Tool Use Research Articles

Basic Analysis for Evaluation of Tennis Volley Skill Using Body Propagated Vibration Sensing

In sports that use tools, it is necessary to master tool manipulation with a high degree of accuracy because proficiency in tool manipulation leads to victory or defeat in a competition. The purpose of this study was to clarify the force transfer of the body, including the racket, from the perspective of vibration analysis to realize training to efficiently improve tennis skills. In this study, we measured the propagating vibration, surface electromyography of finger flexors and extensors, and racket movement under two conditions of strong- and weak-volleying in tennis and aimed to explain the meaning of the measured propagating vibration in terms of muscle control and racket kinematics. Based on the experimental results, it was confirmed that it is feasible to measure the change in stiffness from the racket to the wrist due to the muscle co-contraction owing to the propagating vibration signal intensity. These results indicate the possibility of evaluating tennis shot skill by analyzing the propagating vibrations measured using a wearable vibration measurement system.

Experimental Assessment of Positioning Precision During Free-Hand and Robot-Assisted Tool Manipulation in Transoral Microsurgery Model

Experimental Assessment of Positioning Precision During Free-Hand and Robot-Assisted Tool Manipulation in Transoral Microsurgery Model

The Influence of Hand Dimensions on Finger Flexion during Lower Paleolithic Stone Tool Use in a Comfortable Grip

Considering the biomechanical and cognitive aspects involved in tool manipulation, hand size emerges as a critical factor. Males, on average, exhibit greater grip strength attributed to larger hand dimensions. Beyond mere physical factors, cognitive components tied to visuospatial abilities also influence stone tool use. However, the intricate relationship between hand size, grip strength, and ergonomic patterns necessitates further exploration. Here, we study the ergonomic pattern of phalanx flexion during the manipulation of Lower Paleolithic stone tools (choppers and handaxes) to understand the nuanced interplay between hand dimensions and grasping behaviors in Lower Paleolithic stone tool use. The static hand posture during the comfortable grasping of each tool is measured using a motion capture hand glove. Flexions are measured at the metacarpophalangeal joint, the proximal interphalangeal joint and the distal interphalangeal joint of each finger. Our investigation into Lower Paleolithic stone tool manipulation reveals gender-based differences in phalanx flexion, with hand dimensions showing correlation only in pooled samples. However, these associations diminish when analyzing males and females separately. This study suggests a minimal link between hand size and grasping behavior within our sample, hinting at the influence of cognitive, behavioral, and motor factors. Exploring lifestyle and psychometric profiles could provide further insights. In the context of early human technology, our results prompt considerations on the evolution of the hand-tool interaction system, linking our tool-dependent culture to our phylogenetic history.

First clinical implementation of insertion force measurement in cochlear implantation surgery.

The significance of atraumatic electrode array (EA) insertion in cochlear implant (CI) surgery is widely acknowledged, with consensus that forces due to EA insertion are directly correlated with insertion trauma. Unfortunately, the manual perception of these forces through haptic feedback is inherently limited, and techniques for in vivo force measurements to monitor the insertion are not yet available. Addressing this gap, we developed of a force-sensitive insertion tool capable of capturing real-time insertion forces during standard CI surgery. This paper describes the tool and its pioneering application in a clinical setting and reports initial findings from an ongoing clinical study. Data and experiences from five patients have been evaluated so far, including force profiles of four patients. The initial intraoperative experiences are promising, with successful integration into the conventional workflow. Feasibility of in vivo insertion force measurement and practicability of the tool's intraoperative use could be demonstrated. The recorded in vivo insertion forces show the expected rise with increasing insertion depth. Forces at the end of insertion range from 17.2 mN to 43.6 mN, while maximal peak forces were observed in the range from 44.8 mN to 102.4 mN. We hypothesize that this novel method holds the potential to assist surgeons in monitoring the insertion forces and, thus, minimizing insertion trauma and ensuring better preservation of residual hearing. Future data recording with this tool can form the basis of ongoing research into the causes of insertion trauma, paving the way for new and improved prevention strategies.

Minimal clinically important differences in health-related quality of life after treatment with direct-acting antivirals for chronic hepatitis C: ANRS CO22 HEPATHER cohort (PROQOL-HCV).

