The Queen Square Encephalitis Multidisciplinary Team Meeting - experience over three years, pre and post the COVID-19 pandemic

Background: Patients with suspected encephalitis continue to represent a diagnostic and therapeutic challenge, even in highly resourced centres. In February 2018, we set up a monthly in-person multidisciplinary team meeting (MDT). We describe the experience and outcomes of the MDT over three years. Methods: A retrospective analysis was performed to summarise patient demographics, MDT outcomes and final diagnoses. Results: Over the three-year period, 324 discussions of 238 patients took place. Cases were diverse; approximately 40% related to COVID-19 or brain infection, 40% autoimmune or other inflammatory disorders and 20% encephalitis mimics or uncertain aetiologies. Feedback from an online survey sent to referring teams and attendees highlighted the value of the MDT; 94% reported the discussion was useful and 69% reported resulting change in patient management. Conclusions: Multidisciplinary input is crucial in this challenging area, ensuring that all diagnostic avenues are explored and opening doors to novel diagnostics and therapeutics. It also supports clinicians dealing with unwell patients, including in centres where less specialist input is available, and when decisions have to be made where there is little or no evidence base

Better Together: Reliable Application of the Post-9/11 and Post-Iraq US Intelligence Tradecraft Standards Requires Collective Analysis

Background: The events of 9/11 and the October 2002 National Intelligence Estimate on Iraq’s Continuing Programs for Weapons of Mass Destruction precipitated fundamental changes within the United States Intelligence Community. As part of the reform, analytic tradecraft standards were revised and codified into a policy document – Intelligence Community Directive (ICD) 203 – and an analytic ombudsman was appointed in the newly created Office for the Director of National Intelligence to ensure compliance across the intelligence community. In this paper we investigate the untested assumption that the ICD203 criteria can facilitate reliable evaluations of analytic products.Methods: Fifteen independent raters used a rubric based on the ICD203 criteria to assess the quality of reasoning of 64 analytical reports generated in response to hypothetical intelligence problems. We calculated the intra-class correlation coefficients for single and group-aggregated assessments.Results: Despite general training and rater calibration, the reliability of individual assessments was poor. However, aggregate ratings showed good to excellent reliability.Conclusion: Given that real problems will be more difficult and complex than our hypothetical case studies, we advise that groups of at least three raters are required to obtain reliable quality control procedures for intelligence products. Our study sets limits on assessment reliability and provides a basis for further evaluation of the predictive validity of intelligence reports generated in compliance with the tradecraft standards

The Next Generation Event Horizon Telescope Collaboration: History, Philosophy, and Culture

This white paper outlines the plans of the History Philosophy Culture Working Group of the Next Generation Event Horizon Telescope Collaboration.Comment: 23 pages, 1 figur

Predicting reliability through structured expert elicitation with the repliCATS (Collaborative Assessments for Trustworthy Science) process

As replications of individual studies are resource intensive, techniques for predicting the replicability are required. We introduce the repliCATS (Collaborative Assessments for Trustworthy Science) process, a new method for eliciting expert predictions about the replicability of research. This process is a structured expert elicitation approach based on a modified Delphi technique applied to the evaluation of research claims in social and behavioural sciences. The utility of processes to predict replicability is their capacity to test scientific claims without the costs of full replication. Experimental data supports the validity of this process, with a validation study producing a classification accuracy of 84% and an Area Under the Curve of 0.94, meeting or exceeding the accuracy of other techniques used to predict replicability. The repliCATS process provides other benefits. It is highly scalable, able to be deployed for both rapid assessment of small numbers of claims, and assessment of high volumes of claims over an extended period through an online elicitation platform, having been used to assess 3000 research claims over an 18 month period. It is available to be implemented in a range of ways and we describe one such implementation. An important advantage of the repliCATS process is that it collects qualitative data that has the potential to provide insight in understanding the limits of generalizability of scientific claims. The primary limitation of the repliCATS process is its reliance on human-derived predictions with consequent costs in terms of participant fatigue although careful design can minimise these costs. The repliCATS process has potential applications in alternative peer review and in the allocation of effort for replication studies

The Next Generation Event Horizon Telescope Collaboration: History, Philosophy, and Culture

This white paper outlines the plans of the History Philosophy Culture Working Group of the Next Generation Event Horizon Telescope Collaboration

Key Science Goals for the Next-Generation Event Horizon Telescope

The Event Horizon Telescope (EHT) has led to the first images of a supermassive black hole, revealing the central compact objects in the elliptical galaxy M87 and the Milky Way. Proposed upgrades to this array through the next-generation EHT (ngEHT) program would sharply improve the angular resolution, dynamic range, and temporal coverage of the existing EHT observations. These improvements will uniquely enable a wealth of transformative new discoveries related to black hole science, extending from event-horizon-scale studies of strong gravity to studies of explosive transients to the cosmological growth and influence of supermassive black holes. Here, we present the key science goals for the ngEHT and their associated instrument requirements, both of which have been formulated through a multi-year international effort involving hundreds of scientists worldwide

