Number concepts without number lines in an indigenous group of Papua New Guinea

Background

The generic concept of number line, which maps numbers to unidimensional space, is a fundamental concept in mathematics, but its cognitive origins are uncertain. Two defining criteria of the number line are that (i) there is a mapping of each individual number (or numerosity) under consideration onto a specific location on the line, and (ii) that the mapping defines a unidimensional space representing numbers with a metric — a distance function. It has been proposed that the number line is based on a spontaneous universal human intuition, rooted directly in brain evolution, that maps number magnitude to linear space with a metric. To date, no culture lacking this intuition has been documented.

Methodology/Principal Findings

By means of a number line task, we investigated the universality proposal with the Yupno of Papua New Guinea. Unschooled adults did exhibit a number-to-space mapping (criterion i) but, strikingly, despite having precise cardinal number concepts, they located numbers only on the endpoints, thus failing to use the extent of the line. The produced mapping was bi-categorical and metric-free, in violation of criterion ii. In contrast, Yupnos with scholastic experience used the extent of the segment according to known standards, but they did so not as evenly as western controls, exhibiting a bias towards the endpoints.

Conclusions/Significance

Results suggest that cardinal number concepts can exist independently from number line representations. They also suggest that the number line mapping, although ubiquitous in the modern world, is not universally spontaneous, but rather seems to be learned through — and continually reinforced by — specific cultural practices.     

Reduced Context Effects on Retrieval in First-Episode Schizophrenia

Background

A recent modeling study by the authors predicted that contextual information is poorly integrated into episodic representations in schizophrenia, and that this is a main cause of the retrieval deficits seen in schizophrenia.

Methodology/Principal Findings

We have tested this prediction in patients with first-episode schizophrenia and matched controls. The benefit from contextual cues in retrieval was strongly reduced in patients. On the other hand, retrieval based on item cues was spared.

Conclusions/Significance

These results suggest that reduced integration of context information into episodic representations is a core deficit in schizophrenia and one of the main causes of episodic memory impairment.     

A first- and second-order motion energy analysis of peripheral motion illusions leads to further evidence of "feature blur" in peripheral vision

Background

Anatomical and physiological differences between the central and peripheral visual systems are well documented. Recent findings have suggested that vision in the periphery is not just a scaled version of foveal vision, but rather is relatively poor at representing spatial and temporal phase and other visual features. Shapiro, Lu, Huang, Knight, and Ennis (2010) have recently examined a motion stimulus (the “curveball illusion”) in which the shift from foveal to peripheral viewing results in a dramatic spatial/temporal discontinuity. Here, we apply a similar analysis to a range of other spatial/temporal configurations that create perceptual conflict between foveal and peripheral vision.

Methodology/Principal Findings

To elucidate how the differences between foveal and peripheral vision affect super-threshold vision, we created a series of complex visual displays that contain opposing sources of motion information. The displays (referred to as the peripheral escalator illusion, peripheral acceleration and deceleration illusions, rotating reversals illusion, and disappearing squares illusion) create dramatically different perceptions when viewed foveally versus peripherally. We compute the first-order and second-order directional motion energy available in the displays using a three-dimensional Fourier analysis in the (x, y, t) space. The peripheral escalator, acceleration and deceleration illusions and rotating reversals illusion all show a similar trend: in the fovea, the first-order motion energy and second-order motion energy can be perceptually separated from each other; in the periphery, the perception seems to correspond to a combination of the multiple sources of motion information. The disappearing squares illusion shows that the ability to assemble the features of Kanisza squares becomes slower in the periphery.

Conclusions/Significance

The results lead us to hypothesize “feature blur” in the periphery (i.e., the peripheral visual system combines features that the foveal visual system can separate). Feature blur is of general importance because humans are frequently bringing the information in the periphery to the fovea and vice versa.     

