The Hidden Markov Modeling approach for eye-movement data analysis is able to quantitatively assess differences and similarities among individual patterns. Here we applied this approach to examine ...the relationships between eye-movement patterns in face recognition and age-related cognitive decline. We found that significantly more older than young adults adopted “holistic” patterns, in which most eye fixations landed around the face center, as opposed to “analytic” patterns, in which eye movements switched among the two eyes and the face center. Participants showing analytic patterns had better performance than those with holistic patterns regardless of age. Interestingly, older adults with lower cognitive status (as assessed by the Montreal Cognitive Assessment), particularly in executive and visual attention functioning (as assessed by Tower of London and Trail Making Tests) were associated with a higher likelihood of holistic patterns. This result suggests the possibility of using eye movements as an easily deployable screening assessment for cognitive decline in older adults.
Abstract
Background
Hairdressers have a high prevalence of contact dermatitis, especially to nickel. The presence of nickel in hairdressing tools has been evaluated in the European Union, where the ...government limits nickel release levels from objects.
Objectives
The aim of this study is to qualitatively investigate nickel release in hairdresser tools in both rural and urban United States, a country without nickel release legislation.
Methods
Hairdressers and individuals with hairdressing tools were invited to participate. Metallic parts of each tool were tested with dimethylglyoxime (DMG), which detects nickel release. Data on tool cost were recorded.
Results
A total of 89 tools from 9 salons and 2 over‐the‐counter sets were tested. Twenty‐four (27%) tested positive: trimmers (100%), curling irons (100%), clippers (50%), hair clips (36%), texturizing shears (26%), and trimming shears (4%). Nickel was detected in both salon and over‐the‐counter tools, and rural and urban salons. Nickel‐releasing tools were cheaper than DMG‐negative tools of the same type.
Conclusions
Our findings help explain the high prevalence of contact dermatitis among hairdressers, alert clinicians to consider occult occupational nickel when assessing patients with allergic contact dermatitis, reinforces the importance of using barrier protection including gloves when handling hairdressing tools including at home, and augments impetus for more legislation regulating common allergens.
A New Other-Race Effect for Gaze Perception Collova, Jemma R; Kloth, Nadine; Crookes, Kate ...
Journal of experimental psychology. Human perception and performance,
11/2017, Volume:
43, Issue:
11
Journal Article
Peer reviewed
Open access
The well-known other-race effect in face recognition has been widely studied, both for its theoretical insights into the nature of face expertise and because of its social and forensic importance. ...Here we demonstrate an other-race effect for the perception of a simple visual signal provided by the eyes, namely gaze direction. In Study 1, Caucasian and Asian participants living in Australia both showed greater perceptual sensitivity to detect direct gaze in own-race than other-race faces. In Study 2, Asian (Chinese) participants living in Australia and Asian (Chinese) participants living in Hong Kong both showed this other-race effect, but Caucasian participants did not. Despite this inconsistency, meta-analysis revealed a significant other-race effect when results for all 5 participant groups from corresponding conditions in the 2 studies were combined. These results demonstrate a new other-race effect for the perception of the simple, but socially potent, cue of direct gaze. When identical morphed-race eyes were inserted into the faces, removing race-specific eye cues, no other-race effect was found (with 1 exception). Thus, the balance of evidence implicated perceptual expertise, rather than social motivation, in the other-race effect for detecting direct gaze.
Public Significance Statement
People tend to be poorer at recognizing other-race faces than own-race faces. This "other-race effect" has been widely studied, both for insights into the nature of perceptual expertise and for its social and forensic implications. For the first time, we have observed a small but potentially detrimental other-race effect for the perception of direct gaze. Gaze direction is a powerful social cue, and direct gaze establishes an important foundation for communication and can enhance social interactions. A reduced sensitivity to direct gaze in other-race faces may therefore have a variety of consequences on behavioral and cognitive responses to other-race people. We also sought to determine the underlying basis of this other-race effect. There is a long history of difficulty in distinguishing between perceptual expertise and social motivation accounts of other-race effects. Here, our results more clearly link the effect to reduced perceptual expertise with other-race eyes.
Whether Helicobacter pylori increases the risk of ulcers in patients taking non-steroidal anti-inflammatory drugs (NSAIDs) is controversial. We hypothesised that eradication of H pylori infection ...would reduce the risk of ulcers for patients starting long-term NSAID treatment.
Patients were enrolled if they were NSAID naïve, had a positive urea breath test, had dyspepsia or an ulcer history, and required long-term NSAID treatment. They were randomly assigned omeprazole triple therapy (eradication group) or omeprazole with placebo antibiotics (placebo group) for 1 week. All patients were given diclofenac slow release 100 mg daily for 6 months from randomisation. Endoscopy was done at 6 months or if severe dyspepsia or gastrointestinal bleeding occurred. The primary endpoint was the probability of ulcers within 6 months. Analyses were by intention to treat.
