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Accounts of cognitive processes in judgment and decision-making are frequently based on a dual-process framework, which reflects two qualitatively different types of processing: intuitive (Type 1) and analytical (Type 2) processes. The present study investigated the effects of bilateral transcranial direct current stimulation (tDCS) to the dorsolateral prefrontal cortex (DLPFC) on judgment and decision-making performance. Participants received anodal tDCS stimulation to the right DLPFC, left DLPFC or sham. There were 3 tasks: vignettes measuring heuristic thinking, belief bias syllogisms, and the cognitive reflection test (CRT), a measure of the ability to inhibit automatic responses to reach a correct solution. Fifty-four participants (mean age = 24.63 ± 4.46 years; 29 females) were recruited. Results showed that anodal tDCS to the right DLPFC was associated with an increase in cognitive reflection performance (Type 2 processing) as compared to left DLPFC and to sham. Logic thinking was reduced following anodal tDCS to the left DLPFC. These findings are broadly consistent with a dual process framework, and cannot be explained by differences in cognitive ability and thinking style. The results demonstrate the involvement of the right DLPFC in cognitive reflection, and suggest the possibility of improving cognitive performance through tDCS. • Dual-process framework of decision-making suggests that decisions can be made by intuitive thinking or analytic thinking. • The right DLPFC is involved in crucial executive functions (inhibition & set-shifting) for the dual-process framework. • We find that anodal stimulation of the right DLPFC boosts analytic (Type 2) thinking. [ABSTRACT FROM AUTHOR]

The article highlights Joshua Reynolds's earliest drawings. The earliest account of Reynolds's drawings is provided in Edmond Malone's biography of 1797. He was for sometime instructed in the classics, but his artistic inclination for the art began to manifest itself. Reynolds's first drawings were made from copying different pictures. When he was eight, he read with interest "The Jesuit's Perspective," a book which happened to lie on the window seat of his father's shop. He attempted to draw the School at Plympton, wherein his father commented that he did a good job.

Summary: Augmented reality (AR) systems for surgical navigation provides the capability to project preoperative CT scans and segmented anatomical structures directly into the surgeon's field of view, along with virtual displays akin to traditional monitors. Utilizing the Meta Quest 3 consumer AR headset, we found that it can achieve clinically acceptable accuracy in surgical navigation for deep inferior epigastric perforator (DIEP) surgeries. Notably, the Quest 3 can operate independently thanks to a novel registration technique employing hand tracking, suitable for use in sterile environments.The DIEP flap is a widely favored option for autologous breast reconstructions. Intraoperatively, the perforator arteries are selected to maximize tissue perfusion and minimize donor site morbidity. Conventionally, preoperative CT angiograms are used to locate perforators and visualize vessel courses, thus reducing DIEP flap harvest time and complication rates. Though, there are currently very limited means to reliably translate information found on preoperative imaging for use in the operating theater.The Meta Quest 3 was trialed in three DIEP flap surgeries by displaying segmented deep inferior epigastric arteries and DIEP arteries during preoperative and intraoperative phases of surgery. The AR projections facilitated the visualization of the DIEP arteries and efficient pedicle dissection by guiding the placement and length of the fascial incision. Furthermore, this work supports the hypothesis that AR will improve flap design, reduce harvest time, and improve safety during DIEP flap harvesting., Competing Interests: DISCLOSURES: Kathryn Isaac, Philip Edgcumbe, and Tony Jiang are cofounders of MAP Medicine Inc., a company focused on augmented reality (AR) solutions for surgery. All other authors declare no conflicts of interest related to MAP Medicine Inc. The authors declare no additional potential conflicts of interest., (Copyright © 2024 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the American Society of Plastic Surgeons. All rights reserved.)

In laparoscopic surgery, the surgeon must operate with a limited field of view and reduced depth perception. This makes spatial understanding of critical structures difficult, such as an endophytic tumour in a partial nephrectomy. Such tumours yield a high complication rate of 47%, and excising them increases the risk of cutting into the kidney's collecting system. To overcome these challenges, an augmented reality guidance system is proposed. Using intra-operative ultrasound, a single navigation aid, and surgical instrument tracking, four augmentations of guidance information are provided during tumour excision. Qualitative and quantitative system benefits are measured in simulated robot-assisted partial nephrectomies. Robot-to-camera calibration achieved a total registration error of 1.0 ± 0.4 mm while the total system error is 2.5 ± 0.5 mm. The system significantly reduced healthy tissue excised from an average (±standard deviation) of 30.6 ± 5.5 to 17.5 ± 2.4 cm 3 ( p < 0.05) and reduced the depth from the tumor underside to cut from an average (±standard deviation) of 10.2 ± 4.1 to 3.3 ± 2.3 mm ( p < 0.05). Further evaluation is required in vivo, but the system has promising potential to reduce the amount of healthy parenchymal tissue excised.

The Pico Lantern is a miniature projector developed for structured light surface reconstruction, augmented reality and guidance in laparoscopic surgery. During surgery it will be dropped into the patient and picked up by a laparoscopic tool. While inside the patient it projects a known coded pattern and images onto the surface of the tissue. The Pico Lantern is visually tracked in the laparoscope's field of view for the purpose of stereo triangulation between it and the laparoscope. In this paper, the first application is surface reconstruction. Using a stereo laparoscope and an untracked Pico Lantern, the absolute error for surface reconstruction for a plane, cylinder and ex vivo kidney, is 2.0 mm, 3.0 mm and 5.6 mm, respectively. Using a mono laparoscope and a tracked Pico Lantern for the same plane, cylinder and kidney the absolute error is 1.4 mm, 1.5 mm and 1.5 mm, respectively. These results confirm the benefit of the wider baseline produced by tracking the Pico Lantern. Virtual viewpoint images are generated from the kidney surface data and an in vivo proof-of-concept porcine trial is reported. Surface reconstruction of the neck of a volunteer shows that the pulsatile motion of the tissue overlying a major blood vessel can be detected and displayed in vivo. Future work will integrate the Pico Lantern into standard and robot-assisted laparoscopic surgery., (Copyright © 2015 Elsevier B.V. All rights reserved.)

The Pico Lantern is proposed as a new tool for guidance in laparoscopic surgery. Its miniaturized design allows it to be picked up by a laparoscopic tool during surgery and tracked directly by the endoscope. By using laser projection, different patterns and annotations can be projected onto the tissue surface. The first explored application is surface reconstruction. The absolute error for surface reconstruction using stereo endoscopy and untracked Pico Lantern for a plane, cylinder and ex vivo kidney is 2.0 mm, 3.0 mm and 5.6 mm respectively. The absolute error using a mono endoscope and a tracked Pico Lantern for the same plane, cylinder and kidney is 0.8mm, 0.3mm and 1.5mm respectively. The results show the benefit of the wider baseline produced by tracking the Pico Lantern. Pulsatile motion of a human carotid artery is also detected in vivo. Future work will be done on the integration into standard and robot-assisted laparoscopic surgery.