Endoscopic Valve Therapy in COPD Patients with Hypercapnia.

BACKGROUND: Endoscopic valve therapy has been established as a therapeutic option for patients with severe emphysema. Several randomized controlled trials confirmed the efficacy of this therapeutic approach in COPD patients without significant collateral ventilation. However, patients with clinical relevant hypercapnia were excluded from these trials. AIMS AND OBJECTIVES: Patients with hypercapnia who underwent endoscopic valve treatment were enrolled in this retrospective analysis. The efficacy of valve treatment and its impact on blood gases were analysed. METHODS: COPD patients with mild to severe hypercapnia (pCO2 ≥45 mm Hg) who were treated by endoscopic valve placement at the Thoraxklinik, University of Heidelberg, were enrolled in this retrospective trial. Lung function test (vital capacity [VC], forced expiratory volume in 1 s [FEV1], residual volume [RV]), blood gases (pO2, pCO2), and 6-minute-walk test (6-MWT) were assessed prior to intervention and at 3 and 6 months following valve implantation. RESULTS: 129 patients (mean age 64 ± 7 years) with severe COPD (mean FEV1 26 ± 12% of predicted, mean RV 285 ± 22% of predicted) with hypercapnia (pCO2 ≥45 mm Hg, mean pCO2 50 ± 5 mm Hg) underwent endoscopic valve treatment. 3 and 6 months following intervention, statistical significant improvement was observed in VC, FEV1, RV, and 6-MWT (all p < 0.001). Blood gas analysis revealed a significant improvement of mean pCO2 at 3- and 6-month follow-up (both p < 0.001). 40% of the patients had normal pCO2 values 3 and 6 months following intervention. CONCLUSION: COPD patients with hypercapnia should not be excluded from valve treatment, as the hyperinflation reduction improves the respiratory mechanics and thus leading to improvement of hypercapnia.

Calibration-Free Gaze Interfaces Based on Linear Smooth Pursuit.

Since smooth pursuit eye movements can be used without calibration in spontaneous gaze interaction, the intuitiveness of the gaze interface design has been a topic of great interest in the human-computer interaction field. However, since most related research focuses on curved smooth-pursuit trajectories, the design issues of linear trajectories are poorly understood. Hence, this study evaluated the user performance of gaze interfaces based on linear smooth pursuit eye movements. We conducted an experiment to investigate how the number of objects (6, 8, 10, 12, or 15) and object moving speed (7.73 ˚/s vs. 12.89 ˚/s) affect the user performance in a gaze-based interface. Results show that the number and speed of the displayed objects influence users' performance with the interface. The number of objects significantly affected the correct and false detection rates when selecting objects in the display. Participants' performance was highest on interfaces containing 6 and 8 objects and decreased for interfaces with 10, 12, and 15 objects. Detection rates and orientation error were significantly influenced by the moving speed of displayed objects. Faster moving speed (12.89 ˚/s) resulted in higher detection rates and smaller orientation error compared to slower moving speeds (7.73 ˚/s). Our findings can help to enable a calibration-free accessible interaction with gaze interfaces.

Thermic and chemical procedures for bronchoscopic lung volume reduction.

In the last 14 years several endoscopic procedures have been developed to offer patients with advanced chronic obstructive pulmonary disease (COPD) and emphysema further therapeutic options, complementary to a medical treatment. In addition to the established valve implantation, new approaches have been available since 2009. These procedures include bronchoscopic thermal vapor ablation (BTVA) and polymeric lung volume reduction. Both therapies are independent of collateral ventilation (CV), are irreversible and can be used on segmental (BTVA) and sub-segmental level [polymeric lung volume reduction (PLVR)], in contrast to valve therapy. The intention is to induce a local inflammation with a following fibrosis and shrinkage and thus a volume reduction in the treated lung areas. Currently, only patients with predominant upper-lobe emphysema are treated. An improvement of lung function, exercise capacity and quality of life could be proved in RCTs for BTVA as well as for PLVR. However, the data for PLVR is very limited and has recently been available only in studies. Furthermore, the risk profile is unfavourable with a high number of adverse respiratory events. While BTVA is an established new approach, the PLVR requires re-evaluation regarding materials, predictive factors, safety profile and dosage.

The warning glove - development and evaluation of a multimodal action-specific warning prototype.

This paper has two objectives: first, to introduce the concept of multimodal action-specific warnings and its prototypic realization in the form of a warning glove and second, to present the main findings of a user study that was conducted to test the warning glove against a conventional warning system. Regarding the first goal, the combination of multimodality and action-specificity was implemented by attaching electronic actuators on a right-handed glove for transmitting visual, auditory and tactile feedback. For the second objective, a user study was conducted to test the hypothesis that the warning glove is capable of obtaining faster responses and to determine the perceptions of the users regarding the appropriateness of the warning glove. The results confirmed the assumption of faster response times and participants perceived the warning glove to be 'fairly appropriate'. These results warrant further development of this multimodal action-specific warning glove.

How can multimodality be used to design usable interfaces in IPS2 for older employees?

