Time Interaction Research Articles

Toward mainstreaming care activities in transportation: a time use and mobility segmentation approach

ABSTRACT This paper assesses the importance of incorporating care dimensions into activity-travel segmentation to understand daily life mobility strategies. The data came from six neighbourhoods in Concepción, Chile, and included detailed information on activity-travel time use and interaction and classification schemes to identify care purposes. The study uses self-organizing maps to build incremental behavioural segments from weekly mobility and time use variables, adding care activities to assess their role in this segmentation. The results identify groups with a higher burden on care than others, emphasizing the role of transport mode and time use patterns. The result remarks caregiving activities hidden within other categories, identifying groups of caregivers, including domestic workers and women who work and have intense accompanying activities with children. The results highlight the differences between mobility patterns between different segments to make more invisible care and other related activities disproportionately performed by groups of women.

The Transformative Therapeutic Relationship: A Challenge and Opportunity.

The transformative therapeutic relationship is a unique interpersonal and intrapsychic phenomenon between analyst and patient. It occurs within the therapeutic framework, and is characterized by specific boundaries of time, place, and verbal and behavioral interactions. Collectively, these interactions may facilitate mutual trust, caring, respect, and affection between analyst and patient. The shared experience of the transformative therapeutic relationship can result in significant intrapsychic and interpersonal changes for both patient and analyst. Clinical case presentations are provided.

Use of an ambient artificial intelligence tool to improve quality of clinical documentation

BackgroundElectronic health records (EHRs) have contributed to increased workloads for clinicians. Ambient artificial intelligence (AI) tools offer potential solutions, aiming to streamline clinical documentation and alleviate cognitive strain on healthcare providers. ObjectiveTo assess the clinical utility of an ambient AI tool in enhancing consultation experience and the completion of clinical documentation. MethodsOutpatient consultations were simulated with actors and clinicians, comparing the AI tool against standard EHR practices. Documentation was assessed by the Sheffield Assessment Instrument for Letters (SAIL). Clinician experience was measured through questionnaires and the NASA Task Load Index. ResultsAI-produced documentation achieved higher SAIL scores, with consultations 26.3% shorter on average, without impacting patient interaction time. Clinicians reported an enhanced experience and reduced task load. ConclusionsThe AI tool significantly improved documentation quality and operational efficiency in simulated consultations. Clinicians recognised its potential to improve note-taking processes, indicating promise for integration into healthcare practices.

The Effect of Chronic Overcrowding on Social Behavior and Expression of Neuroinflammation-Associated Genes in Rats.

The effect of chronic overcrowding on the social behavior of adult male Wistar rats was studied. From postnatal day 30 (P30) to P180, the rats lived under standard (STND) or overcrowded (CRWD) conditions. Starting from P100, rat behavior was studied in the social preference and tube dominance tests, and aggressive behavior was investigated in the resident-intruder test. After decapitation of rats on P180, amygdala, dorsal hippocampus, ventromedial hypothalamus, and medial prefrontal cortex were collected and analyzed for expression of the IL-1β, TNF, TGF-β1, and IL-6 mRNAs by quantitative polymerase chain reaction. Compared to the STND group, rats from the CRWD group demonstrated shorter interaction time with a social object in the social preference test. They also had more wins in the tube test and initiated more attacks in the resident-intruder test. Expression of the IL1β gene in the hippocampus and medial prefrontal cortex and of the TGFβ1 gene in the hippocampus, amygdala, and prefrontal cortex was increased in the CRWD group. The stress induced by overcrowding increased social dominance and aggressiveness and decreased social motivation in rats. The changes in the social behavior of CRWD rats were accompanied by upregulation of expression of genes for the proinflammatory cytokine IL-1β and the anti-inflammatory cytokine TGF-β1 in a number of brain structures, which can be considered as manifestations of neuroinflammation and compensatory processes, respectively.

Resistance training improves cardiac function in older women: a randomized controlled trial.

