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This study evaluated how informing clinicians about Clostridioides difficile (CD) carriage affected antibiotic stewardship. A quasi-experimental pre/post design assessed antibiotic use in carriers versus non-carriers. Clinician awareness was associated with reduced antibiotic use, particularly quinolones, among carriers. Findings suggest screening and targeted education enhance stewardship and reduce high-risk antibiotic use.
We explore strategic betting in competitive environments with multiple participants and potential winners. We examine two scenarios: an ‘inclusive’ low-competition scenario with many winners and an ‘exclusive’ high-competition scenario with few winners. Using a simple model, we illustrate the strategic insights in these scenarios and present experimental results that align with our predictions. In the experiment, participants made repeated bets with feedback on past results and their payoffs. In the inclusive scenario, all but the worst guessers were rewarded, while in the exclusive scenario, only the top guessers received rewards. Our findings show that in the inclusive scenario, participants exhibit herding behavior by coordinating their bets, while in the exclusive scenario, they diversify their bets across multiple options. The main general insight of our findings is that in moderate competitions, one tends to join the majority to avoid standing out in case of failure, whereas in intense competitions, one tends to differentiate oneself from one’s peers to ensure that success stands out. This insight is relevant for a broad domain of strategic interactions.
Aims: Safe and effective prescribing in people living with dementia (PLWD) is particularly challenging due to the increased risk of adverse events, polypharmacy and potentially inappropriate medications. Cognitive impairment and reliance on caregivers to report symptoms can further complicate the assessment of drug benefits. This case study demonstrates how novel contactless monitoring could address these challenges by enabling remote evaluation of drug effects in PLWD.
Methods: We present the case of a 77-year-old gentleman with late onset Alzheimer’s disease enrolled on the CR&T MINDER cohort study and continuously monitored using the Withing’s Sleep Analyzer. He visited his GP with complaints of insomnia and was subsequently prescribed 15 mg of mirtazapine. He reported immediate beneficial effects, although noted that the drug made him drowsy. We evaluated his sleep by comparing baseline sleep metrics (a 2-week average 1 month before drug administration) with average sleep metrics 2 weeks after starting mirtazapine. Statistical analysis was performed using a paired t-test and a rolling average to assess trends over time.
Results: Calculated rolling average showed reductions in time spent awake overnight and in light sleep, while deep sleep and total sleep time increased. These trends were confirmed by period comparisons. Baseline deep sleep duration (M = 1.19 hrs, SD = 1.02 hrs), and total sleep time (M = 7.16 hrs, SD = 1.03 hrs) significantly increased 2 weeks post mirtazapine (deep sleep: M = 2.63 hrs, SD = 1.03 hrs); total sleep time: M = 7.87 hrs, SD = 0.47 hrs), t(13) = −3.639, p = 0.003, and t(13) = −2.256, p = 0.042. There was also a significant reduction in time spent awake during the night from baseline (M = 1.17 hrs, SD = 0.51 hrs) to 2 weeks post mirtazapine (M = 0.65 hrs, SD = 0.43 hrs), t(13) = 2.616, p = 0.0214.
Conclusion: This case study shows that contactless remote monitoring could be used objectively to evaluate the effects of mirtazapine on sleep in PLWD. Our results demonstrate that improvements in sleep detected by monitoring align with the participants’ reported benefits. These findings suggests continuous remote monitoring could provide valuable, timely insights into drug effects in PLWD, improving clinical decision-making and personalising care.
Given how common portrayals of vigilantism are in history books, literature, cinema, television, and the popular press, it is surprising how little we know about the public’s attitudes and beliefs about the phenomena. While there is a fair amount of research by historians, political scientists, sociologists, and cultural anthropologists on various forms of vigilantism, only a limited number of psychological studies have explored people’s moral judgments about vigilantism in a controlled and systematic way. Our goal was to build upon the work that has been done by probing people’s moral, legal, and political judgments about what we call “retributive vigilantism” – that is, vigilante acts that are intended to give the deserved suffering to those who have harmed other people.
