Response Bias Research Articles (Page 1)

Stress is a well-established risk factor for psychological burden, yet individual vulnerability varies, suggesting that stress intensity and cognitive-psychological factors might be implicated in this process. This study examined how perceived stress at two different phases (moderate vs. high stress) relates to psychological symptoms and positive mental health through lower levels of psychological flexibility and whether interpretation biases in response to social ambiguity moderate this effect. A total of 228 healthy undergraduate students were assessed once at the beginning of a semester (T0: moderate stress phase) and 12weeks later during exams (T1: high stress phase). Psychological flexibility mediated the relationship between stress and both psychological symptoms and positive mental health at both time points. Notably, baseline negative interpretation biases moderated this mediation effect for depressive symptoms at T1 (high stress phase), such that lower psychological flexibility was linked to higher depression levels only among individuals with moderate to high levels of negative interpretation bias. In turn, the absence of negative biases buffered against these effects. No such moderation effects were observed under moderate stress (T0) or for positive interpretation biases at either time point. These findings highlight the importance of interventions that combine techniques to foster psychological flexibility and reduce negative interpretation biases, particularly for individuals under high stress or vulnerable to depression.

The association between exposure to particulates in polluted air and cognitive impairment is an emerging and significant health concern, particularly among younger populations. Although exposure to particulate matter ≤ 2.5μm (PM2.5) is linked with a lower estimated risk for dementia compared to traditional risk factors such as APOEɛ4 gene variants, the widespread and long-term population exposure to PM2.5 pose substantial implications for public health. This review explores the sex differences in cognitive function induced by PM2.5, which are age-dependent and distinct from the sex bias observed in Alzheimer's disease. In addition to biological sex and sex hormones, we also discuss the role of epigenetic regulation as a mechanism underlying sex-specific cognitive vulnerabilities to environmental toxins, particularly PM2.5. Understanding these differences is important for developing targeted interventions and public health strategies to mitigate the cognitive impacts of PM2.5 exposure.

Background Emergency nurses frequently experience moral injury (MI) arising from high-risk ethical conflicts, heavy workloads, and exposure to traumatic events, which can contribute to health-related productivity loss (HRPL). However, the underlying mechanisms remain unclear. Crucially, perceived social support and moral resilience may mediate this relationship by mitigating negative effects. Clarifying the mediating roles of perceived social support and moral resilience is essential to evaluate their influence on the relationship between MI and productivity loss, and to establish a model that explains this mechanism, thereby contributing to protecting nurses’ well-being and safeguarding patient care quality. Objective This study aims to explore the relationship between MI and HRPL, and to examine the mediating roles of social support and moral resilience. These insights are of great significance for enhancing the physical and mental well-being of emergency nurses and improving the overall quality of medical care. Methods A prospective cross-sectional survey was conducted among 483 emergency nurses from five tertiary hospitals across three provinces in mainland China between January and May 2025. The survey instruments included the General demographic questionnaire, Moral Injury Symptoms Scale-Health Professionals Version (MISS-HP), Rushton Moral Resilience Scale (RMRS), Perceived Social Support Scale (PSSS) and Stanford presenteeism scale-6 (SPS-6). Descriptive analysis and Pearson correlation analysis were performed using SPSS 29.0. The structural equation model was constructed with AMOS 29.0 software, and Bootstrap testing was conducted. Results The results showed that moral injury directly affected Health-related productivity loss ( β = 0.282, 95% CI [0.183, 0.382]). Perceived social support and moral resilience both played mediating roles in the relationship between MI and HRPL ( β = 0.042, 95%CI [0.008, 0.076]) ( β = 0.079, 95%CI [0.046, 0.117]). Perceived social support and moral resilience play chain mediating roles between MI and HRPL ( β = 0.020, 95%CI [0.010, 0.034]). The structural model demonstrated good fit indices (CFI = 0.947, RMSEA = 0.045), indicating the robustness of the proposed model. Conclusion Perceived social support and moral resilience jointly buffer the impact of MI on nurses’ health-related productivity. Interventions should therefore strengthen both support and resilience. For example, hospitals could implement peer-support groups or resilience workshops, and nurses could practice mindfulness or seek mentorship to bolster coping skills. These strategies may mitigate the negative effects of moral injury and improve productivity. However, as a cross-sectional survey relying on self-reported measures, this study may be subject to response bias, highlighting the need for future longitudinal research.

