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When making inferences about the mental lives of others (e.g., others' preferences), it is critical to consider the extent to which the choices we observe are constrained. Prior research on the development of this tendency indicates a contradictory pattern: Children show remarkable sensitivity to constraints in traditional experimental paradigms, yet often fail to consider real-world constraints and privilege inherent causes instead. We propose that one explanation for this discrepancy may be that real-world constraints are often stable over time and lose their salience. The present research tested whether children (N = 133, 5- to 12-year-old mostly US children; 55% female, 45% male) become "less" sensitive to an actor's constraints after first observing two constrained actors (Stable condition) versus after first observing two actors in contexts with greater choice (Not Stable condition). We crossed the "stability" of the constraint with the "type" of constraint: either the constraint was deterministic such that there was only one option available (No Other Option constraint) or, in line with many real-world constraints, the constraint was probabilistic such that there "was" another option, but it was difficult to access (Hard to Access constraint). Results indicated that children in the Stable condition became less sensitive to the probabilistic Hard to Access constraint across trials. Notably, we also found that children's sensitivity to constraints was enhanced in the Not Stable condition regardless of whether the constraint was probabilistic or deterministic. We discuss implications for children's sensitivity to real-world constraints.

How do people come to opposite causal judgments about societal problems, such as whether a public health policy reduced COVID-19 cases? The current research tests an understudied cognitive mechanism in which people may agree about what "actually" happened (e.g., that a public health policy was implemented and COVID-19 cases declined), but can be made to disagree about the counterfactual, or what "would have" happened otherwise (e.g., whether COVID-19 cases would have declined naturally without intervention) via comparison cases. Across two preregistered studies (total N = 480), participants reasoned about the implementation of a public policy that was followed by an immediate decline in novel virus cases. Study 1 shows that people's judgments about the causal impact of the policy could be pushed in opposite directions by emphasizing comparison cases that imply different counterfactual outcomes. Study 2 finds that people recognize they can use such information to influence others. Specifically, in service of persuading others to support or reject a public health policy, people systematically showed comparison cases implying the counterfactual outcome that aligned with their position. These findings were robust across samples of U.S. college students and politically and socioeconomically diverse U.S. adults. Together, these studies suggest that implied counterfactuals are a powerful tool that individuals can use to manufacture others' causal judgments and warrant further investigation as a mechanism contributing to belief polarization.

Disparate impact rules are formally neutral but indirectly discriminate against protected groups (i.e., by targeting a characteristic that is more prevalent in a given group). Because these rules are not obviously malicious, they have been widely enacted to circumvent policies against explicit discrimination. In a series of four experiments, we show that adults and children are sensitive to the moral implications of disparate impact rules. However, we also find that they are more accepting of these rules when strong justification is provided, compared to rules with no justification. Crucially, demographic differences also impact people's judgments of disparate impact rules and their creators. We find that conservatives and those from groups not directly affected by the rule tend to be more accepting of it. By studying people's reasoning about disparate impact rules, this work aims to identify the mechanisms by which these rules may evade detection. Finally, we discuss how these insights may inform the development of interventions that highlight the problematic effects of indirectly discriminatory policies.

Abstract Background We explore an optimized approach for increasing lesion size using a novel ablation catheter with a surface thermocouple and efficient irrigation in a temperature‐control setting. Methods We conducted radiofrequency applications at various power levels (35 W, 40 W, and 45 W), contact forces (CFs, 10 g/20 g), and durations (60 s/120 s/180 s) in perpendicular/parallel catheter orientations, with normal saline irrigation (NS‐irrigation) and Half NS‐irrigation (HNS‐irrigation) in an ex‐vivo model (Step 1). In addition, we performed applications (35 W/40 W/45 W for 60 s/120 s/180 s in NS‐irrigation and 35 W/40 W for 60 s/120 s/180 s in HNS‐irrigation) in four swine (Step 2), evaluating lesion characteristics and the occurrence of steam pops. Results In Step 1, out of 288 lesions, we observed 47 (16.3%) steam pops, with 13 in NS‐irrigation and 34 in HNS‐irrigation (p = .001). Although steam pops were mostly observed with the most aggressive setting (45 W/180 s, 54%) with NS‐irrigation, they happened in less aggressive settings with HNS irrigation. Lesion size significantly increased with longer‐duration ablation but not with HNS‐irrigation. The optimal %impedance‐drop cutoff to predict steam pops was 20% with a negative‐predictive‐value (NPV) = 95.1% including NS‐ and HNS‐irrigation groups, and 22% with an NPV = 96.1% in NS‐irrigation group. In Step 2, similar to the ex‐vivo model, lesion size significantly increased with longer‐duration ablation but not with HNS‐irrigation. Steam pops were absent with NS‐irrigation (0/35) even with the largest %impedance‐drop reaching 31% at 45 W/180 s. All steam pops were observed with HNS‐irrigation (6/21, 29%). The optimal %impedance‐drop cutoff predicting steam pops was 24% with an NPV = 96.3% including both NS‐ and HNS‐irrigation groups. Conclusions Rather than using HNS‐irrigation, very long‐duration of radiofrequency applications up to 45 W/180 s may be recommended to safely and effectively increase lesion dimensions using this catheter with NS‐irrigation.

