Differences by Race in Outcomes of an In-Person Training Intervention on Use of an Inpatient Portal: A Secondary Analysis of a Randomized Clinical Trial.

Importance: Differences in patient use of health information technologies by race can adversely impact equitable access to health care services. While this digital divide is well documented, there is limited evidence of how health care systems have used interventions to narrow the gap. Objective: To compare differences in the effectiveness of patient training and portal functionality interventions implemented to increase portal use among racial groups. Design, Setting, and Participants: This secondary analysis used data from a randomized clinical trial conducted from December 15, 2016, to August 31, 2019. Data were from a single health care system and included 6 noncancer hospitals. Participants were patients who were at least 18 years of age, identified English as their preferred language, were not involuntarily confined or detained, and agreed to be provided a tablet to access the inpatient portal during their stay. Data were analyzed from September 1, 2022, to October 31, 2023. Interventions: A 2 × 2 factorial design was used to compare the inpatient portal training intervention (touch, in-person [high] vs built-in video tutorial [low]) and the portal functionality intervention (technology, full functionality [full] vs a limited subset of functions [lite]). Main Outcomes and Measures: Primary outcomes were inpatient portal use, measured by frequency and comprehensiveness of use, and use of specific portal functions. A logistic regression model was used to test the association of the estimators with the comprehensiveness use measure. Outcomes are reported as incidence rate ratios (IRRs) for the frequency outcomes or odds ratios (ORs) for the comprehensiveness outcomes with corresponding 95% CIs. Results: Of 2892 participants, 550 (19.0%) were Black individuals, 2221 (76.8%) were White individuals, and 121 (4.2%) were categorized as other race (including African, American Indian or Alaska Native, Asian or Asian American, multiple races or ethnicities, and unknown race or ethnicity). Black participants had a significantly lower frequency (IRR, 0.80 [95% CI, 0.72-0.89]) of inpatient portal use compared with White participants. Interaction effects were not observed between technology, touch, and race. Among participants who received the full technology intervention, Black participants had lower odds of being comprehensive users (OR, 0.76 [95% CI, 0.62-0.91), but interaction effects were not observed between touch and race. Conclusions and Relevance: In this study, providing in-person training or robust portal functionality did not narrow the divide between Black participants and White participants with respect to their inpatient portal use. Health systems looking to narrow the digital divide may need to consider intentional interventions that address underlying issues contributing to this inequity. Trial Registration: ClinicalTrials.gov Identifier: NCT02943109.

Cortical activations associated with spatial remapping of finger touch using EEG.

The spatial coding of tactile information is functionally essential for touch-based shape perception and motor control. However, the spatiotemporal dynamics of how tactile information is remapped from the somatotopic reference frame in the primary somatosensory cortex to the spatiotopic reference frame remains unclear. This study investigated how hand position in space or posture influences cortical somatosensory processing. Twenty-two healthy subjects received electrical stimulation to the right thumb (D1) or little finger (D5) in three position conditions: palm down on right side of the body (baseline), hand crossing the body midline (effect of position), and palm up (effect of posture). Somatosensory-evoked potentials (SEPs) were recorded using electroencephalography. One early-, two mid-, and two late-latency neurophysiological components were identified for both fingers: P50, P1, N125, P200, and N250. D1 and D5 showed different cortical activation patterns: compared with baseline, the crossing condition showed significant clustering at P1 for D1, and at P50 and N125 for D5; the change in posture showed a significant cluster at N125 for D5. Clusters predominated at centro-parietal electrodes. These results suggest that tactile remapping of fingers after electrical stimulation occurs around 100-125 ms in the parietal cortex.

First-sight recognition of touched objects shows that chicks can solve Molyneux's problem.

