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OBJECTIVE: A clear relationship between higher surgeon volume and improved outcomes has not been convincingly established in rectal cancer surgery. The aim of this study was to evaluate the impact of individual surgeon's caseload and hospital volume on perioperative outcome. METHODS: We retrospectively analyzed 336 consecutive patients undergoing oncological resection for rectal cancer at two Viennese hospitals between 1 January 2015 and 31 December 2020. The effect of baseline characteristics as well as surgeons' caseloads (low volume: 0-5 cases per year, high volume >â¯5 cases per year) on postoperative complication rates (Clavien-Dindo Classification groups of <â¯3 and ≥â¯3) were evaluated. RESULTS: No differences in baseline characteristics were found between centers in terms of sex, smoking status, or comorbidities of patients. Interestingly, only 14.7% of surgeons met the criteria to be classified as high-volume surgeons, while accounting for 66.3% of all operations. There was a significant difference in outcomes depending on the treating center in univariate and multivariate binary logistic regression analysis (odds ratio (OR)â¯= 2.403, pâ¯= 0.008). Open surgery was associated with lower complication rates than minimally invasive approaches in univariate analysis (ORâ¯= 0.417, pâ¯= 0.003, 95%CIâ¯= 0.232-0.739) but not multivariate analysis. This indicated that the center's policy rather than surgeon volume or mode of surgery impact on postoperative outcomes. CONCLUSION: Treating center standards impacted on outcome, while individual caseload of surgeons or mode of surgery did not independently affect complication rates in this analysis. The majority of rectal cancer resections are performed by a small number of surgeons in Viennese hospitals.
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Motor learning is often viewed as a unitary process that operates outside of conscious awareness. This perspective has led to the development of sophisticated models designed to elucidate the mechanisms of implicit sensorimotor learning. In this review, we argue for a broader perspective, emphasizing the contribution of explicit strategies to sensorimotor learning tasks. Furthermore, we propose a theoretical framework for motor learning that consists of three fundamental processes: reasoning, the process of understanding action-outcome relationships; refinement, the process of optimizing sensorimotor and cognitive parameters to achieve motor goals; and retrieval, the process of inferring the context and recalling a control policy. We anticipate that this '3R' framework for understanding how complex movements are learned will open exciting avenues for future research at the intersection between cognition and action.
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Aprendizaje , Humanos , Aprendizaje/fisiología , Cognición/fisiología , Desempeño Psicomotor/fisiologíaRESUMEN
The Asia-Pacific region has had decades of progress in reducing malaria cases and deaths. The region is now accelerating its efforts towards malaria elimination by 2030 using a science-based approach by applying evidence-based best practices alongside existing tools. However, there are concerns of knowledge gaps and external factors challenging this goal. The COVID-19 pandemic served as reminder of the need for a holistic approach. This report summarizes the outcomes of the discussions from the "Asia Pacific Conference on Mosquito and Vector Control" held in Chiang Mai, Thailand from 27 to 30 November, 2023. The conference aims to provide insights into recent research, cutting-edge tools, and the strength of the Asia-Pacific regional mosquito and vector control capacity post-COVID-19 pandemic era. The conference featured discussions on mosquito surveillance, monitoring and control; enabling the resolution of local problems with local expertise and forging new partnerships; and exploring recent research advancements in vector control strategies. More than 500 experts from 55 countries attended.
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Control de Mosquitos , Mosquitos Vectores , Control de Mosquitos/métodos , Animales , Humanos , Asia , Malaria/prevención & control , COVID-19/prevención & control , COVID-19/epidemiología , Congresos como AsuntoRESUMEN
During the Trump administration it was widely asserted in the news media that the administration's agency appointees were less professional than appointees from previous administrations. Using qualitative data from 35 interviews with lobbyists, congressional staffers, and executive branch officials, and quantitative and qualitative data on years of relevant experience and job type at the date of nomination, it is demonstrated that indeed the Trump administration attracted less talent than the Obama and Biden administrations, which resulted in less supply and demand for expertise and thus a diminished role of expertise in the policymaking process.
