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.
E-readers provide an opportunity for hospital librarians to reach out to staff and patients with new approaches to library lending. Librarians in four Veterans Health Administration medical centers are using e-readers to enlarge their scope of service in unique ways. The libraries of VA hospitals in Minneapolis, Des Moines, Tampa, and Philadelphia have developed several ways to reach out to new library users.
The mass digitization of books is changing the way information is created, disseminated and displayed. Electronic book readers (e-readers) generally refer to two main display technologies: the electronic ink (E-ink) and the liquid crystal display (LCD). Both technologies have advantages and disadvantages, but the question whether one or the other triggers less visual fatigue is still open. The aim of the present research was to study the effects of the display technology on visual fatigue. To this end, participants performed a longitudinal study in which two last generation e-readers (LCD, E-ink) and paper book were tested in three different prolonged reading sessions separated by--on average--ten days. Results from both objective (Blinks per second) and subjective (Visual Fatigue Scale) measures suggested that reading on the LCD (Kindle Fire HD) triggers higher visual fatigue with respect to both the E-ink (Kindle Paperwhite) and the paper book. The absence of differences between E-ink and paper suggests that, concerning visual fatigue, the E-ink is indeed very similar to the paper.
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.
Librarians purchased 12 e-readers and six tablets to provide patrons the opportunity to experiment with the latest mobile technologies. After several train-the-trainer sessions, librarians shared device information with the broader health sciences community. Devices were cataloged and made available for a two-week checkout. A limited number of books and applications (apps) were preloaded for all the devices, and patrons were allowed to download their own content. Each tablet has Google Books, iBooks, Kindle, and Nook apps available to allow choice in reading e-books. Upon return, patrons were asked to complete a ten-question survey to determine preferences for device use.
College textbook publishers are planning to make college and professional education textbooks available online to be downloaded to personal communication devices (e.g., smartphones), digital audio players (e.g., iPods), and digital readers (e.g., Kindles). The current literature on the attitudes of current students to this technological change, especially as it relates to medical school students is reviewed. A short survey attempted to determine how ready the first-year medical students at the University of Louisville are to accept this change in their study habits.
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Electrophoretic Displays (EPDs) are widely adopted in e-readers and portable devices due to their ultra-low power consumption and eye-friendly reflective characteristics. However, inherent hardware limitations, such as low resolution, slow response speed, and display degradation, frequently result in blurred strokes and degraded text readability. While traditional driving waveform optimizations can mitigate these issues, they are device-dependent and require extensive manual calibration. To address these challenges, this paper proposes an Improved Whale Optimization Algorithm-based Multi-scale Fusion Attention-enhanced SwinIR (IWOA-MFA-SwinIR) model for super-resolution and recognition of text images on EPDs. Structurally, the model incorporates a multi-scale fused attention (MFA) module that synergistically integrates channel, spatial, and gated attention mechanisms to precisely capture high-frequency text details while suppressing background noise within the SwinIR architecture. Furthermore, to enhance model robustness and eliminate manual tuning, an Improved Whale Optimization Algorithm (IWOA) is employed to adaptively optimize critical hyperparameters, including embedding dimension (d), attention head count (h), learning rate (lr), and dimensionality reduction coefficient (r). Experiments conducted on the TextZoom and EPD datasets demonstrate that the proposed model achieves state-of-the-art performance. In the ablation study, it attains a Peak Signal-to-Noise Ratio (PSNR) of 24.406, a Structural Similarity Index (SSIM) of 0.8837, and a Character Recognition Accuracy (CRA) of 89.81%. In the comparative evaluation, the proposed model consistently outperforms the second-best comparison model across three difficulty levels, yielding approximately a 1% improvement in PSNR, a 0.8% improvement in SSIM, and an 8% improvement in CRA. This confirms the proposed model's superiority over mainstream comparative models in restoring text fidelity and improving recognition rates.
Despite their low power consumption, commercial black-and-white reflective displays based on electrophoretic technology (i.e., electronic paper) suffer from limited brightness, contrast, and temperature tolerance. Here, this study presents an electrochemical display mechanism that addresses these limitations by integrating a light-scattering layer beneath a roughened indium tin oxide (ITO) electrode supporting reversible metal electrodeposition (RME). The scattering layer is composed of an interwoven titanium dioxide nanowire (TiO2 NW) network, which provides efficient broadband light scattering to produce a white appearance, while simultaneously ensuring mechanical durability and ion transport. In contrast, a black state is achieved via copper electrodeposition onto the roughened ITO, where the resulting morphology induces strong broadband light absorption. The device exhibits brightness and contrast ratios exceeding those of current commercial e-readers by more than two-fold, along with stable switching across a wide temperature range (-5 °C to 55 °C). These results demonstrate a scalable electrochemical nanophotonic platform for next-generation black-and-white reflective displays.
