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https://www.readbyqxmd.com/read/28103483/dynamic-interaction-between-reinforcement-learning-and-attention-in-multidimensional-environments
#1
Yuan Chang Leong, Angela Radulescu, Reka Daniel, Vivian DeWoskin, Yael Niv
Little is known about the relationship between attention and learning during decision making. Using eye tracking and multivariate pattern analysis of fMRI data, we measured participants' dimensional attention as they performed a trial-and-error learning task in which only one of three stimulus dimensions was relevant for reward at any given time. Analysis of participants' choices revealed that attention biased both value computation during choice and value update during learning. Value signals in the ventromedial prefrontal cortex and prediction errors in the striatum were similarly biased by attention...
January 18, 2017: Neuron
https://www.readbyqxmd.com/read/28103408/functional-planning-units-for-the-management-of-an-endangered-brazilian-titi-monkey
#2
Sidney F Gouveia, João Pedro Souza-Alves, Bruno B de Souza, Raone Beltrão-Mendes, Leandro Jerusalinsky, Stephen F Ferrari
Conservation practices in the tropics often rely on the data available for a few, better-known species and the adoption of an appropriate spatial scale. By defining a set of landscape units that account for critical aspects of the focal species, the information available on these conservation targets can support regional conservation policies. Here, we define and classify adjacent landscapes, termed planning units, to orientate management decisions within and among these landscapes, which are occupied by an endangered flagship primate species (Coimbra-Filho's titi monkey, Callicebus coimbrai) from eastern Brazil...
January 19, 2017: American Journal of Primatology
https://www.readbyqxmd.com/read/28103289/cost-effectiveness-analysis-of-five-competing-strategies-for-the-management-of-multiple-recurrent-community-onset-clostridium-difficile-infection-in-france
#3
Emilie Baro, Tatiana Galperine, Fanette Denies, Damien Lannoy, Xavier Lenne, Pascal Odou, Benoit Guery, Benoit Dervaux
BACKGROUND: Clostridium difficile infection (CDI) is characterized by high rates of recurrence, resulting in substantial health care costs. The aim of this study was to analyze the cost-effectiveness of treatments for the management of second recurrence of community-onset CDI in France. METHODS: We developed a decision-analytic simulation model to compare 5 treatments for the management of second recurrence of community-onset CDI: pulsed-tapered vancomycin, fidaxomicin, fecal microbiota transplantation (FMT) via colonoscopy, FMT via duodenal infusion, and FMT via enema...
2017: PloS One
https://www.readbyqxmd.com/read/28102939/what-is-the-relationship-between-increased-access-to-haart-relationship-status-and-fertility-decisions-amongst-hiv-positive-women-a-literature-review-and-meta-analysis
#4
REVIEW
Abigail Burgess, Edward Purssell
AIMS AND OBJECTIVES: To investigate the relationship between fertility decisions, to have already had a child or to desire to have one in the future, and the prognostic factors of; access to antiretrovirals, the time since these became widely available (year of the study) and relationship status. BACKGROUND: There have been significant advances in the treatment of Human Immunodeficiency Virus (HIV) with the advent of antiretroviral therapy which has been used to successfully reduce the rate of mother to child transmission; leading researchers to hypothesise that HIV positive women may desire to have children more so now than in the past...
January 19, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28102901/risk-of-arrhythmic-death-in-ischemic-heart-disease-a-prospective-controlled-observer-blind-investigation-over-10-years
#5
Thomas Pezawas, André Diedrich, David Robertson, Robert Winker, Bernhard Richter, Li Wang, Herwig Schmidinger
BACKGROUND: Risk of arrhythmic death is considered highest in ischemic heart disease with severe left ventricular ejection fraction (LVEF) reduction. Non-invasive testing should improve decision-making of prophylactic defibrillator (ICD) implantation. METHODS AND RESULTS: We enrolled 120 patients with ischemic heart disease and LVEF <50% and 30 control subjects without ischemic heart disease and normal LVEF. An initial assessment, a second assessment after 3 years, and a final follow-up comprised of: pharmacological baroreflex testing (BRS), short-term spectral (low frequency (LF) to high frequency (HF) ratio) and long-term time domain analysis of heart rate variability (SDNN), exercise Microvolt T-wave alternans (MTWA) and others...
