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https://www.readbyqxmd.com/read/28915871/virtual-patients-in-the-acquisition-of-clinical-reasoning-skills-does-presentation-mode-matter-a-quasi-randomized-controlled-trial
#1
Fabian Schubach, Matthias Goos, Götz Fabry, Werner Vach, Martin Boeker
BACKGROUND: The objective of this study is to compare two different instructional methods in the curricular use of computerized virtual patients in undergraduate medical education. We aim to investigate whether using many short and focused cases - the key feature principle - is more effective for the learning of clinical reasoning skills than using few long and systematic cases. METHODS: We conducted a quasi-randomized, non-blinded, controlled parallel-group intervention trial in a large medical school in Southwestern Germany...
September 15, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28899812/the-starving-brain-overfed-meets-undernourished-in-the-pathology-of-mild-cognitive-impairment-mci-and-alzheimer-s-disease-ad
#2
REVIEW
Kelly J Gibas
Type II Diabetes affects 400 million people worldwide (IDF, 2013). The pathology is paradoxical: internal starvation activated by overfeeding. Hyperinsulinemic impairments of glucose homeostasis are treated with anti-hyperglycemics exacerbating cell starvation, inducing hypoglycemia and raising respiratory quotient. Reductions in hyperglycemia are achieved at the expense of glucose dependency and metabolic inflexibility (Gibas & Gibas, 2017). The brain is not immune from these cycles of starvation. The bioenergetic model characterizes propagation of late-onset, sporadic Alzheimer's disease as loss of molecular fidelity and compromised energy originating in brain networks with highest metabolic demand...
September 9, 2017: Neurochemistry International
https://www.readbyqxmd.com/read/28882750/grey-areas-new-zealand-ambulance-personnel-s-experiences-of-challenging-resuscitation-decision-making
#3
Natalie Elizabeth Anderson, Merryn Gott, Julia Slark
INTRODUCTION: When faced with a patient in cardiac arrest, ambulance personnel must rapidly make complex decisions with limited information. Much of the research examining decisions to commence, continue, withhold or terminate resuscitation has used retrospective audits of registry data and clinical documentation. This study offers a provider-perspective which characterises uncertainty and highlights clinical, cognitive, emotional and physical demands associated with decision-making in the cardiac arrest context...
September 4, 2017: International Emergency Nursing
https://www.readbyqxmd.com/read/28862266/genomic-and-epigenomic-mechanisms-of-glucocorticoids-in-the-brain
#4
REVIEW
Jason D Gray, Joshua F Kogan, Jordan Marrocco, Bruce S McEwen
Following the discovery of glucocorticoid receptors in the hippocampus and other brain regions, research has focused on understanding the effects of glucocorticoids in the brain and their role in regulating emotion and cognition. Glucocorticoids are essential for adaptation to stressors (allostasis) and in maladaptation resulting from allostatic load and overload. Allostatic overload, which can occur during chronic stress, can reshape the hypothalamic-pituitary-adrenal axis through epigenetic modification of genes in the hippocampus, hypothalamus and other stress-responsive brain regions...
September 1, 2017: Nature Reviews. Endocrinology
https://www.readbyqxmd.com/read/28856337/neurobiological-and-systemic-effects-of-chronic-stress
#5
Bruce S McEwen
The brain is the central organ of stress and adaptation to stress because it perceives and determines what is threatening, as well as the behavioral and physiological responses to the stressor, which promote adaptation ("allostasis") but also contribute to pathophysiology ("allostatic load/overload") when overused and dysregulated. The adult as well as developing brain possesses a remarkable ability to show structural and functional plasticity in response to stressful and other experiences, including neuronal replacement, dendritic remodeling and synapse turnover...
January 2017: Chronic stress
https://www.readbyqxmd.com/read/28854205/the-more-total-cognitive-load-is-reduced-by-cues-the-better-retention-and-transfer-of-multimedia-learning-a-meta-analysis-and-two-meta-regression-analyses
#6
Heping Xie, Fuxing Wang, Yanbin Hao, Jiaxue Chen, Jing An, Yuxin Wang, Huashan Liu
Cueing facilitates retention and transfer of multimedia learning. From the perspective of cognitive load theory (CLT), cueing has a positive effect on learning outcomes because of the reduction in total cognitive load and avoidance of cognitive overload. However, this has not been systematically evaluated. Moreover, what remains ambiguous is the direct relationship between the cue-related cognitive load and learning outcomes. A meta-analysis and two subsequent meta-regression analyses were conducted to explore these issues...
