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The output of predictive models is routinely recalibrated by reconciling low-level predictions with known quantities defined at higher levels of aggregation. For example, models predicting vote probabilities at the individual level in U.S. elections can be adjusted so that their aggregation matches the observed vote totals in each county, thus producing better-calibrated predictions. In this research note, we provide theoretical grounding for one of the most commonly used recalibration strategies, known colloquially as the “logit shift.” Typically cast as a heuristic adjustment strategy (whereby a constant correction on the logit scale is found, such that aggregated predictions match target totals), we show that the logit shift offers a fast and accurate approximation to a principled, but computationally impractical adjustment strategy: computing the posterior prediction probabilities, conditional on the observed totals. After deriving analytical bounds on the quality of the approximation, we illustrate its accuracy using Monte Carlo simulations. We also discuss scenarios in which the logit shift is less effective at recalibrating predictions: when the target totals are defined only for highly heterogeneous populations, and when the original predictions correctly capture the mean of true individual probabilities, but fail to capture the shape of their distribution.
Three experiments (N = 550) examined the effect of an interval construction elicitation method used in several expert elicitation studies on judgment accuracy. Participants made judgments about topics that were either searchable or unsearchable online using one of two order variations of the interval construction procedure. One group of participants provided their best judgment (one step) prior to constructing an interval (i.e., lower bound, upper bound, and a confidence rating that the correct value fell in the range provided), whereas another group of participants provided their best judgment last, after the three-step confidence interval was constructed. The overall effect of this elicitation method was not significant in 8 out of 9 univariate tests. Moreover, the calibration of confidence intervals was not affected by elicitation order. The findings warrant skepticism regarding the benefit of prior confidence interval construction for improving judgment accuracy.
Individuals often assess themselves as being less susceptible to common biases compared to others. This bias blind spot (BBS) is thought to represent a metacognitive error. In this research, we tested three explanations for the effect: The cognitive sophistication hypothesis posits that individuals who display the BBS more strongly are actually less biased than others. The introspection bias hypothesis posits that the BBS occurs because people rely on introspection more when assessing themselves compared to others. The conversational processes hypothesis posits that the effect is largely a consequence of the pragmatic aspects of the experimental situation rather than true metacognitive error. In two experiments (N = 1057) examining 18 social/motivational and cognitive biases, there was strong evidence of the BBS. Among the three hypotheses examined, the conversational processes hypothesis attracted the greatest support, thus raising questions about the extent to which the BBS is a metacognitive effect.
Do people cheat more when they have something to gain, or when they have something to lose? The answer to this question isn’t straightforward, as research is mixed when it comes to understanding how unethical people will be when they might acquire something good versus avoid something bad. To wit, research has found that people cheat more in a loss (vs. gain) frame, yet research on regulatory focus has found that people cheat more in a promotion focus (where the focus is on acquiring gains) than in a prevention focus (where the focus is on avoiding losses). Through a large-scale field study containing 332,239 observations including 27,350 transgressions, we address the contradictory results of gain/loss frames and regulatory focus on committing unethical behavior in a context that contains a high risk of detecting unethical behavior (NFL football games). Our results replicated the separate effects of more cheating in a loss frame, and more cheating in a promotion focus. Furthermore, our data revealed a heretofore undocumented crossover interaction, in accordance with regulatory fit, which could disentangle past results: Specifically, we found promotion focus is associated with more cheating in a loss (vs. gain) frame, whereas prevention focus is associated with more cheating in a gain (vs. loss) frame. In gridiron football, this translates to offensive players fouling more when their team is losing (vs. winning) and defensive players fouling more when their team is winning (vs. losing).
Farm animal welfare has become an important issue for the European public, especially in the last two decades when a number of crises (eg Bovine Spongiform Encephalopathy and Avian Influenza) have affected farm animal populations. Public concern about this issue led the European Union to fund the Welfare Quality® project. This project aimed to develop a protocol for assessing animal welfare on farms and at slaughter plants, to identify the main animal welfare problems, and to address possible welfare improvement strategies. In fulfilling these aims, the Welfare Quality® project incorporated inputs from both science and society. This was crucial, as the public perception of what constitutes ‘animal welfare’ sometimes differs from animal science-based definitions. Furthermore, these differences are often interwoven with broader variations in ethical- and value-based understandings about human/non-human animal relationships. This paper presents the steps that we adopted to establish a dialogue between science and society during the construction of the Welfare Quality® assessment protocols. This dialogue involved numerous interactions between animal scientists, social scientists and members of the public. These interactions took several forms, including: meetings, conferences, workshops, websites, newsletters, interviews, focus groups, and citizen and farmers juries. Here, we address four key moments within this dialogue: the development of the initial list of twelve welfare criteria; the consumer focus groups; the development of the Welfare Quality® scoring system; and the citizen juries. In particular, we focus on the results of the focus groups and citizen juries. The focus groups were conducted in France, Italy, Sweden, The Netherlands, the United Kingdom, Norway, and Hungary and the citizen juries were carried out in Italy, the United Kingdom, and Norway. Drawing on this research, we highlight the similarities and differences between societal understandings of farm animal welfare and the views of scientific experts. Furthermore, and crucially, we outline how the animal scientists took account of societal opinion when developing their farm animal welfare assessment tools.
