Models need mechanisms, but not labels.

The target article proposes a model involving the important but not well-investigated topics of curiosity and creativity. The model, however, falls short of providing convincing explanations of the basic mechanisms underlying these phenomena. We outline the importance of mechanistic thinking in dealing with the concepts outlined in this article specifically and within psychology and cognitive neuroscience in general.

The Role of Stimulus Uncertainty and Curiosity in Attention Control.

Most cognitive psychological studies assume that participants in lab-based tasks maintain a single goal based on task instructions. However, people can be motivated by other factors, such as curiosity. We examined if people attend to seemingly task-irrelevant information out of curiosity by manipulating stimulus uncertainty in a cueing paradigm. Participants were presented with an abrupt-onset cue followed by a letter target (E or H). Next, a mask either at the target location (low uncertainty) or at all four locations (high uncertainty) was shown. We expected high uncertainty to induce a state of curiosity that in turn influences the processing of the cue. Cueing effects were greater in the high-uncertainty condition compared to the low-uncertainty condition. In Experiment 2, we additionally elicited self-report ratings on curiosity. In sum, target-specific uncertainty leads to greater processing of task-irrelevant peripheral cues across two experiments. We tentatively conclude that uncertainty modulates attention control and further research is necessary to examine if this is indeed due to curiosity induced by uncertainty.

Parallel Interactions Between Linguistic and Contextual Factors in Bilinguals.

The necessity for introducing interactionist and parallelism approaches in different branches of cognitive science emerged as a reaction to classical sequential stage-based models. Functional psychological models that emphasized and explained how different components interact, dynamically producing cognitive and perceptual states, influenced multiple disciplines. Chiefly among them were experimental psycholinguistics and the many applied areas that dealt with humans' ability to process different types of information in different contexts. Understanding how bilinguals represent and process verbal and visual input, how their neural and psychological states facilitate such interactions, and how linguistic and nonlinguistic processing overlap, has now emerged as an important area of multidisciplinary research. In this article, we will review available evidence from different language-speaking groups of bilinguals in India with a focus on situational context. In the discussion, we will address models of language processing in bilinguals within a cognitive psychological approach with a focus on existent models of inhibitory control. The paper's stated goal will be to show that the parallel architecture framework can serve as a theoretical foundation for examining bilingual language processing and its interface with external factors such as social context.

Safety and efficacy of very low calorie diet in patients receiving haemodialysis therapy.

Background: Very low calorie diets (VLCDs) are an obesity treatment option in the general population, but their efficacy and safety in patients on haemodialysis (HD) is unknown. Methods: Prospective single arm study of VLCD in haemodialysis patients. All participants received 2.5-3.3 MJ/day for 12 weeks. Weekly assessment of VLCD, pre- and post-dialysis weight, inter-dialytic weight gain, and blood electrolytes occurred for the first 4 weeks, then fortnightly for another 8 weeks. Linear mixed models compared the change in weight over time as well as biochemical outcomes including potassium. Results: Twenty-two participants [nine home HD (HHD) and 13 satellite HD (SHD)] enrolled with 19 completing the 12-week intervention. Mean post-dialysis weight declined from 121.1 kg at baseline to 109.9 at week 12 resulting in average decline of 0.88 kg per week (95% C.I. 0.71, 1.05, P < .001) with 12-week mean percentage weight loss9.3% (SD 3.5). Mean post-dialysis body mass index declined from 40.9 kg/m2 at baseline to 37.1 kg/m2 at week 12 (95% C.I. 0.25, 0.35, P < .001). Serum potassium rose from week 1 to 3, stabilized during weeks 4 to 6, and fell from week 8, returning near baseline by week 12. Six of the nine (66.6%) HHD participants and seven of the 13 (70%) SHD participants had at least one episode of hyperkalaemia (K > 6 mmol/l). There were no clinical changes in serum sodium, corrected calcium, or phosphate levels during the study. Conclusion: VLCD with dietitian supervision was effective in producing significant weight reduction, with an acceptable safety profile in patients treated with haemodialysis.

The use of routine preoperative magnetic resonance imaging in identifying intraspinal anomalies in patients with idiopathic scoliosis: a 10-year review.

