The communication of pain in individuals with co‐morbid Autism Spectrum Disorder and intellectual disability (ASD‐ID) is largely unexplored. The communication deficits associated with ASD‐ID can result in nonverbal behavior such as self‐injurious behavior, aggression, irritability, and reduced activity as a means to communicate that pain is present. The objective of this study was to determine whether a behavioral‐based educational intervention could increase the pain‐related communication of children with ASD‐ID who experience pain frequently. Specifically, the study aimed to determine if children with ASD‐ID can label the location of their pain or quantify pain severity and request pain relief. The sample included three children with ASD‐ID who experienced pain frequently. The intervention utilized educational materials and behavioral reinforcements and the intervention was conducted using a series of case studies. Pain was assessed daily by caregivers using the Non‐Communicating Children's Pain Checklist—Postoperative (NCCPC‐PV) and the ability of the individual to identify and express pain was recorded using the Wong Baker FACES Pain (WBFPS) Scale. Challenging behavior was recorded based on frequency count. The results indicated that all participants displayed the ability to independently respond to a question about how they were feeling by vocalizing the location of pain or indicating their level of pain on the WBFPS and requesting pain relief. The results suggest a role for behavioral‐based educational interventions to promote communication of pain in people with ASD‐ID. Findings from caregiver reports have found wide‐ranging estimates of daily pain, ranging from 15%‐50% of people with ID.A recent study on the prevalence of pain , in a representative sample of children in the United States found that children with ASD showed a higher incidence (15.6%) compared with children without ASD (8.2%). However, the prevalence of pain was highest among children with ASD and developmental co‐morbidities (19.9%). The authors opined that underlying sensory sensitivities, comorbidity of conditions associated with pain such as cerebral palsy and gastrointestinal conditions, as well as more frequent medical procedures, could account for the elevated prevalence of pain.Self‐report is considered the “gold standard” in the assessment of pain; however, self‐report measures are not always accessible or feasible for use with individuals with ID and ASD.To date, only two studies have examined psychological interventions focused on pain in individuals with a diagnosis of ID, both using cognitive behavioral therapy to teach self‐management strategies for chronic pain.The ways in which children in general learn about the concept of pain is relatively under‐researched. The limited literature in this area suggests that age‐appropriate language should be used and that tasks such as drawing and vignettes should be used to allow children to communicate their concept of pain, such as asking children about how the person may be feeling and what the person may need to feel better or different.From their work on the concept of pain in children, Pate et al identified four themes labeled as follows: (i) “my pain related knowledge,” (ii) “pain in the world around me,” (iii) “pain in me,” and (iv) “communicating my concept of pain.” They concluded that the first three themes  are inputs that combine in varying proportions to produce the output which is how a child communicates their individual concept of pain.There is therefore a reasonable conceptual basis to assume that labeling pain in oneself (pain in me) and labeling pain in others and identifying how the person is feeling (pain in the world around me) or identifying what someone would need to feel better (pain‐related knowledge) are prerequisites in order for a child to reliably communicate their own pain and their pain management needs.The current study aimed to use a behavioral‐based educational intervention to teach children with ASD and ID to communicate about their pain, by communicating the severity of pain, reporting the location of the pain, and requesting pain relief, using a series of case studies, in which the initial baseline was staggered and ongoing probes were taken to monitor for the emergence of the skill. Data were also gathered on challenging behavior and pain (as measured by the Non‐Communicating Children's Pain Checklist) to (i) identify if pain was present for each participant, (ii) utilize this information in order to facilitate skills teaching when pain was present (participants learning the skill of communicating pain), and (iii) determine if there was any reduction in challenging behavior in response to the ability to communicate pain.22.1The Non‐Communicating Children's Pain Checklist‐Postoperative Version  had a confirmed diagnosis of ASD (made by an interdisciplinary service), (ii) presented with co‐morbid ID , (iii) presented with a delay in language function, (iv) never vocalized or reported pain, and (v) experienced daily or frequent pain based on 2.2Vineland Adaptive Behavior ScalesThree male children with a diagnosis of ASD and ID were recruited from a school for children with special educational needs. Participant 1 was aged 11 years and 4 months with a diagnosis of ASD, moderate level of ID, co‐morbid neurological conditions and limb amputation which resulted in him having a prosthetic limb. The The Psychoeducational Profile—Third Edition  in participants with ASD‐ID could be achieved using principles of applied behavior analysis.Each of the four components of the intervention was introduced individually and sequentially: (1) label body parts on iPad, (2) label body parts on self, (3) label pain and score severity using the Wong Baker FACES Pain Scale, and (4) request pain relief. Following this, in‐situ training was implemented. The intervention was introduced in a staggered fashion across participants following achievement of each component for each participant.2.5Communication of pain was the dependent variable and was defined as the participant: (i) either pointing to the Wong Baker FACES Pain Scale (WBFPS) to indicate the level of pain they were experiencing or (ii) verbally expressing the location of pain and (iii) verbally requesting pain relief. Data was gathered on all three behaviors. An Independent Response occurred in response to being asked “How are you feeling?” and was defined as an independent point to the WBFPS or verbally expressing the location of pain and an independent verbal utterance to request pain relief. An Independent Initiation occurred in the absence of any question about how the participant was feeling and was defined as an independent point to the WBFPS Scale or verbally expressing the location of pain, and an independent verbal utterance to request pain relief.2.62.6.1Hand biting was defined as any instance where the child's teeth made contact with their hand with enough force to leave a visual mark on the skin and/or make hand bleed. Crying was defined as any instance in which the child engaged in loud vocalizations accompanied with tears when pain was present. Participant 2 had a history of aggressive behaviors (hitting others and throwing objects) when pain was present. Hitting was defined as any instance where the child would use their dominant hand with force and hit another person on their upper body . Throwing objects was defined as any instance where the child would pick up an object  that was in close proximity to them and throw it with force. Participant 3 has a history of noncompliance and irritable behaviors (crying) when pain was present. Noncompliance was defined as any instance where the child physically and/or verbally refused to follow an instruction or complete a task. The definition of crying was identical to that detailed for Participant 1.Frequency of challenging behavior was collected by the therapist and teacher using an individualized data collection sheet to record the occurrence of challenging behavior. A “+” was marked for each instance of challenging behavior in order to gather a tally of the occurrence of challenging behavior across the day. A “−” was marked if no instances of challenging behavior occurred for the entire day. All three participants displayed different topographies of challenging behavior. Participant 1 had a history of self‐injurious behavior (hand biting) and crying when pain was present. 2.6.2(a) The Non‐Communicating Children's Pain Checklist—Postoperative Version  The Wong Baker FACES Pain Scale  label body parts on iPad, (2) label body parts on self, and (3) label pain and score severity using the Wong Baker FACES Pain Scale. The introduction of subsequent components was based on stable responding on the communication of pain. All probe conditions were identical to baseline, with the addition of the WBFPS following Component 3. Following Component 3, the WBFPS was permanently placed on the participant's desk, this is denoted below in Figure  label boDuring baseline and across all probes, the teacher was working with the participant in their typical classroom environment, therefore, was aware if the participant engaged in any behavioral indicators of pain. The NCCPC‐PV was completed by the teacher at the end of each school day, and a score was calculated to quantify the level of pain behaviors. The NCCPC‐PV was used as a guide to observe pain‐related behaviors of all three participants within the baseline conditions. Frequency data was also collected on the occurrence of challenging behavior across a school day. At baseline and throughout the intervention phase, staff asked participants “How are you feeling?” when they believed the participant was experiencing pain based on the presence of challenging behavior or based on the NCCPC score.2.8During the intervention phase, four target skills  were identified as prerequisites to communicating pain and requesting (rather than just identifying) pain relief. Participants were assessed to verify if these skills were present and in cases where they were absent, the skill was taught to mastery. The mastery criteria for each component was 100% correct once or 90% correct on two consecutive trails. Training on the four components took place for 1 hour per session and was consistent for all three participants. Prior to commencing teaching sessions, each participant was presented with a choice board containing three preferred items and offered to select one item, which they would receive as a reinforcer during the teaching session. Each participant had individualized choices, token boards, and tokens.2.8.1The first component of the intervention consisted of labeling body parts  using a representation of a body on an iPad using the “Learn Body Parts” app. [Details on how to deliver training to teach this component can be obtained from the corresponding author on request].2.8.2Component two was introduced, whereby the participant had to point and label the requested body part on themselves. The participant was presented with the instruction “show me ____” , participants were required to respond by pointing to the body part on themselves.2.8.3This component consisted of the presentation of five painful scenarios . Each scenario contained three pictures on flashcards outlining a story in which the character experienced pain, each scenario began with an image of a boy or girl doing an activity but without evidence of injury or pain. The participant was presented with one scenario at a time and then the WBFPS. During the teaching session, each participant was presented with all five scenarios (see Table The therapist presented the scenario in conjunction with five questions (How is s/he feeling (at the start of the sequence)? What is s/he doing? What happened? Where does it hurt? How is s/he feeling (at the end of the sequence)?). Data was taken on three trials which related to answering “how is s/he feeling?” (at the start of the sequence), “where does it hurt?” and “how is s/he feeling?” (at the end of the sequence). When the researcher gave the instruction “how is the person feeling?” pointing at picture 1, the participant was then presented with the WBFPS to which they had to point to the appropriate face. The purpose of labeling “not hurt” (happy) at the start of the sequence was essential as it allowed the participant to differentiate between no pain and the presence of pain. Five trials were conducted on each scenario.If the participant labeled the correct face using the WBFPS, verbal praise and a token were given to the participant to place on their token board. However, if the participant labeled an incorrect face , an error correction procedure was used whereby the therapist touched and labeled the correct face and said “s/he is not hurt.” Praise and tokens were withheld for any incorrect responses. The scenarios were all presented in the same way for each participant. The visual sequences were designed to display moderate levels of pain to ensure that the participant selected 6 or more on the WBFPS.2.8.4This component consisted of the presentation of the flashcards with an additional visual representation of pain relief (four‐picture sequence). This component was delivered in the same way as component three with each scenario being accompanied by five questions (How is s/he feeling (at the start of the sequence)? What is s/he doing? What happened? Where does it hurt? How is s/he feeling (at the send of the sequence)?). However, when the participant labeled the level of pain on the WBFPS, the therapist then asked the participant, “what do they need to feel better?”