Sex, race, and BMI in clinical trials of medications for obesity over the past three decades: a systematic review.

Medications for obesity have been studied in various populations over the past three decades. We aimed to quantify the baseline demographic characteristics of BMI, sex, age, and race in randomised clinical trials (RCTs) across three decades to establish whether the population studied is representative of the global population affected by the disease. Clinical trials of 12 medications for obesity (ie, orlistat, naltrexone-bupropion, topiramate-phentermine, liraglutide, semaglutide, lorcaserin, sibutramine, rimonabant, taranabant, tirzepatide, retatrutide, and orforglipron) published from Jan 20, 1999, to Nov 12, 2023, were assessed through a systematic review for methodological quality and baseline demographic characteristics. 246 RCTs were included, involving 139 566 participants with or without type 2 diabetes. Most trials over-recruited White, female participants aged 40 years or older with class 1 (30·0-34·9 kg/m2) and class 2 (35·0-39·9 kg/m2) obesity; older participants, those with class 3 (≥40·0 kg/m2) obesity, non-White participants, and male participants were under-recruited. Our systematic review suggests that future trials need to recruit traditionally under-represented populations to allow for accurate measures of efficacy of medications for obesity, enabling more informed decisions by clinicians. It is also hoped that these data will help to refine trial recruitment strategies to ensure that future studies are relevant to the population affected by obesity.

Developmental changes in the visual, haptic, and bimodal perception of geometric angles.

Geometrical knowledge is typically taught to children through a combination of vision and repetitive drawing (i.e. haptics), yet our understanding of how different spatial senses contribute to geometric perception during childhood is poor. Studies of line orientation suggest a dominant role of vision affecting the calibration of haptics during development; however, the associated multisensory interactions underpinning angle perception are unknown. Here we examined visual, haptic, and bimodal perception of angles across three age groups of children: 6 to 8 years, 8 to 10 years, and 10 to 12 years, with age categories also representing their class (grade) in primary school. All participants first learned an angular shape, presented dynamically, in one of three sensory tracing conditions: visual only, haptic only, or bimodal exploration. At test, which was visual only, participants selected a target angle from four possible alternatives with distractor angle sizes varying relative to the target angle size. We found a clear improvement in accuracy of angle perception with development for all learning modalities. Angle perception in the youngest group was equally poor (but above chance) for all modalities; however, for the two older child groups, visual learning was better than haptics. Haptic perception did not improve to the level of vision with age (even in a comparison adult group), and we found no specific benefit for bimodal learning over visual learning in any age group, including adults. Our results support a developmental increment in both spatial accuracy and precision in all modalities, which was greater in vision than in haptics, and are consistent with previous accounts of cross-sensory calibration in the perception of geometric forms.

Body image disturbance, interoceptive sensibility and the body schema across female adulthood: a pre-registered study.

Introduction: Body image disturbance (BID) typically involves explicit negative attitudes toward one's shape and weight and is associated with altered interoceptive sensibility (the subjective perception of internal bodily states). This association is a known risk factor for the development and maintenance of eating disorders. However, while research has centred on younger women with eating disorders, diverse facets of BID appear in women without eating disorders across adulthood. Research shows that in the general population, young women (ages 18-25) with high BID exhibit disturbances in the body schema: an implicit sensorimotor representation of the body in space which includes mental simulation of a movement such as motor imagery. Given that body image is subject to age-related influences, it is important to investigate how age-related variation in BID can influence the body schema beyond young adulthood alone. Here, we examine the relationship between BID, interoceptive sensibility and the body schema across female adulthood. Methods: Cross-sectional data was collected online from 1,214 women across four age groups: Young adults (18-24), Adults (25-39), Middle-aged adults (40-59), and Older aged adults (60-75). BID was indexed by questionnaires measuring body objectification, state, and trait body dissatisfaction. Interoceptive sensibility (IS) was measured using the MAIA-2 questionnaire. The body schema was evaluated through the Own Body Transformation task: a mental rotation task which assesses the capacity to make an embodied mental transformation. Results: Analyses revealed that while body objectification and trait body dissatisfaction decreased from young to older adulthood, state body dissatisfaction showed a marked increase. A negative relationship between IS and BID across all age groups was also evidenced. Finally, age, BID and orientation of the presented body were significant predictors of the time taken to make an embodied transformation. Discussion: These findings highlight the consistent relationship of BID and IS across age groups beyond young adulthood and demonstrate the varying importance of different aspects of BID as individuals age. We also evidence for the first time that disruptions in body image have the potential to impact implicit sensorimotor representations of the body even in women without eating disorders across female adulthood.

Primary Schoolers' Response to a Multisensory Serious Game on Cartesian Plane Coordinates in Immersive Virtual Reality.

