{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,4]],"date-time":"2026-01-04T02:45:12Z","timestamp":1767494712699,"version":"build-2065373602"},"reference-count":20,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2022,11,29]],"date-time":"2022-11-29T00:00:00Z","timestamp":1669680000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Nakamir Inc."}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Imaging"],"abstract":"<jats:p>This work aims to leverage medical augmented reality (AR) technology to counter the shortage of medical experts in low-resource environments. We present a complete and cross-platform proof-of-concept AR system that enables remote users to teach and train medical procedures without expensive medical equipment or external sensors. By seeing the 3D viewpoint and head movements of the teacher, the student can follow the teacher\u2019s actions on the real patient. Alternatively, it is possible to stream the 3D view of the patient from the student to the teacher, allowing the teacher to guide the student during the remote session. A pilot study of our system shows that it is easy to transfer detailed instructions through this remote teaching system and that the interface is easily accessible and intuitive for users. We provide a performant pipeline that synchronizes, compresses, and streams sensor data through parallel efficiency.<\/jats:p>","DOI":"10.3390\/jimaging8120319","type":"journal-article","created":{"date-parts":[[2022,11,29]],"date-time":"2022-11-29T01:42:02Z","timestamp":1669686122000},"page":"319","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Remote Training for Medical Staff in Low-Resource Environments Using Augmented Reality"],"prefix":"10.3390","volume":"8","author":[{"given":"Austin","family":"Hale","sequence":"first","affiliation":[{"name":"UNC Graphics and Virtual Reality Group, Department of Computer Science, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA"},{"name":"Nakamir Inc., Menlo Park, CA 94025, USA"}]},{"given":"Marc","family":"Fischer","sequence":"additional","affiliation":[{"name":"Nakamir Inc., Menlo Park, CA 94025, USA"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5534-3903","authenticated-orcid":false,"given":"Laura","family":"Sch\u00fctz","sequence":"additional","affiliation":[{"name":"School of Engineering, Stanford University, Stanford, CA 94305, USA"},{"name":"Chair for Computer Aided Medical Procedures and Augmented Reality, Department of Informatics, Technical University of Munich, 80333 Munich, Germany"}]},{"given":"Henry","family":"Fuchs","sequence":"additional","affiliation":[{"name":"UNC Graphics and Virtual Reality Group, Department of Computer Science, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA"}]},{"given":"Christoph","family":"Leuze","sequence":"additional","affiliation":[{"name":"Nakamir Inc., Menlo Park, CA 94025, USA"}]}],"member":"1968","published-online":{"date-parts":[[2022,11,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Azimi, E., Winkler, A., Tucker, E., Qian, L., Sharma, M., Doswell, J., Navab, N., and Kazanzides, P. (2018, January 18\u201322). Evaluation of Optical See-Through Head-Mounted Displays in Training for Critical Care and Trauma. Proceedings of the 25th IEEE Conference on Virtual Reality and 3D User Interfaces, Reutlingen, Germany.","DOI":"10.1109\/VR.2018.8446583"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"S40","DOI":"10.1097\/TA.0000000000003263","article-title":"Augmented reality visualization tool for the future of tactical combat casualty care","volume":"91","author":"Leuze","year":"2021","journal-title":"J. Trauma Acute Care Surg."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e008999","DOI":"10.1136\/bmjopen-2015-008999","article-title":"Can training non-physician clinicians\/associate clinicians (NPCs\/ACs) in emergency obstetric, neonatal care and clinical leadership make a difference to practice and help towards reductions in maternal and neonatal mortality in rural Tanzania? The ETATMBA project","volume":"6","author":"Ellard","year":"2016","journal-title":"BMJ Open"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1308","DOI":"10.1111\/1475-6773.12854","article-title":"Strengthening the health care workforce in Fragile States: Considerations in the Health Care Sector and Beyond","volume":"53","author":"Snowden","year":"2018","journal-title":"Health Serv. Res."},{"key":"ref_5","unstructured":"Silver, L., and Johnson, C. (2022, February 24). Internet Connectivity Seen as Having Positive Impact on Life in Sub-Saharan Africa. Available online: https:\/\/www.pewresearch.org\/global\/2018\/10\/09\/internet-connectivity-seen-as-having-positive-impact-on-life-in-sub-saharan-africa\/."},{"key":"ref_6","unstructured":"Kato, H., and Billinghurst, M. (1999, January 20\u201321). Marker tracking and HMD calibration for a video-based augmented reality conferencing system. Proceedings of the 2nd IEEE and ACM International Workshop on Augmented Reality (IWAR\u201999), San Francisco, CA, USA."