Non-Tobacco Nicotine dependence associated with increased Postoperative Complications following Intramedullary Nailing for Intertrochanteric Femur Fractures.

Objectives: Nicotine usage is known to increase postoperative complications; however, studies show that the general population believes that non-tobacco nicotine delivery devices are a safer option compared to tobacco-based nicotine products. This study evaluates postoperative complications between non-tobacco nicotine dependent and non-nicotine dependent patients for intramedullary nailing in intertrochanteric femur fractures. Methods: Utilizing the TriNetX database, we retrospectively examined postoperative outcomes in patients aged 18 to 90 who underwent intramedullary nailing for intertrochanteric femur fractures between November 21, 2013, and November 21, 2023. Two cohorts were analyzed: Cohort A comprised nicotine-dependent patients without tobacco product usage (e.g. cigarettes or chewing tobacco) and Cohort B consisted of patients without any nicotine dependence. Propensity matching was performed for BMI, type 2 diabetes, alcohol/substance abuse, socioeconomic status, and demographic factors. Outcomes assessed included mortality, sepsis, pneumonia, revision, dehiscence, pulmonary embolism, nonunion, and deep vein thrombosis within 1 day to 6 months post-treatment. Results: A total of 2,041 non-tobacco nicotine dependent patients were matched with 22,872 non-nicotine dependent patients. Non-tobacco nicotine dependent patients experienced higher associated risk for numerous postoperative complications compared to non-nicotine dependent patients including increased risk for mortality within 6 months postoperatively (RR 1.386, 10.7% vs 7.7%, P = 0.001), sepsis (RR 1.459, 4.4% vs 3.0%, P = 0.027), and pneumonia (RR 1.751, 5.8% vs 3.3%, P = 0.001). Conclusions: Non-tobacco nicotine dependence increases postoperative complications for patients undergoing intramedullary nailing for intertrochanteric femur fractures. Our findings support the need for development of perioperative nicotine cessation guidelines for non-tobacco nicotine users. Level of evidence: Level III, Prognostic.

Association of Posterior Horn Meniscus Tears with Obesity: A Retrospective Study.

Our study aims to determine the association between obesity and meniscal tears involving the posterior third of the medial meniscus and meniscal root tears. We conducted a 3-year retrospective review of isolated operatively treated meniscal injuries in adult patients performed by a single surgeon. Cases with concomitant pathology were excluded. Patient demographics, height, weight, and body mass index (BMI) were recorded and compared against location of meniscus tear noted via magnetic resonance imaging and arthroscopic imaging. Eighty-nine patients met the inclusion criteria, of which 65.2% were obese (BMI > 30) and 10.1% were morbidly obese (BMI > 40). Average BMI across all patients was 32.6 ± 6.7. Forty-four patients had a tear involving the posterior horn of the medial meniscus, including 20 involving the meniscal root. The average BMI of patients with tears involving the meniscal root was 35.7 ± 6. There was a statistically significant association between type of meniscus tear and BMI as well as height. Obese patients were more likely to have a posterior horn of the medial meniscus tear (odds ratio [OR]: 1.59) and meniscal root tear (OR: 124.67), as were morbidly obese patients (OR: 2.21 and 5.41, respectively). Elevated BMI is associated with posterior horn of the medial meniscus tear. Obesity and morbid obesity are strongly associated with meniscal root tears and tears included in the posterior third of the medial meniscus.

Eliciting real cravings with virtual food: Using immersive technologies to explore the effects of food stimuli in virtual reality.

In this paper, we explore the current technical possibilities of eating in virtual reality (VR) and show how this could be used to influence eating behaviors. Cue-based exposure therapy is a well-known method used to treat eating disorders. There are several benefits to using VR in combination with cue-based therapy. However, before VR-based cue-exposure can be used for therapeutic purposes, the ability of the VR environment to elicit craving responses in participants must be assessed. This was the objective of the first part of the study, where we assessed whether our VR environment elicited food craving responses in participants. Results showed that our VR environment elicited food craving responses: Salivation Magnitude, Food Craving State and Urge to Eat was significantly different from the neutral baseline. In addition, results showed that food cravings measured through the salivation magnitude in response to the virtual condition were not significantly different from the real condition, thus showing that VR had a comparable effect on producing food cravings. The second part of the study was conducted to determine whether the addition of olfactory and interaction cues in VR increased the development of food cravings. The results of this part showed that adding synthetic olfactory cues, paired with visual cues, to our system, provided a significant further increase in food cravings. Our results demonstrate that the use of food cues in VR can increase the development of food cravings and that it is possible to provide a simple yet convincing eating experience in VR. Inevitably, food interaction in VR is still underexplored territory and further research is needed to improve utility and application in disciplines related to food and eating.

