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Stroke is an acute cerebrovascular disease in which sudden interruption of blood supply to the brain or rupture of cerebral blood vessels cause damage to brain cells and consequently impair the patient's motor and cognitive abilities. A novel rehabilitation training model integrating brain-computer interface (BCI) and virtual reality (VR) not only promotes the functional activation of brain networks, but also provides immersive and interesting contextual feedback for patients. In this paper, we designed a hand rehabilitation training system integrating multi-sensory stimulation feedback, BCI and VR, which guides patients' motor imaginations through the tasks of the virtual scene, acquires patients' motor intentions, and then carries out human-computer interactions under the virtual scene. At the same time, haptic feedback is incorporated to further increase the patients' proprioceptive sensations, so as to realize the hand function rehabilitation training based on the multi-sensory stimulation feedback of vision, hearing, and haptic senses. In this study, we compared and analyzed the differences in power spectral density of different frequency bands within the EEG signal data before and after the incorporation of haptic feedback, and found that the motor brain area was significantly activated after the incorporation of haptic feedback, and the power spectral density of the motor brain area was significantly increased in the high gamma frequency band. The results of this study indicate that the rehabilitation training of patients with the VR-BCI hand function enhancement rehabilitation system incorporating multi-sensory stimulation can accelerate the two-way facilitation of sensory and motor conduction pathways, thus accelerating the rehabilitation process.

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BACKGROUND: The patient with pusher syndrome (PS) is characterized by showing postural control alterations due to a lack of perception of his own body in the space. It appears when the patient actively pushes with his unaffected limbs towards the injured side, reacting with resistance to passive straightening towards the midline. Between 10% and 50% of strokes present PS. Nowadays, there is no clearly defined treatment for PS. OBJECTIVE: To design and validate an exercise program using visual feedback and specific core stability exercises (FeViCoS) for the treatment of patients with PS. METHODS: Validation was conducted by expert consensus using the Delphi method. Thirteen neurorehabilitation experts participated in the process. An online questionnaire with 18 Likert-type questions was used to evaluate the designed program. Consensus was considered reached if there was convergence between the quartile 1 and 3 values (RIQ = Q1-Q3) or if the relative interquartile range (RIR) was less than 20%. The degree of agreement between experts was measured by calculating the Fleiss' kappa coefficient. RESULTS: A total of 2 rounds were required to achieve 97.44% consensus with 100% participation. The RIR was less than or equal to 20% for all questions. The Fleiss' kappa index (0.831) showed that the degree of agreement between experts was excellent. CONCLUSION: Neurorehabilitation experts considered FeViCoS valid for the therapeutic approach to patients with PS. Expert consensus suggests a novel strategy in physical therapy clinical practice to improve balance and postural orientation in patients with subacute stroke and PS.

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While the sensorimotor cortices are central neural substrates for motor control and learning, how the interaction between their subregions with visual cortices contributes to acquiring de novo visuomotor skills is poorly understood. We design a continuous visuomotor task in fMRI where participants control a cursor using their fingers while learning an arbitrary finger-to-cursor mapping. To investigate visuomotor interaction in the de novo motor task, we manipulate visual feedback of a cursor such that they learn to control using fingers under two alternating conditions: online cursor feedback is available or unavailable except when a target is reached. As a result, we find double dissociation of fMRI activity in subregions of the sensorimotor and visual cortices. Specifically, motor and late visual cortices are more active with online cursor feedback, and somatosensory and early visual cortices are more active without online cursor feedback. We also find a significant reduction in functional connectivity between somatosensory cortices and early visual cortices, which is highly correlated with performance improvement. These findings support the distinct interaction between subregions of sensorimotor cortices and visual cortices, while the connectivity analysis highlights the critical role of somatosensory cortices during de novo motor learning.

