Why 'scaffolding' is the wrong metaphor : the cognitive usefulness of mathematical representations.

The metaphor of scaffolding has become current in discussions of the cognitive help we get from artefacts, environmental affordances and each other. Consideration of mathematical tools and representations indicates that in these cases at least (and plausibly for others), scaffolding is the wrong picture, because scaffolding in good order is immobile, temporary and crude. Mathematical representations can be manipulated, are not temporary structures to aid development, and are refined. Reflection on examples from elementary algebra indicates that Menary is on the right track with his ‘enculturation’ view of mathematical cognition. Moreover, these examples allow us to elaborate his remarks on the uniqueness of mathematical representations and their role in the emergence of new thoughts.Peer reviewe

Hope for “Continued Vitality”: Qualitative Study of Adults With Traumatic Brain Injury and Low Mood on Their Rehabilitation

ObjectiveDepression is highly comorbid with traumatic brain injury (TBI) with often complex and interacting symptomology that contributes to the experience of disability. Comorbid depression results in poorer TBI rehabilitation and downstream participation outcomes yet perspectives of this group regarding person-centered care is unknown.PurposeThis study aimed to explicate the perspectives of persons with TBI and depression on their values, preferences, and desired outcomes for optimal rehabilitation.MethodsA qualitative descriptive approach was taken. Thirteen adults [mean age: 40.5 (standard deviation 9.8)] diagnosed with TBI and with self-reported low mood were recruited through convenience sampling. Participants were predominantly female (n = 12) with concussion/mild TBI and at least 6 months post-injury. One-on-one, semi-structured interviews were conducted by phone with Canadian participants (March-May 2020). Interviews were transcribed; data were analyzed thematically by two researchers and the thematic map refined by the research team.ResultsThree themes were identified on values, preferences, and desired outcomes in person-centered care. Participants valued “validation” from healthcare providers and the health system to feel seen and believed about their conditions and concerns. They preferred for healthcare providers to “share the burden of managing care” through improved interactions and better access to concussion care. Participants expressed that “meaningful outcomes” were to be symptom free, to resume valued life activities, and to be able to adapt/be resilient. The latter indicated hope for “continued vitality” for life participation despite past and ongoing challenges.ConclusionsMany adults with TBI and self-identified low mood expressed rehabilitation experiences that were invalidating. Their identified values, preferences, and desired outcomes provide directions for better person-centered care by healthcare providers and health systems to support participation

Insight out : making creativity visible

Models of creative problem solving are predicated upon mental states to explain everything from the outcome of problem‐solving experiments to the emergence of artistic creativity. We present two converging perspectives that describe a profoundly different ontological description of creativity. Our analysis proceeds from a distinction between first‐order problem solving, where the agent interacts with a physical model of the problem and second‐order problem solving, where the agent must cogitate a solution to a problem that is presented as a verbal description of a state of the world but where the agent does not or cannot transform physical elements of a problem. We acknowledge the recent evidence that foregrounds the importance of working memory in problem solving, including insight problem solving. However, we stress that the impressive psychometric success is obtained with a methodology that only measures second‐order problem solving; we question whether first‐order problem solving is equally well predicted by measures of cognitive or dispositional capacities. We propose that if mental simulation is replaced by the opportunity to engage with a physical model of a problem then the environment can provide affordances that help the participant to solve problems. In the second part of the paper, we present the subjective experience of an artist as he monitors the microdecisions that occur during the morphogenesis of a large, clay, sculptural installation. The testimony is a vivid demonstration that creative action occurs, not in the brain, but in the movement between the hand and the clay. Insight becomes outsight

Clinical Justification for Preliminary Thermal Exposure to Composite in the Treatment of Caries: Randomized Clinical Trial

