bluuebunny/crossref_metadata_2025 huggingface dataset:
Discussion Panel HFES Technical Standards Update 2019 HFES Annual Meeting
Authors: Fox Robert R. (Bob) , Kerr Michelle , Albin Tom , Gardner-Bonneau Daryle , Rempel David , Hale Kelly , Reid Christopher R.
Published: November 2019

HFES oversees a variety of ergonomics and human factors standards activities including standards developed within HFES (e.g. HFES 100) and standards work outside of HFES such as ANSI and ISO. This session is intended to update HFES members on the standards work that HFES is involved. This year the emphasis will be on specific new standards work on topical areas. A new ISO Technical Report on human factors in robotic, intelligent and autonomous systems (RIA) will be introduced along with the work of the HFES liaison to the US Department of Defense HF/E TAG. There will be an update on the new work of the ASTM 48.02 on exoskeletons and exosuits. The work on the revised ANSI/HFES 100 Human Factors Engineering of Computer Workstations, which is nearing completion, will be discussed. An update on the ACGIH work on ergonomics standards will be reviewed.
Operating Room Turnover Time: Definitions and Future Research Needs
Authors: Schock Gianna , Blickensderfer Beth
Published: November 2019

One aspect of healthcare efficiency is operating room (OR) turnover time. OR turnover time is an area of high interest to hospital administration, however, limited Human Factors research exists on turnover time. The current paper describes OR turnover time and describes variables involved (e.g., tasks, procedures, personnel, and others). Next, research topics related to OR turnover time are described. This includes measuring turnover time, parallel processes, workflow layout, teamwork, and several other areas. Research gaps in these areas are discussed.
Human Reliability Analysis for Verification and Validation of New Designs
Authors: Laurids Boring Ronald
Published: November 2019

As the commercial nuclear industry prepares to extend the life of existing power reactors and build new reactors, it becomes necessary to verify and validate the human-system interfaces found in the main control rooms and elsewhere at the plants. Verification has consisted of comparison of the system to human factors standards. Validation has consisted of operator-in-the-loop studies to identify potential shortcomings in the system design and establish the safety of operations of the system. The empirical studies in support of validation have typically been led by human factors experts, who treat the validation exercise as a type of detailed usability study to meet regulatory and internal quality standards. Human reliability analysis (HRA) has not held a prominent role in validation. In this paper, we explore the role of HRA to augment human factors studies. It is suggested that HRA can serve as an important driver in the design of validation studies by identifying those critical performance shaping factors known to lead to decreased operator reliability. Additionally, HRA can support verification by serving as a standard checklist against which to base expected operator performance.
Using an Integrated Cognitive Architecture to Model the Effect of Environmental Complexity on Drivers’ Situation Awareness
Authors: Rehman Umair , Cao Shi , MacGregor Carolyn
Published: November 2019

The goal of this research is to computationally model and simulate drivers’ situation awareness (SA). In order to achieve this, we have developed a computational cognitive model in a cognitive architecture that can be connected to interact with a driving simulator, as means to infer quantitative predictions of drivers’ SA. We demonstrate the theory of modelling and predicting SA through the lens of human cognition utilizing the QN-ACTR (Queueing Network-Adaptive Control of Thought-Rational) framework as a foundation. We integrate a dynamic visual sampling model (SEEV) to create QN-ACTR-SA in order to allow the model to simulate realistic attention allocation patterns of human drivers. A driver model is also incorporated within QN-ACTR-SA architecture that can simulate human driving behavior by interacting with a driving simulator with the help of virtual modalities such as motor, visual and memory functions. A preliminary validation study is conducted to determine whether SA results of the model correspond to empirical data. The model is probed with SA queries similar to how a Situation Awareness Global Assessment Technique (SAGAT) is conducted on human participants. A comparative assessment demonstrates the model’s ability to simulate drivers’ SA in both easy (with fewer traffic vehicles and signboards) and complex (with more traffic vehicles and signboards) driving conditions.
Auditory Warnings Invoking Startle Response Cause Faster and More Intense Neck Muscle Contractions Prior to Head Impacts
Authors: Homayounpour Mohammad , Mortensen Jonathan D , Merryweather Andrew S
Published: November 2019

High-pressure level and sudden sound, especially during an elevated state of alertness can elicit a startle response. Startle response can induce sudden, intense muscle activations. Some studies have shown that increasing neck muscle activation during impact situations can reduce the risk of concussion and neck injury. This research aimed to study muscle coactivation patterns, contraction latency and the level of muscle activation in startle response compared to the voluntary response. To achieve this goal, a testbed capable of applying impacts to the head in four directions was created. Auditory (115 dB) startle stimulus was delivered and muscle activation measured using sEMG on neck muscles during startle and voluntary responses. We investigated a 1000 ms time period starting at the time that the sound is played to the time at impact. Results indicate that the first muscle activation in startle response is 2.1 times higher, 5.9 times faster and involved more muscles than in a voluntary response.
How analysts think: A preliminary study of human needs and demands for AI-based conversational agents
Authors: Hepenstal Sam , Wong B.L. William , Zhang Leishi , Kodogoda Neesha
Published: November 2019

