Decision-making Processes In Response Research Articles

Navigating the Pandemic: Shifts in Breast Reconstruction Trends and Surgical Decision-Making in the United States.

Background: This study aimed to investigate the impact of the COVID-19 pandemic on breast reconstruction trends in the United States, focusing on implant-based and autologous techniques, as well as the timing of reconstruction (immediate vs. delayed). Methods: A retrospective analysis of data from 2015 to 2022 from the American Society of Plastic Surgeons' National Plastic Surgery Statistics was conducted. Annual trends in breast reconstruction procedures were analyzed, comparing the pre-pandemic (2015-2019) and pandemic (2020-2022) periods. A sensitivity analysis was performed to assess the impact of missing data from 2019 and 2021. Results: The total number of breast reconstructions increased from 106,338 in 2015 to 151,641 in 2022. The proportion of implant-based reconstructions decreased from 81.41% pre-pandemic to 76.51% during the pandemic (p < 0.001), with a notable rise in direct-to-implant procedures from 10.37% to 19.12% (p < 0.001). Autologous reconstructions increased from 18.59% to 23.49% (p < 0.001). Among autologous techniques, DIEP flaps remained the most popular. Immediate reconstruction rates increased from 72.61% pre-pandemic to 75.57% during the pandemic, while delayed reconstruction rates decreased from 27.39% to 24.43% (p < 0.001). The sensitivity analysis confirmed the robustness of these trends. Conclusions: During the COVID-19 pandemic, there was a significant shift towards autologous breast reconstruction techniques, particularly DIEP flaps, and an increase in immediate reconstructions in the United States. Within implant-based reconstructions, the proportion of DTI procedures increased while the proportion of tissue expander procedures decreased. These changes likely reflect adaptations in surgical practice and decision-making processes in response to the unique challenges posed by the pandemic, rather than alterations in surgical techniques themselves. The insights gained from this study can help guide plastic surgeons and healthcare providers in preparing for future pandemics or similar disruptions.

Designing Shared Information Displays for Agents of Varying Strategic Sophistication

Data-driven predictions are often perceived as inaccurate in hindsight due to behavioral responses. In this study, we explore the role of interface design choices in shaping individuals' decision-making processes in response to predictions presented on a shared information display in a strategic setting. We introduce a novel staged experimental design to investigate the effects of design features, such as visualizations of prediction uncertainty and error, within a repeated congestion game. In this game, participants assume the role of taxi drivers and use a shared information display to decide where to search for their next ride. Our experimental design endows agents with varying level-k depths of thinking, allowing some agents to possess greater sophistication in anticipating the decisions of others using the same information display. Through several extensive experiments, we identify trade-offs between displays that optimize individual decisions and those that best serve the collective social welfare of the system. We find that the influence of display characteristics varies based on an agent's strategic sophistication. We observe that design choices promoting individual-level decision-making can lead to suboptimal system outcomes, as manifested by a lower realization of potential social welfare. However, this decline in social welfare is offset by a reduction in the distribution shift, narrowing the gap between predicted and realized system outcomes, which potentially enhances the perceived reliability and trustworthiness of the information display post hoc. Our findings pave the way for new research questions concerning the design of effective prediction interfaces in strategic environments.

Simulated operant reflex conditioning environment reveals effects of feedback parameters.

Operant conditioning of neural activation has been researched for decades in humans and animals. Many theories suggest two parallel learning processes, implicit and explicit. The degree to which feedback affects these processes individually remains to be fully understood and may contribute to a large percentage of non-learners. Our goal is to determine the explicit decision-making processes in response to feedback representing an operant conditioning environment. We developed a simulated operant conditioning environment based on a feedback model of spinal reflex excitability, one of the simplest forms of neural operant conditioning. We isolated the perception of the feedback signal from self-regulation of an explicit unskilled visuomotor task, enabling us to quantitatively examine feedback strategy. Our hypothesis was that feedback type, biological variability, and reward threshold affect operant conditioning performance and operant strategy. Healthy individuals (N = 41) were instructed to play a web application game using keyboard inputs to rotate a virtual knob representative of an operant strategy. The goal was to align the knob with a hidden target. Participants were asked to "down-condition" the amplitude of the virtual feedback signal, which was achieved by placing the knob as close as possible to the hidden target. We varied feedback type (knowledge of performance, knowledge of results), biological variability (low, high), and reward threshold (easy, moderate, difficult) in a factorial design. Parameters were extracted from real operant conditioning data. Our main outcomes were the feedback signal amplitude (performance) and the mean change in dial position (operant strategy). We observed that performance was modulated by variability, while operant strategy was modulated by feedback type. These results show complex relations between fundamental feedback parameters and provide the principles for optimizing neural operant conditioning for non-responders.

