Orienting of attention with eye and arrow cues and the effect of overtraining.

In contrast to the classical distinction between a controlled orienting of attention induced by central cues and an automatic capture induced by peripheral cues, recent studies suggest that central cues, such as eyes and arrows, may trigger a reflexive-like attentional shift. Yet, it is not clear if the attention shifts induced by these two cues are similar or if they differ in some important aspect. To answer this question, in Experiment 1 we directly compared eye and arrow cues in a counter-predictive paradigm while in Experiment 2 we compared the above cues with a different symbolic cue. Finally, in Experiment 3 we tested the role of over-learned associations in cueing effects. The results provide evidence that eyes and arrows induce identical behavioural effects. Moreover, they show that over-learned associations between spatially neutral symbols and the cued location play an important role in yielding early attentional effects.

Psychophysical and electrophysiological evidence of independent facilitation by collinearity and similarity in texture grouping and segmentation.

Gestalt factors of collinearity and similarity facilitate two fundamental perceptual tasks: grouping elements into figures and segmentation of figures from the ground. We have used a global-local paradigm to examine the psychophysical and neural correlates of these processes in humans: observers discriminated between orientations of either a three-Gabor group (grouping), or of a central Gabor within the group (segmentation). Groups were centered on a background of differently oriented Gabors. In both tasks, accuracy was increased by the collinearity (Experiment 1) and similarity (Experiment 2) of elements within the three-Gabor group. ERP correlates of facilitation differed across tasks. For segmentation, they were indexed by increased amplitude of negative ERP components, specific for processing textures, peaking at 75-250 and 150-250 ms, respectively. For grouping, collinearity and similarity had different effects. Collinearity produced a positive polarity deflection between 40 and 179 ms (i.e. the opposite to segmentation). This task-dependent switch in sign of polarity change, without corresponding changes in the stimulus or perception, reflects distinct neural mechanisms for collinear facilitation in grouping and segmentation. In contrast, similarity reduced positivity at 275 ms. Results show similar modulation of segmentation components via the distinct mechanism underlying collinearity and similarity, but distinct modulation of grouping components via collinearity and similarity.

Attentional orienting induced by arrows and eye-gaze compared with an endogenous cue.

Exogenous orienting has been widely studied by using peripheral cues whereas endogenous orienting has been studied with directional central cues. However, recent evidence has shown that centrally presented eye-gaze and arrows may produce an automatic rather than voluntary orienting of attention. Therefore, the aim of the present study was to investigate the behavioural and electrophysiological (event-related potentials-ERP) correlates of the attentional shift induced by arrows and eye-gaze. In order to have a control condition, we compared arrows and eye-gaze with a purely endogenous cue, i.e., a texture arbitrarily coding one direction. We analyzed the ERP components (P1, N1, P2a, P2p, P3) elicited by the cue stimuli and the early lateralised attentional effect (early directing attention negativity-EDAN). In addition, in order to investigate the topography of the neural mechanisms underlying the cortical activity in each cueing condition, we applied a temporal segmentation procedure. The results showed that the three cueing conditions induced a different strength of activation within the same cortical network. Occipito-parietal regions were involved in the early processing of visual information, followed by an involvement of frontal areas, likely implicated in learning associations. These data confirm the assumption that, in contrast to purely endogenous cues, arrows and eye-gaze induce a very fast attentional shift. However, the similarity of the ERP components and of the topographical cortical maps among conditions suggest that this early orienting of attention is more likely related to an overlearned association mechanism rather than to a real exogenous attentional process.

Tranexamic acid compared with high-dose aprotinin in primary elective heart operations: effects on perioperative bleeding and allogeneic transfusions.

OBJECTIVE: Since excessive fibrinolysis during cardiac surgery is frequently associated with abnormal perioperative bleeding, many authors have advocated prophylactic use of antifibrinolytic drugs to prevent hemorrhagic disorders. We compared the effects of tranexamic acid (a synthetic antifibrinolytic drug) with aprotinin (a natural derivative product with antifibrinolytic properties) on perioperative bleeding and the need for allogeneic transfusions. METHODS: In a single-center prospective randomized unblinded trial, 1040 consecutive patients undergoing primary, elective cardiac operations with cardiopulmonary bypass received either high-dose aprotinin or tranexamic acid. The aprotinin group (518 patients) received 280 mg in 20 minutes before the skin incision, 280 mg in the priming solution of the extracorporeal circuit, and a continuous infusion of 70 mg/h throughout the operation. The tranexamic acid group (522 patients) received 1 g in 20 minutes before the skin incision, 500 mg in the priming solution of the extracorporeal circuit, and a continuous infusion of 400 mg/h during the operation. Postoperative bleeding, perioperative transfusions, and hematologic variables were evaluated at fixed times. Postoperative thrombotic complications, intubation time, intensive care unit stay, and hospital stay were recorded. RESULTS: Postoperative bleeding was similar in the 2 groups: aprotinin 250 mL (150-400 mL) versus tranexamic acid 300 mL (200-450 mL) (median and 25th-75th quartiles), median difference of 50 mL (95% confidence intervals, 0-50 mL). The number of transfusions and the outcome did not differ. CONCLUSIONS: Tranexamic acid and aprotinin show similar clinical effects on bleeding and allogeneic transfusion in patients undergoing primary elective heart operations. Since tranexamic acid is about 100 times cheaper than aprotinin, its use is preferable in this type of patient.

Hemostatic effects of aprotinin, tranexamic acid and epsilon-aminocaproic acid in primary cardiac surgery.

BACKGROUND: The effects of epsilon-aminocaproic acid (EACA) and tranexamic acid (TA) on bleeding and allogeneic transfusions, and the cost of pharmacological and transfusional treatment were compared to aprotinin (AP). METHODS: We randomized 210 patients subjected to elective cardiac surgery. Of these, 68 patients received EACA (a bolus of 5 g, an infusion of 2 g/h, and 2.5 g in the priming), 72 patients received TA (a bolus of 1 g, an infusion of 400 mg/h, and 500 mg in the priming), and 70 patients received AP (a bolus of 280 mg, an infusion of 70 mg/h, and 280 mg in the priming). Postoperative blood loss and homologous transfusions were collected and the cost of pharmacological treatment and homologous transfusions were calculated. RESULTS: Bleeding but not allogeneic transfusions was significantly higher in the EACA group (467+/-234 versus TA, 311+/-231 versus AP, 283+/-233; p < 0.001). Costs of pharmacological and transfusional treatment were significantly lower in the TA group ($58.10+/-$105.10) versus the EACA group ($100.70+/-$158.60) versus the AP group ($432.60+/-$118.70) (p < 0.0001). CONCLUSIONS: Compared to AP, TA has the same effects on bleeding and transfusions, but with a significant reduction of costs. Patients treated with EACA showed a significantly higher postoperative bleeding with an increased trend of transfusion requirement.