A Study of Pharmacist-Patient Communication: Examining Optimal Distance and Angle Using an Eye-Tracking System

This study focuses on seating arrangement and interpersonal distance as important aspects of nonverbal communication and aims to elucidate the optimal distance and angle between pharmacist and patient through an analysis based on the subjective evaluation of the patient and the objective evaluation of eye movements. Seven female simulated patients and one male and one female pharmacist cooperated as patients and pharmacists, respectively. The medication teaching scenes were set up with three pharmacist placements (face-to-face at 50 cm and 70 cm, 90-degree at 70 cm) and three hospital rooms (0-degree, 45-degree, 90-degree). Pupil diameter, blink rate, saccades, and fixation rate of the patient at each of these locations were measured using a Tobii Pro Glass 2. The patient’s subjective evaluation at each placement was also investigated using the conversation scale, which assesses the optimal distance for conversation. The results for the pharmacy setting revealed that pupils were significantly more mydriatic at the 50 cm point than at the other points. The results for the hospital room setting showed the greatest mydriasis at the 0-degree point. The result of the 50 cm point for the pharmacy setting and the 0-degree point for the hospital room setting was similar to that of the subjective evaluation. When the likelihood of saccades occurrence in the hospital room setting was compared, saccades were found to be most likely to occur when medication instructions were given to patients at the 0-degree point. We believe that using pupil diameter for interpersonal distance, and saccades for angle will enable more accurate determinations of the optimal distance and angle between pharmacist and patient. The results of the present study suggest that the 70 cm face-to-face point in the pharmacy and the 45-degree point in the ward may be suitable for medication instruction.

Psychophysiological Effects of Zembrin®Using Quantitative EEG Source Density in Combination with Eye-Tracking in 60 Healthy Subjects. A Double-Blind, Randomized, Placebo-Controlled, 3-Armed Study with Parallel Design

The endemic South African succulent plant Sceletium tortuosum (L.) N.E. Br., family Mesembryathemaceae, is known as kanna in Nama, kougoed in Afrikaans, and sceletium in English. The plant has been used as a tea and as a masticatory for millennia by indigenous San hunter-gatherers and Nama pastoralists for endurance and well-being. It has been reported that the plant “gives strength to their limbs, and takes away pain, and makes their memory strong”. The current investigation aimed at the psychophysiological characterization of 25.0 and 50.0 mg of a special extract marketed as Zembrin® in comparison to placebo using a new methodology called “EnkephaloVision”. This combination of EEG Neurocode-Tracking and Eye-Tracking allows for concomitant analysis of time epochs of only 364 ms duration. Spectral EEG analysis during cognitive and emotional challenges revealed statistically significant increases of delta (p < 0.01 during arithmetic calculation and watching a boring animal video) and theta spectral power (p < 0.10 during these same challenges) in the presence of Zembrin® within the frontal brain. It is these same increases of slow waves in the frontal brain that are described in the literature during performance of mental tests. This indicates a positive effect of Zembrin® on the electrical activity of the brain during cognitive processing. In addition, alpha1 and alpha2 spectral power in the frontal brain was increased during several challenges including brain teasing, arithmetic calculations and performance of a memory test. From the literature, increases of spectral alpha1 power indicate a greater degree of calmness and may represent decreased depressive symptoms, while increases in alpha2 waves have been related to memory. Beta2 waves increased during mental performance in the presence of the higher dosage of Zembrin® in parietal, occipital and temporal brain regions. In comparison to placebo, Zembrin® induced frequency changes in the brain, which have been related to enhanced attention and memory. These results may represent a positive action of Zembrin® on cognitive and emotional processes in the brain.

Immersion Analysis Through Eye-Tracking and Audio in Virtual Reality

In this study,using Head Mounted Display(HMD),which is one of the biggest advantage of Virtual Reality(VR)environment,tracks the user’s gaze in 360◦video content,and examines how the gaze pattern is distributed according to the user’s immersion.As a result of analyzing the gaze pattern distribution of contents with high user immersion and contents with low user immersion through a questionnaire,it was confirmed that the higher the immersion,the more the gaze distribution tends to be concentrated in the center of the screen.Through this experiment,we were able to understand the factors that make users immerse themselves in the VR environment,and among them,the importance of the audio of the content was shown.Furthermore,it was found that the shape of the gaze distribution for grasping the degree of immersion by the subject of the content was different.While reviewing the experimental results,we also confirmed the necessity of research to recognize specific objects in a VR environment.

