Choice Of Options Research Articles

Indiana

This report about Indiana school funding relates to budgetary changes in the state’s school funding priorities and technical changes to its state aid to schools formula. Pressing issues that affect school funding as well as public policy dimensions of alternatives to traditional public schools are considered. The most pressing need for the schooling system that is mediated by the school funding program remains increasing the labor market supply of highly credentialed teachers. The most evident public policy trend is the continuing expansion of free market-based school choice options.

Storage of evidence and delayed reporting after sexual assault: Rates and impact factors on subsequent reporting

BackgroundSexual assault (SA) is alarmingly prevalent, yet reporting rates remain disproportionately low. Forensic examinations (FE) play a crucial role in both immediate medical care and evidence collection, yet many victims/survivors may not report the crime initially, leading to the loss of vital forensic evidence. The storage of evidence “Option 3″ care alternative provides post-SA care including FE without initial police involvement. MethodsThis is a cross-sectional study analysing the attendances of people who chose to store evidence at the Dublin Sexual assault Treatment Unit (SATU) between January 1, 2017 and December 31, 2023. ResultsThere were 238 storage of evidence FEs (‘Option 3’) performed during the study period, which represented 12.8 % of all FEs. The majority identified as female (89.1 %), with an average age of 26.6 years. 31.9 % attended within 24 h of the incident, and 51.3 % self-referred. Most assaults occurred over weekends (64.7 %), with alcohol consumption reported in 82.2 % of cases and drug-facilitated SA concerns in 20.2 %. Genital injuries were present in 17.9 % of females and 19 % of males.Those that availed of storage of evidence (compared with those who initially reported to the police) were significantly more likely to have consumed alcohol (p < 0.001) and the assault was more likely to have occurred indoors (p = 0.002). There was no significant difference in care option choice for those ‘unsure’ of the assault occurrence (p = 0.353).Among storage of evidence cases, 20.2 % subsequently reported to the police, with females more likely to report (p = 0.02), while people who were uncertain whether an assault had occurred were less likely to report (p = 0.04). Genital injury (p = 0.822), victim-assailant relationship (p = 0.465), assault location (p = 0.487), and substance consumption (p = 0.332) did not significantly affect subsequent reporting rates. ConclusionsThe availability of storage of evidence has afforded people the opportunity to access prompt, responsive SATU care including collection of forensic evidence which may have significant evidential value. This approach provides further opportunity for comprehensive detection of a crime, even if reporting to the police is delayed.

Factors affecting Ethiopian Consumers’ Attitudes towards Purchasing Locally Produced Apparel: An Empirical Study

: Currently, customers have an ever-expanding choice of purchase options owing to globalization, which leads to increased competition. Globalization and current marketing trends have made consumers more sensitive and challenging than ever. As consumers are the most important asset any business has, organizations must understand consumers’ behavior to maintain a strategic advantage in today's increased competition and globalized marketing. In this regard, this study aimed to assess the determinants of Ethiopian consumers' purchasing behavior in locally-produced apparel by using the Theory of Planned Behavior (TPB) model. Cross-sectional data from 539 consumers were collected using convenience sampling and analyzed using structural equation modeling. The structural equation model results showed that all variables had a positive and significant effect on the dependent variables, which means that all hypotheses are supported. The results also indicate that consumers' attitude toward locally produced apparel was the most influential determinant of their purchasing intention towards locally produced apparel, followed by perceived behavioral control and subjective norms. Further, consumers' purchasing intention is more influential in their purchasing behavior than perceived behavioral control. The findings of this study provide insight into domestic apparel consumption, as well as the factors affecting consumer purchasing intentions and behavior in the Ethiopian context. The results from the measurement and structural models offer key inputs for policymakers, marketers, manufacturers, and retailers.

