Response Button Research Articles

Reaching Distance Influences Perceptual Decisions.

Decision making is an integral part of everyday life. Recently, there has been a growing interest in the potential influence of action on perceptual decisions, following ideas of embodied decision making. Studies examining decisions regarding the direction of noisy visual motion have found a bias towards the least effortful response option in experiments in which the differences in motor costs associated with alternative response actions were implicit, but not in an experiment in which these differences were made explicit. It remains unclear whether the biasing effect generalizes to other perceptual tasks than motion perception and whether consciously experiencing motor costs prevents such biases. To test the generalizability of effects across perceptual tasks, we used a within-subjects design where 24 participants performed both a motion discrimination task and an orientation discrimination task. Motor costs were manipulated by presenting response buttons for the two alternative choices at different reaching distances. By varying distances randomly, we avoided implicit biases linked to specific decisions. Our findings revealed a bias towards closer response options in both tasks, indicating that explicit information of motor costs significantly impacts perceptual decisions beyond motion discrimination. Contrary to prevailing theories that consider the motor system as a mere effector of the decision, our study implies that the actions that are associated with the response options influence the decision process itself.

False Alarms in Wearable Cardioverter Defibrillators-A Relevant Issue or an Insignificant Observation.

Background: The wearable cardioverter defibrillator (WCD) has emerged as a valuable tool used for temporary protection from sudden cardiac death. However, since the WCD uses surface electrodes to detect arrhythmias, it is susceptible to inappropriate detection. Although shock conversion rates for the WCD are reported to be high for detected events, its efficacy in clinical practice tends to be degraded by patient noncompliance. Reasons for this include wearer discomfort and frequent false alarms, which may interrupt sleep and generate anxiety. Up to now, data on the incidence of false alarms emitted by the WCD and their predictors are rare. Objectives: The aim of our study was to assess the relationship between both artifact sensing and episode misclassification burden and wearing compliance in patients with a WCD (ZOLL LifeVest™ 4000 system, ZOLL CMS GmbH, Cologne, Germany). Methods and Results: We conducted a single-center retrospective observational study, analyzing patients with a WCD prescribed at our institution. A total of 134 patients (mean age 51.7 ± 13.8 years, 79.1% male) were included. Arrhythmia recordings were analyzed and categorized as non-sustained ventricular tachycardia, sustained ventricular tachycardia or fibrillation, artifact sensing or misclassified episodes. Indication for WCD prescription was both primary and secondary prophylaxis. A total of 3019 false WCD alarms were documented in 78 patients (average number of false alarms 38.7 ± 169.5 episodes per patient) over a mean WCD wearing time of 71.5 ± 70.9 days (daily WCD wearing time 20.2 ± 5.0 h). In a total of 78 patients (58.2% of the study population), either artifact sensing (76.9%), misclassified episodes (6.4%), or both (16.7%) occurred. Misclassified episodes included sinus tachycardias, atrial flutter, atrial fibrillation, premature ventricular contractions (PVCs), and intermittent bundle branch block. A multiple linear regression identified loop diuretics (regression coefficient [B] -0.11; 95% CI -0.21-(-0.0001); p = 0.049), angiotensin receptor-neprilysin inhibitors (ARNIs) (B -0.11; 95% CI 0.22-(-0.01); p = 0.033), and a higher R-amplitude of the WCD baseline electrocardiogram (ECG) (B -0.17; 95% CI -0.27-(-0.07); p = 0.001) as independent predictors for a lower number of artifact episodes per day. In addition, atrial fibrillation (B 0.05; 95% CI 0.01-0.08; p = 0.010), and calcium antagonists (B 0.07; 95% CI 0.02-0.12; p = 0.012) were independent predictors for increased numbers of misclassified episodes per day, while beta-blockers seemed to reduce them (B -0.06; 95% CI -0.10-(-0.01); p = 0.013). Patients terminated 61.0% of all false alarms manually by pressing the response button on average 1.9 times per false alarm with overall 3.6 manual terminations per affected patient per month. Conclusions: In conclusion, false alarms from the ZOLL LifeVest™ system were frequent, with artifact sensing being the most common cause. Hence, the occurrence of false alarms represents a significant side effect of WCD therapy, and efforts should be made to minimize false alarms.

