Filmmakers at Sundance Explore New Narratives Using Artificial Intelligence

At the 2018 Sundance Film Festival, innovation, creativity and new tech tools help filmmakers use AI to create deeper, more meaningful human connections.

Computer-generated characters that look impossibly human, interactive exhibits that evolve from audience interaction and art that literally feeds off peoples’ emotions are just some of the new innovations that captivated visitors at the 2018 Sundance Film Festival.

Using artificial intelligence (AI) to create films once was limited to the likes of Steven Spielberg and directors of big-budget science fiction movies. But more powerful and increasingly more affordable technologies are helping filmmakers use machine learning techniques to both create and inform art.

This was evident throughout Sundance, which has been breaking barriers in technology innovation for over a decade thanks in large part to Sundance Institute’s New Frontier, which supports independent artists in exploring new and emerging mediums, such as virtual reality (VR), augmented reality (AR) and AI.

“This year, New Frontier artists are opening new avenues to a deeper understanding of AI through direct narrative engagement with the technology,” said Shari Frilot, Sundance senior programmer and chief curator for New Frontier.

“AI is a ubiquitous technology that is having a significant impact on the development of the media landscape,” said Frilot.

Until recently, creating computer-generated characters required filmmakers to have big studio backing and costly post-production muscle to even remotely create something able to suspend an audiences’ disbelief. That’s changing, as new technology tools become more accessible.

Computer as Animator

At Sundance, visitors to the Intel Tech Lodge on Park City’s Main Street could see demos by Vancouver-based Ziva Dynamics, whose software uses machine learning algorithms to create computer-generated simulations that can transform the way special effects studios create characters.

“Our software equips people with the tools to create the most realistic representations of creatures and characters as possible,” said VFX pioneer James Jacobs, Ziva’s co-CEO who won a SciTech Academy Award in 2013 for the engineering that powered characters in AvatarThe Hobbit and Planet of the Apes, among others.

Ziva’s software uses offline finite element simulations combined with geometric warping and machine learning to create real-time characters that can progressively learn, according to Jacobs. Instead of learning from time consuming and expensive scans, the software can synthesize data from the simulation itself — in minutes.

Ziva’s software is capable of mapping the natural body features of a real person — or any living, breathing animal — by creating computational models of anatomy and soft tissue like skin elasticity, fibrous muscle and gelatinous layers of fat.

All of those details are fed into machine learning algorithms that learn the body’s movements.

“Imagine a person doing every conceivable thing, and then when you have all this data, you can compress it down into something you can interact with,” said Jacobs. “It looks just as real as a thing that took hours to produce.”

Back at Intel’s Tech Lodge, visitors could also see an example of ProtoMax, a template character that any filmmaker or special-effects artist can customize to quickly create and replicate animated, engaging characters.

“Max is a representative human,” said Jacobs. “A lot of studios are using him right now as a base upon which to create different characters.”

While Ziva’s technology has been used in major productions such as Ghostbusters, Suicide Squad, Fantastic Beasts and Pacific Rim, Jacobs said the technology is now easier and more cost-effective, so more creators can use it.

ProtoMax GIF

He said it just requires software and hardware robust enough to keep up.

“We use Intel on all levels,” said Jacobs. “With our software written against a number of Intel frameworks, people using Ziva generate their results by running a number of computationally expensive offline simulations. With our Intel Xeon Scalable server running 8164 processors, we are able to run multiple simulations in parallel. When we used it to build this demo for Sundance, it gave us an over 2,000 percent speed and capacity increase.”

Ziva’s website offers tutorials and a community forum to help creators collaborate and keep pushing the capabilities of Ziva’s tools.

“Ziva is leveling the playing field for independent filmmakers or even aspirational filmmakers to create content in a way that would never have been imaginable before without millions of dollars in pre- and post-production,” said Rick Hack, who manages media and entertainment partnerships at Intel.

Intel will continue to innovate the tools and tech as fast and precisely as possible, said Alyson Griffin, vice president of global marketing at Intel.

“Our job is to help get the amazing experience imagined by the creator out for the world to enjoy,” said Griffin.

