Initial Preference Research Articles

The antecedent, consequences, and importance of students’ learning preference on learning outcomes with the flipped classroom approach: a person-environment fit perspective

Flipped learning performance is possible to be improved when there is an alignment between students’ learning preferences and educators’ chosen pedagogy, especially in the student-centered learning context. Adopting pretest-posttest research design among students in diverse academic disciplines (Study 1: N = 361; Study 2: N = 408), this research revealed the antecedents of learning experience on learning preference and showed the temporal consequences of initial learning preference on the end-of-course twenty first century competencies. The findings supported that individual attributes outweigh external factors in university learning, and these varied across disciplines. The findings highlighted the implications for the flipped classroom and support for the constructivist movement.

Available and unavailable decoys in capuchin monkeys (Sapajus spp.) decision-making

Decision-making has been observed to be systematically affected by decoys, i.e., options that should be irrelevant, either because unavailable or because manifestly inferior to other alternatives, and yet shift preferences towards their target. Decoy effects have been extensively studied both in humans and in several other species; however, evidence in non-human primates remains scant and inconclusive. To address this gap, this study investigates how choices in capuchin monkeys (Sapajus spp.) are affected by different types of decoys: asymmetrically dominated decoys, i.e., available and unavailable options that are inferior to only one of the other alternatives, and phantom decoys, i.e., unavailable options that are superior to another available alternative. After controlling for the subjective strength of initial preferences and the distance of each decoy from its target in attribute space, results demonstrate a systematic shift in capuchins’ preference towards the target of both asymmetrically dominated decoys (whether they are available or not) and phantom decoys, regardless of what options is being targeted by such decoys. This provides the most comprehensive evidence to date of decoy effects in non-human primates, with important theoretical and methodological implications for future comparative studies on context effects in decision-making.

Externally Provided Rewards Increase Internal Preference, but Not as Much as Preferred Ones Without Extrinsic Rewards

AbstractIt is well known that preferences are formed through choices, known as choice-induced preference change (CIPC). However, whether value learned through externally provided rewards influences the preferences formed through CIPC remains unclear. To address this issue, we used tasks for decision-making guided by reward provided by the external environment (externally guided decision-making; EDM) and for decision-making guided by one’s internal preference (internally guided decision-making; IDM). In the IDM task, we presented stimuli with learned value in the EDM and novel stimuli to examine whether the value in the EDM affects preferences. Stimuli reinforced by rewards given in the EDM were reflected in the IDM’s initial preference and further increased through CIPC in the IDM. However, such stimuli were not as strongly preferred as the most preferred novel stimulus in the IDM (superiority of intrinsically learned values; SIV), suggesting that the values learned by the EDM and IDM differ. The underlying process of this phenomenon is discussed in terms of the fundamental self-hypothesis.

Understanding or Manipulation: Rethinking Online Performance Gains of Modern Recommender Systems

Recommender systems are expected to be assistants that help human users find relevant information automatically without explicit queries. As recommender systems evolve, increasingly sophisticated learning techniques are applied and have achieved better performance in terms of user engagement metrics such as clicks and browsing time. The increase in the measured performance, however, can have two possible attributions: a better understanding of user preferences, and a more proactive ability to utilize human bounded rationality to seduce user over-consumption. A natural following question is whether current recommendation algorithms are manipulating user preferences. If so, can we measure the manipulation level? In this article, we present a general framework for benchmarking the degree of manipulations of recommendation algorithms, in both slate recommendation and sequential recommendation scenarios. The framework consists of four stages, initial preference calculation, training data collection, algorithm training and interaction, and metrics calculation that involves two proposed metrics, Manipulation Score and Preference Shift. We benchmark some representative recommendation algorithms in both synthetic and real-world datasets under the proposed framework. We have observed that a high online click-through rate does not necessarily mean a better understanding of user initial preference, but ends in prompting users to choose more documents they initially did not favor. Moreover, we find that the training data have notable impacts on the manipulation degrees, and algorithms with more powerful modeling abilities are more sensitive to such impacts. The experiments also verified the usefulness of the proposed metrics for measuring the degree of manipulations. We advocate that future recommendation algorithm studies should be treated as an optimization problem with constrained user preference manipulations.

