Think TB! A rare case of influenza and rapid progressive Neurotuberculosis coinfection

An Indian migrant presented with increasing neurological symptoms after an acute influenza B infection. We diagnosed progressive neurotuberculosis—a rare and difficult case of tuberculosis and influenza co-infection. It highlights the importance of broad-based diagnostics in people from low- and middle-income countries, taking into account unusual manifestations of tuberculosis.

Kindness in short supply: Evidence for inadequate prosocial input

In everyday life, people often have opportunities to improve others' lives, whether offering well-intentioned advice or complimenting someone on a job well done. These are opportunities to provide "prosocial input" (information intended to benefit others), including feedback, advice, compliments, and expressions of gratitude. Despite widespread evidence that giving prosocial input can improve the well-being of both givers and recipients, people sometimes hesitate to offer their input. The current paper documents when and why people fail to give prosocial input, noting that potential givers overestimate the costs of doing so (e.g., making recipients uncomfortable) and underestimate the benefits (e.g., being helpful) for at least four psychological reasons. Unfortunately, the reluctance to give prosocial input results in a short supply of kindness.

Outcome of transcutaneous edge-to-edge mitral valve repair in patients with diabetes mellitus: results from a real-world cohort

Background

Transcutaneous edge-to-edge repair (TEER) has become a treatment option for selected patients with severe mitral regurgitation (MR). Analysis of the COAPT trial indicated patients with diabetes mellitus to have higher death rates and a trend to higher rates of heart failure hospitalization (HFH) than those without diabetes. However, in that study only patients with secondary MR with specific criteria were included and there are only limited data on diabetes patients in real-world settings.

Purpose

This study sought to evaluate safety and efficacy of TEER in patients with diabetes mellitus in comparison to non-diabetics.

Methods

In this monocentric study 340 consecutive patients with severe primary and secondary MR who underwent TEER were included. Immediate results of the procedure, intrahospital as well as one-year outcome were compared between patients with and without diabetes.

Results

Diabetes was present in 109 patients (32%) of the study group. Patients with diabetes were younger (75±8 vs. 78±8 years; p=0.003), had more often ischemic cardiomyopathy (68% vs. 48%, p<0.001), previous coronary-artery bypass graft (35% vs. 20%; p=0.002) and arterial hypertension (89% vs. 75%; p<0.001) compared to those without diabetes. All other baseline clinical and imaging characteristics including NYHA class, left ventricular dimensions and function (ejection fraction: 38±13% vs. 41±14%; p=0.10) as well as severity of MR were not different between both patient groups (Table 1).

Success of the procedure was comparable between patients with and without diabetes (95% vs. 95%; p=0.84). There was no difference in intrahospital mortality between both groups (5.5% vs. 4.8%; p=0.98). At one-year follow up, there was no difference regarding all-cause mortality (24.2% vs. 23.0%; p=0.72), HFH (37.4% vs. 31.0%, p=0.23), NYHA class (p=0.11) or MR severity (p=0.20) between both groups (Table 2).

Conclusion

In contrast to previous published data on patients with diabetes and severe MR TEER seems to be similar safe and effective in a real-world setting compared to non-diabetics.

Funding Acknowledgement

Type of funding sources: None.

POS0246 SEQUENTIAL RITUXIMAB AND MEPOLIZUMAB IN EOSINOPHILIC GRANULOMATOSIS WITH POLYANGIITIS

Background

Rituximab (RTX) is an effective remission-induction treatment in ANCA-associated vasculitides (AAVs). Some reports have suggested that it might be effective also in Eosinophilic Granulomatosis with Polyangiitis (EGPA), to induce and maintain remission of vasculitic manifestations [1,2]. However, its effects for preventing respiratory relapses seem to be poor. Mepolizumab (Mepo) (both 100 and 300mg/month) is effective in improving respiratory manifestations and lung function, while partially controlling also systemic activity [3,4]. Isolated case reports further indicate that the sequential therapy with RTX and Mepo might be effective [5-7].

Objectives

The study aimed to investigate the efficacy and safety of a therapeutic regimen based on sequential RTX and Mepo for the control of EGPA.

Methods

A multicenter, retrospective, cohort study was conducted on adult patients diagnosed with EGPA according to the ACR classification criteria [8] or MIRRA trial criteria [3]. Only patients who received induction therapy with RTX (any dosage), and subsequent treatment with Mepo (100-300 mg/4 weeks) within 12 months from last RTX administration were included. Patients receiving other induction therapies between RTX and Mepo were excluded. The effectiveness of sequential RTX and Mepo was assessed in terms of disease activity (by the Birmingham Vasculitis Activity Score, BVAS) and daily corticosteroid dosage. Safety data were also collected.

Results

Thirty-four EGPA patients treated with sequential RTX and Mepo were included (59% females, median age of 51 years (IQR 40-58); 41% ANCA positive).

In most cases (26/34; 76%), RTX was started at the dosage of 1g q2w, and all except two patients had active disease at time of RTX beginning [median BVAS of 9 (IQR 6-14)]. Specifically, most patients started RTX for the control of systemic manifestations (19/34; 56%), or of both systemic and respiratory symptoms (11/34; 32%). All except one patient were receiving oral corticosteroids, at a median dosage of 25 mg/day (10-38).

Mepo was started after a median of 14 months (6-23) from RTX initiation and after a median of 5 months (IQR 3-11) from the last RTX administration. Mepo was used at the dosage of 100mg/4 weeks in 32/34 (94%), mostly for the control of respiratory manifestations (25/34, 74%). At the time of starting Mepo, the median BVAS was 4 (2-8), and median prednisolone dose 10 mg/day (7-15). After a median follow-up of 28 months (IQR 23-33) from starting Mepo, the median BVAS decreased to 1.5 (IQR 0-4) and the median corticosteroid dosage to 5 mg/day (2.5-5), with 7/34 (21%) patients being off steroids. At last follow-up, most patients were off-RTX (28/34), typically due to stable disease remission (20/34; 59%).

