Unsupervised Screen Exposure and Poor Language Development: A Scoping Review to Assess Current Evidence and Suggest Priorities for Research.

Screen exposure has both negative and positive effects on the level of language skills a child acquires. The purpose of this review is to address current literature on the possible relationship between unsupervised screen exposure and language development in children and to provide recommendations to caregivers regarding screen exposure of children, taking into consideration the possible effects. A scoping review was conducted using the PubMed/MEDLINE (Medical Literature Analysis and Retrieval System Online) database. A total of 590 articles were retrieved and considered for inclusion. Twenty-one articles were finally included and reviewed with an emphasis on language, communication, and executive skills as well as cognitive development. The negative effects of screen exposure for children outweigh the positive effects. The largest number of studies demonstrate that unsupervised screen exposure may negatively impact a child's language usage and cognitive and executive skills, disrupt playtime, and affect the quality of sleep. On the other hand, supervised screen use is associated with improved language skills. More evidence is needed on unsupervised exposure in children to new types of screens. As technology could play a significant role in schools in the future, additional research is required to create educational media for schoolchildren with specific guidelines.

Origami-Based Haptic Syringe for Local Anesthesia Simulator.

Although medical simulators have benefited from the use of haptics and virtual reality (VR) for decades, the former has become the bottleneck in producing a low-cost, compact, and accurate training experience. This is particularly the case for the inferior alveolar nerve block (IANB) procedure in dentistry, which is one of the most difficult motor skills to acquire. As existing works are still oversimplified or overcomplicated for practical deployment, we introduce an origami-based haptic syringe interface for IANB local anesthesia training. By harnessing the versatile mechanical tunability of the Kresling origami pattern, our interface simulated the tactile experience of the plunger while injecting the anesthetic solution. We present the design, development, and characterization process, as well as a preliminary usability study. The force profile generated by the syringe interface is perceptually similar with that of the Carpule syringe. The usability study suggests that the haptic syringe significantly improves the IANB training simulation and its potential to be utilized in several other medical training/simulation applications.

Origami-Inspired Vibrotactile Actuator (OriVib): Design and Characterization.

The use of vibrotactile feedback, in place of a full-fledged force feedback experience, has recently received increased attention in haptic communities due to their clear advantages in terms of cost, expressiveness, and wearability. However, designers and engineers are required to trade off a number of technical challenges when designing vibrotactile actuators, including expressiveness (a wide band of actuation frequency), flexibility, and the complexity of the manufacturing process. To address these challenges, we present the design and characterization of an origami-inspired flexible vibrotactile actuator, named OriVib, with a tunable resonance frequency (expressiveness), an origami-inspired design (flexible, soft contact with the human body), and a streamlined manufacturing process (low-cost). Based on its characterization, the fabricated OriVib actuator with 54 mm diameter can produce up to 1.2 g vibration intensity where the vibration intensity increases linearly from 6-11 V input. The resonance frequency is tunable through the characteristic diameter (the resonance frequency decreases in an almost inversely proportional fashion as the diameter increases). As for the thermal signature, the OriVib actuator maintains its temperature below 38  oC when actuated within 6-8 V. In terms of repeatability, the OriVib maintained an average vibration intensity of 0.849 g (standard deviation 0.035 g) for at least 2 million cycles. These results validate the effectiveness of the OriVib actuator to offer an expressive, low-cost, and flexible vibrotactile actuator.

Neural correlates of thermal stimulation during active touch.

Introduction: Thermal feedback technologies have been explored in human-computer interaction to provide secondary information and enhance the overall user experience. Unlike fast-response haptic modalities such as vibration and force feedback, the human brain's processes associated with thermal feedback are not fully understood. Methods: In this study, we utilize electroencephalography (EEG) brain imaging to systematically examine the neural correlates associated with a wide range of thermal stimuli, including 9, 15, 32, and 42°C, during active touch at the fingertip. A custom experimental setup is developed to provide thermal stimulation at the desirable temperature levels. A total of 30 participants are recruited to experience the four levels of thermal stimulation by actively touching a thermal stimulation unit with the index finger while recording brain activities via EEG. Time-frequency analysis and power spectral density (PSD) of the EEG data are utilized to analyze the delta, theta, alpha, beta, and gamma frequency bands. Results: The results show that the delta, theta, and alpha PSDs of 9 and 15°C stimuli are significantly higher than the PSDs of 32 and 42°C in the right frontal area during the early stage of the stimulation, from 282 ms up to 1,108 ms (One-way ANOVA test, Holm-Bonferroni correction, p < 0.05). No significant differences in PSDs are found between 9 and 15°C thermal stimuli or between 32 and 42°C thermal stimuli. Discussion: The findings of this study inform the development of thermal feedback system in human-computer interaction.

