Embodied prosthetic arm stabilizes body posture, while unembodied one perturbs it.

Senses of ownership (this arm belongs to me) and agency (I am controlling this arm) originate from sensorimotor system. External objects can be integrated into the sensorimotor system following long-term use, and recognized as one's own body. We examined how an (un)embodied prosthetic arm modulates whole-body control, and assessed the components of prosthetic embodiment. Nine unilateral upper-limb amputees participated. Four frequently used their prosthetic arm, while the others rarely did. Their postural sway was measured during quiet standing with or without their prosthesis. The frequent users showed greater sway when they removed the prosthesis, while the rare users showed greater sway when they fitted the prosthesis. Frequent users reported greater everyday feelings of postural stabilization by prosthesis and a larger sense of agency over the prosthesis. We suggest that a prosthetic arm maintains or perturbs postural control, depending on the prosthetic embodiment, which involves sense of agency rather than ownership.

Pupillary Responses to Dot Patterns on a Human Face Background.

Dots on natural backgrounds can elicit significant pupillary constrictions within the entire image phase associated with parasympathetic activation, suggesting disgust rather than fear. Although studies have reported that dots on faces elicit stronger disgust than dots on non-face backgrounds, it remains unclear whether dots on a face elicit stronger pupil constrictions than non-face backgrounds. Pupillometry was used while viewing dots on faces and compared with luminance- and spatial frequency-controlled images (dots on phase-scrambled faces) and luminance-controlled images (face only, phase-scrambled faces). Relative pupillary constrictions were elicited when dots were placed on faces and phase-scrambled faces; however, the response to dots on faces did not differ significantly from that to the control stimuli. Approximately 3-5 s after stimulus onset, pupillary responses to dots on faces recovered to baseline faster than those to dots on phase-scrambled faces with a larger pupil size. The initial pupillary constrictions observed are consistent with those in response to dots on natural backgrounds, suggesting that regardless of the background, dots may stimulate parasympathetic activation and elicit disgust rather than fear. The faster recovery from the pupil constriction and larger pupil size in the later phase may be caused by a dynamic balance between the sympathetic and parasympathetic neuronal activities.

Robot occupations affect the categorization border between human and robot faces.

The Uncanny Valley hypothesis implies that people perceive a subjective border between human and robot faces. The robot-human border refers to the level of human-like features that distinguishes humans from robots. However, whether people's perceived anthropomorphism and robot-human borders are consistent across different robot occupations remains to be explored. This study examined the robot-human border by analyzing the human photo proportion represented by the point of subjective equality in three image classification tasks. Stimulus images were generated by morphing a robot face photo and one each of four human photos in systematically changed proportions. Participants classified these morphed images in three different robot occupational conditions to explore the effect of changing robot jobs on the robot-human border. The results indicated that robot occupation and participant age and gender influenced people's perceived anthropomorphism of robots. These can be explained by the implicit link between robot job and appearance, especially in a stereotyped context. The study suggests that giving an expected appearance to a robot may reproduce and strengthen a stereotype that associates a certain appearance with a certain job.

Japanese Consumers' Attitudes towards Obtaining and Sharing Health Information Regarding Over-the-Counter Medication: Designing an Over-the-Counter Electronic Health Record.

Designing an over-the-counter medication electronic health record (OTC-EHR) may help improve OTC usage. An online survey for the conceptual OTC-EHR design examined participant characteristics, attitudes towards obtaining user-shared OTC medication information, health-related application usage, and the inclination to share anonymized health information. Descriptive statistics, tests to assess statistical significance, and text mining were used to analyze the results. The findings revealed that Japanese consumers, particularly those with high eHealth literacy and women, possess relatively positive attitudes towards obtaining user-shared OTC medication information than those with low eHealth literacy (t (280.71) = -4.11, p < 0.001) and men (t (262.26) = -2.78, p = 0.006), respectively. Most consumers own smartphones but do not use health-related applications. A minority held positive attitudes about sharing anonymized health information. The perceived helpfulness of OTC-EHR was positively associated with the usage of health-related applications (χ2 (4) = 18.35, p = 0.001) and attitude towards sharing anonymized health information (χ2 (3) = 19.78, p < 0.001). The study findings contribute towards OTC-EHR's design to enhance consumers' self-medication and reduce risks, while the psychological barriers to sharing anonymized health information should be improved by increasing the OTC-EHR's penetration rate and engaging in appropriate information design.

