Protocol for the TRANSLATE prospective, multicentre, randomised clinical trial of prostate biopsy technique.

OBJECTIVES: Primary objectives: to determine whether local anaesthetic transperineal prostate (LATP) biopsy improves the detection of clinically significant prostate cancer (csPCa), defined as International Society of Urological Pathology (ISUP) Grade Group ≥2 disease (i.e., any Gleason pattern 4 disease), compared to transrectal ultrasound-guided (TRUS) prostate biopsy, in biopsy-naïve men undergoing biopsy based on suspicion of csPCa. SECONDARY OBJECTIVES: to compare (i) infection rates, (ii) health-related quality of life, (iii) patient-reported procedure tolerability, (iv) patient-reported biopsy-related complications (including bleeding, bruising, pain, loss of erectile function), (v) number of subsequent prostate biopsy procedures required, (vi) cost-effectiveness, (vii) other histological parameters, and (viii) burden and rate of detection of clinically insignificant PCa (ISUP Grade Group 1 disease) in men undergoing these two types of prostate biopsy. PATIENTS AND METHODS: The TRANSLATE trial is a UK-wide, multicentre, randomised clinical trial that meets the criteria for level-one evidence in diagnostic test evaluation. TRANSLATE is investigating whether LATP biopsy leads to a higher rate of detection of csPCa compared to TRUS prostate biopsy. Both biopsies are being performed with an average of 12 systematic cores in six sectors (depending on prostate size), plus three to five target cores per multiparametric/bi-parametric magnetic resonance imaging lesion. LATP biopsy is performed using an ultrasound probe-mounted needle-guidance device (either the 'Precision-Point' or BK UA1232 system). TRUS biopsy is performed according to each hospital's standard practice. The study is 90% powered to detect a 10% difference (LATP biopsy hypothesised at 55% detection rate for csPCa vs 45% for TRUS biopsy). A total of 1042 biopsy-naïve men referred with suspected PCa need to be recruited. CONCLUSIONS: This trial will provide robust prospective data to determine the diagnostic ability of LATP biopsy vs TRUS biopsy in the primary diagnostic setting.

Review: Approaches to Visual-motor Control in Baseball Batting.

SIGNIFICANCE: This review evaluates model-based online approaches to visual-motor control in baseball batting in light of research studies on this topic.Throughout the history of research on baseball batting, there has been a presumptive winner in terms of how visual-motor control occurs for this complex skill. Because of the severe time constraints and the short duration of the action, it has been assumed that a baseball swing must involve model-based control. That is, hitting involves using an open-loop, pre-programmed movement that is parameterized based on situational probabilities, advance cues from the pitcher's delivery, and information early in the ball flight, which are used by an internal model to predict the future location of the ball. In this review, the author contrasts two variants of this type of model-based control (a 3D world model and spatial memory of trajectories) with an online control approach in which the batter uses only currently available perceptual information to control the swing prospectively via information-movement coupling. It is shown that the assumed necessity of predictive control in baseball batting is based on too narrow of a conception of online control. Although work still needs to be done to elucidate the specifics of the control, it is argued here that online control provides an account of visual-motor control in baseball batting that is both more parsimonious and more consistent with published research findings.

Ironic and Reinvestment Effects in Baseball Pitching: How Information About an Opponent Can Influence Performance Under Pressure.

Are pressure-induced performance errors in experts associated with novice-like skill execution (as predicted by reinvestment/conscious processing theories) or expert execution toward a result that the performer typically intends to avoid (as predicted by ironic processes theory)? The present study directly compared these predictions using a baseball pitching task with two groups of experienced pitchers. One group was shown only their target, while the other group was shown the target and an ironic (avoid) zone. Both groups demonstrated significantly fewer target hits under pressure. For the target-only group, this was accompanied by significant changes in expertise-related kinematic variables. In the ironic group, the number of pitches thrown in the ironic zone was significantly higher under pressure, and there were no significant changes in kinematics. These results suggest that information about an opponent can influence the mechanisms underlying pressure-induced performance errors.

