Enhanced mismatch negativity in harmonic compared with inharmonic sounds.

Many natural sounds have frequency spectra composed of integer multiples of a fundamental frequency. This property, known as harmonicity, plays an important role in auditory information processing. However, the extent to which harmonicity influences the processing of sound features beyond pitch is still unclear. This is interesting because harmonic sounds have lower information entropy than inharmonic sounds. According to predictive processing accounts of perception, this property could produce more salient neural responses due to the brain's weighting of sensory signals according to their uncertainty. In the present study, we used electroencephalography to investigate brain responses to harmonic and inharmonic sounds commonly occurring in music: Piano tones and hi-hat cymbal sounds. In a multifeature oddball paradigm, we measured mismatch negativity (MMN) and P3a responses to timbre, intensity, and location deviants in listeners with and without congenital amusia-an impairment of pitch processing. As hypothesized, we observed larger amplitudes and earlier latencies (for both MMN and P3a) in harmonic compared with inharmonic sounds. These harmonicity effects were modulated by sound feature. Moreover, the difference in P3a latency between harmonic and inharmonic sounds was larger for controls than amusics. We propose an explanation of these results based on predictive coding and discuss the relationship between harmonicity, information entropy, and precision weighting of prediction errors.

Psychosocial predictors of persistent low back pain in patients presenting to the emergency department.

OBJECTIVES: Chronic low back pain is an important public health problem, generating high financial and social costs. While most clinical guidelines stress the importance of managing low back pain in primary care, in practice a disproportionate amount of patients with low back pain present to emergency departments. Patients presenting to emergency departments may form a specific group with different factors leading to chronicity. This prospective cohort study aimed to determine the sociodemographic and psychological predictors of persistent low back pain and the length of sick leave due to pain in patients with acute symptoms visiting an emergency department. METHODS: Patients with a first episode of non-specific acute low back pain in at least three months were qualified for this study. The participants filled a battery of questionnaires, including measures of pain, pain-related disability, depression, anxiety and pain coping strategies. A structured telephone interview was performed after three months with questions regarding pain and the length of sick leave. RESULTS: 110 patients participated in the study. 97 patients completed the follow-up, with 70.1% suffering from pain after three months. Lower self-rated health predicted pain after three months. Longer length of sick leave was predicted by lower self-rated health, distraction as a coping strategy and decreased behavioral activity. CONCLUSION: Because of its simplicity, a measurement of self-rated health may be included in future clinical practice for assessing the risk of persistent pain.

Coupling of Blood Pressure and Subarachnoid Space Oscillations at Cardiac Frequency Evoked by Handgrip and Cold Tests: A Bispectral Analysis.

The aim of the study was to assess blood pressure-subarachnoid space (BP-SAS) width coupling properties using time-frequency bispectral analysis based on wavelet transforms during handgrip and cold tests. The experiments were performed on a group of 16 healthy subjects (F/M; 7/9) of the mean age 27.2 ± 6.8 years and body mass index of 23.8 ± 4.1 kg/m2. The sequence of challenges was first handgrip and then cold test. The handgrip challenge consisted of a 2-min strain, indicated by oral communication from the investigator, at 30% of maximum strength. The cold test consisted of 2 min of hand immersion to approximately wrist level in cold water of 4 °C, verified by a digital thermometer. Each test was preceded by 10 min at baseline and was followed by 10-min recovery recordings. BP and SAS were recorded simultaneously. Three 2-min stages of the procedure, baseline, test, and recovery, were analyzed. We found that BP-SAS coupling was present only at cardiac frequency, while at respiratory frequency both oscillators were uncoupled. Handgrip and cold test failed to affect BP-SAS cardiac-respiratory coupling. We showed similar handgrip and cold test cardiac bispectral coupling for individual subjects. Further studies are required to establish whether the observed intersubject variability concerning the BP-SAS coupling at cardiac frequency has any potential clinical predictive value.

