Conventional Training Research Articles

Narrative Creativity Training: A Case Study from the US Army

ABSTRACT: Though integral to thinking about causality, narrative—in particular narrative thinking—has been overlooked in traditional approaches to creativity studies and creative problem solving. Emphasizing the intrinsically speculative and causal aspects of narrative, this study investigates the effectiveness of narrative creativity training as a means of fostering innovative problem-solving skills within the US Army. Through two experiments conducted at the US Army Command and General Staff College, this research compares the outcomes of narrative training against conventional associational creativity training. Our results suggest that specifically narrative capacities are cognitively distinct, can be directly trained, and substantially improve problem solving. This research contributes to scholarship on the practical and empirical applications of narrative theory, as well as scholarship in creativity studies and creative problem solving, evincing the specific utility of narrative thinking in addressing complex, open-ended challenges.

Benefits of using virtual reality in cariology teaching

BackgroundVirtual Reality (VR) has been widely used as an useful educational tool in modern dentistry and is considered as an alternative training tool adjunct to conventional training methods.ObjectiveThis study was designed to investigate the effectiveness of VR haptic-enhanced simulators for training undergraduate dental students during practical cariology pre-clinical caries excavation sessions.MethodsA total number of 76 students were recruited for this study. Students were randomly divided into 2 groups (38 students each). The experimental group (VR-Start group), students performed caries removal at the VR haptic-enhanced simulator prior to practicing on natural extracted teeth. Conversely, the control group (Natural Tooth-Start Group), students exposed to VR simulation training after practicing on extracted natural teeth. An evaluation questionnaire was disseminated among students to evaluate their self-confidence, perceived clinical skills and their perception of providing better care to patients in the future. They were also invited to express their opinions on the usefulness of VR simulator in comparison with conventional learning methods.ResultsThe outcome of Chi-square test showed no significant difference in students’ response among this study groups (p > 0.05). Moreover, the outcome of this study revealed that both student groups considered virtual reality as a useful learning tool. Majority of students (90%) superiorly ranked experience gained from practicing on natural carious teeth. They also clearly stated that virtual reality allowed them to practice more and improve their self-confidence level as well as eye-hand coordination.ConclusionsVirtual reality simulator is a useful learning tool which can benefit undergraduate dental students at their pre-clinical stage; but, it cannot totally replace the conventional caries excavation.

A Study on the Work Process-Based Practical Training Model for Basic Nursing Skills in Vocational Colleges

Objective: To explore and analyze the work process-based practical training teaching model for basic nursing skills in vocational colleges and its implementation effects. Methods: A total of 82 nursing students from our school were selected for the study, which was conducted from April 2023 to April 2024. Using a random number table method, the students were divided into an observation group and a control group, each with 41 students. The control group received conventional practical training teaching, while the observation group followed the work process-based practical training model for basic nursing skills. The assessment scores and teaching satisfaction of the two groups were compared. Results: The comparison of assessment scores showed that the observation group performed significantly better than the control group (P < 0.05). The comparison of teaching satisfaction also indicated that the observation group had significantly higher satisfaction than the control group (P < 0.05). Conclusion: The work process-based practical training teaching model for basic nursing skills in vocational colleges can improve students’ assessment scores and enhance teaching satisfaction, demonstrating its value for wider application.

Exploration and Application of the Flipped Classroom Based on Outcome-Oriented Educational Principles in Vocational Nursing Practical Training

Purpose: To explore the practical effects of using the flipped classroom approach based on outcome-oriented educational concepts in nursing practical training at vocational colleges. Methods: From February 2023 to February 2024, a total of 62 nursing trainees from our school were sampled and randomly divided into a study group and a control group using a randomized controlled trial design, with 31 students in each group. The control group received conventional training, while the study group received practical training based on the outcome-oriented educational concept in flipped classrooms. Comparison was made between the two groups on assessment scores, teaching satisfaction, and self-directed learning ability ratings. Results: Statistical comparisons showed that the study group’s assessment scores, teaching satisfaction, and self-directed learning ability ratings were significantly higher than those of the control group (P < 0.05). Conclusion: The flipped classroom model based on outcome-oriented educational concepts in nursing practical training at vocational colleges can improve students’ assessment scores and self-directed learning abilities, and enhance teaching satisfaction, demonstrating potential for wider application and dissemination.

Long-term self-reported attendance in exercise training or lung choir and status of quality of life following initial pulmonary rehabilitation for COPD.

Both adherence rates to pulmonary rehabilitation (PR) programmes and long-term attendance in exercise training after PR remain a challenge. In our previous randomised controlled trial (RCT), effects were positively associated with a dose-response pattern, regardless of whether PR contained conventional physical exercise training (PExT) or Singing for Lung Health (SLH) as a training modality within a 10 weeks' PR programme for chronic obstructive pulmonary disease (COPD). However, long-term status of this RCT cohort remains unknown. In this study, we investigated whether current status (=attendance in supervised exercise training or a lung choir and scoring in quality of life (QoL)) was related to initial PR completion, randomisation, or adherence. We collected data via telephone, using a researcher-developed questionnaire on current self-reported attendance in supervised exercise training or a lung choir and on perceived benefits of the initial RCT intervention. Additionally, we used COPD-validated questionnaires (primarily: QoL (measure: St George's Respiratory Questionnaire; SGRQ). In 2023 (i.e., mean/median 4.7 years after initial PR), surviving participants were contacted (n = 196; 73% of 270), and 160 (82% of 196) were included. Out of the included participants, 30 (19%) had not completed initial PR. Compared to the initial PR-completers, non-completers reported less current attendance in exercise training or lung choir (24% vs. 46%, p = 0.03) but SGRQ scores were comparable. Yet, those who attended exercise training or lung choir at present (n = 66/160; 41% out of 160) reported better QoL score than those with no current attendance (SGRQ; Attending: 39.9 ± 15.4; Not attending: 43.1 ± 16.7; p = 0.02). Neither having had SLH instead of PExT, nor adherence level during initial PR, was related to current attendance or to QoL scores. This study indicates that long-term self-reported attendance and current QoL scores are positively related to initial completion of a PR programme. Surprisingly, neither initial PR content (PExT or SLH) nor initial PR adherence was related to long-term outcomes. We suggest that future PR programmes include special attention to those who do not complete PR to support long-term attendance and QoL status.

Evaluation of a Three-Dimensional Printed Interventional Simulator for Cardiac Ablation Therapy Training

Cardiac ablation (CA) is an interventional electrophysiological procedure used to disrupt arrhythmic substrates in the myocardium by inducing localized scarring. Current CA training relies on the master–apprentice model. In different fields of medicine including CA, virtual and physical simulators have proven to enhance, and even outperform, conventional training modalities while providing a risk-free learning environment. Despite the benefits, high costs and operational difficulties limit the widespread use of interventional simulators. Our previous research introduced a low-cost CA simulator using a 3D-printed biatrial cardiac model, successfully recording ten ablation lesions on the phantom myocardium. In this work, we present and evaluate an enhanced version: compared to the previous version, the cardiac phantom’s electrical behavior and ablation settings were optimized to produce consistent lesions, while 3D-printed components improved the haptic and radiographic properties of the simulator. Seven cardiologists compared the experimental simulator’s performance to the leading commercial system from Heartroid in a 24-question survey on a 5-point Likert scale. The four following areas of fidelity were considered: catheter entry, anatomical correctness, radiographic appearance, and mapping and ablation. The experimental simulator significantly outperformed the commercial system (p < 0.01), particularly in radiographic appearance (p < 0.01). The results show the potential for the experimental simulator in routine CA training.

Efficacy and safety of using a unilateral lower limb exoskeleton combined with conventional treatment in post-stroke rehabilitation: a randomized controlled trial.

