What is the impact of interleaving practice and delaying judgments on the accuracy of category-learning judgments?

How could people enhance the accuracy of judgments for predicting math performance on an upcoming test? Research on category-learning judgments shows that their accuracy is poor for predicting performance for mathematics concepts. Based on cue-utilization theory, interleaved practice (which can enhance performance) and delaying judgments after initial study were expected to produce diagnostic cues for predicting performance and in turn improve judgment accuracy. In three experiments, we had participants practice solving problems involving (a) volumes of three-dimensional shapes (Experiments 1, 2, and 3) and (b) fractions (Experiments 1 and 3). Critically, participants either interleaved or blocked their practice of these math materials, and then judgments were made immediately after practice and after a week-long delay when participants returned for the criterion test. Judgment accuracy did not improve for the interleaved practice versus blocked practice groups, but judgment accuracy was greater when the judgments were delayed compared to when they were immediate. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Instructions to shift eyes do not increase item-method directed forgetting.

Successful forgetting of recently-studied information has been shown to be positively correlated with eye movements [Lee, Y. (2018). Withdrawal of spatial overt attention following intentional forgetting: Evidence from eye movements. Memory (Hove, England), 26(4), 503-513. https://doi.org/10.1080/09658211.2017.1378360]. We tested whether eye movements caused forgetting by manipulating instructions to move eyes following forget and remember cues in item-method directed forgetting. In Experiment 1, participants were instructed to move eyes to the periphery after TBF trials or to focus on the centre where the TBF word and cue had been presented. In Experiment 2, we manipulated eye movement instructions within participants such that on half of the TBR and TBF trials participants shifted their eyes to the periphery, and on the other half of the trials, participants focused on the centre of the screen. Experiment 3 replicated Experiment 2 with an added probe task which ensured participants were moving their eyes as instructed. Results overall showed eye movements did not increase directed forgetting. Instructing participants to shift or focus eyes did not interact with the effectiveness of directed forgetting. Furthermore, metacognitive measures collected during study indicated that participants are sensitive to the significant effects of directed forgetting, but - like recall - judgments were not affected by eye movement instructions. From these findings, we concluded that eye movements do not promote intentional forgetting.

Compromise of Personal Protective Clothing from Liquid Exposure.

INTRODUCTION: Following critiques of multiple personal contamination events from entries into the Oak Ridge National Laboratory's Spallation Neutron Source Transfer Bay, it was considered that the most likely causes for contamination were personal protective clothing doffing errors or moisture (sweat) allowing contamination to wick through the protective clothing. Radiological protection staff looked more closely, however, at the specific area of the clothing where contamination was highest; under enhanced lighting and photochromic manipulation, there appeared to have been some type of moisture in the area. Recognizing the possibility that moisture may have allowed for migration of contamination through the clothing, further experiments were undertaken to determine under which conditions this transport might have occurred. OBJECTIVE: The objective for this work was to identify the susceptibility of different types of personal protective clothing to various liquids encountered in the workplace. METHOD: Several tests were performed to determine if perspiration had enabled migration of contamination and to identify what other liquids might have affected contamination transport. Two layers of personal protective clothing were subjected to static conditions and dynamic conditions to include active rubbing of the materials while wet. Food dye added to each of the liquids tested enabled visual indications of liquid breakthrough. Additional tests were conducted to see if solid contamination could be transported through the materials along with the liquids. RESULTS: All but one type of non-rubberized personal protective clothing in use at Oak Ridge National Laboratory were permanently compromised to some extent by the solvents used for decontamination. CONCLUSION: It was determined that most common cleaning agents immediately and permanently destroyed the hydrophobic nature of several of the tested protective clothing materials, potentially allowing for radioactive contamination to penetrate through the material to the worker. Work around wet surfaces or performing wet decontamination will only be performed in protective clothing known to prevent transport of the wetting agent.

Long-term Performance of Fresh Autologous Pericardium for Mitral Valve Leaflet Repair.

