Zooming in on what counts as core and auxiliary: A case study on recognition models of visual working memory.

Research on best practices in theory assessment highlights that testing theories is challenging because they inherit a new set of assumptions as soon as they are linked to a specific methodology. In this article, we integrate and build on this work by demonstrating the breadth of these challenges. We show that tracking auxiliary assumptions is difficult because they are made at different stages of theory testing and at multiple levels of a theory. We focus on these issues in a reanalysis of a seminal study and its replications, both of which use a simple working-memory paradigm and a mainstream computational modeling approach. These studies provide the main evidence for "all-or-none" recognition models of visual working memory and are still used as the basis for how to measure performance in popular visual working-memory tasks. In our reanalysis, we find that core practical auxiliary assumptions were unchecked and violated; the original model comparison metrics and data were not diagnostic in several experiments. Furthermore, we find that models were not matched on "theory general" auxiliary assumptions, meaning that the set of tested models was restricted, and not matched in theoretical scope. After testing these auxiliary assumptions and identifying diagnostic testing conditions, we find evidence for the opposite conclusion. That is, continuous resource models outperform all-or-none models. Together, our work demonstrates why tracking and testing auxiliary assumptions remains a fundamental challenge, even in prominent studies led by careful, computationally minded researchers. Our work also serves as a conceptual guide on how to identify and test the gamut of auxiliary assumptions in theory assessment, and we discuss these ideas in the context of contemporary approaches to scientific discovery.

The effects of filler similarity and lineup size on eyewitness identification.

A photo lineup, which is a cross between an old/new and a forced-choice recognition memory test, consists of one suspect, whose face was either seen before or not, and several physically similar fillers. First, the participant/witness must decide whether the person who was previously seen is present (old/new) and then, if present, choose the previously seen target (forced choice). Competing signal-detection models of eyewitness identification performance make different predictions about how certain variables will affect a witness's ability to discriminate previously seen (guilty) suspects from new (innocent) suspects. One key variable is the similarity of the fillers to the suspect in the lineup, and another key variable is the size of the lineup (i.e., the number of fillers). Previous research investigating the role of filler similarity has supported one model, known as the Ensemble model, whereas previous research investigating the role of lineup size has supported a competing model, known as the Independent Observations model. We simultaneously manipulated these two variables (filler similarity and lineup size) and found a pattern that is not predicted by either model. When the fillers were highly similar to the suspect, increasing lineup size reduced discriminability, but when the fillers were dissimilar to the suspect, increasing lineup size enhanced discriminability. The results suggest that each additional filler adds noise to the decision-making process and that this noise factor is minimized by maximizing filler dissimilarity. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Transcutaneous osseointegration for amputees.

Transcutaneous osseointegration for amputees (TOFA) is an evolving technology that has the potential to revolutionize the interface between the amputee and their prosthesis, showing potential at many levels of amputation. While no amputation is without its challenges, TOFA requires a highly specialized prosthesis and a multidisciplinary team that includes specialized surgeons, physical therapists, wound care teams, and social workers who guide the amputee through surgery, postoperative rehabilitation, and the chronic wound care that goes into maintaining the prosthesis. The infrastructure required to facilitate care pathways that lead to reliable, successful outcomes are unique in each health care setting, including those in advanced health care systems such as the United States and Australia. This article details the emerging evidence supporting the use of this prosthetic interface design and many of the challenges that providers face when establishing programs to offer this type of care in the United States.

Bacteriophage therapy and current delivery strategies for orthopedic infections: A SCOPING review.

