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BackgroundCommonly offered as supportive care, therapist-led online support groups (OSGs) are a cost-effective way to provide support to individuals affected by cancer. One important indicator of a successful OSG session is group cohesion; however, monitoring group cohesion can be challenging due to the lack of nonverbal cues and in-person interactions in text-based OSGs. The Artificial Intelligence–based Co-Facilitator (AICF) was designed to contextually identify therapeutic outcomes from conversations and produce real-time analytics. ObjectiveThe aim of this study was to develop a method to train and evaluate AICF’s capacity to monitor group cohesion. MethodsAICF used a text classification approach to extract the mentions of group cohesion within conversations. A sample of data was annotated by human scorers, which was used as the training data to build the classification model. The annotations were further supported by finding contextually similar group cohesion expressions using word embedding models as well. AICF performance was also compared against the natural language processing software Linguistic Inquiry Word Count (LIWC). ResultsAICF was trained on 80,000 messages obtained from Cancer Chat Canada. We tested AICF on 34,048 messages. Human experts scored 6797 (20%) of the messages to evaluate the ability of AICF to classify group cohesion. Results showed that machine learning algorithms combined with human input could detect group cohesion, a clinically meaningful indicator of effective OSGs. After retraining with human input, AICF reached an F1-score of 0.82. AICF performed slightly better at identifying group cohesion compared to LIWC. ConclusionsAICF has the potential to assist therapists by detecting discord in the group amenable to real-time intervention. Overall, AICF presents a unique opportunity to strengthen patient-centered care in web-based settings by attending to individual needs. International Registered Report Identifier (IRRID)RR2-10.2196/21453

BackgroundThe recent onset of the COVID-19 pandemic and the social distancing requirement have created an increased demand for virtual support programs. Advances in artificial intelligence (AI) may offer novel solutions to management challenges such as the lack of emotional connections within virtual group interventions. Using typed text from online support groups, AI can help identify the potential risk of mental health concerns, alert group facilitator(s), and automatically recommend tailored resources while monitoring patient outcomes. ObjectiveThe aim of this mixed methods, single-arm study was to evaluate the feasibility, acceptability, validity, and reliability of an AI-based co-facilitator (AICF) among CancerChatCanada therapists and participants to monitor online support group participants’ distress through a real-time analysis of texts posted during the support group sessions. Specifically, AICF (1) generated participant profiles with discussion topic summaries and emotion trajectories for each session, (2) identified participant(s) at risk for increased emotional distress and alerted the therapist for follow-up, and (3) automatically suggested tailored recommendations based on participant needs. Online support group participants consisted of patients with various types of cancer, and the therapists were clinically trained social workers. MethodsOur study reports on the mixed methods evaluation of AICF, including therapists’ opinions as well as quantitative measures. AICF’s ability to detect distress was evaluated by the patient's real-time emoji check-in, the Linguistic Inquiry and Word Count software, and the Impact of Event Scale-Revised. ResultsAlthough quantitative results showed only some validity of AICF’s ability in detecting distress, the qualitative results showed that AICF was able to detect real-time issues that are amenable to treatment, thus allowing therapists to be more proactive in supporting every group member on an individual basis. However, therapists are concerned about the ethical liability of AICF’s distress detection function. ConclusionsFuture works will look into wearable sensors and facial cues by using videoconferencing to overcome the barriers associated with text-based online support groups. International Registered Report Identifier (IRRID)RR2-10.2196/21453

The worked example effect has been well documented within the framework of Cognitive Load Theory (CLT), which suggests that teaching with examples would be superior to engaging in unguided problem solving, particularly for novices, as using worked examples would reduce their cognitive load, compared to solving problems, thus facilitating knowledge retention. This paper, using multiple-step mathematics problems, reports an experiment investigating the micro level of the worked example effect on learning solution steps, from the perspective of cognitive load and challenge (as a relevant affective, motivational factor), testing the worked example effect with a transfer test. The results favoured worked examples on both the retention and transfer tests after learning and showed that using worked examples would reduce cognitive load and impose less challenge on each step during learning.