2017: PloS One
https://www.readbyqxmd.com/read/28827155/effects-of-mental-workload-on-involuntary-attention-a-somatosensory-erp-study
#7
Sungchul Mun, Mincheol Whang, Sangin Park, Min-Chul Park
Previous psychophysiological assessments of mental workload have relied on the addition of visual or auditory stimuli. This study investigated the tactile ERP and EEG spectral power correlates of mental workload by relating limited-capacity involuntary attention allocation to changes in late positive potential (LPP) amplitude, alpha, and theta powers. We examined whether mental workload (high-level cognitive control) can be evaluated using somatosensory stimuli. Sixteen participants all performed three tasks of varying difficulty...
August 18, 2017: Neuropsychologia
https://www.readbyqxmd.com/read/28827127/temporary-removal-evidence-for-a-role-of-plasma-membrane-calcium-pumps-in-neurodegenerative-disease-recent-developments
#8
Emanuel E Strehler, Stanley A Thayer
No abstract text is available yet for this article.
August 19, 2017: Neuroscience Letters
https://www.readbyqxmd.com/read/28821470/design-of-the-drepagreffe-trial-a-prospective-controlled-multicenter-study-evaluating-the-benefit-of-genoidentical-hematopoietic-stem-cell-transplantation-over-chronic-transfusion-in-sickle-cell-anemia-children-detected-to-be-at-risk-of-stroke-by-transcranial
#9
Sylvie Chevret, Suzanne Verlhac, Elisabeth Ducros-Miralles, Jean-Hugues Dalle, Regis Peffault de Latour, Mariane de Montalembert, Malika Benkerrou, Corinne Pondarré, Isabelle Thuret, Corinne Guitton, Emmanuelle Lesprit, Maryse Etienne-Julan, Gisèle Elana, Jean-Pierre Vannier, Patrick Lutz, Bénédicte Neven, Claire Galambrun, Catherine Paillard, Camille Runel, Charlotte Jubert, Cécile Arnaud, Annie Kamdem, Valentine Brousse, Florence Missud, Marie Petras, Lydia Doumdo-Divialle, Claire Berger, Françoise Fréard, Olivier Taieb, Elise Drain, Monique Elmaleh, Manuela Vasile, Yacine Khelif, Myriam Bernaudin, Philippe Chadebech, France Pirenne, Gérard Socié, Françoise Bernaudin
BACKGROUND: Children with sickle cell anemia (SCA) have an 11% risk of stroke by the age of 18. Chronic transfusion applied in patients detected to be at risk by transcranial Doppler allows a significant reduction of stroke risk. However, chronic transfusion exposes to several adverse events, including alloimmunization and iron overload, and is not curative. Hematopoietic stem cell transplantation allows termination of the transfusion program, but its benefit has not been demonstrated...
August 15, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28802436/quantifying-the-cognitive-cost-of-laparo-endoscopic-single-site-surgeries-gaze-based-indices
#10
Leandro L Di Stasi, Carolina Díaz-Piedra, Juan Francisco Ruiz-Rabelo, Héctor Rieiro, Jose M Sanchez Carrion, Andrés Catena
BACKGROUND: Despite the growing interest concerning the laparo-endoscopic single-site surgery (LESS) procedure, LESS presents multiple difficulties and challenges that are likely to increase the surgeon's cognitive cost, in terms of both cognitive load and performance. Nevertheless, there is currently no objective index capable of assessing the surgeon cognitive cost while performing LESS. We assessed if gaze-based indices might offer unique and unbiased measures to quantify LESS complexity and its cognitive cost...
