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Background Active video games are a new method for increasing physical activity (PA). Fully immersive virtual reality (VR) is a hardware device on which an active video game can run. Active (video games in) VR (AVR), might increase immersion, game engagement, and MVPA, thereby yielding greater exercise-related benefits, e.g., cognitive performance. Methods We examined the induction of moderate-to-vigorous PA (MVPA) via an AVR and a sedentary VR (SVR) as well as the effects of VR play on cognitive performance, which was monitored using 2 different methods. Each of 29 sedentary college students attended three 20-min laboratory sessions (AVR, SVR, or control) in a randomized order; during the control session, they sat quietly doing nothing. A fully immersive headset was used for the 2 video game sessions. We monitored and computed participants’ PA using hip-worn accelerometers (wGT3x-bt; ActiGraph, Pensacola, FL, USA) and a heart rate band (Polar H7; Polar, Kempele, Finland). After each session, the participants completed a mnemonic similarity test (MST) to measure recognition memory. They also filled out a motion sickness questionnaire and an abbreviated game experience questionnaire. Results The AVR session induced a significantly greater heart rate and more time spent in MVPA than did either of the other 2 sessions regardless of the PA monitoring method. AVR elicited greater game experience questionnaire-assessed sensory and imaginative immersion, challenge, and positive affect than did SVR. The mnemonic similarity test recognition score was marginally higher post-AVR session than it was post-SVR session. Conclusion AVR elicited MVPA without a significant increase in motion sickness and induced a better game experience and better borderline cognitive performance than did SVR.

Objective The recent development of extended reality technology has attracted interest in medicine. We explored the use of patient-specific virtual reality (VR) and mixed reality (MR) temporal bone models in anatomical teaching, pre-operative surgical planning and intra-operative surgical referencing. Methods VR and MR temporal bone models were created and visualized on head-mounted display (HMD) and MR headset respectively, by a novel webservice that allows users to convert computed tomography images to VR and MR images without specific knowledge of programming. Eleven otorhinolaryngology trainees and specialists were asked to manipulate the healthy VR temporal bone model and to assess its validity by filling out a questionnaire. Additionally, VR and MR pathological models of petrous apex cholesteatoma were utilized for surgical planning pre-operatively and for referring to the anatomy during the surgery. Results Most participants were favorable about the VR model and considered HMD as superior to a flat computer screen. 91% of the participants agreed or somewhat agreed that VR through HMD is cost effective. In addition, the VR pathological model was used for planning and sharing the surgical approach during a pre-operative surgical conference. The MR headset was worn intra-operatively to clarify the relationship between the pathological lesion and vital anatomical structures. Conclusion Regardless of the participants’ training level in otorhinolaryngology or VR experience, all participants agreed that the VR temporal bone model is useful for anatomical education. Furthermore, the creation of patient-specific VR and MR models using the webservice and their pre- and intra-operative usages indicated the potential of innovative adjunctive surgical instrument.

To reduce serious crashes, contemporary research leverages opportunities provided by technology. A potentially higher added value to reduce road trauma may be hidden in utilising emerging technologies, such as headset-delivered virtual reality (VR). However, there is no study to analyse the application of such VR in road safety research systematically. Using the PRISMA protocol, our study identified 39 papers presented at conferences or published in scholarly journals. In those sources, we found evidence of VR's applicability in studies involving different road users (drivers, pedestrians, cyclists and passengers). A number of articles were concerned with providing evidence around the potential adverse effects of VR, such as simulator sickness. Other work compared VR with conventional simulators. VR was also contributing to the emerging field of autonomous vehicles. However, few studies leveraged the opportunities that VR presents to positively influence the involved road users' behaviour. Based on our findings, we identified pathways for future research.

PURPOSE Intracavitary brachytherapy is critical in treatment of cervical cancer with the highest rates of local control and survival. Only about 50% of graduating residents express confidence to develop a brachytherapy practice with caseload as the greatest barrier. We hypothesize that virtual reality (VR)-based intracavitary brachytherapy simulation will improve resident confidence, engagement, and proficiency. METHODS We created a VR training video of an intracavitary brachytherapy case performed by a board-certified gynecologic radiation oncologist and medical physicist. Residents performed a timed intracavitary procedure on a pelvic simulator before and after viewing the VR simulation module on a commercially available VR headset while five objective measures of implant quality were recorded. The residents completed a pre- and postsimulation questionnaire assessing self-confidence, procedural knowledge, and perceived usefulness of the session. RESULTS There were 14 residents, including five postgraduate year (PGY)-2, three PGY-3, four PGY-4, and two PGY-5, who participated in the VR curriculum. There were improvements in resident confidence (1.43–3.36), and subjective technical skill in assembly (1.57–3.50) and insertion (1.64–3.21) after the simulation. Average time of implant decreased from 5:51 to 3:34 (p = 0.0016). Median technical proficiencies increased from 4/5 to 5/5. Overall, the residents found VR to be a useful learning tool and indicated increased willingness to perform the procedure again. CONCLUSIONS VR intracavitary brachytherapy simulation improves residents’ self-confidence, subjective and objective technical skills, and willingness to perform brachytherapy. Furthermore, VR is an immersive, engaging, time-efficient, inexpensive, and enjoyable tool that promotes residents interest in brachytherapy.

An important aspect in safety–critical domains is Situational Awareness (SA) where operators consolidate data into an understanding of the situation that needs to be updated dynamically as the situation changes over time. Among existing measures of SA, only physiological measures can assess the cognitive processes associated with SA in real-time. Some studies showed promise in detecting cognitive states associated with SA in complex tasks using brain signals (e.g. electroencephalogram/EEG). In this paper, an analytical methodology is proposed to identify EEG signatures associated with SA on various regions of the brain. A new data set from 32 participants completing the SA test in the PEBL is collected using a 32-channel dry-EEG headset. The proposed method is tested on the new data set and a correlation is identified between the frequency bands of β ( 12 - 30 Hz ) and γ ( 30 - 45 Hz ) and SA. Also, activation of neurons in the left and right hemisphere of the parietal and temporal lobe is observed. These regions are responsible for the visuo-spatial ability and memory and reasoning tasks. Among the presented results, the highest achieved accuracy on test data is 67 % .

This paper describes the development of PlatypOUs - an open-source electromyography (EMG)-controlled mobile robot platform that uses the MindRove Brain Computer Interface (BCI) headset as signal acquisition unit, implementing remote control. Simultaneously with the physical mobile robot, simulation environment is also prepared using Gazebo, within the Robot Operating System (ROS) framework, with the same capabilities as the physical device, from the point of view of the ROS. The purpose of the PlatypOUs project is to create a tool for STEM-based education, and it involves two major disciplines: mobile robotics and machine learning, with several sub-areas included in each. The use of the platform and the simulation environment exposes students to hands-on laboratory sessions, which contribute to their progression as engineers. An important feature of our project is that the platform is made up of open-source and easily available commercial hardware and software components. In this paper, an electromyography (EMG) based controller has been developed using support vector machine (SVM) based classification for robot control purposes.

