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In vitro associative conditioning of Hermissenda: cumulative depolarization of type B photoreceptors and short-term associative behavioral changes.

Cumulative depolarization of Hermissenda type B photoreceptors, a short-term neural correlate of associative learning, was produced by simulating associative training in the isolated nervous system (in vitro conditioning). This simulation entailed stimulation and recording from three classes of neurons normally affected by the associative training procedure: a type B photoreceptor, the silent/excitatory (S/E) optic ganglion cell, and a statocyst caudal hair cell. Exposure of the isolated nervous system to five simultaneous pairings of light and current-induced impulse activity of the caudal hair cell resulted in an average 10-mV depolarization of type B cells. Cumulative depolarization was found to be pairing specific, to occur with a minimal number of training trials, and was paralleled by short-term pairing-specific changes in phototactic behavior for the intact animal. Two important determinants of cumulative depolarization were found to be the magnitude and duration of the long-lasting depolarization (LLD) response of type B cells to light, and a pairing-specific synaptic facilitation of the LLD response. The synaptic facilitation arose from two distinct sources: increased excitatory postsynaptic potential (EPSP) feedback on B cells following light and caudal hair cell stimulation pairings, and disinhibition of the type B photoreceptor following pairings. The S/E optic ganglion cell was found to be a potent regulator of B cell EPSPs. Cumulative depolarization was substantially reduced when the S/E cell was hyperpolarized throughout the course of pairings. Conversely, pairings of light with depolarizing current stimulation of the S/E cell were sufficient to produce cumulative depolarization of B cells. Precluding disinhibition of the B cell from the caudal hair cell was also found to attenuate cumulative depolarization. Additional constraints, inherent to the neural organization of the visual and statocyst neural systems were found to further limit the degree of cumulative depolarization. Among the most important of these were the interpairing interval and light intensity. Exposure of intact animals of five pairings of light and rotation resulted in short-term suppression of phototactic behavior. Like the cumulative depolarization of B cells with in vitro conditioning procedures, these changes were relatively pairing specific and persisted for comparable durations of time. Cumulative depolarization of B cells appears to be an important initial step in the production of long-term associative neural and behavioral changes in Hermissenda.

Animals

Respiratory and cardiac responses to exercise-simulating peripheral perfusion in endurance trained and untrained rats. I. Reflex responses and changes in perfusion outflow.

Ventilatory and circulatory drives elicited by exercise-simulating perfusion of the circulatory isolated hindleg were examined in 10 trained (TR) and untrained (UTR) rats. TR were submitted to endurance training on a motordriven treadmill (30.min-1 at a grade of 10%, 5 days a week for 30 min). Exercise was simulated by perfusion with modified tyrode solutions: I.) hypoxic, enriched with lactic acid (15 mmol.l-1), II.) normoxic, enriched with lactic acid. III.) hypoxic without lactic acid. Perfusion was performed in anaesthetized animals through cannulae in the femoral artery and vein; the hindled was connected to the rest of the body only by nerve and bone. 10 min of control perfusion (normoxic tyrode solution) was followed by a 20 min test period and another 10 min control perfusion. Apart from heart rate (HR), respiratory rate (RR) and several outflow parameters were measured ([K+], [Na+], [lactate], pH, PO2, PCO2). During control period HR was slightly higher in UTR than in TR (375.5 +/- 3.9 (SE) vs. 364.1 +/- 5.5 beats/min-1, p less than 0.6 n.s.), and RR in UTR was significantly higher than those in TR (61.5 +/- 0.4 bpm vs. 55.5 +/- 3.9 breaths.min-1, p less than 0.001). During the test periods both HR and RR in UTR increased significantly while in TR they did not (e.g. in series I mean HR and RR in UTR increased by 8.9 +/- 1.2 beats.min-1 and 1.4 +/- 0.1 breaths.min-1 respectively, whereas in TR the changes were - 2.9 +/- 1.5 beats/min-1 and -0.8 +/- 0.2 breaths.min-1.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals

Relations between physicians' behaviors and analogue patients' satisfaction, recall, and impressions.

