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“Harlequin effect” may be observed in the watershed region of a patient with pulmonary dysfunction, receiving peripheral veno-arterial extracorporeal membrane oxygenation via the femoral vessels. In such cases, retrograde oxygenated blood from the peripheral inflow cannula converges with the antegrade deoxygenated blood ejected from the left ventricle. This occurs when the left ventricle is ejecting significantly but the recovery of pulmonary function lags behind. Herein, we describe the occurrence of “Harlequin effect” in the setting of central veno-arterial extracorporeal membrane oxygenation that ensues due to the persistence of right ventricular dysfunction in the presence of an interatrial communication. This results in right to left shunting at the atrial level while weaning the patient from extracorporeal life support.
Cardiac myxoma is a relatively rare tumour, usually solitary, that occurs primarily in the left atrium of adults, but comprises only 30% of cardiac tumours in children. We recently treated a 12-year-old girl with multiple recurrent myxomas in three cardiac chambers(following surgical resection 3 years earlier). Genomic analysis showed the PKAR1A mutation typical for Carney complex
In many situations of indeterminacy, where people agree that no decisive arguments favor one alternative to another, they are still strongly opposed to resolving the dilemma by a coin toss. The robustness of this judgment-decision discrepancy is demonstrated in several experiments, where factors like the importance of consequences, similarity of alternatives, conflicts of opinion, outcome certainty, type of randomizer, and fairness considerations are systematically explored. Coin toss is particularly inappropriate in cases of life and death, even when participants agree that the protagonists should have the same chance of being saved. Using a randomizer may seem to conflict with traditional ideas about argument-based rationality and personal responsibility of the decision maker. Moreover, a concrete randomizer like a coin appears more repulsive than the abstract principle of using a random device. Concrete randomizers may, however, be admissible to counteract potential partiality. Implications of the aversion to use randomizers, even under circumstances in which there are compelling reasons to do so, are briefly discussed.
The pursuit of unhealthy behaviors, such as smoking or binge drinking, not only carries various downside risks, but also provides pleasure. A parsimonious model, used in the literature to explain the decision to pursue an unhealthy activity, represents that decision as a tradeoff between risks and benefits. We build on this literature by surveying a rural population in South Africa to elicit the perceived riskiness and the perceived pleasure for various risky activities and to examine how these perceptions relate to the pursuit of four specific unhealthy behaviors: frequent smoking, problem drinking, seatbelt nonuse, and risky sex. We show that perceived pleasure is a significant predictor for three of the behaviors and that perceived riskiness is a significant predictor for two of them. We also show that the correlation between the riskiness rating and behavior is significantly different from the correlation between the pleasure rating and behavior for three of the four behaviors. Finally, we show that the effect of pleasure is significantly greater than the effect of riskiness in determining drinking and risky sex, while the effects of pleasure and riskiness are not different from each other in determining smoking and seatbelt nonuse. We discuss how our findings can be used to inform the design of health promotion strategies.
Predictions of magnitudes (costs, durations, environmental events) are often given as uncertainty intervals (ranges). When are such forecasts judged to be correct? We report results of four experiments showing that forecasted ranges of expected natural events (floods and volcanic eruptions) are perceived as accurate when an observed magnitude falls inside or at the boundary of the range, with little regard to its position relative to the “most likely” (central) estimate. All outcomes that fell inside a wide interval were perceived as equally well captured by the forecast, whereas identical outcomes falling outside a narrow range were deemed to be incorrectly predicted, in proportion to the magnitude of deviation. In these studies, ranges function as categories, with boundaries distinguishing between right or wrong predictions, even for outcome distributions that are acknowledged as continuous, and for boundaries that are arbitrarily defined (for instance, when the narrow prediction interval is defined as capturing 50 percent and the wide 90 percent of all potential outcomes). However, the boundary effect is affected by label. When the upper limit of a range is described as a value that “can” occur (Experiment 5), outcomes both below and beyond this value were regarded as consistent with the forecast.
We show how to elicit the beliefs of an expert in the form of a “most likely interval”, a set of future outcomes that are deemed more likely than any other outcome. Our method, called the Most Likely Interval elicitation rule (MLI), asks the expert for an interval and pays according to how well the answer compares to the actual outcome. We show that the MLI performs well in economic experiments, and satisfies a number of desirable theoretical properties such as robustness to the risk preferences of the expert.
In most previous studies of verbal probabilities, participants are asked to translate expressions such as possible and not certain into numeric probability values. This probabilistic translation approach can be contrasted with a novel which-outcome (WO) approach that focuses on the outcomes that people naturally associate with probability terms. The WO approach has revealed that, when given bell-shaped distributions of quantitative outcomes, people tend to associate certainty with minimum (unlikely) outcome magnitudes and possibility with (unlikely) maximal ones. The purpose of the present paper is to test the factors that foster these effects and the conditions in which they apply. Experiment 1 showed that the association of probability term and outcome was related to the association of scalar modifiers (i.e., it is certain that the battery will last at least…, it is possible that the battery will last up to…). Further, we tested whether this pattern was dependent on the frequency (e.g., increasing vs. decreasing distribution) or the nature of the outcomes presented (i.e., categorical vs. continuous). Results showed that despite being slightly affected by the shape of the distribution, participants continue to prefer to associate possible with maximum outcomes and certain with minimum outcomes. The final experiment provided a boundary condition to the effect, showing that it applies to verbal but not numerical probabilities.