Dichotomous horizontal representation of acute deterioration risk on illnesses

The possibility that risks interact with spatial information (such as the SNARC effect) has been explored but studies did not demonstrate a consistent left-to-right representation of risks. This is probably due to the perception of risk being different in each individual experience. The present study aimed to clarify the spatial characteristics of acute deterioration risks perceived from illnesses. Registered nurses and general students participated in the present experiment. They were instructed to judge, by pressing one of the left/right response buttons, whether the risk of a given target (illness name) presented on a computer screen was higher or lower compared to that of a standard stimulus. Reaction times to the target were measured. No spatial-risk association was observed in the comprehensive analysis, but further inspection revealed that approximately half of the participants have a left-to-right representation and the other half have a right-to-left representation. Moreover, participants’ responses appeared to be faster when the target was representationally farther away from the standard stimulus (i.e., distance effect). These findings therefore suggest a spatially aligned magnitude representation of acute deterioration risk (i.e., mental risk line) but this horizontal risk orientation is likely to be dichotomous depending on the individuals and/or given situations.

The effects of simultaneous point gains and losses on human persistence.

Four experiments assessed the effects of simultaneous point gains and losses on human responding on a moving response button. Experiments 1 and 2 examined the effects of point loss arranged in variable-time (VT) and variable-interval (VI) schedules on persistence. For that purpose, a multiple schedule was in force. One component had point gains only, and the other had point gains and losses. The net reinforcement rate was equated across components by arranging greater point gains in the gains-plus-losses component. Increases in the speed of the moving response button disrupted responding during test sessions. No differential persistence between point-gains and point-gains-and-loss conditions was observed during Experiments 1 and 2. To ensure that point losses could function as punishers, Experiments 3 and 4 compared the effects of point loss arranged in fixed-ratio (FR) or VI schedules on response rate and persistence. The FR and VI point loss decreased the response rate during Experiment 3 but did not produce differential persistence in Experiment 4. These results suggest that point loss decreases response rate but does not weaken persistence more than gains strengthen persistence.

Usability, Engagement, and Report Usefulness of Chatbot-Based Family Health History Data Collection: Mixed Methods Analysis.

Family health history (FHx) is an important predictor of a person's genetic risk but is not collected by many adults in the United States. This study aims to test and compare the usability, engagement, and report usefulness of 2 web-based methods to collect FHx. This mixed methods study compared FHx data collection using a flow-based chatbot (KIT; the curious interactive test) and a form-based method. KIT's design was optimized to reduce user burden. We recruited and randomized individuals from 2 crowdsourced platforms to 1 of the 2 FHx methods. All participants were asked to complete a questionnaire to assess the method's usability, the usefulness of a report summarizing their experience, user-desired chatbot enhancements, and general user experience. Engagement was studied using log data collected by the methods. We used qualitative findings from analyzing free-text comments to supplement the primary quantitative results. Participants randomized to KIT reported higher usability than those randomized to the form, with a mean System Usability Scale score of 80.2 versus 61.9 (P<.001), respectively. The engagement analysis reflected design differences in the onboarding process. KIT users spent less time entering FHx information and reported more conditions than form users (mean 5.90 vs 7.97 min; P=.04; and mean 7.8 vs 10.1 conditions; P=.04). Both KIT and form users somewhat agreed that the report was useful (Likert scale ratings of 4.08 and 4.29, respectively). Among desired enhancements, personalization was the highest-rated feature (188/205, 91.7% rated medium- to high-priority). Qualitative analyses revealed positive and negative characteristics of both KIT and the form-based method. Among respondents randomized to KIT, most indicated it was easy to use and navigate and that they could respond to and understand user prompts. Negative comments addressed KIT's personality, conversational pace, and ability to manage errors. For KIT and form respondents, qualitative results revealed common themes, including a desire for more information about conditions and a mutual appreciation for the multiple-choice button response format. Respondents also said they wanted to report health information beyond KIT's prompts (eg, personal health history) and for KIT to provide more personalized responses. We showed that KIT provided a usable way to collect FHx. We also identified design considerations to improve chatbot-based FHx data collection: First, the final report summarizing the FHx collection experience should be enhanced to provide more value for patients. Second, the onboarding chatbot prompt may impact data quality and should be carefully considered. Finally, we highlighted several areas that could be improved by moving from a flow-based chatbot to a large language model implementation strategy.

