Electrophysiological and functional neuroimaging findings indicate that the neural mechanisms underlying the processing of emotional dimensions (i.e., valence, arousal) constitute a spatially and ...temporally distributed emotional network, modulated by the arousal and/or valence of the emotional stimuli. We examined the time course and source distribution of gamma time-locked magnetoencephalographic activity in response to a series of emotional stimuli viewed by healthy adults. We used a beamformer and a sliding window analysis to generate a succession of spatial maps of event-related brain responses across distinct levels of valence (pleasant/unpleasant) and arousal (high/low) in 30-100 Hz. Our results show parallel emotion-related responses along specific temporal windows involving mainly dissociable neural pathways for valence and arousal during emotional picture processing. Pleasant valence was localized in the left inferior frontal gyrus, while unpleasant valence in the right occipital gyrus, the precuneus, and the left caudate nucleus. High arousal was processed by the left orbitofrontal cortex, amygdala, and inferior frontal gyrus, as well as the right middle temporal gyrus, inferior parietal lobule, and occipital gyrus. Pleasant by high arousal interaction was localized in the left inferior and superior frontal gyrus, as well as the right caudate nucleus, putamen, and gyrus rectus. Unpleasant by high arousal interaction was processed by the right superior parietal gyrus. Valence was prioritized (onset at ∼60 ms) to all other effects, while pleasant valence was short lived in comparison to unpleasant valence (offsets at ∼110 and ∼320 ms, respectively). Both arousal and valence × arousal interactions emerged relatively early (onset at ∼150 ms, and ∼170 ms, respectively). Our findings support the notion that brain regions differentiate between valence and arousal, and demonstrate, for the first time, that these brain regions may also respond to distinct combinations of these two dimensions within specific time windows.
Virtual Patients (VPs) may improve cognitive and behavioral skills better than traditional methods do. The aim of this paper was to investigate challenges faced by teachers and students in order to ...effectively implement VPs across undergraduate and postgraduate curricula. In addition, differences in student and teacher perceptions that could impact curricular integration of VPs were explored.
A two-phase descriptive study was performed: 1) evaluation of the VP design process and curricular integration, conducted upon academic medical teachers; 2) evaluation of learning and clinical reasoning experiences with VPs, from the students' perspective.
The results of this study document high acceptance of VPs by both medical teachers and students (n = 252).VPs seem to fulfill most needs as set by course directors, while they satisfy student needs and create perceptions of improved knowledge and clinical skills reasoning.
Medical educators have encountered educational challenges upon transforming the curriculum. To develop VPs, academic institutions have to pay equal attention to the needs of potential adopters and VP authors. Strategic development and use of VPs may motivate more widespread integration of VPs and lead to a high quality medical education system.
Legal interoperability constitutes a prerequisite for the provision of high-quality cross border e-health services, like ePrescription and ePatientSummary. A review of EU legislation, policy ...initiatives and relevant judgments of the European Court of Justice (ECJ) and the European Court of Human Rights (ECHR) was held, concerning personal medical data. Four European social welfare systems, according to Esping – Andersen’s typology, were selected and a study of health policy in relation to the national legal framework regarding the data protection regulation is examined. A model of legal interoperability for cross-border eHealth services is proposed for policy makers at EU level based on the following major domains: protection and security of data, transparency and liability, further analyzed in multiple axes and combined with EU targets, policy priorities and basic European legal principles. This model could be viable because of the EU’s transnational existence, the coexistence of national and Community law, and the need of novel models of political governance under a unified regulatory and normative base.
Mathematical anxiety (MA) is defined as a feeling of tension, apprehension, or fear that interferes with mathematical performance in various daily or academic situations. Cognitive consequences of MA ...have been studied a lot and revealed that MA seriously affects solving the complex problem due to the corruption of working memory (WM). The corruption of WM caused by MA is well documented in behavioral level, but the involved neurophysiological processes have not been properly addressed, despite the recent attention drawn on the neural basis of MA. This is the second part of our study that intents to investigate the neurophysiological aspects of MA and its implications to WM. In the first study, we saw how MA affects the early stages of numeric stimuli processes as the WM indirectly using event-related potentials in scalp electroencephalographic (EEG) signals. This paper goes one step further to investigate the cortical activations, obtained by the multichannel EEG recordings as well as the cortical functional networks in three WM tasks with increasing difficulty. Our results indicate that the high-math anxious (HMA) group activated more areas linked with negative emotions, pain, and fear, while the low-math anxious (LMA) group activated regions related to the encoding and retrieval processes of the WM. Functional connectivity analysis also reveals that the LMAs' brain has got more structured cortical networks with increased connectivity in areas related to WM, such as the frontal cortex, while the HMAs' brain has a more diffused and unstructured network, superimposing the evidence that the structured processes of WM are corrupted.