Abstract A037: Metabolic maneuvering of glycocalyx hypersialylation is a smart and healthy way of curbing metastatic potential in breast cancer

Abstract Metastatic breast cancer is currently the most deadly and incurable stage of breast cancer. A recent metabolic screen has identified sialic acid as a key player in progression of breast cancer metastasis. In the present study, we metabolically target the hypersialylation of metastatic breast cancer cells using appropriately designed nutritionary interventions. Our rationales are the following: (a) The aberrantly sialylated, hyperbranched glycocalyx promotes metastasis by facilitating cellular migration and immune evasion. (b) As hypersialylation relies heavily on enhanced sialic acid biosynthesis from the oncogenic glycolytic surge and preferential dietary uptake of glucose by cancer cells, it stands to reason that dietary changes can impact the extent of sialylation of the glycocalyx. Considering these points, we hypothesized that it was possible to control the degree of glycocalyx sialylation in breast cancer cells using an appropriate nutritionary regimen, which will in turn modulate the progression to invasive phenotype. The goal is to harness the metabolism of cancer cells themselves to curb their metastatic potential. Using a specific ketone-body forming metabolite called 3-hydroxybutyrate (HB) and lowering of glucose concentration, the cell culture medium was modified to mimic ketogenic diet. The response of metastatic breast cancer cells and normal breast epithelial cells was then monitored. The two main measures of cellular response were: cell surface sialylation via fluorescence microscopy and fluorescence lifetime imaging (FLIM) of intracellular NADH as a marker of metabolic index. We are currently investigating the consequences of nutritionary interventions on metastatic potential of breast cancer cells by measuring their impact on cellular proliferation, clonogenicity and migratory abilities. We have observed that the main metabolite of ketogenic diet, HB, tends to protect metastatic breast cancer cells from DOX treatment when supplemented in a low-glucose (LG) medium. However, the extent of increase in cell surface sialylation is very modest in comparison to that in normal breast epithelial cells. This differential increase in sialylation implies that a ketogenic diet might significantly promote the proliferation of healthy cells over the proliferation of metastatic breast cancer cells. FLIM measurements indicate that the chemotherapeutic, Doxorubicin tends to induce an initial preference for glycolysis in invasive breast cancer cells. While an HB rich LG media by itself promotes glycolysis in these cells, it suppresses any further Doxorubicin induced onset of glycolysis pointing to a protective mechanism against the chemotherapeutic. Through this ongoing study, we aim to decipher the right set of nutrients that would “deshield” the breast cancer cells and lower their metastatic disposition. The ultimate goal of our research is to determine a paradigm of drugs and diet that metastatic breast cancer cells are most responsive to, and that would translate into a viable remedy for metastatic breast cancer with minimal side-effects. Citation Format: Mohini Kamra, Yuan-I Chen, Paula C Delgado, Tim Yeh, Amy Brock, Sapun H Parekh. Metabolic maneuvering of glycocalyx hypersialylation is a smart and healthy way of curbing metastatic potential in breast cancer [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Advances in Breast Cancer Research; 2023 Oct 19-22; San Diego, California. Philadelphia (PA): AACR; Cancer Res 2024;84(3 Suppl_1):Abstract nr A037.

