Construct Validity of Simulation Model for Training the Ultrasound-Guided Nerve Block and Catheter Placement

Background: Continuous ultrasound-guided peripheral nerve block is a widely practiced technique that can be a challenge for young anesthesiologists. We developed a new simulation model for learning perineural catheter placement. This study aims to test the validity of the model and investigate the learning process of residents on this model. Methods: The simulation model was constructed with partial animal tissue and physical materials. Ultrasound-guided simulation of perineural catheter placement was then performed. Twenty-eight anesthesiologists representing novices, intermediates and experts were required to perform 30 trials within one single day. Practice trials were video-recorded to extract data of task time and performance errors. Construct validity were assessed. Results: Practicing on the simulation model, experts were able to achieve superior task performance, i.e., shorter task time (P < 0.001) and fewer performance errors (P < 0.001), than intermediates and novices. Learning curve recorded from young residents suggested that they were not able to reach the proficiency level as experts within one training day. Conclusions: This hybrid simulation model was capable of training the skills required for continuous ultrasound-guided peripheral nerve block. Future studies under this model need to concern extending the duration of the training phase for residents.

A Spanish Neuropsychological Battery Discriminates Between the Behavioral Variant of Frontotemporal Dementia and Primary Progressive Aphasia in a Colombian Sample

The differential diagnosis among the behavioral variant of frontotemporal dementia FTD (bvFTD) and the linguist one primary progressive aphasia (PPA) is challenging. Presentations of dementia type or variants dominated by personality change or aphasia are frequently misinterpreted as psychiatric illness, stroke, or other conditions. Therefore, it is important to identify cognitive tests that can distinguish the distinct FTD variants to reduce misdiagnosis and best tailor interventions. We aim to examine the discriminative capacity of the most frequently used cognitive tests in their Spanish version for the context of dementia evaluation as well as the qualitative aspects of the neuropsychological performance such as the frequency and type of errors, perseverations, and false positives that can best discriminate between bvFTD and PPA. We also described mood and behavioral profiles of participants with mild to moderate probable bvFTD and PPA. A total of 55 subjects were included in this cross-sectional study: 20 with PPA and 35 with bvFTD. All participants underwent standard dementia screening that included a medical history and physical examination, brain MRI, a semistructured caregiver interview, and neuropsychological testing. We found that bvFTD patients had worse performance in executive function tests, and the PPA presented with the lower performance in language tests and the global score of Mini-Mental State Examination (MMSE). After running the linear discriminant model, we found three functions of cognitive test and subtests combination and three functions made by the Montreal Cognitive Assessment (MoCA) language subtest and performance errors that predicted group belonging. Those functions were more capable to classify bvFTD cases rather than PPA. In conclusion, our study supports that the combination of an individual test of executive function and language, MoCA's subtest, and performance errors as well have good accuracy to discriminate between bvFTD and PPA.

Mistaking an Intention for a Behavior: The Case of Enacting Behavioral Decisions Versus Simply Intending to Enact Them

Five experiments investigated a previously unrecognized phenomenon—remembering that one enacted a mundane behavioral decision when one only intended to do so—and its psychological mechanisms. The theoretical conceptualization advanced in this research proposes that this error stems from a misattribution when an intention and a behavior are similar. Intentions and behaviors are similar when the physical aspects of the behavior resemble the intention (e.g., both require similar keystrokes) and when the behavior and the intention share mental contents (e.g., both rely on the same criterion). Experiments 1 and 2 introduced a paradigm with similar intentions and enactments and showed misreports and subsequent performance errors even when controlling for guessing. Experiments 3 and 4 demonstrated greater confusion when the physical involvement and mental criteria for intention and behavior were similar. Finally, Experiment 5 indicated that monitoring enactment is highly effective at reducing this error and more effective than monitoring intention.

