Google ‘makes people think they are smarter than they are’ 

 Woman using laptop, technology, internet, internet security

Searching the internet for information gives people a ‘widely inaccurate’ view of their own intelligence, Yale psychologists believe

Search engines like Google or Yahoo make people think they are smarter than they actually are because they have the world’s knowledge at their fingertips, psychologists at Yale University have found.

Browsing the internet for information gives people a ‘widely inaccurate’ view of their own intelligence and could lead to over-confidence when making decisions, experts warn.

In a series of experiments, participants who had searched for information on the internet believed they were far more knowledgeable about a subject that those who had learned by normal routes, such as reading a book or talking to a tutor. Internet users also believed their brains were sharper.

“The Internet is such a powerful environment, where you can enter any question, and you basically have access to the world’s knowledge at your fingertips,” said lead researcher Matthew Fisher, a fourth-year doctoral candidate in psychology at Yale University.

“It becomes easier to confuse your own knowledge with this external source. When people are truly on their own, they may be wildly inaccurate about how much they know and how dependent they are on the Internet.”

Online searches made students feel smarter 

More than 1,000 students took part in a range of experiments aimed at gauging the psycholgocal impact of searching on the internet.

In one test, the internet group were given a website link which gave the answer to the question ‘how does a zip work’ while a control group were given a print-out of the same information.

When they two groups were quizzed later on an unrelated question – ‘why are cloudy nights warmer?’ the group who had searched online believed they were more knowledgeable even though they were not allowed to look up the correct answer.

Psychology professor Frank Keil, of Yale University, said the study showed that the cognitive effects of “being in search mode” on the internet were so powerful that people still feel smarter even when their online searches did not help.

And the growing use of smartphones may exacerbate the problem because an internet search is always within reach.

“With the internet, the lines become blurry between what you know and what you think you know,” added Mr Fisher.

The researchers also believe that an inflated sense of personal knowledge also could be dangerous in the political realm or other areas involving high-stakes decisions.

“In cases where decisions have big consequences, it could be important for people to distinguish their own knowledge and not assume they know something when they actually don’t,” Mr Fisher added.

“The Internet is an enormous benefit in countless ways, but there may be some trade-offs that aren’t immediately obvious and this may be one of them.

“Accurate personal knowledge is difficult to achieve, and the Internet may be making that task even harder.”

The study was published by the American Psychological Association. Journal of Experimental Psychology: General.


Surgery Without Scars.

Report of Transluminal Cholecystectomy in a Human Being



Hypothesis  Natural orifice transluminal endoscopic surgery (NOTES) provides the potential for performance of incisionless operations. This would break the physical barrier between bodily trauma and surgery, representing an epical revolution in surgery. Our group at IRCAD-EITS (Institut de Recherche contre les Cancers de l’Appareil Digestif [Institute of Digestive Cancer Research]–European Institute of TeleSurgery) has been actively involved in the development of NOTES since 2004 with a dedicated project created to develop feasibility and survival studies and new endoscopic technology.

Design  NOTES cholecystectomy in a woman via a transvaginal approach.

Setting  University hospital.

Patient  The patient was a 30-year-old woman with symptomatic cholelithiasis.

Intervention  The procedure was carried out by a multidisciplinary team using a standard double-channel flexible videogastroscope and standard endoscopic instruments. The placement of a 2-mm needle port, mandatory to insufflate carbon dioxide and to monitor the pneumoperitoneum, was helpful for further retraction of the gallbladder. At no stage of the procedure was there need for laparoscopic assistance. All of the principles of cholecystectomy were strictly adhered to.

Results  The postoperative course was uneventful. The patient had no postoperative pain and no scars, and was discharged on the second postoperative day.

Conclusions  Transluminal surgery is feasible and safe. NOTES, a radical shift in the practice and philosophy of interventional treatment, is becoming established and is enormously advantageous to the patient. With its invisible mending and tremendous potential, NOTES might be the next surgical evolution.

The abolishment of pain in surgery is a chimera. It is absurd to go on seeking it. . . . Knife and pain are two words in surgery that must forever be associated in the consciousness of the patient.—Dr Alfred Velpeau, French surgeon (1839)

Change is part of surgery but it is never easy to accept. At the dawn of surgery, excellence was associated with big incisions: “Big scar, big surgeon.” Surgery with no scars was an impossible reverie. Now natural orifice transluminal endoscopic surgery (NOTES) is being performed, and the philosophy of surgery will be dramatically changed. Transluminal surgery has the potential to break the physical barrier between bodily trauma and surgery, representing an epical evolution in surgery.

