What’s the chance of that?

Research shows that we interpret the language of uncertainty differently, and ambiguous positive or negative terms can influence our decisions

University of Tokyo

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This table shows the verbal probability expressions and numerical probabilities which were presented to the participants to assess how positive and negative framing of uncertainty, and explicitly stated neutral probabilities, may affect their choice to recommend a new treatment to a friend.

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Credit: H. Honda, H. Kumazaki and K. Ueda 2026/ Psychonomic Bulletin & Review.

We don’t all understand the same words in the same way, and this can affect the choices we make, according to researchers including those from the University of Tokyo. A team sought to compare how people with an autism spectrum disorder (ASD) and people without ASD interpret probability terms. They found that people with and without ASD could be divided into three groups of decision-makers, whose judgment varied depending on the relative influence of positive or negative framing and the numerical probabilities they inferred from verbal expressions. This work highlights the importance of dialogue to check whether people have understood information as intended and to support informed decision-making.

Communicating about uncertain situations is not easy, as we can see from debates around climate change, the economy, and how to help people make decisions in a world where it feels like everything is shifting. Researchers at the University of Tokyo wanted to find out how our understanding varies when probabilities are expressed in words, such as “it is likely”, or in numbers as a “30% chance.” In particular, they wanted to compare people with and without an autism spectrum disorder, to see if there were any noticeable trends.

“ASD is often associated with differences in communication and information processing, so we wondered if people with ASD might interpret expressions of uncertainty differently,” explained Professor Kazuhiro Ueda from the Graduate School of Arts and Sciences. “While we found that participants with ASD tended to assign more similar numerical meanings to different verbal phrases, we more importantly identified three distinct patterns of decision-making, revealing variation both within and across the groups.”

The participants included 48 people with ASD and 90 people without. They were given a hypothetical scenario where a friend was considering an expensive treatment for migraines and they had to decide how strongly they would recommend the treatment, based on a doctor's statement about its chance of success. The language used to explain the treatment varied, from numerical probabilities (such as “a 30% chance the treatment will be successful”) to positive and negative probability words (such as “it is possible” or “it is unlikely to succeed”). The participants were also asked to assign a numerical value to the verbal terms.

Their answers revealed three groups of decision-makers:

1) Group 1 consisted mostly of people with ASD. Their decisions were relatively strongly influenced by positive or negative framing and less strongly influenced by the numerical probabilities they inferred from the verbal expressions.
2) Group 2 consisted mostly of people without ASD. Their decisions were relatively less influenced by wording and more strongly influenced by the numerical probabilities inferred from verbal expressions.
3) Group 3, a combination of people with and without ASD, was similarly influenced by both numerical interpretations and wording.
 
Although these distinct decision-making patterns were found, the team says further research is needed to find out what causes people to fall into each group and the underlying psychological processes involved. Also, as the current participants included a range of ages and intellectual abilities, they could not conclude that the observed differences were attributable solely to ASD.

“Even so, our findings suggest that the way we communicate uncertainty deserves more attention, especially when people make important decisions about health, education or everyday life. We could see that even subtle differences in wording can influence people’s decisions,” said Ueda. 

“We would like to see greater awareness that communicating uncertainty is not simply a matter of choosing understandable words. It is important to clearly explain the context and background of the information being provided and to understand which aspects of that information influence each person’s judgments and decisions. We hope our findings will encourage professionals, particularly in healthcare and education, to explain uncertain information more explicitly and check whether their intended meaning has been understood.”

--- Paper and Contact Details ---

Paper Details:
Hidehito Honda, Hirokazu Kumazaki, and Kazuhiro Ueda. ‘Understanding verbal and numerical probability information and decision-making among individuals with and without autism spectrum disorder.’ Psychonomic Bulletin & Review. 
November 12th 2026. doi: 10.3758/s13423-026-03032-0 

Funding: 
This research was supported by Grants-in-Aid for Scientific Research (Grant Numbers JP22H03911 and JP25H01131).

Conflicts of Interest:
The authors declare no conflicts of interest.

