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Brain electroencephalography (EEG), the complex, weak, multivariate, nonlinear, and nonstationary time series, has been recently widely applied in neurocognitive disorder diagnoses and brain-machine interface developments. With its specific features, unlabeled EEG is not well addressed by conventional unsupervised time-series learning methods. In this article, we handle the problem of unlabeled EEG time-series clustering and propose a novel EEG clustering algorithm, that we call mwcEEGc. The idea is to map the EEG clustering to the maximum-weight clique (MWC) searching in an improved Fréchet similarity-weighted EEG graph. The mwcEEGc considers the weights of both vertices and edges in the constructed EEG graph and clusters EEG based on their similarity weights instead of calculating the cluster centroids. To the best of our knowledge, it is the first attempt to cluster unlabeled EEG trials using MWC searching. The mwcEEGc achieves high-quality clusters with respect to intracluster compactness as well as intercluster scatter. We demonstrate the superiority of mwcEEGc over ten state-of-the-art unsupervised learning/clustering approaches by conducting detailed experimentations with the standard clustering validity criteria on 14 real-world brain EEG datasets. We also present that mwcEEGc satisfies the theoretical properties of clustering, such as richness, consistency, and order independence.

This article proposes an approach to select EEG channels based on EEG shapelet transformation, aiming to reduce the setup time and inconvenience for subjects and to improve the applicable performance of Brain-Computer Interfaces (BCIs). In detail, the method selects top- k EEG channels by solving a logistic loss-embedded minimization problem with respect to EEG shapelet learning, hyperplane learning, and EEG channel weight learning simultaneously. Especially, to learn distinguished EEG shapelets for weighting contributions of each EEG channel to the logistic loss, EEG shapelet similarity is also minimized during the procedure. Furthermore, the gradient descent strategy is adopted in the article to solve the non-convex optimization problem, which finally leads to the algorithm termed StEEGCS. In a result, classification accuracy, with those EEG channels selected by StEEGCS, is improved compared to that with all EEG channels, and classification time consumption is reduced as well. Additionally, the comparisons with several state-of-the-art EEG channel selection methods on several real-world EEG datasets also demonstrate the efficacy and superiority of StEEGCS.

This article explores valid brain electroencephalography (EEG) selection for EEG classification with different classifiers, which has been rarely addressed in previous studies and is mostly ignored by existing EEG processing methods and applications. Importantly, traditional selection methods are not able to select valid EEG signals for different classifiers. This article focuses on a source control-based valid EEG selection to reduce the impact of invalid EEG signals and aims to improve EEG-based classification performance for different classifiers. We propose a novel centroid-based EEG selection approach named CenEEGs, which uses a scale-and-shift-invariance similarity metric to measure similarities of EEG signals and then applies a globally optimal centroid strategy to select valid EEG signals with respect to a similarity threshold. A detailed comparison with several state-of-the-art time series selection methods by using standard criteria on 8 EEG datasets demonstrates the efficacy and superiority of CenEEGs for different classifiers.

Currently, electroencephalogram (EEG) is mostly analyzed in a supervised way, which requires EEG labels (e.g., EEG classification). With the ever-increasing amount of unlabeled/mislabeled EEG in neuropsychiatric disorder diagnosis, BCI, and rehabilitation, manually labeling of EEG data is a labor intensive and time-consuming process, and few labs have developed algorithms to analyze EEG in an unsupervised manner (i.e., EEG clustering). In this paper, we propose a cooperative game inspired approach to cluster multi-trial EEG data. The idea is to map multi-trial EEG clustering to the coalition formation in a cooperative game, and then identify cluster center (the EEG trial with highest Shapley value) and assign EEG trials into proper clusters based on their cross correlation-transformed Shapley values. We demonstrate the mapped EEG cooperative game is convex, and it leads to an algorithm for multi-trial EEG clustering named CoGEEGc. The CoGEEGc yields high-quality multi-trial EEG clustering with respect to intra-cluster compactness and inter-cluster scatter. We show that CoGEEGc outperforms 15 state-of-the-art EEG or time series clustering approaches through detailed experimentation on real-world multi-trial EEG datasets. Comparison against 15 methods with four theoretical properties of clustering further illustrates the superiority of CoGEEGc, as it satisfies two properties while other approaches only satisfy one.

The present document represents the position of Swiss health-care associations, clinical and research centers, research-supporting foundations, and the association Alzheimer Switzerland regarding the care of persons with dementia and Alzheimer’s disease. We claim that dementia is not part of normal aging but a disease developing more frequently in old age; early diagnosis and treatment of dementia is paramount; all patients with dementia have the right to receive state-of-the-art treatments; more intense information, education, and counseling on dementia are necessary; media should provide balanced and fair reporting of scientific discoveries on Alzheimer’s and dementia; all patients with dementia have the right to be treated; anti-dementia drugs should be used and accompanied by listening, compassion, and understanding.

In this study we present a methodology to develop a global winter wheat crop calendar based on the existing crop calendar products from FAO and GEOGLAM Crop Monitor in the framework of the WorldCereal project. It is based on integrating both datasets by building on the accuracy from Crop Monitor and the spatial resolution from the Food and Agriculture Organization of the United Nations (FAO). Additionally, given the global extent of WorldCereal and the gaps that both products present at global scale, we simulated the crop calendars in those areas not covered by any of the products. To do so, we integrated a Regression-Kriging model considering as training data the calendars derived from both products and based on the latitude, height and distance to the coast (DTC).

It is well-known that visual attention can be tuned in a top-down controlled manner to various attributes. Amongst other search strategies, previous research has identified a feature search mode in which attention is tuned to the target feature (e.g., colour) vs. a singleton search mode, where all salient items can attract attention. A short review of the literature reveals that singleton search mode is not regularly applied in single-target search, but could play a role in two-target search. Here we critically tested whether results suggesting singleton search could alternatively be due to top-down tuning to different attributes of the targets (e.g., luminance). The results of the first experiment show a mixture of attentional tuning to the target colours (red, green), as well as luminance (darker), and residual singleton capture. A second experiment shows that such mixed results can be obtained in the standard paradigm, with only small changes to the stimuli. These results cannot be coherently described within a single mental representation, and are therefore difficult to reconcile with the notion of a target template. Non-representational theories such as feature map theories seem better equipped to explain mixed search results, which could be a decisive weakness of representational theories.

