The role of rehearsal and reminding in the recall of categorized word lists.

Most theories of free recall emphasize the importance of retrieval in explaining temporal and semantic regularities in recall; rehearsal mechanisms are often absent or limit rehearsal to a subset of what was last rehearsed. However, in three experiments using the overt rehearsal method, we show clear evidence that just-presented items act as retrieval cues during encoding (study-phase retrieval) with prior related items rehearsed despite well over a dozen intervening items. Experiment 1 examined free recall of categorized and uncategorized lists of 32 words. In Experiments 2 and 3, we presented categorized lists of 24, 48, and 64 words for free recall or cued recall, with the category exemplars blocked in successive list positions (Experiment 2) or randomized throughout the list (Experiment 3). The probability of rehearsing a prior word was affected by its semantic similarity to the just-presented item, and the frequency and recency of its prior rehearsals. These rehearsal data suggest alternative interpretations to well-known recall phenomena. With randomized designs, the serial position curves were reinterpreted by when words were last rehearsed (which contributed to the list length effects), and semantic clustering and temporal contiguity effects at output were reinterpreted by whether words were co-rehearsed during study. The contrast with the blocked designs suggests that recall is sensitive to the relative (not absolute) recency of targeted list items. We discuss the benefits of incorporating rehearsal machinery into computational models of episodic memory, and suggest that the same retrieval processes that generate the recalls are used to generate the rehearsals.

Control processes in short-term storage: Retrieval strategies in immediate recall depend upon the number of words to be recalled.

According to the Atkinson and Shiffrin (1968) model, control processes in the short-term memory store determine the selection of different storage, search, and retrieval strategies. Although rehearsal is the most studied short-term control process, it is necessary to specify the different retrieval strategies available for participants to use in searching for and outputting from short-term or immediate memory, as well as the degree to which participants can flexibly select different retrieval strategies for recalling rehearsed and unrehearsed materials. In three experiments we examined retrieval strategies in tests of immediate free recall (Exp. 1), immediate serial recall (ISR; Exp. 2), and a variant of ISR that we call ISR-free (Exp. 3). In each experiment, participants were presented with very short lists of four, five, or six words and were instructed to recall one, two, three, or all of the items from each list. Neither the list length nor the number of to-be-recalled items was known in advance. The serial position of the first item recalled in all three tasks depended on the number of to-be-recalled items. When only one or two items were to be recalled, participants tended to initiate recall with the final or penultimate list item, respectively; when participants were required to recall as many list items as possible, they tended to initiate recall with the first list item. These findings show that different retrieval strategies exist for rapidly searching for different numbers of items from immediate memory, and they confirm that participants have some control over their output order, as measured by the first items recalled.

The comparative genomics of human respiratory syncytial virus subgroups A and B: genetic variability and molecular evolutionary dynamics.

Genomic variation and related evolutionary dynamics of human respiratory syncytial virus (RSV), a common causative agent of severe lower respiratory tract infections, may affect its transmission behavior. RSV evolutionary patterns are likely to be influenced by a precarious interplay between selection favoring variants with higher replicative fitness and variants that evade host immune responses. Studying RSV genetic variation can reveal both the genes and the individual codons within these genes that are most crucial for RSV survival. In this study, we conducted genetic diversity and evolutionary rate analyses on 36 RSV subgroup B (RSV-B) whole-genome sequences. The attachment protein, G, was the most variable protein; accordingly, the G gene had a higher substitution rate than other RSV-B genes. Overall, less genetic variability was found among the available RSV-B genome sequences than among RSV-A genome sequences in a comparable sample. The mean substitution rates of the two subgroups were, however, similar (for subgroup A, 6.47 × 10(-4) substitutions/site/year [95% credible interval {CI 95%}, 5.56 × 10(-4) to 7.38 × 10(-4)]; for subgroup B, 7.76 × 10(-4) substitutions/site/year [CI 95%, 6.89 × 10(-4) to 8.58 × 10(-4)]), with the time to their most recent common ancestors (TMRCAs) being much lower for RSV-B (19 years) than for RSV-A (46.8 years). The more recent RSV-B TMRCA is apparently the result of a genetic bottleneck that, over longer time scales, is still compatible with neutral population dynamics. Whereas the immunogenic G protein seems to require high substitution rates to ensure immune evasion, strong purifying selection in conserved proteins such as the fusion protein and nucleocapsid protein is likely essential to preserve RSV viability.

A Comparison of Tranexamic Acid in Nasal Versus Sinus Surgeries: a Systematic Review and Meta-Analysis.

