Prenatal ultrasound screening and pregnancy outcomes in HIV-positive women in Germany: results from a retrospective single-center study at the Charité-Universitätsmedizin Berlin.

OBJECTIVES: The aim of this study was to investigate the rate of Mother-to-child-transmission (MTCT) in women living with HIV (WLWH) in a tertiary care institution. Furthermore, we aimed to assess prenatal ultrasound screening for fetal anomalies and outcomes in high-risk pregnancies due to maternal HIV infection." METHODS: In this single-center study, retrospective data related to pregnancy and childbirth were collected from 420 WLWH. All data were evaluated descriptively. RESULTS: From January 2014 to December 2020, a total number of 420 pregnant WLWH delivered 428 newborns. 415 (98.8%) were receiving antiretroviral therapy (ART) and 88.8% had a viral load of < 50 cop/ml prior delivery. 46 (11%) of the newborns were born prematurely. Low birth weight < 2500 g occurred in 38 (9.1%) of the children. 219 (52.1%) caesarean sections (CS) were performed. The most frequent indication for an elective CS was a previous CS (70.2%). 8 severe malformations were detected using first and second trimester ultrasound. In one child, MTCT was detected postpartum, resulting in an HIV transmission rate of 0.2% in the presented cohort. CONCLUSIONS: The low rate of vertical HIV-transmission in our cohort of 0.2% is the result of interdisciplinary prenatal care and high experience of healthcare providers in treatment of WLWH. Despite high ART coverage and adherence, good maternal immune system and very low vertical HIV transmission rate, maternal HIV infection remains a challenge in obstetric care. First and second ultrasound screening should be a part of prenatal care for HIV-infected women and should also be offered to HIV-negative women. A reduction of the rate of unnecessary elective caesarean deliveries in WLWH is necessary to reduce complications in subsequent pregnancies.

Emotional face expressions and group membership: Does affective mismatch induce conflict?

When asked to judge or react to a facial emotional display of a person, people do not only take the emotion into account, but also other socially important features of the face, such as, for example, ethnicity (Kozlik & Fischer, 2020; Paulus & Wentura, 2014). Importantly, the emotion-related and nonemotion-related features are seemingly not (or not always) processed in a simple, additive manner, but are-in a more functional manner-integrated to provide an "amalgamated signal" on which individuals base their judgment and responses. Whereas Paulus and Wentura (2014) put forward a social-message account of this amalgamated signal, Kozlik and Fischer (2020) recently proposed a processing-conflict explanation. The empirical evidence regarding this issue is, however, mixed. In three experiments, we aimed at replicating and extending Kozlik and Fischer's central experiment to gain further insight into the validity of the social-message versus the processing-conflict account. However, we failed to replicate their findings. The implications of the new evidence for the two accounts are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Assessing subjective prime awareness on a trial-by-trial basis interferes with masked semantic priming effects.

Ratings of perceptual experience on a trial-by-trial basis are increasingly used in masked priming studies to assess prime awareness. It is argued that such subjective ratings more adequately capture the content of phenomenal consciousness compared to the standard objective psychophysical measures obtained in a session after the priming experiment. However, the concurrent implementation of the ratings within the priming experiment might alter magnitude and processes underlying semantic priming, because participants try to identify the masked prime. In the present study, we therefore compared masked semantic priming effects assessed within the classical sequential procedure, in which prime identification is psychophysically assessed after the priming experiment, with those obtained in a condition, in which prime awareness is rated within the priming experiment. Two groups of participants performed a lexical decision task (LDT) on targets preceded by masked primes of 20, 40, or 60 ms durations, to induce the variability of prime awareness. One group additionally rated prime visibility trials-wise using the Perceptual Awareness Scale (PAS), whereas the other group only performed the LDT. Analysis of reaction times (RTs) as well as drift diffusion modeling revealed general priming effects on RT and drift rate only in the PAS-absent group. In the PAS-present group, residual priming effects on RT and the non-decisional component t0 were obtained for trials with rated prime awareness. This shows that assessing subjective perceptual experience on a trial-by-trial basis heavily interferes with semantic processes underlying masked priming, presumably due to attentional demands associated with concurrent prime identification. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

When emotions cannot be efficiently used to guide attention: Flexible, goal-relevant utilization of facial emotions is hindered by social anxiety.

