Effectiveness of head-mounted ultrasound display for radial arterial catheterisation in paediatric patients by anaesthesiology trainees: A randomised clinical trial.

BACKGROUND: The effectiveness of head mounted real-time ultrasound displays (hereafter referred to as 'smart glasses') in improving hand-eye coordination in less experienced individuals, such as trainees in anaesthesia, is unclear. OBJECTIVES: To compare the first-attempt success rate of smart glasses-assisted ultrasound-guided paediatric radial artery catheterisation with conventional ultrasound guided catheterisation performed by anaesthesiology trainees. DESIGN: Prospective randomised controlled trial. SETTINGS: Tertiary university hospital from September 2021 to February 2023. PATIENTS: One hundred and twenty-two paediatric patients (age <7 years, weight ≥3 kg) who required radial artery cannulation during general anaesthesia. INTERVENTIONS: The participants were randomly assigned to either the ultrasound screen group (control) or the smart glasses group prior to radial artery catheterisation. MAIN OUTCOME MEASURES: The primary outcome was the first attempt success rate. Secondary outcomes included the number of attempts, use of transfixion technique, overall complication rate, and clinical anaesthesiology (CA) year of the operators. RESULTS: A total of 119 paediatric patients were included in the analysis. The smart glasses group exhibited higher first-attempt success rate than did the control group (89.8% [53/59] vs. 71.7% [43/60]; P  = 0.023; odds ratio (OR) 3.49; (95% confidence interval (CI) 1.27-9.6). The overall number of attempts [median, 1; interquartile range (IQR), 1-1; range, 1-3 vs. median, 1; IQR, 1-2; range, 1-4; P   =  0.006], use of transfixion technique (12/59 [20.3%] vs. 28/60 [46.7%]; P  = 0.002), and overall complication rate (6.8% [4/59] vs. 30.0% [18/60]; P  = 0.002) were lower in the smart glasses group than in the control group. However, among paediatric anaesthesiology fellows (CA 5 years), the first- (89.3% [25/28] vs. 80.8% [21/26]; P  = 0.619) and second-attempt success rates (96.4% [27/28] vs. 80.8% [21/26]; P  = 0.163) did not differ between the two groups. CONCLUSIONS: Smart glasses-assisted ultrasound guided radial artery catheterisation improved the first attempt success rate among anaesthesiology trainees, reducing the number of attempts and overall complication rates in small paediatric patients. Smart glasses were more effective for anaesthesia residents (CA 2-4 years) but were not effective for paediatric anaesthesiology fellows (CA 5 years). TRIAL REGISTRATION: ClinicalTrials.gov (NCT05030649) ( https://classic.clinicaltrials.gov/ct2/show/NCT05030649 ).

Omnidirectional Virtual Visual Acuity: A User-Centric Visual Clarity Metric for Virtual Reality Head-Mounted Displays and Environments.

Users' perceived image quality of virtual reality head-mounted displays (VR HMDs) is determined by multiple factors, including the HMD's structure, optical system, display and render resolution, and users' visual acuity (VA). Existing metrics such as pixels per degree (PPD) have limitations that prevent accurate comparison of different VR HMDs. One of the main limitations is that not all VR HMD manufacturers released the official PPD or details of their HMDs' optical systems. Without these details, developers and users cannot know the precise PPD or calculate it for a given HMD. The other issue is that the visual clarity varies with the VR environment. Our work has identified a gap in having a feasible metric that can measure the visual clarity of VR HMDs. To address this gap, we present an end-to-end and user-centric visual clarity metric, omnidirectional virtual visual acuity (OVVA), for VR HMDs. OVVA extends the physical visual acuity chart into a virtual format to measure the virtual visual acuity of an HMD's central focal area and its degradation in its noncentral area. OVVA provides a new perspective to measure visual clarity and can serve as an intuitive and accurate reference for VR applications sensitive to visual accuracy. Our results show that OVVA is a simple yet effective metric for comparing VR HMDs and environments.

A Comparison of Head Movement Classification Methods.

