Muted Impact Research Articles

Quantifying Variability in Zebrafish Larvae Locomotor Behavior across Experimental Conditions: A Learning-Based Tracker

This study investigated the effects of environmental changes on zebrafish larval behavior, using single-factor and orthogonal experiments to assess locomotion during temperature and pH changes. In single-factor experiments, zebrafish larvae were exposed to variations in temperature (22 to 30 °C) and pH levels (6.0, 7.0, 9.0). The simultaneous temperature and pH changes were investigated by orthogonal tests. In both experiments, each zebrafish larva was recorded in three 5 min videos at different stages (before exposure, during short-term exposure (10 min), and after long-term exposure (60 min)). You Look Only Once (YOLOv5) and Deep Simple Online Real Time Tracking (DeepSORT) models were adopted to develop a zebrafish larva tracking system, and YOLOv5 was improved in two aspects of anchor clustering and network structure. The tracking accuracy of the tracking system for small targets effectively improved, reaching more than 98% MOTA (Multiple Object Tracking Accuracy). Principal Component Analysis (PCA) was employed to extract three behavioral features from 13 motion parameters, namely motion activity, edge behavior, and motion direction preference. Our findings reveal that lower temperatures and acidic conditions both led to a decrease in motion behavioral activity, and the former also increased edge behavior. Conversely, elevated temperatures and alkaline conditions had a muted impact on these behaviors. Interestingly, concurrent changes in temperature and pH significantly altered directional preference. Additionally, we observed that lower temperatures elicited distinct temporal behavioral patterns at a constant pH level. In summary, we recommend the precise control and explicit reporting of ambient temperature and pH in both breeding devices and experimental wells to minimize the environmental impact on zebrafish behavior and enhance experiment repeatability and reliability.

Inflation at risk in advanced and emerging market economies

Using quantile regression techniques, we study the drivers of inflation risks in a large panel of advanced and emerging market economies (EMEs). We document several facts regarding the inflation forecast distribution and highlight some key differences between these two groups of countries. First, the exchange rate has a quantitatively important and non-linear impact on the inflation outlook in EMEs: a depreciation is associated with larger increases in the upper quantiles than in the lower quantiles, increasing the right skewness of the distribution. By contrast, there is no evidence of such non-linearities for advanced economies. Second, tighter financial conditions in EMEs carry both downside and upside risks to inflation, while having a muted impact on the modal or mean outcome. This is in contrast to advanced economies, where only downside risks prove sensitive. Third, the zero lower bound on policy rates translates into substantial downside risks to inflation. Finally, the adoption of inflation targeting is associated not only with lower mean inflation but also with a less right-skewed distribution. Our findings underscore the importance of including non-linearities in structural models of inflation dynamics.

The Impact of Credit Market Sentiment Shocks

AbstractThis paper investigates the role of credit market sentiment and investor beliefs in credit cycle dynamics and their transmission to businesscycle fluctuations. Using U.S. data from 1968 to 2014, we find that credit market sentiment is indeed able to detect asymmetries in a small‐scale macroeconomic model. An unexpected credit market sentiment shock has different impacts in an optimistic and pessimistic credit market environment. While an unexpected movement in the optimistic regime leads to a rather muted impact on output and credit, we find a significant negative impact on these variables in the pessimistic regime. The findings highlight the relevance of expectation formation mechanisms as a source of macroeconomic instability.

Local Intraoperative Marrow-Derived Augmentation for Primary Rotator Cuff Repair: An Updated Systematic Review and Meta-analysis of Studies From 2010 to 2022