The Cartesian coordinate system is a fundamental concept for mathematics and science and poses a teaching challenge at primary school level. Learning the Cartesian coordinate system has the potential to promote numerical cognition through number-space associations, as well as core geometric concepts, including isometric transformations, symmetry, and shape perception. Immersive virtual reality (VR) facilitates embodied forms of teaching and learning mathematics through whole-body sensorimotor interaction and offers benefits as a platform to learn the Cartesian coordinate system compared with "real world" classroom activities. Our goal was to validate the Cartesian-Garden, a serious game designed to provide an educationally robust but engaging vehicle to teach these concepts in primary-level mathematics in a multisensory VR environment. In the game, the child explores a Cartesian-Garden, that is, a field of flowers in which each flower corresponds to x and y coordinates. Specifically, we tested whether exploring numbers spatially represented improved spatial and numerical skills independently from the use of VR. Children (n = 49; age 7-11 years old) were divided into experimental and age-matched control groups. The experimental group explored the Cartesian-Garden and picked flowers corresponding to target coordinates; the control group played a VR game unrelated to Cartesian coordinates. To quantify potential improvements, children were tested before and after training with perceptual tests investigating number line and spatial thinking. The results point toward differential age-related improvements depending on the tested concept, especially for the number line. This study provides the guidelines for the successful use of the Cartesian-Garden game, beneficial for specific age groups.

Beyond Gender: Interoceptive Sensibility as a Key Predictor of Body Image Disturbances.

Body image disturbance (BID) involves negative attitudes towards shape and weight and is associated with lower levels of interoceptive sensibility (IS) (the subjective perceptions of internal bodily states). This association is considered a risk factor for developing eating disorders (EDs) and is linked to altered sensorimotor representations of the body (i.e., body schema). BIDs manifest across genders and are currently understudied in men. This study investigated gender-related differences in BID and its relationship to the body schema and IS. Data were collected from 86 men and 86 women. BID was assessed using questionnaires measuring self-objectification, state, and trait body dissatisfaction. IS was measured via the MAIA-2. The body schema was indexed via an embodied mental rotation task. Results showed that women reported higher BID than men across all scales. Gender differences in sub-components of interoceptive sensibility were found. Overall, both gender and interoceptive sensibility predicted BID. However, interoceptive sensibility exhibited its own unique association with BID beyond the influence of gender. BID, IS and gender were not significant predictors of performance in the body schema task. Therefore, while gender predicts differences in BID and interoceptive sensibility, there was no evidence of gender-related differences in body schema.

Effects of elevated temperature, reduced hydroperiod, and invasive bullfrog larvae on pacific chorus frog larvae.

Climate change and invasive species threaten many ecosystems, including surface freshwater systems. Increasing temperatures and reduced hydroperiod due to climate change may promote the persistence of invasive species and facilitate new invasions due to potentially higher tolerance to environmental stress in successful invaders. Amphibians demonstrate high levels of plasticity in life history characteristics, particularly those species which inhabit both ephemeral and permanent water bodies. We tested the influence of two projected effects of climate change (increased temperature and reduced hydroperiod) on Pacific chorus frog (Pseudacris regilla) tadpoles alone and in combination with the presence of tadpoles of a wide-spread invasive amphibian, the American bullfrog (Lithobates catesbeianus). Specifically, we explored the effects of projected climate change and invasion on survival, growth, mass at stage 42, and development rate of Pacific chorus frogs. Direct and indirect interactions between the invasive tadpole and the native tadpole were controlled via a cage treatment and were included to account for differences in presence of the bullfrog compared to competition for food resources and other direct effects. Overall, bullfrogs had larger negative effects on Pacific chorus frogs than climate conditions. Under future climate conditions, Pacific chorus frogs developed faster and emerged heavier. Pacific chorus frog tadpoles developing in the presence of American bullfrogs, regardless of cage treatment, emerged lighter. When future climate conditions and presence of invasive American bullfrog tadpoles were combined, tadpoles grew less. However, no interaction was detected between climate conditions and bullfrog presence for mass, suggesting that tadpoles allocated energy towards mass rather than length under the combined stress treatment. The maintenance of overall body condition (smaller but heavier metamorphs) when future climate conditions overlap with bullfrog presence suggests that Pacific chorus frogs may be partially compensating for the negative effects of bullfrogs via increased allocation of energy towards mass. Strong plasticity, as demonstrated by Pacific chorus frog larvae in our study, may allow species to match the demands of new environments, including under future climate change.

Holistic processing of faces and words predicts reading accuracy and speed in dyslexic readers.