Метод оценки критериев оптимизации системы электробезопасности в инфраструктуре села

The article provides an analysis of the state of energy availability and equipment of electric installations for infrastructure facilities in rural settlements. The main type of technogenic hazards is marked – the electrical hazard that occurs in emergency modes of operation of electrical installations. The conditions for solving the safety problem and choosing the optimal variant of the electrical safety system are given. The indicators of the technical efficiency of the electrical safety system are determined, characterized by the likelihood of electrical injury to a person and the likelihood of a fire in electrical installations at facilities. The choice of the most appropriate options for the use of electrical protection equipment, providing for the joint use of automatic switches and protective shutdown devices, was made as a result of comparing the likelihood of electrical injury and fire with a normalized risk level of electrical and fire safety. A method for optimizing the electrical safety system is considered according to two particular criteria representing the average values of the probabilities of electrical injury and fire with the equivalence of their values. The task of optimizing the security system is indicated, which consists in constructing a vector criterion of optimality and converting it into a scalar criterion using the "assignment" method to obtain a normalized partial criterion. The normalized private criteria of electrical and fire safety are determined using a scalar criterion for the selection of electrical protection options for an agricultural facility. An algorithm for evaluating the effectiveness of the electrical safety system in dangerous situations of electrical injuries has been built. The description of the construction of an algorithm for modeling the state of fire safety of the system in the event of fires in electrical installations is given. A comprehensive assessment of the normalized criterion for optimizing the electrical safety system was obtained according to two normalized criteria for electrical and fire safety and the choice of optimal electrical protection options at the studied facility. Keywords: TECHNOGENIC HAZARD, ELECTRICAL INSTALLATION, ACCIDENT, ELECTRICAL INJURY, TECHNICAL EFFICIENCY, EVALUATION CRITERIA, OPTIMIZATION OF ELECTRICAL SAFETY SYSTEM, ELECTRICAL PROTECTION

Real-world evidence of a novel tetravalent immunoglobulin Y effectiveness and safety in patients with the refractory Helicobacter pylori infection

BackgroundRefractory Helicobacter pylori (H. pylori) infection inevitably increase the difficulty of drug selection. Here, we described our experience with the use of a novel tetravalent IgY against H. pylori for the treatment of patients with refractory H. pylori infection.MethodsPatients were randomly assigned to receive the standard quadruple therapy (amoxicillin, clarithromycin, omeprazole and bismuth potassium citrate ) for 2 weeks or 250 mg of avian polyclonal IgY orally twice a day for 4 weeks. The binding efficacy of IgY to H. pylori antigens was detected by western blotting13. C-urea breath test was performed to evaluate the eradication therap’s efficacy. The side effects of IgY were evaluated via various routine tests. The questionnaire was used to gather clinical symptoms and adverse reactions.ResultsWestern blot analysis showed that tetravalent IgY simultaneously bind to VacA, HpaA, CagA and UreB of H. pylori. Tetravalent IgY had an eradication rate of 50.74% in patients with refractory H. pylori and an inhibition rate of 50.04% against DOB (delta over baseline) of 13C-urea. The symptom relief rate was 61.76% in thirty-four patients with clinical symptoms, and no adverse reactions were observed during tetravalent IgY treatment period.ConclusionsPolyclonal avian tetravalent IgY reduced H. pylori infection, and showed good efficacy and safety in the treatment of refractory H. pylori infection patients, which represented an effective therapeutic option of choice for patients with refractory H. pylori infection.

Effect of Flexible Working Hours on Employee Performance of Isiolo County Government, Kenya

The study sought to evaluate the effect of flexible working hours on employee performance of Isiolo County Government, Kenya. The study adopted a descriptive research design whereby quantitative data was collected using close-ended questionnaires. Therefore, the target population included 1,662 employees of Isiolo County government in various departments. These employees were further sampled using a simple random method to obtain 43 directors, 48 managers, and 309 operational staff as the sample size. Further, the study undertook a pre-test study in Samburu County government whose feedback was assessed using Cronbach Alpha coefficient to test the reliability of the questionnaires. SPSS software version 25 was used during the analysis process to provide descriptive and inferential analysis. The findings of the questionnaire indicated that 86(25%) respondents, strongly agreed and 117(35%) agreed on a mean of 4.21, that there is a local arrangement between the staff and their supervisors on how to deliver the assigned tasks on remote working option However, 76(22%) respondents, strongly disagreed and 107(32%) disagreed on a mean of 2.43, Tasks are sub-divided using a job-sharing technique to allow employees attend to other areas of their lives and still manage to attain the departmental objectives. The correlation coefficient for flexible working hours r=0.741 at α &lt; 0.02 and 99% significance level. Flexible working hours had a positive effect on the performance of employees. It was established that there was a hybrid working method that included in-office and remote operations. That notwithstanding, the choice of hybrid options was based on an informal agreement between first-line supervisor and an employee. This brought about unprofessional favors and an unbalanced allocation of tasks to the staff. Consequently, the long-term effect was poor completion of tasks, late submission of assignments, and lack of adequate supervision leading to unsatisfactory work. The recommendations on flexible working hours are that there should be a formal policy structure formulation by the management that allows equality and fairness in allocation of tasks and the choice of either working in an office or remotely. Additionally, there should be empowerment of organization laws and regulations to support disciplinary actions by the management, to discourage late submission of assignments. There should be an encouragement of work contract signing an agreement between the workers and the supervisors that supports in job training to reduce work-related errors/ unsatisfactory work.