Analysis of Japanese consumers' attitudes toward the digital transformation of OTC medicine purchase behavior and eHealth literacy: an online survey for digital experience design.

Introduction: Since the enactment of the revised Pharmaceutical Affairs Act in Japan in 2009, self-medication practices have increased in the country. However, studies report that consumers pay little attention to the medication facts and risks indicated on the packages of over-the-counter (OTC) medicines, which could be a potential risk. Since the COVID-19 pandemic, the digital transformation of purchasing OTC medicines has progressed. As an appropriate design for the digital transformation is likely to improve consumers' literacy and them obtaining medical information, this study systematically examines Japanese consumers' attitudes toward the digital transformation of OTC medicine purchase behavior and its correlation to eHealth literacy, exploring an appropriate digital experience design in purchasing OTC medicine. Methods: Participants from the Greater Tokyo Area of Japan participated in an online survey. Consumers' current behavior and preferences in accessing OTC medicine, receiving medication guidance, and obtaining medical information were examined. eHealth literacy was assessed using the J-eHEALS. Descriptive statistics, text mining, and thematic analysis were conducted to answer research questions. Results: Over 89% of the respondents who had experience in purchasing OTC medicines preferred local pharmacies or stores rather than online purchasing, p < 0.001. Obtaining medicine guidance in pharmacies or stores was the main preference over other approaches, p < 0.001. Furthermore, most of the participants accepted selecting medicine on shelves and digital screens in-store. However, they were accustomed to using smartphones to obtain additional information at the pharmacy or drug store, p < 0.001; this behavior was positively correlated with eHealth literacy, p < 0.001. Conclusions: Japanese consumers are seeking a combination of conventional and digital behaviors for purchasing OTC medicine rather than opting for a particular method. Most consumers prefer purchasing and receiving instructions in-store while searching for additional decision-making information online. eHealth literacy is positively associated with digital behaviors of OTC medicine information acquisition but less associated with medicine purchases and selections. The hybrid digital experience design may enhance the OTC medicine purchase experience and reduce potential risks by providing appropriate information.

Neuropsychological and radiological assessments of two cases with apparent idiopathic rapid eye movement sleep behaviour disorder.

We examined two male patients (64 and 70 years old) with rapid eye movement sleep behaviour disorder (RBD) using cognitive tests, myocardial (123)I-metaiodobenzylguanidine (MIBG) scintigraphy, and dopamine positron emission tomography (PET) imaging. One patient had impaired social cognition and decision-making skills and reduced MIBG reuptake, and dopamine PET imaging indicated striatal terminal loss. The other patient had normal social cognition and reduced MIBG reuptake, but no abnormalities were detected by dopamine PET imaging. Both patients reported constipation. This study supports the hypothesis by Braak et al. [Mov Disord 2006;21:2042-2051] that impairment of the amygdala and striatum occurs at the same stage as α-synucleinopathy, and the findings suggest that autonomic dysfunctions such as reduced MIBG reuptake and constipation are the earliest symptoms of RBD. Detailed neuropsychological and radiological assessments of these 2 cases revealed that idiopathic RBD could develop in various clinical situations and include cognitive and autonomic changes. Further longitudinal studies with larger sample sizes will help understand the neuropsychology and pathophysiology of RBD.

Picture agnosia as a characteristic of posterior cortical atrophy.