We compared the performance of dyslexic and typical readers on two perceptual tasks, the Vanderbilt Holistic Face Processing Task and the Holistic Word Processing Task. Both yield a metric of holistic processing that captures the extent to which participants automatically attend to information that is spatially nearby but irrelevant to the task at hand. Our results show, for the first time, that holistic processing of faces is comparable in dyslexic and typical readers but that dyslexic readers show greater holistic processing of words. Remarkably, we show that these metrics predict the performance of dyslexic readers on a standardized reading task, with more holistic processing in both tasks associated with higher accuracy and speed. In contrast, a more holistic style on the words task predicts less accurate reading of both words and pseudowords for typical readers. We discuss how these findings may guide our conceptualization of the visual deficit in dyslexia.

Towards a Cognitive Theory of Cyber Deception.

This work is an initial step toward developing a cognitive theory of cyber deception. While widely studied, the psychology of deception has largely focused on physical cues of deception. Given that present-day communication among humans is largely electronic, we focus on the cyber domain where physical cues are unavailable and for which there is less psychological research. To improve cyber defense, researchers have used signaling theory to extended algorithms developed for the optimal allocation of limited defense resources by using deceptive signals to trick the human mind. However, the algorithms are designed to protect against adversaries that make perfectly rational decisions. In behavioral experiments using an abstract cybersecurity game (i.e., Insider Attack Game), we examined human decision-making when paired against the defense algorithm. We developed an instance-based learning (IBL) model of an attacker using the Adaptive Control of Thought-Rational (ACT-R) cognitive architecture to investigate how humans make decisions under deception in cyber-attack scenarios. Our results show that the defense algorithm is more effective at reducing the probability of attack and protecting assets when using deceptive signaling, compared to no signaling, but is less effective than predicted against a perfectly rational adversary. Also, the IBL model replicates human attack decisions accurately. The IBL model shows how human decisions arise from experience, and how memory retrieval dynamics can give rise to cognitive biases, such as confirmation bias. The implications of these findings are discussed in the perspective of informing theories of deception and designing more effective signaling schemes that consider human bounded rationality.

Children's spatial-numerical associations on horizontal, vertical, and sagittal axes.

There is substantial evidence linking numerical magnitude to the physical properties of space. The most influential support for this connection comes from the SNARC effect (spatial-numerical association of response codes), in which responses to small/large numbers are faster on the left/right side of space, respectively. The SNARC effect has been extensively replicated, and is understood as horizontal mapping of numerical magnitude. However, much less is known about how numbers are represented on the vertical and sagittal axes, and whether spatial-numerical associations on different axes emerge during childhood. To that end, we tested two groups of children, aged 5-7 years and 8 and 9 years, on a single-digit magnitude comparison task with response buttons positioned either upper/lower (vertical), left/right (horizontal) or near/far (sagittal). Our results provide evidence of spatial-numerical mapping on all three axes for both age groups that are similar in strength. This indicates that, even at an early stage of formal education, children can flexibly assign numerical magnitude to any spatial dimension. To examine the contribution of extracorporeal space and spatio-anatomical mapping to the SNARC effect across axes, these sources were pitted against each other by swapping the position of the response hands in Experiment 1b. Switching hand position did not reveal convincing evidence for SNARC effects on any axis. Results are discussed with respect to the utility of three-dimensional mental number lines, and potential avenues for future research are outlined.

The development of visuotactile congruency effects for sequences of events.

Sensitivity to the temporal coherence of visual and tactile signals increases perceptual reliability and is evident during infancy. However, it is not clear how, or whether, bidirectional visuotactile interactions change across childhood. Furthermore, no study has explored whether viewing a body modulates how children perceive visuotactile sequences of events. Here, children aged 5-7 years (n = 19), 8 and 9 years (n = 21), and 10-12 years (n = 24) and adults (n = 20) discriminated the number of target events (one or two) in a task-relevant modality (touch or vision) and ignored distractors (one or two) in the opposing modality. While participants performed the task, an image of either a hand or an object was presented. Children aged 5-7 years and 8 and 9 years showed larger crossmodal interference from visual distractors when discriminating tactile targets than the converse. Across age groups, this was strongest when two visual distractors were presented with one tactile target, implying a "fission-like" crossmodal effect (perceiving one event as two events). There was no influence of visual context (viewing a hand or non-hand image) on visuotactile interactions for any age group. Our results suggest robust interference from discontinuous visual information on tactile discrimination of sequences of events during early and middle childhood. These findings are discussed with respect to age-related changes in sensory dominance, selective attention, and multisensory processing.

Toward Personalized Deceptive Signaling for Cyber Defense Using Cognitive Models.

