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Fun as a strategic advantage: applying lessons in engagement from commercial games to military logistics training

Summary

Digital games offer many elements to augment traditional classroom lectures and reading assignments. They enable players to explore concepts through repeat play in a low-risk environment, and allow players to integrate feedback given during gameplay and evaluate their own performance. Commercial games leverage a number of features to engage players and hold their attention. But do those engagement-improving methods have a place in instructional environments with a captive and motivated audience? Our experience building a logistics supply chain training game for the Marine Corps University suggests that yes; applying lessons in engagement from commercial games can both help improve player experience with the learning environment, and potentially improve learning outcomes.
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Summary

Digital games offer many elements to augment traditional classroom lectures and reading assignments. They enable players to explore concepts through repeat play in a low-risk environment, and allow players to integrate feedback given during gameplay and evaluate their own performance. Commercial games leverage a number of features to engage players...

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COVID-19 exposure notification in simulated real-world environments

Summary

Privacy-preserving contact tracing mobile applications, such as those that use the Google-Apple Exposure Notification (GAEN) service, have the potential to limit the spread of COVID-19 in communities, but the privacy-preserving aspects of the protocol make it difficult to assess the performance of the apps in real-world populations. To address this gap, we exercised the CovidWatch app on both Android and iOS phones in a variety of scripted realworld scenarios, relevant to the lives of university students and employees. We collected exposure data from the app and from the lower-level Android service, and compared it to the phones' actual distances and durations of exposure, to assess the sensitivity and specificity of the GAEN service configuration as of February 2021. Based on the app's reported ExposureWindows and alerting thresholds for Low and High alerts, our assessment is that the chosen configuration is highly sensitive under a range of realistic scenarios and conditions. With this configuration, the app is likely to capture many long-duration encounters, even at distances greater than six feet, which may be desirable under conditions with increased risk of airborne transmission.
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Summary

Privacy-preserving contact tracing mobile applications, such as those that use the Google-Apple Exposure Notification (GAEN) service, have the potential to limit the spread of COVID-19 in communities, but the privacy-preserving aspects of the protocol make it difficult to assess the performance of the apps in real-world populations. To address this...

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The Simulation of Automated Exposure Notification (SimAEN) Model

Summary

Automated Exposure Notication (AEN) was implemented in 2020 to supplement traditional contact tracing for COVID-19 by estimating "too close for too long" proximities of people using the service. AEN uses Bluetooth messages to privately label and recall proximity events, so that persons who were likely exposed to SARS-CoV-2 can take the appropriate steps recommended by their health care authority. This paper describes an agent-based model that estimates the effects of AEN deployment on COVID-19 caseloads and public health workloads in the context of other critical public health measures available during the COVID-19 pandemic. We selected simulation variables pertinent to AEN deployment options, varied them in accord with the system dynamics available in 2020-2021, and calculated the outcomes of key metrics across repeated runs of the stochastic multi-week simulation. SimAEN's parameters were set to ranges of observed values in consultation with public health professionals and the rapidly accumulating literature on COVID-19 transmission; the model was validated against available population-level disease metrics. Estimates from SimAEN can help public health officials determine what AEN deployment decisions (e.g., configuration, workflow integration, and targeted adoption levels) can be most effective in their jurisdiction, in combination with other COVID-19 interventions (e.g., mask use, vaccination, quarantine and isolation periods).
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Summary

Automated Exposure Notication (AEN) was implemented in 2020 to supplement traditional contact tracing for COVID-19 by estimating "too close for too long" proximities of people using the service. AEN uses Bluetooth messages to privately label and recall proximity events, so that persons who were likely exposed to SARS-CoV-2 can take...

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Bluetooth Low Energy (BLE) Data Collection for COVID-19 Exposure Notification

Summary

Privacy-preserving contact tracing mobile applications, such as those that use the Google-Apple Exposure Notification (GAEN) service, have the potential to limit the spread of COVID-19 in communities; however, the privacy-preserving aspects of the protocol make it difficult to assess the performance of the Bluetooth proximity detector in real-world populations. The GAEN service configuration of weights and thresholds enables hundreds of thousands of potential configurations, and it is not well known how the detector performance of candidate GAEN configurations maps to the actual "too close for too long" standard used by public health contact tracing staff. To address this gap, we exercised a GAEN app on Android phones at a range of distances, orientations, and placement configurations (e.g., shirt pocket, bag, in hand), using RF-analogous robotic substitutes for human participants. We recorded exposure data from the app and from the lower-level Android service, along with the phones' actual distances and durations of exposure.
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Summary

Privacy-preserving contact tracing mobile applications, such as those that use the Google-Apple Exposure Notification (GAEN) service, have the potential to limit the spread of COVID-19 in communities; however, the privacy-preserving aspects of the protocol make it difficult to assess the performance of the Bluetooth proximity detector in real-world populations. The...

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Alternative cue and response modalities maintain the Simon effect but impact task performance

Published in:
Appl. Ergon., Vol. 100, 2022, 103648.

Summary

Inhibitory control, the ability to inhibit impulsive responses and irrelevant stimuli, enables high level functioning and activities of daily living. The Simon task probes inhibition using interfering stimuli, i.e., cues spatially presented on the opposite side of the indicated response; incongruent response times (RT) are slower than congruent RTs. Operational applicability of the Simon task beyond finger/hand manipulations and visual/auditory cues is unclear, but important to consider as new technologies provide tactile cues and require motor responses from the lower extremity (e.g., exoskeletons). In this study, twenty participants completed the Simon task under four conditions, each combination of two cue (visual/tactile) and response (upper/lower-extremity) modalities. RT were significantly longer for incongruent than congruent cues across cue-response pairs. However, alternative cue-response pairs yielded slower RT and decreased accuracy for tactile cues and lower extremity responses. Results support operational usage of the Simon task to probe inhibition using tactile cues and lower-extremity responses relevant for new technologies like exoskeletons and immersive environments.
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Summary

Inhibitory control, the ability to inhibit impulsive responses and irrelevant stimuli, enables high level functioning and activities of daily living. The Simon task probes inhibition using interfering stimuli, i.e., cues spatially presented on the opposite side of the indicated response; incongruent response times (RT) are slower than congruent RTs. Operational...

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Individuals differ in muscle activation patterns during early adaptation to a powered ankle exoskeleton

Published in:
Applied Ergonomics Volume 98, January 2022, 103593

Summary

Exoskeletons have the potential to assist users and augment physical ability. To achieve these goals across users, individual variation in muscle activation patterns when using an exoskeleton need to be evaluated. This study examined individual muscle activation patterns during walking with a powered ankle exoskeleton. 60% of the participants were observed to reduce medial gastrocnemius activation with exoskeleton powered and increase with the exoskeleton unpowered during stance. 80% of the participants showed a significant increase in tibialis anterior activation upon power addition, with inconsistent changes upon power removal during swing. 60% of the participants that were able to adapt to the system, did not de-adapt after 5 min. Muscle activity patterns differ between individuals in response to the exoskeleton power state, and affected the antagonist muscle behavior during this early adaptation. It is important to understand these different individual behaviors to inform the design of exoskeleton controllers and training protocols.
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Summary

Exoskeletons have the potential to assist users and augment physical ability. To achieve these goals across users, individual variation in muscle activation patterns when using an exoskeleton need to be evaluated. This study examined individual muscle activation patterns during walking with a powered ankle exoskeleton. 60% of the participants were...

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AI-enabled, ultrasound-guided handheld robotic device for femoral vascular access

Summary

Hemorrhage is a leading cause of trauma death, particularly in prehospital environments when evacuation is delayed. Obtaining central vascular access to a deep artery or vein is important for administration of emergency drugs and analgesics, and rapid replacement of blood volume, as well as invasive sensing and emerging life-saving interventions. However, central access is normally performed by highly experienced critical care physicians in a hospital setting. We developed a handheld AI-enabled interventional device, AI-GUIDE (Artificial Intelligence Guided Ultrasound Interventional Device), capable of directing users with no ultrasound or interventional expertise to catheterize a deep blood vessel, with an initial focus on the femoral vein. AI-GUIDE integrates with widely available commercial portable ultrasound systems and guides a user in ultrasound probe localization, venous puncture-point localization, and needle insertion. The system performs vascular puncture robotically and incorporates a preloaded guidewire to facilitate the Seldinger technique of catheter insertion. Results from tissue-mimicking phantom and porcine studies under normotensive and hypotensive conditions provide evidence of the technique's robustness, with key performance metrics in a live porcine model including: a mean time to acquire femoral vein insertion point of 53 plus or minus 36 s (5 users with varying experience, in 20 trials), a total time to insert catheter of 80 plus or minus 30 s (1 user, in 6 trials), and a mean number of 1.1 (normotensive, 39 trials) and 1.3 (hypotensive, 55 trials) needle insertion attempts (1 user). These performance metrics in a porcine model are consistent with those for experienced medical providers performing central vascular access on humans in a hospital.
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Summary

Hemorrhage is a leading cause of trauma death, particularly in prehospital environments when evacuation is delayed. Obtaining central vascular access to a deep artery or vein is important for administration of emergency drugs and analgesics, and rapid replacement of blood volume, as well as invasive sensing and emerging life-saving interventions...

