Mise à jour des croyances et congruence à l'humeur dans le trouble dépressif

Depressive disorder is characterized by a polymorphic symptomatology associating emotional, cognitive and behavioral disturbances. One of the most specific symptoms is negative beliefs, called congruent to mood. Despite the importance of these beliefs in the development, the maintenance, and the recurrence of depressive episodes, little is known about the processes underlying the generation of depressive beliefs. In this paper, we detail the link between belief updating mechanisms and the genesis of depressive beliefs. We show how depression alters information processing, generating cognitive immunization when processing positive information, affective updating bias related to the valence of belief and prediction error, and difficultie to disengage from negative information. We suggest that disruption of belief-updating mechanisms forms the basis of belief-mood congruence in depression.     

A critical commentary and updating of the guinea pig maximization test

The guinea pig maximization test (GPMT) of Magnusson and Kligman was published in 1969. Since then, a vast body of practical experience with the test has been accumulated. New information requires that certain aspects of the procedure be reevaluated, especially with regard to the interpretation of challenge results. In particular, awareness of the phenomenon of hyperirritable skin (the 'angry back' phenomenon) suggests that presently used controls are not always adequate and may overstate allergenicity owing to false-positive reactions. The control group should be exposed to a chemical insult at induction which provokes an inflammatory reaction comparable to the test substance. We present strategies to distinguish irritant from allergic responses. Allergic reactions should persist on rechallenge weeks later, while nonspecific irritant reactions generally fade and are irreproducible in particular animals. Finally, when a chemical is identified as a contact sensitizer of risk is necessary to estimate the relevance of the test result to usage in the real world.     

我国科技期刊封面特点及问题建议——以中国科学院主管主办科技期刊为例

【目的】 总结中国科学院主管主办科技期刊的封面特点,以促进我国科技期刊通过期刊封面增强内容传播与品牌建设。【方法】 对中国科学院主管主办的341种科技期刊封面按期更换比例、期刊封面的演进与美学特点进行调研和分析。【结果】 按期更换封面的科技期刊比例有所提升、演进速度明显加快、美感明显提升,版式表现出学科特点。同时,按期更换封面的期刊比例仍然偏低,封面规范性、美感、网络传播能力仍需加强,相关管理规范也存在滞后性。【结论】 我国科技期刊需要进一步提升封面的规范性与美感,增强在线与多媒体衍生品的创作与传播,管理部门也要与时俱进地改进管理规范,充分发挥期刊封面在学术成果传播中的重要价值。     

Assessing the need to update prevention guidelines: a comparison of two methods.

BACKGROUND: An important concern for developers of clinical practice guidelines is how best to determine when guidelines require updating to ensure they remain current and evidence based. Because of the high costs associated with updating guidelines, recent attention has focused on approaches that can reliably assess the extent of updating required. Recently, Shekelle and colleagues proposed a model of limited literature searches with modest expert involvement as a way to reduce the cost and time requirements for assessing whether a guideline needs updating. METHODS: The main objective of this study was to compare the Shekelle et al. assessment model (review approach) and a conventional process using typical systematic review methods (traditional approach) in terms of comprehensiveness and effort. We modeled the review approach on that by Shekelle and colleagues but refined it iteratively over three phases to achieve greater efficiency. Using both methods independently, we assessed the need to update six topics from the 1996 Guide to Clinical Preventive Services from the US Preventive Services Task Force. Main outcomes included completeness of study identification, importance of missed studies and the effort involved. RESULTS: Although the review approach identified fewer eligible studies than the traditional approach, none of the studies missed was rated as important by task force members acting as liaisons to the project with respect to whether the topic required an update. On average, the review approach produced substantially fewer citations to review than the traditional approach. The effort involved and potential time saving depended largely on the scope of the topic. CONCLUSIONS: The revised review approach provides an efficient and acceptable method for judging whether a guideline requires updating.     

The many weak instruments problem and Mendelian randomization

Instrumental variable estimates of causal effects can be biased when using many instruments that are only weakly associated with the exposure. We describe several techniques to reduce this bias and estimate corrected standard errors. We present our findings using a simulation study and an empirical application. For the latter, we estimate the effect of height on lung function, using genetic variants as instruments for height. Our simulation study demonstrates that, using many weak individual variants, two‐stage least squares (2SLS) is biased, whereas the limited information maximum likelihood (LIML) and the continuously updating estimator (CUE) are unbiased and have accurate rejection frequencies when standard errors are corrected for the presence of many weak instruments. Our illustrative empirical example uses data on 3631 children from England. We used 180 genetic variants as instruments and compared conventional ordinary least squares estimates with results for the 2SLS, LIML, and CUE instrumental variable estimators using the individual height variants. We further compare these with instrumental variable estimates using an unweighted or weighted allele score as single instruments. In conclusion, the allele scores and CUE gave consistent estimates of the causal effect. In our empirical example, estimates using the allele score were more efficient. CUE with corrected standard errors, however, provides a useful additional statistical tool in applications with many weak instruments. The CUE may be preferred over an allele score if the population weights for the allele score are unknown or when the causal effects of multiple risk factors are estimated jointly. © 2014 The Authors. Statistics in Medicine published by John Wiley & Sons Ltd.     

