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PURPOSE: Surgical training methods are evolving with the technological advancements, including the application of virtual reality (VR) and augmented reality. However, 28 to 40% of novice residents are not confident in performing a major surgical procedure. VR surgery, an immersive VR (iVR) experience, was developed using Oculus Rift and Leap Motion devices (Leap Motion, Inc, San Francisco, CA) to address this challenge. Our iVR is a multisensory, holistic surgical training application that demonstrates a maxillofacial surgical technique, the Le Fort I osteotomy. The main objective of the present study was to evaluate the effect of using VR surgery on the self-confidence and knowledge of surgical residents. MATERIALS AND METHODS: A multisite, single-blind, parallel, randomized controlled trial (RCT) was performed. The participants were novice surgical residents with limited experience in performing the Le Fort I osteotomy. The primary outcome measures were the self-assessment scores of trainee confidence using a Likert scale and an objective assessment of the cognitive skills. Ninety-five residents from 7 dental schools were included in the RCT. The participants were randomly divided into a study group of 51 residents and a control group of 44. Participants in the study group used the VR surgery application on an Oculus Rift with Leap Motion device. The control group participants used similar content in a standard PowerPoint presentation on a laptop. Repeated measures multivariate analysis of variance was applied to the data to assess the overall effect of the intervention on the confidence of the residents. RESULTS: The study group participants showed significantly greater perceived self-confidence levels compared with those in the control group (P = .034; α = 0.05). Novices in the first year of their training showed the greatest improvement in their confidence compared with those in their second and third year. CONCLUSIONS: iVR experiences improve the knowledge and self-confidence of the surgical residents.
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Internado y Residencia/métodos , Osteotomía Le Fort/educación , Entrenamiento Simulado/métodos , Cirugía Bucal/educación , Realidad Virtual , Adulto , Competencia Clínica , Femenino , Humanos , Masculino , Autoimagen , Método Simple Ciego , Reino UnidoRESUMEN
Stroke often results in hemiparesis, impairing the patient's motor abilities and leading to upper extremity motor deficits that require long-term training and assessment. However, existing methods for assessing patients' motor function rely on clinical scales that require experienced physicians to guide patients through target tasks during the assessment process. This process is not only time-consuming and labor-intensive, but the complex assessment process is also uncomfortable for patients and has significant limitations. For this reason, we propose a serious game that automatically assesses the degree of upper limb motor impairment in stroke patients. Specifically, we divide this serious game into a preparation stage and a competition stage. In each stage, we construct motor features based on clinical a priori knowledge to reflect the ability indicators of the patient's upper limbs. These features all correlated significantly with the Fugl-Meyer Assessment for Upper Extremity (FMA-UE), which assesses motor impairment in stroke patients. In addition, we design membership functions and fuzzy rules for motor features in combination with the opinions of rehabilitation therapists to construct a hierarchical fuzzy inference system to assess the motor function of upper limbs in stroke patients. In this study, we recruited a total of 24 patients with varying degrees of stroke and 8 healthy controls to participate in the Serious Game System test. The results show that our Serious Game System was able to effectively differentiate between controls, severe, moderate, and mild hemiparesis with an average accuracy of 93.5%.
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Rehabilitación de Accidente Cerebrovascular , Accidente Cerebrovascular , Humanos , Rehabilitación de Accidente Cerebrovascular/métodos , Recuperación de la Función , Accidente Cerebrovascular/complicaciones , Accidente Cerebrovascular/diagnóstico , Extremidad Superior , Paresia/diagnóstico , Paresia/etiologíaRESUMEN
Healive® was the only Chinese WHO-prequalified inactivated vaccine for the hepatitis A virus, which has been widely used in national immunization programs in China. Long-term follow-up studies are needed to estimate the persistence of vaccine-induced antibody levels and the necessity for booster vaccines. During the trial, geometric mean concentrations (GMCs) and seroconversion rates (SRs) of anti-HAV antibodies were compared based on two different inactivated hepatitis A vaccines, Healive® and Havrix®. Four hundred children were randomly assigned to receive two doses of Healive® or Havrix® at 0 and 6 months. The current study assessed antibody persistence for both vaccines 15 years post-immunization. A mixed linear model was used to predict long-term antibody persistence. The GMCs were significantly higher for Healive® compared to Havrix® at 1, 6, 7, 66, 138 months (P < .001) and 186 months (P = .004 < .05) post-vaccination. Healive® and Havrix® reached a GMC of 164.8 mIU/ml and 105.7 mIU/ml post-15 years of vaccination, respectively. The seroconversion rates of both vaccines showed no statistically significant differences (97.9% for Healive® and 94.7% for Havrix®, P = .20). The prediction showed that Healive® would provide protection for a minimum of 30 years following immunization, with a lower limit of the 95% confidence intervals for GMCs greater than 20mIU/mL. Compared to Havrix®, the vaccine Healive® showed a stronger protective effect and better persistence among children at 15 years post-full immunization. Prediction indicated at least 30 years of antibody persistence for Healive® and at least 25 years for Havrix®.