This investigation aimed to determine the effects of 24weeks of resistance training (RT) on cardiac function in older women. Seventy-three physically independent older women were selected for this investigation. Participants were randomized into a training group (TG, n = 38) and a control group (CG, n = 35). The RT program was conducted over 24weeks and consisted of three sessions a week. Participants performed eight exercises for the whole body in three sets of 8-12 repetitions. Tissue Doppler echocardiography was performed, according to current guidelines, before and after 24weeks of the intervention. One-repetition maximum (1-RM) tests were used to assess muscular strength. A group vs. time interaction (P < 0.05) was shown for left ventricular end-diastolic volume (TG = - 8.3% vs. CG = - 0.6%), left ventricular end-systolic volume (TG = - 10.6% vs. CG = + 1.1%), and left atrial volume index (TG = - 9.1% vs. CG = + 3.9%). A main time effect (P < 0.05) was found for left ventricular mass index (TG = + 4.9% vs. CG = - 0.6%), septal thickness (TG = + 3.3% vs. CG = - 1.7%), left ventricular ejection fraction (TG = + 3.7% vs. CG = - 0.5%), E'/E septal (TG = - 4.8% vs. CG = + 0.5%), deceleration time (TG = - 4.1% vs. CG = + 3.9%), E septal (TG = + 4.6% vs. CG = - 0.6%), and E lateral (TG = + 5.2% vs. CG = - 1.1%). These results suggest that 24weeks of RT improves cardiac morphological and functional variables in older women.

Changes and relevant factors in depressive and anxiety symptoms among Chinese adolescents after the “Double Reduction” policy: A repeated cross-sectional survey with a nested longitudinal subsample

BackgroundThe Chinese government has enacted the “Double Reduction” Policy, which aims to reduce students' academic burden and promote their mental health, but there is limited research examining the policy's impact on students' well-being. This study aims to evaluate changes in students' mental health problems before and after the “Double Reduction” Policy and explore relevant influential factors. MethodsA total of 101,976 elementary and junior high school students were recruited before the “Double Reduction” Policy, and 91,832 students were recruited one year later. Through data integration, a total of 36,637 students participated in both web-based surveys and provided complete data on all measures. ResultsAs a whole, we found that the prevalence of students' depression (12.1 % to 9.2 %) and anxiety (8.9 % to 6.2 %) tended to decline after the “Double Reduction” Policy. Attending private school, reduced homework, more extracurricular activities, more time with parents, reduced academic stress, and sleep duration ≥8 h/n were associated with the decrease in the likelihood of mental health problems in students. Female gender, negative life events, and negative impact of COVID-19 as risk factors for mental health. ConclusionsThese findings indicated that the “Double Reduction” Policy has improved the well-being of Chinese students. Reducing students' homework burden and alleviating their academic pressure are beneficial for their mental health. Increasing time for extracurricular activities and interaction with parents, as well as ensuring sufficient sleep for students, are also effective ways to prevent the onset and exacerbation of mental health symptoms in adolescents.

Extended reality for education: Mapping current trends, challenges, and applications

The advancements in 5G technology and Artificial Intelligence (AI) have accelerated the integration of immersive technologies such as Extended Reality (XR) into educational practices. There is a notable scarcity of studies focusing specifically on the applications and impact of XR in academic settings. Most existing research has concentrated on AR and VR, leaving a gap in understanding the full potential of XR. Addressing these gaps and challenges is crucial for harnessing the full potential of XR in education. This study aims to map and analyze the applications, trends, and educational challenges of XR technology. This study conducts a bibliometric analysis covering XR's application in education from 2018 to 2023, analyzing 32 articles from Scopus sources. Key findings highlight XR's annual growth in research publications, with significant contributions from the United States, China, and Canada. XR enriches education by facilitating immersive simulations, real time interaction with virtual objects, and spatial manipulation in three dimensions. It fosters presence and embodiment in virtual environments, supports practical training through realistic simulations, enhances multi-sensory engagement, promotes collaborative learning environments, and improves accessibility for diverse learners. The main challenges of XR technology include high costs, technical hurdles, regulatory issues, infrastructure limitations, and the need for digital literacy and skills. Addressing these challenges, collaborative efforts among educators, researchers, and industry stakeholders are required. Such collaboration is crucial for harnessing the full potential of XR technology to revolutionize education and prepare learners for a dynamic future.