Recurrent tears of the rotator cuff pose a substantial problem despite advances in repair technique. Biologic augmentation via marrow stimulation or vented anchors may strengthen the suture-tendon junction and improve healing rates of native tissue, thereby enhancing outcomes of primary surgical repair. To provide a focused systematic review and meta-analysis of local, intraoperative marrow-derived augmentation techniques in clinical primary rotator cuff repair. Systematic review; Level of evidence, 4. A systematic review of PubMed, Embase, and Cochrane was conducted following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A total of 2131 studies from 2010 to 2022, focused on either marrow stimulation or vented anchors, were isolated and classified as either preclinical or clinical. Meta-analysis was performed for comparative marrow stimulation and vented anchor studies. Heterogeneity was tested through calculation of I 2. A total of 13 clinical studies were included in the review. All 9 comparative studies included in the meta-analysis demonstrated high methodologic quality or a low risk of bias. The pooled retear rate across all 9 clinical studies for patients undergoing marrow stimulation was 11%. For the 5 studies in the meta-analysis, the pooled retear rates were 15% for marrow stimulation and 30% for controls. Meta-analysis demonstrated a significant difference in the overall retear rate that favored marrow stimulation (odds ratio [OR], 0.41; 95% CI, 0.25-0.66; P = .0003; I 2 = 0%). Similarly, meta-analysis of the Constant score at final follow-up demonstrated a statistically significant difference between the 2 groups that favored a higher Constant score in the marrow stimulation group (mean difference, 2.84; 95% CI, 1.02-4.66; P = .002; I 2 = 29%). Vented anchors demonstrated improved ossification and bone density at the anchor site, but no difference in outcomes or retear. Pooled retear rates were 22.5% for vented anchors and 27.8% for controls. Current evidence demonstrates that marrow-stimulation techniques may have a positive impact on healing and retear rate, while vented anchors have a muted impact relative to nonvented anchors. Although available evidence is limited and more research is needed, findings to date suggest that marrow stimulation techniques may be an inexpensive, straightforward technique to consider in qualifying patients to prevent rotator cuff retears.

The Dallas Accountable Health Community: Its Impact on Health-Related Social Needs, Care, and Costs

Summary In May 2017, the U.S. Centers for Medicare & Medicaid Services (CMS) launched the Accountable Health Communities (AHC) Model, a 5-year initiative to address a critical gap between clinical care and community services in the current delivery system. The initiative tested whether systematically identifying and addressing the health-related social needs (HRSNs) of Medicare and Medicaid beneficiaries through screening, referral, and community navigation would reduce utilization and health care expenditures. As one of 32 original awardees, the Parkland Center for Clinical Innovation (PCCI) served as an Alignment Track bridge organization. PCCI partnered with 17 clinical sites, representing five Dallas health care systems and more than 100 local community-based organizations (CBOs), to establish the Dallas Accountable Health Community (DAHC). Using a CMS-developed HRSN screening tool, PCCI and its partners screened 12,548 unique Dallas County beneficiaries meeting the criteria for Model eligibility. PCCI and partner community health workers provided 9,161 unique individuals with active navigation services consisting of referrals to aligned CBOs, accompanied by monthly follow-up calls for up to 12 months or until the documented HRSNs were addressed successfully. Over the initiative’s 5-year course, PCCI identified more than 19,000 distinct needs, with 61% of individuals having two or more concurrent needs. Through the referral process, CBOs provided a multitude of support services, including more than 200,000 pounds of food and $540,000 in utility and rent assistance. Results show that actively navigated individuals experienced a greater decrease in per-person ED visits than those in a comparable control cohort, with the navigation cohort having a statistically significant reduction in average ED utilization, both while actively navigated and in the 12 months after navigation. The navigated cohort also demonstrated a greater likelihood to seek — and keep — outpatient visits compared with the control cohort. Although inpatient admissions were reduced within both cohorts, the between-cohort differences were not statistically significant. Not including the CBO-provided intervention costs and using Model year 4 data (May 2020 to April 2021), the DAHC demonstrated a positive ROI of 1.3 to 1 with a gross savings exceeding $1.25 million. The impact analysis accounted for the dynamic, multidimensional Covid-19 impact via an innovative control group matching algorithm. This study demonstrated the nature and scope of HRSNs among a high-risk vulnerable Dallas County population, a positive impact on health care outcomes, and a more muted impact on expenditures using regularly occurring active navigation of engaged beneficiaries. Importantly, the DAHC showed that combining clinical care with appropriate social services to address HRSNs — at the right time and by the right personnel — resulted in lower utilization and a decrease in health care expenditures. These two factors alone argue for the expansion of the initiative to other at-risk populations while establishing the initiative’s long-term sustainability.

