External Distraction Research Articles

Attention, mindwandering, and mood.

We tested the hypothesis that mindwandering and external distraction are both manifestations of a common state of reduced attention focus, and examined how both relate to reported level of happiness. We conducted real-time sampling of people's experience of mindwandering, irrelevant distraction (e.g. by music, phone, etc.), and happiness levels, in two studies with 524 people undertaking common daily-life activities. All irrelevant external distractions were positively correlated with mindwandering. Indeed mindwandering duration could be predicted from the reported duration of external distraction, when controlling for a range of background variables. An exploratory factor analysis of mindwandering and distraction reports suggested a single underlying construct. In addition, duration of irrelevant distraction by both mobile phones and mindwandering was significantly associated with reduced reported levels of happiness. The results are consistent with the hypothesis that that a state of reduced attention focus underlies both mindwandering and distractibility and clarify the link with happiness.

The effects of driver fatigue, gender, and distracted driving on perceived and observed aggressive driving behavior: A correlated grouped random parameters bivariate probit approach

Previous research has shown that the determinants of perceived and observed aggressive driving behavior may differ. However, the consideration of major sources of aggressive patterns may introduce additional variations in the effect of such determinants. This study aims to provide further insights in the variations of these two behavioral components arising from driver’s fatigue, gender as well as internal and external distractions (such as, rushing to destination, listening to music and solving logical problems) during the driving task. To identify how the factors determining perceived and observed aggressive behavior may vary across groups of drivers associated with such sources of aggressive driving, survey and simulation data are statistically analyzed. Separate models of perceived and observed aggressive driving behavior are estimated for fatigued and non-fatigued, distracted and non-distracted, male and female drivers. To address various aspects of unobserved heterogeneity, associated with the unobserved variations that are commonly shared among the behavioral components and participants, as well as their unobserved interactions, the correlated grouped random parameters bivariate probit modeling framework is employed. The results of the empirical analysis showed that the effect of the socio-demographic and behavioral factors on perceived and aggressive driving behavior may vary across the aforementioned groups of drivers, in terms of magnitude and directional effect. In addition, the identification of correlation among the unobserved characteristics further illustrates the complexities of the driving decision mechanism, especially when fundamental sources of aggressive driving are evident.

Classification of Motor Imagery Task by Using Novel Ensemble Pruning Approach

Brain-computer interface (BCI) assists communication for the disabled and handicapped. It is usually electroencephalogram (EEG) based and uses motor imagery (MI) in its operation. EEG signals are known for being nonstationary and are sensitive to artifacts from various sources such as the physical and mental state of the patient, their mood, their posture, and any external noise or distractions, etc. Processing of this data directly affects the classification accuracy, making it a critical step in any BCI system. Ensemble learning has been used for many kinds of BCI classification applications including MI and P300 event related potential, which has been proven to be robust. The purpose of this paper is to generate an algorithm that uses ensemble pruning method for EEG classification evoked by an MI task. In order to achieve this, we extracted the features of an EEG dataset and trained a range of support vector machines to make a diverse ensemble of classifiers. This ensemble is then pruned by using a novel optimization model by a difference of convex algorithm, which has not been used on EEG data before.

Two-stage maxillary distraction osteogenesis using a modified external device: clinical outcome and complications

Rigid external distraction is currently used to correct severe maxillary hypoplasia. The purpose of this retrospective study was to present the clinical results and complications of a two-stage surgical approach using a modified external distraction system that consists of maxillary distraction and then maxillary fixation. We treated eight patients with cleft lip and palate in this way from 2016 to 2018. Lateral cephalograms taken before the first operation, after distraction, two weeks after the second operation, and one year after treatment were used to examine maxillofacial morphology. Velopharyngeal function was evaluated by a speech therapist. The mean movements of the maxilla forwards and downwards at Point A were 12.0mm and 8.0mm at the completion of distraction and those at Point B were 5.0mm backwards and 9.7mm downwards. Mouth opening was limited at this time, and was relieved after maxillary fixation. The mean relapse one year postoperatively was 24.3% horizontally and 52.5% vertically. Velopharyngeal function was unchanged by the operation. We conclude that the method has advantages that include the short duration of wearing distractors and increased acceptance by patients. The modified external device advanced the midface sufficiently.

