Visual gaze patterns in trainee endoscopists - a novel assessment tool.

BACKGROUND: Colonoscopy proficiency is significantly influenced by skills achieved during training. Although assessment scores exist, they do not evaluate the impact of visual search strategies and their use is time and labour intensive. Eye-tracking has shown significant differences in visual gaze patterns (VGPs) between expert endoscopists with varying polyp detection rates, so may provide a means of automated assessment and guidance for trainees. This study aimed to assess the feasibility of eye-tracking as a novel assessment method for trainee endoscopists. METHODS: Eye-tracking glasses were used to record 26 colonoscopies from 12 endoscopy trainees who were assessed with directly observed procedural scores (DOPS), devised by the Joint Advisory Group (JAG) on GI endoscopy, and a visual analogue score of overall competence. A 'total weighted procedure score' (TWPS) was calculated from 1 to 20. Primary outcomes of fixation duration (FixD) and fixation frequency (FixF) were analysed according to areas of interest (AOIs) with the bowel surface and lumen represented by three concentric rings. Correlation was assessed using Pearson's coefficient. Significance was set at p<.050. RESULTS: Trainees displayed a significant positive correlation between TWPS and FixD (R = 0.943, p<.0001) and FixF (R = 0.936, p<.0001) in the anatomical bowel mucosa peripheries. Conversely, they had significant negative correlations between TWPS and the anatomical bowel lumen (FixD: R= -0.546, p=.004; FixF: R= -0.568, p=.002). CONCLUSIONS: Higher objective performance scores were associated with VGPs focussing on bowel mucosa. This is consistent with prior analysis showing peripheral VGPs correspond with higher polyp detection rates. Analysis of VGPs, therefore, has potential for training and assessment in colonoscopy.

Cross-cultural asymmetries in oculomotor interference elicited by gaze distractors belonging to Asian and White faces.

The averted gaze of others triggers reflexive attentional orienting in the corresponding direction. This phenomenon can be modulated by many social factors. Here, we used an eye-tracking technique to investigate the role of ethnic membership in a cross-cultural oculomotor interference study. Chinese and Italian participants were required to perform a saccade whose direction might be either congruent or incongruent with the averted-gaze of task-irrelevant faces belonging to Asian and White individuals. The results showed that, for Chinese participants, White faces elicited a larger oculomotor interference than Asian faces. By contrast, Italian participants exhibited a similar oculomotor interference effect for both Asian and White faces. Hence, Chinese participants found it more difficult to suppress eye-gaze processing of White rather than Asian faces. The findings provide converging evidence that social attention can be modulated by social factors characterizing both the face stimulus and the participants. The data are discussed with reference to possible cross-cultural differences in perceived social status.

Evaluating the data quality of the Gazepoint GP3 low-cost eye tracker when used independently by study participants.

The portability of low-cost eye trackers makes them attractive for research outside of the laboratory. Such research may require independent eye-tracker use. The present work compared the data quality of the Gazepoint GP3 when used independently by research participants with expert eye-tracking users. Twenty participants completed a training and a testing session 1 week apart. At training visits, participants were taught how to set up and use eye-tracking hardware and software and how to complete two tasks: a calibration task to measure accuracy and precision, as well as a visual search task to assess target fixations. At the testing session, participants set up the Gazepoint eye tracker and completed the two tasks without assistance. Participant accuracy and precision and visual search performance were compared to values obtained from two expert eye-tracking users. Additionally, the eye-tracker sampling rate, which is sensitive to factors such as head motion, was assessed in both participants and the expert users. Participant accuracy and precision closely approximated expert user values. Participant target fixations were detected with a 92.5% sensitivity and 76.8% specificity, closely mirroring expert user sensitivity and specificity. The sampling rate distribution was also similar between the participants and expert user (the means of those distributions were 16.99 ± 3.0 ms and 16.43 ± 2.3 ms, respectively). When used independently, data quality obtained from a low-cost, portable eye-tracking setup closely approximated values obtained from an expert user and was adequate enough to be a feasible option for some studies that require independent use by study participants.

