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Journal of Neuroengineering and... Apr 2024The objective of this study was to evaluate users' driving performances with a Power Wheelchair (PWC) driving simulator in comparison to the same driving task in real... (Clinical Trial)
Clinical Trial
OBJECTIVE
The objective of this study was to evaluate users' driving performances with a Power Wheelchair (PWC) driving simulator in comparison to the same driving task in real conditions with a standard power wheelchair.
METHODS
Three driving circuits of progressive difficulty levels (C1, C2, C3) that were elaborated to assess the driving performances with PWC in indoor situations, were used in this study. These circuits have been modeled in a 3D Virtual Environment to replicate the three driving task scenarios in Virtual Reality (VR). Users were asked to complete the three circuits with respect to two testing conditions during three successive sessions, i.e. in VR and on a real circuit (R). During each session, users completed the two conditions. Driving performances were evaluated using the number of collisions and time to complete the circuit. In addition, driving ability by Wheelchair Skill Test (WST) and mental load were assessed in both conditions. Cybersickness, user satisfaction and sense of presence were measured in VR. The conditions R and VR were randomized.
RESULTS
Thirty-one participants with neurological disorders and expert wheelchair drivers were included in the study. The driving performances between VR and R conditions were statistically different for the C3 circuit but were not statistically different for the two easiest circuits C1 and C2. The results of the WST was not statistically different in C1, C2 and C3. The mental load was higher in VR than in R condition. The general sense of presence was reported as acceptable (mean value of 4.6 out of 6) for all the participants, and the cybersickness was reported as acceptable (SSQ mean value of 4.25 on the three circuits in VR condition).
CONCLUSION
Driving performances were statistically different in the most complicated circuit C3 with an increased number of collisions in VR, but were not statistically different for the two easiest circuits C1 and C2 in R and VR conditions. In addition, there were no significant adverse effects such as cybersickness. The results show the value of the simulator for driving training applications. Still, the mental load was higher in VR than in R condition, thus mitigating the potential for use with people with cognitive disorders. Further studies should be conducted to assess the quality of skill transfer for novice drivers from the simulator to the real world. Trial registration Ethical approval n 2019-A001306-51 from Comité de Protection des Personnes Sud Mediterranée IV. Trial registered the 19/11/2019 on ClinicalTrials.gov in ID: NCT04171973.
Topics: Adult; Aged; Female; Humans; Male; Middle Aged; Young Adult; Automobile Driving; Computer Simulation; Nervous System Diseases; Pilot Projects; Psychomotor Performance; User-Computer Interface; Virtual Reality; Wheelchairs
PubMed: 38654367
DOI: 10.1186/s12984-024-01354-5 -
Lab on a Chip May 2024Cancer drug testing in animals is an extremely poor predictor of the drug's safety and efficacy observed in humans. Hence there is a pressing need for functional testing...
Cancer drug testing in animals is an extremely poor predictor of the drug's safety and efficacy observed in humans. Hence there is a pressing need for functional testing platforms that better predict traditional and immunotherapy responses in human, live tumor tissue or tissue constructs, and at the same time are compatible with the use of mouse tumor tissue to facilitate building more accurate disease models. Since many cancer drug actions rely on mechanisms that depend on the tumor microenvironment (TME), such platforms should also retain as much of the native TME as possible. Additionally, platforms based on miniaturization technologies are desirable to reduce animal use and sensitivity to human tissue scarcity. Present high-throughput testing platforms that have some of these features, based on patient-derived tumor organoids, require a growth step that alters the TME. On the other hand, microdissected tumors (μDTs) or "spheroids" that retain an intact TME have shown promising responses to immunomodulators acting on native immune cells. However, difficult tissue handling after microdissection has reduced the throughput of drug testing on μDTs, thereby constraining the inherent advantages of producing numerous TME-preserving units of tissue for drug testing. Here we demonstrate a microfluidic 96-well platform designed for drug treatment of hundreds of similarly-sized, cuboidal μDTs ("cuboids") produced from a single tumor sample. The platform organizes a monodisperse array of four cuboids per well in 384 hydrodynamic traps. The microfluidic device, entirely fabricated in thermoplastics, features 96 microvalves that fluidically isolate each well after the cuboid loading step for straightforward multi-drug testing. Since our platform makes the most of scarce tumor tissue, it can potentially be applied to human biopsies that preserve the human TME while minimizing animal testing.