Nasal surgeries (e.g.: rhinoplasties, septoplasties) and sinus surgeries (e.g.: Functional Endoscopic Sinus Surgeries) are common procedures in Otorhinolaryngology. Tranexamic acid (TXA), an antifibrinolytic drug, has been increasingly utilized to reduce hemorrhage recently. While close in proximity anatomically, the bleeding nature of sinus and nasal surgeries may differ. We present the first meta-analysis that has reviewed both nasal and sinus surgery collectively and compares the two. Pubmed, Embase, Cochrane Library and WoS were searched until April 2023. Outcomes of interest include Boezart Scoring, clotting time, postoperative complications and surgical field quality. 27 Studies were assessed, of which 25 studies were evaluated quantitatively. Of the 27 studies, 15 studies involved Sinus surgery while 12 involved Nasal surgery. The use of tranexamic acid was notably beneficial in the evaluation of blood loss, reduction of operating time, surgical field quality and surgeon satisfaction. TXA has proven to be efficacious in both nasal and sinus surgeries to varying degrees. TXA has more effects in sinus surgeries compared to nasal surgeries in objective markers such as reducing blood loss and operating time, but the converse occurs for subjective markers such as surgeon satisfaction scores. Supplementary Information: The online version contains supplementary material available at 10.1007/s12070-024-04579-x.

Use of patient-reported experience and outcome measures within the colorectal cancer care continuum: a scoping review.

OBJECTIVE: Patient-reported outcome measures (PROM) are frequently adopted to evaluate colorectal cancer (CRC) care, but the use of patient-reported experience measures (PREM) appears to be underdeveloped and not widely validated. This scoping review aims to understand the contexts for deployment of PREMs in CRC care, reliability of measures, gaps in current use of PREMs, and how PREMs are associated with PROMs when deployed together. METHODS: Four scientific databases (PubMed, CINAHL, PsycINFO, Scopus) were systematically searched from January 2011 to December 2023. Observational or interventional studies involving quantitative or mixed methodology with samples consisting CRC patients undergoing screening, treatment, or cancer surveillance and utilizing at least one PREM as an exposure or outcome were included. RESULTS: The initial search resulted in 10,400 records. Only 13 relevant studies (consisting of 17,105 participants) met the eligibility criteria. Utilization of PREMs was heterogenous across our sample and the CRC care continuum, and about half of the studies (53.8%) evaluated the relationship between PREMs and PROMs. PREM usage across the CRC care continuum largely focused on treatment/survivorship. Better care experience was positively associated with improved patient-reported outcomes. CONCLUSIONS: Future work in CRC PREM development should focus on (1) establishing validated measures that aim to either capture disease/treatment-specific granularity or capitalize on applicability across care settings, (2) localizing novel or existing PREMs to consider different cultural contexts in healthcare, and (3) benchmarking associations between PREMs, PROMs, and other outcomes of interest. IMPLICATIONS FOR CANCER SURVIVORS: Individuals progressing through the CRC care continuum often undergo a multitude of procedures from detection and diagnosis to treatment and surveillance. The establishment of validated PREMs specific to CRC would help to benchmark and further improve the quality of care received-which should translate to better patient-reported outcomes-and serve as process indicators for institutions and providers to maintain rigorous health service delivery standard for CRC survivors.

The Association of Dry Eye Disease with Functional Visual Acuity and Quality of Life.

BACKGROUND: Dry eye disease (DED) is a common chronic condition with increasing prevalence. Standard discriminative visual acuity is not reflective of real-world visual function, as patients can achieve normal acuities by blinking. METHODS: Participants recruited from a tertiary referral eye centre were divided into two groups-Severe DED (with significant, central staining) and Mild DED (absence of such staining). Functional Visual Acuity (FVA) in both groups was assessed using the DryeyeKT mobile application and Impact of Vision Impairment (IVI) questionnaire to assess quality of life (QOL). RESULTS: Among the 78 participants (74.4% women), 30 (38.5%) had Severe DED and 48 (61.5%) Mild DED. In women, Severe DED produced a significantly worse FVA of 0.53 ± 0.20 vs. 0.73 ± 0.30 in the Mild DED group (p = 0.006). FVA decreased with increasing age, showing a significant inverse correlation (r = -0.55). A poorer FVA ≤ 0.6 was seen in older patients (68.2 years ± 7.68) vs. an FVA > 0.6 in younger patients (58.9 years ± 10.7), p < 0.001. When adjusting for age, FVA was still 0.107 lower in the Severe DED group, p = 0.003. There was significant difficulty in performing specific daily activities in the Severe DED group, after adjusting for age, gender and FVA. CONCLUSIONS: FVA is reduced in severe DED and older people. Severe DED significantly impacts certain aspects of QOL. However, no significant relationship was found between FVA and QOL. FVA is not the only reason for the compromise of health-related QOL in severe dry eye.

