Animation supported communication on intensive care; a service improvement initiative.

Objective: COVID-19 has created unique challenges for families of patients admitted to intensive care units. Restricted visiting, language barriers and time constraints have limited communication, resulting in a lack of understanding and anxiety. We introduced digital animations to support communication and assessed the impact on families of patients admitted to intensive care.

Cardiac Transplantation following Cobalt Cardiomyopathy from Bilateral Metal-on-Metal Hip Replacements.

A fifty-two-year-old man underwent heart transplantation at our centre after four years of developing progressive heart failure symptoms due to cobalt toxicity-related cardiomyopathy. Between the ages of forty and forty-two, he underwent bilateral metal-on-metal hip arthroplasties for early onset osteoarthritis. Six years later, he developed increasing fatigue and pericardial effusions.

Bedside post-pyloric tube placement using direct visualisation in mechanically ventilated patients: A single centre case series.

Introduction: Post-pyloric feeding tubes are used for intensive care patients unable to tolerate gastric feeding. The Kangaroo Feeding Tube with IRIS Technology ('IRIS') uses real-time visualisation of anatomical markers to guide bedside placement, however limited studies currently explore post-pyloric insertions in mechanically ventilated patients. We describe a case series of 'IRIS' post-pyloric placements performed by trained intensivists and dietitians.

Contrast-Enhanced Echocardiography Application in Patients Supported by Extracorporeal Membrane Oxygenation (ECMO): A Narrative Review.

Extracorporeal membrane oxygenation (ECMO) is a lifesaving intervention increasingly used to support patients with severe respiratory and cardiac dysfunction. Echocardiography is an important tool, aiding implantation and monitoring during ECMO therapy, but often its use is limited by poor acoustic windows. This limitation may be overcome by the use of echocardiography contrast agents to improve diagnostic yield and reduce the need for other imaging modalities that may require patient transfer, involve ionizing radiation and, occasionally, nephrotoxic radio-opaque contrast medium.

Functional Networks for Social Communication in the Macaque Monkey.

All primates communicate. To dissect the neural circuits of social communication, we used fMRI to map non-human primate brain regions for social perception, second-person (interactive) social cognition, and orofacial movement generation. Face perception, second-person cognition, and face motor networks were largely non-overlapping and acted as distinct functional units rather than an integrated feedforward-processing pipeline.

Primate social attention: Species differences and effects of individual experience in humans, great apes, and macaques.

When viewing social scenes, humans and nonhuman primates focus on particular features, such as the models' eyes, mouth, and action targets. Previous studies reported that such viewing patterns vary significantly across individuals in humans, and also across closely-related primate species. However, the nature of these individual and species differences remains unclear, particularly among nonhuman primates.

Enhanced recovery for thoracic surgery in the elderly.

Purpose Of Review: Both surgical workload and the age of those patients being considered for radial pulmonary resection are increasing. Enhanced recovery programmes are now well established in most surgical disciplines and are increasingly reported in thoracic procedures. This review will discuss the relevant principles of these programmes as applied to an increasing elderly population.

Fatal cardiovascular instability secondary to hypercalcaemia and intracellular calcium deposition complicating T-cell leukaemia-lymphoma.

Adult T-cell leukaemia-lymphoma is a rare haematological malignancy, which can cause severe hypercalcaemia and metastatic calcification resulting in life-threatening arrhythmias.

Pharmacological Therapy for the Prevention and Treatment of Weakness After Critical Illness: A Systematic Review.

Objectives: ICU-acquired weakness is a common complication of critical illness and can have significant effects upon functional status and quality of life. As part of preliminary work to inform the design of a randomized trial of a complex intervention to improve recovery from critical illness, we sought to identify pharmacological interventions that may play a role in this area.

Data Sources: We systematically reviewed the published literature relating to pharmacological intervention for the treatment and prevention of ICU-acquired weakness.

Availability and use of capnography for in-hospital cardiac arrests in the United Kingdom.

Background: Airway complications occur more frequently outside the operating theatre and in emergency situations. Capnography remains the gold standard for confirming correct endotracheal tube placement, retaining high sensitivity and specificity in cardiac arrest. The 2010 European Resuscitation Council guidelines for adult advanced life support recommended waveform capnography in this setting.

What's new in the management of traumatic brain injury on neuro ICU?

Purpose Of Review: In recent years, we have begun to better understand how to monitor the injured brain, look for less common complications and importantly, reduce unnecessary and potentially harmful intervention. However, the lack of consensus regarding triggers for intervention, best neuromonitoring techniques and standardization of therapeutic approach is in need of more careful study. This review covers the most recent evidence within this exciting and dynamic field.