January 19, 2017: European Journal of Clinical Investigation
https://www.readbyqxmd.com/read/28102592/six-uneventful-pregnancy-outcomes-in-an-extended-vascular-ehlers-danlos-syndrome-family
#6
Annette F Baas, Wilko Spiering, Frans L Moll, Lieve Page-Christiaens, Ingrid C M Beenakkers, Dennis Dooijes, Evert-Jan P A Vonken, Jasper J van der Smagt, Nine V Knoers, Steven V Koenen, Joost A van Herwaarden, Gertjan Tj Sieswerda
Vascular Ehlers-Danlos Syndrome (vEDS) is caused by heterozygous mutations in COL3A1 and is characterized by fragile vasculature and hollow organs, with a high risk of catastrophic events at a young age. During pregnancy and delivery, maternal mortality rates up until 25% have been reported. However, recent pedigree analysis reported a substantial lower pregnancy-related mortality rate of 4.9%. Here, we describe an extended vEDS family with multiple uneventful pregnancy outcomes. In the proband, a 37-year-old woman, DNA-analysis because of an asymptomatic iliac artery dissection revealed a pathogenic mutation in COL3A1 (c...
February 2017: American Journal of Medical Genetics. Part A
https://www.readbyqxmd.com/read/28102433/advanced-forensic-validation-for-human-spermatozoa-identification-using-sperm-hy-liter%C3%A2-express-with-quantitative-image-analysis
#7
Ayari Takamura, Ken Watanabe, Tomoko Akutsu
Identification of human semen is indispensable for the investigation of sexual assaults. Fluorescence staining methods using commercial kits, such as the series of SPERM HY-LITER™ kits, have been useful to detect human sperm via strong fluorescence. These kits have been examined from various forensic aspects. However, because of a lack of evaluation methods, these studies did not provide objective, or quantitative, descriptions of the results nor clear criteria for the decisions reached. In addition, the variety of validations was considerably limited...
January 19, 2017: International Journal of Legal Medicine
https://www.readbyqxmd.com/read/28102020/families-experiences-of-involvement-in-care-planning-in-mental-health-services-an-integrative-literature-review
#8
REVIEW
Owen Doody, Mary Pat Butler, Rosemary Lyons, Daniel Newman
INTRODUCTION: Mental health service policy stipulates that family carers be involved in care planning. AIM: To identify families experiences of care planning involvement in adult mental health services. METHOD: An integrative review where electronic databases and grey literature were searched for papers published between 01 Jan 2005 and 10 February 2016. RESULTS: Fifteen papers met the inclusion criteria. Thematic analysis generated three themes: (1)families experience of collaboration, (2)families perceptions of professionals and (3)families impressions of the care planning process...
January 19, 2017: Journal of Psychiatric and Mental Health Nursing
https://www.readbyqxmd.com/read/28101972/an-evaluation-of-the-quality-of-evidence-available-to-inform-current-bone-conduction-hearing-device-national-policy
#9
Rishi Mandavia, Alex Carter, Nadine Haram, Elias Mossialos, Anne Gm Schilder
OBJECTIVES: In 2016 NHS England published the commissioning policy on Bone Conducting Hearing Devices (BCHDs). This policy was informed by updated evidence on the clinical and cost effectiveness of BCHDs as well as by the 2013 Bone Anchored Hearing Aid (BAHA) policy. Commissioning policies set the criteria for service delivery and therefore have a major impact on the care received by patients. It is important that stakeholders have a good appreciation of the available evidence informing policy, since this will promote engagement both with the policy as well as with future research leading on from the policy...
January 18, 2017: Clinical Otolaryngology
https://www.readbyqxmd.com/read/28101678/breast-carcinoma-subtypes-show-different-patterns-of-metastatic-behavior
#10
István Artúr Molnár, Béla Ákos Molnár, Laura Vízkeleti, Krisztina Fekete, Judit Tamás, Péter Deák, Csilla Szundi, Borbála Székely, Judit Moldvay, Stefan Vári-Kakas, Marcell A Szász, Balázs Ács, Janina Kulka, Anna-Mária Tőkés
The aim of our retrospective study was to analyze patterns of subtype specific metastatic spread and to identify the time course of distant metastases. A consecutive series of 490 patients with breast cancer who underwent surgery and postoperative treatment at Semmelweis University, Hungary, and diagnosed between the years 2000 and 2007 was identified from the archives of the 2nd Department of Pathology, Hungary. Molecular subtypes were defined based on the 2011 St. Gallen recommendations. Statistical analysis was performed with SPSS Statistics for Windows, Version 22...
