Objective Measurement Techniques Research Articles

Objective Measurement of Experiences in Tourism and Hospitality: A Systematic Review of Methodological Approaches and Best Practices

Understanding the complex and dynamic nature of experiences requires the use of proper measurement tools. As interest grows in the objective measurement of experiences within tourism and hospitality, there is an urgent need to consolidate and synthesize these studies. Thus, this study investigated prevalent objective measurement techniques via a systematic review. We analyzed physiological measures such as electroencephalography (EEG), heart rate variability (HRV), skin conductance (SC), and facial electromyography (fEMG) along with behavioral measures, including eye tracking and location tracking. This review identified 100 empirical studies that employed objective measurement to examine tourism and hospitality experiences over the last decade, highlighting trends, research contexts and designs, and the synergies between different methods. Our discussion on methodological issues and best practices will help researchers and practitioners identify the best tools to capture people’s experiences and promote more standardized practices and comparable findings on studying experiences in tourism and hospitality settings.

Inertial Sensor Technologies-Their Role in Equine Gait Analysis, a Review.

Objective gait analysis provides valuable information about the locomotion characteristics of sound and lame horses. Due to their high accuracy and sensitivity, inertial measurement units (IMUs) have gained popularity over objective measurement techniques such as force plates and optical motion capture (OMC) systems. IMUs are wearable sensors that measure acceleration forces and angular velocities, providing the possibility of a non-invasive and continuous monitoring of horse gait during walk, trot, or canter during field conditions. The present narrative review aimed to describe the inertial sensor technologies and summarize their role in equine gait analysis. The literature was searched using general terms related to inertial sensors and their applicability, gait analysis methods, and lameness evaluation. The efficacy and performance of IMU-based methods for the assessment of normal gait, detection of lameness, analysis of horse-rider interaction, as well as the influence of sedative drugs, are discussed and compared with force plate and OMC techniques. The collected evidence indicated that IMU-based sensor systems can monitor and quantify horse locomotion with high accuracy and precision, having comparable or superior performance to objective measurement techniques. IMUs are reliable tools for the evaluation of horse-rider interactions. The observed efficacy and performance of IMU systems in equine gait analysis warrant further research in this population, with special focus on the potential implementation of novel techniques described and validated in humans.

Parametric design methods development for the comparison of American football faceguards using validated structural stiffness models

Recent advances in headgear design research have sought to inform athletes’ safety related decisions by ranking headgear systems according to impact performance. These rankings have provided athletes with greater agency in their safety-related decisions. Despite these improvements, little quantitative information exists to compare faceguard performance. Using validated structural stiffness finite element models, this study sought to develop a parametric design approach that could be consistently applied to faceguards of different qualitative categories and of different helmet-compatible series. The methods presented in this study detail the objective measurement techniques and parameters of interest used to fully define three common American football faceguards. The results of this study indicate an ability to define parameters consistently for faceguards of different qualitative categories and of different helmet-compatible series. The high degree of correlation between mass and structural stiffness indicates expected model performance – providing increased confidence in results. Intuitively, the greatest effect on mass and structural stiffness was the size of the diameter of the main bars. Increases in mass were achieved with minimal changes in structural stiffness. Conversely, increases in structural stiffness were achieved with minimal changes in mass. These results have implications for manufacturers as some faceguards, such as those classified as “overbuilt,” are banned – in part – for their weight. Future work should continue to compare manufacturers’ original designs and investigate other metrics to further quantify performance and safety for athletes. This tool may be used to improve new faceguard designs by comparing new models to faceguards allowed for use.