OBJECTIVES: Interest in phages as adjunctive therapy to treat difficult infections has grown in the last decade. However, phage dosing and delivery for orthopedic infections have not been systematically summarized. METHODS: Following PRISMA-ScR guidelines, we conducted a SCOPING review through September 1st, 2023, of MEDLINE, Embase, Web of Science Core Collection, and Cochrane Central. RESULTS: In total, 77 studies were included, of which 19 (24.7%) were in vitro studies, 17 (22.1%) were animal studies, and 41 (53.2%) were studies in humans. A total of 137 contemporary patients receiving phage therapy are described. CONCLUSIONS: Direct phage delivery remains the most studied form of phage therapy, notably in prosthetic joint infections, osteomyelitis, and diabetic foot ulcers. Available evidence describing phage therapy in humans suggests favorable outcomes for orthopedic infections, though this evidence is composed largely of low-level descriptive studies. Several phage delivery devices have been described, though a lack of comparative and in-human evidence limits their therapeutic application. Limitations to the use of phage therapy for orthopedic infections that need to be overcome include a lack of understanding related to optimal dosing and phage pharmacokinetics, bacterial heterogeneity in an infection episode, and phage therapy toxicity.

Antibiotic prophylaxis following low-velocity gunshot fractures: an updated review.

PURPOSE: Low-velocity gunshot fractures (LVGFs) are a common type of gunshot-induced trauma with the potential for complications such as infection and osteomyelitis. The effectiveness of antibiotic therapy in LVGFs remains uncertain, leading to ongoing debate about the appropriate treatment. In this review, we evaluate recent updates on the current understanding of antibiotic therapy in LVGFs, how previous studies have investigated the use of antibiotics in LVGFs, and the current state of institutional policies and protocols for treating LVGFs with antibiotics. METHODS: We conducted a review of PubMed, Embase, and Web of Science databases to identify studies that investigated the use of antibiotics in LVGFs after the last review in 2013. Due to the lack of quantitative clinical trial studies, we employed a narrative synthesis approach to analyze and present the findings from the included primary studies. We categorized the outcomes based on the anatomical location of the LVGFs. RESULTS: After evaluating 67 publications with the necessary qualifications out of 578 abstracts, 17 articles were included. The sample size of the studies ranged from 22 to 252 patients. The antibiotics used in the studies varied, and the follow-up period ranged from three months to ten years. The included studies investigated the use of antibiotics in treating LVGFs at various anatomic locations, including the humerus, forearm, hand and wrist, hip, femur, tibia, and foot and ankle. CONCLUSION: Our study provides updated evidence for the use of antibiotics in LVGFs and highlights the need for further research to establish evidence-based guidelines. We also highlight the lack of institutional policies for treating LVGFs and the heterogeneity in treatments among institutions with established protocols. A single-dose antibiotic approach could be cost-effective for patients with non-operatively treated LVGFs. We suggest that a national or international registry for gunshot injuries, antibiotics, and infections could serve as a valuable resource for collecting and analyzing data related to these important healthcare issues.

Retrograde Intramedullary Nailing Versus Locked Plating for Extreme Distal Periprosthetic Femur Fractures: A Multicenter Retrospective Cohort Study.

OBJECTIVES: To compare clinical and radiographic outcomes after retrograde intramedullary nailing (rIMN) versus locked plating (LP) of "extreme distal" periprosthetic femur fractures, defined as those that contact or extend distal to the anterior flange. DESIGN: Retrospective review. SETTING: Eight academic level I trauma centers. PATIENT SELECTION CRITERIA: Adult patients with periprosthetic distal femur fractures at or distal to the anterior flange (OTA/AO 33B-C[VB1]) treated with rIMN or LP. OUTCOME MEASURES AND COMPARISONS: The primary outcome was reoperation to promote healing or to treat infection (reoperation for elective removal of symptomatic hardware was excluded from this analysis). Secondary outcomes included nonunion, delayed union, fixation failure, infection, overall reoperation rate, distal femoral alignment, and ambulatory status at final follow-up. Outcomes were compared between patients treated with rIMN or LP. RESULTS: Seventy-one patients treated with rIMN and 224 patients treated with LP were included. The rIMN group had fewer points of fixation in the distal segment (rIMN: 3.5 ± 1.1 vs. LP: 6.0 ± 1.1, P < 0.001) and more patients who were allowed to weight-bear as tolerated immediately postoperatively (rIMN: 45%; LP: 9%, P < 0.01). Reoperation to promote union and/or treat infection was 8% in the rIMN group and 16% in the LP group ( P = 0.122). There were no significant differences in nonunion ( P > 0.999), delayed union ( P = 0.079), fixation failure ( P > 0.999), infection ( P = 0.084), or overall reoperation rate ( P > 0.999). Significantly more patients in the rIMN group were ambulatory without assistive devices at final follow-up (rIMN: 35%, LP: 18%, P = 0.008). CONCLUSIONS: rIMN of extreme distal periprosthetic femur fractures has similar complication rates compared with LP, with a possible advantage of earlier return to weight-bearing. Surgeons can consider this treatment strategy in all fractures with stable implants and amenable prosthesis geometry, even extreme distal fractures. LEVEL OF EVIDENCE: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Norman Henry Anderson (1925-2022).

