Lower Scores Research Articles

Associations between physical activity and development in preschool-aged children born

ObjectiveTo investigate the effect of physical activity (PA) on development (motor, cognitive, social-emotional) in children 4–5 years old born <30 weeks’ gestation, and to describe subgroups of children at risk...

The Cosmetic Readiness Questionnaire (CRQ): Validation of a Pre-Operative Psychological Screening Tool for Aesthetic Procedures.

Several psychological risk factors are associated with patient dissatisfaction with aesthetic procedures, such as body dysmorphic disorder (BDD), unmanaged mental health concerns or unrealistic expectations. Identifying these risks via preoperative screening may protect patients from adverse psychological outcomes and provide reputational or legal protection for practitioners. This study aimed to further develop and validate the Cosmetic Readiness Questionnaire (CRQ), a comprehensive psychological screening tool to assess patient suitability for surgical and non-surgical aesthetic procedures. The CRQ was validated across two studies in clinical contexts, examining structural and construct validity in a sample of 8031 individuals who completed the CRQ as part of routine clinical care. In a further sample (n = 574), criterion validity was explored through the relationship between the CRQ and dissatisfaction with past aesthetic treatments. Risk category cut-off scores were developed. Results supported the reliability and validity of a five-factor CRQ which measures Body Dysmorphia, Psychological Distress, Self-Criticism, Unrealistic Expectations and Lack of Openness. High scorers on the CRQ were 78% more likely to report dissatisfaction with a past cosmetic procedure than low scorers. The CRQ is a comprehensive and valid screening measure to identify patients who may require further psychological assessment or additional support prior to aesthetic treatment. Instructions are provided on how to implement the CRQ in clinical practice.

Molecular subtypes and prognostic models for predicting prognosis of lung adenocarcinoma based on miRNA-related genes.

MicroRNAs (miRNAs) are crucial in cancer development and progression, and therapies targeting miRNAs demonstrate great therapeutic promise. We sought to predict the prognosis and therapeutic response of lung adenocarcinoma (LUAD) by classifying molecular subtypes and constructing a prognostic model based on miRNA-related genes. This study was based on miRNA-mRNA action pairs and ceRNA networks in the Cancer Genome Atlas (TCGA) database. Three molecular subtypes were determined based on 64 miRNA-associated target genes identified in the ceRNA network. The S3 subtype had the best prognosis, and the S2 subtype had the worst prognosis. The S2 subtype had a higher tumor mutational load (TMB) and a lower immune score. The S2 subtype was more suitable for immunotherapy and sensitive to chemotherapy. The least absolute shrinkage and selection operator (LASSO) algorithm was performed to determine eight miRNA-associated target genes for the construction of prognostic models. High-risk patients had a poorer prognosis, lower immune score, and lower response to immunotherapy. Robustness was confirmed in the Gene-Expression Omnibus (GEO) database cohort (GSE31210, GSE50081, and GSE37745 datasets). Overall, our study deepened the understanding of the mechanism of miRNA-related target genes in LUAD and provided new ideas for classification. Such miRNA-associated target gene characterization could be useful for prognostic prediction and contribute to therapeutic decision-making in LUAD.

Timing of induction of labor in suspected macrosomia: retrospective cohort study, systematic review and meta-analysis.

