Benign paroxysmal positional vertigo (BPPV) is a specific type of short-duration vertigo that is provoked by changes in head position and usually lasts less than one minute. It is a common vestibular pathology that can have significant effects on patient safety, quality of life, and medical costs. Therefore, it is crucial that medical students are educated and trained to facilitate and coordinate care of patients who may have undiagnosed BPPV. Because there is evidence to suggest that physicians—specifically primary care physicians—may not be properly equipped in their education to manage patients with BPPV, the purpose of this study was to investigate medical students’ evaluations of their preparedness to provide evidence-based care in the diagnosis and treatment of BPPV. An anonymous survey was administered via email to medical students in their fourth and final year of medical school at East Tennessee State University’s Quillen College of Medicine. This survey includes statements about the evidence-based Clinical Practice Guideline on BPPV provided by the American Academy of Otolaryngology. Respondents rated the degree to which they agreed or disagreed with how prepared they felt to address each item using a 5-point response scale from “strongly disagree” to “strongly agree.” Of the 70 students in the current fourth year class, 41 (59%) completed the survey. Students felt prepared for some aspects of diagnosing and treating BPPV, especially with regard to their general knowledge of BPPV, its impact on patients’ lives, and the options available to manage it. They felt less prepared to know when or if it is appropriate to recommend additional testing, imaging, or medication. They did not feel confident in their ability to perform the maneuvers to diagnose and treat BPPV. Overall, these results suggest medical students have a good foundation in their knowledge of BPPV. These results also propose topics to support more specialized training during their residencies to build upon the foundational knowledge obtained during their didactic training and optimize diagnosis and management of BPPV.

The purpose of this study was to examine the prevalence of nystagmus found in healthy individuals during the positional testing subtest of the standard vestibular test battery. Positional testing involves moving the patient's head, and sometimes the entire body, into a variety of positions while observing eye movement. The hypothesis of the current study was that a relatively low percentage of participants would display nystagmus during positional testing used routinely in clinical diagnostic procedures. The findings were then compared to those of an earlier study in which 82% of normal, healthy individuals were reported to exhibit nystagmus during this testing. Twenty-five participants were selected that had no known otologic disease and who reported normal hearing sensitivity. In addition, the participants affirmed they had not consumed any alcohol or taken any medications that are known to affect nystagmus. They were then observed in nine different positions. Forty-eight percent of the participants experienced nystagmus in at least one position. Although this percentage was considerably lower than that reported in the earlier study, methodological differences appear to account for the discrepancy. Specifically, the criterion for determining the presence/absence of nystagmus potentially explains the difference in full.

Computer games, especially Massively Multiplayer Online Role Playing Games, have elements where communication between players is of great need. This communication is generally conducted through in-game text chats, in-game voice chats or external voice programs. In-game voice chats can be constructed to work in a similar way as talking does in real life. When someone talks, anyone close enough to that person can hear what is said, with a volume depending on distance. This is called positional or spatial voice chat in games. This differs from the commonly implemented voice chat where participants in conversations are statically defined by a team or group belonging. Positional voice chat has been around for quite some time in games and it seems to be of interest for a lot of users, despite this, it is still not very common. This thesis investigates impacts of implementing a positional voice chat in the existing MMORPG Mortal Online by Star Vault. How is it built, what are the costs, how many users can it support and what do the users think of it? These are some of the questions answered within this project. The design science research method has been selected as scientific method. A product in form of a positional voice chat library has been constructed. This library has been integrated into the existing game engine and its usage has been evaluated by the game’s end users. Results show a positional voice system that in theory supports up to 12500 simultaneous users can be built from scratch and be patched into an existing game in less than 600 man-hours. The system needs third-party libraries for threading, audio input/output, audio compression, network communication and mathematics. All libraries used in the project are free for use in commercial products and do not demand code using them become open source. Based on a survey taken by more than 200 users, the product received good ratings on Quality of Experience and most users think having a positional voice chat in a game like Mortal Online is important. Results show a trend of young and less experienced users giving the highest average ratings on quality, usefulness and importance of the positional voice chat, suggesting it may be a good tool to attract new players to a game.

