Feedback Device Research Articles

The effect of standalone audio-visual feedback devices on the quality of chest compressions during laypersons' cardiopulmonary resuscitation training: a systematic review and meta-analysis.

Individual studies that investigated the effect of standalone audio-visual feedback (AVF) devices during laypersons' cardiopulmonary resuscitation (CPR) training have yielded conflicting results. This review aimed to evaluate the effect of standalone AVF devices on the quality of chest compressions during laypersons' CPR training. Randomized controlled trials of simulation studies recruiting participants without actual patient CPR experience were included. The intervention evaluated was the quality of chest compressions with standalone AVF devices vs. without AVF devices. Databases, such as PubMed, Cochrane Central, Embase, Cumulative Index to Nursing & Allied Health Literature (CINAHL), Web of Science, and PsycINFO, were searched from January 2010 to January 2022. The risk of bias was assessed using the Cochrane risk of bias tool. A meta-analysis alongside a narrative synthesis was used for examining the effect of standalone AVF devices.Sixteen studies were selected for this systematic review. A meta-analysis revealed an increased compression depth of 2.22 mm [95% CI (Confidence Interval), 0.88-3.55, P = 0.001] when participants performed CPR using the feedback devices. Besides, AVF devices enabled laypersons to deliver compression rates closer to the recommended range of 100-120 per min. No improvement was noted in chest recoil and hand positioning when participants used standalone AVF devices. The quality of the included studies was variable, and different standalone AVF devices were used. Standalone AVF devices were instrumental in guiding laypersons to deliver deeper compressions without compromising the quality of compression rates. However, the devices did not improve the quality of chest recoil and placement of the hands. PROSPERO: CRD42020205754.

Evaluating the effect of non-invasive force feedback on prosthetic grasp force modulation in participants with and without limb loss.

Grasping an object is one of the most common and complex actions performed by humans. The human brain can adapt and update the grasp dynamics through information received from sensory feedback. Prosthetic hands can assist with the mechanical performance of grasping, however currently commercially available prostheses do not address the disruption of the sensory feedback loop. Providing feedback about a prosthetic hand's grasp force magnitude is a top priority for those with limb loss. This study tested a wearable haptic system, i.e., the Clenching Upper-Limb Force Feedback device (CUFF), which was integrated with a novel robotic hand (The SoftHand Pro). The SoftHand Pro was controlled with myoelectrics of the forearm muscles. Five participants with limb loss and nineteen able-bodied participants completed a constrained grasping task (with and without feedback) which required modulation of the grasp to reach a target force. This task was performed while depriving participants of incidental sensory sources (vision and hearing were significantly limited with glasses and headphones). The data were analyzed with Functional Principal Component Analysis (fPCA). CUFF feedback improved grasp precision for participants with limb loss who typically use body-powered prostheses as well as a sub-set of able-bodied participants. Further testing, that is more functional and allows participants to use all sensory sources, is needed to determine if CUFF feedback can accelerate mastery of myoelectric control or would benefit specific patient sub-groups.

A Robust Forward Compensated Type-2 PLL Without DC Phase Error During Frequency Ramp for Embedded Magnetic Encoder

To achieve high performance vector control of permanent magnet synchronous machine (PMSM), high precision rotor angle is essential. Compared to traditionally used angle feedback device, e.g., encoder and resolver, the embedded magnetic encoder (EME) achieves high precision angle estimation without extra space occupation by installing several linear Hall sensors into PMSM cavity to monitor the flux leakage and rotor angle. The conventional synchronous reference frame (SRF) phase-locked loop (PLL) can extract phase and frequency from three or two Hall signals simultaneously. Although the type-2 SRF-PLL shows good robust performance against parameter variation, phase error emerges when input frequency changes. More specifically, a DC phase error appears in type-2 SRF-PLL during speed ramp stage due to insufficient order. Increase of the loop order removes the DC phase error but leads to instability risk. In this paper, a novel forward compensation (FC) module is attached on type-2 SRF-PLL to achieve phase error-free when frequency changes, where the instability risk is avoided. The effectiveness of proposed FC module is analytically and experimentally proved, where the phase error elimination, noise immunity and dynamic response are evaluated.