In order to achieve optimal outcomes in diverse situations, emotional information can be used to initiate novel, goal-directed processes that are not inherently related to the emotional meaning. Demonstrating this goal-dependent flexibility, in a recent study, we presented facial emotions as informative spatial cues: Participants could direct their attention to the probable target location based on the expressed emotion with a remarkable efficiency (Folyi, Rohr, & Wentura, 2020). However, as inherent motivational aspects of threat-related facial expressions can be particularly salient to socially anxious individuals (e.g., Staugaard, 2010), they might not be able to use this information flexibly in the pursuit of a context-specific goal. The present study tested this assumption in an endogenous cueing task with anger and fear expressions as informative central cues. Indeed, in Experiment 1 (N = 174), higher social anxiety was associated with reduced cueing at a 600 ms cue-target asynchrony, and this deficit was specific to social as opposed to general anxiety. Furthermore, this effect occurred only when faces were presented upright (Experiment 1), and not under inverted presentation (Experiment 2, N = 90), ruling out a general deficit in attentional control. The results suggest that flexible utilization of threat-related emotional information is sensitive to participants' social anxiety, suggesting an imbalance between using emotional information in the pursuit of a context-dependent goal on the one hand, and processes intrinsically related to the emotional meaning on the other.

Assessment of high-risk human papillomavirus infections and associated cervical dysplasia in HIV-positive pregnant women in Germany: a prospective cross-sectional two-centre study.

PURPOSE: Invasive cervical cancer (ICC) is associated in nearly 100% with persistent high-risk Human Papillomavirus (HR-HPV) infection. ICC is still one of the leading causes for cancer mortality in women worldwide. The immunosuppressive influence of Human Immunodeficiency Virus (HIV) and the immunocompromised period of pregnancy due to tolerance induction against the hemiallogeneic fetus, are generally risk factors for acquisition and persistence of HR-HPV infections and their progression to precancerous lesions and HPV-associated carcinoma. METHODS: Overall, 81 pregnant women living with HIV (WLWH) were included. A medical history questionnaire was used to record clinical and HIV data. Participants received cervicovaginal cytological smear, colposcopy and HPV testing. HPV test was performed using BSGP5+/6+ PCR with Luminex read-out. The HR-HPV genotypes 16, 18, 31, 33, 45, 52, 58 were additionally grouped together as high-high-risk HPV (HHR-HPV) for the purpose of risk-adapted analysis. RESULTS: HR-HPV prevalence was 45.7%. Multiple HPV infections were detected in 27.2% of participants, of whom all had at least one HR-HPV genotype included. HR-HPV16 and HR-HPV52 were the most prevalent genotypes and found when high squamous intraepithelial lesion (HSIL) was detected by cytology. HIV viral load of ≥ 50 copies/ml was associated with higher prevalence of HR-HPV infections. Whereas, CD4 T cells < 350/µl showed association with occurrence of multiple HPV infections. Time since HIV diagnosis seemed to impact HPV prevalence. CONCLUSION: Pregnant WLWH require particularly attentive and extended HPV-, colposcopical- and cytological screening, whereby clinical and HIV-related risk factors should be taken into account.

How Emotion Relates to Language and Cognition, Seen Through the Lens of Evaluative Priming Paradigms.