Purpose: The aim of this study was to retrospectively compare bone substitute fracture patterns and outcomes in patients who underwent open wedge high tibial osteotomy (OWHTO) with OSferion60 or OSferion60 Marvelous bone substitutes. Patients with and without bone substitute fractures were compared and risk factors for bone substitute fracture were identified. Methods: Included patients were physically active non-smokers with knee osteoarthritis and deformity in the proximal tibia, persistent pain, and

Abstract Companion diagnostic (CDx) tests play important roles in identifying oncogenic driver genes and tailoring effective molecularly targeted therapies for lung cancer patients. In Japan, the Oncomine Dx target test (ODxTT) and the AmoyDx pan lung cancer PCR panel (AmoyDx) are prominent CDx tests and only one of these tests is covered by the domestic insurance system. However, these CDx tests cover different target regions and apply different technologies (ODxTT is amplicon-based next-generation sequencing and AmoyDx is multiplex PCR-based assay), which may lead to missing of actionable mutations affecting patient prognosis. Here, we performed a direct comparison analysis of 1059 genetic alterations of eight driver genes from 131 samples and evaluated the concordance between two CDx tests for detecting actionable variants and fusions. When excluding the eight uncovered variants (ODxTT: two variants, AmoyDx: six variants), the overall percent agreement was 97.6% (1026/1051) with 89.0% of overall positive percent agreement (89/100) and 98.5% of overall negative percent agreement (937/951). Of the 25 discordant genetic alterations, two were undetected despite being covered in the AmoyDx (one EGFR variant and one ROS1 fusion). Furthermore, there were potential false positives in the ODxTT (nine MET exon 14 skippings) and in the AmoyDx (five variants, six ROS1 and three RET fusions). These potential false positives in the AmoyDx likely due to non-specific amplification, which was validated by the unique molecular barcoding sequencing. The ODxTT missed two uncovered EGFR rare variants, which was visually confirmed in the raw sequencing data. Our study provides insights into real-world performance of CDx tests for lung cancer and ensures reliability to advance precision medicine.

The oxygen evolution reaction (OER) on the TiO2 surface at the solid–liquid interface was observed in real-time and operando using fluorescence-yield X-ray absorption spectroscopy (XAS) in the soft X-ray region. The OER was observed during a potential sweep with UV light on or off, focusing on the oxygen K-edge XAS. Although conventional XAS measurements require long measurement times, the spectra during the reaction were obtained every 3 s in the present experiment via wavelength-dispersive XAS technique. An increase in the X-ray absorption intensity at approximately 533.8 eV was observed during the potential sweep only with UV light on. The observed spectral change is discussed in relation to the reaction mechanism of the OER. The present technique can be applied to a wide range of analyses of (photo-) electrocatalysis and electrochemical reactions at solid–liquid interfaces to observe their products and intermediates during the reaction.

To make accurate causal inferences about social-group inequalities, people must consider structural causes. Structural causes are a distinct type of extrinsic cause-they are stable, interconnected societal forces that systematically advantage some social groups and disadvantage others. We propose a new cognitive framework to specify how people attribute inequality to structural causes. This framework is rooted in counterfactual theories of causal judgment and suggests that people will recognize structural factors as causal when they are perceived as "difference-making" for inequality above and beyond any intrinsic causes. Building on this foundation, our framework makes the following contributions. First, we propose specific types of evidence that support difference-making inferences about structural factors: within-group change (i.e., observing that disadvantaged groups' outcomes improve under better societal conditions) and well-matched between-group comparisons (i.e., observing that advantaged group members, who have similar baseline traits to the disadvantaged group, experience more favorable societal conditions and life outcomes). Second, we consider contextual, cognitive, and motivational barriers that may complicate the availability and acceptance of this evidence. We conclude by exploring how the framework might be applied in future research examining people's causal inferences about inequality.

