An appropriate verbal probability lexicon for communicating surgical risks is unlikely to exist

Effective risk communication about medical procedures is critical to ethical shared decision-making. Here, we explore the potential for development of an evidence-based lexicon for verbal communication of surgical risk. We found that Ear, Nose and Throat (ENT) surgeons expressed a preference for communicating such risks using verbal probability expressions (VPEs; e.g., “high risk”). However, there was considerable heterogeneity in the expressions they reported using (Study 1). Study 2 compared ENT surgeons’ and laypeople’s (i.e., potential patients) interpretations of the ten most frequent VPEs listed in Study 1. While both groups displayed considerable variability in interpretations, lay participants demonstrated more, as well as providing systematically higher interpretations than those of surgeons. Study 3 found that lay participants were typically unable to provide unique VPEs to differentiate between the ranges of (low) probabilities required. Taken together, these results add to arguments that reliance on VPEs for surgical risk communication is ill-advised. Not only are there systematic interpretational differences between surgeons and potential patients, but the coarse granularity of VPEs raises severe challenges for developing an appropriate evidence-based lexicon for surgical risk communication. We caution against the use of VPEs in any risk context characterized by low, but very different, probabilities. (PsycInfo Database Record (c) 2022 APA, all rights reserved

From Vicious Walkers to TASEP

We propose a model of semi-vicious walkers, which interpolates between the totally asymmetric simple exclusion process and the vicious walkers model, having the two as limiting cases. For this model we calculate the asymptotics of the survival probability for $m$ particles and obtain a scaling function, which describes the transition from one limiting case to another. Then, we use a fluctuation-dissipation relation allowing us to reinterpret the result as the particle current generating function in the totally asymmetric simple exclusion process. Thus we obtain the particle current distribution asymptotically in the large time limit as the number of particles is fixed. The results apply to the large deviation scale as well as to the diffusive scale. In the latter we obtain a new universal distribution, which has a skew non-Gaussian form. For $m$ particles its asymptotic behavior is shown to be $e^{-\frac{y^{2}}{2m^{2}}}$ as $y\to -\infty$ and $e^{-\frac{y^{2}}{2m}}y^{-\frac{m(m-1)}{2}}$ as $y\to \infty$.Comment: 37 pages, 4 figures, Corrected reference

The role of negative emotions in the social processes of entrepreneurship: Power rituals and shame-related appeasement behaviors

This paper examines the role of negative emotions in the social processes of entrepreneurship. Drawing on a study of Russian entrepreneurs, we develop a model of the emotional effects of social interactions between entrepreneurs and state officials. We found that negative emotions were elicited by these interactions and, in turn, fueled three forms of shame-related corrective appeasement behavior (reactive, anticipatory, and sporadic), which served to corrode entrepreneurial motivation and direct attention and energy away from business growth and development

Origins of the Ambient Solar Wind: Implications for Space Weather

The Sun's outer atmosphere is heated to temperatures of millions of degrees, and solar plasma flows out into interplanetary space at supersonic speeds. This paper reviews our current understanding of these interrelated problems: coronal heating and the acceleration of the ambient solar wind. We also discuss where the community stands in its ability to forecast how variations in the solar wind (i.e., fast and slow wind streams) impact the Earth. Although the last few decades have seen significant progress in observations and modeling, we still do not have a complete understanding of the relevant physical processes, nor do we have a quantitatively precise census of which coronal structures contribute to specific types of solar wind. Fast streams are known to be connected to the central regions of large coronal holes. Slow streams, however, appear to come from a wide range of sources, including streamers, pseudostreamers, coronal loops, active regions, and coronal hole boundaries. Complicating our understanding even more is the fact that processes such as turbulence, stream-stream interactions, and Coulomb collisions can make it difficult to unambiguously map a parcel measured at 1 AU back down to its coronal source. We also review recent progress -- in theoretical modeling, observational data analysis, and forecasting techniques that sit at the interface between data and theory -- that gives us hope that the above problems are indeed solvable.Comment: Accepted for publication in Space Science Reviews. Special issue connected with a 2016 ISSI workshop on "The Scientific Foundations of Space Weather." 44 pages, 9 figure

Incretin-based therapy: a powerful and promising weapon in the treatment of type 2 diabetes mellitus

Type 2 diabetes mellitus (T2DM) is a progressive multisystemic disease that increases significantly cardiovascular morbidity and mortality. It is associated with obesity, insulin resistance, beta-cell dysfunction, and hyperglucagonemia, the combination of which typically leads to hyperglycemia. Incretin-based treatment modalities, and in particular glucagon-like peptide 1 (GLP-1) receptor agonists, are able to successfully counteract several of the underlying pathophysiological abnormalities of T2DM. The pancreatic effects of GLP-1 receptor agonists include glucose-lowering effects by stimulating insulin secretion and inhibiting glucagon release in a strictly glucose-dependent manner, increased beta-cell proliferation, and decreased beta-cell apoptosis. GLP-1 receptors are widely expressed throughout human body; thus, GLP-1-based therapies exert pleiotropic and multisystemic effects that extend far beyond pancreatic islets. A large body of experimental and clinical data have suggested a considerable protective role of GLP-1 analogs in the cardiovascular system (decreased blood pressure, improved endothelial and myocardial function, functional recovery of failing and ischemic heart, arterial vasodilatation), kidneys (increased diuresis and natriuresis), gastrointestinal tract (delayed gastric emptying, reduced gastric acid secretion), and central nervous system (appetite suppression, neuroprotective properties). The pharmacologic use of GLP-1 receptor agonists has been shown to reduce bodyweight and systolic blood pressure, and significantly improve glycemic control and lipid profile. Interestingly, weight reduction induced by GLP-1 analogs reflects mainly loss of abdominal visceral fat. The critical issue of whether the emerging positive cardiometabolic effects of GLP-1 analogs can be translated into better clinical outcomes for diabetic patients in terms of long-term hard endpoints, such as cardiovascular morbidity and mortality, remains to be elucidated with prospective, large-scale clinical trials

Chemokine CXCL4 interactions with extracellular matrix proteoglycans mediate widespread immune cell recruitment independent of chemokine receptors

Leukocyte recruitment from the vasculature into tissues is a crucial component of the immune system but is also key to inflammatory disease. Chemokines are central to this process but have yet to be therapeutically targeted during inflammation due to a lack of mechanistic understanding. Specifically, CXCL4 (Platelet Factor 4, PF4) has no established receptor that explains its function. Here, we use biophysical, in vitro, and in vivo techniques to determine the mechanism underlying CXCL4-mediated leukocyte recruitment. We demonstrate that CXCL4 binds to glycosaminoglycan (GAG) sugars on proteoglycans within the endothelial extracellular matrix, resulting in increased adhesion of leukocytes to the vasculature, increased vascular permeability, and non-specific recruitment of a range of leukocytes. Furthermore, GAG sulfation confers selectivity onto chemokine localization. These findings present mechanistic insights into chemokine biology and provide future therapeutic targets

Do maize crop models catch the impact of future [CO2] on maize yield and water use?

Do maize crop models catch the impact of future [CO2] on maize yield and water use?. iCROPM2016 International Crop Modelling Symposiu