Achieving Accountable Care: Are We on the Right Path?

Based on the Commonwealth Fund Commission on a High Performance Health System's ten recommendations, highlights considerations for the Centers for Medicare and Medicaid Services in finalizing rules for the Shared Savings Program, slated to begin in 2012

The use of graphics in the design of the human-telerobot interface

The Man-Systems Telerobotics Laboratory (MSTL) of NASA's Johnson Space Center employs computer graphics tools in their design and evaluation of the Flight Telerobotic Servicer (FTS) human/telerobot interface on the Shuttle and on the Space Station. It has been determined by the MSTL that the use of computer graphics can promote more expedient and less costly design endeavors. Several specific examples of computer graphics applied to the FTS user interface by the MSTL are described

Investigation of varying gray scale levels for remote manipulation

A study was conducted to investigate the effects of variant monitor gray scale levels and workplace illumination levels on operators' ability to discriminate between different colors on a monochrome monitor. It was determined that 8-gray scale viewing resulted in significantly worse discrimination performance compared to 16- and 32-gray scale viewing and that there was only a negligible difference found between 16 and 32 shades of gray. Therefore, it is recommended that monitors used while performing remote manipulation tasks have 16 or above shades of gray since this evaluation has found levels lower than this to be unacceptable for color discrimination task. There was no significant performance difference found between a high and a low workplace illumination condition. Further analysis was conducted to determine which specific combinations of colors can be used in conjunction with each other to ensure errorfree color coding/brightness discrimination performance while viewing a monochrome monitor. It was found that 92 three-color combination and 9 four-color combinations could be used with 100 percent accuracy. The results can help to determine which gray scale levels should be provided on monochrome monitors as well as which colors to use to ensure the maximal performance of remotely-viewed color discrimination/coding tasks

Telepresence for space: The state of the concept

The purpose here is to examine the concept of telepresence critically. To accomplish this goal, first, the assumptions that underlie telepresence and its applications are examined, and second, the issues raised by that examination are discussed. Also, these assumptions and issues are used as a means of shifting the focus in telepresence from development to user-based research. The most basic assumption of telepresence is that the information being provided to the human must be displayed in a natural fashion, i.e., the information should be displayed to the same human sensory modalities, and in the same fashion, as if the person where actually at the remote site. A further fundamental assumption for the functional use of telepresence is that a sense of being present in the work environment will produce superior performance. In other words, that sense of being there would allow the human operator of a distant machine to take greater advantage of his or her considerable perceptual, cognitive, and motor capabilities in the performance of a task than would more limited task-related feedback. Finally, a third fundamental assumption of functional telepresence is that the distant machine under the operator's control must substantially resemble a human in dexterity

Mach edges: a critical test of the nonlinear 3rd derivative model for edge-detection

Feature detection is a crucial stage of visual processing. In previous feature-marking experiments we found that peaks in the 3rd derivative of the luminance profile can signify edges where there are no 1st derivative peaks nor 2nd derivative zero-crossings (Wallis and George 'Mach edges' (the edges of Mach bands) were nicely predicted by a new nonlinear model based on 3rd derivative filtering. As a critical test of the model, we now use a new class of stimuli, formed by adding a linear luminance ramp to the blurred triangle waves used previously. The ramp has no effect on the second or higher derivatives, but the nonlinear model predicts a shift from seeing two edges to seeing only one edge as the added ramp gradient increases. In experiment 1, subjects judged whether one or two edges were visible on each trial. In experiment 2, subjects used a cursor to mark perceived edges and bars. The position and polarity of the marked edges were close to model predictions. Both experiments produced the predicted shift from two to one Mach edge, but the shift was less complete than predicted. We conclude that the model is a useful predictor of edge perception, but needs some modification