BACKGROUND: Posterior cortical atrophy (PCA) is a degenerative disease characterized by progressive visual agnosia with posterior cerebral atrophy. We examine the role of the picture naming test and make a number of suggestions with regard to diagnosing PCA as atypical dementia. METHODS: We investigated 3 cases of early-stage PCA with 7 control cases of Alzheimer disease (AD). The patients and controls underwent a naming test with real objects and colored photographs of familiar objects. We then compared rates of correct answers. RESULTS: Patients with early-stage PCA showed significant inability to recognize photographs compared to real objects (F = 196.284, p = 0.0000) as measured by analysis of variants. This difficulty was also significant to AD controls (F = 58.717, p = 0.0000). CONCLUSION: Picture agnosia is a characteristic symptom of early-stage PCA, and the picture naming test is useful for the diagnosis of PCA as atypical dementia at an early stage.

Depth perception between dots and the background face reduces trypophobic discomfort.

BACKGROUND: Studies have shown that viewing a cluster of dots evokes feelings of discomfort in viewers and that the discomfort becomes especially strong when the dots are placed on background images of human skin. This phenomenon has been explained by the physical properties and spatial and semantic relationships between the dots and the background. However, it was not known whether the perceived, as well as the physical, spatial relationships contributes to the generation of discomfort. METHODS: We evoked illusory depth perception between black dots and the background face by drawing shadow-like gray dots around the black dots, while keeping the same black dots at the same positions, and examined whether illusory depth perception could increase or decrease discomfort. In each trial, participants viewed one of the following types of facial images: (a) face-only (face without dots), (b) a cluster of black dots on the face, (c) a cluster of gray dots on the face, and (d) a cluster of black dots and shadow-like gray dots on the face. After seeing each picture, they evaluated how much discomfort they felt from viewing the picture using a Likert scale and reported whether they perceived depth between the dots and the face. RESULTS: Participants felt discomfort toward all three types of faces with dots, that is, faces with black dots, gray dots, and both. However, interestingly, participants felt less discomfort when both black and gray dots were presented on the face than when only black dots were presented. The participants perceived depth between the black dots and the face in 85% of the trials with black dots and shadow-like gray dots, and there was a significant correlation between discomfort and frequency of depth perception. However, in the trials with black dots only and gray dots only, they perceived depth in only 18% and 27% of the trials, respectively, and the correlations between the frequencies of depth perception and discomfort were not significant. CONCLUSIONS: Our results suggest that the perceived spatial relationship, such as attached vs. separate, as well as the physical spatial relationship, contribute to the generation of discomfort.

A social media network analysis of trypophobia communication.

Trypophobia has attracted scientific attention in recent years. Few related studies have recruited participants using online methods, and even less is known about health communication in an environment where trypophobia was first widely discussed (i.e., the Internet). This study describes communication patterns in a Facebook group for trypophobia by detecting frequent topics, top contributors, and their discourses. We identified key commenters and performed word frequency analysis, word co-occurrence analysis, topic modeling, and content analysis. Impactful users posted and replied more often when discussing peer-reviewed science. Triggering content was actively removed by the group administrators. A wide variety of triggers not discussed in trypophobia-related literature were frequently mentioned. However, there was a lack of discussion on peer-reviewed treatments. The combination of a few expert and many supportive amateur gatekeepers willing to understand trypophobia, along with active monitoring by administrators, might contribute to in-group trust and the sharing of peer-reviewed science by top users of the trypophobia Facebook group.

[Preoperative intravenous administration of droperidol (1.25 mg) reduced postoperative nausea and vomiting after intrathecal morphine administration].