Arthrodiastasis in the management of stiff hip

<p class="abstract">Arthrodiastasis (using external fixator and distraction) has been used for various pathologies including deformity correction/stiff hip/slipped capital femoral epiphysis. Historically this has been used for treatment of Perthes disease. The purpose of our study is to evaluate efficacy of arthrodiastasis in management of stiff hip. A 15 year old boy with stiff hip presented with complaints of pain in the left hip for past 6 months. Radiologically the left proximal femur was found to be deformed with metaphyseal widening, sclerosis and arthritic changes. Hip spanning external fixator using limb reconstruction system was done. Distraction was done at a rate of 1 mm/day. After 2 months, fixator was removed. Hip was mobilized under anaesthesia. Good range of all movements was achieved. Arthrodiastasis seems to be a good option in young adolescent in whom total hip replacement needs to be delayed as much as possible.</p>

Understanding driver distractions in fatal crashes: An exploratory empirical analysis

Introduction: Driver distraction has become a significant problem in transportation safety. As more portable wireless devices and driver assistance and entertainment systems become available to drivers, the sources of distraction are increasing. Method: Based on the results of different studies in the literature review, this paper categorizes different distraction enablers into six subcategories according to their fundamental characteristics and how they would affect a driver's likelihood of engaging in non-driving related activities. The review also discusses the characteristics and influence of external and internal distractions. The objective of this study is to examine the effect of different distraction sources in fatal crashes with the consideration of a driver's age and sex. Tukey test, chi-square test of independence, Nemenyi post-hoc test, and Marascuilo procedure have been used to investigate the top distraction sources, the trend of distraction-affected fatal crashes, the effect of different distractions on drives in different age groups, and their influence on female and male drivers. Results: It was found that inner cognitive inferences accounted for the greatest proportion of driver engagement in distractions. Young drivers show a larger probability of being distracted by in-vehicle technology-related devices/objects. Within the group of young drivers, female drivers showed a higher probability than their male counterparts of engaging in distracted driving caused by in-vehicle technology-related devices. Among six subcategories of distractions, drivers older than 80 years old were found to be most likely affected by inner cognitive interferences.

Examining the effects of probe frequency, response options, and framing within the thought-probe method.

A recent surge of interest in the empirical measurement of mind-wandering has led to an increase in the use of thought-probing to measure attentional states, which has led to large variation in methodologies across studies (Weinstein in Behavior Research Methods, 50, 642-661, 2018). Three sources of variation in methodology include the frequency of thought probes during a task, the number of response options provided for each probe, and the way in which various attentional states are framed during the task instructions. Method variation can potentially affect behavioral performance on the tasks in which thought probes are embedded, the experience of various attentional states within those tasks, and/or response biases to the thought probes. Therefore, such variation can be problematic, both pragmatically and theoretically. Across three experiments, we examined how manipulating probe frequency, response options, and framing affected behavioral performance and responses to thought probes. Probe frequency and framing did not affect behavioral performance or probe responses. But, in light of the present results, we argue that thought probes need at least three responses, corresponding to on-task, off-task, and task-related interference. When researchers are specifically investigating mind-wandering, the probe responses should also distinguish between mind-wandering, external distraction, and mind-blanking.