Attention allows selection of sought-after objects by tuning attention in a top-down manner to task-relevant features. Among other possible search modes, attention can be tuned to the exact feature values of a target (e.g., red, large), or to the relative target feature (e.g., reddest, largest item), in which case selection is context dependent. The present study tested whether we can tune attention simultaneously to a specific feature value (e.g., specific size) and a relative target feature (e.g., relative color) of a conjunction target, using a variant of the spatial cueing paradigm. Tuning to the specific feature of the target was encouraged by randomly presenting the conjunction target in a varying context of nontarget items, and feature-specific versus relational tuning was assessed by briefly presenting conjunction cues that either matched or mismatched the relative versus physical features of the target. The results showed that attention could be biased to the specific size and the relative color of the conjunction target or vice versa. These results suggest the existence of local and relatively low-level attentional control mechanisms that operate independently of each other in separate feature dimensions (color, size) to choose the best search strategy in line with current top-down goals.

Particular design features intended to improve usability – including graphically displayed observations and integrated colour-based scoring-systems – have been shown to increase the speed and accuracy with which users of hospital observation charts detect abnormal patient observations. We used eye-tracking to evaluate two potential cognitive mechanisms underlying these effects. Novice chart-users completed a series of experimental trials in which they viewed patient data presented on one of three observation chart designs (varied within-subjects), and indicated which observation was abnormal (or that none were). A chart that incorporated both graphically displayed observations and an integrated colour-based scoring-system yielded faster, more accurate responses and fewer, shorter fixations than a graphical chart without a colour-based scoring-system. The latter, in turn, yielded the same advantages over a tabular chart (which incorporated neither design feature). These results suggest that both colour-based scoring-systems and graphically displayed observations improve search efficiency and reduce the cognitive resources required to process vital sign data.

In October 2019, a Swiss panel of experts met for the Dementia Summit in Brunnen, Switzerland, to discuss the latest scientific findings on basic and clinical research, as well as practical and political approaches to the challenges of dementia disorders in Switzerland. Here, we present the conference summary. To study pathophysiological changes, as well as the underlying mechanism of fluid biomarker changes, excellent experimental approaches, including transgenic mouse models, are available. Current knowledge about presymptomatic disease progression is largely derived from the longitudinal study of individuals with autosomal dominant mutations (Dominantly Inherited Alzheimer Network). Importantly, more than one third of identified dementia risk factors can be modified. For example, sleep disturbances are not only associated with dementia and neurodegeneration in specific brain regions, but also precede cognitive decline and contribute to the development of brain pathology. Regarding the neuropsychological examination of dementia disorders, standardised tests of social cognition, one of the six cognitive domains that must be assessed according to the fifth edition of the Diagnostic and Statistical Manual for Mental Disorders, are missing, but now under development. The most important new therapeutic approach in the treatment of Alzheimer’s disease is the current attempt to prevent β-amyloid accumulation. While until now clinical studies have failed because of side effects or insufficient clinical effectiveness, Biogen recently announced positive results of high doses of aducanumab, a monoclonal antibody against β-amyloid. Other approaches also show promise. In China, sodium oligomannate has been approved to treat Alzheimer's disease. The substance suppresses gut bacterial amino acids-shaped neuroinflammation to inhibit Alzheimer’s disease progression. Assistive technologies for dementia patients can help identify relevant information for care and nursing, as well as measurements for clinical interventions. Dementia patients have a high risk of developing delirium, even in the home environment. Therefore, it is necessary to use and further develop multi-disciplinary and systematic detection and prevention strategies. Homecare models for dementia patients with multidisciplinary teams have been established and evaluated and should be expanded. Dementia is the third-leading cause of death in Switzerland. In palliative care for severe dementia, the improvement of quality of life is of primary importance. The goals of the National Dementia Strategy, to increase the quality of life in those affected and to reduce taboos surrounding the disease, are still unrealised. The need for further national and regional engagement in order to implement the different findings of the strategy has largely been acknowledged, and these implementations have become the core tasks of a national dementia platform.

Reaching movements, as a basic yet complex motor behavior, are a foundational model system in neuroscience. In particular, there has been a significant recent expansion of investigation into the neural circuit mechanisms of reach behavior in mice. Nevertheless, quantification of mouse reach kinematics remains lacking, limiting comparison to the primate literature. In this study, we quantitatively demonstrate the homology of mouse reach kinematics to primate reach and also discover novel late-phase correlational structure that implies online control. Overall, our results highlight the decelerative phase of reach as important in driving successful outcome. Specifically, we develop and implement a novel statistical machine-learning algorithm to identify kinematic features associated with successful reaches and find that late-phase kinematics are most predictive of outcome, signifying online reach control as opposed to preplanning. Moreover, we identify and characterize late-phase kinematic adjustments that are yoked to midflight position and velocity of the limb, allowing for dynamic correction of initial variability, with head-fixed reaches being less dependent on position in comparison to freely behaving reaches. Furthermore, consecutive reaches exhibit positional error correction but not hot-handedness, implying opponent regulation of motor variability. Overall, our results establish foundational mouse reach kinematics in the context of neuroscientific investigation, characterizing mouse reach production as an active process that relies on dynamic online control mechanisms. NEW & NOTEWORTHY Mice use reaching movements to grasp and manipulate objects in their environment, similar to primates. To better establish mouse reach as a model for motor control, we implement several analytical frameworks, from basic kinematic relationships to statistical machine learning, to quantify mouse reach, finding many canonical features of primate reaches are conserved in mice, as well as evidence for midflight course corrections, expanding the utility of mouse reach paradigms for motor control studies.

Current models of attention propose that we can tune attention in a top-down controlled manner to a specific feature value (e.g., shape, color) to find specific items (e.g., a red car; feature-specific search). However, subsequent research has shown that attention is often tuned in a context-dependent manner to the relative features that distinguish a sought-after target from other surrounding nontarget items (e.g., larger, bluer, and faster; relational search). Currently, it is unknown whether search will be feature-specific or relational in search for multiple targets with different attributes. In the present study, observers had to search for 2 targets that differed either across 2 stimulus dimensions (color, motion; Experiment 1) or within the same stimulus dimension (color; Experiment 2: orange/redder or aqua/bluer). We distinguished between feature-specific and relational search by measuring eye movements to different types of irrelevant distractors (e.g., relatively matching vs. feature-matching). The results showed that attention was biased to the 2 relative features of the targets, both across different feature dimensions (i.e., motion and color) and within a single dimension (i.e., 2 colors; bluer and redder). The results were not due to automatic intertrial effects (dimension weighting or feature priming), and we found only small effects for valid precueing of the target feature, indicating that relational search for two targets was conducted with relative ease. This is the first demonstration that attention is top-down biased to the relative target features in dual target search, which shows that the relational account generalizes to multiple target search. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

The purpose of this exploratory qualitative study was to identify and describe emerging models of school health services. Participants ( N = 11) provided information regarding their models in semistructured phone interviews. Results identified a variety of funding sources as well as different staffing configurations and supervision. Strengths of the new models included an increase in school nurses and improved communication between schools, public health agencies, and health providers. Challenges for nurses practicing in the new models included not feeling connected to the school and unclear roles of unlicensed assistive personnel. Additional research is recommended to determine the effectiveness of new models. This continued study can provide insight and guidance to schools struggling to meet student health concerns.

