The role of attention in eye-movement awareness

People are unable to accurately report on their own eye movements most of the time. Can this be explained as a lack of attention to the objects we fixate? Here, we elicited eye-movement errors using the classic oculomotor capture paradigm, in which people tend to look at sudden onsets even when they are irrelevant. In the first experiment, participants were able to report their own errors on about a quarter of the trials on which they occurred. The aim of the second experiment was to assess what differentiates errors that are detected from those that are not. Specifically, we estimated the relative influence of two possible factors: how long the onset distractor was fixated (dwell time), and a measure of how much attention was allocated to the onset distractor. Longer dwell times were associated with awareness of the error, but the measure of attention was not. The effect of the distractor identity on target discrimination reaction time was similar whether or not the participant was aware they had fixated the distractor. The results suggest that both attentional and oculomotor capture can occur in the absence of awareness, and have important implications for our understanding of the relationship between attention, eye movements, and awareness

Rethinking the final year project report: cutting out the waffle

All final year students in the Department of Mathematical Sciences at the University of Greenwich undertake either a weekly placement or the research methods and project module. The assessment for the project module is made up of a group project, followed by an individual project. In 2012 the Universitys academic calendar and term structure was changed following recommendations during the UG-Flex project, which advocated the flexibility of a trimester calendar (JISC, 2012). This resulted in the research methods and project students having a significantly shorter period of time to write up their research. As a result, the individual project assessment was redesigned to incorporate a seven-page, research paper style report, cognate to journal articles that students necessarily encounter as part of their research. This paper describes the format of the new report, and discusses findings and feedback from academic staff. In particular, external examiners have commented very favourably on this format and think other HEIs might benefit from adopting a similar approach to project reports

Agent-based models of social behaviour and communication in evacuations: A systematic review

Most modern agent-based evacuation models involve interactions between evacuees. However, the assumed reasons for interactions and portrayal of them may be overly simple. Research from social psychology suggests that people interact and communicate with one another when evacuating and evacuee response is impacted by the way information is communicated. Thus, we conducted a systematic review of agent-based evacuation models to identify 1) how social interactions and communication approaches between agents are simulated, and 2) what key variables related to evacuation are addressed in these models. We searched Web of Science and ScienceDirect to identify articles that simulated information exchange between agents during evacuations, and social behaviour during evacuations. From the final 70 included articles, we categorised eight types of social interaction that increased in social complexity from collision avoidance to social influence based on strength of social connections with other agents. In the 17 models which simulated communication, we categorised four ways that agents communicate information: spatially through information trails or radii around agents, via social networks and via external communication. Finally, the variables either manipulated or measured in the models were categorised into the following groups: environmental condition, personal attributes of the agents, procedure, and source of information. We discuss promising directions for agent-based evacuation models to capture the effects of communication and group dynamics on evacuee behaviour. Moreover, we demonstrate how communication and group dynamics may impact the variables commonly used in agent-based evacuation models.Comment: Pre-print submitted to Safety Science special issue following the 2023 Pedestrian and Evacuation Dynamics conferenc

Agent-based models of social behaviour and communication in evacuations:A systematic review

Most modern agent-based evacuation models involve interactions between evacuees. However, the assumed reasons for interactions and portrayal of them may be overly simple. Research from social psychology suggests that people interact and communicate with one another when evacuating and evacuee response is impacted by the way information is communicated. Thus, we conducted a systematic review of agent-based evacuation models to identify 1) how social interactions and communication approaches between agents are simulated, and 2) what key variables related to evacuation are addressed in these models. We searched Web of Science and ScienceDirect to identify articles that simulated information exchange between agents during evacuations, and social behaviour during evacuations. From the final 70 included articles, we categorised eight types of social interaction that increased in social complexity from collision avoidance to social influence based on strength of social connections with other agents. In the 17 models which simulated communication, we categorised four ways that agents communicate information: spatially through information trails or radii around agents, via social networks and via external communication. Finally, the variables either manipulated or measured in the models were categorised into the following groups: environmental condition, personal attributes of the agents, procedure, and source of information. We discuss promising directions for agent-based evacuation models to capture the effects of communication and group dynamics on evacuee behaviour. Moreover, we demonstrate how communication and group dynamics may impact the variables commonly used in agent-based evacuation models