Large-for-gestational age (LGA) is associated with several adverse maternal and neonatal outcomes. Although many studies have found that early induction of labor (IOL) in case of a LGA fetus reduces the incidence of shoulder dystocia, no current guidelines recommend this particular clinical strategy, owing to concerns about increased rates of Cesarean delivery (CD) and neonatal complications. The purpose of this study was to assess whether the timing of IOL in LGA fetuses affected maternal and neonatal outcomes in a single center, and to combine these results with evidence reported in the literature. This study comprised two parts. The first part was a retrospective cohort study that included consecutive patients with a singleton pregnancy and an estimated fetal weight ≥ 90th percentile on ultrasound between 35 + 0 and 39 + 0 weeks' gestation, who were eligible for normal vaginal delivery. The second part of the study was a systematic review of the literature and meta-analysis, including the results of our cohort study as well as those of previous studies that compared IOL with expectant management in patients with a LGA fetus. The perinatal outcomes of the study were CD, operative vaginal delivery, shoulder dystocia, brachial plexus palsy, anal sphincter injury, postpartum hemorrhage, Apgar score, umbilical artery pH, admission to the neonatal intensive care unit, use of continuous positive airway pressure, intracranial hemorrhage, need for phototherapy and bone fracture. Of the 547 patients included in this retrospective cohort study, 329 (60.1%) underwent IOL and 218 (39.9%) experienced spontaneous labor. Following covariate balancing, the odds of CD were significantly higher in the IOL group compared with the spontaneous-labor group. This difference only became apparent beyond 40 weeks' gestation (hazard ratio, 1.90; P = 0.030). The difference between the IOL and spontaneous-labor groups for the rate of shoulder dystocia was not statistically significant (hazard ratio, 1.57; P = 0.200). Seventeen studies, in addition to our own results, were included in the systematic review and meta-analysis, giving a total population of 111 300 participants. Although there was no significant difference in the rate of CD between IOL and expectant management after pooling the results of included studies, the risk for shoulder dystocia was significantly lower in the IOL group (odds ratio (OR), 0.64 (95% CI, 0.42-0.98); I2 = 19% from 12 studies) when considering only IOL performed before 40 + 0 weeks. When the studies in which IOL was carried out exclusively before 40 + 0 weeks were removed from the analysis, the risk for CD in the remaining studies was significantly higher in the IOL group (OR, 1.46 (95% CI, 1.02-2.09); I2 = 56%). There were no statistically significant differences between the IOL and expectant-management groups for the remaining perinatal outcomes. Nulliparity, history of CD and low Bishop score, but not method of induction, were independent risk factors for intrapartum CD in patients that underwent IOL for LGA. The timing of IOL in patients with suspected macrosomia significantly impacts on perinatal adverse outcomes. IOL has no impact on rates of shoulder dystocia but increases the odds of CD when considered irrespective of gestational age; in contrast, IOL may decrease the risk of shoulder dystocia without increasing the risk of other adverse maternal outcomes, in particular CD, when performed before 40 + 0 weeks (GRADE: low/very low). © 2024 International Society of Ultrasound in Obstetrics and Gynecology.

Relationships Between Throwing Yips in Baseball, Experiential Avoidance, Cognitive Fusion, Values, and Social Factors

Despite the high prevalence of yips, a psychoneuromuscular impairment affecting fine motor skills in sports performance, the specific aspects of its causality and treatment have not been identified or verified. This cross-sectional study examined psychosocial factors relating to throwing yips in baseball. Amateur baseball players (N = 292) living in Japan completed a self-report questionnaire on their anxiety/fear about throwing the ball, the Acceptance and Action Questionnaire-II, the Cognitive Fusion Questionnaire, the Short Fear of Negative Evaluation Scale, and self-reports evaluating values and social factors relevant to baseball. A hierarchical multiple regression analysis indicated that a low values-based throwing score, a high Cognitive Fusion Questionnaire score, and overreprimanding others’ mistakes were positively associated with baseball players’ yips symptoms. These results suggest that changing the context of playing baseball, reducing cognitive fusion, and improving coaching methods could reduce the risk of baseball players’ throwing yips.

