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PubMed1998

Place cells, navigational accuracy, and the human hippocampus.

The hippocampal formation in both rats and humans is involved in spatial navigation. In the rat, cells coding for places, directions, and speed of movement have been recorded from the hippocampus proper and/or the neighbouring subicular complex. Place fields of a group of the hippocampal pyramidal cells cover the surface of an environment but do not appear to do so in any systematic fashion. That is, there is no topographical relation between the anatomical location of the cells within the hippocampus and the place fields of these cells in an environment. Recent work shows that place cells are responding to the summation of two or more Gaussian curves, each of which is fixed at a given distance to two or more walls in the environment. The walls themselves are probably identified by their allocentric direction relative to the rat and this information may be provided by the head direction cells. The right human hippocampus retains its role in spatial mapping as demonstrated by its activation during accurate navigation in imagined and virtual reality environments. In addition, it may have taken on wider memory functions, perhaps by the incorporation of a linear time tag which allows for the storage of the times of visits to particular locations. This extended system would serve as the basis for a spatio-temporal event or episodic memory system.

Animals↗

PubMed2004

Virtual patient: a photo-real virtual human for VR-based therapy.

A high fidelity Virtual Human Interface (VHI) system was developed using low-cost and portable computers. The system features real-time photo-realistic digital replicas of multiple individuals capable of talking, acting and showing emotions and over 60 different facial expressions. These virtual patients appear in a high-performance virtual reality environment featuring full panoramic backgrounds, animated 3D objects, behavior and AI models, a complete vision system for supporting interaction and advanced animation interfaces. The VHI takes advantage of the latest advances in computer graphics. As such, it allows medical researchers and practitioners to create real-time responsive virtual humans for their experiments using computer systems priced under $2000.

Computer Graphics↗

PubMed2003

Teaching Pharmacology in 2010--new knowledge, new tools, new attitudes.

Changes in pharmacology teaching are being driven by various pressures. These originate: from changes in the discipline itself; from government; from professional bodies; from students; from changes in teaching styles and opportunities; from academic staff; from ethical/animal rights considerations; from employers and from higher education institutions. These changes will require an alteration in the knowledge, skills and attitudes of academic pharmacologists as much as they will require changes in the way teaching is delivered and learning is facilitated. Pharmacology courses will be provided in a changed environment and must prepare students to work in a changed discipline as well as being appropriate for students who will take employment in non-pharmacology areas. Change is likely to centre around the curriculum, problem based learning, simulated practicals, peer assessment, use of the internet, information technology and interactive computer based learning, virtual learning environments and integrated medical courses. The most effective strategy to achieve the necessary changes is likely to involve collaboration between pharmacology teachers on a global scale and a general consciousness among current academic pharmacologists that we need to ensure tomorrow's academics are well prepared for the changed environment in which they will have to work.

Attitude of Health Personnel↗

PubMed2001

Incidental memory and navigation in panoramic virtual reality for electronic commerce.

Recently much effort has been dedicated to designing and implementing World Wide Web sites for virtual shopping and e-commerce. Despite this effort, relatively little empirical work has been done to determine the effectiveness with which different site designs sell products. We report three experiments in which participants were asked to search for products in various experimental e-commerce sites. Across the experiments participants were asked to search in either QTVR (QuickTime Virtual Reality), hypertext, or pictorially rich hypertext environments; they were then tested for their ability to recall the products seen and to recognize product locations. The experiments demonstrated that when using QTVR (Experiments 1, 2, and 3) or pictorial environments (Experiment 2), participants retained more information about products that were incidental to their goals. In two of the experiments it was shown that participants navigated more efficiently when using a QTVR environment. The costs and benefits of using 3D virtual environments for on-line shops are discussed. Actual or potential applications of this research include support for the development of e-commerce design guidelines.

Adult↗

PubMed2001

The VEPSY updated project: virtual reality in clinical psychology.