Of 210 arthritis patients screened, 128 (61%) were positive for H pylori. 102 patients were enrolled, and 100 were included in the intention-to-treat analysis. H pylori was eradicated in 90% of the eradication group and 6% of the placebo group. Five of 51 eradication-group patients and 15 of 49 placebo-group patients had ulcers. The 6-month probability of ulcers was 12·1% (95% CI 3·1–21·1) in the eradication group and 34·4% (21·1–47·7) in the placebo group (p=0·0085). The corresponding 6-month probabilities of complicated ulcers were 4·2% (1·3–9·7) and 27·1% (14·7–39·5; p=0·0026).
Screening and treatment for H pylori infection significantly reduces the risk of ulcers for patients starting long-term NSAID treatment.
In three studies, EEGs from three groups of participants were recorded during progressively more real world situations after drinking alcoholic beverages that brought breath alcohol contents near the ...limit for driving in California 30 minutes after drinking. A simple equation that measured neurophysiological effects of alcohol in the first group of 15 participants performing repetitive cognitive tasks was applied to a second group of 15 operating an automobile driving simulator, and to a third group of 10 ambulatory people recorded simultaneously during a cocktail party. The equation derived from the first group quantified alcohol's effect by combining measures of higher frequency (beta) and lower frequency (theta) power into a single score. It produced an Area Under the Receiver Operator Characteristic Curve of .73 (p<.05; 67% sensitivity in recognizing alcohol and 87% specificity in recognizing placebo). Applying the same equation to the second group operating the driving simulator, AUC was .95, (p<.0001; 93% sensitivity and 73% specificity), while for the cocktail party group AUC was .87 (p<.01; 80% sensitivity and 80% specificity). EEG scores were significantly related to breath alcohol content in all studies. Some individuals differed markedly from the overall response evident in their respective groups. The feasibility of measuring the neurophysiological effect of a psychoactive substance from an entire group of ambulatory people at a cocktail party suggests that future studies may be able to fruitfully apply brain function measures derived under rigorously controlled laboratory conditions to assess drug effects on groups of people interacting in real world situations.
Onychomycosis affects 43 million people in the United States and Europe. Topical therapies can be effective but require lengthy and costly regimens without an established method for predicting the ...treatment outcome.
We studied the role of optical coherence tomography (OCT), a noninvasive imaging device approved by the United States Food and Drug Administration, in evaluating onychomycosis treatment outcomes.
This investigator-initiated prospective clinical study recruited subjects from two urban medical centers. A total of 34 subjects with mild-to-moderate onychomycosis, confirmed using periodic acid-Schiff (PAS) staining, were treated with topical efinaconazole for 48 weeks, at which time a final PAS result was obtained.
A positive final PAS result was associated with fungal findings on OCT and with nonclearance of fungal findings by week 12. A negative final PAS was associated with the absence of fungal findings by week 12. OCT findings at Week 8 may suggest a 77% chance of mycological nonclearance or 82% chance of clearance. These predictive values are higher than the currently documented mycological cure rate of 54%. Clinical examination data had no predictive value alone or in concert with OCT.
We recommend OCT imaging be performed at the end of the second month of treatment to inform shared decision-making regarding whether or not to continue efinaconazole for nine additional months. OCT's ability to evaluate onychomycosis outcome in patients on topical efinaconazole both earlier and more reliably than nonimaging variables may improve the care given to and reduce the cost of onychomycosis for millions of patients.
Cannabinoids are emerging as potential options for neuropathic pain treatment. This study evaluated an oral cannabinoid, nabilone, in the treatment of refractory human diabetic peripheral neuropathic ...pain (DPN). We performed a single-center, randomized, double-blind, placebo-controlled, flexible-dose study with an enriched enrollment randomized withdrawal design. DPN subjects with a pain score ≥ 4 (0-10 scale) continued regular pain medications and were administered single-blinded adjuvant nabilone for 4 weeks. Subjects achieving ≥ 30% pain relief (26/37) were then randomized and treated with either flexible-dose nabilone 1-4 mg/day (n=13) or placebo (n=13) in a further 5-week double-blind treatment period, with 30% (11/37) of subjects deemed run-in-phase nabilone nonresponders. For nabilone run-in-phase responders, there was an improvement in the change in mean end-point neuropathic pain vs placebo (mean treatment reduction of 1.27; 95% confidence interval 2.29-0.25, P=0.02), with an average nabilone dose at end point of 2.9 ± 1.1mg/day, and improvements from baseline for the anxiety subscale of the Hospital Anxiety and Depression Scale, the Medical Outcomes Study sleep scale problems index, and the European Quality of Life-5-Domains index score (each P<0.05). Nabilone run-in-phase responders reported greater global end-point improvement with nabilone than with placebo (100% vs 31%; P<0.05). Medication-related confusion led to discontinuation in 2/37 subjects during single-blind nabilone treatment. Potential unmasking occurred in 62% of both groups. Flexible-dose nabilone 1-4 mg/day was effective in relieving DPN symptoms, improving disturbed sleep, quality of life, and overall patient status. Nabilone was well tolerated and successful as adjuvant in patients with DPN.
