Do LUTS Predict Mortality? An Analysis Using Random Forest Algorithms.

Purpose: To evaluate a random forest (RF) algorithm of lower urinary tract symptoms (LUTS) as a predictor of all-cause mortality in a population-based cohort. Materials and Methods: A population-based cohort of 3143 men born in 1924, 1934, and 1944 was evaluated using a mailed questionnaire including the Danish Prostatic Symptom Score (DAN-PSS-1) to assess LUTS as well as questions on medical conditions and behavioral and sociodemographic factors. Surveys were repeated in 1994, 1999, 2004, 2009 and 2015. The cohort was followed-up for vital status until the end of 2018. RF uses an ensemble of classification trees for prediction with a good flexibility and without overfitting. RF algorithms were developed to predict the five-year mortality using LUTS, demographic, medical, and behavioral factors alone and in combinations. Results: A total of 2663 men were included in the study, of whom 917 (34%) died during follow-up (median follow-up time 15.0 years). The LUTS-based RF algorithm showed an area under the curve (AUC) 0.60 (95% CI 0.52-0.69) for five-year mortality. An expanded RF algorithm, including LUTS, medical history, and behavioral and sociodemographic factors, yielded an AUC 0.73 (0.65-0.81), while an algorithm excluding LUTS yielded an AUC 0.71 (0.62-0.78). Conclusion: An exploratory RF algorithm using LUTS can predict all-cause mortality with acceptable discrimination at the group level. In clinical practice, it is unlikely that LUTS will improve the accuracy to predict death if the patient's background is well known.

Do men adapt to lower urinary tract symptoms? An 11-year longitudinal study of male urinary urgency and associated bother.

OBJECTIVE: The study objective is to evaluate prognosis and predictors of bother caused by urinary urgency among middle-aged and older men. MATERIAL AND METHODS: A population-based sample of men born in 1974, 1964, 1954, 1944, 1934 and 1924 was followed-up from 2004 to 2015. The course of urgency and associated bother was evaluated with the Danish Prostatic Symptom Score at baseline and follow-up. Logistic regression was utilized to explore risk factors of increased bother at follow-up. RESULTS: A total of 2,480 men (39%) who had responded at baseline and follow-up were included in the study. Of them, 1,056 men (43%) had persistent mild urgency and 132 men (5%) persistent moderate or severe urgency at follow-up. The proportions of men experiencing at least moderate bother due to persistent urgency at follow-up were 6% (95% confidence interval 4.5-7.3) of those with mild and 79% (71.7-85.9) of the men with moderate or severe urgency. In multivariable-adjusted logistic regression, moderate to severe urgency was strongly associated with bother (odds ratio, OR 55.2, 95% CI 32.1-95.2). Other predictors of bother included cardiac disease (OR 1.8, 95% CI 1.0-31.1), pulmonary disease (OR 1.9, 95% CI 1.1-3.5) and medical treatment (OR 2.7, 95% CI 1.6-4.6). CONCLUSIONS: Most men with urinary urgency have mild symptoms and bother. Only one out of five men with persistent moderate or severe urgency adapt to the symptoms. Men with a history of medical treatment for lower urinary tract symptoms (LUTS) or impaired cardiopulmonary health are more likely to experience bother from urinary urgency.

The Fewer Reasons, the More You Like It! How Decision-Making Heuristics of Image Quality Estimation Exploit the Content of Subjective Experience.

Imaging science has approached subjective image quality (IQ) as a perceptual phenomenon, with an emphasis on thresholds of defects. The paradigmatic design of subjective IQ estimation, the two-alternative forced-choice (2AFC) method, however, requires viewers to make decisions. We investigated decision strategies in three experiments both by asking the research participants to give reasons for their decisions and by examining the decision times. We found that typical for larger quality differences is a smaller set of subjective attributes, resulting from convergent attention toward the most salient attribute, leading to faster decisions and better accuracy. Smaller differences are characterized by divergent attention toward different attributes and an emphasis on preferential attributes instead of defects. In larger differences, attributes have sigmoidal relationships between their visibility and their occurrence in explanations. For other attributes, this relationship is more random. We also examined decision times in different attribute configurations to clarify the heuristics of IQ estimation, and we distinguished a top-down-oriented Take-the-Best heuristic and a bottom-up visual salience-based heuristic. In all experiments, heuristic one-reason decision-making endured as a prevailing strategy independent of quality difference or task.

