710. Comparison of Initial CXR to CT in Patients (pts) with Hematologic Malignancy (HEM) and Documented Symptomatic Pulmonary Mucormycosis (PM)

Background There is a spectrum of pulmonary disease burden in pts with HEM and PM. There have not been any data comparing the sensitivity and findings of initial Chest X-Ray (CXR) and chest CT in these pts. Methods We compared the findings of the initial CXR and CT in all pts with proven or probable PM via EORTC/MSG criteria. We included only pts who had pulmonary symptoms and who had both CXR and CT within 5 days of each other and within seven days of symptom onset or date of culture at MD Anderson Cancer Center from April 2000 and April 2020. We collected data regarding demographics, status of HEM, clinical presentation, frequency and findings of BAL and imaging findings, mold-active prophylaxis and treatment regimens, and mortality. CXR findings were classified as normal or abnormal, and if abnormal sub-classified as mass-like/consolidative, nodular, cavitary or heterogenous/non-specific. CT findings were classified in a similar manner. Results We Identified such 39 pts with PM who had both CXR and CT within 5 d. All pts had positive CT. Five pts (13%) had a negative CXR. The majority of pts 28 (72%) were neutropenic (neutrophil count < 500). The most common CXR findings were consolidation or mass-like lesions (56%), followed by patchy, heterogenous or non-specific findings (33%) and nodules (13%). Only 3% had cavitary lesions. Similarly, consolidation or mass-like lesions were the most common finding on CT (69%), followed by nodular lesions with or without ground glass halos (56%). Cavitary lesions and/or reverse halo sign (RHS) were common (31%) on CT. Patients with normal CXR vs those with abnormal CXR were comparable in all clinical parameters we collected. The median survival from time of symptoms onset for all pts was 45 days. There was a trend for lower 42 day mortality in pts with normal CXR (20% vs 47%, P=.253). Conclusion A negative CXR does not preclude PM, especially in neutropenic pts. A CT is recommended for better sensitivity and although there was concordance in CXR with CT findings in some chest abnormalities (mass, consolidation), CT more commonly revealed nodules and signs highly suggestive of PM such as RHS. Although small numbers precluded a robust comparison, it is possible that HEM pts with PM and negative initial CXR have better prognosis, perhaps reflecting a lower burden of pulmonary involvement Disclosures Dimitrios P. Kontoyiannis, MD, Astellas (Consultant)Cidara Therapeutics (Advisor or Review Panel member)Gilead Sciences (Consultant, Grant/Research Support, Other Financial or Material Support, Honoraria)

Metamemory for pictures of naturalistic scenes: Assessment of accuracy and cue utilization

Memory for naturalistic pictures is exceptionally good. However, little is known about people’s ability to monitor the memorability of naturalistic pictures. We report the first systematic investigation into the accuracy and basis of metamemory in this domain. People studied pictures of naturalistic scenes, predicted their chances of recognizing each picture at a later test (judgment of learning, JOL), and completed a recognition memory test. Across three experiments, JOLs revealed substantial accuracy. This was due to people basing their JOLs on multiple cues, most of which predicted recognition memory. Identified cues include intrinsic picture attributes (e.g., peacefulness of scenes; scenes with or without persons) and extrinsic aspects of the study situation (e.g., presentation frequency; semantic distinctiveness of scenes with respect to the context). This work provides a better understanding of metamemory for pictures and it demonstrates close parallels between metamemory for naturalistic scenes and verbal materials.

Word Detection in Individual Subjects Is Difficult to Probe With Fast Periodic Visual Stimulation

Measuring cognition in single subjects presents unique challenges. On the other hand, individually sensitive measurements offer extraordinary opportunities, from informing theoretical models to enabling truly individualised clinical assessment. Here, we test the robustness of fast, periodic, and visual stimulation (FPVS), an emerging method proposed to elicit detectable responses to written words in the electroencephalogram (EEG) of individual subjects. The method is non-invasive, passive, and requires only a few minutes of testing, making it a potentially powerful tool to test comprehension in those who do not speak or who struggle with long testing procedures. In an initial study, Lochy et al. (2015) used FPVS to detect word processing in eight out of 10 fluent French readers. Here, we attempted to replicate their study in a new sample of 10 fluent English readers. Participants viewed rapid streams of pseudo-words with words embedded at regular intervals, while we recorded their EEG. Based on Lochy et al. (2015) we expected that words would elicit a steady-state response at the word-presentation frequency (2 Hz) over parieto-occipital electrode sites. However, across 40 datasets (10 participants, two conditions, and two regions of interest–ROIs), only four datasets met the criteria for a unique response to words. This corresponds to a 10% detection rate. We conclude that FPVS should be developed further before it can serve as an individually-sensitive measure of written word processing.

