Efficacy of once-nightly sodium oxybate (FT218) on daytime symptoms in individuals with narcolepsy with or without concomitant alerting agent use: A post hoc analysis from the phase 3 REST-ON trial.

OBJECTIVE/BACKGROUND: Extended-release, once-nightly sodium oxybate (ON-SXB) significantly improved narcolepsy symptoms in participants in the phase 3, randomized, double-blind, placebo-controlled REST-ON trial. This post hoc analysis of REST-ON data evaluated ON-SXB efficacy in participants with or without concomitant alerting agent use. PATIENTS/METHODS: Participants with narcolepsy aged >16 years were randomized 1:1 to ON-SXB (week 1: 4.5 g, weeks 2-3: 6 g, weeks 4-8: 7.5 g, weeks 9-13: 9 g) or placebo. Primary endpoints in this post hoc analysis included change from baseline in mean sleep latency on the Maintenance of Wakefulness Test (MWT), Clinical Global Impression-Improvement (CGI-I) rating, and number of weekly cataplexy episodes. The secondary endpoints were change from baseline in the Epworth Sleepiness Scale (ESS) score and in objective and subjective disrupted nighttime sleep parameters. Post hoc analyses assessed participants with and without alerting agent use across 6-, 7.5-, and 9-g doses. RESULTS: In the modified intent-to-treat population, 119 (63 %) were (ON-SXB, n = 66; placebo, n = 53) and 71 (37 %) were not (ON-SXB, n = 31; placebo, n = 40) taking alerting agents. Regardless of alerting agent use, treatment with ON-SXB resulted in significant improvements vs placebo (all doses, P < 0.05) for MWT, CGI-I, and number of weekly cataplexy episodes. Significant improvements in ESS (all doses, P < 0.05) with ON-SXB vs placebo were observed in the alerting agent use cohort. Directional improvements in ESS were reported with all doses in the no alerting agent use group. CONCLUSIONS: Regardless of concomitant alerting agent use, ON-SXB improved daytime and nighttime narcolepsy symptoms vs placebo.

Overt and Covert Effects of Mental Fatigue on Attention Networks: Evidence from Event-Related Potentials during the Attention Network Test.

Mental fatigue is a variation in the psychophysiological state that subjects encounter during or after prolonged cognitive activity periods, affecting top-down attention and cognitive control. The present study aimed to investigate the effects of mental fatigue on attention in the context of the three attention networks according to the Posnerian model (alerting, orienting, and executive networks) by combining the Attentional Network Test (ANT) and event-related potentials technique. Thirty healthy subjects were enrolled in the study. A continuous arithmetic task lasting one hour induced mental fatigue, and EEG recordings were conducted before and after the task while subjects were performing the ANT. The efficiencies of three networks were comparable between groups, while RTs shortened only in the control group and the accuracy related to the alerting and conflict networks declined only after mental effort. Mental fatigue reduced N1 amplitude during alerting network engagement and p3 amplitude during orienting. It also reduced N2 and P3 amplitude during the conflict, particularly the incongruent target-locked response. These findings underscore the covert effects of mental fatigue on attention, suggesting that even in healthy young subjects, compensatory mechanisms may maintain adequate overt performances, but fatigue still has a detrimental effect on top-down attentional mechanisms.

Addressing out-of-hospital cardiac arrest with current technology advances: Breaking the deadlock with a mobile network.

