Frequency-specific and periodic masking of peripheral characters by delayed foveal input.

The foveal-feedback mechanism supports peripheral object recognition by processing information about peripheral objects in foveal retinotopic visual cortex. When a foveal object is asynchronously presented with a peripheral target, peripheral discrimination performance is affected differently depending on the relationship between the foveal and peripheral objects. However, it is not clear whether the delayed foveal input competes for foveal resources with the information processed by foveal-feedback or masks it. In the current study, we tested these hypotheses by measuring the effect of foveal noise at different spatial frequencies on peripheral discrimination of familiar and novel characters. Our results showed that the impairment of foveal-feedback was strongest for low-spatial frequency noise. A control experiment revealed that for spatially overlapping noise, low-spatial frequencies were more effective than medium-spatial frequencies in the periphery, but vice versa in the fovea. This suggests that the delayed foveal input selectively masks foveal-feedback when it is sufficiently similar to the peripheral information. Additionally, this foveal masking was periodic as evidenced by behavioral oscillations at around 5 Hz. Thus, we conclude that foveal-feedback supports peripheral discrimination of familiar and novel objects by periodically processing peripheral object information.

Development of a Sensor Technology to Objectively Measure Dexterity for Cardiac Surgical Proficiency.

BACKGROUND: Technical skill is essential for good outcomes in cardiac surgery. However, no objective methods exist to measure dexterity while performing surgery. The purpose of this study was to validate sensor-based hand motion analysis (HMA) of technical dexterity while performing a graft anastomosis within a validated simulator. METHODS: Surgeons at various training levels performed an anastomosis while wearing flexible sensors (BioStamp nPoint, MC10 Inc) with integrated accelerometers and gyroscopes on each hand to quantify HMA kinematics. Groups were stratified as experts (n = 8) or novices (n = 18). The quality of the completed anastomosis was scored using the 10 Point Microsurgical Anastomosis Rating Scale (MARS10). HMA parameters were compared between groups and correlated with quality. Logistic regression was used to develop a predictive model from HMA parameters to distinguish experts from novices. RESULTS: Experts were faster (11 ± 6 minutes vs 21 ± 9 minutes; P = .012) and used fewer movements in both dominant (340 ± 166 moves vs 699 ± 284 moves; P = .003) and nondominant (359 ± 188 moves vs 567 ± 201 moves; P = .02) hands compared with novices. Experts' anastomoses were of higher quality compared with novices (9.0 ± 1.2 MARS10 vs 4.9 ± 3.2 MARS10; P = .002). Higher anastomosis quality correlated with 9 of 10 HMA parameters, including fewer and shorter movements of both hands (dominant, r = -0.65, r = -0.46; nondominant, r = -0.58, r = -0.39, respectively). CONCLUSIONS: Sensor-based HMA can distinguish technical dexterity differences between experts and novices, and correlates with quality. Objective quantification of hand dexterity may be a valuable adjunct to training and education in cardiac surgery training programs.

Interaction of dynamic error signals in saccade adaptation.

Motor adaptation maintains movement accuracy. To evaluate movement accuracy, motor adaptation relies on an error signal, generated by the movement target, while suppressing error signals from irrelevant objects in the vicinity. Previous work used static testing environments, where all information required to evaluate movement accuracy was available simultaneously. Using saccadic eye movements as a model for motor adaptation, we tested how movement accuracy is maintained in dynamic environments, where the availability of conflicting error signals varied over time. Participants made a vertical saccade toward a target (either a small square or a large ring). Upon saccade detection, two candidate stimuli were shown left and right of the target, and participants were instructed to discriminate a feature on one of the candidates. Critically, candidate stimuli were presented sequentially, and saccade adaptation, thus, had to resolve a conflict between a task-relevant and a task-irrelevant error signal that were separated in space and time. We found that the saccade target influenced several aspects of oculomotor learning. In presence of a small target, saccade adaptation evaluated movement accuracy based on the first available error signal after the saccade, irrespective of its task relevance. However, a large target not only allowed for greater flexibility when evaluating movement accuracy, but it also promoted a stronger contribution of strategic behavior when compensating inaccurate saccades. Our results demonstrate how motor adaptation maintains movement accuracy in dynamic environments, and how properties of the visual environment modulate the relative contribution of different learning processes.NEW & NOTEWORTHY Motor adaptation is typically studied in static environments, where all information that is required to evaluate movement accuracy is available simultaneously. Here, using saccadic eye movements as a model, we studied motor adaptation in a dynamic environment, where the availability of conflicting information about movement accuracy varied over time. We demonstrate that properties of the visual environment determine how dynamic movement errors are corrected.

