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To investigate the relationship between Type D (distressed) personality and cardiac biomarkers of disease severity in patients with acute coronary syndrome. To identify potential mechanisms behind the effect of Type D personality on cardiovascular disease (CVD).Cross-sectional.Patients (N = 215) with acute coronary syndrome completed a survey including a measure of Type D personality. Blood samples including a lipid profile and cardiac enzymes were taken within 3 days after the cardiovascular event. Data were analysed using simple correlations, multiple regressions, and mediation analyses.Type D personality was more predictive of severity of the acute coronary syndrome among patients with previous CVD compared to patients without previous CVD. Among patients with previous CVD, Type D personality was associated with the presence of ST elevation (R(2) =.07) and more damage to the myocardium as indicated by higher troponin-I (R(2) = .05) and myoglobin (R(2) = .07) levels. These effects were independent from demographics, CV risk factors, and depression. Lower HDL cholesterol levels mediated the relationship between Type D personality and disease severity (Κ(2) = .12 [95% CI 0.02, 0.28]) for myoglobin and Κ(2) = .08 [95% CI 0.01, 0.21] for troponin-I).Type D personality was related to a worse lipid profile and more severe acute coronary syndrome in patients with previous history of CVD. Given the strong relationship between disease severity and subsequent mortality, these results suggest that severity of the myocardial infarction may be a potential mechanism explaining increased mortality in Type D patients with recurrent CVD. Statement of contribution What is already known on this subject? Type D personality has been related to worse outcomes in cardiac patients. However, recent studies show mixed results, suggesting the need to clarify potential mechanisms. What does this study add? Type D personality is related to severity of acute coronary syndrome in patients with previous history of cardiovascular disease. This effect is partially accounted for by lower HDL levels in Type D patients. Disease severity is a potential mechanism by which Type D personality may affect cardiovascular health of patients with recurrent CVD.

Task (over-)load imposed on surgeons is a main contributing factor to surgical errors. Recent research has shown that gaze metrics represent a valid and objective index to asses operator task load in non-surgical scenarios. Thus, gaze metrics have the potential to improve workplace safety by providing accurate measurements of task load variations. However, the direct relationship between gaze metrics and surgical task load has not been investigated yet. We studied the effects of surgical task complexity on the gaze metrics of surgical trainees. We recorded the eye movements of 18 surgical residents, using a mobile eye tracker system, during the performance of three high-fidelity virtual simulations of laparoscopic exercises of increasing complexity level: Clip Applying exercise, Cutting Big exercise, and Translocation of Objects exercise. We also measured performance accuracy and subjective rating of complexity. Gaze entropy and velocity linearly increased with increased task complexity: Visual exploration pattern became less stereotyped (i.e., more random) and faster during the more complex exercises. Residents performed better the Clip Applying exercise and the Cutting Big exercise than the Translocation of Objects exercise and their perceived task complexity differed accordingly. Our data show that gaze metrics are a valid and reliable surgical task load index. These findings have potential impacts to improve patient safety by providing accurate measurements of surgeon task (over-)load and might provide future indices to assess residents’ learning curves, independently of expensive virtual simulators or time-consuming expert evaluation.

Purpose: Short- or long-term implant survival and success are related to peri-implant marginal bone loss (MBL), among other key factors. The purpose of this study was to analyze the role of clinical and implant-related variables in MBL over a long-term follow-up. Materials and Methods: A retrospective study of 558 implants in 172 patients was conducted, analyzing the relationship between MBL and clinical, implant-related, and prosthetic design-related variables. MBL was measured on digital radiographs with specific software, using implant threads as reference. Results: Linear mixed analysis revealed the following significant effects: a lower mean MBL for type IV bone (0.047 mm/year, 95% CI [-0.019, 0.119]) than for type III bone (0.086 mm/year, 95% CI [0.038, 0.138]), type II bone (0.112 mm/year, 95% CI [0.070, 0.167]), or type I bone (0.138 mm/year, 95% CI [0.052, 0.23]); an increased MBL of 0.033 mm/year for each increment of 1 mm in diameter (95% CI [0.002, 0.065]); a lower mean MBL in smooth implants (0.103 mm/year, 95% CI [0.090, 0.117]) vs rough implants (0.122 mm/year, 95% CI [0.102, 0.142]). The mean MBL was > 0 mm/year for all prostheses except for fixed complete dental prostheses. Conclusion: Within the limits of a retrospective follow-up study, a lower mean peri-implant MBL was associated with type IV bone, a smaller diameter, a smooth surface, and a fixed complete dental prosthesis.

We investigated the associations of different sedentary behaviors (SB) with gray matter volume and we tested whether SB related to gray matter volume is associated with intelligence. Methods: 99 children with overweight or obesity aged 8&ndash, 11 years participated in this cross-sectional study. SB was measured using the Youth Activity Profile-Spain questionnaire. T1-weighted images were acquired with a 3.0 T Magnetom Tim Trio system. Intelligence was assessed with the Kaufman Brief Test. Whole-brain voxel-wise multiple regression models were used to test the associations of each SB with gray matter volume. Results: Watching TV was associated with lower gray matter volume in six brain regions (&beta, ranging &minus, 0.314 to &minus, 0.489 and cluster size 106 to 323 voxels, p &lt, 0.001), playing video games in three brain regions (&beta, 0.391 to &minus, 0.359, and cluster size 96 to 461 voxels, 0.001) and total sedentary time in two brain regions (&beta, 0.341 to &minus, 0.352, and cluster size 897 to 2455 voxels, 0.001). No brain regions showed a significant positive association (all p &gt, 0.05). Two brain regions were related, or borderline related, to intelligence. Conclusions: SB could have the potential to negatively influence brain structure and, in turn, intelligence in children with overweight/obesity.

The aim of the present study was to examine the associations of physical fitness, sedentary time, and physical activity (PA) with working memory and neuroelectric activity in children with overweight/obesity. Seventy-nine children with overweight/obesity (10.2 ± 1.1 years old) participated in this cross-sectional study. We assessed physical fitness components (ie, muscular strength, speed agility, and cardiorespiratory fitness) using the ALPHA battery. Sedentary time and PA were assessed by GT3X+accelerometers (ActiGraph). Working memory was assessed using the delayed non-matched-to-sample task; mean reaction time (RT) and response accuracy were registered. Neuroelectric activity (ie, P3 amplitude and latency) was registered using the ActiveTwo System of BioSemi electroencephalogram. Higher upper-limb absolute strength was associated with lower response accuracy (P = 0.023), while higher lower-limb relative-to-weight strength was associated with larger P3 amplitude (P < 0.05). Higher speed agility and cardiorespiratory fitness levels were associated with shorter mean RT and larger P3 amplitude, and speed agility was also associated with shorter P3 latency (all P < 0.05). Vigorous PA was associated with larger P3 amplitude (P < 0.05). No associations were found for sedentary time or the rest of PA intensities (P ≥ 0.05). In addition to cardiorespiratory fitness, muscular strength and speed agility are also associated with working memory and neuroelectric activity in children with overweight/obesity. The association between PA and working memory is intensity-dependent, as significant findings were only observed for vigorous PA. Randomized controlled trials in this population would help to better understand whether improvements in different components of fitness and PA lead to better working memory and underlying brain function.

