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Dynamic decision making

Narges Aghaallaei, Baubak Bajoghli
T-cell development is coupled with a highly ordered migratory pattern. Lymphoid progenitors must follow a precise journey; starting from the hematopoietic tissue, they move toward the thymus and then migrate into and out of distinct thymic microenvironments, where they receive signals and cues required for their differentiation into naïve T-cells. Knowing where, when, and how these cells make directional "decisions" is key to understanding T-cell development. Such insights can be gained by directly observing developing T-cells within their environment under various conditions and following specific experimental manipulations...
2018: Frontiers in Immunology
Linda Aimée Hartford Kvæl, Jonas Debesay, Anne Langaas, Asta Bye, Astrid Bergland
OBJECTIVE: Although the concept of patient participation has been discussed for a number of years, there is still no clear definition of what constitutes the multidimensional concept, and the application of the concept in an intermediate care (IC) context lacks clarity. Therefore this paper seeks to identify and explore the attributes of the concept, to elaborate ways of understanding the concept of patient participation for geriatric patients in the context of IC. METHODS: Walker and Avant's model of Concept analysis [1] based on a literature review...
March 5, 2018: Patient Education and Counseling
K A Honn, J M Hinson, P Whitney, H P A Van Dongen
In around-the-clock operations, reduced alertness due to circadian misalignment and sleep loss causes performance impairment, which can lead to catastrophic errors and accidents. There is mounting evidence that performance on different tasks is differentially affected, but the general principles underlying this differentiation are not well understood. One factor that may be particularly relevant is the degree to which tasks require executive control, that is, control over the initiation, monitoring, and termination of actions in order to achieve goals...
March 14, 2018: Accident; Analysis and Prevention
Peter Khooshabeh, Gale Lucas
The cyber domain of military operations presents many challenges. A unique element is the social dynamic between cyber operators and their leadership because of the novel subject matter expertise involved in conducting technical cyber tasks, so there will be situations where senior leaders might have much less domain knowledge or no experience at all relative to the warfighters who report to them. Nonetheless, it will be important for junior cyber operators to convey convincing information relevant to a mission in order to persuade or influence a leader to make informed decisions...
2018: Frontiers in Psychology
Heidi Lourens, Brian Watermeyer, Leslie Swartz
PURPOSE: Scholars agree that effective rehabilitation relies on a bedrock of reciprocity, relational trust, and authenticity. It is therefore essential for practitioners to develop insight into the complex dynamics within helping relationships. This study aims to provide an in-depth understanding of visually impaired students' experience of informal helping relationships. METHODS: Ten visually impaired students at a South African university participated in one of two semi-structured focus group interviews (six and four in each group, respectively) wherein we explored their experience of informal helping relationships...
March 16, 2018: Disability and Rehabilitation
Sarah Donnelly, Emer Begley, Marita O'Brien
In recent years, there have been national and international policy advances around capacity and decision-making and an apparent burgeoning rights-based approach to the issue, all of which have the potential to impact on the experience for people with dementia in Ireland. There is little evidence however on whether these policies and principles are being translated into practice and whether traditional paternalistic approaches to decision-making are being challenged. To gain insight into current practice, research was undertaken with social workers working with older people in Ireland; reporting on the involvement of people living with dementia in care-planning processes...
January 1, 2018: Dementia
Yair Litman, Davide Donadio, Michele Ceriotti, Mariana Rossi
Water molecules adsorbed on inorganic substrates play an important role in several technological applications. In the presence of light atoms in adsorbates, nuclear quantum effects (NQEs) influence the structural stability and the dynamical properties of these systems. In this work, we explore the impact of NQEs on the dissociation of water wires on stepped Pt(221) surfaces. By performing ab initio molecular dynamics simulations with van der Waals corrected density functional theory, we note that several competing minima for both intact and dissociated structures are accessible at finite temperatures, making it important to assess whether harmonic estimates of the quantum free energy are sufficient to determine the relative stability of the different states...