Global Navigation Satellite Systems (GNSS) i kombination med Nätverks-RTK (NRTK) har idag blivit en vanlig metod för geodetiska inmätningar i plan och höjd. Inmätningar med NRTK har fördelen att de är relativt enkel att använda, ger koordinater i realtid och med låg mätosäkerhet (2–3 cm). Dock har användare rapporterat om att större avvikelser i höjd är vanligare än avvikelser i plan, vilka varierar över tid. Tidigare studier har inte funnit samband mellan avvikelser i höjd med NRTK och variationen över tid.  Studiens syfte var att undersöka hur resultatet av inmätta höjder med NRTK varierar över tid och vad som påverkar avvikelsen i höjd samt om det går att finna ett samband för avvikelserna.   I studien användes en GNSS-mottagare med NRTK för att på två stompunkter insamla mätdata en gång i minuten i tre timmar på varje punkt, under totalt två dagar. Mätdata som lagrades och analyserades var antal satelliter, PDOP, vertikal precision, och tidpunkt för inmätt höjd och höjdvärde. Under fältarbetet användes också två olika elevationsvinklar, 10 och 15 grader, för att se hur mätosäkerheten påverkades. Vidare utfördes en dubbelavvägning mellan stompunkterna som en kontroll av de angivna höjdkoordinaterna. Resultatet visar att variationen för enskild inmätt höjd är slumpmässig. En undersökning av PDOP, antal satelliter, horisontell och vertikal precision gav inga korrelationer till mätresultatet. Standardosäkerheten i höjd för mätserie på punkt 8316 med 10° elevationsvinkel beräknades till 1,2 cm och med en förändring till 15° elevationsvinkel 1,6 cm. På punkt 8318 med 10° elevationsvinkel beräknades 2,6 cm och med 15° elevationsvinkel 3,4 cm.  Analysen av mätdata förtydligar att behov finns för att öka tillförlitligheten vid GNSS-mätning med NRTK. Standardosäkerheten överskrider angiven mätosäkerhet för metoden, vid mätning på 8318 med 15° elevationsvinkel. Med elevationsvinkel 10° uppnås inte 68 % av mätningarna inom sigmanivå 2, och drygt 13 % återfinns inom sigmanivå 2–3. Vid en beräkning av standardosäkerhet, med medeltals-bildning, erhölls markanta förbättringar på punkt 8316 för båda mätserierna upp till 20 min medan det följande ger avtagande förbättringar. På punkt 8318 erhölls ständiga förbättringar kontinuerligt till 60 min vilket var den högsta gränsen som undersöktes. Differens mellan högsta och lägsta avvikelse för inmätt höjd, jämfört med känd höjd, beräknades till 9,2 cm för punkt 8316 med 15° elevation och 6,9 cm med 10°. Motsvarande för punkt 8318 med 15° beräknades avvikelsen till 16,5 cm och 12,3 cm för 10°. För GNSS-användare behövs insikt i att enskilda mätningar, med lågt angivna värden i handenheten, inte säkerställer goda mätresultat. Flera mätningar under kort tid kan ge mycket låg standardosäkerhet, men en timme senare kan samma låga standard-osäkerhet för nya mätningar fortfarande representera en avvikande inmätt höjd. Medeltalsbildning, tidsseparation och en lämplig elevationsvinkel är sannolikt krav för att tillförlitligt kunna säkerställa att metoden uppnår 2–3 cm mätosäkerhet i höjd för 68 % av mätningarna. / The usage of GNSS is becoming increasingly more common due to its efficiency and time saving capacities. Network-RTK is a method that uses relative positioning and is supposed to deliver measurements with a positional accuracy of about 2-3 cm for plane and height. Previous research shows variety in measuring results using NRTK at different times or days, but the focus was on other aspects than time itself. This study focused on time and its impact on GNSS-derived heights, linked to used methods for practical use of GNSS, and these results were meant to create guidelines or routines for increased reliability in measuring data if it exceeded the positional accuracy. Measurment data were gathered at two vertical control points during three hours each, on two separate days, with data being collected at a one-minute interval. The findings of this study show that the variety over time is random, and that there are no standard settings or routines that guarantee reliability for the method to deliver commonly stated positional accuracies. Although, we found that certain steps for improving measurements are time-separating, averaged measurements for at least twenty minutes, and a good understanding of how to set an appropriate elevation mask.