Impact of Different Illness Perceptions and Emotions Associated with Chronic Back Pain on Anxiety and Depression in Patients Qualified for Surgery.

BACKGROUND: Anxiety and depression are known comorbidities of chronic back pain. Their psychological predictors are not well established in patients with chronic back pain qualified for neurosurgery. AIMS: The purpose of this study was to determine the psychological predictors of depression and anxiety in patients with chronic back pain qualified for surgery. DESIGN: This was a cross-sectional study. SETTINGS: A neurosurgical ward in Gdansk, Poland. PARTICIPANTS/SUBJECTS: All patients who were admitted to the neurosurgical ward and met the inclusion criteria were recruited for the study. Finally, 83 patients with chronic back pain waiting for surgery were recruited. METHODS: A battery of questionnaires, including Illness Perceptions Questionnaire-Revised, Multidimensional Health Locus of Control Scale, Hospital Anxiety and Depression Scale, and Brief Pain Inventory, was used in 83 spinal surgery candidates. RESULTS: Higher anxiety was predicted by stronger beliefs about negative consequences of illness (ß = .205, p < .05), worse illness coherence (ß = .204, p < .05), negative emotional representations of illness (ß = .216, p < .05), and depression (ß = .686, p < .001). Higher depression was predicted by anxiety (ß = .601, p < .001), pain interference (ß = .323, p < .01), lower personal control over pain (ß = -.160, p < .05), and lower external control of health (ß = -.161, p < .05) but, surprisingly, higher internal control of health (ß = .208, p < .01). CONCLUSIONS: Anxiety and depression commonly coexist in chronic back pain sufferers qualified for spine surgery but are derived from dissimilar beliefs. The results highlight the usefulness of advising about the disease and treatment in comprehensive care for this group of patients.

Temporal hierarchies in the predictive processing of melody - From pure tones to songs.

Listening to musical melodies is a complex task that engages perceptual and memoryrelated processes. The processes underlying melody cognition happen simultaneously on different timescales, ranging from milliseconds to minutes. Although attempts have been made, research on melody perception is yet to produce a unified framework of how melody processing is achieved in the brain. This may in part be due to the difficulty of integrating concepts such as perception, attention and memory, which pertain to different temporal scales. Recent theories on brain processing, which hold prediction as a fundamental principle, offer potential solutions to this problem and may provide a unifying framework for explaining the neural processes that enable melody perception on multiple temporal levels. In this article, we review empirical evidence for predictive coding on the levels of pitch formation, basic pitch-related auditory patterns,more complex regularity processing extracted from basic patterns and long-term expectations related to musical syntax. We also identify areas that would benefit from further inquiry and suggest future directions in research on musical melody perception.

Contributors to Preterm Birth: Data from a Single Polish Perinatal Center.

Preterm birth may result from overlapping causes including maternal age, health, previous obstetric history and a variety of social factors. We aimed to identify factors contributing to preterm birth in respect to new social and environmental changes in the reproductive patterns. Our cross-sectional study included 495 mother-infant pairs and was based on maternal self-reporting in an originally developed questionnaire. Neonates were divided into two groups: 72 premature babies (study group) and 423 full-term babies (control group). We analyzed maternal, sociodemographic and economic characteristics, habits, chronic diseases, previous obstetric history and pregnancy complications. For statistical analysis, Pearson's Chi-squared independence test was used with a statistical significance level of 0.05. Preterm births were more common among mothers living in villages (p < 0.001) and with lower education level (p = 0.01). Premature births were also positively associated with mothers who were running their own businesses (p = 0.031). Mothers with a history of previous miscarriages gave birth at a significantly older age (p < 0.001). The most frequent pregnancy complications were hypothyroidism (41.4%), pregestational and gestational diabetes mellitus (DM; 17.8%) and hypertension (8.1%). Pregestational DM significantly influenced the occurrence of prematurity (p < 0.05). Pregestational DM, being professionally active, a lower education level and living outside cities are important risk factors of prematurity.