Abstract Aims Myocardial fibrosis of the left ventricle (LV) is a prognostic factor in dilated cardiomyopathy (DCM). This study aims to evaluate whether fibrosis of right ventricular (RV) endomyocardial biopsy (EMB) can predict the degree of LV fibrosis beforehand in DCM. Methods and results Fibrosis extent in 70 RV‐EMB specimens of DCM diagnosis was compared with that in the whole cross‐sectional LV of excised hearts in the same patients (52 explanted hearts for transplant and 18 autopsied hearts). The median interval between biopsy and excision was 4.1 (0.13–19.3) years. The fibrosis area ratio of the EMBs and excised hearts were evaluated via image analysis. The distribution of cardiovascular magnetic resonance–late gadolinium enhancement (LGE) in the intraventricular septum was classified into four quartile categories. The fibrosis area ratio in RV‐EMB correlated significantly with that in the short‐axis cut of the LV of excised hearts (r = 0.82, P

Abstract Detailed examinations of the internal structure of tablets are imperative for comprehending their formulation, physical attributes, and ensuring their safe utilization. While X-ray computed tomography (CT) is valuable for noninvasively analyzing internal structural changes, the influence of humidity on these structural changes remains unexplored. Accordingly, we aimed to assess the viability of X-ray CT in non-destructively evaluating the internal structure of humidified magnesium oxide (MgO) tablets. MgO tablets were subjected to conditions of 40 °C and 75% humidity for 7 days, weighed pre- and post-humidification, and subsequently stored at room temperature (22–27 °C) until day 90. Their internal structure was evaluated using X-ray CT. We observed a substantial increase in the weight of MgO tablets concomitant with moisture absorption, with minimal changes observed upon storage at room temperature. The skewness reduced immediately post-moisture absorption, remained almost the same post-storage at room temperature, and failed to revert to pre-humidification levels during the storage period. These findings highlight the utility of X-ray CT as an effective tool for non-destructive, three-dimensional, and detailed evaluation of internal structural transformations in MgO tablets.

Abstract Efforts to simplify standard polysomnography (PSG) in laboratories, especially for obstructive sleep apnea (OSA), and assess its agreement with portable electroencephalogram (EEG) devices are limited. We aimed to evaluate the agreement between a portable EEG device and type I PSG in patients with OSA and examine the EEG-based arousal index’s ability to estimate apnea severity. We enrolled 77 Japanese patients with OSA who underwent simultaneous type I PSG and portable EEG monitoring. Combining pulse rate, oxygen saturation (SpO2), and EEG improved sleep staging accuracy. Bland–Altman plots, paired t-tests, and receiver operating characteristics curves were used to assess agreement and screening accuracy. Significant small biases were observed for total sleep time, sleep latency, awakening after falling asleep, sleep efficiency, N1, N2, and N3 rates, arousal index, and apnea indexes. All variables showed > 95% agreement in the Bland–Altman analysis, with interclass correlation coefficients of 0.761–0.982, indicating high inter-instrument validity. The EEG-based arousal index demonstrated sufficient power for screening AHI ≥ 15 and ≥ 30 and yielded promising results in predicting apnea severity. Portable EEG device showed strong agreement with type I PSG in patients with OSA. These suggest that patients with OSA may assess their condition at home.

Children often need to rely on other peopleÕs testimony to figure out what happened. One challenge in learning from others is that people can disagree in their interpretations of what happened. The present research examined how children ages 7 to 11 use disagreement to make inferences about past social events. Specifically, when there is no reason to question the reliability of either informant, can children use disagreement to infer that an ambiguous social event occurred? Experiment 1 (N = 52) found that children are indeed more likely to infer that an ambiguous social event occurred after learning that people disagreed (versus agreed) about what happened and that this ability strengthens with age. Experiment 2 (n = 43; data collection ongoing) examines how children make this inference. We predict that childrenÕs ability to reason about what would cause disagreement is critical to make inferences from disagreement about what happened.