Lower Urinary Tract Symptoms and Mortality among Finnish Men: The Roles of Symptom Severity and Bother.

PURPOSE: The utility of male lower urinary tract symptoms (LUTS) as mortality risk factors remains unclear. We explored LUTS-associated mortality among Finnish men, evaluating the association of symptom severity and bother with risk of death. MATERIALS AND METHODS: A questionnaire including the Danish Prostatic Symptom Score was mailed to a population-based cohort of 3,143 men aged 50, 60 and 70 years in 1994, with repeat surveys in 1999, 2004, 2009 and 2015. The men were followed until the end of 2018. Mortality associated with LUTS was analyzed using time-dependent Cox regression adjusted for age and comorbidity, updating symptom data every 5 years, including interaction terms between symptoms and associated bother. RESULTS: Of the 1,167 men in the analysis, 591 (50.6%) died during the 24-year followup. In analyses of moderate and severe symptoms disregarding bother, overall voiding and storage LUTS, daytime frequency and urgency incontinence were associated with increased mortality: the multivariable-adjusted hazard ratios were 1.19 (95% CI 1.00-1.40), 1.35 (1.13-1.62), 1.31 (1.09-1.58) and 2.19 (1.42-3.37), respectively. In analyses disregarding symptom severity and bother, voiding LUTS were associated with decreased mortality, while daytime frequency and nocturia were associated with increased mortality: the HRs were 0.82 (95% CI 0.67-1.00), 1.31 (95% CI 1.09-1.58) and 1.52 (95% CI 1.21-1.91), respectively. Excess mortality associated with bothersome daytime frequency and nocturia tended to be slightly higher: the HRs were 1.86 (95% CI 1.41-2.47) and 1.88 (95% CI 1.38-2.58), respectively. No significant interactions were found between symptoms and associated bother, however. CONCLUSIONS: Moderate and severe LUTS are potential risk factors for mortality, independently of their bother.

A Method for Measuring Contact Points in Human-Object Interaction Utilizing Infrared Cameras.

This article presents a novel method for measuring contact points in human-object interaction. Research in multiple prehension-related fields, e.g., action planning, affordance, motor function, ergonomics, and robotic grasping, benefits from accurate and precise measurements of contact points between a subject's hands and objects. During interaction, the subject's hands occlude the contact points, which poses a major challenge for direct optical measurement methods. Our method solves the occlusion problem by exploiting thermal energy transfer from the subject's hand to the object surface during interaction. After the interaction, we measure the heat emitted by the object surface with four high-resolution infrared cameras surrounding the object. A computer-vision algorithm detects the areas in the infrared images where the subject's fingers have touched the object. A structured light 3D scanner produces a point cloud of the scene, which enables the localization of the object in relation to the infrared cameras. We then use the localization result to project the detected contact points from the infrared camera images to the surface of the 3D model of the object. Data collection with this method is fast, unobtrusive, contactless, markerless, and automated. The method enables accurate measurement of contact points in non-trivially complex objects. Furthermore, the method is extendable to measuring surface contact areas, or patches, instead of contact points. In this article, we present the method and sample grasp measurement results with publicly available objects.

Impact of lower urinary tract symptoms on mortality: a 21-year follow-up among middle-aged and elderly Finnish men.