Investigating behavioral patterns to facilitate performance predictions during online peer assessment through learning analytics approach

Insights into student behavioral patterns yield benefits for both educators and learners. Nevertheless, only a few studies have investigated the behavioral patterns of high-scoring (HS) and low-scoring (LS) students to facilitate predictions during peer assessment (PA). Therefore, we performed learning analytics to explore the behavioral patterns of HS and LS students in 52 university students from affective, cognitive, and metacognitive perspectives as these students engage in online PAs. The results indicated that on the affective dimension, HS students tended to exhibit negative affection while LS students tended to display positive affection. On the cognitive dimension, HS students demonstrated more intricate transformations compared to the LS students. Regarding the metacognitive dimension, LS students more likely reflected upon and accepted the reviews provided by others than the HS. Additionally, the findings also revealed that HS students were supported by focused social networks and overall stable activity engagement, whereas the LS students were less engaged at the beginning of the activity but had evolving social networks and were more engaged in the later stages of the activity. These findings offer valuable insights for educators in effectively predicting student performance based on behavioral patterns while providing new perspectives to support instructional decision-making processes.

Sleep duration associated with feelings but not with test scores: an observational study

Sleep and mood/emotion influence learning and academic achievement. However, inconclusive/contradictory findings have been reported. Unlike previous studies that examined either sleep or mood and grade-point-average (combined result of several assessments over long period), this study examined UK university students for the relationship of test scores with both, previous night’s sleep-duration, and mood/emotion approximately an hour before the test. Mood/feelings data were collected by presenting a selection of emojis and text. Here, test scores did not associate with night sleep-duration. There were no differences in distribution of scores across sleepers of 5, 6, 7 and 8 h and sleeping for less than these hours did not increase the odds of scoring low (scoring ≤ 25%). There was no significant difference in distribution of night-sleep-hours between high scorers (score ≥ 75%) and low scorers (score ≤ 25%). Furthermore, test scores did not associate with feelings/emotions. There were no significant differences in the distribution of scores across different feelings. Unhappy/negative feelings did not increase the odds of scoring low. However, feelings (specifically expressed through selection of words/phrases) predicted scores (p = 0.01) and both negative and positive feelings associated with increased odds of high score (p ≤ 0.04). Night-sleep-duration positively associated with feelings (p < 0.001). Distribution of night-sleep-duration differed between feelings (p ≤ 0.003). Night sleep of less than 5, 6, 7 or 8 h increased the odds of feeling unhappy/negative (p ≤ 0.01). This data (i) defies the generic notion of a night of sub-optimal sleep-duration negatively affecting scores, (ii) provides empirical evidence of association between night-sleep-duration and emotions/mood/feelings, and (iii) proposes that sleep may affect learning via mood.

On Network Structural and Temporal Encodings: A Space and Time Odyssey.

The dynamic network visualization design space consists of two major dimensions: network structural and temporal representation. As more techniques are developed and published, a clear need for evaluation and experimental comparisons between them emerges. Most studies explore the temporal dimension and diverse interaction techniques supporting the participants, focusing on a single structural representation. Empirical evidence about performance and preference for different visualization approaches is scattered over different studies, experimental settings, and tasks. This paper aims to comprehensively investigate the dynamic network visualization design space in two evaluations. First, a controlled study assessing participants' response times, accuracy, and preferences for different combinations of network structural and temporal representations on typical dynamic network exploration tasks, with and without the support of standard interaction methods. Second, the best-performing combinations from the first study are enhanced based on participants' feedback and evaluated in a heuristic-based qualitative study with visualization experts on a real-world network. Our results highlight node-link with animation and playback controls as the best-performing combination and the most preferred based on ratings. Matrices achieve similar performance to node-link in the first study but have considerably lower scores in our second evaluation. Similarly, juxtaposition exhibits evident scalability issues in more realistic analysis contexts.

Impact of Adjuvant Radiotherapy Setting on Quality-of-Life in Head and Neck Squamous Cell Carcinoma.

