Visual Vigilance Research Articles

Attention to Changes on a Head-Worn Display: Two Preclinical Studies with Healthcare Scenarios.

In two experiments, we examined how quickly different visual alerts on a head-worn display (HWD) would capture participants' attention to a matrix of patient vital sign values, while multitasking. An HWD could help clinicians monitor multiple patients, regardless of where the clinician is located. We sought effective ways for HWDs to alert multitasking wearers to important events. In two preclinical experiments, university student participants performed a visuomotor tracking task while simultaneously monitoring simulated patient vital signs on an HWD to detect abnormal values. Methods to attract attention to abnormal values included highlighting abnormal vital signs and imposing a white flash over the entire display. Experiment 1 found that participants detected abnormal values faster with high contrast than low contrast greyscale highlights, even while performing difficult tracking. In Experiment 2, a white flash of the entire screen quickly and reliably captured attention to vital signs, but less so on an HWD than on a conventional screen. Visual alerts on HWDs can direct users' attention to patient transition events (PTEs) even under high visual-perceptual load, but not as quickly as visual alerts on fixed displays. Aspects of the results have since been tested in a healthcare context. Potential applications include informing the design of HWD interfaces for monitoring multiple processes and informing future research on capturing attention to HWDs.

Cognitive dysfunction associated with COVID-19: A comprehensive neuropsychological study

ObjectiveRecent evidence suggests that patients suffering post-acute COVID syndrome frequently report cognitive complaints, but their characteristics and pathophysiology are unknown. This study aims to determine the characteristics of cognitive dysfunction in patients reporting cognitive complaints after COVID-19 and to evaluate the correlation between cognitive function and anxiety, depression, sleep, and olfactory function. MethodsCross-sectional study involving 50 patients with COVID-19 reporting cognitive complaints 9.12 ± 3.46 months after the acute infection. Patients were evaluated with a comprehensive neuropsychological protocol, and scales of fatigue, depression, anxiety, sleep and an olfactory test. Normative data and an age- and education matched healthy control group were used for comparison. ResultsCOVID-19 patients showed a diminished performance on several tests evaluating attention and executive function, with alterations in processing speed, divided attention, selective attention, visual vigilance, intrinsic alertness, working memory, and inhibition; episodic memory; and visuospatial processing. Cognitive performance was correlated with olfactory dysfunction, and sleep quality and anxiety to a lesser extent, but not depression. ConclusionsPatients with COVID-19 reporting cognitive symptoms showed a reduced cognitive performance, especially in the attention-concentration and executive functioning, episodic memory, and visuospatial processing domains. Future studies are necessary to disentangle the specific mechanisms associated with COVID-19 cognitive dysfunction.

Changes in accommodation and behavioural performance with a contact lens for myopia management: A comparison between a dual-focus and a single-vision soft contact lens.

IntroductionDual‐focus soft contact lenses for myopia management have demonstrated to be an effective strategy to reduce myopia progression. However, this optical design has been shown to alter visual quality and accommodative function. The aim of this study was to examine the accommodative and behavioural performance during the execution of a psychomotor vigilance task (PVT) while wearing dual‐focus and single‐vision soft contact lenses.MethodsThe steady‐state accommodative response was recorded with the WAM‐5500 binocular open‐field autorefractor during the execution of a 10‐min PVT at 50 cm either with the dual‐focus (MiSight 1‐day) or single‐vision (Proclear 1‐day) soft contact lenses, using a sample of 23 healthy young adults. Each experimental session was performed on two different days in a counterbalanced order.ResultsA greater lag of accommodation, variability of accommodation and reaction time was found while wearing dual‐focus in comparison with single‐vision soft contact lenses (mean differences during the 10‐min PVT were 0.58 ± 0.81 D, p < 0.001; 0.31 ± 0.17 D, p < 0.001 and 15.22 ± 20.93 ms, p = 0.002, respectively). Also, a time‐on‐task effect was found for the variability of accommodation and reaction time (p = 0.001 and p < 0.001, respectively), observing higher values over time. However, the lag of accommodation did not change significantly as a function of time‐on‐task (p = 0.33).ConclusionDual‐focus soft contact lens wear influences the steady‐state accommodative response and behavioural performance during the execution of a visual vigilance task in the short‐term. Eye care practitioners should be aware of these effects when prescribing these lenses for myopia management, and provide specific recommendations according to the individual visual needs.