. The therapist presented two visual images as options after the instruction was given; one correct response and one incorrect response. The participant had to pick the correct picture and place it next to the four‐picture sequence. See Table If the participant selected the correct picture of pain relief, the therapist provided praise  and a token was given to the participant for him to place on the token board. However, if the participant picked the incorrect picture  and any instances of challenging behavior were recorded.Individuals with ASD often have difficulty with skill generalization. To address this, in‐situ training was implemented for 5 days. The aim of in‐situ training was to transfer the use of the WBPFS and the visual supports for pain relief used during Component 4 to support participants to communicate their pain. Participants had continuous access to the WBPFS and a visual support containing images of their individualized pain relief regimen . Data were also collected on level of pain using the Each participant's teacher was trained to deliver prompts, if required, when the participant may have been experiencing pain  was present). The teacher posed the question, “How do you feel?”. If Participants did not emit an independent response to the question they were prompted using a gestural prompt  and then presenting the participant with the visual images of the pain relief options available. If participants did not point to a visual representation of pain relief or verbally request pain relief, they were provided with a gestural and verbal prompt to request pain relief.33.13.1.1All three participants correctly labeled and vocalized the five targeted body parts on the iPad (Component 1) and on themselves (Component 2). The participants had already acquired the skill of labeling their body parts, as they achieved 100% correct responding first time  on the NCCPC‐PV each day and displayed high levels of challenging behavior. Participant 1 experienced at least mild pain daily. Participant 2 and 3 scored above the threshold each day (indicating that they experienced at least mild pain daily). For Participants 2 and 3, it was noted that on days where participants scored 11 or higher on the NCCPC‐PV , challenging behavior was also evident. However, on days that they obtained a score of 10 or below , there was no occurrence of challenging behavior, indicating that there was a strong association between the presence of moderate to severe pain and the occurrence of challenging behavior . However, on this day he independently initiated communication of his pain. Similarly, Participants 2 and 3 displayed challenging behavior on days where participants scored 11 or above on the NCCPC‐PV.3.3.2During in‐situ training, Participant 1 continued to display the presence of pain with scores on the NCCPC‐PV above 6 daily. However, in contrast to baseline and probe conditions, challenging behavior was reduced, occurring only on two of the 5 days. In addition, the number of incidents of challenging behavior was lower than baseline .Participant 2 displayed pain daily across the 5 days with a score of 6 or above on the NCCPC‐PV. Similar to Participant 1, challenging behavior was lower than baseline  with challenging behavior only present on one day.Participant 3 was found to be experiencing pain daily across the 5 days with scores of 6 or above on the NCCPC‐PV. Similar to findings for Participant 1 and 2, challenging behavior was lower than baseline (during which it occurred on four of the 8 days), with its presence only recorded on one of the 5 days.3.4The researcher used a fidelity checklist to ensure that the intervention was implemented consistently across all three participants. The fidelity checklist included a 19‐item checklist of each step of the intervention. The researcher delivered the intervention while a teacher/teacher's assistant observed the intervention and completed the fidelity checklist. Fidelity checks were taken for over 30% of sessions and was 100% for all training sessions.3.5Inter‐observer agreement was assessed in all components of the study by a second observer. Both the first and second observer took data independently for all targeted responses. For participant 1, the inter‐observer agreement was 92.5% with a range of 80%‐100%, while for participant 2, inter‐observer agreement was 97.5% (range 90%‐100%), and for participant 3, inter‐observer agreement was 95% (range 80%‐100%).4This study aimed to increase communication of pain among three individuals with autism spectrum disorder and intellectual disability using a behaviorally‐based educational intervention by ensuring the presence of prerequisite skills (labeling and identifying) and using in‐situ training. All three participants learned how to report when pain was present, by reporting the severity of pain using the Wong Baker FACES Pain Scale or verbalizing the location of pain, and then requesting pain relief. The results showed that for all three participants, labeling body parts (Component 1 and 2) did not generalize to communication of pain for the participants themselves. Following teaching focused on identifying pain in others (Component 3), communication of pain increased for one of the three participants. In‐situ training involving prompts  was required to increase the communication of pain, in particular the request for pain relief, for all three participants.Pain was present for all three participants across the experiment, as the NCCPC‐PV scores were above 6, indicating that they displayed behavioral indicators of pain on a daily basis throughout the study. During baseline and probes, it was noted that Participant 2 and 3 consistently displayed challenging behavior when a score of 10 or above was obtained on the NCCPC‐PV. Participant 1 displayed similar results with the exception of Day 1 in Probe 3. During this session Participant 1 independently initiated communication of his pain. These findings are consistent with Symons et alDuring in‐situ training, the score from the NCCPC‐PV and the occurrence of challenging behavior served as antecedents to identify for staff, suitable opportunities to teach the communication of pain, given the higher probability of the presence of pain for the participants. During this phase of training, the findings indicate that participants engaged in communication of pain on days when their NCCPC‐PV scores were highest. It is possible that the experience of more severe pain may have motivated the participants to communicate their pain. Furthermore, pain‐related communication was associated with lower levels of challenging behavior which may indicate that an alternative response (the communication of pain and requesting pain relief) may have acted to suppress the occurrence of challenging behavior.For all participants, the Wong Baker FACES Pain Scale was present in their environment consistently following Component 3. For Participants 2 and 3, the presence of the visual support (WBFPS) alone was not sufficient to increase the independent communication of pain. From in‐situ training, it is evident that teaching in context  and prompting was required to support individuals with ASD‐ID to communicate the presence of pain. However, for Participant 3, he did not use the WBFPS to denote that pain was present, but rather vocalized the location of his pain. The behavioral indicators of the NCCPC‐PV can be helpful to educators, to identify when an individual may be experiencing pain, and thus, enabling them to capture opportunities to teach the person to communicate their pain.The current findings highlight the issue of skills generalization for individuals with ASD. Despite all participants displaying the skills of labeling body parts, the presence of pain and the severity of pain in others , this did not consistently generalize to personally‐relevant pain‐related communication. It is evident that in‐situ training was required to teach the communication of pain, in the presence of the occurrence of pain, to enable individuals with ASD‐ID independently communicate their pain in response to being asked how they are feeling. During the research, Participant 1 engaged in one independent initiation; however, more work is needed to determine how this skill can be reliably established in this population.4.1Although all three participants increased their communication of pain, there are some limitations to the study. For example, each of the participants had different locations of pain, and not all of the relevant body parts were included in the study. The study used the five most common locations of pain from McGuire et al’sSimilarly, the scenarios used within the current study did not represent the individualized pain experienced by each of the three participants. The scenarios were standardized depictions of pain in common situations. Future research could compare the use of standardized depictions of pain versus painful situations individualized to each participant.A limitation of the current research is that the WBFPS and visual representation of pain relief were not used throughout the study. The WBFPS was introduced during Component 3 and the visual representations of pain relief were introduced during Component 4 and remained present on the participant's desk in all subsequent phases. Future research should ensure the WBFPS and visual representation of pain relief are used throughout the study. Furthermore, the study design could be enhanced by the inclusion of an additional probe following Component 4, prior to the in‐situ training.As pain is a subjective experience, it is difficult to confirm its occurrence for individuals who have limited ability to communicate. During in‐situ training, there were occasions when staff reported a score of above 6 on the NCCPC‐PV and prompted the participant to communicate pain; however, the participants did not always do so. Tools which rely on behavioral indicators of pain are the most accessible options in applied settings. However, future research could explore the use of other physiological indicators to identify the presence of pain.Further prevalence studies are also needed to determine the extent and nature of pain in people with ASD‐ID and to elucidate the most common behavioral indicators of pain so that functionally equivalent behaviors can be taught.5This study showed that in‐situ training was required in addition to the presence of the prerequisite skills of being able to identify and label pain, in order to develop pain‐related communication. The current study highlighted that for individuals with ASD‐ID, a visual prompt  alone does not increase communication to report pain or request pain relief. Following in‐situ training, all participants displayed the ability to independently respond to a question about how they were feeling by vocalizing the location of pain or indicating their level of pain on the WBFPS and requesting pain relief. In addition, the current study supports the clinical utility of the NCCPC‐PV as a measure to assist staff in identifying the presence of pain in individuals with ASD‐ID, and thus assisting in identifying appropriate opportunities to teach the communication of pain.


