5,071 research outputs found
Patient centred diagnosis: sharing diagnostic decisions with patients in clinical practice.
Patient centred diagnosis is best practised through shared decision making; an iterative dialogue between doctor and patient, whichrespects a patient’s needs, values, preferences, and circumstances.
Shared decision making for diagnostic situations differs fundamentally from that for treatment decisions. This has important implications when considering its practical application.
The nature of dialogue should be tailored to the specific diagnostic decision; scenarios with higher stakes or uncertainty usually require more detailed conversation
Minority Becomes Majority in Social Networks
It is often observed that agents tend to imitate the behavior of their
neighbors in a social network. This imitating behavior might lead to the
strategic decision of adopting a public behavior that differs from what the
agent believes is the right one and this can subvert the behavior of the
population as a whole.
In this paper, we consider the case in which agents express preferences over
two alternatives and model social pressure with the majority dynamics: at each
step an agent is selected and its preference is replaced by the majority of the
preferences of her neighbors. In case of a tie, the agent does not change her
current preference. A profile of the agents' preferences is stable if the
preference of each agent coincides with the preference of at least half of the
neighbors (thus, the system is in equilibrium).
We ask whether there are network topologies that are robust to social
pressure. That is, we ask if there are graphs in which the majority of
preferences in an initial profile always coincides with the majority of the
preference in all stable profiles reachable from that profile. We completely
characterize the graphs with this robustness property by showing that this is
possible only if the graph has no edge or is a clique or very close to a
clique. In other words, except for this handful of graphs, every graph admits
at least one initial profile of preferences in which the majority dynamics can
subvert the initial majority. We also show that deciding whether a graph admits
a minority that becomes majority is NP-hard when the minority size is at most
1/4-th of the social network size.Comment: To appear in WINE 201
The sub-energetic GRB 031203 as a cosmic analogue to GRB 980425
Over the six years since the discovery of the gamma-ray burst GRB 980425,
associated with the nearby (distance, ~40 Mpc) supernova 1998bw, astronomers
have fiercely debated the nature of this event. Relative to bursts located at
cosmological distances, (redshift, z~1), GRB 980425 was under-luminous in
gamma-rays by three orders of magnitude. Radio calorimetry showed the explosion
was sub-energetic by a factor of 10. Here, we report observations of the radio
and X-ray afterglow of the recent z=0.105 GRB 031203 and demonstrate that it
too is sub-energetic. Our result, when taken together with the low gamma-ray
luminosity, suggest that GRB 031203 is the first cosmic analogue to GRB 980425.
We find no evidence that this event was a highly collimated explosion viewed
off-axis. Like GRB 980425, GRB 031203 appears to be an intrinsically
sub-energetic gamma-ray burst. Such sub-energetic events have faint afterglows.
Intensive follow-up of faint bursts with smooth gamma-ray light curves (common
to both GRBs 031203 and 980425) may enable us to reveal their expected large
population.Comment: To Appear in Nature, August 5, 200
How do banks assess entrepreneurial competence? The role of voluntary information disclosure
This research adds to the literature on relationship lending in the small business context by discussing the roles of entrepreneurial competence and voluntarily disclosed information as determinants of credit access. More specifically, we propose that the loan manager’s evaluation of the information voluntarily disclosed by the entrepreneur is an important complement to publicly available financial data and soft information collected through observation and third parties in framing the loan manager’s perception of the entrepreneur’s competence. Further, we argue that banks charge lower interest rates if the loan manager perceives the entrepreneur to be competent. Econometric analysis based on 433 bank-firm relationships supports these hypothesised relationships. The results imply that entrepreneurs need to communicate their competence effectively to loan managers, and that banks should utilise their loan managers’ personal evaluations as inputs to lending decisions
Alterations in Platelet Alpha-Granule Secretion and Adhesion on Collagen under Flow in Mice Lacking the Atypical Rho GTPase RhoBTB3