Brain Computer Interfaces (BCIs) allow a user to control a computer application by acquiring brain activity using Electro Enchephalo Gram (EEG). Non-invasive practical EEG headset available in the market brings more and more research in the field of BCI. BCI applications such as speller device is used both in entertainment field and health industry for typing using brain without using hands. There are a variety of paradigms available for designing a BCI based speller device. Here the primary design goals are to analyze the following parameters: speed in terms of the information transfer rate (ITR) and accuracy of word selection and increasing user friendliness. The common requirement for each method is stimulus design. In most cases the stimulus designs are responsible for the performance factors. This paper analyses the design of those stimuli used in the speller device and the associated Event Related Potential (ERP). The design parameters common to all the methodologies and performance parameters are also systematically discussed. The character selection time with each type of stimuli also has been compared.

This paper presents an Augmented Reality (AR) application that aims to facilitate the operator’s work in an industrial, human-robot collaboration environment with mobile robots. In such a flexible environment, with robots and humans working and moving in the same area, the ease of communication between the two sides is critical and prerequisite. The developed application provides the user with handy tools to interact with the mobile platform, give direct instructions to it and receive information about the robot’s and the broader system’s state, through an AR headset. The communication between the headset and the robot is achieved through a ROS based system, that interconnects the resources. The discussed tool has been deployed and tested in a use case inspired from the automotive industry, assisting the operators during the collaborative assembly tasks.

In this paper we evaluate the accuracy, recording interference, and articulatory quality of two different ultrasound probe stabilization headsets: a metallic Ultrasound Stabilisation Headset (USH) and UltraFit, a recently developed headset that is 3D printed in Nylon. To evaluate accuracy, we recorded three native speakers of German with different head sizes using an optical marker tracking system that provides sub-millimeter tracking accuracy (NaturalPoint OptiTrack Expression). The speakers had to read C1V1C2V1/2 non-words (to diminish lexical influences) in three conditions: wearing the USH headset, wearing the UltraFit headset, and without a headset. To estimate the relative headset movement, we measured the movement between tracked points on the probe, headset, and speaker’s nose. By also tracking visual marker points on the speaker’s lip and chin, we compared the movement of the outer articulators with and without a headset and, thereby, measured how the headsets interfere with the articulatory space of the speaker. Additionally, we computed the differences in tongue profiles at the acoustic midpoint of V1 under the three conditions and evaluated the articulatory recording quality with a distance index and an area index. In the final evaluation, we also compared formant measurements of recordings with and without headsets. With this objective evaluation we provide a systematic analysis of different headsets for Ultrasound Tongue Imaging (UTI) and also contribute to the discussion of using UTI stabilization headsets for recording natural speech. We show that both headsets have a similar accuracy, with the USH performing slightly better overall but introducing the largest error for one speaker, and that the UltraFit headset shows more flexibility during recordings. Each headset influences the lip opening differently. Concerning the tongue movement, there are no significant differences between different sessions, showing the stability of both headsets during the recordings. Acoustic analysis of formant differences in vowels revealed that the USH headset has a larger influence on formant production than the UltraFit headset.

Eye-tracking with gaze estimation is a key element in many applications, ranging from foveated rendering and user interaction to behavioural analysis and usage metrics. For virtual reality, eye-tracking typically relies on near-eye cameras that are mounted in the VR headset. Such methods usually involve an initial calibration to create a mapping from eye features to a gaze position. However, the accuracy based on the initial calibration degrades when the position of the headset relative to the users’ head changes; this is especially noticeable when users readjust the headset for comfort or even completely remove it for a short while. We show that a correction of such shifts can be achieved via 2D drift vectors in eye space. Our method estimates these drifts by extracting salient cues from the shown virtual environment to determine potential gaze directions. Our solution can compensate for HMD shifts, even those arising from taking off the headset, which enables us to eliminate reinitialization steps.

Talking on a cell phone can impair driving performance, but the dynamics of this effect are not fully understood. We examined the effects of leaving a voicemail message on driving when there are critical driving targets to attend to (crosswalks and pedestrians). Participants engaged in an ecologically-valid “voicemail” task while navigating a virtual environment using a driving simulator. We also examined the potential weakening or strengthening of effects of leaving a voicemail message on driving as the familiarity and predictability of critical targets changed. Participants completed four experimental runs through the same driving environment in a driving simulator. There were two crosswalks, one with a pedestrian entering the roadway and one without a pedestrian and the location of the pedestrian was predictable (the same pedestrian consistently used the same crosswalk) for the first three runs and then unpredictable for the fourth. Half of the participants left voicemail messages using a hands-free headset, while the other half drove in silence. Leaving a voicemail message increased steering deviation and velocity. Drivers who were leaving a voicemail message decelerated for pedestrians in the roadway to a similar speed as drivers who were not leaving a voicemail message, but they were delayed in braking. Drivers who were leaving a voicemail message also had worse memory for roadway landmarks. These effects were relatively stable across runs through the same driving environment, suggesting that familiarity and predictability did not impact the effects of leaving a voicemail message while driving. Therefore, leaving a voicemail message leads to poorer driving behavior; faster speed, variable steering, and worse memory for roadway landmarks. Interestingly, although drivers who were leaving a voicemail message were slower to react to local targets, they slowed as much as drivers who were not leaving a voicemail message and familiarity with the driving environment did not impact the effects of leaving a voicemail message on driving.

Emotion recognition from electroencephalography (EEG) has been an important research direction in affective brain–computer interactions (ABCI). An integration of EEG-based emotion recognition algorithms in ABCI can make the users experience more complete and engaging. In this paper, we propose a new data representation of electroencephalogram (EEG), which transforms 1D chain-like EEG vector sequences into 2D mesh-like matrix sequences. The mesh structure of the matrix at each time point corresponds to the electrodes’ location of EEG headset, which could better represent the spatial correlation of EEG signals among multiple physically adjacent electrodes. Then, the sliding window is used to divide the 2D matrix sequences into segments containing equal time points, and each segment is seen as an EEG sample integrating the temporal and spatial correlation of raw EEG recordings. We also propose both cascaded and parallel hybrid convolution recurrent neural networks to accurately predict the emotional category of each EEG sample. Extensive binary emotion classification experiments in valence and arousal are carried out on a large scale DEAP dataset (32 subjects, 9,830,400 EEG recordings). The experimental results demonstrate that the classification accuracies of both proposed hybrid networks on our spatial–temporal EEG representation achieve over 93%, which outperform the most recent baseline methods and other deep learning models in within-subject validation scenario. Our proposed methods and hybrid models effectively improve the accuracy and robustness of EEG emotion classification, which can be applied to develop affective BCI applications using consumer multi-electrode EEG headset.