Background: Age-related macular degeneration (AMD) is a disease that currently affects approximately 196 million individuals and is projected to affect 288 million in 2040. As a result, better and earlier detection methods for this disease are needed in an effort to provide a higher quality of care. One way to achieve this is through the utilization of machine learning. A deep neural network, specifically a convoluted neural network (CNN) can be trained to differentiate between different types of AMD images given the proper training data.Methods: In this study, a CNN was trained on 420 Optos wide-field retinal images for 70 epochs in order to classify between exudative and non-exudative AMD. These images were obtained and labeled by ophthalmologists from the Martel Eye Clinic in Rancho Cordova, CA. Results: After completing the study, a model was created with 88% accuracy. Both the training and validation loss started above 1 and ended below 0.2. Despite only analyzing a single image at a time, the model was still able to accurately identify if the individual had AMD in both eyes or one eye only. The model had the most trouble with bilateral non-exudative AMD. Overall the model was fairly accurate in the other categories. It was noted that the neural network was able to further differentiate from a single image if the disease is present in left, right, or both eyes. This is a point of contention for further investigation as it is impossible for the artificial intelligence (AI) to extrapolate the condition of both eyes from only one image.Conclusion: This research fostered the development of a CNN that was able to differentiate between exudative and non-exudative AMD. As well as determine if the disease is present in the right, left, or both eyes with a relatively high degree of accuracy. The model was trained on clinical data and can theoretically be used to classify other clinical images it has never encountered before.  Age-related macular degeneration is a chronic disease occurring in the central retina that affects 196 million people worldwide . As a reThis was a retrospective cohort study of individuals diagnosed with exudative or non-exudative macular degeneration. Retinal fundus images from patients and diagnoses by ophthalmologists were obtained from the Martel Eye Clinic in Rancho Cordova, CA. Images used were wide-field Optos images collected from 2017 to 2021. Images collected were initially filtered to remove low-quality images from the dataset. They were then labeled based on the respective side they were taken on (left or right) and ICD-10-CM diagnostic codes . The images labeled with H35.35 were relabeled to “#na#”. From an initial pool of 957 images, 20% of the images and their labels were randomly sampled and separated into the validation set. The remaining images were randomly sampled until each category had a total of 50 images each. This created a training set of 350 images and a validation set of 70 images for a total of 420 images used. The patient sample size for this study was 210. The machine-learning CNN algorithm was run on a Windows computer with an Nvidia GTX 3090 24GB. A batch size of four images was used with an initial learning rate of 1 x 10-3. Batch image augmentations were applied along with resizing of the images to 1950 x 1535 pixels. The CNN was run for a total of 70 epochs taking about three minutes and 20 s for each epoch.Figure Figure Figure Age-related macular degeneration is an extremely pervasive ocular disease that can cause complications such as blindness if left untreated . MacularIn this investigation, the AI software was trained for 70 epochs utilizing 350 retinal scans of patients with either exudative and non-exudative macular degeneration. The AI software was able to distinguish patients who had exudative macular degeneration in their left eye and bilaterally with an accuracy of 100%. It was also able to determine if a patient had exudative macular degeneration in their right eye with an accuracy rating of 81.8%. The software was also able to determine if a patient had non-exudative macular degeneration in their right eye with 100% accuracy, their left eye with 92.3% accuracy, and both eyes with 69.6% accuracy. The program was also able to determine if a patient did not fall into any of the other categories with an accuracy rating of 100%. The results from the data suggest that it may be easier for the AI software to identify signs of exudative macular degeneration. This could potentially illustrate that there are more obvious signs on retinal scans for cases of exudative macular edema such as physicians that make it easier for the AI to obtain higher accuracy results to detect the disease. This could also indicate that the retinal scans for exudative macular degeneration may have been of better quality, or that the limited sample size resulted in these accuracy readings. The accuracy ratings of the AI software for detecting macular degeneration bilaterally were surprisingly high. Since only a single image is processed at a time, the program should have had difficulty determining if the image bilateral, left, or right as bilateral contains both left and right images. Despite this, the majority of the bilateral images were able to be correctly predicted. This would suggest that there is a difference in the macular degeneration between bilateral cases than cases only in the left or right eye. This would be a point of further research to determine if there is a fundamental difference between bilateral macular degeneration and macular degeneration only occurring in one eye.Our findings have crucial implications for the field of medicine. Our report is the first to our knowledge that reports an AI software that is able to scan a single retinal image and tell if a patient has macular degeneration in both eyes. This proves that the application and usage of AI software in the field of medicine is not only useful at decreasing costs and improving patient outcomes but that it can also be utilized to identify new patterns and make discoveries within the field of medicine. One of the biggest strengths of this study is that the AI software utilized raw unprocessed clinical data to identify patterns and produce results. Unlike previous studies that were done using processed images and datasets, our software was able to function using low-quality images -15, 20. The authors in this investigation developed a CNN algorithm that is able to differentiate between exudative and non-exudative macular degeneration from ultrawide field Optos images. On the validation dataset, the model was calculated to be 88%. The model was able to differentiate from analyzing a single image if AMD is present in the left eye, right eye, or both eyes. Being able to identify if AMD is present in both eyes from an image of a single retina. AMD needs to be caught early on in order to prevent further patient complications, therefore, it is quintessential for physicians to continue developing tools and methods that facilitate diagnosis. Further research is required to verify and explain the possibility of extrapolating the fact that a patient has AMD in both eyes when only looking at one retinal scan. The results from this exploration demonstrate that AI has the potential to have a significant impact on diagnostics and the overall quality of care in the healthcare industry.


The common phenomenon of lightning still harbors many secrets such as what are the conditions for lightning initiation and what is driving the discharge to propagate over several tens of kilometers through the atmosphere forming conducting ionized channels called leaders. Since lightning is an electric discharge phenomenon, there are positively and negatively charged leaders. In this work we report on measurements made with the LOFAR radio telescope, an instrument primarily build for radio-astronomy observations. It is observed that a negative leader rather suddenly changes, for a few milliseconds, into a mode where it radiates 100 times more VHF power than typical negative leaders after which it spawns a large number of more typical negative leaders. This mode occurs during the initial stage, soon after initiation, of all lightning flashes we have mapped (about 25). For some flashes this mode occurs also well after initiation and we show one case where it is triggered twice, some 100 ms apart. We postulate that this is indicative of a small (order of 5 km This is corroborated further by the observation of a correlation between a certain type of broadband radio pulses  and VHF pulse amplitudes in13. In this work we show that an IRNL mode is not confined to the initial stage of a lightning (as is expressed by using a different name) and rather is evidence of a small but dense charge pocket. This charge pocket enhances the local electric field and thus facilitates lightning initiation.In the work of14) the charge layers are usually at much lower altitudes than the storms measured in some parts of the US15. The main negative charge is at altitudes of 4–5 km with a positive charge layer below17. From the flashes we have imaged we infer that a large majority (more than 90%) of flashes we have imaged were initiated just below the negative charge layer with a downward negative leader that propagates towards the lower-lying positive charge layers.In Dutch thunderstorms , its large baseline (about 100 km), its high timing stability (better than 1 ns over a few seconds), and the possibility to retrieve the time trace of each antenna. These VHF observations are, however, not sensitive to currents at length scales of order 100 m and greater. To ameliorate this, a broadband magnetic-loop antenna12 was installed in the vicinity of the LOFAR core. These combined observations between LOFAR and a broadband antenna have facilitated the identification of the IRNL mode.In recent years radio observations of lightning has gone through some major developments, starting with lightning mapping arraysWe show and analyze in “8 we have already shown the general structure of flash A, we focus here on the first 50 ms. The time calibration is such that For two flashes we have recorded simultaneous measurements with LOFAR and the broadband antenna. Both flashes occurred on April 24, 2019 shortly after each other. The general structure of each of the two flashes can be seen from Fig. 17. For Flash B the negative charge layer lay much lower, below and around 2 km height. Twinkling positive leaders are seen in a band around 4 km height and also above 6 km from which it can be inferred that there were two negative charge layers.From the structure of the leaders it can be inferred that for Flash A there was a positive charge layer below 4.5 km with a large number of negative leaders and a negative charge layer between 4.5–6.5 km height marked by the tell-tale twinkles24. The data from the broadband antenna are available for only a part of each flash due to the fact that the broadband antenna stores traces of 167 ms length upon triggering.The top two panels show the time traces as measured with the broadband antenna and the VHF power as measured by LOFAR. The broadband and LOFAR signal are aligned using the GPS timing of both systems. The VHF noise power is normalized to the background-noise, about In Fig. 25 this initial leader has similar properties as those of a normal negative leader, however it propagates fast and quickly reaches a velocity of As shown in the lower panels on the left of Fig. At shown on the right of Fig. When the