To examine the associations of physical fitness and physical activity with executive function in children with overweight and obesity.A cross-sectional study involving 100 children with overweight and obesity (10.1 ± 1.1 years old; 58.0% boys). We assessed physical fitness components (ie, muscular strength, speed-agility, and cardiorespiratory fitness) using the ALPHA battery, and physical activity and sedentary time by accelerometry. Cognitive flexibility was measured by the Design Fluency Test and Trail Making Test, inhibition by the Stroop test, and planning ability by the Zoo Map Test.Handgrip strength was positively associated with planning ability (P = .025). Speed-agility was positively related to cognitive flexibility and inhibition (P .05). Cardiorespiratory fitness and an overall fitness Z-score were positively associated with indicators of cognitive flexibility (P .05). No associations were found for physical activity and sedentary time with executive function (P ≥ .05).Muscular strength, speed agility, and cardiorespiratory fitness are associated with executive function in children with overweight and obesity. Cognitive flexibility seems to be more robustly associated with all fitness components, whereas planning ability and inhibition might depend on the component analyzed. The positive associations found in the present study in children with overweight and obesity call for more exercise-based randomized controlled trials in this population.

Cortical thickness and surface area are thought to be genetically unrelated and shaped by independent neurobiological events suggesting that they should be considered separately in morphometric analyses. Although the developmental trajectories of cortical thickness and surface area may differ across brain regions and ages, there is no consensus regarding the relationships of physical fitness with cortical thickness and surface area as well as for its subsequent influence on intelligence. Thus, this study examines: (i) the associations of physical fitness components (i.e., cardiorespiratory fitness, speed-agility and muscular fitness) with overall and regional cortical thickness and surface area; (ii) whether body composition indicators (i.e., body mass index, fat-free mass index and fat mass index) mediate these associations; and (iii) the association of physical fitness and cortical thickness with intelligence in overweight/obese children. A total of 101 overweight/obese children aged 8–11 years were recruited in Granada, Spain. The physical fitness components were assessed following the ALPHA health-related fitness test battery. T1-weighted images were acquired with a 3.0 Tesla Siemens Magnetom Tim Trio system. We used FreeSurfer software version 5.3.0 to assess cortical thickness (mm) and surface area (mm2). The main results showed that cardiorespiratory fitness and speed-agility were related to overall cortical thickness (β = 0.321 and β = 0.302, respectively; both P 0.05). The associations of cardiorespiratory fitness and speed-agility with overall cortical thickness were mediated by fat mass index (56.86% & 62.28%, respectively). In conclusion, cardiorespiratory fitness and speed-agility, but not muscular fitness, are associated with overall cortical thickness, and in turn, thicker brain cortex is associated with higher intelligence in overweight/obese children. Yet, none of the three physical fitness components were related to surface area. Importantly, adiposity may hinder the benefits of cardiorespiratory fitness and speed-agility on cortical thickness. Understanding individual differences in brain morphology may have important implications for educators and policy makers who aim to determine policies and interventions to maximize academic learning and occupational success later in life.

We studied the effects of task load variations as a function of flight complexity on combat pilots' gaze behavior (i.e., entropy) while solving in-flight emergencies. The second company of the Spanish Army Attack Helicopter Battalion (n = 15) performed three sets of standardized flight exercises with different levels of complexity (low [recognition flights], medium and high [emergency flights]). Throughout the flight exercises we recorded pilots' gaze entropy, as well as pilots' performance (assessed by an expert flight instructor) and subjective ratings of task load (assessed by the NASA-Task Load Index). Furthermore, we used pilots' electroencephalographic (EEG) activity as a reference physiological index for task load variations. We found that pilots' gaze entropy decreased ∼2% (i.e., visual scanning became less erratic) while solving the emergency flight exercises, showing a significant decreasing trend with increasing complexity (p .05). This is in consonance with the ∼12% increase in the frontal theta band of their EEG spectra during said exercises. Pilots' errors and subjective ratings of task load increased as flight complexity increased (p-values .05). Gaze data suggest that pilots used nondeterministic visual patterns when the aircraft was in an error-free state (low complexity), and changed their scanning behavior, becoming more deterministic, once emergencies occurred (medium/high complexity). Overall, our findings indicate that gaze entropy can serve as a sensitive index of task load in aviation settings.

We are often required to make decisions that can have safe or risky consequences. Evaluating the risk of each possible alternative is an important step before making our final decision. The main goal of the present research was to explore the neural basis of risk perception in a naturalistic context (driving). Twenty-two drivers evaluated the perceived risk in 72 traffic situations (previously categorized by driving instructors) while brain activity was recorded using fMRI. A neural network involving attentional factors, emotional processing, stimulus-response associations, and risk aversion was related to the perception of risks. Given the nature of our task, a more prominent role was played by emotional factors (evaluation of the consequences) than cognitive factors (e.g. probabilistic calculations). Moreover, activation in the insula, inferior frontal gyrus, precentral/postcentral gyrus, inferior parietal gyrus, and temporal and occipital regions linearly increased as a function of risk level. Our findings provide a new step towards understanding the neural processing underlying risk behavior in daily life tasks, which is particularly relevant given the study context and its important practical implications for our society.

Overweight, obesity, and gestational diabetes (GD) during pregnancy may negatively affect neurodevelopment in the offspring. However, the mechanisms are unclear and objective measures of neurodevelopment in infancy are scarce. We hypothesized that these maternal metabolic pathologies impair cortical visual evoked potentials (cVEPs), a proxy for visual and neuronal maturity. At 3 months of age, visual acuity was significantly poorer in offspring born to GD mothers. At 18 months of age, there were no differences in visual acuity but infants born to GD mothers had significantly longer latencies of cVEPs when measured at 15', and 30' of arc. The group differences at 30' remained significant after confounder adjustment (mean [SD] 121.0 [16.0] vs. 112.6 [7.6] ms in controls, p = 0.007) and the most prolonged latencies were observed in offspring to GD mothers with concurrent overweight (128.9 [26.9] ms, p = 0.002) and obesity (118.5 [5.1] ms, p = 0.020). Infants born to mothers with GD, particularly those with concurrent overweight or obesity, have prolonged latencies of visual evoked potentials at 18 months of age, suggesting that this maternal metabolic profile have a long lasting, non-optimal, effect on infants brain development., This work was supported by Spanish Ministry of Innovation and Science. Junta de AndalucõÂa: Excellence Projects (P06-CTS-02341 [to CC]); Spanish Ministry of Education (Grant no. SB2010- 0025 [to CC]); Spanish Ministry of Economy and Competitiveness (BFU2012-40254- C03-01 [to CC]); Abbott Laboratories, Granada, Spain; Henning and Johan Throne-Holst's foundation (Post Doc scholarship [to SKB]).