Simulating movement devices used in hospital evacuation

In hospitals, the evacuation of those with severe movement impairments can be highly problematic for the patients, for the staff and for other evacuees. It is critical to understand the performance of horizontal and vertical evacuation procedures, including the means by which people with reduced mobility can be assisted during stair descent. Microsimulation modelling provides a useful tool to assess evacuation strategies, given the challenges of preparing and transporting patients in need of on-going care and the unfeasibility of real evacuation drills. However, current simulation models typically focus on the movement of individual agents, not the staff-patient interactions and sizable equipment required to carry out assisted evacuation. To address this, the buildingEXODUS evacuation model has been enhanced to represent moving objects in addition to moving individual agents. This paper describes the modelling theory behind this development, where dedicated data has been applied to enable the explicit specification of evacuation devices, operated by agents (for instance, representing the vertical travel speeds achieved—with averages ranging between 0.6 m/s and 0.84 m/s—when employing different movement devices). Algorithms are presented that calculate the movement of devices along corridors, through doorways and in stairway descent, including a method of geometric decomposition of the available hospital evacuation routes. This new functionality addresses the key evacuation components of repeated patient collection and has numerous applications, both in simulating hospital evacuation and in representing evacuation of other premises that include people with reduced mobility. Examination of the performance of this functionality found it predicated performance within 6% of expectation. Once further testing is completed, the resultant tool can be used to significantly enhance planning and diagnostic capabilities related to the evacuation of hospital and other healthcare facilities

The effects of sequential heat treatment on microbial reduction and spore inactivation during milk processing

peer-reviewedSequential heating processes are commonly applied to milk by the dairy industry as part of their microbiological control strategy. Often pasteurisation at 72 °C is followed by a sequential high heat treatment step of up to 125 °C; however, such severe heat treatment can lead to reduced protein quality. Nine temperature combinations (80–90 °C) were evaluated to assess microbial reduction and whey protein nitrogen index values during pilot scale milk processing. A total of 110 bacterial isolates were identified to species level by 16S rDNA sequencing, with Bacillus licheniformis identified as the dominant species. While the experimental treatments did not achieve microbial reductions comparable with the control heating process, the results of this study provide a benchmark for milk processors relative to the effects of sequential heat treatments on milk and their impact on the survival of both thermally resistant microbial populations and thermally labile milk components during processing.Department of Agriculture, Food and the Marine, Irelan

A protocol for a randomised clinical trial of the effect of providing feedback on inhaler technique and adherence from an electronic device in patients with poorly controlled severe asthma.

INTRODUCTION: In clinical practice, it is difficult to distinguish between patients with refractory asthma from those with poorly controlled asthma, where symptoms persist due to poor adherence, inadequate inhaler technique or comorbid diseases. We designed an audio recording device which, when attached to an inhaler, objectively identifies the time and technique of inhaler use, thereby assessing both aspects of adherence. This study will test the hypothesis that feedback on these two aspects of adherence when passed on to patients improves adherence and helps clinicians distinguish refractory from difficult-to-control asthma. METHODS: This is a single, blind, prospective, randomised, clinical trial performed at 5 research centres. Patients with partially controlled or uncontrolled severe asthma who have also had at least one severe asthma exacerbation in the prior year are eligible to participate. The effect of two types of nurse-delivered education interventions to promote adherence and inhaler technique will be assessed. The active group will receive feedback on their inhaler technique and adherence from the new device over a 3-month period. The control group will also receive training in inhaler technique and strategies to promote adherence, but no feedback from the device. The primary outcome is the difference in actual adherence, a measure that incorporates time and technique of inhaler use between groups at the end of the third month. Secondary outcomes include the number of patients who remain refractory despite good adherence, and differences in the components of adherence after the intervention. Data will be analysed on an intention-to-treat and a per-protocol basis. The sample size is 220 subjects (110 in each group), and loss to follow-up is estimated at 10% which will allow results to show a 10% difference (0.8 power) in adherence between group means with a type I error probability of 0.05. TRIAL REGISTRATION NUMBER: NCT01529697; Pre-results

Shared attention for action selection and action monitoring in goal-directed reaching

Dual-task studies have shown higher sensitivity for stimuli presented at the targets of upcoming actions. We examined whether attention is directed to action targets for the purpose of action selection, or if attention is directed to these locations because they are expected to provide feedback about movement outcomes. In our experiment, endpoint accuracy feedback was spatially separated from the action targets to determine whether attention would be allocated to (a) the action targets, (b) the expected source of feedback, or (c) to both locations. Participants reached towards a location indicated by an arrow while identifying a discrimination target that could appear in any one of eight possible locations. Discrimination target accuracy was used as a measure of attention allocation. Participants were unable to see their hand during reaching and were provided with a small monetary reward for each accurate movement. Discrimination target accuracy was best at action targets but was also enhanced at the spatially separated feedback locations. Separating feedback from the reaching targets did not diminish discrimination accuracy at the movement targets but did result in delayed movement initiation and reduced reaching accuracy, relative to when feedback was presented at the reaching target. The results suggest attention is required for both action planning and monitoring movement outcomes. Dividing attention between these functions negatively impacts action performance

Continuous glucose monitoring in pregnant women with type 1 diabetes (CONCEPTT): a multicentre international randomised controlled trial.

