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Learning prosthetic vision: a virtual-reality study.

Acceptance of prosthetic vision will be heavily dependent on the ability of recipients to form useful information from such vision. Training strategies to accelerate learning and maximize visual comprehension would need to be designed in the light of the factors affecting human learning under prosthetic vision. Some of these potential factors were examined in a visual acuity study using the Landolt C optotype under virtual-reality simulation of prosthetic vision. Fifteen normally sighted subjects were tested for 10-20 sessions. Potential learning factors were tested at p < 0.05 with regression models. Learning was most evident across-sessions, though 17% of sessions did express significant within-session trends. Learning was highly concentrated toward a critical range of optotype sizes, and subjects were less capable in identifying the closed optotype (a Landolt C with no gap, forming a closed annulus). Training for implant recipients should target these critical sizes and the closed optotype to extend the limit of visual comprehension. Although there was no evidence that image processing affected overall learning, subjects showed varying personal preferences.

Adolescent↗

The structure of hydroxyethyl starch.

1. It is suggested that the structure currently used to describe hydroxyethyl starch (a blood plasma volume expander) is a gross oversimplification.2. A model having a much more complex substitution-pattern is proposed, and an accurate, rapid test has been devised for distinguishing between the two models.3. This test shows that the simple model has no basis in reality, and that the more complex substitution pattern is correct.4. Studies involving the enzymic hydrolysis of hydroxyethyl starch are shown to provide qualitative support for the new model, and the significance of the findings is discussed.

Chemical Phenomena↗

The structure of fantasied movement in suicidal children and adolescents.

Guided by the hypothesis that imagining actions is a way of rehearsing actions in the service of effective adaptations to reality, various characteristics of imagined motion, assessed by the Rorschach Test, were compared in hospitalized suicidal and nonsuicidal preadolescents and adolescents, and in public school children. A number of differences were found for example, suicidal children imagined less vigorous motion than distinguished suicidal and nonsuicidal children and preadolescent and adolescent suicidal children. Further, the scale devised to assess imagined motion successfully predicted about 75 percent of the suicidal children. Implications for diagnosis and treatment of suicidal children are discussed.

Adolescent↗

Virtual reality as a distraction intervention for women receiving chemotherapy.

PURPOSE/OBJECTIVES: To explore the use of virtual reality as a distraction intervention to relieve symptom distress in women receiving chemotherapy for breast cancer. DESIGN: Crossover study. SETTING: The outpatient clinic of a midwestern comprehensive cancer center. SAMPLE: 20 women 18-55 years of age. METHODS: Using a crossover design, 20 subjects served as their own controls. For two matched chemotherapy treatments, one pretest and two post-test measures were employed. Participants were assigned randomly to receive the virtual reality distraction intervention during one chemotherapy treatment and received no distraction intervention (control condition) during an alternate chemotherapy treatment. An open-ended questionnaire elicited each subject's evaluation of the intervention. MAIN RESEARCH VARIABLES: Symptom distress, fatigue, anxiety. FINDINGS: Significant decreases in symptom distress and fatigue occurred immediately following chemotherapy treatments when women used the virtual reality intervention. CONCLUSIONS: The distraction intervention decreased symptom distress, was well received, and was easy to implement in the clinical setting. IMPLICATIONS FOR NURSING: Nursing interventions to manage chemotherapy-related symptom distress can improve patient quality of life and increase chances for survival by reducing treatment-related symptom distress and enhancing patients' ability to adhere to treatment regimens and cope with their disease.

Adaptation, Psychological↗

Incidental memory and navigation in panoramic virtual reality for electronic commerce.

Recently much effort has been dedicated to designing and implementing World Wide Web sites for virtual shopping and e-commerce. Despite this effort, relatively little empirical work has been done to determine the effectiveness with which different site designs sell products. We report three experiments in which participants were asked to search for products in various experimental e-commerce sites. Across the experiments participants were asked to search in either QTVR (QuickTime Virtual Reality), hypertext, or pictorially rich hypertext environments; they were then tested for their ability to recall the products seen and to recognize product locations. The experiments demonstrated that when using QTVR (Experiments 1, 2, and 3) or pictorial environments (Experiment 2), participants retained more information about products that were incidental to their goals. In two of the experiments it was shown that participants navigated more efficiently when using a QTVR environment. The costs and benefits of using 3D virtual environments for on-line shops are discussed. Actual or potential applications of this research include support for the development of e-commerce design guidelines.

