A Review of User-Centered Design for Diabetes-Related Consumer Health Informatics Technologies

User-centered design (UCD) is well recognized as an effective human factor engineering strategy for designing ease of use in the total customer experience with products and information technology that has been applied specifically to health care information technology systems. We conducted a literature review to analyze the current research regarding the use of UCD methods and principles to support the development or evaluation of diabetes-related consumer health informatics technology (CHIT) initiatives. Findings indicate that (1) UCD activities have been applied across the technology development life cycle stages, (2) there are benefits to incorporating UCD to better inform CHIT development in this area, and (3) the degree of adoption of the UCD process is quite uneven across diabetes CHIT studies. In addition, few to no studies report on methods used across all phases of the life cycle with process detail. To address that void, the Appendix provides an illustrative case study example of UCD techniques across development stages.     

Virtual reality aided design of parts and assemblies

Current virtual reality (VR) systems provide an enormous potential for enhancing the visualization of 3D-design drafts. Based on new navigation techniques the designer is able to interact, model in a more intuitive and efficient way. In our contribution we present a novel interaction metaphor that facilitates the synthesis of efficient virtual reality interaction and visualization techniques with modern feature based CAD systems. We present “NAVIMODE”, an alternative approach for navigation, manipulation and selection, to combine the advantages of VR and CAD systems. The design engineer has the chance to design in his/her habitual environment using the advantage of virtual reality concurrently.     

Virtual reality approaches for immersive design

The current application of virtual reality (VR) systems in the design process is limited mostly to design review. The reason for this limitation is the different data formats used for CAD and VR visualization. To use the benefits of VR during the design process, solutions for immersive design, the model manipulation inside the VE based on CAD data, are required. There are different approaches allowing VR systems to work as an active development platform. Three examples introduce the realization of the integration of CAD and VR software at different levels by the online coupling of complete applications or by integration of CAD core functionalities in VR systems.     

VirDe: a new virtual reality design approach

Virtual reality (VR), even if it does not represent any more a novel technology, is one of the most powerful tool to help designers during the development of new projects. This is proved by very numerous research activities related to this field. In this research, we have studied a new way to approach the development of a product. We present the ongoing development of a system, called VirDe, acronym of virtual design, which can allow the designers to perform the whole design process, from the modelling phase to the finite element method (FEM) simulation analysis, in a virtual reality environment. This new method allows remarkable time and money saving in the overall product design process, but the most important contribution of VirDe is that, as far as we concerned, there is no known similar approach which has been studying the simultaneous combination of CAD, FEM and virtual environment (VE).     

CAD data workflow toward the thermal simulation and visualization in virtual reality

This paper presents a CAD transfer method to visualize thermal simulation results in a virtual environment in order to optimize building design determined by energy efficiency. As the goal is to present a more immersive thermal simulation and to project the calculation results in projective displays particularly in cave automatic virtual environment, the main idea of the method is to provide a workflow so that the thermal result can be visualized and simulated in the virtual environment (VE). The paper shows the experiment results conducted in an immersion room by some respondents. An evaluation of the method has demonstrated that it is possible to conduct a specific data workflow in order to represent building performance data and particularly thermal simulation results in virtual reality (VR). With this method, the data flow that starts from the design process is completely and accurately channeled to the VR system. CAD data in 3D mock-up models composed of basic geometry are usually designed and transferred to other tools particularly if intended for VR. However, CAD data needed for the VE is not simple, it needs to be structured in a workflow method. Challenges in data exchange and interoperability among design, simulation and VR tools used have become an important issue to investigate how the workflow works.     

