Augmented reality visualization tool for the future of tactical combat casualty care

ABSTRACT

The objective of this project was to identify and develop software for an augmented reality application that runs on the US Army Integrated Visual Augmentation System (IVAS) to support a medical caregiver during tactical combat casualty care scenarios. In this augmented reality tactical combat casualty care application, human anatomy of individual soldiers obtained predeployment is superimposed on the view of an injured war fighter through the IVAS. This offers insight into the anatomy of the injured war fighter to advance treatment in austere environments.In this article, we describe various software components required for an augmented reality tactical combat casualty care tool. These include a body pose tracking system to track the patient's body pose, a virtual rendering of a human anatomy avatar, speech input to control the application and rendering techniques to visualize the virtual anatomy, and treatment information on the augmented reality display. We then implemented speech commands and visualization for four common medical scenarios including injury of a limb, a blast to the pelvis, cricothyrotomy, and a pneumothorax on the Microsoft HoloLens 1 (Microsoft, Redmond, WA).The software is designed for a forward surgical care tool on the US Army IVAS, with the intention to provide the medical caregiver with a unique ability to quickly assess affected internal anatomy. The current software components still had some limitations with respect to speech recognition reliability during noise and body pose tracking. These will likely be improved with the improved hardware of the IVAS, which is based on a modified HoloLens 2.

Characterization of Mixing Performance Induced by Double Curved Passive Mixing Structures in Microfluidic Channels

Functionalized sensor surfaces combined with microfluidic channels are becoming increasingly important in realizing efficient biosensing devices applicable to small sample volumes. Relaxing the limitations imposed by laminar flow of the microfluidic channels by passive mixing structures to enhance analyte mass transfer to the sensing area will further improve the performance of these devices. In this paper, we characterize the flow performance in a group of microfluidic flow channels with novel double curved passive mixing structures (DCMS) fabricated in the ceiling. The experimental strategy includes confocal imaging to monitor the stationary flow patterns downstream from the inlet where a fluorophore is included in one of the inlets in a Y-channel microfluidic device. Analyses of the fluorescence pattern projected both along the channel and transverse to the flow direction monitored details in the developing homogenization. The mixing index (MI) as a function of the channel length was found to be well accounted for by a double-exponential equilibration process, where the different parameters of the DCMS were found to affect the extent and length of the initial mixing component. The range of MI for a 1 cm channel length for the DCMS was 0.75–0.98, which is a range of MI comparable to micromixers with herringbone structures. Overall, this indicates that the DCMS is a high performing passive micromixer, but the sensitivity to geometric parameter values calls for the selection of certain values for the most efficient mixing.

Differential optical shadow sensor for sub-nanometer displacement measurement and its application to drag-free satellites

We present a method for 3D sub-nanometer displacement measurement using a set of differential optical shadow sensors. It is based on using pairs of collimated beams on opposite sides of an object that are partially blocked by it. Applied to a sphere, our 3-axis sensor module consists of 8 parallel beam-detector sets for redundancy. The sphere blocks half of each beam's power in the nominal centered position, and any displacement can be measured by the differential optical power changes amongst the pairs of detectors. We have experimentally demonstrated a displacement sensitivity of 0.87nm/Hz at 1 Hz and 0.39nm/Hz at 10 Hz. We describe the application of the module to the inertial sensor of a drag-free satellite, which can potentially be used for navigation, geodesy and fundamental science experiments as well as ground based applications.