Anodal tDCS Over the Left Frontal Eye Field Improves Sustained Visual Search Performance.

Monotonous and repetitive tasks cause vigilance, or sustained attention decrement, which possibly leads to irreparable accident consequences in the aerospace and nuclear industry. Buffering the decrement of vigilance in visual search tasks is essential for cognitive enhancement and ergonomic research. This study aimed to evaluate the efficacy of anodal transcranial direct current stimulation (tDCS) applied to the left frontal eye field (FEF) to improve the performance of the sustained visual search. Twenty-seven healthy participants received anodal and sham tDCS of 2 mA for 28.8 min and completed a visual search task lasting for approximately 40 min without any break. For the online effect, results showed that the d' hit rate and accuracy under anodal tDCS were significantly higher than those under sham conditions during 0-19.2 min time intervals. For the after-effect, compared with sham, anodal tDCS caused significantly higher d' in the 10 min after completing the tDCS. Our findings suggest that anodal tDCS over the left FEF could effectively mitigate the decline of visual vigilance performance by buffering cognitive resource depletion.

Pupillometry and the vigilance decrement: Task-evoked but not baseline pupil measures reflect declining performance in visual vigilance tasks.

Baseline and task‐evoked pupil measures are known to reflect the activity of the nervous system's central arousal mechanisms. With the increasing availability, affordability and flexibility of video‐based eye tracking hardware, these measures may one day find practical application in real‐time biobehavioural monitoring systems to assess performance or fitness for duty in tasks requiring vigilant attention. But real‐world vigilance tasks are predominantly visual in their nature and most research in this area has taken place in the auditory domain. Here, we explore the relationship between pupil size—both baseline and task‐evoked—and behavioural performance measures in two novel vigilance tasks requiring visual target detection: (1) a traditional vigilance task involving prolonged, continuous and uninterrupted performance (n = 28) and (2) a psychomotor vigilance task (n = 25). In both tasks, behavioural performance and task‐evoked pupil responses declined as time spent on task increased, corroborating previous reports in the literature of a vigilance decrement with a corresponding reduction in task‐evoked pupil measures. Also in line with previous findings, baseline pupil size did not show a consistent relationship with performance measures. Our data offer novel insights into the complex interplay of brain systems involved in vigilant attention and question the validity of the assumption that baseline (prestimulus) pupil size and task‐evoked (poststimulus) pupil measures reflect the tonic and phasic firing modes of the locus coeruleus.

Visual Alertness and Brain Diffusion Tensor Imaging at Term Age Predict Neurocognitive Development at Preschool Age in Extremely Preterm-Born Children

Visual Alertness and Brain Diffusion Tensor Imaging at Term Age Predict Neurocognitive Development at Preschool Age in Extremely Preterm-Born Children

Sex influences the brain functional connectivity correlates of originality

Creative cognition is thought to involve two processes, the creation of new ideas and the selection and retention of suitable new ideas. Neuroimaging studies suggest that the Default Mode Network contributes to the creation of new ideas while left inferior frontal and parieto-temporal cortical networks mediate the selection/retention process. Higher levels of activity in the selection/retention have been shown to be associated with stricter criteria for selection and hence the expression of fewer novel ideas. In this study, we examined the brain functional connectivity correlates of an originality score while 27 males and 27 females performed a low and a high demand visual vigilance task. Brain functional connectivity was estimated from the steady state visual evoked potential event related partial coherence. In the male group, we observed a hypothesized left frontal functional connectivity that was negatively correlated with originality in both tasks. By contrast, in the female group no significant correlation between functional connectivity and originality was observed in either task. We interpret the findings to suggest that males and females engaged different functional networks when performing the vigilance tasks. We conclude with a consideration of the possible risks when data pooling across sex in studies of higher cortical function.

The Influence of Audible Alarm Loudness and Type on Clinical Multitasking.

