Over half of older adult falls are caused by tripping. Many of these trips are likely due to obstacles present on walkways that put older adults or other individuals with low foot clearance at risk. Yet, Minimum Foot Clearance (MFC) values have not been measured in real-world settings and existing methods make it difficult to do so. In this paper, we present the Minimum Foot Clearance Estimation (MFCE) system that includes a device for collecting calibrated video data from pedestrians on outdoor walkways and a computer vision algorithm for estimating MFC values for these individuals. This system is designed to be positioned at ground level next to a walkway to efficiently collect sagittal plane videos of many pedestrians’ feet, which is then processed offline to obtain MFC estimates. Five-hundred frames of video data collected from 50 different pedestrians was used to train (370 frames) and test (130 frames) a convolutional neural network. Finally, data from 10 pedestrians was analyzed manually by three raters and compared to the results of the network. The footwear detection network had an Intersection over Union of 85% and was able to find the bottom of a segmented shoe with a 3-pixel average error. Root Mean Squared (RMS) errors for the manual and automated methods for estimating MFC values were 2.32 mm, and 3.70 mm, respectively. Future work will compare the accuracy of the MFCE system to a gold standard motion capture system and the system will be used to estimate the distribution of MFC values for the population. Falls are a major health issue, especially among those who are 65 or older, for whom falling is the most common reason for non-fatal injuries . Each yeA trip typically occurs during swing phase at or near the Minimum Foot Clearance (MFC) point if the trajectory of the foot is suddenly interrupted by an obstacle . The MFCTherefore, a better understanding of the distribution of MFC values for the overall population would allow for safer design of the built environment. Current guidelines vary considerably from one jurisdiction to the next. For instance, the Americans with Disabilities Act (ADA) , verticaConditions such as advanced age, Parkinson’s disease, performing dual tasks, or simply being fatigued, can cause individuals to have reduced mean MFC mean or increased MFC variance compared to young healthy individuals.There is a large body of literature when it comes to the measurement of MFC values but nearly all perform the measurement in the laboratory and most use optical motion capture . OpticalTherefore, new methods for efficiently measuring MFC in the real-world from large numbers of individuals are needed to develop a better understanding of MFC values for the population.The objective of this work is to present the Proof of Principle for an automated Minimum Foot Clearance Estimation (MFCE) system for estimating MFC values to address the limitations of existing MFC estimation methods. The MFCE system was designed to quickly gather and process MFC estimates for large numbers (thousands) of pedestrians on outdoor walkways that include level ground as well as obstacles of different sizes. This data will then be used to create population level distributions of MFC values that we think will be beneficial for revising standards for the design and maintenance of outdoor walkways. We describe our data collection and analysis methods  and describe the development and evaluation of the automated footwear detection, trajectory estimation and laser detection subsystems. Finally, we compare the manual and automated analysis methods and comment on the potential for the system to be used for estimating the distribution of MFC values for the population.It can easily collect large amounts of data quickly from many pedestriansThe measured MFC values will represent the lowest point of the entire footThe system is marker-less, there is no need for attaching markers to the participants or control the environment in any wayIt utilizes a simple and relatively low-cost equipment (consumer grade video camera and two lasers)The pedestrians are not aware of the device recording them therefore this measurement will not affect their walking performanceThe MFCE system includes two modules: A data collection module and an automated data analysis module that processes video data offline. The benefits of this novel system are that:The overarching objective of this work is to develop a system to define the population-level MFC distribution for pedestrians walking over level-ground walkways as well as over walkways that include a range of imperfections including surface discontinuities, obstacles or bumps. The resulting foot clearance distribution data will contribute to developing evidence-based guidelines for outdoor walkway maintenance and inform other strategies for minimizing the risk of trip-related falls on outdoor walkways.The data collection module  consistsThe device was designed to be positioned at ground level next to a public walkway to collect sagittal plane video images of pedestrians’ feet and lower legs as they walk by . Note thVideo was collected using the following camera settings: resolution of 1080 by 1920 pixels, frame rate of 60 p, shutter speed set to 1/10,000 s, and bit rate settings 130 Mb/s. This study was approved by the University Health Network Research Ethics Board and the University of Toronto Research Ethics Board.In this section we present the manual method for estimating MFC values from the video captured using the Data Collection Module and describe the development of the automated Data Analysis Module along with our method for comparing the manual and automated analyses.k) was calculated using Equation (x).To manually measure MFC values from MFCE video data, separate video clips were cropped for each pedestrian (50 frames) and identified the frame(s) where the laser beams land on their lower leg/foot (Equation  where thd) and calculated MFC value as shown in Equation  between the lowest point of the pedestrian’s footwear and the ground plane for each frame in where the foot was in swing phase. These distances were plotted for all frames from each pedestrian and the local minima was extracted. We measured this distance (Equation .(2)MFC=Automated analysis of MFCE video data requires five steps: selecting the video frames where each pedestrian is visible, detecting the ground plane, detecting the footwear, finding the MFC point in the swing foot trajectory, and locating the laser dots in the video image. In this paper, we describe how we used computer vision and machine learning techniques to automate three of these steps: footwear detection, estimation of the MFC point in the swing foot trajectory, and laser dot location detection. Future work will focus on automating the remaining two steps: selecting the video frames for each pedestrian, and ground plane detection.Footwear Detection. Mask Region-based Convolutional Neural Network (Mask R-CNN) [k R-CNN)  was usedk R-CNN) , which ik R-CNN)  with a bOur data set consisted of 500 frames taken from 10 video frames from each of 50 pedestrians walking through the camera view from three different locations. All three locations were in the vicinity of Toronto Rehabilitation Institute and were sections of level concrete sidewalk with not observable discontinuities or obstacles. The three sites were similar in appearance except that the lighting conditions varied (locations A and B were in shade while location C was in bright sun). Eighteen pedestrians were captured location A, 19 in location B and 13 in location C. We included 370 frames from 37 different pedestrians (locations A and B) to train the network and the remaining 130 frames from 13 pedestrians (location C) to test the performance of the network. The footwear visible in each frame was manually traced for each frame as shown in Each foot’s distance from the sidewalk was determined for each frame. The foot that was further from the sidewalk was labelled the swing foot and the other was labelled the stance foot. In video frames where the two feet were overlapping, the network initially struggled to find the exact boundaries of the feet. To solve this problem, we used knowledge of the number of footwear masks found in previously analyzed frames to categorize each new frame of video into one of four states by following the state diagram shown in We evaluated the performance of the Footwear Detection System by calculating the Intersection over Union (IOU) between the detected footwear masks and the ground truth masks. We also calculated the RMS error between the bottom of the detected footwear mask and the ground truth masks.Finding the MFC Point in the Swing Foot Trajectory. To calculate the trajectory, we needed to first separate individual strides since most pedestrians walked an average of 2.5 strides within the MFCE field of view. To separate strides, we identified the direction each person was moving based on which side of the video image their shoe was detected in first. Next, we tracked the position of the center of the swing foot’s mask. The change in direction of the swing foot was used to indicate the transition to stance phase indicating the end of the stride.Next, the lowest point of the swing foot (foot clearance) was located in each frame and stored in a vector and a 5th degree polynomial was fit to the set of points making up a stride. A 5th degree curve was chosen based on previous work that had identified foot trajectory has three inflection points . Figure Laser Dot Location Detection. The following assumptions were made about the characteristics of the lasers in the video images to locate them:The laser dots were among the brightest points in the entire imageThe two lasers were aligned nearly vertically within the 2D video imageThe laser points were circularThe lasers were located by thresholding  to elimiTo evaluate the performance of the automated system, we compared the RMS errors of automatic and manual MFC estimates from 10 pedestrians from Site A. The RMS errors were calculated by comparing to the mean manual measurement in each case.Locate the laser points: The raters were asked to record the frame number in each video clip where the laser points were projected onto each pedestrian’s lower leg or foot and click the centre of each to record their 2D coordinates in pixels using MB Ruler.Locate the ground plane: The raters were asked to define the ground plane in each video clip by clicking on two points to record their coordinates.Locate the frame where the MFC occurred and estimate the distance to the ground plane that was defined previously.Five manual raters  were asked to estimate MFC values from 10 pedestrians recorded with the MFCE system. Each manual rater was asked to:The raters were given two additional video frames for each pedestrian to analyze to allow for