Open reduction in neglected elbow dislocation in children: a case series

BackgroundElbow deformity in children due to neglected proper fracture management is a devastating condition. The stiffness and pain complicated the function in daily activity. Successful management of neglected elbow dislocation is a challenging problem for orthopedic surgeons. In this study, we aimed to evaluate results of open reduction for neglected elbow dislocation in children.Case DescriptionThis is a case series of 13-14 years old neglected elbow dislocations, for up to 15 months. Open reduction after external distractor and followed by intensive rehabilitation was implemented. Clinical and functional outcome were evaluated within 4-7 years. Initial average elbow flexion was 53,3°, extension was 0°, arc of flexion was 53,3°, arc of pronation-supination was 150° and Mayo Elbow Performance Index (MEPI) was 80. Clinical and functional outcome were evaluated within 4-7 years. At follow-up after open reduction, the improvement in whole range of movement was significant. Average elbow flexion was 118,3°, extension was 36,67°, arc of flexion was 81,67°, arc of pronation-supination was 133°. The average improvement of flexion was 65°, arc of flexion was 31,67°, and arc of pronation-supination was 8,3°. The average loss of flexion was 15,5%, arc of flexion was 44,2%, and arc of pronation-supination was 10,7% compared with uninjured side. The average Mayo Elbow Performance Index (MEPI) was 96,67; all with excellent results.ConclusionPlanned and well execution open reduction in pediatric neglected elbow dislocation may bring back the painless movement within normal daily function.

Correction of Biapical Tibial Deformity by True Spherical Osteotomy, Modified Circular External Skeletal Fixation and Distraction Osteogenesis

Objectives The aim of this study was to describe a case of biapical tibial deformity as a result of premature distal physeal closure corrected by true spherical osteotomy, circular external skeletal fixation and distraction osteogenesis. Methods A 6-month-old male Labrador Retriever was presented for the evaluation and treatment of angular limb deformity of the left pelvic limb, with radiography and computed tomography revealing a multiplanar, biapical, compensatory tibial growth deformity, with marked distal tibial recurvatum and varus. A true spherical osteotomy was performed at the distal tibial centre of rotation of angulation (CORA), allowing for correction of the deformity in three planes, with a transverse osteotomy performed at the most proximal CORA. A circular external skeletal fixator was applied and distraction osteogenesis performed at the transverse osteotomy. Latency, distraction osteogenesis, and consolidation were performed over a 113-day period. Results At frame removal, tibial length discrepancy improved from 16.8% to 0.6% and frontal plane varus angulation improvement from 20° to 5°, when compared with the contralateral limb. Long-term evaluation revealed a satisfactory clinical and cosmetic outcome, judged by the clinician and owners, with force plate analysed symmetry index of the pelvic limb within reported normal limits. Clinical significance To our knowledge this is the first case report illustrating the value of true spherical osteotomy for the treatment of an angular limb deformity when performed in combination with distraction osteogenesis in a canine pelvic limb.

Anesthesia challenges in a case of Crouzon syndrome for corrective rigid external distraction frame insertion

Crouzon syndrome is an autosomal dominant disease occurs in approximately 1 in 25,000 births, due to a mutation in the fibroblast growth factor receptor 2 gene on chromosome 10 characterized by craniosynostosis, mid-face hypoplasia, hypertelorism, high-arched palate, skull base abnormalities, and exophthalmos. Patients present in early childhood for cranial reconstructive surgery. We describe here the successful management of a 5-year-old child with Crouzon syndrome with hypertrophic adenoids and Arnold-Chiari malformation type 1 posted for bifrontal craniotomy with fronto-facial advancement and application of a rigid external distraction frame.

Midface correction in patients with Crouzon syndrome is Le Fort III distraction osteogenesis with a rigid external distraction device the gold standard?

