The line bisection bias as a deficit of proportional reasoning - evidence from number line estimation in neglect

This study aimed to investigate whether neurological patients presenting with a bias in line bisection show specific problems in bisecting a line into two equal parts or their line bisection bias rather reflects a special case of a deficit in proportional reasoning more generally. In the latter case, the bias should also be observed for segmentations into thirds or quarters. To address this question, six neglect patients with a line bisection bias were administered additional tasks involving horizontal lines (e.g., segmentation into thirds and quarters, number line estimation, etc.). Their performance was compared to five neglect patients without a line bisection bias, 10 patients with right hemispheric lesions without neglect, and 32 healthy controls. Most interestingly, results indicated that neglect patients with a line bisection bias also overestimated segments on the left of the line (e.g., one third, one quarter) when dissecting lines into parts smaller than halves. In contrast, such segmentation biases were more nuanced when the required line segmentation was framed as a number line estimation task with either fractions or whole numbers. Taken together, this suggests a generalization of line bisection bias towards a segmentation or proportional processing bias, which is congruent with attentional weighting accounts of line bisection/neglect. As such, patients with a line bisection bias do not seem to have specific problems bisecting a line, but seem to suffer from a more general deficit processing proportions.

Optimal Positioning of Inertial Measurement Units in a Smart Shirt for Determining Respiratory Volume

Tidal volume can be estimated using the surface motions of the upper body induced by respiration. However, the precision and instrumentation of such estimation must be improved to allow widespread application. In this study, respiration induced changes in parameters that can be recorded with inertial measurement units are examined to determine tidal volumes. Based on the data of an optical motion capture system, the optimal positions of inertial measurement units (IMU) in a smart shirt for sets of 4, 5 or 6 sensors were determined. The errors observed indicate the potential to determine tidal volumes using IMUs in a smart shirt.Clinical Relevance- The measurement of respiratory volumes via a low-cost and unobtrusive smart shirt would be a major advance in clinical diagnostics. In particular, conventional methods are expensive, and uncomfortable for conscious patients if measurement is desired over an extended period. A smart-shirt based on inertial sensors would allow a comfortable measurement and could be used in many clinical scenarios - from sleep apnoea monitoring to homecare and respiratory monitoring of comatose patients.

Disconnection in a left-hemispheric temporo-parietal network impairs multiplication fact retrieval

Arithmetic fact retrieval has been suggested to recruit a left-lateralized network comprising perisylvian language areas, parietal areas such as the angular gyrus (AG), and non-neocortical structures such as the hippocampus. However, the underlying white matter connectivity of these areas has not been evaluated systematically so far. Using simple multiplication problems, we evaluated how disconnections in parietal brain areas affected arithmetic fact retrieval following stroke. We derived disconnectivity measures by jointly considering data from n = 73 patients with acute unilateral lesions in either hemisphere and a white-matter tractography atlas (HCP-842) using the Lesion Quantification Toolbox (LQT). Whole-brain voxel-based analysis indicated a left-hemispheric cluster of white matter fibers connecting the AG and superior temporal areas to be associated with a fact retrieval deficit. Subsequent analyses of direct gray-to-gray matter disconnections revealed that disconnections of additional left-hemispheric areas (e.g., between the superior temporal gyrus and parietal areas) were significantly associated with the observed fact retrieval deficit. Results imply that disconnections of parietal areas (i.e., the AG) with language-related areas (i.e., superior and middle temporal gyri) seem specifically detrimental to arithmetic fact retrieval. This suggests that arithmetic fact retrieval recruits a widespread left-hemispheric network and emphasizes the relevance of white matter connectivity for number processing.

