Simultaneous quantification and confirmation of oxycodone and its metabolites in equine urine using ultra-high performance liquid chromatography-tandem mass spectrometry

Oxycodone, an opioid commonly used to treat pain in humans, has the potential to be abused in racehorses to enhance their performance. To understand the pharmacokinetics of oxycodone and its metabolites in horses, as well as to detect the illegal use of oxycodone in racehorses, a method for quantification and confirmation of oxycodone and its metabolites is needed. In this study, we developed and validated an ultra-high performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS) method that can simultaneously quantify and confirm oxycodone and eight metabolites in equine urine. Samples were subjected to enzymatic hydrolysis and then liquid-liquid extraction using ethyl acetate. The analyte separation was achieved on a Hypersil Gold C18 sub-2 µm column and analytes were detected on a triple quadrupole mass spectrometer. The limit of detection (LOD) and lower limit of quantification (LLOQ) were 25-50 pg/mL and 100 pg/mL, respectively. Excellent linearity of the calibration curves was observed over a range of 100-10000 pg/mL for all nine analytes. Retention time, signal-to-noise ratio, and product ion ratios were utilized as confirmation criteria, with the limits of confirmation (LOC) ranging from 100 to 250 pg/mL. The data from a pilot pharmacokinetic (PK) study suggested that oxycodone metabolites have longer detection periods in equine urine compared to oxycodone itself; thus, the detection of metabolites in equine urine extends the ability to detect oxycodone exposure in racehorses.

Predictivism and avoidance of ad hoc-ness: An empirical study

Predictivism is the thesis that evidence successfully predicted by a scientific theory counts more (or ought to count more) in the confirmation of that theory than already known evidence would. One rationale that has been proposed for predictivism is that predictive success guards against ad hoc hypotheses. Despite the intuitive attraction of predictivism, there is historical evidence that speaks against it. As valuable as the historical evidence may be, however, it is largely indirect evidence for the epistemic attitudes of individual - albeit prominent - scientists. This paper presents the results of an empirical study of scientists' attitudes toward predictivism and ad hoc-ness (n = 492), which will put the debate on a more robust empirical footing. The paper also draws attention to a tension between the ad hoc-ness avoidance rationale of predictivism and the ways philosophers have spelled out the notion of ad hoc-ness.

Painful bruising: Gynecology, hematology, or just pill bias? A case report

A 23-year-old woman, G0, presented to the emergency department with painful bruising of the legs shortly after starting an oral contraceptive pill. The presumed diagnosis was pill-induced ecchymosis, and she was instructed to discontinue the medication. Her bruising resolved. However, the working diagnosis was later questioned as the patient had used other oral contraceptive pills in the past without any adverse reaction. In addition, there is robust literature associating these medications with thrombosis, not bruising. The patient later disclosed that she had concomitantly started an oral hair supplement along with her oral contraceptive pill. Analysis of the supplement contents revealed that it contained extract of Aesculus hippocastanum, a herbal anticoagulant, making this a much more plausible explanation for the ecchymosis. She then resumed the original oral contraceptive pill alone without any reaction. The case highlights how cognitive bias resulted in a misdiagnosis. Specifically, this case introduces the concept of pill bias, as the patient's unexplained bruising was presumed to be a result of her use of an oral contraceptive despite the lack of evidence to support this claim. This bias has the potential to impact clinical decision-making and lead to clinical errors.

How good is an explanation?

How good is an explanation and when is one explanation better than another? In this paper, I address these questions by exploring probabilistic measures of explanatory power in order to defend a particular Bayesian account of explanatory goodness. Critical to this discussion is a distinction between weak and strong measures of explanatory power due to Good (Br J Philos Sci 19:123-143, 1968). In particular, I argue that if one is interested in the overall goodness of an explanation, an appropriate balance needs to be struck between the weak explanatory power and the complexity of a hypothesis. In light of this, I provide a new defence of a strong measure proposed by Good by providing new derivations of it, comparing it with other measures and exploring its connection with information, confirmation and explanatory virtues. Furthermore, Good really presented a family of strong measures, whereas I draw on a complexity criterion that favours a specific measure and hence provides a more precise way to quantify explanatory goodness.

