Minimal model of strategy switching in the plus-maze navigation task

International audiencePrefrontal cortex (PFC) has been implicated in the ability to switch behavioral strategies in response to changes in reward contingencies. A recent experimental study has shown that separate subpopulations of neurons in the prefrontal cortex were activated when rats switched between allocentric place strategies and egocentric response strategies in the plus maze. In this paper we propose a simple neural-network model of strategy switching, in which the learning of the two strategies as well as learning to select between those strategies is governed by the same temporal-difference (TD) learning algorithm. We show that the model reproduces the experimental data on both behavioral and neural levels. On the basis of our results we derive testable prediction concerning a spatial dynamics of the phasic dopamine signal in the PFC, which is thought to encode reward-prediction error in the TD-learning theory

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries