Maintaining credibility when communicating uncertainty: The role of communication format

Research into risk communication has commonly highlighted the disparity between the meaning intended by the communicator and what is understood by the recipient. Such miscommunications will have implications for perceived trust and expertise of the communicator, but it is not known whether this differs according to the communication format. We examined the effect of using verbal, numerical and mixed communication formats on perceptions of credibility and correctness, as well as whether they influenced a decision to evacuate, both before and after an ‘erroneous’ prediction (i.e. an ‘unlikely’ event occurs, or a ‘likely’ event does not occur). We observed no effect of communication format on any of the measures pre-outcome, but found the numerical format was perceived as less incorrect, as well as more credible than the other formats after an ‘erroneous’ prediction, but only when low probability expressions were used. Our findings suggest numbers should be used in consequential risk communications

'Unlikely' outcomes might never occur, but what about 'unlikely (20% chance)' outcomes?

A commonly suggested solution to reduce misinterpretations of verbal probability expressions in risk communications is to use a verbal-numerical (mixed format) approach, but it is not known whether this increases understanding over and above a purely numerical format. Using the ‘which outcome’ methodology (Teigen & Filkuková, 2013), we examined the effect of using verbal, numerical and mixed communication formats, as well as investigating whether marking outcomes as salient would alter the outcomes people perceived as ‘unlikely’ or having a 20% chance of occurring. We observed no effect of saliency, but replicated previous findings, with general preference for values at the high end of a distribution (including maximum/above maximum values) present in both verbal and mixed communication formats. This demonstrates the relevance of these findings for real-world consequential risk communication. Whilst the estimates differed between the mixed and numerical formats, we fo

A preferential loss of GABAergic, symmetric synapses in epileptic foci: a quantitative ultrastructural analysis of monkey neocortex.

Previous immunocytochemical results from five monkeys with cortical focal epilepsy produced by alumina gel showed a severe decrease at seizure foci of axon terminals that contained glutamic acid decarboxylase (GAD), the synthesizing enzyme for the inhibitory neurotransmitter, GABA. These data indicated a functional loss of GABAergic terminals but did not show: whether this loss was caused by GABAergic nerve terminal degeneration or by a lack of GAD immunoreactivity within these terminals and if this loss of GABAergic terminals was selective for only this terminal type. To resolve these issues, cortical tissue from three of the five monkeys used in the previous study was reexamined using electron microscopy, and a quantitative morphological analysis of cortical structures was made to compare profiles of terminals and glia in the nonepileptic cortex with those in the focus and parafocus. The following statistically significant changes were observed: the number of axosomatic symmetric synapses with layer V pyramidal cells was decreased 80% at the focus and 50% at the parafocus; in the neuropil adjacent to these pyramidal somata, the number of terminals forming symmetric synapses was reduced 50% at the epileptic focus but was unchanged at the parafocus, while the number of asymmetric synapses was reduced 25% at the focus and 15% at the parafocus; and a 50% increase of glial profiles occurred at epileptic foci both in the neuropil and at sites apposed to pyramidal cell somata. The quantitative results also showed that terminals which form symmetric synapses had twice the number of mitochondria per terminal as those that form asymmetric synapses. Axon terminals which form symmetric synapses with somata and dendrites in the neocortex have been shown previously to contain GAD. Therefore, the large reduction in the number of symmetric synapses at epileptic foci and the increased gliosis indicate that the previously observed loss of GABAergic terminals at sites of focal epilepsy is caused by terminal degeneration. Since such terminals are reduced more severely at epileptic foci than other terminals, their loss could be the basis for seizure activity due to a preferential decrease of inhibitory function at epileptic foci. Hypoxia has been shown to cause a selective degeneration of terminals with the same morphology as GABAergic terminals in the cortex, and the basis for this loss could be related to higher physiological and/or metabolic activities of GABAergic cortical cells which may inhibit other cells tonically. The fact that increased numbers of mitochondria occur in GABAergic terminals supports this idea

Association between glucocorticoid therapy and incidence of diabetes mellitus in polymyalgia rheumatica and giant cell arteritis: a systematic review and meta-analysis

Background: Polymyalgia rheumatica (PMR) and giant cell arteritis (GCA) are almost always treated with glucocorticoids (GCs), but long-term GC use is associated with diabetes mellitus (DM). The absolute incidence of this complication in this patient group remains unclear. Objective: To quantify the absolute risk of GC-induced DM in PMR and GCA from published literature. Methods: We identified literature from inception to February 2017 reporting diabetes following exposure to oral GC in patients with PMR and/or GCA without pre-existing diabetes. A random-effects meta-analysis was performed to summarise the findings. Results: 25 eligible publications were identified. In studies of patients with GCA, mean cumulative GC dose was almost 1.5 times higher than in studies of PMR (8.2 g vs 5.6 g), with slightly longer treatment duration and longer duration of follow-up (6.4 years vs 4.4 years). The incidence proportion (cumulative incidence) of patients who developed new-onset DM was 6% (95% CI 3% to 9%) for PMR and 13% (95% CI 9% to 17%) for GCA. Based on UK data on incidence rate of DM in the general population, the expected background incidence rate of DM over 4.4 years in patients with PMR and 6.4 years in patients with GCA (follow-up duration) would be 4.8% and 7.0%, respectively. Heterogeneity between studies was high (I2=79.1%), as there were differences in study designs, patient population, geographical locations and treatment. Little information on predictors of DM was found. Conclusion: Our meta-analysis produced plausible estimates of DM incidence in patients with PMR and GCA, but there is insufficient published data to allow precise quantification of DM risk

