The Role of Psychological Factors in Noncardiac Chest Pain of Esophageal Origin.

Background/Aims: Noncardiac chest pain (NCCP) of esophageal origin is a challenging clinical problem of diverse etiology that affects more than 80 million Americans yearly. We assess the prevalence and impact of psychological disorders on NCCP of esophageal origin, describe possible mechanisms associated with this condition, and review psychological therapy options. Methods: Online search using PubMed and Medline from January 1, 1966, to April 30, 2023. Results: Psychological disorders have been reported in up to 79% of patients with NCCP of esophageal origin. Several psychological disturbances have been identified with this condition, including depression, anxiety, panic disorder, phobias, and obsessive-compulsive and somatoform disorders. It is unclear whether the psychological disorders trigger the chest pain or vice versa. Multiple psychological mechanisms have been linked to chest pain and may contribute to its pathogenesis and severity. These mechanisms include cardiophobia, poor coping strategies, negative social problem solving, stress and perceived control, hypervigilance to cardiopulmonary sensations, altered pain perception, and alexithymia. Psychological therapies for NCCP of esophageal origin include cognitive behavioral therapy, hypnotherapy, physical and relaxation training, breathing retraining, and alternative medicine. Among the therapeutic options, cognitive behavioral therapy has been shown to be an effective treatment for NCCP of esophageal origin. Conclusion: This review raises awareness about the high prevalence of psychological disorders in NCCP of esophageal origin and highlights the need for clinical trials and trained therapists to address the management of this taxing clinical problem.

Diagnostic differences in high-resolution esophageal motility in a large Mexican cohort based on geographic distribution.

High-resolution esophageal manometry [HRM] has become the gold standard for the evaluation of esophageal motility disorders. It is unclear whether there are HRM differences in diagnostic outcome based on regional or geographic distribution. The diagnostic outcome of HRM in a diverse geographical population of Mexico was compared and determined if there is variability in diagnostic results among referral centers. Consecutive patients referred for HRM during 2016-2020 were included. Four major referral centers in Mexico participated in the study: northeastern, southeastern, and central (Mexico City, two centers). All studies were interpreted by experienced investigators using Chicago Classification 3 and the same technology. A total of 2293 consecutive patients were included. More abnormal studies were found in the center (61.3%) versus south (45.8%) or north (45.2%) P < 0.001. Higher prevalence of achalasia was noted in the south (21.5%) versus center (12.4%) versus north (9.5%) P < 0.001. Hypercontractile disorders were more common in the north (11.0%) versus the south (5.2%) or the center (3.6%) P.001. A higher frequency of weak peristalsis occurred in the center (76.8%) versus the north (74.2%) or the south (69.2%) P < 0.033. Gastroesophageal junction obstruction was diagnosed in (7.2%) in the center versus the (5.3%) in the north and (4.2%) in the south p.141 (ns). This is the first study to address the diagnostic outcome of HRM in diverse geographical regions of Mexico. We identified several significant diagnostic differences across geographical centers. Our study provides the basis for further analysis of the causes contributing to these differences.

Event representation at the scale of ordinary experience.

Weeks are divided into weekdays and weekends; years into semesters and seasons; lives into stages like childhood, adulthood, and adolescence. How does the structure of experience shape memory? Though much work has examined event representation in human cognition, little work has explored event representation at the scale of ordinary experience. Here, we use shared experiences - in the form of popular television shows - to explore how memories are shaped by event structure at a large scale. We find that memories for events in these shows exhibit several hallmarks of event cognition. Namely, we find that memories are organized with respect to their event structure (boundaries), and that beginnings and endings are better remembered at multiple levels of the event hierarchy simultaneously. These patterns seem to be partially, but not fully, explained by the perceived story-relevance of events. Lastly, using a longitudinal design, we also show how event representations evolve over periods of several months. These results offer an understanding of event cognition at the scale of ordinary human lives.

Intuitive network topology.

