Tobii Pro Glasses Research Articles

Strabismus Screening Using Eyetracker Combined with Machine Learning

Purpose: To assess the effectiveness of an automated screening program that diagnoses horizontal strabismus using machine learning based on ocular deviation data captured by the wearable eyetracker, Tobii pro glasses 2 (TPG2).Methods: The TPG2 which locates the pupil center to measure ocular movement was used. In normal adults wearing TPG2, horizontal ocular deviation was induced by covering the left eye and applying prisms of varying strengths (2, 3, 4, 5, 6, 8, 10, 12, 15, 20, 25, 30, 35, and 40 PD base-in and out) to the right eye. TPG2 automatically recorded ocular deviation before and after prism induction generating 28 types of ocular deviation sets. From each set, 20 X-axis values before and after ocular deviation were randomly extracted using an oversampling technique creating a total of 61,600 ocular deviation sets. For training, 56,000 sets were used and 5,600 were evaluated for sensitivity, specificity, and area under the curve (AUC).Results: Eleven normal adults (5 males) participated with a mean age of 34.8 ± 7.37 years. Based on an 8 PD threshold, deviations of 8 PD or less demonstrated a sensitivity of 1.0, a specificity of 0.95, and an AUC of 0.97. When categorized into three groups based on 8 PD and 20 PD thresholds, the results were: sensitivity of 0.90 and specificity of 0.95 for ≤ 8 PD; sensitivity of 0.60 and specificity of 1.00 for 8-20 PD; sensitivity of 1.00 and specificity of 0.88 for > 20 PD.Conclusions: The machine learning program developed using induced ocular deviations measured with prisms and TPG2 shows promise for use in future strabismus screening tests.

Reducing Driving Risk Factors in Adolescents with Attention Deficit Hyperactivity Disorder (ADHD): Insights from EEG and Eye-Tracking Analysis.

Adolescents with attention deficit hyperactivity disorder (ADHD) face significant driving challenges due to deficits in attention and executive functioning, elevating their road risks. Previous interventions targeting driving safety among this cohort have typically addressed isolated aspects (e.g., cognitive or behavioral factors) or relied on uniform solutions. However, these approaches often overlook this population's diverse needs. This study introduces the "Drive-Fun" innovative intervention (DFI), aimed at enhancing driving skills among this vulnerable population. The intervention was tested in a pilot study including 30 adolescents aged 15-18, comparing three groups: DFI, an educational intervention, and a control group with no treatment. Assessments included a driving simulator, EEG, and Tobii Pro Glasses 2. Evaluation was conducted pre- and post-intervention and at a 3-month follow-up. Results indicated that the DFI group significantly improved in the simulated driving performance, attentional effort, and focused gaze time. The findings underscore that holistic strategies with personalized, comprehensive approaches for adolescents with ADHD are particularly effective in improving driving performance. These outcomes not only affirm the feasibility of the DFI but also highlight the critical role of sensor technologies in accurately measuring and enhancing simulator driving performance in adolescents with ADHD. Outcomes suggest a promising direction for future research and application.

Assessing the data quality of AdHawk MindLink eye-tracking glasses.

Most commercially available eye-tracking devices rely on video cameras and image processing algorithms to track gaze. Despite this, emerging technologies are entering the field, making high-speed, cameraless eye-tracking more accessible. In this study, a series of tests were conducted to compare the data quality of MEMS-based eye-tracking glasses (AdHawk MindLink) with three widely used camera-based eye-tracking devices (EyeLink Portable Duo, Tobii Pro Glasses 2, and SMI Eye Tracking Glasses 2). The data quality measures assessed in these tests included accuracy, precision, data loss, and system latency. The results suggest that, overall, the data quality of the eye-tracking glasses was lower compared to that of a desktop EyeLink Portable Duo eye-tracker. Among the eye-tracking glasses, the accuracy and precision of the MindLink eye-tracking glasses were either higher or on par with those of Tobii Pro Glasses 2 and SMI Eye Tracking Glasses 2. The system latency of MindLink was approximately 9 ms, significantly lower than that of camera-based eye-tracking devices found in VR goggles. These results suggest that the MindLink eye-tracking glasses show promise for research applications where high sampling rates and low latency are preferred.

Decreased Visual Search Behavior in Elderly Drivers during the Early Phase of Reverse Parking, But an Increase during the Late Phase.

