scholarly journals Additive Effects of Cognitive Load, Motor Demand, and Environmental Complexity on Attention: A Real-World EEG-study

2021 ◽  
Author(s):  
Magnus Liebherr ◽  
Andrew W. Corcoran ◽  
Phillip M. Alday ◽  
Scott Coussens ◽  
Valeria Bellan ◽  
...  
Keyword(s):  
Real World ◽  
Essential Feature ◽  
Task Demands ◽  
Event Related Potential ◽  
University Campus ◽  
Environmental Complexity ◽  
Attentional Processing ◽  
Auditory Oddball ◽  
Environmental Demand ◽  
The Impact

The capacity to regulate ones attention in accordance with fluctuating task demands and environmental contexts is an essential feature of adaptive behavior. Although the electrophysiological correlates of attentional processing have been extensively studied in the laboratory, relatively little is known about the way they unfold under more variable, ecologically-valid conditions. Accordingly, this study employed a real-world EEG design to investigate how attentional processing varies under increasing levels of cognitive, motor, and environmental demand. Forty-four participants were exposed to an auditory oddball task while (1) sitting in a quiet room inside the lab, (2) walking around a sports field, and (3) wayfinding across a university campus. In each condition, participants were instructed to either attend to (i.e., count) or ignore oddball stimuli. While behavioral performance was similar across the lab and field conditions, oddball count accuracy was significantly reduced in the campus condition. Moreover, event-related potential components (mismatch negativity and P3) elicited in both real-world settings differed significantly from those obtained under laboratory conditions. These findings demonstrate the impact of environmental factors on attentional processing during simultaneously-performed motor and cognitive tasks, highlighting the value of incorporating dynamic and unpredictable contexts within naturalistic designs.

scholarly journals EEG and behavioral correlates of attentional processing while walking and navigating naturalistic environments

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Magnus Liebherr ◽  
Andrew W. Corcoran ◽  
Phillip M. Alday ◽  
Scott Coussens ◽  
Valeria Bellan ◽  
...  
Keyword(s):  
Real World ◽  
Essential Feature ◽  
Task Demands ◽  
Event Related Potential ◽  
University Campus ◽  
Behavioral Correlates ◽  
Attentional Processing ◽  
Auditory Oddball ◽  
The Impact ◽  
Auditory Oddball Task

AbstractThe capacity to regulate one’s attention in accordance with fluctuating task demands and environmental contexts is an essential feature of adaptive behavior. Although the electrophysiological correlates of attentional processing have been extensively studied in the laboratory, relatively little is known about the way they unfold under more variable, ecologically-valid conditions. Accordingly, this study employed a ‘real-world’ EEG design to investigate how attentional processing varies under increasing cognitive, motor, and environmental demands. Forty-four participants were exposed to an auditory oddball task while (1) sitting in a quiet room inside the lab, (2) walking around a sports field, and (3) wayfinding across a university campus. In each condition, participants were instructed to either count or ignore oddball stimuli. While behavioral performance was similar across the lab and field conditions, oddball count accuracy was significantly reduced in the campus condition. Moreover, event-related potential components (mismatch negativity and P3) elicited in both ‘real-world’ settings differed significantly from those obtained under laboratory conditions. These findings demonstrate the impact of environmental factors on attentional processing during simultaneously-performed motor and cognitive tasks, highlighting the value of incorporating dynamic and unpredictable contexts within naturalistic designs.

scholarly journals Dry EEG Measurement of P3 to Evaluate Cognitive Load During Sitting, Standing, and Walking

2021 ◽  
Author(s):  
Margaret Swerdloff ◽  
Levi Hargrove
Keyword(s):  
Cognitive Load ◽  
Dual Task ◽  
Brain Activity ◽  
Motor Task ◽  
Event Related Potential ◽  
Motor Impairments ◽  
Auditory Oddball ◽  
Brain Signals ◽  
Subjective Assessments ◽  
The Impact

Abstract The impact of cognitive load on individuals with motor impairments is poorly understood. Cognitive load has been studied using subjective assessments, dual-task studies, physiological measures, and clinical metrics, which are specific to the motor task being performed and do not measure brain signals directly. Combining brain imaging with dual-task paradigms provides a quantitative, direct metric of cognitive load that is agnostic to the motor task. To better understand the impact of cognitive load during activities of daily living, we measured brain activity from a dry EEG headset as participants attended to an auditory stimulus paradigm during sitting, standing, and walking. The stimulus paradigm consisted of an auditory oddball task in which they had to report the number of oddball tones that were heard during each task. The P3 event-related potential, which is sensitive to cognitive load, was extracted from EEG signals in each condition. Results showed that P3 was significantly lower during walking compared to sitting (p = .039), indicating that cognitive load was higher during walking compared to the other activities. No significant differences in P3 were found between sitting and standing. Head motion did not have a significant impact on the measurement of cognitive load. These results encourage the use of a dry EEG system to further investigate cognitive load during dynamic activities in individuals with and without motor impairments.

