Simultaneous Presentation Research Articles

Recognition and classification of noise signals by dolphins under conditions of noise interference and spatial uncertainty of their simultaneous presentation

The ability of dolphin`s auditory system to recognize and classify noise signals according to certain invariant features under the influence of noise interference and spatial uncertainty of their simultaneous presentation was studied. The bottlenose dolphins trained to differentiate such signals had to solve this problem under conditions simulating real marine ones, when the perception of a useful signal occurs against the background of similar signals and noise interference. First, the noise signals were sequentially presented to the animal against the background of white masking noise. Further the dolphin had to identify a signal of a positive class from several simultaneously sounding sound sources. The efficiency of the animal was evaluated at several given levels of noise interference. In this case, the actual noise interference was both white noise and simultaneously sounding negative signals. It`s shown that the efficiency and noise immunity of dolphin`s auditory system depend on the degree of alternativeness of the spatial uncertainty of the simultaneous presentation of signals.

Twists to Classical Conditioning of Adult Drosophila.

Memory has been extensively studied in Drosophila since the early 1970s. Straightforward aversive and appetitive conditioning paradigms train populations of flies to associate the pairing of one of two odors with either punishment or reward. After training, the flies show either preferential avoidance or approach behavior, to the appropriate odor, when given a choice between the two odors in a simple T-maze apparatus. These basic experimental approaches have proven useful in understanding the genetic, molecular, cellular, and neuronal network bases of various valence-specific memories in the fly brain. In addition, numerous modifications to these assays have permitted the study of a broad range of memory-related phenomena. Labile short-term avoidance and approach memories can be readily distinguished from more stable "consolidated" long-term memory equivalents. Prior or subsequent experience of the training cues, and manipulations of the flies' condition, have revealed how parallel competing memories and incompatible states can temporarily interfere with memory retrieval, providing insight into mechanisms of forgetting. Recent studies have also modified the training and testing apparatus to allow simultaneous presentation of odors and colors, providing insight into mechanisms of multisensory learning.

Visual and auditory factors on seat preference in a small musical theatre

This paper investigates the visual and auditory factors influencing seat preference in a small musical theater. The venue is as a versatile space capable of accommodating musical performances, with an irregularly shaped seating area designed for 300 seats. Specifically, the seating structure is designed to enhance intimacy, connecting from the first to the second floor, and features staggered blocks of seats arranged in a curved formation. Visual images of the stage view and binaural impulse responses towards the center of the stage were collected at nine selected seats in situ conditions. To determine factors related to visual, auditory, and seat preferences, a paired comparison method was employed in a laboratory setting to derive scale values for each seat. Ten subjects with experience attending musical performances and normal hearing were participated in the experiments. The auditory stimuli were convolved with vocal anechoic recordings, and visual images were synthesized to depict the same performance scene. Preference scores were obtained through three type of experiments, considering visual information only, auditory information only, and simultaneous presentation of visual and auditory information. Based on the results, influence of visual and auditory factors on seat preference was discussed.

Enhanced neural phase locking through audio-tactile stimulation.

Numerous studies have underscored the close relationship between the auditory and vibrotactile modality. For instance, in the peripheral structures of both modalities, afferent nerve fibers synchronize their activity to the external sensory stimulus, thereby providing a temporal code linked to pitch processing. The Frequency Following Response is a neurological measure that captures this phase locking activity in response to auditory stimuli. In our study, we investigated whether this neural signal is influenced by the simultaneous presentation of a vibrotactile stimulus. Accordingly, our findings revealed a significant increase in phase locking to the fundamental frequency of a speech stimulus, while no such effects were observed at harmonic frequencies. Since phase locking to the fundamental frequency has been associated with pitch perceptual capabilities, our results suggests that audio-tactile stimulation might improve pitch perception in human subjects.

