Exploring Fatigue Effects on Performance Variation of Intensive Brain–Computer Interface Practice

Motor imagery (MI) is an endogenous mental process and is commonly used as an electroencephalogram (EEG)-based brain–computer interface (BCI) strategy. Previous studies of P300 and MI-based (without online feedback) BCI have shown that mental states like fatigue can negatively affect participants’ EEG signatures. However, exogenous stimuli cause visual fatigue, which might have a different mechanism than endogenous tasks do. Furthermore, subjects could adjust themselves if online feedback is provided. In this sense, it is still unclear how fatigue affects online MI-based BCI performance. With this question, 12 healthy subjects are recruited to investigate this issue, and an MI-based online BCI experiment is performed for four sessions on different days. The first session is for training, and the other three sessions differ in rest condition and duration—no rest, 16-min eyes-open rest, and 16-min eyes-closed rest—arranged in a pseudo-random order. Multidimensional fatigue inventory (MFI) and short stress state questionnaire (SSSQ) reveal that general fatigue, mental fatigue, and distress have increased, while engagement has decreased significantly within certain sessions. However, the BCI performances, including percent valid correct (PVC) and information transfer rate (ITR), show no significant change across 400 trials. The results suggest that although the repetitive MI task has affected subjects’ mental states, their BCI performances and feature separability within a session are not affected by the task significantly. Further electrophysiological analysis reveals that the alpha-band power in the sensorimotor area has an increasing tendency, while event-related desynchronization (ERD) modulation level has a decreasing trend. During the rest time, no physiological difference has been found in the eyes-open rest condition; on the contrary, the alpha-band power increase and subsequent decrease appear in the eyes-closed rest condition. In summary, this experiment shows evidence that mental states can change dramatically in the intensive MI-BCI practice, but BCI performances could be maintained.

Addressing Systemic Racism by Creating a Diversity, Equity, and Inclusion Department Initiative

Background Catalyzed by social injustice and worsening racial inequities highlighted by the COVID-19 pandemic, a diverse academic geriatrics and palliative medicine department in NYC launched a DEI initiative. This report presents key program components and lessons learned in launching this initiative in the interprofessional academic medicine setting. Methods First, DEI core and departmental administration met 2-4 times/month to plan and review program activities, vision, and mission. The team conducted confidential roundtable discussions about DEI issues and 1:1 interviews to assess needs. A monthly Humanities, Arts, and Books (HAB) Initiative provided a safe space for discussion and learning. The HAB platform supported a longitudinal curriculum emphasizing (1) group discussion and self-reflection on DEI concerns, (2) knowledge dissemination including a “Learning Pathway” series, and (3) skill-based workshops. With each event, we collected anonymous feedback. Comments were systematically recorded and an engagement evaluation was conducted to iteratively shape future sessions. Departmental administration was engaged to track DEI-focused measures of recruitment, career advancement, and retention. Finally, we centralized DEI activities on a departmental website, including an anonymous online feedback box. Results Quantitative and qualitative assessment of DEI initiatives are forthcoming. Metrics include DEI and professional development surveys, departmental demographic and diversity measures, increase in DEI-related projects and grants, and individual participation in DEI programs. Conclusions Creating a strong and sustainable DEI initiative within an academic medical setting requires a passionate and diverse core team, deliberate backing by administration, and thoughtful dissemination of sensitive content in the midst of a highly charged social justice landscape.

Students Feedback Regarding the Effectiveness of Think Pair Share Strategy in the Anatomy Class

Lectures are a major part of a university student’s learning experience and are an effective means of transferring knowledge and concepts to large groups in less time and with minimal resources. Objectives: To find the effects of lectures alone and when lectures are combined with strategy of think-pair-share, on the 1st and 2nd year medical student’s participation, confidence, critical thinking and involvement in learning activities during the Anatomy class. Study Design: Descriptive Cross sectional study. Methodology: Present study enrolled 200 participants involving both genders. Online feedback Performa based on 5 questions was developed and collected data from students before and after the 10-week treatment program. Statistical analysis: Data was analyzed by SPSS software, version 19 as qualitative variables were expressed as percentages. Results: There was a significant benefit to majority of students by applying think-pair-share technique during their Anatomy lectures. Conclusion: We concluded that think pair share strategy in lectures kept the students more actively involved in the class discussion and they felt more confident in sharing their ideas with the peers. It also promoted critical thinking among the students and they received feedback more frequently from the teacher. Keywords: Lectures, Think Pair Share Strategy, Critical Thinking and Anatomy Class.

