Maladaptive daydreaming is a distinct syndrome in which the main symptom is excessive vivid fantasising that causes clinically significant distress and functional impairment in academic, vocational and social domains. Unlike normal daydreaming, maladaptive daydreaming is persistent, compulsive and detrimental to one’s life. It involves detachment from reality in favour of intense emotional engagement with alternative realities and often includes specific features such as psychomotor stereotypies (e.g. pacing in circles, jumping or shaking one’s hands), mouthing dialogues, facial gestures or enacting fantasy events. Comorbidity is common, but existing disorders do not account for the phenomenology of the symptoms. Whereas non-specific therapy is ineffective, targeted treatment seems promising. Thus, we propose that maladaptive daydreaming be considered a formal syndrome in psychiatric taxonomies, positioned within the dissociative disorders category. Maladaptive daydreaming satisfactorily meets criteria for conceptualisation as a psychiatric syndrome, including reliable discrimination from other disorders and solid interrater agreement. It involves significant dissociative aspects, such as disconnection from perception, behaviour and sense of self, and has some commonalities with but is not subsumed under existing dissociative disorders. Formal recognition of maladaptive daydreaming as a dissociative disorder will encourage awareness of a growing problem and spur theoretical, research and clinical developments.

Substantial productivity increases have been reported when incentives are framed as losses rather than gains. Loss-framed contracts have also been reported to be preferred by workers. The results from our meta-analysis and real-effort experiment challenge these claims. The meta-analysis’ summary effect size of loss framing is a 0.16 SD increase in productivity. Whereas the summary effect size in laboratory experiments is a 0.33 SD, the summary effect size from field experiments is 0.02 SD. We detect evidence of publication biases among laboratory experiments. In a new laboratory experiment that addresses prior design weaknesses, we estimate an effect size of 0.12 SD. This result, in combination with the meta-analysis, suggests that the difference between the effect size estimates in laboratory and field experiments does not stem from the limited external validity of laboratory experiments, but may instead stem from a mix of underpowered laboratory designs and publication biases. Moreover, in our experiment, most workers preferred the gain-framed contract and the increase in average productivity is only detectable in the subgroup of workers (~ 20%) who preferred the loss-framed contracts. Based on the results from our experiment and meta-analysis, we believe that behavioral scientists should better assess preferences for loss-framed contracts and the magnitude of their effects on productivity before advocating for greater use of such contracts among private and public sector actors.

Azrieli et al. (J Polit Econ, 2018) provide a characterization of incentive compatible payment mechanisms for experiments, assuming subjects’ preferences respect dominance but can have any possible subjective beliefs over random outcomes. If instead we assume subjects view probabilities as objective—for example, when dice or coins are used—then the set of incentive compatible mechanisms may grow. In this paper we show that it does, but the added mechanisms are not widely applicable. As in the subjective-beliefs framework, the only broadly-applicable incentive compatible mechanism (assuming all preferences that respect dominance are admissible) is to pay subjects for one randomly-selected decision.

This research builds on the work of D.K. Gode and Shyam Sunder who demonstrated the existence of a strong relationship between market institutions and the ability of markets to seek equilibrium—even when the agents themselves have limited intelligence and behave with substantial randomness. The question posed is whether or not market institutions account for the operation of the law of supply and demand in markets populated by humans with no role required of human rationality. Are institutions responsible for the operations of the law of supply and demand or are behavioral principles also at work? Experiments with humans and simulations with robots both conducted in conditions in which major institutional and structural aids to convergence were removed, produced clear answers. Human markets converge, while robot markets do not. The structural and institutional features certainly facilitate convergence under conditions of substantial irrationality, but they are not necessary for convergence in markets in which agents have the rationality of humans.

In this paper we propose and test a contracting mechanism, Multi-Contract Cost Sharing (MCCS), for use in the management of a sequence of projects. The mechanism is intended for situations where (1) the contractor knows more about the true costs of various projects than does the contracting agency (adverse selection), and (2) unobservable effort on the part of the contractor may lead to cost reductions (moral hazard). The proposed process is evaluated in an experimental environment that includes the essential economic features of the NASA process for the acquisition of Space Science Strategic missions. The environment is complex and the optimal mechanism is unknown. The design of the MCCS mechanism is based on the optimal contract for a simpler related environment. We compare the performance of the proposed process to theoretical benchmarks and to an implementation of the current NASA ‘cost cap’ procurement process. The data indicate that the proposed MCCS process generates significantly higher value per dollar spent than using cost caps, because it allocates resources more efficiently among projects and provides greater incentives to engage in cost-reducing innovations.