Resistance to change as a function of response speed

This study examined the effects of different response-speed requirements on resistance to change. Undergraduates were exposed to a simulated scenario aiming to destroy pollution sources by clicking on moving targets. During baseline, a multiple variable interval (VI) 15 s VI 15 s was in effect. Points (100) served as reinforcers. In the Low-Speed Component, the response button moved across the computer screen at a speed of 30 % of the screen length per second. In the High-Speed Component, the response button moved across the computer screen at a speed of 60 % of the screen length per second. A VI 10 s of point loss (-95) disrupted responding during the test. Behavioral resistance was calculated as proportional changes from baseline response rates to test response rates. When the point-loss disrupted responding, greater resistance was observed in the Low-Speed Component, corroborating previous studies with other dimensions of physical requirements.

Measurement of paracentral stereopsis using a new method with the binocular open perimeter imovifa® in normal adults.

No method to quantitatively evaluate stereopsis within the 15º visual field has been clinically established. We developed a program to measure paracentral stereopsis and evaluated its feasibility in visually normal participants. Experimental investigation METHODS: Ten visually normal volunteers with stereopsis of 60 arcseconds or better were included. The Stereo Eccentricity Analysis (SEA) program for stereopsis measurement across the visual field was integrated into the binocular visual field analyzer imovifa®. Subjects with established binocular stereopsis detected a stereoscopic circular target presented with crossed disparity on random dots at the fovea, 3°, 5°, 10°, and 15° on the 45°, 135°, 225°, and 315° meridians. The subjects performed two tasks for measurement in the periphery: a detection task by pressing the response button when the circular target was perceived and a localization task by tilting a joystick to indicate in which quadrant the circular target was perceived. The duration of the target presentation was 500 ms. The stereo thresholds at 0º and 3° did not significantly differ. The thresholds at 10º and 15º were significantly higher than at 0° (P < 0.01). While no inter-individual threshold difference was observed at the fovea, the difference was large at 15°. The stereo thresholds for the detection and localization tasks also did not differ significantly. With the SEA program, paracentral stereopsis can be measured and the stereo threshold increases with eccentricity. The SEA program appears to be a feasible clinical method to evaluate paracentral stereopsis.

The effect of visual sensory interference during multitask obstacle crossing in younger and older adults.

When older adults step over obstacles during multitasking, their performance is impaired; the impairment results from central and/or sensory interference. The purpose was to determine if sensory interference alters performance under low levels of cognitive, temporal, and gait demand, and if the change in performance is different for younger versus older adults. Participants included 17 younger adults (20.9±1.9 years) and 14 older adults (69.7±5.4 years). The concurrent task was a single, simple reaction time (RT) task: depress button in response to light cue. The gait task was stepping over an obstacle (8 m walkway) in three conditions: (1) no sensory interference (no RT task), (2) low sensory interference (light cue on obstacle, allowed concurrent foveation of cue and obstacle), or (3) high sensory interference (light cue away from obstacle, prevented concurrent foveation of cue and obstacle). When standing, the light cue location was not relevant (no sensory interference). An interaction (sensory interference by task, p<0.01) indicated that RT was longer for high sensory interference during walking, but RT was not altered for standing, confirming that sensory interference increased RT during obstacle approach. An interaction (sensory interference by age, p<0.01) was observed for foot placement before the obstacle: With high sensory interference, younger adults placed the trail foot closer to the obstacle while older adults placed it farther back from the obstacle. The change increases the likelihood of tripping with the trail foot for younger adults, but with the lead limb for older adults. Recovery from a lead limb trip is more difficult due to shorter time for corrective actions. Overall, visual sensory interference impaired both RT and gait behavior with low levels of multitask demand. Changes in foot placement increased trip risk for both ages, but for different limbs, reducing the likelihood of balance recovery in older adults.