Características clínicas y epidemiológicas en pacientes con leucemia linfoblástica aguda de un instituto especializado en pediatría de Perú, periodo 2017-2022

Objective: To describe the clinical-epidemiological characteristics at the time of the diagnosis in patients with acute lymphoblastic leukemia (ALL) at a specialized pediatric institute in Peru, from 2017 to 2022. Materials and Methods: An observational, descriptive, cross-sectional, and retrospective study was conducted. Medical records of patients under 18 years old with a recent confirmed diagnosis of ALL were included. Variables analyzed included sex, age, origin, discharge outcome, hospital stay, signs, symptoms, history of chronic diseases, laboratory findings, and hematological complications. Data were collected through medical record review and processed using STATA v. 16. Results: Out of 247 medical records, 25 patients who did not meet inclusion criteria were excluded. The study sample consisted of 222 patients. 54.1% of the patients were male, with a median age of 5 years. 64.0% had fever, and 78.8% had pallor. 91.8% of patients had hemoglobin below 11 g/dL, 65.3% had platelets below 50,000/µL, and 13.1% had leukocytosis above 100,000/µL. The most common hematological abnormality was the simultaneous presentation of anemia, thrombocytopenia, and leukocytosis (43.0%). Conclusion: ALL predominantly occurred in male children and those under 5 years old. A high frequency of hematological alterations such as anemia, thrombocytopenia, and leukocytosis was observed. Clinically, two-thirds of the patients had fever, and nearly three-quarters had pallor. Further studies on the progression of ALL in the Peruvian population are suggested.

All-Cause Mortality of Atrial Fibrillation and Heart Failure in the Same Patient: Does the Order Matter?

Atrial fibrillation (AF) and heart failure (HF) often coexist due to the common elements of the pathomechanism they share. The potential significance of the order these entities present in the same patient is ill-defined. Herein, we report our results from a nationwide database on the occurrence of various sequences AF and HF may present, the time delays between the two conditions and all-cause mortality associated with different scenarios. Patients diagnosed with both AF and HF between 2015 and 2021 were enrolled from the Hungarian National Health Insurance Fund (NHIF) database. The order the two entities followed each other, and the time delay in between were registered. Median survival rates were calculated in AF → HF; HF → AF and simultaneous scenarios. A total of 109,075 patients were enrolled: 29,937 with AF → HF, 38,171 with HF → AF, and 40,967 diagnosed simultaneously. Time delays between AF → HF and HF → AF were 6 and 10months, respectively. The median survival was 46months in the AF → HF, 38months in the HF → AF, and 21months in the simultaneous group. Patients with HF → AF, and with simultaneous presentations had 5% and 16% greater mortality risk as compared to the AF → HF sequence, with hazard ratios (95% confidence intervals) of 0.95 (0.93-0.97) and 0.84 (0.82-0.85), respectively (P < 0.0001). HF occurred significantly earlier after the diagnosis of AF than vice versa. Patients diagnosed simultaneously had the worst, while the AF → HF sequence had the best prognosis. These data should have implications for the intensification of monitoring and therapy in different scenarios.

The role of attention and verbal rehearsal in remembering more valuable item-colour binding

ABSTRACT Selectively remembering more valuable information can improve memory efficiency. Such value effects have been observed on long-term memory for item-colour binding, but the possible contributory factors are unclear. The current study explored contributions from attention (Experiment 1) and verbal rehearsal (Experiment 2). Across two experiments, memory was superior for item-colour bindings that were associated with high (relative to low) point values at encoding, both in an immediate test and a delayed re-test. When availability of attentional resources was reduced during encoding, value only influenced immediate and not delayed memory (Experiment 1). This indicates that a transient value effect can be obtained with little attentional resources, but attentional resources are involved in creating a longer lasting effect. When articulatory suppression was implemented during encoding (Experiment 2), value effects were somewhat reduced in the immediate test and abolished in the delayed re-test, suggesting a role for verbal rehearsal in value effects on item-colour binding memory. These patterns of value effects did not interact with encoding presentation format (i.e., sequential vs. simultaneous presentation of objects). Together, these results suggest that attentional resources and verbal rehearsal both contribute to value effects on item-colour binding memory, with varying impacts on the durability of these effects.

Electrophysiological correlates of (mis)judging social information.