Out-of-hospital cardiac arrest (OHCA) is a global public health problem, with survival rates remaining low at around 10% or less despite widespread cardiopulmonary resuscitation (CPR) training and availability of automated external defibrillators (AEDs). This is partly due to the challenges of knowing when and where a sudden OHCA occurs and where the nearest AED is located. In response, countries around the world have begun to use network technology-based smartphone applications. These applications are activated by emergency medical service dispatchers and alert preregistered volunteer first responders (VFRs) to nearby OHCAs using Global Positioning System localization. Accumulating evidence, although mostly from observational studies, shows their effectiveness in increasing the rate of bystander CPR, defibrillation, and patient survival. Current guidelines recommend the use of these VFR alerting systems, and the results of ongoing randomized trials are awaited for further dissemination. This article also proposed the concept of a life-saving mobile network (LMN), which uses opportunistic network and wireless sensor network technologies to create a dynamic mesh network of potential victims, rescuers, and defibrillators. The LMN works by detecting a fatal arrhythmia with a wearable sensor device, localizing the victim and the nearest AED with nearby smartphones, and notifying VFRs through peer-to-peer communication. While there are challenges and limitations to implementing the LMN in society, this innovative network technology would reduce the tragedy of sudden cardiac death from OHCA.

Challenges of Integrating ICD 11 into Automatic Alerting Systems.

Automatic alerting systems (AASs) can identify adverse health events but emergency communication relies on human operators and natural languages. For complete automation, we need to code the diversity of adverse events in a granularity that supports optimal dispatches. Hence, AAs shall integrate with the International Classification of Diseases (ICD). The ICD-11 coding system includes chapters for external causes of injury. However, ICD-11 supports coding injury incidents in electronic health records (EHRs) after they have occurred, while disregarding integrating real-time injury reporting within its framework. We explore the potential challenges associated with integrating ICD-11 into AAS by analyzing external causes of morbidity or mortality and the dimensions of external causes as potential areas of integration. We recognize the themes: (i) incident of injury, (ii) mode of transport, (iii) indoor location, (iv) outdoor location, and (v) type of building, and identify four challenges: (i) conceptual differences between the two systems, (ii) injury identification, (iii) presence of entities below the shoreline in ICD-11, and (iv) lack of specificity in certain ICD-11 codes related to AASs. For easy integration of ICD-11 into AASs, we recommend an AAS data dictionary and propose ICD-11 updates related to external causes of injury.

Selective attention function impairment in HIV-negative patients with early forms of neurosyphilis.

BACKGROUND: The attentional network test (ANT) is widely used to evaluate the performance of three attentional networks: alerting, orienting and executive attention networks. This study aimed to investigate the characteristics of attention functions in HIV-negative patients with early forms of neurosyphilis (NS) and their correlation with abnormalities in brain magnetic resonance imaging (MRI). METHODS: Thirty patients with early forms of NS, 31 patients with syphilis but without NS (Non-NS) and 35 healthy controls were recruited from an HIV-negative cohort between September 2020 and November 2022. The participants were evaluated with the ANT and the Mini-Mental State Examination (MMSE). Brain MRI was performed in NS and Non-NS patients. RESULTS: No significant differences were observed in the MMSE scores among the three groups. However, patients with early forms of NS showed poorer performance in orienting and alerting functions than Non-NS group (F = 6.952, P = 0.011 and F = 8.794, P = 0.004, respectively); No significant difference was observed in executive function between the two groups (F = 0.001, P = 0.980). Multivariate analysis of variance using the Bonferroni post hoc test indicated that patients with NS exhibited less efficient orienting function (P = 0.023), and alerting function (P = 0.003) but not executive function (P = 0.99), compared to Non-NS patients. Additionally, a significant difference was found in orienting function between patients with NS and healthy controls (P < 0.001) compared to healthy controls. MRI scans revealed that the NS group had a higher prevalence of abnormalities in the frontal lobes and/or the temporoparietal junction compared to the Non-NS group (24/25 vs. 13/19, P = 0.032). CONCLUSIONS: The orienting and alerting functions but not executive function were significantly less efficient in early forms of NS group than in the Non-NS group (P < 0.01). This indicates deficits in selective attention in patients with early forms of NS. Brain MRI scans revealed abnormalities in the frontal and/or parietal lobes, as well as the temporoparietal junction, suggesting potential neuropathological correlates of these attentional deficits.

Integrating brain function and structure in the study of the human attentional networks: a functionnectome study.