determining the magnitude of each potential source of error present in the manual analysis. The first was the video frame for each pedestrian was pre-determined to be the one in which the MFC point occurred and the raters were asked to define the ground plane and measure the distance between the lowest point of the shoe and the ground.The second of these two additional frames included the same frame used in the previous task, but with the ground plane pre-defined as well. This meant raters only needed to select the lowest point on the pedestrian’s shoe to estimate the MFC values for each of the 10 pedestrians again.The results of the manual methods were compared to the results obtained from using the automated sub-systems to analyze the video data from the same pedestrians. The videos were manually cropped and the ground plane was manually defined as part of the automated process.The footwear detection network was found to have an Intersection over Union of 85%. The combined approach consisting of the network and the post-processing occlusion method to locate the shoes in a stride was able to identify the bottom of the swing shoe with an average RMS error of 6.8 pixels or 5 mm compared to the manual ground truth masks.The network was able to correctly distinguish between the stance foot and the swing foot in 100% of the cases of which the two feet were not overlapping in the sagittal plane. When they are overlapping, the post-processing algorithm is designed to only look for the swing shoe.Our algorithm was able to locate the laser pointer dots in each frame in 60% of the cases initially without the need for user interaction. The use of user input was able to locate the laser points in the remaining 40% of frames where the laser dots were visible on the pedestrian’s leg/foot.The Bland-Altman plot in The automated algorithm was also used with the same 10 pedestrians to see if the automated measurements’ RMS was comparable to that of the manual method.The manual evaluation demonstrated that there was a wide variability in MFC estimates for different manual raters. If we eliminate the conversion factor and only compare the measurements done in pixels, the RMS error from the mean of all manual raters was 2.88 pixels.After controlling for the chosen MFC video frame, the average root mean squared error for different raters dropped to 2.36 pixels (0.5 pixel less than the first step).After pre-defining the ground plane and pre-determining the MFC frame, the average RMS error for different raters further dropped to 0.97 pixels (1.11 pixels less than the second step).The results demonstrate that the performance of the automated elements of the MFCE system are comparable to the manual measurements and are therefore an acceptable substitute for the analysis of data gathered with the MFCE device. However, there is still room for improving the performance of the algorithm and the overall performance of the device.The following are the potential sources of random and systematic error in the MFCE system. (1) Video camera image resolution: Higher resolution (4K) consumer-grade cameras are available and would increase accuracy of the system. (2) Camera to sidewalk alignment: If the sidewalk was at an angle relative to the camera, it would become more difficult to define the ground plane accurately and this variability will result in uncertainty in the location of the MFC values. (3) Pedestrian route to camera angle: To correctly measure the MFC using our settings, we assume that the pedestrians are walking in a plane perpendicular to the camera. However, this is not always the case. (4) Lasers not being parallel: If the lasers were not parallel, the distance would not stay the same throughout the depth of the sidewalk location and the measured pixel-to-millimeter scale would be wrong.This system is yet to be validated against the gold standard to evaluate the performance. A future study will compare MFC estimates produced by our system and an optical motion capture system.Future work will include the use of higher resolution (4K) video recording, automating video cropping, ground plane detection, and measuring the accuracy of the system by comparing to a gold standard optical motion capture system. The device will be used to collect data to gather MFC data from a wide range of public walkways and pedestrians. Data will be gathered from approximately 1000 members of the public to estimate their MFC values using walkways that are level, sloped, and locations with existing tripping hazards of different sizes to determine if and how people adjust their foot clearances. These findings will be used as the basis for influencing positive changes to minimize outdoor trips, that is, influencing policy changes for outdoor walkway maintenance. Future work will also assess the potential benefits and limitations of using the MFCE system in the clinical environment, in the home, or in other settings.


Ectopic thymus is an uncommon cause of neck masses in children that frequently present as lateral cervical swelling especially on the right side. We report two cases with atypical clinical presentation of ectopic thymus and superior herniation of normal thymus. Both of the patients manifested as intermittent midline mass at the suprasternal region during Valsalva manuevre. Unique ultrasound features with the location along the thymic descent together with dynamic assessment of the organ movement were essential to reach the correct diagnosis. Conservative approach was considered in these patients considering the necessity of thymus in the process of puberty. High index of suspicion is of utmost importance when encounter patient with similar clinical manifestation to avoid unnecessary diagnostic modalities and surgeries. Accurate diagnosis will also alleviate parents’ anxiety. Neck masses are fairly common during infancy and childhood. There is a wide range of differential diagnoses of neck masses including branchial cleft cyst, thyroglossal duct cyst, cervical lymphadenopathies, thyroid and parathyroid neoplasms, aberrant thyroid, vascular tumors, ectopic thymus, benign and malignant tumours of the neck . HoweverCase 1:A 15-month old girl was referred to our otorhinolaryngology clinic for the evaluation of intermittent midline suprasternal mass with the suspicion of laryngocele. The child was first noticed by her mother that she had a midline neck mass that appeared only during laughing or crying for 5 months duration. The swelling was painless and there was no precipitating factors such as previous trauma, vaccination or upper respiratory symptoms. It was not associated with compressive symptoms such as hoarseness, dysphagia or odynophagia, shortness of breath or noisy breathing. On examination, she thrived well and not in respiratory distress. There was no abnormality detected in the neck region at rest . HoweverUltrasound neck of the patient showed the presence of ectopic thymus tissue measuring 1.2 cm (anteroposterior diameter) x 3.3cm (width) at the thoracic inlet which slides superiorly into the lower neck during crying ,2b.It demonstrated homogenous echogenicity and did not compress or encase the adjacent vessel such as the brachiocephalic vein, internal jugular vein, and trachea. There was no displacement of the trachea and thyroid tissue in which it indicates the soft consistency of the mass. Normal thymus tissue is also seen more inferiorly in the retrosternal region . No air-filled structures or abnormal bone around this region. The patient was managed in a conservative way and was under regular follow up for monitoring of the mass with ultrasound.Case 2:A 6-year-old boy was referred to our centre for the assessment of an intermittent neck swelling. His main complaint was apparent neck swelling at central of the neck for 5 months duration in which it appeared only during straining, laughing or shouting. It was painless and no history suggestive of infection or compressive symptoms. His medical history, birth history and family history were unremarkable. Upon neck examination, an anterior neck swelling at the suprasternal region was palpable during the Valsalva maneuver . b) There is no prominent neck mass over suprasternal region (as shown by red arrow) during Valsalva maneuver.The swelling was soft in consistency, smooth in surface, not tender and no skin changes. Flexible nasopharyngolaryngoscopy examination was normal. Ultrasound neck showed a well-encapsulated hypoechoic soft tissue mass with scattered speckled echogenic foci seen at the left cervical region inferolateral to left thyroid lobe. It had similar echogenicity as the thymus was and it was separated from the mediastinal thymus. There was mediastinal thymus which demonstrated superior cervical extension above the clavicle to the left cervical region during increased intrathoracic pressure ,5b. Both internal jugular vein and common carotid artery were patent. The thyroid gland was normal in size and echogenicity. The decision was made to manage the patient conservatively with regular follow up to monitor the symptoms and size of the mass clinically and also with ultrasound. The patient remained asymptomatic with no progression of the neck mass at 3 month follow-up. Embryologically, thymus develops from the third and fourth pharyngeal pouch at the time of sixth gestational week. During the seventh week, the bud-like thymic primordia elongates into thymopharyngeal ducts that migrate caudally and medially to their final location in the anterior mediastinum. Once the thymus reaches its ultimate destination, the thymopharyngeal duct is obliterated . Arrest According to the literature worldwide, slightly more than 100 cases of cervical ectopic thymus have been described with only 10% occurred in infants. The cases generally occurred between 2 and 15 years of age, with male predominance . The mosThis is consistent with our cases in which both patients manifested with painless neck swelling. The interesting point to be discussed is the unusual presentation of the neck swelling in the cases. For the first patient in our series, the 15-month-old girl presented with intermittent midline neck swelling at the suprasternal region during the Valsalva maneuver. It was identified as an ectopic thymus using ultrasound scan of the neck. The superior herniation of the ectopic thymus was rarely described in the previously published cases Generally, aberrant thymic tissue often presented as neck swelling in the lateral aspect of the neck with the preponderance to the right side . For theOur hypothesis is that the normal or ectopic thymus may be located in the thoracic inlet at rest while during the Valsalva maneuver the mass was pushed up to the neck with the increased intrathoracic pressure. The presumed theory of herniation of the thymus is due to the loose connective tissues surrounding the