Distraction Factors Research Articles

Influence of Distraction Factors on Performance in Laparoscopic Surgery in Immersive Virtual Reality: Study Protocol of a Cross-Over Trial in Medical Students and Residents-DisLapVR.

Working in an operating room (OR) is physically and mentally challenging: the operation itself demands the surgeon's full attention, while time and cost efficiency constraints, daily planning, and emergency care interfere with the procedure. Thus, multitasking becomes an integral surgical competence. This study aims to examine the effect of disruptions during surgery in a highly immersive virtual reality (IVR) operation environment combined with a virtual reality (VR) laparoscopy simulator. This study aims to identify distractions in the OR and their importance in the clinical setting. An IVR environment was created using a high-resolution, stereoscopic 360° video of the OR. Different distractions were identified, classified as auditory, visual, or audio-visual, and recorded accordingly. The surrounding was combined with a VR laparoscopic simulator. Participants-medical students and surgical residents-received proficiency-based training in basic laparoscopic skills and were blinded to the aim of the experiment. Following a cross-over design, each participant received a unique order of virtual distraction factors while performing tasks on the laparoscopic simulator. During the experiment, subjective passing of time, stress, heart rate, and visually induced motion sickness are recorded. After the experiment, validated questionnaires for usability, immersion, and stress were completed, as well as subjective evaluation of the distractions. The questionnaires used included the system usability scale, Self-Assessment Manikin score, National Aeronautics and Space Administration Task Load Index, and the immersion rating scale as described by Nichols. Performance in the laparoscopic tasks in relation to distractions will be evaluated by the Wilcoxon test and ANOVA for continuous variables. Subgroup analyses in regard to age, gender, and expertise (medical students vs surgical residents) are planned. The described trial started in August 2022 and is ongoing. By July 2024, a total of 30 medical students and 9 surgeons have completed the study. We present a study protocol aiming to identify the impact of different disruptions in OR during laparoscopic training in IVR. Hence, it may lead to an improved awareness of distractions and facilitate accommodations toward an improved work environment. Prior research leads to the hypothesis that the performance of a more experienced surgeon is less impacted by distractions than the performance of inexperienced surgeons and medical students. Furthermore, we investigate which type of distraction has the largest impact on performance. With this knowledge, specific multitasking training can be devised, which may be particularly useful in medical education, for which VR might play a leading role. Additionally, workplace surroundings in the OR can be optimized with this knowledge. German Registry for Clinical Trials DRKS00030033; https://drks.de/search/en/trial/DRKS00030033. DERR1-10.2196/59014.

Construction of user experience model iniImmersive virtual environment based on ontology

With the rapid development of virtual immersion technology, immersive virtual environment (IVE) has shown its unique application potential in many fields. The purpose of this study is to explore and construct a user experience model in immersive virtual environment based on ontological theory. The key factors affecting user experience include sensory experience, interaction control, distraction factors, realism perception, ownership, motion control and location. Environmental dimension and physical dimension are the two core aspects of user experience. Sensory experience and sense of ownership have a significant positive impact on users' sense of existence in a specific environment, while control dimension, sensory dimension and realism dimension play an important role in enhancing users' sense of ontology. The different dimensions of the sense of ontology have a significant positive impact on the user's sense of immersion and presence, which verifies the central role of the sense of ontology in enhancing the user's immersion experience. We look forward to further enhancing the user's immersion experience and promoting the application of immersive virtual environment in a wider range of fields