Grazing is a crucial component of dairy farms across many regions of the world. This review explores challenges related to grazing infrastructure and opportunities for future improvement. Farmers who aim to increase pasture utilisation face heightened inter-animal competition necessitated by pasture restriction to achieve target post-grazing sward heights. Increasing the frequency of fresh pasture allocation beyond once per day has been observed to reduce milk production in primiparous animals, due to intensified competition for limited feed resources. Implementing grazing paddocks tailored for 24 to 36 hour allocations helps to mitigate inter-animal competition while concurrently preventing the grazing of fresh regrowth. Crucial to this approach is establishing farm roadway infrastructure, that allows access to all sections of the grazing platform. However, the development of these roadway networks has often occurred without a comprehensive assessment of their impact on the efficiency of the dairy herd’s movement between grazing paddocks and the milking parlour. The efficiency of the dairy herd’s movement is most significantly influenced by the location of the milking parlour within the grazing platform. Extreme walking distances or challenging terrain on farm roadways may have an impact on milk production per cow. Factors such as farm roadway surface quality and width significantly influence cow throughput on farm roadways. Recent studies have highlighted inadequate roadway widths on many farms relative to their herd size, while surface condition may also be limiting cow throughput on these farms. Enhancing roadway width and surface condition of farm roadways may improve labour efficiency on commercial farms.

Rapid blood culture identification is most effective with antimicrobial stewardship feedback, which is limited during non-business hours. We implemented overnight review of Blood Culture Identification 2 panel results by intensive care unit pharmacists and demonstrated reduced time to evaluation (3.6 vs 9.3 hours, P < .01).

Lewy body dementias (LBD) are the second most common dementia. Several genes have been associated with LBD, but little is known about their contributions to LBD pathophysiology. Each gene may transcribe multiple RNA, and LBD brains have extensive RNA splicing dysregulation. Hence, we completed the first transcriptome-wide transcript-level differential expression analysis of post-mortem LBD brains for gaining more insights into LBD molecular pathology that are essential for facilitating discovery of novel therapeutic targets and biomarkers for LBD. We completed transcript-level quantification of next-generation RNA-sequencing data from post-mortem anterior cingulate (ACC) and dorsolateral prefrontal cortices (DLPFC) of people with pathology-verified LBD (LBD = 14; Controls = 7) using Salmon. We identified differentially expressed transcripts (DET) using edgeR and investigated their functional implications using DAVID. We performed transcriptome-wide alternative splicing analysis using DRIMseq. We identified 74 DET in ACC and 96 DET in DLPFC after Benjamini-Hochberg false discovery rate (FDR) correction (5%). There were 135 and 98 FDR-corrected alternatively spliced genes in ACC and DLPFC of LBD brains, respectively. Identified DET may contribute to LBD pathology by altering DNA repair, apoptosis, neuroplasticity, protein phosphorylation, and regulation of RNA transcription. We confirm widespread alternative splicing and absence of chronic neuroinflammation in LBD brains. Transcript-level differential expression analysis can reveal specific DET that cannot be detected by gene-level expression analyses. Therapeutic and diagnostic biomarker potential of identified DET, especially those from TMEM18, MICB, MPO, and GABRB3, warrant further investigation. Future LBD blood-based biomarker studies should prioritise measuring the identified DET in small extracellular vesicles.

Dilated cardiomyopathy (DCM) is a leading cause of heart failure and the most common indication for a heart transplant. Guidelines are regularly based on studies of adults and applied to the young. Children and adolescents diagnosed with DCM face different lifestyle challenges from individuals diagnosed in adulthood that include medical trauma and are influenced by maturity levels and confidence with advocacy to adults.

Using a UK patient-scientist’s perspective, we reviewed the age-specific challenges faced by the young with DCM, evaluated current guidelines and evidence, and identified areas requiring further recommendations and research. We highlight the importance of (i) the transition clinic from paediatric to adult services, (ii) repeated signposting to mental health services, (iii) standardised guidance on physical activity, (iv) caution surrounding alcohol and smoking, (v) the dangers of illegal drugs, and (vi) reproductive options and health.

Further research is needed to address the many uncertainties in these areas with respect to young age, particularly for physical activity, and such guidance would be welcomed by the young with DCM who must come to terms with being different and more limited amongst healthy peers.

Murayama and Jach rightfully aim to conceptualize motivation as an emergent property of a dynamic system of interacting elements. However, they do not embrace the ontological and paradigmatic constraints of the dynamic systems approach. They therefore miss the very process of emergence and how it can be formally modeled and tested by specific types of computer simulation.