To navigate the field of digital cancer care and define and discuss key aspects and applications of big data analytics, artificial intelligence (AI), and data-driven interventions.
Peer-reviewed ...scientific publications and expert opinion.
The digital transformation of cancer care, enabled by big data analytics, AI, and data-driven interventions, presents a significant opportunity to revolutionize the field. An increased understanding of the lifecycle and ethics of data-driven interventions will enhance development of innovative and applicable products to advance digital cancer care services.
As digital technologies become integrated into cancer care, nurse practitioners and scientists will be required to increase their knowledge and skills to effectively use these tools to the patient's benefit. An enhanced understanding of the core concepts of AI and big data, confident use of digital health platforms, and ability to interpret the outputs of data-driven interventions are key competencies. Nurses in oncology will play a crucial role in patient education around big data and AI, with a focus on addressing any arising questions, concerns, or misconceptions to foster trust in these technologies. Successful integration of data-driven innovations into oncology nursing practice will empower practitioners to deliver more personalized, effective, and evidence-based care.
Abstract Objective The objective of this study is the development and evaluation of efficient neurophysiological signal statistics, which may assess the driver’s alertness level and serve as ...potential indicators of sleepiness in the design of an on-board countermeasure system. Methods Multichannel EEG, EOG, EMG, and ECG were recorded from sleep-deprived subjects exposed to real field driving conditions. A number of severe driving errors occurred during the experiments. The analysis was performed in two main dimensions: the macroscopic analysis that estimates the on-going temporal evolution of physiological measurements during the driving task, and the microscopic event analysis that focuses on the physiological measurements’ alterations just before, during, and after the driving errors. Two independent neurophysiologists visually interpreted the measurements. The EEG data were analyzed by using both linear and non-linear analysis tools. Results We observed the occurrence of brief paroxysmal bursts of alpha activity and an increased synchrony among EEG channels before the driving errors. The alpha relative band ratio (RBR) significantly increased, and the Cross Approximate Entropy that quantifies the synchrony among channels also significantly decreased before the driving errors. Quantitative EEG analysis revealed significant variations of RBR by driving time in the frequency bands of delta, alpha, beta, and gamma. Most of the estimated EEG statistics, such as the Shannon Entropy, Kullback–Leibler Entropy, Coherence, and Cross-Approximate Entropy, were significantly affected by driving time. We also observed an alteration of eyes blinking duration by increased driving time and a significant increase of eye blinks’ number and duration before driving errors. Conclusions EEG and EOG are promising neurophysiological indicators of driver sleepiness and have the potential of monitoring sleepiness in occupational settings incorporated in a sleepiness countermeasure device. Significance The occurrence of brief paroxysmal bursts of alpha activity before severe driving errors is described in detail for the first time. Clear evidence is presented that eye-blinking statistics are sensitive to the driver’s sleepiness and should be considered in the design of an efficient and driver-friendly sleepiness detection countermeasure device.
Virtual patients are interactive computer simulations that are increasingly used as learning activities in modern health care education, especially in teaching clinical decision making. A key ...challenge is how to retrieve and repurpose virtual patients as unique types of educational resources between different platforms because of the lack of standardized content-retrieving and repurposing mechanisms. Semantic Web technologies provide the capability, through structured information, for easy retrieval, reuse, repurposing, and exchange of virtual patients between different systems.
An attempt to address this challenge has been made through the mEducator Best Practice Network, which provisioned frameworks for the discovery, retrieval, sharing, and reuse of medical educational resources. We have extended the OpenLabyrinth virtual patient authoring and deployment platform to facilitate the repurposing and retrieval of existing virtual patient material.
