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Journal of Medical Extended Reality – Premiere Issue Published

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The American Medical Extended Reality Association (@theAMXRA) In collaboration with the editorial board of the newly published Journal of Medical Extended Reality, AMXRA has developed a new guideline to define the emerging field of Medical Extended Reality (MXR). 

Medical Extended Reality Defined

The guideline presents a new taxonomy with five core domains, encompassing 13 primary topics and a comprehensive set of 180 secondary topics. This taxonomy is intended to serve as a crucial tool for harmonizing communication and collaboration among researchers, clinicians, educators, and policymakers. The goal is to establish a common language and structure to support the field’s continued growth and integration into health care. With this tool, various stakeholders can systematically classify and navigate the complexities of the MXR field.

Extended Reality in Mental Health

Through the use of virtual reality (VR) and artificial intelligence (AI), XAIA offers personalized cognitive behavioral therapy (CBT)-based mental health support. Users can select from nine nature scenes and interact with a robot avatar. The platform has shown promise in helping individuals with mild to moderate anxiety and depression, with no participants stopping therapy due to distress and no reports of VR-induced vertigo.

Virtual Reality in Healthcare Education

There is increasing interest in VR within healthcare and healthcare education, as it offers a unique opportunity to teach and assess key skills relating to situational awareness (SA) and decision making (DM) across undergraduate healthcare professions.

However, there is a perceived gap in literature regarding the use of VR for these purposes. A scoping review aims to address this gap and further explore the potential of VR, augmented reality (AR), and mixed reality (MR) in healthcare education.

Publication of the Journal of Medical Extended Reality is a step towards advancing the field of MXR. Continuing to explore and understand the potential of these technologies, it is clear that there may be a important role for MXR to play in transforming the future of healthcare.

The Journal of Medical Extended Reality is a Mary Ann Liebert, Inc publication . To learn more about the Journal and featured content and editorial board visit https://home.liebertpub.com/publications/journal-of-medical-extended-reality/680.

FDA Accepts First AI Drug Development Tool

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The FDA began accepting submissions in 2022 for a program to provide support for unconventional drug development tools that can assist, enhance and expedite new drug research. Finally in January 2024, it has accepted its first artificial intelligence-powered tool.

The program called Innovative Science and Technology Approaches for New Drugs (ISTAND) pilot is designed to create a new pathway to FDA review novel tools that may not fit into currently existing routes of evaluation, but that could potentially improve the development of new drugs.

The newest tool accepted into ISTAND comes from Deliberate AI. The AI-generated Clinical Outcome Assessment—AI-COA for short—uses multimodal behavioral signal processing and machine learning technology to record mental health symptoms and assess the severity of cases of anxiety and depression.

“This marks a pioneering step for the ISTAND program as the first artificial intelligence-based, digital health technology project in neuroscience to be accepted into the pilot program,” Peter Stein, M.D., director of the Office of New Drugs within the FDA’s Center for Drug Evaluation and Research, said in an agency announcement this week. “Our acceptance aligns with FDA’s vision of optimizing drug development and evaluation, potentially expediting the availability of safe and effective treatments.”

Resources

FDA Announcement and Links to more info.

Deliberate AI

ISTAND program

New York is the First US State to Officially Declare Social Media Usage a Hazard

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New York City declared social media ‘Health hazard’ a threat to the mental health of young people, NYC is the first major U.S. city to take such action.

The city’s Health Commissioner, Ashwin Vasan, issued an advisory officially labeling social media as a public health hazard in New York City. Mayor Eric Adams blamed platforms like TikTok, YouTube, and Facebook for contributing to a mental health crisis with their addictive and harmful features and likened this move to how the U.S. surgeon general addressed issues with tobacco and guns in the past.

In response to the concerns raised, Vasan provided guidance in the advisory to young people on promoting healthy social media use. This includes establishing tech-free times and places, being aware of emotions while using social media, and discussing concerns related to social media and mental health with adults.

