Assessing patient's belief on HIV testing before elective surgery: room for improvements in Switzerland !

Background: ln Switzerland no HIV test is performed without the patient's consent based on a Voluntary Counseling and Testing policy (VCT). We hypothesized that a substantial proportion of patients going through an elective surgery falsely believed that an HIV test was performed on a routine basis and that the lack of transmission of result was interpreted as being HIV negative. Method: All patients with elective orthopedic surgery during 2007 were contacted by phone in 2008. A structured questionnaire assessed their belief about routine preoperative blood analysis (diabetes, coagulation function, HIV test and cholesterol level) as well as result awareness and interpretation. Variables included age and gender. Analysis were conducted using the software JMP 6.0.3. Results: 1123 patients were included. 130 (12 %) were excluded (Le. unreachable, unable to communicate on the phone, not operated). 993 completed the survey (89 %). Median age was 51 (16-79). 50 % were female. 376 (38 %) patients thought they had an HIV test performed before surgery but none of them had one. 298 (79 %) interpreted the absence of result as a negative HIV test. A predictive factor to believe an HIV test had been done was an age below 50 years old (45 % vs 33 % for 16-49 years old and 50-79 years old respectively, p < 0.001). No difference was observed between genders. Conclusion: ln Switzerland, nearly 40 % of the patients falsely thought an HIV test had been performed on a routine basis before surgery and were erroneously reassured about their HIV status. These results should either improve the information given to the patient regarding preoperative exams, or motivate public health policy to consider HIV opt-out screening instead of VCT strategy.

Social justice in education : how the function of selection in educational institutions predicts support for (non)egalitarian assessment practices

Educational institutions are considered a keystone for the establishment of a meritocratic society. They supposedly serve two functions: an educational function that promotes learning for all, and a selection function that sorts individuals into different programs, and ultimately social positions, based on individual merit. We study how the function of selection relates to support for assessment practices known to harm vs. benefit lower status students, through the perceived justice principles underlying these practices. We study two assessment practices: normative assessment-focused on ranking and social comparison, known to hinder the success of lower status students-and formative assessment-focused on learning and improvement, known to benefit lower status students. Normative assessment is usually perceived as relying on an equity principle, with rewards being allocated based on merit and should thus appear as positively associated with the function of selection. Formative assessment is usually perceived as relying on corrective justice that aims to ensure equality of outcomes by considering students' needs, which makes it less suitable for the function of selection. A questionnaire measuring these constructs was administered to university students. Results showed that believing that education is intended to select the best students positively predicts support for normative assessment, through increased perception of its reliance on equity, and negatively predicts support for formative assessment, through reduced perception of its ability to establish corrective justice. This study suggests that the belief in the function of selection as inherent to educational institutions can contribute to the reproduction of social inequalities by preventing change from assessment practices known to disadvantage lowerstatus student, namely normative assessment, to more favorable practices, namely formative assessment, and by promoting matching beliefs in justice principles.

Believing in belief : the modernist quest for spiritual meaning (Croyer en croyance : la quête moderniste pour le sens spirituel)