Medical Liability of Residents in Taiwan Criminal Court: An Analysis of Closed Malpractice Cases

Objective. By analyzing closed criminal malpractice claims involving resident physicians, we aimed to clarify the characteristics of litigations and examine the litigious errors leading to guilty verdicts. Design. A retrospective descriptive study. Setting/Study Participants. The verdicts pertaining to physicians recorded on the national database of the Taiwan justice system were reviewed. Main Outcome Measures. The characteristics of litigations were documented. Negligence and guilty verdicts were further analyzed to identify litigious errors. Results. Between January 1, 2000, and December 31, 2014, from a total of 436 closed criminal malpractice cases, 40 included resident physicians. Five (12.5%) cases received guilty verdicts with mean imprisonment sentences of 5.4 ± 4.1 months. An average of 77.2 months was required for the final adjudication, and surgery residents were involved most frequently (38.9%). Attending physicians were codefendants in 82.5% of cases and were declared guilty in 60% of them. Sepsis (37.5%) was the most common disease in the 40 cases examined, followed by operation/procedure complications (25%). Performance errors (70%) were more than twice as common than diagnostic errors (30%), but the percentage of guilty verdicts in performance error cases was much lower (7.1% vs. 25%). Four negligence cases received nonguilty verdicts, which were mostly due to lack of causation. Conclusion. Closed criminal malpractice cases involving residents took on average 6.22 years to conclude. Performance errors accounted for 70% of cases, with treatment of sepsis and operation/procedure complications predominant. To reduce medicolegal risk, residents should learn experiences from analyzing malpractice cases to avoid similar litigious pitfalls.

Implementasi Metode Prototyping pada Perancangan Aplikasi Electronic Ticket (E-Ticket) berbasis Android

Public transportation is currently starting to experience very rapid development. This development is due to the increasing public demand for safety and comfort on the journey. Presentation of bus ticket availability information at this time is still manual, so potential users must come to the agent to find out the availability of tickets and make ticket reservations so that it is not uncommon if there are users who run out of bus tickets because the user does not get information directly. To facilitate prospective users in booking tickets and searching for bus departure information, an Android-based bus ticket booking application was built. This application was designed using MySQL, Adobe Dreamweaver and Android Studio. The system development method used in this study is the prototyping method. As for the testing method using BlackBox Testing. This method is used to find out if there are performance errors on the system. The purpose of this application is to make it easy for prospective bus users to search for buses and order tickets so they can be done anywhere and anytime without being bound by time and place.

Adaptive rescheduling of error monitoring in multitasking

The concurrent execution of temporally overlapping tasks leads to considerable interference between the subtasks. This also impairs control processes associated with the detection of performance errors. In the present study, we investigated how the human brain adapts to this interference between task representations in such multitasking scenarios. In Experiment 1, participants worked on a dual-tasking paradigm with partially overlapping execution of two tasks (T1 and T2), while we recorded error-related scalp potentials. The error positivity (Pe), a correlate of higher-level error evaluation, was reduced after T1 errors but occurred after a correct T2-response instead. MVPA-based and regression-based single-trial analysis revealed that the immediate Pe and deferred Pe are negatively correlated, suggesting a trial-wise trade-off between immediate and postponed error processing. Experiment 2 confirmed this finding and additionally showed that this result is not due to credit-assignment errors in which a T1 error is falsely attributed to T2. For the first time reporting a Pe that is temporally detached from its eliciting error event by a considerable amount of time, this study illustrates how reliable error detection in dual-tasking is maintained by a mechanism that adaptively schedules error processing, thus demonstrating a remarkable flexibility of the human brain when adapting to multitasking situations.Significance StatementMultitasking situations are associated with impaired performance, as the brain needs to allocate resources to more than one task at a time. This also makes it more difficult to detect one’s own performance errors in such complex scenarios. In two experiments, we recorded error-related electroencephalographic (EEG) activity and found that the commonly assumed fixed temporal succession of control processes in error monitoring can be strategically interrupted. Individual processes of error detection can be temporally rescheduled to after completion of competing tasks. This reduces interference between the neural task representations and supports a more efficient execution of concurrent tasks in multitasking.

From Live Music to Electronic Offerings

Distribution of music via recordings and broadcasts has been a lively activity for well over a century. The value for music is immense, but this is a symbiotic process, where the musical demands spawned the invention of electronic amplifiers, microphones, speakers, and onward to all modern electronics. The original aim was to make a faithful recording of a performance. In reality, this is impossible because the conditions for listening are always different from the original performance. The musical data and reproduction are modified by every aspect of the electronics, and the way in which sound engineers and marketing companies handle the music. There may be advantages in that performance errors can be corrected, balance between instruments adjusted, or the pop music autotune which corrects the pitch. This chapter considers many aspects of current and future sound processing.