IntroductionLe Fort III distraction osteogenesis with a rigid external distraction device is a powerful procedure to correct both exorbitism and impaired airways in faciocraniosynostosis. The aim of this study was to investigate treatment effect, perioperative parameters and volumetric outcomes after Le Fort III distraction osteogenesis in patients with Crouzon syndrome in a retrospective study design and to explore potential strengths and weaknesses of this procedure. Materials and methodsFrom June 2013 to February 2015, a total of nine children with Crouzon syndrome underwent Le Fort III distraction osteogenesis with a rigid external distraction device (RED device, KLS Martin, Tuttlingen, Germany). Along with perioperative parameters, sleep study reports, traditional cephalometric analysis, three-dimensional imaging and photographs were evaluated for severity of disease and therapeutic effect and structural and functional changes of the upper airway preoperatively, after device removal and one year postoperatively. ResultsSurgery for Le Fort III distraction was performed at a median age of 12.5 years (SD 2.5 months) with an average weight of 43.0 kg (SD 12.9 kg). Mean estimated blood loss was 535.7 ml (SD 128.1 ml), not requiring any red blood cell transfusions. Mean duration of surgery was 240 min (SD 30.6min), average hospital stay eight days (SD 0.5 days) with a planned median ICU stay of 1.7 days (SD 0.4 days) for all patients.There were a total of five minor complications. Exorbitism and Angle class III malocclusions were corrected in all patients. No patient showed velopharyngeal problems postoperatively. The average amount of distraction was 18.4 mm (14–26 mm). Average length of the distraction period was 18.3 days (SD 0.4 days), with a total distraction plus consolidation time of three months (SD 0.25 months). In two patients, vector correction was performed during distraction. A counterclockwise movement despite vector correction, clinically resulting in an open bite, was observed in one of these two patients. Eight of the nine patients showed a frontal overbite at the end of the distraction period.Cephalometric analysis revealed a significant increase of Sella-Nasion-Point A angle (SNA) from 76.0° (+/− 2.9; T1) to 86.0° (+/− 3.4; T2) (p = 0.006) and growth-related point A-Nasion-point B angle (ANB) from −4.8° (+/−3.7) to 5.7° (+/−4.8) (p = 0.001) from preoperatively to device removal and stable results one year postoperatively.Upper airway structure and respiratory function were improved clinically after the Le Fort III DO treatment in all cases with an average posterior airway space increase from 3199 mm3 (+/− 229.6 mm3) to 8917,7 ml (+/−415.1 mm3) (T1 to T2).Surgical outcome was judged good to excellent both by patients and families and the craniofacial team. ConclusionLe Fort III DO with a rigid external distraction device in patients with Crouzon syndrome is a powerful and reliable surgical procedure that reliably produces a more significant change of appearance than most other single procedures routinely performed by craniofacial surgeons. It effectively treated sleep apnea in the affected patients. In our collective, the maxilla remained stable after advancement without any relapse, but there was no subsequent anterior growth on one year follow-up. Careful vector planning was able to avoid frontal open bite in eight patients. Complication rates were acceptably low and patients’ functional and esthetic outcome was high.

How valuable are independent directors? Evidence from external distractions

We provide new evidence on the value of independent directors by exploiting exogenous events that seriously distract independent directors. Approximately 20% of independent directors are significantly distracted in a typical year. They attend fewer meetings, trade less frequently in the firm's stock, and resign from the board more frequently, indicating declining firm-specific knowledge and a reduced board commitment. Firms with more preoccupied independent directors have declining firm valuation and operating performance and exhibit weaker merger and acquisition (M&A) profitability and accounting quality. These effects are stronger when distracted independent directors play key board monitoring roles and when firms require greater director attention.

A Mouse Distraction Osteogenesis Model.

Distraction osteogenesis (DO) is a surgical procedure that involves skeletal tissue regeneration without cell transplantation. A DO model consists of the following three phases: the latency phase after osteotomy and placement of the external distractor; the distraction phase, wherein the separated bone ends are gradually and continuously distracted; and the consolidation phase. This custom-made distractor used for DO is comprised of two incomplete acrylic resin rings and an expansion screw. The process was initiated by making a mold with silicone impression material and then creating the custom-made distractor. Dental resin was poured into the formwork made of silicone impression material, and it was allowed to polymerize to create the incomplete resin rings required for the custom-made distractor. These rings were fixed with an expansion screw using transparent resin. The custom-made distractor created via this approach was attached to the tibia of mice. The tibia was fixed to the device using one pair of 25 G needles proximally, one pair of 27 G needles distally, and acrylic resin. After a latency period of 5 days, distraction was initiated at a rate of 0.2 mm/12 h. The lengthening was continued for 8 days, resulting in a total gap of 3.2 mm. The mice were sacrificed 4 weeks after distraction. Bone formation in the distraction gap was confirmed using both radiography and histology.