Adult↗

[Multicenter study on sensitization to Alternaria mold].

The reality emerged of a non-negligible frequency of positive tests to "Alternaria". This was conducted by the inclusion of this mould in the standard allergy assessment, especially if a summer predominance of symptoms was known. A significant difference emerged between seasonal peaks which had to do with mono or polysensitisation. The highest frequency of positives was found near to humid surroundings or woods.

Adolescent↗

Does sex influence the relation between symptoms and neurocognitive functions in schizophrenia?

OBJECTIVE: A secondary analysis of our data to investigate if sex influences the specificity of the relationship between each of the 3 clinical syndromes (i.e., reality distortion, disorganization and psychomotor poverty) in schizophrenia and the neurocognitive functions that are thought to represent regional brain functions. PATIENTS AND DESIGN: Fifty-seven male and 30 female patients with a DSM-III-R diagnosis of schizophrenia were rated on the Scale for Assessment of Negative Symptoms and the Scale for Assessment of Positive Symptoms to derive scores for psychomotor poverty, disorganization, and reality distortion syndromes. All subjects completed a battery of neuropsychological tests purported to assess functioning of left temporal, right temporal, left basal frontal, right basal frontal, and dorsolateral prefrontal cortex. RESULTS: Correlation coefficients between syndrome scores and neuropsychological measures showed only word fluency (left frontal functioning) to have a statistically significant association with psychomotor poverty in women (p < 0.01). This relation was specific to psychomotor poverty syndrome. No relations between neurocognitive measures and symptoms were seen in men. CONCLUSIONS: The lack of specific relations between symptom dimensions in schizophrenia may be influenced by the fact that the neuronal circuitry associated with particular symptom dimensions may differ in men and women.

Adult↗

Risk assessment of contact allergens.

BACKGROUND: Quantitative risk assessment has been used successfully for a number of human health hazards associated with product use. Dermal contact allergy or sensitization is a relatively late addition to the list. OBJECTIVE: This article outlines the concepts and operational elements of product safety risk assessment of contact allergens. METHODS: The basic risk assessment paradigm is presented along with various dermal dose metrics in the context of their application in describing the dose response or risk of allergic response per unit dose of a product. This analysis of toxic effect is then combined with an assessment of exposure in the real world to estimate the risk of elicitation of active skin disease. RESULTS: Human health risk assessment in general and as it is applied to contact allergy in particular is an emerging science. As with any real science, it allows for the formulation and testing of hypotheses that elucidate a model or description of reality. The model, in turn, allows for predictions that, in this case, are the risk assessments. Of course, the elements of this model and its predictions are also then testable in successive rounds of hypothesis formation and investigation. The entire system runs on data, and a lack of data with a concomitant abundance of scientific uncertainty limits the utility and ultimately the credibility of the process. CONCLUSIONS: Uncertainty from variability and lack of knowledge notwithstanding, the risk assessment paradigm and its scientific construct are valuable in gauging and ultimately controlling the risk of contact allergy from products.

Algorithms↗

[Use of VR (virtual reality) software for preoperative implantation fitting with an implantable hearing aid as an example].

PURPOSE: To prove the feasibility of a preoperative fitting test for an implantable hearing aid using a VR environment. METHODS: A high-resolution spiral CT was performed after mastoidectomy in 10 temporal bone specimens. The bony structures were segmented and merged with the Computer-Aided Design (CAD) data of the hearing aid in a VR environment. For each specimen a three-dimensional fitting test was carried out by three examiners determining the implantability of the hearing aid. The implantation simulation was compared with the real implantation procedure performed by an experienced ENT surgeon. RESULTS: The used VR system enabled real-time 3D-visualisation and manipulation of CT- and CAD-data. All objects could be independently moved in all three dimensions. The VR fitting test corresponded closely with the real implantation. The implantability of the hearing aid was properly predicted by all three examiners. CONCLUSION: Merging CT and CAD data in a virtual reality environment bears high potential for the pre-surgical determination of the fit and mountability of medical implants in complex anatomical regions.

Cochlear Implantation↗

Virtual action planning in Parkinson's disease: a control study.