Underestimation of the number of hidden objects.

The perceptual representation of our environment does not only involve what we actually can see, but also inferences about what is hidden from our sight. For example, in amodal completion, simple contours or surfaces are filled-in behind occluding objects allowing for a complete representation. This is important for many everyday tasks, such as visual search, foraging, and object handling. Although there is support for completion of simple patterns from behavioral and neurophysiological studies, it is unclear if these mechanisms extend to complex, irregular patterns. Here, we show that the number of hidden objects on partially occluded surfaces is underestimated. Observers did not consider accurately the number of visible objects and the proportion of occlusion to infer the number of hidden objects, although these quantities were perceived accurately and reliably. However, visible objects were not simply ignored: estimations of hidden objects increased when the visible objects formed a line across the occluder and decreased when the visible objects formed a line outside of the occluder. Confidence ratings for numerosity estimation were similar for fully visible and partially occluded surfaces. These results suggest that perceptual inferences about what is hidden in our environment can be very inaccurate und underestimate the complexity of the environment.

Familiar objects benefit more from transsaccadic feature predictions.

The transsaccadic feature prediction mechanism associates peripheral and foveal information belonging to the same object to make predictions about how an object seen in the periphery would appear in the fovea or vice versa. It is unclear if such transsaccadic predictions require experience with the object such that only familiar objects benefit from this mechanism by virtue of having peripheral-foveal associations. In two experiments, we tested whether familiar objects have an advantage over novel objects in peripheral-foveal matching and transsaccadic change detection tasks. In both experiments, observers were unknowingly familiarized with a small set of stimuli by completing a sham orientation change detection task. In the first experiment, observers subsequently performed a peripheral-foveal matching task, where they needed to pick the foveal test object that matched a briefly presented peripheral target. In the second experiment, observers subsequently performed a transsaccadic object change detection task where a peripheral target was exchanged or not exchanged with another target after the saccade, either immediately or after a 300-ms blank period. We found an advantage of familiar objects over novel objects in both experiments. While foveal-peripheral associations explained the familiarity effect in the matching task of the first experiment, the second experiment provided evidence for the advantage of peripheral-foveal associations in transsaccadic object change detection. Introducing a postsaccadic blank improved change detection performance in general but more for familiar than for novel objects. We conclude that familiar objects benefit from additional object-specific predictions.

Humans trade off search costs and accuracy in a combined visual search and perceptual task.

To interact with one's environment, relevant objects have to be selected as targets for saccadic eye movements. Previous studies have demonstrated that factors such as visual saliency and reward influence saccade target selection, and that humans can dynamically trade off these factors to maximize expected value during visual search. However, expected value in everyday situations not only depends on saliency and reward, but also on the required time to find objects, and the likelihood of a successful object-interaction after search. Here we studied whether search costs and the accuracy to discriminate an object feature can be traded off to maximize expected value. We designed a combined visual search and perceptual discrimination task, where participants chose whether to search for an easy- or difficult-to-discriminate target in search displays populated by distractors that shared features with either the easy or the difficult target. Participants received a monetary reward for correct discriminations and were given limited time to complete as many trials as they could. We found that participants considered their discrimination performance and the search costs when choosing targets and, by this, maximized expected value. However, the accumulated reward was constrained by noise in both the choice of which target to search for, and which elements to fixate during search. We conclude that humans take into account the prospective search time and the likelihood of successful a object-interaction, when deciding what to search for. However, search performance is constrained by noise in decisions about what to search for and how to search for it.

Evaluation of the Addition of Angiotensin II in Patients With Shock After Cardiac Surgery at a Veterans Affairs Medical Center.