The advisory pointed out that a large percentage of U.S. teens use social media, but the growing mental health crisis among young people has raised worries about the impact of these platforms and their potential to create addictive habits.

Some social media companies, such as TikTok and YouTube, have taken steps to address concerns by introducing features that allow parents to have more control over their children’s online activity and limit their screen time.

Last year, the U.S. Surgeon General Vivek H. Murthy expressed in an advisory that there isn’t enough evidence to determine whether social media is “sufficiently safe for children and adolescents.” He acknowledged the potential contribution of social media to the ongoing youth mental health crisis.

The advisory from the New York City health commissioner revealed alarming increases in rates of hopelessness and suicidal ideation among high-schoolers in the city between 2011 and 2021, with certain demographics, such as Black, Latino, female, or LGBTQ+ individuals, experiencing disproportionately high rates of hopelessness.

According to Axios News,

NY City’s Department of Health and Mental Hygiene issued an advisory identifying unrestricted access to and use of social media as a public health hazard.

  • The department urged parents and caregivers to delay giving children access to a smartphone or social media until at least age 14.
  • They also urged federal and state policymakers to expand on legislative proposals that protect youth from “predatory practices by social media companies.”

NYC Mayor Eric Adams said in his State of the City speech Wednesday, “We won’t let Big Tech endanger our kids.” The advisory urged all New Yorkers to “advocate to hold social media companies accountable and advance reform that protects youth from harmful and predatory practices.”

Recent Pew Research on US teens use of social media. [Link]

CES: Electronics Show, Las Vegas, January 9-12, 2024

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Registration is now open for CES® 2024 — taking place Jan. 9-12, in Las Vegas.

CES is not just for consumers. Experience global business opportunities with CES, where you can meet with partners, customers, media, investors, and policymakers from across the industry and the world all in one place.

Don’t miss your chance to be a part of the most powerful tech event in the world.

Special Digital Health Sections exploring:

Exploring Innovations in Mental Health
How Tech Can Transform Women’s Health
Future of Care: How Other Industries Shape Health
Personalized, Digitized Care
Digital Health and AI
Longevity and Biohacking

Working with the Consumer Technology Association®, the American Psychological Association will launch PsyTech at CES, a look at how psychological science intersects with and influences technology. As the science of human behavior, psychology plays a significant role in advancing technology. Psychological researchers are engaged across all aspects of technology innovation and advancement, including human-computer interaction and user experience, the application of learning science to education technology products and studies of the effectiveness of digital products focused on behavior change. PsyTech sessions will showcase examples of the contributions of ethical and equitable psychological research to product development, consumer acceptance and innovation.

All PsyTech sessions will take place Tuesday, Jan. 9. Highlights include:

  1. Harnessing the Power of AI Ethically (9 a.m. PST)
    This panel will dive into the ethics of artificial intelligence and provide examples of how industry leaders can use what is known about human behavior to address ethical issues and help realize the power of AI to benefit human health and well-being.
  2. Social Media’s Impact on Kids: What’s Next for Tech? (11 a.m. PST)
    This session will explore a science-based roadmap that industry leaders can use to enhance the positive effects of social media and keep kids safe.
  3. Making Digital Interventions Accessible and Affordable (1 p.m. PST) This session will examine how experts on the cutting edge of behavioral health treatments are teaming up with the technology industry to bring evidence-based digital treatments into the mainstream, changing how technology and health care work together.
  4. Your Brain Gaming for Good (3 p.m. PST)
    This session will look at the latest findings on games associated with enhancements to human performance and bring together leaders developing games that promote positive behaviors and prevent violence.

Digital Healthcare Summit

Healthcare is increasingly more personal, portable and customizable. From wearables to telehealth and digital consultations, technology innovators are answering the call for consumer-friendly and effective self-care, accessible to and from virtually anywhere and at any time.

At CES, you have the opportunity to connect with gamechangers, investors, and policymakers not only from digital health, but complementary industries – like AI, gaming and smart home – that together, aid in more meaningful conversations and can ultimately effect change in more impactful ways.

