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1.
J Neurosci ; 41(26): 5711-5722, 2021 06 30.
Artigo em Inglês | MEDLINE | ID: mdl-34035140

RESUMO

A successful class of models link decision-making to brain signals by assuming that evidence accumulates to a decision threshold. These evidence accumulation models have identified neuronal activity that appears to reflect sensory evidence and decision variables that drive behavior. More recently, an additional evidence-independent and time-variant signal, called urgency, has been hypothesized to accelerate decisions in the face of insufficient evidence. However, most decision-making paradigms tested with fMRI or EEG in humans have not been designed to disentangle evidence accumulation from urgency. Here we use a face-morphing decision-making task in combination with EEG and a hierarchical Bayesian model to identify neural signals related to sensory and decision variables, and to test the urgency-gating model. Forty females and 34 males took part (mean age, 23.4 years). We find that an evoked potential time locked to the decision, the centroparietal positivity, reflects the decision variable from the computational model. We further show that the unfolding of this signal throughout the decision process best reflects the product of sensory evidence and an evidence-independent urgency signal. Urgency varied across subjects, suggesting that it may represent an individual trait. Our results show that it is possible to use EEG to distinguish neural signals related to sensory evidence accumulation, decision variables, and urgency. These mechanisms expose principles of cognitive function in general and may have applications to the study of pathologic decision-making such as in impulse control and addictive disorders.SIGNIFICANCE STATEMENT Perceptual decisions are often described by a class of models that assumes that sensory evidence accumulates gradually over time until a decision threshold is reached. In the present study, we demonstrate that an additional urgency signal impacts how decisions are formed. This endogenous signal encourages one to respond as time elapses. We found that neural decision signals measured by EEG reflect the product of sensory evidence and an evidence-independent urgency signal. A nuanced understanding of human decisions, and the neural mechanisms that support it, can improve decision-making in many situations and potentially ameliorate dysfunction when it has gone awry.


Assuntos
Encéfalo/fisiologia , Tomada de Decisões/fisiologia , Adulto , Teorema de Bayes , Eletroencefalografia , Feminino , Humanos , Masculino
2.
J Nurs Care Qual ; 35(4): 365-371, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31972784

RESUMO

BACKGROUND: Hospital fall rates have changed minimally with preventive measures; however, the effect on injury rate is unclear. PURPOSE: The purpose was to determine whether fall-related injuries have changed over time. METHODS: A retrospective comparison was done of 1134 adult inpatient falls in 2017 to 1235 falls in 2001-2002 for injury and fall circumstances. Separate comparisons were made of patient characteristics by service line for 2017. RESULTS: Severe fall injuries declined from 6% to 2.4%. Elimination issues remained the most common circumstance (38.9% and 42%). In 2017, malnutrition (31.6%), low function (61.4%), fall history (26.3%), and use of high-risk medications (83.2%) were common in patients who fell. Predictors of falls with injury by patient population were as follows: surgery-male gender (P = .01), low function (P = .006), elimination issues (P = .04); oncology-low function (P = .04); and neurology-low function (P = .02). CONCLUSIONS: Severe fall-related injuries have decreased in the past 15 years. The most common circumstance for falls remains elimination issues.


Assuntos
Acidentes por Quedas , Previsões , Pacientes Internados/estatística & dados numéricos , Ferimentos e Lesões , Acidentes por Quedas/prevenção & controle , Acidentes por Quedas/estatística & dados numéricos , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco
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