The aim of this study was to assess the characteristics of visual search behavior in elderly drivers in reverse parking. Fourteen healthy elderly and fourteen expert drivers performed a perpendicular parking task. The parking process was divided into three consecutive phases (Forward, Reverse, and Straighten the wheel) and the visual search behavior was monitored using an eye tracker (Tobii Pro Glasses 2). In addition, driving-related tests and quality of life were evaluated in elderly drivers. As a result, elderly drivers had a shorter time of gaze at the vertex of the parking space both in direct vision and reflected in the driver-side mirror during the Forward and the Reverse phases. In contrast, they had increased gaze time in the passenger-side mirror in the Straighten the wheel phase. Multiple regression analysis revealed that quality of life could be predicted by the total gaze time in the Straighten the wheel phase (β = -0.45), driving attitude (β = 0.62), and driving performance (β = 0.58); the adjusted R2 value was 0.87. These observations could improve our understanding of the characteristics of visual search behavior in parking performance and how this behavior is related to quality of life in elderly drivers.

The Gaze Patterns of Group Fitness Instructors Based on Different Levels of Training and Professional Experience.

The way in which group fitness instructors observe participants has a great influence on their pedagogical intervention. Based on the above, the main objective of this research is to characterize and compare their gaze patterns according to their training and professional experience. Twenty group fitness instructors of choreographed classes participated, aged between 18 and 42 years old, and for the comparison, four groups were created. Eye movements were captured with TOBII Pro Glasses 3, and data were coded and analyzed using the TOBII Pro Lab software. For the characterization of the gaze patterns, descriptive statistics were used in terms of count (f/m) and duration (s/m), while the comparison was performed using a one-way ANOVA test. More trained and experienced instructors tend to look at participants less, in count (80.59 ± 0.74) and duration (17.74 ± 0.71), with significant differences between the groups in some areas of interest (head, lower body, and other). There are also significant differences in the total number of eye fixations (F = 34.614; p = 0.001; η2 = 0.866; effect size very high). In conclusion, and projecting future works, it is important to understand how these gaze patterns are related to pedagogical behaviors in general or based on some specific factors (e.g., pedagogical feedback).

Evaluating the Tobii Pro Glasses 2 and 3 in static and dynamic conditions

Over the past few decades, there have been significant developments in eye-tracking technology, particularly in the domain of mobile, head-mounted devices. Nevertheless, questions remain regarding the accuracy of these eye-trackers during static and dynamic tasks. In light of this, we evaluated the performance of two widely used devices: Tobii Pro Glasses 2 and Tobii Pro Glasses 3. A total of 36 participants engaged in tasks under three dynamicity conditions. In the “seated with a chinrest” trial, only the eyes could be moved; in the “seated without a chinrest” trial, both the head and the eyes were free to move; and during the walking trial, participants walked along a straight path. During the seated trials, participants’ gaze was directed towards dots on a wall by means of audio instructions, whereas in the walking trial, participants maintained their gaze on a bullseye while walking towards it. Eye-tracker accuracy was determined using computer vision techniques to identify the target within the scene camera image. The findings showed that Tobii 3 outperformed Tobii 2 in terms of accuracy during the walking trials. Moreover, the results suggest that employing a chinrest in the case of head-mounted eye-trackers is counterproductive, as it necessitates larger eye eccentricities for target fixation, thereby compromising accuracy compared to not using a chinrest, which allows for head movement. Lastly, it was found that participants who reported higher workload demonstrated poorer eye-tracking accuracy. The current findings may be useful in the design of experiments that involve head-mounted eye-trackers.

How sweet odors affect healthy food choice: An eye-tracking study

How to make healthy food choices the preferred ones is a public health concern worldwide. A promising way could be to utilize the sensory food cues in the environment, such as odors. Previous studies have shown conflicting results on whether odors can impact food choice, and its underlying mechanism remains unclear. The current study aims to investigate the effect of sweet food odors on food choices. A total of 53 participants were recruited to complete two sessions of different sweet odor exposure: healthy (apple, honey melon) or unhealthy (chocolate, caramel). In each session, the participants were asked to choose from eight (in-)congruent food products (an unhealthy and healthy option for each of the odors) after 10 min odor exposure. Visual attention to the food products was measured by Tobii Pro Glasses 2 eye-tracker. Results showed that healthy food products were chosen more frequently regardless of the (healthiness of the) odor exposure. Moreover, participants fixated on all food products for a longer time and more often, and showed a longer time to first fixation on food products during healthy odor exposure compared to unhealthy odor exposure. These findings indicate that healthy odors can prime visual attention and orientation towards both healthy and unhealthy foods. However, this priming does not necessarily lead to congruent food choices, and other cognitive factors likely play a role in the final food decision-making.