ProtoMax graphic

Audience as Creator

Movie experiences are evolving from passive to more active endeavors where audiences become part of the story narrative, even changing outcomes, according to Sundance’s Frilot. Today, audiences are becoming an active part of the narrative — even changing the outcome.

“The New Frontier art works, Frankenstein AI: A Monster Made by Many and TendAR, aim to challenge popular assumptions, fears and hopes around AI, through artfully engaging audience participation with it,” said Frilot.

The Frankenstein AI experience celebrates the 200th anniversary of Mary Shelley’s seminal work by examining the cultural and ethical ramifications of bringing something artificial to life — literally creating a “monster.”

The project comes from the Columbia University School of the Arts Digital Storytelling Lab, led by founding director Lance Weiler, a digital pioneer who Businessweek once called “one of the 18 who changed Hollywood” (sharing company with George Lucas and Steve Jobs).

“Sundance is a really amazing opportunity to be able to show the new grammar that’s emerging for storytelling, and what does it look like where machine intelligence and human creativity intersect,” said Weiler. “This project is right at the cusp.”

Frankenstein AI_hands

The Frankenstein AI experience lasts around 45 minutes. Eight audience members are taken into a dark room and paired up with a stranger. The duo swaps stories based on scripted questions — such as a time they felt really seen, or a time they felt isolated.

The questions were painstakingly designed to create instant intimacy and connection, according to Rachel Ginsberg, creative strategist and experience designer on the project.

“This is about human connection first, and that we’re exploring artificial intelligence through a human lens, as opposed to leaning into the really dystopian narrative that has dominated that universe for such a long time,” said Ginsberg.

The project’s AI begins to learn about human emotion based on the participant’s emotional responses to provocative questions like, “Why do people kill other people?” and “What is something you’ve overcome?”

“We’re trying to shift away from those formally known as the audience,” said Weiler. “When you come into this piece it is a monster made by many, so it’s literally at the edge of what’s happening in terms of the culture.”

Fishy Friends

In another New Frontier installation at Sundance, TendAR is an AI-driven virtual pet that evolves by feeding off people’s emotional responses.

TendAR, AI-driven virtual pet

The installation experience has two people tethered together via a shared ear piece. They interact with each other via a mobile app, while both holding the phone. The partners answer several questions and, based on the answers, get assigned a distinct animated fish “friend,” which learns more about the pair and the surroundings by asking questions.

“By going through and engaging with this AI fish, you are training his algorithm and training his software to understand emotion,” explained Samantha Gorman, co-founder of the new media design studio Tender Claws, which designed the app.

As the guppy friend gulps up responses via facial and object-recognition software, it learns how to better read people’s emotions. One of the implications, said Gorman, is that brands could learn about their audience and tailor their products based on the biometric feedback.

“This idea that storytelling can have a physicality to it, can be customized or personalized in interesting ways is like a whole new frontier in terms of the work that can be done,” said Weiler.

“Cinema has been a certain way for over 100 years, but now we have these new palettes and incredible new tools to play with.”

Chatbot: The Therapist in Your Pocket

AI chatbots offer a modern twist to mental health services, using texting to digitally counsel today’s smartphone generation.

Artificial intelligence (AI)-powered chatbots provide a new form of mental health support for a tech-savvy generation already comfortable using texting as its dominant form of communication.

As the demand for mental health services grows nationwide, there’s a shortage of available psychiatric professionals, according to the National Institute of Mental Health. And college campuses are seeing unprecedented rates of anxiety and depression.

Chatbots designed to spot indicators of mental health distress may provide emotional support when traditional therapy is out of reach.

While these chatbot counselors don’t replace the critical human touch essential during a personal crisis, AI and machine learning can enable the mental health community to reach more people and ensure consistent follow up, according to Michiel Rauws, co-founder and CEO of the mental health tech startup X2AI.

“There are millions of people globally who struggle with anxiety and depression, and simply not enough psychologists to take care of everyone,” Rauws said.

AI chatbots help college students

Chatbots may offer greater access to mental health services for today’s tech-savvy generation.