Associations between individual variations in visual attention at 9 months and behavioral competencies at 18 months in rural Malawi.

Theoretical and empirical considerations suggest that individual differences in infant visual attention correlate with variations in cognitive skills later in childhood. Here we tested this hypothesis in infants from rural Malawi (n = 198-377, depending on analysis), who were assessed with eye tracking tests of visual orienting, anticipatory looks, and attention to faces at 9 months, and more conventional tests of cognitive control (A-not-B), motor, language, and socioemotional development at 18 months. The results showed no associations between measures of infant attention at 9 months and cognitive skills at 18 months, either in analyses linking infant visual orienting with broad cognitive outcomes or analyses linking specific constructs between the two time points (i.e., switching of anticipatory looks and manual reaching responses), as correlations varied between -0.08 and 0.14. Measures of physical growth, and family socioeconomic characteristics were also not correlated with cognitive outcomes at 18 months in the current sample (correlations between -0.10 and 0.19). The results do not support the use of the current tests of infant visual attention as a predictive tool for 18-month-old infants' cognitive skills in the Malawian setting. The results are discussed in light of the potential limitations of the employed infant tests as well as potentially unique characteristics of early cognitive development in low-resource settings.

Modeling and quality assessment of nystagmus eye movements recorded using an eye-tracker.

Mathematical modeling of nystagmus oscillations is a technique with applications in diagnostics, treatment evaluation, and acuity testing. Modeling is a powerful tool for the analysis of nystagmus oscillations but quality assessment of the input data is needed in order to avoid misinterpretation of the modeling results. In this work, we propose a signal quality metric for nystagmus waveforms, the normalized segment error (NSE). The NSE is based on the energy in the error signal between the observed oscillations and a reconstruction from a harmonic sinusoidal model called the normalized waveform model (NWM). A threshold for discrimination between nystagmus oscillations and disturbances is estimated using simulated signals and receiver operator characteristics (ROC). The ROC is optimized to find noisy segments and abrupt waveform and frequency changes in the simulated data that disturb the modeling. The discrimination threshold, 𝜖, obtained from the ROC analysis, is applied to real recordings of nystagmus data in order to determine whether a segment is of high quality or not. The NWM parameters from both the simulated dataset and the nystagmus recordings are analyzed for the two classes suggested by the threshold. The optimized 𝜖 yielded a true-positive rate and a false-positive rate of 0.97 and 0.07, respectively, for the simulated data. The results from the NWM parameter analysis show that they are consistent with the known values of the simulated signals, and that the method estimates similar model parameters when performing analysis of repeated recordings from one subject.

Clinical validation of an optimized multimodal neurocognitive assessment of chronic mild TBI.

OBJECTIVE: Previous laboratory-based studies have shown that neurocognitive eye-tracking metrics are sensitive to chronic effects of mild traumatic brain injury (mTBI), even in individuals with normal performance on traditional neuropsychological measures. In this study, we sought to replicate and extend these findings in a military medical environment. We expected that metrics from the multimodal Fusion n-Back test would successfully distinguish chronic mTBI participants from controls, particularly eye movement metrics from the more cognitively challenging "1-Back" subtest. METHODS: We compared performance of participants with chronic mTBI (n = 46) and controls (n = 33) on the Fusion n-Back test and a battery of conventional neuropsychological tests. Additionally, we examined test reliability and the impact of potential confounds to neurocognitive assessment. RESULTS: Our results supported hypotheses; Fusion 1-Back metrics were successful in multimodal (saccadic and manual) classification of chronic mTBI versus control. In contrast, conventional neuropsychological measures could not distinguish these groups. Additional findings demonstrated the reliability of Fusion n-Back test metrics and provided evidence that saccadic metrics are resistant to confounding influences of age, intelligence, and psychiatric symptoms. INTERPRETATION: The Fusion n-Back test could provide advantages in differential diagnosis for complex brain injury populations. Additionally, the rapid administration of this test could be valuable for screening patients in clinical settings where longer test batteries are not feasible.