Objective Regular cardiovascular risk screening can prevent cardiovascular disease through timely implementation of lifestyle changes or medication. However, few studies have investigated what factors promote regular screening for risk factors like hypertension and high blood cholesterol. The aim of this study was to investigate the relationship between social support and adherence to cardiovascular risk screening. Methods We analyzed data from the Spanish National Health Survey—a cross-sectional representative survey conducted by the Spanish Ministry of Health in 2012 (N = 21,007). Participants reported whether they had their blood pressure and cholesterol levels measured by a health professional in the previous 12 months. Social support (i.e., the perception that emotional and practical support was available when needed) was measured with a validated scale. Multiple logistic regressions were conducted adjusted for demographic and health-related factors. Results Compared to individuals who reported a lack of social support, individuals who perceived sufficient social support were on average twice more likely to report participation in blood pressure screening, OR = 2.06, 95% CI [1.60, 2.66] and cholesterol screening, OR = 2.85, 95% CI [1.99, 4.09]. These effects were uniform across different demographics and were replicated in a previous wave of the survey. Factors associated with worse screening adherence were low social class, being single or widowed, smoking, alcohol consumption, and no history of cardiovascular risk. Discussion Perceptions of social support are positively related to cardiovascular risk screening adherence. Future research should investigate what type of social support most effectively increases screening participation among high risk populations.

Background Peroxisome proliferator activated receptors (PPARs) are ligand activated transcription factors with crucial functions in lipid homeostasis, glucose metabolism, anti-inflammatory processes, placental development, and are involved in cognitive functions and neurodegenerative diseases. Polymorphisms in PPAR genes are shown to influence the activity of these receptors. Aims 1) To examine the association of PPARG Pro12Ala polymorphism in pregnant women and their offspring on infant's neurodevelopmental outcomes during the first 18months of life; 2) to determine the influence of Pro12Ala polymorphism on fatty acid concentrations in plasma phospholipids and placental tissue. Study design 138 mother–infant pairs from the PREOBE observational study were genotyped for PPARG Pro12Ala. Plasma phospholipids and placental fatty acid concentrations were measured at delivery. Infants' neuropsychological assessment at 6 and 18months of age was performed using Bayley III. Results The effect of Pro12Ala on infant's neurodevelopmental outcomes was detected at 18months, but not at 6months of age. 18months old infants born to mothers with wild-type Pro12 genotype had better cognitive (OR=5.11, 95% CI: 1.379–18.96, p=0.015), language (OR=3.41, 95% CI: 1.35–11.24, p=0.044), and motor development scores (OR=4.77, 95% CI: 1.243–18.33, p=0.023) than the Ala allele carriers. Pro12Ala variants did not seem to affect fatty acids concentrations in blood nor in placenta at delivery. Conclusions Infants born to mothers with Pro12 genotype have better neurodevelopmental outcomes at 18months of age than Ala allele carriers, indicating a long-term transplacental action of PPARγ variants on foetal brain development.

Background Sleep complaints are one of the most frequent and relevant symptoms that characterize fibromyalgia syndrome (FMS). However, objective sleep disturbances have not been consistently described across FMS studies. It is therefore commonly accepted that FMS patients experience sleep misperception, even though no studies have investigated the contribution of polysomnographic parameters to determine subjective sleep quality in FMS. We aimed to compare sleep variables (polysomnographic parameters and subjective sleep quality) between FMS patients and healthy controls. Furthermore, we also aimed to define the predictors of subjective sleep quality in FMS. Methods We performed in-home polysomnography to 99 women (53 FMS patients and 36 healthy controls). We also collected subjective ratings of sleep quality, daytime sleepiness, pain, depression, and anxiety. Results Multivariate analysis showed that groups differed in polysomnographic parameters ( p = 0.015) – after accounting for age, body mass index, and antidepressant consumption. Specifically, FMS patients exhibited lower sleep efficiency, greater percentage of stage N1 and wakefulness, and more frequent awakenings than controls ( p -values p 0.001). Percentage of time awake (as obtained by polysomnography), depression levels, and antidepressant consumption predicted self-reported sleep quality in FMS patients (adjusted R 2 = 0.33, p 0.001). Conclusions One night of in-home polysomnography supports the hypothesis that women with FMS show polysomnographic alterations compared to age-matched controls. In addition, the time spent awake is the best predictor of subjective sleep quality, although greater levels of depression and antidepressant consumption might result in exaggerated complaints. These findings contribute to our understanding of FMS symptoms and its management.

Although sleep complaints are often reported in patients with fibromyalgia syndrome (FMS), there is no conclusive evidence that these complaints represent symptomatic disorders of sleep physiology. Thus, the question of the role of sleep disturbances as an etiological or maintenance factor in FMS remains open. This study identifies the subjective and objective characteristics of sleep disturbances in adult women diagnosed with FMS. We carried out a systematic review of publications since 1990, the publication year of the American College of Rheumatology criteria of FMS. We selected empirical studies comparing sleep characteristics of adult women with FMS and healthy women or women with rheumatic diseases. We identified 42 articles. Patients with FMS were more likely to exhibit sleep complaints and also a less efficient, lighter and fragmented sleep. The evidence of a FMS signature on objective measures of sleep is inconsistent, however, as the majority of studies lacks statistical power. Current evidence cannot confirm the role played by sleep physiology in the pathogenesis or maintenance of FMS symptoms; nonetheless, it is clear that sleep disturbances are present in this syndrome.

Dual-process theories have dominated the study of risk perception and risk-taking over the last two decades. However, there is a lack of objective brain-level evidence supporting the two systems of processing in every-day risky behavior. To address this issue, we propose the dissociation between evaluative and urgent behaviors as evidence of dual processing in risky driving situations. Our findings show a dissociation of evaluative and urgent behavior both at the behavioral and neural level. fMRI data showed an increase of activation in areas implicated in motor programming, emotional processing, and visuomotor integration in urgent behavior compared to evaluative behavior. These results support a more automatic processing of risk in urgent tasks, relying mainly on heuristics and experiential appraisal. The urgent task, which is characterized by strong time pressure and the possibility for negative consequences among others factors, creates a suitable context for the experiential-affective system to guide the decision-making process. Moreover, we observed greater frontal activation in the urgent task, suggesting the participation of cognitive control in safe behaviors. The findings of this research are relevant for the study of the neural mechanisms underlying dual process models in risky perception and decision-making, especially because of their proximity to everyday activities.

Purpose: Control over marginal bone loss (MBL) and its progression is critical for preserving peri-implant tissue health. A moderate MBL over the first year has conventionally been associated with clinical success. However, different implants are associated with distinct amounts of MBL during their first functional year. Therefore, this study evaluated the MBL in pristine maxillary bone around implants with different types of implant-abutment connections and sought to determine the effect of other clinical factors on this tissue response. Materials and Methods: Two hundred forty-six implants were placed in 101 patients with a mean age of 54.43 years. The MBL around two different types of implants (internal versus external prosthetic connection) was evaluated at 6 and 18 months after loading. Different variables were recorded to analyze their influence on radiographic parameters using a complex samples general linear model. Results: At 18 months, MBL ranged from 0 to 3.56 mm; less than 1 mm was lost around 46.3% (mesial) and 40.2% (distal) of the implants, while no bone was lost around 19.5% (mesial) and 19.9% (distal). The MBL was significantly higher around external than internal connections (0.714 vs 0.516 mm/year, respectively). Age, smoking habit, and connection type were directly related to mesial and distal MBL at 6 and 18 months postloading. Conclusion: Implant design is a key factor in peri-implant MBL. Age and smoking also play major roles in maintaining the stability of peri-implant bone.