This paper investigates associations between physicians' task-oriented and socioemotional behaviors, on the one hand, and analogue patients' satisfaction, recall of information, and global impressions. The study is based on role-playing subjects' responses to interactions between physicians and simulated patients. Audiotapes of two standardized patient cases presented by trained patient simulators to 43 primary care physicians were rated by role-playing patients (N = 258), and electronically filtered excerpts from the encounters were rated for vocal affect by 37 independent judges. Content analysis was made of the visits' transcripts to assess interaction process and to identify all medical information communicated. Finally, speech error rate was calculated from a combination of audiotape and transcript. Findings revealed that role-playing patients clearly distinguished task from socioemotional behaviors of the physicians, and a consistent pattern of association emerged between physicians' task behaviors and role-playing patients' satisfaction, recall, and impressions. Within the task domain, patient-centered skills (i.e., giving information and counseling) were consistently related to patient effects in a positive direction, but physician-centered behaviors (i.e., giving directions and asking questions) demonstrated the opposite relationship. A negative pattern of association was also evident between physicians' socioemotional behaviors and patient effects.

Affect

Recent advances in computer image generation simulation.

An explosion in flight simulator technology over the past 10 years is revolutionizing U.S. Air Force (USAF) operational training. The single, most important development has been in computer image generation. However, other significant advances are being made in simulator handling qualities, real-time computation systems, and electro-optical displays. These developments hold great promise for achieving high fidelity combat mission simulation. This article reviews the progress to date and predicts its impact, along with that of new computer science advances such as very high speed integrated circuits (VHSIC), on future USAF aircrew simulator training. Some exciting possibilities are multiship, full-mission simulators at replacement training units, miniaturized unit level mission rehearsal training simulators, onboard embedded training capability, and national scale simulator networking.

Aviation

Physician's interviewing styles and medical information obtained from patients.

This paper investigates the association between physicians' interviewing styles and medical information obtained during simulated patient encounters. The sources of data are audiotapes and transcripts of two standardized patient cases presented by trained patient simulators to 43 primary care practitioners. Transcripts were scored for physician proficiency using expert-generated criteria and were content-analyzed to assess the process of communication and information content. Relevant patient disclosure was also scored from the transcripts based on expert-generated criteria. Findings were: 1) On the whole, physicians elicited only slightly more than 50% of the medical information considered important according to expert consensus, with a range from 9% to 85%. 2) Both open and closed questions were substantially related to patient disclosure of medical information to the physician, but open questions were substantially more so (Pearson correlations of 0.37 and 0.72, respectively). 3) Patient education, particularly information regarding prognosis, cause, and prevention, was substantially related to patient disclosure of medical information to the physician (Pearson correlations of 0.44, 0.36, and 0.34, respectively). 5) Finally, clinical expertise was only weakly associated with patient disclosure of medical information to the physician (Pearson correlation of 0.16).

Humans

Auditory reaction times for functional and nonfunctional hearing loss.

Differences in decision processes as measured by auditory reaction times of simulated or actual functional hearing-loss subjects and nonfunctional subjects were investigated. Sensation level data are presented that reflect marked differences between such individuals with regard to probability of response, and means and standard deviations of auditory reaction times. Means and standard deviations of auditory reaction times for nonfunctional subjects are greatly reduced when compared with results obtained by simulated or actual functional subjects. Probability of response data was less effective in differentiating functional from nonfunctional subjects. Individuals who were trained to simulate hearing loss responded in a manner similar to functional patients. The results of this study suggest that auditory reaction time measures can be employed to determine the existence or nonexistence of functional hearing loss with considerable accuracy.

Audiometry

Immersive virtual reality-assisted anatomy training improves endotracheal intubation performance in simulation: a randomized controlled trial among Chinese non-anesthesiology residents.