BACKGROUND: Pregnant women with type 1 diabetes are a high-risk population who are recommended to strive for optimal glucose control, but neonatal outcomes attributed to maternal hyperglycaemia remain suboptimal. Our aim was to examine the effectiveness of continuous glucose monitoring (CGM) on maternal glucose control and obstetric and neonatal health outcomes. METHODS: In this multicentre, open-label, randomised controlled trial, we recruited women aged 18-40 years with type 1 diabetes for a minimum of 12 months who were receiving intensive insulin therapy. Participants were pregnant (≤13 weeks and 6 days' gestation) or planning pregnancy from 31 hospitals in Canada, England, Scotland, Spain, Italy, Ireland, and the USA. We ran two trials in parallel for pregnant participants and for participants planning pregnancy. In both trials, participants were randomly assigned to either CGM in addition to capillary glucose monitoring or capillary glucose monitoring alone. Randomisation was stratified by insulin delivery (pump or injections) and baseline glycated haemoglobin (HbA1c). The primary outcome was change in HbA1c from randomisation to 34 weeks' gestation in pregnant women and to 24 weeks or conception in women planning pregnancy, and was assessed in all randomised participants with baseline assessments. Secondary outcomes included obstetric and neonatal health outcomes, assessed with all available data without imputation. This trial is registered with ClinicalTrials.gov, number NCT01788527. FINDINGS: Between March 25, 2013, and March 22, 2016, we randomly assigned 325 women (215 pregnant, 110 planning pregnancy) to capillary glucose monitoring with CGM (108 pregnant and 53 planning pregnancy) or without (107 pregnant and 57 planning pregnancy). We found a small difference in HbA1c in pregnant women using CGM (mean difference -0·19%; 95% CI -0·34 to -0·03; p=0·0207). Pregnant CGM users spent more time in target (68% vs 61%; p=0·0034) and less time hyperglycaemic (27% vs 32%; p=0·0279) than did pregnant control participants, with comparable severe hypoglycaemia episodes (18 CGM and 21 control) and time spent hypoglycaemic (3% vs 4%; p=0·10). Neonatal health outcomes were significantly improved, with lower incidence of large for gestational age (odds ratio 0·51, 95% CI 0·28 to 0·90; p=0·0210), fewer neonatal intensive care admissions lasting more than 24 h (0·48; 0·26 to 0·86; p=0·0157), fewer incidences of neonatal hypoglycaemia (0·45; 0·22 to 0·89; p=0·0250), and 1-day shorter length of hospital stay (p=0·0091). We found no apparent benefit of CGM in women planning pregnancy. Adverse events occurred in 51 (48%) of CGM participants and 43 (40%) of control participants in the pregnancy trial, and in 12 (27%) of CGM participants and 21 (37%) of control participants in the planning pregnancy trial. Serious adverse events occurred in 13 (6%) participants in the pregnancy trial (eight [7%] CGM, five [5%] control) and in three (3%) participants in the planning pregnancy trial (two [4%] CGM and one [2%] control). The most common adverse events were skin reactions occurring in 49 (48%) of 103 CGM participants and eight (8%) of 104 control participants during pregnancy and in 23 (44%) of 52 CGM participants and five (9%) of 57 control participants in the planning pregnancy trial. The most common serious adverse events were gastrointestinal (nausea and vomiting in four participants during pregnancy and three participants planning pregnancy). INTERPRETATION: Use of CGM during pregnancy in patients with type 1 diabetes is associated with improved neonatal outcomes, which are likely to be attributed to reduced exposure to maternal hyperglycaemia. CGM should be offered to all pregnant women with type 1 diabetes using intensive insulin therapy. This study is the first to indicate potential for improvements in non-glycaemic health outcomes from CGM use. FUNDING: Juvenile Diabetes Research Foundation, Canadian Clinical Trials Network, and National Institute for Health Research

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research