To understand human behavior, it is essential to study it in the context of natural movement in immersive, three-dimensional environments. Virtual reality (VR), with head-mounted displays, offers an unprecedented compromise between ecological validity and experimental control. However, such technological advancements mean that new data streams will become more widely available, and therefore, a need arises to standardize methodologies by which these streams are analyzed. One such data stream is that of head position and rotation tracking, now made easily available from head-mounted systems. The current study presents five candidate algorithms of varying complexity for classifying head movements. Each algorithm is compared against human rater classifications and graded based on the overall agreement as well as biases in metrics such as movement onset/offset time and movement amplitude. Finally, we conclude this article by offering recommendations for the best practices and considerations for VR researchers looking to incorporate head movement analysis in their future studies.

Short Step Length Estimation for Parkinson's Disease Patients by Using Fusion Data From Camera-IMU in Smart Glasses.

Shortened step length is a prominent motor abnormality in Parkinson's disease (PD) patients. Current methods for estimating short step length have the limitation of relying on laboratory scenarios, wearing multiple sensors, and inaccurate estimation results from a single sensor. In this paper, we proposed a novel method for estimating short step length for PD patients by fusing data from camera and inertial measurement units in smart glasses. A simultaneous localization and mapping technique and acceleration thresholding-based step detection technique were combined to realize the step length estimation. Two sets of experiments were conducted to demonstrate the performance of our method. In the first set of experiments with 12 healthy subjects, the proposed method demonstrated an average error of 8.44% across all experiments including six fixed step lengths below 30 cm. The second set of straightly walking experiments were implemented with 12 PD patients, the proposed method exhibited an average error of 4.27% compared to a standard gait evaluation technique in total walking distance. Notably, among the results of step lengths below 40 cm, our method agreed with the standard technique (R 2=0.8659). This study offers a promising approach for estimating short step length for PD patients during smart glasses-based gait training.

How Cognitive Absorption Influences Responses to Immersive Narratives of Environmental Threats.

Nongovernment organizations are increasingly leveraging the metaverse and its suite of extended reality technologies, such as 360° video and virtual reality, to immerse audiences in situations depicting environmental threats. The promise of immersive storytelling as a conservation tool is predicated on the verisimilitude of the mediated experience, with exposure to environmental threats in immersive video akin to in vivo exposure. However, the psychological mechanisms explaining users' environmental responses to immersive stories remain ambiguous. In three controlled laboratory experiments, we examined unique properties (e.g., interactivity and modality) of immersive technologies vis-à-vis environmental stories and their influence on proenvironmental outcomes. Study 1 (N = 48) implemented a two-condition (interactivity: high vs. low) between-subjects experiment, showing that interactive 360° video significantly influenced attitudes through the mechanism of cognitive absorption. A 2 (interactivity: high/low) × 2 (distance: proximal/distant) between-subjects experiment (study 2; N = 76) further supported this mediation model by showing the mediating effects of cognitive absorption on attitudes and threat perceptions toward both distant and proximal threats. Lastly, study 3 (N = 68) replicated the mediating effects of cognitive absorption across 360° video modalities, though head-mounted display-based, rather than screen-based, 360° videos only significantly increased attitudes and absorption when threats were proximal. We discuss the results' practical and theoretical implications and propose avenues for future research. Moreover, we outline important considerations for environmental organizations seeking to leverage metaverse platforms for communicating environmental threats.

An analysis of the effectiveness of reflective learning through watching videos recorded with smart glasses-With multiple views (student, patient, and overall) in radiography education.