Affect and emotion are essential aspects of human life. These states or feelings signal personally relevant things or situations and color our memories and thoughts. Within the area of affective or emotion processing, evaluation-the assessment of the valence associated with a stimulus or event (i.e., its positivity or negativity)-is considered a fundamental process, representing an early and crucial stage in constructivist emotion theories. Valence evaluation is assumed to occur automatically when encountering a stimulus. But does this really apply always, even if we simply see a word? And if so, what exactly is processed or activated in memory? One approach to investigating this evaluative process uses behavioral priming paradigms and, first and foremost, the evaluative priming paradigm and its variants. In the present review, we delineate the insights gained from this paradigm about the relation of affect and emotion to cognition and language. Specifically, we reviewed the empirical evidence base with regard to this issue as well as the proposed theoretical models of valence evaluation, specifically with regard to the nature of the representations activated via such paradigms. It will become clear that affect and emotion are foremost (and, perhaps, even exclusively) triggered by evaluative priming paradigms in the sense that semantic affective knowledge is activated. This knowledge should be modeled as being active in working memory rather than in long-term memory as was assumed in former models. The emerging evidence concerning the processing of more specific emotion aspects gives rise to the assumption that the activation of these semantic aspects is related to their social importance. In that sense, the fast and (conditionally) automatic activation of valence and other emotion aspects in evaluative priming paradigms reveals something about affect and emotion: Valence and specific emotion aspects are so important for our daily life that encountering almost any stimulus entails the automatic activation of the associated valence and other emotion aspects in memory, when the context requires it.

Emotion misattribution from complex scene pictures: Evidence for affective processing beyond valence.

The present experiments employed an emotion misattribution procedure to investigate if, and to what extent, emotional pictures are automatically processed on an emotion-specific level. We employed emotional pictures from the International Affective Picture System (Lang, Bradley, & Cuthbert, 2008) depicting joy-, anger-, fear-, and sadness-related contents as prime stimuli in the four-category emotion misattribution procedure (Rohr, Degner, & Wentura, 2015). Pictures were presented briefly and masked to avoid intentional responding. The pattern of results across all experiments provides evidence for an unfolding of emotion specificity along with the degree of visibility of primes. When presentation duration allowed for relatively good prime visibility (40 ms; Experiment 1), we observed emotion-specific misattribution effects for each prime category. With shorter prime presentation reducing prime visibility (30 ms; Experiment 2a and 2b), misattribution effects became less specific: While anger-related emotional scenes were clearly differentiated from fear and sadness-associated scenes, the latter two were not differentiated from one another. This pattern cannot be explained by simple semantic processing, but fits to an early appraisal of the coping ability associated with the emotion triggered by the pictorial content highlighting that specific, emotion-related processes are involved at the very early stages of emotional information processing. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Corrigendum: Degree and Complexity of Non-conscious Emotional Information Processing - A Review of Masked Priming Studies.

[This corrects the article DOI: 10.3389/fnhum.2021.689369.].

Degree and Complexity of Non-conscious Emotional Information Processing - A Review of Masked Priming Studies.

Whether and to what degree information can be processed non-consciously has been a matter of debate since the emergence of psychology as a science. Emotional information, in particular, has often been assumed to have a privileged status because of its relevance for well-being and survival (e.g., to detect a threat). Indeed, many studies have explored non-conscious processing of evaluative (i.e., "emotional" in a broad sense) or emotional (e.g., facial expressions) features using the "silver bullet" of non-consciousness research - the masked sequential priming paradigm. In its prototypical form, this paradigm involves the categorization of target stimuli according to valence (e.g., is the target positive or negative?). Each target is preceded by a briefly presented prime that is followed by a mask to constrain awareness. Non-conscious processing is inferred from subtle influences of the prime on target processing, that is, whether responses are faster if prime and target are valence-congruent or not. We will review this research with a focus on three questions: first, which methods are used in this area to establish non-conscious processing? Second, is there evidence for non-conscious extraction of evaluative information? Third, is there evidence for non-conscious processing beyond a simple valence (positive/negative) discrimination, for example, processing of emotion-specific information? We will highlight important current debates and potential directions in which the field will move in the future.

Consumer perspective on healthcare services for juvenile idiopathic arthritis: results of a multicentre JIA inception cohort study.

