Reduction of the self-reference effect in younger and older adults

Relating information to the self improves memory. However, this self-reference effect (SRE) is typically studied through explicit self-judgments on individual trials. The current study assessed whether a self-referential mode of thought, induced through a writing task, also induced an SRE on a later task. The study also tested the effects of aging on the SRE, given that a long-lasting mnemonic strategy may be especially relevant for this group. Ninety-two younger adults and 60 older adults were assigned to different writing conditions and then completed an unrelated SRE task. Across younger and older adults, the classic SRE effect was observed in the narrative writing condition, reduced in the semantic self-reference condition, and further reduced in the episodic self-reference condition. These results support the induction of a self-referential mode of thought, but this mode does not enhance memory. The classic SRE effect can be reduced after thinking about the self by reflecting on autobiographical memories. Results argue for a single shared self-referential mechanism that can be accessed through self-focused writing or the classic SRE task

A Self-Reference False Memory Effect in the DRM Paradigm: Evidence from Eastern and Western Samples

It is well established that processing information in relation to oneself (i.e., selfreferencing) leads to better memory for that information than processing that same information in relation to others (i.e., other-referencing). However, it is unknown whether self-referencing also leads to more false memories than other-referencing. In the current two experiments with European and East Asian samples, we presented participants the Deese-Roediger/McDermott (DRM) lists together with their own name or other people’s name (i.e., “Trump” in Experiment 1 and “Li Ming” in Experiment 2). We found consistent results across the two experiments; that is, in the self-reference condition, participants had higher true and false memory rates compared to those in the other-reference condition. Moreover, we found that selfreferencing did not exhibit superior mnemonic advantage in terms of net accuracy compared to other-referencing and neutral conditions. These findings are discussed in terms of theoretical frameworks such as spreading activation theories and the fuzzytrace theory. We propose that our results reflect the adaptive nature of memory in the sense that cognitive processes that increase mnemonic efficiency may also increase susceptibility to associative false memories

The self-reference effect in dementia: Differential involvement of cortical midline structures in Alzheimer’s disease and behavioural-variant frontotemporal dementia

Encoding information in reference to the self enhances subsequent memory for the source of this information. In healthy adults, self-referential processing has been proposed to be mediated by the cortical midline structures (CMS), with functional differentiation between anterior-ventral, anterior-dorsal and posterior regions. While both Alzheimer’s disease (AD) and behavioural-variant frontotemporal dementia (bvFTD) patients show source memory impairment, it remains unclear whether they show a typical memory advantage for self-referenced materials. We also sought to identify the neural correlates of this so-called ‘self-reference effect’ (SRE) in these patient groups. The SRE paradigm was tested in AD (n=16) and bvFTD (n=22) patients and age-matched healthy controls (n=17). In this task, participants studied pictures of common objects paired with one of two background scenes (sources) under self-reference or other-reference encoding instructions, followed by an item and source recognition memory test. Voxel-based morphometry was used to investigate correlations between SRE measures and regions of grey matter atrophy in the CMS. The behavioural results indicated that self-referential encoding did not ameliorate the significant source memory impairments in AD and bvFTD patients. Furthermore, the reduced benefit of self-referential relative to other-referential encoding was not related to general episodic memory deficits. Our imaging findings revealed that reductions in the SRE were associated with atrophy in the anterior-dorsal CMS across both patient groups, with additional involvement of the posterior CMS in AD and anterior-ventral CMS in bvFTD. These findings suggest that although the SRE is comparably reduced in AD and bvFTD, this arises due to impairments in different subcomponents of self-referential processing

High School Teachers' Experiences with Employment Mobility

This record of study was a sequential quan-QUAL mixed methods study that followed a case-selection explanatory sequential mixed methods research design to understand the employment mobility experiences of teachers on a small, rural high school campus. A descriptive survey instrument was used to gain background knowledge on high school teachers’ experiences and as a means through which to determine participants for the qualitative phase of the study. In the qualitative phase of the study, I conducted semi-structured interviews with three teachers who elaborated on the factors that impacted their decisions to leave prior employment positions, factors that impacted their decisions to accept their current teaching role, and the strengths and limitations of their current employment situation. Common responses to factors impacting high school teachers’ employment decisions included: geographic location, the support of campus administration, salary, family, student discipline, burnout/stress, and personal connections with current employees. Based on the data analysis, I created a employment brochure for the high school that campus administrators will use during recruiting events