thymus that permit the thymic herniation superiorly into the lower neck .Ultrasound is the sole imaging to evaluate the neck masses in this study due to its lack of ionizing radiation, the relatively short examination time,cost-effective and the ability to dynamically assess the mass especially in cases of intermittent mass appearance . The chaJugular phlebectasia was excluded as the mass was not compressible, and meanwhile, laryngocoele and lung herniation were excluded due to the absence of air visualized in the neck mass . The uniFor the management of the ectopic thymus, it remains controversial. Previously reported cases recommended empiric surgical excision mainly due to the inability to obtain diagnosis through alternative means, concerns of malignant transformation and low recurrence after surgical excision . HoweverSurgical excision of thymic neck masses in children results in significant morbidity as the risk of adherence to vital structures such as the jugular vein, carotid artery, and/or the recurrent laryngeal, vagus, hypoglossal and phrenic nerves. Besides that, some cases demonstrated mediastinal connection that possibly needs a sternotomy for total excision. Furthermore, the removal of a cervical thymic mass without the presence of mediastinal thymus can result in immunologic dysfunction . In addition, the thymus undergoes physiological changes in which it achieves its largest relative size at age of 3 years and attains its largest weight at puberty before involuting in adulthood . In viewDespite its rarity, ectopic thymus should be considered in the list of differential diagnosis of asymptomatic neck masses, specifically in infants and children. Location of the lesion along the thymus descent pathway and unique sonographic features make the diagnosis of ectopic cervical thymus easily established. Recognition of the atypical presentation of the ectopic thymus as prominent neck swelling only during the Valsalva maneuver is crucial to avoid unnecessary tests and radiation as well as the need of biopsy and surgical intervention. Conservative management with serial ultrasound will be needed by means of longitudinal follow-up.


Normal speed, 2 speed, and 3 speed). Results revealed that the manipulation of video speed did not attune emergent gaze patterns differently because participants displayed similar visual behaviors, regardless of speed. However, the normal speed resulted in a higher percentage of correct decisions than the 3 speed. Participants tended toward non-flagging decision bias errors when judging offsides with the 3 speed because they made more misses, than false alarms.The aim of the study was to assess the effects of manipulating video speeds on visual behavior and decision accuracy of 10 amateur football assistant referees (ARs) when perceived video sequences of 24 possible offside actions on a large screen. An eye tracker was used to analyze participants’ visual behaviors. Signal detection analysis provided further detail of participants’ decision-level accuracy. Participants were required to decide when they perceived a player to be offside during observed sequences with different video speed manipulations ( Sport officials must interpret and correctly enforce the rules of each sport to maintain fairness and players’ safety, but also to achieve high performance in judging and making decisions about ambiguous performance situations . Expert In football, In judging offside situations in association football, for example, To facilitate acquisition of perceptual-cognitive expertise, many years of specific goal-oriented practice activities and instructions are necessary . In thisA promising new paradigm to enhance the decision-making in sport is the use of “above real-time training” (ARTT). This research paradigm consists of using speeded-up video images as a realistic method to improve decision-making in elite athletes , providiSimilarly, In football refereeing, In general, these previous findings seem to reveal that the ARTT could be an effective strategy to train decision-making in football refereeing, specifically for referees at higher skilled levels. Regardless, little evidence exists about the impact of video speed manipulations in enhancing the performance of novice athletes and sport officials. In an exception, However, the expert ARs learned to adopt more conservative response criteria when judged offside sequences , compared to a normal video speed condition, would influence the visual behaviors of amateur ARs and their decision accuracy in judging offside situations, perceived from a specific AR perspective. We decided to investigate increasing speed conditions due to the lack of studies testing their effects on performance of referees of lower-skill levels. Specifically, we selected the three times normal speed for the first time in studies of video speed manipulation to address whether this high video speed condition would be accompanied by decreases in amateur ARs’ decision-making performance, compared to other slower video speeds manipulated in this study.Based on previous research, we hypothesized that perception of offside events at a normal speed would increase the efficiency of visual behaviors of these amateur ARs . All participants had accumulated more than 10 years performing as ARs at the Third National Football League and/or the First Regional League. These leagues are the fourth and fifth levels of competition in the Spanish male football, respectively. Therefore, the ARs were defined as amateurs because although they had experience in a national league, and only officiated at regional-level competitions without professional experience . Participants received general information about the research contexts, but were naïve to the specific objectives and hypotheses.An Applied Sciences Laboratories Eye Tracking ASL SE5000 recorded the visual fixations made by the participants as they observed the video speed manipulations. This device is a head-mounted, monocular eye-tracking system using corneal reflection to measure eye-line-of-gaze with respect to the field of view with an accuracy and precision of ±0.5 visual angle. The assistant referees’ gaze data were stored on a digital recording device (Panasonic NV-HS1000ECP).A total of 240 offside events were recorded from games during several training sessions of experienced football players from the Third Division of the Spanish National Football League. These events included judgments to be made whether a player had moved offside or not during the games performed in the training sessions.The offside judgments were recorded with a digital camera (Sony DCR-SR30), and the location on the field was chosen to simulate the viewing perspective of an assistant referee . Specifically, the camera was placed 25 m from the goal line, 1.20 m beyond the sideline, and 1.70 m above ground level. The Kinovea software (version 8.27) was used to edit the play sequence.The design used for the video test was based in previous studies to ensure a realistic offside situation for analysis of ARs’ perceptual and decision-making behaviors. To exemplify: (i) the interactions between the attacker receiving the ball and the last defender took place in front of the camera to simulate the correct position of the AR during the perception of these events. This methodological decision eliminated possible optical error effects as the camera angle for viewing offside events occurred at the exact place that the assistant referee should be located to observe play on the field .The independent variable was the video speed manipulation . These specific locations during the perception of offside events have been previously used in other studies  or when they did not raise the flag if an attacking player was not offside . In contrast, participants made incorrect decisions when they raised the flag when a player was not offside  or they did not raise the flag when offside occurred .The dependent variable for decision-making performance was the response accuracy. Participants made correct decisions judging an offside action if they raised a flag when they perceived an offside situation to have occurred , containing offside judgment decisions was video-projected onto a large screen , from the 240 initial offside events recorded during training sessions of football players. The ratio of onside and offside situations in the randomized video sequences displayed was exactly 50%. The same rate of onside vs. offside decisions was used to minimize the potential influence of any pre-conceived ideas that the ARs might have had about the likelihood of an offside taking place.A selection of high quality sequences  were based on previous studies , and theThe procedure used in this study was identical to that undertaken by The mean duration of the video sequences of offside events was about 7 s, lasting between 4 and 12 s depending on the video speed manipulation. For example, if a normal speed clip was 12 s in duration, then, the edited version of 3x that speed, was completed in 4 s. If it was edited to 2x the normal speed, then the film sequence was completed in 6 s. These temporal interval values were similar to those used by The sequence contained a pause of 3 s between trials to avoid psychological fatigue in the participants give allow them to prepare to judge the next offside event. Before the observations of the offside events, ARs undertook two practice trials to familiarize them with the experimental procedures. No performance feedback was given during the test. ARs taking part in this study had never previously viewed the offside sequences observed during the test.Shapiro-Wilks and Levene analyses confirmed that the data of the dependent variables did not display a normal distribution, and then, nonparametric tests were used in this study. For the point-of-gaze data, descriptive statistics of means and SDs were used to explore the visual patterns of the participants with respect to number of visual fixations made, fixation duration times, and percentage viewing time spent on specific visual locations. A Kruskal-Wallis test was performed to determine differences between groups of video speed manipulation. The Rho Spearman correlation coefficient was calculated to address relations between visual behavior and decision-making in each video speed condition.hits, correct rejections, false alarms, and misses, and between correct (hits and correct rejections) and incorrect decisions . Additionally, The Kruskall-Wallis test was performed to determinate group differences in percentages of correct (hits vs. correct rejections) and incorrect  decisions made by the assistant referees. This last analysis of incorrect decisions provided information whether the groups of video speed compensated for the FLE. The Mann-Whitney test was used to determinate pairwise comparisons in these