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Developmental Science Jul 2024Impaired numerosity perception in developmental dyscalculia (low "number acuity") has been interpreted as evidence of reduced representational precision in the...
Impaired numerosity perception in developmental dyscalculia (low "number acuity") has been interpreted as evidence of reduced representational precision in the neurocognitive system supporting non-symbolic number sense. However, recent studies suggest that poor numerosity judgments might stem from stronger interference from non-numerical visual information, in line with alternative accounts that highlight impairments in executive functions and visuospatial abilities in the etiology of dyscalculia. To resolve this debate, we used a psychophysical method designed to disentangle the contribution of numerical and non-numerical features to explicit numerosity judgments in a dot comparison task and we assessed the relative saliency of numerosity in a spontaneous categorization task. Children with dyscalculia were compared to control children with average mathematical skills matched for age, IQ, and visuospatial memory. In the comparison task, the lower accuracy of dyscalculics compared to controls was linked to weaker encoding of numerosity, but not to the strength of non-numerical biases. Similarly, in the spontaneous categorization task, children with dyscalculia showed a weaker number-based categorization compared to the control group, with no evidence of a stronger influence of non-numerical information on category choice. Simulations with a neurocomputational model of numerosity perception showed that the reduction of representational resources affected the progressive refinement of number acuity, with little effect on non-numerical bias in numerosity judgments. Together, these results suggest that impaired numerosity perception in dyscalculia cannot be explained by increased interference from non-numerical visual cues, thereby supporting the hypothesis of a core number sense deficit. RESEARCH HIGHLIGHTS: A strongly debated issue is whether impaired numerosity perception in dyscalculia stems from a deficit in number sense or from poor executive and visuospatial functions. Dyscalculic children show reduced precision in visual numerosity judgments and weaker number-based spontaneous categorization, but no increasing reliance on continuous visual properties. Simulations with deep neural networks demonstrate that reduced neural/computational resources affect the developmental trajectory of number acuity and account for impaired numerosity judgments. Our findings show that weaker number acuity in developmental dyscalculia is not necessarily related to increased interference from non-numerical visual cues.
PubMed: 38949566
DOI: 10.1111/desc.13538 -
International Maritime Health 2024In confined waters, ships run a high risk of groundings, contact, sinkings and near misses. In such waters the maritime traffic is dense, the waterway is narrow, the...
BACKGROUND
In confined waters, ships run a high risk of groundings, contact, sinkings and near misses. In such waters the maritime traffic is dense, the waterway is narrow, the depth is limited, and tides and currents are constantly changing.
MATERIALS AND METHODS
From 2009-2019, 75 accidents were investigated in the estuary of the Seine. Weather conditions and perceived fatigue were studied. From May to June 2020, 114 seafarers, 34 pilots and 80 captains, responded to a questionnaire focusing on the use of Pilot Portable Units (PPU) and Electronic Chart Display Information Systems (ECDIS).
RESULTS
The 75 accidents corresponded to an average of 6.8 ± 3.2 accidents per year. Groundings were the most frequent accidents (35%, n = 26) followed by contact accidents with the quayside (25%, n = 19), between ships or tugs while manoeuvring (8%, n = 6) or while sailing (1%, n = 1). There was no loss of vessels nor fatalities of crew members. In poor weather conditions, there were 76% more accidents than in normal conditions (4.4 ± 2.5 accidents/10,000 movements versus 2.5 ± 1.9 accidents/10,000 movements, p < 0.03). Almost all the accidents (96%) were related to human errors of judgment (81%), or negligence (53%), or both (39). Perceived fatigue was probably in cause in 6 accidents. Only 3 accidents were related to mechanical causes. Through the questionnaires, 69% of the pilots complained of difficulties in mastering the devices and software. They felt distracted by alarms which affected their attention while navigating. They requested training on a simulator. Concerning ship captains, 83% felt comfortable with ECDIS devices yet only 20% were able to configure the ECDIS correctly.
CONCLUSIONS
In the Seine estuary, 75 accidents occurred within the 11 year-study. Risk factors were poor weather conditions and human error. PPU and ECDIS were considered as useful tools in the prevention of accidents. However, pilots and captains requested more thorough training in their use.
