Assessment of International GNSS Service Global Ionosphere Map products over China region based on measurements from the Crustal Movement Observation Network of China

The global ionosphere maps(GIM)provided by the International GNSS Service(IGS)are extensively utilized for ionospheric morphology monitoring,scientific research,and practical application.Assessing the credibility of GIM products in data-sparse regions is of paramount importance.In this study,measurements from the Crustal Movement Observation Network of China(CMONOC)are leveraged to evaluate the suitability of IGS-GIM products over China region in 2013-2014.The indices of mean error(ME),root mean square error(RMSE),and normalized RMSE(NRMSE)are then utilized to quantify the accuracy of IGS-GIM products.Results revealed distinct local time and latitudinal dependencies in IGS-GIM errors,with substantially high errors at nighttime(NRMSE:39%)and above 40°latitude(NRMSE:49%).Seasonal differences also emerged,with larger equinoctial deviations(NRMSE:33.5%)compared with summer(20%).A preliminary analysis implied that the irregular assimilation of sparse IGS observations,compounded by China’s distinct geomagnetic topology,may manifest as error variations.These results suggest that modeling based solely on IGS-GIM observations engenders inadequate representations across China and that a thorough examination would proffer the necessary foundation for advancing regional total electron content(TEC)constructions.

Force-induced Caspase-1-dependent pyroptosis regulates orthodontic tooth movement

Pyroptosis,an inflammatory caspase-dependent programmed cell death,plays a vital role in maintaining tissue homeostasis and activating inflammatory responses.Orthodontic tooth movement(OTM)is an aseptic force-induced inflammatory bone remodeling process mediated by the activation of periodontal ligament(PDL)progenitor cells.However,whether and how force induces PDL progenitor cell pyroptosis,thereby influencing OTM and alveolar bone remodeling remains unknown.In this study,we found that mechanical force induced the expression of pyroptosis-related markers in rat OTM and alveolar bone remodeling process.Blocking or enhancing pyroptosis level could suppress or promote OTM and alveolar bone remodeling respectively.Using Caspase-1^(−/−)mice,we further demonstrated that the functional role of the force-induced pyroptosis in PDL progenitor cells depended on Caspase-1.Moreover,mechanical force could also induce pyroptosis in human ex-vivo force-treated PDL progenitor cells and in compressive force-loaded PDL progenitor cells in vitro,which influenced osteoclastogenesis.Mechanistically,transient receptor potential subfamily V member 4 signaling was involved in force-induced Caspase-1-dependent pyroptosis in PDL progenitor cells.Overall,this study suggested a novel mechanism contributing to the modulation of osteoclastogenesis and alveolar bone remodeling under mechanical stimuli,indicating a promising approach to accelerate OTM by targeting Caspase-1.

The osteoclastic activity in apical distal region of molar mesial roots affects orthodontic tooth movement and root resorption in rats

The utilization of optimal orthodontic force is crucial to prevent undesirable side effects and ensure efficient tooth movement during orthodontic treatment.However,the sensitivity of existing detection techniques is not sufficient,and the criteria for evaluating optimal force have not been yet established.Here,by employing 3D finite element analysis methodology,we found that the apical distal region(A-D region)of mesial roots is particularly sensitive to orthodontic force in rats.Tartrate-resistant acidic phosphatase(TRAP)-positive osteoclasts began accumulating in the A-D region under the force of 40 grams(g),leading to alveolar bone resorption and tooth movement.When the force reached 80 g,TRAP-positive osteoclasts started appearing on the root surface in the A-D region.Additionally,micro-computed tomography revealed a significant root resorption at 80 g.Notably,the A-D region was identified as a major contributor to whole root resorption.It was determined that 40 g is the minimum effective force for tooth movement with minimal side effects according to the analysis of tooth movement,inclination,and hyalinization.These findings suggest that the A-D region with its changes on the root surface is an important consideration and sensitive indicator when evaluating orthodontic forces for a rat model.Collectively,our investigations into this region would aid in offering valuable implications for preventing and minimizing root resorption during patients’orthodontic treatment.

Modifying the progression of Parkinson's disease through movement interventions:multimodal quantification of underlying mechanisms

Introduction:Parkinson’s disease(PD)is the most common neurodegenerative movement disorder.The pathological hallmark is the progressive loss of dopaminergic neurons of the substantia nigra pars compacta,which is accompanied by widespread alterations in the structu re and function of distributed brain networks.Togethe r,these processes cause a variety of motor symptoms such as bradykinesia,rigidity,tremor,gait disorders,or difficulties in fine motor control(Bange et al.,2022).

