The Role of Accurate Self-Assessments in Optimizing Mate Choice

Individuals are thought to seek the best possible romantic partner in exchange for their own desirability. We investigated whether individuals' self-evaluations were related to their partner choices and whether the accuracy of these self-evaluations was associated with mating outcomes. Participants (N = 1,354) took part in a speed-dating study where they rated themselves and others on mate value and indicated their willingness to date each potential partner. Individuals were somewhat accurate in their self-evaluations, and these self-evaluations were associated with individuals' revealed minimum and maximum standards for a potential partner, but not the number of partners they were interested in. Participants who overestimated their mate value were accepted by an equivalent number of partners compared with under-estimators, but the over-estimators were choosier and thus ended up with fewer (but similarly attractive) reciprocal matches. Results support social exchange theory and the matching hypothesis, and contrast findings that self-enhancement facilitates positive social outcomes.

Creation of Novel Sensitive Probe Substrate and Moderate Inhibitor Models for a Comprehensive Prediction of CYP2C8 Interactions for Tucatinib

A physiologically-based pharmacokinetic (PBPK) model was developed to simulate plasma concentrations of tucatinib (TUKYSA®) after single-dose or multiple-dose administration of 300 mg b.i.d. orally. This PBPK model was subsequently applied to support evaluation of drug-drug interaction (DDI) risk as a perpetrator resulting from tucatinib inhibition of CYP3A4, CYP2C8, CYP2C9, P-gp, or MATE1/2-K. The PBPK model was also applied to support evaluation of DDI risk as a victim resulting from co-administration with CYP3A4 or CYP2C8 inhibitors, or a CYP3A4 inducer. After refinement with clinical DDI data, the final PBPK model was able to recover the clinically observed single and multiple-dose plasma concentrations for tucatinib when tucatinib was administered as a single agent in healthy subjects. In addition, the final model was able to recover clinically observed plasma concentrations of tucatinib when administered in combination with itraconazole, rifampin, or gemfibrozil as well as clinically observed plasma concentrations of probe substrates of CYP3A4, CYP2C8, CYP2C9, P-gp, or MATE1/2-K. The PBPK model was then applied to prospectively predict the potential perpetrator or victim DDIs with other substrates, inducers, or inhibitors. To simulate a potential interaction with a moderate CYP2C8 inhibitor, two novel PBPK models representing a moderate CYP2C8 inhibitor and a sensitive CYP2C8 substrate were developed based on the existing PBPK models for gemfibrozil and rosiglitazone, respectively. The simulated population geometric mean area under the curve ratio of tucatinib with a moderate CYP2C8 inhibitor ranged from 1.98- to 3.08-fold, and based on these results, no dose modifications were proposed for moderate CYP2C8 inhibitors for the tucatinib label.

The importance of face-shape masculinity for perceptions of male dominance depends on study design

Dominance perceptions play an important role in social interactions. Although many researchers have proposed that shape masculinity is an important facial cue for dominance perceptions, evidence for this claim has come almost exclusively from studies that assessed perceptions of experimentally manipulated faces using forced-choice paradigms. Consequently, we investigated the role of masculine shape characteristics in perceptions of men's facial dominance (1) when shape-manipulated stimuli were presented in a forced-choice paradigm and (2) when unmanipulated face images were rated for dominance and shape masculinity was measured from face images. Although we observed large effects of masculinity on dominance perceptions when we used the forced-choice method (Cohen's ds = 2.51 and 3.28), the effect of masculinity on dominance perceptions was considerably smaller when unmanipulated face images were rated and shape masculinity measured from face images (Cohen's ds = 0.44 and 0.62). This pattern was observed when faces were rated separately for physical dominance, social dominance, and masculinity, and was seen for two different sets of stimuli. Collectively, these results suggest that shape masculinity may not be a particularly important cue for dominance perceptions when faces vary simultaneously on multiple dimensions, as is the case during everyday social interactions.

Women's Preferences for Masculinity in Male Faces Are Predicted by Material Scarcity, But Not Time or Psychological Scarcity

Facial femininity in men is purportedly used as a cue by women as a signal of parental quality and willingness to provide resources. Accordingly, in contexts where choosing a partner that will provide resources is more beneficial (e.g., when resources are scarce), women have shown an increase preference for facial femininity in male faces. However, domains of scarcity often covary, and it is, therefore, unclear whether these contextual shifts in facial masculinity/femininity preferences are specific to material scarcity (as implied by previous theory), or due to an unrelated domain of scarcity (e.g., time or psychological scarcity). Here, a sample of 823 women completed the Perceived Scarcity Scale, which measures three separate domains of scarcity: material scarcity, time scarcity, and psychological scarcity. Participants also rated the attractiveness of 42 male faces, which were measured on objective sexual dimorphism and perceived masculinity. Consistent with theory, material scarcity, and not time or psychological scarcity, was associated with a decreased preference for objective sexual dimorphism (i.e., an increased preference for facial femininity). This study provides evidence that women use sexual dimorphism as a cue to material resource provisioning potential when assessing men as a mate.

No evidence that sociosexual orientation moderates effects of conception probability on women's preferences for male facial masculinity

Although many researchers have proposed that women will show stronger preferences for male facial masculinity when conception probability is high, empirical tests of this hypothesis have produced mixed results. One possible explanation for these inconsistent findings is that effects of conception probability on women's preferences for facial masculinity are moderated by additional factors not typically considered in these empirical tests. One such potential moderator is individual differences in women's openness to uncommitted sexual relationships (i.e., individual differences in women's sociosexual orientation); women who are more open to uncommitted sexual relationships might show stronger positive effects of conception probability on masculinity preferences, as their sexuality is more overt and sexual attitudes and behaviours are more diversified. Consequently, we analysed data from three independent samples (N = 2304, N = 483, and N = 339) to assess whether sociosexual orientation moderates the hypothesised positive effect of conception probability on women's facial masculinity preferences. Analyses showed no evidence that higher conception probability increased preferences for facial masculinity or that sociosexual orientation moderated the effect of conception probability on women's preferences for facial masculinity. While it remains possible that factors other than sociosexual orientation moderate effects of conception probability on masculinity preferences, our null results suggest that the mixed results for the effects of conception probability on facial masculinity preferences in previous studies are unlikely to be a consequence of failing to consider the moderating role of sociosexual orientation.