Using Virtual Reality to Enhance Food Technology Education.

The use of Virtual Reality (VR) technology combined with 360-degree images and videos provide an opportunity for teachers to bring students into the classroom even when they are located somewhere else. During the COVID-19 lockdown and pandemic, with students across the world forced into home-based learning via remote teaching, a VR classroom shows potential as a tool for adding depth to their learning. The possibility of immersing students in a virtual environment could provide an answer to motivation and engagement issues for today's students as well as a solution to some of the current constraints faced by teachers. In particular, VR has the potential to increase the time students are able to spend in (virtual) environments that are suitable for teaching and learning practical skills. With the cost of VR equipment reducing rapidly and the increasing quality of virtual experiences, it appears VR is on the tipping-point of becoming a regular part of school programmes.This article outlines the development and testing of a VR Classroom for the delivery of a food-based lesson with middle school students in a New Zealand school. Kitchens are a costly commodity for schools and the obvious health and safety issues make teaching practical cooking skills challenging. With a focus on student engagement and motivation, data is collected from observation of students using the virtual classroom and a post-test survey. Results show that students were highly motivated and perceived the VR classroom as fun to use.

Directions for 3D User Interface Research from Consumer VR Games.

With the continuing development of affordable immersive virtual reality (VR) systems, there is now a growing market for consumer content. The current form of consumer systems is not dissimilar to the lab-based VR systems of the past 30 years: the primary input mechanism is a head-tracked display and one or two tracked hands with buttons and joysticks on hand-held controllers. Over those 30 years, a very diverse academic literature has emerged that covers design and ergonomics of 3D user interfaces (3DUIs). However, the growing consumer market has engaged a very broad range of creatives that have built a very diverse set of designs. Sometimes these designs adopt findings from the academic literature, but other times they experiment with completely novel or counter-intuitive mechanisms. In this paper and its online adjunct, we report on novel 3DUI design patterns that are interesting from both design and research perspectives: they are highly novel, potentially broadly re-usable and/or suggest interesting avenues for evaluation. The supplemental material, which is a living document, is a crowd-sourced repository of interesting patterns. This paper is a curated snapshot of those patterns that were considered to be the most fruitful for further elaboration.

Floor-vibration VR: Mitigating Cybersickness Using Whole-body Tactile Stimuli in Highly Realistic Vehicle Driving Experiences.

This work addresses cybersickness, a major barrier to successful long-exposure immersive virtual reality (VR) experiences since user discomfort frequently leads to prematurely ending such experiences. Starting from sensory conflict theory, we posit that if a vibrating floor delivers vestibular stimuli that minimally match the vibration characteristics of a scenario, the size of the conflict between the visual and vestibular senses will be reduced and, thus, the incidence and/or severity of cybersickness will also be reduced. We integrated a custom-built, computer-controlled vibrating floor in our VR system. To evaluate the system, we implemented a realistic off-road vehicle driving simulator in which participants rode multiple laps as passengers on an off-road course. We programmed the floor to generate vertical vibrations similar to those experienced in real off-road vehicle travel. The scenario and driving conditions were designed to be cybersickness-inducing for users in both the Vibration and No-vibration conditions. We collected subjective and objective data for variables previously shown to be related to levels of cybersickness or presence. These included presence and simulator sickness questionnaires (SSQ), self-rated discomfort levels, and the physiological signals of heart rate, galvanic skin response (GSR), and pupil size. Comparing data between participants in the Vibration group (N=11) to the No-Vibration group (N=11), we found that Delta-SSQ Oculomotor response and the GSR physiological signal, both known to be positively correlated with cybersickness, were significantly lower (with large effect sizes) for the Vibration group. Other variables differed between groups in the same direction, but with trivial or small effect sizes. The results indicate that the floor vibration significantly reduced some measures of cybersickness.

Improved Position Accuracy of Foot-Mounted Inertial Sensor by Discrete Corrections from Vision-Based Fiducial Marker Tracking.

