Fatigue and vigilance in medical experts detecting breast cancer.

An abundance of laboratory-based experiments has described a vigilance decrement of reducing accuracy to detect targets with time on task, but there are few real-world studies, none of which have previously controlled the environment to control for bias. We describe accuracy in clinical practice for 360 experts who examined >1 million women's mammograms for signs of cancer, whilst controlling for potential biases. The vigilance decrement pattern was not observed. Instead, test accuracy improved over time, through a reduction in false alarms and an increase in speed, with no significant change in sensitivity. The multiple-decision model explains why experts miss targets in low prevalence settings through a change in decision threshold and search quit threshold and propose it should be adapted to explain these observed patterns of accuracy with time on task. What is typically thought of as standard and robust research findings in controlled laboratory settings may not directly apply to real-world environments and instead large, controlled studies in relevant environments are needed.

Optimised Multi-Channel Transcranial Direct Current Stimulation (MtDCS) Reveals Differential Involvement of the Right-Ventrolateral Prefrontal Cortex (rVLPFC) and Insular Complex in those Predisposed to Aberrant Experiences.

Research has shown a prominent role for cortical hyperexcitability underlying aberrant perceptions, hallucinations, and distortions in human conscious experience - even in neurotypical groups. The rVLPFC has been identified as an important structure in mediating cognitive affective states / feeling conscious states. The current study examined the involvement of the rVLPFC in mediating cognitive affective states in those predisposed to aberrant experiences in the neurotypical population. Participants completed two trait-based measures: (i) the Cortical Hyperexcitability Index_II (CHi_II, a proxy measure of cortical hyperexcitability) and (ii) two factors from the Cambridge Depersonalisation Scale (CDS). An optimised 7-channel MtDCS montage for stimulation conditions (Anodal, Cathodal and Sham) was created targeting the rVLPFC in a single-blind study. At the end of each stimulation session, participants completed a body-threat task (BTAB) while skin conductance responses (SCRs) and psychological responses were recorded. Participants with signs of increasing cortical hyperexcitability showed significant suppression of SCRs in the Cathodal stimulation relative to the Anodal and sSham conditions. Those high on the trait-based measures of depersonalisation-like experiences failed to show reliable effects. Collectively, the findings suggest that baseline brain states can mediate the effects of neurostimulation which would be missed via sample level averaging and without appropriate measures for stratifying individual differences.

Framing the fallibility of Computer-Aided Detection aids cancer detection.

Computer-Aided Detection (CAD) has been proposed to help operators search for cancers in mammograms. Previous studies have found that although accurate CAD leads to an improvement in cancer detection, inaccurate CAD leads to an increase in both missed cancers and false alarms. This is known as the over-reliance effect. We investigated whether providing framing statements of CAD fallibility could keep the benefits of CAD while reducing over-reliance. In Experiment 1, participants were told about the benefits or costs of CAD, prior to the experiment. Experiment 2 was similar, except that participants were given a stronger warning and instruction set in relation to the costs of CAD. The results showed that although there was no effect of framing in Experiment 1, a stronger message in Experiment 2 led to a reduction in the over-reliance effect. A similar result was found in Experiment 3 where the target had a lower prevalence. The results show that although the presence of CAD can result in over-reliance on the technology, these effects can be mitigated by framing and instruction sets in relation to CAD fallibility.

Differing Effects of Nociception and Pain Memory on Isometric Muscle Strength in Participants With and Without a History of Injury: A Quasi-Experimental Study.