Social information can be used to optimize decision-making. However, the simultaneous presentation of multiple sources of advice can lead to a distinction bias in judging the validity of the information. While the involvement of event-related potential (ERP) components in social information processing has been studied, how they are modulated by (mis)judging an advisor's information validity remains unknown. In two experiments participants performed a decision-making task with highly accurate or inaccurate cues. Each experiment consisted of an initial, learning, and test phase. During the learning phase, three advice cues were simultaneously presented and the validity of them had to be assessed. The effect of different cue constellations on ERPs was investigated. In the subsequent test phase, the willingness to follow or oppose an advice cue was tested. Results demonstrated the distinction bias with participants over or underestimating the accuracy of the most uncertain cues. The P2 amplitude was significantly increased during cue presentation when advisors were in disagreement as compared to when all were in agreement, regardless of cue validity. Further, a larger P3 amplitude during outcome presentation was found when advisors were in disagreement and increased with more informative cues. As such, the most uncertain cues were related to the smallest P3 amplitude. The findings hint at the possible role of P3 in judging and learning the predictability of social cues. This study provides novel insights into the role of P2 and P3 components during the judgment of social information validity.

Investigating the overlapping presentation of irritable bowel syndrome and vulvodynia: a scoping review of the evidence and mechanisms.

Vulvodynia is a complex and multifactorial medical condition characterized by pain in the vulvar area without any identifiable cause. Vulvodynia is underdiagnosed, leading to increased risk of sexual dysfunction and reduced quality of life. Irritable bowel syndrome (IBS) is a gastrointestinal disorder predominantly affecting women. Vulvodynia and IBS frequently co-occur in women, with a 2- to 4-fold increased likelihood of IBS diagnosis in those with vulvodynia. These conditions may share underlying causes, highlighting the need for research to better understand their shared pathophysiology and develop effective therapeutics. The aim of this scoping review was to assess the evidence of simultaneous presentation of IBS and vulvodynia. A comprehensive search was conducted in 6 databases between inception of database and August 2023: PubMed, Web of Science, Scopus, Science Direct, Google Scholar, and Cochrane Library. Studies included primary research about IBS and vulvodynia in terms of presentation overlap, diagnosis, or treatment. Data were extracted from eligible studies, summarized, and collated. Of the 306 unique articles identified, 33 were included in the final analysis: 20 cross-sectional studies, 4 case-control studies, 2 case reports, 4 cohort studies, 2 quasi-experimental studies, and 1 randomized trial. Common themes included a high prevalence of overlapping vulvodynia and IBS with a significant diagnostic delay in vulvodynia, mast cell involvement and visceral hypersensitization as common pathophysiology, and the need for a multimodal treatment. Our review adds to the evidence that there is an association between vulvodynia and IBS. Despite this, research on the underlying molecular mechanisms of this association is scarce, and diagnostic delays persist for vulvodynia. Increasing awareness of the overlap of these conditions will improve screening for vulvodynia in the patient population with IBS, thereby improving the diagnostic delay, and understanding the pathophysiology will enable treatment strategies that address both conditions.

Pathologic complete response to KEYNOTE522 and HER2-directed therapy for synchronous TNBC and HER2+ breast cancer

Simultaneous presentation of two separate primary breast cancers of differing histology at initial diagnosis is an uncommon phenomenon; it is even rarer to find these pathologically distinct populations within the same biopsy. Here we report the case of a patient diagnosed with clearly demarcated, pathologically heterogenous triple negative breast cancer (TNBC) and HER2+ breast cancer that was treated with a hybrid chemoimmunotherapy regimen combining elements of Keynote-522 and a standard HER2-directed neoadjuvant regimen, yielding apathologic complete response by the time of surgery with no notable adverse events. Molecular analysis of the histologically distinct tumor populations confirmed molecular evidence of differential HER2 expression but also suggested clonal relatedness of the two tumor populations based upon mutational profile, with phenotypic divergence potentially resulting from copy number alterations in NF1. Overall, this case highlights a rare histologic phenomenon that was successfully treated by combining both TNBC and HER2 directed neoadjuvant therapies.

Augmented reality for chemistry education to promote the use of chemical terminology in teacher training.