INTRODUCTION: This study aimed to compare immersive virtual reality (IVR)-assisted versus conventional anatomy training for teaching endotracheal intubation (ETI) to novice non-anesthesiology residents enrolled in China's Standardized Residency Training program. METHODS: A total of 90 non-anesthesiology residents without prior ETI experience were randomly assigned to either an IVR group receiving IVR-assisted anatomy training (n&#x2009;=&#x2009;45) or a control group receiving conventional anatomy training (n&#x2009;=&#x2009;45). All participants underwent a standardized teaching protocol. The primary endpoint was residents' ETI performance on a simulator, assessed using both the Global Rating Scale (GRS) and a task-specific checklist. The secondary endpoints included changes in written multiple-choice question (MCQ) scores and residents' evaluations of the course. RESULTS: In practical ETI assessments on a manikin, the IVR group achieved significantly higher scores on the task-specific checklist than the control group (90.34&#x2009;&#xb1;&#x2009;2.89 vs. 87.20&#x2009;&#xb1;&#x2009;3.29; p&#x2009;<&#x2009;0.001), whereas GRS scores were comparable between groups. Both groups showed significant post-training improvement in knowledge scores (p&#x2009;<&#x2009;0.001), with the IVR group showing a greater gain in theoretical knowledge (54.0% vs. 36.3%; p&#x2009;<&#x2009;0.001). Participants in the IVR group also expressed a stronger preference for their training method (80.8%) and reported higher levels of motivation, confidence, and enjoyment (all p&#x2009;<&#x2009;0.05). CONCLUSION: IVR-assisted anatomy training enhances the effectiveness of ETI training for novice non-anesthesiology residents, offering an interactive, engaging, and reproducible approach within China's Standardized Residency Training framework.

Humans

Standardized visual overlays enhance laparoscopic instruction: A mixed-methods evaluation.

Effective communication during laparoscopic procedures is frequently undermined by spatial disorientation and inconsistent terminology between instructors and trainees. This study examined whether standardized visual overlays on endoscopic monitors could enhance communication and learning. We conducted a three-phase mixed-methods study: qualitative observation of 20 laparoscopic teaching cases; a randomized trial of 63 second-year medical students assigned to control, clock, or alphanumeric grid (AG) overlays during three trials of a standardized transfer task; and intraoperative implementation in 44 cases (30 AG, 14 clock) with post-case surveys and qualitative feedback. In simulation, the clock overlay produced the fastest completion times, whereas the AG yielded the lowest error scores, and both overlays outperformed the control. Intraoperatively, the AG was rated higher than the clock for communication clarity, spatial orientation, perceived operative efficiency, and trainee confidence. Standardized visual overlays, particularly the AG, appear to support intraoperative teaching by providing a shared spatial frame of reference.

Laparoscopy

Isokinetic dynamometry. Applications and limitations.

Isokinetic contraction is the muscular contraction that accompanies constant velocity limb movements around a joint. The velocity of movement is maintained constant by a special dynamometer. The resistance of the dynamometer is equal to the muscular forces applied throughout the range of movement. This method allows the measurement of the muscular forces in dynamic conditions and provides optimal loading of the muscles. However, during movements in the vertical plane, the torque registered by the dynamometer is the resultant torque produced by the muscular and gravitational forces. The error depends on the angular position and the torque potential of the tested muscle group. Several methods have been developed for the correction of gravitational errors in isokinetic data. The torque output also contains artefacts that are associated with the inertial forces during acceleration and deceleration periods before the development of the constant preset angular velocity. For an accurate assessment of muscle function, only constant velocity data should be analysed. The most frequently used isokinetic parameters are the maximum torque and the angular position where it was recorded, the torque output at different angular velocities of movement, the torque ratio of reciprocal muscle groups and the torque output during repeated contractions. The unique features of isokinetic dynamometry are optimal loading of the muscles in dynamic conditions and constant preselected velocity of movement. These features provide safety in the rehabilitation of patients with muscular and ligamentous injuries. Isokinetic dynamometry has also been used for the training of various muscle groups in order to improve the muscular performance in dynamic conditions. The movement velocity of different activities can be simulated during training in order to improve the training effect. Data acquisition and analysis have been improved by using computer systems interfaced to isokinetic dynamometers. Recently developed computer systems provide correction for gravitational and inertial errors, accurate computation of isokinetic parameters and real-time display of the torque output.

