“These pretzels are making me thirsty” so I’ll have water tomorrow: A partial replication and extension of adults’ induced-state episodic foresight

The ability to consider the future under the influence of an induced current state is known as induced-state episodic foresight. One study to date has examined adults’ induced episodic foresight and found that adults’ (like children’s) preferences for the future are related to their current state such that they predicted wanting water (vs. pretzels) in the future when experiencing a current state of thirst [1]. We attempted to replicate these findings in adults. In Study 1, adults (N = 198) in a laboratory selected pretzels for tomorrow at the same rate (around 20%) in an experimental condition (thirst induced) and a control condition (thirst not induced). In a lecture, 32% of adults preferred pretzels for tomorrow without thirst induction (Study 2, N = 63). Partially replicating Kramer et al. [1], we found that a minority of adults preferred pretzels (vs. water) when experiencing a current state of thirst. However, in contrast to their findings, our results showed that when thirst was not induced, a minority of adults also preferred pretzels for tomorrow. Thus, adults’ future preference was similar regardless of thirst induction. We also tested thirst as a mechanism for adults’ preference for the future and found that across conditions adults’ thirst predicted their choice of water (vs. pretzels) for the future. In sum, our results partially replicated Kramer et al. [1] by showing the current state, regardless of thirst induction, predicts adults’ choices for the future.

Effectiveness, safety and acceptability of no-test medical abortion provided via telemedicine: a national cohort study

ObjectivesTo compare the effectiveness, safety and acceptability of medical abortion before and after the introduction of no-test telemedicine abortion care.DesignCohort study to assess whether a no-test telemedicine-hybrid care model (telemedicine with in-person provision only when indicated) was non-inferior to the traditional service model (blanket in-person provision including ultrasound scan).SettingThe three main abortion providers in England and Wales.ParticipantsAll patients having an early medical abortion in the two months before and after the service model change. Patient demographic and clinical characteristics were compared between the cohorts to adjust for any systematic differences in the two groups.Main outcome measuresAccesswaiting time, gestation at abortionEffectivenessthe proportion of successful medical abortionsSafetysignificant adverse events defined as: haemorrhage requiring transfusion, significant infection requiring hospital admission, major surgery, death. We also examined the incidence of ectopic pregnancy and late gestation.AcceptabilityPatient-reported outcomes of satisfaction, future preference, and privacy of consultationResultsThe study sample included 52,142 medical abortions; 22,158 in the traditional cohort and 29,984 in the telemedicine-hybrid cohort, of which 61% were provided using no-test telemedicine. The cohorts accounted for 85% of all medical abortions provided in England and Wales during the study period. Mean waiting times were 4.2 days shorter in the telemedicine-hybrid cohort, and 40% were provided at ≤6 weeks’ gestation compared to 25% in the traditional cohort (p<0.001). There was no difference in success rates between the two groups (98.2% vs. 98.8%, p=1.0), nor in the prevalence of serious adverse events (0.04% vs. 0.02%, p=0.557). The incidence of ectopic pregnancy was equivalent in both cohorts (0.2%, p=0.796), with no significant difference in the proportions being treated after abortion (0.01% vs 0.03%, p=0.123). In 0.04% of cases the abortion appeared to have been provided at over 10 weeks’ gestation; these abortions were all completed at home without additional medical complications. In the telemedicine-hybrid group, the effectiveness for abortions conducted using telemedicine (n=18,435) was higher than for those conducted in-person (n=11,549), 99.2% vs. 98.1%, p<0.001. Acceptability was high (96% satisfied), 80% reported a future preference for telemedicine and none reported that they were unable to consult in private using teleconsultation.ConclusionsMedical abortion provided through a hybrid model that includes no-test telemedicine without routine ultrasound is effective, safe, acceptable, and improves access to care.Summary BoxWhat is already known on this topicThe UK’s National Institute for Health and Care Excellence (NICE) conducted a systematic review and recommended using telemedicine to improve access to medical abortion care.Several models for using telemedicine to facilitate medical abortion have been described, but most existing trials are small, and many required attendances to have medicines administered or for an ultrasound scan or blood tests.What this study addsThis study (n=52,142) is the first to assess a real-world no-test telemedicine abortion care pathway in a national population. The new national model demonstrates how a permissive framework for medical abortion can deliver significant quality improvements to those needing to access abortion care. There was no difference in effectiveness (p=1.0) or safety (p=0.6) when compared to a traditional in-person model, but the no-test telemedicine pathway improved access to care, was highly acceptable to patients and is likely to be especially beneficial for vulnerable groups and in resource-poor settings.

The Correlation Between Land Ownership Status, Parents Occupation, and Future of Agriculture with the Youth Attitude who Work in Agricultural Sector (Case of Pamijahan Sub-District, Bogor District)

The objectives of this research were (1) identifying parents’ land ownership status in Pamijahan Sub-District, Bogor District, (2) Identifying parents’ occupation in Pamijahan Sub-District, Bogor District, (3) Identifying the youth preference towards residency place in the future, (4) analyzing the correlation between land ownership status, parents’ occupation, youth future residency preference and rural-youth attitude towards agricultural sector. This research was performed in Ciasmara Village, Pamijahan Sub-District, Bogor District, from 2019 to 2020, using quantitative method and chi-square to identify the association between land ownership status, parents’ occupation, youth future residency preference, and rural-youth attitude towards agricultural sector. This research found that parents’ occupation and youth future preference towards residency place were correlated with rural-youth attitude towards agricultural sector