Topology is the branch of mathematics that seeks to understand and describe spatial relations. A number of studies have examined the human perception of topology-in particular, whether adults and young children perceive and differentiate objects based on features like closure, boundedness, and emptiness. Topology is about more than "wholes and holes," however; it also offers an efficient language for representing network structure. Topological maps, common for subway systems across the world, are an example of how effective this language can be. Inspired by this idea, here we examine "intuitive network topology." We first show that people readily differentiate objects based on several different features of topological networks. We then show that people both remember and match objects in accordance with their topology, over and above substantial variation in their surface features. These results demonstrate that humans possess an intuitive understanding for the basic topological features of networks, and hint at the possibility that topology may serve as a format for representing relations in the mind. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Number adaptation: A critical look.

It is often assumed that adaptation - a temporary change in sensitivity to a perceptual dimension following exposure to that dimension - is a litmus test for what is and is not a "primary visual attribute". Thus, papers purporting to find evidence of number adaptation motivate a claim of great significance: That number is something that can be seen in much the way that canonical visual features, like color, contrast, size, and speed, can. Fifteen years after its reported discovery, number adaptation's existence seems to be nearly undisputed, with dozens of papers documenting support for the phenomenon. The aim of this paper is to offer a counterweight - to critically assess the evidence for and against number adaptation. After surveying the many reasons for thinking that number adaptation exists, we introduce several lesser-known reasons to be skeptical. We then advance an alternative account - the old news hypothesis - which can accommodate previously published findings while explaining various (otherwise unexplained) anomalies in the existing literature. Next, we describe the results of eight pre-registered experiments which pit our novel old news hypothesis against the received number adaptation hypothesis. Collectively, the results of these experiments undermine the number adaptation hypothesis on several fronts, whilst consistently supporting the old news hypothesis. More broadly our work raises questions about the status of adaptation itself as a means of discerning what is and is not a visual attribute.

Oblique warping: A general distortion of spatial perception.

There are many putatively distinct phenomena related to perception in the oblique regions of space. For instance, the classic oblique effect describes a deficit in visual acuity for oriented lines in the obliques, and classic "prototype effects" reflect a bias to misplace objects towards the oblique regions of space. Yet these effects are explained in very different terms: The oblique effect itself is often understood as arising from orientation-selective neurons, whereas prototype effects are described as arising from categorical biases. Here, we explore the possibility that these effects (and others) may stem from a single underlying spatial distortion. We show that there is a general distortion of (angular) space in the oblique regions that influences not only orientation judgments, but also location, extent, and size. We argue that these findings reflect oblique warping, a general distortion of spatial representations in the oblique regions which may be the root cause of many oblique effects.

Deep-Sea Sponges and Corals off the Western Coast of Florida-Intracellular Mechanisms of Action of Bioactive Compounds and Technological Advances Supporting the Drug Discovery Pipeline.

The majority of natural products utilized to treat a diverse array of human conditions and diseases are derived from terrestrial sources. In recent years, marine ecosystems have proven to be a valuable resource of diverse natural products that are generated to defend and support their growth. Such marine sources offer a large opportunity for the identification of novel compounds that may guide the future development of new drugs and therapies. Using the National Oceanic and Atmospheric Administration (NOAA) portal, we explore deep-sea coral and sponge species inhabiting a segment of the U.S. Exclusive Economic Zone, specifically off the western coast of Florida. This area spans ~100,000 km2, containing coral and sponge species at sea depths up to 3000 m. Utilizing PubMed, we uncovered current knowledge on and gaps across a subset of these sessile organisms with regards to their natural products and mechanisms of altering cytoskeleton, protein trafficking, and signaling pathways. Since the exploitation of such marine organisms could disrupt the marine ecosystem leading to supply issues that would limit the quantities of bioactive compounds, we surveyed methods and technological advances that are necessary for sustaining the drug discovery pipeline including in vitro aquaculture systems and preserving our natural ecological community in the future. Collectively, our efforts establish the foundation for supporting future research on the identification of marine-based natural products and their mechanism of action to develop novel drugs and therapies for improving treatment regimens of human conditions and diseases.

Voriconazole-Induced Periostitis: A Case Report.

