Disentangling the Roles of Cue Visibility and Knowledge in Adjusting Cognitive Control: A Preregistered Direct Replication of the Farooqui and Manly (2015) Study

Recent research suggests that people can learn to link the control process of task switching to predictive cues so that switch costs are attenuated following informative precues of switch likelihood. However, the precise conditions that shape such contextual cuing of control are not well understood. Farooqui and Manly (2015) raised the possibility that cued task switching is more effective when cues of control demand are presented subliminally. In the current study, we aimed to replicate and extend these findings by more systematically manipulating whether cues of control demand are consciously perceived or are presented subliminally and whether participants have explicit prior knowledge of the cue meaning or acquire cue knowledge through experience. The direct replication was unsuccessful: We found no evidence for effective subliminal cuing but observed some evidence for participants reducing switch costs with explicit, supraliminal cues. Thus, cognitive control may be guided most effectively by explicitly understood and consciously perceived precues.

Non-traumatic rhabdomyolysis complicating antihistamine overdose

Antihistamines are common over the counter medications which are frequently involved in overdoses. The usual clinical course is dominated by the anticholinergic affects of these agents; it includes significant autonomic and central nervous system effects and direct cardiac toxicity (1). We report a case of a suicide attempt in a young adult male where ingestion of the antihistamines diphenhydramine and doxylamine was complicated by non-traumatic rhabdomyolysis and acute renal failure.

Pediatric ingestions: charcoal alone versus ipecac and charcoal

STUDY OBJECTIVES

To determine the effect of syrup of ipecac (SOI) on time to receive and retention of activated charcoal (AC) and on total ED time.

DESIGN

During a two-year period, patients were enrolled in a prospective, randomized, unblinded, controlled trial.

SETTING

All patients were recruited and studied in a pediatric emergency department.

PARTICIPANTS

Seventy children less than 6 years old (mean age, 2.4 +/- 0.2 years) who presented with mild-to-moderate acute oral ingestions.

INTERVENTIONS

Group 1 received SOI before AC. Group 2 received only AC.

MEASUREMENTS AND MAIN RESULTS

Group 1 patients took significantly longer to receive AC than group 2 from the time of ED arrival (2.6 +/- 0.1 vs 0.9 +/- 0.1 hours, P less than .0001). Group 1 children were significantly more likely to vomit AC than were group 2 children (18 of 32 vs six of 38, P less than .001). Patients receiving SOI who were subsequently discharged spent significantly more time in the ED than those receiving only AC (4.1 +/- 0.2 vs 3.4 +/- 0.2 hours, P less than .05).

CONCLUSIONS

Ipecac delays the administration of AC, hinders its retention, and prolongs ED time in pediatric ingestion patients. These data support the recommendation that AC alone should be the gastrointestinal decontamination method of choice for the mild-to-moderate pediatric ingestion patient presenting to an ED.