Mach edges: a key role for 3rd derivative filters in spatial vision

Edges are key points of information in visual scenes. One important class of models supposes that edges correspond to the steepest parts of the luminance profile, implying that they can be found as peaks and troughs in the response of a gradient (first-derivative) filter, or as zero-crossings (ZCs) in the second-derivative. A variety of multi-scale models are based on this idea. We tested this approach by devising a stimulus that has no local peaks of gradient and no ZCs, at any scale. Our stimulus profile is analogous to the classic Mach-band stimulus, but it is the local luminance gradient (not the absolute luminance) that increases as a linear ramp between two plateaux. The luminance profile is a smoothed triangle wave and is obtained by integrating the gradient profile. Subjects used a cursor to mark the position and polarity of perceived edges. For all the ramp-widths tested, observers marked edges at or close to the corner points in the gradient profile, even though these were not gradient maxima. These new Mach edges correspond to peaks and troughs in the third-derivative. They are analogous to Mach bands - light and dark bars are seen where there are no luminance peaks but there are peaks in the second derivative. Here, peaks in the third derivative were seen as light-to-dark edges, troughs as dark-to-light edges. Thus Mach edges are inconsistent with many standard edge detectors, but are nicely predicted by a new model that uses a (nonlinear) third-derivative operator to find edge points

Third-derivative filters predict edge locations in spatial vision

Edge detection is crucial in visual processing. Previous computational and psychophysical models have often used peaks in the gradient or zero-crossings in the 2nd derivative to signal edges. We tested these approaches using a stimulus that has no such features. Its luminance profile was a triangle wave, blurred by a rectangular function. Subjects marked the position and polarity of perceived edges. For all blur widths tested, observers marked edges at or near 3rd derivative maxima, even though these were not 1st derivative maxima or 2nd derivative zero-crossings, at any scale. These results are predicted by a new nonlinear model based on 3rd derivative filtering. As a critical test, we added a ramp of variable slope to the blurred triangle-wave luminance profile. The ramp has no effect on the (linear) 2nd or higher derivatives, but the nonlinear model predicts a shift from seeing two edges to seeing one edge as the ramp gradient increases. Results of two experiments confirmed such a shift, thus supporting the new model. [Supported by the Engineering and Physical Sciences Research Council]

Binocular fusion, suppression and diplopia for blurred edges

Purpose: (1) To devise a model-based method for estimating the probabilities of binocular fusion, interocular suppression and diplopia from psychophysical judgements, (2) To map out the way fusion, suppression and diplopia vary with binocular disparity and blur of single edges shown to each eye, (3) To compare the binocular interactions found for edges of the same vs opposite contrast polarity. Methods: Test images were single, horizontal, Gaussian-blurred edges, with blur B = 1-32 min arc, and vertical disparity 0-8.B, shown for 200 ms. In the main experiment, observers reported whether they saw one central edge, one offset edge, or two edges. We argue that the relation between these three response categories and the three perceptual states (fusion, suppression, diplopia) is indirect and likely to be distorted by positional noise and criterion effects, and so we developed a descriptive, probabilistic model to estimate both the perceptual states and the noise/criterion parameters from the data. Results: (1) Using simulated data, we validated the model-based method by showing that it recovered fairly accurately the disparity ranges for fusion and suppression, (2) The disparity range for fusion (Panum's limit) increased greatly with blur, in line with previous studies. The disparity range for suppression was similar to the fusion limit at large blurs, but two or three times the fusion limit at small blurs. This meant that diplopia was much more prevalent at larger blurs, (3) Diplopia was much more frequent when the two edges had opposite contrast polarity. A formal comparison of models indicated that fusion occurs for same, but not opposite, polarities. Probability of suppression was greater for unequal contrasts, and it was always the lower-contrast edge that was suppressed. Conclusions: Our model-based data analysis offers a useful tool for probing binocular fusion and suppression psychophysically. The disparity range for fusion increased with edge blur but fell short of complete scale-invariance. The disparity range for suppression also increased with blur but was not close to scale-invariance. Single vision occurs through fusion, but also beyond the fusion range, through suppression. Thus suppression can serve as a mechanism for extending single vision to larger disparities, but mainly for sharper edges where the fusion range is small (5-10 min arc). For large blurs the fusion range is so much larger that no such extension may be needed