Most theories of visual search maintain that attention is selectively tuned to the attributes of the search target (e.g., orange). Conversely, according to the relational account, attention is bias...

Career situation of first and presenting author Post-doctoral fellow. Introduction The pain reducing effects of certain natural springs containing the radioactive noble gas radon have been described for centuries. Today, one expects that small cumulative dose of radiation of about 0.3 mSv originating from radon progeny impacts on the immune system and bone metabolism of patients suffering from chronic painful degenerative and/or inflammatory diseases. However, osteoimmunological analyses of patients during radon spa were lacking. Objectives We initiated the observational and explorative RAD-ON01 study to analyse for the first time the impact of radon spa on the immune status in the whole blood of 100 patients. Methods Whole blood of the patients was drawn before and at weeks 6, 12 and 30 after therapy. Deep immunophenotyping was performed by multicolour flow cytometry and cytokine analyses by ELISA. Results The RAD-ON01 study confirmed a long-lasting pain reduction. While the major immune cells were only marginally affected, in particular regulatory T cells and dendritic cells were temporarily increased and activation markers on immune cells were decreased. Further, a decrease of serum markers related to bone erosion was observed. The cytokine analyses showed that temporarily increased TGFβ following radon spa correlates with reduced pain perception of the patients. To exclude placebo effects, in November 2018 the RAD-ON02 study (EUDRACT: 2016-002085-31) started. With this prospective, temporarily placebo-controlled and double- blinded trial the evidence level of radon spa application and knowledge on osteoimmunological modes of action of radon should be improved. Conclusions We conclude that patients with musculoskeletal disorders do benefit from radon spa and that osteoimmunological mechanisms are modulated by exposure of the patients to very low doses of radiation. Future randomized studies should improve the evidence level for radon as therapeutic option for chronic painful degenerative and/or inflammatory diseases. Acknowledgements This work was supported by the German Federal Ministry of Education and Research (GREWIS, 02NUK017G and GREWIS-alpha, 02NUK050E), the Bayerisches Staatsbad Bad Steben GmbH, the Landesamt fur Gesundheit und Lebensmittelsicherheit Bayern, and the EU (FP7 Nuclear Fission, Safety and Radiation Protection; FP7–249689). Disclosure of Interest None declared.

Career situation of first and presenting author Student for a master or a PhD. Introduction The treatment of chronic inflammatory and/or degenerative diseases by low dose radiation therapy (LDRT) is a successful alternative treatment option, especially for patients who were refractory for treatment with drugs. Generally, LDRT aims to reduce pain of patients and to increase their mobility. Although LDRT has successfully been applied since the late 19th century, the underlying immunological mechanisms are only fragmentarily analyzed. Objectives Therefore we have aimed to analyze the impact of locally delivered LDRT on systemic immune changes. Methods For this the IMMO-LDRT01 study (NCT02653079) was initiated in 2016. The study will include 150 patients suffering from chronic inflammatory and/or degenerative diseases, such as arthritis, arthrosis or benign calcaneodynia. The patients are treated with six local irradiations (single dose per fraction of 0.5Gy) in three weeks. If necessary, the serial irradiation can be repeated after 8–12 weeks, in order to achieve a further reduction of the pain. Blood samples are taken before and after every serial irradiation, as well as during follow-up appointments of the patients. For detailed immunophenotyping of whole blood, we established a multicolor flow cytometry assay, which allows the monitoring of seven main immune cell types, 26 immune cell subtypes, and the activation status of the immune cells. Results To date 80 patients have been included in the study. First evaluations showed a significant reduction of B cells and cytotoxic T cells in the peripheral blood of patients. In particular, LDRT impacted on activation markers of immune cells. One has to stress that the immunological effects of LDRT were dependent on the particular type of disease of the patients. Currently, the data of the immunophenotyping are correlated to pain perception and quality of life of the patients. Conclusions These analyses will be helpful to optimize LDRT. A better patient stratification based on pain- and immune-related biomarkers is envisaged for the future, alongside with initiation of deliberated randomized clinical trials. Acknowledgements This study has been in part funded by the Bundesministerium fur Bildung und Forschung (GREWIS and GREWIS-alpha, 02NUK017G and 02NUK050E). Disclosure of Interest None declared.

Present day models of visual search focus on explaining search efficiency by visual guidance: The target guides attention to the target's position better in more efficient than in less efficient search. The time spent processing the distractor, however, is set to a constant in these models. In contrast to this assumption, recent studies found that dwelling on distractors is longer in more inefficient search. Previous experiments in support of this contention all presented the same distractors across all conditions, while varying the targets. While this procedure has its virtues, it confounds the manipulation of search efficiency with target type. Here we use the same targets over the entire experiment, while varying search efficiency by presenting different types of distractors. Eye fixation behavior was used to infer the amount of distractor dwelling, skipping, and revisiting. The results replicate previous results, with similarity affecting dwelling, and dwelling in turn affecting search performance. A regression analysis confirmed that variations in dwelling account for a large amount of variance in search speed, and that the similarity effect in dwelling accounts for the similarity effect in overall search performance. Copyright © 2019. Published by Elsevier B.V.

