Hypothesis awareness confounds asynchronous control conditions in indirect measures of the rubber hand illusion

Reports of changes in experiences of body location and ownership following synchronous tactile and visual stimulation of fake and real hands (rubber hand (RH) effects) are widely attributed to multisensory integration mechanisms. However, existing control methods for subjective report measures (asynchronous stroking and control statements) are confounded by participant hypothesis awareness; the report may reflect response to demand characteristics. Subjective report is often accompanied by indirect (also called ‘objective’ or ‘implicit’) measures. Here, we report tests of expectancies for synchronous ‘illusion’ and asynchronous ‘control’ conditions across two pre-registered studies ( n = 140 and n = 45) for two indirect measures: proprioceptive drift (a change in perceived hand location) and skin conductance response (a measure of physiological arousal). Expectancies for synchronous condition measures were greater than for asynchronous conditions in both studies. Differences between synchronous and asynchronous control condition measures are therefore confounded by hypothesis awareness. This means indirect measures of RH effects may reflect compliance, bias and phenomenological control in response to demand characteristics, just as for subjective measures. Valid control measures are required to support claims of a role of multisensory integration for both direct and indirect measures of RH effects.

Relationship Between Pitch Volume and Subjective Report of Injury in High School Female Fast-Pitch Softball Pitchers

Background: The relationship between pitch volume and injury is well-represented within baseball literature. However, the impact of softball pitch volume on injury epidemiology is limited. Hypothesis: The purpose was to determine if increased pitch volumes in high school–aged softball pitchers are related to increased rates of subjectively reported pain/injury. We hypothesized that pitchers with increased volumes would have higher pain/injury rates. Study Design: Cross-sectional study. Level of Evidence: Level 4. Methods: A total of 28 female softball pitchers (aged 14-18 years) completed an online survey of questions pertaining to pitching history, pitch volume, and subjective report of pain or injury in the back, shoulder, and elbow. An independent-samples t test was used to (1) compare pitch volumes in those who reported pain in individual body regions (shoulder, elbow, back) compared with those who did not; (2) compare pitch volumes in those who reported pain in 0 or 1 of the regions of interest compared with 2 or 3 regions; and (3) compare the reported percentage of the past year that players reported playing through pain in players who averaged >85 compared with <85 pitches per game. Chi-square analysis was used to compare those who pitched either >85 or <85 pitches per game with regard to frequency of shoulder pain, elbow pain, back pain, seeking of medical attention, and actual injury diagnosis. Type I error was set at α = 0.05. Results: Weekly and yearly pitch counts were higher in those reporting pain or injury (YES) than those who did not (NO) in the shoulder (pitches per week: NO = 219 ± 35; YES = 429 ± 101; P = 0.027) (pitches per year: NO = 8876 ± 946; YES = 19,195 ± 4944; P = 0.022) and back (pitches per week: NO = 188 ± 16; YES = 426 ± 90; P = 0.014) (pitches per year: NO = 8334 ± 793; YES = 18,252 ± 4340; P = 0.027). Similar results were observed for those with pain or injury reported in 2 or 3 regions compared with 0 or 1 regions (pitches per week: NO = 220 ± 38; YES = 414 ± 95; P = 0.039) (pitches per year: NO = 8765 ± 1010; YES = 18,661 ± 4623; P = 0.028). Those reporting shoulder pain or injury also reported higher pitch counts per game (NO = 71.4 ± 5.2; YES = 83 ± 4; P = 0.049), and those reporting back pain also reported playing more games per week (NO = 2.7 ± 0.2; YES = 5.2 ± 1.1; P = 0.034). Those with pitch counts of >85/game were more than twice as likely to see a physician regarding pain/injury ( P = 0.027) and reported playing through pain a higher percentage of the year (>85, 49.3% ± 10%; <85, 25.2% ± 6%; P < 0.05). Conclusion: High pitching volumes commonly prevalent in high school–aged softball pitchers may be associated with increased pain/injury and appear related to cumulative volume. Clinical Relevance: This study provides recommendations for cumulative pitch volume guidelines in softball pitchers.

Challenging the Boundaries of the Physical Self: Distal Cues Impact Body Ownership

The unique ability to identify one’s own body and experience it as one’s own is fundamental in goal-oriented behavior and survival. However, the mechanisms underlying the so-called body ownership are yet not fully understood. Evidence based on Rubber Hand Illusion (RHI) paradigms has demonstrated that body ownership is a product of reception and integration of self and externally generated multisensory information, feedforward and feedback processing of sensorimotor signals, and prior knowledge about the body. Crucially, however, these designs commonly involve the processing of proximal modalities while the contribution of distal sensory signals to the experience of ownership remains elusive. Here we propose that, like any robust percept, body ownership depends on the integration and prediction across all sensory modalities, including distal sensory signals pertaining to the environment. To test our hypothesis, we created an embodied goal-oriented Virtual Air Hockey Task, in which participants were to hit a virtual puck into a goal. In two conditions, we manipulated the congruency of distal multisensory cues (auditory and visual) while preserving proximal and action-driven signals entirely predictable. Compared to a fully congruent condition, our results revealed a significant decrease on three dimensions of ownership evaluation when distal signals were incongruent, including the subjective report as well as physiological and kinematic responses to an unexpected threat. Together, these findings support the notion that the way we represent our body is contingent upon all the sensory stimuli, including distal and action-independent signals. The present data extend the current framework of body ownership and may also find applications in rehabilitation scenarios.

