Scientific Doubt Research Articles

Agents of scientific uncertainty: Conflicts over evidence and expertise in gender-affirming care bans for minors

Globally, as medical and mental health associations increasingly have expressed support for the gender-affirming care model for trans and gender expansive youth, this model has been paradoxically banned across the United States. Ban proponents have deemed the science behind gender-affirming care to be dangerously uncertain. Examining the first gender-affirming care ban for minors, Arkansas's Save Adolescents from Experimentation (SAFE) Act of 2021, we addressed the following two questions: 1) who are the scientists, clinicians, and political organizations that promote SAFE and similar bans?; and 2) what are the scientific arguments they make to defend SAFE in federal court? First, we developed a typology of the various “agents of scientific uncertainty” behind these bans, drawing on literature from the sociology and history of science and medicine as well as the political economy of scientific doubt. Second, we created and qualitatively analyzed a dataset featuring 375 unique citations referenced throughout federal litigation over SAFE to identify these agents of scientific uncertainty's arguments. We sorted these arguments into eight categories, which reveal how agents distorted scientific evidence and exaggerated real uncertainties and risks in gender-affirming care. This case study establishes a frame for understanding the growing prevalence and legal impact of scientific arguments against gender-affirming care.

How can a new UN ocean treaty change the course of capacity building?

Abstract Few States are able to undertake scientific research in the half of the planet that lies in marine areas beyond national jurisdiction. Capacity building is therefore a key part of the development of a new international legally binding instrument for the conservation and sustainable use of marine biological diversity of areas beyond national jurisdiction, under the United Nations Convention on the Law of the Sea (BBNJ Agreement). The final negotiations for the BBNJ Agreement are scheduled for early 2022, after almost two decades of development. There is an urgent need to address remaining questions relating to capacity building to secure an effective and equitable outcome from this process and safeguard the global ocean commons. Persisting gaps in scientific capacity cast doubt on the adequacy of past and current approaches to implement long‐standing international commitments. There is a need to build equitable partnerships for long‐term outcomes. As an international legally binding instrument, the BBNJ Agreement is a critical opportunity to change the course of capacity building by strengthening the international legal framework, including funding, information‐sharing, monitoring and decision‐making. This rapidly closing window to develop international legal obligations, collaboration frameworks and funding mechanisms is relevant not only to the conservation of the global ocean commons, but also for ocean sustainability more generally as the UN Ocean Decade begins.

Terms of engagement

Terms of engagement

Detection of bloodstains using attenuated total reflectance-Fourier transform infrared spectroscopy supported with PCA and PCA-LDA.

The most important task in a criminal investigation is to detect and identify the recovered biological stains beyond reasonable scientific doubt and preserve the sample for further DNA analysis. In the light of this fact, many presumptive and confirmatory tests are routinely employed in the forensic laboratories to determine the type of body fluid. However, the currently used techniques are specific to one type of body fluid and hence it cannot be utilized to differentiate multiple body fluids. Moreover, these tests consume the samples in due process, and thus it becomes a great limitation especially considering the fact that samples are recovered in minute quantity in forensic cases. Therefore, such limitations necessitate the use of non-destructive techniques that can be applied simultaneously to all types of bodily fluids and allow sample preservation for further analysis. In the current work, attenuated total reflectance-Fourier transform infrared (ATR-FTIR) spectroscopy has been used to circumvent the aforementioned limitations. The important factors which could influence the detection of blood such as the effect of substrates, washing/chemical treatment, ageing, and dilution limits on the analysis of blood have been analysed. In addition, blood discrimination from non-blood substance (biological and non-biological in nature) has also been studied. Chemometric technique that is PCA-LDA has been used to discriminate blood from other body fluids and it resulted in 100% accurate classification. Furthermore, blood and non-blood substances including fake blood have also been classified into separate clusters with a 100% accuracy, sensitivity, and specificity. All-inclusive, this preliminary study substantiates the potential application of ATR-FTIR spectroscopy for the non-destructive identification of blood traces in simulated forensic casework conditions with 0% rate of false classification.