Big STEM collaborations should include humanities and social science

Correspondence in Nature Human Behaviou

Multiple sclerosis in the Republic of Moldova: a descriptive study of prevalence and evolution of clinical manifestations

Introduction. Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system, which can lead to standing disability in young adults. Investigation of MS epidemiology in the Republic of Moldova shows interest, taking into account the fact that the natural evolution of the disease is still not affected by use of the disease modifying drugs. Material and methods. The study included patients diagnosed with MS according to the McDonald criteria 2010, clinical and imagistic defined forms. Epidemiological sources were collected from records of family doctors from different regions of the country, neurologists form district, municipal and city hospitals, investigations archives of magnetic resonance imaging (MRI) of republican diagnostic centers, administrative records (centralized). Collection of cases included: questionnaire of patient assessment with inclusion of demographic and clinical data. Results. 747 MS patients were living in the study area, on the prevalence day, 31 December 2012. A crude prevalence was 21.0 per 100.000 inhabitants (95% CI: 14.8–27.1). From 724 prevalent cases, 460 (63.5%) were females with a mean age of 42.1±11.9 years and 264 (36.5%) were males, mean age of 40. 8±12.8 years. The highest estimates were observed in the age group 40-49, for women, 57.0 per 100.000 inhabitants and, for men, 29.0 per 100.000 inhabitants. The distribution of 721 prevalent cases by administrative areas in the Republic of Moldova was the following: Center – 32%, Chisinau – 13.9%, North – 33.8%, South – 11.1%, Transnistria – 2.1% and UTA Gagauzia – 7.1%. Conclusion. The estimated prevalence of multiple sclerosis in the Republic of Moldova was 21.0 per 100.000 inhabitants. This proved to be lower than in European countries. Also the patient’s neglect of the first appeared signs and symptoms lead to a late addressing to the neurologist doctor. On the other hand, when the patient addresses in time to a doctor, the reason why MS is not detected would be underestimating the diagnosis, which in some cases is established with delay and in the other cases it is not set at all

Prevalence of Multiple Sclerosis in the Republic of Moldova

BACKGROUND: The occurrence of multiple sclerosis (MS) increases in populations featuring both high and low disease burden, and variations across regions at the same latitude are reported. MS epidemiological data in Eastern Europe are scarce and out of date. We report on sex- and age-specific prevalence of MS in the Republic of Moldova. METHODS: Benefitting from a nationwide survey aimed to quantify the MS burden in Moldovans (3,559,541 population in 2012), multiple epidemiological sources were scrutinized. RESULTS: On prevalence day, December 31, 2012, 747 MS patients (McDonald criteria) resided in the study area, yielding a crude prevalence of 20.9 per 100,000 (95% CI 14.7-27.1), 25.7 (95% CI 20.5-30.5) in women and 15.8 (95% CI 12.2-19.3) in men (F:M ratio of 1.63), and standardized estimates of 20.2, 24.3 and 15.5 per 100,000, respectively. Prevalence was highest in the age group 40-49 years (43.9 per 100,000) and higher in rural (72.6%) than in urban (27.4%) areas. CONCLUSIONS: This is the first report on sex- and age-specific prevalence of MS in the Republic of Moldova, which was lower than in Europe on average, but consistent with that of neighboring countries, Romania and Ukraine. Moldovans represent a population wherein MS natural history is not yet influenced by use of disease-modifying drugs.Background: The occurrence of multiple sclerosis (MS) increases in populations featuring both high and low disease burden, and variations across regions at the same latitude are reported. MS epidemiological data in Eastern Europe are scarce and out of date. We report on sex- and age-specific prevalence of MS in the Republic of Moldova. Methods: Benefitting from a nationwide survey aimed to quantify the MS burden in Moldovans (3,559,541 population in 2012), multiple epidemiological sources were scrutinized. Results: On prevalence day, December 31, 2012, 747 MS patients (McDonald criteria) resided in the study area, yielding a crude prevalence of 20.9 per 100,000 (95% CI 14.7-27.1), 25.7 (95% CI 20.5-30.5) in women and 15.8 (95% CI 12.2-19.3) in men (F:M ratio of 1.63), and standardized estimates of 20.2, 24.3 and 15.5 per 100,000, respectively. Prevalence was highest in the age group 40-49 years (43.9 per 100,000) and higher in rural (72.6%) than in urban (27.4%) areas. Conclusions: This is the first report on sex- and age-specific prevalence of MS in the Republic of Moldova, which was lower than in Europe on average, but consistent with that of neighboring countries, Romania and Ukraine. Moldovans represent a population wherein MS natural history is not yet influenced by use of disease-modifying drugs. (C) 2016 S. Karger AG, Base