Based on his own experience with depression and work with immigrants affected by the war in Syria, he realized that much of cognitive behavioral therapy (CBT) is about coaching people to reframe how they think of themselves and their lives. He developed Tess, an AI chatbot that helps psychologists monitor patients, and remotely deliver personalized psychotherapy and mental health coaching.

“I had learned the psychological techniques and innovations, and realized that I might help others,” he said.

Now 27, Rauws says his generation often feels more comfortable chatting about sensitive issues via text rather than in person at a therapist’s office.

Available through text, web browsers and Facebook Messenger, Tess is offered through healthcare organizations to provide care whenever and wherever a patient needs it.

In addition to helping patients work through their issues, the AI chatbot also recognizes signals that indicate an acute crisis, such as suicidal thoughts. It alerts a human therapist when emergency intervention is essential.

The Digital Doctor is In

Several companies are developing mental health-related chatbots for direct consumer use, including the Woebot, a digital mental health coach that uses CBT to help users deal with anxiety or depression.

“Woebot is a robot you can tell anything to,” Woebot CEO Alison Darcy told Wired. “It’s not an AI that’s going to tell you stuff you don’t know about yourself by detecting some magic you’re not even aware of.”

Using Facebook Messenger, Woebot uses talk therapy prompts such as “What’s going on in your world right now?” This helps people talk about their emotional responses to life events, and identify the traps that cause stress and depression.

There’s no Freudian psychoanalysis of childhood wounds, just solutions for changing behavior. Woebot notes CBT is based on the idea that it’s not events themselves that affect people, it’s how they think about those events. What people think is often revealed in what they say.

This is just the beginning of a new era of tech-enabled mental health care. Machine learning has become so sophisticated that it can read between the lines of conversations and look for warning signs, according to researchers at IBM.

IBM used cognitive systems and machine learning to analyze written transcripts and audio recordings from psychiatric interviews to identify patterns that can indicate, and maybe even predict, mental illness.

It takes only 300 words to help clinicians predict the probability of psychosis, according to Guillermo Cecchi, a neuroscientist and researcher at IBM Research.

AI chatbots help mental health

AI technology can help in identifying patterns of thinking.

In five years, the IBM team predicts that advanced analytics, machine learning and computational biology will provide a real-time overview of a patient’s mental health.

Bringing Care to Rural Areas

These CBT technologies could meet a growing need for mental health care among the younger generation. Rates of depression and anxiety among young people are rising, according to the American College Health Association (ACHA).

Within the past year, 50 percent of college students reported feeling that things were hopeless, 58 percent felt overwhelming anxiety and 37 percent felt so depressed it was difficult to function. While universities encourage students to seek help, the social stigma still associated with mental illness can keep them from looking for a traditional therapist, according to ACHA research.

Chatbots may also help address the shortage of mental health services in rural areas where patients drive long distances to see a therapist face-to-face, said Gloria Zaionz, tech guru at the Innovation Learning Network, a think tank in Silicon Valley that studies how technology can improve healthcare.

More than 106 million people live in areas that are federally designated as having a shortage of mental health care professionals, according to the Kaiser Family Foundation.

“Mental health professionals are often limited in their capacity to provide treatment, and there are other barriers like wait times, cost and social stigma that can prevent people from getting the support they need,” Rauws said.

Companies are careful to note that AI chatbots are not intended to replace in-person treatment, but rather to expand limited access to mental health services. The tech provides more ways for patients to check in between visits and receive consistent follow-up care.

Data on the effectiveness of AI therapy is limited, but early results look encouraging, according to Rauws at X2AI. He said a trial of Tess across several U.S. universities showed a decrease in the standard depression scale and anxiety scale scores. A pilot study of Woebot also reported reduced levels of depression and anxiety.

Through a simple text conversation, AI may help in overcoming the stigma of seeking mental health care, ultimately expanding the reach of services. And a seemingly nonjudgmental chatbot may encourage people to honestly answer the question, “Are you OK?”

“There’s something about the screen that makes people feel a little bit more anonymous,” said Zaionz, “so they open up more.”