Deficits in Implicit Attention to Social Signals in Schizophrenia and High Risk Groups: Behavioural Evidence from a New Illusion

Background

An increasing body of evidence suggests that the apparent social impairments observed in schizophrenia may arise from deficits in social cognitive processing capacities. The ability to process basic social cues, such as gaze direction and biological motion, effortlessly and implicitly is thought to be a prerequisite for establishing successful social interactions and for construing a sense of “social intuition.” However, studies that address the ability to effortlessly process basic social cues in schizophrenia are lacking. Because social cognitive processing deficits may be part of the genetic vulnerability for schizophrenia, we also investigated two groups that have been shown to be at increased risk of developing schizophrenia-spectrum pathology: first-degree relatives of schizophrenia patients and men with Klinefelter syndrome (47,XXY).

Results

We compared 28 patients with schizophrenia, 29 siblings of patients with schizophrenia, and 29 individuals with Klinefelter syndrome with 46 matched healthy control subjects on a new paradigm. This paradigm measures one''s susceptibility for a bias in distance estimation between two agents that is induced by the implicit processing of gaze direction and biological motion conveyed by these agents. Compared to control subjects, patients with schizophrenia, as well as siblings of patients and Klinefelter men, showed a lack of influence of social cues on their distance judgments.

Conclusions

We suggest that the insensitivity for social cues is a cognitive aspect of schizophrenia that may be seen as an endophenotype as it appears to be present both in relatives who are at increased genetic risk and in a genetic disorder at risk for schizophrenia-spectrum psychopathology. These social cue–processing deficits could contribute, in part, to the difficulties in higher order social cognitive tasks and, hence, to decreased social competence that has been observed in these groups.     

Sounds Move a Static Visual Object

Background

Vision provides the most salient information with regard to stimulus motion, but audition can also provide important cues that affect visual motion perception. Here, we show that sounds containing no motion or positional cues can induce illusory visual motion perception for static visual objects.

Methodology/Principal Findings

Two circles placed side by side were presented in alternation producing apparent motion perception and each onset was accompanied by a tone burst of a specific and unique frequency. After exposure to this visual apparent motion with tones for a few minutes, the tones became drivers for illusory motion perception. When the flash onset was synchronized to tones of alternating frequencies, a circle blinking at a fixed location was perceived as lateral motion in the same direction as the previously exposed apparent motion. Furthermore, the effect lasted at least for a few days. The effect was well observed at the retinal position that was previously exposed to apparent motion with tone bursts.

Conclusions/Significance

The present results indicate that strong association between sound sequence and visual motion is easily formed within a short period and that, after forming the association, sounds are able to trigger visual motion perception for a static visual object.     

Comparison of Total Variation with a Motion Estimation Based Compressed Sensing Approach for Self-Gated Cardiac Cine MRI in Small Animal Studies

Purpose

Compressed sensing (CS) has been widely applied to prospective cardiac cine MRI. The aim of this work is to study the benefits obtained by including motion estimation in the CS framework for small-animal retrospective cardiac cine.

Methods

We propose a novel B-spline-based compressed sensing method (SPLICS) that includes motion estimation and generalizes previous spatiotemporal total variation (ST-TV) methods by taking into account motion between frames. In addition, we assess the effect of an optimum weighting between spatial and temporal sparsity to further improve results. Both methods were implemented using the efficient Split Bregman methodology and were evaluated on rat data comparing animals with myocardial infarction with controls for several acceleration factors.

Results

ST-TV with optimum selection of the weighting sparsity parameter led to results similar to those of SPLICS; ST-TV with large relative temporal sparsity led to temporal blurring effects. However, SPLICS always properly corrected temporal blurring, independently of the weighting parameter. At acceleration factors of 15, SPLICS did not distort temporal intensity information but led to some artefacts and slight over-smoothing. At an acceleration factor of 7, images were reconstructed without significant loss of quality.

Conclusion

We have validated SPLICS for retrospective cardiac cine in small animal, achieving high acceleration factors. In addition, we have shown that motion modelling may not be essential for retrospective cine and that similar results can be obtained by using ST-TV provided that an optimum selection of the spatiotemporal sparsity weighting parameter is performed.     