November 2017: Applied Ergonomics
https://www.readbyqxmd.com/read/28763355/regulatory-considerations-for-physiological-closed-loop-controlled-medical-devices-used-for-automated-critical-care-food-and-drug-administration-workshop-discussion-topics
#11
Bahram Parvinian, Christopher Scully, Hanniebey Wiyor, Allison Kumar, Sandy Weininger
Part of the mission of the Center for Devices and Radiological Health (CDRH) at the US Food and Drug Administration is to facilitate medical device innovation. Therefore, CDRH plays an important role in helping its stakeholders such as manufacturers, health care professionals, patients, patient advocates, academia, and other government agencies navigate the regulatory landscape for medical devices. This is particularly important for innovative physiological closed-loop controlled (PCLC) devices used in critical care environments, such as intensive care units, emergency settings, and battlefield environments...
July 28, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28761885/self-directed-learning-barriers-in-a-virtual-environment-a-qualitative-study
#12
Noushin Kohan, Kamran Soltani Arabshahi, Rita Mojtahedzadeh, Abbas Abbaszadeh, Tayebeh Rakhshani, Amirhousein Emami
INTRODUCTION: There is a growing trend in online education courses in higher education institutes. Previous studies have shown that high levels of self-direction are essential for successful online learning. The present study aims to investigate challenges of and barriers to self-directed virtual-learning among postgraduate students of medical sciences. METHOD: 23 postgraduate virtual students of medical sciences in Iran, collected through maximum variation purposive sampling and semi-structured interviews, served as the sample of this study...
July 2017: Journal of Advances in Medical Education & Professionalism
https://www.readbyqxmd.com/read/28712343/overload-from-anxiety-a-non-motor-cause-for-gait-impairments-in-parkinson-s-disease
#13
Kaylena A Ehgoetz Martens, Carolina R A Silveira, Brittany N Intzandt, Quincy J Almeida
Threatening situations lead to observable gait deficits in individuals with Parkinson's disease (PD) who suffer from high trait anxiety levels. The specific characteristics of gait that are affected appear to be similar to behaviors observed while walking during a dual-task (DT) condition. Yet, it remains unclear whether anxiety is similar to a cognitive load. If it were, then those with PD who have high trait anxiety might be expected to be more susceptible to DT interference during walking. Thus, the overall aim of this study was to evaluate whether trait anxiety influences gait during single-task (ST) and DT walking...
July 17, 2017: Journal of Neuropsychiatry and Clinical Neurosciences
https://www.readbyqxmd.com/read/28644490/potentiating-role-of-copper-on-spatial-memory-deficit-induced-by-beta-amyloid-and-evaluation-of-mitochondrial-function-markers-in-the-hippocampus-of-rats
#14
Ladan Behzadfar, Mohammad Abdollahi, Omid Sabzevari, Rohollah Hosseini, Ahmad Salimi, Parvaneh Naserzadeh, Mohammad Sharifzadeh, Jalal Pourahmad
Mounting evidence suggests that copper, a crucial element in normal brain function, plays an important role in the etiology of Alzheimer's disease, which is known as a neurodegenerative mitochondrial disorder. However, the precise mechanisms of its effects on cognitive and mitochondrial functions through the CNS have not been thoroughly recognized yet. In this study, we aimed to investigate the long-term (3-week) effects of copper sulfate (50, 100 and 200 mg kg(-1) day(-1)) exposure on learning and memory as well as on mitochondrial function in the hippocampus of rats in the presence and absence of beta amyloid (1 μg μl(-1) per side) intrahippocampally (IH)...
July 19, 2017: Metallomics: Integrated Biometal Science
https://www.readbyqxmd.com/read/28548091/cellular-interplay-via-cytokine-hierarchy-causes-pathological-cardiac-hypertrophy-in-raf1-mutant-noonan-syndrome
#15
Jiani C Yin, Mathew J Platt, Xixi Tian, Xue Wu, Peter H Backx, Jeremy A Simpson, Toshiyuki Araki, Benjamin G Neel
Noonan syndrome (NS) is caused by mutations in RAS/ERK pathway genes, and is characterized by craniofacial, growth, cognitive and cardiac defects. NS patients with kinase-activating RAF1 alleles typically develop pathological left ventricular hypertrophy (LVH), which is reproduced in Raf1(L613V/+) knock-in mice. Here, using inducible Raf1(L613V) expression, we show that LVH results from the interplay of cardiac cell types. Cardiomyocyte Raf1(L613V) enhances Ca(2+) sensitivity and cardiac contractility without causing hypertrophy...