Voriconazole-induced periostitis (VIP) is an uncommon side effect typically seen in immunosuppressed patients requiring prolonged antifungal therapy. These patients can present with bone pain, fragility, and elevated alkaline phosphatase (ALP). We present a case of VIP in a 72-year-old immunocompromised female on antifungal therapy presenting with a comminuted intertrochanteric fracture after a ground-level fall. VIP, although rare, should be included as a differential diagnosis for patients presenting with bone pain and/or fractures with radiographic features of periostitis. This is particularly true when there is a history of or prior imaging suggesting a solid organ transplant. In these cases, a dedicated review of current medications noting long-term voriconazole use in the absence of underlying rheumatologic disease can result in a confident diagnosis.

A common format for representing spatial location in visual and motor working memory.

Does the mind rely on similar systems of spatial representation for both perception and action? Here, we assessed the format of location representations in two simple spatial localization tasks. In one task, participants simply remembered the location of an item based solely on visual input. In another, participants remembered the location of a point in space based solely on kinesthetic input. Participants' recall errors were more consistent with the use of polar coordinates than Cartesian coordinates in both tasks. Moreover, measures of spatial bias and performance were correlated across modalities. In a subsequent study, we tested the flexibility with which people use polar coordinates to represent space; we show that the format in which the information is presented to participants influences how that information is encoded and the errors that are made as a result. We suggest that polar coordinates may be a common means of representing location information across visual and motor modalities, but that these representations are also flexible in form.

More than a moment: What does it mean to call something an 'event'?

Experiences are stored in the mind as discrete mental units, or 'events,' which influence-and are influenced by-attention, learning, and memory. In this way, the notion of an 'event' is foundational to cognitive science. However, despite tremendous progress in understanding the behavioral and neural signatures of events, there is no agreed-upon definition of an event. Here, we discuss different theoretical frameworks of event perception and memory, noting what they can and cannot account for in the literature. We then highlight key aspects of events that we believe should be accounted for in theories of event processing--in particular, we argue that the structure and substance of events should be better reflected in our theories and paradigms. Finally, we discuss empirical gaps in the event cognition literature and what the future of event cognition research may look like.

Are we Teleologically Essentialist?

People may conceptualize certain categories as held together by a category-specific "essence"-some unobservable, critical feature that causes the external features of a category to emerge. But what is the nature of this essence? Recently, Rose and Nichols have argued that something's essence is fundamentally its telos or purpose. However, Neufeld has challenged this work on theoretical grounds, arguing that these effects arise only because people infer an underlying internal change when reasoning about a change in telos. In Neufeld's view, it is the underlying internal cause, and not the telos itself, that serves as an essence (consistent with classic views of scientific essentialism). Here, we ask: Is teleology the primary force behind psychological essentialism? We begin by successfully replicating Rose and Nichols' key findings in support of teleological essentialism. In two further experiments, however, we demonstrate that teleology may not be the central way that people understand the essences of living things. We show that internal changes matter at least as much as changes in teleology. These findings suggest that while teleology may be one important cue to category membership and the essences of living things, it may be premature to say that we are "teleologically essentialist."

The antibody landscapes following AS03 and MF59 adjuvanted H5N1 vaccination.

Current seasonal and pre-pandemic influenza vaccines induce short-lived predominantly strain-specific and limited heterosubtypic responses. To better understand how vaccine adjuvants AS03 and MF59 may provide improved antibody responses to vaccination, we interrogated serum from subjects who received 2 doses of inactivated monovalent influenza A/Indonesia/05/2005 vaccine with or without AS03 or MF59 using hemagglutinin (HA) microarrays (NCT01317758 and NCT01317745). The arrays were designed to reflect both full-length and globular head HA derived from 17 influenza A subtypes (H1 to H16 and H18) and influenza B strains. We observed significantly increased strain-specific and broad homo- and heterosubtypic antibody responses with both AS03 and MF59 adjuvanted vaccination with AS03 achieving a higher titer and breadth of IgG responses relative to MF59. The adjuvanted vaccine was also associated with the elicitation of stalk-directed antibody. We established good correlation of the array antibody responses to H5 antigens with standard HA inhibition and microneutralization titers.

Redundancy and Reducibility in the Formats of Spatial Representations.