In high-consequence industries such as health care, auditory alarms are an important aspect of an informatics system that monitors patients and alerts providers attending to multiple concurrent tasks. Alarms levels are unnecessarily high and alarm signals are uninformative. In a laboratory-based task setting, we studied 25 anesthesiology residents' responses to auditory alarms in a multitasking paradigm comprised of three tasks: patient monitoring, speech perception/intelligibility, and visual vigilance. These tasks were in the presence of background noise plus/minus music, which served as an attention-diverting stimulus. Alarms signified clinical decompensation and were either conventional alarms or a novel informative auditory icon alarm. Both alarms were presented at four different levels. Task performance (accuracy and response times) were analyzed using logistic and linear mixed-effects regression. Salient findings were 1), the icon alarm had similar performance to the conventional alarm at a +2dB signal-to-noise-ratio (SNR) (accuracy: OR 1.21 (95% CI 0.88, 1.67), response time: 0.04s at 2dB (95% CI: -0.16, 0.24), which is a much lower level than current clinical environments; 2) the icon alarm was associated with 27% greater odds (95% CI: 18%, 37%) of correctly addressing the vigilance task, regardless of alarm SNR, suggesting crossmodal/multisensory multitasking benefits; and 3) compared to the conventional alarm, the icon alarm was associated with an absolute improvement in speech perception of 4% in the presence of an attention-diverting auditory stimulus (p = 0.031). These findings suggest that auditory icons can provide multitasking benefits in cognitively demanding clinical environments.

For Visual Attention, are there any Tendencies in Form Interpretation?

We examined if there is any intrinsically "hard-wired" tendency in the subject's Visual Attention. When asked to spontaneously decide preferences for shape or grouping of shapes, distinct patterns of preference in human test subjects were found. These preferences were consistent among ages older than 20 years adulthood and both genders. These findings could result in broad practical applications ranging from interface designs to visual alerts.

Psychometric Curves Reveal Three Mechanisms of Vigilance Decrement

The vigilance decrement is a decline in signal detection rate that occurs over time on a sustained-attention task. The effect has typically been ascribed to conservative shifts of response bias and losses of perceptual sensitivity. Recent work, though, has suggested that sensitivity losses in vigilance tasks are spurious, and other findings have implied that attentional lapses contribute to vigilance failures. To test these possibilities, we used Bayesian hierarchical modeling to compare psychometric curves for the first and last blocks of a visual vigilance task. Participants were a convenience sample of 99 young adults. Data showed evidence for all three postulated mechanisms of vigilance loss: a conservative shift of response bias, a decrease in perceptual sensitivity, and a tendency toward more frequent attentional lapses. Results confirm that sensitivity losses are possible in a sustained-attention task but indicate that mental lapses can also contribute to the vigilance decrement.

Newborn Neurobehavior Is Related to Later Neurodevelopment and Social Cognition Skills in Extremely Preterm-Born Children: A Prospective Longitudinal Cohort Study.

Objective: The aim of this study was to evaluate the ability of the neonatal neurobehavioral characteristics to act as an indicator for later neurodevelopment and neurocognitive performance.Methods: Sixty-six infants born extremely preterm (<28 gestational weeks) were followed until 6.5 years. Neurobehavior at term age was assessed by the behavior subscale of the Hammersmith Neonatal Neurological Examination (HNNE) using dichotomic rating, optimal, and non-optimal. The Griffiths Mental Developmental Scales (GMDS) at 2 years, and the Wechsler Intelligence Scales at 6.5 years, and a Neuropsychological Assessment at 6.5 years were used to assess neurodevelopment and neurocognitive performance including social cognition skills.Results: An optimal auditory orientation at term age was associated with better developmental quotients (DQ) in Personal–Social, and Hearing–Language GMDS subscale at 2 years (p < 0.05). An optimal visual alertness was associated with better Total (p < 0.01), Locomotor (p < 0.001), and Eye–Hand Coordination (p < 0.01) DQs at 2 years, and with sensorimotor function (p < 0.001) and social perception (p < 0.01) tests at 6.5 years.Conclusion: The neurobehavioral characteristics of newborns might serve as a precursor of social cognition skills and the HNNE behavior subscale offers a tool to identify infants at risk for later deficits in neurodevelopment and social cognition.