In this paper, we present a novel pedestrian indoor positioning system that uses sensor fusion between a foot-mounted inertial measurement unit (IMU) and a vision-based fiducial marker tracking system. The goal is to provide an after-action review for first responders during training exercises. The main contribution of this work comes from the observation that different walking types (e.g., forward walking, sideways walking, backward walking) lead to different levels of position and heading error. Our approach takes this into account when accumulating the error, thereby leading to more-accurate estimations. Through experimentation, we show the variation in error accumulation and the improvement in accuracy alter when and how often to activate the camera tracking system, leading to better balance between accuracy and power consumption overall. The IMU and vision-based systems are loosely coupled using an extended Kalman filter (EKF) to ensure accurate and unobstructed positioning computation. The motion model of the EKF is derived from the foot-mounted IMU data and the measurement model from the vision system. Existing indoor positioning systems for training exercises require extensive active infrastructure installation, which is not viable for exercises taking place in a remote area. With the use of passive infrastructure (i.e., fiducial markers), the positioning system can accurately track user position over a longer duration of time and can be easily integrated into the environment. We evaluated our system on an indoor trajectory of 250 m. Results show that even with discrete corrections, near a meter level of accuracy can be achieved. Our proposed system attains the positioning accuracy of 0.55 m for a forward walk, 1.05 m for a backward walk, and 1.68 m for a sideways walk with a 90% confidence level.

Effect of Elbow Position on Load to Failure in Olecranon Fracture Fixation: A Biomechanical Cadaveric Study.

OBJECTIVES: This study evaluates if relative flexion or extension of the ulnohumeral joint affects the strength of repair in olecranon fractures treated with a precontoured locking plate. METHODS: A cadaveric study was performed in matched pair cadaveric elbows. All soft tissue was dissected from the radius, ulna, and elbow of each specimen, leaving interosseous ligaments and joint capsules intact. Soft tissue from the humerus was dissected away, leaving only the triceps tendon and ulnar insertions intact. An oblique proximal to distal olecranon osteotomy was created in each specimen 1 cm from the tip of the olecranon. Internal fixation with standard precontoured locking plates and a Krackow augmentation suture with #2 FiberWire followed. Specimens were randomized to elbow position of 90 or 20 degrees° and loaded to failure via axial pull through the triceps. Load at failure, displacement at the time of failure, peak load, stiffness, and mechanism of failure was recorded and compared. The study was repeated a second time with the osteotomy more proximal, 0.6 cm creating a smaller fragment with less opportunities for locking screw fixation. This small fragment group was then tested as the large fragment group had. RESULTS: There were no significant differences in load at failure, peak load, or stiffness between the elbow position in the large fragment group. Displacement at time of failure was significantly different, although not clinically relevant. Failure of fixation in this group was a mix of triceps avulsion and failure through fracture site. The smaller fragment group with less points of fixation demonstrated no statistically significant differences in any parameters. A majority of the failures were at the fracture site. CONCLUSIONS: Ulnohumeral position does not significantly affect overall construct strength even in olecranon fractures with small proximal fragments with limited points of fixation.

A SWOT Analysis of the Field of Virtual Reality for Firefighter Training.

Virtual reality (VR) research has gone through rapid advances and the technology has established itself as a valuable training tool in many domains. While research in the field of emergency response, and more specifically in the field of firefighting, is still catching up, the future potential of VR technology for training is promising. This paper uses the SWOT framework to analyse the strengths, weaknesses, opportunities, and threats immersive VR technology faces in the field of firefighter training. While using VR for training is cost-effective, safe to use and provides the ability to prepare trainees with a large variety of high fidelity training environments, the lack in specialization of the applications for the fire-service sector and issues with technology acceptance and limitations need to be addressed. Looking to current research, there are promising findings that might be directly transferable, creating affective, and multi-sensory experiences for more effective mental and physical training of firefighters in the future. More research is needed to establish methods of skills transfer from VR to real life scenarios and to evaluate the potential risk of frequent training in engaging and physiologically stimulating virtual environments.

Arthroscopic Identification of Partial-Thickness Rotator Cuff Tears.

Partial-thickness rotator cuff tears are among the most common challenges faced by orthopaedic surgeons today. The ability to adequately manage these injuries depends on identifying their full extent during arthroscopic evaluation. There are many ways to fully visualize these tears, including arm positioning and gentle debridement. The purpose of this article is to highlight several tips and techniques to enable full visualization of partial-thickness rotator cuff tears to determine appropriate treatment.

A Systematic Review of 10 Years of Augmented Reality Usability Studies: 2005 to 2014.

Augmented Reality (AR) interfaces have been studied extensively over the last few decades, with a growing number of user-based experiments. In this paper, we systematically review 10 years of the most influential AR user studies, from 2005 to 2014. A total of 291 papers with 369 individual user studies have been reviewed and classified based on their application areas. The primary contribution of the review is to present the broad landscape of user-based AR research, and to provide a high-level view of how that landscape has changed. We summarize the high-level contributions from each category of papers, and present examples of the most influential user studies. We also identify areas where there have been few user studies, and opportunities for future research. Among other things, we find that there is a growing trend toward handheld AR user studies, and that most studies are conducted in laboratory settings and do not involve pilot testing. This research will be useful for AR researchers who want to follow best practices in designing their own AR user studies.