Publications by authors named "Peter Dayan"

344 Publications

Human subjects exploit a cognitive map for credit assignment.

Proc Natl Acad Sci U S A 2021 Jan;118(4)

Max Planck UCL Centre for Computational Psychiatry and Ageing Research, University College London, WC1B 5EH London, United Kingdom.

An influential reinforcement learning framework proposes that behavior is jointly governed by model-free (MF) and model-based (MB) controllers. The former learns the values of actions directly from past encounters, and the latter exploits a cognitive map of the task to calculate these prospectively. Considerable attention has been paid to how these systems interact during choice, but how and whether knowledge of a cognitive map contributes to the way MF and MB controllers assign credit (i.e., to how they revaluate actions and states following the receipt of an outcome) remains underexplored. Here, we examine such sophisticated credit assignment using a dual-outcome bandit task. We provide evidence that knowledge of a cognitive map influences credit assignment in both MF and MB systems, mediating subtly different aspects of apparent relevance. Specifically, we show MF credit assignment is enhanced for those rewards that are related to a choice, and this contrasted with choice-unrelated rewards that reinforced subsequent choices negatively. This modulation is only possible based on knowledge of task structure. On the other hand, MB credit assignment was boosted for outcomes that impacted on differences in values between offered bandits. We consider mechanistic accounts and the normative status of these findings. We suggest the findings extend the scope and sophistication of cognitive map-based credit assignment during reinforcement learning, with implications for understanding behavioral control.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1073/pnas.2016884118DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7848688PMC
January 2021

Dissecting the links between reward and loss, decision-making, and self-reported affect using a computational approach.

PLoS Comput Biol 2021 Jan 8;17(1):e1008555. Epub 2021 Jan 8.

Centre for Behavioural Biology, School of Veterinary Science, University of Bristol, Langford, United Kingdom.

Links between affective states and risk-taking are often characterised using summary statistics from serial decision-making tasks. However, our understanding of these links, and the utility of decision-making as a marker of affect, needs to accommodate the fact that ongoing (e.g., within-task) experience of rewarding and punishing decision outcomes may alter future decisions and affective states. To date, the interplay between affect, ongoing reward and punisher experience, and decision-making has received little detailed investigation. Here, we examined the relationships between reward and loss experience, affect, and decision-making in humans using a novel judgement bias task analysed with a novel computational model. We demonstrated the influence of within-task favourability on decision-making, with more risk-averse/'pessimistic' decisions following more positive previous outcomes and a greater current average earning rate. Additionally, individuals reporting more negative affect tended to exhibit greater risk-seeking decision-making, and, based on our model, estimated time more poorly. We also found that individuals reported more positive affective valence during periods of the task when prediction errors and offered decision outcomes were more positive. Our results thus provide new evidence that (short-term) within-task rewarding and punishing experiences determine both future decision-making and subjectively experienced affective states.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1371/journal.pcbi.1008555DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7819615PMC
January 2021

PEMCRC anaphylaxis study protocol: a multicentre cohort study to derive and validate clinical decision models for the emergency department management of children with anaphylaxis.

BMJ Open 2021 Jan 5;11(1):e037341. Epub 2021 Jan 5.

Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.

Introduction: There remain significant knowledge gaps about the management and outcomes of children with anaphylaxis. These gaps have led to practice variation regarding decisions to hospitalise children and length of observation periods following treatment with epinephrine. The objectives of this multicentre study are to (1) determine the prevalence of and risk factors for severe, persistent, refractory and biphasic anaphylaxis, as well as persistent and biphasic non-anaphylactic reactions; (2) derive and validate prediction models for emergency department (ED) discharge; and (3) determine data-driven lengths of ED and inpatient observation prior to discharge to home based on initial reaction severity.

Methods And Analysis: The study is being conducted through the Pediatric Emergency Medicine Collaborative Research Committee (PEMCRC). Children 6 months to less than 18 years of age presenting to 30 participating EDs for anaphylaxis from October 2015 to December 2019 will be eligible. The primary outcomes for each objective are (1) severe, persistent, refractory or biphasic anaphylaxis, as well as persistent or biphasic non-anaphylactic reactions; (2) safe ED discharge, defined as no receipt of acute anaphylaxis medications or hypotension beyond 4 hours from first administered dose of epinephrine; and (3) time from first to last administered dose of epinephrine and vasopressor cessation. Analyses for each objective include (1) descriptive statistics to estimate prevalence and generalised estimating equations that will be used to investigate risk factors for anaphylaxis outcomes, (2) least absolute shrinkage and selection operator regression and binary recursive partitioning to derive and validate prediction models of children who may be candidates for safe ED discharge, and (3) Kaplan-Meier analyses to assess timing from first to last epinephrine doses and vasopressor cessation based on initial reaction severity.