Les inhibiteurs du SGLT2 : une nouvelle ère pour nos patients

Since 2015, 10 randomized clinical trials assessed the cardiovascular safety of SGLT2 inhibitors, and then assessed the potential renal and cardiovascular benefits of these drugs (EMPAREG Outcome, CANVAS, DECLARE, DAPA-HF, CREDENCE, EMPEROR-reduced, VERTIS, DAPA-CKD, SCORED, SOLOIST-WHF) in over 88,000 patients. The results of EMPAREG Outcome showed major renal and cardiovascular protection but they were unexpected. The other trials regarding the effects of dapagliflozin, canagliflozin, empagliflozin and more recently sotagliflozin have confirmed most of these results and extended them to other populations. There is no scientific doubt that these drugs confer a marked renal protection in patients already treated with renin angiotensin system blockers (reduction of the risk of end-stage renal disease: −35 to 40%) et reduce the risk of hospitalization for heart failure (−30 to 35%), especially in patients with heart failure with reduced ejection fraction. The benefit/risk profile is highly favorable but minor (genital candidosis, urinary tract infections, euglycemic acido-ketosis) and serious (Fournier gangrene) side effects must not be forgotten. Renal protection is twice the effect of renin angiotensin system blockers, and is maintained in patients already treated with them, in patients with GFR 25mL/min/1.73m2 and over, regardless of whether they have type 2 diabetes mellitus or not (of note, patients with type 1 diabetes mellitus, polycystic kidney disease, lupus and vasculitis were excluded in these studies). Reduction of the incidence of heart failure is similar to that observed with sacubitril/valsartan, and is maintained in patients already treated with sacubitril/valsartan. SGLT2 inhibitors have now defined a new standard of care, and it will be necessary to explore the proper use of the new mineralocorticoid receptor antagonist finerenone that demonstrated significant renal and cardiovascular protection in mostly SGLT2 inhibitors-untreated diabetic patients with chronic kidney disease (or even some GLP-1 agonists). A new era for our patients.

Novelty, Ignorance and the Unknown: Uncertain Science and the Frontiers of Science Doctrine

This paper examines the historical boundaries of relying upon risk assessment as the bedrock of environmental law. It does so by revisiting a number of historical environmental and public health cases that illustrate the ebbs and flows of judicial and regulatory insights into uncertain science. The paper concludes that the current approach to dealing with scientific uncertainty and doubt based on risk and quantification in environmental law is flawed. A fresh look at the frontiers of science doctrine which developed the link between, novelty, uncertain science and ignorance requires fresh appraisal. Without this key doctrine in place neither a precautionary approach nor the EU’s precautionary principle can function as a driver for key environmental protection.

Recent applications of the precautionary principle in the jurisprudence of the CJEU – a new yardstick in EU environmental decision making?

In recent judgments on species protection and waste, the Court of Justice has taken up a very restrictive concept to specify the precautionary principle, which – in this form – it had so far only applied to site protection under the Habitats Directive. According to this concept, certain activities can only be permitted if there is no reasonable scientific doubt that they will not cause harm. This paper will present the respective decisions and then discuss their practical consequences, the context of complex assessments, proportionality and the possible transfer of this line of jurisprudence to other provisions on permits.

The judicial interpretation of the Habitats Directive by the CJEU: a high water mark for offshore renewable energy developers

This paper offers a strong critique of the particular interpretation of the precautionary principle by the Court of Justice of the European Union (CJEU) under the appropriate assessment procedure of the Habitats Directive. The CJEU favours a ‘criminal-like’ standard of proof whereby project developers must provide the necessary evidence to inform national licensing authorities beyond all reasonable scientific doubt of the absence of threats to the integrity of nearby marine Natura 2000 sites. This strict application of the precautionary principle is no longer suitable with respect to nascent offshore renewable energy technologies. It erects a standard of proof that cannot be realistically met by project developers in the marine environment and stands as an obstacle in the way of technologies that are needed to tackle the greatest environmental threat of climate change.

