Not all numbers are equal: preferences and biases among children and adults when generating random sequences

Scientific guidelines for preclinical research on potentised preparations manufactured according to current pharmacopoeias-the PrePoP guidelines

OBJECTIVE

Pharmacopoeias regulate the manufacture of potentised pharmaceutical preparations used in different branches of complementary and integrative medicine. The physicochemical properties and biological activity of these preparations are often investigated in preclinical research, yet no guidelines for experimental research currently exist in this area. The present PrePoP guidelines aim to provide recommendations to promote high-quality, statistically sound, and reproducible preclinical research on potentised preparations.

METHODS

Input was gathered from researchers nominated by the relevant scientific societies using a simplified Delphi consensus approach covering the most relevant aspects of basic research methodology in the field including appropriate controls, sample preparation and handling, and statistics. After three rounds of feedback, a consensus was finally reached on the most important aspects and considerations for conducting high-quality research on potentised preparations.

RESULTS

We present a series of recommendations on a range of topics including experimental controls, system stability, blinding and randomisation, environmental influences, and procedures for the preparation of potentised samples and controls, and we address some specific challenges of this research field.

CONCLUSION

This expert consensus process resulted in a robust set of methodological guidelines for research on potentised preparations and provides a valuable framework that will inform and improve the quality of subsequent research in this emerging field.

PLEASE CITE THIS ARTICLE AS

Tournier AL, Bonamin LV, Buchheim-Schmidt S, Cartwright S, Dombrowsky C, Doesburg P, Holandino C, Kokornaczyk MO, van de Kraats EB, López-Carvallo JA, Nandy P, Mazón-Suástegui JM, Mirzajani F, Poitevin B, Scherr C, Thieves K, Würtenberger S, Baumgartner S. Scientific guidelines for preclinical research on potentised preparations manufactured according to current pharmacopoeias-the PrePoP guidelines. J Integr Med. 2024; 22(5): 533-544.

Counting on random number generation: Uncovering mild executive dysfunction in congenital heart disease

Congenital heart disease (CHD) is associated with various neurocognitive deficits, particularly targeting executive functions (EFs), of which random number generation (RNG) is one indicator. RNG has, however, never been investigated in CHD. We administered the Mental Dice Task (MDT) to 67 young adults with CHD and 55 healthy controls. This 1-minute-task requires the generation of numbers 1 to 6 in a random sequence. RNG performance was correlated with a global EF score. Participants underwent MRI to examine structural-volumetric correlates of RNG. Compared to controls, CHD patients showed increased backward counting, reflecting deficient inhibition of automatized behavior. They also lacked a small-number bias (higher frequency of small relative to large numbers). RNG performance was associated with global EF scores in both groups. In CHD patients, MRI revealed an inverse association of counting bias with most of the volumetric measurements and the amount of small numbers was positively associated with corpus callosum volume, suggesting callosal involvement in the "pseudoneglect in number space". In conclusion, we found an impaired RNG performance in CHD patients, which is associated with brain volumetric measures. RNG, reportedly resistant to learning effects, may be an ideal task for the longitudinal assessment of EFs in patients with CHD.

Neuromuscular Diseases Affect Number Representation and Processing: An Exploratory Study

Spinal muscular atrophy (SMA) and Duchenne muscular dystrophy (DMD) both are rare genetic neuromuscular diseases with progressive loss of motor ability. The neuromotor developmental course of those diseases is well documented. In contrast, there is only little evidence about characteristics of general and specific cognitive development. In both conditions the final motor outcome is characterized by an inability to move autonomously: children with SMA never accomplish independent motoric exploration of their environment, while children with DMD do but later lose this ability again. These profound differences in developmental pathways might affect cognitive development of SMA vs. DMD children, as cognition is shaped by individual motor experiences. DMD patients show impaired executive functions, working memory, and verbal IQ, whereas only motor ability seems to be impaired in SMA. Advanced cognitive capacity in SMA may serve as a compensatory mechanism for achieving in education, career progression, and social satisfaction. This study aimed to relate differences in basic numerical concepts and arithmetic achievement in SMA and DMD patients to differences in their motor development and resulting sensorimotor and environmental experiences. Horizontal and vertical spatial-numerical associations were explored in SMA/DMD children ranging between 6 and 12 years through the random number generation task. Furthermore, arithmetic skills as well as general cognitive ability were assessed. Groups differed in spatial number processing as well as in arithmetic and domain-general cognitive functions. Children with SMA showed no horizontal and even reversed vertical spatial-numerical associations. Children with DMD on the other hand revealed patterns in spatial numerical associations comparable to healthy developing children. From the embodied Cognition perspective, early sensorimotor experience does play a role in development of mental number representations. However, it remains open whether and how this becomes relevant for the acquisition of higher order cognitive and arithmetic skills.