Simulation-Oriented Analysis and Modeling of Distracted Driving

Distracted driving significantly affects the efficiency and safety of traffic flow. Modeling distracted driving behavior in microscopic traffic flow simulation is essential for understanding its critical impacts on traffic flow. However, due to the influence of various external factors and the considerable uncertainties in behavior characteristics, modeling distracted driving behavior remains a challenge. This study proposed a model which incorporates distraction features into the microscopic traffic flow model to simulate distracted driving behavior. Specifically, the study first examines the characteristics of distracted driving, including the intervals and durations of distraction events, as well as the patterns and environments of distraction. It then introduces distraction parameters into the Intelligent Driver Model (IDM), including reaction time delays and perception deviations in both speed difference and following distance. These parameters are quantified by probabilistic distributions to reflect the uncertainty and individual differences in driving behavior. The model is calibrated and validated using 772 distracted following events from the Shanghai Naturalistic Driving Study (SH-NDS) data. Three patterns of distraction (excessive, moderate, mild) are distinguished and modeled separately. The results show that the model’s accuracy surpasses that of the IDM under various road types and traffic volumes, with an average improvement in model accuracy of about 11.30% on expressways with high traffic volume, 4.54% on expressways with low traffic volume, and 4.46% on surface roads. Meanwhile, the model can effectively simulate the variations in reaction times and perceptual deviations in both speed and following distance for different distraction modes at the individual level, maintaining consistency with reality. Finally, the study simulates distracted driving behavior under different road environments and traffic volumes to explore the impact of distracted driving on traffic flow. The simulation results indicate that an increase in the proportion of distraction reduces the efficiency and safety of traffic flow, which is consistent with real-world observations. Since the model considers human distraction factors, it can generate more dangerous driving scenarios in simulations, which holds significant importance for safety-related research. The findings from this study are expected to be helpful for understanding distracted driving behavior and mitigate its negative influence on the efficiency and safety of traffic flow.

Student Attitudes Toward Foreign Language Learning During Wartime in Ukraine

Introduction. The war that has raged in Ukraine for over a year and a half has profoundly affected our students at the Ferenc Rákóczi II Transcarpathian Hungarian College of Higher Education, both physically and mentally. It was hypothesized that the war had a negative impact on students’ learning; learning a foreign language was challenging due to numerous distracting factors. Consequently, students’ attitudes toward language learning were adversely affected. Purpose. The purpose of this study is to gain a better understanding of what students experienced during martial law, their overall feelings about language learning, how this challenging period influenced their attitudes toward language learning, and the specific challenges they encountered. To achieve this, a survey was designed. Methods. An anonymous online questionnaire was developed to gain insights into the research questions. It consisted of three blocks of Likert-scale statements. Students had to rate the extent to which these statements were true for them on a scale from 1 to 5, where 1 meant ‘not at all true,’ and 5 meant ‘totally true.’ In total, 194 questionnaires were completed. Results. The results have revealed intriguing findings. A significant majority of students (75%) expressed optimism, believing that wise decisions would soon be made to end the war as soon as possible. Additionally, students expressed high levels of satisfaction with the Google Classrooms assigned to every discipline at the college (77%) since they greatly facilitated the monitoring of their studies. Conclusion. Students highlighted their appreciation for the opportunity to have offline classes despite the challenging circumstances. They emphasized that language learning was significantly more effective when there was direct contact with teachers and fellow students (79%).

Detection and Removal of Assymmetrical Skin Lesions Using DU-Net for Patch Extraction

The incidence of melanoma, a highly fatal kind of malignant tumor, is exhibiting an upward trend in its progression. Timely intervention and management of skin cancer significantly enhance the likelihood of survival. Analyzing dermoscopic images poses challenges for dermatologists due to various distracting factors, including fluctuations in lighting and reflections on the skin's surface. Accurately delineating the area of skin pathology is crucial for diagnosing the specific skin condition. This study introduces DU-net, a method for identifying and removing pigmented skin lesions. The DU-net framework incorporates deep convolutional neural networks, notably YOLOv5, to perform patch detection. It also employs asymmetrical patch contouring methods to preserve edge information. Additionally, clustering algorithms are utilized to identify pixel groups and extract patches from the image. The De Trop Noise Exclusion technique, in conjunction with the process of in-painting, is employed to successfully eliminate hair from the images within the ISIC-2018 and 2019 datasets. Rigorous annotation of skin images with lesions of various sizes and shapes using rectangle bounding is carried out, and YOLOv5 hyper-parameters are fine-tuned to achieve high-confidence multiple lesion detection in dermoscopic images. Despite complex textures and unclear boundaries, our approach consistently detects and labels patches, accurately segmenting the areas of skin pathology. The model's performance is assessed on these datasets using various parameter metrics, the results of the study indicate that the segmentation strategies described in this research exhibit an average accuracy ranging from about 92% to 94%.

