L’enfant autiste,le clinicien et la tablette numerique. Pour un usage plus « libre » des tablettes numériques dans le cadre d’une médiation thérapeutique

BackgroundMany researchers and clinicians for several years have shown a strong interest in the use of digital tablets with children with ASDs. However, it seems that the majority of publications on this subject mainly focus on specific applications created to respond to the difficulties of autistic children, particularly in the educational, pedagogical or cognitive remediation fields. However, it seems a regrettable fact to us to see digital tablets only from this angle. Indeed, these are not only simple palliative tools to the communication or comprehension difficulties of autistic children, but they allow them to couple their inner world with the digital worlds in a simple and adapted way.MethodBased on the case of an autistic child that we followed in a “digital tablet” mediation therapy, in a Children's Day Hospital, we will try to show how a “freer” use of these tools can also have multiple therapeutic interests. The “Therapy with digital tablet” will also be described to help the clinician wishing to set up this type of therapy in his institution.FindingsChang's case showed us that the use of the digital tablet in a dual patient/therapist situation offered the autistic child an opportunity to establish an intersubjective relationship, and that the “free” use of the tablet allowed him to express his internal experiences more easily.ConclusionFrom his digital tablet, the autistic child will be able to try different actions to see the impact they may have on the digital objects presented to him. Every action can then reveal new objects, new possibilities for action or communication which, if they take place in an interactive loop with the caregiver, can encourage him to develop his exploratory process. Finally, if the digital medium offered by the tablet is caught in an interactive loop with the therapist, who comments on what he observes and shares his emotions about what the child gives him to see, the digital tool becomes secondary in itself: it is no longer really what happens on the screen that matters in this therapeutic situation but what is played and said around the screen.     

“Just for fun?”: An exploration of digital games’ potential for eudaimonic media experiences among Flemish adolescents

ABSTRACT

Research shows that media entertainment can induce eudaimonic or meaningful experiences, such as being emotionally moved or being stimulated to reflect about oneself. While these studies have primarily focused on adults’ eudaimonic media entertainment experiences, the current study explores whether games can lead to eudaimonic experiences amongst adolescents, for instance, via characteristics like emotionally deep stories and moral choices. Games are very popular among adolescents, while eudaimonic experiences may possibly fulfill key needs of identity development and peer relatedness as well as prove to be beneficial for adolescents’ well-being and overall development. To explore adolescents’ eudaimonic game experiences, we performed a qualitative study existing of six focus groups (N = 33) and 20 individual in-depth interviews (total N = 53). Results indicate that adolescents do experience eudaimonic game moments. Specifically, they experienced socially bonding, reflective (about oneself and society), emotionally moving, and elevating moments. These were considered particularly meaningful when they were somehow connected to real life. Finally, adolescents mostly mentioned narrative aspects (i.e., the game’s story, characters, moral choices), other real players, and audiovisual aspects like graphics and soundtrack as important elicitors of eudaimonic game experiences. Limitations and future research suggestions are further discussed.     

Perceptions of digital storytelling in the classroom

Digital storytelling is used as an educational tool that enhances learning in many disciplines, although little is known about how prelicensure nursing students perceive the use of digital stories in the classroom. Digital stories were featured in the class sessions followed by a group care planning activity with objectives based on The Quality and Safety Education for Nurses (QSEN) Initiative Patient-Centered Care Competency. Focus group discussions and classroom evaluations by prelicensure students indicated positive results.     

Machine learning to identify lymph node metastasis from thyroid cancer in patients undergoing contrast-enhanced CT studies

IntroductionWe compared the diagnostic performance of morphological methods such as the major axis, the minor axis, the volume and sphericity and of machine learning with texture analysis in the identification of lymph node metastasis in patients with thyroid cancer who had undergone contrast-enhanced CT studies.MethodsWe sampled 772 lymph nodes with histology defined tissue types (84 metastatic and 688 benign lymph nodes) that were visualised on CT images of 117 patients. A support vector machine (SVM), free programming software (Python), and the scikit-learn machine learning library were used to discriminate metastatic-from benign lymph nodes. We assessed 96 texture and 4 morphological features (major axis, minor axis, volume, sphericity) that were reported useful for the differentiation between metastatic and benign lymph nodes on CT images. The area under the curve (AUC) obtained by receiver operating characteristic analysis of univariate logistic regression and SVM classifiers were calculated for the training and testing datasets.ResultsThe AUC for all classifiers in training and testing datasets was 0.96 and 0.86, at the SVM for machine learning. When we applied conventional methods to the training and testing datasets, the AUCs were 0.63 and 0.48 for the major axis, 0.70 and 0.44 for the minor axis, 0.66 and 0.43 for the volume, and 0.69 and 0.54 for sphericity, respectively. The SVM using texture features yielded significantly higher AUCs than univariate logistic regression models using morphological features (p = 0.001).ConclusionFor the identification of metastatic lymph nodes from thyroid cancer on contrast-enhanced CT images, machine learning combined with texture analysis was superior to conventional diagnostic methods with the morphological parameters.Implications for practiceOur findings suggest that in patients with thyroid cancer and suspected lymph node metastasis who undergo contrast-enhanced CT studies, machine learning using texture analysis is high diagnostic value for the identification of metastatic lymph nodes.     