Ethics And Dissemination: All sites will obtain institutional review board approval; results will be published in peer-reviewed journals and disseminated via traditional and social media, blogs and online education platforms.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1136/bmjopen-2020-037341DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7786808PMC
January 2021

Comparison of preadministered and coadministered lidocaine for treating pain and distress associated with intranasal midazolam administration in children: A randomized clinical trial.

J Am Coll Emerg Physicians Open 2020 Dec 26;1(6):1562-1570. Epub 2020 Aug 26.

Department of Emergency Medicine Division of Pediatric Emergency Medicine Columbia University College of Physicians and Surgeons New York New York USA.

Objective: Pain and distress associated with intranasal midazolam administration can be decreased by administering lidocaine before intranasal midazolam (preadministered lidocaine) or combining lidocaine with midazolam in a single solution (coadministered lidocaine). We hypothesized coadministered lidocaine is non-inferior to preadministered lidocaine for decreasing pain and distress associated with intranasal midazolam administration.

Methods: Randomized, outcome assessor-blinded, noninferiority trial. Children aged 6 months to 7 years undergoing laceration repair received intranasal midazolam with preadministered or coadministered lidocaine. Pain and distress were evaluated with the Observational Scale of Behavioral Distress-Revised (OSBD-R) (primary outcome; non-inferiority margin 1.8 units) and the Children's Hospital of Eastern Ontario Pain Scale (CHEOPS) and Faces, Legs, Activity, Cry, Consolability (FLACC) scales and cry duration (secondary outcomes). Secondary outcomes also included adverse events, clinician and caregiver satisfaction, and pain and distress associated with intranasal lidocaine administration.

Results: Fifty-one patients were analyzed. Mean OSBD-R scores associated with intranasal midazolam administration were 6.4 (95% confidence interval [CI] 5, 7.8) and 7 (95% CI 5.2, 8.9) units for preadministered and coadministered lidocaine, respectively. The difference of 0.6 (95% CI -1.7, 2.8) units represented an inconclusive non-inferiority determination. CHEOPS and FLACC scores and cry duration were similar between groups. OSBD-R, CHEOPS, and FLACC scores and cry duration associated with intranasal lidocaine administration were 3.8, 9.9, and 6 units, and 56 seconds, respectively. Clinicians considered coadministered lidocaine easier to administer.

Conclusion: Pain and distress associated with intranasal midazolam administration were similar when using coadministered or preadministered lidocaine, but our non-inferiority determination was inconclusive. Administration of intranasal lidocaine by itself was associated with a measurable degree of pain and distress.Keywords: intranasal, midazolam, anxiolysis, sedation, emergency department, emergency medicine, pain, distress, pediatric, lidocaine, laceration.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/emp2.12227DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7771777PMC
December 2020

Impaired adaptation of learning to contingency volatility in internalizing psychopathology.

Elife 2020 12 22;9. Epub 2020 Dec 22.

Department of Psychology, UC Berkeley, Berkeley, United States.

Using a contingency volatility manipulation, we tested the hypothesis that difficulty adapting probabilistic decision-making to second-order uncertainty might reflect a core deficit that cuts across anxiety and depression and holds regardless of whether outcomes are aversive or involve reward gain or loss. We used bifactor modeling of internalizing symptoms to separate symptom variance common to both anxiety and depression from that unique to each. Across two experiments, we modeled performance on a probabilistic decision-making under volatility task using a hierarchical Bayesian framework. Elevated scores on the common internalizing factor, with high loadings across anxiety and depression items, were linked to impoverished adjustment of learning to volatility regardless of whether outcomes involved reward gain, electrical stimulation, or reward loss. In particular, high common factor scores were linked to dampened learning following better-than-expected outcomes in volatile environments. No such relationships were observed for anxiety- or depression-specific symptom factors.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.7554/eLife.61387DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7755392PMC
December 2020

Computational Psychiatry for Computers.

iScience 2020 Dec 7;23(12):101772. Epub 2020 Nov 7.

Max Planck Institute for Biological Cybernetics, Tübingen, Baden-Württemberg, Germany.

Computational psychiatry is a nascent field that attempts to use multi-level analyses of the underlying computational problems that we face in navigating a complex, uncertain and changing world to illuminate mental dysfunction and disease. Two particular foci of the field are the costs and benefits of environmental adaptivity and the danger and necessity of heuristics. Here, we examine the extent to which these foci and others can be used to study the actual and potential flaws of the artificial computational devices that we are increasingly inventing and empowering to navigate this very same environment on our behalf.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.isci.2020.101772DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7691174PMC
December 2020

Invasive Bacterial Infections in Afebrile Infants Diagnosed With Acute Otitis Media.

Pediatrics 2021 Jan 7;147(1). Epub 2020 Dec 7.

Department of Emergency Medicine, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York.

Objectives: To determine the prevalence of invasive bacterial infections (IBIs) and adverse events in afebrile infants with acute otitis media (AOM).