Topics: Humans; Ships; Accidents, Occupational; France; Adult; Surveys and Questionnaires; Weather; Male; Estuaries; Pilots; Naval Medicine; Fatigue; Female; Middle Aged
PubMed: 38949220
DOI: 10.5603/imh.99407 -
Addressing Confusion and Inconsistencies Surrounding the Provider Role in Medical Cannabis Programs.Journal of Addiction Medicine Jul 2024More than 40 states in the United States have established medical Cannabis programs that authorize the use of Cannabis for specific medical conditions. Initially, these...
More than 40 states in the United States have established medical Cannabis programs that authorize the use of Cannabis for specific medical conditions. Initially, these medical Cannabis programs aimed to offer compassionate care primarily for terminal or rare, untreatable conditions. However, the scope of these programs has broadened to include nonterminal and more common conditions, including various medical and mental disorders. This expansion introduces several health care challenges: a lack of robust research evidence for many listed conditions, a sense of unpreparedness among providers, and a disparity in provider roles, expectations, and responsibilities across different states, leading to potential confusion. To address these issues, medical organizations need to develop expert consensus or guidelines that underscore evidence-based shared decision-making and patient monitoring standards. Medical education should also include such training. Concurrently, medical providers must prioritize evidence-based treatment over public opinion, exercise clinical judgment, and take responsibility for their recommendations.
PubMed: 38949204
DOI: 10.1097/ADM.0000000000001338 -
Sichuan Da Xue Xue Bao. Yi Xue Ban =... May 2024The aim of this study is to explore the practical value of prenatal magnetic resonance imaging (MRI) in the assessment of congenital cystic lung disease in fetuses, to...
OBJECTIVE
The aim of this study is to explore the practical value of prenatal magnetic resonance imaging (MRI) in the assessment of congenital cystic lung disease in fetuses, to evaluate the relative size of the lesion and the status of lung development, and to make an attempt at utilizing the strength of MRI in post-processing to obtain assessment indicators of the size of the lesion and the status of lung development, with which predictions can be made for the prognosis that these fetuses may face after birth. We retrospectively collected and analyzed the data of fetuses diagnosed with congenital cystic lung disease. Prenatal ultrasound examination of these fetuses led to the diagnosis that they were suspected of having congenital cystic lung disease and the diagnosis was confirmed by subsequent prenatal MRI. The fetuses were followed up to track their condition at birth (postnatal respiratory distress, mechanical ventilation, etc.), whether the fetuses underwent surgical treatment, and the recovery of the fetuses after surgical treatment. The recovery of the fetuses was followed up to explore the feasibility of prenatal MRI examination to assess fetal congenital pulmonary cystic disease, and to preliminarily explore the predictive value of prenatal MRI for the prognosis of fetuses with congenital pulmonary cystic disease.
METHODS
MRI fetal images were collected from pregnant women who attended the West China Second University Hospital of Sichuan University between May 2018 and March 2023 and who were diagnosed with fetal congenital pulmonary cystic disease by prenatal ultrasound and subsequent MRI. Fetal MRI images of congenital cystic lung disease were post-processed to obtain the fetal lung lesion volume, the fetal affected lung volume, the healthy lung volume, and the fetal head circumference measurements. The signal intensity of both lungs and livers, the lesion volume/the affected lung volume, the lesion volume/total lung volume, the cystic volume ratio (CVR), and the bilateral lung-liver signal intensity ratio were measured. The feasibility and value of MRI post-processing acquisition indexes for evaluating the prognosis of fetuses with congenital cystic lung disease were further analyzed by combining the follow-up results obtained 6 months after the birth of the fetus. Logistic regression models were used to quantify the differences in maternal age, gestational week at the time of MRI, CVR, and bilateral lung-to-liver signal intensity ratio, and to assess whether these metrics correlate with poor prognosis. Receiver operating characteristic (ROC) curves were used to assess the value of the parameters obtained by MRI calculations alone and in combination with multiple metrics for predicting poor prognosis after birth.