If a congenitally blind person learns to distinguish between a cube and a sphere by touch, would they immediately recognize these objects by sight once their vision is restored? This question, posed by Molyneux in 1688, has puzzled philosophers and scientists since then. To overcome ethical and practical difficulties in the investigation of cross-modal recognition, we studied inexperienced poultry chicks, which can be reared in darkness until the moment of a visual test with no detrimental consequences. After hatching chicks in darkness, we exposed them to either tactile smooth or tactile bumpy stimuli for 24 h. Immediately after the tactile exposure, chicks were tested in a visual recognition task, during their first experience with light. At first sight, chicks that had been exposed in the tactile modality to smooth stimuli approached the visual smooth stimulus significantly more than those exposed to the tactile bumpy stimuli. These results show that visually inexperienced chicks can solve Molyneux's problem, indicating cross-modal recognition does not require previous multimodal experience. At least in this precocial species, supra-modal brain areas appear functional already at birth. This discovery paves the way for the investigation of predisposed cross-modal cognition that does not depend on visual experience.

Evaluation of the neuromotor ability of the tongue in pediatric patients using a stereognostic examination.

BACKGROUND: The term "stereognosis" comes from neurology and describes the capacity to distinguish objects solely by touch. AIM: The aim of this research study was to compare the neuromotor ability of the tongue in patients with malocclusion and tongue dysfunction with and without superficial anesthesia on the tip of the tongue and hard palate. MATERIALS AND METHODS: The study included 132 patients aged 6-13 years. Using a spatula for speech therapy and a visual evaluation while swallowing saliva, all individuals were identified as having swallowing dysfunctions and divided into three groups: study group (children with malocclusions and tongue dysfunctions) - 44 patients, comparator group (children with malocclusions and without tongue dysfunctions) - 44 patients, and control group (children without malocclusions or tongue dysfunctions) - 44 patients. The Koczorowski methods were used for the stereognostic tests. RESULTS: Age, sex, and malocclusion were taken into account during the differential analysis. The study and comparison groups, study and control groups, and the comparator and control groups all showed statistically significant differences from one another. According to the results, tongue dysfunction affects patients' ability to coordinate their movements with their senses at a developing stage. CONCLUSION: Patients with malocclusions that are made worse by tongue dysfunctions have poorer oral stereognostic sensibility. Speech therapy and interdisciplinary specialist orthodontic treatment are required for individuals with impaired oral perception who are still in the developmental stage and have abnormal tongue position and function.

Vision matters for shape representation: Evidence from sculpturing and drawing in the blind.

Shape is a property that could be perceived by vision and touch, and is classically considered to be supramodal. While there is mounting evidence for the shared cognitive and neural representation space between visual and tactile shape, previous research tended to rely on dissimilarity structures between objects and had not examined the detailed properties of shape representation in the absence of vision. To address this gap, we conducted three explicit object shape knowledge production experiments with congenitally blind and sighted participants, who were asked to produce verbal features, 3D clay models, and 2D drawings of familiar objects with varying levels of tactile exposure, including tools, large nonmanipulable objects, and animals. We found that the absence of visual experience (i.e., in the blind group) led to stronger differences in animals than in tools and large objects, suggesting that direct tactile experience of objects is essential for shape representation when vision is unavailable. For tools with rich tactile/manipulation experiences, the blind produced overall good shapes comparable to the sighted, yet also showed intriguing differences. The blind group had more variations and a systematic bias in the geometric property of tools (making them stubbier than the sighted), indicating that visual experience contributes to aligning internal representations and calibrating overall object configurations, at least for tools. Taken together, the object shape representation reflects the intricate orchestration of vision, touch and language.

Fluid face but not gender: Enfacement illusion through digital face filters does not affect gender identity.

It has been shown that observing a face being touched or moving in synchrony with our own face increases self-identification with the former which might alter both cognitive and affective processes. The induction of this phenomenon, termed enfacement illusion, has often relied on laboratory tools that are unavailable to a large audience. However, digital face filters applications are nowadays regularly used and might provide an interesting tool to study similar mechanisms in a wider population. Digital filters are able to render our faces in real time while changing important facial features, for example, rendering them more masculine or feminine according to normative standards. Recent literature using full-body illusions has shown that participants' own gender identity shifts when embodying a different gendered avatar. Here we studied whether participants' filtered faces, observed while moving in synchrony with their own face, may induce an enfacement illusion and if so, modulate their gender identity. We collected data from 35 female and 33 male participants who observed a stereotypically gender mismatched version of themselves either moving synchronously or asynchronously with their own face on a screen. Our findings showed a successful induction of the enfacement illusion in the synchronous condition according to a questionnaire addressing the feelings of ownership, agency and perceived similarity. However, we found no evidence of gender identity being modulated, neither in explicit nor in implicit measures of gender identification. We discuss the distinction between full-body and facial processing and the relevance of studying widely accessible devices that may impact the sense of a bodily self and our cognition, emotion and behaviour.