The Catheter and Guidewire Operating Systems of Vascular Interventional Surgical Robots: A Systematic Review

Vascular interventional surgical robots (VISR) assisted doctors in surgery can not only protect doctors from X-ray radiation, but also improve the accuracy of surgery. The catheter and guidewire operating systems with master-slave operation mode play an important role in VISR. In recent years, the operating systems have gradually become a research hotspot. After nearly two decades of development, they have made great progress, but there are still some problems to be solved. This review first introduces the research necessity and development history of these operating systems. Then, we summarize the research direction of operating systems from the perspective of hardware devices and algorithms. In the hardware devices, we analyzed the catheter and guidewire operating mechanisms, contact force detection devices, master operating mechanisms and master force feedback devices. In the algorithm, we introduce the bilateral control methods, security strategies and skill evaluation methods. Next, we discuss the actual performance and shortcomings of the operating systems from the perspective of clinical application. Finally, we summarize the current problems of the operating systems and propose the future development direction. This review is helpful for researchers to understand the current situation, and provides a reference framework of catheter and guidewire operating system.

Remote Ischemic Conditioning with Novel Optical Sensor Feedback Device in Acute Ischemic Stroke-a feasibility study (P11-5.002)

<h3>Objective:</h3> To check the feasibility of a novel Remote Ischemic Conditioning (RIC) device. <h3>Background:</h3> RIC therapy is delivered by increasing the pressure in the arm cuff 50 mmHg above systolic BP to a maximum of 200 mmHg. This may be associated with discomfort and consequently reduced compliance with RIC therapy. Our group has developed a novel RIC device, with an optical skin perfusion sensor to assess distal limb ischemia during RIC therapy. <h3>Design/Methods:</h3> This is a prospective, single-center, randomized control trial for the feasibility of the device. Patients of acute ischemic stroke with moderate to severe small vessel disease are randomized 2:1 to intervention vs sham control arms for a period of 7 days or until discharge. All patients randomized to the intervention arm will receive 5 cycles of ischemia/reperfusion in a non-paralyzed arm. Patients in the sham control arm will receive pressure sensation by keeping the cuff pressure at 30 mmHg for 5 minutes for 5 cycles. <h3>Results:</h3> We have enrolled a total of 10 (7 Intervention arm and 3 Sham Control) patients to date at a median(IQR) 71.5 (79.5) hours after symptom onset, with mean±SD age of 68.6±9years and median (IQR) NIHSS of 5(8). We found no differences in oxygenated hemoglobin and hemoglobin concentration with either 30 or 50 mmHg systolic BP increase in the arm cuff in the intervention group. The procedure-related comfort measured by the Likert scale showed a median(IQR) of 3.00(1, neither comfortable nor uncomfortable) in the intervention arm and 1.50(1, very comfortable) in the sham control arm. No safety concerns were noted in the intervention or sham arm. <h3>Conclusions:</h3> RIC with the skin perfusion sensor assessment is feasible. There were no safety concerns. <b>Clinical Trial Registration Number</b>: clinicaltrials.gov NCT05408130 <b>Disclosure:</b> Dr. Sarmiento has nothing to disclose. Dr. Nair has nothing to disclose. Dr. Shuaib has nothing to disclose. Dr. Buck has nothing to disclose. Mr. Gauthier has nothing to disclose. The institution of Prof. Mushahwar has received research support from University Hospital Foundation. Dr. Ferguson-Pell has stock in Click&amp;Push Inc.. Dr. Ferguson-Pell has stock in Moshion Inc.. Dr. Kate has nothing to disclose.

Real-Time Intubation and Ventilation Feedback: A Randomized Controlled Simulation Study.

