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Simon et al. (2020) argue that the concept of response strength is unnecessary and potentially harmful in that it misdirects behavior analysts away from more fruitful molar analyses. I defend the term as a useful summary of the effects of reinforcement and point particularly to its utility as an interpretive tool in making sense of complex human behavior under multiple control. Physiological data suggest that the concept is not an explanatory fiction, but strength cannot be simply equated with neural conductivity; interaction with competing behaviors must be considered as well. Decisions about appropriate scales of analysis require a clarification of terms. I suggest defining behavior solely in terms of its sensitivity to behavioral principles, irrespective of locus, magnitude, or observability. Furthermore, I suggest that the term response class be restricted to units that vary together in probability in part because of overlapping topography. In contrast, functional classes are united by common consequences; they vary together with respect to motivational variables but need not share formal properties and need not covary with acquisition and extinction contingencies.

Introduction/Aims In this study, we examined the social and health impacts of the coronavirus disease 2019 (COVID‐19) pandemic and social guidelines on people with muscular dystrophies. Methods A prospective de‐identified electronic survey was distributed to adults with self‐reported facioscapulohumeral muscular dystrophy (FSHD), myotonic dystrophy (DM), and limb‐girdle muscular dystrophy (LGMD) enrolled in national registries or with patient advocacy groups. The COVID‐19 Impact Survey was developed by muscular dystrophy experts in association with patient collaborators and advocacy groups. The Perceived Stress Scale was used to measure perceived stress. Results Respondents (n = 774: 56% FSHD; 35% DM, and 9% LGMD) were mostly women and middle‐aged (range 19–87 y). Rates of COVID‐19 infections were low (

D.S.P. and D.J.F. thank the EPSRC for funding via Prosperity Partnership EP/S035990/1. D.S.P. and D.J.F. thank the ARCHIE-WeSt High-Performance Computing Centre (www.archie-west.ac.uk) for computational resources. The UCL authors thank Prof. Keith Refson for guidance with the phonon calculations, which used the ARCHER U.K. National Supercomputing Service (http://www.archer.ac.uk) as part of the U.K. HEC Materials Chemistry Consortium, which is funded by the EPSRC (EP/L000202, EP/R029431). R.G. was funded by MagnaPharm, a project funded by the European Union’s Horizon 2020 Research and Innovation programme under grant agreement number 736899. We demonstrate that physics-based calculations of intrinsic aqueous solubility can rival cheminformatics-based machine learning predictions. A proof-of-concept was developed for a physics-based approach via a sublimation thermodynamic cycle, building upon previous work that relied upon several thermodynamic approximations, notably the 2RT approximation, and limited conformational sampling. Here, we apply improvements to our sublimation free-energy model with the use of crystal phonon mode calculations to capture the contributions of the vibrational modes of the crystal. Including these improvements with lattice energies computed using the model-potential-based Ψmol method leads to accurate estimates of sublimation free energy. Combining these with hydration free energies obtained from either molecular dynamics free-energy perturbation simulations or density functional theory calculations, solubilities comparable to both experiment and informatics predictions are obtained. The application to coronene, succinic acid, and the pharmaceutical desloratadine shows how the methods must be adapted for the adoption of different conformations in different phases. The approach has the flexibility to extend to applications that cannot be covered by informatics methods. Publisher PDF

The core teachings of the Baha’i Faith are often summarized as the “Oneness of God, the Oneness of Religion, and the Oneness of Humanity.” Can such principles resonate with a pluralism based on the...