Evaluating the Measurement Properties of the ScanCourse, a Dual-Task Assessment of Visual Scanning.

IMPORTANCE: The ScanCourse is used by occupational therapists to evaluate visual scanning ability during locomotion. Its measurement properties have not been examined. OBJECTIVE: To assess the interrater reliability, test-retest reliability, and construct validity of the ScanCourse. DESIGN: This study involved data collection at two time points. To assess test-retest reliability, the ScanCourse was administered twice within a 2-week period. To assess interrater reliability, a second rater was present for one session. To assess level of agreement, a Bland-Altman plot was created. To assess absolute reliability, the standard error of measurement was calculated. To evaluate construct validity, the results of the ScanCourse were compared with results of the Bells Test and Trail Making Test A and B. SETTING: Rehabilitation hospital. PARTICIPANTS: Forty-one patients with neurological impairments. OUTCOMES AND MEASURES: The ScanCourse (participants identify numbered cards placed on both sides of a hallway at various heights during locomotion). RESULTS: The ScanCourse was found to have excellent interrater reliability (intraclass correlation coefficient [ICC] [1,1] = .998; 95% confidence interval [CI] [.996-.999]), test-retest reliability (ICC [1,1] = .912; 95% CI [.811-.959]), a high level of agreement, and a low standard error of measurement (.503), and it was found to be significantly correlated with Trails A (rs = -.436, p = .009) and B (rs = -.364, p = .029). CONCLUSIONS AND RELEVANCE: The assessment was found to have strong measurement properties, and it is therefore an appropriate tool for assessing dual-task visual scanning among those with neurological impairments. WHAT THIS ARTICLE ADDS: This research demonstrates that the ScanCourse is reliable between raters and over time and that scores on the measure vary as anticipated with scores on a related measure, which provides evidence of its validity. These findings support its use in practice.

Awareness and Perceived Value of Eye Tracking Technology for Concussion Assessment among Sports Medicine Clinicians: A Multinational Study.

Objective: The awareness of concussion as a serious and frequently occurring sports injury and its management has evolved significantly. One viable objective diagnostic tool is eye tracking technology. The authors hypothesized that while clinicians may be aware that assessing eye movements in concussed athletes can be beneficial, it is possible that, due to the novelty of the eye tracking technology and limited exposure, only a few actually use it in their practice. The study aimed to assess the awareness of eye movement deficits associated with concussion amongst sports medicine clinicians and to determine the utilization and perceptions of the eye tracking technology for concussion diagnosis.Methods: An online 18-question survey was distributed internationally from January until December 2017 and completed by 171 sports medicine clinicians (sport physicians, therapists, general practitioners, neuropsychologists) from 32 countries.Results: Respondents indicated that subjectivity of assessments remained a major limitation of established diagnostic tools. Eye tracking technology, despite its potential to attenuate this limitation, was only used by 12% of respondents. To diagnose concussion, 77% did not use any eye movement assessment tools other than own clinical assessment. With the exception of abnormal pupil light reflex, which was checked by 68%, eye movement deficits were inspected by less than half of the respondents (46.3 ± 12%).Conclusion: Even among sports medicine clinicians who regularly attend to patients with concussions, there is insufficient awareness that concussion can lead to abnormal eye tracking behavior. Lack of exposure to the sensitive eye tracking equipment may be a limiting factor for using eye movement metrics for concussion diagnostics. Facilitating the awareness of objective methods, like eye tracking technology, may help assure the appropriate continuum of identification and treatment for concussed athletes. Increasing educational opportunities and practical experience of clinicians regarding concussive symptoms and potential innovative technology is strongly advocated.

Gaze and Movement Assessment (GaMA): Inter-site validation of a visuomotor upper limb functional protocol.

