Pediatricians' focus of sight at pain assessment during a neonatal heel puncture / Foco do olhar do pediatra na avaliação da dor neonatal durante uma punção de calcanhar

ABSTRACT Objective: To evaluate the focus of pediatricians' gaze during the heel prick of neonates. Methods: Prospective study in which pediatricians wearing eye tracker glasses evaluated neonatal pain before/after a heel prtick. Pediatricians scored the pain they perceived in the neonate in a verbal analogue numerical scale (0=no pain; 10=maximum pain). The outcomes measured were number and time of visual fixations in upper face, lower face, and hands, in two 10-second periods, before (pre) and after the puncture (post). These outcomes were compared between the periods, and according to pediatricians' pain perception: absent/mild (score: 0-5) and moderate/intense (score: 6-10). Results: 24 pediatricians (31 years old, 92% female) evaluated 24 neonates. The median score attributed to neonatal pain during the heel prick was 7.0 (Interquartile range: 5-8). Compared to pre-, in the post-periods, more pediatricians fixed their gaze on the lower face (63 vs. 92%; p=0.036) and the number of visual fixations was greater on the lower face (2.0 vs. 5.0; p=0.018). There was no difference in the number and time of visual fixations according to the intensity of pain. Conclusions: At bedside, pediatricians change their focus of attention on the neonatal face after a painful procedure, focusing mainly on the lower part of the face.

RESUMO Objetivo: Avaliar o foco do olhar do pediatra durante a punção do calcanhar de neonatos. Métodos: Estudo prospectivo no qual pediatras, utilizando óculos de rastreamento visual, avaliaram a dor neonatal antes/depois de uma punção de calcanhar. Os pediatras pontuaram a dor de acordo com a sua percepção por meio de uma escala analógica verbal (0=sem dor; 10=dor máxima). Os desfechos analisados foram o número e o tempo das fixações visuais na face superior, face inferior e mãos, em dois períodos de 10 segundos, antes (PRÉ) e depois da punção (PÓS). Os resultados foram comparados entre os períodos e segundo a percepção da dor do pediatra: ausente/leve (escore: 0-5) e moderada/grave (escore: 6-10). Resultados: Vinte e quatro pediatras (31 anos, 92% sexo feminino) avaliaram 24 neonatos. A mediana do escore atribuído à dor do recém-nascido durante a punção do calcanhar foi 7,0 (intervalo interquartil: 5-8). Comparado ao período PRÉ, no período PÓS, o maior número de pediatras fixou o olhar na face inferior (63 vs. 92%; p=0,036) e o número de fixações visuais foi maior na face inferior (2,0 vs. 5,0; p=0,018). Não houve diferença no número e no tempo das fixações visuais de acordo com a intensidade da dor. Conclusões: À beira do leito, os pediatras mudam seu foco de atenção visual na face do recém-nascido após um procedimento doloroso, focando o olhar principalmente na parte inferior da face.

Looking at neonatal facial features of pain: do health and non-health professionals differ?

Abstract Objective: To analyze the regions that trigger the attention of adults' gaze when assessing pain in newborn infants' pictures and to verify if there are differences between health and non-health professionals. Method: Experimental study with 84 health professionals and 59 non-health professionals, who evaluated two images of 10 neonates, one at rest and the other during a painful procedure. Each image was shown for 7 seconds on a computer screen, while eye movements were tracked by the Tobii TX300 EyeTracker. After evaluating each image, participants gave a score from 0 (absent pain) to 10 (maximum pain), according to their perception of neonatal pain. For each image, the number and total time of gaze fixations in the forehead, eyes, nasolabial furrow, and mouth were studied. Comparisons between both groups of adults were made by an intraclass correlation coefficient, Student's t-test, and Bland Altman graphic. Results: Health professionals (93% female; 34 ± 9 years old), compared to non-health professionals (64% female; 35 ± 11 years old), gave lower scores for images at rest (0.81 ± 0.50 vs. 1.59 ± 0.76; p = 0.010), with no difference for those obtained during the painful procedure (6.98 ± 1.08 vs. 6.73 ± 0.82). There was a strong or almost perfect correlation for the number of fixations in the mouth, eyes, forehead, and for the total fixation time in the eyes and forehead. Conclusions: Adults, irrespective of their profession, showed a homogeneous gaze pattern when evaluating pictures of neonates at rest or during a painful procedures.

