Understanding how personality traits, experiences, and attitudes shape negative bias toward AI-generated artworks

The study primarily aimed to understand whether individual factors could predict how people perceive and evaluate artworks that are perceived to be produced by AI. Additionally, the study attempted to investigate and confirm the existence of a negative bias toward AI-generated artworks and to reveal possible individual factors predicting such negative bias. A total of 201 participants completed a survey, rating images on liking, perceived positive emotion, and believed human or AI origin. The findings of the study showed that some individual characteristics as creative personal identity and openness to experience personality influence how people perceive the presented artworks in function of their believed source. Participants were unable to consistently distinguish between human and AI-created images. Furthermore, despite generally preferring the AI-generated artworks over human-made ones, the participants displayed a negative bias against AI-generated artworks when subjective perception of source attribution was considered, thus rating as less preferable the artworks perceived more as AI-generated, independently on their true source. Our findings hold potential value for comprehending the acceptability of products generated by AI technology.

Best humans still outperform artificial intelligence in a creative divergent thinking task

Creativity has traditionally been considered an ability exclusive to human beings. However, the rapid development of artificial intelligence (AI) has resulted in generative AI chatbots that can produce high-quality artworks, raising questions about the differences between human and machine creativity. In this study, we compared the creativity of humans (n = 256) with that of three current AI chatbots using the alternate uses task (AUT), which is the most used divergent thinking task. Participants were asked to generate uncommon and creative uses for everyday objects. On average, the AI chatbots outperformed human participants. While human responses included poor-quality ideas, the chatbots generally produced more creative responses. However, the best human ideas still matched or exceed those of the chatbots. While this study highlights the potential of AI as a tool to enhance creativity, it also underscores the unique and complex nature of human creativity that may be difficult to fully replicate or surpass with AI technology. The study provides insights into the relationship between human and machine creativity, which is related to important questions about the future of creative work in the age of AI.

Watching Nature Videos Promotes Physiological Restoration: Evidence From the Modulation of Alpha Waves in Electroencephalography

Various lines of evidence have shown that nature exposure is beneficial for humans. Despite several empirical findings pointing out to cognitive and emotional positive effects, most of the evidence of these effects are correlational, and it has been challenging to identify a cause-effect relationship between nature exposure and cognitive and emotional benefits. Only few of the published studies use psychophysiological methods to assess the biological correlates of these positive effects. Establishing a connection between human physiology and contact with natural settings is important for identifying cause-effect relationships between exposure to natural environments and the positive effects commonly reported in connection to nature exposure. In the present study, we recorded physiological indexes of brain activity (electroencephalography) and sympathetic nervous system (electrodermal activity), while the participants were presented with a series of videos displaying natural, urban, or neutral (non-environmental, computerized) scenes. Participants rated the scenes for their perceived relaxing value, and after each experimental condition, they performed a cognitive task (digit span backward). Participants rated natural videos as the most relaxing. Spectral analyses of EEG showed that natural scenes promoted alpha waves, especially over the central brain. The results suggest that experiencing natural environments virtually produces measurable and reliable brain activity markers which are known to be related to restorative processes.

Modality-specific and modality-general electrophysiological correlates of visual and auditory awareness: Evidence from a bimodal ERP experiment

To date, most studies on the event-related potential (ERP) correlates of conscious perception have examined a single perceptual modality. We compared electrophysiological correlates of visual and auditory awareness in the same experiment to test whether there are modality-specific and modality-general correlates of conscious perception. We used near threshold stimulation and analyzed event-related potentials in response to aware and unaware trials in visual, auditory and bimodal conditions. The results showed modality-specific negative amplitude correlates of conscious perception between 200 and 300 ms after stimulus onset. A combination of these auditory and visual awareness negativities was observed in the bimodal condition. A later positive amplitude difference, whose early part was modality-specific, possibly reflecting access to global workspace, and later part shared modality-general features, possibly indicating higher level cognitive processing involving the decision making, was also observed.

Transcranial magnetic stimulation (TMS)-induced Blindsight of Orientation is Degraded Conscious Vision

Patients with blindsight are blind due to an early visual cortical lesion, but they can discriminate stimuli presented to the blind visual field better than chance. Studies using transcranial magnetic stimulation (TMS) of early visual cortex have tried to induce blindsight-like behaviour in neurologically healthy individuals, but the studies have yielded varied results. We hypothesized that previous demonstrations of TMS-induced blindsight may result from degraded awareness of the stimuli due to the use of dichotomous visibility scales in measuring awareness. In the present study, TMS was applied to early visual cortex during an orientation discrimination task and the subjective scale measuring awareness was manipulated: The participants reported their conscious perception either using a dichotomous scale or a 4-point Perceptual Awareness Scale. Although the results with the dichotomous scale replicated previous reports of blindsight-like behaviour, there was no evidence of TMS-induced blindsight for orientation when the participants used the lowest rating of the 4-point graded scale to indicate that they were not aware of the presence of the stimulus. Moreover, signal detection analyses indicated that across participants, the individual's sensitivity to consciously discriminate orientation predicted behaviour on reportedly unconscious trials. These results suggest that blindsight-like discrimination of orientation in neurologically healthy individuals does not occur for completely invisible stimuli, that is, when the observers do not report any kind of consciousness of the stimulus. TMS-induced blindsight for orientation is likely degraded conscious vision.

