Information search and information distortion in the diagnosis of an ambiguous presentation

Physicians often encounter diagnostic problems with ambiguous and conflicting features. What are they likely to do in such situations? We presented a diagnostic scenario to 84 family physicians and traced their information gathering, diagnoses and management. The scenario contained an ambiguous feature, while the other features supported either a cardiac or a musculoskeletal diagnosis. Due to the risk of death, the cardiac diagnosis should be considered and managed appropriately. Forty-seven participants (56%) gave only a musculoskeletal diagnosis and 45 of them managed the patient inappropriately (sent him home with painkillers). They elicited less information and spent less time on the scenario than those who diagnosed a cardiac cause. No feedback was provided to participants. Stimulated recall with 52 of the physicians revealed differences in the way that the same information was interpreted as a function of the final diagnosis. The musculoskeletal group denigrated important cues, making them coherent with their representation of a pulled muscle, whilst the cardiac group saw them as evidence for a cardiac problem. Most physicians indicated that they were fairly or very certain about their diagnosis. The observed behaviours can be described as coherencebased reasoning, whereby an emerging judgment influences the evaluation of incoming information, so that confident judgments can be achieved even with ambiguous, uncertain and conflicting information. The role of coherence-based reasoning in medical diagnosis and diagnostic error needs to be systematically examined

Comment on "Electron transport through correlated molecules computed using the time-independent Wigner function: Two critical tests"

The many electron correlated scattering (MECS) approach to quantum electronic transport was investigated in the linear response regime [I. Baldea and H. Koeppel, Phys. Rev. B. 78, 115315 (2008)]. The authors suggest, based on numerical calculations, that the manner in which the method imposes boundary conditions is unable to reproduce the well-known phenomena of conductance quantization. We introduce an analytical model and demonstrate that conductance quantization is correctly obtained using open system boundary conditions within the MECS approach.Comment: 18 pages, 4 figures. Physical Review B, to appea

GENHYP - A FORTRAN 5 program for general linear hypothesis testing

GENHYP FORTRAN 5 program for general linear hypothesis testin

Characterization and Management of Auxin-Resistant Palmer amaranth in Tennessee

Palmer amaranth has a long history of evolving resistance to herbicides to the point it has become a significant row crop production obstacle. Cotton and soybean growers were offered new technologies in 2016, expanding in-crop herbicide options to include dicamba or 2,4-D. Within three years of commercialization, dicamba use in these crops increased ten-fold and growers began to report Palmer amaranth escapes in west Tennessee auxin-tolerant production systems. A survey of Palmer amaranth escapes in dicamba and 2,4-D-tolerant cotton and soybean fields in Tennessee was conducted in the fall of 2021 with the objective of determining if poor control was due to environmental phenomenon or development of auxin resistance in west Tennessee. Field experiments were conducted across Tennessee in locations where growers witnessed poor control following these herbicides and in Georgia and Texas to characterize potentially resistant populations and compare these with known susceptible populations. Greenhouse findings confirmed three Palmer amaranth accessions with relative resistance factor to dicamba between 1.85-2.49 and one population from Lauderdale County, Tennessee with a relative resistance factor of 14.25. In field studies across multiple locations in Tennessee, the labelled rate of dicamba or 2,4-D controlled Palmer amaranth ≤60%. The addition of malathion insecticide in field experiments did not improve Palmer amaranth control, ruling out certain cytochrome p-450’s as a resistance mechanism

The Impact of Doulas on Breastfeeding in Black Women: a Literature Review

This literature review was conducted to explore the impacts doulas have on breastfeeding initiation and continuation in the Black population. Black women’s breastfeeding and continuation is exceptionally low compared to white women and other races and ethnicities. Six journal articles were used to examine the relationships that doulas have on breastfeeding initiation and continuation in black communities. There was an array of study designs found throughout the articles to help support the doula and breastfeeding relationship in Black women. The results of this literature review were preliminarily positive, but more evidence is required to firmly establish the positive impact of doulas on breastfeeding initiation and continuation among Black mothers

A Novel Method for Analysis of Proprioceptor Sensory Neuron Subtypes in the Mouse Dorsal Root Ganglia

Proprioceptive sensory neurons encode critical mechanosensory information that helps determine how the body interacts with the outside world and monitors the proper execution of motor movements. Housed in skeletal muscles lie specialized mechanoreceptors that are critical to this feedback loop: muscle spindles supplied by group Ia & group II afferents, and Golgi tendon organs supplied by group Ib afferents relay information regarding changes in muscle force, length, and tension. All three afferent subtypes originate in the muscle and travel to the dorsal root ganglia, relaying information to the central nervous system. GTO and MS proprioceptive afferent subtypes have been identified, traced, and labeled by restrictive RNA and DNA sequencing techniques that eliminate the potential for in vivo and ex vivo analysis. To confirm the identity of different proprioceptive afferent subtypes in the dorsal root ganglia of mice, the present study developed a method of fluorescence tracing using a dextran dye to trace afferents and their origins. By injecting tetramethylrhodamine dextran dye directly into the quadriceps muscle, the muscle spindle proprioceptive afferents selectively transport the dye to the cell body in the DRG demonstrating its origin and classification. Being able to selectively label and trace muscle spindle afferents allows us to accurately collect data on the cells in the DRGs

Independent particle descriptions of tunneling from a many-body perspective

Currents across thin insulators are commonly taken as single electrons moving across classically forbidden regions; this independent particle picture is well-known to describe most tunneling phenomena. Examining quantum transport from a different perspective, i.e., by explicit treatment of electron-electron interactions, we evaluate different single particle approximations with specific application to tunneling in metal-molecule-metal junctions. We find maximizing the overlap of a Slater determinant composed of single particle states to the many-body current-carrying state is more important than energy minimization for defining single particle approximations in a system with open boundary conditions. Thus the most suitable single particle effective potential is not one commonly in use by electronic structure methods, such as the Hartree-Fock or Kohn-Sham approximations.Comment: 4+ pages, 4 figures; accepted to Phys. Rev. B Rapid Communication

Validating the Use of Vignettes for Subjective Threshold Scales

Comparing self-assessed indicators of subjective outcomes such as health, work disability, political efficacy, job satisfaction, etc. across countries or socio-economic groups is often hampered by the fact that different groups use systematically different response scales. Anchoring vignettes have been introduced as an effective tool to correct for such differences. This paper develops an integrated framework in which objective measurements are used to validate the vignette-based corrections. The framework is applied to vignettes and objective and subjective self-assessments of drinking behavior by students in Ireland. Model comparisons using the Akaike information criterion favor a specification with response consistency and vignette corrected response scales. Put differently, vignette based corrections appear quite effective in bringing objective and subjective measures closer together.anchoring vignettes;reporting bias;hopit model