CARD1: Human Factors Evaluation of HeartMate 3 LVAD Peripherals: Insights gained from an Eye Tracking based Simulation Study

Background: Although left ventricular assist devices (LVADs) have demonstrated excellent clinical outcomes and design improvements over the past decade, human factors issues including limited usability and unintuitive handling continue to challenge this therapy. The aim of this study was to evaluate user experience of former LVAD patients and laypersons (LP) with the HeartMate 3 (HM3) LVAD peripherals in simulated everyday and emergency scenarios. Methods: This cross sectional, single center cohort study included former non-HM3 LVAD patients post heart transplantation (HTX) and LP without any previous LVAD peripherals handling experience. Seven predefined everyday and emergency scenarios, including battery exchanges (without alarm, in response to alarm, in dim light, within carry bag), power supply change to AC power, driveline dis- and reconnection and controller exchange were simulated. Subjects’ gaze behavior was recorded using eye tracking (ET) technology (Tobii Pro Glasses 2, Tobii Pro Lab), whereas areas of interest (AOIs) were defined for LVAD components used. Completion rate, duration to success (DTS), pump-off time, and percental fixation duration per AOI were defined as outcome measures to identify differences between initially successful and unsuccessful subjects and to correlate subject performances with demographics. Results: Thirty gender and age matched, untrained subjects (15 HTX vs. 15 LP, median age: 64 (IQR=11) vs. 63 (10) yrs., p=0.84), 20 vs. 20% female, p=1.00) completed 210 scenarios, whereas 82.9 vs. 81.9% (p=1.00) could be solved at first attempt. Changing power supply from batteries to AC power revealed highest complexity for both groups (DTS=251±93s, p=0.76): only 26.7% of subjects succeeded at first attempt (33.3% vs. 20.0%, p=0.68) and 56.7% at second attempt (66.7% vs. 46.7%, p=0.04) with significantly more LP failing. The first attempt resulted in 10 unnecessary hazards from disconnecting the driveline (5 HTX vs. 5 LP, pump-off time 2-118 s, p=0.25) and significant differences in percental fixation durations for five AOIs in participants with vs. without initial success (p<0.029, see Figure). Significantly decreased DTS during battery exchange (no alarm 32.5 (18.8)s vs. alarm 26.5 (20.8)s and dim light 21.0 (19.0)s, p<0.001, without group differences, p>0.34) indicate a high level of learnability and routine establishment. Exchanging batteries in the bag was more time consuming (75.0 (45.0) s, p=0.09), especially in elderly patients (r=0.61, p<0.001). Conclusion: This ET based human factors study provides insights into user experiences of untrained former non-HM3 LVAD patients and LP in handling HM3 peripherals in simulated everyday and emergency scenarios. It highlights unintuitive and potentially hazardous handling characteristics and provides guidance for future user centered design of LVAD wearables.

Evaluation of an Eye-Tracking-Based Method for Assessing the Visual Performance with Progressive Lens Designs

Due to the lack of sensitivity of visual acuity (VA) measurement to quantify differences in visual performance between progressive power lenses (PPLs), in this study, we propose and evaluate an eye-tracking-based method to assess visual performance when wearing PPLs. A wearable eye-tracker system (Tobii-Pro Glasses 3) recorded the pupil position of 27 PPL users at near and distance vision during a VA test while wearing three PPL designs: a PPL for general use (PPL-Balance), a PPL optimized for near vision (PPL-Near), and a PPL optimized for distance vision (PPL-Distance). The participants were asked to recognize eye charts at both near and distance vision using centered and oblique gaze directions with each PPL design. The results showed no statistically significant differences between PPLs for VA. However, significant differences in eye-tracking parameters were observed between PPLs. Furthermore, PPL-Distance had a lower test duration, complete fixation time, and number of fixations at distance evaluation. PPL-Near has a lower test duration, complete fixation time, and number of fixations for near vision. In conclusion, the quality of vision with PPLs can be better characterized by incorporating eye movement parameters than the traditional evaluation method.