A Computational Model of Deep Brain Stimulation for Parkinson's Disease Tremor and Bradykinesia.

Parkinson's disease (PD) is a progressive neurological disorder that is typically characterized by a range of motor dysfunctions, and its impact extends beyond physical abnormalities into emotional well-being and cognitive symptoms. The loss of dopaminergic neurons in the substantia nigra pars compacta (SNc) leads to an array of dysfunctions in the functioning of the basal ganglia (BG) circuitry that manifests into PD. While active research is being carried out to find the root cause of SNc cell death, various therapeutic techniques are used to manage the symptoms of PD. The most common approach in managing the symptoms is replenishing the lost dopamine in the form of taking dopaminergic medications such as levodopa, despite its long-term complications. Another commonly used intervention for PD is deep brain stimulation (DBS). DBS is most commonly used when levodopa medication efficacy is reduced, and, in combination with levodopa medication, it helps reduce the required dosage of medication, prolonging the therapeutic effect. DBS is also a first choice option when motor complications such as dyskinesia emerge as a side effect of medication. Several studies have also reported that though DBS is found to be effective in suppressing severe motor symptoms such as tremors and rigidity, it has an adverse effect on cognitive capabilities. Henceforth, it is important to understand the exact mechanism of DBS in alleviating motor symptoms. A computational model of DBS stimulation for motor symptoms will offer great insights into understanding the mechanisms underlying DBS, and, along this line, in our current study, we modeled a cortico-basal ganglia circuitry of arm reaching, where we simulated healthy control (HC) and PD symptoms as well as the DBS effect on PD tremor and bradykinesia. Our modeling results reveal that PD tremors are more correlated with the theta band, while bradykinesia is more correlated with the beta band of the frequency spectrum of the local field potential (LFP) of the subthalamic nucleus (STN) neurons. With a DBS current of 220 pA, 130 Hz, and a 100 microsecond pulse-width, we could found the maximum therapeutic effect for the pathological dynamics simulated using our model using a set of parameter values. However, the exact DBS characteristics vary from patient to patient, and this can be further studied by exploring the model parameter space. This model can be extended to study different DBS targets and accommodate cognitive dynamics in the future to study the impact of DBS on cognitive symptoms and thereby optimize the parameters to produce optimal performance effects across modalities. Combining DBS with rehabilitation is another frontier where DBS can reduce symptoms such as tremors and rigidity, enabling patients to participate in their therapy. With DBS providing instant relief to patients, a combination of DBS and rehabilitation can enhance neural plasticity. One of the key motivations behind combining DBS with rehabilitation is to expect comparable results in motor performance even with milder DBS currents.

Attentional mechanisms of the date/delay effect in intertemporal choice: An eye-tracking study.

Temporal discounting refers to the tendency to discount future rewards as a function of time until receipt of rewards. The discount rate can be reduced by experimentally manipulating time framing, an example being the date/delay effect: Specifically, if time until receipt of the reward is presented as a date (e.g., August 21, 2022) rather than as a delay (e.g., 136 days), temporal discounting is reduced. While this effect has been replicated several times, its underlying cognitive mechanisms are not well understood. Therefore, we used eye tracking to examine the role of attention in the date/delay effect. Participants completed both a delay and date condition of the Monetary Choice Questionnaire, while eye movements were recorded (N = 54). Results revealed a successful replication of the date/delay effect (p < .001, gav = 0.48). Eye tracking showed that participants compared time attributes (relative to reward attributes) more and fixated them longer in the date compared to the delay condition. Moreover, the absolute difference in reward values of choice options was more predictive of choosing the delayed reward in the date compared to the delay condition. Finally, explorative correlations revealed a stronger date/delay effect in participants who paid more attention to time than reward attributes in the delay condition and who used a more integrative search strategy. Our findings suggest that the date manipulation causes participants to weight rewards more strongly in their decision process than in the delay condition, ultimately reducing temporal discounting. Computation of time intervals in the date condition could possibly reflect an adaptation lowering the date/delay effect. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Decision Coaching for Healthy Women With BRCA1/2 Pathogenic Variants.