Optimistic amnesia: how online and offline processing shape belief updating and memory biases in immediate and long-term optimism biases

When people are confronted with feedback that counters their prior beliefs, they preferentially rely on desirable rather than undesirable feedback in belief updating, i.e. an optimism bias. In two pre-registered EEG studies employing an adverse life event probability estimation task, we investigated the neurocognitive processes that support the formation and the change of optimism biases in immediate and 24 h delayed tests. We found that optimistic belief updating biases not only emerged immediately but also became significantly larger after 24 h, suggesting an active role of valence-dependent offline consolidation processes in the change of optimism biases. Participants also showed optimistic memory biases: they were less accurate in remembering undesirable than desirable feedback probabilities, with inferior memories of undesirable feedback associated with lower belief updating in the delayed test. Examining event-related brain potentials (ERPs) revealed that desirability of feedback biased initial encoding: desirable feedback elicited larger P300s than undesirable feedback, with larger P300 amplitudes predicting both higher belief updating and memory accuracies. These results suggest that desirability of feedback could bias both online and offline memory-related processes such as encoding and consolidation, with both processes contributing to the formation and change of optimism biases.     

Neural correlates of informational cascades: brain mechanisms of social influence on belief updating

Informational cascades can occur when rationally acting individuals decide independently of their private information and follow the decisions of preceding decision-makers. In the process of updating beliefs, differences in the weighting of private and publicly available social information may modulate the probability that a cascade starts in a decisive way. By using functional magnetic resonance imaging, we examined neural activity while participants updated their beliefs based on the decisions of two fictitious stock market traders and their own private information, which led to a final decision of buying one of two stocks. Computational modeling of the behavioral data showed that a majority of participants overweighted private information. Overweighting was negatively correlated with the probability of starting an informational cascade in trials especially prone to conformity. Belief updating by private information was related to activity in the inferior frontal gyrus/anterior insula, the dorsolateral prefrontal cortex and the parietal cortex; the more a participant overweighted private information, the higher the activity in the inferior frontal gyrus/anterior insula and the lower in the parietal-temporal cortex. This study explores the neural correlates of overweighting of private information, which underlies the tendency to start an informational cascade.     

71例药品说明书样稿中 [注意事项] 问题分析

药品说明书的 [注意事项] 是消费者用药的重要参考,因此药品生产企业认真撰写该项目对保障安全、有效地用药非常重要。从2010年以来报送到国家食品药品监督管理总局药品审评中心的药品说明书样稿中,收集不符合我国有关法规的 [注意事项] 71例,其中进口药36例、国产药35例,涉及20多种临床用药类别,并分析存在的主要问题。结果发现不及时更新内容是最多见而严重的问题,急待药品生产厂商（包括进口药厂商）正确对待、及时改进,以确保用药安全。     

Bayesian logistic regression for online recalibration and revision of risk prediction models with performance guarantees

ObjectiveAfter deploying a clinical prediction model, subsequently collected data can be used to fine-tune its predictions and adapt to temporal shifts. Because model updating carries risks of over-updating/fitting, we study online methods with performance guarantees. Materials and MethodsWe introduce 2 procedures for continual recalibration or revision of an underlying prediction model: Bayesian logistic regression (BLR) and a Markov variant that explicitly models distribution shifts (MarBLR). We perform empirical evaluation via simulations and a real-world study predicting Chronic Obstructive Pulmonary Disease (COPD) risk. We derive “Type I and II” regret bounds, which guarantee the procedures are noninferior to a static model and competitive with an oracle logistic reviser in terms of the average loss.ResultsBoth procedures consistently outperformed the static model and other online logistic revision methods. In simulations, the average estimated calibration index (aECI) of the original model was 0.828 (95%CI, 0.818–0.938). Online recalibration using BLR and MarBLR improved the aECI towards the ideal value of zero, attaining 0.265 (95%CI, 0.230–0.300) and 0.241 (95%CI, 0.216–0.266), respectively. When performing more extensive logistic model revisions, BLR and MarBLR increased the average area under the receiver-operating characteristic curve (aAUC) from 0.767 (95%CI, 0.765–0.769) to 0.800 (95%CI, 0.798–0.802) and 0.799 (95%CI, 0.797–0.801), respectively, in stationary settings and protected against substantial model decay. In the COPD study, BLR and MarBLR dynamically combined the original model with a continually refitted gradient boosted tree to achieve aAUCs of 0.924 (95%CI, 0.913–0.935) and 0.925 (95%CI, 0.914–0.935), compared to the static model’s aAUC of 0.904 (95%CI, 0.892–0.916).DiscussionDespite its simplicity, BLR is highly competitive with MarBLR. MarBLR outperforms BLR when its prior better reflects the data.ConclusionsBLR and MarBLR can improve the transportability of clinical prediction models and maintain their performance over time.