This paper introduces an intelligent system that can manipulate an industrial robot using the electroencephalogram signals of human brains to perform collaborative assembly tasks. The system is initiated by capturing the brain signals using a wearable headset, and the signals are then filtered to remove any possible artifact. Consequently, the process continues by identifying the brain signals patterns using a classifier based on pre-recorded samples. The classifier’s output determines the proper matching of the robot command that is intended by the human. To validate the results, an industrial collaborative assembly scenario of a car manifold is examined as a case study.

Recent advances in technology bring about novel operating environments where the role of human participants is reduced to passive observation. While opening new frontiers in productivity and lifestyle, such environments also create hazards related to the inability of human individuals to maintain focus and concentration during passive control tasks. A passive brain-computer interface for monitoring mental attention states of human individuals (focused, unfocused, and drowsy) by using electroencephalographic (EEG) brain activity imaging and machine learning data analysis methods is developed in this work. An EEG data processing pipeline and a machine learning mental state detection algorithm using the Support Vector Machine (SVM) method were designed and compared with k-Nearest Neighbor and Adaptive Neuro-Fuzzy System methods. To collect 25 h of EEG data from 5 participants, a classic EEG headset was modified. We found that the changes in EEG activity in frontal and parietal lobes occurring at 1–5 Hz and 10–15 Hz frequency bands were associated with the changes in individuals’ attention state. We demonstrated the ability to use such changes to identify individuals’ attention state with 96.70% (best) and 91.72% (avg.) accuracy in experimental settings using a version of continuous performance task with SVM-based mental state detector. The findings help guide the design of future systems for monitoring the state of human individuals by means of EEG brain activity data.

Immersive technologies simulating real-life environments can be effective tools in consumer testing, providing results with a higher external validity than laboratory testing and be a valid alternative to consumer testing in real-life situations. The current study compares three immersive techniques implemented in laboratory settings reproducing the situation of ‘drinking beer in a pub’ – 1. immersive room with the projection of the situation on flat walls with videos at 180° and with a pub set-up, 2. VR headset with the projection of the situation from a 360° Video, 3. VR headset with the projection of the situation from 3D modelling and 360° photos. The aim was to assess their added value versus tests conducted in a traditional testing environment (“in-lab”) and in a real pub. Emotional profile, liking, intention to re-taste the beer samples and consumers’ perceived engagement were assessed and compared in these five test conditions. A total of 513 Italian male adults (mean age 37.4) were involved in the study, each participating in one test setting. The immersive techniques were assessed for efficacy in products’ discrimination and repeatability through comparison of duplicate samples. Overall, the findings provided evidence of lesser product discrimination for hedonic questions and for emotions in assessments in the real pub and in the immersive approaches compared with central location test. Repeatability, measured as proximity of hedonic scores provided by individual participants to the duplicate products, was better in the real pub and in the immersive room. Data on emotions showed a good level of repeatability in all the test conditions. Moreover, the frequency of emotions showing positive relation with liking was higher for in-context evaluations compared to central location test. All the immersive technologies tested improved consumers engagement. Overall, more similarity of the results with the real pub was obtained for the immersive room and VR 3D modelling.

Objective The paper aims to control an electric wheel chair with a Brain-Computer Interface (BCI) headset. This wheel chair would be helpful for disabled people who cannot move their hands and legs or basically suffering from cerebromedullospinal disconnection. The main objective is to map different facial expression to the movement of the wheelchair. Methods The headset used for this purpose comprises of an EEG cap which has a total of 16 electrodes connected out of which 14 electrodes are used for acquiring data and the rest 2 are used as ground and reference. To operate the wheelchair the subject has to place the cap on his/her head and different facial expressions (clench, smile, blink, etc.) are performed. The movement of muscles around the face due to facial expressions can be observed from the EEG signals being recorded. Each expression is linked to movement of the wheelchair. Signal is preprocessed to remove the artifacts and then features are extracted using Fast Fourier Transform. In this paper, for classification we have used state-of-the-art machine learning technique which is a slight variation of Extreme Learning Machine called as Online Sequential Extreme Learning Machine abbreviated as OS-ELM. Results An overall accuracy of 97.62% was obtained using 10-fold cross validation. Conclusion The proposed framework attains better classification accuracy compared to various other classifiers.

Humans can recognize living organisms and understand their actions solely on the basis of a small animated set of well-positioned points of light, i.e. by recognizing biological motion. Our aim was to determine whether this type of recognition and integration also occurs during the perception of one's own movements. The participants (60 females) were immersed with a virtual reality headset in a virtual environment, either dark or illuminated, in which they could see a humanoid avatar from a first-person perspective. The avatar's forearms were either realistic or represented by three points of light. Embodiment was successfully achieved through a 1-min period during which either the realistic or point-light avatar's forearms faithfully reproduced voluntary flexion-extension movements. Then, the "virtual mirror paradigm" was used to evoke kinesthetic illusions. In this paradigm, a passive flexion-extension of the participant's left arm was coupled with the movements of the avatar's forearms. This combined visuo-proprioceptive stimulation, was compared with unimodal stimulation (either visual or proprioceptive stimulation only). We found that combined visuo-proprioceptive stimulation with realistic avatars evoked more vivid kinesthetic illusions of a moving right forearm than unimodal stimulations, regardless of whether the virtual environment was dark or illuminated. Kinesthetic illusions also occurred with point-light avatars, albeit less frequently and a little less intense, and only when the visual environment was optimal for slow motion detection of the point-light display (lit environment). We conclude that kinesthesia does not require visual access to an elaborate representation of a body segment. Access to biological movement can be sufficient.

Despite its marked success in recent years, it is still not clear how Virtual Reality (VR) can assist architects at the early stages of ideation and design. In this paper, we approach VR to build and explore maquettes at different scales in early design stages. To this end we developed a VR environment where user interactions are supported by untethered, easy to operate, peripherals, using a mobile virtual reality headset to provide virtual immersion and simplified geometric information to create voxel-based maquettes. Usability studies with laypeople suggest that the proposed system is both easier to use and more effective [better suited] than current CAD software to rapidly create simplified models. Additionally, tests with architects have shown the system's potential to improve their toolset. This is partly due to VR combining real-time performance with immersive exploration of the content, where body-scale relationships become visible to support the creative process, allowing architects to become both builders and explores of spatial constructs.

