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This research tentatively suggests that one option for increasing the use of algorithms is to give people constrained ability to intervene. In the same way that NASA gave the first astronauts limited control, with sometimes poor but thankfully not disastrous outcomes, we can allow people to tweak the output of the algorithm.

Surveys on attitudes about self-driving cars suggest an opportunity of this nature. While over three quarters of Americans are afraid to ride in a self-driving vehicle, the majority stated that they want some automation in their next vehicle. It is a degree of control they want, not complete control. How constrained could this control be? A big red stop button on the dash of the new self-driving car? And does that button have to be connected to anything?

Another study by Dietvorst ( working paper ) suggests a different strategy—changing what the decision maker perceives to be the default. When experimental subjects were asked what they would require to shift from their own judgement to that of the algorithm, they tended to assess the accuracy of the algorithm against the bonus threshold they were trying to meet, not against the weaker performance of their own judgement. However, when the algorithm was the default and they were asked what they would require to shift to their own judgement, they were substantially more likely to use the algorithm and performed better on the task.

When the algorithm was the default and they were asked what they would require to shift to their own judgement, they were substantially more likely to use the algorithm and performed better on the task.

This study is a limited and preliminary result, but it illustrates the central challenge to this approach—the difficulty of manipulating the default across numerous domains. But on the bright side, once an algorithm becomes the default, there will be a barrier to sliding back to the old option. There appears little demand for elevator operators today.

So now to another side of this story.

John Glenn, the first American astronaut to orbit the Earth. Image: adidas Cloudfoam Groove Mens Trainers Black Schwarz Lead/Core Black/Ftwr White cheap sale official site free shipping websites clearance excellent buy cheap real for sale cheap price from china sDOB5KO

The third Mercury flight was taken by John Glenn in what would become the first orbit of the earth by anAmerican (although he was also preceded by a chimpanzee). When Glenn was flying over California, the automatic attitude control and the gyros, which controlled the capsule’s orientation, started to go haywire. Glenn’s attempts to reset the gyros did not solve the problem. The automatic firing of the thrusters from the capsule trying to right itself was chewing up the fuel supply.

That Glenn was drifting around in circles did not matter at this stage of the flight—it only mattered at the critical point of re-entry that the blunt end of the capsule be pointed in the right direction. Too steep an angle of attack and the capsule would burn up; too shallow and he would bounce off the earth’s atmosphere and remain in space. He also needed fuel at the time that angle would be set.

First things first. Facebook no longer cares how much time users spend on its platform, as long as that time is “quality” time.

Man alive, this Facebook webinar is so scripted by the presenter … pic.twitter.com/3Fx565GlGi

— Matt Navarra (@MattNavarra) February 2, 2018

This is a big deal as most social networks, including Facebook, have traditionally competed for increasing lengths of “time spent.” The longer users spent on a network, the better. It was a signal of the network-in-question’s popularity.

But no longer. One of the ways Facebook is measuring quality is by defining certain actions as more “meaningful” than others.

The new algorithm prioritizes active interactions like commenting and sharing over likes and click-throughs ( passive interactions )—the idea being that actions requiring more effort on the part of the user are of higher quality and thus more meaningful. Rather than passively scrolling through the News Feed and occasionally pausing to “like” a photo or an article, Facebook wants users to be inspired to engage in conversations with each other.

active interactions passive interactions

It is these kinds of “meaningful” interactions—the ones that take more effort—that contribute to “quality” time on the platform and (arguably) help Facebook get back to its roots as a network primarily used by friends and family to keep in touch with each other.

Here’s a breakdown of the interactions Facebook says qualify as “meaningful.”

In his announcement, Zuckerberg wrote, “Pages making posts that people generally don’t react to or comment on could see the biggest decreases in distribution. Pages whose posts prompt conversations between friends will see less of an effect.”

This means brands should create quality content focused on sparking conversations between users. Try including questions in your posts, or writing about timely, relevant topics that users are sure to have an opinion on.

The point is, users will be more likely to see your Facebook posts if their friends and family are commenting on it.

If a user takes the time to hit the “love” icon vs. the “like” icon, your content will receive a minor boost in the News Feed. Just as in life, “loving” is a more valued emotional signal than “liking.”

The same goes for all Facebook’s reactions: Haha, Wow, Sad, and Angry. Facebook wants to see those “active” emotions.

The algorithm not only favors comments, but also replies to comments. These signal that a piece of content is inspiring conversation between users. (Remember, Zuckerberg deems “conversation” the most important outcome of this algorithm update). That means you want to be publishing content that inspires users to tag their friends in comments and start a conversation.

If a user shares a piece of content to their wall, that’s great. But what’s even better is if they take the time to send it to a friend (or a group of friends) over Facebook messenger.