Detoxification of Meghalayan cherry (Prunus nepalensis) kernel and its effect on structural and thermal properties of proteins

Valorizing food wastes and by-products can improve economic and environmental sustainability of the food production chain. In this regard, Meghalayan cherry kernels are a good source of proteins, but the presence of toxic compounds like amygdalin, makes them underutilized. Therefore, the present study was focused on detoxifying Meghalayan cherry kernel using thermal, soaking and ultrasound treatments and studying their impact on the structural and thermal characteristics of protein isolate. The results showed that all three treatments significantly reduced amygdalin content, with complete detoxification achieved after 30 and 60 min at 70 °C and 60 °C, respectively, in ultrasound, and after 90 and 120 min at 70 °C and 60 °C, respectively, in soaking + thermal treatment. The detoxification treatments significantly affected the protein content and weight-loss of Meghalayan cherry kernel. Fluorescence spectroscopy and FTIR showed alterations in Meghalayan cherry kernel protein isolate (MCKPI) secondary and tertiary structure. The fluorescence intensity was observed at 340 nm for native and detoxified protein isolate, and the lowest peak for MCKPI-US depicts conformational changes. The fading of bands in SDS-PAGE confirms structural changes due to thermal and sonication effects. SEM images demonstrated that more cracks and porous structures were seen in treated MCKPI than native MCKPI. Detoxification treatment increased thermal stability, resulting in lesser weight loss and higher denaturation temperature than native MCKPI. In this study, ultrasound treatment demonstrated the most pronounced effects on the detoxification of MCKPI and its thermal and structural properties, suggesting that Meghalayan cherry kernel is one of the most promising substrates for zero-waste bioprocess development.

Students' continuance intention to use MOOCs: empirical evidence from India

In recent years, there has been an increasing interest in understanding the Massive open online courses (MOOCs) due to its gaining popularity. Even though the number of online platforms and programs has grown during the COVID-19 pandemic, there is still a high rate of dropout and non-completion. In this work, the expectation-confirmation model is combined with MOOC features such as perceived openness, perceived reputation, and other factors i.e., perceived enjoyment, and perceived computer self-efficacy to investigate the learner's continued intention to use MOOC. A survey was undertaken and the data was collected from 383 students pursuing their degrees (undergraduate and post-graduate) in Karnataka state, India. The collected data were analyzed with structural equation modelling in Smart PLS 3. The study confirms a significant influence of confirmation and perceived usefulness on satisfaction, and direct significant influence of perceived computer self-efficacy, satisfaction, and perceived usefulness on continuance intention. Also, the results demonstrated the significant influence of confirmation on perceived enjoyment and usefulness and the effect of computer self-efficacy on usefulness. The findings in this study indicate that the MOOC platforms should focus on confirming learner expectations and the usefulness of courses to ensure student satisfaction and continuance of courses.

Charles Darwin as a statistical thinker

Recently historians and philosophers of science have been interested in the role of statistics and probability in investigating population variation. The focus is typically on investigators applying statistics and probability to explain large scale phenomenon that arise out of the collective behavior of numerous and varied individuals. The case studies that inform this work come mostly from molecular physics and 20th century genetical versions of evolutionary theory. Charles Darwin's work on evolution is rarely mentioned in this context except to point out his shortcomings-he made evolutionary theory "ripe" for statistical investigations, but he was not a statistical thinker. But this is a mistake, Darwin was a statistical thinker. In this essay I describe two instances where Darwin utilized statistical methods to investigate evolution. In the light of these cases, we ought to revise our views about Darwin's scientific methodology, in particular, how he came to develop his ideas about evolution and about the nature of his "population thinking". Furthermore, Darwin's cases provide us with an expanded view about what constitutes "statistical thinking" in the biological sciences. In the examples we will find Darwin using statistical measures of type frequencies to detect large scale ensemble effects, confirm hypotheses by comparing between expected and observed averages, and applying the astronomer's law of error to explain evolutionary trends.

Variety of evidence in multimessenger astronomy

The confirmation of models in multimessenger astronomy requires variety of evidence. Variety of evidence (VoE) should be understood as an eliminative epistemic principle: where multiple and heterogenous types of evidence converge upon model assumptions or predictions, confidence in the representational accuracy of that model and/or its assumptions is made stronger than if sources of evidence were homogenous. Varied evidence increases confidence indirectly by providing grounds upon which to eliminate under-supported alternatives. I discuss the role VoE reasoning plays in multimessenger astronomy, emphasizing the oft-neglected constraint of chronological evidential support to capture the importance of time series and timescales in astronomy. I then show that in a key case, the convergence of varied types of empirical observations lends confirmatory support to the kilonova model of neutron star mergers.¹.

Comparative evaluation of the Geenius HCV supplemental assay and Inno-LIA HCV score assay in detecting anti-HCV antibodies

OBJECTIVE

This study compared two assays aimed at confirming the presence of anti-HCV antibodies (Ab) after a positive screening: Geenius HCV supplemental assay (Bio-Rad, Marne la Coquette, France) and the Inno-LIA HCV score assay (Fujirebio, Les Ulis, France).

MATERIAL AND METHODS

A total of 180 archived samples were investigated including 119 samples collected at different stages of HCV infection in 25 hemodialyzed patients who underwent HCV seroconversion, 14 samples from 4 commercial seroconversion panels, 47 Ab positive/HCV-RNA positive blood donations of which 7 showing an single reactivity in confirmatory assays. Samples were investigated and results were interpreted with the two assays according to the manufacturers' instructions.