Patient Reported Outcomes Quality of Life survey for HCV (PROQOL-HCV) is a specific tool developed to assess health-related quality of life (HRQoL) in patients with chronic hepatitis C receiving direct-acting antivirals (DAA). Thresholds for clinically meaningful changes in PROQOL-HCV scores should be documented to improve the tool's use in clinical practice. This study aimed to estimate the minimal clinically important differences (MCIDs) in PROQOL-HCV scores before and after HCV cure by DAA among participants in the prospective cohort ANRS-CO22 HEPATHER. Data from 460 chronic HCV patients were collected at DAA initiation (baseline) and 24weeks after treatment end. MCIDs were estimated for the six HRQoL dimensions (Physical Health (PH), Emotional Health (EH), Future Uncertainty (FU), Intimate Relationships (IR), Social Health (SH), and Cognitive Functioning (CF)) using two approaches: anchor-based and score distribution-based. Each MCID was estimated for improvement/deterioration both globally and separately for patients with a baseline PRQoL-HCV score ≤ 50 (group1) and patients with a baseline PRQoL-HCV score > 50 (group2). The pooled MCIDs for improvement/deterioration globally, in group1, and in group2, respectively, were as follows: 8.8/-7.6, 9.7/-9.5, and 6.0/-6.9 for PH; 7.1/-4.6, 7.7/-9.6, and 6.6/-6.7 for EH; 6.7/-6.7, 8.2/-8.2, and 6.0/-6.0 for FU; 7.0/-7.0, 5.4/-5.4, and 6.2/-6.2 for IR; 7.7/-7.7, 8.6/-8.6, and 6.5/-6.5 for SH; 7.3/-5.6, 9.1/-8.0, and 6.5/-6.3 for CF. The overall MCID for the PROQOL-HCV scores ranged from 6.7 to 8.8 for improvement and from -7.7 to -4.6 for deterioration. The effect of DAA on PROQOL-HCV scores seemed particularly beneficial for patients with lower baseline scores. This subgroup could be motivated to take DAA if they are informed of the benefits for their HRQoL.

LLM Outputs Are Fictions

Abstract The development of large language model (LLM) tools presents both benefits and challenges. One issue is the expectation of reliable information from users, particularly students. The tool's use conditions and expectations influence its effectiveness. The concept of fictional truth negotiates relations that hold between the real world and the world of fiction and is therefore useful for understanding LLM outputs that rely on and contain facts even as they also contain false or invented information.

Fiberbots: Robotic fibers for high-precision minimally invasive surgery.

Precise manipulation of flexible surgical tools is crucial in minimally invasive surgical procedures, necessitating a miniature and flexible robotic probe that can precisely direct the surgical instruments. In this work, we developed a polymer-based robotic fiber with a thermal actuation mechanism by local heating along the sides of a single fiber. The fiber robot was fabricated by highly scalable fiber drawing technology using common low-cost materials. This low-profile (below 2 millimeters in diameter) robotic fiber exhibits remarkable motion precision (below 50 micrometers) and repeatability. We developed control algorithms coupling the robot with endoscopic instruments, demonstrating high-resolution in situ molecular and morphological tissue mapping. We assess its practicality and safety during in vivo laparoscopic surgery on a porcine model. High-precision motion of the fiber robot delivered endoscopically facilitates the effective use of cellular-level intraoperative tissue identification and ablation technologies, potentially enabling precise removal of cancer in challenging surgical sites.

Douglas–Rachford algorithm for control-constrained minimum-energy control problems

Splitting and projection-type algorithms have been applied to many optimization problems due to their simplicity and efficiency, but the application of these algorithms to optimal control is less common. In this paper we utilize the Douglas–Rachford (DR) algorithm to solve control-constrained minimum-energy optimal control problems. Instead of the traditional approach where one discretizes the problem and solves it using large-scale finite-dimensional numerical optimization techniques we split the problem in two subproblems and use the DR algorithm to find an optimal point in the intersection of the solution sets of these two subproblems hence giving a solution to the original problem. We derive general expressions for the projections and propose a numerical approach. We obtain analytic closed-form expressions for the projectors of pure, under-, critically- and over-damped harmonic oscillators. We illustrate the working of our approach to solving not only these example problems but also a challenging machine tool manipulator problem. Through numerical case studies, we explore and propose desirable ranges of values of an algorithmic parameter which yield smaller number of iterations.

