Measuring Fun: A Case Study in Adapting to the Evolving Metrics of Player Experience

The gaming industry and the concept of gamification have altered the way many developers and users approach interactive products. As social gaming demographics expand to what was previously considered “casual” audiences, more users expect an enjoyable experience from their digital applications and games. Developers now request more detailed subjective descriptions of satisfaction and the player experience from user-experience (UX) practitioners. Focusing on how fun a product is for users/players requires subjective, situationally dependent metrics rather than traditional UX efficiency metrics. The UX discipline is still constructing a comprehensive ecology of the player experience and how to measure it. This article contributes to that ecology by detailing a case in which our team conducted a usability test on a new video game peripheral. Our client’s primary concern dealt with how fun experienced gamers found the device. As our test progressed, we encountered a number of fun-related participant behaviors that led us to develop new metrics beyond our initial planned metrics. These new metrics helped us and our client better define and discuss enjoyability. Our case, in conjunction with a detailed definition and review of player experience and UX scholarship, shows the importance of adopting metrics contextually specific to the video-game product and player group when measuring fun is the primary goal

Health-Related Quality of Life of Rural Clients Seeking Telepsychology Services

Sixty million US residents live in rural areas, but health policies and interventions developed from an urban mindset often fail to address the significant barriers to health experienced by these local communities. Telepsychology, or psychological services delivered by distance via technology, is an emerging treatment modality with special implications for underserved rural areas. This study found that a sample of rural residents seeking telepsychology services (n=94) had low health-related quality of life (HRQOL), often due to cooccurring physical and mental health diagnoses including high rates of depression. However, a brief telepsychology treatment delivered to rural clients (n=40) was associated with an improvement in mental health-related quality of life (d = 0.70,  P<.001). These results indicate that despite the complex health needs of these underserved communities, telepsychology interventions may help offset the disparities in health service access in rural areas

Systematic Investigation of the Permeability of Androgen Receptor PROTACs.

Bifunctional molecules known as PROTACs simultaneously bind an E3 ligase and a protein of interest to direct ubiquitination and clearance of that protein, and they have emerged in the past decade as an exciting new paradigm in drug discovery. In order to investigate the permeability and properties of these large molecules, we synthesized two panels of PROTAC molecules, constructed from a range of protein-target ligands, linkers, and E3 ligase ligands. The androgen receptor, which is a well-studied protein in the PROTAC field was used as a model system. The physicochemical properties and permeability of PROTACs are discussed.This work was funded by Alzheimer’s Research UK (grant: ARUK-2015DDI-CAM), with support from the ALBORADA Trust. The ALBORADA Drug Discovery Institute is core funded by Alzheimer’s Research UK (registered charity No. 1077089 and SC042474)

Competing risks of death in women treated with adjuvant aromatase inhibitors for early breast cancer on NCIC CTG MA.27

Baseline patient and tumor characteristics differentially affected type of death in the MA.17 placebo-controlled letrozole trial where cardiovascular death was not separately identified. The MA.27 trial allowed competing risks analysis of breast cancer (BC), cardiovascular, and other type (OT) of death. MA.27 was a phase III adjuvant breast cancer trial of exemestane versus anastrozole. Effects of baseline patient and tumor characteristics were tested for whether factors were associated with (1) all cause mortality and (2) cause-specific mortality. We also fit step-wise forward cause-specific-adjusted models. 7576 women (median age 64 years; 5417 (72 %) < 70 years and 2159 (28 %) ≥ 70 years) were enrolled and followed for median 4.1 years. The 432 deaths comprised 187 (43 %) BC, 66 (15 %) cardiovascular, and 179 (41 %) OT. Five baseline factors were differentially associated with type of death. Older patients had greater BC (p = 0.03), cardiovascular (p < 0.001), and other types (p < 0.001) of mortality. Patients with pre-existing cardiovascular history had worse cardiovascular mortality (p < 0.001); those with worse ECOG performance status had worse OT mortality (p < 0.001). Patients with T1 tumors (p < 0.001) and progesterone receptor positive had less BC mortality (p < 0.001). Fewer BC deaths occurred with node-negative disease (p < 0.001), estrogen receptor-positive tumors (p = 0.001), and without adjuvant chemotherapy (p = 0.005); worse cardiovascular mortality (p = 0.01), with trastuzumab; worse OT mortality, for non-whites (p = 0.03) and without adjuvant radiotherapy (p = 0.003). Overall, 57 % of deaths in MA.27 AI-treated patients were non-breast cancer related. Baseline patient and tumor characteristics differentially affected type of death with women 70 or older experiencing more non-breast cancer death

