Estimating Systemic Cognitive States from a Mixture of Physiological and Brain Signals.

As human-machine teams are being considered for a variety of mixed-initiative tasks, detecting and being responsive to human cognitive states, in particular systematic cognitive states, is among the most critical capabilities for artificial systems to ensure smooth interactions with humans and high overall team performance. Various human physiological parameters, such as heart rate, respiration rate, blood pressure, and skin conductance, as well as brain activity inferred from functional near-infrared spectroscopy or electroencephalogram, have been linked to different systemic cognitive states, such as workload, distraction, or mind-wandering among others. Whether these multimodal signals are indeed sufficient to isolate such cognitive states across individuals performing tasks or whether additional contextual information (e.g., about the task state or the task environment) is required for making appropriate inferences remains an important open problem. In this paper, we introduce an experimental and machine learning framework for investigating these questions and focus specifically on using physiological and neurophysiological measurements to learn classifiers associated with systemic cognitive states like cognitive load, distraction, sense of urgency, mind wandering, and interference. Specifically, we describe a multitasking interactive experimental setting used to obtain a comprehensive multimodal data set which provided the foundation for a first evaluation of various standard state-of-the-art machine learning techniques with respect to their effectiveness in inferring systemic cognitive states. While the classification success of these standard methods based on just the physiological and neurophysiological signals across subjects was modest, which is to be expected given the complexity of the classification problem and the possibility that higher accuracy rates might not in general be achievable, the results nevertheless can serve as a baseline for evaluating future efforts to improve classification, especially methods that take contextual aspects such as task and environmental states into account.

The novel Mechanical Ventilator Milano for the COVID-19 pandemic.

This paper presents the Mechanical Ventilator Milano (MVM), a novel intensive therapy mechanical ventilator designed for rapid, large-scale, low-cost production for the COVID-19 pandemic. Free of moving mechanical parts and requiring only a source of compressed oxygen and medical air to operate, the MVM is designed to support the long-term invasive ventilation often required for COVID-19 patients and operates in pressure-regulated ventilation modes, which minimize the risk of furthering lung trauma. The MVM was extensively tested against ISO standards in the laboratory using a breathing simulator, with good agreement between input and measured breathing parameters and performing correctly in response to fault conditions and stability tests. The MVM has obtained Emergency Use Authorization by U.S. Food and Drug Administration (FDA) for use in healthcare settings during the COVID-19 pandemic and Health Canada Medical Device Authorization for Importation or Sale, under Interim Order for Use in Relation to COVID-19. Following these certifications, mass production is ongoing and distribution is under way in several countries. The MVM was designed, tested, prepared for certification, and mass produced in the space of a few months by a unique collaboration of respiratory healthcare professionals and experimental physicists, working with industrial partners, and is an excellent ventilator candidate for this pandemic anywhere in the world.

[Treatment of non-small cell lung cancer]. / Niet-kleincellig longcarcinoom.

In this review article we discuss the diagnostic workup and current treatment strategies for non-small cell lung cancer (NSCLC). Anatomical resection and systematic lymph node dissection is the recommended treatment for early-stage NSCLC. Stereotactic body radiotherapy (SBRT) is an alternative for non-operable patients. Locally advanced NSCLC could be treated with a combination of chemotherapy, radiotherapy and immunotherapy, and in select cases followed by surgical resection. Treatment for patients with metastasized NSCLC depends on molecular tumor characteristics, PD-L1 expression and could consist of chemotherapy, immunotherapy, targeted therapy or a combination of these modalities. In all stages, best supportive care is an option to consider. Because of the success of immunotherapy and targeted therapy for stage IV NSCLC, numerous trials have started to investigate the efficacy of these modalities in early-stage NSCLC as well, further optimizing treatment strategies for this patient group.

Mouse models in the era of large human tumour sequencing studies.

