Timing and correction of stepping movements with a virtual reality avatar

Research into the ability to coordinate one’s movements with external cues has focussed on the use of simple rhythmic, auditory and visual stimuli, or interpersonal coordination with another person. Coordinating movements with a virtual avatar has not been explored, in the context of responses to temporal cues. To determine whether cueing of movements using a virtual avatar is effective, people’s ability to accurately coordinate with the stimuli needs to be investigated. Here we focus on temporal cues, as we know from timing studies that visual cues can be difficult to follow in the timing context. Real stepping movements were mapped onto an avatar using motion capture data. Healthy participants were then motion captured whilst stepping in time with the avatar’s movements, as viewed through a virtual reality headset. The timing of one of the avatar step cycles was accelerated or decelerated by 15% to create a temporal perturbation, for which participants would need to correct to, in order to remain in time. Step onset times of participants relative to the corresponding step-onsets of the avatar were used to measure the timing errors (asynchronies) between them. Participants completed either a visual-only condition, or auditory-visual with footstep sounds included, at two stepping tempo conditions (Fast: 400ms interval, Slow: 800ms interval). Participants’ asynchronies exhibited slow drift in the Visual-Only condition, but became stable in the Auditory-Visual condition. Moreover, we observed a clear corrective response to the phase perturbation in both the fast and slow tempo auditory-visual conditions. We conclude that an avatar’s movements can be used to influence a person’s own motion, but should include relevant auditory cues congruent with the movement to ensure a suitable level of entrainment is achieved. This approach has applications in physiotherapy, where virtual avatars present an opportunity to provide the guidance to assist patients in adhering to prescribed exercises

Using digital tools in clinical, health and social care research:a mixed-methods study of UK stakeholders

Objective: The COVID-19 pandemic accelerated changes to clinical research methodology, with clinical studies being carried out via online/remote means. This mixed-methods study aimed to identify which digital tools are currently used across all stages of clinical research by stakeholders in clinical, health and social care research and investigate their experience using digital tools.Design: Two online surveys followed by semistructured interviews were conducted. Interviews were audiorecorded, transcribed and analysed thematically.Setting, participants: To explore the digital tools used since the pandemic, survey participants (researchers and related staff (n=41), research and development staff (n=25)), needed to have worked on clinical, health or social care research studies over the past 2 years (2020–2022) in an employing organisation based in the West Midlands region of England (due to funding from a regional clinical research network (CRN)). Survey participants had the opportunity to participate in an online qualitative interview to explore their experiences of digital tools in greater depth (n=8).Results: Six themes were identified in the qualitative interviews: ‘definition of a digital tool in clinical research’; ‘impact of the COVID-19 pandemic’; ‘perceived benefits/drawbacks of digital tools’; ‘selection of a digital tool’; ‘barriers and overcoming barriers’ and ‘future digital tool use’. The context of each theme is discussed, based on the interview results.Conclusions: Findings demonstrate how digital tools are becoming embedded in clinical research, as well as the breadth of tools used across different research stages. The majority of participants viewed the tools positively, noting their ability to enhance research efficiency. Several considerations were highlighted; concerns about digital exclusion; need for collaboration with digital expertise/clinical staff, research on tool effectiveness and recommendations to aid future tool selection. There is a need for the development of resources to help optimise the selection and use of appropriate digital tools for clinical research staff and participants

Classification of paediatric brain tumours by diffusion weighted imaging and machine learning

To determine if apparent diffusion coefficients (ADC) can discriminate between posterior fossa brain tumours on a multicentre basis. A total of 124 paediatric patients with posterior fossa tumours (including 55 Medulloblastomas, 36 Pilocytic Astrocytomas and 26 Ependymomas) were scanned using diffusion weighted imaging across 12 different hospitals using a total of 18 different scanners. Apparent diffusion coefficient maps were produced and histogram data was extracted from tumour regions of interest. Total histograms and histogram metrics (mean, variance, skew, kurtosis and 10th, 20th and 50th quantiles) were used as data input for classifiers with accuracy determined by tenfold cross validation. Mean ADC values from the tumour regions of interest differed between tumour types, (ANOVA P < 0.001). A cut off value for mean ADC between Ependymomas and Medulloblastomas was found to be of 0.984 × 10-3 mm2 s-1 with sensitivity 80.8% and specificity 80.0%. Overall classification for the ADC histogram metrics were 85% using Naïve Bayes and 84% for Random Forest classifiers. The most commonly occurring posterior fossa paediatric brain tumours can be classified using Apparent Diffusion Coefficient histogram values to a high accuracy on a multicentre basis

Light quarks masses and condensates in QCD

We review some theoretical and phenomenological aspects of the scenario in which the spontaneous breaking of chiral symmetry is not triggered by a formation of a large condensate . Emphasis is put on the resulting pattern of light quark masses, on the constraints arising from QCD sum rules and on forthcoming experimental tests.Comment: 23 pages, 12 Postscript figures, LaTeX, uses svcon2e.sty, to be published in the Proceedings of the Workshop on Chiral Dynamics 1997, Mainz, Germany, Sept. 1-5, 199

Harmonising evidence-based medicine teaching: a study of the outcomes of e-learning in five European countries