Reversible inactivation of pSTS suppresses social gaze following in the macaque (Macaca mulatta).

Humans and other primates shift their attention to follow the gaze of others [gaze following (GF)]. This behavior is a foundational component of joint attention, which is severely disrupted in neurodevelopmental disorders such as autism and schizophrenia. Both cortical and subcortical pathways have been implicated in GF, but their contributions remain largely untested.

Updates in the management of intracranial pressure in traumatic brain injury.

Purpose Of Review: Traumatic brain injury remains a common and often debilitating event across the world, producing significant burdens upon health and social care. Effective neurocritical care coupled with timely and appropriate neurosurgical intervention can produce significant improvements in patient outcome. There remains controversy about how best to manage intracranial pressure on the ICU; we review the recent literature addressing a number of key variables.

Facial muscle coordination in monkeys during rhythmic facial expressions and ingestive movements.

Evolutionary hypotheses regarding the origins of communication signals generally suggest, particularly for the case of primate orofacial signals, that they derive by ritualization of noncommunicative behaviors, notably including ingestive behaviors such as chewing and nursing. These theories are appealing in part because of the prominent periodicities in both types of behavior. Despite their intuitive appeal, however, there are little or no data with which to evaluate these theories because the coordination of muscles innervated by the facial nucleus has not been carefully compared between communicative and ingestive movements.

Chemotherapy options in elderly and frail patients with metastatic colorectal cancer (MRC FOCUS2): an open-label, randomised factorial trial.

Background: Elderly and frail patients with cancer, although often treated with chemotherapy, are under-represented in clinical trials. We designed FOCUS2 to investigate reduced-dose chemotherapy options and to seek objective predictors of outcome in frail patients with advanced colorectal cancer.

Methods: We undertook an open, 2 × 2 factorial trial in 61 UK centres for patients with previously untreated advanced colorectal cancer who were considered unfit for full-dose chemotherapy.

Eye-gaze and arrow cues influence elementary sound perception.

We report a novel effect in which the visual perception of eye-gaze and arrow cues change the way we perceive sound. In our experiments, subjects first saw an arrow or gazing face, and then heard a brief sound originating from one of six locations. Perceived sound origins were shifted in the direction indicated by the arrows or eye-gaze.

Following gaze: gaze-following behavior as a window into social cognition.

In general, individuals look where they attend and next intend to act. Many animals, including our own species, use observed gaze as a deictic ("pointing") cue to guide behavior. Among humans, these responses are reflexive and pervasive: they arise within a fraction of a second, act independently of task relevance, and appear to undergird our initial development of language and theory of mind.

Human-monkey gaze correlations reveal convergent and divergent patterns of movie viewing.

The neuroanatomical organization of the visual system is largely similar across primate species, predicting similar visual behaviors and perceptions. Although responses to trial-by-trial presentation of static images suggest that primates share visual orienting strategies, these reduced stimuli fail to capture key elements of the naturalistic, dynamic visual world in which we evolved. Here, we compared the gaze behavior of humans and macaques when they viewed three different 3-minute movie clips.

Social attention and the brain.

Humans and other animals pay attention to other members of their groups to acquire valuable social information about them, including information about their identity, dominance, fertility, emotions, and likely intent. In primates, attention to other group members and the objects of their attention is mediated by neural circuits that transduce sensory information about others and translate that information into value signals that bias orienting. This process likely proceeds via two distinct but integrated pathways: an ancestral, subcortical route that mediates crude but fast orienting to animate objects and faces; and a more derived route involving cortical orienting circuits that mediate nuanced and context-dependent social attention.

Role of central and mixed venous oxygen saturation measurement in perioperative care.

Complications after major surgery are a leading cause of morbidity and mortality. The etiology of postoperative complications is complex, but poor cardiorespiratory reserve appears to be a key factor. There is increasing interest in the use of central and mixed venous oxygen saturation to guide therapeutic interventions during the perioperative period.

Mirroring of attention by neurons in macaque parietal cortex.

Macaques, like humans, rapidly orient their attention in the direction other individuals are looking. Both cortical and subcortical pathways have been proposed as neural mediators of social gaze following, but neither pathway has been characterized electrophysiologically in behaving animals. To address this gap, we recorded the activity of single neurons in the lateral intraparietal area (LIP) of rhesus macaques to determine whether and how this area might contribute to gaze following.