Cancer is a complex disease in which cells progressively accumulate mutations disrupting their cellular processes. A fraction of these mutations drive tumourigenesis by affecting oncogenes or tumour suppressor genes, but many mutations are passengers with no clear contribution to tumour development. The advancement of DNA and RNA sequencing technologies has enabled in-depth analysis of thousands of human tumours from various tissues to perform systematic characterization of their (epi)genomes and transcriptomes in order to identify (epi)genetic changes associated with cancer. Combined with considerable progress in algorithmic development, this expansion in scale has resulted in the identification of many cancer-associated mutations, genes and pathways that are considered to be potential drivers of tumour development. However, it remains challenging to systematically identify drivers affected by complex genomic rearrangements and drivers residing in non-coding regions of the genome or in complex amplicons or deletions of copy-number driven tumours. Furthermore, functional characterization is challenging in the human context due to the lack of genetically tractable experimental model systems in which the effects of mutations can be studied in the context of their tumour microenvironment. In this respect, mouse models of human cancer provide unique opportunities for pinpointing novel driver genes and their detailed characterization. In this review, we provide an overview of approaches for complementing human studies with data from mouse models. We also discuss state-of-the-art technological developments for cancer gene discovery and validation in mice.

Repair: The Interface Between Interaction and Cognition.

Conversational repair is the process people use to detect and resolve problems of speaking, hearing, and understanding. Through repair, participants in social interaction display how they establish and maintain communication and mutual understanding. We argue that repair provides a crucial theoretical interface for research between diverse approaches to studying human interaction. We provide an overview of conversation analytic findings about repair in order to encourage further cross-disciplinary research involving both detailed inductive inquiry and more theory-driven experimental approaches. We outline CA's main typologies of repair and its methodological rationale, and we provide transcripts and examples that readers can explore for themselves using open data from online corpora. Since participants in interaction use repair to deal with problems as they emerge at the surface level of talk, we conclude that repair can be a point of convergence for studying mis/communication from multiple methodological perspectives.

Prediction of turn-ends based on anticipation of upcoming words.

During conversation listeners have to perform several tasks simultaneously. They have to comprehend their interlocutor's turn, while also having to prepare their own next turn. Moreover, a careful analysis of the timing of natural conversation reveals that next speakers also time their turns very precisely. This is possible only if listeners can predict accurately when the speaker's turn is going to end. But how are people able to predict when a turn-ends? We propose that people know when a turn-ends, because they know how it ends. We conducted a gating study to examine if better turn-end predictions coincide with more accurate anticipation of the last words of a turn. We used turns from an earlier button-press experiment where people had to press a button exactly when a turn-ended. We show that the proportion of correct guesses in our experiment is higher when a turn's end was estimated better in time in the button-press experiment. When people were too late in their anticipation in the button-press experiment, they also anticipated more words in our gating study. We conclude that people made predictions in advance about the upcoming content of a turn and used this prediction to estimate the duration of the turn. We suggest an economical model of turn-end anticipation that is based on anticipation of words and syntactic frames in comprehension.

Observation of tool use and modification for apparent hygiene purposes in a mandrill.

Tool making or modification to produce a tool of apparent improved functionality has rarely been reported in monkeys, especially when tools are used outside the context of food acquisition. We report on an observation of selection, modification and use of splinters for hygiene purposes in a male mandrill. The zoo-housed animal was video-recorded breaking splinters in sequence to use them underneath his toenails. This record brings forward new evidence that the ability to use and modify tools is not limited to apes and some New World monkeys but is also apparent in Old Word monkeys.

The epidemiology of intra-abdominal flora in critically ill patients with secondary and tertiary abdominal sepsis.