Towards IPB Immersive Field Trip Platform: Virtual Reality Field Trip to Introduce Digital Village Ecosystem to Computer Science Students

The virtual field trip format offers several advantages over a fully three-dimensional world, including its ease and cost-effectiveness in creation and development. By utilizing a 360 camera, capturing images becomes convenient, portable, and viable even in remote regions. With the amount of activity involving students and agricultural society, the potential for integrating these field trip experiences into a learning experience is significant in IPB University. Not only it able to help students understand the context before doing the actual field trip, it also able to improve their empathy to the society introduced through the virtual field trip. This research aims to present the development of a virtual reality tour to introduce digital village ecosystem to computer science students and measure its presence among the students. The 360 scenes were captured during a visit to a digital village in West Java, and an immersive learning plan was devised to introduce the digital village ecosystems. The learning path was designed based on the cone of learning principle. To evaluate the effectiveness of the virtual reality system, presence questionnaires were administered, a knowledge test was conducted, and interviews were carried out with 22 students. Research indicates that the virtual field trip successfully introduced one digital village ecosystem in Cibodas, West Java Province. Students were able to explore the village site, learn about the digital village ecosystem, and provide valuable feedback. The presence questionnaire yielded a score of 5.49 out of 7, indicating a positive immersive experience. The two are of improvements are Involvement (4.96 of 7.00) and Distraction Factor (5.20 of 7.00). The interviews identified areas for improvement, such as enhancing content quality and increasing natural interaction within the system. In conclusion, this research has laid the foundation for the IPB Immersive Field Trip Platform by developing a virtual field trip that introduces computer science students to a digital village ecosystem. The findings demonstrate promising results and provide insights for further refinement of the platform.

The “Comfort Zoom”: Preservice Teachers’ (PTs’) Perceptions on Distance Learning During the Pandemic

The study aims to evaluate in real time the level of PTs’ satisfaction with distance learning in three main aspects: lecturers, college’s functioning and self-appraisal of learning practices with distance learning in a teacher training campus. It can be defined as an action research, to understand and improve the quality of the educative process in an agile way during the crisis. Through the lens of performance improvement theory, we sought to determine if Preservice Teachers satisfaction with learning remotely would change over time because of institutional preparedness and faculty support. The sample group consisted of n=183 PTs ’in the first semester (31% Return percentage), N=193 in the second semester (32% Return percentage) and N=284 (47% Return percentage in the third semester (out of 600 Preservice Teachers’). The findings indicate both challenges and successes. In the second and third semesters, PTs’ reported higher levels of motivation, desire to learn, concentration taking an active part in class, and interest in the studied material, focusing on the lesson and ignoring distracting factors compared to the first semester. Preservice Teachers’’ coping with distance learning during the third semester were significantly better than the previous two semesters. Their evaluation of the lecturers’ at third semester was significantly higher. Preservice Teachers has perceived the lecturers’ role as an anchor of stability in the sea of change. The findings indicate the speed at which PTs’s adopted the innovative changes during the crisis. However, their evaluation of the college at the second semester was better than at the first and third semesters. These findings are important, as they shine a spotlight on associations between PTs’ satisfactions during times of change. Keywords: comfort zoom, distance learning, Covid-19, teacher training, teacher satisfaction