Quantitative Objective Assessment of Websites by Neurocode-Tracking in Combination with Eye-Tracking

Assessment of websites remains a definite challenge within advertisement research. In order to gather objective information, one possibility exists in using Eye-Tracking. This method allows for determination of where and how long particular areas of a website are fixed. However, longer fixation values do not necessarily reflect higher attention or even memorizing of the content. It could also mean that the content is too complicated. Therefore more information can be obtained by addition of quantitative analysis of brain electricity. Following the changes of the frequency content of electric brain activity has been recently introduced as “Neurocode-Tracking”. In the present study, quantitative assessment of websites has been performed by the combination of Neuro-code-Tracking with Eye-Tracking. Fast dynamic quantitative EEG recording with a time resolution of nearly 3 images/second provided electric power values according to frequency analysis in 17 brain regions (electrode positions). Particular values represented changes of electric brain activity, which were interpreted to represent visual perception, mental activation, concentration, stimulation, memory and tension according to earlier experience. Eye-Tracking was performed in a conventional manner by defining special areas of interest for detection of fixation lengths and time to first awareness. Ten male subjects (aged 36 ± 4.4 years) entered the study. They were asked to view Internet landing pages of five bank institutions: ComDirect, DKB, INGDiBa, Postbank and Targo-Bank. According to Eye-Track analysis, ComDirect was recognized to have the shortest time-to-awareness with respect to conditions, bonus, faces and application or address form. With respect to region of interest “service”, INGDiBa showed the shortest time-to-awareness. Neurocode-Tracking provided best results for INGDiBa with respect to mental activation and concentration. Stimulation and memory values were headed by Targo-Bank. Lowest tension was observed by the landing page of the Postbank. In summary, the combination of Neurocode-Tracking and Eye-Tracking provided much more information than any one of the methods used in separate. We therefore recommend this combination for the assessment and optimizing of Internet websites.

Neuromarketing: Neurocode-Tracking in Combination with Eye-Tracking for Quantitative Objective Assessment of TV Commercials

The term “neuromarketing” suggests a combination of marketing research and brain research. Within marketing research, objective assessment of TV commercials is performed by use of Eye-Tracking devices. Brain research has been dominated by NMRI technologies during the last years. However, information content and time resolution are much better when monitoring electric activity by spectral analysis. The current experimental approach was initiated in order to test the combination of a newly developed EEG technology (Neurocode-Tracking) with commercially available Eye-Tracking. Ten male subjects were exposed to a reference recording condition (watching a fixed cross on the screen) followed by 5 TV commercials representing 5 different banks. Video films obtained from Eye-Tracking (so-called heat maps) were synchronized with the results of Neurocode-Tracking in form of a second video with a time resolution of 364 ms per image. Spectral power analysis of the EEG in different brain regions allowed for assessment of single scenes for cognitive and emotional responses. Averaging of data over the whole time course gave information on mental activation, attention, visual perception, memory, pleasure and tension. Comparison of the 5 commercials to reference recording revealed the clip of the Targo-Bank having the highest values with respect to mental activation and attention.These experiments have proven that the combination of Neurocode-Tracking with Eye-Tracking can be successfully used in advertisement research and gives valid information on individual as well as group dependent cognitive and emotional responses leading to objective assessment of TV commercials.

Increasing Pupil Size Is Associated with Increasing Cognitive Processing Demands: A Pilot Study Using a Mobile Eye-Tracking Device

Previous studies have shown that increases in pupil size are correlated with increasing cognitive processing demands. Our aim was to confirm whether these findings could be replicated with new portable and less obtrusive eye-tracking technology. We assessed the percentage change of pupillary diameter from baseline as eight subjects completed a series of randomly ordered arithmetic problems of varying difficulty. The mean peak pupil diameter expressed as a percentage change from baseline was significantly greater when answering difficult questions compared to easier questions. Moreover, the time to reach peak pupillary diameter occurred significantly faster when participants answered easier questions compared to more difficult questions. Finally, there was a significant difference when all groups were compared to control. This experiment confirms findings of previous studies that show that pupillary size is related to cognitive processing demands. It also demonstrates that mobile eye-trackers can be used to reliably gather this type of data. Furthermore, this experiment provides the basis for future studies using eye-tracking technology in new environments, for example in the study of expertise and performance in medical crisis situations.