Sedentary behavior in relation to selected indicators of movement and characteristics of children in the lower-secondary school

Introduction: Sedentary behavior (SB) of adolescents is often associated with warning signs of emerging civilization diseases and reduced participation in physical activities (PA). Although some studies point out that SB does not necessarily mean avoiding PA, the opinion of the public prevails, that in addition to the time devoted to sitting during school lessons, the time spent watching monitors and screens is constantly increasing at the expense of PA. Our goal was to determine the indicators of the participation of lower-secondary school students in voluntary SB and to relate them to selected characteristics of their movement behavior or evaluate them from the point of view of compliance with medically recommended criteria. Material and Methods: The research was carried out using objective and subjective measurement techniques during a two-year period with pupils of the lower-secondary schools in the Usti Region (N = 512). A record sheet was used to record data on time indicators of participation in physical and SB and basic anthropometric characteristics. Physical activity was monitored by the Yamax SW-700 and SW-800 pedometer for 7 consecutive days, i.e., during regular school days and weekend days. Results: In daily values of time spent in SB, boys surpass girls. Both boys and girls spend more time voluntarily sitting in front of monitors and mobile phones on weekends than on school days (MBW = 162.0 ± 141.4 min. × MBSD = 129.0 ± 109.8 min.; MGW = 133.0 ± 118.1 min. × MGSD = 121.0 ± 110.1 min.). The time values of weekend days show statistical differences between boys and girls (p = 0.02). As pupils age, the time spent on SB increases. In connection with the volume of voluntary SB, neither the mutual relationship of the time of participation in PA (r = -0.006, p = 0.90) nor the volume of locomotor activities (r = -0.058, p = 0.199) was confirmed. Conclusion: The obtained data confirm the increased level of SB in relation to the recommended criteria. In proportion to the reported time of participation in PA or locomotion indicators, it is not sufficiently compensated. However, in many individuals this behavior is well beyond the tolerated recommended values.

Electrophysiological evidence of subclinical trigeminal dysfunction in patients with COVID-19 and smell impairment: A pilot study.

BackgroundSmell and taste disturbances are among the most frequent neurological symptoms in patients with COVID-19. A concomitant impairment of the trigeminal nerve has been suggested in subjects with olfactory dysfunction, although it has not been confirmed with objective measurement techniques. In this study, we explored the trigeminal function and its correlations with clinical features in COVID-19 patients with impaired smell perception using electrophysiological testing.MethodsWe enrolled 16 consecutive patients with mild COVID-19 and smell impairment and 14 healthy controls (HCs). Olfactory and gustatory symptoms were assessed with self-reported questionnaires. Electrophysiological evaluation of the masseter inhibitory reflex (MIR) and blink reflex (BR) was carried out to test the trigeminal function and its connections within the brainstem.ResultsMasseter inhibitory reflex (MIR) analysis revealed higher latency of ipsilateral and contralateral early silent period in patients when compared with HCs. No significant differences between groups were detected as regards the duration of the early and late silent period. However, several patients showed a prolonged duration of the early silent period. BR evaluation disclosed only an increased amplitude of early components in patients.ConclusionsPatients with COVID-19 and smell impairment show a subclinical trigeminal nerve impairment. Trigeminal alterations mainly involve the oligosynaptic pathway, as a result of either direct viral damage or secondary neuroinflammation of the peripheral trigeminal fibers, whereas the polysynaptic ponto-medullary circuits seem to be spared. The prolonged duration of the early silent period and the increased amplitude of early BR response might reflect a compensatory upregulation of the trigeminal function as a consequence of the olfactory dysfunction.

Repeated IT Interruption: Habituation and Sensitization of User Responses

ABSTRACT Information technology (IT) interruptions are IT-based events that capture users’ attention and interfere with other activities. This study focuses on repeated IT interruption and task performance. We draw on dual-process theory and suggest that users may get used to repeated IT interruption, known as habituation, or may become hypersensitive, known as sensitization. We validate the research model based on data from a laboratory experiment with 100 subjects by using a multivariate latent growth model (LGM). With subjective and objective measurement techniques, we show how users respond to repeated IT interruption with physiological arousal, psychological exhaustion, and behavioral task performance. Our results indicate that user responses follow different patterns over time, revealing time-dependent effects of arousal and exhaustion on task performance. We contribute to literature by providing evidence that repeated IT interruption results in unique habituation and sensitization user response patterns compared to a single IT interruption.