Detection of Driving Distractions and Their Impacts

For decades, road crashes have caused many deaths and injuries and generally have had a severe social and economic impact on societies. According to studies, driver distraction has led to an increase in driving-related risks. In recent years, there have been more distracting factors that commonly affect drivers, highlighting the need for a resolution. Therefore, as technology is becoming more advanced, there is an opportunity to minimize these risks, for which driver distraction detection would be required. As there are a variety of distractions that might affect drivers and their performance, there are many studies focusing on this topic. To better understand the field of driver distraction detection, this paper has reviewed the existing studies in this field. For this purpose, different variables of the existing methodologies and experimental setups are identified and explained. Also, the results of these experiments and the impacts of different distraction factors on drivers’ physiological responses, visual signals, or their performances are categorized and described. Furthermore, this study discusses the factors of the existing methodologies and their results, along with pointing out the research gaps. The purpose of this study is to assist future research and investigation in this field, by creating a review that comprehensively covers different aspects of existing studies and discusses and assesses their methodologies and findings.

A field‐based study demonstrating the need of holistic management system for household biogas plants in rural India

AbstractIndian household biogas system appears promising to contribute substantially to its commitment to increase the share of renewable energy. There has been a consistent effort to promote the household biogas system by the Government of India. Despite such need and effort, the growth of household biogas system in India is not encouraging. Further, the need for appropriate management services for hassle‐free operation and maintenance of household biogas system is also analyzed based on field survey conducted in three villages. Cow dung is the primary feedstock and its abundant availability results in a higher level of adoption of household biogas plants in one of the villages. Alternative feedstocks can adequately supplement cow dung to support the household biogas system in the remaining two villages. Though the higher capital cost of the biogas system is a distracting factor, biogas as a cooking fuel is cheaper than both LPG and fuelwood while considering long‐term analysis. Thus, the continuation of subsidy on household biogas plant is justified considering the issue of affordability to bear capital cost even though for long‐term use non‐subsidized option is also profitable. The non‐availability of own feedstock is a critical issue which influences the economy of biogas users and hence the motivation. Analysis also revealed that the undesirable performance of household biogas system is mostly linked with the absence of proper diagnosis. Chronical poor performance is attributed to one or more factors related to feedstock, microbial activities, and climatic parameters which remain unknown to the users and lead to their diminishing interest. Technology‐integrated management support is expected to revive the interest in household biogas system in rural India.

Understanding the Distraction and Distraction Mitigation Factors and Their Relationship with the Procrastination of Master’s and Doctoral Students in Administration

The lack of studies on academic procrastination caused by distractions in the context of social isolation, during the COVID-19 pandemic, motivated the study that sought to answer: How do master’s and doctoral students perceive distraction and distraction mitigation factors in about your procrastinating behavior? Aiming to understand the distraction and attention mitigation factors that influence procrastinating behavior in the postgraduate academic context. This is qualitative research of phenomenological nature. The study participants are twenty-four students, twelve master’s students representing about 23% of the universe, and twelve doctoral students, corresponding to approximately 21% of the universe. Based on a literature review, a theoretical framework developed that allowed comparison with the earlier analysis categories and the data collected in the semi-structured interviews. The topics Academic Distraction Factors (ADF) and Academic Distraction Mitigation (ADM) generated 583 citations, finding sixty-one codes or subcodes. The lack of planning and work outside presented as complicating factors that lead to academic procrastination. Suitable time management and the use of tools to help manage learning are good allies in mitigating distractions.