March 14, 2018: Journal of Chemical Physics
Trisha M Prentice, Lynn Gillam
When healthcare professionals feel constrained from acting in a patient's best interests, moral distress ensues. The resulting negative sequelae of burnout, poor retention rates, and ultimately poor patient care are well recognized across healthcare providers. Yet an appreciation of how particular disciplines, including physicians, come to be "constrained" in their actions is still lacking. This paper will examine how the application of shared decision-making may contribute to the experience of moral distress for physicians and why such distress may go under-recognized...
March 14, 2018: Journal of Bioethical Inquiry
Bei-Bei Wu, Ye Ma, Lei Xie, Jin-Zhuang Huang, Zong-Bo Sun, Zhi-Duo Hou, Rui-Wei Guo, Zhi-Rong Lin, Shou-Xing Duan, Shan-Shan Zhao, Yao-Xie, Dan-Miao Sun, Chun-Min Zhu, Shu-Hua Ma
BACKGROUND: Systemic lupus erythematosus (SLE) is associated with cognitive deficit but the exact neural mechanisms remain unclear. PURPOSE: To explore sequential brain activities using functional magnetic resonance imaging (fMRI) during the performance of a decision-making task, and to determine whether serum or clinical markers can reflect the involvement of the brain in SLE. SUBJECTS: Sixteen female SLE patients without overt clinical neuropsychiatric symptoms and 16 healthy controls were included...
March 14, 2018: Journal of Magnetic Resonance Imaging: JMRI
Anne-Marie Reid, Jeremy M Brown, Julie M Smith, Alexandra C Cope, Susan Jamieson
CONTEXT: For medical education researchers, a key concern may be the practicalities of gaining ethical approval where this is a national or local requirement. However, in qualitative studies, where the dynamics of human interaction pervade, ethical considerations are an ongoing process which continues long after approval has been granted. Responding to ethical dilemmas arising 'in the moment' requires a reflexive approach whereby the researcher questions his/her own motivations, assumptions and interests...
March 13, 2018: Perspectives on Medical Education
Sarah K Mesrobian, Alessandro E P Villa, Michel Bader, Lorenz Götte, Alessandra Lintas
Attention-deficit hyperactivity disorder (ADHD) is characterized by deficits in executive functions and decision making during childhood and adolescence. Contradictory results exist whether altered event-related potentials (ERPs) in adults are associated with the tendency of ADHD patients toward risky behavior. Clinically diagnosed ADHD patients ( n = 18) and healthy controls ( n = 18), aged between 18 and 29 (median 22 Yo), were screened with the Conners' Adult ADHD Rating Scales and assessed by the Mini-International Neuropsychiatric Interview, adult ADHD Self-Report Scale, and by the 60-item HEXACO Personality Inventory...
2018: Frontiers in Human Neuroscience
Archana Ram, Andrew W Lo
Bacteria are easily characterizable model organisms with an impressively complicated set of abilities. Among them is quorum sensing, a cell-cell signaling system that may have a common evolutionary origin with eukaryotic cell-cell signaling. The two systems are behaviorally similar, but quorum sensing in bacteria is more easily studied in depth than cell-cell signaling in eukaryotes. Because of this comparative ease of study, bacterial dynamics are also more suited to direct interpretation than eukaryotic dynamics, e...
2018: Frontiers in Computational Neuroscience
Giovanni Improta, Mario Alessandro Russo, Maria Triassi, Giuseppe Converso, Teresa Murino, Liberatina Carmela Santillo
Health technology assessments (HTAs) are often difficult to conduct because of the decisive procedures of the HTA algorithm, which are often complex and not easy to apply. Thus, their use is not always convenient or possible for the assessment of technical requests requiring a multidisciplinary approach. This paper aims to address this issue through a multi-criteria analysis focusing on the analytic hierarchy process (AHP). This methodology allows the decision maker to analyse and evaluate different alternatives and monitor their impact on different actors during the decision-making process...
March 5, 2018: Mathematical Biosciences
Christian E Vincenot
Progress in understanding and managing complex systems comprised of decision-making agents, such as cells, organisms, ecosystems or societies, is-like many scientific endeavours-limited by disciplinary boundaries. These boundaries, however, are moving and can actively be made porous or even disappear. To study this process, I advanced an original bibliometric approach based on network analysis to track and understand the development of the model-based science of agent-based complex systems (ACS). I analysed research citations between the two communities devoted to ACS research, namely agent-based (ABM) and individual-based modelling (IBM)...