types of decisions.For the response accuracy, a Chi-Squared test was used to determine differences between video speeds in the percentages of ESs), based on the correlation coefficient (r), were calculated to provide a better interpretation of the results. The value of the z distribution, obtained from performing the Mann-Whitney tests, was used to estimate the magnitude of ES. This statistic was reported for those non-parametric tests with significant differences between pairs of video speed conditions. Specifically, three categories of ES . The CIs for ESs were calculated to provide a practical value of the study in real-world terms .A signal detection analysis  was alsoSpecifically, the Kruskal-Wallis analyses did not reveal statistical differences between values of any visual variables as a function of video speed manipulations. No relations were also found between visual and decision-making variables in any of the video speed manipulations.3 speed, the ARs achieved the highest number of correct rejections in correct decisions, compared to the other video speed manipulations. For incorrect decisions, the ARs showed the lowest percentage of false alarms and misses in the normal speed, compared to the speeded video conditions.X2 = 10.74; p = 0.09), nor in the proportion of correct and incorrect decisions . The Kruskal-Wallis test also showed no significant differences between video speed conditions in the percentages of decisions when participants correctly judged the offside events , neither when incorrectly judging the offside events .The Chi-Squared test showed no significant differences between video speed manipulations in the proportions of decisions made , and in the proportions of hits and correct rejections when correctly judged the offside events . Specifically, the ES was medium when the comparison included all types of decisions , and small for the correct decisions . The power of these tests was 57.12 and 56.31%, respectively.The Mann-Whitney test revealed that some pairwise comparisons between the d') was significantly different from zero for all video speed manipulations, being 2.41 for normal speed, 1.83 for 2 speed, and 1.26 for 3 speed. The ARs showed no decision bias toward making false alarms or misses because the criterion c showed no difference from zero, being −0.03 for normal speed, and 0.01 for 2 speed. However, they reported a slight bias in response accuracy toward making non-flagging errors when they perceived offsides with the 3 speed because the criterion c achieved a positive value of 0.23.The ARs discriminated between “offside” and “no offside” above chance level because the sensitivity index . In contrast, participants displayed a similar gaze pattern between the different speed manipulations. Previously, Interestingly, the video speed manipulation had no impact on ARs’ gaze patterns because they did not modify their visual behavior despite the task constraints of the research in the form of the video speed manipulations. Consistent with these data, the hypothesis is rejected. We expected to find more gaze behavior efficiency in ARs when they observed the offside sequences at a We reasoned that the increase of the video speeds during the perception of offsides may have created a “juggling effect” for the collapse of ARs’ object tracking ability . AccordiPrevious studies have reported higher levels of decision accuracy when assistants fixated on the offside line for longer ,b. Howevnormal speed compared to the 3 speed. The CIs for ESs did not include zero or a negative number, and then, there was a 95% likelihood that a true population effect was found between the lower and the upper scores. However, this finding did not exist in the real-world because the values achieved in the power analyses were lower than 0.80 . With this low statistical power, we are aware about our limitation to state that the video speed manipulation caused true effects in ARs’ response accuracy.For the decision-making performance, some specific effects in the ARs’ response accuracy were found between video speed conditions. To exemplify, they performed different percentages of decisions or different proportions of correct decisions when they judged the offsides at the normal speed compared to the speeded video conditions is not fully accomplished. We reasoned that an underlying effect would exist in response accuracy as a result of manipulating video speed conditions because ARs showed a clear tendency to make less correct decisions and more incorrect decisions when video speeds were increased. A possible explanation to this decrease in decision-making performance during the speeded video conditions was the more distorted relative motion information between players, masking the relative position between the attacker and the last defender at the moment of the pass. We argue that the increase of the video speeds could have prevented the ARs from correcting their perception of the positions of ball carrier, attacker receiving the ball, and last defender just before the last pass; constraining a precise recall of these spatial locations at the moment of the pass  differed significantly from 0. Results suggest that the ARs had the perceptual sensitivity to discriminate these ambiguous situations in football officiating because they had accumulated enough visual and motor experiences for more than 10 years whistling as assistant referees in amateur categories. These previous observations and executions of the offside events could have helped assistants to save not biased decisions in judging offsides  revealed that the assistants discriminated between “offsides” and “not offsides” in each video speed manipulation, even in the offsides , showing3 speed because the criterion c showed a positive value different from zero . In elite assistant referees, this decision-level for the FLE was compensated eliminating a forward memory shift induced by this spatiotemporal illusion . As the assistants had more difficulties to perceive exactly that information in the fastest videos, they gave the attacker the benefit of the doubt, showing a decisional behavior biased to not raise the flag.Intriguingly, no differences were found between video speed manipulations for the number of incorrect decisions made. However, the assistants showed a decision bias toward errors in perceiving offsides in the illusion ,c. Howevn misses . We sugg3 speed compared to the normal speed, and reported a FLE in this 3 speed toward the misses.Taken together, these findings posited that the video speed manipulation caused some underpowered effects in the decision accuracy (at a cognitive level) but not on the visual behavior  of amateur ARs when observed offside sequences. Specifically, the speeded video manipulations did not lead to further improvements in response accuracy. Conversely, the ARs decreased significantly the percentage of correct decisions in the This research study had two main advantages. First, we investigated effects of video speed manipulations on visual behaviors and types of decisions of amateur ARs , using signal detection analysis methodology. Second, the design used for the video test of offside decisions, based on previous studies  and percnormal speed and 2 speed or between 2 speed and 3 speed if more assistant referees were recruited to participate in the study. This small number of assistant referees investigated could explain the low power estimation observed in this study. According to the G*Power software 3.1.9.2 (ES (d' = 0.8). Similarly, it would be interesting to address whether this tendency found of fixating longer on the offline line achieves significant levels with larger samples of participants.The study could be improved by increasing the limited amount of cases analyzed, to avoid masking observations of statistically significant differences in response accuracy levels between video speeds, which in this study remained at the level of statistical trends in the data. For example, questions exist whether there would be differences between  3.1.9.2 , a totalAnother limitation was that the experienced football players involved in the recording of the offside sequences did not receive indications about what speed execution should be performed during these specific events in football. They had freedom to perform, in a natural manner, these specific situations to accomplish with the requirements of the research team. The absence of control in this variable  could mask a possible effect of perceptual sensitivity in judging offsides, intrinsically linked to the speed in which the offside events were performed and recorded.The video speed manipulation for the refereeing performance should be introduced carefully in the perceptual trainings of the referees, according to their sport skill level. To do this, the learning task designs should state clear previously what video speed thresholds are more adequate to enhance decision accuracy for expert and amateur assistant referees. This study represents another step to elucidate this question, trying to add new evidence for a better design of perceptual training programs in development of skills in assistant referees because the influence of video speed manipulations in referees’ decision-making has received sparse interest in the literature .3 speed. In contrast, the use of normal speed video clips for observations of offside sequences may prevent ARs from making incorrect decisions. It is also possible that low skilled ARs should also be exposed to different emotional and contextual variables of real-game scenarios  to learn how to maintain their decision-making skills under pressure. Following this relationship between emotions and decision-making, the off-field training programs undertaken in controlled-laboratory settings would gain fidelity and representativeness by including cognitive and emotional constraints that are embedded in football matches.With these data, the speeded video conditions seem not to be a reasonable strategy for the improvement of decision performance in amateur assistant referees, at least when they perceived offsides with the To do this, emotional intelligence training . The participants provided their written informed consent to participate in this study. Written informed consent was obtained from the individuals for the publication of any potentially identifiable images or data included in this article.VL and JM equally contributed to the conception and design of the study. JM performed the measurements of the experiment. VL performed the experimental data and the statistical analyses. VL and JM wrote the first draft of the manuscript. Both authors contributed to manuscript revision, and approved the final version of the manuscript and agreed with the order of presentation of the authors.The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.


