Trusting scientific experts in an online world.

A perennial problem in social epistemology is the problem of expert testimony, specifically expert testimony regarding scientific issues: for example, while it is important for me to know information pertaining to anthropogenic climate change, vaccine safety, Covid-19, etc., I may lack the scientific background required to determine whether the information I come across is, in fact, true. Without being able to evaluate the science itself, then, I need to find trustworthy expert testifiers to listen to. A major project in social epistemology has thus become determining what the markers of trustworthiness are that laypersons can appeal to in order to identify and acquire information from expert testifiers. At the same time, the ways in which we acquire scientific information has changed significantly, with much of it nowadays being acquired in online environments. While much has been said about the potential pitfalls of seeking information online (e.g. the prevalence of filter bubbles, echo chambers, and the overall proliferation of "fake news"), little has been said about how the nature of seeking information online should make us think about the problem of expert testimony. Indeed, it seems to be an underlying assumption that good markers of trustworthiness apply equally well when seeking information from expert testifiers in online and offline environments alike, and that the new challenges and opportunities presented by online environments merely affects the methods by which we can acquire evidence of said trustworthiness. Here I argue that in making this assumption one risks failing to account for how unique features of the ways in which we acquire information online affect how we evaluate the trustworthiness of experts. Specifically, I argue for two main claims: first, that the nature of information-seeking online is such that the extent to which information is susceptible to manipulation is a dominant marker of trustworthiness; second, as a result, one will be more likely to seek out a particular kind of expert testifier in online environments, what I call a cooperative as opposed to preemptive expert. The result is that criteria for expert trustworthiness may look significantly different when acquiring information online as opposed to offline.

Beyond politics: additional factors underlying skepticism of a COVID-19 vaccine.

Even before it had been developed there had already been skepticism among the general public concerning a vaccine for COVID-19. What are the factors that drive this skepticism? While much has been said about how political differences are at play, in this article I draw attention to two additional factors that have not received as much attention: witnessing the fallibility of the scientific process play out in real time, and a perceived breakdown of the distinction between experts and non-experts.

Krebs von den Lungen-6 (KL-6) is a pathophysiological biomarker of early-stage acute hypersensitivity pneumonitis among pigeon fanciers.

BACKGROUND: Identifying early stages of hypersensitivity pneumonitis (HP) is hampered by variable presentation, heterogeneous or undetected causal antigens and lack of gold-standard biomarkers. Krebs von den Lungen (KL)-6 is pathophysiological biomarker of alveolar epithelial damage. Pigeon fanciers, susceptible to HP, provide a model to investigate early HP. OBJECTIVE: To test the hypothesis that plasma concentrations of KL-6 are increased in early-stage acute HP. METHODS: Clinical history, spirometry and blood samples were obtained from pigeon fanciers, 20 with intermittent acute symptoms indicative of developing HP, 27 with no symptoms and 10 healthy subjects with no avian exposure. Plasma KL-6 (units/mL) and pigeon antigen-specific IgG antibody were quantified by enzyme immunoassay. Blood lymphocytes were quantified by flow cytometry and antigen specificity by in vitro cytokine production. RESULTS: KL-6 was higher in fanciers than controls, median (IQR) 452 (244, 632) vs 274 (151, 377), P = .01. Although fanciers with symptoms had similar antigen exposure and lung function, they had higher KL-6 than those without, 632 (468, 1314) vs 320 (200, 480), P < .001. KL-6 correlated with IgG antibody titre in those with symptoms, r = .591, P = .006. High KL-6, irrespective of symptom category, was associated with higher antibody (P = .006) and lymphocyte proliferation (P = .041), and lower CD4+ T lymphocyte proportion (P = .032). CONCLUSION AND CLINICAL RELEVANCE: Raised KL-6 is associated with acute symptoms of early-stage HP, and its correlation with antibody may support therapeutic strategies when HP is suspected. KL-6 may act as a mechanistic biomarker of early pathogenesis by linking lung pathophysiological changes with an endotype of immune hypersensitivity.

The impossibility of informed consent?

The problematic nature of informed consent to medical treatment and research, and its relation to autonomy, trust and clinical practice, has been addressed on many occasions and from a variety of ethical perspectives in the pages of the Journal of Medical Ethics. This paper gives an account of how discussion of these issues has developed and changed, by describing a number of significant contributions to these debates which provide examples of 'doing good medical ethics' over the 40 years of the Journal's publication.

Metabolite profile shifts in the heathland lichen Cladonia portentosa in response to N deposition reveal novel biomarkers.

The heathland lichen Cladonia portentosa was collected from sites in mainland Britain differing either in rates of wet N deposition or in annual mean N concentration in rainfall based on a modelled data set. Methanolic extracts of thalli were analyzed by liquid chromatography time-of-flight mass spectrometry to yield metabolic profiles. Differences between sites in metabolite concentration were quantified using multivariate statistical tools and used to identify potential biomarker molecules. The abundances of three structurally related betaine lipids showed an increase with increasing modelled N deposition to a threshold of 22.3 kg ha(-1) year(-1) after which they remained constant. In contrast, the abundance of a phosphatidylcholine (PC) lipid showed concomitant decrease. Correlations of the identified biomarkers with N deposition and precipitation were stronger than those with N concentrations. The results presented in this study clearly show that N enrichment associated with tissue P limitation changes lipid composition, leading to shifts from PCs to betaine lipids, and that these lipids identified have the potential to be used as biomarkers for nitrogen enrichment.

Effect of long-term storage and harvest site on the fatty acid profiles, mineral and antioxidant properties of selected edible Scottish seaweeds.