May 26, 2017: Nature Communications
https://www.readbyqxmd.com/read/28448453/working-memory-in-the-prefrontal-cortex
#16
REVIEW
Shintaro Funahashi
The prefrontal cortex participates in a variety of higher cognitive functions. The concept of working memory is now widely used to understand prefrontal functions. Neurophysiological studies have revealed that stimulus-selective delay-period activity is a neural correlate of the mechanism for temporarily maintaining information in working memory processes. The central executive, which is the master component of Baddeley's working memory model and is thought to be a function of the prefrontal cortex, controls the performance of other components by allocating a limited capacity of memory resource to each component based on its demand...
April 27, 2017: Brain Sciences
https://www.readbyqxmd.com/read/28424602/assessing-the-driver-s-current-level-of-working-memory-load-with-high-density-functional-near-infrared-spectroscopy-a-realistic-driving-simulator-study
#17
Anirudh Unni, Klas Ihme, Meike Jipp, Jochem W Rieger
Cognitive overload or underload results in a decrease in human performance which may result in fatal incidents while driving. We envision that driver assistive systems which adapt their functionality to the driver's cognitive state could be a promising approach to reduce road accidents due to human errors. This research attempts to predict variations of cognitive working memory load levels in a natural driving scenario with multiple parallel tasks and to reveal predictive brain areas. We used a modified version of the n-back task to induce five different working memory load levels (from 0-back up to 4-back) forcing the participants to continuously update, memorize, and recall the previous 'n' speed sequences and adjust their speed accordingly while they drove for approximately 60 min on a highway with concurrent traffic in a virtual reality driving simulator...
2017: Frontiers in Human Neuroscience
https://www.readbyqxmd.com/read/28399463/distraction-or-cognitive-overload-using-modulations-of-the-autonomic-nervous-system-to-discriminate-the-possible-negative-effects-of-advanced-assistance-system
#18
D Ruscio, A J Bos, M R Ciceri
The interaction with Advanced Driver Assistance Systems has several positive implications for road safety, but also some potential downsides such as mental workload and automation complacency. Malleable attentional resources allocation theory describes two possible processes that can generate workload in interaction with advanced assisting devices. The purpose of the present study is to determine if specific analysis of the different modalities of autonomic control of nervous system can be used to discriminate different potential workload processes generated during assisted-driving tasks and automation complacency situations...
June 2017: Accident; Analysis and Prevention
https://www.readbyqxmd.com/read/28395667/effects-of-workload-work-complexity-and-repeated-alerts-on-alert-fatigue-in-a-clinical-decision-support-system
#19
Jessica S Ancker, Alison Edwards, Sarah Nosal, Diane Hauser, Elizabeth Mauer, Rainu Kaushal
BACKGROUND: Although alert fatigue is blamed for high override rates in contemporary clinical decision support systems, the concept of alert fatigue is poorly defined. We tested hypotheses arising from two possible alert fatigue mechanisms: (A) cognitive overload associated with amount of work, complexity of work, and effort distinguishing informative from uninformative alerts, and (B) desensitization from repeated exposure to the same alert over time. METHODS: Retrospective cohort study using electronic health record data (both drug alerts and clinical practice reminders) from January 2010 through June 2013 from 112 ambulatory primary care clinicians...
April 10, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28334149/higher-striatal-iron-concentration-is-linked-to-frontostriatal-underactivation-and-poorer-memory-in-normal-aging
#20
Grégoria Kalpouzos, Benjamín Garzón, Rouslan Sitnikov, Carmel Heiland, Alireza Salami, Jonas Persson, Lars Bäckman
In the brain, intracellular iron is essential for cellular metabolism. However, an overload of free iron is toxic, inducing oxidative stress and cell death. Although an increase of striatal iron has been related to atrophy and impaired cognitive performance, the link between elevated iron and altered brain activity in aging remains unexplored. In a sample of 37 younger and older adults, we examined whether higher striatal iron concentration could underlie age-related differences in frontostriatal activity induced by mental imagery of motor and non-motor scenes, and poorer recall of the scenes...
June 1, 2017: Cerebral Cortex
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