Acting is perceiving!

We challenge Firestone & Scholl's (F&S's) narrow conceptualization of what perception is and - most important - what it is for. Perception guides our (inter)actions with the environment, with attention ensuring that the actor is attuned to information relevant for action. We dispute F&S's misconceived (and counterfactual) view of perception as a module that functions independently from cognition, attention, and action.

Size estimates remain stable in the face of differences in performance outcome variability in an aiming task.

In perceptual-motor tasks such as dart throwing, those who hit the target more successfully report the target to be bigger than those who hit less successfully. While initial evidence seemed to support the recent contention that the variability in performance (rather than the amount of successful hits) may scale reported target size, here we provide counterevidence for this hypothesis. We systematically manipulated performance outcomes in a shuffling task by means of magnetic fields. Participants were asked to slide a disk on a wooden board towards a circular target. Using a within-subjects design, in two conditions throw outcomes were manipulated to produce either high or low variability in performance outcome, while the mean success of performance (i.e., the mean error) remained constant across conditions. Despite the successful manipulations of high and low variability in the performance outcomes, results revealed that size estimates of the target remained stable.

Differences in Attentional Focus Associated With Recovery From Sports Injury: Does Injury Induce an Internal Focus?

Although it is commonly believed that focusing too much attention on the injured body area impairs recovery in sports, this has not been directly assessed. The present study investigated attentional focus following sports injury. Experienced baseball position players recovering from knee surgery (Expt 1) and baseball pitchers recovering from elbow surgery (Expt 2) performed simulated batting and pitching respectively. They also performed three different secondary tasks: leg angle judgments, arm angle judgments, and judgments about the ball leaving their bat/hand. Injured athletes were compared with expert and novice control groups. Performance on the secondary tasks indicated that the injured batters had an internal focus of attention localized on the area of the injury resulting in significantly poorer batting performance as compared with the expert controls. Injured pitchers had a diffuse, internal attentional focus similar to that of novices resulting in poorer pitching performance as compared with the expert controls.

Dynamic vibrotactile warning signals for frontal collision avoidance: towards the torso versus towards the head.

Three experiments were conducted to assess the effectiveness of dynamic vibrotactile warning signals with different spatial patterns and to compare dynamic towards-torso and towards-head vibrotactile warnings in a simulated driving task. The results revealed that embedding additional stimuli between the participant's hands and waist in the towards-torso cues (Experiment 1) and increasing the spatial distance between adjacent stimuli in the towards-head cues (Experiment 2) did not result in any further benefits in braking response times (BRTs). The triple towards-head cues resulting from the sequential operation of three pairs of stimuli on the torso gave rise to a significant advantage over the static cues; however, it did not outperform the dynamic towards-torso cues with just two pairs of stimuli. Taken together, these results demonstrated the promise of dynamic vibrotactile warnings (especially, the towards-torso warnings) in terms of the future design of more effective rear-end collision warnings. PRACTITIONER SUMMARY: Three experiments assessed the effectiveness of dynamic towards-torso and towards-head vibrotactile warning signals in a simulated driving task. The results demonstrated the promise of dynamic vibrotactile warnings (especially, the towards-torso vibrotactile warnings) in terms of the future design of more effective frontal collision warnings.

EFFECTS OF STROBOSCOPIC VISUAL TRAINING ON VISUAL ATTENTION, MOTION PERCEPTION, AND CATCHING PERFORMANCE.

