Priming Analogical Reasoning with False Memories

Like true memories, false memories are capable of priming answers to insight-based problems. Recent research has attempted to extend this paradigm to more advanced problem-solving tasks, including those involving verbal analogical reasoning. However, these experiments are constrained inasmuch as problem solutions could be generated via spreading activation mechanisms (much like false memories themselves) rather than using complex reasoning processes. In three experiments we examined false memory priming of complex analogical reasoning tasks in the absence of simple semantic associations. In Experiment 1, we demonstrated the robustness of false memory priming in analogical reasoning when backward associative strength among the problem terms was eliminated. In Experiments 2a and 2b, we extended these findings by demonstrating priming on newly created homonym analogies that can only be solved by inhibiting semantic associations within the analogy. Overall, the findings of the present experiments provide evidence that the efficacy of false memory priming extends to complex analogical reasoning problems

An underused opportunity to introduce ACE inhibitors and influence prognosis: observational study of patients undergoing aortic surgery

OBJECTIVE: To asses whether Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) are underused in patients with aortic disease due to concerns regarding flow limiting (>70%) renal artery stenosis (RAS). DESIGN: A prospective analysis of patients admitted for aortic surgery was performed (January-July 2009). Co-morbidity, ACEI/ARB use and renal function were recorded. Computerised tomography (CT) angiograms were reviewed by a single blinded radiologist for the presence and severity of RAS. SETTING: St Mary's Hospital, Vascular Unit, Imperial College Healthcare NHS Trust, London, UK. PARTICIPANTS: 75 randomly selected patients admitted to our vascular unit including elective and emergency admissions. MAIN OUTCOME MEASURES: Indications for ACEI therapy were identified as determined by the National Institute of Health and Clinical Excellence (NICE) guidance. The ratio of the measurement distal to the stenosis and at the area of maximal stenosis on CT angiography were used to calculate the percentage RAS. RESULTS: 60 patients were identified (15 patients excluded due to previously modified renal vessels). The median age was 73 [interquartile range 68, 77]. Their underlying aortic disease included 52 (87%) aortic aneurysm, 6 (10%) with aortic dissection, 1 (1.7%) patient with occlusive disease and 1 (1.7%) patient with mycotic disease. Overall, 56/60 (93%) patients had at least one indication for ACEI therapy. 33/60 (55%) of patients were already receiving ACEI. CT angiogram examination demonstrated 17/60 (28%) patients have RAS of some degree, of which only 9/60 (15%) have flow limiting RAS. CONCLUSION: A large proportion of aortic patients do not receive ACEI/ARB therapy despite definite indications and a low prevalence of flow-limiting RAS is low. After the exclusion of RAS at angiography, careful introduction of ACEI therapy with appropriate monitoring could be considered for many more patients

A pilot study of video-motion analysis in endovascular surgery: development of real-time discriminatory skill metrics

Materials and methods: A semi-automated catheter-tracking software was developed which allows for frame-by-frame motion analysis of fluoroscopic videos and calculation 2D catheter tip path-length. 21 interventionalists (6 cardiologists, 8 interventional radiologists, 7 vascular surgeons; 14/21 had performed >500 endovascular procedures) performed an identical carotid artery stenting procedure (CAS) on a VIST simulator (Mentice, Gothenburg, Sweden). Operators were sub-divided into four categories according to CAS experience: 6 inexperienced (0 CAS-group A), 3 low-volume (1–20 CAS-group B), 5 moderate-volume (21–50 CAS-group C) and 7 high-volume (>50 CAS-group D) CAS experience. Total PL was calculated for each case and comparisons made between groups. PL was correlated with: quantitative, simulator-derived metrics and qualitative performance scores (generic and procedure-specific) derived from post-hoc video analysis by three blinded observers. Results: Group D used 5160.3 (inter-quartile range- IQR 4046.4–7142.9) pixels of movement, compared to 6856.7 (5914.4–8106.9) for group A (p = 0.046); 10,905.1 (7851.1–14,381.5) for group B (p = 0.017); and 9482.6 (8663.5–13,847.6) for group C (p = 0.003). Statistically significant inverse correlations were seen between total PL and qualitative performance scores (rho = −0.519 for generic (p = 0.027) rho = −0.567 for procedure-specific (p = 0.014) scores). PL did not correlate with any of the simulator-derived metrics (errors, contrast volume, total procedure and fluoroscopy times, cine-loops used). Conclusion: Endovascular instrument video motion analysis is feasible and may represent a valuable tool for the objective assessment of endovascular skill

Patient-specific endovascular simulation influences interventionalists performing carotid artery stenting procedures

AbstractObjectiveThe ability to perform patient-specific simulated rehearsal of complex endovascular interventions is a technological advance with potential benefits to patient outcomes. This study aimed to evaluate whether patient-specific rehearsal of a carotid artery stenting (CAS) procedure has an influence on tool selection and the use of fluoroscopy.MethodsFollowing case note and computed tomography (CT) angiographic review of a real patient case, subjects performed the CAS procedure on a virtual reality simulator. Endovascular tool requirements and fluoroscopic angles were evaluated with a pre- and post-case questionnaire. Participants also rated the simulation from 1 (poor) to 5 (excellent).ResultsThirty-three endovascular physicians with varying degrees of CAS experience were recruited: inexperienced (5–20 CAS procedures) n = 11, moderately (21–50 CAS procedures) n = 7 or highly experienced (>50 CAS procedures) n = 15. For all participants, 96 of a possible 363 changes (26%) were observed from pre- to post-case questionnaires. This was most notable for optimal fluoroscopy C-arm position 15/33 (46%), choice of selective catheter 13/33 (39%), choice of sheath or guiding catheter 11/33 (33%) and balloon dilatation strategy 10/33 (30%). Experience with the CAS procedure did not influence the degree of change significantly (p > 0.05), and all groups exhibited a considerable modification in tool and fluoroscopy preference. The model was considered realistic and useful as a tool to practice a real case (median score 4/5).ConclusionPatient-specific simulated rehearsal of a complex endovascular procedure strongly influences tool selection and fluoroscopy preferences for the real case. Further research has to evaluate how this technology may transfer from in vitro to in vivo and if it can reduce the radiation dose and the number of endovascular tools used and improve outcomes for patients in the clinical setting