Continuous unobtrusive assessment of meaningful change in older adults with cancer: The Pacific Aging & Cancer Study Collaborative—PACS collaborative.

1569 Background: Knowledge of changes in health that precede a cancer diagnosis is challenging because of a lack of longitudinal, objective measurement techniques. Current approaches rely on periodic assessment via self-report which may miss when and how health changes, particularly when changes may appear subtly over time. Remote-monitoring technologies provide a mechanism to continuously, passively, and unobtrusively monitor changes in health so that trajectories of change in relation to a life event (i.e., cancer diagnosis, treatment) can be detected and described. We examined the changes in digital indicators of health and life events 1 year before and after a self-reported cancer diagnosis in community-dwelling adults aged 65 and older. Methods: This is a secondary, retrospective data analysis of older adults who self-reported a new cancer diagnosis in the Oregon Center for Aging & Technology (ORCATECH) cohort. Ten older adults (age = 71.8±4.9 years, 30% women) were included with various cancer types (esophageal, prostate, uterine, pancreatic, b-cell follicular lymphoma, multiple myeloma, basal cell melanoma, basal and/or squamous cell carcinoma). Daily physical activity was measured using step counts derived from an actigraph watch. Weekly health and life events (pain severity, loneliness, hospitalization/emergency room (ER) visits, days away from home overnight) were self-reported from weekly online surveys. Results: A total of 3,624 days of actigraphy data (210 ± 88 days pre-cancer; 153 ± 81 days post-cancer) and 750 weeks of self-reported online survey data (36 ± 12 weeks pre-cancer; 39 ± 14 weeks post-cancer) were collected. Longitudinal linear mixed-effects models revealed that the trajectory of step counts was different pre- and post-cancer (β = -1.52, p <.001), with a gradual decrease in step counts before a cancer diagnosis. The trajectory of pain severity was different pre- and post-cancer (β = 0.01, p <.001), with a gradual increase in pain severity before a cancer diagnosis. There was a gradual increase in the occurrence of hospitalization/ER visits (OR = 1.07, p = 0.02) and days away from home overnight (OR = 1.04, p = 0.01) before a cancer diagnosis. Feelings of loneliness increased over time, regardless of pre- or post-cancer (OR = 1.04, p <.001). Conclusions: Changes in health and life events 1-year before a cancer diagnosis in older adults with varying cancer types and severity were unobtrusively observed. This study suggests that a remote-monitoring technology platform deployed in homes can detect meaningful intra-individual changes before and after a cancer diagnosis. Future studies can employ this technology as a pathway for improving the timeliness of detection and more effective therapeutic follow-up for older adults.

Could a 2D/3D US based model be helpful in the assessment of myometrial invasion at time of intraoperative frozen section? A pilot study.

The assessment of myometrial invasion is a pivotal step in the preoperative staging of endometrial cancer. Intraoperative frozen section (FS) represents a reliable tool in directing surgeon's choices. Preoperative transvaginal ultrasound (US) showed high accuracy in evaluating myometrial invasion. This study aimed to understand if the application of a standardized ultrasonographic protocol for the pre-operative evaluation of myometrial invasion can help pathologists in improving the accuracy of FS. Furthermore, the agreement between US and FS in the assessment of myometrial invasion was assessed. Sixty-six patients who underwent surgery for endometrial cancer were analyzed. Preoperative 2D/3D ultrasound was performed in all the patients. Myometrial invasion was estimated by subjective assessment and objective measurement techniques. Data from US were reported to pathologists through a prefilled form with depth and site of the maximum myometrial invasion. Diagnostic performance of US and FS were compared having the definitive histological examination as the gold standard. Influenced by the information given by our 3D US-model, FS showed a 90% sensitivity and a 93% specificity, with a 93% PPV and an 89% NPV. The agreement with histology was strong (K=0.824). Myometrial invasion was missed at the level of the isthmus by FS just in one case. Subjective assessment was confirmed as the most reliable ultrasonographic technique in assessing myometrial invasion, with 90% sensitivity, 78% specificity, 80% PPV and 89% NPV. The agreement with histology was substantial (K=0.68). The application of a preoperative 2D/3D US assessment would seem to help pathologists in detecting myometrial invasion in difficult areas of the uterus such as the isthmus, reducing downstaging and overtreatment.