Object Segmentation from Motion Discontinuities and Temporal Occlusions–A Biologically Inspired Model

Background

Optic flow is an important cue for object detection. Humans are able to perceive objects in a scene using only kinetic boundaries, and can perform the task even when other shape cues are not provided. These kinetic boundaries are characterized by the presence of motion discontinuities in a local neighbourhood. In addition, temporal occlusions appear along the boundaries as the object in front covers the background and the objects that are spatially behind it.

Methodology/Principal Findings

From a technical point of view, the detection of motion boundaries for segmentation based on optic flow is a difficult task. This is due to the problem that flow detected along such boundaries is generally not reliable. We propose a model derived from mechanisms found in visual areas V1, MT, and MSTl of human and primate cortex that achieves robust detection along motion boundaries. It includes two separate mechanisms for both the detection of motion discontinuities and of occlusion regions based on how neurons respond to spatial and temporal contrast, respectively. The mechanisms are embedded in a biologically inspired architecture that integrates information of different model components of the visual processing due to feedback connections. In particular, mutual interactions between the detection of motion discontinuities and temporal occlusions allow a considerable improvement of the kinetic boundary detection.

Conclusions/Significance

A new model is proposed that uses optic flow cues to detect motion discontinuities and object occlusion. We suggest that by combining these results for motion discontinuities and object occlusion, object segmentation within the model can be improved. This idea could also be applied in other models for object segmentation. In addition, we discuss how this model is related to neurophysiological findings. The model was successfully tested both with artificial and real sequences including self and object motion.     

Developmental changes in peanut root structure during root growth and root-structure modification by nodulation

Background and Aims

Basic information about the root and root nodule structure of leguminous crop plants is incomplete, with many aspects remaining unresolved. Peanut (Arachis hypogaea) forms root nodules in a unique process. Structures of various peanut root types were studied with emphasis on insufficiently characterized lateral roots, changes in roots during their ontogenesis and root modification by nodule formation.

Methods

Peanut plants were grown in the field, in vermiculite or in filter paper. The taproot, first-order and second-order lateral roots and root nodules were analysed using bright-field and fluorescence microscopy with hand sections and resin sections.

Key Results

Three root categories were recognized. The primary seminal root was thick, exhibiting early and intensive secondary thickening mainly on its base. It was tetrarch and contained broad pith. First-order lateral roots were long and thin, with limited secondary thickening; they contained no pith. Particularly different were second- and higher-order lateral roots, which were anatomically simple and thin, with little or no secondary growth. Unusual wall ingrowths were visible in the cells of the central part of the cortex in the first-order and second-order lateral roots. The nodule body was formed at the junction of the primary and lateral roots by the activity of proliferating cells derived originally from the pericycle.

Conclusions

Two morphologically and anatomically distinct types of lateral roots were recognized: long, first-order lateral roots, forming the skeleton of the root system, and thin and short second- and higher-order lateral roots, with an incomplete second state of endodermal development, which might be classified as peanut ‘feeder roots’. Formation of root nodules at the base of the lateral roots was the result of proliferating cell divisions derived originally from the pericycle.Key words: Endodermis, lateral root structure, nodule structure, peanut, Arachis hypogaea, primary root structure     

Establishing and Applying a Schistosomiasis Early Warning Index (SEWI) in the Lower Yangtze River Region of Jiangsu Province,China

Background

China has made remarkable progress in schistosomiasis control over the past decades. Transmission control has replaced morbidity control as the country moves towards the goal of elimination and the current challenge is to find a sensitive measure capable of gauging transmission risk in low-prevalence areas. The study aims to develop a Schistosomiasis Early Warning Index (SEWI) and demonstrate its use in Jiangsu Province along the lower Yangtze River.