Veto power consists of the right of one or more players to unilaterally block decisions but without the ability to unilaterally secure their preferred outcome. Our experiment shows that (i) committees with a veto player take longer to reach decisions (are less efficient) and generate less consensus than without a veto player, (ii) veto power substantially enhances proposer's power, and (iii) non-veto players are substantially more willing to compromise than veto players. We relate our results to the theoretical literature on the impact of veto power as well as to concerns about the impact of veto power in real-life committees.
We run an experiment in which students of different European nationalities are matched in groups of five and repeatedly choose with whom within their group they want to play a trust game. Participants observe of each other age, gender, nationality and number of siblings. The region of origin, “North” or “South” is a major determinant of success in the experiment. Participants tend to trust those they trusted before and who trusted them. We do not find evidence of regional discrimination per se. It is only the underlying and significant differences in behavior that translate through repeated interactions into differences in payoffs between the two regions.
This paper examines the occurrence and fragility of information cascades in two laboratory experiments. One group of low informed participants sequentially guess which of two states has been randomly chosen. In a matched pairs design, another group of high informed participants make similar guesses after having observed the guesses of the low informed participants. In the second experiment, participants’ beliefs about the chosen state are elicited. In equilibrium, low informed players who observe an established pattern of identical guesses herd without regard to their private information whereas high informed players always guess according to their private information. Equilibrium behavior implies that information cascades emerge in the group of low informed participants, the belief based solely on cascade guesses is stationary, and information cascades are systematically broken by high informed participants endowed with private information contradicting the cascade guesses. Experimental results show that the behavior of low informed participants is qualitatively in line with the equilibrium prediction. Information cascades often emerge in our experiments. The tendency of low informed participants to engage in cascade behavior increases with the number of identical guesses. Our main finding is that information cascades are not fragile. The behavior of high informed participants differs markedly from the equilibrium prediction. Only one-third of laboratory cascades are broken by high informed participants endowed with private information contradicting the cascade guesses. The relative frequency of cascade breaks is 15% for the situations where five or more identical guesses are observed. Participants’ elicited beliefs are strongly consistent with their own behavior and show that, unlike in equilibrium, the more cascade guesses participants observe the more they believe in the state favored by those guesses.
To examine the risk of perinatal mental illness, including new diagnoses and recurrent use of mental healthcare, comparing women with and without traumatic brain injury (TBI), and to identify injury-related factors associated with these outcomes among women with TBI.
Methods
We conducted a population-based cohort study in Ontario, Canada, of all obstetrical deliveries to women in 2012–2021, excluding those with mental healthcare use in the year before conception. The cohort was stratified into women with no remote mental illness history (to identify new mental illness diagnoses between conception and 365 days postpartum) and those with a remote mental illness history (to identify recurrent illnesses). Modified Poisson regression generated adjusted relative risks (aRRs) (1) comparing women with and without TBI and (2) according to injury-related variables (i.e., number, severity, timing, mechanism and intent) among women with TBI.
Results
There were n = 12,724 women with a history of TBI (mean age: 27.6 years [SD, 5.5]) and n = 786,317 without a history of TBI (mean age: 30.6 years [SD, 5.0]). Women with TBI were at elevated risk of a new mental illness diagnosis in the perinatal period compared to women without TBI (18.5% vs. 12.7%; aRR: 1.31, 95% confidence interval [CI]: 1.24–1.39), including mood and anxiety disorders. Women with a TBI were also at elevated risk for recurrent use of mental healthcare perinatally (35.5% vs. 27.8%; aRR: 1.18, 95% CI: 1.14–1.22), including mood and anxiety, psychotic, substance use and other mental health disorders. Among women with a history of TBI, the number of TBI-related healthcare encounters was positively associated with an elevated risk of new-onset mental illness.
Conclusions
These findings demonstrate the need for providers to be attentive to the risk for perinatal mental illness in women with a TBI. This population may benefit from screening and tailored mental health supports and treatment options.