Topics: Humans; Animals; Lab-On-A-Chip Devices; Antineoplastic Agents; Drug Screening Assays, Antitumor; Mice; Tumor Microenvironment; Microfluidic Analytical Techniques; Equipment Design; Cell Line, Tumor; Neoplasms
PubMed: 38651213
DOI: 10.1039/d4lc00016a -
International Journal of Medical... Jul 2024Immersive virtual reality (IVR) as a research platform to study human behaviors is an emerging field and may be useful for studying self-care management, especially in... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Immersive virtual reality (IVR) as a research platform to study human behaviors is an emerging field and may be useful for studying self-care management, especially in the gap between formal healthcare recommendations and day-to-day living. Self-care activities, such as grocery shopping, can be challenging for people with chronic illness. We developed an IVR environment that simulates a real-life grocery store and conducted a usability study to demonstrate the safety and acceptability of IVR as an experimental environment.
METHODS
This study was a three-arm randomized control trial involving 24 participants, conducted as a usability study to evaluate aspects of the experimental condition including the effectiveness of a training exposure, the occurrence of undesirable effects associated with IVR, and participants' experiences of realism, immersion, and spatial presence. The experiment, using a head mounted device and handheld controllers, included a 10-minute training exposure, followed by one of three unique 30-minute experimental conditions which exposed participants to different combinations of tasks and stimuli, and a post-experience interview. We measured controller errors, undesirable symptoms associated with IVR, and the perception of realism, immersion, and spatial presence.
RESULTS
Participants used controllers effectively to interact within the IVR environment. Hand controller use errors were fewer during the experimental conditions compared to the training exposure. Minimal undesirable IVR symptoms were reported. Presence was rated in the middle range with no significant differences based on experimental condition. Overall, user experience feedback was positive.
CONCLUSIONS
We demonstrated that participants could engage in our IVR environment without excessive error or experiencing undesirable effects and confirmed that the virtual experience attained a level of presence necessary to effectively engage in the study. These findings give us confidence that this IVR intervention designed to explore instrumental activities of daily living is safe, effective and provides a credible, controlled simulated community-like setting.
Topics: Humans; Virtual Reality; Male; Female; Adult; User-Computer Interface; Young Adult; Self Care; Middle Aged
PubMed: 38648684
DOI: 10.1016/j.ijmedinf.2024.105458 -
Case Reports in Psychiatry 2024When a person experiences maladaptive daydreaming (MD), they spend a prolonged period daydreaming with a strong sense of presence. The symptoms of MD are often...
BACKGROUND
When a person experiences maladaptive daydreaming (MD), they spend a prolonged period daydreaming with a strong sense of presence. The symptoms of MD are often excessive, interfere with functioning, and are linked to distress and comorbid mental disorders. In this paper, apparent false memory is described in the context of a woman with MD and visual impairment due to a progressive eye condition. Her vivid daydreams seemed indistinguishable from actual memories. . A 35-year-old woman with a lifelong MD reported three incidents of fabricating detailed false memories of events that her family confirmed never occurred: obtaining a new job, miscarrying twins, and hospitalization for COVID-19. She experienced anxiety and shame when the stories were disproven. The assessment confirmed MD, PTSD, OCD, and other disorders. Her verbal memory was below average, especially for longer narratives. Her misattributions of daydreams as real-life memories may relate to reliance on vivid mental images over deteriorating vision and source monitoring deficits.
CONCLUSION
This first reported case of confabulations in an individual with MD and visual disability suggests daydreams could potentially be mistaken for actual events in some MD cases. While sensitive, more research is needed on the prevalence of false memories among individuals with MD. The default mode network, prefrontal cortex, and their connectivity may be implicated in generating vivid daydreams and misattributing them to actual episodic events. Understanding the relationship between sensory impairments, dissociation, and susceptibility to memory distortions could inform interventions to improve reality testing for some MD patients.
PubMed: 38633732
DOI: 10.1155/2024/9391645 -
IEEE Transactions on Visualization and... Apr 2024User-Avatar interaction within augmented reality applications is rapidly increasing in frequency. Applications routinely place users in rooms with other, remote users...
User-Avatar interaction within augmented reality applications is rapidly increasing in frequency. Applications routinely place users in rooms with other, remote users embodied by photorealistic avatars, or require users to work with an avatar of a remote user to complete a task. During these types of interactions, it is often required to modify or redirect the posture of an avatar to achieve goals such as contact with or pointing at an object or maintaining eye gaze with the local user. A key limitation of modern redirection techniques is successfully preserving body posture, a critical component of nonverbal communication. This paper presents a new pose-preserving objective function to be used in the multi-objective optimization of an avatar's kinematic configuration. This objective function not only mimics the correct placement of body joints, but also preserves their orientation in space. We have tested this approach against several commonly used and current state-of-the-art redirection techniques and have found that our new approach achieves a significant reduction in targeted redirection error while simultaneously reducing body posture error. Additionally, human subject testing has shown that our new technique provides both a significantly more natural looking redirection and a significantly more realistic and believable overall body posture.