Chemistry as a whole is divided into three levels. The macroscopic level describes real, observable phenomena of the material world. The submicroscopic level focuses on particles. The representative level includes pictorial and symbolic representations to visualize substance in its nature. Students often have problems separating these levels and conceptually transfer each of the three levels to the other. Therefore, teachers need to use chemical terminology correctly when teaching the substance-particle concept. Augmented Reality (AR) connects real and virtual world. The observer physically moves in a real environment that integrates virtual elements. The AR technology has great potential for learning in the subject chemistry, especially when it comes to making the "invisible" visible and illustrating scientific phenomena at particle level. The simultaneous presentation should avoid split-attention and offers new possibilities to interactively deal with (M)ER. The question arises whether AR has a positive effect on the use of technical language and the associated understanding of the concept of dealing with (M)ER at the substance and particle levels. With an AR app on the tablet and the AR glasses, the chemical processes of a real experiment are represented by AR visualizations. Therefore, the AR app was piloted. This study captured the chemistry handling with (M)ER of chemistry teachers (N = 30) using a pre-post survey. The participating preservice teachers are described below. Each test includes five tasks elaborated by thinking aloud. The thinking-aloud protocols to acquire the use of the chemical terminology are evaluated in MAXQDA.

Simultaneous presentation and differential reinforcement to increase consumption

AbstractMany autistic children display feeding difficulties and consume a limited food variety. These feeding difficulties could be conceptualized as change‐resistant behavior because children often exhibit rigid mealtime routines, avoid novel foods, and only consume foods according to specific types, textures, or under specific mealtime conditions. Currently, behavior‐analytic treatments for pediatric feeding disorders have the most empirical support and many studies have demonstrated the effectiveness of extinction‐based treatments. However, there is less research on alternative treatments for increasing consumption of novel or non‐preferred foods among children with autism spectrum disorder (ASD). In the current study, we evaluated simultaneous presentation and differential reinforcement to increase consumption of novel, target foods for two participants with ASD and change‐resistant feeding behavior.

Using a mixed-reality headset to elicit and track clinically relevant movement in the clinic.

21st century neurology will require scalable and quantitative tools that can improve neurologic evaluations over telehealth and expand access to care. Commercially available mixed-reality headsets allow for simultaneous presentation of stimuli via holograms projected into the real world and objective and quantitative measurement of hand movement, eye movement, and phonation. We created 6 tasks designed to mimic standard neurologic assessments and administered them to a single participant via the Microsoft HoloLens 2 mixed-reality headset. The tasks assessed postural hand tremor, finger tapping, pronation and supination of hands, hand and eye tracking of a center-out task, hand and eye tracking of a random motion task, and vocal assessment. We show the utility of the HoloLens for commonly used neurological exams. First, we demonstrate that headset-derived holograms can project hand movements and objects in 3D space, providing a method to accurately and reproducibly present test stimuli to reduce test-test variability. Second, we found that participant hand movements closely matched holographic stimuli using a variety of metrics calculated on recorded movement data. Third, we showed that the HoloLens can record and playback exam tasks for visual inspection, sharing with other medical providers, and future analysis. Fourth, we showed that vocal recordings and analysis could be used to profile vocal characteristics over time. Together, this demonstrates the versatility of mixed reality headsets and possible applications for neurological assessment. Administering components of the neurologic exam via a self-contained and commercially available mixed-reality headset has numerous benefits including detailed kinematic quantification, reproducible stimuli presentation from test to test, and can be self-administered expanding access to neurological care and saving hospital time and money. This work was supported by grants from the National Institutes of Health (NIH) (F30AG063468) (E.L.), (F31NS113395) (D.J.C), and the Pilot Grant Award from the University of Colorado Movement Disorders Center (D.J.C).

Hemostatic radiotherapy: a narrative review of the literature.