RESULTS

Overall, Geenius and Inno-LIA were concordant for 84% (151/180) samples: 38 negative, 17 indeterminate and 96 positive. Of the 29 discrepant results, 26 were overclassified with Inno-LIA. HCV seroconversion was detected with Inno-LIA 4 and 7 days prior to Geenius in two panels. The high positive rate observed with Inno-LIA (64%) compared to Geenius (54%) was mainly due to low reactivities considered positive according to interpretation criteria, which could affect specificity.

CONCLUSION

Although HCV supplemental assays are not recommended for the diagnostic of HCV infection, which is primarily based on HCV-RNA testing, both assays are suitable as second line anti-HCV tests when Ab screening is positive and RNA testing cannot be performed. Moreover, Geenius system provides an objective result in less than 30minutes, which is compatible when a rapid diagnostic is required.

Meta-empirical confirmation: Addressing three points of criticism

I respond to three points of criticism that have been raised against the concept of meta-empirical confirmation. I argue that meta-empirical confirmation can be set up in a coherent way and is sufficiently discriminating for rendering it a non-trivial indicator of a theory's viability. Moreover, I argue that acknowledging the significance of meta-empirical confirmation provides an argument for the pursuit of alternative research programs rather than for their suppression.

Confirmation by Robustness Analysis: A Bayesian Account

Some authors claim that minimal models have limited epistemic value (Fumagalli, 2016; Grüne-Yanoff, 2009a). Others defend the epistemic benefits of modelling by invoking the role of robustness analysis for hypothesis confirmation (see, e.g., Levins, 1966; Kuorikoski et al., 2010) but such arguments find much resistance (see, e.g., Odenbaugh & Alexandrova, 2011). In this paper, we offer a Bayesian rationalization and defence of the view that robustness analysis can play a confirmatory role, and thereby shed light on the potential of minimal models for hypothesis confirmation. We illustrate our argument by reference to a case study from macroeconomics. At the same time, we also show that there are cases in which robustness analysis is detrimental to confirmation. We characterize these cases and link them to recent investigations on evidential variety (Landes, 2020b, 2021; Osimani and Landes, forthcoming). We conclude that robustness analysis over minimal models can confirm, but its confirmatory value depends on concrete circumstances.

Detection and Sequencing of Multiple Human Norovirus Genotypes from Imported Frozen Raspberries Linked to Outbreaks in the Province of Quebec, Canada, in 2017

Human noroviruses are among the main causes of acute gastroenteritis worldwide. Frozen raspberries have been linked to several norovirus food-related outbreaks. However, the extraction of norovirus RNA from frozen raspberries remains challenging. Recovery yields are low and PCR inhibitors limit the sensitivity of the detection methodologies. In 2017, 724 people from various regions of the Province of Quebec, Canada, were infected by noroviruses and the outbreak investigation pointed to frozen raspberries as a putative source. A new magnetic silica bead approach was used for the extraction of viruses from different outbreak samples. The RNA extracts were tested by reverse transcription-quantitative polymerase chain reaction (RT-qPCR) and five samples were confirmed positive for norovirus by RT-qPCR amplicon sequencing. A multiplex long-range two-step RT-PCR approach was developed to amplify norovirus ORF2 and ORF3 capsid genes from the positive frozen raspberry RNA extracts and other sequencing strategies were also explored. These capsid genes were sequenced by Next-Generation Sequencing. Phylogenetic analyses confirmed the presence of multiple genotypes (GI.3, GI.6, and GII.17) and intra-genotype variants in some of the frozen raspberry samples. Variants of genotype GI.3 and GI.6 had 100% homology with sequences from patient samples. Similar strains were also reported in previous outbreaks. Confirmation approaches based on sequencing the norovirus capsid genes using Next-Generation Sequencing can be applied at trace level contaminations and could be useful to assess risk and assist in source tracking.

Cognitive and functional deficits are associated with white matter abnormalities in two independent cohorts of patients with schizophrenia

BACKGROUND

Significant evidence links white matter (WM) microstructural abnormalities to cognitive impairment in schizophrenia (SZ), but the relationship of these abnormalities with functional outcome remains unclear.

METHODS

In two independent cohorts (C1, C2), patients with SZ were divided into two subgroups: patients with higher cognitive performance (SZ-HCP-C1, n = 25; SZ-HCP-C2, n = 24) and patients with lower cognitive performance (SZ-LCP-C1, n = 25; SZ-LCP-C2, n = 24). Healthy controls (HC) were included in both cohorts (HC-C1, n = 52; HC-C2, n = 27). We compared fractional anisotropy (FA) of the whole-brain WM skeleton between the three groups (SZ-LCP, SZ-HCP, HC) by a whole-brain exploratory approach and an atlas-defined WM regions-of-interest approach via tract-based spatial statistics. In addition, we explored whether FA values were associated with Global Assessment of Functioning (GAF) scores in the SZ groups.