Both RTX and Mepo were well-tolerated; 5 patients had adverse events on RTX (none serious), and 5 on Mepo (including one serious infection).

Conclusion

Sequential use of RTX and Mepo seems to be effective for remission induction and maintenance in EGPA.

References

[1]Emmi, Ann Rheum Dis, 2018

[2]Teixeira, RMD Open, 2019 3. Wechsler, NEJM, 2017

[4]Bettiol, Arthritis Rheumatol, 2021

[5]Shiroshita, Respir Med Case Rep, 2018

[6]Higashitani, Mod Rheumatol Case Rep, 2021

[7]Afiari, Cureus 2020

[8]Masi, Arthritis Rheum, 1990

Table 1.

Effectiveness of sequential RTX and Mepo in the 34 patients included in the study

RTX beginningMepo beginningLast follow-upMedian time elapsed (IQR)-14 months (6-23) from RTX beginning28 months (23-33) from Mepo beginningDosage1g q2w (26/34);100mg/4 weeks (32/34)6 patients off Mepo; 28 patients off RTX375mg/m2 for 4 weeks (8/34)300mg/4 weeks (2/34)Reason for treatment beginning (manifestations)Systemic (19/34);Respiratory (25/34);-Systemic + respiratory (11/34);Systemic (4/34);Only respiratory (3/34);Remission maintenance (5/34)Other (1/34)BVAS (median, IQR)9 (6-14)4 (2-8)1.5 (0-4)Prednisolone dosage (median, IQR), mg/day25 (10-38)10 (7-15)5 (2.5-5)

Disclosure of Interests

Alessandra Bettiol: None declared, Maria Letizia Urban: None declared, Federica Bello: None declared, Davide Fiori: None declared, Irene Mattioli: None declared, Giuseppe Lopalco: None declared, Florenzo Iannone: None declared, Allyson Egan: None declared, Luca Moroni: None declared, Lorenzo Dagna Consultant of: Consultation honoraria from GSK outside the current work, Marco Caminati: None declared, Simone Negrini: None declared, Paolo Cameli: None declared, Marco Folci: None declared, Paola Toniati: None declared, Roberto Padoan: None declared, Oliver Flossmann: None declared, Roser Solans-Laqué: None declared, Laura Losappio: None declared, Jan Schroeder Consultant of: Advisory Board fees from AstraZeneca and GSK, Marc André: None declared, Laura Moi: None declared, paola parronchi Consultant of: Consultation honoraria from GSK and Novartis, Fabrizio Conti: None declared, Savino Sciascia: None declared, David Jayne Consultant of: Consultant for Astra-Zeneca, Aurinia, BMS, Boehringer-Ingelheim, Chemocentryx, Chugai, CSL, GSK, Infla-RX, Janssen, Novartis, Roche/Genentech, Takeda and Vifor, Augusto Vaglio Consultant of: Consultation honoraria from GSK outside the current work, Giacomo Emmi Consultant of: Consultation honoraria from GSK outside the current work

Computational ethics

Technological advances are enabling roles for machines that present novel ethical challenges. The study of 'AI ethics' has emerged to confront these challenges, and connects perspectives from philosophy, computer science, law, and economics. Less represented in these interdisciplinary efforts is the perspective of cognitive science. We propose a framework - computational ethics - that specifies how the ethical challenges of AI can be partially addressed by incorporating the study of human moral decision-making. The driver of this framework is a computational version of reflective equilibrium (RE), an approach that seeks coherence between considered judgments and governing principles. The framework has two goals: (i) to inform the engineering of ethical AI systems, and (ii) to characterize human moral judgment and decision-making in computational terms. Working jointly towards these two goals will create the opportunity to integrate diverse research questions, bring together multiple academic communities, uncover new interdisciplinary research topics, and shed light on centuries-old philosophical questions.

"Just letting you know … " Underestimating others' desire for constructive feedback

People sometimes avoid giving feedback to others even when it would help fix others' problems. For example, only 2.6% of individuals in a pilot field study provided feedback to a survey administrator who had food or lipstick on their face. Five experiments (N = 1,984) identify a possible reason for the lack of feedback: People underestimate how much others want to receive constructive feedback. Initial experiments demonstrated this underestimation of others' desire for feedback in hypothetical scenarios (Experiment 1), recalled feedback experiences (Experiment 2), and real-time feedback among friends (Experiment 3). We further examine how people ascertain others' desire for feedback, testing how much they consider the potential consequences of feedback for themselves (e.g., discomfort giving feedback or harm to their relationship with the receiver) or the receiver (e.g., discomfort receiving feedback or value from feedback). While we found evidence that people consider both types of consequences, people particularly underestimated how much receivers value their feedback, a mechanism not extensively tested in prior research. Specifically, in Experiment 4, two interventions-making feedback-givers consider receivers' perspectives (enhancing consideration of receivers' consequences) or imagine someone else providing feedback (reducing consideration of givers' consequences)-both improved givers' recognition of others' desire for feedback compared to no intervention, but the perspective-taking intervention was most effective. Finally, Experiment 5 demonstrates the underestimation during a financially incentivized public-speaking contest and shows that giving less constructive feedback resulted in less improvement in feedback-receivers' performances. Overall, people consistently underestimate others' desire for feedback, with potentially negative consequences for feedback-receivers' outcomes. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Undersociality: miscalibrated social cognition can inhibit social connection

A person's well-being depends heavily on forming and maintaining positive relationships, but people can be reluctant to connect in ways that would create or strengthen relationships. Emerging research suggests that miscalibrated social cognition may create psychological barriers to connecting with others more often. Specifically, people may underestimate how positively others will respond to their own sociality across a variety of social actions, including engaging in conversation, expressing appreciation, and performing acts of kindness. We suggest that these miscalibrated expectations are created and maintained by at least three mechanisms: differential construal, uncertain responsiveness, and asymmetric learning. Underestimating the positive consequences of social engagement could make people less social than would be optimal for both their own and others' well-being.

