How Do Engineering Scientists Think? Model‐Based Simulation in Biomedical Engineering Research Laboratories

Designing, building, and experimenting with physical simulation models are central problem‐solving practices in the engineering sciences. Model‐based simulation is an epistemic activity that includes exploration, generation and testing of hypotheses, explanation, and inference. This paper argues that to interpret and understand how these simulation models function in creating knowledge and technologies requires construing problem solving as accomplished by a researcher–artifact system. It draws on and further develops the framework of “distributed cognition” to interpret data collected in ethnographic and cognitive‐historical studies of two biomedical engineering research laboratories, and articulates the notion of distributed model‐based cognition to answer the question posed in the title.     

基于实体语法系统的泽漆治疗肺癌的作用机制研究

目的:利用数据融合及分析手段研究泽漆治疗肺癌的分子机制。方法:通过实体语法系统将泽漆化学成分数据、泽漆“成分-靶点”关系数据、人类蛋白-蛋白相互作用(PPI)数据等进行融合,得到有向网络;利用实体语法系统进行定性推理,得到泽漆化学成分作用于肺癌的靶点;利用基因本体(GO)富集分析、通路富集分析等解析泽漆治疗肺癌的作用机制。结果:通过实体语法系统推理,获得泽漆7个化学成分及55个肺癌治疗靶点;经过实体语法推理和富集分析,泽漆成分中的木犀草素可抑制生长因子(GF)、没食子酸甲酯和槲皮素可抑制上皮生长因子(EGFR)、槲皮素可抑制周期蛋白依赖性激酶1(CDK1),共同发挥抑制肺癌细胞增殖的作用;没食子酸和木犀草素可直接激活半胱氨酸天冬氨酸蛋白酶-3(CASP3)发挥促进肺癌细胞凋亡的作用;泽漆内酯B和泽漆内酯C通过抑制三磷酸腺苷结合盒转运蛋白G2(ABCG2)发挥逆转肺癌肿瘤多药耐药的作用。结论:泽漆主要通过调节丝裂原活化蛋白激酶(MAPK)信号通路和磷脂酰肌醇3-激酶(PI3K)-蛋白激酶B(Akt)信号通路等发挥抑制肺癌细胞增殖和促进肺癌细胞凋亡的综合作用,为泽漆的应用和肺癌的治疗提供参考。     

Deductive Reasoning and Pathological Anxiety: Evidence for a Relatively Strong ldquo;Belief Bias” in Phobic Subjects

The present study investigated the relationship between deductive reasoning and phobic fear. In the first experiment, we succesfully evaluated a reasoning paradigm that was specifically designed to index interference effects of prior beliefs. Forty-two female undergraduates were presented with a series of syllogisms varying in believability and logical validity and were asked to judge the syllogisms' logical validity. Participants were relatively fast when there was a match and relatively slow when there was a mismatch between believability and validity (belief bias). In Experiment 2, participants were 31 spider-phobic women and 27 nonfearful women. They were presented with two types of syllogisms. One category of syllogisms was concerned with neutral themes and the other with phobia-relevant themes. Again, participants showed a belief bias. This bias was especially strong in the phobic group. Yet, the enhanced belief bias in phobic women was not specific for phobic material. The results support the view that phobic subjects are characterized by a general tendency to confirm rather than to falsify prior beliefs.     

Diagnostic errors and reflective practice in medicine

BACKGROUND: Adverse effects of medical errors have received increasing attention. Diagnostic errors account for a substantial fraction of all medical errors, and strategies for their prevention have been explored. A crucial requirement for that is better understanding of origins of medical errors. Research on medical expertise may contribute to that as far as it explains reasoning processes involved in clinical judgements. The literature has indicated the capability of critically reflecting upon one's own practice as a key requirement for developing and maintaining medical expertise throughout life. OBJECTIVES: This article explores potential relationships between reflective practice and diagnostic errors. METHODS: A survey of the medical expertise literature was conducted. Origins of medical errors frequently reported in the literature were explored. The potential relationship between diagnostic errors and the several dimensions of reflective practice in medicine, brought to light by recent research, were theoretically explored. RESULTS AND DISCUSSION: Uncertainty and fallibility inherent to clinical judgements are discussed. Stages in the diagnostic reasoning process where errors could occur and their potential sources are highlighted, including the role of medical heuristics and biases. The authors discuss the nature of reflective practice in medicine, and explore whether and how the several behaviours and reasoning processes that constitute reflective practice could minimize diagnostic errors. Future directions for further research are discussed. They involve empirical research on the role of reflective practice in improving clinical reasoning and the development of educational strategies to enhancing reflective practice.     

