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Stop before you saccade: Looking into an artificial peripheral scotoma.

ABSTRACT: We investigated whether adults with healthy vision can move their eyes toward an informative target area that is initially hidden by a gaze-contingent scotoma in the periphery when they are under time pressure. In the experimental task, participants had to perform an object-comparison task requiring a same-different judgment about two silhouettes. One silhouette was visible, whereas the other was hidden under the scotoma. Despite time pressure and the presence of the visible silhouette, most participants were able to move their eyes toward the informative region to reveal the hidden silhouette. Saccades to the hidden stimulus occurred when the visible stimulus was presented directly opposite in either fixed or variable locations and when the visible stimulus was presented at an adjacent location. Older participants were also able to perform this task. First saccades in the direction of the hidden stimulus had longer latencies compared with saccades toward the visible stimulus. This suggests the use of a deliberate, nonreflexive saccade strategy ("stop before you saccade"). A subset of participants occasionally made curved saccades that were aimed first toward the visible stimulus and then toward the hidden stimulus. We discuss the implications of our findings for patients who have a biological scotoma, for example, in macular degeneration.

SUBMITTER: Janssen CP

PROVIDER: S-EPMC4429928 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundCessation of long-term aspirin treatment before noncardiac surgery can cause adverse cardiac events in patients at risk, particularly in those with previous percutaneous coronary interventions (PCI) with stent implantation. The factors influencing the clinical decision to stop aspirin treatment are currently unknown.MethodsIn a single-center, cross-sectional study (retrospective registration: NCT03049566) carried out from February to December 2014, we took a survey among patients scheduled for noncardiac surgery who were under long-term aspirin treatment, and among their treating anesthesiologists using standardized questionnaires on preoperative aspirin use, comorbidities, and risk-benefit assessments. The main objective was to identify factors associated with the decision to stop aspirin treatment. The results of multivariable logistic regressions and intraclass correlations are presented.Results805 patients were included in the study, and 636 questionnaires were returned (203 of which concerned patients with coronary stents). 46.8% of the patients stopped their long-term aspirin treatment before surgery; 38.7% of these patients stopped it too early (>10 days before surgery) or too late (≤ 3 days before surgery). A prior PCI with stent implantation lowered the probability of aspirin cessation (odds ratio [OR] = 0.47 [0.31; 0.72]; p <0.001). On the other hand, patients were more likely to stop their long-term aspirin treatment if it had already been discontinued once before (OR = 4.58 [3.06; 6.84]; p <0.001), if there was a risk of bleeding into a closed space (OR = 4.54 [2.02; 10.22]; p <0.001), if they did not know why they were supposed to take aspirin (OR = 2.12 [1.05; 4.28]; p = 0.036), or if the preoperative consultation with the anesthesiologist occurred <2 days before surgery (OR = 1.60 [1.08; 2.37]; p = 0.018). Patients often assessed the risks related to aspirin cessation lower than their physicians did.ConclusionThis study reveals discordance between guideline recommendations and everyday clinical practice in patients with coronary stents. The early integration of cardiologists and anesthesiologists and a more widespread use of stent implant cards could promote adherence to the guidelines.

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Stop before you saccade: Looking into an artificial peripheral scotoma.

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