Cognitive control in number processing: new evidence from number compatibility effects in task-switching

A growing body of research suggests that basic numerical abilities such as number magnitude processing are influenced by cognitive control processes. So far, evidence for number processing being affected by cognitive control processes stems primarily from observed adaptations of numerical effects to stimulus set characteristics (e.g. order or ratio of specific stimulus types). Complementing previous research on adaptation to stimulus set characteristics as an index of influences of cognitive control, the present study employed a task-switching paradigm to examine how cognitive control processes influence number processing. Participants were presented with a two-digit number and had to either judge its parity or compare its magnitude to a standard depending on a preceding cue. We expected numerical congruency effects (i.e. the unit-decade compatibility effect for magnitude comparisons and the parity congruity effect for parity judgements) to be larger in switch trials, as persisting activation of the task set of the preceding trial should increase interference. In contrast to our expectations, both numerical congruity effects were reduced following task switches as compared to repetitions. This interaction of task-switching with numerical congruency effects suggests an influence of cognitive control on basic number processing in form of persisting inhibition of previously abandoned task sets, so that these exert less influence on current number processing demands.

Cognitive control in number processing: new evidence from task switching

Recently, it was demonstrated that even basic numerical cognition such as the processing of number magnitude is under cognitive control. However, evidence so far primarily came from adaptation effects to stimulus characteristics (e.g., relative frequency of specific stimulus categories). Expanding this approach, we evaluated a possible influence of more active exertion of cognitive control on basic number processing in task switching. Participants had to perform a magnitude comparison task while we manipulated the order of compatible and incompatible input–output modalities (i.e., auditory/vocal input–visual/manual output vs. auditory/visual input–manual/vocal output, respectively) on the trial level, differentiating repeat vs. switch trials. Results indicated that the numerical distance effect but not the problem size effect was increased after a switch in input–output modality compatibility. In sum, these findings substantiate that basic number processing is under cognitive control by providing first evidence that it is influenced by the active exertion of cognitive control as required in task switching.

An alternative way to measure respiration induced changes of circumferences: a pilot study

Various measurement systems can be used to obtain dynamic circumferences of the human upper body, but each of these systems has disadvantages. In this feasibility study we introduce a non-invasive and wearable thoracic belt to measure dynamic changes of circumferences of thorax or abdomen. To evaluate this approach, five subjects undertook various breaths of disparate tidal volumes, which were measured by the belt and simultaneously by a motion capture system which provided a reference metric.The results of the belt concurred with the reference system. A coefficient of determination (adjusted R²) of 0.99 and a mean squared error of less than 0.87 mm² showed that the belt is capable of measuring changes accurately and a couple of respiratory parameters, such as the respiratory rate, can be obtained.Clinical Relevance-The introduced system links surface motions of the upper body with the underlying respiratory mechanics. Thus it provides some respiratory parameters without the disadvantages of a facemask or a mouthpiece. The system could allow the analysis of breathing status in some clinical applications and could be used for low-cost monitoring in homecare or to analyse respiratory parameters during sports.

Tidal volume via circumferences of the upper body: a pilot study

The gold standard for tidal volume measurement is spirometry. Based on retrospective data, this study evaluates different geometric lung models in their ability to deliver accurate tidal volumes from changes in thoracic and abdominal circumference. The geometric lung models showed good coefficients of determination (adjusted R² >0.97) compared to the tidal volumes measured by a body plethysmograph. Tidal volumes obtained by circumference changes might be used in surveillance systems to analyze respiration without a face mask.

The ESC ACCA EAPCI EORP acute coronary syndrome ST-elevation myocardial infarction registry

Aims 

The Acute Cardiac Care Association (ACCA)–European Association of Percutaneous Coronary Intervention (EAPCI) Registry on ST-elevation myocardial infarction (STEMI) of the EurObservational programme (EORP) of the European Society of Cardiology (ESC) registry aimed to determine the current state of the use of reperfusion therapy in ESC member and ESC affiliated countries and the adherence to ESC STEMI guidelines in patients with STEMI.

Methods and results 

Between 1 January 2015 and 31 March 2018, a total of 11 462 patients admitted with an initial diagnosis of STEMI according to the 2012 ESC STEMI guidelines were enrolled. Individual patient data were collected across 196 centres and 29 countries. Among the centres, there were 136 percutaneous coronary intervention centres and 91 with cardiac surgery on-site. The majority of centres (129/196) were part of a STEMI network. The main objective of this study was to describe the demographic, clinical, and angiographic characteristics of patients with STEMI. Other objectives include to assess management patterns and in particular the current use of reperfusion therapies and to evaluate how recommendations of most recent STEMI European guidelines regarding reperfusion therapies and adjunctive pharmacological and non-pharmacological treatments are adopted in clinical practice and how their application can impact on patients’ outcomes. Patients will be followed for 1 year after admission.

