What was I thinking? Eye-tracking experiments underscore the bias that architecture exerts on nuclear grading in prostate cancer

We previously reported that nuclear grade assignment of prostate carcinomas is subject to a cognitive bias induced by the tumor architecture. Here, we asked whether this bias is mediated by the non-conscious selection of nuclei that "match the expectation" induced by the inadvertent glance at the tumor architecture. 20 pathologists were asked to grade nuclei in high power fields of 20 prostate carcinomas displayed on a computer screen. Unknown to the pathologists, each carcinoma was shown twice, once before a background of a low grade, tubule-rich carcinoma and once before the background of a high grade, solid carcinoma. Eye tracking allowed to identify which nuclei the pathologists fixated during the 8 second projection period. For all 20 pathologists, nuclear grade assignment was significantly biased by tumor architecture. Pathologists tended to fixate on bigger, darker, and more irregular nuclei when those were projected before kigh grade, solid carcinomas than before low grade, tubule-rich carcinomas (and vice versa). However, the morphometric differences of the selected nuclei accounted for only 11% of the architecture-induced bias, suggesting that it can only to a small part be explained by the unconscious fixation on nuclei that "match the expectation". In conclusion, selection of « matching nuclei » represents an unconscious effort to vindicate the gravitation of nuclear grades towards the tumor architecture.

Using micropower impulse radar technology to screen for pneumothorax: an international bi-institutional study

Pneumothoraces (PTXs) are a common entity in thoracic trauma. Micropower impulse radar (MIR) has been able to detect PTXs in surgical patients. However, this technology has not been tested previously on trauma patients. The purpose of this study was to determine the sensitivity and specificity of MIR to detect clinically significant PTXs. We hypothesized that MIR technology can effectively screen trauma patients for clinically significant PTXs.

Can handheld micropower impulse radar technology be used to detect pneumothorax? Initial experience in a European trauma centre

BACKGROUND: Pneumothoraces are a common injury pattern in emergency medicine. Rapid and safe identification can reduce morbidity and mortality. A new handheld, battery powered device, the Pneumoscan (CE 561036, PneumoSonics Inc., Cleveland, OH, USA), using micropower impulse radar (MIR) technology, has recently been introduced in Europe for the rapid and reliable detection of PTX. However, this technology has not yet been tested in trauma patients. This is the first quality control evaluation to report on emergency room performance of a new device used in the trauma setting. MATERIAL AND METHODS: This study was performed at a Level I trauma centre in Switzerland. All patients with thoracic trauma and undergoing chest X-ray and CT-scan were eligible for the study. Readings were performed before the chest X-ray and CT scan. The patients had eight lung fields tested (four on each side). All readings with the Pneumoscan were performed by two junior residents in our department who had previously received an instructional tutorial of 15min. The qualitative MIR results were blinded, and stored on the device. We then compared the results of the MIR to those of the clinical examination, chest X-ray and CT-scan. RESULTS: 50 patients were included, with a mean age of 46 (SD 17) years. Seven patients presented with PTX diagnosed by CT; six of these were detected by Pneumoscan, leading to an overall sensitivity of 85.7 (95% confidence interval 42.1-99.6)%. Only two of seven PTX were found during clinical examination and on chest X-ray (sensitivity 28.6 (95% CI 3.7-71.0)%). Of the remaining 43 of 50 patients without PTX, one false-positive PTX was found by the Pneumoscan, resulting in a specificity of 97.7 (95% CI 87.7-99.9)%. DISCUSSION: The Pneumoscan is an easy to use handheld technology with reliable results. In this series, the sensitivity to detect a PTX by the Pneumoscan was higher than by clinical examination and chest X-ray. Further studies with higher case numbers and a prospective study design are needed to confirm our findings.