Effectiveness of clinic-based cardiovascular disease prevention: A randomized encouragement design experiment in the Philippines

RationaleEvidence on effectiveness of routine clinic-based cardiovascular disease (CVD) prevention in low- and middle-income countries is lacking. This study aimed to provide evidence on exposure to primary prevention of CVDs obtained through visits to public health clinics in the Philippines that are responsible for operating a widely-adopted CVD risk screening and management protocol. MethodIn a 2018 cluster-randomized experiment in Nueva Ecija province, participants aged 40–70 with no history of CVD in randomly selected communities were offered a money-prize lottery ticket if they visited a public health clinic for a check-up. The induced variation in clinic visits was used to estimate effects of a check-up on exposure to CVD prevention indicators (measurement, diagnosis and medication of physiological CVD risk factors, and medical advice about behavioural risk factors), as well as on health behaviour and predicted 10-year CVD risk score. ResultsGoing for a check-up at a public clinic raised a weighted average of effect sizes of the prevention indicators by 0.16 (95% CI 0.06 to 0.26, FWER-corrected p = 0.0218). Disaggregated analyses revealed positive effects on blood pressure measurement and receipt of medical advice, but no significant effect on diagnosis or medication of either hypertension or diabetes/dyslipidaemia. Despite high baseline prevalence of CVD risk factors and increased receipt of medical advice, there were no significant effects after six months on health behaviour, physiological risk factors or CVD risk score. ConclusionGetting Filipinos to health clinics responsible for opportunistic CVD risk screening had a muted impact on exposure to CVD prevention and no significant impact on health behaviour and predicted CVD risk. Issuing well-founded protocols may be insufficient to ensure exposure to CVD prevention through routine clinic visits.

The socio-spatial determinants of COVID-19 diffusion: the impact of globalisation, settlement characteristics and population

BackgroundCOVID-19 is an emergent infectious disease that has spread geographically to become a global pandemic. While much research focuses on the epidemiological and virological aspects of COVID-19 transmission, there remains an important gap in knowledge regarding the drivers of geographical diffusion between places, in particular at the global scale. Here, we use quantile regression to model the roles of globalisation, human settlement and population characteristics as socio-spatial determinants of reported COVID-19 diffusion over a six-week period in March and April 2020. Our exploratory analysis is based on reported COVID-19 data published by Johns Hopkins University which, despite its limitations, serves as the best repository of reported COVID-19 cases across nations.ResultsThe quantile regression model suggests that globalisation, settlement, and population characteristics related to high human mobility and interaction predict reported disease diffusion. Human development level (HDI) and total population predict COVID-19 diffusion in countries with a high number of total reported cases (per million) whereas larger household size, older populations, and globalisation tied to human interaction predict COVID-19 diffusion in countries with a low number of total reported cases (per million). Population density, and population characteristics such as total population, older populations, and household size are strong predictors in early weeks but have a muted impact over time on reported COVID-19 diffusion. In contrast, the impacts of interpersonal and trade globalisation are enhanced over time, indicating that human mobility may best explain sustained disease diffusion.ConclusionsModel results confirm that globalisation, settlement and population characteristics, and variables tied to high human mobility lead to greater reported disease diffusion. These outcomes serve to inform suppression strategies, particularly as they are related to anticipated relocation diffusion from more- to less-developed countries and regions, and hierarchical diffusion from countries with higher population and density. It is likely that many of these processes are replicated at smaller geographical scales both within countries and within regions. Epidemiological strategies must therefore be tailored according to human mobility patterns, as well as countries’ settlement and population characteristics. We suggest that limiting human mobility to the greatest extent practical will best restrain COVID-19 diffusion, which in the absence of widespread vaccination may be one of the best lines of epidemiological defense.