Most research connecting task performance and neural activity to date has been conducted in laboratory conditions. Thus, field studies remain scarce, especially in extreme conditions such as during real flights. Here, we investigated the effects of flight procedures of varied complexity on the in-flight EEG activity of military helicopter pilots. Flight procedural complexity modulated the EEG power spectrum: highly demanding procedures (i.e., takeoff and landing) were associated with higher EEG power in the higher frequency bands, whereas less demanding procedures (i.e., flight exercises) were associated with lower EEG power over the same frequency bands. These results suggest that EEG recordings may help to evaluate an operator's cognitive performance in challenging real-life scenarios, and thus could aid in the prevention of catastrophic events.

Purpose The purpose was to radiographically analyze and compare the marginal bone loss (MBL) between implants with different mismatching distance and to study the influence of the prosthetic abutment height on the MBL in association with the related mismatching distances. Material and methods This retrospective study included 108 patients in whom 228 implants were placed, 180 with diameter of 4.5 mm and 48 with diameter of 5 mm. All patients received OsseoSpeed™ implants with internal tapered conical connection (Denstply Implants). Different mismatching distances were obtained, given that all implants were loaded with the same uni-abutment type (Lilac; Denstply Implants). Data were gathered on age, gender, bone substratum, smoking habits, previous history of periodontitis, and prosthetic features. MBL was analyzed radiographically at 6 and 18 months post-loading. Results Mixed linear analysis of mesial and distal MBL values yielded significant effects of abutment, implant diameter, follow-up period, bone substratum, smoking, and abutment × time interaction. MBL was greater at 18 vs. 6 months, for short vs. long abutments, for grafted vs. pristine bone, for a heavier smoking habit, and for implants with a diameter of 5.0 vs. 4.5 mm. Conclusion Greater mismatching does not minimize the MBL; abutment height, smoking habit, and bone substratum may play a role in the MBL over the short- and medium term.

Human and animal research has found that red perception is associated with specific behavioral reactions, generally characterized by intense responses. Here, we explored whether red cars are perceived as more dangerous than other colored cars. One hundred Spanish drivers examined several road scenarios which involved hazardous cars with different colors: red, green, yellow, black, gray, and white. Driver's behavior (response time and probability of braking) and the perceived level of risk for each scenario were analyzed. Although car color affected participants' response times, contrary to expectations, red cars did not elicit faster responses or higher perceived levels of risk.

INTRODUCTION Previous studies have shown links of body composition and fitness measures with brain structure, as well as with different aspects of emotional adjustment and well-being. However, the possible role of trait emotion-regulation success in the relationship between fitness/body composition and emotion-related subcortical structures has never been directly addressed. METHODS Twenty-three elite helicopter pilots were assessed in fat mass percentage, an endurance test to volitional exhaustion, bench-press power output, and negative urgency (trait affect regulation failure). Their brains were scanned using magnetic resonance imaging to estimate the size of the accumbens/amygdala, considered together, and the thalamus. Resulting correlations were used to test the relationship between body composition/fitness measures and brain structures' size, and the role of negative urgency therein, using structural equation modeling. RESULTS Fat mass percentage was associated with the size of the thalamus and the amygdala/accumbens. In the latter case, negative urgency and bench-press power output predicted structure size (and explained the effect of fat mass percentage away). In other words, bench-press power output and emotion regulation success (but not endurance performance) were associated with a larger amygdala/accumbens size. CONCLUSIONS Bench-press power output and emotion regulation success are independently associated with a larger amygdala/accumbens size, although present evidence does not allow for determination of causal directionality.

Background: Micronutrients such as vitamins and minerals and long-chain polyunsaturated omega-3 fatty acids (PUFAs) are essential for children’s brain development and cognitive functions. The current study investigated whether milk fortified with micronutrients and PUFA can result in improved cognitive function in mainstream school children. Methods: One-hundred-and-nineteen children (age 8–14, 58 boys) were randomly allocated to a fortified milk group or a regular full milk control group. Participants consumed 0.6L/day of the milk for 5 months. We recorded relevant biochemical, anthropometric, and cognitive measures (working memory and processing speed) at the start of the study and at follow-up after 5 months. Results: The fortified milk significantly increased docosahexaenoic acid (DHA) (change from baseline of 28% [95% CI 17–39%] vs. −6% [95% CI − 13 to 0%] in the control group) and serum 25OH-vitamin D concentrations (41% [95% CI 30–52%] vs. 21% [95% CI 11–30%] in the control group). The fortified milk improved working memory on one of two tests (32% [95% CI 17–47%] vs. 13% [95% CI 6–19%] in the control group). The fortified milk also indirectly increased processing speed on one of two tests; this effect was small and completely mediated by increases in 25OH-vitamin D concentrations. Conclusions: These results suggest that fortifying milk with micronutrients and PUFA could be an effective and practical way to aid children’s cognitive development., The study was funded by Lactalis Puleva SL. JF is currently employed and ELH was employed by Biosearch Life, which is part of Lactalis. Dafina Petrova is supported by a Juan de la Cierva Fellowship (FJCI-2016-28279) from the Spanish Ministry of Economy, Industry, and Competitiveness. We would like to thank the schools in Granada that participated in the study: I.E.S. Albayzín de Granada, Colegio Diocesano Virgen del Espino de Chauchina (Granada), and C.E.I.P. Cardenal Cisneros de Villanueva Mesía.

Our environment is rich in statistical information. Frequencies and proportions—or their visual depictions—are pervasive in the media, and frequently used to support or weaken causal statements, or to bias people’s beliefs in a given direction. The topic of this chapter is how people integrate naturally available frequencies and probabilities into judgments of the strength of the link between a candidate cause and an effect. We review studies investigating various rules that have been claimed to underlie intuitive causal judgments. Given that none of these rules has been established as a clear winner, we conclude presenting a tentative framework describing the general psychological processes operating when people select, ponder, and integrate pieces of causally-relevant evidence with the goal of meeting real-life demands.

On behalf of the HELENA project group., Objectives To examine the association of health-related physical fitness components and accurate measures of fatness with attention in European adolescents. Design Cross-sectional study. Methods A sub-sample of 444 adolescents from the HELENA study (14.5 ± 1.2 years) from 6 different countries participated in this study. Adolescents underwent evaluations of fitness (20 m shuttle run, handgrip strength, standing long jump and 4 × 10 m shuttle run tests), fatness (body mass index, skinfold thicknesses, bioelectrical impedance, Bod Pod and dual-energy X-ray absorptiometry) and attention (d2-test). Results Higher cardiorespiratory fitness was positively associated with better attention capacity (β = 0.1, p = 0.03). Body mass index and fat mass index measured by Bod Pod and dual-energy X-ray absorptiometry in a subset were negatively associated with attention (β = −0.11, p = 0.02; β = −0.36, p = 0.02; β = −0.34, p = 0.03; respectively). All models were adjusted for age, sex, family-affluence scale and mother education. When these models were additionally adjusted for cardiorespiratory fitness when fatness was the main predictor and vice versa, the associations were somewhat attenuated and were no longer statistically significant. Muscular strength, speed-agility and body fatness markers measured by bioelectrical impedance and skinfolds were not associated with attention. The fit and non-overweight adolescents presented the highest values of attention capacity whilst their unfit and overweight peers showed the lowest values of attention (47.31 ± 2.34 vs. 33.74 ± 4.39; p, The HELENA Study was carried out with the financial support of the European Community Sixth RTD Framework Programme (Contract FOOD-CT-2005-007034) and of the Stockholm County Council. FBO and JRR are supported by grants from the Spanish Ministry of Science and Innovation (RYC-2011-09011 and RYC-2010-05957, respectively). CCS is supported by grants from the University of Granada and Spanish Ministry of Economy and Competitiveness (FPU2013/55, BES-2014-068829). In addition, this study takes place under the umbrella of the ActiveBrains project, funded by the Spanish Ministry of Economy and Competitiveness (Ref. DEP2013-47540); and it was further supported by the SAMID III network, RETICS, funded by the PN I+D+I 2017-2021 (Spain), ISCIII- Sub-Directorate General for Research Assessment and Promotion and the European Regional Development Fund (ERDF) (Ref. RD16/0022). This work is part of a Ph.D. Thesis conducted in the Biomedicine Doctoral Studies of the University of Granada, Spain.

