Search

Background: Children and young adults needing surgery for a primary malignant bone tumour around the knee face a difficult, life-changing decision. A previous study showed that this population wants to be involved more in the decision-making process and that more involvement leads to less decisional stress and regret. Therefore, a well-designed and standardized decision-making process based on the principles of shared decision-making needs to be designed, implemented, and evaluated., Methods: We developed a shared decision-making (SDM) model for this patient population, including an online decision aid (DA). This model has been implemented in the standard care of patients with a primary malignant bone tumour around the knee. Following implementation, we will analyse its effect on the decision-making process and the impact on patient experiences using questionnaires and interviews. Moreover, potential areas for improvement will be identified., Discussion: Given the importance of involving patients and parents in surgical decision-making, particularly in life-changing surgery such as malignant bone tumour surgery, and given the lack of SDM models applicable for this purpose, we want to share our model with the international community, including our study protocol for evaluating and optimising the model. This study will generate valuable knowledge to facilitate the optimisation of current patient care for local treatment. The sharing of our implementation and study protocol can serve as an example for other centres interested in implementing SDM methods in an era characterized by more empowered patients and parents who desire autonomy and reliable and realistic information., (© 2024. The Author(s).)

This systematic review provides a structured overview of the measurement instruments of functional outcome used in lower extremity and pelvic bone sarcoma patients. We identified 42 unique instruments covering 18 distinct functional outcome constructs with most studies measuring constructs within the activity domain of the International Classification of Functioning, disability, and health. The MusculoSkeletal Tumor Society 1993 and 1987 score, Toronto Extremity Salvage Score, and range of motion instruments were the measurement instruments most commonly used., (© 2024 Wiley Periodicals LLC.)

Therapy for public speaking phobia using virtual reality exposure (VRE) has focused on distress arousal rather than distress habituation. Understanding habituation will help optimise session duration, making treatment more affordable and accessible. This pilot study utilised within-speech repeated measures to examine distress habituation during three brief public speaking scenarios in a non-clinical sample (n = 19; 18-76 years). VRE elicited significant distress in all three scenarios. Although within-scenario distress habituation was not observed, between-scenario habituation was partially supported. An increase in distress during the second scenario indicated that three consecutive speech performances were critical in achieving habituation. Brief repeated VRE scenarios using an agent audience were effective in eliciting public speaking distress, as well as habituation., Competing Interests: I have read the journal’s policy and the authors of this manuscript have the following competing interests: Virtual Human Technologies provided support in the form of materials (software). This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Objectives: Previous research demonstrated decreased cardiorespiratory fitness (CRF) in patients with JDM during active disease and remission. However, longitudinal data regarding trajectories of CRF are currently lacking. The objective of this study was to determine trajectories of CRF in patients with both monocyclic and chronic JDM, and to identify potential predictors of these trajectories., Methods: Thirty-six patients with JDM [median age (interquartile range) at diagnosis: 8.3 (6.3-15.4) years] treated in our paediatric rheumatology outpatient clinic were included. All patients performed multiple cardiopulmonary exercise tests between 2003 and 2016. Relevant CRF parameters were analysed, including peak oxygen uptake, maximal workload, mechanical efficacy and oxygen uptake at ventilatory anaerobic threshold. We analysed trajectories up to 10 years after diagnosis and determined predictors of CRF outcome parameters by multilevel analyses., Results: Trajectories demonstrated significant declines in CRF during the active phase of the disease with subsequent improvement in CRF during the initial years after diagnosis. However, hereafter no further improvements, and even a decrease, in CRF were observed over time in both monocyclic and chronic subtypes of JDM. We found that a longer disease duration, younger age of onset and higher prednisone dose negatively influence CRF., Conclusion: Patients with both monocyclic and chronic JDM show decreases in long-term CRF trajectories. Longer disease duration, younger age of onset and higher prednisone dose negatively influence CRF. This study stresses the need for regular evaluation of CRF and implementation of (exercise) interventions to improve CRF in patients with JDM, even in monocyclic patients., (© The Author 2017. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com)

We designed an observational study where participants (n = 17) were exposed to pictures and look-alike avatars pictures of themselves, a familiar friend or an unfamiliar person. By measuring participants' brain activity with electroencephalography (EEG), we found face-recognition event related potentials (ERPs) in the visual cortex, around 200-250 ms, to be prominent for the different familiarity levels. A less positive component was found for self-recognized pictures (P200) than pictures of others, showing similar effects in both real faces and look-alike avatars. A rapid adaptation in the same component was found when comparing the neural processing of avatar faces vs. real faces, as if avatars in general were assimilated as real face representations over time. ERP results also showed that in the case of the self-avatar, the P200 component correlated with more complex conscious encodings of self-representation, i.e., the difference in voltage in the P200 between the self-avatar and the self-picture was reduced in participants that felt the avatar looked like them. This study is put into context within the literature of self-recognition and face recognition in the visual cortex. Additionally, the implications of these results on look-alike avatars are discussed both for future virtual reality (VR) and neuroscience studies.

Agency, the attribution of authorship to an action of our body, requires the intention to carry out the action, and subsequently a match between its predicted and actual sensory consequences. However, illusory agency can be generated through priming of the action together with perception of bodily action, even when there has been no actual corresponding action. Here we show that participants can have the illusion of agency over the walking of a virtual body even though in reality they are seated and only allowed head movements. The experiment (n = 28) had two factors: Perspective (1PP or 3PP) and Head Sway (Sway or NoSway). Participants in 1PP saw a life-sized virtual body spatially coincident with their own from a first person perspective, or the virtual body from third person perspective (3PP). In the Sway condition the viewpoint included a walking animation, but not in NoSway. The results show strong illusions of body ownership, agency and walking, in the 1PP compared to the 3PP condition, and an enhanced level of arousal while the walking was up a virtual hill. Sway reduced the level of agency. We conclude with a discussion of the results in the light of current theories of agency.

It has been shown that it is possible to induce a strong illusion that a virtual body (VB) is one's own body. However, the relative influence of a first-person-perspective (1PP) view of the VB and spatial coincidence of the real body and VB remains unclear. We demonstrate a method that permits separation of these two factors. It provides a 1PP view of a VB, supporting visuomotor synchrony between real body and VB movements, but where the entire scene including the body is rotated 15 degrees upwards through the axis connecting the eyes, so that the VB and real body are coincident only through this axis. In a within-subjects study that compared this 15 degrees rotation with a 0 degrees rotation condition, participants reported only slightly diminished levels of perceived ownership of the VB in the rotated condition and did not detect the rotation of the scene. These results indicate that strong spatial coincidence of the virtual and real bodies is not necessary for a full-body ownership illusion. The rotation method used, similar to the effects of vertical prisms, did not produce significant negative side-effects, thus providing a useful methodology for further investigations of body ownership.