Quantifying events or entities?—A corpus-based study of universal quantifiers in early child English and child-directed speech

The acquisition of quantifiers is a central topic in cognitive science. The present study investigated the emergence, frequency, and non-target-like production of the universal quantifiers all, every, and each in child English from a linguistic perspective, based on the data from longitudinal naturalistic observation of 10 English-speaking children and their caregivers. We found that the use of these quantifiers as adverbs or in adverbials generally appeared earlier, and was more frequent, than their use as (pre)determiners in early child English. We also found that input frequency exerts a great influence on some aspects of the acquisition of universal quantifiers, for example, the frequency of the predeterminer all, but there are still some patterns that cannot be explained by mere input frequency, such as children’s initial preference for using universal quantifiers in A(dverbial)-quantification and their non-target forms. Their initial overreliance on A-quantification may be explained by event quantification being cognitively less demanding than entity quantification, and their non-target productions likely result from their developing grammatical systems. We argue that the acquisition of universal quantifiers involves multiple factors, such as cognitive complexity, children’s developing grammatical systems, and input frequency, interacting with each other.

Patient's Preference for Same-Day Discharge or Hospitalization After Bariatric Surgery.

Enhanced Recovery After Bariatric Surgery protocols have proven to be effective in reducing complication rates and length of stay. Guidelines do not include a recommendation on the length of hospital stay whereas same-day discharge is currently widely investigated on safety and feasibility. However, none of these studies takes patient preferences into account. The study aimed to reveal the patient's preference for outpatient surgery (OS) in patients who underwent primary bariatric surgery. A single-center preference-based randomized trial was performed between March and December of 2021. Adult patients planned for primary bariatric surgery were able to choose their care pathway, either OS with remote heart and respiratory rate monitoring by a wearable data logger or standard care with at least one-night hospitalization. Out of the 202 patients, nearly everyone (98.5%) had a preference. Of 199 patients, 99 (49.7%) chose inpatient surgery. Of the 100 with a preference for OS, 23 stayed in the hospital due to medical reasons and 12 patients changed their preference. Based on both initial preference and changed preference, there were no differences between sex, age, body mass index, and co-morbidities such as diabetes mellitus, hypertension, and atrial fibrillation, nor in the use of anticoagulants or type of surgery. Patients seemed to have a strong preference for their stay after a bariatric procedure. The preference is equally divided between outpatient and inpatient surgery and is not influenced by any patient characteristics.

P1023 Variability in Mesalazine Management for Ulcerative Proctitis Include Doses, Route of Administration and Use of Fecal Calprotectin: Insights from Clinical Practice Across Spain Beyond Clinical Guidelines

Abstract Background Despite universal use of mesalazine in ulcerative colitis treatment, many aspects of clinical practice remain unclear or are not even addressed in clinical guidelines, leading to significant variations in mesalazine management among clinicians. We aimed to gather different approaches of mesalazine use in ulcerative proctitis (UP). Methods After discussion of a clinical case, a predefined questionnaire was anonymously answered throughout a series of meetings held at 10 different locations in Spain. Results were categorized according to experience levels and inflammatory bowel disease (IBD) focus. Results 259 IBD treating gastroenterologists were engaged; 84% had <10 years of experience and 25% had a specific focus on IBD. Most participants (84%) manage UP based on clinical symptoms (i.e. fecal urgency). In case of a clinically moderate-severe UP, 81% would initiate treatment with high dose of combined mesalazine, while 11% proposed only suppositories. 60% of participants would assess response at 4 weeks. If clinical remission achieved, 85% would use fecal calprotectin (FC) to assess deep remission. Upon initial failure of combined mesalazine treatment at standard dose, 59% attempt optimizing mesalazine doses, while 38% add beclomethasone dipropionate. Younger physicians without specific focus on IBD prefer modifying mesalazine doses (70.5% vs 37.1%), (P=0,006), whereas more experienced physicians with monographic dedication prefer adding beclomethasone dipropionate (60% vs 29.4%), (P=0,006). For maintenance therapy (oral or topical mesalazine) the most important drivers in therapeutic decision-making were severity of the initial flare (40%) and patient preferences (36%). After a moderate-severe flare of UP, 80% would recommend maintenance therapy with high dose oral mesalazine and 3 suppositories/week. For monitoring, less experienced physicians and those not working in IBD units more frequently relied only on clinical parameters (26.6% vs. 8.7%, p=0.01), using FC to a lesser extent (73% vs. 88%, p=0.1) compared to more experienced and IBD focused physicians. In the case of elevated FC in asymptomatic patients, 49% would prefer to scope, while 47% increase mesalazine dose directly. The preferred high dose of mesalazine was 4g (55%) or 4-5g (44%). 73% would not reduce the dose upon achieving remission. Only 75% actively investigate therapeutic adherence. Conclusion Management of mesalazine in UP patients is highly heterogeneous, and clinical guidelines do not address all issues arising in clinical practice. Nevertheless, clinicians in our setting often use high oral and rectal mesalazine doses for both induction and maintenance and they commonly monitor patients using FC.