The Objective Structured Clinical Examination (OSCE) is designed to assess medical students' skills and attitude competencies before clinical practice. However, no method of reflective learning using video-based content has been used in OSCE education. This study aimed to confirm whether using smart glasses-based educational content is effective for OSCE reflective learning using multiple views (patient, student, and overall). This educational intervention study included a control group exposed to the traditional learning method and an intervention group exposed to a learning method incorporating smart glasses. Participants were 117 (72 in the control group and 45 in the intervention group) third-year radiological technology students scheduled to take the OSCE and 70 (37 in the control group and 33 in the intervention group) who met the eligibility criteria. Mock OSCEs were administered before and after the educational intervention (traditional and smart glasses-based education) to investigate changes in scores. After the educational intervention, a self-reported comprehension survey and a questionnaire were administered on the effectiveness of the video-based content from different views for student reflective learning. Unexpectedly, the OSCE evaluation score after the preliminary investigation significantly increased for the smart glasses control group (0.36±0.1) compared to the intervention group (0.06±0.1) setting up the radiographic conditions (x-ray center and detector center; p = 0.042). The intervention group's lower score in the mock OSCEs may have been due to the discomfort of wearing the smart glasses to perform the radiography procedure and their unfamiliarity with the smart glasses, which may have affected their concentration. The findings suggest that smart glasses-based education for OSCEs can be improved (e.g., being easy to handle and use and trouble-free).

Smart surgical glasses for orofacial cleft surgery training in high- and low-income countries: A proof of concept.

INTRODUCTION: The coronavirus 2019 pandemic urged us to find alternatives for education through remote proctoring and international surgical collaborations among high-, middle-, and low-income countries. Smart surgical glasses are promising for remote surgical education and international surgical collaborations. AIMS: This study aimed to assess the usability of smart surgical glasses during cleft surgery and explore their potential in remote surgical education and collaboration. METHODS: Six plastic surgical cases were randomly selected and recorded using the RODS&CONES glasses in 4K (3840 × 2160p). A 23-point questionnaire was sent to one plastic surgeon, one plastic surgery resident, and eight doctors who were not trained to critically appraise the video and audio quality of the smart surgical glasses and their applicability for remote surgical education. RESULTS: The participants indicated that the smart glasses had several significant advantages over conventional on-site education, such as facilitating a better view of the surgical field and providing possibilities for remote interaction. The audio quality was considered excellent. The main limitations were image stabilization issues and loss of video connection due to weak wireless fidelity. CONCLUSIONS: All participants appreciated the use of smart glasses for remote education and considered them a promising tool for enhancing the quality of surgical education. The glasses can enable remote assistance and education of local surgical residents and may facilitate sustainable surgical collaborations among high-, middle-, and low-income countries.

New communication tool for basic life support training: smart glasses. A quasi-experimental study.

AIM: To analyze the effectiveness of a teaching-learning methodology for teletraining in basic life support (BLS) based on communication through smart glasses. DESIGN: Pilot quasi-experimental non-inferiority study. PARTICIPANTS: Sixty college students. INTERVENTIONS: Randomization of the participants in: tele-training through smart glasses (SG) and traditional training (C) groups. Both training sessions were very brief (less than 8 min) and included the same BLS content. In SG, the instructor trained through a video call with smart glasses. MAIN VARIABLES OF INTEREST: The BLS protocol, the use of AED, the quality of resuscitation and the response times were evaluated. RESULTS: In most of the BLS protocol variables, the resuscitation quality and performance times, there were no statistically significant differences between groups. There were significant differences (in favor of the SG) in the assessment of breathing (SG: 100%, C: 81%; p = 0.013), the not-to-touch warning before applying the shock (SG: 79%, C: 52%; p = 0.025) and compressions with correct recoil (SG: 85%, C: 32%; p = 0.008). CONCLUSIONS: Laypeople BLS-AED brief tele-training through smart glasses could potentially be, at least, as effective as traditional training methods. In addition, smart glasses could be more advantageous than traditional teaching for certain points of the BLS protocol and chest compressions quality, probably due to the capability of real-time visualization of images which supports the BLS sequence. Augmented reality supported teaching should be considered for BLS training, although caution is required in extrapolating findings, and further in-depth studies are needed to confirm its potential role depending on concrete target populations and environments.

Slim and robust eye tracker on eyeglass temples with NIR patterned mirrors.

