Real-time integration between Microsoft HoloLens 2 and 3D Slicer with demonstration in pedicle screw placement planning

PURPOSE

Up to date, there has been a lack of software infrastructure to connect 3D Slicer to any augmented reality (AR) device. This work describes a novel connection approach using Microsoft HoloLens 2 and OpenIGTLink, with a demonstration in pedicle screw placement planning.

METHODS

We developed an AR application in Unity that is wirelessly rendered onto Microsoft HoloLens 2 using Holographic Remoting. Simultaneously, Unity connects to 3D Slicer using the OpenIGTLink communication protocol. Geometrical transform and image messages are transferred between both platforms in real time. Through the AR glasses, a user visualizes a patient's computed tomography overlaid onto virtual 3D models showing anatomical structures. We technically evaluated the system by measuring message transference latency between the platforms. Its functionality was assessed in pedicle screw placement planning. Six volunteers planned pedicle screws' position and orientation with the AR system and on a 2D desktop planner. We compared the placement accuracy of each screw with both methods. Finally, we administered a questionnaire to all participants to assess their experience with the AR system.

RESULTS

The latency in message exchange is sufficiently low to enable real-time communication between the platforms. The AR method was non-inferior to the 2D desktop planner, with a mean error of 2.1 ± 1.4 mm. Moreover, 98% of the screw placements performed with the AR system were successful, according to the Gertzbein-Robbins scale. The average questionnaire outcomes were 4.5/5.

CONCLUSIONS

Real-time communication between Microsoft HoloLens 2 and 3D Slicer is feasible and supports accurate planning for pedicle screw placement.

Designing user interfaces for content simplification aimed at people with cognitive impairments

Cognitive accessibility aims to make content more accessible for people with cognitive impairments, such as the elderly and people with intellectual and learning disabilities. In this sense, it is possible to design an accessible user interface from a cognitive point of view. As a contribution, this article presents cognitive accessibility design patterns and their application in designing the Easier web system's user interface. The Easier web system provides a tool that assists in the understanding and readability of text content geared towards people with intellectual disabilities. It detects complex words and offers easier replacements and other resources such as a definition of the complex word. In addition to applying the design patterns, user tests with people with intellectual disabilities and older people have been carried out to evaluate the cognitive accessibility of the Easier system's interface. The results indicate that people with cognitive impairments know how to use the interfaces and have a satisfactory experience. In addition, a design proposal to provide a glossary mechanism to be used in web interfaces with simplified texts is presented and validated.

Machine Ethics: Do Androids Dream of Being Good People?

Is ethics a computable function? Can machines learn ethics like humans do? If teaching consists in no more than programming, training, indoctrinating… and if ethics is merely following a code of conduct, then yes, we can teach ethics to algorithmic machines. But if ethics is not merely about following a code of conduct or about imitating the behavior of others, then an approach based on computing outcomes, and on the reduction of ethics to the compilation and application of a set of rules, either a priori or learned, misses the point. Our intention is not to solve the technical problem of machine ethics, but to learn something about human ethics, and its rationality, by reflecting on the ethics that can and should be implemented in machines. Any machine ethics implementation will have to face a number of fundamental or conceptual problems, which in the end refer to philosophical questions, such as: what is a human being (or more generally, what is a worthy being); what is human intentional acting; and how are intentional actions and their consequences morally evaluated. We are convinced that a proper understanding of ethical issues in AI can teach us something valuable about ourselves, and what it means to lead a free and responsible ethical life, that is, being good people beyond merely "following a moral code". In the end we believe that rationality must be seen to involve more than just computing, and that value rationality is beyond numbers. Such an understanding is a required step to recovering a renewed rationality of ethics, one that is urgently needed in our highly technified society.

ABENEARIO: A system for learning early maths with ABN

ABN (Abierto Basado en Números-Open Calculation Based on Numbers) is a method for teaching basic arithmetic operations in primary education that has become popular in recent years and that is based on the decomposition of numbers through manipulative materials that encourage mental calculation. Currently there is limited number of tools that can be used to support the ABN method and so this article presents the design and development of two tools that facilitate learning with this method, a physical device, ABENEARIO-P, and a virtual device (web application), ABENEARIO-V, that complements the physical device. In addition, a study of the use of these tools was carried out with 80 learners (ages 7 and 9) and 9 teachers with a focus on ABENEARIO-V. The results of this study showed a positive evaluation of the tool by both learners and teachers, an adequate time to complete the mathematical operations assigned to learners and an improvement in performance as the tool was used. As a conclusion, it is important to provide adequate tools that can support teachers and learners in the practice with the ABN method as in the case of ABENEARIO-P and ABENEARIO-V. Limitations refer mainly to the context of the study, which was conducted at a time of severe social distance restrictions during the COVID-19 pandemic on touching physical devices or being able to gather a larger number of learners in the classroom.

