In 1992, scientist and technologist Louis Rosenberg created Virtual Fixtures, one of the first augmented reality systems ever developed. By using a full upper-body exoskeleton, the wearer was able to control two physical robots, while innovative optics aligned the robot arms as an overlay of the user’s own arms.

In the nearly 30 years that followed, technology has advanced considerably, enabling fully immersive “virtual-reality” experiences, as well as “mixed reality”—the result of blending the physical world with the digital world.

While mixed reality is still a relatively new technology in health, it has the potential to make a significant impact on patient care. Its unique ability to project visualizations into physical space and its low barrier of entry is spurring health organizations to experiment in ways that are incredibly promising. Here are three examples of providers that are pioneering mixed reality in medical education, the perioperative pathway, and virtual care.

Enhancing medical education by helping students see the human body in three dimensions

While medical students have traditionally learned through textbooks and hands-on training, this approach has its disadvantages, such as a lack of real-world exposure to multiple anatomical variations. For practicing physicians, on-the-job training is often conducted via mannequins and simulators, which are an improvement over textbooks, but even these sophisticated tools have limitations. Each patient is different, and while mannequins are helpful, nothing beats actual patient care for learning.

Mixed reality enhances physician education by combining the anatomical and procedural to create a more robust education platform. Case Western Reserve University in Cleveland is utilizing mixed-reality devices to accelerate their medical students’ grasp of anatomy. With mixed reality, students can visualize the muscles on top of a skeleton and understand the body’s different layers. They can project any piece of anatomy digitally and examine it in three dimensions, move it around, or make it translucent to see through to what lies underneath.

As a result, students have more freedom to experiment and explore the ways anatomical systems work together, helping them build confidence and empowering them with stronger working knowledge of anatomy.

Expanding the opportunity to learn in a new dimension changes the way medical students and physicians see their patients and the world, opening new avenues to approach medicine from a “hands-on” perspective, not just a theoretical one.

Delivering new intelligence to the perioperative pathway by simulating the physical world

When approaching complicated surgeries, each scenario is unique. Some procedures are more complex than others due to the unique characteristics of the patient’s anatomy and the type of surrounding tissue and organs. A growing number of surgeons have already adopted innovative methods like three-dimensional (3D) printing to prepare for the intricacies of each surgery, but this approach is challenging to scale and hinders collaboration among surgical teams.

Mixed reality takes this innovation further, enabling surgeons to interact with an accurate digital representation of a patient’s unique organ structure, as well as collaborate with their teams to orchestrate and rehearse procedures. The University of Oslo is leveraging mixed reality to plan complex procedures, such as liver surgery. By creating a digital 3D model of the patient’s liver from a computed tomography (CT) scan, surgeons can move, scale, rotate and isolate different parts of the organ, as well as switch layers of the model off and on with simple hand gestures. Multiple surgeons can also share the same experience through separate devices.

The new technique enables doctors to navigate around the patient’s other organs and leave more of their healthy liver tissue undisturbed, improving their ability to withstand surgery during treatment. Researchers are looking for ways to apply this technology to patients undergoing other complicated procedures such as cardiac surgery.

Applying mixed reality to perioperative planning enables a customized approach for each patient, offering surgeons enhanced visibility into the patient’s unique anatomy. This approach can improve each individual surgery, helping surgical teams prepare more effectively to create the best possible outcome for each patient.

Bringing doctors and patients together virtually when they can’t be in the same place

Within certain patient populations, connecting patients with providers can be time-consuming and costly. For instance, getting to a provider’s office is a major challenge for elderly patients who lack transportation. Those in remote areas often face similar challenges in making the time to travel and finding transportation.

Through mixed-reality devices, doctors can provide high-quality care to patients in their own homes, saving time, money, and hassle while making them feel more comfortable. Silver Chain Group in Australia is doing this already by using Microsoft’s HoloLens to create an “Enhanced Medical Mixed Reality (EMMR) interface. By having a visiting nurse wear a mixed-reality headset at the patient’s bedside, a doctor can see the patient remotely as if they were in the same room. This extends doctors’ reach beyond the walls of the exam room and enables patients to receive care that would otherwise be difficult to obtain. As the world’s population continues to grow older, demand for community-based care will only increase, and innovative telehealth options will be even more critical.

Augmenting reality eliminates logistical challenges to providing care to remote and elderly populations, putting the patient and the problem in front of doctors’ eyes and removing the friction that can get in the way of patients receiving the right care at the right time.

Enable healthcare innovation with mixed reality

For years, technology adoption in medicine has been driven by doctors seeking ways to improve their techniques as well as by patients demanding high-quality care and convenience. Mixed reality is showing great promise in improving medical education, surgical planning, and even office visits, making healthcare delivery easier, faster, and cheaper while driving better results for patients. To learn more about what Microsoft and its partners are achieving with mixed reality, download our eBook on digital transformation in health.