Our ability to select task-relevant information from cluttered visual environments is widely believed to be due to our ability to tune attention to the particular elementary feature values of a sought-after target (e.g., red, orange, yellow). By contrast, recent findings showed that attention is often tuned to feature relationships, that is, features that the target has relative to irrelevant features in the context (e.g., redder, yellower). However, the evidence for such a relational account is so far exclusively based on behavioral measures that do not allow a safe inference about early perceptual processes. The present study provides a critical test of the relational account, by measuring an electrophysiological marker in the EEG of participants (N2pc) in response to briefly presented distractors (cues) that could either match the physical features of the target or its relative features. In a first experiment, the target color and nontarget color were kept constant across trials. In line with a relational account, we found that only cues with the same relative color as the target were attended, regardless of whether the cues had the same physical color as the target. In a second experiment, we demonstrate that attention is biased to the exact target feature value when the target is embedded in a randomly varying context. Taken together, these results provide the first electrophysiological evidence that attention can modulate early perceptual processes differently; in a context-dependent manner versus a context-independent manner, resulting in marked differences in the range of colors that can attract attention.

It is well-known that we can tune attention to specific features (e.g., colors). Originally, it was believed that attention would always be tuned to the exact feature value of the sought-after target (e.g., orange). However, subsequent studies showed that selection is often geared towards target-dissimilar items, which was variably attributed to (1) tuning attention to the relative target feature that distinguishes the target from other items in the surround (e.g., reddest item; relational tuning), (2) tuning attention to a shifted target feature that allows more optimal target selection (e.g., reddish orange; optimal tuning), or (3) broad attentional tuning and selection of the most salient item that is still similar to the target (combined similarity/saliency). The present study used a color search task and assessed gaze capture by differently coloured distractors to distinguish between the three accounts. The results of the first experiment showed that a very target-dissimilar distractor that matched the relative color of the target but was outside of the area of optimal tuning still captured very strongly. As shown by a control condition and a control experiment, bottom-up saliency modulated capture only weakly, ruling out a combined similarity-saliency account. With this, the results support the relational account that attention is tuned to the relative target feature (e.g., reddest), not an optimal feature value or the target feature.

There is minimal information on malnutrition in neurologic-psychiatric patients compared to internal and trauma-surgical patients. The aim of the present study was to explore if there is a correlation of these different disease groups with the nutritional assessment and biochemical markers. Cross - sectional study. The study was done in a department of geriatric medicine with subspecialisation in neurologic diseases and stroke unit. 338 patients (m / f = 136 / 202, mean age 81.4 ± 7.3 years) were evaluated. The nutritional status was evaluated by using the short form of the Mini Nutritional Assessment (MNA-SF) and seven biochemical markers (hemoglobin, iron, ferritin, vitamin B 12, folic acid, albumin and cholinesterase) were measured. There were 74 (22%) patients with MNA ≤ 7 points (malnutrition), 148 (44%) patients with an MNA 8 - 11 points (risk of malnutrition) and 116 (34%) patients with an MNA ≥ 12 points (good nutritional status). The mean MNA score of the three major disease groups trauma-surgery, internal medicine and neurology-psychiatry was 9.1 ± 3.2 vs. 9.9 ± 3.1 vs. 10.0 ± 2.8 (p=0.236). There were significant differences of laboratory markers between the disease groups. A deficit of albumin, cholinesterase and hemoglobin was found more often in trauma-surgical and internal patients than in neurological-psychiatric patients (albumin: 21.4%, 15.7%, 5.3%; p=0.001; cholinesterase 16.7%, 16.9%, 6.3%; p=0.007; hemoglobin 78.6%, 61.4%, 50.0%; p=0.002). Following Mini Nutritional Assessment, the additional measurement of albumin, cholinesterase and hemoglobin allowed a more precise grading of malnutrition. There were significant differences between the disease groups. A deficit of albumin, cholinesterase and hemoglobin was found more often in multimorbid trauma-surgical and internal patients than in neurologic-psychiatric patients.

It is widely known that irrelevant onsets (i.e., items appearing in previously empty locations) can automatically capture attention and attract our gaze. Some studies have shown that onset capture is stronger when the onset distractor matches the target feature, indicating that onset capture can be modulated by feature-based (top-down) tuning to the target. However, it is less clear whether and to what extent the perceptual saliency of the distractor can further modulate this effect. This study examined the effects of target similarity, competition between target and distractor, and bottom-up color contrast on the ability of onset distractor to capture the gaze, by varying the color (contrast) and stimulus-onset asynchrony of the onset distractor. The results clearly show that competition and feature-based attention modulate capture by the irrelevant onset to a large extent, whereas bottom-up color contrasts do not modulate onset capture. These results indicate the need to revise current accounts of gaze control.

Accurate motor control is mediated by internal models of how neural activity generates movement. We examined neural correlates of an adapting internal model of visuomotor gain in motor cortex while two macaques performed a reaching task in which the gain scaling between the hand and a presented cursor was varied. Previous studies of cortical changes during visuomotor adaptation focused on preparatory and perimovement epochs and analyzed trial-averaged neural data. Here, we recorded simultaneous neural population activity using multielectrode arrays and focused our analysis on neural differences in the period before the target appeared. We found that we could estimate the monkey's internal model of the gain using the neural population state during this pretarget epoch. This neural correlate depended on the gain experienced during recent trials and it predicted the speed of the subsequent reach. To explore the utility of this internal model estimate for brain-machine interfaces, we performed an offline analysis showing that it can be used to compensate for upcoming reach extent errors. Together, these results demonstrate that pretarget neural activity in motor cortex reflects the monkey's internal model of visuomotor gain on single trials and can potentially be used to improve neural prostheses.

The diagnosis of Alzheimer's disease can be improved by the use of biological measures. Biomarkers of functional impairment, neuronal loss, and protein deposition that can be assessed by neuroimaging (ie, MRI and PET) or CSF analysis are increasingly being used to diagnose Alzheimer's disease in research studies and specialist clinical settings. However, the validation of the clinical usefulness of these biomarkers is incomplete, and that is hampering reimbursement for these tests by health insurance providers, their widespread clinical implementation, and improvements in quality of health care. We have developed a strategic five-phase roadmap to foster the clinical validation of biomarkers in Alzheimer's disease, adapted from the approach for cancer biomarkers. Sufficient evidence of analytical validity (phase 1 of a structured framework adapted from oncology) is available for all biomarkers, but their clinical validity (phases 2 and 3) and clinical utility (phases 4 and 5) are incomplete. To complete these phases, research priorities include the standardisation of the readout of these assays and thresholds for normality, the evaluation of their performance in detecting early disease, the development of diagnostic algorithms comprising combinations of biomarkers, and the development of clinical guidelines for the use of biomarkers in qualified memory clinics.