Somatically acquired mutations in the E1 ubiquitin-activating enzyme UBA1 within hematopoietic stem and progenitor cells (HSPCs) were recently identified as the cause of the adult-onset autoinflammatory syndrome VEXAS (vacuoles, E1 enzyme, X linked, autoinflammatory, somatic)1. UBA1 mutations in VEXAS lead to clonal expansion within the HSPC and myeloid, but not lymphoid, compartments. Despite its severity and prevalence, the mechanisms whereby UBA1 mutations cause multiorgan autoinflammation and hematologic disease are unknown. Here, we employ somatic gene editing approaches to model VEXAS-associated UBA1 mutations in primary macrophages and HSPCs. Uba1-mutant macrophages exposed to inflammatory stimuli underwent aberrant apoptotic and necroptotic cell death mediated by Caspase-8 and RIPK3-MLKL, respectively. Accordingly, in mice challenged with TNF or LPS, the UBA1 inhibitor TAK-243 exacerbated inflammation in a RIPK3-Caspase-8-dependent manner. In contrast, Uba1 mutation in HSPCs induced an unfolded protein response and myeloid bias independently of RIPK3-Caspase-8. Mechanistically, aberrant cell death of Uba1-mutant macrophages coincided with a kinetic defect in Lys63/Met1 (i.e., linear) polyubiquitylation of inflammatory signaling complexes. Collectively, our results link VEXAS pathogenesis with that of rarer monogenic autoinflammatory syndromes; highlight specific ubiquitin-associated defects stemming from an apical mutation in the ubiquitylation cascade; and support therapeutic targeting of the inflammatory cell death axis in VEXAS.

Autosuggestion and mental imagery bias the perception of social emotions.

Patient-centred care is a cornerstone for healthcare quality, leading many hospitals to implement programs that prioritise patient, even within time-constrained clinical environments. Effects of these programs are poorly evaluated. This retrospective observational cohort study aims to evaluates the impact of a patient-centred initiative aimed at protecting clinical encounter time by enhancing communication, fostering shared decision-making, and minimizing care interruptions on the quality of pain management in hospitalised patients. Electronic health record data and a difference-in-differences estimator were used to examine changes in quality of pain management outcomes in over 15,000 patients across 80,000 hospital stays ranging from 2018 to 2022 in the University Hospitals of Geneva, SwitzerlandPain management quality was evaluated using timeliness of pain relief delivery, adequacy of pain documentation, and patient satisfaction with pain management. Data were compared in units who implemented the programs compared to matched control units to evaluate both the immediate and sustained effects of the program, accounting for potential selection and contamination biases. The results demonstrated significant and sustained improvements in pain management quality in intervention units. Rates of timely painkiller administration increased significantly more in intervention units compared to control units (OR 1.46, 95% CI [1.37, 1.56]), with effects persisting over time. Pain documentation also showed significant improvement in intervention units (OR 1.47, 95% CI [1.15, 1.88]), although a minor initial decline was observed, likely due to temporary staffing disruptions during implementation. However, there was no significant improvement in patient-reported satisfaction with pain management, which may reflect limitations in survey sensitivity and response biases given the 53.3% response rate. This patient-centred program effectively improved objective measures of pain management quality in a tertiary hospital setting. However, further research is needed to assess its impact on patient experience, as well as healthcare professional engagement and satisfaction. Insights from future studies could guide the development of similar patient-centred initiatives that aim to balance efficiency with high-quality patient care.

