How reputation does (and does not) drive people to punish without looking.

Punishing wrongdoers can confer reputational benefits, and people sometimes punish without careful consideration. But are these observations related? Does reputation drive people to people to "punish without looking"? And if so, is this because unquestioning punishment looks particularly virtuous? To investigate, we assigned "Actors" to decide whether to sign punitive petitions about politicized issues ("punishment"), after first deciding whether to read articles opposing these petitions ("looking"). To manipulate reputation, we matched Actors with copartisan "Evaluators," varying whether Evaluators observed i) nothing about Actors' behavior, ii) whether Actors punished, or iii) whether Actors punished and whether they looked. Across four studies of Americans (total n = 10,343), Evaluators rated Actors more positively, and financially rewarded them, if they chose to (vs. not to) punish. Correspondingly, making punishment observable to Evaluators (i.e., moving from our first to second condition) drove Actors to punish more overall. Furthermore, because some of these individuals did not look, making punishment observable increased rates of punishment without looking. Yet punishers who eschewed opposing perspectives did not appear particularly virtuous. In fact, Evaluators preferred Actors who punished with (vs. without) looking. Correspondingly, making looking observable (i.e., moving from our second to third condition) drove Actors to look more overall-and to punish without looking at comparable or diminished rates. We thus find that reputation can encourage reflexive punishment-but simply as a byproduct of generally encouraging punishment, and not as a specific reputational strategy. Indeed, rather than fueling unquestioning decisions, spotlighting punishers' decision-making processes may encourage reflection.

Ideology selectively shapes attention to inequality.

Contemporary debates about addressing inequality require a common, accurate understanding of the scope of the issue at hand. Yet little is known about who notices inequality in the world around them and when. Across five studies (N = 8,779) employing various paradigms, we consider the role of ideological beliefs about the desirability of social equality in shaping individuals' attention to-and accuracy in detecting-inequality across the class, gender, and racial domains. In Study 1, individuals higher (versus lower) on social egalitarianism were more likely to naturalistically remark on inequality when shown photographs of urban scenes. In Study 2, social egalitarians were more accurate at differentiating between equal versus unequal distributions of resources between men and women on a basic cognitive task. In Study 3, social egalitarians were faster to notice inequality-relevant changes in images in a change detection paradigm indexing basic attentional processes. In Studies 4 and 5, we varied whether unequal treatment adversely affected groups at the top or bottom of society. In Study 4, social egalitarians were, on an incentivized task, more accurate at detecting inequality in speaking time in a panel discussion that disadvantaged women but not when inequality disadvantaged men. In Study 5, social egalitarians were more likely to naturalistically point out bias in a pattern detection hiring task when the employer was biased against minorities but not when majority group members faced equivalent bias. Our results reveal the nuances in how our ideological beliefs shape whether we accurately notice inequality, with implications for prospects for addressing it.

Final Measurement of the

This Letter reports one of the most precise measurements to date of the antineutrino spectrum from a purely ^{235}U-fueled reactor, made with the final dataset from the PROSPECT-I detector at the High Flux Isotope Reactor. By extracting information from previously unused detector segments, this analysis effectively doubles the statistics of the previous PROSPECT measurement. The reconstructed energy spectrum is unfolded into antineutrino energy and compared with both the Huber-Mueller model and a spectrum from a commercial reactor burning multiple fuel isotopes. A local excess over the model is observed in the 5-7 MeV energy region. Comparison of the PROSPECT results with those from commercial reactors provides new constraints on the origin of this excess, disfavoring at 2.0 and 3.7 standard deviations the hypotheses that antineutrinos from ^{235}U are solely responsible and noncontributors to the excess observed at commercial reactors, respectively.

Neutrophil lymphocyte ratio (NLR) and systemic immune inflammatory index (SII) for the differential diagnosis of CT-negative mild acute ischemic stroke and transient ischemic attack.