Investigation of the possibility of using an augmented reality-based endotracheal aspiration simulation tool for nursing education.

We developed an augmented reality technology-based endotracheal aspiration simulation tool (the AR tool) consisting of three modes: a mode for nursing students to learn endotracheal aspiration by themselves (learning mode); a mode for repeated practice (practice mode); and a mode for confirmation testing (test mode). This study aimed to compare the learning outcomes of the AR tool with traditional training mannequins and identify potential uses and improvements of the AR tool. We invited students, and faculty members from the three universities who agreed to cooperate in conducting this study. Fifty-four students and nine faculty members agreed to participate in this study. The students were divided into two groups. One group was to study with the AR tool and the other group was to study with the traditional half-body training mannequin for suction. The students in both groups were asked to demonstrate endotracheal aspiration on another full-body type training mannequin which could be used as a patient with a tracheostomy (Skill test). Group interviews with faculty members focused on the topic of the AR tool's potential use in nursing education and improvement needed. There was little significant difference in the skill test results of endotracheal aspiration of students in both groups. The students and faculty members both expressed an interest in the AR tool. They said it was suitable for self-study of endotracheal aspiration. This AR tool is an effective teaching tool for learning the sequence of endotracheal suctioning, although there are some areas that need improvement.

Influence of COVID-19 on the emergence of stone-tool use behavior in a population of common long-tailed macaques (Macaca fascicularis fascicularis) in Thailand.

Stone tool use is a rare behavior across nonhuman primates. Here we report the first population of common long-tailed macaques (Macaca fascicularis fascicularis) who customarily used stone tools to open rock oysters (Saccostrea forskali) on a small island along the Thai Gulf in Koh Ped (KPE), eastern Thailand. We observed this population several times during the past 10 years, but no stone-tool use behavior was observed until our survey during the coronavirus disease 2019 (COVID-19) pandemic in July 2022. KPE is located in Pattaya City, a hotspot for tourism in Thailand. Tourists in this area frequently provided large amounts of food for the monkeys on KPE. During the COVID-19 curfew, however, tourists were not allowed to access the island, and monkeys began to face food scarcity. During this time, we observed stone-tool use behavior for the first time on KPE. Based on our observations, the first tool manipulation was similar to stone throwing (a known precursor of stone tool use). From our observations in March 2023, we found 17 subadult/adult animals performing the behavior, 15 of 17 were males and mostly solitary while performing the behavior. The M. f. fascicularis subspecies was confirmed by distribution, morphological characteristics, and mtDNA and SRY gene sequences. Taken together, we proposed that the stone tool use behavior in the KPE common long-tailed macaques emerged due to the COVID-19 food scarcity. Since traveling is no longer restricted many tourists have started coming back to the island, and there is a high risk for this stone tool-use behavior to disappear within this population of long-tailed macaques.

The West Tofts handaxe: A remarkably average, structurally flawed, utilitarian biface

The West Tofts handaxe is a small British Acheulean biface well known for its cortical preservation of a fossilised bivalve shell. The shell's retention, its prominent central placement, and perceptions of the tool's broader aesthetic-value have resulted in it being described as an example of early hominin aesthetic intent. When combined with its mid-to-late Pleistocene age, the handaxe plausibly has implications for our understanding of hominin cognitive evolution and the origins of Palaeolithic art. Crucial to the assignment of aesthetic intent are a series of assumptions concerning the exceptionality of the tool's design, production and use. Here, we test those assumptions. The West Tofts handaxe is revealed to be technologically and morphologically unremarkable for the British late Acheulean, was produced on a tabular flint nodule that did not require invasive (central) flake removals, and displays remarkably average flaking investment. High-resolution micro-CT scans of its internal structure reveal numerous fractures and air pockets, and at least one – potentially two – additional fossilised shells. These inclusions and flaws feasibly impacted the tool's production, potentially resulting in the shell's retention. Limited microwear traces were identified on its distal flaked edges, potentially hinting at the tool's expedient use. These and other data underline the importance of restraint when attributing aesthetic intent or ‘over-investment’ to the West Tofts handaxe. Today we may consider it a remarkable artefact worthy of elevation, but to the Acheulean individual who produced it, the West Tofts handaxe was likely an average utilitarian tool produced on a flawed but conveniently thin flint nodule.

