Development of a new immersive virtual reality (VR) headset-based dexterity training for patients with multiple sclerosis: Clinical and technical aspects.

BACKGROUND Impaired manual dexterity is frequent and disabling in patients with multiple sclerosis (MS), affecting activities of daily living and quality of life. OBJECTIVE To develop a new immersive virtual-reality (VR) headset-based dexterity training to improve impaired manual dexterity in persons with MS (pwMS) while being feasible and usable in a home-based setting. METHODS The training intervention was tailored to the specific group of pwMS by implementing a simple and intuitive application with regard to hardware and software. To be efficacious, the training intervention covers the main functions of the hands and arm relevant for use in everyday life. RESULTS Taking clinical, feasibility, usability as well as technical aspects with regard to hardware and software into account, six different training exercises using hand tracking technology were developed on the Meta quest 2 using Unity. CONCLUSION We report the developmental process of a new immersive virtual VR headset-based dexterity training for pwMS implementing clinical and technical aspects. Good feasibility, usability, and patient satisfaction was already shown in a feasibility study qualifying this training intervention for further efficacy trials

Feasibility and usability of a new home-based immersive virtual reality headset-based dexterity training in multiple sclerosis.

BACKGROUND Impaired manual dexterity is frequent and disabling in patients with multiple sclerosis (MS), affecting activities of daily living and quality of life. OBJECTIVE The aim of this study was to evaluate the feasibility, usability and patient engagement/satisfaction of a home-based immersive virtual reality (VR) headset-based dexterity training in persons with multiple sclerosis (pwMS). In addition, preliminary efficacy data on the impact of this new training on manual dexterity were collected. METHODS Single arm prospective study. After a waiting period of two weeks, pwMS performed a specifically developed home-based VR headset-based dexterity training using the Oculus quest 2 for two weeks with five training sessions/week, each session for approximately 20 minutes. Primary endpoints were feasibility (measured by the adherence rate), usability (System Usability Scale, SUS) and patient engagement/satisfaction (Custom User Engagement Questionnaire, CUEQ). Secondary exploratory efficacy endpoints, measured before and after the waiting period as well as after the training intervention, were the Nine-hole-Peg-Test (9HPT), Coin rotation task (CRT), Handheld JAMAR dynamometer, Arm Function in Multiple Sclerosis Questionnaire (AMSQ) and the Multiple Sclerosis Impact Scale 29 (MSIS 29). RESULTS Eleven pwMS (mean age 49 ± 10.87 SD, mean EDSS 4.28 ± 1.48 SD) participated in the study. Feasibility (adherence rate: 81.8%), usability (median SUS score 94 (IQR = 78-96)) and patient engagement/satisfaction (median 8 on scale of 1-10) of the VR training was very high. In addition, the CRT for the dominant hand improved significantly after training (p = 0.03). CONCLUSIONS The good results on feasibility, usability, and patient engagement/satisfaction qualify this home-based immersive VR headset-based dexterity training approach for the use in home-based neurorehabilitation in pwMS. Improved fine motor skills for the dominant hand suggest preliminary efficacy, but this needs to be proven in a future randomized-controlled trials

Seeking the Goal in the Process, the Process for the Goal: Organizational Learning in a Public Sector Change Project

This paper describes how a combination of process modelling and goal modelling techniques has been used to facilitate organizational learning. The case study comes from the public sector in the UK. The modelling techniques have helped users to rationalise about the existing processes and then to design how they would like the process to work. The paper describes how the users have been able to confront the complex issues involved. The experience suggests that the combination of the modelling techniques is important to the learning experience of the users involved

Laser linewidth determination in the sub-Megahertz range using a Brillouin fibre laser

The Brillouin fibre laser has experimentally demonstrated its suitability for the measurement of laser linewidth in the 1 kHz to 500 kHz frequency range. A major advantage of this system is to be widely independent of the source wavelength by generating the uncorrelated reference signal at a fixed frequency below the source under test. This solution is simple and affordable, since it only requires widely available standard optical supplies. The measured spectra of a compact diode-pumped Nd:YAG laser and a spectrally-narrowed semiconductor laser are show