Background: Exoscope has been used in otoneurologic surgery in several reports. However, most ear surgeries are performed using either microscope or endoscopy today. The purpose of this study is to present our subjective and objective experience of using this instrument in our institution. Methods: Sixteen ears with different severity and condition in 15 consecutive patients were enrolled. A questionnaire with 12 questions was sent to different participants, including surgeons, residents, medical students, and scrub nurses in the operation room. The total score and average score of each item were calculated and analyzed. Results: Exclusive exoscopic operation was performed on 13 patients with 14 procedures. A combination of endoscopy-exoscope and microscope-exoscope was used in one patient, respectively. There were no complications. Hearing recovery or disease extirpation was achieved in most patients. Twenty participants in the operation room filled out the questionnaire. There was no significant difference between the different groups. High ratings were reported in terms of image quality, stereoscopic effects, magnification rate, and the same field of view as the surgeon. Worse ratings were reported in items related to limited working space, increase in eye strain by video observation, and focusing difficulty. Conclusion: Exoscopic ear surgery is feasible, safe, and effective in managing various otologic conditions involving external ear, middle ear, mastoid, and lateral skull base. Its high-definition image quality, stereoscopic effects, sufficient magnification, reliability and teaching value made it a potential instrument in general ear surgeries. Further improvements to current drawbacks can be anticipated. [ABSTRACT FROM AUTHOR]

Background: The prevalence of adult cochlear implant (CI) surgery is increasing. However, the relevant adult CI data in Taiwan are insufficient due to the relatively small number of adult implant patients. The two main factors hindering adult implantation are the high cost of the surgery itself and inadequate knowledge regarding the effectiveness of CI for hearing and suppression of tinnitus. Here, we present data regarding adult CI outcomes from a single tertiary hospital. Methods: A total of 116 consecutive adult CI recipients (=18 years old) who completed at least 12 months of speech perception tests (words and sentences) between January 1999 and December 2020 were enrolled in this retrospective population-based cohort study. Thirty patients completed speech perception (words and sentences) testing as well as three questionnaires relating to quality of life, and 71 completed full tinnitus suppression studies. Subjects' pre- and post-CI questionnaires were evaluated to assess overall CI outcome. Results: For auditory evaluation, the scores of easy sentences (ES), difficult sentences (DS), and phonetically balanced (PB) word recognition tests reached a plateau at 3 months post-CI (p = 0.005, 0.001, and 0.004, respectively) in most subjects. The post-CI scores of bodily pain, mental health, and social role functioning were significantly higher than corresponding pre-CI scores on the SF-36 Health Survey-Taiwan version (p = 0.036, 0.019, and 0.002, respectively). Furthermore, the post-CI scores of basic sound perception, speech production, and advanced sound perception were significantly higher than the corresponding pre-CI scores on the Nijmegen Cochlear Implant Questionnaire (p < 0.001, 0.013, and <0.001, respectively). Self-esteem was significantly correlated with the Categories of Auditory Performance scale and Speech Intelligibility Rating scale at 3, 6, and 9 months post-CI. CI improved tinnitus in approximately 65.1% of 71 adults. Based on the Tinnitus Handicap Inventory, 66.7% of patients were in grade 3-5 before surgery. However, after CI, only 34.4% of patients remained in THI grade 3-5. Conclusion: This study confirmed that CI can improve speech perception (words and sentences), physical health, mental health, social interaction, and self-esteem in adult patients with profound hearing loss. CI also significantly alleviated tinnitus. The outcomes of ES, DS, and PB tests at 3 months post-CI were non-inferior to other longer post-CI periods and could be utilized as references for recovery and evaluation of prognosis. [ABSTRACT FROM AUTHOR]