A Comparison of Vibrotactile Feedback and Electrical Muscle Stimulation (EMS) for Motor Response During Active Hand Movement.

Wearable haptic technologies have garnered recent widespread attention due to increased accessibility, functionality, and affordability. These systems typically provide haptic feedback to augment the human ability to interact with their environment. This study compares two haptic feedback modalities, vibrotactile and EMS, against visual feedback to elicit a motor response during active hand movement. Forty-five participants, divided into three groups, performed a task to touch their face and received one of three possible sensory feedback cues, namely visual, vibrotactile, and electrical muscle stimulation (EMS), to interrupt their movement and avoid touching their face. Two quantitative performance measures are used in the comparison, the response time (time elapsed from stimulation to motor response) and the error rate (percentage that the user fails to avoid touching their face). Results showed that vibrotactile and EMS feedback yielded significantly faster response time than visual feedback, while no significant differences between vibrotactile and EMS were observed. Furthermore, the error rate was significantly lower for EMS compared to visual feedback, whereas no significant differences were observed between vibrotactile and visual feedback. In conclusion, it seems that EMS feedback is preferable for applications where errors are not tolerable (critical medical applications), whereas vibrotactile is superior for non-critical applications due to its low cost and higher usability (more pleasant compared to EMS).

Clinical and Microbiological Factors Associated With Abscess Formation in Adult Acute Epiglottitis.

OBJECTIVES: To evaluate clinical and microbiological findings that are correlated with abscess formation in adult acute epiglottitis (AE). METHODS: We reviewed 140 cases of adult AE. Demographic, clinical, imaging, and microbiological findings are analyzed for all patients with AE in comparison to those with epiglottic abscess (EA). RESULTS: A total of 113 patients presented with AE and 27 presented or progressed to EA (19.3%). Age, sex, seasonality, smoking, body mass index (BMI), and comorbidities were statistically insignificant between the 2 groups. Muffled voice (P < .013), respiratory distress (P < .001), and pre-existence of epiglottic cyst (P < .001) are symptoms and signs connected with abscess formation. A total of 120 patients were treated conservatively. Surgical treatment was performed on 20 patients with EA. About 72 out of 80 cultures revealed monomicrobial infection. Mixed flora was isolated in 8 patients with EA. Streptococcus was isolated in 51 out of 80 positive cultures (64%). Haemophilus Influenza (Hib) was not isolated in any sample. EA and mixed flora relates to a higher rate of airway intervention (P < .001). CONCLUSION: A high level of suspicion for abscess formation is required if clinical examination reveals dyspnea, muffled voice, or an epiglottic cyst in adult with AE. The existence of EA doubles the duration of hospitalization. EA is typically found on the lingual surface of the epiglottis. Supraglottic or deep neck space expansion should be treated surgically. EA is associated with a mixed flora and a higher rate of airway obstruction. Streptococcus is discovered to be the most common pathogen.

Contactless Kinesthetic Feedback to Support Handwriting Using Magnetic Force.

Handwriting is a fundamental human skill that is essential for communication yet is one of the most complex skills to be mastered. Pen-based interaction with touchscreen devices are increasingly used in digital handwriting practices to simulate pen and paper experience, but are mostly based on auditory-visual feedback. Given that handwriting relies on visual and motor skills, haptic feedback is recently explored to augment audio-visual systems to further support the handwriting process. In this article, we present an assistive platform entitled KATIB (means writer in Arabic) that provides high fidelity kinesthetic feedback, in addition to audio-visual feedback, to support handwriting using magnetic forces. We propose novel contactless kinesthetic guidance methods, namely proactive and retroactive guidance, to guide the handwriting stylus along a desirable trajectory based on position control. Detaching the handwriting stylus from any mechanical device enables learners to have full control over grasping and moving at their own pace and style. The proposed platform is characterized for haptic interaction. Finally, a psychophysical experiment is conducted to validate that the kinesthetic guidance is perceivable and beneficial as a sensory feedback using a novel handwriting copy task. Contactless kinesthetic feedback seems to play a significant role in supporting digital handwriting by influencing the kinematics of the handwriting process.

FaceGuard: A Wearable System To Avoid Face Touching.