Previous research has demonstrated that exposure to nature environments, as opposed to urban environments, can help restore depleted cognitive resources and reduce emotional and physiological stress. The present research examined the restorative properties of nature on creativity, and also whether this effect was moderated across different levels of reality and psychological immersion of the environment, using 2-dimensional (2D) videos, 3-dimensional (3D) virtual reality (VR), and real-life outdoor settings. Across two experiments, it was predicted that higher levels of reality would increase the restorative benefits of viewing nature environments and enhance creative thinking compared to viewing urban environments. Creativity was evaluated using the Alternative Uses Test when viewing the different environments. Experiment 1 showed that nature videos facilitated higher creativity compared to urban videos, across mediums of viewing stimuli through a 2D mobile tablet and a 3D VR headset. Experiment 2 replicated the first experiment by showing enhanced creativity for nature stimuli compared to urban stimuli using a 2D mobile tablet, but for real-life outdoor environments, both nature and urban conditions evoked the same relatively high level of creativity. The results suggest that the restorative properties of nature are most apparent for creativity when viewing stimuli indoors, however, being outdoors in general may be enough to stimulate creativity, regardless of being surrounded by nature or a busy urban environment.

Stereoscopic 3D gives the viewer the same shape, size, perspective and depth they would experience viewing the real world and could mimic the perceptual threat cues present in real life. This is the first study to investigate whether an immersive stereoscopic 3D video exposure-based treatment would be effective in reducing fear of spiders. Participants with a fear of spiders (N = 77) watched two psychoeducational videos with facts about spiders and phobias. They were then randomized to a treatment condition that watched a single session of a stereoscopic 3D immersive video exposure-based treatment (six 5-minute exposures) delivered through a virtual reality headset or a psychoeducation only control condition that watched a 30-minute neutral video (2D documentary) presented on a computer monitor. Assessments of spider fear (Fear of Spiders Questionnaire [FSQ], Behavioral Approach Task [BAT], & subjective ratings of fear) were completed pre- and post-treatment. Consistent with prediction, the stereoscopic 3D video condition outperformed the control condition in reducing fear of spiders showing a large between-group change effect size on the FSQ (Cohen's d = 0.85) and a medium between-group effect size on the BAT (Cohen's d = 0.47). This provides initial support for stereoscopic 3D video in treating phobias.

As a new type of Virtual Reality (VR) headset, VR glasses rise rapidly in a number of areas. It's essential to understand the importance of user experience (UX) on VR glasses design. This study aimed to develop questionnaires for evaluating VR glasses' UX, as well as to investigate the relationship between various UX variables. With using lab-based usability tests, this study analyzed participants' self-reports and performance based on testing eight VR glasses and seven mobile applications. A nine-item questionnaire and a ten-item questionnaire were successfully developed to measure VR glasses systems' UX quality in terms of hardware and application, respectively. Within a proposed UX evaluation framework, the perceived UX quality relative to VR glasses hardware emerged as a core predictor in predicting interactive operation performance, whereas the application UX perception was a significant predictor of motion sickness.

Background Virtual reality (VR) has been used to study locomotor adaptability during balance-demanding tasks by exploring how humans react and adapt to the virtual environment (VE) and discordant sensorimotor stimulations. Previous research primarily focused on treadmill walking and little is known regarding the propensity for gait adaptations during overground walking and over time. Research question To what extent healthy young adults modify and adapt gait during overground walking in a VE and with continuous multidirectional perturbations of the visual field while wearing a VR headset? Methods Twelve healthy young adults walked for 6 min on an instrumented walkway in four different conditions: RE, VE, and VE with antero-posterior (AP) and medio-lateral (ML) pseudo-random oscillations of the visual field. For each condition, stride length (SL), stride width (SW), stride time (ST) and their variability (SLV, SWV, and STV) were calculated using one-minute walking intervals. A 2-way repeated-measures ANOVA was performed to determine the main and interaction effects of the walking conditions and time. Results Participants took shorter SL and showed higher SWV while walking in the VE. Perturbations of the visual field resulted in reduced SL, larger SW, and higher stride variability (i.e., SLV, SWV, and STV). The response was anisotropic, such that effects were more pronounced during the ML compared to AP perturbations. Over time, participants adapted to the VE and the visual perturbations by increasing SL and reducing SW, SLV, STV, and ST (only during VE and ML conditions). SWV did not adapt over time. Significance The paper provided first evidence for visuomotor adaptations during unperturbed overground walking and during visual perturbations while wearing a VR headset. It represents an initial investigation that may help the development of new VR methods for early detection and remediation of gait deficits in more ecological conditions.

The steady-state visual evoked potential (SSVEP) signal is widely utilized for Brain-Computer Interfaces (BCIs) that enable a direct communication between a user and an external device. Most devices in high-bit-rate SSVEP-based BCI, however, are lab-oriented and expensive, and thus not suitable for personal use in daily life. In this paper, we aim to investigate the feasibility of implementing high-bit-rate BCI using consumer-grade portable devices. We utilize a portable EEG headset to capture brain activities and extract user׳s intention from the weak and noisy signal through an optimization framework. We investigate several important factors that affect the bit rate and finally maximize the bit rate with the best choices of these factors. We can achieve 54.8 bits/min on a normal computer monitor, which is comparable to the result with expensive devices, and 17.3 bits/min on a smartphone screen, which is the first work of such on a smartphone screen. Our work can be easily integrated into security application such as defending against shoulder-surfing attacks, and assist patients with reduced motor abilities as well.

Background: Otitis Media with Effusion (OME) causing hearing impairments affects ~1 in 10 children starting school in UK/ Europe. 80% have at least one episode with most having conductive hearing loss. Studies showed children with OME hear better with bone conducting headsets. During COVID-19 we investigated whether children with deafness secondary OME, without access to audiology or grommet surgery, could be aided with bone conduction kits and the HearGlueEar app. Methods: Starting July 2020, during COVID-19, children aged 3-11 years with OME and on a grommet waiting list were invited to a single arm, prospective study. They received the kit, instructions and HearGlueEar app by post. By 3 weeks parents were asked to charge and pair the devices, attend a remote consultation and complete an OMQ-14 questionnaire. Remote follow-up lasted 3 months. Outcomes: ability to use the equipment, complete the questionnaire about child’s hearing and behaviour before and with the equipment, declining grommet surgery or where deafness resolved, and give opinion about the intervention.Findings26 children enrolled. Families used the kit at home and school. Most found remote consultations positive and convenient. OMQ-14 responses were 90% positive. Comments were: “Other people have said, wow his speech is clearer.”, “It is making a real difference at home.”, “He said over and over again, “I can hear everybody, wow, wow, wow.”, “It is no exaggeration to say this has made an astronomical improvement to his quality of life”. One child reported “I can hear my best friend again”. “She is getting on really well with the headphones - pairing them with the iPad at home is simply brilliant.” Three families continued with the headset to avoid grommets. Interpretation: Posting a bone conduction kit, HearGlueEar app and remote consultation is effective support for children with deafness secondary to OME. Trial Registration: The study was registered IRAS 262816. Funding Statement: None of the authors have received any funding or payment for completing the research nor benefitted from sales of the equipment. Declaration of Interests: Dr Tamsin Holland Brown helped create the free, charity funded, Hear Glue Ear app that was used in this study. Dr Holland Brown has not received funding or payment related to the Hear Glue Ear app. Other authors declare no conflict of interest. Ethics Approval Statement: The study was approved by the Solihull REC and Health Research Authority (HRA).