One of the most widespread views in vision research is that top-down control over visual selection is achieved by tuning attention to a particular feature value (e.g., red/yellow). Contrary to this view, previous spatial cueing studies showed that attention can be tuned to relative features of a search target (e.g., redder): An irrelevant distractor (cue) captured attention when it had the same relative color as the target (e.g., redder), and failed to capture when it had a different relative color, regardless of whether the distractor was similar or dissimilar to the target. The present study tested whether the same effects would be observed for eye movements when observers have to search for a color or shape target and when selection errors were very noticeable (resulting in an erroneous eye movement to the distractor). The results corroborated the previous findings, showing that capture by an irrelevant distractor does not depend on the distractor's similarity to the target but on whether it matches or mismatches the relative attributes of the search target. Extending on previous work, we also found that participants can be pretrained to select a color target in virtue of its exact feature value. Contrary to the prevalent feature-based view, the results suggest that visual selection is preferentially biased toward the relative attributes of a search target. Simultaneously, however, visual selection can be biased to specific color values when the task requires it, which rules out a purely relational account of attention and eye movements.

Lyme arthritis caused by infection with Borrelia burgdorferi is a common late manifestation of Lyme borreliosis. Current treatment recommendations include at least one oral or intravenous antibiotic course, followed by antirheumatic therapy in case of refractory arthritis. We reviewed the course of 31 children with Lyme arthritis who had received antibiotic treatment and assessed outcome and requirement of antirheumatic therapy. Of a total of 31 patients, 23 (74 %) showed complete resolution of arthritis after one or two courses of antibiotics, whereas in 8 patients (28 %), steroid injections had been performed due to relapsing or remaining symptoms. All of these 8 patients showed immediate resolution of symptoms after intraarticular steroid injections. Four of them (50 %) remained asymptomatic so far with a follow-up period between five up to 40 months. In two cases, multiple intraarticular corticosteroid injections were required; three patients received additional or consecutive treatment with systemic antirheumatic treatment. Patients with antibiotic refractory arthritis showed a higher rate of positivity of the IgG p58 and OspC immunoblot bands (p = 0.05) at presentation. Antibodies against OspA, an indicator of later stage infection, occurred more frequently in the refractory group without reaching significant level. No clinical marker as indicator for severe or prolonged course of Lyme arthritis was identifiable. A quarter of childhood Lyme arthritis patients were refractory to antibiotics and required antirheumatic treatment. Intraarticular steroid injections in childhood Lyme arthritis refractory to antibiotics can lead to marked clinical improvement.

How do we select relevant information from cluttered visual environments? Current theories of attention and eye movement control have proposed a framework of feature detectors that allows us to attend to potentially important information and ignore irrelevant information. Each feature detector supposedly signals the existence of a single elementary feature (e.g., red) in the environment and can be modulated by the intention to search for particular features. In contrast to these feature detector accounts, recent visual search studies show that features are encoded relative to other features in the surround, in a context-dependent manner. Attention and eye movements are attracted to items with appropriate relative features (e.g., redder/larger/darker), regardless of their feature value. These findings question the feature detector concept and argue for a relational account of attention and eye movements.

What factors determine which stimuli of a scene will be visually selected and become available for conscious perception? The currently prevalent view is that attention operates on specific feature values, so attention will be drawn to stimuli that have features similar to those of the sought-after target. Here, we show that, instead, attentional capture depends on whether a distractor’s feature relationships match the target-nontarget relations (e.g., redder). In three spatial-cuing experiments, we found that (a) a cue with the target color (e.g., orange) can fail to capture attention when the cue–cue-context relations do not match the target-nontarget relations (e.g., redder target vs. yellower cue), whereas (b) a cue with the nontarget color can capture attention when its relations match the target-nontarget relations (e.g., both are redder). These results support a relational account in which attention is biased toward feature relationships instead of particular feature values, and show that attentional capture by an irrelevant distractor does not depend on feature similarity, but rather depends on whether the distractor matches or mismatches the target’s relative attributes (e.g., relative color).

How do we select behaviourally important information from cluttered visual environments? Previous research has shown that both top-down, goal-driven factors and bottom-up, stimulus-driven factors determine which stimuli are selected. However, it is still debated when top-down processes modulate visual selection. According to a feedforward account, top-down processes modulate visual processing even before the appearance of any stimuli, whereas others claim that top-down processes modulate visual selection only at a late stage, via feedback processing. In line with such a dual stage account, some studies found that eye movements to an irrelevant onset distractor are not modulated by its similarity to the target stimulus, especially when eye movements are launched early (within 150-ms post stimulus onset). However, in these studies the target transiently changed colour due to a colour after-effect that occurred during premasking, and the time course analyses were incomplete. The present study tested the feedforward account against the dual stage account in two eye tracking experiments, with and without colour after-effects (Exp. 1), as well when the target colour varied randomly and observers were informed of the target colour with a word cue (Exp. 2). The results showed that top-down processes modulated the earliest eye movements to the onset distractors (

European bat species are strictly protected by law, and the Member States of the European Union are obliged to record species condition and to contribute to their conservation. Habitat-suitability models are an essential aid in assessing the conservation status and distribution of a species. However, model performance depends on the data quality. This study compares habitat-suitability models that were generated from two data sets that differ in the degree of details included. The first model used data that were low in detail but freely available and the second used data that were very detailed but costly. Three hypotheses were addressed: (1) that the model using low-detailed data is sufficient in its performance to aid the assessment of species distribution and infrastructural planning; (2) the visualisation of actual species distribution is more accurate in the high-detailed model; and (3) habitat-suitability maps can depict species distribution better than species occurrence data alone. To develop models, climate, geographic and roosting data of Myotis bechsteinii were used. Models allowed very good spatial predictions of suitable habitats. However, the model using low-detailed data overestimated suitable habitat. The high-detailed model was more able to predict actual species distribution. These findings were supported by field evaluation where M. bechsteinii could only be detected in areas where both models predicted high habitat suitability. This framework is promising as it resulted in spatially explicit habitat-suitability maps and suggests that similar models may be used to improve the understanding of bat distribution and factors endangering other species of bats.

In visual search, an irrelevant colour singleton captures attention when the colour of the distractor changes across trials (e.g., from red to green), but not when the colour remains constant (Becker, 2007). The present study shows that intertrial changes of the distractor colour also modulate oculomotor capture: an irrelevant colour singleton distractor was only selected more frequently than the inconspicuous nontargets (1) when its features had switched (compared to the previous trial), or (2) when the distractor had been presented at the same position as the target on the previous trial. These results throw doubt on the notion that colour distractors capture attention and the eyes because of their high feature contrast, which is available at an earlier point in time than information about specific feature values. Instead, attention and eye movements are apparently controlled by a system that operates on feature-specific information, and gauges the informativity of nominally irrelevant features.