The assessment of significant effects on the integrity of “Natura 2000” sites under Article 6(2) and 6(3) of the Habitats Directive

This article investigates the question of how the significance of potential adverse effects on Natura 2000 sites – comprising sites of Community importance (SCI) and special protection areas (SPA) – can be determined legally and methodologically within the scope of appropriate assessments for projects and plans in accordance with Article 6(3) of the Habitats Directive 92/43/EEC1 (HD) and whether the results can be transferred to the prohibition of disturbance and deterioration stipulated in Article 6(2) HD. The assessment of significance is important as, according to the European Court of Justice (ECJ)2 and the German Federal Administrative Court (BVerwG)3, a project or plan is only permissible if, in the light of the best scientific knowledge in the field and without reasonable scientific doubt, the plan or project will not have lasting significant adverse effects on the integrity of that site. In this process, all aspects of the plan or project have to be identified which may, either independently or in combination with other plans or projects, affect the conservation objectives of the site concerned. This also includes a specialist forecast. Furthermore, closer specification is required of the threshold above which a non-significant adverse effect turns into a significant adverse effect and whether thresholds for bagatelles can be attributed to the proposed development.

The European Union legal boundaries for semi-natural habitats management in Natura 2000 sites

The Habitats Directive provides for the setting up of Natura 2000, a coherent European ecological network of special areas of conservation as well as for the protection of these sites. The sites are characterised by the presence of specific habitat types as listed in Annex I of the Directive and of species as listed in Annex II. This contribution will focus on semi-natural habitats and the legal boundaries the Directive imposes on their management. Management measures affecting semi-natural habitats of Natura 2000 sites can fall under two different legal regimes. The first regime is comprised of the strict site protection requirements of Art. 6(2) − (4) of the Habitats Directive. These have been clarified by extensive jurisprudence. However, as it is indicated in Art. 6(3), at least the appropriate assessment under this provision does not apply to measures “directly connected with or necessary to the management of the site”. Such measures should fall under the second legal regime, laid down in Art. 6(1). Therefore, it is necessary to discuss the distinction between site management measures and other plans or projects as well as the legal boundaries applicable to the former. It will be demonstrated that the strict protection standard of Art. 6(3), absence of reasonable scientific doubt that the plan or project will not significantly affect the site, cannot be transposed to the management of semi-natural habitats because, irrespective of scientific uncertainty or doubt, some management strategy for semi-natural habitats needs to be chosen. Moreover, the necessity to decide on site management in the light of uncertainty also affects the question whether a measure needs to be considered directly connected with or necessary to the management of the site. Therefore, at least as far as EU law is concerned, only manifest errors with regard to both questions need to be sanctioned. Accordingly, judicial control needs to focus on the decision making process, that is procedural issues such as the collection of the relevant information, relying on the best available science, stakeholder participation or the duty to give reasons.

Ethical perspectives and ramifications of the Paolo Macchiarini case.

The Paolo Macchiarini case has several ethical ramifications. Professor Macchiarini, formerly of the Karolinska Institutet (KI), became famous for the tracheal surgeries he conducted between 2008 and 2014. His rapid rise to fame was followed by an almost equally rapid fall from grace as official reports, articles in newspapers and television programmes revealed several aspects related to misconduct in his curriculum vitae, professional practices and publishing-related activity. Formal misconduct reports issued by four KI co-workers in late 2014, then again in 2016, coupled with social scandals, including the tricking of a famous US television newscaster into a false marriage, a previous arrest in Italy for apparent bribery, and acute narcissism, all tainted Macchiarini's legend. In the short space of just two years, Macchiarini was no longer remembered for the revolutionary changes he had claimed to have brought about in stem cell research and regenerative medicine. Instead, at least seven dead patients later, Macchiarini faces potential aggravated manslaughter charges and an uphill battle to save his published research, now shrouded in scandal and scientific doubt, from being retracted and scratched out from the list of verified medical science. This paper examines some of the possible ethical ramifications of the Macchiarini case.

Testing the robustness of Citizen Science projects: Evaluating the results of pilot project COMBER.