scholarly journals Interpretability of Spatiotemporal Dynamics of the Brain Processes Followed by Mindfulness Intervention in a Brain-Inspired Spiking Neural Network Architecture

Sensors ◽  
2020 ◽  
Vol 20 (24) ◽  
pp. 7354
Author(s):  
Zohreh Doborjeh ◽  
Maryam Doborjeh ◽  
Mark Crook-Rumsey ◽  
Tamasin Taylor ◽  
Grace Y. Wang ◽  
...  
Keyword(s):  
Neural Network ◽  
Network Architecture ◽  
Temporal Dynamics ◽  
Psychological Intervention ◽  
Task Demands ◽  
Mindfulness Training ◽  
Event Related Potential ◽  
Spiking Neural Network ◽  
Auditory Oddball ◽  
Brain States

Mindfulness training is associated with improvements in psychological wellbeing and cognition, yet the specific underlying neurophysiological mechanisms underpinning these changes are uncertain. This study uses a novel brain-inspired artificial neural network to investigate the effect of mindfulness training on electroencephalographic function. Participants completed a 4-tone auditory oddball task (that included targets and physically similar distractors) at three assessment time points. In Group A (n = 10), these tasks were given immediately prior to 6-week mindfulness training, immediately after training and at a 3-week follow-up; in Group B (n = 10), these were during an intervention waitlist period (3 weeks prior to training), pre-mindfulness training and post-mindfulness training. Using a spiking neural network (SNN) model, we evaluated concurrent neural patterns generated across space and time from features of electroencephalographic data capturing the neural dynamics associated with the event-related potential (ERP). This technique capitalises on the temporal dynamics of the shifts in polarity throughout the ERP and spatially across electrodes. Findings support anteriorisation of connection weights in response to distractors relative to target stimuli. Right frontal connection weights to distractors were associated with trait mindfulness (positively) and depression (inversely). Moreover, mindfulness training was associated with an increase in connection weights to targets (bilateral frontal, left frontocentral, and temporal regions only) and distractors. SNN models were superior to other machine learning methods in the classification of brain states as a function of mindfulness training. Findings suggest SNN models can provide useful information that differentiates brain states based on distinct task demands and stimuli, as well as changes in brain states as a function of psychological intervention.

Using Mobile, Wearable, Technology to Understand the Role of Built Environment Demand for Outdoor Mobility

2018 ◽  
Vol 51 (6) ◽  
pp. 671-688 ◽  
Author(s):  
Kate Duchowny ◽  
Philippa Clarke ◽  
Nancy Ambrose Gallagher ◽  
Robert Adams ◽  
Andrea L. Rosso ◽  
...  
Keyword(s):  
Built Environment ◽  
Real Time ◽  
Real World ◽  
Assessment Tool ◽  
Community Dwelling ◽  
Motion Sensors ◽  
Convenience Sample ◽  
Mobility Data ◽  
Environmental Demand ◽  
The Impact

Walking outdoors requires navigating a complex environment. However, no studies have evaluated how environmental barriers affect outdoor mobility in real time. We assessed the impact of the built environment on outdoor mobility, using mobile, wearable inertial measurement units. Data come from a convenience sample of 23 community-dwelling adults in Southeast Michigan. Participants walked a defined outdoor route where gait metrics were captured over a real-world urban environment with varying challenges. Street segments were classified as high versus low environmental demand using the Senior Walking Environmental Assessment Tool. Participants ranged in age from 22 to 74 years (mean age of 47 years). Outdoor gait speed was 0.3 m/s slower, and gait variability almost doubled, over the high- versus low-demand environments (coefficient of variability = 10.6% vs. 5.6%, respectively). This is the first study to demonstrate the feasibility of using wearable motion sensors to gather real-time mobility data in response to outdoor environmental demand. Findings contribute to the understanding of outdoor mobility by quantifying how real-world environmental challenges influence mobility in real time.

scholarly journals Economic threat heightens conflict detection: sLORETA evidence

2020 ◽  
Vol 15 (9) ◽  
pp. 981-990
Author(s):  
Kyle Nash ◽  
Alex Tran ◽  
Josh Leota ◽  
Andy Scott
Keyword(s):  
White Noise ◽  
Conflict Detection ◽  
Social Consequences ◽  
Event Related Potential ◽  
Anterior Cingulate ◽  
Economic Forecast ◽  
Auditory Oddball ◽  
Economic Threat ◽  
Potential Component ◽  
The Impact

