Nudge-based misinformation interventions are effective in information environments with low misinformation prevalence.

Nudge-based misinformation interventions are presented as cheap and effective ways to reduce the spread of misinformation online. However, despite online information environments typically containing relatively low volumes of misinformation, most studies testing the effectiveness of nudge interventions present equal proportions of true and false information. As the effectiveness of nudges can be highly context-dependent, it is imperative to validate the effectiveness of nudge-based interventions in environments with more realistic proportions of misinformation. The current study (N = 1387) assessed the effectiveness of a combined accuracy and social-norm nudge in simulated social-media environments with varying proportions of misinformation (50%, 20%, and 12.5%) relative to true and non-news-based (i.e., "social") information. The nudge intervention was effective at improving sharing discernment in conditions with lower proportions of misinformation, providing ecologically valid support for the use of nudge-based interventions to counter misinformation propagation on social media.

Source-credibility information and social norms improve truth discernment and reduce engagement with misinformation online.

Misinformation on social media is a pervasive challenge. In this study (N = 415) a social-media simulation was used to test two potential interventions for countering misinformation: a credibility badge and a social norm. The credibility badge was implemented by associating accounts, including participants', with a credibility score. Participants' credibility score was dynamically updated depending on their engagement with true and false posts. To implement the social-norm intervention, participants were provided with both a descriptive norm (i.e., most people do not share misinformation) and an injunctive norm (i.e., sharing misinformation is the wrong thing to do). Both interventions were effective. The social-norm intervention led to reduced belief in false claims and improved discrimination between true and false claims. It also had some positive impact on social-media engagement, although some effects were not robust to alternative analysis specifications. The presence of credibility badges led to greater belief in true claims, lower belief in false claims, and improved discrimination. The credibility-badge intervention also had robust positive impacts on social-media engagement, leading to increased flagging and decreased liking and sharing of false posts. Cumulatively, the results suggest that both interventions have potential to combat misinformation and improve the social-media information landscape.

The (Mis)Information Game: A social media simulator.

Given the potential negative impact reliance on misinformation can have, substantial effort has gone into understanding the factors that influence misinformation belief and propagation. However, despite the rise of social media often being cited as a fundamental driver of misinformation exposure and false beliefs, how people process misinformation on social media platforms has been under-investigated. This is partially due to a lack of adaptable and ecologically valid social media testing paradigms, resulting in an over-reliance on survey software and questionnaire-based measures. To provide researchers with a flexible tool to investigate the processing and sharing of misinformation on social media, this paper presents The Misinformation Game-an easily adaptable, open-source online testing platform that simulates key characteristics of social media. Researchers can customize posts (e.g., headlines, images), source information (e.g., handles, avatars, credibility), and engagement information (e.g., a post's number of likes and dislikes). The platform allows a range of response options for participants (like, share, dislike, flag) and supports comments. The simulator can also present posts on individual pages or in a scrollable feed, and can provide customized dynamic feedback to participants via changes to their follower count and credibility score, based on how they interact with each post. Notably, no specific programming skills are required to create studies using the simulator. Here, we outline the key features of the simulator and provide a non-technical guide for use by researchers. We also present results from two validation studies. All the source code and instructions are freely available online at https://misinfogame.com .

Correction format has a limited role when debunking misinformation.

Given that being misinformed can have negative ramifications, finding optimal corrective techniques has become a key focus of research. In recent years, several divergent correction formats have been proposed as superior based on distinct theoretical frameworks. However, these correction formats have not been compared in controlled settings, so the suggested superiority of each format remains speculative. Across four experiments, the current paper investigated how altering the format of corrections influences people's subsequent reliance on misinformation. We examined whether myth-first, fact-first, fact-only, or myth-only correction formats were most effective, using a range of different materials and participant pools. Experiments 1 and 2 focused on climate change misconceptions; participants were Qualtrics online panel members and students taking part in a massive open online course, respectively. Experiments 3 and 4 used misconceptions from a diverse set of topics, with Amazon Mechanical Turk crowdworkers and university student participants. We found that the impact of a correction on beliefs and inferential reasoning was largely independent of the specific format used. The clearest evidence for any potential relative superiority emerged in Experiment 4, which found that the myth-first format was more effective at myth correction than the fact-first format after a delayed retention interval. However, in general it appeared that as long as the key ingredients of a correction were presented, format did not make a considerable difference. This suggests that simply providing corrective information, regardless of format, is far more important than how the correction is presented.

Tailor-made recombinant prokaryotic lectins for characterisation of glycoproteins.