RESULTS

In both cohorts, mean FA values of whole-brain WM skeleton were significantly lower in the SCZ-LCP group than in the SCZ-HCP group. Whereas in C1 the FA of the frontal part of the left inferior fronto-occipital fasciculus (IFOF) was positively correlated with GAF score, in C2 the FA of the temporal part of the left IFOF was positively correlated with GAF score.

CONCLUSIONS

We provide robust evidence for WM microstructural abnormalities in SZ. These abnormalities are more prominent in patients with low cognitive performance and are associated with the level of functioning.

The role of meta-empirical theory assessment in the acceptance of atomism

The universal acceptance of atomism in physics and chemistry in the early 20th century went along with an altered view on the epistemic status of microphysical conjectures. Contrary to the prevalent understanding during the 19th century, on the new view unobservable objects could be 'discovered'. It is argued in the present paper that this shift can be connected to the implicit integration of elements of meta-empirical theory assessment into the concept of theory confirmation.

The Epistemology of a Positive SARS-CoV-2 Test

We investigate the epistemological consequences of a positive polymerase chain reaction SARS-CoV test for two relevant hypotheses: (i) V is the hypothesis that an individual has been infected with SARS-CoV-2; (ii) C is the hypothesis that SARS-CoV-2 is the cause of flu-like symptoms in a given patient. We ask two fundamental epistemological questions regarding each hypothesis: First, how much confirmation does a positive test lend to each hypothesis? Second, how much evidence does a positive test provide for each hypothesis against its negation? We respond to each question within a formal Bayesian framework. We construe degree of confirmation as the difference between the posterior probability of the hypothesis and its prior, and the strength of evidence for a hypothesis against its alternative in terms of their likelihood ratio. We find that test specificity-and coinfection probabilities when making inferences about C-were key determinants of confirmation and evidence. Tests with < 87% specificity could not provide strong evidence (likelihood ratio > 8) for V against ¬V regardless of sensitivity. Accordingly, low specificity tests could not provide strong evidence in favor of C in all plausible scenarios modeled. We also show how a positive influenza A test disconfirms C and provides weak evidence against C in dependence on the probability that the patient is influenza A infected given that his/her symptoms are not caused by SARS-CoV-2. Our analysis points out some caveats that should be considered when attributing symptoms or death of a positively tested patient to SARS-CoV-2.

Traditional Methods of Analysis for Listeria monocytogenes

Conventional methods for the detection of Listeria monocytogenes in foods and environmental samples rely on selective pre-enrichment, enrichment, and plating. This is followed by confirmation of suspected colonies by testing a limited number of biochemical markers.

Identity confirmation of anthocyanins in berries by LC-DAD-IM-QTOFMS

Rugged analytical methods for the screening and identity confirmation of anthocyanins require a dedicated sample preparation, chromatographic setup, and the reliable generation of multiple identification points to confirm identity against the wide range of phenolic compounds typically present in food, beverage, and plant material samples. To this end, combinations of spectroscopic and mass spectrometric detection are frequently employed for this application to provide higher confidence in the absence of authentic standards. In the present work, low‐field drift tube ion mobility (DTIM) separation is evaluated for this task using a LC–DAD–DTIM–QTOFMS method. DTIM‐MS allows accurate determination of collision cross sections (^DTCCS) for all analysed compounds as well as a precise alignment tool for reconciling fragment and precursor ions in data independent acquisition mode. The presented approach thereby allows for an anthocyanin screening method taking true advantage of all dimensions of the analytical platform: relative retention (RPLC), UV/VIS absorption spectrum, accurate mass, ^DTCCS_N2, and confirmed high‐resolution fragment ions. From the analysis of authentic standards and several berry samples primarily from the Vaccinium genus, Level 1 confirmation data for six anthocyanins from the cyanidin family, and Level 2 confirmation for a further 29 anthocyanins confirmed in berry samples is provided. The method and accompanying dataset provided as part of this work provides a means to develop anthocyanin screening methods using the ion mobility dimension as an additional alignment and filtering parameter in data independent analysis acquisition across any LC–IM–MS platform.

Use of the Bio-Rad Geenius HIV-1/2 supplemental assay for the testing of oral fluids for the presence of HIV antibody