BACKGROUND: Successful hand-object interactions require precise hand-eye coordination with continual movement adjustments. Quantitative measurement of this visuomotor behaviour could provide valuable insight into upper limb impairments. The Gaze and Movement Assessment (GaMA) was developed to provide protocols for simultaneous motion capture and eye tracking during the administration of two functional tasks, along with data analysis methods to generate standard measures of visuomotor behaviour. The objective of this study was to investigate the reproducibility of the GaMA protocol across two independent groups of non-disabled participants, with different raters using different motion capture and eye tracking technology. METHODS: Twenty non-disabled adults performed the Pasta Box Task and the Cup Transfer Task. Upper body and eye movements were recorded using motion capture and eye tracking, respectively. Measures of hand movement, angular joint kinematics, and eye gaze were compared to those from a different sample of twenty non-disabled adults who had previously performed the same protocol with different technology, rater and site. RESULTS: Participants took longer to perform the tasks versus those from the earlier study, although the relative time of each movement phase was similar. Measures that were dissimilar between the groups included hand distances travelled, hand trajectories, number of movement units, eye latencies, and peak angular velocities. Similarities included all hand velocity and grip aperture measures, eye fixations, and most peak joint angle and range of motion measures. DISCUSSION: The reproducibility of GaMA was confirmed by this study, despite a few differences introduced by learning effects, task demonstration variation, and limitations of the kinematic model. GaMA accurately quantifies the typical behaviours of a non-disabled population, producing precise quantitative measures of hand function, trunk and angular joint kinematics, and associated visuomotor behaviour. This work advances the consideration for use of GaMA in populations with upper limb sensorimotor impairment.

Allocentric Versus Egocentric Neglect in Stroke Patients: A Pilot Study Investigating the Assessment of Neglect Subtypes and Their Impacts on Functional Outcome Using Eye Tracking.

OBJECTIVE: Few studies have investigated the assessment and functional impact of egocentric and allocentric neglect among stroke patients. This pilot study aimed to determine (1) whether allocentric and egocentric neglect could be dissociated among a sample of stroke patients using eye tracking; (2) the specific patterns of attention associated with each subtype; and (3) the nature of the relationship between neglect subtype and functional outcome. METHOD: Twenty acute stroke patients were administered neuropsychological assessment batteries, a pencil-and-paper Apples Test to measure neglect subtype, and an adaptation of the Apples Test with an eye tracking measure. To test clinical discriminability, twenty age- and education-matched control participants were administered the eye tracking measure of neglect. RESULTS: The eye tracking measure identified a greater number of individuals as having egocentric and/or allocentric neglect than the pencil-and-paper Apples Test. Classification of neglect subtype based on eye tracking performance was a significant predictor of functional outcome beyond that accounted for by the neuropsychological test performance and Apples Test neglect classification. Preliminary evidence suggests that patients with no neglect symptoms had superior functional outcomes compared with patients with neglect. Patients with combined egocentric and allocentric neglect had poorer functional outcomes than those with either subtype. Functional outcomes of patients with either allocentric or egocentric neglect did not differ significantly. The applications of our findings, to improve neglect detection, are discussed. CONCLUSION: Results highlight the potential clinical utility of eye tracking for the assessment and identification of neglect subtype among stroke patients to predict functional outcomes. (JINS, 2019, 25, 479-489).

Response suppression produces a switch-cost for spatially compatible saccades.

