What do experts look at and what do experts find when reading mammograms?

Purpose: Radiologists sometimes fail to report clearly visible, clinically significant findings. Eye tracking can provide insight into the causes of such errors. Approach: We tracked eye movements of 17 radiologists, searching for masses in 80 mammograms (60 with masses). Results: Errors were classified using the Kundel et al. (1978) taxonomy: search errors (target never fixated), recognition errors (fixated < 500    ms ), or decision errors (fixated > 500    ms ). Error proportions replicated Krupinski (1996): search 25%, recognition 25%, and decision 50%. Interestingly, we found few differences between experts and residents in accuracy or eye movement metrics. Error categorization depends on the definition of the useful field of view (UFOV) around fixation. We explored different UFOV definitions, based on targeting saccades and search saccades. Targeting saccades averaged slightly longer than search saccades. Of most interest, we found that the probability that the eyes would move to the target on the next saccade or even on one of the next three saccades was strikingly low ( ∼ 33 % , even when the eyes were < 2    deg from the target). This makes it clear that observers do not fully process everything within a UFOV. Using a probabilistic UFOV, we find, unsurprisingly, that observers cover more of the image when no target is present than when it is found. Interestingly, we do not find evidence that observers cover too little of the image on trials when they miss the target. Conclusions: These results indicate that many errors in mammography reflect failed deployment of attention; not failure to fixate clinically significant locations.

Priming effects in inefficient visual search: Real, but transient

In visual search tasks, responses to targets on one trial can influence responses on the next trial. Most typically, target repetition speeds response while switching to a different target slows response. Such "priming" effects have sometimes been given very significant roles in theories of search (e.g., Theeuwes, Philosophical Transactions of the Royal Society B: Biological Sciences, 368, 1628, 2013). Most work on priming has involved "singleton" or "popout" tasks. In non-popout priming tasks, observers must often perform a task-switching operation because the guiding template for one target (e.g., a red vertical target in a conjunction task) is incompatible with efficient search for the other target (green horizontal, in this example). We examined priming in inefficient search where the priming feature (Color: Experiments 1-3, Shape: Experiments 4-5) was irrelevant to the task of finding a T among Ls. We wished to determine if finding a red T on one trial helped observers to be more efficient if the next T was also red. In all experiments, we found additive priming effects. The reaction time (RT) for the second trial was shorter if the color of the T was repeated. However, there was no interaction with set size. The slope of the RT × Set Size function was not shallower for runs of the same target color, compared to trials where the target color switched. We propose that priming might produce transient guidance of the earliest deployments of attention on the next trial or it might speed decisions about a selected target. Priming does not appear to guide attention over the entire search.

Assisted Versus Unassisted Domiciliary Alcohol Detoxification: A Randomized Controlled Trial

Background

Detoxification stands as a crucial phase in the treatment of alcohol use disorders (AUD), yet only limited data is available on the outcomes of home-based detoxification. Assisted domiciliary detoxification involves monitoring an individual's withdrawal progress, while offering psychosocial support and detoxification services in the comfort of their home.

Aim

To study outcomes of assisted over routine domiciliary alcohol detoxification in randomized controlled trials.

Methodology

100 consenting male patients who were advised of domiciliary detoxification were randomized into intervention (n = 49) and control (n = 51) groups. A predesigned semi-structured questionnaire was used to assess the socio-demographic and drinking-related variables. Both groups received routine care for alcohol withdrawal from respective treating doctors. Additionally, the intervention group received two sessions of brief intervention for alcohol and daily phone call assistance. Records were kept for adverse events. Phone calls were discontinued once detoxification was completed. Outcomes were measured for successful completion of detoxification and abstention from alcohol at the end of one month.

Results

The intervention group had significantly higher successful detoxification rates (85.7% vs. 62.7%, p = .008) and significantly higher abstinence days at the end of one month compared to the control group (22 vs. 10 days, p < .001) with an effect size of 1.2 (confidence interval (CI) 0.69-1.53).

Conclusion

This study demonstrates that receiving assistance in the acute phase of domiciliary detoxification helps in a successful detoxification and achieving a significant level of abstinence at the end of one month compared to the control group.

A Rare Presentation of Delusional Parasitosis With Koro-Like Syndrome

Delusional parasitosis (DP) with Koro-like syndrome poses a complex clinical challenge, demanding a comprehensive and empathetic approach from healthcare professionals. This exceptional combination of fixed beliefs about infestation and experiences of genital retraction can profoundly impact patients' well-being and daily functioning. The associated stigma and misconceptions further compound the difficulties faced by individuals struggling with these co-occurring conditions. Given the rarity of encountering both conditions simultaneously, navigating the diagnosis and treatment of delusional parasitosis with Koro-like syndrome requires a thorough understanding of its multifaceted nature. Embracing a holistic strategy encompassing psychoeducation, psychotherapy, and pharmacological interventions is essential for effectively addressing these dual conditions.

Unexpected Cataract Formation Following Valproate Treatment: A Case Report

Valproic acid (VPA), or sodium valproate, is a frequently prescribed medication for many psychiatric conditions, notably for the management of bipolar affective disorder. While its common side effects are well known and thoroughly documented in medical literature, the occurrence of cataracts as a side effect is exceedingly rare. There is evidence of cataract formation with long-term use of VPA in a few studies. Recognizing this potential adverse effect is crucial. It is important to recommend that patients undergo regular eye examinations if they experience any visual disturbances or as a preventative measure to ensure effective management. This case report examines the unusual occurrence of cataract development associated with valproate use.