Acting rehearsal in collaborative multimodal mixed reality environments

This paper presents the use of our multimodal mixed reality telecommunication system to support remote acting rehearsal. The rehearsals involved two actors, located in London and Barcelona, and a director in another location in London. This triadic audiovisual telecommunication was performed in a spatial and multimodal collaborative mixed reality environment based on the 'destination-visitor' paradigm, which we define and put into use. We detail our heterogeneous system architecture, which spans the three distributed and technologically asymmetric sites, and features a range of capture, display, and transmission technologies. The actors' and director's experience of rehearsing a scene via the system are then discussed, exploring successes and failures of this heterogeneous form of telecollaboration. Overall, the common spatial frame of reference presented by the system to all parties was highly conducive to theatrical acting and directing, allowing blocking, gross gesture, and unambiguous instruction to be issued. The relative inexpressivity of the actors' embodiments was identified as the central limitation of the telecommunication, meaning that moments relying on performing and reacting to consequential facial expression and subtle gesture were less successful.

Neuromonitorage après coma aigu aux soins intensifs [Multimodal neuromonitoring for the critical care management of acute coma].

Management of neurocritical care patients is focused on the prevention and treatment of secondary brain injury, i.e. the number of pathophysiological intracerebral (edema, ischemia, energy dysfunction, seizures) and systemic (hyperthermia, disorders of glucose homeostasis) events that occur following the initial insult (stroke, hemorrhage, head trauma, brain anoxia) that may aggravate patient outcome. The current therapeutic paradigm is based on multimodal neuromonitoring, including invasive (intracranial pressure, brain oxygen, cerebral microdialysis) and non-invasive (transcranial doppler, near-infrared spectroscopy, EEG) tools that allows targeted individualized management of acute coma in the early phase. The aim of this review is to describe the utility of multimodal neuromonitoring for the critical care management of acute coma.

Multimodal MRI analysis of structural and functional networks in the human brain : application to two clinical studies : driving abilities under THC intoxication and early white matter changes in FXTAS

Les approches multimodales dans l'imagerie cérébrale non invasive sont de plus en plus considérées comme un outil indispensable pour la compréhension des différents aspects de la structure et de la fonction cérébrale. Grâce aux progrès des techniques d'acquisition des images de Resonance Magnetique et aux nouveaux outils pour le traitement des données, il est désormais possible de mesurer plusieurs paramètres sensibles aux différentes caractéristiques des tissues cérébraux. Ces progrès permettent, par exemple, d'étudier les substrats anatomiques qui sont à la base des processus cognitifs ou de discerner au niveau purement structurel les phénomènes dégénératifs et développementaux. Cette thèse met en évidence l'importance de l'utilisation d'une approche multimodale pour étudier les différents aspects de la dynamique cérébrale grâce à l'application de cette approche à deux études cliniques: l'évaluation structurelle et fonctionnelle des effets aigus du cannabis fumé chez des consommateurs réguliers et occasionnels, et l'évaluation de l'intégrité de la substance grise et blanche chez des jeunes porteurs de la prémutations du gène FMR1 à risque de développer le FXTAS (Fragile-X Tremor Ataxia Syndrome). Nous avons montré que chez les fumeurs occasionnels de cannabis, même à faible concentration du principal composant psychoactif (THC) dans le sang, la performance lors d'une tâche visuo-motrice est fortement diminuée, et qu'il y a des changements dans l'activité des trois réseaux cérébraux impliqués dans les processus cognitifs: le réseau de saillance, le réseau du contrôle exécutif, et le réseau actif par défaut (Default Mode). Les sujets ne sont pas en mesure de saisir les saillances dans l'environnement et de focaliser leur attention sur la tâche. L'augmentation de la réponse hémodynamique dans le cortex cingulaire antérieur suggère une augmentation de l'activité introspective. Une investigation des ef¬fets au niveau cérébral d'une exposition prolongée au cannabis, montre des changements persistants de la substance grise dans les régions associées à la mémoire et au traitement des émotions. Le niveau d'atrophie dans ces structures corrèle avec la consommation de cannabis au cours des trois mois précédant l'étude. Dans la deuxième étude, nous démontrons des altérations structurelles des décennies avant l'apparition du syndrome FXTAS chez des sujets jeunes, asymptomatiques, et porteurs de la prémutation du gène FMR1. Les modifications trouvées peuvent être liées à deux mécanismes différents. Les altérations dans le réseau moteur du cervelet et dans la fimbria de l'hippocampe, suggèrent un effet développemental de la prémutation. Elles incluent aussi une atrophie de la substance grise du lobule VI du cervelet et l'altération des propriétés tissulaires de la substance blanche des projections afférentes correspondantes aux pédoncules cérébelleux moyens. Les lésions diffuses de la substance blanche cérébrale peu¬vent être un marquer précoce du développement de la maladie, car elles sont liées à un phénomène dégénératif qui précède l'apparition des symptômes du FXTAS. - Multimodal brain imaging is becoming a leading tool for understanding different aspects of brain structure and function. Thanks to the advances in Magnetic Resonance imaging (MRI) acquisition schemes and data processing techniques, it is now possible to measure different parameters sensitive to different tissue characteristics. This allows for example to investigate anatomical substrates underlying cognitive processing, or to disentangle, at a pure structural level degeneration and developmental processes. This thesis highlights the importance of using a multimodal approach for investigating different aspects of brain dynamics by applying this approach to two clinical studies: functional and structural assessment of the acute effects of cannabis smoking in regular and occasional users, and grey and white matter assessment in young FMR1 premutation carriers at risk of developing FXTAS. We demonstrate that in occasional smokers cannabis smoking, even at low concentration of the main psychoactive component (THC) in the blood, strongly decrease subjects' performance on a visuo-motor tracking task, and globally alters the activity of the three brain networks involved in cognitive processing: the Salience, the Control Executive, and the Default Mode networks. Subjects are unable to capture saliences in the environment and to orient attention to the task; the increase in Hemodynamic Response in the Anterior Cingulate Cortex suggests an increase in self-oriented mental activity. A further investigation on long term exposure to cannabis, shows a persistent grey matter modification in brain regions associated with memory and affective processing. The degree of atrophy in these structures also correlates with the estimation of drug use in the three months prior the participation to the study. In the second study we demonstrate structural changes in young asymptomatic premutation carriers decades before the onset of FXTAS that might be related to two different mechanisms. Alteration of the cerebellar motor network and of the hippocampal fimbria/ fornix, may reflect a potential neurodevelopmental effect of the premutation. These include grey matter atrophy in lobule VI and modification of white matter tissue property in the corresponding afferent projections through the Middle Cerebellar Peduncles. Diffuse hemispheric white matter lesions that seem to appear closer to the onset of FXTAS and be related to a neurodegenerative phenomenon may mark the imminent onset of FXTAS.