Eye trackers play a crucial role in the development of future display systems, such as head-mounted displays and augmented reality glasses. However, ensuring robustness and accuracy in gaze estimation poses challenges, particularly with limited space available for the transmitter and receiver components within these devices. To address the issues, we propose what we believe is a novel eye tracker design mounted on foldable temples, which not only supports accurate gaze estimation but also provides slim form-factor and unobstructed vision. Our temple-mounted eye tracker utilizes a near-infrared imaging system and incorporates a patterned near-infrared mirror for calibration markers. We present wearable prototypes of the eye tracker and introduce a unique calibration and gaze extraction algorithm by considering the mirror's spatial reflectance distribution. The accuracy of gaze extraction is evaluated through tests involving multiple users with realistic scenarios. We conclude with an evaluation of the results and a comprehensive discussion on the applicability of the temple-mounted eye tracker.

The use of smart glasses in nursing education: A scoping review.

AIM: The aim of this scoping review was to give an overview of the usability and feasibility of smart glasses in nursing education. In addition, this study will highlight nursing students' experiences of using smart glasses in learning situations. BACKGROUND: Healthcare is becoming increasingly complex and technological and so is nursing education. Technology enhanced learning aims to enhance the teaching-learning process through use of technology, for example through smart glasses. DESIGN AND METHODS: A literature review using a scoping review methodology was conducted. Qualitative content analysis was performed to analyse data. 14 references were included in the analysis. References were found using the databases PubMed, SCOPUS and ERIC. RESULTS: The analysis resulted in three categories; (1) Situations in which smart glasses have been used in nursing education, (2) Learning experiences from using smart glasses in nursing education, and (3) User experiences from using smart glasses in nursing education. Smart glasses were used in different learning situations and were in general positively evaluated by nursing students. Although, drawbacks of using smart glasses were noted which could negatively effect student learning. CONCLUSIONS: Smart glasses have been used in a variety of learning situations in nursing education and enabled new learning situations. Students found smart glasses beneficial for their learning and smart glasses motivated and engaged students in the learning situation. Although, this was both user- and situation dependent. Technical issues could cause students to lose focus and there is need for technical support to facilitate the learning curve. By learning from others' experiences unnecessary drawbacks can be avoided.

Measuring trust with the Wayfinding Task: Implementing a novel task in immersive virtual reality and desktop setups across remote and in-person test environments.

Trust is a key feature of social relationships. Common measures of trust, questionnaires and economic games, lack ecological validity. Hence, we sought to introduce an immersive, virtual reality (VR) measure for the behavioral assessment of trust across remote and in-person settings, building on the maze task of Hale et al. (2018). Our 'Wayfinding Task' consists of an interconnected urban environment for participants to navigate on the advice of two characters of differing trustworthiness. We present four studies implementing the Wayfinding Task in remote and in-person testing environments and comparing performance across head-mounted display (HMD)-based VR and desktop setups. In each study, the trustworthiness of two virtual characters was manipulated, through either a fact sheet providing trustworthiness information, or a behavior-based trustworthiness manipulation task termed the Door Game, based on Van der Biest et al., 2020. Participants then completed the Wayfinding Task. Overall, we found that participant behavior in the Wayfinding Task reflected the relative trustworthiness of the two characters; in particular, the trustworthy character was approached more often for advice, reflecting data from our Door Game. We found mostly null results for our novel outcome measure, interpersonal distance. Remote testing successfully achieved these effects. While HMD-based VR and desktop setups both showed these effects, there was a stronger effect of trustworthiness in the HMD VR version of the task. These results have implications for the measurement of trust in behavioral settings and the use of remote and VR-based testing in social experiments.

The effect of visual rivalry in peripheral head-mounted displays on mobility.

Recent head-mounted displays and smart glasses use vision multiplexing, an optical approach where two or more views are superimposed on each other. In vision multiplexing, augmented information is presented over an observer's natural field of view, providing field expansion and critical information during mobility situations like walking and driving. Yet despite its utility, vision multiplexing may produce visual rivalry, a phenomenon where perception alternates between the augmented information and the background scene for seconds at a time. To investigate, we compared the effect of different peripheral vision multiplexing configurations (unilateral opaque, unilateral see-through and bilateral see-through) on the detection of augmented information, incorporating at the same time real-world characteristics (target eccentricity, depth condition, and gaze movement) for a more realistic assessment. Results showed a persistently lower target detection rate in unilateral configurations than the bilateral configuration, suggesting a larger effect of binocular rivalry on target visibility. Nevertheless, this effect does become attenuated when more naturalistic elements are incorporated, and we discuss recommendations for vision multiplexing design and possible avenues for further research.