PURPOSE: This study sought to quantify the frequency of previously unidentified spinal cord anomalies identified by routine preoperative magnetic resonance imaging (MRI), in patients planned for surgical scoliosis correction. METHODS: Our study group comprised 206 patients with idiopathic scoliosis who underwent deformity correction from 1998 to 2008. Clinical records of all the patients were retrospectively reviewed to ascertain the proportion having a neural abnormality on preoperative MRI scan. RESULTS: Twenty of 206 patients (9.7 %) were diagnosed with an unexpected intraspinal anomaly on routine preoperative MRI. In all cases, a neurosurgical opinion was sought prior to further intervention. Of the 20 patients, 11 underwent a neurosurgical procedure (de-tethering of cord, decompression of Chiari, decompression of syrinx). There was no statistically significant difference between the group of patients who had intrinsic spinal cord anomalies on preoperative MRI and those did not have a cord abnormality with regard to age at presentation, gender, side of dominant curve and degree of curve (p < 0.05). CONCLUSION: The high frequency of spinal cord abnormalities unidentified by preoperative neurological examination, and the frequent need for subsequent neurosurgical intervention, suggests that MRI assessment prior to deformity correction is important in the management of idiopathic scoliosis.

Investigating the role of spatial filtering on distractor suppression.

In recent years, evidence has accumulated towards a distractor suppression mechanism that enables efficient selection of targets in a visual search task. According to these findings, the search for a target is faster in the presence of a salient distractor in a display among homogenous distractors as opposed to its absence. Studies have also shown that distractor suppression not only operates on the feature level but can also be spatially guided. The motivation of the current study was to examine if spatially guided distractor suppression can be goal-driven. We tested this across four experiments. In Experiment 1A, the task was to search for a shape target (e.g., a circle) and discriminate the orientation of the line within it. In some trials, a salient color distractor was presented in the display while participants were told that it appeared in one of the two locations on the horizontal axis (or the vertical axis, counterbalanced across participants). We expected enhanced distractor suppression when the salient distractor appeared within this "spatial filter" but did not find it since the target was also presented at the filtered locations. Experiment 1B replicated Experiment 1A, except that the target was always presented outside the filter; filtering enhanced search performance. In Experiment 2 even when the filter contained the salient distractor in only 65% of the filtered trials, filtering benefited search performance. In Experiment 3, the filter changed on every trial and did not benefit suppression.

Enhancing Functional Rehabilitation Through Orthotic Interventions for Foot and Ankle Conditions: A Narrative Review.

Non-surgical, conservative approaches to foot and ankle conditions are of important consideration. Orthotics play a significant role in treating these conditions, preventing progression, and alleviating pressure on affected areas, thereby promoting normal gait. This article aims to assess the utility and effectiveness of various orthotic treatments in different clinical scenarios. We reviewed 27 peer-reviewed articles using electronic databases, employing keywords such as "orthoses," "orthotic treatment," "arthritis," "neuropathy," and "foot and ankle trauma." Studies conducted in recent decades have explored the effectiveness of orthoses in various conditions, including connective tissue disorders, tendon and ligament injuries, foot arthritis, neuropathic and inflammatory wounds, and sports-related recurrent injuries. Orthotic management has proven effective across diverse foot and ankle conditions. Integrating orthotic treatment with systemic approaches benefits patients with foot and ankle disorders. We believe this review can be utilised by clinicians in the management of foot and ankle disorders.

Large pelvic masses of obscure origin: urologist's perspective.

BACKGROUND: Large pelvic masses pose unique diagnostic and therapeutic challenges due to varied aetiology, paucity of characteristic imaging features, lack of therapeutic algorithms and surgical difficulties in resection inside the narrow confines of the pelvis with close proximity of vital structures. METHODS: Records of 22 patients with large pelvic masses in the last six years were analysed. Their demographic and clinical features were noted, along with imaging features, preoperative biopsy, surgical procedure, intraoperative difficulties, complications, adjuvant therapy and outcome. RESULTS: There were 14 men and 8 women with a median age of 45 years. Presenting symptoms were abdominal mass, pain, lower urinary tract symptoms, urinary retention and constipation. Imaging was mostly unable to determine the organ of origin of the tumour. Histopathology revealed pelvic fibromatosis (2), chondrosarcoma (1), liposarcoma (1), haemangioendothelioma (1), lymphangioma (2), fibroleiomyoma (1), leiomyosarcoma (3), schwannoma (4), malignant nerve sheath tumour (1), rectal gastrointestinal stromal tumour (1), retrovesical hydatid cysts (3), sacral chordoma (1) and Ewing's sarcoma (1). In 5 patients complete excision was not possible because of extension into vital structures. Fifteen patients were alive at 1-5 years of follow-up. CONCLUSIONS: Urologists, being the 'gatekeepers of the pelvis', are usually involved in the management of large pelvic masses. Good outcome can be achieved with careful surgical planning.

