Options to design more ethical and still successful default nudges: a review and recommendations

On the one hand, default nudges are proven to strongly influence behavior. On the other hand, a number of consumer autonomy and welfare concerns have been raised that hinder public policy applications. Both nudge success and ethical concerns depend heavily on the design of defaults. We identify six taxonomic characteristics that matter to the ethical and the nudge success dimension. We review the default nudge literature (N = 61) and review ethical studies to assess both dimensions concerning the taxonomy. When designing a default, a choice architect inevitably makes a decision concerning the characteristics. Among others, the results show three main findings. (1) The initial choice architecture regularly imposes welfare losses and impedes consumer autonomy. Forced active choosing can mitigate both issues. (2) Empirical evidence suggests that transparent defaults are similarly effective as the non-transparent counterparts. (3) The framing of the choice in combination with a choice structuring default leads to greater nudge success and tends to involve the reflective decision-making patterns. Choice architects can trade-off nudge success for legitimacy but a design change may also benefit one without harming the other. We discuss further options of choice architects to legitimize a default.

From Molecular Recognition to the “Vehicles” of Evolutionary Complexity: An Informational Approach

Countless informational proposals and models have explored the singular characteristics of biological systems: from the initial choice of information terms in the early days of molecular biology to the current bioinformatic avalanche in this “omic” era. However, this was conducted, most often, within partial, specialized scopes or just metaphorically. In this paper, we attempt a consistent informational discourse, initially based on the molecular recognition paradigm, which addresses the main stages of biological organization in a new way. It considers the interconnection between signaling systems and information flows, between informational architectures and biomolecular codes, between controlled cell cycles and multicellular complexity. It also addresses, in a new way, a central issue: how new evolutionary paths are opened by the cumulated action of multiple variation engines or mutational ‘vehicles’ evolved for the genomic exploration of DNA sequence space. Rather than discussing the possible replacement, extension, or maintenance of traditional neo-Darwinian tenets, a genuine informational approach to evolutionary phenomena is advocated, in which systemic variation in the informational architectures may induce differential survival (self-construction, self-maintenance, and reproduction) of biological agents within their open ended environment.

A weighted constraint satisfaction approach to human goal-directed decision making

When we choose actions aimed at achieving long-range goals, proximal information cannot be exploited in a blindly myopic way, as relevant future information must often be taken into account. However, when long-range information is irrelevant to achieving proximal subgoals, it can be desirable to focus exclusively on subgoal-relevant considerations. Here, we consider how an underlying parallel mechanism simultaneously influenced by proximal and future information may be at work when decision makers confront both types of situations. Participants were asked to find the shortest path in a simple maze where the optimal path depended on both starting-point and goal-proximal constraints. This simple task was then embedded in a more complex maze where the same two constraints, but not the final goal position, determined the optimal path to the subgoal. In both tasks, initial choice responses predominantly reflected the joint influence from relevant immediate and future constraints, yet we also found systematic deviations from optimality. We modeled initial path choice as an evidence integration process and found that participants weighted the starting-point more than the equally relevant goal in the simple task. In the complex task, there was no evidence of a separate processing stage where participants first zeroed in on the subgoal as would be expected if task decomposition occurred strictly prior to choosing a path to the subgoal. Participants again placed slightly more weight on the starting point than the subgoal as in the simple task, and also placing some weight on the irrelevant final goal. These results suggest that optimizing decision making can be viewed as adjusting the weighting of constraints toward values that favor relevant ones in a given task context, and that the dynamic re-weighting of constraints at different points in a decision process can allow an inherently parallel process to exhibit approximate emergent hierarchical structure.