There is currently an absence of products which are cleared by the FDA to provide supplemental testing for oral fluid for HIV antibody. We created a procedure for the use of the BioRad Geenius HIV-1/2 as a supplemental antibody test for oral fluid specimens. The modified procedure was evaluated for its ability to detect HIV-1 antibody in oral fluid in specimens that were found to be repeatedly reactive for HIV-1 antibody by way of the Avioq HIV-1 enzyme immunoassay (EIA). Evaluated were oral fluid specimens analyzed at a local public health laboratory which were stored frozen and oral fluid specimens collected prospectively. Prospectively collected specimens were from patients whose HIV status was subsequently assessed through blood-based testing. For retrospective specimens found repeatedly EIA reactive, and positive by Western blot, the modified Geenius was found positive in 37/38 instances (97.4 %). Those specimens with a mean EIA signal-to-cutoff (S/CO) greater than 3.00 were found to be positive by Geenius in 34/34 (100 %) of instances. For specimens found repeated reactive by EIA and positive by Western blot with mean S/CO less than or equal to 3.00, the Geenius was positive in 4/5 instances (80 %) of instances. For prospectively collected specimens, the Geenius accurately confirmed infection in 22/24 cases (92 %) while prospective specimens found repeatedly reactive by EIA without supplemental Geenius testing were confirmed positive in 29/37 instances (78 %). A modified usage of the Geenius HIV-1/2 Supplemental Assay antibody test may provide utility in the supplementation of testing of oral fluid for the presence of HIV-1 antibody.

The confirmation of treatment effects in Japanese acupuncture

BACKGROUND

Japanese acupuncture is gaining international recognition. However, previous research has failed to comprehensively describe the characteristics of Japanese acupuncture by not investigating it within the Japanese clinical environment. This qualitative ethnographic study aimed to identify unique and routine elements of Japanese acupuncture, describe these in detail and examine how they related to treatment principles.

METHODS

Between August 2012 and December 2016, ethnographic fieldwork was conducted in Japan. Participants were recruited by chain referral and emergent sampling. Data were collected through participant observation and interviews as well as by analyzing documents. A total of 38 participants were recruited. A total of 22 agreed to clinical observation; 221 treatments were observed with 172 patients. Seventeen participants consented to participate in formal interviews and 28 to informal interviews. Thematic analysis was used to evaluate data.

RESULTS

That practitioners tended to confirm perceived effects of interventions during treatment, was a major theme interpreted from the data. Confirmation was performed continually throughout treatment and at three different levels of timing and anatomical areas (micro, meso and macro). Many markers signified treatment effects which were in general, perceived by observing and/or palpating body tissue. Belief in the instantaneous effects of treatment and the value of effect through technique exemplify the philosophical foundations of confirmation. Continually monitoring treatment results at a range of time and body location increments is an important element of Japanese acupuncture.

CONCLUSION

This effect confirmation practice model promotes a system of constant feedback gained by repeated intervention and confirmation. This may be a unique feature of Japanese acupuncture.

Confirmation of occurrence of Anopheles (Anopheles) veruslanei Vargas in Quintana Roo, Mexico using morphology and DNA barcodes

In Mexico, genus Anopheles includes 27 species divided into three subgenera: Anopheles, Kerteszia, and Nyssorhynchus. Some species occur in the Nearctic region (northern Mexico), whereas other species occur in the Neotropical region (south and southeast Mexico) and only a few species occur in both regions. In Quintana Roo State (southeast Mexico) 11 species have been recorded: An. apicimacula, An. atropos, An. bradleyi, An. crucians, An. franciscanus, An. neomaculipalpus, An. pseudopunctipennis, An. punctimacula, An. veruslanei, An. vestitipennis and An. albimanus. However, the occurrence and identity of An. veruslanei has been questioned in recent years, since its description 39 years ago, it has not been reported in recent studies. In October 2015, five females of An. veruslanei were collected and identified. To corroborate their occurrence and identity in Quintana Roo State, we used morphological and molecular evidence that confirms it, and the type material of this species was studied to compare with the specimens of our collections.

Paranormal belief, thinking style preference and susceptibility to confirmatory conjunction errors

This study examines the extent to which belief in extrasensory perception (ESP), psychokinesis (PK) or life after death (LAD), plus need for cognition (NFC) and faith in intuition (FI), predict the generation of confirmatory conjunction errors. An opportunity sample (n = 261) completed sixteen conjunction problems manipulated across a 2 event type (paranormal vs. non-paranormal) × 2 outcome type (confirmatory vs. disconfirmatory) within subjects design. Three Generalised Linear Mixed Models - one per paranormal belief type - were performed. With respondent gender and age controlled for, ESP, PK and LAD beliefs were all associated with the making (vs. non-making) of conjunction errors both generally and specifically for confirmatory conjunctive outcomes. Event type had no impact. Individuals high in NFC were less likely to commit the fallacy. The role thinking style plays in shaping paranormal believers' susceptibility to confirmatory conjunction biases is discussed. Methodological issues and future research ideas are also considered.