Background. Polymer composites have good aesthetic characteristics and pronounced physicochemical properties, as compared to traditional restorative materials such as amalgam. However, the polymerization reaction of composite material containing bismethacrylate group commonly used in clinical practice is always accompanied by a different degree of volumetric shrinkage (2.7%~7.1%). The resulting stress can lead to adhesion failure and some other unfavorable clinical consequences, such as enamel destruction, microcracking of composite material and formation of microleakage between composite and tooth cavity wall, which can result in recurrent caries and postoperative sensitivity, thereby affecting the long-term effect of restoration. Therefore, studying the effect of preheating on composite restoration is important for its clinical application. Objective. To improve the effectiveness of treatment of patients with dental caries by improving the physicochemical properties of composite restorations.Methods. A randomized clinical trial enrolled 180 patients aged 18 to 45 years, diagnosed with dentin caries class I, according to Black (K02.1 in ICD). The study was conducted in the Dental Clinic of Kuban State Medical University, Russia. 180 composite restorations were performed in the treatment of dentin caries of molars. Patients were randomized into 2 groups): the control group — 90 patients and the main group — 90 patients. The control and main groups, in turn, were divided into three subgroups, depending on the composite used — Estelite Sigma Quick (Tokuyama Dental, Japan), Filtek Bulk Fill Posterior Restorative (3M Espe, USA) and DentLight (VladMiVa, Russia). Each subgroup consisted of 30 patients. In the control group, the classical method of filling with a composite material at “room temperature” was applied. In the main group, a composite heating conditioner “Ena Heat” (Micerium, Italy) was used to heat the composite to 55 °C before adapting the material in the formed cavity with subsequent photopolymerization. The quality of composite restorations within the clinical study was evaluated using the modified Ryge criterion immediately after treatment and after 6, 12, 18, 24 months. Statistical processing of the obtained data was carried out by means of one-factor analysis of variance using the GraphPadPrism 9 program (GraphPad Software, USA).Results. The duration of the clinical study comprised 24 months. The study revealed a statistically significant decrease in the quality of marginal fit of composite restorations (according to the Ryge score) by 20.1% (p = 0.0001) in the control group and by 5.7% (p = 0.0328) in the main group.  At the same time, no statistically significant changes in Ryge scores were reported in the subgroups of composite materials of the main group (pF = 0.9480, pE = 0.1837, pD = 0.2529). As a result of the study, an optimal time algorithm (7 seconds) for using a special furnace for preheating the composite before sealing with subsequent photopolymerization was obtained.Conclusion. The study revealed a statistically significant positive effect of the proposed algorithm for working with a heated composite on the quality of marginal fit in the long term after treatment in comparison with the classical method of working with a composite at “room temperature”

Diagnostic Algorithm for Joint Pain in Patients with Inflammatory Bowel Disorders

Aim. An algorithm development for joint pain differential diagnosis in patients with inflammatory bowel disorders (IBD) and its validation in clinical practice.Materials and methods. A total of 349 IBD patients hospitalised for gastroenterological complaints at the Chelyabinsk Regional Clinical Hospital during 2017–2020 have been examined.Results. Upon survey, 97 (27.8%) IBD patients complained of joint pain. Ulcerative colitis (UC) predominated (79 patients; 81.4%), Crohn’s disease (CD) had a 18.6% incidence. In survey, 27% UC and 32.1% CD patients reported joint pain (p = 0.26). Among IBD patients, 52.6% had mechanical, and 47.4% — inflammatory pain. The inflammatory back pain (IBP) rate in survey cohort was 23.7%. Use of a diagnostic algorithm allowed concomitant rheumatic disease detection in 7 (7.2%) patients from the IBD–joint pain cohort: 2 patients were diagnosed with psoriatic spondyloarthritis, 2 — rheumatoid arthritis, 1 — gout and 2 — with ankylosing spondylitis. IBD-associated arthritis was diagnosed in 41 (42.3%) cases, osteoarthritis — in 38 (39.2%) IBD patients with joint pain, arthralgia with no objective inflammation, impaired joint function or lesions in X-ray and/or ultrasound — in 13 (13.4%) patients.Conclusion. Joint pain complaints are common in IBD patients and require a multispecialty rheumatologists-involving approach to proceed with differential diagnosis and opting for treatment tactics. A clinically verified algorithm coupled with laboratory tests and instrumental imaging facilitates diagnosis and optimal therapy selection in IBD patients with complaints of joint pain

Aspirin but not ibuprofen use is associated with reduced risk of prostate cancer: a PLCO study.