A bi-directional interface for improved interaction with engineering models in virtual reality design reviews

Leveraging virtual reality (VR) technology to enhance engineering design reviews has been an area of significant interest for researchers since the advent of modern VR. The ability to interact meaningfully with 3D computer-aided engineering models in these VR design reviews is an important, though often neglected, capability due to the difficulty of performing data translation between native computer-aided design (CAD) data and VR compatible file formats. A bi-directional interface was developed between a VR design review environment and a commercial CAD package that streamlines the data translation process. Transmitting both geometric data and selected metadata from the CAD system enabled the development of enhanced model interaction tools in a VR design review application. User experiments were performed that compared the enhanced tools developed to a baseline toolset. Participants success using these toolsets was measured as they performed tasks related to design understanding and decision making, such as counting the number of gears in a gearbox or evaluating the feasibility of a proposed design change in a four-cylinder engine. The analysis of the data from these experiments showed a statistically significant improvement in participants ability to understand the geometry of the model correctly, confidently, and quickly, as well as in participants ability to correctly and confidently understand the implications of a proposed design change when using the Enhanced Toolset. We conclude that the bi-directional interface concept developed in this work can be extended to enable advanced interaction with a diversity of engineering data in VR.     

Feasibility of a virtual reality intervention in the intensive care unit

BackgroundDelirium prevention requires optimal management of pain and anxiety. Given the limitations of current pharmacologic interventions, evaluation of novel non-pharmacological interventions is required. Virtual reality (VR) stimulation may be a promising intervention because of its capability to reduce psychophysiological stress, pain, and anxiety and to restore cognitive and attentional capacities.ObjectiveTo ascertain patients’ and providers’ perceptions of acceptability and safety of VR intervention in the intensive care unit (ICU).MethodsWe enrolled a cohort of 15 ICU patients and 21 health care providers to administer a 15-minute session showing a relaxing beach scene with VR headsets and nature sound effects. Participants were then asked to rate their experiences on a Likert scale survey.ResultsThe majority of patients (86%, 12 of 14) rated the headsets as moderately to very comfortable. All had moderate or greater sense of presence in the virtual environment, and 79% (11 of 14) rated their overall experience at 3 or greater (5 indicating that they enjoyed it very much). Seventy-one percent (10 of 14) of the patients felt that their anxiety was better with VR, and 57% (8 of 14) did not notice a change in their pain or discomfort. All health care providers found the headset to be at least moderately comfortable and felt a moderate or greater sense of presence. All providers concluded that VR therapy should be available for their patients. Both groups experienced minimal side effects.ConclusionIn this prospective study of perceptions of VR therapy for ICU patients and health care providers, there was a high level of acceptance, with minimal side effects, for both groups despite their low levels of prior experience with virtual reality and video gaming.     

Exploring the Role of Virtual Reality to Support Clinical Diabetes Training—A Pilot Study

Background:It is estimated that 16 to 25% of patients in hospital have diabetes and 1 in 25 inpatients with Type 1 Diabetes develop diabetic ketoacidosis (DKA). It is vital that non-specialist doctors recognize and appropriately manage diabetes emergencies. Simulation training is increasingly being used in healthcare and virtual reality (VR) based educational resources is transforming medical education. This study aimed to evaluate the use of virtual reality to help non-specialist clinicians manage clinical scenarios related to diabetes.Methods:This pilot project, titled ‘DEVICE’ (Diabetes Emergencies: Virtual Interactive Clinical Education) was developed in collaboration with Oxford Medical Simulation. Fully interactive immersive VR scenarios were created to stimulate real life diabetes emergencies. Users then received personalized feedback and performance metrics. Feedback surveys were provided before and after the participation in the VR scenario. Kirkpatrick’s training evaluation model was used.Results:Thirty-nine participants from 2 hospitals in UK provided feedback up to 3 months after attending the VR education sessions. Overall feedback was extremely positive, and participants found this immersive teaching experience very helpful. After use of virtual reality scenarios, the mean trainee confidence in managing DKA (on an 8-point Likert scale) increased from 3.92 (3.38-4.47) 95% CI to 5.41 (4.79-6.03) 95% CI (statistically significant). The VR study demonstrates Kirkpatrick level 3 in the follow up survey.Conclusion:VR based training scenarios in this pilot project increased confidence in managing diabetes emergencies and demonstrated positive changes in their behavior. VR education is a safe, useful and a well-liked training tool for diabetes emergencies.     

