While consciousness is typically considered equivalent to mental contents, certain meditation practices-including open monitoring (OM)-are said to enable a unique conscious state where meditators can experience mental content from a de-reified perspective as \"ongoing phenomena.\" Phenomenologically, such a state is considered as reduction of intentionality, the mental act upon mental content. We hypothesised that this de-reified state would be characterised by reduced mental actional processing of affording objects. We recruited two groups of participants, meditators with long-term experience in cultivating a de-reified state, and demographically-matched novice meditators. Participants performed a task with images in two configurations-where objects did (high-affordance) and did not imply actions (low-affordance)-following both a baseline and OM-induced de-reified state, along with EEG recordings. While long-term meditators exhibited preferential processing of high-affordance images compared to low-affordance images during baseline, such an effect was abolished during the OM state, as hypothesised. For novices, however, the high-affordance configuration was preferred over the low-affordance one both during baseline and OM. Perceptual durations of objects across conditions positively correlated with the degree of µ-rhythm desynchronization, indicating that neural processing of affordance impacted perceptual awareness. Our results indicate that OM styles of meditation may help in mentally decoupling otherwise automatic cognitive processing of mental actions by affording objects.

BACKGROUND: The popularity of medical writing workshops highlights the need for a standard measurement tool to assess the impact of such workshops on participants\' confidence in: 1- writing a standard article and 2- using optimal English language. Because such an instrument is not yet available, we undertook this study to devise and evaluate the first measurement tool to assess such confidence.
METHODS: We created an item pool of 50 items by searching Medline, Embase, and Clarivate Analytics to find related articles, using our prior experience, and approaching the key informants. We revised and edited the item pool, and redundant ones were excluded. Finally, the 36-item tool comprised two domains. We tested it in a group of workshop applicants for internal consistency and temporal reliability using Cronbach\'s α and Pearson correlations and for content and convergent validity using the content validity index and Pearson correlations.
RESULTS: The participants had a mean age of 40.3 years, a female predominance (74.3%), and a majority of faculty members (51.4%). The internal consistency showed high reliability (> 0.95). Test-retest reliability showed very high correlations (r = 0.93). The CVI for domain 1 was 0.78, for domain 2 was 0.73, and for the entire instrument was 0.75.
CONCLUSIONS: This unique, reliable, and valid measurement tool could accurately measure the level of confidence in writing a standard medical article and in using the appropriate English language for this purpose.

UNASSIGNED: Medical history contributes approximately 80% to a diagnosis, although physical examinations and laboratory investigations increase a physician\'s confidence in the medical diagnosis. The concept of artificial intelligence (AI) was first proposed more than 70 years ago. Recently, its role in various fields of medicine has grown remarkably. However, no studies have evaluated the importance of patient history in AI-assisted medical diagnosis.
UNASSIGNED: This study explored the contribution of patient history to AI-assisted medical diagnoses and assessed the accuracy of ChatGPT in reaching a clinical diagnosis based on the medical history provided.
UNASSIGNED: Using clinical vignettes of 30 cases identified in The BMJ, we evaluated the accuracy of diagnoses generated by ChatGPT. We compared the diagnoses made by ChatGPT based solely on medical history with the correct diagnoses. We also compared the diagnoses made by ChatGPT after incorporating additional physical examination findings and laboratory data alongside history with the correct diagnoses.
UNASSIGNED: ChatGPT accurately diagnosed 76.6% (23/30) of the cases with only the medical history, consistent with previous research targeting physicians. We also found that this rate was 93.3% (28/30) when additional information was included.
UNASSIGNED: Although adding additional information improves diagnostic accuracy, patient history remains a significant factor in AI-assisted medical diagnosis. Thus, when using AI in medical diagnosis, it is crucial to include pertinent and correct patient histories for an accurate diagnosis. Our findings emphasize the continued significance of patient history in clinical diagnoses in this age and highlight the need for its integration into AI-assisted medical diagnosis systems.