Correlation between reading time and characteristics of eye fixations and progressive lens design.

The purpose of this study is to evaluate reading time and characteristics of fixations at different distances when looking through different areas of progressive power lenses (PPL) with different power distributions by means of eye-tracking technology. A wearable eye tracker system (Tobii-Pro Glasses 3) was used to record the pupil position of 28 PPL subjects when reading at near and distance vision while using 3 different PPL designs: a PPL optimized for distance vision (PPL-Distance), a PPL optimized for near vision (PPL-Near) and one of them balanced for a general use (PPL-Balance). Subjects were asked to read out loud a text displayed on a digital screen located at 5.25m and 0.37m when they were looking through the central and peripheral regions of each PPL. Reading time, total duration of fixations, and the number of fixations were analyzed for each reading condition and PPL. Statistical analysis was carried out using Statgraphics Centurion XVII.II Software. The analysis of eye movements at distance-reading vision showed a statistically significant lower reading time (p = 0.004) and lower total duration of fixations (p = 0.01) for PPL-Distance. At near-reading vision, PPL-Near provided statistically significant lower reading time (p<0.001), lower total duration of fixations (p = 0.02), and less fixation count(p<0.001) in comparison with PPL-Balance and PPL-Distance. Reading time and fixations characteristics are affected by the power distribution of a PPL. A PPL design with a wider distance region provides better distance-reading performance while a PPL with a wider near area performs better at a near-reading task. The power distribution of PPLs influences the user performance at vision-based tasks. Thus, to provide the user with the best visual experience, PPL selection must consider user needs.

변성암 분류 과정에서 정보 제공 정도에 따른 지구과학 교사들의 시선 특성과 암석 판별의 정확성 분석

Objectives The purposes of this study is to find out whether there is a difference in earth science teachers’ gaze characteristics and accuracy of rock identification according to the level of information provided in the metamorphic rock classification process.&#x0D; Methods To this end, 6 samples of metamorphic rocks (phyllite, slate, gneiss, hornfels, marble, and schist) were selected, and by using them, tasks related to metamorphic rock classification with different levels of information were developed. Afterwards, the developed task was applied to 21 earth science teachers, and quantitative data on gaze movement in the process of classifying metamorphic rock was collected and analyzed using a eye tracker (Tobii Pro Glasses 2 model).&#x0D; Results In the process of classifying metamorphic rocks, earth science teachers tended to focus too much on specific areas or unique features of the rock surface rather than the overall characteristics of the rock, and tended to classify rocks based on the limited information collected in this way. Second, although there are some differences depending on the type of rock, the more specific the information provided, the more the teachers’ total duration of fixation and number of fixation tended to decrease. Third, as the information provided was more specific, the accuracy of rock identification increased, and the types of rocks mentioned tended to decrease. Fourth, according to the level of information provided by earth science teachers, the most accurate pattern for classifying rocks was ‘wrong answer-wrong answer-correct answer’.&#x0D; Conclusions Through the result of this study, it was confirmed that it is necessary to provide a systematic manual on matters to be paid attention to when observing the characteristics of metamorphic rocks, and to reduce the cognitive loads of learners through effective rock arrangement enhance understanding of metamorphic rocks classification.

Effects of Different Basketball Shooting Positions and Distances on Gaze Behavior and Shooting Accuracy

Basketball is a sport where in order to obtain points, it is necessary to put the ball in the basket. Therefore, basketball players need to shoot the ball accurately. This study aimed to evaluate if there are differences between shooting positions and angles concerning athlete visual behavior. Tobii Pro Glasses 3 was used to measure the number and duration of fixations in the target during shooting movement. The sample included 18 basketball players (10 female and 8 males; 22 ± 3.72 years; 12.5 ± 4.52 years of federated basketball practice) who performed a total of 60 shots in all shooting conditions and positions. Two distances (free throw and 3 points line) and three angles (45°, 90°, and 135°) in the 3 points shot were considered in all three shooting conditions (baseline, simulated opposition, and gym audience noise). Between distances, statistically significant differences occurred in the number and total duration of fixations and shooting accuracy. At a greater distance from the basket, the athlete tended to have less accuracy, as well as a lower number and duration of fixations. Between angles, there was no statistically significant differences, neither a tendency towards lower or higher values between them. Moreover, the shooting accuracy was better when the athlete focused for more time on the target, which occurred in the free throw condition.