Background: Early detection of cancer is vital to improve patient survival, since earlier diagnosis and treatment maximizes the opportunity to combat or control disease progression. Specifically for colorectal cancer (CRC), the average 5-survival rate after diagnosis decreases from 91% in early-stage CRC, to as low as 15% for stage IV CRC. Furthermore, the rapid detection and subsequent removal of pre-cancerous adenomas - e.g., advanced adenomas (AA) - can improve survival rates of affected patients. Current stool-based tests, such as FIT and FIT-DNA, have poor AA sensitivities of 24% and 42%, and specificities of 95% and 87%, respectively. Recent research into liquid biopsies have shown some promise, however tests based on tumor-derived biomarkers alone have limited sensitivity, especially in early-stage disease. Methods: We initially applied the Dxcover® Cancer Liquid Biopsy for use as a multi-cancer early detection (MCED) test. The test uses Fourier transform infrared (FTIR) spectroscopy and machine learning algorithms to build a classifier of the resultant spectral profiles to detect cancer, and can be fine-tuned to maximize either sensitivity or specificity depending on the requirements of specific international healthcare systems. Additionally, we have analyzed a retrospective cohort of serum samples comprising 100 CRC, 99 advanced adenomas removed by surgical resection and 97 colonoscopy screening controls. Results: The CRC classifier from the discovery MCED dataset reported an area under the receiver operating characteristic curve (AUROC) value of 0.91, with 74% sensitivity and 91% specificity when differentiating CRC and non-cancer, which surpasses the targets set by the Centers for Medicare & Medicaid Services (CMS) for coverage of CRC tests. When tuned for higher sensitivity, the model produced 97% sensitivity (49% specificity), and when tailored for greater specificity (97%) the sensitivity was 47%. In this study, we have progressed these findings to examine the ability of the technology to differentiate patients with CRC, AA and colonoscopy controls. Conclusions: Cancer treatment is more effective when given earlier and this low-cost strategy can facilitate the requisite earlier diagnosis. A rapid blood test that sensitive to AA and early-stage CRC could improve patient prognosis and ultimately reduce mortality. Citation Format: James M. Cameron, Georgios Antoniou, Paul M. Brennan, Justin J. Conn, Sharon King, Rose G. McHardy, Susan Moug, Jennifer Nobes, David S. Palmer, Alexandra Sala, Benjamin R. Smith, Judith Strachan, Craig Mowat, Matthew J. Baker. Early colorectal cancer detection with a spectroscopic liquid biopsy [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 6506.

Pancreatic cancer claims over 460,000 victims per year. The carbohydrate antigen (CA) 19-9 test is the blood test used for pancreatic cancer’s detection; however, its levels can be raised in symptomatic patients with other non-malignant diseases, or with other tumors in the surrounding area. Attenuated total reflection Fourier-transform infrared (ATR-FTIR) spectroscopy has demonstrated exceptional potential in cancer diagnostics, and its clinical implementation could represent a significant step towards early detection. This proof-of-concept study, investigating the use of ATR-FTIR spectroscopy on dried blood serum, focused on the discrimination of both cancer versus healthy control samples, and cancer versus symptomatic non-malignant control samples, as a novel liquid biopsy approach for pancreatic cancer diagnosis. Machine learning algorithms were applied, achieving results of up to 92% sensitivity and 88% specificity when discriminating between cancers (n = 100) and healthy controls (n = 100). An area under the curve (AUC) of 0.95 was obtained through receiver operating characteristic (ROC) analysis. Balanced sensitivity and specificity over 75%, with an AUC of 0.83, were achieved with cancers (n = 35) versus symptomatic controls (n = 35). Herein, we present these results as demonstration that our liquid biopsy approach could become a simple, minimally invasive, and reliable diagnostic test for pancreatic cancer detection.