Executive function supports the rapid alternation between tasks for online reconfiguration of attentional and motor goals. The oculomotor literature has found that a prosaccade (i.e., saccade to veridical target location) preceded by an antisaccade (i.e., saccade mirror symmetrical to a target) elicits an increase in reaction time (RT), whereas the converse switch does not. This switch-cost has been attributed to the antisaccade task's requirement of inhibiting a prosaccade (i.e., response suppression) and transforming a target's coordinate (i.e., vector inversion)-executive processes thought to contribute to a task-set inertia that proactively interferes with the planning of a subsequent prosaccade. It is, however, unclear whether response suppression and vector inversion contribute to a task-set inertia or whether the phenomenon relates to a unitary component (e.g., response suppression). Here, the same stimulus-driven (SD) prosaccades (i.e., respond at target onset) as used in previous work were used with minimally delayed (MD) prosaccades (i.e., respond at target offset) and arranged in an AABB paradigm (i.e., A = SD prosaccade, B = MD prosaccade). MD prosaccades provide the same response suppression as antisaccades without the need for vector inversion. RTs for SD task-switch trials were longer and more variable than their task-repeat counterparts, whereas values for MD task-switch and task-repeat trials did not reliably differ. Moreover, SD task-repeat and task-switch movement times and amplitudes did not vary and thus demonstrate that a switch-cost is unrelated to a speed accuracy trade-off. Accordingly, results suggest the executive demands of response suppression is sufficient to engender the persistent activation of a non-standard task-set that selectively delays the planning of a subsequent SD prosaccade.

VisMET: a passive, efficient, and sensitive assessment of visuospatial memory in healthy aging, mild cognitive impairment, and Alzheimer's disease.

The entorhinal-hippocampal circuit is one of the earliest sites of cortical pathology in Alzheimer's disease (AD). Visuospatial memory paradigms that are mediated by the entorhinal-hippocampal circuit may offer a means to detect memory impairment during the early stages of AD. In this study, we developed a 4-min visuospatial memory paradigm called VisMET (Visuospatial Memory Eye-Tracking Task) that passively assesses memory using eye movements rather than explicit memory judgements. We had 296 control or memory-impaired participants view a set of images followed by a modified version of the images with either an object removed, or a new object added. Healthy controls spent significantly more time viewing these manipulations compared to subjects with mild cognitive impairment and AD. Using a logistic regression model, the amount of time that individuals viewed these manipulations could predict cognitive impairment and disease status with an out of sample area under the receiver-operator characteristic curve of 0.85. Based on these results, VisMET offers a passive, sensitive, and efficient memory paradigm capable of detecting objective memory impairment and predicting cognitive and disease status.

New and emerging access technologies for adults with complex communication needs and severe motor impairments: State of the science.

Individuals with complex communication needs often use alternative access technologies to control their augmentative and alternative communication (AAC) devices, their computers, and mobile technologies. While a range of access devices is available, many challenges continue to exist, particularly for those with severe motor-control limitations. For some, access options may not be readily available or access itself may be inaccurate and frustrating. For others, access may be available but only under optimal conditions and support. There is an urgent need to develop new options for individuals with severe motor impairments and to leverage existing technology to improve efficiency, increase accuracy, and decrease fatigue of access. This paper describes person-centred research and development activities related to new and emerging access technologies, with a particular focus on adults with acquired neurological conditions.

Effects of Varying Color, Imagery, and Text of Cigarette Package Warning Labels among Socioeconomically Disadvantaged Middle School Youth and Adult Smokers.

The U.S. Family Smoking Prevention and Tobacco Control Act (Tobacco Control Act) of 2009 paved the way for the Food and Drug Administration (FDA) to propose nine different graphic warning labels (GWLs) intended for prominent placement on the front and back of cigarette packs and on cigarette advertisements. Those GWLs were adjudicated as unconstitutional on the ground that they unnecessarily infringed tobacco companies' free speech without sufficiently advancing the government's public health interests. This study examines whether less extensive alternatives to the original full-color GWLs, including black-and-white GWLs and text-only options, have similar or divergent effects on visual attention, negative affect, and health risk beliefs. We used a mobile media research lab to conduct a randomized experiment with two populations residing in socioeconomically disadvantaged communities: biochemically confirmed adult smokers (N = 313) and middle school youth (N = 340). Results indicate that full-color GWLs capture attention for longer than black-and-white GWLs among both youth and adult smokers. Among adults, packages with GWLs (in either color or black-and-white) engendered more negative affect than those with text-only labels, while text-only produced greater negative affect than the packages with brand imagery only. Among youth, GWLs and text-only labels produced comparable levels of negative affect, albeit more so than brand imagery. We thus offer mixed findings related to the claim that a less extensive alternative could satisfy the government's compelling public health interest to reduce cigarette smoking rates.