Facial Attractiveness, but not Facial Masculinity, is Used as a Cue to Paternal Involvement in Fathers

Purpose

Facial femininity in men is purportedly used as a cue by women as a signal of paternal involvement. However, evidence for this claim is questionable. Previous findings have shown that paternal involvement is linked to testosterone, but have not investigated facial masculinity directly, while other studies have found that facial masculinity is negatively associated with perceptions of paternal involvement but do not assess the accuracy of this judgement. Here, we assess whether facial masculinity in men is used as a cue to paternal involvement, and whether this cue is accurate.

Methods

We collected facial photographs of 259 men (156 of which were fathers) who also completed self-report measures of paternal involvement. Facial images were then rated by a separate group of raters on facial masculinity, attractiveness, and perceived paternal involvement. Shape sexual dimorphism was also calculated from the images using geometric morphometrics.

Results

We found that facial masculinity was not associated with perceptions of paternal involvement, nor was it related with self-reported paternal involvement. Interestingly, facial attractiveness was negatively associated with perceptions of paternal involvement, and we found partial evidence that facial attractiveness was also negatively associated with self-reported paternal involvement.

Conclusion

These findings challenge the hypothesis that sexual dimorphism is used as a cue to paternal involvement, and perhaps indicate that facial attractiveness is more important for this judgement instead.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40750-023-00217-y.

The role of valence, dominance, and pitch in perceptions of artificial intelligence (AI) conversational agents' voices

There is growing concern that artificial intelligence conversational agents (e.g., Siri, Alexa) reinforce voice-based social stereotypes. Because little is known about social perceptions of conversational agents' voices, we investigated (1) the dimensions that underpin perceptions of these synthetic voices and (2) the role that acoustic parameters play in these perceptions. Study 1 (N = 504) found that perceptions of synthetic voices are underpinned by Valence and Dominance components similar to those previously reported for natural human stimuli and that the Dominance component was strongly and negatively related to voice pitch. Study 2 (N = 160) found that experimentally manipulating pitch in synthetic voices directly influenced dominance-related, but not valence-related, perceptions. Collectively, these results suggest that greater consideration of the role that voice pitch plays in dominance-related perceptions when designing conversational agents may be an effective method for controlling stereotypic perceptions of their voices and the downstream consequences of those perceptions.

No increased inbreeding avoidance during the ovulatory phase of the menstrual cycle

Mate preferences and mating-related behaviours are hypothesised to change over the menstrual cycle to increase reproductive fitness. Recent large-scale studies suggest that previously reported hormone-linked behavioural changes are not robust. The proposal that women's preference for associating with male kin is down-regulated during the ovulatory (high-fertility) phase of the menstrual cycle to reduce inbreeding has not been tested in large samples. Consequently, we investigated the relationship between longitudinal changes in women's steroid hormone levels and their perceptions of faces experimentally manipulated to possess kinship cues (Study 1). Women viewed faces displaying kinship cues as more attractive and trustworthy, but this effect was not related to hormonal proxies of conception risk. Study 2 employed a daily diary approach and found no evidence that women spent less time with kin generally or with male kin specifically during the fertile phase of the menstrual cycle. Thus, neither study found evidence that inbreeding avoidance is up-regulated during the ovulatory phase of the menstrual cycle.

Mechanistic Modeling of Central Nervous System Pharmacokinetics and Target Engagement of HER2 Tyrosine Kinase Inhibitors to Inform Treatment of Breast Cancer Brain Metastases

PURPOSE

This study evaluated the central nervous system (CNS) pharmacokinetics and target engagement of lapatinib, neratinib, and tucatinib in patients with cancer, using a physiologically based pharmacokinetic (PBPK) modeling approach.

EXPERIMENTAL DESIGN

Drug-specific parameters for in vitro metabolism, binding to plasma proteins and brain tissues, transcellular passive permeability, and interactions with efflux transporters were determined. Whole-body PBPK models integrated with a 4-compartment permeability-limited brain model was developed and verified for predicting plasma and CNS pharmacokinetics. Target engagement ratio (TER), defined as the ratio of the average steady-state unbound drug brain concentration (Css,ave,br) to in vitro IC50 for HER2 inhibition, was used as a predictor of intracranial efficacy.

RESULTS

PBPK models predicted that following 1 cycle of standard dosing, tucatinib and lapatinib achieved similar Css,ave,br (14.5 vs. 16.8 nmol/L), while neratinib Css,ave,br (0.68 nmol/L) was 20-fold lower. Tucatinib and neratinib were equally potent for HER2 inhibition (IC50, 6.9 vs. 5.6 nmol/L), while lapatinib was less potent (IC50, 109 nmol/L). The model-predicted population mean TER in the human normal brain was 2.1 for tucatinib, but < 0.20 for lapatinib and neratinib.

CONCLUSIONS

The PBPK modeling suggests that tucatinib induces sufficient HER2 inhibition (TER > 2.0) in not only brain metastases with a disrupted blood-brain barrier (BBB), but also micrometastases where the BBB largely remains intact. These findings, in line with available clinical pharmacokinetics and efficacy data, support the therapeutic value of tucatinib for treatment of brain metastases and warrant further clinical investigation for the prevention of brain metastases in patients with HER2-positive breast cancer.

Risk-Based Pharmacokinetic and Drug-Drug Interaction Characterization of Antibody-Drug Conjugates in Oncology Clinical Development: An International Consortium for Innovation and Quality in Pharmaceutical Development Perspective

Antibody-drug conjugates (ADCs) represent a rapidly evolving area of drug development and hold significant promise. To date, nine ADCs have been approved by the US Food and Drug Administration (FDA). These conjugates combine the target specificity of monoclonal antibodies with the anticancer activity of small-molecule therapeutics (also referred to as payload). Due to the complex structure, three analytes, namely ADC conjugate, total antibody, and unconjugated payload, are typically quantified during drug development; however, the benefits of measuring all three analytes at later stages of clinical development are not clear. The cytotoxic payloads, upon release from the ADC, are considered to behave like small molecules. Given the relatively high potency and low systemic exposure of cytotoxic payloads, drug-drug interaction (DDI) considerations for ADCs might be different from traditional small molecule therapeutics. The International Consortium for Innovation and Quality in Pharmaceutical Development (IQ Consortium) convened an ADC working group to create an IQ ADC database that includes 26 ADCs with six unique payloads. The analysis of the ADC data in the IQ database, as well as nine approved ADCs, supports the strategy of pharmacokinetic characterization of all three analytes in early-phase development and progressively minimizing the number of analytes to be measured in the late-phase studies. The systemic concentrations of unconjugated payload are usually too low to serve as a DDI perpetrator; however, the potential for unconjugated payloads as a victim still exists. A data-driven and risk-based decision tree was developed to guide the assessment of a circulating payload as a victim of DDI.