Background: A number of acute ischemic stroke (AIS) cases may be misdiagnosed as transient ischemic attack (TIA), due to no infarct on initial computed tomography scan and/or mild deficits upon presentation. Several studies have found that the neutrophil-lymphocyte ratio (NLR) is an accurate differential diagnostic biomarker for AIS versus TIA; however, no study has evaluated the use of the NLR in differentiating CT negative AIS from TIA. Furthermore, the systemic immune-inflammation index (SII) is a relatively novel immune biomarker that has been shown to be positively correlated with AIS severity, poor functional outcomes and mortality. The purpose of this study is to determine if NLR or SII can be used as a diagnostic biomarker for the differential diagnosis of mild AIS with a negative CT upon admission and TIA. Methods: We performed a retrospective medical record review of patients diagnosed with either AIS or TIA. We collected peripheral white blood cell counts within 24 h of symptom onset and calculated the NLR and SII. Logistic regression was utilized to determine if NLR or SII are significant predictors of CT negative mild AIS. Results: CT negative mild AIS patients were 2 times as likely to have an NLR ≥ 2.71 compared to TIA patients, and CT negative mild AIS patients were 2.1 times as likely to have an SII ≥ 595 compared to TIA patients. Conclusion: NLR and SII are easily obtained biomarkers that can be used in early clinical decision making in cases of mild AIS with negative CT scan upon admission.

Programmed Cell Death in Diabetic Nephropathy: A Review of Apoptosis, Autophagy, and Necroptosis.

Diabetic nephropathy is a common complication of type I and type II diabetes, in which renal glomeruli are destroyed, resulting in renal damage, proteinuria, and hypertension. Apoptosis, autophagy, and necroptosis are 3 forms of programmed cell death that have been implicated in the pathogenesis of diabetic nephropathy. Apoptosis of podocytes leads to glomerular injury and podocyte depletion, which are associated with proteinuria and glomerular structural damage in diabetic nephropathy. Additionally, epithelial cells in the proximal convoluted tubules also undergo apoptosis in diabetic nephropathy, leading to tubular atrophy, which causes tubular cell depletion and the subsequent formation of atubular glomeruli in association with the loss of renal function. On the other hand, insufficiency of autophagy has been correlated with the pathogenesis of diabetic nephropathy. For instance, decreased autophagic activity has been shown in podocytes of the diabetic kidney, causing variations in podocyte function and subsequent disruption to the glomerular filtration barrier. Furthermore, attenuated autophagic activity has also been demonstrated in proximal tubular cells of the diabetic kidney, resulting in the buildup of impaired molecules and organelles, which are normally broken down by autophagy, leading to proteinuria. Moreover, necroptosis might have a key role in podocyte damage and subsequent decline in diabetic nephropathy. Thus, this article aims to review the mechanisms and effects of programmed cell death in diabetic nephropathy, including the roles of apoptosis, autophagy, and necroptosis.

Autophagy and Its Association with Genetic Mutations in Parkinson Disease.

Parkinson disease is the second most common neurodegenerative disorder, affecting 0.1-0.2% of the general population. It is a progressive debilitating disorder caused by degeneration of dopaminergic neurons in the substantia nigra pars compacta. It is characterized by motor and non-motor symptoms. Parkinson disease can be caused by mutations in genes that encode proteins involved in the autophagic process, resulting in impaired autophagy. Indeed, autophagy has been implicated in the pathogenesis of Parkinson disease, particularly because its impairment causes the buildup of proteins. Thus, this review aims to provide an overview of Parkinson disease-related genetic mutations and their association with autophagy impairment in Parkinson disease, which can be helpful in improving the understanding of the pathogenesis of Parkinson disease, illustrating the potential therapeutic implications of agents that can enhance autophagy in Parkinson disease. Additionally, we will highlight the essential need for the development of highly sensitive and specific assays for gene-based diagnostic biomarkers. Finally, we will provide an overview on the potential gene-based therapeutic approaches for Parkinson disease, which have been most advanced and are associated with the most common targets being alpha-synuclein (SNCA), leucine-rich repeat kinase-2 (LRRK2), and glucocerebrosidase (GBA).

Political ideology shapes the amplification of the accomplishments of disadvantaged vs. advantaged group members.

