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1.
Q J Exp Psychol (Hove) ; : 17470218241264627, 2024 Jun 14.
Article in English | MEDLINE | ID: mdl-38876999

ABSTRACT

Atypical visual processing has been reported in developmental conditions like autism and dyslexia, and some accounts propose a causal role for visual processing in the development of these conditions. However, few studies make direct comparisons between conditions, or use sufficiently sensitive methods, meaning that it is hard to say whether atypical visual processing tells us anything specific about these conditions, or whether it reflects a more general marker of atypical development. Here I review findings from two computational modelling approaches (equivalent noise and diffusion modelling) and related electroencephalography (EEG) indices which we have applied to data from autistic, dyslexic and typically developing children to reveal how the component processes involved in visual processing and decision-making are altered in autism and dyslexia. The results identify both areas of convergence and divergence in autistic and dyslexic children's visual processing and decision-making, with implications for influential theoretical accounts such as weak central coherence, increased internal noise and dorsal-stream vulnerability. In both sets of studies, we also see considerable variability across children in all three groups. To better understand this variability, and further understand the convergence and divergence identified between conditions, future studies would benefit from studying how the component processes reviewed here relate to transdiagnostic dimensions, which will also give insights into individual differences in visual processing and decision-making more generally.

2.
Autism Adulthood ; 5(4): 411-422, 2023 Dec 01.
Article in English | MEDLINE | ID: mdl-38116051

ABSTRACT

Background: Sensory processing differences are commonly experienced by autistic individuals, and some sensory experiences can greatly impact the mental health and quality of life of individuals. Previous research suggests that adapting the sensory nature of environments may improve individual experiences and engagement with these spaces. However, knowledge about which public places are particularly disabling is limited, especially from the perspective of autistic individuals. Little is also known about what in the sensory environment makes them particularly disabling. Methods: In this participatory research study, we investigated the sensory experiences of autistic adults in public spaces. We used an online focus group method, recruiting 24 autistic adults across 7 focus groups. We applied content analysis, reflexive thematic analysis, and case study analysis. Results: The results of the content analysis showed that supermarkets, eateries (i.e., restaurants, cafés, pubs), highstreets and city/town centers, public transport, health care settings (i.e., doctor's surgeries and hospitals), and retail shops and shopping centers are experienced to be commonly disabling sensory environments for autistic adults. However, outdoor spaces, retail shops, museums, concert venues/clubs, cinemas/theaters, and stadiums are identified to be commonly less disabling sensory environments. In addition, through reflexive thematic analysis we identified 6 key principles that underlie how disabling or enabling sensory environments are: Sensoryscape (sensory environment), Space, Predictability, Understanding, Adjustments, and Recovery. We represented these principles as a web to emphasize the interconnected, dimensional spectrum of the different themes. Lastly, we used case study analysis to evidence these principles in the commonly disabling sensory environments for richer detail and context and to provide credibility for the principles. Conclusions: Our findings have important implications for businesses, policy, and built environment designers to reduce the sensory impact of public places to make them more enabling for autistic people. By making public spaces more enabling, we may be able to improve quality of life for autistic individuals.