Methods: We conducted a 33-site cross-sectional study of afebrile infants ≤90 days of age with AOM seen in emergency departments from 2007 to 2017. Eligible infants were identified using emergency department diagnosis codes and confirmed by chart review. IBIs (bacteremia and meningitis) were determined by the growth of pathogenic bacteria in blood or cerebrospinal fluid (CSF) culture. Adverse events were defined as substantial complications resulting from or potentially associated with AOM. We used generalized linear mixed-effects models to identify factors associated with IBI diagnostic testing, controlling for site-level clustering effect.

Results: Of 5270 infants screened, 1637 met study criteria. None of the 278 (0%; 95% confidence interval [CI]: 0%-1.4%) infants with blood cultures had bacteremia; 0 of 102 (0%; 95% CI: 0%-3.6%) with CSF cultures had bacterial meningitis; 2 of 645 (0.3%; 95% CI: 0.1%-1.1%) infants with 30-day follow-up had adverse events, including lymphadenitis (1) and culture-negative sepsis (1). Diagnostic testing for IBI varied across sites and by age; overall, 278 (17.0%) had blood cultures, and 102 (6.2%) had CSF cultures obtained. Compared with infants 0 to 28 days old, older infants were less likely to have blood cultures ( < .001) or CSF cultures ( < .001) obtained.

Conclusion: Afebrile infants with clinician-diagnosed AOM have a low prevalence of IBIs and adverse events; therefore, outpatient management without diagnostic testing may be reasonable.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1542/peds.2020-1571DOI Listing
January 2021

Respiratory viruses in pediatric emergency department patients and their family members.

Influenza Other Respir Viruses 2021 01 30;15(1):91-98. Epub 2020 Jul 30.

Environmental Health Sciences Department, Mailman School of Public Health, Columbia University, New York, NY, USA.

Background: Respiratory viral infections account for a substantial fraction of pediatric emergency department (ED) visits. We examined the epidemiological patterns of seven common respiratory viruses in children presenting to EDs with influenza-like illness (ILI). Additionally, we examined the co-occurrence of viral infections in the accompanying adults and risk factors associated with the acquisition of these viruses.

Methods: Nasopharyngeal swab were collected from children seeking medical care for ILI and their accompanying adults (Total N = 1315). Study sites included New York Presbyterian, Bellevue, and Tisch hospitals in New York City. PCR using a respiratory viral panel was conducted, and data on symptoms and medical history were collected.

Results: Respiratory viruses were detected in 399 children (62.25%) and 118 (17.5%) accompanying adults. The most frequent pathogen detected was human rhinovirus (HRV) (28.81%). Co-infection rates were 14.79% in children and 8.47% in adults. Respiratory syncytial virus (RSV) and parainfluenza infections occurred more often in younger children. Influenza and HRV occurred more often in older children. Influenza and coronavirus were mostly isolated in winter and spring, RSV in fall and winter and HRV in fall and spring. Children with HRV were more likely to have history of asthma. Adults with the same virus as their child often accompanied ≤ 2-year-old-positive children and were more likely to be symptomatic compared to adults with different viruses.

Conclusions: Respiratory viruses, while presenting the same suite of symptoms, possess distinct seasonal cycles and affect individuals differently based on a number of identifiable factors, including age and history of asthma.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/irv.12789DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7767945PMC
January 2021

The Anterior Cingulate Cortex Predicts Future States to Mediate Model-Based Action Selection.

Neuron 2021 01 4;109(1):149-163.e7. Epub 2020 Nov 4.

Champalimaud Neuroscience Program, Champalimaud Centre for the Unknown, Lisbon, Portugal; Department of Neuroscience and Neurology, Zuckerman Mind Brain Behavior Institute, Columbia University, New York, NY, USA.

Behavioral control is not unitary. It comprises parallel systems, model based and model free, that respectively generate flexible and habitual behaviors. Model-based decisions use predictions of the specific consequences of actions, but how these are implemented in the brain is poorly understood. We used calcium imaging and optogenetics in a sequential decision task for mice to show that the anterior cingulate cortex (ACC) predicts the state that actions will lead to, not simply whether they are good or bad, and monitors whether outcomes match these predictions. ACC represents the complete state space of the task, with reward signals that depend strongly on the state where reward is obtained but minimally on the preceding choice. Accordingly, ACC is necessary only for updating model-based strategies, not for basic reward-driven action reinforcement. These results reveal that ACC is a critical node in model-based control, with a specific role in predicting future states given chosen actions.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.neuron.2020.10.013DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7837117PMC
January 2021

Adversarial vulnerabilities of human decision-making.

Proc Natl Acad Sci U S A 2020 11 4;117(46):29221-29228. Epub 2020 Nov 4.

Max Planck Institute for Biological Cybernetics, 72076 Tübingen, Germany.