Harnessing the Power of AI for Enhanced Regulatory Compliance and Risk Management in Fintech

Purpose: This article analyzes how artificial intelligence (AI) is revolutionizing risk management and regulatory compliance in the fintech industry. The objective is to conduct an analysis of AI applications, highlighting how it may be used for proactive risk management, fraud prevention, real-time regulatory monitoring, and risk assessment.&#x0D; Methodology: Using a literature review methodology, the paper puts together data gathered from multiple sources to give a comprehensive knowledge of how AI is being applied to change the regulatory and risk landscape for fintech. As part of the method, significant works in the subject are reviewed and analyzed, and numerous perspectives are integrated to provide a thorough overview.&#x0D; Findings: The results highlight how AI significantly improves decision-making processes in response to complicated risk situations and dynamic regulatory contexts while also increasing efficiency and lowering costs. Fintech practices are evolving due to specific applications such as proactive risk management, precise risk assessment, fraud detection, real-time monitoring, and accurate risk management.&#x0D; Unique contribution to theory, practice and policy: The work adds additional value by combining various AI applications for risk management and regulatory compliance in finance. It provides useful insights for researchers, practitioners, and policymakers by bridging the gap between theory and practice. The article offers industry professionals useful implications in addition to educating the academic community on the complex effects of AI on fintech. It also draws attention to the necessity of flexible regulatory frameworks that can keep up with the fintech industry's rapid advancements in technology, which adds to the policy considerations in this dynamic environment. For individuals negotiating the convergence of artificial intelligence, regulatory compliance, and risk management in the fintech industry, the article is essentially a short and important resource.

Direct-proactive communication and the post-infidelity stay-leave decision

ABSTRACT Research at the intersection of infidelity and communication has primarily focused on how partners communicate post-infidelity. However, researchers have yet to investigate whether direct-proactive communication (i.e. having an intentional conversation with one’s partner about attitudes toward infidelity prior to its occurrence) can influence victims’ stay-leave decision-making process in response to the transgression. We conducted two studies (total N = 271) to compare the influence of this communication strategy on people’s anticipated responses to infidelity in hypothetical scenarios, versus people’s actual responses to infidelity that occurred in a past or current relationship. Study 1 results did not reveal a significant association between this strategy and the anticipated stay-leave decision, nor between this strategy and anticipated decision confliction. Study 2 results also failed to reveal a significant association between this strategy and the actual stay-leave decision. However, we did find that particularly among individuals who chose to stay with their unfaithful partner, those who had engaged in direct-proactive communication were significantly more conflicted about staying than those who did not. Exploratory analyses further suggest that although people anticipate direct-proactive communication would greatly influence their choice to stay or leave post-infidelity, it doesn’t seem to matter for those faced with the real decision.