In this work, we develop an integral representation for the partial L-function of a pair $\pi \times \tau $ of genuine irreducible cuspidal automorphic representations, $\pi $ of the m-fold covering of Matsumoto of the symplectic group $\operatorname {\mathrm {Sp}}_{2n}$ and $\tau $ of a certain covering group of $\operatorname {\mathrm {GL}}_k$, with arbitrary m, n and k. Our construction is based on the recent extension by Cai, Friedberg, Ginzburg and the author, of the classical doubling method of Piatetski-Shapiro and Rallis, from rank-$1$ twists to arbitrary rank twists. We prove a basic global identity for the integral and compute the local integrals with unramified data. Our global results are subject to certain conjectures, but when $k=1$ they are unconditional for all m. One possible future application of this work will be a Shimura-type lift of representations from covering groups to general linear groups. In a recent work, we used the present results in order to provide an analytic definition of local factors for representations of the m-fold covering of $\operatorname {\mathrm {Sp}}_{2n}$.
Prolific is a website that offers researchers the ability to recruit and sample participants for online research. In contrast to earlier crowdsourcing platforms, such as Amazon Mechanical Turk (MTurk), it focuses primarily on academic and marketing research – typically done through online surveys and experiments. In this chapter, I aim to introduce this platform to researchers conducting online studies and to provide knowledge and practical advice on how to best use the platform for online research. The review includes explanations of how the site works, the composition of its pool of participants, the options available to researchers for sampling and recruiting participants online, how to achieve advanced abilities by connecting Prolific to research software (e.g., Qualtrics, Gorilla), and how to ensure high data quality when using Prolific. I then review the evidence on the current state of data quality on Prolific, suggesting that it can provide higher data quality than MTurk and also better than some commercial panels. I conclude with a summary of the advantages and disadvantages of using Prolific for online research and potential future developments in the platform that could promote more credible online research.
Edited by
David M. Greer, Boston University School of Medicine and Boston Medical Center,Neha S. Dangayach, Icahn School of Medicine at Mount Sinai and Mount Sinai Health System
Delirium is an acute disturbance of attention and awareness that can be associated with poor prognosis, including dependence and death.[1,2] Delirium is exceedingly common in critically ill patients across many different contexts, and can be considered a state of acute organ dysfunction or failure. Neuroprognostication in the setting of delirium is challenging due to the multifactorial nature of the syndrome and requires careful consideration of the various ways in which delirium manifests.
Monitoring cerebral and renal near-infrared spectroscopy for regional venous oxygenation is a common practice in the postoperative care of neonates recovering from surgery for CHD. In this study, we aimed to test the feasibility of using this technology for monitoring changes in splanchnic perfusion during feeds in infants recovering from cardiac surgery.
Methods:
We monitored renal and splanchnic near-infrared spectroscopy in 29 neonates once recovered from the critical postoperative state and tolerating full enteral nutrition. Infants were tested over 3 feeds for splanchnic regional oxygenation (rO2), arterial to splanchnic saturation difference and splanchnic to renal regional oxygenation ratio.
Result:
Splanchnic regional oxygenation data were obtained with no failure or interruptions. Interclass correlation for agreement between measurements suggested good repeatability: 0.84 at baseline and 0.82 at end of feed. Infants with physiologic repair (n = 19) showed a trend towards increased splanchnic regional oxygenation at the end of feeds and were more likely to achieve regional oxygenation > 50% compared to infants with shunt-dependent circulation (n = 10, p = 0.02). Calculating AVO2 and regional oxygenation index did not result in improved test sensitivity.
Conclusion:
Monitoring splanchnic regional oxygenation during feeds for infants recovering from congenital heart surgery is feasible and reliable. These results suggest that near-infrared spectroscopy could be further studied as a tool for bedside monitoring to assist in feeding management and prevention of necrotising enterocolitis in this sensitive patient population.