Looking for COVID side effects in the EU through the analysis of health and behavioural profiles

More than two years after the great outbreak of COVID suffered in almost the whole world, and in particular in Europe, we have gradually learned about the direct effects of this virus on our health and what consequences it can have if we become infected. However, this pandemic also had great economic and social consequences that affected people in an indirect way, which we can call COVID side effects. In this work we carried out an innovative type of analysis based on the concept of archetypoids in order to find extreme observations in a database of mixed-type data and used them to classify individuals yielding to different health and behavioural profiles in coping with the COVID outbreak in the EU. We use data from the first COVID-19 Survey of the SHARE project (Survey on Health, Aging and Retirement in Europe). The resulting profiles are easier to interpret than others based on central observations, and help to understand how the situations of restrictions and lock-downs affected people since the outbreak of the pandemic. Another key point of the work was to analyse how determinant are some aspects such as gender, age group or even geographical location in how each person experienced the pandemic. The method that we propose is wide enough to be used in other health and wellbeing surveys.

The heterogeneous effects of the great recession on informal care to the elderly

This paper studies the role of unobserved factors to measure the impact of the economic downturn on informal care availability to the elderly in Europe. We use the Survey of Health, Ageing and Retirement in Europe (SHARE), which allows controlling for socio-demographic variables. Our results show that the impact of the Great Recession on care receipt depends not only on observed, but also on unobserved characteristics. For 21% of the sample, the effect is three to four times larger than the average effect for the entire sample. For 57% of the sample, there is no effect of the economic crisis, and this is related to unobservable factors. In our estimation process, we are able to characterize how this unobserved heterogeneity correlates with the observable variables. Moreover, we show that if the unobserved heterogeneity in the effect of the crisis is ignored, then we are not able to capture that there is no effect for more than half of the individuals, even if we allow for unobserved heterogeneity in the intercept of the model and for the heterogeneous effect of the crisis based on observables.

Mergers and bank branches: two decades of evidence from the USA

In recent decades, the US bank market has been exposed to several waves of mergers, resulting in concerns about branch presence and consumer access to financial services. This paper examines the effects of bank mergers on branch density in the period 2000-2020. To do so, we use panel regressions and matching techniques at the census tract level to study the impact of inter- and intrastate mergers before and after the Great Recession of 2007. To generate plausible exogenous variation for mergers, our analysis focuses on transactions involving large entities, and we consider the within-tract variation in exposure to mergers. A comparison of exposed and unexposed tracts shows that in the period under study each merger  reduced branch density by around 3%. Moreover, interstate mergers reduced branch density at the tract level across the whole period but had an expansionary effect on the number of branches at the county level before the crisis. Intrastate mergers, in contrast, had a consolidation effect across the whole period, an impact that was more intense in rural tracts and in tracts where merging entities operated overlapping branch networks. Finally, we show that the reduction of bank branches was stronger in tracts with a relatively higher penetration of broadband Internet services, but we find no evidence that the adoption of FinTech services intensified branch closures.

Cultural Historical Psychology and the Reset of History

The authors argue that, in the research trajectory of cultural historical psychology, there are nuclear aspects of Vygotsky’s theory that have been insufficiently considered. Three of these aspects are herein discussed: the intense and rapid changes to mediational processes and their influence on human psyche; meaningful findings on neuroplasticity that require a neuropsychological approach; and, perhaps most importantly, the need for cultural historical approach, and for psychology at large, to return to the study of the direction and meaning of human life.

Do elections accelerate the COVID-19 pandemic?: Evidence from a natural experiment

Elections define representative democracies but also produce spikes in physical mobility if voters need to travel to polling places. In this paper, we examine whether large-scale, in-person elections propagate the spread of COVID-19. We exploit a natural experiment from the Czech Republic, which biannually renews mandates in one-third of Senate constituencies that rotate according to the 1995 election law. We show that in the second and third weeks after the 2020 elections (held on October 9-10), new COVID-19 infections grew significantly faster in voting compared to non-voting constituencies. A temporarily related peak in hospital admissions and essentially no changes in test positivity rates suggest that the acceleration was not merely due to increased testing. The acceleration did not occur in the population above 65, consistently with strategic risk-avoidance by older voters. Our results have implications for postal voting reforms or postponing of large-scale, in-person (electoral) events during viral outbreaks.