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  1. In this study, we developed a new haptic–mixed reality intravenous (HMR-IV) needle insertion simulation system, providing a bimanual haptic interface integrated into a mixed reality system with programmable variabilities considering real clinical environments. The system was designed for nursing students or healthcare professionals to practice IV needle insertion into a virtual arm with unlimited attempts under various changing insertion conditions (e.g., skin: color, texture, stiffness, friction; vein: size, shape, location depth, stiffness, friction). To achieve accurate hand–eye coordination under dynamic mixed reality scenarios, two different haptic devices (Dexmo and Geomagic Touch) and a standalone mixed reality system (HoloLens 2) were integrated and synchronized through multistep calibration for different coordinate systems (real world, virtual world, mixed reality world, haptic interface world, HoloLens camera). In addition, force-profile-based haptic rendering proposed in this study was able to successfully mimic the real tactile feeling of IV needle insertion. Further, a global hand-tracking method, combining two depth sensors (HoloLens and Leap Motion), was developed to accurately track a haptic glove and simulate grasping a virtual hand with force feedback. We conducted an evaluation study with 20 participants (9 experts and 11 novices) to measure the usability of the HMR-IV simulation system with user performance under various insertion conditions. The quantitative results from our own metric and qualitative results from the NASA Task Load Index demonstrate the usability of our system.

     
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  2. Pilot fatigue is a critical reason for aviation accidents related to human errors. Human-related accidents might be reduced if the pilots’ eye movement measures can be leveraged to predict fatigue. Eye tracking can be a non-intrusive viable approach that does not require the pilots to pause their current task, and the device does not need to be in direct contact with the pilots. In this study, the positive or negative correlations among the psychomotor vigilance test (PVT) measures (i.e., reaction times, number of false alarms, and number of lapses) and eye movement measures (i.e., pupil size, eye fixation number, eye fixation duration, visual entropy) were investigated. Then, fatigue predictive models were developed to predict fatigue using eye movement measures identified through forward and backward stepwise regressions. The proposed approach was implemented in a simulated short-haul multiphase flight mission involving novice and expert pilots. The results showed that the correlations among the measures were different based on expertise (i.e., novices vs. experts); thus, two predictive models were developed accordingly. In addition, the results from the regressions showed that either a single or a subset of the eye movement measures might be sufficient to predict fatigue. The results show the promise of using non-intrusive eye movements as an indicator for fatigue prediction and provides a foundation that can lead us closer to developing a near real-time warning system to prevent critical accidents. 
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