Cyber-attacks and the right of self-defense: a case study of the Netherlands

Whilst Article 51 of the UN Charter as a rule indicates that an “armed attack” may trigger a State’s right of self-defense, the actual purport of armed attack remains a matter of interpretation and qualification. To improve the notion of the rule on self-defense and contribute to the jus ad bellum, more clarification as to what constitutes an armed attack in cyberspace is necessary. Therefore, policy norms—regarding when cyber-attacks reach the threshold of an armed attack—could guide State behavior. On the one hand, these policy norms could be used in the political decision-making processes for States that consider initiating cyber-attacks. On the other, they could help victim States in their decision-making processes in response to grave cyber-attacks. The aim of the paper is to propose a tangible guideline that outlines when cyber-attacks—perpetrated solely in or through cyberspace and not in conjunction with conventional military attacks—can qualify as an armed attack. By assessing the positions of States and leading academic opinions regarding the qualification of cyber-attacks as armed attacks, and applying international and interdisciplinary policy documents to transfer the legal debate into tangible options, a policy framework is deduced that can serve as a baseline for international cyber norms. This framework distinguishes three separate categories of armed attack in cyberspace, each with their own distinctive levels to determine when a cyber-attack can qualify as an armed attack. These absolute levels are tailored for the Netherlands but could also be suitable for other States when transferred to percentages of the gross national/domestic product and the population size.

Integrating national culture into the organizational performance feedback theory

The organizational response to performance feedback is a collective process in which groups of decision-makers face uncertainty about the future when making organizational decisions based on past performance feedback. Culture is an important variable to explain the context of collective decision processes, but it is not well understood by Organizational Performance Feedback Theory (PFT) research. The current internationalization trend of PFT research poses the question if empirical results are comparable across different cultural settings, and whether culture is a general condition of organizational performance feedback. We analyze the role of national culture as a proxy for collective interpretive processes that influence the organizational decision-making process in response to performance feedback, and we resolve some of the unexplained variances in the empirical results. We use a meta-analysis to understand if national culture poses a general condition for the organizational performance feedback process. We analyze the empirical results of 153 PFT studies covering organizations from 16 countries, and we examine the impact of four dimensions of national culture: uncertainty avoidance, performance orientation, future orientation, and institutional collectivism. We demonstrate that national culture is an important concept for PFT development.

The wisdom of stalemates: consensus and clustering as filtering mechanisms for improving collective accuracy.

Groups of organisms, from bacteria to fish schools to human societies, depend on their ability to make accurate decisions in an uncertain world. Most models of collective decision-making assume that groups reach a consensus during a decision-making bout, often through simple majority rule. In many natural and sociological systems, however, groups may fail to reach consensus, resulting in stalemates. Here, we build on opinion dynamics and collective wisdom models to examine how stalemates may affect the wisdom of crowds. For simple environments, where individuals have access to independent sources of information, we find that stalemates improve collective accuracy by selectively filtering out incorrect decisions (an effect we call stalemate filtering). In complex environments, where individuals have access to both shared and independent information, this effect is even more pronounced, restoring the wisdom of crowds in regions of parameter space where large groups perform poorly when making decisions using majority rule. We identify network properties that tune the system between consensus and accuracy, providing mechanisms by which animals, or evolution, could dynamically adjust the collective decision-making process in response to the reward structure of the possible outcomes. Overall, these results highlight the adaptive potential of stalemate filtering for improving the decision-making abilities of group-living animals.

Experiences of Suicide in Transgender Youth: A Qualitative, Community-Based Study

Objective: The aim was to develop understanding around the experience of suicide in transgender youth. Method: Qualitative analysis with 85 interviews with transgender youth about their histories with suicidality was performed. Participants were recruited from community clinics in three counties (United States, Canada, and Ireland) between 2010 and 2014. Results: Factors that precipitated participants’ suicide attempts included rejection based on gender identity and gender dysphoria. Participants demonstrated resilience by attempting to connect with loved ones for support and through self-awareness of mental states, including by regulating behaviors they perceived to adversely affect their mental health. Conclusions: Transgender youth may fear seeking health care due to health professionals’ lack of understanding of transgender issues and fear of further victimization. Reframing suicidality as a rational decision-making process in response to stress may further understanding of why people attempt suicide and provide new avenues for intervention.