OBJECTIVE: The goals of this study are to establish whether mechanical pressure pain, short-term memory recall of a painful stimulus, or long-term memory of a previous painful lower limb injury alters isometric muscle strength and whether there was a difference in responses between participants with and without a previous history of injury. DESIGN: Fifty-nine pain-free participants (29 with previous injury and 30 without) participated in this study. Tibialis anterior isometric muscle strength was compared pre- and post-noxious mechanical stimulus with instructions to recall pain (short- and long-term). RESULTS: Short- and long-term pain recall produced a significant reduction in muscle strength (short-term: F (1,57) = 160.472, P < 0.001; long-term: F (1,57) = 128.899, P < 0.001). A greater decrease was experienced with short- and long-term pain memory than exposure to mechanical pain (mechanical pain: -14.8% or -32.98 kg, 95% confidence interval [CI], -41.57 to -24.19; short-term: -24.1% or -52.70 kg, 95% CI = -60.98 to -44.34; long-term: -20.3% or -44.63 kg, 95% CI = -52.77 to -36.95). There was no significant difference in responses associated with an injury history. CONCLUSIONS: Findings suggest that recalled pain memory can impact motor responses and calls attention to the role of past injury history in the rehabilitation process.

Development of dynamic attention: Time-based visual selection for objects in motion between 6-12 years of age.

By approximately 6 years of age, children can use time-based visual selection to ignore stationary stimuli, already in the visual field and prioritize the selection of newly arriving stimuli. This ability can be studied using preview search, a version of the visual search paradigm with an added temporal component, in which one set of distractors is presented (previewed) before a second set that contains the target item. Preview search is more efficient than if all items are presented simultaneously, suggesting that temporally "old" objects can be ignored (the preview benefit). In two experiments, we examined the developmental trajectory for time-based visual selection in a sample of 192 6-, 8-, and 12-year-old children (49% female, predominantly White), with adults as controls (75% female, predominantly White), in the United Kingdom. The results showed an absence of the ability to ignore previewed moving distractors in 6-year-olds and confirmed its presence from 8 years of age. However, full development of this ability, which includes maintaining inhibition of previewed items over extended periods, was only present from the age of 12. Individual differences in executive functions, namely inhibition, were associated with preview search efficiency in 6-year-olds and adults. Overall, the results suggest a developmental trajectory in the ability to ignore moving old objects that occurs in two stages and develops later than the ability to ignore previewed stationary objects. The results are discussed in terms of underlying inhibitory mechanisms, in addition to individual differences in the expression of this ability. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Telephone conversations affect the executive but not the alerting or orienting network.

Previous work has shown that talking on a mobile phone leads to an impairment of visual attention. Gunnell et al. (2020) investigated the locus of these dual-task impairments and found that although phone conversations led to cognitive delays in response times, other mechanisms underlying particular selective attention tasks were unaffected. Here, we investigated which attentional networks, if any, were impaired by having a phone conversation. We used the attentional network task (ANT) to evaluate performance of the alerting, orienting, and executive attentional networks, both in conditions where people were engaged in a conversation and where they were silent. Two experiments showed that there was a robust delay in response across all three networks. However, at the individual network level, holding a conversation did not influence the size of the alerting or orienting effects but it did reduce the size of the conflict effect within the executive network. The findings suggest that holding a conversation can reduce the overall speed of responding and, via its influence on the executive network, can reduce the amount of information that can be processed from the environment. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Investigating age-related differences in ability to distinguish between original and manipulated images.

Manipulated images can have serious and persistent ramifications across many domains: They have undermined trust in political campaigns, incited fear and violence, and fostered dangerous global movements. Despite growing concern about the power of manipulated images to influence people's beliefs and behavior, few studies have examined whether people can detect manipulations and the psychological processes underpinning this task. We asked 5,291 older adults, 5,291 middle-aged adults, and 5,291 young adults to detect and locate manipulations within images of real-world scenes. To determine whether a simple intervention could improve people's ability to detect manipulations, some participants viewed a short video which described the five common manipulation techniques used in the present study. Overall, participants demonstrated a limited ability to distinguish between original and manipulated images. Older adults were less accurate in detecting and locating manipulations than younger and middle-aged adults, and the effect of age varied by manipulation type. The video intervention improved performance marginally. Participants were often overconfident in their decisions, despite having limited ability to detect manipulations. Older adults were more likely than younger and middle-aged adults to report checking for shadow/lighting inconsistencies, a strategy that was not associated with improved discriminability, and less likely to report using other strategies (e.g., photometric inconsistencies) that were associated with improved discriminability. Differences in strategy use might help to account for the age differences in accuracy. Further research is needed to advance our understanding of the psychological mechanisms underlying image manipulation detection and the myriad factors that may enhance or impair performance. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Genome-wide interaction analysis of menopausal hormone therapy use and breast cancer risk among 62,370 women.

