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PloS One 2024Cognitive rehabilitation, STEM (science, technology, engineering, and math) skill acquisition, and coaching games such as chess often require tutoring decision-making...
Cognitive rehabilitation, STEM (science, technology, engineering, and math) skill acquisition, and coaching games such as chess often require tutoring decision-making strategies. The advancement of AI-driven tutoring systems for facilitating human learning requires an understanding of the impact of evaluative feedback on human decision-making and skill development. To this end, we conduct human experiments using Amazon Mechanical Turk to study the influence of evaluative feedback on human decision-making in sequential tasks. In these experiments, participants solve the Tower of Hanoi puzzle and receive AI-generated feedback while solving it. We examine how this feedback affects their learning and skill transfer to related tasks. Additionally, treating humans as noisy optimal agents, we employ maximum entropy inverse reinforcement learning to analyze the effect of feedback on the implicit human reward structure that guides their decision making. Lastly, we explore various computational models to understand how people incorporate evaluative feedback into their decision-making processes. Our findings underscore that humans perceive evaluative feedback as indicative of their long-term strategic success, thus aiding in skill acquisition and transfer in sequential decision-making tasks. Moreover, we demonstrate that evaluative feedback fosters a more structured and organized learning experience compared to learning without feedback. Furthermore, our results indicate that providing intermediate goals alone does not significantly enhance human learning outcomes.
Topics: Humans; Decision Making; Learning; Male; Female; Adult; Young Adult; Artificial Intelligence; Reinforcement, Psychology
PubMed: 38805441
DOI: 10.1371/journal.pone.0303949 -
Pediatric Reports Apr 2024Assisted reproductive technology (ART) is an emerging field in medicine that incorporates complex procedures and has profound ethical, moral, social, religious, and... (Review)
Review
Assisted reproductive technology (ART) is an emerging field in medicine that incorporates complex procedures and has profound ethical, moral, social, religious, and economic implications not just for the individuals who have access to this method but also for society. In this narrative review, we summarise multiple aspects of ART procedures and the possible consequences on the mother and newborn. Moreover, we provide an overview of the possible long-term consequences of ART procedures on the health of newborns, although longitudinal evidence is particularly scant. Users should be informed that ART procedures are not risk-free to prepare them for the possible negative outcomes that may occur in the perinatal period or even in childhood and adulthood. Indeed, risk estimates point to increased liability for major nonchromosomal birth defects; cardiovascular, musculoskeletal, and urogenital (in male newborns) defects; and any other birth defects. Less certainty is present for the risk of neuropsychiatric sequelae in children conceived through ART. Thus, its application should be accompanied by adequate counselling and psychological support, possibly integrated into specific multidisciplinary clinical programmes.
PubMed: 38804372
DOI: 10.3390/pediatric16020029 -
Toxics Apr 2024This study investigated lead (Pb) and cadmium (Cd) transfer in three dairy farming areas in the Mantaro river headwaters in the central Peruvian Andes and at varying...
This study investigated lead (Pb) and cadmium (Cd) transfer in three dairy farming areas in the Mantaro river headwaters in the central Peruvian Andes and at varying distances from the mining complex at La Oroya. At each of these sites, the transfer of trace metals from the soil to raw milk was estimated, and a hazard assessment for lead and cadmium was carried out in scenarios of minimum, average, and maximum milk consumption in a Peruvian population aged 2-85. Pb and Cd were quantified by flame atomic absorption spectrometry. Significantly, the concentrations of lead and cadmium were found to exceed the maximum limits recommended by the World Health Organization, with a positive geospatial trend correlated with the distance from mining activity. Both Pb and Cd were found to be transferred through the soil-pasture-milk pathway, with the primary source of Cd being phosphate-based fertilizers used in pasture improvement. Pb was found to be the most significant contributor to the Hazard Index (HI) with those under 19 years of age and over 60 recording an HI of >1, with infants being the most vulnerable group due to their greater milk consumption in relation to their body weight. A marginal increase in contamination was observed in the dry season, indicating the need for studies to be expanded over several annual cycles.
PubMed: 38787087
DOI: 10.3390/toxics12050308 -
BMJ Open Quality May 2024In healthcare teams, psychological safety is associated with improved performance, communication, collaboration and patient safety. Extracorporeal membrane oxygenation...
INTRODUCTION
In healthcare teams, psychological safety is associated with improved performance, communication, collaboration and patient safety. Extracorporeal membrane oxygenation (ECMO) retrieval teams are multidisciplinary teams that initiate ECMO therapy for patients with severe acute respiratory failure in referring hospitals and transfer patients to regional specialised centres for ongoing care. The present study aimed to explore an ECMO team's experience of psychological safety and generate recommendations to strengthen psychological safety.