Let $\mathcal {O}$ be a maximal order in the quaternion algebra over $\mathbb Q$ ramified at p and $\infty $. We prove two theorems that allow us to recover the structure of $\mathcal {O}$ from limited information. The first says that for any infinite set S of integers coprime to p, $\mathcal {O}$ is spanned as a ${\mathbb {Z}}$-module by elements with norm in S. The second says that $\mathcal {O}$ is determined up to isomorphism by its theta function.
We study the low-temperature $(2+1)$D solid-on-solid model on with zero boundary conditions and nonnegative heights (a floor at height $0$). Caputo et al. (2016) established that this random surface typically admits either $\mathfrak h $ or $\mathfrak h+1$ many nested macroscopic level line loops $\{\mathcal L_i\}_{i\geq 0}$ for an explicit $\mathfrak h\asymp \log L$, and its top loop $\mathcal L_0$ has cube-root fluctuations: For example, if $\rho (x)$ is the vertical displacement of $\mathcal L_0$ from the bottom boundary point $(x,0)$, then $\max \rho (x) = L^{1/3+o(1)}$ over . It is believed that rescaling $\rho $ by $L^{1/3}$ and $I_0$ by $L^{2/3}$ would yield a limit law of a diffusion on $[-1,1]$. However, no nontrivial lower bound was known on $\rho (x)$ for a fixed $x\in I_0$ (e.g., $x=\frac L2$), let alone on $\min \rho (x)$ in $I_0$, to complement the bound on $\max \rho (x)$. Here, we show a lower bound of the predicted order $L^{1/3}$: For every $\epsilon>0$, there exists $\delta>0$ such that $\min _{x\in I_0} \rho (x) \geq \delta L^{1/3}$ with probability at least $1-\epsilon $. The proof relies on the Ornstein–Zernike machinery due to Campanino–Ioffe–Velenik and a result of Ioffe, Shlosman and Toninelli (2015) that rules out pinning in Ising polymers with modified interactions along the boundary. En route, we refine the latter result into a Brownian excursion limit law, which may be of independent interest. We further show that in a $ K L^{2/3}\times K L^{2/3}$ box with boundary conditions $\mathfrak h-1,\mathfrak h,\mathfrak h,\mathfrak h$ (i.e., $\mathfrak h-1$ on the bottom side and $\mathfrak h$ elsewhere), the limit of $\rho (x)$ as $K,L\to \infty $ is a Ferrari–Spohn diffusion.
We investigated the effect of adding 3 levels of sodium bicarbonate (SB: 0, 0.74 and 1.47% of total mixed ration (TMR) dry matter) to a low-roughage TMR (20.8% wheat silage, 9% wheat hay and 2.3% clover hay) on feed intake, production (milk and milk-component yields), whole-tract apparent digestibility, rumen pH and rumination time. After 2 wk of receiving the same TMR, 42 mid-lactation multiparous cows were blocked into groups of 3 according to their dry matter intake and energy-corrected milk (ECM) yield and divided into 3 treatment groups. The experimental rations were fed for 7 wk while monitoring intake, production and rumination. Rumen pH was measured after 6 h without access to feed and 6 h after feeding (at 0600 and 1500 h) every other week, and feces samples were taken for whole-tract apparent digestibility at wk 7. Dietary SB level did not affect intake, ECM yield, digestibility or efficiency. Dietary SB concentration negatively correlated with daily rumination time but did not affect rumen pH measured before or after feeding. Lactating cows may, therefore, increase their rumination time to compensate for lack of buffer but overall, removing SB from a wheat-based, low roughage TMR does not impair intake or milk or milk-component yields.