BACKGROUND: Glutaraldehyde-fixed autologous or bovine pericardial patches used for mitral valve leaflet reconstruction have been associated with late calcification. Fresh autologous pericardium (FAP) may be a durable alternative. METHODS: Transthoracic echocardiography was used to assess valve function (regurgitation, mean pressure gradient, patch pliability, and calcification) in patients undergoing FAP mitral leaflet repairs. Pliability was scored between 1 (similar to native leaflets) and 4 (rigid). Calcification was scored between 1 (echobrightness similar to native leaflets) and 4 (very bright). RESULTS: Between 2002 and 2018, 62 consecutive patients (50% male, 51 ± 2 years, 69% infective endocarditis) underwent mitral valve repair with FAP, and Patch placement was on the anterior (31 of 62), posterior (27 of 62), or both (1 of 62) leaflets. Late echocardiographic follow-up was available for 43 of 62 patients (median follow-up, 3.6 years; range, 0.5-6 years). Average pliability scores were unchanged between discharge (1.2 ± 0.1) and follow-up (1.2 ± 0.2, P = .79). Average brightness scores increased modestly (predischarge, 1.6 ± 0.1; follow-up, 1.8 ± 0.1; P = .01). Three patients had recurrent severe mitral regurgitation, and 2 underwent reoperation, 1 at 1 year postoperatively for recurrent endocarditis and 1 at 6 years postoperatively for degenerative disease progression. At reoperation, patches were pliable, free from calcification, and comparable in thickness to adjacent native leaflet. One patient developed suture line leak, which was repaired. No other evidence of patch dehiscence, retraction, or aneurysm was observed. The 10-year freedom from reoperation of 82% and survival rate of 84% are comparable to repair with glutaraldehyde-fixed or bovine pericardial patches. CONCLUSIONS: FAP is an excellent substrate for complex mitral valve leaflet patch repairs and can be used with the expectation of durable, long-term valve function, without evidence of late patch calcification, stiffness, or aneurysmal degeneration.

Why does interleaving improve math learning? The contributions of discriminative contrast and distributed practice.

Interleaved practice involves studying exemplars from different categories in a non-systematic, pseudorandom order under the constraint that no two exemplars from the same category are presented consecutively. Interleaved practice of materials has been shown to enhance test performance compared to blocked practice in which exemplars from the same category are studied together. Why does interleaved practice produce this benefit? We evaluated two non-mutually exclusive hypotheses, the discriminative-contrast hypothesis and the distributed-practice hypothesis, by testing participants' performance on calculating the volume of three-dimensional geometric shapes. In Experiment 1, participants repeatedly practiced calculating the volume of four different-sized shapes according to blocked practice, interleaved practice, or remote-interleaved practice (which involved alternating the practice of volume calculation with non-volume problems, like permutations and fraction addition). Standard interleaving enhanced performance compared to blocked practice but did not produce enhanced performance compared to remote interleaving. In Experiment 2, we replicated this pattern and extended the results to include a remote-blocked group, which involved blocking volume calculation with non-volume problems. Performance on key measures was better for remote-interleaved groups compared to remote-blocked groups, a finding that supports the distributed-practice hypothesis.

Isolated Mitral Valve Surgery: The Society of Thoracic Surgeons Adult Cardiac Surgery Database Analysis.

BACKGROUND: Data from The Society of Thoracic Surgeons Adult Cardiac Surgery Database were analyzed to identify trends in patient characteristics and outcomes of mitral valve operations in North America. METHODS: All patients with isolated primary mitral valve operations with or without tricuspid valve repair, surgical atrial fibrillation ablation, or atrial septal defect closure performed July 2011 to September 2016 were identified. A subgroup analysis assessed patients with degenerative leaflet prolapse (DLP). RESULTS: Isolated primary mitral valve operations were performed on 87,214 patients at 1,125 centers, increasing by 24% between 2011 (n = 14,442) and 2016 (n = 17,907). The most common etiology was DLP (60.7%); 4.3% had functional mitral regurgitation. Preoperatively, 47.3% of patients had an ejection fraction less than 60% and 34.2% had atrial fibrillation. Overall mitral valve repair rate was 65.6%, declining from 67.1% (2011) to 63.2% (2016; p < 0.0001). Repair rates were related to etiology (DLP, 82.5%; rheumatic, 17.5%). Of the 29,970 mitral valve replacements, 16.2% were preceded by an attempted repair. Repair techniques included prosthetic annuloplasty (94.3%), leaflet resection (46.5%), and artificial cord implantation (22.7%). Bioprosthetic valves were implanted with increasing frequency (2011, 65.4%; 2016, 75.8%; p < 0.0001). Less-invasive operations were performed in 23.0% and concomitant tricuspid valve repair in 15.7%. Unadjusted operative mortality was 3.7% (replacements) and 1.1% (repairs). CONCLUSIONS: Patients undergoing primary isolated mitral valve operations commonly have ventricular dysfunction, atrial fibrillation, and heart failure. Although contemporary outcomes are excellent, earlier guideline-directed referral and increased frequency and quality of repair may further improve results of mitral valve operations.

