Can e-readers loaded with medical textbooks and other relevant material benefit medical students, residents, and preceptors in clinical settings? The settings are North Carolina community clinics served by Duke University Medical Center and St. Joseph's Hospital in Bryan, Texas, and Scott and White Memorial Hospital in Temple, Texas. DUKE UNIVERSITY: Twenty second-year medical students and fourteen family medicine clerkship preceptors used Kindle e-readers in clinics during eight months of rotations. Students and preceptors provided feedback through an anonymous online survey. Texas A&M University: Nine fourth-year medical students in an elective compared medical textbooks in print, online, and on a Kindle. Six residents at a local hospital completed an anonymous online survey after a three-week loan of a Kindle loaded with medical textbooks. The e-reader's major advantages in clinical settings are portability and searchability. The selected e-reader's limitations include connection speed, navigation, and display. User preferences varied, but online resources were preferred. Participants suggested additional uses for Kindles in medical education. The selected e-reader's limitations may be resolved with further development of the device. Investigation of other e-readers is needed. Criteria for evaluating e-readers in clinical settings should include portability, searchability, speed, navigation, and display. Research comparing e-readers and mobile devices in clinical education is also warranted.
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The digitalisation of literature is proliferating, and the increasing spread of digital reading devices and the availability of digital texts is likely to make books on screen a lasting phenomenon, but little attention has been paid to the consequences of digitalisation for the experience of narrative fiction. While on the one hand, reading literature on a digital reading device might trigger a superficial processing of the text, and problems regarding orientation within the narrative, the awareness of reading a literary text might, on the other hand, lead to more in-depth and complex processing, independent of reading medium. This study examines whether the reading performance and the emotional and cognitive experiences of the reception of a literary text vary between reading a printed book or an e-reader. Using a between-subjects experimental design, 207 participants read the beginning of a novel either in a printed book or on an e-reader. They then completed a reading comprehension test and questionnaires about their cognitive and emotional experiences. Overall, the results do not suggest the clear superiority of either of the two reading media. Neither reading speed nor reading comprehension differed significantly between the two groups. Even though a broad range of reading experiences was measured, neither cognitive nor emotional reading experiences differed significantly between the groups. An e-reader does not affect either reading performance or cognitive and emotional experience of reading a narrative text, compared with a printed book.
The Explorer(®) 2.0 tube test is a microbial inhibition test for the screening of antimicrobial residues in food samples. The new e-Reader(®) device coupled to Explorer(®) 2.0 operates by incubation at a selected temperature, determination of the endpoint of the assay and interpretation to generate results. This system was validated for muscle samples according to the European Commission Decision 2002/657/EC. Sensitivity towards 25 substances from several groups of antimicrobials was investigated in a first step. Detection capabilities for six substances representing the six major antimicrobial groups were also determined in bovine muscle. The detection capabilities for amoxicillin (10 µg l(-1)), cefalexin (200 µg l(-1)), doxycyclin (100 µg l(-1)), sulfamethazine (100 µg l(-1)), tylosin (100 µg l(-1)) and neomycin (200 µg l(-1)) were in all cases at or below the maximum residue limit (MRL). Specificity and applicability of the test were demonstrated with muscle samples from four animal species (bovine, porcine, ovine and poultry) and results were found to be satisfactory. Ruggedness was evaluated on negative and spiked samples with sulfamethazine as a representative antimicrobial. Neither false-positives nor false-negatives were detected when varying the sample volume, the time of pre-incubation, the temperature of incubation and the batch of the test. These results prove that Explorer(®) 2.0 coupled to e-Reader(®) is a valuable tool for the screening of a broad range of antimicrobials in muscle. This new methodology simplifies the analysis and increases the accuracy of interpretation of the test results since the endpoint of the assay is automatically determined and results are interpreted objectively.