Modelling dynamic effects of multi-scale institutions on land use change

Formal institutions impact on the dynamics of land use change through their objectives, actions and decision-making processes in response to socio-economic or environmental changes such as climate change. The effects and interplay of these actions are not fully understood, and hence, institutional processes are rarely integrated in modelling analyses of land use change. The complex effects of institutional interactions within land systems can be better understood through modelling approaches that address the heterogeneity of the institutional actors involved and how their decisions affect temporal and spatial dynamics. In this paper, we present an agent-based model of autonomous land managers interacting with institutional agents at two spatial scales. We explore different parameters of institutional intervention (subsidy rate, triggers for action, delay in monitoring, scale-based precedence) under socio-economic drivers and analyse key metrics such as the maximum over- and undersupply of ecosystem services, connectivity of land uses, and degree of change in land use patterns. Levels of subsidy and action triggers have the greatest impact on the magnitude of land use change and the maximum oversupply of ecosystem services. In terms of achieving institutional objectives, subsidy rate is the most important single parameter in the model. Furthermore, we find non-linearity with variations in parameters that have important implications for current land use change modelling and requirements for empirical studies of land use planning institutions. Finally, the effects of high-end climate change may require entirely novel institutional behaviours.

How can a binary switch within the pars tuberalis control seasonal timing of reproduction?

Life in seasonally changing environments is challenging. Biological systems have to not only respond directly to the environment, but also schedule life history events in anticipation of seasonal changes. The cellular and molecular basis of how these events are scheduled is unknown. Cellular decision-making processes in response to signals above certain thresholds regularly occur i.e. cellular fate determination, apoptosis and firing of action potentials. Binary switches, the result of cellular decision-making processes, are defined as a change in phenotype between two stable states. A recent study presents evidence of a binary switch operating in the pars tuberalis (PT) of the pituitary, seemingly timing seasonal reproduction in sheep. Though, how a binary switch would allow for anticipation of seasonal environmental changes, not just direct responsiveness, is unclear. The purpose of this review is to assess the evidence for a binary switching mechanism timing seasonal reproduction and to hypothesize how a binary switch would allow biological processes to be timed over weeks to years. I draw parallels with mechanisms used in development, cell fate determination and seasonal timing in plants. I propose that the adult PT is a plastic tissue, showing a seasonal cycle of cellular differentiation, and that the underlying processes are likely to be epigenetic. Therefore, considering the mechanisms behind adult cellular plasticity offers a framework to hypothesize how a long-term timer functions within the PT.

Vulnerability of women to climate change in arid and semi-arid regions: The case of India and South Asia

This article is a collation and synthesis of the literature review with the focus on the vulnerability of rural women in developing countries to climate change on the one hand and being pro-active in adapting to climate change on the other. The geographic coverage of the literature is global but with specific examples from India. The information presented in this paper is derived from diverse sources including journal articles and thematic books, and indicates severe adverse impacts not only on women's livelihood opportunities but also on exacerbating the workload and fatigue while decreasing their self esteem and forcing them to undertake some high risks and hazardous activities. The literature indicates that poverty, gender inequality, insecure land rights, heavy reliance on agriculture, less access to education and information are among the principal reasons for their vulnerability to climate change. The vulnerability is also confounded by the meager asset base, social marginalization, lack of mobility and exclusion from the decision-making processes in response to a disaster. However, the literature also shows that women are not only the passive victims of climate change but are also pro-active and agents of hope for adaptation to and mitigation of abrupt climate change. They utilize their experience and expertise to reduce the adverse impacts by adopting prudent strategies. They are also concerned about environmental issues, and are highly supportive of policies regarding environmental restoration. Large knowledge gaps exist regarding the vulnerability of women to changing and uncertain climate especially in arid regions. Authors of this article suggest some action plans and strategies to minimize vulnerability to climate change such as empowering women economically and educationally, organizing training and outreach programmes, and involving them in formal climate change mitigation and adaptation policies and programmes. Authors also outline research needed in order to identify and implement strategies regarding climate change. Collective and continuous efforts are critical to finding the sustainable solutions for this global phenomenon which is adversely impacting the most vulnerable but critically important members of the society.

