Movement characteristics impact decision-making and vice versa.

Previous studies suggest that humans are capable of coregulating the speed of decisions and movements if promoted by task incentives. It is unclear however whether such behavior is inherent to the process of translating decisional information into movements, beyond posing a valid strategy in some task contexts. Therefore, in a behavioral online study we imposed time constraints to either decision- or movement phases of a sensorimotor task, ensuring that coregulating decisions and movements was not promoted by task incentives. We found that participants indeed moved faster when fast decisions were promoted and decided faster when subsequent finger tapping movements had to be executed swiftly. These results were further supported by drift diffusion modelling and inspection of psychophysical kernels: Sensorimotor delays related to initiating the finger tapping sequence were shorter in fast-decision as compared to slow-decision blocks. Likewise, the decisional speed-accuracy tradeoff shifted in favor of faster decisions in fast-tapping as compared to slow-tapping blocks. These findings suggest that decisions not only impact movement characteristics, but that properties of movement impact the time taken to decide. We interpret these behavioral results in the context of embodied decision-making, whereby shared neural mechanisms may modulate decisions and movements in a joint fashion.

Comparing the motivational value of rewards and losses in an EEG-pupillometry study.

We found earlier that performance-contingent rewards lead to faster performance than equivalent losses [Carsten, Hoofs, Boehler, & Krebs, 2019. Motivation Science, 5(3). http://dx.doi.org/10.1037/mot0000117]. Here, we further tested the hypothesis that motivation to gain rewards is higher than to avoid losses, even when incentive values are matched. As implicit markers of motivation, we assessed electroencephalography (EEG) focusing on the P3 after target and feedback onset, and the Feedback-Related Negativity (FRN), as well as simultaneously recorded pupil size. Comparing only reward and loss prospect trials in Experiment 1, we found no consistent differences in behavior and electrophysiological markers of motivation, although pupil data suggested higher arousal after feedback in potential-loss trials. Including additional no-incentive trials in Experiment 2, we found consistent evidence that motivation to gain rewards was higher than to avoid losses: In line with behavior, the target-P3 was most pronounced for reward-related stimuli, followed by loss and no-incentive ones. This same ranking was found in the P3 and the FRN after positive outcomes (i.e., reward, avoided loss, and correct feedback in no-incentive trials). Negative outcomes featured a different pattern in line with the pupil response, which suggests that losses are emotionally salient events, without invigorating behavior proportionally. In sum, these findings suggest that the motivation to gain rewards is more pronounced than motivation to avoid equivalent losses, at least in tasks promoting transient increases in attention triggered by incentive prospect. These motivational differences may arise as avoided losses are not profitable in the long term, in contrast to gained rewards.

Differential effects of sustained and transient effort triggered by reward - A combined EEG and pupillometry study.

In instrumental task contexts, incentive manipulations such as posting reward on successful performance usually trigger increased effort, which is signified by effort markers like increased pupil size. Yet, it is not fully clear under which circumstances incentives really promote performance, and which role effort plays therein. In the present study, we compared two schemes of associating reward with a Flanker task, while simultaneously acquiring electroencephalography (EEG) and pupillometry data in order to explore the contribution of effort-related processes. In Experiment 1, reward was administered in a block-based fashion, with series of targets in pure reward and no-reward blocks. The results imply increased sustained effort in the reward blocks, as reflected in particular in sustained increased pupil size. Yet, this was not accompanied by a behavioral benefit, suggesting a failure of translating increased effort into a behavioral pay-off. In Experiment 2, we introduced trial-based cues in order to also promote transient preparatory effort application, which indeed led to a behavioral benefit. Again, we observed a sustained pupil-size increase, but also transient ones. Consistent with this, the EEG data of Experiment 2 indicated increased transient preparatory effort preceding target onset, as well as reward modulations of target processing that arose earlier than in Experiment 1. Jointly, our results indicate that incentive-triggered effort can operate on different time-scales, and that, at least for the current task, its transient (and largely preparatory) form is critical for achieving a behavioral benefit, which may relate to the temporal dynamics of the catecholaminergic systems.

Pupillary contagion is independent of the emotional expression of the face.

The concept of pupillary contagion refers to the automatic imitation of observed pupil size and reflects shared autonomic arousal. Previous studies have linked the experience of sadness to changes in pupil size. Accordingly, in a 2006 Social Cognitive and Affective Neuroscience article, Harrison, Singer, Rotshtein, Dolan, and Critchley found evidence for pupillary contagion when the observed face expressed sadness but not when it showed a neutral, happy, or angry expression. However, differences in eye movements might have influenced these results. Furthermore, the relatively small sample size of the study merits additional replication. In the current study, we modified the experimental design of Harrison et al. by requiring high attention toward the eye region of the face, which minimized differences in eye movements between facial expressions. In doing so, we demonstrate that the degree of pupillary contagion is independent of the observed emotional expression. Instead, pupil size and emotional expression of the shown face independently contribute to the observer's pupil size. The role of pupillary contagion for social communication is discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Interactions between incentive valence and action information in a cued approach-avoidance task.