UNLABELLED: It has been shown recently that stroboscopic visual training can improve visual-perceptual abilities, such as central field motion sensitivity and anticipatory timing. Such training should also improve a sports skill that relies on these perceptual abilities, namely ball catching. Thirty athletes (12 women, 18 men; M age=22.5 yr., SD=4.7) were assigned to one of two types of stroboscopic training groups: a variable strobe rate (VSR) group for which the off-time of the glasses was systematically increased (as in previous research) and a constant strobe rate group (CSR) for which the glasses were always set at the shortest off-time. Training involved simple, tennis ball-catching drills (9×20 min.) occurring over a 6-wk. PERIOD: In pre- and post-training, the participants completed a one-handed ball-catching task and the Useful Field of View (UFOV) and the Motion in Depth Sensitivity (MIDS) tests. Since the CSR condition used in the present study has been shown to have no effect on catching performance, it was predicted that the VSR group would show significantly greater improvement pre-post-training. There were no significant differences between the CSR and VSR on any of the tests. However, changes in catching performance (total balls caught) pre-post-training were significantly correlated with changes in scores for the UFOV single-task and MIDS tests. That is, regardless of group, participants whose perceptual-cognitive performance improved in the post-test were significantly more likely to improve their catching performance. This suggests that the perceptual changes observed in previous stroboscopic training studies may be linked to changes in sports skill performance.

Role of audiovisual synchrony in driving head orienting responses.

Many studies now suggest that optimal multisensory integration sometimes occurs under conditions where auditory and visual stimuli are presented asynchronously (i.e. at asynchronies of 100 ms or more). Such observations lead to the suggestion that participants' speeded orienting responses might be enhanced following the presentation of asynchronous (as compared to synchronous) peripheral audiovisual spatial cues. Here, we report a series of three experiments designed to investigate this issue. Upon establishing the effectiveness of bimodal cuing over the best of its unimodal components (Experiment 1), participants had to make speeded head-turning or steering (wheel-turning) responses toward the cued direction (Experiment 2), or an incompatible response away from the cue (Experiment 3), in response to random peripheral audiovisual stimuli presented at stimulus onset asynchronies ranging from -100 to 100 ms. Race model inequality analysis of the results (Experiment 1) revealed different mechanisms underlying the observed multisensory facilitation of participants' head-turning versus steering responses. In Experiments 2 and 3, the synchronous presentation of the component auditory and visual cues gave rise to the largest facilitation of participants' response latencies. Intriguingly, when the participants had to subjectively judge the simultaneity of the audiovisual stimuli, the point of subjective simultaneity occurred when the auditory stimulus lagged behind the visual stimulus by 22 ms. Taken together, these results appear to suggest that the maximally beneficial behavioural (head and manual) orienting responses resulting from peripherally presented audiovisual stimuli occur when the component signals are presented in synchrony. These findings suggest that while the brain uses precise temporal synchrony in order to control its orienting responses, the system that the human brain uses to consciously judge synchrony appears to be less fine tuned.

Putting health metrics into practice: using the disability-adjusted life year for strategic decision making.

BACKGROUND: Implementing organizations are pressured to be accountable for performance. Many health impact metrics present limitations for priority setting; they do not permit comparisons across different interventions or health areas. In response, Population Services International (PSI) adopted the disability-adjusted life year (DALY) averted as its bottom-line performance metric. While international standards exist for calculating DALYs to determine burden of disease (BOD), PSI's use of DALYs averted is novel. It uses DALYs averted to assess and compare the health impact of its country programs, and to understand the effectiveness of a portfolio of interventions. This paper describes how the adoption of DALYs averted influenced organizational strategy and presents the advantages and constraints of using the metric. METHODS: Health impact data from 2001-2011 were analyzed by program area and geographic region to measure PSI's performance against its goal of doubling health impact between 2007-2011. Analyzing 10 years of data permitted comparison with previous years' performance. A case study of PSI's Asia and Eastern European (A/EE) region, and PSI/Laos, is presented to illustrate how the adoption of DALYs averted affected strategic decision making. RESULTS: Between 2007-2011, PSI's programs doubled the total number of DALYs averted from 2002-2006. Most DALYs averted were within malaria, followed by HIV/AIDS and family planning (FP). The performance of PSI's A/EE region relative to other regions declined with the switch to DALYs averted. As a result, the region made a strategic shift to align its work with countries' BOD. In PSI/Laos, this redirection led to better-targeted programs and an approximate 50% gain in DALYs averted from 2009-2011. CONCLUSIONS: PSI's adoption of DALYs averted shifted the organization's strategic direction away from product sales and toward BOD. Now, many strategic decisions are based on "BOD-relevance," the share of the BOD that interventions can potentially address. This switch resulted in more targeted strategies and greater program diversification. Challenges remain in convincing donors to support interventions in disease areas that are relevant to a country's BOD, and in developing modeling methodologies. The global health community will benefit from the use of standard health impact metrics to improve strategic decision making and more effectively respond to the changing global burden of disease.