Word detection in individual subjects is difficult to probe with fast periodic visual stimulation

Measuring cognition in single subjects presents unique challenges. Yet individually sensitive measurements offer extraordinary opportunities, from informing theoretical models to enabling truly individualised clinical assessment. Here, we test the robustness of fast, periodic, visual stimulation (FPVS), an emerging method proposed to elicit detectable responses to written words in the electroencephalogram (EEG) of individual subjects. The method is non-invasive, passive, and requires only a few minutes of testing, making it a potentially powerful tool to test comprehension in those who do not speak or who struggle with long testing procedures. In an initial study, Lochy et al. (2015) used FPVS to detect word processing in 8 out of 10 fluent French readers. Here, we attempted to replicate their study in a new sample of ten fluent English readers. Participants viewed rapid streams of pseudo-words with words embedded at regular intervals, while we recorded their EEG. Based on Lochy et al., we expected that words would elicit a steady-state response at the word-presentation frequency (2 Hz) over parieto-occipital electrode sites. However, across 40 datasets (10 participants, two conditions, and two regions of interest - ROIs), only four datasets met the criteria for a unique response to words. This corresponds to a 10% detection rate. We conclude that FPVS should be developed further before it can serve as an individually-sensitive measure of written word processing.

Illusory Truth in Minimal Groups

Repetition increases rated truth for facts, falsities and sociopolitical opinions. One current model proposes that recent activation of coherent referential networks representing initial stimuli creates the processing fluency which produces illusory truth effects. We review evidence of self-referential memory and social identity maintenance, noting an absence of social group statements as stimuli in illusory truth studies. In three experiments we assigned participants to minimal social groups, then presented group-descriptive sentences in interest and truth rating phases. Ingroup sentences contained reflexive pronouns (“[group] like yourself often ‘tell it like it is.’”) and outgroup sentences did not (“[group] often ‘holds things in.’”). We observed ingroup-specific illusory truth which was inconsistently related to prior interest. After seven days we found weak illusory truth effects for statements without ingroup marking and equated in prior presentation frequency, a demanding homogenous fluency context. Constructive social memory processes create lasting memory representations for novel, arbitrary social information.

Investigation of the mirrored-word reading paradigm for BCI implementation

Brain-computer interface (BCI) applications such as keyboard control and vehicular navigation present significant assistive merit for disabled individuals. However, there are limitations associated with BCI paradigms which restrict a wider adoption of BCI technology. For example, rapid serial visual presentation (RSVP) paradigms can induce seizures in photosensitive epileptic subjects. This paper evaluates the novel mirrored-word reading paradigm (MWRP) for BCI implementation using an offline experimental study. The offline study obtained an average single-trial classification accuracy of 74.10%. The results also demonstrate that the use of multiple trials for classification can increase the accuracy as is common with BCIs. The developed MWRP-based BCI also utilized a low presentation frequency which averts the possibility of paradigm induced photosensitivity. However, there are multiple avenues for future work. The MWRP can be implemented in the online format for real-time device control. For example, a vehicular application platform can be used where the word orientation represents directions for travel. The MWRP can also be investigated across a wider range of stimulus presentation parameters such as timing, color and stimulus size. Such studies can be used to suggest further improvements to the paradigm which can enhance its applicability for online device control.

Learning reward frequency over reward probability: A tale of two learning rules

Learning about reward and expected values of choice alternatives is critical for adaptive behavior. Although human choice is affected by the presentation frequency of reward-related alternatives, this is overlooked by some dominant models of value learning. For instance, the delta rule learns average rewards, whereas the decay rule learns cumulative rewards for each option. In a binary-outcome choice task, participants selected between pairs of options that had reward probabilities of .65 (A) versus .35 (B) or .75 (C) versus .25 (D). Crucially, during training there were twice as many AB trials as CD trials, therefore option A was associated with higher cumulative reward, while option C gave higher average reward. Participants then decided between novel combinations of options (e.g., AC). Participants preferred option A, a result predicted by the Decay model, but not the Delta model. This suggests that expected values are based more on total reward than average reward.