Methodology/Principal Findings

The Delphi approach, a structured communication technique, was used to develop the SEWI. Two rounds of interviews with 30 public health experts specialized in schistosomiasis control were conducted using 40 indicators that reflected different aspects of schistosomiasis transmission and control. The necessity, feasibility, and sensitivity of each indicator were assessed and the weight value of each indicator determined based on these experts'' judgment. The system included 3 first-order indicators, 7 second-order indicators, and 30 third-order indicators. The 3 first-order indicators were endemic status, control measures, social and environmental factors, with the weight values 0.366, 0.343 and 0.291, respectively. For the 7 second-order indicators, the highest weight value was for control measures for snails (0.175) and the lowest for transmission route (0.110). We estimated and mapped the SEWI for endemic areas at the county scale in Jiangsu Province finding that the majority of the endemic areas were characterized as medium transmission risk (SEWI risk values between 0.3 and 0.6), while areas where transmission interruption had been officially declared showed SEWI values <0.30. A few isolated areas (e.g. endemic islands in the Yangtze River) produced SEWI values >0.60. These estimates are largely in agreement with the endemicity levels based on recent epidemiological surveys.

Conclusions/Significance

The SEWI should be useful for estimation of schistosomiasis transmission surveillance, particularly with reference to the elimination of the disease in China.     

Alternation of Sound Location Induces Visual Motion Perception of a Static Object

Background

Audition provides important cues with regard to stimulus motion although vision may provide the most salient information. It has been reported that a sound of fixed intensity tends to be judged as decreasing in intensity after adaptation to looming visual stimuli or as increasing in intensity after adaptation to receding visual stimuli. This audiovisual interaction in motion aftereffects indicates that there are multimodal contributions to motion perception at early levels of sensory processing. However, there has been no report that sounds can induce the perception of visual motion.

Methodology/Principal Findings

A visual stimulus blinking at a fixed location was perceived to be moving laterally when the flash onset was synchronized to an alternating left-right sound source. This illusory visual motion was strengthened with an increasing retinal eccentricity (2.5 deg to 20 deg) and occurred more frequently when the onsets of the audio and visual stimuli were synchronized.

Conclusions/Significance

We clearly demonstrated that the alternation of sound location induces illusory visual motion when vision cannot provide accurate spatial information. The present findings strongly suggest that the neural representations of auditory and visual motion processing can bias each other, which yields the best estimates of external events in a complementary manner.     

Cue-reactors: individual differences in cue-induced craving after food or smoking abstinence

Background

Pavlovian conditioning plays a critical role in both drug addiction and binge eating. Recent animal research suggests that certain individuals are highly sensitive to conditioned cues, whether they signal food or drugs. Are certain humans also more reactive to both food and drug cues?

Methods

We examined cue-induced craving for both cigarettes and food, in the same individuals (n = 15 adult smokers). Subjects viewed smoking-related or food-related images after abstaining from either smoking or eating.

Results

Certain individuals reported strong cue-induced craving after both smoking and food cues. That is, subjects who reported strong cue-induced craving for cigarettes also rated stronger cue-induced food craving.

Conclusions

In humans, like in nonhumans, there may be a “cue-reactive” phenotype, consisting of individuals who are highly sensitive to conditioned stimuli. This finding extends recent reports from nonhuman studies. Further understanding this subgroup of smokers may allow clinicians to individually tailor therapies for smoking cessation.     

Similarities and differences in Chinese and Caucasian adults' use of facial cues for trustworthiness judgments

Background

All cultural groups in the world place paramount value on interpersonal trust. Existing research suggests that although accurate judgments of another''s trustworthiness require extensive interactions with the person, we often make trustworthiness judgments based on facial cues on the first encounter. However, little is known about what facial cues are used for such judgments and what the bases are on which individuals make their trustworthiness judgments.