Open and empathic personalities see two things at the same time: the relationship of big-five personality traits and cognitive empathy with mixed percepts during binocular rivalry

Does our personality predict what we see? This question was studied in 100 university students with binocular rivalry paradigm by presenting incompatible images to each eye, allowing multiple interpretations of the same sensory input. During continuous binocular presentation, dominance of perception starts to fluctuate between the images. When neither of the images is fully suppressed, the two images combine into mixed percepts. We focused on the link between mixed percepts, big-five traits, and empathy. The results revealed that openness and agreeableness correlated with the occurrence of mixed percepts after the first dominant perception. However, these correlations of openness and agreeableness were mediated by cognitive empathy. In addition, openness had a direct association with reporting the initial percept in the onset of stimulation as a mixed percept, suggesting a mechanism that is separate from the one mediated by cognitive empathy. Overall, the results provide preliminary evidence suggesting that personality predicts what we see. Such individual differences in perceptual interpretations may be linked to both higher level cognitive mechanisms as well as lower level visual mechanisms.

Differential interactions of age and sleep deprivation in driving and spatial perception by male drivers in a virtual reality environment

We determined the effects of age and sleep deprivation on driving and spatial perception in a virtual reality environment. Twenty-two young (mean age: 22 years, range: 18-35) and 23 old (mean age: 71 years, range: 65-79) participants were tested after a normal night of sleep and a night of sleep deprivation. The participants drove a virtual car while responding to uni- and bilateral visual and auditory stimuli. Driving errors (crossing the lane borders), reaction times and accuracy to visual and auditory stimuli, performance in psychological tests, and subjective driving ability and tiredness were measured. Age had no effect on the number of driving errors, whereas sleep deprivation increased significantly especially the number of left lane border crossings. Age increased the number of stimulus detection errors, while sleep deprivation increased the number of errors particularly in the young and in the auditory modality as response omissions. Age and sleep deprivation together increased the number of response omissions in both modalities. Left side stimulus omissions suggest a bias to the right hemispace. The subjective evaluations were consistent with the objective measures. The psychological tests were more sensitive to the effects of age than to those of sleep deprivation. Driving simulation in a virtual reality setting is sensitive in detecting the effects of deteriorating factors on both driving and simultaneous spatial perception.

The Level of Processing Modulates Visual Awareness: Evidence from Behavioral and Electrophysiological Measures

The level of processing hypothesis (LoP) proposes that the transition from unaware to aware visual perception is graded for low-level (i.e., energy, features) stimulus whereas dichotomous for high-level (i.e., letters, words, meaning) stimulus. In this study, we explore the behavioral patterns and neural correlates associated with different depths (i.e., low vs. high) of stimulus processing. The low-level stimulus condition consisted of identifying the color (i.e., blue/blueish vs. red/reddish) of the target, and the high-level stimulus condition consisted of identifying stimulus category (animal vs. object). Behavioral results showed that the levels of processing manipulation produced significant differences in both the awareness rating distributions and accuracy performances between tasks, the low-level task producing more intermediate subjective ratings and linearly increasing accuracy performances and the high-level task producing less intermediate ratings and a more nonlinear pattern for accuracies. The electrophysiological recordings revealed two correlates of visual awareness, an enhanced posterior negativity in the N200 time window (visual awareness negativity [VAN]), and an enhanced positivity in the P3 time window (late positivity [LP]). The analyses showed a double dissociation between awareness and the level of processing hypothesis manipulation: Awareness modulated VAN amplitudes only in the low-level color task, whereas LP amplitude modulations were observed only in the higher level category task. These findings are compatible with a two-stage microgenesis model of conscious perception, where an early elementary phenomenal sensation of the stimulus (i.e., the subjective perception of color) would be indexed by VAN, whereas stimulus' higher level properties (i.e., the category of the target) would be reflected in the LP in a later latency range.

Subjective ratings of fear are associated with frontal late positive potential asymmetry, but not with early brain activity over the occipital and centro-parietal cortices

The human frontal cortex is asymmetrically involved in motivational and affective processing. Several studies have shown that the left-frontal hemisphere is related to positive and approach-related affect, whereas the right-frontal hemisphere is related to negative and withdrawal-related affect. The present study aimed to investigate whether evolutionarily threatening stimuli modulate asymmetrical frontal activity. We examined hemispheric differences in frontal late positive potentials (f-LPP asymmetry) and frontal alpha power activation (frontal alpha asymmetry, FAA) in response to images depicting snakes, spiders, butterflies, and birds. Results showed that the late component of f-LPP asymmetry, but not FAA, was modulated by the category of stimuli. Specifically, threatening stimuli (snakes and spiders) evoked a relatively large late f-LPP over the right-frontal hemisphere than non-threatening stimuli (birds and butterflies). Moreover, this relatively great right-frontal activity was positively associated with the subjective ratings of fear. Importantly, the subjective ratings of fear were not associated with early brain activity over the occipital or centro-parietal cortices. These results suggest that late f-LPP asymmetry may reflect higher order affective processes, specifically the subjective appraisal of threatening stimuli and the subjective experience of fear, that are independent of the fast and automatic processing of evolutionarily significant and affectively arousing stimuli.

ERP and MEG correlates of visual consciousness: The second decade

The first decade of event-related potential (ERP) research had established that the most consistent correlates of the onset of visual consciousness are the early visual awareness negativity (VAN), a posterior negative component in the N2 time range, and the late positivity (LP), an anterior positive component in the P3 time range. Two earlier extensive reviews ten years ago had concluded that VAN is the earliest and most reliable correlate of visual phenomenal consciousness, whereas LP probably reflects later processes associated with reflective/access consciousness. This article provides an update to those earlier reviews. ERP and MEG studies that have appeared since 2010 and directly compared ERPs between aware and unaware conditions are reviewed, and important new developments in the field are discussed. The result corroborates VAN as the earliest and most consistent signature of visual phenomenal consciousness, and casts further doubt on LP as an ERP correlate of phenomenal consciousness.