Mantle cell lymphoma presenting as intussuscepting ascending colon mass.

Malignant lymphoma is a rare cause of gastrointestinal intussusception in adults, accounting for less than 1% of all cases of intussusception. This is a case of a South-East Asian woman in her 50s, presenting with intermittent abdominal pain, loose stools and weight loss. CT of the abdomen and pelvis showed an irregular mass causing ileocolic intussusception and she underwent emergency open right hemicolectomy with end ileostomy. Intraoperatively, her bowel was covered with lymphoma nodules, and bulky mesenteric nodules of small bowel and colon were seen. The histology shows mantle cell lymphoma, a rare subtype of B cell non-Hodgkin's lymphoma. She recovered well postoperatively and was started on chemotherapy (Nordic protocol) early.

The impact of value-driven outcomes initiative on endo-laparoscopic groin hernia repair.

PURPOSE: Value driven outcome (VDO) initiative is a value-based, patient-focused tool which utilizes a clinical outcome-based approach to optimize value of care based on clinically relevant quality indicators and costs required to achieve the care. In this study, we evaluate the impact of a VDO initiative on groin hernia repair, a commonly performed elective surgery in our hospital. METHODS: A VDO initiative was implemented in 2019 to encourage elective inguinal hernia repair to be performed at a day surgery setting. A comparison of outcomes was made between hernia surgeries performed in 2019 with those in 2020 and 2021. Pre-defined criteria were used to select patients that can be operated at a day surgery setting. Patients' expectations were addressed preoperatively about day surgery procedure and postoperative recovery. Day surgery bundles were used to standardize pre- and post-surgery protocols. Pain control was optimized using a specialized local anesthesia regime. RESULTS: A total of 263 laparoscopic hernia surgeries were performed between May 2019 and December 2021. After implementation of VDO initiative, the percentage of patients discharged within 24 h increased from 78% in year 2019 to 97% in year 2020 and 99% in year 2021. Conversion rate for day surgery to short stay decreased from 9% in year 2019 to 1% in year 2020 and 2% in year 2021. In 2019 to 2021, there were no 30-day readmission, no hernia recurrence in 90 days, no conversion to open surgery. CONCLUSION: VDO initiative is a promising tool to deliver better value-based care for patients undergoing endo-laparoscopic inguinal hernia repair.

Open versus laparoscopic intraperitoneal on-lay mesh repair: A comparison of outcomes in small ventral hernia.

PURPOSE: The ideal surgical treatment of small ventral hernias (defect less than 4 cm) is still debatable. In our study, we sought to compare the outcomes of open versus laparoscopic intraperitoneal on-lay mesh (IPOM) repair in small ventral hernias. METHODS: Patients with a single ventral hernia defect of less than 4 cm undergoing surgical mesh repair between January 2016 and September 2018 were prospectively registered for this study. The minimum follow-up duration was 12 months. Patient demographics, operative findings and regular post-operative follow-up details including recurrence rates and complications were recorded and analysed. RESULTS: 41 patients underwent laparoscopic IPOM repair and 47 patients underwent open IPOM repair. The mean age for both groups is similar with no significant difference. The mean hernia defect size for the laparoscopic group is 2.8 cm (±0.8) whereas the mean hernia defect size for the open repair group is 2.1 cm (±0.4). The mean surgery duration for open IPOM repair was significantly shorter (59 min (±17) vs 74 min (±26); p = 0.001). There was no significant difference in the incidence of seroma formation and surgical site infections post-operatively. There was also no significant difference in both groups in terms of chronic pain and recurrence at 1-year follow-up. CONCLUSION: Open IPOM repair for small ventral hernias may be superior to laparoscopic IPOM repair due to the shorter operative duration, single incision, and no additional risk of port-site hernias. There was no difference in chronic pain, wound infection and recurrence rate between the two groups.

Factors to Consider in the Use of Vital Signs Wearables to Minimize Contact With Stable COVID-19 Patients: Experience of Its Implementation During the Pandemic.

The COVID-19 pandemic has created a huge burden on the healthcare industry worldwide. Pressures to increase the isolation healthcare facility to cope with the growing number of patients led to an exploration of the use of wearables for vital signs monitoring among stable COVID-19 patients. Vital signs wearables were chosen for use in our facility with the purpose of reducing patient contact and preserving personal protective equipment. The process of deciding on the wearable solution as well as the implementation of the solution brought much insight to the team. This paper presents an overview of factors to consider in implementing a vital signs wearable solution. This includes considerations before deciding on whether or not to use a wearable device, followed by key criteria of the solution to assess. With the use of wearables rising in popularity, this serves as a guide for others who may want to implement it in their institutions.