Eye tracking studies related to social attention deficits in autism spectrum disorders / 中华行为医学与脑科学杂志

Autism spectrum disorder (ASD) is a group of neurodevelopmental disorders.Impaired social functioning is a core characteristic of individuals with ASD.Social attention deficits are important manifestation of their impaired social functioning.And it mainly reflected in the gaze on faces and social interactions.Eye movement technology is an objective and sensitive non-invasive measurement tool.Its application makes the measurement of individual core characteristics of ASD more accurate and objective.A review of recent studies revealed that the type of eye-movement stimuli for social attention in patients with AD gradually shifted from face image processing to social interaction scenes, and developed from static presentation to dynamic presentation.Dimensional embodiment of the progress of eye-movement studies of social attention in individuals with ASD.These studies suggest that individuals with ASD are less likely to gaze at the face region and the eye region of the face.More studies are currently using eye-tracking technology, and the analysis of emotional face gaze reveals that, the reduction in eye gaze in individuals with ASD is due to the discomfort associated with threatening faces.These findings validate the " gaze aversion" hypothesis regarding impaired social attention in individuals with ASD.Related neural mechanism studies have found a general lack of attention to social cues in the environment in individuals with ASD.Brain regions such as the amygdala, cingulate gyrus, superior temporal sulcus and anterior insula are associated with social attention in individuals with ASD.Especially with the superior temporal sulcus, the dorsal and ventral sides of the anterior insula, and so on.Future research should explore the cognitive neural mechanisms of social attention deficits in ASD, and the application of advanced information technology, such as eye-tracking technology, in the rehabilitation of patients with ASD.

An eye-tracking study of dynamic threatening and non-threatening emotional faces in children with autism spectrum disorders / 中华行为医学与脑科学杂志

Objective:To investigate the gaze characteristics of children with autism spectrum disorder (ASD) on dynamic threatening (fear, anger) and non-threatening emotional (sadness, happiness) faces, and to explore the correlation between their eye-tracking data and autism symptomatology scores to provide a basis for the treatment and rehabilitation of children with ASD.Methods:From November 2020 to June 2021, 26 children with ASD and 30 age-and sex-matched normally developing children (typical developmental, TD) who met the enrollment criteria were included, and children with ASD were assessed for symptoms by the childhood autism rating scale (CARS). The SMI-red portable eye-tracking recording system was used to record the eye-movement gaze characteristics of children in both groups during free viewing of dynamic threatening and non-threatening emotional face segments.Statistical processing was performed by SPSS 21.0 software.The independent sample t-test and chi square test were used for the data conforming to the normal distribution, and the non parametric test was used for the data not conforming to the normal distribution, and Pearson correlation analysis was used to analyze the correlation between eye-tracking data and symptomatology scores. Results:The total CARS score of the ASD group was (32.64±7.42). The eye tracking data for children with ASD showed gaze aversion characteristics.Children with ASD spent significantly less time gazing at the eye area of threatening emotional faces in fear (2.41(0.26, 10.65)s) and anger (2.17(0.13, 6.13)s) than children with TD (8.81(2.54, 12.11)s, 5.21(3.80, 12.49)s), with statistically significant differences (fear: Z=-2.252, P<0.05.anger: Z=-2.793, P<0.01). Children with ASD spent significantly less time gazing at the mouth area of all four emotional faces (sad: 3.56(0.44, 7.16)s, fear: 2.68(0.42, 4.78)s, anger: 2.13(0.35, 4.20)s, happiness: 2.93(0.46, 5.71)s) than children with TD (sad: 11.43(6.97, 14.22) s, fear: 6.73(3.65, 10.10)s, anger: 6.86(4.55, 12.33)s, happiness: 11.72(7.22, 14.39)s), with statistically significant differences (sad: Z=-4.502, P<0.01.fear: Z=-3.493, P<0.01.anger: Z=-4.025, P<0.01.happiness: Z=-4.699, P<0.01). Correlation analysis revealed that the time spent gazing at emotional faces in children with ASD was negatively correlated with the total CARS score ( r=-0.476, P<0.05), and further analysis of different emotional faces revealed that the time spent gazing at fearful faces in children with ASD was negatively correlated with the total CARS score ( r=-0.455, P<0.05). Conclusions:Eye tracking in children with ASD show a gaze profile with less gaze time to threatening emotional faces compared with TD children, and the more severe the symptoms in children with ASD, the less gaze time to fearful faces.