Simple auditory and visual interruptions of a continuous visual tracking task: modality effects and time course of interference

Research has produced conflicting evidence regarding whether performance of an on-going visual task is disrupted more by an interruption from a visual or an auditory alert. Tasks and alerts studied to date have been complex or idiosyncratic. This experiment examined how the modality of simple alerts—visual icons or auditory tones—affected performance of an on-going visual task. Participants (58 females and 4 males) tracked a visual target while performing a choice reaction time task in response to alerts. Visual alerts were more harmful to performance of the tracking task. Dual task workload was lowest with an auditory alert, provided there was not noise present. Interruptions affected tracking task performance for around 1500 ms. Results supported the predictions of Multiple Resources Theory and showed no evidence of auditory preemption. In practical applications for which an on-going visual task is interrupted, auditory alerts may be less disruptive and may reduce perceived workload. Practitioner Summary: Many practical scenarios involve on-going visual tasks that are interrupted by simple alerts requiring a simple response. Auditory alerts may be less disruptive than visual alerts and may reduce perceived workload. A conservative estimate is that the effects of even simple interruptions will last a minimum of 1500 ms. Abbreviations: ANOVA: analysis of variance; LSD: least significant difference; TLX: task load index

Comparing the Effectiveness of the Transcranial Alternating Current Stimulation (TACS) and Ritalin on Symptoms of Attention Deficit Hyperactivity Disorder in 7-14-Year-Old Children

Several studies have been conducted on the effect of transcranial direct current stimulation on adult patients. But, in recent years, only a few studies have been carried out in children and teenagers because the aim of the present study was to compare the effectiveness of TACS and Ritalin in the treatment of attention deficit hyperactivity disorder (ADHD) symptoms. This interventional clinical trial study was performed on 62 children with ADHD who were referred to the private psychiatric clinic of children in Tehran. The children were randomly assigned to two coded groups based on a lottery so that they were enrolled in the TACS or the Ritalin group. A questionnaire child syndrome inventory (parental form) and integrated visual and auditory (IVA) test with a pretest and posttest design was used in this study. TACS therapy protocol was employed (3 days a week for eight weeks using alternating current stimulation at 10 Hz over two points on the prefrontal cortex: the anode centered over F3 [the left dorsolateral prefrontal cortex] and the cathode over F4[the right dorsolateral prefrontal cortex]). Results showed that the posttest scores of the TACS-treated group were higher than those of the Ritalin-treated group, and there was a significant difference between the areas of visual attention (visual vigilance, visual focus, Sustained attention visual) and response control visual and auditory prudence (P&lt;0.05). Results indicated that TACS was more effective and more durable compared to Ritalin in reducing attention deficit, hyperactivity, and impulsivity.

Distinct alterations in resting-state electroencephalogram during eyes closed and eyes open and between morning and evening are present in first-episode psychosis patients

Abnormalities in resting-state electroencephalogram (rs-EEG) activity have been previously reported in schizophrenia. While most rs-EEG recordings were performed in patients with chronic schizophrenia during eyes closed (EC), only a handful of studies have investigated rs-EEG activity during both EC and eyes open (EO) conditions. It is also unknown whether EC and EO rs-EEG alterations are present at illness onset, and whether they change during the day. Here, we performed EC and EO rs-EEG recordings in the morning (AM) and evening (PM) in twenty-six first-episode psychosis (FEP) patients and seventeen matched healthy controls (HC). In AM/EC rs-EEG, a widespread reduction was found in low alpha power in FEP relative to HC. In PM/EC, the FEP group demonstrated a trend toward decreased theta power in parietal regions, while decreased high alpha power in frontal and left parietal regions was present during PM/EO. Moreover, reduced low alpha power during AM/EC was associated with worse positive symptoms. Altogether, those findings indicate that rs-EEG alterations are present in FEP patients at illness onset, that they are linked to the severity of their psychosis, and that distinct RS abnormalities can be detected in different conditions of visual alertness and time of the day. Future work should therefore account for those factors, which will help reduce variability of rs-EEG findings across studies and may serve as monitoring biomarkers of illness severity in schizophrenia and related psychotic disorders.