Assessing a New Clue to How Much Carbon Plants Take Up

Current climate models disagree on how much carbon dioxide land ecosystems take up for photosynthesis. Tracking the stronger carbonyl sulfide signal could help

Scientific Communities Striving for a Common Cause: Innovations in Carbon Cycle Science

Where does the carbon released by burning fossil fuels go? Currently, ocean and land systems remove about half of the CO₂ emitted by human activities; the remainder stays in the atmosphere. These removal processes are sensitive to feedbacks in the energy, carbon, and water cycles that will change in the future. Observing how much carbon is taken up on land through photosynthesis is complicated because carbon is simultaneously respired by plants, animals, and microbes. Global observations from satellites and air samples suggest that natural ecosystems take up about as much CO₂ as they emit. To match the data, our land models generate imaginary Earths where carbon uptake and respiration are roughly balanced, but the absolute quantities of carbon being exchanged vary widely. Getting the magnitude of the flux is essential to make sure our models are capturing the right pattern for the right reasons. Combining two cutting-edge tools, carbonyl sulfide (OCS) and solar-induced fluorescence (SIF), will help develop an independent answer of how much carbon is being taken up by global ecosystems. Photosynthesis requires CO₂, light, and water. OCS provides a spatially and temporally integrated picture of the “front door” of photosynthesis, proportional to CO₂ uptake and water loss through plant stomata. SIF provides a high-resolution snapshot of the “side door,” scaling with the light captured by leaves. These two independent pieces of information help us understand plant water and carbon exchange. A coordinated effort to generate SIF and OCS data through satellite, airborne, and ground observations will improve our process-based models to predict how these cycles will change in the future

Striatal intrinsic reinforcement signals during recognition memory: relationship to response bias and dysregulation in schizophrenia

Ventral striatum (VS) is a critical brain region for reinforcement learning and motivation, and VS hypofunction is implicated in psychiatric disorders including schizophrenia. Providing rewards or performance feedback has been shown to activate VS. Intrinsically motivated subjects performing challenging cognitive tasks are likely to engage reinforcement circuitry even in the absence of external feedback or incentives. However, such intrinsic reinforcement responses have received little attention, have not been examined in relation to behavioral performance, and have not been evaluated for impairment in neuropsychiatric disorders such as schizophrenia. Here we used fMRI to examine a challenging “old” vs. “new” visual recognition task in healthy subjects and patients with schizophrenia. Targets were unique fractal stimuli previously presented as salient distractors in a visual oddball task, producing incidental memory encoding. Based on the prediction error theory of reinforcement learning, we hypothesized that correct target recognition would activate VS in controls, and that this activation would be greater in subjects with lower expectation of responding correctly as indexed by a more conservative response bias. We also predicted these effects would be reduced in patients with schizophrenia. Consistent with these predictions, controls activated VS and other reinforcement processing regions during correct recognition, with greater VS activation in those with a more conservative response bias. Patients did not show either effect, with significant group differences suggesting hyporesponsivity in patients to internally generated feedback. These findings highlight the importance of accounting for intrinsic motivation and reward when studying cognitive tasks, and add to growing evidence of reward circuit dysfunction in schizophrenia that may impact cognition and function

Opposing brain differences in 16p11.2 deletion and duplication carriers

Deletions and duplications of the recurrent ∼600 kb chromosomal BP4–BP5 region of 16p11.2 are associated with a broad variety of neurodevelopmental outcomes including autism spectrum disorder. A clue to the pathogenesis of the copy number variant (CNV)'s effect on the brain is that the deletion is associated with a head size increase, whereas the duplication is associated with a decrease. Here we analyzed brain structure in a clinically ascertained group of human deletion (N = 25) and duplication (N = 17) carriers from the Simons Variation in Individuals Project compared with age-matched controls (N = 29 and 33, respectively). Multiple brain measures showed increased size in deletion carriers and reduced size in duplication carriers. The effects spanned global measures of intracranial volume, brain size, compartmental measures of gray matter and white matter, subcortical structures, and the cerebellum. Quantitatively, the largest effect was on the thalamus, but the collective results suggest a pervasive rather than a selective effect on the brain. Detailed analysis of cortical gray matter revealed that cortical surface area displays a strong dose-dependent effect of CNV (deletion > control > duplication), whereas average cortical thickness is less affected. These results suggest that the CNV may exert its opposing influences through mechanisms that influence early stages of embryonic brain development

The American Association for the Surgery of Trauma renal injury grading scale: Implications of the 2018 revisions for injury reclassification and predicting bleeding interventions.