Abstract Economic threat has far-reaching emotional and social consequences, yet the impact of economic threat on neurocognitive processes has received little empirical scrutiny. Here, we examined the causal relationship between economic threat and conflict detection, a critical process in cognitive control associated with the anterior cingulate cortex (ACC). Participants (N = 103) were first randomly assigned to read about a gloomy economic forecast (Economic Threat condition) or a stable economic forecast (No-Threat Control condition). Notably, these forecasts were based on real, publicly available economic predictions. Participants then completed a passive auditory oddball task composed of frequent standard tones and infrequent, aversive white-noise bursts, a task that elicits the N2, an event-related potential component linked to conflict detection. Results revealed that participants in the Economic Threat condition evidenced increased activation source localized to the ACC during the N2 to white-noise stimuli. Further, ACC activation to conflict mediated an effect of Economic Threat on increased justification for personal wealth. Economic threat thus has implications for basic neurocognitive function. Discussion centers on how effects on conflict detection could shed light on the broader emotional and social consequences of economic threat.

1607-P: Real-World Evidence of the Impact of Obesity on Residual Teeth in the Japanese Population

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 1607-P
Author(s):  
MAYU HAYASHI ◽  
KATSUTARO MORINO ◽  
KAYO HARADA ◽  
MIKI ISHIKAWA ◽  
ITSUKO MIYAZAWA ◽  
...  
Keyword(s):  
Real World ◽  
Japanese Population ◽  
Real World Evidence ◽  
The Impact

scholarly journals POS1121 DEMOGRAPHICS, COMORBIDITIES, AND RENAL FUNCTION OF UNCONTROLLED GOUT PATIENTS WHO RECEIVED PEGLOTICASE: FINDING FROM A LARGE US CLAIMS DATABASE

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 839.2-840
Author(s):  
C. Vesel ◽  
A. Morton ◽  
M. Francis-Sedlak ◽  
B. Lamoreaux
Keyword(s):  
Kidney Function ◽  
Real World ◽  
Randomized Clinical Trials ◽  
Small Subset ◽  
Phase 3 ◽  
Claims Database ◽  
Medical Diagnoses ◽  
Ckd Stage ◽  
Before And After ◽  
The Impact

Background:NHANES data indicate that approximately 9.2 million Americans have gout,1 with a small subset having uncontrolled disease.2 Pegloticase is a PEGylated recombinant uricase enzyme indicated for treating uncontrolled gout that markedly reduces serum uric acid levels (sUA)3 and resolves tophi in treatment responders.4 Despite pegloticase availability in the US for many years, real world demographics of pegloticase users in the treatment of uncontrolled gout have not been previously reported in a population-based cohort.Objectives:This study utilized a large US claims database to examine demographics and co-morbidities of uncontrolled gout patients treated with pegloticase. Kidney function before and after pegloticase treatment and concomitant therapy with immunomodulators were also examined.Methods:The TriNetX Diamond database includes de-identified data from 4.3 million US patients with gout (as of September 2019), including demographics, medical diagnoses, laboratory values, procedures (e.g. infusions, surgeries), and pharmacy data. Patients who had received ≥1 pegloticase infusion were included in these analyses. The number of infusions was evaluated for a subgroup of patients who were in the database ≥3 months before and ≥2 years after the first pegloticase infusion (i.e. first infusion prior to September 2017) to ensure only complete courses of therapy were captured. In this subpopulation, kidney function before and after pegloticase therapy was examined, along with the presence of immunomodulation prescriptions (methotrexate, mycophenolate mofetil, azathioprine, leflunomide) within 60 days prior to and 14 days after the first pegloticase infusion.Results:1494 patients treated with pegloticase were identified. Patients were 63.1 ± 14.0 years of age (range: 23–91), mostly male (82%), and white (76%). Mean sUA prior to pegloticase was 8.7 ± 2.4 mg/dL (n=50), indicating uncontrolled gout in the identified population. The most commonly reported comorbidities were chronic kidney disease (CKD, 48%), essential hypertension (71%), type 2 diabetes (39%), and cardiovascular disease (38%), similar to pegloticase pivotal Phase 3 trial populations. In patients with pre-therapy kidney function measures (n=134), pre-treatment eGFR averaged 61.2 ± 25.7 ml/min/1.73 m2, with 44% having Stage 3-5 CKD. In patients with complete therapy course capture and pre- and post-therapy eGFR measures (n=48), kidney function remained stable (change in eGFR: -2.9 ± 18.2 ml/min/1.73 m2) and CKD stage remained the same or improved in 81% of patients. In 791 patients with complete treatment course capture, patients had received 8.7 ± 13.8 infusions (median: 3, IQR: 2-10). Of these, 189 (24%) patients received only 1 pegloticase infusion and 173 (22%) received ≥12 infusions. As the data cut-off for this analysis pre-dated emerging data on the use of immunomodulation as co-therapy, only 19 of 791 (2%) patients received immunomodulation co-therapy with pegloticase.Conclusion:This relatively large group of patients with uncontrolled gout treated with pegloticase had similar patient characteristics of those studied in the phase 3 randomized clinical trials. Patients with uncontrolled gout are significantly burdened with systemic co-morbid diseases. The majority of patients had stable or improved kidney function following pegloticase treatment. As these results reflect patients initiating treatment prior to 2018, before co-treatment with immunomodulation was introduced, this cohort only included a small percentage of patients who were co-treated with an immunomodulator. Future studies using more current datasets are needed to evaluate real world outcomes in patients treated with pegloticase/immunomodulator co-therapy and to evaluate the impact of systemic co-morbid diseases.References:[1]Chen-Xu M, et al. Arthritis Rheumatol 2019 71:991-999.[2]Fels E, Sundy JS. Curr Opin Rheumatol 2008;20:198-202.[3]Sundy J, et al. JAMA 2011;306:711-720.[4]Mandell BF, et al. Arthritis Res Ther 2018;20:286.Disclosure of Interests:Claudia Vesel Shareholder of: Horizon Therapeutics plc, Employee of: Horizon Therapeutics plc, Allan Morton Speakers bureau: Sanofi, Amgen, and Horizon, Megan Francis-Sedlak Shareholder of: Horizon Therapeutics plc, Employee of: Horizon Therapeutics plc, Brian LaMoreaux Shareholder of: Horizon Therapeutics plc, Employee of: Horizon Therapeutics plc.