Gear Up: How to Watch the Olympic Winter Games PyeongChang 2018 in Virtual Reality

For the first time in history, fans can experience the drama and excitement of the XXIII Olympic Winter Games in live or on-demand VR.

From the breath-holding tension of ski jumping to the intricacy of pairs ice dancing and the drama of speed skating, PyeongChang 2018 brings the ultimate display of excellence in winter sports.

For the first time in history, fans watching at home can experience the XXIII Olympic Winter Games in live virtual reality (VR). More than 30 events will be broadcast live and via video on demand (VOD) from PyeongChang, South Korea via the NBC Sports VR app (in the U.S.), powered by Intel True VR.

“This will give fans across the globe the opportunity to sit front row at the Olympic Winter Games PyeongChang 2018,” said James Carwana, vice president and general manager of Intel Sports.

“You now have an opportunity to virtually sit right there and watch those moments happen.”

The 17 days of games in South Korea will represent the biggest VR event ever.

Viewers will be able to choose from up to a half dozen different viewpoints, including angles that were previously unavailable, and immerse themselves in the action, whether in the snow or on the ice.

To capture the Olympic events in VR, Intel’s True VR team set up camera “pods” around nine Olympic venues. Each pod is equipped with six pairs of lenses (or 12 cameras) that capture a stereoscopic view – capturing 180 degrees of action, but also depth, so viewers feel like they’re at the event.

“It’s a full 3D stereoscopic experience with graphics and data that immerses fans,” said Carwana. “They get to experience the intensity and amazement of the events up close and from different angles.”

True VR will broadcast marquee events such as alpine skiing (Downhill, Slalom and Super-G), ice hockey, figure skating, snowboarding and “big air” events, speed skating, curling and many of the sliding events.


Viewers can sit back and watch the director’s cut, which will switch between camera angles, based on the judgment and expertise of the broadcast team. Or they can pick and choose angles to track a favorite hockey player or focus on a particularly treacherous portion of the slope.

And, with picture-in-picture available, it’s not necessarily an either-or choice.

Additional information will help viewers understand what they’re watching.

“Things like athlete names and results will appear over our VR video, to provide context to what you’re viewing and identify the athletes on the screen,” said Blake Rowe, Intel True VR implementation manager at the Olympic Winter Games. The app will send notifications when events are airing live, so you never miss a key heat or hockey game.

Fans can watch the events live or after the fact via full-event replays and highlight reels.

How to Watch

The VR Olympic experience will be available across multiple platforms on a variety of devices via several different apps. What app to download depends on where viewers are in the world. In the U.S., the VR content will be part of NBC’s Olympics coverage, available via the NBC Sports VR app. NBC will also have 2D, 180-degree panorama content available to anyone with a smartphone.

Winter Olympics virtual reality: Four speed skaters move gracefully around track.

“The best way to experience the content is through a head-mounted display, such as the Samsung GearVRGoogle Daydream or Windows Mixed Reality,” said Rowe.

“But we are aware that some people don’t necessarily want a headset or haven’t purchased one yet,” Rowe said. “To meet that need, we are also providing an IOS and Android app that fans can download specifically for the Winter Olympics and access the same content.”

Rowe said that people can turn their smartphone into a low-tech VR headset by making an inexpensive homemade cardboard viewer.

“If you have a phone and a cardboard viewer, you can view through the stereoscopic lenses of that cardboard device to get the 3D experience on your mobile phone.”

T-Minus Two Months

True VR has been used at several other sporting events.

Whether Olympic Winter Games fans are seasoned VR users or are new to VR, they can immerse themselves in the PyeongChang 2018 experience without ever pulling on a winter coat.

10 Physical and Psychosocial Benefits of Physical Activity for Hemophilia Patients

Hemophilia is a blood disorder that’s usually genetically inherited from parents. People born with hemophilia have little or no clotting factor – a protein needed for normal blood clotting. Hemophilia can also be acquired, meaning patients don’t inherit the disease from their parents but instead develop it at some point during their lifetime. This can happen if their body forms antibodies that attack the clotting factors in the blood.