BACKGROUND: Intrathecal morphine (ITM) is an excellent postoperative analgesic, but may often cause postoperative nausea and vomiting (PONV). We designed this prospective, randomized and controlled study to evaluate the antiemetic efficacy of low-dose droperidol for the treatment of PONV caused by ITM. METHODS: Two hundred female patients undergoing elective total hip arthroplasty were enrolled. They received spinal anesthesia with isobaric bupivacaine and 0.08 mg ITM, and 100 patients were randomly administered with 1.25 mg droperidol intravenously before operation. We observed the incidence of PONY and pain score until 24 hr after operation, and investigated the doses of anti-hypotensive drugs (ephedrine and phenylephrine) and fluid administered intraoperatively. RESULTS: The incidence of PONV was lower in the droperidol group within 6 hr after operation (control group 47%, droperidol group 15%), and especially lower within 2 hr (43% vs. 3%), but was not different 6 hr after operation. The pain score was very low throughout the observation period in both groups and especially within 12 hr. The respective doses of the anti-hypotensive drugs and fluid administered intraoperatively during the operation were higher in the droperidol group. Severe arrhythmia was not observed in any patient throughout the observation period. CONCLUSIONS: Single intravenous administration of 1.25 mg droperidol before operation showed prophylactic efficacy in early PONV caused by ITM. The duration of droperidol action was shorter than that of ITM. Hence we recommend that droperidol should be administered more frequently or continuously in the postoperative period.

[Examination of the optimal midazolam dose required for loss of puncture memory at the time of spinal anesthesia].

BACKGROUND: We examined midazolam ED50 according to age that was necessary for loss of puncture memory at the time of spinal anesthesia and determined whether we could estimate the presence of puncture memory from the degree of sedation after midazolam administration. METHODS: We enrolled patients with ASA PS 1 or 2 and patients from 50 to 80 years of age who had been planned for surgery with spinal anesthesia. We divided the patients into groups according to their age--50s, 60s, and 70s as L, M, and H groups, respectively. We evaluated the degree of sedation with six phases of scores after intravenous administration of midazolam and spinal anesthesia was performed. The midazolam dose was based on the ups and downs method. RESULTS: The midazolam ED50s required for the loss of puncture memory in groups L, M, and H were 0.043, 0.035, and 0.026 mg x kg(-1), respectively. We estimated the association between the sedation degree score after midazolam administration and the puncture memory from ROC curve, but AUC was 0.56 for all cases. CONCLUSIONS: The midazolam ED50 required for the loss of puncture memory decreased with age but it was difficult to estimate puncture memory from the degree of sedation.

[Anesthetic management of a hemodialysis-dependent patient implanted with a CRT-D device undergoing an operation for perforated peritonitis].

A 53-year-old man was admitted to our hospital for hematochezia, and an emergency operation was scheduled for his perforated sigmoid colon. He had received a CRT-D (cardiac resynchronization therapy with defibrillator) device for dilated cardiomyopathy two years before and had been receiving hemodialysis for the past year. Anesthesia was induced with midazolam and remifentanil and maintained with remifentanil and sevoflurane in oxygen. Before surgery, we disabled the defibrillation function of the CRT-D device and changed its pacing mode from VVI to VOO, and electrodes of an external defibrillator were attached to the chest wall. Dopamine and norepinephrine were administered via a central venous catheter, and systolic blood pressure was maintained between 70 and 80 mmHg and CVP between 8 and 13 mmHg. Sigmoidectomy was performed and he was transferred to the ICU intubated. Although intensive care procedures, such as mechanical ventilation, continuous hemodiafiltration, and direct hemoperfusion with polymyxin B-immobilized fibers were performed, he died of multiple organ failure on postoperative day 48. CRT-D has become mainstream cardiac resynchronization therapy and will require attention for anesthetic management of patients implanted with the CRT-D device.

Investigating the relationship between users' eye movements and perceived product attributes in design concept evaluation.

