Joint perception: gaze and social context

We found that the way people looked at images was influenced by their belief that others were looking too. If participants believed that an unseen other person was also looking at what they could see, it shifted the balance of their gaze between negative and positive images. The direction of this shift depended upon whether participants thought that later they would be compared against the other person or would be collaborating with them. Changes in the social context influenced both gaze and memory processes, and were not due just to participants' belief that they are looking at the same images, but also to the belief that they are doing the same task. We believe that the phenomenon of joint perception reveals the pervasive and subtle effect of social context upon cognitive and perceptual processes

American Society of Hematology 2020 guidelines for sickle cell disease: Prevention, diagnosis, and treatment of cerebrovascular disease in children and adults

BACKGROUND: Central nervous system (CNS) complications are among the most common, devastating sequelae of sickle cell disease (SCD) occurring throughout the lifespan.OBJECTIVE: These evidence-based guidelines of the American Society of Hematology are intended to support the SCD community in decisions about prevention, diagnosis, and treatment of the most common neurological morbidities in SCD.METHODS: The Mayo Evidence-Based Practice Research Program supported the guideline development process, including updating or performing systematic evidence reviews. The panel used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach, including GRADE evidence-to-decision frameworks, to assess evidence and make recommendations.RESULTS: The panel placed a higher value on maintaining cognitive function than on being alive with significantly less than baseline cognitive function. The panel developed 19 recommendations with evidence-based strategies to prevent, diagnose, and treat CNS complications of SCD in low-middle- and high-income settings.CONCLUSIONS: Three of 19 recommendations immediately impact clinical care. These recommendations include: use of transcranial Doppler ultrasound screening and hydroxyurea for primary stroke prevention in children with hemoglobin SS (HbSS) and hemoglobin Sβ0 (HbSβ0) thalassemia living in low-middle-income settings; surveillance for developmental delay, cognitive impairments, and neurodevelopmental disorders in children; and use of magnetic resonance imaging of the brain without sedation to detect silent cerebral infarcts at least once in early-school-age children and once in adults with HbSS or HbSβ0 thalassemia. Individuals with SCD, their family members, and clinicians should become aware of and implement these recommendations to reduce the burden of CNS complications in children and adults with SCD.</p

Recent advance in high manufacturing readiness level and high temperature CMOS mixed-signal integrated circuits on silicon carbide

A high manufacturing readiness level silicon carbide (SiC) CMOS technology is presented. The unique process flow enables the monolithic integration of pMOS and nMOS transistors with passive circuit elements capable of operation at temperatures of 300 °C and beyond. Critical to this functionality is the behaviour of the gate dielectric and data for high temperature capacitance–voltage measurements are reported for SiO2/4H-SiC (n and p type) MOS structures. In addition, a summary of the long term reliability for a range of structures including contact chains to both n-type and p-type SiC, as well as simple logic circuits is presented, showing function after 2000 h at 300 °C. Circuit data is also presented for the performance of digital logic devices, a 4 to 1 analogue multiplexer and a configurable timer operating over a wide temperature range. A high temperature micro-oven system has been utilised to enable the high temperature testing and stressing of units assembled in ceramic dual in line packages, including a high temperature small form-factor SiC based bridge leg power module prototype, operated for over 1000 h at 300 °C. The data presented show that SiC CMOS is a key enabling technology in high temperature integrated circuit design. In particular it provides the ability to realise sensor interface circuits capable of operating above 300 °C, accommodate shifts in key parameters enabling deployment in applications including automotive, aerospace and deep well drilling

Physical and optical properties of the International Simple Glass

Radioactive waste immobilization is a means to limit the release of radionuclides from various waste streams into the environment over a timescale of hundreds to many thousands of years. Incorporation of radionuclide-containing wastes into borosilicate glass during vitrification is one potential route to accomplish such immobilization. To facilitate comparisons and assessments of reproducibility across experiments and laboratories, a six-component borosilicate glass (Si, B, Na, Al, Ca, Zr) known as the International Simple Glass (ISG) was developed by international consensus as a compromise between simplicity and similarity to waste glasses. Focusing on a single glass composition with a multi-pronged approach utilizing state-of-the-art, multi-scale experimental and theoretical tools provides a common database that can be used to assess relative importance of mechanisms and models. Here we present physical property data (both published and previously unpublished) on a single batch of ISG, which was cast into individual ingots that were distributed to the collaborators. Properties from the atomic scale to the macroscale, including composition and elemental impurities, phase purity, density, thermal properties, mechanical properties, optical and vibrational properties, and the results of molecular dynamics simulations are presented. In addition, information on the surface composition and morphology after polishing is included. Although the existing literature on the alteration of ISG is not extensively reviewed here, the results of well-controlled static alteration experiments are presented here as a point of reference for other performance investigations

The Cholecystectomy As A Day Case (CAAD) Score: A Validated Score of Preoperative Predictors of Successful Day-Case Cholecystectomy Using the CholeS Data Set