A standalone Web distribution and Web interface, which contains an extension for the OpenLabyrinth virtual patient authoring system, was implemented. This extension was designed to semantically annotate virtual patients to facilitate intelligent searches, complex queries, and easy exchange between institutions. The OpenLabyrinth extension enables OpenLabyrinth authors to integrate and share virtual patient case metadata within the mEducator3.0 network. Evaluation included 3 successive steps: (1) expert reviews; (2) evaluation of the ability of health care professionals and medical students to create, share, and exchange virtual patients through specific scenarios in extended OpenLabyrinth (OLabX); and (3) evaluation of the repurposed learning objects that emerged from the procedure.
We evaluated 30 repurposed virtual patient cases. The evaluation, with a total of 98 participants, demonstrated the system's main strength: the core repurposing capacity. The extensive metadata schema presentation facilitated user exploration and filtering of resources. Usability weaknesses were primarily related to standard computer applications' ease of use provisions. Most evaluators provided positive feedback regarding educational experiences on both content and system usability. Evaluation results replicated across several independent evaluation events.
The OpenLabyrinth extension, as part of the semantic mEducator3.0 approach, is a virtual patient sharing approach that builds on a collection of Semantic Web services and federates existing sources of clinical and educational data. It is an effective sharing tool for virtual patients and has been merged into the next version of the app (OpenLabyrinth 3.3). Such tool extensions may enhance the medical education arsenal with capacities of creating simulation/game-based learning episodes, massive open online courses, curricular transformations, and a future robust infrastructure for enabling mobile learning.
The COVID-19 pandemic has spread rapidly worldwide with critical consequences in health, as well as in social, economic, and particularly in psychological conditions of vulnerable people, especially ...older adults. Therefore, it is necessary the direct attention to their health care needs and related interventions. Information and Communication Technology (ICT) have direct impact on older adults' health and quality of life leading to decreased depression and loneliness, along with empowerment of independent life. Many studies involve cognitive training programs/software based on new technological systems that provide to vulnerable people access to gamified, attractive, cognitive exercises for overall functionality everywhere and at any time. Twenty-four participants (mean age 69.3 years) were assigned to this study. The cognitive training component of LLM Care was used as an interactive software to enhance participants' cognitive functions. The intervention lasted 12 weeks with the frequency of 2-4 times per week in sessions of at least 30 min. Participants used their personal devices (tablets/laptops) in their own residence, while technical and consulting guidance was provided by LLM Care certified trainers. They were informed about the purpose of the study, while consent forms along with psychological assessments were distributed every 2 weeks to periodically evaluate their psychosocial and mental health conditions. The assessments included the World Health Organization-Five Well-Being Index (WHO-5), the Short Anxiety Screening Test (SAST), the System Usability Scale (SUS) and the Impact Factor Event Scale (IES-R). According to the results, the participants with improved well-being tended to report decreased subjective distress caused by COVID-19, and their engagement with new technologies can potentially minimize the negative outcomes occurred by the current stressful situation, mitigating the effect of hyperarousal symptoms, while increasing their overall well-being. Well-being seems to remain relatively stable among older adults and decreases only when adversities occur, while the usability of the software was perceived as marginally acceptable by participants. The exploitation of the LLM Care contributes to the improvement of older adults' well-being and alleviates the negative experience caused by stressful situations like COVID-19.
The expansive curricular volume of healthcare education makes a necessity the incorporation of innovative methods and immersive media in it. The core challenge in such approaches is the timely ...development of relevant immersive content such as Virtual, Augmented or Mixed Reality (VR/AR/MR) resources for healthcare topics. There is currently significant interest in the use of co-creative methods for streamlining immersive content development.
A core research pursuit in this translational research field is the formulation of evidence-based, optimized workflows that streamline immersive content creation allowing for rapid expansion of innovative educational approaches in healthcare curricula. The purpose of this paper is to aggregate the perceptions of healthcare technologists and educators who participated in a series of co-creation sessions in order to elicit their best practice insights for design and development of XR educational resources using co-creative methods.
According to our thematic analysis, findings of the qualitative study demonstrated that a rigorous organizational approach is required to maintain a constructive exchange of information and to keep the design process alive for both content and technical experts. In addition, rapid prototype and display of co-created features can empower their contributions and help them design more efficiently.
Co-creative content production can benefit from adaption of existing frameworks and lightweight authoring environments that can facilitate generalized XR content development use cases.
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