This work describes a multi-functional active noise control (ANC) system installation in an airplane seat. Most researchers in the field have focused on systems that cancel narrowband noise on headrests owing to the causality constraint of ANC system. Therefore, ANC systems in seats have limited performance. In this paper, an ANC system is designed for an airplane seat and the electronic delay of the ANC system is reduced to meet the causality requirement of a feedforward ANC system. An infrared sensor is used to detect the head of the occupant of the seat, so the ANC system can automatically cause the quiet zone to surround the ears of users with various sitting postures. Multiple noise sources and the automatic activation function of the ANC system are discussed. Experimental results show that the proposed ANC system for an airplane seat effectively reduces recorded airplane noise without the need for earplugs or an ANC headset.

Online tools and platforms for assessment and learning are gaining importance in all ages of life. Stress monitoring is analyzed by measuring the cognitive states during learning and software development activities. Constant use of digital tools and medium for learning and development among end users leads to stress that gradually reduces the cognition outcomes. Short and long term stress factors leads to acute and chronic effects. Mental stress is monitored by acquired EEG signal that are the vital tools involved in the measurement of cognitive task like recall (question and answering), reading and coding skills. The signals captured using Emotiv Epoc Headset device with 14 channels is being used for measurement of mental stress. DWT and machine learning algorithms with enhanced CNN is implemented for feature extraction and stress (i.e High and Low) classification. Highly accurate feedback models are used to predict stress levels.

RATIONALE AND OBJECTIVES: Three-dimensional (3D) visualization has been shown to benefit new generations of medical students and physicians-in-training in a variety of contexts. However, there is limited research directly comparing student performance after using 3Dtools to those using two-dimensional (2D) screens. MATERIALS AND METHODS: A CT was performed on a donated cadaver and a 3D CT hologram was created. A total of 30 first-year medical students were randomly assigned into two groups to review head and neck anatomy in a teaching session that incorporated CT. The first group used an augmented reality headset, while the second group used a laptop screen. The students were administered a five-question anatomy test before and after the session. Two-tailed t-tests were used for statistical comparison of pretest and posttest performance within and between groups. A feedback survey was distributed for qualitative data. RESULTS: Pretest vs. posttest comparison of average percentage of questions answered correctly demonstrated both groups showing significant in-group improvement (p < 0.05), from 59% to 95% in the augmented reality group, and from 57% to 80% in the screen group. Between-group analysis indicated that posttest performance was significantly better in the augmented reality group (p = 0.022, effect size = 0.73). CONCLUSION: Immersive 3D visualization has the potential to improve short-term anatomic recall in the head and neck compared to traditional 2D screen-based review, as well as engage millennial learners to learn better in anatomy laboratory. Our findings may reflect additional benefit gained from the stereoscopic depth cues present in augmented reality-based visualization.

Nowadays, prosthetic field has seen many accomplishments and success by the use of different technological advanced techniques. Prosthetic hands are made out of very high-quality materials but at the same time they are very expensive. There are different techniques available for designing prosthetic hand but most of these techniques have some problems; they are extremely expensive, very hard to install and may require operative surgery before using them. Most of the amputees who require upper limb amputation do not prefer to go for highly expensive prosthesis despite of their high quality. Therefore, the idea is to introduce the initial design of an EEG based controlled smart prosthetic hand which can be treated as customised solution. In our approach we controlling prosthetic hands by the brain waves, obtained from an electroencephalography (EEG) headset. The EEG-based headset (Mind wave Mobile) designed by Neurosky is used to communicate with human brains. The device tries to resemble like natural hand movement as the brain part is involved in it. The movement of biological neuroprosthetic hand by signal acquisition through neurosky headset. The brain waves are sensed by sensors in the neurosky headset and then this signal is processed by the processing system which detects the different levels of attention and meditation through headset. When the system detects that the attention meter value indicates the high attention level it gives command signal to the servo motors so it drives forward, and hand starts closing. If an amputee wants to open the hand to release an object, he/she needs to be in relaxing position and that in turn reduces level of the attention meter value. It senses by control system and that gives command to servo motor which move backward and close hand. According to the level, hand movement can be generated. It is used for an amputee below the elbow.

Second language (L2) learning research suggests that virtual reality (VR) has the potential to enhance the development of language skills due to its immersive nature and the situated learning opportunities it provides. This quantitative, between-subjects study compared the effectiveness of three learning conditions. University students (N = 63) studied vocabulary annotated on: (1) 360° pictures viewed using a VR headset, (2) 360° pictures viewed on a desktop monitor, and (3) standard two-dimensional (2D) pictures viewed on a desktop monitor (control condition). After the experiment, the students completed productive and receptive post-tests measuring vocabulary recall. Through analyses of variance, the study revealed that learning new vocabulary with annotated 360° pictures is associated with significantly higher post-tests scores, compared with learning with standard 2D pictures, as long as viewing is on a desktop monitor and not with a VR headset.

A Telepresence Robot allows a user to have a limited virtual access to a physical environment. The proposed system aims to use the concept of telepresence robots incorporating Virtual Reality to create a VR surveillance robot for the military. The novelty of our robot is that no conventional controllers are used for the motion control rather the user's movement in the physical space itself is mapped to the robot. The robot design is based on an Arduino Mega coupled with motors for driving the wheels. The VR design is based on a Raspberry Pi to which a camera module is connected. The live footage captured by the camera is then streamed wirelessly to an android smartphone running the VR app. The smartphone is placed in a VR headset worn by the user. The main advantage of the proposed system is that the user will not have to depend on an additional controller for controlling the robot.

Dancing is a very popular entertainment activity which is, however, quite difficult to learn. Our objective is to facilitate the traditional dance-learning process – based on imitating teacher’s movements – by employing current technological advances. In particular, we record professional dancers’ performances using a motion capture system and display the recorded data as moving avatars within a developed mobile-phone application. This application in combination with the mobile phone used as a headset, allows students to observe professional dancing within an augmented-reality environment. To demonstrate the benefits of such environment, we show that students can learn dancing when using the developed application. We assess the dancing quality by determining a similarity with respect to professional performance, based on the Dynamic Time Warping applied to the recorded motion capture data. Also, we analyze the effect of transcranial direct current stimulation (tDCS) on motor learning. We experimentally demonstrate that students with received tDCS perform dancing significantly better. We evaluate all the experiments on a real-life dataset of folk dances.