Most people touch their faces unconsciously, for instance to scratch an itch or to rest one's chin in their hands. To reduce the spread of the novel coronavirus (COVID-19), public health officials recommend against touching one's face, as the virus is transmitted through mucous membranes in the mouth, nose and eyes. Students, office workers, medical personnel and people on trains were found to touch their faces between 9 and 23 times per hour. This paper introduces FaceGuard, a system that utilizes deep learning to predict hand movements that result in touching the face, and provides sensory feedback to stop the user from touching the face. The system utilizes an inertial measurement unit (IMU) to obtain features that characterize hand movement involving face touching. Time-series data can be efficiently classified using 1D-Convolutional Neural Network (CNN) with minimal feature engineering; 1D-CNN filters automatically extract temporal features in IMU data. Thus, a 1D-CNN based prediction model is developed and trained with data from 4,800 trials recorded from 40 participants. Training data are collected for hand movements involving face touching during various everyday activities such as sitting, standing, or walking. Results showed that while the average time needed to touch the face is 1,200 ms, a prediction accuracy of more than 92% is achieved with less than 550 ms of IMU data. As for the sensory response, the paper presents a psychophysical experiment to compare the response time for three sensory feedback modalities, namely visual, auditory, and vibrotactile. Results demonstrate that the response time is significantly smaller for vibrotactile feedback (427.3 ms) compared to visual (561.70 ms) and auditory (520.97 ms). Furthermore, the success rate (to avoid face touching) is also statistically higher for vibrotactile and auditory feedback compared to visual feedback. These results demonstrate the feasibility of predicting a hand movement and providing timely sensory feedback within less than a second in order to avoid face touching.

Mid-Air Tactile Feedback Co-Located With Virtual Touchscreen Improves Dual-Task Performance.

The use of haptic technology has recently become essential in Human-Computer Interaction to improve performance and user experience. Mid-air tactile feedback co-located with virtual touchscreen displays have a great potential to improve the performance in dual-task situations, such as when using a phone while walking or driving. The purpose of this article is to investigate the effects of augmenting virtual touchscreen with mid-air tactile feedback to improve dual-task performance where the primary task is driving in a simulation environment and the secondary task involves interacting with a virtual touchscreen. Performance metrics included primary task performance in terms of velocity error, deviation from the middle of the road, number of collisions, and the number of off-road glances, secondary task performance including the interaction time and the reach time, and quality of user experience for perceived difficulty and satisfaction. Results demonstrate that adding mid-air tactile feedback to virtual touchscreen resulted in statistically significant improvement in the primary task performance (the average speed error, spatial deviation, and the number of off-road glances), the secondary task (reach time), and the perceived difficulty. These results provide a great motivation for augmenting virtual touchscreens with mid-air tactile feedback in dual-task human-computer interaction applications.

Investigating Haptic Guidance Methods for Teaching Children Handwriting Skills.

Haptics technologies have the potential to considerably improve the acquisition of handwriting skills by providing physical assistance to improve movement accuracy and precision. To date, very few studies have thoroughly examined the effectiveness of various haptic guidance methods to leverage the acquisition of handwriting skills. In this paper, we examine the role of several methods for haptic guidance, namely full haptic guidance, partial haptic guidance, disturbance haptic guidance, and no-haptic guidance toward improving the learning outcomes of handwriting skills acquisition for typical children. A group of 42 children from Cranleigh School Abu Dhabi across two educational stages, namely Foundation Stage 2 (FS2, 4-5 years old) and Year 2 (6-7 years old), participated in this study. Results showed that disturbance haptic guidance was the most effective for high complexity handwriting tasks (such as writing the letters "o" and "g"), partial haptic guidance was the most effective for medium complexity handwriting tasks (such as "t," "r," "s," "e," "n," "a," and "b"), and full haptic guidance was the most effective for low complexity letters (such as "i"). Another interesting finding was that FS2 participants had statistically significant improvement in handwriting speed compared to the Year 2 group, demonstrated by a significantly shorter test completion time. Furthermore, female children performed statistically better than their male counterparts in partial guidance. These results can be utilized to build more effective haptic-based handwriting tools for typical children.

A Vibrotactile Alarm System for Pleasant Awakening.

There has been a vast development of personal informatics devices combining sleep monitoring with alarm systems, in order to find an optimal time to awaken a sleeping person in a pleasant way. Most of these systems implement auditory feedback, which is not always pleasant and may disturb other sleepers. We present an adaptive alarm system that detects sleeping cycles and triggers alarm signal during shallow sleep, to minimize sleep inertia. Since tactile sensation is associated with positive valence, vibrotactile stimulation is investigated as a silent alarm to enhance pleasant awakening. Three modulation techniques to render the tactile stimuli for pleasant awakening are considered, namely simultaneous, continuous, and successive stimulation. Two experimental studied are conducted. Experiment 1 studied exogenous attention towards tactile stimulation in a multimodal scenario (involving visual and haptic interactions) with fully awake individuals. Results from the attention task and the subjective valence rating suggest that the vibrotactile stimulation should be based on the continuous modulation, since this not only is very perceivable but also associated with positive attention. Experiment 2 evaluated the user experience with tactile stimulation patterns during sleep. Results confirmed the findings of experiment 1. Continuous modulation was rated highest for pleasant yet arousing sleep-awake transition.