Random/Cognitive Hybrid Uncertainty Analysis of Ship Multitasking Cabin Layout

Identifying the optimal cabin layout is an important way to improve the efficiency of ship systems and ensure the efficient circulation of personnel and materials. The ship task state refers to the state maintained by the joint actions of ship machinery and equipment, cargo, and personnel when facing different jobs and tasks during operation. A cabin layout that facilitates multitasking states can improve the efficiency of collaboration between systems and ensure the operation of the ship. The demand for human flow and logistics is different in multitasking states. To express the demand in mathematical form, there is a certain random uncertainty in the numerical quantification of the demand. Thus, to better meet the needs of different states, the coefficient values of each state can be integrated using special methods. Ensuring values’ initial preference to the greatest extent inevitably produces a degree of cognitive uncertainty. Therefore, uncertainty analysis is necessary for cabin layout design to be used for multitasking states. In this paper, a deterministic optimization platform of cabin layout in multitasking states is obtained. Adjacent and circulating strength coefficients are obtained through numerical quantization of the demand for human flow and logistics. The random uncertainty in the input values of two coefficients was represented by random variables, and the cognitive uncertainty was represented by interval variables. In order to solve the problem of two types of variables, a random-interval hybrid uncertainty model was established. Through random intervalization and interval randomization, three cases, of random variables, interval variables, and random variables and interval variables, were studied. The probability distribution of the model function was used to evaluate the influence of different compositions of uncertainty parameters on the robustness of the cabin layout scheme. The necessity and effectiveness of uncertainty analysis in multitasking cabin layout are discussed below.

Temporomandibular disorders, occlusal splints, and treatment options: a survey-based investigation

Background: The term "temporomandibular disorders" (TMDs) refers to a group of painful conditions that affect both the hard and soft orofacial anatomical structures. The primary objectives of TMD treatment are to lessen pain and enhance mandibular movements, re-establishing proper functioning. One of the widely used treatment options for TMDs pathology is the occlusal splint. This non-invasive intraoral device, determines both the muscle relaxation and reversibly repositions the temporomandibular joint structures. The study aimed to compare the efficacy of different occlusal splint designs or materials in managing TMD symptoms. Methods: Twenty-six patients, nineteen of whom were female and seven of whom were male, ranging in age from twenty to seventy, met the criteria needed participate in this study. Two different questionnaires were formulated: a patient-focused and a clinician-focused questionnaire. The patient's data encompassed general health status and TMD signs and symptoms, whereas the clinician's questions addressed assessment and treatment alternatives, including the particularities of occlusal splint therapy. Results: The majority of the patients were diagnosed with disc displacement with reduction (61.5%), followed by myalgia (26.9%). The only form of treatment preferred by physicians was the Michigan occlusal splint, which was mainly used on the maxillary dental arch (84,6%). After the splint therapy was completed and the intended results were obtained, the treatment plan was finished using selective grinding, prosthetic dental restorations, orthodontic therapy, or a combination of these procedures. The patient was required to continue physical therapy (7,7%), wear a full-arch night guard (42.3%), and undergo rigorous periodic control sessions (34.6%) to maintain the final aesthetic and functional results. Conclusions: Occlusal splints are an efficient and reliable initial therapy preference for patients with temporomandibular disorders. In addition to improving symptoms in the temporomandibular joint, occlusal splints may determine mandibular repositioning, which also implies a variety of treatment approaches, ranging from the minimally invasive to the most complex, to achieve a functional occlusal status.

A New Fuzzy Joint Choquet Integral Method Under Interval-Valued Function

A new fuzzy group decision-making method considering multi-attributes correlation under interval-valued function is presented, which mainly includes (1) acquiring the group fuzzy preference matrix and (2) handling the interactions between multiple evaluation attributes. To do that, firstly, the fuzzy joint Choquet integral based on an interval-valued function is proposed, which not only reflects the interaction between multiple attributes in a complex and uncertain environment, but also retains the initial preference of the decision maker. Secondly, a Shapley value with fuzzy measure is applied to assign each decision maker's weight, and the fuzzy group preference matrix is acquired by fusing the fuzzy preference matrices of all decision makers. Finally, a nursing home selection case is depicted to explain the effectiveness of the proposed technique. The corresponding sensitivity analysis is operated, which clarifies the reliability and flexibility of the proposed technique.

Conditioned taste avoidance and conditioned place preference induced by the third-generation synthetic cathinone eutylone in female sprague-dawley rats.

Recently, use of the synthetic cathinone (aka "bath salt") eutylone has risen in the United States and globally. Due to its novelty in drug markets, its affective properties remain largely uninvestigated. In this context, drugs of abuse have both rewarding and aversive effects and understanding these effects, their relative balance, and factors that impact each are important to understanding the likelihood of drug use and abuse. This investigation attempted to characterize eutylone's rewarding and aversive effects in a combined conditioned taste avoidance/place preference assay. Female Sprague-Dawley rats were given 20-min access to saccharin, injected with one of five doses of eutylone (0, 3, 10, 18, 32 mg/kg; intraperitoneally; IP), and placed on one side of a place conditioning apparatus. On the following day, subjects were given 20-min access to water, injected IP with vehicle, and placed on the other side of the apparatus. After five conditioning cycles, place preference and saccharin avoidance were assessed. Eutylone induced significant taste avoidance but did not significantly increase time spent on the drug-paired side (relative to controls). Excluding animals with high initial side preference, however, eutylone induced a preference at all doses with the high dose group displaying higher preference than controls. There was no significant correlation between eutylone's aversive and rewarding effects. These data indicate that eutylone (like other synthetic cathinones) induces both rewarding and aversive effects and highlight the need to assess the impact of various factors on its affective properties (and their balance) and on their use and abuse. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Incomplete interval-valued probabilistic uncertain linguistic preference relation in group decision making

In group decision making (GDM), due to complexity of various factors, decision makers (DMs) often provide incomplete preference relations (PRs) in preference matrix. Interval-valued probabilistic uncertain linguistic term set (IVPULTS) is a flexible and accurate tool to depict evaluation information of experts. In this paper, we mainly propose a new concept pertaining to interval-valued probabilistic uncertain linguistic preference relation (IVPULPR) that applies the IVPULTS to preference relations. Firstly, some new basic theoretical concepts of IVPULTS are developed including ordered IVPULTS, normalization method and new expectation function. Secondly, we establish several goal programming models to estimate the unknown elements in incomplete IVPULPR and propose the expected additive consistency of IVPULPR. To improve the consistency level, two optimization models are constructed based on the idea of minimum adjustment. Thirdly, we derive the experts’ weights in terms of information uncertainty, where a new method to measure information uncertainty of IVPULTS is proposed. For the sake of improving group consensus, we construct a group consensus index (GCI) and two optimization models depending on the adjustment mechanism of expert weight. Finally, a complete GDM framework with incomplete IVPULPR is devised based on the analysis of IVPULPR consistency and group consensus. Through an experiment analysis by using an UCI dataset, we find that the proposed GDM model can not only precisely express fuzzy preference information of DMs, but also ensure achievement of acceptable consistency and group consensus under the condition of not changing the initial preference as much as possible.

