682 research outputs found
Risk taking for potential losses but not gains increases with time of day
Humans exhibit distinct risk preferences when facing choices involving potential gains and losses. These preferences are believed to be subject to neuromodulatory influence, particularly from dopamine and serotonin. As neuromodulators manifest circadian rhythms, this suggests decision making under risk might be affected by time of day. Here, in a large subject sample collected using a smartphone application, we found that risky options with potential losses were increasingly chosen over the course of the day. We observed this result in both a within-subjects design (N = 2599) comparing risky options chosen earlier and later in the day in the same individuals, and in a between-subjects design (N = 26,720) showing our effect generalizes across ages and genders. Using computational modelling, we show this diurnal change in risk preference reflects a decrease in sensitivity to increasing losses, but no change was observed in the relative impacts of gains and losses on choice (i.e., loss aversion). Thus, our findings reveal a striking diurnal modulation in human decision making, a pattern with potential importance for real-life decisions that include voting, medical decisions, and financial investments
Conservative and disruptive modes of adolescent change in human brain functional connectivity
Adolescent changes in human brain function are not entirely understood. Here, we used multiecho functional MRI (fMRI) to measure developmental change in functional connectivity (FC) of resting-state oscillations between pairs of 330 cortical regions and 16 subcortical regions in 298 healthy adolescents scanned 520 times. Participants were aged 14 to 26 y and were scanned on 1 to 3 occasions at least 6 mo apart. We found 2 distinct modes of age-related change in FC: “conservative” and “disruptive.” Conservative development was characteristic of primary cortex, which was strongly connected at 14 y and became even more connected in the period from 14 to 26 y. Disruptive development was characteristic of association cortex and subcortical regions, where connectivity was remodeled: connections that were weak at 14 y became stronger during adolescence, and connections that were strong at 14 y became weaker. These modes of development were quantified using the maturational index (MI), estimated as Spearman’s correlation between edgewise baseline FC (at 14 y, FC14) and adolescent change in FC (ΔFC14−26), at each region. Disruptive systems (with negative MI) were activated by social cognition and autobiographical memory tasks in prior fMRI data and significantly colocated with prior maps of aerobic glycolysis (AG), AG-related gene expression, postnatal cortical surface expansion, and adolescent shrinkage of cortical thickness. The presence of these 2 modes of development was robust to numerous sensitivity analyses. We conclude that human brain organization is disrupted during adolescence by remodeling of FC between association cortical and subcortical areas
Extended phase space thermodynamics for charged and rotating black holes and Born-Infeld vacuum polarization
We investigate the critical behaviour of charged and rotating AdS black holes
in d spacetime dimensions, including effects from non-linear electrodynamics
via the Born-Infeld action, in an extended phase space in which the
cosmological constant is interpreted as thermodynamic pressure. For
Reissner-Nordstrom black holes we find that the analogy with the Van der Walls
liquid-gas system holds in any dimension greater than three, and that the
critical exponents coincide with those of the Van der Waals system. We find
that neutral slowly rotating black holes in four space-time dimensions also
have the same qualitative behaviour. However charged and rotating black holes
in three spacetime dimensions do not exhibit critical phenomena. For
Born-Infeld black holes we define a new thermodynamic quantity B conjugate to
the Born-Infeld parameter b that we call Born-Infeld vacuum polarization. We
demonstrate that this quantity is required for consistency of both the first
law of thermodynamics and the corresponding Smarr relation.Comment: 23 pages, 32 figures, v2: minor changes, upgraded reference
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Investigation of the in-vitro loading on an artificial spinal disk prosthesis
Spinal diseases imposes considerable burden to both patients and society. In recent years, much surgical efforts have been made in advancing the treatment of neck and back pain. Of particular prominence is the increasing clinical acceptance and use of intervertebral artificial disk prosthesis for the treatment of discogenic back pain. Despite this increased use of such disks, their in-vivo monitoring remains rudimentary. In an effort to develop an intelligent artificial spinal disk where the in-vivo loading of the spine can by studied for the first time an experimental set up has been created in order to initially study the in-vitro loading on an artificial disc prosthesis. Eight strain gauges and two piezoresistive sensors were used and placed suitably in the artificial disk prosthesis. The results from the in-vitro loading showed linear relationship between loading and the outputs from the sensors with good repeatability and less hysteresis
Under pressure: Response urgency modulates striatal and insula activity during decision-making under risk
When deciding whether to bet in situations that involve potential monetary loss or gain (mixed gambles), a subjective sense of pressure can influence the evaluation of the expected utility associated with each choice option. Here, we explored how gambling decisions, their psychophysiological and neural counterparts are modulated by an induced sense of urgency to respond. Urgency influenced decision times and evoked heart rate responses, interacting with the expected value of each gamble. Using functional MRI, we observed that this interaction was associated with changes in the activity of the striatum, a critical region for both reward and choice selection, and within the insula, a region implicated as the substrate of affective feelings arising from interoceptive signals which influence motivational behavior. Our findings bridge current psychophysiological and neurobiological models of value representation and action-programming, identifying the striatum and insular cortex as the key substrates of decision-making under risk and urgency
P-V criticality of charged AdS black holes
Treating the cosmological constant as a thermodynamic pressure and its
conjugate quantity as a thermodynamic volume, we reconsider the critical
behaviour of charged AdS black holes. We complete the analogy of this system
with the liquid-gas system and study its critical point, which occurs at the
point of divergence of specific heat at constant pressure. We calculate the
critical exponents and show that they coincide with those of the Van der Waals