This article memorializes Norman Henry Anderson (1925-2022), best known for his information integration theory (IIT). Norman Anderson's work was influential in its time, and his legacy endures. He was the recipient of the 1972 American Association for the Advancement of Science Prize for Behavioral Science Research, and, as a tribute to his work, scholars in the field established a conference that continues to this day: the International Information Integration Theory/Functional Measurement Conference. Highlights of Anderson's career and professional contributions are noted. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Electrical impedance myography for the early detection of muscle ischemia secondary to compartment syndrome: a study in a rat model.

Acute Compartment Syndrome (ACS) is one of the most devastating orthopedic conditions, affecting any of the body's many compartments, which, if sufficiently severe, may result in disability and amputation. Currently, intra-compartmental pressure measurements serve as the gold standard for diagnosing ACS. Diagnosing limbs at risk for ACS before irreversible damage to muscle and nerve is critical. Standard approaches for diagnosing impending compartment syndrome include clinical evaluation of the limb, such as assessment for "tightness" of the overlying skin, reduced pulses distally, and degree of pain, none of which are specific or sensitive. We have proposed a novel method to detect ACS via electrical impedance myography (EIM), where a weak, high-frequency alternating current is passed between one pair of electrodes through a region of tissue, and the resulting surface voltages are measured via a second pair. We evaluated the ability of EIM to detect early muscle ischemia in an established murine model of compression-induced muscle injury, where we collected resistance, reactance, and their dimensionless product, defined as Relative Injury Index (RII) during the study. Our model generated reproducible hypoxia, confirmed by Hypoxyprobe™ staining of endothelial regions within the muscle. Under conditions of ischemia, we demonstrated a reproducible, stable, and significant escalation in resistance, reactance, and RII values, compared to uninjured control limbs. These data make a reasonable argument for additional investigations into using EIM for the early recognition of muscle hypoperfusion and ischemia. However, these findings must be considered preliminary steps, requiring further pre-clinical and clinical validation.

Fracture healing-orthobiologics: from basic science to clinical application.

Orthopaedics as a field and a profession is fundamentally concerned with the treatment of musculoskeletal disease, in all of its many forms. Our collective understanding of the cellular mechanisms underlying musculoskeletal pathology resulting from injury continues to evolve, opening novel opportunities to develop orthobiologic treatments to improve care. It is a long path to move from an understanding of cellular pathology to development of successful clinical treatment, and this article proposes to discuss some of the challenges to achieving translational therapies in orthopaedics. The article will focus on challenges that clinicians will likely face in seeking to bring promising treatments forward to clinical practice and strategies for improving success in translational efforts.

Outcomes of fixation of Vancouver B periprosthetic fractures around cemented versus uncemented stems.

BACKGROUND: The incidence of periprosthetic femur fracture (PPFF) in the setting of total hip arthroplasty (THA) is steadily increasing. We seek to address whether there is a difference in outcomes between Vancouver B fracture types managed with ORIF when the original stem was a press-fit stem versus a cemented stem. METHODS: In this retrospective cohort study at a level 1 trauma center, we identified 136 patients over 65 years-of-age with Vancouver B-type fractures sustained between 2005 and 2019. Patients were treated by ORIF and had either cemented or press-fit stems prior to their injury. Outcomes were subsidence of the femoral implant, time to full weight bearing, rate of the hip implant revision, estimated blood loss (EBL), postoperative complications, and the one-year mortality rate. RESULTS: A total of 103 (75.7%) press-fit and 33 (24.3%) cemented patients were reviewed. Patient baseline characteristics, Vancouver fracture sub-types, and implant characteristics were not found to be significantly different between groups. The difference in subsidence rates, postoperative complications, and time to weight bearing were not significantly different between groups. EBL and one-year mortality rate were significantly higher in the cemented group. CONCLUSIONS: In geriatric patients with Vancouver B type periprosthetic fractures managed with ORIF, patients with an originally press fit stem may have lower mortality, lower estimated blood loss, and similar subsidence and hospital length of stays when compared to those with a cemented stem.