043 Sleep Restriction Affects Memory in Healthy Adults: Preliminary Findings

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A18-A19
Author(s):  
Molly Zimmerman ◽  
Christiane Hale ◽  
Adam Brickman ◽  
Lok-Kin Yeung ◽  
Justin Cochran ◽  
...  
Keyword(s):  
Working Memory ◽  
Negative Impact ◽  
Positive Impact ◽  
Healthy Adults ◽  
Task Demands ◽  
Sleep Restriction ◽  
Neuropsychological Function ◽  
Wake Time ◽  
Sleep Condition ◽  
The Impact

Abstract Introduction Sleep loss has a range of detrimental effects on cognitive ability. However, few studies have examined the impact of sleep restriction on neuropsychological function using an experimental design. The goal of this study was to examine the extent to which maintained insufficient sleep affects cognition in healthy adults compared to habitual adequate sleep. Methods This study used a randomized, crossover, outpatient sleep restriction design. Adults who regularly slept at least 7 h/night, verified by 2 weeks of screening with actigraphy, completed 2 phases of 6 weeks each: habitual sleep (>7 h of sleep/night) or sleep restriction (habitual sleep minus 1.5 h) separated by a 6-week washout period. During the sleep restriction phase, participants were asked to delay their bedtime by 1.5 hours/night while maintaining their habitual wake time. Neuropsychological function was evaluated with the NIH Toolbox Cognition Battery at baseline (week 0) and endpoint (week 6) of each intervention phase. The NIH Toolbox evaluates a range of cognitive abilities, including attention, executive functioning, and working memory. General linear models with post hoc paired t-tests were used to assess demographically-adjusted test scores prior to and following each sleep condition. Results At the time of analyses, 16 participants were enrolled (age 34.5□14.5 years, 9 women), 10 of whom had completed study procedures. An interaction between sleep condition and testing session revealed that individuals performed worse on List Sorting, a working memory test, after sleep restriction but improved slightly after habitual sleep (p<0.001). While not statistically reliable, the pattern of test results was similar on the other tests of processing speed, executive function, and attention. Conclusion In these preliminary results from this randomized experimental study, we demonstrated that sleep restriction has a negative impact while stable habitual adequate sleep has a positive impact on working memory, or the ability to temporarily hold information in mind while executing task demands. This finding contributes to our understanding of the complex interplay between different aspects of sleep quality (i.e., both sleep restriction as well as the maintenance of stable sleep patterns) on cognition and underscores the importance of routine sleep screening as part of medical evaluations. Support (if any):

PP469 From Theory To Practice: Which Value Framework Is Applied For Onco-Hematology Therapies In Italy? A 5-year Retrospective Analysis

