Concept: Multistage rocket
- Proceedings of the National Academy of Sciences of the United States of America
- Published about 4 years ago
We test the conjecture that becoming unemployed erodes the extent to which a person acknowledges earned entitlement. We use behavioral experiments to generate incentive-compatible measures of individuals' tendencies to acknowledge earned entitlement and incorporate these experiments in a two-stage study. In the first stage, participants' acknowledgment of earned entitlement was measured by engaging them in the behavioral experiments, and their individual employment status and other relevant socioeconomic characteristics were recorded. In the second stage, a year later, the process was repeated using the same instruments. The combination of the experimentally generated data and the longitudinal design allows us to investigate our conjecture using a difference-in-difference approach, while ruling out the pure self-interest confound. We report evidence consistent with a large, negative effect of becoming unemployed on the acknowledgment of earned entitlement.
Multi-staged repair of contaminated primary and recurrent giant incisional herniae in the same hospital admission: a proposal for a new approach
- Hernia : the journal of hernias and abdominal wall surgery
- Published over 7 years ago
BACKGROUND: Repair of primary and recurrent giant incisional herniae is extremely challenging and more so in the face of surgical field contamination. Literature supports the single- and multi-staged approaches including the use of biological meshes for these difficult patients with their associated benefits and limitations. PATIENTS AND METHODS: This is a retrospective analysis of a prospective study of five patients who were successfully treated through a multi-staged approach but in the same hospital admission, not previously described, for the repair of contaminated primary and recurrent giant incisional herniae in a district general hospital between 2009 and 2012. Patient demographics including their BMI and ASA, previous and current operative history including complications and follow-up were collected in a secure database. The first stage involved the eradication of contamination, and the second stage was the definitive hernia repair with the new generation-coated synthetic meshes. RESULTS: Of the five patients, three were men and two women with a mean age of 58 (45-74) years. Two patients had grade 4 while the remaining had grade 3 hernia as per the hernia grading system with a mean BMI of 35 (30-46). All patients required extensive adhesiolysis, bowel resection and anastomoses and wash out. Hernial defect was measured as 204* (105-440) cm(2), size of mesh implant was 568* (375-930) cm(2) and the total duration of operation (1st + 2nd Stage) was 354* (270-540) min. Duration of hospital stay was 11* (7-19) days with a follow-up of 17* (6-36) months. CONCLUSION: We believe that our multi-staged approach in the same hospital admission (for the repair of contaminated primary and recurrent giant incisional herniae), excludes the disadvantages of a true multi-staged approach and simultaneously minimises the risks and complications associated with a single-staged repair, can be adopted for these challenging patients for a successful outcome (* indicates mean).
BACKGROUND: /st>Our aim was to estimate the ED(95) of prilocaine 1% w/v for femoral nerve block. METHODS: /st>This two-stage dose-finding sequential clinical trial followed an adaptive design based on the continual reassessment method (CRM). Adult patients undergoing Vastus medialis muscle biopsy under ultrasound-guided femoral nerve block were recruited. Data from previously published studies and our own previous experience were used to set the dose levels and their guesstimate probabilities of response. RESULTS: /st>Forty patients were recruited in the trial (n=26 in the first stage and n=14 in the second stage). Using the CRM, the estimated response probabilities with 13 and 17 ml prilocaine 1% w/v were 90.4% (95% credibility interval: 68-98%) and 99.1% (95% credibility interval: 89-100%), respectively. CONCLUSION: /st>Our study demonstrates that the dose closest to the ED(95) of prilocaine 1% w/v for ultrasound-guided femoral nerve block is 17 ml. The study also illustrates the value of CRM in dose-finding experiments.