BACKGROUND: We developed and evaluated the outcomes of an e-learning course for evidence based medicine (EBM) training in postgraduate medical education in different languages and settings across five European countries. METHODS: We measured changes in knowledge and attitudes with well-developed assessment tools before and after administration of the course. The course consisted of five e-learning modules covering acquisition (formulating a question and search of the literature), appraisal, application and implementation of findings from systematic reviews of therapeutic interventions, each with interactive audio-visual learning materials of 15 to 20 minutes duration. The modules were prepared in English, Spanish, German and Hungarian. The course was delivered to 101 students from different specialties in Germany (psychiatrists), Hungary (mixture of specialties), Spain (general medical practitioners), Switzerland (obstetricians-gynaecologists) and the UK (obstetricians-gynaecologists). We analysed changes in scores across modules and countries. RESULTS: On average across all countries, knowledge scores significantly improved from pre- to post-course for all five modules (p < 0.001). The improvements in scores were on average 1.87 points (14% of total score) for module 1, 1.81 points (26% of total score) for module 2, 1.9 points (11% of total score) for module 3, 1.9 points (12% of total score) for module 4 and 1.14 points (14% of total score) for module 5. In the country specific analysis, knowledge gain was not significant for module 4 in Spain, Switzerland and the UK, for module 3 in Spain and Switzerland and for module 2 in Spain. Compared to pre-course assessment, after completing the course participants felt more confident that they can assess research evidence and that the healthcare system in their country should have its own programme of research about clinical effectiveness. CONCLUSION: E-learning in EBM can be harmonised for effective teaching and learning in different languages, educational settings and clinical specialties, paving the way for development of an international e-EBM course

Variational Quark Mass Expansion and the Order Parameters of Chiral Symmetry Breaking

We investigate in some detail a "variational mass" expansion approach, generalized from a similar construction developed in the Gross-Neveu model, to evaluate the basic order parameters of the dynamical breaking of the $SU(2)_L \times SU(2)_R$ and $SU(3)_L \times SU(3)_R$ chiral symmetries in QCD. The method starts with a reorganization of the ordinary perturbation theory with the addition of an arbitrary quark mass $m$. The new perturbative series can be summed to all orders thanks to renormalization group properties, with specific boundary conditions, and advocated analytic continuation in $m$ properties. In the approximation where the explicit breakdown of the chiral symmetries due to small current quark masses is neglected, we derive ansatzes for the dynamical contribution to the "constituent" masses $M_q$ of the $u,d,s$ quarks; the pion decay constant $F_\pi$; and the quark condensate $$ in terms of the basic QCD scale $\Lambda_{\bar{MS}}$. Those ansatzes are then optimized, in a sense to be specified, and also explicit symmetry breaking mass terms can be consistently introduced in the framework. The obtained values of $F_\pi$ and $M_q$ are roughly in agreement with what is expected from other non-perturbative methods. In contrast we obtain quite a small value of $|< \bar q q >|$ within our approach. The possible interpretation of the latter results is briefly discussed.Comment: 40 pages, LaTex, 2 PS figures. Additions in section 2.2 to better explain the relation between the current mass and the dynamical mass ansatz. Minor misprints corrected. Version to appear in Phys. Rev.

How are "teaching the teachers" courses in evidence based medicine evaluated? A systematic review

Background Teaching of evidence-based medicine (EBM) has become widespread in medical education. Teaching the teachers (TTT) courses address the increased teaching demand and the need to improve effectiveness of EBM teaching. We conducted a systematic review of assessment tools for EBM TTT courses. To summarise and appraise existing assessment methods for teaching the teachers courses in EBM by a systematic review. Methods We searched PubMed, BioMed, EmBase, Cochrane and Eric databases without language restrictions and included articles that assessed its participants. Study selection and data extraction were conducted independently by two reviewers. Results Of 1230 potentially relevant studies, five papers met the selection criteria. There were no specific assessment tools for evaluating effectiveness of EBM TTT courses. Some of the material available might be useful in initiating the development of such an assessment tool. Conclusion There is a need for the development of educationally sound assessment tools for teaching the teachers courses in EBM, without which it would be impossible to ascertain if such courses have the desired effect

A Nonperturbative Study of Inverse Symmetry Breaking at High Temperatures

The optimized linear $\delta$-expansion is applied to multi-field $O(N_1) \times O(N_2)$ scalar theories at high temperatures. Using the imaginary time formalism the thermal masses are evaluated perturbatively up to order $\delta^2$ which considers consistently all two-loop contributions. A variational procedure associated with the method generates nonperturbative results which are used to search for parameters values for inverse symmetry breaking (or symmetry nonrestoration) at high temperatures. Our results are compared with the ones obtained by the one-loop perturbative approximation, the gap equation solutions and the renormalization group approach, showing good agreement with the latter method. Apart from strongly supporting inverse symmetry breaking (or symmetry nonrestoration), our results reveal the possibility of other high temperature symmetry breaking patterns for which the last term in the breaking sequence is $O(N_1-1) \times O(N_2-1)$.Comment: 28 pages,5 eps figures (uses epsf), RevTeX. Only a small misprint in Eq. (2.10) and a couple of typos fixe