We compare four different risk-taking propensity measures on their ability to describe and to predict actual risky behavior in the domain of health. The risk-taking propensity measures we compare are: (1) a general measure of risk-taking propensity derived from a one-item survey question (Dohmen et al., 2011), (2) a risk aversion index calculated from a set of incentivized monetary gambles (Holt & Laury, 2002), (3) a measure of risk taking derived from an incentive compatible behavioral task—the Balloon Analog Risk Task (Lejuez et al., 2002), and (4) a composite score of risk-taking likelihood in the health domain from the Domain-Specific Risk Taking (DOSPERT) scale (Weber et al., 2002). Study participants are 351 clients of health centers around Witbank, South Africa. Our findings suggest that the one-item general measure is the best predictor of risky health behavior in our population, predicting two out of four behaviors at the 5% level and the remaining two behaviors at the 10% level. The DOSPERT score in the health domain performs well, predicting one out of four behaviors at the 1% significance level and two out of four behaviors at the 10% level, but only if the DOSPERT instrument contains a hypothetical risk-taking item that is similar to the actual risky behavior being predicted. Incentivized monetary gambles and the behavioral task were unrelated to actual health behaviors; they were unable to predict any of the risky health behaviors at the 10% level. We provide evidence that this is not because the participants had trouble understanding the monetary trade-off questions or performed poorly in the behavioral task. We conclude by urging researchers to further test the usefulness of the one-item general measure, both in explaining health related risk-taking behavior and in other contexts.
The purpose of this article is to investigate emerging areas of precarious employment in Sweden. Based on the literature on dimensions of precariousness and neoliberalism, this article will begin with an analysis of the transitioning Swedish welfare state and the contextual environment of precarious employment in Sweden. This will serve as a point of departure for the development of an occupational classification scheme including measures of income and employment security. In an empirical analysis, the occupational classification will be applied to a population-based register material including two birth cohorts of employed Swedish residents aged 28–33, with a registered income. The development of income and employment security will be described and discussed. By applying this newly developed measure of precarious employment, this article will provide a platform for future theoretical and empirical research on precarious employment in a transitioning welfare state.
We report two studies on the perceived responsibility of opponents competing for a goal that can be attained by only one of them. Responsibility judgments were collected in seven samples of lay people and experts before, during, and after the World Chess Championship in 2013. Participants assessed the responsibility of the two players, their supporting teams, local conditions, and chance factors for four hypothetical outcomes (large and small loss/win for each player), along with probabilities for these outcomes, demonstrating subadditivity (sums exceeding 100%) in all samples, even among chess experts. The winner was consistently perceived to be more responsible than the loser, and more for outcomes with large than small margins. There was also an effect of focal player, as Carlsen was given more responsibility both for losses and wins than Anand, by the present (Norwegian) pro-Carlsen samples. However, this effect could be modified by describing the outcomes as Anand’s (rather than Carlsen’s) wins and losses. Thus the study adds to the valence framing literature by showing how responsibility judgments are affected by the way outcomes are framed.
In this paper, changes in Norwegian bargaining and participation since the end of the eighties are discussed in a twenty year perspective. It is argued that a corporatist bargaining structure has been reinstated as a pragmatic measure to handle a difficult economic situation. This is contrary to the general political sentiments which have prevailed since the beginning of the eighties. However, a new constellation of actors are emerging on the organisational level who may irreversibly change the bargaining structure. With regard to participation, the laws and institutions that were introduced during the 1970s are still in place. However, their content is changing from democratisation as a value by itself to a focus on productivity-improvement as the ultimate goal.
People often make predictions about the future based on trends they have observed in the past. Revised probabilistic forecasts can be perceived by the public as indicative of such a trend. In five studies, we describe experts who make probabilistic forecasts of various natural events (effects of climate changes, landslide and earthquake risks) at two points in time. Prognoses that have been upgraded or downgraded from T1 to T2 were in all studies expected to be updated further, in the same direction, later on (at T3). Thus, two prognoses were in these studies enough to define a trend, forming the basis for future projections. This “trend effect” implies that non-experts interpret recent forecast in light of what the expert said in the past, and think, for instance, that a “moderate” landslide risk will cause more worry if it has previously been low than if it has been high. By transcending the experts’ most recent forecasts the receivers are far from conservative, and appear to know more about the experts’ next prognoses than the experts themselves.
Systematic reviews (SRs) are central to evaluating therapies but have high costs in time and money. Many software tools exist to assist with SRs, but most tools do not support the full process, and transparency and replicability of SR depends on performing and presenting evidence according to established best practices. In order to provide a basis for comparing between software tools that support SR, we performed a feature-by-feature comparison of SR tools.