Typical Rho GTPases, such as Rac1, Cdc42, and RhoA, act as molecular switches regulating various aspects of platelet cytoskeleton reorganization. The loss of these enzymes results in reduced platelet functionality. Atypical Rho GTPases of the RhoBTB subfamily are characterized by divergent domain architecture. One family member, RhoBTB3, is expressed in platelets, but its function is unclear. In the present study we examined the role of RhoBTB3 in platelet function using a knockout mouse model. We found the platelet count, size, numbers of both alpha and dense granules, and surface receptor profile in these mice were comparable to wild-type mice. Deletion of Rhobtb3 had no effect on aggregation and dense granule secretion in response to a range of agonists including thrombin, collagen, and adenosine diphosphate (ADP). By contrast, alpha-granule secretion increased in mice lacking RhoBTB3 in response to thrombin, collagen related peptide (CRP) and U46619/ADP. Integrin activation and spreading on fibrinogen and collagen under static conditions were also unimpaired; however, we observed reduced platelet accrual on collagen under flow conditions. These defects did not translate into alterations in tail bleeding time. We conclude that genetic deletion of Rhobtb3 leads to subtle alterations in alpha-granule secretion and adhesion to collagen without significant effects on hemostasis in vivo
Impact of Radiotherapy, Chemotherapy and Surgery in Multimodal Treatment of Locally Advanced Esophageal Cancer
Objectives: It was the aim of this study to assess our institutional experience with definitive chemoradiation (CRT) versus induction chemotherapy followed by CRT with or without surgery (C-CRT/S) in esophageal cancer. Methods: We retrospectively analyzed 129 institutional patients with locally advanced esophageal cancer who had been treated by either CRT in analogy to the RTOG 8501 trial (n = 78) or C-CRT/S (n = 51). Results: The median, 2-and 5-year overall survival (OS) of the entire collective was 17.6 months, 42 and 24%, respectively, without a significant difference between the CRT and C-CRT/S groups. In C-CRT/S patients, surgery statistically improved the locoregional control (LRC) rates (2-year LRC 73.6 vs. 21.2%; p = 0.003); however, this was translated only into a trend towards improved OS (p = 0.084). The impact of escalated radiation doses (>= 60.0 vs. <60.0 Gy) on LRC was detectable only in T1-3 N0-1 M0 patients of the CRT group (2-year LRC 77.8 vs. 42.3%; p = 0.036). Conclusion: Definitive CRT and a trimodality approach including surgery (C-CRT/S) had a comparable outcome in this unselected patient collective. Surgery and higher radiation doses improve LRC rates in subgroups of patients, respectively, but without effect on OS. Copyright (C) 2012 S. Karger AG, Base
The bright optical afterglow of the nearby gamma-ray burst of 29 March 2003
Many past studies of cosmological gamma-ray bursts (GRBs) have been limited
because of the large distance to typical GRBs, resulting in faint afterglows.
There has long been a recognition that a nearby GRB would shed light on the
origin of these mysterious cosmic explosions, as well as the physics of their
fireballs. However, GRBs nearer than z=0.2 are extremely rare, with an
estimated rate of localisation of one every decade. Here, we report the
discovery of bright optical afterglow emission from GRB 030329. Our prompt
dissemination and the brilliance of the afterglow resulted in extensive
followup (more than 65 telescopes) from radio through X-ray bands, as well as
measurement of the redshift, z=0.169. The gamma-ray and afterglow properties of
GRB 030329 are similar to those of cosmological GRBs (after accounting for the
small distance), making this the nearest known cosmological GRB. Observations
have already securely identified the progenitor as a massive star that exploded
as a supernova, and we anticipate futher revelations of the GRB phenomenon from
studies of this source.Comment: 13 pages, 4 figures. Original tex
Higgs boson enhancement effects on squark-pair production at the LHC
We study the Higgs boson effects on third-generation squark-pair production
in proton-proton collision at the CERN Large Hadron Collider (LHC), including
\Stop \Stop^*, \Stop\Sbot^*, and \Sbot \Sbot^*. We found that substantial
enhancement can be obtained through s-channel exchanges of Higgs bosons at
large , at which the enhancement mainly comes from , , and initial states. We compute the complete set of electroweak
(EW) contributions to all production channels. This completes previous
computations in the literature. We found that the EW contributions can be
significant and can reach up to 25% in more general scenarios and at the
resonance of the heavy Higgs boson. The size of Higgs enhancement is comparable
or even higher than the PDF uncertainties and so must be included in any
reliable analysis. A full analytical computation of all the EW contributions is
presented.Comment: 23 pages, 7 figures, 1 tabl
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