OBJECTIVES: To evaluate healthcare services for patients with juvenile idiopathic arthritis (JIA) from the parent-proxy perspective and to identify factors associated with perceived deficits in care. METHODS: Patients with JIA from 11 paediatric rheumatology units were enrolled in an inception cohort within the first 12 months after diagnosis. Healthcare services were assessed using The Child Healthcare Questionnaire on satisfaction, utilisation and needs. Factors associated with deficits in care were identified by logistic regression analysis. RESULTS: Data from parents of 835 JIA-patients were included in the analysis. At the assessment (4.7 months after diagnosis), 85% of the patients received drug treatment, and 50% had received multi-professional care. The most frequently used services were physiotherapy (84%), occupational therapy (23%), and telephone counselling (17%). Almost one-third of families reported that they had not received the services that they needed, with health education being the most frequently reported need. Most parents (93%) were satisfied with the overall healthcare provided for their children, especially regarding doctors' behaviour. However, approximately 1 in 3 consumers were dissatisfied with the time to JIA diagnosis and the school services. The lower the child's quality of life, the higher the chance was that the child and the family received multi-professional care, perceived unmet needs, and were dissatisfied with care. CONCLUSIONS: According to parents' experience and satisfaction with their child's care, performance at the system level can be further improved by diagnosing JIA earlier, providing additional information at disease onset, and ensuring that the child's social environment is taken into account.

[Care of children and adolescents with type 1 diabetes: solutions for technical and psychosocial challenges]. / Versorgung von Kindern und Jugendlichen mit Typ-1-Diabetes: Lösungen für technische und psychosoziale Herausforderungen.

Type 1 diabetes mellitus is the most common endocrine disease in children and adolescents below age 15 years. A cure for the autoimmune disease against the insulin-secreting beta cells is still not in sight. Nevertheless, in recent years technical advances in innovation concerning glucose sensor technology, insulin pumps, and new algorithms that regulate insulin delivery have led to a constant improvement of metabolic control achieved in children and adolescents with type 1 diabetes.This review article shows the current care situation of children and adolescents with type 1 diabetes and their parents. The multidisciplinary care in specialized pediatric diabetes teams of pediatric diabetologists, diabetes educators, social workers, and psychotherapists has been established for many years and has set grounds for a very good quality of care for children and adolescents with type 1 diabetes in Germany. The focus is on diabetes education, in particular self-management, psychosocial support and intervention, and the inclusion of children and adolescents with diabetes in school, kindergarten, and daycare centers. We also address new, social developments in the online diabetes community. A current example is the patient-operated ecosystem of the Do-It-Yourself Artificial Pancreas System (DIY APS) movement, which, as a patient-operated, open-source project, has meanwhile also become an innovator for industry. Finally, we highlight related opportunities and shifts in classical doctor-patient roles.

How Monitor Characteristics Affect Human Perception in Visual Computer Experiments: CRT vs. LCD Monitors in Millisecond Precise Timing Research.

Liquid crystal display (LCD) monitors are nowadays standard in computerized visual presentation. However, when millisecond precise presentation is concerned, they have often yielded imprecise and unreliable presentation times, with substantial variation across specific models, making it difficult to know whether they can be used for precise vision experiments or not. The present paper intends to act as hands-on guide to set up an experiment requiring millisecond precise visual presentation with LCD monitors. It summarizes important characteristics relating to precise visual stimulus presentation, enabling researchers to transfer parameters reported for cathode ray tube (CRT) monitors to LCD monitors. More importantly, we provide empirical evidence from a preregistered study showing the suitability of LCD monitors for millisecond precise timing research. Using sequential testing, we conducted a masked number priming experiment using CRT and LCD monitors. Both monitor types yielded comparable results as indicated by Bayes factor favoring the null hypothesis of no difference between display types. More specifically, we found masked number priming under conditions of zero awareness with both types of monitor. Thus, the present study highlights the importance of hardware settings for empirical psychological research; inadequate settings might lead to more "noise" in results thereby concealing potentially existing effects.

When emotions guide your attention in line with a context-specific goal: Rapid utilization of visible and masked emotional faces for anticipatory attentional orienting.