RESULTS
We collected a total of 67 cases of fetuses diagnosed with congenital cystic lung disease by fetal MRI between May 2018 and March 2023, and excluded 6 cases with no normal lung tissue in the affected lungs, 11 cases of fetal induction, and 3 cases of loss of pregnancy. In the end, 47 cases of fetuses with congenital cystic lung disease were included, of which 30 cases had a good prognosis and 17 cases had a poor prognosis. The difference in the difference between the signal intensity ratios of the affected and healthy sides of the lungs and livers of the fetuses in the good prognosis group and that in the poor prognosis group was statistically significant (<0.05), and the signal intensity ratio of the healthy side of the lungs and livers was higher than the signal intensity ratio of the affected side of the lungs and livers. Further analysis showed that CVR (odds ratio [OR]=1.058, 95% confidence interval [CI]: 1.014-1.104), and the difference between the lung-to-liver signal intensity ratios of the affected and healthy sides (OR=0.814, 95% CI: 0.700-0.947) were correlated with poor prognosis of birth in fetuses with congenital cystic lung disease. In addition, ROC curve analysis showed that the combined application of lesion volume/affected lung volume and the observed difference in the signal intensity ratio between the affected and healthy lungs and liver predicted the prognosis of children with congenital cystic lung disease more accurately than the single-parameter judgment did, with the area under the curve being 0.988, and the cut-off value being 0.33, which corresponded to a sensitivity of 100%, a specificity of 93.3%, and a 95% CI of 0.966-1.000.
CONCLUSIONS
Based on the MRI of fetuses with congenital cystic lung disease, we obtained information on lesion volume, lesion volume/affected lung volume, lesion volume/total lung volume, CVR, and bilateral lung-to-liver signal intensity ratio difference, all of which showing some clinical value in predicting the poor prognosis in fetuses with congenital cystic lung disease. Furthermore, among the combined indexes, the lesion volume/affected lung volume and bilateral lung-to-liver signal intensity ratio difference are more effective predictors for the poor prognosis of fetuses with congenital cystic lung disease, and show better efficacy in predicting the poor prognosis of fetuses with congenital cystic lung disease. This provides a new and effective predictive method for further assessment of pulmonary lung development in fetuses with congenital cystic lung disease, and helps improve the assessment and prediction of the prognosis of fetuses with congenital cystic lung disease.
Topics: Humans; Female; Magnetic Resonance Imaging; Pregnancy; Prognosis; Prenatal Diagnosis; Retrospective Studies; Lung; Cystic Adenomatoid Malformation of Lung, Congenital; Fetal Diseases; Cysts; Ultrasonography, Prenatal
PubMed: 38948284
DOI: 10.12182/20240560109 -
Belitung Nursing Journal 2024Breast cancer is the most common female malignancy. Although chemotherapy is the primary treatment for breast cancer, it frequently has several detrimental side effects....
BACKGROUND
Breast cancer is the most common female malignancy. Although chemotherapy is the primary treatment for breast cancer, it frequently has several detrimental side effects. Patients with breast cancer require self-compassion to regulate their emotions in order to cope with their suffering. Factors affecting self-compassion have mostly been investigated in the context of chronic diseases in general, not specifically in relation to patients receiving chemotherapy for breast cancer.
OBJECTIVE
This cross-sectional study sought to describe the self-compassion level and to examine the predictive ability of self-critical judgment, body image, stress, attachment style, social support, hope, and self-reassuring on self-compassion among patients with breast cancer undergoing chemotherapy.
METHODS
The participants were 210 Thai women with breast cancer who received chemotherapy in northern Thailand and were selected using proportionate random sampling. Data were collected from December 2021 to January 2023 using validated instruments. Data were analyzed using descriptive statistics and hierarchical regression analysis.
RESULTS
Self-compassion was moderate (Mean = 2.91, SD = 0.91). Self-critical judgment (β = 0.487, <0.001) and hope (β =0.128, = 0.032) could predict self-compassion in patients with breast cancer undergoing chemotherapy and explained 40.1% of the variance.
CONCLUSION
The study's findings highlight the importance of addressing self-critical judgment and fostering hope in patients with breast cancer undergoing chemotherapy to enhance their self-compassion. Nurses and other healthcare providers can use the findings to provide interventions to promote self-compassion.
PubMed: 38947302
DOI: 10.33546/bnj.3359 -
Frontiers in Medicine 2024The development of critical thinking (CT) has been a universal goal in higher education. A systematic review of the literature was conducted to evaluate the...