An exploratory, cross-cultural study on perception of putative cyclical changes in facial fertility cues

Although many researchers have argued that facial traits evolved as honest cues to women's current fertility (possibly via changes in facial femininity), evidence that women's facial attractiveness is significantly, positively related to probability of conception throughout menstrual cycle is mixed. These mixed results could reflect differences among studies in the methods used to assess facial attractiveness (i.e., forced choice versus rating-scale methods), differences in how fertility was assessed, differences in perceiver characteristics (e.g., their own attractiveness), and facial preferences possibly being moderated by the characteristics of the living environment. Consequently, the current study investigated the putative effect of cyclical changes in fertility on women's facial attractiveness and femininity (1) using forced choice and rating-scale method, (2) conducting both ovulation tests and repeated daily measures of estradiol assessing the conception probability, (3) based on a culturally diverse sample of perceivers, while (4) controlling for inter-individual variation. Although we found some limited evidence that women's faces became more attractive when conception probability increased, these effects differed depending on the methods used to assess both attractiveness and fertility. Moreover, where statistically significant effects were observed, the effect sizes were extremely small. Similarly, there was little robust evidence that perceivers' characteristics reliably predicted preferences for fertility cues. Collectively, these results suggest that mixed results in previous studies examining cyclical fluctuation in women's facial attractiveness are unlikely to reflect inter-cultural differences and are more likely to reflect differences in the methods used to assess facial attractiveness and fertility.

Are Sex Differences in Human Brain Structure Associated With Sex Differences in Behavior?

On average, men and women differ in brain structure and behavior, raising the possibility of a link between sex differences in brain and behavior. But women and men are also subject to different societal and cultural norms. We navigated this challenge by investigating variability of sex-differentiated brain structure within each sex. Using data from the Queensland Twin IMaging study (n = 1,040) and Human Connectome Project (n = 1,113), we obtained data-driven measures of individual differences along a male-female dimension for brain and behavior based on average sex differences in brain structure and behavior, respectively. We found a weak association between these brain and behavioral differences, driven by brain size. These brain and behavioral differences were moderately heritable. Our findings suggest that behavioral sex differences are, to some extent, related to sex differences in brain structure but that this is mainly driven by differences in brain size, and causality should be interpreted cautiously.

The impact of disability on performance in a high-stakes postgraduate surgical examination: a retrospective cohort study

OBJECTIVE

Despite rising numbers of doctors in the workforce with disabilities, little is known about the impact of disabilities on postgraduate performance. To ensure all groups are treated fairly in surgical training, it is essential to know whether any attainment differences exist in markers of surgical performance. To address this gap, we assessed the impact of disabilities on performance on the Intercollegiate Membership of the Royal College of Surgeons examination (MRCS).

DESIGN

Retrospective cohort study.

SETTING

Secondary care.

PARTICIPANTS

All UK MRCS candidates attempting Part A (n = 9600) and Part B (n = 4560) between 2007 and 2017 with linked disability data in the UK Medical Education Database (https://www.ukmed.ac.uk) were included.

MAIN OUTCOME MEASURES

Chi-square tests and correlation coefficients established univariate associations with MRCS performance, while multiple logistic regressions identified independent predictors of success.

RESULTS

Though MRCS Part B pass rates were similar (p = 0.339), candidates with registered disabilities had significantly lower first-attempt Part A pass rates (46.3% vs. 59.8%, p < 0.001). Candidates with disabilities also performed less well in examinations taken throughout school and medical school, and after adjusting for prior academic performance and sociodemographic predictors of success, logistic regression found that candidates with disabilities were no less likely to pass MRCS than their peers (odds ratio 1.04, 95% confidence interval 0.66 to 1.62). No significant variation was found in MRCS performance between type of disability or degree of limitations caused by disability (p > 0.05).

CONCLUSION

Although candidates with registered disabilities performed less well in formal, written examinations, our data indicate that they are as likely to pass MRCS at first attempt as their peers who achieved similar grades at high school and medical school. In order to enable equity in career progression, further work is needed to investigate the causes of attainment differences in early career assessments.

A cross-sectional study examining the association between MRCS performance and surgeons receiving sanctions against their medical registration

BACKGROUND

Fitness to practice (FtP) investigations by the General Medical Council (GMC) safeguard patients and maintain the integrity of the medical profession. The likelihood of FtP sanctions is influenced by specialty and socio-demographic factors and can be predicted by performance at postgraduate examinations. This is the first study to characterise the prevalence of FtP sanctions in early-career surgeons and to examine the association with performance at the Membership of the Royal College of Surgeons (MRCS) examination.

METHODS

All UK graduates who attempted MRCS between September 2007-January 2020 were matched to the GMC list of registered medical practitioners. Clinicians who had active FtP sanctions between 28th August 2018 and 28th August 2020 were identified. Data were anonymised by RCS England prior to analysis.

RESULTS

Of 11,660 candidates who attempted MRCS within the study period, only 31 (0.3%) had FtP sanctions between 2018 and 2020. Of these, 12 had active conditions on registration, seven had undertakings and 14 had warnings. There was no statistically significant difference in MRCS performance in either Parts A or B of the examination for those with and those free from FtP sanctions (P > 0.05).

CONCLUSIONS

In this, the largest study of MRCS candidates to date, the prevalence of active FtP sanctions in early-career surgeons was 0.3%, significantly lower than the prevalence of sanctions across more experienced UK surgeons (0.9%). These data highlight early-career surgeons as a low-risk group for disciplinary action and should reassure patients and medical professionals of the rarity of FtP sanctions.

Does Self-rated Attractiveness Predict Women’s Preferences for Facial Masculinity? Data From an Arab Sample

Objectives

Because more attractive women may be better able to attract and/or retain masculine mates, many researchers have proposed that women who consider themselves to be more physically attractive will show stronger preferences for men displaying masculine facial characteristics. Empirical evidence for this putative association between women’s self-rated attractiveness and preference for facial masculinity has come almost entirely from studies of Western women. Thus, we investigated whether this pattern of results also occurs in a sample of non-Western women.