Does it look safe? An eye tracking study into the visual aspects of fear of crime.

Studies of fear of crime often focus on demographic and social factors, but these can be difficult to change. Studies of visual aspects have suggested that features reflecting incivilities, such as litter, graffiti, and vandalism increase fear of crime, but methods often rely on participants actively mentioning such aspects, and more subtle, less conscious aspects may be overlooked. To address these concerns, this study examined people's eye movements while they judged scenes for safety. In total, 40 current and former university students were asked to rate images of day-time and night-time scenes of Lincoln, UK (where they studied) and Egham, UK (unfamiliar location) for safety, maintenance, and familiarity while their eye movements were recorded. Another 25 observers not from Lincoln or Egham rated the same images in an Internet survey. Ratings showed a strong association between safety and maintenance and lower safety ratings for night-time scenes for both groups, in agreement with earlier findings. Eye movements of the Lincoln participants showed increased dwell times on buildings, houses, and vehicles during safety judgements and increased dwell times on streets, pavements, and markers of incivilities for maintenance. Results confirm that maintenance plays an important role in perceptions of safety, but eye movements suggest that observers also look for indicators of current or recent presence of people.

Objective Assessment of Disparity Vergence after Treatment of Symptomatic Convergence Insufficiency in Children.

SIGNIFICANCE: This first report of the use of objective measures of disparity vergence as outcome measures for symptomatic convergence insufficiency in children provides additional information that is not accessible with clinical tests. The study results also demonstrate that objective measures of vergence could be used in future randomized clinical trials of binocular vision disorders with children. PURPOSE: This study was designed to evaluate changes in objective measures of disparity vergence after office-based vergence/accommodative therapy (OBVAT) for convergence insufficiency in children 12 to 17 years old. METHODS: In this prospective trial, we recruited 10 participants with normal binocular vision and 12 with convergence insufficiency. All participants with convergence insufficiency were treated with 12 weeks of OBVAT. The primary outcome measure was average peak velocity for 4° symmetrical convergence steps. Other objective outcome measures of disparity vergence included time to peak velocity, latency, and accuracy. Changes in clinical measures (near point of convergence, positive fusional vergence at near) and symptoms were evaluated. RESULTS: There was a statistically significant increase in peak velocity and more accurate response amplitude to 4° symmetrical convergence step stimuli after OBVAT compared with baseline measurements. Near point of convergence, positive fusional vergence, and symptoms also statistically significantly improved after OBVAT. Ten of the 12 participants met clinical success criteria. CONCLUSIONS: In this prospective study on the treatment of symptomatic convergence insufficiency in children in which both clinical and objective eye movement measurements were used to evaluate the results of treatment, significant changes were found in symptoms and both clinical and objective measures of disparity vergence after completion of OBVAT in children with symptomatic convergence insufficiency.

A post-exercise facilitation of executive function is independent of aerobically supported metabolic costs.

A single-bout of aerobic or resistance training facilitates executive function and is a benefit thought to be specific to exercise durations greater than 20 min. We sought to determine whether an executive benefit is observed for a session as brief as 10-min, and whether distinct and participant-specific exercise intensities - and associated metabolic costs - influence the magnitude of the benefit. Participants completed exercise sessions - via cycle ergometer - at moderate (80% of lactate threshold [LT]), heavy (15% of the difference between LT and VO2 peak) and very-heavy (50% of the difference between LT and VO2 peak) intensities determined via an incremental ramp test to volitional exhaustion. Pre- and post-exercise executive function was examined via antisaccades - an executive task requiring a saccade mirror-symmetrical to a visual stimulus. Antisaccades are an ideal tool for examining post-exercise executive changes due to the resolution of eye-tracking and because the task is mediated via the same frontoparietal networks as modified following single-bout and chronic exercise. A non-executive prosaccade task (i.e., saccade to veridical target location) was also completed to determine if the putative post-exercise benefit was specific to executive function. Results showed a 20 ms reduction in pre- to post-exercise antisaccade RTs (p < .02) and was independent of exercise intensity, whereas no such change was observed for prosaccades (p = .14). Furthermore, the antisaccade benefit occurred without concomitant changes in directional errors or endpoint accuracy; that is, participants did not decrease their post-exercise RTs at the cost of increased planning and execution errors (ps > 0.34). Accordingly, we propose that an exercise duration as brief as 10-min provides a reliable benefit to executive function and is an effect observed across the continuum of moderate to very-heavy intensities.