Background With the rapid proliferation of misinformation on social media, increasing attention has been paid to its psychological and behavioral mechanisms. Emotional valence—particularly the positive or negative tone of information—is often used in constructing misinformation, facilitating its wide dissemination. However, existing findings on how emotional valence influences misinformation sharing remain mixed, especially among adolescent populations. This study explores the impact of information valence on high school students’ willingness to share misinformation and evaluates the effectiveness of a targeted accuracy prompt. Methods Two experiments were conducted. In Experiment 1, 53 high school students completed a news-sharing task involving both true and false headlines with varying emotional valence. Their willingness to share was measured. In Experiment 2, 40 students received a valence-targeted accuracy prompt designed to highlight common characteristics of misinformation. The effectiveness of the intervention in reducing misinformation sharing was then assessed. Results Experiment 1 showed that participants were significantly more willing to share positive misinformation than negative misinformation, regardless of authenticity. Information valence had a significant effect on response bias. In Experiment 2, students who received the accuracy prompt intervention demonstrated significantly lower willingness to share misinformation compared to the control group, indicating the effectiveness of this brief and targeted approach. Conclusion Information valence plays a critical role in shaping adolescents’ willingness to share misinformation, with positive content being more readily shared. A brief accuracy prompt intervention tailored to information characteristics and emotional valence can effectively reduce misinformation sharing among high school students. These findings provide theoretical and practical insights into combating misinformation in adolescent populations.

Abstract Owing to the evolution of information and technology, SMEs intensively get information about future probable economic benefits for their internal businesses. Furthermore, by adapting to the dynamics of their business environment, SMEs encourage themselves to carry out disruptive innovations that create distinctive products and new market segments, improving their aggregative competencies and overall business. Therefore, this study investigates whether SMEs in Indonesia posit and employ sociodynamic factors and disruptive innovation to gain resilience and sustainability. Moreover, it explores the importance of the government's strategic policy formulation in connection with the embeddedness of sociodynamic factors and disruptive innovation in SMEs’ businesses. Methodologically, within a qualitative approach, this study comprehensively collected its data through three methods: in-depth interviews, observations, and document studies. In addition, it utilised purposive criteria to select high-quality informants from Indonesian SMEs, achieving minimum response bias. Thus, firstly, this paper demonstrates the sequential reasons Indonesian SMEs have overcome economic downturns using sociodynamic factors and disruptive innovation. Secondly, this study shows that the Indonesian Ministry of SMEs has issued fallacious policies focusing on the digital economy. This ministry should encourage SMEs to have a bundled knowledge of sociodynamics and disruptive innovation. Thirdly, this study contradicts the evidence of the barriers to Indonesian SMEs’ capability enhancements via digital transformation by evidencing that most SMEs adopt low-single-platform information.

Purpose This study examines the factors leading to low service quality in the hospitality industry in northwestern Nigeria, emphasising the lack of digitalisation and supply chain integration. The sector faces challenges, such as security issues and reduced investor and tourist numbers, which affect productivity. Our study explores how digital tools and integrated supply chains can enhance service quality by highlighting employee satisfaction and customer service. Design/methodology/approach Using a mixed-methods approach, we conducted a web-based survey with 100 hotel employees, semi-structured interviews with six hotel managers and an analysis of relevant organisational documents. Quantitative data were analysed using linear regression and descriptive statistics. Findings We identified the interconnections between digital transformation, supply chain integration, employee satisfaction and service quality, culminating in the development of a Digital Integration Satisfaction Model (DISM). Research limitations/implications This study provides useful insights into digital transformation in hospitality but has several limitations. It focuses solely on Northwest Nigeria, limiting generalisability. The small interview sample, while achieving thematic saturation, may not reflect broader managerial views. Reliance on self-reported data raises the risk of response bias. Data were collected over six months, so recent changes may be missed. Additionally, the study emphasises service quality and efficiency, omitting financial metrics like ROI or cost savings, which could provide a more comprehensive assessment. Originality/value This study aligns with the technology-organisation-environment (TOE) framework, supply chain management model, Herzberg’s two-factor theory and SERVQUAL model, using the terms digitalisation and technology adoption interchangeably. This study advances the understanding of the critical role of digitalisation and supply chain integration in enhancing hospitality sector performance in a challenging regional context, contributing to both theoretical models and practical insights.