Investigation of the Indications for Endoscopic Papillectomy and Transduodenal Ampullectomy for Ampullary Tumors

Objective: The standard treatment for ampullary tumors is pancreaticoduodenectomy. However, minimally invasive procedures such as endoscopic papillectomy (EP) and transduodenal ampullectomy (TDA) have recently gained popularity. Therefore, we aimed to evaluate the effectiveness of these minimally invasive procedures for ampullary tumors. Methods: We conducted a retrospective study of 42 patients who underwent either EP or TDA for ampullary tumors between June 2011 and November 2020. Results: We found that in patients with significantly larger tumors, TDA was often selected. Patients who underwent EP had significantly shorter hospital stays. No significant differences were observed regarding procedural accidents, tumor size, and recurrence. Conclusion: No differences were observed regarding the treatment outcomes of EP and TDA except hospital stay. EP is less invasive and can be the initial choice of procedure. TDA is performed when EP is not technically feasible. No significant relationship was noted between tumor size and recurrence, and careful observation of the patient’s postoperative course is required.

417 Initial Choice of Imaging Investigation for Patients Presenting with Acute Pancreatitis: Should MRCP Be First Line in Selected Patients?

Introduction Current guidelines for acute pancreatitis advocate abdominal ultrasound (AUS) as the first-line imaging investigation to identify if gallstones are the cause of pancreatitis. However, many patients have a history of cholecystectomy or present with known gallstones and deranged liver function tests (LFTs). In these patients, magnetic resonance cholangiopancreatography (MRCP) is indicated due to its higher sensitivity and specificity for detecting choledocholithiasis. Method This retrospective audit reviewed all consecutive patients who presented to the surgical assessment unit with acute pancreatitis over one month. Their past surgical history, bloods and imaging were reviewed. Results Of the 30 patients, seventeen (57%) had no previous cholecystectomy or known gallstones, nine (30%) had previous cholecystectomy and eight (27%) had known gallstones, seven (88%) of which presented with deranged LFTs. Of the seventeen patients who should have had AUS first (n = 17), thirteen (76%) had AUS first, none had MRCP first and four (24%) had computerised tomography (CT) first. Of the patients in whom MRCP was indicated first-line (n = 13), seven (54%) had AUS first, none had MRCP first, four (31%) had CT first and two (15%) went straight to endoscopic retrograde cholangiopancreatography having had recent outpatient MRCPs. In the seven patients in whom MRCP was indicated but AUS was performed first, six (86%) underwent subsequent MRCP. Conclusions MRCP should be considered the first line imaging investigation for patients presenting with acute pancreatitis and a history of cholecystectomy or known gallstones with deranged LFTs, as AUS rarely prevents the need for subsequent MRCP.

Vegetation memory effects and their association with vegetation resilience in global drylands

Vegetation memory describes the effect of antecedent environmental and ecological conditions on the present ecosystem state and has been proposed as an important proxy for vegetation resilience. In particular, strong vegetation-memory effects have been identified in dryland regions, but the factors underlying the spatial patterns of vegetation memory remain unknown. We aim to map the components and drivers of vegetation memory in dryland regions using state-of-the-art climate reanalysis data and refined approaches to identify vegetation-memory characteristics across dryland regions worldwide. Using a framework which distinguishes between intrinsic and extrinsic ecological memory, we show that: (i) intrinsic memory is a much stronger component than extrinsic memory in the majority of dryland regions; and (ii) climate reanalysis data sets change the detection of extrinsic vegetation memory effects in some global dryland regions. Synthesis: Our study offers a global picture of the vegetation response to two climate forcing variables using satellite data, information which is potentially relevant for mapping components and properties of vegetation responses worldwide. However, the large differences in the spatial patterns in intrinsic vegetation memory in our study compared to previous analyses show the overall sensitivity of this component in particular to the initial choice of extrinsic forcing variables. As a result, we caution against using the oversimplified link between intrinsic vegetation-memory and vegetation recovery rates at large spatial scales.

Why do micro and small merchants use mobile payment systems? A grounded theory study in China