Inmigración e interacción en la enseñanza/adquisición de lenguas: la construcción conversacional del alumnado de origen inmigrante

Además de presentar la interacción en el aula desde la perspectiva del trabajo en parejas alumno autóctono/no autóctono, nuestro objetivo en el presente apartado de este volumen es analizar los procesos interactivos que llevan a que una misma tarea escolar se resuelva de manera más o menos eficiente. Al mismo tiempo, contemplamos y comparamos en nuestro análisis la interacción que tiene lugar entre dos parejas de alumnos (alumna inmigrante/alumno autóctono) en la resolución de tareas escolares en lengua inglesa, prestando especial atención a cómo y en qué medida los interlocutores se orientan interactivamente hacia la identidad del alumno inmigrante.

La influencia de las TIC en la interacción docente y discente en los procesos formativos universitarios

La interacción, un elemento básico en cualquier proceso formativo, debe replantearse con la irrupción de la tecnología. Con la intención de abordar los cambios metodológicos que las TIC implican en la docencia desde la perspectiva de la interacción que generan, se planteó un estudio en la Universidad de Lérida para observar los procesos que interactúan en diferentes asignaturas en función de si éstas se desarrollaban bajo la modalidad presencial, semipresencial o no presencial. El diseño metodológico se articuló alrededor de tres técnicas de recogida de datos: análisis documental de programas de asignaturas, cuestionarios a profesores y estudiantes y entrevistas a profesores. Los datos mostraron que, conforme aumenta la no presencialidad de las asignaturas, profesorado y estudiantado utilizaban más herramientas tecnológicas (correo electrónico, foro, chat, redes sociales...) para comunicarse. Además, el tipo de comunicación imperante tenía finalidades académicas, mientras que se producía una escasa interacción para aspectos más personales (de orientación, apoyo...); en este sentido, tanto profesorado como estudiantado preferirían un contacto más cercano no tan centrado en los elementos académicos del proceso. También observamos que en las asignaturas en línea se desarrolla un trabajo más individual por parte del estudiantado. Aunque todavía queda camino por recorrer en la interacción docente-discente a través de las TIC, los agentes implicados en el proceso reconocen sus potencialidades, pero aún no las utilizan como consideran que convendría hacerse.

Recommendations for the use of multimodal monitoring in the neurointensive care unit.