Lack of Surgeon Standardization on Implant Selection in Ankle Fracture Fixation May Increase Costs and Decrease Contribution Margin.

BACKGROUND: Surgical standardization has been shown to decrease costs without impacting quality; however, there is limited literature on this subject regarding ankle fracture fixation. Methods. Between October 5, 2015 and September 27, 2017, a total of 168 patients with isolated ankle fractures who underwent open reduction, internal fixation (ORIF) were analyzed. Financial data were analyzed across ankle fracture classification type, implant characteristics, and surgeons. Bivariate analyses were conducted. One-way analysis of variance was used to compare hardware costs across all 5 surgeons. Linear regression analysis was used to determine if hardware cost differed by surgeon when accounting for fracture type. RESULTS: The mean contribution margin was $4853 (SD $6446). There was a significant difference in implant costs by surgeon (range, lowest-cost surgeon: $471 [SD $283] to $1609 [SD $819]; P < .001). There was no difference in the use of a suture button or locking plate by fracture type (P = .13); however, the cost of the implant was significantly higher if a suture button or locking plate was used ($1014 [SD $666] vs $338 [SD $176]; P < .001). There was an association between surgeon 3 (ß = 200.32 [95% CI 6.18-394.47]; P = .043) and surgeon 4 (ß = 1131.07 [95% CI 906.84-1355.30]; P < .001) and higher hardware costs. CONCLUSIONS: Even for the same ankle fracture type, a wide variation in implant costs exists. The lack of standardization among surgeons accounted for a nearly 3.5-fold difference, on average, between the lowest- and highest-cost surgeons, negatively affecting contribution margin. LEVELS OF EVIDENCE: Level IV.

Measuring memory is harder than you think: How to avoid problematic measurement practices in memory research.

We argue that critical areas of memory research rely on problematic measurement practices and provide concrete suggestions to improve the situation. In particular, we highlight the prevalence of memory studies that use tasks (like the "old/new" task: "have you seen this item before? yes/no") where quantifying performance is deeply dependent on counterfactual reasoning that depends on the (unknowable) distribution of underlying memory signals. As a result of this difficulty, different literatures in memory research (e.g., visual working memory, eyewitness identification, picture memory, etc.) have settled on a variety of fundamentally different metrics to get performance measures from such tasks (e.g., A', corrected hit rate, percent correct, d', diagnosticity ratios, K values, etc.), even though these metrics make different, contradictory assumptions about the distribution of latent memory signals, and even though all of their assumptions are frequently incorrect. We suggest that in order for the psychology and neuroscience of memory to become a more cumulative, theory-driven science, more attention must be given to measurement issues. We make a concrete suggestion: The default memory task for those simply interested in performance should change from old/new ("did you see this item'?") to two-alternative forced-choice ("which of these two items did you see?"). In situations where old/new variants are preferred (e.g., eyewitness identification; theoretical investigations of the nature of memory signals), receiver operating characteristic (ROC) analysis should be performed rather than a binary old/new task.

The epidemiology and management of iliopsoas hematoma with femoral nerve palsy: A descriptive systematic review of 174 cases.