Many of us grew up with the naive assumption that couches are the best used therapeutic tools in psychotherapy. But tools for psychotherapy are evolving in a much more complex environment than a designer's chaise lounge. In particular, virtual reality (VR) devices have the potential for appearing soon in many consulting rooms. The use of VR in medicine is not a novelty. Applications of virtual environments for health care have been developed in the following areas: surgical procedures (remote surgery or telepresence, augmented or enhanced surgery, and planning and simulation of procedures before surgery); preventive medicine and patient education; medical education and training; visualization of massive medical databases; and architectural design for health care facilities. However, there is a growing recognition that VR can play an important role in clinical psychology, too. To exploit and understand this potential is the main goal of the Telemedicine and Portable Virtual Environment in Clinical Psychology--VEPSY Updated--a European Community-funded research project (IST-2000-25323, http://www.vepsy.com). The project will provide innovative tools-telemedicine and portable-for the treatment of patients, clinical trials to verify their viability, and action plans for dissemination of its results to an extended audience-potential users and influential groups. The project will also develop different personal computer (PC)-based virtual reality modules to be used in clinical assessment and treatment. In particular, the developed modules will address the following pathologies: anxiety disorders; male impotence and premature ejaculation; and obesity, bulimia, and binge-eating disorders.

Adult↗

PubMed2000

Head-related transfer functions of the Rhesus monkey.

Head-related transfer functions (HRTFs) are direction-specific acoustic filters formed by the head, the pinnae and the ear canals. They can be used to assess acoustical cues available for sound localization and to construct virtual auditory environments. We measured the HRTFs of three anesthetized Rhesus monkeys (Macaca mulatta) from 591 locations in the frontal hemisphere ranging from -90 degrees (left) to 90 degrees (right) in azimuth and -60 degrees (down) to 90 degrees (up) in elevation for frequencies between 0.5 and 15 kHz. Acoustic validation of the HRTFs shows good agreement between free field and virtual sound sources. Monaural spectra exhibit deep notches at frequencies above 9 kHz, providing putative cues for elevation discrimination. Interaural level differences (ILDs) and interaural time differences (ITDs) generally vary monotonically with azimuth between 0.5 and 8 kHz, suggesting that these two cues can be used to discriminate azimuthal position. Comparison with published subsets of HRTFs from squirrel monkeys (Saimiri sciureus) shows good agreement. Comparison with published human HRTFs from the frontal hemisphere demonstrates overall similarity in the patterns of ILD and ITD, suggesting that the Rhesus monkey is a good acoustic model for these two sound localization cues in humans. Finally, the measured ITDs in the horizontal plane agree well between -40 degrees and 40 degrees in azimuth with those calculated from a spherical head model with a radius of 52 mm, one-half the interaural distance of the monkey.

Animals↗

PubMed1987

A process model for the development of schizophrenia.

Less than two decades ago scientists interested in the etiology of schizophrenia were still vigorously debating the nature-nurture controversy, with many adhering to the view that the illness grew either out of a constitutional deficit or a pathological family environment. Today, virtually all researchers adopt interactional models that include both constitutional and environmental factors. Interactional models are most often expressed in diathesis-stress terms: Development of schizophrenia requires both a biological vulnerability (diathesis) and stressful life circumstances that facilitate expression of the illness. Modern debate within the field now primarily focuses on understanding the characteristics of the biological diathesis, the stressful environment, and their interaction. Scientists using diathesis-stress theories have employed several research strategies (Rosenthal 1970): (1) consanguinity studies exploring the distribution of illness among the relatives of schizophrenics, (2) twin studies comparing the concordance of schizophrenic illness in monozygotic and dizygotic twin pairs reared together or apart, (3) retrospective studies examining the premorbid behavior and development of schizophrenic parents, and (4) prospective studies of children at high risk for schizophrenia. The population most frequently followed in prospective high-risk studies has been offspring of schizophrenics. Biological offspring of schizophrenics who are reared by their parents are at extremely high risk for becoming schizophrenic themselves, approximately ten times greater risk than the general population. The present paper will make use of the Israeli High-Risk Study to test a diathesis-stress model for the transmission of schizophrenia. The goodness of fit of this model to the data will be explored using a simple decision tree data analytic approach.

Child↗

PubMed2002

Real-time collaborative environment for radiation treatment planning virtual simulation.

