1,968 research outputs found
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Cognitive control of saccadic selection and inhibition from within the core cortical saccadic network
The ability to select the task-relevant stimulus for a saccadic eye movement, while inhibiting saccades to task-irrelevant stimuli, is crucial for active vision. Here, we present a novel saccade-contingent behavioural paradigm and investigate the neural basis of the central cognitive functions underpinning such behaviour - saccade selection, saccade inhibition and saccadic choice â in female and male human participants. The paradigm allows for exceptionally well-matched contrasts, with task demands formalized with stochastic accumulation-to-threshold models. Using functional magnetic resonance imaging, we replicated the core cortical eye-movement network for saccade generation (frontal eye fields, posterior parietal cortex and higher-level visual areas). However, in contrast to previously published tasks, saccadic selection and inhibition recruited only this core network. Brain12 behaviour analyses further showed that inhibition efficiency may be underpinned by white matter integrity of tracts between key saccade generating regions, and that inhibition efficiency is associated with right inferior frontal gyrus engagement, potentially implementing general-purpose inhibition. The core network, however, was insufficient for saccadic choice which recruited anterior regions commonly attributed to saccadic action selection, including dorsolateral prefrontal cortex and anterior cingulate cortex. Jointly, the results indicate that extra-saccadic activity observed for free choice, and in previously published tasks probing saccadic control, is likely due to increased load on higher-level cognitive processes, and not saccadic selection per se, which is achieved within the canonical cortical eye movement network
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Increasing compliance with low tidal volume ventilation in the ICU with two nudge-based interventions: evaluation through intervention time-series analyses
Objectives: Low tidal volume (TVe) ventilation improves outcomes for ventilated patients, and the majority of clinicians state they implement it. Unfortunately, most patients never receive low TVes. âNudgesâ influence decision-making with subtle cognitive mechanisms and are effective in many contexts. There have been few studies examining their impact on clinical decision-making. We investigated the impact of 2 interventions designed using principles from behavioural science on the deployment of low TVe ventilation in the intensive care unit (ICU).
Setting: University Hospitals Bristol, a tertiary, mixed medical and surgical ICU with 20 beds, admitting over 1300 patients per year.
Participants: Data were collected from 2144 consecutive patients receiving controlled mechanical ventilation for more than 1â
hour between October 2010 and September 2014. Patients on controlled mechanical ventilation for more than 20â
hours were included in the final analysis.
Interventions: (1) Default ventilator settings were adjusted to comply with low TVe targets from the initiation of ventilation unless actively changed by a clinician. (2) A large dashboard was deployed displaying TVes in the format mL/kg ideal body weight (IBW) with alerts when TVes were excessive.
Primary outcome measure: TVe in mL/kg IBW.
Findings: TVe was significantly lower in the defaults group. In the dashboard intervention, TVe fell more quickly and by a greater amount after a TVe of 8â
mL/kg IBW was breached when compared with controls. This effect improved in each subsequent year for 3â
years.
Conclusions: This study has demonstrated that adjustment of default ventilator settings and a dashboard with alerts for excessive TVe can significantly influence clinical decision-making. This offers a promising strategy to improve compliance with low TVe ventilation, and suggests that using insights from behavioural science has potential to improve the translation of evidence into practice
Distance measures to compare real and ideal quantum processes
With growing success in experimental implementations it is critical to
identify a "gold standard" for quantum information processing, a single measure
of distance that can be used to compare and contrast different experiments. We
enumerate a set of criteria such a distance measure must satisfy to be both
experimentally and theoretically meaningful. We then assess a wide range of
possible measures against these criteria, before making a recommendation as to
the best measures to use in characterizing quantum information processing.Comment: 15 pages; this version in line with published versio
Ample consumption period available until use-by dates: a potential, marketing position for store brands
Traditionally store brands in Australia are viewed with suspicion in regard to their quality and are usually purchased because of the "value for money" that they offer. Australian supermarket majors are considering introducing a new suite of store brands in the higher price brackets. The danger of moving upscale however is that these store brands are relinquishing their value for money appeal and will come head to head with the manufactured brands. Store brands will now require some quality dimension to compete. This paper after studying the attitudes and behavioural response of grocery shoppers to use by dates, is proposing that that the promise of "generous" use-by dates as a surrogate for quality, could be considered as a positioning plank to promote store brands as alternatives to manufactured brands. Logit analysis is employed to explain shoppers' perception and response to use-by dates, of products that they regularly buy, and of alternative products which they have never bought before if the use-by dates of their regular items are perceived to be too shor
Redesigning the 'choice architecture' of hospital prescription charts: a mixed methods study incorporating in situ simulation testing.