Recent years have witnessed an increased public outcry in certain quarters about a perceived lack of attention given to successful members of disadvantaged groups relative to equally meritorious members of advantaged groups, exemplified by social media campaigns centered around hashtags, such as #OscarsSoWhite and #WomenAlsoKnowStuff. Focusing on political ideology, we investigate here whether individuals differentially amplify successful targets depending on whether these targets belong to disadvantaged or advantaged groups, behavior that could help alleviate or entrench group-based disparities. Study 1 examines over 500,000 tweets from over 160,000 Twitter users about 46 unambiguously successful targets varying in race (white, black) and gender (male, female): American gold medalists from the 2016 Olympics. Leveraging advances in computational social science, we identify tweeters' political ideology, race, and gender. Tweets from political liberals were much more likely than those from conservatives to be about successful black (vs. white) and female (vs. male) gold medalists (and especially black females), controlling for tweeters' own race and gender, and even when tweeters themselves were white or male (i.e., advantaged group members). Studies 2 and 3 provided experimental evidence that liberals are more likely than conservatives to differentially amplify successful members of disadvantaged (vs. advantaged) groups and suggested that this is driven by liberals' heightened concern with social equality. Addressing theorizing about ideological asymmetries, we observed that political liberals are more responsible than conservatives for differential amplification. Our results highlight ideology's polarizing power to shape even whose accomplishments we promote, and extend theorizing about behavioral manifestations of egalitarian motives.

Programmed cell death in cerebellar Purkinje neurons.

Apoptosis, autophagy and necrosis are the three main types of programmed cell death. One or more of these types of programmed cell death may take place in neurons leading to their death in various neurodegenerative disorders in humans. Purkinje neurons (PNs) are among the most highly vulnerable population of neurons to cell death in response to intrinsic hereditary diseases or extrinsic toxic, hypoxic, ischemic, and traumatic injury. In this review, we will describe the three main types of programmed cell death, including the molecular mechanisms and the sequence of events in each of them, and thus illustrating the intracellular proteins that mediate and regulate each of these types. Then, we will discuss the role of Ca2+ in PN function and increased vulnerability to cell death. Additionally, PN death will be described in animal models, namely lurcher mutant mouse and shaker mutant rat, in order to illustrate the potential therapeutic implications of programmed cell death in PNs by reviewing the previous studies that were carried out to interfere with the programmed cell death in an attempt to rescue PNs from death.

Apoptosis and its therapeutic implications in neurodegenerative diseases.

Neurodegenerative disorders are characterized by progressive loss of particular populations of neurons. Apoptosis has been implicated in the pathogenesis of neurodegenerative diseases, including Parkinson disease, Alzheimer disease, Huntington disease, and amyotrophic lateral sclerosis. In this review, we focus on the existing notions relevant to comprehending the apoptotic death process, including the morphological features, mediators and regulators of cellular apoptosis. We also highlight the evidence of neuronal apoptotic death in Parkinson disease, Alzheimer disease, Huntington disease, and amyotrophic lateral sclerosis. Additionally, we present evidence of potential therapeutic agents that could modify the apoptotic pathway in the aforementioned neurodegenerative diseases and delay disease progression. Finally, we review the clinical trials that were conducted to evaluate the use of anti-apoptotic drugs in the treatment of the aforementioned neurodegenerative diseases, in order to highlight the essential need for early detection and intervention of neurodegenerative diseases in humans.

Introducing the Sociopolitical Motive × Intergroup Threat Model to Understand How Monoracial Perceivers' Sociopolitical Motives Influence Their Categorization of Multiracial People.

Researchers have used social dominance, system justification, authoritarianism, and social identity theories to understand how monoracial perceivers' sociopolitical motives influence their categorization of multiracial people. The result has been a growing understanding of how particular sociopolitical motives and contexts affect categorization, without a unifying perspective to integrate these insights. We review evidence supporting each theory's predictions concerning how monoracial perceivers categorize multiracial people who combine their ingroup with an outgroup, with attention to the moderating role of perceiver group status. We find most studies cannot arbitrate between theories of categorization and reveal additional gaps in the literature. To advance this research area, we introduce the sociopolitical motive × intergroup threat model of racial categorization that (a) clarifies which sociopolitical motives interact with which intergroup threats to predict categorization and (b) highlights the role of perceiver group status. Furthermore, we consider how our model can help understand phenomena beyond multiracial categorization.