Dexterous manipulation of construction tools using anthropomorphic robotic hand

Emerging studies are utilizing reinforcement learning (RL) and imitation learning (IL) to control large-scale robots in heavy construction tasks. There is limited attention given to the automation of delicate tasks typically performed manually. This paper proposes the control of an anthropomorphic robotic hand with a high degree of freedom for the manipulation of construction tools in a learning-based approach. For controlling the robotic hand, a simulation-based policy learning framework based on pretraining policies through IL is presented, subsequently fine-tuning them for construction tool manipulation using RL. In experimental trials, six policies are trained for the robotic hand to grasp six different construction tools. The results indicate that each of the learned policies enables the robotic hand to manipulate the corresponding tool with an almost 100% success rate, demonstrating resilience when confronted with tools of different scales. Additionally, the paper showcases the potential for scaling up the fundamental policy for downstream applications.

Microsurgery Robots: Applications, Design, and Development.

Microsurgical techniques have been widely utilized in various surgical specialties, such as ophthalmology, neurosurgery, and otolaryngology, which require intricate and precise surgical tool manipulation on a small scale. In microsurgery, operations on delicate vessels or tissues require high standards in surgeons' skills. This exceptionally high requirement in skills leads to a steep learning curve and lengthy training before the surgeons can perform microsurgical procedures with quality outcomes. The microsurgery robot (MSR), which can improve surgeons' operation skills through various functions, has received extensive research attention in the past three decades. There have been many review papers summarizing the research on MSR for specific surgical specialties. However, an in-depth review of the relevant technologies used in MSR systems is limited in the literature. This review details the technical challenges in microsurgery, and systematically summarizes the key technologies in MSR with a developmental perspective from the basic structural mechanism design, to the perception and human-machine interaction methods, and further to the ability in achieving a certain level of autonomy. By presenting and comparing the methods and technologies in this cutting-edge research, this paper aims to provide readers with a comprehensive understanding of the current state of MSR research and identify potential directions for future development in MSR.

Study of communication modalities to support teaching tool manipulation skills in a shared immersive environment

This work investigates the potential benefits of using a shared immersive environment for training purposes. Such an environment provides a safe space for teachers to impart their knowledge and expertise to trainees, especially when teaching technical skills that require proper tool manipulation. Our research focuses on exploring different communication modalities that can be used to teach movement amplitude during tool manipulation tasks. Specifically, we examine the effectiveness of haptic, visual, and verbal modalities in enhancing the learning process. Our user study results reveal that trainees were able to replicate movements more accurately when given instructions using the visual modality, and they were able to replicate movements faster when given instructions using the haptic modality. While verbal instructions increased the sense of copresence with the teacher, it was the least preferred modality. These findings suggest that multimodality could be the most appropriate approach to enhance the teaching of movement amplitude skills. Our study provides insights for improving the design of immersive shared systems. It opens up new avenues for further research on the effectiveness of shared immersive virtual environments in supporting the teaching of technical skills.

Graphical User Interface Development for a Hospital-Based Predictive Risk Tool: Protocol for a Co-Design Study.

This co-design research method details the iterative process developed to identify health professional recommendations for the graphical user interface (GUI) of an artificial intelligence (AI)-enabled risk prediction tool. Driving the decision to include a co-design process is the belief that choices regarding the aesthetic and functionality of an intervention are best made by its intended users and that engaging these users in its design will promote the tool's adoption and use. The aim of this research is to identify health professional design and uptake recommendations for the GUI of an AI-enabled predictive risk tool. We will hold 3 research phases, each consisting of 2 workshops with health professionals, between mid-2023 and mid-2024. A total of 6 health professionals will be sought per workshop, resulting in a total enrollment of 36 health professionals at the conclusion of the research. A total of 7 workshop activities have been scheduled across the 3 workshops; these include context of use, notifiers, format, AI survey-Likert, prototype, AI survey-written, and testing. The first 6 of these activities will be repeated in each workshop to enable the iterative development and refinement of GUI. The last activity (testing) will be performed in the final workshop to examine health professionals' thoughts on the final GUI iteration. Qualitative and quantitative results data will be produced from tasks in each research activity. Qualitative data will be examined through inductive thematic analysis or deductive thematic analysis in accordance with the Nonadoption, Abandonment, and Challenges to the Scale-up, Spread, and Sustainability (NASSS) framework; visual data will be examined in accordance with "framework of interactivity;" and quantitative data will be examined using descriptive statistics. Project registration with the Australia and New Zealand Clinical Trial Registry has been requested (#384098). Finalized design recommendations are expected in early to mid-2024, with a results manuscript to be submitted in mid-2024. This research method has human research ethics approval from the South Australian Department of Health and Wellbeing (#2022/HRE00131) as well as from the Human Research Ethics Committee of the University of South Australia (application ID#204143). Understanding whether an intervention is needed in a particular situation is just the start; designing an intervention so that it is used within that situation is paramount. This co-design process engages end users to create a GUI that includes the aesthetic and functional details they need in a manner that aligns with their existing work practices. Indeed, interventions that fail to do this may be disliked, and at worst, they may be dangerous. PRR1-10.2196/47717.