Evaluation of the CRE and ESBL ELITe MGB® kits for the accurate detection of carbapenemase- or CTX-M-producing bacteria

As carbapenemase-producing Enterobacteriaceae (CPE) and extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E) are becoming a major public health issue, there is an urgent need for accurate and fast diagnostic tests. The ELITe InGenius is a fully automated sample-to-result system designed for the extraction and detection by multiplex real-time polymerase chain reaction of carbapenemases KPC, NDM, VIM, IMP, and OXA-48-like variants and CTX-M group 1 and 9-producers from diverse sample matrices such as colonies, positive blood cultures, and rectal swabs. CRE and ESBL ELITe MGB® kits were evaluated on 153 cultured colonies of enterobacterial isolates with characterized β-lactamase content, on 30 spiked blood cultures, and the CRE kit was also evaluated on 53 clinical rectal swabs collected prospectively during a 3-month period and 10 spiked rectal swabs. CRE ELITe MGB® kit's performances reached 100% sensitivity and 100% specificity, while for the ESBL ELITe kit, 100% sensitivity and 96.6% specificity were observed, with a sample to result of less than 3 h and a total percentage of agreement with expected results of 99.6% (255/256).

A coherentist conception of ad hoc hypotheses

What does it mean for a hypothesis to be ad hoc? One prominent account has it that ad hoc hypotheses have no independent empirical support. Others have viewed ad hoc judgements as stemming from a lack of unifiedness of the amended theory. Still others view them as merely subjective. Here I critically review these views and defend my own Coherentist Conception of Ad hocness by working out its conceptual and descriptive attractions.

Decision Making in Paediatric Cardiology. Are We Prone to Heuristics, Biases and Traps?

Hidden traps in decision making have been long recognised in the behavioural economics community. Yet we spend very limited, if any time, analysing our decision-making processes in medicine and paediatric cardiology. Systems 1 and 2 thought processes differentiate between rapid emotional thoughts and slow deliberate rational thoughts. For fairly clear cut medical decisions, in-depth analysis may not be needed, but in our field of paediatric cardiology it is not uncommon for challenging cases and occasionally 'simple' cases to generate significant debate and uncertainty as to the best decision. Although morbidity and mortality meetings frequently highlight poor outcomes for our patients, they often neglect to analyse the process of thought which underlined those decisions taken. This article attempts to review commonly acknowledged traps in decision making in the behavioural economics world to ascertain whether these heuristics translate to decision making in the paediatric cardiology environment. We also discuss potential individual and collective solutions to pitfalls in decision making.

The contents of a patient diary and its significance for persons cared for in an ICU: A qualitative study

OBJECTIVES

The aim of this study was to describe the contents of a patient diary and its significance for persons cared for in an ICU.

RESEARCH METHODOLOGY

An empirical study with a qualitative design. Eight telephone interviews and one face-to-face interview were conducted with nine persons previously been treated in an ICU and been given a patient diary. In addition, the person would have read his/her diary. The data have been analysed with qualitative content analysis.

FINDINGS

The study identified one overarching theme; Gaining understanding, and four categories; The diary is written for me, Creating memories from the time of care, Who writes in the diary and, The ability to return to the diary. The diary meant that participants gained an understanding of their time in the ICU while they were critically ill and the diary was important to be able to return to.

CONCLUSION

What formerly critically ill patients appreciate most about the diary is that the diary is personally written, which makes them feel confirmed and valuable as a person. Guidelines for how and when a diary should be written and used would likely encourage critical care nurses and relatives to write in it.

O-5S quantitative real-time PCR: a new diagnostic tool for laboratory confirmation of human onchocerciasis

Background

Onchocerciasis is a parasitic disease caused by the filarial nematode Onchocerca volvulus. In endemic areas, the diagnosis is commonly confirmed by microscopic examination of skin snip samples, though this technique is considered to have low sensitivity. The available melting-curve based quantitative real-time PCR (qPCR) using degenerated primers targeting the O-150 repeat of O. volvulus was considered insufficient for confirming the individual diagnosis, especially in elimination studies. This study aimed to improve detection of O. volvulus DNA in clinical samples through the development of a highly sensitive qPCR assay.

Methods

A novel hydrolysis probe based qPCR assay was designed targeting the specific sequence of the O. volvulus O-5S rRNA gene. A total of 200 clinically suspected onchocerciasis cases were included from Goma district in South-west Ethiopia, from October 2012 through May 2013. Skin snip samples were collected and subjected to microscopy, O-150 qPCR, and the novel O-5S qPCR.

Results

Among the 200 individuals, 133 patients tested positive (positivity rate of 66.5%) and 67 negative by O-5S qPCR, 74 tested positive by microscopy (37.0%) and 78 tested positive by O-150 qPCR (39.0%). Among the 133 O-5S qPCR positive individuals, microscopy and O-150 qPCR detected 55.6 and 59.4% patients, respectively, implying a higher sensitivity of O-5S qPCR than microscopy and O-150 qPCR. None of the 67 individuals who tested negative by O-5S qPCR tested positive by microscopy or O-150 qPCR, implying 100% specificity of the newly designed O-5S qPCR assay.

Conclusions

The novel O-5S qPCR assay is more sensitive than both microscopic examination and the existing O-150 qPCR for the detection of O. volvulus from skin snip samples. The newly designed assay is an important step towards appropriate individual diagnosis and control of onchocerciasis.

Electronic supplementary material

The online version of this article (10.1186/s13071-017-2382-3) contains supplementary material, which is available to authorized users.