For conversational agents to provide benefit to intelligence analysis they need to be able to recognise and respond to the analysts intentions. Furthermore, they must provide transparency to their algorithms and be able to adapt to new situations and lines of inquiry. We present a preliminary analysis as a first step towards developing conversational agents for intelligence analysis: that of understanding and modeling analyst intentions so they can be recognised by conversational agents. We describe in-depth interviews conducted with experienced intelligence analysts and implications for designing conversational agent intentions.
Feedback on system or operator performance: Which is more useful for the timely detection of changes in reliability, trust calibration and appropriate automation usage?
Authors: Lu Yidu , Sarter Nadine
Published: November 2019

Creating safe human-machine systems requires that operators can quickly notice changes in system reliability in the interest of trust calibration and proper automation usage. Operators’ readiness to trust a system is determined not only by the performance of the automation but also by their confidence in their own abilities. This study therefore compared the usefulness of feedback on the performance of either agent. The experiment required two groups of ten participants each to perform an automation-assisted target identification task with “Automation Performance Feedback” (APF) or “Operator Performance Feedback” (OPF). Four different scenarios differed with respect to the degree and duration of changes in system reliability. Findings indicate that APF was more effective for supporting timely adjustments of perceived system reliability, especially with large and long reliability changes. Subjective trust ratings and performance were not affected, however, suggesting that these two factors are closely linked and more relevant for automation reliance.
Accuracy of An Algorithm Using Motion Data Of Five Wearable IMU Sensors For Estimating Lifting Duration And Lifting Risk Factors
Authors: Barim Menekse S. , Lu Ming-Lun , Feng Shuo , Hughes Grant , Hayden Marie , Werren Dwight
Published: November 2019

The objective of this study was to assess the accuracy of an algorithm for processing data from five inertial measurement unit (IMU) sensors for measuring the vertical distance (V) and horizontal distance (H) of two handed lifting, trunk flexion angle (T) and lifting duration (LD). The sensors were placed on five body segments including the left wrist, right wrist, upper arm of the dominant hand, upper back, and thigh of the dominant leg. A laboratory-grade optical motion capture system was used as the ground truth for the assessment. Data were collected on ten subjects that performed 12 two-handed lifting tasks varying in height of the hands and horizontal distance between the body and the lifted object. Results showed that the algorithm performed well for determining the LD (~1 sec error) and T (~2° error). The average errors for V and H were about 33 and 6.5 cm, respectively.
The Consequences of Purposefulness And Human-Likeness on Trust Repair Attempts Made by Self-Driving Vehicles
Authors: Kohn Spencer C. , Momen Ali , Wiese Eva , Lee Yi-Ching , Shaw Tyler H.
Published: November 2019

Autonomous systems are rapidly gaining the capacity to recognize their own errors and utilize social strategies to mitigate the trust deficit that accompanies those errors. While previous research has catalogued the effects of trust repair attempts in human-human relationships, much remains unknown about the consequences of similar strategies when administered by autonomous systems such as self-driving vehicles. While we tend to treat computers like social actors, autonomous systems may have a wider spectrum of perceived human-likeness and may be subject to different interpretations of the purposefulness of their errors. This paper seeks to understand the consequences of these factors on the effectiveness of trust repair attempts administered by self-driving cars, and the results highlight the importance of considering human-likeness and purposefulness in the design of autonomous systems.
Improving Expertise in Local Law Enforcement: Utilizing Virtual Environments to Assess Officer Performance and Standardize Training Procedures
Authors: Connelly Monica , Suss Joel , DiBello Lia
Published: November 2019

Training for non-federal law enforcement agencies is subject to little regulation—training academies and education requirements often vary between departments—resulting in new officers with varying abilities and on-job proficiencies. The role of expertise can be evaluated in law enforcement and assessed to determine best practices for ideal on-job performance, especially in incidents requiring officers to make potentially lethal, rapid critical decisions (e.g., a use-of-force scenario). Training in a virtual environment has successfully been utilized to maximize management decision-making performance and accelerate the training process. A supplementation of cognitive skills training to existing law enforcement training procedures is proposed along with a recommendation on utilizing virtual environments to enhance expert training and develop a safer community environment.
Shoulder Risk Assessment Based on Fatigue Failure Theory
Authors: Hani Dania Bani , Gallagher Sean , Sesek Richard F. , Huangfu Rong , Schall Mark C. , Davis Jerry
Published: November 2019