Evaluation of upper extremity functional capacity and activities of daily living in patients with heart failure: A cross-sectional study

BackgroundConsidering the limitations in activities of daily living (ADL) and the impact of improvements in patients with heart failure (HF), appropriate assessment of upper extremity functional capacity and ADL is important. ObjectivesTo evaluate upper extremity functional capacity and ADL in patients with HF and compare them with healthy controls. MethodsThis study included 30 HF patients and healthy controls. Upper extremity functional capacity was assessed with the 6-Minute Pegboard Ring Test (6PBRT), ADL by the Londrina protocol, exercise capacity by 6-Minute Walk Test (6MWT), peripheral muscle strength by hand dynamometer, and dyspnea by Modified Medical Research Council Scale (MMRC). For performance tests, pre-test (resting) and post-test (after performance) values ​​were also measured. ResultsPatients with HF with ejection fraction ≤50 % and controls were similar in terms of age (52.63±6.2 and 50.03±6.5 years, respectively) and gender (25 females for each group) (p > 0.05). Patients showed a statistically significant increase in total test time in the Londrina protocol and fewer rings moved in 6PBRT (p < 0.0001). The post-test dyspnea (p = 0.03) and pre-test arm fatigue (p < 0.0001) were observed to be higher in patients in the Londrina protocol. There was a statistically significant group by time interaction in the patients’ pre- and post-test lower heart rate (F= 4.80, p = 0.03), post-test dyspnea (p < 0.0001), and post-test arm fatigue (p = 0.005) were observed to be higher in patients in 6PBRT. ConclusionsThe evidence showed a decrease in upper extremity functional capacity in patients with HF. Patients required more time to perform their ADLs compared with healthy controls.

Nanoscale interactions of arginine-containing dipeptide repeats with nuclear pore complexes as measured by transient scanning electrochemical microscopy.

The nuclear pore complex (NPC) plays imperative biological and biomedical roles as the sole gateway for molecular transport between the cytoplasm and nucleus of eukaryotic cells. The proteinous nanopore, however, can be blocked by arginine-containing polydipeptide repeats (DPRs) of proteins resulting from the disordered C9orf72 gene as a potential cause of serious neurological diseases. Herein, we report the new application of transient scanning electrochemical microscopy (SECM) to quantitatively characterize DPR-NPC interactions for the first time. Twenty repeats of neurotoxic glycine-arginine and proline-arginine in the NPC are quantified to match the number of phenylalanine-glycine (FG) units in hydrophobic transport barriers of the nanopore. The 1 : 1 stoichiometry supports the hypothesis that the guanidinium residue of a DPR molecule engages in cation-π interactions with the aromatic residue of an FG unit. Cation-π interactions, however, are too weak to account for the measured free energy of DPR transfer from water into the NPC. The DPR transfer is thermodynamically as favorable as the transfer of nuclear transport receptors, which is attributed to hydrophobic interactions as hypothesized generally for NPC-mediated macromolecular transport. Kinetically, the DPRs are trapped by FG units for much longer than the physiological receptors, thereby blocking the nanopore. Significantly, the novel mechanism of toxicity implies that the efficient and safe nuclear import of genetic therapeutics requires strong association with and fast dissociation from the NPC. Moreover, this work demonstrates the unexplored power of transient SECM to determine the thermodynamics and kinetics of biological membrane-molecule interactions.