Development of the palatal size in Pan troglodytes, hominids and Homo sapiens

As the hard palate plays an important role in speech production it was the aim of this study whether similarities or dissimilarities in palatal size may allow conclusions about the ability to produce speech in the extant investigated species. The palatal size of Pan troglodytes, Homo sapiens, Australopithecus afarensis, Australopithecus africanus, Australopithecus robustus, Australopithecus boisei, Homo erectus, Homo neanderthalensis and Cro-Magnon has been investigated using euclidian distance matrix analysis (EDMA) and thin-plate-spline analysis. The results show that the palatal size of all australopithecine specimens and H. erectus is very similar to that of P toglodytes, whereas the palatal size of H. neanderthalensis more closely resembles that of H. sapiens. Postnatal development of palatal size in P troglodytes is different from that of H. sapiens. In P troglodytes not only the size of the palate changes but also the form. In H. sapiens there is little change in form, but a continuos uniform growth from infantile to adult specimens. From the results we conclude that in all australopithecine samples which have been investigated, the palatal size is similar to that of P troglodytes. Therefore, it is unlikely that austraopithecine individuals were capable of producing vowels and consonants. The palatal size of H. neandethalensis and Cro-Magnon is similar to that of H. sapiens which may indicate the possibility that they were capable of speech production.

Correlation between clinical scoring of secondary caries at crown margins and histologically assessed extent of the lesions

PURPOSE

The aim of this study was to propose a new clinical diagnostic rating index for secondary caries lesions at crown margins and to correlate this index with histologic evaluations.

MATERIALS AND METHODS

Based on criteria for the evaluation of root caries, a modification of secondary caries lesions at the crown margin (SC index) was applied; the lesion characteristics were described as SCO to SC4. A total of 16 crowned teeth exhibiting secondary caries were randomly selected. The teeth were rated and grouped according to their clinical SC grades (SC1 to SC4). After embedding in Technovit, the teeth were serially sectioned and histologic caries scores were given for each section.

RESULTS

Fifty-two percent of the prepared margins were in cementum/dentin. Crown margins with no caries lesions were mainly found in teeth clinically rated as SC1 and exhibiting localized discolorations, whereas deep lesions were found histologically at teeth rated SC4. The nonparametric test according to Spearman's rank correlation coefficient (rho) confirmed a highly significant correlation between the clinical SC index and the histologic evaluation (rho = 0.87, 95% confidence interval = 0.67 to 0.96, P < 0.01). SC1 discolorations overestimate caries lesions, whereas SC2 and SC4 lesions are well correlated to the percentage of histologically evaluated caries extension into all sections of a tooth. Lesions rated SC3 demonstrated a high variability of caries penetration into the dentin.

CONCLUSION

The depth of discolorations and circular lesions is clinically not well predictable. Clinical diagnosis for localized superficial caries and deep caries lesions at the crown margin correlated well with the histologic caries rating.

Histobacteriology and pulp reactions to long-term dental restorations

The prevention of degeneration and necrosis of the endodont is one of the main goals of dental treatment. Kerschbaum and Voss (1979, 1981) described that 15% of teeth showed negative results to sensitivity testing 10 years after crown preparation. Pulpal responses to dental treatment depend on many factors including thermal injury, transsection of the odontoblastic process, vibration, desiccation of dentin, pulp exposure, smear layer, remaining dentin thickness and used materials. The knowledge concerning endodontic reactions in short and medium term observation is mainly based on research by Klötzer and Langeland. Histological assessment of reactions is a well accepted method for biocompatibility testing (i.e. ISO/TR 7405). It is consistent to apply its principles to the evaluation of endodontic reactions of teeth with long term restorations. As pulpal injury is furthermore due to microleakage between filling material and the wall of the cavity the analysis of infected dentin tubules seems to be important. A consideration of the location of the tubules and of the severity of the invasion is necessary. Using a classification (grade 1-6) comprising the parameters of degenerative and regenerative reactions and bacterial invasion, 24 teeth restored with different types of fixed prosthodontic restorations were investigated. The restorations were between 0-6, 7-12 and 13-18 years in situ. Serial sections (5 microns) were stained with haematoxylin-eosin, azan, according to Goldner and J. Hopkins. 22 of 24 teeth showed typical degenerative reactions. Negative sensitivity testing occurred in teeth with no pain and no or partial necrosis. The histobacteriological assessment showed bacterial invasion of the dentin tubules of 21 teeth. From this investigation it was concluded that the proposed classification shows sufficient sensitivity for the evaluation of progressive endodontic changes of long-term restored teeth. Furthermore it was shown that bacterial invasion must be considered as a possible co-factor for the described degenerative character of the pulpal tissue.