Adversarial examples are carefully crafted input patterns that are surprisingly poorly classified by artificial and/or natural neural networks. Here we examine adversarial vulnerabilities in the processes responsible for learning and choice in humans. Building upon recent recurrent neural network models of choice processes, we propose a general framework for generating adversarial opponents that can shape the choices of individuals in particular decision-making tasks toward the behavioral patterns desired by the adversary. We show the efficacy of the framework through three experiments involving action selection, response inhibition, and social decision-making. We further investigate the strategy used by the adversary in order to gain insights into the vulnerabilities of human choice. The framework may find applications across behavioral sciences in helping detect and avoid flawed choice.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1073/pnas.2016921117DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7682379PMC
November 2020

Presence and Duration of Symptoms in Febrile Infants With and Without SARS-CoV-2 Infection.

Pediatr Infect Dis J 2020 11;39(11):e372-e374

From the Division of Pediatric Emergency Medicine, Department of Emergency Medicine.

The clinical course of SARS-CoV-2 infection in young infants is not well understood. In this prospective cohort study, we compared the presence and duration of symptoms in febrile infants ≤60 days with (n = 7) and without (n = 16) SARS-CoV-2 infection. Overall, we observed overlapping symptoms and duration of illness, with longer length of cough and nasal congestion among the SARS-CoV-2-positive infants.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/INF.0000000000002858DOI Listing
November 2020

The Challenge of Clearly Counting COVID-19 Cases in Children.

Pediatrics 2020 12 29;146(6). Epub 2020 Sep 29.

Division of Pediatric Emergency Medicine, Department of Emergency Medicine, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1542/peds.2020-031682DOI Listing
December 2020

Playground equipment-related extremity fractures in children presenting to US emergency departments, 2006-2016.

Inj Epidemiol 2020 Sep 21;7(1):56. Epub 2020 Sep 21.

Department of Emergency Medicine, Columbia University Vagelos College of Physicians and Surgeons, 3959 Broadway, CHN-1-116, New York, NY, 10032, USA.

Background: Despite updated playground equipment and improved industry standards, playgrounds remain a common source of childhood injury. Fractures account for 35% of all playground injuries presenting to emergency departments (EDs). We aimed to examine the time trends and epidemiologic patterns of playground equipment-related extremity fractures in children in the United States.

Methods: We analyzed data from the National Electronic Injury Surveillance System. Children ≤14 years presenting to US emergency departments from 2006 to 2016 with playground equipment-related injuries were included. We used weighted complex survey analysis to describe the epidemiologic patterns and severity of playground equipment-related extremity fractures and Joinpoint linear weighted regression analysis to determine trends in extremity fractures.

Results: An annual average of 72,889 children were treated in US EDs for playground equipment-related extremity fractures, yielding a national annual incidence rate of 119.2 per 100,000 children. Playground equipment-related extremity fractures accounted for 33.9% of ED presentations and 78.7% of hospitalizations for playground equipment-related injuries. Of patients with playground equipment-related extremity fractures, 11.2% had severe fractures requiring hospitalization. The annual rate of ED visits due to playground equipment-related extremity fractures remained stable (annual rate of change = 0.74, p = 0.14) from 2006 to 2016. Adjusted for age, injuries on monkey bars or climbing gyms were associated with significantly increased odds of extremity fractures in comparison to injuries from other playground equipment (adjusted odds ratio [aOR]: 2.0; 95% CI: 1.9-2.1). Overall, 49.8% of extremity fractures and 54.7% of severe extremity fractures (i.e. those requiring hospitalization) occurred on monkey bars or climbing gyms.

Conclusions: Despite enhanced playground safety standards, national rates of playground equipment-related extremity fractures have remained stable in the US. Extremity fractures remain the most common type of playground injury presenting to EDs and most commonly occur on monkey bars and climbing gyms.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s40621-020-00275-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7504645PMC
September 2020

A User-Informed, Theory-Based Pregnancy Prevention Intervention for Adolescents in the Emergency Department: A Prospective Cohort Study.

J Adolesc Health 2020 Sep 15. Epub 2020 Sep 15.

Division of Pediatric Emergency Medicine, Department of Emergency Medicine, Columbia University Medical Center, New York, New York.

Purpose: Female adolescents seeking emergency department (ED) care are at high risk of unintended pregnancy, primarily because of contraceptive nonuse; yet, few ED patients follow up for reproductive care when referred. The objective of this cohort study was to determine the feasibility, acceptability, adoption, fidelity, and potential efficacy of a personalized and interactive ED-based pregnancy prevention mobile health intervention (Emergency Room Interventions to improve the Care of Adolescents [Dr. Erica]).

Methods: We conducted a prospective cohort study with sexually active female ED patients aged 14-19 years who were not using highly effective contraceptives. Dr. Erica consists of a 10-week, automated, two-way texting intervention based on an evidence-based sexual health curriculum, the Social Cognitive Theory, and motivational interviewing techniques. At 12 weeks, we conducted follow-up via online survey and phone call to measure feasibility, acceptability, adoption, fidelity, and preliminary efficacy data (contraception initiation).