Russia-India cooperation on Post-American Afghanistan

Russian foreign policy has long championed multipolarity in international relations. As relations between Russia and the West have deteriorated, Russia has sought to establish a Eurasian project involving non-Western great powers. India has been identified by Russia as one of the major pillars of this global realignment. However, India’s global reach and power have been undermined by its entanglement in regional disputes and volatile relations with some of its partners. While some minor differences exist on the regional level in Eurasia between Russia and India, a major disagreement has been the role of the Shanghai Cooperation Organization, which Russia views as a global organization, and India sees it as regional. Our analysis suggests that the US military presence in Afghanistan, along with its plans for geoeconomic and geopolitical dominance in Eurasia, has been a major distracting factor in Russia-India relations. The US withdrawal from Afghanistan and the decline of its influence may provide new opportunities for regional cooperation between Russia and India. Our research indicates that Afghanistan may be one such country where the interests of Russia and India can converge. Both countries are interested in a stable and secure Afghanistan, and both may be willing to accept Taliban rule, subject to certain conditions, if it helps achieve that goal. In Central Asia, Russia and India have previously pursued divergent agendas, with Russia being somewhat protective of its natural sphere of interests. However, we conclude that with the elimination of external disturbances in the form of US military occupation of Afghanistan, the interests of both countries could be reconciled in relation to Central Asia. By working in synergy, Russia and India could collaborate more effectively in this region.

Texting While Driving: A Literature Review on Driving Simulator Studies.

Road safety is increasingly threatened by distracted driving. Studies have shown that there is a significantly increased risk for a driver of being involved in a car crash due to visual distractions (not watching the road), manual distractions (hands are off the wheel for other non-driving activities), and cognitive and acoustic distractions (the driver is not focused on the driving task). Driving simulators (DSs) are powerful tools for identifying drivers' responses to different distracting factors in a safe manner. This paper aims to systematically review simulator-based studies to investigate what types of distractions are introduced when using the phone for texting while driving (TWD), what hardware and measures are used to analyze distraction, and what the impact of using mobile devices to read and write messages while driving is on driving performance. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR) guidelines. A total of 7151 studies were identified in the database search, of which 67 were included in the review, and they were analyzed in order to respond to four research questions. The main findings revealed that TWD distraction has negative effects on driving performance, affecting drivers' divided attention and concentration, which can lead to potentially life-threatening traffic events. We also provide several recommendations for driving simulators that can ensure high reliability and validity for experiments. This review can serve as a basis for regulators and interested parties to propose restrictions related to using mobile phones in a vehicle and improve road safety.

Adaptive Latent Graph Representation Learning for Image-Text Matching.

Image-text matching is a challenging task due to the modality gap. Many recent methods focus on modeling entity relationships to learn a common embedding space of image and text. However, these methods suffer from distractions of entity relationships such as irrelevant visual regions in an image and noisy textual words in a text. In this paper, we propose an adaptive latent graph representation learning method to reduce the distractions of entity relationships for image-text matching. Specifically, we use an improved graph variational autoencoder to separate the distracting factors and latent factor of relationships and jointly learn latent textual graph representations, latent visual graph representations, and a visual-textual graph embedding space. We also introduce an adaptive cross-attention mechanism to perform feature attending on the latent graph representations across images and texts, thus further narrowing the modality gap to boost the matching performance. Extensive experiments on two public datasets, Flickr30K and COCO, show the effectiveness of our method.

Progress on knee cartilage repair by knee joint distraction

Knee joint distraction is a new technology for the treatment of knee osteoarthritis in recent years. It could reduce knee pain and improve knee function, which is inseparable from the role of cartilage repair. The mechanism and influencing factors of knee joint distraction in repairing cartilage are the focus of current research. In this paper, the author reviewed literature and found that knee joint distraction could reduce knee joint load and provide a appropriate mechanical environment for cartilage repair, and it is resulting hydrostatic pressure fluctuation in the knee joint not only helps cartilage to absorb nutrients, but also promotes cartilage formation genes and inhibits cartilage matrix degrading enzyme gene expression. In addition, knee joint distraction creates conditions for synovial mesenchymal stem cells to be collected to cartilage injury, and improves ability of synovial mesenchymal stem cells to proliferate and differentiate into a chondrogenic lineage. Knee joint distraction could reduce inflammatory reaction and cartilage injury of knee joint by reducing content of inflammatory factors and inhibiting expression of inflammatory genes. At present, it is known that the factors affect repair of cartilage by knee joint distraction include, increasing weight-bearing activity and height and time of distraction is helpful for cartilage repair, male patients and patients with higher severity of knee osteoarthritis have better cartilage repair effect after knee joint distraction.The better efficacy of cartilage repair on the first year after knee joint distraction predicts a higher long-term survival rate of knee joint distraction with knee preservation. However, the research on the above hot spots is only at the initial stage and further exploration is still needed, in order to better guide clinical application of knee joint distraction.

