When does size not matter? Effects of stimulus size on affective modulation

Motivationally relevant stimuli have been shown to receive prioritized processing compared to neutral stimuli at distinct processing stages. This effect has been related to the evolutionary importance of rapidly detecting dangers and potential rewards and has been shown to be modulated by the distance between an organism and a faced stimulus. Similarly, recent studies showed degrees of emotional modulation of autonomic responses and subjective arousal ratings depending on stimulus size. In the present study, affective modulation of pictures presented in different sizes was investigated by measuring event-related potentials during a two-choice categorization task. Results showed significant emotional modulation across all sizes at both earlier and later stages of processing. Moreover, affective modulation of earlier processes was reduced in smaller compared to larger sizes, whereas no changes in affective modulation were observed at later stages.     

How did cells get their size?

Cells exercise size homeostasis, and the origins of their ability to do so is the topic of this essay. Before there were cells, there were protocells. The most basic questions about protocells as objects are: What were they made of, and how big were they? Asking how big they were implies that the answer to the first part includes a boundary. The best candidate for that boundary is a self-assembling lipid bilayer. Therefore, protocells are defined here as Darwinian liposomes-bilayer vesicles with mutable on-board replicases linked to phenotypes. Because liposomes undergo spontaneous fission and fusion, and are subject to osmotic forces, size regulation in the earliest protocells would essentially have been liposome physics. For successful protocells, averting osmotic lysis would have been the first order of business. However, from the outset size mattered too, because of sex and reproduction (i.e., genome mixing and genome copying in entities with phenotypes). Protocell fission and fusion would have blended seamlessly into protocell sex and reproduction, making any gene product that furnished control over protocell size changes doubly adaptive. A recurrent theme is the feedback role of bilayer tension in protocell size control. Ways in which primitive peptides and their aggregates (e.g., channels) might have allowed liposomes to gain improved volume and surface area homeostasis are suggested. Domain-swapped proteins that polymerize as filaments are discussed as the origin of cytoskeleton structures that diversify and stabilize liposome shapes and sizes. Throughout, attention is paid to the question of set points for cell size.     

Manual size estimation: a neuropsychological measure of perception?

Manual size estimation (participants indicate the size of an object with index finger and thumb) is often interpreted as a measure of perceptual size information in the visual system, in contrast to size information used by the motor system in visually guided grasping. Because manual estimation is a relatively new measure, I compared it to a more traditional perceptual measure (method of adjustment). Manual estimation showed larger effects of the Ebbinghaus (or Titchener) illusion than the traditional perceptual measure. This inconsistency can be resolved by taking into account that manual estimation is also unusually responsive to a physical variation of size. If we correct for the effect of physical size, manual estimation and the traditional perceptual measure show similar illusion effects. Most interestingly, the corrected illusion effects are also similar to the illusion effects found in grasping. This suggests that the same neuronal signals which generate the illusion in the traditional perceptual measure are also responsible for the effects of the illusion on manual estimation and on grasping.     

The effect size statistic: useful in health outcomes research ?

An increasing array of health status instruments provides challenges to the researcher in selecting the most appropriate measure in health outcomes studies. The responsiveness of a measure is its ability to identify small but important changes over time or following interventions. For health outcomes studies, responsiveness is an important psychometric requirement to guide instrument selection and it can be evaluated using the effect size statistic. The calculation and meaning of effect sizes are described here. Effect size considerations can also contribute to other topics of importance to health researchers. Issues of power and statistical and clinical significance are discussed.     

Is patient size important in dose determination and optimization in cardiology?