BackgroundIn 2018, the American Association for the Surgery of Trauma (AAST) published revisions to the renal injury grading system to reflect the increased reliance on computed tomography scans and non-operative management of high-grade renal trauma (HGRT). We aimed to evaluate how these revisions will change the grading of HGRT and if it outperforms the original 1989 grading in predicting bleeding control interventions.MethodsData on HGRT were collected from 14 Level-1 trauma centers from 2014 to 2017. Patients with initial computed tomography scans were included. Two radiologists reviewed the scans to regrade the injuries according to the 1989 and 2018 AAST grading systems. Descriptive statistics were used to assess grade reclassifications. Mixed-effect multivariable logistic regression was used to measure the predictive ability of each grading system. The areas under the curves were compared.ResultsOf the 322 injuries included, 27.0% were upgraded, 3.4% were downgraded, and 69.5% remained unchanged. Of the injuries graded as III or lower using the 1989 AAST, 33.5% were upgraded to grade IV using the 2018 AAST. Of the grade V injuries, 58.8% were downgraded using the 2018 AAST. There was no statistically significant difference in the overall areas under the curves between the 2018 and 1989 AAST grading system for predicting bleeding interventions (0.72 vs. 0.68, p = 0.34).ConclusionAbout one third of the injuries previously classified as grade III will be upgraded to grade IV using the 2018 AAST, which adds to the heterogeneity of grade IV injuries. Although the 2018 AAST grading provides more anatomic details on injury patterns and includes important radiologic findings, it did not outperform the 1989 AAST grading in predicting bleeding interventions.Level of evidencePrognostic and Epidemiological Study, level III

Physiotherapy and occupational therapy vs no therapy in mild to moderate Parkinson disease: a randomized clinical trial

IMPORTANCE It is unclear whether physiotherapy and occupational therapy are clinically effective and cost-effective in Parkinson disease (PD). OBJECTIVE To perform a large pragmatic randomized clinical trial to evaluate the clinical effectiveness of individualized physiotherapy and occupational therapy in PD. DESIGN, SETTING, AND PARTICIPANTS The PD REHAB Trial was a multicenter, open-label, parallel group, controlled efficacy trial. A total of 762 patients with mild to moderate PD were recruited from 38 sites across the United Kingdom. Recruitment took place between October 2009 and June 2012, with 15 months of follow-up. INTERVENTIONS Participants with limitations in activities of daily living (ADL) were randomized to physiotherapy and occupational therapy or no therapy. MAIN OUTCOMES AND MEASURES The primary outcome was the Nottingham Extended Activities of Daily Living (NEADL) Scale score at 3 months after randomization. Secondary outcomes were health-related quality of life (assessed by Parkinson Disease Questionnaire–39 and EuroQol-5D); adverse events; and caregiver quality of life. Outcomes were assessed before trial entry and then 3, 9, and 15 months after randomization. RESULTS Of the 762 patients included in the study (mean [SD] age, 70 [9.1] years), 381 received physiotherapy and occupational therapy and 381 received no therapy. At 3 months, there was no difference between groups in NEADL total score (difference, 0.5 points; 95%CI, −0.7 to 1.7; P = .41) or Parkinson Disease Questionnaire–39 summary index (0.007 points; 95%CI, −1.5 to 1.5; P = .99). The EuroQol-5D quotient was of borderline significance in favor of therapy (−0.03; 95%CI, −0.07 to −0.002; P = .04). The median therapist contact time was 4 visits of 58 minutes over 8 weeks. Repeated-measures analysis showed no difference in NEADL total score, but Parkinson Disease Questionnaire–39 summary index (diverging 1.6 points per annum; 95%CI, 0.47 to 2.62; P = .005) and EuroQol-5D score (0.02; 95%CI, 0.00007 to 0.03; P = .04) showed small differences in favor of therapy. There was no difference in adverse events. CONCLUSIONS AND RELEVANCE Physiotherapy and occupational therapy were not associated with immediate or medium-term clinically meaningful improvements in ADL or quality of life in mild to moderate PD. This evidence does not support the use of low-dose, patient-centered, goal-directed physiotherapy and occupational therapy in patients in the early stages of PD. Future research should explore the development and testing of more structured and intensive physical and occupational therapy programs in patients with all stages of PD