Comprehensive Monetary Easing In The Eurozone: Lessons Learnt From Japan

The European Central Bank’s (ECB) unconventional monetary policy has so far failed to deliver the much-anticipated results. In October 2019, the euro area’s (EA-19) HICP-inflation fell to a three-year low of just 0.7% year-over-year (y/y), thus being far below the ECB’s goal of “below, but close to 2.00% over the medium term”. By November 2019, HICP-inflation had recovered to a modest 1.0% (y/y) with seasonally-adjusted Eurozone GDP growing at a disappointing 1.2% (y/y) in Q3 2019 compared with the same quarter of the previous year (Eurostat, 2019). Inevitably, these developments raise the question to what extent the ECB might eventually consider extending its Quantitative Easing (QE) program, i.e. its €2.6tn asset purchase programs (APP) beyond the ongoing €20bn-per-month purchase of fixed income securities. Any further easing could, for example, foresee an enhancement of the securities purchased to inter alia include shares of stock. In contrast to widely held beliefs, this by no means were an entirely unprecedented phenomenon, but corresponded to measures (so-called comprehensive monetary easing, CME) adopted by the Bank of Japan (BoJ) as early as 2010 (Bank of Japan, 2010a). Notwithstanding the BoJ’s CME, however, HICP-inflation in Japan fell to 0.0% (y/y) in December 2019, the latest date for which data were available, which caused annual HICP-inflation for the full year to drop to only 0.8% (y/y). Based on the experiences gained in Japan, and notwithstanding a potential revision of the ECB’s inflation target to a 1.5% to 2.5% range, this contribution will analyse the extent to which an expansion of the ECB’s set of hitherto employed unconventional monetary policies through CME could sustainably stimulate economic growth - and inflation - in the euro area. Preliminary results suggest a rather muted impact.

Wage Growth and Inflation in Europe

Wages have been rising faster than productivity in many European countries for the past few years, yet signs of underlying consumer price pressures remain limited. To shed light on this puzzle, this paper examines the historical link between wage growth and inflation in Europe and factors that influence the strength of the passthrough from labor costs to prices. Historically, wage growth has led to higher inflation, but the impact has weakened since 2009. Empirical analysis suggests that the passthrough from wage growth to inflation is significantly lower in periods of subdued inflation and inflation expectations, greater competitive pressures, and robust corporate profitability. Thus the recent pickup in wage growth is likely to have a more muted impact on inflation than in the past.

Muted impact: Is political geography still a backwater?

Political geography has devoted substantial attention to visual popular culture. Where the aural has been considered, this has generally been through the spoken-word (e.g. radio) or lyrics (e.g. popular music). The geopolitics of instrumental music – music without words – is yet to be considered in depth. This article provides an outline of how such media might be approached, building on affectual analyses of sound in human geography. In particular, it examines the example of instrumental film score. It suggests that, rather than just providing background to the visual component of film, score provides a key mode through which geopolitical knowledges are communicated. Through case studies of musical constructions of identity/difference from three geopolitical periods – World War Two, the Cold War, and the War on Terror – this article makes the case for adding instrumental musical literacy to political geography's methodological toolkit.

Direct and indirect effects of Holocene climate variations on catchment and lake processes of a treeline lake, SW China

Sedimentary records of inorganic elements and pigments over the last 12,000 years are used to assess major changes in limnological conditions of Tiancai Lake (a small treeline lake, SW China), in response to Holocene climate variations. Algal communities shifted from the dominance of cyanobacteria and cryptophytes in the early Holocene, towards siliceous algae in the mid-Holocene and chlorophytes in the late Holocene. Algae responded to a combination of climate-mediated vegetation and soil development associated with allochthonous inputs of dissolved nutrients and organic matter, and sediment infilling. Decreases in Al, Pb, Cu and Zn from the early Holocene probably resulted from soil podsolization and the sequestration of these elements within soils. Changes in Mn and Fe were likely linked to redox condition in catchment soils and water column. Synchronous peaks in Ti, Ba, Ca, Sr, Na, K and Mg, median grain size and magnetic susceptibility coincided with the troughs in the chemical index of alteration, indicating that episodic cold events enhanced upland bedrock erosion and transported unleached and coarse detritus into the lake. These cold events broadly correlate with Holocene ice-rafting events in the North Atlantic. Although the cold events altered the influx of minerogenic elements by regulating upland bedrock erosion, climate-mediated vegetation and soil development led to a muted impact on primary producers. Holocene algal community shifts were subtle, reflecting the relative abundance of P (derived from weathering) and N (derived from soils) throughout the record, with the most pronounced effects on the lake biota being benthic expansion which occurred in response to sediment infilling.