A rapid, low-cost, sensitive, multi-cancer early detection (MCED) test would be transformational in the diagnostics field. Earlier cancer detection can increase survival rates and quality of life of patients. An effective test must accurately identify the small proportion of patients with typically non-specific symptoms who have cancer. Such symptoms do not easily segregate by organ system, necessitating a multi-cancer approach. In this large-scale study (n = 2094 patients) we applied the Dxcover® Cancer Liquid Biopsy to differentiate cancer against non-cancer patients, as well as organ specific tests to identify cancers of the brain, breast, colorectal, kidney, lung, ovary, pancreas, and prostate. The test uses Fourier transform infrared (FTIR) spectroscopy to analyze all macromolecules in a minute volume of patient serum, and machine learning algorithms to build a classifier of the resultant spectral profiles to detect cancer. This approach can be fine-tuned to maximize either sensitivity or specificity depending on the requirements from different healthcare systems and cancer diagnostic pathways. The cancer v asymptomatic non-cancer classification detected 64% of stage I cancers when specificity was 99% (overall sensitivity 56%). When tuned for higher sensitivity, this model identified 99% of stage I cancers (while specificity was 58%). When examining cancer against all non-cancer (including symptomatic patients), the sensitivity-tuned model enabled 90% sensitivity with 61% specificity, with detection rates of 93% for stage I, 84% for stage II, 92% for stage III and 95% for stage IV. For organ specific cancer classifiers, area under the receiver operating characteristic (ROC) curve values were calculated for all cancers: brain (0.90), breast (0.75), colorectal (0.91), kidney (0.91), lung (0.91), ovarian (0.86), pancreatic (0.85) and prostate (0.86). Cancer treatment is more effective when given earlier and this low-cost strategy can facilitate the requisite earlier diagnosis.

In a letter to the Editor last year, Duployez and Fenwarth [1] highlighted the controversies surrounding germline RUNX1 missense variants, which exist outside of the runt-homology domain (RHD). Of ...

The relations between society and non-governmental organizations (NGOs) have been relatively neglected in the field of China NGO studies, which remains largely wedded to a state–NGO problematic within a state–society framework. In this anthropological study of an NGO’s post-Wenchuan earthquake recovery programme, we adopt an actor-oriented approach to identify the main lines of tension between the strategies, rationalities, and techniques deployed by the different actors in the field. Focusing on NGO–society relations, we take the NGO not as an incarnation of society vis-a-vis the state, nor as an incarnation of the state vis-a-vis society, but as a key link in a shifting chain of state and non-state actors that aims to introduce to local society an assemblage of techniques, discourses, and values for the promotion of self-government. This ‘international development package’ is a specific form of what social scientists have theorized as ‘governmentality’. In this case study, the modalities of participation and cooperative self-government promoted within this development package are in tension with local values, social relations, and political structures. The case shows that dynamic tensions between the actors are mediated by the deployment of practices of governance that circulate between international institutions and networks, state agencies, NGOs, and local authorities and actors.

During the mass protest movement, Hong Kong has witnessed intense and disturbing levels of violence, intolerance, and anti-Chinese xenophobia. In this article, I reflect on the aggravation of a con...

Identification of correct protein–ligand binding poses is important in structure-based drug design and crucial for the evaluation of protein–ligand binding affinity. Protein–ligand coordinates are commonly obtained from crystallography experiments that provide a static model of an ensemble of conformations. Binding pose metadynamics (BPMD) is an enhanced sampling method that allows for an efficient assessment of ligand stability in solution. Ligand poses that are unstable under the bias of the metadynamics simulation are expected to be infrequently occupied in the energy landscape, thus making minimal contributions to the binding affinity. Here, the robustness of the method is studied using crystal structures with ligands known to be incorrectly modeled, as well as 63 structurally diverse crystal structures with ligand fit to electron density from the Twilight database. Results show that BPMD can successfully differentiate compounds whose binding pose is not supported by the electron density from those with well-defined electron density.

This position article on reducing topical drug waste with ophthalmic surgery was written by the Ophthalmic Instrument Cleaning and Sterilization Task Force, comprising representatives of the ASCRS, American Academy of Ophthalmology, American Glaucoma Society, and Outpatient Ophthalmic Surgery Society. Drug waste significantly increases the costs and carbon footprint of ophthalmic surgery. Surgical facilities should be permitted to use topical drugs in multidose containers on multiple patients until the manufacturer's labeled date of expiration, if proper guidelines are followed. Surgical patients requiring a topical medication not used for other patients should be allowed to bring that partially used medication home for postoperative use. These recommendations are based on published evidence and clarification of policies from multiple regulatory and accrediting agencies with jurisdiction over surgical facilities. Surveys suggest that most ambulatory surgery centers and hospitals performing cataract surgery are wasting topical drugs unnecessarily.