Research on Recommendation Systems using Deep Learning Models

Recommender System is the effective tools that are accomplished of recommending the future preference of a set of products to the consumer and to predict the most likelihood items. Today, customers has the ability to purchase or sell different items with advancement of e-commerce website, nevertheless it made complicate to investigate the majority of appropriate items suitable for the interest of the consumer from many items. Due to this scenario, recommender systems that can recommend items appropriate for user's interest and likings have become mandatory. In recent days, various recommendation methods are applied to resolve the data abundance setback in numerous application areas like movie recommendation, e-commerce, news recommendation, song recommendation and social media. Even if all the available current recommender systems are successful in generating reasonable predictions, these recommendation system still facing the issues like accuracy, cold-start, sparsity and scalability problem. Deep learning, the recently developed sub domain of machine learning technique is utilized in recommendation systems to enhance the feature of predicted output. Deep Learning is used to generate recommendations and the research challenges specific to recommendation systems when using Deep Learning are also presented. In this research, the basic terminologies, the fundamental concepts of Recommendation engine and a wide-ranging review of deep learning models utilized in Recommender Systems are presented.

Patient Satisfaction with General versus Local Anesthesia during Carotid Endarterectomy

Background and Study Aims Both general and local anesthesia are used in our department for carotid endarterectomy (CEA). The decision as to which anesthetic technique to use during surgery is made individually. The aim of our study was to evaluate patient satisfaction and preference with the anesthesia type used. Material and Methods The satisfaction of a group of 205 patients with regard to anesthesia used and their future preferences were evaluated prospectively through a questionnaire. The reasons for dissatisfaction were assessed. Results CEA was performed under general anesthesia (GA) in 159 cases (77.6%) and under local anesthesia (LA) in 46 cases (22.4%). In the GA group, 148 patients (93.1%) were satisfied; 30 patients (65.2%) in the LA group were satisfied (p < 0.0001). The reason for dissatisfaction with GA were postoperative nausea and vomiting (7 patients), postoperative psychological alteration (3), and fear of GA (1). The reasons for dissatisfaction with LA were intraoperative pain (9 patients), intraoperative discomfort and stress (5), and intraoperative breathing problems (2). Of the GA group, 154 (96.9%) patients would prefer GA again, and of the LA group, 28 (60.9%) patients would prefer LA if operated on again (p < 0.0001). Overall, 172 patients (83.9%) would prefer GA in the future, and 33 patients (16.1%) would prefer LA. Conclusion Overall patient satisfaction with CEA performed under both GA and LA is high. Nevertheless, in the GA group, patient satisfaction and future preference were significantly higher. Both GA and LA have advantages and disadvantages for CEA. An optimal approach is to make use of both anesthetic techniques based on their individual indications and patient preference.

Necessity of transnasal gastroscopy in routine diagnostics: a patient-centred requirement analysis

IntroductionNumerous indications require regular upper gastrointestinal endoscopy (oesophagogastroduodenoscopy; EGD) in outpatients. In most cases, peroral gastroscopy is performed. The aim of this study was to evaluate the need of transnasal gastroscopy (nEGD) in outpatients.MethodsA questionnaire was used to assess patients’ preferred choice of method, previous experience with EGD, psychological aspects and sociodemographic data. Furthermore, patient satisfaction with and potentially perceived discomfort during the examination as well as preference for a method in regard to future examinations was evaluated.ResultsFrom September 2016 to March 2017, a total of 283 outpatients at endoscopy of the University Hospital of Leipzig were approached to participate in the study. 196 patients were eligible, of whom 116 (60%) chose nEGD. For 87 patients (87/283, 31%) nEGD had to be excluded for medical reasons. The average age in the total sample was 53 (±17) years. 147 (77%) have had previous experience with peroral EGD (oEGD). Of the nEGD examined patients 83% were fairly up to extremely satisfied with the procedure. Satisfaction significantly predicted the choice of future EGD examinations. Nasal pain experienced during nEGDs was associated with rejection of nEGD in further EGD examinations (p<0.01). Patients who did choose a specific procedure were more likely to select the same procedure as their future preference (χ²= 73.6, df=1, p<0.001); this preference was unaffected by the procedure that had been chosen previously (reselecting nEGD: 84%, oEGD: 89%, p=0.874).ConclusionnEGD without sedation is a viable alternative. Patient satisfaction with nEGD is high, and reselection rate for nEGD is similar to that for oEGD. As a result of this study nEGD is now offered as a routine procedure at the University of Leipzig.Trial registration numberNCT03663491.

The association between future time perspective and sexual behaviours in individuals attending HIV testing centres

Background Most European countries are still facing a high burden of sexually transmitted infections (STIs) cases each year. Available literature has found associations between time preference, i.e. the relative weight given by individuals to future outcomes compared to present ones, and various health behaviours such as tobacco or alcohol consumption, vaccination or participation in cancer screening programmes. Our objective is to investigate the role of future preference in risky sexual behaviours. Methods We conducted a cross-sectional study using self-administered questionnaires in three HIV testing centres in Paris. We collected data on sexual behaviours, risk perceptions, risk attitude, future preference (Considerations of Future Consequences scale) and socioeconomic and demographic variables. Full data for variables used in regression analyses were available for 1090 respondents. We study factors associated with condom use at the first sexual encounter, with the frequency of condom use and with the number of sexual partners. Results In the full sample, future preference is positively correlated with both measures of condom use while it is negatively correlated with the number of sexual partners. Decomposing the analysis by risk group, our results indicate that future preference has more impact on sexual behaviours, especially condom use, among men who have sex with men compared to heterosexual men and, to a lesser extent, compared to heterosexual women. Conclusion If future time perspective is confirmed as a determinant of safer sexual behaviours, prevention campaigns could be shifted towards greater information on short-term consequences of STIs.