Cette thèse défend l’idée que plusieurs auteurs modernistes ont utilisé des concepts centraux à la croyance religieuse traditionnelle afin de préconiser le changement social. Au lieu de soutenir l'hypothèse de la sécularisation, qui prétend que les modernistes ont rejeté la religion en faveur d'une laïcité non contestée, j'argumente en faveur de ce que j'appelle « la spiritualité moderniste, » qui décrie une continuité intégrale des concepts spirituels dans l'agitation de la période moderniste qui a déstabilisée les institutions qui avait auparavant jeté les bases de la société Occidentale. En me basant sur les écrit de Sigmund Freud, William James et Émile Durkheim concernant les fins poursuivis par la religion, je développe cinq concepts centraux de la croyance religieuse que les modernistes ont cherché à resignifier, à savoir la rédemption, la communauté, la sacralité, le spectre, et la liturgie, et, dans chaque cas, j'ai montré comment ces catégories ont été réinterprétées pour traiter des questions considérées comme essentielles au début du vingtième siècle, à savoir ce que l’on identifie aujourd’hui comme le féminisme, l'écologie, la biopolitique, les crises, et le rôle du poète. Le chapitre I se concentre sur la rédemption par le féminin telle qu’on la trouve dans le recueil de vers de H.D. portant sur la Seconde Guerre mondiale, Trilogy (1944-1946), qui projette un certain espoir grâce à un mélange synchrétique de Christianisme, de mythes anciens, d’astrologie, et de psychologie. Mon deuxième chapitre discute de The Grapes of Wrath (1939) de John Steinbeck, qui élargit le rôle de la communauté en avançant une écologie universelle qui concevoit tous les gens comme étant intimement liés entre eux et avec le monde. Le chapitre III traite de la notion du sacré dans The Light in August (1932) de Willam Faulkner et Nightwood (1936) de Djuna Barnes, qui préconisent une foi privatisée qui accentue l'illégitimité des concepts de sacralité et de pollution en élevant des individus qui sont marginalisés biopolitiquement. Le chapitre IV cherche à comprendre le retour des morts, et je soutiens que le topos a été utilisé par les modernistes comme un symbole de crises sociales; le chapitre enquête d'abord sur “The Jolly Corner” (1908) de Henry James, que j'ai lu comme la séquence rêvée d'un homme faisant face à son propre spectre, Ulysses (1922) de James Joyce, où Stephen Dedalus est hanté de façon répétée par le spectre de sa mère, et Mrs. Dalloway (1925) de Virginia Woolf, qui se concentre sur le motif caché de la Fête des Morts. Ma cinquième section traite de la liturgie, la langue poétique utilisée pour les rites religieux, dans la première poésie de Wallace Stevens, qui conçoit le rôle du poète comme une vocation de l'imagination.

Are shrubs really a sign of declining ecosystem function? Disentangling the myths and truths of woody encroachment in Australia

Since European settlement, there has been a dramatic increase in the density, cover and distribution of woody plants in former grassland and open woodland. There is a widespread belief that shrub encroachment is synonymous with declines in ecosystem functions, and often it is associated with landscape degradation or desertification. Indeed, this decline in ecosystem functioning is considered to be driven largely by the presence of the shrubs themselves. This prevailing paradigm has been the basis for an extensive program of shrub removal, based on the view that it is necessary to reinstate the original open woodland or grassland structure from which shrublands are thought to have been derived. We review existing scientific evidence, particularly focussed on eastern Australia, to question the notion that shrub encroachment leads to declines in ecosystem functions. We then summarise this scientific evidence into two conceptual models aimed at optimising landscape management to maximise the services provided by shrub-encroached areas. The first model seeks to reconcile the apparent conflicts between the patch- and landscape-level effects of shrubs. The second model identifies the ecosystem services derived from different stages of shrub encroachment. We also examined six ecosystem services provided by shrublands (biodiversity, soil C, hydrology, nutrient provision, grass growth and soil fertility) by using published and unpublished data. We demonstrated the following: (1) shrub effects on ecosystems are strongly scale-, species- and environment-dependent and, therefore, no standardised management should be applied to every case; (2) overgrazing dampens the generally positive effect of shrubs, leading to the misleading relationship between encroachment and degradation; (3) woody encroachment per se does not hinder any of the functions or services described above, rather it enhances many of them; (4) no single shrub-encroachment state (including grasslands without shrubs) will maximise all services; rather, the provision of ecosystem goods and services by shrublands requires a mixture of different states; and (5) there has been little rigorous assessment of the long-term effectiveness of removal and no evidence that this improves land condition in most cases. Our review provides the basis for an improved, scientifically based understanding and management of shrublands, so as to balance the competing goals of providing functional habitats, maintaining soil processes and sustaining pastoral livelihoods.

Uniformly reweighted belief propagation for distributed Bayesian hypothesis testing

Belief propagation (BP) is a technique for distributed inference in wireless networks and is often used even when the underlying graphical model contains cycles. In this paper, we propose a uniformly reweighted BP scheme that reduces the impact of cycles by weighting messages by a constant ?edge appearance probability? rho ? 1. We apply this algorithm to distributed binary hypothesis testing problems (e.g., distributed detection) in wireless networks with Markov random field models. We demonstrate that in the considered setting the proposed method outperforms standard BP, while maintaining similar complexity. We then show that the optimal ? can be approximated as a simple function of the average node degree, and can hence be computed in a distributed fashion through a consensus algorithm.