Laparoscopic gallbladder resection changed the focus of surgery and the mindset of nearly all surgeons. Cholecystectomy seems to be the logical next step in developing the clinical application of NOTES.

In 1882, Langenbuch, as cited by van Gulik,1 successfully removed the gallbladder in a 43-year-old man who had cholelithiasis. His initial report was ignored. Nevertheless, Langenbuch’s open cholecystectomy remained the standard criterion for the treatment of symptomatic cholelithiasis for more than a century. In 1985, Muhe, as cited by Reynolds,2 performed the first laparoscopic cholecystectomy using a modified laparoscope, called the galloscope. In 1986, he presented his technique at the German Surgical Society Congress but was strongly criticized. In 1987, Mouret3performed the first laparoscopic cholecystectomy with an approach that would become the standard technique within 2 years, that is, use of 1 optical trocar and 2 other trocars. The world of general surgery was soon divided into a small group of enthusiastic surgeons convinced of the superiority of laparoscopic over conventional cholecystectomy and a second, large group of surgeons with varying opinions ranging from curiosity to frank condemnation of laparoscopic cholecystectomy.

The controversy was intense but short. In 1992, the National Institutes of Health Consensus Development Conference4 statement on gallstones and laparoscopic cholecystectomy concluded that, compared with open cholecystectomy, laparoscopic cholecystectomy was safe and effective in most patients and should be the treatment of choice. Even if surgeons were reluctant to acknowledge this shift in treatment, patients applauded the new minimally invasive surgery. Whenever it was possible, patients would ask for a surgical procedure that left no outer scarring and resulted in no postoperative pain. Patients, both male and female, independent of age and body shape, dislike scars, not only for cosmetic reasons but because scars indicate they have undergone treatment because of illness. This resulted in NOTES, with its general goal of minimizing the trauma of any interventional process by eliminating the incision through the abdominal wall and using natural orifices. To our knowledge, this is the first report of the use of NOTES to treat cholecystectomy in a human being via transvaginal access, performed at University Hospital in Strasbourg, France.


With the successful performance of the first transluminal cholecystectomy, we witnessed the introduction of NOTES into clinical practice with mixed feelings of excitement and caution. Even if the advantages of NOTES in this first clinical case are apparent, transvaginal cholecystectomy is time consuming and difficult. Will NOTES generate a major paradigm shift in surgical care? We know that laparoscopic surgery is just the beginning of the minimally invasive evolution of surgery. We have come to an even more critical juncture in the history of surgery. With its invisible mending and tremendous potential for improving patient care and well-being, NOTES might represent the next greatest surgical evolution.







Intraoperative neurophysiological monitoring of extracranial-intracranial bypass procedures.

Intraoperative neurophysiological monitoring (IONM) represents an established tool in neurosurgery to increase patient safety. Its application, however, is controversial. Its use has been described as helpful in avoiding neurological deterioration during intracranial aneurysm surgery. Its impact on extracranial-intracranial (EC-IC) bypass surgery involving parent artery occlusion for the treatment of complex aneurysms has not yet been studied. The authors therefore sought to evaluate the effects of IONM on patient safety, the surgeon’s intraoperative strategies, and functional outcome of patients after cerebral bypass surgery. Intraoperative neurophysiological monitoring results were compared with those of intraoperative blood flow monitoring to assess bypass graft perfusion.


Compound motor action potentials (CMAPs) were generated using transcranial electrical stimulation in patients undergoing EC-IC bypass surgery. Preoperative and postoperative motor function was analyzed. To assess graft function, intraoperative flowmetry and indocyanine green fluorescence angiography were performed. Special care was taken to compare the relevance of electrophysiological and blood flow monitoring in the detection of critical intraoperative ischemic episodes.


The study included 31 patients with 31 aneurysms and 1 bilateral occlusion of the internal carotid arteries, undergoing 32 EC-IC bypass surgeries in which radial artery or saphenous vein grafts were used. In 11 cases, 15 CMAP events were observed, helping the surgeon to determine the source of deterioration and to react to it: 14 were reversible and only 1 showed no recovery. In all cases, blood flow monitoring showed good perfusion of the bypass grafts. There were no false-negative results in this series. New postoperative motor deficits were transient in 1 case, permanent in 1 case, and not present in all other cases.


Intraoperative neurophysiological monitoring is a helpful tool for continuous functional monitoring of patients undergoing large-caliber vessel EC-IC bypass surgery. The authors’ results suggest that continuous neurophysiological monitoring during EC-IC bypass surgery has relevant advantages over flow-oriented monitoring techniques such as intraoperative flowmetry or indocyanine green–based angiography.

Source: JNS