The ability to evaluate the balance between risk and reward and to adjust behavior accordingly is fundamental to adaptive decision-making. Although brain-imaging studies consistently have shown involvement of the dorsolateral prefrontal cortex, anterior insula and striatum during risky decision-making, activation in a neural network formed by these regions has not been linked to structural connectivity. Therefore, in this study, white-matter connectivity was measured with diffusion-weighted imaging in 40 healthy research participants who performed the Balloon Analogue Risk Task, a test of risky decision-making, during fMRI. Fractional anisotropy within a network that includes white-matter pathways connecting four regions (the prefrontal cortex, insula and midbrain to the striatum) was positively correlated with the number of risky choices and total amount earned on the task, and with the parametric modulation of activation in regions within the network to the level of risk during choice selection. Furthermore, analysis using a mixed model demonstrated how relationships of the parametric modulation of activation in each of the four aforementioned regions are related to risk probabilities, and how previous trial outcomes and task progression influence the choice to take risk. The present findings provide the first direct evidence that white-matter integrity is linked to function within previously identified components of a network that is activated during risky decision-making, and demonstrate that the integrity of white-matter tracts is critical in consolidating and processing signals between cortical and striatal circuits during the decision-making process.

No abstract

Tear gas is designated a chemical weapon by multiple treaties that prohibit its use in war. However, despite mounting reports suggesting that tear gas may endanger targets beyond transient discomfort, its domestic use as a crowd control mechanism has not been adequately studied, nor is its use regulated by any United States government agency. Without comprehensive and demographically-representative epidemiological studies, the continued use of tear gas on civilian protesters poses an unknown and potentially severe threat to public safety. Chemical substances employed on civilians for a desired effect are more akin to drugs than to weapons. We, therefore, propose that legislation be introduced to place tear gas under the regulatory purview of the Food and Drug Administration (FDA) in order to understand its effects on the health of all members of the public and to better regulate its deployment.

Sexual and reproductive healthcare restrictions imposed by faith-based hospitals prevent women, sexual minorities, and gender minorities from accessing the full range of comprehensive healthcare. The share of faith-based hospitals in California has increased rapidly in recent years, but no analysis has been completed to understand their distribution and rate of growth. In this paper, we calculate the percentage of religiously affiliated acute, short-term hospital beds per California county. We find that faith-based hospitals have a majority market share in 17 out of 58 California counties. Furthermore, while the percentage of faith-based hospitals in these counties has remained relatively stable from 2000-2010, this proportion has increased tenfold in the past decade. Our data suggest that the expansion of faith-based healthcare systems in California presents a significant barrier to sexual and reproductive healthcare access.

The detrimental effects of incarceration on physical and mental health are widely acknowledged. However, 76% of the United States jail population is awaiting trial without having been convicted of a crime (Sawyer and Wagner 2020). This is driven by the monetary bail system, which the state of California moved to abolish by passing the 2018 California Money Bail Reform Act (Senate Bill 10, hereafter SB 10). SB 10 proposes the use of algorithmically driven risk assessment tools to determine pretrial release. However, actuarial risk assessments are not calibrated to California’s diverse demography and are insufficient to determine which defendants pose flight or public safety risks. SB 10 is predicted to perpetuate similar socioeconomic and racial disparities as the current system, while failing to decrease pretrial detention. We recommend opposing SB 10 in favor of pretrial release for most misdemeanor and nonviolent defendants. The funding currently allocated for pretrial detainment should be redirected toward evidence-based and restorative pretrial supervision practices through the enactment of new bail-reform legislation by the state of California. Increasing the use of diversion programs, which redirect defendants to the appropriate mental health or substance abuse programs, also presents opportunities to restore treatment to the jurisdiction of public health rather than criminal justice. Transitioning from a reliance on pretrial detention to pretrial services will mitigate the collateral effects of incarceration while improving public health, public safety, and substantially reducing the cost of incarceration.