Recent studies support the notion that a fatigue failure process may be responsible for the development of MSDs, including epidemiological studies, animal studies, and in vitro testing of musculoskeletal tissues. This study presents a new risk assessment model for the shoulder, which estimates the daily dose of the cumulative damage (CD) for the shoulder and allows the CD for multiple tasks to be summed to get an overall estimate for the daily cumulative damage. Videotapes of jobs from an existing epidemiological study from a large U.S. automotive manufacturer were analyzed to get exposure information required for the model. The model was then validated using outcomes from the epidemiological database. Logistic regression was used to assess the associations between Log CD and various shoulder outcomes. Results indicated that the cumulative damage for the shoulder was highly associated with all shoulder outcomes and that application of the fatigue failure methods also works extremely well in assessing the probability of association with shoulder outcomes. These results provide further support regarding the role of the fatigue failure process in the development of MSDs.
Cognitive Load Variability from Road Characteristics Should Influence a Safety Requirement for Vehicle Stopping Sight Distance
Authors: Pennetti Cody A. , Hollenback Kelsey , Kim Inki , Lambert James H.
Published: November 2019

Current U.S. geometric road design standards are based on a prescribed value for a driver’s perception-reaction time (a constant value of 2.5 seconds), which represents the time necessary for a driver to safely stop the vehicle to avoid a crash (referred to as a stopping sight distance); however, these standards fail to consider how road complexity, driver risk perception, and visual stimuli can influence perception-reaction time. With over a million vehicle fatalities a year (WHO, n.d.), it is necessary to investigate methods of improving driver safety. The influence of road characteristics is considered with some road design policies, but not currently applied to stopping sight distance. This paper introduces theoretical considerations for increasing perception-reaction time (and thereby adjusting speed limits or road geometry) based on roadway complexity (volume of vehicles, road geometry, pedestrian crossings, frequency of adverse weather conditions, or other conditions).
Adaptive Auditory Alerts for Smart In-Vehicle Interfaces
Authors: Šabić Edin , Henning Daniel , MacDonald Justin
Published: November 2019

Missing a message from an in-vehicle device can range in severity from annoying at best to dangerous at worst. The in-cab auditory environment can vary spontaneously, making some volume levels too loud while rendering others too quiet. It is in the best interest of system designers, both from a safety and user experience perspective, to ensure that users are able to adequately hear alerts, and that drivers do not have to alter their gaze or attention during a visually and attentionally demanding task such as driving. To this end, we propose a system for dynamically tracking the background noise intensity level immediately prior to alert presentation in order to present an alert at an appropriate loudness. Furthermore, we evaluated the proposed system across both behavioral (accuracy and reaction time) and subjective (questionnaire results) measures. Behavioral results showed that while the proposed system increased recognition in one noise condition (background music), it also led to slower responses in two other noise conditions (windows-down and windows-up noise).
A Context-Driven Framework for Selecting Mental Model Elicitation Methods
Authors: Harper Samantha , Dorton Stephen
Published: November 2019

Mental models describe an internal representation of knowledge of an individual or group, which can be used to interpret interactions with their environment and provide insight into decision-making strategies and prediction of performance. There are several ways to elicit mental models and analyze them; however, there is little guidance for selecting an appropriate elicitation method. Depending on different constraints of research and desired outcomes, different elicitation methods are more appropriate than others. Three criteria were identified as useful for selecting an appropriate elicitation method. These were the interaction level with participants, the number of participants being evaluated, and the resulting level of analytical detail that is required. A process for selecting the most appropriate mental model elicitation method is herein presented. Additionally, an overview of the factors that affect the selection of the mental models, and the different types of mental models are also presented.
Gymnastics Vault Board Design: A Comparison of Spring Configuration and Style of Spring – Preliminary Study
Authors: Middelkoop Courtney , Stone Richard
Published: November 2019

The goal of this study is to analyze the gymnastics vault board spring configuration to provide insight for a follow-up study to compare a traditional compression springboard with a new leaf springboard design. Traditionally, during the vaulting apparatus, gymnasts use a compression springboard to propel themselves onto the vaulting table to perform their routine. However, a new innovative leaf spring design has been produced and little research has been done to evaluate the performance of the springboard. Video recordings were taking during a NCAA Division 1 gymnastics competition. The video captured the gymnast’s interaction with the springboard during their competition vaults. During the gymnastics competition, two vault entry styles were performed, three spring configurations were used, and the number of springs inside the board were either 7 or 8. With the current data, there is no significant evidence that correlates the spring configuration with the performance score of the athlete. However, the maximum amount of compression achieved on the vault board varies from gymnasts and the number of springs and configuration placed in the springboard. Further research should be conducted to investigate the effects of spring configuration and the amount of compression achieved during the vaulting apparatus with two different springboards: the conical springboard design and the leaf spring design.
Online Product Reviews: Effects of Star Ratings and Valence on Review Perception among Those High and Low in Need for Cognition
Authors: Schreck Jacquelyn L. , Chin Matthew G.
Published: November 2019

This study seeks to understand online product review perception based on ratings, valence, and need for cognition. Review perception, review recollection, and intent to purchase after reading the reviews were being measured. Results showed that need for cognition had an effect on accuracy of review recognition and perceived review valence. Need for cognition and congruency (between rating of the review and valence of the review), as well as actual valence had an effect on perceived valence. Need for cognition, actual review valence, and review congruency all had an effect on purchase intention.
Effectiveness of Diagrammatic Guide Signs at Complex Interchanges
Authors: Magee Kelly , Venkatraman Vindhya , Hoekstra-Atwood Liberty , Richard Christian
Published: November 2019