Methodology/Principal Findings

In the present study, we tested the hypothesis that individuals may use facial attractiveness cues as a “shortcut” for judging another''s trustworthiness due to the lack of other more informative and in-depth information about trustworthiness. Using data-driven statistical models of 3D Caucasian faces, we compared facial cues used for judging the trustworthiness of Caucasian faces by Caucasian participants who were highly experienced with Caucasian faces, and the facial cues used by Chinese participants who were unfamiliar with Caucasian faces. We found that Chinese and Caucasian participants used similar facial cues to judge trustworthiness. Also, both Chinese and Caucasian participants used almost identical facial cues for judging trustworthiness and attractiveness.

Conclusions/Significance

The results suggest that without opportunities to interact with another person extensively, we use the less racially specific and more universal attractiveness cues as a “shortcut” for trustworthiness judgments.     

Epithelium percentage estimation facilitates epithelial quantitative protein measurement in tissue specimens

Background

The rapid advancement of high-throughput tools for quantitative measurement of proteins has demonstrated the potential for the identification of proteins associated with cancer. However, the quantitative results on cancer tissue specimens are usually confounded by tissue heterogeneity, e.g. regions with cancer usually have significantly higher epithelium content yet lower stromal content.

Objective

It is therefore necessary to develop a tool to facilitate the interpretation of the results of protein measurements in tissue specimens.

Methods

Epithelial cell adhesion molecule (EpCAM) and cathepsin L (CTSL) are two epithelial proteins whose expressions in normal and tumorous prostate tissues were confirmed by measuring staining intensity with immunohistochemical staining (IHC). The expressions of these proteins were measured by ELISA in protein extracts from OCT embedded frozen prostate tissues. To eliminate the influence of tissue heterogeneity on epithelial protein quantification measured by ELISA, a color-based segmentation method was developed in-house for estimation of epithelium content using H&E histology slides from the same prostate tissues and the estimated epithelium percentage was used to normalize the ELISA results. The epithelium contents of the same slides were also estimated by a pathologist and used to normalize the ELISA results. The computer based results were compared with the pathologist’s reading.

Results

We found that both EpCAM and CTSL levels, measured by ELISA assays itself, were greatly affected by epithelium content in the tissue specimens. Without adjusting for epithelium percentage, both EpCAM and CTSL levels appeared significantly higher in tumor tissues than normal tissues with a p value less than 0.001. However, after normalization by the epithelium percentage, ELISA measurements of both EpCAM and CTSL were in agreement with IHC staining results, showing a significant increase only in EpCAM with no difference in CTSL expression in cancer tissues. These results were obtained with normalization by both the computer estimated and pathologist estimated epithelium percentage.

Conclusions

Our results show that estimation of tissue epithelium percentage using our color-based segmentation method correlates well with pathologists'' estimation of tissue epithelium percentages. The epithelium contents estimated by color-based segmentation may be useful in immuno-based analysis or clinical proteomic analysis of tumor proteins. The codes used for epithelium estimation as well as the micrographs with estimated epithelium content are available online.     

Metabolic robustness and network modularity: a model study

Background

Several studies have mentioned network modularity—that a network can easily be decomposed into subgraphs that are densely connected within and weakly connected between each other—as a factor affecting metabolic robustness. In this paper we measure the relation between network modularity and several aspects of robustness directly in a model system of metabolism.

Methodology/Principal Findings

By using a model for generating chemical reaction systems where one can tune the network modularity, we find that robustness increases with modularity for changes in the concentrations of metabolites, whereas it decreases with changes in the expression of enzymes. The same modularity scaling is true for the speed of relaxation after the perturbations.

Conclusions/Significance

Modularity is not a general principle for making metabolism either more or less robust; this question needs to be addressed specifically for different types of perturbations of the system.     

Effect of Village-wide Use of Long-Lasting Insecticidal Nets on Visceral Leishmaniasis Vectors in India and Nepal: A Cluster Randomized Trial

Background

Visceral leishmaniasis (VL) control in the Indian subcontinent is currently based on case detection and treatment, and on vector control using indoor residual spraying (IRS). The use of long-lasting insecticidal nets (LN) has been postulated as an alternative or complement to IRS. Here we tested the impact of comprehensive distribution of LN on the density of Phlebotomus argentipes in VL-endemic villages.