Keep talking: (Mis)understanding the hedonic trajectory of conversation

People regularly interact with new acquaintances, yet little research has examined the hedonic dynamics of these conversations or the extent to which people are aware of them. Five preregistered laboratory experiments (N = 1,093 participants, including 966 spoken conversations) address these gaps. We find that people misunderstand the hedonic trajectory of conversation: After enjoying the initial minutes of conversation with a new acquaintance, participants expected their enjoyment to decline as their conversations continued, but experienced stable or increasing enjoyment in reality. This miscalibration arose at least partly because participants underestimated how much they would have to discuss. Thus, instructing participants to mentally simulate the conversation in detail drew their attention to the conversation material they could discuss and helped to calibrate their enjoyment predictions. When left uncorrected, misunderstanding the hedonic trajectory of conversation can undermine well-being. In one study, participants preferred to spend less time in conversation and more time alone than was optimal for their enjoyment-a finding that emerged even among participants who reported wanting to enjoy themselves. Throughout our experiments we assessed various conversational contexts (including whether participants had one long conversation with a single partner or several short conversations with different partners), and features of conversation (including participants' perceived and actual interest in talking to each other, fatigue, and the intimacy of conversation), thus shining novel light on conversational dynamics more broadly. People hold incorrect assumptions about how social interaction changes over time and, consequently, may avoid longer-lasting conversations that would forge closer connections. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Hello, stranger? Pleasant conversations are preceded by concerns about starting one

Connecting with others makes people happier, but strangers in close proximity often ignore each other. Prior research (Epley & Schroeder, 2014) suggested this social disconnection stems from people misunderstanding how pleasant it would be to talk with strangers. Extending these prior results, in a field experiment with London-area train commuters, those assigned to talk with a stranger reported having a significantly more positive experience, and learning significantly more, than those assigned to a solitude or control condition. Commuters also expected a more positive experience if they talked to a stranger than in the solitude or control conditions. A second experiment explored why commuters nevertheless avoid conversation even when it is generally pleasant. Commuters predicted that trying to have a conversation would be less pleasant than actually having one because they anticipated that others would be uninterested in talking. These experiments clarify the precise aspects of social interaction that may be misunderstood. People may avoid pleasant conversations with strangers because of miscalibrated concerns about starting them. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Ending Conversation is a Fraught Endeavor

Have you ever been in a conversation that lasted too long or ended too soon? According to recent findings from Mastroianni et al., conversations rarely end when people want them to end. I propose a framework for studying conversation and outline new questions that follow from Mastroianni and colleagues' generative studies.

When alterations are violations: Moral outrage and punishment in response to (even minor) alterations to rituals

From Catholics performing the sign of the cross since the 4th century to Americans reciting the Pledge of Allegiance since the 1890s, group rituals (i.e., predefined sequences of symbolic actions) have strikingly consistent features over time. Seven studies (N = 4,213) document the sacrosanct nature of rituals: Because group rituals symbolize sacred group values, even minor alterations to them provoke moral outrage and punishment. In Pilot Studies A and B, fraternity members who failed to complete initiation activities that were more ritualistic elicited relatively greater moral outrage and hazing from their fraternity brothers. Study 1 uses secular holiday rituals to explore the dimensions of ritual alteration-both physical and psychological-that elicit moral outrage. Study 2 suggests that altering a ritual elicits outrage even beyond the extent to which the ritual alteration is seen as violating descriptive and injunctive norms. In Study 3, group members who viewed male circumcision as more ritualistic (i.e., Jewish vs. Muslim participants) expressed greater moral outrage in response to a proposal to alter circumcision to make it safer. Study 4 uses the Pledge of Allegiance ritual to explore how the intentions of the person altering the ritual influence observers' moral outrage and punishment. Finally, in Study 5, even minor alterations elicited comparable levels of moral outrage to major alterations of the Jewish Passover ritual. Across both religious and secular rituals, the more ingroup members believed that rituals symbolize sacred group values, the more they protected their rituals-by punishing those who violated them. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

A sacred commitment: How rituals promote group survival

Religious groups have survived for thousands of years despite drastic changes in society. One reason for their successful survival is the proliferation of group rituals (i.e. meaningful sequences of actions characterized by rigidity, formality, and repetition). We propose that rituals enhance religious group survival not only by signaling external commitment but also by fostering internal commitment toward the group in three ways: (1) enhancing belief in the group's values ('committed cognition'), (2) increasing the desire to maintain membership in the group ('committed affect'), and (3) increasing contributions to the welfare of the group ('committed behavior'). We conclude with a call for new empirical research on how participating in rituals can enhance internal commitment toward one's group (116/120).

When "enemies" become close: Relationship formation among Palestinians and Jewish Israelis at a youth camp

Having close relationships with outgroup members is an especially powerful form of intergroup contact that can reduce prejudice. Rather than examine the consequences of forming close outgroup relationships, which has previously been studied as part of intergroup contact theory, we examine how outgroup relationships-relative to ingroup relationships-form in the first place. We collected 7 years of data from Jewish Israeli and Palestinian teenagers attending a 3-week summer camp at Seeds of Peace, one of the largest conflict transformation programs in the world. We tested how being assigned to share an activity group (e.g., bunk, table, dialogue group) influenced relationship formation among outgroup pairs (Jewish Israeli-Palestinian) compared with ingroup pairs (Israeli-Israeli, Palestinian-Palestinian). Existing research offers competing theories for whether propinquity is more impactful for the formation of ingroup or outgroup relationships; here, we found propinquity was significantly more impactful for outgroup relationships. Whereas 2 ingroup participants were 4.46 times more likely to become close if they were in the same versus different bunk, for example, 2 outgroup participants were 11.72 times more likely to become close. We propose that sharing an activity group is especially powerful for more dissimilar dyads because people are less likely to spontaneously engage with outgroup members in ways that promote relationships. Thus, structured, meaningful engagement can counteract homophily. Furthermore, in this setting, propinquity proved to be an even better predictor of outgroup (vs. ingroup) relationship formation than that pair's initial outgroup attitudes. We discuss theoretical and practical implications for intergroup processes and relationship formation. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Human "resources"? Objectification at work