The present work investigated if drivers’ interpretation of diagrammatic arrow signs dropped in accuracy as the number of lanes at an interchange increased. A set of diagrammatic arrow signs were shown to 183 participants as part of a slideshow. Participants were prompted with a navigation objective, briefly shown a picture of a diagrammatic arrow sign that communicated the necessary information for navigation, then they were asked to make a navigation decision. The three factors considered were 1) the total number of lanes on the roadway, 2) the parity of lanes included in each of two branches on the sign, and 3) the difficulty of the navigation task decision. When positioned in an edge lane (easy condition), drivers were good at determining where their lane would lead. When positioned in a center lane (hard condition), their navigation performance improved with an odd number of lanes.
Testing an Integrated Team Effectiveness Framework in League of Legends
Authors: Eaton Joshua A. , Mendonça David J.
Published: November 2019

Objective: This paper investigates factors impacting team performance in the Multi-player Online Battle Arena gaming environment, League of Legends™, by testing an integrated Input Mediator-Outcome team effectiveness framework. Background: Secondary data and Naturally Occurring Data Sets (NODS) are data that have been collected from respondents without research interests in mind and can occur naturally in the environment. There are numerous sources of secondary data, including government data, financial databases, industry association groups, and Application Programming Interfaces, which this research utilizes to study the performance of teams. Methods: Path Analysis and Partial Least Squares Discriminant Analysis (PLS-DA) are analytical methods that are well suited for large data sets and sample sizes, confirmatory in nature, and can test a theoretical model. This research utilizes both in order to study factors impacting team performance. Results: A total of 5,927 matches from 742 teams are sampled and analyzed. Six team performance measures are used to discriminate between winning and losing teams, including role familiarity, team familiarity, team effectiveness, team efficiency, and the Kills, Deaths, Assist (KDA) ratio. Using path analysis and supervised PLS-DA, the models led to the successful prediction of 89.4% of the matches. The error rate for the PLS-DA model is 0.106 (Q2 = 0.523; R2 = 0.551). Conclusions: This work shows how objective, detailed data on teamwork may be used to provide insights into questions of the performance of teams. Additionally, the results demonstrate the value of using path analysis and PLS-DA to test an integrated framework. Application: This research highlights the value and feasibility of studying virtual teams for new insights into team performance.
Trend Analysis of Cyber Security Research Published in HFES Proceedings from 1980 to 2018
Authors: Mouloua Salim A. , Ferraro James , Mouloua Mustapha , Matthews Gerald , Copeland Robert R.
Published: November 2019

The prevalence of information technology (IT) and widespread use of electronic data storage systems by individuals, corporations, and government branches has prompted investigation into threats to cyber security and data privacy. Within the human factors community, researchers have sought to identify issues related to cyber-attacks and cyber defense and human-centered design. These issues range from placing too much trust in modern technology, to remaining vigilant in the presence of cyber threats such as phishing emails. This study aimed to evaluate trends in cyber security research published in the Proceedings of the Human Factors and Ergonomics Society Annual Meeting from 1980 to 2018. This paper reviewed 114 unique articles, identified using keyword terms related to cyber security. Results were organized, analyzed, and graphed based on topic areas, author and funding agency affiliations, and applicable domains. Analyses indicated that cyber security research has grown exponentially in recent years, with nearly 73% of relevant proceedings papers produced since 2010. Gaps in the literature, directions for future research, and emerging issues related to training are also discussed.
Homes of children with medical complexity as a complex work system: outcomes associated with interactions in the physical environment
Authors: Doutcheva Nadejda , Thomas Hannah , Parks Reid , Coller Ryan , Werner Nicole
Published: November 2019

Family caregivers provide critical care for children with medical complexity (CMC) at home, yet homes are still a poorly understood healthcare setting. Home environments include diverse physical environments, technologies, tools, tasks, and people, and are therefore complex work systems. Research suggests that home environments can contribute positively and negatively to both individuals’ well-being and the quality of care that families can provide. Our objective for this study was to determine how the physical environment of the home interacts within a work system to affect outcomes related to in-home care of CMC. We used contextual inquiry to interview 30 caregivers in their homes and analyzed our data using the Systems Engineering Initiative for Patient Safety (SEIPS) 2.0 model. We focused on identifying physical environments’ interactions with other work system components and the resulting CMC outcomes. We identified six categories of outcomes that are influenced by work system interactions within the physical environment: 1) Safe or Unsafe delivery of care; 2) Prepared for or Inability to Respond to Care Crisis; 3) Home Mobility or Inaccessibility; 4) Efficient and Inefficient Care; 5) Inclusion and Isolation from Family; and 6) Socioemotional Comfort and Stress. The physical environment influences a range of outcomes from patient safety to families’ emotional well-being. Our results point to the need for adaptation of SEIPS 2.0 to the home environment by incorporating consideration for family and home-based outcomes into the model.
The Effects of Restricted Sight Distances on Drivers at Simulated Rural Intersections
Authors: Achtemeier Jacob , Craig Curtis M. , Morris Nichole L.
Published: November 2019

Short sight distances at rural intersections can result in reduced safety including drivers choosing smaller gaps between oncoming vehicles (Yan & Richards, 2010). Conversely, increased sight distances may result in improved driver confidence, but not safety as seen at rail crossings (Ward & Wilde, 1996). Thus, simply increasing sight distances may not result in linear gains in safety. Establishing appropriate lower and upper-visibility limits at rural intersections will minimize operational costs for clearing and grubbing labor and may reduce serious injury and fatal crashes by promoting safer crossing behavior around rural thru-STOP intersections. This driving simulation study will examine intersection visibility and other intersection design factors that influence driver behavior at rural thru-STOPs.