Residue analysis of picoxystrobin in oriental melon using gas chromatography coupled with electron capture detection and mass spectrometric confirmation: application to dissipation kinetics and risk assessment

This study was carried out to determine the residual amounts of picoxystrobin in oriental melon (Cucumis melo L.) grown under plastic house conditions at two different sites. Samples collected over 10 days were extracted using acetonitrile and salting out (using solid sodium chloride) and purified using Florisil SPE cartridges. The analyte was determined using GC-ECD and field-incurred residues were verified using GC-MS. The calibration curve was linear over the range 0.02-2.0 mg/L with a R 2  = 0.9998. The LOD and LOQ were 0.003 and 0.01 mg/kg, respectively. Recoveries, tested at three spiking levels, were satisfactory with rates in the range 87.7-101.5% and relative standard deviations ≤9.6. The dissipation half-lives were 3.4 and 3.7 days for sites 1 and 2, respectively. Hazard estimates obtained using hazard quotients revealed no health risk from the suggested pesticide application dosage when considering an adult's body weight, oriental melon consumption, and the acceptable daily intake of picoxystrobin.

[Diagnostic means for tuberculosis]

Tuberculosis is a public health problem. In recent years, there is a change in the epidemiological profile of tuberculosis. The diagnosis of tuberculosis is based on clinical and radiological arguments but confirmation is bacteriological and/or histological. Culture remains the gold standard. Technological progress especially in molecular biology provides the clinician now new means of tuberculosis diagnostics.

Inference to the best explanation and mechanisms in medicine

This article considers the prospects of inference to the best explanation (IBE) as a method of confirming causal claims vis-à-vis the medical evidence of mechanisms. I show that IBE is actually descriptive of how scientists reason when choosing among hypotheses, that it is amenable to the balance/weight distinction, a pivotal pair of concepts in the philosophy of evidence, and that it can do justice to interesting features of the interplay between mechanistic and population level assessments.

Confirming mental health care in acute psychiatric wards, as narrated by persons experiencing psychotic illness: an interview study

Background

It is important that mental health nurses meet the safety, security and care needs of persons suffering from psychotic illness to enhance these persons’ likelihood of feeling better during their time in acute psychiatric wards. Certain persons in care describe nurses’ mental health care as positive, whereas others report negative experiences and express a desire for improvements. There is limited research on how persons with psychotic illness experience nurses’ mental health care acts and how such acts help these persons feel better. Therefore, the aim of this study was to explore, describe and understand how the mental health nurses in acute psychiatric wards provide care that helps persons who experienced psychotic illness to feel better, as narrated by these persons.

Method

This study had a qualitative design; 12 persons participated in qualitative interviews. The interviews were transcribed, content analysed and interpreted using Martin Buber’s concept of confirmation.

Results

The results of this study show three categories of confirming mental health care that describe what helped the participants to feel better step-by-step: first, being confirmed as a person experiencing psychotic illness in need of endurance; second, being confirmed as a person experiencing psychotic illness in need of decreased psychotic symptoms; and third, being confirmed as a person experiencing psychotic illness in need of support in daily life. The underlying meaning of the categories and of subcategories were interpreted and formulated as the theme; confirming mental health care to persons experiencing psychotic illness.

Conclusion

Confirming mental health care acts seem to help persons to feel better in a step-wise manner during psychotic illness. Nurses’ openness and sensitivity to the changing care needs of persons who suffer from psychotic illness create moments of confirmation within caring acts that concretely help the persons to feel better and that may enhance their health. The results show the importance of taking the experiential knowledge of persons who have experienced psychotic illness seriously to develop and increase the quality of mental health care in acute psychiatric wards.

Acceptance, values, and probability

This essay makes a case for regarding personal probabilities used in Bayesian analyses of confirmation as objects of acceptance and rejection. That in turn entails that personal probabilities are subject to the argument from inductive risk, which aims to show non-epistemic values can legitimately influence scientific decisions about which hypotheses to accept. In a Bayesian context, the argument from inductive risk suggests that value judgments can influence decisions about which probability models to accept for likelihoods and priors. As a consequence, if the argument from inductive risk is sound, then non-epistemic values can affect not only the level of evidence deemed necessary to accept a hypothesis but also degrees of confirmation themselves.

Roadside drug testing: comparison of two legal approaches in Belgium

BACKGROUND

Internationally, urine on-site testing has been used for detecting drivers under the influence of drugs (DUID) but more and more countries, such as Belgium, are switching to oral fluid screening.

OBJECTIVE

To compare the previous (published in 1999) and current (published 2009) enforcement procedures of DUID in Belgium. The two evaluated procedures differ in the way the drivers are screened by the police (signs of impairment versus signs of recent drug use), the matrix for screening (urine versus oral fluid) and the analytical cut-off concentrations in plasma.