In locally advanced cancer, bleeding is a common clinical presentation and radiotherapy (RT) provides a noninvasive, well-tolerated, cost-effective treatment. However, the choice for fractionation dose and schedule seem to merely depend on physician's preference rather than specific guidelines. We reviewed the available literature on palliative hemostatic RT for response rate (RR) and bleeding duration in relation with the given dose. The PubMed database was used to search for articles, which were assessed by predetermined inclusion and exclusion criteria. A total of 54 articles, published over the last 20 years until December 2023 were analyzed for dose and/or fractionation regimen and their relation to the RR. A variety of fractionation schedules are used for palliative symptom control, including hemostasis. Research focusing on hemostatic irradiation specifically and prospective studies are rare. Moreover, to our knowledge, there are no specific (prospective) studies ongoing. Both external beam radiotherapy (EBRT) and brachytherapy lead to bleeding control and daily or weekly hypofractionated irradiation is safe and effective for both high and low biological equivalent dose (BED) regimens. If feasible, based on patient condition, some studies favor higher BED regimens to obtain more durable tumor/higher bleeding response. Higher radiation dose for thoracic irradiation may be indicative for simultaneous presentation of obstruction and/or dysphagia. Brachytherapy may be used solely or in combination with EBRT or in the setting of re-irradiation. Short-course regimens are preferred in patients in with low performance index scores. For future studies, multivariate analysis, including BED, can be important to assess efficacy of different fractionation schedules for a variety of tumor etiologies. Hemostatic RT, both by EBRT and brachytherapy, appears to be a safe and effective palliative treatment that clinically and statistically significantly reduces bleeding in cancer patients. The available literature is limited regarding prospective and uniform evaluation of hemostatic RT, including fractionation schedules. BED seems to be indicative for a better RR for specific indications. Current evidence suggests that treatment decisions should be tailored according to the patients' condition, tumor etiology and other clinical symptoms. More (prospective) research focusing on hemostasis is necessary to develop clear guidelines.

The temporal dynamics of conscious and unconscious audio-visual semantic integration

We compared the time course of cross-modal semantic effects induced by both naturalistic sounds and spoken words on the processing of visual stimuli, whether visible or suppressed form awareness through continuous flash suppression. We found that, under visible conditions, spoken words elicited audio-visual semantic effects over longer time (−1000, −500, −250 ms SOAs) than naturalistic sounds (−500, −250 ms SOAs). Performance was generally better with auditory primes, but more so with congruent stimuli. Spoken words presented in advance (−1000, −500 ms) outperformed naturalistic sounds; the opposite was true for (near-)simultaneous presentations. Congruent spoken words demonstrated superior categorization performance compared to congruent naturalistic sounds. The audio-visual semantic congruency effect still occurred with suppressed visual stimuli, although without significant variations in the temporal patterns between auditory types. These findings indicate that: 1. Semantically congruent auditory input can enhance visual processing performance, even when the visual stimulus is imperceptible to conscious awareness. 2. The temporal dynamics is contingent on the auditory types only when the visual stimulus is visible. 3. Audiovisual semantic integration requires sufficient time for processing auditory information.

Bouveret Syndrome: A Curious Simultaneous Presentation of Two Cases: Comparison of Clinical Observations and Surgical Management.

Gallstone ileus is an uncommon occurrence and accounts for about 0.3-0.5% of complications of cholelithiasis in elderly patients. Bouveret syndrome is an uncommon medical condition resulting from the blockage of the duodenal bulb by a stone, which consequently obstructs the outlet of the stomach. Until now, a comparison of two different presentations of Bouveret syndrome has not been published in the literature due to the rarity of this pathology. The curious simultaneous occurrence of the two cases discussed here made it possible for us to compare the different diagnostic and therapeutic pathways. In fact, both cases differ not only in their presenting symptoms, but also in the management adopted by the same surgical team.

This or not that: select and reject control of relational responding in rats using a blank comparison procedure with odor stimuli

The blank comparison (BLC) task was developed to assess stimulus relations in discrimination learning; that is, are subjects learning to “select” the correct stimulus (S+) or “reject” the incorrect stimulus (S-) or both? This task has been used to study exclusion learning, mostly in humans and monkeys, and the present study extends the procedure to rats. The BLC task uses an ambiguous stimulus (BLC+/-) that replaces S+ (in the presence of S-) and replaces S- (in the presence of S+). In the current experiment, four rats were trained to remove session-novel scented lids from sand-filled cups in a two-choice, simultaneous presentation procedure called the Odor Span Task (OST) before being trained on the BLC procedure using odors as the discriminative stimuli. The BLC training procedure utilized simple discrimination training (S+ and S-) and added select (S+ and BLC-) and reject (BLC+ and S-) trial types. All rats demonstrated accurate performance in sessions with both select and reject type trials. Next, BLC probe trials were interspersed in standard OST sessions to assess the form of stimulus control in the OST. Rats performed accurately on select type probe trials (similar to baseline OST performance) and also showed above chance accuracy on reject type trials. Thus, we demonstrated that rats could acquire an odor-based version of the BLC task and that both select and exclusion-based (reject) relations were active in the OST. The finding of exclusion in rats under the rigorous BLC task conditions confirms that exclusion-based responding is not limited to humans and non-human primates.