Why was this study done?: Autistic people often experience differences in sensory processing, such as finding bright lights and sounds overwhelming and painful. This has been linked to poorer quality of life and mental health. Not much is known about how public places could be changed to be less disabling for autistic adults. What was the purpose of this study?: We aimed to find out which public places are disabling for autistic adults due to the sensory environment, and what about these places makes them especially challenging. What did the researchers do?: We invited autistic adults to take part in online focus groups to tell us about their sensory experiences in public places. In total, 24 people took part across 7 focus groups. We analysed the data 3 ways: 1) we conducted content analysis, identifying categories of words or phrases that share meaning to find commonly disabling and enabling places; 2) we conducted reflexive thematic analysis, developing themes and sub-themes from trends in the data to understand how sensory environments can be experienced as disabling or enabling; and 3) we conducted case study analysis, to see if the themes and sub-themes were present in the commonly disabling environments. What were the results of the study?: We found that supermarkets, eateries (i.e., restaurants, cafés, pubs), highstreets and city/town centres, public transport, healthcare settings (i.e., doctor's surgeries and hospitals), and retail shops and shopping centres, were most often mentioned as being disabling sensory environments. But, outdoor spaces, retail shops, museums, concert venues/clubs, cinemas/theatres, and stadiums were most often talked about as being less disabling sensory environments. We also identified principles that can make these environments either disabling or enabling. These included Sensoryscape or the `sensory landscape' (sensory burden, sustained and inescapable input, uncontrollable environment), Space (busy and crowded, confined the built environment is), Predictably (lack of information, inconsistent and unfamiliar, and uncertainty), Understanding (unsupportive people, misunderstanding and judgement), Adjustments (suitable adjustments, pace pressures, inflexible communication), and Recovery (space to escape, unable to recover and prepare). Last, we showed in more detail what these principles look like in the different disabling public places. What do these findings add to what was already known?: Our findings add to our understanding about how autistic adults experience public places; particularly, that there are a range of external factors linked with sensory processing differences which can make public places disabling. What are potential weaknesses in the study?: Our study could have recruited a more diverse range of autistic individuals, such as those with cooccurring intellectual disability. It is important to understand experiences from a diverse range of autistic people to ensure that outcomes from research can improve the lives of all autistic people. How will these findings help autistic adults now or in the future?: Our findings provide insights into how public places could be improved so that they can become more enabling environments for autistic people. This is important for businesses, policy, and the design of spaces to make public places more accessible, improving mental wellbeing and quality of life for autistic individuals.

3.
Curr Dir Psychol Sci ; 32(4): 300-306, 2023 Aug.
Article in English | MEDLINE | ID: mdl-37547284

ABSTRACT

A cornerstone of human information processing is how we make decisions about incoming sensory percepts. Much of psychological science has focused on understanding how these judgements operate in skilled adult observers. While not typically the focus of this research, there is considerable variability in how adults make these judgements. Here, we review complementary computational modelling, electrophysiological data, eye-tracking and longitudinal approaches to the study of perceptual decisions across neurotypical development and in neurodivergent individuals. These data highlight multiple parameters and temporal dynamics feeding into how we become skilled adult perceptual decision makers, and which may help explain why we vary so much in how we make perceptual decisions.

5.
Proc Natl Acad Sci U S A ; 120(15): e2210409120, 2023 04 11.
Article in English | MEDLINE | ID: mdl-37023130

ABSTRACT

Stimulator of interferon genes (STING) is a key mediator of type-I interferon (IFN-I) signaling in response to a variety of stimuli, but the contribution of STING to homeostatic processes is not fully characterized. Previous studies showed that ligand activation of STING limits osteoclast differentiation in vitro through the induction of IFNß and IFN-I interferon-stimulated genes (ISGs). In a disease model (SAVI) driven by the V154M gain-of-function mutation in STING, fewer osteoclasts form from SAVI precursors in response to receptor activator of NF-kappaB ligand (RANKL) in an IFN-I-dependent manner. Due to the described role of STING-mediated regulation of osteoclastogenesis in activation settings, we sought to determine whether basal STING signaling contributes to bone homeostasis, an unexplored area. Using whole-body and myeloid-specific deficiency, we show that STING signaling prevents trabecular bone loss in mice over time and that myeloid-restricted STING activity is sufficient for this effect. STING-deficient osteoclast precursors differentiate with greater efficiency than wild types. RNA sequencing of wild-type and STING-deficient osteoclast precursor cells and differentiating osteoclasts reveals unique clusters of ISGs including a previously undescribed ISG set expressed in RANKL naïve precursors (tonic expression) and down-regulated during differentiation. We identify a 50 gene tonic ISG signature that is STING dependent and shapes osteoclast differentiation. From this list, we identify interferon-stimulated gene 15 (ISG15) as a tonic STING-regulated ISG that limits osteoclast formation. Thus, STING is an important upstream regulator of tonic IFN-I signatures shaping the commitment to osteoclast fates, providing evidence for a nuanced and unique role for this pathway in bone homeostasis.