Interactions between performance pressure, performance streaks, and attentional focus.

How is performance under pressure influenced by the history of events that precede it, and how does the pressure outcome influence the series of events that follow? A baseball batting simulation was used with college players to investigate these questions. In Experiment 1, the difficulty of the simulation was first adaptively adjusted to equate performance level. Batters next completed 20 at-bats used to classify them into one of three performance groups (normal, cold streak, or hot streak) followed by a one at-bat pressure condition. Finally, performance was evaluated over a period of 20 postpressure at-bats. In Experiment 2, a series of secondary tasks were added to assess attentional focus. In both experiments, whether batters succeeded or failed under pressure was significantly related to their performance history immediately before the pressure event, with the normal group having the poorest pressure performance. Performance postpressure was significantly related to both the pressure outcome and prepressure performance. These performance effects were related to changes in the batter's attentional focus as shown by changes in secondary task accuracy.

A critical systematic review of the Neurotracker perceptual-cognitive training tool.

In this systematic review, we evaluate the scientific evidence behind "Neurotracker," one of the most popular perceptual-cognitive training tools in sports. The tool, which is also used in rehabilitation and aging research to examine cognitive abilities, uses a 3D multiple object-tracking (MOT) task. In this review, we examine Neurotracker from both a sport science and a basic science perspective. We first summarize the sport science debate regarding the value of general cognitive skill training, based on tools such as Neurotracker, versus sport-specific skill training. We then consider the several hundred MOT publications in cognitive and vision science from the last 30 years that have investigated cognitive functions and object tracking processes. This literature suggests that the abilities underlying object tracking are not those advertised by the Neurotracker manufacturers. With a systematic literature search, we scrutinize the evidence for whether general cognitive skills can be tested and trained with Neurotracker and whether these trained skills transfer to other domains. The literature has major limitations, for example a total absence of preregistered studies, which makes the evidence for improvements for working memory and sustained attention very weak. For other skills as well, the effects are mixed. Only three studies investigated far transfer to ecologically valid tasks, two of which did not find any effect. We provide recommendations for future Neurotracker research to improve the evidence base and for making better use of sport and basic science findings.

Perceptual-Motor and Perceptual-Cognitive Skill Acquisition in Soccer: A Systematic Review on the Influence of Practice Design and Coaching Behavior.