Time to collision, or TTC, is a primary motivating factor on driver decisions to cross intersections. Drivers’ TTC perception is a function of oncoming vehicle speed, distance, and rate of retinal expansion (tau; Hancock & Manser, 1997). We hypothesize TTC factors may interact with confidence in intersection crossing judgments. Specifically, when people must quickly make judgments, their confidence must be estimated after the decision has been made, but if the time pressure is not high and the decision is not immediate, people’s judgments and their confidence in those judgments can both be considered prior to action. This can be problematic because people are normally overconfident in their judgments (Harvey, 1997).

The present study comprised a crossing judgment block, and a mainline drive block. The experimental stimuli were validated by engineers with experience in rural intersections, who rated the simulated intersections as “significantly representative” to real-world intersections through an average rating score of 5.25 ( SD = 0.5) on a 7-pt scale. This was done to ensure that the study findings would be more likely to be applicable to world intersections. The goal of the study is to identify whether sight distance and other variables, including speed for the judgment task and vehicle proximity to the intersection for the mainline drive task, impact safety at rural intersections.
The Effects of Automation and Role Allocation on Team Performance
Authors: Dikmen Murat , Li Yeti , Farrell Philip , Ho Geoffrey , Cao Shi , Burns Catherine
Published: November 2019

An experiment was conducted to investigate the effects of automation and role allocation on performance in a simulated picture compilation task with fourteen two-person student teams. In the absence of automation support, the system integrated sensor information. In the presence of automation support, the system both integrated sensor information and identified contacts. Roles were assigned either based on warfare domain or geographical sectors. Results showed that human-automation system performance was similar in two automation conditions, but participants were slower in classifying tracks and overall classified fewer tracks when the automation was present. We conclude that working with automation may lead to degraded team performance due to complacency and additional task complexity.
Flood Risk Literacy: Communication and Implications for Protective Action
Authors: Ramasubramanian Madhuri , Allan Jinan N. , Retamero Rocio Garcia , Jenkins-Smith Hank , Cokely Edward T.
Published: November 2019

Flooding is among the costliest natural disasters in the United States. Research indicates that flood risk perceptions and knowledge often shape flood-related decision making; however, relatively less is known about specific individual differences in flood risk literacy. The current study presents data from 630 participants who completed a flood risk communication experiment and a general decision-making inventory (e.g., numeracy, risk perceptions, knowledge). Structural equation modeling revealed that both numeracy and flood knowledge partially explain differences in vulnerability, including effects on risk comprehension, weather risk perceptions, and decision quality (i.e., taking protective action). Limitations and implications for enhancing flood risk literacy are discussed.
The Feeling is Real: Emotion Elicitation in Virtual Reality
Authors: Susindar Sahinya , Sadeghi Mahnoosh , Huntington Lea , Singer Andrew , Ferris Thomas K.
Published: November 2019

Classical methods for eliciting emotional responses, including the use of emotionally-charged pictures and films, have been used to study the influence of affective states on human decision-making and other cognitive processes. Advanced multisensory display systems, such as Virtual Reality (VR) headsets, offer a degree of immersion that may support more reliable elicitation of emotional experiences than less-immersive displays, and can provide a powerful yet relatively safe platform for inducing negative emotions such as fear and anger. However, it is not well understood how the presentation medium influences the degree to which emotions are elicited. In this study, emotionally-charged stimuli were introduced via two display configurations – on a desktop computer and on a VR system –and were evaluated based on performance in a decision task. Results show that the use of VR can be a more effective method for emotion elicitation when study decision-making under the influence of emotions.
The autonomous vehicle social network: Analyzing tweets after a recent Tesla autopilot crash
Authors: Jefferson Jacelyn , McDonald Anthony D.
Published: November 2019

Automated vehicle technologies offer a potentially safer alternative than manually driven vehicles, but only if they are accepted and used appropriately. Social media platforms may offer an opportunity to assess peoples’ willingness to accept and use automated vehicle technology, but questions remain on the structure and content of the social media conversation. To answer these questions, we performed an analysis of tweets surrounding a recent Tesla Autopilot incident. Tweets were analyzed at three levels: term frequency, account tweet and retweet frequency, and sentiment. The most frequent terms of the conversation shifted from “amazon” and “startup” to “autopilot” and “vehicle” following the crash, however, the specific tweet content referenced an earlier event. A small portion of accounts were responsible for the majority of the tweets in the dataset, and were rarely retweeted. Positive and negative sentiment decreased following the crash, suggesting that a more complex sentiment analysis is needed to gauge changes in public opinion of automated vehicles.
Effects of Control-Display Mapping and Spatially Dependent Gain on Supported Free-Hand Gesture Pointing Performance
Authors: Kota Sreemannarayana , Young Justin G.
Published: November 2019