BACKGROUND: Vasoplegic shock occurs in up to 37% of cardiac surgery patients. We investigated the use of angiotensin II for treating vasoplegic shock in these patients. OBJECTIVES: We assessed clinical outcomes and mortality in patients undergoing cardiac surgery at our center between March 1, 2018 and October 31, 2020 who developed vasoplegic shock, comparing those who received angiotensin II with those who did not. METHODS: This was a retrospective chart review. Response to angiotensin II was defined as increase in or maintenance of mean arterial pressure (MAP) and decrease in background vasopressor dosage. RESULTS: Angiotensin II was administered to 7 patients (postoperatively in 4 patients [57.1%]) with vasoplegic shock and baseline norepinephrine equivalent (NEE) of 0.49 ± 0.08 µg/kg/min; 12 patients with vasoplegic shock did not receive angiotensin II. Within 3 hours of angiotensin II administration, NEE decreased by 38.0 ± 33.1%. Angiotensin patients were more likely to newly require renal replacement therapy (66.7% vs 9.1%, P = 0.03) and had a longer, although not statistically significant, postoperative stay (23.1 vs 14.0 days, P = 0.16). Despite higher NEE requirements at baseline (0.49 vs 0.30, P = 0.03) and over the next 48 hours in the angiotensin group, no between-group differences in 7-day mortality (14.3% vs 0.0%, P = 0.37) or 30-day mortality (28.6% vs 8.3%, P = 0.52) were noted. CONCLUSION AND RELEVANCE: In patients who developed vasoplegic shock after cardiac surgery, angiotensin II administration allowed immediate dosage reductions of other vasopressors while maintaining MAP. Despite its small sample size, this study adds to the paucity of data in these patients and highlights future research needs.

Telerehabilitation: Future of Phase II Cardiac Rehabilitation: Review of Preliminary Outcomes.

In this brief communication, we reported Telehealth Home-Based Cardiac Rehabilitation (CR) program structure and preliminary outcomes from patients that completed a 12-week program after coronary artery bypass graft surgery (CABG). We aim to advocate the use of Telerehabilitation as a Phase II CR in patients immediately after the CABG. This approach was innovative and encouraging because the patients were still in subacute phase. The program can serve as a continuation of care for the patients after being discharged from a hospital while regaining their functional ability at home. Our preliminary outcomes demonstrated improvements in resting heart rate, activity level, nutrition status, self-efficacy for managing cardiac diseases, muscle strength, endurance and depression. There were no adverse events during the virtual sessions. Patient satisfaction score was high.

Structure of visual biases revealed by individual differences.

Multiple studies have shown that certain visual stimuli are perceived in accordance with strong biases that are both robust within individuals and highly variable from one individual to the next. These biases undergo small changes over time that demonstrate that they constitute latent states of the visual system. The literature to date indicates that the individual biases for different stimulus classes are independent of each other. Here we asked whether some of these biases are nonetheless related to one another. We measured individual biases for five classes of stimuli in 1000 participants. The stimuli were two different versions of two-dimensional apparent motion, smooth motion in Glass patterns, and two different structure-from-motion stimuli. There were pronounced individual biases in all stimuli, and these biases varied in direction and strength across individuals. Some biases were not independent: the two biases for apparent motion direction were most strongly correlated, and they were both correlated, but less strongly, to the bias direction for smooth motion. While all other pairs of biases had unrelated directions, the strengths of all biases were correlated. The correlation of bias strengths may be due to either a common factor across the stimulus types, or an attentional effect. Only a tiny fraction of the between-participant variance can be explained by age and gender. These results show that latent states of the visual system that we measure as individual biases are organized in a structured way, and call out for further study of this under-explored aspect of visual perception.

Humans represent the precision and utility of information acquired across fixations.

Our environment contains an abundance of objects which humans interact with daily, gathering visual information using sequences of eye-movements to choose which object is best-suited for a particular task. This process is not trivial, and requires a complex strategy where task affordance defines the search strategy, and the estimated precision of the visual information gathered from each object may be used to track perceptual confidence for object selection. This study addresses the fundamental problem of how such visual information is metacognitively represented and used for subsequent behaviour, and reveals a complex interplay between task affordance, visual information gathering, and metacogntive decision making. People fixate higher-utility objects, and most importantly retain metaknowledge about how much information they have gathered about these objects, which is used to guide perceptual report choices. These findings suggest that such metacognitive knowledge is important in situations where decisions are based on information acquired in a temporal sequence.

A Revised Framework for the Investigation of Expectation Update Versus Maintenance in the Context of Expectation Violations: The ViolEx 2.0 Model.