According to the sensorimotor supremacy hypothesis, conscious perception draws on motor action. In the present report, we will sketch two lines of potential development in the field of masking research based on the sensorimotor supremacy hypothesis. In the first part of the report, evidence is reviewed that masked, invisible stimuli can affect motor responses, attention shifts, and semantic processes. After the review of the corresponding evidence – so-called masked priming effects – an approach based on the sensorimotor supremacy hypothesis is detailed as to how the question of a unitary mechanism of unconscious vision can be pursued by masked priming studies. In the second part of the report, different models and theories of backward masking and masked priming are reviewed. Types of models based on the sensorimotor hypothesis are discussed that can take into account ways in which sensorimotor processes (reflected in masked priming effects) can affect conscious vision under backward masking conditions.

Background In the last few years, the therapy of cervical carcinoma has progressed substantially due to the use of simultaneous platinum- containing radiochemotherapy. However, there are no data which evaluate an individualized treatment adapted to tumor biology, in spite of the fact that patients show remarkably different responses to chemotherapy. Therefore this preclinical phase I study aims at finding therapeutic alternatives to the current cytostatic drugs to treat cervical carcinoma. Material and methods In a tumor chemosensitivity assay, 8 drugs were tested on freshly isolated tumor cells of 16 patients [carbo- and cisplatin, topotecan, paclitaxel as well as the 2 tyrosine kinase inhibitors imatinib (Glivec) and gefitinib (Iressa (R) ) and the 2 monoclonal antibodies cetuximab (Erbitux) and trastuzumab (Herceptin (R) )]. Results Overall the test was evaluable for 16 specimens (100%). Ten of 15 tumor samples (66.6%) were sensitive to imatinib. A sensitive therapeutic response could be demonstrated in all tested FIGO stages. An interindividual comparison could establish sensitivity to cetuximab in 12.5% of cases, to gefitinib in 6.25%, to trastuzumab in 6.6%, to cisplatin in 13.3%, to carboplatin in 7.6%, to paclitaxel in 93.8% and to topotecan in 25%. Conclusion Imatinib seems to be an efficacious therapeutic option for patients with cervical carcinoma, independently of tumor subtype.

This study investigated feature- and dimension-based intertrial effects in visual search for a pop-out target. The 2 prominent theories explaining intertrial effects, priming of pop-out and dimension weighting, both assume that repeating the target from the previous trial facilitates attention shifts to the target, whereas changing the target leads to attentional switch costs. In contrast, the results from the present study indicate that intertrial effects from changing features and dimensions involve different underlying mechanisms: Eye movement recordings showed that feature priming reliably modulates the speed of visually selecting the target, whereas changing the target dimension interferes only with processes after selection of the search target. Further experiments with a size and orientation singleton target showed that feature priming does not consist in carryover effects of target activation or nontarget inhibition, contrary to standard assumptions in visual search. Instead, priming effects critically depended on whether a coarse relation between target and nontarget features (e.g., smaller or larger) was repeated or reversed across trials. These results suggest the need to modify current models of priming in visual search.

Previous work on attentional capture has shown the attentional system to be quite flexible in the stimulus properties it can be set to respond to. Several different attentional “modes” have been identified. Feature search mode allows attention to be set for specific features of a target (e.g., red). Singleton detection mode sets attention to respond to any discrepant item (“singleton”) in the display. Relational search sets attention for the relative properties of the target in relation to the distractors (e.g., redder, larger). Recently, a new attentional mode was proposed that sets attention to respond to any singleton within a particular feature dimension (e.g., colour; Folk & Anderson, 2010). We tested this proposal against the predictions of previously established attentional modes. In a spatial cueing paradigm, participants searched for a colour target that was randomly either red or green. The nature of the attentional control setting was probed by presenting an irrelevant singleton cue prior to the target display and assessing whether it attracted attention. In all experiments, the cues were red, green, blue, or a white stimulus rapidly rotated (motion cue). The results of three experiments support the existence of a “colour singleton set,” finding that all colour cues captured attention strongly, while motion cues captured attention only weakly or not at all. Notably, we also found that capture by motion cues in search for colour targets was moderated by their frequency; rare motion cues captured attention (weakly), while frequent motion cues did not.

BACKGROUND The optimal sequencing ofantiretroviral regimens for the treatment of infection with human immunodeficiency virus type 1 (HIV-1) is unknown. We compared several different antiretroviral treatment strategies. METHODS This multicenter, randomized, partially double-blind trial used a factorial design to compare pairs of sequential three-drug regimens, starting with a regimen including zidovudine and lamivudine or a regimen including didanosine and stavudine in combination with either nelfinavir or efavirenz. The primary end point was the length of time to the failure ofthe second three-drug regimen. RESULTS A total of 620 subjects who had not previously received antiretroviral therapy were followed for a median of 2. 3 years. Starting with a three-drug regimen containing efavirenz combined with zidovudine and lamivudine (but not efavirenz combined with didanosine and stavudine) appeared to delay the failure ofthe second regimen, as compared with starting with a regimen containing nelfinavir (hazard ratio for failure ofthe second regimen, 0.71; 95 percent confidence interval, 0.48 to 1.06), as well as to delay the second virologic failure (hazard ratio, 0.56; 95 percent confidence interval, 0.29 to 1.09), and significantly delayed the failure ofthe first regimen (hazard ratio, 0.39) and the firstvirologic failure (hazard ratio, 0.34). Starting with zidovudine and lamivudine combined with efavirenz (but not zidovudine and lamivudine combined with nelfinavir) appeared to delay the failure of the second regimen, as compared with starting with didanosine and stavudine (hazard ratio, 0.68), and significantly delayed both the first and the second virologic failures (hazard ratio for the firstvirologic failure, 0.39; hazard ratio for the second virologic failure, 0.47), as well as the failure ofthe first regimen (hazard ratio, 0.35). The initial use of zidovudine, lamivudine, and efavirenz resulted in a shorter time to viral suppression. CONCLUSIONS The efficacy ofantiretroviral drugs depends on how they are combined. The combination of zidovudine, lamivudine, and efavirenz is superior to the other antiretroviral regimens used as initial therapy in this study.