While gesture controls will be important as future computing input modalities, they are limited by reduced performance and increase ergonomic risk. Performance of pointing in free-hand gestural controls is affected by control-display (CD) parameters such as gain and mapping, but specific CD function parameters that yield optimal performance are unclear. This paper describes an experiment that examines the effect of altering CD gain in different movement directions (‘spatially dependent gain’, SDG) for different CD mappings on their performance in armrest-supported pointing tasks. Thirteen participants were given a series of circular Fitts’ tasks with different fixed CD gain and mapping settings. The SDG was used to warp the Fitts’ circle in the participants’ physical motor-space in order to take advantage of inherent motor performance differences. Additionally, the placement of the movement controller was also studied. The results show that mapping is the most significant factor; vertical mapping produced throughput results that were approximately 0.5 bits/s greater on average than the other mappings. Vertical mapping is also where CD gain shows the most effect. Lower gain settings produce results that are 0.14 bits/s faster than higher gain when the user is in vertical mapping. No significant differences were found in pointing performance between SDG conditions. These preliminary results suggest that participants adapt easily to motor-space warping and that further study of non-fixed gain functions (e.g. pointer acceleration functions) is necessary in order to maximize free-hand performance.
Smart Home Devices: Promoting User Trust and Protecting User Data
Authors: Goh Lih Seng , Nathan-Roberts Dan
Published: November 2019

As smart technology is introduced into our homes, new dangers emerge that threaten our safety. New technology is usually subjected to much scrutiny, but smart home devices face even more because they are brought into the home environment, which is focused on safety and privacy. The potential for smart home technology to improve home life is hindered by the fact that potential users face difficulty in trusting and accepting smart home technology. This paper explores different types of trust that can be used to inform strategies, promote trust, reduce threats towards smart home technologies, and overcome challenges in designing these systems and different methods for designing a trustworthy and secure system. To begin designing a trustworthy product that establishes trust between users and smart home technology, manufacturers should use these findings to understand how human beings form trust with new technology.
Substance Use in Registered Nurses: “I Heard About a Nurse Who . . .”
Authors: Foli Karen J. , Reddick Blake , Zhang Lingsong , Krcelich Kathryn
Published: November 2019

BACKGROUND: Estimates of substance use (SU) in nurses is on par with that of the general population: between 6% and 8%. However, collecting sensitive information such as SU is difficult based on social desirability and fears of disclosure. AIMS: Part of a larger study surrounding nurses’ self-reports of SU ( n = 1,478), the purpose was to explore open-ended responses of nurses ( n = 373) who were invited to “Please add any additional comments related to substance or alcohol use that you have experienced or witnessed in registered nurses.” METHOD: This qualitative study employed a content analysis of 373 nurses’ open-ended responses collected via an online survey. RESULTS: The majority of nurses ( n = 250) forwarded comments that described SU in other nurses, while 24 comments reflected the nurse’s past or current SU. Content analysis revealed the following four themes: (1) differing social network proximity to SU; (2) individual process: vulnerability to adaptive/maladaptive coping resulting in positive and negative outcomes; (3) bedside, system, and organizational spaces and effects; and (4) there are no SU issues in nursing. CONCLUSIONS: Although direct reports of SU constitute approximately one quarter of the comments forwarded, nurses reported peers’ struggles with SU, including observing nurses working in patient care while impaired and the use of substances to cope with work and personal stressors. Individual factors and system-related failures appear to be contributors to SU in nurses.
Are We Underdiagnosing Hirschsprung Disease?
Authors: Kapur Raj P , Ambartsumyan Lusine , Smith Caitlin
Published: November 2019

Hirschsprung disease (HSCR) is conventionally defined as aganglionosis of the distal rectum and a variable length of proximal contiguous bowel with a transition zone of ganglionic, but neuroanatomically abnormal, bowel located immediately upstream. Recent improvement in our understanding of the pathology and genetics of HSCR and relevant animal models indicates highly variable expressivity. The spectrum of intestinal neuropathology includes patients with very short-segment aganglionosis, limited to the distal 1 to 2 cm of the rectum, and possibly patients with no true aganglionic segment, but nonphysiological transition zone pathology in their distal rectums. The presence or absence of submucosal ganglion cells in a rectal biopsy is not sufficient to exclude these patients, in whom submucosal nerve hypertrophy and/or abnormal cholinergic mucosal innervation may be the only diagnostic clues. In addition, diagnosis or exclusion of HSCR by rectal biopsy now relies in part on mucosal patterns of calretinin immunohistochemistry, with less emphasis on submucosal tissue adequacy and assessment of cholinergic innervation. These recent trends in the surgical pathology approach to rectal biopsies may miss patients at the phenotypically milder end of the malformation spectrum, with profound implications for subsequent management, prognosis, and genetic counseling.
Prevalence and incidence of neuromyelitis optica spectrum disorder and multiple sclerosis in Korea
Authors: Kim Jee-Eun , Park Sang-Hyun , Han Kyungdo , Kim Ho Jin , Shin Dong-Wook , Kim Sung-Min
Published: November 2019

Background:

The epidemiology of neuromyelitis optica spectrum disorder and multiple sclerosis varies depending on the region and ethnicity.

