The Importance of Distrust in AI

In recent years the use of Artificial Intelligence (AI) has become increasingly prevalent in a growing number of fields. As AI systems are being adopted in more high-stakes areas such as medicine and finance, ensuring that they are trustworthy is of increasing importance. A concern that is prominently addressed by the development and application of explainability methods, which are purported to increase trust from its users and wider society. While an increase in trust may be desirable, an analysis of literature from different research fields shows that an exclusive focus on increasing trust may not be warranted. Something which is well exemplified by the recent development in AI chatbots, which while highly coherent tend to make up facts. In this contribution, we investigate the concepts of trust, trustworthiness, and user reliance. In order to foster appropriate reliance on AI we need to prevent both disuse of these systems as well as overtrust. From our analysis of research on interpersonal trust, trust in automation, and trust in (X)AI, we identify the potential merit of the distinction between trust and distrust (in AI). We propose that alongside trust a healthy amount of distrust is of additional value for mitigating disuse and overtrust. We argue that by considering and evaluating both trust and distrust, we can ensure that users can rely appropriately on trustworthy AI, which can both be useful as well as fallible.Comment: This preprint has not undergone peer review or any post-submission improvements or corrections. The version of records of this contribution is published in Explainable Artificial Intelligence First World Conference, xAI 2023, Lisbon, Portugal, July 26-28, 2023, Proceedings, Part III (CCIS, volume 1903) and is available at https://doi.org/10.1007/978-3-031-44070-

Continuous Spikes and Waves during Sleep: Electroclinical Presentation and Suggestions for Management

Continuous spikes and waves during sleep (CSWS) is an epileptic encephalopathy characterized in most patients by (1) difficult to control seizures, (2) interictal epileptiform activity that becomes prominent during sleep leading to an electroencephalogram (EEG) pattern of electrical status epilepticus in sleep (ESES), and (3) neurocognitive regression. In this paper, we will summarize current epidemiological, clinical, and EEG knowledge on CSWS and will provide suggestions for treatment. CSWS typically presents with seizures around 2–4 years of age. Neurocognitive regression occurs around 5-6 years of age, and it is accompanied by subacute worsening of EEG abnormalities and seizures. At approximately 6–9 years of age, there is a gradual resolution of seizures and EEG abnormalities, but the neurocognitive deficits persist in most patients. The cause of CSWS is unknown, but early developmental lesions play a major role in approximately half of the patients, and genetic associations have recently been described. High-dose benzodiazepines and corticosteroids have been successfully used to treat clinical and electroencephalographic features. Corticosteroids are often reserved for refractory disease because of adverse events. Valproate, ethosuximide, levetiracetam, sulthiame, and lamotrigine have been also used with some success. Epilepsy surgery may be considered in a few selected patients

Primary care practice-based care management for chronically ill patients (PraCMan): study protocol for a cluster randomized controlled trial [ISRCTN56104508]

Background: Care management programmes are an effective approach to care for high risk patients with complex care needs resulting from multiple co-occurring medical and non-medical conditions. These patients are likely to be hospitalized for a potentially "avoidable" cause. Nurse-led care management programmes for high risk elderly patients showed promising results. Care management programmes based on health care assistants (HCAs) targeting adult patients with a high risk of hospitalisation may be an innovative approach to deliver cost-efficient intensified care to patients most in need. Methods: PraCMan is a cluster randomized controlled trial with primary care practices as unit of randomisation. The study evaluates a complex primary care practice-based care management of patients at high risk for future hospitalizations. Eligible patients either suffer from type 2 diabetes mellitus, chronic obstructive pulmonary disease, chronic heart failure or any combination. Patients with a high likelihood of hospitalization within the following 12 months (based on insurance data) will be included in the trial. During 12 months of intervention patients of the care management group receive comprehensive assessment of medical and non-medical needs and resources as well as regular structured monitoring of symptoms. Assessment and monitoring will be performed by trained HCAs from the participating practices. Additionally, patients will receive written information, symptom diaries, action plans and a medication plan to improve self-management capabilities. This intervention is addition to usual care. Patients from the control group receive usual care. Primary outcome is the number of all-cause hospitalizations at 12 months follow-up, assessed by insurance claims data. Secondary outcomes are health-related quality of life (SF12, EQ5D), quality of chronic illness care (PACIC), health care utilisation and costs, medication adherence (MARS), depression status and severity (PHQ-9), self-management capabilities and clinical parameters. Data collection will be performed at baseline, 12 and 24 months (12 months post-intervention). Discussion: Practice-based care management for high risk individuals involving trained HCAs appears to be a promising approach to face the needs of an aging population with increasing care demands. Trial registration: Current Controlled Trials ISRCTN5610450

Facilitation of oral sensitivity by electrical stimulation of the faucial pillars