METHODS
The study was conducted in the Royal Brompton Hospital (RBH), part of Guy's and St Thomas' NHS Foundation Trust in London. RBH is one of six centres commissioned to provide ECMO therapy in the UK. 10 participants were recruited: 2 consultants, 5 nurses and 3 perfusionists. Semistructured interviews were used to explore the team members' views on teamwork, their perceived ability to discuss concerns within the team and the interaction between speaking up, teamwork and hierarchy. A Reflexive Thematic Analysis approach was used to explore the interview data.
RESULTS
The analysis of the interview dataset identified structural and team factors shaping psychological safety in the specific context of the ECMO team. The high-risk environment in which the team operates, the clearly defined process and functions and the structured opportunities that provide legitimate moments to reflect together influence how psychological safety is experienced. Furthermore, speaking up is shaped by the familiarity among team members, the interdependent work, which requires boundary spanning across different roles, and leadership behaviour. A hierarchy of expertise is privileged over traditional institutional ranking.
CONCLUSION
This study surfaced the structural and team factors that influence speaking up in the specific context of an ECMO retrieval team. Such information is used to suggest interventions to improve and strengthen psychological safety.
Topics: Humans; Extracorporeal Membrane Oxygenation; Qualitative Research; Patient Care Team; Patient Safety; London; Interviews as Topic; Quality Improvement; Female; Male; Psychological Safety
PubMed: 38782489
DOI: 10.1136/bmjoq-2023-002706 -
Trials May 2024Acquired brain injury (ABI) often leads to persisting somatic, cognitive, and social impairments. Cognitive impairments of processing speed, sustained attention, and...
Virtual reality as a method of cognitive training of processing speed, working memory, and sustained attention in persons with acquired brain injury: a protocol for a randomized controlled trial.
BACKGROUND
Acquired brain injury (ABI) often leads to persisting somatic, cognitive, and social impairments. Cognitive impairments of processing speed, sustained attention, and working memory are frequently reported and may negatively affect activities of daily living and quality of life. Rehabilitation efforts aiming to retrain these cognitive functions have often consisted of computerized training programs. However, few studies have demonstrated effects that transfer beyond the trained tasks. There is a growing optimism regarding the potential usefulness of virtual reality (VR) in cognitive rehabilitation. The research literature is sparse, and existing studies are characterized by considerable methodological weaknesses. There is also a lack of knowledge about the acceptance and tolerability of VR as an intervention method for people with ABI. The present study aims to investigate whether playing a commercially available VR game is effective in training cognitive functions after ABI and to explore if the possible effects transfer into everyday functioning.
METHODS
One hundred participants (18-65 years), with a verified ABI, impairments of processing speed/attention, and/or working memory, and a minimum of 12 months post injury will be recruited. Participants with severe aphasia, apraxia, visual neglect, epilepsy, and severe mental illness will be excluded. Participants will be randomized into two parallel groups: (1) an intervention group playing a commercial VR game taxing processing speed, working memory, and sustained attention; (2) an active control group receiving psychoeducation regarding compensatory strategies, and general cognitive training tasks such as crossword puzzles or sudoku. The intervention period is 5 weeks. The VR group will be asked to train at home for 30 min 5 days per week. Each participant will be assessed at baseline with neuropsychological tests and questionnaires, after the end of the intervention (5 weeks), and 16 weeks after baseline. After the end of the intervention period, focus group interviews will be conducted with 10 of the participants in the intervention group, in order to investigate acceptance and tolerability of VR as a training method.
DISCUSSION
This study will contribute to improve understanding of how VR is tolerated and experienced by the ABI population. If proven effective, the study can contribute to new rehabilitation methods that persons with ABI can utilize in a home setting, after the post-acute rehabilitation has ended.