Eye movements as the indicators of human information processing have been studied in many domains. However, it is not clear how users' eye movements differ among specific product attribute, while visual impression of a product plays a crucial part in distinguishing product designs. Therefore, this paper attempts to establish guidance for exploring eye tracking applications in design concept validations through two case studies. The first case study investigated the product attributes based on the theory of cognitive-affective emotions. The second investigated the product attributes for apparent functionality and affective quality. The eye movements of 105 participants were analyzed when they evaluated the products images. The results indicated that product attributes perceived in evaluation tasks can be predicted from eye movements. Moreover, compared to the new users, experienced users had a longer mean fixation duration and tended to form their impressions of the product from multiple components.

Size resolved characteristics of urban and suburban bacterial bioaerosols in Japan as assessed by 16S rRNA amplicon sequencing.

To study the size-resolved characteristics of airborne bacterial community composition, diversity, and abundance, outdoor aerosol samples were analysed by 16S rRNA gene-targeted quantitative PCR and amplicon sequencing with Illumina MiSeq. The samples were collected using size-resolved samplers between August and October 2016, at a suburban site in Toyama City and an urban site in Yokohama City, Japan. The bacterial communities were found to be dominated by Actinobacteria, Firmicutes, and Proteobacteria. At the genus level, we found a high abundance of human skin-associated bacteria, such as Propionibacterium, Staphylococcus, and Corynebacterium, in the urban site. Whereas, a high abundance of bacteria associated with soil and plants, such as Methylobacterium and Sphingomonas, was observed in the suburban site. Furthermore, our data revealed a shift in the bacterial community structure, diversity, and abundance of total bacteria at a threshold of 1.1-µm diameter. Interestingly, we observed that Legionella spp., the causal agents of legionellosis in humans, were mainly detected in > 2.1 µm coarse particles. Our data indicate that local environmental factors including built environments could influence the outdoor airborne bacterial community at each site. These results provide a basis for understanding the size-resolved properties of bacterial community composition, diversity, and abundance in outdoor aerosol samples and their potential influence on human health.

[Uncrossmatched type O red blood cell transfusion and cell saver autologous blood transfusion effective for intraoperative massive bleeding].

We experienced rapid and massive bleeding in a 57-year-old woman undergoing resection of ovarian tumor metastasis. One hour after the start of operation, blood loss increased due to adhesion of the tumor. The blood hemoglobin level decreased from 11.7 to 4.6 g x dl(-1). Since available matched homologous blood had been consumed, we transfused type O uncrossmatched red blood cells followed by cell saver autologous blood. For the treatment of uncontrollable hyperkalemia and metabolic acidosis, continuous hemodiafiltration was started. A total of 66 U of red blood cells, 48 U of FFP, and 40 U of platelets were transfused intraoperatively. No neurological deficit, pulmonary edema, renal failure, or hemolysis was found postoperatively.

Separate processing of different global-motion structures in visual cortex is revealed by FMRI.

The visual system has the remarkable ability to extract several types of meaningful global-motion signals, such as radial motion, translation motion, and rotation, for different visual functions and actions. In the monkey brain, different groups of cells in MST respond best to different types of global motion [1, 2] whereas in lower cortical areas including MT, no such differential responses have been found. Here, we show that an area (or areas) lower than MST in the human brain [3] responds to different types of global motion. A series of human functional magnetic resonance imaging (fMRI) experiments, in which attention was controlled for, indicated that the center of radial motion activates the corresponding location in the V3A representation, whereas translation motion activates mainly in a more peripheral representation of V3A. These results suggest that in the human brain, V3A is an area that differentially responds according to the type of global motion.

Decision making in Parkinson's disease: Analysis of behavioral and physiological patterns in the Iowa gambling task.