Focal laser ablation as clinical treatment of prostate cancer: report from a Delphi consensus project.

PURPOSE: To define the role of focal laser ablation (FLA) as clinical treatment of prostate cancer (PCa) using the Delphi consensus method. METHODS: A panel of international experts in the field of focal therapy (FT) in PCa conducted a collaborative consensus project using the Delphi method. Experts were invited to online questionnaires focusing on patient selection and treatment of PCa with FLA during four subsequent rounds. After each round, outcomes were displayed, and questionnaires were modified based on the comments provided by panelists. Results were finalized and discussed during face-to-face meetings. RESULTS: Thirty-seven experts agreed to participate, and consensus was achieved on 39/43 topics. Clinically significant PCa (csPCa) was defined as any volume Grade Group 2 [Gleason score (GS) 3+4]. Focal therapy was specified as treatment of all csPCa and can be considered primary treatment as an alternative to radical treatment in carefully selected patients. In patients with intermediate-risk PCa (GS 3+4) as well as patients with MRI-visible and biopsy-confirmed local recurrence, FLA is optimal for targeted ablation of a specific magnetic resonance imaging (MRI)-visible focus. However, FLA should not be applied to candidates for active surveillance and close follow-up is required. Suitability for FLA is based on tumor volume, location to vital structures, GS, MRI-visibility, and biopsy confirmation. CONCLUSION: Focal laser ablation is a promising technique for treatment of clinically localized PCa and should ideally be performed within approved clinical trials. So far, only few studies have reported on FLA and further validation with longer follow-up is mandatory before widespread clinical implementation is justified.

The Link Between Self-Dehumanization and Immoral Behavior.

People perceive morality to be distinctively human, with immorality representing a lack of full humanness. In eight experiments, we examined the link between immorality and self-dehumanization, testing both (a) the causal role of immoral behavior on self-dehumanization and (b) the causal role of self-dehumanization on immoral behavior. Studies 1a to 1d showed that people feel less human after behaving immorally and that these effects were not driven by having a negative experience but were unique to experiences of immorality (Study 1d). Studies 2a to 2c showed that self-dehumanization can lead to immoral and antisocial behavior. Study 3 highlighted how self-dehumanization can sometimes produce downward spirals of immorality, demonstrating initial unethical behavior leading to self-dehumanization, which in turn promotes continued dishonesty. These results demonstrate a clear relationship between self-dehumanization and unethical behavior, and they extend previous theorizing on dehumanization.

Autophagy precedes apoptosis among at risk cerebellar Purkinje cells in the shaker mutant rat: an ultrastructural study.

Cerebellar Purkinje cell (PC) death has been shown to occur in essential tremor, ataxia, and many other neurodegenerative diseases in humans. Shaker mutant rats have an X-linked recessive mutation that causes hereditary degeneration of "at risk" cerebellar PCs. This defect can occur in the restricted anterior (ADC) and posterior (PDC) vermal degeneration compartments postnatally within 7 to 14 weeks of age as a natural phenotype in the shaker mutant rat. "Secure" PCs persist in a flocculonodular survival compartment (FNSC). Because we have previously shown that "at risk" PCs die due to apoptosis in the shaker mutant rat, we hypothesized that the PC death observed in the hereditary shaker mutant rat may be due to the activation of more than one type of death pathway. This ultrastructural investigation suggests that "at risk" PCs die due to apoptosis as a result of autophagic activation. Moreover, our data suggest that both apoptosis and autophagy must be simultaneously inhibited to rescue "at risk" PCs from death.

Thoracic impedance pneumography in propofol-sedated patients undergoing percutaneous endoscopic gastrostomy (PEG) placement in gastrointestinal endoscopy: A prospective, randomized trial.