Transmitral Septal Myectomy for Hypertrophic Obstructive Cardiomyopathy.

BACKGROUND: Intrinsic abnormalities of the mitral valve are common in patients with hypertrophic cardiomyopathy and may need to be addressed at operation. METHODS: Consecutive patients undergoing transmitral septal myectomy were retrospectively reviewed. The ventricular septum was exposed through a left atriotomy, and the anterior leaflet of the mitral valve was detached from its annulus. An extended myectomy was performed to the base of the papillary muscles. After myectomy, the anterior leaflet was reattached and concomitant mitral valve repair or replacement was performed. In some cases, we performed a modified anterolateral commissural closure suture, which served to reposition the lateral aspect of the anterior leaflet out of the left ventricular outflow tract ("curtain stitch"). RESULTS: Twenty patients who underwent this procedure were identified (70% women; mean age 63 years). Mitral regurgitation was moderate in 55% and severe in 40%. Preoperative peak left ventricular outflow tract gradient was 92 ± 43 mm Hg. Mitral valve repair (n = 11) or replacement (n = 9) was performed. Predischarge transthoracic echocardiography demonstrated a left ventricular outflow tract gradient of 10 ± 5 mm Hg. There was no operative mortality. Follow-up was 100% complete and averaged 22 ± 25 months. No patient required reoperation, and there was no recurrence of left ventricular outflow tract obstruction or mitral regurgitation greater than mild. CONCLUSIONS: Potential advantages of transmitral myectomy include a panoramic view of the septum and mitral subvalvular apparatus and the ability to simultaneously address mitral valve pathology. Consideration should be given to using the transmitral approach to septal myectomy as the preferred approach for the surgical treatment of hypertrophic cardiomyopathy.

Do people use category-learning judgments to regulate their learning of natural categories?

Although research has established that people can accurately judge how well they have learned categories, no research has examined whether people use their category-learning judgments (CLJs) to regulate their restudy of natural categories. Thus, in five experiments we investigated the relationship between people's CLJs and selections of categories for restudy. Participants first attempted to learn natural categories (bird families; e.g., finches, grosbeaks, and warblers) so that they could categorize new exemplars on a final test. After this initial study phase, participants made a CLJ for each category and then selected a subset of the categories for restudy. Across experiments, we also manipulated several variables (e.g., selecting either three or nine categories, or obtaining 30% vs. 80% performance on the final test) that were expected to influence restudy selections. However, the manipulations typically had minimal impact. More important, in all experiments we found an unexpected outcome: Some participants tended to select the categories they judged to be most well learned for restudy, and others tended to select those judged to be least well learned. We discovered these qualitative differences in the use of CLJs to make restudy selections by using post-hoc analyses in Experiments 1a and 1b, and hence we sought to (a) replicate them in Experiments 2, 3, and 4 and (b) provide preliminary evidence regarding factors that can (vs. cannot) account for them. Most important, evidence across all of the experiments supported the conclusion that people do use their CLJs to select categories for restudy.

Undersized Rigid Nonplanar Annuloplasty: The Key to Effective and Durable Repair of Functional Tricuspid Regurgitation.

BACKGROUND: Previous clinical experiences have demonstrated high early and late recurrence rates after repair of functional tricuspid regurgitation (TR). We investigated the results of functional TR repair with undersized rigid nonplanar annuloplasty rings. METHODS: From January 2007 to December 2013, 216 consecutive patients with moderate or greater functional TR were treated with undersized (size 26 mm or 28 mm) rigid nonplanar annuloplasty rings. RESULTS: The mean age was 69 ± 13 years. There was a previous history of cardiac operation in 25% (54 of 216 patients). Tricuspid regurgitation was graded as severe in 47% (102 of 216) and moderate in 53% (114 of 216). Concomitant operations included mitral valve procedures in 92% (198 of 216), coronary artery bypass grafting in 21% (45 of 216), aortic valve procedures in 9% (20 of 216), and cryomaze procedures in 35% (76 of 216). Size 26 mm rings were used in 38% of patients (81 of 216), and size 28 mm in 62% (135 of 216). The perioperative mortality rate was 6% (14 of 216). On predischarge echocardiography, TR grade was none or mild in 94% (176 of 187 patients), moderate in 4% (7 of 187), and severe in 2% (4 of 187). At a mean follow-up of 33.0 ± 24.0 months, TR grade was none or mild in 81% of patients (130 of 160), moderate in 16% (26 of 160), and severe in 2% (4 of 160). There were no reoperations for recurrent TR, and no patients have had tricuspid stenosis or annuloplasty ring dehiscence. CONCLUSIONS: Treatment of functional TR with undersized (26 mm or 28 mm) nonplanar rigid annuloplasty rings is safe and highly effective, with a near absence of recurrent severe TR at midterm follow-up.