Gender differences in the influence of emotional intelligence on the situation selection among college students / 中华行为医学与脑科学杂志

Objective:To investigate the effect of emotional intelligence (EI) in situation selection among college students under different gender.Methods:Using the emotional intelligence scale to test 416 students from an university in Chengdu, and 42 students (high emotional intelligence: high EI) and 42 students (low emotional intelligence: low EI) were selected as preselected subjects according to their scores. A total of 40 subjects, including 20 in the high EI group (10 males and 10 females) and 20 in the low EI group (10 males and 10 females), were selected to participate in the experiment by excluding subjects who gave up the experiment and taking into account both genders. Using the emotion picture selection task, the eye movement data of the subjects watching the situation picture and the reaction time of selecting the situation picture again were recorded respectively.The R language Bruce R package was used for three-factor analysis of variance. If there was interaction effect, the post simple effect analysis was carried out.Results:(1) About the eye-movement data before picture selection, the females with higher EI scores had significantly greater saccade amplitude when viewing negative pictures than the females with lower EI scores ((2.79±1.58)°, (2.46±0.85)°, F(1, 36)=7.39, P=0.007), and the males with high EI scores had less saccade amplitude when viewing all pictures than the males with low EI scores ((2.00±0.83)°, (2.17±0.85)°, F(1, 36)=6.58, P=0.011). The females with high EI scores had a significantly faster saccade velocity than the females with low EI scores((98.93±35.60)°/s, (92.81±20.56)°/s, F(1, 36)=8.39, P=0.004), and the males with high EI scores had a significantly slower saccade velocity than the males with low EI scores ((79.35±18.55)°/s, (85.11±18.53)°/s, F(1, 36)=6.70, P=0.01). The females with high EI scores had a significantly shorter fixation duration for negative emotional pictures than the females with low EI scores ((2 654.7±530.85) ms, (2 877.87±205.44) ms, F(1, 36)=30.38, P<0.001), and the males with high EI scores had a significantly shorter fixation duration for positive emotional pictures than the males with low EI scores ((2 839.74±405.34) ms, (2 932.83±228.07) ms, F(1, 36)=9.46, P=0.002). About the fixation number, females gazed at the negative pictures significantly less than males ((9.43±2.31), (10.24±2.05), F(1, 36)=21.49, P<0.01). (2) In terms of choice response times, the females with high EI scores chose to look back at positive neutral pictures with shorter reaction times than the females with low EI scores (positive: (726.79±329.12) ms, (924.51±758.34) ms, F(1, 36)=9.07, P=0.003; neutral: (783.46±543.54)ms, (962.44±463.57)ms, F(1, 36)=6.23, P=0.013), and the males with high EI scores chose to look back with longer reaction times than the males with low EI scores, but the difference was only significant when viewing neutral pictures ((1 092.29±905.52) ms, (871.27±461.68) ms, F(1, 36)=9.07, P=0.002). Conclusion:The influence of emotional intelligence on the process of situation selection is different by gender: the higher the emotional intelligence of female college students, the faster they can process negative emotional information in the process of situation selection, and the broader and more dispersed the processing patterns; the higher the emotional intelligence of male college students, the faster they can process positive emotional information in the process of situation selection, and the more concentrated the processing patterns.