This study aims to address a gap in the literature by analyzing the relationships between social media addiction, sleep quality, and life satisfaction, particularly in medical students who are under significant stress. This research employed a cross-sectional design at a university medical faculty. The study population included 1210 students, with a minimum sample size calculated as 292 based on a 95% confidence level and a 5% margin of error. Data were collected voluntarily from 433 students using validated tools, including the Social Media Addiction Scale-Adult Form (SMAS-AF), the Life Satisfaction Scale (LSS), and the Republic Subjective Sleep Quality Scale. Statistical analyses included descriptive statistics, Independent Samples t-tests, Kruskal–Wallis, Pearson correlation, and multiple linear regression analysis. Of the participants, 62.4% were female, and 49.4% used social media for 2–4 h daily. A significant negative relationship was identified between social media addiction and life satisfaction (p<0.05), while a positive relationship was found between sleep quality and life satisfaction (p<0.05). Social media addiction negatively affected life satisfaction by disrupting sleep patterns, while sleep quality partially mitigated this adverse effect. Female students exhibited higher social media addiction and life satisfaction scores than male students (p<0.05). Students who used social media for more than 4 h daily reported significantly lower life satisfaction. Social media addiction significantly reduced life satisfaction among medical students, mainly by disrupting sleep quality. However, better sleep quality seemed to buffer this effect. These findings underscore the need for university programmes to reduce excessive social media use and promote healthy sleep routines. Training that fosters regular sleep habits may further support students' academic and psychological well-being. Still, the results should be interpreted with caution due to limitations such as the single-institution setting, cross-sectional design, and reliance on self-reported data, which may introduce response bias. Future research should adopt multi-centre, longitudinal designs to improve generalizability and causal understanding.

This study examines the complex issue of specifically quantifying sensitive quantitative variables while ensuring respondents’ privacy and maintaining data integrity. The present study presents two novel optional stratified double response models (OSDRMs) that integrate simultaneously additive and subtractive frantically mechanisms to improve privacy protection while maintaining efficiency. The models utilize two scrambling variables for each response and employ stratified random sampling (SRS) to divide the population into similar subgroups (strata), ensuring that each subgroup is representative. In every stratum, simple random sampling with replacement (SRSWR) is employed, resulting in more precise estimates. The OSDRMs develop unbiased and viable estimates by assessing the mean as well as the sensitivity level for highly sensitive information, thereby reducing the likelihood of response bias and social desirability effects. The mathematical derivations and comprehensive simulation studies indicate notable enhancements in relative efficiency when contrasted with conventional randomized response methods. We investigated the suggested models in actual scenarios by conducting a cross-sectional survey in the Lahore, Faisalabad, and Sargodha districts of Punjab, Pakistan. The results demonstrate that OSDRMs are an effective, privacy-protecting technique for collecting sensitive data, resulting in improved precision and dependability of data. This strategy is significant for public health management because it promotes ethical data gathering while also improving monitoring and policy formulation in circumstances involving sensitive data.

Disclosure: C.M. Craig: Amylyx, Aardvark. T.L. McLaughlin: Regeneron Pharmaceuticals, Amylyx, January AI, Recordati.Significance: Post-bariatric hypoglycemia (PBH) is a complication of bariatric surgery in which postprandial hypoglycemia can be severe, frequent, and debilitating. It does not remit over time and there are no approved therapies. The incidence reported in the published literature varies from 0.1% to 75% of all bariatric procedures, largely due to differences in methodologies and definitions used to identify incident cases. To accurately define the burden of PBH, the incidence and prevalence must be ascertained, with accurate definitions of incident cases used. We performed a critical review of published literature with the following goals: 1) Outline differences between methodologies and definitions used to determine incidence of PBH; 2) Suggest optimal parameters to use in defining incident cases; 3) Provide incidence estimates for “Any PBH” and “Medically-Important PBH” based on published studies using best methods; 4) Estimate current U.S. prevalence based on surgical census data and disease-state modeling. Methodologic Assessment: Studies estimating PBH incidence include retrospective registry and hospital studies interrogating registry and electronic medical records, observational patient-reported outcomes studies, prospective hypoglycemia provocation studies, and prospective continuous glucose monitor (CGM) studies. Inconsistencies exist across studies in diagnostic codes used to define incident cases, glycemic thresholds used to define events, and requirement for hypoglycemia symptoms. Underestimation may result from hypoglycemia unawareness, treatment before glucose is checked, not seeking medical attention, misdiagnosis, difficulty obtaining glucose at time of event, short duration of sampling after provocation, and survey response bias. Overestimation may result from use of high glycemic thresholds (e.g., <60mg/dL), use of oral glucose tolerance tests for provocation, and inaccuracies in CGM readings. Incidence estimates: Based on Level A studies, categorized by surgery type and severity: Any PBH (> 3 symptoms hypoglycemia, neuroglycopenia, need for assistance, or glucose ≤54 mg/dL): RYGB 32%; VSG 11.8%Medically-Important PBH (visit to inpatient or outpatient facility): RYGB 11.8%; VSG 4.2% Prevalence estimates: Based on surgeries performed 1993-2023, incidence estimates, and life expectancy estimates (Center for Vital Statistics):RYGB: Any PBH: 323,658; Medically important PBH: 119,350VSG: Any PBH: 128,213; Medically important PBH: 46,719Total: Any PBH: 451,871; Medically important PBH: 166,069 Clinical Implications: With over 450,000 affected individuals in the U.S., and more than one-third requiring medical attention, PBH represents a significant burden. These findings underscore the need for standardized definitions and diagnostic criteria and development of safe and effective therapies.Presentation: Saturday, July 12, 2025