(029) INVESTIGATING THE OVERLAPPING PRESENTATION OF IRRITABLE BOWEL SYNDROME AND VULVODYNIA: A SYSTEMATIC REVIEW OF THE EVIDENCE AND MECHANISMS

Abstract Introduction Vulvodynia is a complex and multifactorial medical condition characterized by pain and discomfort in the vulvar and vaginal area without any identifiable cause. Despite its prevalence, vulvodynia remains underdiagnosed, especially in the United States, leading to delayed diagnosis, increased risk of sexual dysfunction, and reduced quality of life. Concurrently, irritable bowel syndrome (IBS) is a gastrointestinal disorder with a global prevalence predominantly affecting women. Vulvodynia and IBS frequently co-occur in women, with a 2 to 4-fold increased likelihood of IBS diagnosis in those with vulvodynia (1). These comorbid conditions may share common underlying causes, highlighting the need for comprehensive research to better understand the underlying molecule mechanisms and develop effective management strategies. Recognizing the interplay between vulvodynia and IBS is crucial for improving women's health and well-being. Objective The aim of this review was to assess the evidence and mechanism of simultaneous presentation of IBS and vulvodynia, and whether the incidence of one condition predicts the incidence or increases susceptibility of the other condition. Additionally, this review aims to assess whether treating one condition impacts the presentation, prognosis, or outcome of the other. Methods A systematic search was conducted in 6 electronic databases: PubMed, Web of Science, Scopus, Science Direct, Google Scholar, and Cochrane Library (publication dates between January 1950 and August 2023). Primary research about the overlap of presentation, diagnosis, or treatment of IBS and vulvodynia was included. Data were extracted from eligible studies, summarized, and collated. Results Of the 306 unique articles identified, 38 were included in the final analysis: 33 were cross-sectional studies, along with 2 case reports, 1 open-label non-comparative study, 1 cohort study, and 1 nested case-control study. The data represents patients from 21 countries. Common themes amongst the studies included a hypothesis of central hypersensitization which can manifest as either and/or both vulvodynia and IBS, the incidence of vulvodynia being higher in younger and older women (women in their mid-40s had the lowest odds), the significant diagnostic delay in vulvodynia, and the need for a multimodal treatment strategy. Conclusions Our review adds to the evidence that there is a pervasive association with vulvodynia and IBS. Despite this, research on the underlying molecular mechanisms of the association is scarce, and diagnostic delays persist for vulvodynia. Increasing awareness of the overlap of these conditions will improve screening for vulvodynia in the IBS patient population, therefore improving the diagnostic delay. Further studies over longer time periods, and utilizing randomized study designs are needed to elucidate the mechanism of simultaneous presentation of IBS and vulvodynia, and how we can leverage their pathophysiology clinically to optimize diagnosis and treatment. Disclosure No.

Simultaneous Presentation of Swimming-Induced Pulmonary Edema in a Set of Monozygotic Twin Elite Maritime Warfare Candidates: A Novel Case Report.

Swimming-induced pulmonary edema (SIPE) is an incompletely understood condition that is often seen in U.S. special operations candidates participating in maritime qualification training courses. We present a case of two monozygotic twins with the simultaneous onset of acute respiratory distress during a crucible event of a maritime assessment and selection course. Subsequent pulmonary ultrasonography in both candidates showed wedge-shaped hyperechoic lines (B-lines) extending from the pleural interface into the interstitium. Chest radiography of both candidates revealed bilateral asymmetric hazy opacities consistent with SIPE. Both candidates recovered with supportive measures but were medically removed from training. Given the near-identical exposures of the candidates to the same ambient and water temperatures, duration of water submersion, magnitude of physical stressors, and viral colonization, this case study suggests that there may be underlying genetic factors, in addition to environmental factors, that predispose individuals to developing SIPE. Further benchtop and clinical research must be performed to identify potential genetic polymorphisms that contribute to the development of SIPE and to investigate safe interventions that address the underlying etiologies of SIPE pathophysiology.

Simultaneous presentation of thyrotoxicosis and diabetic ketoacidosis in two previously healthy men

Simultaneous presentation of thyrotoxicosis and diabetic ketoacidosis in two previously healthy men