Head circumference in infants has been reported to predict brain size, total grey matter volume (GMV) and neurocognitive development. However, it is unknown whether it has predictive value on regional and subcortical brain volumes. We aimed to explore the relationship between several head circumference measurements since birth and distributions of GMV and subcortical volumes at later childhood. We examined seventy-four, Caucasian, singleton, term-born infants born to mothers randomised to receive fish oil and/or 5-methyltetrahydrofolate or placebo prenatal supplementation. We assessed head circumference at birth and at 4 and 10 years of age and cognitive abilities at 7 years of age. We obtained brain MRI at 10 years of age, on which we performed voxel-based morphometry, cortical surface extraction and subcortical segmentation. Analyses were controlled for sex, age, height, weight, family status, laterality and total intracranial volume. Prenatal supplementation did not affect head circumference at any age, cognitive abilities or total brain volumes. Head circumference at 4 years presented the highest correlation with total GMV, white matter volume and brain surface area, and was also strongly associated with GMV of frontal, temporal and occipital areas, as well as with caudate nucleus, globus pallidus, putamen and thalamus volumes. As relationships between brain volumes in childhood and several outcomes extend into adulthood, we have found that ages between 0 and 4 years as the optimal time for brain growth; postnatal factors might have the most relevant impact on structural maturation of certain cortical areas and subcortical nuclei, independent of prenatal supplementation.

A few studies have recently reported that higher cardiorespiratory fitness is associated with higher volumes of subcortical brain structures in children. It is, however, unknown how different fitness measures relate to shapes of subcortical brain nuclei. We aimed to examine the association of the main health-related physical fitness components with shapes of subcortical brain structures in a sample of forty-four Spanish children aged 9·7 (sd 0·2) years from the NUtraceuticals for a HEALthier life project. Cardiorespiratory fitness, muscular strength and speed agility were assessed using valid and reliable tests (ALPHA-fitness test battery). Shape of the subcortical brain structures was assessed by MRI, and its relationship with fitness was examined after controlling for a set of potential confounders using a partial correlation permutation approach. Our results showed that all physical fitness components studied were significantly related to the shapes of subcortical brain nuclei. These associations were both positive and negative, indicating that a higher level of fitness in childhood is related to both expansions and contractions in certain regions of the accumbens, amygdala, caudate, hippocampus, pallidum, putamen and thalamus. Cardiorespiratory fitness was mainly associated with expansions, whereas handgrip was mostly associated with contractions in the structures studied. Future randomised-controlled trials will confirm or contrast our findings, demonstrating whether changes in fitness modify the shapes of brain structures and the extent to which those changes influence cognitive function.

The aim of the present study was to develop and validate a Spanish version of the short Domain-Specific Risk-Taking (DOSPERT-30) scale, measuring risk-taking behavior, risk perception, and expected beneficial consequences (from taking risks) in five life domains: ethics, finance, health/security, recreational, and social decisions.The scale was back-translated, and administered online to 826 participants. Validity evidence was tested using correlations with construct-related instruments (UPPS-P and SSS-V), as well as using factor analysis. Internal consistency reliability was calculated with the ordinal Alpha coefficient, and gender differences were considered.Internal consistency was good, and factor analysis confirmed the five factors proposed by the authors. With respect to the external validity, high correlations with the positive urgency and the sensation seeking subscales of the UPPS-P, as well as with the thrill and adventure seeking and disinhibition subscales of the SSS-V were found. Finally, gender differences were found in all subscales and domains, with men tending to take more risks, perceive less risk and expect more beneficial consequences, except for the social domain where an inverse pattern was found.As these findings are in line with the original version, they indicate the scale was successfully adapted.

To investigate the correlation between patient-dependent variables and dimensional variations of the maxillary sinus.In this cross-sectional study, a total of 394 individual cone-beam computed tomography scans were evaluated by one calibrated examiner to measure the total volume of the maxillary sinus, the distance between the medial and the lateral walls at 5, 10, and 15 mm vertically from the sinus floor, the height of septa (if present), and the height of the maxillary sinus cavity from both the alveolar crest and the sinus floor to the meatus. Recorded patient-dependent variables were age, gender, and edentulism status.Total maxillary sinus volume was significantly smaller in completely and partially edentulous patients than in dentate subjects. This finding was influenced by age, as older patients exhibited less volume, regardless of gender and edentulism status. Age showed an indirect correlation with the distance to the meatus, the sinus volume, and the mediolateral dimensions. Additionally, the prevalence of accessory meatus in this population was 29.19%.The dimensions of the maxillary sinus are influenced by age and edentulism status being reduced by aging and tooth loss.

Background: Injury of the inferior alveolar nerve (IAN) is a serious intraoperative complication that may occur during routine surgical procedures, such as dental implant placement or extraction of impacted teeth. Thus, the purpose of this study was to analyze the trajectory of the mandibular canal (MC), the location of the mental foramen (MF) and the presence and extension of an anterior loop of the mental nerve (AL). Study Design: In this cross-sectional study, a total of 348 CBCTs were analyzed. Distances from MC to the surface of the basal, medial and lateral cortical of the mandible were measured at the level of the second molar, first molar and second premolar. Location of the MF relative to the apices of the premolars, as well as incidence and anterior extent of the AL were also determined. Results: Significant and clinically relevant correlations were found between the position of the MC in women, which was located more caudal (r=-0.219, p=0.007; r=-0.276, p

Many patients delay seeking medical attention during acute coronary syndromes (ACS), profoundly increasing their risk for death and major disability. Although research has identified several risk factors, efforts to improve patient decision making have generally been unsuccessful, prompting a call for more research into psychological factors. The purpose of this study is to estimate the relationship between ACS decision delay and numeracy, a factor closely related to general decision making skill and risk literacy. About 5 days after experiencing ACS, 102 survivors (mean age = 58, 32–74) completed a questionnaire including measures of numeracy, decision delay, and other relevant factors (e.g., anxiety, depression, symptom severity, knowledge, demographics). Low patient numeracy was related to longer decision delay, OR = 0.64 [95 % confidence interval (CI) 0.44, 0.92], which was in turn related to higher odds of positive troponin on arrival at the hospital, OR = 1.37 [95 % CI 1.01, 2.01]. Independent of the influence of all other assessed factors, a patient with high (vs. low) numeracy was about four times more likely to seek medical attention within the critical first hour after symptom onset (i.e., ORhigh-low = 3.84 [1.127, 11.65]). Numeracy may be one of the largest decision delay risk factors identified to date. Results accord with theories emphasizing potentially pivotal roles of patient deliberation, denial, and outcome understanding during decision making. Findings suggest that brief numeracy assessments may predict which patients are at greater risk for life-threatening decision delay and may also facilitate the design of risk communications that are appropriate for diverse patients who vary in risk literacy.

