Social Behavior: A Penny for Your Shocks

SummaryAntisocial behavior is an enormously costly social problem, but its origins are poorly understood. A new study shows that prosocial and antisocial behaviors arise from individual differences in how we represent the value of others’ pain relative to our own potential gain, rather than from variability in the capacity for effortful inhibitory control

Publisher Correction: Controllability governs the balance between Pavlovian and instrumental action selection

An amendment to this paper has been published and can be accessed via a link at the top of the paper

Overestimating the intensity of negative emotion in autobiographical memory: evidence from the 9/11 attack and Covid-19 pandemic

Project examining how well negative emotions are remembered 1 year after initial intake across two different events: 9/11 and Covid-1

Overestimating the intensity of negative feelings in autobiographical memory: Evidence from the 9/11 attack and COVID-19 pandemic

When recalling autobiographical events, people not only retrieve event details but also the feelings they experienced. The current study examined whether people are able to consistently recall the intensity of past feelings associated with two consequential and negatively valenced events, i.e. the 9/11 attack (N = 769) and the COVID-19 pandemic (N = 726). By comparing experienced and recalled intensities of negative feelings, we discovered that people systematically recall a higher intensity of negative feelings than initially reported – overestimating the intensity of past negative emotional experiences. The COVID-19 dataset also revealed that individuals who experienced greater improvement in emotional well- being displayed smaller biases in recalling their feelings. Across both datasets, the intensity of remembered feelings was correlated with initial feelings and current feelings, but the impact of the current feelings was stronger in the COVID-19 dataset than in the 9/11 dataset. Our results demonstrate that when recalling negative autobiographical events, people tend to overestimate the intensity of prior negative emotional experiences with their degree of bias influenced by current feelings and well-being

A Bayesian reanalysis of the Standard versus Accelerated Initiation of Renal-Replacement Therapy in Acute Kidney Injury (STARRT-AKI) trial

Background Timing of initiation of kidney-replacement therapy (KRT) in critically ill patients remains controversial. The Standard versus Accelerated Initiation of Renal-Replacement Therapy in Acute Kidney Injury (STARRT-AKI) trial compared two strategies of KRT initiation (accelerated versus standard) in critically ill patients with acute kidney injury and found neutral results for 90-day all-cause mortality. Probabilistic exploration of the trial endpoints may enable greater understanding of the trial findings. We aimed to perform a reanalysis using a Bayesian framework. Methods We performed a secondary analysis of all 2927 patients randomized in multi-national STARRT-AKI trial, performed at 168 centers in 15 countries. The primary endpoint, 90-day all-cause mortality, was evaluated using hierarchical Bayesian logistic regression. A spectrum of priors includes optimistic, neutral, and pessimistic priors, along with priors informed from earlier clinical trials. Secondary endpoints (KRT-free days and hospital-free days) were assessed using zero–one inflated beta regression. Results The posterior probability of benefit comparing an accelerated versus a standard KRT initiation strategy for the primary endpoint suggested no important difference, regardless of the prior used (absolute difference of 0.13% [95% credible interval [CrI] − 3.30%; 3.40%], − 0.39% [95% CrI − 3.46%; 3.00%], and 0.64% [95% CrI − 2.53%; 3.88%] for neutral, optimistic, and pessimistic priors, respectively). There was a very low probability that the effect size was equal or larger than a consensus-defined minimal clinically important difference. Patients allocated to the accelerated strategy had a lower number of KRT-free days (median absolute difference of − 3.55 days [95% CrI − 6.38; − 0.48]), with a probability that the accelerated strategy was associated with more KRT-free days of 0.008. Hospital-free days were similar between strategies, with the accelerated strategy having a median absolute difference of 0.48 more hospital-free days (95% CrI − 1.87; 2.72) compared with the standard strategy and the probability that the accelerated strategy had more hospital-free days was 0.66. Conclusions In a Bayesian reanalysis of the STARRT-AKI trial, we found very low probability that an accelerated strategy has clinically important benefits compared with the standard strategy. Patients receiving the accelerated strategy probably have fewer days alive and KRT-free. These findings do not support the adoption of an accelerated strategy of KRT initiation

Regional Practice Variation and Outcomes in the Standard Versus Accelerated Initiation of Renal Replacement Therapy in Acute Kidney Injury (STARRT-AKI) Trial: A Post Hoc Secondary Analysis.

ObjectivesAmong patients with severe acute kidney injury (AKI) admitted to the ICU in high-income countries, regional practice variations for fluid balance (FB) management, timing, and choice of renal replacement therapy (RRT) modality may be significant.DesignSecondary post hoc analysis of the STandard vs. Accelerated initiation of Renal Replacement Therapy in Acute Kidney Injury (STARRT-AKI) trial (ClinicalTrials.gov number NCT02568722).SettingOne hundred-fifty-three ICUs in 13 countries.PatientsAltogether 2693 critically ill patients with AKI, of whom 994 were North American, 1143 European, and 556 from Australia and New Zealand (ANZ).InterventionsNone.Measurements and main resultsTotal mean FB to a maximum of 14 days was +7199 mL in North America, +5641 mL in Europe, and +2211 mL in ANZ (p p p p p p p p = 0.007).ConclusionsAmong STARRT-AKI trial centers, significant regional practice variation exists regarding FB, timing of initiation of RRT, and initial use of continuous RRT. After adjustment, such practice variation was associated with lower ICU and hospital stay and 90-day mortality among ANZ patients compared with other regions