Extraocular muscle afferent signals modulate visual attention.

PurposeExtraocular muscle afferent signals contribute to oculomotor control and visual localization. Prompted by the close links between the oculomotor and attention systems, it was investigated whether these proprioceptive signals also modulated the allocation of attention in space.MethodsA suction sclera contact lens was used to impose an eye rotation on the nonviewing, dominant eye. With their viewing, nondominant eye, participants (n = 4) fixated centrally and detected targets presented at 5° in the left or right visual hemifield. The position of the viewing eye was monitored throughout the experiment. As a control, visual localization was tested using finger pointing without visual feedback of the hand, whereas the nonviewing eye remained deviated.ResultsThe sustained passive rotation of the occluded, dominant eye, while the other eye maintained central fixation, resulted in a lateralized change in the detectability of visual targets. In all participants, the advantage in speed and accuracy for detecting right versus left hemifield targets that occurred during a sustained rightward eye rotation of the dominant eye was reduced or reversed by a leftward eye rotation. The control experiment confirmed that the eye deviation procedure caused pointing errors consistent with an approximately 2° shift in perceived eye position, in the direction of rotation of the nonviewing eye.ConclusionsWith the caveat of the small number of participants, these results suggest that extraocular muscle afferent signals modulate the deployment of attention in visual space

Early elevation in plasma high-sensitivity troponin T and morbidity after elective noncardiac surgery: prospective multicentre observational cohort study.

BACKGROUND: Elevated high-sensitivity troponin (hsTnT) after noncardiac surgery is associated with higher mortality, but the temporal relationship between early elevated troponin and the later development of noncardiac morbidity remains unclear. METHODS: Prospective observational study of patients aged ≥45 yr undergoing major noncardiac surgery at four UK hospitals (two masked to hsTnT). The exposure of interest was early elevated troponin, as defined by hsTnT >99th centile (≥15 ng L-1) within 24 h after surgery. The primary outcome was morbidity 72 h after surgery, defined by the Postoperative Morbidity Survey (POMS). Secondary outcomes were time to become morbidity-free and Clavien-Dindo ≥grade 3 complications. RESULTS: Early elevated troponin (median 21 ng L-1 [16-32]) occurred in 992 of 4335 (22.9%) patients undergoing elective noncardiac surgery (mean [standard deviation, sd] age, 65 [11] yr; 2385 [54.9%] male). Noncardiac morbidity was more frequent in 494/992 (49.8%) patients with early elevated troponin compared with 1127/3343 (33.7%) patients with hsTnT <99th centile (odds ratio [OR]=1.95; 95% confidence interval [CI], 1.69-2.25). Patients with early elevated troponin had a higher risk of proven/suspected infectious morbidity (OR=1.54; 95% CI, 1.24-1.91) and critical care utilisation (OR=2.05; 95% CI, 1.73-2.43). Clavien-Dindo ≥grade 3 complications occurred in 167/992 (16.8%) patients with early elevated troponin, compared with 319/3343 (9.5%) patients with hsTnT <99th centile (OR=1.78; 95% CI, 1.48-2.14). Absence of early elevated troponin was associated with morbidity-free recovery (OR=0.44; 95% CI, 0.39-0.51). CONCLUSIONS: Early elevated troponin within 24 h of elective noncardiac surgery precedes the subsequent development of noncardiac organ dysfunction and may help stratify levels of postoperative care in real time

‘No cultural policy to speak of': Liverpool 2008

Recent academic work on European Capital of Culture (ECoC) has fallen into two broad categories: either evaluative, based on assessing the effectiveness of hosting ECoC for policy agendas; or critical, questioning the rationale behind ECoC and its impact on the cities that have held the title. However, little attention has been paid to the role ECOC has played in the ‘modernisation’ of urban governance, particularly in the UK. This article seeks to explore ECoC’s role in city governance by examining the specific case of Liverpool, ECoC 2008 and the related local government agencies in the city, particularly Liverpool City Council (LCC). A narrative of the history of cultural policy within LCC, using institutionalist theory, shows that cultural policy has had a difficult evolution within a city that was initially reluctant to devote institutional capacity and resources to cultural matters. Problems in the build up to 2008 reflect the influence of ‘institutions’ in Liverpool’s political culture and history. The influence of these institutions is at the root of the uncertainty surrounding the long‐term viability of cultural policy in the city. As a corollary to the exploration of the role of institutions in Liverpool, a concluding discussion of ECoC’s role in city governance offers prospects for the cultural policy settlement within Liverpool in the post‐ECoC 2008 era, particularly focusing on the role of Liverpool’s cultural sector as a motivator for cultural policy