Suppression of Cofilin function in the somatosensory cortex alters social contact behavior in the BTBR mouse inbred line.

Sensory differences are a core feature of autism spectrum disorders (ASD) and are predictive of other ASD core symptoms such as social difficulties. However, the neurobiological substrate underlying the functional relationship between sensory and social functioning is poorly understood. Here, we examined whether misregulation of structural plasticity in the somatosensory cortex modulates aberrant social functioning in BTBR mice, a mouse model for autism spectrum disorder-like phenotypes. By locally expressing a dominant-negative form of Cofilin (CofilinS3D; a key regulator of synaptic structure) in the somatosensory cortex, we tested whether somatosensory suppression of Cofilin activity alters social functioning in BTBR mice. Somatosensory Cofilin suppression altered social contact and nest-hide behavior of BTBR mice in a social colony, assessed for seven consecutive days. Subsequent behavioral testing revealed that altered social functioning is related to altered tactile sensory perception; CofilinS3D-treated BTBR mice showed a time-dependent difference in the sensory bedding preference task. These findings show that Cofilin suppression in the somatosensory cortex alters social functioning in BTBR mice and that this is associated with tactile sensory processing, a critical indicator of somatosensory functioning.

Tactile shape discrimination for moving stimuli.

In this study, we explored spatial-temporal dependencies and their impact on the tactile perception of moving objects. Building on previous research linking visual perception and human movement, we examined if an imputed motion mechanism operates within the tactile modality. We focused on how biological coherence between space and time, characteristic of human movement, influences tactile perception. An experiment was designed wherein participants were stimulated on their right palm with tactile patterns, either ambiguous (incongruent conditions) or non-ambiguous (congruent conditions) relative to a biological motion law (two-thirds power law) and asked to report perceived shape and associated confidence. Our findings reveal that introducing ambiguous tactile patterns (1) significantly diminishes tactile discrimination performance, implying motor features of shape recognition in vision are also observed in the tactile modality, and (2) undermines participants' response confidence, uncovering the accessibility degree of information determining the tactile percept's conscious representation. Analysis based on the Hierarchical Drift Diffusion Model unveiled the sensitivity of the evidence accumulation process to the stimulus's informational ambiguity and provides insight into tactile perception as predictive dynamics for reducing uncertainty. These discoveries deepen our understanding of tactile perception mechanisms and underscore the criticality of predictions in sensory information processing.

Cortical cellular encoding of thermotactile integration.

Recent evidence suggests that primary sensory cortical regions play a role in the integration of information from multiple sensory modalities. How primary cortical neurons integrate different sources of sensory information is unclear, partly because non-primary sensory input to a cortical sensory region is often weak or modulatory. To address this question, we take advantage of the robust representation of thermal (cooling) and tactile stimuli in mouse forelimb primary somatosensory cortex (fS1). Using a thermotactile detection task, we show that the perception of threshold-level cool or tactile information is enhanced when they are presented simultaneously, compared with presentation alone. To investigate the cortical cellular correlates of thermotactile integration, we performed in vivo extracellular recordings from fS1 in awake resting and anesthetized mice during unimodal and bimodal stimulation of the forepaw. Unimodal stimulation evoked thermal- or tactile- specific excitatory and inhibitory responses of fS1 neurons. The most prominent features of combined thermotactile stimulation are the recruitment of unimodally silent fS1 neurons, non-linear integration features, and response dynamics that favor longer response durations with additional spikes. Together, we identify quantitative and qualitative changes in cortical encoding that may underlie the improvement in perception of thermotactile surfaces during haptic exploration.

A primary sensory cortical interareal feedforward inhibitory circuit for tacto-visual integration.

Tactile sensation and vision are often both utilized for the exploration of objects that are within reach though it is not known whether or how these two distinct sensory systems combine such information. Here in mice, we used a combination of stereo photogrammetry for 3D reconstruction of the whisker array, brain-wide anatomical tracing and functional connectivity analysis to explore the possibility of tacto-visual convergence in sensory space and within the circuitry of the primary visual cortex (VISp). Strikingly, we find that stimulation of the contralateral whisker array suppresses visually evoked activity in a tacto-visual sub-region of VISp whose visual space representation closely overlaps with the whisker search space. This suppression is mediated by local fast-spiking interneurons that receive a direct cortico-cortical input predominantly from layer 6 neurons located in the posterior primary somatosensory barrel cortex (SSp-bfd). These data demonstrate functional convergence within and between two primary sensory cortical areas for multisensory object detection and recognition.

Intelligent perceptual textiles based on ionic-conductive and strong silk fibers.

Endowing textiles with perceptual function, similar to human skin, is crucial for the development of next-generation smart wearables. To date, the creation of perceptual textiles capable of sensing potential dangers and accurately pinpointing finger touch remains elusive. In this study, we present the design and fabrication of intelligent perceptual textiles capable of electrically responding to external dangers and precisely detecting human touch, based on conductive silk fibroin-based ionic hydrogel (SIH) fibers. These fibers possess excellent fracture strength (55 MPa), extensibility (530%), stable and good conductivity (0.45 S·m-1) due to oriented structures and ionic incorporation. We fabricated SIH fiber-based protective textiles that can respond to fire, water, and sharp objects, protecting robots from potential injuries. Additionally, we designed perceptual textiles that can specifically pinpoint finger touch, serving as convenient human-machine interfaces. Our work sheds new light on the design of next-generation smart wearables and the reshaping of human-machine interfaces.

Grasping objects with the aid of haptics.

A smart suction cup uses haptics to supplement vision for exploration of objects in a grasping task.

[The declining power of the human touch in the digital world.] / Il potere declinante del tocco umano nel mondo digitale.

Humans are social creatures, and touch is the most primitive form of relationship. In the context of the traditional medical examination, touch, palpation, is essential to diagnose or suspect pathology. But it is not only an issue of semeiotics. The physician's ability to examine a body through his or her hands is at the heart of the doctor-patient relationship. Moreover, we have been witnessing for many years to the progressive downgrading of the objective examination in clinical practice. First, the obsolescence of interaction with the patient due to the lure of diagnostic technology, then the "social distancing" of Covid-19 and, finally, the expansion of telemedicine has contributed to the distancing of caregivers from patients. The same technology that tends to distance doctor and patient provides haptic wearable devices that can digitize touch and open up application scenarios that are still largely unexplored. These, however, cannot replace human interaction. What can we do to preserve the culture of physical contact in the doctor-patient relationship? As always, awareness is the first step. The technology that separates us from patients is not the real problem. It is only when it becomes an end instead of a means that we risk losing centuries of medical tradition. It is therefore necessary to strike a balance between using technology and ensuring that health care professionals maintain a central role in providing emotional support and understanding to patients. Such issues should be introduced early in the medical student's training. In the course of study, not only the mechanisms of disease should be taught, but also how to approach care with compassion, empathy and "human touch". In any case, even if digital culture eventually prevails, it is necessary to practice at least "touch" as interpersonal sensitivity, gentleness, and the ability to intercept the other's state of mind and respect it.

Towards sensory substitution and augmentation: Mapping visual distance to audio and tactile frequency.

Multimodal perception is the predominant means by which individuals experience and interact with the world. However, sensory dysfunction or loss can significantly impede this process. In such cases, cross-modality research offers valuable insight into how we can compensate for these sensory deficits through sensory substitution. Although sight and hearing are both used to estimate the distance to an object (e.g., by visual size and sound volume) and the perception of distance is an important element in navigation and guidance, it is not widely studied in cross-modal research. We investigate the relationship between audio and vibrotactile frequencies (in the ranges 47-2,764 Hz and 10-99 Hz, respectively) and distances uniformly distributed in the range 1-12 m. In our experiments participants mapped the distance (represented by an image of a model at that distance) to a frequency via adjusting a virtual tuning knob. The results revealed that the majority (more than 76%) of participants demonstrated a strong negative monotonic relationship between frequency and distance, across both vibrotactile (represented by a natural log function) and auditory domains (represented by an exponential function). However, a subgroup of participants showed the opposite positive linear relationship between frequency and distance. The strong cross-modal sensory correlation could contribute to the development of assistive robotic technologies and devices to augment human perception. This work provides the fundamental foundation for future assisted HRI applications where a mapping between distance and frequency is needed, for example for people with vision or hearing loss, drivers with loss of focus or response delay, doctors undertaking teleoperation surgery, and users in augmented reality (AR) or virtual reality (VR) environments.

Self-recognition: From touching the body to knowing the self.

Recognizing oneself in a mirror is a classic test of self-concept. A new study has revealed the perceptual-motor foundations of conceptual self-knowledge: infants' success in the mirror test was accelerated after touching a tactile stimulus while viewing themselves in a mirror.

The Latest Research Progress on Cell-Free DNA and Prospects of Its Forensic Application.

In recent years, with the continuous progress of DNA extraction and detection technology, cell-free DNA(cfDNA)has been widely used in the life science field, and its potential application value in forensic identification is becoming more and more obvious. This paper reviews the concept, formation mechanism, and classification of cfDNA, etc., and describes the latest research progress of cfDNA in personal identification of crime scene touch DNA samples and non-invasive prenatal paternity testing (NIPPT). Meanwhile, this paper summarizes the potential application of cfDNA in injury inference, and discusses the advantages and disadvantages of common cfDNA analysis methods and techniques, and its application prospects, to provide a new idea for the wide application of cfDNA in the field of forensic science.

Elastic Tactile Sensor Glove for Dexterous Teaching by Demonstration.

We present a thin and elastic tactile sensor glove for teaching dexterous manipulation tasks to robots through human demonstration. The entire glove, including the sensor cells, base layer, and electrical connections, is made from soft and stretchable silicone rubber, adapting to deformations under bending and contact while preserving human dexterity. We develop a glove design with five fingers and a palm sensor, revise material formulations for reduced thickness, faster processing and lower cost, adapt manufacturing processes for reduced layer thickness, and design readout electronics for improved sensitivity and battery operation. We further address integration with a multi-camera system and motion reconstruction, wireless communication, and data processing to obtain multimodal reconstructions of human manipulation skills.

High-speed and large-scale intrinsically stretchable integrated circuits.

Intrinsically stretchable electronics with skin-like mechanical properties have been identified as a promising platform for emerging applications ranging from continuous physiological monitoring to real-time analysis of health conditions, to closed-loop delivery of autonomous medical treatment1-7. However, current technologies could only reach electrical performance at amorphous-silicon level (that is, charge-carrier mobility of about 1 cm2 V-1 s-1), low integration scale (for example, 54 transistors per circuit) and limited functionalities8-11. Here we report high-density, intrinsically stretchable transistors and integrated circuits with high driving ability, high operation speed and large-scale integration. They were enabled by a combination of innovations in materials, fabrication process design, device engineering and circuit design. Our intrinsically stretchable transistors exhibit an average field-effect mobility of more than 20 cm2 V-1 s-1 under 100% strain, a device density of 100,000 transistors per cm2, including interconnects and a high drive current of around 2 µA µm-1 at a supply voltage of 5 V. Notably, these achieved parameters are on par with state-of-the-art flexible transistors based on metal-oxide, carbon nanotube and polycrystalline silicon materials on plastic substrates12-14. Furthermore, we realize a large-scale integrated circuit with more than 1,000 transistors and a stage-switching frequency greater than 1 MHz, for the first time, to our knowledge, in intrinsically stretchable electronics. Moreover, we demonstrate a high-throughput braille recognition system that surpasses human skin sensing ability, enabled by an active-matrix tactile sensor array with a record-high density of 2,500 units per cm2, and a light-emitting diode display with a high refreshing speed of 60 Hz and excellent mechanical robustness. The above advancements in device performance have substantially enhanced the abilities of skin-like electronics.