INTRODUCTION: Iliopsoas hematoma with femoral nerve palsy is a rare phenomenon with no consensus treatment algorithm. The objective of this study was to perform a systematic review of all reported cases of femoral nerve palsy secondary to iliopsoas hematoma to better elucidate it's optimal treatment. MATERIALS AND METHODS: Queries of the PubMed, Embase, and Cochrane databases were performed for reports available in English of femoral nerve palsy secondary to iliopsoas, psoas, or iliacus hematoma. 1491 articles were identified. After removal of duplicated publications and review of abstract titles via a majority reviewer consensus, 217 articles remained for consideration. Dedicated review of the remaining articles (including their reference sections) yielded 122 articles representing 174 distinct cases. Clinical data including patient age, sex, medical history, use of pharmacologic anticoagulation, sensory and motor examination at presentation and follow-up, hematoma etiology and location, time to intervention, and type of intervention were collected. Descriptive statistics were generated for each variable. RESULTS: Femoral nerve palsy secondary to iliopsoas hematoma occurred at a mean age of 44.5 years old. A majority of patients (60%) were male, and a majority of hematomas (54%) occurred due to pharmacologic anticoagulation. Most hematomas (57%) were treated conservatively, and almost half (49%) - regardless of treatment modality - resulted in persistent motor deficits at final follow-up. A minority of patients treated surgically (34%) had residual motor deficit at final follow-up, while 66% of those treated medically had resultant motor deficits, although no direct statistical comparison was able to be performed. DISCUSSION AND CONCLUSIONS: The disparate available data on iliopsoas hematoma with femoral nerve palsy precludes the completion of a true metanalysis, and therefore any conclusions on an optimal treatment algorithm. Based on review of the literature, small to moderate hematomas are often treated conservatively, while larger hematomas with progressive neurological symptoms are usually managed with a percutaneous decompression or surgery. LEVEL OF EVIDENCE: IV.

Modeling face similarity in police lineups.

Police investigators worldwide use lineups to test an eyewitness's memory of a perpetrator. A typical lineup consists of one suspect (who is innocent or guilty) plus five or more fillers who resemble the suspect and who are known to be innocent. Although eyewitness identification decisions were once biased by police pressure and poorly constructed lineups, decades of social science research led to the development of reformed lineup procedures that provide a more objective test memory. Under these improved testing conditions, cognitive models of memory can be used to better understand and ideally enhance eyewitness identification performance. In this regard, one question that has bedeviled the field for decades is how similar the lineup fillers should be to the suspect to optimize performance. Here, we model the effects of manipulating filler similarity to better understand why such manipulations have the intriguing effects they do. Our findings suggest that witnesses rely on a decision variable consisting of the degree to which the memory signal for a particular face in the lineup stands out relative to the crowd of memory signals generated by the set of faces in the lineup. The use of that decision variable helps to explain why discriminability is maximized by choosing fillers that match the suspect on basic facial features typically described by the eyewitness (e.g., age, race, gender) but who otherwise are maximally dissimilar to the suspect. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Absolute versus relative forgetting.

Slamecka and McElree (1983) and Rivera-Lares et al. (2022), like others before them, factorially manipulated the number of learning trials and the retention interval. The results revealed two unsurprising main effects: (a) the more study trials, the higher the initial degree of learning, and (b) the longer the retention interval, the more items were forgotten. However, across many experiments, the interaction was not significant, a finding that is often interpreted to mean that the degree of learning is independent of the absolute rate of forgetting (i.e., the absolute number of items forgotten per unit time). Yet there is considerable tension between that interpretation and the fact that forgetting has long been characterized by a power law, according to which the absolute rate of forgetting is not a particularly meaningful measure. When the power function is fit to the same data, the results show that a higher degree of learning results in a lower relative (i.e., proportional) rate of forgetting. This raises an interesting question: which of the two definitions of "forgetting rate" (absolute vs. relative) is theoretically relevant? Here, I make the case that it is the relative rate of forgetting. Theoretically, the explanation of why a higher degree of learning is associated with a lower relative rate of forgetting may be related to why, as observed by Jost (1897) long ago, the passage of time itself is associated with a lower relative rate of forgetting. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

You cannot "count" how many items people remember in visual working memory: The importance of signal detection-based measures for understanding change detection performance.