Electrostrictive nonlinearity in optical fiber deduced from Brillouin gain measurements

The nonlinear refractive index has drawn considerable attention these past few years, because it may significantly perturbate long-range propagation of lightwaves in optical fibers. Two main origins to this nonlinearity have been identified: nonresonant electronic nonlinearity and electrostriction. This paper shows that the electrostrictive contribution to the nonlinear refractive index n, may indeed be straightfowardly calculated from Brillouin gain measurements. The Brillouin linear gain g, is dependent on material properties and in particular on the electrostrictive coefficient

Efficacy-aware Business Process Modeling

In business process design, business objective models can fulfill the role of formal requirement definitions. Matching process models against objective models would, for instance, enable sound comparison of implementation alternatives. For that purpose, objective models should be available independently of their concrete implementation in a business process. This issue is not addressed by common business process management concepts yet. Moreover, process models are currently not sufficiently expressive to determine business process efficacy in the sense of fulfilling a business objective. Therefore, this paper develops and integrates constructs required for efficacy-aware process modeling and apt to extend common modeling approaches. The concept is illustrated with a sample scenario. Overall, it serves as an enabler for progressive applications like automated process optimization

Bevacizumab continuation versus no continuation after first-line chemotherapy plus bevacizumab in patients with metastatic colorectal cancer: a randomized phase III non-inferiority trial (SAKK 41/06)

In this trial, stopping bevacizumab after completion of induction chemotherapy was associated with a shorter time to progression, but no statistically significant difference in overall survival compared with the bevacizumab continuation strategy. Non-inferiority could not be demonstrated. Treatment costs are substantially higher for continuous bevacizumab treatmen

What Shall I Do Next? Intention Mining for Flexible Process Enactment

International audienceBesides the benefits of flexible processes, practical implementations of process aware information systems have also revealed difficulties encountered by process participants during enactment. Several support and guidance solutions based on process mining have been proposed, but they lack a suitable semantics for human reasoning and decisions making as they mainly rely on low level activities. Applying design science, we created FlexPAISSeer, an intention mining oriented approach, with its component artifacts: 1) IntentMiner which discovers the intentional model of the executable process in an unsupervised manner; 2) In-tentRecommender which generates recommendations as intentions and confidence factors, based on the mined intentional process model and probabilistic calculus. The artifacts were evaluated in a case study with a Netherlands software company, using a Childcare system that allows flexible data-driven process enactment

Fabrication and characterization of dual function nanoscale pH-scanning ion conductance microscopy (SICM) probes for high resolution pH mapping

The easy fabrication and use of nanoscale dual function pH-scanning ion conductance microscopy (SICM) probes is reported. These probes incorporate an iridium oxide coated carbon electrode for pH measurement and an SICM barrel for distance control, enabling simultaneous pH and topography mapping. These pH-SICM probes were fabricated rapidly from laser pulled theta quartz pipets, with the pH electrode prepared by in situ carbon filling of one of the barrels by the pyrolytic decomposition of butane, followed by electrodeposition of a thin layer of hydrous iridium oxide. The other barrel was filled with an electrolyte solution and Ag/AgCl electrode as part of a conductance cell for SICM. The fabricated probes, with pH and SICM sensing elements typically on the 100 nm scale, were characterized by scanning electron microscopy, energy-dispersive X-ray spectroscopy, and various electrochemical measurements. They showed a linear super-Nernstian pH response over a range of pH (pH 2–10). The capability of the pH-SICM probe was demonstrated by detecting both pH and topographical changes during the dissolution of a calcite microcrystal in aqueous solution. This system illustrates the quantitative nature of pH-SICM imaging, because the dissolution process changes the crystal height and interfacial pH (compared to bulk), and each is sensitive to the rate. Both measurements reveal similar dissolution rates, which are in agreement with previously reported literature values measured by classical bulk methods