Driver fatigue is a common cause of car accidents. Thus, the objective detection of driver fatigue is a first step toward the effective management of fatigue-related traffic accidents. Here, we investigated the effects of driving time, a common inducer of driver fatigue, on the dynamics of fixational eye movements. Participants drove for 2 h in a virtual driving environment while we recorded their eye movements. Microsaccade velocities decreased with driving time, suggesting a potential effect of fatigue on microsaccades during driving.

With the increased use of short dental implants (10 mm), a high crown/implant (C/I) ratio has become a common finding. However, the effect of the C/I ratio on the marginal bone loss (MBL) has not yet been examined extensively. Hence, the aim of the present systematic review is to explore the influence of the C/I ratio on the success rate and MBL of dental implants.Three electronic databases (PubMed, Ovid MEDLINE, and Cochrane Central) and a manual search for human trials with a minimal follow-up of 6 months are used for the present study. A statistical analysis of the influence of the C/I ratio was performed on the peri-implant MBL while considering follow-up period, type of implants, implant connection, and technical and biologic complications.One hundred ninety-six potential articles were identified on the selected databases. Only 57 articles were selected for full-text evaluation. According to the inclusion criteria, a total of 13 articles were included in this systematic review. A significant negative association between the C/I ratio and the MBL was found (P = 0.012). However, no statistically significant difference was found (P0.15) for potential effects regarding the observation period, the type of implant connection, or between both methods of evaluating the C/I ratio.Within the limitations of the present study, the C/I ratio of implant-supported restorations has an effect on peri-implant marginal bone level. Within the range of 0.6/1 to 2.36/1, the higher the C/I ratio, the less the peri-implant MBL.

Recent research has proposed that altered reward and punishment sensitivity, heightened impulsivity, and faulty dynamic decision-making are at the core of disordered gambling. However, each of these traits and cognitive aspects dimensionally vary in the normal population, such that the link between individual differences in these dimensions and gambling use can be ultimately informative to explain disordered gambling. The main aim of the present study was to investigate the contribution of such decision-making-related indices to gambling use parameters in a community sample of college students. Assessment included punishment and reward sensitivity (as measured by the shortened Sensitivity to Punishment and Sensitivity to Reward Questionnaire), impulsivity (as measured by the UPPS-P model and a motor inhibition Go/No-go task), and dynamic decision-making [as measured by the probabilistic reversal learning task (PRLT)]. A structured interview was conducted to explore quantitative aspects of the participants gambling habits (gambling presence, gambling frequency, and average amount of money spent in gambling per unit of time). Our results showed the existence of a decision-making profile of gambling, as it naturally occurs in college students, in which sensation seeking is directly and specifically related to gambling presence (gambling, or not gambling at all), punishment sensitivity is inversely related to gambling frequency, and inflexibility in the PRLT specifically predicts the losses accrued because of gambling. These results are compatible with the idea that sensation seeking and punishment insensitivity could increase exposure to gambling activities, whereas reversal learning inflexibility, in people who already gamble, could boost the risk to accumulate losses.

Batería de Evaluación Neuropsicológica Infantil (BENCI) is a computerized battery for the neuropsychological evaluation of children. This battery has been used in different studies to evaluate neuropsychological functions and neurodevelopment in children. The objective of this study is to test the validity and reliability of the first Arabic version of the BENCI on an Arabic population where neuropsychological tests are very scarce. We administrate the BENCI to 198 school-age children (98 boys and 100 girls) from Morocco. To examine the test retest reliability of the BENCI battery, we administered the battery 2 times to 43 children (23 boys and 20 girls) with 15 days in between the pre- and posttest. The results revealed good validity and reliability of the battery in Arabic children. Also, the BENCI battery has demonstrated the capacity to differentiate between children by their age group. This battery can be of great use to both the research and clinical areas of Arabic countries and/or in assistance to Arabic immigrants that live outside of their native country.

The use of narrow-diameter implants has been proposed to restore small edentulous spans, thus avoiding extensive bone augmentation procedures and reducing the surgical complexity of implant rehabilitations. Although success rates of narrow-diameter implants have already been analyzed in the literature, to the best of the authors' knowledge, no meta-analysis based on prospective and randomized controlled trials has been performed. The aim of this study is to analyze the survival rates of narrow-diameter implants compared with standard or wide-diameter implants.An electronic search from three databases and a hand search in implant-related journals of studies published in English before September 1, 2012 were performed. Prospective human clinical studies with at least 10 implants and a follow-up period of 1 year were included in the meta-analysis. Implants were divided into two groups based on their diameters.The initial search yielded 484 articles, of which 49 were evaluated in full text for eligibility. Finally, 16 studies were chosen and separated into two groups: 1) implants of diameter3.3 mm (group 1) and 2) implants of diameter ≥3.3 mm (group 2). A meta-analysis performed for groups 1 and 2 showed survival rates of 75% and 87%, respectively.This meta-analysis showed that narrower implants (3.3 mm) had significantly lower survival rates compared with wider implants (≥3.3 mm). Other variables, such as type of prosthesis, implant surface, and timing of prosthetic loading, were found to have influenced the implant survival rates.

Background and objectives Whilst traditional studies have shown that obese individuals are at a higher risk of cardiovascular events compared to lean subjects, recent studies in patients with acute myocardial infarction (AMI) have suggested that obesity may exert protective effects (the “obesity paradox”). We sought to assess the relationship between body mass index (BMI) and the BARI score (BARIsc), a validated tool used to assess myocardium at risk, in patients with acute coronary syndrome.

Among the factors associated with driving safety, sleep-related variables constitute a leading cause of road accidents. Circadian fluctuations of driver's somnolence has been previously linked to road safety. However, the role of chronotype in this relationship has been poorly investigated. Thus, the aim of the present work was to address whether driving performance is influenced by circadian patterns, in turn modulated by the driver's chronotype and the time of day (i.e. synchrony effect). We assessed 47 healthy young adults with specific chronotypes in several simulated driving sessions, both in the morning and in the evening. We collected driving performance data, along with self-reported levels of activation prior to each driving session and other sleep-related variables. Participants drove less safely when testing times took place outside their optimal time of day, as determined by their chronotype and confirmed by self-reported levels of activation. These differences were more pronounced in the morning, when morning types shown a better driving performance. Our results suggest that chronotype plays an important role as a modulator of the relationship between the time of day and driving safety. Therefore, it is necessary to acknowledge this variable in theoretical models of driving behavior, and for the improvement of occupational accidents prevention programs.