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BACKGROUND: Restoration of limb function for individuals with unilateral weakness typically requires volitional muscle control, which is often not present for individuals with severe impairment. Mirror therapy-interventions using a mirror box to reflect the less-impaired limb onto the more-impaired limb-can facilitate corticospinal excitability, leading to enhanced recovery in severely impaired clinical populations. However, the mirror box applies limitations on mirror therapy, namely that all movements appear bilateral and are confined to a small area, impeding integration of complex activities and multisensory feedback (e.g., visuo-tactile stimulation). These limitations can be addressed with virtual reality, but the resulting effect on corticospinal excitability is unclear. OBJECTIVE: Examine how virtual reality-based unilateral mirroring, complex activities during mirroring, and visuo-tactile stimulation prior to mirroring affect corticospinal excitability. MATERIALS AND METHODS: Participants with no known neurological conditions (n = 17) donned a virtual reality system (NeuRRoVR) that displayed a first-person perspective of a virtual avatar that matched their motions. Transcranial magnetic stimulation-induced motor evoked potentials in the nondominant hand muscles were used to evaluate corticospinal excitability in four conditions: resting, mirroring, mirroring with prior visuo-tactile stimulation (mirroring + TACT), and control. During mirroring, the movements of each participant's dominant limb were reflected onto the nondominant limb of the virtual avatar, and the avatar's dominant limb was kept immobile (i.e., unilateral mirroring). The mirroring + TACT condition was the same as the mirroring condition, except that mirroring was preceded by visuo-tactile stimulation of the nondominant limb. During the control condition, unilateral mirroring was disabled. During all conditions, participants performed simple (flex/extend fingers) and complex (stack virtual blocks) activities. RESULTS: We found that unilateral mirroring increased corticospinal excitability compared to no mirroring (p < 0.001), complex activities increased excitability compared to simple activities during mirroring (p < 0.001), and visuo-tactile stimulation prior to mirroring decreased excitability (p = 0.032). We also found that these features did not interact with each other. DISCUSSIONS: The findings of this study shed light onto the neurological mechanisms of mirror therapy and demonstrate the unique ways in which virtual reality can augment mirror therapy. The findings have important implications for rehabilitation for design of virtual reality systems for clinical populations.

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Interventional radiologists mainly rely on visual feedback via imaging modalities to steer a needle toward a tumor during biopsy and ablation procedures. In the case of CT-guided procedures, there is a risk of exposure to hazardous X-ray-based ionizing radiation. Therefore, CT scans are usually not used continuously, which increases the chances of a misplacement of the needle and the need for reinsertion, leading to more tissue trauma. Interventionalists also encounter haptic feedback via needle-tissue interaction forces while steering a needle. These forces are useful but insufficient to clearly perceive and identify deep-tissue structures such as tumors. The objective of this paper was to investigate the effect of enhanced force feedback for sensing interaction forces and guiding the needle when applied individually and simultaneously during a virtual CT-guided needle insertion task. We also compared the enhanced haptic feedback to enhanced visual feedback. We hypothesized that enhancing the haptic feedback limits the time needed to reach the target accurately and reduces the number of CT scans, as the interventionalist depends more on real-time enhanced haptic feedback. To test the hypothesis, a simulation environment was developed to virtually steer a needle in five degrees of freedom (DoF) to reach a tumor target embedded in a liver model. Twelve participants performed in the experiment with different feedback conditions where we measured their performance in terms of the following: targeting accuracy, trajectory tracking, number of CT scans required, and the time needed to finish the task. The results suggest that the combination of enhanced haptic feedback for guidance and sensing needle-tissue interaction forces significantly reduce the number of scans and the duration required to finish the task by 32.1% and 46.9%, respectively, when compared to nonenhanced haptic feedback. The other feedback modalities significantly reduced the duration to finish the task by around 30% compared to nonenhanced haptic feedback.