In Forza Horizon 4, Seasons change everything where players must master driving in dry, wet, muddy, snowy and icy conditions. A first for the racing genre and rarely seen in any open-world game, dynamic seasons create a world that is constantly evolving each week and with more than 450 cars, novices and veterans alike can explore the beautiful open world of Britain filled with unique and challenging driving experiences.

While Forza Horizon 4’s deep upgrade system can optimize any car for any season, it’s always best to think about the right car choice for each weather condition, whether you need to adjust your suspension and how you need to change your driving style depending on the terrain. Luckily, we have some tips and tricks on how best to tackle each season and what to expect, sourced by Turn 10 Studios’ Design Director Jon Knoles.

Summer

 Under a high, mid-day summer sun, conditions are perfect for putting the pedal to the metal on Britain’s fastest motorways or ripping along the golden sands of the northern coast past the brooding Bamburgh Castle. You may encounter the occasional summer rain, but most of the time you’ll find dry weather.

If you take a shortcut through fields, you’ll easily plow through tall grasses and flowers. Don’t worry about wood and wire fences, small trees, or stacked drystone walls. Whatever you’re driving, if you’re going fast enough they’ll break without breaking your car. Smaller, lighter cars will slow down considerably more than larger, heavier vehicles when you plow through these obstacles.

When Horizon summer arrives, as with all seasons, keep an eye out for seasonal gameplay events, challenges, and rewards, which expire at the end of the season. You may find summer events often take advantage of the perfect driving conditions to feature faster cars on faster, paved roads.

Autumn

 Whether you call it autumn or fall, it’s perhaps the most beautiful and most colorful season to explore the tree-lined, winding roads of Britain’s Lake Country in the world’s greatest road cars, or to tackle the 4×4 Adventure Park’s muddy playground for off-roaders.

It’s after harvest, so fields that were full of tall grasses in summer are now plowed and full of soft or muddy earth that will slow you down a bit, and are peppered with new obstacles in the form of big and heavy bales of hay, which will definitely slow you down if you hit them. It will rain in autumn more than in summer and roads do become a bit slicker in the wet, so you’ll be wanting to plan a little earlier for hard turns.

When autumn arrives, keep an eye out for a seasonal barn find car—each season reveals a classic to discover and restore, but you’ll want to find it before the season changes again.

Winter

With the low sun shimmering through bare trees across a frosty landscape, you might be worried that you’ll be sliding all over the place. Don’t worry, all tires are good for all seasons, and will be enough to keep you on the roads if you remember to brake—and turn—for curves. If you want more grip on the snow and ice, you can equip your car with studded winter tires in the upgrade shop, and any car that was already equipped with off-road or rally tires will automatically switch to studded tires.

The weather may range from clear to light flurries, or the occasional blizzard. Higher elevations in the north will have more deep snow than lowland areas in the south. Coastal beaches are still sandy, and motorways, the city streets of historic Edinburgh, and other major roads are cleared of ice and snow. In winter, you can reach previously inaccessible areas to search for bonus boards to smash or barn find cars, such as on an island in the middle of a deep lake. And when you’re on the frozen lake, it doesn’t matter what you’re driving or what kind of tires you have, you will slide around a lot, which itself is a lot of fun.

Keep an eye out for snowmen, too. Smashing them is fun, and it will net you combo skill points. Seasonal events are sure to test your mettle on the slippery ice, but rest assured there are still clear roads to conquer.

Spring

After a cold winter, the British landscape bursts to life once again in vibrant color, and one thing you can be sure of is a lot more rain, but you’ll also get a lot of sun. Or as they say in much of Britain in the spring, “If you don’t like the weather, just wait a few minutes.”

Of all the seasons, spring is probably the one with the most varied conditions throughout. Previously dry or shallow riverbeds become deep, rushing streams, which may bring low-slung supercars and lightweight cars to a crawl, but don’t pose much of a challenge for off-road vehicles such as SUVs, trophy trucks, and buggies. If you happen to climb to a mountain peak in the north, you’ll still find pockets of snow to play around in.

As with autumn, spring events may bring a more rally-heavy theme with mixed-surface races to suit the varied conditions. Whether it’s in a sturdy new Subaru WRX Sti, or a classic Group B rally monster from the 80s, you’ll be sure to discover some trail-blazing events in cars built to tackle all the tarmac, gravel, and mud that you’ll get plenty of in spring.

Forza Horizon 4 launches on October 2, 2018 on Xbox One, Windows 10 and Xbox Game Pass, and is now available for pre-order in the Microsoft Store. Stay tuned to Xbox Wire and ForzaMotorsport.net for future updates.

If you’re a game developer even working partially in the mobile market, you’re probably aware that even a light amount of in-app purchases are needed to help keep your game alive. But what happens when you and your indie-dev brother decide not to go that route? 

Earlier today, we were lucky enough to speak with the Trese (prounced Tray-see) Brothers, an indie dev duo behind the Star Trader games, a set of strategy RPGs that have found their home on mobile and PC platforms. Last week, they released Star Trader: Frontiers, a surprisingly deep and complex spacefaring RPG where you take on the role of a mercenary captain and rely on a lot of procedural data to build your own story. 

If you’re curious about how the brothers built such broad systems with a small team, you should waste no time and watch our conversation with them in the video above. 

And while you’re at it, be sure to follow the Gamasutra Twitch channel for more developer interviews & editor roundtables. 

In this GDC 2013 talk, artist Scott Campbell (of Psychonauts fame) shares his creative process for creating amazing and inspiring characters.

Campbell discusses how artists can create memorable and distinctive characters through describing his creative approach and showing past works.

He also presents a live demonstration where he develops a new character design, sharing his thoughts and providing tips during the process.

It wan informative talk that’s still definitely worth watching, so developers shouldn’t miss the opportunity to do so now that it’s freely available on the official GDC YouTube channel!

In addition to this presentation, the GDC Vault and its accompanying YouTube channel offers numerous other free videos, audio recordings, and slides from many of the recent Game Developers Conference events, and the service offers even more members-only content for GDC Vault subscribers.

Those who purchased All Access passes to recent events like GDC or VRDC already have full access to GDC Vault, and interested parties can apply for the individual subscription via a GDC Vault subscription page. Group subscriptions are also available: game-related schools and development studios who sign up for GDC Vault Studio Subscriptions can receive access for their entire office or company by contacting staff via the GDC Vault group subscription page. Finally, current subscribers with access issues can contact GDC Vault technical support.

Gamasutra and GDC are sibling organizations under parent UBM Americas.

In We Happy Few, you’ll play the tale of a plucky bunch of moderately terrible people trying to escape from a lifetime of cheerful denial in the city of Wellington Wells. In this alternative 1960s England, conformity is key. You’ll have to fight or blend in with the drug-addled inhabitants, most of whom don’t take kindly to people who won’t abide by their not-so-normal rules.

When discovering the retrofuturistic city’s dark history, you’ll play through the intertwined narratives of three quietly rebellious citizens of Wellington Wells. Each with their own strengths and weaknesses, you’ll discover their pasts, prepare for their future, and engage in activities that aren’t exactly status quo in the artificially-enthused society.

We Happy Few is just weeks from launch and it’s time to learn more about the games second playable character, Sally Boyle.

Wellington Wells’ fabulous “It Girl,” Sally, is sparkling and witty, and wears the grooviest fashions better than any Wellette in the Village.

A brilliant chemist, she keeps the rich and powerful supplied with powerful concoctions that no mere pharmacist can make.

“Early on, we knew we wanted Sally Boyle to be both a clever chemist and glamorous, fashionable socialite,” says Whitney Clayton, Art Director for We Happy Few. “Her dress is the epitome of mod. To give her a look that was both iconic and distinct, we designed her to be both classy and slightly futuristic. Her dress is made of simple, graphic shapes, and a mix of modern (for the time) materials like white felt and black vinyl. Her short hair and pixie features reference fashion icons from the 60s like Twiggy and Edie Sedgwick.”

But Sally’s fabulousness is a front. She’s a survivor, wounded by her past, and she has secrets that would get her killed if they ever got out.

Fortunately, she has other drugs that she can use, affording her the means to escape detection, evade capture, and take down even the toughest of enemies.

As you reveal Sally’s story and dangerous secrets, you’ll interact with the other two playable characters, Arthur and Ollie, who each have their own secrets, motivations, and special skills in the story of We Happy Few.

“You might see the same scene from several different perspectives” adds Alex Epstein, the Narrative Director at Compulsion Games. “The dialog might change. The location might change, depending on who’s remembering. But the second version isn’t necessarily the truth just because it comes second.”

We Happy Few is coming to the Xbox One family of devices and enhanced for Xbox One X on August 10, 2018. Pre-order now on the Microsoft Store and get $9 off plus the exclusive Jolly Brolly weapon at launch!

The latest Nintendo Download update for North America has arrived, and it’s bringing new games galore to the eShop in your region. As always, be sure to drop a vote in our poll and a comment down below with your potential picks for the week. Enjoy!