People behave differently when at work than not at work; for example, they are less interested in making close friends and use more transactional language (networking vs. socializing). These examples hint at a broader phenomenon: that people engage in more objectification-treating people akin to objects-in work contexts than non work contexts. We propose that objectification is more prevalent at work because people engage in more calculative and strategic thinking (i.e., making decisions by computing the costs and benefits). Seven studies (N = 2,712) test this. In Study 1, participants objectified the same individuals more when they were pictured at work (e.g., in an office) than not at work (e.g., in a coffee shop). In Study 2, there was more objectification when the same event was framed as more (vs. less) work-related. Studies 3a and 3b (experience-sampling studies with 2,300 data points) show that working adults objectify others more during work than non work interactions and demonstrate which situational characteristics enhance objectification. Study 4 manipulates the proposed mechanism: Participants nudged to think less calculatively and strategically showed a reduced tendency to objectify others in work contexts. Considering consequences, job applicants in Study 5 who read company mission statements containing more calculative language expected more objectification and were less interested in applying. Moreover, employees who perceived more objectification in their workplace reported more negative work experiences (e.g., feeling lower belonging, experiencing more incivility; Study 6). Together, these studies provide insight into how objectification arises, where it occurs, and its consequences. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Tell it like it is: When politically incorrect language promotes authenticity

When a person's language appears to be political-such as being politically correct or incorrect-it can influence fundamental impressions of him or her. Political correctness is "using language or behavior to seem sensitive to others' feelings, especially those others who seem socially disadvantaged." One pilot study, 6 experiments, and 3 supplemental experiments (N = 4,956) demonstrate that being politically incorrect makes communicators appear more authentic-specifically, less susceptible to external influence-albeit also less warm. These effects, however, are moderated by perceivers' political ideology and how sympathetic perceivers feel toward the target group being labeled politically correctly. In Experiments 1, 2, and 3 using politically incorrect language (e.g., calling undocumented immigrants illegals) made a communicator appear particularly authentic among conservative perceivers but particularly cold among liberal perceivers. However, in Experiment 4 these effects reversed when conservatives felt sympathetic toward the group that was being labeled politically correctly or incorrectly (e.g., calling poor Whites white trash). Experiment 5 tests why political incorrectness can boost authenticity, demonstrating that it makes communicators seem less strategic. Finally, Experiment 6 examines the use of political language in a meaningful field context: perceived persuasion in real political debates. Debaters instructed to be politically correct (vs. politically incorrect) were judged by their uninstructed conversation partners to be easier to persuade during the conversation, although they actually reported being similarly persuaded. Together, these findings demonstrate when and how using politically incorrect language can enhance a person's authenticity. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

OP0148 MEPOLIZUMAB FOR EOSINOPHILIC GRANULOMATOSIS WITH POLYANGIITIS (EGPA): A RETROSPECTIVE REAL-WORLD EUROPEAN STUDY ON 142 PATIENTS

Background:

Evidence on the efficacy of Mepolizumab (MEPO) in Eosinophilic Granulomatosis with Polyangiitis (EGPA) is scarce [1].

Objectives:

To assess the efficacy and safety of MEPO in real-life clinical practice.

Methods:

We retrospectively included patients diagnosed with EGPA and treated with MEPO (100 or 300 mg/month). MEPO efficacy was evaluated in the first 12 months in terms of systemic disease and asthma control. The occurrence of any adverse event (AE) was recorded.

Results:

142 patients were included (38% males; median age 46.4 (IQR 36.7-54.4); 110 and 32 on MEPO 100 and 300 mg/month, respectively). General, ear-nose-throat, pulmonary, and neurological symptoms significantly decreased during treatment (table 1). MEPO accounted for a significant reduction in the BVAS (figure 1) and for a steroid sparing effect (figure 2). The proportion of patients with asthma attacks decreased by 90% at 12 months compared to t0, and asthma-related emergency accesses dropped from 17.4% to 2.3%. Overall, 21.1% of patients had a non-serious AE.

Table 1.

Control of clinical symptoms

MEPO beginning (t0)3 monthsp-value(t3 vs t0)6 monthsp-value(t6 vs t0)12 monthsp-value(t12 vs t0)N obsN=142N=135N=123N=89General symptoms40 (28.2%)17 (12.6%)<0.00119 (15.5%)<0.00113 (14.6%)0.002Cutaneous manifestations13 (9.2%)6 (4.4%)0.0085 (4.1%)0.0254 (4.5%)0.180ENT manifestations106 (74.7%)52 (38.5%)<0.00144 (35.8%)<0.00129 (32.6%)<0.001Pulmonary manifestations130 (91.6%)59 (43.7%)<0.00139 (31.7%)<0.00128 (31.5%)<0.001Cardiac manifestations6 (4.2%)2 (1.5%)0.0832 (1.6%)0.08300.157Intestinal manifestations10 (7.0%)1 (0.7%)0.0054 (3.3%)0.0593 (3.4%)0.059Renal manifestations5 (3.5%)3 (2.2%)0.41400.0461 (1.1%)0.317Neurological manifestations36 (25.4%)22 (16.3%)0.01218 (14.6%)0.00310 (11.2%)0.035Figure 1.

Changes in BVAS

Figure 2.

Steroid treatment

Conclusion:

MEPO effectively controlled systemic and respiratory EGPA symptoms in a large European cohort, with no major safety concerns.