negative leaders in the INRL mode propagated downward at high velocity, strong pulses were seen in the broadband antenna, consistent with the fact that this antenna is exclusively sensitive to vertical polarization as emitted by a vertical current. Although the density of broadband pulses is large, most of them are initially positive bi-polar pulses which is indicative of negative charge moving down (due to polarization of the antenna). This is a clear signature of a downward moving negative stepped leader with a large current moment. After fanning-out, the IRNL transitioned into a second batch of normal negative leaders at around t = 6 ms that then gradually slowed down to a typical propagation velocity of a negative leader of about It commences with the acceleration of a more normal negative leader or the acceleration of the negative leader formed at initiation.It reaches a speed of the order of It is not propagating along an existing leader channel and thus is clearly distinct from a recoil or a dart leader.It is emitting strong pulses detected by the broadband antenna.It produces a strong increase in VHF power.There are fewer located VHF sources during this mode  by the imaging techniques used in this work.During the IRNL mode, propagation at top speed is observed for about 1–3 ms, covering distances of several km, after which it decelerates and creates a few dozen negative leaders that slow down to normal negative leader propagation speeds.26) that tend to fan out to form a complex system spawning a large number of more normal negative leaders.In the image, broad filaments, or channels, can be distinguished with a width of the order of 100 m  techniques to be able to image the sources of the many strong and partially overlapping VHF pulses. The stepping during the IRNL mode is seen most clearly at initiation (evident from the pulsed structure seen in the VHF power) when only one or two filaments (or channels) propagate in parallel. For the IRNL mode occurring later during the flash this stepping cannot be seen clearly. It may be due to the fact that there are too many propagating structures washing out the peak structure. It may also be that at the high velocity stage the propagation mode of these negative leaders becomes continuous rather than stepping.Figure Most interesting is that the IRNL mode is not confined to the initiation region but may occur during the later development of the flash and appears to be linked to a particular spot in the atmosphere. The left-hand panel of Fig. The right half of Fig. As discussed above, the VHF power shows strong spikes on top of the broader emission from the IRNL in Fig. 27 as about 100 ms later  and is instead likely due to the presence of a relatively rare small high-charge pocket, sheds important light on the mystery of lightning initiation8 where some of the essential steps are summarized in “The imaging procedure uses the time-traces recorded with LOFAR, see “14 is a radio telescope consisting of several thousands antennas primarily built for radio-astronomy observations. These antennas are spread over many European countries. The low-band antennas operate in the 30–80 MHz frequency band we use are bend-dipole antennas, installed in pairs oriented in the NE-SW and NW-SE directions. With this dual-polarized antenna pair the full polarization can be determined for an incoming plane wave. The Superterp is the core of LOFAR, it contains a dense array of antennas and is located near Exloo, the Netherlands. For radio-astronomy observations, the antenna signals are added coherently to effectively operate as a gigantic radio dish antenna with a diameter of 1000 km when the international stations are included.LOFARFrom each LOFAR station we use 6 dual-polarized low-band antennas sensitive to 30–80 MHz. Each antenna samples at 200 MHz and has a 5 s long buffer. Using only the Dutch stations we reach baselines of up to 100 km Extracting leader velocities is complicated by the fact that leaders branch. This makes it ambiguous to determine which sources should be grouped together to calculate the velocity along the main branch. The distance between sources is small enough that they frequently do not occur in time-sequence along the leader. This may be due to physics, i.e. VHF is not only emitted at the propagating leader tip but a few meters behind the propagating tip, or this may be due to source-location inaccuracies.From the general structure of the leader first the leader track is drawn, as for example shown by the light blue band in the lower panels of Fig.


When a Möbius loop is cut along the middle of the band, the result is a single connected loop, yet anecdotal evidence from science demonstrations and the use of this effect in magic tricks suggest that most people are thoroughly surprised by this because they strongly believe that the result should be two separate loops. Here, we present results from a behavioral experiment confirming this anecdotal evidence and discuss potential theoretical explanations for why this demonstration evokes strong, but misleading intuitions and a related illusion of impossibility. The well-known Möbius band , which cThe purpose of the present experiment was to establish to what extent people actually have difficulties in reasoning about the outcome of cutting the Möbius band, and to what extent their expectations are shaped by a heuristic biasing them to expect two objects, as the anecdotal evidence suggests. We asked our participants to predict the results of cutting a standard Möbius band (Supplementary Movies 1 and 3), as well as a slightly more complicated modification of it (Supplementary Movies 2 and 4), where the strip is twisted by 360 degrees (rather than 180 degrees) before it is joined into a loop Gardner, . While cTo anticipate, the results suggest that people perform very poorly in reasoning about the result of cutting the Möbius strip, and that they almost always instead rely on a heuristic biasing them to expect two parts or abstract knowledge based on familiarity with this type of effect. After presentation of the experimental findings, we discuss potential explanations for the difficulty in reasoning about the Möbius strip and the tendency to expect two parts.A and B of movies presented on Powerpoint slides in a lecture hall setting. One pair (Supplementary Movies 1 and 3) showed the standard Möbius loop  and the other pair (Supplementary Movies 2 and 4) showed a modified version (where the band is twisted by a whole turn). The first movie in each pair showed how the experimenter constructed the loop in question by gluing together the two ends of a paper strip, while the second movie just showed the finished loop being moved about and rotated a little in order to provide a good spatial impression of it. The paper strips used to construct the loops had a clearly visible black line drawn along the middle to illustrate how the loops were supposed to be cut. The construction of the loops in the former movies was accompanied by audio tracks of the experimenter carefully explaining each step in the construction. The audio tracks in Supplementary Movies 1 and 3 are in English, but the audio tracks actually used in the experiment were in Norwegian (Supplementary Movies 7 and 8). The English transcripts are also provided in the Appendix. At the end of the construction movies, when the loops were finished, the experimenter asked “What will you end up with, if you cut along the line in the middle the whole way around?”. After that, a new Powerpoint slide was shown, where the question was repeated in writing and the second movie illustrating the same loop was running in loop mode while the participants filled in a response sheet containing two written specifications of the same question, namely, “Describe what you will end up with if you cut along the line in the middle of the object:” and “Draw a simple sketch to illustrate your description:”. The participants were asked to complete their responses within 4 minutes. After that, they were asked to turn their response forms around. The backside contained the same two questions, and the procedure was repeated for the second set of movies showing the other version of the Möbius loop. The two sides of the response sheet were identical apart from the heading which read “Task A” at the first page and “Task B” at the second page. After completion of the second round, a new slide was shown with the question “How many pieces do you think would have resulted in Task A? State the number in the top right corner at the page for Task A.” Afterwards, a new slide was shown with the same question for Task B.The participants in our study viewed two different pairs The main reason why we asked the participants to provide descriptions and drawings of what they thought would result before asking explicitly about how many of pieces they thought would result was that we suspected that the explicit question about numbers may influence their response. If it appears self-evident to a participant that two pieces would result, asking explicitly about the number of pieces may nudge him or her towards questioning this assumption and consider other alternatives.The experiment was performed with two groups of university students in the break between two 45-minute parts of a first-year introductory lecture in social psychology. Both groups of students attended the same lecture in terms of content but were enrolled in different programs which attended the lecture at different times. In one group, the half twist Möbius band was presented first, and the whole twist modification second. In the other group, the presentation order was reversed.Prior to the experiment, the participants were informed that the aim of the study was to investigate “apprehension of spatial objects” and provided written informed consent. To encourage participation, one participant in each group was randomly drawn to win 500 NOK (about 45€) in cash and two participants in each group were randomly drawn to each win two cinema vouchers.In total 261 participants returned a response sheet, 146 participants in the group where the half-twist stimulus was presented first and 115 in the group where the whole-twist stimulus was presented first.completely correct whenever they were correct with respect to all of them.For each participant and condition, author M. H. evaluated how many pieces the participant believed would result after cutting the loops along the middle, by considering the combined evidence from the participant’s verbal description and drawing. He also evaluated two further properties of the objects depicted in the participants’ drawings that are informative about the correctness of the response. First, he judged whether the strip(s) were depicted as closed or open. In the half turn condition, a single closed strip is correct, while an open strip  is wrong. The same holds for the whole turn condition, except that there are two closed strips. Second, whenever participants (correctly) drew two loops in the whole turn condition, he also evaluated whether the two loops were interlinked (correct) or not (wrong). Based on these separately evaluated aspects  of the responses, a given single response was coded as Cases where the participant had not filled in the form for the particular task, or the description and drawing were impossible to interpret were treated as missing values. More specifically, data obtained by evaluating the verbal descriptions and drawings of a given participant were only analyzed if