Subject(s)
Osteoclasts , Signal Transduction , Animals , Mice , Cell Differentiation/physiology , Interferons/metabolism , Ligands , Mice, Inbred C57BL , Osteoclasts/metabolism , RANK Ligand/genetics , RANK Ligand/metabolism
6.
R Soc Open Sci ; 9(5): 200414, 2022 May.
Article in English | MEDLINE | ID: mdl-35592763

ABSTRACT

Dyslexic individuals have been reported to have reduced global motion sensitivity, which could be attributed to various causes including atypical magnocellular or dorsal stream function, impaired spatial integration, increased internal noise and/or reduced external noise exclusion. Here, we applied an equivalent noise experimental paradigm alongside a traditional motion-coherence task to determine what limits global motion processing in dyslexia. We also presented static analogues of the motion tasks (orientation tasks) to investigate whether perceptual differences in dyslexia were restricted to motion processing. We compared the performance of 48 dyslexic and 48 typically developing children aged 8 to 14 years in these tasks and used equivalent noise modelling to estimate levels of internal noise (the precision associated with estimating each element's direction/orientation) and sampling (the effective number of samples integrated to judge the overall direction/orientation). While group differences were subtle, dyslexic children had significantly higher internal noise estimates for motion discrimination, and higher orientation-coherence thresholds, than typical children. Thus, while perceptual differences in dyslexia do not appear to be restricted to motion tasks, motion and orientation processing seem to be affected differently. The pattern of results also differs from that previously reported in autistic children, suggesting perceptual processing differences are condition-specific.

7.
Sci Rep ; 12(1): 6072, 2022 04 12.
Article in English | MEDLINE | ID: mdl-35414064

ABSTRACT

Many studies report atypical responses to sensory information in autistic individuals, yet it is not clear which stages of processing are affected, with little consideration given to decision-making processes. We combined diffusion modelling with high-density EEG to identify which processing stages differ between 50 autistic and 50 typically developing children aged 6-14 years during two visual motion tasks. Our pre-registered hypotheses were that autistic children would show task-dependent differences in sensory evidence accumulation, alongside a more cautious decision-making style and longer non-decision time across tasks. We tested these hypotheses using hierarchical Bayesian diffusion models with a rigorous blind modelling approach, finding no conclusive evidence for our hypotheses. Using a data-driven method, we identified a response-locked centro-parietal component previously linked to the decision-making process. The build-up in this component did not consistently relate to evidence accumulation in autistic children. This suggests that the relationship between the EEG measure and diffusion-modelling is not straightforward in autistic children. Compared to a related study of children with dyslexia, motion processing differences appear less pronounced in autistic children. Exploratory analyses also suggest weak evidence that ADHD symptoms moderate perceptual decision-making in autistic children.


Subject(s)
Autistic Disorder , Dyslexia , Bayes Theorem , Child , Decision Making/physiology , Humans
8.
J Illusion ; 32022 Jan 10.
Article in English | MEDLINE | ID: mdl-35111989

ABSTRACT

Across two independent developmental labs, we have been puzzled by the observation that a small proportion of our child and adult participants consistently report perceiving motion in the direction opposite to that presented in random-dot motion displays, sometimes even when the motion is at 100% coherence. In this review, we first draw together existing reports of misperceptions of motion direction in random dot displays across observers in a small percentage of trials, before reporting evidence of consistent reverse motion perception in a minority of observers, including previously unreported observations from our own studies of visual development. We consider possible explanations for this reverse motion illusion, including motion induction, motion energy, correspondence noise and spatial undersampling. However, more work is required to understand the individual differences relating to this percept. We suggest that errors in perceived motion direction are likely to be more widespread than can be currently gleaned from the literature and explain why systematic study is needed, especially in children. Finally, we list some remaining open questions and call for collaborative efforts to document this phenomenon and stimulate future investigation.