Subject matter experts’ feedback on a prototype development of an audio, visual, and haptic phishing email alert system

Phishing emails, also defined as email spam messages, present a threat to both personal and organizational data loss. About 93% of cybersecurity incidents are due to phishing and/or social engineering. Users are continuing to click on phishing links in emails even after phishing awareness training. Thus, it appears that there is a strong need for creative ways to alert and warn users to signs of phishing in emails. ‘System 2 Thinking Mode’ (S2) describes an individual in a more aware state of mind when making important decisions. Ways to trigger S2 include audio alerts, visual alerts, and haptic/vibrations. Assisting the user in noticing signs of phishing in emails could possibly be studied through the delivery of audio, visual, and haptic (vibration) alerts and warnings. This study outlines the empirical results from 32 Subject Matter Experts (SMEs) on an initial prototype design and development of an email phishing alert and warning system. The prototype will be developed to alert and warn users to the signs of phishing in emails in an attempt to switch them to an S2 state of mind. The preliminary results of the SMEs indicated that several features for a phishing alert and warning system could be assembled, resulting in a mobile phishing alert and warning prototype. Visual icons were chosen for each sign of phishing used in the prototype, as well as voice over warnings and haptic vibrations. The preliminary results also determined task measurements, ‘ability to notice’, and ‘time to notice’ signs of phishing in emails.

Adenoma detection rate is not influenced by the time of day in computer-aided detection colonoscopy.

Because of endoscopist fatigue, the time of colonoscopy have been shown to influence adenoma detection rate (ADR). Computer-aided detection (CADe) provides simultaneous visual alerts on polyps during colonoscopy and thus to increase adenoma detection rate. This is attributable to the strengthening of endoscopists diagnostic level and alleviation of fatigue. The aim of the study was to investigate whether CADe colonoscopy could eliminate the influence of the afternoon fatigue on ADR.We retrospectively analyzed the recorded data of patients who were performed CADe colonoscopy from September 2017 to February 2019 in Endoscopy Center of Sichuan Provincial People's Hospital. Patients demographic as well as baseline data recorded during colonoscopy were used for the analysis. Morning colonoscopy was defined as colonoscopic procedures starting between 8:00 am and 12:00 noon. Afternoon colonoscopy was defined as procedures starting at 2:00 pm and thereafter. The primary outcome was ADR. Univariate analysis and multivariate regression analysis were also performed.A total of 484 CADe colonoscopies were performed by 4 endoscopists in the study. The overall polyp detection rate was 52% and overall ADR was 35.5%. The mean number of adenomas detected per colonoscopy (0.62 vs 0.61, P > .05) and ADR (0.36 vs 0.35, P > .05) were similar in the am and pm group. Multivariable analysis shows that the ADR of CADe colonoscopy was influenced by the age (P < .001), gender (P = .004) and withdrawal time (P < .001), no correlation was found regarding bowel preparation (P = .993) and endoscopist experience (P = .804).CADe colonoscopy could eliminate the influence of the afternoon fatigue on ADR. The ADR during CADe colonoscopy is significantly affected by age, gender and withdrawal time.

Tactile Vigilance Is Stressful and Demanding.

The primary aims of the study were to replicate the vigilance decrement in the tactile modality, examine whether a decrease in sensitivity is associated with the decrement, and determine whether tactile vigilance is stressful and demanding. When people monitor occasional and unpredictable signals for sustained durations, they experience a decline in performance known as the vigilance decrement, which has important practical consequences. Prior studies of the vigilance decrement focused primarily on visual vigilance and, to a lesser degree, on auditory vigilance. There are relatively few studies of tactile vigilance. Participants monitored vibrotactile stimuli that were created from a tactor, for 40 min. Sensitivity declined, self-report ratings of distress increased, and ratings of task engagement decreased, during the vigil, and perceived workload was moderately high. Monitoring tactile signals is demanding and stressful and results in a decrement in signal detection. Monitoring tactile signals may result in a decrement in tasks requiring discrimination, such as monitoring lane position with the use of rumble strips; these require discrimination between current road vibration and increased vibration when the car drifts out of its lane and crosses over the strip.