360° video recording inside a GI endoscopy room: Technical feasibility and its potential use for the acquisition of gastrointestinal endoscopy skills. Pilot experience

New advances in video processing, 3-dimensional designs, and augmented/virtual reality are exciting and evolving fields. These new tools can facilitate the learning phase of basic or advanced endoscopic procedures. Herein, we explain our initial experience, creating an immersive virtual reality (IVR) by using 360-degree recording videos from an interventional endoscopy room.Some common terms used around this technology, such as Augmented reality (AR), Virtual Reality (VR), Three hundred sixty videos, and Mixed Reality (MR), are discussed below.Three examples of VR 360 endoscopic room videos are included in this article.     

Development of and Feedback on a Fully Automated Virtual Reality System for Online Training in Weight Management Skills

Virtual reality (VR) technology can provide a safe environment for observing, learning, and practicing use of behavioral weight management skills, which could be particularly useful in enhancing minimal contact online weight management programs. The Experience Success (ES) project developed a system for creating and deploying VR scenarios for online weight management skills training. Virtual environments populated with virtual actors allow users to experiment with implementing behavioral skills via a PC-based point and click interface. A culturally sensitive virtual coach guides the experience, including planning for real-world skill use. Thirty-seven overweight/obese women provided feedback on a test scenario focused on social eating situations. They reported that the scenario gave them greater skills, confidence, and commitment for controlling eating in social situations.     

The activation mechanism of rat vanilloid receptor 1 by capsaicin involves the pore domain and differs from the activation by either acid or heat

The recently cloned rat vanilloid receptor, VR1, can be activated by capsaicin, acid, and heat. To determine the molecular mechanisms facilitating channel opening in response to these stimuli, VR1 and six channels containing charge neutralization point mutations surrounding the putative channel pore domain were expressed and characterized in Xenopus laevis oocytes. Steady-state dose-response relationships, current-voltage relationships, ionic selectivities, and single-channel properties were recorded using voltage-clamp techniques. Three of the mutant channels are significantly more sensitive to capsaicin than is wild-type VR1, whereas none differed in their activation by acidic pH or temperature. Furthermore, one of the mutants has lost all positive cooperativity for capsaicin activation (Hill coefficient congruent with 1, VR1 congruent with 2), is much more selective for Ca(2+), and exhibits a lower efficacy for acid than for capsaicin activation. Single-channel recordings show that capsaicin- and acid-activated channels have the same conductance, that the three mutants with increased capsaicin sensitivity exhibit higher open probabilities at submaximal capsaicin concentrations, and that the gating properties of capsaicin activation differ from those of acid activation. These data indicate that VR1 undergoes conformational changes upon capsaicin binding that it does not undergo in response to activation by protons or thermal stimuli. Furthermore, these structural rearrangements include the putative pore domain and reveal the location of an intracellular domain that contributes to the positive cooperativity seen for capsaicin activation.     

虚拟现实技术应用于脑卒中康复治疗的研究现状及进展

虚拟现实技术自20世纪80年代问世至今,已融入经济、教育、娱乐甚至军事等各个领域,为用户提供各种逼真体验。虚拟现实可以为操作者提供身临其境的沉浸感,在反复场景交互中,使操作者强化互动中所带来的感官刺激及场景中功能的学习。在近年各种疾病的临床康复治疗中,虚拟现实凭借以上优势,日益得到重视并已广泛应用于运动、平衡及认知等康复治疗中。脑卒中后肢体运动功能康复一直是康复领域的难点及热点,本文对比传统康复手段,综述了虚拟现实技术对脑卒中患者康复的优势、特点和不足,并展望虚拟现实技术对促进脑卒中患者康复的前景。     

Methods for designing assistive devices extracted from 16 case studies in the literature