Contemporary outcomes of operations for tricuspid valve infective endocarditis.

BACKGROUND: Tricuspid valve infective endocarditis (TVIE) is uncommon. Patients are traditionally treated with antibiotics alone, and indications for operation are not clearly established. We report our operative single-center experience. METHODS: We retrospectively reviewed 56 patients who underwent operations for TVIE between January 2002 and December 2012. RESULTS: Methicillin-resistant Staphylococcus aureus was present in 41% of patients, septic pulmonary emboli in 63%, moderate/severe tricuspid regurgitation in 66%, and 86% were intravenous drug abusers. Patients underwent early operation if there was concomitant left-sided endocarditis with indications for operation (n = 18), atrial septal defect (n = 6), infected pacemaker lead (n = 4), or prosthetic TVIE (n = 1). The remaining 27 patients were treated with intravenous antibiotics. Five patients completed a 6-week course of intravenous antibiotics before requiring an operation for symptomatic severe tricuspid regurgitation or persistent bacteremia. Twenty-two patients did not complete the antibiotic therapy and underwent operation for symptomatic severe tricuspid regurgitation (n = 15), persistent fevers/bacteremia (n = 3), or patient-specific factors (n = 4). Valve repair was successful in 57% of patients. Overall operative mortality was 7.1%. No operative deaths occurred in patients with isolated native TVIE. Recurrent TVIE was diagnosed in 21% (5 of 24) of the replacement group and in 0% (0 of 32) in the repair group. Use of repair was strongly protective against recurrent TVIE (p < 0.01). CONCLUSIONS: In contrast to previously published reports of high operative mortality with TVIE, this experience demonstrates improved outcomes with low morbidity and mortality, particularly for native isolated TVIE. Future prospective comparisons between surgically and medically treated patients may help to further define indications and timing for operation for patients with TVIE.

Metacognition influences item-method directed forgetting.

In 4 experiments, we examined whether metacognitive beliefs about item memorability influence item-method directed forgetting. In Experiment 1, participants studied loud and quiet items, which were subsequently cued as to-be-remembered (TBR) or to-be-forgotten (TBF). Typically, the volume of stimuli does not influence recall, although loud items are judged as more memorable than quiet items (Rhodes & Castel, 2009). In contrast, we found a recall advantage for loud items in directed forgetting, although this was observed for TBR items but not TBF items. The loud item advantage disappeared in Experiment 2, when we eliminated all TBF trials and instead inserted additional trials during which participants could engage in extra rehearsal of earlier presented items. In Experiments 3 and 4, a recall advantage for loud items was observed again when items were assigned a mixture of positive and negative values, but it did not emerge when items were assigned graded positive values. Overall, the results showed that the recall advantage for loud items emerges only in response to the need to forget some items. We propose 2 mechanisms to account for these results-either participants select to rehearse loud items as a controlled strategy that allows them to forget some items, or they have an unconscious preference for loud items that emerges only in response to the need to forget.

The role of forget-cue salience in list-method directed forgetting.

Research suggests that manipulating the wording of the forget cue in list-method directed forgetting affects the magnitude of directed forgetting both in younger children (Aslan, Staudigl, Samenieh, & Bauml, in press) and in older adults (Sahakyan, Delaney, & Goodmon, 2008). This occurs when the forget cue overemphasises the importance of forgetting in the current context. The present experiment investigated whether de-emphasising forgetting affected the magnitude of list-method directed forgetting in college adults. Some participants received overt forget cues that explicitly instructed them to forget earlier studied items, whereas others received covert forget cues that implied forgetting by emphasising selective remembering (e.g., "you will only need to remember some of the items"). Results indicated equivalent directed forgetting for both types of cues. However, regardless of the type of cue received, participants who reported using specific forgetting strategies in response to the forget cue showed directed forgetting, whereas those that reported doing nothing did not show any effects. The results underscore that successful directed forgetting requires engagement of controlled processes.