Methods

A cluster-randomized controlled trial with household P. argentipes density as outcome was designed. Twelve clusters from an ongoing LN clinical trial—three intervention and three control clusters in both India and Nepal—were selected on the basis of accessibility and VL incidence. Ten houses per cluster selected on the basis of high pre-intervention P. argentipes density were monitored monthly for 12 months after distribution of LN using CDC light traps (LT) and mouth aspiration methods. Ten cattle sheds per cluster were also monitored by aspiration.

Findings

A random effect linear regression model showed that the cluster-wide distribution of LNs significantly reduced the P. argentipes density/house by 24.9% (95% CI 1.80%–42.5%) as measured by means of LTs.

Interpretation

The ongoing clinical trial, designed to measure the impact of LNs on VL incidence, will confirm whether LNs should be adopted as a control strategy in the regional VL elimination programs. The entomological evidence described here provides some evidence that LNs could be usefully deployed as part of the VL control program.

Trial registration

ClinicalTrials.gov CT-2005-015374     

Effect of pictorial depth cues, binocular disparity cues and motion parallax depth cues on lightness perception in three-dimensional virtual scenes

Background

Surface lightness perception is affected by scene interpretation. There is some experimental evidence that perceived lightness under bi-ocular viewing conditions is different from perceived lightness in actual scenes but there are also reports that viewing conditions have little or no effect on perceived color. We investigated how mixes of depth cues affect perception of lightness in three-dimensional rendered scenes containing strong gradients of illumination in depth.

Methodology/Principal Findings

Observers viewed a virtual room (4 m width×5 m height×17.5 m depth) with checkerboard walls and floor. In four conditions, the room was presented with or without binocular disparity (BD) depth cues and with or without motion parallax (MP) depth cues. In all conditions, observers were asked to adjust the luminance of a comparison surface to match the lightness of test surfaces placed at seven different depths (8.5–17.5 m) in the scene. We estimated lightness versus depth profiles in all four depth cue conditions. Even when observers had only pictorial depth cues (no MP, no BD), they partially but significantly discounted the illumination gradient in judging lightness. Adding either MP or BD led to significantly greater discounting and both cues together produced the greatest discounting. The effects of MP and BD were approximately additive. BD had greater influence at near distances than far.

Conclusions/Significance

These results suggest the surface lightness perception is modulated by three-dimensional perception/interpretation using pictorial, binocular-disparity, and motion-parallax cues additively. We propose a two-stage (2D and 3D) processing model for lightness perception.     

Why Publishing Everything Is More Effective than Selective Publishing of Statistically Significant Results

Background

De Winter and Happee [1] examined whether science based on selective publishing of significant results may be effective in accurate estimation of population effects, and whether this is even more effective than a science in which all results are published (i.e., a science without publication bias). Based on their simulation study they concluded that “selective publishing yields a more accurate meta-analytic estimation of the true effect than publishing everything, (and that) publishing nonreplicable results while placing null results in the file drawer can be beneficial for the scientific collective” (p.4).

Methods and Findings

Using their scenario with a small to medium population effect size, we show that publishing everything is more effective for the scientific collective than selective publishing of significant results. Additionally, we examined a scenario with a null effect, which provides a more dramatic illustration of the superiority of publishing everything over selective publishing.

Conclusion

Publishing everything is more effective than only reporting significant outcomes.     

Peeling Plaids Apart: Context Counteracts Cross-Orientation Contrast Masking

Background

Contrast discrimination for an image is usually harder if another image is superimposed on top. We asked whether such contrast masking may be enhanced or relieved depending on cues promoting integration of both images as a single pattern, versus segmentation into two independent components.

Methodology & Principal Findings

Contrast discrimination thresholds for a foveal test grating were sharply elevated in the presence of a perfectly overlapping orthogonally-oriented mask grating. However thresholds returned to the unmasked baseline when a surround grating was added, having the same orientation and phase of either the test or mask grating. Both such masking and ‘unmasking’ effects were much stronger for moving than static stimuli.