The incidence of hemiplegia caused by stroke is high. In particular, lower limb dysfunction affects the daily activities of patients, and lower limb robotic devices have been proposed to provide rehabilitation therapy to improve balance function in this patient population. To assess the effectiveness of the LiteStepper® unilateral lower limb exoskeleton (ULLE) combined with conventional treatment for balance function training in patients with post-stroke hemiplegia. This multicenter randomized controlled trial, conducted in the convalescent rehabilitation ward of four hospitals, involved 92 patients in their post-stroke phase. Participants were randomized into an experimental group (EG) or a conventional group (CG). The EG adopted the LiteStepper® ULLE combined with conventional treatment for 21days. The CG underwent a standard daily rehabilitation routine for 21days. The Berg Balance Scale (BBS), Functional Ambulation Category scale (FAC), 6-min walk test (6MWT), and Barthel Index (Barthel) were used for evaluations before and after 21days of rehabilitative training. The BBS scores in EG was significantly elevated compared to CG, exhibiting a profound statistical difference (P< 0.0001). Notably, these disparities persisted at both day 21 (P < 0.0001) and day 14 (P < 0.0047) post-intervention, underscoring the efficacy of the treatment in the EG. The EG demonstrated a markedly greater improvement in BBS scores from pre-rehabilitation to 21days post-training, significantly outperforming the CG. Furthermore, at both day 14 and day 21, functional assessments including the FAC, 6MWT, and Barthel revealed improvements in both groups. However, the improvements in the EG were statistically significant compared to the CG at both time points: day 14 (FAC, P = 0.0377; 6MWT, P = 0.0494; Barthel, P = 0.0225) and day 21 (FAC, P = 0.0015; 6MWT, P = 0.0005; Barthel, P = 0.0004). These findings highlight the superiority of the intervention in the EG in enhancing functional outcomes. Regarding safety, the analysis revealed a solitary adverse event (AEs) related to the LiteStepper®ULLE device during the study period, affirming the combination therapy's safety profile when administered alongside conventional balance training in post-stroke hemiplegic patients. This underscores the feasibility and potential of incorporating LiteStepper®ULLE into rehabilitation protocols for this patient population. The LiteStepper® ULLE combined with conventional treatment is effective and safe for balance function training in patients with post-stroke hemiplegia.

Enhancing trainee performance in obstetric ultrasound through an artificial intelligence system: randomized controlled trial.

Performing obstetric ultrasound scans is challenging for inexperienced operators; therefore, the prenatal screening artificial intelligence system (PSAIS) software was developed to provide real-time feedback and guidance for trainees during their scanning procedures. The aim of this study was to investigate the potential benefits of utilizing such an artificial intelligence system to enhance the efficiency of obstetric ultrasound training in acquiring and interpreting standard basic views. A prospective, single-center randomized controlled study was conducted at The First Affiliated Hospital of Sun Yat-sen University. From September 2022 to April 2023, residents with no prior obstetric ultrasound experience were recruited and assigned randomly to either a PSAIS-assisted training group or a conventional training group. Each trainee underwent a four-cycle practical scan training program, performing 20 scans in each cycle on pregnant volunteers at 18-32 gestational weeks, focusing on acquiring and interpreting standard basic views. At the end of each cycle, a test scan evaluated trainees' ability to obtain standard ultrasound views without PSAIS assistance, and image quality was rated by both the trainees themselves and an expert (in a blinded manner). The primary outcome was the number of training cycles required for each trainee to meet a certain standard of proficiency (i.e. end-of-cycle test scored by the expert at ≥ 80%). Secondary outcomes included the expert ratings of the image quality in each trainee's end-of-cycle test and the discordance between ratings by trainees and the expert. In total, 32 residents and 1809 pregnant women (2720 scans) were recruited for the study. The PSAIS-assisted trainee group required significantly fewer training cycles compared with the non-PSAIS-assisted group to meet quality requirements (P = 0.037). Based on the expert ratings of image quality, the PSAIS-assisted training group exhibited superior ability in acquiring standard imaging views compared with the conventional training group in the third (P = 0.012) and fourth (P < 0.001) cycles. In both groups, the discordance between trainees' ratings of the quality of their own images and the expert's ratings decreased with increasing training time. A statistically significant difference in overall trainee-expert rating discordance between the two groups emerged at the end of the first training cycle and remained at every cycle thereafter (P < 0.013). By assisting inexperienced trainees in obtaining and interpreting standard basic obstetric scanning views, the use of artificial intelligence-assisted systems has the potential to improve training effectiveness. © 2024 International Society of Ultrasound in Obstetrics and Gynecology.