Effects of the dual-task training program for Korean older adults with mild cognitive impairment in community

This study was to examine the effects of dual-task training program on the cognitive function, physical functional status, self-efficacy, and life satisfaction of Korean older adults with mild cognitive impairment living in community. A quasi-experimental pretest-posttest control group design was used. The study participants were a total of 32 older adults with mild cognitive impairment over the age of 65 in the community, South Korea (Intervention: n = 16, Control: n = 16). The effects of time and group interactions between the intervention and control groups were statistically significant for the cognitive function (F=60.99, p < 0.001), physical function status (F=25.59, p < 0.001), self-efficacy (F=69.36, p < 0.001), and life satisfaction level (F=25.81, p < 0.001). The intervention group showed positive improvements in health-related outcome variables compared to the control group. The intervention showed beneficial effects immediately after 10 weeks applied and the effects were sustained at 14 weeks.

Cystatin C vs creatinine eGFR in advanced CKD: an analysis of the STOP-ACEi trial

ABSTRACT Background In this secondary analysis of the STOP-ACEi trial, we explored the impact of discontinuing or continuing renin–angiotensin system inhibitor therapy in people with advanced chronic kidney disease on cystatin C estimated glomerular filtration rate (eGFR). Methods Cystatin C eGFRs were calculated at baseline, 12, 24 and 36 months using Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) cystatin 2012, European Kidney Function Consortium and CKD-EPI Combined 2021 equations. We excluded samples obtained after the initiation of kidney replacement therapy. Primary analysis used complete case analysis and mixed-effects linear regression model, adjusting for minimization variables, baseline value, time-point and treatment by time interaction. Sensitivity analysis was conducted using a pattern mixture model to account for missing data that was not at random. To model the longitudinal cystatin C data with time-to-event data, a joint model was utilized which incorporated the cystatin C measurements at various time points and accounted for the occurrence of kidney replacement therapy. Results The mean cystatin C eGFRs (CKD-EPI 2012) at baseline were 17.8 mg/L [standard deviation (SD 6.3)] and 17.9 mL/min/1.73 m2 (SD 6.3) in the STOP and CONTINUE arms, respectively. The estimated least squares mean difference at 12 months between STOP and CONTINUE arm was –1.46 [95% confidence interval (CI) –2.39 to –0.52, P = .002]. The estimated least squares mean difference at 24 months was –2.27 (95% CI –3.48 to –1.06, P &amp;lt; .001). The estimated least squares mean difference at 36 months was –1.72 (95% CI –3.48 to 0.03, P = .05). Conclusion Our results are consistent with the primary study's analysis and sensitivity analyses support these findings and provide additional insights. Our findings demonstrate the similarity of creatinine and cystatin eGFR results and therefore support the use of cystatin C as an alternative marker of eGFR in advanced CKD, particularly in those in whom creatinine is likely to be less accurate.

Effects of Fu’s subcutaneous needling on clinical efficacy and psychological cognitive characteristics in patients with chronic non-specific low back pain: A randomized controlled trial

Background and purposeLow back pain (LBP) is a major global public health problem. Evidence shows that LBP is also related to cognitive, psychological, and lifestyle factors. Fu’s subcutaneous needling (FSN) has been used for the treatment of musculoskeletal problems for many years. This prospective randomized controlled trial aimed to evaluate the clinical efficacy and fear avoidance beliefs of FSN in the treatment of patients with chronic non-specific LBP. Material and methodsNinety participants with chronic non-specific LBP were randomly divided into the FSN and the traditional acupuncture (TA) groups (n = 45) and received either FSN or TA treatment for three consecutive days from December 2021 to March 2023. The primary outcome was pain intensity measured by the visual analogue scale (VAS). Secondary outcomes were trunk extensor endurance (TEE), lumbar range of motion (ROM), and the Fear Avoidance Beliefs Questionnaire (FABQ). Outcome measurements were made before the first treatment and after each treatment. Follow-up assessments of VAS and FABQ scores were conducted one month after treatment. ResultsThe FSN group had significantly lower VAS and FABQ scores at each time point after intervention compared to the TA group (P < 0.01). The scores of TEE and lumbar ROM were higher in the FSN group than those in the TA group (P < 0.01). Repeated measures analysis of variance (ANOVA) showed significant time effects, group effects, and interaction effects for VAS, TEE, lumbar ROM, and FABQ in both groups (P < 0.01). One month after treatment, the FSN group had significantly lower VAS and FABQ scores compared to the TA group (P < 0.05). ConclusionThis study suggested that FSN was superior to TA in terms of clinical efficacy and fear-avoidance beliefs in the treatment of chronic non-specific LBP. FSN could be used as an effective clinical treatment.

