Visual Conditions Research Articles

Quantifying Human Gait Symmetry During Blindfolded Treadmill Walking.

Bilateral gait symmetry is an essential requirement for normal walking since asymmetric gait patterns increase the risk of falls and injuries. While human gait control heavily relies on the contribution of sensory inputs, the role of sensory systems in producing symmetric gait has remained unclear. This study evaluated the influence of vision as a dominant sensory system on symmetric gait production. Ten healthy adults performed treadmill walking with and without vision. Twenty-two gait parameters including ground reaction forces, joint range of motion, and other spatial-temporal gait variables were evaluated to quantify gait symmetry and compared between both visual conditions. Visual block caused increased asymmetry in most parameters of ground reaction force, however mainly in the vertical direction. When vision was blocked, symmetry of the ankle and knee joint range of motion decreased, but this change did not occur in the hip joint. Stance and swing time symmetry decreased during no-vision walking while no significant difference was found for step length symmetry between the two conditions. This study provides a comprehensive analysis to reveal how the visual system influences bilateral gait symmetry and highlights the important role of vision in gait control. This approach could be applied to investigate how vision alters gait symmetry in patients with disorders to help better understand the role of vision in pathological gaits.

Autonomous Vision-Based Navigation and Stability Augmentation Control of a Biomimetic Robotic Hammerhead Shark

The application potential of robotic fish embedded with intelligent visual navigation algorithms in underwater autonomous operation is on full display recently. However, the existing visual navigation methods are limited by the underwater visual conditions and the motion characteristics of robotic fish. To this end, this paper proposes a novel autonomous navigation framework integrated with visual stabilization control. In practice, a stereo vision-based navigation network is proposed to generate the guidance law. On this basis, a biomimetic robotic hammerhead shark with a controllable cephalofoil is developed, and a nonlinear model predictive controller for cephalofoil stabilization relying on the dynamic model is elaborately designed. Extensive simulations and underwater experiments are conducted to validate the effectiveness and superiority of the proposed methods, which significantly enhance exploration efficiency and reduce image jitter by 26.02% compared to the traditional methods. The obtained results provide a new idea for underwater robots to autonomously explore the ocean. <italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">Note to Practitioners</i> —This paper is motivated by the problem of vision-based underwater autonomous navigation for a biomimetic robotic fish that possesses underwater visual stability and good maneuverability. The existing visual navigation networks usually generate unexpected navigation instructions when dealing with complex or ambiguous underwater scenes. Additionally, image jitter caused by the rhythmic motion of robotic fish can lead to navigation failure. This paper suggests an integrated navigation framework that includes a biomimetic platform design, a visual stabilization controller, and an intelligent underwater navigation network. Specifically, a novel sphyrnidae-inspired robotic shark is designed as a new platform with superior motion performance. To enhance underwater visual stability, a nonlinear model predictive control-based visual stabilization controller is proposed. Furthermore, a deep stereo attention navigation network based on a parallax attention mechanism is proposed to improve the generalization of vision-based autonomous navigation. A series of underwater search experiments on the robotic shark demonstrate the effectiveness and superiority of the proposed navigation framework. Hopefully, our proposed methods can provide valuable guidance and support for universal underwater robot navigation to accomplish practical marine tasks, such as underwater rescue, resource exploitation, biological observation, and so on.

Comorbid health conditions in people with attention-deficit/hyperactivity disorders: An umbrella review of systematic reviews and meta-analyses

BackgroundWe aimed to systematically review meta-analyses on the link between attention-deficit/hyperactivity disorder (ADHD) and a broad range of psychiatric, physical, and behavioral health conditions (PROSPERO; no.CRD42023448907). ResultsWe identified 22 meta-analyses that included 544 primary studies, covering 76 unique conditions in over 234 million participants across 36 countries and six continents. We found high-certainty evidence for the associations between ADHD and neuropsychiatric conditions (bipolar disorders, personality disorders, schizophrenia, and pragmatic language skills), night awakenings, obesity, decayed incipient surfaces, asthma, astigmatism, hyperopia and hypermetropia, strabismus, and suicide ideation. Moderate-certainty evidence suggested that ADHD was associated with headache, mood/affective disorders, depression, bruxism, bone fractures, atopic rhinitis, vision problems, suicide attempts, completed suicide, and all-cause mortality. Low-certainty evidence indicated associations with eating disorders, sleep efficiency, type 2 diabetes, dental trauma prevalence, atopic diseases, and atopic dermatitis. Very low-certainty evidence showed associations between ADHD and several sleep parameters. ConclusionWe found varied levels of evidence for the associations of ADHD with multiple health conditions. Therefore, clinicians should consider a wide range of neurological, psychiatric, sleep and suicide-related, metabolic, musculoskeletal, oral, allergic, and visual conditions, as well as the increased risk of mortality when assessing individuals with ADHD.