Dual roles of the amygdala-hippocampus circuit in the regulation of rapid eye movement sleep and depression symptoms by repetitive transcranial magnetic stimulation in patients with insomnia

To the editor:It is commonly reported that people with insomnia often experience comorbid emotional disorders,such as mood and anxiety disorders.12 A study found that fragmented rapid eye movement(REM)sleep in individuals with insomnia is associated with higher Beck Depression Inventory(BDI)scores.3 REM sleep architecture disruption is a typical symptom of insomnia.

Present-day movement characteristics of the Qinghai Nanshan fault and its surrounding area from GPS observation

The Qinghai Nanshan fault is a larger fault in the Northeastern Xizang Plateau.In previous studies,its movement characteristics are mainly investigated with geological and seismic observations,and the tectonic transformation role of the fault on its east is not yet clear.This study uses data fusion to obtain denser GPS observations near the Qinghai Nanshan fault.Based on tectonic characteristics,we establish a block model to investigate the fault slip rate,locking degree,and slip deficit.The results show that the Qinghai Nanshan fault slip rate is characterized by sinistral and convergent movement.Both the sinistral and convergent rates display a decreasing trend from west to east.The locking degree and slip deficit are higher in the western segment(with an average of about 0.74 and 1.1 mm/a)and lower in the eastern segment.Then,we construct a strain rate field using GPS observations to analyze the regional strain characteristics.The results indicate that along the fault,the western segment shows a larger shear strain rate and negative dilation rate.Regional earthquake records show that the frequency of earthquakes is lower near the fault.The joint results suggest that the western segment may have a higher earthquake risk.In addition,the insignificant fault slip rate in the eastern segment may indicate that it does not participate in the tectonic transformation among the Riyueshan,Lajishan,and West Qinling faults.

Obtaining 2D Soil Geotechnical Profiles from Cokriging Interpolation of Sample Data and Electrical Resistivity Tomography (ERT)—Applications in Mass Movements Studies

Brazil annually faces significant challenges with mass movements, particularly in areas with poorly constructed housing, inadequate engineering, and lacking sanitation infrastructure. Campos do Jordão, in São Paulo state, is a city currently grappling with these issues. This paper details a study conducted within a pilot area in Campos do Jordão, where geophysical surveys and geotechnical borehole data were integrated. The geophysical surveys provided 2D profiles, and samples were collected to analyse soil moisture and plasticity. These datasets were combined using a Cokriging-based model to produce an accurate representation of the subsurface conditions. The enhanced modelling of subsurface variability facilitates a deeper understanding of soil behavior, which can be used to improve landslide risk assessments. This approach is innovative, particularly within the international context where similar studies often do not address the complexities associated with urban planning deficits such as those observed in some areas of Brazil. These conditions, including the lack of proper sanitation and irregular housing, significantly influence the geological stability of the region, adding layers of complexity to subsurface assessments. Adapting geotechnical evaluation methods to local challenges offers the potential to increase the efficacy and relevance of geological risk management in regions with similar socio-economic and urban characteristics.

Effect of different interventions on orthodontic tooth movement acceleration:A network meta-analysis

Objective: To explore the effectiveness of various interventions in accelerating tooth movement, a systematic review and net-work meta analysis were used to draw a conclusion. Methods: MEDLINE, EMBASE, Willey Library, EBSCO, Web of Science Databases, and Cochrane Central Register of Controlled Trials databases to identify relevant studies. ADDIS 1.16.6 and Stata 16.0 software were used for NMA. Results: Five thousand five hundred and forty-two articles were searched out. After screening by two independent investigators, forty-seven randomized controlled trials, 1 390 participants, were included in this network meta-analysis. A total of 11 interventions involving Piezocision (Piezo), Photobiomodulation therapy (PBMT), Plate- let-rich plasma(PRP), Electromagnetic field(EF), Low intensity laser therapy(LLLT), Low intensity pulsed ultrasound(LI-PUS), Low-frequency vibrations(LFV), Distraction osteogenesis(DAD), Corticotomy(Corti), Microosteoperforations (MOPS), Traditional orthodontic(OT)were identified and classified into 3 classes including surgical treatment, non-surgical treatment and traditional orthodontic treatment. According to SUCRA probability ranking of the best intervention effect, when orthodontic treatment lasted for 1 month, PBMT (90.6%), Piezo(87.4%) and MOPs(73.6%)were the top three interventions to improve the efficiency of canine tooth movement. When orthodontic treatment lasted for 2 months, Corti (75.7%), Piezo (69.6%) and LFV(58.9%)were the top three interventions for improving the mobility efficiency of canine tooth movement. When orthodontic treatment lasted for 3 months, Cort (73.3%), LLLT(68.4%)and LFV(60.8%)were the top three interventions for improving the mobility efficiency of canine tooth movement. Conclusion: PBMT and Piezo can improve the efficiency of canine tooth movement significantly after 1 month, while Corti and LFV can improve the efficiency of canine tooth movement better after 2 and 3 months.