Abstract Background Delayed anterior cruciate ligament (ACL) reconstruction often causes residual anterolateral rotatory instability (ALRI) and consequent knee osteoarthritis, warranting the recommendation of early ACL reconstruction within 6 months after injury. Nonetheless, some cases show notable instability, even shortly after injury. The purpose of this study was to identify risk factors for an increase in quantitatively measured pivot shift in patients with ACL‐deficient knees within 6 months after injury. Methods Patients with primary ACL reconstruction within 6 months after injury and quantitative triaxial accelerometer measurements of preoperative pivot shift were included. Descriptive statistics were calculated for 11 independent variables (age, gender, time from injury to surgery, KT‐1000, knee extension angle, lateral and medial posterior tibial slope angle, medial and lateral meniscus tears, ramp lesion and Tegner active scale). A single regression analysis was performed on the 11 items and acceleration during the pivot shift, and a multiple regression analysis was performed for items with p value less than 0.1. Results Overall, 111 patients met the inclusion criteria. Single regression analysis showed that medial posterior tibial slope angle, medial meniscus tear and ramp lesion were significantly correlated with acceleration during the pivot shift (p

Abstract Purpose The correlation of cartilage thickness measured by three‐dimensional (3D) magnetic resonance imaging (MRI) and the medial meniscal coverage ratio (MMCR), which presented pathology of the medial meniscus extrusion (MME) in 3D MRI, has not yet been elucidated. The study's purpose was to retrospectively verify whether the average cartilage thickness calculated by the automatic MRI 3D analysis system for each subregion was correlated with MMCR. Methods A total of 60 patients underwent medial meniscus repair or high tibial osteotomy to treat their medial knee osteoarthritis. Cartilage thickness and MMCR were automatically calculated using 3D MRI software. The MMCR was defined as the ratio of the area covered by the meniscus within the medial tibial cartilage area to the total medial tibial cartilage area. The association between MMCR and the average cartilage thickness at 15 subregions in the medial femoral condyle (MFC) and medial tibial plateau (MTP) was evaluated using Spearman's rank correlation coefficient. Results Kellgren–Lawrence grade exhibited a negative correlation with MMCR and a positive correlation with MME width. Cartilage thickness in the MTP had a moderately positive correlation with MMCR at four subregions and a weakly positive correlation at another subregion. Cartilage thickness in the MFC showed a moderately positive correlation with MMCR at five subregions and a weakly positive correlation at one subregion. Conclusions Cartilage thickness calculated by automatic MRI 3D analysis system had a positive correlation with MMCR for all subregions of the anterior and middle subregions in the MFC and for five regions of nine subregions of the anterior and middle subregions in the MTP. Level of evidence Level II, cross‐sectional study (diagnosis).

Objective Although adverse childhood experiences (ACEs) are associated with poor health in adulthood, positive childhood experiences (PCEs) can reduce the risk of negative health outcomes. This study aimed to investigate whether PCEs in the community (CPCEs, ie, trusted adults other than parents, supportive friends, belongingness to school, or community traditions) would have an independent effect on better health outcomes and moderate the association between ACEs and adult illnesses.Design Cross-sectional survey.Setting Data were gathered from a nationwide, cross-sectional internet survey conducted in Japan in 2022.Participants This study included 28 617 Japanese adults aged 18–82 years (51.1% female; mean age=48.1 years).Primary and secondary outcome measures The associations among self-reported ACEs, CPCEs before the age of 18 years and current chronic diseases (eg, cancer and depression) were investigated using multivariable logistic regression models.Results CPCEs were associated with lower odds of adult diseases (such as stroke, chronic obstructive pulmonary disease (COPD), chronic pain, depression, suicidal ideation and severe psychological distress) after adjusting for ACEs. More CPCEs weakened the association between ACEs and adult diseases. Specifically, among those with ACEs, ≥3 CPCEs (vs 0–2 CPCEs) lowered the adjusted prevalence by ≥50% for stroke (2.4% to 1.2%), COPD (2.2% to 0.7%) and severe psychological distress (16.4% to 7.4%).Conclusion CPCEs could reduce ACE-related risk of poor physical and mental health in later life. Early-life interventions that enhance PCEs in schools and/or neighbourhoods are recommended.