The need for overcorrection: evaluation of computer-assisted, virtually planned, fronto-orbital advancement using postoperative 3D photography

The main indication for craniofacial remodeling of craniosynostosis is to correct the deformity, but potential increased intracranial pressure resulting in neurocognitive damage and neuropsychological disadvantages cannot be neglected. The relapse rate after fronto-orbital advancement (FOA) seems to be high; however, to date, objective measurement techniques do not exist. The aim of this study was to quantify the outcome of FOA using computer-assisted design (CAD) and computer-assisted manufacturing (CAM) to create individualized 3D-printed templates for correction of craniosynostosis, using postoperative 3D photographic head and face surface scans during follow-up. The authors included all patients who underwent FOA between 2014 and 2020 with individualized, CAD/CAM-based, 3D-printed templates and received postoperative 3D photographic face and head scans at follow-up. Since 2016, the authors have routinely planned an additional "overcorrection" of 3 mm to the CAD-based FOA correction of the affected side(s). The virtually planned supraorbital angle for FOA correction was compared with the postoperative supraorbital angle measured on postoperative 3D photographic head and face surface scans. The primary outcome was the delta between the planned CAD/CAM FOA correction and that achieved based on 3D photographs. Secondary outcomes included outcomes with and those without "overcorrection," time of surgery, blood loss, and morbidity. Short-term follow-up (mean 9 months after surgery; 14 patients) showed a delta of 12° between the planned and achieved supraorbital angle. Long-term follow-up (mean 23 months; 8 patients) showed stagnant supraorbital angles without a significant increase in relapse. Postsurgical supraorbital angles after an additionally planned overcorrection (of 3 mm) of the affected side showed a mean delta of 11° versus 14° without overcorrection. The perioperative and postoperative complication rates of the whole cohort (n = 36) were very low, and the mean (SD) intraoperative blood loss was 128 (60) ml with a mean (SD) transfused red blood cell volume of 133 (67) ml. Postoperative measurement of the applied FOA on 3D photographs is a feasible and objective method for assessment of surgical results. The delta between the FOA correction planned with CAD/CAM and the achieved correction can be analyzed on postoperative 3D photographs. In the future, calculation of the amount of "overcorrection" needed to avoid relapse of the affected side(s) after FOA may be possible with the aid of these techniques.

Dual Toning Method with the Combination of Picosecond and Microsecond Nd:YAG in Refractory Melasma Unresponsive to Picosecond Alone.

Background:Melasma is an acquired and treatment-resistant aging facial skin condition prevalent among the older Asian females. The Q-switched toning laser is the most widely used for the treatment of moderate to severe melasma in Asia. Recently, the picosecond laser has been introduced for various pigmentary disorders such as melasma. We evaluated the efficacy and safety of dual toning combined with 1064 nm Nd:YAG picosecond and quasi-long-pulsed laser in the treatment of severe melasma.Subjects and Methods:Twenty Vietnamese females, mean age 41.9 ± 6.4 years, Fitzpatrick skin type IV, with clinical diagnosis of severe dermal and mixed-type melasma were treated by at least eight sessions picosecond Nd:YAG 1064 nm reducing Melasma Area and Severity Index (MASI) to less than 15%. Then they were treated with 3 sessions of dual toning combined picosecond Nd:YAG 1064 nm laser having an energy and spot size of 0.6–0.8 J/cm2 and 8 mm with micropulsed mode Nd:YAG 1064 nm laser (350 µs) having an energy and spot size of 2.6 J/cm2 and 15 mm with ICD off. Mild and even erythema was the endpoint (40–42°C using the infrared thermometer). Treatments were given every 4 weeks. Improvement was rated by MASI at the baseline (T1), after eight sessions of picotoning (T2), and three sessions of dual toning (T3).Results:The mean MASI score of 20 patients at baseline (T1) was 16.24 ± 4.88 (min 6.0; max 28.8); after at least eight picotoning sessions, the mean MASI was 15.12 ± 4.69, representing a 7.44 ± 4.41% reduction in MASI score. The MASI score of the dual toning laser continued to decrease after three dual toning sessions from 15.12 ± 4.6 to 9.77 ± 3.86 (MASI score reduced by a mean of 5.35 ± 2.64), achieving 35.15 ± 13.51% reduction from T2 and 40.17 ± 12.14% reduction from baseline MASI (T1). There were no unexpected side effects in any patients.Conclusion:The dual toning method using the 1064 nm Nd:YAG picosecond and microsecond laser was safe and effective and well tolerated by all patients without downtime. However, larger number of studies should be conducted with more objective measurement techniques to confirm the results of this preliminary study.