Home practice for robotic surgery: a randomized controlled trial of a low-cost simulation model

Pre-operative simulated practice allows trainees to learn robotic surgery outside the operating room without risking patient safety. While simulation practice has shown efficacy, simulators are expensive and frequently inaccessible. Cruff (J Surg Educ 78(2): 379–381, 2021) described a low-cost simulation model to learn hand movements for robotic surgery. Our study evaluates whether practice with low-cost home simulation models can improve trainee performance on robotic surgery simulators. Home simulation kits were adapted from those described by Cruff (J Surg Educ 78(2): 379–381, 2021). Hand controllers were modified to mimic the master tool manipulators (MTMs) on the da Vinci Skills Simulator (dVSS). Medical students completed two da Vinci exercises: Sea Spikes 1 (SS1) and Big Dipper Needle Driving (BDND). They were subsequently assigned to either receive a home simulation kit or not. Students returned two weeks later and repeated SS1 and BDND. Overall score, economy of motion, time to completion, and penalty subtotal were collected, and analyses of covariance were performed. Semi-structured interviews assessed student perceptions of the robotic simulation experience. Thirty-three medical students entered the study. Twenty-nine completed both sessions. The difference in score improvement between the experimental and control groups was not significant. In interviews, students provided suggestions to increase fidelity and usefulness of low-cost robotic home simulation. Low-cost home simulation models did not improve student performance on dVSS after two weeks of at-home practice. Interview data highlighted areas to focus future simulation efforts. Ongoing work is necessary to develop low-cost solutions to facilitate practice for robotic surgery and foster more inclusive and accessible surgical education.

Facilitating Data Sovereignty and Digital Transformation in Municipalities and Companies: An Examination of the Data for All Initiative

Access to comprehensive and up-to-date knowledge in the field of data is crucial for municipalities and regional authorities to make informed decisions and effectively address challenges. The Data for All project 2022-2025 (Data for All 2023) explores the benefits of online tools that provides comprehensive and intuitive access to knowledge in the field of data, specifically designed to support the needs of municipalities and regional authorities.The online tools offer a user-friendly interface that enables easy exploration and analysis of data sets relevant to various aspects of governance, planning, and service delivery. It consolidates diverse data sources, including public records, surveys, and real-time data feeds, into a unified platform. The tools employ advanced data visualization techniques, interactive dashboards, and customizable reports to present complex information in a clear and digestible manner.The benefits of these data access tools for municipalities, companies and regional authorities are manifold. Firstly, it facilitates evidence-based decision-making by providing access to reliable and up-to-date data. Decision-makers can quickly access relevant data sets, conduct in-depth analysis, and identify trends and patterns that inform policy development, resource allocation, and service planning.Secondly, the tools enhance transparency and accountability by making data readily available to the public. Municipalities and regional authorities can leverage the platform to share information on key metrics, performance indicators, and public services, fostering trust and engagement with citizens. Additionally, the tools enable data-driven performance monitoring, allowing authorities to track progress, evaluate outcomes, and continuously improve service delivery.Furthermore, case studies of the tool's implementation and use will illustrate its effectiveness in diverse contexts. For instance, a regional authority may utilize the tool to analyze transportation data, leading to optimized route planning, reduced congestion, and improved public transportation services. Another municipality may leverage the tool to monitor environmental indicators, leading to evidence-based sustainability initiatives and informed land-use planning.In conclusion, the online data access tools will provide municipalities and regional authorities with a powerful resource to leverage data-driven decision-making, enhance transparency, and drive effective governance. Its user-friendly interface, comprehensive data coverage, and customizable features will enable authorities to harness the potential of data for improved service delivery and better outcomes for their communities.