Use of menopausal hormone therapy (MHT) is associated with increased risk for breast cancer. However, the relevant mechanisms and its interaction with genetic variants are not fully understood. We conducted a genome-wide interaction analysis between MHT use and genetic variants for breast cancer risk in 27,585 cases and 34,785 controls from 26 observational studies. All women were post-menopausal and of European ancestry. Multivariable logistic regression models were used to test for multiplicative interactions between genetic variants and current MHT use. We considered interaction p-values < 5 × 10-8 as genome-wide significant, and p-values < 1 × 10-5 as suggestive. Linkage disequilibrium (LD)-based clumping was performed to identify independent candidate variants. None of the 9.7 million genetic variants tested for interactions with MHT use reached genome-wide significance. Only 213 variants, representing 18 independent loci, had p-values < 1 × 105. The strongest evidence was found for rs4674019 (p-value = 2.27 × 10-7), which showed genome-wide significant interaction (p-value = 3.8 × 10-8) with current MHT use when analysis was restricted to population-based studies only. Limiting the analyses to combined estrogen-progesterone MHT use only or to estrogen receptor (ER) positive cases did not identify any genome-wide significant evidence of interactions. In this large genome-wide SNP-MHT interaction study of breast cancer, we found no strong support for common genetic variants modifying the effect of MHT on breast cancer risk. These results suggest that common genetic variation has limited impact on the observed MHT-breast cancer risk association.

Interactions between exposure to polycyclic aromatic hydrocarbons and xenobiotic metabolism genes, and risk of breast cancer.

PURPOSE: Polycyclic aromatic hydrocarbons (PAHs) are a group of environmental pollutants associated with multiple cancers, including female breast cancer. Several xenobiotic metabolism genes (XMGs), including the CYP450 family, play an important role in activating and detoxifying PAHs, and variations in the activity of the enzymes they encode can impact this process. This study aims to examine the association between XMGs and breast cancer, and to assess whether these variants modify the effects of PAH exposure on breast cancer risk. METHODS: In a case-control study in Vancouver, British Columbia, and Kingston, Ontario, 1037 breast cancer cases and 1046 controls had DNA extracted from blood or saliva and genotyped for 138 single nucleotide polymorphisms (SNPs) and tagSNPs in 27 candidate XMGs. Occupational PAH exposure was assessed using a measurement-based job-exposure matrix. RESULTS: An association between genetic variants and breast cancer was observed among six XMGs, including increased risk among the minor allele carriers of AKR1C3 variant rs12387 (OR 2.71, 95% CI 1.42-5.19) and AKR1C4 variant rs381267 (OR 2.50, 95% CI 1.23-5.07). Heterogeneous effects of occupational PAH exposure were observed among carriers of AKR1C3/4 variants, as well as the PTGS2 variant rs5275. CONCLUSION: Our findings support an association between SNPs of XMGs and female breast cancer, including novel genetic variants that modify the toxicity of PAH exposure. These results highlight the interplay between genetic and environmental factors, which can be helpful in understanding the modifiable risks of breast cancer and its complex etiology.

Influence of traffic context and information presentation on evaluation of autonomous highway journeys.