it was codable with respect to all the three above criteria for both stimuli. This left us with 219 valid response pairs. Similarly, data resulting from the participants’ explicit statements regarding the resulting number of pieces were only analyzed if they were provided for both stimuli. This left us with 248 valid response pairs.p = .36, odds ratio 1.5, McNemar’s test) from the percentage for the half-twist stimulus (10.5%). The small differences between the two groups were also not statistically significant .much higher for the whole-twist stimulus (89% based on the description and drawings and 84.3% based on the explicitly stated numbers).p = .010, odds ratio 2.55 and p = .034, odds ratio 1.85, respectively, both McNemar’s tests), but the difference is rather small.Remember that the response “2 pieces” is wrong for the half-twist condition, but correct for the whole-twist condition. Panel C replots the percentages in Panel B as percentages of “2 pieces” responses. The tendency to respond “2 pieces” is similar and strong for both stimuli, but somewhat larger for the whole-twist stimulus (89% based on the description and drawings and 84.3% based on the explicitly stated numbers) than for the half-twist stimulus , and the difference is statistically significant . In the latter case (Panel E), this difference is small (approximately 1% in both cases), goes in the opposite direction in the case of the explicitly stated numbers, and is not statistically significant (p = 1 in both cases). The larger effect of stimulus type in the group of participants to whom the half-twist stimulus was presented first (Panel D) than in the group of participants to whom the whole-twist stimulus was presented first (Panel E) was also statistically significant .Panels D and E show the same as Panel C, but plotted separately for the group of participants to whom the half-twist stimulus was presented first and the group of observers to whom the whole-twist stimulus was presented first. In the former group (Panel D), the difference between the two stimuli (13.7% based on the description and drawings and 13.1% based on the explicitly stated numbers) is more pronounced and also statistically significant (The majority (about 80%) of the participants in our study erroneously predicted that cutting the standard Möbius band along the middle will produce two separate pieces, although this operation actually produces a single unbroken loop. This finding confirms the anecdotal evidence from magic tricks and science demonstrations suggesting that peoples’ intuitions about what will happen here are systematically misleading. The specific source of this misleading intuition is presently unknown, but Regardless of the specific details of this account, however, the general hypothesis is that the intuition that the cutting will produce two separate pieces is due to automatic heuristic processing  are due to system-2-like processing or mere familiarity with the effect from before. Even so, it is clear from our results that successful system-2-like processing of the half-twist stimulus, if it ever occurs at all, is relatively rare since only about 20% provided a response with the correct number of pieces , and onlConsidering that the participants can be expected to provide responses indicating the correct number of pieces (two) for the whole-twist stimulus regardless of whether they rely on system-1-like heuristic processing or system-2-like processing, it is hardly surprising that the large majority of our participants  seems to be very difficult.There is a strong tendency to expect that two pieces will result, irrespective of whether that is correct, as it is for the whole twist version, or wrong, as it is for the standard Möbius loop. This tendency probably reflects an immediate intuition based on a cognitive heuristic.Although there are some responses to the standard Möbius strip which indicate the correct number of pieces (one), and many more responses to the modified Möbius strip which indicate the correct number of pieces (two), at best very few and possibly even none of the correct responses are due to successful system-2-like thinking. Rather, these responses may reflect the application of previous abstract knowledge and guessing or, in the case of the whole twist version, reliance on the abovementioned intuitive heuristic, which in that case happens to be correct.The following are the main conclusions suggested by the results of the present study:The results of our study can be taken to suggest that a large majority experience a misleading intuition that cutting the Möbius strip will result in two separate pieces. We can also conclude that a large majority fail to think correctly about the result of cutting the Möbius strip, either because the strong and misleading intuition inhibit them from engaging in effortful system-2-like thinking, or because the time period they had available for doing so (4 minutes) was too short. Thus, further research clarifying the specific source of this misleading intuition and the difficulty in reasoning correctly about the Möbius loop seem warranted and theoretically interesting.Viewed from the theoretical perspective offered by the concept of attribute substitution  the mislThe gist of a potential answer to the first question would be that reasoning about the result of cutting the Möbius loop is difficult because it involves questions of connectedness, and that our cognitive apparatus for establishing connectedness is limited. Determining connectedness is a computationally expensive problem , and altThe misleading intuition evoked by the Möbius band can be characterized as an “illusion of imagery”  that refIt is worth noting that there are many similarities and interconnections between mathematics and magic . Many ma


The non-relativistic equations of motion for a dipole in a stationary non-homogeneous electromagnetic field are derived and analysed. It is shown that they are Hamiltonian with respect to a certain degenerated Poisson structure. Described by them dynamics is complex because the motion of the centre of mass of the dipole is coupled with its rotational motion. The problem of the existence of linear in momenta first integrals which can be useful for the separation of rotational motion is discussed. The presence of such first integral appears to be related with a linear symmetry of electric and magnetic fields. Also results of search of quadratic in momenta first integrals for uniform and stationary electromagnetic fields are reported. Deriving equations of motion of a dipole in arbitrary stationary electromagnetic fields and analysis of described by them dynamics is important for the construction of electromagnetic traps for polar particles. The main aim of this paper is to give a general framework for a study dynamics of electric dipole in a stationary non-homogeneous electromagnetic field. In our considerations a dipole is modelled by two equal, and opposite sign point charges. The distance between them is fixed, and the masses of the charges are not necessarily equal. From the dynamical point of view, such a dipole is a degenerated charged rigid body—one of its principal moments of inertia vanishes. Our goal is to derive and investigate equations of motion in the most general case when the mass centre motion of the dipole is coupled with its rotation.5. More specifically, in5 we investigated the motion of a small dipole in a special configuration of non-homogeneous electromagnetic field that was proposed as a model of a trap for polar particles. These investigations showed that for a study similar traps we have to construct a general description of a dipole in an electromagnetic field of arbitrary form.Motivations for this investigation come from our study of electromagnetic traps for charged and neutral particles4 that even in a stationary homogeneous electromagnetic field the motion of a dipole is complex and, in general, it is chaotic. If the field is not homogeneous, then having in mind possible physical applications, it makes sense to assume that the dipole is small. But then it is not clear what are the properties of reasonable approximations of the equations. In the commonly used approximation a dipole is just a neutral point mass which carry a dipole moment. However considering polar particles we have to take into account that they have finite dimensions and that their mass distribution in not spherically symmetric. Moreover, the charge and the mass distributions of a polar particle do not need to be necessarily proportional to each other. This is why in our considerations we assume that the dipole is small but we take into account that it can be inertially non-symmetric. That is, its mass centre does not necessarily coincide with its centre of the charge distribution. This asymmetry is described by the parameter l is the charges separation distance.We showed in4. For a single charge q of mass m in an electromagnetic field the canonical momentum conjugated to its position 6. The advantage is that the system is gauge invariant. The equations of motion for a dipole can be obtained by a restriction of non-canonical Hamilton’s equations for two charges. The constrain, the constant distance between charges, is holonomic so one can expect that the constrained system is Hamiltonian, and, it is. The other way is just to start from the Lagrangian formulation and use local generalised coordinates. However, the first approach needs not so well known theoretical tools, and the second gives highly complicated formulae.The Hamiltonian formalism gives appropriate tools and language for classical description of motion. However, considering problems where electromagnetic is involved the canonical description can be done in two ways, see4. In this article we show that this method works in a general case. The derived equations are Hamiltonian with respect to a degenerated Poisson bracket and they are starting point for our further analysis.This is why we choose simple and direct method to derive the equations of motion for a dipole. We just use the Newton–Lorenz equations for a charge in an electromagnetic field and the basic laws of mechanics. We demonstrated it for a dipole in a stationary homogeneous electromagnetic field inThe key goal of out analysis was derivation of equations of motion for a small dipole. To this end we expand into the power series the right hand sides of general equations and truncate them at the first term proportional to the asymmetry parameter. We proved that these equations are Hamiltonian with respect to an appropriate Poisson bracket. This fact is not evident.4 for details. This is why it is important to know whether the obtained equations of motion of the dipole admit first integrals linear in momenta. We analyse this problem in details and show among other things that if such a first integral exits, then the vector fields As we already mentioned the motion of the centre of mass of the dipole is coupled with its rotational motion. The centre of mass does not move with constant velocity. Nevertheless, if the electromagnetic field is stationary and homogeneous, then existence of first integrals linear in the momenta allows to separate equations for the rotational motion of the dipole, seeThe plan of this paper is as follows. In Section “In this section, we derive equations of non-relativistic motion of an electric dipole in a time independent electromagnetic field without assumption about the smallness of the dipole with respect to the size