Pattern matters: Snakes exhibiting triangular and diamond-shaped skin patterns modulate electrophysiological activity in human visual cortex

The neural and perceptual mechanisms that support the efficient visual detection of snakes in humans are still not fully understood. According to the Snake Detection Theory, selection pressures posed by snakes on early primates have shaped the development of the visual system. Previous studies in humans have investigated early visual electrophysiological activity in response to snake images vs. various alternative dangerous or non-dangerous stimuli. These studies have shown that the Early Posterior Negativity (EPN) component is selectively elicited by snake or snake-like images. Recent findings yielded the complementary/alternative hypothesis that early humans (and possibly other primates) evolved an aversion especially for potentially harmful triangular shapes, such as teeth, claws or spikes. In the present study we investigated the effect of triangular and diamond-shaped patterns in snake skins on the ERP correlates of visual processing in humans. In the first experiment, we employed pictures of snakes displaying either triangular/diamond-shaped patterns or no particular pattern on their skins, and pictures of frogs as control. Participants observed a random visual presentation of these pictures. Consistent with previous studies, snakes elicited an enhanced negativity between 225 and 300 ms (EPN) compared to frogs. However, snakes featuring triangular/diamond-shaped patterns on their skin produced an enhanced EPN compared to the snakes that did not display such patterns. In a second experiment we used pictures displaying only skin patterns of snakes and frogs. Results from the second experiment confirmed the results of the first experiment, suggesting that triangular snake-skin patterns modulate the activity in human visual cortex. Taken together, our results constitute an important contribution to the snake detection theory.

Visual features and perceptual context modulate attention towards evolutionarily relevant threatening stimuli: Electrophysiological evidence

The snake detection hypothesis claims that predatory pressure from snakes has shaped the primate visual system, but we still know very little about how the brain processes evolutionarily important visual cues, and which factors are crucial for quick detection of snakes. We investigated how visual features modulate the electrophysiological markers of early attentional processes. In Experiment 1, we compared snake, rope, gun, and bird images to isolate the effects due to curvilinearity of the stimuli. The results showed that both snake and rope images elicited enhanced P1 and N1 event-related potential components as well as early posterior negativity (EPN). In Experiment 2, we studied whether nonthreatening curvilinear images (i.e., ropes) still elicit the enhanced electrophysiological responses when snake images are not presented as stimuli, and therefore the context does not provoke top-down attention to curvilinear shapes. Rope images still evoked an enhanced EPN, suggesting that curvilinear shapes are preferably captured by attentional processes. However, this effect was smaller than in Experiment 1, in which snake images were present. Thus, our results hint to the possibility that the perceptual context may interact with processing of shape information, drawing attention to curvilinear shapes when the presence of snakes is expectable. Furthermore, we observed that spatial frequency of the visual stimuli modulated especially the early electrophysiological responses, and decreased the differences between stimulus categories in EPN without completely eliminating them. The findings suggest that low-level and high-level mechanisms interact to give an attentional priority to potentially threatening stimuli. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Unconscious response priming during continuous flash suppression

Continuous flash suppression (CFS) has become a popular tool for studying unconscious processing, but the level at which unconscious processing of visual stimuli occurs under CFS is not clear. Response priming is a robust and well-understood phenomenon, in which the prime stimulus facilitates overt responses to targets if the prime and target are associated with the same response. We used CFS to study unconscious response priming of shape: arrows with left or right orientation served as primes and targets. The prime was presented near the limen of consciousness and each trial was followed by subjective rating of visibility and a forced-choice response concerning the orientation of the prime in counterbalanced order. In trials without any reported awareness of the presence of the prime, discrimination of the prime's orientation was at chance level. However, priming was elicited in such unconscious trials. Unconscious priming was not influenced by the prime-target onset-asynchrony (SOA)/prime duration, whereas conscious processing, as indicated by the enhanced discriminability of the prime's orientation and conscious priming, increased at the longest SOAs/prime durations. These results show that conscious and unconscious processes can be dissociated with CFS and that CFS-masking does not completely suppress unconscious visual processing of shape.

The right-side perceptual bias in aging determined in a laboratory setting and during a virtual driving task

Spatial perceptual rightward bias which was originally described in Dichotic Listening studies seems to be a general phenomenon. This bias is age dependent, being evident in children with developing executive functions, and emerging again at older age as a function of aging and the declining executive functions. In the two studies presented here we compared the performance of young and elderly adults in spatial divided attention tasks with auditory and visual stimuli when the stimulus detection performance was measured in separate sessions in a laboratory setting (Study I), to performance when the same types of stimuli were mixed with a task in which the subject's primary objective was to drive a car in a virtual environment (virtual reality; Study II). The aim was to see if the perceptual bias could be detected and also to look at how it would differ in these two situations. 90 right-handed subjects (50 young and 40 elderly) participated in Study I and 84 subjects (64 young and 20 elderly) participated in Study II. Study I showed the rightward bias to be more evident in the elderly subjects in both modalities and in more demanding tasks. Study II revealed that in the triple task the spatial perceptual bias was evident in both modalities for the elderly participants when the conditions were more demanding. An interesting finding concerning the right-side perceptual bias was the simultaneous occurrence of left-side driving errors, i.e. crossing the lane border to the left especially by the elderly. Both of these biases may reflect the asymmetries of the attention-related neuronal networks.

