Subjective Feedback Research Articles

In Case of Doubt, One Follows One's Self: The Implicit Guidance of the Embodied Self-Avatar.

The sense of embodiment in virtual reality (VR) is commonly understood as the subjective experience that one's physical body is substituted by a virtual counterpart, and is typically achieved when the avatar's body, seen from a first-person view, moves like one's physical body. Embodiment can also be experienced in other circumstances (e.g., in third-person view) or with imprecise or distorted visuo-motor coupling. It was moreover observed, in various cases of small or progressive temporal and spatial manipulations of avatars' movements, that participants may spontaneously follow the movement shown by the avatar. The present work investigates whether, in some specific contexts, participants would follow what their avatar does even when large movement discrepancies occur, thereby extending the scope of understanding of the self-avatar follower effect beyond subtle changes of motion or speed manipulations. We conducted an experimental study in which we introduced uncertainty about which movement to perform at specific times and analyzed participants' movements and subjective feedback after their avatar showed them an incorrect movement. Results show that, when in doubt, participants were influenced by their avatar's movements, leading them to perform that particular error twice more often than normal. Importantly, results of the embodiment score indicate that participants experienced a dissociation with their avatar at those times. Overall, these observations not only demonstrate the possibility of provoking situations in which participants follow the guidance of their avatar for large motor distortions, despite their awareness about the avatar movement disruption and on the possible influence it had on their choice, and, importantly, exemplify how the cognitive mechanism of embodiment is deeply rooted in the necessity of having a body.

A Comprehensive Evaluation of Arbitrary Image Style Transfer Methods.

Despite the remarkable process in the field of arbitrary image style transfer (AST), inconsistent evaluation continues to plague style transfer research. Existing methods often suffer from limited objective evaluation and inconsistent subjective feedback, hindering reliable comparisons among AST variants. In this study, we propose a multi-granularity assessment system that combines standardized objective and subjective evaluations. We collect a fine-grained dataset considering a range of image contexts such as different scenes, object complexities, and rich parsing information from multiple sources. Objective and subjective studies are conducted using the collected dataset. Specifically, we innovate on traditional subjective studies by developing an online evaluation system utilizing a combination of point-wise, pair-wise, and group-wise questionnaires. Finally, we bridge the gap between objective and subjective evaluations by examining the consistency between the results from the two studies. We experimentally evaluate CNN-based, flow-based, transformer-based, and diffusion-based AST methods by the proposed multi-granularity assessment system, which lays the foundation for a reliable and robust evaluation. Providing standardized measures, objective data, and detailed subjective feedback empowers researchers to make informed comparisons and drive innovation in this rapidly evolving field. Finally, for the collected dataset and our online evaluation system, please see http://ivc.ia.ac.cn.

Taking Action Against Clinician Burnout Through Reducing the Documentation Burden With an Operating Room Supply Scanning Approach.

Documenting surgical supply items in the operating room can be a burdensome task for circulating nurses because of manual input within the electronic medical record. This can lead to documentation fatigue and contribute to nursing burnout. The aim of this quality improvement project was to design and implement a supply item scanning process and evaluate the effect on intraoperative documentation completion time, room turnover time, picklist documentation accuracy, nurse satisfaction, and burnout. The sample included nine acute care hospitals throughout the United States, with 189 total circulating nurses and 31 718 procedures occurring during the study timeframe of 8 months. Results indicated that nurses were able to complete documentation on average 37.33 minutes sooner, and the operating room turnover time decreased by 1.88 minutes. Although nurses reported that their perceived picklist documentation accuracy did not improve, and the presence of new scanning technology did not influence their hospital employment decision, subjective feedback was mostly positive, with most responses citing the helpfulness of scanning for documentation. This study shows that an interdisciplinary team can effectively work to optimize documentation efficiency and performance improvement using a scanning intervention. Lessons learned through this process can translate into optimizations elsewhere in the electronic medical record.

Development of a ground-based sensorimotor disorientation analog to replicate astronaut postflight experience.