Rehabilitandenzufriedenheit in den sozialen Medien und auf Online-Bewertungsportalen

Zusammenfassung Ziel Rehabilitanden äußern sich zu ihrem Rehabilitationsaufenthalt vermehrt im Internet, bewerten die Leistungserbringer mit Sterneratings und schreiben Erfahrungsberichte. Bisher liegen keine Erkenntnisse zur im Internet kommunizierten Rehabilitandenzufriedenheit für die stationäre medizinische Rehabilitation in Deutschland vor. Die Studie verfolgte erstmalig das Ziel einer systematischen Analyse der Rehabilitandenzufriedenheit in den sozialen Medien und auf Klinikvergleichsportalen. Methoden Bewertungen zur Rehabilitation auf dem Portal Klinikbewertungen.de und dem sozialen Netzwerk Facebook wurden für 8 Indikationsgruppen (Orthopädie, Psychosomatik/Psychotherapie, Onkologie, Kardiologie, Neurologie, Innere Medizin, Pneumologie/Dermatologie, Gastroenterologie) in einer Vollerhebung über drei Jahre (10/2014–09/2017) für federführend belegte Reha-Kliniken der Rentenversicherung (N=497) erhoben. Zur Bestimmung der Rehabilitandenzufriedenheit wurden die Sternebewertungen, aggregriert nach Indikationsgruppen, ausgewertet (Chi-Quadrat-Test nach Pearson, Exakter Test nach Fisher, Phi-Koeffizient). Ergebnisse Auf Klinikbewertungen.de waren 97,2% der Reha-Kliniken mit 24 806 Bewertungen vertreten. Die am häufigsten bewerteten Indikationsgruppen waren die Orthopädie (38,5%) und die Psychosomatik/Psychotherapie (27,1%). Für Facebook wurden Bewertungen (N=4127) zu Reha-Kliniken (38,6%) mit jeweils einer Fachabteilung erfasst, um eine Indikationsgruppenzuordnung sicherzustellen. Es wurden annährend gleich viele Bewertungen auf offiziellen (48,7%) wie inoffiziellen Facebookseiten (51,3%) ermittelt, wobei kein signifikanter Zusammenhang der Seitenverwaltung zur Gesamtzufriedenheit bestand (p>0,05). Auf den Facebookseiten waren 49,1% der Bewertungen von Frauen (38,5% männlich; 12,4% nicht zuordenbar). Soziodemografische Angaben auf Klinikbewertungen.de bezogen sich einzig auf den Versichertenstatus (89,1% gesetzlich Versicherte). Die Bewertungen wurden zu 95,4% von Rehabilitanden und 4,0% von Angehörigen verfasst. 77,5% der Rehabilitanden gaben eine Weiterempfehlung ab (Angehörige: 37,2%). Die meisten Rehabilitandenbewertungen waren positiv. Es zeigten sich Unterschiede in der Gesamtzufriedenheit zwischen den Indikationsgruppen. Die Rehabilitanden in der Onkologie (77,9%) waren zufriedener als in der Neurologie (59,0%). Schlussfolgerung Online-Bewertungen über die stationäre medizinische Rehabilitation konnten im erheblichen Umfang erhoben werden. Diese fallen überwiegend positiv aus und sind mit Ergebnissen standardisierter Befragungen vergleichbar. Trotz Einschränkungen bei der Nutzung von Daten aus den sozialen Medien weisen die Ergebnisse darauf hin, dass das öffentlich zugängliche zeitnahe Online-Feedback von Rehabilitanden nützliche Informationen für das Qualitätsmanagement der Kliniken sowie für Patienten in der Wahrnehmung des Wunsch- und Wahlrechts haben kann.

Reinforcement Learning-Based Assistive Framework for Disabled Persons

Robot programming by demonstration (PbD) enables human users to teach the robot and increases its capabilities by interactive teaching without having to manually program the robot. PbD combined with intelligent machine learning algothrims can help us to develop autonomous robots for various industrial and domestic tasks. One such task is the pouring of liquids from bottle into the cup/glass. In this paper the first step is to teach the robot liquid pouring task by the human user in order to facilitate physically disabled people in making various types of drinks and then dataset is created from the user taken demonstrations. In training stage the dataset obtained is feed to the decision-making algorithm based on reinforcement learning. The algorithm enables the robot to learn to pour different liquids under different pouring conditions with the help of minimum number of human user demonstrations needed for the learning of task. The acquired results show that the robot can learn to pour different liquids and is able to accurately adapt to different pouring conditions by using reward-based system and online feedback. Furthermore the results show that the proposed framework can work with different types of liquid and container sizes without any further need for reprogramming or demonstrations.