The role of Toll-like receptors in regulating the immune response against respiratory syncytial virus.

Toll-like receptors (TLRs) play a distinct role in battling respiratory syncytial virus (RSV) infections. However, due to a lack of representative animal models and several early controversies, the field is unclear. In this systematic review, we have elucidated conflicting results and outlined important factors that might affect study outcomes. We reviewed studies that used different doses/viral strains, performed virus propagation in different cell lines, or used different mice strains. The following firm conclusions can be drawn: multiple TLRs activate innate immunity upon RSV infection; TLR4 can influence TLR2 expression, suggesting that optimal induction of multiple signaling pathways is required to elicit protective, rather than deleterious innate immune responses following infection; in mice, TLR4, TLR2/-6, and TLR7 have immune-stimulating properties, while TLR3 activation occurs later and appears to downregulate immune responses; in humans, polymorphism studies have demonstrated an important role for TLR4-signaling; and activation of TLR-signaling leads to antiviral cytokine production, such as TNF-a and IFNs. Viral factors may block these pathways, thereby contributing to immune evasion and RSV survival. A better understanding of the complex interplay between TLRs and severe RSV infections might lead to efficient prophylactic and therapeutic treatments, as well as the development of adequate vaccines combined with TLR adjuvants.

Rehearsal in immediate serial recall.

We report for the first time overt rehearsal data in immediate serial recall (ISR) undertaken at three presentation rates (1, 2.5, and 5 sec/word). Two groups of participants saw lists of six words for ISR and were required either to engage in overt rehearsal or to remain silent after reading aloud the word list during its presentation. Typical ISR serial position effects were obtained for both groups, and recall increased with slower rates. When participants rehearsed, they tended to do so in a cumulative forward order up to Serial Position 4, after which the amount of rehearsal decreased substantially. There were similarities between rehearsal and recall data: Both broke down toward the end of longer sequences, and there were strong positive correlations between the maximum sequence of participants' rehearsals and their ISR performance. We interpret these data as suggesting that similar mechanisms underpin both rehearsal and recall in ISR.

Heat Shock Factor 5 Is Essential for Spermatogenesis in Zebrafish.

Heat shock factors (Hsfs) are transcription factors that regulate responses to heat shock and other environmental stimuli. Four heat shock factors (Hsf1-4) have been characterized from vertebrates to date. In addition to stress response, they also play important roles in development and gametogenesis. Here, we study the fifth member of heat shock factor family, Hsf5, using zebrafish as a model organism. Mutant hsf5-/- males, generated by CRISPR/Cas9 technique, were infertile with drastically reduced sperm count, increased sperm head size, and abnormal tail architecture, whereas females remained fertile. We show that Hsf5 is required for progression through meiotic prophase 1 during spermatogenesis as suggested by the accumulation of cells in the leptotene and zygotene-pachytene stages and increased apoptosis in post-meiotic cells. hsf5-/- mutants show gonadal misregulation of a substantial number of genes with roles in cell cycle, apoptosis, protein modifications, and signal transduction, indicating an important role of Hsf5 in early stages of spermatogenesis.

Common modality effects in immediate free recall and immediate serial recall.

In 2 experiments, participants were presented with lists of between 2 and 12 words for either immediate free recall (IFR) or immediate serial recall (ISR). Auditory recall advantages at the end of the list (modality effects) and visual recall advantages early in the list (inverse modality effects) were observed in both tasks and the extent and magnitude of these effects were dependent upon list length. Both tasks displayed modality effects with short lists that were large in magnitude but limited to the final serial position, consistent with those observed in the typically short lists used in ISR, and both tasks displayed modality effects with longer lists that were small in magnitude and more extended across multiple end-of-list positions, consistent with those observed in the typically longer lists used in IFR. Inverse modality effects were also observed in both tasks at early list positions on longer lengths. Presentation modality did not affect where recall was initiated, but modality effects were greatest on trials where participants initiated recall with the first item. We argue for a unified account of IFR and ISR. We also assume that the presentation modality affects the encoding of all list items, and that modality effects emerge due to the greater resistance of auditory items to output interference. (PsycINFO Database Record

Staphylococcal protein Ecb impairs complement receptor-1 mediated recognition of opsonized bacteria.