Attention is a heterogeneous function theoretically divided into different systems. While functional magnetic resonance imaging (fMRI) has extensively characterized their functioning, the role of white matter in cognitive function has gained recent interest due to diffusion-weighted imaging advancements. However, most evidence relies on correlations between white matter properties and behavioral or cognitive measures. This study used a new method that combines the signal from distant voxels of fMRI images using the probability of structural connection given by high-resolution normative tractography. We analyzed three fMRI datasets with a visual perceptual task and three attentional manipulations: phasic alerting, spatial orienting, and executive attention. The phasic alerting network engaged temporal areas and their communication with frontal and parietal regions, with left hemisphere dominance. The orienting network involved bilateral fronto-parietal and midline regions communicating by association tracts and interhemispheric fibers. The executive attention network engaged a broad set of brain regions and white matter tracts connecting them, with a particular involvement of frontal areas and their connections with the rest of the brain. These results partially confirm and extend previous knowledge on the neural substrates of the attentional system, offering a more comprehensive understanding through the integration of structure and function.

Electrophysiological correlation between executive vigilance and attention network based on cognitive resource control theory.

Attention is comprised of three independent and interacting attention networks: phasic alertness, orienting, and executive control. Previous studies have explored event-related potentials associated with these attention networks and executive vigilance, there is a lack of research on the relationship between executive vigilance and the three attention networks. However, there is a lack of research on the relationship between executive vigilance and the three attention networks. The present study aims to investigate this relationship. Based on the theory of cognitive resource control, two experimental blocks were designed with the vigilance task as the control variable. A total of 39 participants completed both ANTI and ANTI-V trials (two variants of the traditional attention network test ANT) in the same period. Through analysis of behavior measures (RT) and electrophysiological results related to phasic alertness (N1, P2, and contingent negative variation), orienting (P1, N1, and P3), and executive control (N2 and slow positive potential), we found that the reaction time of the ANTI block was lower than that of the ANTI-V block under all conditions, This suggests that adding a vigilance task may lead to reduced allocation of attention resources across all three attention networks. Furthermore, the orienting ability was weaker in the ANTI-V experimental block compared to that in the ANTI block due to effects on P1 and P3 regulation by the vigilance task. The N2 amplitude of the ANTI-V block was consistently reduced under similar conditions, indicating a weakening of executive control ability. The electrophysiological results revealed that executive vigilance inhibited the component of early attention perception related to the orienting network and was also related to the ability to detect conflict in the executive control network.

Introducing the portable AttentionTrip: An engaging tool for measuring the networks of attention.

BACKGROUND: Measurement of the efficacy of the networks of attention is a frequent component of research in cognitive and clinical neuroscience. Developed in 2002, the Attention Network Test (ANT), has become the most widely used tool for this purpose. NEW METHOD: In 2017 a more engaging, game-like tool based on the ANT, called the AttentionTrip was described. The network scores from five studies which used AttentionTrip are shown to be robust. NEWER METHOD: That version of AttentionTrip required a steering wheel and desk-top computer. Here we describe a new, portable version of the AttentionTrip that is administered using a hand-held tablet (iPad) RESULTS: Three samples of participants (total = 44) completed the portable version of AttentionTrip. The network scores generated using the portable AttentionTrip were also robust. Effect sizes compare favourably with those generated by the ANT and the desktop version. CONCLUSIONS: The findings support the use of the portable AttentionTrip as an alternative to the ANT when user engagement is important, such as when participants are prone to boredom, and when repeated administrations are required.

Event Analysis for Automated Estimation of Absent and Persistent Medication Alerts: Novel Methodology.