Nonparametric generalized belief propagation based on pseudo-junction tree for cooperative localization in wireless networks

Non-parametric belief propagation (NBP) is a well-known message passing method for cooperative localization in wireless networks. However, due to the over-counting problem in the networks with loops, NBP’s convergence is not guaranteed, and its estimates are typically less accurate. One solution for this problem is non-parametric generalized belief propagation based on junction tree. However, this method is intractable in large-scale networks due to the high-complexity of the junction tree formation, and the high-dimensionality of the particles. Therefore, in this article, we propose the non-parametric generalized belief propagation based on pseudo-junction tree (NGBP-PJT). The main difference comparing with the standard method is the formation of pseudo-junction tree, which represents the approximated junction tree based on thin graph. In addition, in order to decrease the number of high-dimensional particles, we use more informative importance density function, and reduce the dimensionality of the messages. As by-product, we also propose NBP based on thin graph (NBP-TG), a cheaper variant of NBP, which runs on the same graph as NGBP-PJT. According to our simulation and experimental results, NGBP-PJT method outperforms NBP and NBP-TG in terms of accuracy, computational, and communication cost in reasonably sized networks.

Palette-colouring: a belief propagation approach

We consider a variation of the prototype combinatorial optimization problem known as graph colouring. Our optimization goal is to colour the vertices of a graph with a fixed number of colours, in a way to maximize the number of different colours present in the set of nearest neighbours of each given vertex. This problem, which we pictorially call palette-colouring, has been recently addressed as a basic example of a problem arising in the context of distributed data storage. Even though it has not been proved to be NP-complete, random search algorithms find the problem hard to solve. Heuristics based on a naive belief propagation algorithm are observed to work quite well in certain conditions. In this paper, we build upon the mentioned result, working out the correct belief propagation algorithm, which needs to take into account the many-body nature of the constraints present in this problem. This method improves the naive belief propagation approach at the cost of increased computational effort. We also investigate the emergence of a satisfiable-to-unsatisfiable 'phase transition' as a function of the vertex mean degree, for different ensembles of sparse random graphs in the large size ('thermodynamic') limit.

Decentralised supply chain formation:a belief propagation-based approach

Decentralised supply chain formation involves determining the set of producers within a network able to supply goods to one or more consumers at the lowest cost. This problem is frequently tackled using auctions and negotiations. In this paper we show how it can be cast as an optimisation of a pairwise cost function. Optimising this class of functions is NP-hard but good approximations to the global minimum can be obtained using Loopy Belief Propagation (LBP). Here we detail a LBP-based approach to the supply chain formation problem, involving decentralised message-passing between potential participants. Our approach is evaluated against a well-known double-auction method and an optimal centralised technique, showing several improvements: it obtains better solutions for most networks that admit a competitive equilibrium Competitive equilibrium as defined in [3] is used as a means of classifying results on certain networks to allow for minor inefficiencies in their auction protocol and agent bidding strategies. while also solving problems where no competitive equilibrium exists, for which the double-auction method frequently produces inefficient solutions.

Decentralized supply chain formation using max-sum loopy belief propagation

Supply chain formation is the process by which a set of producers within a network determine the subset of these producers able to form a chain to supply goods to one or more consumers at the lowest cost. This problem has been tackled in a number of ways, including auctions, negotiations, and argumentation-based approaches. In this paper we show how this problem can be cast as an optimization of a pairwise cost function. Optimizing this class of energy functions is NP-hard but efficient approximations to the global minimum can be obtained using loopy belief propagation (LBP). Here we detail a max-sum LBP-based approach to the supply chain formation problem, involving decentralized message-passing between supply chain participants. Our approach is evaluated against a well-known decentralized double-auction method and an optimal centralized technique, showing several improvements on the auction method: it obtains better solutions for most network instances which allow for competitive equilibrium (Competitive equilibrium in Walsh and Wellman is a set of producer costs which permits a Pareto optimal state in which agents in the allocation receive non-negative surplus and agents not in the allocation would acquire non-positive surplus by participating in the supply chain) while also optimally solving problems where no competitive equilibrium exists, for which the double-auction method frequently produces inefficient solutions. © 2012 Wiley Periodicals, Inc.