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Across the animal kingdom, neural responses in the auditory cortex are suppressed during vocalization, and humans are no exception. A common hypothesis is that suppression increases sensitivity to auditory feedback, enabling the detection of vocalization errors. This hypothesis has been previously confirmed in non-human primates, however a direct link between auditory suppression and sensitivity in human speech monitoring remains elusive. To address this issue, we obtained intracranial electroencephalography (iEEG) recordings from 35 neurosurgical participants during speech production. We first characterized the detailed topography of auditory suppression, which varied across superior temporal gyrus (STG). Next, we performed a delayed auditory feedback (DAF) task to determine whether the suppressed sites were also sensitive to auditory feedback alterations. Indeed, overlapping sites showed enhanced responses to feedback, indicating sensitivity. Importantly, there was a strong correlation between the degree of auditory suppression and feedback sensitivity, suggesting suppression might be a key mechanism that underlies speech monitoring. Further, we found that when participants produced speech with simultaneous auditory feedback, posterior STG was selectively activated if participants were engaged in a DAF paradigm, suggesting that increased attentional load can modulate auditory feedback sensitivity.

The brain lowers its response to inputs we generate ourselves, such as moving or speaking. Essentially, our brain 'knows' what will happen next when we carry out these actions, and therefore does not need to react as strongly as it would to unexpected events. This is why we cannot tickle ourselves, and why the brain does not react as much to our own voice as it does to someone else's. Quieting down the brain's response also allows us to focus on things that are new or important without getting distracted by our own movements or sounds. Studies in non-human primates showed that neurons in the auditory cortex (the region of the brain responsible for processing sound) displayed suppressed levels of activity when the animals made sounds. Interestingly, when the primates heard an altered version of their own voice, many of these same neurons became more active. But it was unclear whether this also happens in humans. To investigate, Ozker et al. used a technique called electrocorticography to record neural activity in different regions of the human brain while participants spoke. The results showed that most areas of the brain involved in auditory processing showed suppressed activity when individuals were speaking. However, when people heard an altered version of their own voice which had an unexpected delay, those same areas displayed increased activity. In addition, Ozker et al. found that the higher the level of suppression in the auditory cortex, the more sensitive these areas were to changes in a person's speech. These findings suggest that suppressing the brain's response to self-generated speech may help in detecting errors during speech production. Speech deficits are common in various neurological disorders, such as stuttering, Parkinson's disease, and aphasia. Ozker et al. hypothesize that these deficits may arise because individuals fail to suppress activity in auditory regions of the brain, causing a struggle when detecting and correcting errors in their own speech. However, further experiments are needed to test this theory.

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BACKGROUND: Planning and executing movements requires the integration of different sensory modalities, such as vision and proprioception. However, neurological diseases like stroke can lead to full or partial loss of proprioception, resulting in impaired movements. Recent advances focused on providing additional sensory feedback to patients to compensate for the sensory loss, proving vibrotactile stimulation to be a viable option as it is inexpensive and easy to implement. Here, we test how such vibrotactile information can be integrated with visual signals to estimate the spatial location of a reach target. METHODS: We used a center-out reach paradigm with 31 healthy human participants to investigate how artificial vibrotactile stimulation can be integrated with visual-spatial cues indicating target location. Specifically, we provided multisite vibrotactile stimulation to the moving dominant arm using eccentric rotating mass (ERM) motors. As the integration of inputs across multiple sensory modalities becomes especially relevant when one of them is uncertain, we additionally modulated the reliability of visual cues. We then compared the weighing of vibrotactile and visual inputs as a function of visual uncertainty to predictions from the maximum likelihood estimation (MLE) framework to decide if participants achieve quasi-optimal integration. RESULTS: Our results show that participants could estimate target locations based on vibrotactile instructions. After short training, combined visual and vibrotactile cues led to higher hit rates and reduced reach errors when visual cues were uncertain. Additionally, we observed lower reaction times in trials with low visual uncertainty when vibrotactile stimulation was present. Using MLE predictions, we found that integration of vibrotactile and visual cues followed optimal integration when vibrotactile cues required the detection of one or two active motors. However, if estimating the location of a target required discriminating the intensities of two cues, integration violated MLE predictions. CONCLUSION: We conclude that participants can quickly learn to integrate visual and artificial vibrotactile information. Therefore, using additional vibrotactile stimulation may serve as a promising way to improve rehabilitation or the control of prosthetic devices by patients suffering loss of proprioception.