The emotional value of a stimulus influences how the stimulus itself is perceived, and can "automatically" give rise to processes whose characteristics are inherently related to the emotional content of the stimuli (e.g., emotion-specific action tendencies). However, to provide optimal contextual flexibility, we propose that emotional information can be utilized in an "automatic" manner for novel, goal-directed processes that are not inherently signaled by the emotional meaning of the stimulus. We investigated this question using the endogenous cueing paradigm: Specifically, we asked how rapidly, efficiently, and to what degree of specificity emotional expressions can be utilized to anticipate the location of targets. We tested the specificity of the utilized emotional information by presenting emotional faces with contrasting affective valence (i.e., joy and anger) or pairs of negative expressions (e.g., anger and fear) as informative central cues. By presenting both masked and visible face cues, we tested whether and to what degree of specificity facial expressions can be utilized to orient attention under conditions of limited cue awareness. Cue validity effects emerged consistently in all experiments, and cuing effects built up fast, already at 300 ms cue-target asynchrony, and-at least partly-on the basis of holistic face representation. These results indicate that emotional faces can be utilized in line with a context-specific goal, with high specificity, rapidly, and even on the basis of limited perceptual input, suggesting that the utilization of emotional information can combine remarkable efficiency and situational flexibility in order to achieve optimal outcomes in various critical situations. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Emotion-specific priming effects with marginally perceptible facial expression primes: Evidence from the "leave-one-out" paradigm.

Priming studies investigating the processing of emotional faces under conditions of limited awareness have shown that people can extract more than just valence from masked faces. However, previous results have been inconsistent with regard to the degree of differentiation among negative expressions. Some results have suggested a relevance differentiation (i.e., anger differentiated from fear or sadness) and some have suggested differentiation by arousal (i.e., sadness differentiated from fear or anger); others have not suggested any differentiation beyond valence. It may even be possible that differentiation occurs down to the level of the specific emotion. To gain further insight into emotion differentiation under such conditions, we presented angry, fearful, and sad faces as masked primes in a response priming task with nontarget primes (i.e., primes and targets were from different stimulus sets). More important, in each of four experiments, only 2 of the prime emotions were used as target emotions in a binary emotion categorization task; that is, 1 prime emotion was left out as a target category. The relevance, arousal, and specificity hypotheses make contrasting predictions regarding (a) the presence or absence of focal priming effects (i.e., effects from prime emotions contained in the response set) and (b) the presence or absence of priming effects arising from the prime emotion left out from the response set. Results of conventional analysis of response times as well as diffusion model analyses were most compatible with the specificity hypothesis. However, the particular response set partially determined which information was extracted from masked primes. Results are interpreted in terms of an action-trigger account. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Emotional misattribution: Facial muscle responses partially mediate behavioral responses in the emotion misattribution procedure.

There is ongoing debate regarding the degree to which, and the conditions under which, physiological, affect-related (i.e., embodied) processes contribute to emotion information processing. Whereas most studies focus on clearly visible and intentional processing conditions, the present study targeted this issue by studying the implicit processing of emotional (angry, fearful, joyful, neutral) faces in a masked emotion misattribution procedure. That is, participants had to categorize neutral-looking faces with regard to the allegedly felt emotion, which were preceded by a very briefly presented emotional expression. In addition to behavioral measures, facial muscle responses were obtained as an index of physiological, affect-related processes. Linear mixed-model mediation analyses confirmed that facial muscle responses partially mediated the behavioral responses to the masked primes in the misattribution task.

Recognition memory for low- and high-frequency-filtered emotional faces: Low spatial frequencies drive emotional memory enhancement, whereas high spatial frequencies drive the emotion-induced recognition bias.

This article deals with two well-documented phenomena regarding emotional stimuli: emotional memory enhancement-that is, better long-term memory for emotional than for neutral stimuli-and the emotion-induced recognition bias-that is, a more liberal response criterion for emotional than for neutral stimuli. Studies on visual emotion perception and attention suggest that emotion-related processes can be modulated by means of spatial-frequency filtering of the presented emotional stimuli. Specifically, low spatial frequencies are assumed to play a primary role for the influence of emotion on attention and judgment. Given this theoretical background, we investigated whether spatial-frequency filtering also impacts (1) the memory advantage for emotional faces and (2) the emotion-induced recognition bias, in a series of old/new recognition experiments. Participants completed incidental-learning tasks with high- (HSF) and low- (LSF) spatial-frequency-filtered emotional and neutral faces. The results of the surprise recognition tests showed a clear memory advantage for emotional stimuli. Most importantly, the emotional memory enhancement was significantly larger for face images containing only low-frequency information (LSF faces) than for HSF faces across all experiments, suggesting that LSF information plays a critical role in this effect, whereas the emotion-induced recognition bias was found only for HSF stimuli. We discuss our findings in terms of both the traditional account of different processing pathways for HSF and LSF information and a stimulus features account. The double dissociation in the results favors the latter account-that is, an explanation in terms of differences in the characteristics of HSF and LSF stimuli.