TMS-EEG reveals hemispheric asymmetries in top-down influences of posterior intraparietal cortex on behavior and visual event-related potentials

Clinical data and behavioral studies using transcranial magnetic stimulation (TMS) suggest right-hemisphere dominance for top-down modulation of visual processing in humans. We used concurrent TMS-EEG to directly test for hemispheric differences in causal influences of the right and left intraparietal cortex on visual event-related potentials (ERPs). We stimulated the left and right posterior part of intraparietal sulcus (IPS1) while the participants were viewing and rating the visibility of bilaterally presented Gabor patches. Subjective visibility ratings showed that TMS of right IPS shifted the visibility toward the right hemifield, while TMS of left IPS did not have any behavioral effect. TMS of right IPS, but not left one, reduced the amplitude of posterior N1 potential, 180-220ms after stimulus-onset. The attenuation of N1 occurred bilaterally over the posterior areas of both hemispheres. Consistent with previous TMS-fMRI studies, this finding suggests that the right IPS has top-down control on the neural processing in visual cortex. As N1 most probably reflects reactivation of early visual areas, the current findings support the view that the posterior parietal cortex in the right hemisphere amplifies recurrent interactions in ventral visual areas during the time-window that is critical for conscious perception.

Different Electrophysiological Correlates of Visual Awareness for Detection and Identification

Detecting the presence of an object is a different process than identifying the object as a particular object. This difference has not been taken into account in designing experiments on the neural correlates of consciousness. We compared the electrophysiological correlates of conscious detection and identification directly by measuring ERPs while participants performed either a task only requiring the conscious detection of the stimulus or a higher-level task requiring its conscious identification. Behavioral results showed that, even if the stimulus was consciously detected, it was not necessarily identified. A posterior electrophysiological signature 200–300 msec after stimulus onset was sensitive for conscious detection but not for conscious identification, which correlated with a later widespread activity. Thus, we found behavioral and neural evidence for elementary visual experiences, which are not yet enriched with higher-level knowledge. The search for the mechanisms of consciousness should focus on the early elementary phenomenal experiences to avoid the confounding effects of higher-level processes.

Unicompartmental Knee Arthroplasties are Performed on the Patients with Radiologically Too Mild Osteoarthritis

Background:

Patient selection for either total knee arthroplasty or unicompartmental knee arthroplasty remains controversial. The latter has several reported advantages over total knee arthroplasty, but it also appears to have significant drawbacks in terms of revision rates.

Aims:

This study aimed to determine the influence of the preoperative degree of osteoarthritis on the risk of reoperation following unicompartmental knee arthroplasty.

Methods:

Surgery was carried out on 294 knees in 241 patients between 2001 and 2012 at a single institute, using cemented Oxford phase III unicompartmental knee arthroplasty. The mean age at the time of operation was 67 years, and the mean follow-up time was 8.7 years.

Results and Conclusion:

The knees with a preoperative Kellgren–Lawrence grade of 0–2 osteoarthritis had a higher risk of reoperation than those with a Kellgren–Lawrence grade of 3–4 (odds ratio = 1.89; 95% confidence interval, 1.03–3.45; p = 0.04). In addition, the knees with a medial joint space width of more than 1 mm or a high medial/lateral joint space width ratio had an increased risk of reoperation. In conclusion, we suggest that unicompartmental knee arthroplasty should only be performed in cases showing severe osteoarthritis in preoperative radiographs, with medial bone-on-bone contact, and a medial/lateral ratio of <20%.

A Mediation Analysis of Childhood Maltreatment and Suicidal Behavior among Patients with Depressive or Bipolar Disorders

Introduction

Substantial evidence supports association between childhood maltreatment and suicidal behaviour, however, a limited number of studies have examined psychological mechanisms mediating the relationship among patients with mood disorders.

Objective

To investigate directly the potential intermediating mechanisms between childhood maltreatment and suicidal behaviour among patients with mood disorders.

Aims

We examine by formal mediation analyses, if:

– the effect of childhood maltreatment on suicidal behaviour is mediated through borderline personality disorder traits;

– the mediation effect differs between lifetime suicidal ideation and lifetime suicide attempts.

Methods

Depressive disorder and bipolar disorder (ICD-10-DCR) patients (n = 287) from the Helsinki university psychiatric consortium (HUPC) Study were surveyed on self-reported childhood experiences, current depressive symptoms, borderline personality disorder traits and lifetime suicidal behaviour. Psychiatric records served to complement the information on suicide attempts.

Results

The influence of childhood maltreatment on lifetime suicidal ideation and lifetime suicide attempts showed comparable total effects. In formal mediation analyses, borderline personality disorder traits mediated all of the total effect of childhood maltreatment on lifetime suicide attempts, but only 21% of the total effect on lifetime suicide ideation. The mediation effect was stronger for lifetime suicide attempts compared to ideation (P = 0.002) and independent of current depressive symptoms.

Conclusions

The mechanisms of the effect of childhood maltreatment on suicidal ideation and attempts may diverge among psychiatric patients with mood disorders. Borderline personality disorder traits may contribute to these mechanisms, although the influence appears considerably stronger for suicide attempts than for suicide ideation.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Top-down preparation modulates visual categorization but not subjective awareness of objects presented in natural backgrounds

Top-down processes are widely assumed to be essential in visual awareness, subjective experience of seeing. However, previous studies have not tried to separate directly the roles of different types of top-down influences in visual awareness. We studied the effects of top-down preparation and object substitution masking (OSM) on visual awareness during categorization of objects presented in natural scene backgrounds. The results showed that preparation facilitated categorization but did not influence visual awareness. OSM reduced visual awareness and impaired categorization. The dissociations between the effects of preparation and OSM on visual awareness and on categorization imply that they influence at different stages of cognitive processing. We propose that preparation influences at the top of the visual hierarchy, whereas OSM interferes with processes occurring at lower levels of the hierarchy. These lower level processes play an essential role in visual awareness.

