基于机体反馈调控保护扭转肿瘤治疗思路

肿瘤的临床治疗经过漫长积极探索研究,中西医疗效均未取得成就性突破,本文穿越时空隧道,基于人类亿万年适应环境生存生物进化历程形成的精细反馈调控保护视角,循证机体实施反馈调控保护顽强延续生命依据,结合肿瘤病理生理机制,剖析肿瘤形成原因,追溯肿瘤临床治疗误区,扭转肿瘤治疗思路,引领肿瘤治疗新路径。     

Perceptual strength is different from sensorimotor strength: Evidence from the centre–periphery asymmetry in masked priming

Near-threshold prime stimuli can facilitate or hinder responses to target stimuli, creating either a positive compatibility effect (PCE) or a negative compatibility effect (NCE). An asymmetry has been reported between primes presented in near periphery, which produced a PCE, and foveal primes, which produced an NCE under comparable conditions. This asymmetry has been attributed to the difference in retinal sensitivity, but it remains unclear whether this means that equating discrimination performance for primes in fovea and periphery, in order to account for differences in perceptual sensitivity, would make the priming effects the same. Wider work indicates that perceptual ability can dissociate from visuomotor effects, predicting that equating perceptual ability for fovea and periphery would not equate priming. We tested these opposite possibilities by matching discrimination performance for masked Gabor patches in fovea and near periphery (6°) and using these as primes in a masked priming paradigm expected to elicit NCEs. We found the asymmetry remained: NCE for fovea and PCE for periphery. We replicated this with both blocked and randomized procedures to check for attentional effects. We conclude that equating perceptual strength (discriminability) of stimuli does not equate their sensorimotor impact due to differences in the relative importance of different visual pathways and differing temporal dynamics in perceptual and sensorimotor processes.     

Human performance on negative slope schedules of points exchangeable for money: a failure of molar maximization

Panel pressing was generated and maintained in 5 adult humans by schedules of points exchangeable for money. Following exposure to a variable-interval 30-s schedule and to a linear variable-interval 30-s schedule (which permitted points to accumulate in an unseen "store" in the absence of responding), subjects were exposed to a series of conditions with a point-subtraction contingency arranged conjointly with the linear variable-interval schedule. Specifically, points were added to the store according to the linear-variable interval 30-s schedule and were subtracted from the store according to a ratio schedule. Ratio value varied across conditions and was determined individually for each subject such that the subtraction contingency would result in an approximately 50% reduction in the rate of point delivery. Conditions that included the subtraction contingency were termed negative slope schedules because the feedback functions were negatively sloped across all response rates greater than the inverse of the variable-interval schedule, in this case, two per minute. Overall response rates varied inversely with the subtraction ratio, indicating sensitivity to the negative slope conditions, but were in excess of that required by accounts based on strict maximization of overall reinforcement rate. Performance was also not well described by a matching-based account. Detailed analyses of response patterning revealed a consistent two-state pattern in which bursts of high-rate responding alternated with periods of prolonged pausing, perhaps reflecting the joint influence of local and overall reinforcement rates.     

Interpreting the uninterpretable: The effect of self-esteem on the interpretation of meaningless feedback

People often seek out and retain positive information about themselves via self-enhancement processes. Under other circumstances, they seek out and retain self-confirmatory information via self-verification processes. Research on both of these self-evaluation processes has been based heavily on domains such as social skills, in which people have a large database of prior information that presumably influences the way in which incoming self-relevant information is interpreted. In the present research, participants were asked to evaluate themselves on a set of imaginary "pseudotraits" to investigate how self-esteem influences the self-evaluation process when prior information is unavailable. Participants who had been identified through pre-testing as either high or low in self-esteem received false feedback on five pseudotraits (e.g., "casortic"), after which they evaluated the favorability of this feedback. High self-esteem participants tended to view their feedback as favorable, whereas low self-esteem participants did not.     

Interlimb coordination following stroke

Studies investigating whether simultaneous bilateral movements can facilitate performance of the impaired limb(s) of stroke patients have returned mixed results. In the present study we compared unilateral limb performance (amplitude, cycle duration) with performance during an interlimb coordination task involving both homologous (both arms, both legs) and non-homologous (one arm, one leg) limbs in stroke participants (n=7) and healthy age-matched controls (n=7). In addition, the effect of on-line augmented visual feedback on interlimb coordination was investigated. Participants performed cyclical flexion-extension movements of the arms and legs in the sagittal plane paced by an auditory metronome (1 Hz). Movement amplitudes were larger and cycle durations shorter during homologous limb coordination than non-homologous coordination. Compared with unilateral movements both groups had reduced movement amplitudes and the stroke group increased cycle duration when interlimb coordination tasks were performed. These effects were most evident during non-homologous (arm and leg) coordination. No evidence of facilitation of the impaired limb(s) was found in any of the interlimb coordination conditions. Augmented visual feedback had minimal effect on the movements of control participants but lead to an increase of cycle duration for stroke participants.     