Contrasting prefrontal cortex contributions to episodic memory dysfunction in behavioural variant frontotemporal dementia and alzheimer's disease

Recent evidence has questioned the integrity of episodic memory in behavioural variant frontotemporal dementia (bvFTD), where recall performance is impaired to the same extent as in Alzheimer's disease (AD). While these deficits appear to be mediated by divergent patterns of brain atrophy, there is evidence to suggest that certain prefrontal regions are implicated across both patient groups. In this study we sought to further elucidate the dorsolateral (DLPFC) and ventromedial (VMPFC) prefrontal contributions to episodic memory impairment in bvFTD and AD. Performance on episodic memory tasks and neuropsychological measures typically tapping into either DLPFC or VMPFC functions was assessed in 22 bvFTD, 32 AD patients and 35 age- and education-matched controls. Behaviourally, patient groups did not differ on measures of episodic memory recall or DLPFC-mediated executive functions. BvFTD patients were significantly more impaired on measures of VMPFC-mediated executive functions. Composite measures of the recall, DLPFC and VMPFC task scores were covaried against the T1 MRI scans of all participants to identify regions of atrophy correlating with performance on these tasks. Imaging analysis showed that impaired recall performance is associated with divergent patterns of PFC atrophy in bvFTD and AD. Whereas in bvFTD, PFC atrophy covariates for recall encompassed both DLPFC and VMPFC regions, only the DLPFC was implicated in AD. Our results suggest that episodic memory deficits in bvFTD and AD are underpinned by divergent prefrontal mechanisms. Moreover, we argue that these differences are not adequately captured by existing neuropsychological measures

The Perceived Importance of Same-Sex Mentors in Academic Medicine

As medicine diversifies, the importance of peer-based mentorship is often cited as the driving force behind inspiring women to enter surgical specialties. This driving force may be further influenced by the gender of the mentor, especially within male-dominated fields.There has remained a paucity of female representation in Orthopedic Surgery. Despite the proportion of females in the 2019 US medical student graduation class increasing to 48%, Orthopedic Surgery retains the lowest percentage of female residents of all surgical specialties (15% in 2019).This gender disparity can make it challenging for medical students and residents to find mentors/role models with whom they identify and from whom they can obtain the guidance to successfully navigate career choices and tackle potentially gender-nuanced situations

The Perceived Value of Same-Sex or Race Mentors and Role Models in Academic Medicine

Mentorship has been shown to play a large part in career development, program retention and workplace satisfaction. Previous studies have shed light on the importance of improving the representation of women and racial minorities among faculty mentors across several medical specialties. This is especially true in the field of surgery, where female and minority representation has been historically low. Women, for example, represent only 15% of orthopaedic surgery residents while racial/ethnic minorities account for 3% to 10% of US orthopaedic surgeons. Recognizing these continued disparities, our study aimed to describe the implication and perception of need for same-sex and same-race mentorship and role models at evolving stages of a medical career, from medical student to resident to attending physician and to explore if these differences affect specific career choices within the field of medicine

ACS Children’s Surgery Center Verification Improves Efficiency and Decreases Narcotic Administration in Treating Pediatric Trauma Patients