INTRODUCTION
The development of critical thinking (CT) has been a universal goal in higher education. A systematic review of the literature was conducted to evaluate the effectiveness of currently used pedagogical practices to foster CT/ clinical reasoning (CR)/ clinical judgment (CJ) skills and/or dispositions in undergraduate medical students.
METHODS
PubMed, Web of Science and Scopus databases were searched from January 2010 to April 2021 with a predefined Boolean expression.
RESULTS
Of the 3221 articles originally identified, 33 articles were included by using PICOS methodology. From these, 21 (64%) reported CR pedagogical practices and 12 (36%) CT pedagogical practices.
DISCUSSION
Overall, pedagogical practices such as cognitive/visual representation, simulation, literature exposure, test-enhancing and team-based learning, clinical case discussion, error-based learning, game-based learning seem to enhance CT/CR skills and/or dispositions. Further research is required to identify the optimal timing, duration and modality of pedagogical interventions for effectively foster CT/CR in medical education.
PubMed: 38947238
DOI: 10.3389/fmed.2024.1358444 -
Biomedical Engineering Letters Jul 2024The aim of this study is to propose a new diagnostic model based on "segmentation + classification" to improve the routine screening of Thyroid nodule...
The aim of this study is to propose a new diagnostic model based on "segmentation + classification" to improve the routine screening of Thyroid nodule ultrasonography by utilizing the key domain knowledge of medical diagnostic tasks. A Multi-scale segmentation network based on a pyramidal pooling structure of multi-parallel void spaces is proposed. First, in the segmentation network, the exact information of the underlying feature space is obtained by an Attention Gate. Second, the inflated convolutional part of Atrous Spatial Pyramid Pooling (ASPP) is cascaded for multiple downsampling. Finally, a three-branch classification network combined with expert knowledge is designed, drawing on doctors' clinical diagnosis experience, to extract features from the original image of the nodule, the regional image of the nodule, and the edge image of the nodule, respectively, and to improve the classification accuracy of the model by utilizing the Coordinate attention (CA) mechanism and cross-level feature fusion. The Multi-scale segmentation network achieves 94.27%, 93.90% and 88.85% of mean precision (mPA), Dice value (Dice) and mean joint intersection (MIoU), respectively, and the accuracy, specificity and sensitivity of the classification network reaches 86.07%, 81.34% and 90.19%, respectively. Comparison tests show that this method outperforms the U-Net, AGU-Net and DeepLab V3+ classical models as well as the nnU-Net, Swin UNetr and MedFormer models that have emerged in recent years. This algorithm, as an auxiliary diagnostic tool, can help physicians more accurately assess the benign or malignant nature of Thyroid nodules. It can provide objective quantitative indicators, reduce the bias of subjective judgment, and improve the consistency and accuracy of diagnosis. Codes and models are available at https://github.com/enheliang/Thyroid-Segmentation-Network.git.
PubMed: 38946824
DOI: 10.1007/s13534-024-00375-2 -
Diabetic Medicine : a Journal of the... Jun 2024People with Type 1 diabetes (T1D) face an increased risk of eating disorders/disordered eating (ED/DE), with adolescents being particularly vulnerable. Empirical...
OBJECTIVE
People with Type 1 diabetes (T1D) face an increased risk of eating disorders/disordered eating (ED/DE), with adolescents being particularly vulnerable. Empirical knowledge on the mechanisms underlying development of ED/DE in T1D is crucial for evolving prevention strategies.
RESEARCH DESIGN AND METHODS
Fourteen semi-structured interviews with adolescent females with T1D and ED/DE between 14 and 18 years were conducted and analyzed using reflexive thematic analysis.
RESULTS
Analyses identified four main themes; 'Interconnected afflictions', 'Judgment', 'Feeling Different', and 'Chaos & Control', These themes explore the interconnectedness of T1D and ED/DE, with shame and guilt emerging as common underlying mechanism. The development of a biopsychosocial model was based on the integration of these data with existing models.
CONCLUSIONS
The study extends previous developmental pathways of ED/DE in adolescents with T1D. We propose a biopsychosocial model that incorporates various factors: predisposing factors such as parental management of T1D and weight gain during adolescence; precipitating factors including comments on weight, frequency of weighing, perceptions of surveillance; the perpetuating bilateral influence of ED/DE and T1D and finally highlighting the protective mechanisms of disease acceptance encompassing parental handling of diagnosis and the contribution of healthcare professionals (HCP's) role in psychoeducation. The present study highlight the vulnerability of adolescence in the presence of T1D, particularly concerning issues related to eating, weight, and body. It offers clinically relevant insights, with the aim to improve communication and management strategies for this very specific group.