A Critique of Eye-Tracking Approach in Translation Process Research

With the rapid growth of eye-tracking studies in translation process research, concomitant methodologicalproblems have become increasingly prominent. This paper starts with the discussion of the controversial “eye-mindassumption”, and then focuses on various threats to experimental validity in research design and problems witheye-tracking data filtering and analysis. It is hoped that this discussion would be beneficial to those who are now orwill be engaged in eye-tracking based translation studies.

Proof of Effectiveness of PASCOFLAIR®in Subjects Suffering from Examination Anxiety Using Quantitative EEG in Combination with Eye-Tracking (EnkephaloVision). A Double-Blind, Randomized, Placebo Controlled, 2-Armed, Phase IV Study in Parallel Design

The pharmaco-dynamic action of plant-derived drugs still remains a big challenge in the field of pharmacology. This applies especially for the discovering of the possible mechanism of action. With respect to the brain, surrogate parameters may be very helpful. Non-invasive pharmaco-EEG has been proven to provide valid information on drug effects in general. Fast dynamic EEG recording with epoch length of 364 ms has now been achieved in combination with Eye-Tracking in order to elucidate single scenes during cognitive and emotional challenges (EnkephaloVision). The present investigation deals with the psychophysiological characterization of the effect of a plant-derived preparation marketed in Germany under the name of PASCOFLAIR® containing 425 mg of passionflower extract in subjects suffering from examination anxiety. Forty healthy volunteer subjects (17 men and 23 woman), with ages varying between 18 and 40 years (26 ± 6.726 for men and 25 ± 5.397 for women) were included into the study when having a score higher than 60 in the PAF (Pr&#220fungsangstfragebogen). Spectral power analysis of pre-drug data with respect to beta waves revealed a significant correlation to the score of the PAF. Increases of delta, theta and beta waves as induced by 4 cognitive and 4 emotional challenges were attenuated in the presence of 2 tablets of PASCOFLAIR® already 45 minutes after intake in a statistically significant manner in comparison to placebo. Regarding attenuation of beta1 and beta2 spectral power, effects on glutamatergic and GABAergic neurotransmission, respectively, can be suspected according to our knowledge of frequency—transmitter relations. Accordingly, this attenuation must be interpreted as ability to counteract examination induced stress symptoms. Results confirm and extend earlier experimental data showing a calming action of PASCOFLAIR®.

Revisiting processing time for metaphorical expressions： An eye-tracking study on eye-voice span during sight translation

This paper aims to investigate the eye-voice span (EVS), the distance between eyeandvoice,insighttranslatingmetaphoricalexpressions(MEs).24MAtranslation students, with no professional translation or interpreting experience, were asked to conduct a sight translation (STR) task, and the processes were registered by eye-tracker and audio recorder. The qualified eye-tracking and audio data were further analysed by Tobii Studio and Audacity audio processing software. Our findings suggest that the time of the pause preceding an ME was largely, but not entirely, spent in processing the ensuing ME. However, due to the general existence of reading ahead activities in STR, the planning step for sight translating an ME takes place prior to the preceding pause; moreover, due to local processing difficulty causedbytheME,thetimeforreadingaheadintoME(temporalEVS)ismostlygreater than for reading ahead beyond ME. Our findings also reveal that the rate of methodological deviation(causedbythetwodifferentcalculationapproaches)forMEprocessingtimeis around10%,butthetwoprocessingtimeshavedemonstratednostatisticallysignificant difference, validating the processing time calculated by audio data in Zheng&Xiang (2013).We conclude this paper with some reservation on eye-tracking translation research:though powerful in providing solid and informative process data, it has some limitations in clearly probing into intricate human cognitive process.