Objective:

To estimate the prevalence and incidence of neuromyelitis optica spectrum disorder and multiple sclerosis in Korea during 2010–2016.

Methods:

We analyzed the National Health Insurance research database, which contains single-payer health insurance data collected in Korea. Neuromyelitis optica spectrum disorder was defined based on the 2006 Wingerchuk criteria (for 2010–2015), and the 2015 International Panel for Neuromyelitis Optica Diagnosis criteria (for 2016). Multiple sclerosis was defined by the 2005 International Panel criteria for multiple sclerosis.

Results:

In 2016, the age-standardized prevalence per 100,000 persons was 2.56 (95% confidence interval: 2.43–2.7) for neuromyelitis optica spectrum disorder and 3.23 (95% confidence interval: 3.08–3.39) for multiple sclerosis. The age-standardized incidence of neuromyelitis optica spectrum disorder and multiple sclerosis were 0.73 (95% confidence interval: 0.66–0.8) and 0.50 (95% confidence interval: 0.44–0.56) per 100,000 persons in 2016. The prevalence of neuromyelitis optica spectrum disorder and multiple sclerosis have increased over time during 2010–2016 (18.5% and 5.4% annually; both p-trend < 0.001). The incidence of neuromyelitis optica spectrum disorder increased annually (10.0%, p-trend < 0.001), while the incidence of multiple sclerosis remained stable.

Conclusion:

While the prevalence of neuromyelitis optica spectrum disorder and multiple sclerosis are comparable in Korea, the incidence of neuromyelitis optica spectrum disorder is higher than that of multiple sclerosis. Both the prevalence and incidence of neuromyelitis optica spectrum disorder are rapidly increasing in Korea.
Outcomes and moderators of Early Start Denver Model intervention in young children with autism spectrum disorder delivered in a mixed individual and group setting
Authors: Contaldo Annarita , Colombi Costanza , Pierotti Caterina , Masoni Patrizia , Muratori Filippo
Published: November 2019

Several studies have shown the efficacy and effectiveness of the Early Start Denver Model, both in university and in community-based settings. However, a limited number of studies have investigated predictors of outcomes. In this study, we examined outcomes in 32 children diagnosed with autism spectrum disorder after 1 year of community-based Early Start Denver Model intervention, with the aim to identify predictors of treatment objectives acquisition, as measured by the Early Start Denver Model Curriculum Checklist. At a group level, the participants demonstrated improvement in their communication as well as adaptive functioning skills, while they showed a decrease in symptom severity. The large heterogeneity in outcomes identified was related to the pre-treatment non-verbal abilities, symptom severity, action and gesture repertoire, and lexical comprehension. We discussed our results in terms of implications for developing “personalized” interventions for children with autism spectrum disorder.
Treatment of Advanced Central Lung Cancer by Bronchoscope-Guided Interventional Cryotherapy
Authors: Feng Huasong , Meng Jiguang , Nie Zhoushan , Han Zhihai , Zhang Xinhong , Ding Xinmin , Yongqun Li , Li Yi , Zhang Yan , Liu Yongqin
Published: November 2019

The purpose of this study is to investigate the curative effect of the bronchoscope-guided interventional cryotherapy in the treatment of stenosis and obstruction of the airway, due to the advanced central lung cancer. A total of 20 cases of advanced central lung cancer were treated by 38 cycles of cryotherapy; the symptoms, as seen under the bronchoscope, were compared before and after treatment, so as to observe the curative effect. For all the subjects, there were the varying degrees of alleviation of cough, hemoptysis and dyspnea after treatment, disappearance of original obstructive pneumonia and pulmonary atelectasis, and the re-deoppilation of tracheal cavity. Ten subjects (50%) enjoyed the complete remission (CR), and nine subjects (45%) enjoyed the partial remission (PR), while only one subject showed no remission (NR), achieving a total efficiency of 95%. The bronchoscope-guided cryotherapy can be used for the treatment of endoluminal central lung cancer; it is able to reduce the size of the tumor, control the obstructive pneumonia, and improve hemoptysis and dyspnea, thereby significantly enhancing the patients' quality of life. When used for the treatment of narrow or obstructive central lung cancer in the airway, this therapeutic method is also safe and effective without obvious complication and adverse reaction. It provides a new choice for the treatment of lung cancer.
Targeted Cryosurgery for the Treatment of Cerebral Glioma with Cryocare Surgical System Guided by Stereotactic Technology
Authors: Shi-Zhong Zhang , Ru-Xiang Xu , Yuan Zhou , Ji-Ren Zhang , Zhi-Liang Liu , Wang-Ming Zhang , Sen-Ming Wang
Published: November 2019