A drift diffusion model analysis of age-related impact on multisensory decision-making processes

Older adults (OAs) are typically slower and/or less accurate in forming perceptual choices relative to younger adults. Despite perceptual deficits, OAs gain from integrating information across senses, yielding multisensory benefits. However, the cognitive processes underlying these seemingly discrepant ageing effects remain unclear. To address this knowledge gap, 212 participants (18–90 years old) performed an online object categorisation paradigm, whereby age-related differences in Reaction Times (RTs) and choice accuracy between audiovisual (AV), visual (V), and auditory (A) conditions could be assessed. Whereas OAs were slower and less accurate across sensory conditions, they exhibited greater RT decreases between AV and V conditions, showing a larger multisensory benefit towards decisional speed. Hierarchical Drift Diffusion Modelling (HDDM) was fitted to participants’ behaviour to probe age-related impacts on the latent multisensory decision formation processes. For OAs, HDDM demonstrated slower evidence accumulation rates across sensory conditions coupled with increased response caution for AV trials of higher difficulty. Notably, for trials of lower difficulty we found multisensory benefits in evidence accumulation that increased with age, but not for trials of higher difficulty, in which increased response caution was instead evident. Together, our findings reconcile age-related impacts on multisensory decision-making, indicating greater multisensory evidence accumulation benefits with age underlying enhanced decisional speed.

The FreiBurger: a new optotype for P300-based acuity estimation.

Accurate objective assessment of visual acuity is crucial, particularly in cases of suspected malingering, or when the patient's inability to cooperate makes standard psychophysical acuity tests unreliable. The P300 component of the event-related potentials offers a potential solution and even allows for the use of standard optotypes like the Landolt C. However, low-vision patients with large eccentric visual field defects often struggle to locate the Landolt C gap quickly enough for a P300 to be reliably produced. Addressing this challenge, we introduce a novel optotype (the "FreiBurger") with a critical detail that extends through the optotype's center. Two experiments, with 16 and 12 participants, respectively, were conducted. In the first, psychophysical acuity estimates were obtained with both the FreiBurger and the Landolt C. In the second, we tested the performance of the FreiBurger, relative to the Landolt C, in eliciting a P300 with undegraded vision, simulated low vision, and in a simulated combination of low vision and visual field constriction. Comparable psychophysical acuity values (average difference 0.03 logMAR) were obtained for both optotypes. In the P300 recordings, both optotypes produced similar P300 responses under conditions of undegraded vision and low vision. However, with the combination of low vision and constricted visual field, the P300 could only be reliably obtained with the FreiBurger, while the amplitude was drastically reduced with the Landolt C (9.1µV vs. 2.2µV; p < 0.0005). The new optotype extends the applicability of P300-based acuity estimation to the frequently encountered combination of low vision and constricted visual field, where Landolt C optotypes fail. Although impairments were simulated in the present study, we assume that the advantages of the new optotype will also manifest in patients with such impairments. We furthermore expect the advantages to apply to time-sensitive psychophysical examinations as well.

Multivariate Universal Local Linear Kernel Estimators in Nonparametric Regression: Uniform Consistency

In this paper, for a wide class of nonparametric regression models, new local linear kernel estimators are proposed that are uniformly consistent under close-to-minimal and visual conditions on design points. These estimators are universal in the sense that their designs can be either fixed and not necessarily satisfying the traditional regularity conditions, or random, while not necessarily consisting of independent or weakly dependent random variables. With regard to the design elements, only dense filling of the regression function domain with the design points without any specification of their correlation is assumed. This study extends the dense data methodology and main results of the authors’ previous work for the case of regression functions of several variables.