During the past 30 yr an impasse has developed in the discovery and commercialization of synthetic herbicides with new molecular targets and novel chemistries. Similarly, there has been little success with bioherbicides, both microbial and chemical. These bioherbicides are needed to combat fast-growing herbicide resistance and to fulfill the need for more environmentally and toxicologically safe herbicides. In response to this substantial and growing opportunity, numerous start-up companies are utilizing novel approaches to provide new tools for weed management. These diverse new tools broaden the scope of discovery, encompassing advanced computational, bioinformatic, and imaging platforms; plant genome–editing and targeted protein degradation technologies; and machine learning and artificial intelligence (AI)-based strategies. This review contains summaries of the presentations of 10 such companies that took part in a symposium held at the WSSA annual meeting in 2024. Four of the companies are developing microbial bioherbicides or natural product–based herbicides, and the other six are using advanced technologies, such as AI, to accelerate the discovery of herbicides with novel molecular target sites or to develop non-GMO, herbicide-resistant crops.
Exposure to maternal depressive symptoms (MDS) may have a pertinent role in shaping children’s emotional development. However, little is known about how these processes emerge in the early postpartum period. The current study examined the direct and interactive associations between MDS and cry-processing cognitions in the prediction of infant negative emotionality and affective concern. Participants were 130 mother-child dyads (50% female) assessed at three time points. During the second trimester of pregnancy, expectant mothers completed a procedure to assess responses to video clips of distressed infants and reported about MDS. Mothers also reported about MDS at 1- and 3-months postpartum. At age 3 months, infants’ negative emotionality and affective concern responses were observed and rated. We found no direct associations between MDS and both measures of infant emotional reactivity. However, MDS interacted with cry-processing cognitions to predict affective concern and negative emotionality. Overall, MDS were related to increased affective concern and decreased negative emotionality when mothers held cognitions that were more focused on their own emotions in the face of the infant’s cry rather than the infant’s emotional state and needs. Clinical implications for early screening and intervention are discussed.
Let $X$ and $Y$ be compact hyper-Kähler manifolds deformation equivalent to the Hilbert scheme of length $n$ subschemes of a $K3$ surface. A class in $H^{p,p}(X\times Y,{\mathbb {Q}})$ is an analytic correspondence, if it belongs to the subring generated by Chern classes of coherent analytic sheaves. Let $f:H^2(X,{\mathbb {Q}})\rightarrow H^2(Y,{\mathbb {Q}})$ be a rational Hodge isometry with respect to the Beauville–Bogomolov–Fujiki pairings. We prove that $f$ is induced by an analytic correspondence. We furthermore lift $f$ to an analytic correspondence $\tilde {f}: H^*(X,{\mathbb {Q}})[2n]\rightarrow H^*(Y,{\mathbb {Q}})[2n]$, which is a Hodge isometry with respect to the Mukai pairings and which preserves the gradings up to sign. When $X$ and $Y$ are projective, the correspondences $f$ and $\tilde {f}$ are algebraic.
Clay fractions of eight vertisols and vertisolic soils from Israel were found to consist principally of a Fe-rich beidellite. Sediment volumes of Na-clay suspensions, obtained in measuring cylinders and read every 24 hr for as long as 720 hr, ranged from 3.8 to 8.4 cm/l00 mg clay and were as much as 19 times larger than corresponding suspensions of Ca-clays. Optical density data for all clay suspensions showed absorption curves typical of smectite. The relative number of platelets per tactoid, calculated from optical density measurements, ranged between 1.4 and 5.4 for the Na-clays and between 7.4 and 14.1 for the Ca-clays. In the Ca-clays, the sediment volume decreased with an increase in the relative number of platelets per tactoid. With increase in the major dimension of particles (calculated also from optical density curves), sediment volume tended to increase for the Na-clays and decrease for the Ca-clays. These relationships can be explained on the basis of particle arrangement patterns: face-to-face arrangements dominated the Ca-clays and edge-to-edge and edge-to-face arrangements dominated the Na-clays. The amount of iron extractable in dithionite-citrate-bicarbonate (DCB) correlated positively with the relative number of plates per tactoid and with the major dimensions of the particles in the Ca-clay suspensions. This correlation suggests that DCB-extractable iron affects the tactoid dimensions of Ca-clays from vertisols and, therefore, may also affect structural properties of vertisols.