Results: We screened 209 female ED patients to enroll 42. The average age was 17.5 years (standard deviation ± 1.4); the majority were Hispanic (n = 37, 88%) and had a primary provider (n = 40, 95%). One participant opted out (1/42, 2%), and a total of 35 participants (83%) completed follow-up. Although interactivity diminished with time, 83% of participants (35/42) replied to one or more text. Ninety-four percent of participants (29/31) liked the messages, and 83% (25/30) would recommend the program. Hormonal contraceptives were initiated by 46% of participants (16/35).

Conclusions: Dr. Erica was feasible and acceptable among female adolescent ED patients and demonstrated high fidelity and adoption. The intervention also showed potential to increase highly effective contraceptive use among high-risk females.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jadohealth.2020.07.020DOI Listing
September 2020

Considerations for Designing EHR-Embedded Clinical Decision Support Systems for Antimicrobial Stewardship in Pediatric Emergency Departments.

Appl Clin Inform 2020 08 9;11(4):589-597. Epub 2020 Sep 9.

Department of Pediatrics and Emergency Medicine, Section of Emergency Medicine, School of Medicine, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, United States.

Objective: This study was aimed to explore the intersection between organizational environment, workflow, and technology in pediatric emergency departments (EDs) and how these factors impact antibiotic prescribing decisions.

Methods: Semistructured interviews with 17 providers (1 fellow and 16 attending faculty), and observations of 21 providers (1 physician assistant, 5 residents, 3 fellows, and 12 attendings) were conducted at three EDs in the United States. We analyzed interview transcripts and observation notes using thematic analysis.

Results: Seven themes relating to antibiotic prescribing decisions emerged as follows: (1) professional judgement, (2) cognition as a critical individual resource, (3) decision support as a critical organizational resource, (4) patient management with imperfect information, (5) information-seeking as a primary task, (6) time management, and (7) broad process boundaries of antibiotic prescribing.

Discussion: The emerging interrelated themes identified in this study can be used as a blueprint to design, implement, and evaluate clinical decision support (CDS) systems that support antibiotic prescribing in EDs. The process boundaries of antibiotic prescribing are broader than the current boundaries covered by existing CDS systems. Incongruities between process boundaries and CDS can under-support clinicians and lead to suboptimal decisions. We identified two incongruities: (1) the lack of acknowledgment that the process boundaries go beyond the physical boundaries of the ED and (2) the lack of integration of information sources (e.g., accessibility to prior cultures on an individual patient outside of the organization).

Conclusion: Significant opportunities exist to improve appropriateness of antibiotic prescribing by considering process boundaries in the design, implementation, and evaluation of CDS systems.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1055/s-0040-1715893DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7557324PMC
August 2020

Short-Term Fasting Selectively Influences Impulsivity in Healthy Individuals.

Front Psychol 2020 14;11:1644. Epub 2020 Jul 14.

Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom.

Previous research has shown that short-term fasting in healthy individuals is associated with changes in risky decision-making. The current experiment was designed to examine the influence of short-term fasting in healthy individuals on four types of impulsivity: reflection impulsivity, risky decision-making, delay aversion, and action inhibition. Participants were tested twice, once when fasted for 20 h, and once when satiated. Participants demonstrated impaired action inhibition when fasted; committing significantly more errors of commission during a food-related Affective Shifting Task. Participants also displayed decreased reflection impulsivity when fasted, opening significantly more boxes during the Information Sampling Task (IST). There were no significant differences in performance between fasted and satiated sessions for risky decision-making or delay aversion. These findings may have implications for understanding eating disorders such as Bulimia Nervosa (BN). Although BN has been characterized as a disorder of poor impulse control, inconsistent findings when comparing individuals with BN and healthy individuals on behavioral measures of impulsivity question this characterization. Since individuals with BN undergo periods of short-term fasting, the inconsistent findings could be due to differences in the levels of satiation of participants. The current results indicate that fasting can selectively influence performance on the IST, a measure of impulsivity previously studied in BN. However, the results from the IST were contrary to the original hypothesis and should be replicated before specific conclusions can be made.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3389/fpsyg.2020.01644DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7381251PMC
July 2020

Memory Alone Does Not Account for the Way Rats Learn a Simple Spatial Alternation Task.

J Neurosci 2020 09 4;40(38):7311-7317. Epub 2020 Aug 4.

Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, California 94143.