of non-linearities of the electromagnetic field. We show that it is possible to present them as Hamilton’s equations with respect to a certain degenerated Poisson structure.At first let us fix notation. A vector mentclass2pt{minimm, electric charge q and radius vector Let us recall that motion of a point with mass We consider a dipole which is modelled by two charges mentclass2pt{minimThe total angular momentum of the dipole isThe torque of electrostatic forces acting on the dipole ismentclasspt{minimaentities  can be wt}L, see , is20\doSystem  has the e system  in the fBracket defined by 20) the t5. Namely, in this paper we analysed numerically the dynamics of a small dipole in the superposition of quadrupolar magnetic field D is the characteristic trap size. We demonstrated that such a non-homogeneous electromagnetic field seems to be useful for trapping of polar particles. We shown this by numerical calculations of trajectories of the centre of mass various physical polar particles: the DAST nanocrystal, the cellulose nanocrystal and protein lac repressor. Simulations with different initial conditions give different mass centre trajectories but they remain bounded to a restricted volume. However the general properties of equations Assume thF given above is a polynomial of third degree in F is a first integral if and only if all Assume that For further consideration we assume that integral  exists tF is a polynomial of third degree in variables F.The Lie derivative of given by  where poIf  a a\documenditions , respectAssume that the system ,,\documenCondition 0=0, see  and \documentAssume that the system Assume thWe can assume 0=0, see  or 62),,\documenCondition 0=0, see  and , see , we easinditions  and  ar ar\documH, F are functionally independent but F does not commute with If given by –56e) re re\docum formula  gives adthe form  exists oS which are functionally dependent. Among them seven functions are functionally independent but we cannot choose a commutative set of first integrals. Looking on non-vanishing commutators In the case when the form  and it r14.In the case when H and Casimir functions One can continue search of first integrals of system  which are system  possesseConsidered equations of motion were obtained in non-relativistic framework under assumption that velocities of material points are very small in comparison with the velocity of light.q is the charge of the particle and 7. Since the dipole is created by two charges of opposite signs which radiate independently its energy loss isWe did not consider the energy losses resulting from the fact that a charge moving with acceleration emits electromagnetic waves which carries the energy, the momentum and the angular momentum. The change of energy of an accelerated point charge in time is described by means of famous Larmor’s formula7, Sec. 75 in15 or16, which we should add to the right-hand side of the Newton–Lorentz equation (Loss of the energy, the momentum and the angular momentum means damping of motion of the point charge. Using conservation of energy and Larmor’s formula  one can 7 or16. One of the most frequently applied remedies is to use the Landau-Lifshitz formula as an alternative to the Abraham–Lorentz expression. The Landau-Lifshitz formula is obtained by expressing the time derivative of acceleration in (15. These difficulties also persist in the relativistic version of the Abraham-Lorentz formula called the Lorentz-Abraham-Dirac formula and there is a relativistic version of the Landau-Lifshitz formula described for example in Sec. 76 of15.Although that the Abraham–Lorentz formula is commonly accepted non-relativistic expression for the radiation damping force acting on a point charge in an external electromagnetic field it suffers from certain nonphysical solutions: runaway solutions and preacceleration, for more details see, for example, Sec. 11.2.2 ination in  by means


Many prepared actions have to be withheld for a certain amount of time in order to have the most beneficial outcome. Therefore, keeping track of time accurately is vital to using temporal regularities in our environment. Traditional theories assume that time is tracked by means of a clock and an “attentional gate” (AG) that modulates subjective time if not enough attentional resources are directed toward the temporal process. According to the AG theory, the moment of distraction does not have an influence on the subjective modulation. Here, we show, based on an analysis of 28,354 datasets, that highly motivated players of the online multiplayer real‐time strategy game StarCraft2 indeed respond later to timed events when they are distracted by other tasks during the interval. However, transient periods of distraction during the interval influence the response time to a lesser degree than distraction just before the required response. We extend the work of Taatgen, van Rijn, and Anderson (2007) and propose an alternative active check theory that postulates that distracted attention prevents people from checking their internal clock; we demonstrate that this account better predicts variance observed in response time. By analyzing StarCraft2 data, we assessed the role of attention in a naturalistic setting that more directly generalizes to real‐world settings than typical laboratory studies. However, when we only start preparing at the moment when a response is needed, the response will be too late. Thus, we have to start the preparation before the expected response is needed, taking into account the duration of the response execution. However, as the preparation of a response is a noisy process, we should aim to be prepared before our action is actually needed. As a consequence, we often face the situation in which we are prepared to respond, but have to withhold the execution of the action for a certain amount of time. For example, an experienced cook prepares to remove a pan from the stove after the potatoes are done, but before they are overcooked; and an athlete prepares to be ready to go at exactly the moment of the expected go‐signal, but definitely not earlier to prevent disqualification. Whereas the athlete is fully focused on keeping track of time for one important event, the cook might have several pans on the stove which all need attention. When we have to pay attention to several tasks at once, we might lose track of time for one of the tasks, which might cause us to miss the onset altogether. Here we will present a study using a real‐time strategy (RTS) game, in which sharing attention between timing and other tasks is critical for optimal game performance, that can shed light on the mechanisms through which attention acts on time perception.The mechanisms that allow humans and animals to keep track of time are described in theories that are typically supported by carefully designed laboratory experiments. Most of these theories assume some sort of timekeeping mechanism that interacts with memory to keep track of previously encountered durations  mechanism. For example, if the pacemaker is temporarily sped up, it emits more pulses in the same amount of time. If a specific interval learned under normal pacemaker conditions results in n pulses, the same interval will, with a clock sped up with factor x, be associated with n*x pulses, and thus this interval will subjectively feel to have lasted longer. Although the neural mechanism of this pacemaker component is still under discussion, studies have demonstrated that the speed of the clock is influenced by emotion  theory . If a player had played in multiple leagues, their rounded mean league was used in the analysis. The distribution of included players over the leagues is displayed in Fig. We collected 28,354 replay files of StarCraft2 games that were played between May 2013 and July 2016 from der Kim,  and custLarvae are the primary units for players who opt to play as Zerg. Larvae spawn every 11 s at each of the player’s hatcheries. The game starts with a single hatchery for a Zerg player, but throughout the game players typically construct additional hatcheries to increase the rate at which larvae become available. To construct a hatchery, or any Zerg building or unit, a player needs to invest a larva and additional resources. Additionally, Zerg players may construct queens that can use their spawn larvae ability to inject a hatchery.Like most RTS multiplayer games, the objective of StarCraft2 is to defeat an opponent by destroying their virtual buildings and units. Successful players can quickly expand their initial base by strategically timing the construction of new buildings, units, and upgrades to gain an advantage over their opponent(s). injection, is analyzed in this study. This ability can only be performed if at least 29 s have passed since the previous injection. After the 29 s have passed, the player is granted four extra larvae. Thus, perfectly timed injections increase the default larvae‐spawn rate by a factor of 2.5. To execute an injection, the player must (a) move the focus of the game to a hatchery by either clicking near it on the mini‐map or moving to it manually using the arrow keys; (b) selecting the queen near the hatchery; (c) selecting the spawn larvae ability of the queen; and (d) clicking the hatchery. Most players use a combination of customizable hotkeys to do steps (a)–(c) to increase their speed. After the hatchery is clicked, an empty bar appears across the width of the hatchery, filling up over the course of the next 29 s. However, as soon as the focus of the game is moved, this bar is not visible anymore. The typical accumulation of larvae during the course of a game is displayed in Fig. Although the game requires a player to attend to many tasks simultaneously, only the timing of the spawn larvae ability, called an Timing accuracy was determined by injection response time (IRT). IRT is defined by the amount of time passed between the moment the larvae from a previous injection are spawned and the moment a new injection is performed, which is referred to by StarCraft2 players as “missed injection.” A player typically has multiple hatcheries, some of which have a queen nearby with the purpose of injecting that hatchery. IRTs that deviated more than three absolute median deviations from the median were not considered in the analysis (13.1%). The distribution of number of injections per game is shown in Fig. Minute is the standard measure to express action frequency in the gaming community , and the 5‐s interval starting 10 s before the spawning of larvae from the previous injection . The model with the lowest BIC was considered only if the Bayes Factor (BF) of that model over a previous model was larger than 3  to the model. Finally, our main hypothesis was tested by adding APS Inject and APS During to the model separately as continuous fixed factors. To summarize the heavy tailed IRTs in the same figures as the estimated models, the median IRT per game was calculated. Five quantiles of these medians—20%, 40%, 50%, 60%, and 80%—are displayed together with model predictions and are referred to as 3W was used in further analysis. When presenting the model prediction in figures, IRTW is transformed back using the function IRT=IRTW∗expIRTW.After applying the inclusion criteria to the parsed replay files, observations of 13,456 games played by 3,625 players remained. The distribution of IRT per league is shown in Fig. W depends on APS During and APS Inject. Fig. summary quantiles of IRT across seven quantiles of Game Stage, pooled over