9.
J Neurosci ; 42(1): 121-134, 2022 01 05.
Article in English | MEDLINE | ID: mdl-34782439

ABSTRACT

Children with and without dyslexia differ in their behavioral responses to visual information, particularly when required to pool dynamic signals over space and time. Importantly, multiple processes contribute to behavioral responses. Here we investigated which processing stages are affected in children with dyslexia when performing visual motion processing tasks, by combining two methods that are sensitive to the dynamic processes leading to responses. We used a diffusion model which decomposes response time and accuracy into distinct cognitive constructs, and high-density EEG. Fifty children with dyslexia (24 male) and 50 typically developing children (28 male) 6-14 years of age judged the direction of motion as quickly and accurately as possible in two global motion tasks (motion coherence and direction integration), which varied in their requirements for noise exclusion. Following our preregistered analyses, we fitted hierarchical Bayesian diffusion models to the data, blinded to group membership. Unblinding revealed reduced evidence accumulation in children with dyslexia compared with typical children for both tasks. Additionally, we identified a response-locked EEG component which was maximal over centro-parietal electrodes which indicated a neural correlate of reduced drift rate in dyslexia in the motion coherence task, thereby linking brain and behavior. We suggest that children with dyslexia tend to be slower to extract sensory evidence from global motion displays, regardless of whether noise exclusion is required, thus furthering our understanding of atypical perceptual decision-making processes in dyslexia.SIGNIFICANCE STATEMENT Reduced sensitivity to visual information has been reported in dyslexia, with a lively debate about whether these differences causally contribute to reading difficulties. In this large preregistered study with a blind modeling approach, we combine state-of-the art methods in both computational modeling and EEG analysis to pinpoint the stages of processing that are atypical in children with dyslexia in two visual motion tasks that vary in their requirement for noise exclusion. We find reduced evidence accumulation in children with dyslexia across both tasks, and identify a neural marker, allowing us to link brain and behavior. We show that children with dyslexia exhibit general difficulties with extracting sensory evidence from global motion displays, not just in tasks that require noise exclusion.


Subject(s)
Brain/physiopathology , Decision Making/physiology , Dyslexia/physiopathology , Motion Perception/physiology , Adolescent , Child , Electroencephalography , Female , Humans , Male
10.
Cortex ; 143: 109-126, 2021 10.
Article in English | MEDLINE | ID: mdl-34399308

ABSTRACT

Atypicalities in psychophysical thresholds for global motion processing have been reported in many neurodevelopmental conditions, including autism and dyslexia. Cross-syndrome comparisons of neural dynamics may help determine whether altered motion processing is a general marker of atypical development or condition-specific. Here, we assessed group differences in N2 peak amplitude (previously proposed as a marker of motion-specific processing) in typically developing (n = 57), autistic (n = 29) and dyslexic children (n = 44) aged 6-14 years, in two global motion tasks. High-density EEG data were collected while children judged the direction of global motion stimuli as quickly and accurately as possible, following a period of random motion. Using a data-driven component decomposition technique, we identified a reliable component that was maximal over occipital electrodes and had an N2-like peak at ~160 msec. We found no group differences in N2 peak amplitude, in either task. However, for both autistic and dyslexic children, there was evidence of atypicalities in later stages of processing that require follow up in future research. Our results suggest that early sensory encoding of motion information is unimpaired in dyslexic and autistic children. Group differences in later processing stages could reflect sustained global motion responses, decision-making, metacognitive processes and/or response generation, which may also distinguish between autistic and dyslexic individuals.