A virtual simulation (VS) system is a software system that enables the delineation of anatomical structures, and the placement of irradiation fields for the purpose of radiation treatment planning, making use of patient's tomographic data, instead of the real patient. Since patient's tomographic data can be communicated between distinct radiotherapy departments, collaborative work on VS, connecting remote health care professionals, becomes feasible. In this paper, an environment enabling real-time collaboration on VS is presented. The environment architecture is based on both offline and online communication of data under a secure framework and can be directly integrated into the infrastructure of a radiotherapy department. The online collaboration relies on the simultaneous execution of all actions at both collaborating sites, and prerequisites the offline communication of the data set on which the collaboration will be performed. Analytical description of the custom-made layered service, which supports the offline communication is given, along with a detailed presentation of the secure management of messages, which enables the real-time collaboration. The technical evaluation of the environment highlights the effectiveness of the proposed methodology, since real-time secure collaboration on VS is achieved.

Computer Graphics↗

PubMed2006

Pseudoneglect in back space.

Successful interaction with the environment depends upon our ability to retain and update visuo-spatial information of both front and back egocentric space. Several studies have observed that healthy people tend to show a displacement of the egocentric frame of reference towards the left. However representation of space behind us (back space) has never been systematically investigated in healthy people. In this study, by means of a novel visual imagery task performed within a virtual reality environment, we found that representation of right back space is perceived as smaller than the left. These results suggest that there is a selective compression or distortion for mental representation related to the right space behind us.

Adult↗

PubMed2000

Binaural gap duration discrimination in listeners with impaired hearing and normal hearing.

OBJECTIVE: This study was designed to measure the ability of listeners with and without sensorineural hearing loss to discriminate silent gaps between noise band markers of different frequencies presented in an anechoic and a reverberant listening environment. DESIGN: A two-interval, two-alternative, forced-choice paradigm was used to measure gap discrimination ability for six listeners with normal-hearing and six listeners with sensorineural hearing impairment. Marker stimuli were narrow bands of noise centered at frequencies from 500 to 7000 Hz. The center frequency of the leading marker was held constant at 2000 Hz and the center frequency of the trailing marker was varied randomly across runs. Stimuli were presented in two virtual listening environments (anechoic and reverberant). The listeners' task was to indicate which interval contained the marker pair separated by the larger silent gap. Gap discrimination was measured as a function of the center frequency of the trailing marker and as a function of listening environment. RESULTS: Gap discrimination thresholds (msec) varied as a function of the center frequency of the trailing marker. As the trailing marker frequency increased above and decreased below the leading marker frequency (2000 Hz), gap thresholds increased significantly. Hearing loss and listening environment did not have a significant effect on gap discrimination thresholds. Analysis of the gap discrimination functions revealed significantly steeper slopes for trailing marker frequencies below 2000 Hz than for trailing marker frequencies above 2000 Hz. A possible age effect was observed in the data and significant correlations were found between age and function slopes for several conditions. CONCLUSIONS: Gap discrimination becomes more difficult as the frequency disparity between leading and trailing noise bands increases. This pattern of results occurs independent of hearing loss but may be influenced by listener age.

Adult↗

PubMed2005

An integrated environment for plastic surgery support: building virtual patients, simulating interventions, and supporting intraoperative decisions.

In the last decade a number of environments for Computer Supported Plastic Surgery have been presented. Nevertheless, an overall approach for training and intraoperative support is still missing or has not been widely exploited yet. We developed a fully integrated system which allows surgical simulation, planning, and support for computer-guided plastic surgery procedures starting from image acquisition to final intraoperative assistance. The system also provides the user with a radiological workstation able to analyse patient medical images and case studies, with advanced bidimensional and three dimensional image processing functionalities. We intend to demonstrate that such a platform can be built at an affordable cost. The radiological workstation is capable of supporting radiologists and surgeons in real patient case studies and the simulation workstation may be adopted by plastic surgeons in teaching and training of complex surgical planning. Moreover, results of simulation can be used in the operating room with a relatively high benefit in terms of improved accuracy, reduction of surgical risks, and decrease in training costs.

Decision Support Techniques↗

PubMed1997

Multiaccommodative stimuli in VR systems: problems & solutions.