The perceptual and motor coordination problems experienced following return from spaceflight reflect the sensory adaptation to altered gravity. The purpose of this study was to develop a ground-based analog that replicates similar sensorimotor impairment using a standard measures test battery and subjective feedback from experienced crewmembers. This Sensorimotor Disorientation Analog (SDA) included varying levels of sensorimotor disorientation through combined vestibular, visual, and proprioceptive disruptions. The SDA was evaluated on five previously flown astronauts to compare with their postflight experience and functional motor performance immediately (Return (R)+0 days) and +24h (R+1) after landing. The SDA consisted of galvanic vestibular stimulation (GVS), visual disruption goggles, and a weighted suit to alter proprioceptive feedback and replicate perceived heaviness postflight. Astronauts reported that GVS alone replicated ∼50-90% of their postflight performance with the weighted suit fine-tuning the experience to replicate an additional 10%-40% of their experience. Astronauts did not report feeling that the disruption goggles represented either the visual disruptions or illusory sensations that they experienced, nor did they impact motor performance in postflight tasks similarly. Based on these results, we recommend an SDA including the GVS and the weighted suit. These results provide a more realistic and portable SDA framework to provide transient spaceflight-relevant sensorimotor disruptions for use in countermeasure testing and as a pre-flight training tool.

Sustainable Packaging Design using Life Cycle Thinking

This research examines environmental impact data, sustainable packaging qualities, consumer feedback surveys, and price comparisons to draw important findings. Research focuses on “Packaging Sustainability Revolution: Life Cycle Thinking Reveals Eco-Friendly Innovations.” This research examines sustainable packaging design evolution. Life cycle analysis (LCA) showed that packaging materials had an average carbon footprint of 120 grams of CO2 per unit and a 60% recycling rate. This shows the diverse environmental impacts of packing options. A study of sustainable package design shows that individuals have preferences. The favorability of biodegradable, recyclable, and minimalist packaging increased significantly. In subjective consumer feedback surveys, Packaging A and Packaging B scored 8.3 and 8.7 total satisfaction. In contrast, Packaging C and D do well. The cost increases among models in Cost comparisons expenditures show the economic effects of sustainable design. This emphasizes the tight balance between consumer satisfaction and sustainable practices' economic sustainability. The empirical findings improve scholarly discourse on life cycle thinking in Cost comparisons by revealing the sustainability variables driving the Packaging Sustainability Revolution.

Analysis of the motivation of college students’ participation in governance: Endogenous demands and exogenous promotions

The participation of university students in school governance is an inevitable requirement for building a modern higher education community. As participants in this community, students undoubtedly play an important role in governance, whether they are “producers and consumers” in the economic sense, “rights holders and obligation implementers” in the legal sense, or “responsible persons” in organizational behavior. To study the mechanism of student participation in university governance, it is necessary to first explore the motives behind student participation in university governance, delve into its logical starting point, and thus construct a mechanism system. The participation of college students in university governance has both internal and external driving factors. Constructing a motivation mechanism for student participation in university governance, consisting of subjective attitude, participation needs, self-efficacy, participation system, democratic communication, and information feedback, helps to comprehensively understand the internal correlation of the motivation factors for student participation in university governance, and provides useful theoretical support or reference basis for strengthening university governance.

Developing knowledge, attitude and practice questionnaire in desmoid tumours (KAPID study): applying e-Delphi to rare diseases.

Rare diseases are associated with unique challenges encountered in diagnosis, treatment and conduct of clinical research. Desmoid tumour (DT) is one such ultra-rare malignancy about which awareness among medical professionals remains limited. We developed a questionnaire to assess knowledge, attitude and practice (KAP) among medical professionals on DT. E-Delphi method was used for the assessment of KAP for DT amongst clinical experts (experience of >/= 3 years in DT). 22 open-ended statements were developed by the core research group using current consensus guidelines. In round 1, experts provided subjective feedback which was incorporated into a 35-item questionnaire. Round 2 entailed experts giving feedback as a 5-point Likert scale classified into agreement (median score >/=4), neutral (median score 3) and disagreement (median score <3). Feedback from Round 2 was incorporated and questions with neutral consensus were modified. Questions in Round 3 achieved consensus if >/= 75% participants agreed. 11 (64.7%) of 17 contacted experts responded in Round 1 including 6 (54.4%) who gave additional inputs and 5 (45.6%) who agreed to all statements. In round 2, 8 out of 11 experts responded to the 35-item questionnaire on knowledge (n = 16), attitude (n = 8) and practice (n = 11). 32 questions obtained agreement and 3 (8.5%) had neutral consensus. These were modified for round 3, in which consensus on 2 (66.6%) was attained. The final questionnaire comprises 34 items with 15, 8 and 11 questions on in the sections of knowledge, attitude and practice (KAP), respectively.