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Some species have evolved the ability to use the sense of hearing to modify existing vocalizations, or even create new ones, which enlarges their repertoires and results in complex communication systems.1 This ability corresponds to various forms of vocal production learning that are all possessed by humans and independently displayed by distantly related vertebrates.1,2,3,4,5,6,7 Among mammals, a few species, including the Egyptian fruit bat,8,9,10 would possess such vocal production learning abilities.7 Yet the necessity of an intact auditory system for the development of the Egyptian fruit bat typical vocal repertoire has not been tested. Furthermore, a systematic causal examination of learned and innate aspects of the entire repertoire has never been performed in any vocal learner. Here we addressed these gaps by eliminating pups' sense of hearing at birth and assessing its effects on vocal production in adulthood. The deafening treatment enabled us to both causally test these bats' vocal learning ability and discern learned from innate aspects of their vocalizations. Leveraging wireless individual audio recordings from freely interacting adults, we show that a subset of the Egyptian fruit bat vocal repertoire necessitates auditory feedback. Intriguingly, these affected vocalizations belong to different acoustic groups in the vocal repertoire of males and females. These findings open the possibilities for targeted studies of the mammalian neural circuits that enable sexually dimorphic forms of vocal learning.

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INTRODUCTION: The use of visual and proprioceptive feedback is a key property of motor rehabilitation techniques. This feedback can be used alone, for example, for vision in mirror or video therapy, for proprioception in focal tendon vibration therapy, or in combination, for example, in robot-assisted training. This Electroencephalographic (EEG) study in healthy subjects explored the distinct neurophysiological impact of adding visual (video therapy), proprioceptive (focal tendinous vibration), or combined feedback (video therapy and focal tendinous vibration) to a motor imagery task. METHODS: Sixteen healthy volunteers performed 20 mental imagery (MI) tasks involving right wrist extension and flexion under four conditions: MI alone (IA), MI + video feedback observation (IO), MI + vibratory feedback (IV), and MI + observation + vibratory feedback (IOV). Brain activity was monitored with EEG, and time-frequency neurophysiological markers of movement were computed. The emotions of the patients were also measured during the task. RESULTS: In the alpha band, we observed bilateral ERD in the visual feedback conditions (IO, IOV). In the beta band, the ERD was bilateral in the IA, IV and IOV but more lateralized in the IV and IOV. After movement, we observed strong ERS in the IO and IOV but not in the IA or IV. Embodiment was stronger in conditions with vibratory feedback (IOV > IV > IA and IO) CONCLUSION: Conditions with visual feedback (IO, IOV) recruit the mirror neurons system (alpha ERD) and provide more accurate feedback of the task than IA and IV, which triggers motor validation pathways (beta rebound analysis). Vibratory feedback enhances the recruitment of the left sensorimotor areas, with a synergistic effect in the IOV (beta ERD analysis), thus maximizing embodiment. Visual and vibratory feedback recruits the sensorimotor cortex during motor imagery in different ways and can be combined to maximize the benefits of both techniques TRIAL REGISTRATION: https://clinicaltrials.gov/study/NCT04449328 .

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Despite intensive research and development of systems for restoration of sensory information, these have so far only been the subject of study protocols. A new noninvasive feedback system translates pressure loads on the forefoot and hindfoot into gait-synchronized vibrotactile stimulation of a defined skin area. To increase the authenticity, this treatment can be supplemented by a surgical procedure. Targeted sensory reinnervation (TSR) describes a microsurgical procedure in which a defined skin area on the amputated stump of the residual limb is first denervated and then reinnervated by a specific, transposed sensory nerve harvested from the amputated part of the limb. This creates a sensory interface at the residual stump. This article presents the clinical and orthopedic technical treatment pathway with this innovative vibrotactile feedback system and explains in detail the surgical procedure of TSR after amputation of the lower limb.