How many joints does the 5th toe have? A review of 606 patients of 655 foot radiographs.

BACKGROUND: It is a common understanding that the fifth toe has three bones with two interphalangeal joints. However, our experience shows that a significant number have only two phalanges with one interphalangeal joint. METHODS: We identified 676 patients listed as having had a foot radiograph, during an eight week period, of which 606 radiographs were available for the assessment. The radiographs were then assessed counting the number of phalanges in the fifth toe. RESULTS: The patients consisted of 344 females and 262 males. Bilateral radiographs had been performed in 49 patients. 362 radiographs (55.3%) were found to have 3 phalanges in their 5th toe, with 291 (44.4%) having only two phalanges. CONCLUSIONS: We have demonstrated the presence of two phalanges is a common anatomical variant. This finding has clinical implications with regard to the treatment of deformities of the fifth toe and the type of internal fixation device used.

Attention capture by brief abrupt-onset cues in deaf individuals.

Auditory loss in deaf individuals has been associated with an enhancement in the visual modality. Visual attention is one domain where such plasticity-induced changes have been observed, although which specific attentional mechanisms are improved is still not clear. Using a modified spatial cueing paradigm, we examined attention capture in deaf and normal-hearing participants. Brief abrupt-onset cues were presented for 16 ms either in attended or ignored locations. The to-be-attended locations for each trial were indicated by a horizontal or a vertical bar at the centre of the screen. These were presented either in vertical- or horizontal-only blocks or mixed together. We observed greater negative cueing effects in the NH group compared to deaf. Additionally, people with deafness showed greater capture by cues at ignored locations in the slower responses. These findings shed further light on orienting mechanisms in deaf and help in understanding the specificity of the differences in visual processing between deaf and normal-hearing individuals.

Dimethyl sulfoxide with lignocaine versus eutectic mixture of local anesthetics: prospective randomized study to compare the efficacy of cutaneous anesthesia in shock wave lithotripsy.

The objective of the study was to compare the efficacy of dimethyl sulfoxide (DMSO) mixed with lignocaine and eutectic mixture of local anesthetics (EMLA) cream as topically applied surface anesthetics in relieving pain during shock wave lithotripsy (SWL) in a prospective randomized study. Of the 160 patients, 80 patients received DMSO with lignocaine and 80 patients received EMLA cream, applied to the skin of the flank at the area of entry of shock waves. SWL was done with Seimens lithostar multiline lithotripter. The pain during the procedure was assessed using visual analog and verbal rating scores. The mean visual analog scale scores for the two groups were 3.03 for DMSO group and 4.43 for EMLA group. The difference of pain score on visual analog scale was statistically significant (p < 0.05). Similarly, the pain scores as rated on the verbal rating scale were also evaluated; the mean score on verbal rating scale were 2.34 for DMSO group and 3.00 for the EMLA group. The difference between the pain score on verbal rating scale was also found to be statistically significant (p < 0.05). Our study showed that DMSO with lignocaine is a better local anesthetic agent for SWL than EMLA cream. The stone fragmentation and clearance rates are also better in the DMSO group.

A comparative assessment of the clinical efficacy of intranasal desmopressin spray and diclofenac in the treatment of renal colic.

The aim of this study was to assess the efficacy of desmopressin nasal spray compared with diclofenac given intramuscularly in patients with acute renal colic caused by urolithiasis. The study included 72 patients randomized into three different groups: group A received desmopressin (40 mg, nasal spray), group B diclofenac (75 mg) intramuscularly and group C, both desmopressin and diclofenac. Pain was assessed using a visual analogue scale at baseline, 10, 30 min and 1 h after administering the treatments. Rescue analgesia was given at 30 min if needed. On admission, the pain level was the same in all three groups (group A 85; and group B and C 90 each). At 10 min the pain decreased minimally in all the groups but more in group B and C (group A 80 and group B and C 70 each). At 30 min pain scores were 75, 37.5 and 40 for group A, B and C, respectively, indicating that there was no significant pain relief in desmopressin group. Rescue analgesic had to be given to all patients in group A and two patients in group B and three patients in group C. Pain relief in the desmopressin only group was significantly less at 1 h even after rescue analgesia (pain scores of 27.5, 15 and 20 for group A, B and C respectively). Intranasal desmopressin is not an effective analgesic in renal colic: exerts mild analgesic effect over a period of 30 min. It does not potentiate the effect of diclofenac.

Re-examining attention capture at irrelevant (ignored?) locations.