References:

[1]Wechsler et al. MEPO or Placebo for Eosinophilic Granulomatosis with Polyangiitis. NEJM. 2017

Disclosure of Interests:

Alessandra Bettiol: None declared, Maria Letizia Urban: None declared, Federico Alberici: None declared, Carlo Agostini: None declared, Chiara Baldini: None declared, Enrica Bozzolo: None declared, Paolo Cameli: None declared, Nunzio Crimi: None declared, Stefano Del Giacco: None declared, Allyson Egan: None declared, Georgina Espigol-Frigole Consultant of: Roche and Janssen, Mara Felicetti: None declared, Marco Folci: None declared, Paolo Fraticelli: None declared, Marcello Govoni: None declared, Anna Kernder Grant/research support from: Grant/research support from: GlaxoSmithKline and UCB Pharma for performing the LuLa-study., Carlo Lombardi: None declared, Giuseppe Lopalco: None declared, Claudio Lunardi: None declared, Aladdin J Mohammad Speakers bureau: lecture fees from Roche and Elli Lilly Sweden, PI (GiACTA study), Frank Moosig: None declared, Simone Negrini: None declared, Thomas Neumann: None declared, Pavel Novikov Grant/research support from: This work was supported by the 5-100 Project, Sechenov University, Moscow, Giuseppe Paolazzi: None declared, paola parronchi: None declared, Luca Quartuccio Consultant of: Abbvie, Bristol, Speakers bureau: Abbvie, Pfizer, Vito Racanelli: None declared, Carlo Salvarani: None declared, Maxime Samson: None declared, Jan Schroeder: None declared, Savino Sciascia: None declared, Renato A. Sinico: None declared, Benjamin Terrier: None declared, Paola Toniati: None declared, Domenico Prisco: None declared, Augusto Vaglio: None declared, Giacomo Emmi: None declared

Demeaning: Dehumanizing others by minimizing the importance of their psychological needs

We document a tendency to demean others' needs: believing that psychological needs-those requiring mental capacity, and hence more uniquely human (e.g., need for meaning and autonomy)-are relatively less important to others compared with physical needs-those shared with other biological agents, and hence more animalistic (e.g., need for food and sleep). Because valuing psychological needs requires a sophisticated humanlike mind, agents presumed to have relatively weaker mental capacities should also be presumed to value psychological needs less compared with biological needs. Supporting this, our studies found that people demeaned the needs of nonhuman animals (e.g., chimpanzees) and historically dehumanized groups (e.g., drug addicts) more than the needs of close friends or oneself (Studies 1 and 3). Because mental capacities are more readily recognized through introspection than by external observation, people also demean peers' needs more than their own, inferring that one's own behavior is guided more strongly by psychological needs than identical behavior in others (Study 4). Two additional experiments suggest that demeaning could be a systematic error (Studies 5 and 6), as charity donors and students underestimated the importance of homeless people's psychological (vs. physical) needs compared with self-reports and choices from homeless people. Underestimating the importance of others' psychological needs could impair the ability to help others. These experiments indicate that demeaning is a unique facet of dehumanization reflecting a reliable, consequential, and potentially mistaken understanding of others' minds. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Meloidogyne aegracyperi n. sp. (Nematoda: Meloidogynidae), a root-knot nematode parasitizing yellow and purple nutsedge in New Mexico

Meloidogyne aegracyperi n. sp. is described from roots of purple nutsedge in southern New Mexico, USA. Mature females are small (310–460 µm), pearly white, with their egg masses completely contained inside root galls. The neck is often at a 90 to 130° angle to the protruding posterior end with the perineal pattern. The distance of the dorsal esophageal gland orifice (DGO) to the base of the stylet is relatively long (4.0–6.1 µm), and the excretory pore is level with the base of the stylet. The anterior portion of the rounded lumen lining of the metacorpus contains 3 to 10 small vesicles. The perineal pattern has a rounded dorsal arch with a tail terminal area that is smooth or marked with rope-like striae. Only two males were found. The body twists 90° throughout its length. The DGO to the base of the stylet is long (3.0–3.3) µm. The cephalic framework of the second-stage juvenile is weak, and the stylet is short (10.1–11.8 µm). The DGO to the base of the stylet is long (3–5 µm). The tail is very long (64–89 µm) and the hyaline portion of the tail is very narrow, making the tail finely pointed. Eggs are typical for the genus and vary in length (85.2–99.8 µm) and width (37.1–48.1 µm), having a L/W ratio of (2.1–2.6). Maximum likelihood phylogenetic analyses of the different molecular loci (partial 18S rRNA, D2-D3 of 28S rRNA, internal transcribed spacer (ITS) rRNA, cytochrome oxidase subunit II (COII)-16S rRNA of mitochondrial DNA gene fragments and partial Hsp90 gene) placed this nematode on an independent branch in between M. graminicola and M. naasi and a cluster of species containing M. chitwoodi. M. fallax, and M. minor. Greenhouse tests showed that yellow and purple nutsedge were the best hosts, but perennial ryegrass, wheat, bentgrass, and barley were also hosts.

Enacting rituals to improve self-control

Rituals are predefined sequences of actions characterized by rigidity and repetition. We propose that enacting ritualized actions can enhance subjective feelings of self-discipline, such that rituals can be harnessed to improve behavioral self-control. We test this hypothesis in 6 experiments. A field experiment showed that engaging in a pre-eating ritual over a 5-day period helped participants reduce calorie intake (Experiment 1). Pairing a ritual with healthy eating behavior increased the likelihood of choosing healthy food in a subsequent decision (Experiment 2), and enacting a ritual before a food choice (i.e., without being integrated into the consumption process) promoted the choice of healthy food over unhealthy food (Experiments 3a and 3b). The positive effect of rituals on self-control held even when a set of ritualized gestures were not explicitly labeled as a ritual, and in other domains of behavioral self-control (i.e., prosocial decision-making; Experiments 4 and 5). Furthermore, Experiments 3a, 3b, 4, and 5 provided evidence for the psychological process underlying the effectiveness of rituals: heightened feelings of self-discipline. Finally, Experiment 5 showed that the absence of a self-control conflict eliminated the effect of rituals on behavior, demonstrating that rituals affect behavioral self-control specifically because they alter responses to self-control conflicts. We conclude by briefly describing the results of a number of additional experiments examining rituals in other self-control domains. Our body of evidence suggests that rituals can have beneficial consequences for self-control. (PsycINFO Database Record

P3721Clinical and echocardiographic outcomes after treatment of patent foramen ovale with two transcatheter occlusion devices: mononcenter observational study

Background

Percutaneous closure of patent foramen ovale (PFO) after cryptogenic stroke (CS) is strongly recommended in the current guidelines. Most available evidence has been obtained from randomized studies in which Amplatzer PFO occluder device or Groe occluder device were implanted. Several occluder devices are used off-label for percutaneous treatment of PFO. Rate of recurrent CS and rate of residual shunting after percutaneously occlusion of PFO varies between different occlusion devices. To date, there are no randomized clinical studies that compare the effectivity and safety of several devices in patients with CS.