List of Summit Sessions and Faculty

Link to CES Website for more information and registration.

New Pew Study on Teens and Social Media

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A new Pew Research Center survey of U.S. teens conducted Sept. 26-Oct. 23, 2023, among 1,453 13- to 17-year-olds – covered social media, internet use and device ownership among teens. Even though negative headlines and growing concerns about social media’s impact on youth has drawn the attention of parents, teachers, the medical profession and lawmakers, teens continue to use these platforms at high rates – with some describing their social media use as “almost constant.”

YouTube continues to dominate. Roughly nine-in-ten teens say they use YouTube, making it the most widely used platform measured in our survey.

Other key findings include:
TikTok, Snapchat and Instagram remain popular among teens: Majorities of teens ages 13 to 17 say they use TikTok (63%), Snapchat (60%) and Instagram (59%). For older teens ages 15 to 17, these shares are about seven-in-ten.

Teens are less likely to be using Facebook and Twitter (recently renamed X) than they were a decade ago: Facebook once dominated the social media landscape among America’s youth, but the share of teens who use the site has dropped from 71% in 2014-2015 to 33% today. Twitter, which was renamed X in July 2023, has also seen its teen user base shrink during the past decade – albeit at a less steep decline than Facebook.

Teens’ site and app usage has changed little in the past year. The share of teens using these platforms has remained relatively stable since spring 2022, when the Center last surveyed on these topics. For example, the percentage of teens who use TikTok is statistically unchanged since last year.

And for the first time, we asked teens about using BeReal: 13% report using this app.

When asked about frequency

By Gender
Teen girls are more likely than boys to say they almost constantly use TikTok (22% vs. 12%) and Snapchat (17% vs. 12%).

But there are little to no differences in the shares of boys and girls who report almost constantly using YouTube, Instagram and Facebook.

By Race and Ethnicity
There were also differences by race and ethnicity in how much time teens report spending on these platforms. Larger shares of Black and Hispanic teens report being on YouTube, Instagram and TikTok almost constantly, compared with a smaller share of White teens who say the same. Hispanic teens stand out in TikTok and Snapchat use. For instance, 32% of Hispanic teens say they are on TikTok almost constantly, compared with 20% of Black teens and 10% of White teens.

By Age
Older teens are more likely than younger teens to use many of the platforms asked about, including Instagram, Snapchat, Facebook, Twitter, TikTok and Reddit. For example, while 68% of teens ages 15 to 17 say they use Instagram, this share drops to 45% among teens ages 13 and 14.

Source and additional information

Teens, Social Media and Technology 2023

Revised Digital Media Overuse Scale Adapts to Changing Technology

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The rapid changes in the nature of digital media presents a challenge for those who study digital addiction. Various social networks and computer games might be popular now, but they could be irrelevant in a few years. A new tool developed by researchers from Binghamton University, State University of New York will make it easier for clinicians and researchers to measure digital media addiction as new technologies emerge. 

Daniel Hipp, PhD and Peter Gerhardstein, PhD from Binghamton Univ. collaborated with the Digital Media Treatment and Education Center in Boulder, Colorado in developing the Digital Media Overuse Scale, or dMOS. The goal of fMOS is to allow clinicians and researchers who are using the tool to be free to make their investigations as broad (i.e. social media) or as granular (i.e. Instagram) as they want for their particular use. Rather than focusing on the technology the focus is the behavioral, emotional or psychological aspects of an individual’s experience.

To test the Digital Media Overuse Scale, the researchers conducted an anonymous survey with over 1,000 college students to investigate clinically relevant behaviors and attitudes as they relate to five digital media domains: general smartphone use, internet video consumption, social media use, gaming, and pornography use.

They found the following: 

  • A majority of students demonstrate few indicators of addiction or overuse 
  • Use patterns were highly targeted to specific domains for specific users.  
  • A select set of students’ responses indicated attitudes and behaviors around digital media use that, if they were derived from drug use or sex, would be deemed clinically problematic.  