Eye movement study on facial emotion processing in patients with Alzheimer's disease / 中华行为医学与脑科学杂志

Objective:To explore the effect of visual processing patterns on emotional face processing in patients with Alzheimer's disease (AD).Methods:From June 2020 to August 2021, twenty-two AD patients (AD group) who met the conditions of this study were selected from the memory impairment clinic of the First Affiliated Hospital of Anhui Medical University, and demographically matched twenty-one elderly healthy people (control group) were selected from the patients' family members and community residents. The two groups of subjects performed emotional face visual scanning and facial recognition experiments after completing the evaluation of the cognitive scale and eye movement data were recorded in the emotional face visual scanning task. Statistical analysis of the obtained results was performed using SPSS 23.0 Windows version software. The data that conformed to the normal distribution were tested by independent samples t-test and variance analysis, and the data that did not conform to the normal distribution were tested by nonparametric test. Results:(1)In the emotional face recognition task, the total accuracy of facial emotion recognition of AD patients(0.52(0.42, 0.59)) was lower than that of the normal control group(0.67(0.64, 0.69)), and the difference was statistically significant( Z=-4.023, P<0.01), which was mainly manifested in recognizing complex facial emotion. (2) In the emotional face visual processing task, the saccade count ((1.96±0.97), (2.50±0.44)), fixation count ((3.93±2.58), (6.37±2.08))and fixation time ((1 205.89±727.32)s, (1 761.38±525.54)s)of AD patients were lower than those of the control group( t=-2.314, -3.402, -2.880, all P<0.05), and the surrounding facial fixation time (384.95 (276.51, 587.78)s, 276.06 (190.03, 384.55)s) was higher than that of the control group( Z=-2.478, P=0.013). Patients with AD had a lower fixation count than that in the control group on the eye area of surprise ((3.76±2.90), (6.25±2.19)), anger ((4.48±2.72), (7.06±2.55)) and disgust ((4.10±2.45), (6.67±2.45)), and the differences were statistically significant ( t=-3.164, -3.207, -3.436, all P<0.05). Patients with AD had a lower fixation time than those of the control group on the eye area of surprise ((1 150.26±753.22)s, (1 779.91±551.66)s), angry ((1 430.85±869.52)s, (1 944.51±612.63)s) and disgust ((1 266.14±765.67)s, (1 898.33±676.02)s), and the differences were statistically significant ( t=-3.115, -2.247, -2.865, all P<0.05). (3) Spearman correlation analysis showed that the accuracy of overall emotional face recognition was positively correlated with the fixation time in the eye area in AD patients ( r=0.429, P<0.05). Conclusion:The impaired visual processing of AD patients causes emotional face recognition disorders. Therefore, AD patients have different visual processing patterns in emotional face processing than age-matched normal controls, mainly manifested as the decreased fixation on the eye area.

Smile Arc Esthetics in Middle-Aged Man from the Layperson's Perspective Via Eye-Tracking

Abstract Objective: To evaluate the perceptions of smile esthetics associated with variations in the vertical plane of the maxillary incisors in the smile arc using eye-tracking software. Material and Methods: An image of a 59-year-old Caucasian male model was adapted and edited to make three changes in the vertical plane, simulating a convex, straight, and reverse smile arc. Four areas of interest were inserted at the right and left eyes, nose, and mouth. Forty laypeople raters between 18 and 45 years of age participated of the study. Eye-tribe hardware and Ogama software were used to perform eye-tracking. Attractiveness and age-perception questions were also incorporated into the study. ANOVA test and Pearson's correlation coefficient, at p < 0.05. Results: The most observed AOI in images with convex, straight, and reverse smiles, as assessed using heatmaps and point maps, was the mouth, followed by the right eye. A significant difference for the eye (p=0.02) was found when comparing convex and reverse smiles, whereas a significant difference for the mouth was observed between the straight and reverse smiles (p=0.03). Conclusion: Convex and straight smile arcs were associated with equal levels of attractiveness; the reverse smile was less attractive. No significant difference was noticed regarding age perception and the smile arcs. However, the reverse smile recorded a more complete fixation time.