STUDY OBJECTIVE: To assess the efficacy of an ECG-based method called thoracic impedance pneumography to reduce hypoxic events in endoscopy. DESIGN: This was a single center, 1:1 randomized controlled trial. SETTING: The trial was conducted during the placement of percutaneous endoscopic gastrostomy (PEG). PATIENTS: 173 patients who underwent PEG placement were enrolled in the present trial. Indication was oncological in most patients (89%). 58% of patients were ASA class II and 42% of patients ASA class III. INTERVENTIONS: Patients were randomized in the standard monitoring group (SM) with pulse oximetry and automatic blood pressure measurement or in the intervention group with additional thoracic impedance pneumography (TIM). Sedation was performed with propofol by gastroenterologists or trained nurses. MEASUREMENTS: Hypoxic episodes defined as SpO2 < 90% for >15 s were the primary endpoint. Secondary endpoints were minimal SpO2, apnea >10s/>30s and incurred costs. MAIN RESULTS: Additional use of thoracic impedance pneumography reduced hypoxic episodes (TIM: 31% vs SM: 49%; p = 0.016; OR 0.47; NNT 5.6) and elevated minimal SpO2 per procedure (TIM: 90.0% ± 8.9; SM: 84.0% ± 17.6; p = 0.007) significantly. Apnea events >10s and > 30s were significantly more often detected in TIM (43%; 7%) compared to SM (1%; 0%; p < 0.001; p = 0.014) resulting in a time advantage of 17 s before the occurrence of hypoxic events. As a result, adjustments of oxygen flow were significantly more often necessary in SM than in TIM (p = 0.034) and assisted ventilation was less often needed in TIM (2%) compared with SM (9%; p = 0.053). Calculated costs for the additional use of thoracic impedance pneumography were 0.13$ (0.12 €/0.11 £) per procedure. CONCLUSIONS: Additional thoracic impedance pneumography reduced the quantity and extent of hypoxic events with less need of assisted ventilation. Supplemental costs per procedure were negligible. KEY WORDS: thoracic impedance pneumography, capnography, sedation, monitoring, gastrointestinal endoscopy, percutaneous endoscopic gastrostomy.

A gene for autosomal dominant sacral agenesis maps to the holoprosencephaly region at 7q36.

Sacral agenesis is a rare disorder of uncertain incidence that has been reported in diverse populations. Although usually sporadic and most commonly associated with maternal diabetes, there is a hereditary form which may occur in isolation or with a presacral mass (anterior meningocele and/or presacral teratoma) and anorectal abnormalities, which constitute the Currarino triad (MIM 176450). The radiological hallmark of hereditary sacral agenesis is a hemi-sacrum (sickle-shaped sacrum) with intact first sacral vertebra. Bowel obstruction is the usual neonatal presentation, but, unlike other neural tube defects, adult presentation is not uncommon. The major pathology is confined to the pelvic cavity and may present as a space-occupying lesion or meningitis due to ascending infection. All recurrences in families have been compatible with autosomal dominant inheritance except for those associated with the isomerism gene at Xq24-q27.1 (ref. 3). Several associated cytogenetic defects have been reported, including 7q deletions. Previous studies failed to detect linkage to HLA markers, but we now present evidence for a location on 7q36. The same region also contains a gene for holoprosencephaly, an early malformation of the extreme rostral end of the neural tube.

Political (Meta-)Dehumanization in Mental Representations: Divergent Emphases in the Minds of Liberals Versus Conservatives.

We conducted two reverse-correlation studies, as well as two pilot studies reported in the online supplement (total N = 1,411), on the topics of (a) whether liberals and conservatives differ in the types of dehumanization that they cognitively emphasize when mentally representing one another, and if so, (b) whether liberals and conservatives are sensitive to how they are represented in the minds of political outgroup members. Results suggest that partisans indeed differ in the types of dehumanization that they cognitively emphasize when mentally representing one another: whereas conservatives' dehumanization of liberals emphasizes immaturity (vs. savagery), liberals' dehumanization of conservatives more strongly emphasizes savagery (vs. immaturity). In addition, results suggest that partisans may be sensitive to how they are represented. That is, partisans' meta-representations-their representations of how the outgroup represents the ingroup-appear to accurately index the relative emphases of these two dimensions in the minds of political outgroup members.

Emerging Alzheimer's disease therapeutics: promising insights from lipid metabolism and microglia-focused interventions.

