Optical coherence tomography-based consensus definition for lamellar macular hole.

BackgroundA consensus on an optical coherence tomography definition of lamellar macular hole (LMH) and similar conditions is needed.MethodsThe panel reviewed relevant peer-reviewed literature to reach an accord on LMH definition and to differentiate LMH from other similar conditions.ResultsThe panel reached a consensus on the definition of three clinical entities: LMH, epiretinal membrane (ERM) foveoschisis and macular pseudohole (MPH). LMH definition is based on three mandatory criteria and three optional anatomical features. The three mandatory criteria are the presence of irregular foveal contour, the presence of a foveal cavity with undermined edges and the apparent loss of foveal tissue. Optional anatomical features include the presence of epiretinal proliferation, the presence of a central foveal bump and the disruption of the ellipsoid zone. ERM foveoschisis definition is based on two mandatory criteria: the presence of ERM and the presence of schisis at the level of Henle's fibre layer. Three optional anatomical features can also be present: the presence of microcystoid spaces in the inner nuclear layer (INL), an increase of retinal thickness and the presence of retinal wrinkling. MPH definition is based on three mandatory criteria and two optional anatomical features. Mandatory criteria include the presence of a foveal sparing ERM, the presence of a steepened foveal profile and an increased central retinal thickness. Optional anatomical features are the presence of microcystoid spaces in the INL and a normal retinal thickness.ConclusionsThe use of the proposed definitions may provide uniform language for clinicians and future research

Robotic simulators for tissue examination training with multimodal sensory feedback

Tissue examination by hand remains an essential technique in clinical practice. The effective application depends on skills in sensorimotor coordination, mainly involving haptic, visual, and auditory feedback. The skills clinicians have to learn can be as subtle as regulating finger pressure with breathing, choosing palpation action, monitoring involuntary facial and vocal expressions in response to palpation, and using pain expressions both as a source of information and as a constraint on physical examination. Patient simulators can provide a safe learning platform to novice physicians before trying real patients. This paper reviews state-of-the-art medical simulators for the training for the first time with a consideration of providing multimodal feedback to learn as many manual examination techniques as possible. The study summarizes current advances in tissue examination training devices simulating different medical conditions and providing different types of feedback modalities. Opportunities with the development of pain expression, tissue modeling, actuation, and sensing are also analyzed to support the future design of effective tissue examination simulators

A Review of Pneumatic Actuators Used for the Design of Medical Simulators and Medical Tools

International audienc

Augmented reality (AR) for surgical robotic and autonomous systems: State of the art, challenges, and solutions

Despite the substantial progress achieved in the development and integration of augmented reality (AR) in surgical robotic and autonomous systems (RAS), the center of focus in most devices remains on improving end-effector dexterity and precision, as well as improved access to minimally invasive surgeries. This paper aims to provide a systematic review of different types of state-of-the-art surgical robotic platforms while identifying areas for technological improvement. We associate specific control features, such as haptic feedback, sensory stimuli, and human-robot collaboration, with AR technology to perform complex surgical interventions for increased user perception of the augmented world. Current researchers in the field have, for long, faced innumerable issues with low accuracy in tool placement around complex trajectories, pose estimation, and difficulty in depth perception during two-dimensional medical imaging. A number of robots described in this review, such as Novarad and SpineAssist, are analyzed in terms of their hardware features, computer vision systems (such as deep learning algorithms), and the clinical relevance of the literature. We attempt to outline the shortcomings in current optimization algorithms for surgical robots (such as YOLO and LTSM) whilst providing mitigating solutions to internal tool-to-organ collision detection and image reconstruction. The accuracy of results in robot end-effector collisions and reduced occlusion remain promising within the scope of our research, validating the propositions made for the surgical clearance of ever-expanding AR technology in the future

Advancing proxy-based haptic feedback in virtual reality

This thesis advances haptic feedback for Virtual Reality (VR). Our work is guided by Sutherland's 1965 vision of the ultimate display, which calls for VR systems to control the existence of matter. To push towards this vision, we build upon proxy-based haptic feedback, a technique characterized by the use of passive tangible props. The goal of this thesis is to tackle the central drawback of this approach, namely, its inflexibility, which yet hinders it to fulfill the vision of the ultimate display. Guided by four research questions, we first showcase the applicability of proxy-based VR haptics by employing the technique for data exploration. We then extend the VR system's control over users' haptic impressions in three steps. First, we contribute the class of Dynamic Passive Haptic Feedback (DPHF) alongside two novel concepts for conveying kinesthetic properties, like virtual weight and shape, through weight-shifting and drag-changing proxies. Conceptually orthogonal to this, we study how visual-haptic illusions can be leveraged to unnoticeably redirect the user's hand when reaching towards props. Here, we contribute a novel perception-inspired algorithm for Body Warping-based Hand Redirection (HR), an open-source framework for HR, and psychophysical insights. The thesis concludes by proving that the combination of DPHF and HR can outperform the individual techniques in terms of the achievable flexibility of the proxy-based haptic feedback.Diese Arbeit widmet sich haptischem Feedback für Virtual Reality (VR) und ist inspiriert von Sutherlands Vision des ultimativen Displays, welche VR-Systemen die Fähigkeit zuschreibt, Materie kontrollieren zu können. Um dieser Vision näher zu kommen, baut die Arbeit auf dem Konzept proxy-basierter Haptik auf, bei der haptische Eindrücke durch anfassbare Requisiten vermittelt werden. Ziel ist es, diesem Ansatz die für die Realisierung eines ultimativen Displays nötige Flexibilität zu verleihen. Dazu bearbeiten wir vier Forschungsfragen und zeigen zunächst die Anwendbarkeit proxy-basierter Haptik durch den Einsatz der Technik zur Datenexploration. Anschließend untersuchen wir in drei Schritten, wie VR-Systeme mehr Kontrolle über haptische Eindrücke von Nutzern erhalten können. Hierzu stellen wir Dynamic Passive Haptic Feedback (DPHF) vor, sowie zwei Verfahren, die kinästhetische Eindrücke wie virtuelles Gewicht und Form durch Gewichtsverlagerung und Veränderung des Luftwiderstandes von Requisiten vermitteln. Zusätzlich untersuchen wir, wie visuell-haptische Illusionen die Hand des Nutzers beim Greifen nach Requisiten unbemerkt umlenken können. Dabei stellen wir einen neuen Algorithmus zur Body Warping-based Hand Redirection (HR), ein Open-Source-Framework, sowie psychophysische Erkenntnisse vor. Abschließend zeigen wir, dass die Kombination von DPHF und HR proxy-basierte Haptik noch flexibler machen kann, als es die einzelnen Techniken alleine können

