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Frontiers in Psychology 2024The skill-performance relationship is a cornerstone of a meritocratic society. People are selected for schools, colleges and jobs based on the premise that more skillful... (Review)
Review
The skill-performance relationship is a cornerstone of a meritocratic society. People are selected for schools, colleges and jobs based on the premise that more skillful individuals perform better. Scientific understanding of the skill-performance relationship demands that the effect of skill on performance is objectively assessed without subjective, social, and political considerations. One of the best areas for this analysis is sports. In many sports settings, the skill-performance relationship can objectively be examined at the technical, behavioral, psychological, and neurological levels. This examination reveals that skill and performance are inextricably intertwined. While skill affects performance, performance in turn defines and affects skill. To disentangle the previously confusing and interchangeable use of these key constructs, the paper presents a theoretical model specifying that ability and effort have their own direct effects on performance, as well as indirect effects on performance through skill possession and skill execution in cognitive and physical domains of human performance. Thus, ability and skill are not the same. Although skill is a key determinant of performance, recent theory and research suggests that successful performers are successful not just because of their skills per se, but because they take advantage of their skills by creating more occurrences of momentum, making them last longer, and using them to bounce back faster from streaks of unsuccessful performance. Thus, momentum is an important mediator of the effects of skill on performance.
PubMed: 38406307
DOI: 10.3389/fpsyg.2024.1296014 -
Aerospace Medicine and Human Performance Apr 2024Sleep inertia is the transition state during which alertness and cognitive performance are temporarily impaired after awakening. Magnitude and time course of sleep... (Review)
Review
Sleep inertia is the transition state during which alertness and cognitive performance are temporarily impaired after awakening. Magnitude and time course of sleep inertia are characterized by high individual variability with large differences between the cognitive functions affected. This period of impairment is of concern to pilots, who take sleep or nap periods during on-call work hours or in-flight rest, then need to perform safety-critical tasks soon after waking. This review analyzes literature related to sleep inertia and countermeasures applicable for aviation. The large part of scientific literature that focuses on sleep inertia is based on studies in patients with chronic sleep inertia. We analyzed 8 narrative reviews and 64 papers related to acute sleep inertia in healthy subjects. Sleep inertia is a multifactorial, complex process, and many different protocols have been conducted, with a low number of subjects, in noncontrolled laboratory designs, with questionnaires or cognitive tests that have not been replicated. Evidence suggests that waking after sleep loss, or from deeper stages of sleep, can exacerbate sleep inertia through complex interactions between awakening and sleep-promoting brain structures. Nevertheless, no meta-analyses are possible and extrapolation to pilots' performances is hypothetical. Studies in real life or simulated operational situations must be conducted to improve the description of the impact of sleep inertia and kinetics on pilots' performances. Taking rest or sleep time remains the main method for pilots to fight against fatigue and related decreases in performance. We propose proactive strategies to mitigate sleep inertia and improve alertness.
Topics: Humans; Aviation; Brain; Cognition; Rest; Sleep
PubMed: 38486319
DOI: 10.3357/AMHP.6343.2024 -
IEEE Transactions on Neural Networks... Dec 2023Federated learning (FL) collaboratively trains a shared global model depending on multiple local clients, while keeping the training data decentralized to preserve data...
Federated learning (FL) collaboratively trains a shared global model depending on multiple local clients, while keeping the training data decentralized to preserve data privacy. However, standard FL methods ignore the noisy client issue, which may harm the overall performance of the shared model. We first investigate the critical issue caused by noisy clients in FL and quantify the negative impact of the noisy clients in terms of the representations learned by different layers. We have the following two key observations: 1) the noisy clients can severely impact the convergence and performance of the global model in FL and 2) the noisy clients can induce greater bias in the deeper layers than the former layers of the global model. Based on the above observations, we propose federated noisy client learning (Fed-NCL), a framework that conducts robust FL with noisy clients. Specifically, Fed-NCL first identifies the noisy clients through well estimating the data quality and model divergence. Then robust layerwise aggregation is proposed to adaptively aggregate the local models of each client to deal with the data heterogeneity caused by the noisy clients. We further perform label correction on the noisy clients to improve the generalization of the global model. Experimental results on various datasets demonstrate that our algorithm boosts the performances of different state-of-the-art systems with noisy clients. Our code is available at https://github.com/TKH666/Fed-NCL.
PubMed: 38039172
DOI: 10.1109/TNNLS.2023.3336050 -
Frontiers in Neurology 2023Idiopathic normal pressure hydrocephalus (INPH) is a neurological disorder that is potentially reversible and clinically characterized by a specific triad of symptoms,...
INTRODUCTION
Idiopathic normal pressure hydrocephalus (INPH) is a neurological disorder that is potentially reversible and clinically characterized by a specific triad of symptoms, including gait disturbance, cognitive disorders, and urinary incontinence. In INPH assessment, the most commonly used test is the Timed Up and Go test (TUG), but a more comprehensive assessment would be necessary. The first aim of the present study is to verify the sensitivity of a protocol with both clinical and instrumental outcome measures for gait and balance in recognizing INPH patients. The second aim is to verify the most important spatio-temporal parameters in INPH assessment and their possible correlations with clinical outcome measures.