Self-reported psychosis-like experiences in patients with mood disorders

BACKGROUND

Self-reported psychosis-like experiences (PEs) may be common in patients with mood disorders, but their clinical correlates are not well known. We investigated their prevalence and relationships with self-reported symptoms of depression, mania, anxiety, borderline (BPD) and schizotypal (SPD) personality disorders among psychiatric patients with mood disorders.

METHODS

The Community Assessment of Psychic Experiences (CAPE-42), Mood Disorder Questionnaire (MDQ), McLean Screening Instrument (MSI), The Beck Depressive Inventory (BDI), Overall Anxiety Severity and Impairment Scale (OASIS) and Schizotypal Personality Questionnaire-Brief form (SPQ-B) were filled in by patients with mood disorders (n=282) from specialized care. Correlation coefficients between total scores and individual items of CAPE-42 and BDI, SPQ-B, MSI and MDQ were estimated. Hierarchical multivariate regression analysis was conducted to examine factors influencing the frequency of self-reported PE.

RESULTS

PEs are common in patients with mood disorders. The "frequency of positive symptoms" score of CAPE-42 correlated strongly with total score of SPQ-B (rho=0.63; P<0.001) and moderately with total scores of BDI, MDQ, OASIS and MSI (rho varied from 0.37 to 0.56; P<0.001). Individual items of CAPE-42 correlated moderately with specific items of BDI, MDQ, SPQ-B and MSI (r_φ varied from 0.2 to 0.5; P<0.001). Symptoms of anxiety, mania or hypomania and BPD were significant predictors of the "frequency of positive symptoms" score of CAPE-42.

CONCLUSIONS

Several, state- and trait-related factors may underlie self-reported PEs among mood disorder patients. These include cognitive-perceptual distortions of SPD; distrustfulness, identity disturbance, dissociative and affective symptoms of BPD; and cognitive biases related to depressive or manic symptoms.

Radiological Incidence and Course of Bronchopulmonary Dysplasia in 100 Consecutive Low Birth Weight Neonates

Bronchopulmonary dysplasia (BPD) is an important cause of chronic respiratory distress in low birth infants. The radiological incidence and course of BPD were assessed in 100 consecutive low birth weight infants. Chest radiographs were examined on admission, at the ages of 3 days, 7 days, 2 weeks and 4 weeks and at later follow-up until the examinations were normal. Twelve of the children died. The severity and typical radiological abnormalities of BPD were assessed. Among the children alive, there were 26 with BPD (29.5%). The BPD incidence was highest between the age of 2 weeks and 3 months (18–21%) declining to 3.4% at the age of 12 months. Radiological evidence of BPD was already seen at the age of 2 weeks in 16 of the children. Most cases (73%) had their maximum BPD score at the age of 1 to 3 months. The normalisation of the chest radiography occurred predominantly in the age between 3 and 6 months. The most frequent underlying condition in BPD was hyaline membrane disease in 81%.

HRCT findings in the lungs of primary care patients with lower respiratory tract infection

Purpose: To survey the prevalence and type of lung patterns detectable at high-resolution CT (HRCT) in a primary care population seeking help for cough and fever.

Material and Methods: The HRCT patterns of 103 patients obtained at the primary visit to a municipal health centre for cough and fever were evaluated. Forced expiratory examinations were obtained in 93 patients.

Results: Lower respiratory tract infection (LRTI)-related findings (present at inclusion, healed at follow-up, not explained by any other factor) were seen in 19 patients (18.7%), of whom 11 also showed opacities, even though of lesser extent, at conventional chest radiography. The following patterns were found: ground-glass opacity (58%), discrete consolidations (52%), confluent consolidations (16%; 1 case with an air bronchogram), air space nodules (10%), peribronchovascular thickening (37%), tree-in-bud pattern (26%), free pleural fluid (5%), and septal thickening (5%). An expiratory mosaic pattern was seen in 19 (20%) out of 93 patients. In addition, lymph node enlargement (&gt;1 cm) was recorded in 7 patients out of 103.

Conclusion: HRCT is more sensitive than chest radiography in detecting LRTI-related lung lesions in a primary care population. The pattern typically comprises subtle scattered polymorphous opacities with varying attenuation affecting several lung segments. LRTI-related HRCT pattern deserves consideration as a differential diagnostic alternative in patients examined due to any lower respiratory tract symptoms.

Splenic Abscess

We reviewed the imaging findings of 14 splenic abscesses in 13 patients. All patients underwent chest radiography, 12 ultrasonography (US), 9 CT, 4 plain abdominal radiography, 2 99mTc-HMPAO leukocyte scan and 2 99mTc-HIG scan. Three patients were treated with percutaneous catheter drainage, and 5 with diagnostic or therapeutic fine-needle aspiration (FNA). At US the abscess was hypoechoic (n = 9), anechoic (n = 2), or anechoic with gasbubbles (n = 1), or the entire spleen was inhomogeneous with gasbubbles (n = 1). At CT the abscesses appeared as low density (18–30 HU) lesions with (n = 2) or without (n = 7) gas. In 2 cases 99mTc-HMPAO leukocyte scan, and in one case 99mTc-HIG scan showed an intrasplenic defect, and in one case 99mTc-HIG scan was considered normal. At plain abdominal radiography extraintestinal gas was suggested in 2 patients, and the findings were normal in 2. US-guided FNA confirmed infectious etiology of the lesion in 4 patients, and a necrotic specimen suggested infection in one. One patient was cured with repeated aspirations. Catheter drainage was successful in all 3 patients who underwent the procedure. We conclude that US and CT are accurate in detecting splenic abscesses. Our results in splenic interventions advocate wider use of the procedures.