Facilitating players' skill acquisition is a major challenge within sport coaches' work which should be supported by evidence-based recommendations outlining the most effective practice and coaching methods. This systematic review aimed at accumulating empirical knowledge on the influence of practice design and coaching behavior on perceptual-motor and perceptual-cognitive skill acquisition in soccer. A systematic search was carried out according to the PRISMA guidelines across the databases SPORTDiscus, PsycInfo, MEDLINE, and Web of Science to identify soccer-specific intervention studies conducted in applied experimental settings (search date: 22nd November 2020). The systematic search yielded 8,295 distinct hits which underwent an independent screening process. Finally, 34 eligible articles, comprising of 35 individual studies, were identified and reviewed regarding their theoretical frameworks, methodological approaches and quality, as well as the interventions' effectiveness. These studies were classified into the following two groups: Eighteen studies investigated the theory-driven instructional approaches Differential Learning, Teaching Games for Understanding, and Non-linear Pedagogy. Another seventeen studies, most of them not grounded within a theoretical framework, examined specific aspects of practice task design or coaches' instructions. The Downs and Black checklist and the Template for Intervention Description and Replication were applied to assess the quality in reporting, risk of bias, and the quality of interventions' description. Based on these assessments, the included research was of moderate quality, however, with large differences across individual studies. The quantitative synthesis of results revealed empirical support for the effectiveness of coaching methodologies aiming at encouraging players' self-exploration within representative scenarios to promote technical and tactical skills. Nevertheless, "traditional" repetition-based approaches also achieved improvements with respect to players' technical outcomes, yet, their impact on match-play performance remains widely unexplored. In the light of the large methodological heterogeneity of the included studies (e.g., outcomes or control groups' practice activities), the presented results need to be interpreted by taking the respective intervention characteristics into account. Overall, the current evidence needs to be extended by theory-driven, high-quality studies within controlled experimental designs to allow more consolidated and evidence-based recommendations for coaches' work.

Enskilment: an Ecological-Anthropological Worldview of Skill, Learning and Education in Sport.

The aim of this paper is to explore a different, more relational worldview of skill, learning and education in sport. To do this, we turn to the work of social anthropologist, Tim Ingold, leaning on the notion of enskilment, which proposes that learning is inseparable from doing and place. From this worldview, what is learned is not an established body of knowledge, transmitted into the mind of a passive recipient from an authorised being, but is a progressively deepening embodied-embedded attentiveness, where an individual learns to self-regulate by becoming more responsive to people and environmental features by 'looking, listening and feeling'. As we discuss, Ingold's perspectives on enskilment are rooted in the etymological connotations of education-ex-ducere, which roughly means 'to lead out'. In applying this notion to sport, we unpack three of its entangled components, taskscapes, guided attention, and wayfinding, detailing the implications of each for the growth of enskilled sports performers. To promote the translation of these ideas, in addition to encouraging their inquiry beyond the scope of what is discussed here, sporting examples are threaded throughout the paper.

Switching tools: perceptual-motor recalibration to weight changes.

In order to effectively switch between tools, an actor must re-calibrate perceptual-motor control appropriately for the new tool's kinetic properties. This study explored changes in perceptual-motor control in response to switching to a tool of a different weight when performing a complex control task with moving objects. In Experiment 1, 30 participants were each randomly assigned to one of three groups in a baseball batting simulation: a standard group that always used the same bat weight (1.08 kg), a Lighter group that switched from the standard bat to a 0.79 kg bat, and a Heavier group that switched from the standard bat to a 1.36 kg bat. For both the Heavier and Lighter groups, temporal swing errors were significantly larger (as compared to the standard group) in the first block of trials following the bat change. Both groups re-calibrated quickly: within 5-10 trials after the bat change there were no significant difference between the groups. Analysis of swing kinematics indicated that the two change groups used different means for re-calibrating perceptual-motor control: the Lighter group altered swing velocity while the Heavier group altered swing onset time. In Experiment 2, when batters switched from a 0.79 kg bat to a 1.08 kg bat, perceptual-motor calibration depended on the recommended bat weight for each participant (Bahill and Freitas in Ann Biomed Eng 23:436-444, 1995): batters with a heavier recommended weight altered swing velocity while batters with a lower recommended weight altered onset time. The strategy used for perceptual-motor recalibration and time required to re-calibrate in a complex motor task is dependent on the action boundaries of the actor.

Nonconscious activation of an elderly stereotype and speed of driving.

Under the guise of evaluating a head-up display in a driving simulator, 11 participants (5 men), ages 21 to 35 years, completed scrambled-sentence tasks (while waiting at stop signs) designed to prime an elderly stereotype. Each driver completed both the Elderly Stereotype and Control conditions with order counterbalanced across participants. Further, order of presentation of word sets for each trial was random. Driving speed and driving time between stop signs in the Elderly Stereotype condition were compared to the Control condition in which nonspecific age words were substituted for elderly stereotyped words. Participants showed lower maximum speed and longer driving time in the Elderly Stereotype condition than in the Control condition, even though participants reported no awareness of the theme in the experimental condition.