Considerations when trying to quantify immersion with secondary tasks

Immersion is a crucial component to characterizing virtual reality (VR) and discovering its many implications for our lives. Studies have defined immersion as the extent that virtual environments submerge users’ perceptual systems, shut out the physical environments’ inputs, and induce engrossment in users. The present study sought to further understand the applications of immersion in virtual environments by leveraging traditional self-report measures, as well as investigating the use of distraction to quantify immersion objectively. We hypothesized that participants in immersive 3-dimensional VR would self-report higher levels of immersion and engagement compared to a non-VR condition. We also predicted that participants in the VR condition would have impaired responses to a secondary task compared to the non-VR condition. Using a within-subjects design, participants engaged in a VR meditation both on a computer screen (non-VR) and through a VR headset (VR). During the meditations, they completed a secondary detection-response task (DRT) by pressing a button in response to a tactile stimulus. We used DRT reaction times to objectively measure immersion. Following the meditations, participants completed questionnaires regarding their experiences. As predicted, participants reported that the VR condition increased their engagement and presence compared to the non-VR version of the same meditation scenario. With regard to the secondary detection task, we did not find a significant effect of VR on DRT performance, although DRT performance was numerically worse in the VR condition compared to the non-VR condition. These mixed results suggest that the use of a secondary task depends upon several factors, which we discuss.

Primary Arterial Hypertension Associated with Cognitive Dysfunction in Young Adults: Results from a Cross-Sectional Controlled Study.

Despite evidence of primary hypertension (PH)-associated cognitive dysfunction in pediatric, middle-aged, and older adult populations, respective data in young adults remains scarce. We aimed to define differences in cognitive performance between individuals with PH and healthy controls in early adulthood. A convenience sample of young adults (age 18-45 years) with PH and their healthy sex, age, education, and household income matched counterparts were cross-sectionally tested for verbal fluency, verbal memory, general intelligence, reaction speed, attention, visual memory, and executive functioning. Between-group differences were determined using Student's t and Mann-Whitney U tests. Sensitivity analysis was performed by adjusting for body mass index (BMI) in analysis of covariance (ANCOVA) and regression models. Thirty-three adults with PH (22, 66.7% male, median age 38.8, interquartile range (IQR) = 33.2-41.6 years) and twenty-two healthy controls (9, 40.9% male, median age 36.1, IQR = 27.5-39.8 years) completed the neuropsychological assessment. Participants with PH performed worse on computerized tasks of reaction time (median response time (Z = -2.019, p = 0.044), median time for release of response button (Z = -2.509, p = 0.012)) and sustained attention (signal detection measure, RVPA (t = 2.373, p = 0.021), false alarms ÷ (false alarms + correct rejections), RVPPFA (Z = -2.052, p = 0.040)). The group variable was not a statistically significant predictor of performance in these domains after adjustment for BMI (p > 0.05). In regression analyses, high office systolic blood pressure (oSBP) was independently associated with poor sustained attention (βSBP(st.) = -0.283, multiple R2 = 0.252 (RVPA), βSBP(st.) = 0.551, multiple R2 = 0.386 (RVPPFA)). Young adults with PH were found to perform worse in tasks of response speed and sustained attention. While the difference between neuropsychological evaluation results in PH and control groups was confounded by BMI, oSBP measures were independently related to sustained attention. The selectivity of PH-associated cognitive profile in young adults has to be confirmed in larger trials.

Distance in depth: A comparison of explicit and implicit numerical distances in the horizontal and radial dimensions.

Numbers are a constant presence in our daily lives: A brain devoid of the ability to process numbers would not be functional in its external environment. Comparing numerical magnitudes is a fundamental ability that requires the processing of numerical distances. From magnitude comparison tasks, a comparison distance effect (DE) emerges: It describes better performance when comparing numerically distant rather than close numbers. Unlike other signatures of number processing, the comparison DE has been assessed only implicitly, with numerical distance as nonsalient task property. Different assessments permit identification of different cognitive processes underlying a specific effect. To investigate whether explicit and implicit assessment of the comparison DE influences numerical cognition differently, we introduced the distance classification task, involving explicit classification of numbers as close or far from a reference. N = 93 healthy adults classified numbers either by magnitude or by numerical distance. To investigate associations between numerical and physical distance, response buttons were positioned horizontally (Experiment 1) or radially (Experiment 2). In both experiments, there was an advantage for both the closest and farthest numbers with respect to the reference during distance classification, but not during magnitude classification. In Experiment 2, numerically close/far numbers were classified faster with the close/far response button, respectively, suggesting radial correspondence between physical and representational distances. These findings provide new theoretical and methodological insights into the mental representation of numbers. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Factors Associated With the Nursing Care Experience of Patients Admitted to Riyadh Region Hospitals.