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Nowadays mid-range smartphones have enough computational power to run simultaneous location and mapping (SLAM) algorithms that, together with their onboard inertial sensors makes them capable of position and rotation tracking. Based on this, Google and Apple have released their own respective software development kits (SDKs) that allow smartphones to run augmented reality applications using six degrees of freedom tracking. However, this same approach could be implemented to virtual reality head-mounted-display (HMD) based on smartphones, but current virtual reality SDKs only offer rotational tracking. In this study the positional tracking technology used for augmented reality mobile applications has been implemented in a virtual reality head-mounted-display only powered by a smartphone by combining virtual and augmented reality SDKs. Compatibility issues between SDKs have been faced to develop a working prototype. An objective and controlled measurement study has been conducted that included 34.200 measurements, to test the accuracy, precision and jitter tracking of the protype against the Oculus Rift, a dedicated virtual reality system. Results show that the developed prototype offers a decent tracking precision and accuracy in optimal conditions. It was concluded to be highly dependent on the camera view. Although, jitter presented the opposite behavior, being dependent to the device used but independent on the camera view. In its optimal conditions, user studies demonstrated that the prototype was capable of offering the same tracking performance feeling as the Oculus Rift although jitter was quite noticeable, and a common user complain. Further studies are proposed that can improve the tracking performance of the prototype by filtering jitter and using two or more cameras with a different angular to correlate feature points and obtain a wider view of the environment were the prototype is used. / Idag har mellanklass-smartphones tillräckligt med beräkningskapacitet för att simultant köra lokalisering och kartläggnings(SLAM) algoritmer tillsammans med deras tröghetssensorer ombord, vilket gör att de kan positionera och rotera spårning. Baserat på det här så har Google och Apple släppt sina egna respektive programvaror (SDK) som gör att smartphones kan köra ökade realitetsapplikationer med sex graders frihetsspårning. Emellertid kan samma tillvägagångssätt implementeras till virtuell verklighet på en huvudmonterad display (HMD) baserat på smartphones, men nuvarande VR SDK erbjuder endast rotationsspårning. I denna studie så har positionell spårningsteknik som används för AR i mobila applikationer implementerats i ett VRheadset som endast drivs av en smartphone genom att kombinera VR och ARSDKs. Kompatibilitetsproblem mellan SDKs har resulterat i att utveckla en fungerande prototyp. En objektiv och kontrollerad mätstudie har genomförts som inkluderade 34.200 mätningar, för att testa noggrannheten, precision och jitterspårning av protyp mot Oculus Rift, ett dedikerat virtuellt verklighetssystem. Resultat visar att den utvecklade prototypen ger en anständig spårningsprecision och noggrannhet i optimala betingelser. Denna slutsats var mycket beroende av kameravy. Även om jitter presenterade det motsatta beteendet, beroende på vilken enhet som används men oberoende av kamerans vy. I sina optimala förhållanden visade användarstudier att prototypen kunde erbjuda samma spårningsförmåga som Oculus Rift, även om jitter var ganska märkbar, och en vanlig användares klagomål. Ytterligare studier föreslås som kan förbättra prototypens spårningsprestanda genom att filtrera jitter och använder två eller flera kameror med en annan vinkling till att korrelera funktionspunkter och få en bredare bild av miljön var prototypen används.

Objective: To determine the difference in effectiveness of positional release therapy (PRT) compared with therapeutic massage (TM) in treating trigger and tender points in the upper trapezius muscle. Background: Trigger points in the upper trapezius muscle are common and can be painful. Therapeutic massage is a more traditional treatment method for this condition while PRT is relatively new. Design and Setting: A randomized-group design was used to examine the differences between the 2 treatments for reducing pain and muscle tension. Subjects: Sixty healthy subjects (males = 24, females = 36; age = 27.1 ± 8.8 years; wt = 75.2 ± 17.9 kg; ht = 172.8 ± 9.7 cm) presenting with upper trapezius pain and a trigger point. Subjects were randomly assigned to the TM group or the PRT group. Measurements: Presence of upper trapezius trigger points was found via palpation by a clinician. Level of pain was measured by a visual analog scale (VAS) and pain pressure threshold (PPT) was assessed by a pressure algometer. Muscle thickness was measured by B-mode ultrasound (US) and muscle tension was measured by shear-wave elastography (SWE). Subjects were measured pretreatment and posttreatment and 48 hours later. Results: All measurements showed significant improvements for both treatments. Positional release therapy was more effective (p = 0.05) at reducing pain at day 2 and was able to maintain the pain loss. The SWE and US showed no difference between the treatment groups. There was no significant difference in PPT, but PRT PPT increased each visit while TM dropped significantly at day 2 (p = .003). Conclusion: Both treatments showed a significant ability to reduce pain and acutely decrease muscle stiffness (as measured by SWE) but there were few differences between the treatments. However, there appeared to be a slight benefit for pain reduction with PRT up to 2 days posttreatment.

Objective: To determine the difference in effectiveness of positional release therapy (PRT) compared with therapeutic massage (TM) in treating trigger and tender points in the upper trapezius muscle. Background: Trigger points in the upper trapezius muscle are common and can be painful. Therapeutic massage is a more traditional treatment method for this condition while PRT is relatively new. Design and Setting: A randomized-group design was used to examine the differences between the 2 treatments for reducing pain and muscle tension. Subjects: Sixty healthy subjects (males = 24, females = 36; age = 27.1 ± 8.8 years; wt = 75.2 ± 17.9 kg; ht = 172.8 ± 9.7 cm) presenting with upper trapezius pain and a trigger point. Subjects were randomly assigned to the TM group or the PRT group. Measurements: Presence of upper trapezius trigger points was found via palpation by a clinician. Level of pain was measured by a visual analog scale (VAS) and pain pressure threshold (PPT) was assessed by a pressure algometer. Muscle thickness was measured by B-mode ultrasound (US) and muscle tension was measured by shear-wave elastography (SWE). Subjects were measured pretreatment and posttreatment and 48 hours later. Results: All measurements showed significant improvements for both treatments. Positional release therapy was more effective (p = 0.05) at reducing pain at day 2 and was able to maintain the pain loss. The SWE and US showed no difference between the treatment groups. There was no significant difference in PPT, but PRT PPT increased each visit while TM dropped significantly at day 2 (p = .003). Conclusion: Both treatments showed a significant ability to reduce pain and acutely decrease muscle stiffness (as measured by SWE) but there were few differences between the treatments. However, there appeared to be a slight benefit for pain reduction with PRT up to 2 days posttreatment.

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