Peripheral vision for perception and action

Abstract Anatomical and physiological evidence suggests that vision-for-perception and vision-for-action may be differently sensitive to increasingly peripheral stimuli, and to stimuli in the upper and lower visual fields (VF). We asked participants to fixate one of 24 randomly presented LED arranged radially in eight directions and at three eccentricities around a central target location. One of two (small, large) target objects was presented briefly, and participants responded in two ways. For the action task, they reached for and grasped the target. For the perception task, they estimated target height by adjusting thumb-finger separation. In a final set of trials for each task, participants knew that target size would remain constant. We found that peak aperture increased with eccentricity for grasping, but not for perceptual estimations of size. In addition, peak grip aperture, but not size-estimation aperture, was more variable when targets were viewed in the upper as opposed to the lower VF. A second experiment demonstrated that prior knowledge about object size significantly reduced the variability of perceptual estimates, but had no effect on the variability of grip aperture. Overall, these results support the claim that peripheral VF stimuli are processed differently for perception and action. Moreover, they support the idea that the lower VF is specialized for the control of manual prehension. Finally, the effect of prior knowledge about target size on performance substantiates claims that perception is more tightly linked to memory systems than action

Association of early postnatal transfer and birth outside a tertiary hospital with mortality and severe brain injury in extremely preterm infants: observational cohort study with propensity score matching

Objective To determine if postnatal transfer or birth in a non-tertiary hospital is associated with adverse outcomes. Design Observational cohort study with propensity score matching. Setting National health service neonatal care in England; population data held in the National Neonatal Research Database. Participants Extremely preterm infants born at less than 28 gestational weeks between 2008 and 2015 (n=17 577) grouped based on birth hospital and transfer within 48 hours of birth: upward transfer (non-tertiary to tertiary hospital, n=2158), non-tertiary care (born in non-tertiary hospital; not transferred, n=2668), and controls (born in tertiary hospital; not transferred, n=10 866). Infants were matched on propensity scores and predefined background variables to form subgroups with near identical distributions of confounders. Infants transferred between tertiary hospitals (horizontal transfer) were separately matched to controls in a 1:5 ratio. Main outcome measures Death, severe brain injury, and survival without severe brain injury. Results 2181 infants, 727 from each group (upward transfer, non-tertiary care, and control) were well matched. Compared with controls, infants in the upward transfer group had no significant difference in the odds of death before discharge (odds ratio 1.22, 95% confidence interval 0.92 to 1.61) but significantly higher odds of severe brain injury (2.32, 1.78 to 3.06; number needed to treat (NNT) 8) and significantly lower odds of survival without severe brain injury (0.60, 0.47 to 0.76; NNT 9). Compared with controls, infants in the non-tertiary care group had significantly higher odds of death (1.34, 1.02 to 1.77; NNT 20) but no significant difference in the odds of severe brain injury (0.95, 0.70 to 1.30) or survival without severe brain injury (0.82, 0.64 to 1.05). Compared with infants in the upward transfer group, infants in the non-tertiary care group had no significant difference in death before discharge (1.10, 0.84 to 1.44) but significantly lower odds of severe brain injury (0.41, 0.31 to 0.53; NNT 8) and significantly higher odds of survival without severe brain injury (1.37, 1.09 to 1.73; NNT 14). No significant differences were found in outcomes between the horizontal transfer group (n=305) and controls (n=1525). Conclusions In extremely preterm infants, birth in a non-tertiary hospital and transfer within 48 hours are associated with poor outcomes when compared with birth in a tertiary setting. We recommend perinatal services promote pathways that facilitate delivery of extremely preterm infants in tertiary hospitals in preference to postnatal transfer