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Objectives: The cognitive expertise of experts has been an intriguing theme; there has been rapid growth in cognitive research related to esports. Given the close association between esports activities and cognition, esports holds promise in offering new perspectives for understanding cognitive expertise. This meta-analysis aims at quantitatively delineating the cognitive disparities between esports experts and amateurs. Methods: The expert group comprised professional video game players and high-ranking players (top 1%), while amateurs were assigned to the control group. Research studies published between January 2000 and December 2023 were systematically searched in databases. A three-level model with cluster-robust variance estimation was used to calculate the overall effect size. The moderating variables included professional level, cognitive abilities, dependent variable type, game genre, gender and age. Results: A total of 15 studies containing 142 effect sizes and 1085 participants were included in this meta-analysis. The results indicated that, compared to amateurs, video game experts demonstrated superior cognitive abilities with a small effect size (Hedges' g = 0.373, 95% CI [0.055-0.691], p = .012). The differences between experts and amateur players mainly manifest in spatial cognition and attention. Sensitivity analysis, risk of bias, and publication bias results indicated the reliability of these findings. Conclusions: This meta-analysis confirms that esports experts possess superior cognitive abilities compared to amateurs, particularly in aspects of spatial cognition and attention. These can provide an effective reference for future selection and training in esports.
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Cognición , Juegos de Video , Humanos , Cognición/fisiología , Competencia ProfesionalRESUMEN
INTRODUCTION: Ophthalmology as a specialty is a pioneer in the area of telemedicine. Remote consultation represents one of the 5 types of telemedicine services, with a growing volume of activity in university hospitals. In November 2020, the ophthalmology department of Rennes University Medical Center launched its remote consultation network with the secured platform OMNIDOC. The goal of this study was to assess its contribution during its first year of use. MATERIALS AND METHODS: Beginning in November 2020, ophthalmology consults at Rennes University Medical Center were directed towards the dedicated OMNIDOC network. Three-hundred and forty-one requests for remote consultation were received and analyzed between November 2020 and October 2021. We sent a satisfaction survey to both the requesting and consultant physicians to assess whether or not the network was beneficial. RESULTS: Three-hundred and twenty-seven remote consultations requested by 126 practitioners were included in the study. The median response time was 6hours. Every field of the specialty was involved, of which 22.3% were for pediatric patients under 6years of age. Among the requests, 89.7% were regional (Brittany) and came mostly from ophthalmologists (61.77%). Nearly one out of two patients did not require an in-person consultation at Rennes University Medical Center. DISCUSSION: The implementation of a remote consultation network allowed access to a rapid, facilitated medical ophthalmology consultation. Such a platform delivers safety and traceability of the interactions. It enhances and optimizes the patients' care pathway and encourages relationships with community physicians.
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Anticipation is key to performance in many sports. By definition, anticipation as a perceptual-cognitive process is meant to inform action and help athletes reduce potential motor costs under spatiotemporal pressure. Anticipation research has repeatedly been criticized for neglecting action and raised the need for predominant testing under conditions of perception-action coupling (PAC). To the best of our knowledge, however, there is a lack of explicit criteria to characterize and define PAC conditions. This can lead to blurred terminology and may complicate interpretation and comparability of PAC conditions and results across studies. Here, we make a first proposal for a 7-level classification of PAC conditions with the defining dimensions of stimulus presentation and response mode. We hope this classification may constitute a helpful orientation for study planning and reporting in research on anticipation. Further, we illustrate the potential utilization of the PAC classification as a template for experimental protocol analysis in a review on anticipation in racket sports. Analysis of N = 115 studies reported in N = 91 articles confirms an underrepresentation of representative PAC conditions and reveals little change in PAC approaches over more than 40 years of research in that domain. We discuss potential reasons for these findings, the benefits of adopting the proposed PAC classification and reiterate the call for more action in anticipation research.
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In this work, we investigate the impact of annotation quality and domain expertise on the performance of Convolutional Neural Networks (CNNs) for semantic segmentation of wear on titanium nitride (TiN) and titanium carbonitride (TiCN) coated end mills. Using an innovative measurement system and customized CNN architecture, we found that domain expertise significantly affects model performance. Annotator 1 achieved maximum mIoU scores of 0.8153 for abnormal wear and 0.7120 for normal wear on TiN datasets, whereas Annotator 3 with the lowest expertise achieved significantly lower scores. Sensitivity to annotation inconsistencies and model hyperparameters were examined, revealing that models for TiCN datasets showed a higher coefficient of variation (CV) of 16.32% compared to 8.6% for TiN due to the subtle wear characteristics, highlighting the need for optimized annotation policies and high-quality images to improve wear segmentation.
