Impact of haptic feedback on surgical training outcomes: A Randomised Controlled Trial of haptic versus non-haptic immersive virtual reality training.

Objective: This study aimed to evaluate the educational impact of integrated haptic feedback in an immersive VR bone drilling simulation on the performance of a cohort of junior surgeons. Design: Block randomised, controlled, double-blinded study. Setting: St Georges University Hospital, London, United Kingdom. Participants: and methods: 31 trainee doctors (postgraduate years 1-3) with limited orthopaedic experience were recruited to participate in this randomised controlled study through e-mail and poster advertising. They were allocated to haptic or non-haptic group through block randomisation prior to entering the study environment. All participants provided verbal and written consent to participate in this study. All participants were blinded to the nature of the study as well as its intervention arms. All participants completed an immersive virtual reality training module with either haptic feedback or no haptic feedback in which they had to drill 3 bicortical holes in a VR tibia bone model in preparation for screw insertion followed by an ex vivo equivalent task on a tibial sawbone model once again drilling 3 holes through both cortices of the tibia. Outcome measures were plunge gap distance, drilling time and objective structures assessment of technical skills (OSAT) as well as qualitative questionnaire outcomes. Results: Haptic feedback in the VR training module showed significantly less plunge gap distance compared to the non-haptic group (7.6 mm ± 4.3 vs 13.6 mm ± 7.4 (p = 0.012)). The haptic group also had longer drill times (17.5 s ± 4.0 vs 13.8 s ± 4.2 (p = 0.027)), higher combined OSAT cores (14 (10,17) vs 8.5 (7.75, 12), p = 0.0006) and greater number of safe drills of <5 mm plunge gap in at least 2 out of 3 attempts (6 (40) vs 0 (0), p = 0.021. Conclusions: This study demonstrates better performance for an orthopaedic surgical task when using a VR-based simulation model incorporating haptic feedback, compared to one without haptic feedback supporting the pursuit and implementation of haptics in surgical training simulation models to enhance their educational value.

Attitudes and Beliefs Regarding Pregnancy Physical Activity in a Non-pregnant Population.

The purpose of this study was to examine the attitudes and beliefs about pregnancy physical activity (PA) in non-pregnant individuals. We hypothesized that younger, more educated, females, those who had ever been pregnant (or partner had been pregnant, for males) and physically active individuals would view pregnancy PA more positively than older individuals, those with less education, males, those who had not ever been pregnant (partner had not been pregnant, for males), and those who are inactive, respectively. Participants were non-pregnant adults ages 20+ years who were recruited by word-of-mouth, social media, and from physician offices. A total of n=698 completed a survey consisting of 27 items in five sections: demographics, PA over prior six months, questions regarding efficacy of PA during pregnancy, importance of exercise for pregnant women, and safety of moderate or vigorous intensity PA. Participants were dichotomized by sex (male; female), PA (meets or does not meet PA Guidelines), education (Bachelor's degree; no Bachelor's degree), and prior experience with pregnancy (self/partner had ever been pregnant; self/partner had never been pregnant). Overall, physically active individuals, those with college degrees, and those age 40+ years viewed pregnancy PA more favorably, and non-pregnant females and more educated people believed moderate activity is safe (p<0.05 for all comparisons) compared to males and less educated, respectively. Beliefs and attitudes about pregnancy PA vary by age, sex, education, and PA level. High levels of agreement with statements about benefits from and safety of light and moderate intensity PA were reported. Targeting education and PA promotion related to pregnancy to less educated, inactive, and younger age groups should be encouraged, as well as increasing education in all groups regarding safety of vigorous intensity PA during pregnancy.

Verbal and non-verbal intelligence changes in the teenage brain.

Intelligence quotient (IQ) is a standardized measure of human intellectual capacity that takes into account a wide range of cognitive skills. IQ is generally considered to be stable across the lifespan, with scores at one time point used to predict educational achievement and employment prospects in later years. Neuroimaging allows us to test whether unexpected longitudinal fluctuations in measured IQ are related to brain development. Here we show that verbal and non-verbal IQ can rise or fall in the teenage years, with these changes in performance validated by their close correlation with changes in local brain structure. A combination of structural and functional imaging showed that verbal IQ changed with grey matter in a region that was activated by speech, whereas non-verbal IQ changed with grey matter in a region that was activated by finger movements. By using longitudinal assessments of the same individuals, we obviated the many sources of variation in brain structure that confound cross-sectional studies. This allowed us to dissociate neural markers for the two types of IQ and to show that general verbal and non-verbal abilities are closely linked to the sensorimotor skills involved in learning. More generally, our results emphasize the possibility that an individual's intellectual capacity relative to their peers can decrease or increase in the teenage years. This would be encouraging to those whose intellectual potential may improve, and would be a warning that early achievers may not maintain their potential.

Auditory short-term memory capacity correlates with gray matter density in the left posterior STS in cognitively normal and dyslexic adults.

A central feature of auditory STM is its item-limited processing capacity. We investigated whether auditory STM capacity correlated with regional gray and white matter in the structural MRI images from 74 healthy adults, 40 of whom had a prior diagnosis of developmental dyslexia whereas 34 had no history of any cognitive impairment. Using whole-brain statistics, we identified a region in the left posterior STS where gray matter density was positively correlated with forward digit span, backward digit span, and performance on a "spoonerisms" task that required both auditory STM and phoneme manipulation. Across tasks and participant groups, the correlation was highly significant even when variance related to reading and auditory nonword repetition was factored out. Although the dyslexics had poorer phonological skills, the effect of auditory STM capacity in the left STS was the same as in the cognitively normal group. We also illustrate that the anatomical location of this effect is in proximity to a lesion site recently associated with reduced auditory STM capacity in patients with stroke damage. This result, therefore, indicates that gray matter density in the posterior STS predicts auditory STM capacity in the healthy and damaged brain. In conclusion, we suggest that our present findings are consistent with the view that there is an overlap between the mechanisms that support language processing and auditory STM.