Assessment of Childhood Apraxia of Speech: A Review/Tutorial of Objective Measurement Techniques

Background With respect to the clinical criteria for diagnosing childhood apraxia of speech (commonly defined as a disorder of speech motor planning and/or programming), research has made important progress in recent years. Three segmental and suprasegmental speech characteristics-error inconsistency, lengthened and disrupted coarticulation, and inappropriate prosody-have gained wide acceptance in the literature for purposes of participant selection. However, little research has sought to empirically test the diagnostic validity of these features. One major obstacle to such empirical study is the fact that none of these features is stated in operationalized terms. Purpose This tutorial provides a structured overview of perceptual, acoustic, and articulatory measurement procedures that have been used or could be used to operationalize and assess these 3 core characteristics. Methodological details are reviewed for each procedure, along with a short overview of research results reported in the literature. Conclusion The 3 types of measurement procedures should be seen as complementary. Some characteristics are better suited to be described at the perceptual level (especially phonemic errors and prosody), others at the acoustic level (especially phonetic distortions, coarticulation, and prosody), and still others at the kinematic level (especially coarticulation, stability, and gestural coordination). The type of data collected determines, to a large extent, the interpretation that can be given regarding the underlying deficit. Comprehensive studies are needed that include more than 1 diagnostic feature and more than 1 type of measurement procedure.

Pelvic floor muscle training for prevention and treatment of urinary incontinence during pregnancy and after childbirth and its effect on urinary system and supportive structures assessed by objective measurement techniques.

During the second and the third trimesters of pregnancy and in the first 3months following childbirth, about one-third of women experience urinary incontinence (UI). During pregnancy and after delivery, the strength of the pelvic floor muscles may decrease following hormonal and anatomical changes, facilitating musculoskeletal alterations that could lead to UI. Pelvic floor muscle training (PFMT) consists in the repetition of one or more sets of voluntary contractions of the pelvic muscles. By building muscles volume, PFMT elevates the pelvic floor and the pelvic organs, closes the levator hiatus, reduces pubovisceral length and elevates the resting position of the bladder. Objective of this review is to evaluate the efficacy of PFMT for prevention and treatment of UI during pregnancy and after childbirth and its effect on urinary system and supportive structures assessed by objective measurement techniques. The largest medical information databases (Medline-Pubmed, EMBASE, Lilacs, Cochrane Library and Physiotherapy Evidence Database) were searched using the medical subject heading terms "pelvic floor muscle training", "prevention", "urinary incontinence", "urinary stress incontinence", "objective measurement techniques", "pregnancy, "exercise", "postpartum" and "childbirth" in different combinations. Overall, the quality of the studies was low. At the present time, there is insufficient evidence to state that PFMT is effective in preventing and treating UI during pregnancy and in the postpartum. However, based on the evidence provided by studies with large sample size, well-defined training protocols, high adherence rates and close follow-up, a PFMT program following general strength-training principles can be recommended both during pregnancy and in the postnatal period.