To determine differences in post-treatment QoL across treatment settings in patients receiving adjuvant radiation therapy for head and neck squamous cell carcinoma (HNSCC). This was a prospective observational cohort study of patients with HNSCC initially evaluated in a head and neck surgical oncologic and reconstructive clinic at an academic medical center (AMC). Participants were enrolled prior to treatment in a prospective registry collecting demographic, social, and clinical data. Physical and social-emotional QoL (phys-QoL and soc-QoL, respectively) was measured using the University of Washington-QoL questionnaire at pre-treatment and post-treatment visits. A cohort of 177 patients, primarily male and White with an average age of 61.2 ± 11.2 years, met inclusion criteria. Most patients presented with oral cavity tumors (n = 132, 74.6%), had non-HPV-mediated disease (n = 97, 61.8%), and were classified as Stage IVa (n = 72, 42.8%). After controlling for covariates, patients treated at community medical centers (CMCs) reported a 7.15-point lower phys-QoL compared with those treated at AMCs (95% CI: -13.96 to -0.35, p = 0.040) up to 12 months post-treatment. Additionally, patients who were treated at CMCs had a 5.77-point (-11.86-0.31, p = 0.063) lower soc-QoL score compared with those treated at an AMC, which was not statistically significant. This study revealed that HNSCC patients treated with radiation at AMCs reported significantly greater phys-QoL in their first-year post-treatment compared to those treated at CMCs, but soc-QoL did not differ significantly. Further observational studies are needed to explore potential factors, including treatment planning and cancer resource engagement, behind disparities between AMCs and CMCs. 3 Laryngoscope, 134:3645-3655, 2024.

The effect of physical activity on stress levels of medical students: A cross-sectional analysis

Objectives To determine association between physical activity and hours of physical activity and stress levels in medical students Methods A cross sectional study was conducted at a private medical college in Karachi, during April and May 2015. Convenience sampling was used to identify the study participants. The subjects were medical students from year one through five. We interviewed 235 students. A pre-tested, self-administered three-part questionnaire was used to collect the data. The first part of the questionnaire inquired about the subjects’ demographics and exercise habits, the second part of the questionnaire was adapted from the Perceived Stress Scale (PSS) to determine stress scores within participants, and the third part of the questionnaire asked about other stress relieving factors. Results According to the PSS, 30.3% of the participants were moderately stressed. The mean PSS was found to be 16.95 ± 5.72. 2A significant correlation was found between physical activity and stress levels; those involved in physical activity were 52 percent less likely to be moderately stressed (OR 0.48, p-value = 0.015) as compared to those who had not partaken in physical activity. Furthermore, studentswho performed physical activity for &gt;4 hours per week had a lower mean PSS score (16.2) when compared to those who exercised for &lt;2 hours per week. (18.2). Post-hoc statistical testing revealed the difference to be significant (p=0.028). Conclusion Based on the findings of our study, we conclude that physical activity of any form is associated with significantly decreased stress levels in medical students.

Influence of Motivation Climate on Service-Learning Benefits among Physical Education Students

&lt;p style="text-align: justify;"&gt;Service-learning (SL) emphasizes the fusion and integration of community service and academic learning, while Physical Education (PE) is oriented towards community health and well-being, aligning with Sustainable Development Goals. The study's primary objective is to discern the benefits perceived by PE students when engaged in SL courses and to test the correlation between benefits and the motivational climate they experience. Additionally, the research explores potential gender-specific variations in students' attitudes. The research was conducted with a survey on a sample of 58 students responding to a Motivational Climate in Physical Education Scale (MPCES) and the SErvice LEarning Benefit Scale (SELEB), which assesses the motivation of students and their perceptions of SL benefits. Descriptive statistics was used to analyse the data. Pearson's correlation coefficient was used to test the relationship between the core constructs - SL benefits and student motivation, and t-tests to evaluate gender differences in SL benefits. Key findings underscore that students primarily perceived the greatest advantages from SL in the domain of knowledge application, with comparatively lower scores in general life skills. Notably, female students, on the whole, exhibited higher ratings in both SL benefits and student motivation compared to their male counterparts. Nonetheless, specific exceptions emerged in certain sub-scales, including social relatedness and ego climate within the MPCES scale, as well as critical thinking within the SELEB scale. According to the results, it is suggested that cultivating a student-centered learning environment can augment engagement and motivation in the realm of physical education (PE). Furthermore, the delineated gender differences offer valuable insights for educators, highlighting the need for tailored approaches to accommodate the diverse preferences and requirements of male and female students.&lt;/p&gt;