January 19, 2017: Virchows Archiv: An International Journal of Pathology
https://www.readbyqxmd.com/read/28101424/detection-and-classification-of-three-class-initial-dips-from-prefrontal-cortex
#11
Amad Zafar, Keum-Shik Hong
In this paper, the use of initial dips using functional near-infrared spectroscopy (fNIRS) for brain-computer interface (BCI) is investigated. Features and window sizes for detecting initial dips are also discussed. Three mental tasks including mental arithmetic, mental counting, and puzzle solving are performed in obtaining fNIRS signals from the prefrontal cortex. Vector-based phase analysis method combined with a threshold circle, as a decision criterion, are used to detect the initial dips. Eight healthy subjects participate in experiment...
January 1, 2017: Biomedical Optics Express
https://www.readbyqxmd.com/read/28100938/public-perceptions-of-plastic-surgery-practice-in-brazil
#12
Rafael Denadai, Karin Milleni Araujo, Hugo Samartine, Rodrigo Denadai, Cassio Eduardo Raposo-Amaral
The perception of medical specialists by the public has a significant effect on health-care decisions, research funding allocation, and implantation of educational measures. The purpose of this survey was to assess the public's perception of the field of plastic surgery practice. General public members (n = 1290) completed a survey where they matched nine specialties with 28 plastic surgery-related scenarios. Response patterns were distributed as "plastic surgeon alone," "plastic surgeon combined with other specialists," or "no plastic surgeon...
December 2016: Indian Journal of Surgery
https://www.readbyqxmd.com/read/28100628/external-validation-of-the-great-score-to-predict-relapse-risk-in-graves-disease-results-from-a-multicenter-retrospective-study-with-741-patients
#13
Tristan Struja, Marina Kaeslin, Fabienne Boesiger, Rebecca Jutzi, Noemi Imahorn, Alexander Kutz, Luca Bernasconi, Esther Mundwiler, Beat Mueller, Mirjam Christ-Crain, Fabian Meienberg, Fahim Ebrahimi, Christoph Henzen, Stefan Fischli, Marius Kraenzlin, Christian Meier, Philipp Schuetz
CONTEXT: First line treatment in Graves' disease is often done with antithyroid agents (ATD) but relapse rates remain high making definite treatment necessary. Predictors for relapse risk help guiding initial treatment decisions. OBJECTIVE: We aimed to externally validate the prognostic accuracy of the recently proposed Graves' Recurrent Events After Therapy [GREAT] score to predict relapse risk in Graves` disease. DESIGN, SETTING, AND PARTICIPANTS: We retrospectively analyzed data (2004-2014) of patients with a first episode of Graves' hyperthyroidism from four Swiss endocrine outpatient clinics...
January 18, 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/28100559/what-is-involved-in-medicines-management-across-care-boundaries-a-qualitative-study-of-healthcare-practitioners-experiences-in-the-case-of-acute-kidney-injury
#14
Denham L Phipps, Rebecca L Morris, Tom Blakeman, Darren M Ashcroft
OBJECTIVES: To examine the role of individual and collective cognitive work in managing medicines for acute kidney injury (AKI), this being an example of a clinical scenario that crosses the boundaries of care organisations and specialties. DESIGN: Qualitative design, informed by a realist perspective and using semistructured interviews as the data source. The data were analysed using template analysis. SETTING: Primary, secondary and intermediate care in England...
January 18, 2017: BMJ Open
https://www.readbyqxmd.com/read/28100524/making-robust-assessments-of-specialist-trainees-workplace-performance
#15
J M Weller, D J Castanelli, Y Chen, B Jolly
BACKGROUND: Workplace-based assessments should provide a reliable measure of trainee performance, but have met with mixed success. We proposed that using an entrustability scale, where supervisors scored trainees on the level of supervision required for the case would improve the utility of compulsory mini-clinical evaluation exercise (CEX) assessments in a large anaesthesia training program. METHODS: We analysed mini-CEX scores from all Australian and New Zealand College of Anaesthetists trainees submitted to an online database over a 12-month period...