Recent research in cybersecurity has begun to develop active defense strategies using game-theoretic optimization of the allocation of limited defenses combined with deceptive signaling. These algorithms assume rational human behavior. However, human behavior in an online game designed to simulate an insider attack scenario shows that humans, playing the role of attackers, attack far more often than predicted under perfect rationality. We describe an instance-based learning cognitive model, built in ACT-R, that accurately predicts human performance and biases in the game. To improve defenses, we propose an adaptive method of signaling that uses the cognitive model to trace an individual's experience in real time. We discuss the results and implications of this adaptive signaling method for personalized defense.

Do synaesthesia and mental imagery tap into similar cross-modal processes?

Synaesthesia has previously been linked with imagery abilities, although an understanding of a causal role for mental imagery in broader synaesthetic experiences remains elusive. This can be partly attributed to our relatively poor understanding of imagery in sensory domains beyond vision. Investigations into the neural and behavioural underpinnings of mental imagery have nevertheless identified an important role for imagery in perception, particularly in mediating cross-modal interactions. However, the phenomenology of synaesthesia gives rise to the assumption that associated cross-modal interactions may be encapsulated and specific to synaesthesia. As such, evidence for a link between imagery and perception may not generalize to synaesthesia. Here, we present results that challenge this idea: first, we found enhanced somatosensory imagery evoked by visual stimuli of body parts in mirror-touch synaesthetes, relative to other synaesthetes or controls. Moreover, this enhanced imagery generalized to tactile object properties not directly linked to their synaesthetic associations. Second, we report evidence that concurrent experience evoked in grapheme-colour synaesthesia was sufficient to trigger visual-to-tactile correspondences that are common to all. Together, these findings show that enhanced mental imagery is a consistent hallmark of synaesthesia, and suggest the intriguing possibility that imagery may facilitate the cross-modal interactions that underpin synaesthesic experiences. This article is part of a discussion meeting issue 'Bridging senses: novel insights from synaesthesia'.

Spatial orienting of attention to social cues is modulated by cue type and gender of viewer.

Across three experiments, we examined the efficacy of three cues from the human body-body orientation, head turning, and eye-gaze direction-to shift an observer's attention in space. Using a modified Posner cueing paradigm, we replicate the previous findings of gender differences in the gaze-cueing effect whereby female but not male participants responded significantly faster to validly cued than to invalidly cued targets. In contrast to the previous studies, we report a robust cueing effect for both male and female participants when head turning direction was used as the central cue, whereas oriented bodies proved ineffectual as cues to attention for both males and females. These results are discussed with reference to the time course of central cueing effects, gender differences in spatial attention, and current models of how cues from the human body are combined to judge another person's direction of attention.

Point Me in the Right Direction: Same and Cross Category Visual Aftereffects to Directional Cues.

Of the many hand gestures that we use in communication pointing is one of the most common and powerful in its role as a visual referent that directs joint attention. While numerous studies have examined the developmental trajectory of pointing production and comprehension, very little consideration has been given to adult visual perception of hand pointing gestures. Across two studies, we use a visual adaptation paradigm to explore the mechanisms underlying the perception of proto-declarative hand pointing. Twenty eight participants judged whether 3D modeled hands pointed, in depth, at or to the left or right of a target (test angles of 0°, 0.75° and 1.5° left and right) before and after adapting to either hands or arrows which pointed 10° to the right or left of the target. After adaptation, the perception of the pointing direction of the test hands shifted with respect to the adapted direction, revealing separate mechanisms for coding right and leftward pointing directions. While there were subtle yet significant differences in the strength of adaptation to hands and arrows, both cues gave rise to a similar pattern of aftereffects. The considerable cross category adaptation found when arrows were used as adapting stimuli and the asymmetry in aftereffects to left and right hands suggests that the adaptation aftereffects are likely driven by simple orientation cues, inherent in the morphological structure of the hand, and not dependent on the biological status of the hand pointing cue. This finding provides evidence in support of a common neural mechanism that processes these directional social cues, a mechanism that may be blind to the biological status of the stimulus category.

Heads First: Visual Aftereffects Reveal Hierarchical Integration of Cues to Social Attention.

Determining where another person is attending is an important skill for social interaction that relies on various visual cues, including the turning direction of the head and body. This study reports a novel high-level visual aftereffect that addresses the important question of how these sources of information are combined in gauging social attention. We show that adapting to images of heads turned 25° to the right or left produces a perceptual bias in judging the turning direction of subsequently presented bodies. In contrast, little to no change in the judgment of head orientation occurs after adapting to extremely oriented bodies. The unidirectional nature of the aftereffect suggests that cues from the human body signaling social attention are combined in a hierarchical fashion and is consistent with evidence from single-cell recording studies in nonhuman primates showing that information about head orientation can override information about body posture when both are visible.