Effects of Second Dose of SARS-CoV-2 Vaccination on Household Transmission, England.

A single SARS-CoV-2 vaccine dose reduces onward transmission from case-patients. We assessed the potential effects of receiving 2 doses on household transmission for case-patients in England and their household contacts. We used stratified Cox regression models to calculate hazard ratios (HRs) for contacts becoming secondary case-patients, comparing contacts of 2-dose vaccinated and unvaccinated index case-patients. We controlled for age, sex, and vaccination status of case-patients and contacts, as well as region, household composition, and relative socioeconomic condition based on household location. During the Alpha-dominant period, HRs were 0.19 (0.13-0.28) for contacts of 2-dose BNT162b2-vaccinated case-patients and 0.54 (0.41-0.69) for contacts of 2-dose Ch4dOx1-vaccinated case-patients; during the Delta-dominant period, HRs were higher, 0.74 (0.72-0.76) for BNT162b2 and 1.06 (1.04-1.08) for Ch4dOx1. Reduction of onward transmission was lower for index case-patients who tested positive ≥2 months after the second dose of either vaccine.

Economic evaluation of the cost of different methods of retesting chlamydia positive individuals in England.

OBJECTIVES: The National Chlamydia Screening Programme (NCSP) in England opportunistically screens eligible individuals for chlamydia infection. Retesting is recommended three3 months after treatment following a positive test result, but no guidance is given on how local areas should recall individuals for retesting. Here , we compare cost estimates for different recall methods to inform the optimal delivery of retesting programmes. DESIGN: Economic evaluation. SETTING: England. METHODS: We estimated the cost of chlamydia retesting for each of the six most commonly used recall methods in 2014 based on existing cost estimates of a chlamydia screen. Proportions accepting retesting, opting for retesting by post, returning postal testing kits and retesting positive were informed by 2014 NCSP audit data. Health professionals 'sense-checked' the costs. PRIMARY AND SECONDARY OUTCOMES: Cost and adjusted cost per chlamydia retest; cost and adjusted cost per chlamydia retest positive. RESULTS: We estimated the cost of the chlamydia retest pathway, including treatment/follow-up call, to be between £45 and £70 per completed test. At the lower end, this compared favourably to the cost of a clinic-based screen. Cost per retest positive was £389-£607. After adjusting for incomplete uptake, and non-return of postal kits, the cost rose to £109-£289 per completed test (cost per retest positive: £946-£2,506). The most economical method in terms of adjusted cost per retest was no active recall as gains in retest rates with active recall did not outweigh the higher cost. Nurse-led client contact by phone was particularly uneconomical, as was sending out postal testing kits automatically. CONCLUSIONS: Retesting without active recall is more economical than more intensive methods such as recalling by phone and automatically sending out postal kits. If sending a short message service (SMS) could be automated, this could be the most economical way of delivering retesting. However, patient choice and local accessibility of services should be taken into consideration in planning.

Potential for diagnosis of infectious disease from the 100,000 Genomes Project Metagenomic Dataset: Recommendations for reporting results.

The identification of microbiological infection is usually a diagnostic investigation, a complex process that is firstly initiated by clinical suspicion. With the emergence of high-throughput sequencing (HTS) technologies, metagenomic analysis has unveiled the power to identify microbial DNA/RNA from a diverse range of clinical samples (1). Metagenomic analysis of whole human genomes at the clinical/research interface bypasses the steps of clinical scrutiny and targeted testing and has the potential to generate unexpected findings relating to infectious and sometimes transmissible disease. There is no doubt that microbial findings that may have a significant impact on a patient's treatment and their close contacts should be reported to those with clinical responsibility for the sample-donating patient. There are no clear recommendations on how such findings that are incidental, or outside the original investigation, should be handled. Here we aim to provide an informed protocol for the management of incidental microbial findings as part of the 100,000 Genomes Project which may have broader application in this emerging field. As with any other clinical information, we aim to prioritise the reporting of data that are most likely to be of benefit to the patient and their close contacts. We also set out to minimize risks, costs and potential anxiety associated with the reporting of results that are unlikely to be of clinical significance. Our recommendations aim to support the practice of microbial metagenomics by providing a simplified pathway that can be applied to reporting the identification of potential pathogens from metagenomic datasets. Given that the ambition for UK sequenced human genomes over the next 5 years has been set to reach 5 million and the field of metagenomics is rapidly evolving, the guidance will be regularly reviewed and will likely adapt over time as experience develops.

Do healthcare professionals and young adults know about the National Chlamydia Screening Programme? Findings from two cross-sectional surveys.