ПЕДАГОГИЧЕСКИЕ ФАКТОРЫ, СПОСОБСТВУЮЩИЕ УЛУЧШЕНИЮ ЭФФЕКТИВНОСТИ ДИСТАНЦИОННОГО ОБРАЗОВАНИЯ НА УРОВНЕ ВЫСШЕГО УЧЕБНОГО ЗАВЕДЕНИЯ

This article examines the impact of the 2020 pandemic on the use of distance learning technologies in educational institutions, emphasizing the need to develop and analyze digitalization in the educational field. Special attention is paid to the opinions of students with special educational needs regarding distance learning methods, their interaction with teachers and the problems they face. The article aims to identify the key pedagogical conditions for effective distance learning, based on the subjective feedback of students. Based on the survey data, the authors emphasize the importance of the theoretical and methodological basis for the development of digital education and emphasize the need for a critical review of its components for the formation of competencies and professional growth of students.

Evaluation of a Voice-Enabled Autonomous Camera Control System for the da Vinci Surgical Robot

Robotic surgery involves significant task switching between tool control and camera control, which can be a source of distraction and error. This study evaluated the performance of a voice-enabled autonomous camera control system compared to a human-operated camera for the da Vinci surgical robot. Twenty subjects performed a series of tasks that required them to instruct the camera to move to specific locations to complete the tasks. The subjects performed the tasks (1) using an automated camera system that could be tailored based on keywords; and (2) directing a human camera operator using voice commands. The data were analyzed using task completion measures and the NASA Task Load Index (TLX) human performance metrics. The human-operated camera control method was able to outperform an automated algorithm in terms of task completion (6.96 vs. 7.71 correct insertions; p-value = 0.044). However, subjective feedback suggests that a voice-enabled autonomous camera control system is comparable to a human-operated camera control system. Based on the subjects’ feedback, thirteen out of the twenty subjects preferred the voice-enabled autonomous camera control system including the surgeon. This study is a step towards a more natural language interface for surgical robotics as these systems become better partners during surgery.

Developing, Implementing, and Evaluating the Effectiveness of a Sleep Health Educational Module for Pharmacy Students

ObjectivePharmacists need sleep health knowledge and management skills to deliver evidence-based treatments to patients with sleep disorders/disturbances. This study aimed to develop, implement, and evaluate a pedagogically informed, interactive sleep health educational module for pharmacy students. MethodsAn educational module utilizing a flipped classroom approach, with an interactive lecture, student self-reflection of sleep patterns, case discussions, and pharmacist-patient role-play scenarios, was designed and implemented. A questionnaire assessing pre/post-module changes in knowledge about and attitudes toward sleep health as well as post-module learning satisfaction, was administered to all participating second-year pharmacy students at an Australian university. ResultsMean total knowledge scores for participating students (n = 125, 70.4% female) improved significantly, from a baseline of 11.1 ± 3.8 to 17.1 ± 3.5 post-module (range: 0–25). Attitudes toward sleep health were moderately high at baseline (28.8 ± 3.2) and improved marginally post-module (29.4 ± 3.8) (range: 10–50); however, this increase was insignificant. Participants expressed high satisfaction with the module through subjective feedback, and post-module reflective statements indicated plans for changing sleep behaviors. ConclusionThe results of this study have shown that a targeted educational module for pharmacy students improved sleep health knowledge. It appeared that positive attitudes toward sleep health were not significantly increased which may reflect a ceiling effect. Future modules should focus on attitudinal aspects of positive sleep health to enhance pharmacists’ skills in providing clinically related sleep health care to patients with sleep disturbance.