Previous research into perceptions of autonomous vehicles has largely focused on a priori attitudes, with little work on the perception of specific traffic situations, context and driving styles. The present study used three simulator experiments (total N = 150) to examine the combined effects of vehicle speed, lane position, information presentation and traffic context on occupants' levels of satisfaction with autonomous highway journeys. Overall, occupants preferred being in a vehicle that was mostly overtaking compared to being overtaken, regardless of whether the overtaking vehicles were exceeding the speed limit. This finding remained even when occupants were given additional reminders that they themselves were travelling at an appropriate speed (Experiments 1 & 2). Experiment 3 found that occupants preferred overtaking to being overtaken when following another car, but this preference disappeared when they were following a lorry, suggesting that occupants' sensitivity to position amongst the traffic was partially context dependent. Overall, the findings suggest that journey satisfaction is sensitive to overtaking contexts and the inappropriate behaviour of other drivers (e.g., speeding) can reduce journey satisfaction for occupants in autonomous vehicles that drive within the speed limit, depending on the specific traffic situation. Potential implications for the integration of autonomous vehicles with other traffic and the need for in-vehicle presentation of information are discussed.

Double reading reduces miss errors in low prevalence search.

Low prevalence studies show that people miss a large proportion of targets if they appear rarely. This finding has implications for real-world tasks, such as mammography, where it is important to detect infrequently appearing cancers. We examined whether having people search in pairs in a "double reading" procedure reduces miss errors in low prevalence search compared with when participants search the displays alone. In Experiment 1 pairs of participants searched for a mass in a laboratory mammogram task. Participants either searched the same display together (in the same room) or searched the displays independently (in separate rooms). Experiment 2 further manipulated the reading order so that paired participants either read the mammograms in the same or different orders. The results showed that, although there was no effect of reading order, double reading led to a substantial reduction in miss errors compared with single reading conditions. Furthermore, the reason for the double reading improvement differed across reading environments: When participants read the displays in a shared environment (i.e., in the same room) the improvement occurred due to an increase in sensitivity; however, when participants read the display in different rooms the improvement occurred due to a change in response bias. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Outcome of primary mediastinal large B-cell lymphoma using R-CHOP: impact of a PET-adapted approach.

Cure rates for primary mediastinal large B-cell lymphoma (PMBCL) have improved with the integration of rituximab. However, the type of primary therapy and role of radiotherapy (RT) remains ill-defined. Herein, we evaluated the outcome of PMBCL primarily treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) and the impact of an end-of-treatment (EOT) 18F-fluorodeoxyglucose positron emission tomography (PET) scan to guide consolidative RT. Patients ≥18 years of age with PMBCL treated with curative intent rituximab-chemotherapy were identified. Prior to 2005, patients were recommended to receive R-CHOP + RT (RT era). Beginning in 2005, EOT PET was used to guide RT and only those with a PET-positive scan received RT (PET era). In total, 159 patients were identified, 94% were treated with R-CHOP and 44% received RT (78% in RT era, 28% in PET era). The 5-year time to progression (TTP) and overall survival (OS) for the entire cohort were 80% and 89%, respectively, similar across treatment eras. Overall, 10% had refractory disease. In total, 113 patients had an EOT PET scan: 63% negative and 37% positive with a 5-year TTP of 90% vs 71% and 5-year OS of 97% vs 88%, respectively. For those with Deauville (D)-scored PET scans (n = 103), the 5-year TTP for PET-negative cases by Deauville criteria (D1-D3, DX) was 91%, with inferior outcomes for D5 vs D4 (5-year TTP 33% vs 87%, P = .0002). Outcomes for PMBCL treated with RCHOP are favorable and use of a PET-adapted approach reduces RT in the majority of patients. A small proportion have refractory disease and may benefit from an alternate treatment.

Seen this scene? Scene recognition in the reaction-time Concealed Information Test.

