Faculty Bibliography

INTRODUCTION/UNASSIGNED:Parkinson's disease (PD) is the second most prevalent neurodegenerative disease. Complementary and alternative therapies are increasingly utilized to address its complex multisystem symptomatology. Art therapy involves motoric action and visuospatial processing while promoting broad biopsychosocial wellness. The process involves hedonic absorption, which provides an escape from otherwise persistent and cumulative PD symptoms, refreshing internal resources. It involves the expression in nonverbal form of multilayered psychological and somatic phenomena; once these are externalized in a symbolic arts medium, they can be explored, understood, integrated, and reorganized through verbal dialogue, effecting relief and positive change. METHODS/UNASSIGNED:42 participants with mild to moderate PD were treated with 20 sessions of group art therapy. They were assessed before and after therapy with a novel arts-based instrument developed to match the treatment modality for maximum sensitivity. The House-Tree-Person PD Scale (HTP-PDS) assesses motoric and visuospatial processing-core PD symptoms-as well as cognition (thought and logic), affect/mood, motivation, self (including body-image, self-image, and self- efficacy), interpersonal functioning, creativity, and overall level of functioning. It was hypothesized that art therapy will ameliorate core PD symptoms and that this will correlate with improvements in all other variables. RESULTS/UNASSIGNED:HTP-PDS scores across all symptoms and variables improved significantly, though causality among variables was indeterminate. DISCUSSION/UNASSIGNED:Art therapy is a clinically efficacious complementary treatment for PD. Further research is warranted to disentangle causal pathways among the aforementioned variables, and additionally, to isolate and examine the multiple, discrete healing mechanisms believed to operate simultaneously in art therapy.

Haptic technology is a critical component of human-computer interfaces. Traditional haptic actuators are often unable to provide the broad frequency range and latency that is required in many advanced applications. To address this problem, we propose a new type of tactor based on macro-fiber composites (MFCs), composites of piezoelectric fibers. We propose a physics-based model for the actuation of the tactors, calibrated and validated through experiments. As our tactors are intended for haptic applications, we consider the role of skin on their response, an aspect seldom analyzed in the literature. In our experiments, we simulate the presence of the skin with a rubber membrane in contact with the tactor, with varying pre-stretch, mimicking different indentations of the tactor on the skin. The MFC-based tactor can always generate vibration amplitudes higher than skin discrimination thresholds, over the range of frequencies of interest for haptics, with a latency much smaller than traditional actuators. We theoretically investigate the effect of the skin on tactor vibrations, highlighting the individual roles of skin stiffness and damping and their combined effect across a series of pre-stretches. Our tactor shows promise in haptic applications, including assistive technologies and real-time feedback systems for training, safety, and monitoring.

OBJECTIVE:People with blindness and low vision face substantial challenges when navigating both indoor and outdoor environments. While various solutions are available to facilitate travel to and from public transit hubs, there is a notable absence of solutions for navigating within transit hubs, often referred to as the "middle mile". Although research pilots have explored the middle mile journey, no solutions exist at scale, leaving a critical gap for commuters with disabilities. In this paper, we proposed a novel mobile application, Commute Booster, that offers full trip planning and real-time guidance inside the station. METHODS AND PROCEDURES/METHODS:Our system consists of two key components: the general transit feed specification (GTFS) and optical character recognition (OCR). The GTFS dataset generates a comprehensive list of wayfinding signage within subway stations that users will encounter during their intended journey. The OCR functionality enables users to identify relevant navigation signs in their immediate surroundings. By seamlessly integrating these two components, Commute Booster provides real-time feedback to users regarding the presence or absence of relevant navigation signs within the field of view of their phone camera during their journey. RESULTS:As part of our technical validation process, we conducted tests at three subway stations in New York City. The sign detection achieved an impressive overall accuracy rate of 0.97. Additionally, the system exhibited a maximum detection range of 11 meters and supported an oblique angle of approximately 110 degrees for field of view detection. CONCLUSION/CONCLUSIONS:The Commute Booster mobile application relies on computer vision technology and does not require additional sensors or infrastructure. It holds tremendous promise in assisting individuals with blindness and low vision during their daily commutes. Clinical and Translational Impact Statement: Commute Booster translates the combination of OCR and GTFS into an assistive tool, which holds great promise for assisting people with blindness and low vision in their daily commute.