Methods

We investigated the relationship between self-rated attractiveness and facial-masculinity preferences in a sample of Arab women (N = 281). Facial-masculinity preferences were assessed from attractiveness judgments of masculinized versus feminized versions of face images.

Results

By contrast with previous findings for Western women’s self-rated attractiveness, we observed no compelling evidence that Arab women who considered themselves to be more attractive showed stronger preferences for masculine men.

Conclusions

Our results suggest that previously reported associations between self-rated attractiveness and masculinity preferences might be somewhat culture specific, potentially reflecting cultural differences in typical mating strategies.

Facial Masculinity Increases Perceptions of Men’s Age, But Not Perceptions of Their Health: Data From an Arab Sample

Masculine characteristics in men’s faces are often assumed to function as health cues. However, evidence for this assumption from empirical tests is mixed. For example, research on Western women’s face perceptions found that masculinized versions of men’s faces were perceived to be older, but not healthier, than feminized versions. Since research on this topic has focused on Western women’s face perceptions, we investigated the effects of masculinizing face images on Arab women’s perceptions of men’s health (study 1, N = 211) and age (study 2, N = 209). Arab women perceived masculinized versions of male face images to be older, but not healthier, than feminized versions. These results add to a growing body of evidence challenging the assumption that male facial masculinity functions primarily as a health cue.

Tucatinib Inhibits Renal Transporters OCT2 and MATE Without Impacting Renal Function in Healthy Subjects

Tucatinib is a potent tyrosine kinase inhibitor selective for human epidermal growth factor receptor 2 (HER2) approved by the US Food and Drug Administration for the treatment of HER2‐positive metastatic breast cancer and in development for other HER2‐positive solid tumors. Modest, reversible serum creatinine (SCr) elevations have been observed in tucatinib clinical trials. SCr is conveyed by the renal drug transporters organic cation transporter 2 (OCT2) and multidrug and toxin extrusion protein 1 (MATE1) and 2‐K (MATE2‐K) and can increase in the presence of inhibitors of these transporters. In vitro, tucatinib inhibited OCT2‐, MATE1‐, and MATE2‐K‐mediated transport of metformin, with IC₅₀ values of 14.7, 0.340, and 0.135 µM, respectively. Tucatinib also inhibited OCT2‐ and MATE1‐mediated transport of creatinine, with IC₅₀ values of 0.107 and 0.0855 µM, respectively. A phase 1 study with metformin administered orally in the absence and presence of tucatinib was conducted in 18 healthy subjects. Renal function was assessed by measuring glomerular filtration rate (GFR; based on iohexol plasma clearance) and endogenous markers (SCr, cystatin C‐based estimated glomerular filtration rate [eGFR]) with and without tucatinib. Metformin exposure increased (1.4‐fold) and renal clearance decreased (29.99‐17.64 L/h) with tucatinib, with no effect on metformin maximum concentration. Creatinine clearance transiently decreased 23% with tucatinib. GFR and eGFR, which are unaffected by OCT2 and/or MATE1/2‐K transport, were unchanged with tucatinib. These data demonstrate that tucatinib inhibits OCT2‐ and MATE1/2‐K‐mediated tubular secretion of creatinine, which may manifest as mild SCr elevations that are not indicative of renal impairment.

Are affective factors related to individual differences in facial expression recognition?

Evidence that affective factors (e.g. anxiety, depression, affect) are significantly related to individual differences in emotion recognition is mixed. Palermo et al. (Palermo et al. 2018 J. Exp. Psychol. Hum. Percept. Perform. 44, 503-517) reported that individuals who scored lower in anxiety performed significantly better on two measures of facial-expression recognition (emotion-matching and emotion-labelling tasks), but not a third measure (the multimodal emotion recognition test). By contrast, facial-expression recognition was not significantly correlated with measures of depression, positive or negative affect, empathy, or autistic-like traits. Because the range of affective factors considered in this study and its use of multiple expression-recognition tasks mean that it is a relatively comprehensive investigation of the role of affective factors in facial expression recognition, we carried out a direct replication. In common with Palermo et al. (Palermo et al. 2018 J. Exp. Psychol. Hum. Percept. Perform. 44, 503-517), scores on the DASS anxiety subscale negatively predicted performance on the emotion recognition tasks across multiple analyses, although these correlations were only consistently significant for performance on the emotion-labelling task. However, and by contrast with Palermo et al. (Palermo et al. 2018 J. Exp. Psychol. Hum. Percept. Perform. 44, 503-517), other affective factors (e.g. those related to empathy) often also significantly predicted emotion-recognition performance. Collectively, these results support the proposal that affective factors predict individual differences in emotion recognition, but that these correlations are not necessarily specific to measures of general anxiety, such as the DASS anxiety subscale.

Predicting the chances of having a baby with or without treatment at different time points in couples with unexplained subfertility

STUDY QUESTION

Can we develop a prediction model that can estimate the chances of conception leading to live birth with and without treatment at different points in time in couples with unexplained subfertility?

SUMMARY ANSWER

Yes, a dynamic model was developed that predicted the probability of conceiving under expectant management and following active treatments (in vitro fertilisation (IVF), intrauterine insemination with ovarian stimulation (IUI + SO), clomiphene) at different points in time since diagnosis.

WHAT IS KNOWN ALREADY

Couples with no identified cause for their subfertility continue to have a realistic chance of conceiving naturally, which makes it difficult for clinicians to decide when to intervene. Previous fertility prediction models have attempted to address this by separately estimating either the chances of natural conception or the chances of conception following certain treatments. These models only make predictions at a single point in time and are therefore inadequate for informing continued decision-making at subsequent consultations.

STUDY DESIGN, SIZE, DURATION

A population-based study of 1316 couples with unexplained subfertility attending a regional clinic between 1998 and 2011.

PARTICIPANTS/MATERIALS, SETTING, METHODS

A dynamic prediction model was developed that estimates the chances of conception within 6 months from the point when a diagnosis of unexplained subfertility was made. These predictions were recomputed each month to provide a dynamic assessment of the individualised chances of conception while taking account of treatment status in each month. Conception must have led to live birth and treatments included clomiphene, IUI + SO, and IVF. Predictions for natural conception were externally validated using a prospective cohort from The Netherlands.

