Studying the sense of agency in the absence of motor movement: an investigation into temporal binding of tactile sensations and auditory effects.

People form coherent representations of goal-directed actions. Such agency experiences of intentional action are reflected by a shift in temporal perception: self-generated motor movements and subsequent sensory effects are perceived to occur closer together in time-a phenomenon termed intentional binding. Building on recent research suggesting that temporal binding occurs without intentionally performing actions, we further examined whether such perceptual compression occurs when motor action is fully absent. In three experiments, we used a novel sensory-based adaptation of the Libet clock paradigm to assess how a brief tactile sensation on the index finger and a resulting auditory stimulus perceptually bind together in time. Findings revealed robust temporal repulsion (instead of binding) between tactile sensation and auditory effect. Temporal repulsion was attenuated when participants could anticipate the identity and temporal onset (two crucial components of intentional action) of the tactile sensation. These findings are briefly discussed in the context of differences between intentional movement and anticipated bodily sensations in shaping action coherence and agentic experiences.

Intentional action and limitation of personal autonomy. Do restrictions of action selection decrease the sense of agency?

The experience of being an intentional agent is a key component of personal autonomy. Here, we tested how undermining intentional action affects the sense of agency as indexed by intentional binding. In three experiments using the Libet clock paradigm, participants judged the onset of their action (key presses) and resulting effect (auditory stimuli) under conditions of no, partial, or full autonomy over selecting and timing their actions. In all cases, we observed a moderate to strong intentional binding effect. However, we found no evidence for an influence of personal autonomy on intentional binding. These findings thus suggest that being unable to decide how and when to perform actions does not affect the perceived temporal binding between action and effect, a phenomenon suggested to be associated with the implicit sense of agency. We discuss the implications of our findings in the context of research on personal autonomy and goal-directed behavior.

Intentionality and temporal binding: Do causality beliefs increase the perceived temporal attraction between events?

Intentional motor actions and their effects are bound together in temporal perception, resulting in the so-called intentional binding effect. In the current study, we address an alternative explanatory mechanism for the emergence of temporal binding by excluding the role of motor action. Employing a sensory-based Libet clock paradigm, we examined temporal perception of two different auditory stimuli, and tested the influence of beliefs about the causal relationship between the two auditory stimuli, thus simulating a crucial feature of intentional action. In two experiments, we found a robust temporal repulsion effect, indicating that instead of being attracted to each other, the auditory stimuli were shifted away from each other in temporal perception. Interestingly, repulsion was attenuated by causal beliefs, but this effect was fragile. Furthermore, temporal repulsion was unaffected by the intensity of prior learning. Findings are discussed in the context of intentional action awareness research and multisensory integration.

Evaluation of the iVET® birth monitoring system in primiparous dairy heifers.

The objective was to validate the iVET® birth monitoring system and to determine if it reduced fetal death in primiparous dairy heifers over a 1-y interval. There were 359 pregnant heifers enrolled; 167 heifers in the iVET® group were monitored electronically and the remaining 192 (controls) were monitored visually for onset of Stage 2 labor, according to routine farm management. In addition, as a reference, all heifers were observed throughout the study by two independent investigators. Calves born dead or that died within 24 h after birth were defined as stillborn. The interval from appearance of the chorioallantoic sac to recognition of onset of calving in the control group averaged 21 min longer than the iVET® signal (p = 0.0001) and rate of fetal death was numerically lower in the iVET® group (8.9%) than in the control group (10.4%, p = 0.65). Interestingly, dystocia occurred more often in the iVET® group (58.3%) than in the control group (40.9%, p = 0.001). The iVET® system detected onset of Stage 2 labor earlier than conventional monitoring by farm staff. However, the device was lacking in several aspects and should be improved before its use in primiparous heifers can be recommended.

Virological and Social Outcomes of HIV-Infected Adolescents and Young Adults in The Netherlands Before and After Transition to Adult Care.