Vision-based localization approaches now underpin newly emerging navigation pipelines for myriad use cases, from robotics to assistive technologies. Compared to sensor-based solutions, vision-based localization does not require pre-installed sensor infrastructure, which is costly, time-consuming, and/or often infeasible at scale. Herein, we propose a novel vision-based localization pipeline for a specific use case: navigation support for end users with blindness and low vision. Given a query image taken by an end user on a mobile application, the pipeline leverages a visual place recognition (VPR) algorithm to find similar images in a reference image database of the target space. The geolocations of these similar images are utilized in a downstream task that employs a weighted-average method to estimate the end user's location. Another downstream task utilizes the perspective-n-point (PnP) algorithm to estimate the end user's direction by exploiting the 2D-3D point correspondences between the query image and the 3D environment, as extracted from matched images in the database. Additionally, this system implements Dijkstra's algorithm to calculate a shortest path based on a navigable map that includes the trip origin and destination. The topometric map used for localization and navigation is built using a customized graphical user interface that projects a 3D reconstructed sparse map, built from a sequence of images, to the corresponding a priori 2D floor plan. Sequential images used for map construction can be collected in a pre-mapping step or scavenged through public databases/citizen science. The end-to-end system can be installed on any internet-accessible device with a camera that hosts a custom mobile application. For evaluation purposes, mapping and localization were tested in a complex hospital environment. The evaluation results demonstrate that our system can achieve localization with an average error of less than 1 m without knowledge of the camera's intrinsic parameters, such as focal length.

Although visual symptoms are common following concussion, quantitative measures of visual function are missing from concussion evaluation protocols on the athletic sideline. For the past half century, rapid automatized naming (RAN) tasks have demonstrated promise as quantitative neuro-visual assessment tools in the setting of head trauma and other disorders but have been previously limited in accessibility and scalability. The Mobile Interactive Cognitive Kit (MICK) App is a digital RAN test that can be downloaded on most mobile devices and can therefore provide a quantitative measure of visual function anywhere, including the athletic sideline. This investigation examined the feasibility of MICK App administration in a cohort of Division 1 college football players. Participants (n = 82) from a National Collegiate Athletic Association (NCAA) Division 1 football team underwent baseline testing on the MICK app. Total completion times of RAN tests on the MICK app were recorded; magnitudes of best time scores and between-trial learning effects were determined by paired t-test. Consistent with most timed performance measures, there were significant learning effects between the two baseline trials for both RAN tasks on the MICK app: Mobile Universal Lexicon Evaluation System (MULES) (p < 0.001, paired t-test, mean improvement 13.3 s) and the Staggered Uneven Number (SUN) (p < 0.001, mean improvement 3.3 s). This study demonstrated that the MICK App can be feasibly administered in the setting of pre-season baseline testing in a Division I environment. These data provide a foundation for post-injury sideline testing that will include comparison to baseline in the setting of concussion.