Detecting a suspect's recognition of a crime scene (e.g., a burgled room or a location visited for criminal activity) can be of great value during criminal investigations. Although it is established that the Reaction-Time Concealed Information Test (RT-CIT) can determine whether a suspect recognizes crime-related objects, no research has tested whether this capability extends to the recognition of scenes. In Experiment 1, participants were given an autobiographic scene-based RT-CIT. In Experiment 2, participants watched a mock crime video before completing an RT-CIT that included both scenes and objects. In Experiment 3, participants completed an autobiographic scene-based RT-CIT, with half instructed to perform a physical countermeasure. Overall, the findings showed that an equivalent RT-CIT effect can be found with both scene and object stimuli and that RT-CITs may not be susceptible to physical countermeasure strategies, thereby increasing its real-world applicability.

The Body-Threat Assessment Battery (BTAB): A new instrument for the quantification of threat-related autonomic affective responses induced via dynamic movie clips.

We present a new instrument for the assessment of responses to threat-related imagery directed towards a human body - the Body-Threat Assessment Battery (BTAB). The BTAB consists of a series of high-definition dynamic clips depicting body-threats and matched non-threat baseline behaviours. For body-threat stimuli a perspective manipulation was included to assess the effects of viewing threats from the point-of-view of the observer (POV) or from an external/exocentric perspective (EXO). Green-screen technology was used so that extraneous background information could be removed and standardised in post-production. Categorical normative data for psychological ratings (valence, arousal and pain), psychophysiological, phasic skin conductance responses (SCRs) and tonic skin conductance levels (SCLs) were obtained for all stimuli. Body-threat stimuli evoked significantly higher psychological ratings of arousal and pain, with more negative ratings of valence, relative to baseline stimuli. In addition, threat stimuli also had an increased efficacy at evoking SCRs, and these were significantly stronger relative to baseline stimuli. There were no effects of perspective on psychophysiological or psychological responses to threat imagery. The findings are discussed in the context of the utility and scope of the BTAB for supporting neurocognitive investigations of aversive imagery and body-threats specifically in the study of embodiment, body-processing and self-consciousness.

Pregnancy outcomes in the omalizumab pregnancy registry and a disease-matched comparator cohort.

BACKGROUND: The Observational Study of the Use and Safety of Xolair (omalizumab) during Pregnancy (EXPECT) pregnancy registry was a prospective observational study established in 2006 to evaluate perinatal outcomes in pregnant women exposed to omalizumab and their infants. OBJECTIVE: This analysis compares EXPECT outcomes with those from a disease-matched population of pregnant women not treated with omalizumab. Data from a substudy of platelet counts among newborns are also presented. METHODS: The EXPECT study enrolled 250 women with asthma exposed to omalizumab during pregnancy. The disease-matched external comparator cohort of women with moderate-to-severe asthma (n = 1153), termed the Quebec External Comparator Cohort (QECC), was created by using data from health care databases in Quebec, Canada. Outcome estimates were age adjusted based on the maternal age distribution of the EXPECT study. RESULTS: Among singleton infants in the EXPECT study, the prevalence of major congenital anomalies was 8.1%, which was similar to the 8.9% seen in the QECC. In the EXPECT study 99.1% of pregnancies resulted in live births, which was similar to 99.3% in the QECC. Premature birth was identified in 15.0% of EXPECT infants and 11.3% in the QECC. Small for gestational age was identified in 9.7% of EXPECT infants and 15.8% in the QECC. CONCLUSION: There was no evidence of an increased risk of major congenital anomalies among pregnant women exposed to omalizumab compared with a disease-matched unexposed cohort. Given the observational nature of this registry, however, an absence of increased risk with omalizumab cannot be definitively established.

Having a phone conversation delays but does not disrupt cognitive mechanisms.

