It's the Economy, Stupid: Applying (Micro)economic Principles to Microbiome Science.

A key challenge in microbiome science is the scale mismatch problem, which arises when the scale at which microbial communities are sampled, interrogated, and averaged is different from the scale at which individual microorganisms within those communities interact with each other and with their environment. Profiling the microbial communities in a teaspoon of soil, from a scoop of fecal matter, or along a plant leaf surface represents a scale mismatch of multiple orders of magnitude, which may limit our ability to interpret or predict species interactions and community assembly within such samples. In this Perspective, we explore how economists, who are historically and topically split along the lines of micro- and macroeconomics, deal with the scale mismatch problem, and how taking clues from (micro)economists could benefit the field of microbiomics.

Urinary tract infection pocket card effect on preferred antimicrobial prescribing for cystitis among patients discharged from the emergency department.

PURPOSE: To evaluate the impact of a urinary tract infection (UTI) pocket card on preferred antibiotic prescribing for patients discharged from the emergency department (ED) with a diagnosis of cystitis. METHODS: A multicenter, retrospective, pre-post study was conducted to compare outcomes following the introduction of a UTI pocket card. The primary outcome was prescribing rates for institutional first-line preferred antibiotics (cephalexin and nitrofurantoin) versus other antimicrobials for cystitis. Secondary outcomes included prescriber adherence to recommended therapy in regards to discharge dose, frequency, duration, and healthcare utilization rates. RESULTS: The study included 915 patients in total, 407 in the preintervention group and 508 in the postintervention group. The frequency of preferred antibiotic prescribing was significantly increased after the introduction of a UTI pocket card compared to prior to its introduction (81.7% vs 72.0%, P = 0.001). Significant increases in prescribing of an appropriate antibiotic dose (78.0% vs 66.8%, P < 0.0001) and frequency (64.2% vs 47.4%, P < 0.0001) were also found post intervention. No significant differences were seen between the pre- and postintervention groups with regards to healthcare utilization rates. CONCLUSION: A UTI pocket card increased preferred antibiotic prescribing for cystitis in the ED. This study provides data on a successful antimicrobial stewardship intervention in the ED setting.

A Neurocomputational Model of Altruistic Choice and Its Implications.

We propose a neurocomputational model of altruistic choice and test it using behavioral and fMRI data from a task in which subjects make choices between real monetary prizes for themselves and another. We show that a multi-attribute drift-diffusion model, in which choice results from accumulation of a relative value signal that linearly weights payoffs for self and other, captures key patterns of choice, reaction time, and neural response in ventral striatum, temporoparietal junction, and ventromedial prefrontal cortex. The model generates several novel insights into the nature of altruism. It explains when and why generous choices are slower or faster than selfish choices, and why they produce greater response in TPJ and vmPFC, without invoking competition between automatic and deliberative processes or reward value for generosity. It also predicts that when one's own payoffs are valued more than others', some generous acts may reflect mistakes rather than genuinely pro-social preferences.