This paper studies existing design methods for designing assistive devices. Publications discussing how to select a design method when designing for disabled people are rare. However, designers do design for disabled people and researchers do publish these case-studies. The aim of this paper is to extract the underlying design methods from design cases. Sixteen case-studies presenting the design of assistive device have been analyzed. A table summarizes the design methods identified in the case-studies. Unusual methods are described. Then, each method is discussed. Results show that user-Centred Design (UCD) tools are widely used for designing assistive device. UCD approach is expected to be helpful but evidences are lacking. Recently, some authors have adapted existing tools outside the disability world to use them in the context of design projects for disabled people (ABAB design, AD SWOT and AD TOWS and Fitts’ law). More investigations of these tools would be needed to be able to evaluate their benefits and weaknesses. In addition, tools coming from the rehabilitation field have been reused by designers (joint range and muscle force measure, and psycho-motor tests). Since, those tools were created initially to measure disabled people’s abilities, they seem totally relevant for designers in the disability field.     

A new product design method based on virtual reality, gaming and scenarios

Through the years, many methods and tools have been developed that support designers in creating good products. Current trends, for example, are to use virtual reality (VR) simulation, gaming principles, and scenario based techniques during product design processes. Each of these methods and tools contributes to the potential effectiveness and efficiency of product design processes. However, in current practice, they are often applied in an ad-hoc manner. This paper presents a new product design method that integrates elements of a number of important trends in contemporary product design processes. Using VR simulation, gaming principles and scenarios, the new product design method gives non-designers (e.g. users, production engineers, marketing managers, maintenance workers) a proactive role in the design process. Within a dedicated design environment, all stakeholders are allowed to create their own designs and immediately test these in a wide variety of use scenarios. By letting stakeholders realistically interact with their personal creations, designers can quickly and reliably pinpoint their needs and preferences. At the same time, good designs are generated. The new product design method was applied to the design of a lane change support system; a system that supports the driver of a vehicle in performing lane change maneuvers. Using the design environment that was established for this case, the designer was able to get a consistent image of everyone's preferences as well as to draw a reliable conclusion about what would be a good design.     

An interactive design approach for nuclear fusion purposes: remote handling system for FAST divertor

The paper deals with the design issues concerning the remote maintenance of divertors in fusion advanced studies torus (FAST), a satellite tokamak acting as a test bed for the study and the develop of innovative technologies oriented to ITER and DEMO programs, pilot examples of the feasibility of energy production from nuclear fusion on the Earth. FAST remote handling (RH) solutions are provided according to an “interactive design review” philosophy based on virtual prototyping techniques. Assuming an ITER configuration as start point, it foresees an iterative process of design review, carried out in virtual reality (VR) environment and oriented to obtain a sort of best solution from the RH point of view. Any iteration includes the analysis of the current solution and the proposal of new and alternative ones, based on the requirements fulfillment and the improvement of critical points highlighted. In such a way, and this is the main novelty introduced by the paper, the interactive design review in a VR collaborative environment becomes the tool able to put in cooperation and in positive competition various and different competences, required by a multidisciplinary problem as the realization of nuclear fusion machine, in order to reach a shared solution. A first preliminary FAST RH solution is hereinafter presented, accompanied by the design of a compatible support system, due to the strict relationship between the divertor maintenance and the support configuration. The work was carried out via the collaboration of the “Divertor Test Platform 2” (DTP2) team, in charge of ITER divertor RH tests and located in VTT’s Labs of Tampere (Finland), and the IDEAinVR team of CREATE Consortium, with competence in interactive design and VR simulations and located in the Virtual Reality Lab of University of Naples Federico II (Italy).     