Background: Distal posterior inferior cerebellar artery (PICA) aneurysms are uncommon intracranial vascular lesions. The coincidence of these aneurysms and Arteriovenous malformation (AVM) is even more rare. Since 1956, a total of 57 cases of distal PICA aneurysms associated with AVM have been reported with clear and adequate description. None of these reports describe a giant prenidal aneurysm at this particular location. The paucity of natural history data as well as lack of consensus about treatment strategies in such cases present a significant challenge that requires an individualized management approach.Case Description: A 68-year-old male presented with recurrent episodes of nausea and vomiting precipitated by physical exertion and change of head position. An MRI of the brain demonstrated a giant partially thrombosed right posterior inferior cerebellar artery (PICA) aneurysm with mass effect on the floor of the fourth ventricle. A conventional cerebral angiogram revealed a giant (3.1 x 3.1 x 2.8cm) distal right PICA pre-nidal aneurysm with two smaller distal PICA aneurysms. An AVM (Spetzler-Martin Grade 1) supplied by the right PICA as well as the right superior cerebellar artery (SCA) was also identified on cerebral angiography (not seen on an MRI). Endovascular coil embolization with parent vessel sacrifice was performed to occlude the giant aneurysm. Due to the asymptomatic nature, low risk of rupture, and the patient's age, AVM treatment was deferred.Conclusion: This paper presents the first case of a giant PICA aneurysm associated with cerebellar AVM. For PICA aneurysm-AVM complexes, meticulous evaluation of the morphology, associated anatomy, and comparative risk analysis for both lesions are key for treatment planning. Distal PICA aneurysms can be treated safely with parent vessel occlusion, particularly in the case of prenidal aneurysms. Most ofIn order to counsel patients, consideration must be given to the rupture risk of both the AVM and the prenidal aneurysm in these rare cases. Firstly, the presence of a prenidal aneurysm is an independent risk factor for AVM rupture and poor outcome. In fact, the PICA-aneurysm-AVM complex has an exceedingly high risk of rupture compared to other intracranial vessels . In addiA 68-year-old, right-handed male presented with episodes of nausea and vomiting over the last year. These episodes could be precipitated by sudden head movement, physical exertion, or sometimes in response to changes in ambient temperature. The severity and frequency of the episodes gradually progressed. Mild gait instability was also noted. His only other medical history included hypothyroidism and dyslipidemia. There was no family history of cerebral aneurysms. There was no history of smoking or excess alcohol consumption. On examination, he had difficulty performing tandem gait but had no other neurologic deficits. No other cerebellar signs were noted.An MRI of the brain, arranged by his family physician, demonstrated a partially thrombosed giant right PICA aneurysm filling the fourth ventricle . The filAfter a detailed discussion with the patient and a review of both endovascular and open microsurgical options, the patient underwent endovascular treatment of the giant aneurysm with coil embolization/parent vessel occlusion . Though all approaches, including endovascular and microsurgical interventions, have been applied to this specific lesion complex of multiple pedicle PICA aneurysm and AVM , the treUnder general anesthesia and after obtaining a femoral access, the aneurysm was approached using a 6 French guiding catheter  and a micro catheter . Using detachable coils, the distal segment of the PICA just proximal to the aneurysm was sacrificed including the aneurysm sac. Post coiling, angiography showed no residual filling of the aneurysm and occlusion of the right PICA at the inflow site to the giant aneurysm . There wAt the 9-month follow up, an MRI showed a reduction in the size of the thrombosed aneurysm, now measuring 2.1 cm × 2.2 cm × 2.3 cm, with no evidence of recanalization. The patient reported improvement of his nausea and vomiting as well as his gait with no new complaints reported .The current paper reports the first case of a giant prenidal PICA aneurysm in the fourth ventricle, associated with a small midline cerebellar AVM. Our review of literature did not identify any similar cases of a giant PICA aneurysm in combination with an AVM at this particular location.A literature search for PICA-AVM associated with distal aneurysm revealed a total of 57 cases previously reported with clear and adequate description. Most of these cases are reported within other larger series of distal PICA aneurysms . The preThe exact mechanism of how an AVM and prenidal/intranidal aneurysm develop is unknown. There are at least three different theories describing this relationship. The first (and least favored) was described by Boyd-Wilson in 1959 where this association was considered a random coincidence . This exPICA aneurysms are diverse in terms of location and morphology. No single treatment modality can therefore be consistently applied to all PICA aneurysms. A recent retrospective study reported at least nine different treatment modalities used for PICA aneurysms  . To dateHaving said this, the open surgical option was less favored for the case presented in this study. This is mainly due to the fact that the patient was initially intact with no neurological deficits and the high possibility of surgical-related morbidity. This includes injury to lower cranial nerves or brainstem perforators. In addition, the aneurysm and the AVM are located relatively far apart, which poses a significant surgical challenge to target both lesions with one approach. On the other hand, the endovascular option, in this situation, would provide a less invasive alternative that can target both lesions at once. In addition, there were a number of important characteristics that favor endovascular vessel occlusion present in this patient. These include the distal location of the aneurysm that spares most of the brainstem perforators as well as the favorable vascular morphology (see next section).The angioarchitecture of this particular aneurysm includes a complex morphology and a giant partially thrombosed dome that would make it unsuitable for clipping or primary coiling. Parent vessel occlusion would target both the aneurysm and the main arterial feeder to the AVM. Occluding the PICA in a distal location would also spare the brainstem perforators.Reviewing the literature, parent vessel occlusion is considered an appealing option for treating distal PICA aneurysms; especially with dissecting pseudoaneurysms or those with complex morphology . For a dAt 9-month follow up, there was no further filling of the giant aneurysm and a significant reduction in mass effect. No brainstem ischemia or infarction were noted. Obliteration of the second and third aneurysms, located more along the course of PICA, was also noted, perhaps owing to the decrease in flow after parent vessel occlusion. The AVM, which itself has two patent feeders coming from the SCA, is still filling . The magPICA aneurysms associated with an AVM are rare and clinically challenging entities. This paper presents the first case of a giant prenidal PICA aneurysm associated with a cerebellar AVM. Thorough evaluation of the pertinent anatomy, location, and morphology of both lesions, along with meticulous assessment of comparative risk of rupture, is of paramount importance. Parent artery occlusion can be a useful and well-tolerated option in treating distal PICA aneurysms with minor risk of ischemia. Involvement of a multidisciplinary team is a key for diligent planning of treatment, considering the complexity of these lesions. The information provided is this report is meant to assist in the decision-making process.The original contributions presented in the study are included in the article/Ethical review and approval was not required for the study on human participants in accordance with the local legislation and institutional requirements. Written informed consent for participation was not required for this study in accordance with the national legislation and the institutional requirements.HK: conceptualization, data curation, formal analysis, investigation, methodology, resources, visualization, writing—original draft, and writing—review and editing. CH: data curation, formal analysis, investigation, software, validation, visualization, and writing—review and editing. AA: conceptualization, project administration, supervision, validation, visualization, and writing—review and editing. All authors contributed to the article and approved the submitted version.The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.