PubMed: 38630563
DOI: 10.1109/TVCG.2024.3388376 -
Paediatric Respiratory Reviews Apr 2024There is an increasing demand for the assessment of sleep-disordered breathing in children of all ages to prevent the deleterious neurocognitive and behaviour... (Review)
Review
There is an increasing demand for the assessment of sleep-disordered breathing in children of all ages to prevent the deleterious neurocognitive and behaviour consequences of the under-diagnosis and under-treatment of obstructive sleep apnoea [OSA]. OSA can be considered in three broad categories based on predominating contributory features: OSA type 1 [enlarged tonsils and adenoids], type II [Obesity] and type III [craniofacial abnormalities, syndromal, storage diseases and neuromuscular conditions]. The reality is that sleep questionnaires or calculations of body mass index in isolation are poorly predictive of OSA in individuals. Globally, the access to testing in tertiary referral centres is comprehensively overwhelmed by the demand and financial cost. This has prompted the need for better awareness and focussed history taking, matched with simpler tools with acceptable accuracy used in the setting of likely OSA. Consequently, we present key indications for polysomnography and present scalable, existing alternatives for assessment of OSA in the hospital or home setting, using polygraphy, oximetry or contactless sleep monitoring.
PubMed: 38616458
DOI: 10.1016/j.prrv.2024.04.002 -
Enfermeria Clinica (English Edition) 2024Define the modes of procedure of the Deductive Care Methodology (DCM) in the generation of knowledge about person's health care.
OBJECTIVE
Define the modes of procedure of the Deductive Care Methodology (DCM) in the generation of knowledge about person's health care.
METHODOLOGY
Design and test of the DCM modes based on three phases: mapping of the DCM, generation of models from this methodology and testing of the models through studies in a clinical context.
RESULTS
The DCM presents five levels of abstraction with three modes broken down to 16 types. The modes are: Philosophical Mode to conceptualize and obtain generalities about reality, Mathematical Mode to operate with generalities, and Physical Mode to operationally verify, validating the results and the predictive capacity of the model. This MDC allows the creation of three models: Knowledge Model about Person Care, an ontology of care, Vulnerability Model about the person and Taxonomic Triangulation Model for knowledge management. All models generate products for computational knowledge management. In addition, the models are applied in teaching and generate research with more than a hundred participations in conferences and journals, of which five impact publications (from 2008 to 2022) classified in the categories of Nursing and Informatics are analysed.
CONCLUSIONS
The DCM collects prior knowledge to work with certainties, evidence and applying inferences that do not depend on the number of cases or inductive designs. This research presents a formal structure of the DCM with an interdisciplinary orientation between Health Sciences and Computer Sciences.
Topics: Humans; Nursing Research; Research Design
PubMed: 38614457
DOI: 10.1016/j.enfcle.2024.04.001 -
Cureus Mar 2024Introduction Humerus fractures are fairly prevalent in the general population, and their incidence increases with age. The majority of minimally displaced fractures may...
Introduction Humerus fractures are fairly prevalent in the general population, and their incidence increases with age. The majority of minimally displaced fractures may be treated with prompt rehabilitation. An interdisciplinary team strategy involving experienced musculoskeletal specialists, geriatricians, and skilled physiotherapists should be employed for optimal therapy. Rehabilitation is essential in coping with the consequences of the fracture. The greatest current information for shoulder rehabilitation comprises the use of counseling, exercises, and mobility of restricted joints to regain upper limb function. Virtual reality (VR) based therapies are among the most effective since they may give visual, aural, and somatosensory cues to help patients. In fact, VR-based treatments have been shown to enhance motor function, neuropathic pain, balance, and aerobic performance in individuals with neurological disorders. However, there is limited evidence on the use of VR's therapeutic efficacy on individuals with musculoskeletal disorders. This study applied oculus-guided VR rehabilitation in addition to conventional physical therapy for the rehabilitation of patients with proximal humerus fractures. This study aims to assess the impact of virtual rehabilitation in adjunct to conventional physical therapy on proximal humerus fracture. Methods This study is a randomized controlled trial in which 50 patients were divided randomly into two groups: 25 patients in group A and 25 patients in group B. Group A was an experimental group that received VR plus conventional therapy. At the same time, group B was a control group that received only conventional therapy. Shoulder range of motion (ROM), manual muscle testing (MMT), numerical pain rating scale (NPRS), disabilities of arm, shoulder, and hand (DASH), and Shoulder pain and disability index (SPADI) were used as outcome measures of this study. Results There is an increase in flexion (t=7.58, P=0.0001), extension (t=6.90, P=0.0001), abduction (t = 9.57, P=0.0001), internal rotation (t=6.31, P=0.0001), and external rotation (t=3.41, P=0.001) in group A is statistically more significant than group B. The improvement in MMT scores in group B (t=1.71, P=0.10) is not significant, whereas improvements in group A are statistically significant (t=13.86, P=0.0001). The SPADI and DASH scores improved more significantly in group A (t=62.46, P=0.0001, and t=57.48, P=0.0001, respectively) than in group B (t=39.14, P=0.0001 and 46.58, P=0.0001, respectively). There is no significant difference in pain outcomes between the two groups. Conclusion The findings of this study reveal that virtual rehabilitation in adjunct to conventional physical therapy on proximal humerus fracture is more effective in improving shoulder ROM, muscle strength, and upper limb function than conventional therapy alone. However, no intervention can be considered superior to others in terms of the management of pain associated with proximal humerus fracture.