Using the local density approximation and the LYP, BLYP, and B3LYP functionals within Reference--State One--Particle Density--Matrix Theory

For closed-shell systems, the local density approximation (LDA) and the LYP, BLYP, and B3LYP functionals are shown to be compatible with reference-state one-particle density-matrix theory, where this recently introduced formalism is based on Brueckner-orbital theory and an energy functional that includes exact exchange and a non-universal correlation-energy functional. The method is demonstrated to reduce to a density functional theory when the exchange-correlation energy-functional has a simplified form, i.e., its integrand contains only the coordinates of two electron, say r1 and r2, and it has a Dirac delta function -- delta(r1 - r2) -- as a factor. Since Brueckner and Hartree--Fock orbitals are often very similar, any local exchange functional that works well with Hartree--Fock theory is a reasonable approximation with reference-state one-particle density-matrix theory. The LDA approximation is also a reasonable approximation. However, the Colle--Salvetti correlation-energy functional, and the LYP variant, are not ideal for the method, since these are universal functionals. Nevertheless, they appear to provide reasonable approximations. The B3LYP functional is derived using a linear combination of two functionals: One is the BLYP functional; the other uses exact exchange and a correlation-energy functional from the LDA.Comment: 26 Pages, 0 figures, RevTeX 4, Submitted to Mol. Phy

Discordant bioinformatic predictions of antimicrobial resistance from whole-genome sequencing data of bacterial isolates: an inter-laboratory study.

Antimicrobial resistance (AMR) poses a threat to public health. Clinical microbiology laboratories typically rely on culturing bacteria for antimicrobial-susceptibility testing (AST). As the implementation costs and technical barriers fall, whole-genome sequencing (WGS) has emerged as a 'one-stop' test for epidemiological and predictive AST results. Few published comparisons exist for the myriad analytical pipelines used for predicting AMR. To address this, we performed an inter-laboratory study providing sets of participating researchers with identical short-read WGS data from clinical isolates, allowing us to assess the reproducibility of the bioinformatic prediction of AMR between participants, and identify problem cases and factors that lead to discordant results. We produced ten WGS datasets of varying quality from cultured carbapenem-resistant organisms obtained from clinical samples sequenced on either an Illumina NextSeq or HiSeq instrument. Nine participating teams ('participants') were provided these sequence data without any other contextual information. Each participant used their choice of pipeline to determine the species, the presence of resistance-associated genes, and to predict susceptibility or resistance to amikacin, gentamicin, ciprofloxacin and cefotaxime. We found participants predicted different numbers of AMR-associated genes and different gene variants from the same clinical samples. The quality of the sequence data, choice of bioinformatic pipeline and interpretation of the results all contributed to discordance between participants. Although much of the inaccurate gene variant annotation did not affect genotypic resistance predictions, we observed low specificity when compared to phenotypic AST results, but this improved in samples with higher read depths. Had the results been used to predict AST and guide treatment, a different antibiotic would have been recommended for each isolate by at least one participant. These challenges, at the final analytical stage of using WGS to predict AMR, suggest the need for refinements when using this technology in clinical settings. Comprehensive public resistance sequence databases, full recommendations on sequence data quality and standardization in the comparisons between genotype and resistance phenotypes will all play a fundamental role in the successful implementation of AST prediction using WGS in clinical microbiology laboratories

Towards an Accurate Identification of Pyloric Neuron Activity with VSDi

Voltage-sensitive dye imaging (VSDi) which enables simultaneous optical recording of many neurons in the pyloric circuit of the stomatogastric ganglion is an important technique to supplement electrophysiological recordings. However, utilising the technique to identify pyloric neurons directly is a computationally exacting task that requires the development of sophisticated signal processing procedures to analyse the tri-phasic pyloric patterns generated by these neurons. This paper presents our work towards commissioning such procedures. The results achieved to date are most encouraging

Do you see what I see? Identification of child protection concerns by hospital staff and general dental practitioners

Aim An exploration of the threshold that dentists, doctors and nurses recognise for dental and child protection (CP) actions in sample clinical cases, and any differences between these professional groups. Method We present a cross-sectional survey of dentists, doctors and nurses (50 each), who regularly examine children, utilised five fictitious vignettes, combining an oral examination image and clinical history reflecting dental and CP issues. Demographics were collected, and each participant gave their likely action for the cases presented. Results Dentists were significantly better at answering the dental element than the doctors and nurses, (P <0.0001) with no significant difference between these two; only 8% of the latter had undergone any training in assessment of dental health. Although 90.6% of all professionals had undergone CP training, dentists were significantly less accurate at identifying the CP component than doctors and nurses, (P <0.0001) between whom there were no significant differences. Those with higher levels of CP training were most accurate at identifying correct CP actions. Conclusions CP training is effective at improving recognition of child maltreatment, although there remains a worrying lack of knowledge about thresholds for action among dentists. Doctors and nurses have minimal training in, or knowledge of, dental health in children, thus precluding appropriate onward referrals