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Wang, S., Parsons, M., Stone-McLean, J., Rogers, P., Boyd, S., Hoover, K., Meruvia-Pastor, O., Gong, M., and Smith, A. (2017). Augmented reality as a telemedicine platform for remote procedural training. Sensors, 17.","DOI":"10.3390\/s17102294"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1093\/milmed\/usz298","article-title":"Augmented Reality Forward Damage Control Procedures for Nonsurgeons: A Feasibility Demonstration","volume":"185","author":"Harris","year":"2020","journal-title":"Mil. Med."},{"key":"ref_9","first-page":"1","article-title":"Evaluation of an augmented reality platform for austere surgical telementoring: A randomized controlled crossover study in cricothyroidotomies","volume":"3","author":"Lin","year":"2020","journal-title":"npj Digit. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"741","DOI":"10.1097\/TA.0000000000000829","article-title":"The marriage of surgical simulation and telementoring for damage-control surgical training of operational first responders: A pilot study","volume":"79","author":"Kirkpatrick","year":"2015","journal-title":"J. Trauma Acute Care Surg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"S88","DOI":"10.1503\/cjs.014214","article-title":"Technical innovations that may facilitate real-time telementoring of damage control surgery in austere environments: A proof of concept comparative evaluation of the importance of surgical experience, telepresence, gravity and mentoring in the conduct of damage control laparotomies","volume":"58","author":"Kirkpatrick","year":"2015","journal-title":"Can. J. Surg."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Lin, C., Andersen, D., Popescu, V., Rojas-Munoz, E., Cabrera, M.E., Mullis, B., Zarzaur, B., Anderson, K., Marley, S., and Wachs, J. (2018, January 16\u201320). A first-person mentee second-person mentor AR interface for surgical telementoring. Proceedings of the 2018 IEEE International Symposium on Mixed and Augmented Reality Adjunct (ISMAR-Adjunct), Munich, Germany.","DOI":"10.1109\/ISMAR-Adjunct.2018.00021"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Gasques, D., Johnson, J.G., Sharkey, T., Feng, Y., Wang, R., Xu, Z.R., Zavala, E., Zhang, Y., Xie, W., and Zhang, X. (2021, January 8\u201313). ARTEMIS: A collaborative mixed-reality system for immersive surgical telementoring. Proceedings of the 2021 CHI Conference on Human Factors in Computing Systems, Yokohama, Japan.","DOI":"10.1145\/3411764.3445576"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Roth, D., Yu, K., Pankratz, F., Gorbachev, G., Keller, A., Lazarovici, M., Wilhelm, D., Weidert, S., Navab, N., and Eck, U. (April, January 27). Real-time mixed reality teleconsultation for intensive care units in pandemic situations. Proceedings of the 2021 IEEE Conference on Virtual Reality and 3D User Interfaces Abstracts and Workshops (VRW), Lisbon, Portugal.","DOI":"10.1109\/VRW52623.2021.00229"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"4129","DOI":"10.1109\/TVCG.2021.3106480","article-title":"Avatars for teleconsultation: Effects of avatar embodiment techniques on user perception in 3D asymmetric telepresence","volume":"27","author":"Yu","year":"2021","journal-title":"IEEE Trans. Vis. Comput. Graph."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Strak, R., Yu, K., Pankratz, F., Lazarovici, M., Sandmeyer, B., Reichling, J., Weidert, S., Kraetsch, C., Roegele, B., and Navab, N. (2021, January 4\u20137). Comparison Between Video-Mediated and Asymmetric 3D Teleconsultation During a Preclinical Scenario. Proceedings of the Mensch Und Computer 2021, Ingolstadt, Germany.","DOI":"10.1145\/3473856.3473883"},{"key":"ref_17","unstructured":"Ungureanu, D., Bogo, F., Galliani, S., Sama, P., Duan, X., Meekhof, C., St\u00fchmer, J., Cashman, T.J., Tekin, B., and Sch\u00f6nberger, J.L. (2020). Hololens 2 research mode as a tool for computer vision research. arXiv."},{"key":"ref_18","unstructured":"(2022, February 24). Microsoft Hololens 2 Research Mode for Unreal Engine. Available online: https:\/\/github.com\/microsoft\/HoloLens-ResearchMode-Unreal."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Wilson, A. (2017, January 17\u201320). Fast Lossless Depth Image Compression. Proceedings of the 2017 ACM International Conference on Interactive Surfaces and Spaces (ISS \u201917), Brighton, UK.","DOI":"10.1145\/3132272.3134144"},{"key":"ref_20","unstructured":"(2022, February 24). 3D Skeletal Tracking on Azure Kinect. Available online: https:\/\/www.microsoft.com\/en-us\/research\/uploads\/prod\/2020\/01\/AKBTSDK.pdf."}],"container-title":["Journal of Imaging"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2313-433X\/8\/12\/319\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:28:54Z","timestamp":1760146134000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2313-433X\/8\/12\/319"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,29]]},"references-count":20,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["jimaging8120319"],"URL":"https:\/\/doi.org\/10.3390\/jimaging8120319","relation":{},"ISSN":["2313-433X"],"issn-type":[{"type":"electronic","value":"2313-433X"}],"subject":[],"published":{"date-parts":[[2022,11,29]]}}}