Biomechanical Phenomena

Respiratory and cardiac responses to exercise-simulating peripheral perfusion in endurance trained and untrained rats. II. Temporal relationships between outflow parameters and cardiac and respiratory responses.

In endurance trained (TR) and untrained (UTR) rats heart rate (HR) and respiratory rate (RR) were recorded during perfusion of the circulatorily isolated hind leg of the rat with exercise simulating modified tyrode solutions (TR:n = 10, UTR:n = 10; compare part I). During the 20 min test period and the preceding and succeeding periods of control perfusions with an unmodified tyrode solution, [lactate], pH, [K+], [Na+], PO2 and PCO2 were measured in the outflow of the femoral vein. In 3 experimental series: (1) hypoxic tyrode solution enriched with lactic acid (15 mmol.l-1), (2) normoxic solution with lactic acid, (3) hypoxic solution without lactic acid, were applied. The outflow parameters were cross correlated with both HR and RR. The analysis revealed a significant temporal relationship between [lactate], pH, PO2, PCO2 and [K+] and both HR and RR. In the trained rats no temporal correlation between either of the outflow and reflex parameters could be determined. This result was not due to low [lactate], but was also found during perfusion with lactic acid. In all 3 test conditions [lactate] in untrained individuals was best correlated with both HR and RR. Although the correlation peaks of the respiratory response, but not of the HR response were definitely lower in normoxic lactic and perfusion than in the two other experimental conditions, both inter- and intraindividual correlation analyses revealed a high degree of interdependence between respiratory and cardiac responses.

Animals

Nondominant Hand Training in Laparoscopy for Surgical Interns: Feasibility and Impact.

OBJECTIVE: Laparoscopy requires bimanual proficiency, yet early trainees demonstrate underdeveloped nondominant hand (NDH) performance. Although deliberate practice of NDH skill contributes to overall performance, NDH training is rarely incorporated into residency simulation curricula and has not been formally evaluated in surgical trainees. We assessed feasibility and impact of integrating structured NDH training with established laparoscopic curriculum for surgery interns. DESIGN: Prospective, single-institution randomized pilot study. Interns were assigned the standard 4-week curriculum of laparoscopic dominant hand and bimanual tasks (Control) or completed assigned NDH tasks in addition to the standard curriculum (Intervention). Feasibility was determined by assigned task completion, daily standard and NDH-specific self-reported practice time, and improvement in bimanual task performance. Performance was video recorded weekly and assessed by blinded evaluators using MISTELS and GOALS scoring. Cognitive workload during laparoscopic tasks was measured via NASA-TLX. Exploratory analyses were conducted within a Bayesian framework. SETTING: A single academic institution with a surgical simulation training program. PARTICIPANTS: General surgery interns on their 4-week simulation rotation. RESULTS: Eleven general surgery interns (6 intervention, 5 controls; all right-hand dominant) completed the study with 100% task completion and practice log compliance. Both groups improved in bimanual performance and perceived cognitive load. Reduction in cognitive workload during bimanual task performance was greater in the NDH group. Time spent on NDH practice over 4 weeks was associated with improved bimanual performance, independent of time spent on standard curriculum tasks. CONCLUSIONS: Structured NDH training is feasible to implement within an existing curriculum and reduces perceived cognitive workload during bimanual laparoscopic tasks. NDH practice demonstrates a beneficial dose-response relationship with performance, supporting its integration into early laparoscopic training.