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Motor adaptation is attenuated when sensory feedback about the movement is uncertain. Although this was initially shown for small visual errors, attenuation seems not to hold when visual errors are larger and the contributions of implicit adaptation are isolated with the error-clamp method, which makes visual feedback task-irrelevant. Here we ask whether adaptation to a similarly large perturbation is attenuated when task-relevant visual feedback is uncertain. In a first experiment, we tested participants on a 30° movement-contingent visuomotor rotation under both low (cursor) and high (cloud of moving dots) visual feedback uncertainty. In line with optimal integration, we found that the early increase in adaptation and final extent of adaptation were reduced with high feedback uncertainty. In a second experiment, we included several blocks of no-feedback trials during the perturbation block to quantify the contribution of implicit adaptation. Results showed that implicit adaptation was smaller with high compared to low feedback uncertainty throughout the perturbation block. The estimated contribution of explicit adaptation was overall small, particularly for high feedback uncertainty. Our results demonstrate an influence of task-relevant visual feedback, and the resulting target errors, on implicit adaptation. We show that our motor system is sensitive to the feedback it receives even for larger error sizes and accordingly adjusts its learning properties when our ability to achieve the task goal is affected.NEW & NOTEWORTHY Motor adaptation is linked to the estimation of our actions. Whereas uncertainty of task-irrelevant visual feedback appears not to influence implicit adaptation for errors beyond a certain size, here we tested whether this is still the case for task-relevant feedback. We show that implicit adaptation is attenuated when task-relevant visual feedback is uncertain, suggesting a dependency on the assessment of not just sensory prediction errors but also target errors.

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Visual feedback gain is a crucial factor influencing the performance of precision grasping tasks, involving multiple brain regions of the visual motor system during task execution. However, the dynamic changes in brain network during this process remain unclear. The aim of this study is to investigate the impact of changes in visual feedback gain during precision grasping on brain network dynamics. Sixteen participants performed precision grip tasks at 15% of MVC under low (0.1°), medium (1°), and high (3°) visual feedback gain conditions, with simultaneous recording of EEG and right-hand precision grip data during the tasks. Utilizing electroencephalogram (EEG) microstate analysis, multiple parameters (Duration, Occurrence, Coverage, Transition probability(TP)) were extracted to assess changes in brain network dynamics. Precision grip accuracy and stability were evaluated using root mean square error(RMSE) and coefficient of variation(CV) of grip force. Compared to low visual feedback gain, under medium/high gain, the Duration, Occurrence, and Coverage of microstates B and D increase, while those of microstates A and C decrease. The Transition probability from microstates A, C, and D to B all increase. Additionally, RMSE and CV of grip force decrease. Occurrence and Coverage of microstates B and C are negatively correlated with RMSE and CV. These findings suggest that visual feedback gain affects the brain network dynamics during precision grasping; moderate increase in visual feedback gain can enhance the accuracy and stability of grip force, whereby the increased Occurrence and Coverage of microstates B and C contribute to improved performance in precision grasping. Our results play a crucial role in better understanding the impact of visual feedback gain on the motor control of precision grasping.

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The accurate estimation of limb state is necessary for movement planning and execution. While state estimation requires both feedforward and feedback information, we focus here on the latter. Prior literature has shown that integrating visual and proprioceptive feedback improves estimates of static limb position. However, differences in visual and proprioceptive feedback delays suggest that multisensory integration could be disadvantageous when the limb is moving. We formalized this hypothesis by modeling feedback-based state estimation using the long-standing maximum likelihood estimation model of multisensory integration, which we updated to account for sensory delays. Our model predicted that the benefit of multisensory integration was largely lost when the limb was passively moving. We tested this hypothesis in a series of experiments in human subjects that compared the degree of interference created by discrepant visual or proprioceptive feedback when estimating limb position either statically at the end of the movement or dynamically at movement midpoint. In the static case, we observed significant interference: discrepant feedback in one modality systematically biased sensory estimates based on the other modality. However, no interference was seen in the dynamic case: participants could ignore sensory feedback from one modality and accurately reproduce the motion indicated by the other modality. Together, these findings suggest that the sensory feedback used to compute a state estimate differs depending on whether the limb is stationary or moving. While the former may tend toward multimodal integration, the latter is more likely to be based on feedback from a single sensory modality.