E-readers are fast rivaling print as a dominant method for reading. Because they offer accessibility options that are impossible in print, they are potentially beneficial for those with impairments, such as dyslexia. Yet, little is known about how the use of these devices influences reading in those who struggle. Here, we observe reading comprehension and speed in 103 high school students with dyslexia. Reading on paper was compared with reading on a small handheld e-reader device, formatted to display few words per line. We found that use of the device significantly improved speed and comprehension, when compared with traditional presentations on paper for specific subsets of these individuals: Those who struggled most with phoneme decoding or efficient sight word reading read more rapidly using the device, and those with limited VA Spans gained in comprehension. Prior eye tracking studies demonstrated that short lines facilitate reading in dyslexia, suggesting that it is the use of short lines (and not the device per se) that leads to the observed benefits. We propose that these findings may be understood as a consequence of visual attention deficits, in some with dyslexia, that make it difficult to allocate attention to uncrowded text near fixation, as the gaze advances during reading. Short lines ameliorate this by guiding attention to the uncrowded span.
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Consumer electronic devices such as smartphones, tablet computers, and e-book readers have become far more widely used in recent years. Many of these devices contain accessibility features such as large print and speech. Anecdotal experience suggests people with vision impairment frequently make use of these systems. Here we survey people with self-identified vision impairment to determine their use of this equipment. An internet-based survey was advertised to people with vision impairment by word of mouth, social media, and online. Respondents were asked demographic information, what devices they owned, what they used these devices for, and what accessibility features they used. One hundred and thirty-two complete responses were received. Twenty-six percent of the sample reported that they had no vision and the remainder reported they had low vision. One hundred and seven people (81%) reported using a smartphone. Those with no vision were as likely to use a smartphone or tablet as those with low vision. Speech was found useful by 59% of smartphone users. Fifty-one percent of smartphone owners used the camera and screen as a magnifier. Forty-eight percent of the sample used a tablet computer, and 17% used an e-book reader. The most frequently cited reason for not using these devices included cost and lack of interest. Smartphones, tablet computers, and e-book readers can be used by people with vision impairment. Speech is used by people with low vision as well as those with no vision. Many of our (self-selected) group used their smartphone camera and screen as a magnifier, and others used the camera flash as a spotlight.
LiCoPO4 and LiNiPO4 phosphate pigments have colorations very close to the primary colors of the subtractive system: magenta and yellow, respectively. These two pigments are therefore of great interest in a variety of applications, including e-reader devices. However, the need to reduce their crystallite size in order to formulate stable electrophoretic inks has revealed that aggressive milling results in significant color changes, particularly for cobalt-based pigments. Here, we elucidate the origin of this phenomenon by carefully examining the structural changes induced by grinding, utilizing a combination of X-ray diffraction pattern refinement, molecular dynamics simulations, and UV-visible near-infrared, EPR, and NMR spectroscopies. Structural distortion near the crystallite surfaces was shown to be responsible for the change in coloration. As the surface-to-volume ratio increases with a decreasing crystallite size, these atomic reorganizations in the first few atomic layers close to the surface become increasingly significant and even critical for sample coloration.
The American Optometric Association defines computer vision syndrome (CVS), also known as digital eye strain, as "a group of eye- and vision-related problems that result from prolonged computer, tablet, e-reader and cell phone use". We aimed to create a well-structured, valid, and reliable questionnaire to determine the prevalence of CVS, and to analyze the visual, ocular surface, and extraocular sequelae of CVS using a novel and smart self-assessment questionnaire. This multicenter, observational, cross-sectional, descriptive, survey-based, online study included 6853 complete online responses of medical students from 15 universities. All participants responded to the updated, online, fourth version of the CVS questionnaire (CVS-F4), which has high validity and reliability. CVS was diagnosed according to five basic diagnostic criteria (5DC) derived from the CVS-F4. Respondents who fulfilled the 5DC were considered CVS cases. The 5DC were then converted into a novel five-question self-assessment questionnaire designated as the CVS-Smart. Of 10 000 invited medical students, 8006 responded to the CVS-F4 survey (80% response rate), while 6853 of the 8006 respondents provided complete online responses (85.6% completion rate). The overall CVS prevalence was 58.78% (n = 4028) among the study respondents; CVS prevalence was higher among women (65.87%) than among men (48.06%). Within the CVS group, the most common visual, ocular surface, and extraocular complaints were eye strain, dry eye, and neck/shoulder/back pain in 74.50% (n = 3001), 58.27% (n = 2347), and 80.52% (n = 3244) of CVS cases, respectively. Notably, 75.92% (3058/4028) of CVS cases were involved in the Mandated Computer System Use Program. Multivariate logistic regression analysis revealed that the two most statistically significant diagnostic criteria of the 5DC were ≥2 symptoms/attacks per month over the last 12 months (odds ratio [OR] = 204177.2; P <0.0001) and symptoms/attacks associated with screen use (OR = 16047.34; P <0.0001). The CVS-Smart demonstrated a Cronbach's alpha reliability coefficient of 0.860, Guttman split-half coefficient of 0.805, with perfect content and construct validity. A CVS-Smart score of 7-10 points indicated the presence of CVS. The visual, ocular surface, and extraocular diagnostic criteria for CVS constituted the basic components of CVS-Smart. CVS-Smart is a novel, valid, reliable, subjective instrument for determining CVS diagnosis and prevalence and may provide a tool for rapid periodic assessment and prognostication. Individuals with positive CVS-Smart results should consider modifying their lifestyles and screen styles and seeking the help of ophthalmologists and/or optometrists. Higher institutional authorities should consider revising the Mandated Computer System Use Program to avoid the long-term consequences of CVS among university students. Further research must compare CVS-Smart with other available metrics for CVS, such as the CVS questionnaire, to determine its test-retest reliability and to justify its widespread use.
Electronic (E) devices read and quantify lateral flow-based rapid tests, providing a novel approach to assay interpretation. We evaluated the performance of one E-reader for two dual HIV and syphilis immunoassays. We enrolled men who have sex with men and transgender women >18 years of age seeking medical services at an STD clinic in Lima, Peru, between October 2016 and April 2017. Venous blood was tested using two dual HIV and syphilis antibody immunoassays (SD BIOLINE HIV/Syphilis Duo, Republic of Korea, and First Response HIV 1+2/Syphilis Combo, India). Reference testing included a fourth-generation ELISA for HIV antibodies and use of the Treponema pallidum particle agglutination assay for syphilis antibodies. Trained clinic staff visually inspected the immunoassay results, after which the immunoassays were read by the HRDR-200 E-reader (Cellmic, USA), an optomechanical smartphone attachment. We calculated the concordance of the E-reader with visual inspection, as well as the sensitivity of both rapid immunoassays, in detecting HIV and T. pallidum antibodies. On reference testing of 283 participant specimens, 34% had HIV antibodies and 46% had T. pallidum antibodies. Using First Response, the concordance of the E-reader with visual inspection was 97% (95% CI 94% to 99%) for T.pallidum and 97% (95% CI 95% to 99%) for HIV antibodies. Using SD BIOLINE, the concordance of the E-reader with visual inspection was 97% (95% CI 94% to 99%) for T. pallidum and 99% (95% CI 98% to 99%) for HIV antibodies. For both immunoassays, the sensitivity for HIV antibodies was 98% (95% CI 93% to 100%) and the sensitivity for T. pallidum antibodies was 81% (95% CI 73% to 87%). E-reader results correlated well with visual inspection. The sensitivities of both rapid assays were comparable with past reports. Further evaluation of the E-reader is warranted to investigate its utility in data collection, monitoring and documentation of immunoassay results.
Lateral Flow Immunoassay (LFI) is a disposable tool designed to detect target substances using minimal resources. For qualitative analysis, LFI does not require a device (i.e., reader) to interpret test results. However, various studies have been conducted to implement quantitative analysis using LFI systems, incorporating LFI along with electrical/electronic readers, to overcome the limitations associated with qualitative LFI analysis. The reader used for the quantitative analysis of LFI should ensure mobility for easy on-site diagnostics and inspections, be user-friendly in operation, and have a fast processing speed until the results are obtained. Due to these requirements, smartphones are increasingly utilized as readers in quantitative analysis of LFI. Among the various components constituting a smartphone, high-performance cameras can serve as sensors converting visual signals into electrical signals. With powerful processing units, large storage capacity, and network capabilities for transmitting analysis results, smartphones are also utilized as interfaces for quantitative analysis. Absolutely, the widespread global use of smartphones is a key advantage, leading to their utilization as diagnostic devices for acquiring, analyzing, storing, and transmitting assay test results. This paper summarizes research cases where smartphones are utilized as readers for quantitative LFI systems used in confirming contamination in food or the environment, detecting drugs, and diagnosing diseases in humans or animals. The systems are classified based on the types of label particles used in the assay, and efforts to improve the quantitative analysis performance for each are examined. Cases where smartphones were used as LFI readers for the diagnosis of the 2019 Coronavirus Disease (COVID-19), which has recently caused significant global damage, have also been investigated.