The limited understanding of the effect of pre-and post-harvest techniques still hinders the full exploitation of seaweed. Here, the effect of harvest site, long term storage and species on the elemental composition, fatty acid profile, lipid content, and antioxidant properties were determined in eight intertidal seaweed species common to Scotland, harvested for potential food application and stored for up to 128 weeks. Result showed that the most significant variation was due to species, with no statistical link found for the combined interaction effect of both storage duration and harvest site in most cases, except for the antioxidant parameters and some selected elements, which was limited to some seaweed species. Overall, our result showed that the chemical profiles of the seaweed species studied were remarkably consistent and unaffected by long term storage. Thus, suggesting that seaweeds sampled from Scotland could be a valuable resource for the development of functional foods.

Spatiotemporal trends and annual fluxes of pharmaceuticals in a Scottish priority catchment.

Pharmaceuticals (a class of emerging contaminants) are continuously introduced into effluent-receiving surface waters due to their incomplete removal within wastewater treatment plants (WWTPs). This work investigated the presence and distribution of eight commonly used human pharmaceuticals in the River Dee (Scotland, UK), a Scottish Environment Protection Agency priority catchment that is a conservation site and important raw water source. Grab sampling and passive sampling (Polar Organic Chemical Integrative Sampler, POCIS) was performed over 12 months, targeting: paracetamol, ibuprofen, and diclofenac (analgesics/anti-inflammatories); clarithromycin and trimethoprim (antibiotics); carbamazepine and fluoxetine (psychoactive drugs); and 17α-ethynylestradiol (estrogen hormone). Sampling sites spanned from the river's rural source to the heavily urbanised estuary into the North Sea. Ibuprofen (ranging 0.8-697 ng/L), paracetamol (ranging 4-658 ng/L), trimethoprim (ranging 3-505 ng/L), diclofenac (ranging 2-324 ng/L) and carbamazepine (ranging 1-222 ng/L) were consistently detected at the highest concentrations through grab sampling, with concentrations generally increasing down river with increasing urbanisation. However, POCIS revealed trace contamination of most compounds throughout the river (commonly <0.5 ng/L), indicating pollution may be related to diffuse sources. Analysis of river flows revealed that low flow and warm seasons corresponded to statistically significantly higher concentrations of diclofenac and carbamazepine, two compounds of environmental and regulatory concern. Below the largest WWTP, annual average fluxes ranged 0.1 kg/yr (clarithromycin) to 143.8 kg/yr (paracetamol), with 226.2 kg/yr for total target compounds. It was estimated that this source contributed >70% of the total mass loads (dissolved phase) of the target compounds in the river. As the River Dee is an important raw water source and conservation site, additional catchment monitoring is warranted to safeguard water quality and assess environmental risk of emerging contaminants, particularly in relation to unusual weather patterns, climate change and population growth.

Antimicrobial resistant Escherichia coli in Scottish wild deer: Prevalence and risk factors.

Antimicrobial resistance (AMR) is a recognised threat to global health. Obtaining data on the prevalence of AMR in environmental bacteria is key to understanding drivers and routes of transmission. Here, 325 Shiga toxin negative deer faecal samples-gathered from across the Scottish mainland-were screened for the presence of AMR Escherichia coli and investigated for potential risk factors associated with AMR occurrence. E. coli with resistance to antimicrobials of clinical health concern, including carbapenems and 3rd generation cephalosporins, were targeted. Ninety-nine percent of samples yielded E. coli, and the prevalence of resistant E. coli at the level of faecal samples was 21.8% (n = 71) for tetracycline, 6.5% (n = 21) for cefpodoxime, 0.3% for ciprofloxacin (n = 1), with no recorded resistance to meropenem. Potential risk factors for tetracycline and cefpodoxime resistance were investigated. The presence of broadleaved woodlands was significantly associated with both AMR phenotypes, which may relate to land use within or around such woodlands. Associated risk factors varied across resistance phenotype and deer species, with proximity or density of horses an indicator of significantly decreased and increased risk, respectively, or tetracycline and cefpodoxime resistance in E. coli from roe deer, but not from red deer. Distance from wastewater treatment plants was a significant risk factor for tetracycline resistance in E. coli from red deer but not from roe deer. Data indicated that AMR E. coli can occur in wild deer populations that are not directly exposed to the selective pressure exerted by antimicrobial treatment. Overall, resistance to critically important antimicrobials was found to be low in the studied population, suggesting no immediate cause for concern regarding human health. Utilising existing culling frameworks, wild deer in Scotland could function well as a sentinel species for the surveillance of AMR in the Scottish environment.

Sustaining University Operations During the COVID-19 Pandemic.

Colleges and universities around the world engaged diverse strategies during the COVID-19 pandemic. Baylor University, a community of ˜22,700 individuals, was 1 of the institutions which resumed and sustained operations. The key strategy was establishment of multidisciplinary teams to develop mitigation strategies and priority areas for action. This population-based team approach along with implementation of a "Swiss Cheese" risk mitigation model allowed small clusters to be rapidly addressed through testing, surveillance, tracing, isolation, and quarantine. These efforts were supported by health protocols including face coverings, social distancing, and compliance monitoring. As a result, activities were sustained from August 1 to December 8, 2020. There were 62,970 COVID-19 tests conducted with 1435 people testing positive for a positivity rate of 2.28%. A total of 1670 COVID-19 cases were identified with 235 self-reports. The mean number of tests per week was 3500 with approximately 80 of these positive (11/d). More than 60 student tracers were trained with over 120 personnel available to contact trace, at a ratio of 1 per 400 university members. The successes and lessons learned provide a framework and pathway for similar institutions to mitigate the ongoing impacts of COVID-19 and sustain operations during a global pandemic.