The coronavirus disease 2019 (COVID-19) pandemic and the necessary spreading control measures implemented by the governments have induced drastic changes in daily life. The reduction in mobility and strict social contact limitations are posing a great challenge, particularly for the adolescents. The purpose of this study is to investigate the psychological and emotional impact of lockdown and their relationship with resilience, on adolescents and young adults listed for liver transplant or liver trans-plant recipient. Social and demographic variables of subjects (n=66) were collected and the analyses were based on the Depression Anxiety and Stress Scales (DASS-21), and Connor-Davidson Resilience Scale (CD-RISC 25), exploring the following areas: emotional states of depression, anxiety and stress; and resilience factors. A correlation between the measured degrees of depression/anxiety and resilience was evaluated by Pearson’s correlation coefficient and linear regression models. The results showed a significant correlation between subscales: DASS depression/anxiety (r2=0.62) depression/stress (r2=0.65) CD-RISC commitment/optimism (r2=0.71). The total score of DAAS depression/anxiety/stress scales significantly diminished at the increasing of CD-RISC total score. The inverse correlation between CD-RISC and DAAS seems to refer to the subscale of the relationship between DAAS depression and CDRISC (β= –0.33, P=0.006). Our findings suggest that resilience can be a protective factor for adolescent liver transplant recipients and liver transplant candidates in mitigating the onset of negative psychological symptoms correlated with the pandemic.

We describe a behavioral training protocol using visual perceptual learning (VPL) to improve visual detection skills in non-experts for subtle mammographic lesions indicative of breast cancer. This protocol can be adapted for the professional training of experts (radiologists) or to improve visual skills for other tasks, such as the detection of targets in photo or video surveillance. For complete details on the use and execution of this protocol, please refer to Frank et al. (2020a).

There have been long-standing debates regarding whether supervised or unsupervised learning mechanisms are involved in visual perceptual learning (VPL) [1-14]. However, these debates have been based on the effects of simple feedback only about response accuracy in detection or discrimination tasks of low-level visual features such as orientation [15-22]. Here, we examined whether the content of response feedback plays a critical role for the acquisition and long-term retention of VPL of complex natural images. We trained three groups of human subjects (n = 72 in total) to better detect "grouped microcalcifications'' or "architectural distortion'' lesions (referred to as calcification and distortion in the following) in mammograms either with no trial-by-trial feedback, partial trial-by-trial feedback (response correctness only), or detailed trial-by-trial feedback (response correctness and target location). Distortion lesions consist of more complex visual structures than calcification lesions [23-26]. We found that partial feedback is necessary for VPL of calcifications, whereas detailed feedback is required for VPL of distortions. Furthermore, detailed feedback during training is necessary for VPL of distortion and calcification lesions to be retained for 6 months. These results show that although supervised learning is heavily involved in VPL of complex natural images, the extent of supervision for VPL varies across different types of complex natural images. Such differential requirements for VPL to improve the detectability of lesions in mammograms are potentially informative for the professional training of radiologists.

Recent accounts of large-scale cortical organisation suggest that the default mode network (DMN) is positioned at the top of a principal gradient, reflecting the separation between heteromodal and unimodal sensory-motor regions in patterns of connectivity and in geodesic distance along the cortical surface (Margulies et al., 2016). This isolation of DMN from external inputs might allow the integration of disparate sources of information that can constrain subsequent cognition. We tested this hypothesis by manipulating the degree to which semantic decisions for ambiguous words (e.g. jam) were constrained by preceding visual cues depicting relevant spatial contexts (e.g. supermarket or road) and/or facial emotions (e.g. happy vs. frustrated). We contrasted (i) the effects of a single preceding cue with a no-cue condition employing scrambled images, and (ii) convergent spatial and emotion cues with single cues. Single cues elicited stronger activation in the multiple demand network relative to no cues, consistent with the requirement to maintain information in working memory. The availability of two convergent cues elicited stronger activation within DMN regions (bilateral angular gyrus, middle temporal gyrus, medial prefrontal cortex, and posterior cingulate), even though behavioural performance was unchanged by cueing – consequently task difficulty is unlikely to account for the observed differences in brain activation. A regions-of-interest analysis along the unimodal-to-heteromodal principal gradient revealed maximal activation for the convergent cue condition at the heteromodal end, corresponding to the DMN. Our findings are consistent with the view that regions of DMN support states of information integration that constrain ongoing cognition and provide a framework for understanding the location of these effects at the heteromodal end of the principal gradient.

Perceptual learning (PL) is not only a strong tool for understanding visual plasticity (Sasaki, Nanez and Watanabe, 2011; Watanabe & Sasaki, 2015) but also for reducing symptoms of eye diseases. Here, we show that PL can also be a strong tool to increase the detectability of breast cancers in mammography scans only if an appropriate response feedback during training is given for different types of breast cancer. Response feedback is known to facilitate PL (Herzog and Fahle, 1998; Shibata et al., 2011), although a detailed role of feedback remains unclear. We examined the role of response feedback for two types of breast cancer: calcification cancer and architectural distortion cancer. The former is easier to detect than the latter. Thus, we examined how different contents of feedback are effective on PL for different breast cancers. Three 30-min long training sessions were conducted on separate days. Detection performance was measured in pre-training and post-training tests. Three different groups of participants (N = 48 subjects in total) without medical training background were trained with different contents of feedback. In the detailed feedback condition, participants were given feedback regarding the location of cancer as well as the correctness of detection. In the partial feedback condition, participants were provided with feedback only about the correctness of detection. In the no feedback condition, participants received no feedback. In the detailed condition detectability improved for architectural distortion and calcification cancers, whereas in the partial feedback condition detectability improved only for calcification. No learning for either cancer was observed in the no feedback condition. These results suggest that PL significantly improves the detectability of breast cancers in mammograms. More importantly, the content of feedback leads to different learning outcomes for different breast cancers, indicating the importance of future studies on the effect of content of feedback on PL.

Detecting subtle lesions in mammograms indicative of early breast cancer usually requires years of experience. Well-designed training paradigms could be a strong tool for promoting perceptual learning (PL) with rapid and long-lasting improvement in detectability of these subtle mammographic lesions. Given that PL occurs without feedback about the accuracy of subjects’ responses, the role of feedback has been completely ignored in clinical applications of PL. However, in this study, we found that the contents of the feedback profoundly and differentially influence the formation and retention of PL to detect calcification and architectural distortion lesions, two types of mammographic lesions that are frequently missed in mammographic screenings. We trained subjects to detect one type of lesion in a mammogram and manipulated the content of the response feedback during training for 3 groups (no feedback, correctness only, and both correctness and location of the lesion). We found that PL occurred for both lesions when both correctness and location feedback were provided. PL also occurred for calcifications but not for distortions when only correctness was provided. No learning occurred without feedback for either lesion. A retest conducted six months later showed that PL was retained only in the group with both correctness and location feedback for both types of lesions. In contrast to the general consensus of basic PL studies, our results demonstrate that the content of the response feedback is a determining factor in forming and retaining PL to detect mammographic lesions.