With the increasing prevalence of electronic readers (e-readers) for vocational and professional uses, it is important to discover if there are visual consequences in the use of these products. There are no studies in the literature quantifying the incidence or severity of eyestrain, nor are there clinical characteristics that may predispose to these symptoms with e-reader use. The primary objective of this pilot study was to assess the degree of eyestrain associated with e-reader use compared to traditional paper format. The secondary outcomes of this study were to assess the rate of eyestrain associated with e-reader use and identify any clinical characteristics that may be associated with the development of eyestrain. Forty-four students were randomly assigned to study (e-reader iPAD) and control (print) groups. Participant posture, luminosity of the room, and reading distance from reading device were measured during a 1-h session for both groups. At the end of the session, questionnaires were administered to determine symptoms. Significantly higher rates of eyestrain (p = 0.008) and irritation (p = 0.011) were found among the iPAD study group as compared to the print 'control' group. The study group was also 4.9 times more likely to report severe eyestrain (95 % CI [1.4, 16.9]). No clinical characteristics predisposing to eyestrain could be identified. These findings conclude that reading on e-readers may induce increased levels of irritation and eyestrain. Predisposing factors, etiology, and potential remedial interventions remain to be determined.
Aim/background Digital eye strain, also called computer vision syndrome (CVS), is a group of symptoms resulting from prolonged computer, tablet, e-reader, and cell phone use. The level of discomfort and the severity of these symptoms appear to increase with the amount of digital screen use. These symptoms include eyestrain, headaches, blurred vision, and dry eyes. This study aims to assess the changes in the prevalence of digital eye strain among college students in Riyadh, Saudi Arabia. Methods A cross-sectional study was conducted among university students at different college institutions in Riyadh, Saudi Arabia. Subjects were interviewed, and the data were collected using an online questionnaire. The questionnaire was composed of student demographic data, students' general knowledge and risk perception of digital eye strain, and the assessment of CVS symptoms questionnaire. Results Of the 364 university students, 55.5% were females, and 96.2% were aged between 18 and 29 years. A significant proportion of university students (84.6%) were using digital devices for five hours or more. The proportion of university students who were aware of the 20-20-20 rule was 37.4%. The overall prevalence of positive for CVS symptoms was 76.1%. Independent risk factors for CVS symptoms were gender female, ocular disorders, and using digital devices at a shorter distance. Conclusion There was a high prevalence of CVS symptoms among university students in our region. Female students with an ocular disease were more likely to exhibit CVS symptoms than other university students, but using a digital device at a longer distance could alleviate the symptoms of CVS. A longitudinal study is needed to establish the effect of CVS symptoms among university students, especially during the post-pandemic era.
Purposeful movement across unpredictable environments requires quick, accurate, and contextually appropriate motor corrections in response to disruptions in balance and posture.1,2,3 These responses must respect both the current position and limitations of the body, as well as the surrounding environment,4,5,6 and involve a combination of segmental reflexes in the spinal cord, vestibulospinal and reticulospinal pathways in the brainstem, and forebrain structures such as the motor cortex.7,8,9,10 These motor plans can be heavily influenced by the animal's surrounding environment, even when that environment has no mechanical influence on the perturbation itself. This environmental influence has been considered as cortical in nature, priming motor responses to a perturbation.8,11 Similarly, postural responses can be influenced by environments that alter threat levels in humans.12,13,14,15,16,17,18 Such studies are generally in agreement with work done in the mouse showing that optogenetic stimulation of the lateral vestibular nucleus (LVN) only results in motor responses when the animal is on a balance beam at height and not when walking on the stable surface of a treadmill.10 In general, this ability to flexibly modify postural responses across terrains and environmental conditions is a critically important component of the balance system.19,20 Here we show that LVN-generated motor corrections can be altered by manipulating the surrounding environment. Furthermore, environmental influence on corrections requires noradrenergic signaling from the locus coeruleus, suggesting a potential link between forebrain structures that convey sensory information about the environment and brainstem circuits that generate motor corrections.