Combining Full and Partial Haptic Guidance Improves Handwriting Skills Development.

It has been shown in previous studies that haptic guidance improves the learning outcomes of handwriting motor skills. Full and partial haptic guidance are developed and evaluated in the literature. In this paper, we present two experimental studies to examine whether combining full and partial haptic guidance is more effective for improving handwriting skills than merely full or partial guidance methods. Experiment I, with 22 participants, compares the effectiveness of merely full and partial haptic guidance methods towards improving learning outcomes of Arabic handwriting. Even though haptic guidance in general is found to be effective and pleasant by all participants, experiment I concludes that there are no statistically significant differences in the learning outcomes between full and partial haptic guidance. Experiment II investigates whether a combination of full and partial haptic guidance could further improve the learning outcomes, compared to merely full or partial haptic guidance. The learning outcomes and quality of experience are measured to evaluate each group's performance. Results from experiment II demonstrate that the combination of full and partial haptic guidance results in statistically significant improvements in the quality of handwriting, compared to mere full or partial haptic guidance. In particular, starting with partial haptic guidance at early stage of learning and then using full guidance at intermediate/advanced learning stages seemed to be the most effective. This implies that partial haptic guidance is more effective to learn the gross shape of handwriting skills (at early stages of the learning process) whereas full haptic guidance is more effective to learn the fine details of the handwriting skills (at intermediate or advanced stage of learning). Therefore, partial-then-full haptic guidance seems to be the most effective to improve learning outcomes.

Mid-Air Tactile Stimulation for Pain Distraction.

Using the human sense of touch, pain control has been studied for decades. With the rise of Virtual Reality (VR) and haptic technologies, creating VR and haptic sensations provide a unique opportunity for pain distraction. In this paper, we present an experimental study to test whether VR and mid-air ultrasound tactile stimulation reduce perceived pain simulated via the cold pressor test, i.e., submerging a human hand in cold water (2 C) for as long as the test subject can. Fifty right-handed subjects participated in the study and three tasks were considered: task 1 involved experiencing the cold pressor test with no distraction (considered as the control task), task 2 involved playing a simple VR game with no tactile feedback, and task 3 utilized the same VR game with tactile feedback; tasks 2 and 3 were assigned in random order after task 1. The tolerance time, perceived pain rating, and quality of experience were evaluated and compared for the three tasks. Results demonstrated that when a VR task involves physical (touch) interaction, tactile stimulation plays a significant role in increasing pain tolerance time. Furthermore, the study demonstrated that for high pain tolerance participants, tactile stimulation is more effective for pain distraction compared to low pain tolerance participants. Although there are no significant differences in perceived pain and quality of experience between VR and VR+Tactile tasks, there are significant differences in tolerance time (Wilcox signed rank test, p 0.05). It is presumed that VR and the tactile stimulation induces positive emotions when utilized (for both valence and arousal).

The knowledge of osteoporosis risk factors in a Greek female population.

OBJECTIVES: The social and economic burden of osteoporosis is important since it concerns a continuously aging population, while the disease is silent until the emergence of fractures. Aim of the study was to assess female population knowledge about osteoporosis risk factors and to identify the risk factors of the studied population. METHODS: A sample of 99 (aged: 61.59+/-9.61 years) women under treatment for osteoporosis or osteopenia answered the questionnaire provided by their pharmacists and were included in the study's analysis. Various parameters on osteoporosis awareness and risk factor knowledge of the population sample studied were analyzed. RESULTS: It was revealed that 96% of the participants knew osteoporosis definition and sources of this knowledge were one or more of the following: doctors (86.3%), mass media (20%) and friends or relatives (13.7%). It was found that the older age was associated with less knowledge (OR=0.93, CI: 0.88-0.97, p=0.004), and higher education with increased knowledge (OR=1.68, CI: 1.10-2.55, p=0.014) about osteoporosis. 56.4% of the participants were aware of at least one osteoporosis risk factor. In multivariate analysis, it was revealed that the participants who referred increased milk products consumption in childhood (OR=3.72, CI: 1.34-10.36, p=0.012) and current performance of physical activity (OR=13.06, CI: 3.22-53.05, p<0.001) were more likely to be informed about osteoporosis risk factors; age >61 years was associated with decreased knowledge of risk factors (OR=0.27, CI: 0.09-0.82, p=0.018). CONCLUSIONS: This study implies that a higher degree of participant's health education may result in the avoidance of osteoporosis risk factors. Increasing knowledge of osteoporosis should be a priority for future intervention programs in order to promote specific behavioural strategies for osteoporosis prevention.