MAIN RESULTS AND THE ROLE OF CHANCE

A total of 554 (42%) couples started fertility treatment within 2 years of their first fertility consultation. The natural conception leading to live birth rate was 0.24 natural conceptions per couple per year. Active treatment had a higher chance of conception compared to those who remained under expectant management. This association ranged from weak with clomiphene to strong with IVF [clomiphene, hazard ratio (HR) = 1.42 (95% confidence interval, 1.05 to 1.91); IUI + SO, HR = 2.90 (2.06 to 4.08); IVF, HR = 5.09 (4.04 to 6.40)]. Female age and duration of subfertility were significant predictors, without clear interaction with the relative effect of treatment.

LIMITATIONS, REASONS FOR CAUTION

We were unable to adjust for other potentially important predictors, e.g. measures of ovarian reserve, which were not available in the linked Grampian dataset that may have made predictions more specific. This study was conducted using single centre data meaning that it may not be generalizable to other centres. However, the model performed as well as previous models in reproductive medicine when externally validated using the Dutch cohort.

WIDER IMPLICATIONS OF THE FINDINGS

For the first time, it is possible to estimate the chances of conception following expectant management and different fertility treatments over time in couples with unexplained subfertility. This information will help inform couples and their clinicians of their likely chances of success, which may help manage expectations, not only at diagnostic workup completion but also throughout their fertility journey.

STUDY FUNDING/COMPETING INTEREST(S)

This work was supported by a Chief Scientist Office postdoctoral training fellowship in health services research and health of the public research (ref PDF/12/06). B.W.M. is supported by an NHMRC Practitioner Fellowship (GNT1082548). B.W.M. reports consultancy for ObsEva, Merck, and Guerbet. None of the other authors declare any conflicts of interest.

Kin recognition and perceived facial similarity

Facial similarity between individuals informs kinship judgments in third-party kin recognition. Indeed, one study found that similarity and kinship judgments encapsulate the same information (Maloney & Dal Martello, 2006). Yet, another study found that this is not the case when comparing adult face pairs of different sex (DeBruine et al., 2009). We replicated these studies to further clarify the role of facial similarity in kin recognition. We recruited 318 raters, who were shown 50 sibling pairs and 50 age- and sex-matched unrelated pairs ranging from 3 to 17 years old. Each rater was randomly assigned to make either kinship judgments (“related” or “unrelated”) or similarity judgments (scale from 0 [not very similar] to 10 [very similar]). The threshold model found that performance in both tasks was equally accurate, with participants detecting child siblings in the kinship task above chance and giving significantly higher similarity ratings to siblings in the similarity task. In both tasks, opposite-sex siblings were perceived to be siblings less often than same-sex siblings, and judgments of unrelated face pairs were not affected by the sex of faces. Conversely, the effect of age difference within pairs of faces differed for the two tasks: a greater age difference decreased all kinship judgments, but only decreased similarity judgments of siblings, not unrelated pairs. In line with DeBruine et al. (2009), these findings suggest that similarity and kinship judgments are highly correlated but not strictly synonymous. The OSF Pre-registration Challenge for this project can be found at osf.io/ps9hy and the data at osf.io/sef9k.

Preferences for Sexually Dimorphic Body Characteristics Revealed in a Large Sample of Speed Daters

While hundreds of studies have investigated the indices that make up attractive body shapes, these studies were based on preferences measured in the laboratory using pictorial stimuli. Whether these preferences translate into real-time, face-to-face evaluations of potential partners is unclear. Here, 539 (275 female) participants in 75 laboratory-based sessions had their body dimensions measured before engaging in round-robin speed dates. After each date, they rated each other’s body, face, personality, and overall attractiveness and noted whether they would go on a date with the partner. Women with smaller waists and lower waist-to-hip ratios were found most attractive, and men with broader shoulders and higher shoulder-to-waist (or hips) ratios were found most attractive. Taller individuals were preferred by both sexes. Our results show that body dimensions associated with greater health, reproductive value (in women), and formidability (in men) influence face-to-face evaluations of attractiveness, consistent with a role of intersexual selection in shaping human bodies.

Mating Strategies and the Masculinity Paradox: How Relationship Context, Relationship Status, and Sociosexuality Shape Women's Preferences for Facial Masculinity and Beardedness

According to the dual mating strategy model, in short-term mating contexts women should forego paternal investment qualities in favor of mates with well-developed secondary sexual characteristics and dominant behavioral displays. We tested whether this model explains variation in women's preferences for facial masculinity and beardedness in male faces. Computer-generated composites that had been morphed to appear ± 50% masculine were rated by 671 heterosexual women (M age = 31.72 years, SD = 6.43) for attractiveness when considering them as a short-term partner, long-term partner, a co-parent, or a friend. They then completed the Revised Sociosexual Inventory (SOI-R) to determine their sexual openness on dimensions of desire, behavior, and attitudes. Results showed that women's preferences were strongest for average facial masculinity, followed by masculinized faces, with feminized faces being least attractive. In contrast to past research, facial masculinity preferences were stronger when judging for co-parenting partners than for short-term mates. Facial masculinity preferences were also positively associated with behavioral SOI, negatively with desire, and were unrelated to global or attitudinal SOI. Women gave higher ratings for full beards than clean-shaven faces. Preferences for beards were higher for co-parenting and long-term relationships than short-term relationships, although these differences were not statistically significant. Preferences for facial hair were positively associated with global and attitudinal SOI, but were unrelated to behavioral SOI and desire. Although further replication is necessary, our findings indicate that sexual openness is associated with women's preferences for men's facial hair and suggest variation in the association between sociosexuality and women's facial masculinity preferences.

Evidence Head Tilt Has Dissociable Effects on Dominance and Trustworthiness Judgments, But Does Not Have Category-Contingent Effects on Hypothetical Leadership Judgments

Previous research has found that physical characteristics in faces that influence perceptions of trustworthiness and dominance have context-contingent effects on leadership perceptions. People whose faces are perceived to be trustworthy are judged to be better leaders in peacetime contexts than wartime contexts. By contrast, people whose faces are perceived to be dominant are judged to be better leaders in wartime contexts than peacetime contexts. Here, we tested for judgment-contingent (dominance vs. trustworthiness) effects of head tilt (i.e., head pitch rotation) on person perception and context-contingent (peacetime vs. wartime) effects of head tilt on leadership judgments. Although we found that head tilt influenced judgments of trustworthiness and dominance (Study 1), head tilt did not influence leadership judgments (Study 2). Together, these results suggest that the context-contingent effects of physical characteristics on leadership judgments reported in previous work do not necessarily extend to head tilt, even though head tilt influences perceptions of trustworthiness and dominance.