Subject(s)
Autistic Disorder , Dyslexia , Motion Perception , Child , Evoked Potentials , Humans
11.
Q J Exp Psychol (Hove) ; 74(11): 1953-1965, 2021 Nov.
Article in English | MEDLINE | ID: mdl-33998332

ABSTRACT

Interpreting the world around us requires integrating incoming sensory signals with prior information. Autistic individuals have been proposed to rely less on prior information and make more cautious responses than non-autistic individuals. Here, we investigated whether these purported features of autistic perception vary as a function of autistic-like traits in the general population. We used a diffusion model framework, whereby decisions are modelled as noisy evidence accumulation processes towards one of two bounds. Within this framework, prior information can bias the starting point of the evidence accumulation process. Our pre-registered hypotheses were that higher autistic-like traits would relate to reduced starting point bias caused by prior information and increased response caution (wider boundary separation). 222 participants discriminated the direction of coherent motion stimuli as quickly and accurately as possible. Stimuli were preceded with a neutral cue (square) or a directional cue (arrow). 80% of the directional cues validly predicted the upcoming motion direction. We modelled accuracy and response time data using a hierarchical Bayesian model in which starting point varied with cue condition. We found no evidence for our hypotheses, with starting point bias and response caution seemingly unrelated to Adult Autism Spectrum Quotient (AQ) scores. Alongside future research applying this paradigm to autistic individuals, our findings will help refine theories regarding the role of prior information and altered decision-making strategies in autistic perception. Our study also has implications for models of bias in perceptual decision-making, as the most plausible model was one that incorporated bias in both decision-making and sensory processing.


Subject(s)
Autistic Disorder , Adult , Bayes Theorem , Cognition , Cues , Humans , Reaction Time
12.
Comput Brain Behav ; 4(1): 53-69, 2021.
Article in English | MEDLINE | ID: mdl-33604512

ABSTRACT

Children make faster and more accurate decisions about perceptual information as they get older, but it is unclear how different aspects of the decision-making process change with age. Here, we used hierarchical Bayesian diffusion models to decompose performance in a perceptual task into separate processing components, testing age-related differences in model parameters and links to neural data. We collected behavioural and EEG data from 96 6- to 12-year-old children and 20 adults completing a motion discrimination task. We used a component decomposition technique to identify two response-locked EEG components with ramping activity preceding the response in children and adults: one with activity that was maximal over centro-parietal electrodes and one that was maximal over occipital electrodes. Younger children had lower drift rates (reduced sensitivity), wider boundary separation (increased response caution) and longer non-decision times than older children and adults. Yet, model comparisons suggested that the best model of children's data included age effects only on drift rate and boundary separation (not non-decision time). Next, we extracted the slope of ramping activity in our EEG components and covaried these with drift rate. The slopes of both EEG components related positively to drift rate, but the best model with EEG covariates included only the centro-parietal component. By decomposing performance into distinct components and relating them to neural markers, diffusion models have the potential to identify the reasons why children with developmental conditions perform differently to typically developing children and to uncover processing differences inapparent in the response time and accuracy data alone.

13.
Eur J Haematol ; 105(5): 555-560, 2020 Nov.
Article in English | MEDLINE | ID: mdl-32602982

ABSTRACT

OBJECTIVES: Management of pregnancy in women with congenital bleeding disorders (CBD) is challenging and requires understanding of risks conferred to both the mother and the foetus. Some elements of labour management are considered to increase the risk of neonatal bleeding and are not recommended for neonates at risk of a significant bleeding disorder. The impact of these restrictions on obstetric outcomes in women with CBD is unknown. METHODS: We retrospectively reviewed obstetric outcomes in a large cohort of women with CBD attending a specialised obstetric/haematology antenatal clinic over a 6-year period. RESULTS: Ninety-four pregnancies in 76 women with a wide variety of CBDs were assessed. Foetal precautions were recommended in the majority of cases (88%). Twenty (21.2%) were delivered by elective Caesarean section (CS), predominantly for obstetric indications. Of the 63 women who laboured with foetal precautions in place, 6 (10%) had a CS that was performed because of these precautions. There was no neonatal bleeding but primary postpartum haemorrhage (PPH) occurred in 12.2% of women. CONCLUSIONS: These data show that foetal precautions in labour recommended for women with CBDs will influence mode of delivery in approximately 10% of cases. This is important information for counselling these women about labour and delivery.