BACKGROUND: As a result of effective combination antiretroviral therapy (cART) and advanced supportive healthcare, a growing number of human immunodeficiency virus (HIV)-infected children survive into adulthood. The period of transition to adult care is often associated with impaired adherence to treatment and discontinuity of care. We aimed to evaluate virological and social outcomes of HIV-infected adolescents and young adults (AYAs) before and after transition, and explore which factors are associated with virological failure. METHODS: We included 59 HIV-infected AYAs from the Netherlands who had entered into pediatric care and transitioned from pediatric to adult healthcare. We used HIV RNA load and cART data from the Dutch Stichting HIV Monitoring database (1996-2014), and collected social and treatment data from patients' medical records from all Dutch pediatric HIV treatment centers and 14 Dutch adult treatment centers involved. We evaluated risk factors for virological failure (VF) in a logistic regression model adjusted for repeated measurements. RESULTS: HIV VF occurred frequently during the study period (14%-36%). During the transition period (from 18 to 19 years of age) there was a significant increase in VF compared with the reference group of children aged 12-13 years (odds ratio, 4.26 [95% confidence interval, 1.12-16.28]; P = .03). Characteristics significantly associated with VF were low educational attainment and lack of autonomy regarding medication adherence at transition. CONCLUSIONS: HIV-infected AYAs are vulnerable to VF, especially during the transition period. Identification of HIV-infected adolescents at high risk for VF might help to improve treatment success in this group.

[Neonatal outcomes of prevention of vertical HIV transmission; 15 years of experience in a non-university HIV centre]. / Neonatale uitkomsten van preventie van verticale hiv-besmetting; 15 jaar ervaring in een niet-universitair hiv-centrum.

OBJECTIVE: To evaluate the neonatal outcomes of the policy for the prevention of vertical HIV transmission in a non-university HIV centre. DESIGN: Retrospective, descriptive study. METHOD: We analysed the HIV status of newborns of HIV-positive mothers during pregnancy in the period between 1 January 1995 and 31 December 2010 in St. Elisabeth Hospital, Tilburg, the Netherlands and compared these results with the Dutch HIV monitoring foundation (SHM) registration data. RESULTS: Eighty-seven children from 84 pregnancies and their 71 HIV-positive mothers were included. Compared with SHM data, more women were African, younger at HIV diagnosis and had less resistance to the usual combination antiretroviral therapy (cART). In line with SHM data, the percentage of elective caesarean sections declined in the study period. There were fewer preterm births than in SHM data. There were no significant differences between preterm birth (p = 0.18), SGA (p = 0.25) or congenital abnormality (p = 0.45) and detectable HIV-RNA or cART use during pregnancy. During 10 (12%) pregnancies the mother presented to the HIV centre too late. At the age of 18 months, all 72 tested children were HIV negative. Of the 15 children lost to follow-up, 8 (9%) left to an unknown destination. CONCLUSION: All newborns of HIV-positive mothers were HIV negative, 12% of the HIV-positive mothers presented too late and 9% of the children disappeared from medical control. These results emphasize the importance of better communication between HIV centres, medical services of asylum centres and first-line obstetric care for female asylum seekers and their children.

[Adherence to ambulatory oxygen therapy. Assessment and determinants in patients receiving long-term oxygen therapy]. / Observance à l'oxygénothérapie gazeuse de déambulation. Évaluation et déterminants chez des patients bénéficiant d'une oxygénothérapie de longue durée.

BACKGROUND: The provision of ambulatory oxygen in addition to a stationary oxygen supply has been suggested to increase adherence to long-term oxygen therapy (LTOT) and promote ambulation. The degree of adherence to ambulatory oxygen therapy and the determinants of adherence remain largely unknown. METHODS: These were assessed in patients treated with LTOT (oxygen concentrator plus small oxygen cylinders with a demand oxygen delivery system [DODS]) in a tertiary care hospital supplied according to the Belgian criteria for LTOT refunding. Adherence to ambulatory oxygen was defined as mean use of ambulatory oxygen greater than 30 min/day. Patients' files were reviewed and a questionnaire was sent for assessing patients' view on the use of ambulatory oxygen. RESULTS: Forty-six patients were included. Mean use of ambulatory oxygen was 40±36min/day. Twenty-three patients were adherent to ambulatory oxygen according to our definition. There was no difference between adherent and non-adherent patients regarding lung function or blood gases, nor was there any correlation between mean daily ambulatory oxygen use and any parameter. However, patients with MMRC 4 dyspnoea scale had a significantly lower use of ambulatory oxygen than patients with less severe dyspnoea (mean 33±24 vs 42±39min/day ; P=0.03) despite self reporting better adherence to LTOT. CONCLUSION: Adherence to ambulatory oxygen in this series of patients is quite low but at the higher end of data reported previously. Patients with MMRC 4 dyspnoea scale had a lower use of ambulatory oxygen despite reporting better adherence to LTOT. We could not identify any other predictive factors of adherence to ambulatory oxygen.