N = 19,414). In support of DFT and in replication of the literature, lineups yielded higher discriminability than showups. In support of encoding specificity, conditions that matched information between encoding and retrieval were generally superior to mismatch conditions. More importantly, we supported several DFT and encoding specificity predictions not previously tested, including that (a) adding non-diagnostic information will reduce discriminability for showups more so than lineups, and (b) removing diagnostic information will lower discriminability for both showups and lineups. These results have implications for police deciding whether to conduct a showup or a lineup, and when dealing with partially disguised perpetrators .The diagnostic feature-detection theory (DFT) of eyewitness identification is based on facial information that is diagnostic versus non-diagnostic of suspect guilt. It primarily has been tested by discounting non-diagnostic information at retrieval, typically by surrounding a single suspect showup with good fillers to create a lineup. We tested additional DFT predictions by manipulating the presence of facial information  at both encoding and retrieval with a large between-subjects factorial design ( DNA exoneration cases have revealed the prevalence of mistaken eyewitness identifications, and it is critical to develop theory-driven approaches to improving eyewitness identification accuracy. According to diagnostic feature-detection theory (DFT), eyewitnesses assess suspect guilt by evaluating facial information that matches their memory for the perpetrator but is not also shared by innocent lineup members. We tested several DFT predictions by manipulating the presence of facial information at both encoding  and retrieval . By adding this encoding manipulation, we also tested a popular cognitive theory known as encoding specificity, which predicts that eyewitness performance should be superior when encoding conditions match retrieval conditions . A nationwide sample of participants viewed either a full face or the internal region only and were later tested with a showup or lineup containing full faces or only internal regions. We supported DFT by replicating the lineup advantage over showups, and we supported encoding specificity such that match conditions were generally superior to mismatch conditions. We also confirmed DFT predictions that (a) removing diagnostic information will harm performance and (b) adding non-diagnostic information will harm showups more than lineups. These results provide additional support for DFT as a powerful theory of eyewitness decision-making.Mistaken eyewitness identification (ID) is a factor in approximately 71% of the convictions revealed by DNA exoneration in the USA , and diagnostic information is represented in the right-center two columns (f3 and f4). It is important to note that DFT is agnostic regarding what exactly the so-called features represent. Wixted and Mickes used examples such as face shape and size of eyes. However, any aspect of facial information, be it featural, holistic or configural, can be substituted in these columns. What is important is whether or not the information is diagnostic of suspect guilt . Notice the blank areas in this table , which represent non-diagnostic information that is being discounted or unweighted in the eyewitness decision-making process. The idea in this example is that everyone in the lineup is of the same race and age, so the eyewitness discounts those aspects and focuses instead on diagnostic information such as face shape and size of eyes. This differential weighting of diagnostic over non-diagnostic information is what drives discriminability.This original table from Wixted and Mickes  demonstrLineup with Non-Diagnostic Features Added Prediction  and the second the Showup with Non-Diagnostic Features Added Prediction .Turning back to Table Showup with Diagnostic Features Removed Prediction  and Lineup with Diagnostic Features Removed Prediction .The second way to change discriminability that has not been addressed in the literature is removing diagnostic information, which should lower discriminability for both showups and lineups. In our experiment, this is possible by presenting a full-face target at encoding and then at test presenting only the internal region of the face, either as a showup or in a lineup . Unlike the hoodie example above, we can think of no real-world example of this scenario and we included this manipulation for theoretical reasons only. Why would police intentionally hide part of the suspect’s face during an ID procedure, if it was visible during the crime and has not changed? We will call the first prediction the Lineup with Non-Diagnostic Features Added Prediction modifies this prediction due to the DFT process of discounting non-diagnostic information. We still expect that the match condition  could outperform the mismatch condition , but, critically, we expect this difference to be smaller (and possibly nonsignificant) for lineups compared to showups. As described further below, this prediction is our most direct novel test of DFT. If there is a DFT process of discounting shared non-diagnostic information , this should reduce the encoding specificity effect of reduced performance  for mismatch compared to match conditions, for lineups more so than showups.It is important to note that these DFT predictions also come from encoding specificity  or full faces (lineup) at test. The same logic could not be applied to adding diagnostic information because, if the information is not in memory, how could it become diagnostic? This is why we had no predictions specific to this issue of potentially adding diagnostic information. However, we could certainly remove diagnostic information to test other predictions, by requiring other participants to encode a full target face and then be tested on an internal face (showup) or internal faces (lineup). Moreover, by factorially investigating full versus internal faces at both encoding and retrieval, as noted above we were also able to test encoding specificity predictions . As for our presentation of full versus internal faces in showups and lineups, this is analogous to police determining how to present a suspect to eyewitnesses when the perpetrator was disguised. Very little research has investigated this issue, but Manley, Chan, and Wells (2018) found that if the perpetrator wore a ski mask, it is best for police to present a lineup in which all members also have a ski mask , (d) if an internal face is encoded, discriminability will be (slightly) higher for an internal lineup compared to a full lineup (Lineup with Non-Diagnostic Features Added Prediction), (e) if a full face is encoded, discriminability will be higher for a full showup compared to an internal showup (Showup with Diagnostic Features Removed Prediction), and (f) if a full face is encoded, discriminability will be higher for a full lineup compared to an internal lineup (Lineup with Diagnostic Features Removed Prediction).There are several additional simple effects that come from Table Showup with Non-Diagnostic Features Added Prediction will result in a larger discriminability difference  than the Lineup with Non-Diagnostic Features Added Prediction. As shown in Table However, as described above, we expect that the In sum, we have 10 predictions in the form of four main effects and six simple effects  was asked to select the best match to the description for each lineup. We used these data to compute Tredoux’s E’ . The simultaneous lineups were displayed in a 2 × 3 array, with the target and innocent suspect presented in either position Tredoux , a lineu Tredoux .This experiment followed a 2  × 2 (test face(s): full vs internal) × 2 (ID procedure: showup vs simultaneous lineup) × 2 (target presence in ID procedure: TP vs TA) between-subjects factorial design, for a total of 16 experimental cells. Another way to describe the design involves encoding specificity: a match or mismatch between encoded and test faces. We had two match and two mismatch conditions: (a) full face at both encoding and test, (b) internal face at both encoding and test, (c) full face at encoding and internal face at test, (d) internal face at encoding and full face at test.After providing informed consent, participants were instructed to “Pretend that you are about to witness a crime. On the next screen you will see the perpetrator's face for 5 s. Study it carefully.” They were then randomly assigned to one of the four targets for 5 s, presented as either full or internal face. Next, participants watched a 2-min distractor video about animals and then were asked a 4-item multiple-choice attention check question about the last animal they saw in the video. After completing the attention check, they were randomly assigned to a TP or TA showup or lineup, with either full or internal face(s). Just prior to their ID procedure, they were informed that the target may or may not be present. Those given a showup were instructed to identify the individual if he was the same person seen before. Those shown a lineup were instructed to either select a lineup member, labeled 1–6, if he was the person seen earlier, or select “none of the above.” After completing the ID procedure, participants were asked to rate their decision confidence on a 0–100% scale.Full will be used to represent the Full Face conditions (at encoding or test), and Internal will be used to represent the Internal Face conditions (at encoding or test). For example, the condition in which a Full Face target was encoded, but tested with the Internal region only (either showup or lineup), will be referred to as Full-Internal. Table Terminologically, Although ROC analysis is a