The extent to which healthcare professionals (HCPs) and young people (YP) are aware of, and adhere to, National Chlamydia Screening Programme (NCSP) recommendations on testing frequency is unclear. To address this two cross-sectional surveys in 2015-2016: one among genitourinary medicine (GUM) and non-GUM HCPs (n = 109) and the other among YP attending a GUM clinic in England (n = 195). For both, questions were designed to measure awareness of NCSP guidance and whether respondents acted on that knowledge. This included questions about YP's most recent test(s) (if ever) and the time since first and last sex with their most recent partners. Knowledge of NCSP testing guidelines varied among both GUM and non-GUM HCP respondents. However, lack of knowledge of the guidelines did not preclude HCPs from recommending testing in line with NCSP recommendations in practice. While most YP were not aware of NCSP recommendations, around two-thirds had tested for Chlamydia at least once in the last year. However, testing seldom appeared to coincide with partnership change. There is a knowledge gap and a discord between testing recommendations and practice. Interventions are needed to encourage appropriate testing patterns to maximise the individual and public health benefits of testing.

The Creative Stereotype Effect.

Because of its fundamental relevance to scientific innovation, artistic expression, and human ingenuity, creativity has long been the subject of systematic psychological investigation. Concomitantly, the far-reaching effects of stereotypes on various cognitive and social processes have been widely researched. Bridging these two literatures, we show in a series of two studies that stereotypes related to creativity can both enhance and diminish individuals' performance on a divergent thinking task. Specifically, Study 1 demonstrated that participants asked to take on a stereotypically uninhibited perspective performed significantly better on a divergent thinking task than those participants who took on a stereotypically inhibited perspective, and a control group. Relatedly, Study 2 showed that the same effect is found within-subjects, with divergent thinking significantly improving when participants invoke an uninhibited stereotype. Moreover, we demonstrate the efficacy of Latent Semantic Analysis as an objective measure of the originality of ideas, and discuss implications of our findings for the nature of creativity. Namely, that creativity may not be best described as a stable individual trait, but as a malleable product of context and perspective.

Introduction to the special section on the neural substrate of analogical reasoning and metaphor comprehension.

The special section on the neural substrate of relational reasoning includes 4 articles that address the processes and brain regions involved in analogical reasoning (Green, Kraemer, Fugelsang, Gray, & Dunbar, 2011; Maguire, McClelland, Donovan, Tillman, & Krawczyk, 2011) and in metaphor comprehension (Chettih, Durgin, & Grodner, 2011; Prat, Mason, & Just, 2011). We see this work as an example of how neuroscience approaches to cognition can lead to increased understanding of cognitive processes. In this brief introduction, we first situate the 4 articles in the context of prior cognitive neuroscience work on relational reasoning. We then highlight the main issues explored in these articles: different sources of complexity and difficulty in relational processing, potential differences between the roles of the 2 hemispheres, and the impact of individual differences in various cognitive abilities. The 4 articles illustrate a range of methodologies, including functional magnetic resonance imaging (fMRI; Green et al., 2011; Prat et al., 2011), event-related potentials (ERPs; Maguire et al., 2011), and different types of semantic priming (Chettih et al., 2011; Prat et al., 2011). They highlight the connections between research on analogy and on metaphor comprehension and suggest, collectively, that a cognitive neuroscience approach to relational reasoning can lead to converging conclusions.

Neural correlates of creativity in analogical reasoning.

Brain-based evidence has implicated the frontal pole of the brain as important for analogical mapping. Separately, cognitive research has identified semantic distance as a key determinant of the creativity of analogical mapping (i.e., more distant analogies are generally more creative). Here, we used functional magnetic resonance imaging to assess brain activity during an analogy generation task in which we varied the semantic distance of analogical mapping (as derived quantitatively from a latent semantic analysis). Data indicated that activity within an a priori region of interest in left frontopolar cortex covaried parametrically with increasing semantic distance, even after removing effects of task difficulty. Results implicate increased recruitment of frontopolar cortex as a mechanism for integrating semantically distant information to generate solutions in creative analogical reasoning.

Connecting long distance: semantic distance in analogical reasoning modulates frontopolar cortex activity.