PubMed: 38946057
DOI: 10.1111/dme.15397 -
Annals of Behavioral Medicine : a... Jun 2024Previous research on COVID-19 vaccination highlights future thoughts associated with possible Coronavirus infection and vaccine side effects as key predictors of vaccine...
BACKGROUND
Previous research on COVID-19 vaccination highlights future thoughts associated with possible Coronavirus infection and vaccine side effects as key predictors of vaccine hesitancy. Yet, research has focused on independent contributions of such future thoughts, neglecting their interactive aspects.
PURPOSE
We examined whether thoughts about two possible COVID-related futures (suffering from COVID-19 and vaccine side effects) interactively predict vaccine hesitancy and vaccination behavior among unvaccinated and vaccinated people. Importantly, we compared two forms of future thinking: beliefs or expectations (likelihood judgments) versus fantasies (free thoughts and images describing future events).
METHODS
In Study 1, we conducted a longitudinal study with an unvaccinated group (N = 210). We assessed expectations versus fantasies about the two COVID-related futures as predictors. As outcome variables, we measured vaccine hesitancy, and 9 weeks later we assessed information seeking and vaccine uptake. Study 2 was a cross-sectional study comparing vaccine hesitancy of an unvaccinated group (N = 307) to that of a vaccinated group (N = 311).
RESULTS
Study 1 found that more negative fantasies about COVID-19 impact and less negative fantasies about vaccine side effects interactively predicted lower vaccine hesitancy and more vaccine-related behaviors among unvaccinated people; no such interaction was observed between respective expectations. Study 2 replicated these results of Study 1. Additionally, for vaccinated people, low expectations of negative COVID-19 impact and high expectations of negative vaccine impact interactively predicted higher vaccine hesitancy, whereas no such interaction was observed for respective fantasies.
CONCLUSIONS
Research on vaccine hesitancy should explore interactions between future thinking about disease and about vaccine side effects. Importantly, there is much to be gained by distinguishing expectations versus fantasies: vaccination interventions aiming to boost vaccine uptake among unvaccinated people should tap into their negative future fantasies regarding both disease and vaccine side effects.
PubMed: 38944699
DOI: 10.1093/abm/kaae034 -
The Journal of Clinical Endocrinology... Jun 2024Medical treatment of acromegaly is currently performed through a trial-error approach using first generation somatostatin receptor ligands (fgSRLs) as first-line drugs,...
UNLABELLED
Medical treatment of acromegaly is currently performed through a trial-error approach using first generation somatostatin receptor ligands (fgSRLs) as first-line drugs, with an effectiveness of about 50%, and subsequent drugs are indicated through clinical judgment. Some biomarkers can predict fgSRLs response. Here we report the results of the ACROFAST study, a clinical trial in which a protocol based on predictive biomarkers of fgSRLs was evaluated.
METHODS AND SUBJECTS
prospective trial (21 university hospitals) comparing the effectiveness and time-to control of two treatment protocols during 12 months: A) A personalized protocol in which first option were fgSRLs as monotherapy or in combination with pegvisomant or, pegvisomant as monotherapy depending on the short Acute Octreotide Test (sAOT) results, tumor T2 Magnetic Resonance (MRI) signal or immunostaining for E-cadherin and, B) A control group with treatment always started by fgSRLs and the other drugs included after demonstrating inadequate control.
RESULTS
Eighty-five patients participated; 45 in the personalized and 40 in the control group. More patients in the personalized protocol achieved hormonal control compared to those in the control group (78% vs 53%, p < 0.05). Survival analysis revealed a hazard ratio for achieving hormonal control adjusted by age and sex of 2.53 (CI 1.30-4.80). Patients from personalized arm were controlled in a shorter period of time (p = 0.01).
CONCLUSION
Personalized medicine is feasible using a relatively simple protocol and allows a higher number of patients achieving control in a shorter period of time.
PubMed: 38943661
DOI: 10.1210/clinem/dgae444