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To determine whether accommodative microfluctuations (AMFs) are affected by the image resolution of the display type being observed. The effect of refractive error is also examined. Twenty participants, (10 myopes and 10 emmetropes) observed a target on four different displays: paper, smartphone, e-reader and visual display unit screen (VDU), whilst their accommodative responses were measured using a continuous recording infrared autorefractor. The accommodative response and AMF measures comprising low frequency components (LFC), high frequency components (HFC) and the root mean square (RMS) of the AMFs were analysed. A significant increase in LFC power was observed for the paper stimulus when compared to the VDU and smartphone conditions. Myopes demonstrated a significantly higher LFC and mean accommodative response compared to emmetropes across the four displays. A significant difference in the mean AR between the displays with the lowest and highest resolution was found. A higher mean AR was found with higher resolution of the image. The HFC and RMS accommodation were not affected by display type. The mean accommodative response and the mean LFC power appear to respond differently depending on the type of display in use. Higher resolution devices showed a reduced lag of accommodation to the accommodative demand; however, this may cause a lead of accommodation in myopes for higher resolution display types.
A comparison of the legibility of the three different media: paper personal computer (LCD) and the e-reader in schoolchildren (12-14 years of age) was performed. Comprehensive assessment of the reading performance (speed of reading aloud, the number of errors in reading, and integral indicator of the degree of difficulty of visual task), its physiological value (according to data of EEG, EOG and ECG), and subjective preference of type of media by the schoolchildren showed that by the sum of signs e-reader occupies an intermediate position between printed text and the computer screen. The effect of increased emotional intensity of using e-reader (increased motivation), which is manifested in the preservation of the sympathetic nervous system activation after the reading, was obtained. The necessity of additional research has been shown.
In this work, we present a self-powered electronic reader (e-reader) for point-of-care diagnostics based on the use of a fuel cell (FC) which works as a power source and as a sensor. The self-powered e-reader extracts the energy from the FC to supply the electronic components concomitantly, while performing the detection of the fuel concentration. The designed electronics rely on straightforward standards for low power consumption, resulting in a robust and low power device without needing an external power source. Besides, the custom electronic instrumentation platform can process and display fuel concentration without requiring any type of laboratory equipment. In this study, we present the electronics system in detail and describe all modules that make up the system. Furthermore, we validate the device's operation with different emulated FCs and sensors presented in the literature. The e-reader can be adjusted to numerous current ranges up to 3 mA, with a 13 nA resolution and an uncertainty of 1.8%. Besides, it only consumes 900 µW in the low power mode of operation, and it can operate with a minimum voltage of 330 mV. This concept can be extended to a wide range of fields, from biomedical to environmental applications.
While electronic reading devices are extremely popular, research is equivocal regarding their benefits for outcomes such as reader comprehension. Integrating literatures on reading medium comparisons and matching effects in persuasion, this research tested whether comprehension is maximized when the content of the material (e.g., whether it is traditional vs. modern) matches the medium (e.g., reading from a traditional book vs. digital e-reader). In Study 1, participants read a traditional- or modern-themed short story from either a book or an e-reader. Story comprehension was greater when participants read from the printed medium compared to the e-reader, an effect that was marginally moderated by story content, consistent with a matching effect. In Study 2, participants read a persuasive message that emphasized either a traditional versus modern solution to improving health in either a magazine format or on an iPad. Message comprehension was marginally greater among participants who read their message in a printed format. Participants' interest in weight loss showed evidence of a matching effect - participants were more interested in losing weight when a modern solution to obesity article was presented on an iPad compared to a printed format. The results are applied to the study of reading and attitude change.