The Role of Wearable Sensors in the Future Primary Healthcare – Preferences of the Adult Swiss Population: A Mixed Methods Approach

Wearable sensors have the potential to increase continuity of care and reduce healthcare expenditure. The user concerns and preferences regarding wearable sensors are the least addressed topic in related literature. Therefore, this study aimed first, to examine the preferences of the adult Swiss population regarding the use of wearable sensors in primary healthcare. Second, the study aimed to explain and learn more about these preferences and why such wearable sensors would or would not be used. An explanatory sequential design was used to reach the two aims. In the initial quantitative phase preferences of a nationwide survey were analyzed descriptively and a multivariable ordered logistic regression was used to identify key characteristics, that influence the preferences. In the second phase, eight semi-structured interviews were conducted. The cleaned study sample of the survey included 687 participants, 46% of whom gave a positive rating regarding the use of wearable sensors. In contrast, 44% gave a negative rating and 10% were neutral. The interviews showed that sensors should be small, not flashy and be compatible with everyday activities. Individuals without a current health risk or existing chronic disease showed lower preferences for using wearable sensors, particularly because they fear losing control over their own body. In contrast, individuals with increased risk or with an existing chronic disease were more likely to use wearable sensors as they can increase the personal safety and provide real-time health information to physicians. Therefore, an important deciding factor for and against the use of wearable sensors seems to be the perceived personal susceptibility for potential health problems.

The search for orphan radioactive source based on GPR-PRM method

The loss of radioactive sources poses potential risks to public safety, in order to safely recover radioactive sources, a method for orphan radioactive source localization is proposed. The method is divided into two parts: constructing the radiation field by Gaussian process regression (GPR) and path planning for the mobile robot using the probabilistic roadmap (PRM) method. A mobile robot collects data from grid cells along its path, alternating between the two parts until the source localization condition is met. The path planning is determined by the PRM method combining with the improved A* algorithm, which can also help the robot jump out of local optima. The feasibility of the proposed method is verified through two simulation experiments. The first experiment comprehensively demonstrated the search process of the proposed method. In the second experiment, a comparison of different initial parameter pa was added to show that the initial search preference of the robot has an impact on the efficiency. Overall, this method enables high-precision localization of indoor radioactive source in the presence of radiation shielding at low equipment costs.

Generalized Stochastic Arbitrage Opportunities

Concepts are introduced and applied for analyzing and selecting arbitrage portfolios in the face of uncertainty about initial positions and risk preferences. A stochastic arbitrage opportunity is defined as a zero-cost investment portfolio that enhances every feasible host portfolio for all admissible utility functions. The alternative to the existence of such investment opportunities is the existence of a solution to a dual system of asset pricing restrictions based on a class of stochastic discount factors. Feasible approaches to numerical optimization and statistical inference are discussed. Empirical results suggest that equity factor investing is appealing for all risk-averse stock investors with a wide range of initial position and sufficiently low transactions costs by mixing multiple factor portfolios with high after-cost appraisal ratios, low mutual correlation, and negative exposures to the relevant host portfolios. These findings weaken the case for risk-based explanations for the profitability of factor investing. This paper was accepted by Kay Giesecke, finance. Supplemental Material: The data files are available at https://doi.org/10.1287/mnsc.2023.4892 .

Reconsidering Miranda rights: Modeling strategic action during the invocation stage of a police interrogation

This paper develops a method to identify manipulation of custodial suspects who attempt to invoke the Miranda right to legal counsel during a custodial interrogation. The method, developed from a combination of framing theory and hypergame theory, first documents the point where custodial suspects’ preferences shift and second identifies the proximate cause of that shift using excerpts from legal cases. The method applies linguistic analysis within a hypergame framework to reveal rational behavior of custodial suspects who, despite owning an initial preference to invoke, waive their right to counsel without explicit pressure from police. The paper terms this shift in preferences “manipulation” adding the concept to hypergames and to the literature on noncooperative discursive exchanges.