Sex Differences in Misperceptions of Sexual Interest Can Be Explained by Sociosexual Orientation and Men Projecting Their Own Interest Onto Women

Sex differences in misperceptions of sexual interest have been well documented; however, it is unclear whether this cognitive bias could be explained by other factors. In the current study, 1,226 participants (586 men, 640 women) participated in a speed-dating task in which they rated their sexual interest in each other as well as the sexual interest they perceived from their partners. Consistent with previous findings, results showed that men tended to overperceive sexual interest from their partners, whereas women tended to underperceive sexual interest. However, this sex difference became negligible when we considered potential mediators, such as the raters' sociosexual orientation and raters' tendency to project their own levels of sexual interest onto their partners. These findings challenge the popular notion that sex differences in misperceptions of sexual interest have evolved as a specialized adaptation to different selection pressures in men and women.

A multivariate analysis of women's mating strategies and sexual selection on men's facial morphology

The strength and direction of sexual selection via female choice on masculine facial traits in men is a paradox in human mate choice research. While masculinity may communicate benefits to women and offspring directly (i.e. resources) or indirectly (i.e. health), masculine men may be costly as long-term partners owing to lower paternal investment. Mating strategy theory suggests women's preferences for masculine traits are strongest when the costs associated with masculinity are reduced. This study takes a multivariate approach to testing whether women's mate preferences are context-dependent. Women (n = 919) rated attractiveness when considering long-term and short-term relationships for male faces varying in beardedness (clean-shaven and full beards) and facial masculinity (30% and 60% feminized, unmanipulated, 30% and 60% masculinized). Participants then completed scales measuring pathogen, sexual and moral disgust, disgust towards ectoparasites, reproductive ambition, self-perceived mate value and the facial hair in partners and fathers. In contrast to past research, we found no associations between pathogen disgust, self-perceived mate value or reproductive ambition and facial masculinity preferences. However, we found a significant positive association between moral disgust and preferences for masculine faces and bearded faces. Preferences for beards were lower among women with higher ectoparasite disgust, providing evidence for ectoparasite avoidance hypothesis. However, women reporting higher pathogen disgust gave higher attractiveness ratings for bearded faces than women reporting lower pathogen disgust, providing support for parasite-stress theories of sexual selection and mate choice. Preferences for beards were also highest among single and married women with the strongest reproductive ambition. Overall, our results reflect mixed associations between individual differences in mating strategies and women's mate preferences for masculine facial traits.

Chinese and UK participants' preferences for physical attractiveness and social status in potential mates

Men are hypothesized to show stronger preferences for physical attractiveness in potential mates than women are, particularly when assessing the attractiveness of potential mates for short-term relationships. By contrast, women are thought to show stronger preferences for social status in potential mates than men are, particularly when assessing the attractiveness of potential mates for long-term relationships. These mate-preference sex differences are often claimed to be 'universal' (i.e. stable across cultures). Consequently, we used an established 'budget-allocation' task to investigate Chinese and UK participants' preferences for physical attractiveness and social status in potential mates. Confirmatory analyses replicated these sex differences in both samples, consistent with the suggestion that they occur in diverse cultures. However, confirmatory analyses also showed that Chinese women had stronger preferences for social status than UK women did, suggesting cultural differences in the magnitude of mate-preference sex differences can also occur.

Prediction of success at UK Specialty Board Examinations using the mandatory postgraduate UK surgical examination

Background

While performance in other mandatory examinations taken at the beginning of a doctor's career are predictive of final training outcomes, the influence early postgraduate surgical examinations might have on success at Specialty Board Exams in the UK is currently unknown. The aim was to investigate whether performance at the mandatory Membership of the Royal College of Surgeons (MRCS) examination, and other variables, are predictive of success at the Fellowship of the Royal College of Surgeons (FRCS) examination, thus potentially identifying those who may benefit from early academic intervention.

Methods

Pearson correlation coefficients examined the linear relationship between both examinations and logistic regression analysis identified potential independent predictors of FRCS success. All UK medical graduates who attempted either section of FRCS (Sections 1 and 2) between 2012 and 2018 were included.

Results

First attempt pass rates for Sections 1 and 2 FRCS were 87.4 per cent (n = 854) and 91.8 per cent (n = 797) respectively. In logistic regression analysis, sex (male: odds ratio (OR) 2.32, 95 per cent c.i 1.43 to 3.76), age (less than 29 years at graduation: OR 3.22, 1.88 to 5.51), Part B MRCS attempts (1 attempt: OR 1.77, 1.08 to 3.00), Part A score (OR 1.14, 1.09 to 1.89) and Part B score (OR 1.06, 1.03 to 1.09) were independent predictors of Section 1 FRCS success. Predictors of Section 2 FRCS success were age (less than 29 years at graduation: OR 3.55, 2.00 to 6.39), Part A score (OR 1.06, 1.02 to 1.11) and Section 1 FRCS score (OR 1.13, 1.07 to 1.18).

Conclusion

Part A and B MRCS performance were independent predictors of FRCS success, providing further evidence to support the predictive validity of this mandatory postgraduate exam. However, future research must explore the reasons between the attainment gaps observed for different groups of doctors.