Staphyloccus aureus is a major human pathogen leading frequently to sepsis and soft tissue infections with abscesses. Multiple virulence factors including several immune modulating molecules contribute to its survival in the host. When S. aureus invades the human body, one of the first line defenses is the complement system, which opsonizes the bacteria with C3b and attract neutrophils by release of chemotactic peptides. Neutrophils express Complement receptor-1 [CR1, CD35) that interacts with the C3b-opsonized particles and thereby plays an important role in pathogen recognition by phagocytic cells. In this study we observed that a fraction of S. aureus culture supernatant prevented binding of C3b to neutrophils. This fraction consisted of S. aureus leukocidins and Efb. The C-terminus of Efb is known to bind C3b and shares significant sequence homology to the extracellular complement binding protein [Ecb). Here we show that S. aureus Ecb displays various mechanisms to block bacterial recognition by neutrophils. The presence of Ecb blocked direct interaction between soluble CR1 and C3b and reduced the cofactor activity of CR1 in proteolytic inactivation of C3b. Furthermore, Ecb could dose-dependently prevent recognition of C3b by cell-bound CR1 that lead to impaired phagocytosis of NHS-opsonized S. aureus. Phagocytosis was furthermore reduced in the presence of soluble CR1 [sCR1). These data indicate that the staphylococcal protein Ecb prevents recognition of C3b opsonized bacteria by neutrophil CR1 leading to impaired killing by phagocytosis and thereby contribute to immune evasion of S. aureus.

Examining the relationship between free recall and immediate serial recall: the effect of concurrent task performance.

In 3 experiments, participants saw lists of 16 words for free recall with or without a 6-digit immediate serial recall (ISR) task after each word. Free recall was performed under standard visual silent and spoken-aloud conditions (Experiment 1), overt rehearsal conditions (Experiment 2), and fixed rehearsal conditions (Experiment 3). The authors found that in each experiment, there was no effect of ISR on the magnitude of the recency effect, but interleaved ISR disrupted free recall of those words that would otherwise be rehearsed. The authors conclude that ISR and recency cannot both be outputs from a unitary limited-capacity short-term memory store and discuss the possibility that the process of rehearsal may be common to both tasks.

Beginning at the beginning: Recall order and the number of words to be recalled.

When participants are asked to recall a short list of words in any order that they like, they tend to initiate recall with the first list item and proceed in forward order, even when this is not a task requirement. The current research examined whether this tendency might be influenced by varying the number of items that are to be recalled. In 3 experiments, participants were presented with short lists of between 4 and 6 words and instructed to recall 1, 2, 3, or all of the items from the lists. Data were collected using immediate free recall (IFR, Experiment 1), immediate serial recall (ISR, Experiment 2), and a variant of ISR that we call ISR-free (Experiment 3), in which participants had to recall words in their correct serial positions but were free to output the words in any order. For all 3 tasks, the tendency to begin recall with the first list item occurred only when participants were required to recall as many items from the list as they could. When participants were asked to recall only 1 or 2 items, they tended to initiate recall with end-of-list items. It is argued that these findings show for the first time a manipulation that eliminates the initial tendency to recall in forward order, provide some support for recency-based accounts of IFR and help explain differences between single-response and multiple-response immediate memory tasks. (PsycINFO Database Record

The effect of the length of to-be-remembered lists and intervening lists on free recall: a reexamination using overt rehearsal.

In 3 experiments, the authors investigated the effects of to-be-remembered (TBR) and intervening list length on free recall to determine whether selective rehearsal could explain the previous finding that recall was affected only by TBR list length. In Experiments 1 (covert rehearsal) and 2 (overt rehearsal), participants saw 5- and 20-word lists and had to recall the list prior to that last presented list. In Experiment 3, either 1 or 2 lists were presented, and recall of TBR list was postcued. Recall proportion decreased with increased TBR list length. Moreover, the authors found extended recency effects when recall was replotted by when words were last rehearsed (Experiments 2 and 3) and an effect of intervening list length when rehearsal was reduced (Experiment 3).

Reducing suffering to improve quality of life through health promotion.

This paper deals with complex concepts of suffering, quality of life and palliative care in the context of health promotion. Although these concepts have been examined separately, relatively few researchers have attempted to describe and link these concepts with the aim of health promotion. The reason why few attempts have been made is because the concepts are paradoxical and include contrasting ideas. Additionally, a number of core aspects of palliative care are underdeveloped and there is failure to address issues of suffering. Preliminary findings from a phenomenological study of community nurses providing palliative care to suffering clients revealed themes of power and showing the way coming to suffer through not knowing, being as giving by enhancing quality of life and being as giving by sharing. Embedded in these themes are concepts of quality of life, core concerns for managing suffering in terminal illness and ideas for health promotion. These concerns are incorporated in the recommendations for nursing practice and future reseach.