BACKGROUND: Prescription writing skills are essential for physician practice. This study describes the development and implementation of a curricular intervention focused on improving the knowledge and confidence of preclerkship medical students\' prescription writing practices utilizing an interprofessional education model, with a focus on electronic prescribing.
METHODS: Medicine and Pharmacy Faculty from a large, urban university collaborated to develop the content of the workshop and a simulation platform was used for the e-prescribing activity. Second-year medical students attended a mandatory in-person workshop facilitated by fourth-year pharmacy students. A pre and post knowledge test and confidence survey were used to assess students\' knowledge, confidence, and satisfaction. Outcomes from the knowledge test were evaluated with paired-samples proportions tests, and confidence survey data was evaluated with paired t-tests and Wilcoxon signed-rank tests in a pre-post study design.
RESULTS: Students demonstrated a significant increase in prescription writing knowledge and confidence after completing the workshop. On the pre-test, 7% of students (21/284) completed the electronic prescribing assessment correctly and 51% of students (149/295) completed it correctly on the post-test. All items on the confidence survey showed a significant increase in pre- versus post-survey comparisons (p < 0.001).
CONCLUSIONS: This interprofessional prescription writing workshop facilitated by pharmacy students shows promise for improving the knowledge and confidence of prescription writing and electronic prescribing practices in preclerkship medical students.

Questions concerning analysts\' publication of material from the analyses of their patients have troubled the field of psychoanalysis since its inception. Disguise inevitably distorts the clinical material and is often insufficient to protect the patient from recognition. Asking the patient\'s consent for publication intrudes upon and alters the analytic process. While analysts have largely reached a consensus about the need for anonymity in published material, there is still considerable debate about the necessity for obtaining patients\' consent when using their material for publication. In this paper, I will trace the evolving meanings of disguise, and particularly of consent, in the analytic literature. I will place a particular emphasis upon the differing theoretical belief systems that underlie the analyst\'s decision to ask consent from her patient or not to do so, and I will argue that, although decisions on asking consent remain a complex matter, such coherent belief systems should play an important part in analysts\' decisions regarding consent. I will illustrate my thought processes and some clinical situations with brief examples, and I will conclude with some practical recommendations, with the hope that these will stimulate further discussion in the analytic community.

The author describes and then clinically illustrates what he terms the ontological dimension of psychoanalysis (having to do with coming into being) and the epistemological dimension of psychoanalysis (having to do with coming to know and understand). Neither of these dimensions of psychoanalysis exists in pure form; they are inextricably intertwined. Epistemological psychoanalysis, for which Freud and Klein are the principal architects, involves the work of arriving at understandings of play, dreams, and associations; while ontological psychoanalysis, for which Winnicott and Bion are the principal architects, involves creating conditions in which the patient might become more fully alive and real to him- or herself. The author provides clinical illustrations of the ontological dimension of psychoanalysis in which the process of the patient\'s coming more fully into being is facilitated by the experiences in which the patient feels recognized for the individual he is and is becoming. This occurs in an analysis in which the analyst and patient invent a form of psychoanalysis that is uniquely their own.

Perceptual confidence is thought to arise from metacognitive processes that evaluate the underlying perceptual decision evidence. We investigated whether metacognitive access to perceptual evidence is constrained by the hierarchical organization of visual cortex, where high-level representations tend to be more readily available for explicit scrutiny. We found that the ability of human observers to evaluate their confidence did depend on whether they performed a high-level or low-level task on the same stimuli, but was also affected by manipulations that occurred long after the perceptual decision. Confidence in low-level perceptual decisions degraded with more time between the decision and the response cue, especially when backward masking was present. Confidence in high-level tasks was immune to backward masking and benefitted from additional time. These results can be explained by a model assuming confidence heavily relies on postdecisional internal representations of visual stimuli that degrade over time, where high-level representations are more persistent.