Patient dose determination and optimization have become more topical in recent years with the implementation of the Medical Exposures Directive into national legislation, the Ionising Radiation (Medical Exposure) Regulations. This legislation incorporates a requirement for new equipment to provide a means of displaying a measure of patient exposure and introduces the concept of diagnostic reference levels. It is normally assumed that patient dose is governed largely by patient size; however, in cardiology, where procedures are often very complex, the significance of patient size is less well understood. This study considers over 9000 cardiology procedures, undertaken throughout the north of England, and investigates the relationship between patient size and dose. It uses simple linear regression to calculate both correlation coefficients and significance levels for data sorted by both room and individual clinician for the four most common examinations, left ventrical and/or coronary angiography, single vessel stent insertion and single vessel angioplasty. This paper concludes that the correlation between patient size and dose is weak for the procedures considered. It also illustrates the use of an existing method for removing the effect of patient size from dose survey data. This allows typical doses and, therefore, reference levels to be defined for the purposes of dose optimization.     

Meaning-making and the matrix model: does one size really fit all?

Despite the multifocal complexity of the matrix model (C.R. Snyder & T.R. Elliott, this issue, pp. 1033-1054), its close correspondence with the theoretical dialectics and philosophy of clinical constructivism auger well for its capacity to articulate with existing approaches to graduate education in psychology. In this article points of contact are documented between the two approaches, and a caveat is included about the limits of the matrix model in ensuring greater relevance of clinical training to the settings in which contemporary professionals will work.     

Influence of β-tricalcium phosphate granule size and morphology on tissue reaction in vivo

In this study the tissue reaction to five different β-tricalcium phosphate (β-TCP)-based bone substitute materials differing only in size, shape and porosity was analyzed over 60 days, at 3, 10, 15, 30 and 60 days after implantation. Using the subcutaneous implantation model in Wistar rats both the inflammatory response within the implantation bed and the resulting vascularization of the biomaterials were qualitatively and quantitatively assessed by means of standard and special histological staining methods. The data from this study showed that all investigated β-TCP bone substitutes induced the formation of multinucleated giant cells. Changes in size, shape and porosity influenced the integration of the biomaterials within the implantation bed and the formation of tartrate-resistant acid phosphatase (TRAP)-positive and TRAP-negative multinucleated giant cells, as well as the rate of vascularization. While a high porosity generally allowed cell and fiber in-growth within the center of the bone substitute, a lower porosity resulted in a mosaic-like integration of the materials, with the granules serving as place holders. The number of multinucleated giant cells located in the implantation bed positively correlated with the vascularization rate. These data emphasize that all biomaterials investigated were capable of inducing the formation of TRAP-positive multinucleated giant cells as a sign of biomaterial stability. Furthermore, these cells directly influenced vascularization by secretion of vascular endothelial growth factor (VEGF), as well as other chemokines. Based on these findings, the role of multinucleated giant cells in the foreign body reaction to biomaterials might need to be reconsidered. This study demonstrates that variations in the physical properties of a bone substitute material clearly influence the (extent of the) inflammatory reaction and its consequences.     

What is the pelvic lymph node normal size? Determination from normal MRI examinations

Purpose

There are few previous reports on maximal pelvic lymph node sizes and no data on normal mesorectal nodes. Therefore, the aim of the study was to estimate the normal size of pelvic lymph nodes and to determine the upper limits of the normal range.

Materials and methods

Pelvic magnetic resonance imaging (MRI) examinations were prospectively carried out using a Intera 1.5 T magnet (Philips, the Netherlands), on 36 healthy volunteers (22 females, 14 males, mean age 25 years). A balanced fast field echo (b-FFE) sequence was used with the following parameters: 3-mm-thick contiguous slice, matrix 512 × 512. Short axis diameters of pelvic and inguinal lymph nodes were measured in each anatomic territory (internal iliac, external iliac, common iliac, mesorectum and inguinal). After normalization of the measurements, the influences of age, gender, laterality and territory were evaluated. Upper limits (95th percentile) were then calculated.

Results

A total of 1147 lymph nodes were measured. Age, gender and side (right/left) had no significant influence on size. The upper limits of the normal range were, respectively, 5.3, 4.4, 6.3 and 3.9 mm for the external and common iliac, internal iliac, inguinal and mesorectum nodes.

Conclusion

This work presents maximal normal values for each pelvic area, and the values for mesorectum nodes are reported for the first time.