Laparoscopy

Effectiveness of artificial intelligence in nursing simulation education: A systematic review, meta-analysis and bibliometric visualization analysis.

OBJECTIVES: To synthesize the roles and core functions of AI in nursing simulation education for nursing students via systematic review, quantitatively evaluate its effects on students' knowledge and skill outcomes through meta-analysis, and map the research landscape and development trends of this field through bibliometric visualization analysis. DESIGN: Systematic review, meta-analysis and bibliometric visualization analysis. DATA SOURCES: Eight electronic databases: PubMed, Web of Science, MEDLINE, ERIC, Academic Search Complete, China National Knowledge Infrastructure (CNKI), Wanfang Database, VIP Chinese Science and Technology Journal Database (VIP) were employed to search studies from the time of construction to 16 December 2025. REVIEW METHODS: Studies meeting the inclusion criteria were screened. The revised Cochrane Risk of Bias tool (ROB 2) and Joanna Briggs Institute (JBI) critical appraisal checklists were used for quality assessment. Meta-analysis was performed with Review Manager 5.4, and bibliometric visualization analysis was conducted using VOSviewer 1.6.20 and Bibliometrix (based on R4.4.3). RESULTS: A total of 61 studies were included. AI primarily played two roles in nursing simulation education: peer-type new subject (n&#xa0;=&#xa0;24) and direct mediator (n&#xa0;=&#xa0;22). Meta-analysis showed that AI interventions significantly improved nursing students' knowledge (SMD&#xa0;=&#xa0;1.49, 95% CI [0.55,2.43], p&#xa0;=&#xa0;0.002) and skills (SMD&#xa0;=&#xa0;0.66, 95% CI [0.02,1.31], p&#xa0;=&#xa0;0.04). Bibliometric analysis identified that the United States of America and China were the two main contributing countries in this field, and the key motor themes included generative artificial intelligence, virtual patients, and geriatric care. CONCLUSIONS: AI exerts positive effects on nursing students' knowledge acquisition and skill enhancement in simulation education, with peer-type new subject and direct mediator as the dominant roles. Future research should focus on expanding AI applications in multi-specialty simulation scenarios, activating the data-driven value of machine learning, and strengthening international collaboration and standardization construction, so as to promote the sustainable development of AI-integrated nursing simulation education.

Humans

Altitude training and muscular metabolism.

To study the effects of training at moderate altitude on muscle metabolism; we defined the lowest altitude which affected the aerobic capacity in man, and we studied the differences between training at an altitude of 2300 m and at sea level, both at the same relative (to the VO2max) and absolute intensity of work. We confirmed that at 1200 m the VO2max is decreased in sedentary and well-trained persons. Elite athletes already at 900 m decrease their VO2max. We have found an increase in myoglobin, oxidative enzyme activities and endurance capacity and a decrease in some glycolytic enzyme activities associated with simulated altitude training. We conclude that when the amount of training performed at altitude is similar to the amount at sea level, the stimulus of hypoxia associated with the training stimulus induces improvements in the muscle oxidative enzymes and myoglobin.

Adaptation, Physiological

The design of CAST (Computer-Aided Speechreading Training).

The underlying theoretical assumptions, goals, design, and implementation of a Computer-Aided Speechreading Training system (CAST) are described as a case study in program design. This computerized speechreading assessment and training system simulates face-to-face intervention and is designed to be one component of a comprehensive aural rehabilitation program for preretirement adults with acquired mild-to-moderate hearing loss. The interactive, automated course consists of eight training lessons, each focusing on a particular viseme that is practiced by a modified discourse tracking method using viseme-specific texts. Three basic speechreading skills are emphasized: visual speech perception, use of linguistic redundancy, and use of feedback between message sender and receiver. These skills are evaluated separately by means of CAST tracking rate, receiver strategy, and inferred error type. Four example case assessments are provided to illustrate the potential applications of CAST as a standardizable rehabilitative tool. An independent program evaluation is provided in a companion paper (Gagné, Dinon, & Parsons, 1991). Comparisons between CAST, face-to-face tracking procedures, and natural discourse are presented and discussed with reference to theoretical and clinical issues in speechreading and program evaluation.