Association between Meeting 24-Hour Movement Guidelines and Psychological Features of Chinese Emerging Adults

Background:Emerging adulthood is a pivotal life stage,presenting significant psychological and social changes,such as decreased sociability,depression,and other mental health problems.Previous studies have associated these changes with an unhealthy lifestyle.The 24-h movement guidelines for healthy lifestyles have been developed to promote appropriate health behaviors and improve individual wellness.However,the relationship between adherence to the 24-h movement guidelines and different characteristics of Chinese emerging adults is yet to be explored.This cross-sectional study aimed to investigate the association between adherence to the 24-h movement guidelines and four characteristics(self-exploration,instability,possibilities,and responsibility)of Chinese emerging adults.Methods:Overall,1,510 Chinese emerging adults aged 18–29 years were included in this study.Each participant completed a self-administered questionnaire that included questions on adherence to the 24-h movement guidelines(physical activity,sedentary behavior,and sleep)and the inventory of dimensions of emerging adulthood.Multivariable logistic regression analysis was employed to investigate the associations between adherence to the 24-h movement guidelines and each of the four characteristics.Results:The proportion of participants who adhered to the 24-h movement guidelines was 31.72%.Multiple regression analysis revealed a significantly negative relationship between adhering to more guidelines and instability(β=−0.51,p<0.001).A statistically significant association was observed between instability and meeting only sedentary behavior(β=−1.27,95%confidence interval[CI]:[−2.32,−0.24],p=0.02),sedentary behavior+sleep(β=−1.30,95%CI:[−2.24,−0.35],p<0.01),and physical activity+sedentary behavior(β=−1.08,95%CI:[1.94,−0.21],p=0.02)guidelines.Further,positive and significant associations were observed between possibilities and meeting the guidelines for only physical activity(β=0.70,95%CI:[0.14,1.27),p=0.01),only sleep(β=0.61,95%CI:[0.01,1.21],p=0.04),physical activity+sedentary behavior(β=0.56,95%CI:[0.04,1.07),p=0.01),and physical activity+sleep(β=0.76,95%CI:[0.23,1.27],p=0.01).Conclusions:These findings suggest that adherence to the 24-h movement guidelines was associated with instability in Chinese emerging adults.Future studies are warranted to verify our findings to highlight the importance of maintaining a heath lifestyle to promote health in emerging adulthood.

Movement Function Assessment Based on Human Pose Estimation from Multi-View

Human pose estimation is a basic and critical task in the field of computer vision that involves determining the position(or spatial coordinates)of the joints of the human body in a given image or video.It is widely used in motion analysis,medical evaluation,and behavior monitoring.In this paper,the authors propose a method for multi-view human pose estimation.Two image sensors were placed orthogonally with respect to each other to capture the pose of the subject as they moved,and this yielded accurate and comprehensive results of three-dimensional(3D)motion reconstruction that helped capture their multi-directional poses.Following this,we propose a method based on 3D pose estimation to assess the similarity of the features of motion of patients with motor dysfunction by comparing differences between their range of motion and that of normal subjects.We converted these differences into Fugl–Meyer assessment(FMA)scores in order to quantify them.Finally,we implemented the proposed method in the Unity framework,and built a Virtual Reality platform that provides users with human–computer interaction to make the task more enjoyable for them and ensure their active participation in the assessment process.The goal is to provide a suitable means of assessing movement disorders without requiring the immediate supervision of a physician.