The capability of Augmented Reality (AR) technology to track and visualize relations of objects in space has led to diverse industry applications to support complex engineering tasks. Object assembly is one of them. For an AR aid to support Ready-to-Assemble (RTA) furniture particularly, the challenge is to effectively design the visual features and mode of interaction, so that the first-time users can quickly conceive spatial relations of its parts. However, AR developers and engineers do not have sufficient guidelines to achieve such performance-driven goals. The scientific evidence and account of how one could cognitively benefit in object assembly can be useful to guide them. This experimental research developed an Augmented Reality (AR) application on the Microsoft HoloLens™ headset, and tested it on the first-time users of RTA furniture. The controlled experiments and behavioral analyses of fourteen participants in working out the two RTA furniture with different assembly complexity showed that, the application was effective to improve spatial problem-solving abilities. Especially, the positive effects of the AR-based supports stood out against the assembly of higher complexity. The findings have implications for the information design of advanced AR applications to support assembly tasks with high demands of spatial knowledge. In addition, the extensive analyses of the participants’ performance, behaviors, cognitive workload, and subjective responses helped identify usability issues with the Microsoft HoloLens™.

Laser safety glasses block visibility of the laser light. This is a big nuisance when a clear view of the beam path is required. A headset made up of a smartphone and a viewer can overcome this problem. The user looks at the image of the real world on the cellphone display, captured by its rear camera. An unimpeded and safe sight of the laser beam is then achieved. If the infrared blocking filter of the smartphone camera is removed, the spectral sensitivity of the CMOS image sensor extends in the near infrared region up to 1100 nm. This substantial improvement widens the usability of the device to many laser systems for industrial and medical applications, which are located in this spectral region. The paper describes this modification of a phone camera to extend its sensitivity beyond the visible and make a true augmented reality laser viewer.

Background The Brain Computer Interfaces (BCI) are devices allowing direct communication between the brain of a user and a machine. This technology can be used by disabled people in order to improve their independence and maximize their capabilities such as finding an object in the environment. Such devices can be realized by the non-invasive measurement of information from the cortex by electroencephalography (EEG). Methods Our work proposes a novel BCI system that consists of controlling a robot arm based on the user's thought. Four subjects (1 female and 3 males) aged between 20 and 29 years have participated to our experiment. They have been instructed to imagine the execution of movements of the right hand, the left hand, both right and left hands or the movement of the feet depending on the protocol established. EMOTIV EPOC headset was used to record neuronal electrical activities from the subject's scalp, these activities were then sent to the computer for analysis. Feature extraction was performed using the Principal Component Analysis (PCA) method combined with the Fast Fourier transform (FFT) spectrum within the frequency band responsible for sensorimotor rhythms (8 Hz–22 Hz). These features were then fed into a Support Vector Machine (SVM) classifier based on a Radial Base Function (RBF) whose outputs were translated into commands to control the robot arm. Results The proposed BCI enabled the control of the robot arm in the four directions: right, left, up and down, achieving an averaged accuracy of 85.45% across all the subjects. Conclusion The results obtained would encourage, with further developments, the use of the proposed BCI to perform more complex tasks such as execution of successive movements or stopping the execution once a searched object is detected. This would provide a useful assistance means for people with motor impairment.

PURPOSE To develop and validate a smartphone based Virtual Reality Epley Maneuver System (VREMS) for home use. METHODS A smartphone application was designed to produce stereoscopic views of a Virtual Reality (VR) environment, which when viewed after placing a smartphone in a virtual reality headset, allowed the user to be guided step-by-step through the Epley maneuver in a VR environment. Twenty healthy participants were recruited and randomized to undergo either assisted Epleys or self-administered Epleys following reading instructions from an Instructional Handout (IH). All participants were filmed and two expert Otologists reviewed the videos, assigning each participant a score (out of 10) for performance on each step. Participants rated their perceived workload by completing a validated task-load questionnaire (NASA Task Load Index) and averages for both groups were calculated. RESULTS Twenty participants were evaluated with average age 26.4±7.12years old in the VREMS group and 26.1±7.72 in the IH group. The VR assisted group achieved an average score of 7.78±0.99 compared to 6.65±1.72 in the IH group. This result was statistically significant with p=0.0001 and side dominance did not appear to play a factor. Analyzing each step of the Epley maneuver demonstrated that assisted Epleys were done more accurately with statically significant results in steps 2-4. Results of the NASA-TLX scores were variable with no significant findings. CONCLUSION We have developed and demonstrated face validity for VREMS through our randomized controlled trial. The VREMS platform is promising technology, which may improve the accuracy and effectiveness of home Epley treatments. LEVEL OF EVIDENCE N/A.

In online games, gamers may become frustrated when playing against stronger players or get bored when playing against weaker players, thus losing interest in the game. Dynamic Difficulty Adjustment (DDA) has been suggested as an intelligent handicapping mechanism, by reducing the difficulty for the weaker player, or increasing the difficulty for the stronger player. A key question when using DDA, is when to activate the difficulty adjustment. In this paper we suggest using the Emotiv EPOC EEG headset to monitor the personal excitement level of a player and use this information to trigger DDA when the player’s excitement decreases in order to ensure that the player is engaged and enjoying the game. We experiment with an open-source third-person shooter game, in a multiplayer adversarial setting. We conduct experiments, showing that the detected excitement patterns correlate to game events. Experiments designed to evaluate the DDA triggering mechanism confirm that DDA triggered based on EEG increases the players excitement and improves the gaming experience compared to the heuristic triggered DDA and the experience of playing a game without DDA.

Military training and international operations require different nationalities to communicate in a common language, where there are potential challenges with non-native (L2) speech communication. An experiment of speech communication in military noise was conducted for co-located (face-to-face [F2F]) and distributed (using communication headsets) talker-listener pairs. Half of the twenty-four participants were monolingual English speakers (native group, NA) and the remaining half had obtained English fluency after the age of eight years (non-native group, NN). Two tests of speech understanding were used: the Modified Rhyme Test (MRT) and the Speech Perception in Noise test (SPIN). In the F2F condition, the participants wore a communication headset (earmuff) with the power off for occluded listening. Three levels of armoured vehicle noise were used, 55, 60 and 65 dBA, for speech-to-noise ratios ranging from −10 to +5 dB. In the radio condition, the pairs were separated by a visual barrier and used the communication headset for the tests in 80 dBA armoured vehicle noise. The results showed that the NN group had difficulty with the SPIN test in the radio and F2F conditions. This result was attributed to the open-response set of the SPIN. Headset occlusion likely contributed to the lower scores for the NN listeners in the F2F condition. There was a main effect of talker for the MRT in the F2F and radio conditions, and for the SPIN in the radio condition, suggesting that foreign accent reduced the intelligibility for both the NA and NN groups. The results were surprising considering the high L2 proficiency of the NN group. Training methods for improving L2 communication in operational settings should be further investigated.