2020 ◽  
Vol 36 (S1) ◽  
pp. 37-37
Author(s):  
Americo Cicchetti ◽  
Rossella Di Bidino ◽  
Entela Xoxi ◽  
Irene Luccarini ◽  
Alessia Brigido
Keyword(s):  
Real World ◽  
Ad Hoc ◽  
Grey Literature ◽  
National Level ◽  
Pharmaceutical Products ◽  
European Medicines Agency ◽  
The Real ◽  
R Process ◽  
The One ◽  
The Impact

IntroductionDifferent value frameworks (VFs) have been proposed in order to translate available evidence on risk-benefit profiles of new treatments into Pricing & Reimbursement (P&R) decisions. However limited evidence is available on the impact of their implementation. It's relevant to distinguish among VFs proposed by scientific societies and providers, which usually are applicable to all treatments, and VFs elaborated by regulatory agencies and health technology assessment (HTA), which focused on specific therapeutic areas. Such heterogeneity in VFs has significant implications in terms of value dimension considered and criteria adopted to define or support a price decision.MethodsA literature research was conducted to identify already proposed or adopted VF for onco-hematology treatments. Both scientific and grey literature were investigated. Then, an ad hoc data collection was conducted for multiple myeloma; breast, prostate and urothelial cancer; and Non Small Cell Lung Cancer (NSCLC) therapies. Pharmaceutical products authorized by European Medicines Agency from January 2014 till December 2019 were identified. Primary sources of data were European Public Assessment Reports and P&R decision taken by the Italian Medicines Agency (AIFA) till September 2019.ResultsThe analysis allowed to define a taxonomy to distinguish categories of VF relevant to onco-hematological treatments. We identified the “real-world” VF that emerged given past P&R decisions taken at the Italian level. Data was collected both for clinical and economical outcomes/indicators, as well as decisions taken on innovativeness of therapies. Relevant differences emerge between the real world value framework and the one that should be applied given the normative framework of the Italian Health System.ConclusionsThe value framework that emerged from the analysis addressed issues of specific aspects of onco-hematological treatments which emerged during an ad hoc analysis conducted on treatment authorized in the last 5 years. The perspective adopted to elaborate the VF was the one of an HTA agency responsible for P&R decisions at a national level. Furthermore, comparing a real-world value framework with the one based on the general criteria defined by the national legislation, our analysis allowed identification of the most critical point of the current national P&R process in terms ofsustainability of current and future therapies as advance therapies and agnostic-tumor therapies.

scholarly journals Is the use of two versus one long-acting bronchodilator by patients with COPD associated with a higher risk of acute coronary syndrome in real-world clinical practice?

2021 ◽  
Vol 8 (1) ◽  
pp. e000840
Author(s):  
Lianne Parkin ◽  
Sheila Williams ◽  
David Barson ◽  
Katrina Sharples ◽  
Simon Horsburgh ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Clinical Practice ◽  
Real World ◽  
Chronic Obstructive ◽  
Treatment Intensification ◽  
Cardiovascular Comorbidity ◽  
Coronary Syndrome ◽  
Long Acting ◽  
The Impact

BackgroundCardiovascular comorbidity is common among patients with chronic obstructive pulmonary disease (COPD) and there is concern that long-acting bronchodilators (long-acting muscarinic antagonists (LAMAs) and long-acting beta2 agonists (LABAs)) may further increase the risk of acute coronary events. Information about the impact of treatment intensification on acute coronary syndrome (ACS) risk in real-world settings is limited. We undertook a nationwide nested case–control study to estimate the risk of ACS in users of both a LAMA and a LABA relative to users of a LAMA.MethodsWe used routinely collected national health and pharmaceutical dispensing data to establish a cohort of patients aged >45 years who initiated long-acting bronchodilator therapy for COPD between 1 February 2006 and 30 December 2013. Fatal and non-fatal ACS events during follow-up were identified using hospital discharge and mortality records. For each case we used risk set sampling to randomly select up to 10 controls, matched by date of birth, sex, date of cohort entry (first LAMA and/or LABA dispensing), and COPD severity.ResultsFrom the cohort (n=83 417), we identified 5399 ACS cases during 281 292 person-years of follow-up. Compared with current use of LAMA therapy, current use of LAMA and LABA dual therapy was associated with a higher risk of ACS (OR 1.28 (95% CI 1.13 to 1.44)). The OR in an analysis restricted to fatal cases was 1.46 (95% CI 1.12 to 1.91).ConclusionIn real-world clinical practice, use of two versus one long-acting bronchodilator by people with COPD is associated with a higher risk of ACS.

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