TRACking health behavior in people with multiple sclerosis: Effects of a randomized trial on physical activity and working memory.

Multiple sclerosis is associated with impairments in working memory functioning. Lifestyle physical activity interventions show promise in improving cognitive functioning; however, the evidence is limited. We examined the efficacy of a lifestyle physical activity intervention, involving step tracking and psychoeducational materials, on improving step counts, working memory functioning, and network strength in a whole-brain network of working memory. Participants (n = 75) were randomly assigned to a group tracking steps with a pedometer (step-track), or a group tracking water intake with a smart water bottle (water-track), for 6 months. At baseline, mid, and postintervention, we assessed weekly physical activity (GT3X+ accelerometer), weekly water intake (H20 Pal Smart Bottle), and working memory functioning. Additionally, the combined network strength of a validated working memory connectome was calculated. We ran random intercept linear mixed models to examine differences between the groups, over time. A significant Group × Time interaction effect with steps and water intake indicated that the step-track group increased their steps, and the water-track group increased their water intake, in comparison to each other, from baseline to postintervention (p < .05). Both groups improved in behavioral working memory over time (p < .05). No significant differences were found on the network strength. Our 6-month randomized controlled trial involving physical activity tracking showed increased step count in the intervention group. Behavioral working memory improved in both groups, potentially due to practice effects. Future studies should include both active and passive control groups to discern practice effects from intervention impact. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Effectiveness of a training program for caregivers of institutionalized older people on sedentary behavior, physical activity, and functionality of residents

Training caregivers of institutionalized older adults about an expanded care approach seems to be a way to maintain the resident's capabilities from the long-term care perspective. Objective: to analyze the effectiveness of training for caregivers of institutionalized older adults on sedentary behavior (SB), physical activity (PA) levels, and functionality of residents. Methods: Instructional training (four weeks) followed by the caregiver goal application period (12 weeks). Primary outcomes: Sedentary behavior (accelerometry) and functional mobility (Timed Up and Go). Secondary: physical function (SPPB), the performance of activities of daily living (Barthel Index), physical activity (accelerometer), handgrip strength, and anthropometric measurements. All analyses were conducted according to the intention-to-treat principle. Generalized Estimating Equations (GEE) and the Bonferroni post-hoc test were applied for comparison between time points (pre and post-intervention) and groups (p&lt;0.05). Results: 49 older adults participated in the study, 25 of which comprised the intervention group (IG) and 24 the control group (CG). There was a group and time interaction effect, and the IG showed a reduction in SB (p=.017), increased light PA (p=.006), and total PA (p=.018). There were no changes in moderate PA and functionality. Although not statistically significant, the Barthel Index increased by 6.8 points in the IG, a clinically meaningful difference. Conclusion: The caregiver training strategy can be important in reducing SB and promoting participation in PA, which is relevant, considering the profile of the institutionalized older adult population. Keywords: Sedentary Behavior; Physical Functional Performance; Older Adults; Caregivers; Nursing home.