Characterization of hematomas is essential in scan reading, manual delineation, and designing automatic segmentation algorithms. Our purpose is to characterize the distribution of intraventricular (IVH) and intracerebral hematomas (ICH) in NCCT scans, study their relationship to gray matter (GM), and to introduce a new tool for quantitative hematoma delineation. We used 289 serial retrospective scans of 51 patients. Hematomas were manually delineated in a two-stage process. Hematoma contours generated in the first stage were quantified and enhanced in the second stage. Delineation was based on new quantitative rules and hematoma profiling, and assisted by a dedicated tool superimposing quantitative information on scans with 3D hematoma display. The tool provides: density maps (40-85HU), contrast maps (8/15HU), mean horizontal/vertical contrasts for hematoma contours, and hematoma contours below a specified mean contrast (8HU). White matter (WM) and GM were segmented automatically. IVH/ICH on serial NCCT is characterized by 59.0HU mean, 60.0HU median, 11.6HU standard deviation, 23.9HU mean contrast, -0.99HU/day slope, and -0.24 skewness (changing over time from negative to positive). Its 0.1(st)-99.9(th) percentile range corresponds to 25-88HU range. WM and GM are highly correlated (R (2)=0.88; p<10(-10)) whereas the GM-GS correlation is weak (R (2)=0.14; p<10(-10)). The intersection point of mean GM-hematoma density distributions is at 55.6±5.8HU with the corresponding GM/hematoma percentiles of 88(th)/40(th). Objective characterization of IVH/ICH and stating the rules quantitatively will aid raters to delineate hematomas more robustly and facilitate designing algorithms for automatic hematoma segmentation. Our two-stage process is general and potentially applicable to delineate other pathologies on various modalities more robustly and quantitatively.
As the enterprise of the “Internet of Things” is rapidly gaining widespread acceptance, sensors are being deployed in an unrestrained manner around the world to make efficient use of this new technological evolution. A recent survey has shown that sensor deployments over the past decade have increased significantly and has predicted an upsurge in the future growth rate. In health-care services, for instance, sensors are used as a key technology to enable Internet of Things oriented health-care monitoring systems. In this paper, we have proposed a two-stage fundamental approach to facilitate the implementation of such a system. In the first stage, sensors promptly gather together the particle measurements of an android application. Then, in the second stage, the collected data are sent over a Femto-LTE network following a new scheduling technique. The proposed scheduling strategy is used to send the data according to the application’s priority. The efficiency of the proposed technique is demonstrated by comparing it with that of well-known algorithms, namely, proportional fairness and exponential proportional fairness.
Language-processing functions follow heterogeneous developmental trajectories. The human embryo can already distinguish vowels in utero, but grammatical complexity is usually not fully mastered until at least 7 years of age. Examining the current literature, we propose that the ontogeny of the cortical language network can be roughly subdivided into two main developmental stages. In the first stage extending over the first 3 years of life, the infant rapidly acquires bottom-up processing capacities, which are primarily implemented bilaterally in the temporal cortices. In the second stage continuing into adolescence, top-down processes emerge gradually with the increasing functional selectivity and structural connectivity of the left inferior frontal cortex.
People with higher IQ scores also tend to perform better on elementary cognitive-perceptual tasks, such as deciding quickly whether an arrow points to the left or the right Jensen (2006). The worst performance rule (WPR) finesses this relation by stating that the association between IQ and elementary-task performance is most pronounced when this performance is summarized by people’s slowest responses. Previous research has shown that the WPR can be accounted for in the Ratcliff diffusion model by assuming that the same ability parameter-drift rate-mediates performance in both elementary tasks and higher-level cognitive tasks. Here we aim to test four qualitative predictions concerning the WPR and its diffusion model explanation in terms of drift rate. In the first stage, the diffusion model was fit to data from 916 participants completing a perceptual two-choice task; crucially, the fitting happened after randomly shuffling the key variable, i.e., each participant’s score on a working memory capacity test. In the second stage, after all modeling decisions were made, the key variable was unshuffled and the adequacy of the predictions was evaluated by means of confirmatory Bayesian hypothesis tests. By temporarily withholding the mapping of the key predictor, we retain flexibility for proper modeling of the data (e.g., outlier exclusion) while preventing biases from unduly influencing the results. Our results provide evidence against the WPR and suggest that it may be less robust and less ubiquitous than is commonly believed.