Seeing Spaces: An Eye-Tracking Study Of Speech Segmentation

Speech is often a multimodal process, presented audiovisually through a talking face. One area of speech perception influenced by visual speech is speech segmentation, or the process of breaking a stream of speech into individual words. Mitchel and Weiss (2013) demonstrated that a talking face contains specific cues to word boundaries and that subjects can correctly segment a speech stream when given a silent video of a speaker. The current study expanded upon these results, using an eye tracker to identify highly attended facial features of the audiovisual display used in Mitchel and Weiss (2013). In Experiment 1, subjects were found to spend the most time watching the eyes and mouth, with a trend suggesting that the mouth was viewed more than the eyes. Although subjects displayed significant learning of word boundaries, performance was not correlated with gaze duration on any individual feature, nor was performance correlated with a behavioral measure of autistic-like traits. However, trends suggested that as autistic-like traits increased, gaze duration of the mouth increased and gaze duration of the eyes decreased, similar to significant trends seen in autistic populations (Boratston & Blakemore, 2007). In Experiment 2, the same video was modified so that a black bar covered the eyes or mouth. Both videos elicited learning of word boundaries that was equivalent to that seen in the first experiment. Again, no correlations were found between segmentation performance and SRS scores in either condition. These results, taken with those in Experiment, suggest that neither the eyes nor mouth are critical to speech segmentation and that perhaps more global head movements indicate word boundaries (see Graf, Cosatto, Strom, & Huang, 2002). Future work will elucidate the contribution of individual features relative to global head movements, as well as extend these results to additional types of speech tasks.

Geophysical Investigation of Subsurface Three-Dimensional Architecture of Icy Debris Fans With Ground Penetrating Radar in the Wrangell Mountains, Alaska

Icy debris fans have are newly-described landforms (Kochel and Trop, 2008 and 2012) as landforms developed immediately after deglaciation on Earth and similar features have been observed on Mars. Subsurface characteristics of Icy debris fans have not been previously investigated. Ground penetrating radar (GPR) was used to non-invasively investigate the subsurface characteristics of icy debris fans near McCarthy, Alaska, USA. The three fans investigated in Alaska are the East, West, and Middle fans (Kochel and Trop, 2008 and 2012) which below the Nabesna ice cap and on top of the McCarthy Creek Glacier. Icy debris fans in general are a largely unexplored suite of paraglacial landforms and processes in alpine regions. Recent field studies focused on direct observations and depositional processes. Their results showed that the fan's composition is primarily influenced by the type and frequency of depositional processes that supply the fan. Photographic studies show that the East Fan receives far more ice and snow avalanches whereas the Middle and West Fans receive fewer mass wasting events but more clastic debris is deposited on the Middle and West fan from rock falls and icy debris flows. GPR profiles and Wide-angle reflection and refraction (WARR) surveys consisting of both, common mid-point (CMP), and common shot-point (CSP) surveys investigated the subsurface geometry of the fans and the McCarthy Creek Glacier. All GPR surveys were collected in July of 2013 with 100MHz bi-static antennas. Four axial profiles and three cross-fan profiles were done on the West and Middle fans as well as the McCarthy Creek Glacier in order to investigate the relationship between the three features. GPR profiles yielded reflectors that were continuous for 10+ m and hyperbolic reflections in the subsurface. The depth to these reflections in the subsurface requires knowledge of the velocity of the subsurface. To find the velocity of the subsurface eight WARR surveys collected on the fans and on the McCarthy Creek glacier to provide information on variability of subsurface velocities. The profiles of the Middle and West fan have more reflections in their profiles compared to profiles done on the McCarthy Creek Glacier. Based on the WARR surveys, we interpret the lower energy return in the glacier to be caused by two reasons. 1) The increased attenuation due to wet ice versus drier ice and on the fan with GPR velocities >0.15m/ns. 2) Lack of interfaces in the glacier compared to those in the fans which are inferred to be produced by the alternating layers of stratified ice and lithic-rich layers. The GPR profiles on the West and Middle Fans show the shallow subsurface being dominated by lenticular reflections interpreted to be consistent with the shape of surficial deposits. The West Fan is distinguished from the Middle Fan by the nature of its reflections patterns and thicknesses of reflection packages that clearly shows the Middle fan with a greater thickness. The changes in subsurface reflections between the Middle and West Fans as well as the McCarthy Creek Glacier are thought to reflect the type and frequency of depositional processes and surrounding bedrock and talus slopes.