Change in eating habits after 2 years of pandemic restrictions among adolescents living in a city in northern Italy: results of the COALESCENT Observational Study (Change amOng ItAlian adoLESCENTs)

BackgroundLockdown measures during the recent pandemic, due to the novel COVID-19, affected several other aspects of lifestyle, but little is known about their long-term impact, especially among adolescents. Our study...

Long-term outcomes in sacral agenesis.

Sacral agenesis (SA) includes a range of clinical presentations of varying severity, with implications for function and quality of life (QoL). Diagnosis is often made perinatally, and prognostic discussions become an important aspect of parental counselling. This study engaged SA sufferers and their caregivers to obtain objective, long-term patient reported outcome data. Patients with radiologically confirmed SA from a single tertiary spinal unit underwent retrospective medical record review. Patients were then contacted by telephone to complete QoL questionnaires including EQ-ED-5L for adults and EQ-ED-Y for < 16-year-olds. Additional information including Renshaw grade, employment, living situation and bladder function was also collected. Twenty-six patients with SA were identified. Mean age is 23.35years (range 0.92-63.53), 13M:17F. Renshaw grade ranged from 1 to 4. Sixty-eight percent had associated kyphoscoliotic deformities. The majority (70%) had either impaired or absent bladder control, and 80% need walking aids to mobilise. Twenty patients completed the questionnaire (10 adults and 10 < 16-year-olds). Mean EQ-ED-5L index for adults was +0.474 (range -0.1 to +0.089, 1 = best), with a lower mean value of +0.287 (range -0.54 to +1) for the < 16-year cohort. Those undergoing spinal fusion procedures had significantly lower scores (-0.08 v +0.44, p = 0.022). This study provides an objective record of the QoL of individuals with SA, illustrating a wide variety of outcomes, with differences between younger and older individuals which may reflect the results of a long-term adaptive process. The implications for individuals should be carefully tailored to the specific deformity and the likely underlying neurological deficits.

Multi-omics comprehensive analysis reveals the predictive value of N6-methyladenosine- related genes in prognosis and immune escape of bladder cancer.

N6-methyladenosine (m6A) is the most frequent RNA modification in mammals, and its role in bladder cancer (BC) remains rarely revealed. To predict the value of m6A-related genes in prognosis and immunity in BC. We performed multiple omics analysis of 618 TCGA and GEO patients and used principal component analysis (PCA) to calculate the m6A score for BC patients. We described the multiple omics status of 23 m6A methylation-related genes (MRGs), and four m6A clusters were identified, which showed significant differences in immune infiltration and biological pathways. Next, we intersected the differential genes among m6A clusters, and 11 survival-related genes were identified, which were used to calculate the m6A score for the patients. We found that the high-score (HS) group showed lower tumor mutation burden (TMB) and TP53 mutations and better prognosis than the low-score (LS) group. Lower immune infiltration, higher expression of PD-L1, PD-1, and CTLA4, and higher immune dysfunction and immune exclusion scores were identified in the LS group, suggesting a higher possibility of immune escape. Finally, the experimental verification shows that the m6A related genes, such as IGFBP1, plays an important role in the growth and metastasis of bladder cancer. These findings revealed the important roles of m6A MRGs in predicting prognosis, TMB status, TP53 mutation, immune functions and immunotherapeutic response in BC.

Comparison of balloon guide catheter versus non-balloon guide catheter for mechanical thrombectomy in patients with distal medium vessel occlusion

BackgroundSeveral studies have established the safety and efficacy of balloon guide catheters (BGCs) for large vessel occlusions. However, the utility of BGCs remains largely unexplored for distal medium vessel occlusions...