Reliability of digital ulcer definitions as proposed by the UK Scleroderma Study Group: A challenge for clinical trial design.

The reliability of clinician grading of systemic sclerosis-related digital ulcers has been reported to be poor to moderate at best, which has important implications for clinical trial design. The aim of this study was to examine the reliability of new proposed UK Scleroderma Study Group digital ulcer definitions among UK clinicians with an interest in systemic sclerosis. Raters graded (through a custom-built interface) 90 images (80 unique and 10 repeat) of a range of digital lesions collected from patients with systemic sclerosis. Lesions were graded on an ordinal scale of severity: 'no ulcer', 'healed ulcer' or 'digital ulcer'. A total of 23 clinicians - 18 rheumatologists, 3 dermatologists, 1 hand surgeon and 1 specialist rheumatology nurse - completed the study. A total of 2070 (1840 unique + 230 repeat) image gradings were obtained. For intra-rater reliability, across all images, the overall weighted kappa coefficient was high (0.71) and was moderate (0.55) when averaged across individual raters. Overall inter-rater reliability was poor (0.15). Although our proposed digital ulcer definitions had high intra-rater reliability, the overall inter-rater reliability was poor. Our study highlights the challenges of digital ulcer assessment by clinicians with an interest in systemic sclerosis and provides a number of useful insights for future clinical trial design. Further research is warranted to improve the reliability of digital ulcer definition/rating as an outcome measure in clinical trials, including examining the role for objective measurement techniques, and the development of digital ulcer patient-reported outcome measures.

Comparability of subjective and objective measurements of nuclear density in cataract patients

To evaluate the relationship between subjective and objective measurements of lens density and the energy of phacoemulsification. University Eye Clinic, Maastricht University Medical Centre, Maastricht, the Netherlands. Cross-sectional study. The study population included 69 patients. Nuclear opalescence (NO) was graded with the Lens Opacities Classification System III (LOCS III). Thereafter, lens density was measured objectively with Scheimpflug imaging, anterior segment optical coherent tomography and spectral fundus reflectometry (SFR). Cumulative dissipative energy (CDE) and total ultrasound time (US t.t.) of the phacoemulsification were noted. The relationship between the different measurement techniques and energy of phacoemulsification was assessed using Spearman's correlation coefficients. We found moderate to strong correlations between LOCS III and objective measurements of the lens density (rho's from 0.53 to 0.78, p<0.05) and a moderate correlation between three objective measurement techniques (rho's between 0.29 and 0.57, p<0.05). There was a moderate correlation between CDE, US t.t. and lens density measurements (rho's from 0.29 to 0.55, p<0.05), and the highest correlation was found between CDE and NO scores. Exclusion of patients with advanced cortical and posterior subcapsular opacities improved the correlation between SFR and lens density measurements but not the correlation with the energy of phacoemulsification. Lens Opacities Classification System III has shown the highest correlation with phacoemulsification energy and may be a preferred technique for prediction of use of phacoemulsification energy. Advanced cortical and posterior opacities may interfere with the quality of objective measurements but do not affect the correlation between lens density measurements and phacoemulsification energy.

A review of the impact of pregnancy and childbirth on pelvic floor function as assessed by objective measurement techniques.

The objective of this narrative review is to study the impact of pregnancy and childbirth on pelvic floor function as assessed by objective measurement techniques with quantitative data carried out during pregnancy and after childbirth. A literature search in MEDLINE and relevant and up-to-date journals from 1960 until April 2017 was performed for articles dealing with the impact of pregnancy and childbirth on pelvic floor function as assessed by objective measurement methods. Only studies describing objective measurement techniques. i.e., urodynamics, ultrasound (US), magnetic resonance imaging (MRI), Pelvic Organ Prolapse Quantification (POP-Q) system, and neurophysiologic tests carried out throughout pregnancy and after childbirth are included. Relevant studies presenting objective quantitative data are analyzed and briefly summarized. The number of studies meeting selection criteria was relatively few. Pregnancy, especially first pregnancy, is associated bladder neck lowering, increased bladder neck mobility, pelvic organ descent, decreased levator ani strength, and decreased urethral resistance. These changes are accentuated after vaginal delivery. Data on the impact of obstetrical and neonatal variables are transient and seem of less importance. Cesarean delivery is not completely protective. In most women, pelvic floor muscle function recovers in the year after delivery. Objective measurement techniques during pregnancy may allow identification of women susceptible to pelvic floor dysfunction later in life and offer the opportunity for counseling and preventive treatment strategies.