Previous research has shown that talking on a mobile phone leads to impairments in a number of cognitive tasks. However, it is not yet known whether the act of conversation disrupts the underlying cognitive mechanisms (the Cognitive Disruption hypothesis) or leads to a delay in response due to a limit on central cognitive resources (the Cognitive Delay hypothesis). We investigated this here using two cognitive search tasks that investigate spatial learning and time-based selection: Contextual Cueing and Visual Marking. In Contextual Cueing, responses to repeated displays are faster than those to novel displays. In Visual Marking, participants prioritize attention to new information and deprioritize old, unimportant information (the Preview Benefit). Experiments 1 to 3 investigated whether Contextual Cueing occurred while people were engaged in a phone conversation, whereas Experiments 4 to 6 investigated whether a Preview Benefit occurred, again while people were engaged in conversation. The results showed that having a conversation did not interfere with the mechanisms underlying spatial learning or time-based selection. However, in all experiments there was a significant increase in response times. The results are consistent with a Cognitive Delay account explaining the dual-task cost of having a phone conversation on concurrent cognitive tasks. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Validation of a simplified international prognostic score (IPS-3) in patients with advanced-stage classic Hodgkin lymphoma.

A novel prognostic score (IPS-3), comprised of only three of the seven IPS-7 indicators (age ≥45, stage IV, haemoglobin <105 g/l), was recently proposed as a simplified model for advanced-stage classic Hodgkin lymphoma (cHL). We aimed to validate this model in advanced-stage cHL patients treated with doxorubicin, bleomycin, vinblastine, dacarbazine (ABVD) in British Columbia. The estimated five-year freedom from progression (FFP) for scores of 0, 1, 2 and 3 were very similar to the original report at 84%, 76%, 72% and 68% respectively. The IPS-3 score is highly reproducible in this independent dataset and its simplicity makes it appealing for everyday clinical practice.

Perceptual grouping constrains inhibition in time-based visual selection.

In time-based visual selection, task-irrelevant, old stimuli can be inhibited in order to allow the selective processing of new stimuli that appear at a later point in time (the preview benefit; Watson & Humphreys, 1997). The current study investigated if illusory and non-illusory perceptual groups influence the ability to inhibit old and prioritize new stimuli in time-based visual selection. Experiment 1 showed that with Kanizsa-type illusory stimuli, a preview benefit occurred only when displays contained a small number of items. Experiment 2 demonstrated that a set of Kanizsa-type illusory stimuli could be selectively searched amongst a set of non-illusory distractors with no additional preview benefit obtained by separating the two sets of stimuli in time. Experiment 3 showed that, similarly to Experiment 1, non-illusory perceptual groups also produced a preview benefit only for a small number of number of distractors. Experiment 4 demonstrated that local changes to perceptually grouped old items eliminated the preview benefit. The results indicate that the preview benefit is reduced in capacity when applied to complex stimuli that require perceptual grouping, regardless of whether the grouped elements elicit illusory contours. Further, inhibition is applied at the level of grouped objects, rather than to the individual elements making up those groups. The findings are discussed in terms of capacity limits in the inhibition of old distractor stimuli when they consist of perceptual groups, the attentional requirements of forming perceptual groups and the mechanisms and efficiency of time-based visual selection.

Can people detect errors in shadows and reflections?

The increasing sophistication of photo-editing software means that even amateurs can create compelling doctored images. Yet recent research suggests that people's ability to detect image manipulations is limited. Given the prevalence of manipulated images in the media, on social networking sites, and in other domains, the implications of mistaking a fake image as real, or vice versa, can be serious. In seven experiments, we tested whether people can make use of errors in shadows and reflections to determine whether or not an image has been manipulated. Our results revealed that people's ability to identify authentic and manipulated scenes based on shadow and reflection information increased with the size of the manipulation, but overall, detection rates remained poor. Consistent with theories of incomplete visual representation, one possible reason for these findings could be that people rarely encode the details of scenes that provide useful cues as to the authenticity of images. Overall, our findings indicate that people do not readily make use of shadow and reflection cues to help determine the authenticity of images-yet it remains possible that people could make use of these cues, but they are simply unaware of how to do so.