Comprehensive Evaluation of Imagination's Impact on Psychological Strength in Sports Education

In sports education, psychological strength is considered as an integral component in the performance of any athlete. One of the effective ways to improve many psychological attributes involves training. The sample consisted of 450 athletes divided into an experimental group (EG) (n = 225) that received eight-week imagination training and a control group (CG) (n = 225) that continued with conventional training. Data was examined using the latest version of SPSS 17.0, using descriptive statistics, paired t-tests, and Analysis of covariance (ANCOVA) to control for pre-existing differences. Psychological strength, mental resilience, focus and concentration, confidence, and stress management are important in athletic performance. It is proposed as a method of enhancing these psychological attributes in sports education. There were differences in significance in the EG in psychological strength, focus and concentration, confidence, and stress management compared with the CG. Paired t-tests in these variables reflect p&lt; 0.05. ANCOVA supported the efficiency of imagination training. Imagination training significantly develops psychological strength and other related attributes in athletes. In all the variables studied, the EG performed better compared to the CG, which provided evidence that imagination training is indeed a helpful tool in enhancing psychological strength and performance in sports education.

Sensor-Based Balance Training with Exergaming Feedback in Subjects with Chronic Stroke: A Pilot Randomized Controlled Trial.

As one of the leading causes of disability in the world, stroke can determine a reduction of balance performance with a negative impact on daily activity and social life. In this study, we aimed to evaluate the effects of sensor-based balance training with exergaming feedback on balance skills in chronic stroke patients. 21 individuals (11F, 57.14 ± 13.82 years) with a single event of ischemic stroke were randomly assigned to the sensor-based balance training group (SB-group) or the usual care balance training group (UC-group). Both groups received 10 add-on sessions with exergaming feedback (SB-group) or conventional training (UC-group). Clinical and instrumental evaluation was performed before (t0), after (t1), and after one month (t2) from intervention. Participation level was assessed using the Pittsburgh Rehabilitation Participation Scale at the end of each session. The SB-group showed an improvement in postural stability (p = 0.02) when compared to the UC-group. In the evaluation of motivational level, the score was statistically higher in the SB-group with respect to the UC-group (p < 0.01). Except for the improvement in postural stability, no difference was recorded in clinical score, suggesting a comparable gain in both groups. However, patients undergoing sensor-based training exhibited a higher participation score, ultimately indicating the use of this training to improve the adherence to rehabilitation settings, especially in patients with lower compliance.

Model and Method for Providing Resilience to Resource-Constrained AI-System.

Artificial intelligence technologies are becoming increasingly prevalent in resource-constrained, safety-critical embedded systems. Numerous methods exist to enhance the resilience of AI systems against disruptive influences. However, when resources are limited, ensuring cost-effective resilience becomes crucial. A promising approach for reducing the resource consumption of AI systems during test-time involves applying the concepts and methods of dynamic neural networks. Nevertheless, the resilience of dynamic neural networks against various disturbances remains underexplored. This paper proposes a model architecture and training method that integrate dynamic neural networks with a focus on resilience. Compared to conventional training methods, the proposed approach yields a 24% increase in the resilience of convolutional networks and a 19.7% increase in the resilience of visual transformers under fault injections. Additionally, it results in a 16.9% increase in the resilience of convolutional network ResNet-110 and a 21.6% increase in the resilience of visual transformer DeiT-S under adversarial attacks, while saving more than 30% of computational resources. Meta-training the neural network model improves resilience to task changes by an average of 22%, while achieving the same level of resource savings.

Comparative Efficacy of Cognitive Training for Post-Stroke Aphasia: A Systematic Review and Network Meta-Analysis.