METHODS
Between January 2019 and June 2022, we evaluated 70 INPH subjects. We assessed balance performances with the Berg Balance Scale (BBS), Short Physical Performance Battery (SPPB), and TUG, both single (ST) and dual task (DT). We also performed an instrumental gait assessment with the GAITRite electronic walkway system, asking the patients to walk on the carpet for one minute at normal speed, fast speed, and while performing a dual task. We compared the results with those of 20 age-matched healthy subjects (HS).
RESULTS
INPH patients obtained statistically significant lower scores at the BBS, SPPB, and TUG DT but not at the TUG ST, likely because the DT involves cognitive factors altered in these subjects. Concerning instrumental gait evaluation, we found significant differences between HS and INPH patients in almost all spatio-temporal parameters except cadence, which is considered a relevant factor in INPH guidelines. We also found significant correlations between balance outcome measures and gait parameters.
DISCUSSION
Our results confirm the usefulness of BBS and suggest improving the assessment with SPPB. Although the TUG ST is the most commonly used test in the literature to evaluate INPH performances, it does not identify INPH; the TUG DT, instead, might be more useful. The GAITRite system is recognized as a quick and reliable tool to assess walking abilities and spatio-temporal parameters in INPH patients, and the most useful parameters are stride length, stride width, speed, and the percentage of double support. Both clinical and instrumental evaluation may be useful in recognizing subjects at risk for falls.
PubMed: 37609661
DOI: 10.3389/fneur.2023.1201932 -
Memory & Cognition Apr 2024To acquire and process information, performers can frequently rely on both internal and extended cognitive strategies. However, after becoming acquainted with two...
To acquire and process information, performers can frequently rely on both internal and extended cognitive strategies. However, after becoming acquainted with two strategies, performers in previous studies exhibited a pronounced behavioral preference for just one strategy, which we refer to as perseveration. What is the origin of such perseveration? Previous research suggests that a prime reason for cognitive strategy choice is performance: Perseveration could reflect the preference for a superior strategy as determined by accurately monitoring each strategy's performance. However, following our preregistered hypotheses, we conjectured that perseveration persisted even if the available strategies featured similar performances. Such persisting perseveration could be reasonable if costs related to decision making, performance monitoring, and strategy switching would be additionally taken into account on top of isolated strategy performances. Here, we used a calibration procedure to equalize performances of strategies as far as possible and tested whether perseveration persisted. In Experiment 1, performance adjustment of strategies succeeded in equating accuracy but not speed. Many participants perseverated on the faster strategy. In Experiment 2, calibration succeeded regarding both accuracy and speed. No substantial perseveration was detected, and residual perseveration was conceivably related to metacognitive performance evaluations. We conclude that perseveration on cognitive strategies is frequently rooted in performance: Performers willingly use multiple strategies for the same task if performance differences appear sufficiently small. Surprisingly, other possible reasons for perseveration like effort or switch cost avoidance, mental challenge seeking, satisficing, or episodic retrieval of previous stimulus-strategy-bindings, were less relevant in the present study.
Topics: Humans; Cognition
PubMed: 37874485
DOI: 10.3758/s13421-023-01475-7 -
Military Medicine Nov 2023With the Army's emerging doctrine of prolonged field care, and with burns being a common injury among soldiers, non-expert providers must be trained to perform...
INTRODUCTION
With the Army's emerging doctrine of prolonged field care, and with burns being a common injury among soldiers, non-expert providers must be trained to perform escharotomy when indicated. However, the existing physical simulators and training protocols are not sufficient for training non-experts for performing effective escharotomy. Hence, to provide guidance in developing realistic escharotomy simulators and effective training protocols suitable for prolonged field care, a cognitive task analysis (CTA) is needed. This work aims to obtain educative information from expert burn surgeons regarding escharotomy procedures via the CTA.
MATERIALS AND METHODS
The CTA was done by interviewing five subject matter experts with experience in performing escharotomy ranging from 20 to over 100 procedures and analyzing their responses. Interview questions were developed to obtain educative information from expert burn surgeons regarding the escharotomy procedure. A "gold standard protocol" was developed based on the CTA of each of the subject matter experts.
RESULTS
The CTA helped identify general themes, including objectives, conditions that mandate escharotomy, signs of successful escharotomy, precautions, challenges, decisions, and performance standards, and specific learning goals such as the use of equipment, vital signs, performing the procedure, and preoperative and postoperative care. A unique aspect of this CTA is that it identifies the background information and preparations that could be useful to the practitioners at various levels of expertise.
CONCLUSIONS
The CTA enabled us to compile a "gold standard protocol" for escharotomy that may serve as a guide for practitioners at various levels of expertise. This information will provide a framework for escharotomy training systems and simulators.