Commodity index trading in futures markets is a relatively new investment strategy whose consequences are not fully understood. This paper tests the hypothesis that long-only, passive index trading in agricultural futures markets influences futures prices. Vector Autoregressive (VAR) models are a common empirical research approach for analyzing index trading. Factor-Augmented Vector Autoregression (FAVAR) models are a new approach to analyzing index trading. FAVAR models can incorporate a large data set into the traditional VAR framework. Using a FAVAR model improves the analysis by including additional market factors relevant to futures price formation. Models were estimated for 13 agricultural commodities (corn, soybean, soybean oil, soybean meal, soft red winter wheat, hard red winter wheat, cotton, cocoa, sugar, coffee, live cattle, feeder cattle, and lean hog) from January 2006 to December 2022. The results demonstrate the added value of FAVAR models in explaining the dynamics between prices and index trading. The conclusions are similar to other findings that prices lead index positions; however, adding demand-related data through a FAVAR model allows for a better understanding of market dynamics.

Vaccines have revolutionised the field of medicine, eradicating and controlling many diseases. Recent pandemic vaccine successes have highlighted the accelerated pace of vaccine development and deployment. Leveraging this momentum, attention has shifted to cancer vaccines and personalised cancer vaccines, aimed at targeting individual tumour-specific abnormalities. The UK, now regarded for its vaccine capabilities, is an ideal nation for pioneering cancer vaccine trials. This article convened experts to share insights and approaches to navigate the challenges of cancer vaccine development with personalised or precision cancer vaccines, as well as fixed vaccines. Emphasising partnership and proactive strategies, this article outlines the ambition to harness national and local system capabilities in the UK; to work in collaboration with potential pharmaceutic partners; and to seize the opportunity to deliver the pace for rapid advances in cancer vaccine technology.

This article investigates whether environmental planning law can demonstrate ethical responsibility for its role in settler colonialism. Planning law contributes to settler colonialism by diminishing, excluding, and eliminating alternative views of land that are fundamental to First Nations culture, philosophy, and law/lore. The article adopts a transnational legal frame that recognizes and promotes First Nations as sovereign. The investigation is focused primarily on the planning law system in New South Wales (NSW), Australia, while being guided by interpretations and applications of the rights of First Nations peoples by courts in Canada. It is argued that state planning law in NSW fails to give effect to ethical responsibility because its operation continues to dominate and marginalize Aboriginal legal culture by eroding the necessary ontological and epistemic relationships with land. However, there is potential for change. Opportunities to disrupt settler colonialism have emerged through bottom-up litigation, which has promoted interpretations, applications, and implementation of law that can be performed in ways that resonate with Canadian case law. While the absence of treaty or constitution-based rights protection in NSW and Australia means that the transplant is not seamless, the article argues that laws should not be interpreted and applied in ways that perpetuate settler colonialism where alternative interpretations can lead to a different outcome.

Hand, foot and mouth disease (HFMD) is a contagious communicable disease, with a high incidence in children aged under 10 years. It is a mainly self-limiting disease but can also cause serious neurological or cardiopulmonary complications in some cases, which can lead to death. Little is known about the burden of HMFD on primary care health care services in the UK. The aim of this work was to describe trends in general practitioner (GP) consultations for HFMD in England from January 2017 to December 2022 using a syndromic surveillance network of GPs. Daily GP consultations for HFMD in England were extracted from 1 January 2017 to 31 December 2022. Mean weekly consultation rates per 100,000 population and 95% confidence intervals (CI) were calculated. Consultation rates and rate ratios (RR) were calculated by age group and sex. During the study period, the mean weekly consultation rate for HFMD (per 100,000 registered GP patients) was 1.53 (range of 0.27 to 2.47). In England, children aged 1–4 years old accounted for the largest affected population followed by children <1 years old. We observed a seasonal pattern of HFMD incidence during the non-COVID years, with a seasonal peak of mean weekly rates between months of September and December. HFMD is typically diagnosed clinically rather than through laboratory sampling. Therefore, the ability to look at the daily HFMD consultation rates provides an excellent epidemiological overview on disease trends. The use of a novel GP-in-hours surveillance system allowed a unique epidemiological insight into the recent trends of general practitioner consultations for HFMD. We demonstrate a male predominance of cases, the impact of the non-pharmaceutical interventions during the COVID-19 pandemic, and a change in the week in which the peak number of cases happens post-pandemic.