Although patients had been previously warned against physical exercise, there are in fact numerous benefits of physical exercise for hemophilia sufferers, according to

  1. Exercise creates strong muscles around the joints, reducing the risk of bleeding.
  2. Regular exercises improves balance and flexibility, reducing the risk of accidents.
  3. By exercising regularly, joint stiffness is reduced which means the likelihood of bleeding after an accident is reduced.
  4. The higher the level of fitness, the quicker a patient recovers after a bleed or surgery.
  5. Regular exercises increases energy levels and reduces fatigue.
  6. Exercise increases self-esteem and confidence, and can be an enjoyable activity for both children and adults.
  7. Exercise reduces stress.
  8. Weight-bearing exercises increase bone density, promoting healthy bone maintenance.
  9. Certain studies show that regular exercise increases the effect of hemophilia treatments and reduces bleeding episodes.
  10. Regular exercise can also provide a peer group for social interaction and help promote social interaction.

Man Becomes First With Severe Hemophilia to Climb Seven Summits

Earlier this month, Chris Bombardier became the first person to climb the Seven Summits with severe hemophilia. The Seven Summits consist of the tallest peaks on each continent: Carstesz Pyramid in Australia, Mount Everest in Asia, Denali in North America, Mount Elbrus in Europe,  Mt. Vinson in Antarctica, Mount Kilimanjaro in Africa and Mount Aconcagua in Argentina.

According to, Bombardier reached the summit of Mt. Vinson on January 6, 2018. He says he took on the challenge to “to bring awareness to the fact that only 25 percent of the people in the world who live with hemophilia have access to proper treatment.”

Bombardier also said his accomplishment proves that those living with hemophilia aren’t limited. That they can achieve “the impossible with proper treatment, training and medical care.”

You can follow Chris’s future adventures on his website,

Balance and Eye Training Program Succeeds in MS Patients

Balance and fatigue outcomes improved even in patients with lesionsAction Points

An integrated program of balance and eye-movement exercises improved balance, dizziness, fatigue, and quality of life in people with multiple sclerosis (MS), researchers reported.

In a randomized controlled trial, MS patients who had at least minimally impaired balance and fatigue experienced improved outcomes with Balance and Eye-Movement Exercises for Persons with Multiple Sclerosis (BEEMS) training, even when brainstem or cerebellar lesions were present.

 In 6 weeks from baseline, BEEMS participants achieved greater improvements than controls in Computerized Dynamic Posturography-Sensory Organization Test (CDP-SOT) composite, Dizziness Handicap Inventory (DHI) total, Modified Fatigue Impact Scale (MFIS) total, and Short Form-36 Health Status Questionnaire (SF-36) mental and physical scores, reported Jeffrey Hebert, PT, PhD, of the University of Colorado School of Medicine in Aurora, and colleagues.

And at 14 weeks from baseline, they bettered controls in CDP-SOT composite, DHI total, MFIS total, and SF-36 mental and physical scores, they wrote in Neurology.

Response differences in patients with brainstem or cerebellar lesions were evident at 6 weeks, but not sustained at 14 weeks, they added.

“The results of this study should inform how we deliver balance retraining in a population at high risk of falls,” wrote Susan Bennett, DPT, EdD, of the University at Buffalo in New York, and Victoria Leavitt, PhD, of Columbia University Medical Center in New York City, in an accompanying editorial. “These findings are promising and encourage future work to further probe the benefits and mechanisms of BEEMS.”

“Most rehabilitation programs to improve balance have focused mainly on strength exercises and balance exercises that are not designed for the specific problems of people with MS,” Hebert said in a statement. “We wanted to see if performing balance and eye movement exercises while processing multiple different sensory information could help people improve their balance and fatigue issues.”

This investigation was a follow-up to a pilot study and was an examiner-blinded trial with three phases:

  • 2-week baseline phase
  • 6-week treatment phase 1
  • 8-week treatment phase 2

During the baseline phase, the researchers obtained outcome measures twice to control for learning effects of the dynamic posturography-based balance test.

Adult patients were included if they had clinically definite MS and the ability to ambulate 100 m with intermittent or unilateral constant use of an assistive device. “The inclusion of participants who required use of an assistive device is another strength of this study because these persons have a greater challenge with balance,” noted Bennett and Leavitt.