A visual measurement method of vibration displacement of railway bridge bearings based on phase correlation

Currently, contact displacement meters for bearing displacement measurement are prone to fatigue failure. Non-contact visual measurement has become a more effective technique. In this study, an innovative model based on phase correlation is established for the visual measurement of vibration displacement of railway bridge bearings. Firstly, it is suggested to extract the vehicle–bridge interaction time using the sliding window average detection and K-means methods. Secondly, to circumvent the limited measurement accuracy of the existing methods, the phase correlation technique is applied to efficiently calculate the displacement of bearings within a two-dimensional plane. Thirdly, an image sharpness estimation method based on the Tenengrad function is proposed, and then a line segment detector is used for updating the measurement parameters. Through comparative experiments, the measurement error of presented method is within 0.04 mm. In the process of long-term service, the proposed method exhibits no fatigue failure issues, highlighting its good technical advantage.

8-Week Online Fitness Intervention on Muscle Strength, Flexibility, Body Composition and Physical-Self Perception: A Randomized Controlled Trial

This research examines the effect of an online physical fitness intervention plan on health-related components, and self-perception with randomized controlled trial. A total of 43 individuals completed the study, 21 of them were in the experimental group, and 22 were in the control group. Muscle strength was assessed using push-ups and sit-ups, while flexibility was determined through sit-and-reach tests. Fat and muscle mass in the arms, legs, trunk, android, gynoid regions, and total body were measured in grams by using Dual Energy X-Ray Absorptiometry. Health, body fat, strength, flexibility, endurance sub-dimensions of Marsh Physical Self-Description Inventory was used for self-perception. Results showed that group and time interaction had a significant effect on self-perception of body fat and push-ups, flexibility left and right, total fat, body fat mass in the arm, leg, and gynoid regions. Although the muscle mass of the experimental group increased in the 8-week period, this situation was not statistically significant. The implemented physical fitness intervention program has a significant impact, particularly in terms of fat burning. The findings obtained in strength tests can be associated with a decrease in fat mass, especially in the upper body. In conclusion, these findings underscore the potential of online fitness interventions in achieving positive health outcomes, emphasizing the multifaceted benefits of such programs on both perceived and measured physical well-being.

Balancing Academic and Personal Life: Challenges for Medical StudentsPersonal Life in Medical Students

Medical students are found to experience stress with a considerable impact because of the academic studies they are undertaking. High demands compared to non-medical students can interfere with other life domains, such as personal life. This interference can manifest in several ways, such as diminished time for social interactions and leisure activities. The purpose of this study was to explore and understand the potential impact on the relationship between academic life and personal life. The research was conducted with a sample of 7 medical student participants from Universitas Padjadjaran. Participants completed a questionnaire with 5 open-ended questions designed to capture their experiences and perspectives in detail. The findings revealed that a significant number of participants struggle with time management, feeling that their academic commitments leave them with minimal time for free activities and social engagements. This imbalance contributes to a sense of inadequacy in maintaining a fulfilling personal life. The study highlighted that a well-rounded personal life is crucial for sustaining optimal academic performance. A good personal life can provide good academic conditions, but the lack of free time for personal life makes participants do other alternatives such as postponing, procrastinating, and causing stress. Addressing these issues requires a holistic approach that not only alleviates academic burdens but also promotes a healthy balance between professional and personal domains. It’s essential for ensuring the well-being and success of medical students in both their academic pursuits and personal life.

The effect of intranasal (R,S)-ketamine on symptoms of fatigue in severe major depressive disorder or bipolar depression with and without comorbid alcohol use disorder: Results from a randomized, double-blind, placebo-controlled trial