March 14, 2018: Proceedings. Biological Sciences
Simon Mitchell, Koushik Roy, Thomas A Zangle, Alexander Hoffmann
Rapid antibody production in response to invading pathogens requires the dramatic expansion of pathogen-derived antigen-specific B lymphocyte populations. Whether B cell population dynamics are based on stochastic competition between competing cell fates, as in the development of competence by the bacterium Bacillus subtilis , or on deterministic cell fate decisions that execute a predictable program, as during the development of the worm Caenorhabditis elegans , remains unclear. Here, we developed long-term live-cell microscopy of B cell population expansion and multiscale mechanistic computational modeling to characterize the role of molecular noise in determining phenotype heterogeneity...
March 7, 2018: Proceedings of the National Academy of Sciences of the United States of America
Ulrik Nikolaj Ascanius Felding
Isolated fractures of the orbital floor or medial wall are often referred to as blowout fractures (BOFs). Debilitating double vision and aesthetic deformity may affect the patients' quality of life and daily living skills, for instance, working or driving a car. The management of blowout fractures is, however, challenging, since not all fractures demand surgery. Some patients may have symptoms which subside, or may never develop symptoms. Due to a lack of evidence, there are still considerable differences in opinion on the criteria for surgery...
March 2018: Danish Medical Journal
Fabrizio Bracco, Gabriele de Tonetti, Michele Masini, Marcello Passarelli, Francesca Geretto, Danilo Celleno
Human factors are the most relevant issues contributing to adverse events in obstetrics. Specific training of Crisis Resource Management (CRM) skills (i.e., problem solving and team management, resource allocation, awareness of environment, and dynamic decision-making) is now widespread and is often based on High Fidelity Simulation. In order to be used as a guideline in simulated scenarios, CRM skills need to be mapped to specific and observable behavioral markers. For this purpose, we developed a set of observable behaviors related to the main elements of CRM in the delivery room...
March 3, 2018: International Journal of Environmental Research and Public Health
Jordan F Hastings, Joanna N Skhinas, Dirk Fey, David R Croucher, Thomas R Cox
The extracellular matrix (ECM) is a salient feature of all solid tissues within the body. This complex, acellular entity is composed of hundreds of individual molecules whose assembly, architecture and biomechanical properties are critical to controlling the behaviour and phenotype of the different cells types residing within tissues. Cells are the basic unit of life and the core building block of tissues and organs. At their simplest, they follow a set of rules, governed by their genetic code, and actioned through the complex protein signalling networks that these genes encode...
March 6, 2018: British Journal of Pharmacology
Vita Machiulskiene, Joana Christina Carvalho
Classifications employed to measure dental caries should first of all reflect the dynamics of the disease, in order to provide a solid basis for subsequent treatment decisions and for further monitoring of dental health of individual patients and populations. The contemporary philosophy of dental caries management implies that nonoperative treatment of caries lesions should be implemented whenever possible, limiting operative interventions to the severe and irreversible cases. The ORCA Saturday Afternoon Symposium 2016, held back-to-back to the 63rd ORCA Congress in Athens, Greece, was intended to provide an update on general requirements for clinical caries diagnosis and to overview caries diagnostic classifications including their rationale, validation, advantages, and limitations...
March 5, 2018: Caries Research
Kan Li, Sammy Yuan, William Wang, ShuyanSabrina Wan, Paulette Ceesay, Joseph F Heyse, Shahrul Mt-Isa, Sheng Luo
Benefit-risk (BR) assessment is essential to ensure the best decisions are made for a medical product in the clinical development process, regulatory marketing authorization, post-market surveillance, and coverage and reimbursement decisions. One challenge of BR assessment in practice is that the benefit and risk profile may keep evolving while new evidence is accumulating. Regulators and the International Conference on Harmonization (ICH) recommend performing periodic benefit-risk evaluation report (PBRER) through the product's lifecycle...
March 2, 2018: Contemporary Clinical Trials
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