Change detection tasks are commonly used to measure and understand the nature of visual working memory capacity. Across three experiments, we examine whether the nature of the memory signals used to perform change detection are continuous or all-or-none and consider the implications for proper measurement of performance. In Experiment 1, we find evidence from confidence reports that visual working memory is continuous in strength, with strong support for an equal variance signal detection model with no guesses or lapses. Experiments 2 and 3 test an implication of this, which is that K should confound response criteria and memory. We found K values increased by roughly 30% when criteria are shifted despite no change in the underlying memory signals. Overall, our data call into question a large body of work using threshold measures, like K, to analyze change detection data. This metric confounds response bias with memory performance and is inconsistent with the vast majority of visual working memory models, which propose variations in precision or strength are present in working memory. Instead, our data indicate an equal variance signal detection model (and thus, d')-without need for lapses or guesses-is sufficient to explain change detection performance. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Two kinds of memory signals in neurons of the human hippocampus.

Prior studies of the neural representation of episodic memory in the human hippocampus have identified generic memory signals representing the categorical status of test items (novel vs. repeated), whereas other studies have identified item specific memory signals representing individual test items. Here, we report that both kinds of memory signals can be detected in hippocampal neurons in the same experiment. We recorded single-unit activity from four brain regions (hippocampus, amygdala, anterior cingulate, and prefrontal cortex) of epilepsy patients as they completed a continuous recognition task. The generic signal was found in all four brain regions, whereas the item-specific memory signal was detected only in the hippocampus and reflected sparse coding. That is, for the item-specific signal, each hippocampal neuron responded strongly to a small fraction of repeated words, and each repeated word elicited strong responding in a small fraction of neurons. The neural code was sparse, pattern-separated, and limited to the hippocampus, consistent with longstanding computational models. We suggest that the item-specific episodic memory signal in the hippocampus is fundamental, whereas the more widespread generic memory signal is derivative and is likely used by different areas of the brain to perform memory-related functions that do not require item-specific information.

Theoretical false positive psychology.

A fundamental goal of scientific research is to generate true positives (i.e., authentic discoveries). Statistically, a true positive is a significant finding for which the underlying effect size (δ) is greater than 0, whereas a false positive is a significant finding for which δ equals 0. However, the null hypothesis of no difference (δ = 0) may never be strictly true because innumerable nuisance factors can introduce small effects for theoretically uninteresting reasons. If δ never equals zero, then with sufficient power, every experiment would yield a significant result. Yet running studies with higher power by increasing sample size (N) is one of the most widely agreed upon reforms to increase replicability. Moreover, and perhaps not surprisingly, the idea that psychology should attach greater value to small effect sizes is gaining currency. Increasing N without limit makes sense for purely measurement-focused research, where the magnitude of δ itself is of interest, but it makes less sense for theory-focused research, where the truth status of the theory under investigation is of interest. Increasing power to enhance replicability will increase true positives at the level of the effect size (statistical true positives) while increasing false positives at the level of theory (theoretical false positives). With too much power, the cumulative foundation of psychological science would consist largely of nuisance effects masquerading as theoretically important discoveries. Positive predictive value at the level of theory is maximized by using an optimal N, one that is neither too small nor too large.

Eyewitness memory is reliable, but the criminal justice system is not.

The reliability of any type of forensic evidence (e.g., forensic DNA) is assessed by testing its information value when it is not contaminated and is properly tested. Assessing the reliability of forensic memory evidence should be no exception to that rule. Unfortunately, testing a witness's memory irretrievably contaminates it. Thus, only the first (properly conducted) test is relevant to the question of whether eyewitness memory is reliable. With few exceptions, the results of studies conducted in the lab and in the real world show that confidence is highly predictive of accuracy on the first test, and high-confidence often implies high accuracy. The fact that many eyewitnesses are known to have made high-confidence misidentifications in the courtroom has cemented the almost universal impression that eyewitness memory is unreliable. However, it is the criminal justice system that is guilty of unwittingly using contaminated memory evidence (relying on the last memory test, in court) in conjunction with an improper testing procedure (namely, a courtroom showup) to win convictions of the innocent. That mistake should no longer be blamed on the unreliability of eyewitness memory.