Integration of experimental analyses of behavior and neuroscience provides an interpretation of a substantial number of the diverse behavioral deficits observed within the autism spectrum. To that end, the behavioral and neural conditions under which experience changes the environmental guidance of behavior are first described, that is, the conditions under which learning occurs. These findings lead to the conclusion that acquired reinforcers-events that function as reinforcers as the result of individual experience-satisfy the same requirements and ultimately engage the same neural system as unconditioned reinforcers. Acquired reinforcers are critical to the development of complex behavior and some of the behavioral problems seen in autism may be due to these deficits. Specific consequences of these deficits are described-including effects on automatic reinforcement, joint control, and joint attention. Environmental as well as genetic factors can produce neurodevelopmental errors that impair acquired reinforcement and a possible such factor is identified. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Background Diagnostic delays impact the quality of life and survival of patients with brain tumors. Earlier and expeditious diagnoses in these patients are crucial to reduce the morbidities and mortalities associated with brain tumors. A simple, rapid blood test that can be administered easily in a primary care setting to efficiently identify symptomatic patients who are most likely to have a brain tumor would enable quicker referral to brain imaging for those who need it most. Methods Blood serum samples from 603 patients were prospectively collected and analyzed. Patients either had non-specific symptoms that could be indicative of a brain tumor on presentation to the Emergency Department, or a new brain tumor diagnosis and referral to the neurosurgical unit, NHS Lothian, Scotland. Patient blood serum samples were analyzed using the Dxcover® Brain Cancer liquid biopsy. This technology utilizes infrared spectroscopy combined with a diagnostic algorithm to predict the presence of intracranial disease. Results Our liquid biopsy approach reported an area under the receiver operating characteristic curve of 0.8. The sensitivity-tuned model achieves a 96% sensitivity with 45% specificity (NPV 99.3%) and identified 100% of glioblastoma multiforme patients. When tuned for a higher specificity, the model yields a sensitivity of 47% with 90% specificity (PPV 28.4%). Conclusions This simple, non-invasive blood test facilitates the triage and radiographic diagnosis of brain tumor patients while providing reassurance to healthy patients. Minimizing time to diagnosis would facilitate the identification of brain tumor patients at an earlier stage, enabling more effective, less morbid surgical and adjuvant care.

Group singing and playing of wind instruments increase COVID-19 transmission risk. After a pause during the initial period of the COVID-19 pandemic, The Tabernacle Choir at Temple Square organization (hereinafter, Choir) resumed musical events in September 2021 with prevention protocols, including required vaccination and pre-event rapid antigen testing. We investigated potential SARS-CoV-2 transmission at Choir events during September 21–November 7, 2021. We interviewed COVID-19–positive members (hereinafter, case-members) and identified members exposed when a case-member attended a Choir event during his or her infectious period. We compared whole genome sequencing results to assess the genetic relatedness of available SARS-CoV-2 specimens obtained from case-members. We identified 30 case-members through pre-event testing (n = 10), self-reported positive test results (n = 18), and a review of Utah’s disease surveillance system (n = 2). All 30 case-members reported symptoms; 21 (70%) were women and 23 (77%) received a positive test result by nucleic acid amplification test. No hospitalizations or deaths were reported. We identified 176 test-eligible exposed members from 14 instances of case-members attending events during their infectious periods. All were tested at least once 2 to 14 days after exposure: 74 (42%) by rapid antigen test only (all negative) and 102 (58%) by nucleic acid amplification test (4 positive, 97 negative, and 1 equivocal). Among viral sequences available from 15 case-members, the smallest single-nucleotide polymorphism distance between 2 sequences was 2, and the next-smallest distance was 10. The lack of disease detected in most exposed members suggests that minimal, if any, transmission occurred at Choir events. When community COVID-19 incidence is high, prevention protocols might help limit SARS-CoV-2 transmission during group musical activities.

