Widening the scope of virtual reality and augmented reality in dermatology

Virtual reality (VR) and augmented reality (AR) are making headlines, pushing the boundaries of educational experiences and applicability in a variety of fields. Medicine has seen a rapid growth of utilization of these devices for various educational and practical purposes. With respect to the field of dermatology, very few uses are discussed in the literature. We briefly present the current status of VR/AR with regard to this specialty

Near mean-field behavior in the generalized Burridge-Knopoff earthquake model with variable range stress transfer

Simple models of earthquake faults are important for understanding the mechanisms for their observed behavior in nature, such as Gutenberg-Richter scaling. Because of the importance of long-range interactions in an elastic medium, we generalize the Burridge-Knopoff slider-block model to include variable range stress transfer. We find that the Burridge-Knopoff model with long-range stress transfer exhibits qualitatively different behavior than the corresponding long-range cellular automata models and the usual Burridge-Knopoff model with nearest-neighbor stress transfer, depending on how quickly the friction force weakens with increasing velocity. Extensive simulations of quasiperiodic characteristic events, mode-switching phenomena, ergodicity, and waiting-time distributions are also discussed. Our results are consistent with the existence of a mean-field critical point and have important implications for our understanding of earthquakes and other driven dissipative systems.Comment: 24 pages 12 figures, revised version for Phys. Rev.

Breaking a one-dimensional chain: fracture in 1 + 1 dimensions

The breaking rate of an atomic chain stretched at zero temperature by a constant force can be calculated in a quasiclassical approximation by finding the localized solutions ("bounces") of the equations of classical dynamics in imaginary time. We show that this theory is related to the critical cracks of stressed solids, because the world lines of the atoms in the chain form a two-dimensional crystal, and the bounce is a crack configuration in (unstable) mechanical equilibrium. Thus the tunneling time, Action, and breaking rate in the limit of small forces are determined by the classical results of Griffith. For the limit of large forces we give an exact bounce solution that describes the quantum fracture and classical crack close to the limit of mechanical stability. This limit can be viewed as a critical phenomenon for which we establish a Levanyuk-Ginzburg criterion of weakness of fluctuations, and propose a scaling argument for the critical regime. The post-tunneling dynamics is understood by the analytic continuation of the bounce solutions to real time.Comment: 15 pages, 5 figure

Reducing weight and increasing physical activity in people at high risk of cardiovascular disease: a randomised controlled trial comparing the effectiveness of enhanced motivational interviewing intervention with usual care.

OBJECTIVE: The epidemic of obesity is contributing to the increasing prevalence of people at high risk of cardiovascular disease (CVD), negating the medical advances in reducing CVD mortality. We compared the clinical and cost-effectiveness of an intensive lifestyle intervention consisting of enhanced motivational interviewing in reducing weight and increasing physical activity for patients at high risk of CVD. METHODS: A three-arm, single-blind, parallel-group randomised controlled trial was conducted in consenting primary care centres in south London. We recruited patients aged 40-74 years with a QRisk2 score ≥20.0%, which indicates the probability of having a CVD event in the next 10 years. The intervention was enhanced motivational interviewing which included additional behaviour change techniques and was delivered by health trainers in 10 sessions over 1 year, in either group (n=697) or individual (n=523) format. The third arm received usual care (UC; n=522). The primary outcomes were physical activity (mean steps/day) and weight (kg). Secondary outcomes were changes in low-density lipoprotein cholesterol and CVD risk score. We estimated the relative cost-effectiveness of each intervention. RESULTS: At 24 months, the group and individual interventions were not more effective than UC in increasing physical activity (mean difference=70.05 steps, 95% CI -288.00 to 147.90 and mean difference=7.24 steps, 95% CI -224.01 to 238.50, respectively), reducing weight (mean difference=-0.03 kg, 95% CI -0.49 to 0.44 and mean difference=-0.42 kg, 95% CI -0.93 to 0.09, respectively) or improving any secondary outcomes. The group and individual interventions were not cost-effective at conventional thresholds. CONCLUSIONS: Enhancing motivational interviewing with additional behaviour change techniques was not effective in reducing weight or increasing physical activity in those at high CVD risk

Enhanced motivational interviewing for reducing weight and increasing physical activity in adults with high cardiovascular risk: the MOVE IT three-arm RCT.