Women with pathogenic variants (PV) of the genes BRCA1/2 have a choice of preventive options. To help these women decide for themselves, we developed and implemented a decision coaching (DC) program and evaluated it for congruence between the participants' desired and actual roles in decision-making. Healthy BRCA1/2 PV carriers (25-60 years of age) were recruited at six centers in Germany. Those who returned baseline (T1) questionnaires were randomly assigned to the intervention group (IG) or the control group (CG). The IG attended a nurse-led DC program. The primary outcome was congruence between the participants' preferred and actual roles in decision-making. The secondary outcomes were an active role, satisfaction, decisional conflict, and knowledge. The follow-up questionnaires were administered at 12 weeks (T2) and 6 months (T3). Of the 413 women who were recruited, 389 returned the T1 questionnaires. At T2, the groups did not differ significantly in congruence between their preferred and actual roles in decision-making (0.12, 95% confidence interval [-0.03; 0.28], p = 0.128), with a slightly higher congruence in the CG. Women in both groups played a more active role at T2 than their stated preference at T1, with a notably higher percentage in the IG than the CG (IG: 40%, CG: 24.4% [-25.1; -6.1]). IG participants were more satisfied with their role and had less decisional conflict and greater knowledge. This DC program can help women who are carriers of BRCA1/2 PV participate actively in decision-making with regard to preventive measures.

A Comparison of Rapid Rule-Learning Strategies in Humans and Monkeys.

Interspecies comparisons are key to deriving an understanding of the behavioral and neural correlates of human cognition from animal models. We perform a detailed comparison of the strategies of female macaque monkeys to male and female humans on a variant of the Wisconsin Card Sorting Test (WCST), a widely studied and applied task that provides a multiattribute measure of cognitive function and depends on the frontal lobe. WCST performance requires the inference of a rule change given ambiguous feedback. We found that well-trained monkeys infer new rules three times more slowly than minimally instructed humans. Input-dependent hidden Markov model-generalized linear models were fit to their choices, revealing hidden states akin to feature-based attention in both species. Decision processes resembled a win-stay, lose-shift strategy with interspecies similarities as well as key differences. Monkeys and humans both test multiple rule hypotheses over a series of rule-search trials and perform inference-like computations to exclude candidate choice options. We quantitatively show that perseveration, random exploration, and poor sensitivity to negative feedback account for the slower task-switching performance in monkeys.

Navigating High-Risk and Ultrahigh-Risk Multiple Myeloma: Challenges and Emerging Strategies.

Despite significant improvement in the outcomes of patients with newly diagnosed multiple myeloma (NDMM) with novel therapies, there is still an underserved high-risk (HR) population that experiences early disease progression and death. With the median survival crossing 10 years, we defined ultrahigh-risk (uHR)MM as MM leading to death within 24-36 months of diagnosis and HRMM as MM leading to death within 36-60 months. Several features have emerged as markers of uHRMM: the co-occurrence of two or more high-risk cytogenetic abnormalities, extramedullary disease, plasma cell leukemia and a high-risk gene expression profiling signature. The heterogeneous risk definition across trials, the few trials available designed for HR patients, and the small HR subgroups in all-comers trials make it difficult to generate recommendations with high levels of evidence. Nevertheless, regardless of treatment administered, several studies consistently showed that achieving and maintaining measurable residual disease negativity is now considered the main factor able to mitigate the adverse prognosis related to baseline features. For fit patients with HR transplant-eligible (TE) NDMM, quadruplet induction/consolidation treatment with anti-CD38 monoclonal antibodies, immunomodulatory agents, proteasome inhibitors and dexamethasone, and autologous stem-cell transplant and maintenance with, if available, at least a doublet combination could be considered the option of choice. For non-TE NDMM, considering the recent data generated and carefully reviewing those upcoming, quadruplet treatment consisting of anti-CD38 monoclonal antibodies, immunomodulatory agents, proteasome inhibitors, and dexamethasone should also be considered. Future trials integrating BCMA-directed novel generation immunotherapies hold great potential for further advancing the treatment landscape in all NDMM patients with HR disease.