The researchers found that overuse is “not a general thing” but more specific, and typically reported in one or a few domains only. Broadly speaking, the data paint a picture of a population who are using digital media substantially, and social media in particular, to a level that increases concern regarding overuse.

Initial indications are that the Digital Media Overuse Scale is a reliable, valid, and extendible clinical instrument capable of providing clinically relevant scores within and across digital media domains, wrote the researchers.

Reference: Hipp, D., Blakley, E. C., Hipp, N., Gerhardstein, P., Kennedy, B., & Markle, T. (2023). The Digital Media Overuse Scale (dMOS): A Modular and Extendible Questionnaire for Indexing Digital Media Overuse. Technology, Mind, and Behavior, 4(3: Fall 2023). https://doi.org/10.1037/tmb0000117

Our Brains On Zoom

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Ever wonder how our brains deal with Zoom sessions or calls? Researchers from Yale decided to find out how our brains react to this form of social interaction.

Image created with generative AI (Michael S. Helfenbein

We know that social interactions are the cornerstone of all human societies, and our brains are finely tuned to process dynamic facial cues (a primary source of social information) during real in-person encounters, So does that change with online interactions such as video meetings and calls?

Neural signaling during online exchanges was substantially suppressed compared to activity observed in those having face-to-face conversations, researchers found.

While most previous research using imaging tools to track brain activity during these interactions has involved only single individuals, Hirsch’s lab developed a unique suite of neuroimaging technologies that allows them to study, in real time, interactions between two people in natural settings.

Findings

Researchers found that the strength of neural signaling was dramatically reduced on Zoom relative to “in-person” conversations. Specifically, there was Increased activity among those participating in face-to-face conversations which were associated with increased gaze time and increased pupil diameters, suggestive of increased arousal in the two brains. Increased EEG activity during in-person interactions was characteristic of enhanced face processing ability.

In addition, the researchers found more coordinated neural activity between the brains of individuals conversing in person, which suggests an increase in reciprocal exchanges of social cues between the interacting partners.

According to Dr Hirsch, “Overall, the dynamic and natural social interactions that occur spontaneously during in-person interactions appear to be less apparent or absent during Zoom encounters. This is a really robust effect.” She continued, ” These findings illustrate how important live, face-to-face interactions are to our natural social behaviors. Online representations of faces, at least with current technology, do not have the same ‘privileged access’ to social neural circuitry in the brain that is typical of the real thing,” she said.

Sources:

Hathaway B. Yale News. Zooming in on our brains on Zoom. October 25, 2023. [Link]

Zhao N, Zhang X, J. Noah A, Tiede M, Hirsch J. Separable Processes for Live “In-Person” and Live “Zoom-like” Faces. Imaging Neuroscience (2023) https://doi.org/10.1162/imag_a_00027

Tablet App Screens For Autism

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Duke University researchers have demonstrated an app which is AI driven that can run on a tablet to screen for autism in children by measuring and weighing a variety of behavioral indicators.

Image: Nature Medicine

Published online in the October 2023 journal Nature Medicine, an app called SenseToKnow evaluates and measures a variety of behavioral indicators and delivers scores that suggest the probability that the child tested may be on the autism spectrum. The results are fully interpretable, meaning that they spell out exactly which of the behavioral indicators led to its conclusions and why.

This ability gives health care providers detailed information on what to look for and consider in children referred for full assessments and intervention. The researchers state that SenseToKnow’s ease of use and lack of hardware limitations, combined with its demonstrated accuracy across sex, ethnicity and race, could help eliminate known disparities in early autism diagnosis and intervention by allowing autism screening to take place in any setting, even in the child’s own home.

The app uses almost every sensor in the tablet’s arsenal to measure and characterize the child’s response without the need for any sort of calibration or special equipment. It then uses AI to analyze the child’s responses to predict how likely it is that the child will be diagnosed with autism.