BACKGROUND: Motivational interviewing (MI) enhanced with behaviour change techniques (BCTs) and deployed by health trainers targeting multiple risk factors for cardiovascular disease (CVD) may be more effective than interventions targeting a single risk factor. OBJECTIVES: The clinical effectiveness and cost-effectiveness of an enhanced lifestyle motivational interviewing intervention for patients at high risk of CVD in group settings versus individual settings and usual care (UC) in reducing weight and increasing physical activity (PA) were tested. DESIGN: This was a three-arm, single-blind, parallel randomised controlled trial. SETTING: A total of 135 general practices across all 12 South London Clinical Commissioning Groups were recruited. PARTICIPANTS: A total of 1742 participants aged 40-74 years with a ≥ 20.0% risk of a CVD event in the following 10 years were randomised. INTERVENTIONS: The intervention was designed to integrate MI and cognitive-behavioural therapy (CBT), delivered by trained healthy lifestyle facilitators in 10 sessions over 1 year, in group or individual format. The control group received UC. RANDOMISATION: Simple randomisation was used with computer-generated randomisation blocks. In each block, 10 participants were randomised to the group, individual or UC arm in a 4 : 3 : 3 ratio. Researchers were blind to the allocation. MAIN OUTCOME MEASURES: The primary outcomes are change in weight (kg) from baseline and change in PA (average number of steps per day over 1 week) from baseline at the 24-month follow-up, with an interim follow-up at 12 months. An economic evaluation estimates the relative cost-effectiveness of each intervention. Secondary outcomes include changes in low-density lipoprotein cholesterol and CVD risk score. RESULTS: The mean age of participants was 69.75 years (standard deviation 4.11 years), 85.5% were male and 89.4% were white. At the 24-month follow-up, the group and individual intervention arms were not more effective than UC in increasing PA [mean 70.05 steps, 95% confidence interval (CI) -288 to 147.9 steps, and mean 7.24 steps, 95% CI -224.01 to 238.5 steps, respectively] or in reducing weight (mean -0.03 kg, 95% CI -0.49 to 0.44 kg, and mean -0.42 kg, 95% CI -0.93 to 0.09 kg, respectively). At the 12-month follow-up, the group and individual intervention arms were not more effective than UC in increasing PA (mean 131.1 steps, 95% CI -85.28 to 347.48 steps, and mean 210.22 steps, 95% CI -19.46 to 439.91 steps, respectively), but there were reductions in weight for the group and individual intervention arms compared with UC (mean -0.52 kg, 95% CI -0.90 to -0.13 kg, and mean -0.55 kg, 95% CI -0.95 to -0.14 kg, respectively). The group intervention arm was not more effective than the individual intervention arm in improving outcomes at either follow-up point. The group and individual interventions were not cost-effective. CONCLUSIONS: Enhanced MI, in group or individual formats, targeted at members of the general population with high CVD risk is not effective in reducing weight or increasing PA compared with UC. Future work should focus on ensuring objective evidence of high competency in BCTs, identifying those with modifiable factors for CVD risk and improving engagement of patients and primary care. TRIAL REGISTRATION: Current Controlled Trials ISRCTN84864870. FUNDING: This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 23, No. 69. See the NIHR Journals Library website for further project information. This research was part-funded by the NIHR Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London

Fluctuations and correlations in sandpile models

We perform numerical simulations of the sandpile model for non-vanishing driving fields $h$ and dissipation rates $\epsilon$. Unlike simulations performed in the slow driving limit, the unique time scale present in our system allows us to measure unambiguously response and correlation functions. We discuss the dynamic scaling of the model and show that fluctuation-dissipation relations are not obeyed in this system.Comment: 5 pages, latex, 4 postscript figure

Avalanches in Breakdown and Fracture Processes

We investigate the breakdown of disordered networks under the action of an increasing external---mechanical or electrical---force. We perform a mean-field analysis and estimate scaling exponents for the approach to the instability. By simulating two-dimensional models of electric breakdown and fracture we observe that the breakdown is preceded by avalanche events. The avalanches can be described by scaling laws, and the estimated values of the exponents are consistent with those found in mean-field theory. The breakdown point is characterized by a discontinuity in the macroscopic properties of the material, such as conductivity or elasticity, indicative of a first order transition. The scaling laws suggest an analogy with the behavior expected in spinodal nucleation.Comment: 15 pages, 12 figures, submitted to Phys. Rev. E, corrected typo in authors name, no changes to the pape

Gutenberg Richter and Characteristic Earthquake Behavior in Simple Mean-Field Models of Heterogeneous Faults

The statistics of earthquakes in a heterogeneous fault zone is studied analytically and numerically in the mean field version of a model for a segmented fault system in a three-dimensional elastic solid. The studies focus on the interplay between the roles of disorder, dynamical effects, and driving mechanisms. A two-parameter phase diagram is found, spanned by the amplitude of dynamical weakening (or ``overshoot'') effects (epsilon) and the normal distance (L) of the driving forces from the fault. In general, small epsilon and small L are found to produce Gutenberg-Richter type power law statistics with an exponential cutoff, while large epsilon and large L lead to a distribution of small events combined with characteristic system-size events. In a certain parameter regime the behavior is bistable, with transitions back and forth from one phase to the other on time scales determined by the fault size and other model parameters. The implications for realistic earthquake statistics are discussed.Comment: 21 pages, RevTex, 6 figures (ps, eps

Statistics of Earthquakes in Simple Models of Heterogeneous Faults

Simple models for ruptures along a heterogeneous earthquake fault zone are studied, focussing on the interplay between the roles of disorder and dynamical effects. A class of models are found to operate naturally at a critical point whose properties yield power law scaling of earthquake statistics. Various dynamical effects can change the behavior to a distribution of small events combined with characteristic system size events. The studies employ various analytic methods as well as simulations.Comment: 4 pages, RevTex, 3 figures (eps-files), uses eps