Solving problems often requires seeing new connections between concepts or events that seemed unrelated at first. Innovative solutions of this kind depend on analogical reasoning, a relational reasoning process that involves mapping similarities between concepts. Brain-based evidence has implicated the frontal pole of the brain as important for analogical mapping. Separately, cognitive research has identified semantic distance as a key characteristic of the kind of analogical mapping that can support innovation (i.e., identifying similarities across greater semantic distance reveals connections that support more innovative solutions and models). However, the neural substrates of semantically distant analogical mapping are not well understood. Here, we used functional magnetic resonance imaging (fMRI) to measure brain activity during an analogical reasoning task, in which we parametrically varied the semantic distance between the items in the analogies. Semantic distance was derived quantitatively from latent semantic analysis. Across 23 participants, activity in an a priori region of interest (ROI) in left frontopolar cortex covaried parametrically with increasing semantic distance, even after removing effects of task difficulty. This ROI was centered on a functional peak that we previously associated with analogical mapping. To our knowledge, these data represent a first empirical characterization of how the brain mediates semantically distant analogical mapping.

Representations of physical plausibility revealed by event-related potentials.

Maintaining an accurate mental representation of the current environment is crucial to detecting change in that environment and ensuring behavioral coherence. Past experience with interactions between objects, such as collisions, has been shown to influence the perception of object interactions. To assess whether mental representations of object interactions derived from experience influence the maintenance of a mental model of the current stimulus environment, we presented physically plausible and implausible collision events while recording brain electrical activity. The parietal P300 response to 'oddball' events was found to be modulated by the physical plausibility of the stimuli, suggesting that past experience of object interactions can influence working memory processes involved in monitoring ongoing changes to the environment.

The Micro-Category account of analogy.

Here, we investigate how activation of mental representations of categories during analogical reasoning influences subsequent cognitive processing. Specifically, we present and test the central predictions of the "Micro-Category" account of analogy. This account emphasizes the role of categories in aligning terms for analogical mapping. In a semantic priming paradigm, a four-word analogy task was compared to two other four-word tasks. Stimuli were identical in all tasks; only the instructions given to participants differed. Participants were instructed to identify analogy relations, category relations, or conventionalized semantic relations in the four-word sets. After each four-word set, a single target word appeared and participants named this word aloud. Target words that referred to category relations in the preceding four-word sets were primed as strongly when participants identified analogies as when participants identified categories, suggesting that activation of category concepts plays an important role in analogical thinking. In addition, priming of category-referent words in the analogy and category tasks was significantly greater than priming of these words when participants identified conventionalized semantic relations. Since identical stimuli were used in all conditions, this finding indicates that it is the activation of category relations, distinct from any effect of basic semantic association, that causes analogical reasoning to prime category-referent words. We delineate how the "Micro-Category" account of analogy predicts these phenomena and unifies findings from diverse areas of research concerning analogical reasoning.

Frontopolar cortex mediates abstract integration in analogy.

Integration of abstractly similar relations during analogical reasoning was investigated using functional magnetic resonance imaging. Activation elicited by an analogical reasoning task that required both complex working memory and integration of abstractly similar relations was compared to activation elicited by a non-analogical task that required complex working memory in the absence of abstract relational integration. A left-sided region of the frontal pole of the brain (BA 9/10) was selectively active for the abstract relational integration component of analogical reasoning. Analogical reasoning also engaged a left-sided network of parieto-frontal regions. Activity in this network during analogical reasoning is hypothesized to reflect categorical alignment of individual component terms that make up analogies. This parieto-frontal network was also engaged by the complex control task, which involved explicit categorization, but not by a simpler control task, which did not involve categorization. We hypothesize that frontopolar cortex mediates abstract relational integration in complex reasoning while parieto-frontal regions mediate working memory processes, including manipulation of terms for the purpose of categorical alignment, that facilitate this integration.

Automatic activation of categorical and abstract analogical relations in analogical reasoning.

We examined activation of concepts during analogical reasoning. Subjects made either analogical judgments or categorical judgments about four-word sets. After each four-word set, they named the ink color of a single word in a modified Stroop task. Words that referred to category relations were primed (as indicated by longer response times on Stroop color naming) subsequent to analogical judgments and categorical judgments. This finding suggests that activation of category concepts plays a fundamental role in analogical thinking. When colored words referred to analogical relations, priming occurred subsequent to analogical judgments, but not to categorical judgments, even though identical four-word stimuli were used for both types of judgments. This finding lends empirical support to the hypothesis that, when people comprehend the analogy between two items, they activate an abstract analogical relation that is distinct from the specific content items that compose the analogy.

Dissociating processes supporting causal perception and causal inference in the brain.