Factors influencing physical therapists’ clinical reasoning: qualitative systematic review and meta-synthesis

Background: The capacity of physical therapists to reason effectively in patient management is essential to maximizing outcomes. Although conceptual frameworks of clinical reasoning exist, their theoretical foundations are insufficiently validated to establish those factors that are paramount in guiding physical therapists’ clinical reasoning. Studies on how physical therapists clinically reason constitute important means of identifying constructs of such reasoning.

Objective: This systematic review aimed to synthesize and interpret the findings of qualitative studies designed to examine factors that are inherent in physical therapists’ clinical reasoning with respect to their knowledge, experiences, and practices.

Methods: Searches of studies were carried out in four databases, gray literature, and reference lists. Two reviewers independently assessed methodological quality of the studies using the Critical Appraisal Skills Program (CASP) and performed the analysis: extraction and comparative appraisal of findings, identification of themes, reciprocal translation synthesis, and identification of categories and subcategories.

Results: Ten studies were included. Four themes of factors influencing physical therapists’ clinical reasoning emerged, namely, Physical therapist as a source, Patient as a source, Elements of the reasoning process, and Context.

Conclusions: The identified themes validated some constructs underlying existing clinical reasoning frameworks. Most influencing factors were related to the physical therapist, which highlights opportunities to improve effective reasoning at this level. The notion that this process is recurrent, multifaceted, and contextual lends itself to changing in accordance with the needs of the patient, consistent with a biopsychosocial perspective. How clinicians weigh biomedical and psychosocial elements in their reasoning however warrants further study.     

General and specialized brain correlates for analogical reasoning: A meta‐analysis of functional imaging studies

Reasoning by analogy allows us to link distinct domains of knowledge and to transfer solutions from one domain to another. Analogical reasoning has been studied using various tasks that have generally required the consideration of the relationships between objects and their integration to infer an analogy schema. However, these tasks varied in terms of the level and the nature of the relationships to consider (e.g., semantic, visuospatial). The aim of this study was to identify the cerebral network involved in analogical reasoning and its specialization based on the domains of information and task specificity. We conducted a coordinate‐based meta‐analysis of 27 experiments that used analogical reasoning tasks. The left rostrolateral prefrontal cortex was one of the regions most consistently activated across the studies. A comparison between semantic and visuospatial analogy tasks showed both domain‐oriented regions in the inferior and middle frontal gyri and a domain‐general region, the left rostrolateral prefrontal cortex, which was specialized for analogy tasks. A comparison of visuospatial analogy to matrix problem tasks revealed that these two relational reasoning tasks engage, at least in part, distinct right and left cerebral networks, particularly separate areas within the left rostrolateral prefrontal cortex. These findings highlight several cognitive and cerebral differences between relational reasoning tasks that can allow us to make predictions about the respective roles of distinct brain regions or networks. These results also provide new, testable anatomical hypotheses about reasoning disorders that are induced by brain damage. Hum Brain Mapp 37:1953–1969, 2016. © 2016 Wiley Periodicals, Inc .     

Everyday reasoning abilities in persons with Parkinson's disease

Parkinson's disease (PD) patients develop progressive cognitive decline. The degree to which such decline impacts instrumental activities of daily living (IADL) among individuals in the early stages of PD without dementia is not well documented. The Everyday Cognitive Battery Reasoning subtest (ECB) was used to assess ability to solve everyday reasoning tasks for IADL among 19 non‐demented older adults with PD in comparison to 20 older adults without PD. The two groups were similar in age, education, race and gender. Individuals with PD had significantly lower scores (M = 61.98, SD = 12.03) than the comparison group (M = 69.80, SD = 9.48). Individuals with PD, who do not have dementia, may be more likely to experience difficulties in IADL requiring reasoning including medication use, finances, and nutrition. Even more serious implications lie in the capacity to make treatment choices. © 2010 Movement Disorder Society