league. IRT becomes slower as the game progresses. Furthermore, Fig. W  to three models with either Player ID , Game ID , or both . As including both random effects yielded the lowest BIC, we compared subsequent models to this model. Next, we assessed Game Stage. The model that included Game Stage as a fixed effect with random slopes of Game Stage on Game ID  was preferred over the ones that included random slopes of Player ID , both random slopes , and no random slopes . Adding the unweighted effects coded variables for League as fixed main effects improved the model further , but its interaction with Game Stage did not . Fig. We set out to assess whether IRT BIC = 52,115, Gam10BF > 1,000). Fig. summary quantiles of IRT across seven quantiles of both APS variables separately pooled over League. The steeper lines for APS Inject than for APS During already suggest that the APS just before the inject is a better predictor of the IRT than the action per second during the last inject phase, a finding confirmed by the analyses. APS Inject improved the model when considered as just the main effect . This model was preferred over models with an interaction with Game Stage , an interaction with League , and an interaction with both Game Stage and League . However, APS During also improved the model when it was entered as just the main effect . This model was preferred over models with an interaction with Game Stage , an interaction with League , and an interaction with both Game Stage and League . Although both APS variables improved the model when considered separately, a full model including both APS variables without interaction  was only preferred over the model with APS During , but not over the model with APS Injects (10BF < 0.001). This suggests that the variance explained by APS During is partially explained by APS Inject.Adding either APS During or APS Inject to the model as continuous fixed factor resulted in improved models (both 4We set out to address how timing is influenced by attention in naturalistic settings. Using a large set of naturalistic data from the RTS game StarCraft2, we show that timing is indeed affected by distracted attention, but that the pattern of this interference does not match the patterns predicted by the AG theory. Instead, response latency to a timed action was predominantly predicted by distraction around the time of responding, rather than during the interval itself. These results are more in line with an AC account in which distracted attention has the strongest effect around the time an action should have been performed. Distraction from timing during a game of StarCraft2 is not surprising, as players are known to perform a large number of actions per minute. This may vary from about 50 actions per minute in novices to 450 actions per minute in professional players.when this distraction occurs. In contrast, the AC theory would predict that increase in IRT is mostly caused by distracted attention during the end of an interval when an action needs to be initiated to check the clock. Based on 28,354 datasets, we did not observe an effect of APS during the interval when we also included the APS just before the next injection was executed. This behavioral signature matches the AC theory instead of the AG theory.The accuracy of timed intervals was operationalized as time between the end of a previous 29‐s interval and a new reaction. Distracted attention was operationalized as the APS measured during a period immediately leading up to the response and a period during which the 29‐s interval was still ongoing. According to AG theory, it should not matter when distraction happens; APS during either period is expected to influence IRT comparably (Zakay & Block, These findings extend the results of Taatgen et al.  in whichThis conclusion is drawn based on data of a well‐trained and highly motivated group of participants in a naturalistic setting. This is an advantage over typical lab‐based studies in which participants are required to do tasks that they are not intrinsically motivated to perform, and that are typically difficult to generalize to real‐world situations (Darlow et al., Importantly, the task has similarities with classic foreperiod experiments (Niemi & Näätänen, Some gaming behavior that is unrelated to timing or attention may partially influence the results of our analyses. For example, expert players describe a habit of keeping their hands “warmed up” during idle moments by rapidly cycling through the routines of selecting their units without issuing commands to them (Huang et al., This study provides a framework for studying a wide variety of cognitive functions in well‐trained individuals. The richness and availability of replay data from StarCraft2 far exceed any form of laboratory studies. Using data mining of the RTS game StarCraft 2, we contrasted the AG theory and the AC theory in motivated timers. We found support for the view that distracted attention influences timing predominantly when it occurs around the moment a response is required, questioning the continuously modulating role of attention as proposed in most current literature.https://osf.io/fwmj7/.This article has earned Open Data and Open Materials badges. Data and materials are available at


Since the meniscus is an important stabilizing structure of the knee joint and has a significant role in load‐bearing and shock absorption, so the complete structural and functional reconstructions of the teared menisci should be done not only after partial meniscectomy but also post total meniscectomy. So far, animal experiments and good clinical practice have showed that TMAT after total meniscectomy has partially solved the problem of structural and functional reconstructions after total meniscectomy. However, partial meniscectomy will also lead to accelerated knee degeneration, and its proportion is much higher than that of patients with total meniscectomy. Herein, the feasibility of PMAT after partial meniscectomy was investigated for the first time by using the 40% posterior horn meniscectomy model of the medial meniscus in Beagle dogs, and also for the first time, TMAT group and the total meniscectomy group were used as control groups. Compared with the TMAT, the transcriptomics evaluation, scanning electron microscope observation, histological regeneration and structure, biomechanical property, inflammation environment, and the knee function post PMAT were more similar to that of normal meniscus was first reported. This study provides a PMAT scheme with clinical translational value for the complete structural and functional reconstruction of the patients with partial meniscectomy and fills the gap in the field of teared meniscus therapy on the basis of quite well clinical applications of the meniscus repair and the TMAT. Regenerated menisci were evaluated using systematic parameters including (i) extracellular matrix (ECM) synthesis of Glycosaminoglycans (GAGs), COL‐1, COL‐2 and COL‐3, which are primary macromolecules in the native meniscus; (ii) macroscopic and microscopic observation of the implants; (iii) biomechanical properties of the implants; (iv) regenerated meniscus transcriptome determined by RNA sequencing; and (v)macroscopic and microscopic observation of the articular cartilage.The ability of the regenerated meniscus to delay the degeneration of articular cartilage was further investigated in vivo using 1.5–2 years old of Beagle dogs’ model with body weight of 11–15 kg. A power analysis was performed before the study as described below. Twelve weeks after the operation, 6 knees per group were collected for histological, biomechanical and transcriptome analyses. A total of 18 dogs were operated on, with all reaching the end‐points. The end‐points were predefined as the presence or the absence of significant differences in the systematic parameters listed above. All animal experiments were approved by the Animal Care and Use Committee of Peking University Third Hospital and complied with the Guide for the Care and Use of Laboratory Animals published by the National Academy Press . Animals were euthanised before anatomy. No outliers were eliminated in the study.2.2Six Beagle dogs were obtained from other irrelevant studies within 6 h of their euthanasia, and their medial menisci were excised for use as the source of allografts. The dog menisci were washed in phosphate‐buffered saline  to remove residual blood and shaped into appropriate size. The allografts were then triple bagged separately, treated with 25 k Gray gamma irradiation and deeply frozen (−80°C) for transplanting.2.3n = 6), total group (n = 6) and meni group (n = 6). Intramuscular penicillin (400 000 U) was administered preoperatively as antibiotic prophylaxis. After anaesthesia and other routine preoperative preparation, a medial parapatellar approach was made through the skin and subcutaneous tissue. A total meniscectomy was performed by resecting the right medial meniscus sharply along the periphery and detaching it from its anterior and posterior junction. The meniscus allograft was thawed in sterile saline and trimmed to a matched size. The anterior and posterior horn of the meniscus allograft were fixed in the anatomical position by means of 1.5 mm bone canal. The body of meniscus allograft was sutured to the adjacent synovium with absorbable 3‐0 sutures . Then, a partial meniscectomy was performed by resecting posterior 40% of the left medial meniscus but retaining the posterior horn. The size‐matched partial allograft was sutured to the recipient meniscus and the peripheral synovium tissue. For the Norm group, the operation was only performed on the medial compartment of contralateral knee joint of experimental dogs without operating on the meniscus. The joint capsule, periarticular tissues and skin were closed separately with the continuous suture. Finally, the surgical incision was isolated with sterilised gauze and the knee of dogs was externally fixed with plaster.Eighteen Beagle dogs were randomly allocated into part group  and antibiotic prophylaxis were administered intramuscularly for 1 week. Dogs were in direct visual, vocal and nasal contact with each other, but were in separate pens to minimise mutual trauma. The plaster was removed 7 days and skin sutures were removed 8–10 days post‐operation. After the dogs had achieved normal gait movement with no signs of infection (2–3 weeks post‐operation), they were transferred to an IACUC‐approved farm for unrestricted movement and exercise.2.5The recovery of the experimental dogs was continuously observed after the operation and the knee joint function of each group was evaluated by Lysholm score standard at the post‐operative week 12.2.6At the end time point, synovial fluid was collected via a 1‐ml syringe with an 18‐gauge needle and assayed for IL‐1 and TNF‐α) through standard enzyme‐linked immunosorbent assay (ELISA) kits .2.7The joints were dissected with the femur detached from the tibia and the medial meniscus remains on the tibial plateau (TP). Photographs were taken of the TP with the meniscus and the femoral condyles (FC). The menisci in each group were grossly evaluated by the Gross Evaluation of Meniscus Implant Score.3 and the samples for compressive testing were about 4 × 3 × 2 mm3. The working temperature is about 22°C and the samples were kept hydrated using 0.9% NaCl solution. For the tensile testing, the samples were preconditioned to a maximum displacement of 2 mm at a displacement rate of 0.5 mm/min. The samples were tested