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Relationships between cognitive factors and gait strategy during exoskeleton-augmented walking

Published in:
Proc. Human Factors and Ergonomics Society Annual Mtg, HFES, Vol. 65, No. 1, 2021.

Summary

Individual variation in exoskeleton-augmented gait strategy may arise from differences in cognitive factors, e.g., ability to respond quickly to stimuli or complete tasks under divided attention. Gait strategy is defined as different approaches to achieving gait priorities (e.g., walking without falling) and is observed via changes in gait characteristics like normalized stride length or width. Changes indicate shifting priorities like increasing stability or coordination with an exoskeleton. Relationships between cognitive factors and exoskeleton gait characteristics were assessed. Cognitive factors were quantified using a modified Simon task and a speed achievement task on a self-paced treadmill with and without a secondary go/no-go task. Individuals with faster reaction times and decreased ability to maintain a given speed tended to prioritize coordination with an exoskeleton over gait stability. These correlations indicate relationships between cognitive factors and individual exoskeleton-augmented gait strategy that should be further investigated to understand variation in exoskeleton use.
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Summary

Individual variation in exoskeleton-augmented gait strategy may arise from differences in cognitive factors, e.g., ability to respond quickly to stimuli or complete tasks under divided attention. Gait strategy is defined as different approaches to achieving gait priorities (e.g., walking without falling) and is observed via changes in gait characteristics like...

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Utility of inter-subject transfer learning for wearable-sensor-based joint torque prediction models

Published in:
43rd Annual Intl. Conf. of the IEEE Engineering in Medicine & Biology, 31 October 2021-4 November 2021.

Summary

Generalizability between individuals and groups is often a significant hurdle in model development for human subjects research. In the domain of wearable-sensor-controlled exoskeleton devices, the ability to generalize models across subjects or fine-tune more general models to individual subjects is key to enabling widespread adoption of these technologies. Transfer learning techniques applied to machine learning models afford the ability to apply and investigate the viability and utility such knowledge-transfer scenarios. This paper investigates the utility of single- and multi-subject based parameter transfer on LSTM models trained for "sensor-to-joint torque" prediction tasks, with regards to task performance and computational resources required for network training. We find that parameter transfer between both single- and multi-subject models provide useful knowledge transfer, with varying results across specific "source" and "target" subject pairings. This could be leveraged to lower model training time or computational cost in compute-constrained environments or, with further study to understand causal factors of the observed variance in performance across source and target pairings, to minimize data collection and model retraining requirements to select and personalize a generic model for personalized wearable-sensor-based joint torque prediction technologies.
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Summary

Generalizability between individuals and groups is often a significant hurdle in model development for human subjects research. In the domain of wearable-sensor-controlled exoskeleton devices, the ability to generalize models across subjects or fine-tune more general models to individual subjects is key to enabling widespread adoption of these technologies. Transfer learning...

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Metrics for quantifying cognitive factors that may underlie individual variation in exoskeleton use

Published in:
Proc. of the Human Factors and Ergonomics Society Annual Meeting, Vol. 65, No. 1, 2021, pp. 216-20.

Summary

Individual differences in adaptation to exoskeletons have been observed, but are not well understood. Kinematic, kinetic, and physiologic factors are commonly used to assess these systems. Parameters from experimental psychology and gait literature wereadapted to probe the lower extremity perception-cognition-action loop using measures of reaction times, gait task performance, and gait strategy. Parameters were measured in 15 subjects via two tasks: (1) a modified Simon task and (2) a speed-achievement task with secondary go/no-go cues on a self-paced treadmill. Outcome metrics were assessed for significantly different intra- versus inter-subject variability. Reaction time measures from the modified Simon task, as well two speed-achievement metrics and one gait-strategy characteristic were found to show significant differences in intra- versus inter-subject variability. These results suggest that select cognitive factors may differentiate between individuals and be potential predictors for individual variation during exoskeleton system operation.
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Summary

Individual differences in adaptation to exoskeletons have been observed, but are not well understood. Kinematic, kinetic, and physiologic factors are commonly used to assess these systems. Parameters from experimental psychology and gait literature wereadapted to probe the lower extremity perception-cognition-action loop using measures of reaction times, gait task performance, and...

READ MORE