BACKGROUND: The usefulness of lower urinary tract symptoms (LUTS) as mortality risk factors remains unclear. Repeated assessments are required to take into account symptom fluctuation and de novo symptom appearance. The study objective was to evaluate mortality in relation to three urinary storage symptoms-urgency, daytime frequency, and nocturia-in middle-aged and elderly men, considering also other time-varying factors during follow-up. METHODS: A mail survey of a population-based cohort of men initially aged 50, 60, and 70 years was conducted in Finland in 1994, 1999, 2004, and 2009. The questionnaire included assessments of LUTS based on the Danish Prostatic Symptom Score and comorbidities. The men were followed up for mortality through the population registry through 2014. LUTS-related hazard ratios (HR) were analyzed with time-dependent Cox regression adjusted for the year of birth and comorbidities using variable values updated every 5 years. Sensitivity analyses were conducted using values of all variables fixed to the baseline assessment of 1994. RESULTS: Of the 1332 eligible men with data on LUTS from each preceding survey, 514 (38.6%) died during the 21-year follow-up. In time-dependent analyses, daytime frequency, and nocturia were significantly associated with increased mortality: the adjusted HR was 1.42 (95% CI 1.11-1.83) for daytime frequency, 1.38 (1.07-1.79) for nocturia and 1.19 (0.94-1.50) for urgency. In sensitivity analyses with fixed baseline characteristics, only nocturia was suggestively associated with an increased risk of death: the adjusted HR was 1.09 (0.84-1.42) for daytime frequency, 1.41 (0.99-2.02) for nocturia and 0.94 (0.52-1.68) for urgency. CONCLUSIONS: Among aging men, LUTS are more accurate predictors of short-term than longer-term mortality risk. Repeated assessments are needed to detect clinically relevant and persistent symptoms, often associated with ill health. Accordingly, men with daytime frequency or nocturia exhibit a 1.4-fold risk of death and therefore, should be evaluated for underlying comorbidity.

Severity and bother of lower urinary tract symptoms among men aged 30-80 years: Tampere Ageing Male Urological Study (TAMUS).

OBJECTIVE: The aim of this study was to determine the severity and bother of lower urinary tract symptoms (LUTS) and evaluate the burden of each symptom in a male population. MATERIALS AND METHODS: Postal questionnaires were sent to 7470 men aged 30-80 years. The Danish Prostatic Symptom Score (DAN-PSS-1) was used to determine the severity, bother and total symptom score for each symptom. To assess the total burden of each symptom at the population level, the total symptom scores were weighted by the prevalence they represented. RESULTS: The overall response rate was 58.7% (4384/7470 men). Urgency caused the greatest burden to men aged 30-80, with a prevalence-weighted symptom score of 0.712. Urgency affected 66.2% of men and 5.1% experienced moderate symptoms with moderate bother. Post-micturition dribble caused the second greatest burden, with a prevalence-weighted score of 0.704, affecting 58.7% of men and with 31.1% reporting mild bother from it. Nocturia and feeling of incomplete emptying caused the third and fourth greatest burdens, respectively. In young men (aged 30 and 40 years), post-micturition dribble caused the greatest burden, as moderate symptoms were common and caused mild bother to 11.4%. Among retired (70 and 80 years) and middle-aged (50 and 60 years) men, urgency was the most burdensome symptom. CONCLUSIONS: The most burdensome LUTS in men aged 30-80 years was urgency, followed by post-micturition dribble, nocturia and feeling of incomplete emptying. Urgency and nocturia were prominent in old men and post-micturition dribble was noted in young men.

Upper nasal hemifield location and nonspatial auditory tones accelerate visual detection during dichoptic viewing.

Visual performance is asymmetric across the visual field, but locational biases that occur during dichoptic viewing are not well understood. In this study, we characterized horizontal, vertical and naso-temporal biases in visual target detection during dichoptic stimulation and explored whether the detection was facilitated by non-spatial auditory tones associated with the target's location. The detection time for single monocular targets that were suppressed from view with a 10 Hz dynamic noise mask presented to the other eye was measured at the 4° intercardinal location of each eye with the breaking Continuous Flash Suppression (b-CFS) technique. Each target was either combined with a sound (i.e., high or low pitch tone) that was congruent or incongruent with its vertical location (i.e., upper or lower visual field) or presented without a sound. The results indicated faster detection of targets in the upper rather than lower visual field and faster detection of targets in the nasal than temporal hemifield of each eye. Sounds generally accelerated target detection, but the tone pitch-elevation congruency did not further enhance performance. These findings suggest that visual detection during dichoptic viewing differs from standard viewing conditions with respect to location-related perceptual biases and crossmodal modulation of visual perception. These differences should be carefully considered in experimental designs employing dichoptic stimulation techniques and in display applications that utilize dichoptic viewing.