Developmental Changes in the Effect of Active Left and Right Head Rotation on Random Number Generation

Numbers are thought to be spatially organized along a left-to-right horizontal axis with small/large numbers on its left/right respectively. Behavioral evidence for this mental number line (MNL) comes from studies showing that the reallocation of spatial attention by active left/right head rotation facilitated the generation of small/large numbers respectively. While spatial biases in random number generation (RNG) during active movement are well established in adults, comparable evidence in children is lacking and it remains unclear whether and how children’s access to the MNL is affected by active head rotation. To get a better understanding of the development of embodied number processing, we investigated the effect of active head rotation on the mean of generated numbers as well as the mean difference between each number and its immediately preceding response (the first order difference; FOD) not only in adults (n = 24), but also in 7- to 11-year-old elementary school children (n = 70). Since the sign and absolute value of FODs carry distinct information regarding spatial attention shifts along the MNL, namely their direction (left/right) and size (narrow/wide) respectively, we additionally assessed the influence of rotation on the total of negative and positive FODs regardless of their numerical values as well as on their absolute values. In line with previous studies, adults produced on average smaller numbers and generated smaller mean FODs during left than right rotation. More concretely, they produced more negative/positive FODs during left/right rotation respectively and the size of negative FODs was larger (in terms of absolute value) during left than right rotation. Importantly, as opposed to adults, no significant differences in RNG between left and right head rotations were observed in children. Potential explanations for such age-related changes in the effect of active head rotation on RNG are discussed. Altogether, the present study confirms that numerical processing is spatially grounded in adults and suggests that its embodied aspect undergoes significant developmental changes.

The Gold Standard Paradox in Digital Image Analysis: Manual Versus Automated Scoring as Ground Truth

CONTEXT

- Novel therapeutics often target complex cellular mechanisms. Increasingly, quantitative methods like digital tissue image analysis (tIA) are required to evaluate correspondingly complex biomarkers to elucidate subtle phenotypes that can inform treatment decisions with these targeted therapies. These tIA systems need a gold standard, or reference method, to establish analytical validity. Conventional, subjective histopathologic scores assigned by an experienced pathologist are the gold standard in anatomic pathology and are an attractive reference method. The pathologist's score can establish the ground truth to assess a tIA solution's analytical performance. The paradox of this validation strategy, however, is that tIA is often used to assist pathologists to score complex biomarkers because it is more objective and reproducible than manual evaluation alone by overcoming known biases in a human's visual evaluation of tissue, and because it can generate endpoints that cannot be generated by a human observer.

OBJECTIVE

- To discuss common visual and cognitive traps known in traditional pathology-based scoring paradigms that may impact characterization of tIA-assisted scoring accuracy, sensitivity, and specificity.

DATA SOURCES

- This manuscript reviews the current literature from the past decades available for traditional subjective pathology scoring paradigms and known cognitive and visual traps relevant to these scoring paradigms.

CONCLUSIONS

- Awareness of the gold standard paradox is necessary when using traditional pathologist scores to analytically validate a tIA tool because image analysis is used specifically to overcome known sources of bias in visual assessment of tissue sections.

Which numbers do you have in mind? Number generation is influenced by reading direction

In Western participants, small numbers are associated with left and larger numbers with right space. A biological account proposes that brain asymmetries lead to these attentional asymmetries in number space. In contrast, a cultural account proposes that the direction of this association is shaped by reading direction. We explored whether number generation is influenced by reading direction in participants from a left-to-right (UK) and a right-to-left (Arab) reading culture. Participants generated numbers randomly while lying on their left and right side. The mean number generated by participants from a left-to-right reading culture was smaller when they lay on their left than on their right side, and the opposite was found for participants from a right-to-left reading culture. Asymmetries in number space observed in number generation are more compatible with a cultural than biological account.

The oculomotor resonance effect in spatial-numerical mapping

We investigated automatic Spatial-Numerical Association of Response Codes (SNARC) effect in auditory number processing. Two experiments continually measured spatial characteristics of ocular drift at central fixation during and after auditory number presentation. Consistent with the notion of a spatially oriented mental number line, we found spontaneous magnitude-dependent gaze adjustments, both with and without a concurrent saccadic task. This fixation adjustment (1) had a small-number/left-lateralized bias and (2) it was biphasic as it emerged for a short time around the point of lexical access and it received later robust representation around following number onset. This pattern suggests a two-step mechanism of sensorimotor mapping between numbers and space - a first-pass bottom-up activation followed by a top-down and more robust horizontal SNARC. Our results inform theories of number processing as well as simulation-based approaches to cognition by identifying the characteristics of an oculomotor resonance phenomenon.