Main objective of the recently started collaborative research project SFB/TR29 B4 is to provide cross-generational assistance to human operators working in industrial product-service systems (IPS(2)). By combining the ideas of action-specificity and multimodality a more immediate and purposeful reaction towards warnings is assumed. For this purpose, an action-specific warning system in form of a glove has been developed. It provides either visual, auditory or haptic feedback or a combination of all modalities. In a first study this prototype was compared with a conventional warning system, where multimodal devices were directly mounted to the machine. The test scenario used in this study is the 'changing of a spindle' on a replica of a micro milling machine. It was conducted with 42 participants. The experimental design is a within-design in terms of the two warning systems and a between-design concerning the three modalities and its combinations. Results of the two-way ANOVA with repeated measures on both factors 'system' and 'modality' show a significant main effect for the 'modality' and a significant interaction effect between both factors. Especially the haptic warnings on the action-specific glove were described as "that kind of warning, which evokes the fastest response".

Influence of task combination on EEG spectrum modulation for driver workload estimation.

OBJECTIVE: This study investigates the feasibility of using a method based on electroencephalography (EEG) for deriving a driver's mental workload index. BACKGROUND: The psychophysiological signals provide sensitive information for human functional states assessment in both laboratory and real-world settings and for building a new communication channel between driver and vehicle that allows for driver workload monitoring. METHODS: An experiment combining a lane-change task and n-back task was conducted. The task load levels were manipulated in two dimensions, driving task load and working memory load, with each containing three task load conditions. RESULTS: The frontal theta activity showed significant increases in the working memory load dimension, but differences were not found with the driving task load dimension. However, significant decreases in parietal alpha activity were found when the task load was increased in both dimensions. Task-related differences were also found. The driving task load contributed more to the changes in alpha power, whereas the working memory load contributed more to the changes in theta power. Additionally, these two task load dimensions caused significant interactive effects on both theta and alpha power. CONCLUSION: These results indicate that EEG technology can provide sensitive information for driver workload detection even if the sensitivities of different EEG parameters tend to be task dependent. APPLICATION: One potential future application of this study is to establish a general driver workload estimator that uses EEG signals.

Chinese truck drivers' attitudes toward feedback by technology: a quantitative approach.

This study examined Chinese truck drivers' attitudes toward receiving feedback about their driving performance by in-cab technology and explored the best ways of providing feedback to truck drivers in China. The similarities and differences between US and Chinese drivers were also compared. Survey data were collected from 200 long-haul truck drivers in China to provide quantitative information. The results of the current study were compared to the results of a previous study published in 2006 which utilized focus group discussions with Chinese truck drivers, and to the data of a similar survey conducted in the US and published in 2005. Results of the current study showed that Chinese truck drivers were eager for more feedback about their driving performance and they were willing to receive feedback from technology. Although negative feedback was most prevalent in their working environment and was considered acceptable if it improves driving safety, they considered positive feedback as more helpful to safe driving. They perceived many benefits of receiving feedback by technology and comparatively few drawbacks and concerns. Compared to US truck drivers who strongly preferred feedback from a human (e.g., safety director, dispatcher) rather than from technology, Chinese truck drivers were more positive in terms of receiving feedback from technology. They considered feedback from technology to be more objective and scientific than feedback from humans. This study showed the importance of considering cross-culture differences when planning to apply interventions in different countries and cultures.

Driver's views and behaviors about safety in China--what do they NOT know about driving?

Driving safety has become an extremely severe problem in China due to rapid motorization. Unless more effective measures are taken, the fatality risk and the total fatalities due to road traffic accidents are expected to continue to increase. Therefore, focus group discussions were conducted to explore driver attitudes and safe driver characteristics. The results were then compared with a similar study conducted with US drivers. Although similarities were found, differences were of more importance. The Chinese drivers concentrate more on driving skills and capabilities, whereas the US drivers concentrate more on practical safe driving guidelines. Then direct field observations were conducted for the Chinese drivers to empirically investigate the issues discovered. The use of safety belts, running lights, headlights, and turn signals were observed to investigate the drivers' behaviors. Results show that the safety belt use ratio is about 64%, running light use is nearly zero during rainy and snowy weather, headlights use after sunset is substantially delayed, and only about 40% of drivers use turn signals to indicate their intention to change lanes. These findings indicate that the authorities need to take appropriate countermeasures to change the views of the Chinese drivers regarding driving safety and their unsafe driving behaviors. Improvement of training content and methods as well as police enforcement would be recommended.

Let's talk: anthropomorphization as means to cope with stress of interacting with technical devices.

This study is concerned with the anthropomorphization of technical devices and the resulting influence on human-machine interaction; a special focus is on the verbal interaction between human and machine. Questions included: why do people regard technical devices as humans, when do they do so and how do they perceive their own dialogue and other persons' dialogues with technical devices? Correlation coefficients were calculated between the amount of displayed anthropomorphism and subjects' personality structure, fear of technical devices and self-rated technical competency. A subsequent regression analysis revealed that extraversion and gender of the respondents significantly predicted the amount of interaction with technical devices. Regression analysis showed that neuroticism and agreeableness significantly predicted self-rated technical competency. Technical devices that were seen as helpers or friends were generally treated less unfriendly than devices perceived as merely tools. The findings are discussed in the context of emotion and stress at work and the usability of technical devices.