Classifying ADHD subtypes/presentations considering the joint effect of three levels of investigation

Aim Discriminant validity of the Attention Deficits/Hyperactive Disorders (ADHD) subtypes/presentations is not yet clear. The purpose of this study was to investigate joint contribution of the strongest factors of the three dimensions, namely psychopathology, neuropsychology and electrophysiology for subtyping of presentations. Method A sample of 104 boys aged 7–12 years was subdivided into three groups with ADHD combined (n = 22), inattentive (n = 25) and hyperactive/impulsive subtype (n = 14), and 43 typically developing controls (TDC). Children were investigated regarding the Child Behavior Checklist (CBCL), the Integrated Visual and Auditory Test (IVA), and EEG spectral power during eyes closed resting state. Subsequently, statistical analysis included discriminant functional analysis and principle component analysis. Results Neuropsychological parameters had the highest contribution in classifying of the groups. EEG parameters had no effect on differentiation of the groups, and among the psychopathological parameters, only the oppositional behavioral disorder score contributed to correctly classify 74.3% of the groups. Furthermore, we found four factors with eigenvalues higher than 1 in the ADHD and typical groups, with one factor characterized by four CBCL scales, another one by auditory and visual vigilance, speed and beta band power, the third by auditory and visual prudence, and forth by theta band power. Conclusions Our results demonstrated that ADHD subtypes/presentations can be differentiated from each other at different levels of investigation despite some clinical symptoms overlap. The results suggested that not only psychopathology but also the impairment of sensory processing should be assessed in children with ADHD in order to use this additional information for a jointly multilevel clinical intervention, which may improve treatment success.

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Lower Adenoma Miss Rate of Computer-Aided Detection-Assisted Colonoscopy vs Routine White-Light Colonoscopy in a Prospective Tandem Study

Up to 30% of adenomas might be missed during screening colonoscopy-these could be polyps that appear on-screen but are not recognized by endoscopists or polyps that are in locations that do not appear on the screen at all. Computer-aided detection (CADe) systems, based on deep learning, might reduce rates of missed adenomas by displaying visual alerts that identify precancerous polyps on the endoscopy monitor in real time. We compared adenoma miss rates of CADe colonoscopy vs routine white-light colonoscopy. We performed a prospective study of patients, 18-75 years old, referred for diagnostic, screening, or surveillance colonoscopies at a single endoscopy center of Sichuan Provincial People's Hospital from June 3, 2019 through September 24, 2019. Same day, tandem colonoscopies were performed for each participant by the same endoscopist. Patients were randomly assigned to groups that received either CADe colonoscopy (n=184) or routine colonoscopy (n=185) first, followed immediately by the other procedure. Endoscopists were blinded to the group each patient was assigned to until immediately before the start of each colonoscopy. Polyps that were missed by the CADe system but detected by endoscopists were classified as missed polyps. False polyps were those continuously traced by the CADe system but then determined not to be polyps by the endoscopists. The primary endpoint was adenoma miss rate, which was defined as the number of adenomas detected in the second-pass colonoscopy divided by the total number of adenomas detected in both passes. The adenoma miss rate was significantly lower with CADe colonoscopy (13.89%; 95% CI, 8.24%-19.54%) than with routine colonoscopy (40.00%; 95% CI, 31.23%-48.77%, P<.0001). The polyp miss rate was significantly lower with CADe colonoscopy (12.98%; 95% CI, 9.08%-16.88%) than with routine colonoscopy (45.90%; 95% CI, 39.65%-52.15%) (P<.0001). Adenoma miss rates in ascending, transverse, and descending colon were significantly lower with CADe colonoscopy than with routine colonoscopy (ascending colon 6.67% vs 39.13%; P=.0095; transverse colon 16.33% vs 45.16%; P=.0065; and descending colon 12.50% vs 40.91%, P=.0364). CADe colonoscopy reduced the overall miss rate of adenomas by endoscopists using white-light endoscopy. Routine use of CADe might reduce the incidence of interval colon cancers. chictr.org.cn study no: ChiCTR1900023086.