Development of biosimilars is costly, where glycan analysis is a significant constraint on time and money. This paper provides an in-depth characterisation of several novel recombinant prokaryotic lectins (RPLs), developed through directed evolution, displaying specific binding activities to α-mannose, ß-galactose, fucose and sialic acid residues, tested against major biosimilar targets. The binding characterisation of all lectins was performed employing the principles of bio-layer interferometry (BLI), with help of the streptavidin-coated sensor with the biotinylated lectins. The binding activity of the RPLs and the specificity to a broad range of glycoproteins and glycoconjugates were evaluated and compared to those of equivalent plant-derived lectins. While exhibiting better or similar specificity, RPLs displayed significantly better binding in all cases. The binding mechanisms are explained with particular focus on the role hydrogen bonding plays in the change of specificity for a galactose specific lectin. Furthermore, different sets of RPLs and their plant equivalents were assayed against the different glycoprotein targets to evaluate the analytical parameters of the lectin-glycoprotein interaction. The obtained LoDs reached by the RPLs were lower than those of their plant counterparts apart from one, exhibiting RPL:PL LoD ratios of 0.8, 2.5, 14.2 and 380 for the sets of lectins specific to fucose, α-mannose, ß-galactose and sialic acid, respectively. Such enhancement in analytical parameters of RPLs shows their applicability in protein purification and as bioanalytical tools for glycan analysis and biosensor development.

Challenges for biosimilars: focus on rheumatoid arthritis.

Healthcare systems worldwide are struggling to find ways to fund the cost of innovative treatments such as gene therapies, regenerative medicine, and monoclonal antibodies (mAbs). As the world's best known mAbs are close to facing patent expirations, the biosimilars market is poised to grow with the hope of bringing prices down for cancer treatment and autoimmune disorders, however, this has yet to be realized. The development costs of biosimilars are significantly higher than their generic equivalents due to therapeutic equivalence trials and higher manufacturing costs. It is imperative that academics and relevant companies understand the costs and stages associated with biologics processing. This article brings these costs to the forefront with a focus on biosimilars being developed for Rheumatoid Arthritis (RA). mAbs have remarkably changed the treatment landscape, establishing their superior efficacy over traditional small chemicals. Five blockbuster TNFα mAbs, considered as first line biologics against RA, are either at the end of their patent life or have already expired and manufacturers are seeking to capture a significant portion of that market. Although in principle, market-share should be available, withstanding that the challenges regarding the compliance and regulations are being resolved, particularly with regards to variation in the glycosylation patterns and challenges associated with manufacturing. Glycan variants can significantly affect the quality attributes requiring characterization throughout production. Successful penetration of biologics can drive down prices and this will be a welcome change for patients and the healthcare providers. Herein we review the biologic TNFα inhibitors, which are on the market, in development, and the challenges being faced by biosimilar manufacturers.

You don't have to tell a story! A registered report testing the effectiveness of narrative versus non-narrative misinformation corrections.

Misinformation often has an ongoing effect on people's memory and inferential reasoning even after clear corrections are provided; this is known as the continued influence effect. In pursuit of more effective corrections, one factor that has not yet been investigated systematically is the narrative versus non-narrative format of the correction. Some scholars have suggested that a narrative format facilitates comprehension and retention of complex information and may serve to overcome resistance to worldview-dissonant corrections. It is, therefore, a possibility that misinformation corrections are more effective if they are presented in a narrative format versus a non-narrative format. The present study tests this possibility. We designed corrections that are either narrative or non-narrative, while minimizing differences in informativeness. We compared narrative and non-narrative corrections in three preregistered experiments (total N = 2279). Experiment 1 targeted misinformation contained in fictional event reports; Experiment 2 used false claims commonly encountered in the real world; Experiment 3 used real-world false claims that are controversial, in order to test the notion that a narrative format may facilitate corrective updating primarily when it serves to reduce resistance to correction. In all experiments, we also manipulated test delay (immediate vs. 2 days), as any potential benefit of the narrative format may only arise in the short term (if the story format aids primarily with initial comprehension and updating of the relevant mental model) or after a delay (if the story format aids primarily with later correction retrieval). In all three experiments, it was found that narrative corrections are no more effective than non-narrative corrections. Therefore, while stories and anecdotes can be powerful, there is no fundamental benefit of using a narrative format when debunking misinformation.

Group acceptance and commitment therapy for patients and caregivers in psychosis services: Feasibility of training and a preliminary randomized controlled evaluation.