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Vacunas contra la Hepatitis A , Hepatitis A , Humanos , Niño , Estudios de Seguimiento , Anticuerpos de Hepatitis A , Vacunación , Inmunización Secundaria , Vacunas de Productos InactivadosRESUMEN
Over the years, the various mediums available for storytelling have progressively expanded, from spoken to written word, then to film, and now to Virtual Reality (VR) and Augmented Reality (AR). In 2016, the cutting-edge Head-Mounted Display (HMD) AR Microsoft HoloLens was released. However, though it has been several years, the quality of the user experience with narration using HMD-based AR technology has been rarely discussed. The present study explored interactive narrative in HMD-based AR regarding different user interfaces and their influence on users' presence, narrative engagement and reflection. Inspired by an existing exhibition at the National Holocaust Centre and Museum in the U.K., a HoloLens narrative application, entitled The AR Journey, was developed by the authors using two different interaction methods, Natural User Interface (NUI) and Graphical User Interface (GUI), which were used to perform an empirical study. As revealed from the results of the between-subject design experiment, NUI exhibited statistically significant advantages in creating presence for users without 3D Role Playing Game (RPG) experience, and GUI was superior in creating presence and increasing narrative engagement for users with 3D RPG experience. As indicated by the results of the interviews, the overall narrative experience in HMD-based AR was acceptable, and the branching narrative design was engaging. However, HoloLens hardware issues, as well as virtuality and reality mismatch, adversely affected user experience. Design guidelines were proposed according to the qualitative results. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11042-021-11723-0.
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The fields of neural prosthetic technologies and Brain-Computer Interfaces (BCIs) have witnessed in the past 15 years an unprecedented development, bringing together theories and methods from different scientific fields, digital media, and the arts. More in particular, artists have been amongst the pioneers of the design of relevant applications since their emergence in the 1960s, pushing the boundaries of applications in real-life contexts. With the new research, advancements, and since 2007, the new low-cost commercial-grade wireless devices, there is a new increasing number of computer games, interactive installations, and performances that involve the use of these interfaces, combining scientific, and creative methodologies. The vast majority of these works use the brain-activity of a single participant. However, earlier, as well as recent examples, involve the simultaneous interaction of more than one participants or performers with the use of Electroencephalography (EEG)-based multi-brain BCIs. In this frame, we discuss and evaluate "Enheduanna-A Manifesto of Falling," a live brain-computer cinema performance that enables for the first time the simultaneous real-time multi-brain interaction of more than two participants, including a performer and members of the audience, using a passive EEG-based BCI system in the context of a mixed-media performance. The performance was realised as a neuroscientific study conducted in a real-life setting. The raw EEG data of seven participants, one performer and two different members of the audience for each performance, were simultaneously recorded during three live events. The results reveal that the majority of the participants were able to successfully identify whether their brain-activity was interacting with the live video projections or not. A correlation has been found between their answers to the questionnaires, the elements of the performance that they identified as most special, and the audience's indicators of attention and emotional engagement. Also, the results obtained from the performer's data analysis are consistent with the recall of working memory representations and the increase of cognitive load. Thus, these results prove the efficiency of the interaction design, as well as the importance of the directing strategy, dramaturgy and narrative structure on the audience's perception, cognitive state, and engagement.
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OBJECTIVE: To investigate the change of immunosuppressive acidic protein (IAP) in sera of patients with pulmonary tuberculosis (TB) and its clinical value. METHOD: IAP in sera of 336 patients suffering from pulmonary TB and controls was detected by agar diffusion assay. RESULTS: In pulmonary TB, healthy controls and non-TB respiratory diseases, the level of IAP was (797 +/- 168) mg/L, (367 +/- 71) mg/L and (404 +/- 75) mg/L, respectively. If > 500 mg/L was regarded as positive threshold, the positive rates in the above groups were 96.7%, 9.2% and 9.6%, respectively. IAP positive rates in cases of primary, disseminated, infiltrative, chronic fibro-cavernous pulmonary TB and tuberculous pleuritis were 100, 0%, 100.0%, 96.0%, 98.6% and 96.9%, respectively. IAP was significantly higher in progressive pulmonary TB than in stable pulmonary TB, and was decreased when patients' condition improved after treatment. CONCLUSION: Detection of IAP in sera of patients with pulmonary TB can reflect patients' immunosuppression status and the severity of the disease, and may be useful in assessing treatment effect and evaluating prognosis.
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Proteínas de Neoplasias/sangre , Tuberculosis Pulmonar/sangre , Humanos , Tuberculosis Pulmonar/inmunologíaRESUMEN
Computer-generated three-dimensional (3D) animation is an ideal media to accurately visualize crime or accident scenes to the viewers and in the courtrooms. Based upon factual data, forensic animations can reproduce the scene and demonstrate the activity at various points in time. The use of computer animation techniques to reconstruct crime scenes is beginning to replace the traditional illustrations, photographs, and verbal descriptions, and is becoming popular in today's forensics. This article integrates work in the areas of 3D graphics, computer vision, motion tracking, natural language processing, and forensic computing, to investigate the state-of-the-art in forensic visualization. It identifies and reviews areas where new applications of 3D digital technologies and artificial intelligence could be used to enhance particular phases of forensic visualization to create 3D models and animations automatically and quickly. Having discussed the relationships between major crime types and level-of-detail in corresponding forensic animations, we recognized that high level-of-detail animation involving human characters, which is appropriate for many major crime types but has had limited use in courtrooms, could be useful for crime investigation.