Comparing theory-driven and data-driven attractiveness models using images of real women's faces

Facial attractiveness plays a critical role in social interaction, influencing many different social outcomes. However, the factors that influence facial attractiveness judgments remain relatively poorly understood. Here, we used a sample of 594 young adult female face images to compare the performance of existing theory-driven models of facial attractiveness and a data-driven (i.e., theory-neutral) model. Our data-driven model and a theory-driven model including various traits commonly studied in facial attractiveness research (asymmetry, averageness, sexual dimorphism, body mass index, and representational sparseness) performed similarly well. By contrast, univariate theory-driven models performed relatively poorly. These results (a) highlight the utility of data driven models of facial attractiveness and (b) suggest that theory-driven research on facial attractiveness would benefit from greater adoption of multivariate approaches, rather than the univariate approaches that they currently almost exclusively employ. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Mothers are sensitive to men's beards as a potential cue of paternal investment

Mating strategy theories assert that women's preferences for androgen dependent traits in men are stronger when the costs of reduced paternal investment are lowest. Past research has shown that preferences for facial masculinity are stronger among nulliparous and non-pregnant women than pregnant or parous women. In two studies, we examine patterns in women's preferences for men's facial hair - likely the most visually conspicuous and sexually dimorphic of men's secondary sexual traits - when evaluating men's masculinity, dominance, age, fathering, and attractiveness. Two studies were conducted among heterosexual pregnant women, mothers, non-contractive and contraceptive users. Study 1 used a between-subjects sample (N = 2103) and found that mothers had significantly higher preferences for beards when judging fathering than all other women. Pregnant women and mothers also judged beards as more masculine and older, but less attractive, than non-contractive and contraceptive users. Parous women judged beards higher for age, masculinity and fathering, but lower for attractiveness, than nulliparous women. Irrespective of reproductive status, beards were judged as looking more dominant than clean-shaven faces. Study 2 used a within-subjects design (N = 53) among women surveyed during pregnancy and three months post-partum. Judgments of parenting skills were higher for bearded stimuli during pregnancy among women having their first baby, whereas among parous women parenting skills judgments for bearded stimuli were higher post-partum. Our results suggest that mothers are sensitive to beardedness as a masculine secondary sexual characteristic that may denote parental investment, providing evidence that women's mate preferences could reflect sexual selection for direct benefits.

A Data-Driven Test for Cross-Cultural Differences in Face Preferences

Previous research has shown strong cross-cultural agreement in facial attractiveness judgments. However, these studies all used a theory-driven approach in which responses to specific facial characteristics are compared between cultures. This approach is constrained by the predictions that can be derived from existing theories and can therefore bias impressions of the extent of cross-cultural agreement in face preferences. We directly addressed this problem by using a data-driven, rather than theory-driven, approach to compare facial attractiveness judgments made by Chinese-born participants who were resident in China, Chinese-born participants currently resident in the UK, and UK-born and UK-resident White participants. Analyses of the principal components along which faces naturally varied suggested that Chinese and White UK participants used face information in different ways, at least when judging women’s facial attractiveness. In other words, the data-driven approach used in this study revealed some cross-cultural differences in face preferences that were not apparent in studies using theory-driven approaches.

Individual-specific mortality is associated with how individuals evaluate future discounting decisions

How organisms discount the value of future rewards is associated with many important outcomes, and may be a central component of theories of life-history. According to life-history theories, prioritizing immediacy is indicative of an accelerated strategy (i.e. reaching reproductive maturity quickly and producing many offspring at the cost of long-term investment). Previous work extrapolating life-history theories to facultative calibration of life-history traits within individuals has theorized that cues to mortality can trigger an accelerated strategy; however, compelling evidence for this hypothesis in modern humans is lacking. We assessed whether country-level life expectancy predicts individual future discounting behaviour across multiple intertemporal choice items in a sample of 13 429 participants from 54 countries. Individuals in countries with lower life expectancy were more likely to prefer an immediate reward to one that is delayed. Individuals from countries with greater life expectancy were especially more willing to wait for a future reward when the relative gain in choosing the future reward was large and/or the delay period was short. These results suggest that cues to mortality can influence the way individuals evaluate intertemporal decisions, which in turn can inform life-history trade-offs. We also found that older (but not very old) participants were more willing to wait for a future reward when there is a greater relative gain and/or shorter delay period, consistent with theoretical models that suggest individuals are more future-orientated at middle age.

Are Sex Differences in Preferences for Physical Attractiveness and Good Earning Capacity in Potential Mates Smaller in Countries With Greater Gender Equality?

On average, women show stronger preferences for mates with good earning capacity than men do, while men show stronger preferences for physically attractive mates than women do. Studies reporting that sex differences in mate preferences are smaller in countries with greater gender equality have been interpreted as evidence that these sex differences in mate preferences are caused by the different roles society imposes on men and women. Here, we attempted to replicate previously reported links between sex differences in mate preferences and country-level measures of gender inequality in a sample of 3,073 participants from 36 countries (data and code available at https://osf.io/4sr5f/ ). Although women preferred mates with good earning capacity more than men did and men preferred physically attractive mates more than women did, we found little evidence that these sex differences were smaller in countries with greater gender equality. Although one analysis suggested that the sex difference in preferences for good earning capacity was smaller in countries with greater gender equality, this effect was not significant when controlling for Galton's problem or when correcting for multiple comparisons. Collectively, these results provide little support for the social roles account of sex differences in mate preferences.

Women's preferences for men's facial masculinity are strongest under favorable ecological conditions

The strength of sexual selection on secondary sexual traits varies depending on prevailing economic and ecological conditions. In humans, cross-cultural evidence suggests women’s preferences for men’s testosterone dependent masculine facial traits are stronger under conditions where health is compromised, male mortality rates are higher and economic development is higher. Here we use a sample of 4483 exclusively heterosexual women from 34 countries and employ mixed effects modelling to test how social, ecological and economic variables predict women’s facial masculinity preferences. We report women’s preferences for more masculine looking men are stronger in countries with higher sociosexuality and where national health indices and human development indices are higher, while no associations were found between preferences and indices of intra-sexual competition. Our results show that women’s preferences for masculine faces are stronger under conditions where offspring survival is higher and economic conditions are more favorable.

The effects of human factor related issues on assessors during the recruitment process for general and vascular surgery in the UK

INTRODUCTION

Healthcare professionals increasingly recognise how human factors (HF) can contribute to medical error. An understanding of HF is also important during other high stakes activities such as summative assessments or examinations. National organisations hosting such events need to be aware of potential fatigue, boredom and stress that can occur in interviewers during these often repetitive activities.

METHODS

A previously validated questionnaire based around the well known HF analysis and classification system (HFACS) was used to evaluate four factors (care and support, asking questions about the role as an interviewer, working within the rules and boundaries, and stress and pressure) at the 2018 UK general and vascular surgery trainee national selection process.