How Would the Twenty-First-Century Warming Influence Pacific Decadal Variability and Its Connection to North American Rainfall: Assessment Based on a Revised Procedure for the IPO/PDO

AbstractDecadal climate variability of sea surface temperature (SST) over the Pacific Ocean can be characterized by interdecadal Pacific oscillation (IPO) or Pacific decadal oscillation (PDO) based on empirical orthogonal function (EOF) analysis. Although the procedures to derive the IPO and PDO indices differ in their regional focuses and filtering methods to remove interannual variability, the IPO and PDO are highly correlated in time and are often used interchangeably. Studies have shown that the IPO and PDO conjointly (IPO/PDO for conciseness) play a vital role in modulating the pace of global warming. It is less clear, however, how externally forced global warming may, in turn, affect the IPO/PDO. One obstacle to revealing this effect is that the conventional definitions of the IPO/PDO fail to account for the spatial heterogeneity of the background warming trend, which causes the IPO/PDO to be conflated with the warming trend, especially for the twenty-first-century simulation when the forced change is likely to be more dominant. Using a large-ensemble simulation in the Community Earth System Model, version 1 (CESM1), it is shown here that a better practice of detrending prior to EOF analysis is to remove the local and nonlinear trend, defined as the ensemble-mean time series at each grid box (or simply as the quadratic fit of the local time series if such an ensemble is not available). The revised IPO/PDO index is purely indicative of internal decadal variability. In the twenty-first-century warmer climate, the IPO/PDO has a weaker amplitude in space, a higher frequency in time, and a muted impact on global and North American temperature and rainfall.

Hydrogeology of the Sterkfontein Cave System, Cradle of Humankind, South Africa

Abstract A water level rise of almost 3 m in the space of two years in the Sterkfontein Cave system since late-2009 necessitated the re-routing of the tourist path through the cave to successively higher elevations on three occasions. It also raised concern for a possible association with copious acidic and sulphate-rich mine water drainage from the West Rand Goldfield (a.k.a. Western Basin) starting in early-2010, and the related threat to the UNESCO-inscribed fossil site. Although these circumstances have had little impact on the tourist value of the site, a prognosis of the impact on cave water level and quality is indicated by virtue of its karst setting and palaeontological significance. Historical and recent potentiometric data, together with ancillary hydrogeological and hydrochemical information acquired in the course of a water resources monitoring programme for the broader Cradle of Humankind World Heritage Site, provides new insight into the hydrogeology of the cave system. An improved understanding of the hydrophysical and hydrochemical response of the cave water system sheds light on the location of this system within the water resources environment. It is proposed that the present-day maximum cave water level is constrained to an elevation of ~1440 m above mean sea level. The recent electrical conductivity of 78 mS/m for cave water is 32% greater than the 59 mS/m recorded in mid-2010 and earlier. Similarly, the recent sulphate concentration of 161 mg/L is 178% greater than the 58 mg/L recorded before 2010. Compared to coeval values for ambient karst groundwater represented by the normative Zwartkrans Spring water, the magnitude of the increases in the springwater are similar, viz. 48% (from 84 to 124 mS/m) in salinity and 166% (from 154 to 409 mg/L) in sulphate. Although a distinct mine water impact is evident in both instances, the values indicate a muted impact on the cave water chemistry compared to the springwater. These and other documented observations better inform the threat from various poorer quality water sources to the fossil site in particular, and to the broader karst water resource in general. This contextualises concern for the hydroenvironmental future of Sterkfontein Cave and other nearby fossil sites such as Swartkrans, Rising Star and Bolt’s Farm. The dynamic response of the water resources environment to a variety of hydrological and hydrogeological drivers reinforces the need for monitoring vigilance across a range of disciplines.

Learning in the Oil Futures Markets: Evidence and Macroeconomic Implications

We show that a model where investors learn about the persistence of oil-price movements accounts well for the fluctuations in oil-price futures since the late 1990s. Using a DSGE model, we then show that this learning process alters the impact of oil shocks, making it time-dependent and consistent with the muted impact oil-price changes had on macroeconomic outcomes during the early 2000s and again over the past two years. The Spring 2008 increase in oil prices had a larger impact because market participants considered that it was likely driven by permanent shocks.