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When it comes to health-related information-seeking behavior, online communities play a key role for some groups, such as parents. With a case study of online communities in a loosely organized vaccination system, that of Austria, we study how parents make use of a prominent online forum (parents.at) in their vaccination trajectories and situate this analysis in its socio-political context. Based on inductive qualitative analysis of relevant threads (n = 27), we find that parents use forums in three ways: First, the forum serves as a platform through which parents seek orientation in a loosely organized and fragmented vaccination system. Second, the forum offers space for sharing, collecting, and evaluating different forms of expertise. In doing so, parents carve out a space in which they can comfortably put lay expertise and credentialed expertise on a par, particularly in their advice to peers. Third, and on that basis, parents use the forum for deliberating on future or past vaccination-related decisions. In doing so, they frequently draw on idiosyncratic notions of individual risks and benefits. These three practices enable parents to accumulate and share what we label navigational capital. We conclude that parents resort to online spaces both out of a subjective need and, for some, as a result of a dysfunction of the national childhood vaccination program which offers little orientation for parents.
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In 2009, the German Cancer Research Center (DKFZ) and the biopharmaceutical company Bayer AG initiated an academic-industry co-discovery collaboration. The partners combined their expertise in tumor biology and drug discovery to identify and validate novel targets for cancer treatment. In the early phase of the Alliance, the focus was on target identification and validation projects. Over time, both partners realized that they could also successfully collaborate on later stages of drug discovery. As a result over the past few years, and following several contract extensions, the two partners have collaborated on several late-stage drug discovery projects. This has resulted in the achievement of several drug discovery milestones and the initiation of early clinical trials, the most recent in 2022. This success has been possible thanks to both partners' understanding of each other's needs and challenges. They jointly developed solutions to issues such as the intrinsic potential conflict of early publishing versus patent protection. Both partners also appreciated the risks involved in some of the experiments, such as starting a joint laboratory for immune-therapy with scientists from both parties working bench-to-bench. Recently, despite these successes the partners decided to terminate the Alliance, as Bayer AG wants to focus its activities on the development of its late pipeline.
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With expertise, athletes develop motor strategies that enhance sports performance or reduce functional costs. Motor variability is known as a relevant way to characterize these strategies in athletes with different levels of expertise. The aim of this scoping review is to gather and discuss the latest advances in the impact of expertise on motor variability during sports-related tasks. A search encompassing three databases, Medline, SportDiscus, and Academic Search Complete, was performed. Our research methodology included three core themes: motor variability, laboratory instruments, and sports. Motor variability metrics (e.g., standard deviation and approximate entropy) and laboratory instruments (e.g., motion capture system, EMG, and force plate) were compiled. Athletes' expertise was defined by the time of deliberate practice, the performance results, or the level in which they performed. Overall, 48 of the 59 included studies determined that higher-skilled athletes had lesser motor variability than lower-skilled athletes. This difference in motor variability between skill levels was present within individual athletes (intra-individual) and between athletes (inter-individual). This result was independent of the criteria used to define expertise, the type of instrumentation used, and the metrics used to quantify motor variability.