This study focused on the effects of emotion-laden stimuli (emotional roadside advertisements) on driver decision making. A common dilemma in driving is whether to speed up or brake when the lights turn yellow at an intersection. This study focused on this aspect of driver decision making. We compared the influence of emotion-laden roadside advertisements (positive, negative, and neutral solutions) either on the evaluation of possible risk (i.e., evaluative behavior) or the decision to stop/speed up (i.e., urgent behavior). We showed that drivers brake more often after negative advertisements than after positive and neutral ones; at the same time, the response latency was shorter when they decided to speed up. We also demonstrated that urgent behavior responses were faster than evaluative ones, independent of the emotional content. Thus, we conclude that urgent behavior may be more automatic than evaluative behavior according to the dual system models of risk perception and decision-making. Overall, our results suggest that emotional factors play a decisive role in making driving decisions, particularly in risky driving situations. These findings provide important information for the development of new and advanced driver emotional support systems and, in general, for the specification of future transportation police design guidelines.

Purpose: The aim of this study was to test the sensitivity of the resonance frequency analysis for detecting early implant failure. Materials and Methods: In all, 3,786 implants placed from June 2007 to January 2013 were retrospectively evaluated. A total of 20 implants (in 20 patients) placed in pristine bone were found to have failed before loading. The implant stability quotient (ISQ) values were extracted from these 20 implants at baseline (immediate) and 4 months after placement (delayed). Simple linear regression, logistic regression, and two-way contingency tables were used to test for the relationships between ISQ values and early implant failure. Results: Immediate ISQ values were significantly related to failure (odds ratio [OR] = 4.27). Furthermore, the results of the second regression showed a significant relationship between ISQ at delayed measurement and implant failure (OR = 9.20). For immediate ISQ, it seems that the 73.7% correct classifications were obtained at the cost of an incorrect classification of 55% of the implant failures. However, for the delayed ISQ, 86.2% correct classifications were obtained at the cost of assuming that all implants will survive. Conclusion: The present study showed that ISQ values are not reliable in predicting early implant failure. In addition, the real cutoff ISQ value to differentiate between success and early implant failure remains to be determined.

Early life factors may influence brain and academic outcomes later in life, especially during childhood. Here we investigate the associations of early life factors (i.e., birth weight, birth length, and breastfeeding) with gray matter volume, adjusted for body mass index and cardiorespiratory fitness, and ii) we test whether early-life factor-related differences in gray matter volume are associated with academic performance in overweight/obese children. 96 children with overweight/obesity aged 8-11 years participated. Birth weight, birth length and gestational age were collected from birth records, and breastfeeding practices were asked to parents. T1-weighted images were acquired with a 3.0 T Magnetom Tim Trio system. Academic performance was assessed with the Bateria III Woodcock-Muñoz Tests of Achievement. Whole-brain voxel-wise multiple regressions were used to test the associations of each early life factor with gray matter volume. Higher birth weight and birth length were associated with greater gray matter volume in 9 brain regions including the middle frontal gyrus, rectal gyrus, thalamus, putamen, middle temporal gyrus, lingual gyrus, middle occipital gyrus, calcarine cortex and cerebellum bilaterally (β ranging from 0.361 to 0.539, t ranging from 3.46 to 5.62 and cluster size from 82 to 4478 voxels; p 0.001); and greater duration of any breastfeeding was associated with greater gray matter volume in 3 regions including the bilateral inferior frontal gyrus and rolandic operculum (β ranging from 0.359 to 0.408, t ranging from 4.01 to 4.32 and cluster size from 64 to 171 voxels; p 0.001). No associations were found for duration of exclusive breastfeeding. Additionally, none of the gray matter regions that were associated with the early life factors were associated with academic performance (all p 0.05). Our results demonstrate that birth weight, birth length, and breastfeeding are predictive of gray matter volume of numerous brain structures that are involved in higher order cognition and emotion regulation, but how these results relate to measures of academic achievement remain a matter of speculation.

Summary This research focused on the influence of imaginary passengers on drivers' estimation of the probability of having an accident in traffic situations. Participants had to imagine riding a motorcycle with either a son or a workmate as a passenger. Their task was to assess the risk of accident in a set of traffic scenarios. Risk perception was a function of sex and type of passenger. Women perceived higher risk when the passenger was a son than when a workmate. In contrast, men's estimations were rather the same for both passengers. The emotional significance of the consequences of the accident (losing a son vs. losing a workmate) modulate the perception of probability of having an accident. Finally, these results could help in designing more effective campaigns promoting road safety. Copyright © 2013 John Wiley & Sons, Ltd.

Recent technological developments in active advanced driver assistance systems and in-car infotainment devices have contributed to reducing the number and severity of road accidents as well as improving and simplifying driver experience. However, these systems may impact driving performance in undesired ways, especially when emotionally-charged stimuli are used as warning signals. Emotional distraction can be a serious danger, causing delays in information processing, and reducing driving safety below minimal acceptable levels. Here we study the effect of emotionally-laden auditory signals on the speed of concurrent driving decisions. We distinguished two categories of behavioural responses: ‘urgent’ vs ‘evaluative’. In the experiments reported here participants were quicker to evaluate whether a traffic scene was risky or not after hearing an emotionally-charged auditory stimulus than after a neutral one. However, urgent (braking) responses to the same scenes were not affected by the emotional quality of the auditory signal. Based on these results, we give preliminary advice on the design of guidelines for in-car interfaces particularly in the field of affective in-car computing. First published online: 25 Oct 2013

Different studies have demonstrated that culture has a basic role in intelligence tests performance. Nevertheless, the specific neuropsychological abilities used by different cultures to perform an intelligence test have never been explored. In this study, we examine the differences between Spaniards and Moroccans in the neuropsychological abilities utilized to perform the Beta III as a non-verbal intelligence test. The results showed that the Spaniard group obtained a higher IQ than the Moroccan group in the Beta III. Moreover, the neuropsychological abilities that predicted scores for the Beta III were dependent on the country of origin and were different for each subtest. Besides showing the cultural effect on non-verbal intelligence test performance, our results suggest that a single test may measure different functions, depending on the subject's cultural background.

Purpose The purpose of this study is to evaluate the vertical and horizontal graft bone resorption (GR) in grafted maxillary sinuses and the marginal bone loss (MBL) around implants placed in the sinuses with different prosthetic connections and to determine the effect of other clinical factors on these tissue responses at 6 and 18 months postloading. Material and Method A total of 254 implants were placed in 150 grafted maxillary sinuses of 101 patients (51.5% female) with mean age of 52.2 years (range, 32–82 years). GR and MBL measurements were made in implants placed with two different prosthetic connections (internal and external) at 6 and 18 months postloading. The complex samples general linear model was used to analyze the influence of patient age, gender, smoking habit, history of periodontal disease, implantation timing (simultaneous vs deferred), and prosthetic abutment length on radiographic GR and MBL values. Results At 18 months postloading, the MBL ranged from 0 mm to 5.89 mm; less than 1 mm was lost around 49.0% (mesial) and 44.3% (distal) of the implants, while no bone was lost around 32.9% (mesial) and 26.7% (distal). The GR was significantly affected by smoking, remnant alveolar bone height, graft length, graft height, gender, and age, and it significantly decreased over time. The MBL was influenced by the type of connection, implantation timing, and prosthetic abutment length. The MBL was greater with longer postloading interval and higher patient age and in smokers. Conclusion Resorption of grafts that combine autogenous cortical bone with anorganic bovine bone is dependent on the anatomic features of the sinus and is not affected by the time elapsed after the first 6 months. The MBL in implants placed in these grafted areas is time dependent and mainly related to potentially modifiable clinical decisions and patient habits.