Saccadic slowing as a component of supranuclear saccadic gaze palsy is an important diagnostic sign in multiple neurologic conditions, including degenerative, inflammatory, genetic, or ischemic lesions affecting brainstem structures responsible for saccadic generation. Little attention has been given to the accuracy with which clinicians correctly identify saccadic slowing. We compared clinician (n = 19) judgements of horizontal and vertical saccade speed on video recordings of saccades (from 9 patients with slow saccades, 3 healthy controls) to objective saccade peak velocity measurements from infrared oculographic recordings. Clinician groups included neurology residents, general neurologists, and fellowship-trained neuro-ophthalmologists. Saccades with normal peak velocities on infrared recordings were correctly identified as normal in 57% (91/171; 171 = 9 videos × 19 clinicians) of clinician decisions; saccades determined to be slow on infrared recordings were correctly identified as slow in 84% (224/266; 266 = 14 videos × 19 clinicians) of clinician decisions. Vertical saccades were correctly identified as slow more often than horizontal saccades (94% versus 74% of decisions). No significant differences were identified between clinician training levels. Reliable differentiation between normal and slow saccades is clinically challenging; clinical performance is most accurate for detection of vertical saccade slowing. Quantitative analysis of saccade peak velocities enhances accurate detection and is likely to be especially useful for detection of mild saccadic slowing.

Smart health applications have received significant attention in recent years. Novel applications hold significant promise to overcome many of the inconveniences faced by persons with disabilities throughout daily living. For people with blindness and low vision (BLV), environmental perception is compromised, creating myriad difficulties. Precise localization is still a gap in the field and is critical to safe navigation. Conventional GNSS positioning cannot provide satisfactory performance in urban canyons. 3D mapping-aided (3DMA) GNSS may serve as an urban GNSS solution, since the availability of 3D city models has widely increased. As a result, this study developed a real-time 3DMA GNSS-positioning system based on state-of-the-art 3DMA GNSS algorithms. Shadow matching was integrated with likelihood-based ranging 3DMA GNSS, generating positioning hypothesis candidates. To increase robustness, the 3DMA GNSS solution was then optimized with Doppler measurements using factor graph optimization (FGO) in a loosely-coupled fashion. This study also evaluated positioning performance using an advanced wearable system's recorded data in New York City. The real-time forward-processed FGO can provide a root-mean-square error (RMSE) of about 21 m. The RMSE drops to 16 m when the data is post-processed with FGO in a combined direction. Overall results show that the proposed loosely-coupled 3DMA FGO algorithm can provide a better and more robust positioning performance for the multi-sensor integration approach used by this wearable for persons with BLV.

ABSTRACT/UNASSIGNED:While the physiatric community increasingly embraces Evidence-Based Medicine (EBM), the current state of EBM training for trainees in physiatry is unclear. The purpose of this article is to report the results of the Association of Academic Physiatrists (AAP)'s surveys of physiatry residency programs in the United States (US), to discuss the implications of their findings, and to better delineate the 'baseline' upon which sound and clear recommendations for systematic EBM training can be made. The two AAP surveys of US physiatry residency programs reveal that most survey respondents report that they include EBM training in their programs that covers the five recommended steps of EBM core competencies. However, while most respondents reported using traditional pedagogical methods of training such as journal club, very few reported that their EBM training used a structured and systematic approach. Future work is needed to support and facilitate physiatry residency programs interested in adopting structured EBM training curricula that include recommended EBM core-competencies and the evaluation of their impact.

A group of international researchers and editors summarize how (promptly and easily) an original manuscript can be written using certain tips and tricks. In other words, the authors guide novice colleagues with minimal experience using simple hints and straightforward advice in scholarly publishing. The main body of an original article is composed of four parts: Introduction, Methods, Results and Discussion (the IMRaD format). We make recommendations about how to write these sections. We also make suggestions regarding the title, abstract, key words, and references. In addition, we underline the importance of carefully reading and following both general recommendations for the conduct, reporting, editing, and publication of scholarly papers. Specific guidelines are reviewed for improving clarity, accuracy and transparency, from protocol registration and ethical approval to submission issues, inclusive of rehabilitation specificities. A thorough review of the mission and instructions of the journals under consideration is critical inclusive of manuscript preparation guidelines such as word limits of main text, limits in number and style of references, tables and figures, format, checklist, and other specific instructions. Finally, each and every sentence should be iteratively revised for grammar, style, and clarity.