Environmental stimuli can provoke specific response tendencies depending on their incentive valence. While some studies report positive-approach and negative-avoidance biases, others find no such mappings. To further illuminate the relationship between incentive valence and action requirement, we combined a cued monetary incentive paradigm with an approach/avoidance joystick task. Incentive type was manipulated between groups: The reward group won money, while the punishment group avoided losing money for correct and fast responses to targets following incentive cues. Depending on their orientations, targets had to be 'approached' or 'avoided'. Importantly, incentive valence (signaled by cue color) was orthogonal to action requirement (target orientation). Moreover, targets could carry valence-associated information or not (target color), which was, however, task-irrelevant. First, we observed that both valence cues (reward/punishment) improved performance compared to neutral cues, independent of the required action (approach/avoid), suggesting that advance valence cues do not necessarily produce specific action biases. Second, task-irrelevant valence associations with targets promoted action biases, with valence-associated targets facilitating approach and impairing avoid responses. Importantly, this approach bias for valence-associated targets was observed in both groups and hence occurred independently of absolute valence ('unsigned'). This rather unexpected finding might be related to the absence of a direct contrast between positive valence and negative valence within groups and the common goal to respond fast and accurately in all incentive trials. Together, our results seem to challenge the notion that monetary incentives trigger 'hard-wired' valence-action biases in that specific design choices seem to modulate the presence and/or direction of valence-action biases.

Postoperative course after emergency colorectal surgery for secondary peritonitis in the elderly is often complicated by delirium.

Postoperative delirium, morbidity, and mortality in our elderly patients with secondary perionitis of colorectal origin is described. This is a chart-based retrospective analysis of 63 patients who were operated on at the University Hospital Basel from April 2001 to May 2004. Postoperative delirium occurred in 33%. Overall morbidity was 71.4%. Surgery-related morbidity was 43.4%. Mortality was 14.4%. There was no statistical significance between delirium, morbidity and mortality (P  =  0.279 and P  =  0.364). There was no statistically significant correlation between the analyzed scores (American Society of Anesthesiologists classification, Mannheimer Peritonitis Index, Acute Physiology and Chronic Health Evaluation score II, physiological and operative surgical severity and enumeration of morbidity and mortality score' or short 'cr-POSSUM') and postoperative delirium, morbidity or mortality. Postoperative delirium occurred in one-third of the patients, who seem to have a trend to higher morbidity. Even if the different scores already had proven to be predictive in terms of morbidity and mortality, they do not help the risk stratification of postoperative delirium, morbidity, or mortality in our collective population.

Success and failure of primary medical, nonoperative management in breast cancer.

BACKGROUND: Nonoperative but systemic therapy as first-line management is offered to some patients with breast cancer (BC) who have assumed limited life expectancy, such as older women or those who have distant metastases at initial presentation. We evaluated rates of and predicting factors for success and failure of this therapy approach. METHODS: Seventy-five patients who were initially treated only systemically, and cases in which local control while avoiding surgery was the intended long-term therapy goal were analyzed. Additionally, two stage-dependent subgroups were distinguished (A: stage I-III, n = 31; B: stage IV, n = 44). Failure of therapy was defined as when secondary surgery had to be performed due to locoregional progression or in case of no surgery when severe locoregional clinical signs/symptoms were observed during the further course. RESULTS: Patients in group A were older than those in group B (81 vs. 67.5 years; P < 0.001) and showed an increased survival (5-year rates: 40.2% vs. 24.3%). In 24 patients of the entire cohort (32%), secondary surgery had to be performed; surgery was performed more often in group A (58.1% vs. 13.6%). In the cases in which no surgery was performed (n = 51), 11 women (21.6%) suffered from severe locoregional symptoms in the palliative situation (A: n = 1; B: n = 10). Although the presence of stage IV was a significant factor for therapy success (odds ratio (OR), 2.59; 95% confidence interval (CI), 0.95-7.05; P = 0.039), skin involvement was associated with failure of therapy (OR, 3.57; 95% CI, 1.16-11.11; P = 0.031). CONCLUSIONS: Nonoperative treatment may be offered to selected patients with BC who have assumed limited life expectancy. These women must be openly informed that this approach is not successful in nearly half of the cases.

Three-dimensional pathological size assessment in primary breast carcinoma.

Maximal tumor diameter (MD) is traditionally an important prognostic factor in breast cancer. It must be questioned, however, how well a one-dimensional parameter alone can represent the actual morphologic condition of a three-dimensional body. Along with the pathologically assessed MD and two perpendicular diameters (PDs) of a lesion, eccentricity (EF) and the three-dimensional parameters tumor volume (TV) and surface area (TSA) of 395 ductal invasive breast carcinomas of limited size (10-40 mm) were calculated. The dependent prognostic variable was axillary lymph node involvement (ALNI). MD, TV and TSA area were highly significant predictors of ALNI; these variables had similar levels of prediction accuracy (univariate analyses: MD: P = 0.0003, TV: P = 0.0009, TSA: P < 0.0001; multivariate analyses: MD: P = 0.0018, TV: P = 0.0109, TSA: P = 0.0009; pseudo R-squared values: MD: 0.42, TV: 0.39, TSA: 0.39). Despite certain variations in tumor shape, TV and TSA with similar MD, there is no evidence that three-dimensional pathologic measurements (TV/TSA) are more precise prognostic predictors of ALNI compared to the one-dimensional measurement alone.