Models need mechanisms, but not labels.

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

The Role of Stimulus Uncertainty and Curiosity in Attention Control.

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

Investigating the role of spatial filtering on distractor suppression.

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

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

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

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

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

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

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

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

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

Reward Influences Masked Free-Choice Priming.

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

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

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

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

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

The Nature of Unconscious Attention to Subliminal Cues.

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

Language proficiency does not modulate executive control in older bilinguals.

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

Cross-modal plasticity in the deaf enhances processing of masked stimuli in the visual modality.

Compensatory changes as a result of auditory deprivation in the deaf lead to higher visual processing skills. In two experiments, we explored if such brain plasticity in the deaf modulates processing of masked stimuli in the visual modality. Deaf and normal-hearing participants responded to targets either voluntarily or by instruction. Masked primes related to the response were presented briefly before the targets at the center and the periphery. In Experiment 1, targets appeared only at the foveal region whereas, in Experiment 2, they appeared both at the fovea and the periphery. The deaf showed higher sensitivity to masked primes in both the experiments. They chose the primed response more often and also were faster during congruent responses compared to the normal hearing. These results suggest that neuroplasticity in the deaf modulates how they perceive and use information with reduced visibility for action selection and execution.

Task Irrelevant External Cues Can Influence Language Selection in Voluntary Object Naming: Evidence from Hindi-English Bilinguals.

We examined if external cues such as other agents' actions can influence the choice of language during voluntary and cued object naming in bilinguals in three experiments. Hindi-English bilinguals first saw a cartoon waving at a color patch. They were then asked to either name a picture in the language of their choice (voluntary block) or to name in the instructed language (cued block). The colors waved at by the cartoon were also the colors used as language cues (Hindi or English). We compared the influence of the cartoon's choice of color on naming when speakers had to indicate their choice explicitly before naming (Experiment 1) as opposed to when they named directly on seeing the pictures (Experiment 2 and 3). Results showed that participants chose the language indicated by the cartoon greater number of times (Experiment 1 and 3). Speakers also switched significantly to the language primed by the cartoon greater number of times (Experiment 1 and 2). These results suggest that choices leading to voluntary action, as in the case of object naming can be influenced significantly by external non-linguistic cues. Importantly, these symbolic influences can work even when other agents are merely indicating their choices and are not interlocutors in bilingual communication.

Iconic Native Culture Cues Inhibit Second Language Production in a Non-immigrant Population: Evidence from Bengali-English Bilinguals.

We examined if iconic pictures belonging to one's native culture interfere with second language production in bilinguals in an object naming task. Bengali-English bilinguals named pictures in both L1 and L2 against iconic cultural images representing Bengali culture or neutral images. Participants named in both "Blocked" and "Mixed" language conditions. In both conditions, participants were significantly slower in naming in English when the background was an iconic Bengali culture picture than a neutral image. These data suggest that native language culture cues lead to activation of the L1 lexicon that competed against L2 words creating an interference. These results provide further support to earlier observations where such culture related interference has been observed in bilingual language production. We discuss the results in the context of cultural influence on the psycholinguistic processes in bilingual object naming.

Effect of Exogenous Cues on Covert Spatial Orienting in Deaf and Normal Hearing Individuals.

Deaf individuals have been known to process visual stimuli better at the periphery compared to the normal hearing population. However, very few studies have examined attention orienting in the oculomotor domain in the deaf, particularly when targets appear at variable eccentricity. In this study, we examined if the visual perceptual processing advantage reported in the deaf people also modulates spatial attentional orienting with eye movement responses. We used a spatial cueing task with cued and uncued targets that appeared at two different eccentricities and explored attentional facilitation and inhibition. We elicited both a saccadic and a manual response. The deaf showed a higher cueing effect for the ocular responses than the normal hearing participants. However, there was no group difference for the manual responses. There was also higher facilitation at the periphery for both saccadic and manual responses, irrespective of groups. These results suggest that, owing to their superior visual processing ability, the deaf may orient attention faster to targets. We discuss the results in terms of previous studies on cueing and attentional orienting in deaf.

Rare adrenal gland emergencies: a case series of giant myelolipoma presenting with massive hemorrhage and abscess.

INTRODUCTION: Adrenal Myelolipoma is a rare benign neoplasm, which contains mature adipose tissue and variable amounts of haematopoietic elements. Most lesions are small and asymptomatic, discovered incidentally during autopsy or imaging studies performed for other reasons. CASE PRESENTATION: Here we reported a series of two cases of giant myelolipomas of the adrenal gland; first one the largest tumor reported so far presented with massive hemorrhage and the second case introduced with its rare unreported presentation of adrenal myelolipomas i.e. a large abscess. DISCUSSION: Adrenal myelolipoma is a rare and asymptomatic tumor usually discovered incidentally in less than 1% of population on autopsy or imaging performed for other reasons. There is an increasing incidence of large adrenal myelolipoma (> 10 cm) presenting with life threatening and recurrent retroperitoneal hemorrhage along with other complications as abscess. To avoid such a life-threatening situation, authors recommend close monitoring and consideration of urgent surgical intervention for tumors larger than 4 cm at presentation or increase in size or change in appearance during follow-up.

Spectrum of retroperitoneal and genitourinary paraganglioma: Experience at a North Indian tertiary care center.

INTRODUCTION: Genitourinary and retroperitoneal paragangliomas are infrequent tumors with bizarre presentation. A high index of suspicion is required to make a diagnosis in young hypertensive individuals. Our aim is to study the varied clinical presentations and management of these paragangliomas. Herein, we share our experience of clinical presentation, diagnosis, and management of these paragangliomas. MATERIAL AND METHODS: Seventeen consecutive patients who underwent surgery for paraganglioma at our institute from August 2009 to July 2014 were included. Demographic, peri-operative, surgical, and follow up data were collected and analyzed. RESULTS: Mean age of presentation was 34.8 years with female predominance. The majority of the tumors were located in the retroperitoneum and urinary bladder. Most of them presented with classical symptoms of catecholamine excess and hypertension. Complete surgical resection could be performed in 13 cases. At a median follow up of two years, cases with R0 resection (no microscopic malignant cells) did not show recurrence. Among patients on chemotherapy, one died, another had partial response, and yet another had progressive disease. CONCLUSIONS: Genitourinary and retroperitoneal paragangliomas are a disease of a young age group with variable clinical features at presentation. Appropriate pre-operative optimization and complete surgical resection provide the best chance of cure.