Arithmetic operations are complex mental processes rooted in the abstract concept of numerosity. Despite the significance, the neural architecture responsible for these operations has remained largely uncharted. In this study, we explored the presence of specific neuronal activity in the dorsal premotor cortex of the monkey dedicated to numerical addition and subtraction. Our findings reveal that many of these neural activities undergo a transformation, shifting their coding from arithmetic to motor representations. These motor representations include information about which hand to use and the number of steps involved in the action. We consistently observed that cells related to the right-hand encoded addition, while those linked to the left-hand encoded subtraction, suggesting that arithmetic operations and motor commands are intertwining with each other. Furthermore, we used a multivariate decoding technique to predict the monkey\'s behaviour based on the activity of these arithmetic-related cells. The classifier trained to discern arithmetic operations, including addition and subtraction, not only predicted the arithmetic decisions but also the subsequent motor actions of the right and left-hand. These findings imply a cognitive extension of the motor cortex\'s function, where inherent neural systems are repurposed to facilitate arithmetic operations.

Emotion regulation is a process by which individuals modulate their emotional responses to cope with different environmental demands, for example, by reappraising the emotional situation. Here, we tested whether effective connectivity of a reappraisal-related neural network at rest is predictive of successfully regulating high- and low-intensity negative emotions in an emotion-regulation task. Task-based and resting-state functional magnetic resonance imaging (rs-fMRI) data of 28 participants were collected using ultra-high magnetic field strength at 7 Tesla during three scanning sessions. We used spectral dynamic causal modeling (spDCM) on the rs-fMRI data within brain regions modulated by emotion intensity. We found common connectivity patterns for both high- and low-intensity stimuli. Distinctive effective connectivity patterns in relation to low-intensity stimuli were found from frontal regions connecting to temporal regions. Reappraisal success for high-intensity stimuli was predicted by additional connections within the vlPFC and from temporal to frontal regions. Connectivity patterns at rest predicting reappraisal success were generally more pronounced for low-intensity stimuli, suggesting a greater role of stereotyped patterns, potentially reflecting preparedness, when reappraisal was relatively easy to implement. The opposite was true for high-intensity stimuli, which might require a more flexible recruitment of resources beyond what is reflected in resting state connectivity patterns. Resting-state effective connectivity emerged as a robust predictor for successful reappraisal, revealing both shared and distinct network dynamics for high- and low-intensity stimuli. These patterns signify specific preparatory states associated with heightened vigilance, attention, self-awareness, and goal-directed cognitive processing, particularly during reappraisal for mitigating the emotional impact of external stimuli. Our findings hold potential implications for understanding psychopathological alterations in brain connectivity related to affective disorders.

Background: Asthma affects one in every 12 children in United States with significant prevalence in underserved groups. Family caregiver education is essential to improve childhood asthma control. The literature suggests that family caregivers\' lack of knowledge about asthma management affects their children\'s health outcomes. An evidence-based education program that improves caregivers\' asthma knowledge may improve the family\'s well-being. Objectives: The goal of the Asthma Academy project is to improve the disease management of children with asthma by providing an in-person family caregiver education program. The main objectives are to (a) improve family caregivers\' asthma knowledge, (b) enhance their confidence in asthma management, and (c) evaluate caregivers\' satisfaction with the education program. Method: This quality improvement project used an in-person educational program with an asthma education video resource for caregivers of children with asthma. Results: The family caregivers\' asthma knowledge improved significantly after the education. The confidence levels in caring for children with asthma increased. Caregivers\' satisfaction with the Asthma Academy education session was favorable. Conclusions: The Asthma Academy was an acceptable and effective delivery method of education for family caregivers of children with asthma in the in-patient setting. Empowering family caregivers of vulnerable children through asthma education may improve child health outcomes and mitigate complications from asthma. Implications for Nursing Nurses and clinicians are steward of providing patient education. Individualized, patient-tailored education is recommended.