More than 55 million people suffer from dementia, with this number projected to double every 20 years. In the United States, 1 in 3 aged individuals dies from Alzheimer's disease (AD) or another type of dementia and AD kills more individuals than breast cancer and prostate cancer combined. AD is a complex and multifactorial disease involving amyloid plaque and neurofibrillary tangle formation, glial cell dysfunction, and lipid droplet accumulation (among other pathologies), ultimately leading to neurodegeneration and neuronal death. Unfortunately, the current FDA-approved therapeutics do not reverse nor halt AD. While recently approved amyloid-targeting antibodies can slow AD progression to improve outcomes for some patients, they are associated with adverse side effects, may have a narrow therapeutic window, and are expensive. In this review, we evaluate current and emerging AD therapeutics in preclinical and clinical development and provide insight into emerging strategies that target brain lipid metabolism and microglial function - an approach that may synergistically target multiple mechanisms that drive AD neuropathogenesis. Overall, we evaluate whether these disease-modifying emerging therapeutics hold promise as interventions that may be able to reverse or halt AD progression.

Perception of Saudi undergraduate medical students on telemedicine training and its implementation.

BACKGROUND: The use of telemedicine has increased considerably in healthcare delivery, especially during this time of the coronavirus disease 2019 (COVID-19) pandemic. It has, therefore, become necessary to train medical students to better equip them for this new means of healthcare delivery. The aim of the present study was to assess the perception of undergraduate medical students on telemedicine training. MATERIALS AND METHODS: A cross-sectional study was conducted on a total of 521 undergraduate medical students studying in the Eastern Region of Saudi Arabia. Data were collected via a self-administered pretested questionnaire comprising two main sections: demographics and knowledge and opinions regarding telemedicine training. RESULTS: About 73% students think that the use of telemedicine for patient care will increase in the future, and 59.3% think that the medical students should be trained in telemedicine. Majority of the students (78%) opined that telemedicine training should be optional and 58% said it should be taught during the clinical phase of the undergraduate curriculum. The best telemedicine training course learning objectives medical students opined to be included were: telemedicine practical skills (70.2%), legal aspects of telemedicine practice (68.3%), and potential positive and/or negative use of telemedicine tools and methods (67.6%). Telemedicine skills students would like to learn how to effectively engage patients, knowledge about telemedicine regulations and the consequences of breaching them. CONCLUSION: Medical students are aware of the importance of incorporating telemedicine training into the medical curriculum. Training these students is vital to ensure their competence as physicians in their future clinical careers, that is make them a digitally health-literate future workforce.

A prospective evaluation of the American College of Surgeons Surgical Risk Calculator as a predictor of complications for breast surgery.

BACKGROUND: The infection rates for operative management of breast cancer are often unpredictable and higher than average for a clean surgical procedure (0.8% and 28%). We aimed to assess the effectiveness of the American College of Surgeons (ACS) Surgical Risk Calculator (SRC), a preoperative scoring system to calculate the risk of surgical site infection (SSI) and serious complications following breast surgery. METHODS: Prospective risk scoring using the SRC on 213 patients in the preoperative clinic and the incidence of SSI and serious complications within 30 days postoperatively was prospectively collected. RESULTS: The overall SSI rate in our sample was 5% (n=11/210 patients). For a one-unit increase in SRC score, the odds of having SSI increased by a factor of 1.88 (95% CI 1.33 to 2.74). Odds of developing SSI were higher in patients with high Body Mass Index (OR 1.25; 95% 1.13 to 1.40) and American Society of Anesthesiologists score 3 (OR 11.54; 95% CI 2.98 to 43.65). The odds of developing an SSI were ∼19 times higher if a patient had an SRC score >3.0 versus those with an SRC score <3.0. Only 3% (n=4) of patients who had an SRC score of <3.0 experienced SSI, compared with 33% (n=7) for those with a risk score of >3.0. Out of 210 patients, 9 had serious complications (4.2%). CONCLUSIONS: ACS SRC Score of more than 3 was associated with a higher likelihood of SSI. SRC was able to predict the risk of SSI and serious complications and can be used preoperatively for identification and risk minimisation.