The Graded Incomplete Letters Test (GILT): a rapid test to detect cortical visual loss, with UK Biobank implementation

Impairments of object recognition are core features of neurodegenerative syndromes, in particular posterior cortical atrophy (PCA; the ‘visual-variant Alzheimer’s disease’). These impairments arise from damage to higher-level cortical visual regions and are often missed or misattributed to common ophthalmological conditions. Consequently, diagnosis can be delayed for years with considerable implications for patients. We report a new test for the rapid measurement of cortical visual loss – the Graded Incomplete Letters Test (GILT). The GILT is an optimised psychophysical variation of a test used to diagnose cortical visual impairment, which measures thresholds for recognising letters under levels of increasing visual degradation (decreasing "completeness") in a similar fashion to ophthalmic tests. The GILT was administered to UK Biobank participants (total n=2,359) and participants with neurodegenerative conditions characterised by initial cortical visual (PCA, n=18) or memory loss (typical Alzheimer’s disease, n=9). UK Biobank participants, including both typical adults and those with ophthalmological conditions, were able to recognise letters under low levels of completeness. In contrast, participants with PCA consistently made errors with only modest decreases in completeness. GILT sensitivity to PCA was 83.3% for participants reaching the 80% accuracy cut-off, increasing to 88.9% using alternative cut-offs (60% or 100% accuracy). Specificity values were consistently over 94% when compared to UK Biobank participants without or with documented visual conditions, regardless of accuracy cut-off. These first-release UK Biobank and clinical verification data suggest the GILT has utility in both rapidly detecting visual perceptual losses following posterior cortical damage and differentiating perceptual losses from common eye-related conditions.

Investigating the role of flight phase and task difficulty on low-time pilot performance, gaze dynamics and subjective situation awareness during simulated flight.

Gaze behaviour has been used as a proxy for information processing capabilities that underlie complex skill performance in real-world domains such as aviation. These processes are highly influenced by task requirements, expertise and can provide insight into situation awareness (SA). Little research has been done to examine the extent to which gaze behaviour, task performance and SA are impacted by various task manipulations within the confines of early-stage skill development. Accordingly, the current study aimed to understand the impact of task difficulty on landing performance, gaze behaviour and SA across different phases of flight. Twenty-four low-time (<300 hours) pilots completed simulated landing scenarios under visual flight rules conditions. Traditional gaze metrics, entropybased metrics, and blink rate provided meaningful insight about the extent to which information processing is modulated by flight phase and task difficulty. The results also suggested that gaze behavior changes compensated for increased task demands and minimized the impact on task performance. Dynamic gaze analyses were shown to be a robust measure of task difficulty and pilot flight hours. Recommendations for the effective implementation of gaze behaviour metrics and their utility in examining information processing changes are discussed.

Awareness of Visual Offset Reduces but Does Not Eliminate Joint Repositioning Errors in Virtual Reality

The present study investigated the effect of visual offset (visuo-proprioceptive mismatch) in joint repositioning task in a three-dimensional virtual reality (VR) environment when participants were instructed to ignore vision. Twenty-five physically healthy young individuals performed shoulder joint position sense test. Repositioning accuracy was tested under two visual conditions, accurate and offset visions, and two instructions, no guidance or ignore vision. In accurate vision trials, the virtual hand of the tested limb seen in VR was congruent with where the participant placed their hand. In the offset vision condition, the virtual hand was seen 8° above or below their actual hand in the vertical plane. Repositioning error (i.e. constant error) in offset vision trials was lower when the participants were instructed to ignore vision compared to when no instruction about the visual offset was given (p < 0.001). However, constant error in offset vision trials was larger than accurate vision trials when the participants tried to ignore vision in both visual conditions (p < 0.001). Our results suggest that humans may be able to down-weight vision to some extent by conscious effort, while the influence of vision is difficult to eliminate when vision is present.