Conclusion 

The ESC ACCA-EAPCI EORP ACS STEMI registry is an international registry of care and outcomes of patients hospitalized with STEMI. It will provide insights into the contemporary patient profile, management patterns, and 1-year outcome of patients with STEMI.

Molecular imaging of neuroinflammation in patients after mild traumatic brain injury: a longitudinal 123 I-CLINDE single photon emission computed tomography study

BACKGROUND AND PURPOSE

Neuroinflammation has been proposed as part of the pathogenesis of post-concussion symptoms (PCS), but the inflammatory response of the human brain to mild traumatic brain injury (mTBI) remains unknown. We hypothesized that a neuroinflammatory response is present in mTBI at 1-2 weeks post-injury and persists in patients with PCS.

METHODS

We scanned 14 patients with mTBI without signs of structural damage at 1-2 weeks and 3-4 months post-injury and 22 healthy controls once using the single photon emission computed tomography tracer ¹²³ I-CLINDE, which visualizes translocator protein (TSPO), a protein upregulated in active immune cells. PCS was defined as three or more persisting symptoms from the Rivermead Post Concussion Symptoms Questionnaire at 3 months post-injury.

RESULTS

Across brain regions, patients had significantly higher ¹²³ I-CLINDE binding to TSPO than healthy controls, both at 1-2 weeks after the injury in all patients (P = 0.011) and at 3-4 months in the seven patients with PCS (P = 0.006) and in the six patients with good recovery (P = 0.018). When the nine brain regions were tested separately and results were corrected for multiple comparisons, no individual region differed significantly, but all estimated parameters indicated increased ¹²³ I-CLINDE binding to TSPO, ranging from 2% to 19% in all patients at 1-2 weeks, 13% to 27% in patients with PCS at 3-4 months and -9% to 17% in patients with good recovery at 3-4 months.

CONCLUSIONS

Neuroinflammation was present in mTBI at 1-2 weeks post-injury and persisted at 3-4 months post-injury with a tendency to be most pronounced in patients with PCS.

Ventilation inhomogeneity in obstructive lung diseases measured by electrical impedance tomography: a simulation study

Electrical impedance tomography (EIT) has mostly been used in the Intensive Care Unit (ICU) to monitor ventilation distribution but is also promising for the diagnosis in spontaneously breathing patients with obstructive lung diseases. Beside tomographic images, several numerical measures have been proposed to quantitatively assess the lung state. In this study two common measures, the 'Global Inhomogeneity Index' and the 'Coefficient of Variation' were compared regarding their capability to reflect the severity of lung obstruction. A three-dimensional simulation model was used to simulate obstructed lungs, whereby images were reconstructed on a two-dimensional domain. Simulations revealed that minor obstructions are not adequately recognized in the reconstructed images and that obstruction above and below the electrode plane may result in misleading values of inhomogeneity measures. EIT measurements on several electrode planes are necessary to apply these measures in patients with obstructive lung diseases in a promising manner.

Compensation for large thorax excursions in EIT imaging

Besides the application of EIT in the intensive care unit it has recently also been used in spontaneously breathing patients suffering from asthma bronchiole, cystic fibrosis (CF) or chronic obstructive pulmonary disease (COPD). In these cases large thorax excursions during deep inspiration, e.g. during lung function testing, lead to artifacts in the reconstructed images. In this paper we introduce a new approach to compensate for image artifacts resulting from excursion induced changes in boundary voltages. It is shown in a simulation study that boundary voltage change due to thorax excursion on a homogeneous model can be used to modify the measured voltages and thus reduce the impact of thorax excursion on the reconstructed images. The applicability of the method on human subjects is demonstrated utilizing a motion-tracking-system. The proposed technique leads to fewer artifacts in the reconstructed images and improves image quality without substantial increase in computational effort, making the approach suitable for real-time imaging of lung ventilation. This might help to establish EIT as a supplemental tool for lung function tests in spontaneously breathing patients to support clinicians in diagnosis and monitoring of disease progression.