Tracking the implicit self using event-related potentials

Negative biases in implicit self-evaluation are thought to be detrimental to subjective well-being and have been linked to various psychological disorders, including depression. An understanding of the neural processes underlying implicit self-evaluation in healthy subjects could provide a basis for the investigation of negative biases in depressed patients, the development of differential psychotherapeutic interventions, and the estimation of relapse risk in remitted patients. We thus studied the brain processes linked to implicit self-evaluation in 25 healthy subjects using event-related potential (ERP) recording during a self-relevant Implicit Association Test (sIAT). Consistent with a positive implicit self-evaluation in healthy subjects, they responded significantly faster to the congruent (self-positive mapping) than to the incongruent sIAT condition (self-negative mapping). Our main finding was a topographical ERP difference in a time window between 600 and 700 ms, whereas no significant differences between congruent and incongruent conditions were observed in earlier time windows. This suggests that biases in implicit self-evaluation are reflected only indirectly, in the additional recruitment of control processes needed to override the positive implicit self-evaluation of healthy subjects in the incongruent sIAT condition. Brain activations linked to these control processes can thus serve as an indirect measure for estimating biases in implicit self-evaluation. The sIAT paradigm, combined with ERP, could therefore permit the tracking of the neural processes underlying implicit self-evaluation in depressed patients during psychotherapy.

Daily organ tracking in intensity-modulated radiotherapy of prostate cancer using an electronic portal imaging device with a dose saving acquisition mode

BACKGROUND AND PURPOSE: Daily use of conventional electronic portal imaging devices (EPID) for organ tracking is limited due to the relatively high dose required for high quality image acquisition. We studied the use of a novel dose saving acquisition mode (RadMode) allowing to take images with one monitor unit per image in prostate cancer patients undergoing intensity-modulated radiotherapy (IMRT) and tracking of implanted fiducial gold markers. PATIENTS AND METHODS: Twenty five patients underwent implantation of three fiducial gold markers prior to the planning CT. Before each treatment of a course of 37 fractions, orthogonal localization images from the antero-posterior and from the lateral direction were acquired. Portal images of both the setup procedure and the five IMRT treatment beams were analyzed. RESULTS: On average, four localization images were needed for a correct patient setup, resulting in four monitor units extra dose per fraction. The mean extra dose delivered to the patient was thereby increased by 1.2%. The procedure was precise enough to reduce the mean displacements prior to treatment to < o =0.3 mm. CONCLUSIONS: The use of a new dose saving acquisition mode enables to perform daily EPID-based prostate tracking with a cumulative extra dose of below 1 Gy. This concept is efficiently used in IMRT-treated patients, where separation of setup beams from treatment beams is mandatory.

Augmenting the effective field of view of optical tracking cameras--a way to overcome difficulties during intraoperative camera alignment

An Internet survey demonstrated the existence of problems related to intraoperative tracking camera set-up and alignment. It is hypothesized that these problems are a result of the limited field of view of today's optoelectronic camera systems, which is usually insufficiently large to keep the entire site of surgical action in view during an intervention. A method is proposed to augment a camera's field of view by actively controlling camera orientation, enabling it to track instruments as they are used intraoperatively. In an experimental study, an increase of almost 300% was found in the effective volume in which instruments could be tracked.

Tracking the subprocesses of decision-based action in the human frontal lobes

Situationally adaptive behavior relies on the identification of relevant target stimuli, the evaluation of these with respect to the current context and the selection of an appropriate action. We used functional magnetic resonance imaging (fMRI) to disentangle the neural networks underlying these processes within a single task. Our results show that activation of mid-ventrolateral prefrontal cortex (PFC) reflects the perceived presence of a target stimulus regardless of context, whereas context-appropriate evaluation is subserved by mid-dorsolateral PFC. Enhancing demands on response selection by means of response conflict activated a network of regions, all of which are directly connected to motor areas. On the midline, rostral anterior paracingulate cortex was found to link target detection and response selection by monitoring for the presence of behaviorally significant conditions. In summary, we provide new evidence for process-specific functional dissociations in the frontal lobes. In target-centered processing, target detection in the VLPFC is separable from contextual evaluation in the DLPFC. Response-centered processing in motor-associated regions occurs partly in parallel to these processes, which may enhance behavioral efficiency, but it may also lead to reaction time increases when an irrelevant response tendency is elicited.