Topics: Humans; Attention; Memory, Short-Term; Brain Injuries; Cognition; Middle Aged; Adult; Adolescent; Young Adult; Time Factors; Male; Aged; Female; Treatment Outcome; Video Games; Randomized Controlled Trials as Topic; Activities of Daily Living; Virtual Reality; Neuropsychological Tests; Cognitive Remediation; Virtual Reality Exposure Therapy; Recovery of Function; Transfer, Psychology; Cognitive Training; Processing Speed
PubMed: 38778411
DOI: 10.1186/s13063-024-08178-7 -
International Wound Journal May 2024Older adults are at increased risk of pressure injuries (PIs) due to age-related changes. Traditionally, PI knowledge and education have been delivered in hospitals and... (Review)
Review
Older adults are at increased risk of pressure injuries (PIs) due to age-related changes. Traditionally, PI knowledge and education have been delivered in hospitals and residential aged care facilities, however, there remains a critical gap in understanding how PI knowledge on prevention and management is shared with older adults and their carers living in the community. We aimed to describe the nature and characteristics of structured and unstructured PI education programs available to community-dwelling older adults and their carers. As coping review was undertaken. We searched five databases: CINAHL, Medline, Scopus, Cochrane Library and ProQuest from 2009 to August 2023. The review was guided by Arksey and O'Malley's six-step framework and adhered to the PRISMA-ScR guidelines. It included primary peer-reviewed papers published in English, which focus on PI education for older adults and/or their carers living in community settings. Data extraction was organised in a table, and findings presented as a narrative summary. One-hundred and thirty-six papers were screened and four included in the review. Results indicate that consideration was placed on literacy levels and cognitive status of older adults and their carers when designing PI education materials. Educational materials such as leaflets/brochures, in-person training sessions or a combination of both were used. However, duration of these interventions varied, lasting for 1-4 weeks while others were completed over 12 months. Some improvements in PI knowledge such as how to treat PI, dietary requirements and importance of mobility were noted. However, information retention and its translation into effective long-term behaviour change remained unclear. In conclusion, adopting a multifaceted educational approach increases the effectiveness of PI knowledge translation. Continuous education, support and reinforcement on PIs over time are necessary when interacting with older adults and caregivers to ensure long-term management and prevention success. Conversations on PIs should start at the primary care levels when older adults and carers are visiting their GP clinics and accessing support services for other healthcare needs. Understanding older adults' and carers' literacy levels, cognitive status and cultural background can assist clinicians in designing and delivering fit-for-purpose PI educational interventions that are accessible, relatable and effective in promoting knowledge transfer and behaviour change. Carers are vital conduits in the care continuum. These factors will lead to a more informed, collaborative and person-centred approaches to PI management and prevention.
Topics: Humans; Caregivers; Aged; Pressure Ulcer; Independent Living; Aged, 80 and over; Male; Patient Education as Topic; Female; Middle Aged
PubMed: 38772749
DOI: 10.1111/iwj.14894 -
Proceedings of the National Academy of... May 2024Optimal decision-making balances exploration for new information against exploitation of known rewards, a process mediated by the locus coeruleus and its norepinephrine...
Optimal decision-making balances exploration for new information against exploitation of known rewards, a process mediated by the locus coeruleus and its norepinephrine projections. We predicted that an exploitation-bias that emerges in older adulthood would be associated with lower microstructural integrity of the locus coeruleus. Leveraging in vivo histological methods from quantitative MRI-magnetic transfer saturation-we provide evidence that older age is associated with lower locus coeruleus integrity. Critically, we demonstrate that an exploitation bias in older adulthood, assessed with a foraging task, is sensitive and specific to lower locus coeruleus integrity. Because the locus coeruleus is uniquely vulnerable to Alzheimer's disease pathology, our findings suggest that aging, and a presymptomatic trajectory of Alzheimer's related decline, may fundamentally alter decision-making abilities in later life.
Topics: Locus Coeruleus; Humans; Decision Making; Aged; Male; Female; Aging; Magnetic Resonance Imaging; Alzheimer Disease; Middle Aged; Aged, 80 and over; Reward
PubMed: 38771873
DOI: 10.1073/pnas.2322617121 -
PloS One 2024Given an escalated interest in fostering environmental protection, scholars have associated green entrepreneurial behavior as a stimulating factor and the cornerstone of...
Impact of institutional support and green knowledge transfer on university students' absorptive capacity and green entrepreneurial behavior: The moderating role of environmental responsibility.
AIM/OBJECTIVE
Given an escalated interest in fostering environmental protection, scholars have associated green entrepreneurial behavior as a stimulating factor and the cornerstone of green entrepreneurial performance. Nevertheless, the underlying mechanism that nurtures university students' green entrepreneurial behavior is yet to be explored in the extant literature. Our study proposes the antecedent effects of institutional support and green knowledge transfer to enhance university students' green entrepreneurial behavior. Moreover, we also expand the boundary conditions of these relationships and suggest the mediating effect of university students' absorptive capacity and the moderating effect of environmental responsibility.
METHODOLOGY
The study samples university graduates in Chinese universities (N = 434) by adopting a lagged research design spanning over three months. We assessed the proposed model through the multivariate analytical technique.
FINDINGS
The findings indicate that institutional support and green knowledge transfer significantly elevate university students' green entrepreneurial behavior. Further, these relationships are intervened considerably through absorptive capacity's mediating effect and environmental responsibility's moderating effect.
IMPLICATIONS
By investigating the crucial roles of institutional support and green knowledge transfer in culminating university students' green entrepreneurial behavior, our study extends the boundary conditions of these relationships and investigates the hitherto unexplored moderated mediation model.