Freedom Constrained Liner for the Treatment and Prevention of Dislocation in Total Hip Arthroplasty

BACKGROUND AND PURPOSE

Dislocation is one of the most common complications following total hip arthroplasty. The aim of our study was to assess failure rate of the Biomet Freedom constrained liner (Biomet, Warsaw, IN, USA) either in revision surgery for recurrent dislocation, or as a preventive method in high dislocation risk patients.

PATIENTS AND METHODS

We assessed retrospectively 105 consecutive surgical procedures in 103 patients where a Freedom constrained liner or cup was used in Turku University Hospital over a 7-year period from 2007 to 2014. The mechanical failure rate of the device was assessed based on medical records. The average age of the patients was 73.4 years. The number of male patients was 53 (51%). Mean follow-up time was 2.5 years. The association between failure of the device and potential risk factors-age, gender, indication, and approach-was analyzed with logistic regression. Results were expressed by odd ratios and 95% confidence intervals.

RESULTS

The mechanical failure rate of the Freedom device was 6 out of 105 (5.7%). None of the 11 preventive primary THAs against dislocation failed, 4 out of 52 (7.7%) preventive revision THAs against dislocation failed, and 2 out of 42 (4.8%) of the treated dislocation cases failed. Four out of six failures were dislocations due to impingement and failure of the locking mechanism. Two liners failed because of loosening. The risk factors assessed were not associated with failure of the device.

INTERPRETATION

We found out that the mechanical failure rate of a Freedom constrained device was low. These results encourage us to continue using the device.

Anxiety symptoms in a major mood and schizophrenia spectrum disorders

BACKGROUND

Comorbid anxiety symptoms and disorders are present in many psychiatric disorders, but methodological variations render comparisons of their frequency and intensity difficult. Furthermore, whether risk factors for comorbid anxiety symptoms are similar in patients with mood disorders and schizophrenia spectrum disorders remains unclear.

METHODS

The Overall Anxiety Severity and Impairment Scale (OASIS) was used to measure anxiety symptoms in psychiatric care patients with schizophrenia or schizoaffective disorder (SSA, n=113), bipolar disorder (BD, n=99), or depressive disorder (DD, n=188) in the Helsinki University Psychiatric Consortium Study. Bivariate correlations and multivariate linear regression models were used to examine associations of depressive symptoms, neuroticism, early psychological trauma and distress, self-efficacy, symptoms of borderline personality disorder, and attachment style with anxiety symptoms in the three diagnostic groups.

RESULTS

Frequent or constant anxiety was reported by 40.2% of SSA, 51.5% of BD, and 55.6% of DD patients; it was described as severe or extreme by 43.8%, 41.4%, and 41.2% of these patients, respectively. SSA patients were significantly less anxious (P=0.010) and less often avoided anxiety-provoking situations (P=0.009) than the other patients. In regression analyses, OASIS was associated with high neuroticism, symptoms of depression and borderline personality disorder and low self-efficacy in all patients, and with early trauma in patients with mood disorders.

CONCLUSIONS

Comorbid anxiety symptoms are ubiquitous among psychiatric patients with mood or schizophrenia spectrum disorders, and in almost half of them, reportedly severe. Anxiety symptoms appear to be strongly related to both concurrent depressive symptoms and personality characteristics, regardless of principal diagnosis.

Seeing Blue As Red: A Hypnotic Suggestion Can Alter Visual Awareness of Colors

Some highly hypnotizable individuals have reported changes in objects' color with suggestions given in normal waking state. However, it is not clear whether this occurs only in their imagination. The authors show that, although subjects could imagine colors, a posthypnotic suggestion was necessary for seeing altered colors, even for a hypnotic virtuoso. She reported posthypnotic color alterations also selectively in response to specific target shapes in briefly presented object arrays. Surprisingly, another highly hypnotizable person showed a very different pattern of results. The control participants could not simulate virtuosos' results by applying cognitive strategies. The results imply that hypnosis can alter the functioning of automatic visual processes but only in some of the most hypnotizable individuals.

Self-reported symptoms of schizotypal and borderline personality disorder in patients with mood disorders

BACKGROUND

Distinguishing between symptoms of schizotypal (SPD) and borderline personality disorders (BPD) is often difficult due to their partial overlap and frequent co-occurrence. We investigated correlations in self-reported symptoms of SPD and BPD in questionnaires at the levels of both total scores and individual items, examining overlapping dimensions.

METHODS

Two questionnaires, the McLean Screening Instrument (MSI) for BPD and the Schizotypal Personality Questionnaire Brief (SPQ-B) for SPD, were filled in by patients with mood disorders (n=282) from specialized psychiatric care in a study of the Helsinki University Psychiatric Consortium. Correlation coefficients between total scores and individual items of the MSI and SPQ-B were estimated. Multivariate regression analysis (MRA) was conducted to examine the relationships between SPQ-B and MSI.