The future of pathology is digital

Information, archives, and intelligent artificial systems are part of everyday life in modern medicine. They already support medical staff by mapping their workflows with shared availability of cases’ referral information, as needed for example, by the pathologist, and this support will be increased in the future even more.In radiology, established standards define information models, data transmission mechanisms, and workflows. Other disciplines, such as pathology, cardiology, and radiation therapy, now define further demands in addition to these established standards. Pathology may have the highest technical demands on the systems, with very complex workflows, and the digitization of slides generating enormous amounts of data up to Gigabytes per biopsy. This requires enormous amounts of data to be generated per biopsy, up to the gigabyte range.Digital pathology allows a change from classical histopathological diagnosis with microscopes and glass slides to virtual microscopy on the computer, with multiple tools using artificial intelligence and machine learning to support pathologists in their future work.     

The crucial role of imaging in digital dentistry

One of the recent trends in dentistry – and this in every field from the restorative to the orthodontic one– is the introduction of simplified completely digital workflows. Digital dentistry is supposed to allow dentists to work more efficiently, and this at higher precision, and with the possibility of all-in-one sessions using in-house computerized techniques. In this workflow, one of the major tools for simulating and transferring dental treatments is imaging. Both 3D low dose radiographic as well as optical imaging are playing crucial roles and have been overwhelming the market. Novel design platforms, compact and extremely fast milling and printing units are now also plentiful and rapidly being adopted in practice. Nevertheless, many of the steps in this digital dentistry process, no matter how simplified, present risks that can contribute to reduced precision and clinical difficulties. It is therefore the purpose of the article to briefly describe the role of imaging in this digital workflow, and where the pitfalls can be found that may lead to errors and imprecision.     

数字化口腔虚拟教学评估系统用于前牙全瓷冠牙体预备评分的初步评价

目的探讨数字化口腔虚拟教学评估系统在前牙全瓷冠牙体预备评分中的应用及可靠性。 方法2018年参加第二届"华南杯"口腔医学生临床技能邀请赛的21名选手和2019年参加第三届"光华杯"口腔医学生临床技能展示活动的24名选手，使用数字化口腔虚拟教学评估系统的考试模式进行左上中切牙全瓷冠牙体预备。分别采用评委评分和机器评分两种方式对牙体预备结果进行评分，记录评委所用评分时间，采用SPSS 26.0软件对评委评分与机器评分的结果进行相关性分析。 结果2018年和2019年两种评分方式评分结果均相关（r₂₀₁₈ = 0.567，P₂₀₁₈ = 0.007；r₂₀₁₉ = 0.546，P₂₀₁₉ = 0.006）；机器评分在牙体预备结束时即刻获得，评委用于每个学生的平均评分时间分别为2.31和1.88 min。 结论数字化口腔虚拟教学评估系统可应用于固定义齿修复牙体预备教学，可对牙体预备结果进行即刻评分，机器评分与评委评分成正相关性，两者各有优缺点，在牙体预备实验教学中应注意取长补短。     

Application of digital technology in nasal reconstruction

Nasal defects are facial defects caused by trauma, tumors, or congenital diseases that seriously damage a patient’s physical and mental health. Nasal defects, from skin defects to total nasal defects, require surgical repair and reconstruction to restore the appearance and function of the nose, which have always been challenges for rhinoplasty. The development of digital technology has increased the possibility of nasal reconstruction. Digital technology is involved in the preoperative, intraoperative, and postoperative stages of nasal construction and is of great significance in improving the effect of this surgery. This article reviews the application of major digital technologies, including three-dimensional (3D) imaging technology, computer-assisted surgical navigation, and 3D printing, in nasal reconstruction and discusses the shortcomings of the current application of digital technology.