Useful links: 
Graduate School of Arts and Sciences: https://www.c.u-tokyo.ac.jp/eng_site/info/about/education/GSAS/ 

About The University of Tokyo:
The University of Tokyo is Japan's leading university and one of the world's top research universities. The vast research output of some 6,000 researchers is published in the world's top journals across the arts and sciences. Our vibrant student body of around 15,000 undergraduate and 15,000 graduate students includes over 5,000 international students. Find out more at www.u-tokyo.ac.jp/en/ or follow us on X (formerly Twitter) at @UTokyo_News_en.

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Journal

Psychonomic Bulletin & Review

DOI

10.3758/s13423-026-03032-0

Method of Research

Survey

Subject of Research

People

Article Title

Understanding verbal and numerical probability information and decision-making among individuals with and without autism spectrum disorder

Article Publication Date

12-Nov-2026

 

The introduction of a medieval public health system in Trondheim exposed the population to roundworm

Norwegian University of Science and Technology

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Nidaros (now Trondheim) was a bustling city in the Middle Ages, characterized by trade, migration, and powerful institutions such as Nidaros Cathedral and the Archbishop’s Palace. This drawing depicts the urban landscape around the city’s main thoroughfare, Kaupmannastretet (known today as Krambugata). It is a reconstruction of how the area appeared around 1250. 

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Credit: Illustration: Kari Støren Binns, NTNU University Museum.

Ancient skeletons can tell us a great deal about how people lived, what they ate, what diseases they suffered from, and what caused their deaths. They also provide insight into social conditions and how society was organized.

Inside the Trondheim Public Library, you can see parts of a medieval cemetery unearthed by archaeologists. This was the burial ground for people who belonged to a stone church that once stood beneath the library building.

Another medieval cemetery lies just across the street, situated beneath the premises of the current bank building, SpareBank 1.

One cemetery was centrally located in the oldest part of the city, while the other was situated on the outskirts of the urban core. Archaeological excavations and findings at these two sites have revealed significant differences between the individuals buried there.

Differing diets

Bone analysis indicates that child mortality was significantly higher, and general health poorer, among those buried in the cemetery on the city’s periphery at the time – an area inhabited primarily by craft workers.

Their diet was less varied than that of Kaupmannastretet (known today as Krambugata) residents, who belonged to the church beneath the public library. The latter group represented the city’s social elite; they were engaged in trade and resided in large townhouses. Their diet was more diverse, including seafood, for example. Social inequality affected health and mortality –then and today.

MedHeal600 (Medieval Urban Health: From private to public responsibility) is a research project led by the University Museum at the Norwegian University of Science and Technology (NTNU).

The researchers have investigated public health and living conditions in Trondheim from the year 1000 to 1600, including how public authorities facilitated access to healthcare.

The origins of a public health system

Analyses of the skeletons reveal that well over half of the city’s inhabitants experienced physiological stress during childhood and adolescence, caused by an insufficient or overly monotonous diet. Many people also died from infectious diseases such as leprosy, typhoid fever, and tuberculosis.

“Society was familiar with these diseases, and public authorities implemented measures to limit their spread. In the Middle Ages, responsibility for health, hygiene, and waste management shifted from being a private concern to increasingly becoming a public urban responsibility," says Axel Christophersen.

Christophersen is a professor emeritus of historical archaeology at the NTNU University Museum and has headed the Medieval Urban Health research project.

"The city initiated measures to improve hygiene, ensure cleaner streets, and manage waste," says Christophersen.

Here we see the beginnings of a public health system.

Responsibility for the community and the King’s inspectors

Erik Opsahl is a professor of medieval history and head of the Centre for Medieval Studies at NTNU. He points out the importance of the fundamental principle in Magnus the Lawmender’s Landslov (Norwegian Code of the Realm) of 1274 – and the Bylov (Town Law) two years later. The local community bore, to a large extent, what we might call the operational responsibility for the common good.

In many respects, the King’s officials acted as overseers to ensure that tasks were carried out.

Erik Opsahl, Axel Christophersen, and James Barrett edited the recently published book Health in Medieval Urban Trondheim: From Individual to Communal Responsibility AD 1000–1600.

The changes in the new waste management system did not follow a linear progression from simple to advanced, or from private to public. Rather, these were dynamic processes driven by shifts in various practices.

“Moreover, the modern distinction between the private and public sphere is difficult to apply to medieval society,” says Opsahl.