Assessing the Relative Progressivity of the Biden Administration's Federal Student Loan Forgiveness Proposal

Abstract We quantify the total stock of balances eligible for the Biden Administration's 2022 student loan forgiveness proposal and examine which groups would have benefited most. Up to $442 billion in loans were eligible. Those who would have benefited most were younger, had lower credit scores, and lived in lower- and middle-income neighborhoods. We also find that Black and Hispanic borrowers would have disproportionately benefited from the proposal. We then compare the distribution of beneficiaries for the proposed policy to several alternative hypothetical forgiveness proposals and three existing tax credits. The additional forgiveness for Pell Grant recipients increased the progressivity of the policy at a cost of $129 billion. Reducing the income eligibility criterion in half from the proposal would have reduced the cost by nearly $100 billion and made the policy more progressive. Compared with existing tax credits, the announced forgiveness policy is less progressive than the Earned Income Tax Credit but more progressive than the 2019 Child Tax Credit and higher education tax credits. We conclude with a discussion of how each policy lever affects the progressivity of loan cancellation to help inform future policy.

Effect of an online posture exercise program during the COVID-19 pandemic on students' musculoskeletal pain and quality of life.

Prolonged sitting and poor posture can contribute to musculoskeletal pain and have a negative effect on health-related quality of life (HRQoL) among young adults. Any prolonged posture leads to static loading of soft tissues and causes discomfort. Seated posture leads to inactivity causing an accumulation of metabolites, accelerating disk degeneration and musculoskeletal pain. Regular exercise has major contributions to the prevention and treatment of some health problems such as musculoskeletal disorders. This study aimed to assess the impact of online posture exercises on musculoskeletal pain and health related quality of life among university students receiving distance education during the COVID-19pandemic. This randomized controlled trial involved 72students divided into intervention (n= 35) and control (n= 37) groups. The intervention group followed an 8-week online stretching and posture exercise program. Baseline and 8-week results were measured using the SF-36 QoL Questionnaire and Cornell Musculoskeletal Discomfort Questionnaire (CMDQ). Students spent an average of 5.4 ± 2.5hours daily at computers. While there was no difference between the scores of any region in the CMDQ in the control group, there was a decrease in the neck, right shoulder, left shoulder, waist, left upper leg, right lower leg, and left lower leg discomfort scores in the intervention group (p< 0.05). There was a significant difference between the intervention and control groups in the total score of SF-36 and the sub-dimensions of vitality and mental health (p< 0.05). The online posture exercise program led to notable reductions in musculoskeletal pain and improvements in QoL among university students. Examining the effectiveness of online exercise programs in different age groups is important for health benefits during quarantines.

Impact of bariatric surgery on maternal gestational weight gain and pregnancy outcomes in women with obesity: A population-based cohort study from Qatar.