Purpose This study aims to reveal the decision-making process that micro and small merchants (MSMs) may go through when deciding on the mobile payment system (MPS) adoption and usage and explore how relevant factors may impact this process. Design/methodology/approach This paper uses the grounded theory approach. Specifically, this paper conducts individual, semi-structured interviews with MSMs in China. Each interview was focused on an MSM’s decisions on initial adoption and continued use of MPSs. The paper then coded the interviews to derive conceptual categories and integrated the categories to form a cohesive framework to explain how MSMs make decisions on MPS adoption and usage. Findings MSMs make decisions on MPS adoption and usage in three phases: first, due to variations in social and economic surroundings, some merchants develop intentions to adopt MPSs, whereas others do not. Second, merchants developing adoption intentions in phase one have to select which MPS brands to adopt and then begin using them. The brand value affects their selection. Finally, the use of MPSs of their initial choice has consequences for business operations. Merchants with different levels of personal innovativeness evaluate the consequences differently. Satisfied merchants continue using the initial MPSs, while dissatisfied merchants switch to other brands. Originality/value The findings first give a more complete depiction of how MSMs make MPS adoption and usage decisions; second show that MSMs’ MPS adoption intention is solely influenced by pro-mobile-payment surroundings and explain what constitutes pro-mobile-payment surroundings and through what mechanisms the surroundings influence adoption intentions; third reveals that selecting which MPS brand to adopt is an important decision phase; fourth explain both why merchants may continue using MPSs and why they may switch from one MPS brand to another.

Cherry-picking information: humans actively sample evidence to support prior beliefs

No one likes to be wrong. Previous research has shown that participants may underweight information incompatible with previous choices, a phenomenon called confirmation bias. In this paper we argue that a similar bias exists in the way information is actively sought. We investigate how choice influences information gathering using a perceptual choice task and find that participants sample more information from a previously chosen alternative. Furthermore, the higher the confidence in the initial choice, the more biased information sampling becomes. As a consequence, when faced with the possibility of revising an earlier decision, participants are more likely to stick with their original choice, even when incorrect. Critically, we show that agency controls this phenomenon. The effect disappears in a fixed sampling condition where presentation of evidence is controlled by the experimenter, suggesting that the way in which confirmatory evidence is acquired critically impacts the decision process. These results suggest active information acquisition plays a critical role in the propagation of strongly held beliefs over time.

Specialists with higher medical education on the labor market

Based on the weighted microdata of the 2019 Rosstat Labor Force Survey, it was examined how the labor strategies of doctors implemented at the microlevel affect the situation on the labor market on the whole. To do this, the author tried to find answers to the following questions: 1) how the potential of those who had higher medical education was used in terms of their involvement in economic activity, 2) what is the amount of those whose labor path ran within the field of their chosen profession, and who did not work in the specialty and 3) what are the reserves of the unemployed, which, under certain conditions, could be used. The analysis carried out from the perspective of not only the standard, but also the extended concept of labor force showed high involvement of this professionally qualified group in the economy. Specialists with diplomas from medical higher schools stood out sharply among other categories of specialists by their commitment to their initial choice of profession. Only a relatively small number of doctors changed the type of occupation. Young doctors (graduates of2016-2018) followed the same strategies Judging by the scale of the real and potential resources of medical specialists, there is no reason to say that they are available in any significant amount. In scientific and political circles it is widely discussed how to overcome the shortage of doctors. Underestimation of the rather rigid restrictions on inter-professional mobility in the field of medicine leads to an increase in the vulnerability of this group of highly qualified specialists in the labor market and, as a consequence, to professional burnout and a decrease in motivation to work, which is extremely dangerous in medical practice.

Eosinophilic appendicitis due to Strongyloides stercoralis: a challenging differential diagnosis for clinicians

A 45-year-old man presents with 48-hour status of high temperature, cough and dyspnoea. In the context of pandemic, the patient is initially diagnosed with COVID-19 syndrome. Later, the laboratory and ultrasound study supported acute appendicitis diagnosis. Appendicectomy was performed. The histopathology study confirmed eosinophilic appendicitis and that a parasitic infection was suspected. The stool sample was positive for Strongyloides stercoralis. The diagnosis of a S.stercoralis is a rare finding in Spain. S. stercoralis simulates clinical findings of inflammatory bowel disease or eosinophilic gastroenteritis, which may lead to the wrong therapeutic choice. Since in inflammatory diseases corticosteroid treatments are considered the initial choice in many cases, in the case of S. stercoralis infection, the administration of this therapy can be fatal. In Spain, the number of diagnoses is much lower than in the past decade, although it is highly probable that the infection has been underdiagnosed due to low clinical awareness among Spanish population.