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Rendimiento Atlético , Destreza Motora , Humanos , Fenómenos Biomecánicos , Destreza Motora/fisiología , Rendimiento Atlético/fisiología , Deportes/fisiología , Atletas , ElectromiografíaRESUMEN
There are widespread calls for increased demographic diversity in science, often linked to the epistemic claim that including more perspectives will improve the quality of the knowledge produced. By distinguishing between demographic and epistemic diversity, we show that this is only true some of the time. There are cases where increasing demographic diversity will not bring about the necessary epistemic diversity and cases where failing to exclude some voices reduces the quality of the scientific debate. We seek to resolve these tensions with an analysis that turns on the way the experience-based expertise of non-scientists can be absorbed into mainstream science. Mostly it has to be done via what we call 'virtual diversity', in which scientists take responsibility for acquiring interactional expertise in the non-scientific expertise-based domains which they consider provide knowledge valuable to the science. We argue that virtual diversity represents the only feasible option in most scenarios, with cases where demographic diversity or full cultural mergers provide the solution being the exception rather than the rule. This analysis is an exercise in the sociology of knowledge, which is considered as being continuous with philosophy. The paper is prescriptive as well as descriptive, and the moral, cultural, political, and educational implications of the argument are drawn out. A main conclusion is that the acquisition of virtual diversity should be a new norm for science, allowing the voices of experienced non-scientist citizens to be heard but without eroding the institution of science, which continues to be a vital foundation of truth in democracy.
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Traditional theories of motor learning emphasize the automaticity of skillful actions. However, recent research has emphasized the role of pre-reflective self-consciousness accompanying skillful action execution. In the present paper, we present the course-of-experience framework as a means of studying elite athletes' pre-reflective self-consciousness in the unfolding activity of performance optimization. We carried out a synthetic presentation of the ontological and epistemological foundation of this framework. Then we illustrated the methodology by an in-depth analysis of two elite windsurfers' courses of experience. The analysis of global and local characteristics of the riders' courses of experience reveal (a) the meaningful activities accompanying the experience of ongoing performance optimization; (b) the multidimensionality of attentional foci and the normativity of performance self-assessment; and (c) a micro-scale phenomenological description of continuous improvement. These results highlight the fruitfulness of the course-of-experience framework to describe the experience of being absorbed in an activity of performance optimization.
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There is increasing evidence that competent handling of social interactions among conspecifics has positive effects on individual fitness. While individual variation in social competence has been appreciated, the role of long-term experience in the acquisition of superior social skills has received less attention. With the goal of promoting further research, we integrate knowledge across disciplines to assess social expertise, defined as the characteristics, skills and knowledge allowing individuals with extensive social experience to perform significantly better than novices on a given social task. We focus on three categories of social behaviour. First, animals can gain from adjusting social behaviour towards individually recognised conspecifics that they interact with on a regular basis. For example, there is evidence that some territorial animals individually recognise their neighbours and modify their social interactions based on experience with each neighbour. Similarly, individuals in group-living species learn to associate with specific group members based on their expected benefits from such social connections. Individuals have also been found to devote considerable time and effort to learning about the spatial location and timing of sexual receptivity of opposite-sex neighbours to optimise reproduction. Second, signallers can enhance their signals, and receivers can refine their response to signals with experience. In many birds and insects, individuals can produce more consistent signals with experience, and females across a wide taxonomic range can adaptively adjust mating preferences after perceiving distinct male signals. Third, in many species, individuals that succeed in reproducing encounter the novel, complex task of caring for vulnerable offspring. Evidence from a few species of mammals indicates that mothers improve in providing for and protecting their young over successive broods. Finally, for social expertise to evolve, heritable variation in social expertise has to be positively associated with fitness. Heritable variation has been shown in traits contributing to social expertise including social attention, empathy, individual recognition and maternal care. There are currently limited data associating social expertise with fitness, most likely owing to sparse research effort. Exceptions include maternal care, signal refinement, and familiarity with neighbours and group members. Overall, there is evidence that individuals in many species keep refining their social skills with experience throughout life. Hence we propose promising lines of research that can quantify more thoroughly the development of social expertise and its effects on fitness.