Aim

The aim of this study was to compare rate of residual shunting and recurrent CS after percutaneus treatment of PFO with the most common used PFO occluder devises.

Methods

This was a retrospective, non-randomized, monocenter study. Between 2008 and 2014, all patients with CS or transient ischemic attack (TIA) treated with transcatheter occlusion of PFO with Amplatzer PFO occlusion device or Occlutech occlusion device were included. Patients were followed up at 1 and 6 months with contrast-enhanced transesophageal echocardiography (TEE), and at 3 months with contrast-enhanced transthoracic echocardiography. Primary endpoint was residual shunting at 6 months. Secondary endpoint was recurrent CS or TIA at 6 months after the procedure.

Results

220 consecutive patients (57±12 year, 131 men) were treated with Amplanz PFO occlusion device (140 patients) or Occlutech PFO occlusion device (80 patients) after CS or TIA. Procedural success was 100% in both groups. Residual shunting was observed directly after the procedure in 26 patients in the Amplatzer group and 22 patients in the Occlutech group (19% and 27%, respectively; p=0.003), at 1 months follow (15% and 25%, respectively; p=0.064) and at 6 months (9% and 16%, respectively; p=0.024). There was no significant difference between both groups according recurrent CS (0.7% and 0%, respectively; p=0.449). At 6 months follow up atrial fibrillation was detected in 2 patients from Amplatzer group and 5 patients from Occlutech group (1.4% and 6.0%, respectively; p=0.050). Death, aortic erosion and pericardial effusion was not observed in both groups.

Clinical and echocardiographic outcome Variable Amplatzer occluder device (N=140) Occlutech occluder device (N=80) p-value Clinical outcome at 6 months follow up   Death, n (%) 0 (0%) 0 (0%) 1.000   Stroke, n (%) 1 (1%) 0 (0%) 0.449   Transient ischemic attack, n (%) 0 (0%) 0 (0%) 1.000   Atrial fibrillation, n (%) 2 (1.4%) 5 (6%) 0.050   Aortic erosion, n (%) 0 (0%) 0 (0%) 1.000   Pericardial effusion, n (%) 0 (0%) 0 (0%) 1.000 Echocardiographic Outcome at 6 months follow up   Residual shunting after Implantation directly, n (%) 26 (19%) 22 (27%) 0.003   Residual shunting at one month, n (%) 21 (15%) 20 (25%) 0.064   Residual shunting at 6 months, n (%) 13 (9%) 16 (20%) 0.024

Conclusion

Percutaneous treatment of PFO after CS or TIA with Amplatzer PFO occluder device was associated with lower rate of residual shunting and lower rate of atrial fibrillation at 6 months follow up, whereas rate of recurrent CS and TIA was comparable between both groups.

Power and decision making: new directions for research in the age of artificial intelligence

Throughout history, the experience of power has occurred within the context of human-human interactions. Such power can influence decision making through at least two primary mechanisms: (1) increased goal-orientation, and (2) increased activation of social role expectations. Importantly, new advances in artificial intelligence (AI) are creating the potential to experience power in human-AI interactions. To the extent that some forms of AI can be made to seem like low-power humans (e.g. autonomous digital assistants), people may feel powerful when interacting with such entities. However, it is unclear whether feeling power over AI will lead to the same psychological consequences as feeling power over humans. In this article, we review findings on power and decision making and then consider how they may be meaningfully extended by considering interactions with artificially intelligent digital assistants. We conclude with a call for new theorizing and research on power in the age of artificial intelligence.

Handshaking promotes deal-making by signaling cooperative intent

We examine how a simple handshake-a gesture that often occurs at the outset of social interactions-can influence deal-making. Because handshakes are social rituals, they are imbued with meaning beyond their physical features. We propose that during mixed-motive interactions, a handshake is viewed as a signal of cooperative intent, increasing people's cooperative behavior and affecting deal-making outcomes. In Studies 1a and 1b, pairs who chose to shake hands at the onset of integrative negotiations obtained better joint outcomes. Study 2 demonstrates the causal impact of handshaking using experimental methodology. Study 3 suggests a driver of the cooperative consequence of handshaking: negotiators expected partners who shook hands to behave more cooperatively than partners who avoided shaking hands or partners whose nonverbal behavior was unknown; these expectations of cooperative intent increased negotiators' own cooperation. Study 4 uses an economic game to demonstrate that handshaking increased cooperation even when handshakes were uninstructed (vs. instructed). Further demonstrating the primacy of signaling cooperative intent, handshaking actually reduced cooperation when the action signaled ill intent (e.g., when the hand-shaker was sick; Study 5). Finally, in Study 6, executives assigned to shake hands before a more antagonistic, distributive negotiation were less likely to lie about self-benefiting information, increasing cooperation even to their own detriment. Together, these studies provide evidence that handshakes, ritualistic behaviors imbued with meaning beyond mere physical contact, signal cooperative intent and promote deal-making. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Natural cause mortality in persons with serious mental illness

OBJECTIVE

To identify the determinants of natural cause mortality in a cohort of individuals with serious mental illness assessed prospectively.

METHOD

Persons with schizophrenia (n = 789) and bipolar disorder (n = 498), mean age of 38 (s.d. 12.6) years, underwent an in-person clinical assessment. They also had a blood sample drawn from which infectious disease markers were measured. Mortality was subsequently determined utilizing data from the National Death Index following a period of up to 16.9 years.