The search for indisputable traces of life in Archean cherts is of prime importance. However, their great age and metamorphic history pose constraints on the study of molecular biomarkers. We propose a quantitative criterion to document the thermal maturity of organic matter in rocks in general, and Archean rocks in particular. This is definitively required to select the best candidates for seeking non-altered sample remnants of life. Analysis of chemical (Raman spectroscopy, (13)C NMR, elemental analysis) and structural (HRTEM) features of Archean and non-Archean carbonaceous matter (CM) that was submitted to metamorphic grades lower than, or equal to, that of greenschist facies showed that these features had all undergone carbonization but not graphitization. Raman-derived quantitative parameters from the present study and from literature spectra, namely, R1 ratio and FWHM-D1, were used to draw a carbonization continuum diagram showing two carbonization stages. While non-Archean samples can be seen to dominate the first stage, the second stage mostly consists of the Archean samples. In this diagram, some Archean samples fall at the boundary with non-Archean samples, which thus demonstrates a low degree of carbonization when compared to most Archean CM. As a result, these samples constitute candidates that may contain preserved molecular signatures of Archean CM. Therefore, with regard to the search for the oldest molecular traces of life on Earth, we propose the use of this carbonization continuum diagram to select the Archean CM samples. Key Words: Archean-Early life-Kerogen-Raman spectroscopy-Carbonization. Astrobiology 16, xxx-xxx.
BEHAVIORAL EVIDENCE SUGGESTS THAT INSTRUMENTAL CONDITIONING IS GOVERNED BY TWO FORMS OF ACTION CONTROL: a goal-directed and a habit learning process. Model-based reinforcement learning (RL) has been argued to underlie the goal-directed process; however, the way in which it interacts with habits and the structure of the habitual process has remained unclear. According to a flat architecture, the habitual process corresponds to model-free RL, and its interaction with the goal-directed process is coordinated by an external arbitration mechanism. Alternatively, the interaction between these systems has recently been argued to be hierarchical, such that the formation of action sequences underlies habit learning and a goal-directed process selects between goal-directed actions and habitual sequences of actions to reach the goal. Here we used a two-stage decision-making task to test predictions from these accounts. The hierarchical account predicts that, because they are tied to each other as an action sequence, selecting a habitual action in the first stage will be followed by a habitual action in the second stage, whereas the flat account predicts that the statuses of the first and second stage actions are independent of each other. We found, based on subjects' choices and reaction times, that human subjects combined single actions to build action sequences and that the formation of such action sequences was sufficient to explain habitual actions. Furthermore, based on Bayesian model comparison, a family of hierarchical RL models, assuming a hierarchical interaction between habit and goal-directed processes, provided a better fit of the subjects' behavior than a family of flat models. Although these findings do not rule out all possible model-free accounts of instrumental conditioning, they do show such accounts are not necessary to explain habitual actions and provide a new basis for understanding how goal-directed and habitual action control interact.
We present a two-stage variational approach for segmenting 3D bone CT data that performs robustly with respect to thin cartilage interfaces. In the first stage, we minimize a flux-augmented Chan-Vese model that accurately segments well-separated regions. In the second stage, we apply a new phase-field fracture inspired model that reliably eliminates spurious bridges across thin cartilage interfaces, resulting in an accurate segmentation topology, from which each bone object can be identified. Its mathematical formulation is based on the phase-field approach to variational fracture, which naturally blends with the variational approach to segmentation. We successfully test and validate our methodology for the segmentation of 3D femur and vertebra bones, which feature thin cartilage regions in the hip joint, the intervertebral disks, and synovial joints of the spinous processes. The major strength of the new methodology is its potential for full automation and seamless integration with downstream predictive bone simulation in a common finite element framework.