Background: Event analysis is a promising approach to estimate the acceptance of medication alerts issued by computerized physician order entry (CPOE) systems with an integrated clinical decision support system (CDSS), particularly when alerts cannot be interactively confirmed in the CPOE-CDSS due to its system architecture. Medication documentation is then reviewed for documented evidence of alert acceptance, which can be a time-consuming process, especially when performed manually. Objective: We present a new automated event analysis approach, which was applied to a large data set generated in a CPOE-CDSS with passive, noninterruptive alerts. Methods: Medication and alert data generated over 3.5 months within the CPOE-CDSS at Heidelberg University Hospital were divided into 24-hour time intervals in which the alert display was correlated with associated prescription changes. Alerts were considered "persistent" if they were displayed in every consecutive 24-hour time interval due to a respective active prescription until patient discharge and were considered "absent" if they were no longer displayed during continuous prescriptions in the subsequent interval. Results: Overall, 1670 patient cases with 11,428 alerts were analyzed. Alerts were displayed for a median of 3 (IQR 1-7) consecutive 24-hour time intervals, with the shortest alerts displayed for drug-allergy interactions and the longest alerts displayed for potentially inappropriate medication for the elderly (PIM). Among the total 11,428 alerts, 56.1% (n=6413) became absent, most commonly among alerts for drug-drug interactions (1915/2366, 80.9%) and least commonly among PIM alerts (199/499, 39.9%). Conclusions: This new approach to estimate alert acceptance based on event analysis can be flexibly adapted to the automated evaluation of passive, noninterruptive alerts. This enables large data sets of longitudinal patient cases to be processed, allows for the derivation of the ratios of persistent and absent alerts, and facilitates the comparison and prospective monitoring of these alerts.

Alerting effects require the absence of surprise.

Ongoing actions are interrupted for a brief period of time whenever salient and expectancy-discrepant stimuli (surprise stimuli) interfere with the present task set. By contrast, salient stimuli (alerting cues) preceding targets can facilitate behaviour by reducing time to initiate actions. Both phenomena seem to be at odds with each other as actions are either impaired or facilitated. Therefore, in the present study, we asked how surprise and alerting effects interact. In two experiments, participants performed choice reaction tasks without any prior knowledge of the impending alerting cue. After a baseline period of trials without an alerting cue, the alerting cue was presented for the first time. It was found that the initial presentation of the alerting cue significantly slowed down reaction times. However, after just a single trial this impairment went away. This reveals that the beneficial effects of alerting for action presuppose that alerting cues are expected and represented in the top-down task set. As such, the present findings challenge the standard view of phasic alerting as a bottom-up and entirely stimulus-driven phenomenon.

The Effect of Emotion on Time Perception in Youth Athletes with Different Alerting Efficiencies.

Purpose: Time perception plays a critical role in executing movements in various competitions. However, less research has been conducted on the alerting component of attention in the processing of time perception, and that the effects of emotion on the alerting network show inconsistent effects. This study is aimed to explore the factors that may influence time perception in youth athletes and these relationships. Methods: A total of 225 participants were recruited to assess alerting efficiency using the Attention Network Test and were divided into high and low alerting efficiency groups based on the front and back 27% of the ranked alerting scores as a dividing metric, and subsequently participants completed Time replication task under different emotionally induced conditions. Results: Alerting efficiency had a significant effect on time perception, with the high alerting efficiency subjects having higher time estimation accuracy [F (1106) = 6.32, p = 0.013, η2p = 0.10] and being more inclined to overestimate time perception [F (1106) = 12.64, p = 0.001, η2 p = 0.11]. An interaction was found between emotion and alerting efficiency on time replication ratio [F (2106) = 3.59, p = 0.031, η2p = 0.08], and further simple effects analyses found that the low alerting efficiency subjects tended to overestimate time in the anger state relative to the happy and neutral states [F (2106) = 5.93, p < 0.01, η2p = 0.10]. Conclusion: These findings suggest that high alerting efficiency in youth athletes is associated with greater time perception response advantage; The time perception of low alerting efficiency youth athletes was more likely to be affected by emotions. This study provides a reference for the training of time perception and specialized perceptual ability of youth athletes, enriches the index system of psychological selection of youth athletes.

Molecular signatures of attention networks.