Electrophysiological frequency domain analysis of driver passive fatigue under automated driving conditions

With the continuous improvement of automated vehicles, researchers have found that automated driving is more likely to cause passive fatigue. To explore the impact of automation and scenario complexity on the passive fatigue of a driver, we collected electroencephalography (EEG), detection-response task (DRT) performance, and the subjective report scores of 48 drivers. We found that in automated driving under monotonic conditions, after 40 min, the alpha power of the driver’s EEG indicators increased significantly, the accuracy of the detection reaction task decreased, and the reaction time became slower. The receiver characteristic curve was used to calculate the critical threshold of the alpha power during passive fatigue. The determination of the threshold further clarifies the occurrence time and physiological characteristics of passive fatigue and improves the passive fatigue theory.

Protocol for a prospective multisite cohort study investigating hysterectomy versus uterine preservation for pelvic organ prolapse surgery: the HUPPS study

IntroductionPelvic organ prolapse (POP) is the descent of pelvic organs into the vagina resulting in bulge symptoms and occurs in approximately 50% of women. Almost 20% of women will elect surgical correction of this condition by age 85. Removal of the uterus (hysterectomy) with concomitant vaginal vault suspension is a long-standing practice in POP surgery to address apical (uterine) prolapse. Yet, contemporary evidence on the merits of this approach relative to preservation of the uterus through suspension is needed to better inform surgical decision making by patients and their healthcare providers. The objective of this study is to evaluate POP-specific health outcomes and service utilisation of women electing uterine suspension compared with those electing hysterectomy and vaginal vault suspension for POP surgery up to 1-year postsurgery.Methods and analysisThis is a prospective cohort study planning to enrol 321 adult women with stage ≥2 POP from multiple sites in Alberta, Canada. Following standardised counselling from study surgeons, participants self-select either a hysterectomy based or uterine preservation surgical group. Data are being collected through participant questionnaires, medical records and administrative data linkage at four time points spanning from the presurgical consultation to 1-year postsurgery. The primary outcome is anatomic failure to correct POP, and secondary outcomes include changes in positioning of pelvic structures, retreatment, subjective report of bulge symptoms, pelvic floor distress and impact, sexual function and health service use. Data will be analysed using inverse probability weighting of propensity scores and generalised linear models.Ethics and disseminationThis study is approved by the Conjoint Health Research Ethics Board at the University of Calgary (REB19-2134). Results will be disseminated via peer-reviewed publications, presentations at national and international conferences, and educational handouts for patients.Trial registration numberNCT04890951.

Beyond exposure therapy: formulation-based therapy treating a fear of urinary incontinence – a case study

Background: The current literature on the specific phobia of urinary incontinence is limited, with no specific empirically established model or treatment protocol. Aims: This article consists of a case study of formulation-driven cognitive behaviour therapy (CBT) for phobia of urinary incontinence. Method: Martin attended a total of 12 treatment sessions. The treatment included the development of an idiosyncratic formulation, and the use of well-established cognitive and behavioural treatment strategies from other anxiety disorders. Results: Both outcome measures and Martin’s subjective report indicate that the treatment was effective. Conclusion: This case study contributes to the current limited literature on this phobia, and emphasises the importance of formulation-driven CBT to map for idiosyncratic features and target cognitive and behavioural factors.

True Consciousness Science Requires Strongly Dynamically-Unorthodox Physics

Whether there can be a science of consciousness is both of the utmost importance, and a matter of intense current debate in the field. Recently, two major papers seemed to reach dramatically conflicting conclusions, one denying scientific method currently exists in the field, the other promoting a way to ‘make the hard problem easier’. Here I apply uncontroversial mathematical physics together with a new symbolism for conscious experience, to decisively resolve this issue. Under dynamically-orthodox physics (e.g. current physical theory), there can’t be a scientifically-reliable approach. But under a strong form of dynamically-unorthodox physics, subjective report is not provably unreliable, thus meeting the minimal necessary conditions for a true science. Implications for the epistemological foundations of science are briefly discussed.