Advances in knowledge

The mesorectum nodes should be considered as abnormal when they are over 4 mm in short diameter. For the other node areas, the upper limits of the normal range were, respectively, 6, 6, 5, 7 mm for the external and common iliac, internal, iliac and inguinal nodes for the short axis.

     

Are endocasts good proxies for brain size and shape in archosaurs throughout ontogeny?

Cranial endocasts, or the internal molds of the braincase, are a crucial correlate for investigating the neuroanatomy of extinct vertebrates and tracking brain evolution through deep time. Nevertheless, the validity of such studies pivots on the reliability of endocasts as a proxy for brain morphology. Here, we employ micro‐computed tomography imaging, including diffusible iodine‐based contrast‐enhanced CT, and a three‐dimensional geometric morphometric framework to examine both size and shape differences between brains and endocasts of two exemplar archosaur taxa – the American alligator (Alligator mississippiensis) and the domestic chicken (Gallus gallus). With ontogenetic sampling, we quantitatively evaluate how endocasts differ from brains and whether this deviation changes during development. We find strong size and shape correlations between brains and endocasts, divergent ontogenetic trends in the brain‐to‐endocast correspondence between alligators and chickens, and a comparable magnitude between brain–endocast shape differences and intraspecific neuroanatomical variation. The results have important implications for paleoneurological studies in archosaurs. Notably, we demonstrate that the pattern of endocranial shape variation closely reflects brain shape variation. Therefore, analyses of endocranial morphology are unlikely to generate spurious conclusions about large‐scale trends in brain size and shape. To mitigate any artifacts, however, paleoneurological studies should consider the lower brain–endocast correspondence in the hindbrain relative to the forebrain; higher size and shape correspondences in chickens than alligators throughout postnatal ontogeny; artificially ‘pedomorphic’ shape of endocasts relative to their corresponding brains; and potential biases in both size and shape data due to the lack of control for ontogenetic stages in endocranial sampling.     

Ultrasound-guided fine-needle aspiration of thyroid nodules: does the size limit its efficiency?

Purpose: The management criterion of thyroid nodules is to evaluate the risk of malignancy, based on cytological examinations. Ultrasound-guided fine-needle aspiration biopsy (US-FNAB) has a highly diagnostic value for thyroid nodules. The aim of this study was to compare the efficacy of US-FNAB for thyroid nodules with different sizes. Material and methods: From August 2013 to November 2013, 344patients with thyroid nodules who had undergone US-FNAB were divided into three groups, according to the largest diameter of their nodules (group A, ≤ 5.0 mm; group B, 5.1-10.0 mm; group C, > 10.0 mm). All the nodules were subsequently verified by histology or follow-up findings. The accuracy, sensitivity, specificity, positive predictive value, negative predictive value of aspiration cytology in each group was compared. Results: Among 344 thyroid nodules diagnosed by cytology, the cytology was classified as nondiagnostic or unsatisfactory for 53 (15.4%) lesions, benign for 144 (41.9%) lesions, atypia of undetermined significance or follicular lesion of undetermined significance for 20 (5.8%) lesions, follicular neoplasm or suspicious for a follicular neoplasm for 26 (7.6%) lesions, suspicious for malignancy for 36 (10.5%) lesions, malignant for 65 (18.9%) lesions. There were 243 benign and 101 malignant nodules confirmed by the pathological or follow-up ultrasound. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were confirmed to be 87.5% (14/16), 92.5% (37/40), 91% (51/56), 82.3% (14/17), and 94.8% (37/39) in group A; 92.3% (36/39), 96.9% (94/97), 95.5% (130/136), 92.3% (36/39), and 96.9% (94/97) in group B; and 91.3% (42/46), 93.4% (99/106), 92.7% (141/152) 85.7% (42/49), and 96.1% (99/103), in group C. There were no statistical differences in accuracy, sensitivity, specificity, false positive accuracy, false negative rate of fine needle aspiration of thyroid nodules with different sizes (P > 0.05). Conclusion: US-FNAB has similar diagnostic efficacy to thyroid nodules with different sizes.     