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Sensorimotor adaptation alters mappings between motor commands and their predicted outcomes. Such remapping has been extensively studied in the visual domain, but the degree to which it occurs in modalities other than vision remains less well understood. Here, we manipulated the modality of reach target presentation to compare sensorimotor adaptation in response to perturbations of visual and auditory feedback location. We compared the extent of adaptation to perturbed sensory feedback for visual and auditory sensory modalities, and the magnitude of reach-direction aftereffects when the perturbation was removed. To isolate the contribution of implicit sensorimotor recalibration to adaptation in reach direction, we held sensory prediction errors and task-performance errors constant via a task-irrelevant clamp of sensory feedback. Seventy-two participants performed one of three experiments in which target location information and endpoint reach direction feedback were presented by loudspeakers (n = 24), headphones (n = 24), or a visual display (n = 24). Presentation durations for target stimuli (500 ms) and (non-veridical) endpoint feedback of reach direction (100 ms) were matched for visual and auditory modalities. For all three groups, when endpoint feedback was perturbed, adaptation was evident: reach-directions increased significantly in the direction opposite the clamped feedback, and a significant aftereffect persisted after participants were instructed that the perturbation had been removed. This study provides new evidence that implicit sensorimotor adaptation occurs in response to perturbed auditory feedback of reach direction, suggesting that an implicit neural process to recalibrate sensory to motor maps in response to sensory prediction errors may be ubiquitous across sensory modalities.

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A case of successful correction of the pitch frequency using the computer program Circ FFT is described.

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Integrating tactile feedback through haptic interfaces enhances experiences in virtual and augmented reality. However, electrotactile systems, which stimulate mechanoreceptors directly, often yield inconsistent tactile results due to variations in pressure between the device and the finger. In this study, we present the integration of a transparent electrotactile screen with pressure-sensitive transistors, ensuring highly consistent quantitative haptic sensations. These transistors effectively calibrate tactile variations caused by touch pressure. Additionally, we explore remote-distance tactile stimulations achieved through the interference of electromagnetic waves. We validated tactile perception using somatosensory evoked potentials, monitoring the somatosensory cortex response. Our haptic screen can stimulate diverse electrotactile sensations and demonstrate various tactile patterns, including Morse code and Braille, when integrated with portable smart devices, delivering a more immersive experience. Furthermore, interference of electric fields allows haptic stimulation to facilitate diverse stimulus positioning at lower current densities, extending the reach beyond direct contact with electrodes of our screen.

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Most of current prostheses can offer motor function restoration for limb amputees but usually lack natural and intuitive sensory feedback. Many studies have demonstrated that Transcutaneous Electrical Nerve Stimulation (TENS) is promising in non-invasive sensation evoking for amputees. However, the objective evaluation and mechanism analysis on sensation feedback are still limited. This work utilized multi-channel TENS with diverse stimulus patterns to evoke sensations on four non-disabled subjects and two transradial amputees. Meanwhile, electroencephalogram (EEG) was collected to objectively assess the evoked sensations, where event-related potentials (ERPs), brain electrical activity maps (BEAMs), and functional connectivity (FC) were computed. The results show that various sensations could be successfully evoked for both amputees and non-disabled subjects by customizing stimulus parameters. The ERP confirmed the sensation and revealed the sensory-processing-related components like N100 and P200; the BEAMs confirmed the corresponding regions of somatosensory cortex were activated by stimulation; the FC indicated an increase of interactions between the regions of sensorimotor cortex. This study may shed light on how the brain responds to external stimulation as sensory feedback and serve as a pilot for further bidirectional closed-loop prosthetic control.

