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With improvements in early survival following congenital heart surgery, it has become increasingly important to understand longer-term outcomes; however, routine collection of these data is challenging and remains very limited. We describe the development and initial results of a collaborative programme incorporating standardised longitudinal follow-up into usual care at the Children’s Hospital of Philadelphia (CHOP) and University of Michigan (UM).
We included children undergoing benchmark operations of the Society of Thoracic Surgeons. Considerations regarding personnel, patient/parent engagement, funding, regulatory issues, and annual data collection are described, and initial follow-up rates are reported.
The present analysis included 1737 eligible patients undergoing surgery at CHOP from January 2007 to December 2014 and 887 UM patients from January 2010 to December 2014. Overall, follow-up data, of any type, were obtained from 90.8% of patients at CHOP (median follow-up 4.3 years, 92.2% survival) and 98.3% at UM (median follow-up 2.8 years, 92.7% survival), with similar rates across operations and institutions. Most patients lost to follow-up at CHOP had undergone surgery before 2010. Standardised questionnaires assessing burden of disease/quality of life were completed by 80.2% (CHOP) and 78.4% (UM) via phone follow-up. In subsequent pilot testing of an automated e-mail system, 53.4% of eligible patients completed the follow-up questionnaire through this system.
Standardised follow-up data can be obtained on the majority of children undergoing benchmark operations. Ongoing efforts to support automated electronic systems and integration with registry data may reduce resource needs, facilitate expansion across centres, and support multi-centre efforts to understand and improve long-term outcomes in this population.
We review the current status and future prospects of the PLANET collaboration, an international team of astronomers performing high-precision photometric monitoring of microlensing events. Our photometric precision and sampling is characterised and the suitability of the database for variable star studies is discussed. Preliminary results on K-giant stability are presented.
We present the results of two 2.3 μm near-infrared (NIR) radial velocity (RV) surveys to detect exoplanets around 36 nearby and young M dwarfs. We use the CSHELL spectrograph (R ~ 46,000) at the NASA InfraRed Telescope Facility (IRTF), combined with an isotopic methane absorption gas cell for common optical path relative wavelength calibration. We have developed a sophisticated RV forward modeling code that accounts for fringing and other instrumental artifacts present in the spectra. With a spectral grasp of only 5 nm, we are able to reach long-term radial velocity dispersions of ~20–30 m s−1 on our survey targets.
Mike Kane is a cognitive psychologist who studies the dynamic interaction between attention and memory. Mike has Tourette's Syndrome (TS), a disorder characterized by multiple motor tics and at least one vocal tic. His first professional paper, while still a graduate student in psychology, was an introspective case study of his own experience of TS tics. Whereas the tics that characterize TS have typically been thought to be involuntary, Kane's observations and the work of others have suggested that TS tics tend to be compulsory, perhaps emitted in response to a subjective tactile/kinesthetic/sensory experience. Kane observed in himself, as have others, that tics are preceded by premonitory sensations:
These sensations are not mere precursors to tics; they precipitate tics. … I experience the TS state as one of keen bodily awareness, or a continual consciousness of muscle, joint, and skin sensations. For example when sitting in a chair, I do not lose awareness of the tactile sensation of the seat against my body, nor can I ignore the deeper somatic sensations of what my back and legs feel like.
The TS state is omnipresent with few exceptions (e.g., during intense concentration or attentional focus, such as in lecturing), but it is not constant in bodily location or intensity.…
If a tic is temporarily stopped, its respective bodily location becomes less ignorable. If all tics are suppressed, virtually all of my joints and muscles begin to demand my attention. The TS state heightens to a stiffening feeling, such that my skin feels like a hardened casing and my joints feel as though they are becoming rigid. […]
Blair equates the constructs of working memory (WM), executive function, and general fluid intelligence (gF). We argue that there is good reason not to equate these constructs. We view WM and gF as separable but highly related, and suggest that the mechanism behind the relationship is controlled attention – an ability that is dependent on normal functioning of the prefrontal cortex.
The idea that short-term memory is an important component of intelligence is not new. For example, over a century ago, James (1890) wrote, “All the intellectual value for us of a state of mind depends on our after memory of it. Only then is it combined in a system and knowingly made to contribute to a result. Only then does it count for us.” Around the same time, Binet (1905) included a test of short-term memory in a test battery designed to identify learning disabled children in the Paris school system. And more recently, short-term memory has been conceptualized as a fundamental component of human cognition. For example, Miller (1956) famously proposed that the capacity of short-term memory is limited to 7 ± 2 bits of information. Later, Atkinson and Shiffrin (1968) incorporated this idea of a central bottleneck in information processing into their “modal” model of memory.
Nevertheless, the extent to which short-term memory plays an important role in higher-level cognition — intelligence manifested in complex cognitive activities like reasoning and learning — has been a topic of considerable debate in cognitive psychology. Consider, for example, the results of a series of experiments by Baddeley and Hitch (1974). The surprising finding in these experiments was that a secondary task designed to tax short-term memory had little or no effect on a variety of reasoning, comprehension, and memory primary tasks.
Working memory is a system consisting of those long-term memory traces active above threshold, the procedures and skills necessary to achieve and maintain that activation, and limited-capacity, controlled attention. The specific features of our model include:
(2) Domain-specific codes and maintenance (phonological loop and visuospatial sketchpad are two examples but the potential number of such codes is large).
(3) Individual differences in both 1 and 2, but individual differences in capacity for controlled processing are general and possibly the mechanism for general fluid intelligence. Although people can, with practice and expertise, circumvent the abiding limitations of controlled attention in quite specific situations, the limitations reemerge in novel situations and even in the domain of expertise if the situation calls for controlled processing.
(4) Limited-capacity, controlled processing is required for maintaining temporary goals in the face of distraction and interference and for blocking, gating, and/or suppressing distracting events.
(5) The dorsolateral prefrontal cortex (PFC) and associated structures mediate the controlled processing functions of working memory. We also argue that individual differences in controlled processing represent differences in functioning of the PFC.
A number of intellectual influences have served to shape our thinking about working memory (WM) and its evolution as a construct separate from that of short-term memory (STM).
Individuals may differ in the general-attention executive
component or in the subordinate domain-specific “slave”
components of working memory. Tasks requiring sustained memory
representations across attention shifts are reliable, valid indices of
executive abilities. Measures emphasizing specific processing skills
may increase reliability within restricted samples but will not
reflect the attention component responsible for the broad
predictive validity of span tasks.