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Introduction: There is a growing interest in characterizing the cognitive-motor processes that underlie superior performance in highly skilled athletes. The aim of this study was to explore neural markers of putting performance in highly skilled golfers by recording mobile EEG (electroencephalogram) during the pre-shot period. Methods: Twenty-eight right-handed participants (20 males) with a mean age of 24.2 years (± 6.4) and an average handicap of +1.7 (± 6.4) completed a testing session. Following the warm-up, participants completed 140 putts from a distance of 8ft (2.4m), with putts taken from 5 different positions. While putting, participants wore an eye tracker and a gel-based EEG system with 32 electrodes. Time and frequency domain features of the EEG signals were extracted to characterize Movement-Related Cortical Potentials (MRCP) and rhythmic modulations of neural activity in theta, alpha, sensorimotor and beta frequency bands associated with putting performance. Results: Eye-tracking data demonstrate that mean Quiet Eye durations are not a reliable marker of expertise as the same duration was found for both successful and unsuccessful putts. Following rigorous data processing data from 12 participants (8 males, mean age 21.6 years ± 5.4, average handicap +1.5 ± 4.4) were included in the EEG analysis. MRCP analysis revealed performance-based differences, with unsuccessful putts having a greater negative amplitude in comparison to successful putts. Time frequency analysis of the EEG data revealed that successful putts exhibit distinct neural activity profiles compared to unsuccessful ones. For successful putts, greater suppression of beta was present in the central region prior to the putt. By contrast, increased frontal theta power was present for unsuccessful putts immediately before the putt (consistent with hesitation and the need for motor plan adjustments prior to execution). Discussion: We propose that neural activity may provide plausible insights into the mechanisms behind why identical QE durations can lead to both success and failure. From an applied perspective, this study highlights the merits of a multi-measure approach to gain further insights into performance differences within highly skilled golfers. We discuss considerations for future research and solutions to address the challenges related to the complexities of collecting clean EEG signals within naturalistic sporting contexts.
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When people indicate the vanishing location of a moving target that suddenly disappears, systematic errors forward (in the direction of motion) and downward (in the direction of gravity) emerge. These spatial displacements were coined, respectively, Representational Momentum and Representational Gravity, and are believed to reflect internalized ecologically relevant physical invariants useful for the anticipation of future states of an event. Previous research has shown that sports athletes exhibit increased Representational Momentum, indicating enhanced motion extrapolation and anticipation, albeit it is still not clear up to what degree this effect is specific for the expertise context or if it generalizes to other dynamic events. Furthermore, the influence of expertise on Representational Gravity, particularly in contexts where anticipation of vertically moving objects is crucial, remains understudied. This study aimed to address these gaps by focusing on Volleyball as a context of expertise due to the prevalence of fast vertically moving balls. Volleyball athletes and non-athletes indicated the perceived offset location of a smoothly moving target, which moved at a constant speed or was subjected to acceleration/deceleration, embedded either in a Volleyball or neutral context. Outcomes revealed that for the Volleyball context, athletes, but not non-athletes, revealed a significant trend to misperceive targets moving along the left diagonal to be further displaced forward beyond what would be expected due to Representational Momentum alone. This finding is discussed in relation to the natural statistics of Volleyball games, where crossed ball trajectories, particularly by the outside hitter, are more prevalent, fast, and offensive, requiring better anticipation to be efficiently dealt with.
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Atletas , Percepción de Movimiento , Voleibol , Humanos , Voleibol/fisiología , Masculino , Femenino , Adulto Joven , Percepción de Movimiento/fisiología , Adulto , Anticipación Psicológica/fisiología , GravitaciónRESUMEN
AIM: This study was designed to examine the relationship between humble leadership and nurses' turnover intention and investigate the moderating role of leader expertise in this relationship. BACKGROUND: Leader humility and expertise are two key dimensions of professional spirit in competitive magnet organizations. Many organizational factors could make nurses take a decision to leave their organization; however, leader humility and expertise could help nurses retract from this decision. METHOD: This is a multisite cross-sectional study that was conducted at all medical-surgical units of four university hospitals. Using scales for assessing leader humility, nurses' turnover intention, and leader expertise, 385 nurses were surveyed. Data were investigated via descriptive and inferential statistics, where correlation, path analysis, and structured equation modeling were used to test the hypothetical relationship among study variables. RESULTS: There is a statistically significant negative relationship between humble leadership and nurses' turnover intention. Humble leadership and leader expertise were significant predictors of nurses' turnover intention. The moderating effect of leader expertise on the relationship between humble leadership and nurses' turnover intention was statistically significant, making it more negative, implying that leader expertise amplifies the effect of leader humility on reducing nurses' turnover. CONCLUSION: Incorporating leader expertise with humility could provide an efficient panacea for reducing turnover intentions among nurses in different healthcare organizations. IMPLICATIONS FOR NURSING AND HEALTH POLICY: Healthcare organizations could develop an efficient retention plan for nurses by cultivating humility among both leaders and nurses. In addition, building nurse leaders' expertise through opening avenues for professional development is a good strategy in the face of nurses' shortage and high turnover. Furthermore, succession planning in healthcare organizations must consider humility as a vital skill among anticipated leaders.