The researchers randomized 88 participants (44 BEEMS, 44 controls) and 76 patients completed the trial.

Participants were screened for balance (CDP-SOT ≤82 of 100) and fatigue (MFIS ≥22 of 84). The CDP-SOT cutoff is the clinically meaningful difference of 8 points below that of healthy adults, the authors noted; the MFIS score is greater than the clinically relevant change of 15 reported for pharmaceutical interventions.

 Patients performed BEEMS training twice weekly with supervision and daily at home. The program consisted of three components: standing on difference surfaces, mobility-based walking with and without head movements, and visual stability including voluntary saccadic movements, smooth pursuits, and gaze stability.

“Of specific interest in this study was the presence of unsteady gaze fixation, which may reduce eye-hand coordination, and dysmetric saccades, which may interfere with guided stepping,” Bennett and Leavitt noted.

Additional training included visual input alterations such as ball tossing, somatosensory alterations that involved changing surfaces, and vestibular input alterations that affected yaw and pitch directions and whole-body movements.

From baseline to 6 weeks, BEEMS participants experienced greater improvements than controls in CDP-SOT composite (model-estimated difference in change 4.9, P=0.006), DHI total (−13.5, P<0.0001), MFIS total (−11.4, P<0.0001), SF-36 Mental (5.6, P=0.0006), and SF-36 Physical (3.5, P=0.004) scores.

From baseline to 14 weeks, the BEEM group had better CDP-SOT composite (8.3, P< 0.0001), DHI total (−13.9, P<0.0001), MFIS total (−12.3, P<0.0001), SF-36 Mental (3.9, P=0.02), and SF-36 Physical (3.2, P=0.01) scores.

BEEMS participants with brainstem or cerebellar lesion involvement experienced greater improvements compared with those without in CDP-SOT composite (5.26, P=0.04) and MFIS total (−7.6, P=0.02) scores from baseline to 6 weeks, but those differences were not sustained by 14 weeks.

“Overall, these findings demonstrate that the BEEMS protocol improved balance, consistent with previous nonspecific intervention studies, and resulted in greater improvements of dizziness and fatigue,” the authors wrote. “These findings suggest that vestibular rehabilitation and eye/head/limb coordination under progressively more challenging conditions should be included in physical interventions.”

Study limitations included an insufficient sample size to compare BEEMS patients against controls by lesion/no lesion. Gait outcomes that challenge postural control and clinical measures of balance should be considered in the future, the authors noted. The only measures related to the vestibulo-ocular reflex were the gaze stabilization and dynamic visual acuity tests; future investigations should include direct assessments like the head impulse test, they added.

Reminder: Start Planning Your Vacation Right Now

Today is National Plan for Vacation Day, so bust out your calendar and start thumbing through those travel guides. You don’t want to let those precious vacation days go to waste just because you got too busy before you organized some much deserved R and R.

I was reminded of today, my favorite of all fake marketing stunt holidays, by travel expert Samantha Brown. In a video from the Project: Time Off YouTube channel (above), Brown shares some of Project: Time Off’s alarming data. For example, 54 percent of Americans left 662 million vacation days unused in 2016. That’s roughly 1.8 million years of time not spent sipping margaritas or visiting grandma. I never expected the travel host I used to watch on TV after school would be scolding me for not taking enough vacation (Passport to Europe with Samantha anyone?), but here we are—and she’s right.

Why is planning your vacation early important? For starters, the more notice you can give work, the less stressed you’ll be about actually using your alloted days. Studies, like this one out of the Netherlands, suggest people find their vacations more enjoyable and more restorative when the time off itself isn’t causing them any stress. Planning early will also save you a ton of money in the long run. Between hotels, event venues, and flights, the earlier you can get things organized, the better for your wallet. Airbnb is even taking strides to appeal to you reluctant planners out there. Recently, they’ve started allowing guests to play less up front when booking, making the service feel a bit more like a hotel. The site lets guests book a place ahead of time without with minimal headaches if their plans fall through at the last minute, and helps keep hosts from losing out on advance bookings from “cash flow-sensitive guests.”

