What "Evidence" in Evidence-Based Medicine?

The concept of evidence has gone unanalysed in much of the current debate between proponents and critics of evidence-based medicine. In this paper I will suggest that part of the controversy rests on an understanding of the word "evidence" that is too broad, and therefore contains the contradictions that allow both camps to defend their position and charge their adversaries. I will argue that reconciling the different meanings of the word 'evidence' in "evidence-based medicine" should help put EBM in its rightful place.Peer reviewe

Introduction : Evidence, Expertise and Argumentation in Evidence-Based Medicine

Non peer reviewe

The History of Gin and Tonic; the Infectious Disease Specialist Long Drink. When Gin and Tonic was not Ordered but Prescribed

Winston Churchill statement promoting Gin and Tonic as a life saver during British Empire extension hides many truths. As a matter of fact, the modern cocktail is thought to be born in India where it was widely dis-tributed by Royal Navy for its anti-malarial properties. The aim of the present work is to review and unveil the history of Gin and Tonic through the centuries. As a matter of facts, primitive Gin and Tonic protective effects were well understood by physicians far before the advent of the “germ theory” and its fortunate in-vention is one of the most fascinating approaches in the history of preventive medicine. Indeed, quinine, a compound with protective effects on the replicative cycle of Plasmodium spp was discovered in 18th Century and since 19th it become the main compound of tonic beverages such as Schweppe’s ones. Interestingly, it was administered to British expatriates’ seamen and soldiers in order to prevent febrile paroxysms. Soon after, British military doctors demonstrated that the addition of lime or lemon peels to tonics was effective in preventing scurvy. While, addition of alcoholic beverages and gin contributed to make more enjoyable the bitter and unpleasant taste of this beverages. Results: The spectacular voyage of Gin and Tonic teach-es us that a popular recreational drink of our Century was a powerful prophylaxis which certainly helped British colonial expansion

Efficacy and Tolerability of Fitostimoline in Two Different Forms (Soaked Gauzes and Cream) and Citrizan Gel in the Topical Treatment of Second-Degree Superficial Cutaneous Burns

A total of 227 patients (mean age 41.3 years, 52% females) with at least one second-degree superficial cutaneous burn of thermal origin of a smallest transverse diameter ≥20 mm and a largest transverse diameter ≤90 mm were randomised to receive the topical application of aqueous extract of Triticum vulgare (Fitostimoline) in two different forms (soaked gauzes and cream) or catalase of horse origin in form of gel (Citrizan Gel), given up to healing or to a maximum of 20 days. The rate of lesion healing at end of study was significantly higher in patients treated with Fitostimoline (gauzes 97.3%, cream 91.5%) than in those receiving catalase (84.5%). The pooled Fitostimoline groups were also significantly more effective than catalase gel in reducing total symptoms score, pain at medication, pain at rest, and burning at end of study. Both formulations of Fitostimoline and catalase gel were well tolerated in terms of adverse effects in the site of application

Meta-Analysis of cortical inhibitory interneurons markers landscape and their performances in scRNA-seq studies.

The mammalian cortex contains a great variety of neuronal cells. In particular, GABAergic interneurons, which play a major role in neuronal circuit function, exhibit an extraordinary diversity of cell types. In this regard, single-cell RNA-seq analysis is crucial to study cellular heterogeneity. To identify and analyze rare cell types, it is necessary to reliably label cells through known markers. In this way, all the related studies are dependent on the quality of the employed marker genes. Therefore, in this work, we investigate how a set of chosen inhibitory interneurons markers perform. The gene set consists of both immunohistochemistry-derived genes and single-cell RNA-seq taxonomy ones. We employed various human and mouse datasets of the brain cortex, consequently processed with the Monocle3 pipeline. We defined metrics based on the relations between unsupervised cluster results and the marker expression. Specifically, we calculated the specificity, the fraction of cells expressing, and some metrics derived from decision tree analysis like entropy gain and impurity reduction. The results highlighted the strong reliability of some markers but also the low quality of others. More interestingly, though, a correlation emerges between the general performances of the genes set and the experimental quality of the datasets. Therefore, the proposed method allows evaluating the quality of a dataset in relation to its reliability regarding the inhibitory interneurons cellular heterogeneity study

Earthquake‐induced landslide scenarios for seismic microzonation. Application to the Accumoli area (Rieti, Italy)

Scenarios of earthquake-induced landslides are necessary for seismic microzonation (SM) studies since they must be integrated with the mapping of instability areas. The PARSIFAL (Probabilistic Approach to pRovide Scenarios of earthquake‐Induced slope FAiLures) approach provides extensive analyses, over tens to thousands of square kilometers, and is designed as a fully comprehensive methodology to output expected scenarios which depend on seismic input and saturation conditions. This allows to attribute a rating, in terms of severity level, to the landslide-prone slope areas in view of future engineering studies and designs. PARSIFAL takes into account first-time rock- and earth-slides as well as re-activations of existing landslides performing slope stability analyses of different failure mechanisms. The results consist of mapping earthquake-induced landslide scenarios in terms of exceedance probability of critical threshold values of co-seismic displacements (P[D≥Dc|a(t),ay]). PARSIFAL was applied in the framework of level 3 SM studies over the municipality area of Accumoli (Rieti, Italy), strongly struck by the 2016 seismic sequence of Central Apennines. The use of the PARSIFAL was tested for the first time to screen the Susceptibility Zones (ZSFR) from the Attention Zones (ZAFR) in the category of the unstable areas, according to the guidelines by Italian Civil Protection. The results obtained were in a GIS-based mapping representing the possibility for a landslide to be induced by an earthquake (with a return period of 475 years) in three different saturation scenarios (i.e. dry, average, full). Only 41% of the landslide-prone areas in the Municipality of Accumoli are existing events, while the remaining 59% is characterized by first-time earth- or rock-slides. In dry conditions, unstable conditions or P[D≥Dc|a(t),ay]>0 were for 54% of existing landslides, 17% of first-time rock-slides and 1% of first-time earth- slides. In full saturation conditions, the findings are much more severe since unstable conditions or P[D≥Dc|a(t),ay]>0 were found for 58% of the existing landslides and for more than 80% of first-time rock- and earth-slides. Moreover, comparison of the total area of the ZAFR versus ZSFR, resulted in PARSIFAL screening reducing of 22% of the mapped ZAFR

Knowledge Brokers in Crisis : Public Communication of Science During the COVID-19 Pandemic

Knowledge brokers are among the main channels of communication between scientists and the public and a key element to establishing a relation of trust between the two. But translating knowledge from the scientific community to a wider audience presents several difficulties, which can be accentuated in times of crisis. In this paper we study some of the problems that knowledge brokers face when communicating in times of crisis. During the first wave of the COVID-19 pandemic, we collected interviews with Italian experts that played a major role as knowledge brokers in the local media. We asked them questions about five main topics: the features and role of science communicators; the use of language in communicating science; the importance of the relation of trust with the public; the peculiarity of communicating in a context of emergency; the problem of disagreement among experts, and its public perception and communication. The goal of this paper is to understand, through the words of knowledge brokers themselves, what they consider as best practices (and obstacles) to create trust between scientists and the public. Our empirical work can inform normative accounts of what knowledge brokering should be about.Peer reviewe