Dysphagia is common in neurological disease. However, our understanding of swallowing and its central nervous control is limited. Sensory information plays a vital role in the initiation of the swallowing reflex and is often reduced in stroke patients. We hypothesized that the sensitivity threshold of the anterior faucial pillar could be facilitated by either electrical stimulation (ES) or taste and smell information. The sensitivity threshold was measured by ES in the anterior faucial pillar region. The measurement was repeated 5 min after baseline. Thirty minutes after baseline, the participants underwent a test for taste and smell. Immediately after the test, the ES was repeated. Thirty healthy volunteers with a mean age of 275.1 participated in the trial. Mean sensitivity threshold at baseline was 1.9 +/- 0.59 mA. The values 5 min after baseline (1.74 +/- 0.56 mA, p=0.027) and 30 min after baseline (1.67 +/- 0.58 mA, p=0.011) were significantly lower compared to the baseline, but there was no difference between the latter (p=0.321). After 5 min, a potentially facilitating effect was found on oral sensitivity by ES of the faucial pillar area. Thirty minutes later, this effect was still present. Trial registration Clinicaltrials.gov, NCT03240965. Registered 7th August 2017-https://clinicaltrials.gov/ct2/show/NCT03240965

Human Lin28 forms a high-affinity 1:1 complex with the 106~363 cluster miRNA miR-363

Lin28A is a post-transcriptional regulator of gene expression that interacts with and negatively regulates the biogenesis of let-7 family miRNAs. Recent data suggested that Lin28A also binds the putative tumour suppressor miR-363, a member of the 106~363 cluster of miRNAs. Affinity toward this miRNA and the stoichiometry of the protein-RNA complex are unknown. Characterisation of human Lin28's interaction with RNA has been complicated by difficulties in producing stable RNA-free protein. We have engineered a maltose binding protein fusion with Lin28, which binds let-7 miRNA with a Kd of 54.1 ± 4.2 nM, in agreement with previous data on a murine homologue. We show that human Lin28A binds miR-363 with 1:1 stoichiometry and with similar, if not higher, affinity (Kd = 16.6 ± 1.9 nM). Further analysis suggests that the interaction of the N-terminal cold shock domain of Lin28A with RNA is salt-dependent, supporting a model where the cold shock domain allows the protein to sample RNA substrates through transient electrostatic interactions

Age-Related Attenuation of Dominant Hand Superiority

The decline of motor performance of the human hand-arm system with age is well-documented. While dominant hand performance is superior to that of the non-dominant hand in young individuals, little is known of possible age-related changes in hand dominance. We investigated age-related alterations of hand dominance in 20 to 90 year old subjects. All subjects were unambiguously right-handed according to the Edinburgh Handedness Inventory. In Experiment 1, motor performance for aiming, postural tremor, precision of arm-hand movement, speed of arm-hand movement, and wrist-finger speed tasks were tested. In Experiment 2, accelerometer-sensors were used to obtain objective records of hand use in everyday activities

The metaRbolomics Toolbox in Bioconductor and beyond

Metabolomics aims to measure and characterise the complex composition of metabolites in a biological system. Metabolomics studies involve sophisticated analytical techniques such as mass spectrometry and nuclear magnetic resonance spectroscopy, and generate large amounts of high-dimensional and complex experimental data. Open source processing and analysis tools are of major interest in light of innovative, open and reproducible science. The scientific community has developed a wide range of open source software, providing freely available advanced processing and analysis approaches. The programming and statistics environment R has emerged as one of the most popular environments to process and analyse Metabolomics datasets. A major benefit of such an environment is the possibility of connecting different tools into more complex workflows. Combining reusable data processing R scripts with the experimental data thus allows for open, reproducible research. This review provides an extensive overview of existing packages in R for different steps in a typical computational metabolomics workflow, including data processing, biostatistics, metabolite annotation and identification, and biochemical network and pathway analysis. Multifunctional workflows, possible user interfaces and integration into workflow management systems are also reviewed. In total, this review summarises more than two hundred metabolomics specific packages primarily available on CRAN, Bioconductor and GitHub

Executive Agencies, Ministers, and Departments: Can Policy and Management Ever be Separated?

The creation of executive agencies outside core departments has been a major element of administrative reforms throughout Europe during the past two decades, driven by a managerial logic, which also has been at the core of most academic works on "agencification." In this article, the authors take a different perspective by focusing on executive agencies' influence in the policy process. The authors analyze the policy influence of a large executive agency with service delivery tasks in the context of a parliamentary system of government (Flanders, Belgium). A comparison of the agency's influence in two major policy processes shows that a complex interplay of policy content, patterns of interaction, and mutual trust with the political leadership and organizational characteristics helps in explaining the observed patterns of influence. The findings also raise normative concerns regarding potential problems of disconnecting operations from policy formulation via agencification. © 2012 SAGE Publications

Genome-wide association meta-analysis for early age-related macular degeneration highlights novel loci and insights for advanced disease

Peer reviewedPublisher PD

Temperature extremes of 2022 reduced carbon uptake by forests in Europe

The year 2022 saw record breaking temperatures in Europe during both summer and fall. Similar to the recent 2018 drought, close to 30% (3.0 million km2) of the European continent was under severe summer drought. In 2022, the drought was located in central and southeastern Europe, contrasting the Northern-centered 2018 drought. We show, using multiple sets of observations, a reduction of net biospheric carbon uptake in summer (56-62 TgC) over the drought area. Specific sites in France even showed a widespread summertime carbon release by forests, additional to wildfires. Partial compensation (32%) for the decreased carbon uptake due to drought was offered by a warm autumn with prolonged biospheric carbon uptake. The severity of this second drought event in 5 years suggests drought-induced reduced carbon uptake to no longer be exceptional, and important to factor into Europe’s developing plans for net-zero greenhouse gas emissions that rely on carbon uptake by forests