CFS MATLAB toolbox: An experiment builder for continuous flash suppression (CFS) task.

CFS toolbox is an open-source collection of MATLAB functions that utilizes PsychToolbox-3 (PTB-3). It is designed to allow a researcher to create and run continuous flash suppression experiments using a variety of experimental parameters (i.e., stimulus types and locations, noise characteristics, and experiment window settings). In a CFS experiment, one of the eyes at a time is presented with a dynamically changing noise pattern, while the other eye is concurrently presented with a static target stimulus, such as a Gabor patch. Due to the strong interocular suppression created by the dominant noise pattern mask, the target stimulus is rendered invisible for an extended duration. Very little knowledge of MATLAB is required for using the toolbox; experiments are generated by modifying csv files with the required parameters, and result data are output to text files for further analysis. The open-source code is available on the project page under a Creative Commons License ( http://www.mikkonuutinen.arkku.net/CFS_toolbox/ and https://bitbucket.org/mikkonuutinen/cfs_toolbox ).

Turning water into rock: The inverted waves effect.

Humans perceive shape in two-dimensional shaded images, and turning such an image upside down can result in inversion of the relief of this image. Previous research indicates that this inversion is caused by assumptions related to overhead illumination, global convexity and viewpoint above the surface. In our article, we describe the inverted waves effect, in which turning an image of waves upside down changes its relief and also its perceived material properties.

Perception of stereoscopic direct gaze: The effects of interaxial distance and emotional facial expressions.

Gaze perception has received considerable research attention due to its importance in social interaction. The majority of recent studies have utilized monoscopic pictorial gaze stimuli. However, a monoscopic direct gaze differs from a live or stereoscopic gaze. In the monoscopic condition, both eyes of the observer receive a direct gaze, whereas in live and stereoscopic conditions, only one eye receives a direct gaze. In the present study, we examined the implications of the difference between monoscopic and stereoscopic direct gaze. Moreover, because research has shown that stereoscopy affects the emotions elicited by facial expressions, and facial expressions affect the range of directions where an observer perceives mutual gaze-the cone of gaze-we studied the interaction effect of stereoscopy and facial expressions on gaze perception. Forty observers viewed stereoscopic images wherein one eye of the observer received a direct gaze while the other eye received a horizontally averted gaze at five different angles corresponding to five interaxial distances between the cameras in stimulus acquisition. In addition to monoscopic and stereoscopic conditions, the stimuli included neutral, angry, and happy facial expressions. The observers judged the gaze direction and mutual gaze of four lookers. Our results show that the mean of the directions received by the left and right eyes approximated the perceived gaze direction in the stereoscopic semidirect gaze condition. The probability of perceiving mutual gaze in the stereoscopic condition was substantially lower compared with monoscopic direct gaze. Furthermore, stereoscopic semidirect gaze significantly widened the cone of gaze for happy facial expressions.

Population-level and Individual-level Bother of Lower Urinary Tract Symptoms Among 30- to 80-year-old Men.

OBJECTIVE: To estimate the bother using both population- and individual-level bother of lower urinary tract symptoms (LUTS) across a wide age range among men. MATERIALS AND METHODS: A total of 7470 men aged 30-80 years were approached using a postal questionnaire in 2004. The overall response was 58.7% (4384 respondents). The Danish Prostatic Symptom Score was used to evaluate bother of 12 LUTS. In the population-level analysis, prevalence of bother was calculated by relating the number of men with bother to the population size (instead of only affected men). To evaluate the bother at individual level, its prevalence among the men experiencing the symptom was assessed. RESULTS: In the population-level analysis, postmicturition dribble was the most common cause of bother among 30- and 40-year-old men, as 25% of the men experienced small bother and 4.5% had moderate to major bother. Men aged 70-80 years experienced the most bother from urgency followed closely by nocturia, with about 40% reporting small bother and roughly 20% moderate or major bother. When only symptomatic men were evaluated, incontinence symptoms, especially urge incontinence, were the most bothersome as more than 80% of the men with incontinence reported bother. CONCLUSION: At population level, the most bothersome symptom varied by age. Men aged 30-40 years experienced bother most commonly from postmicturition dribble. With increasing age, urgency and nocturia became the most bothersome symptoms by age 70-80 years. At individual level, incontinence symptoms were the most bothersome LUTS, with less influence by age.