Topics: Humans; Universities; Students; Male; Female; Entrepreneurship; Conservation of Natural Resources; Young Adult; China; Knowledge; Adult
PubMed: 38771852
DOI: 10.1371/journal.pone.0304070 -
Nursing Open May 2024To understand the real experience of family members of patients in neurosurgical intensive care unit (NICU) during intra-hospital transport (IHT), explore their inner...
AIM
To understand the real experience of family members of patients in neurosurgical intensive care unit (NICU) during intra-hospital transport (IHT), explore their inner needs and provide effective intervention measures for the construction of standardized IHT plan.
DESIGN
A descriptive qualitative study.
METHODS
For the purposes of this study, 10 family members of IHT patients were included using a purposive sampling method. Semi-structured in-depth interviews were used to collect the data, Nvivo 11 software was used to organize the data, and Colaizzi's 7-step descriptive phenomenology method was used to analyse the data.
RESULTS
A total of three themes and nine subthemes were extracted, namely: Experience of emotional changes at different stages (uncertainty before transfer, complex internal activity during transit, ambivalence after transfer); Perception of problems in IHT (poor doctor-patient communication, weak awareness of risk assessment, deficiencies in the transfer procedure); Consciousness of the real needs (emotional respect and closeness, stay informed of the progression of the disease, greater social support).
CONCLUSION
Family members of patients in the NICU have complex internal experiences and multiple support needs during IHT, reflecting the need for further standardization of the transport process. In the future, we should improve the mode of safe IHT involving doctors, nurses and family members of patients, ensure the safety of patient transport, meet the social support needs of family members and improve the experience of IHT and the medical satisfaction of family members.
Topics: Humans; Family; Qualitative Research; Male; Intensive Care Units; Female; Middle Aged; Adult; Emotions; Patient Transfer; Transportation of Patients; Aged; Interviews as Topic
PubMed: 38770898
DOI: 10.1002/nop2.2151 -
Journal of Ovarian Research May 2024In the realm of assisted reproduction, a subset of infertile patients demonstrates high ovarian response following controlled ovarian stimulation (COS), with...
BACKGROUND
In the realm of assisted reproduction, a subset of infertile patients demonstrates high ovarian response following controlled ovarian stimulation (COS), with approximately 29.7% facing the risk of Ovarian Hyperstimulation Syndrome (OHSS). Management of OHSS risk often necessitates embryo transfer cancellation, leading to delayed prospects of successful pregnancy and significant psychological distress. Regrettably, these patients have received limited research attention, particularly regarding their metabolic profile. In this study, we aim to utilize gas chromatography-mass spectrometry (GC-MS) to reveal these patients' unique serum metabolic profiles and provide insights into the disease's pathogenesis.
METHODS
We categorized 145 infertile women into two main groups: the CON infertility group from tubal infertility patients and the Polycystic Ovary Syndrome (PCOS) infertility group. Within these groups, we further subdivided them into four categories: patients with normal ovarian response (CON-NOR group), patients with high ovarian response and at risk for OHSS (CON-HOR group) within the CON group, as well as patients with normal ovarian response (PCOS-NOR group) and patients with high ovarian response and at risk for OHSS (PCOS-HOR group) within the PCOS group. Serum metabolic profiles were analyzed using GC-MS. The risk criteria for OHSS were: the number of developing follicles > 20, peak Estradiol (E2) > 4000pg/mL, and Anti-Müllerian Hormone (AMH) levels > 4.5ng/mL.
RESULTS
The serum metabolomics analysis revealed four different metabolites within the CON group and 14 within the PCOS group. Remarkably, 10-pentadecenoic acid emerged as a discernible risk metabolite for the CON-HOR, also found to be a differential metabolite between CON-NOR and PCOS groups. cysteine and 5-methoxytryptamine were also identified as risk metabolites for the PCOS-HOR. Furthermore, KEGG analysis unveiled significant enrichment of the aminoacyl-tRNA biosynthesis pathway among the metabolites differing between PCOS-NOR and PCOS-HOR.
CONCLUSION
Our study highlights significant metabolite differences between patients with normal ovarian response and those with high ovarian response and at risk for OHSS within both the tubal infertility control group and PCOS infertility group. Importantly, we observe metabolic similarities between patients with PCOS and those with a high ovarian response but without PCOS, suggesting potential parallels in their underlying causes.
Topics: Humans; Female; Fertilization in Vitro; Infertility, Female; Adult; Ovulation Induction; Ovarian Hyperstimulation Syndrome; Polycystic Ovary Syndrome; Gas Chromatography-Mass Spectrometry; Metabolome; Metabolomics; Pregnancy; Ovary
PubMed: 38760835
DOI: 10.1186/s13048-024-01411-6