Expectations are probabilistic beliefs about the future that shape and influence our perception, affect, cognition, and behavior in many contexts. This makes expectations a highly relevant concept across basic and applied psychological disciplines. When expectations are confirmed or violated, individuals can respond by either updating or maintaining their prior expectations in light of the new evidence. Moreover, proactive and reactive behavior can change the probability with which individuals encounter expectation confirmations or violations. The investigation of predictors and mechanisms underlying expectation update and maintenance has been approached from many research perspectives. However, in many instances there has been little exchange between different research fields. To further advance research on expectations and expectation violations, collaborative efforts across different disciplines in psychology, cognitive (neuro)science, and other life sciences are warranted. For fostering and facilitating such efforts, we introduce the ViolEx 2.0 model, a revised framework for interdisciplinary research on cognitive and behavioral mechanisms of expectation update and maintenance in the context of expectation violations. To support different goals and stages in interdisciplinary exchange, the ViolEx 2.0 model features three model levels with varying degrees of specificity in order to address questions about the research synopsis, central concepts, or functional processes and relationships, respectively. The framework can be applied to different research fields and has high potential for guiding collaborative research efforts in expectation research.

Rapid visual adaptation persists across saccades.

Neurons in the visual cortex quickly adapt to constant input, which should lead to perceptual fading within few tens of milliseconds. However, perceptual fading is rarely observed in everyday perception, possibly because eye movements refresh retinal input. Recently, it has been suggested that amplitudes of large saccadic eye movements are scaled to maximally decorrelate presaccadic and postsaccadic inputs and thus to annul perceptual fading. However, this argument builds on the assumption that adaptation within naturally brief fixation durations is strong enough to survive any visually disruptive saccade and affect perception. We tested this assumption by measuring the effect of luminance adaptation on postsaccadic contrast perception. We found that postsaccadic contrast perception was affected by presaccadic luminance adaptation during brief periods of fixation. This adaptation effect emerges within 100 milliseconds and persists over seconds. These results indicate that adaptation during natural fixation periods can affect perception even after visually disruptive saccades.

Selective postsaccadic enhancement of motion perception.

Saccadic eye movements can drastically affect motion perception: during saccades, the stationary surround is swept rapidly across the retina and contrast sensitivity is suppressed. However, after saccades, contrast sensitivity is enhanced for color and high-spatial frequency stimuli and reflexive tracking movements known as ocular following responses (OFR) are enhanced in response to large field motion. Additionally, OFR and postsaccadic enhancement of neural activity in primate motion processing areas are well correlated. It is not yet known how this postsaccadic enhancement arises. Therefore, we tested if the enhancement can be explained by changes in the balance of centre-surround antagonism in motion processing, where spatial summation is favoured at low contrasts and surround suppression is favoured at high contrasts. We found motion perception was selectively enhanced immediately after saccades for high spatial frequency stimuli, consistent with previously reported selective postsaccadic enhancement of contrast sensitivity for flashed high spatial frequency stimuli. The observed enhancement was also associated with changes in spatial summation and suppression, as well as contrast facilitation and inhibition, suggesting that motion processing is augmented to maximise visual perception immediately after saccades. The results highlight that spatial and contrast properties of underlying neural mechanisms for motion processing can be affected by an antecedent saccade for highly detailed stimuli and are in line with studies that show behavioural and neuronal enhancement of motion processing in non-human primates.

Age effects on saccadic suppression of luminance and color.

Saccadic eye movements modulate visual perception: they initiate and terminate high acuity vision at a certain location in space, but before and during their execution visual contrast sensitivity is strongly attenuated for 100 to 200 ms. Transient perisaccadic perceptual distortions are assumed to be an important mechanism to maintain visual stability. Little is known about age effects on saccadic suppression, even though for healthy adults other major age-related changes are well documented, like a decrease of visual contrast sensitivity for intermediate and high spatial frequencies or an increase of saccade latencies. Here, we tested saccadic suppression of luminance and isoluminant chromatic flashes in 100 participants from eight to 78 years. To estimate the effect of saccadic suppression on contrast sensitivity, we used a two-alternative forced choice (2AFC) design and an adaptive staircase procedure to modulate the luminance or chromatic contrast of a flashed detection target during fixation and 15 ms after saccade onset. The target was a single horizontal luminance or chromatic line flashed 2° above or below the fixation or saccade target. Compared to fixation, average perisaccadic contrast sensitivity decreased significantly by 66% for luminance and by 36% for color. A significant correlation was found for the strength of saccadic suppression of luminance and color. However, a small age effect was found only for the strength of saccadic suppression of luminance, which increased from 64% to 70% from young to old age. We conclude that saccadic suppression for luminance and color is present in most participants independent of their age and that mechanisms of suppression stay relatively stable during healthy aging.