relatively new technique in its application to eyewitness ID /s, where s is the standard error of the difference between the two pAUCs based on bootstrapping  with fillers that were highly similar to the targets and innocent suspects. Therefore, we would argue that the second set of analyses is more meaningful, as it is not affected by the variability of innocent suspect choosing rates, and low overall innocent suspect choosing rates , divided by the nominal lineup size of six. Some of our designated innocent suspects were not chosen very often, based on the fact that we had fair lineups . In other words, when comparing two ROC curves, a cutoff point must be determined for the x-axis. See Fig. p value with Bonferroni-corrected alpha of 0.05/10 = 0.005. We will describe our results in the same order as the hypotheses are laid out in the predictions section above , D = 4.37, p < 0.001.Moving now to simple effects, we had six predictions. The first two were derived from both DFT  was superior to Internal-Full Showup , D = 3.65, p < 0.001  yielded higher discriminability than the Full-Internal Showup , D = 8.63, p < 0.001  was superior to Full-Internal Lineup , D = 8.45, p < 0.001  as Internal-Full Lineups , D = 2.14, p = 0.033 d' for each condition included in our 10 predictions, along with 95% inferential confidence intervals to allow evaluation of statistical significance. This table establishes two points: (a) the theoretical discriminability results match the empirical discriminability results, and (b) the results are the same regardless of how false ID rate is calculated, such that the results based on all IDs from TA lineups  match those based on designated innocent suspects . Note how the last two conditions listed in Table d's, providing additional support for this DFT prediction.To support our ROC analyses, we confirmed all differences among pAUCs with SDT analysis applied to correct and false ID rates from Table We conducted a high-powered experiment with a demographically diverse sample to test several predictions derived from diagnostic feature-detection theory , we supported all of these predictions. One of the 10 predictions  represents a DFT prediction that qualifies the typical pattern expected based on encoding specificity . According to DFT, there will be some degree of discounting of shared non-diagnostic information in a lineup that is not possible in a showup, and therefore, we expected that the typical match > mismatch pattern from encoding specificity would be either reduced or eliminated. The comparison of pAUCs revealed a reduced and nonsignificant match > mismatch effect here, which was not the case for any other match versus mismatch comparison . Moreover, the d's were virtually identical.In contrast, we tested DFT by adding non-diagnostic information and also by removing diagnostic information. Both were made possible by manipulating the presence of facial information  at both encoding and at retrieval. Therefore, some participants could see more facial information at retrieval than they did at encoding , and others could see less facial information at retrieval than they did at encoding . As shown in Tables shared information will be discounted, which is a scenario possible for a lineup, but not for a showup (as no information can be shared across lineup members in a showup). For the sake of simplicity in the table, we assumed 100% discounting of non-diagnostic information from the lineup and 0% discounting in the showup. This assumes optimality in the decision-making process, which is unlikely in real eyewitnesses. A more realistic scenario is that discriminability will be harmed by adding non-diagnostic facial information , it was nonsignificant. Additionally, there was no difference in d' between these two conditions. We conclude from these patterns that there is evidence of a discounting process applied to added non-diagnostic information that is stronger for lineups than for showups, which supports DFT.This is arguably our most important finding, so we will expand our interpretation of it here. We presented an oversimplification of DFT assumptions in Table Our results fit well with recent studies testing other novel predictions from DFT (Carlson et al. We encourage other researchers to further test DFT, or to present alternative quantitatively specified models against which DFT can compete. There is much fertile ground left to investigate, such as the aforementioned theoretical possibility of adding diagnostic information. As we noted before, we struggle to think of a real-world example of this, and it could also be difficult to execute in an experiment. One possibility is to present a blurry image of a target, and later testing with a crystal-clear image. This would be akin to a witness who views a perpetrator from a distance (e.g., Lockamyeir et al. It is important for researchers to test quantitatively specified theories in order to develop robust methods to help police get the most from eyewitnesses. DFT is shaping up to be a powerful theory of eyewitness decision-making. It can help police to not only understand the importance of presenting fair simultaneous lineups over showups, but also to understand what makes a lineup fair. It is well known that a suspect should not stand out (e.g., Colloff et al.


A cardiotocogram (CTG) is a device used to perceive the status of a fetus in utero in real time. There are a few reports of its use at home or during emergency transport.The aim of this study was to test whether CTG and other perinatal information can be transmitted accurately using an experimental station with a 5G transmission system.In the research institute, real-time fetal heart rate waveform data from the CTG device, high-definition video ultrasound images of the fetus, and high-definition video taken with a video camera on a single line were transmitted by 5G radio waves from the transmitting station to the receiving station.All data were proven to be transmitted with a minimum delay of less than 1 second. The CTG waveform image quality was not inferior, and there was no interruption in transmission. Images of the transmitted ultrasound examination and video movie were fine and smooth.CTG and other information about the fetuses and pregnant women were successfully transmitted by a 5G system. This finding will lead to prompt and accurate medical treatment and improve the prognosis of newborns. A cardiotocogram (CTG) is a device used worldwide in obstetrics to perceive the status of a fetus in the second half of the gestational period in utero in real time. It has been relied upon as a test comparable to fetal ultrasound because a decelerated heart rate detected by this method indicates fatal stress in the fetus, an accelerated heart rate baseline indicates infection in the fetus in utero, and a fair baseline variability indicates the sparing ability of the fetus. However, at present, it is used only in medical care facilities, and there are few reports of its use at home or during emergency transport. In addition, there are many limitations to the prehospital diagnosis that can be made during transport of perinatal diseases , and theRecently, wireless/mobile transmission using the next generation of high-speed, high-capacity systems, so-called 5G , has beeIn this pilot study, we tested whether CTG and other perinatal information can be transmitted accurately using an experimental station with a 5G transmission system.This study was conducted in December 2019 at the Research Institute of NTT DoCoMo Incorporated . We combined real-time fetal heart rate waveform data of 30 minutes from the MT-610 CTG device , which stores and reproduces anonymized data from actual normal fetuses; high-definition (HD) video ultrasound images of the fetus ; and HD video taken with a common digital video camera on a single 5G line. All data were transmitted by 4.5 GHz radio waves  from the transmitting station to the receiving station, which is housed at the institute on the same floor of the building. All of this information was reproduced on a computer on the receiving end that simulated a secondary hospital. The CTG waveforms and ultrasound movie images that could be seen on the receiving screen were checked by an obstetrics and gynecology consultant (KN) to confirm if they were acceptable for diagnosis. Another consultant (HK) later checked them again from the stored images. The face of a female model was featured in the HD video, and the complexion and expression of the model could be recognized after the transmission. The model also held a digital clock, so that the delay in data transmission could be defined later.Connection of the devices using the 5G transmission system from the source side (1, 2, and 3 in All data were proven to be transmitted with a minimum delay of less than 1 second as per the digital clock in the HD video. The CTG waveform image quality was not inferior, and there was no interruption in transmission. The fetal heart rate was clearly legible, and the variability of the baseline was easy to read. At the same time, the real-time images of the transmitted ultrasound examination were fine and smooth, and no unnatural movements were observed. In addition, the color of the model’s face and surrounding movements in the video image were correctly transmitted. There were no unnatural color tones; as a result, we were able to recognize her complexion and expression .To our knowledge, this study is the first to show that CTG and other information about fetuses and pregnant women can be transmitted by a 5G system. A system to monitor CTGs within a medical care facility via an intranet is common, and a system to exchange CTG waveforms between medical institutions via the internet has been put to practical use. However, attempts to send data from a pregnant woman's home to a medical institution via a mobile network or to send data from an ambulance or air ambulance in transit have not been sufficiently carried out, except in one case in 1992 . If feta5G systems are anticipated to have the potential to significantly improve the speed and stability of transmission in mobile communications. In this study, we found that not only CTG, but also images during ultrasound examinations and high-quality videos of people who mimicked patients could be transmitted without problems. Although our study was performed in a laboratory, and the distance between the transmitter and receiver was not far, recent planning of information technology infrastructure on 5G transmission promises better linkage of devices under both low or high power . 5G systAdditionally, as predicted by Oleshchuk and Fensli , the 5G