Animal behavior provides context for understanding disease models and physiology. However, that behavior is often characterized subjectively, creating opportunity for misinterpretation and misunderstanding. For example, spatial alternation tasks are treated as paradigmatic tools for examining memory; however, that link is actually an assumption. To test this assumption, we simulated a reinforcement learning (RL) agent equipped with a perfect memory process. We found that it learns a simple spatial alternation task more slowly and makes different errors than a group of male rats, illustrating that memory alone may not be sufficient to capture the behavior. We demonstrate that incorporating spatial biases permits rapid learning and enables the model to fit rodent behavior accurately. Our results suggest that even simple spatial alternation behaviors reflect multiple cognitive processes that need to be taken into account when studying animal behavior. Memory is a critical function for cognition whose impairment has significant clinical consequences. Experimental systems aimed at testing various sorts of memory are therefore also central. However, experimental designs to test memory are typically based on intuition about the underlying processes. We tested this using a popular behavioral paradigm: a spatial alternation task. Using behavioral modeling, we show that the straightforward intuition that these tasks just probe spatial memory fails to account for the speed at which rats learn or the types of errors they make. Only when memory-independent dynamic spatial preferences are added can the model learn like the rats. This highlights the importance of respecting the complexity of animal behavior to interpret neural function and validate disease models.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1523/JNEUROSCI.0972-20.2020DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7534917PMC
September 2020

Reward and punisher experience alter rodent decision-making in a judgement bias task.

Sci Rep 2020 07 16;10(1):11839. Epub 2020 Jul 16.

Bristol Veterinary School, University of Bristol, Bristol, BS40 5DU, UK.

The influence of affective states on decision-making is likely to be complex. Negative states resulting from experience of punishing events have been hypothesised to generate enhanced expectations of future punishment and 'pessimistic'/risk-averse decisions. However, they may also influence how decision-outcomes are valued. Such influences may further depend on whether decisions at hand are germane to the rewards or punishers that induced the affective state in the first place. Here we attempt to dissect these influences by presenting either many or few rewards or punishers of different types (sucrose vs air-puff; 50 kHz vs 22 kHz ultrasonic vocalisations) to rats, and investigating their subsequent decisions in a judgement bias task that employed sucrose and air-puff as decision outcomes. Rats that received many sucrose pellets prior to testing were more risk-averse than those receiving many air-puffs. Ultrasonic vocalisations did not alter decision-making. Computational analysis revealed a higher weighting of punishers relative to rewards (in agreement with findings from a separate behavioural task) and a bias towards the risk-averse response following pre-test sucrose compared to pre-test air-puff. Thus, in this study reward and punisher manipulation of affective state appeared to alter decision-making by influencing both expectation and valuation of decision-outcomes in a domain-specific way.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1038/s41598-020-68737-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7366639PMC
July 2020

Representation, abstraction, and simple-minded sophisticates.

Authors:
Peter Dayan

Behav Brain Sci 2020 06 19;43:e126. Epub 2020 Jun 19.

Max-Planck-Gesellschaft, Max Planck-Ring 8, 72076Tübingen,

Bayesian decision theory provides a simple formal elucidation of some of the ways that representation and representational abstraction are involved with, and exploit, both prediction and its rather distant cousin, predictive coding. Both model-free and model-based methods are involved.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1017/S0140525X19002942DOI Listing
June 2020

The value of what's to come: Neural mechanisms coupling prediction error and the utility of anticipation.

Sci Adv 2020 Jun 19;6(25):eaba3828. Epub 2020 Jun 19.

Max-Planck UCL Centre for Computational Psychiatry and Ageing Research, 10-12 Russell Square, London WC1B 5EH, UK.

Having something to look forward to is a keystone of well-being. Anticipation of future reward, such as an upcoming vacation, can often be more gratifying than the experience itself. Theories suggest the utility of anticipation underpins various behaviors, ranging from beneficial information-seeking to harmful addiction. However, how neural systems compute anticipatory utility remains unclear. We analyzed the brain activity of human participants as they performed a task involving choosing whether to receive information predictive of future pleasant outcomes. Using a computational model, we show three brain regions orchestrate anticipatory utility. Specifically, ventromedial prefrontal cortex tracks the value of anticipatory utility, dopaminergic midbrain correlates with information that enhances anticipation, while sustained hippocampal activity mediates a functional coupling between these regions. Our findings suggest a previously unidentified neural underpinning for anticipation's influence over decision-making and unify a range of phenomena associated with risk and time-delay preference.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1126/sciadv.aba3828DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7304967PMC
June 2020

Combined model-free and model-sensitive reinforcement learning in non-human primates.

PLoS Comput Biol 2020 06 22;16(6):e1007944. Epub 2020 Jun 22.

Institute of Neurology, Department of Clinical and Movement Neurosciences, University College London, London, United Kingdom.