EP.TU.426Evaluating the Efficacy of Online Teaching for Neuroscience, Neurology & Neurosurgery

Aims The current climate brought forth by the COVID-19 pandemic has caused considerable changes in academic teaching at the undergraduate and postgraduate level. Online teaching and webinars over video conferencing platforms have become the new standard for delivery of material. Here we evaluate the efficacy of online webinars in the area of Neuroscience, Neurology and Neurosurgery. Methods We delivered 10 online webinars across 10 weeks, with one or two speakers, covering a range of topics across the fields of Neuroscience, Neurology and Neurosurgery. Feedback was gathered anonymously using an online feedback form following the event. Results were statistically analysed and significance reported using the Wilcoxon signed-rank test. Results Our results show a statistically significant increase in the attendees’ self-reported knowledge on the subject, before and after the webinar (P < 0.0001, n = 117); this represents a 57.3% increase in self-reported knowledge. Our feedback indicated that of all attendees across the 10 webinars, 82.9% rated the event overall “Very Good”, 79.5% were “Very Satisfied” with the organisation of the event, 84.6% with the speaker(s), 76.9% with the content of the event and 82.9% with the format of the webinar. Conclusions In summary, our analysis shows that delivering Neurological and Neurosurgical teaching via an online platform is a viable and effective method of delivering knowledge. This finding has significant implications not only in the current response to the COVID-19 pandemic, but also in the future provision of medical education at the undergraduate and postgraduate level.

EP.WE.17Surgical Telemedicine Clinics during the Covid-19 Pandemic – Patient-Reported Outcomes Report

Aims The primary aim was to obtain patient feedback about surgical telemedicine clinics. The secondary endpoint was to investigate any factors influencing the patient’s feedback. Methods A retrospective qualitative study was undertaken, during the period between June – September 2020, at Darent Valley Hospital in West Kent. Telephone and online feedback were obtained using a 5 point questionnaire designed to assess their experience and preference for future consultations. Variables such as ‘demographics’, ‘first or follow-up clinic appointment’ and ‘physician-grade’, were analysed for any influence on patients feedback. Results A total of 200 patients responded to the questionnaire (telephone = 133, online = 77). The median age was 67 years (IQR 44 – 79) and male: female ratio 1. About 35.9% were a new referral and 42.7% has had some face-to-face appointment in the hospital before the pandemic. During the period of the study, about 42.7% had more than one telemedicine appointments. About 83.2% were consulted by surgical registrars. A rating from good to excellent for ‘overall experience’, ‘opportunity to express own concern’ and ‘how well the doctor addressed their concerns’ was given at 90%, 93.1% and 89.4%, respectively. About 80.2% felt reassured and 21.7% would prefer telemedicine for future consultations. There was no association between the variables studied and patient responses. Conclusions A high percentage of patients reported satisfactory service provision via telemedicine clinics. A majority of patients felt reassured. However, given the option, the face-to-face clinic would be the prefered option for the majority.

EFL Students’ Responses on Teacher’s Online Written Feedback: Interaction, Revision, and Perception

This study examines students’ interactions with the teacher’s feedback in an online course on paragraph writing at higher education in Indonesia. The instructional moves, interactional approach, and students’ perceived usefulness of the feedback were investigated. Through a discourse analysis framework, 355 comments on discussion posts from five students in four meetings were analyzed. The Learning Analytics (LA) data correlated with semi-structured interviews were employed to obtain the students’ perceived usefulness of teacher feedback for revision. The semi-structured interview was done with six students. The findings revealed that the teacher enacted fifteen moves to handle social interaction in online feedback from directive to dialogic categories. These moves are employed to create knowledge-building and solidarity for pedagogical and interactional goals, particularly. These are shown by the relation between LA and the students’ perceptions of the feedback for writing revision. Therefore, such findings highlight the (de)merits of directive-dialogic interactions in online written feedback and LA data to improve teaching and learning.

Closed-Loop Cognitive-Driven Gain Control of Competing Sounds Using Auditory Attention Decoding

Recent advances have shown that it is possible to identify the target speaker which a listener is attending to using single-trial EEG-based auditory attention decoding (AAD). Most AAD methods have been investigated for an open-loop scenario, where AAD is performed in an offline fashion without presenting online feedback to the listener. In this work, we aim at developing a closed-loop AAD system that allows to enhance a target speaker, suppress an interfering speaker and switch attention between both speakers. To this end, we propose a cognitive-driven adaptive gain controller (AGC) based on real-time AAD. Using the EEG responses of the listener and the speech signals of both speakers, the real-time AAD generates probabilistic attention measures, based on which the attended and the unattended speaker are identified. The AGC then amplifies the identified attended speaker and attenuates the identified unattended speaker, which are presented to the listener via loudspeakers. We investigate the performance of the proposed system in terms of the decoding performance and the signal-to-interference ratio (SIR) improvement. The experimental results show that, although there is a significant delay to detect attention switches, the proposed system is able to improve the SIR between the attended and the unattended speaker. In addition, no significant difference in decoding performance is observed between closed-loop AAD and open-loop AAD. The subjective evaluation results show that the proposed closed-loop cognitive-driven system demands a similar level of cognitive effort to follow the attended speaker, to ignore the unattended speaker and to switch attention between both speakers compared to using open-loop AAD. Closed-loop AAD in an online fashion is feasible and enables the listener to interact with the AGC.