BackgroundCitizen Science (CS) as a term implies a great deal of approaches and scopes involving many different fields of science. The number of the relevant projects globally has been increased significantly in the recent years. Large scale ecological questions can be answered only through extended observation networks and CS projects can support this effort. Although the need of such projects is apparent, an important part of scientific community cast doubt on the reliability of CS data sets.New informationThe pilot CS project COMBER has been created in order to provide evidence to answer the aforementioned question in the coastal marine biodiversity monitoring. The results of the current analysis show that a carefully designed CS project with clear hypotheses, wide participation and data sets validation, can be a valuable tool for the large scale and long term changes in marine biodiversity pattern change and therefore for relevant management and conservation issues.

Timing Is Everything: Exploring Parental Decisions to Delay HPV Vaccination.

The delayed uptake of the human papillomavirus (HPV) vaccine offers an opportunity to explore how temporality and risk are at work in everyday life. Drawing from a mixed-methods study with parents ( N = 50) in Northern California, this study explored parents' decision to delay HPV vaccination for their children among parents who had not yet vaccinated ( n = 27). At the core of these decisions were temporal assessments of risk whereby parents weighed their child's (perceived) present risk of HPV exposure against the uncertain perceived risks of the vaccine itself. Our findings are promising as they indicate that given time, and the continued growth of evidence regarding the safety and effectiveness of HPV vaccination, completion rates should increase. However, our results also suggest that vaccination delays are not merely a matter of scientific doubt but also based on parents' (potentially inaccurate) perceptions of their child's sexual readiness, and thus potentially more difficult to overcome.

Prescription behavior for gastroprotective drugs in new users as a result of communications regarding clopidogrel - proton pump inhibitor interaction.

Safety concerns of the concomitant use of clopidogrel and proton pump inhibitors (PPIs) were published in 2009 and 2010 by the medicines regulatory agencies, including a direct healthcare professional communication. We examined the association between various safety statements and prescription behavior for gastroprotective drugs in naïve patients in the Netherlands during the years 2008–2011. Data from the PHARMO Database Network were analyzed with interrupted time series analyses to estimate the impact of each communication on drug prescriptions. Dispensings were used as a proxy variable for prescription behavior. After the early communication in January 2009, 15.5% (95% CI 7.8, 23.4) more patients started concomitantly with (es)omeprazole and 13.8% (95% CI 6.5, 21.2) less with other PPIs. Directly after the first statement in June 2009, we found a steep increase in histamine 2‐receptor antagonists (H2RA) peaking at 25%, placing those patients at risk for gastrointestinal events. This effect for H2RA faded away after a few months. In February 2010, when the official advice via an adjusted statement was to avoid (es)omeprazole, we found a decrease of 11.9% (95% CI 5.7, 18.2) for (es)omeprazole and an increase of +16.0% (95% CI 10.3, 21.7) for other PPIs. Still 22.6% (95% CI 19.5, 25.7) of patients started on (es)omeprazole in February 2010, placing them at risk for cardiovascular events. Advices of regulatory authorities were followed, however, reluctantly and not fully, probably partly because of the existing scientific doubt about the interaction.

Miners, silica and disability: The bi-national interplay between South Africa and the United Kingdom, c1900-1930s.

This paper investigates silicosis as a disabling disease in underground mining in the United Kingdom (UK) before Second World War, exploring the important connections between South Africa and the UK and examining some of the issues raised at the 1930 International Labour Office Conference on silicosis in Johannesburg in a British context. The evidence suggests there were significant paradoxes and much contestation in medical knowledge creation, advocacy, and policy-making relating to this occupational disease. It is argued here that whilst there was an international exchange of scientific knowledge on silicosis in the early decades of the twentieth century, it was insufficient to challenge the traditional defense adopted by the British government of proven beyond all scientific doubt before effective intervention in coal mining. This circumspect approach reflected dominant business interests and despite relatively robust trade union campaigning and eventual reform, the outcome was an accumulative legacy of respiratory disease and disability that blighted coalfield communities.