Good intentions, mixed outcomes

In her PhD dissertation as part of this research project, Elisabeth Forrestad Swensen explored the development of a functional new water and waste management system during the Middle Ages and the early modern period.

Swensen examined how Trondheim managed waste, sewage, and drinking water, and how these factors influenced public health and the spread of disease. Archaeological findings indicate that the inhabitants of Nidaros (as Trondheim was then known) actively addressed the challenges related to water and waste.

“Measures were taken with clear, positive intentions; however, not all of them proved equally effective in practice. Although waste was often handled with care, certain changes may nonetheless have led to an increase in infectious diseases and parasites,” Swensen says.

Latrine waste was not mixed with other types of waste. The two waste types were disposed of in separate locations. The distinction between general waste pits and latrine pits indicates that human waste was managed according to its own specific protocols.

A vicious cycle of roundworms

During the High Middle Ages (1130–1350), Europe – including Norway – experienced significant population growth.

Everything increased: more people, more houses, more waste... and more foul odours. During this period, the theory of miasmas gained traction. This concept was linked to unpleasant smells, which were believed to be the actual cause of disease.

This belief is likely why the authorities in Trondheim decreed that fetid latrine waste should be transported to pits outside the city centre – a measure that sounds both sensible and smart.

However, "an analysis of the contents of these latrines reveals that nearly the entire population was infected with roundworms. This occurred because the latrine waste was incorporated into manure once it began being transported out of the city centre. Roundworms thrive especially well in manure," says Swensen.

"This manure was spread across the city’s agricultural land where food was grown. allowing the roundworm parasite to enter the food supply, and consequently, the people living in the city," she explains.

The result was a kind of perpetual cycle between humans and roundworms.

Wood chips dampened unpleasant odours

Latrine waste was transported out of the city, whereas most other waste pits remained within the city limits. However, these were situated on separate plots of land, suggesting that the inhabitants understood the health benefits of keeping organic waste at a distance.

Sawdust or wood chips were mixed in and made up a significant portion of this waste, which helped to dampen the smell of decaying refuse.

The volume of wood chips – a byproduct of house construction – dropped significantly toward the end of the 13th century. This could be linked to a massive volcanic eruption in Indonesia in 1257, which sent ash clouds across vast distances. Traces of this ash can still be found in the northern and southern polar regions.

Temperatures fell sharply for several years, tree growth slowed, and these climatic changes dampened societal activity.

Wood chip shortage led to new waste-disposal practices

“Migration into Trondheim appears to have stagnated during the second half of the 13th century as well. Archaeological investigations have shown that house construction all but ceased from around 1300. This could be related in part to a stagnation in population growth. Construction over the course of several centuries had also exhausted the timber supply surrounding Trondheim. This led to a reduction in construction waste – notably wood shavings and wood chips," says Axel Christophersen.

The shortage of wood chips contributed to a significant worsening of the stench emanating from the waste pits within the city.

Reduced risk of disease

Excavations reveal that the practice of discarding organic waste into the pits along city streets where people lived came to an end during this period. Organic waste was now transported out of the city instead. The loss of wood chips and the intensified stench from the waste pits are likely reasons for the shift in managing waste.

This change in waste management helped lower the risk of infectious diseases.

Then the Black Death swept in

The Black Death reached Europe from Asia via the Silk Road and wreaked havoc starting in the mid-14th century. The deadly plague arrived in Norway in 1349, claiming the lives of an estimated one-third of the population, though the exact death toll remains unknown.

“The late Middle Ages has a particularly poor reputation, and the Black Death has been blamed for a long period of decline in Norway. This ultimately led to Norway becoming politically subordinate to Denmark in 1537 – an event often referred to as Norway’s ‘loss of independence,’” says Opsahl.

“However, a single plague epidemic cannot account for such a sharp population decline, which persisted for several centuries. This decline was the result of repeated outbreaks of the plague. Around 1340, Norway’s population was approximately 500,000; by the early 16th century, the country had only about 200,000 inhabitants,” Opsahl says.

Population Trends

We cannot know exactly how the population evolved between these two points in time. Was the decline a steady, continuous drop in population? Or did it follow a pattern of recovery and growth following one plague outbreak, only to be reduced again by the next?

