Effects of Anacetrapib in Patients with Atherosclerotic Vascular Disease

BACKGROUND: Patients with atherosclerotic vascular disease remain at high risk for cardiovascular events despite effective statin-based treatment of low-density lipoprotein (LDL) cholesterol levels. The inhibition of cholesteryl ester transfer protein (CETP) by anacetrapib reduces LDL cholesterol levels and increases high-density lipoprotein (HDL) cholesterol levels. However, trials of other CETP inhibitors have shown neutral or adverse effects on cardiovascular outcomes. METHODS: We conducted a randomized, double-blind, placebo-controlled trial involving 30,449 adults with atherosclerotic vascular disease who were receiving intensive atorvastatin therapy and who had a mean LDL cholesterol level of 61 mg per deciliter (1.58 mmol per liter), a mean non-HDL cholesterol level of 92 mg per deciliter (2.38 mmol per liter), and a mean HDL cholesterol level of 40 mg per deciliter (1.03 mmol per liter). The patients were assigned to receive either 100 mg of anacetrapib once daily (15,225 patients) or matching placebo (15,224 patients). The primary outcome was the first major coronary event, a composite of coronary death, myocardial infarction, or coronary revascularization. RESULTS: During the median follow-up period of 4.1 years, the primary outcome occurred in significantly fewer patients in the anacetrapib group than in the placebo group (1640 of 15,225 patients [10.8%] vs. 1803 of 15,224 patients [11.8%]; rate ratio, 0.91; 95% confidence interval, 0.85 to 0.97; P=0.004). The relative difference in risk was similar across multiple prespecified subgroups. At the trial midpoint, the mean level of HDL cholesterol was higher by 43 mg per deciliter (1.12 mmol per liter) in the anacetrapib group than in the placebo group (a relative difference of 104%), and the mean level of non-HDL cholesterol was lower by 17 mg per deciliter (0.44 mmol per liter), a relative difference of -18%. There were no significant between-group differences in the risk of death, cancer, or other serious adverse events. CONCLUSIONS: Among patients with atherosclerotic vascular disease who were receiving intensive statin therapy, the use of anacetrapib resulted in a lower incidence of major coronary events than the use of placebo. (Funded by Merck and others; Current Controlled Trials number, ISRCTN48678192 ; ClinicalTrials.gov number, NCT01252953 ; and EudraCT number, 2010-023467-18 .)

High level influences on visual action recognition

Action recognition is important for social interactions. Because little is known about the visual tuning properties of processes involved in action recognition, we examined the visual tuning properties of action recognition by means of a behavioral adaptation paradigm. Participants were adapted to images showing a person hitting or waving and subsequently categorized test images showing an ambiguous action as either hitting or waving. We found the perception of the test images to be significantly biased away from the adapted action (action adaptation aftereffect (AAA)). Subsequent experiments ruled out that the AAA was not merely driven by the adaptation of local visual contrast or the emotional content of the action. However adaptation to action words (e.g. “hitting” or “waving”) did not induce an AAA. Finally we found evidence for the AAA being modulated by the social context in which an action is embedded, suggesting high level influences on action recognition

Investigating the influence of personal BMI on own body size perception in females using self-avatars

Previous research has suggested that inaccuracies in own body size estimation can largely be explained by a known error in perceived magnitude, called contraction bias (Cornelissen, Bester, Cairns, Tovée Cornelissen, 2015). According to this, own body size estimation is biased towards an average reference body, such that individuals with a low body mass index (BMI) should overestimate their body size and high BMI individuals should underestimate their body size. However, previous studies have mainly focused on self-body size evaluation of patients suffering from anorexia nervosa. In this study, we tested healthy females varying in BMI to investigate whether personal body size influences accuracy of body size estimation and sensitivity to weight changes, reproducing a scenario of standing in front of a full length mirror. We created personalized avatars with a 4D full-body scanning system that records participants’ body geometry and texture, and altered the weight of the avatars based on a statistical body model. In two psychophysical experiments, we presented the stimuli on a stereoscopic, large-screen immersive display, and asked participants to respond to whether the body they saw was their own. Additionally, we used several questionnaires to assess participants’ self-esteem, eating behavior, and their attitudes towards their body shape and weight. Our results show that participants, across the range of BMI, veridically perceived their own body size, contrary to what is suggested by the contraction bias hypothesis. Interestingly, we found that BMI influenced sensitivity to weight changes in the positive direction, such that people with higher BMIs were more willing to accept bigger bodies as their own. BMI did not influence sensitivity to weight changes in the negative direction