Neurocomputational Mechanisms Underlying Differential Reinforcement Learning From Wins and Losses in Obesity With and Without Binge Eating

BackgroundBinge-eating disorder (BED) is thought of as a disorder of cognitive control, but evidence regarding its neurocognitive mechanisms is inconclusive. Key limitations of previous research include a lack of consistent separation between effects of BED and obesity and a disregard for self-report evidence suggesting that neurocognitive alterations may emerge primarily in loss- or harm-avoidance contexts. MethodsTo address these gaps, in this longitudinal study we investigated behavioral flexibility and its underlying neurocomputational processes in reward-seeking and loss-avoidance contexts. Obese participants with BED, obese participants without BED, and healthy normal-weight participants (n = 96) performed a probabilistic reversal learning task during functional imaging, with different blocks focused on obtaining wins or avoiding losses. They were reinvited for a 6-month follow-up assessment. ResultsAnalyses informed by computational models of reinforcement learning showed that unlike obese participants with BED, obese participants without BED performed worse in the win than in the loss condition. Computationally, this was explained by differential learning sensitivities in the win versus loss conditions in the groups. In the brain, this was echoed in differential neural learning signals in the ventromedial prefrontal cortex per condition. The differences were subtle but scaled with BED symptoms, such that more severe BED symptoms were associated with increasing bias toward improved learning from wins versus losses. Across conditions, obese participants with BED switched more between choice options than healthy normal-weight participants. This was reflected in diminished representation of choice certainty in the ventromedial prefrontal cortex. ConclusionsOur study highlights the importance of distinguishing between obesity with and without BED to identify unique neurocomputational alterations underlying different styles of maladaptive eating behavior.

The role of conflict representation in abstinence versus moderation in self-control.

Self-control-the prioritization of valued global goals over immediate local rewards-is typically conceptualized and studied as isolated decisions. Goal pursuit, however, generally requires people to make repeated self-control decisions across contexts. We adopt a higher order, strategic level of analysis of self-control and explore, for the first time, people's preferences for abstinence (a pattern of choices in which one never indulges) versus moderation (a pattern of choices in which one indulges when doing so does not harm one's goals or even helps promote the pursuit of those goals). To understand when and why people may opt for one over the other, the present work explores one psychological feature that may support these strategy preferences: the representation of self-control conflicts as inherent (i.e., choice options are mutually contradictory) versus situational (i.e., choice options compete for limited resources). We present eight studies in the main text and three in the online Supplemental Materials documenting that people associate inherent and situational conflict representations with abstinence and moderation, respectively. By documenting that strategy preferences may differ as a function of conflict representations, this work questions the assumption of abstinence as the primary indicator of self-control success, raises methodological and conceptual questions about how best to assess these strategy preferences, and calls for greater understanding of self-control as a recurrent decision-making process. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Not Everyone Chooses Profit (If It Is too Tiring): What Behavioral and EEG Data Tell Us

Background: A more rewarding choice, even if it requires more effort, is usually preferred by individuals; yet, in some cases, individuals choose less profitable and less tiring options. This study explored the behavioral and electrophysiological (EEG) correlates of healthy adults performing a task, designed to investigate the decision-making process behind the selection of more effortful (but highly monetarily rewarding) and less effortful (but less monetarily rewarding) options. Methods: A sample of 20 healthy adults (mean age = 46.40) performed the decision-making task, while behavioral data and EEG frequency bands (delta, theta, alpha, and beta) were collected. The Maximization Scale (MS) was administered to evaluate individuals’ differences in the tendency to maximize their choices. Results: the results showed a general preference for selecting more compared to less effortful options, while no significant differences were obtained for the response times. Individuals who score higher on the MS High Standards subscale are more inclined to choose less effortful options; conversely, those with lower scores are more likely to choose a more effortful and rewarding option. However, no significant correlations were found between the behavioral data and the alternative search, or the decision difficulty subscales of the MS. EEG findings reported a significant interaction effect Choice × Electrode in delta, theta, alpha and beta bands. Specifically, the choice of less effortful options is associated with a higher increase in delta, theta, alpha, and beta band power in the right temporoparietal area (TP10) and by a lower activation of delta and theta in the contralateral site (TP9). The delta band decreased in left frontal area (AF7) during the task for the less versus more effortful options. Conclusions: Overall, despite more effortful and more monetarily rewarding options seeming to be the most rational ones to choose, less effortful choices are associated with specific EEG correlates, suggesting that there is a perceived advantage in avoiding automatisms, delaying gratification, and maximizing future possibilities.