Conclusions & Significance

Our results suggest that common-fate motion reinforces the perception of a single coherent plaid pattern, while the surround helps to identify each component independently, thus peeling the plaid apart again. These results challenge current models of early vision, suggesting that higher-level surface organization influences contrast encoding, determining whether the contrast of a grating may be recovered independently from that of its mask.     

Quantifying the Role of Adverse Events in the Mortality Difference between First and Second-Generation Antipsychotics in Older Adults: Systematic Review and Meta-Synthesis

Background

Observational studies have reported higher mortality among older adults treated with first-generation antipsychotics (FGAs) versus second-generation antipsychotics (SGAs). A few studies examined risk for medical events, including stroke, ventricular arrhythmia, venous thromboembolism, myocardial infarction, pneumonia, and hip fracture.

Objectives

1) Review robust epidemiologic evidence comparing mortality and medical event risk between FGAs and SGAs in older adults; 2) Quantify how much these medical events explain the observed mortality difference between FGAs and SGAs.

Data sources

Pubmed and Science Citation Index.

Study eligibility criteria, participants, and interventions

Studies of antipsychotic users that: 1) evaluated mortality or medical events specified above; 2) restricted to populations with a mean age of 65 years or older 3) compared FGAs to SGAs, or both to a non-user group; (4) employed a “new user” design; (5) adjusted for confounders assessed prior to antipsychotic initiation; (6) and did not require survival after antipsychotic initiation. A separate search was performed for mortality estimates associated with the specified medical events.

Study appraisal and synthesis methods

For each medical event, we used a non-parametric model to estimate lower and upper bounds for the proportion of the mortality difference—comparing FGAs to SGAs—mediated by their difference in risk for the medical event.

Results

We provide a brief, updated summary of the included studies and the biological plausibility of these mechanisms. Of the 1122 unique citations retrieved, we reviewed 20 observational cohort studies that reported 28 associations. We identified hip fracture, stroke, myocardial infarction, and ventricular arrhythmias as potential intermediaries on the causal pathway from antipsychotic type to death. However, these events did not appear to explain the entire mortality difference.

Conclusions

The current literature suggests that hip fracture, stroke, myocardial infarction, and ventricular arrhythmias partially explain the mortality difference between SGAs and FGAs.     

Clarifying the Use of Aggregated Exposures in Multilevel Models: Self-Included vs. Self-Excluded Measures

Background

Multilevel analyses are ideally suited to assess the effects of ecological (higher level) and individual (lower level) exposure variables simultaneously. In applying such analyses to measures of ecologies in epidemiological studies, individual variables are usually aggregated into the higher level unit. Typically, the aggregated measure includes responses of every individual belonging to that group (i.e. it constitutes a self-included measure). More recently, researchers have developed an aggregate measure which excludes the response of the individual to whom the aggregate measure is linked (i.e. a self-excluded measure). In this study, we clarify the substantive and technical properties of these two measures when they are used as exposures in multilevel models.

Methods

Although the differences between the two aggregated measures are mathematically subtle, distinguishing between them is important in terms of the specific scientific questions to be addressed. We then show how these measures can be used in two distinct types of multilevel models—self-included model and self-excluded model—and interpret the parameters in each model by imposing hypothetical interventions. The concept is tested on empirical data of workplace social capital and employees'' systolic blood pressure.

Results

Researchers assume group-level interventions when using a self-included model, and individual-level interventions when using a self-excluded model. Analytical re-parameterizations of these two models highlight their differences in parameter interpretation. Cluster-mean centered self-included models enable researchers to decompose the collective effect into its within- and between-group components. The benefit of cluster-mean centering procedure is further discussed in terms of hypothetical interventions.

Conclusions

When investigating the potential roles of aggregated variables, researchers should carefully explore which type of model—self-included or self-excluded—is suitable for a given situation, particularly when group sizes are relatively small.