BACKGROUND: Background: Different micro-organisms can be cultured from abdominal fluid obtained from patients with intra-abdominal infection resulting from a perforated digestive tract. We evaluated a cohort of patients with abdominal sepsis admitted to the intensive care with the aim of obtaining more insight into the type of microorganisms involved and the efficacy of treatment. MATERIALS AND METHODS: A 5-year prospective observational cohort study was performed in patients admitted to the intensive care unit with abdominal sepsis syndrome, defined as a perforation of the digestive tract and inflammatory response with organ failure. Abdominal fluid was obtained for microbial culture during the surgical procedures and from abdominal drains. The initial treatment protocol was cefotaxim, ciprofloxacin, metronidazole, and amphotericin B, tailored according to microbiological results. Selective decontamination of the digestive tract was administered to prevent secondary endogenous infections. RESULTS: Abdominal fluid was taken for microbial culture from 221 of the 239 patients admitted with abdominal sepsis. Aerobic Gram-negative bacteria (AGNB) were found in 52.9% of the cultures of abdominal fluid taken at the time of operation, of which 45% were Escherichia coli; in 36% of patients more than one AGNB was found. The incidence of AGNB was highest in colorectal perforations (68.6%) and perforated appendicitis (77.8%) and lowest in gastroduodenal perforations (20.5%). Gram-positive bacteria were found in 42.5% of the abdominal fluid cultures and most frequently in colorectal perforations (50.0%). Candida was found in 19.9% of patients, with 59.1% of these cultures being Candida albicans. The incidence of Candida was 41.0% in gastroduodenal perforations and 11.8% in colorectal perforation. Anaerobic bacteria were cultured in 77.8% of patients with perforated appendicitis. Over time, the prevalence of AGNB in abdominal fluid decreased from 117 patients (52.9%) in the first culture to one patient (6.7%) in week 4 (efficacy 87%). The prevalence of Gram-positive bacteria increased from 42.5% to 86.7% in a 4-week period. CONCLUSION: The composition of the intra-abdominal flora found in critically ill patients with abdominal sepsis varies depending on the location of the perforation. The efficacy of combined surgical and antibiotic treatment was 87% in 4 weeks for AGNB.

Male dominance rank, mating and reproductive success in captive bonobos (Pan paniscus).

In the recent past, application of DNA genotyping techniques has enabled researchers to more accurately test relationships between dominance rank (DR), mating success (MS) and reproductive success (RS). Paternity studies often reveal that reproductive outcome does not always correlate with male DR and/or MS and thus open room for discussion and interpretation of alternative reproductive tactics of both sexes. In this study, we analysed male DR, MS and RS in a group of bonobos at Twycross Zoo (UK). Genetic relationships were determined using 8 tetrameric microsatellite loci. Despite clear and asymmetric dominance relationships, analysed using normalised David's scores based on a dyadic index of dominance among the group's 3 mature males, we found that the most dominant male did not sire the most offspring. In fact, both infants conceived during the observation period were found to be sired by the lower-ranking males. Although the alpha male had almost exclusive mating access to one of the females during the time she was showing a maximal anogenital swelling, her infant was sired by the lowest-ranking male who mostly mated with her when outside the maximal swelling period. This result suggests that either sperm competition operates and/or ovulation is decoupled from the phase of maximal anogenital swelling which could allow greater female choice.

Optimization of pheromone lure and trap characteristics for currant clearwing, Synanthedon tipuliformis.

Currant clearwing Synanthedon tipuliformis (Sesiidae) has been a pioneering and successful target of mating disruption in New Zealand, with virtually universal black currant industry adoption since c. 1990. Recent unexplained control failures using mating disruption lead to questions about pheromone efficacy. In this study, we have investigated the possible reasons for reduced control from mating disruption, and report improvements in trap catch based on pheromone loading and trap color. No differences were found in electrophysiological responses to pheromone components from two New Zealand populations. Male moth catches in traps baited with synthetic lures were disrupted in the presence of mating disruption dispensers ( > 99.99%) indicating no apparent barrier to efficacy from the pheromone formulation. Field behavioral observations confirmed this result. Male attraction to yellow delta traps was equivalent to green delta traps, but was greater than to red, black, blue, or white traps. Solid yellow delta traps were more attractive than black traps with yellow stripes, the latter designed to mimic the color pattern of the insect. Solid yellow funnel traps were less attractive than a composite of green, yellow, and white funnel traps. Trap catch increased as a function of pheromone loading, and trap color. In another experiment conducted in Tasmania, there was no difference in catch with single component [(E,Z)-2,13-octadecadienyl acetate] or two component lures [97% (E,Z)-2,13-octadecadienyl acetate:3% (E,Z)-3,13octadecadienyl acetate], refuting the suggestion of a different pheromone strain there.