Apparel Brand Overlap Based on Customer Perceived Value and Eye-Tracking Technology

Competition in the apparel market has developed from preliminary price competition, quality competition, and scale competition to the current state of brand competition. The phenomenon of brand overlap cannot be avoided by apparel enterprises during the process of building and manufacturing their brands. This paper has selected nine identification elements of three dimensions, which we used to construct an apparel brand overlap identification model. This model is based on the theories of customer perceived value and brand identity and was constructed by taking consumer perspectives as the starting point. Two apparel brands from the representative international E Company have been selected as our empirical research objects. An apparel brand overlap identification model has been constructed based on questionnaire analysis and a cognitive experiment involving eye-tracking technology. In addition, the overlap elements among apparel brands, as well as the cognitive situation of consumers with regard to brand overlap, have been analyzed.

An Easily Compatible Eye-tracking System for Freely-moving Small Animals

Measuring eye movement is a fundamental approach in cognitive science as it provides a variety of insightful parameters that reflect brain states such as visual attention and emotions.Combining eye-tracking with multimodal neural recordings or manipulation techniques is beneficial for understanding the neural substrates of cognitive function.Many commercially-available and custom-built systems have been widely applied to awake,head-fixed small animals.However,the existing eyetracking systems used in freely-moving animals are still limited in terms of their compatibility with other devices and of the algorithm used to detect eye movements.Here,we report a novel system that integrates a general-purpose,easily compatible eye-tracking hardware with a robust eye feature-detection algorithm.With ultra-light hardware and a detachable design,the system allows for more implants to be added to the animal's exposed head and has a precise synchronization module to coordinate with other neural implants.Moreover,we systematically compared the performance of existing commonly-used pupil-detection approaches,and demonstrated that the proposed adaptive pupil feature-detection algorithm allows the analysis of more complex and dynamic eye-tracking data in freemoving animals.Synchronized eye-tracking and electroencephalogram recordings,as well as algorithm validation under five noise conditions,suggested that our system is flexibly adaptable and can be combined with a wide range of neural manipulation and recording technologies.

EDVAM:a 3D eye-tracking dataset for visual attention modeling in a virtual museum

Predicting visual attention facilitates an adaptive virtual museum environment and provides a context-aware and interactive user experience.Explorations toward development of a visual attention mechanism using eye-tracking data have so far been limited to 2D cases,and researchers are yet to approach this topic in a 3D virtual environment and from a spatiotemporal perspective.We present the first 3D Eye-tracking Dataset for Visual Attention modeling in a virtual Museum,known as the EDVAM.In addition,a deep learning model is devised and tested with the EDVAM to predict a user’s subsequent visual attention from previous eye movements.This work provides a reference for visual attention modeling and context-aware interaction in the context of virtual museums.

Eye-tracking analysis in interactive information retrieval

Eye-tracking was first used in the study of reading behavior,and with the development of this technology,it has been widely used in psychology,medicine,advertising,human-computer interaction and other fields.At present,the application of eye-tracking technology in the field of information retrieval is also a frontier topic.Interactive Information Retrieval(IIR)has a strong interdisciplinary nature.

Segmented trust assessment in autonomous vehicles via eye-tracking

Previous studies have identified trust as one of the key factors in the technology acceptance of autonomousvehicles. As these studies mostly investigated the population in general, little is known about segment-specific differences.Furthermore, the widely used survey methods are less able to capture the deeper forms of trust—which neuroscientificmethods are much better suited to capture. The main objective of our research is to study trust as one of the key factors oftechnology acceptance related to autonomous vehicles by using neuroscientific methods for specific consumer segments.Real-time eye-tracking tests were applied to a sample of 113 participants, combined with a posttest self-report. The testswere carried out under laboratory conditions during which our subjects watched videos recorded with the internal camerasof autonomous vehicles. Based on the fixation count, total fixation duration, and pupil dilation, we empirically verified thatthe trust level of all five identified segments is relatively low, while the trust level of the “traditional rejecting” segment is thelowest. An increase in trust level can be shown if the subjects receive extra information about the journey. Anotherimportant finding is that the self-reported trust level is not always congruent with the eye-tracking analysis results;therefore,combined approaches can lead to greater measurement validity.