Objective
To determine the prevalence of anxiety and depression in axial spondyloarthritis (SpA) patients by a psychiatrist using the Chinese‐bilingual Structured Clinical Interview for Diagnostic ...and Statistical Manual of Mental Disorders, fourth edition patient research version (CB‐SCID‐I/P), and to examine the effectiveness of the Hospital Anxiety and Depression Scale (HADS) as a screening tool.
Methods
We recruited 160 Chinese axial‐SpA patients to determine the prevalence of anxiety and depression using the CB‐SCID‐I/P. Recruited subjects were asked to complete the HADS. HADS, HADS‐depression (HADS‐D) subscale and HADS‐anxiety (HADS‐A) subscale were analyzed to determine their effectiveness in screening for depressive and anxiety disorders.
Results
The prevalence of current major depressive disorder (MDD) and anxiety disorder were 10.6% and 15.6%, respectively. The full‐scale HADS outperformed the HADS‐D subscale in screening for current MDD (area under the curve AUC 0.889; 0.844) and all depressive disorders (AUC 0.885; 0.862) while the HADS‐A subscale outperformed the full scale HADS in screening for anxiety disorders (AUC 0.894; 0.846). The optimal cut‐off point of the full scale HADS for screening current MDD and all depressive disorders were 7/8 and 6/7, yielding a sensitivity of 82.4% and 83.9%, specificity of 78.7% and 74.8%, respectively. The optimal cut‐off point of HADS‐A subscale for screening anxiety disorders was 6/7, yielding a sensitivity of 88.0% and specificity of 74.4%.
Conclusion
The prevalence of MDD and anxiety disorder in SpA patients were 10.6% and 15.6%, respectively. We recommend using the full‐scale HADS in screening for depressive disorders and HADS‐A subscale for anxiety disorders.
The objective of this study is to describe survival outcomes in patients with metastatic melanoma in a real-world setting receiving combination and single-agent immunotherapy outside the clinical ...trial context. We conducted a retrospective single-institution study of patients with metastatic melanoma in a real-world setting. Survival was calculated using log-rank test. Contingency tables were analyzed using Fisher's Exact test. CD8 + T-cell densities were measured using quantitative immunofluorescence and analyzed using Mann-Whitney U test. The median overall survival (OS) for 132 patients was 45.3 months. Brain metastasis did not confer a higher risk of death relative to liver and/or bone disease (39.53 versus 30.00 months, respectively; P = 0.687). Anti-PD-1 monotherapy was the most common first-line treatment, received by 49.2% of patients. There was no significant difference in OS between patients receiving single-agent anti-PD-1 and combination anti-PD-1 plus CTLA-4 (39.4 months versus undefined; P = 0.643). Patients treated with combination therapy were more likely to be alive without progression at the last follow-up than those who received monotherapy (70.4% versus 49.2%; P = 0.0408). Median OS was 21.8 months after initiation of second-line therapy after anti-PD-1 monotherapy. CD8+ T-cell densities were higher in patients who achieved disease control on first-line immunotherapy ( P = 0.013). In a real-world setting, patients with metastatic melanoma have excellent survival rates, and treatment benefit can be achieved even after progression on first-line therapy. Combination immunotherapy may produce more favorable long-term outcomes in a real-world setting. High pretreatment CD8+ T-cell infiltration correlates with immunotherapy efficacy.
Abstract Background Inflammatory mechanisms involved in the onset and progression of labor at term may affect the fetal compartment impacting neonatal outcomes. Study design Umbilical cord blood ...collected from umbilical cords after delivery of the fetus and again after delivery of the placenta in low-risk non-laboring and laboring patients was analyzed for blood gases/pH and multiple cytokines. Results Umbilical cord levels of IL-6, IL-8 and IL-10 were increased 6, 2 and 1.5 fold, respectively, in laboring patients without placental inflammation, and for IL-6 and IL-8 a further 12 and 6 fold, respectively, in laboring patients showing histologic chorioamnionitis, but with no evident effect of nuchal cord with FHR decelerations, fetal acidemia, nor of labor duration. For laboring patients, umbilical vein levels of IL-10 and MIP-1α were increased compared to arterial levels indicating net flux from the placenta, while umbilical artery levels of IL-6 and IL-8 were increased compared to venous levels indicating net flux from fetal sources. Placental cord levels of IL-6, IL-10, MIP-1α and MIP-1β were also increased compared to respective umbilical cord levels, confirming placental release of these cytokines into cord blood after delivery of the fetus. Conclusion Labor in low-risk patients at term will result in increased cytokines in umbilical cord blood and moreso when associated with histologic chorioamnionitis with the potential to impact neonatal outcomes. IL-6 and IL-8 as the primary cytokines increased in cord blood may act synergistically in promoting the inflammatory response with labor, and are likely released from both placental and fetal tissues contributing to widespread distribution through the fetal circulation.
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