RESULTS

A total of 6.8% (87 of 1287) of persons died of natural causes. Mortality was predicted in a multivariate model by baseline cigarette smoking (RR = 6.29, 95% CI 1.41, 3.72, P = 0.00076); divorced or widowed status (RR = 1.90, CI 1.21, 2.99); reduced cognitive score (RR = 0.73, CI 0.61, 0.87); receipt of antidepressant medication (RR = 1.74, CI 1.12, 2.71); elevated levels of antibodies to Epstein-Barr virus (EBV) (RR = 1.29, CI 1.01, 1.66); and a genitourinary (RR = 1.82, CI 1.16, 2.86), respiratory (RR = 1.82, CI 1.16, 2.86), or cardiac (RR = 2.09, CI 1.33, 3.29) condition. There was an additive effect of smoking and both a cardiac and a respiratory condition but not elevated EBV antibody levels.

CONCLUSION

Smoking is a modifiable behaviour which is associated with mortality in this population.

The Psychology of Rituals: An Integrative Review and Process-Based Framework

Traditionally, ritual has been studied from broad sociocultural perspectives, with little consideration of the psychological processes at play. Recently, however, psychologists have begun turning their attention to the study of ritual, uncovering the causal mechanisms driving this universal aspect of human behavior. With growing interest in the psychology of ritual, this article provides an organizing framework to understand recent empirical work from social psychology, cognitive science, anthropology, behavioral economics, and neuroscience. Our framework focuses on three primary regulatory functions of rituals: regulation of (a) emotions, (b) performance goal states, and (c) social connection. We examine the possible mechanisms underlying each function by considering the bottom-up processes that emerge from the physical features of rituals and top-down processes that emerge from the psychological meaning of rituals. Our framework, by appreciating the value of psychological theory, generates novel predictions and enriches our understanding of ritual and human behavior more broadly.

The Humanizing Voice: Speech Reveals, and Text Conceals, a More Thoughtful Mind in the Midst of Disagreement

A person's speech communicates his or her thoughts and feelings. We predicted that beyond conveying the contents of a person's mind, a person's speech also conveys mental capacity, such that hearing a person explain his or her beliefs makes the person seem more mentally capable-and therefore seem to possess more uniquely human mental traits-than reading the same content. We expected this effect to emerge when people are perceived as relatively mindless, such as when they disagree with the evaluator's own beliefs. Three experiments involving polarizing attitudinal issues and political opinions supported these hypotheses. A fourth experiment identified paralinguistic cues in the human voice that convey basic mental capacities. These results suggest that the medium through which people communicate may systematically influence the impressions they form of each other. The tendency to denigrate the minds of the opposition may be tempered by giving them, quite literally, a voice.

Heritability and social brood effects on personality in juvenile and adult life-history stages in a wild passerine

How has evolution led to the variation in behavioural phenotypes (personalities) in a population? Knowledge of whether personality is heritable, and to what degree it is influenced by the social environment, is crucial to understanding its evolutionary significance, yet few estimates are available from natural populations. We tracked three behavioural traits during different life-history stages in a pedigreed population of wild house sparrows. Using a quantitative genetic approach, we demonstrated heritability in adult exploration, and in nestling activity after accounting for fixed effects, but not in adult boldness. We did not detect maternal effects on any traits, but we did detect a social brood effect on nestling activity. Boldness, exploration and nestling activity in this population did not form a behavioural syndrome, suggesting that selection could act independently on these behavioural traits in this species, although we found no consistent support for phenotypic selection on these traits. Our work shows that repeatable behaviours can vary in their heritability and that social context influences personality traits. Future efforts could separate whether personality traits differ in heritability because they have served specific functional roles in the evolution of the phenotype or because our concept of personality and the stability of behaviour needs to be revised.

Comparison of two interdental cleaning aids: A randomized clinical trial

AIM

The aim of this study was a comparison of the handling and acceptance of two kinds of interdental brushes (interdental brush with a handle [HB] and a newly invented interdental cleaning device [NB]).

METHODS AND MATERIALS

In a randomized crossover trial, 40 test subjects with an average number of 23.5 interdental areas were examined. At two appointments with a "washout" period of one week, the volunteers tried out both cleaning tools (HB and NB). They were asked to clean as many interdental spaces as possible. The percentage of spaces, which could be reached, is the IRI (Interdental Reachability Index). Furthermore, subjective impressions were determined.

RESULTS

The average IRI using HB was 64% compared to 80% using of NB (P<.001); 62.5% of the volunteers found the cleaning with HB painful and 15% the cleaning with NB. The subjective feeling after cleaning was 1.75 with NB compared to 2.2 with HB (P=.015), grading the feeling, from 1 for "very good" to 5 for "poor." The acceptance of regular interdental hygiene was rated 1.95 in the case of the NB and 2.85 in the case of the HB. After both appointments, the test subjects declared that they would use the NB 3.05 times and the HB 1.78 times a week.

CONCLUSION

This study shows that the test subjects reached more interdental spaces with NB than with the HB. NB can improve the usage of interdental brushes. Regarding subjective comfort, participants also favoured NB over HB.