Recent studies suggest that social recognition processes are affected by Parkinson's disease (PD). However, whether PD patients exhibit behavioral changes is still controversial. The purpose of the present study was to examine the decision making of PD patients performing the Iowa Gambling Task (IGT). We recruited a large number of early, nondemented PD patients for the IGT. We also recorded the skin conductance responses (SCRs) during the task as a measure of emotional arousal. Compared with the normal control (NC) subjects, PD patients selected more disadvantageous decks in the IGT, and their SCRs were lower than those of NC subjects before making decisions and after receiving reward or punishment. The tendency toward risky choices was not correlated with age, education, global cognitive function, or the severity of the disease. These results confirmed that the decision making of PD patients was affected by the disease, rather than by other cognitive functions; moreover, such behavior was related to lower emotional responses. Behavioral and SCR patterns of PD patients were similar to those of amygdala-damaged patients. The response bias toward risky choices in PD may be explained by the dysfunction of the amygdala, which is known to be involved in risk evaluation.

Writing errors and anosognosia in amyotrophic lateral sclerosis with dementia.

Amyotrophic lateral sclerosis (ALS) with dementia (ALS-D) is known to exhibit characteristics of frontotemporal dementia. However, in clinical situations, it is often difficult to evaluate their cognitive functions because of impaired voluntary speech and physical disabilities. In order to identify characteristic and diagnostic cognitive symptoms of relatively advanced ALS-D patients, we retrospectively reviewed the clinical features of seven cases of clinically definitive ALS who had dementia, impaired voluntary speech, and physical disability. Their medical records showed that six out of seven patients made writing errors, and all of the patients demonstrated anosognosia. The writing errors consisted of paragraphia such as substitution, omission, or syntactic errors with individual differences in error types. Dissociation between kana and kanji were also observed. Anosognosia was evaluated by a self-rating scale with which the patients and the medical staff evaluated the patient's physical ability; the results indicated a large discrepancy between the evaluation by the patients and the medical staff. We emphasize that aphasic writing errors have been underestimated, particularly in ALS-D patients with impaired voluntary speech. We also reported that anosognosia was the most important and quantifiable symptom in ALS-D. The relationship between writing errors and anosognosia should be investigated further.

Greater plasticity in lower-level than higher-level visual motion processing in a passive perceptual learning task.

Simple exposure is sufficient to sensitize the human visual system to a particular direction of motion, but the underlying mechanisms of this process are unclear. Here, in a passive perceptual learning task, we found that exposure to task-irrelevant motion improved sensitivity to the local motion directions within the stimulus, which are processed at low levels of the visual system. In contrast, task-irrelevant motion had no effect on sensitivity to the global motion direction, which is processed at higher levels. The improvement persisted for at least several months. These results indicate that when attentional influence is limited, lower-level motion processing is more receptive to long-term modification than higher-level motion processing in the visual cortex.

[Conscious sedation and amnesic effect of intravenous low-dose midazolam prior to spinal anesthesia].

BACKGROUND: The pain associated with spinal puncture is severe, and the memory of this uncomfortable procedure often deters patients from undergoing the procedure again. Therefore, it is important to make the patient as comfortable as possible when this procedure is performed. METHODS: We administrated a low-dose (1-2.5 mg) of midazolam intravenously several minutes before conducting a spinal-tap in 200 patients undergoing elective surgery of the lower limb. The dose of midazolam used was based on the patient's age and weight, and we investigated remaining of a memory concerning the spinal-tap procedure and side effects of midazolam at the end of surgery. RESULTS: Memory of the spinal-tap procedure remained in 14.0%, 1.9%, and 32.7% of the patients who had received benzodiazepine preoperatively and in 25.0%, 40.0%, and 60.9% of the patients who hadn't received benzodiazepine preoperatively in the age group <60, 60-70, and > or =70 years, respectively. No patient experienced severe respiratory depression, but an excessive sedation or restlessness was experienced in 1.6%, 4.8%, and 5.2% of the patients. CONCLUSIONS: In the patients aged <70 years, intravenous administration of 0.023-0.044 mg x kg(-1) of midazolam was very effective in preventing a bad memory concerning the spinal-tap procedure; however, it is important to note that the number of side effects associated with this procedure increases in patients aged > or =60 years.