Since the completion of the Human Genome Project (HGP), biomedical sciences have moved away from a gene-centred view and towards a multi-factorial one in which environment, broadly speaking, plays a central role in the determination of human health and disease. Environmental exposures have been shown to be highly prevalent in disease causation. They are considered as complementary to genetic factors in the etiology of diseases, hence the introduction of the concept of the \"exposome\" as encompassing the totality of human environmental exposures, from conception onwards (Wild in Cancer Epidemiol Biomark Prev 14:1847-1850, 2005), and the launch of the Human Exposome Project (HEP) which aims to complement the HGP. At first sight, and seen as complementary to the genome, the exposome could thus appear as contributing to the rise of novel postgenomic deterministic narratives which place the environment at their core. Is this really the case? If so, what sort of determinism is at work in exposomics research? Is it a case of environmental determinism, and if so, in what sense? Or is it a new sort of deterministic view? In this paper, we first show that causal narratives in exposomics are still very similar to gene-centred deterministic narratives. They correspond to a form of Laplacian determinism and, above all, to what Claude Bernard called the \"determinism of a phenomenon\". Second, we introduce the notion of \"reversed heuristic determinism\" to characterize the specific deterministic narratives present in exposomics. Indeed, the accepted sorts of external environmental exposures conceived as being at the origins of diseases are determined, methodologically speaking, by their identifiable internal and biological markers. We conclude by highlighting the most relevant implications of the presence of this heuristic determinism in exposomics research.

In the context of socio-technical systems, traditional engineering approaches are inadequate, calling for a fundamental change in perspective. A different approach encourages viewing socio-technical systems as complex living entities rather than through a simplistic lens, which enhances our understanding of their dynamics. However, these systems are designed to facilitate human activities, and the goal is not only to comprehend how they operate but also to guide their function. Currently, we lack the appropriate terminology. Hence, we introduce two principal concepts, simplexity and complixity, drawing inspiration from how nature conceals intricate mechanisms beneath straightforward, user-friendly interfaces.

Work at the intersection of philosophy and psychiatry has an extensive and influential history, and has received increased attention recently, with the emergence of professional associations and a growing literature. In this paper, we review key advances in work on philosophy and psychiatry, and their related clinical implications. First, in understanding and categorizing mental disorder, both naturalist and normativist considerations are now viewed as important - psychiatric constructs necessitate a consideration of both facts and values. At a conceptual level, this integrative view encourages moving away from strict scientism to soft naturalism, while in clinical practice this facilitates both evidence-based and values-based mental health care. Second, in considering the nature of psychiatric science, there is now increasing emphasis on a pluralist approach, including ontological, explanatory and value pluralism. Conceptually, a pluralist approach acknowledges the multi-level causal interactions that give rise to psychopathology, while clinically it emphasizes the importance of a broad range of \"difference-makers\", as well as a consideration of \"lived experience\" in both research and practice. Third, in considering a range of questions about the brain-mind, and how both somatic and psychic factors contribute to the development and maintenance of mental disorders, conceptual and empirical work on embodied cognition provides an increasingly valuable approach. Viewing the brain-mind as embodied, embedded and enactive offers a conceptual approach to the mind-body problem that facilitates the clinical integration of advances in both cognitive-affective neuroscience and phenomenological psychopathology.

Notwithstanding the huge progress in molecular and cellular neuroscience, our ability to understand the brain and develop effective treatments promoting mental health is still limited. This can be partially ascribed to the reductionist, deterministic and mechanistic approaches in neuroscience that struggle with the complexity of the central nervous system. Here, I introduce the Context theory of constrained systems proposing a novel role of contextual factors and genetic, molecular and neural substrates in determining brain functioning and behavior. This theory entails key conceptual implications. First, context is the main driver of behavior and mental states. Second, substrates, from genes to brain areas, have no direct causal link to complex behavioral responses as they can be combined in multiple ways to produce the same response and different responses can impinge on the same substrates. Third, context and biological substrates play distinct roles in determining behavior: context drives behavior, substrates constrain the behavioral repertoire that can be implemented. Fourth, since behavior is the interface between the central nervous system and the environment, it is a privileged level of control and orchestration of brain functioning. Such implications are illustrated through the Kitchen metaphor of the brain. This theoretical framework calls for the revision of key concepts in neuroscience and psychiatry, including causality, specificity and individuality. Moreover, at the clinical level, it proposes treatments inducing behavioral changes through contextual interventions as having the highest impact to reorganize the complexity of the human mind and to achieve a long-lasting improvement in mental health.