In the contemporary healthcare landscape, the paradigm of patient experience and patient-centered care has emerged as a crucial point for healthcare reform, emphasizing the patient's active role in shaping healthcare systems. This study aimed to investigate the patient experience level of nursing care and examine associated factors among hospitalized patients in Riyadh, Saudi Arabia. Cross-sectional secondary analysis of patient experience data included more than 8,000 patients discharged from Ministry of Health hospitals in Riyadh during 2022G. The national survey examined patient perceptions of multiple aspects of nursing care. Although most patients gave high overall scores, lower scores were observed for nurse introductions and prompt responses to call buttons. There are opportunities to improve communication and response through interventions targeting nurse staffing, training, and incentives. A checklist called Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) was used to report the study. 71.2% Of patients rated their nursing care experience as "very good." No differences were seen between genders. However, Saudi patients reported higher satisfaction than non-Saudis (p = .001). The top-scored nursing aspects were friendliness/courtesy (70.2% "very good") and nurses' skill level (65.8% "very good"). Lower ratings occurred for nurses who introduced themselves (54.0% "very good") and for prompt response to call buttons (58.5% "very good"). Targeted improvements in communication and responsiveness could help address these gaps in patient experience scores between nursing care domains. Most of the patients indicated overall positive nursing care experiences, which include opportunities for improvement in nurse introductions and responsiveness to patient needs. Boosting communication through nurses consistently introducing themselves and managing heavy workloads to allow faster call button response times could enhance patients' perceptions of their nursing care quality.

CONTACT: AN ONLINE COACHING TOOL TO EMPOWER CARE PARTNERS TO FACILITATE CONVERSATIONS IN NURSING HOMES

Abstract In the post COVID-19 context, nursing homes struggle with staffing. The role of care partners (CPs; relative, friend) has never been more crucial, including the need to advocate for persons living with dementia (PLWD) and being an integral part of the care team. The online CONversaTion cAre Coaching Tool (CONTACT) empowers CPs of PLWD prepare for conversations that may include communicating what matters to the PLWD, need for a different type of care, or treatment decisions. We engaged CPs to complete and provide feedback on CONTACT, which includes four sections: 1) education about nursing homes to clarify key terms/processes 2) guidance on goal setting to identify what is important; 3) creation of action plan to achieve the goal; and 4) reflection on the impact of achieving the goal. CPs (n=8) completed a survey about using the tool (acceptability (4 items), appropriateness (4 items), feasibility (4 items); scale of 1=strongly disagree to 5=strongly agree), and participated in a focus group to discuss the tool’s content and function. CPs favorably rated the tool. Mean ratings for acceptability ranged from 4.13 – 4.25, appropriateness 3.88 – 4.43, and feasibility 4.13 – 4.57. CPs reported that the tool was clear, simple, logically organized, informative, and it provided direction for starting a conversation. They liked the definitions of terms, large response buttons and that instructions were provided via video and in writing. Recommendations included additional videos depicting conversation prompts and scenarios, and utilizing community-based programs such as the Ombudsman office to disseminate CONTACT.

The role of response conflict in concealed information detection with reaction times

The concealed information test (CIT) presents various probe (familiar) items amidst irrelevant (unfamiliar) items. When the probe items appear, reaction time (RT) slows down. This RT-CIT effect has been accounted for by a conflict resulting from the need to deny familiarity of the familiar probes. The present pre-registered study (n = 292) examined whether response conflict is sufficient to account for the RT-CIT effect, using city and name items. Specifically, we compared the common conflict condition, where the response buttons emphasized familiarity of CIT items (“unfamiliar” versus “familiar”), to a novel no conflict condition, where the buttons emphasized categorical membership (“city” versus “name”). In line with our expectations, the RT-CIT effect was substantially stronger in the conflict condition; yet, it remained significant even in the no conflict condition. This implies a critical role for response conflict, but also suggests that other mechanisms (e.g. orientation to significant stimuli) may contribute to the RT-CIT effect.