This study is to compare the knee kinematic measurements between the novel portable skin marker-based motion analysis system (Opti-Knee®) and a conventional system (Vicon®). Nineteen subjects were recruited and asked to perform stair descent with lower limb placed with skin markers. Knee kinematic data was computed from the trajectories of the skin markers. Pearson's correlation coefficient and Root-mean-square deviation (RMSD) were used to analyse the data. For the waveform, sagittal plane rotation is strongly positive correlated between systems, while for axial and coronal plane rotation, it was moderately to strongly positive correlated in both normal (ACLN) and ACL-deficient (ACLD) group. Substantial difference between two groups was found in correlation of abduction/adduction in both stance and swing phase, as well as in external/internal rotation in all selected regions of interest. Moreover, the RMSD was larger in ACLN than in ACLD in three planes of rotation. The capability of Opti-Knee® in tracking lower limb sagittal plane rotation was comparable to Vicon®. However, for coronal and axial plane rotation, although the correlation to Vicon® in kinematic waveforms was moderately high, their ROM and peak values substantially deviated from the values in Vicon®. [ABSTRACT FROM AUTHOR]

Background/Objective: Evaluating hamstring strength by isokinetic dynamometry is limited by various practical issues such as time and cost. A video-based Nordic hamstring exercise is introduced as an alternative option. The aims of this study are to evaluate 1.) the between-session reliability and 2.) concurrent validity of the testing method compared to a standardized isokinetic dynamometry. Methods: Thirty male elite footballers were recruited for the study. From the Nordic hamstring exercise, the video-analysis-determined Nordic break-point angles where the participant could no longer withstand the force of the fall (eccentric mode) and the number of seconds that the player could hold at 30° forward flexion angle (isometric mode) were measured. Intra-class correlation coefficients for betweensession reliability, Pearson r correlations between the current method and isokinetic dynamometry were calculated. Results: The reliability of the eccentric mode was moderate (ICC(2,1) = 0.82) while that of isometric mode was poor (ICC(2,1) = 0.57). The Nordic break-point angle of the eccentric mode significantly correlated with the concentric and eccentric hamstring peak torque (r = 0.48 and 0.58, p < 0.001), while the isometric was not (r = 0.02 - 0.07, p > 0.05). Conclusion: The eccentric mode of the video-based hamstring strength test was a moderately reliable and valid method to measure the eccentric hamstring strength in elite football players. [ABSTRACT FROM AUTHOR]

The article presents a study which examined if low intensity pulsed ultrasound (LIPUS) effects on matrix synthesis change at various stages of tendon healing. Based on results, a single sonication of LIPUS increased collagen type COL1A1 and COL3A1 messenger Ribonucleic Acid (mRNA) in healing patellar tendons on application on the fourth or 14th day following injury, but not on the 28th day. It is stated that to promote tendon healing, LIPUS should be administered during the granulation phase and not during the remodeling phase.

Extra-adrenal paragangliomata are uncommon entities. They can be classified into four basic groups according to their anatomical sites, i.e. branchiomeric, intravagal, aorticosympathetic and visceral autonomic. Similar tumours may arise in sites away from the usual distribution of the sympathetic and parasympathetic ganglia, e.g. orbit, nose, small intestine and even in the pancreas. We report three instructive cases of extra-adrenal paraganglioma which were found in unusual sites such as urinary bladder, thyroid gland and on the wall of the inferior vena cava. [ABSTRACT FROM AUTHOR]

The article presents the results of a study which investigated the effects of a program of tai chi chuan (TCC) exercises on bone mineral density (BMD) and the prevention of osteoporosis in older people. A relatively low-intensity exercise which can be easily practiced by most older people, TCC was found to improve coordination and balance, preventing falls. Its effects on BMD, while positive, were limited.

Despite preference for community-based living, large numbers of people with psychiatric disabilities live in nursing homes throughout the US. Community-based services for this population are limited by public policy and service system barriers. This paper summarizes these barriers and presents the second phase of a participatory action research project jointly developed by university-based researchers and two Centers for Independent Living. A qualitative case study methodology was used to understand the experiences of three individuals with psychiatric disabilities reintegrating into the community from nursing homes. Findings revealed themes of social isolation, participation in virtual communities, variability of impairment experiences and unmet needs for community supports. In addition to thematic findings, action products were generated for the benefit of community partners. These products included national best practice resources and a needs assessment survey tool. Study findings and products point to specific systems change and policy recommendations to better support community reintegration for this population. These recommendations are discussed in light of U.S. healthcare reform and broader disability advocacy efforts. [ABSTRACT FROM AUTHOR]