Projection helps to improve visual impact: On a dark or foggy day

Driving is a highly visually demanding activity. Different driving conditions have different effects on drivers, so to understand the effects of driving vision on drivers, this paper directly investigates the role of central and peripheral vision in different scenarios and tests whether projection training improves driving behavior. We use a VR device to selectively present information in the central and peripheral parts of the field of view to achieve these goals. In Experiment 1, we compare drivers’ performance with and without experience when driving through four different visual conditions under dark and foggy skies. Participants’ visual search behavior and driving behavior activities were recorded simultaneously. Experiment 2 determined whether training with a circular projection of three colors improved the driver’s behavior. The results showed that (1) central vision is critical to the driver, and the importance of peripheral vision can be directly measured using the VR device; (2) a clear middle and blurred peripheral vision not only improves driver behavior in foggy weather but also helps to improve attention and driving ability; and (3) the color projection training indicated that the green projection was more effective than the others and that it significantly improved (4) Novice drivers collected visual information mainly from their central vision and were less able to drive than veterans, but green projection improved their driving ability and reduced collisions. Most importantly, the study results provide a new visual training paradigm that can improve driver behavior on dark and foggy days, especially for female novices.

From Distraction to Action: Elevating Situation Awareness with Visual Assistance in Level 3 Autonomous Driving

This study examines the impact of visual assistance and cognitive load on situation awareness (SA) during takeover events in Level 3 (L3) autonomous driving, where drivers are permitted to engage in Non-Driving Related Tasks (NDRTs). Utilizing a driving simulator, the research explores how different NDRTs, occupying various sensory channels, influence drivers’ SA under two visual assistance conditions: full marking and key marking. Results from the Situation Awareness Global Assessment Technique (SAGAT) and NASA Task Load Index (NASA-TLX) scales, along with eye-tracking data, demonstrate significant interactions between visual assistance conditions and tasks, highlighting key marking’s superior effectiveness in enhancing SA across all NDRTs. The study reveals that cognitive workload, largely arising from NDRTs rather than road attention, remains unaffected by visual assistance conditions. Findings suggest that drivers’ strategies for allocating attention are consistent, regardless of the visual task presence. This research contributes to understanding SA in autonomous driving takeovers, offering valuable insights for developing Human-Machine Interface (HMI) designs to improve SA and takeover performance in autonomous driving systems.

Good vision &amp;ndash; good driver

Vision is a complex act that allows the visual analyzer to perceive and analyse objects in the environment. The teams of two eye clinics conducted a &amp;ldquo;good vision-good driver&amp;rdquo; awareness campaign in combination with a survey. In most countries in the world, drivers over the age of 65 are required to renew their licences every 2 or 3 years. The European Commission wants car drivers over 70 to prove their ability every 5 years. The aim was to analyze the relationship between patients&amp;rsquo; visual performance concerning their self-reported driving and their subjective general health. The survey was conducted through a direct survey at St. Nikolay Chudotvorets Eye Clinic Eye Clinics from 1.06.2021 to 31.06.2022. For the period, 103 patients were surveyed, 84 male and 19 &amp;ndash; female. The group of 50&amp;ndash;70-year-olds was the most numerous. Uncorrected vision equal to or less than 0.3 was present in 45.6% of all 206 eyes. Almost all respondents drove a car, only 3 were not drivers, and most (50.9%) had no difficulty driving. More than 42% of the respondents found driving difficult only at night, and 6.8% had difficulty always. There is an overlap in the results of the questions of whether the patient had had a traffic accident &amp;ndash; positive in 13.7% and whether they had ever had a stroke. The ability to drive is a multifactorial process in which vision plays an undeniable role. Visual acuity reflects the need for correction in the driving licence. The present research proves the need because it shows patients with poor vision driving and not at a young age who overestimate their general and visual objective condition.

The impacts of public space flagship projects on local communities: evidence from Atigh Square of Isfahan, Iran

The examination of the comprehensive effects of flagship projects on adjacent neighborhoods remains inadequately explored, particularly within developing countries. This scholarly void is expanding despite limited research on public space flagship projects. The current study delves into a problematic case study: Atigh Square, located within the historical center of Isfahan, Iran. This site has undergone substantial efforts to transform into a pedestrian-oriented public space, aimed at recapturing its original configuration fro the eleventh century. The 5 criteria of identity, economy, social, physical, and tourism features and 22 indicators attributed to them were extracted from the theoretical literature. Mixed methods research was pursued, using seminal publications, quantitative data from a questionnaire, and qualitative analysis of interviews conducted with several experts. Furthermore, the integration and connectivity of the area before and after regeneration was compared using Depth map software package. The results of the analysis show that the impact of the project in social, identity-related, infrastructural, and economic sub-criteria was weak, but it achieved relative success in terms of planning and tourism indicators. Besides, the sanitation sub-class received the highest rank whereas facilities and public services had the lowest rank among the sub-classes. As with the subjective and objective quality of life, the project was not a great success. Overall, although the project has considerably enhanced the physical and visual conditions of the area, it has failed to solve the social and economic problems of the surrounding fabric. The findings significantly contribute to the existing body of global literature concerning the impacts of flagship projects on surrounding areas, as the research explores diverse facets of these effects. The results underscore the necessity for flagship projects to be meticulously planned, taking into account not only the specific circumstances and challenges of local communities but also their integration into the broader socio-economic dynamics of the entire city.

Evaluating Visual Dependence in Postural Stability Using Smartphone and Stroboscopic Glasses

This study explores the efficacy of integrating stroboscopic glasses with smartphone-based applications to evaluate postural control, offering a cost-effective alternative to traditional forceplate technology. Athletes, particularly those with visual and visuo-oculomotor enhancements due to sports, often suffer from injuries that necessitate reliance on visual inputs for balance—conditions that can be simulated and studied using visual perturbation methods such as stroboscopic glasses. These glasses intermittently occlude vision, mimicking visual impairments that are crucial in assessing dependency on visual information for postural stability. Participants performed these tasks under three visual conditions: full vision, partial vision occlusion via stroboscopic glasses, and no vision (eyes closed), on foam surfaces to induce postural instability. The use of a smartphone app to measure postural sway was validated against traditional force plate measurements, providing a comparative analysis of both tools under varied sensory conditions. We investigated postural parameters like anterior–posterior and medial–lateral sway ranges, root mean square values, 95% confidence ellipse area, and sway velocity and median dominant sway frequency from both the smartphone and the force plates. Our findings indicate that force plates exhibit high sensitivity to various visual conditions, as evidenced by significant differences observed in certain postural parameters, which were not detected by smartphone-based measurements. Overall, our findings indicate that smartphones show promise as a cost-effective alternative to force plate measurements for routine monitoring of postural control in sports, although they may not achieve the same level of accuracy as force plates. The integration of stroboscopic glasses further refined the assessment by effectively simulating visual impairments, thereby allowing precise evaluation of an individual’s ability to maintain balance under visually perturbed conditions.

Solar responsive building glazing: Experimental analysis of the impact of photochromic glazing on indoor thermal and luminous conditions

The application of films on conventional glazing aims at increasing the glazing performance by reducing energy needs and increasing indoor comfort. Photochromic films in particular can alter their optical properties due to a chromatic change in response to solar radiation, allowing for reduced glare levels and solar heat gains. However, despite the potential of application, this refurbishment solution is still poorly explored. Therefore, the main purpose of this work was to experimentally evaluate the thermal and luminous performance of a double glazing with and without a photochromic film installed, using two office rooms in Lisbon as case study. An extended field experimental campaign was conducted simultaneously in both offices, where temperature, solar radiation and illuminance levels were collected. The key contribution and novelty of this research lies on the experimental assessment of the thermal and visual comfort conditions with the photochromic film under real-occupancy. Even though the photochromic film significantly increased the surface temperatures of the glazing, the indoor air temperature was not negatively affected, with an increase up to 14 % of working hours with comfortable temperature during the heating period. Illuminance levels on vertical/horizontal plane were reduced by 24/36 % in the presence of the photochromic film, when compared to the clear glazing without film, resulting in an increase of 7 % of working hours with useful illuminance during the heating period, and large areas in the office room with imperceptible daylight glare levels when facing the glazing system. The impact of the film was less noticeable during the cooling period.

A study on the effects of visual condition on postural stability in adults with and without chronic low back pain

This study was conducted to compare postural stability during repeated unilateral standing tasks between adults with and without chronic low back pain (LBP) while considering visual input. The study involved 26 participants with LBP and 39 control participants. Each participant performed three trials of standing tasks on the dominant limb using a stable platform. The Falls Efficacy Scale was utilized to assess fall-related self-efficacy and fear of falling due to potential physical frailty. The center of pressure (COP) sway excursion was analyzed at 10 mm and 20 mm thresholds for the time-in-boundary (TIB). The results indicated a significant fear of falling difference in the LBP group compared to the control group (t = 3.27, p = 0.001). The LBP group demonstrated a significant interaction between visual condition and TIB (F = 8.45, p = 0.01), particularly in the LBP group, which demonstrated a notable decrease in TIB at 10 mm (54.02 % compared to the control group's 70.40 %) and 20 mm (70.93 % compared to the control group's 85.92 %) thresholds during the second trial and at 10 mm (59.73 % compared to the control group's 73.84 %) during the third trial in the eyes open condition. Overall, visual condition demonstrated significant interactions on thresholds (F = 15.80, p = 0.001, η2p = 0.21) as well as trials × thresholds (F = 4.21, p = 0.04, η2p = 0.07). These findings indicate a potential adaptation in postural control among the LBP group with visual feedback. Further research is warranted to explore group differences when considering visual conditions and sway excursion thresholds.

Turning the operating room into a mixed-reality environment: a prospective clinical investigation for cerebral aneurysm clipping.

The overall aim of this study was to demonstrate the potential benefit of a novel mixed-reality-head-mounted display (MR-HMD) on the spatial orientation of surgeons. In a prospective clinical investigation, the authors applied for the first time a new multicamera navigation technology in an operating room setting that allowed them to directly compare MR-HMD navigation to standard monitor navigation. In the study, which included 14 patients with nonruptured middle cerebral artery aneurysms, the authors investigated how intuitively and effectively surgical instruments could be guided in 5 different visual navigation conditions. The authors demonstrate that multicamera tracking can be reliably integrated in a clinical setting (usability score 1.12 ± 0.31). Moreover, the technology captures large volumes of the operating room, allowing the team to track and integrate different devices and instruments, including MR-HMDs. Directly comparing mixed-reality navigation to standard monitor navigation revealed a significantly improved intuition in mixed reality, leading to navigation times that were twice as fast (2.1×, p ≤ 0.01). Despite the enhanced speed, the same targeting accuracy (approximately 2.5 mm, freehand tool use) in comparison to monitor navigation could be observed. Intraoperative planning strategies with mixed reality clearly outperformed classic preoperative planning: surgeons scored the mixed-reality plan as the best trajectory in 63% of the cases (chance level 33%). The incorporation of mixed reality in neurosurgical operations marks a significant advancement in the field. The use of mixed reality in brain surgery enhances the spatial awareness of surgeons, enabling more instinctive and precise surgical interventions. This technological integration promises to refine the execution of complex procedures without compromising accuracy.

Late mortality and chronic health conditions in long-term survivors of nasopharyngeal cancers: The 20-year follow-up of territory-wide Hong Kong Nasopharyngeal Cancer Survivor Study (HKNPCSS).

12045 Background: The survival rate of patients with nasopharyngeal cancer (NPC) has significantly improved in the last decade. However, there are only a few studies that have quantified the long-term morbidity and mortality that follow NPC treatment. This study aims to analyze the chronic health conditions, all-cause mortality, and cause-specific mortality among NPC survivors. Methods: The Hong Kong NPC Survivor Study (HKNPCSS) is a retrospective cohort study conducted across all six oncology centers in Hong Kong. It included longitudinal follow-up of 5-year survivors diagnosed with NPC between 1997 to 2015. We compared the standardized mortality ratio (SMRs) of 7893 survivors to a matched population in terms of age, sex, and calendar year. We also calculated the frequencies of chronic conditions of 7893 survivors and 23679 healthy individuals with matched age, sex, and date of cohort entry. Chronic health conditions were classified using the Common Terminology Criteria for Adverse Events. Cox proportional hazard models were used to estimate hazard ratios (HRs) for chronic health conditions. Results: The mean age of NPC survivors was 49.1 years, while healthy individuals had a mean age of 50.5 years. Among the 7893 NPC survivors, the 20-year cumulative all-cause mortality was 34.0% (95% CI, 29.1%-38.9%), with 1668 (59.9%) of 2785 deaths attributed to health-related causes. The SMR for NPC survivors compared to the general population was 3.81 (95% CI, 3.67-3.95), with the highest SMRs observed for pulmonary (SMR: 6.18, 95% CI, 5.73-6.64) and cardiovascular (SMR: 2.12, 95% CI, 1.90-2.36) causes. Among the survivors, 59.2% (n=4674) had severe, life-threatening, or fatal (grade 3-5) health conditions, with a 20-year cumulative incidence of 59.0% (95% CI, 56.4%-61.5%). The adjusted hazard ratio (HR) of grade 3-5 chronic condition in NPC survivors, compared to healthy cohorts, was 7.02 (95% CI, 6.64-7.42). Gastrointestinal (HR: 20.7), hearing, visual, and nasal (HR: 15.4), and neurological (HR: 8.39) conditions had the highest risks. Intensity modulated radiotherapy (IMRT), compared to non-IMRT, was associated with reduced risks of all-cause mortality (HR: 0.83, 95% CI, 0.74-0.91) and a trend towards reduced grade 3-5 chronic health conditions (HR: 0.89, 95% CI, 0.75-1.05). Conclusions: Even 20 years after diagnosis, NPC survivors still face increased risks of late mortality and morbidity. The findings emphasize the need for a comprehensive survivorship program to improve outcomes for NPC survivors.

Effects of Different Visual Flow Velocities on Psychophysiological Responses During Virtual Reality Cycling.

Virtual reality cycling (VRC) is simulated outdoor cycling with changes in scenery in virtual reality (VR) with rotating ergometer pedals. The speed at which the scenery changes, which is the visual flow velocity, can shift according to the same pedal rotation speed. This study investigated the effects of different visual flow velocities on the psychophysiological responses of cyclists using the VRC. Participants were asked to cycle for 20 min at 30% of their maximum exercise load under four conditions: (1) bicycle ergometer without VR (control), (2) VRC at normal visual flow velocity (VRC-normal), (3) VRC at 0.5 times the visual flow velocity of VRC-normal (VRC-slow), and (4) VRC at 1.5 times the visual flow velocity of VRC-normal (VRC-fast). The order of the four conditions was randomized in a counterbalanced design. The heart rate and rating of perceived exertion were recorded during the exercise. Participants graded their enjoyment of the task using the physical activity enjoyment scale (PACES). The measured data were analyzed by comparing the visual flow velocity conditions (VRC-slow, VRC-normal, and VRC-fast), and comparing the VRC and bicycle ergometer (VRC-normal and control). A total of 24 participants were enrolled in the study. There was a significant main effect observed in the PACES score (F(2,46)=20.129,p<0.001,partial η2=0.467). In the post-hoc test for the PACES, significant differences were found in the following combinations: VRC-normal > VRC-slow (p=0.005); VRC-fast > VRC-normal (p=0.003); and VRC-fast > VRC-slow (p<0.001). In the modified Borg scale for lower-limb fatigue, there were significant differences in time factor (F(2,46)=134.048, p<0.001, partial η2=0.854) and interaction effects (F(4,92)=3.156, p=0.018, partial η2=0.121). In the post-hoc test for the modified Borg scale, significant trends were found in the following combinations: VRC-normal > VRC-fast (p=0.068) and VRC-slow > VRC-fast (p=0.083). The results suggest that a slower visual flow velocity may reduce the enjoyment of exercise, whereas a faster visual flow velocity may make the exercise feel less fatigued and more enjoyable.

Emergency Response Person Localization and Vital Sign Estimation Using a Semi-Autonomous Robot Mounted SFCW Radar.

The large number and scale of natural and man-made disasters have led to an urgent demand for technologies that enhance the safety and efficiency of search and rescue teams. Semi-autonomous rescue robots are beneficial, especially when searching inaccessible terrains, or dangerous environments, such as collapsed infrastructures. For search and rescue missions in degraded visual conditions or non-line of sight scenarios, radar-based approaches may contribute to acquire valuable, and otherwise unavailable information. This article presents a complete signal processing chain for radar-based multi-person detection, 2D-MUSIC localization and breathing frequency estimation. The proposed method shows promising results on a challenging emergency response dataset that we collected using a semi-autonomous robot equipped with a commercially available through-wall radar system. The dataset is composed of 62 scenarios of various difficulty levels with up to five persons captured in different postures, angles and ranges including wooden and stone obstacles that block the radar line of sight. Ground truth data for reference locations, respiration, electrocardiogram, and acceleration signals are included.