OBJECTIVE: Psychological interventions reduce the impact of psychosis, but widescale implementation is problematic. We tested the feasibility of group acceptance and commitment therapy for Psychosis (G-ACTp), delivered by frontline staff, and co-facilitated by service-user experts-by-experience (SU-EbyE), for service-users and informal caregivers (ISRCTN: 68540929). We estimated recruitment/retention rates and outcome variability for future evaluation. METHODS: Staff and SU-EbyE facilitators completed 1-day workshops, then delivered closely supervised G-ACTp, comprising four sessions (weeks 1-4) and two boosters (10 and 12 weeks). Participants recruited from adult community psychosis services were randomized to receive G-ACTp immediately or after 12 weeks, completing outcome assessments at 0, 4, and 12 weeks. Service-use/month was calculated for 1-year pre-randomization, weeks 0-12, and 5-year uncontrolled follow-up. RESULTS: Of 41 facilitators trained (29 staff, 12 SU-EbyE), 29 (71%; 17 staff, 12 SU-EbyE) delivered 18 G-ACTp courses. Participant refusal rates were low (9% of service-users [10/112]; 5% of caregivers [4/79]); 60% of those invited to participate attended ≥1 G-ACTp session (64% of service-users [39/61]; 56% of caregivers [35/63]). Randomization of facilitators and participants proved problematic and participant follow-up was incomplete (78% [66/85]; 82% of service-users [36/44]; 73% of caregivers [30/41]). Effect sizes ranged from very small to large mostly favouring treatment. Service-use reductions require cautious interpretation, as very few participants incurred costs. CONCLUSIONS: Implementation appears feasible for service-users; for caregivers, retention needs improving. Outcome variability indicated n = 100-300/arm followed up (α = 0.05, 90% power). Methodological limitations' mean replication is needed: identified sources of potential bias may be reduced in a cluster randomized design with sessional outcome completion. PRACTITIONER POINTS: Group acceptance and commitment therapy can be successfully adapted for people with psychosis and their caregivers. Implementation (training and delivery) is possible in routine community mental health care settings. Clinical and economic outcomes are promising, but replication is needed. Recommendations are made for future studies.

Using the COVID-19 economic crisis to frame climate change as a secondary issue reduces mitigation support.

The COVID-19 pandemic has understandably dominated public discourse, crowding out other important issues such as climate change. Currently, if climate change enters the arena of public debate, it primarily does so in direct relation to the pandemic. In two experiments, we investigated (1) whether portraying the response to the COVID-19 threat as a "trial run" for future climate action would increase climate-change concern and mitigation support, and (2) whether portraying climate change as a concern that needs to take a "back seat" while focus lies on economic recovery would decrease climate-change concern and mitigation support. We found no support for the effectiveness of a trial-run frame in either experiment. In Experiment 1, we found that a back-seat frame reduced participants' support for mitigative action. In Experiment 2, the back-seat framing reduced both climate-change concern and mitigation support; a combined inoculation and refutation was able to offset the drop in climate concern but not the reduction in mitigation support.

Balancing ACT: evaluating the effectiveness of psychoeducation and Acceptance and Commitment Therapy (ACT) groups for people with bipolar disorder: study protocol for pilot randomised controlled trial.

BACKGROUND: Bipolar disorder is a chronic and disabling psychiatric condition, characterised by recurrent episodes of mania, hypomania and depression. It places a heavy burden on sufferers and families, with high societal and healthcare costs. Many service users with a diagnosis of bipolar disorder also experience prominent psychotic symptoms, with differential diagnoses of schizoaffective disorder, and relapses characterised by repeated manic psychotic episodes and grandiosity. Such presentations require specific adaptations to standard bipolar disorder interventions in order to address their psychosis, alongside mood regulation, with a particular emphasis on impulsivity, irritability, disinhibition and elation. The Balancing ACT study aims to evaluate an innovative group intervention combining Acceptance and Commitment Therapy and psychoeducation approaches (ACT/PE) with individuals experiencing bipolar disorder and/or symptoms within community psychosis services. METHODS: The Balancing ACT study is a randomised controlled trial comparing Balancing ACT groups (ACT/PE) plus routine care to routine care alone. Balancing ACT (ACT/PE) comprises ten group sessions, each lasting 2 hours, delivered weekly. The primary outcome is psychological wellbeing; secondary outcomes are mental health relapses (measured by service use averages for the 12 months pre baseline and 3 months post baseline). We will also measure mood, distress, recovery and psychological change processes. Participants will be randomised in a 1:1 ratio, after baseline assessment. Outcomes will be assessed by trained assessors blind to treatment condition at 0, 10 and 14 weeks. Recruitment began in April 2017 and is on-going until the end of October 2017. DISCUSSION: The Balancing ACT study will contribute to the currently limited evidence base for psychological interventions for people experiencing bipolar disorder and/or symptoms in the context of community psychosis services. TRIAL REGISTRATION: ISRCTN73327972 . Registered on 27 March 2017. Balancing ACT: evaluating the effectiveness of psychoeducation and Acceptance and Commitment Therapy (ACT) groups for people with bipolar disorder.

The feasibility and acceptability of a brief Acceptance and Commitment Therapy (ACT) group intervention for people with psychosis: The 'ACT for life' study.

BACKGROUND AND OBJECTIVES: Acceptance and Commitment Therapy (ACT) is a contextual cognitive-behavioural approach with a developing evidence base for clinical and cost-effectiveness as an individually-delivered intervention to promote recovery from psychosis. ACT also lends itself to brief group delivery, potentially increasing access to therapy without inflating costs. This study examined, for the first time, the feasibility and acceptability of ACT groups for people with psychosis (G-ACTp). METHODS: Participants were recruited from community psychosis teams. Ratings of user satisfaction, and pre-post change in self-rated functioning (primary outcome), mood (secondary outcome) and ACT processes were all completed with an independent assessor. Of 89 people recruited, 83 completed pre measures, 69 started the four-week G-ACTp intervention, and 65 completed post measures. RESULTS: Independently assessed acceptability and satisfaction were high. Functioning (Coeff. = -2.4, z = -2.9, p = 0.004; 95% CI: -4.0 to -0.8; within subject effect size (ES) d = 0.4) and mood (Coeff. = -2.3, z = -3.5, p = 0.001; 95% CI: -3.5 to -1.0; d = 0.4) improved from baseline to follow-up. Commensurate changes in targeted ACT processes were consistent with the underlying model. LIMITATIONS: The uncontrolled, pre-post design precluded blinded assessments, and may have inflated effect sizes. Participants may have improved as a result of other factors, and findings require replication in a randomized controlled trial (RCT). CONCLUSIONS: This preliminary study showed that brief group ACT interventions for people with psychosis are feasible and acceptable. Uncontrolled, pre-post assessments suggest small clinical improvements, and changes in psychological processes consistent with an ACT model. Replication in an RCT is required, before implementation can be recommended.

Jumping to the wrong conclusions? An investigation of the mechanisms of reasoning errors in delusions.

Understanding how people with delusions arrive at false conclusions is central to the refinement of cognitive behavioural interventions. Making hasty decisions based on limited data ('jumping to conclusions', JTC) is one potential causal mechanism, but reasoning errors may also result from other processes. In this study, we investigated the correlates of reasoning errors under differing task conditions in 204 participants with schizophrenia spectrum psychosis who completed three probabilistic reasoning tasks. Psychotic symptoms, affect, and IQ were also evaluated. We found that hasty decision makers were more likely to draw false conclusions, but only 37% of their reasoning errors were consistent with the limited data they had gathered. The remainder directly contradicted all the presented evidence. Reasoning errors showed task-dependent associations with IQ, affect, and psychotic symptoms. We conclude that limited data-gathering contributes to false conclusions but is not the only mechanism involved. Delusions may also be maintained by a tendency to disregard evidence. Low IQ and emotional biases may contribute to reasoning errors in more complex situations. Cognitive strategies to reduce reasoning errors should therefore extend beyond encouragement to gather more data, and incorporate interventions focused directly on these difficulties.

Combined internal and external Le Fort III distraction osteogenesis--the "elusive vector".

This article describes a modified surgical technique using both internal and external distractors for distraction osteogenesis at the Le Fort III level. This technique optimizes vector control, superior to single-device techniques, resulting in excellent control and, ultimately, a functional occlusion.

Cell shape changes indicate a role for extrinsic tensile forces in Drosophila germ-band extension.

Drosophila germ-band extension (GBE) is an example of the convergence and extension movements that elongate and narrow embryonic tissues. To understand the collective cell behaviours underlying tissue morphogenesis, we have continuously quantified cell intercalation and cell shape change during GBE. We show that the fast, early phase of GBE depends on cell shape change in addition to cell intercalation. In antero-posterior patterning mutants such as those for the gap gene Krüppel, defective polarized cell intercalation is compensated for by an increase in antero-posterior cell elongation, such that the initial rate of extension remains the same. Spatio-temporal patterns of cell behaviours indicate that an antero-posterior tensile force deforms the germ band, causing the cells to change shape passively. The rate of antero-posterior cell elongation is reduced in twist mutant embryos, which lack mesoderm. We propose that cell shape change contributing to germ-band extension is a passive response to mechanical forces caused by the invaginating mesoderm.

Tissue tectonics: morphogenetic strain rates, cell shape change and intercalation.

The dynamic reshaping of tissues during morphogenesis results from a combination of individual cell behaviors and collective cell rearrangements. However, a comprehensive framework to unambiguously measure and link cell behavior to tissue morphogenesis is lacking. Here we introduce such a kinematic framework, bridging cell and tissue behaviors at an intermediate, mesoscopic, level of cell clusters or domains. By measuring domain deformation in terms of the relative motion of cell positions and the evolution of their shapes, we characterized the basic invariant quantities that measure fundamental classes of cell behavior, namely tensorial rates of cell shape change and cell intercalation. In doing so we introduce an explicit definition of cell intercalation as a continuous process. We mapped strain rates spatiotemporally in three models of tissue morphogenesis, gaining insight into morphogenetic mechanisms. Our quantitative approach has broad relevance for the precise characterization and comparison of morphogenetic phenotypes.