This article presents datasets associated with the research article entitled “Intravitreal gene therapy protects against retinal dysfunction and degeneration in sheep with CLN5 Batten disease” (Murray et al., [1] ). The neuronal ceroid lipofuscinoses (NCL; Batten disease) are a group of fatal inherited diseases caused by mutations in a number of CLN genes that lead to degenerative and fatal encephalopathies in children. Naturally-occuring sheep models of NCL exist. Affected sheep share the clinical and pathological features of the human disease, including retinal degeneration. Electroretinography (ERG) was employed to characterise the physiological changes in the degenerating retina of CLN5 and CLN6 forms of ovine NCL. ERGs were performed every two months from 3 to 17 months of age in 11 NCL affected (6 CLN5−/− and 5 CLN6−/−) sheep and 12 clinically normal heterozygous controls (6 CLN5+/− and 6 CLN6+/−) under three different adaptation conditions. A-wave and b-wave amplitudes were collected from each eye using the Eickemeyer Veterinary ERG system. These are the first longitudinal datasets assessing the progression of retinal degeneration in ovine NCL, aiding in characterisation of the disease process and providing insight into optimal therapeutic windows for subsequent studies.

Simple Summary Due to the non-specific symptoms of brain cancer (e.g., headaches or memory changes), gliomas will often remain undetected until they are larger or at a higher grade, reducing the patient’s likelihood of a good clinical outcome. Earlier detection and diagnosis of brain tumours is vital to improve patient outcomes, leading to safer surgeries and earlier treatments. A liquid biopsy for brain tumour would prove revolutionary however in order to detect disease earlier the liquid biopsy needs to be able to detect smaller tumours; and current liquid biopsies perform worse when detecting smaller or earlier stage tumours. Here, for the first time, we confirm the applicability of a validated spectroscopic liquid biopsy approach to detect both small and low-grade gliomas proving that the spectroscopic liquid biopsy approach is insensitive to tumour volume unlike other liquid biopsies. Abstract Background: To support the early detection and diagnosis of brain tumours we have developed a rapid, cost-effective and easy to use spectroscopic liquid biopsy based on the absorbance of infrared radiation. We have previously reported highly sensitive results of our approach which can discriminate patients with a recent brain tumour diagnosis and asymptomatic controls. Other liquid biopsy approaches (e.g., based on tumour genetic material) report a lower classification accuracy for early-stage tumours. In this manuscript we present an investigation into the link between brain tumour volume and liquid biopsy test performance. Methods: In a cohort of 177 patients (90 patients with high-grade glioma (glioblastoma (GBM) or anaplastic astrocytoma), or low-grade glioma (astrocytoma, oligoastrocytoma and oligodendroglioma)) tumour volumes were calculated from magnetic resonance imaging (MRI) investigations and patients were split into two groups depending on MRI parameters (T1 with contrast enhancement or T2/FLAIR (fluid-attenuated inversion recovery)). Using attenuated total reflection (ATR)-Fourier transform infrared (FTIR) spectroscopy coupled with supervised learning methods and machine learning algorithms, 90 tumour patients were stratified against 87 control patients who displayed no symptomatic indications of cancer, and were classified as either glioma or non-glioma. Results: Sensitivities, specificities and balanced accuracies were all greater than 88%, the area under the curve (AUC) was 0.98, and cancer patients with tumour volumes as small as 0.2 cm3 were correctly identified. Conclusions: Our spectroscopic liquid biopsy approach can identify gliomas that are both small and low-grade showing great promise for deployment of this technique for early detection and diagnosis.