Muscle Strength, Lumbar Curve, Fear of Movement and Functional Disability among Patients with Lumbar Disc Herniation: A Review

Introduction: Lumbar disc herniation (LDH) refers to the rupture of the fibrous annulus of the intervertebral discs. Lumbar curvature may lead to the occurrence of lumbar disc degeneration. Fear of movement may worsen their disc herniation and cause further pain and injury. LDH conditions impact the individuals’ quality of life, to explore the relationship between lumbar curve, muscle strength, fear of movement and functional disability among patients with LDH. Methods: An electronic search was conducted on PubMed, Medline, Science Direct, Springerlink, Google Scholar and a hand search from reference lists was reviewed. Publications were included in human studies, patients 25 - 85 years of age, original studies and published in English language journals from January 2002 to December 2023. Result: In total, 64 articles were researched through the online search engines, and 9 papers were found through manual searches of reference lists. As a result, a total of 11 articles were included for the purpose of this review. The comprehensive analysis revealed the presence of eight cross-sectional studies, two retrospective studies and one experimental study. A minimum of 25 participants and a maximum of 360 participants were included. Ten studies included both genders, only one studies included healthy adults and patients with LDH but these studies didn’t mention gender. Results showed that the factors influencing LDH can be categorized into non-modifiable factors, such as gender, age, height or others. Modifiable factors included increased BMI, DM, smoking, alcohol, employment status, lifestyle and health problems or psychology. Conclusion: Females with greater VASC may be at risk of LDH. The lumbar extensor muscles indicated a localized disc herniation or nerve root pathology in patients with LDH. The fear of movement may lead to psychological consequences and reduce functional disability among patients with LDH.

Research progress of 24-hour movement behaviors in chronic non-communicable disease

Chronic non-communicable diseases(NCDs)represent a significant impediment to improve life expectancy and remain a focal point in global public health and disease prevention efforts.24-hour movement behaviors,which include sleep,sedentary behavior(SED),and physical activity,underscore the inherent connections between different daily activities and the comprehensive impact of overall movement patterns on health.Evidence suggested that modifying patterns of 24-hour movement behaviors can aid in preventing and attenuating the progression of NCDs.This study systematically delineated the concept,evolution,analytical methods,and intrinsic associations of 24-hour movement behaviors,emphasizing their pivotal role in the prevention and management of NCDs such as obesity,mental disorders,cardiovascular diseases,diabetes,and renal diseases.Future research endeavors should focus on refining methodologies,broadening study populations,developing research tools,and exploring precise intervention strategies and interdisciplinary approaches to comprehensively enhance the effectiveness of NCDs prevention and management from a temporal perspective.Such efforts are poised to provide substantive guidance and support for public health practices.

“Eternal Motion” as a “Form of Movement of a Special Nature” and the Main Condition for the Creation of the Universe

The article hypothesizes that DE and DM (UCM) are a “Form of Motion of a Special Nature”, where “Form of Motion” means “Eternal Motion” as the power of dynamics of different levels and varying degrees of self-sufficiency, and by “Special Nature”, gravitational and two other properties of matter, “tied” to the “Eternal Movement” and completely dependent on it. Carriers of key properties of a “Special Nature” have been established: “0”-DE particles and “3”-DM particles (UDM). The unity of their inherent “motionally-gravitational” properties and the peculiarity of the relationship between “motion” and “gravity” are revealed: the higher the intensity of “Eternal Motion”, the stronger the gravitational properties of matter are manifested (and vice versa). The relationship of “time” with the “vibration frequency” and the “mass” of photons with the “degree of bonding and deformation properties of the field” is shown. The maximum level of gravity has been determined, which allows Nature to successfully create the Universe: such a landmark is the proximity to the property of the Primary Source—the “pure graviton” of the OSP space, the most powerful “motionally-gravitational” particle of the Universe. The reasons for the emergence of such an identity of the gravitational properties of particles with the indicators of a “pure graviton” are established: for “0”-DE particles, this is the acquisition of the function of “freedom of movement”;for “3”-DM particles (UDM), the creation of a special structure—a “double field” (“Main” and “Small”). The presence in the “double field” of specific “tools” for the creation of the worlds of the Universe—gravitational “waves” gives rise to impulses (shocks) of varying intensity and shape. A list of functions performed by “waves” in the “Main” and “Small” fields has been compiled. The specific conditions for the formation of “UDM Streams”, their transformation into a “Vortex” and, under the influence of a powerful Initial Impulse (push), sending them to the “place” of the creation of galaxies, are shown. It is suggested that there is a “Cycle of Matter in Nature” in the closed structure of our Universe due to the “work” of “waves” and the functioning of special “factories” in the form of exotic space objects—Black holes.