Although cognitive training has shown potential for treating post-stroke aphasia (PSA), its efficacy varies across studies, and the optimal training approaches remain unclear. To evaluate and compare the effects of distinct cognitive training interventions, either combined with or independent of speech and language therapy (SLT), on language function in individuals with PSA. A systematic search encompassing PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, Wanfang, VIP, and Chinese Biomedical Databases was conducted for randomized controlled trials (RCTs). A network meta-analysis evaluated interventions, including computer-assisted cognitive training (CCT), conventional cognitive training (CT), virtual reality (VR)-based cognitive training (vrCT), telerehabilitation computer-assisted cognitive training (tCCT), working memory (WM) training, and attention training (AT). Eleven RCTs comprising 501 participants were included. Individuals with PSA who underwent combined WM training with SLT led to significantly enhanced Western Aphasia Battery (WAB) Aphasia Quotient (AQ), as well as in spontaneous speech, auditory comprehension, repetition, and naming, compared to those receiving SLT alone. This combination was more effective than both CCT with SLT and tCCT with SLT in improving WAB AQ. Similarly, it outperformed both CCT with SLT and vrCT with SLT in enhancing WAB spontaneous speech. Additionally, both AT and CT combined with SLT were more effective than SLT alone in enhancing WAB spontaneous speech. Specifically, AT combined with SLT proved more effective than vrCT with SLT in this area. Moreover, vrCT combined with SLT significantly improved auditory comprehension compared with SLT alone. Combining WM training and SLT and integrating vrCT with SLT both significantly enhance language function in individuals with PSA, compared with SLT alone. Our findings advocate for the use of these cognitive training approaches as promising strategies for language rehabilitation in this population. PROSPERO registration number: CRD42023462361.

Effectiveness of whole-body electromyostimulation on knee pain and physical function in knee osteoarthritis: a randomized controlled trial

In a randomized, controlled study, whole-body electromyostimulation (WB-EMS) was investigated as a promising alternative treatment technique compared to conventional strength training for the management of knee osteoarthritis (OA). Seventy-two overweight participants with symptomatic knee OA were randomly assigned to WB-EMS (n = 36) or a usual care group (UCG, n = 36). For seven months, the WB-EMS group received three times per fortnight a WB-EMS training, while the UCG was prescribed six-times physiotherapeutic treatments. We observed significant effects for the primary outcome “pain”, as determined by the Knee injury and Osteoarthritis Outcome Score (KOOS), with more favourable changes in the WB-EMS group vs UCG (between-group difference 9.0 points, 95%CI 2.9–15.1, p = 0.004). Secondary outcomes, including the other KOOS subscales (symptoms, function in daily living, function in sports/recreational activities and quality of life), 7 day pain diary, hip/leg extensor strength and lower limb function (30s sit-to-stand test), were also statistically significant in favour of the WB-EMS group. Overall, WB-EMS was found to be effective in relieving knee pain symptoms and improving physical function in individuals with symptomatic knee OA compared to usual care treatment. WB-EMS could be used as an alternative therapy in the management of knee OA; particularly for patients that cannot be motivated for conventional training.

Study of whey protein on muscle mass and functional rehabilitation in postoperative total knee arthroplasty patients.

Patients who underwent total knee arthroplasty (TKA) often experience muscle loss due to pain and limited mobility. Nutritional supplementation and rehabilitation may positively affect the decline in muscle function. The purpose of this study is to evaluate whether whey protein intervention, in addition to conventional rehabilitation training, is beneficial in improving muscle function and quality of life in patients after TKA. 72 patients who met the criteria were selected for this randomized controlled study. For the experimental group, whey protein was used as a daily supplement for 12 weeks, while the control group was given a placebo, during which both groups received conventional rehabilitation training. Muscle strength and each of the secondary observables needed to be measured and statistically analyzed preoperatively and at 4, 8, and 12 weeks post-intervention. In total, 62 subjects completed the study: 32 in the experimental group and 30 in the control group. Both groups showed significant improvement in muscle strength, VAS, ROM, AKS and leg circumference after 12 weeks of treatment. Compared to the control group, patients in the experimental group showed significant improvement in muscle strength, VAS, ROM, AKS and leg circumference (p= 0.001, p= 0.002, p= 0.001, p= 0.001, p= 0.001, respectively) after 12 weeks of treatment. The 12-week intervention of whey protein nutritional supplement showed significant improvement in muscle mass and function among post-TKA patients besides aiding with conventional rehabilitation exercise.

Focal muscle vibration and action observation: a combined approach for muscle strengthening.

