Human choice behavior exhibits many paradoxical and challenging patterns. Traditional explanations focus on how values are represented, but little is known about how values are integrated. Here we outline a psychophysical task for value integration that can be used as a window on high-level, multiattribute decisions. Participants choose between alternative rapidly presented streams of numerical values. By controlling the temporal distribution of the values, we demonstrate that this process underlies many puzzling choice paradoxes, such as temporal, risk, and framing biases, as well as preference reversals. These phenomena can be explained by a simple mechanism based on the integration of values, weighted by their salience. The salience of a sampled value depends on its temporal order and momentary rank in the decision context, whereas the direction of the weighting is determined by the task framing. We show that many known choice anomalies may arise from the microstructure of the value integration process. decision making | decoy effects | value psychophysics | expanded judgement R ecent research on the psychology and neuroscience of simple, evidence-based choices (e.g., integrating perceptual or reward information) has made impressive progress, leading to the conclusion that the brain is optimized to make the fastest decision for a specified accuracy (1-5). Accordingly, the observer is assumed to infer the most probable cause of a perceived experience by sequentially accumulating samples of noisy evidence until a response criterion is reached. The idea that simple, evidence-based decision making is optimal contrasts with findings in more complex, motivation-based decisions, focused on multiple goals with tradeoffs (e.g., choices among cars or flats). Here, a number of paradoxical and puzzling choice behaviors (6-8) have been revealed, posing a serious challenge to the development of a unified theory of choice.Can a common theoretical framework between evidence-based and motivation-based decisions be established? A natural starting point is to propose that, in the latter, the cognitive system integrates subjective values (rather than, say, pieces of perceptual evidence), that depend on how each alternative matches the decision maker's goals (9). In particular, when alternatives are characterized by different attributes (e.g., product price and quality), preference is shaped through shifting attention across these attributes (8, 10), assessing an item's subjective value on each attribute, integrating these values across time, and finally making a choice when some threshold is reached (11-13). A detailed understanding of these computations might explain the systematic anomalies observed in motivation-based decisions.This line of research has been difficult to pursue, however, because classical laboratory preference tasks provide little control of the moment-by-moment processes of value sampling and integration. This stands in contrast with psychophysical paradigms for studying evidence-based perceptual choice wher...

New methods for long-lasting protection against sexually transmitted disease, such as the human immunodeficiency virus (HIV), are needed to help reduce the severity of STD epidemics, especially in developing countries. Intravaginal delivery of therapeutics has emerged as a promising means to provide women with local protection, but residence times of such agents are greatly reduced by the protective mucus layer, fluctuating hormone cycle, and complex anatomical structure of the reproductive tract. Polymeric nanoparticles (NPs) capable of encapsulating the desired cargo, penetrating through the mucosal surfaces, and delivering agents to the site of action have been explored. However, prolonged retention of polymer carriers and their enclosed materials may also be needed to ease adherence and confer longer-lasting protection against STDs. Here, we examined the fate of two poly(lactic acid)-hyperbranched polyglycerols (PLA-HPG) NP formulations – 1) nonadhesive PLA-HPG NPs (NNPs) and 2) surface-modified bioadhesive NPs (BNPs) – loaded with the antiretroviral elvitegravir (EVG) after intravaginal administration. BNP distribution was widespread throughout the reproductive tract, and retention was nearly 5 times higher than NNPs after 24h. Moreover, BNPs were found to be highly associated with submucosal leukocytes and epithelial cell populations for up to 48h after topical application, and EVG was retained significantly better in the vaginal lumen when delivered with BNPs as opposed to NNPs over a 24h period. Our results suggest that bioadhesive PLA-HPG NPs can greatly improve and prolong intravaginal delivery of agents, which may hold potential in providing sustained protection over longer durations.

Introduction: Intraoperative adverse events (iAEs) occur and have the potential to impact the postoperative course. However, iAEs are underreported and are not routinely collected in the contemporary surgical literature. There is no widely utilized system for the collection of essential aspects of iAEs, and there is no established database for the standardization and dissemination of this data that likely have implications for outcomes and patient safety. The Intraoperative Complication Assessment and Reporting with Universal Standards (ICARUS) Global Surgical Collaboration initiated a global effort to address these shortcomings, and the establishment of an adverse event data collection system is an essential step. In this study, we present the core-set variables for collecting iAEs that were based on the globally validated ICARUS criteria for surgical/interventional and anesthesiologic intraoperative adverse event collection and reporting. Material and Methods: This article includes three tools to capture the essential aspects of iAEs. The core-set variables were developed from the globally validated ICARUS criteria for reporting iAEs (item 1). Next, the summary table was developed to guide researchers in summarizing the accumulated iAE data in item 1 (item 2). Finally, this article includes examples of the method and results sections to include in a manuscript reporting iAE data (item 3). Then, 5 scenarios demonstrating best practices for completing items 1–3 were presented both in prose and in a video produced by the ICARUS collaboration. Dissemination: This article provides the surgical community with the tools for collecting essential iAE data. The ICARUS collaboration has already published the 13 criteria for reporting surgical adverse events, but this article is unique and essential as it actually provides the tools for iAE collection. The study team plans to collect feedback for future directions of adverse event collection and reporting. Highlights This article represents a novel, fully-encompassing system for the data collection of intraoperative adverse events. The presented core-set variables for reporting intraoperative adverse events are not based solely on our opinion, but rather are synthesized from the globally validated ICARUS criteria for reporting intraoperative adverse events. Together, the included text, figures, and ICARUS collaboration-produced video should equip any surgeon, anesthesiologist, or nurse with the tools to properly collect intraoperative adverse event data. Future directions include translation of this article to allow for the widest possible adoption of this important collection system.