Source:

Perochon, S., Di Martino, J.M., Carpenter, K.L.H. et al. Early detection of autism using digital behavioral phenotyping. Nat Med (2023). https://doi.org/10.1038/s41591-023-02574-3

Using Social Media to Self-diagnose

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With social media playing such a large role in people’s lives, it comes as no surprise that when Americans become concerned about their health, they look online for answers. A recent survey from Tebra looked at what platforms people used the most, how accurate their diagnoses were, variations in generational differences and how many of them followed up with a medical professional.

Diagnosis-related medical content on social media has become more widespread over the past few years, filling user feeds with stories of sickness, symptoms, and surprising recoveries. Some of the data searched was from respected sources such as online reference books or created by medical professionals,however, much of it is posted by content creators, influencers, and other random users. The content is so relatable and convincing that some people have begun using social media to self-diagnose.

The Survey

To evaluate and understand the effects of social media self-diagnosing, 1,000 people were surveyed about their experience with medical content across various platforms. Participants were asked how often they came across diagnostic content in their feeds, if they ever self-diagnosed based on it, and what they did after making a diagnosis.

Reported key takeaways were:

  • 1 in 4 people have self-diagnosed based on social media information.
  • 43% of those who self-diagnosed followed up with a medical professional about a disease or illness they discovered on social media.
  • 82% of those who visited a doctor after social media self-diagnosing had their diagnosis confirmed.

Infographic Gallery & Slide Show of Survey Results
(click to view)

The future of medicine?

Social media has become a leading source of information for many people, a role that has extended to the health field. Instead of waiting for appointments and tests, people are turning to their content feeds to learn about symptoms and self-diagnose. While online medical content can be helpful, people should be cautious about self-diagnosing; seeking professional medical advice regarding any major illness, disease, or treatment plan is still crucial. 

Many communities e.g. retirement communities, have a social media community website where residents can ask the community for shopping suggestions or for a recommendation for a service or repair professional. Healthcare is also a prominent feature – it may be a request for a recommendation for a primary care clinician or a specialist. There are even requests about ways to manage an illness or a symptom. or a family member. And more often than not, opinions are plentiful, both positive and negative.

Survey Source: Americans see pros and cons of social media diagnosis content. Tebra. Published June 2, 2023. Accessed July 19, 2023. https://www.tebra.com/blog/social-media-self-diagnosing/

Can Regular Internet Use Help Reduce Dementia Risk in Older Adults?

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According to new research published in the Journal of the American Geriatrics Society,  there is a link between regular use of the internet and a lower risk of dementia.

In a population-based cohort study researchers followed dementia-free adults aged 50–64.9 for a maximum of 17.1 (median = 7.9) years. The association between time-to-dementia and baseline internet usage was examined. In addition,  the interaction between internet usage and education, race-ethnicity, sex, and generation was assessed. Furthermore, the study looked at whether the risk of dementia varies by the cumulative period of regular internet usage to see if starting or continuing usage in old age modulates subsequent risk. The study also examined the association between the risk of dementia and daily hours of usage.

Results

In 18,154 adults, compared with nonregular internet use, regular internet use at baseline was linked with approximately half the risk of dementia, analysis showed. Researchers reported a cause-specific hazard ratio of 0.57. The difference in dementia risk between participants who did and did not use the internet regularly was consistent regardless of educational attainment, race-ethnicity, sex, and generation.

The study also found that periods of regular use in late adulthood were associated with significantly reduced dementia risk; the cause-specific hazard ratio was 0.80. The finding, researchers wrote, suggests that cognitive health can be modified by changes in internet use, even in late adulthood. The lowest dementia risk, according to the study, was among adults who used the internet between 0.1 and 2 hours a day.

Investigators pointed out that since a person’s online engagement may include a wide range of activities, future research may identify different patterns of internet usage associated with the cognitively healthy lifespan while being mindful of the potential side effects of excessive usage.

Study:
Cho, G, Betensky RA, Chang VW. Internet usage and the prospective risk of dementia: A population-based cohort study. Journal of the American Geriatrics Society. First published: 03 May 2023. https://agsjournals.onlinelibrary.wiley.com/doi/10.1111/jgs.18394