Background Despite the growing interest concerning the laparo-endoscopic single-site surgery (LESS) procedure, LESS presents multiple difficulties and challenges that are likely to increase the surgeon's cognitive cost, in terms of both cognitive load and performance. Nevertheless, there is currently no objective index capable of assessing the surgeon cognitive cost while performing LESS. We assessed if gaze-based indices might offer unique and unbiased measures to quantify LESS complexity and its cognitive cost. We expect that the assessment of surgeon's cognitive cost to improve patient safety by measuring fitness-for-duty and reducing surgeons overload. Methods Using a wearable eye tracker device, we measured gaze entropy and velocity of surgical trainees and attending surgeons during two surgical procedures (LESS vs. multiport laparoscopy surgery [MPS]). None of the participants had previous experience with LESS. They performed two exercises with different complexity levels (Low: Pattern Cut vs. High: Peg Transfer). We also collected performance and subjective data. Results LESS caused higher cognitive demand than MPS, as indicated by increased gaze entropy in both surgical trainees and attending surgeons (exploration pattern became more random). Furthermore, gaze velocity was higher (exploration pattern became more rapid) for the LESS procedure independently of the surgeon's expertise. Perceived task complexity and laparoscopic accuracy confirmed gaze-based results. Conclusion Gaze-based indices have great potential as objective and non-intrusive measures to assess surgeons' cognitive cost and fitness-for-duty. Furthermore, gaze-based indices might play a relevant role in defining future guidelines on surgeons' examinations to mark their achievements during the entire training (e.g. analyzing surgical learning curves).

Fatigue is a major contributing factor to operational errors. Therefore, the validation of objective and sensitive indices to detect fatigue is critical to prevent accidents and catastrophes. Whereas tests based on saccadic velocity (SV) have become popular, their sensitivity in the military is not yet clear, since most research has been conducted in laboratory settings using not fully validated instruments. Field studies remain scarce, especially in extreme conditions such as real flights. Here, we investigated the effects of real, long flights on SV. We assessed five newly commissioned military helicopter pilots during their aviation training. Pilots flew Sikorsky S-76C helicopters, under instrumental flight rules, for more than 2 h (ca. 150 min). Eye movements were recorded before and after the flight with an eye tracker using a standard guided-saccade task. We also collected subjective ratings of fatigue. SV significantly decreased from the Pre-Flight to the Post-Flight session in all pilots by around 3% (range: 1-4%). Subjective ratings showed the same tendency. We provide conclusive evidence about the high sensitivity of fatigue tests based on SV in real flight conditions, even in small samples. This result might offer military medical departments a valid and useful biomarker of warfighter physiological state.

The posterior superior alveolar (PSA) artery is frequently encountered in the area where the lateral osteotomy is performed during direct sinus augmentation procedures.To investigate the correlation between patient-dependent variables and measurements related to PSA using cone beam computed tomography (CBCT) data.Three hundred ninety-four CBCT scans were evaluated to assess the PSA artery diameter and distances to the sinus floor and to alveolar crest. Patient's age, gender, and edentulism status were recorded.The PSA artery tends to be wider in older patients. Distances to the sinus floor or the alveolar crest tend to be shorter in women and in partially and completely edentulous patients. Also, as those distances decrease, the mediolateral width of the sinus increases.Tooth loss leads to maxillary sinus vertical collapse with respect to the PSA artery. The position of the artery is stable; so, the mediolateral dimensions at different heights from the floor increase.The reduced distances from the PSA to the sinus floor and the alveolar crest in edentulous patients potentially increase the risk of injury during maxillary sinus lift. Additionally, when the distance to the sinus floor decreases, the mediolateral dimensions of the sinus at different heights increase, which may complicate the technique and challenge the outcomes.

Intense and complex symptoms of grief seem to be related to a series of biases and difficulties in areas such as attention, autobiographical memory and problem solving. However, studies of neuropsychological performance have reported contradictory evidence. The role of executive function (EF) in bereaved individuals has not been systematically studied by differentiating between its components.A total of 38 participants who had experienced the death of a loved one participated in this study. They were divided into two groups based on the intensity of their symptoms. They underwent neuropsychological assessments that included measures of flexibility, inhibition, working memory and emotional decision-making.Group differences were found in the parts of the emotional decision-making task that assessed decisions made under risk. Considering each participantrsquo;s level of education and emotional variables, the symptoms of grief predicted a substantial variance in their performance in the decision-making task.Intense symptoms of grief seem to be related to poorer emotional decision-making performance but not to flexibility, inhibition or working memory.

Contrary to people's intuitions, many screenings can have both benefits (e.g., lives saved) and harms (e.g., unnecessary treatments). Statistical information is often provided to ensure informed decision making. However, few theoretical models have addressed the role of comprehension of such information in screening decisions. In an experiment, we studied how cognitive skills, emotions, and a priori beliefs about screening affect comprehension of the evidence of benefits and harms from screening and intentions to get screened. Young adults (N = 347) received information about a disease for which a screening test was available and numerical information about the benefits and harms from screening. Results showed that comprehension and perceptions of benefits are central to decisions; however, lay perceptions of harms along the screening cascade require further study. Numeracy, science literacy, and emotions can promote informed decision making by facilitating comprehension of the evidence. At the same time emotions and beliefs resulting from persuasive campaigns can have strong effects on screening intentions beyond the available evidence. To apply to screening procedures where informed decision making is recommended, theoretical models of screening decisions need to include comprehension of benefits and harms, and account for how cognitive skills, emotions, and beliefs influence comprehension and decisions. (PsycINFO Database Record

BACKGROUND: Cocaine dependence has been associated with alterations in the brain's white matter integrity, yet relevant questions remain about what alterations are linked to cocaine use and/or polysubstance use, and whether they are amenable to abstinence.METHODS: This study applied a single measurement session of diffusion tensor imaging (DTI) to examine white matter structure in male cocaine polysubstance users (n=37) versus male healthy controls (n=38), along with correlations between DTI measures and patterns of polysubstance use and duration of abstinence. Specifically, we conducted voxel-wise analyses of fractional anisotropy (FA) in the corpus callosum, frontolimbic, striatal and cingulate tracts relevant to drug sequelae.RESULTS: Cocaine polysubstance users, compared to controls, showed lower FA in the body of the corpus callosum, anterior cingulate, uncinate fasciculus and retrolenticular part of the internal capsule. Duration of cocaine use had a marginal negative association with FA in the corpus callosum, and duration of alcohol use was negatively associated with FA in the internal capsule and the uncinate fasciculus. Duration of cocaine abstinence was positively correlated with FA in the uncinate fasciculus, posterior cingulate and fornix-striatum. In the context of cocaine polysubstance use, chronicity of cocaine use is therefore likely to be associated with lower FA in the corpus callosum, and chronicity of alcohol use with lower FA in the frontal-striatal and frontal-limbic tracts. Longer abstinence was correlated to greater FA in frontal-striatal and frontal-limbic tracts, though the direction of causality remains unclear.CONCLUSION: Since the results did not survive multiple comparison-corrected thresholds, more studies are needed to confirm these indications.