An understanding of relations between causes and effects is essential for making sense of the dynamic physical world. It has been argued that this understanding of causality depends on both perceptual and inferential components. To investigate whether causal perception and causal inference rely on common or on distinct processes, the authors tested 2 callosotomy (split-brain) patients and a group of neurologically intact participants. The authors show that the direct perception of causality and the ability to infer causality depend on different hemispheres of the divided brain. This finding implies that understanding causality is not a unitary process and that causal perception and causal inference can proceed independently.

Brain mechanisms underlying perceptual causality.

Functional magnetic resonance imaging (fMRI) was used to examine the neural correlates of perceptual causality. Participants were imaged while viewing alternating blocks of causal events in which a ball collides with, and causes movement of another ball, versus non-causal events in which a spatial or a temporal gap precedes the movement of a second ball. There were significantly higher levels of relative activation in the right middle frontal gyrus and the right inferior parietal lobule for causal relative to non-causal events. Furthermore, when the differential effects of spatial and temporal incontiguities were subtracted from the contiguous stimuli, we observed both common (right prefrontal) and unique (right parietal and right temporal) regions of activation as a function of spatial and temporal processing of contiguity, respectively. Taken together, these data provide a means to help determine how the visual system extracts causality from dynamic visual information in the environment using spatial and temporal cues.

Brain-based mechanisms underlying complex causal thinking.

We use functional magnetic resonance imaging (fMRI) and behavioral analyses to study the neural roots of biases in causal reasoning. Fourteen participants were given a task requiring them to interpret data relative to plausible and implausible causal theories. Encountering covariation-based data during the evaluation of a plausible theory as opposed to an implausible theory selectively recruited neural tissue in the prefrontal and occipital cortices. In addition, the plausibility of a causal theory modulated the recruitment of distinct neural tissue depending on the extent to which the data were consistent versus inconsistent with the theory provided. Specifically, evaluation of data consistent with a plausible causal theory recruited neural tissue in the parahippocampal gyrus, whereas evaluating data inconsistent with a plausible theory recruited neural tissue in the anterior cingulate, left dorsolateral prefrontal cortex, and precuneus. We suggest that these findings provide a neural instantiation of the mechanisms by which working hypotheses and evidence are integrated in the brain.

A cognitive neuroscience framework for understanding causal reasoning and the law.

Over the past couple of decades, there have been great developments in the fields of psychology and cognitive neuroscience that have allowed the advancement of our understanding of how people make judgements about causality in several domains. We provide a review of some of the contemporary psychological models of causal thinking that are directly relevant to legal reasoning. In addition, we cover some exciting new research using advanced neuroimaging techniques that have helped to uncover the underlying neural signatures of complex causal reasoning. Through the use of functional imaging, we provide a first-hand look at how the brain responds to evidence that is either consistent or inconsistent with one's beliefs and expectations. Based on the data covered in this review, we propose some ideas for how the effectiveness of causal reasoning, especially as it pertains to legal decision-making, may be facilitated.

Theory and data interactions of the scientific mind: evidence from the molecular and the cognitive laboratory.

A number of researchers and scholars have stressed the importance of disconfirmation in the quest for the development of scientific knowledge (e.g., Popper, 1959). Paradoxically, studies examining human reasoning in the laboratory have typically found that people display a confirmation bias in that they are more likely to seek out and attend to data consistent rather than data inconsistent with their initial theory (Wason, 1968). We examine the strategies that scientists and students use to evaluate data that are either consistent or inconsistent with their expectations. First, we present findings from scientists reasoning "live" in their laboratory meetings. We show that scientists often show an initial reluctance to consider inconsistent data as "real." However, this initial reluctance is often overcome with repeated observations of the inconsistent data such that they modify their theories to account for the new data. We further examine these issues in a controlled scientific causal thinking simulation specifically developed to examine the reasoning strategies we observed in the natural scientific environment. Like the scientists, we found that participants in our simulation initially displayed a propensity to discount data inconsistent with a theory provided. However, with repeated observations of the inconsistent data, the students, like the scientists, began to see the once anomalous data as "real" and the initial bias to discount that data was significantly diminished.

Representational change and analogy: how analogical inferences alter target representations.

The ways that analogy alters the representation of target information was investigated in 4 experiments. Participants read information about a target, followed by a potential source analog. Participants later completed a recognition test in which some of the sentences were old, some novel, and some analogical inferences that were not seen before. Participants who read the description of a source analog erroneously recognized analogical inferences as being in the target description. The effect occurred with different delays between study and test and with an unfamiliar target domain. It also occurred when source and target shared few superficial features. Reading-time data suggest that participants were drawing analogical inferences when encoding the source. Overall, these experiments show that analogical inferences are incorporated in the representation of the target and cannot be differentiated from information actually presented.