METHODS

Data on positive screening and confirmation results were gathered from 1st April 2008 to 30th September 2010, when urine screening (Dipro Druglab panels test) was performed; and from 1st October 2010 to 31st March 2013, when an on-site oral fluid test (Securetec Drugwipe 5(+)) was used.

RESULTS

Approximately 4100 data sets related to urine screening and 3900 data sets related to oral fluid screening were studied. Eighty-eight percent of positive urine on-site tests yielded positive results in plasma for cannabis, 21% for cocaine, 20% for amphetamines and 7% for opiates. Sixty-six percent of the positive oral fluid on-site tests yielded positive results in plasma for cannabis, 30% for cocaine, 28% for amphetamines and 8% for opiates. For cannabis, opiates and amphetamines more negative results in plasma were observed in the period of urine screening.

CONCLUSIONS

The percentage of plasma samples of tested drivers, in which none of the positive screened target drugs were present in a concentration above the legal cut-off value, has decreased from 17% to 8% since the introduction of the current legislation involving oral fluid screening.

Model robustness as a confirmatory virtue: The case of climate science

I propose a distinct type of robustness, which I suggest can support a confirmatory role in scientific reasoning, contrary to the usual philosophical claims. In model robustness, repeated production of the empirically successful model prediction or retrodiction against a background of independently-supported and varying model constructions, within a group of models containing a shared causal factor, may suggest how confident we can be in the causal factor and predictions/retrodictions, especially once supported by a variety of evidence framework. I present climate models of greenhouse gas global warming of the 20th Century as an example, and emphasize climate scientists' discussions of robust models and causal aspects. The account is intended as applicable to a broad array of sciences that use complex modeling techniques.

Reliability of veterinary drug residue confirmation: high resolution mass spectrometry versus tandem mass spectrometry

Confirmation of suspected residues has been a long time domain of tandem triple quadrupole mass spectrometry (QqQ). The currently most widely used confirmation strategy relies on the use of two selected reaction monitoring signals (SRM). The details of this confirmation procedure are described in detail in the Commission Decision 93/256/EC (CD). On the other hand, high resolution mass spectrometry (HRMS) is nowadays increasingly used for trace analysis. Yet its utility for confirmatory purposes has not been well explored and utilized, since established confirmation strategies like the CD do not yet include rules for modern HRMS technologies. It is the focus of this paper to evaluate the likelihood of false positive and false negative confirmation results, when using a variety of HRMS based measurement modes as compared to conventional QqQ mass spectrometry. The experimental strategy relies on the chromatographic separation of a complex blank sample (bovine liver extract) and the subsequent monitoring of a number of dummy transitions respectively dummy accurate masses. The term "dummy" refers to precursor and derived product ions (based on a realistic neutral loss) whose elemental compositions (CxHyNzOdCle) were produced by a random number generator. Monitoring a large number of such hypothetical SRM's, or accurate masses inevitably produces a number of mass traces containing chromatographic peaks (false detects) which are caused by eluting matrix compounds. The number and intensity of these peaks were recorded and standardized to permit a comparison among the two employed MS technologies. QqQ performance (compounds which happen to produce a response in two SRM traces at identical retention time) was compared with a number of different HRMS(1) and HRMS(2) detection based modes. A HRMS confirmation criterion based on two full scans (an unfragmented and an all ion fragmented) was proposed. Compared to the CD criteria, a significantly lower probability of false positive and false negative findings is obtained by utilizing this criterion.

Corpus-based estimates of word association predict biases in judgment of word co-occurrence likelihood

This paper draws a connection between statistical word association measures used in linguistics and confirmation measures from epistemology. Having theoretically established the connection, we replicate, in the new context of the judgments of word co-occurrence, an intriguing finding from the psychology of reasoning, namely that confirmation values affect intuitions about likelihood. We show that the effect, despite being based in this case on very subtle statistical insights about thousands of words, is stable across three different experimental settings. Our theoretical and empirical results suggest that factors affecting traditional reasoning tasks are also at play when linguistic knowledge is probed, and they provide further evidence for the importance of confirmation in a new domain.

An overview of the diagnostic tools

Prions are unconventional infectious agents that cause fatal neurological illnesses such as Creutzfeldt-Jakob disease (CJD), bovine spongiform encephalopathy, and scrapie. Variant CJD can occur via blood transfusions. However, as no screening assay is available, uncertainties remain over the prevalence of vCJD in asymptomatic blood donors. Development of a diagnostic assay is therefore a primary objective. Little is known about the nature, distribution and level of infectivity in human blood and we have to rely on assumptions made from animal models. Ideally, two types of assays are required: a rapid high-throughput assay to routinely screen all blood donations and a confirmatory assay to ensure that all positive results from initial screening are true positives. Key event in prion disease is thought to be the conversion of normal cellular prion protein PrPc to a misfolded aggregated form termed PrP(TSE). This specific characteristic has been exploited to develop some tests.