In 2018, Ruthruff and Gaspelin used a modified spatial cuing paradigm in which targets were presented at two locations while abrupt-onset cues could be presented at four locations. They found that performance following cues presented at irrelevant locations was no worse than following no cue or following a centrally presented cue. They concluded, as conveyed by the title of their article (Immunity to Attentional Capture at Ignored Locations) that a spatial attentional control setting had eliminated capture of attention. This conclusion was reached by comparing response time to targets on cue-absent versus irrelevant cues condition. We administered the exact same task in Experiment 1 and observed that responses on irrelevant trials were faster compared with cue absent trials providing support for the "immunity to attention capture claim" made by Ruthruff and Gaspelin (2018). However, cue absent trials may not be the most appropriate baseline condition as they lack the alerting benefit provided by cue-present trials. Thus, equivalent response times (RTs) on trials with absent cues and irrelevant cues observed in Ruthruff and Gaspelin (2018) could have been due to the lack of this alerting benefit. We tested this in Experiment 2 by additionally including a warning beep on every trial as an alerting signal. With this methodological change, we observed that responses were slower on irrelevant trials compared with the cue absent trials suggesting interference from cues at irrelevant locations. This study underscores the importance of using the appropriate baseline while testing attention capture. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Efficacy, Safety, and Biomarker Analysis of Combined PD-L1 (Atezolizumab) and VEGF (Bevacizumab) Blockade in Advanced Malignant Peritoneal Mesothelioma.

Malignant peritoneal mesothelioma (MPeM) is a rare but aggressive malignancy with limited treatment options. VEGF inhibition enhances efficacy of immune-checkpoint inhibitors by reworking the immunosuppressive tumor milieu. Efficacy and safety of combined PD-L1 (atezolizumab) and VEGF (bevacizumab) blockade (AtezoBev) was assessed in 20 patients with advanced and unresectable MPeM with progression or intolerance to prior platinum-pemetrexed chemotherapy. The primary endpoint of confirmed objective response rate per RECISTv1.1 by independent radiology review was 40% [8/20; 95% confidence interval (CI), 19.1-64.0] with median response duration of 12.8 months. Six (75%) responses lasted for >10 months. Progression-free and overall survival at one year were 61% (95% CI, 35-80) and 85% (95% CI, 60-95), respectively. Responses occurred notwithstanding low tumor mutation burden and PD-L1 expression status. Baseline epithelial-mesenchymal transition gene expression correlated with therapeutic resistance/response (r = 0.80; P = 0.0010). AtezoBev showed promising and durable efficacy in patients with advanced MPeM with an acceptable safety profile, and these results address a grave unmet need for this orphan disease. SIGNIFICANCE: Efficacy of atezolizumab and bevacizumab vis-à-vis response rates and survival in advanced peritoneal mesothelioma previously treated with chemotherapy surpassed outcomes expected with conventional therapies. Biomarker analyses uncovered epithelial-mesenchymal transition phenotype as an important resistance mechanism and showcase the value and feasibility of performing translationally driven clinical trials in rare tumors.See related commentary by Aldea et al., p. 2674.This article is highlighted in the In This Issue feature, p. 2659.

Reward Influences Masked Free-Choice Priming.

While it is known that reward induces attentional prioritization, it is not clear what effect reward-learning has when associated with stimuli that are not fully perceived. The masked priming paradigm has been extensively used to investigate the indirect impact of brief stimuli on response behavior. Interestingly, the effect of masked primes is observed even when participants choose their responses freely. While classical theories assume this process to be automatic, recent studies have provided evidence for attentional modulations of masked priming effects. Most such studies have manipulated bottom-up or top-down modes of attentional selection, but the role of "newer" forms of attentional control such as reward-learning and selection history remains unclear. In two experiments, with number and arrow primes, we examined whether reward-mediated attentional selection modulates masked priming when responses are chosen freely. In both experiments, we observed that primes associated with high-reward lead to enhanced free-choice priming compared to primes associated with no-reward. The effect was seen on both proportion of choices and response times, and was more evident in the faster responses. In the slower responses, the effect was diminished. Our study adds to the growing literature showing the susceptibility of masked priming to factors related to attention and executive control.

To look or not to look: Subliminal abruptonset cues influence constrained free-choice saccades.