Masked emotional priming: A double dissociation between direct and indirect effects reveals non-conscious processing of emotional information beyond valence.

We demonstrate non-conscious processing beyond valence by employing the masked emotional priming paradigm (Rohr, Degner, & Wentura, 2012) with a stimulus-onset asynchrony (SOA) variation. Emotional faces were briefly presented and directly masked, followed by the target face, using a SOA of either 43ms or 143ms. Targets were categorized as happy, angry, fearful, or sad. With short SOA, we replicated the differentiated priming effect within the negative domain (i.e., angry differentiate from fearful/sad). A direct test of prime awareness indicated that primes could not be discriminated consciously in this condition. With long SOA, however, we did not observe the priming effect whereas the direct test indicated some degree of conscious processing. Thus, indirect effects dissociated from direct effects in our study, an indication for non-conscious processing. Thereby, the present study provides evidence for non-conscious processing of emotional information beyond a simple positive-negative differentiation.

Positive Feeling, Negative Meaning: Visualizing the Mental Representations of In-Group and Out-Group Smiles.

Even though smiles are seen as universal facial expressions, research shows that there exist various kinds of smiles (i.e., affiliative smiles, dominant smiles). Accordingly, we suggest that there also exist various mental representations of smiles. Which representation is employed in cognition may depend on social factors, such as the smiling person's group membership: Since in-group members are typically seen as more benevolent than out-group members, in-group smiles should be associated with more benevolent social meaning than those conveyed by out-group members. We visualized in-group and out-group smiles with reverse correlation image classification. These visualizations indicated that mental representations of in-group smiles indeed express more benevolent social meaning than those of out-group smiles. The affective meaning of these visualized smiles was not influenced by group membership. Importantly, the effect occurred even though participants were not instructed to attend to the nature of the smile, pointing to an automatic association between group membership and intention.

The Color Red Supports Avoidance Reactions to Unhealthy Food.

Empirical evidence suggests that the color red acts like an implicit avoidance cue in food contexts. Thus specific colors seem to guide the implicit evaluation of food items. We built upon this research by investigating the implicit meaning of color (red vs. green) in an approach-avoidance task with healthy and unhealthy food items. Thus, we examined the joint evaluative effects of color and food: Participants had to categorize food items by approach-avoidance reactions, according to their healthfulness. Items were surrounded by task-irrelevant red or green circles. We found that the implicit meaning of the traffic light colors influenced participants' reactions to the food items. The color red (compared to green) facilitated automatic avoidance reactions to unhealthy foods. By contrast, approach behavior toward healthy food items was not moderated by color. Our findings suggest that traffic light colors can act as implicit cues that guide automatic behavioral reactions to food.

The "emotion misattribution" procedure: processing beyond good and bad under masked and unmasked presentation conditions.

In general, it is assumed that misattribution in the Affect Misattribution Procedure (AMP) is restricted to crude affect due to its unbound nature, especially under limited presentation conditions. In two experiments, we investigated whether emotion-specific misattributions occur using a four-category misattribution procedure. Experiment 1 yielded emotion-specific misattribution effects under clearly visible presentation conditions demonstrating that the procedure is principally susceptible for emotion-specific effects. In Experiment 2, we employed masked presentation conditions impeding conscious prime perception. A specific pattern of emotion-specific misattributions effects emerged indicating some emotion-specific processing at initial stages of processing. However, not each emotion was misattributed equally. We discuss the implications of these results for the non-conscious processing of emotional information, for the supposed mechanisms of the AMP and its implicit nature.