This article outlines the spread of the Bahá’í religion—known in Chinese asDatong jiao大同教)— as a form of religious cosmopolitanism in Republican China (1912–1949). Originating in Iran, its spread to China can be traced to links with the Ottoman empire, British Palestine, the United States, and Japan. By tracking the individuals, connections, and events through which knowledge of the Bahá’í movement spread in China, our study reveals an overlapping nexus of networks—intellectual reformers, liberal Christians, Esperantists, Confucian modernizers, redemptive society activists, and socialists—that shared cosmopolitan ideals. The Bahá’í connections thus serve as a thread that reveals the influence of a unique ‘cosmopolitan moment’ in Republican China, hitherto largely ignored in the scholarly literature on this period, which has focused primarily on the growth of modern Chinese nationalism. Leading nationalist figures endorsed these movements at a specific juncture of Asian colonial modernity, showing that nationalism and cosmopolitanism were seen as expressions of the same ideal of a world community. We argue that the sociology of cosmopolitanism should attend to non-secular and non-state movements that advocated utopian visions of cosmopolitanism, map the circulations that form the nexus of such groups, and identify the contextual dynamics that produce ‘cosmopolitan moments’ at specific historical junctures and locations.

This article interrogates the near-complete absence of China as a source of materials and inspiration for constructing theoretical concepts and models in mainstream sociology and anthropology. I outline the story of the largely forgotten mutual engagements, influences, and missed connections between the work of the French sociologist and sinologist Marcel Granet (1884–1940), whose work revolved around Chinese religion, and key figures in the history of sociological and anthropological theory, exemplified by Durkheim, Mauss, and Lévi-Strauss. My purpose is to restore Granet—and, through Granet, China—in the genealogy of classical anthropological and social theory. This involves showing how Granet’s work was informed by the theoretical debates that animated his mentors and colleagues in the French sociological school, and how he, in turn, directly or indirectly influenced subsequent theoretical developments. It also involves raising questions about the implications of connections that were missed, or only briefly evoked, by theoreticians in subsequent generations. These questions open bridges for advancing a mutually productive dialogue between the study of Chinese cosmology, religion, and society, and theory construction in sociology and anthropology.

This paper conceptualizes ‘neo-socialist governmentality’ as a set of rationalities of governance that aim to shape, nurture, constrain and guide the autonomy of Chinese subjects in the post-revolu...

Differential operators are widely used in geometry processing for problem domains like spectral shape analysis, data interpolation, parametrization and mapping, and meshing. In addition to the ubiquitous cotangent Laplacian, anisotropic second-order operators, as well as higher-order operators such as the Bilaplacian, have been discretized for specialized applications. In this paper, we study a class of operators that generalizes the fourth-order Bilaplacian to support anisotropic behavior. The anisotropy is parametrized by a symmetric frame field, first studied in connection with quadrilateral and hexahedral meshing, which allows for fine-grained control of local directions of variation. We discretize these operators using a mixed finite element scheme, verify convergence of the discretization, study the behavior of the operator under pullback, and present potential applications., 15 pages, 15 figures. To be published in proceedings of the 2021 Symposium on Geometry Processing

This study highlights the importance of incorporating objectively quantified, non-market environmental values (such as avoided erosion and carbon sequestration) into land use decision making for sustainable forest management. A continuously developing approach that has facilitated discussions between researchers, industries, and governments on the quantification of non-market values is the ecosystem services (ES) framework. Using a spatial economic tool, called Forest Investment Framework, this study is, to the best of our knowledge, the first assessment of the market (timber) and non-market (carbon sequestration, avoided nitrogen leaching and avoided erosion) ES values of the 1.75 million-hectare New Zealand planted forest estate. To collect the views of key planted forest industry representatives on ES assessment/quantification, we interviewed 14 forest managers representing 60% of the planted forest area. Results from the spatial economic analysis indicated that the non-market ES values can be more than four times the timber profit nationally, and up to 12 times higher in New Zealand’s most erosion-prone region. These estimated values are indicative and should be treated with caution. From a sensitivity analysis, we found that different discount rates significantly impact ES values, ratios, and distributions. Results from the interviews indicated that ES quantification helped inform decision making by supporting license to operate, while also signaling the development of a reward system for sustaining ES. Sixty-four percent of survey respondents identified the importance of quantifying ES in ecological terms and describing other non-market ES in spatial, qualitative, or binary forms. Overall, this study provided evidence of how estimated non-market ES values compare with market values and highlighted the importance of including them in decision making processes. Future cost benefit analyses that incorporate these non-market monetary ES values would complement multi-criteria analysis that integrate additional dimensions and allow decision makers to rank options based on their particular criteria.