Preferred musical attribute dimensions underlie individual differences in music-induced analgesia.

Music-induced analgesia (MIA) is a phenomenon that describes a situation in which listening to music influences pain perception. The heterogeneity of music used in MIA studies leads to a problem of a specific effect for an unspecified stimulus. To address this, we use a previously established model of musical preferences that categorizes the multidimensional sonic space of music into three basic dimensions: arousal, valence and depth. Participants entered an experimental pain stimulation while listening to compilations of short musical excerpts characteristic of each of the three attribute dimensions. The results showed an effect on the part of music attribute preferences on average pain, maximal pain, and pain tolerance after controlling for musical attributes and order effects. This suggests that individual preferences for music attributes play a significant role in MIA and that, in clinical contexts, music should not be chosen arbitrarily but according to individual preferences.

A confirmatory factor analysis for an adapted and validated Polish version of the Chalder Fatigue Questionnaire.

OBJECTIVES: The Chalder Fatigue Questionnaire (CFQ) was developed to measure fatigue in 2 dimensions: physical and mental. The aim of the study was to translate, adapt and evaluate the psychometric properties of the Polish version of the CFQ (CFQ-PL). MATERIAL AND METHODS: The process of translation was conducted using a forward and backward translation procedure. After cultural adaptation, the psychometric properties of the CFQ-PL were evaluated. Participants of the study were healthy individuals: medical students (N = 304) and pregnant women (pregnancy without complications, N = 925). The reliability and validity were estimated using fatigue numerical rating scales, the Beck Depression Inventory and the State-Trait Anxiety Inventory. To examine the factor structure of the CFQ-PL, a confirmatory factor analysis was conducted. RESULTS: The internal consistency of the CFQ-PL was similar to the original version (Cronbach's α 0.85-0.91). Statistically significant correlations between the CFQ-PL and the current fatigue level, average fatigue and the sleepiness level (measured using numerical rating scales), as well as the intensity of depression and anxiety symptoms, all confirming the validity of the adapted scale. Using a confirmatory factor analysis, it was determined that a 1-factor model did not fit the data well. A 2-factor model with a correlation between mental and physical factors fitted better than the 1-factor model, yet fit indices revealed a poor fit. Using a 2-factor model with added covariance between items - 1 (problems with fatigue), 2 (resting more), 9 (slips of the tongue), 10 (finding the correct word) - resulted in acceptable fit indices in both groups of participants. CONCLUSIONS: After the process of translation, adaptation and validation of the CFQ-PL, it is now available for use under Polish conditions. This study provided evidence for structural validity of the 2-factor model of the 11-item version. Int J Occup Med Environ Health. 2020;33(1):67-76.

Cognitive and emotional representations of pain in cancer patients at an inpatient unit and home palliative care.

PURPOSE: To compare symptomatic treatment at inpatient palliative care unit and at home in terms of: pain intensity; negative impact of pain on functioning in different areas of life; and beliefs about pain (cognitive and emotional aspects according to Leventhal's theory). PATIENTS: The sample consisted of 74 cancer patients qualified for palliative care at an inpatient unit (N = 53) and at home (N = 21). METHODS: Brief Pain Inventory--Short Form (measurement of pain intensity and pain interference with daily activities), Karnofsky Scale (performance status), Illness Perception Questionnaire for cognitive and emotional representations and beliefs about pain, and Hospital Anxiety and Depression Scale. RESULTS: Patients treated at inpatient unit and patients treated at home did not differ in terms of pain intensity, depression, and anxiety. The only significant differences between groups were the beliefs about pain. Patients with cancer in home care were more convinced of pain treatment effectiveness but expressed higher level of distress related to pain. Patients convinced that pain can be treated more effectively were younger, the pain they experienced was less severe, and they were treated at home. CONCLUSIONS: Effectiveness of symptomatic treatment is comparable in patients with cancer at inpatient unit and at home. Treatment at home is associated with stronger patient convictions that pain can be effectively treated and higher level of distress. In future studies, the source of higher distress intensity in patients treated at home may be further explored.