In this paper idea of using various non-invasive Brain-Computer Interfaces (BCI) was in detail presented, in particular BCI-systems using Emotiv EPOC+ headset. This work also describes both concept and project of a system designed for communication of physically disabled patients with external environment using Emotiv EPOC+ headset. The project is still at initial stage, however Graphical User Interface (GUI) was designed and developed based on a pictograph writing system. As the project is still on preliminary stage the system was only tested with the implementation of an inexpensive, above mentioned EEG device (Emotiv EPOC+), which was also in detail characterized and described.

The total increase in the use of mobile devices inevitably leads to an increase in the number of different security threats. The cryptographic device described in this article provides a secure (encrypted) transmission of data. It alerts the user if the crypto headset at the opposite end of the link is not trusted, thus extending the offending model (i.e. a list of the potential opportunities of the offender) to the possibility of substituting one of the encrypting devices. All functions for encryption and decryption are enclosed in a separate unit that connects to the phone via Bluetooth. The crypto headset specifications were compared with the closest analogues and ensures a higher level of security for each group of consumers: the corporate sector, government agencies, and individual users.

This paper describes the classification of facial expressions using EEG data. The entire procedure aims at controlling an electric wheelchair with a Brain Computer Interface (BCI) headset. The goal is to help the people who are suffering from locked-in syndrome to move or to pass the necessary signals. The headset consists of the electroencephalogram (EEG) cap comprising 16 electrodes attached to the amplifier out of which 14 electrodes are used for data acquisition while two are used as reference and ground. The EEG cap is placed on the head of the subject and various expressions (blink, eyebrows raise, smile, etc.) are performed on the subject. Muscle activities due to facial expressions can be observed from the recorded EEG signals. Expressions are classified and necessary signals are generated. The features are extracted using the wavelet packet transform processing method and classified primarily using Support Vector Machine (SVM).

Biomedical signals have got very incredible reach to the people outside clinical domain as devices are developed that can be controlled using one’s imagination and this is the very booming area of research nowadays. An effective way of using Human Computer Interaction (HCI) is using the Brain Computer Interaction (BCI) and Electroencephalogram (EEG) which can extend the people’s access to use machines specifically for specially abled persons. Generally, EEG is a costly matter which is not every time affordable by any common person. Here in this proposed system, we tried to explore the possibility of single channel EEG through which a person can communicate to computer according to his/her neurosignal excitement which are classified as Attention, Meditation and Blink strength and then can be interpreted into effective Human Machine Interaction (HMI). The proposed algorithm here uses brainwaves (voluntary blinks as a control tool in BCI) detected using Neurosky Mindwave Mobile headset from the frontal lobe (because it offers EEG clarity since this is the forehead area with minimal hair). This proposed system can be extended for typing, gaming, entertainment as well as for daily life interaction purposes. It can also be extended as a non-verbal communication medium for specially abled persons. The experiment conducted using the proposed system revealed significant development in accessing computer and typing skill. We tried to explore scan keyboard which can be operated by neural signals captured by the Neurosky Mindwave Mobile Headset Single channel EEG Headset.

The article presents our proposed adaptation of the commercially available Emotiv EPOC+ EEG headset for neuroscience research based on event-related brain potentials (ERP). It solves Emotiv EPOC+ synchronization problems (common to most low-cost systems) by applying our proposed stimuli marking circuit. The second goal was to check the capabilities of our modification in neuroscience experiments on emotional face processing. Results of our experiment show the possibility of measuring small differences in the early posterior negativity (EPN) component between neutral and emotional (angry/happy) stimuli consistently with previous works using research-grade EEG systems.

Effective data visualisation is a key part of the scientific process with complex geometric datasets. It is the bridge between the quantitative content of the data and human intuition. Immersion in virtual reality (VR) provides benefits beyond the traditional “desktop” visualization tools and it leads to a demonstrably better perception of dataspace geometry, more intuitive data understanding, and a better retention of the perceived relationships in the data. VR has a great potential for fusion research and in the analysis of its complex physics-based datasets. The work presented in this paper is one of the applications that have been implemented at UKAEA which combines shutdown dose calculations with a virtual reality model of the Joint European Tokamak (JET) in a new code called VORTEX (Virtual Operator RadiaTion EXposure). The shutdown dose calculations were performed for various time steps during the JET DTE2 campaign using the UKAEA code MCR2S which links MCNP and FISPACT-II using the rigorous two step method. The 3 Dimensional dose and activation data created by MCR2S is integrated into the game engine Unity using C# routines to create VORTEX. A virtual reality model has been created from JET CAD data combined with the 3 dimensional radiation and activation data to create of virtual model of the radiological environment after the DTE2 campaign. This model enables more precise planning of operational procedures by having the operator/planner walk around the virtual environment using a virtual reality headset such as the Oculus rift or the HTC vive.

The current study tested the effects of a celebrity's virtual reality (VR) video on YouTube on audience transportation, parasocial interaction, identification, worship, and behavioral intention of social campaign participation. In addition to VR effects, fans and nonfans were compared with each other for engagement. The media content of BTS, a Korean pop boy band, was experimented in six groups: VR video with a headset, 360-degree video, 2D video, audio, news article, and control. A posttest only experiment was conducted among 142 participants in total. Results found that the VR with a headset group showed a significant difference from the news article group in transportation into BTS. The VR with a headset group had higher parasocial interaction with BTS than the control group. BTS fans were more likely than nonfans to show significant transportation, parasocial interaction, identification, worship, and behavioral intention.