Changes in Movement Coordination Associated With Skill Acquisition in Baseball Batting: Freezing/Freeing Degrees of Freedom and Functional Variability.

How do baseball batters solve the problem of coordinating the timing of the different phases of movement to generate a powerful swing that is appropriately adjusted for the trajectory of the pitch? How does the development of this coordination solution depend on the structure of practice? Previously unpublished ground reaction force (GRF) data were analyzed to investigate the swing coordination changes that were associated with the changes in batting performance found in the training study by Gray (2017). From pre-post training, there were significant increases in the magnitude of correlations between adjacent swing phases, significant increases in good variability (changes that keep the swing within the required temporal constraint), significant decreases in bad variability (changes that move the swing outside the temporal constraint), and stronger evidence of online adjustments of the different swing phases. These effects were significantly larger for the virtual environment (VE) Adaptive group from the Gray (2017) study that had higher variability in practice conditions. Across all participants, there were significant correlations between the changes in good and bad variability from pre-post training and measures of batting from VE and real hitting tests, and statistics from league play. These findings suggest that baseball batters solve the problem of coordination by developing functional variability and coupling between swing phases (Katsumata, 2007), which can be facilitated by having more variability in practice conditions.

A model of motor inhibition for a complex skill: baseball batting.

The ability to inhibit an ongoing action in response to a signal from the environment is important for many perceptual-motor actions. This paper examines a particular example of this behavior: attempting to inhibit or "check" a swing in baseball batting. A model of motor inhibition in batting is proposed. In the model there are three different inhibition signals (out of range launch angle, early expected-actual trajectory discrepancy, and late expected-actual trajectory discrepancy) resulting in four possible response outcomes for the batter's swing (full swing, inhibited swing, partial response, or interrupted swing). The predictions of the model were compared with the actual batting performance of 20 baseball players using a high-fidelity batting simulator. The proportions of the different response outcomes could be explained by the inhibition model for 17/20 of the batters in the study. These findings suggest that models of motor inhibition developed for simple, discrete tasks can be applied to complex, multistage behaviors. This batting inhibition model could be used to provide a quantitative measure of a player's bat control for training and player-screening purposes. (PsycINFO Database Record (c) 2009 APA, all rights reserved).

Directing visual attention with spatially informative and spatially noninformative tactile cues.

We investigated the tactile cuing of visual spatial attention using spatially-informative (75% valid) and spatially-noninformative (25% valid) tactile cues. The participants performed a visual change detection task following the presentation of a tactile spatial cue on their back whose location corresponded to one of the four visual quadrants on a computer monitor. The participants were explicitly instructed to use the spatially-informative tactile cues but to ignore the spatially-noninformative cues. In addition to reaction time data, participants' eye-gaze was monitored as a measure of overt visual attention. The results showed that the spatially-informative tactile cues resulted in initial saccades toward the cued visual quadrants, and significantly reduced the visual change detection latencies. When spatially-noninformative tactile cues were used, the participants were largely successful at ignoring them as indicated by a saccade distribution that was independent of the quadrant that was cued, as well as the lack of a significant change in search time as compared to the baseline measure of no tactile cuing. The eye-gaze data revealed that the participants could not always completely ignore the spatially-noninformative tactile cues. Our results suggest that the tactile cuing of visual attention is natural but not automatic when the tactile cue and visual target are not collocated spatially, and that it takes effort to ignore the cues even when they are known to provide no useful information. In addition, our results confirm previous findings that spatially-informative tactile cues are especially effective at directing overt visual attention to locations that are not typically monitored visually, such as the bottom of a computer screen or the rearview mirror in an automobile.