Impact assessment is an important and cost‐effective tool for assisting in the identification and prioritization of invasive alien species. With the number of alien and invasive alien species expected to increase, reliance on impact assessment tools for the identification of species that pose the greatest threats will continue to grow. Given the importance of such assessments for management and resource allocation, it is critical to understand the uncertainty involved and what effect this may have on the outcome. Using an uncertainty typology and insects as a model taxon, we identified and classified the causes and types of uncertainty when performing impact assessments on alien species. We assessed 100 alien insect species across two rounds of assessments with each species independently assessed by two assessors. Agreement between assessors was relatively low for all three impact classification components (mechanism, severity, and confidence) after the first round of assessments. For the second round, we revised guidelines and gave assessors access to each other’s assessments which improved agreement by between 20% and 30% for impact mechanism, severity, and confidence. Of the 12 potential reasons for assessment discrepancies identified a priori, 11 were found to occur. The most frequent causes (and types) of uncertainty (i.e., differences between assessment outcomes for the same species) were as follows: incomplete information searches (systematic error), unclear mechanism and/or extent of impact (subjective judgment due to a lack of knowledge), and limitations of the assessment framework (context dependence). In response to these findings, we identify actions that may reduce uncertainty in the impact assessment process, particularly for assessing speciose taxa with diverse life histories such as Insects. Evidence of environmental impact was available for most insect species, and (of the non‐random original subset of species assessed) 14 of those with evidence were identified as high impact species (with either major or massive impact). Although uncertainty in risk assessment, including impact assessments, can never be eliminated, identifying, and communicating its cause and variety is a first step toward its reduction and a more reliable assessment outcome, regardless of the taxa being assessed.

Early diagnosis of brain tumours is challenging and a major unmet need. Patients with brain tumours most often present with non-specific symptoms more commonly associated with less serious diagnoses, making it difficult to determine which patients to prioritize for brain imaging. Delays in diagnosis affect timely access to treatment, with potential impacts on quality of life and survival. A test to help identify which patients with non-specific symptoms are most likely to have a brain tumour at an earlier stage would dramatically impact on patients by prioritizing demand on diagnostic imaging facilities. This clinical feasibility study of brain tumour early diagnosis was aimed at determining the accuracy of our novel spectroscopic liquid biopsy test for the triage of patients with non-specific symptoms that might be indicative of a brain tumour, for brain imaging. Patients with a suspected brain tumour based on assessment of their symptoms in primary care can be referred for open access CT scanning. Blood samples were prospectively obtained from 385 of such patients, or patients with a new brain tumour diagnosis. Samples were analysed using our spectroscopic liquid biopsy test to predict presence of disease, blinded to the brain imaging findings. The results were compared to the patient’s index brain imaging delivered as per standard care. Our test predicted the presence of glioblastoma, the most common and aggressive brain tumour, with 91% sensitivity, and all brain tumours with 81% sensitivity, and 80% specificity. Negative predictive value was 95% and positive predictive value 45%. The reported levels of diagnostic accuracy presented here have the potential to improve current symptom-based referral guidelines, and streamline assessment and diagnosis of symptomatic patients with a suspected brain tumour., Brennan et al. show a rapid, low-cost blood test can identify which patients with suspected brain tumour to prioritize for diagnostic imaging, reducing time to diagnosis. The test is more than 90% sensitive for the most aggressive tumours. Earlier diagnosis can provide health and economic benefits., Graphical Abstract Graphical Abstract