Subliminal cues have been shown to capture attention and modulate manual response behaviour but their impact on eye movement behaviour is not well-studied. In two experiments, we examined if subliminal cues influence constrained free-choice saccades and if this influence is under strategic control as a function of task-relevancy of the cues. On each trial, a display containing four filled circles at the centre of each quadrant was shown. A central coloured circle indicated the relevant visual field on each trial (Up or Down in Experiment 1; Left or Right in Experiment 2). Next, abrupt-onset cues were presented for 16 ms at one of the four locations. Participants were then asked to freely choose and make a saccade to one of the two target circles in the relevant visual field. The analysis of the frequency of saccades, saccade endpoint deviation and saccade latency revealed a significant influence of the relevant subliminal cues on saccadic decisions. Latency data showed reduced capture by spatiallyirrelevant cues under some conditions. These results indicate that spatial attentional control settings as defined in our study could modulate the influence of subliminal abrupt-onset cues on eye movement behaviour. We situate the findings of this study in the attention-capture debate and discuss the implications for the subliminal cueing literature.

Knowledge, beliefs, and concerns about bone health from a systematic review and metasynthesis of qualitative studies.

BACKGROUND: Patients with low bone density or osteoporosis need information for effective prevention or disease management, respectively. However, patients may not be getting enough information from their primary care providers or other sources. Inadequate disease information leaves patients ill-informed and creates misconceptions and unnecessary concerns about the disease. OBJECTIVE: We systematically reviewed and synthesized the available literature to determine patient knowledge, beliefs, and concerns about osteoporosis and identify potential gaps in knowledge. METHODS: A systematic search was conducted for full-text qualitative studies addressing understanding, literacy, and/or perceptions about osteoporosis and its management, using Medline, EMBASE, Web of Science, Cochrane Library, CINAHL, ERIC, PsychINFO, Psyc Behav Sci Collec, and PubMed, from inception through September 2016. Studies were selected by two reviewers, assessed for quality, and themes extracted using the Joanna Briggs Institute data extraction tool. Thematic analysis was used to identify themes and subthemes. RESULTS: Twenty-five studies with a total of 757 participants (including 105 men) were selected for analysis out of 1031 unique citations. Selected studies were from Australia, Canada, Denmark, Norway, the United Kingdom, and the United States. Four main themes emerged: inadequate knowledge, beliefs and misconceptions, concerns about osteoporosis, and lack of information from health care providers. Participants had inadequate knowledge about osteoporosis and were particularly uninformed about risk factors, causes, treatment, and prevention. Areas of concern for participants included diagnosis, medication side effects, and inadequate information from primary care providers. CONCLUSION: Although there was general awareness of osteoporosis, many misconceptions and concerns were evident. Education on bone health needs to reinforce areas of knowledge and address deficits, misconceptions, and concerns.

The Nature of Unconscious Attention to Subliminal Cues.

Attentional selection in humans is mostly determined by what is important to them or by the saliency of the objects around them. How our visual and attentional system manage these various sources of attentional capture is one of the most intensely debated issues in cognitive psychology. Along with the traditional dichotomy of goal-driven and stimulus-driven theories, newer frameworks such as reward learning and selection history have been proposed as well to understand how a stimulus captures attention. However, surprisingly little is known about the different forms of attentional control by information that is not consciously accessible to us. In this article, we will review several studies that have examined attentional capture by subliminal cues. We will specifically focus on spatial cuing studies that have shown through response times and eye movements that subliminal cues can affect attentional selection. A majority of these studies have argued that attentional capture by subliminal cues is entirely automatic and stimulus-driven. We will evaluate their claims of automaticity and contrast them with a few other studies that have suggested that orienting to unconscious cues proceeds in a manner that is contingent with the top-down goals of the individual. Resolving this debate has consequences for understanding the depths and the limits of unconscious processing. It has implications for general theories of attentional selection as well. In this review, we aim to provide the current status of research in this domain and point out open questions and future directions.

Language proficiency does not modulate executive control in older bilinguals.

We examined if language proficiency modulates performance in tasks that measure executive control in older Telugu-English bilinguals (n = 50, mean age = 57.15 years). We administered numerical Stroop task, Attention Network Task, Dimensional Change Card Sorting task, and stop-signal task that are known to tap into different aspects of executive functioning on healthy aging Telugu-English bilinguals. Second language (English) proficiency was calculated as a cumulative score that considered both subjective and objective measures of L2 fluency and use. Bilinguals were divided into two groups based on the cumulative score and compared on each task. We did not find any effect of language proficiency on any of the executive control measures. The additional Bayesian analysis also supported these findings. Therefore, the results do not support the claim that bilingual language proficiency modulates executive control, at least in the elderly population. We discuss the results with regard to the issue of bilingual advantage in executive control and the role of age and language use.