Measurement of Local Tissue Water in Patients with Breast Cancer-Related Lymphedema.

Studies revealed that having "1.20" or upper interarm local tissue water (LTW) ratio which can be calculated through tissue dielectric constant (TDC) method might be the determinant of clinical lymphedema after breast cancer surgery. The purpose of this study was to confirm these findings and determine the sensitivity and specificity of LTW (%) measurement method in patients with breast cancer related lymphedema (BCRL). Sixty-three participants were recruited to this study in two groups as follows: the lymphedema group (n = 32), who had BCRL after breast cancer surgery, and the latent group (n = 31), who had breast cancer surgery yet having no lymphedema. LTW (%) measurement of those was conducted with Moisture Meter-D compact (MMDc, Delfin Technologies, Kuopio, Finland) at sites 8 cm proximal (biceps) and 6 cm distal (forearm) from the antecubital fossa, 10 cm inferior from the axilla (lateral thorax) in 2.5 mm depth. Sensitivity and specificity of TDC method were analyzed based on the reference having 1.20 or upper interarm LTW ratio in both groups. Absolute LTW (%) values were significantly different (p < 0.001) between groups in forearm (latent: 26.96 ± 3.35, lymphedema: 36.85 ± 9.32) and in biceps (latent: 26.54 ± 4.11, lymphedema: 36.45 ± 9.91) while in lateral thorax reference point (latent: 35.22 ± 7.44, lymphedema: 33.32 ± 5.08) there was not (p = 0.241). Interarm LTW ratios were significantly different (p < 0.001) between groups in forearm (latent: 1.01 ± 0.06, lymphedema: 1.40 ± 0.35) and in biceps (latent: 1.02 ± 0.10, lymphedema: 1.42 ± 0.38) while in lateral thorax reference point (latent: 1.10 ± 0.25, lymphedema: 1.07 ± 0.16) there was not (p = 0.896). Sensitivity and specificity of the TDC method were 65% and 94%, respectively. Absolute LTW (%) values and interarm LTW ratios were significantly different between patients with clinically diagnosed BCRL and patients with no BCRL (latent group). TDC method has been gradually gaining attention in clinical use and this method might be the preferable method in case of early detection of BCRL in patients in latent phase. Regular follow-ups would be beneficial if objective and sensitive measurement techniques were done in clinical settings.

Comparison of Objective and Subjective Techniques of Strabismus Measurement in Adults With Normal Retinal Correspondence.

Accurate measurement of strabismus is vital to proper diagnosis and treatment. Objective and subjective measurement techniques can be used. The authors hypothesized that subjective measurement techniques would measure larger deviations than objective ones. Adults with strabismus, visual acuity greater than 20/50 in each eye, and normal retinal correspondence were measured in primary gaze at distance and near using the alternate prism and cover test and the red glass test. Seventy-three patients were prospectively enrolled. Objective mean deviations were 9.1 (distance horizontal), 5.1 (distance vertical), 10.0 (near horizontal), and 2.6 (near vertical) prism diopters (PD). Subjective mean deviations were 10.2 (distance horizontal), 6.8 (distance vertical), 12.2 (near horizontal), and 3.2 (near vertical) PD. Subjective measurements were larger by a statistically significant margin and were more likely to show the presence of a vertical deviation not measured objectively (19 occurrences vs 2 at near, P = .008; 15 occurrences vs 0 at distance, P = .004). The measured deviations were within 5 PD horizontally and 3 PD vertically most of the time (range: 66.7% to 83.6%). The red glass test was more likely to measure a larger deviation at distance and near and to identify a vertical deviation not seen objectively at both distance and near. The mean difference between the tests was usually not large enough to affect surgical treatment, but could potentially result in different amounts of prescribed prism for patients treated optically. [J Pediatr Ophthalmol Strabismus. 2017;54(4):216-220.].