Attention network theory proposes three distinct types of attention-alerting, orienting, and control-that are supported by separate brain networks and modulated by different neurotransmitters, that is, norepinephrine, acetylcholine, and dopamine. Here, we explore the extent of cortical, genetic, and molecular dissociation of these three attention systems using multimodal neuroimaging. We evaluated the spatial overlap between fMRI activation maps from the attention network test (ANT) and cortex-wide gene expression data from the Allen Human Brain Atlas. The goal was to identify genes associated with each of the attention networks in order to determine whether specific groups of genes were co-expressed with the corresponding attention networks. Furthermore, we analyzed publicly available PET-maps of neurotransmitter receptors and transporters to investigate their spatial overlap with the attention networks. Our analyses revealed a substantial number of genes (3871 for alerting, 6905 for orienting, 2556 for control) whose cortex-wide expression co-varied with the activation maps, prioritizing several molecular functions such as the regulation of protein biosynthesis, phosphorylation, and receptor binding. Contrary to the hypothesized associations, the ANT activation maps neither aligned with the distribution of norepinephrine, acetylcholine, and dopamine receptor and transporter molecules, nor with transcriptomic profiles that would suggest clearly separable networks. Independence of the attention networks appeared additionally constrained by a high level of spatial dependency between the network maps. Future work may need to reconceptualize the attention networks in terms of their segregation and reevaluate the presumed independence at the neural and neurochemical level.

The effect of considering eye movement time in evaluating the efficiency of attentional networks.

The attention network test (ANT) is a tool for assessing the executive, alerting, and orienting components of attention. However, conflicting findings exist regarding the nature and correlation between attention networks. This study aims to investigate the influence of eye movement time on the assessment of attention network efficiency. Forty male students, with an average age of 20.8 ± 1.3 years, participated in the study. The revised attention network test was conducted concurrently with the recording of the electrooculogram signal. The electrooculogram signal was used to estimate eye placement time on target stimuli. Considering eye movement time for calculating the score of each network was proposed as a novel method. The study explored the nature of attention networks and their relationships, and revealed significant effects for attention networks with and without considering the eye movement time. Additionally, a significant correlation is observed between the alerting and orienting networks. However, no significant correlation is found between attention networks using the proposed method. Considering eye movement time alters the assessment of attention network efficiency and modifies the correlation among attention networks.

Impact of electronic AKI alert/care bundle on AKI inpatient outcomes: a retrospective single-center cohort study.

BACKGROUND: Outcomes among acute kidney injury (AKI) patients are poor in United Kingdom (UK) hospitals, and electronic alerts and care bundles may improve them. We implemented such a system at West Suffolk Hospital (WSH) called the 'AKI order set'. We aimed to assess its impact on all-cause mortality, length of stay (LOS) and renal function among AKI patients, and its utilization. METHODS: Retrospective, single-center cohort study of patients ≥ 18 years old with AKI at WSH, a 430-bed general hospital serving a rural UK population of approximately 280,000. 7243 unique AKI events representing 5728 patients with full data were identified automatically from our electronic health record (EHR) between 02 September 2018 and 1 July 2021 (median age 78 years, 51% male). All-cause mortality, LOS and improvement in AKI stage, demographic and comorbidity data, medications and AKI order set use were automatically collected from the EHR. RESULTS: The AKI order set was used in 9.8% of AKI events and was associated with 28% lower odds of all-cause mortality (multivariable odds ratio [OR] 0.72, 95% confidence interval [CI] 0.57-0.91). Median LOS was longer when the AKI order set was utilized than when not (11.8 versus 8.8 days, p < .001), but was independently associated with improvement in the AKI stage (28.9% versus 8.7%, p < .001; univariable OR 4.25, 95% CI 3.53-5.10, multivariable OR 4.27, 95% CI 3.54-5.14). CONCLUSIONS: AKI order set use led to improvements in all-cause mortality and renal function, but longer LOS, among AKI patients at WSH.

Out-of-Hospital cardiac arrest & SmartphonE RespOndErS trial (HEROES Trial): Methodology and study protocol of a pre-post-design trial of the effect of implementing a smartphone alerting system on survival in out-of-hospital cardiac arrest.