“The latter scenario is the most probable, given the broader European trend, says Opsahl. “It also aligns with evidence that we observed in construction activity. So, it’s quite possible that the population of Trondheim experienced periods of relative growth.”

The book Health in Medieval Urban Trondheim: From Individual to Communal Responsibility AD 1000–1600, Scandinavian University Press / Det Kongelige Norske Videnskabers Selskabs Skrifter (Royal Norwegian Society of Sciences and Letters' Publications), published 16 August 2026.

Elisabeth Forrestad Swensen, Chapter 6: "Water and Waste in Medieval Urban Trondheim: How Mind and Matter Affected Health."

You can learn more about the research project in this podcast: Ny funn om livet i middelalderen (link in Norwegian).

Access the complete podcast series "Trondheim i middelalderen" (link in Norwegian), featuring Professor Erik Opsahl and Director of Culture Ola By Rise.

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DOI

10.18261/9788294167104-26-00

Subject of Research

Not applicable

Article Title

Introducing Health in Medieval Urban Trondheim: From Individual to Communal Responsibility AD 1000–1600

Nidaros around the year 1300. The photograph shows a model from the Medieval Museum in Trondheim. 

Credit

Photo: Axel Christophersen

A reconstruction of Kaupmannastretet in the medieval exhibition at the NTNU University Museum in Trondheim. The people who lived here had enough food to eat. However, 60–70 per cent of the city's population had such poor diets that their immune systems were weakened.

Credit

Photo: NTNU University Museum

Christophersen (left) speaking at the the book launch at Trondheim’s House of Literature (Litteraturhuset). From left: Axel Christophersen, Erik Opsahl, Elisabeth Forrestad Swensen, and podcast host Ola By Rise, Director of Culture for the Municipality of Trondheim. 

Credit

Photo: Idun Haugan, NTNU

 

Pilot study tests cell therapy for difficult-to-heal diabetic foot ulcers

Study reported no treatment-related serious adverse events and encouraging findings in wound healing and sensation

Wake Forest University School of Medicine

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WINSTON-SALEM, N.C., Nov., 12, 2026 — An experimental cell therapy was well tolerated in 10 people with chronic diabetic foot ulcers, according to first-in-human study led by researchers at Wake Forest Institute for Regenerative Medicine (WFIRM).  

All 10 participants experienced complete wound closure within six months, and tests indicated improved sensation in the treated feet during the 12-month follow-up period. These encouraging findings support further investigation.  

The findings were published last week in Stem Cells Translational Medicine. 

Diabetic foot ulcers are open wounds that can develop when diabetes damages nerves, reduces a person’s ability to feel injuries to the foot and are the leading cause of lower-limb amputation in the United States. Diabetic peripheral neuropathy, nerve damage associated with diabetes, is generally managed by controlling diabetes and treating symptoms. Options for restoring lost sensation remain limited. The recent findings and further study could provide additional insight into treatment for patients.  

The investigational stem cells used to treat study participants were derived from healthy placental tissue donated following childbirth. This tissue is typically discarded after delivery but contains cells with properties that may help control inflammation and support tissue repair. 

“This early study was designed foremost to answer a safety question,” said Michael Carstens, M.D., an author of the study. “Within the doses we evaluated, the cells were well tolerated, and we did not observe treatment-related serious adverse events during the 12 months of follow-up.” 

Testing the treatment’s safety 

The study enrolled 10 adults, ages 40 to 74, whose diabetic foot ulcers had remained open for at least three months despite receiving the local standard of care.  The ulcers ranged in size from 10 to 100 cm², representing substantial diabetic foot wounds. In Nicaragua, where the study was conducted, and in other parts of the world, there is a higher prevalence and severity of such ulcers and higher rates of amputation, compared to the U.S. 

Participants received a single treatment containing 30 million, 40 million or 60 million investigational cells. The cells were injected into and around the wound and into nearby soft tissue in the foot and ankle. Four participants received the lowest dose, three received the middle dose and three received the highest dose. 

They were then monitored in the hospital following treatment and contacted weekly for the first three weeks, then evaluated at one, three, six and 12 months to assess safety, wound healing, sensation and blood flow in the foot and ankle. 

