Prefrontal transcranial direct-current stimulation improves early technical skills in surgery

Background Studies applying transcranial direct-current stimulation (tDCS) to motor regions to enhance surgical skills have observed modest benefits in performance. Early surgical skills acquisition is known to be dependent on the prefrontal cortex (PFC) which could be a suitable target for performance enhancement in fields with high cognitive demand. Objective To assess whether prefrontal tDCS could improve early phases of surgical skill development. Methods In a randomized sham-controlled double-blind parallel design, 40 surgical novices performed an open knot-tying task repeated in three blocks; pre-, online- and post-tDCS. During online stimulation, participants were randomized to either active tDCS (2 mA for 15 min) to the prefrontal cortex (anode over F3, cathode over F4) or sham tDCS. Performance score (PS) was computed using a validated algorithm and introspective workload domains were assessed using a SURG-TLX questionnaire. Results There was no difference in demographics or PS between groups prior to receiving tDCS. PS significantly improved from pre-to online- (p < 0.001) and from pre-to post-tDCS (p < 0.001) in the active group only. Following active tDCS, PS was closer to the defined proficiency benchmark and significantly greater compared to sham (p = 0.002). Only the active group reported significantly improved temporal demand scores from pre-to online- (p = 0.004) to post-tDCS (p = 0.002). Conclusions This study demonstrates significantly improved early phase surgical-skill acquisition following prefrontal tDCS. Further work is required to determine the underlying neurophysiological mechanisms and whether the benefits observed are retained long-term

Too little, too late: reduced visual span and speed characterize pure alexia

Whether normal word reading includes a stage of visual processing selectively dedicated to word or letter recognition is highly debated. Characterizing pure alexia, a seemingly selective disorder of reading, has been central to this debate. Two main theories claim either that 1) Pure alexia is caused by damage to a reading specific brain region in the left fusiform gyrus or 2) Pure alexia results from a general visual impairment that may particularly affect simultaneous processing of multiple items. We tested these competing theories in 4 patients with pure alexia using sensitive psychophysical measures and mathematical modeling. Recognition of single letters and digits in the central visual field was impaired in all patients. Visual apprehension span was also reduced for both letters and digits in all patients. The only cortical region lesioned across all 4 patients was the left fusiform gyrus, indicating that this region subserves a function broader than letter or word identification. We suggest that a seemingly pure disorder of reading can arise due to a general reduction of visual speed and span, and explain why this has a disproportionate impact on word reading while recognition of other visual stimuli are less obviously affected

Correspondence between geometrical and differential definitions of the sine and cosine functions and connection with kinematics

In classical physics, the familiar sine and cosine functions appear in two forms: (1) geometrical, in the treatment of vectors such as forces and velocities, and (2) differential, as solutions of oscillation and wave equations. These two forms correspond to two different definitions of trigonometric functions, one geometrical using right triangles and unit circles, and the other employing differential equations. Although the two definitions must be equivalent, this equivalence is not demonstrated in textbooks. In this manuscript, the equivalence between the geometrical and the differential definition is presented assuming no a priori knowledge of the properties of sine and cosine functions. We start with the usual length projections on the unit circle and use elementary geometry and elementary calculus to arrive to harmonic differential equations. This more general and abstract treatment not only reveals the equivalence of the two definitions but also provides an instructive perspective on circular and harmonic motion as studied in kinematics. This exercise can help develop an appreciation of abstract thinking in physics.Comment: 6 pages including 1 figur

Thermodynamics of adiabatic feedback control

We study adaptive control of classical ergodic Hamiltonian systems, where the controlling parameter varies slowly in time and is influenced by system's state (feedback). An effective adiabatic description is obtained for slow variables of the system. A general limit on the feedback induced negative entropy production is uncovered. It relates the quickest negentropy production to fluctuations of the control Hamiltonian. The method deals efficiently with the entropy-information trade off.Comment: 6 pages, 1 figur

Outcome reporting in therapeutic mammaplasty: a systematic review

Background Therapeutic mammaplasty (TM) is an oncological procedure which combines tumour resection with breast reduction and mastopexy techniques. Previous systematic reviews have demonstrated the oncological safety of TM but reporting of critically important outcomes such as quality of life, aesthetic and functional outcomes are limited, piecemeal or inconsistent. This systematic review aims to identify all outcomes reported in clinical studies of TM to facilitate development of a Core Outcome Set. Methods Medline, EMBASE, CINAHL and Web of Science were searched from inception to 5 August 2020. Included studies reported clinical outcomes following TM for adult women. Two authors independently screened articles for eligibility. Data was extracted regarding the outcome definition and classification type (e.g., oncologic, quality of life, etc), time of outcome reporting and measurement tools. Results Of 5709 de-duplicated records, 148 were included in the narrative synthesis. The majority of studies (n=102, 68.9 per cent) reported measures of survival and/or recurrence; approximately three-quarters (n=75, 73.5 per cent) had less than 5 years follow-up. Aesthetic outcome was reported in half of studies (n=75, 50.7 per cent) using mainly subjective, non-validated measurement tools. The time-point at which aesthetic assessment was conducted was highly variable, and only defined in 48 (64.0 per cent) studies and none included a pre-operative baseline for comparison. Few studies reported quality of life (n=30, 20.3 per cent), functional outcomes (n=5, 3.4 per cent) or resource use (n=28, 18.9 per cent). Conclusions Given the oncological equivalence of TM and mastectomy, treatment decisions are often driven by aesthetic and functional outcomes, which are infrequently and inconsistently reported with non-validated measurement tools. PROSPERO: CRD4202020036

Thermodynamical Cost of Accessing Quantum Information

Thermodynamics is a macroscopic physical theory whose two very general laws are independent of any underlying dynamical laws and structures. Nevertheless, its generality enables us to understand a broad spectrum of phenomena in physics, information science and biology. Recently, it has been realised that information storage and processing based on quantum mechanics can be much more efficient than their classical counterpart. What general bound on storage of quantum information does thermodynamics imply? We show that thermodynamics implies a weaker bound than the quantum mechanical one (the Holevo bound). In other words, if any post-quantum physics should allow more information storage it could still be under the umbrella of thermodynamics.Comment: 3 figure

Designing optimal discrete-feedback thermodynamic engines

Feedback can be utilized to convert information into useful work, making it an effective tool for increasing the performance of thermodynamic engines. Using feedback reversibility as a guiding principle, we devise a method for designing optimal feedback protocols for thermodynamic engines that extract all the information gained during feedback as work. Our method is based on the observation that in a feedback-reversible process the measurement and the time-reversal of the ensuing protocol both prepare the system in the same probabilistic state. We illustrate the utility of our method with two examples of the multi-particle Szilard engine.Comment: 15 pages, 5 figures, submitted to New J. Phy

Heat Transfer Operators Associated with Quantum Operations

Any quantum operation applied on a physical system is performed as a unitary transformation on a larger extended system. If the extension used is a heat bath in thermal equilibrium, the concomitant change in the state of the bath necessarily implies a heat exchange with it. The dependence of the average heat transferred to the bath on the initial state of the system can then be found from the expectation value of a hermitian operator, which is named as the heat transfer operator (HTO). The purpose of this article is the investigation of the relation between the HTOs and the associated quantum operations. Since, any given quantum operation on a system can be realized by different baths and unitaries, many different HTOs are possible for each quantum operation. On the other hand, there are also strong restrictions on the HTOs which arise from the unitarity of the transformations. The most important of these is the Landauer erasure principle. This article is concerned with the question of finding a complete set of restrictions on the HTOs that are associated with a given quantum operation. An answer to this question has been found only for a subset of quantum operations. For erasure operations, these characterizations are equivalent to the generalized Landauer erasure principle. For the case of generic quantum operations however, it appears that the HTOs obey further restrictions which cannot be obtained from the entropic restrictions of the generalized Landauer erasure principle.Comment: A significant revision is made; 33 pages with 2 figure

Discrete Symmetries and Generalized Fields of Dyons

We have studied the different symmetric properties of the generalized Maxwell's - Dirac equation along with their quantum properties. Applying the parity (\mathcal{P}), time reversal (\mathcal{T}), charge conjugation (\mathcal{C}) and their combined effect like parity time reversal (\mathcal{PT}), charge conjugation and parity (\mathcal{CP}) and \mathcal{CP}T transformations to varius equations of generalized fields of dyons, it is shown that the corresponding dynamical quantities and equations of dyons are invariant under these discrete symmetries. Abstract Key words- parity, time reversal, charge-conjugation, dyons Abstract PACS No.- 14.80 Hv