Web-Based Tool Designed to Encourage Supplemental Nutrition Assistance Program Use in Urban College Students: Usability Testing Study.

Food insecurity continues to be a risk for college students in the United States. It is associated with numerous problems, such as chronic health conditions, increased stress and anxiety, and a lower grade point average. After COVID-19, the Supplemental Nutrition Assistance Program (SNAP) benefits were extended to college-aged students; however, there were some barriers to participation, which persisted such as lack of perceived food insecurity risk, lack of knowledge regarding the SNAP application process, the complexity of determining eligibility, and stigma associated with needing social assistance. A technology-enhanced tool was developed to address these barriers to SNAP enrollment and encourage at-risk college students to apply for SNAP. The purpose of this study was to test the usability and acceptability of a web-based SNAP screening tool designed for college-aged students. College students aged 18-25 years were recruited to participate in 2 rounds of usability testing during fall 2022. Participants tested the prototype of a web-based SNAP screener tool using a standardized think-aloud method. The usability and acceptability of the tool were assessed using a semistructured interview and a 10-item validated System Usability Scale questionnaire. Audio recordings and field notes were systematically reviewed by extracting and sorting feedback as positive or negative comments. System Usability Scale questionnaire data were analyzed using the Wilcoxon signed rank test and sign test. A total of 12 students (mean age 21.8, SD 2.8 years; n=6, 50% undergraduate; n=11, 92% female; n=7, 58% Hispanic or Black or African American; n=9, 78% low or very low food security) participated in both rounds of user testing. Round 1 testing highlighted overall positive experiences with the tool, with most participants (10/12) stating that the website fulfills its primary objective as a support tool to encourage college students to apply for SNAP. However, issues related to user interface design, navigation, and wording of some questions in the screening tool were noted. Key changes after round 1 reflected these concerns, including improved design of response buttons and tool logo and improved clarity of screening questions. The overall system usability showed slight, but not statistically significant, improvement between round 1 and round 2 (91.25 vs 92.50; P=.10, respectively). Overall usability findings suggest that this web-based tool was highly usable and acceptable to urban college students and could be an effective and appealing approach as a support tool to introduce college students to the SNAP application process. The findings from this study will inform further development of the tool, which could eventually be disseminated publicly among various college campuses.

The Effectiveness of Detecting Thematic Relations of Objects in 3–6 Years Old Children

In this work, the ability of preschoolers aged 3–6 to detect and understand the thematic connections of objects was assessed. Children (95 children; 53 girls and 42 boys) of four age groups of 3, 4, 5 and 6 years old (respectively, 17, 33, 18 and 27 children) solved two tasks aimed at the detection of thematic relations of objects within the framework of the standard “yes–no” procedure. In the first task, it was required to indicate whether the image of the shown object was relevant to a given context (the “object-context” task, O–C), and in the second – whether two objects were related thematically (the “object–object” task, O–O). A touch screen computer was used to present images and record motor responses. For each task, we measured the accuracy scores (the proportion of correct responses) and the delay in the motor response “yes” or “no” relative to the moment the image was presented (reaction time). Two components of the reaction time were analyzed separately: the duration of the latent phase and the duration of the overt movement towards the response button. With age, the accuracy of solving both tasks increased, and the time required to discover the thematic connection (reaction time) decreased. At the same time, the accuracy scores were lower, and the detection time was longer in the O–O task compared to the O–C. The gender of the child did not affect the accuracy value, and affected only the duration of the motor (but not the latent) phase of the motor response, and only in the O–O task. The data obtained show that (i) the O–O task is more difficult than the O–C task, and that this may be due to the necessity to activate the thematic links of two objects in the O–O task instead of just one, as in the O–C task, and (ii) the process of activation of thematic links probably does not end in the latent phase of the motor response and continues during its movement phase. The question of the extent to which the success and duration of the process of detecting the thematic links of objects can limit the success of cognitive planning in preschoolers aged 3–6 is also discussed.