The data article refers to the paper titles “Impact of malnutrition on long-term survival in adult patients after elective cardiac surgery”  Specifications Table•Data describe the impact of malnutrition and other baseline and perioperative parameters on long-term survival among cardiac patients.•Researchers conducting studies on nutrition in cardiology may benefit from these data.•Data may be used for sample size calculation and estimation of clinically relevant end points in future clinical trials.1(A)Patient ID;(B)Age in years;(C)Gender, (D)Primary pathology: (E)Primary diagnosis: (F)Type of surgery: (G)Redo surgery: (H)Diabetes: (I)NYHA class: class of heart failure with accordance to New York Heart Association graded 1 to 4;(J)Logistic Euroscore: predicted mortality with accordance to Logistic Euroscore, percent;(K)SNAQ: results of nutritional screening with accordance to Short Nutritional Assessment Questionnaire where 0 is no malnutrition, 1 is moderate malnutrition and 2 is severe malnutrition;(L)MUST: results of nutritional screening with accordance to Malnutrition Universal Screening Tool where 0 is no risk of malnutrition, 1 is medium risk of malnutrition and 2 is high risk of malnutrition;(M)MNA: results of nutritional screening with accordance to Mini Nutritional Assessment screening tool where 0 is no risk of malnutrition, 1 is at risk of malnutrition and 2 indicates malnutrition;(N)NRS_2002: results of nutritional screening with accordance to Nutritional Risk Screening 2002 tool where 0 is no malnutrition and 1 is malnutrition;(O)SGA_grade: results of nutritional assessment with accordance to Subgective Global Assessment where 0 is no malnutrition, 1 is suspected or moderate malnutrition and 2 is severe malnutrition;(P)2;BMI: body mass index expressed in kg/m(Q)Preoperative total lymphocyte count in peripheral blood, expressed in cells/microliter;(R)Preoperative total blood protein, expressed in g/L;(S)Preoperative blood albumin, expressed in g/L;(T)9/L;Preoperative thrombocytes (platelets), expressed in number⋅10(U)C reactive protein in blood, expressed in mg/L;(V)Baseline left ventricle ejection fraction, expressed in percent;(W)Cardiopulmonary bypass time during surgery, expressed in minutes;(X)Aortic cross clamp time during surgery, expressed in minutes;(Y)Ventilation is mechanical ventilation time after surgery, expresses in hours;(Z)Any postoperative complications: ([)New dialysis: (\)(AB) Delirium: (])(AC) Inotropes: (^)(AD) Cardiac arrhythmia: (_)(AE) Bradycardia: (`)(AF) New onset atrial fibrillation: (a)(AG) Bleeding : (b)(AH) Readmission to ICU: (c)(AI) Intensive care unit stay expressed in days;(d)(AG) Hospitalization is duration of hospital stay during initial hospitalization, days;(e)(AK) In hospital mortality: (f)(AL) Survival: total number of days alive after surgery, [lost] means patient was lost to follow up;(g)(AM) Death: Raw data:Repository name: Mendeley DataData identification number: 10.17632/2m6yxvr23h.3https://data.mendeley.com/datasets/2m6yxvr23h/3Direct URL to data: https://doi.org/10.1016/j.nut.2020.111057. The aforementioned paper investigated the relationship between malnutrition and long-term survival in patients operated on under cardiopulmonary bypass (CPB).The tables and figures are supplementary data associated with the research paper entitled “Impact of Malnutrition on Survival in Adult Patients After Elective Cardiac Surgery” Nutrition, In Press ROC analyses were performed to determine the predictive values and the cut-off points of studied variables. Values obtained from ROC analysis of 8 years follow-up stratified by mixed, coronary artery disease (CAD) and heart valve disease (HVD) cohorts are reported in The following risk factors of mortality in accordance with the cohort and follow-up periods were analyzed: age, serum albumin, CPB time, aortic cross-clamp time, C-reactive protein, and left ventricle ejection fraction. Thus, ROC analysis revealed the corresponding cut-off values of age for 3- and 8-year follow-up periods in studied patient cohorts .Fig. 1AcFor every follow-up and all cohorts, preoperative albumin level has a value on a ROC-curve that has significant AUC. Thus, for all cohorts and follow-up periods, this cut-off value is 42.5 g/l except for 3-year follow-up in the HVD cohort, which is 40.5 g/l .Fig. 2ROPredictive values of CPB time in all studied periods and cohorts are presented in ROC curves of predictive value of aortic cross-clamp time are presented in Significant cut-off values of C-reactive protein levels were found in all follow-up periods among mixed and HVD cohorts .Fig. 5ROAbsence of predictive value of preoperative platelets level is illustrated in Left ventricle ejection fraction has significant cut-off values for both time periods in the mixed cohort and 3-year time period in the CAD cohort .Fig. 7ROn = 379) and mixed cohort (n = 738) only in the 3-year follow-up . During the 8-year follow-up, differences in survival probability were not found  showed significant differences in survival for any observed time periods .Fig. 10KPreoperative plasma C-reactive protein and albumin levels also showed significant differences of survival in corresponding stratified groups in 3- and 8-year follow-up .Fig. 11K22.1This data article presents secondary analysis of the 8-year survival among patients who were enrolled in a prospective observational study of nutritional screening in cardiac surgery. This study was approved by the local ethics committee and registered in clinicaltrials.gov (NCT01366807).n = 15) and those who underwent surgery under deep hypothermic circulatory arrest (n = 8). Thus, the data of 1187 patients were used. Both electronic medical records and phone interviews were used for survival data collection. Long-term follow-up was conducted by phone interview.A total of 1210 eligible patients hospitalized between January 1, 2011, and August 31, 2011 were enrolled to the trial and passed nutritional screening was performed. The inclusion criteria were as follows: (1) older than 18 years and (2) elective cardiac surgery under CPB. The exclusion criteria were as follows: (1) emergency surgery, (2) aortic surgery performed under deep hypothermic circulatory arrest, (3) pulmonary thromboembolism requiring thrombectomy, and (4) off-pump surgery. The following patients were excluded: those operated without CPB  and 40 variables (columns). Part of lost-to-follow-up observations (449 rows) were dropped during statistical analysis.9/l), Left ventricle ejection fraction (%), Age (years) as predictors of death in 8 and 3 years periods of follow-up in mixed, CAD, and HVD cohorts. The target value for cut-off point was determined by selecting maximal Youden's J statistic (sensitivity + specificity – 1), corresponding value of numeric variable was used as the threshold for converting variables into two-level factor variables . For every ROC curve, AUC was determined using a statistical package function. P-value for AUC was determined using the Wilcoxon-Mann-Whitney U-Statistic test.The initial goal was determination of cut-off point for the purpose of further converting the numeric variable to factorial type. ROC analysis was performed for the following variables: Preoperative albumin level (g/l), Preoperative C-reactive protein level (mg/l), Cardiopulmonary bypass time (min), Aortic cross clamp time (min), Preoperative thrombocytes level >Criterion, Preoperative C-reactive protein level (mg/l)>Criterion, Preoperative albumin level (g/l) > Criterion . Fitting multivariate models was performed by including all predictors in the model; the optimal model was obtained by step-by-step elimination of predictors with high  p-values.Statistical analysis was performed using R programming language (version 4.0.2) in the interactive development environment, RStudio (version 1.2.5001). In addition to standard packages for analysis, additional packages were also used .All study participants provided informed consent, and the study design was approved by the appropriate ethics review board.Sergey M. Efremov: Conceptualization, Methodology, Data curation, Writing - Review & Editing, Project administration. Tatiana I. Ionova: Data curation, Formal analysis. Tatiana P. Nikitina: Data curation, Formal analysis. Pavel E. Vedernikov: Investigation, Writing- Original draft preparation. Timur A. Dzhumatov: Investigation. Timofey S. Ovchinnikov: Investigation. Abduvahhob A. Rashidov: Investigation. Alexandr E Khomenko: Data curation, Formal analysis, Visualization, Writing- Original draft preparation. Christian Stoppe: Supervision. Daren K. Heyland: Supervision. Vladimir V. Lomivorotov: Supervision, Writing - Review & Editing.The authors declare that they have no known competing financial interests or personal relationships which have, or could be perceived to have, influenced the work reported in this article.