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Converging evidence has shown that domain-general cognitive abilities, especially executive functions (EF), tend to be superior in sport experts. However, recent studies have questioned this cognitive advantage and found inconsistent findings when comparing sport type and sex. This study aimed to compare the impact of sport expertise, sport type, and sex on various domains of cognitive functions. Two hundred and thirty elite athletes (nFemale=124, nMale=106) representing three sport categories (Team [n=91], Precision-skill dependent [n=63], and Speed-strength [n=76] sports) were assessed using a computerized neuropsychological test battery including tests of EF (working memory, inhibition, cognitive flexibility and planning), as well as tests of selective and sustained attention. T-scores and raw values were used to analyse performance through t-tests and ANCOVA with age as covariate. Athletes demonstrated better performance than the normative mean on 5 out of 11 cognitive test variables (p<0.005). However, their performance fell within the average range when considering the results along a normative scale, except for sustained attention and working memory where they performed just above average (<1 SD). There was a significant main effect of sport category on only one EF variable (p=0.003). Males performed significantly faster than females on motor reaction time measures of attention and inhibition (all p<0.001). In this study, the 'expert advantage' on domain-general cognitive tests was less prominent when utilizing a normative scale and controlling for age or speed-accuracy trade-offs, except for sustained attention and working-memory. Cognitive functions did not appear to differ meaningfully based on athletes' sport type or sex.
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Introduction: This study aimed to describe the fixation location and the time of the longer fixation of expert and novice futsal coaches before the ball was in play in futsal set pieces. Methods: A total of 10 experts (ages 48 ± 5) and 10 novice coaches (ages 40 ± 7) participated in the study. They observed that 38 video clips were created to mimic the attack and defensive set-piece moments of the game. Data were collected in a standardized video analysis task using the pupil invisible eye tracker and processed through the pupil cloud platform. The Mann-Whitney test was conducted to evaluate differences in gaze duration between game moments (attack and defense set pieces) and groups (expert vs. novice). Gaze duration was also compared for gaze location between groups. For further comparisons, the game moments (attack and defense set pieces) and the gaze location were summarized in two-dimensional graphics using correspondence analysis. Results and discussion: The results revealed higher values of gaze duration for attack and defense set pieces for the group of experts than for novices. When considering gaze duration, expert coaches had higher values than novices for the attacker 3, defender 3, barrier 1st, and barrier 2nd gaze locations. The correspondence analysis showed different strategies of visual search and, consequently, gaze locations for attack and defense set pieces. In particular, there was different correspondence for free kicks between the level of expertise and gaze location, while corner and sideline kicks revealed some correspondence between the groups and the gaze location. In free kicks, coaches should be particularly concerned about the relationship between attacker and defender three and the barrier 1st and 2nd line positions. In corner and sideline kicks, coaches should be particularly aware of the relationship between attackers' and defenders' positions.
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Previous research on affordance perception has shown that elite athletes can relate the environmental features to their motor abilities to detect the opportunities for action. In playing badminton doubles, experienced players can often anticipate whether a flick serve will go out-of-bounds or not. A field study was performed to examine if such an ability was associated with a developed affordance perception. Twenty-two players with and without badminton playing experience were asked to play a receiver on court to judge without looking back whether a flick serve was out-of-bounds in both standing and retreating conditions. Forty flick serves were randomly delivered to either inner or outer rear corner of the receiver's box and land adjacent to the back service line. Each player's ability to reach high and retreat backward with a racquet was assessed on court. The results showed that predictions were better in the inner direction than the outer direction, but experienced players were more sensitive and conservative overall. Playing experience appeared to be a consistent predictor for judgment accuracy. In identifying the affordance information that could have been utilized by players for accurate predictions, only experienced players demonstrated the ability to utilize both body-scaled and action-scaled affordances effectively and reliably for better predictions in both standing and retreating conditions.