Contemporary reinforcement learning (RL) theory suggests that potential choices can be evaluated by strategies that may or may not be sensitive to the computational structure of tasks. A paradigmatic model-free (MF) strategy simply repeats actions that have been rewarded in the past; by contrast, model-sensitive (MS) strategies exploit richer information associated with knowledge of task dynamics. MF and MS strategies should typically be combined, because they have complementary statistical and computational strengths; however, this tradeoff between MF/MS RL has mostly only been demonstrated in humans, often with only modest numbers of trials. We trained rhesus monkeys to perform a two-stage decision task designed to elicit and discriminate the use of MF and MS methods. A descriptive analysis of choice behaviour revealed directly that the structure of the task (of MS importance) and the reward history (of MF and MS importance) significantly influenced both choice and response vigour. A detailed, trial-by-trial computational analysis confirmed that choices were made according to a combination of strategies, with a dominant influence of a particular form of model sensitivity that persisted over weeks of testing. The residuals from this model necessitated development of a new combined RL model which incorporates a particular credit assignment weighting procedure. Finally, response vigor exhibited a subtly different collection of MF and MS influences. These results provide new illumination onto RL behavioural processes in non-human primates.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1371/journal.pcbi.1007944DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7332075PMC
June 2020

The roles of online and offline replay in planning.

Elife 2020 06 17;9. Epub 2020 Jun 17.

Max Planck UCL Centre for Computational Psychiatry and Ageing Research, University College London, London, United Kingdom.

Animals and humans replay neural patterns encoding trajectories through their environment, both whilst they solve decision-making tasks and during rest. Both on-task and off-task replay are believed to contribute to flexible decision making, though how their relative contributions differ remains unclear. We investigated this question by using magnetoencephalography (MEG) to study human subjects while they performed a decision-making task that was designed to reveal the decision algorithms employed. We characterised subjects in terms of how flexibly each adjusted their choices to changes in temporal, spatial and reward structure. The more flexible a subject, the more they replayed trajectories during task performance, and this replay was coupled with re-planning of the encoded trajectories. The less flexible a subject, the more they replayed previously preferred trajectories during rest periods between task epochs. The data suggest that online and offline replay both participate in planning but support distinct decision strategies.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.7554/eLife.56911DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7299337PMC
June 2020

Novel Coronavirus Infection in Febrile Infants Aged 60 Days and Younger.

Pediatrics 2020 09 11;146(3). Epub 2020 Jun 11.

Division of Pediatric Emergency Medicine, Department of Emergency Medicine, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York.

In this case series, we describe the clinical course and outcomes of 7 febrile infants aged ≤60 days with confirmed severe acute respiratory syndrome coronavirus 2 infection. No infant had severe outcomes, including the need for mechanical ventilation or ICU level of care. Two infants had concurrent urinary tract infections, which were treated with antibiotics. Although a small sample, our data suggest that febrile infants with severe acute respiratory syndrome coronavirus 2 infection often have mild illness.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1542/peds.2020-1550DOI Listing
September 2020

WITHDRAWN: Comparison of Preadministered and Coadministered Lidocaine for Treating Pain and Distress Associated With Intranasal Midazolam Administration in Children: A Randomized Clinical Trial.

Ann Emerg Med 2020 Jun 2. Epub 2020 Jun 2.

Department of Emergency Medicine, Division of Pediatric Emergency Medicine, Columbia University College of Physicians and Surgeons, New York, NY.

This article has been withdrawn at the request of the authors and editor. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/policies/article-withdrawal.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.annemergmed.2020.04.025DOI Listing
June 2020

Interobserver Agreement in the Assessment of Clinical Findings in Children with Headaches.

J Pediatr 2020 06;221:207-214

Division of Pediatric Emergency Medicine, Department of Emergency Medicine, Columbia University College of Physicians and Surgeons, New York, NY.

Objective: To determine the interobserver agreement of history and physical examination findings in children undergoing evaluation in the emergency department (ED) for headaches.

Study Design: We conducted a prospective, cross-sectional study of children aged 2-17 years evaluated at 3 tertiary-care pediatric EDs for non-traumatic headaches. Two clinicians independently completed a standardized assessment of each child and documented the presence or absence of history and physical examination variables. Unweighted κ statistics were determined for 68 history and 24 physical examination variables.

Results: We analyzed 191 paired observations; median age was 12 years, with 19 (9.9%) children younger than 7 years. Interrater reliability was at least moderate (κ ≥ 0.41) for 41 (60.3%) patient history variables. Eleven (61.1%) of 18 physical examination variables for which κ statistics could be calculated had a κ that was at least moderate.

Conclusions: A substantial number of history and physical examination findings demonstrated at least moderate κ statistic values when assessed in children with headaches in the ED. These variables may be generalizable across different types of clinicians for evaluation of children with headaches. If also found to predict the presence or absence of emergent intracranial abnormalities, the more reliable clinical findings may be helpful in the development of clinical prediction rules or risk stratification models that could be used across settings for children with headaches.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jpeds.2020.02.018DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7251971PMC
June 2020

Active surveillance documents rates of clinical care seeking due to respiratory illness.