Adaptive navigation assistance based on eye movement features in virtual reality

Background Navigation assistance is essential for users when roaming virtual reality scenes;however,the traditional navigation method requires users to manually request a map for viewing,which leads to low immersion and poor user experience.Methods To address this issue,we first collected data on who required navigation assistance in a virtual reality environment,including various eye movement features,such as gaze fixation,pupil size,and gaze angle.Subsequently,we used the boosting-based XGBoost algorithm to train a prediction model and finally used it to predict whether users require navigation assistance in a roaming task.Results After evaluating the performance of the model,the accuracy,precision,recall,and F1-score of our model reached approximately 95%.In addition,by applying the model to a virtual reality scene,an adaptive navigation assistance system based on the real-time eye movement data of the user was implemented.Conclusions Compared with traditional navigation assistance methods,our new adaptive navigation assistance method could enable the user to be more immersive and effective while roaming in a virtual reality(VR)environment.

Design of Rehabilitation Training Device for Finger-Tapping Movement Based on Trajectory Extraction Experiment

Patients with stroke, tendon injury and cardiovascular disease commonly have the sequelae of hand dysfunction which seriously affects the patients’ ability in daily life. Previous studies have found that the function of finger-tapping movement accounts for 80% of the hand function, and the recovery of the motor ability of the finger-tapping can greatly improve the patients’ self-care ability. Therefore, a rehabilitation training device to restore the finger-tapping movement is designed. In the study, anthropometry was applied to measure the dynamic and static dimensions of human hands in the finger-tapping movement. Subjects were selected according to the selected size range, and an experimental platform was built. Sampling points were set at key positions of index fingers and thumbs, and characteristic points of coronal planes and sagittal planes were recorded at a frequency of 10 frames per second. MATLAB was used to optimize the fitting of the scatter plot, and the fitted spatial curve parameters were input into the modeling software to establish the joint motion trajectory model and assist the design of rehabilitation training devices. It is proved that the device is ergonomic, and can effectively achieve the finger-tapping movement rehabilitation training of patients.

Three-dimensional assessment of movement patterns of Sichuan snub-nosed monkeys affected by habitat structure in temperate forests

DEAR EDITOR,Movement patterns can reflect species-specific characteristics of individuals and animal groups at a given scale. Accurate three-dimensional(3D) assessment can quantify the relationship between movement patterns of an animal and its unique habitat. Here, we evaluated the effects of habitat structure on movement patterns of the golden snub-nosed monkey(Rhinopithecus roxellana). We used airborne light detection and ranging(LiDAR) to map the 3D structure of the temperate forest in the Qinling Mountains(Shaanxi, China).

Application of Eye Movement Analysis in Landscape Visual Quality Evaluation

The existing methods of landscape visual quality evaluation is mostly based on people's subjective feelings,and the objectivity and scientificity of evaluation results are insufficient.As an important means of experimental psychology,eye movement technology can show great advantages and potential in landscape visual quality evaluation.On the basis of combing and summarizing the relevant literature,based on the explanation of the technical principle of eye movement analysis,the application field,research content,technical methods and other aspects of eye movement analysis were reviewed.The application prospect of eye movement technology in landscape visual quality evaluation was explored to provide theoretical reference for the in-depth evaluation and research of landscape visual quality evaluation theory.

Associations between meeting 24-hour movement guidelines and quality of life among children and adolescents with autism spectrum disorder