Purpose of Study: In 2015, the American College of Surgeons (ACS) created a new hospital designation to improve the efficiency and performance of care for children in American Children’s Hospitals. The Children’s Surgery Center (CSC) verification is achieved when a hospital system demonstrates excellence in its infrastructure and in its operations toward the pediatric-specific care of patients. Several important elements include 24-hour, 7-day a week availability of Pediatric surgical subspecialties, Pediatric Nursing, and Pediatric Anesthesia teams, access to pediatric beds, quality improvement programs, and hospital quality enhancements. Efficient care of pediatric femur fractures is representative of the highest level of care for pediatric trauma patients. The study was performed at one of six ACS pilot sites for the ACS CSC verification, to determine the designation’s effect in improving the efficiency of managing orthopaedic trauma patients. Methods Used: A retrospective analysis was performed on pediatric orthopaedic trauma patients with femur fractures treated at a busy, suburban academic center for two 5-year intervals before (2010-2014) and after (2015-2019) the implementation of policies and enhanced infrastructure designed to meet the guidelines for ACS verification of a Children’s Surgery Center. For each patient, efficiency parameters defined as total narcotic administration (in morphine equivalents), time from admission to surgery, duration of surgery, time from wound closure to exit time in OR, and duration of hospital stay were compared between time periods. Welch’s t-test was used to compare normative data.Summary of Results: Of 287 traumatic femur fractures analyzed, 94 (32.75%) occurred before the implementation of policies meeting ACS CSC criteria and 193 (67.24%) occurred after. The implementation of Pediatric-specific Orthopaedic care led to a 34.49% increase in referrals for femur fractures. Patients received less morphine equivalents in all time periods after ACS CSC verification – admission to OR entry (32.49 vs 21.78; p<0.01), OR exit to discharge (111.91 vs 60.08; p<0.01), and total duration of hospital stay (144.40 vs 81.87; p<0.01). In addition, patients treated within the first 24 hours of each 5-year interval demonstrated a decrease in mean wait time for surgery from admission (13.98 hours before and 11.08 hours after; p<0.01), and total length of hospital stay (101.25 hours before and 72.72 hours after; p<0.01). There was a marginal increase in duration of surgery (1.80 hours before and 2.10 after; p<0.05) and no significant change wait time from surgery closure to OR exit (0.24 hours before, 0.25 hours after; p=0.64).Conclusions: Implementing hospital infrastructure and policies requisite for ACS Children’s Surgery Certification is associated with increased efficiency and decreasing narcotic administration in treating Pediatric trauma patients by reducing narcotic administration throughout the entire hospital stay and decreasing the time elapsed from admission in the emergency department to the start time of surgery and overall time of hospitalization

Can Artificial Intelligence Fool Residency Selection Committees? Analysis of Personal Statements by Real Applicants and Generative AI, a Randomized, Single-Blind Multicenter Study.

INTRODUCTION: The potential capabilities of generative artificial intelligence (AI) tools have been relatively unexplored, particularly in the realm of creating personalized statements for medical students applying to residencies. This study aimed to investigate the ability of generative AI, specifically ChatGPT and Google BARD, to generate personal statements and assess whether faculty on residency selection committees could (1) evaluate differences between real and AI statements and (2) determine differences based on 13 defined and specific metrics of a personal statement. METHODS: Fifteen real personal statements were used to generate 15 unique and distinct personal statements from ChatGPT and BARD each, resulting in a total of 45 statements. Statements were then randomized, blinded, and presented to a group of faculty reviewers on residency selection committees. Reviewers assessed the statements by 14 metrics including if the personal statement was AI-generated or real. Comparison of all metrics was performed. RESULTS: Faculty correctly identified 88% (79/90) real statements, 90% (81/90) BARD, and 44% (40/90) ChatGPT statements. Accuracy of identifying real and BARD statements was 89%, but this dropped to 74% when including ChatGPT. In addition, the accuracy did not increase as faculty members reviewed more personal statements (area under the curve [AUC] 0.498, p = 0.966). BARD performed poorer than both real and ChatGPT across all metrics (p < 0.001). Comparing real with ChatGPT, there was no difference in most metrics, except for Personal Interests, Reasons for Choosing Residency, Career Goals, Compelling Nature and Originality, and all favoring the real personal statements (p = 0.001, p = 0.002, p < 0.001, p < 0.001, and p < 0.001, respectively). CONCLUSION: Faculty members accurately identified real and BARD statements, but ChatGPT deceived them 56% of the time. Although AI can craft convincing statements that are sometimes indistinguishable from real ones, replicating the humanistic experience, personal nuances, and individualistic elements found in real personal statements is difficult. Residency selection committees might want to prioritize these particular metrics while assessing personal statements, given the growing capabilities of AI in this arena. CLINICAL RELEVANCE: Residency selection committees may want to prioritize certain metrics unique to the human element such as personal interests, reasons for choosing residency, career goals, compelling nature, and originality when evaluating personal statements