Glider and remote sensing observations of the upper ocean response to an extended shallow coastal diversion of wastewater effluent

The Orange County Sanitation District (OCSD) diverted wastewater discharge (5.3 × 108 l d−1) from its primary deep (56 m) outfall 8 km offshore, to a secondary shallower (16 m) outfall 1.6 km offshore for a period of three weeks. It was anticipated that the low salinity and density of the effluent would cause it to rise to the surface with limited dilution, elevating nutrient concentrations in near-surface waters and stimulating phytoplankton blooms in the region. Three Teledyne Webb Slocum gliders and a Liquid Robotics surface wave glider were deployed on transects near the outfalls to acquire high spatial and temporal coverage of physical and chemical parameters before, during, and after the wastewater diversion. Combined autonomous underwater vehicle (AUV) and MODIS-Aqua satellite ocean color data indicated that phytoplankton biomass increased in the upper water column in response to the diversion, but that the magnitude of the response was spatially patchy and significantly less than expected. Little evidence of the plume or its effects was detectable 72 h following the diversion. The effluent plume exhibited high rates of dilution and mixed throughout the upper 20 m and occasionally throughout the upper 40 m during the diversion. Rapid plume advection and dilution appeared to contribute to the muted impact of the nutrient-rich effluent on the phytoplankton community in this coastal ecosystem.

Summer Budget: calculated risk or reckless gamble?

Economic OutlookVolume 39, Issue 3 p. 5-10 Economic Outlook Summer Budget: calculated risk or reckless gamble?† First published: 12 August 2015 https://doi.org/10.1111/1468-0319.12163Citations: 2 † By Andrew Goodwin, Lead UK Economist, agoodwin@oxfordeconomics.com and Martin Beck, Lead UK Economist, mbeck@oxfordeconomics.com AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Abstract The Chancellor had created the expectation that his Summer Budget would be radical and he did not disappoint. The ‘rabbit from the hat’ was a compulsory ‘living wage’, expected to reach £9 per hour in 2020, which Mr Osborne hopes will help to compensate the lower paid for the slashing of in-work benefits. This has effectively transferred responsibility for supporting low-income households from the government to employers. The OBR expects this to have a relatively muted impact on employment, but this view looks pretty optimistic and the policy represents a major gamble. The reduction in welfare spending, plus an easing of the near-term fiscal squeeze, has helped to smooth the public spending ‘rollercoaster’. But with a plethora of giveaways failing to disguise a net increase in the tax burden, the Budget is likely to weigh on growth prospects, even if the Chancellor's big gamble pays off. Alongside the Budget the Chancellor announced a new fiscal mandate, which will require governments to run a budget surplus in “normal times”. But meeting this mandate will require a fiscal stance very far from the historical norm and it will also force other sectors to move into deficit to compensate. It will also mean a looser monetary policy than would otherwise be the case. So a policy presented as creating room for fiscal policy to respond to future economic shocks could potentially narrow the scope for the more potent weapon of interest rate cuts. Citing Literature Volume39, Issue3July 2015Pages 5-10 RelatedInformation

Do Credit Constraints Amplify Macroeconomic Fluctuations?

Previous studies on financial frictions have been unable to establish the empirical significance of credit constraints in macroeconomic fluctuations. This paper argues that the muted impact of credit constraints stems from the absence of a mechanism to explain the observed persistent comovements between housing prices and business investment. We develop such a mechanism by incorporating two key features into a dynamic stochastic general equilibrium model: We identify shocks that shift the demand for collateral assets and allow productive agents to be credit-constrained. A combination of these two features enables our model to successfully generate an empirically important mechanism that amplifies and propagates macroeconomic fluctuations through credit constraints.