Turning virtual reality into reality: a checklist to ensure virtual reality studies of eating behavior and physical activity parallel the real world

Virtual reality (VR) provides a potentially powerful tool for researchers seeking to investigate eating and physical activity. Some unique conditions are necessary to ensure that the psychological processes that influence real eating behavior also influence behavior in VR environments. Accounting for these conditions is critical if VR-assisted research is to accurately reflect real-world situations. The current work discusses key considerations VR researchers must take into account to ensure similar psychological functioning in virtual and actual reality and does so by focusing on the process of spontaneous mental simulation. Spontaneous mental simulation is prevalent under real-world conditions but may be absent under VR conditions, potentially leading to differences in judgment and behavior between virtual and actual reality. For simulation to occur, the virtual environment must be perceived as being available for action. A useful chart is supplied as a reference to help researchers to investigate eating and physical activity more effectively.     

Improving design validation of playground equipment in virtual reality

The ISO 9001: 2000 requires the phase of design validation in order to demonstrate that the design output are able to satisfy specified or forecasted user requirements; for this reason, generally, physical prototype are realized in order to evaluate real product performances and their correlation with simulated ones. In this paper, the use of virtual inspection probes to validate playground equipment design is studied, pointing out limits and defining the optimal test strategies. Through the use of Robust Design techniques the authors show that the combined use of real time shadows and positional sound feedback allows to reduce the percentage of wrong inspections in the validation phase of playground equipment design. The authors develop an inspection probe simulation tool in virtual immersive environment. In particular, this tool ensures the collision detection through visual and sound feedback and increases the realism of the immersive environment. Finally, an experimental session, using a physical prototype of playground equipment, is carried out in order to compare these results with the ones coming out from the VR experiments. For a standard entrapment test, the authors assess the dependences of false and missed alarm by the diameter of the openings to evaluate and establish an acceptability threshold for the usability of the virtual probes.     

Developing a virtual reality simulation system for preoperative planning of thoracoscopic thoracic surgery

BackgroundVideo-assisted thoracoscopic surgery (VATS) has become a standard approach for the treatment of lung cancer. However, its minimally invasive nature limits the field of view and reduces tactile feedback. These limitations make it vital that surgeons thoroughly familiarize themselves with the patient’s anatomy preoperatively. We have developed a virtual reality (VR) surgical navigation system using head-mounted displays (HMD). The aim of this study was to investigate the potential utility of this VR simulation system in both preoperative planning and intraoperative assistance, including support during thoracoscopic sublobar resection.MethodsThree-dimensional (3D) polygon data derived from preoperative computed tomography data was loaded into BananaVision software developed at Colorado State University and displayed on an HMD. An interactive 3D reconstruction image was created, in which all the pulmonary structures could be individually imaged. Preoperative resection simulations were performed with patient-individualized reconstructed 3D images.ResultsThe 3D anatomic structure of pulmonary vessels and a clear vision into the space between the lesion and adjacent tissues were successfully appreciated during preoperative simulation. Surgeons could easily evaluate the real patient’s anatomy in preoperative simulations to improve the accuracy and safety of actual surgery. The VR software and HMD allowed surgeons to visualize and interact with real patient data in true 3D providing a unique perspective.ConclusionsThis initial experience suggests that a VR simulation with HMD facilitated preoperative simulation. Routine imaging modalities combined with VR systems could substantially improve preoperative planning and contribute to the safety and accuracy of anatomic resection.     

Interactive simulation of CAD models assemblies using virtual constraint guidance

In the context of virtual reality (VR) and of computed aided design (CAD), haptic simulations are used to perform assembly tasks between 3D objects. To ensure the good assembly of those objects, we propose a new method of interactive assembly that uses both kinematic constraints and guiding virtual fixtures. Modelling a haptic assembly task as a combination of mechanical joints, we focus on the guidance of objects and on the activation cues of kinematic constraints in physical simulation. In this article, we first outline the difficulties related to the haptic-assembly of CAD objects in VR simulation. Introducing the virtual constraint guidance (VCG), we present a new method for haptic guidance that decomposes a task in two independent steps: a guiding step which use geometries as virtual fixtures to position objects, and a functional step which use kinematic constraints to perform the assembly task. We finally present a complete application of our method on a peg-in-hole insertion task.