Methods
We searched for SR tools by reviewing any such tool listed the Systematic Review Toolbox, previous reviews of SR tools, and qualitative Google searching. We included all SR tools that were currently functional, and required no coding and excluded reference managers, desktop applications, and statistical software. The list of features to assess was populated by combining all features assessed in four previous reviews of SR tools; we also added five features (manual addition, screening automation, dual extraction, living review, and public outputs) that were independently noted as best practices or enhancements of transparency/replicability. Then, two reviewers assigned binary ‘present/absent’ assessments to all SR tools with respect to all features, and a third reviewer adjudicated all disagreements.
Results
Of 53 SR tools found, 29 were excluded, leaving 24 for assessment. Thirty features were assessed across six classes, and the inter-observer agreement was 86 percent. DistillerSR (Evidence Partners; n = 26/30, 87%), Nested Knowledge (Nested Knowledge; n = 25/30, 83%), and EPPI-Reviewer Web (EPPI-Centre; n = 24/30, 80%) support the most features followed by Giotto Compliance (Giotto Compliance; n = 23/30, 77%), LitStream (ICF; n = 22/30, 73%), and SRDB.PRO (VTS Software; n = 21/30, 70%). Seven tools support fewer than half of all features assessed: RobotAnalyst, SyRF, Data Abstraction Assistant, SWIFT-Review, SR-Accelerator, RobotReviewer, and COVID-NMA. Notably, only 10 tools (42%) support direct search, 7 (29%) offer dual extraction, and 13 (54%) offer living/updatable reviews.
Conclusions
DistillerSR, EPPI-Reviewer Web, and Nested Knowledge each offer a high density of SR-focused web-based tools. By transparent comparison and discussion regarding SR tool functionality, the medical community can choose among existing software offerings and note the areas of growth needed, most notably in the support of living reviews.
We have demonstrated the effect of covering an N95 filtering facepiece respirator (FFR) with an overlying face mask. In total, 100 participants successfully completed quantitative fit testing wearing a 3M 1870+ FFR. Among them, 13 (13%; 95% CI, 7%–22%) failed subsequent fit testing when simultaneously wearing a Halyard 47117 procedural mask over the FFR.
It is a well-established fact, from decades of research on political socialization, that the children of politically active parents are more likely to become politically active themselves. This poses a challenge for democracy, as it means that inequalities in political influence are reproduced across generations. The present study argues that this problem may be more severe than has hitherto been acknowledged. The reason for this is that previous research on the topic has focused almost exclusively on political transmission between parents and their children, whereas the role played by more distant forebears, such as grandparents, has been largely neglected. In this study, we use Swedish register data to analyze multigenerational associations in electoral participation. The empirical results clearly indicate that the traditional two-generation approach to the study of political transmission tends to underestimate intergenerational persistence in voting behavior and that this excess persistence has both genetic and social roots.
Modern approaches for exploration path planning generally do not assume any structural information regarding the operational area. Therefore, they offer good performance when the region of interest is entirely unknown. However, for some applications such as plantation forest surveying, partial information regarding the survey area is known before the exploration process. Because the region of interest consists only of the lower portions of the tree stems themselves, the ground and high-elevation sections of the environment are unimportant and do not need to be observed. Due to these unconventional conditions, existing methods favoring faster survey speeds produce suboptimal surveys as they do not try and ensure even coverage across the entire exploration volume, while methods that favor reconstruction accuracy produce excessively long survey times. This work proposes a structured exploration approach specifically for plantation forests utilizing a lawnmowing pattern to maximize coverage while minimizing re-visited regions, guiding the unmanned aerial vehicle to visit all areas. Experiments are conducted in various environments, with comparisons made to state-of-the-art exploration planners regarding survey time and coverage. Results suggest that the proposed methods produce surveys with significantly more predictable coverage and survey times at the expense of a longer survey.
Renicolid digeneans parasitize aquatic birds. Their intramolluscan stages develop in marine and brackish-water gastropods, while metacercariae develop in molluscs and fishes. The systematics of renicolids is poorly developed, their life cycles are mostly unknown, and the statuses of many species require revision. Here, we establish based on integrated morphological and molecular data that adult renicolids from gulls Larus argentatus and Larus schistisagus and sporocysts and cercariae of Cercaria parvicaudata from marine snails Littorina spp. are life-cycle stages of the same species. We name it Renicola parvicaudatus and synonymized with it Renicola roscovitus. An analysis of the cox1 gene of R. parvicaudatus from Europe, North America and North Asia demonstrates a low genetic divergence, suggesting that this species has formed quite recently (perhaps during last glacial maximum) and that interregional gene flow is high. In Littorina saxatilis and L. obtusata from the Barents Sea, molecular analysis has revealed intramolluscan stages of Cercaria littorinae saxatilis VIII, a cryptic species relative to R. parvicaudatus. In the molecular trees, Renicola keimahuri from L. schistisagus belongs to another clade than R. parvicaudatus. We show that the species of this clade have cercariae of Rhodometopa group and outline morphological and behavioural transformations leading from xiphidiocercariae to these larvae. Molecular analysis has revealed 3 main phylogenetic branches of renicolids, differing in structure of adults, type of cercariae and host range. Our results elucidate the patterns of host colonization and geographical expansion of renicolids and pave the way to the solution of some long-standing problems of their classification.