This study aimed to determine the best educational application of a respiratory function monitor and a video laryngoscope. This study was a randomized controlled simulation-based trial, including 167 medical students. Participants had to execute ventilation and intubation maneuvers on a newborn manikin. Participants were randomized into 3 groups. In group A (no-access), the feedback devices were not visible but recording. In group B (supervisor-access), the feedback devices were visible to the supervisor only. In group C (full-access), both the participant and the supervisor had visual access. The two main outcome variables were the percentage of ventilations within the tidal volume target range (4-8mL/kg) and the number of intubation attempts. Group C achieved the highest percentage of ventilations within the tidal volume target range (full-access 63.6%, supervisor-access 51.0%, no-access 31.1%, P < .001) and the lowest mask leakage (full-access 34.9%, supervisor-access 46.6%, no-access 61.6%; A to B: P < .001, A to C: P < .001, B to C: P = .003). Overall, group C achieved superior ventilation quality regarding primary and secondary outcome measures. The number of intubation attempts until success was lowest in the full-access group (full-access: 1.29, supervisor-access: 1.77, no-access: 2.43; A to B: P = .001, A to C: P < .001, B to C: P = .015). Our findings confirm that direct visual access to feedback devices for supervisor and trainees alike considerably benefits outcomes and can contribute to the future of clinical education.

Teleoperation of Soft Robots with Real‐Time Fingertip Haptic Feedback Using Small Batteries

AbstractSoft robots are promising candidates for robust grasping and manipulation of different types of objects; however, their development has been a scientific challenge because of the lack of compact, yet precise, controllable soft actuators. In this work, innovative haptic interactive systems based on sensor‐integrated actuators powered by small batteries are reported. A liquid‐metal strain sensor with a versatile form factor and robust sensing performance is incorporated into a fast‐switching high‐force ionic polymer actuator. The structure of the sensor‐integrated actuator is rationally designed through encapsulation technology to achieve the best sensitivity and actuation while maintaining compactness, allowing for accurate, real‐time estimation and tracking of the actuation process. In a closed loop between the user and sensor‐integrated actuator, the motion and manipulation dynamics of a soft gripper made of sensor‐integrated actuators can be controlled by hand motions during a task. By combining with a thimble‐type haptic feedback device, the states of the gripper can be transmitted back to the user in real‐time via the proprioception of the integrated sensor. The approach opens a prospective avenue for the development of future robotic technologies without requiring camera‐based sensors for versatile, wearable, and scalable haptic systems.

Roles of Low-Dimensional Nanomaterials in Pursuing Human-Machine-Thing Natural Interaction.

A wide variety of low-dimensional nanomaterials with excellent properties can meet almost all the requirements of functional materials for information sensing, processing, and feedback devices. Low-dimensional nanomaterials are becoming the star of hope on the road to pursuing human-machine-thing natural interactions, benefiting from the breakthroughs in precise preparation, performance regulation, structural design, and device construction in recent years. This review summarizes several types of low-dimensional nanomaterials commonly used in human-machine-thing natural interactions and outlines the differences in properties and application areas of different materials. According to the sequence of information flow in the human-machine-thing interaction process, the representative research progress of low-dimensional nanomaterials-based information sensing, processing, and feedback devices is reviewed and the key roles played by low-dimensional nanomaterials are discussed. Finally, the development trends and existing challenges of low-dimensional nanomaterials in the field of human-machine-thing natural interaction technology are discussed.

A 3D-Printed Soft Haptic Device with Built-in Force Sensing Delivering Bio-Mimicked Feedback.

Haptics plays a significant role not only in the rehabilitation of neurological disorders, such as stroke, by substituting necessary cognitive information but also in human-computer interfaces (HCIs), which are now an integral part of the recently launched metaverse. This study proposes a unique, soft, monolithic haptic feedback device (SoHapS) that was directly manufactured using a low-cost and open-source fused deposition modeling (FDM) 3D printer by employing a combination of soft conductive and nonconductive thermoplastic polyurethane (TPU) materials (NinjaTek, USA). SoHapS consists of a soft bellow actuator and a soft resistive force sensor, which are optimized using finite element modeling (FEM). SoHapS was characterized both mechanically and electrically to assess its performance, and a dynamic model was developed to predict its force output with given pressure inputs. We demonstrated the efficacy of SoHapS in substituting biofeedback with tactile feedback, such as gripping force, and proprioceptive feedback, such as finger flexion-extension positions, in the context of teleoperation. With its intrinsic properties, SoHapS can be integrated into rehabilitation robots and robotic prostheses, as well as augmented, virtual, and mixed reality (AR/VR/MR) systems, to induce various types of bio-mimicked feedback.