CVD2014-A Database for Evaluating No-Reference Video Quality Assessment Algorithms.

In this paper, we present a new video database: CVD2014-Camera Video Database. In contrast to previous video databases, this database uses real cameras rather than introducing distortions via post-processing, which results in a complex distortion space in regard to the video acquisition process. CVD2014 contains a total of 234 videos that are recorded using 78 different cameras. Moreover, this database contains the observer-specific quality evaluation scores rather than only providing mean opinion scores. We have also collected open-ended quality descriptions that are provided by the observers. These descriptions were used to define the quality dimensions for the videos in CVD2014. The dimensions included sharpness, graininess, color balance, darkness, and jerkiness. At the end of this paper, a performance study of image and video quality algorithms for predicting the subjective video quality is reported. For this performance study, we proposed a new performance measure that accounts for observer variance. The performance study revealed that there is room for improvement regarding the video quality assessment algorithms. The CVD2014 video database has been made publicly available for the research community. All video sequences and corresponding subjective ratings can be obtained from the CVD2014 project page (http://www.helsinki.fi/psychology/groups/visualcognition/).

The effect of introspection on judgment and decision making is dependent on the quality of conscious thinking.

That introspection may impair certain judgments and result in fabrication has been attributed to a distracting shift from more adaptive intuitive processing to more analytic and conscious processing. This phenomenon was studied in an experiment where participants made multidimensional visual choices. It was found that the effect of this shift on decision-making performance was dependent on the quality of the explanations during introspection, while the performance in silent conditions was not. Therefore, it appears that the effect of introspection on judgments is not only influenced by the thinking mode per se, but also by the individual's ability to approach the decision problem analytically.

VQone MATLAB toolbox: A graphical experiment builder for image and video quality evaluations: VQone MATLAB toolbox.

This article presents VQone, a graphical experiment builder, written as a MATLAB toolbox, developed for image and video quality ratings. VQone contains the main elements needed for the subjective image and video quality rating process. This includes building and conducting experiments and data analysis. All functions can be controlled through graphical user interfaces. The experiment builder includes many standardized image and video quality rating methods. Moreover, it enables the creation of new methods or modified versions from standard methods. VQone is distributed free of charge under the terms of the GNU general public license and allows code modifications to be made so that the program's functions can be adjusted according to a user's requirements. VQone is available for download from the project page (http://www.helsinki.fi/psychology/groups/visualcognition/).

Visual Performance With Small Concave and Convex Displays.

OBJECTIVE: In this study, we aim to investigate how users' visual performance with a small flexible display changes based on the direction (i.e., convex, concave) and the magnitude (i.e., low, high) of the display curvature. BACKGROUND: Despite the wide interest in flexible display materials and deformable displays, the potential effects of nonplanar display surfaces on human perception and performance have received little attention. This study is the first to demonstrate how curving affects visual performance with an actual flexible display (4.5-in. active-matrix organic light-emitting diode). METHOD: In a series of three experiments, we compared the performance with a planar display to the performance with concave and convex display surfaces with low and high curvature magnitudes. Two visual search tasks were employed that required the subject to detect target letters based on their contrast (Experiments 1 and 2) and identity (Experiment 3). Performance was measured as the sensitivity of target detection (d') and threshold time of the search, respectively. RESULTS: There were similar sensitivities for targets across the curvature variants, but the high-magnitude curvatures resulted in prolonged search times, especially for the convex form. In both of the tasks, performance was dependent on the display location, which was defined as the target's distance from the display center. CONCLUSION: High curvature magnitudes should be avoided, even in small displays, because large local changes in visual stimuli decrease processing speed outside the central display. APPLICATION: The findings have implications for the development of technologies, applications, and user interfaces for flexible displays and the design of visual display devices.