Causes and clinical consequences of inappropriate shocks experienced by patients wearing a cardioverter-defibrillator

The LifeVest® wearable cardioverter-defibrillator (WCD) prevents sudden cardiac death in at-risk patients who are not candidates for an implantable defibrillator. The safety and efficacy of the WCD may be impacted by inappropriate shocks (IAS). The purpose of this study was to assess the causes and clinical consequences of WCD IAS in survivors of IAS events. The Food and Drug Administration's Manufacturers and User Facility Device Experience database was searched for IAS adverse events (AE) that were reported during 2021 and2022. A total of 2568 IAS-AE were found (average number of IAS per event: 1.5 ± 1.9; range 1-48). IAS were caused by tachycardias (1255 [48.9%]), motion artifacts (840 [32.7%]), and oversensing (OS) of low-level electrical signals (473 [18.4%]) (P <.001). Tachycardias included atrial fibrillation (AF) (828 [32.2%]), supraventricular tachycardia (SVT) (333 [13.0%]), and nonsustained ventricular tachycardia/fibrillation (NSVT/VF) (87 [3.4%]). Activities responsible for motion-induced IAS included riding a motorcycle, lawnmower, or tractor (n = 128). In 19 patients, IAS induced sustained ventricular tachycardia or ventricular fibrillation that subsequently were terminated by appropriate WCD shocks. Thirty patients fell and suffered physical injuries. Conscious patients (n = 1905) did not use the response buttons to abort shocks (47.9%) or used them improperly (20.2%). IAS resulted in 1190 emergency room visits or hospitalizations, and 17.3% of patients (421/2440) discontinued the WCD after experiencing IAS, especially multiple IAS. The LifeVest WCD may deliver IAS caused by AF, SVT, NSVT/VF, motion artifacts, and oversensing of electrical signals. These shocks may be arrhythmogenic, result in injuries, precipitate WCD discontinuation, and consume medical resources. Improved WCD sensing, rhythm discrimination, and methods to abort IAS are needed.

PO-04-168 CAUSES AND CONSEQUENCES OF INAPPROPRIATE SHOCKS DELIVERED BY A WEARABLE DEFIBRILLATOR

Wearable defibrillators (WCD) use skin electrodes (SE) for rhythm monitoring and response buttons (RB) to allow patients to divert unneeded or inappropriate shocks (IAS). Recently we reported deaths caused by arrhythmogenic WCD IAS. However, outcomes of IAS in the general WCD population have not been described. Assess the causes and consequences of inappropriate shocks (IAS) received by patients while wearing the LifeVest 4000 WCD (ZOLL Medical), and evaluate RB usage and efficacy. The Food and Drug Administration's Manufacturers and User Facility Device Experience (MAUDE) was queried for descriptions of events and stored ECG findings of WCD patients who received inappropriate shocks (IAS) outside the hospital and survived. From November 2021 to November 2022, 1,312 patients received IAS (avg 1.55±1.84SD, range: 1-29). IAS were caused by atrial fibrillation (n=391;29.8%), supraventricular tachycardia (n=218;16.6%), non-sustained ventricular tachycardia (VT) or non-sustained ventricular fibrillation (VF) (n=41;3.1%), oversensing of ECG signals (n=236;18.0%), and motion/noise artifacts (n=426;32.5%). IAS in 13 patients (0.1%) induced VT or VF that were subsequently and appropriately shocked and terminated. IAS resulted in 8 falls and 3 fractures, and at least 208 patients (15.9%) discontinued the WCD after receiving IAS. Of 74 patients who received IAS while riding a vehicle, 52 (70.2%) occurred on a motorcycle and 8 (10.8%) on a lawnmower. Only 560 (42.7%) patients attempted to divert impending IAS using the response buttons (RB); RB use by 144 (25.7%) patients failed to abort the shock, and the remaining patients pressed the RB only after shock delivery. The results of this study suggest: 1) Most IAS are due to inaccurate rhythm discrimination and electrogram oversensing; a third are caused by SE motion, especially motor vibrations. 2) IAS may be arrhythmogenic and they promote noncompliance. 3) Improved methods for preventing and aborting IAS are needed.