Functional intimacy: Needing-But not wanting-The touch of a stranger

Intimacy is often motivated by love, but sometimes it is merely functional. For example, disrobing and being touched at an airport security check serves the goal of catching a flight, not building a relationship. We propose that this functional intimacy induces discomfort, making people prefer greater social distance from their interaction partner. Supporting this prediction, participants who considered (Experiments 1 and 2) or experienced (Experiment 3) more physically intimate medical procedures preferred a health provider who is less social. Increased psychological intimacy also led people to prefer social distance from cleaning and health providers (Experiments 4-5), a preference revealed by nonverbal behavior (e.g., turning away and looking away, Experiments 6-7). These patterns of distancing are unique to functional (vs. romantic) intimacy (Experiment 7). Although creating social distance may be an effective strategy for coping with functional intimacy, it may have costs for service providers. (PsycINFO Database Record

Impact of a pre- and postoperative chemotherapy (Ctx) on overall survival (OS) and progression free survival (PFS) in locally advanced gastric cancer (LAGC)

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Background: Perioperative Ctx has become standard of care for LAGC. Duration of pre- and post-op Ctx is a matter of debate. Our study evaluated effects of varying durations of pre- and post-op Ctx on PFS and OS. Secondary endpoints were toxicity, reasons for cessation of Ctx and response. We compared the outcome to a group of pts receiving no perioperative Ctx as an internal control. Methods: Pts with LAGC were included in a prospective cohort trial from a single institution from 2007 to 2015. Inclusion criteria were T1-T4, N0-3, M0, AEG (n=27) or gastric cancers (n=65). Initial therapy decisions were made by an interdisciplinary tumor board for all pts. Pts received DDP/5-FU (qw d28 mod FFCD-Protocol, Ychou et al. JCO 2011) for 2 mo, and a 3rd mo of pre-op Ctx in case of non-progression after 2 mo and proceeded to Ctx after surgery for a planned total of six mo of Ctx. Results: 92 pts (53 m; 39 f pts) with a median age of 69 ys (range 33-96) were included. A total of 74 pts were recommended periop Ctx and 18 primary surgery (S). A total of 67 (91%) of the periop Ctx received pre-op Ctx (NA) of which 47 (64%) received 3 mo of pre-op Ctx, 19 (26%) two mo, 1 pt (1%) one mo, and 7 pts refused preop Ctx (9%) of which only 3 proceeded to surgery. Only 53 pts (72 %) received post-op Ctx; 25 pts (34%) received three mo, 9 pts (12 %) two mo, and another 10 pts (14 %) one mo of postop Ctx. Nine pts (13%) in the NA group and 20 pts (39%) in the post-op Ctx group had to stop Ctx due to toxicity after 1 (n=11) and <2 (n=9) mo of Ctx. Only 23 pts (31%) received the planned pre- and postop Ctx of 6 mo in total. Up to 07/2016 a total of 36 deaths were observed (39%). 5 yr PFS was 49% in the group of periop Ctx vs 14% in the S group. PFS in pts receiving a total of < 4 mo of Ctx was 36% vs. 61% in pts receiving 6 mo of Ctx. 3 yr OS was 19% in the S group vs 48% in the Ctx group. The OS in pts receiving < 4 mo was 34% vs.43% in pts with 6 mo Ctx. A pCR after preop Ctx was observed in 2 pts, a PR in 47 pts, a SD in 12 pts, while a PD occurred in 3 pts only. Conclusions: Pre-op Ctx was considerably better tolerated than post-op Ctx and led to fewer Tx cessations. We found a better PFS for pts with >4 mo of periop Ctx, as well as OS was affected by a shorter duration of periop Ctx.

The feasibility, usability, and clinical utility of traditional paper food and symptom journals for patients with irritable bowel syndrome

BACKGROUND

Paper food and gastrointestinal (GI) symptom journals are used to help irritable bowel syndrome (IBS) patients determine potential trigger foods. The primary aim of this study was to evaluate the feasibility, usability, and clinical utility of such journals as a data collection tool. A secondary aim was to explore a method for analyzing journal data to describe patterns of diet and symptoms.

METHODS

Participants (N=17) were asked to log three sets of 3-day food and symptom journals over a 15-day period. Feasibility was evaluated by journal completion rates, symptom logging compliance, and logging fatigability. The feasibility, usability, and clinical utility of journaling were also assessed by a customized evaluation and exit interview. For each journal, regression analyses were conducted to examine relationships between key meal nutrients and subsequent symptoms.

KEY RESULTS

Most participants were young (mean age 35±12) Caucasian (N=13) women (N=14). Journal completion rates were 100% for all participants with no logging fatigability. Over half perceived paper journaling of food and symptoms as feasible, usable, and clinically useful. Thirteen participants demonstrated a strong association with at least one symptom and meal nutrient. Patterns of associations differed among participants.

CONCLUSIONS AND INFERENCES

Paper journaling of food and GI symptoms for 9 days over a 15-day period appeared to be a feasible and usable data collection tool for IBS patients. Over half perceived journaling as at least somewhat clinically useful. Findings from this study support the anecdote that food trigger(s) and associated symptom(s) vary for each individual.

High sensitivity far infrared laser diagnostics for the C-2U advanced beam-driven field-reversed configuration plasmas

A high sensitivity multi-channel far infrared laser diagnostics with switchable interferometry and polarimetry operation modes for the advanced neutral beam-driven C-2U field-reversed configuration (FRC) plasmas is described. The interferometer achieved superior resolution of 1 × 10¹⁶ m^-2 at >1.5 MHz bandwidth, illustrated by measurement of small amplitude high frequency fluctuations. The polarimetry achieved 0.04° instrument resolution and 0.1° actual resolution in the challenging high density gradient environment with >0.5 MHz bandwidth, making it suitable for weak internal magnetic field measurements in the C-2U plasmas, where the maximum Faraday rotation angle is less than 1°. The polarimetry resolution data is analyzed, and high resolution Faraday rotation data in C-2U is presented together with direct evidences of field reversal in FRC magnetic structure obtained for the first time by a non-perturbative method.

Many hands make overlooked work: Over-claiming of responsibility increases with group size

Logically, group members cannot be responsible for more than 100% of the group's output, yet claims of responsibility routinely sum to more than 100%. This "over-claiming" occurs partly because of egocentrism: People focus on their own contributions, as focal members of the group, more than on others' contributions. Therefore, we predicted that over-claiming would increase with group size because larger groups leave more contributions from others to overlook. In 2 field studies, participants claimed more responsibility as the number of academic authors per article and the number of MBA students per study group increased. As predicted by our theoretical account, this over-claiming bias was reduced when group members considered others' contributions explicitly. Two experiments that directly manipulated group size replicated these results. Members of larger groups may be particularly well advised to consider other members' contributions before considering their own. (PsycINFO Database Record