Multicenter study on midwifery students' attitudes towards abortion and it's place in their future practice - Comparison of respondents at early and late stages of the university education.

Evidence based midwifery education and practice are fundamental to assure high quality care of childbearing women, also with complications. In Poland, midwifery education includes aspects of participation in the abortion. A cross-sectional study was designed to describe the attitudes towards abortion at the beginning and at the end of students' university education. The study was aimed to verify change of attitudes throughout the course of the university education. Most of the students approved abortion if the pregnancy constitutes a threat to woman's health or life, results from a rape, or whenever the fetus presents with a lethal defect. More than a half did not approve participation in the abortion if the fetus presents with a non-lethal defect. Generally, the acceptance rates were significantly higher among the final year students, but more than a half of them stated, that the abortion-related topics were inadequately addressed in their study curriculum. That bring to the conclusion that higher rates of abortion acceptance among the final year students, were not necessarily a manifestation of informed approval for this procedure, but rather a form of a "systemic" adjustment. Midwifery program need to be revised to support students in developing informed and evidence-based attitudes toward abortion.

The Role of Musical Attributes in Music-Induced Analgesia: A Preliminary Brief Report.

Music-induced analgesia (MIA) is the ability of music to influence pain perception. Although this phenomenon has been extensively studied in recent years, only a few studies have addressed what musical characteristics are optimal for MIA. Here, we present a novel approach to this topic, using a recently proposed model of music attribute preferences. The model addresses three musical dimensions: arousal, valence, and depth. Thirty participants (15 women and 15 men, M age = 37.1 years, standard deviation = 15.7) were subjected to experimental pain stimulation (cold-pressor task) while listening to brief music excerpts with characteristics of the three attribute dimensions. Each excerpt was selected to score high on one of the three attributes while being average on the other two, to create three distinct music conditions. There was also a control condition, where participants listened to white noise. Results showed that average pain ratings were significantly lower in the arousal (p = 0.002) and depth (p = 0.01) conditions compared to the control condition. Furthermore, participants showed increased pain tolerance in musical conditions compared to the control condition (p = 0.04). This preliminary report introduces a novel approach to studying MIA in the context of music attribute preferences. With the advent of online music streaming services, this research opens new possibilities for music-based pain interventions.

Knowledge of cancer symptoms and anxiety affect patient delay in seeking diagnosis in patients with heterogeneous cancer locations.

PURPOSE: This research was aimed at identifying factors that predict patient delay in treatment initiation in patients with suspected cancer disease. We sought to determine the differences between delaying and nondelaying patients with reference to their knowledge of cancer symptoms, sociodemographic variables, and the levels of state anxiety and trait anxiety. METHODS: The study involved 301 randomly selected patients with suspected cancer disease before their first oncology appointment at a regional oncology center in Poland. Data were collected by means of a semistructured interview conducted by a trained psychologist. To evaluate the knowledge of cancer symptoms, the symptoms mentioned by subjects were compared to the list of symptoms from cancer awareness measure. Anxiety levels were assessed using the State-Trait Anxiety Inventory. RESULTS: In the course of logistic regression analysis a model was developed, in which knowledge of cancer symptoms and state anxiety allowed to predict patient delay. Knowledge of every additional cancer symptom decreased the chance of patient delay by 16.4% point [95% CI: 1.4-29.2]. An increase in state anxiety for every point of the scale decreased the chance of delay by 2.5% points [95% CI: 0.2-4.6]. Trait anxiety and the studied sociodemographic variables proved to be nonsignificant predictors of patient delay. CONCLUSIONS: Knowledge of cancer symptoms and the level of state anxiety allowed to predict patient delay in the initiation of treatment. Owing to the heterogeneity of the tumor locations within the sample, the obtained model can be used in large scale prevention programs designed for the whole population.