Possibility of additive effects by the presentation of visual information related to distractor sounds on the contra-sound effects of the N100m responses

Auditory-evoked responses can be affected by different types of contralateral sounds or by attention modulation. The present study examined the additive effects of presenting visual information about contralateral sounds as distractions during dichotic listening tasks on the contralateral effects of N100m responses in the auditory-evoked cortex in 16 subjects (12 males and 4 females). In magnetoencephalography, a tone-burst of 500 ms duration at a frequency of 1000 Hz was played to the left ear at a level of 70 dB as a stimulus to elicit the N100m response, and a movie clip was used as a distractor stimulus under audio-only, visual-only, and audio-visual conditions.Subjects were instructed to pay attention to the left ear and press the response button each time they heard a tone-burst stimulus in their left ear. The results suggest that the presentation of visual information related to the contralateral sound, which worked as a distractor, significantly suppressed the amplitude of the N100m response compared with only the contralateral sound condition. In contrast, the presentation of visual information related to contralateral sound did not affect the latency of the N100m response. These results suggest that the integration of contralateral sounds and related movies may have resulted in a more perceptually loaded stimulus and reduced the intensity of attention to tone-bursts. Our findings suggest that selective attention and saliency mechanisms may have cross-modal effects on other modes of perception.

PD22-09 CENTRAL BLADDER PROPRIOCEPTION: ROBUST FINDINGS FROM SENSATION-DRIVEN FUNCTIONAL MRI STUDY

You have accessJournal of UrologyCME1 Apr 2023PD22-09 CENTRAL BLADDER PROPRIOCEPTION: ROBUST FINDINGS FROM SENSATION-DRIVEN FUNCTIONAL MRI STUDY Anugrah Santoso, Stefan Sunaert, and Dirk De Ridder Anugrah SantosoAnugrah Santoso More articles by this author , Stefan SunaertStefan Sunaert More articles by this author , and Dirk De RidderDirk De Ridder More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003295.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Despite being long utilized to study the central control of bladder perception in response to repetitive bladder filling, the reliability and repeatability of functional MRI (fMRI) studies remain problematic. To our knowledge, most of the studies used a block design consisting of discrete epochs of on-off tasks. As proprioception of the bladder filling is immensely subjective, a desire to void event can only be indicated by the participant. In this pilot study, we aim to evaluate the brain response to even-related bladder filling fMRI paradigm. METHODS: Seven healthy female subjects with mean age 30.1 years were included. Ethical approval was obtained. All subjects underwent a baseline urodynamic study and the catheters were maintained for the subsequent MRI session. We used a 3 Tesla scanner with an in-bore screen and response buttons. Each fMRI session lasted 8.5 minutes and was repeated 2-4 times, depending on the subjects’ coping ability with the task. The paradigm consisted of repetitive bladder filling (60ml/minute) until first desire (FD) and strong desire (SD) was indicated, followed by a plateau (5 seconds) and withdrawal of 30 seconds (30ml). To prevent constant engagement of the viscerosensory cortex, a diversion visuomotor task was presented to which the subjects had to respond with the button press. All responses were recorded with Psychopy and further incorporated in data analysis. MRI preprocessing was done with fMRIPrep pipeline (version 20.2.6). SPM12 was used to smooth the data with a 6mm Gaussian filter and to analyse them. A General Linear Model was used to model the FD, SD and distraction tasks as events. Second-level mixed effect analysis was then performed for the 3 event-contrasts and significance was set to cluster level p<0.05 false discovery rate correction. RESULTS: On average subjects indicated FD 3.75 times and SD 4.71 times. The distraction task occurred on average 23.47 times. Figure 1 depicts the brain regions that show stronger mean activation during FD and SD from 7 subjects, including insula, thalamus, cerebellum, pontine micturition center, supplementary motor area and anterior cingulate cortex. CONCLUSIONS: Here we designed a sensation-driven fMRI paradigm that enables evaluation of bladder proprioception during FD and SD. The results were robust despite small number of subjects. Source of Funding: Departmental Funding © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e667 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Anugrah Santoso More articles by this author Stefan Sunaert More articles by this author Dirk De Ridder More articles by this author Expand All Advertisement PDF downloadLoading ...