Dynamic stray current evaluation model of metro system considering reversible DC traction power system

ABSTRACT Stray current of DC metro system will accelerate metal corrosion. Therefore, it is necessary to evaluate it. With the application of inverter feedback devices in recent years, stray current is more complex due to the DC traction power system is reversible. To evaluate stray current more accurately, the dynamic evaluation model is proposed in this paper. Firstly, traction power substation (TPS) is equivalent to controlled source, considering the diverse operating characteristics. Based on this, the dynamic evaluation model is built with multiple trains running and TPSs operation. Then, considering the nonlinear and multivalued function characteristics of TPS, the solution method is proposed. The problem of slow convergence or even non-convergence in the stray current solving process of the metro system considering reversible DC traction power system is solved. The model is validated by the field test data. Finally, the model is used to obtain dynamic stray current. Result shows that stray current level tends to be higher as traction trains and braking trains run separately and concentratedly in different areas of the line.

Super-steep synapses based on positive feedback devices for reliable binary neural networks

This work proposes positive feedback (PF) device-based synaptic devices for reliable binary neural networks (BNNs). Due to PF operation, the fabricated PF device shows a high on/off current ratio (2.69 × 107). The PF device has a charge-trap layer by which the turn-on voltage (Von) of the device can be adjusted by program/erase operations and a long-term memory function is implemented. Also, due to the steep switching characteristics of the PF device, the conductance becomes tolerant to the retention time and the variation in turn-on voltage. Simulations show that high accuracy (88.44% for CIFAR-10 image classification) can be achieved in hardware-based BNNs using PF devices with these properties as synapses.

Development of a Bimanual Wearable Force Feedback Device with Pneumatic Artificial Muscles, MR Fluid Brakes, and Sensibility Evaluation Based on Pushing Motion

In a virtual reality (VR) space, wearing a head-mounted display can help with the visualization of objects; however, users cannot experience realistic tactile sensations. Recently, several force feedback devices have been developed, including wearable devices that use straight-fiber-type pneumatic muscles and magnetorheological fluids. This allows the devices to render elastic, frictional, and viscous forces during spatially unrestricted movement. Nevertheless, a problem remains in that previous devices could handle many bilateral upper limb movement tasks. Therefore, this study aims to develop a device that can handle movements that interact with both arms. Based on experiments concerning the pushing motion in a VR space, the influence of the pseudo force sense was determined to not be small. In addition, we confirmed that the force sensation presented by this system was more realistic when the robot was operated with both arms than when operated with the right arm.

Temporal analysis of continuous chest compression rate and depth performed by firefighters during out of hospital cardiac arrest

BackgroundQuality of chest compressions (CC) during cardiopulmonary resuscitation (CPR) often do not meet guideline recommendations for rate and depth. This may be due to the fatiguing nature of physically compressing a patient’s chest, meaning that CPR quality reduces over time. ObjectiveThis analysis investigates the effect of CPR duration on the performance of continuous CCs delivered by firefighters equipped with CPR feedback devices. MethodsData were collected from a first responder group which used CPR feedback and automatic external defibrillator devices when attending out-of-hospital cardiac arrest events. Depth and rate of CC were analysed for 134 patients. Mean CC depth and rate were calculated every 5 s during two-minute episodes of CPR. Regression models were created to evaluate the relationship between applied CC depth and rate as a function of time. ResultsMean (SD) CC depth during the investigation was 48 (9) mm. An inverse relationship was observed between CC depth and CPR duration, where CC depth decreased by 3.39 mm, over two-minutes of CPR (p < 0.001). Mean (SD) CC rate was 112.06 (5.87) compressions per minute. No significant relationship was observed between CC rate and CPR duration (p = 0.077). Mean depth was within guideline range for 33.58% of patient events, while guideline rate was observed in 92.54% of cases. ConclusionsA reduction in CC depth was observed during two-minutes of continuous CCs while CC rate was not affected. One third of patients received a mean CC depth within guideline range (50 to 60 mm).

Potential Haptic Perceptual Dimensionality of Rendered Compliance.