Subject(s)
Blood Coagulation Disorders, Inherited/epidemiology , Delivery, Obstetric , Fetus , Pregnancy Complications, Hematologic/epidemiology , Blood Coagulation Disorders, Inherited/diagnosis , Blood Coagulation Disorders, Inherited/etiology , Blood Coagulation Disorders, Inherited/therapy , Clinical Decision-Making , Delivery, Obstetric/adverse effects , Delivery, Obstetric/methods , Disease Management , Female , Hemorrhage/etiology , Humans , Infant, Newborn , Outcome Assessment, Health Care , Pregnancy , Pregnancy Complications, Hematologic/diagnosis , Pregnancy Complications, Hematologic/etiology , Pregnancy Complications, Hematologic/therapy , Retrospective Studies
14.
Viral Immunol ; 33(3): 246-249, 2020 04.
Article in English | MEDLINE | ID: mdl-32286184

ABSTRACT

Nucleic acid (NA) sensing receptors were first described in the context of host defense. We now know that some endosomal NA sensors play a critical role in the development of systemic autoimmune diseases such as systemic lupus erythematosus, whereas cytosolic Cyclic GMP-AMP Synthase/Stimulator of IFN Genes (cGAS/STING) DNA-detecting pathway has been associated with monogenic autoinflammatory interferonopathies such as Aicardi-Goutieres and Education; collaboration; communication STING-associated vasculopathy with onset in infancy (SAVI). DNaseII hypomorphic patients and DNase-/- IFNaR-/- (double knockout [DKO]) mice also develop an autoinflammatory syndrome associated with an interferon signature. We now add to the description of an unusual clinical manifestation of DKO mice that involves the accrual of trabecular bone in long bone marrow and the formation of ectopic bone within the spleen. This aberrant bone formation is lost not only in STING-deficient but also in Unc93b1-deficient mice and, therefore, depends on the interplay of cells expressing cytosolic and endosomal NA sensing receptors.


Subject(s)
Endodeoxyribonucleases/deficiency , Inflammation/etiology , Interferons/genetics , Nucleic Acids/metabolism , Osteogenesis , Signal Transduction , Toll-Like Receptors/metabolism , Animals , Endodeoxyribonucleases/genetics , Female , Interferons/immunology , Membrane Proteins/genetics , Membrane Proteins/metabolism , Membrane Transport Proteins/genetics , Membrane Transport Proteins/metabolism , Mice , Mice, Knockout , Toll-Like Receptors/genetics
16.
J Autism Dev Disord ; 49(12): 4901-4918, 2019 Dec.
Article in English | MEDLINE | ID: mdl-31489542

ABSTRACT

Visual perception in individuals with autism spectrum disorder (ASD) is often debated in terms of enhanced local and impaired global perception. Deficits in global motion perception seem to support this characterization, although the evidence is inconsistent. We conducted a large meta-analysis on global motion, combining 48 articles on biological and coherent motion. Results provide evidence for a small global motion processing deficit in individuals with ASD compared to controls in both biological and coherent motion. This deficit appears to be present independent of the paradigm, task, dependent variable, age or IQ of the groups. Results indicate that individuals with ASD are less sensitive to these types of global motion, although the difference in neural mechanisms underlying this behavioral difference remains unclear.