BackgroundFatigue is a multidimensional condition that may overlap with depression. Initial studies found that fatigue responds in only a limited way to standard monoaminergic antidepressants and mood stabilizers but does respond positively to intravenous (IV) racemic (R,S)-ketamine (ketamine). However, IV ketamine's use is limited by cost and access barriers. To date, no study has evaluated intranasal (IN) ketamine in individuals with fatigue. This study sought to evaluate the anti-fatigue effects of a single 50 mg dose of IN ketamine in individuals with major depressive disorder (MDD) or bipolar depression (BDep), both with and without comorbid alcohol use disorder (AUD). MethodsTwenty-eight individuals with primary diagnoses of MDD or BDep I/II currently experiencing a depressive episode with active suicidality were enrolled; approximately 60 % had comorbid AUD. Changes in the NIH-Brief Fatigue Inventory (NIH-BFI) were assessed at baseline and at 4, 24, and 48 h post-treatment. ResultsThe group x time interaction for NIH-BFI score was significant (F = 3.44, p = 0.022), favoring IN ketamine over placebo. IN ketamine was well-tolerated with minimal adverse effects. LimitationsLimitations include the limited sample size, short duration, and single, fixed dose. ConclusionsIN ketamine appears to induce rapid anti-fatigue effects in individuals with severe MDD and BDep both with and without comorbid AUD. This suggests that IN ketamine holds potential as an alternative, rapid-acting, anti-fatigue option for different medical conditions.

Deep learning-based scoring method of the three-chamber social behaviour test in a mouse model of alcohol intoxication. A comparative analysis of DeepLabCut, commercial automatic tracking and manual scoring

BackgroundAlcohol consumption and withdrawal alter social behaviour in humans in a sex-dependent manner. The three-chamber test is a widely used paradigm to assess rodents' social behaviour, including sociability and social novelty. Automatic tracking systems are commonly used to score time spent with conspecifics, despite failing to score direct interaction time with conspecifics rather than time in the nearby zone. Thereby, the automatically scored results are usually inaccurate and need manual corrections. New methodNew advances in artificial intelligence (AI) have been used recently to analyze complex behaviours. DeepLabCat is a pose-estimation toolkit that allows the tracking of animal body parts. Thus, we used DeepLabCut, to introduce a scoring model of the three-chamber test to investigate alcohol withdrawal effects on social behaviour in mice considering sex and withdrawal periods. We have compared the results of two automatic pose estimation methods: automatic tracking (AnyMaze) and DeepLabCut considering the manual scoring method, the current gold standard. ResultsWe have found that the automatic tracking method (AnyMaze) has failed to detect the significance of social deficits in female mice during acute withdrawal. However, tracking the animal's nose using DeepLabCut showed a significant social deficit in agreement with manual scoring. Interestingly, this social deficit was shown only in females during acute and recovered by the protracted withdrawal. DLC and manually scored results showed a higher Spearman correlation coefficient and a lower bias in the Bland-Altman analysis. Conclusionour approach helps improve the accuracy of scoring the three-chamber test while outperforming commercial automatic tracking systems.

Efficacy of a Virtual Reality Rehabilitation Protocol Based on Art Therapy in Patients with Stroke: A Single-Blind Randomized Controlled Trial.

Art therapy has a long history of applications in cognitive and motor rehabilitation. More recently, a growing body of scientific literature has highlighted the potential of virtual reality in neurorehabilitation, though it has focused more on the technology itself than on the principles adopted in digital scenarios. This study is a single-blind randomized controlled trial conducted on 40 patients with stroke, comparing conventional therapy (physical therapy for the upper and lower limbs, for posture and balance, cognitive therapy, occupational therapy, speech therapy, and specific therapy for swallowing, bowel, and bladder dysfunctions) to a protocol in which the upper limb physical therapy was substituted with art therapy administered by means of virtual reality exploiting the so-called Michelangelo effect. After 12 sessions, patients in the virtual art therapy group showed a significantly greater improvement in independence in activities of daily living, as assessed by the Barthel Index (interaction of time and group: p = 0.001). Significant differences were also found in terms of upper limb muscle strength (Manual Muscle Test, p < 0.01) and reduction in spasticity (Ashworth scale, p = 0.007) in favor of the experimental group. In the virtual art therapy group, the effectiveness of the intervention was significantly correlated with patient participation (Pittsburgh Rehabilitation Participation Scale: R = 0.41), patient satisfaction (R = 0.60), and the perceived utility of the intervention by the therapist (R = 0.43). These findings support the efficacy of virtual art therapy leveraging the Michelangelo effect. Further studies should also focus on cognitive domains that could benefit from this type of approach.