Contextual information influences diagnosis accuracy and decision making in simulated emergency medicine emergencies

Background: It is well documented that adaptations in cognitive processes with increasing skill levels support decision making in multiple domains. We examined skill-based differences in cognitive processes in emergency medicine physicians, and whether performance was significantly influenced by the removal of contextual information related to a patient's medical history. Method: Skilled (n=9) and less skilled (n=9) emergency medicine physicians responded to high-fidelity simulated scenarios under high- and low-context information conditions. Results: Skilled physicians demonstrated higher diagnostic accuracy irrespective of condition, and were less affected by the removal of context-specific information compared with less skilled physicians. The skilled physicians generated more options, and selected better quality options during diagnostic reasoning compared with less skilled counterparts. These cognitive processes were active irrespective of the level of context-specific information presented, although high-context information enhanced understanding of the patients' symptoms resulting in higher diagnostic accuracy. Conclusions: Our findings have implications for scenario design and the manipulation of contextual information during simulation training

Association of Accelerometry-Measured Physical Activity and Cardiovascular Events in Mobility-Limited Older Adults: The LIFE (Lifestyle Interventions and Independence for Elders) Study.

BACKGROUND:Data are sparse regarding the value of physical activity (PA) surveillance among older adults-particularly among those with mobility limitations. The objective of this study was to examine longitudinal associations between objectively measured daily PA and the incidence of cardiovascular events among older adults in the LIFE (Lifestyle Interventions and Independence for Elders) study. METHODS AND RESULTS:Cardiovascular events were adjudicated based on medical records review, and cardiovascular risk factors were controlled for in the analysis. Home-based activity data were collected by hip-worn accelerometers at baseline and at 6, 12, and 24 months postrandomization to either a physical activity or health education intervention. LIFE study participants (n=1590; age 78.9±5.2 [SD] years; 67.2% women) at baseline had an 11% lower incidence of experiencing a subsequent cardiovascular event per 500 steps taken per day based on activity data (hazard ratio, 0.89; 95% confidence interval, 0.84-0.96; P=0.001). At baseline, every 30 minutes spent performing activities ≥500 counts per minute (hazard ratio, 0.75; confidence interval, 0.65-0.89 [P=0.001]) were also associated with a lower incidence of cardiovascular events. Throughout follow-up (6, 12, and 24 months), both the number of steps per day (per 500 steps; hazard ratio, 0.90, confidence interval, 0.85-0.96 [P=0.001]) and duration of activity ≥500 counts per minute (per 30 minutes; hazard ratio, 0.76; confidence interval, 0.63-0.90 [P=0.002]) were significantly associated with lower cardiovascular event rates. CONCLUSIONS:Objective measurements of physical activity via accelerometry were associated with cardiovascular events among older adults with limited mobility (summary score >10 on the Short Physical Performance Battery) both using baseline and longitudinal data. CLINICAL TRIAL REGISTRATION:URL: http://www.clinicaltrials.gov. Unique identifier: NCT01072500

Two dimensional magnets: Forgotten history and recent progress towards spintronic applications

The recent discovery of two-dimensional magnetic order in van-der Waals materials has stimulated a renaissance in the field of atomically-thin magnets. This has led to promising demonstrations of spintronic functionality such as tunneling magnetoresistance. The frantic pace of this emerging research, however, has also led to some confusion surrounding the underlying phenomena of phase transitions in two-dimensional (2D) magnets. In fact, there is a rich history of experimental precedents beginning in the 1960s with quasi-2D bulk magnets and progressing to the 1980s using atomically-thin sheets of elemental metals. This review provides a holistic discussion of the current state of knowledge on the three distinct families of low-dimensional magnets: quasi-2D, ultra-thin films and van-der Waals crystals. It highlights the unique opportunities presented by the latest implementation in van-der Waals materials. By revisiting the fundamental insights from the field of low-dimensional magnetism, this review will highlight factors that can be used to enhance material performance. For example, the limits imposed on the critical temperature by the Mermin-Wagner theorem can be escaped in three separate ways: magnetocrystalline anisotropy, long range interactions and shape anisotropy. Several recent experimental reports of atomically-thin magnets with Curie temperatures above room temperature are highlighted.Comment: 28 pages, 7 figure

Keeping an eye on noisy movements: On different approaches to perceptual-motor skill research and training

Contemporary theorising on the complementary nature of perception and action in expert performance has led to the emergence of different emphases in studying movement coordination and gaze behaviour. On the one hand, coordination research has examined the role that variability plays in movement control, evidencing that variability facilitates individualised adaptations during both learning and performance. On the other hand, and at odds with this principle, the majority of gaze behaviour studies have tended to average data over participants and trials, proposing the importance of universal 'optimal' gaze patterns in a given task, for all performers, irrespective of stage of learning. In this article, new lines of inquiry are considered with the aim of reconciling these two distinct approaches. The role that inter- and intra-individual variability may play in gaze behaviours is considered, before suggesting directions for future research

‘Imposter participants’ in online qualitative research, a new and increasing threat to data integrity?

Letter to the Editor: Health Expectation

Network of topological nodal planes, multifold degeneracies, and Weyl points in CoSi

We report the identification of symmetry-enforced nodal planes (NPs) in CoSi providing the missing topological charges in an entire network of band-crossings comprising in addition multifold degeneracies and Weyl points, such that the fermion doubling theorem is satisfied. In our study we have combined measurements of Shubnikov-de Haas (SdH) oscillations in CoSi with material-specific calculations of the electronic structure and Berry curvature, as well as a general analysis of the band topology of space group (SG) 198. The observation of two nearly dispersionless SdH frequency branches provides unambiguous evidence of four Fermi surface sheets at the R point that reflect the symmetry-enforced orthogonality of the underlying wave functions at the intersections with the NPs. Hence, irrespective of the spin-orbit coupling strength, SG198 features always six- and fourfold degenerate crossings at R and $\Gamma$ that are intimately connected to the topological charges distributed across the network

InfuShield: a shielded enclosure for administering therapeutic radioisotope treatments using standard syringe pumps.

The administration of radionuclide therapies presents significant radiation protection challenges. The aim of this work was to develop a delivery system for intravenous radioisotope therapies to substantially moderate radiation exposures to staff and operators. A novel device (InfuShield) was designed and tested before being used clinically. The device consists of a shielded enclosure which contains the therapeutic activity and, through the hydraulic action of back-to-back syringes, allows the activity to be administered using a syringe pump external to the enclosure. This enables full access to the pump controls while simultaneously reducing dose to the operator. The system is suitable for use with all commercially available syringe pumps and does not require specific consumables, maximising both the flexibility and economy of the system. Dose rate measurements showed that at key stages in an I mIBG treatment procedure, InfuShield can reduce dose to operators by several orders of magnitude. Tests using typical syringes and infusion speeds show no significant alteration in administered flow rates (maximum of 1.2%). The InfuShield system provides a simple, safe and low cost method of radioisotope administration

Examining the effect of state anxiety on compensatory and strategic adjustments in the planning of goal-directed aiming

The anxiety-perceptual-motor performance relationship may be enriched by investigations involving discrete manual responses due to the definitive demarcation of planning and control processes, which comprise the early and late portions of movement, respectively. To further examine the explanatory power of self-focus and distraction theories, we explored the potential of anxiety causing changes to movement planning that accommodate for anticipated negative effects in online control. As a result, we posed two hypotheses where anxiety causes performers to initially undershoot the target and enable more time to use visual feedback (“play-it-safe”), or fire a ballistic reach to cover a greater distance without later undertaking online control (“go-for-it”). Participants were tasked with an upper-limb movement to a single target under counter-balanced instructions to execute fast and accurate responses (low/normal anxiety) with non-contingent negative performance feedback (high anxiety). The results indicated that the previously identified negative impact of anxiety in online control was replicated. While anxiety caused a longer displacement to reach peak velocity and greater tendency to overshoot the target, there appeared to be no shift in the attempts to utilise online visual feedback. Thus, the tendency to initially overshoot may manifest from an inefficient auxiliary procedure that manages to uphold overall movement time and response accuracy