Humans do not avoid reactively implementing cognitive control.

The ability to exert cognitive control allows us to achieve goals in the face of distraction and competing actions. However, control is costly-people generally aim to minimize its demands. Because control takes many forms, it is important to understand whether such costs apply universally. Specifically, reactive control, which is recruited in response to stimulus or contextual features, is theorized to be deployed automatically, and not depend on attentional resources. Here, we investigated whether people avoided implementing reactive control in three experiments. In all, participants performed a Stroop task in which certain items were mostly incongruent (MI), that is, associated with a high likelihood of conflict (triggering a focused control setting). Other items were mostly congruent, that is, associated with a low likelihood of conflict (triggering a relaxed control setting). Experiment 1 demonstrated that these control settings transfer to a subsequent unbiased transfer phase. In Experiments 2-3, we used a demand selection task to investigate whether people would avoid choice options that yielded items that were previously MI. In all, participants continued to retrieve focused control settings for previously MI items, but they did not avoid them in the demand selection task. Critically, we only found demand avoidance when there was an objective difference in demand between options. These findings are consistent with the idea that implementing reactive control does not register as costly. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Consciously stochastic in preference reversals

Stochastic choice, the act of choosing differently in repeated decisions, can be a conscious decision made by individuals who are aware of their inability to make a definitive choice. To examine the prevalence and implications of conscious stochastic choice, we developed a novel method and implemented it in a preference reversal experiment: In each valuation choice between the bet and a varying reference option, subjects could either pay a small cost to select a specific option or opt for a free randomization choice where a computer randomly selects an option. Our findings revealed that the majority of subjects exhibited conscious stochastic choice, and further that their choices were significantly affected by the elicitation procedures.

#749 Components in blood collection tubes interfere with the spectral signatures of patients with kidney disease: analysis by infrared microspectroscopy

Abstract Background and Aims Kidney disease is a worldwide public health problem, affecting between 8%-16% of the global population. Chronic Kidney Disease (CKD) is a silent disease and its detection is often late, making the treatment difficult. Considering the emerging Fourier-Transform Infrared spectroscopy (FTIR) as a biophotonic resource for the biomedical sciences, we aimed to identify spectral signatures related to biomarkers of CKD in human blood serum using the microscopy FTIR option. Method Blood serum samples from 17 healthy in comparison to 33 CKD patients were analyzed by micro-reflectance FTIR spectroscopy. The first aspect to be addressed refers to the possible influence of components present in the container tube. Here we showed that separator gel in VACUETTE® tubes is a relevant source of spectral interference which could decrease the accuracy of discrimination from 85% to 65%. Acquiring a diluted gel signal as a background would improve the discrimination performance in spite of some gel bands still present in sample data. Results In this case, our results indicated that vibrations associated with galactose-4-sulfate, CH2 bending of the methylene chains, C=C in lipids and fatty acids, C=N stretching, CH bending vibration from the phenyl rings, N-H bending vibration coupled to C-N stretching and β-sheet of Amide II and ring base are modulated in blood serum samples of chronic kidney disease patients compared to healthy patients. Urinary trypsin inhibitors, fatty acids, phenolic derivatives, tryptophan, and plasminogen were the biomolecules related to these assignments were the biomolecules related to these assignments. Conclusion In conclusion, FTIR is a viable option for fast diagnosis of chronic kidney disease being also a powerful tool for monitoring the disease. Due to its capability of large batch analysis, the micro-FTIR would be an eligible technology for clinical laboratories in healthcare facilities. However, for direct clinical applications, ATR-FTIR would be the option of choice.