The impact of classroom design on pupils' learning: Final results of a holistic, multi-level analysis

Assessments have been made of 153 classrooms in 27 schools in order to identify the impact of the physical classroom features on the academic progress of the 3766 pupils who occupied each of those specific spaces.This study confirms the utility of the naturalness, individuality and stimulation (or more memorably, SIN) conceptual model as a vehicle to organise and study the full range of sensory impacts experienced by an individual occupying a given space. In this particular case the naturalness design principle accounts for around 50% of the impact on learning, with the other two accounting for roughly a quarter each.Within this structure, seven key design parameters have been identified that together explain 16% of the variation in pupils' academic progress achieved. These are Light, Temperature, Air Quality, Ownership, Flexibility, Complexity and Colour. The muted impact of the whole-building level of analysis provides some support for the importance of “inside-out design”.The identification of the impact of the built environment factors on learning progress is a major new finding for schools' research, but also suggests that the scale of the impact of building design on human performance and wellbeing in general, can be isolated and that it is non-trivial. It is argued that it makes sense to capitalise on this promising progress and to further develop these concepts and techniques.

Sticky prospects: Loss frames are cognitively stickier than gain frames.

Research across numerous domains has highlighted the current--and presumably temporary--effects of frames on preference and behavior. Yet people often encounter information that has been framed in different ways across contexts, and there are reasons to predict that certain frames, once encountered, might tend to stick in the mind and resist subsequent reframing. We propose that loss frames are stickier than gain frames in their ability to shape people's thinking. Specifically, we suggest that the effect of a loss frame may linger longer than that of a gain frame in the face of reframing and that this asymmetry may arise because it is more difficult to convert a loss-framed concept into a gain-framed concept than vice versa. Supporting this notion, loss-to-gain (vs. gain-to-loss) reframing had a muted impact on both risk preferences (Study 1) and evaluation (Study 2). Moreover, participants took longer to solve a math problem that required reconceptualizing losses as gains than vice versa (Studies 3-5), and reframing changed gain-based conceptualizations but not loss-based ones (Study 6). We discuss implications for understanding a key process underlying negativity bias, as well as how sequential frames might impact political behavior and economic recovery.

Impact of Policy Change on US Army Combat Transfusion Practices

Clinical practice guidelines (CPGs) are used to keep providers up-to-date with the most recent literature and to guide in decision making. Adherence is typically improved although many have a muted impact. In March 2006, the US Army issued a damage control resuscitation CPG, encouraging 1:1 plasma:red blood cell (RBC) transfusions and limiting crystalloid use. The objective of this study was to determine whether the CPG was associated with a change in the transfusion practices in combat-wounded patients. All US service members injured in Operation Iraqi Freedom/Operation Enduring Freedom who received massive transfusions (MTs; > or = 10 RBC in 24 hours) were queried from the US Army Institute of Surgical Research transfusion database. Whole blood, when used, was counted as 1 unit of RBC, fresh frozen plasma (FFP), and platelet. Subjects were divided into pre- and post-CPG cohorts. Primary outcomes were ratios of FFP:RBC and crystalloid use. A total of 777 MT patients were identified. The cohorts were similar in age (25 years +/- 6 years vs. 25 years +/- 6 years; p = ns) and injury severity scale score (24 +/- 12 vs. 25 +/- 12; p = ns). The post-CPG cohort was warmer (96.5 degrees F +/- 7.8 degrees F vs. 98.2 degrees F +/- 1.9 degrees F; p < 0.05) and was transfused more RBC, platelets, and plasma but received less crystalloid (17 units +/- 12 units vs. 19 units +/- 11 units, 1 unit +/- 2 units vs. 2 units +/- 3 units, 8 units +/- 8 units vs. 14 units +/- 11 units, 14 L +/- 14 L vs. 9 L +/- 13 L, respectively; p < 0.05). The post-CPG cohort also received a higher ratio transfusion (0.5 +/- 0.31 vs. 0.8 +/- 0.31; p < 0.05) representing a change in practice. Overall mortality was not different between the two groups (24 vs. 19%; p = 0.115). MT patients are now receiving a higher FFP:RBC ratio and less crystalloid after implementation of the CPG. Additionally, patients are now presenting normothermic and have higher hemoglobin levels. All of these changes are consistent with the principles of damage control resuscitation. Changes in practice were associated with implementation of the CPG, maturity of the battlefield, and increased availability of products.