Bariatric surgery is performed in obese women of reproductive age to help achieve a healthy prepregnancy weight to reduce the complications associated with obesity in pregnancy. However, these procedures can impact maternal nutrition and gestational weight gain (GWG). This study evaluates the maternal and neonatal outcomes in women with prepregnancy bariatric surgery and determines the impact on GWG. This study included 24 weeks gestation or more pregnancies, with a maternal BMI at delivery of 30 kg/m2 or more. It was categorized into two groups based on whether they had prepregnancy bariatric surgery (exposed) or not (unexposed). The outcomes included gestational diabetes (GDM), gestational hypertension (GHT), mode of delivery, preterm birth (PTB), GWG, birthweight (BW) and customized BW centiles, low birthweight (LBW), congenital anomalies, and admission to the neonatal intensive unit (NICU). Categorization was also done based on the adequacy of GWG (low, adequate, and excess). A total of 8,323 women were included in the study, 194 of whom had prepregnancy bariatric surgery. After adjusting for confounders, the exposed group had a mean GWG 1.33 kg higher than the unexposed group (95% CI 0.55-2.13, p=0.001). The exposed group had higher odds of PTB (aOR 1.78, 95% CI 1.16-2.74, p=0.008), CD (aOR 6.52, 95% CI 4.28-9.93, p<0.001), LBW in term babies (aOR 2.60, 95% CI 1.34-5.03, p=0.005), congenital anomalies (aOR 2.64, 95% CI 1.21-5.77, p=0.015), low APGAR score (aOR 3.75, 95% CI 1.12-12.5, p=0.032) and 80.4g lesser birthweight (95% CI -153.0, -5.8; p=0.034). More women in the low GWG category had LBW babies (28.6% versus 6.7% in the high GWG group, p=0.033), lowest mean BW and median BW centiles (2775 grams versus 3289 grams in the high GWG group, p=0.004 and 57.5% versus 74.5% in the high GWG group, p=0.040, respectively). The findings of this study highlight differences in perinatal outcomes such as preterm birth, low birth weight, congenital anomalies, cesarean deliveries, and gestational weight gain between post-bariatric women and controls. These insights can help inform the planning and provision of appropriate maternity care to enhance patient safety and outcomes. The results of this study can also guide the counseling of reproductive age-group women who are planning to undergo bariatric surgery.

Foot complaints pre-operative to primary total hip or knee arthroplasty

Purpose of the Study: Aim of the study was to determine the prevalence of foot and ankle complaints and radiographic abnormalities, and their association in patients planned for total joint surgery. Methods: A cross-sectional cohort study of 183 patients, planned for total hip or knee arthroplasty (THA, TKA). Assessments included recording of polyneuropathy, previous trauma, foot deformities, and ankle range of motion (ROM); self-reported foot and ankle complaints; and radiographic severity of the foot and ankle joints OA. Results: In patients planned for THA and TKA, the proportions of patients with risk factors or using bespoke footwear ranged from 21-41%, whereas the proportions with clavus, hammertoes, and/or hallux valgus or rigidus varied between 1-17%. Although the mean foot function scores were good (median FAOS &gt;93 and FFI-5pt 0), up to 24% of patients had a low score on one or more of the subscale scores. Prevalence of patients with signs of radiographic OA in foot and ankle were lower in THA than TKA patients, respectively. For the TKA group, we found an association between radiological scores and both self-reported measures of foot and ankle complaints. Conclusion: About a quarter of patients undergoing THA and TKA report some foot complaints, whereas 32-45% have signs of radiographic OA of foot and/or ankle. Since foot and ankle complaints have shown to have a negative effect on outcome of THA and TKA surgery, pre-operative optimisation concerning the foot complaints should be considered to support a more favourable outcome.

APF-S2T: Steering to Target Redirection Walking Based on Artificial Potential Fields.

Redirected walking (RDW) enables users to walk naturally within a virtual environment that is larger than the physical environment. Recently, several artificial potential field (APF) and alignment-based redirected controllers have been developed and have been demonstrated to significantly outperform conventional controllers. APF Steer-to-Gradient (APF-S2G) and APF Redirected Walking (APF-RDW) utilize the negative gradient and the total force vector, respectively, which are localized to the user's position. These vectors usually point towards the opposite wall when the user is in corridors, resulting in frequent resets within those regions. This paper introduces the APF Steer-to-Target (APF-S2T), a redirected controller that first finds the target sample point with the lowest score in the user's walkable area in both physical and virtual environments. The score of a sample point is determined by the APF value at the point and the distance from the user's position. The direction from the user's position to the target point is then used as the steering direction for setting RDW gains. We conducted a simulation-based evaluation to compare APF-S2T, APF-S2G, APF-RDW, Visibility Polygon-based alignment (Vis.-Poly.) and Alignment-Optimized controllers in terms of the number of resets and the average distance between resets. The results indicated that APF-S2T significantly outperformed the state-of-the-art controllers.