A general number-to-space mapping deficit in developmental dyscalculia

Previous research on developmental dyscalculia (DD) suggested that deficits in the number line estimation task are related to a failure to represent number magnitude linearly. This conclusion was derived from the observation of logarithmically shaped estimation patterns. However, recent research questioned this idea of an isomorphic relationship between estimation patterns and number magnitude representation. In the present study, we evaluated an alternative hypothesis: impairments in the number line estimation task are due to a general deficit in mapping numbers onto space. Adults with DD and a matched control group had to learn linear and non-linear layouts of the number line via feedback. Afterwards, we assessed their performance how well they learnt the new number-space mappings. We found irrespective of the layouts worse performance of adults with DD. Additionally, in case of the linear layout, we observed that their performance did not differ from controls near reference points, but that differences between groups increased as the distance to reference point increased. We conclude that worse performance of adults with DD in the number line task might be due a deficit in mapping numbers onto space which can be partly overcome relying on reference points.

Operational Momentum Affects Eye Fixation Behaviour

The operational momentum effect (OM) indicates an association of mental addition with a rightward spatial bias, whereas subtraction is associated with a leftward bias. To evaluate the assumed attentional origin of the OM effect, we evaluated not only participants’ relative estimation error in a task requiring them to locate addition and subtraction results on a given number line but also their eye-fixation behaviour. Furthermore, to investigate the situatedness of spatial–numerical associations, the orientation of the number line (left-to-right vs. right-to left) was manipulated. OM biases in participants’ explicit number line estimations and more implicit eye-fixation behaviour are integrated into a two-process hypothesis of the OM effect suggesting a first rough spatial anticipation followed by an evaluation/correction process. This account not only is capable of accounting for the results observed for participants’ relative estimation error but is also corroborated by the eye-fixation results. Importantly, the fact that all effects were found independent of the orientation of the number line indicates that spatial–numerical associations such as the OM effect may not be hard-wired associations of spatial and numerical representations but rather reflect influences of situatedness on numerical cognition.

Adaptive processing of fractions--evidence from eye-tracking

Recent evidence indicated that fraction pair type determined whether a particular fraction is processed holistically, componentially or in a hybrid manner. Going beyond previous studies, we investigated how participants adapt their processing of fractions not only to fraction type, but also to experimental context. To examine adaptation in fraction processing, we recorded participants' eye-fixation behaviour in a fraction magnitude comparison task. Participants' eye fixation behaviour indicated componential processing of fraction pairs with common components for which the decision-relevant components are easy to identify. Importantly, we observed that fraction processing was adapted to experimental context: Evidence for componential processing was stronger, when experimental context allowed valid expectations about which components are decision-relevant. Taken together, we conclude that fraction processing is adaptive beyond the comparison of different fraction types, because participants continuously adjust to the experimental context in which fractions are processed.

Language influences on numerical development-Inversion effects on multi-digit number processing

In early numerical development, children have to become familiar with the Arabic number system and its place-value structure. The present review summarizes and discusses evidence for language influences on the acquisition of the highly transparent structuring principles of digital-Arabic digits by means of its moderation through the transparency of the respective language's number word system. In particular, the so-called inversion property (i.e., 24 named as “four and twenty” instead of “twenty four”) was found to influence number processing in children not only in verbal but also in non-verbal numerical tasks. Additionally, there is first evidence suggesting that inversion-related difficulties may influence numerical processing longitudinally. Generally, language-specific influences in children's numerical development are most pronounced for multi-digit numbers. Yet, there is currently only one study on three-digit number processing for German-speaking children. A direct comparison of additional new data from Italian-speaking children further corroborates the assumption that language impacts on cognitive (number) processing as inversion-related interference was found most pronounced for German-speaking children. In sum, we conclude that numerical development may not be language-specific but seems to be moderated by language.