Presence 2005: the eighth annual international workshop on presence, 21-23 September, 2005 University College London (Conference proceedings)

OVERVIEW (taken from the CALL FOR PAPERS) Academics and practitioners with an interest in the concept of (tele)presence are invited to submit their work for presentation at PRESENCE 2005 at University College London in London, England, September 21-23, 2005. The eighth in a series of highly successful international workshops, PRESENCE 2005 will provide an open discussion forum to share ideas regarding concepts and theories, measurement techniques, technology, and applications related to presence, the psychological state or subjective perception in which a person fails to accurately and completely acknowledge the role of technology in an experience, including the sense of 'being there' experienced by users of advanced media such as virtual reality. The concept of presence in virtual environments has been around for at least 15 years, and the earlier idea of telepresence at least since Minsky's seminal paper in 1980. Recently there has been a burst of funded research activity in this area for the first time with the European FET Presence Research initiative. What do we really know about presence and its determinants? How can presence be successfully delivered with today's technology? This conference invites papers that are based on empirical results from studies of presence and related issues and/or which contribute to the technology for the delivery of presence. Papers that make substantial advances in theoretical understanding of presence are also welcome. The interest is not solely in virtual environments but in mixed reality environments. Submissions will be reviewed more rigorously than in previous conferences. High quality papers are therefore sought which make substantial contributions to the field. Approximately 20 papers will be selected for two successive special issues for the journal Presence: Teleoperators and Virtual Environments. PRESENCE 2005 takes place in London and is hosted by University College London. The conference is organized by ISPR, the International Society for Presence Research and is supported by the European Commission's FET Presence Research Initiative through the Presencia and IST OMNIPRES projects and by University College London

Kinematic optimization for the design of a collaborative robot end-effector for tele-echography

Tele-examination based on robotic technologies is a promising solution to solve the current worsening shortage of physicians. Echocardiography is among the examinations that would benefit more from robotic solutions. However, most of the state-of-the-art solutions are based on the development of specific robotic arms, instead of exploiting COTS (commercial-off-the-shelf) arms to reduce costs and make such systems affordable. In this paper, we address this problem by studying the design of an end-effector for tele-echography to be mounted on two popular and low-cost collaborative robots, i.e., the Universal Robot UR5, and the Franka Emika Panda. In the case of the UR5 robot, we investigate the possibility of adding a seventh rotational degree of freedom. The design is obtained by kinematic optimization, in which a manipulability measure is an objective function. The optimization domain includes the position of the patient with regards to the robot base and the pose of the end-effector frame. Constraints include the full coverage of the examination area, the possibility to orient the probe correctly, have the base of the robot far enough from the patient’s head, and a suitable distance from singularities. The results show that adding a degree of freedom improves manipulability by 65% and that adding a custom-designed actuated joint is better than adopting a native seven-degrees-freedom robot

A Prospective Look: Key Enabling Technologies, Applications and Open Research Topics in 6G Networks

The fifth generation (5G) mobile networks are envisaged to enable a plethora of breakthrough advancements in wireless technologies, providing support of a diverse set of services over a single platform. While the deployment of 5G systems is scaling up globally, it is time to look ahead for beyond 5G systems. This is driven by the emerging societal trends, calling for fully automated systems and intelligent services supported by extended reality and haptics communications. To accommodate the stringent requirements of their prospective applications, which are data-driven and defined by extremely low-latency, ultra-reliable, fast and seamless wireless connectivity, research initiatives are currently focusing on a progressive roadmap towards the sixth generation (6G) networks. In this article, we shed light on some of the major enabling technologies for 6G, which are expected to revolutionize the fundamental architectures of cellular networks and provide multiple homogeneous artificial intelligence-empowered services, including distributed communications, control, computing, sensing, and energy, from its core to its end nodes. Particularly, this paper aims to answer several 6G framework related questions: What are the driving forces for the development of 6G? How will the enabling technologies of 6G differ from those in 5G? What kind of applications and interactions will they support which would not be supported by 5G? We address these questions by presenting a profound study of the 6G vision and outlining five of its disruptive technologies, i.e., terahertz communications, programmable metasurfaces, drone-based communications, backscatter communications and tactile internet, as well as their potential applications. Then, by leveraging the state-of-the-art literature surveyed for each technology, we discuss their requirements, key challenges, and open research problems