Exoskeleton Usability Questionnaire: a preliminary evaluation questionnaire for the lower limb industrial exoskeletons

Exoskeleton robots are a promising solution to reduce musculoskeletal disorders (MSDs) in different work environments, but a specific usability scale for evaluating them is lacking. This study aimed to develop and verify a preliminary Exoskeleton Usability Questionnaire (EUQ) for the lower limb exoskeletons by creating a draft survey questionnaire from existing questions in prior studies. An experiment was conducted with 20 participants who performed a specific task while wearing three lower limb robots and provided subjective feedback using the developed questionnaire. Data were analysed using exploratory and confirmatory factor analysis (CFA), resulting in a usability evaluation questionnaire for exoskeleton robots clustered into four main factors: mobility, adjustability, handling and safety. This study’s findings are expected to be useful in evaluating the usability of the lower limb exoskeletons in both general production sites and agricultural work, which can aid in reducing the prevalence of lower limb MSDs. Practitioner Summary: This study developed a preliminary subjective usability evaluation questionnaire for exoskeleton robots. The questionnaire is clustered into four main factors: mobility, adjustability, handling and safety. These findings provide a valuable tool for assessing exoskeleton usability, potentially reducing musculoskeletal disorders (MSDs) in various work environments.

The value of Augmented Reality in surgery - A usability study on laparoscopic liver surgery.

Augmented Reality (AR) is considered to be a promising technology for the guidance of laparoscopic liver surgery. By overlaying pre-operative 3D information of the liver and internal blood vessels on the laparoscopic view, surgeons can better understand the location of critical structures. In an effort to enable AR, several authors have focused on the development of methods to obtain an accurate alignment between the laparoscopic video image and the pre-operative 3D data of the liver, without assessing the benefit that the resulting overlay can provide during surgery. In this paper, we present a study that aims to assess quantitatively and qualitatively the value of an AR overlay in laparoscopic surgery during a simulated surgical task on a phantom setup. We design a study where participants are asked to physically localise pre-operative tumours in a liver phantom using three image guidance conditions - a baseline condition without any image guidance, a condition where the 3D surfaces of the liver are aligned to the video and displayed on a black background, and a condition where video see-through AR is displayed on the laparoscopic video. Using data collected from a cohort of 24 participants which include 12 surgeons, we observe that compared to the baseline, AR decreases the median localisation error of surgeons on non-peripheral targets from 25.8 mm to 9.2 mm. Using subjective feedback, we also identify that AR introduces usability improvements in the surgical task and increases the perceived confidence of the users. Between the two tested displays, the majority of participants preferred to use the AR overlay instead of navigated view of the 3D surfaces on a separate screen. We conclude that AR has the potential to improve performance and decision making in laparoscopic surgery, and that improvements in overlay alignment accuracy and depth perception should be pursued in the future.

Perioperative Pain Management Simulation Course: Improving Anesthesia Trainees' Confidence in the Management of Perioperative Pain and the Associated Critical Incidents.

Introduction Pain management is a crucial aspect of patients' perioperative journey and a fundamental duty of every anesthetist. Throughout anesthesia training, there is an emphasis on the management of critical incidents, several of which surround pain management. With changes to the anesthesia curriculum over recent years, variable exposure to training opportunities, and a reduction in clinical hours during training, many trainees report feeling underprepared for their future roles as consultants. However, pain management remains a small fragment of the core anesthesia curriculum with no pain-focused simulation courses currently available across the UK.Simulation has proven to aid learning transfer in complicated and stressful scenarios with a substantial improvement in knowledge retention and prevention of skill loss while eliminating the risk of harm to patients. Aim A novel perioperative pain management simulation course was designed and implemented in the East of England to equip junioranesthesia traineeswith the knowledge, skills, and confidence to manage perioperative pain and the associated critical incidents. Methods A multidisciplinary team (MDT) was involved in the course design. The faculty consisted of anesthesia consultants, trainees, pain nurses, and simulation technicians. The course ran twice over a six-month period both locally and regionally. A blended learning approach was adopted where 17 trainees attended PowerPoint presentations providing an overview of basic pain theories, perioperativepain management, regional anesthesia, and labor analgesia. Trainees then underwent telecasted simulation training using replicated patient notes, imaging, blood gas analysis, and a high-fidelity SimMan®. A debriefing period followed each scenariousing Pendleton'smodel. An anonymized questionnaire was completed by all trainees before and after the course to assess improvement in theirknowledge and confidence levels across fourdomains covering the management of perioperative pain. Results All 17 trainees completed the questionnaire; therefore, the entire dataset was analyzed. The pre-course questionnaire showedthat usinga scale of zero to 10, the vast majority of trainees reported low levels of confidence (<6/10) in the management of chronic pain during the perioperative period (82%), intraoperative pain management (76%),regional anesthesia(88%), and labor analgesia (65%). Following thesimulation training, the results showed an overwhelmingly positive improvement in all 17 trainees' knowledge and confidence across all four tested domains. All 17 trainees (100%) also showed an improvement in their understanding of local pain protocols. The subjective feedback was positive, highlighting the overall usefulness of the course andthat thetailored complexity of each simulation scenario was appropriateto each candidate's prior level of experience. Trainees also reported feeling more confident in starting their anesthesia on-calls. Conclusion This novel simulation course is the first of its kind in pain management. It has shown great improvements in trainee confidence in managing perioperative pain and the associated critical incidents. Subjective feedback has also been positively reassuring. Its inclusion into the East of England anesthesia training programand national training curriculum would greatly enhance trainee's knowledge and experience in pain management in the perioperative setting.