Virtual reality environments can introduce multiple and sometimes conflicting accommodative stimuli. For instance, with the high-powered lenses commonly used in head-mounted displays, small discrepancies in screen lens placement, caused by manufacturer error or user adjustment focus error, can change the focal depths of the image by a couple of diopters. This can introduce a binocular accommodative stimulus or, if the displacement between the two screens is unequal, an unequal (anisometropic) accommodative stimulus for the two eyes. Systems that allow simultaneous viewing of virtual and real images can also introduce a conflict in accommodative stimuli: When real and virtual images are at different focal planes, both cannot be in focus at the same time, though they may appear to be in similar locations in space. In this paper four unique designs are described that minimize the range of accommodative stimuli and maximize the visual system's ability to cope efficiently with the focus conflicts that remain: pinhole optics, monocular lens addition combined with aniso-accommodation, chromatic bifocal, and bifocal lens system. The advantages and disadvantages of each design are described and recommendation for design choice is given after consideration of the end use of the virtual reality system (e.g., low or high end, entertainment, technical, or medical use). The appropriate design modifications should allow greater user comfort and better performance.

Accommodation, Ocular↗

PubMed2005

Differential influence of vision and proprioception on control of movement distance.

The purpose of this study was to investigate the contribution of proprioceptive and visual information about initial limb position in controlling the distance of rapid, single-joint reaching movements. Using a virtual reality environment, we systematically changed the relationship between actual and visually displayed hand position as subjects' positioned a cursor within a start circle. No visual feedback was given during the movement. Subjects reached two visual targets (115 and 125 degrees elbow angle) from four start locations (90, 95, 100, and 105 degrees elbow angle) under four mismatch conditions (0, 5, 10, or 15 degrees). A 2 x 4 x 4 ANOVA enabled us to ask whether the subjects controlled the movement distance in accord with the virtual, or the actual hand location. Our results indicate that the movement distance was mainly controlled according to the virtual start location. Whereas distance modification was most extensive for the closer target, analysis of acceleration profiles revealed that, regardless of target position, visual information about start location determined the initial peak in tangential hand acceleration. Peak acceleration scaled with peak velocity and movement distance, a phenomenon termed "pulse-height" control. In contrast, proprioceptive information about actual hand location determined the duration of acceleration, which also scaled with peak velocity and movement distance, a phenomenon termed "pulse-width" control. Because pulse-height and pulse-width mechanisms reflect movement planning and sensory-based corrective processes, respectively, our current findings indicate that vision is used primarily for planning movement distance, while proprioception is used primarily for online corrections during rapid, unseen movements toward visual targets.

Adult↗

PubMed1995

[A survey of virtual reality research: From technology to psychology].

A technology of virtual reality enables us to immerse ourselves into 3D synthesized environments. In this paper, I review recent researches on virtual reality focusing on (a) the terminology used in this research area, (b) technological approaches to setting up different components of virtual reality autonomy, interaction, and presence, (c) objective measures and subjective ratings of a viewer's sense of presence in virtual environments, (d) present applications of virtual reality in different fields and their relation to pictorial communication. This review concludes that intermodality conflict and measurement of sense of presence are the crucial perceptual and cognitive topics in virtual reality research.

Computer Simulation↗

PubMed2004

Motor rehabilitation using virtual reality.

Virtual Reality (VR) provides a unique medium suited to the achievement of several requirements for effective rehabilitation intervention. Specifically, therapy can be provided within a functional, purposeful and motivating context. Many VR applications present opportunities for individuals to participate in experiences, which are engaging and rewarding. In addition to the value of the rehabilitation experience for the user, both therapists and users benefit from the ability to readily grade and document the therapeutic intervention using various systems. In VR, advanced technologies are used to produce simulated, interactive and multi-dimensional environments. Visual interfaces including desktop monitors and head-mounted displays (HMDs), haptic interfaces, and real-time motion tracking devices are used to create environments allowing users to interact with images and virtual objects in real-time through multiple sensory modalities. Opportunities for object manipulation and body movement through virtual space provide frameworks that, in varying degrees, are perceived as comparable to similar opportunities in the real world. This paper reviews current work on motor rehabilitation using virtual environments and virtual reality and where possible, compares outcomes with those achieved in real-world applications.

Journal Article↗

PubMed2004

Simulation of patient encounters using a virtual patient in periodontology instruction of dental students: design, usability, and learning effect in history-taking skills.