PURPOSE OF REVIEW: Multimodal monitoring (MMM) is routinely applied in neurointensive care. Unfortunately, there is no robust evidence on which MMM-derived physiologic variables are the most clinically relevant, how and when they should be monitored, and whether MMM impacts outcome. The complexity is even higher because once the data are continuously collected, interpretation and integration of these complex physiologic events into targeted individualized care is still embryonic. RECENT FINDINGS: Recent clinical investigation mainly focused on intracranial pressure, perfusion of the brain, and oxygen availability along with electrophysiology. Moreover, a series of articles reviewing the available evidence on all the MMM tools, giving practical recommendations for bedside MMM, has been published, along with other consensus documents on the role of neuromonitoring and electroencephalography in this setting. SUMMARY: MMM allows comprehensive exploration of the complex pathophysiology of acute brain damage and, depending on the different configuration of the pathological condition we are treating, the application of targeted individualized care. Unfortunately, we still lack robust evidence on how to better integrate MMM-derived information at the bedside to improve patient management. Advanced informatics is promising and may provide us a supportive tool to interpret physiologic events and guide pathophysiological-based therapeutic decisions.

Factors cognitius relacionats amb el compliment d'higiene de mans. Impacte d'una campanya multimodal

La higiene de mans (HM) és la mesura preventiva més important per a la prevenció de la transmissió de les infeccions en l’entorn sanitari. No obstant això, tot i la relativa simplicitat del procediment, els estudis observacionals mostren que el compliment d’HM dels professionals de la salut és inferior al 40%. La dificultat per motivar els professionals a seguir les recomanacions respecte a l’HM i, per tant, obtenir un bon compliment suggereix que es tracta d’un comportament complex. El comportament humà és el resultat de múltiples influències com poden ser les característiques biològiques, l’entorn, l’educació i la cultura. La psicologia social intenta entendre aquestes característiques i factors individuals en el comportament. Per això, s’han desenvolupat diferents teories cognitives socials per definir la naturalesa i la relació entre els múltiples factors que afecten els diferents comportaments relacionats amb la salut. Aquestes teories identifiquen tres nivells de factors relacionats amb el comportament: 1) nivell individual o intrapersonal, 2) nivell interpersonal o d’interaccions entre els individus i 3) nivell comunitari.

La resolución de problemas entre iguales: incidencia de la mediación del ordenador en los procesos de interacción y en el aprendizaje

En el presente trabajo se analiza la incidencia de la mediación del ordenador en la resolución de problemas y en los procesos de interacción entre parejas de alumnos de la Enseñanza Secundaria Obligatoria. Para ello, se diseña e implementa una propuesta de enseñanza-aprendizaje que guía el proceso de resolución de problemas e incide en los procesos de interacción entre iguales. Esta propuesta se realiza en dos modalidades o contextos de aprendizaje distintos: un contexto utiliza la mediación del ordenador y el otro contexto no. El análisis de los resultados obtenidos en nuestro trabajo muestra la incidencia positiva de la mediación de la hoja de cálculo en el proceso de aprendizaje de los alumnos y en los procesos de interacción que presentan las distintas parejas durante la resolución de un problema. Los alumnos que han resuelto los problemas con la hoja de cálculo obtienen resultados estadísticamente superiores a los obtenidos por los alumnos que no han utilizado esta herramienta informática y presentan, principalmente, una interacción compartida.

Social network extraction and analysis based on multimodal dyadic interaction

Social interactions are a very important component in people"s lives. Social network analysis has become a common technique used to model and quantify the properties of social interactions. In this paper, we propose an integrated framework to explore the characteristics of a social network extracted from multimodal dyadic interactions. For our study, we used a set of videos belonging to New York Times" Blogging Heads opinion blog. The Social Network is represented as an oriented graph, whose directed links are determined by the Influence Model. The links" weights are a measure of the"influence" a person has over the other. The states of the Influence Model encode automatically extracted audio/visual features from our videos using state-of-the art algorithms. Our results are reported in terms of accuracy of audio/visual data fusion for speaker segmentation and centrality measures used to characterize the extracted social network.

Multimodal counter-argumentation in the workplace : the contribution of gesture and gaze to the expression of disagreement

This paper examines argumentative talk-in-interaction in the workplace. It focuses on counter-argumentative references, which consist of the various resources that the opponent uses to refer to the origin/source of his/her opposition, namely the confronted position and the person who expressed it. Particular attention is paid to the relationship - in terms of sequential positioning and referential extension - between reported speech, polyphony, pointing gestures and shifts in gaze direction. Data are taken from workplace management meetings that have been recorded in New Zealand by the Language in the Workplace Project.

Approaches to the study of individual–landscape interaction as an evocation of intrapersonal communication Aproximaciones al estudio de la interacción individuo-paisaje a modo de evocación comunicativa intrapersonal

Analysis of the interaction between landscape and the individual opens up many research avenues linked to the generation and interpretation of symbolisms and imaginaries. The capacity of landscape for significant and/or communicative evocation finds in intrapersonal communication a relevant argument for the construction of a theoretical framework to study the process of appropriation and experience of the landscape in terms of communicative expression. The principal aim of this paper is to set up the theoretical framework that enables us to interpret the language of landscape and to decode its intangible discourse.