Validation of a modified visual analogue scale to measure user-perceived comfort of a lower-limb exoskeleton

User perceived exoskeleton comfort is likely important for device acceptance, but there is currently no validated instrument to measure it. The Visual Analogue Scale (VAS) is an existing tool to measure subjective human feedback by asking the user to mark a point on a line with each end of the line representing an opposing anchor statement. It can be modified to show the previous response, allowing the subject to directly indicate if the current condition is better or worse than the previous one. The goal of this study was to determine how well the modified VAS could measure user-perceived comfort as the exoskeleton control parameters were varied. To validate the survey, 14 healthy subjects walked in a pair of ankle exoskeletons with approximately ten distinct sets of control parameters tested in a prescribed order. Each set of control parameters was tested twice. After each trial, user-perceived comfort was measured using a two-question VAS survey. The repeatability coefficient was approximately 40 mm, similar to the total range of responses. The results were also inconsistent, with relative rankings between consecutive pairs of conditions matching for approximately 50% of comparisons. Thus, as tested, the VAS was not repeatable or consistent. It is possible that subject adaptation within the trial and over the course of the experiment may have impacted the results. Additional work is needed to develop a repeatable method to measure comfort and to determine how perceived comfort varies as subjects’ gain exoskeleton experience.

The impact of virtual clinical simulation on nursing students' palliative care knowledge, ability, and attitudes: A mixed methods study

BackgroundPalliative care is fraught with numerous challenges when it comes to conducting practical teaching as it involves caring for people facing the complexities of end-of-life and death. Insufficient clinical practice hinders nursing students from mastering knowledge, attitude and ability of hospice care. Virtual clinical simulation has demonstrated its effectiveness as a valuable educational tool in nursing. However, there is a dearth of evidence supporting its utilization in the context of palliative care practice education. ObjectiveTo develop a virtual clinical simulation education system and assess its impact on enhancing nursing students' knowledge, ability, and attitudes toward palliative care. DesignA single-group pretest-posttest design and focus group interviews were employed. SettingThe study was conducted at a medical university in southwest China. ParticipantsA total of 76 third-year nursing students participated. MethodsParticipants underwent a 1-hour learning session using the virtual clinical simulation education system. Pre-test and post-test evaluations were conducted to assess the participants' knowledge, ability, and attitudes toward palliative care. Survey questionnaire was administered to gauge the students' acceptance and perception of virtual clinical simulation. Focus group interviews were integrated to gain insight into students' subjective perceptions and feedback on the virtual clinical simulation. ResultsThere were notable enhancements in the students' overall scores of palliative care knowledge, ability, and attitudes after the learning session. Students positively evaluated the usefulness and usability of virtual clinical simulation. Students' feedback regarding virtual clinical simulation can be categorized into four themes: the value of virtual clinical simulation education system, its role as a complement to clinical practice teaching, the enjoyment and accessibility of learning, and the technological challenges encountered. ConclusionVirtual clinical simulation is an effective learning tool in palliative care practice education, which has the potential to enhance students' knowledge, ability, and attitudes toward palliative care.

Real-World Experience of Using Etelcalcetide for Secondary Hyperparathyroidism in Community-Based Hemodialysis Centers in Singapore.