system.Comment: 13 pages, 15 figures, v2:added reference
Social and ethical criteria for prioritizing patients: a survey of students and health professionals in Portugal
O estudo quali-quantitativo explora
o dilema ético da microalocação dos recursos da
saúde. Objetiva identificar e comparar a opinião
de dois grupos da sociedade portuguesa - estudantes
e profissionais de saúde sobre a importância
das características pessoais dos pacientes no momento
de os priorizar e se as escolhas se explicam
por referenciais bioéticos de caráter utilitaristas ou
deontológicos. Os dados foram recolhidos através
de um questionário aplicado a uma amostra de
180 estudantes universitários e 60 profissionais de
saúde. Os respondentes perante hipotéticos cená-
rios de emergência clínica tiveram de escolher de
entre dois pacientes (distinguidos por idade, sexo,
responsabilidade social, situação económica e laboral,
comportamentos lesivos da saúde e registo
criminal) quem tratar e justificar a escolha. Foram
usados testes estatísticos de associação para
comparar as respostas dos dois grupos e análise
de conteúdo para categorizar as justificações. Os
resultados sugerem a existência de diferenças nas
escolhas dos dois grupos, com os profissionais de
saúde a revelarem aceitar menos a utilização de
critérios sociais em contexto de escassez e coexistência
de critérios utilitaristas e deontológicos,
com predomínio da eficiência por parte dos profissionais
de saúde e da equidade por parte dos
estudantesThis qualitative/quantitative study examines
the ethical dilemma of microallocation of
health resources. It seeks to identify and compare
the opinion of two groups in Portuguese society
– students and health professionals – on the importance
of personal characteristics of patients at
the moment of prioritizing them and if the choices
can be explained by bioethical references of a
utilitarian or deontological nature. Data were
collected by means of a questionnaire administered
to a sample of 180 students and 60 health
professionals. Faced with hypothetical emergency
scenarios, the respondents had to choose between
two patients (distinguished by: age, gender, social
responsibility, economic and employment
situation, harmful health behaviors and criminal
record), duly selecting who to treat and then
justifying their choice. The results suggest the existence
of differences in choices between the two
groups, with health professionals revealing they
are less prepared to accept the use of social criteria
in a context of scarce resources and co-existence
of utilitarian and deontological criteria, with a
predominance of efficiency on the part of health
professionals and equity on the part of students.info:eu-repo/semantics/publishedVersio
A novel regulatory circuit specifies cell fate in the Arabidopsis root epidermis
Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/75165/1/j.1399-3054.2006.00606.x.pd
The social value of a QALY : raising the bar or barring the raise?
Background: Since the inception of the National Institute for Health and Clinical Excellence (NICE) in England,
there have been questions about the empirical basis for the cost-per-QALY threshold used by NICE and whether
QALYs gained by different beneficiaries of health care should be weighted equally. The Social Value of a QALY
(SVQ) project, reported in this paper, was commissioned to address these two questions. The results of SVQ were
released during a time of considerable debate about the NICE threshold, and authors with differing perspectives
have drawn on the SVQ results to support their cases. As these discussions continue, and given the selective use of
results by those involved, it is important, therefore, not only to present a summary overview of SVQ, but also for
those who conducted the research to contribute to the debate as to its implications for NICE.
Discussion: The issue of the threshold was addressed in two ways: first, by combining, via a set of models, the
current UK Value of a Prevented Fatality (used in transport policy) with data on fatality age, life expectancy and
age-related quality of life; and, second, via a survey designed to test the feasibility of combining respondents’
answers to willingness to pay and health state utility questions to arrive at values of a QALY. Modelling resulted in
values of £10,000-£70,000 per QALY. Via survey research, most methods of aggregating the data resulted in values
of a QALY of £18,000-£40,000, although others resulted in implausibly high values. An additional survey, addressing
the issue of weighting QALYs, used two methods, one indicating that QALYs should not be weighted and the
other that greater weight could be given to QALYs gained by some groups.
Summary: Although we conducted only a feasibility study and a modelling exercise, neither present compelling
evidence for moving the NICE threshold up or down. Some preliminary evidence would indicate it could be
moved up for some types of QALY and down for others. While many members of the public appear to be open to
the possibility of using somewhat different QALY weights for different groups of beneficiaries, we do not yet have
any secure evidence base for introducing such a system
User needs elicitation via analytic hierarchy process (AHP). A case study on a Computed Tomography (CT) scanner
Background:
The rigorous elicitation of user needs is a crucial step for both medical device design and purchasing. However, user needs elicitation is often based on qualitative methods whose findings can be difficult to integrate into medical decision-making. This paper describes the application of AHP to elicit user needs for a new CT scanner for use in a public hospital.
Methods:
AHP was used to design a hierarchy of 12 needs for a new CT scanner, grouped into 4 homogenous categories, and to prepare a paper questionnaire to investigate the relative priorities of these. The questionnaire was completed by 5 senior clinicians working in a variety of clinical specialisations and departments in the same Italian public hospital.
Results:
Although safety and performance were considered the most important issues, user needs changed according to clinical scenario. For elective surgery, the five most important needs were: spatial resolution, processing software, radiation dose, patient monitoring, and contrast medium. For emergency, the top five most important needs were: patient monitoring, radiation dose, contrast medium control, speed run, spatial resolution.
Conclusions:
AHP effectively supported user need elicitation, helping to develop an analytic and intelligible framework of decision-making. User needs varied according to working scenario (elective versus emergency medicine) more than clinical specialization. This method should be considered by practitioners involved in decisions about new medical technology, whether that be during device design or before deciding whether to allocate budgets for new medical devices according to clinical functions or according to hospital department
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