Bayesian adaptive estimation of arbitrary points on a psychometric function

Bayesian adaptive methods have been extensively used in psychophysics to estimate the point at which performance on a task attains arbitrary percentage levels, although the statistical properties of these estimators have never been assessed. We used simulation techniques to determine the small-sample properties of Bayesian estimators of arbitrary performance points, specifically addressing the issues of bias and precision as a function of the target percentage level. The study covered three major types of psychophysical task (yes-no detection, 2AFC discrimination and 2AFC detection) and explored the entire range of target performance levels allowed for by each task. Other factors included in the study were the form and parameters of the actual psychometric function Psi, the form and parameters of the model function M assumed in the Bayesian method, and the location of Psi within the parameter space. Our results indicate that Bayesian adaptive methods render unbiased estimators of any arbitrary point on psi only when M=Psi, and otherwise they yield bias whose magnitude can be considerable as the target level moves away from the midpoint of the range of Psi. The standard error of the estimator also increases as the target level approaches extreme values whether or not M=Psi. Contrary to widespread belief, neither the performance level at which bias is null nor that at which standard error is minimal can be predicted by the sweat factor. A closed-form expression nevertheless gives a reasonable fit to data describing the dependence of standard error on number of trials and target level, which allows determination of the number of trials that must be administered to obtain estimates with prescribed precision.

Closing Pandora's box: a defence of Alvin Plantinga's epistemology of religious belief

I argue (1) that Alvin Plantinga’s theory of warrant is plausible and (2) that, contrary to the Pandora’s Box objection, there are certain serious world religions that cannot successfully use Plantinga’s epistemology to demonstrate that their beliefs could be warranted in the same way that Christian belief can be warranted. In arguing for (1), I deploy Ernest Sosa’s Swampman case to show that Plantinga’s proper function condition is a necessary condition for warrant. I then engage three objections to Plantinga’s theory of warrant, each of which attempts to demonstrate that his conditions for warrant are neither necessary nor sufficient. Having defended the plausibility of Plantinga’s theory of warrant, I present and expand his key arguments to the effect that naturalism cannot make use of it. These arguments provide the conceptual tools that are needed to argue for (2): that there are certain world religions that cannot legitimately use Plantinga’s theory of warrant to demonstrate that their beliefs could be warranted in the same way that Christian belief can be warranted.

Error analyses reveal contrasting deficits in “theory of mind”: neuropsychological evidence from a 3-option false belief task

Perspective taking is a crucial ability that guides our social interactions. In this study, we show how the specific patterns of errors of brain-damaged patients in perspective taking tasks can help us further understand the factors contributing to perspective taking abilities. Previous work (e.g., Samson, Apperly, Chiavarino, & Humphreys, 2004; Samson, Apperly, Kathirgamanathan, & Humphreys, 2005) distinguished two components of perspective taking: the ability to inhibit our own perspective and the ability to infer someone else’s perspective. We assessed these components using a new nonverbal false belief task which provided different response options to detect three types of response strategies that participants might be using: a complete and spared belief reasoning strategy, a reality-based response selection strategy in which participants respond from their own perspective, and a simplified mentalising strategy in which participants avoid responding from their own perspective but rely on inaccurate cues to infer the other person’s belief. One patient, with a self-perspective inhibition deficit, almost always used the reality-based response strategy; in contrast, the other patient, with a deficit in taking other perspectives, tended to use the simplified mentalising strategy without necessarily transposing her own perspective. We discuss the extent to which the pattern of performance of both patients could relate to their executive function deficit and how it can inform us on the cognitive and neural components involved in belief reasoning.

Relationship Between Orofacial Function, Dentofacial Morphology, And Bite Force In Young Subjects.