This study is to investigate the therapeutic effects of cryoablation guided by stereotactic technology for targeted cryosurgery of patients with cerebral glioma. The Cosman-Roberts-Wells (CRW) stereotactic apparatus and brain CT (Computed tomography) scan were applied to define the coordinates of the center and marginal points of the glioma. Twelve cases with recurrent glioma were treated by freezing-re-warming-freezing therapy in designated targets with cryocare surgical system's therapeutic probes. One patient, whose temporal tumor was 3.5cm in diameter, underwent drilling-hole cryoablation without resection in the central target of the tumor; the other eleven patients, whose maximum diameters of frontal and occipitoparietal tumors were between 4.5–9cm, underwent stereotactic volumetric resection and the frozen tumor tissues were removed after intraoperative freezing. Postoperative CT scans indicated that glioma tissues and regions 1cm surrounding the tumors in the eleven cases were excised, and no postoperative hemorrhage or remarkable edema was noted; staining of lesions in the case undergoing direct cryosurgery vanished in reexamination two weeks after the treatment, CT density declined and lesions had a tendency to become malacic. One case whose hemiparesis aggravated after operation recovered after symptomatic treatment and one case with poor prognostic scalp incision recovered after scalp flap transposition. The average follow-up duration was 2.6 years in the eleven cases. Eight cases with astrocytic glioma survived, among which three cases recurred and five did not. One case with astrocytic glioma died 1.5 years later and one died 2 years later. The patient with glioblastoma died after 1.2 years. Stereotaxy-guided cryoablation of cerebral glioma can remove brain tumor totally, less traumatic and less hemorrhagic than conventional approaches, it is safe and convenient to perform. Therefore, it may have an encouraging future in clinical applications, though its long-term efficacies still await further observation due to defects in its manipulation.
Comparison of Outcomes Following Infrapopliteal Plain Balloon Angioplasty in the BASIL Trial (1999-2004) and in a Contemporary Series (2009-2013)
Authors: Popplewell Matthew A. , Davies Huw O.B. , Renton Mary , Bate Gareth , Patel Smitaa , Deeks Jonathan J. , Bradbury Andrew W.
Published: November 2019

Objectives:

To compare outcomes in patients randomized to infrapopliteal (IP) plain balloon angioplasty (PBA) for chronic limb-threatening ischemia within the Bypass versus Angioplasty in Severe Ischemia of the Leg (BASIL)-1 trial between 1999 and 2004 with outcomes in consecutive patients undergoing IP PBA at an academic vascular unit a decade later (2009-2013, Contemporary series [CS]).

Methods:

Individual patient data were obtained from prospective BASIL-1 (48 patients) and CS databases (73 patients). All had a minimum of 3-years of follow-up. Outcomes studied were amputation-free survival (AFS), overall survival (OS), major (above ankle) limb amputation, arterial reintervention, immediate technical success, and length of hospital stay for the index procedure and during the following 12-month period. Statistical analysis was performed using SAS version 9.4.

Results:

The BASIL and CS cohorts were well matched for gender, age, diabetes, previous stroke, myocardial infarction and arterial intervention, and presence of tissue loss. More patients in BASIL-1 underwent concomitant treatment of the superficial femoral (60% vs 37%, P = .01) and above knee popliteal (60% vs 34%, P = .005) arteries. Immediate technical success increased from 73% in BASIL-1 to 90% in the CS ( P = .01). Between the two cohorts, there were no differences in AFS (hazard ratio [HR] = 1.00, 95% confidence interval [CI]: 0.65-1.54, P = 1.0), OS (HR = 1.04, 95% CI: 0.66-1.62, P = .9), major amputation (HR = 0.86, 95% CI: 0.37-1.97, P = .7), or reintervention (HR = 0.61, 95% CI: 0.29-1.27, P = .2). Contemporary series patients spent significantly fewer days in hospital following the index procedure ( P = .02) and also over the following 12 months ( P = .002).

Conclusions:

Despite improvements in the immediate technical angiographic success of IP PBA between BASIL and the CS, there were no significant improvements in survival outcomes. Results from BASIL-2 and BEST-CLI are required in order to properly define the clinical and cost-effectiveness of endovascular treatment in such patients.
Hispanics, Addictions, and the Opioid Epidemic: Brief Report
Authors: Brenes Francisco , Henriquez Federico
Published: November 2019

Opioid addiction is a public health concern. Opioid overdose death rates account for one third to a half of all global substance-related deaths. Opioid mortality rates increased nearly fivefold in the United States between 1999 and 2016. Recent research has found health care disparities in the United States among minority populations with opioid use disorder, particularly Hispanics. Current literature also suggests that a number of social and cultural factors, including the stigma linked to mental illness and treatment in the Hispanic culture, may further negatively contribute to the problem. This brief report pays close attention to the opioid epidemic in the United States and addresses issues related to the crisis among Hispanics. Recommendations for clinical practice, research, and health care policy are also discussed.