The Preservation of Cued Recall in the Acute Mentally Fatigued State: A Randomised Crossover Study.

The objective of this study is to investigate the impact of acute mental fatigue on the recall of clinical information in the non-sleep-deprived state. Acute mental fatigue in the non-sleep-deprived subject is rarely studied in the medical workforce. Patient handover has been highlighted as an area of high risk especially in fatigued subjects. This study evaluates the deterioration in recall of clinical information over 2 h with cognitively demanding work in non-sleep-deprived subjects.A randomised crossover study involving twenty medical students assessed free (presentation) and cued (MCQ) recall of clinical case histories at 0 and 2 h under low and high cognitive load using the N-Back task. Acute mental fatigue was assessed through the Visual Analogue Scale, Stanford Scale and NASA-TLX Mental Workload Rating Scale.Free recall is significantly impaired by increased cognitive load (p < 0.05) with subjects demonstrating perceived mental fatigue during the high cognitive load assessment. There was no significant difference in the amount of information retrieved by cued recall under high and low cognitive load conditions (p = 1).This study demonstrates the loss of clinical information over a short time period involving a mentally fatiguing, high cognitive load task. Free recall for the handover of clinical information is unreliable. Memory cues maintain recall of clinical information. This study provides evidence towards the requirement for standardisation of a structured patient handover. The use of memory cues (involving recognition memory and cued recall methodology) would be beneficial in a handover checklist to aid recall of clinical information and supports evidence for their adoption into clinical practice

Serum antioxidants as predictors of the adult respiratory distress syndrome in septic patients

Adult respiratory distress syndrome (ARDS) can develop as a complication of various disorders, including sepsis, but it has not been possible to identify which of the patients at risk will develop this serious disorder. We have investigated the ability of six markers, measured sequentially in blood, to predict development of ARDS in 26 patients with sepsis. At the initial diagnosis of sepsis (6-24 h before the development of ARDS), serum manganese superoxide dismutase concentration and catalase activity were higher in the 6 patients who subsequently developed ARDS than in 20 patients who did not develop ARDS. These changes in antioxidant enzymes predicted the development of ARDS in septic patients with the same sensitivity, specificity, and efficiency as simultaneous assessments of serum lactate dehydrogenase activity and factor VIII concentration. By contrast, serum glutathione peroxidase activity and α1Pi-elastase complex concentration did not differ at the initial diagnosis of sepsis between patients who did and did not subsequently develop ARDS, and were not as effective in predicting the development of ARDS. Measurement of manganese superoxide dismutase and catalase, in addition to the other markers, should facilitate identification of patients at highest risk of ARDS and allow prospective treatment

Can fully automated detection of corticospinal tract damage be used in stroke patients?

We compared manual infarct definition, which is time-consuming and open to bias, with an automated abnormal tissue detection method in measuring corticospinal tract-infarct overlap volumes in chronic stroke patients to help predict motor outcome

The International Pilot Study of Schizophrenia: five-year follow-up findings

A five-year follow-up of the patients initially included in the International Pilot Study of Schizophrenia was conducted in eight of the nine centres. Adequate information was obtained for 807 patients, representing 76% of the initial cohort. Clinical and social outcomes were significantly better for patients in Agra and Ibadan than for those in the centres in developed countries. In Cali, only social outcome was significantly bette

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

Stochastic Energetics of Quantum Transport

We examine the stochastic energetics of directed quantum transport due to rectification of non-equilibrium thermal fluctuations. We calculate the quantum efficiency of a ratchet device both in presence and absence of an external load to characterize two quantifiers of efficiency. It has been shown that the quantum current as well as efficiency in absence of load (Stokes efficiency) is higher as compared to classical current and efficiency, respectively, at low temperature. The conventional efficiency of the device in presence of load on the other hand is higher for a classical system in contrast to its classical counterpart. The maximum conventional efficiency being independent of the nature of the bath and the potential remains the same for classical and quantum systems.Comment: To be published in Phys. Rev.

Safety of tattoos in persons undergoing MRI

In 330 persons who had one to seven tattoos, only one mild tattoo-related adverse reaction was detected during magnetic resonance imaging (MRI). These results suggest a low risk among persons with tattoos when MRI is performed under these specific study conditions

Langevin dynamics with dichotomous noise; direct simulation and applications

We consider the motion of a Brownian particle moving in a potential field and driven by dichotomous noise with exponential correlation. Traditionally, the analytic as well as the numerical treatments of the problem, in general, rely on Fokker-Planck description. We present a method for direct numerical simulation of dichotomous noise to solve the Langevin equation. The method is applied to calculate nonequilibrium fluctuation induced current in a symmetric periodic potential using asymmetric dichotomous noise and compared to Fokker-Planck-Master equation based algorithm for a range of parameter values. Our second application concerns the study of resonant activation over a fluctuating barrier.Comment: Accepted in Journal of Statistical Mechanics: Theory and Experimen

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