The RESPECT-brochure: Development of a tool to inform and empower residents and informal caregivers on the medicines' pathway in nursing homes

ObjectiveTo develop and evaluate a tool to inform and empower nursing home (NH) residents and informal caregivers regarding the medicines' pathway. MethodsFeedback on the tool's text, drafted by the research team, was collected from a professional organization; the lay-out was designed by an illustrator. The tool was pilot tested in NHs, focusing on feasibility, appropriateness, and meaningfulness. Semi-structured interviews and focus groups with residents, informal caregivers, and healthcare professionals were performed, as well as document analysis. Qualitative data were analyzed inductively. ResultsThe RESPECT-brochure was developed and described each process of the medicines' pathway. Piloting showed that the tool was well perceived among residents and informal caregivers and offered opportunities to discuss medication-related questions and concerns, but that skills to tailor the conversation, especially given the changing NH population, a matching vision and local champion are required for the tool's uptake. ConclusionAn informative and empowering tool has been successfully developed and pilot tested in NHs. Future research should investigate which strategies for implementation work best and can explore the impact of the tool's use in daily practice. InnovationThe tool is the first in its kind and grants nursing home staff a new strategy to promote person-centered care.

Interventionalist Hand Motion Recognition With Convolutional Neural Network in Robot-Assisted Coronary Interventions

The development of procedural competencies by interventional cardiology fellows for minimally invasive treatment of cardiac diseases depend on their effective training and evaluation. Learning tool manipulation for safe robotic percutaneous coronary interventions requires expert supervision and use of high-fidelity systems. However, with limited proficiency for real-time hand motion recognition. Therefore, this study proposes a deep learning-based model for identifying operators’ actions. The proposed model is based on the convolutional neural network that consist of one dimensional convolutional layers for automatic feature map extraction, down sampling, and fully connected layers for inference. The developed models were evaluated using a multi-modal dataset collected from sensory glove, EM, and sEMG sensors and real-time angiograms in the course of in-vivo catheterization trials performed by nine subjects (two experts and seven novices) using a custom-built robotic catheter system. The results indicate that the model achieves a 92–96% accuracy in identifying five actions across four clusters compared with a recognition performance of 83% when recognizing all six actions. Furthermore, we compared the proposed model performance with existing studies, the analyses show that our model has a 2-3% higher accuracy for five-action recognition. Therefore, the proposed model could be employed for real-time hand motion recognition in R-PCI trials.

Independently Actuated Soft Magnetic Manipulators for Bimanual Operations in Confined Anatomical Cavities

Soft magnetic manipulators offer the prospect of improved surgical outcomes through their potential for miniaturization and inherently safe tissue interaction. However, independent actuation of multiple manipulators within the same confined workspace is limited by undesired simultaneous actuation and manipulator–manipulator interactions. Herein, for the first time, approaches for the independent magnetic actuation of two magnetic continuum manipulators within the same confined workspace are proposed. A novel modular magnetic soft robot segment design is proposed with modified geometry to provide preferential bending planes and high angles of deflection. This design is integrated into two dual‐segment magnetic manipulators which, when arranged in parallel, can deliver independent bending in two planes of motion. Two distinct independent control strategies are proposed, based on orthogonal manipulator magnetization profiles and local field gradient control, respectively. Each dual‐manipulator configuration is characterized over a sequence of applied magnetic fields and gradients, induced via a dual robotically controlled external permanent magnet system. Manipulator independence, bending range of motion, and twisting behaviors are evaluated as a function of control strategy and manipulator separation distance. To demonstrate the system's potential in clinical scenarios, a dual‐manipulator configuration is adapted to carry an endoscopic camera and optic fiber, respectively. The resultant bimanual system is deployed in the confined anatomy of a skull‐base phantom to simulate minimally invasive ablation of a pituitary adenoma. Independent motion of the camera and tool within the confined workspace demonstrate the potential for an independent magnetic tool manipulation for surgical applications.