Visual adaptation aftereffects to actions are modulated by high-level action interpretations

Action recognition is critical for successful human interaction. Previous research highlighted the importance of the motor system to visual action recognition. Little is known about the visual tuning properties of processes involved in action recognition. Here we examined the visual tuning properties of processes involved in action recognition by means of a behavioral adaptation paradigm. Participants looked at an adaptor image (showing a person hitting or waving) for 4s and subsequently categorized a briefly presented test image as either hitting or waving. The test images were sampled from a video sequence showing a person moving from a hitting to a waving pose. We found the perception of the ambiguous test image to be significantly biased away from the adapted action (action adaptation aftereffect (AAA)). In subsequent experiments we investigated the origin of the AAA. The contrast inversion and mirror flipping of the adaptor image relative to the test images did not abolish the AAA suggesting that local contrastive sensitive units are not solely responsible for the AAA. Similarly the AAA was present when we chose adaptor images that were equated in terms of their emotional content indicating that the AAA is not merely mediated by units sensitive to the emotional content of an action. Moreover presenting words (e.g. "hitting" or "waving") instead of images as adaptors led to the disappearance of the AAA providing evidence that abstract high level linguistic cues about actions alone did not induce the AAA. Finally we changed the action interpretation of the adaptors leaving their physical properties unchanged by means of priming. We found that the priming of the action interpretation of the adaptors modulated the size of the AAA. Im summary these results suggest that mechanisms underlying action recognition are particularly sensitive to the high-level interpretation of an action

Untersuchung der Körperbildstörung bei Anorexia Nervosa mithilfe biometrischer Avatare in virtueller Realität

Hintergrund: Die Körperbildstörung ist ein Kernsymptom der Anorexia Nervosa (AN). Sie gilt als Indikator für eine schlechte Prognose, als schwierig zu therapieren und besteht oft auch nach Gewichtszunahme fort. Diese Studie verwendet individuelle 3D-Avatare, um folgende Forschungsfragen näher zu untersuchen: (1) Repräsentieren AN Patientinnen körperbezogene Informationen generell anders oder ist die Körperbildstörung rein selbstbezogen? (2) Ist die Körperbildstörung eher perzeptuell oder eher durch dysfunktionale Bewertungen charakterisiert? Methoden: Untersucht werden N=20 AN-Patientinnen, N=20 remittierte AN-Patientinnen und N=20 Kontrollprobandinnen. Von jeder Teilnehmerin wird auf Basis eines 3D-Körperscans ein individueller Avatar mit 9 verschiedenen BMI-Stufen gefertigt, nämlich aktueller BMI und +/- 5, 10, 15 und 20 BMI. Um die Rolle des Selbstbezugs zu bestimmen, wird basierend auf der Figur der Teilnehmerin eine zweite Avatar-Serie mit dem Aussehen einer fremden Person erstellt. Die Avatare werden in einer virtuelle Realität- Umgebung lebensgroß und in 3D präsentiert. Das Experiment folgt einem 2x2 gemischten Design mit den Faktoren Gruppe (AN versus Kontrolle) und Avatar-Serie (eigenes versus fremdes Aussehen), wobei es zwei unterschiedliche Aufgabenformate gibt: Im 2 Alternatives Forced Choice Task sieht die Teilnehmerin jeden Avatar 20 Mal für 2 Sekunden, anschließend muss sie entscheiden, ob dies der eigene bzw. richtige oder ein manipulierter Avatar war. Im Method of Adjustment Task soll die Teilnehmerin jeden der Avatare jeweils so verändern, dass er ihrem aktuellen bzw. dem richtigen Körper entspricht und zusätzlich jeweils so, dass er ihrem idealen Körper entspricht. Zusätzlich werden Selbstwert, Körperunzufriedenheit und Essstörungspathologie detailliert erfasst. Ergebnisse: Erste Ergebnisse von N=12 AN-Patientinnen zeigen für die Avatare mit eigenem Aussehen eine klare Neigung der Patientinnen, dünnere Avatare als den eigenen zu identifizieren bzw. einzustellen. Bei Avataren mit Aussehen einer fremden Person waren die AN-Patientinnen hingegen weitgehend akkurat. Bei den N=3 Kontrollprobanden zeigt sich zwar ein ähnliches Muster, jedoch deutlich weniger ausgeprägt. Diskussion: Unsere vorläufigen Ergebnisse weisen darauf hin, dass die Körperbildstörung bei AN-Patientinnen selbstbezogen und vor allem durch Bewertung charakterisiert ist und keine generell andere Wahrnehmung oder Verarbeitung von Körpern zugrunde liegt