RESULTS

A total of 92 questionnaires were completed and analysed (48% response rate). After recoding for negative phrased questions, no significant differences were found between years of experience in the selection process and mean scores obtained for all four factor items. Interviewers had a positive experience during national selection with mean factor scores ranging from 3.84 to 3.98 (out of a maximum satisfaction score of 5).

CONCLUSIONS

Organisations need to plan carefully and recognise the human element to ensure that their interviewers are cared for during any high stakes assessment such as national selection. Our work suggests that a positive assessor experience will further help contribute to a reliable and fair recruitment process.

Birth Order Does Not Affect Ability to Detect Kin

Previous studies suggest that birth order affects kinship detection ability. Kaminski et al. (2010) argued that firstborns use contextual cues (e.g., maternal perinatal association) to assess kinship in their own family, leading to a disadvantage in assessing kinship from facial cues alone in strangers. In contrast, laterborns do not have the contextual cue of maternal perinatal association and hence rely more on facial cues, leading to an advantage in detecting kin from facial cues alone. However, Alvergne et al. (2010) found no evidence in support of such a birthorder effect. The current study aimed to replicate previous studies with better suited methods to determine the effect of birth order on kin recognition. 109 raters viewed 132 pairs of photographs of children (aged 3–17 years), and indicated whether each pair was related or unrelated. Half of the pairs were sibling pairs and half were unrelated child pairs that were age- and gender- matched to the related pairs. No image was shown more than once, related pairs were not known to be related to any other image in the study, and individuals from unrelated pairs were not known to be related to any other image. We used binomial logistic mixed effects modelling to predict kinship judgments from relatedness and birth order (with image pair and rater as random factors). Relatedness was the main factor driving kinship judgments; related child-pairs were more than twice as likely as unrelated pairs to be judged as kin. Kinship judgment accuracy was unaffected by rater birth order. These findings indicate that laterborns did not have an advantage in detecting child sibling pairs. Pre-registration, data, code, and preprint available at osf.io/h43ep.

Facial masculinity is only weakly correlated with handgrip strength in young adult women

OBJECTIVES

Ancestrally, strength is likely to have played a critical role in determining the ability to obtain and retain resources and the allocation of social status among humans. Responses to facial cues of strength are therefore thought to play an important role in human social interaction. Although many researchers have proposed that sexually dimorphic facial morphology is reliably correlated with physical strength, evidence for this hypothesis is somewhat mixed. Moreover, to date, only one study has investigated the putative relationship between facial masculinity and physical strength in women. Consequently, we tested for correlations between handgrip strength and objective measures of face-shape masculinity.

METHODS

531 women took part in the study. We measured each participant's handgrip strength (dominant hand). Sexual dimorphism of face shape was objectively measured from each face photograph using two methods: discriminant analysis and vector analysis. These methods use shape components derived from principal component analyses of facial landmarks to measure the probability of the face being classified as male (discriminant analysis method) or to locate the face on a female-male continuum (vector analysis method).

RESULTS

Our analyses revealed that handgrip strength is, at best, only weakly correlated with facial masculinity in women. There was a weak significant association between handgrip strength and one measure of women's facial masculinity. The relationship between handgrip strength and our other measure of women's facial masculinity was not significant.

DISCUSSION

Together, these results do not support the hypothesis that face-shape masculinity is an important cue of physical strength, at least in women.

Does the Intercollegiate Membership of the Royal College of Surgeons (MRCS) examination predict 'on-the-job' performance during UK higher specialty surgical training?

INTRODUCTION

The Intercollegiate Membership of the Royal College of Surgeons (MRCS) is a mandatory examination to enter higher surgical specialty training in the UK. It is designed to help to ensure that successful candidates are competent to practice as higher surgical trainees. The annual review of competence progression (ARCP) assesses trainees' competence to progress to the next level of training and can be interpreted as a measure of 'on-the-job' performance. We investigated the relationship between MRCS performance and ARCP outcomes.

MATERIALS AND METHODS

All UK medical graduates who passed MRCS (Parts A and B) from 2007 to 2016 were included. MRCS scores, attempts and sociodemographics for each candidate were crosslinked with ARCP outcomes (satisfactory, unsatisfactory and insufficient evidence). Multinomial logistic regression was used to identify potential independent predictors of ARCP outcomes.

RESULTS

A total of 2570 trainees underwent 11,064 ARCPs; 1589 (61.8%) had only satisfactory outcomes recorded throughout training; 510 (19.9%) had at least one unsatisfactory outcome; and 471 (18.3%) supplied insufficient evidence. After adjusting for age, gender, first language and Part A performance, ethnicity (non-white vs white, OR 1.36, 95% CI 1.08 to 1.71), Part B passing score (OR 0.98, 95% CI 0.98 to 1.00) and number of attempts at Part B (two or more attempts vs one attempt, OR 1.50, 95% CI 1.16 to 1.94) were found to be independent predictors of an unsatisfactory ARCP outcome.

CONCLUSIONS

This is the first study to identify predictors of ARCP outcomes during higher surgical specialty training in the UK and provides further evidence of the predictive validity of the MRCS examination.

Smoking, Haemostatic Factors and the Severity of Aorto-lliac and Femoro-Popliteal Disease

To determine relationships between haemostatic and rheological factors and severity of peripheral atherosclerosis and differences by site, an angiographic cross-sectional survey was carried out on 192 men and women with intermittent claudication or rest pain. 34 patients were classified as having aorto-iliac disease, 85 femoro-popliteal disease and 73 dual-site disease. Mean levels of haemostatic or rheological factors did not differ significantly between the three site groups. In all 192 patients, disease severity in the femoro-popliteal segments was correlated with plasma nephelometric fibrinogen (r = 0.20, p ≤0.01), von Willebrand factor (r = 0.14, p ≤0.05) and fibrin D-dimer (r = 0.22, p ≤0.001). On multiple regression analyses, fibrinogen was independently associated with disease severity in the femoro-popliteal segments (p ≤0.05), but not in the aorto-iliac segments. Adjustment for packyears or serum thiocyanate had little effect on the association of fibrinogen with severity of disease. An inverse relationship between plasminogen activator inhibitor and disease severity in the femoro-popliteal segments was found only in men (r = -0.24, p ≤0.01). We conclude that elevated fibrinogen and disturbed fibrinolytic activity may be related to the extent of disease within the femoro-popliteal arteries, more so than in the aorto-iliac arteries.