Cortico-subthalamic connection predicts individual differences in value-driven choice bias

It has been suggested that a connection between the STN and value-sensitive areas of the prefrontal cortex might mediate value-based actions in perceptual decision making. In this study, we first seek to quantify a structural connection between the STN and a cortical region that was associated with mechanisms underlying bias in choice behavior (vmPFC). Next, we tested whether individual differences in the probabilistic tract-strength of this connection were predictive for individual differences in the magnitude of bias in a perceptual decision-making task. Probabilistic tractography was used to measure the tract-strength between the STN and the vmPFC. Bias was quantified using an accumulation-to-bound model where a shift in the starting point of the accumulation of sensory evidence causes faster and more choices for an alternative that is more likely or more valuable. Results show that vmPFC is structurally connected with the STN and that the strength of this connection is predictive for choice bias towards an alternative that is more valuable, but not for choice bias towards an alternative that is more likely. These findings confirm the involvement of the cortico-subthalamic circuit in mechanisms underlying value-based actions in perceptual decision making.     

Video capsule endoscopy for previous overt obscure gastrointestinal bleeding in patients using anti‐thrombotic drugs

Background and Aim: Little is known about the causes of overt obscure gastrointestinal bleeding (OGIB) in patients using anti‐thrombotic therapy. We aimed to describe video capsule endoscopy (VCE) findings and to identify factors associated with positive findings in these patients. Methods: We carried out a retrospective study of 56 patients who underwent VCE for evaluation of previous overt OGIB during anti‐thrombotic therapy. VCE studies were re‐evaluated by a gastroenterologist blinded to clinical details. Clinical data included in the multivariate analysis were sex, age, indication for and type of anti‐thrombotic therapy, hemodynamic instability on admission, type of blood loss, hemoglobin on admission, use of a proton pump inhibitor, NSAID use, time between bleeding episodes and VCE, and whether or not anti‐thrombotic therapy was resumed before the VCE study. Results: A probable cause for gastrointestinal bleeding was identified in 28 (50%) of the 56 studies. Angiodysplasia was found in 19 patients. Twenty‐two studies showed a possible cause in the small bowel. Multivariate logistic regression analysis showed that reinstitution of anti‐thrombotic therapy before VCE was carried out was the only independent predictor of positive VCE findings (OR: 8.61, 95% CI: 1.20–60.42, P = 0.032). Conclusions: Small intestinal angiodysplasia was the most common cause for overt OGIB. Reinstitution of withdrawn anti‐thrombotic drugs before the VCE examination was carried out was associated with positive VCE findings in multivariate analysis.     

Birth characteristics and the risk of childhood leukaemias and lymphomas in New Zealand: a case-control study

Background  

Some studies have found that lower parity and higher or lower social class (depending on the study) are associated with increased risks of childhood acute lymphoblastic leukaemia (ALL). Such findings have led to suggestions that infection could play a role in the causation of this disease. An earlier New Zealand study found a protective effect of parental marriage on the risk of childhood ALL, and studies elsewhere have reported increased risks in relation to older parental ages. This study aimed to assess whether lower parity, lower social class, unmarried status and older parental ages increase the risk of childhood ALL (primarily). These variables were also assessed in relation to the risks of childhood acute non-lymphoblastic leukaemia, non-Hodgkin's lymphomas and Hodgkin's disease.