Muscle strength is essential for autonomy in daily activities and performance in sports activities. Yet, conventional strength training is challenging during recovery from pathological conditions. This study investigates a novel combined intervention employing Focal Muscle Vibration (FMV) and Action Observation (AO) to enhance muscle strength. Twenty-seven healthy volunteers (18 females and 9 males, aged 22 to 42 years) were enrolled for an intervention-control study comparing 2 groups: the intervention group received AO treatment with FMV on the right leg, and the control group underwent only FMV on the right leg. This design allowed the comparison of four conditions: FMV+AO (intervention group, right leg), AO alone (intervention group, left leg), FMV alone (control group, right leg), and no-treatment NT (control group, left leg). The treatment, conducted five times a week (Mon-Fri) for two weeks, involved a 20-minute session of FMV on the right quadriceps, coupled, for the intervention group, with the observation of a gym training video. The assessments of Maximum Voluntary Contraction (MVC), and fatigue coefficient (FC) expressed at knee extension bilaterally were measured at the beginning (T0), after the first week (T1), at the end of treatment (T2), and one-week post-intervention for the follow-up (T3). The FMV+AO group demonstrated a significant improvement in MVC over time, reaching statistical significance at T2 and maintaining the gain at T3. In contrast, all the other conditions demonstrated milder MVC increases without statistical significance. FC did not differ significantly in any condition. The combination of FMV and AO optimized muscle strengthening, offering insights for targeted treatments in various settings.

Education and training of thoracic and cardiovascular surgeons: Academic aspects in France

Over the last 15 years, there have been notable advancements in healthcare services, as well as teaching and organizational aspects, within thoracic and cardiovascular surgery in France. Traditionally, residents would enter a general surgery program before proceeding to a thoracic and cardiovascular surgery fellowship. However, starting from 2017, residents now directly enrol in a six-year thoracic and cardiovascular program, which is divided into three phases: “basic training”, “in-depth development”, and “consolidation”. Theoretical knowledge is taught during regional and national biannual seminars. To improve surgical skills, simulation workshops are organized during these seminars and on dedicated days. Finally, to further diversify their experience, residents benefit from visiting referral centres through a national tour.This article seeks to document the conventional training route for residents specializing in thoracic and cardiovascular surgery in France. We provide an overview of the training structure and methodologies employed in France for these residents, outlining the national framework that oversees their local and day-to-day training activities.

The Effects of Planting Density, Training System and Cultivar on Vegetative Growth and Fruit Production in Young Mango (Mangifera indica L.) Trees

Increasing the planting density of mango orchards appears promising for obtaining higher yields, particularly during the first productive years. However, the challenge is to maintain a good balance between vegetative growth and fruit production in the longer term. The objective of this study was to decipher the effects of planting density, training system and cultivar on young mango trees’ growth and production. The experiment, conducted in North Queensland, consisted of five combinations of planting density and training system applied to the cultivars Keitt, Calypso and NMBP-1243. The planting densities were low (208 tree ha−1), medium (416 tree ha−1) and high (1250 tree ha−1). The closed vase conventional training system was applied at each density. Single leader and espalier on trellis training systems were applied at medium and high densities, respectively. The tree canopy dimensions were measured every 6 months from planting, and tree production was recorded from the third to the fifth years after planting. Vegetative growth and fruit production were the results of complex interactions between planting density, training system, cultivar and/or time. The expected increase in orchard yield with higher planting density was observed from the first productive year, despite lower individual tree production at high planting density. Lower vegetative growth and fruit production at high planting density were probably caused by competition between trees. NMBP-1243 and Keitt showed more rapid vegetative growth. Keitt was the most productive cultivar during the first three productive years. The detailed results of this study provide avenues to further explore the behaviour of mango trees at high planting densities.

Using Virtual Reality-Based Simulation in Neonatal Resuscitation Program Training.

In this article, we investigate the incorporation of virtual reality (VR) into Neonatal Resuscitation Program (NRP) training. We describe the potential advantages and challenges of the use of VR with NRP. We compare conventional training approaches to VR-based simulation, reviewing diverse VR platforms and their specific roles in neonatal resuscitation education. In addition, technological and ethical aspects in medical training, current research, and prospective developments in this innovative educational tool are discussed.