Mental representations are the essence of cognition. Yet to understand how the mind works, one must understand not just the content of mental representations (i.e., what information is stored) but also the format of those representations (i.e., how that information is stored). But what does it mean for representations to be formatted? How many formats are there? Is it possible that the mind represents some pieces of information in multiple formats at once? To address these questions, I discuss a "case study" of representational format: the representation of spatial location. I review work (a) across species and across development, (b) across spatial scales, and (c) across levels of analysis (e.g., high-level cognitive format vs. low-level neural format). Along the way, I discuss the possibility that the same information may be organized in multiple formats simultaneously (e.g., that locations may be represented in both Cartesian and polar coordinates). Ultimately, I argue that seemingly "redundant" formats may support the flexible spatial behavior observed in humans and that researchers should approach the study of all mental representations with this possibility in mind.

Adolescents' Behaviors, Fitness, and Knowledge Related to Active Living before and during the COVID-19 Pandemic: A Repeated Cross-Sectional Analysis.

BACKGROUND: Nearly all schools in the United States experienced shutdown followed by phased reopening during the COVID-19 pandemic, thereby limiting students' opportunities for physical activity (PA). This study aimed to examine adolescents' PA at school (PAS) and PA out-of-school (PAO), screen-based sedentary behaviors (SbSB), health-related fitness, and knowledge understanding about PA and fitness before and during the pandemic. METHODS: Three rounds of data were collected: Time 1 pre-pandemic (January 2020; n = 405), Time 2 schools partially reopened (February 2021; n = 412), and Time 3 schools fully reopened (March 2021; n = 450). Adolescents completed the Youth Activity Profile, the 20 m Progressive Aerobic Cardiovascular Endurance Run (PACER) test and Plank test, and a written test, to measure the behaviors (T1, T2, T3), fitness (T2-T3), and knowledge (T1, T2, T3), respectively. RESULTS: Inferential statistical analyses revealed a significant time effect for the behaviors and fitness. From T1 to T2 PAO decreased but PAS increased; whereas SbSB decreased at T3 compared to T1 and T2. Health-related fitness improved from T2 to T3. Further, the change patterns for SbSB varied by grade, and those for knowledge understanding varied by gender. CONCLUSION: The findings confirm the disruptive impact of the COVID-19 pandemic on adolescents' active living but varied by school grade and gender. The favorable changes from T2 to T3 observed for fitness and other constructs may be partially attributable to an interrupted fitness education intervention. The findings may guide the design and evaluation of future interventions addressing the physical inactivity pandemic during public health crises (e.g., COVID-19).

Quantity perception: The forest and the trees.

Park (2021) has described "flawed stimulus design(s)" in our recent studies on area perception. Here, we briefly respond to those critiques. While the rigorous, computational approaches taken by Park (and others) certainly have value, we believe that our approach - one that focuses the perceptual reality of quantity rather than the physical reality - is essential. We emphasize again (as we have many times in our work) that the study of quantity perception benefits from both approaches. To further illustrate our point, we collected additional data and show that some of Park's arguments, while sensible in principle, further support our view in practice.

Says who? Children consider informants' sources when deciding whom to believe.

To successfully navigate the world, we cannot simply accept everything we hear as true. We must think critically about others' testimony, believing only sources who are well-informed and trustworthy. This ability is especially crucial in early childhood, a time when we both learn the most, and have the least prior knowledge we can fall back upon to verify others' claims. While even young children evaluate testimony by considering whether agents' firsthand experiences license their claims, much of the time, our informants do not possess firsthand knowledge. When agents transmit information learned from others (rather than discovered firsthand), can children also evaluate their testimony's social basis? Across 3 experiments (N = 390), we manipulate the number of primary sources originating a claim, and the number of secondary sources repeating it. We find that by age 6, children understand that a claim is only as reliable as its original source, endorsing claims supported by more primary (rather than secondary) sources. While young preschoolers already understand the link between firsthand perceptual access and knowledge, these results suggest that a full understanding of testimony's social basis may be later-developing. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Understanding "Why:" How Implicit Questions Shape Explanation Preferences.