Topics: Humans; Dermatologic Surgical Procedures; Burns; Educational Status; Learning; Cognition
PubMed: 37948234
DOI: 10.1093/milmed/usad104 -
Clinical Kidney Journal Sep 2023Glomerular filtration rate (GFR) is estimated in clinical practice from equations based on the serum concentration of endogenous biomarkers and demographic data. The... (Review)
Review
Glomerular filtration rate (GFR) is estimated in clinical practice from equations based on the serum concentration of endogenous biomarkers and demographic data. The 2009 creatinine-based Chronic Kidney Disease Epidemiology Collaboration equation (CKD-EPI) was recommended worldwide until 2021, when it was recalibrated to remove the African-American race factor. The CKD-EPI and CKD-EPI equations overestimate GFR of adults aged 18-30 years, with a strong overestimation in estimated GFR (eGFR) at age 18 years. CKD-EPI does not perform better than CKD-EPI in US population, overestimating GFR in non-Black subjects, and underestimating it in Black subjects with the same magnitude. CKD-EPI performed worse than the CKD-EPI in White Europeans, and provides no or limited performance gains in Black European and Black African populations. The European Kidney Function Consortium (EKFC) equation, which incorporates median normal value of serum creatinine in healthy population, overcomes the limitations of the CKD-EPI equations: it provides a continuity of eGFR at the transition between pediatric and adult care, and performs reasonably well in diverse populations, assuming dedicated scaling of serum creatinine (Q) values is used. The new EKFC equation based on cystatin C (EKFC) shares the same mathematical construction, namely, it incorporates the median cystatin C value in the general population, which is independent of sex and ethnicity. EKFC is therefore a sex-free and race-free equation, which performs better than the CKD-EPI equation based on cystatin C. Despite advances in the field of GFR estimation, no equation is perfectly accurate, and GFR measurement by exogenous tracer clearance is still required in specific populations and/or specific clinical situations.
PubMed: 37664574
DOI: 10.1093/ckj/sfad039 -
JAMA Otolaryngology-- Head & Neck... Dec 2023Tracheotomies are frequently performed by nonotolaryngology services. The factors that determine which specialty performs the procedure are not defined in the literature...
IMPORTANCE
Tracheotomies are frequently performed by nonotolaryngology services. The factors that determine which specialty performs the procedure are not defined in the literature but may be influenced by tracheotomy approach (open vs percutaneous) and other clinicodemographic factors.
OBJECTIVE
To evaluate demographic and clinical characteristics associated with tracheotomies performed by otolaryngologists compared with other specialists and to differentiate those factors from factors associated with use of open vs percutaneous tracheotomy.
DESIGN, SETTING, AND PARTICIPANTS
This multicenter, retrospective cohort study included patients aged 18 years or older who underwent a tracheotomy for cardiopulmonary failure at 1 of 8 US academic institutions between January 1, 2013, and December 31, 2016. Data were analyzed from September 2022 to July 2023.
EXPOSURE
Tracheotomy.
MAIN OUTCOMES AND MEASURES
The primary outcome was factors associated with an otolaryngologist performing tracheotomy. The secondary outcome was factors associated with use of the open tracheotomy technique.
RESULTS
A total of 2929 patients (mean [SD] age, 57.2 [17.2] years; 1751 [59.8%] male) who received a tracheotomy for cardiopulmonary failure (652 [22.3%] performed by otolaryngologists and 2277 [77.7%] by another service) were analyzed. Although 1664 of all tracheotomies (56.8%) were performed by an open approach, only 602 open tracheotomies (36.2%) were performed by otolaryngologists. Most tracheotomies performed by otolaryngologists (602 of 652 [92.3%]) used the open technique. Multivariable regression analysis revealed that self-reported Black race (odds ratio [OR], 1.89; 95% CI, 1.52-2.35), history of neck surgery (OR, 2.71; 95% CI, 2.06-3.57), antiplatelet and/or anticoagulation therapy (OR, 1.74; 95% CI, 1.29-2.36), and morbid obesity (OR, 1.54; 95% CI, 1.24-1.92) were associated with greater odds of an otolaryngologist performing tracheotomy. In contrast, history of neck surgery (OR, 1.36; 95% CI, 0.96-1.92), antiplatelet and/or anticoagulation therapy (OR, 0.80; 95% CI, 0.56-1.14), and morbid obesity (OR, 0.94; 95% CI, 0.74-1.19) were not associated with undergoing open tracheotomy when performed by any service, and Black race (OR, 0.56; 95% CI, 0.44-0.71) was associated with lesser odds of an open approach being used. Age-adjusted Charlson Comorbidity Index score greater than 4 was associated with greater odds of both an otolaryngologist performing tracheotomy (OR, 1.26; 95% CI, 1.03-1.53) and use of the open tracheotomy technique (OR, 1.48, 95% CI, 1.21-1.82).
CONCLUSIONS AND RELEVANCE
In this study, otolaryngologists were significantly more likely than other specialists to perform a tracheotomy for patients with history of neck surgery, morbid obesity, and ongoing anticoagulation therapy. These findings suggest that patients undergoing tracheotomy performed by an otolaryngologist are more likely to present with complex and challenging clinical characteristics.
Topics: Humans; Male; Middle Aged; Female; Tracheotomy; Otolaryngologists; Retrospective Studies; Obesity, Morbid; Otolaryngology; Anticoagulants
PubMed: 37796485
DOI: 10.1001/jamaoto.2023.2698