RESULTS

The Spearman's correlation between total scores of the MSI and SPQ-B was strong (rho=0.616, P<0.005). Items of MSI reflecting disrupted relatedness and affective dysregulation correlated moderately (rφ varied between 0.2 and 0.4, P<0.005) with items of SPQ. Items of MSI reflecting behavioural dysregulation correlated only weakly with items of SPQ. In MRA, depressive symptoms, sex and MSI were significant predictors of SPQ-B score, whereas symptoms of anxiety, age and SPQ-B were significant predictors of MSI score.

CONCLUSIONS

Items reflecting cognitive-perceptual distortions and affective symptoms of BPD appear to overlap with disorganized and cognitive-perceptual symptoms of SPD. Symptoms of depression may aggravate self-reported features of SPQ-B, and symptoms of anxiety features of MSI. Symptoms of behavioural dysregulation of BPD and interpersonal deficits of SPQ appear to be non-overlapping.

Behavioral and electrophysiological evidence for fast emergence of visual consciousness

A fundamental unsettled dispute concerns how fast the brain generates subjective visual experiences. Both early visual cortical activation and later activity in fronto-parietal global neuronal workspace correlate with conscious vision, but resolving which of the correlates causally triggers conscious vision has proved a methodological impasse. We show that participants can report whether or not they consciously perceived a stimulus in just over 200 ms. These fast consciousness reports were extremely reliable, and did not include reflexive, unconscious responses. The neural events that causally generate conscious vision must have occurred before these behavioral reports. Analyses on single-trial neural correlates of consciousness revealed that the late cortical processing in fronto-parietal global neuronal workspace (∼300 ms) started after the fastest consciousness reports, ruling out the possibility that this late activity directly reflects the emergence of visual consciousness. The consciousness reports were preceded by a negative amplitude difference (∼160–220 ms) that spread from occipital to frontal cortex, suggesting that this correlate underlies the emergence of conscious vision.

Acetabular reconstruction with impaction bone grafting and cemented polyethylene socket in total hip revision arthroplasty

Background and aims:

Bone deficiency in revision total hip arthroplasty is a challenge to the surgeon. One option for restoration of the bone stock is impaction bone grafting and use of a cemented socket. The aim of this study was to evaluate the mid-term clinical outcome of impaction bone grafting and cemented socket revisions.

Material and methods:

A total of 59 patients (60 hips) underwent revision arthroplasty with impaction bone grafting and application of a cemented socket on the acetabular side in the Turku University Hospital from 1999 to 2004. The study end-point was re-revision for any reason. The cumulative percentages for survival were followed and estimated with Kaplan–Meier curves. Associations between occurrence of re-revision and potential risk factors were analyzed with logistic regression. Results were quantified by odd ratios and 95% confidence intervals. The mean age of the patients was 69 years (33% male). A total of 3% of the patients had a class I Paprosky acetabular defect, 38% had class II, and 55% had class III.

Results:

The overall survival rate was 73%. The mean follow-up time was 7 years. The most common reason for re-revision was aseptic loosening of the acetabular component (13 patients, 81% of re-revisions). Cox’s regression analysis did not identify any risk factors for re-revision.

Conclusion:

Our results were inferior compared to some previous studies. Impaction bone grafting of acetabular defects in revision total hip arthroplasty may not always provide a reliable bone stock in long-term.

The chronometry of visual perception: review of occipital TMS masking studies

Transcranial magnetic stimulation (TMS) continues to deliver on its promise as a research tool. In this review article we focus on the application of TMS to early visual cortex (V1, V2, V3) in studies of visual perception and visual awareness. Depending on the asynchrony between visual stimulus onset and TMS pulse (SOA), TMS can suppress visual perception, allowing one to track the time course of functional relevance (chronometry) of early visual cortex for vision. This procedure has revealed multiple masking effects ('dips'), some consistently (∼+100ms SOA) but others less so (∼-50ms, ∼-20ms, ∼+30ms, ∼+200ms SOA). We review the state of TMS masking research, focusing on the evidence for these multiple dips, the relevance of several experimental parameters to the obtained 'masking curve', and the use of multiple measures of visual processing (subjective measures of awareness, objective discrimination tasks, priming effects). Lastly, we consider possible future directions for this field. We conclude that while TMS masking has yielded many fundamental insights into the chronometry of visual perception already, much remains unknown. Not only are there several temporal windows when TMS pulses can induce visual suppression, even the well-established 'classical' masking effect (∼+100ms) may reflect more than one functional visual process.

Event-related potential responses to perceptual reversals are modulated by working memory load

While viewing ambiguous figures, such as the Necker cube, the available perceptual interpretations alternate with one another. The role of higher level mechanisms in such reversals remains unclear. We tested whether perceptual reversals of discontinuously presented Necker cube pairs depend on working memory resources by manipulating cognitive load while recording event-related potentials (ERPs). The ERPs showed early enhancements of negativity, which were obtained in response to the first cube approximately 500 ms before perceived reversals. We found that working memory load influenced reversal-related brain responses in response to the second cube over occipital areas at the 150-300 ms post-stimulus and over central areas at P3 time window (300-500 ms), suggesting that it modulates intermediate visual processes. Interestingly, reversal rates remained unchanged by the working memory load. We propose that perceptual reversals in discontinuous presentation of ambiguous stimuli are governed by an early (well preceding pending reversals) mechanism, while the effects of load on the reversal related ERPs may reflect general top-down influences on visual processing, possibly mediated by the prefrontal cortex.

The linear impact of concurrent working memory load on dynamics of Necker cube perceptual reversals

Ambiguous figures are visual stimuli that may be perceived in multistable interpretations. The role of attention in modulating perceptual reversals of ambiguous stimuli is not clear. We tested whether perceptual reversals depend on working memory by manipulating its load while the participants were viewing the Necker cube. Increasing working memory load delayed the latency and decreased the frequency of reversals. These effects followed a linear function of load. The findings imply shared resources of the mechanisms responsible for perceptual reversals and working memory maintenance. However, reversals were not completely abolished even with the hard seven-consonants load, suggesting that bottom-up processes continue to operate in the bistable perception dynamics when top-down mechanisms are attenuated.

Electrophysiological evidence for phenomenal consciousness

Abstract Recent evidence from event-related brain potentials (ERPs) lends support to two central theses in Lamme's theory. The earliest ERP correlate of visual consciousness appears over posterior visual cortex around 100-200 ms after stimulus onset. Its scalp topography and time window are consistent with recurrent processing in the visual cortex. This electrophysiological correlate of visual consciousness is mostly independent of later ERPs reflecting selective attention and working memory functions. Overall, the ERP evidence supports the view that phenomenal consciousness of a visual stimulus emerges earlier than access consciousness, and that attention and awareness are served by distinct neural processes.

Experience of structural onlay allografts for the treatment of bone deficiency in revision total hip arthroplasty

Background and Aims:

Loss of femoral bone stock in elective revision total hip arthroplasty poses unique and substantial challenges. Structural onlay allografts may provide mechanical stability for the cementless revision prosthesis and increase bone stock.

Material and methods:

At least one cortical onlay allograft was used in 40 elective total hip arthroplasty revisions (40 patients) to reconstruct femoral bone defects. The operations were performed between January 1999 and August 2010 in the Turku University Hospital, Finland. The mean follow-up time was 52 months (range: 12–125 months).

Results:

The allografts were incorporated into the bone tissue in 37 of 40 (92.5%) patients. Cementless revision stems healed in 36 of 40 (90.0%) patients, but these patients were not exactly the same patients whose allografts were successfully incorporated. One or more surgical complications were experienced by 14 of 40 (35.0%) patients during follow-up. In all, 4 of 40 (10.0%) patients (all women) had hip infections during follow-up. Of the 7 patients with rheumatoid arthritis, 4 (57.1%) had at least one complication.

Conclusions:

The use of the cortical onlay allografts provides a feasible option for restoring the integrity of the proximal femur in revision total hip arthroplasty, but the complication rate is high, particularly in female patients with rheumatoid arthritis.

Recurrent processing enhances visual awareness but is not necessary for fast categorization of natural scenes

Humans are rapid in categorizing natural scenes. Electrophysiological recordings reveal that scenes containing animals can be categorized within 150 msec, which has been interpreted to indicate that feedforward flow of information from V1 to higher visual areas is sufficient for visual categorization. However, recent studies suggest that recurrent interactions between higher and lower levels in the visual hierarchy may also be involved in categorization. To clarify the role of recurrent processing in scene categorization, we recorded EEG and manipulated recurrent processing with object substitution masking while the participants performed a go/no-go animal/nonanimal categorization task. The quality of visual awareness was measured with a perceptual awareness scale after each trial. Masking reduced the clarity of perceptual awareness, slowed down categorization speed for scenes that were not clearly perceived, and reduced the electrophysiological difference elicited by animal and nonanimal scenes after 150 msec. The results imply that recurrent processes enhance the resolution of conscious representations and thus support categorization of stimuli that are difficult to categorize on the basis of the coarse feedforward representations alone.

A preconscious neural mechanism of hypnotically altered colors: a double case study

Hypnotic suggestions may change the perceived color of objects. Given that chromatic stimulus information is processed rapidly and automatically by the visual system, how can hypnotic suggestions affect perceived colors in a seemingly immediate fashion? We studied the mechanisms of such color alterations by measuring electroencephalography in two highly suggestible participants as they perceived briefly presented visual shapes under posthypnotic color alternation suggestions such as "all the squares are blue". One participant consistently reported seeing the suggested colors. Her reports correlated with enhanced evoked upper beta-band activity (22 Hz) 70-120 ms after stimulus in response to the shapes mentioned in the suggestion. This effect was not observed in a control condition where the participants merely tried to simulate the effects of the suggestion on behavior. The second participant neither reported color alterations nor showed the evoked beta activity, although her subjective experience and event-related potentials were changed by the suggestions. The results indicate a preconscious mechanism that first compares early visual input with a memory representation of the suggestion and consequently triggers the color alteration process in response to the objects specified by the suggestion. Conscious color experience is not purely the result of bottom-up processing but it can be modulated, at least in some individuals, by top-down factors such as hypnotic suggestions.

Posthypnotic suggestion alters conscious color perception in an automatic manner

The authors studied whether a posthypnotic suggestion to see a brief, masked target as gray can change the color experience of a hypnotic virtuoso. The visibility of the target was manipulated by varying the delay between the target and the mask that followed it. The virtuoso's subjective reports indicated that her conscious color experience was altered already at short delays between the target and the subsequent mask. The virtuoso's objectively measured pattern of responding under posthypnotic suggestion could not be mimicked either by control participants nor the virtuoso herself. Due to posthypnotic amnesia, the virtuoso was unaware of suggestions given during hypnosis. Importantly, the virtuoso could not alter her color perception without a hypnotic suggestion. These results suggest that hypnosis can affect even a highly automatic process such as color perception.