A Technical Innovation in Midface Advancement With the External Frame Distraction Device.

Maxillary advancement with a rigid external distractor (RED) II is a commonly performed procedure for correcting midface hypoplasia. While there are various methods of anchoring the osteotomized maxillary segment to the halo device, the looped transpyriform wire is the simplest and most cost-effective. However, a common complication with this is the cutting through of the stainless steel traction wire across the pyriform buttress during distraction. The patient with cleft undergoing midface distraction is particularly vulnerable since the force needed for distraction is higher due to scarring from previous operations. A single-hole titanium plate is introduced as an interface between the bone of the pyriform buttress and the looped stainless steel traction wire attached to the external frame device. Twenty-four patients with cleft who underwent midface advancement using the external frame distractor before the introduction of the innovation were compared with 26 patients who underwent the same procedure after its introduction. The former group had 12.5% complication in the form of cut through of the traction wire, while the latter group had only 3.8% complication rate. Introduction of the titanium eyelet as an interface between the traction wire and the bone is a simple technical addition for a more reliable distraction using the RED II device in patients with cleft even in the presence of extensive scarring.

Inhibition and Mathematical Performance: Poorly Correlated, Poorly Measured, or Poorly Matched?

AbstractInhibition is an important aspect of executive functioning (EF) that refers to a cognitive mechanism that blocks or suppresses irrelevant stimuli, memory, habitual responses, or automatized processes from interrupting the desired response. Researchers have found weak and inconsistent relations between inhibitory abilities and mathematics performance (Bull & Lee, 2014). Given anecdotal evidence of the effects of external distraction or intruding thoughts on the ability to stay on task, it is surprising that inhibitory abilities do not have a more prominent role. In this article, we argue that this lower‐than‐expected association is due to (a) age‐related changes in EF, (b) the sensitivity of inhibitory tasks commonly used in studies, (c) a mismatch in how susceptibility to interference and mathematical performance are measured, and (d) the choice of criterion measures, with some mathematical tasks imposing less inhibitory demands than others.

Special reduction instruments

Special and specialized instruments help perform reduction more effectively and in a tissue-preserving manner. In addition to other articles, the application and advantages of the following instruments are presented: colinear reduction forceps, cerclage, cerclage passer, distal radius reduction clamp, modular external fixator, extension table, distraction frame, joystick, manipulators, distractor and assistance of reduction with elastic nails.

Road safety and distraction, results from a responsibility case-control study among a sample of road users interviewed at the emergency room

Despite the complexities of the driving task, more and more drivers engage in non-driving secondary tasks that take their hands (manual distraction), their eyes (visual distraction) and/or their mind (cognitive distraction) away from their primary task. Inattention arising from external distractions has received much less consideration beyond the impact of mobile phone use. We aimed to investigate the association between distraction behind the wheel and risk of being responsible for a road traffic crash in a responsibility case-control study. The study population included 1912 drivers injured in a road traffic crash recruited in two rounds of recruitment (from April 2010 to August 2011 and from March 2013 to January 2015) in the adult emergency department of Bordeaux University Hospital (France). Responsibility levels were estimated using a standardized method. Self-reported activities among a pre-established list of potential distractions were combined into four external distraction variables: visual distraction, manual distraction, auditory distraction, and verbal interaction. A significantly increased risk of being responsible for a road traffic crash was associated with the exposure to activities that take drivers’ eyes off the road (adjusted odds ratio 2.99, 95% confidence interval 1.42–6.28) and activities that take drivers’ hands off the wheel (adjusted odds ratio 2.12, 95% confidence interval 1.20–3.75). No significant associations were found for verbal interaction and listening to the radio and/or singing. This study suggests that beyond the use of mobile phone, particular attention must be paid to activities that involve visual and/or manual distraction.