Die Mandibula stellt eine sehr seltene Lokalisation fur Magenkarzinommetastasen dar. Normalerweise bleibt der hohe kondylare Bereich unberuhrt. Als Grund wird u. a. die eigenstandige Blutversorgung diskutiert. Problematisch ist die Rekonstruktion nach einer Resektion, da haufig eine fruhzeitige adjuvante systemische Therapie erforderlich ist. Am Beispiel dieser Metastasenresektion wird der Einsatz einer Quinn-Kiefergelenkprothese vorgestellt. Wir berichten uber ein hamatogen metastasierendes Magenadenokarzinom eines 51-jahrigen Patienten, bei dem sich initial eine zunehmende Disklusion im Seitzahnbereich zeigte. Wegen des Verdachts auf eine intraartikulare Fernmetastase erfolgte eine Kondylektomie mit Sofortrekonstruktion mittels totaler Kiefergelenkpfannenprothese uber einen praaurikularen Zugang. Die klinische und bildgebende Verdachtsdiagnose wurde histologisch nach Entkalkung als intrakapsulare Adenokarzinommetastase bestatigt. Nach Resektion dieser nach unseren Recherchen weltweit ersten dokumentierten intrakapsularen Metastase eines Magenkarzinoms verlief die Einheilungsphase dieser modifizierten Quinn-Prothese schnell und komplikationslos. Bei fruhzeitiger Wiederherstellung der Funktion und Beschwerdefreiheit konnte die anstehende radiochemotherapeutische Behandlung weiterer, nicht resezierbarer Fernmetastasen zeitgerecht eingeleitet werden. Am Beispiel dieses extrem seltenen Metastasenfalles konnte gezeigt werden, dass eine solche Gelenkprothese eine sehr gute Alternative zu einer aufwendigen autologen Rekonstruktion oder einer unbefriedigenden Girdlestone-Situation darstellt. Insbesondere die modifizierte Quinn-Prothese erweist sich aufgrund des Oberflachendesigns des spharischen Kondylus und der Gelenkpfanne als besonders geeigneter totaler Gelenkersatz nach ausgedehnter Resektion oder auch multiplen Voroperationen.

The 24-week extension of AIDS Clinical Trials Group Protocol 359, a study of human immunodeficiency virus (HIV)‐infected, indinavir-experienced patients, was designed to study the durability of “salvage” treatment regimens. Patients received saquinavir in combination with either ritonavir or nelfinavir and, in addition, delavirdine, adefovir, or both. Patients who demonstrated a virologic response at weeks 12‐16 were eligible to continue therapy in the extension through week 48. Of the 105 eligible subjects who were enrolled in the extension, 86 (82%) completed 48 weeks, and 49 (57%) of those 86 had HIV RNA levels 500 copies/ mL at week 48. For these 86 subjects who completed 48 weeks, the median change in CD4 cell count from baseline was +72 cells/mm 3 . Greater body weight, higher CD4 cell count, and greater degree of phenotypic susceptibility to indinavir and saquinavir at baseline were significantly associated with durable virologic suppression. These results show that some patients who experience treatment failure can demonstrate durable virologic and immunologic responses with salvage antiretroviral regimens. Current treatment guidelines recommend starting therapy for human immunodeficiency virus (HIV) infection with 2 nucleoside analogue reverse-transcriptase inhibitors in combination with 1 or 2 protease inhibitors or a nonnucleoside analogue reversetranscriptase inhibitor [1, 2]. However, 20%‐63% of patients from clinical cohorts experience virologic treatment failure while receiving combination antiretroviral therapy [3‐7]. Recent prospective studies have attempted to identify strategies for treatment of the treatment-experienced patient [8‐13], but these studies have focused primarily on 8‐24-week virologic responses to treatment. The durability of virologic and immunologic re

Summary Aim: Until now scintimammography did not achieve any definite role in the assessment of breast lesions. Purpose of this study was to elaborate its use as well as the limitations of scintimammography after 500 examinations completed. Methods: Scintigraphic findings were correlated with the histopathologic outcome of 219 patients, who underwent surgery or biopsy for histopathological confirmation. The results were determined with respect to palpability of the lesion and tumour size. Additionally, a distinct analysis was performed for the patient subpopulation with indeterminate results of previously performed physical examination, mammography, and sonography. Results: Overall sensitivity for scintimammography was 82.1% at a specificity of 87.5%. For palpable lesions sensitivity was 91.7% which was evidently higher as compared to 64.9% for non palpable lesions. For palpable lesions specificity was 81.1% and 88.6% for non palpable lesions. According to tumour size sensitivity ranged between 65.2% for carcinoma with a diameter 1 cm. In the patients subgroup with indeterminate preliminary diagnosis (n = 143) sensitivity decreased to 71.7% at a specificity of 87.8%. Patients undergoing neoadjuvant chemotherapy showed decreasing sestamibi uptake as early as 8 days after therapy if tumour response was evident. However, small residual invasive tumours in patients with complete remission could not be visualised. Conclusion: Scintimammography is neither suited for screening, nor early diagnosis of breast cancer, nor for the further evaluation of small and unclear mammographic findings. Scintimammography should not be used whenever histopathological clarification of a suspicious lesion is necessary. It is useful to further investigate patients with unclear or probably benign findings in physical examination and/or mammography and to monitor tumour response to neoadjuvant chemotherapy.