Mere Exposure Effects on Implicit Stimulus Evaluation: The Moderating Role of Evaluation Task, Number of Stimulus Presentations, and Memory for Presentation Frequency

The mere exposure (ME) effect refers to the well-established finding that people evaluate a stimulus more positively after repeated exposure to it. So far, the vast majority of studies on ME effects have examined changes in explicit stimulus evaluation. We describe the results of three large-scale studies (combined N = 3,623) that examined ME effects on implicit stimulus evaluation. We looked at three moderators of these effects: the implicit evaluation measure, the number of stimulus presentations, and memory for presentation frequency. We observed ME effects on implicit stimulus evaluations as measured with an Implicit Association Test (IAT) and Affect Misattribution Procedure (AMP), but not an Evaluative Priming Task (EPT). ME effects were more robust when there were relatively few stimulus presentations and when participants had accurate memory for the presentation frequencies. We discuss how these findings relate to ME effects on explicit evaluations as well as theoretical and practical implications.

Etiology, Patterns And Treatment Modalities For Mandibular Fractures

Objective: The objective of current study was to evaluate the etiology, patterns of presentation, frequency and different treatment modalities for mandibular fractures in patients treated at Lahore Medical and Dental College/Ghurki Trust Teaching Hospital (LMDC/GTTH). Methodology: This descriptive – cross sectional study was conducted at Lahore Medical and Dental College, Lahore/Ghurki Trust Teaching Hospital (LMDC/GTTH) from March 2015 to September 2017. The current study included one hundred and twelve (112) patients who were indentified having mandibular fractures. Data were collected regarding patient’s age, gender, etiology, site of fracture, patterns and treatment modalities and analyzed using SPSS version 20. Results: The patients’ ages were between 3 to 55 years (24.87±10.867, mean/SD). The majority of fractures occurred amongst 21-30 years of age group having female to male ratio of 1:5.6. Road traffic accident (RTA) was the most frequent etiological factor for mandibular fractures in 89 (79.47%) of patients, followed by assaults 11(09.82%) and fall 07 (06.25%). A total of 189 fractures were recorded in 112 patients giving a mean of 1.7 fractures per patient. Out of 189 fractures, the parasymphysis was the most prominent site of mandibular fractures(43.39%), followed by condyle (22.75%) and angle (15.87%). The treatment modality of open reduction and internal fixation (ORIF/ORIF with IMF) was performed in 88(78.57%) of patients while closed reduction and indirect fixation (IMF with eyelet wiring/arch bar elastics & splint fixation) was done in 24 (21.43%) of patients. Conclusion: As evidenced by the present study, road traffic accidents are the most common cause of mandibular fractures in young adults, mostly due to violation of traffic rules. These findings highlight the need to reinforce legislation for prevention of such injuries both in children and adults

Trends in Pediatric Otolaryngology Disparities Research

Objectives To describe trends in disparities research within pediatric otolaryngology as evidenced by major meeting presentations and to compare observed trends with those in the realm of patient safety and quality improvement (PSQI). Study Design Retrospective review of presentations at national otolaryngology meetings. Setting Online review of meeting programs. Subjects and Methods Meeting programs from the American Society of Pediatric Otolaryngology, Triological Society, American Academy of Otolaryngology—Head and Neck Surgery Foundation, and Society for Ear, Nose and Throat Advances in Children from 2003 to 2016 were manually searched for pediatric oral and poster presentations addressing disparities and socioeconomic determinants of health, as well as PSQI. Presentation frequency was compared between categories and within each category over time. Results Of 11,311 total presentations, 3078 were related to the pediatric population, and 1945 (63.2%) of those were oral presentations. Disparities-related presentations increased from 0 in 2003 to 17 in 2016. From 2003 to 2009, 9 of 656 (1.4%) presentations involved disparities, as opposed to 70 of 2422 (2.9%) from 2010 to 2016 ( P = .03). The proportion of presentations regarding PSQI also increased: from 42 of 656 (6.4%) in 2003-2009 to 221 of 2422 (9.1%) in 2010-2016 ( P = .01). PSQI presentations remain more common than disparities presentations (9.1% vs 2.9%, P < .001). Conclusion Health care disparities are increasingly addressed in pediatric otolaryngology meeting presentations. Compared with the well-established realm of PSQI, disparities research remains nascent but is gaining attention. Health care reform and quality improvement efforts should recognize the role of socioeconomic factors and include strategies for addressing disparities.