Paediatric studies have shown serum N-terminal pro b-type natriuretic peptide levels to be a valuable tool in the surveillance of myocardial function and an early biomarker for rejection in transplant patients. The correlation between low mean right atrial pressure and increased inferior vena cava collapsibility index is well studied in adults. Our study aims to assess correlation between non-invasive measurements (serum N-terminal pro b-type natriuretic peptide, inferior vena cava dimensions collapsibility, tricuspid regurgitation, and left ventricular remodelling index to invasive mean right atrial pressure in paediatric heart transplant patients).
Methods:
A single centre, retrospective chart review of the paediatric transplant patients from 0 to 21 years of age was performed between 2015 and 2017. Thirty-nine patients had complete data which includes cardiac catheterisation, transthoracic echocardiogram, and serum N-terminal pro b-type natriuretic peptide levels done within a two weeks of interval.
Results:
A higher inferior vena cava collapsibility index correlated with a lower mean right atrial pressure (r = −0.21, p = 0.04) and a larger inferior vena cava diameter in expiration indexed to body surface area (IVCmax/BSA0.5) correlated with a higher mean right atrial pressure (r = 0.29, p = 0.01). There was a correlation between elevated N-terminal pro b-type natriuretic peptide and inferior vena cava collapsibility index (r = −0.38, p = 0.0001), IVCmax/BSA0.5 (r = 0.25, p = 0.0002), and mean right atrial pressure (r = 0.6, p = 0.0001).
Conclusion:
Serum N-terminal pro b-type natriuretic peptide levels correlated to non-invasive measurements (inferior vena cava collapsibility index and IVCmax/BSA0.5) and to the invasive mean right atrial pressure. Non-invasive (IVC-CI IVCmax/BSA0.5) correlates with elevated mean right atrial pressure in this population. Together, these may serve as a reliable surveillance tool in assessing right heart filling pressures and cardiac function within the paediatric heart transplant patient.
Despite the adversity presented by COVID-19 pandemic, it also pushed for experimenting with innovative strategies for community engagement. The Community Research Advisory Council (C-RAC) at Johns Hopkins University (JHU), is an initiative to promote community engagement in research. COVID-19 rendered it impossible for C-RAC to conduct its meetings all of which have historically been in person. We describe the experience of advancing the work of the C-RAC during COVID-19 using digital and virtual strategies. Since March 2020, C-RAC transitioned from in person to virtual meetings. The needs assessment was conducted among C-RAC members, and individualized solutions provided for a successful virtual engagement. The usual working schedule was altered to respond to COVID-19 and promote community engaged research. Attendance to C-RAC meetings before and after the transition to virtual operation increased from 69% to 76% among C-RAC members from the community. In addition, the C-RAC launched new initiatives and in eighteen months since January 2020, it conducted 50 highly rated research reviews for 20 research teams. The experience of the C-RAC demonstrates that when community needs are assessed and addressed, and technical support is provided, digital strategies can lead to greater community collaborations.
The coronavirus disease 2019 (COVID-19) pandemic has placed significant burden on healthcare systems. We compared Clostridioides difficile infection (CDI) epidemiology before and during the pandemic across 71 hospitals participating in the Canadian Nosocomial Infection Surveillance Program. Using an interrupted time series analysis, we showed that CDI rates significantly increased during the COVID-19 pandemic.
To describe the genomic analysis and epidemiologic response related to a slow and prolonged methicillin-resistant Staphylococcus aureus (MRSA) outbreak.
Design:
Prospective observational study.
Setting:
Neonatal intensive care unit (NICU).
Methods:
We conducted an epidemiologic investigation of a NICU MRSA outbreak involving serial baby and staff screening to identify opportunities for decolonization. Whole-genome sequencing was performed on MRSA isolates.
Results:
A NICU with excellent hand hygiene compliance and longstanding minimal healthcare-associated infections experienced an MRSA outbreak involving 15 babies and 6 healthcare personnel (HCP). In total, 12 cases occurred slowly over a 1-year period (mean, 30.7 days apart) followed by 3 additional cases 7 months later. Multiple progressive infection prevention interventions were implemented, including contact precautions and cohorting of MRSA-positive babies, hand hygiene observers, enhanced environmental cleaning, screening of babies and staff, and decolonization of carriers. Only decolonization of HCP found to be persistent carriers of MRSA was successful in stopping transmission and ending the outbreak. Genomic analyses identified bidirectional transmission between babies and HCP during the outbreak.