Transcript-based computer animation of movement: evaluating a new tool for nonverbal behavior research.

A new approach for the use of computer animation in experimental nonverbal research is introduced. The method was evaluated in a pilot study comparing video recordings of movement in dyadic interactions with computer animations based on transcripts of the behavior, to determine whether similar impression effects could be obtained. At the core of our development is a software tool allowing for the conversion of so-called position time-series protocols of movement into animation scripts for a professional computer animation platform. Our software combines computer-assisted movement transcription and editing with state-of-the-art 3-D animation technology. We present empirical evidence indicating remarkable overall correspondence between video recordings and computer animations. Due to the lack of facial activity in the computer animations, a decline in visual attention for the face area could be observed, which did not, however, affect the impression ratings.

Dose-response relationship and infusion requirement of cisatracurium besylate in infants and children during nitrous oxide-narcotic anesthesia.

BACKGROUND: To determine the effect of age on the dose-response relation and infusion requirement of cisatracurium besylate in pediatric patients, 32 infants (mean age, 0.7 yr; range, 0.3-1.0 yr) and 32 children (mean age, 4.9 yr; range, 3.1-9.6 yr) were studied during thiopentone-nitrous oxideoxygen-narcotic anesthesia. METHODS: Potency was determined using a single-dose (20, 26, 33, or 40 microg/kg) technique. Neuromuscular block was assessed by monitoring the electromyographic response of the adductor pollicis to supramaximal train-of-four stimulation of the ulnar nerve at 2 Hz. RESULTS: Least-squares linear regression analysis of the log-probit transformation of dose and maximal response yielded median effective dose (ED50) and 95% effective dose (ED95) values for infants (29+/-3 microg/kg and 43+/-9 microg/kg, respectively) that were similar to those for children (29+/-2 microg/kg and 47+/-7 microg/kg, respectively). The mean infusion rate necessary to maintain 90-99% neuromuscular block during the first hour in infants (1.9+/-0.4 microg x kg(-1) x min(-1); range: 1.3-2.5 microg x kg(-1) x min(-1)) was similar to that in children (2.0+/-0.5 microg x kg(-1) x min(-1); range: 1.3-2.9 microg x kg(-1) x min(-1)). CONCLUSION: The authors conclude that cisatracurium is equipotent in infants and children when dose is referenced to body weight during balanced anesthesia.

Relatedness of matrilines, dispersing males and social groups in long-tailed macaques (Macaca fascicularis).

Genealogical relatedness is thought to be an important causal factor in the evolution of cooperation. We inferred relatedness on the basis of 11 blood protein markers using the Queller and Goodnight index of relatedness in a macaque population with long-term demographic records. This estimate reflected independently determined pedigree relationships in our data set. Mean relatedness among all members of a social group was 0.10 but much higher levels of relatedness (0.30-0.47) were found among the members of matrilineal families with a high or intermediate social rank. Groups of dispersing males that had been born into the same social group were sometimes closely related (0.43 and 0.58), but they could also be less related (0.08). We found that the pattern of distribution of relatedness was associated with gene flow and differential reproduction in males, rather than with group fission and the presence of geographical barriers.

Genetic structure of a population with social structure and migration.