Background: Since 2021, international guidelines for cardiopulmonary resuscitation recommend the implementation of so-called "life-saving systems". These systems include smartphone alerting systems (SAS), which enable dispatch centres to alert first responders via smartphone applications, who are in proximity of a suspected out-of-hospital cardiac arrest (OHCA). However, the effect of SAS on survival remains unknown. Aim: The aim is to assess the rate of survival to hospital discharge in adult patients with OHCA not witnessed by emergency medical services (EMS): before and after SAS implementation. Design: Multicentre, prospective, observational, intention-to-treat, pre-post design clinical trial. Population: Adults (aged ≥ 18 years), OHCA not witnessed by EMS, no traumatic cause for cardiac arrest, cardiopulmonary resuscitation initiated or continued by EMS. Setting: Dispatch-centre-based. Outcomes: Primary: survival to hospital discharge. Secondary: time to first compression, rate of basic life support measures before EMS arrival, rate of patients with shockable rhythm at EMS arrival, Cerebral Performance Category at hospital discharge, and duration of hospital stay. Sample size: Assuming an absolute difference in survival rates to hospital discharge of 4% in the two groups (11% before implementation of the SAS versus 15% after) and 80% power, and a type 1 error rate of 0.05, the required sample size is N = 1,109 patients per group (at least N = 2,218 evaluated patients in total). Conclusions: The HEROES trial will investigate the effects of a SAS on the survival rate after OHCA. Trial registration: German Clinical Trials Register (DRKS, ID: DRKS00032920).

Changes in the Networks of Attention across the Lifespan: A Graphical Meta-Analysis.

Three Posnerian networks of attention (alerting, orienting, and executive control) have been distinguished on the bases of behavioural, neuropsychological, and neuroscientific evidence. Here, we examined the trajectories of these networks throughout the human lifespan using the various Attention Network Tests (ANTs), which were specifically developed to measure the efficacy of these networks. The ANT Database was used to identify relevant research, resulting in the inclusion of 36 publications. We conducted a graphical meta-analysis using network scores from each study, based on reaction time plotted as a function of age group. Evaluation of attentional networks from childhood to early adulthood suggests that the alerting network develops relatively quickly, and reaches near-adult level by the age of 12. The developmental pattern of the orienting network seems to depend on the information value of the spatial cues. Executive control network scores show a consistent decrease (improvement) with age in childhood. During adulthood (ages 19-75), changes in alerting depend on the modality of the warning signal, while a moderate increase in orienting scores was seen with increasing age. Whereas executive control scores, as measured in reaction time, increase (deterioration) from young adulthood into later adulthood an opposite trend is seen when scores are based on error rates.

The Efficiency of Attentional Networks in Takostubo Syndrome: A Study With the Attentional Network Task for Interaction.

INTRODUCTION: The role of cardiovascular risk factors in the occurrence and progression of cognitive impairment is relevant in aging studies. In this condition, attention is one of the processes less studied, but preliminary evidence suggests an association between cardiometabolic alterations and attentional decline. Attention is not a unitary process but a set of independent systems (Alerting, Orienting, Executive), which can interact in certain conditions to ensure maximum behavioral efficiency. METHODS: We investigated attentive networks and their interactions in patients with Takostubo syndrome (TTS). In all, 20 participants with TTS and 20 individuals without cardiovascular pathologies performed an Attention-Network Task for Interaction, which assesses attentional networks and their interactions. RESULTS: Patients with TTS showed an atypical orienting effect when compared to the control group. Moreover, only the control group exhibited an interaction between orienting and alerting. CONCLUSION: These findings establish the relevance of brain-heart interaction in identifying attentional impairment as a prodrome of progressively severe cognitive impairment in TTS.

The effect and efficiency of attentional networks and the brain electrophysiology.