So, now’s the time folks. Pick a destination (it can be home), make a goal for your time off (it can simply be to relax), give yourself ample time to let your time off sink in (eight days or so should do it), and give yourself an extra day buffer just in case (worst case scenario you have an extra day to just chill and get ready for your return to work).

Michael Mosley: ‘Forget walking 10,000 steps a day’

These days it is hard to walk the streets without running into someone who is anxiously looking at their wrist to see if they are on target to reach the magic 10,000 steps.

Is it really a goal worth striving for, or might there be something better?

And where did that figure come from?

You might be surprised to hear it was the result of a 1960s marketing campaign in Japan.

In the run-up to the 1964 Tokyo Olympics, a company came up with a device which they started marketing to the health-conscious.

It was called a Manpo-Kei. In Japanese, “man” means 10,000, “po” means steps and “kei” means meter. So it was, literally, a 10,000 steps meter.

The device was an early pedometer, based on the work of Dr Yoshiro Hatano, a young academic at Kyushu University of Health and Welfare.

Dr Hatano was worried that the Japanese were busy importing a slothful American lifestyle, as well as a love of watching baseball, and wanted to help them get more active.

He reckoned that if he could persuade his fellow Japanese to increase their daily steps from 4,000 to around 10,000 then they would burn off approximately 500 extra calories a day and remain slim.

That, apparently, was how the “10,000 steps a day” regime was born.

It was clearly a great marketing success. But is it still the most effective way to improve our fitness?

‘Knitting is my only activity’

For The Truth about Getting Fit, I went to a factory in Sheffield with Prof Rob Copeland from Sheffield Hallam University.

Our aim was to do a small experiment in which we would compare the benefits and ease of doing 10,000 steps against something called, “Active 10“.

With Active 10 you don’t need to count steps. You simply aim to do three brisk 10-minute walks a day.

Our volunteers all had different reasons for wanting to get fitter.

Walkers who tried Active 10
Image captionSome of the volunteers who took part in our test

Dave said: “I’m very aware that I’m not as fit as I used to be and I’ve put a lot of weight on,” while Judy confessed: “My only activity at the moment is knitting.”

And Nathan, who has a six-year-old daughter, said: “She runs so fast, and I run so slowly, I can’t catch her up.”

Our small group of volunteers was fitted with activity monitors so we could not only monitor what they did, but also how vigorously they did it.

First, a normal day’s activity was measured.

Rob then split them into two groups. One was asked to hit the 10,000-step target – around five miles – in a day, while the other group was asked to do three sessions of “Active 10” – which adds up to around 1.5 miles – more like 3,000 steps.

The Active 10 group were also told that their aim was not to amble but to get their pace up so that they would be working their heart and lungs. Prof Copeland told them: “You are aiming to walk fast enough so that you can still talk but not sing.”

Brisk walks

When we looked at the volunteers’ results, two out of the three asked to do 10,000 steps had managed to hit their target. But they had all struggled.

The Active 10 group, on the other hand, had found it relatively easy. They had formed a small walking group and met together at convenient times during their working day to go for a brisk walk together.

So 10,000 steps was harder to achieve – but which activity was better for health?

Woman walking

Prof Copeland had analysed the data from their tracking monitors and he said the findings were very clear.

“The Active 10 group actually did 30% more ‘moderate to vigorous physical activity’ than the 10,000-step group, even though they moved for less time.

“And it’s when you are doing moderate intensity activity that you are starting to get the greatest health benefits.”

So even though the Active 10 group spent less time actually moving, they spent more time getting out of breath and increasing their heart rate.

Prof Copeland told the group: “What we really wanted you to do was to get your heart beating faster. There’s lots of evidence to suggest that by doing so you can lower your risk of diabetes, cardiovascular disease and some cancers.”

So three short brisk walks were easier to fit into the day and better for health.

I thought that was really interesting and I found it very encouraging, because I really don’t like doing 10,000 steps.

So the fact that you can get similar, perhaps greater, benefits from a few brisk walks a day is enormously encouraging.