Abstract A longstanding puzzle in the African land rental market literature is the often‐observed discrepancy between the number of tenants (renters‐in) and the much smaller number of landlords (renters‐out) in survey data. If this discrepancy derives from systematic biases in survey data responses on rental market participation, then the existing body of survey‐based empirical work on land rental markets impacts may be fundamentally flawed. To examine this issue, we implemented two survey experiments. First, we tested the hypothesis that some categories of rented land are underreported because enumerators and respondents focus primarily on parcels directly managed or cultivated by the household. A random subset of respondents received a priming nudge reminding them to account for all land, including rented‐ or sharecropped‐in and rented‐ or sharecropped‐out parcels. Second, we tested whether households underreport rented‐ or sharecropped‐out land due to reluctance to disclose activities that may carry social or institutional repercussions, using a double‐list experiment to infer true rates of participation. Interestingly, our results indicate a significant underreporting of both renting‐in and renting‐out land but arising through different mechanisms. The priming nudge increased reports of renting‐/sharecropping‐in by 4 percentage points (equivalent to 13% of landlords in the sample) but had negligible effects on reported renting‐/sharecropping‐out. By contrast, the list experiment suggests that the true share of renting‐out households is about 15%: much higher than the 3% in parcel‐roster responses. These results underscore the need for improved survey methods to accurately observe land rental market participation and evaluate its impact.

With the increasing publication of self-report online studies, concerns are growing about the quality of the data collected through these methods. This study focused on response bias, a major threat to data quality, by analyzing data from a real-world study on adult temperament conducted in two different countries. The sample included 1,497 participants aged 18-80 years from the United States (n = 598) and Lithuania (n = 899). The primary objectives were to determine the prevalence of response bias and to evaluate its impact on psychometric outcomes. Indicators of biased responding included patterns suggestive of potentially careless responding (e.g., invariant and random response patterns) and those flagged by internal validity checks or clinical controls (e.g., social desirability and ratings-perception discrepancies). Results indicated that the inclusion of data reflecting potentially careless responding reduced internal consistency and distorted factor structure, whereas its exclusion improved these psychometric indicators. In contrast, with regard to clinical controls, removing flagged data resulted in a decline in psychometric quality. Additionally, higher rates of careless responding were observed in the sample subjected to forced answering. These findings highlight the importance of mitigating response bias in online self-report research and raise broader questions about the integrity of data in existing survey-based datasets. By jointly evaluating careless responding and clinical threats in real-world, cross-national samples, this study extends prior work and demonstrates the applied value of post-hoc screening for improving psychometric quality.

Pre-stimulus alpha oscillations in the visual cortex modulate neuronal excitability, influencing sensory processing and decision-making. While this relationship has been demonstrated mostly in detection tasks with low-visibility stimuli, interpretations of such effects can be ambiguous due to biases, making it difficult to clearly distinguish between perception-related and decision-related effects. In this study, we investigated how spontaneous fluctuations in pre-stimulus alpha power affect iconic memory, a high-capacity, ultra-short visual memory store. Data from 49 healthy adults (34 female and 15 male) was analyzed. We employed a partial report task, where a brief display of six stimuli was followed by a report cue indicating the target stimulus. In this paradigm, accuracy at short stimulus-cue onset asynchronies (SOAs) is typically high, reflecting the initial availability of sensory information, but it rapidly declines at intermediate SOAs due to the decay of the iconic memory trace, stabilizing at a low asymptote at long SOAs, representing the limited capacity of short-term memory. Crucially, performance in this task is constrained by the temporal persistence of sensory information, not by low visibility or response bias. We found that strong pre-stimulus alpha power enhanced performance by amplifying initial stimulus availability without affecting the speed of iconic decay. This effect partially reflects stronger pre-stimulus alpha power in the hemisphere ipsilateral to the to-be-reported target, likely suppressing neuronal excitability of neurons coding irrelevant stimuli. Our findings underscore the role of alpha oscillations in modulating neuronal excitability and visual perception, independent of decision-making strategies implicated in prior studies.Significance statement Pre-stimulus alpha oscillations in the visual cortex are known to influence visual perception, but the exact mechanism has been debated. Our study reveals that spontaneous fluctuations in pre-stimulus alpha power, particularly alpha lateralization, enhance iconic memory - a brief, high capacity visual memory system - by suppressing neuronal excitability at irrelevant spatial locations. This suppression improves the availability and temporal persistence of visual information and highlights a novel link between alpha oscillations and iconic memory. These findings extend our understanding of how pre-stimulus alpha power modulates neuronal excitability by showcasing its influence in a paradigm that is unaffected by low visibility and decision-making strategies.

Background Leprosy-related foot ulceration remains a significant cause of disability despite the decline in global disease prevalence. Self-care practices are essential for preventing foot complications, particularly in resource-limited settings. Aim To assess foot care practices among leprosy-affected persons with foot disabilities and to explore the barriers to proper foot care among the study participants with unsatisfactory foot care practices Methods A community-based cross-sectional mixed-method study with an explanatory sequential design was conducted in a Leprosy Colony of Bankura, West Bengal from December 2023 to August 2024. For the quantitative strand, 104 leprosy-affected adults with Grade 1 and Grade 2 foot disabilities were interviewed using a predesigned, pretested semi-structured questionnaire. In-depth interviews were conducted among seven individual with unsatisfactory foot care practices, for the qualitative strand. Results The median foot care practice score was 5.5 (4, 7), with 84.6% of participants having unsatisfactory practices. Women (p?0.001), widowed/never married status (p?0.004), and Grade 1 foot disability (p?0.034) were significantly associated with unsatisfactory foot care. Qualitative exploration revealed three major barrier themes: cognitive (knowledge deficits, misconceptions, low perceived disease severity), socio-economic (lack of caregivers, insufficient income, forced long-distance walking), and product-related (gender-inappropriate footwear design, poor fit, limited durability). Limitations Conducting this study in a single leprosy colony and non-probabilistic sampling method may limit generalisability and self-reported data may subject to response bias. Conclusions Multiple interconnected factors influence foot care practices among leprosy-affected individuals. Interventions should address gender-specific barriers, enhance risk perception among those with milder disabilities, and improve the design, fit, and quality of protective footwear to reduce disability burden.

Current financial toxicity (FT) screening tools rely on patient-reported risk factors. Underrepresented populations may not be forthcoming about FT fears due to cultural concerns of treatment withholding or migratory repercussions, if applicable. Identifying objective risk factors, such as social determinants of health (SDOH) and disease-specific factors (DSF), could reduce FT in patients with cancer and throughout health care systems. This was a multicenter retrospective study evaluating SDOH and DSF associated with FT (defined as ≥ $15,000 owed) related to cancer treatment. Inferential statistics were used to evaluate differences between the FT cohort and those who owed less than $15,000. Continuous data were compared with a Student t test or Mann-Whitney test, depending on distribution. Categorical outcomes were compared with a χ² test. A logistic regression model was used to evaluate multivariate associations with FT, using a P value of less than .05 to define significant results. The sample comprised 162 records, 81 in each group. Univariate analyses demonstrated participants' differences in age, relationship with a primary care provider, country of origin, insurance status, education level, need for an English interpreter, whether their disease was stage IV at diagnosis, recurrent or metastatic disease, use of immune checkpoint inhibitors, and use of targeted molecular therapy. Employment status and marital status were not statistically different. The logistic regression model showed that lack of insurance and having stage IV disease at diagnosis were significantly associated with FT (P = .001 and P = .0495, respectively). Objective FT screening can minimize response bias and incidence in those at increased risk. In our study, we found that individuals who are first-generation Hispanic immigrants and lack English proficiency faced significant barriers to receiving help for the high financial costs of medical care. These findings identify specific subpopulations at risk for FT and will guide prospective interventions looking to minimize FT. Health care systems should analyze objective measures of FT while considering loco-regional and subcultural SDOH/DSF to overcome response bias.