Subject(s)
Autism Spectrum Disorder/physiopathology , Motion Perception , Adolescent , Adult , Eye Movements , Female , Humans , Male , Vision, Ocular
17.
Dev Cogn Neurosci ; 38: 100670, 2019 08.
Article in English | MEDLINE | ID: mdl-31228678

ABSTRACT

Motion sensitivity increases during childhood, but little is known about the neural correlates. Most studies investigating children's evoked responses have not dissociated direction-specific and non-direction-specific responses. To isolate direction-specific responses, we presented coherently moving dot stimuli preceded by incoherent motion, to 6- to 7-year-olds (n = 34), 8- to 10-year-olds (n = 34), 10- to 12-year-olds (n = 34) and adults (n = 20). Participants reported the coherent motion direction while high-density EEG was recorded. Using a data-driven approach, we identified two stimulus-locked EEG components with distinct topographies: an early component with an occipital topography likely reflecting sensory encoding and a later, sustained positive component over centro-parietal electrodes that we attribute to decision-related processes. The component waveforms showed clear age-related differences. In the early, occipital component, all groups showed a negativity peaking at ˜300 ms, like the previously reported coherent-motion N2. However, the children, unlike adults, showed an additional positive peak at ˜200 ms, suggesting differential stimulus encoding. The later positivity in the centro-parietal component rose more steeply for adults than for the youngest children, likely reflecting age-related speeding of decision-making. We conclude that children's protracted development of coherent motion sensitivity is associated with maturation of both early sensory and later decision-related processes.


Subject(s)
Brain/physiology , Child Development/physiology , Evoked Potentials, Visual/physiology , Motion Perception/physiology , Photic Stimulation/methods , Adolescent , Adult , Child , Electroencephalography/methods , Female , Humans , Male , Reaction Time/physiology , Young Adult
18.
Eur J Obstet Gynecol Reprod Biol ; 239: 60-63, 2019 Aug.
Article in English | MEDLINE | ID: mdl-31185377

ABSTRACT

OBJECTIVE: Vertebral canal haematoma (VCH) complicates 1 in 168,000 obstetric epidurals (Ruppen et al., 2006). This risk is increased in women with inherited bleeding disorders (IBD). The impact of a contraindication to regional anaesthesia on pain management and obstetric outcome in these women is unknown. The purpose of this study was to determine anaesthetic use and obstetric outcomes in a cohort of women with IBD. STUDY DESIGN: 97 women with IBD that delivered 130 babies at the CWIUH from Jan 2011 to Dec 2016 were identified from a maternal medicine database. Multidisciplinary planning of peripartum care was communicated to labour ward staff using a simple checklist. The primary bleeding disorders were: Von Willebrands disease (VWD) Type 1 27 (27.8%); VWD Type 2A 3 (3.8%); Low VWF 3 (3.8%); Bleeding disorder of unknown aetiology (BDUA) 19 (19.6%); deficiency of Factors VII, VIII, IX, X, and XI 13 (13.4%); Carriers of Factor VIII, IX, X, XIII deficiency 17 (17.5%); 5 had combined deficiencies (5.2%) and there was one platelet function defect. 9 had a family history of a bleeding disorder (9.3%). Haemostatic support, analgesia, mode of delivery and maternal and fetal outcomes were compared between pregnancies where regional anaesthesia was permitted and those that were not using the Chi-squared test. RESULTS: When pregnancies where regional anaesthesia was not recommended (49) were compared with pregnancies where regional anaesthesia was considered safe (81), the women were more likely to see an anaesthetist before labour 46 (94%) vs 46 (61%): p < 0.001; to require prophylactic haemostatic support for delivery 30 (61%) vs 1 (1%): p < 0.001; to use a remifentanil infusion 15 (31%) vs 0: p < 0.001, and have general anaesthesia for Caesarean Section (CS) 10 (20%) vs 1(1%): p < 0.001. Vaginal birth 35 (71%) vs 53(65%): p = 0.4 and CS rates 14 (29%) vs 26 (32%) p = 0.28 were similar. Postpartum haemorrhage (PPH) was more common 11 (24%) vs 9(12%) vs p = 0.07 but not statistically so. There were no cases of neonatal bleeding or VCH. CONCLUSION: Contraindication to neuraxial blockade in labouring women with IBD does not influence mode of delivery. This information is reassuring to these women who may be anxious about delivery without regional anaesthesia.