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Upper limb amputation severely affects the quality of life of individuals. Therefore, developing closed-loop upper-limb prostheses would enhance the sensory-motor capabilities of the prosthetic user. Considering design priorities based on user needs, the restoration of sensory feedback is one of the most desired features. This study focuses on employing Transcutaneous Electrical Nerve Stimulation (TENS) as a non-invasive somatotopic stimulation technique for restoring somatic sensations in upper-limb amputees. The aim of this study is to propose two encoding strategies to elicit force and slippage sensations in transradial amputees. The former aims at restoring three different levels of force through a Linear Pulse Amplitude Modulation (LPAM); the latter is devoted to elicit slippage sensations through Apparent Moving Sensation (AMS) by means of three different algorithms, i.e. the Pulse Amplitude Variation (PAV), the Pulse Width Variation (PWV) and Inter-Stimulus Delay Modulation (ISDM). Amputees had to characterize perceived sensations and to perform force and slippage recognition tasks. Results demonstrates that amputees were able to correctly identify low, medium and high levels of force, with an accuracy above the 80% and similarly, to also discriminate the slippage moving direction with a high accuracy above 90%, also highlighting that ISDM would be the most suitable method, among the three AMS strategies to deliver slippage sensations. It was demonstrated for the first time that the developed encoding strategies are effective methods to somatotopically reintroduce in the amputees, by means of TENS, force and slippage sensations.

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Notification systems that convey urgency without adding cognitive burden are crucial in human-computer interaction. Haptic feedback systems, particularly those utilizing vibration feedback, have emerged as a compelling solution, capable of providing desirable levels of urgency depending on the application. High-risk applications require an evaluation of the urgency level elicited during critical notifications. Traditional evaluations of perceived urgency rely on subjective self-reporting and performance metrics, which, while useful, are not real-time and can be distracting from the task at hand. In contrast, EEG technology offers a direct, non-intrusive method of assessing the user's cognitive state. Leveraging deep learning, this study introduces a novel approach to evaluate perceived urgency from single-trial EEG data, induced by vibration stimuli on the upper body, utilizing our newly collected urgency-via-vibration dataset. The proposed model combines a 2D convolutional neural network with a temporal convolutional network to capture spatial and temporal EEG features, outperforming several established EEG models. The proposed model achieves an average classification accuracy of 83% through leave-one-subject-out cross-validation across three urgency classes (not urgent, urgent, and very urgent) from a single trial of EEG data. Furthermore, explainability analysis showed that the prefrontal brain region, followed by the central brain region, are the most influential in predicting the urgency level. A follow-up neural statistical analysis revealed an increase in event-related synchronization (ERS) in the theta frequency band (4-7 Hz) with the increased level of urgency, which is associated with high arousal and attention in the neuroscience literature. A limitation of this study is that the proposed model's performance was tested only the urgency-via-vibration dataset, which may affect the generalizability of the findings.

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This paper proposes measurement and reduction of eye dose in real time for the physician and the assistant performing fluoroscopy guided arterial puncture. Eye dose rates were measured for 30 fluoroscopy-guided punctures of bilateral femoral arteries in pigs. Fifteen fluoroscopy-guided punctures were performed using real time radiation dosimeter without auditory and visual feedback and other fifteen punctures were done using real time radiation dosimeter with visual and auditory feedback worn on forehead by an interventional cardiologist having experience of more than 10 years. The mean radiation dose rate for eyes of physician during arterial puncturing with real time radiation dosimeter with auditory feedback was 0.07 mSv/h (n = 15) whereas it was 0.18 mSv/h (n = 15) without visual and auditory feedback. The percentage of reduction with the device was 61% for eyes. In case of assistant the reduction was 33% for eyes (n = 15). The real time visual and auditory feedback dosimeter has reduced the eye dose rate of the physician and assistant and also helped him staying away from the X-ray source. Real time radiation dosimeters can be an effective tool to measure and reduce the dose to the eyes. The radiation eye dose rate for physician and assistant was significantly reduced by using real time radiation dosimeter with visual and auditory feedback. The real time radiation dosimeter not only helps in measuring but also help in minimizing the radiation dose rate for the physician and assistant in real time.

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