Cognitive planning deficits affect patients with Parkinson's disease (PD) and traditional psychometric tests meet difficulties to evaluate their impact on daily life activities. Virtual reality (VR) may provide a new means of assessment. The objective of this study was firstly to develop a virtual environment (VE) useful to explore planning and secondly to examine the effectiveness of using VR in the assessment of cognitive planning for patients with PD. A virtual supermarket (VS) was designed in which participants carried out a task close to daily activities: a test of shopping list. There were two preliminary sessions to familiarize the participants with the software and the supermarket's layout. Then, during the assessment session, participants completed the task, without any time limitation. Global intellectual efficiency was assessed in order to exclude patients with dementia. Data related to the performance in the VS were recorded. Five patients with PD and five age-matched healthy volunteers, meeting inclusion criteria, constituted our convenience sample. The patients did not perform as well as the control group. In particular, the session's duration and the distance covered were longer. The patients' path is specific with numerous stops, turning around, and hesitancies. Finally, their motivation for further training sessions is aroused. The results underline the potential of using VR in the assessment of cognitive planning in PD. A larger analysis is currently being carried out to confirm and to explore all the outcome measures.

Aged↗

Social influences on reality-monitoring decisions.

A modified Asch (1951) conformity paradigm was used to study the impact of social influence on reality-monitoring decisions about new items. Subjects studied pictures of some objects and imagined others. In a later test phase, they judged whether items had been perceived in the study phase, had been imagined, or were new. Critically, for some items, the subjects were informed of a confederate's response before rendering a judgment. Although the confederate was always correct when they responded to old items, for new items, the confederate responded perceived, imagined, or new, or did not respond (baseline). In two experiments, we show that memory for new items was influenced by an erroneous response of the confederate. Social conformity was reduced by undermining the credibility of the confederate (Experiments 1A and 1B), and the confederate's influence was evident even after there was only a 20-min delay between study and test (Experiment 2), when the subjects were 87% accurate on new baseline items. These experiments reveal the power of social influence on reality-monitoring accuracy and confidence.

Adult↗

Irritable bowel syndrome: clinical and psychopathological correlations.

Irritable bowel syndrome is a common disorder in gastroenterology consultations. Our objectives were to assess patients' psychic functioning, the relationships between psychopathology and pain, the degree of psychopathology in constipated and diarrheic subgroups, and if previous abdominal surgery was related to pain intensity. Forty-five gastroenterological outpatients, both sexes, were studied. Patients were grouped as predominantly constipated, predominantly diarrheic, or alternating constipation and diarrhea. After diagnosis, patients had: Psychologist half-guided interviews, Bender Visuomotor Gestalt Test, Hammer Graphic Tests, and Rorschach Psychodiagnostic Tests. The last one showed that 78% suffered from distortion in reality perception; 100% thought away from reality and had a deficit in organizing capability, synthesis, and integration. Within psychological gnosiology, these patients would be diagnosed as borderline personalities and this would imply an overlapping of neurotic and psychotic functioning. Affective vulnerability and overadjustment to environment were found, and this finding is an original one to the best of our knowledge.

Adolescent↗

A virtual reality scenario for all seasons: the virtual classroom.

Treatment and rehabilitation of the cognitive, psychological, and motor sequelae of central nervous system dysfunction often relies on assessment instruments to inform diagnosis and to track changes in clinical status. Typically, these assessments employ paper-and-pencil psychometrics, hands-on analog/computer tests, and rating of behavior within the context of real-world functional environments. Virtual reality offers the option to produce and distribute identical "standard" simulation environments in which performance can be measured and rehabilitated. Within such digital scenarios, normative data can be accumulated for performance comparisons needed for assessment/diagnosis and for treatment/rehabilitation purposes. In this manner, reusable archetypic virtual environments constructed for one purpose can also be applied for applications addressing other clinical targets. This article will provide a review of such a retooling approach using a virtual classroom simulation that was originally developed as a controlled stimulus environment in which attention processes could be systematically assessed in children with attention-deficit/hyperactivity disorder. This system is now being applied to other clinical targets including the development of tests that address other cognitive functions, eye movement under distraction conditions, social anxiety disorder, and the creation of an earthquake safety training application for children with developmental and learning disabilities.

Humans↗

SAT and serology in adult coeliacs, seronegative coeliac disease seems a reality.