Influenza Other Respir Viruses 2020 09 16;14(5):499-506. Epub 2020 May 16.

Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA.

Background: Respiratory viral infections are a leading cause of disease worldwide. However, the overall community prevalence of infections has not been properly assessed, as standard surveillance is typically acquired passively among individuals seeking clinical care.

Methods: We conducted a prospective cohort study in which participants provided daily diaries and weekly nasopharyngeal specimens that were tested for respiratory viruses. These data were used to analyze healthcare seeking behavior, compared with cross-sectional ED data and NYC surveillance reports, and used to evaluate biases of medically attended ILI as signal for population respiratory disease and infection.

Results: The likelihood of seeking medical attention was virus-dependent: higher for influenza and metapneumovirus (19%-20%), lower for coronavirus and RSV (4%), and 71% of individuals with self-reported ILI did not seek care and half of medically attended symptomatic manifestations did not meet the criteria for ILI. Only 5% of cohort respiratory virus infections and 21% of influenza infections were medically attended and classifiable as ILI. We estimated 1 ILI event per person/year but multiple respiratory infections per year.

Conclusion: Standard, healthcare-based respiratory surveillance has multiple limitations. Specifically, ILI is an incomplete metric for quantifying respiratory disease, viral respiratory infection, and influenza infection. The prevalence of respiratory viruses, as reported by standard, healthcare-based surveillance, is skewed toward viruses producing more severe symptoms. Active, longitudinal studies are a helpful supplement to standard surveillance, can improve understanding of the overall circulation and burden of respiratory viruses, and can aid development of more robust measures for controlling the spread of these pathogens.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/irv.12753DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7276732PMC
September 2020

Space, Time, and Fear: Survival Computations along Defensive Circuits.

Trends Cogn Sci 2020 03 3;24(3):228-241. Epub 2020 Feb 3.

Max Planck Institute for Biological Cybernetics, 72076 Tübingen, Germany; The University of Tübingen, Tübingen, Germany.

Naturalistic observations show that decisions to avoid or escape predators occur at different spatiotemporal scales and that they are supported by different computations and neural circuits. At their extremes, proximal threats are addressed by a limited repertoire of reflexive and myopic actions, reflecting reduced decision and state spaces and model-free (MF) architectures. Conversely, distal threats allow increased information processing supported by model-based (MB) operations, including affective prospection, replay, and planning. However, MF and MB computations are often intertwined, and under conditions of safety the foundations for future effective reactive execution can be laid through MB instruction of MF control. Together, these computations are associated with distinct population codes embedded within a distributed defensive circuitry whose goal is to determine and realize the best policy.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.tics.2019.12.016DOI Listing
March 2020

Uncertainty in learning, choice, and visual fixation.

Proc Natl Acad Sci U S A 2020 02 24;117(6):3291-3300. Epub 2020 Jan 24.

Department of Experimental Psychology, University College London, London WC1H 0AP, United Kingdom.

Uncertainty plays a critical role in reinforcement learning and decision making. However, exactly how it influences behavior remains unclear. Multiarmed-bandit tasks offer an ideal test bed, since computational tools such as approximate Kalman filters can closely characterize the interplay between trial-by-trial values, uncertainty, learning, and choice. To gain additional insight into learning and choice processes, we obtained data from subjects' overt allocation of gaze. The estimated value and estimation uncertainty of options influenced what subjects looked at before choosing; these same quantities also influenced choice, as additionally did fixation itself. A momentary measure of uncertainty in the form of absolute prediction errors determined how long participants looked at the obtained outcomes. These findings affirm the importance of uncertainty in multiple facets of behavior and help delineate its effects on decision making.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1073/pnas.1911348117DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7022187PMC
February 2020

Dissociating neural learning signals in human sign- and goal-trackers.

Nat Hum Behav 2020 02 11;4(2):201-214. Epub 2019 Nov 11.

Center for Addictive Disorders, Hospital of Psychiatry, University of Zürich, Zürich, Switzerland.

Individuals differ in how they learn from experience. In Pavlovian conditioning models, where cues predict reinforcer delivery at a different goal location, some animals-called sign-trackers-come to approach the cue, whereas others, called goal-trackers, approach the goal. In sign-trackers, model-free phasic dopaminergic reward-prediction errors underlie learning, which renders stimuli 'wanted'. Goal-trackers do not rely on dopamine for learning and are thought to use model-based learning. We demonstrate this double dissociation in 129 male humans using eye-tracking, pupillometry and functional magnetic resonance imaging informed by computational models of sign- and goal-tracking. We show that sign-trackers exhibit a neural reward prediction error signal that is not detectable in goal-trackers. Model-free value only guides gaze and pupil dilation in sign-trackers. Goal-trackers instead exhibit a stronger model-based neural state prediction error signal. This model-based construct determines gaze and pupil dilation more in goal-trackers.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1038/s41562-019-0765-5DOI Listing
February 2020