Impact of Smart Glasses on Patient Care Time in Emergency Medical Services Ambulance.

INTRODUCTION: The smart glasses were implemented as an innovative communication tool to enhance effectiveness in the field. The traditional mode of communication for Emergency Medical Services (EMS) was radio, which had significant restrictions, primarily that they were unable to transmit any visual data. To enhance efficiency, the smart glasses were used for a more accurate assessment of the condition of patients during transportation. At this time, however, no prior study has shown significant benefits of employing smart glasses into EMS. STUDY OBJECTIVE: The primary objective of this study is to compare the duration of patient care in an ambulance between the use and non-use of smart glasses. The secondary objective is to identify the characteristics of data communication between the ambulance and the hospital. METHODS: This retrospective study utilized data gathered from closed-circuit television (CCTV) in ambulances at Srinagarind Hospital, Thailand. The data were collected over a six-month period, specifically from July through December 2021. The study included two groups: the smart glasses group and no smart glasses groups, both used during EMS operations. The primary data collected focused on the duration of patient care in the ambulance. Additionally, the type and characteristics of data transfers via smart glasses during EMS operations were also recorded. RESULTS: Out of the 256 EMS operations included in this study, 53.1% (N = 68) of the participants in the smart glasses group were male. The majority of operations were performed during the afternoon shift in both groups. The average patient care time in the smart glasses group was 10.07 minutes, while it was 5.10 minutes in the no smart glasses group (P <.001), indicating a significant difference. Visual data communication between the ambulance and the hospital via smart glasses predominantly involved vital signs (100.0%), physical examination (56.3%), and neurological examination (42.2%). The use of audio data from the hospital to the ambulance primarily included taking additional patient history (26.6%) and performing physical examinations (19.5%). CONCLUSION: The implementation of smart glasses in EMS operations resulted in an increase in patient care time in the ambulance. Furthermore, the use of smart glasses facilitated an effective channel of real-time two-way communication between the ambulance and the hospital.

Comparing Gaze, Head and Controller Selection of Dynamically Revealed Targets in Head-Mounted Displays.

This paper presents a head-mounted virtual reality study that compared gaze, head, and controller pointing for selection of dynamically revealed targets. Existing studies on head-mounted 3D interaction have focused on pointing and selection tasks where all targets are visible to the user. Our study compared the effects of screen width (field of view), target amplitude and width, and prior knowledge of target location on modality performance. Results show that gaze and controller pointing are significantly faster than head pointing and that increased screen width only positively impacts performance up to a certain point. We further investigated the applicability of existing pointing models. Our analysis confirmed the suitability of previously proposed two-component models for all modalities while uncovering differences for gaze at known and unknown target positions. Our findings provide new empirical evidence for understanding input with gaze, head, and controller and are significant for applications that extend around the user.

Towards smart glasses for facial expression recognition using OMG and machine learning.

This study aimed to evaluate the use of novel optomyography (OMG) based smart glasses, OCOsense, for the monitoring and recognition of facial expressions. Experiments were conducted on data gathered from 27 young adult participants, who performed facial expressions varying in intensity, duration, and head movement. The facial expressions included smiling, frowning, raising the eyebrows, and squeezing the eyes. The statistical analysis demonstrated that: (i) OCO sensors based on the principles of OMG can capture distinct variations in cheek and brow movements with a high degree of accuracy and specificity; (ii) Head movement does not have a significant impact on how well these facial expressions are detected. The collected data were also used to train a machine learning model to recognise the four facial expressions and when the face enters a neutral state. We evaluated this model in conditions intended to simulate real-world use, including variations in expression intensity, head movement and glasses position relative to the face. The model demonstrated an overall accuracy of 93% (0.90 f1-score)-evaluated using a leave-one-subject-out cross-validation technique.