Long-tailed macaques (Macaca fascicularis) live in social groups consisting of resident adult females and their offspring, and immigrant males. Subadult males leave their birth group, and might establish themselves as reproducing males in another group. Females do not leave their birth group. Such a social pattern might have consequences for the genetic differentiation between groups and the genetic relationships within groups. In a field study of long-tailed macaques (Macaca fascicularis) in Ketambe, Sumatra, Indonesia, blood samples were taken from individuals in seven adjacent social groups. Electrophoretic analysis showed 17 blood proteins and enzymes to be polymorphic, allowing the computation of heterozygosities and of the F-statistics. Of the F-statistics, F(IS) indicates the deviation from Hardy-Weinberg equilibrium averaged over local populations, FST indicates the differentiation in allele frequency between local populations, and F(IT) indicates the deviation from Hardy-Weinberg equilibrium over the total population. In a computer simulation of the population of long-tailed macaques using many loci with many neutral alleles, F(IS) and FST values proved to be characteristic for a certain demography and life history of the population, and proved not to depend upon the number of alleles or level of heterozygosity. FST values found in the simulation were compatible to those found in the field; in the simulation, values for F(IS) and F(IT) were consistently negative. The explanation for the negative F(IS) appears to be that genetic drift causes differentiation in allele frequencies between groups, and that due to this differentiation, allele frequencies differ between resident females and immigrant males, leading to offspring with an excess of heterozygotes (negative F(IS)) relative to the expectation based upon the overall allele frequency. The excess of heterozygotes might imply that slightly deleterious alleles are protected from selection. A population with a social structure and differential migration of the sexes is liable to accumulate deleterious recessives and, as a consequence, to be very sensitive to inbreeding on disruption of the social structure, as for instance in zoos.

Cancer patients and their network: the meaning of the social network and social interactions for quality of life.

A lot of research is carried out on the subject of social relations and quality of life. One should find at least some indication for an association between the social environment and quality of life of cancer patients; will interventions be appropriate and well-considered? But until now, less has been known about the association between the social network of cancer patients and their quality of life. In this study, the way in which the patients' network can effect their quality of life is examined. Two patient groups are distinguished: a group of cancer patients recently treated for their cancer by surgery and a group treated by chemotherapy (n = 108 and n = 109) and these are compared with a disease-free group of cancer patients (n = 192). Although an association between network, social relations and quality of life is found, only a small part of the variation in quality of life can be explained by this social component. It seems that the cancer itself and the cancer treatment mainly affect the patients' quality of life and that the impact of the social environment is less significant.

The distinction between affect and cognition in the quality of life of cancer patients--sensitivity and stability.

The distinction between affect and cognition has been put forward to clarify the lack of differences found in studies describing quality of life under deteriorated circumstances, such as serious illness. In the study reported here, cancer patients under treatment (n = 201) were compared with a random sample from the normal population (n = 200). As hypothesized, the affective component of life quality turned out to be more severely impaired than the cognitive component. Besides, it was investigated which factors contribute to the affective and the cognitive component of the quality of life of cancer patients under treatment. In cancer patients affect proved more strongly related to the physical domain. Cognition on the other hand was more strongly related to coping resources, especially personality characteristics like the level of self-esteem. It is concluded that an affective measure of quality of life is more sensitive to change in patients. The stability of life quality is attributed to the rather strong relation the affective and the cognitive component both have to coping resources.

Quality of life in bone tumor patients comparing limb salvage and amputation of the lower extremity.

In 33 long-term survivors of lower extremity bone cancer quality-of-life data were studied following limb salvage compared to amputation. Self-report questionnaires, semistructured interviews and visual analog scales were used to measure psychoneurotic and somatical distress, activities of daily living, self-esteem, and adjustment to illness. Fourteen patients with limb salvage (age 13-56 years, median 24) and 19 patients with an amputation (age 21-53 years, median 27) were evaluated 2-17 years (median 10 years) after surgery. The differences between the two groups were not statistically significant. However, physical complaints were reported more often by limb salvage patients, whereas the amputees showed a trend toward lower self-esteem and isolation in social life, due to their disability. Both groups felt equal diminution of quality of life and disability as measured on the visual analog scale. These findings could support the cosmetic advantage of limb salvage compared to amputation.