The aim was to evaluate the relationship between orofacial function, dentofacial morphology, and bite force in young subjects. Three hundred and sixteen subjects were divided according to dentition stage (early, intermediate, and late mixed and permanent dentition). Orofacial function was screened using the Nordic Orofacial Test-Screening (NOT-S). Orthodontic treatment need, bite force, lateral and frontal craniofacial dimensions and presence of sleep bruxism were also assessed. The results were submitted to descriptive statistics, normality and correlation tests, analysis of variance, and multiple linear regression to test the relationship between NOT-S scores and the studied independent variables. The variance of NOT-S scores between groups was not significant. The evaluation of the variables that significantly contributed to NOT-S scores variation showed that age and presence of bruxism related to higher NOT-S total scores, while the increase in overbite measurement and presence of closed lip posture related to lower scores. Bite force did not show a significant relationship with scores of orofacial dysfunction. No significant correlations between craniofacial dimensions and NOT-S scores were observed. Age and sleep bruxism were related to higher NOT-S scores, while the increase in overbite measurement and closed lip posture contributed to lower scores of orofacial dysfunction.

Impaired Compensatory Beta-cell Function And Growth In Response To High-fat Diet In Ldl Receptor Knockout Mice.

In this study, we investigated the effect of low density lipoprotein receptor (LDLr) deficiency on gap junctional connexin 36 (Cx36) islet content and on the functional and growth response of pancreatic beta-cells in C57BL/6 mice fed a high-fat (HF) diet. After 60 days on regular or HF diet, the metabolic state and morphometric islet parameters of wild-type (WT) and LDLr-/- mice were assessed. HF diet-fed WT animals became obese and hypercholesterolaemic as well as hyperglycaemic, hyperinsulinaemic, glucose intolerant and insulin resistant, characterizing them as prediabetic. Also they showed a significant decrease in beta-cell secretory response to glucose. Overall, LDLr-/- mice displayed greater susceptibility to HF diet as judged by their marked cholesterolaemia, intolerance to glucose and pronounced decrease in glucose-stimulated insulin secretion. HF diet induced similarly in WT and LDLr-/- mice, a significant decrease in Cx36 beta-cell content as revealed by immunoblotting. Prediabetic WT mice displayed marked increase in beta-cell mass mainly due to beta-cell hypertrophy/replication. Nevertheless, HF diet-fed LDLr-/- mice showed no significant changes in beta-cell mass, but lower islet-duct association (neogenesis) and higher beta-cell apoptosis index were seen as compared to controls. The higher metabolic susceptibility to HF diet of LDLr-/- mice may be explained by a deficiency in insulin secretory response to glucose associated with lack of compensatory beta-cell expansion.

Long-term Postoperative Atrophy Of Contralateral Hippocampus And Cognitive Function In Unilateral Refractory Mtle With Unilateral Hippocampal Sclerosis.

This study aimed to evaluate long-term atrophy in contralateral hippocampal volume after surgery for unilateral MTLE, as well as the cognitive outcome for patients submitted to either selective transsylvian amygdalohippocampectomy (SelAH) or anterior temporal lobe resection (ATL). We performed a longitudinal study of 47 patients with MRI signs of unilateral hippocampal sclerosis (23 patients with right-sided hippocampal sclerosis) who underwent surgical treatment for MTLE. They underwent preoperative/postoperative high-resolution MRI as well as neuropsychological assessment for memory and estimated IQ. To investigate possible changes in the contralateral hippocampus of patients, we included 28 controls who underwent two MRIs at long-term intervals. The volumetry using preoperative MRI showed significant hippocampal atrophy ipsilateral to the side of surgery when compared with controls (p<0.0001) but no differences in contralateral hippocampal volumes. The mean postoperative follow-up was 8.7 years (± 2.5 SD; median=8.0). Our patients were classified as Engel I (80%), Engel II (18.2%), and Engel III (1.8%). We observed a small but significant reduction in the contralateral hippocampus of patients but no volume changes in controls. Most of the patients presented small declines in both estimated IQ and memory, which were more pronounced in patients with left TLE and in those with persistent seizures. Different surgical approaches did not impose differences in seizure control or in cognitive outcome. We observed small declines in cognitive scores with most of these patients, which were worse in patients with left-sided resection and in those who continued to suffer from postoperative seizures. We also demonstrated that manual volumetry can reveal a reduction in volume in the contralateral hippocampus, although this change was mild and could not be detected by visual analysis. These new findings suggest that dynamic processes continue to act after the removal of the hippocampus, and further studies with larger groups may help in understanding the underlying mechanisms.