Quantitative Analysis of Nursing Observation Employing a Portable Eye-Tracker

Background: Observation is an important skill for making appropriate nursing decisions and engaging in good practice. However, experts’ observation behavior and cognitive processes cannot be easily verbalized or documented in an objective and accurate manner. Quantitative analysis of the observation behavior of nurses with rich clinical experience will yield effective educational data for fostering and improving nursing students’ observation skills. Objectives: To improve nursing assessment education, the differences in the information gathering processes between clinical nurses and nursing students were analyzed by using a portable eye-tracker. Design: An experimental study. Settings: The experiment was performed at a university in Japan. Participants: The participants were 11 clinical nurses with at least 5 years of clinical experience for postoperative patients, and 10 fourth-year nursing students. Methods: In a mock hospital room, wherein we recreated a situation where a patient in postoperative day 1 was confined to a bed, participants wore an eye-tracking camera and engaged in nursing observation to make an early postoperative ambulation assessment of the patient. Participants’ gaze points and gaze fixation durations were extracted from the gaze measurement data and compared. Results: Clinical nurses had shorter observation times and gaze durations than did nursing students, and focused more on the patient chart, intravenous drip, and indwelling drain. Students gazed for longest at the measuring devices for vital signs. Conclusions: We quantitatively analyzed differences in nursing observation according to clinical experience. Although no significant difference was found in gaze points, nursing students had a greater tendency to focus on information that was numerically displayed. Nurses with clinical experience conducted observations by gazing at information that they needed to focus on the most according to the patients’ postoperative course.

Probing the processing of facial expressions in monkeys via time perception and eye tracking

Accurately recognizing facial expressions is essential for effective social interactions.Non-human primates(NHPs)are widely used in the study of the neural mechanisms underpinning facial expression processing,yet it remains unclear how well monkeys can recognize the facial expressions of other species such as humans.In this study,we systematically investigated how monkeys process the facial expressions of conspecifics and humans using eye-tracking technology and sophisticated behavioral tasks,namely the temporal discrimination task(TDT)and face scan task(FST).We found that monkeys showed prolonged subjective time perception in response to Negative facial expressions in monkeys while showing longer reaction time to Negative facial expressions in humans.Monkey faces also reliably induced divergent pupil contraction in response to different expressions,while human faces and scrambled monkey faces did not.Furthermore,viewing patterns in the FST indicated that monkeys only showed bias toward emotional expressions upon observing monkey faces.Finally,masking the eye region marginally decreased the viewing duration for monkey faces but not for human faces.By probing facial expression processing in monkeys,our study demonstrates that monkeys are more sensitive to the facial expressions of conspecifics than those of humans,thus shedding new light on inter-species communication through facial expressions between NHPs and humans.

Machine learning models for stroke detection by observing the eye-movement features under five-color visual stimuli in traditional Chinese medicine

Objective:To develop a novel diagnostic modality to identify and diagnose stroke in daily life scenarios for improving the therapeutic effects and prognoses of patients.Methods:In this study,16 stroke patients and 24 age-matched healthy participants as controls were recruited for comparative analysis.Leveraging a portable eye-tracking device and integrating traditional Chinese medicine theory with modern color psychology principles,we recorded the eye movement signals and calculated eye movement features.Meanwhile,the stroke recognition models based on eye movement features were further trained by using random forest(RF),k-nearest neighbors(KNN),decision tree(DT),gradient boosting classifier(GBC),XGBoost,and CatBoost.Results:The stroke group and the healthy group showed significant differences in some eye movement features(P<.05).The models trained based on eye movement characteristics had good performances in recognizing stroke individuals,with accuracies ranging from 77.40%to 88.45%.Under the red stimulus,the eye movement model trained by RF became the best machine learning model with a recall of 84.65%,a precision of 86.48%,a F1 score of 85.47%.Among the six algorithms,RF and CatBoost performed better in classification.Conclusion:This study pioneers the application of traditional Chinese medicine's five-color stimuli to visual observation tasks.On the basis of the combined design,the eye-movement models can accurately identify stroke,and the developed high-performance models may be used in daily life scenarios.