CID2013: a database for evaluating no-reference image quality assessment algorithms.

This paper presents a new database, CID2013, to address the issue of using no-reference (NR) image quality assessment algorithms on images with multiple distortions. Current NR algorithms struggle to handle images with many concurrent distortion types, such as real photographic images captured by different digital cameras. The database consists of six image sets; on average, 30 subjects have evaluated 12-14 devices depicting eight different scenes for a total of 79 different cameras, 480 images, and 188 subjects (67% female). The subjective evaluation method was a hybrid absolute category rating-pair comparison developed for the study and presented in this paper. This method utilizes a slideshow of all images within a scene to allow the test images to work as references to each other. In addition to mean opinion score value, the images are also rated using sharpness, graininess, lightness, and color saturation scales. The CID2013 database contains images used in the experiments with the full subjective data plus extensive background information from the subjects. The database is made freely available for the research community.

Stereoscopy Amplifies Emotions Elicited by Facial Expressions.

Mediated facial expressions do not elicit emotions as strongly as real-life facial expressions, possibly due to the low fidelity of pictorial presentations in typical mediation technologies. In the present study, we investigated the extent to which stereoscopy amplifies emotions elicited by images of neutral, angry, and happy facial expressions. The emotional self-reports of positive and negative valence (which were evaluated separately) and arousal of 40 participants were recorded. The magnitude of perceived depth in the stereoscopic images was manipulated by varying the camera base at 15, 40, 65, 90, and 115 mm. The analyses controlled for participants' gender, gender match, emotional empathy, and trait alexithymia. The results indicated that stereoscopy significantly amplified the negative valence and arousal elicited by angry expressions at the most natural (65 mm) camera base, whereas stereoscopy amplified the positive valence elicited by happy expressions in both the narrowed and most natural (15-65 mm) base conditions. Overall, the results indicate that stereoscopy amplifies the emotions elicited by mediated emotional facial expressions when the depth geometry is close to natural. The findings highlight the sensitivity of the visual system to depth and its effect on emotions.

Natural course of lower urinary tract symptoms in men not requiring treatment--a 5-year longitudinal population-based study.

OBJECTIVE: To evaluate the natural course of lower urinary tract symptoms (LUTS) by quantifying their longitudinal changes. METHODS: A population-based study of men aged 55, 65, or 75 years in Pirkanmaa region, Finland was conducted with a 5-year follow-up (1999-2004). Mailed self-administered questionnaire with the Danish Prostatic Symptom Score instrument was used to evaluate LUTS. Men with any treatment for LUTS or a history of prostate cancer were excluded. RESULTS: A total of 1331 men were included in the study. All 12 symptoms exhibited considerable fluctuation over time. Incidence of specific symptoms varied by a factor of 10 and remission by a factor of 4. Overall, common symptoms varied most strongly in terms of incidence and remission, whereas the less common ones such as incontinence behaved in a more stable fashion. Remission was more frequent than incidence for all individual LUTS components. The highest incidence was found for post-micturition symptoms and urgency. Remission was most common in weak stream and least frequent in urgency and urgency incontinence. CONCLUSION: LUTS are dynamic conditions with strong spontaneous fluctuation over time. Remission was more common than incidence. The strong propensity for spontaneous resolution should also be borne in mind in treatment decisions including prescription practices.

Concurrent explanations can enhance visual decision making.

The verbalization of one's thoughts has been shown to impair judgment and decision making in some cases, particularly when targets are perceptual. This finding has been attributed to the fact that non-verbal processes are sometimes difficult to verbalize, which may cause a shift in processing that is maladaptive to the task. The study shows that concurrent written explanations can also enhance judgment and decision making in certain visual choice tasks. This finding suggests that the effect of verbalization on perceptual tasks is not dependent on whether the targets of the judgment are verbal or perceptual but rather on whether there is adequate vocabulary to execute the task and whether the task benefits from a more analytic approach.