Subject(s)
Anesthesia, Conduction , Blood Coagulation Disorders, Inherited , Contraindications , Delivery, Obstetric/statistics & numerical data , Cohort Studies , Female , Humans , Pregnancy
19.
J Vis ; 18(6): 15, 2018 06 01.
Article in English | MEDLINE | ID: mdl-30029225

ABSTRACT

The ability to judge speed is a fundamental aspect of visual motion processing. Speed judgments are generally assumed to depend on signals in motion-sensitive, directionally selective, neurons in areas such as V1 and MT. Speed comparisons might therefore be expected to be most accurate when they use information within a common set of directionally tuned neurons. However, there does not appear to be any published evidence on how well speeds can be compared for movements in different directions. We tested speed discrimination judgments between pairs of random-dot stimuli presented side-by-side in a series of four experiments (n = 65). Participants judged which appeared faster of a reference stimulus moving along the cardinal or oblique axis and a comparison stimulus moving either in the same direction or in a different direction. The bias (point of subjective equality) and sensitivity (Weber fraction) were estimated from individual psychometric functions fitted for each condition. There was considerable between-participants variability in psychophysical estimates across conditions. Nonetheless, participants generally made more acute comparisons between stimuli moving in the same direction than those moving in different directions, at least for conditions with an upwards reference (∼20% difference in Weber fractions). We also showed evidence for an oblique effect in speed discrimination when comparing stimuli moving in the same direction, and a bias whereby oblique motion tended to be perceived as moving faster than cardinal motion. These results demonstrate interactions between speed and direction processing, thus informing our understanding of how they are represented in the brain.


Subject(s)
Motion Perception/physiology , Pattern Recognition, Visual/physiology , Adolescent , Adult , Female , Humans , Male , Movement , Neurons/physiology , Psychophysics , Young Adult
20.
Atten Percept Psychophys ; 80(5): 1311-1324, 2018 Jul.
Article in English | MEDLINE | ID: mdl-29582387

ABSTRACT

When assessing the perceptual abilities of children, researchers tend to use psychophysical techniques designed for use with adults. However, children's poorer attentiveness might bias the threshold estimates obtained by these methods. Here, we obtained speed discrimination threshold estimates in 6- to 7-year-old children in UK Key Stage 1 (KS1), 7- to 9-year-old children in Key Stage 2 (KS2), and adults using three psychophysical procedures: QUEST, a 1-up 2-down Levitt staircase, and Method of Constant Stimuli (MCS). We estimated inattentiveness using responses to "easy" catch trials. As expected, children had higher threshold estimates and made more errors on catch trials than adults. Lower threshold estimates were obtained from psychometric functions fit to the data in the QUEST condition than the MCS and Levitt staircases, and the threshold estimates obtained when fitting a psychometric function to the QUEST data were also lower than when using the QUEST mode. This suggests that threshold estimates cannot be compared directly across methods. Differences between the procedures did not vary significantly with age group. Simulations indicated that inattentiveness biased threshold estimates particularly when threshold estimates were computed as the QUEST mode or the average of staircase reversals. In contrast, thresholds estimated by post-hoc psychometric function fitting were less biased by attentional lapses. Our results suggest that some psychophysical methods are more robust to attentiveness, which has important implications for assessing the perception of children and clinical groups.


Subject(s)
Attention/physiology , Photic Stimulation/methods , Sensory Thresholds/physiology , Adult , Child , Female , Humans , Male , Psychometrics/methods , Psychophysics/methods , Random Allocation
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