Quotidian Profile of Vergence Angle in Ambulatory Subjects Monitored With Wearable Eye Tracking Glasses.

Wearable eye trackers record gaze position as ambulatory subjects navigate their environment. Tobii Pro Glasses 3 were tested to assess their accuracy and precision in the measurement of vergence angle. Four subjects wore the eye tracking glasses, with their head stabilized, while fixating at a series of distances corresponding to vergence demands of: 0.25, 0.50, 1, 2, 4, 8, 16, and 32°. After these laboratory trials were completed, 10 subjects wore the glasses for a prolonged period while carrying out their customary daily pursuits. A vergence profile was compiled for each subject and compared with interpupillary distance. In the laboratory, the eye tracking glasses were comparable in accuracy to remote video eye trackers, outputting a mean vergence value within 1° of demand at all angles except 32°. In ambulatory subjects, the glasses were less accurate, due to tracking interruptions and measurement errors, partly mitigated by the application of data filters. Nonetheless, a useful record of vergence behavior was obtained in every subject. Vergence profiles often had a bimodal distribution, reflecting a preponderance of activities at near (mobile phone and computer) or far (driving and walking). As expected, vergence angle correlated with interpupillary distance. Wearable eye tracking glasses make it possible to compile a nearly continuous record of vergence angle over hours, which can be correlated with the corresponding visual scene viewed by ambulatory subjects. This technology provides new insight into the diversity of human ocular motor behavior and may become useful for the diagnosis of disorders that affect vergence function such as: convergence insufficiency, Parkinson disease, and strabismus.

Quantifying Workload and Stress in Intensive Care Unit Nurses:PreliminaryEvaluation Using ContinuousEye-Tracking.

(1) To assess mental workloads of intensive care unit (ICU) nurses in 12-hour working shifts (days and nights) using eye movement data; (2) to explore the impact of stress on the ocular metrics of nurses performing patient care in the ICU. Prior studies have employed workload scoring systems or accelerometer data to assess ICU nurses' workload. This is the first naturalistic attempt to explore nurses' mental workload using eye movement data. Tobii Pro Glasses 2 eye-tracking and Empatica E4 devices were used to collect eye movement and physiological data from 15 nurses during 12-hour shifts (252 observation hours). We used mixed-effect models and an ordinal regression model with a random effect to analyze the changes in eye movement metrics during high stress episodes. While the cadence and characteristics of nurse workload can vary between day shift and night shift, no significant difference in eye movement values was detected. However, eye movement metrics showed that the initial handoff period of nursing shifts has a higher mental workload compared with other times. Analysis of ocular metrics showed that stress is positively associated with an increase in number of eye fixations and gaze entropy, but negatively correlated with the duration of saccades and pupil diameter. Eye-tracking technology can be used to assess the temporal variation of stress and associated changes with mental workload in the ICU environment. A real-time system could be developed for monitoring stress and workload for intervention development.

EG-SNIK: A Free Viewing Egocentric Gaze Dataset and Its Applications

Egocentric vision data captures the first person perspective of a visual stimulus and helps study the gaze behavior in more natural contexts. In this work, we propose a new dataset collected in a free viewing style with an end-to-end data processing pipeline. A group of 25 participants provided their gaze information wearing Tobii Pro Glasses 2 set up at a museum. The gaze stream is post-processed for handling missing or incoherent information. The corresponding video stream is clipped into 20 videos corresponding to 20 museum exhibits and compensated for user’s unwanted head movements. Then, I-VT algorithm is used to identify eye movements as fixations and saccades. Based on the velocity of directional shifts of the eye, the I-VT algorithm classifies the eye movements into either fixations or saccades. Representative scanpaths are built by generalizing multiple viewers’ gazing styles for all exhibits. The application of our dataset is demonstrated for characterizing the inherent gaze dynamics using state trajectory estimator based on ancestor sampling (STEAS) model in solving gaze data classification and retrieval problems.