Encouraging signs of healing 

In the study, all 10 participants’ wounds closed by the six-month mark. Tests also showed improvements in the participants’ ability to feel light touch and vibration in the treated foot. By 12 months, all but one participant had regained what researchers classified as normal protective sensation, the ability to feel enough discomfort or pressure to help recognize a potential injury. 

“For people with diabetic nerve damage, losing sensation in the foot can make it difficult to notice an injury before it becomes a serious wound,” said Anthony Atala, M.D., corresponding author of the study and director of WFIRM. “The improvements we observed in wound healing and two different measures of sensation are encouraging, but further studies are still needed  

The researchers did not find a clear overall improvement in blood flow. Although seven blood vessels changed from having no measurable flow at the beginning of the study to measurable flow after 12 months, results across participants included both increases and decreases. 

What the early findings mean and what’s next 

The wound closure and improvements in sensation observed in this first-in-human study provide encouraging support for continued investigation of placental stem cell therapies. 

A larger, controlled study could help researchers better understand the therapy’s contribution to wound healing and sensation, as well as determine the most appropriate dose. 

The researchers recommend evaluating the treatment in a larger, controlled study that includes a placebo or other appropriate comparison group. Future research may examine how doses might be adjusted based on wound size and further evaluate diabetic peripheral neuropathy as an outcome. 

Researchers also recommend testing sensation in both legs, studying biological indicators of inflammation and healing, and following participants for a longer period to evaluate long-term safety and whether improvements last. 

The clinical trial was registered at ClinicalTrials.gov as NCT06373809, and approved by the Ministry of Health of Nicaragua.  

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Media contact: 

media@advocatehealth.org 

 

About Wake Forest Institute for Regenerative Medicine (WFIRM) 

Wake Forest Institute for Regenerative Medicine (WFIRM) is recognized as an international leader in scientific discovery and its translation into clinical therapies, with many world firsts, including the development of the first permanently implanted engineered organ in a human. Other firsts include discovering a novel source of highly multipotent stem cells from amniotic fluid and placenta now used clinically; advancing 3D printing methods to manufacture tissues and organs; and developing organoid and body-on-a-chip technologies through regenerative medicine for current patient-related applications. Over 500 people at the institute, the largest in the world, work on more than 40 different tissues and organs. A number of the basic principles of tissue engineering and regenerative medicine were first developed at the institute. WFIRM researchers have successfully engineered replacement tissues and organs in all four categories — flat structures, tubular tissues, hollow organs and solid organs — and 18 different applications of cell/tissue therapy technologies, such as skin, urethras, cartilage, bladders, muscle, kidney and vaginal organs, have been successfully used in human patients. The institute —which is part of Wake Forest University School of Medicine, the academic core of Advocate Health — is in the Innovation Quarter in downtown Winston-Salem, NC, and is driven by the urgent needs of patients. The institute is making a global difference in regenerative medicine through collaborations with over 600 entities and institutions worldwide, through its government, academic and industry partnerships, its start-up entities, and through major initiatives in breakthrough technologies, such as tissue engineering, cell therapies, diagnostics, drug discovery, biomanufacturing, nanotechnology, gene editing and 3D printing.

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Journal

Stem Cells Translational Medicine

DOI

10.1093/stcltm/szag085 

 

Ethics & human research November–December 2026

IRBs and psychedelic research, and payment to research subjects

The Hastings Center

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Open Access Researchers’ Experiences with IRB Oversight of Psychedelic Research

Logan Neitzke-Spruill,  Jill Oliver Robinson,  Alison Purcell,  Dominic Sisti,  Amy L. McGuire,  Holly Fernandez Lynch

 

Open Access The Primary Reasons People Participate in Maternal-Fetal Phase I Clinical Trials Are Psychosocial

Julia E. H. Brown,  Leslie S. Riddle,  Emma Canepa,  Billie Lianoglou,  Dawn Gano,  Teresa N. Sparks,  Jodi Halpern

 

Who Is Being Studied? How Retrospective Chart Reviews Can Obscure about Whom Researchers Obtain Information

Kenneth A. Richman

 

How We Pay Matters: The Ethics of Payment Mechanisms for Research Participants

Annie Harper,  Anthony Pavlo,  Steven Olsen

 

Table of Contents https://onlinelibrary.wiley.com/toc/25782363/2026/48/6

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New grant will support data resource to advance studies on elder mistreatment

Weill Cornell Medicine

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Dr. Tony Rosen

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Credit: Weill Cornell Medicine

Weill Cornell Medicine has received a two-year, $1.4 million grant from the National Institute on Aging (NIA) to develop a national data infrastructure that will support efforts to better understand the health consequences of elder mistreatment and guide approaches to protect vulnerable older adults.