Introduction Chronic kidney disease-related mineral and bone disorder (CKD-MBD), characterized by abnormalities in calcium, phosphate, and parathyroid hormone metabolism, with impaired bone turnover and extravascular calcification is a known complication of advanced chronic kidney disease (CKD). Secondary hyperparathyroidism (SHPT) develops early in the disease and its prevalence gradually increases with the disease progression, becoming almost universal in patients with end-stage renal disease (ESRD).The treatment for SHPT includessynthetic vitamin D analogs, calcitriol or calcimimetics. Recently, intravenous etelcalcetide was introduced as a second-generation calcimimetic. This article provides the real-world experience of using etelcalcetide in multiethnic Asian patients receiving hemodialysis at community-based hemodialysis centers in Singapore. Methods This study was real-world evidence, generated by a retrospective clinical audit of routine clinical care of hemodialysis patients in community-based centers in Singapore who received etelcalcetide for treating SHPT.The information on the starting and maximum dose of etelcalcetide, duration of treatment on hemodialysis, parathyroid hormone (PTH) levels, dialysate calcium, concomitant medications, and reasons for discontinuation were collected from the medical records. PTH levels were collected at four-, eight-, and twelve-month intervals. Results A total of 148 patients received etelcalcetide during the study period. Ten patients died and twenty discontinued their treatment, with 118 patients remaining on treatment. Demographically, the patients included Chinese, Malay, Indians, and those belonging to other racial groups. The starting dose of etelcalcetide ranged from 2.5 mg once per week to 7.5 mg three times a week. There was a 16.8% reduction (p=<0.001) in intact-PTH after four months of therapy. Target intact-PTH level of less than 60 pmol/L, was reported as 1.4% at baseline, with 22.3% at four months (p<0.001) and 25.9% at eight months (p=0.028). Calcium and phosphate levels were also tracked as part of the safety and efficacy measures of using etelcalcetide. No symptomatic hypocalcemia was noted and phosphate levels were noted to decline significantly. Overall, the calcium-phosphate product reduced at four months (13.2%, p=<0.001) and eight months (12.7%, p<0.05). An analysis of concomitant medication usage, dialysate calcium utilized, and the side effects of etelcalcetide were also recorded. Finally, a brief descriptive analysis of the patient's subjective feedback regarding etelcalcetide was also reported, especially regarding the reduction in pill burden and overall compliance to medications. Conclusion Etelcalcetide is safe and effective for treating SHPT in multi-ethnic Asian hemodialysis patients and can be considered an alternative to oral cinacalcet. Our study showed no side effects, which was one of the key reasons for non-compliance to traditional calcimimetics. A favorable compliance profile with reduced pill burden was noted by using this intravenous calcimimetic.

Enhancing the Classification of Imbalanced Datasets through the Utilization of the Provisional Clarifier-Alternator (cPAen)

Warmcomfort data is vital for enhancing heating and cooling system efficiency through ML (ML) models. Yet, these datasets often suffer from severe class imbalance due to subjective feedback. To tackle this issue, we introduce a data augmentation algorithm, Provisional Clarifier-Alternator (cPAen). In our research, we evaluated cPAen using real Warmcomfort data and found it outperformed SMOTE, ADASYN, and cWGAN-GP in terms of F1 scores. Notably, cPAen is over 5 times faster than cWGAN-GP while maintaining high test accuracy.

Medical cyber crises and biotechnological syndromes: a multisite clinical simulation study focused on digital health complaints

BackgroundBiotechnological syndromes refer to the illnesses that arise at the intersection of human physiology and digital technology. Implanted technologies can malfunction (eg, runaway pacemakers, hacked insulin pumps), and consumer technologies can be exploited to impose adverse health effects (eg, technology-facilitated abuse, hacks on epilepsy websites inducing seizures). Through a series of clinical simulation events, our study aimed to (1) evaluate the ability of physicians to respond to biotechnological syndromes, (2) explore gaps in training impeding effective patient care in digital cases, and (3) identify clinical cases due to digital technology arising in the population. MethodsThis was a multisite clinical simulation study. Between Jan 1 and July 1, 2023, four half-day clinical simulation events focused on digital pathologies were delivered across three NHS sites in London and the East Midlands. Participants (n=14) ranged in seniority from clinical medical students through to hospital consultants. Ethics approval was attained from University College London. Participant performance was scored by one researcher, using mark schemes built from the Objective Structured Clinical Examinations (OSCEs) format of UK Medical Schools. Qualitative and quantitative feedback was collected from participants following each of the four scenarios. Participants were asked to identify clinical challenges present in each simulation, discuss cases within their own practice, and evaluate the usefulness of the educational material. FindingsParticipants reported a wide range of examples within their own practice (eg, insulin pumps malfunctioning due to Apple watches, cardiac arrests due to faults in ventilators). Participants described barriers to treatment in simulations, including low diagnostic suspicion of technological failures, little education on biotechnological mechanisms, a lack of available expertise, and uncertainty regarding effective therapeutics. In the subjective feedback, participants reported the lowest levels of confidence when managing cases relating to software issues in medical devices, both in terms of confidence in their own ability to deliver care (mean scores: 3·6/10 junior staff, 5·8/10 senior staff) and in their teams (3·8/10 juniors, 6·8/10 seniors). InterpretationIn our digital society, clinical cases related to technology are likely to increase in the population. At present, a lack of clinical awareness, education, training material, and appropriate guidelines are some of the barriers that health-care professionals face when treating these patients. FundingNone.