Movement and muscle activation patterns following medial branch blocks for facet joint pain, and sacroiliac injections for sacroiliac joint pain

Introduction: Relaxation of the erector spinae often occurs in healthy individuals as full trunk flexion is achieved when bending forward from standing. This phenomenon, referred to as flexion relaxation is often absent or disrupted (EMG activity persists) in individuals reporting low back pain (LBP). While many studies have documented this association between chronic low back pain (LBP) and diminished muscular performance capacity, few studies have quantified the changes in these measures following interventions using objective measurement techniques or related them to changes in clinical outcome. A previous study compared the effects of active physiotherapy, muscle reconditioning devices, or low-impact aerobics on back muscle function in LBP patients. Significant changes in muscle performance were observed in all groups, due to presumed changes in neural activation of the lumbar muscles and psychological changes such as pain tolerance. Given the impact of pain tolerance on muscle performance, we aim to assess movement and EMG muscle activity before and after a pain relieving nerve block.

Conceptual development of an advanced air traffic controller workstation based on objective workload monitoring and augmented reality

NextGen, SESAR, and other international projects intend to develop the coming air traffic management (ATM) environment to cope with the present problems, including e.g. capacity, efficiency, safety, and environmental impact. These projects also introduce considerable changes in the role of air traffic controllers (ATCOs), and shift some of the present tasks from ground to on-board (pilots) and diversify automation. Due to the consequential effects of these developments, (i) the models describing the present operational circumstances, (ii) the working conditions, and (iii) the working environment (e.g. human–machine interactions, task-work and mental loads, cognitive aspects, situation awareness, decision support) must be reconsidered and adapted to the future role of operators. This paper aims to describe a new approach to model the ATCOs’ working processes, and also introduces a new concept for the ATCOs’ future working environment. The developed model covers the situation awareness and decision making processes, including the subjective aspects of the ATCOs decision making based on their workload, mental condition, knowledge, or practice. The proposed new working environment contains special information displays, the decision support system and the ATCOs workload and mental condition measurement / monitoring system, based on objective, on-line, continuous, and nonintrusive measurement techniques. Some of the core systems developed in collaboration with HungaroControl were exhibited at the World ATM congress in 2014 and 2015.

Application of Quantitative Measures for Analysing Aircraft Handling Qualities

&lt;p&gt;The ease and precision with which pilot is able to handle the designated task determines the aircraft’s handling qualities. Accordingly, the most common methodology for determining aircraft’s handling qualities is through pilot opinions or through questionnaires. These subjective means of analysis is not reliable as the sole source of judgments. Quantitative metrics to analyse the task difficulty based on pilot’s performance, supplemented with subjective decision, can provide better insight into pilot workload levels and in turn the aircraft’s handling qualities. The application of few objective performance measurement techniques to flight data of a high performance fighter aircraft is discussed. Pilot/aircraft’s performance under different configurations is analysed. Analysis results show that pilots usually tend to give more priority to pitch axis in case of dual axis tracking task. And pilots are therefore more aggressive in accomplishing pitch axis tracking task than in roll. Workload assessments were also performed by comparing the results of single axis tracking experiments conducted using a high fidelity flight simulator with the flight data. It is seen that pilot’s aggressiveness levels in controlling the roll control inceptor is significantly less, with improved tracking accuracy when exercised as the primary task.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Defence Science Journal, Vol. 66, No. 1, January 2016, pp. 03-10, DOI: http://dx.doi.org/10.14429/dsj.66.9196&lt;/strong&gt;&lt;/p&gt;