Each year, as many as 7 million adults in the United States aged 60 and older face mistreatment, including abuse, neglect or exploitation. Millions more experience self-neglect, when individuals can’t take care of their basic needs.

“Though these conditions are associated with significantly adverse health outcomes and increased risk of death, elder mistreatment is an underrecognized public health problem,” said principal investigator Dr. Tony Rosen, associate professor of emergency medicine at Weill Cornell. “As our population ages, more older adults are likely to be affected, yet we still know far too little about how to identify mistreatment early and intervene effectively.”

To address this critical gap, the research team will develop ACLink, a privacy-preserving research infrastructure that links records from state Adult Protective Services (APS) agencies with administrative Medicare and Medicaid claims data.

APS agencies are responsible for investigating and responding to calls about older or vulnerable adults who are neglected or mistreated. Nationwide, they receive more than 1.5 million reports each year and identify approximately 280,000 adults who need help.

“With ACLink, we'll be able to examine how older adults experiencing mistreatment interact with the healthcare system before and after they come to the attention of Adult Protective Services, including their healthcare trajectories,” said Dr. Rosen, who is also an emergency medicine physician at NewYork-Presbyterian/Weill Cornell Medical Center. “This could help us identify missed opportunities to recognize mistreatment and intervene earlier.”

Overcoming Challenges to Connecting Data Sets

“APS data provide critical information on elder mistreatment and self-neglect but lack comprehensive longer-term healthcare information,” said Dr. Yongkang Zhang, associate professor of population health sciences at Weill Cornell, who is co-leading the Data Linkage and Analytic Dataset Access mini-core with Dr. Laura Keohane, associate professor at Vanderbilt University Medical Center. “Conversely, Medicare and Medicaid claims capture healthcare utilization, outcomes and spending but cannot reliably identify elder mistreatment.”

Although researchers have conducted small-scale linkages, broader efforts have been limited by fragmented APS data systems, privacy restrictions, and complex data-sharing and linkage requirements, Dr. Zhang said. Another challenge involves designing a model that harmonizes the existing data systems, since each state tracks and reports data differently.

ACLink aims to overcome these barriers by establishing a standardized, multistate research infrastructure while safeguarding sensitive personal information. The project will initially incorporate APS data from Texas, which has already committed to participating. The National Adult Protective Services Association and other stakeholders will help recruit additional states.  

This collaborative effort brings together Weill Cornell’s Department of Emergency Medicine and Department of Population Health Sciences. The emergency department contributes clinical knowledge of elder mistreatment and self-neglect, established APS partnerships and insights into meaningful research questions. Population health sciences brings experience in Medicare and Medicaid data, data linkage, epidemiology and advanced quantitative methods.

“Together, these complementary strengths ensure that ACLink is both clinically relevant and methodologically rigorous, transforming complex linked data into actionable evidence to improve the identification, prevention, and management of elder mistreatment and self-neglect,” said Dr. Zhang.

Encouraging Broader Research

The team will first establish ACLink's governance structure and develop a standardized data model to integrate information from participating states with Medicaid and Medicare claims. Then they will validate the data-linkage process, characterize the resulting research population and examine healthcare utilization patterns among older adults experiencing mistreatment and self-neglect.

The linked APS–Medicare data will be housed within NIA LINKAGE, a secure research platform, and will not be publicly available. Qualified researchers will be able to request access subject to appropriate approvals and data-use agreements.

The team will also support external investigators through pilot grants, encouraging broader participation in this understudied area. A public-facing ACLink website will provide project updates and information about research, training and opportunities for collaboration.

Ultimately, this work could help reduce avoidable suffering, illness and premature death among older adults.