Enhanced “learning to learn” through a hierarchical dual-learning system: the case of action video game players

In contrast to conventional cognitive training paradigms, where learning effects are specific to trained parameters, playing action video games has been shown to produce broad enhancements in many cognitive functions. These remarkable generalizations challenge the conventional theory of generalization that learned knowledge can be immediately applied to novel situations (i.e., immediate generalization). Instead, a new “learning to learn” theory has recently been proposed, suggesting that these broad generalizations are attained because action video game players (AVGPs) can quickly acquire the statistical regularities of novel tasks in order to increase the learning rate and ultimately achieve better performance. Although enhanced learning rate has been found for several tasks, it remains unclear whether AVGPs efficiently learn task statistics and use learned task knowledge to guide learning. To address this question, we tested 34 AVGPs and 36 non-video game players (NVGPs) on a cue-response associative learning task. Importantly, unlike conventional cognitive tasks with fixed task statistics, in this task, cue-response associations either remain stable or change rapidly (i.e., are volatile) in different blocks. To complete the task, participants should not only learn the lower-level cue-response associations through explicit feedback but also actively estimate the high-level task statistics (i.e., volatility) to dynamically guide lower-level learning. Such a dual learning system is modelled using a hierarchical Bayesian learning framework, and we found that AVGPs indeed quickly extract the volatility information and use the estimated higher volatility to accelerate learning of the cue-response associations. These results provide strong evidence for the “learning to learn” theory of generalization in AVGPs. Taken together, our work highlights enhanced hierarchical learning of both task statistics and cognitive abilities as a mechanism underlying the broad enhancements associated with action video game play.

Effects of body weight support training on balance and walking function in stroke patients: a systematic review and meta-analysis.

To comprehensively and quantitatively evaluate the impact of body weight support training (BWST) on balance and gait function in stroke patients based on an evidence-based basis and to identify the most effective intervention strategies. PubMed, Web of Science, The Cochrane Library, CNKI, Wanfang, and Chinese SinoMed Database were searched until November 25, 2023. Quality assessment and meta-analysis were performed using RevMan 5.2 and Stata 14.0 software. A total of 31 randomized controlled trials involving 1,918 patients were included in the study. The meta-analysis demonstrated that body weight support training (BWST) significantly improved Berg Balance Scale (BBS) scores (MD = 3.60; 95% CI: 1.23 to 5.98; p = 0.003), gait speed (SMD = 0.77; 95% CI: 0.38 to 1.15; p < 0.0001), and step length (SMD = 0.46; 95% CI: 0.19 to 0.72; p = 0.0008) in stroke patients compared to conventional rehabilitation. For enhancing balance function, the most effective interventions were identified as a disease duration of 3-6 months (MD = 5.16; 95% CI: 0.76 to 9.57; p = 0.02), intervention time of 4-8 weeks (MD = 5.70; 95% CI: 2.90 to 8.50; p < 0.0001), a maximum body weight support level above 30% (MD = 3.80; 95% CI: 1.48 to 6.13; p = 0.001), and a maximum training walking speed of 0.2 m/s or more (MD = 4.66; 95% CI: 0.37 to 9.70; p = 0.03). For improving walking function, the optimal interventions were also a disease duration of 3-6 months (gait speed: SMD = 0.59; 95% CI: 0.15 to 1.03; p = 0.008; step length: SMD = 0.27; 95% CI: 0.06 to 0.56; p = 0.04), intervention time of 4-8 weeks (gait speed: SMD = 1.01; 95% CI: 0.44 to 1.59; p = 0.0006; step length: SMD = 0.83; 95% CI: 0.54 to 1.12; p < 0.00001), a maximum body weight support level above 30% (gait speed: SMD = 0.79; 95% CI: 0.36 to 1.22; p = 0.0003; step length: SMD = 0.79; 95% CI: 0.47 to 1.11; p < 0.00001), and a maximum training walking speed of 0.2 m/s or more (gait speed: SMD = 1.26; 95% CI: 0.62 to 1.90; p = 0.0001; step length: SMD = 0.85; 95% CI: 0.38 to 1.31; p = 0.0003). Compared with conventional rehabilitation training, BWST demonstrates superior efficacy in enhancing balance and walking function in stroke patients, with a consistent optimal intervention strategy. The most effective program includes a disease duration of 3-6 months, an intervention period of 4-8 weeks, a maximum body weight support of 30% or more, and a maximum training walking speed of 0.2 m/s or greater. http://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42022358963.