SUV 차량의 외관 감성평가에서 시각적 주목도 및 시선 엔트로피의 성별 특성 분석

Objective: This study was conducted for analyzing the gender characteristics of visual attention and gaze entropy by using eye-tracking equipment in emotional evaluation process for the exterior design of SUV (Sport utility vehicle).<BR>Background: Since emotion is one of the most important factors that determine the competitiveness of a product, it is necessary to conduct the research from various perspectives. Human emotion for products is mostly formed through visual information. It has been known that there are differences in the way humans search for visual information according to gender. It is necessary to find out whether these characteristics exist in the emotional evaluation process of the product.<BR>Method: The gaze movement of men and women was measured in the emotional evaluation process for the exterior of SUV. To measure the eye movement, the Tobii Pro Glasses 2 was used. Front and rear images of three types of SUVs manufactured in Korea were used in this experiment. The subject looked at the image of a car presented on a 65-inch TV monitor for 20 seconds while wearing the eye tracker and evaluated the emotion for it.<BR>Results: In emotional evaluation for the front design of SUV, the subjects showed a significant difference in the fixation duration and count according to design parts, and the values were large in the order of the grill, bumper, and hood. These results were similar in male and female subjects. Gender difference in the fixation duration and count was not significant in mostly design parts, but it was found that women paid more attention to the grill. In the emotional evaluation for the rear image of SUV, both men and women showed high fixation duration and count in the order of trunk, bumper, and left mirror. There was no difference between males and females in the fixation duration and count for rear parts. In the analysis of gaze entropy, gender significance was not found in all of Shannon entropy, dwell time entropy, and heat map entropy.<BR>Conclusion: Through eye tracking, it was found that there was a significant difference in the degree of attention of the exterior design components of SUV. In addition, except for the grill, there was no gender difference in the degree of attention in the exterior design parts. Since no significant difference was found according to gender in according to gender in the emotional evaluation process.<BR>Application: The results could be utilized as a methodology and basic data for the exterior design of SUV.

Eye-tracking during remote collaborative communication under noisy, reverberant and delayed communication transmission conditions

This study, which is part of a larger study, was designed to monitor eye-tracking parameters during remote collaborative communication. Ninety (45 men and 45 women) participants were divided into 30 teams with three members in each team. Each team built different LEGO models under three communication transmission delay conditions in the following order: No delay, 750 ms delay and 5000 ms delay. One individual served as the LEGO builder, who did not have access to the instruction manual. The remaining two team members provided instructions for building the models. Participants were in separate rooms and communicated via earphones. Background white noise (50 dB SPL) was introduced in the ear canals and reverberation was applied to the transmitted communication. Participants were fitted with Tobii Pro Glasses 2 with a sampling rate of 100 fps for eye-tracking. ANOVA was performed on several eyetracking parameters including fixation rate/minute, total whole fixation duration/minute and saccades rate/minute. The results revealed that the cognitive load/or listening effort was lowest in the 750 ms condition compared to the no delay or 5000 ms delay conditions. Detailed results will be discussed during the presentation. Acknowledgement: Graduate students Sydney Osbarn and Melissa Reyes assisted in data collection.

Virtual Reality vs Dry Laboratory Models: Comparing Automated Performance Metrics and Cognitive Workload During Robotic Simulation Training.

Background: This study compares surgical performance during analogous vesico-urethral anastomosis (VUA) tasks in two robotic training environments, virtual reality (VR) and dry laboratory (DL), to investigate transferability of skill assessment across the two platforms. Utilizing computer-generated performance metrics and pupillary data, we evaluated the two environments to distinguish surgical expertise and ultimately whether performance in the VR simulation correlates with performance in live robotic surgery in the DL. Materials and Methods: Experts (≥300 cases) and trainees (<300 cases) performed analogous VUAs during VR and DL sessions on a da Vinci robotic console following an Institutional Review Board (IRB) approved protocol (HS-16-00318). Twenty-two metrics were generated in each environment (kinematic metrics, tissue metrics, and biometrics). The DL included 18 previously validated automated performance metrics (APMs) (kinematics and event metrics) captured by an Intuitive system data recorder. In both settings, Tobii Pro Glasses 2 recorded the task-evoked pupillary response (reported as Index of Cognitive Activity [ICA]) to indicate cognitive workload, analyzed by EyeTracking cognitive workload software. Pearson correlation, Mann-Whitney, and independent t-tests were used for the comparative analyses. Results: Our study included six experts (median caseload 1300 [interquartile range 400-3000]) and 11 trainees (25 [0-250]). A total of 8/9 metrics directly comparable between VR and DL showed significant positive correlation (r ≥ 0.554, p ≤ 0.032); 5/22 VR metrics distinguished expertise, including task time (p = 0.031), clutch usage (p = 0.040), unnecessary needle piercing (p = 0.026), and suspected injury to the endopelvic fascia (p = 0.040). This contrasts with 14/22 APMs in DL (p ≤ 0.038), including linear velocities of all three instruments (p ≤ 0.038) and dominant-hand instrument wrist articulation (p = 0.013). Trainees experienced higher cognitive workload (ICA) in both environments when compared with experts (p < 0.036). Conclusions: Most performance metrics between VR and DL exhibited moderate to strong correlations, showing transferability of skills across the platforms. Comparing training environments, APMs during DL tasks are better able to distinguish expertise than VR-generated metrics.