February 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28100426/ferumoxytol-mra-for-transcatheter-aortic-valve-replacement-planning-with-renal-insufficiency
#16
Kimberly Kallianos, Travis S Henry, Yerem Yeghiazarians, Jeffrey Zimmet, Kendrick A Shunk, Elaine E Tseng, Vaikom Mahadevan, Michael D Hope
BACKGROUND: Computed tomography angiography (CTA) is the test of choice for pre-procedure imaging of transcatheter aortic valve replacement (TAVR) candidates. The iodinated contrast required, however, increases the risk of renal dysfunction in patients with pre-existing renal failure. Ferumoxytol is a magnetic resonance imaging (MRI) contrast agent that can be used with renal failure. Its long vascular resonance time allows gated MRA sequences that approach CTA in image quality. We present respiratory and cardiac gated MRA enabled by ferumoxytol that can be post-processed in an analogous fashion to CTA...
December 30, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/28100231/can-screening-instruments-accurately-determine-poor-outcome-risk-in-adults-with-recent-onset-low-back-pain-a-systematic-review-and-meta-analysis
#17
Emma L Karran, James H McAuley, Adrian C Traeger, Susan L Hillier, Luzia Grabherr, Leslie N Russek, G Lorimer Moseley
BACKGROUND: Delivering efficient and effective healthcare is crucial for a condition as burdensome as low back pain (LBP). Stratified care strategies may be worthwhile, but rely on early and accurate patient screening using a valid and reliable instrument. The purpose of this study was to evaluate the performance of LBP screening instruments for determining risk of poor outcome in adults with LBP of less than 3 months duration. METHODS: Medline, Embase, CINAHL, PsycINFO, PEDro, Web of Science, SciVerse SCOPUS, and Cochrane Central Register of Controlled Trials were searched from June 2014 to March 2016...
January 19, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28099689/effectiveness-and-safety-of-procalcitonin-evaluation-for-reducing-mortality-in-adults-with-sepsis-severe-sepsis-or-septic-shock
#18
REVIEW
Brenda Ng Andriolo, Regis B Andriolo, Reinaldo Salomão, Álvaro N Atallah
BACKGROUND: Serum procalcitonin (PCT) evaluation has been proposed for early diagnosis and accurate staging and to guide decisions regarding patients with sepsis, severe sepsis and septic shock, with possible reduction in mortality. OBJECTIVES: To assess the effectiveness and safety of serum PCT evaluation for reducing mortality and duration of antimicrobial therapy in adults with sepsis, severe sepsis or septic shock. SEARCH METHODS: We searched the Central Register of Controlled Trials (CENTRAL; 2015, Issue 7); MEDLINE (1950 to July 2015); Embase (Ovid SP, 1980 to July 2015); Latin American Caribbean Health Sciences Literature (LILACS via BIREME, 1982 to July 2015); and the Cumulative Index to Nursing and Allied Health Literature (CINAHL; EBSCO host, 1982 to July 2015), and trial registers (ISRCTN registry, ClinicalTrials...
January 18, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28099684/a-multistate-population-based-analysis-of-linked-maternal-and-neonatal-discharge-records-to-identify-risk-factors-for-neonatal-brachial-plexus-injury
#19
Michael D Freeman, Shaun M Goodyear, Wendy M Leith
OBJECTIVE: To evaluate the interaction and contribution of maternal and fetal risk factors associated with neonatal brachial plexus injury (BPI). METHODS: In a case-control study, matched maternal and neonatal discharge records were accessed from US State Inpatient Databases for New Jersey (2010-2012), Michigan (2010-2011), and Hawaii (2010-2011). Univariate and multivariate logistic regressions were used to evaluate associations between risk factors and BPI. Area under the receiver operating characteristic curve was used to build predictive models, including two stratified models evaluating deliveries among obese and diabetic cohorts...
November 14, 2016: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28099378/acs-level-i-trauma-centers-outcomes-do-not-correlate-with-patients-perception-of-hospital-experience
#20
Bellal Joseph, Asad Azim, Terence O'Keeffe, Kareem Ibraheem, Narong Kulvatunyou, Andrew Tang, Gary Vercruysse, Randall Friese, Rifat Latifi, Peter Rhee
INTRODUCTION: The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey is a data collection methodology for measuring a patient's perception of his/her hospital experience, and it has been selected by the Centers of Medicare and Medicaid Services (CMS) as the validated and transparent national survey tool with publicly available results. Since 2012, hospital reimbursements rates have been linked to HCAHPS data based on patient satisfaction scores. The aim of this study was, therefore, to assess whether HCAHPS scores of Level-1 trauma centers correlate with actual hospital performance...
January 17, 2017: Journal of Trauma and Acute Care Surgery
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