Preintervention analysis and improvement of customer greeting in a restaurant

We examined customer greeting by employees at one location of a sandwich restaurant chain. First, a preintervention analysis was conducted to determine the conditions under which greeting a customer within 3 s of his or her entry into the restaurant did and did not occur. Results suggested that an appropriate customer greeting was most likely to occur when a door chime was used to indicate that a customer had entered the store and when the store manager was present behind the service counter. Next, a performance improvement intervention, which consisted of the combination of the use of a door chime and manager presence, was evaluated. Results showed that during baseline, a mean of 6% of customers were greeted; during intervention a mean of 63% of customers were greeted. The addition of manager-delivered verbal and graphic group feedback resulted in 100% of customers being greeted across two consecutive sessions.     

Evaluating a more cost-efficient alternative to providing in-home feedback to parents: the use of spousal feedback.

We evaluated the contribution of spousal feedback to a parent education curriculum designed for parents of children with autism. A modified multiple baseline design across 3 husband-and-wife dyads was used to examine the effects of teaching parents to give each other feedback on their teaching performance. For 5 of 6 participants, improvement in teaching performance occurred following didactic presentations. However, additional improvement was observed for 5 participants when the spousal feedback component was implemented.     

USING NUMBER LINE PROCEDURES AND PEER TUTORING TO IMPROVE THE MATHEMATICS COMPUTATION OF LOW-PERFORMING FIRST GRADERS

Recommendations for mathematics instruction frequently include the use of manipulatives as a critical component. There are few experimental analyses of teaching strategies involving the use of manipulatives (e.g., the number line). This investigation used a multiple baseline design across three groups of students to examine the effectiveness of an experimental procedure for improving low-performing children's skills in solving missing addend arithmetic problems using the number line. To address concerns about inadequate time for instruction and insufficient practice in most mathematics instruction, trained peer tutors implemented the procedure. The results suggest that student performance improved when trained tutors taught the students number line procedures and gave them feedback on accuracy. Further, social validation data indicate that the students, their tutors, and their classroom teachers liked the procedures.     

THE EFFECTS OF FEEDBACK ON BLOOD PRESSURE DISCRIMINATION

Discrimination of blood pressure in the natural environment as a function of feedback was assessed. Seventeen normotensives screened for blood pressure lability were randomly assigned to two groups. These subjects were then asked to estimate their systolic and diastolic blood pressure values two times per day over a 4-week period. Feedback for accuracy of blood pressure discriminations was implemented across the two groups in a multiple baseline fashion, using a feedback withdrawal condition in Group I to assess maintenance effects over time. Results showed improvement in discrimination accuracy for subjects in both groups when feedback was used, and no decrement in performance over a 2-week period after feedback was removed for subjects in Group I. Discrimination of systolic pressures improved at a slightly faster rate than discrimination of diastolic pressures.     

THE GOOD PRODUCTIVITY GAME: INCREASING WORK PERFORMANCE IN A REHABILITATION SETTING1

Simple reinforcement systems have been used to improve performance in a broad range of settings. For example, in classrooms, the “Good Behavior Game” has been shown to be very effective (Barrish, Saunders, and Wolf, Journal of Applied Behavior Analysis, 1969, 2 , 119–124). In industry, small bonuses were used to increase the punctuality of workers (Hermann, deMontes, Dominquez, Montes, and Hopkins, Journal of Applied Behavior Analysis, 1973, 6 , 503–572). In a sheltered workshop setting, Shroeder (Journal of Applied Behavior Analysis, 1972, 5 , 45–52) examined work rates under varying frequencies and amounts of reinforcement and response force. The present study involved the utilization of simple group contingencies to increase productivity in a rehabilitation industry. Four state hospital residents who were trainees at a rehabilitation industry participated in the study which examined the effects of feedback, and feedback plus the “Good Productivity Game” to improve work output. The task, for which the employees were paid a wage, involved sorting boards by size. When the employees were provided with feedback on the number of boards sorted during the observation period, productivity increased slightly over baseline. After a return to baseline, the “Good Productivity Game” was played. For performance, the game afforded the employees pseudo-competition (in that teams were paired against each other, but both teams always “won”) and simple rewards such as candy and early work termination. The game improved performance by 104% over the second baseline and by 64% over the third baseline. Data gathered on rates of on-task behavior by the employees correlate with the productivity rates. Data gathered on rates of staff attention paid to employees show little difference across conditions, thus corroborating the function of the “Good Productivity Game” in increasing work output. Although no formal data were collected, the staff continued to use the game with considerable success after the formal termination of the study. The “Good Productivity Game” appears useful in increasing work output in a rehabilitation setting. Further research should concentrate on the utility of the game throughout longer periods of the workday and over extended periods of time.