Parotidectomy and submandibulectomy for benign diseases in Thuringia, Germany: a population-based study on epidemiology and outcome

Although salivary gland surgery for benign diseases is an integral part of clinical routine of head and neck surgeons, there is not many population-based data published on incidence and efficiency of this surgery. Parotidectomy was performed in 180 patients and submandibulectomy in 97 patients for benign diseases in eight otorhinolaryngology and two maxillofacial surgery departments in Thuringia, Germany, in 2005. All patients were analysed regarding patients' characteristics, therapy, complications and further course of disease. Predominant indications were epithelial tumours for parotidectomy (79 %) and sialolithiasis for submandibulectomy (50 %). The most frequent tumour types were pleomorphic adenoma (46 %) and Warthin tumours (29 %). Pleomorphic adenoma was significantly more frequent in female patients and Warthin tumours in male patients and smokers. The incidence of parotidectomy, i.e. the surgical rate, was 7.8/100,000 habitants and of submandibulectomy 4.1/100,000 habitants. One hundred and seventy-eight tumours including 154 epithelial tumours resulted in an incidence of 7.6/100,000 habitants for all treated tumours and of 6.6/100,000 for epithelial tumours, respectively. The majority of parotid cases were treated by lateral parotidectomy (79 %). Relevant complications were observed in 22 % of patients. After parotidectomy and submandibulectomy a postoperative facial palsy was observed in 28 and 2 % of cases, respectively. Only 1 % was permanent. During a mean follow-up time of 9.6 months, 3 % of parotidectomy patients developed a Frey's syndrome needing treatment and 0.8 % developed a tumour recurrence. This population-based analysis shows that salivary gland surgery is performed in higher incidence than expected, effectively and with low-risk in daily routine of head and neck surgeons.

One language, two number-word systems and many problems: numerical cognition in the Czech language

Comparing numerical performance between different languages does not only mean comparing different number-word systems, but also implies a comparison of differences regarding culture or educational systems. The Czech language provides the remarkable opportunity to disentangle this confound as there exist two different number-word systems within the same language: for instance, "25" can be either coded in non-inverted order "dvadsetpät" [twenty-five] or in inverted order "pätadvadset" [five-and-twenty]. To investigate the influence of the number-word system on basic numerical processing within one culture, 7-year-old Czech-speaking children had to perform a transcoding task (i.e., writing Arabic numbers to dictation) in both number-word systems. The observed error pattern clearly indicated that the structure of the number-word system determined transcoding performance reliably: In the inverted number-word system about half of all errors were inversion-related. In contrast, hardly any inversion-related errors occurred in the non-inverted number-word system. We conclude that the development of numerical cognition does not only depend on cultural or educational differences, but is indeed related to the structure and transparency of a given number-word system.

Early place-value understanding as a precursor for later arithmetic performance--a longitudinal study on numerical development

It is assumed that basic numerical competencies are important building blocks for more complex arithmetic skills. The current study aimed at evaluating this interrelation in a longitudinal approach. It was investigated whether first graders' performance in basic numerical tasks in general as well as specific processes involved (e.g., place-value understanding) reliably predicted performance in an addition task in third grade. The results indicated that early place-value understanding was a reliable predictor for specific aspects of arithmetic performance. Implications of the role of basic numerical competencies for the acquisition of complex arithmetic are discussed.

Eye fixation behaviour in the number bisection task: evidence for temporal specificity

Together with magnitude representations, knowledge about multiplicativity and parity contributes to numerical problem solving. In the present study, we used eye tracking to document how and when multiplicativity and parity are recruited in the number bisection task. Fourteen healthy adults evaluated whether the central number of a triplet (e.g., 21_24_27) corresponds to the arithmetic integer mean of the interval defined by the two outer numbers. We observed multiplicativity to specifically affect gaze duration on numbers, indicating that the information of multiplicative relatedness is activated at early processing stages. In contrast, parity only affected total reading time, suggesting involvement in later processing stages. We conclude that different representational features of numbers are available and integrated at different processing stages within the same task and outline a processing model for these temporal dynamics of numerical cognition.