A New Perspective to Explore the Hydraulic Connectivity of Karst Aquifer System in Jinan Spring Catchment, China

Investigating the hydraulic connectivity of a complex karst aquifer system is an important research topic for sustainable operation and optimization layout of karst groundwater exploitation and recharge. However, the identification of preferential sites of recharge and exploitation is usually subject to regional hydrogeology conditions and the mechanisms of recharge and exploitation. The conventional research methods of hydraulic connectivity often have some limitations. In this study, we developed an improved grey amplitude relation model to explore the hydraulic connectivity in Jinan spring catchment and presented a quantized evaluation index water table fluctuation relation degree (WTFRD) using karst groundwater table data in Western Jinan and Jinan spring groups from 2014 to 2017. Results showed that the total WTFRD was 0.854 between Western Jinan and Jinan spring groups when the external distraction for karst groundwater table was the smallest, which was in high relation degree grade. Meanwhile, the change rules of karst groundwater table in the two sites were basically the same. Accordingly, a high connectivity occurred between the two karst aquifers from a statistical perspective, and further illustrated that Western Jinan could be selected as preferential experiment sites. A comprehensive case in Jinan spring catchment indicated that the WTFRD provided a preliminary idea to investigate hydraulic connectivity quantitatively. This method could be considered as a pre-study of the conventional experiments to form a high-efficiency and low-cost combined method, which has great potential and merits further study.

Separate Room Testing Accommodations for Students With and Without ADHD

Students with attention-deficit/hyperactivity disorder (ADHD) are frequently provided a separate room in which to take exams, to reduce external distractions. However, little research has explored the efficacy of this accommodation. In the present study, college students with ( n = 27) and without ( n = 42) ADHD diagnoses were administered two parallel forms of a timed silent reading comprehension test, one in a classroom with other students, and one in a private, proctored setting. A two-way analysis of variance found no significant main effects for either ADHD status or test setting on performance, and no significant interaction between the factors either. However, inspection of student-level data and exploration of continuous relationships between self-reported ADHD symptoms and test performance patterns suggested that separate room accommodations may be beneficial for a subgroup of students with ADHD.

Rigid External Distraction with Intranasal Bone-borne Traction Hooks for Midfacial Hypoplasia

Rigid external distraction is currently performed to correct cases of severe maxillary hypoplasia. As an improvement of this technique, we propose the use of an intranasal bone-borne traction hook. This study is a retrospective chart review of the intranasal bone-borne traction hooks used in the treatment of severe maxillary hypoplasia. There were 110 patients treated with the hooks from 2005 to 2017. The maximum traction force was 7.75 kg, and there were few complications encountered during distraction. There were 76 patients who had the hooks removed under local anaesthesia. A cephalometric analysis was conducted in 56 patients. The average advancement of A-point was 9.9 ± 4.2 mm, 8.4 ± 2.5 mm, 11.0 ± 3.7 mm, 17.9 ± 4.4 mm for the trans-sutural distraction osteogenesis (DO), maxillary anterior segment DO, Le Fort I osteotomy DO and Le Fort III/II osteotomy DO, respectively. The average changes of sella-nasion-point A (SNA) were 8.89 ± 4.30 degrees, 8.21 ± 3.17 degrees, 10.49 ± 3.26 degrees, and 15.10 ± 4.00 degrees, respectively. The A point-nasion-B point (ANB) also showed increases in all procedures with P < 0.001. In conclusion, this technique sufficiently advances the midface and ensures the scars are concealed in the nasal base. The traction hook can bear a large traction force, causes minimal complications and is easily removed.