is well-known that eye movements are central to visual perception [1]. Visual acuity decreases dramatically in the periphery of vision, and precise eye movements to specific locations are vital to foveate objects of interest and identify them with high accuracy [1–4]. Given the importance of eye movements for visual perception, there has been a surge of interest in the topic, with numerous studies being conducted to clarify the variables that determine our eye movements (for a historical review see [5]). In fact, Google Scholar shows that eye movements are discussed in over a million publications, and a Web of Science search reveals 17,000 publications with eye movement in the title or abstract. As shown in Figure 1, the number of publications with eye movement in the title or abstract has also steadily increased over years, culminating in about 200 papers published in 2013. Figure 1 The number of publications with the “eye movement” in the title or abstract, according to a Web of Science search 2014. Despite the surge of interest in eye movements, many questions remain unresolved. This is also reflected in this special issue on eye movement control. First, there are a variety of different eye movements [2, 4]. Among the most widely known eye movements are the fast, ballistic saccades (including superfast express saccades) (e.g., B. de Gelder et al., this issue), smooth-pursuit eye movements (J. N. van der Geest et al., this issue), and vergence eye movements (e.g., P. M. Grove et al., this issue) required to fixate objects at different depths. Less well-known and yet intensely researched are microsaccades, tremor, slow drift, and vestibuloocular and optokinetic eye movements that stabilize gaze during motions of the head and motions of large regions of the image on the retina [2, 4]. Secondly and more importantly for the current special issue, eye movements are also controlled by a variety of different factors [1, 4]. Apart from being subject to diverse muscular and ocular constraints, successful voluntary control over eye movements critically depends on the quality of the visual input, which in turn depends on a variety of internal and external factors [1, 6, 7]. The contributions to the present special issue clarify key elements of both internal and external factors in eye movement control (G. W. Alpers et al., U. Ansorge et al., B. de Gelder et al., P. M. Grove et al., D. R. Hardwick et al., W. E. Huddlestone et al., J. Kassubek et al., A. Khan et al., A. Piras et al., N. D. Smith et al., J. N. van der Geest et al., and D. Venini et al., this issue). In the present contributions, eye movements have also been used to provide new insights into ocular and neurological disorders (J. Kassubek et al., N. D. Smith et al., this issue) and shed new light on the relationship between covert attention and eye movements (e.g., G. W. Alpers et al., U. Ansorge et al., D. R. Hardwick et al., and A. Khan et al., this issue; see also [6–9]). Together, the papers in this special issue provide a timely update on eye movement control that reflects current hot topics in the field, spanning the range from cognitive science over applied psychology to clinical psychology and neuroscience. Stefanie I. Becker Gernot Horstmann Arvid Herwig

In visual search, responses are slowed, from one trial to the next, both when the target dimension changes (e.g., from a color target to a size target) and when the target feature changes (e.g., from a red target to a green target) relative to being repeated across trials. The present study examined whether such feature and dimension switch costs can be attributed to the same underlying mechanism(s). Contrary to this contention, an EEG study showed that feature changes influenced visual selection of the target (i.e., delayed N2pc onset), whereas dimension changes influenced the later process of response selection (i.e., delayed s-LRP onset). An fMRI study provided convergent evidence for the two-system view: Compared with repetitions, feature changes led to increased activation in the occipital cortex, and superior and inferior parietal lobules, which have been implicated in spatial attention. By contrast, dimension changes led to activation of a fronto-posterior network that is primarily linked with response selection (i.e., pre-motor cortex, supplementary motor area and frontal areas). Taken together, the results suggest that feature and dimension switch costs are based on different processes. Specifically, whereas target feature changes delay attention shifts to the target, target dimension changes interfere with later response selection operations.

In visual search for pop-out targets, search times are shorter when the target and non-target colors from the previous trial are repeated than when they change. This priming effect was originally attributed to a feature weighting mechanism that biases attention towards the target features, and away from the non-target features. However, more recent studies have shown that visual selection is strongly context-dependent: According to a relational account of feature priming, the target color is always encoded relative to the non-target color (e.g., as redder or greener). The present study provides a critical test of this hypothesis, by varying the colors of the search items such that either the relative color or the absolute color of the target always remained constant (or both). The results clearly show that color priming depends on the relative color of a target with respect to the non-targets but not on its absolute color value. Moreover, the observed priming effects did not change over the course of the experiment, suggesting that the visual system encodes colors in a relative manner from the start of the experiment. Taken together, these results strongly support a relational account of feature priming in visual search, and are inconsistent with the dominant feature-based views.

The approval of etanercept for the treatment of the juvenile idiopathic arthritis (JIA) categories extended oligoarthritis (ExtOA), enthesitis-related arthritis (ERA) and psoriasis arthritis (PsA) was recently added to the approval for the treatment of polyarticular-course JIA (PA). This study aims to evaluate the efficacy and safety of etanercept in a large number of patients with the additional JIA categories. The Biologika in der Kinderrheumatologie (BIKER) registry documents baseline demographics, clinical characteristics and disease activity parameters. Efficacy was determined using the PedACR 30/50/70 response criteria and the Juvenile Arthritis Disease Activity Score (JADAS)-10. Safety assessments were based on adverse events’ reports. Until December 2012, a total of 1,678 JIA patients, incorporating 238 ERA, 315 ExtOA and 127 PsA patients were included. JADAS-10 demonstrated marked improvement compared to baseline after 3 to 24 months in ExtOA [16.1 ± 7.6 (baseline), 5.1 ± 5.2 (3 months), 3.0 ± 3.5 (24 months)]; ERA (15.3 ± 7.2, 4.4 ± 4.7, 4.0 ± 4.9) and PsA (14.7 ± 6.4, 5.0 ± 4.6, 5.3 ± 6.4). Compared to patients with PA, the rate of serious adverse events [relative risk (RR) 1.39 (0.95–2.03, p = 0.08)] and nonserious [1.18 (1.02–1.35; p = 0.03)] adverse events were elevated. The rate of uveitis flares was significantly higher in PsA (3.3/100 patient-years), ExtOA (2.8/100 patient-years) and ERA (2.7/100 patient-years) than in rheumatoid factor (RF)-negative polyarticular JIA (1.3/100 pat.yrs) or RF-positive polyarticular JIA (0.27/100 patient-years). Reports on chronic inflammatory bowel disease were numerically more frequent in ExtOA, ERA and PsA. Administration of etanercept in patients with the JIA categories ExtOA, ERA and PsA is safe and very efficacious in children. Attention should be paid to the occurrence of extraarticular autoimmunopathies.

In visual search, some fixations are made between stimuli on empty regions, commonly referred to as “centre-of-gravity” fixations (henceforth: COG fixations). Previous studies have shown that observers with task expertise show more COG fixations than novices. This led to the view that COG fixations reflect simultaneous encoding of multiple stimuli, allowing more efficient processing of task-related items. The present study tested whether COG fixations also aid performance in visual search tasks with unfamiliar and abstract stimuli. Moreover, to provide evidence for the multiple-item processing view, we analysed the effects of COG fixations on the number and dwell times of stimulus fixations. The results showed that (1) search efficiency increased with increasing COG fixations even in search for unfamiliar stimuli and in the absence of special higher-order skills, (2) COG fixations reliably reduced the number of stimulus fixations and their dwell times, indicating processing of multiple distractors, and (3) the proportion of COG fixations was dynamically adapted to potential information gain of COG locations. A second experiment showed that COG fixations are diminished when stimulus positions unpredictably vary across trials. Together, the results support the multiple-item processing view, which has important implications for current theories of visual search.