Studies have proven that humans perceive haptic textures through different perceptual dimensions, such as rough/smooth and soft/hard, which provide useful guidance in the design of haptic devices. However, few of these have focused on the perception of compliance, which is another important perceptual property in haptic interfaces. This research was conducted to investigate the potential basic perceptual dimensions of the rendered compliance and quantify the effects of the simulation parameters. Two perceptual experiments were designed based on 27 stimuli samples generated by a 3-DOF haptic feedback device. Subjects were asked to describe these stimuli using adjectives, classify the samples, and rate them according to corresponding adjective labels. Multi-dimensional scaling (MDS) methods were then used to project adjective ratings into 2D and 3D perception spaces. According to the results, hardness and viscosity are considered two basic perceptual dimensions of the rendered compliance, while crispness can be regarded as a subsidiary perceptual dimension. Then, the relations between simulation parameters and perceptual feelings were analyzed by the regression analysis. This paper may provide a better understanding of the compliance perception mechanism and useful guidance for the improvement of rendering algorithms and devices for haptic human-computer interaction.

Comparison of the CPR Feedback Device Effect on the Effective Technique of the CPR in Two Modes of the Device Warning Being On and Off.

Out-of-hospital cardiac arrest is a major public health problem with over 90% case fatality. Although it is known that good quality of cardiopulmonary Resuscitation (CPR) leads to improved patient outcomes, health care practitioners commonly perform sub-optimal CPR. The CPR feedback device is a small device designed to measure the number and depth of chest compressions (CC) and if the rate of compressions or the depth of the compressions is low or high, it will try to correct the CPR operation by announcing a warning to the resuscitator. The aim of this study was to evaluate the effectiveness of this device which was designed and made by the authors' technician study group member in improving CPR operations, to determine the need for it in all hospitals on a routine basis. This cross-sectional study was performed on patients who have suffered from cardio-pulmonary arrest in Al-Zahra Hospital in 2020. Patients needed primary CPR for any reason, were randomly divided into two groups using random allocation software. The first group contains patients as the CPR Feedback device is on and alarm is on and warns, if resuscitation is ineffective, the second group also uses the device, but with the difference that the alarm is off. The data was analyzed by general linear model method (repeated measure ANOVA). 80 patients were studied, including 63 men (79%) and 17 women (21%). Patients were divided among two groups. There was no significant difference in demographic characteristics between two groups. The results showed that there was no significant interaction between group and time for the compression depth variable and there was no significant difference in the depth of compressions between the two groups(P>0.05). For the rate of compressions, there was a significant interaction between group and time. These results indicate that turning on the CPR feedback device's warning increases the number of compressions during CPR and, as a result, makes it more effective. The between-group effect which showed the difference in the number of compressions in the two groups, was statistically significant (P<0.001). These results indicated that turning on the CPR feedback device's warning increases the rate of compressions during CPR and, as a result, makes it more effective. Therefore, the use of real-time CPR feedback device during chest compression in real-time CPR improves the quality of CPR.

The Use of the Borg Rating of Perceived Exertion Scale in Cardiopulmonary Resuscitation.

A cardiopulmonary arrest is a critical event whose survival rate is related to the quality of resuscitation maneuvers combined with the use of technology. It is important to understand the perception of fatigue during this procedure, aiming to improve the effectiveness of compressions to increase the chances of survival. To apply the Borg rating of perceived exertion scale (Borg scale) to analyze the exertion perceived by nurses during cardiopulmonary resuscitation maneuvers using a feedback device. Experimental study with a randomized distribution of nurses in a teaching hospital. Perceived exertion during simulated cardiopulmonary resuscitation with/without a feedback device was assessed using the Borg scale. The statistical significance level of 5% was adopted. 69 nurses working in critical and non-critical adult care units were included. Perceived exertion and heart rate were lower in the intervention group (p<0.001), influenced by the feedback device, with no significant difference between critical and non-critical units. The Borg scale proved to be adequate for the proposed objectives. The feedback device contributed to lower exertion and heart rate reduction during resuscitation maneuvers. The low cost and ease of application favor its use during training and real-time resuscitation attempts to assess performance using a feedback device to reduce exertion and perception of fatigue. It allows reflection on the intervening factors and resources that can influence the quality of resuscitation attempts and the chances of survival.