Tooth movement, orofacial pain, and leptin, interleukin-1β, and tumor necrosis factor–α levels in obese adolescents

ABSTRACT Objectives To evaluate tooth movement, orofacial pain, and leptin, interleukin (IL)–1β, and tumor necrosis factor (TNF)–α cytokine levels in the gingival crevicular fluid (GCF) during orthodontic treatment in obese adolescents. Materials and Methods Participants included adolescent patients aged 12–18 years: group 1, obese (n = 30), and group 2, nonobese controls (n = 30). They were evaluated before (T0) and after 1 hour (T1), 24 hours (T2), and 1 week (T3) of fixed appliance bonding. Periodontal examination (T0), collection of GCF (T1, T2, T3), and evaluation of Little's irregularity index (T0, T3) were performed, and a visual analog scale was used to measure pain (T1, T2, T3). Evaluation of IL-1β, TNF-α, and leptin cytokines was performed using a Luminex assay. Mann-Whitney and t-tests were used for intergroup comparisons, and a generalized estimating equation and cluster analyses were used for comparisons among observation times (P &lt; .05). Results The obese group had a higher prevalence of probing depth of ≥4 mm and bleeding on probing. Orthodontic tooth movement was similar in both groups. Peak of pain was at T2 in both groups and was higher in the obese patients. TNF-α showed a slight increase at T1, followed by a gradual decrease at T2 and T3 in both groups. The obese group had a higher concentration of IL-1β before and during orthodontic treatment. There was no difference in tooth movement between obese and control patients during the first week of orthodontic treatment. Conclusions Obese adolescents had a greater subjective report of orofacial pain after 24 hours of orthodontic treatment and higher concentrations of IL-1β proinflammatory cytokine before and during tooth movement as compared with nonobese control adolescents.

Pain modulation by your partner: An experimental investigation from a social-affective perspective

Background Social context such as the relationship between a person experiencing pain and a caregiver has been shown to affect the experience of pain, yet, results are not consistent. Possibly, differential effects of interpersonal relationships are modulated by affective states expressed by social partners. Viewing partner pictures in experimental designs is not only associated with lowered perceived pain intensity, but also affects neural responses. However, the role of affective modulation is not clear. The present study aimed to systematically examine the pain modulating effects of stimuli varying in affect and social content including personal relevance using subjective report and psychophysiological measures of facial and autonomic activity. Methods Twenty-nine women underwent a tonic heat pain paradigm with simultaneous picture viewing to investigate the influence of their partners’ faces with a neutral facial expression compared to strangers’ happy, angry and neutral facial expressions on pain intensity and accompanying psychophysiological parameters (facial activity: corrugator muscle activity, autonomic activity: skin conductance level, heart rate). In addition to perceived partner support and relationship characteristics, the contribution of the affective value (valence, arousal) of the partner faces to the observed pain modulation was examined. Results Partner and happy faces reduced self-reported pain intensity and corrugator activity, the latter being lowest when viewing partner faces as compared to all other picture categories. As corrugator activity is indexing stimulus unpleasantness and a core feature of the facial pain expression, this physiological pattern matches well with the subjective ratings. Neutral objects, neutral and angry faces had no effect on pain self-report, although angry faces were rated as highly negative. Partner faces also led to increased skin conductance, being an index of motivational activation, and heart rate deceleration, possibly reflecting increased sensory intake. Partner-related pain modulation was primarily related to perceived arousal of the partner’s picture, i.e., the intensity of the activation of approach motivation, and pain-related catastrophizing. Discussion Our results are partially consistent with emotional pain control models, especially regarding the modulatory influence of valence. Within the context of socially adaptive behavior, they particularly underline the social signal value of emotion and attachment figures. Clinically, our results imply that just looking at pictures of one’s partner when undergoing acute painful procedures can have a robust hypoalgesic effect.

Unrecognized Spatial Disorientation Recognition: A Methodological Study

Pilots also experience spatial disorientation (SD) when flying. One factor contributing to this issue is the lack of a validated procedure for detecting Type I (unrecognized) SD. Most of the current literature focuses on recognized SD evaluation methods, but there are few reports that concentrate on unrecognized SD evaluation methods. We go through some of the issues with SD and compare the various SD assessment approaches. We report on the benefits and drawbacks of the quantitative questionnaire assessment process and the behavior evaluation method in these books. We suggest a tool to diagnose unrecognized SD based on these analyses, which improves SD estimation in many ways. Centered on the subjective report and the core of strain, we establish a new approach to studying unrecognized SD (CoP). This latest approach compensates for the lack of unrecognized SD identification. We will help the pilots appreciate their emotions and physical adjustments as they are subjected to unrecognized SD by using the latest appraisal process. This assessment approach is hoped to provide good encouragement for unrecognized SD countermeasures and profoundly overcome the serious flight injuries induced by unrecognized SD.