Usability evaluation of augmented reality visualizations on an optical see-through head-mounted display for assisting machine operations.

This study explores the effect of using different visual information overlays and guiding arrows on a machine operation task with an optical see-through head-mounted display (OST-HMD). Thirty-four participants were recruited in the experiment. The independent variables included visual information mode (text, animation, and mixed text and animation) and the use of guiding arrows (with and without arrows). In addition, gender difference was also an objective of this study. The task performance indicators were determined based on task completion time and error counts as well as subjective measures (system usability scale, NASA task load index, and immersion scale). This study used the mixed analysis of variance design to evaluate the main and interaction effects. The results showed that males performed better when using the mixed text and animation mode. Females performed better when using the text mode. In addition, using the mixed text and animation mode demonstrated the best outcome in system usability scale and NASA task load index. For the use of guiding arrows, the task completion time was reduced and the system usability scale, NASA task load index, and immersion scale showed positive effects.

Real Time, Remote, and Recorded: Medical Student Experiences with Smart Glasses in Obstetrical Simulation.

OBJECTIVES: The coronavirus disease 2019 pandemic generated the need for a teaching tool for enhancing remote education and evaluation of medical trainees. Smart glasses are being explored as a hands-free teaching tool for teleconferencing with hands-on demonstrations in addition to livestreaming capability. We wanted to understand the efficacy of such virtual teaching techniques in teaching procedural and surgical skills. METHODS: Medical students in their Obstetrics and Gynecology clerkship at our medical school were recruited to participate in a virtual demonstration of normal vaginal delivery. A birthing simulator and smart glasses were used to livestream the simulated delivery, and a previously published checklist was used to show the steps for conducting routine vaginal delivery. A follow-up electronic survey assessed the clarity of the video and audio feed, level of satisfaction, positive and constructive feedback, and an error-identification exercise with a smart glass-recorded video. RESULTS: A total of 62 students participated; 98% of them reported that the audio and video feeds were clear and 95% of the students reported being extremely satisfied or satisfied with the teaching tool. Students could identify on average three out of four errors. Students believed the streaming to be "interactive" and a "most effective remote learning" tool, but expressed that it did not "take the place of clinical skills learning." CONCLUSIONS: The combination of smart glass technology and simulation can be a useful new tool for clinical faculty who simultaneously deliver care to patients and teach. Continued research is needed to explore the use of smart glass technology into livestreaming or surgeries and examinations, with consideration for patient privacy concerns and remote assessment of students.

Photoplethysmogram Biometric Authentication Using a 1D Siamese Network.

In the head-mounted display environment for experiencing metaverse or virtual reality, conventional input devices cannot be used, so a new type of nonintrusive and continuous biometric authentication technology is required. Since the wrist wearable device is equipped with a photoplethysmogram sensor, it is very suitable for use for nonintrusive and continuous biometric authentication purposes. In this study, we propose a one-dimensional Siamese network biometric identification model using a photoplethysmogram. To maintain the unique characteristics of each person and reduce noise in preprocessing, we adopted a multicycle averaging method without using a bandpass or low-pass filter. In addition, to verify the effectiveness of the multicycle averaging method, the number of cycles was changed and the results were compared. Genuine and impostor data were used to verify the biometric identification. We used the one-dimensional Siamese network to verify the similarity between the classes and found that the method with five overlapping cycles was the most effective. Tests were conducted on the overlapping data of five single-cycle signals and excellent identification results were observed, with an AUC score of 0.988 and an accuracy of 0.9723. Thus, the proposed biometric identification model is time-efficient and shows excellent security performance, even in devices with limited computational capabilities, such as wearable devices. Consequently, our proposed method has the following advantages compared with previous works. First, the effect of noise reduction and information preservation through multicycle averaging was experimentally verified by varying the number of photoplethysmogram cycles. Second, by analyzing authentication performance through genuine and impostor matching analysis based on a one-dimensional Siamese network, the accuracy that is not affected by the number of enrolled subjects was derived.