The attention networks test (ANT) is frequently utilized to evaluate executive, alerting, and orienting attentional components. Additionally, it serves as an activation task in neuroimaging studies. This study aimed to examine the relationship between attention networks and brain electrophysiology. The study enrolled 40 right-handed male students (age = 20.8 ± 1.3 years) who underwent the revised attention network test, while their electroencephalogram signals were recorded. The study aimed to explore the effects of attention networks and their efficiencies on brain electrophysiology. The results indicated that the P3 amplitude was modulated by the conflict effect in the central (p-value = 0.014) and parietal (p-value = 0.002) regions. The orienting component significantly influenced P1 and N1 latencies in the parietal and parieto-occipital regions (p-values < 0.006), as well as P1 and N1 amplitude in the parieto-occipital region (p-values = 0.017 and 0.011). The alerting component significantly affected P1 latency and amplitude in the parietal and parieto-occipital regions, respectively (p-value = 0.02). Furthermore, N1 amplitude and the time interval between P1 and N1 were significantly correlated with the efficiency of alerting and orienting networks. In terms of connectivity, the coherence of theta and alpha bands significantly decreased in the incongruent condition compared to the congruent condition. Additionally, the effects of attention networks on event-related spectral perturbation were observed. The study revealed the influence of attention networks on various aspects of brain electrophysiology. Specifically, the alerting score correlated with the amplitude of the N1 component in the double-cue and no-cue conditions in the parieto-occipital region, while the orienting score in the same region correlated with the N1 amplitude in the valid cue condition and the difference in N1 amplitude between the valid cue and double-cue conditions. Overall, empirical evidence suggests that attention networks not only impact the amplitudes of electrophysiological activities but also influence their time course.

Reporting standard for describing first responder systems, smartphone alerting systems, and AED networks.

Standardized reporting of data is crucial for out-of-hospital cardiac arrest (OHCA) research. While the implementation of first responder systems dispatching volunteers to OHCA is encouraged, there is currently no uniform reporting standard for describing these systems. A steering committee established a literature search to identify experts in smartphone alerting systems. These international experts were invited to a conference held in Hinterzarten, Germany, with 40 researchers from 13 countries in attendance. Prior to the conference, participants submitted proposals for parameters to be included in the reporting standard. The conference comprised five workshops covering different aspects of smartphone alerting systems. Proposed parameters were discussed, clarified, and consensus was achieved using the Nominal Group Technique. Participants voted in a modified Delphi approach on including each category as a core or supplementary element in the reporting standard. Results were presented, and a writing group developed definitions for all categories and items, which were sent to participants for revision and final voting using LimeSurvey web-based software. The resulting reporting standard consists of 68 core items and 21 supplementary items grouped into five topics (first responder system, first responder network, technology/algorithm/strategies, reporting data, and automated external defibrillators (AED)). This proposed reporting standard generated by an expert opinion group fills the gap in describing first responder systems. Its adoption in future research will facilitate comparison of systems and research outcomes, enhancing the transfer of scientific findings to clinical practice.

The Impact of Interpreting Training Experience on the Attentional Networks and Their Dynamics.

Interpreting, a complicated and demanding bilingual task, depends heavily on attentional control. However, few studies have focused on the interpreters' advantages in attention, and the findings so far have been inconsistent. Meanwhile, the connection between attentional networks and other cognitive abilities, such as working memory (WM), has rarely been explored in interpreters. The present study investigated whether interpreting experience (IE) contributed to the attentional networks of bilinguals and explored the link between interpreters' attention and WM. Three groups of Chinese-English bilinguals, differing only in their duration of interpreting training (the More-IE group, the Less-IE group, and the No-IE group), completed the Attention Network Test (ANT). Results showed that only the alerting network was more efficient in the More-IE group than in the Less-IE and No-IE groups; moreover, the dynamics between the alerting and executive networks were significant only in the More-IE group. Furthermore, we found a negative correlation between the executive effect and the working memory capacity (WMC) in the More-IE group. Our study validated and provided empirical support for the Attentional Control Model, stimulating further research into neurocognitive mechanisms of advanced second language learning.