ASPECTS OF RECEPTIVITY AND DEFENSIVENESS IN TEACHING ENGLISH AS A FOREIGN LANGUAGE

The teaching of foreign languages is an integrated process in which variety of pedagogical and personal learners' factors should be taken into consideration for a successful educational experience. The pedagogical factors of course include the teaching methodology and aspects of syllabus design. The learners' personal factors consist of all the learners’ personal factors that they come with in this voyage of a foreign language teaching and learning such as learners' aptitude and the affective psychological factors that may enhance or debilitate learning. In this present study our prime aim is to incorporate both the pedagogical and personal factors as factors to which learners may set up respective responses or acceptance if they actually address the learners’ required teaching and learning anticipations; and the defensive perspectives that learners may set up if the learners' factors are not addressed to satisfy their teaching and learning requirements. This study will concentrate on four major aspects of receptivity and defensiveness in foreign language teaching which are namely the teacher as a person, the teaching context and syllabus, the affective factors in teaching, and the defensive and the distracting factors of teaching. To process this study, we begin first by stating the topic under investigation, its importance, scope, and the methodological aspects through which it will be tackled in order to reach to the main results, the recommendations and suggestions for further future studies

Self-Assessment of Driving Abilities of Deaf and Hearing Drivers

This research aim is to evaluate how deaf and hearing traffic participants assess their driving abilities and to determine frequency of communication, traffic violations and traffic accidents that respondents are involved in. Sample of respondents was comprised of 60 drivers, 30 deaf and 30 hearing. Qualitative and quantitative analysis was used in data processing. Self-assessment was conducted by conducting a survey about their driving abilities and abilities of the other subsample of respondents. Differences in answers were determined with t-test. Results indicate that both subsamples assess their driving abilities as very good and their driving as safe. There are differences in the safety aspect of the driving, where hearing drivers expressed some doubt about this aspect when it comes to deaf drivers. By assessing frequency of communication during driving, it has been concluded that hearing drivers communicate more often and have more involvement in traffic accidents. When it comes to correlation between frequency of communication and number of committed traffic violations, no significant differences were observed between the two subsamples. Despite self-assessment of driving ability being very good and safe by both subsamples of respondents, traffic accidents are a very frequent occurrence. Although, conversation with passengers is not prohibited, drivers should be advised to reduce it to minimum, as it has proven to be one of the significant distracting factors when it comes to driving.

Distractions in the operating room: a survey of the healthcare team.

BackgroundDistractions during surgical procedures are associated with team inefficiency and medical error. Little is published about the healthcare provider’s perception of distraction and its adverse impact in the operating room. We aim to explore the perception of the operating room team on multiple distractions during surgical procedures.MethodsA 26-question survey was administered to surgeons, anesthesia team members, nurses, and scrub technicians at our institution. Respondents were asked to identify and rank multiple distractions and indicate how each distraction might affect the flow of surgery.ResultsThere was 160 responders for a response rate of 19.18% (160/834), of which 71 (44.1%) male and 82 (50.9%) female, 48 (29.8%) surgeons, 59 (36.6%) anesthesiologists, Certified Registered Nurse Anesthetists (CRNA), and 53 (32.9%) OR nurses and scrub technicians. Responders were classified into a junior group (< 10 years of experience) and a senior group (≥ 10 years). Auditory distraction followed by equipment were the most distracting factors in the operating room. All potential auditory distractions in this survey were associated with higher percentage of certain level of negative impact on the flow of surgery except for music. The top 5 distractors belonged to equipment and environment categories. Phone calls/ pagers/ beepers and case relevant communications were consistently among the top 5 most common distractors. Case relevant communications, music, teaching, and consultation were the top 4 most perceived positive impact on the flow of surgery. Distractors with higher levels of “bothersome” rating appeared to associate with a higher level of perceived negative impact on the flow of surgery. Vision was the least distracting factor and appeared to cause minimal positive impact on the flow of surgery.ConclusionsTo our knowledge, this is the first survey studying perception of surgery, anesthesia, and OR staff on various distractions in the operating room. Fewer unnecessary distractions might improve the flow of surgery, improve OR teamwork, and potentially improve patient outcomes. Supplementary InformationThe online version contains supplementary material available at 10.1007/s00464-022-09553-8.

