2020 ◽  
Author(s):  
Medha Shekhar ◽  
Dobromir Rahnev

Humans have the metacognitive ability to judge the accuracy of their own decisions via confidence ratings. A substantial body of research has demonstrated that human metacognition is fallible but it remains unclear how metacognitive inefficiency should be incorporated into a mechanistic model of confidence generation. Here we show that, contrary to what is typically assumed, metacognitive inefficiency depends on the level of confidence. We found that, across five different datasets and four different measures of metacognition, metacognitive ability decreased with higher confidence ratings. To understand the nature of this effect, we collected a large dataset of 20 subjects completing 2,800 trials each and providing confidence ratings on a continuous scale. The results demonstrated a robustly nonlinear zROC curve with downward curvature, despite a decades-old assumption of linearity. This pattern of results was reproduced by a new mechanistic model of confidence generation, which assumes the existence of lognormally-distributed metacognitive noise. The model outperformed competing models either lacking metacognitive noise altogether or featuring Gaussian metacognitive noise. Further, the model could generate a measure of metacognitive ability which was independent of confidence levels. These findings establish an empirically-validated model of confidence generation, have significant implications about measures of metacognitive ability, and begin to reveal the underlying nature of metacognitive inefficiency.


Author(s):  
Verena Gotta ◽  
Olivera Marsenic ◽  
Andrew Atkinson ◽  
Marc Pfister

Abstract Background Hemodialysis (HD) dose targets and ultrafiltration rate (UFR) limits for pediatric patients on chronic HD are not known and are derived from adults (spKt/V>1.4 and <13 ml/kg/h). We aimed to characterize how delivered HD dose and UFR are associated with survival in a large cohort of patients who started HD in childhood. Methods Retrospective analysis on a cohort of patients <30 years, on chronic HD since childhood (<19 years), having received thrice-weekly HD 2004–2016 in outpatient DaVita centers. Outcome: Survival while remaining on HD. Predictors: (I) primary analysis: mean delivered dialysis dose stratified as spKt/V ≤1.4/1.4–1.6/>1.6 (Kaplan–Meier analysis), (II) secondary analyses: UFR and alternative dialysis adequacy measures [eKt/V, body-surface normalized Kt/BSA] on continuous scale (Weibull regression model). Results A total of 1780 patients were included (age at the start of HD: 0–12y: n=321, >12–18y: n=1459; median spKt/V=1.55, eKt/V=1.31, Kt/BSA=31.2 L/m2, UFR=10.6 mL/kg/h). (I) spKt/V<1.4 was associated with lower survival compared to spKt/V>1.4–1.6 (P<0.001, log-rank test), and spKt/V>1.6 (P<0.001), with 10-year survival of 69.3% (59.4–80.9%) versus 83.0% (76.8–89.8%) and 84.0% (79.6–88.5%), respectively. (II) Kt/BSA was a better predictor of survival than spKt/V or eKt/V. UFR was additionally associated with survival (P<0.001), with increased mortality <10/>18 mL/kg/h. Associations did not alter significantly following adjustment for demographic characteristics (age, etiology of kidney disease, and ethnicity). Conclusions Our results suggest usefulness of targeting Kt/BSA>30 L/m2 for best long-term outcomes, corresponding to spKt/V>1.4 (>12 years) and >1.6 (<12 years). In contrast to adults, higher UFR of 10–18 ml/kg/h was not associated with greater mortality in this population.


2006 ◽  
Vol 86 (11) ◽  
pp. 1479-1488 ◽  
Author(s):  
Lynn B Panton ◽  
J Derek Kingsley ◽  
Tonya Toole ◽  
M Elaine Cress ◽  
George Abboud ◽  
...  

Abstract Background and Purposes. The purpose of this study was to compare functionality and strength among women with fibromyalgia (FM), women without FM, and older women. Subjects. Twenty-nine women with FM (age [X̅±SD]=46±7 years), 12 age- and weight-matched women without FM (age=44±8 years), and 38 older women who were healthy (age=71±7 years) participated. Methods. The Continuous Scale–Physical Functional Performance Test (CS-PFP) was used to assess functionality. Isokinetic leg strength was measured at 60°/s, and handgrip strength was measured using a handgrip dynamometer. Results. The women without FM had significantly higher functionality scores compared with women with FM and older women. There were no differences in functionality between women with FM and older women. Strength measures for the leg were higher in women without FM compared with women with FM and older women, and both women with and without FM had higher grip strengths compared with older women. Discussion and Conclusion. This study demonstrated that women with FM and older women who are healthy have similar lower-body strength and functionality, potentially enhancing the risk for premature age-associated disability.


2004 ◽  
Vol 21 (Supplement 32) ◽  
pp. 190-191
Author(s):  
C. Gaetano ◽  
T. Saverio ◽  
D. I. Tommaso ◽  
V Michelangelo ◽  
D. A. Margherita ◽  
...  
Keyword(s):  

2009 ◽  
Vol 16 (2) ◽  
pp. 228-237 ◽  
Author(s):  
AS Drake ◽  
B. Weinstock-Guttman ◽  
SA Morrow ◽  
D. Hojnacki ◽  
FE Munschauer ◽  
...  

The MS Functional Composite (MSFC) is a continuous scale of neurological disability for patients with multiple sclerosis (MS). Cognition is represented by the Paced Auditory Serial Addition Test (PASAT), although the Symbol Digit Modalities Test (SDMT) has been proposed as a promising alternative. MSFC scores were calculated using either the PASAT or the SDMT with the following reference populations: National Multiple Sclerosis Society (NMSS) Task Force, 400 MS patients, and 100 normal controls. A subgroup of 115 patients was followed longitudinally, with a test—retest interval of 2.3 ± 1.2 years. Pearson correlations were calculated and analyses of variance (ANOVAs) were used to assess relationships among the MSFC components and composite scores, and differences in performance between patients and controls. Longitudinal changes were also assessed. Logistic regression was performed to determine which MSFC scores are most predictive of diagnosis, course, and work disability. All MSFCs had similar test—retest reliability and correlations with other measures including neurological disability, depression, and fatigue. The SDMT showed slightly better validity with respect to predicting diagnosis, course, and work disability, although the amount of variance accounted for was similar for each version of the MSFC. Our data, derived from a large sample of MS patients and normal controls, supports the validity of both PASAT and SDMT versions of the MSFC. Because the SDMT has slightly better predictive validity and has a relatively easier administration procedure, some clinicians and researchers may wish to replace the PASAT with the SDMT in future calculations of the MSFC using the calculation methods provided in this manuscript.


1878 ◽  
Vol 10 (1) ◽  
pp. 19-19 ◽  
Author(s):  
A. R. Grote

The following note on the structure of Zimmermani is taken from a MS. paper on the N. Am. Phycidæ which I am preparing for publication. I would be glad of more material in this group from any correspondents.“Pinipestis (sub-gen. nov.).Maxillary palpi alike in both sexes, concealed by the porrect labial palpi, which have the third article erect and exceed the front. Ocelli present. Male antennæ very slightly bent at base, where they show slight continuous scale-tufts ; ciliate beneath. Fore wings with veins 4 and 5 running close together at base; these veins are seen to have a separate origin, 5 on the cross-vein close to 4, divaricating at one-third from base. Hind wings 8-veined ; vein 5 running close to 4 at base, but separate and continuous with the discal cross-vein. Head behind with a thick transverse ridge of scales; clypeus with a bunchlike projection of scales centrally.”


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Paul L. P. Brand ◽  
H. Jeroen Rosingh ◽  
Maarten A. C. Meijssen ◽  
Ingrid M. Nijholt ◽  
Saskia Dünnwald ◽  
...  

Abstract Background Even in anonymous evaluations of a postgraduate medical education (PGME) program, residents may be reluctant to provide an honest evaluation of their PGME program, because they fear embarrassment or repercussions from their supervisors if their anonymity as a respondent is endangered. This study was set up to test the hypothesis that current residents in a PGME program provide more positive evaluations of their PGME program than residents having completed it. We therefore compared PGME learning environment evaluations of current residents in the program to leaving residents having completed it. Methods This observational study used data gathered routinely in the quality cycle of PGME programs at two Dutch teaching hospitals to test our hypothesis. At both hospitals, all current PGME residents are requested to complete the Scan of Postgraduate Education Environment Domains (SPEED) annually. Residents leaving the hospital after completion of the PGME program are also asked to complete the SPEED after an exit interview with the hospital’s independent residency coordinator. All SPEED evaluations are collected and analysed anonymously. We compared the residents’ grades (on a continuous scale ranging from 0 (poor) to 10 (excellent)) on the three SPEED domains (content, atmosphere, and organization of the program) and their mean (overall department grade) between current and leaving residents. Results Mean (SD) overall SPEED department grades were 8.00 (0.52) for 287 current residents in 39 PGME programs and 8.07 (0.48) for 170 leaving residents in 39 programs. Neither the overall SPEED department grades (t test, p = 0.53, 95% CI for difference − 0.16 to 0.31) nor the department SPEED domain grades (MANOVA, F(3, 62) = 0.79, p = 0.51) were significantly different between current and leaving residents. Conclusions Residents leaving the program did not provide more critical evaluations of their PGME learning environment than current residents in the program. This suggests that current residents’ evaluations of their postgraduate learning environment were not affected by social desirability bias or fear of repercussions from faculty.


2019 ◽  
Vol 32 (5) ◽  
pp. 1039-1057
Author(s):  
Kunal Ganguly

Purpose The purpose of this paper is to present a comprehensive framework for quality-related performance measures linked to supply chain risk (SCR) by analyzing and framing them into a hierarchical structure. Design/methodology/approach In this paper, quality-related performance measures (QM) are identified on the basis of literature survey and expert opinion. The quality measures are formulated as hierarchy structure and fuzzy AHP as a multi attribute decision-making tool is applied to judge the viable candidates. Findings Based on a fuzzy AHP approach, a revised risk matrix with a continuous scale was proposed to assess the QMs’ classes. The result classifies the QMs in different categories (extreme, high, medium and low). Based on this result, some management implications and suggestions are proposed. Originality/value The present work proposes an assessment methodology for quality-related performance measures linked to SCR. The revised risk matrix with continuous scale for risk assessment in this field is a novel approach. This study contributes to the supply chain management and quality management literature, and provides suggestions for managers to adopt different strategies for different risk classes.


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