Added value of acute multimodal CT-based imaging (MCTI) : a comprehensive analysis

Introduction: MCTI is used to assess acute ischemic stroke (AIS) patients.We postulated that use of MCTI improves patient outcome regardingindependence and mortality.Methods: From the ASTRAL registry, all patients with an AIS and a non-contrast-CT (NCCT), angio-CT (CTA) or perfusion-CT (CTP) within24 h from onset were included. Demographic, clinical, biological, radio-logical, and follow-up caracteristics were collected. Significant predictorsof MCTI use were fitted in a multivariate analysis. Patients undergoingCTA or CTA&CTP were compared with NCCT patients with regards tofavourable outcome (mRS ≤ 2) at 3 months, 12 months mortality, strokemechanism, short-term renal function, use of ancillary diagnostic tests,duration of hospitalization and 12 months stroke recurrence.

Peripheral Nerve Repair: Multimodal Comparison of the Long-Term Regenerative Potential of Adipose Tissue-Derived Cells in a Biodegradable Conduit.

Tissue engineering is a popular topic in peripheral nerve repair. Combining a nerve conduit with supporting adipose-derived cells could offer an opportunity to prevent time-consuming Schwann cell culture or the use of an autograft with its donor site morbidity and eventually improve clinical outcome. The aim of this study was to provide a broad overview over promising transplantable cells under equal experimental conditions over a long-term period. A 10-mm gap in the sciatic nerve of female Sprague-Dawley rats (7 groups of 7 animals, 8 weeks old) was bridged through a biodegradable fibrin conduit filled with rat adipose-derived stem cells (rASCs), differentiated rASCs (drASCs), human (h)ASCs from the superficial and deep abdominal layer, human stromal vascular fraction (SVF), or rat Schwann cells, respectively. As a control, we resutured a nerve segment as an autograft. Long-term evaluation was carried out after 12 weeks comprising walking track, morphometric, and MRI analyses. The sciatic functional index was calculated. Cross sections of the nerve, proximal, distal, and in between the two sutures, were analyzed for re-/myelination and axon count. Gastrocnemius muscle weights were compared. MRI proved biodegradation of the conduit. Differentiated rat ASCs performed significantly better than undifferentiated rASCs with less muscle atrophy and superior functional results. Superficial hASCs supported regeneration better than deep hASCs, in line with published in vitro data. The best regeneration potential was achieved by the drASC group when compared with other adipose tissue-derived cells. Considering the ease of procedure from harvesting to transplanting, we conclude that comparison of promising cells for nerve regeneration revealed that particularly differentiated ASCs could be a clinically translatable route toward new methods to enhance peripheral nerve repair.

International comparison of the German evidence-based S3-guidelines on the diagnosis and multimodal treatment of early and locally advanced gastric cancer, including adenocarcinoma of the lower esophagus.

BACKGROUND: Clinical guidelines are essential in implementing and maintaining nationwide stage-specific diagnostic and therapeutic standards. In 2011, the first German expert consensus guideline defined the evidence for diagnosis and treatment of early and locally advanced esophagogastric cancers. Here, we compare this guideline with other national guidelines as well as current literature. METHODS: The German S3-guideline used an approved development process with de novo literature research, international guideline adaptation, or good clinical practice. Other recent evidence-based national guidelines and current references were compared with German recommendations. RESULTS: In the German S3 and other Western guidelines, adenocarcinomas of the esophagogastric junction (AEG) are classified according to formerly defined AEG I-III subgroups due to the high surgical impact. To stage local disease, computed tomography of the chest and abdomen and endosonography are reinforced. In contrast, laparoscopy is optional for staging. Mucosal cancers (T1a) should be endoscopically resected "en-bloc" to allow complete histological evaluation of lateral and basal margins. For locally advanced cancers of the stomach or esophagogastric junction (≥T3N+), preferred treatment is preoperative and postoperative chemotherapy. Preoperative radiochemotherapy is an evidence-based alternative for large AEG type I-II tumors (≥T3N+). Additionally, some experts recommend treating T2 tumors with a similar approach, mainly because pretherapeutic staging is often considered to be unreliable. CONCLUSIONS: The German S3 guideline represents an up-to-date European position with regard to diagnosis, staging, and treatment recommendations for patients with locally advanced esophagogastric cancer. Effects of perioperative chemotherapy versus chemoradiotherapy are still to be investigated for adenocarcinoma of the cardia and the lower esophagus.