A bias in saccadic suppression of shape change.

Processing of visual information in the central (foveal) and peripheral visual field is vastly different. To achieve a homogeneous representation of the visual world across eye movements, the visual system needs to compensate for these differences. By introducing subtle changes between peripheral and foveal inputs across saccades, one can test this compensation. We morphed shapes between a triangle and a circle and presented two different change directions (circularity decrease or increase) at varying magnitudes across a saccade. In a change-discrimination task, observers disproportionally often reported percepts of circularity increase. To test the relationship with visual-field differences, we measured perception when shapes were exclusively presented either in the periphery (before a saccade), or in the fovea (after a saccade). We found that overall shapes were perceived as more circular before than after a saccade and the more pronounced this difference was for a participant, the smaller was their circularity-increase bias in the change-discrimination task. We propose that visual-field differences have a direct and an indirect influence on transsaccadic perception of shape change. The direct influence is based on the distinct appearance of shape in the central and peripheral visual field in a trial, causing an increase of the perceptual magnitude of circularity-decrease changes. The indirect influence is based on long-term build-up of transsaccadic expectations; if a change is opposite (circularity increase) to the expectation (circularity decrease), it should elicit a strong error signal facilitating change detection. We discuss the concept of transsaccadic expectations and theoretical implications for transsaccadic perception of other feature changes.

Perceptual Difficulty Persistently Increases Dominance in Binocular Rivalry-Even Without a Task.

A major objective of perception is the reduction of uncertainty about the outside world. Eye-movement research has demonstrated that attention and oculomotor control can subserve the function of decreasing uncertainty in vision. Here, we ask whether a similar effect exists for awareness in binocular rivalry, when two distinct stimuli presented to the two eyes compete for awareness. We tested whether this competition can be biased by uncertainty about the stimuli and their relevance for a perceptual task. Specifically, we have stimuli that are perceptually difficult (i.e., carry high perceptual uncertainty) compete with stimuli that are perceptually easy (low perceptual uncertainty). Using a no-report paradigm and reading the dominant stimulus continuously from the observers' eye movements, we find that the perceptually difficult stimulus becomes more dominant than the easy stimulus. This difference is enhanced by the stimuli's relevance for the task. In trials with task, the difference in dominance emerges quickly, peaks before the response, and then persists throughout the trial (further 10 s). However, the difference is already present in blocks before task instruction and still observable when the stimuli have ceased to be task relevant. This shows that perceptual uncertainty persistently increases perceptual dominance, and this is magnified by task relevance.

Achieving visual stability during smooth pursuit eye movements: Directional and confidence judgements favor a recalibration model.

During smooth pursuit eye movements, the visual system is faced with the task of telling apart reafferent retinal motion from motion in the world. While an efference copy signal can be used to predict the amount of reafference to subtract from the image, an image-based adaptive mechanism can ensure the continued accuracy of this computation. Indeed, repeatedly exposing observers to background motion with a fixed direction relative to that of the target that is pursued leads to a shift in their point of subjective stationarity (PSS). We asked whether the effect of exposure reflects adaptation to motion contingent on pursuit direction, recalibration of a reference signal or both. A recalibration account predicts a shift in reference signal (i.e. predicted reafference), resulting in a shift of PSS, but no change in sensitivity. Results show that both directional judgements and confidence judgements about them favor a recalibration account, whereby there is an adaptive shift in the reference signal caused by the prevailing retinal motion during pursuit. We also found that the recalibration effect is specific to the exposed visual hemifield.

Motor learning by selection in visual working memory.

Motor adaptation maintains movement accuracy over the lifetime. Saccadic eye movements have been used successfully to study the mechanisms and neural basis of adaptation. Using behaviorally irrelevant targets, it has been shown that saccade adaptation is driven by errors only in a brief temporal interval after movement completion. However, under natural conditions, eye movements are used to extract information from behaviorally relevant objects and to guide actions manipulating these objects. In this case, the action outcome often becomes apparent only long after movement completion, outside the supposed temporal window of error evaluation. Here, we show that saccade adaptation can be driven by error signals long after the movement when using behaviorally relevant targets. Adaptation occurred when a task-relevant target appeared two seconds after the saccade, or when a retro-cue indicated which of two targets, stored in visual working memory, was task-relevant. Our results emphasize the important role of visual working memory for optimal movement control.