PubMed: 38606214
DOI: 10.7759/cureus.56022 -
RSC Advances Apr 2024The diminishing supply of fossil fuels, their detrimental environmental effects, and the challenges associated with the disposal of agro-waste necessitated the...
The diminishing supply of fossil fuels, their detrimental environmental effects, and the challenges associated with the disposal of agro-waste necessitated the development of renewable and sustainable alternative energy sources. This study aims at developing bio-briquettes from waste, with cassava starch as a binder; both are agricultural wastes. Before and following delignification, alkali-treated (TAHB) and untreated (UAHB) briquettes were evaluated in terms of combustion and physicochemical parameters. FTIR and SEM were utilized to monitor the morphological transformation and bond restructuring of TAHB and UAHB samples. EDXRF was used to assess the Potential Toxic Elements (PTEs) composition and environmental friendliness of both TAHB and UAHB. Furthermore, Adaptive Neuro-Fuzzy Inference System (ANFIS) and fuzzy c-means (FCM) clustering machine learning models were used to optimize the production process and predict the efficiency of bio-briquettes. After delignification, a lower lignin value of 11.47 ± 0.00% in TAHB compared to 12.31 ± 0.01% (UAHB) was recorded. Calorific values of 10.43 ± 0.25 MJ kg (UAHB) and 12.53 ± 0.30 MJ kg (TAHB) were recorded at < 0.05. EDXRF results showed a difference of 0.016% in Pb concentration in both samples. SEM reveals morphological restructuring, while FTIR reveals a 4 cm difference in the C-O stretch. The root mean square error (RMSE), mean absolute percentage error (MAPE), and mean absolute error (MAE) gave values of 0.0249, 2.104, and, 0.0249; (MAE, training) and 0.0223 (MAE, testing) respectively. This shows that the model's predictions match the reality, thereby suggesting a strong agreement between the predicted and experimental data. The finding of this study shows that delignification-disruption improved the solid biofuel's ability to burn cleanly and sustainably.
PubMed: 38601704
DOI: 10.1039/d3ra08378k -
Neuroscience Letters May 2024Concussion can lead to various symptoms such as balance problems, memory impairments, dizziness, and/or headaches. It has been previously suggested that during...
Concussion can lead to various symptoms such as balance problems, memory impairments, dizziness, and/or headaches. It has been previously suggested that during self-motion relevant tasks, individuals with concussion may rely heavily on visual information to compensate for potentially less reliable vestibular inputs and/or problems with multisensory integration. As such, concussed individuals may also be more sensitive to other visually-driven sensations such as visually induced motion sickness (VIMS). To investigate whether concussed individuals are at elevated risk of experiencing VIMS, we exposed participants with concussion (n = 16) and healthy controls (n = 15) to a virtual scene depicting visual self-motion down a grocery store aisle at different speeds. Participants with concussion were further separated into symptomatic and asymptomatic groups. VIMS was measured with the SSQ before and after stimulus exposure, and visual dependence, self-reported dizziness, and somatization were recorded at baseline. Results showed that concussed participants who were symptomatic demonstrated significantly higher SSQ scores after stimulus presentation compared to healthy controls and those who were asymptomatic. Visual dependence was positively correlated with the level of VIMS in healthy controls and participants with concussion. Our results suggest that the presence of concussion symptoms at time of testing significantly increased the risk and severity of VIMS. This finding is of relevance with regards to the use of visual display devices such as Virtual Reality applications in the assessment and rehabilitation of individuals with concussion.
Topics: Humans; Motion Sickness; Brain Concussion; Male; Female; Adult; Young Adult; Photic Stimulation; Visual Perception
PubMed: 38599370
DOI: 10.1016/j.neulet.2024.137767