People increasingly read text displayed on digital devices, including computers, handheld e-readers, and smartphones. Given this, there is rapidly growing interest in understanding how the cognitive processes that support the reading of static text (e.g., books, magazines, or newspapers) might be adapted to reading digital texts. Evidence from recent experiments suggests a complex interplay of visual and cognitive influences on how people engage with digital reading. Although readers can strategically adjust their reading behaviors in response to their immediate reading context, the efficacy of these strategies depends on cognitive, metacognitive, and motivational factors. A better understanding of the factors that influence reading offers the promise of leveraging digital technologies to enhance the reading experience.
Visual word recognition requires encoding letter identities and positions (orthographic processing). The present study focuses on the emergence of the mechanism responsible for encoding letter order in a word: position invariance. Reading experience leads to developing a flexible mechanism that encodes the information of the position of letters, explaining why jugde and judge are easily confused. Critically, orthographic regularities (e.g., frequent letter co-occurrences) modulate letter position encoding: the pseudoword mohter is extremely similar to mother because, in middle positions, the bigram TH is much more frequent than HT. Here, we tested whether position invariance emerges rapidly after the exposition to orthographic regularities-bigrams-in a novel script. To that end, we designed a study with two phases. In Phase 1, following Chetail (2017; Experiment 1b, Cognition, 163, 103-120), individuals were first exposed to a flow of artificial words for a few minutes, with four bigrams occurring frequently. Afterward, participants judged the strings with trained bigrams as more wordlike (i.e., readers quickly picked up subtle new orthographic regularities) than the strings with untrained bigrams, replicating Chetail (2017). In Phase 2, participants performed a same-different matching task in which they had to decide whether pairs of five-letter strings were the same or not. The critical comparison was between pairs with a transposition of letters in a frequent (trained) versus infrequent (untrained) bigram. Results showed that participants were more prone to make errors with frequent bigrams than with infrequent bigrams with a letter transposition. These findings reveal that position invariance emerges rapidly, after continuous exposure to orthographic regularities.
Deployed medical professionals often do not have adequate access to medical reference materials. The objective of this study was to determine the feasibility and perceived benefit of providing reference materials in electronic format to deployed personnel. Prototype e-readers were provided to five physicians deploying to Afghanistan over a 6-month period from September 2009 to March 2010. Selected medical textbooks were converted to electronic format and provided to the physicians via the e-readers. The subjects later completed a questionnaire regarding their experience with the e-readers. Physicians with Internet access were able to reliably download additional content to their e-readers while deployed, although downloading was usually slow. Texts were used for a variety of purposes and could be read in most lighting conditions. The e-readers were easy to navigate, but lacked adequate search functions. The e-readers were adequately durable and were easily transported by the individual. Overall, e-textbooks were valuable to the physicians in this study. However, opportunities for improvement include increasing the availability of textbooks in appropriate electronic format, simplifying distribution, and building an index and search functions within e-texts.
Digital eye strain is a complex, multifactorial condition that can be caused by excessive screen time exposure to various electronic devices such as smartphones, tablets, e-readers, and computers. Current literature suggests oxidative damage concomitant with a chronic pro-inflammatory state represent significant etiopathogenic mechanisms. The present review aims to discuss the potential dietary role for micronutrients with nutraceutical properties to ameliorate various ocular and vision-related symptoms associated with digital eye strain. For ocular surface dysfunction, enhanced anti-inflammatory benefits with omega-3 polyunsaturated fatty acids have been well documented for treatment of dry eye disease. The anti-oxidative and immunosuppressive properties of anthocyanin phytochemicals may also confer protective effects against visually induced cognitive stress and digital asthenopia. Meanwhile, nutraceutical strategies involving xanthophyll macular carotenoids demonstrate enhanced cognitive functioning and overall visual performance that aids digital eye strain. Collectively, preliminary findings seem to offer a strong line of evidence to substantiate the need for additional randomized controlled trials aimed at treating digital eye strain with adjunctive nutraceutical strategies. Further RCT and comparisons on commercially available nutritional supplements are needed to quantify the clinical benefits.
Dynamically controllable reflective structural colors have been garnering growing attention due to increasing commercial interests in smart displays (e.g., colorimetric labels), colored e-readers, etc. To comply with the requirements of future displays, several strategies have been proposed by various research groups to achieve wide color tuning ranges in the visible regime, high on/off contrast ratios, and fast response times. In this review, we first introduce ways to create optical resonances including plasmonic, photonic, and plasmonic-photonic hybrid structures that form the basis of color generation. We then outline strategies that control the refractive index contrast between the system and the surrounding as a means to actively change the reflective structural colors, backed with representative examples from the literature. Finally, we provide a comparison of dynamic structural colors based on various switching mechanisms summarizing performance metrics that are important for future displays, and conclude with an outlook on current challenges.