Conclusions:
In comparison to fast outbreaks, outbreaks that are “slow and sustained” may be more common to units with strong existing infection prevention practices such that a series of breaches have to align to result in a case. We identified a slow outbreak that persisted among staff and babies and was only stopped by identifying and decolonizing persistent MRSA carriage among staff. A repeated decolonization regimen was successful in allowing previously persistent carriers to safely continue work duties.
Due to increasing sustainability demands, textiles manufacturing, an industry that uses substantial amounts of natural resources, energy and labour, are facing tough challenges in the years ahead. One of the more overlooked concepts with great potential for sustainable manufacturing is Industry 4.0. This paper addresses how the textile industry is engaging with Industry 4.0 technologies and applications in the context of sustainable manufacturing. A proposal for an implementation framework is introduced based on a literature review within this field.
Kozłowskiite, ideally Ca4(Fe2+Sn3)(Si2O7)2(Si2O6OH)2, is a new mineral isostructural with kristiansenite and silesiaite, found as a band in the core of a zoned silesiaite–kristiansenite crystal from the granitic pegmatite at Szklarska Poręba, Lower Silesia, Poland. In tiny pieces kozłowskiite is pale brownish, with a calculated density of 3.775 g⋅cm–3 and a mean refractive index ~1.727. The triclinic crystal structure was determined with space-group symmetry C1: a = 10.0183(2), b = 8.3861(1), c = 13.3395(2) Å, α = 89.956(1), β = 109.039(2), γ = 89.979(1)° and V = 1059.40(3) Å3, although, similarly to kristiansenite, it is metrically monoclinic (Laue group 2/m) with α and γ angles equal to 90° and a = 10.0170(3), b = 8.3860(2), c = 13.3421(4) Å, β = 109.050(3)° and V = 1059.40(5) Å3. The seven strongest reflections in the calculated powder X-ray diffraction pattern are [d in Å (I) hkl]: 5.190 (73.2) 111, 1$\bar{1}$1; 4.569 (30.0) $\bar{2}$02; 3.153 (64.7) 004; 3.094 (28.1) $\bar{3}$11, $\bar{3}\bar{1}$1; 3.089 (100) $\bar{2}\bar{2}$2, $\bar{2}$22; 2.595 (27.2) 2$\bar{2}$2, 222; and 2.141 (30.6) $\bar{3}$31, $\bar{3}\bar{3}$1. Electron microprobe analysis gave (in wt.%) SiO2 39.46, ZrO2 0.35, SnO2 31.13, Al2O3 0.35, Sc2O3 2.65, total Fe as Fe2O3 5.06 (= Fe2O3calc. 2.26; FeOcalc. 2.52), MnO 0.71, CaO 18.42 and H2Ocalc. 1.48, sum 99.33. The empirical formula on the basis of 26O + 2(OH) and 16 cations (Z = 2) is Ca4.00(Sn2.52Sc0.47Fe2+0.43Fe3+0.34Mn2+0.12Al0.08Zr0.03)Σ4.00(Si2.00O7)2(Si2.00O6OH)2. The crystal structure of kozłowskiite was refined to an R1 = 2.12% for 4887 reflections with Io>2σI. The Ca and Si sites are occupied solely by Ca and Si, respectively, and three of four M sites: M2, M3 and M4, are dominated by Sn. Four hydrogen atoms present in the kozłowskiite unit cell are shared among the O17–O27 and O47–O37 oxygen atoms where O17 and O47 are OH groups forming relatively strong hydrogen bonds.
A comparison of computer-extracted and facility-reported counts of hospitalized coronavirus disease 2019 (COVID-19) patients for public health reporting at 36 hospitals revealed 42% of days with matching counts between the data sources. Miscategorization of suspect cases was a primary driver of discordance. Clear reporting definitions and data validation facilitate emerging disease surveillance.
There is currently no consensus on the ideal protocol of imaging for post-treatment surveillance of head and neck squamous cell carcinoma. This study aimed to consolidate existing evidence on the diagnostic effectiveness of positron emission tomography-computed tomography versus magnetic resonance imaging.
Method
Systematic electronic searches were conducted using Medline, Embase and Cochrane Library (updated February 2021) to identify studies directly comparing positron emission tomography-computed tomography and magnetic resonance imaging scans for detecting locoregional recurrence or residual disease for post-treatment surveillance.
Results
Searches identified 3164 unique records, with three studies included for meta-analysis, comprising 176 patients. The weighted pooled estimates of sensitivity and specificity for scans performed three to six months post-curative treatment were: positron emission tomography-computed tomography, 0.68 (95 per cent confidence interval, 0.49–0.84) and 0.89 (95 per cent confidence interval, 0.84–0.93); magnetic resonance imaging, 0.72 (95 per cent confidence interval, 0.54–0.88) and 0.85 (95 per cent confidence interval, 0.79–0.89), respectively.