Figure 17
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Diagnostic work-up of cardiovascular autonomic failure (adapted from Fanciulli ). CNS = central nervous system; CRMP-5 = collapsin response mediator protein 5; DAT = dopamine active transporter; HbA1c = haemoglobin A1c; HIV = human immunodeficiency virus; I-MIBG = I-metaiodobenzylguanidine; MRI = magnetic resonance imaging; PCA-2 = Purkinje cell cytoplasmic autoantibody type 2; SPECT = single-photon emission computed tomography; SS-A = Sjogren’s syndrome-associated antigen A; SS-B = Sjogren’s syndrome-associated antigen B.

Figure 17
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Diagnostic work-up of cardiovascular autonomic failure (adapted from Fanciulli ). CNS = central nervous system; CRMP-5 = collapsin response mediator protein 5; DAT = dopamine active transporter; HbA1c = haemoglobin A1c; HIV = human immunodeficiency virus; I-MIBG = I-metaiodobenzylguanidine; MRI = magnetic resonance imaging; PCA-2 = Purkinje cell cytoplasmic autoantibody type 2; SPECT = single-photon emission computed tomography; SS-A = Sjogren’s syndrome-associated antigen A; SS-B = Sjogren’s syndrome-associated antigen B.

The results of interictal EEGs are normal in syncope. 410 , 430 An interictal normal EEG cannot rule out epilepsy and the EEG in epilepsy must always be interpreted in a clinical context. An EEG is not recommended when syncope is the most likely cause of TLOC, but it is when epilepsy is the likely cause or when clinical data are equivocal. The EEG is also useful to establish PPS, if recorded during a provoked attack.

Computed tomography and MRI in uncomplicated syncope should be avoided. If neurological examination points out Parkinsonism, ataxia, or cognitive impairment, MRI is recommended. In cases of contraindication for MRI, computed tomography is recommended to exclude brain lesions.

No studies suggest that carotid Doppler ultrasonography is valuable in patients with typical syncope.

An acute or subacute onset of multidomain autonomic failure suggests a paraneoplastic or autoimmune cause. Screening for specific paraneoplastic antibodies is recommended: the most common paraneoplastic antibodies are anti-Hu, while others are anti-Purkinje cell cytoplasmic autoantibody type 2 and anti-collapsin response mediator protein 5. 431 Seropositivity for any of the above-mentioned antibodies may therefore prompt further investigation for occult malignancy (e.g. whole-body fluorodeoxyglucose−positron emission tomography). 432

Seropositivity for antiganglionic acetylcholine receptor antibodies is the serological hallmark of autoimmune autonomic ganglionopathy. 433 , 434

Patients who have failed to resolve recurrent CDI despite repeated antibiotic treatment attempts present a particularly difficult challenge. Clinical investigations of patients with recurrent CDI have shown significant disruption of the intestinal microbiome diversity as well as relative bacterial population numbers. Instillation of processed stool collected from a healthy donor into the intestinal tract of patients with recurrent CDI has been used with a high degree of success to correct the intestinal dysbiosis brought about by repeated courses of antibiotic administration [ 358–361 ]. Anecdotal treatment success rates of fecal microbiota transplantation (FMT) for recurrent CDI have been high regardless of route of instillation of feces, and have ranged between 77% and 94% with administration via the proximal small bowel [ 358 , 362 ]; the highest success rates (80%–100%) have been associated with instillation of feces via the colon [ 360 , 363–366 ]. By March 2016, >1945 patients (reported as single case reports and larger case series) with recurrent CDI had been described in the peer-reviewed literature (J. S. Bakken, unpublished data).

Despite the large number of anecdotal reports that have consistently demonstrated high efficacy of FMT, the first prospective randomized clinical trial that compared the outcome of standard antibiotic therapy to FMT was published in 2013 [ 367 ]. In this unblinded trial, van Nood and collaborators randomly assigned 43 patients with ≥2 recurrent episodes of CDI to receive either a standard 14-day course of oral vancomycin (13 patients), vancomycin with bowel lavage (13 patients), or a 4-day course of vancomycin followed by bowel lavage and subsequent FMT infusion administered through a nasoduodenal tube (17 patients) [ 367 ]. The primary endpoint was initial response without relapse for 10 weeks after completion of therapy. The investigation was terminated early after interim analysis, due to the marked difference in treatment outcomes. Thirteen of the 16 (81%) patients in the FMT arm had a sustained resolution of diarrhea after the first fecal infusion; only 7 of the 26 (27%) patients who were treated with vancomycin resolved their CDI ( P < .001). Four additional randomized trials of FMT have been published through 2016 [ 368–371 ]. One of these trials compared FMT to antibiotic treatment [ 368 ] and the other 3 compared various refinements of the FMT product [ 370 ], delivery of the product [ 369 ], or FMT to autologous FMT [ 371 ]. In general, the reported efficacy of FMT is lower in most randomized trials than in nonrandomized reports. The largest of these randomized trials reported an efficacy of approximately 50% for one FMT delivered by enema, which increased to 75% for 2 FMT administrations and approximately 90% for >2 FMT administrations. Patient selection, proximity to recurrent CDI episode, and antibiotic treatment prior to FMT all likely influence response to FMT.

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