Gazing through the bubble:an experimental investigation into financial risk‑taking using eye‑tracking

Eye tracking can facilitate understanding irrational decision-making in contexts such as financial risk-taking.For this purpose,we develop an experimental framework in which participants trade a risky asset in a simulated bubble market to maximize individual returns while their eye movements are recorded.Returns are sensitive to eye movement dynamics,depending on the presented visual stimuli.Using eye-tracking data,we investigated the effects of arousal,attention,and disengagement on individual payoffs using linear and nonlinear approaches.By estimating a nonlinear model using attention as a threshold variable,our results suggest that arousal positively influences trading returns,but its effect becomes smaller when attention exceeds a certain threshold,whereas disengagement has a higher negative impact on reduced attention levels and becomes almost irrelevant when attention increases.Hence,we provide a neurobehavioral metric as a function of attention that predicts financial gains in boomand-bust scenarios.This study serves as a proof-of-concept for developing future psychometric measures to enhance decision-making.

Studying gaze abnormalities in autism: Which type of stimulus to use?

Background: Eye-tracking has been used to investigate social perception in autism spectrum disorder (ASD) with variable results. This heterogeneity may be due to the types of stimuli used. In this study, we investigated whether the use of moving vs static stimuli or human actors vs cartoons characters would be more sensitive in detecting gaze abnormalities and discriminating children with ASD from typically developing children. Methods: We studied 18 children with ASD (mean age = 12.9 ± 2.9) and 21 typically developing controls (mean age = 11.3 ± 2.5). Gazes were tracked using Tobii-T120 eye-tracker. Four different types of stimuli were presented: movie with human actors, cartoon movie, picture with human actors and cartoon picture. To identify the type of stimuli that best discriminate the ASD group from the control group, a two-way ANOVA was performed using ecological dimension [human-actors/cartoon] and presentation form [movie/picture] as factors. Results: Children with ASD presented significantly less fixations to eyes and faces in the movie with human actors and in the picture with human actors. Children with ASD also presented significantly more fixations to non-social backgrounds in the movie with human actors and in the cartoon movie. A significant ecological effect was observed for the reduction in fixations to the eyes [human-actors > cartoon]. A significant presentation form effect was observed for the increased fixations to the non-social background [movie > picture]. Conclusions: The direct comparison of gaze behavior across four different types of stimuli demonstrates that gaze abnormalities in ASD depend on the type of stimuli that is used. Our results suggest that general gaze abnormalities in children with ASD are better detected when using dynamic stimuli, and finer details of these abnormalities, especially looking less to the eyes, are better detected in a more ecologically relevant situation presenting human characters.

EnkephaloVision: Anatomical Functionality Indicated by Ultrashort Transient Regional EEG Spectral Power Changes during Cognitive and Emotional Challenges

Anatomical functionality is a major topic in brain research. Numerous investigations have shown task dependent activation of focal brain areas, with most information based on time-averaged data due to methodological limitations. Ultra-fast quantitative EEG, especially in the newly developed combination with eye tracking (EnkephaloVision), is very suitable to follow activities of local electric circuits. This investigation in 57 subjects revealed transient focal frequency changes reaching up to more than 6000% of global median spectra power during cognitive and emotional challenges at frontal electrode positions. Recording epochs of 364 ms uncovered coherences with respect to focal brain areas and single frequencies, which are typically lost during averaged calculations. When averaging data over a whole scene, a least demanding challenge like viewing a boring animal video only activated the lateral frontal lobe, whereas solving brain-teasers and performance of mathematical calculations led to delta (modulated by acetylcholine) and theta (modulated by norepinephrine) increases in all brain regions in a statistically significant manner. In addition to delta and theta increases, performance of the Stroop test led to beta2 (related to GABA-ergic transmission) increases in the temporal lobe. The higher the mental demand the more brain regions were involved during 10 different challenges. There was no challenge which did not activate the lateral frontal brain in terms of increases of delta and theta spectral power. The results are in line with the view that the lateral frontal lobe is involved primarily during cognitive and emotional behavior related to activity changes of acetylcholine and norepinephrine.