Adults and children 'promiscuously' endorse teleological answers to 'why' questions-a tendency linked to arguments that humans are intuitively theistic and naturally unscientific. But how do people arrive at an endorsement of a teleological answer? Here, we show that the endorsement of teleological answers need not imply unscientific reasoning (n = 880). A series of experiments show that (a) 'why' questions can be understood as a query for one of two distinct kinds of information and (b) these "implicit questions" can explain adults' answer preferences without appeal to unscientific worldviews. As a strong test of this view, we show that people endorse teleological answers that can answer relevant (implicit) questions about something's purpose, even when those answers are explicitly non-causal. Thus, we argue that endorsement of teleological answers does not necessarily equate to the endorsement of teleological 'explanations': Instead, explanation preferences may simply be an indication of people's pragmatic expectations about the questions that others ask. This view reframes how we should think about explanation preferences in general, while also offering practical insight into the pragmatics of question asking.

Do children estimate area using an "Additive-Area Heuristic"?

A large and growing body of work has documented robust illusions of area perception in adults. To date, however, there has been surprisingly little in-depth investigation into children's area perception, despite the importance of this topic to the study of quantity perception more broadly (and to the many studies that have been devoted to studying children's number perception). Here, in order to understand the interactions of number and area on quantity perception, we study both dimensions in tandem. This work is inspired by recent studies showing that human adults estimate area via an "Additive Area Heuristic," whereby the horizontal and vertical dimensions are summed rather than multiplied. First, we test whether children may rely on this same kind of heuristic. Indeed, "additive area" explains children's area judgments better than true, mathematical area. Second, we show that children's use of "additive area" biases number judgments. Finally, to isolate "additive area" from number, we test children's area perception in a task where number is held constant across all trials. We find something surprising: even when there is no overall effect of "additive area" or "mathematical area," individual children adopt and stick to specific strategies throughout the task. In other words, some children appear to rely on "additive area," while others appear to rely on true, mathematical area - a pattern of results that may be best explained by a misunderstanding about the concept of cumulative area. We discuss how these findings raise both theoretical and practical challenges of studying quantity perception in young children.

Selective Fetal Growth Restriction Type III: Application of a Recent Expert Consensus Definition.

OBJECTIVES: Per a recent expert definition, diagnosis of selective fetal growth restriction (sFGR) in monochorionic diamniotic twins is based on an estimated fetal weight (EFW) <3% as sole criterion and/or combinations of 4 contributory criteria (1 twin EFW <10%; 1 twin abdominal circumference <10%; EFW discordance ≥25%; and smaller twin umbilical artery [UA] pulsatility index >95th percentile). We assessed these criteria in sFGR Type III (intermittent absent or reversed end-diastolic flow of the UA [iAREDF]) patients to test whether meeting the more stringent parameters of the consensus definition had worse outcomes, that is, progression to sFGR Type II (persistent AREDF) or twin-twin transfusion syndrome; or secondarily, decreased dual survivorship. METHODS: This was a retrospective study of referred sFGR Type III patients (2006-2017). Patients were retrospectively categorized using consensus criteria for 2 comparisons: 1) EFW <3% versus remaining cohort; 2) EFW <3% or met all 4 contributory criteria versus remaining cohort. RESULTS: Forty-eight patients were studied. Comparison 1: EFW <3% patients (58.3%) were not more likely to demonstrate disease progression (46.4% versus 65.0%, P = .2489) or worse dual survivorship (78.6% versus 85.0%, P = .7161). Comparison 2: EFW <3% or met all 4 contributory criteria (75.0%) patients were not more likely than the others to demonstrate progression (44.4% versus 83.3%, P = .0235) or worse dual survivorship (80.6% versus 83.3%, P = 1.0000). CONCLUSIONS: In a referred cohort of sFGR Type III patients, there was no evidence that meeting more stringent parameters of the consensus definition was associated with disease progression or dual survivorship.

Numerosity, area-osity, object-osity? Oh my.

There is ongoing debate about whether number is perceived directly. Clarke and Beck suggest that what plagues this debate is a lack of shared understanding about what it means to perceive number in the first place. I agree. I argue that the perception of number is held to a different standard than, say, the perception of objecthood; considering this, I explore what it might mean for the number system to represent rational numbers.