Putting partisan influence into political context: How initial policy popularity and party attachment shape the effect of party cues

Parties and their actions almost always shape the preferences, attitudes, and behaviour of their voters. However, does partisan influence over public opinion apply to all policy proposals regardless of their initial popularity and to all voters regardless of their degree of partisan attachment? This question is addressed in the real-world context of Finland, where the government enacted two reforms at the same time: an initially popular reform extending the age of compulsory education, and an initially unpopular removal of the ‘retirement tube’ for older laid-off workers. An original panel survey asked respondents about their attitudes before and after the government actions, finding that while voters of government parties increasingly tended to support the enacted policies, the magnitude of opinion change depended on voters’ initial policy preferences and party attachment. Strong party attachment led to government voters increasing their support for a reform that they initially opposed. In contrast, those with weaker partisan attachments tended to alter their preferences for an initially popular reform. These findings are relevant for understanding partisan influence over public opinion in a broader political context.

Hydrolysis Reactions of the High Oxidation State Dimers Th2O4, Pa2O5, U2O6, and Np2O6. A Computational Study.

The energetics of the hydrolysis reactions for high oxidation states of the dimeric actinide species Th2IVO4, Pa2VO5, and U2VIO6 were calculated at the CCSD(T) level and those for triplet Np2VIO6 at the B3LYP level. Hydrolysis is initiated by the formation of a Lewis acid/base adduct with H2O (physisorbed product), followed by a proton transfer to form a dihydroxide molecule (chemisorbed product); this process was repeated until the initial actinide oxide is fully hydrolyzed. For Th2O4, hydrolysis (chemisorption) by the initial and subsequent H2O molecules prefers proton transfer to terminal oxo groups before the bridge oxo groups. The overall Th2O4 hydration pathway is exothermic with chemisorbed products preferred over the physisorption products, and the fully hydrolyzed Th2(OH)8 can form exothermically. Hydrolysis of Pa2O5 forms isomers of similar energies with no initial preference for bridge or terminal hydroxy groups. The most exothermic hydrolysis product for Pa is Pa2O(OH)8 and the most stable species is Pa2O(OH)8(H2O). Hydrolysis of U2O6 and Np2O6 with strong [O═An═O]2+ actinyl groups occurs first at the bridging oxygens rather than at the terminal oxo groups. The U2O6 and Np2O6 pathways predict hydrated products to be more favored than hydrolyzed products, as more H2O molecules are added. The stability of the U and Np clusters is predicted to decrease with increasing number of hydroxyl groups. The most stable species on the hydration reaction coordinate for U and Np is An2O3(OH)6(H2O).

Implementation of a Novel Patient Decision Aid for Women with Elevated Breast Cancer Risk Who Are Considering MRI Screening: A Pilot Study.

To determine the feasibility and acceptability of using a patient decision aid (DA) for women with elevated breast cancer risk who are considering MRI screening. This pilot study employed a mixed methods design to develop, modify, and test an interactive DA. The DA was administered among a consecutive patient sample with an estimated Tyrer-Cuzick v.8 lifetime breast cancer risk of 20% or greater and without a pathologic genetic mutation. The decisional conflict scale was used to measure decisional conflict. Post-intervention provider and patient feedback evaluated shared decision-making, feasibility, and acceptability. Twenty-four patients participated, with a median age of 44 years. Prior to DA use, sixteen patients (67%) were unsure whether to add MRI to their screening, six patients elected MRI (25%), and two patients declined MRI (8%). Following DA use, thirteen of sixteen of the initially undecided participants (81%) established a preference, with eleven electing to add MRI screening. Of participants with an initial preference, all maintained the same decision following use of the DA. Prior to the DA, the median decisional conflict score among participants was 25% (range 0-60%) compared with 0% (range 0-25%) after the DA. Healthcare providers reported that the DA was useful and easily incorporated into clinical workflow. This pilot study shows that there may be a benefit to DA utilization in the high-risk breast cancer clinic to guide shared decision-making in establishing a screening preference. The findings warrant further research to test the use of the DA in a larger, multi-site trial.