Objectives: To incorporate behavioural insights into the user-centred design of an inpatient prescription chart (Imperial Drug Chart Evaluation and Adoption Study, IDEAS chart) and to determine whether changes in the content and design of prescription charts could influence prescribing behaviour and reduce prescribing errors.
Design: A mixed-methods approach was taken in the development phase of the project; in situ simulation was used to evaluate the effectiveness of the newly developed IDEAS prescription chart.
Setting: A London teaching hospital.
Interventions/methods: A multimodal approach comprising (1) an exploratory phase consisting of chart reviews, focus groups and user insight gathering (2) the iterative design of the IDEAS prescription chart and finally (3) testing of final chart with prescribers using in situ simulation.
Results: Substantial variation was seen between existing inpatient prescription charts used across 15 different UK hospitals. Review of 40 completed prescription charts from one hospital demonstrated a number of frequent prescribing errors including illegibility, and difficulty in identifying prescribers. Insights from focus groups and direct observations were translated into the design of IDEAS chart. In situ simulation testing revealed significant improvements in prescribing on the IDEAS chart compared with the prescription chart currently in use in the study hospital. Medication orders on the IDEAS chart were significantly more likely to include correct dose entries (164/164 vs 166/174; p=0.0046) as well as prescriber's printed name (163/164 vs 0/174; p<0.0001) and contact number (137/164 vs 55/174; p<0.0001). Antiinfective indication (28/28 vs 17/29; p<0.0001) and duration (26/28 vs 15/29; p<0.0001) were more likely to be completed using the IDEAS chart.
Conclusions: In a simulated context, the IDEAS prescription chart significantly reduced a number of common prescribing errors including dosing errors and illegibility. Positive behavioural change was seen without prior education or support, suggesting that some common prescription writing errors are potentially rectifiable simply through changes in the content and design of prescription charts
Optimal discrete stopping times for reliability growth tests
Often, the duration of a reliability growth development test is specified in advance and the decision to terminate or continue testing is conducted at discrete time intervals. These features are normally not captured by reliability growth models. This paper adapts a standard reliability growth model to determine the optimal time for which to plan to terminate testing. The underlying stochastic process is developed from an Order Statistic argument with Bayesian inference used to estimate the number of faults within the design and classical inference procedures used to assess the rate of fault detection. Inference procedures within this framework are explored where it is shown the Maximum Likelihood Estimators possess a small bias and converges to the Minimum Variance Unbiased Estimator after few tests for designs with moderate number of faults. It is shown that the Likelihood function can be bimodal when there is conflict between the observed rate of fault detection and the prior distribution describing the number of faults in the design. An illustrative example is provided
Molecular imaging of inflammation - Current and emerging technologies for diagnosis and treatment
Inflammation is a key factor in multiple diseases including primary immune-mediated inflammatory diseases e.g. rheumatoid arthritis but also, less obviously, in many other common conditions, e.g. cardiovascular disease and diabetes. Together, chronic inflammatory diseases contribute to the majority of global morbidity and mortality. However, our understanding of the underlying processes by which the immune response is activated and sustained is limited by a lack of cellular and molecular information obtained in situ. Molecular imaging is the visualization, detection and quantification of molecules in the body. The ability to reveal information on inflammatory biomarkers, pathways and cells can improve disease diagnosis, guide and monitor therapeutic intervention and identify new targets for research. The optimum molecular imaging modality will possess high sensitivity and high resolution and be capable of non-invasive quantitative imaging of multiple disease biomarkers while maintaining an acceptable safety profile. The mainstays of current clinical imaging are computed tomography (CT), magnetic resonance imaging (MRI), ultrasound (US) and nuclear imaging such as positron emission tomography (PET). However, none of these have yet progressed to routine clinical use in the molecular imaging of inflammation, therefore new approaches are required to meet this goal. This review sets out the respective merits and limitations of both established and emerging imaging modalities as clinically useful molecular imaging tools in addition to potential theranostic applications
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