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This paper analyzes the influence of Hans Spemann and Hilde Mangold\'s discovery of the embryonic organizer on society outside the narrower confines of embryology. It begins by overviewing how in the 1920s-1930s, the organizer discovery fit well into the agenda of both right-wing and left-wing political camps, as it supported holistic theories of biological development that aligned with their ideological views. The paper then explores the organizer\'s influence on the formation and interdisciplinary discussions of the 1930s Cambridge Theoretical Biology Club. Club member C.H. Waddington\'s concept of the epigenetic landscape, inspired in part by Spemann and Mangold\'s work, went on to impact diverse fields including mathematics, psychology, anthropology, architecture, and art. Examples include mathematician René Thom\'s catastrophe landscapes and the field of ekistics (the science of human settlements). Spemann and Mangold\'s creation of an embryo chimera by combining tissues from different newt species also helped shape philosophers\' and artists\' understanding of the relationship between nature and technology as an integrated whole rather than separate entities. Additionally, Spemann\'s embryonic field concept helped influence field theories in other areas of science, and thinkers have pointed out metaphorical similarities between the organizer experiment and philosophical dialectics, film editing, or historical events. However, several factors likely limited the long-term societal impact of Spemann\'s holistic perspective, notably the rise of molecular biology and DNA-centric reductionist views of biology in the mid-late 20th century. While such reductionism still dominates public perceptions of biology, there seems to be a renewed openness to holistic perspectives reminiscent of Spemann\'s views.

Beyond abiotic conditions, do population dynamics mostly depend on a species\' direct predators, preys and conspecifics? Or can indirect feedback that ripples across the whole community be equally important? Determining where ecological communities sit on the spectrum between these two characterizations requires a metric able to capture the difference between them. Here we show that the spectral radius of a community\'s interaction matrix provides such a metric, thus a measure of ecological collectivity, which is accessible from imperfect knowledge of biotic interactions and related to observable signatures. This measure of collectivity integrates existing approaches to complexity, interaction structure and indirect interactions. Our work thus provides an original perspective on the question of to what degree communities are more than loose collections of species or simple interaction motifs and explains when pragmatic reductionist approaches ought to suffice or fail when applied to ecological communities.

Expanding the concept of \"precision\" or \"personalized\" medicine, personalized health and precision public health designate the use of various kinds of data-genomic, other omics, clinical, or those produced by individuals themselves through self-tracking-to optimize health interventions benefiting the whole population. This paper draws on an ethnography of the implementation of a population-based environmental health cohort to shed light on the reconfigurations brought about by the \"personalization\" of public health in Switzerland. Combining human biomonitoring and molecular epidemiology, this cohort aims to advance the science of the exposome, a notion referring to the totality of exposures to which individuals are subjected over their lifecourse. Addressing the tension between holism and reductionism, this paper points to the important gap between the promissory horizon of the exposome and the realities of practices. Situations of reductionism are defined as moments of friction and negotiation between different rationales and values, exposing what makes the science of the exposome, including its material, economic, institutional, and methodological constraints, as well as its imaginaries and values. Rather than opposing holism and reductionism, I emphasize that they constitute two sides of the same coin, as they both pragmatically enable action and produce situated versions of the social. This empirical case shows how reductionism operates at the chemical, biological, and populational levels to produce public health scientific and social values. It thus contributes to contextualizing the pragmatic and strategic choices made by scientists, as well as the values they favor, in a research environment marked by the predominance of biomedicine over public health. It shows how the reductionism of the \"social environment\" was made for a better social integration of the cohort into the Swiss political and scientific landscape of public health. Bringing together actors involved in public health and questions of environmental exposures, this cohort can be interpreted as a biomedicalization of public health research, as well as an attempt to socialize it through the broad category of the exposome.

Step counting is among the fundamental features of wearable technology, as it grounds several uses of wearables in biomedical research and clinical care, is at the center of emerging public health interventions and recommendations, and is gaining increasing scientific and political importance. This paper provides a perspective of step counting in wearable technology, identifying some limitations to the ways in which wearable technology measures steps and indicating caution in current uses of step counting as a proxy for physical activity. Based on an overview of the current state of the art of technologies and approaches to step counting in digital wearable technologies, we discuss limitations that are methodological as well as epistemic and ethical-limitations to the use of step counting as a basis to build scientific knowledge on physical activity (epistemic limitations) as well as limitations to the accessibility and representativity of these tools (ethical limitations). As such, using step counting as a proxy for physical activity should be considered a form of reductionism. This is not per se problematic, but there is a need for critical appreciation and awareness of the limitations of reductionistic approaches. Perspective research should focus on holistic approaches for better representation of physical activity levels and inclusivity of different user populations.

This article was migrated. The article was marked as recommended. While the medical humanities have experienced a renaissance, they are still largely a peripheral component of medical education. This is troublesome because the humanities include a number of disciplines that are foundational in understanding medicine and how it should be practiced. Nonetheless, current medical culture makes it difficult to fully incorporate the humanities into curriculum. We therefore propose an incremental approach to shaping the medical culture that can easily be incorporated into daily teaching as opposed to designing additional classes and resources that must be added to existing educational structures. An example of this approach is reviewed here through teaching historical and ethical lessons surrounding Nazi eponyms. The use of names like Wegener provide brief opportunities for sidebars during clinical lectures to remind learners that empirical data do not provide ethical direction and that our medical history has included atrocities that remind us to practice conscientiously. We provide other examples that can be included in daily learning. This approach eschews the burdens associated with large curricular changes, such as student resistance/apathy and logistical barriers, and can be easily implemented. It also enables change to be gradual and through structures that have already been established, allowing learners to see the benefits of insights from the humanities in small, digestible segments. Through this approach, medical culture can be shaped towards a greater appreciation toward the medical humanities.