Background Day-case surgery is associated with significant patient and cost benefits. However, only 43% of cholecystectomy patients are discharged home the same day. One hypothesis is day-case cholecystectomy rates, defined as patients discharged the same day as their operation, may be improved by better assessment of patients using standard preoperative variables. Methods Data were extracted from a prospectively collected data set of cholecystectomy patients from 166 UK and Irish hospitals (CholeS). Cholecystectomies performed as elective procedures were divided into main (75%) and validation (25%) data sets. Preoperative predictors were identified, and a risk score of failed day case was devised using multivariate logistic regression. Receiver operating curve analysis was used to validate the score in the validation data set. Results Of the 7426 elective cholecystectomies performed, 49% of these were discharged home the same day. Same-day discharge following cholecystectomy was less likely with older patients (OR 0.18, 95% CI 0.15–0.23), higher ASA scores (OR 0.19, 95% CI 0.15–0.23), complicated cholelithiasis (OR 0.38, 95% CI 0.31 to 0.48), male gender (OR 0.66, 95% CI 0.58–0.74), previous acute gallstone-related admissions (OR 0.54, 95% CI 0.48–0.60) and preoperative endoscopic intervention (OR 0.40, 95% CI 0.34–0.47). The CAAD score was developed using these variables. When applied to the validation subgroup, a CAAD score of ≤5 was associated with 80.8% successful day-case cholecystectomy compared with 19.2% associated with a CAAD score >5 (p < 0.001). Conclusions The CAAD score which utilises data readily available from clinic letters and electronic sources can predict same-day discharges following cholecystectomy

Inherited prothrombotic states and ischaemic stroke in childhood

Objective - To investigate the prevalence of currently recognised inherited prothrombotic states in a population of children with arterial stroke. Methods - Children with arterial stroke presenting to a tertiary level paediatric neurology centre between 1990 and 1996 were investigated for inherited prothrombotic states. Results - Sixty seven children with arterial stroke were investigated. Abnormalities were initially identified in 16 patients; however, only eight children (12%) had an inherited prothrombotic state. This was type 1 protein S deficiency in one patient, the factor V Leiden mutation in six, and activated protein C resistance (without the factor V Leiden mutation) in one. The prevalence of the factor V Leiden mutation was not significantly higher in children with arterial stroke (12%) than in a control population of children without thrombosis attending the same institution (5.2%; Fisher's exact test, p = 0.19; difference in prevalence between patients and controls (95% confidence interval) = 6.8% (-2.78% to 16.8%)). Conclusions - Currently recognised inherited prothrombotic tendencies were rarely associated with stroke in this group of children, although larger numbers of patients would be needed to confirm this. Age appropriate normal values should be used when interpreting the results of a prothrombotic screen. Prothrombotic abnormalities seen acutely are as often transient as inherited. Longitudinal assessment and family studies are required before low concentrations of an anticoagulant protein found acutely can be attributed to an inherited abnormality.</p

Interrater reliability of Engel, International League Against Epilepsy, and McHugh seizure outcome classifications following vagus nerve stimulator implantation

OBJECT: Interrater reliability as measured by the kappa (?) statistic is a widely used and valuable tool to measure the robustness of a scoring system. Seizure frequency reduction is a central outcome measure following vagus nerve stimulation (VNS). A specific VNS scoring system has been proposed by McHugh, but its interrater reliability has not been tested. The authors assessed its interrater reliability and compared it with that of the Engel and International League Against Epilepsy (ILAE) systems.METHODS: Using the Engel, ILAE, and McHugh scoring systems, 3 observers independently rated the medical records of children who had undergone vagus nerve stimulator implantation between January 2001 and April 2011 at the Southampton University Hospital. The interrater agreements were then calculated using the ? statistic.RESULTS: Interrater reliability for the McHugh scale (?0.693) was very good and was superior to those of the Engel (?0.464) and ILAE (?0.491) systems for assessing outcome in patients undergoing VNS.CONCLUSIONS: The authors recommend considering the McHugh scoring system when assessing outcomes following VNS

Fatal haemorrhagic infarct in an infant with homocystinuria

Thrombotic and thromboembolic complications are the main causes of morbidity and mortality in patients with homocystinuria. However, it is unusual for thrombosis and infarction to be the presenting feature leading to investigation for homocystinuria and cerebrovascular lesions in the first year of life. We describe a previously healthy 6-month-old infant who presented with a large middle-cerebral-artery territory infarction and died of massive brain swelling. Homocystinuria due to cystathionine β-synthase (CBS) deficiency was diagnosed by metabolite analysis and confirmed by enzymatic activity measurement in a postmortem liver biopsy. Homocystinuria should be considered in the differential diagnosis of venous or arterial thrombosis, regardless of age, even in the absence of other common features of the disease. We recommend systematic metabolic screening for hyperhomocysteinemia in any child presenting with vascular lesions or premature thromboembolism.</p