Deep Imitation Learning with Pseudo-haptics Module for Peg-in-hole with Hole Position Uncertainty

Peg-in-hole is a task of product assembly. Robots insert the component (called “peg”) into the hole. In this paper, we tackle peg-in-hole with an uncertainty of hole position. Previous works search hole positions to insert pegs into uncertain holes. However, these methods have problems: annotation cost, positional accuracy, and long search time. Therefore, we use imitation learning (IL) which teaches robots through human teleoperation. IL provides the following benefits: lower annotation costs, rough visual servo, and an ability to find accurate hole positions by trial and error of insertion. However, current image-based IL cannot teach force perception to robots without a haptic feedback device. To solve this problem, we focused on pseudo-haptics. Pseudo-haptics is a force presentation method that does not require a mechanical feedback device. We propose a “Pseudo-haptics Module (PHM)” to feel the robot's pseudo-haptics. The module is designed from the process by which humans perceive pseudo-haptics. Our method with PHM is 7.7% higher peg-in-hole success than simple CNN.

Black phosphorous-based human-machine communication interface

Assistive technology involving auditory feedback is generally utilized by those who are visually impaired or have speech and language difficulties. Therefore, here we concentrate on an auditory human-machine interface that uses audio as a platform for conveying information between visually or speech-disabled users and society. We develop a piezoresistive tactile sensor based on a black phosphorous and polyaniline (BP@PANI) composite by the facile chemical oxidative polymerization of aniline on cotton fabric. Taking advantage of BP’s puckered honeycomb lattice structure and superior electrical properties as well as the vast wavy fabric surface, this BP@PANI-based tactile sensor exhibits excellent sensitivity, low-pressure sensitivity, reasonable response time, and good cycle stability. For a real-world application, a prototype device employs six BP@PANI tactile sensors that correspond to braille characters and can convert pressed text into audio on reading or typing to assist visually or speech-disabled persons. Overall, this research offers promising insight into the material candidates and strategies for the development of auditory feedback devices based on layered and 2D materials for human-machine interfaces.

Neural Active Disturbance Rejection Adaptive Lateral Manipulation Control Method for Unmanned Driving Robot

In this article, a neural active disturbance rejection adaptive lateral manipulation control method for an unmanned driving robot (UDR) is proposed to realize accurate and stable steering and path tracking. Combined with a model of the manipulated vehicle and steering manipulator, an integrated dynamics model of the vehicle manipulated by a UDR is established. Taking the error of the body heading angle and the lateral error of the vehicle as input, an active disturbance rejection controller is designed; it includes a tracking differentiator, nonlinear state error feedback (NLSEF) device, and an extended state observer. To achieve a better performance, the combination mode of the NLSEF is adjusted adaptively by a radial basis function NN. The network is then initialized by a particle swarm optimization algorithm. Finally, the results of simulations and experiments show that the proposed method effectively improves the performance of stable steering and path tracking of the UDR.

A Mobile Natural Interactive Technique With Bare Hand Manipulation and Unrestricted Force Feedback for Virtual Assembly Tasks

Most existing virtual assembly technologies cannot effectively unify the operating and the feedback areas in both visualization and haptics with a large mobile workspace. Therefore, it is difficult to ensure high interactive naturalness and operational efficiency in a large assembly space. To address these problems, we propose a natural mobile interactive virtual assembly method with bare hand manipulation and unrestricted force feedback (MIVAM-BHM-UFF), covering a mobile interaction method, an unrestricted force feedback method, and a bare hand manipulation method. The mobile interaction method is developed to automatically track and capture the operator’s gestures in a moving way, expanding the interactive space. An unrestricted force feedback method is designed to provide a non-contact electromagnetic feedback force, eliminating the limitation of the traditional force feedback device and improving the interactive naturalness. A bare hand manipulation method is proposed to improve interactive efficiency by unifying the operational area and feedback area. To verify the effectiveness of MIVAM-BHM-UFF, five assembly experiments were performed. Experimental results indicate that compared with four assembly techniques, MIVAM-BHM-UFF show better user experiences in the virtual assembly processes.