Exploring intuitive decisions and sense of coherence in synaesthesia.

ABSTRACTThe brain continuously integrates interoceptive signals—such as those arising from cardiac afferents—with sensory input to guide perception, emotion and awareness. Previous research has demonstrated that the timing of external stimuli relative to the cardiac cycle influences perceptual and cognitive processes. However, it remains unclear whether cardiac signals facilitate the access of emotional visual stimuli to conscious awareness. Here, we used a continuous flash suppression (CFS) paradigm to investigate whether the breakthrough of fearful and neutral faces to awareness is modulated by cardiac cycle phase. Fearful and neutral faces were presented to the non‐dominant eye in synchrony with participants' heartbeats—either during estimated‐cortical systole (ec‐systole) or diastole (ec‐diastole)—while dynamic Mondrian patterns suppressed visibility in the dominant eye. Results showed that fearful faces presented during estimated‐cortical systole (ec‐systole) broke through suppression faster and after fewer heartbeat‐synchronized presentations than those presented during ec‐diastole, suggesting facilitated processing. No significant cardiac modulation was found for neutral faces or in emotion discrimination accuracy, confidence, or response bias. These findings demonstrate that cardiac afferent signals selectively enhance the perceptual salience of motivationally salient (e.g., threat signaling) stimuli, promoting earlier access to consciousness. This study extends prior work by showing that cardiac influences on emotion processing operate even at early, preconscious stages of visual perception.

54 Background: Global oncology seeks to improve the delivery of equitable cancer care across diverse populations, including those in low- and middle-income settings. Recognizing the importance of global engagement in addressing cancer disparities, the National Cancer Institute (NCI) has designated global oncology as a strategic priority for its cancer centers. However, many academic institutions still face challenges in integrating global oncology into their care, research, and education missions. We conducted an institutional needs assessment to identify barriers to engagement in global oncology among oncology faculty at the NCI-designated University of Colorado Cancer Center. Methods: A cross-sectional survey was conducted from February 2 to March 20, 2025, using an instrument adapted from the NCI Global Oncology Assessment Survey. The anonymous survey was distributed to University of Colorado Cancer Center members via email, with 5 weekly reminders. It assessed familiarity with global oncology, current or prior involvement in global projects, motivations for participation, and perceived barriers. Results: Twenty-two faculty completed the survey. Over one-third (36%) reported unfamiliarity with the concept of global oncology, and only 45% had prior involvement in related initiatives. Just 14% had worked directly with the institution’s global oncology team. Among all respondents, primary motivations to engage in global work included personal interest (77%), opportunities for collaboration (50%), and a commitment to addressing health disparities. Among those with prior experience, 80% cited challenges securing adequate or sustained funding, 60% reported limited institutional support, 50% noted administrative burdens, and 50% expressed concerns about lack of academic recognition for global work. When asked more broadly about what had prevented or limited their participation, respondents most frequently mentioned limited funding (36%), lack of time (27%), and lack of institutional support (22%). Some respondents acknowledged that their reported familiarity and involvement may be overestimated due to response bias. Conclusions: Despite strong personal interest and alignment with NCI priorities, global oncology remains under-recognized and under-supported within academic centers. Structural barriers—particularly limited funding mechanisms, insufficient institutional backing, and administrative complexity—impede broader faculty engagement. Addressing these challenges through targeted support, dedicated funding, and academic recognition can enhance institutional capacity to deliver equitable cancer care locally and globally.