to ultimate failure at a rate of 1 mm/min. For the compressive testing, the samples were loaded at a displacement rate of 0.5 mm/min with a maximum force of 100 N or a maximum 90% displacement. The elastic modulus was analysed from the linear portion of the stress–strain curve. Indentation assay was performed using the Tri‐boIndenter  with a 20 μm 90° conical probe tip to compare the surface of the regenerated and native meniscus.For ultrastructure observation, the menisci of the part group, total group, and normal group were processed for cryofracturing to create a cut surface in the wedge section and observed with a JSM5600LV scanning electron microscope (JEOL USA Inc.). The biomechanical properties of menisci specimens were assessed using a material testing machine . The samples for tensile testing were about 5 × 6 × 2 mm2.8The cartilages of the medial FC and TP were macroscopically evaluated according to the International Cartilage Repair Society (ICRS) criteria.Osteochondral samples were trimmed without destroying the cartilage structure, fixed immediately in 20 ml of 25% glutaraldehyde for 24 h at 4°C, dehydrated in a graded ethanol series, and finally subjected to critical point drying for complete dehydration. The samples were coated with a 5‐nm layer of gold and then observed by JSM5600LV scanning electron microscope .2.9Q value ≤ 0.05. To take an insight into the change of phenotype, Gene Ontology  and Kyoto Encyclopedia of Genes and Genomes  enrichment analysis of annotated different expressed gene were performed by Phyper (https://en.wikipedia.org/wiki/Hypergeometric_distribution) based on the hypergeometric test. The significant levels of terms and pathways were corrected by Q value with a rigorous threshold  by Bonferroni. The biological process and pathway activity networks were constructed using Cytoscape for graphical representations of enriched biological pathways with significance (P < 0.05), including upregulated and downregulated ones. Finally, we used the method of co‐expression analysis to focus on the gene target of meniscal regeneration in the part group. The degree and K‐core values of each significantly DEGs were obtained by calculating the Pearson correlation coefficient between genes. The importance of each gene for the phenotype modification was determined accordingly . Namely, higher ranked genes played more important roles in the whole gene network for phenotype modification than lower ranked ones. Normalised gene expression data were utilised to evaluate the relative proportions of 22 types of infiltrating immune cells via using the CIBERSORT algorithm.Meniscus samples were collected from the part group, total group and norm group, respectively. We performed RNA sequencing analysis with the NovelBrain Cloud Analysis Platform. Briefly, total RNA was extracted from meniscus samples using Trizol reagent (Invi‐trogen). The cDNA libraries were then constructed for each pooled RNA sample using the VAHTSTM total RNA‐seq (H/M/R). The sequencing data were filtered with SOAPnuke (v1.5.2)2.10P < 0.05 were considered statistically significant.The necessary sample size was 6 to achieve a power value of 0.8 for the parameters in this study. All statistical data were expressed as means ± SD except for Table 33.1From the removal of the plaster to the third week after the operation, dogs in the PMAT group (part group) and the TMAT group  showed hanging hoof and weight‐free when standing, severe limp when walking, which was similar to the total meniscectomy group (meni group). In the sixth‐week post‐operation, dogs in the part group and the total group could bear the weight of the affected limb for a short time while standing and showed moderate limp when walking, but the improvement of the dogs in the meni group was not obvious. In the 12th week post‐operation, the dogs in the part group stood, walked and climbed the stairs back to normal. The dogs in the total group still had mild limp and 1 dog in this group took off both hind limbs at the same time when climbing the stairs. The dogs in the meni group were limping in different degrees, and it was slow and difficult for them to climb the stairs.P < 0.001), and there was also a significant difference between the total group and the meni group (P < 0.001). The scores of the part group or the total group were close to the normal control group (norm group).In this study, Beagle dogs were scored at week 12 postoperatively from four aspects: limp, interlocking, stairclimbing and squatting. The Lysholm score of the knee joint function Figure  showed t3.2P < 0.001).To quantitatively analyse the inflammation of knee joint, synovial fluid was collected to analyse interleukin 1 . And the tensile modulus of the part group was higher than that of the total group  which was significantly lower than the norm group (P < 0.001). According to microscopic geomorphology, the surfaces of implant in the part group  were at the top of the cluster and most likely to be related to the structural and functional regeneration of the meniscus   Figure . Further) Figure .3.7According to the macroscopic evaluation of articular cartilage, no obvious tear was found in the part group. In the total group, the surface of cartilage lost luster, being rough and accompanied with varying degrees of damage. In the meni group, the cartilage was seriously damaged, and even the subchondral bone could be seen with the naked eye Figure . H&E andThe microscopic changes of articular cartilage were further observed by the SEM Figure . In the 4In this study, our findings showed that the partial meniscus transplantation could successfully reconstruct the meniscal histological structure and biomechanics well, could protect cartilage in an inflammation environment enon par with those of the norm group. The PMAT technique showed the superiority in the tissue regeneration, biomechanical characteristics, inflammation stimulating and the chondroprotection compared with the TMAT technique.The part group and the total group showed not only reconstruction of the histological structure of the meniscus in terms of cellular and ECM level but also maintenance of the biomechanical properties of the knee joint. The Lysholm score indicated that the MATs’ techniques could restore normal knee joint function after total and partial meniscectomies in dogs. Both of the ICRS and Mankin scores showed the chondroprotective effect of both MATs’ techniques, especially no obvious cartilage degradation was seen in the part group. The results might be related to the histological and biomechanical remodelling of implant which played an important role in the postoperative procedures. The histological reconstruction of implant is the basis of the biomechanical function. In theory, the meniscus tissue has zone‐specific GAGs and collagens that are responsible for the compressive and tensile loading from relative motion within the joint.Interestingly, the therapeutic effect of the PMAT technique for partial meniscectomy was better than the TMAT technique. Compared with the total group, the compressive modulus was higher in the part group, probably through more deposition of COL‐2 and GAGs in the inner zone. On the other hand, the expression of COL‐2 and GAGs of the total group in the inner zone was relatively less, and the ability to carry compressive loading was weak, which led to more mechanical loading on cartilage and accelerated joint degeneration. Histology and ultrastructure observation of implants showed that the number of fibrochondrocytes in the part group was more than that in the total group, and our transcriptome results also proved that a large number of genes and biological processes related to cell division and proliferation were significantly up‐regulated in the part group. Besides, the analysis of inflammatory factors in synovial fluid showed that the inflammatory response in the part group was not obvious, and the evidence of inhibition of inflammatory response and immune response signal pathways was also found by the transcriptome analysis. Therefore, the PMAT technique retained as much native meniscus tissue as possible, and reconstructed the normal histological structure and biomechanical properties of the meniscus without causing obvious inflammatory reaction and immune response, protecting cartilage and the knee joint function. We speculate that the PMAT technique will also achieve satisfactory results for partial meniscus injuries.Our previous researches have confirmed that the TMAT technique could be a promising alternative for total meniscectomy in rabbit models with tissue regeneration and the ability to protect cartilage.The qualifying criteria for meniscal regeneration include the reconstruction of the histological structure and the recovery of the biomechanical function.The major limitation of this study was that we did not carry on the experimental verification to the screened gene targets. Although accurate targeting of the molecular mechanism related to meniscal regeneration is challenging, future studies using advanced bioinformatics analysis and gene manipulation methods will certainly find closely related molecules or signalling pathway which can promote meniscal regeneration and reduce osteoarthritis severity, such as transcription factors.To establish a reasonable treatment strategy for the refractory meniscus injuries, we evaluated the regenerated meniscus after partial and total meniscal allograft transplantation. The implants in the part group and the total group resumed the histological structure and biomechanical properties similar to those of native menisci, and we also found that the PMAT technique could be an alternative strategy for partial meniscectomy. Therefore, we propose a new surgical method to repair partial meniscectomy, PMAT technique. This PMAT technique verified by a large animal model could provide a reliable basis for the clinical translation. Our study results may provide a comprehensive repair strategy for the treatment of clinical refractory meniscus injuries. The surgical suture can be performed on meniscal injuries allowed to be sutured, such as a simple local tear in the red‐area of meniscus, the PMAT technique can be used for those who underwent partial meniscectomy, and the TMAT technique can only be used for those who have no choice but to undergo total meniscectomy. At present, the researches on tissue‐engineered meniscus transplantation are in full swing, and they have achieved good results in the treatment of meniscus injury in animals, but there is still a long way to go before clinical translation. Furthermore, our research idea provides the consideration for the application in PMAT of the tissue‐engineered meniscus.5In this study, we demonstrated that the PMAT technique can reconstruct the normal histological structure and the biomechanical function post‐partial meniscectomy and achieve a chondroprotective goal. This strategy provides a comprehensive treatment strategy for clinical refractory meniscus injuries, especially the PMAT technique can be the choice after partial meniscectomy. In the near future, for the menisci injuries, if it could be sutured and repaired, suture and repair should be done, the PMAT could be done for meniscus tear which was irreparable, and the TMAT for total meniscectomy. In this way, we can achieve the ideal of reconstructing the structure and function of the injured meniscus for patients suffered from any kind of meniscus tears.The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported.