scholarly journals Immersive Virtual Grocery Shopping to Induce and Measure Cognitive Fatigue: A Two-Phase Randomized Control Trial (Preprint)

2021 ◽  
Author(s):  
Jim Holdnack ◽  
Patricia Flatley Brennan

BACKGROUND Cognitive fatigue (CF) is a human response to stimulation and stress that is a common comorbidity in many medical conditions that can result in serious consequences, yet it is difficult to study under controlled conditions. Immersive virtual reality provides an experimental environment that enables precise measurement of an individual’s response to complex stimuli in a controlled environment. OBJECTIVE We propose to develop an immersive virtual shopping experience to measure subjective and objective indicators of cognitive fatigue induced by an instrumental activities of daily living (IADL). METHODS We propose to recruit 84 healthy participants aged 18-75 for a two-phase study. Phase 1 is a user experience (UX) study to test the software functionality, user interface, and realism of the virtual shopping environment. Phase 2 employs a 3-arm randomized control trial to determine the effect of the immersive environment on fatigue. Participants will be randomized into one of three conditions exploring fatigue response during a typical human activity (grocery shopping) while varying the level of cognitive and emotional challenge. The primary outcome of phase 1 is the experience of user-interface difficulties. The primary outcome of phase 2 is self-reported cognitive fatigue. Core secondary phase two outcomes include subjective cognitive load, change in task performance behavior and eye-tracking. Phase two utilizes within-subjects repeated measures ANOVA to compare pre- and post-fatigue measures under three conditions (control, cognitive challenge, emotional challenge). RESULTS This study was approved by the scientific review committee of the National Institute of Nursing Research and identified as an exempt study by Institutional Review Board of the National Institutes of Health. Data collection will begin Spring 2021. CONCLUSIONS Immersive VR may be a useful research platform for simulating induction of cognitive fatigue associated with the cognitive and emotional challenges of an instrumental activity of daily living.

2016 ◽  
Vol 60 (1) ◽  
pp. 46-52 ◽  
Author(s):  
Nalini Gupta ◽  
John Crossley ◽  
Nick Dudding ◽  
John H.F. Smith

Objective: The cytomorphological criteria of malignant endometrial lesions in cervical samples are less well described than those of cervical lesions. We wished to investigate if there were features in SurePath™ liquid-based cytology samples that would facilitate more accurate differentiation between benign and malignant endometrial cells. Study Design: This was a two-phase study, with a review of all SurePath™ samples reported as endometrial adenocarcinoma (n = 42) evaluating 12 cytological features in the first phase. In phase 2 (test set), all initial cases plus an additional 83 cases were reviewed using these 12 cytological features to predict the outcome. Results: Out of 12 cytological features evaluated in phase 1 (training set), nuclear chromatin pattern, apoptotic bodies and tingible body macrophages were found to be the most significant features determining malignant histological outcome. These 12 cytological features were re-evaluated in phase 2 (n = 125). Of 125 cases, 54 had a benign and 71 had a malignant or premalignant histological outcome, with a positive predictive value of 56.8%. Conclusion: Granular nuclear chromatin, tingible body macrophages and apoptosis in the background are the most significant factors in determining whether endometrial cells present in cervical samples represent malignancy or are benign. Using these features, relatively accurate predictions of endometrial pathology can be made.


2021 ◽  
Author(s):  
Christina Mutschler ◽  
Jen Rouse ◽  
Kelly McShane ◽  
Criss Habal-Brosek

Background Psychosocial rehabilitation is a service that supports recovery from mental illness by providing opportunities for skill development, self-determination, and social interaction. One type of psychosocial rehabilitation is the Clubhouse model. The purpose of the current project was to create, test, and refine a realist theory of psychosocial rehabilitation at Progress Place, an accredited Clubhouse. Method Realist evaluation is a theory driven evaluation that uncovers contexts, mechanisms, and outcomes, in order to develop a theory as to how a program works. The current study involved two phases, encompassing four steps: Phase 1 included (1) initial theory development and (2) initial theory refinement; and Phase 2 included (3) theory testing and (4) refinement. Results The data from this two-phase approach identified three demi-regularities of recovery comprised of specific mechanisms and outcomes: the Restorative demi-regularity, the Reaffirming demi-regularity, and the Re-engaging demi-regularity. The theory derived from these demi-regularities suggests that there are various mechanisms that produce outcomes of recovery from the psychosocial rehabilitation perspective, and as such, it is necessary that programs promote a multifaceted, holistic perspective on recovery. Conclusions The realist evaluation identified that Progress Place promotes recovery for members. Additional research on the Clubhouse model should be conducted to further validate that the model initiates change and promotes recovery outcomes.


2019 ◽  
Vol 119 (4) ◽  
pp. 246-258
Author(s):  
Mark Dooris ◽  
Alan Farrier ◽  
Susan Powell ◽  
Maxine Holt

Purpose The purpose of this paper is to report on an evaluation of the UK Healthy Universities Network (UKHUN), which explored engagement of network members; identified what members value about the network; examined facilitators and barriers to engagement; and informed the network’s future development. Design/methodology/approach The study was a two phase mixed-method study, with participants being staff from Higher Education institutions. Phase 1 involved a documentary review and an online 14-question survey (n=32). Phase 2 comprised follow-up semi-structured interviews and focus groups, conducted using Skype (n=11). These were audio recorded and transcripts were thematically analysed in a two-stage process. Findings A number of key themes emerged from the thematic analysis: value of network meetings and events; popularity of the network website; increased communication and collaboration; sense of leadership offered by the network; interest and inclusion of an international perspective; importance of institutional support. Research limitations/implications Only six universities who are involved in the network took part in Phase 2. Although a range of organisations were chosen purposively, it is possible that additional key issues at other universities were excluded. Originality/value The UKHUN is valued by its membership, particularly its biannual meetings, online presence, leadership, ethos and communication methods. Key barriers include the capacity of staff to attend meetings and contribute to the network, influenced by a lack of institutional commitment and prioritisation. Findings from the evaluation have informed a “refresh” of the network’s website and a revision of its membership structure, as well as guiding its positioning to achieve greater strategic influence.


Geophysics ◽  
1984 ◽  
Vol 49 (5) ◽  
pp. 550-565 ◽  
Author(s):  
Chong‐Yung Chi ◽  
Jerry M. Mendel ◽  
Dan Hampson

In this paper we derive and implement a maximum‐likelihood deconvolution (MLD) algorithm, based on the same channel and statistical models used by Kormylo and Mendel (1983a), that leads to many fewer computations than their MLD algorithm. Both algorithms can simultaneously estimate a nonminimum phase wavelet and statistical parameters, detect locations of significant reflectors, and deconvolve the data. Our MLD algorithm is implemented by a two‐phase block component method (BCM). The phase‐1 block functions like a coarse adjustment of unknown quantities and provides a set of good initial conditions for the phase‐2 block, which functions like a fine adjustment of unknown quantities. We demonstrate good performance of our algorithm for both synthetic and real data.


Author(s):  
Jochen Jaeger ◽  
Dieter Weichenhan ◽  
Boris Ivandic ◽  
Rainer Spang

We present a novel, cost efficient two-phase design for predictive clinical gene expression studies: early marker panel determination (EMPD). In Phase-1, genome-wide microarrays are used only for a small number of individual patient samples. From this Phase-1 data a panel of marker genes is derived. In Phase-2, the expression values of these marker panel genes are measured for a large group of patients and a predictive classification model is learned from this data. Phase-2 does not require the use of expensive whole genome microarrays, thus making EMPD a cost efficient alternative for current trials. The expected performance loss of EMPD is compared to designs which use genome-wide microarrays for all patients. We also examine the trade-off between the number of patients included in Phase-1 and the number of marker genes required in Phase-2. By analysis of five published datasets we find that in Phase-1 already 16 patients per group are sufficient to determine a suitable marker panel of 10 genes, and that this early decision compromises the final performance only marginally.


Blood ◽  
1993 ◽  
Vol 81 (10) ◽  
pp. 2591-2599 ◽  
Author(s):  
RS Weinberg ◽  
JC Thomson ◽  
R Lao ◽  
G Chen ◽  
BP Alter

A two-phase liquid-culture system was used to substantially amplify and differentiate erythroblasts, starting with mononuclear cells from the blood of normal adults, newborn infants, and patients with sickle cell anemia. After the first 7 days (phase 1), in medium plus fetal bovine serum (FBS) alone, or in combination with stem cell factor (SCF) or conditioned medium (CM), the cell number was unchanged, and the cells all looked like lymphocytes. These cells were then diluted into medium with erythropoietin (Ep) alone, with Ep and either SCF or CM, or in methylcellulose with the same factors (phase 2). After 14 days in liquid phase 2 with SCF and Ep, the cell numbers increased an average of 30-fold in the sickle, 24-fold in the newborn, and 4-fold in the normal adult cultures; almost all the cells were erythroblasts and erythrocytes. SCF in phase 1 increased the number of late progenitors (CFU-E) assayed in methylcellulose, with the largest number in sickle, followed by newborn cultures and then adult cultures. We conclude that erythroid progenitor cells survive for at least 7 days without Ep (but with FBS). Progenitor cells are amplified, particularly with SCF. Later in culture, SCF with Ep increases the final number of differentiated erythroid cells. Both the early and the late effects of SCF are most effective in sickle, followed by newborn cultures and then adult cultures.


Author(s):  
Jinqing Li ◽  
Xiaojun Chen ◽  
Dakui Wang ◽  
Yuwei Li

Fine-Grained Entity Typing (FGET) is a task that aims at classifying an entity mention into a wide range of entity label types. Recent researches improve the task performance by imposing the label-relational inductive bias based on the hierarchy of labels or label co-occurrence graph. However, they usually overlook explicit interactions between instances and labels which may limit the capability of label representations. Therefore, we propose a novel method based on a two-phase graph network for the FGET task to enhance the label representations, via imposing the relational inductive biases of instance-to-label and label-to-label. In the phase 1, instance features will be introduced into label representations to make the label representations more representative. In the phase 2, interactions of labels will capture dependency relationships among them thus make label representations more smooth. During prediction, we introduce a pseudo-label generator for the construction of the two-phase graph. The input instances differ from batch to batch so that the label representations are dynamic. Experiments on three public datasets verify the effectiveness and stability of our proposed method and achieve state-of-the-art results on their testing sets.


2019 ◽  
Author(s):  
Cornelia Betsch ◽  
Katrine Habersaat ◽  
Sergei Deshevoi ◽  
Dorothee K. Heinemeier ◽  
Natalia Kostenko ◽  
...  

Background: Published in 2018, the 5C scale is psychometrically validated to assess five psychological antecedents of vaccination (confidence, complacency, constraints, calculation, and collective responsibility). The original version offers a validated English and German scale to assess these determinants with a short 5-item scale (1 item per antecedent) and a long 15-item scale (3-items per antecedent). As the original group of authors has received several requests about how to adapt the scale to another country, language, or cultural context, this sample study protocol provides guidance for this process. Here, we propose a two-phase process of how to adapt the 5C scale to a new country, language, or cultural setting. Methods: Phase 1 comprises the translation and the adaptation to a specific cultural context (if necessary). Phase 2 involves the validation of the translated and potentially expanded scale. Discussion: Following the suggested study protocol will allow better comparability across the data obtained from the scale when used in different countries, languages, and contexts—even if slight changes in the wording of the items are necessary. The data obtained from the 5C scale allows monitoring the antecedents of vaccination, and detecting potentially early warning signals. Consequently, data obtained from the 5C scale can support developing, implementing, and evaluating an intervention. The materials and the syntax for data analysis to support the process described in this protocol are available in https://osf.io/2agxe/.


2014 ◽  
Vol 32 (4_suppl) ◽  
pp. 298-298 ◽  
Author(s):  
Bernard H. Bochner ◽  
Andrew Feifer ◽  
Dahlia Sperling ◽  
Joseph W Mashni ◽  
Dean F. Bajorin ◽  
...  

298 Background: Level 1 evidence supports a survival benefit for BlCa pts that receive periop cisplatin chemotherapy in addition to radical cystectomy (RC). Underutilization of multimodal therapy has been reported nationally. We instituted a multicenter QCI to improve the use of periop chemotherapy. Methods: A two phase effort was initiated at 16 academic institutions. Phase 1 was initiated in 2010 and designed to evaluate baseline patterns of periop chemotherapy use for T2-4N0M0 BlCa pts that underwent RC between 2003-2008. Phase 2 was a prospective QCI. The quality indicators included (1) referral to medical oncology for consideration of multimodality therapy, (2) neoadjuvant, if recommended, be cisplatin based and at least 3 cycles, (3) adjuvant, if recommended, be cisplatin based and at least 3 cycles, (4) all treatment be completed within 6 months. Data on all eligible pts were collected prospectively for 12 months on a web-based survey system. Results: All 16 centers participated in phase 1. Of 4,344 pts on whom data was available, 34% received periop chemotherapy. Neoadjuvant and adjuvant therapy use was 14% and 20%, respectively. 65% of pts receiving periop chemotherapy were treated with a cisplatin-based regimen. Of those treated neoadjuvantly, cisplatin was received in 70% of cases. Nine of the 16 institutions completed phase 2 data collection. Over 700 pts that underwent RC were evaluated. 395 pts with T2-4N0M0 disease were deemed eligible for data entry. Fifty-six percent of eligible pts received periop systemic chemotherapy. Of this 56%, 47% received neoadjuvant cisplatin chemotherapy and 9% received adjuvant cisplatin chemotherapy. This represented a 64.7% increase in the use of any periop chemotherapy and a 3.4 fold increase in neoadjuvant chemotherapy compared to baseline data. Conclusions: We have successfully completed a multi-institutional QCI to improve the use of periop chemotherapy in pts undergoing RC for resectable, non-metastatic bladder cancer. Our data demonstrates that significant improvements can be achieved in not only overall use of periop chemotherapy but most notably in the use of neoadjuvant chemotherapy.


2020 ◽  
Author(s):  
Rachel O'Donnell ◽  
Grace Lewis ◽  
Colin Lumsdaine ◽  
Giovanna Di Tano ◽  
Liz Swanston ◽  
...  

Abstract Background Childhood exposure to second-hand smoke in the home is largely associated with socio-economic disadvantage. Disadvantaged parents face specific challenges creating a smoke-free home, often caring for children in accommodation without access to outdoor garden space. Existing home interventions largely fail to accommodate these constraints. Innovative approaches are required to address this inequality. In this two-phase study, we engaged with parents living in disadvantaged areas of Edinburgh, Scotland, to explore tailored approaches to creating a smoke-free home and develop and pilot-test an intervention based on their views and preferences.Methods In Phase 1, qualitative interviews with 17 parents recruited from Early Years Centres explored alternative approaches to smoke-free home interventions. In Phase 2, an intervention based on parents’ views and preferences was pilot tested with parents recruited through Early Years and Family Nurse Partnership centres. 17 parents took part in an interview to share their views/experience of the intervention. Data from both study phases were thematically analysed.Results Phase 1 findings suggested that parents associated nicotine replacement therapy (NRT) with quit attempts, but supported the idea of NRT use for temporary abstinence to create a smoke-free home, viewing this as a safer option than using e-cigarettes indoors. In Phase 2, 54 parents expressed an interest in accessing NRT to create a smoke-free home, 32 discussed NRT product choice during a home visit from a smoking adviser, and 20 collected their free NRT prescription from the pharmacy. NRT was used for up to 12 weeks in the home, with ongoing advice available from pharmacy staff. During qualitative interviews (N = 17), parents self-reported successfully creating a smoke-free home; quitting smoking; and reduced cigarette consumption, often exceeding their expectations regarding changes made. The intervention was acceptable to parents, but the multi-step process used to access NRT was cumbersome. Some participants were lost to this process.Conclusions Parents living in disadvantage may benefit from access to NRT for temporary abstinence in the home to assist them to protect their children from second-hand smoke exposure. Further research using a more streamlined approach to NRT access, is required to determine the feasibility and cost-effectiveness of this approach.


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