Background:The Canadian 24-hour movement behavior(24-HMB)guidelines suggest that a limited amount of screen time use,an adequate level of physical activity(PA),and sufficient sleep duration are beneficial for ensuring and optimizing the health and quality of life(QoL)of children and adolescents.However,this topic has yet to be examined for children and adolescents with autism spectrum disorder(ASD)specifically.The aim of this cross-sectional observational study was to examine the associations between meeting 24-HMB guidelines and several QoLrelated indicators among a national sample of American children and adolescents with ASD.Methods:Data were taken from the 2020 U.S.National Survey of Children’s Health dataset.Participants(n=956)aged 617 years and currently diagnosed with ASD were included.The exposure of interest was adherence to the 24-HMB guidelines.Outcomes were QoL indicators,including learning interest/curiosity,repeating grades,adaptive ability,victimization by bullying,and behavioral problems.Categorical variables were described with unweighted sample counts and weighted percentages.Age,sex,race,preterm birth status,medication,behavioral treatment,household poverty level,and the educational level of the primary caregivers were included as covariates.Odds ratio(OR)and 95%confidence interval(95%CI)were used to present the strength of association between adherence to 24-HMB guidelines and QoL-related indicators.Results:Overall,452 participants(45.34%)met 1 of the 3 recommendations,216(22.65%)met 2 recommendations,whereas only 39 participants(5.04%)met all 3 recommendations.Compared with meeting none of the recommendations,meeting both sleep duration and PA recommendations(OR=3.92,95%CI:1.639.48,p<0.001)or all 3 recommendations(OR=2.11,95%CI:1.034.35,p=0.04)was associated with higher odds of showing learning interest/curiosity.Meeting both screen time and PA recommendations(OR=0.15,95%CI:0.040.61,p<0.05)or both sleep duration and PA recommendations(OR=0.24,95%CI:0.070.87,p<0.05)was associated with lower odds of repeating any grades.With respect to adaptive ability,participants who met only the PA recommendation of the 24-HMB were less likely to have difficulties dressing or bathing(OR=0.11,95%CI:0.020.66,p<0.05)than those who did not.For participants who met all 3 recommendations(OR=0.38,95%CI:0.150.99,p=0.05),the odds of being victimized by bullying was lower.Participants who adhered to both sleep duration and PA recommendations were less likely to present with severe behavioral problems(OR=0.17,95%CI:0.040.71,p<0.05)than those who did not meet those guidelines.Conclusion:Significant associations were found between adhering to 24-HMB guidelines and selected QoL indicators.These findings highlight the importance of maintaining a healthy lifestyle as a key factor in promoting and preserving the QoL of children with ASD.

Development and Evaluation of Intersection-Based Turning Movement Counts Framework Using Two Channel LiDAR Sensors

This paper presents vehicle localization and tracking methodology to utilize two-channel LiDAR data for turning movement counts. The proposed methodology uniquely integrates a K-means clustering technique, an inverse sensor model, and a Kalman filter to obtain the final trajectories of an individual vehicle. The objective of applying K-means clustering is to robustly differentiate LiDAR data generated by pedestrians and multiple vehicles to identify their presence in the LiDAR’s field of view (FOV). To localize the detected vehicle, an inverse sensor model was used to calculate the accurate location of the vehicles in the LiDAR’s FOV with a known LiDAR position. A constant velocity model based Kalman filter is defined to utilize the localized vehicle information to construct its trajectory by combining LiDAR data from the consecutive scanning cycles. To test the accuracy of the proposed methodology, the turning movement data was collected from busy intersections located in Newark, NJ. The results show that the proposed method can effectively develop the trajectories of the turning vehicles at the intersections and has an average accuracy of 83.8%. Obtained R-squared value for localizing the vehicles ranges from 0.87 to 0.89. To measure the accuracy of the proposed method, it is compared with previously developed methods that focused on the application of multiple-channel LiDARs. The comparison shows that the proposed methodology utilizes two-channel LiDAR data effectively which has a low resolution of data cluster and can achieve acceptable accuracy compared to multiple-channel LiDARs and therefore can be used as a cost-effective measure for large-scale data collection of smart cities.

Eye Movement Modeling Examples as a Teaching Tool for Epidural Block

Introduction: Video examples with task demonstrations by experts, with the expert’s eye movements superimposed on the task, are known as “eye movement modeling examples” (EMME). We performed this study to evaluate if there were improvements in the performance of anesthesia novice trainees when executing the epidural technique after an EMME of epidural block procedure. Methods: We developed an eye movement modeling example (EMME) from eye tracking recordings made by experienced anesthesiologists with more than 20 years of experience. Forty-two PGY3 anesthesia trainees who had never previously performed an epidural block were randomized to receive (study group) or not receive (control group) the EMME video before their institutional training. All the trainees were evaluated every 10 epidural blocks until the end of the rotation period, by an independent, blinded observer using the Global Rating Scale for Epidural Anesthesia (GRS). Results: Trainees who received the EMME training exhibited more respect for the patient’s tissues (P Discussion: This is the first study that has used the EMME for a practical, clinical teaching purpose on real patients and that has used it as an aid in teaching epidural anesthesia. We demonstrated that inexperienced trainees who received the EMME training improved their proficiency at epidural blocks as compared to those who had no EMME training beforehand. Given this result, we welcome further studies to investigate the impact and the role of EMME on clinical teaching in the field of anesthesia.