UNLABELLED: The aim of this study was to assess the correlation of sugar absorption test (SAT) using Lactulose/Mannitol/Sucrose (LMS), with IgA-endomysium (EMA), and IgA-gliadin (AGA) antibodies in relation to the severity of the intestinal mucosal damage in adult coeliacs. We have differentiated the Marsh classification in partial villous atrophy (VA) (III a), subtotal VA (III b), and total VA (III c). Twenty-nine untreated adults coeliacs, with a mean age of 47 years, range 20-76 yrs were studied over 3 years. SAT, IgA-AGA and IgA EMA were performed in 29 consecutive coeliac patients with villous atrophy on a gluten containing diets. RESULTS: Histopathological evaluation of small intestinal mucosa showed a partial VA in 14/29, subtotal VA in 10/29 and total VA in 5/29. All coeliacs with total VA had positive EMA (5/5 100%). However in coeliacs with partial VA sensitivity of EMA was poor (4/14 29%). Sensitivity of EMA in patients with subtotal VA was 50% (5/10). AGA was raised in 3/14 (21%), 6/10 (60%), and in 4/5 (80%) coeliacs with partial, subtotal and total VA respectively. AGA was raised in 13/29 (sensitivity 45%). SAT was abnormal in 26/29 (sensitivity: 89%). One patient had abnormal SAT, EMA and AGA. Eleven of 29 patients (38%) were negative for AGA and EMA, but SAT was abnormal in 10 of them. One patient was positive for EMA, negative for AGA, normal for SAT. EMA and/or AGA were positive in 18/29 (sensitivity 62%). Our study suggests that negative predictive value of serology should be interpreted cautiously since coeliacs with partial VA are negative in serology. Over the last ten years SAT and EMA have been accepted as screening tools for CD. SAT seems to be more sensitive than serology. However there is no standardized agreement in the literature for serology and SAT. A combination of SAT and serology may provide a good sensitivity in order to detect that subgroup of coeliacs with milder histopathological abnormality.

Adult↗

Detection breadth and limits for potential adventitious/endogenous contaminants in biopharmaceutical processes: a reality check for innovative methods.

In this presentation we address the "gold standards" among diagnostic tests used to detect some potential adventitious and endogenous contaminants in human biologics and vaccines, reflecting on the breadth as well as limits of detection of these assays. This perspective may help developers of innovative diagnostics to address the unique needs of this highly regulated industry.

Bacteria↗

Spontaneous confabulation, reality monitoring, and the limbic system--a review.

Patients with anterior limbic damage may present a distinct syndrome, spontaneous confabulation: they fail in common memory tests, act on the basis of previous habits rather than currently relevant memories, produce confabulations composed of elements of past true events, are disorientated, and are absolutely convinced about the veracity of their perceived reality. Spontaneous confabulation is independent of other false memories, such as, provoked confabulations or illusory recognition. Studies showed that spontaneous confabulators fail to suppress (inactivate) evoked memories that do not pertain to ongoing reality. Rehabilitation differs from other memory failures. Prognosis depends on the lesion site, but recovery is always associated with recovery of this suppression capacity. Lesions typically involve the posterior medial orbitofrontal cortex or its connections in the basal forebrain. Imaging and evoked potential studies in healthy subjects support the idea that the anterior limbic system provides a reality monitoring mechanism which selects memories of current relevance by suppressing (inactivating) currently irrelevant memories. This mechanism appears to adjust the cortical representation of activated memories before their content is recognised and consolidated. Comparison with animal studies suggests that human reality monitoring is a property of the brain's reward system.

Delusions↗

Virtual reality and cognitive assessment and rehabilitation: the state of the art.

VR offers the potential to develop human testing and training environments that allow for the precise control of complex stimulus presentations in which human cognitive and functional performance can be accurately assessed and rehabilitated. However, basic feasibility issues need to be addressed in order for this technology to be reasonably and efficiently applied to the neuropsychological assessment (NA) and cognitive rehabilitation (CR) of persons with acquired brain injury and neurological disorders. This chapter will provide an introduction to the basic concepts of neuropsychological assessment and cognitive rehabilitation along with rationales for virtual reality's applicability in these complimentary fields. We review the relevant literature regarding theoretical and pragmatic issues for these applications, and provide a description of our ongoing work developing a mental rotation/spatial skills cognitive assessment and training system. References are provided in each section for further reading in each area reviewed.

Computer Graphics↗