To start doing some Active 10s in your day go to the NHS website where you can download a free Public Health England app. It is a good way to see how much brisk walking you’re doing, and how to do more.

Osteoid osteoma

Osteoid osteomas are benign bone forming tumours that typically occur in children (particularly adolescents). They have characteristic lucent nidus <2 cm and surrounding solid periosteal reaction and classically cause night pain that is relieved by the use of salicylate analgesia, e.g. aspirin.

Osteoid osteomas are usually found in children and adolescents, between the ages of 10 and 35 years 2.

They account for ~10% of all benign bone lesions and there is a male predilection (M:F 2-4:1) 2.

Classically patients present with nocturnal pain and are relieved by salicylates (e.g. aspirin).

When in the spine they are a classic cause of painful scoliosis, concave on the side of lesion. This typical presentation is seen in over 75% of cases 2.

Soft tissue swelling may occur (see case 4) and if close to a growth plate, accelerated growth may be evident 2, presumably related to hyperaemia.

When the lesion is intracapsular, the presentation is more atypical, and more likely mimics and inflammatory arthropathy or synovitis. Joint effusion is often present 2,4.

An osteoid osteoma is composed of three concentric parts 1:

  1. nidus
    • meshwork of dilated vessels, osteoblasts, osteoid and woven bone
    • may have a central region of mineralisation 2
  2. fibrovascular rim
  3. surrounding reactive sclerosis

The nidus releases prostaglandins (via Cox-1 and Cox-2) which in turn result in pain 2.

Most osteoid osteomas occur in long tubular bones of the limbs (especially proximal femur), but essentially any bone may be involved.

  • long bones of the limbs: ~65-80% 1-2,7
    • femur most common (especially neck of femur)
    • mid tibial diaphysis common also
  • phalanges: ~20%
  • vertebrae: ~10%, predominantly posterior elements
    • lumbar: 59% 2
    • cervical: 27%
    • thoracic: 12%
    • sacrum: 2%

Furthermore, osteoid osteomas are usually cortical lesions but they can occur anywhere within the bone including medullary, subperiosteal (most common in talus), and intracapsular 2.

It is important to remember that the sclerosis is reactive and does not represent the lesion itself. The nidus is usually <2 cm in diameter, and is typically ovoid. It may have a central region of mineralisation 2.

May be normal or may show a solid periosteal reaction with cortical thickening. The nidus is sometimes visible as a well circumscribed lucent region, occasionally with a central sclerotic dot.

Excellent at characterising the lesion and is the modality of choice. It typically shows a focally lucent nidus within surrounding sclerotic reactive bone. A central sclerotic dot may also be seen.

Scintigraphy will show typical focal uptake and at times will show a double density sign (also known as the less catchy hotter spot within hot area sign) which if present is highly specific. The central focus showing intense uptake within a surrounding lower, but nonetheless increased uptake rim.

On ultrasound, focal cortical irregularity with adjacent hypoechoic synovitis may be present at the site of intra articular lesions. The nidus can show hypoechogenicity with posterior acoustic enhancement. Ultrasound may be able to identify the nidus as a hypervascular nidus on Doppler examination 2.

Although MRI is sensitive, it is non-specific and is often unable to identify the nidus. The hyperaemia and resultant bone marrow oedema pattern may result in the scans being misinterpreted as representing aggressive pathology 2.

The signal intensity of the nidus is variable on all sequences as is the degree of contrast enhancement 2.

The lesion is benign and treatment has traditionally been with surgical resection. Historically, this has, on occasion, been difficult because of the inherent inability to locate the nidus during surgery 3. However, percutaneous radiofrequency ablation is being used under CT guidance is being used with increasing frequency 5.

There is growing evidence, that osteoid osteoma finally resolves spontaneously over time and can be treated conseratively with NSAIDs in certain groups of patients 6. Average time to resolution is 33 months.

General imaging differential considerations include:

Cells rockin’ in their DNA: Team finds genes suppressed by sound stimulation

Medical Xpress: Cells rockin’ in their DNA: Team finds genes suppressed by sound stimulation

%d bloggers like this: