Brotate and Tribike: Designing Smartphone Control for Cycling

The more people commute by bicycle, the higher is the number of cyclists using their smartphones while cycling and compromising traffic safety. We have designed, implemented and evaluated two prototypes for smartphone control devices that do not require the cyclists to remove their hands from the handlebars - the three-button device Tribike and the rotation-controlled Brotate. The devices were the result of a user-centred design process where we identified the key features needed for a on-bike smartphone control device. We evaluated the devices in a biking exercise with 19 participants, where users completed a series of common smartphone tasks. The study showed that Brotate allowed for significantly more lateral control of the bicycle and both devices reduced the cognitive load required to use the smartphone. Our work contributes insights into designing interfaces for cycling.Comment: 22nd International Conference on Human-Computer Interaction with Mobile Devices and Services (MobileHCI '20), October 5--8, 2020, Oldenburg, German

Brotate and Tribike:Designing Smartphone Control for Cycling

The more people commute by bicycle, the higher is the number of cyclists using their smartphones while cycling and compromising traffic safety. We have designed, implemented and evaluated two prototypes for smartphone control devices that do not require the cyclists to remove their hands from the handlebars - the three-button device Tribike and the rotation-controlled Brotate. The devices were the result of a user-centred design process where we identified the key features needed for a on-bike smartphone control device. We evaluated the devices in a biking exercise with 19 participants, where users completed a series of common smartphone tasks. The study showed that Brotate allowed for significantly more lateral control of the bicycle and both devices reduced the cognitive load required to use the smartphone. Our work contributes insights into designing interfaces for cycling

The Effect of Cognitive Load on Auditory Susceptibility During Automated Driving

Objective We experimentally test the effect of cognitive load on auditory susceptibility during automated driving. Background In automated vehicles, auditory alerts are frequently used to request human intervention. To ensure safe operation, human drivers need to be susceptible to auditory information. Previous work found reduced susceptibility during manual driving and in a lesser amount during automated driving. However, in practice, drivers also perform nondriving tasks during automated driving, of which the associated cognitive load may further reduce susceptibility to auditory information. We therefore study the effect of cognitive load during automated driving on auditory susceptibility. Method Twenty-four participants were driven in a simulated automated car. Concurrently, they performed a task with two levels of cognitive load: repeat a noun or generate a verb that expresses the use of this noun. Every noun was followed by a probe stimulus to elicit a neurophysiological response: the frontal P3 (fP3), which is a known indicator for the level of auditory susceptibility. Results The fP3 was significantly lower during automated driving with cognitive load compared with without. The difficulty level of the cognitive task (repeat or generate) showed no effect. Conclusion Engaging in other tasks during automated driving decreases auditory susceptibility as indicated by a reduced fP3. Application Nondriving task can create additional cognitive load. Our study shows that performing such tasks during automated driving reduces the susceptibility for auditory alerts. This can inform designers of semi-automated vehicles (SAE levels 3 and 4), where human intervention might be needed

Predictors of survival in progressive supranuclear palsy and multiple system atrophy: a systematic review and meta-analysis

Objective To undertake a systematic review and meta-analysis of studies that investigated prognostic factors and survival in patients with progressive supranuclear palsy (PSP) and multiple system atrophy (MSA). Methods Publications of at least 10 patients with a likely or confirmed diagnosis of PSP or MSA were eligible for inclusion. Methodological quality was rated using a modified version of the Quality in Prognostic Studies tool. For frequently examined prognostic factors, HRs derived by univariate and multivariate analysis were pooled in separate subgroups; other results were synthesised narratively and HRs could not be reported here. Results Thirty-seven studies presenting findings on 6193 patients (1911 PSP, 4282 MSA) fulfilled the inclusion criteria. We identified the following variables as unfavourable predictors of survival. In PSP, PSP-Richardson’s phenotype (univariate HR 2.53; 95% CI 1.69 to 3.78), early dysphagia and early cognitive symptoms. In MSA, severe dysautonomia and early development of combined autonomic and motor features but not MSA phenotype (multivariate HR 1.22; 95% CI 0.83 to 1.80). In PSP and MSA, survival was predicted by early falls (multivariate HR 2.32; 95% CI 1.94 to 2.77), the Neuroprotection and Natural History in Parkinson Plus Syndromes Parkinson Plus Score and the Clinical Global Impression Disease Severity Score but not sex (multivariate HR 0.93; 95% CI 0.67 to 1.28). There was conflicting evidence regarding the prognostic effect of age at onset and stridor. Conclusion Several clinical variables were strongly associated with shorter survival in PSP and MSA. Results on most prognostic factors were consistent across methodologically diverse studies; however, the lack of commonality of prognostic factors investigated is a significant limitation

Children with cerebral palsy exhibit greater and more regular postural sway than typically developing children

Following recent advances in the analysis of centre-of-pressure (COP) recordings, we examined the structure of COP trajectories in ten children (nine in the analyses) with cerebral palsy (CP) and nine typically developing (TD) children while standing quietly with eyes open (EO) and eyes closed (EC) and with concurrent visual COP feedback (FB). In particular, we quantified COP trajectories in terms of both the amount and regularity of sway. We hypothesised that: (1) compared to TD children, CP children exhibit a greater amount of sway and more regular sway and (2) concurrent visual feedback (creating an external functional context for postural control, inducing a more external focus of attention) decreases both the amount of sway and sway regularity in TD and CP children alike, while closing the eyes has opposite effects. The data were largely in agreement with both hypotheses. Compared to TD children, the amount of sway tended to be larger in CP children, while sway was more regular. Furthermore, the presence of concurrent visual feedback resulted in less regular sway compared to the EO and EC conditions. This effect was less pronounced in the CP group where posturograms were most regular in the EO condition rather than in the EC condition, as in the control group. Nonetheless, we concluded that CP children might benefit from therapies involving postural tasks with an external functional context for postural control

Regularity of center-of-pressure trajectories depends on the amount of attention invested in postural control

The influence of attention on the dynamical structure of postural sway was examined in 30 healthy young adults by manipulating the focus of attention. In line with the proposed direct relation between the amount of attention invested in postural control and regularity of center-of-pressure (COP) time series, we hypothesized that: (1) increasing cognitive involvement in postural control (i.e., creating an internal focus by increasing task difficulty through visual deprivation) increases COP regularity, and (2) withdrawing attention from postural control (i.e., creating an external focus by performing a cognitive dual task) decreases COP regularity. We quantified COP dynamics in terms of sample entropy (regularity), standard deviation (variability), sway-path length of the normalized posturogram (curviness), largest Lyapunov exponent (local stability), correlation dimension (dimensionality) and scaling exponent (scaling behavior). Consistent with hypothesis 1, standing with eyes closed significantly increased COP regularity. Furthermore, variability increased and local stability decreased, implying ineffective postural control. Conversely, and in line with hypothesis 2, performing a cognitive dual task while standing with eyes closed led to greater irregularity and smaller variability, suggesting an increase in the “efficiency, or “automaticity” of postural control”. In conclusion, these findings not only indicate that regularity of COP trajectories is positively related to the amount of attention invested in postural control, but also substantiate that in certain situations an increased internal focus may in fact be detrimental to postural control

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570