Simulations are important educational tools in the development of health care competence. This study describes a virtual learning environment (VLE) for diagnosis and treatment planning in oral health care. The VLE is a web-based, database application where the learner uses free text communication on the screen to interact with patient data. The VLE contains forms for history taking, clinical images, clinical data and X-rays. After reviewing the patient information, the student proposes therapy and makes prognostic evaluations of the case in free text. A usability test of the application was performed with seven dental students. The usability test showed that the software responded with correct answers to the majority of the free text questions. The application is generic in its basic functions and can be adapted to other dental or medical subject areas. A randomised controlled trial was carried out with 39 students who attended instruction in history taking with problem-based learning cases, lectures and seminars. In addition, 16 of the 39 students were randomly chosen to practise history taking using the virtual patient prior to their first patient encounter. The performance of each student was recorded on video during the patient sessions. The type and order of the questions asked by the student and the degree of empathy displayed towards the patient were analysed systematically on the videos. The data indicate that students who also undertook history taking with a virtual patient asked more relevant questions, spent more time on patient issues, and performed a more complete history interview compared with students who had only undergone standard teaching. The students who had worked with the virtual patient also seemed to have more empathy for the patients than the students who had not. The practising of history taking with a virtual patient appears to improve the capability of dental students to take a relevant oral health history.

Clinical Competence↗

PubMed1995

Measurements of human force control during a constrained arm motion using a force-actuated joystick.

1. When interacting with the environment, human arm movements may be prevented in certain directions (i.e., when sliding the hand along a surface) resulting in what is called a "constrained motion." In the directions that the movement is restricted, the subject is instead free to control the forces against the constraint. 2. Control strategies for constrained motion may be characterized by two extreme models. Under the active compliance model, an essentially feedback-based approach, measurements of contact force may be used in real time to modify the motor command and precisely control the forces generated against the constraint. Under the passive compliance model the motion would be executed in a feedforward manner, using an internal model of the constraint geometry. The feedforward model relies on the compliant behavior of the passive mechanical system to maintain contact while avoiding excessive contact forces. 3. Subjects performed a task in which they were required to slide the hand along a rigid surface. This task was performed in a virtual force environment in which contact forces were simulated by a two-dimensional force-actuated joystick. Unknown to the subject, the orientation of the surface constraint was varied from trial to trial, and contact force changes induced by these perturbations were measured. 4. Subjects showed variations in contact force correlated with the direction of the orientation perturbation. "Upward" tilts resulted in higher contact forces, whereas "downward" tilts resulted in lower contact forces. This result is consistent with a feedforward-based control of a passively compliant system. 5. Subject responses did not, however, correspond exactly to the predictions of a static analysis of a passive, feedforward-controlled system. A dynamic analysis reveals a much closer resemblance between a passive, feedforward model and the observed data. Numerical simulations demonstrate that a passive, dynamic system model of the movement captures many more of the salient features observed in the measured human data. 6. We conclude that human subjects execute surface-following motions in a largely feedforward manner, using an a priori model of the surface geometry. The evidence does not suggest that active, real time use of force feedback is used to guide the movement or to control limb impedance. We do not exclude, however, the possibility that the internal model of the constraint is updated at somewhat longer latencies on the basis of proprioceptive information.

Arm↗

PubMed2003

Integration of advanced technologies to enhance problem-based learning over distance: Project TOUCH.

Distance education delivery has increased dramatically in recent years as a result of the rapid advancement of communication technology. The National Computational Science Alliance's Access Grid represents a significant advancement in communication technology with potential for distance medical education. The purpose of this study is to provide an overview of the TOUCH project (Telehealth Outreach for Unified Community Health; http://hsc.unm.edu/touch) with special emphasis on the process of problem-based learning case development for distribution over the Access Grid. The objective of the TOUCH project is to use emerging Internet-based technology to overcome geographic barriers for delivery of tutorial sessions to medical students pursuing rotations at remote sites. The TOUCH project also is aimed at developing a patient simulation engine and an immersive virtual reality environment to achieve a realistic health care scenario enhancing the learning experience. A traumatic head injury case is developed and distributed over the Access Grid as a demonstration of the TOUCH system. Project TOUCH serves as an example of a computer-based learning system for developing and implementing problem-based learning cases within the medical curriculum, but this system should be easily applied to other educational environments and disciplines involving functional and clinical anatomy. Future phases will explore PC versions of the TOUCH cases for increased distribution.

Craniocerebral Trauma↗