Background: Although most epidemiological studies suggest that non-steroidal anti-inflammatory drug use is inversely associated with prostate cancer risk, the magnitude and specificity of this association remain unclear. Methods: We examined self-reported aspirin and ibuprofen use in relation to prostate cancer risk among 29 450 men ages 55–74 who were initially screened for prostate cancer from 1993 to 2001 in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. Men were followed from their first screening exam until 31 December 2009, during which 3575 cases of prostate cancer were identified. Results: After adjusting for potential confounders, the hazard ratios (HRs) of prostate cancer associated with \u3c1 and 1 pill of aspirin daily were 0.98 (95% confidence interval (CI), 0.90–1.07) and 0.92 (95% CI: 0.85–0.99), respectively, compared with never use (P for trend 0.04). The effect of taking at least one aspirin daily was more pronounced when restricting the analyses to men older than age 65 or men who had a history of cardiovascular-related diseases or arthritis (HR (95% CI); 0.87 (0.78–0.97), 0.89 (0.80–0.99), and 0.88 (0.78–1.00), respectively). The data did not support an association between ibuprofen use and prostate cancer risk. Conclusion: Daily aspirin use, but not ibuprofen use, was associated with lower risk of prostate cancer risk

Debris disks as signposts of terrestrial planet formation. II Dependence of exoplanet architectures on giant planet and disk properties

We present models for the formation of terrestrial planets, and the collisional evolution of debris disks, in planetary systems that contain multiple unstable gas giants. We previously showed that the dynamics of the giant planets introduces a correlation between the presence of terrestrial planets and debris disks. Here we present new simulations that show that this connection is qualitatively robust to changes in: the mass distribution of the giant planets, the width and mass distribution of the outer planetesimal disk, and the presence of gas in the disk. We discuss how variations in these parameters affect the evolution. Systems with equal-mass giant planets undergo the most violent instabilities, and these destroy both terrestrial planets and the outer planetesimal disks that produce debris disks. In contrast, systems with low-mass giant planets efficiently produce both terrestrial planets and debris disks. A large fraction of systems with low-mass outermost giant planets have stable gaps between these planets that are frequently populated by planetesimals. Planetesimal belts between outer giant planets may affect debris disk SEDs. If Earth-mass seeds are present in outer planetesimal disks, the disks radially spread to colder temperatures. We argue that this may explain the very low frequency of > 1 Gyr-old solar-type stars with observed 24 micron excesses. Among the (limited) set of configurations explored, the best candidates for hosting terrestrial planets at ~1 AU are stars older than 0.1-1 Gyr with bright debris disks at 70 micron but with no currently-known giant planets. These systems combine evidence for rocky building blocks, with giant planet properties least likely to undergo destructive dynamical evolution. We predict an anti-correlation between debris disks and eccentric giant planets, and a positive correlation between debris disks and terrestrial planets.Comment: Astronomy and Astrophysics, in press. Movies from simulations are at http://www.obs.u-bordeaux1.fr/e3arths/raymond/movies_debris.htm

Towards an approach for analysing external representations created during sensemaking using generative grammar

During sensemaking, users often create external representations to help them make sense of what they know, and what they need to know. In doing so, they necessarily adopt or construct some form of representational language using the tools at hand. By describing such languages implicit in representations we believe that we are better able to describe and differentiate what users do and better able to describe and differentiate interfaces that might support them. Drawing on approaches to the analysis of language, and in particular, Mann and Thompson’s Rhetorical Structure Theory, we analyse the representations that users create to expose their underlying ‘visual grammar’. We do this in the context of a user study involving evidential reasoning. Participants were asked to address an adapted version of IEEE VAST 2011 mini challenge 3 (interpret a potential terrorist plot implicit in a set of news reports). We show how our approach enables the unpacking of the heterogeneous and embedded nature of user-generated representations and allows us to show how visual grammars evolve and become more complex over time in response to evolving sensemaking needs