Teaching and learning through Virtual Reality(VR) is an emerging technology in the last few years. In this article, the development and use of a VR based teaching–learning system for crystal structures are discussed. The VR system is designed as a lab environment where a user can do experiments related to crystal structures. The VR system is designed in Unity, 1 and Oculus Rift S 2 is used as a VR headset. Currently, the system consists of three phases; in the first phase user can visualize the crystal lattice structures, wherein the second one a user can visualize the light interaction with the crystal lattice structure using a virtual torch ray. The third phase is the X-ray Diffraction (XRD) experiment. In this phase, users can perform the XRD experiment in the lab environment by taking a random crystal from a crystal dispenser machine and placing it in the X-ray machine which identifies the chosen crystalline material and analyses the unit cell. The incident ray colour changes when there is a peak found in the crystal for a better understanding of the user. There is also an interactive display where users can increase/decrease the angles of the radiation and also lock and unlock the experiment to view the diffraction plot for the crystal structure. In many cases, it was found that XRD and the crystal structure is available in the course syllabus but there are no experiments to enhance their learning. Therefore an experiment with 39 participants was performed where the maximum participants are new to crystallography. The study was conducted in two phases; in the first phase, participants are asked to watch video tutorials of the topic followed by questionnaires; in the second phase participants are asked to do the VR based experiment and followed by questionnaires related to overall study and experiment. From the analysis of the study we found that everyone found VR based teaching methods are better than traditional book/video studies. Study results give an average score of 56.74% in comparison to VR based learning approach with an average score of 93.81%. Participants who took part in the experiment found the experience interactive and motivating and found it helpful to learn elusive concepts, which can be learned when simulated. For example, one participant wrote: “The VR experience was surreal and was easy to control. Lucid user experience. Got a view of XRD like never seen before”.

Research Objectives To Create a Virtual Reality (VR) application that encourages people living with Alzheimer's disease and dementia to exercise in combination with a haptic therapeutic vibration device. Design Game designed with Unity game engine (C# coding) based on literature reviews and interviews with SMEs. Virtual environment loads onto VR headset; VR application responds to input from a Bluetooth module connected to VibeTech controller. Sensors and motors enable simple, interactive, therapeutic VR experiences. Setting Game design has taken place on the UW-Stout campus and home offices of the project team. Beta testers of the game will include memory care residents in senior living and skilled nursing. Participants Older adults living with Alzheimer's disease are the intended users of the VR rehab games and therapeutic vibration device developed here. Interventions VR gaming with haptic therapeutic vibration provides stimulation that triggers muscle contraction in the legs. As the user pushes against a haptic vibration plate, it pushes back to deliver resistance exercise to the user. Main Outcome Measures Key design elements and features are bench tested and verified before release in the clinical setting. User engagement will be evaluated in future studies. Results An interactive 3D environment has been created for the Oculus Quest 2.The effect created from this positive reinforcement technique partnered with the relaxing virtual environments is our solution to the problem of patients experiencing an impaired cognitive ability to exercise. Conclusions Our team is creating new tools for caregivers of Alzheimer's residents. The work aims to better engage this population in simple, safe physical activity that is well-suited for individuals with low physical and cognitive function. Author(s) Disclosures Ahmet Turkmen, PhD is an unpaid technical advisor to VibeTech. Jeff Leismer, PhD is an owner of VibeTech. No other authors have anything to disclose.

Understanding the relationship between vection speed and display speed is important to help ensure accurate self-motion experiences in a variety of applications. In the present research, a virtual optokinetic drum was used to induce circular vection at three distinct constant velocities and a method for measuring circular vection speed was developed and examined. In Experiment 1, vection strength was measured using a traditional magnitude estimation rating technique. An optokinetic drum presented on a virtual reality (VR) headset rotated in the yaw axis at slow, medium, and fast speeds. Magnitude estimation ratings were greatest during the fast condition in Experiment 1, replicating previous findings and validating the use of the virtual optokinetic drum in a VR headset. In Experiment 2, participants spun a circular knob in a clockwise or counter-clockwise direction to index their vection speed, direction and duration. The speed at which participants spun the knob increased with drum speed. Vection speed was much faster than the optokinetic drum’s speed, demonstrating that participants may perceive self-motion at faster speeds than intended. It is recommended that indices of vection speed such as the circular knob be used to better understand the relationship between graphic speed and vection speed.

Purpose or Objective: Throughout 2020, two further Chinese oncology centres were scheduled to open with support from our group’s Australian and New Zealand clinical teams. Due to travel restrictions resulting from the COVID-19 pandemic, a remote training and supervision program was developed to support local RTT staff during the preparation and commencement of clinical services. This presentation outlines the program’s structure, as well as how technology was leveraged to enable its successful delivery. Materials and Methods: A pre-existing framework of face-to-face training and supervision was utilised as the basis for the program. An assessment of key barriers to program delivery was then carried out, along with a review of educational strategies and supporting technology that could facilitate engagement between trainees and trainers remotely. Results: Key barriers to overcome included the geographic separation of staff across three countries, conflicting staff availability due to time-zone differences, and language barriers between trainers and trainees. Several methods of content delivery were utilised to overcome these. Bilingual procedural guidelines and a library of subtitled procedural videos were provided via an online learning platform. These were further expanded upon during live teaching sessions via virtual classroom with the assistance of a translator and an interactive polling platform. Wearable video headsets were utilised by trainers to explore components of procedures in greater detail. Headsets were also utilised by local trainees to enable individualised practice guidance and mentoring prior to their first patients. For the initial period of clinical operation, the headset devices continued to be used by local staff to enable peer-review and technical assistance in real-time. Preliminary evaluation of trainee experience and clinical auditing indicated satisfaction with the training provided and a high level of procedural adherence, respectively. Conclusion: Amidst the unanticipated disruption caused by COVID-19, we have successfully adapted to enable the delivery of a remote RTT training and supervision program in an international setting. On-going work includes program evaluation, refinement and expansion;as well as auditing to support continued professional development. Local trainers are also being developed to complement the remote program for staff subsequently recruited to sites.

Locomotion is one of the fundamental interactions in VR. As a relatively easy and simple method to implement VR locomotion, walking-in-place (WIP) techniques have been actively developed, which have shown advantages in terms of spatial constraints and immersion compared to real walking or controller-based interaction. However, existing WIP gestures have been largely adapted or designed from the perspective of developers, not the users, which may result in not only higher cognitive load to learn and memorize, but also worse presence and increased sensory conflict in VR. Therefore, this study aims to elicit and evaluate WIP gestures for different walking directions (forward, sideways, and backward) from users so that a complete user-defined WIP gesture set for VR locomotion can be generated. Two sequential user studies were conducted. In Experiment 1, 20 participants experienced the movement while wearing the VR headset and elicited the gesture for each of 8 walking directions. The grouping analysis revealed that Turn body + Stepping-in-place (SIP) and Step one foot + SIP/Rock/Stay were promising WIP gesture sets for VR locomotion. In the follow-up experiment (Experiment 2), 21 new participants experienced and compared the generated gesture sets and existing ones. The results showed that SIP performed the best for forward walking, while Step one foot + SIP/Rock/Stay were promising for other walking directions, which depended on application scenarios and the tradeoff between efficiency and naturalness. The generated WIP gesture sets from users can be used in VR applications to provide a better user experience and greater movement options in VR locomotion.