Cutaneous Electrohydraulic (CUTE) Wearable Devices for Pleasant Broad-Bandwidth Haptic Cues.

By focusing on vibrations, current wearable haptic devices underutilize the skin's perceptual capabilities. Devices that provide richer haptic stimuli, including contact feedback and/or variable pressure, are typically heavy and bulky due to the underlying actuator technology and the low sensitivity of hairy skin, which covers most of the body. This article presents a system architecture for compact wearable devices that deliver salient and pleasant broad-bandwidth haptic cues: Cutaneous Electrohydraulic (CUTE) devices combine a custom materials design for soft haptic electrohydraulic actuators that feature high stroke, high force, and electrical safety with a comfortable mounting strategy that places the actuator in a non-contact resting position. A prototypical wrist-wearable CUTE device produces rich tactile sensations by making and breaking contact with the skin (2.44 mm actuation stroke), applying high controllable forces (exceeding 2.3 N), and delivering vibrations at a wide range of amplitudes and frequencies (0-200 Hz). A perceptual study with 14 participants achieves 97.9% recognition accuracy across six diverse cues and verifies their pleasant and expressive feel. This system architecture for wearable devices gives unprecedented control over the haptic cues delivered to the skin, providing an elegant and discreet way to activate the user's sense of touch.

Telementoring in Leg Fasciotomies via Mixed-Reality: Clinical Evaluation of the STAR Platform.

INTRODUCTION: Point-of-injury (POI) care requires immediate specialized assistance but delays and expertise lapses can lead to complications. In such scenarios, telementoring can benefit health practitioners by transmitting guidance from remote specialists. However, current telementoring systems are not appropriate for POI care. This article clinically evaluates our System for Telementoring with Augmented Reality (STAR), a novel telementoring system based on an augmented reality head-mounted display. The system is portable, self-contained, and displays virtual surgical guidance onto the operating field. These capabilities can facilitate telementoring in POI scenarios while mitigating limitations of conventional telementoring systems. METHODS: Twenty participants performed leg fasciotomies on cadaveric specimens under either one of two experimental conditions: telementoring using STAR; or without telementoring but reviewing the procedure beforehand. An expert surgeon evaluated the participants' performance in terms of completion time, number of errors, and procedure-related scores. Additional metrics included a self-reported confidence score and postexperiment questionnaires. RESULTS: STAR effectively delivered surgical guidance to nonspecialist health practitioners: participants using STAR performed fewer errors and obtained higher procedure-related scores. CONCLUSIONS: This work validates STAR as a viable surgical telementoring platform, which could be further explored to aid in scenarios where life-saving care must be delivered in a prehospital setting.

Evaluation of an augmented reality platform for austere surgical telementoring: a randomized controlled crossover study in cricothyroidotomies.

Telementoring platforms can help transfer surgical expertise remotely. However, most telementoring platforms are not designed to assist in austere, pre-hospital settings. This paper evaluates the system for telementoring with augmented reality (STAR), a portable and self-contained telementoring platform based on an augmented reality head-mounted display (ARHMD). The system is designed to assist in austere scenarios: a stabilized first-person view of the operating field is sent to a remote expert, who creates surgical instructions that a local first responder wearing the ARHMD can visualize as three-dimensional models projected onto the patient's body. Our hypothesis evaluated whether remote guidance with STAR could lead to performing a surgical procedure better, as opposed to remote audio-only guidance. Remote expert surgeons guided first responders through training cricothyroidotomies in a simulated austere scenario, and on-site surgeons evaluated the participants using standardized evaluation tools. The evaluation comprehended completion time and technique performance of specific cricothyroidotomy steps. The analyses were also performed considering the participants' years of experience as first responders, and their experience performing cricothyroidotomies. A linear mixed model analysis showed that using STAR was associated with higher procedural and non-procedural scores, and overall better performance. Additionally, a binary logistic regression analysis showed that using STAR was associated to safer and more successful executions of cricothyroidotomies. This work demonstrates that remote mentors can use STAR to provide first responders with guidance and surgical knowledge, and represents a first step towards the adoption of ARHMDs to convey clinical expertise remotely in austere scenarios.