#2801 Which patients may benefit most from hemodiafiltration compared with hemodialysis: prediction of the individualized treatment effect

Abstract Background and Aims Haemodiafiltration (HDF) with an appropriate dosing reduces death from any cause based on an individual participant data meta-analysis and aggregated data meta-analyses of available randomized trials. No differences in treatment effect are reported for specific patient populations when defined on a single characteristic in subgroup analyses. Yet, it is unclear to what extent individual patients, characterized by a combination of clinical characteristics, may benefit from HDF. This study aimed to develop and internally validate a treatment effect prediction model to determine which individual patients would benefit most from well dosed HDF, compared with haemodialysis (HD), in terms of survival. Method Individual participant data from five randomized controlled trials (CONTRAST, ESHOL, Turkish HDF study, French HDF study, CONVINCE) comparing HDF with HD on all-cause mortality were used to derive a Royston-Parmar model for exploring the prediction of absolute treatment effect of HDF based on pre-specified patient and disease characteristics, notably age, sex, body mass index, diabetes mellitus, history of cardiovascular disease, creatinine levels, and c-reactive protein levels. Internal validation of the model was performed using internal-external cross validation. Results Among 4153 participants, with a median follow-up of 30 months (Q1-Q3: 24-36), death from any cause occurred in 558 patients (27.2%). The median predicted survival benefit of HDF compared with HD was 6.9 (Q1–Q3: 5.6–9.0) months, with a range of 2 to 42 months. Patients who were predicted to benefit most from HDF were younger, less likely to have diabetes or a cardiovascular history and had higher serum creatinine levels. Internal-external cross validation showed adequate discrimination and calibration. Conclusion All-cause mortality is reduced by HDF compared with HD in ESKD patients. Yet, the absolute survival benefit seems to considerably differ between individual patients. Our results suggest that the effects of HDF on absolute survival can be predicted accurately using a combination of readily available patient and disease characteristics. This prediction model approach exemplifies the potential of prediction algorithms in supporting clinical decision-making for the choice of treatment options. Validation and potential updates to the presented algorithm are necessary, along with a preferable randomized evaluation of its clinical impact before widespread implementation.

Заметки о выборе вариантов в современном газетном жанре из возможных в русском языке

In the “Notes” the author cites the choice of options of a number of Russian words from several issues of the newspaper «Moskovsky Komsomolets» for the summer of 2023: rather frequent usages of dostatochno (≈‘enough’), ochen’ (≈‘very’), dovol’no (≈‘quite’), skhozhest’ (≈‘similarity’), skhozhiy (≈‘similar’), rarer usages of krayne (≈‘extremely’), pokhozhiy (≈‘similar’), podobnyy (≈‘similar’), ochevidno (≈‘obviously’), initial and middle takzhe (≈‘as well’). For even rarer ones vpolne (≈‘quite’), dazhe (≈‘even’), absolyutno (≈‘absolutely’), potryasayushche (≈‘stunning’), the author presents the examples from additionally viewed newspaper issues of 2022 and 2023. The “Notes” present not only examples from the newspaper “Moskovsky Komsomolets”, but also from other newspapers (primarily “Moskovskaya Pravda” and “Argumenty i Facty”), as well as from academic articles and books of linguists of Perm School read by the author recently. Thus, the author draws a conclusion that largely contradicts the usual ideas about the Russian literary language, including even those in the book “Dynamics of Russian Language Norms: A Response to the Challenges of the Time and New Living Conditions” recently published by the Saratov Publishing House concerning the options of the lexeme dostatochno (≈‘enough’). It is shown which of the possible options currently dominate in the Russian language and when the choice is simply the result of a desire for alternation to avoid repetition.

Heuristics in risky decision-making relate to preferential representation of information

When making choices, individuals differ from one another, as well as from normativity, in how they weigh different types of information. One explanation for this relates to idiosyncratic preferences in what information individuals represent when evaluating choice options. Here, we test this explanation with a simple risky-decision making task, combined with magnetoencephalography (MEG). We examine the relationship between individual differences in behavioral markers of information weighting and neural representation of stimuli pertinent to incorporating that information. We find that the extent to which individuals (N = 19) behaviorally weight probability versus reward information is related to how preferentially they neurally represent stimuli most informative for making probability and reward comparisons. These results are further validated in an additional behavioral experiment (N = 88) that measures stimulus representation as the latency of perceptual detection following priming. Overall, the results suggest that differences in the information individuals consider during choice relate to their risk-taking tendencies.