Gaze in a real-world social interaction: A dual eye-tracking study.

People communicate using verbal and non-verbal cues, including gaze cues. Gaze allocation can be influenced by social factors; however, most research on gaze cueing has not considered these factors. The presence of social roles was manipulated in a natural, everyday collaborative task while eye movements were measured. In pairs, participants worked together to make a cake. Half of the pairs were given roles ("Chef" or "Gatherer") and the other half were not. Across all participants we found, contrary to the results of static-image experiments, that participants spent very little time looking at each other, challenging the generalisability of the conclusions from lab-based paradigms. However, participants were more likely than not to look at their partner when receiving an instruction, highlighting the typical coordination of gaze cues and verbal communication in natural interactions. The mean duration of instances in which the partners looked at each other (partner gaze) was longer in the roles condition, and these participants were quicker to align their gaze with their partners (shared gaze). In addition, we found some indication that when hearing spoken instructions, listeners in the roles condition looked at the speaker more than listeners in the no roles condition. We conclude that social context can affect our gaze behaviour during a social interaction.

Assessment of Ocular and Physiological Metrics to Discriminate Flight Phases in Real Light Aircraft.

OBJECTIVE: The purpose of the present study was to find psychophysiological proxies that are straightforward to use and could be implemented in actual flight conditions to accurately discriminate pilots' workload levels. BACKGROUND: Piloting an aircraft is a complex activity where cognitive limitations may jeopardize flight safety. There is a need to implement solutions to monitor pilots' workload level to improve flight safety. There has been recent interest in combining psychophysiological measurements. Most of these studies were conducted in flight simulators at the group level, limiting the interpretation of the results. METHODS: We conducted an experiment with 11 pilots performing two standard traffic patterns in a light aircraft. Five metrics were derived from their ocular and cardiac activities and were evaluated through three flight phases: takeoff, downwind, and landing. RESULTS: Statistical analyses showed that the saccadic rate was the most efficient metric to distinguish between the three flight phases. In addition, a classifier trained on the ocular data collected from the first run predicted the flight phase within a second run with an accuracy of 75%. No gain in the classifier accuracy has been found by combining cardiac and ocular metrics. CONCLUSIONS: Ocular-based metrics may be more suitable than cardiac ones to provide relevant information on pilots' flying activity in operational settings. APPLICATIONS: Electrocardiographic and eye-tracking devices could be implemented in future cockpits as additional flight data for accident analysis, an objective pilot's state evaluation for training, and proxies for human-machine interactions to improve flight safety.

A low-cost platform for eye-tracking research: Using Pupil© in behavior analysis.

Tracking eye movements is being increasingly recognized as a valuable source of information about stimulus control. So far, however, eye-tracking research has suffered from accessibility issues, with expensive hardware and closed-source software. In this article we review Pupil©, an eye-tracking platform developed by Pupil Labs and that combines open-source software with low-cost hardware components. We offer concrete recommendations about Pupil use in stimulus-control research and we show how the software can be extended to automatize the analysis of gaze data. Finally, we present the results of a study of visual discrimination and conditioned reinforcement conducted with Pupil, establishing the usefulness of this platform as a research tool in behavior analysis.