Predicting Outcomes Following Mandibular Distraction Osteogenesis in Patients With Isolated Pierre-Robin Sequence

Pierre Robin sequence (PRS) is characterized by micrognathia, glossoptosis, and obstructive sleep apnea (OSA). MDO has become a well-documented and effective surgical modality to treat OSA and avoid tracheostomy.1,2 The overall benefits of MDO for patients with PRS are well-described in the literature. The effect of distraction distance has not been investigated. The authors sought to elucidate the patient and distraction factors that affect postoperative outcomes for these patients. A retrospective chart review was conducted for patients with isolated PRS who underwent MDO at Children's Hospital Los Angeles between January 2006 to September 2021.

Two-Axis Continuous Distractor for Mandibular Reconstruction.

The application of Distraction Osteogenesis (DO) techniques in the reconstruction of skeletal deficiencies is a relatively new topic in the fields of oral and maxillofacial surgeries. In many reconstruction applications, using DO is the preferred technique, as opposed to conventional reconstruction techniques, as there are more advantages and fewer side effects when it is used. The first generation of DO devices is made up of manual distractors that can apply an intermittent distraction force to the bone segment during the distraction process. Manual DO techniques have shown the functionality of the DO technique. Further research has recently been performed on the development of automatic devices for generating a controlled continuous force. However, the existing automatic techniques have limitations, and are yet to be used in reconstruction applications in humans. There is still a gap between the developed techniques and an ideal distractor to be used in mandibular reconstruction surgeries. In this research, a two-axis continuous distractor is proposed for use in mandibular reconstruction applications. The proposed distractor can generate two continuous distraction forces that can be applied to two independent distraction vectors. The proposed device can perform the standard distraction process using the predetermined distraction factors. The control system has a high positioning accuracy and resolution in controlling the position of the intra-oral end effectors while applying two continuous forces for moving the bone segment. The proposed two-axis continuous distractor meets the current requirements, and can be used as an ideal continuous DO device for different mandibular reconstruction applications.

Progress on epidemiological characteristics and interventions of pedestrian distraction

Pedestrian distraction is one of the important risk factors of road injury. This review summarized the epidemiological characteristics, influencing factors, safety implications, and the published intervention measures. The review found that: a) the prevalence of pedestrian distraction poses a serious threat to pedestrian safety, but most epidemiological studies on pedestrian distraction focus on mobile phone use, and the incidence of pedestrian distraction varied greatly across studies using various research methods and from different countries; b) demographic characteristics, social psychology, and environment are the three main influencing factors of pedestrian distraction; c) distraction differently affected physiology, cognition, motion control, efficiency and behavior of pedestrian's street-crossing to some degrees, threatening the safety of pedestrian; d) engineering interventions and education were the most common interventions to prevent pedestrian distraction currently, but the effectiveness of most measures was not assessed rigorously. In the future, multidisciplinary and systematic epidemiological studies are recommended to design interventions purposely and evaluate the effectiveness of interventions through rigorous designs, providing scientific evidence for reducing pedestrian distraction and improving road safety of pedestrians.