Combined Anchoring: Prosecution and defense claims as sequential anchors in the courtroom

Purpose When making judgements under uncertainty not only lay people but also professional judges often rely on heuristics like a numerical anchor (e.g., a numerical sentencing demand) to generate a numerical response. As the prosecution has the privilege to present its demand first, some scholars have speculated about an anchoring‐based unfair disadvantage for the defence (who has the last albeit less effective word in court). Despite the plausibility of this reasoning, it is based on a hitherto untested assumption that the first of two sequential anchors exerts a greater influence on a later judgement (a primacy effect). We argue that it is also conceivable that the last word in court has a recency advantage (a recency effect) or that order does not matter as both demands even each other out (a combined anchor). Methods We report a pre‐registered experiment with German law students ( N = 475) who were randomly assigned to six experimental conditions in a study on legal decision‐making order to test these three possibilities. Results Results indicate an influence of both the prosecution and the defence recommendation, but no effect of order. Conclusion This provides strong support for combined anchoring even for knowledgeable participants and rich case material. Specifically, the data are best compatible with the notion that both anchors exert an influence but each on different individuals. The implications of this finding for theory and legal decision‐making are discussed

Long-term safety and outcome of intravenous treprostinil via an implanted pump in pulmonary hypertension

BACKGROUND: We examined safety and long-term outcomes of intravenous treprostinil administered via the implantable LENUS Pro pump in patients with severe pulmonary hypertension (PH). METHODS: Patients with PH undergoing pump implantation between December 2009 and October 2016 in German referral centers were retrospectively analyzed (end of follow-up: May 2017). The primary objective was to determine long-term safety of the implantable pump. Secondary end points were 3-year survival and prognostic relevance of pre-implantation hemodynamics. RESULTS: We monitored 129 patients (120 with pulmonary arterial hypertension, 1 with PH due to lung diseases, and 8 with inoperable chronic thromboembolic PH) for 260 patient-years (median follow-up, 19 months; interquartile range, 11-34 months). There were 82 complications/peri-procedural events in 60 patients; of these, 57 were serious adverse events (0.60 per 1,000 treatment-days), including 2 peri-procedural deaths due to right heart failure. The incidence of complications related to the pump, catheter, infection, and pump pocket per 1,000 treatment-days was 0.074, 0.264, 0.032 (3 local infections; no bloodstream infections), and 0.380, respectively. Three-year overall and transplant-free survival were 66.5% and 55.7%, respectively (39 patients died; 16 underwent lung transplantation). Baseline cardiac index independently predicted transplant-free survival (multivariate hazard ratio, 1.90; 95% confidence interval, 1.11-3.28; p = 0.019; n=95). CONCLUSIONS: Our data suggest that intravenous treprostinil via the LENUS Pro pump in advanced PH is associated with a very low risk of bloodstream infections, but other serious adverse events may occur. Therefore, this therapy needs standardization and should be offered in specialized PH centers only. Further technical advances of the pump system and prospective studies are needed. (C) 2018 International Society for Heart and Lung Transplantation. All rights reserved