Modeling Risky Driver Behavior Under the Influence of Flashing Green Signal with Vehicle Trajectory Data

In China, a 3-s flashing green (FG) indication followed by a 3-s yellow (Y) indication is commonly applied to end the green phase at signalized intersections regardless of speed limits. Past research has indicated that the FG may bring more uncertainty and dynamics to drivers’ stop–go decisions at the end of the green phase, particularly at high-speed intersections. Hence, the objective of this study was to propose a probabilistic model for interpreting drivers’ dynamic decision-making processes in response to the combination of FG and Y at rural high-speed intersections, which could help quantitatively analyze the safety effects of FG. The inputs of the proposed model included mainly the acceleration and deceleration rate and the perception-and-reaction time. The outputs were the frequencies of risky behavior, including abrupt stop and aggressive pass on the basis of the cycle. The trajectories of 1,186 vehicles, collected at three rural high-speed intersections in Shanghai, China, with a speed limit of 80 km/h were used for the uncertainty analysis of input variables and model validation. On the basis of the proposed model, three typical scenarios of phase transition periods—3-s FG + 3-s Y, 0-s FG + 5-s Y, and 0-s FG + 3-s Y—were valuated. Results showed that the proposed model was capable of producing an average error of less than 10%. In addition, the scenario of 0-s FG + 5-s Y performed best in reducing risky behavior. It is recommended that a 5-s Y be implemented for high-speed intersections when most of the traffic consists of passenger cars.

Migration for ecological preservation? Tibetan herders' decision making process in the eco-migration policy of Golok Tibetan autonomous prefecture (Qinghai province, PRC)

Abstract This paper considers nomads' decision-making process in response to the 'Eco-Migration Policy' in the Three River Headwaters region of the People's Republic of China. Contrary to previous studies of this policy, which emphasised the need for pastoral communities to wholly assimilate to urban life, this study focuses on individual choices and on the practical meanings of pastoralists' decisions in relation to government policies. Interviews and field surveys revealed the main factors inducing Tibetan pastoralists to become ecological migrants: whether the migrant village was in a convenient location and the facilities were satisfactory, the retention of the right to profit from caterpillar fungus collection, and the flexibility of livestock leases. These rationales stand in stark contrast to the notion of 'environmental correctness' emphasised in the state's discourse regarding these policies.

The Effect of Political Institutions on the Use of Citizen Participation Programs

Local governments` use of citizen participation programs is influenced by external environments, especially in the form of political institutions. Local governments decide to expand or limit citizen participation in administrative decision-making processes in response to political uncertainties created by different types of political institutions. Despite the importance of institutional contexts, few studies have examined the effects of these political institutions on the use of citizen participation programs. This study empirically tested whether political institutions affect the adoption of citizen participation programs. The results suggest that the council-manager form of government increases both the adoption of citizen participation mechanisms and the use of citizen participation programs in functional areas, while nonpartisan elections are associated only with the adoption of citizen participation mechanisms. At-large elections show no statistical association with either type of citizen participation. These findings suggest that local political contexts play important roles in the adoption of bureaucratic practices such as citizen participation programs and still support the classical assertion that public administration is closely connected to politics.

Athletes’ Decision-Making in Career Change-Events

This study examined decision-making processes in response to athletic career change-events (e.g., injury, field position change). Athletes’ (N = 338) initial strategic decisions whether to address or ignore a change-event, and their subsequent decisions whether to make the required change were measured using the Change-Event Inventory (Samuel &amp; Tenenbaum, 2011b). Athletes reported a high tendency of making a strategic decision to consult with others, which could be predicted from the event’s perceived significance and availability of professional support. Athletes also reported a high tendency of making a subsequent decision to change, which could be predicted from the helpfulness of support, motivation for change, and certain coping strategies. The two types of decisions were related. Perceived outcome of the change process and athletes’ motivation could also be accurately predicted. In conclusion, to effectively cope with change-events athletes need to feel involved, be in control, and make independent decisions that reflect their genuine needs and wishes.

Development of risk-based air quality management strategies under impacts of climate change

Climate change is forecast to adversely affect air quality through perturbations in meteorological conditions, photochemical reactions, and precursor emissions. To protect the environment and human health from air pollution, there is an increasing recognition of the necessity of developing effective air quality management strategies under the impacts of climate change. This paper presents a framework for developing risk-based air quality management strategies that can help policy makers improve their decision-making processes in response to current and future climate change about 30–50 years from now. Development of air quality management strategies under the impacts of climate change is fundamentally a risk assessment and risk management process involving four steps: (1) assessment of the impacts of climate change and associated uncertainties; (2) determination of air quality targets; (3) selections of potential air quality management options; and (4) identification of preferred air quality management strategies that minimize control costs, maximize benefits, or limit the adverse effects of climate change on air quality when considering the scarcity of resources. The main challenge relates to the level of uncertainties associated with climate change forecasts and advancements in future control measures, since they will significantly affect the risk assessment results and development of effective air quality management plans. The concept presented in this paper can help decision makers make appropriate responses to climate change, since it provides an integrated approach for climate risk assessment and management when developing air quality management strategies. Implications: Development of climate-responsive air quality management strategies is fundamentally a risk assessment and risk management process. The risk assessment process includes quantification of climate change impacts on air quality and associated uncertainties. Risk management for air quality under the impacts of climate change includes determination of air quality targets, selections of potential management options, and identification of effective air quality management strategies through decision-making models. The risk-based decision-making framework can also be applied to develop climate-responsive management strategies for the other environmental dimensions and assess costs and benefits of future environmental management policies.

Stress modulation of cognitive and affective processes

This review summarizes the major discussion points of a symposium on stress modulation of cognitive and affective processes, which was held during the 2010 workshop on the neurobiology of stress (Boulder, CO, USA). The four discussants addressed a number of specific cognitive and affective factors that are modulated by exposure to acute or repeated stress. Dr David Morilak discussed the effects of various repeated stress situations on cognitive flexibility, as assessed with a rodent model of attentional set-shifting task, and how performance on slightly different aspects of this test is modulated by different prefrontal regions through monoaminergic neurotransmission. Dr Serge Campeau summarized the findings of several studies exploring a number of factors and brain regions that regulate habituation of various autonomic and neuroendocrine responses to repeated audiogenic stress exposures. Dr Kerry Ressler discussed a body of work exploring the modulation and extinction of fear memories in rodents and humans, especially focusing on the role of key neurotransmitter systems including excitatory amino acids and brain-derived neurotrophic factor. Dr Israel Liberzon presented recent results on human decision-making processes in response to exogenous glucocorticoid hormone administration. Overall, these discussions are casting a wider framework on the cognitive/affective processes that are distinctly regulated by the experience of stress and some of the brain regions and neurotransmitter systems associated with these effects.

The physician's professional role in end-of-life decision-making: Voices of racially and ethnically diverse physicians

Objective Previous studies have shown racial/ethnic differences in preferences for end-of-life (EOL) care. We aimed to describe values and beliefs guiding physicians’ EOL decision-making and explore the relationship between physicians’ race/ethnicity and their decision-making. Methods Seven focus groups (3 Caucasian, 2 African American, 2 Hispanic) with internists and subspecialists ( n = 26) were conducted. Investigators independently analyzed transcripts, assigned codes, compared findings, reconciled differences, and developed themes. Results Four themes appeared to transcend physicians’ race/ethnicity: (1) strong support for the physician's role; (2) responding to “unreasonable” requests; (3) organizational factors; and (4) physician training and comfort with discussing EOL care. Five themes physicians seemed to manage differently based on race/ethnicity: (1) preventing and reducing the burden of surrogate decision-making; (2) responding to requests for “doing everything;” (3) influence of physician–patient racial/ethnic concordance/discordance; (4) cultural differences concerning truth-telling; and (5) spirituality and religious beliefs. Conclusions Physicians in our multi-racial/ethnic sample emphasized their commitment to their professional role in EOL decision-making. Implicitly invoking the professional virtue of self-effacement, they were able to identify racially/ethnically common and diverse ethical challenges of EOL decision-making. Practice implications Physicians should use professional virtues to tailor the EOL decision-making process in response to patients’ race/ethnicity, based on patients’ preferences.