Experimental Analysis of Driver Visual Characteristics in Urban Tunnels

Through an urban tunnel-driving experiment, this paper studies the changing trend of drivers’ visual characteristics in tunnels. A Tobii Pro Glasses 2 wearable eye tracker was used to measure pupil diameter, scanning time, and fixation point distribution of the driver during driving. A two-step clustering algorithm and the data-fitting method were used to analyze the experimental data. The results show that the univariate clustering analysis of the pupil diameter change rate of drivers has poor discrimination because the pupil diameter change rate of drivers in the process of “dark adaptation” is larger, while the pupil diameter change rate of drivers in the process of “bright adaptation” is relatively smooth. The univariate and bivariate clustering results of drivers’ pupil diameters were all placed into three categories, with reasonable distribution and suitable differentiation. The clustering results accurately corresponded to different locations of the tunnel. The clustering method proposed in this paper can identify similar behaviors of drivers at different locations in the transition section at the tunnel entrance, the inner section, and the outer area of the tunnel. Through data-fitting of drivers’ visual characteristic parameters in different tunnels, it was found that a short tunnel, with a length of less than 1 km, has little influence on visual characteristics when the maximum pupil diameter is small, and the percentage of saccades is relatively low. An urban tunnel with a length between 1 and 2 km has a significant influence on visual characteristics. In this range, with the increase in tunnel length, the maximum pupil diameter increases significantly, and the percentage of saccades increases rapidly. When the tunnel length exceeds 2 km, the maximum pupil diameter does not continue to increase. The longer the urban tunnel, the more discrete the distribution of drivers’ gaze points. The research results should provide a scientific basis for the design of urban tunnel traffic safety facilities and traffic organization.

Eye tracking metrics and leader\u2019s behavioral performance during a post-partum hemorrhage high-fidelity simulated scenario

BackgroundThe use of eye tracking in the simulated setting can help improve our understanding of what sources of information clinicians are using as they deliver routine patient care.The aim of this simulation study was to observe the differences, if any, between the eye tracking patterns of leaders who performed best in a simulated postpartum hemorrhage (PPH) high-fidelity scenario, in comparison with those who performed worst.MethodsForty anesthesia trainees from the University of Catania Medical School were divided into eight teams, to enact four times the same scenario of a patient with postpartum hemorrhage following vaginal delivery.Trainees who were assigned the leader’s role wore the eye tracking glasses during the scenario, and their behavioral skills were evaluated by two observers, who reviewed the video recordings of the scenarios using a standardized checklist. The leader’s eye tracking metrics, extracted from 27 selected areas of interest (AOI), were recorded by a Tobii Pro Glasses 50 Hz wearable wireless eye tracker. Team performance was evaluated using a PPH checklist.After completion of the study, the leaders were divided into two groups, based on the scores they had received (High-Performance Leader group, HPL, and Low-Performance Leader group, LPL).ResultsIn the HPL group, the duration and number of fixations were greater, and the distribution of gaze was uniformly distributed among the various members of the team as compared with the LPL group (with the exception of the participant who performed the role of the obstetrician).The HPL group also looked both at the patient’s face and established eye contact with their team members more often and for longer (P < .05). The team performance (PPH checklist) score was greater in the HPL group (P < .001).The LPL group had more and/or longer fixations of technical areas of interest (P < .05).ConclusionsOur findings suggest that the leaders who perform the best distribute their gaze across all members of their team and establish direct eye contact. They also look longer at the patient’s face and dwell less on areas that are more relevant to technical skills. In addition, the teams led by these best performing leaders fulfilled their clinical task better. The information provided by the eye behaviors of “better-performing physicians” may lay the foundation for the future development of both the assessment process and the educational tools used in simulation.Trial RegistrationClinical.Trial.Gov ID n. NCT04395963.