The muscle fiber type–fiber size paradox: hypertrophy or oxidative metabolism?

An inverse relationship exists between striated muscle fiber size and its oxidative capacity. This relationship implies that muscle fibers, which are triggered to simultaneously increase their mass/strength (hypertrophy) and fatigue resistance (oxidative capacity), increase these properties (strength or fatigue resistance) to a lesser extent compared to fibers increasing either of these alone. Muscle fiber size and oxidative capacity are determined by the balance between myofibrillar protein synthesis, mitochondrial biosynthesis and degradation. New experimental data and an inventory of critical stimuli and state of activation of the signaling pathways involved in regulating contractile and metabolic protein turnover reveal: (1) higher capacity for protein synthesis in high compared to low oxidative fibers; (2) competition between signaling pathways for synthesis of myofibrillar proteins and proteins associated with oxidative metabolism; i.e., increased mitochondrial biogenesis via AMP-activated protein kinase attenuates the rate of protein synthesis; (3) relatively higher expression levels of E3-ligases and proteasome-mediated protein degradation in high oxidative fibers. These observations could explain the fiber type–fiber size paradox that despite the high capacity for protein synthesis in high oxidative fibers, these fibers remain relatively small. However, it remains challenging to understand the mechanisms by which contractile activity, mechanical loading, cellular energy status and cellular oxygen tension affect regulation of fiber size. Therefore, one needs to know the relative contribution of the signaling pathways to protein turnover in high and low oxidative fibers. The outcome and ideas presented are relevant to optimizing treatment and training in the fields of sports, cardiology, oncology, pulmonology and rehabilitation medicine.     

Does practice size matter? Review of effects on quality of care in primary care

Background

There is a trend towards consolidating smaller primary care practices into larger practices worldwide. However, the effects of practice size on quality of care remain unclear.

Aim

This review aims to systematically appraise the effects of practice size on the quality of care in primary care.

Design and setting

A systematic review and narrative synthesis of studies examining the relationship between practice size and quality of care in primary care.

Method

Quantitative studies that focused on primary care practices or practitioners were identified through PubMed, CINAHL, Embase, Cochrane Library, CRD databases, ProQuest dissertations and theses, conference proceedings, and MedNar databases, as well as the reference lists of included studies. Independent variables were team or list size; outcome variables were measures of clinical processes, clinical outcomes, or patient-reported outcomes. A narrative synthesis of the results was conducted.

Results

The database search yielded 371 articles, of which 34 underwent quality assessment, and 17 articles (13 cross-sectional studies) were included. Ten studies examined the association of practice size and clinical processes, but only five found associations of larger practices with selected process measures such as higher specialist referral rates, better adherence to guidelines, higher mammography rates, and better monitoring of haemoglobin A1c. There were mixed results for cytology and pneumococcal coverage. Only one of two studies on clinical outcomes found an effect of larger practices on lower random haemoglobin A1 value. Of the three studies on patient-reported outcomes, smaller practices were consistently found to be associated with satisfaction with access, but evidence was inconsistent for other patient-reported outcomes evaluated.

Conclusion

There is limited evidence to support an association between practice size and quality of care in primary care.     

Ocular accommodation and cognitive demand: An additional indicator besides pupil size and cardiovascular measures?

Background  

The aim of the present study was to assess accommodation as a possible indicator of changes in the autonomic balance caused by altered cognitive demand. Accounting for accommodative responses from a human factors perspective may be motivated by the interest of designing virtual image displays or by establishing an autonomic indicator that allows for remote measurement at the human eye. Heart period, pulse transit time, and the pupillary response were considered as reference for possible closed-loop accommodative effects. Cognitive demand was varied by presenting monocularly numbers at a viewing distance of 5 D (20 cm) which had to be read, added or multiplied; further, letters were presented in a "n-back" task.