Book Review: Sustainable Healthcare Architecture

As an individual continuously striving to stay current in the healthcare construction field, Sustainable Healthcare Architecture, Second Edition, was instantly appealing, if initially title only. Sustainable building and the concept of less is in terms of resource consumption are appealing both personally and professionally. Many will agree with the notion of leveraging renewable resources, water conservation, and the creation of a holistic healing environment as a worthy goal; however, one aspect of this edition of Sustainable Healthcare Architecture caused this reader significant cognitive dissonance. In Part 1, Context, throughout Chapter 1, Design and Stewardship, and mentioned occasionally throughout the book, the argument of global warming, or climate as caused by human activities appeared.Why start the review presenting this as an issue? Simply for the fact that discussion of this highly politicized issue became a barrier in my ability to absorb the wealth of information the book offers. On page 25, Aaron Bernstein, MD, MPH, is quoted stating, no scientific doubt remains about the causes of climate change, seemingly in reference to human activities as the source.This line of thinking may be credited in part to the timing of writing and publishing of the book. Recently many news stories and studies have been publicized that have debunked early climate change studies and have revealed questionable sources of study funding as well as the emergence of new studies showing global cooling. Physicists have even joined the discussion with explanations of how carbon dioxide molecules repel solar radiation as well as cause a transfer of heat energy when colliding with oxygen molecules, ultimately causing a cooling of the atmosphere. NASA's Sounding of the Atmosphere using Broadband Emission Radiometry (SABER) study supports this theory as well. Further, several studies using data provided by NASA compare the dramatic increase of man- made carbon dioxide in the atmosphere over the past two decades alongside the relatively constant atmospheric temperatures, again, not reflecting a direct correlation to global warming as a man-made phenomenon.It may already be obvious that this reader does not support global warming, global cooling, or climate change theories that place climate change squarely on the shoulders of humans and the creation of carbon dioxide in a statistically significant way. Some may interpret this as heresy and believe me to be some sort of nature-hating, earth-destroying individual-not true. On the contrary, I strongly believe in living conservatively, being self-sufficient, and being a good steward of natural resources. The notion of efficiently leveraging resources, reducing waste, and realizing cost efficiencies in the process is universally appealing. The second edition of this book would have been better served avoiding the political issue of man-made climate change as its premise for the merits of sustainable building in healthcare environments. The notion that humans significantly impact climate change is scientifically flawed and only undermines the value of this work. It should be noted that the first edition of this book (published in 2007) treads much more lightly in regard to the causes of global warming and climate and I would recommend the first edition for those that share in this school of thought.After the strong words rejecting one of the central tenets of this book, one might be surprised to learn that it pulled this reader right back in with its discussion of the direct effect humans do have on the environment, for example, polluted water sources and loss of natural resources. These are tangible impacts to which almost everyone can relate. This discussion makes a perfect argument for the need to build in a more responsible, sustainable manner. Sustainable Healthcare Architecture provides a solid foundation to the benefits of sustainable building supported by multiple case studies. …

The Mark Twain and Robert Ingersoll Connection: Freethought, Borrowed Thought, Stolen Thought

The Mark Twain and Robert Ingersoll Connection: Freethought, Borrowed Thought, Stolen Thought

William Froude, John Henry Newman and Scientific Practice in the Culture of Victorian Doubt

Abstract This article explores the relationship between scientific practice and doubt in Victorian Britain. When compared to the rich historiography of Victorian science and religion, our current image of science and doubt is strikingly monolithic and limiting. Science is treated largely as a stimulus to narratives of doubt, for example, in the form of geology and evolution. This study, focused on the mathematician and mechanic William Froude and his close friend John Henry Newman, reconsiders the various levels on which doubts shaped scientific practice and informed the criteria by which knowledge of the physical and spiritual world were deemed certain and trustworthy.

The Study on College Physical Education based on Quantity Model

With scientific and technological progress and development, the number of models of sports disciplines will be more and more work. Because the use of operations research and statistics, theory and method, relying on strict mathematical logic, as long as sufficient information, data reliability, model ft, solving method is accurate, the conclusions obtained on the scientific doubt. Number of models in sports disciplines in the successful application of a combination of theory and practice of the process, the theory is proven scientific theories, ad similarly, the number of well-proven model is the number of scientific models.

Great Brains of Science

![Figure][1] CREDIT: ROYAL MAIL The United Kingdom's Royal Society this year celebrates its anniversary—“350 years of scientific brilliance and fearless doubt”—with the help of the Royal Mail, which has issued 10 stamps featuring the achievements of some of the society's members. [