Evaluation of a Physical Therapist-Delivered Technology Literacy Algorithm and Protocol for Older Adults: A Pilot Study.

Introduction Technology literacy is the ability to comfortably understand, use, and navigate digital devices. It is considered a "super social determinant of health", and yet 39% of adults aged 65+ report not using a smartphone, and 25% of seniors still lack internet access. The purpose of this study was to examine the applicability of a physical therapist-delivered clinical assessment tool related to technological literacy and to identify relationships between technology utilization and perceptions related to sociodemographic factors in community-dwelling older adults. Methods A prospective mixed-methods observational-descriptive study where physical therapists (PTs) administered a newly designed technology literacy algorithm to older adults and evaluated the results of the algorithm. A convenience sample of 30 participants aged 65 and older was evaluated for their technology literacy. The exclusion criteria were if the person had a vision deficit, lived in a nursing home or extended care facility, was unable to fluently read and understand the English language, or was not willing to have an in-home visit by a licensed PT. After informed consent was obtained, the participant completed a Past Experience with Technology Questionnaire assessing participant confidence with technology usage and a demographic questionnaire. A PT data collector visited participants' homes and administered a novel technology literacy algorithm. The PTs also provided subjective feedback after patient visits as to their perceptions of the algorithm. Inferential statistics were performed for key variables, including a Kruskal-Wallis test being utilized for variables with three or more levels and a two-sample Wilcoxon test being utilized for variables with two levels. The binary results were evaluated with chi-squared tests. Trends in distribution and measures of central tendency were analyzed for demographic data. Statistical significance was set at P<0.05 with a confidence interval of 95%. Results Participants (n=30) were evenly distributed with regard to age, and 66% of people had a college degree. Most were female, of the white race, and retired. There were statistically significant relationships between older age and decreased comfort level with using the internet (P=0.30) and sending messages (P=0.31), with individuals 80+ years old having a mean confidence of 6.78 out of 10. A statistically significant relationship was also found between higher income and increased confidence in browsing the internet (P = 0.07). Most qualitative data from physical therapist experiences included positive trends such as ease of use, efficiency, and confidence instilled. Constructive feedback included a lack of resources to assist with more advanced technology-related needs and recommendations to refine the algorithm when advanced needs were identified. Conclusion Technology literacy is a vital component of accessing health and medical care and maximizing the quality of that care, especially in the older adult population. The tools created may assist clinicians with identifying and addressing issues related to technology in older adults. This may help a patient navigate health issues that require the use of technology in their home. This study provided evidence that a PT-administered algorithm may be feasible to address technology literacy issues in the homes of older adults.

Fit of fire boots: exploring internal morphology using computed tomography

Fit of fire boots is a crucial factor in the safety and performance of firefighters on the hostile fireground. Firefighters have reported that ill-fitting fire boots restrict their lower body movement and sometimes cause very dangerous situations by falling off behind the wearer. By using computed tomography, this study demonstrates the potential to quantify and visualize the fit of fire boots, which previously relied on subjective feedback from the wearers. The high-resolution three-dimensional (3D) models of two fire boot products allowed a detailed observation and measurement of the internal space of the boots. Also, the boot’s internal dimension was compared to the foot measurement of local firefighters, showing the significant differences between the two boots. Lastly, simulation wrapping the 3D scanned foot with the boot revealed large void spaces around the toe box and ankle, as well as the narrower ball width of the boot than the foot.