simultaneously expanding and narrowing medical attention, highlighting certain aspects, while disclosing others, thus mediating medical perceptions and actions. Based on that, we demonstrate how doctors can take Machine Learning systems on board for an enhanced medical diagnosis, while being aware of their non-neutral role. CONCLUSIONS: We show that Machine Learning systems join doctors and patients in co-designing a triad of medical diagnosis. We highlight that it is imperative to examine the hermeneutic role of the Machine Learning systems. Additionally, we suggest including not only the patient, but also colleagues to ensure an encompassing diagnostic process, to respect its inherently hermeneutic nature and to work productively with the existing human and machine biases.

What is morally at stake when using algorithms to make medical diagnoses? Expanding the discussion beyond risks and harms.

In this paper, we examine the qualitative moral impact of machine learning-based clinical decision support systems in the process of medical diagnosis. To date, discussions about machine learning in this context have focused on problems that can be measured and assessed quantitatively, such as by estimating the extent of potential harm or calculating incurred risks. We maintain that such discussions neglect the qualitative moral impact of these technologies. Drawing on the philosophical approaches of technomoral change and technological mediation theory, which explore the interplay between technologies and morality, we present an analysis of concerns related to the adoption of machine learning-aided medical diagnosis. We analyze anticipated moral issues that machine learning systems pose for different stakeholders, such as bias and opacity in the way that models are trained to produce diagnoses, changes to how health care providers, patients, and developers understand their roles and professions, and challenges to existing forms of medical legislation. Albeit preliminary in nature, the insights offered by the technomoral change and the technological mediation approaches expand and enrich the current discussion about machine learning in diagnostic practices, bringing distinct and currently underexplored areas of concern to the forefront. These insights can contribute to a more encompassing and better informed decision-making process when adapting machine learning techniques to medical diagnosis, while acknowledging the interests of multiple stakeholders and the active role that technologies play in generating, perpetuating, and modifying ethical concerns in health care.

Understanding science-in-the-making by letting scientific instruments speak: From semiotics to postphenomenology.

Latour encourages us to use science-in-the-making as an entry point to understanding science, because it allows us to see how scientific knowledge is constituted and through which processes the 'absolute certainties' of ready-made science appear. He approaches science-in-the-making from the perspective of semiotics because it enables him (1) to attribute equal importance to humans and nonhumans, and (2) to let the actors in scientific practices speak for themselves. We argue that Latour's semiotic approach to science-in-the-making and his understanding of scientific instruments as inscription devices do not fulfill these desiderata. This, in turn, prevents him from understanding the crucial role that scientific instruments play in science-in-the-making. As an alternative to Latour's semiotic approach, we present a postphenomenological approach to studying science-in-the-making. Using the notion of technological mediation, we argue that scientific instruments actively mediate how reality becomes present to - and is treated by - scientists. Focusing on how intentional relations between scientists and the world are mediated by scientific instruments makes it possible to turn them into genuine actors that speak for themselves, thereby recognizing their constitutive role in the development of the interpretational frameworks of scientists. We then show how a postphenomenological approach can be understood as an ethnomethodology of human-technology relations that meets both of Latour's requirements when studying science-in-the-making.

Experiencing objectified health: turning the body into an object of attention.

In current phenomenology of medicine, health is often understood as a state of transparency in which our body refrains from being an object of explicit attention. In this paper, I argue that such an understanding of health unnecessarily presupposes an overly harmonious alignment between subjective and objective body, resulting in the idea that our health remains phenomenologically inaccessible. Alternatively, I suggest that there are many occasions in which one's body in health does become an object of attention, and that technologies mediate how a relation with one's body is formed. First, I show prominent accounts in current phenomenology of medicine understand health in terms of a harmonious alignment between objective and subjective body. Second, I argue that there are many occasions in which there is a disharmony between objective and subjective body, and suggest that also in health, we cannot escape being an object that we often relate to. Then, I draw on postphenomenology to show how technologies such as digital self-tracking applications and digital twins can be understood as mediating the relationship with one's own body in a specific way. In conclusion, I argue that both technologies make present the objective body as a site for hermeneutic inquiry such that it can be interacted with in terms of health parameters. Furthermore, I point to some relevant differences in how different technologies make aspects of our own body phenomenologically present.

High climate model dependency of Pliocene Antarctic ice-sheet predictions.

The mid-Pliocene warm period provides a natural laboratory to investigate the long-term response of the Earth's ice-sheets and sea level in a warmer-than-present-day world. Proxy data suggest that during the warm Pliocene, portions of the Antarctic ice-sheets, including West Antarctica could have been lost. Ice-sheet modelling forced by Pliocene climate model outputs is an essential way to improve our understanding of ice-sheets during the Pliocene. However, uncertainty exists regarding the degree to which results are model-dependent. Using climatological forcing from an international climate modelling intercomparison project, we demonstrate the high dependency of Antarctic ice-sheet volume predictions on the climate model-based forcing used. In addition, the collapse of the vulnerable marine basins of Antarctica is dependent on the ice-sheet model used. These results demonstrate that great caution is required in order to avoid making unsound statements about the nature of the Pliocene Antarctic ice-sheet based on model results that do not account for structural uncertainty in both the climate and ice sheet models.