Data-Driven Sparse Skin Stimulation Can Convey Social Touch Information to Humans.

During social interactions, people use auditory, visual, and haptic cues to convey their thoughts, emotions, and intentions. Due to weight, energy, and other hardware constraints, it is difficult to create devices that completely capture the complexity of human touch. Here we explore whether a sparse representation of human touch is sufficient to convey social touch signals. To test this we collected a dataset of social touch interactions using a soft wearable pressure sensor array, developed an algorithm to map recorded data to an array of actuators, then applied our algorithm to create signals that drive an array of normal indentation actuators placed on the arm. Using this wearable, low-resolution, low-force device, we find that users are able to distinguish the intended social meaning, and compare performance to results based on direct human touch. As online communication becomes more prevalent, such systems to convey haptic signals could allow for improved distant socializing and empathetic remote human-human interaction.

Body-Mounted Vibrotactile Stimuli: Simultaneous Display of Taps on the Fingertips and Forearm.

In this article, we present a body-mounted tactile display to deliver haptic feedback to the forearm and user-initiated haptic feedback to the fingertips. The display mounts two vibrotactile actuators on the forearm, leaving the user's hands free for manipulation tasks when the hands are not interacting with the tactile display, while also exploiting the tactile sensitivity of the fingertips when needed. We test the effectiveness of the display using paired vibrotactile taps sensed through the forearm and the fingertips, either separately or simultaneously. We measure the ability of participants to identify the vibrotactile taps. The results show that mounting the device on the forearm, so that the participant touches the forearm-mounted device with their fingertips receiving feedback to both locations simultaneously, decreases performance relative to mounting on the fingertips unless large amplitudes are used. We also test the accuracy with which participants identified different numbers of vibration taps (4, 8, 16, and 25 signals). The results show that as the number of signals changes, participant accuracy is not different when stimulating the fingertips alone compared to stimulating the fingertips and forearm together. We conclude with an example of a portable and wearable vibration display, and discuss future use cases of such a display.

Understanding Continuous and Pleasant Linear Sensations on the Forearm From a Sequential Discrete Lateral Skin-Slip Haptic Device.

A continuous stroking sensation on the skin can convey messages or emotion cues. We seek to induce this sensation using a combination of illusory motion and lateral stroking via a haptic device. Our system provides discrete lateral skin-slip on the forearm with rotating tactors, which independently provide lateral skin-slip in a timed sequence. We vary the sensation by changing the angular velocity and delay between adjacent tactors, such that the apparent speed of the perceived stroke ranges from 2.5 to 48.2 cm/s. We investigated which actuation parameters create the most pleasant and continuous sensations through a user study with 16 participants. On average, the sensations were rated by participants as both continuous and pleasant. The most continuous and pleasant sensations were created by apparent speeds of 7.7 and 5.1 cm/s, respectively. We also investigated the effect of spacing between contact points on the pleasantness and continuity of the stroking sensation, and found that the users experience a pleasant and continuous linear sensation even when the space between contact points is relatively large (40 mm). Understanding how sequential discrete lateral skin-slip creates continuous linear sensations can influence the design and control of future wearable haptic devices.

Progression and prognostic indicators of bronchial disease in children with sickle cell disease.

PURPOSE: The pulmonary complications of sickle cell disease (SCD) are a leading cause of morbidity and mortality (MacLean et al. Am J Respir Crit Care Med 178:1055-1059, 2008; Klings et al. Am J Respir Crit Care Med 173:1264-1269, 2006; National Heart, Lung, and Blood Institute, 2009). Despite this recognition, predictive markers of lung dysfunction progression remain elusive (Klings et al. Am J Respir Crit Care Med 173:1264-1269, 2006; Platt et al. N Engl J Med 330:1639-1644, 1994; Caboot et al. Curr Opin Pediatr 20:279-287, 2008; Field et al. Am J Hematol 83:574-576, 2008; Shirlo et al. Peadiatr Respir Review 12:78-82, 2011). This study was designed describe the longitudinal progression and identify specific markers that influence bronchial disease in SCD. METHODS: A retrospective, chart review of 89 patients with SCD was conducted. All patients underwent spirometry in conjunction with body plethysmography as part of routine care. Eleven lung function variables were assessed, five of which were selected to establish patterns of normal, obstructive, restrictive, or mixed obstructive-restrictive physiology (Klings et al. Am J Respir Crit Care Med 173:1264-1269, 2006; Field et al. Am J Hematol 83:574-576, 2008). RESULTS: In the unadjusted model, forced expiratory volume in one second (FEV1)% of predicted trended downward with age, while total lung capacity (TLC)% of predicted showed a bimodal distribution and carbon monoxide diffusion capacity corrected for hemoglobin (DLCOcor)% of predicted remained stable. Adjusting for acute chest syndrome (ACS) episodes, medication status, and growth velocity (GV), the final model demonstrated that the downward trend between FEV1% of predicted with age was further influenced by the latter two factors. CONCLUSIONS: Initial decline in FEV1% of predicted is associated with worsening pulmonary dysfunction over time. Independent of ACS episodes, the factors most influential on the progression of FEV1% predicted include the introduction of medications as well as the promotion of adequate prepubertal growth. Efforts to ensure normal prepubertal GV and treatment with bronchodilators, such as short-acting beta(2) agonists and inhaled corticosteroids (ICS), should be considered at an early age to delay progression of pulmonary dysfunction.

Diagnosis of cystic fibrosis in the kindred of an infant with CFTR-related metabolic syndrome: importance of follow-up that includes monitoring sweat chloride concentrations over time.

Newly implemented newborn screening (NBS) programs in California have resulted in a large subset of patients in whom at least two cystic fibrosis transmembrane conductance regulator (CFTR) mutations are identified, but subsequent sweat chloride analysis reveals normal or indeterminate values. These patients are diagnosed with CFTR-Related Metabolic Syndrome (CRMS). However, the natural progression and management of these patients are not clearly understood and frequently after the age of 1-year these patients are lost to follow-up with Cystic Fibrosis (CF) Centers. We present the first case of an infant who was referred to Miller Children's Hospital for a NBS positive for CF and subsequent discovery of identical mutations in six of his seven older brothers. Several siblings had positive sweat chloride results on repeat testing after the age of 3 years. We suggest the need for continued follow-up of CRMS in a CF center with diagnostic evaluation including repeat sweat chloride testing, beyond the currently recommended period.

Association between cervical dysplasia and human papillomavirus in HIV seropositive women from Johannesburg South Africa.

OBJECTIVE: To examine the association between CD4 counts, HPV infection and the risk of cervical neoplasia among HIV-seropositive women. METHODS: A cross-sectional observational study was conducted among 1,010 HIV-seropositive women using cytology-based Pap smears. HPV DNA testing using Linear Array genotyping assay (Roche) was carried out in a subset of 191 patients. Multivariable-adjusted prevalence ratios (mPR) and 95% confidence intervals (CIs) were estimated with log-binomial regression. RESULTS: Among 1,010 HIV-seropositive women, the prevalence of AGC/ASCUS, LSIL and HSIL or greater was 8.3, 23.5 and 18.0%, respectively. The risk of cervical lesions was higher with CD4 < 200 cells/mm(3) vs. CD4 levels > 500/mm(3). HPV types 16 (41.7%) and HPV 56 (22.2%) were the most common types in HSIL cases. Women with CD4 levels < 200/mm(3) had a higher prevalence of HPV types 16 (p < 0.01) and 66 (p = 0.04). No statistical relationship between cervical lesions and HAART use was found. CONCLUSION: The burden of HPV infection and HSIL was high and correlated with HIV-induced immunosuppression. HPV 16 was the most common type in HSIL and increased in prevalence with greater immune suppression. Prophylactic HPV 16 vaccination could prevent approximately 40% of HSIL cases. Strengthening screening programs is imperative in this population.