Computer-Assisted Instruction

An improved graphical method for pattern recognition from spike trains of spontaneously active neurons.

Spontaneous activity and rhythmical oscillations are common features of large neuronal networks in mammals. Detection of repetitive spike patterns or pacemaker activity during electrophysiological recording of spontaneous action potentials from single neurons can be difficult if a "noisy" background is present. This paper describes an improved method for an online spike train analysis based on joint interval histograms (JIH, Rodiek et al. 1962). By means of higher ordered JIH the discrimination of spike patterns with repetitive bursting activity or oscillations is possible even when randomly distributed action potentials appear. Examples of simulated spike trains and those recorded from cultured hippocampal neurons are presented.

Animals

Use of a motion sickness history questionnaire for prediction of simulator sickness.

This research assessed the usefulness of the Motion History Questionnaire (MHQ) for the prediction of simulator sickness, a form of motion sickness experienced by pilots training in ground-based flight simulators. Four MHQ scoring keys were compared: (1) the original MHQ key which had been validated on a sample of U.S. Navy student pilots exposed to Coriolis forces, (2 and 3) two keys which had been validated on a sample of civilian college students exposed to simulated ship motions, and (4) a simulator sickness key empirically derived in the present research and cross-validated. Navy and Marine Corps aviators (N = 456) filled out the MHQ prior to their regularly scheduled flight simulator training and were divided into validation and cross-validation samples. All scoring keys were predictive of reported symptoms of sickness, but highest correlations were obtained with the empirically-derived simulator sickness (SS) key. It is suggested that the SS key be used for self-testing so that pilots may be made aware of their risk for developing simulator sickness.

Aerospace Medicine

Limitations of postural equilibrium tests for examining simulator sickness.

The psychometric properties of four ataxia tests and their sensitivities to disorientation were examined to assess their potential for measuring balance disturbances frequently reported with simulator sickness. The study was conducted in two parts. In the first, subjects practiced for 10 sessions to examine learning effects and to stabilize performance. In the second, the sensitivities of the four tests were examined by comparing performance before and after exposure to sensory conflict produced using a disorientation training flight simulator. Subjective measures of disorientation, including reports of postural disequilibrium, were also collected. The results indicated initial learning on all four ataxia measures. Two of the tests, the Stand on One Leg Eyes Closed and the Sharpened Romberg, exhibited acceptable levels of reliability. However, only the latter showed sufficient sensitivity to corroborate subjective reports of postural disequilibrium.

Adult

Phylogenetic Methods Meet Deep Learning.

Deep learning (DL) has been widely used in various scientific fields, but its integration into phylogenetics has been slower, primarily due to the complex nature of phylogenetic data. The studies that apply DL to sequencing data often limit analyses to four-taxon trees. Many of these studies serve as "proof of principle" and perform similarly to traditional phylogeny reconstruction methods. New ways of using training data, such as encoding with compact bijective ladderized vectors or transformers, enable the handling of much larger trees and genomic data sets. This short perspective focuses on the application of DL in phylogenetics, introducing prevalent DL architectures. We highlight potential problems in the field by discussing the risks of using simulation-based training data and emphasize the importance of reproducibility and robustness in computational estimates. Finally, we explore promising research areas, including the combination of phylogenetics and population genetics in DL, the analysis of neighbor dependencies, and the potential to significantly reduce computational cost compared to traditional methods. This perspective illustrates the potential of DL in complementing traditional phylogeny reconstruction methods and aiding the advancement of phylogenetic analysis, especially in performing computationally demanding tasks such as model selection or estimating branch support values.

Humans