Conclusion
Existing studies do not provide evidence for superiority of either positron emission tomography-computed tomography or magnetic resonance imaging in detecting locoregional recurrence or residual disease following curative treatment of head and neck squamous cell carcinoma.
Healthcare workers (HCWs) are a high-priority group for coronavirus disease 2019 (COVID-19) vaccination and serve as sources for public information. In this analysis, we assessed vaccine intentions, factors associated with intentions, and change in uptake over time in HCWs.
Methods:
A prospective cohort study of COVID-19 seroprevalence was conducted with HCWs in a large healthcare system in the Chicago area. Participants completed surveys from November 25, 2020, to January 9, 2021, and from April 24 to July 12, 2021, on COVID-19 exposures, diagnosis and symptoms, demographics, and vaccination status.
Results:
Of 4,180 HCWs who responded to a survey, 77.1% indicated that they intended to get the vaccine. In this group, 23.2% had already received at least 1 dose of the vaccine, 17.4% were unsure, and 5.5% reported that they would not get the vaccine. Factors associated with intention or vaccination were being exposed to clinical procedures (vs no procedures: adjusted odds ratio [AOR], 1.39; 95% confidence interval [CI], 1.16–1.65) and having a negative serology test for COVID-19 (vs no test: AOR, 1.46; 95% CI, 1.24–1.73). Nurses (vs physicians: AOR, 0.24; 95% CI, 0.17–0.33), non-Hispanic Black (vs Asians: AOR, 0.35; 95% CI, 0.21–0.59), and women (vs men: AOR, 0.38; 95% CI, 0.30–0.50) had lower odds of intention to get vaccinated. By 6-months follow-up, >90% of those who had previously been unsure were vaccinated, whereas 59.7% of those who previously reported no intention of getting vaccinated, were vaccinated.
Conclusions:
COVID-19 vaccination in HCWs was high, but variability in vaccination intention exists. Targeted messaging coupled with vaccine mandates can support uptake.
Cardiac intensivists frequently assess patient readiness to wean off mechanical ventilation with an extubation readiness trial despite it being no more effective than clinician judgement alone. We evaluated the utility of high-frequency physiologic data and machine learning for improving the prediction of extubation failure in children with cardiovascular disease.
Methods:
This was a retrospective analysis of clinical registry data and streamed physiologic extubation readiness trial data from one paediatric cardiac ICU (12/2016-3/2018). We analysed patients’ final extubation readiness trial. Machine learning methods (classification and regression tree, Boosting, Random Forest) were performed using clinical/demographic data, physiologic data, and both datasets. Extubation failure was defined as reintubation within 48 hrs. Classifier performance was assessed on prediction accuracy and area under the receiver operating characteristic curve.
Results:
Of 178 episodes, 11.2% (N = 20) failed extubation. Using clinical/demographic data, our machine learning methods identified variables such as age, weight, height, and ventilation duration as being important in predicting extubation failure. Best classifier performance with this data was Boosting (prediction accuracy: 0.88; area under the receiver operating characteristic curve: 0.74). Using physiologic data, our machine learning methods found oxygen saturation extremes and descriptors of dynamic compliance, central venous pressure, and heart/respiratory rate to be of importance. The best classifier in this setting was Random Forest (prediction accuracy: 0.89; area under the receiver operating characteristic curve: 0.75). Combining both datasets produced classifiers highlighting the importance of physiologic variables in determining extubation failure, though predictive performance was not improved.
Conclusion:
Physiologic variables not routinely scrutinised during extubation readiness trials were identified as potential extubation failure predictors. Larger analyses are necessary to investigate whether these markers can improve clinical decision-making.
Suicidal thoughts and behaviors (STBs) are major public health concerns among adolescents, and research is needed to identify how risk is conferred over the short term (hours and days). Sleep problems may be associated with elevated risk for STBs, but less is known about this link in youth over short time periods. The current study utilized a multimodal real-time monitoring approach to examine the association between sleep problems (via daily sleep diary and actigraphy) and next-day suicidal thinking in 48 adolescents with a history of STBs during the month following discharge from acute psychiatric care. Results indicated that specific indices of sleep problems assessed via sleep diary (i.e., greater sleep onset latency, nightmares, ruminative thoughts before sleep) predicted next-day suicidal thinking. These effects were significant even when daily sadness and baseline depression were included in the models. Moreover, several associations between daily-level sleep problems and next-day suicidal thinking were moderated by person-level measures of the construct. In contrast, sleep indices assessed objectively (via actigraphy) were either not related to suicidal thinking or were related in the opposite direction from hypothesized. Together, these findings provide some support for sleep problems as a short-term risk factor for suicidal thinking in high-risk adolescents.