Reading is essential for learning, from literature to physics, from paper to screens on e-readers and smart phones. Even if it is well known that learning to read implies good language skills, children also need to develop good oculomotor and visual-perception skills. Thereby, any deficits in visual processing may affect learning. The possible impact of visual deficits is rarely considered, especially with regard to eye movements and visual perception. Hence, these deficits are usually discovered much later or remain undiagnosed. The present study aimed at assessing the usefulness of visual processing related measures in the early detection of reading difficulties. Visual skill differences that are apparent early in kindergarten might provide predictive insights into risk for learning difficulties at school entry. We used a prospective, longitudinal approach where visual processes (assessed with the Developmental Eye Movement (DEM) test) were measured in 51 preschoolers, and the impact of these processes on future reading development was explored one year later, in Grade 1. Results showed that (1) 31% of our sample of preschoolers showed visual processing impairments (without any clinical complaints) and (2) reading accuracy and speed in first graders were significantly correlated with visual skills assessed in kindergarten, thus confirming the significant role of oculomotor and visual-perception processes in the acquisition of reading skills. These suggests the potential for these measures to be used clinically for identifying children at risk for low academic achievement, enabling appropriate targeting of early interventions.
The rapid development of information and communication technology has replaced traditional books by electronic versions. Most print dermatology journals have been replaced with electronic journals (e-journals), which are readily used by clinicians and medical students. The objectives of this study were to determine whether e-readers are appropriate for reading dermatology journals, to conduct an attitude study of both medical personnel and students, and to find a way of improving e-book use in the field of dermatology. All articles in the Korean Journal of Dermatology published from January 2010 to December 2010 were utilized in this study. Dermatology house officers, student trainees in their fourth year of medical school, and interns at Korea University Medical Center participated in the study. After reading the articles with Kindle 2, their impressions and evaluations were recorded using a questionnaire with a 5-point Likert scale. The results demonstrated that gray-scale e-readers might not be suitable for reading dermatology journals, especially for case reports compared to the original articles. Only three of the thirty-one respondents preferred e-readers to printed papers. The most common suggestions from respondents to encourage usage of e-books in the field of dermatology were the introduction of a color display, followed by the use of a touch screen system, a cheaper price, and ready-to-print capabilities. In conclusion, our study demonstrated that current e-readers might not be suitable for reading dermatology journals. However, they may be utilized in selected situations according to the type and topic of the papers.
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.
People with dyslexia, who ordinarily struggle to read, sometimes remark that reading is easier when e-readers are used. Here, we used eye tracking to observe high school students with dyslexia as they read using these devices. Among the factors investigated, we found that reading using a small device resulted in substantial benefits, improving reading speeds by 27%, reducing the number of fixations by 11%, and importantly, reducing the number of regressive saccades by more than a factor of 2, with no cost to comprehension. Given that an expected trade-off between horizontal and vertical regression was not observed when line lengths were altered, we speculate that these effects occur because sluggish attention spreads perception to the left as the gaze shifts during reading. Short lines eliminate crowded text to the left, reducing regression. The effects of attention modulation by the hand, and of increased letter spacing to reduce crowding, were also found to modulate the oculomotor dynamics in reading, but whether these factors resulted in benefits or costs depended on characteristics, such as visual attention span, that varied within our sample.
To compare patient satisfaction, reading accuracy, and reading speed between digital e-readers (Sony eReader, Apple iPad) and standard paper/print media for patients with stable wet age-related macular degeneration (AMD). Patients recruited for the study were patients with stable wet AMD, in one or both eyes, who would benefit from a low-vision aid. The selected text sizes by patients reflected the spectrum of low vision in regard to their macular disease. Stability of macular degeneration was assessed on a clinical examination with stable visual acuity. Patients recruited for the study were assessed for reading speeds on both digital readers and standard paper text. Standardized and validated texts for reading speeds were used. Font sizes in the study reflected a spectrum from newsprint to large print books. Patients started with the smallest print size they could read on the standardized paper text. They then used digital readers to read the same size standardized text. Reading speed was calculated as words per minute by the formula (correctly read words/reading time (s) ·60). The visual analog scale was completed by patients after reading each passage. These included their assessment on 'ease of use' and 'clarity of print' for each device and the print paper. A total of 27 patients were used in the study. Patients consistently read faster (P<0.0003) on the Apple iPad with larger text sizes (size 24 or greater) when compared with paper, and also on the paper compared with the Sony eReader (P<0.03) in all text group sizes. Patients chose the iPad to have the best clarity and the print paper as the easiest to use. This study has demonstrated that digital devices may have a use in visual rehabilitation for low-vision patients. Devices that have larger display screens and offer high contrast ratios will benefit AMD patients who require larger texts to read.