Nintendo Switch

State of Mind (Daedalic Entertainment, Wed 15th August, $39.99) The world is on the brink. Lack of resources, illnesses caused by polluted air and water, crime on the rise, war. Governments and companies promise remedies through technological progress. Drones and humanoid robots replace humans in the public sector, everything is interconnected, surveillance has become omnipresent.

Switch eShop

Okami HD (Capcom, Today, $19.99) Experience this acclaimed masterpiece with its renowned Sumi-e ink art style in breathtaking high resolution. Take the role of Amaterasu, the Japanese sun goddess who inhabits the form of a legendary white wolf Shiranui. Use magical abilities, attacks, and Celestial Brush techniques to restore the land of Nippon to its previous glory full of life and colour.  Read our Okami HD review.

Minit (Devolver Digital, Today, $9.99) Minit is a peculiar little adventure played sixty seconds at a time. Journey outside the comfort of your home to help unusual folk, uncover countless secrets, and overcome dangerous foes, all in hopes of lifting a rather unfortunate curse that ends each day after just one minute.  Read our Minit review.

2064: Read Only Memories Integral (Midboss, Thu 26th July, $20.64) Your life as a struggling journalist is interrupted by the world’s first sapient machine, a ROM (Relationship and Organizational Manager) named Turing. Together, you and the quirky robot will encounter a colorful cast of locals and overcome challenges as you uncover the city’s secrets behind the overlapping futures of technology and humanity.

ACA NEOGEO PREHISTORIC ISLE 2 (HAMSTER, Thu 2nd August, $7.99) “PREHISTORIC ISLE 2” is a shooting game released by SNK in 1999. Various types of dinosaurs which are large, small, or even have the wings emerged! Your mission is to eliminate these primaeval beasts from the city. Rescue and help all trapped citizens’ escape! 

BlobCat (BySamb, Today, $9.99) In BlobCat it’s your job to protect the DiceMice! Place arrows and guide the Dicemice to the Micehole! But beware, the naive BlobCats are rolling around (not quite at the speed of sound)! Solve over 90 different levels spanning over 5 worlds, each with a unique gameplay twist! Let the battle begin!

Catch ‘Em! Goldfish Scooping (D3Publisher, Thu 2nd August, $7.99) With four modes to enjoy with 2-4 players, you can have an intense battle with this party game. In addition to scooping goldfish for points, you can use items to your advantage and to mess with your opponents! Make this fun goldfish scooping party game your new tradition!

GREEN (Studio Green, Thu 2nd August, $2.99) Create a block yourself and use it to clear the stage Side scrolling 2D puzzle action game Because it uses only the jump and block buttons, it is a simple game that anyone can feel free to play. Please clear all 50 stages and save the lover’s pink.

Megaton Rainfall (Pentadimensional Games, Today, $15.99) Megaton Rainfall is a first-person superhero game. A global alien invasion is taking place and you must face it – alone. Chase massive destruction devices at supersonic speeds around an Earth that’s as large as the real thing and populated with semi-procedurally generated cities. Read our Megaton Rainfall review.

Nightmares from the Deep 2: The Siren’s Call (Artifex Mundi, Fri 10th August, $14.99) When Sarah Black, curator at the Caribbean Naval Museum, receives a package from a mysterious messenger, she is unwittingly drawn into an ancient conflict. Inside the package she finds an artifact, and instantly assailants descend on the museum to rob her.

Shut Eye (Forever Entertainment, Today, $3.99) Shut Eye on Nintendo Switch now with refreshed graphics and gameplay! Play as a young child, who is away from her parents. The girl has suffered from anxiety most of her life, which lead to confusion and an exuberant imagination.

SubaraCity (Flyhigh Works / CIRCLE, Today, $5.00) SubaraCity on Nintendo Switch offers a new twist for puzzle game fans, combining careful planning with relaxing gameplay. You’re not just matching blocks, but you’re city building at the same time!

Tetra’s Escape (Ratalaika Games, Fri 10th August, $4.99) Blocks named Tetras and it is down to the players to do all that they can, to save them and make the most out of their special ability. Via the means of shape-shifting, Tetras can turn into different Tetrominos and used to fill holes and master puzzles, in an attempt to reach the portal on the other side of the level.

The Amazing Shinsengumi: Heroes in Love (D3Publisher, Today, $11.99) A romance game for women where you fall in love with members of the famed Shinsengumi. Okita Soji, Saito Hajime, Nagakura Shinpachi, Harada Sanosuke, Todo Heisuke… Which of the rough and passionate Shinsengumi members will you fall for? Featuring character designs by popular artist for women’s media, Nagaoka.

Unexplored (Digerati, Today, $15.00) Descend into the depths of the Dungeon of Doom and complete your quest: steal the Amulet of Yendor from the fearsome dragon and make it out alive. Unexplored is the roguelite that feels like a roguelike. An accessible yet challenging action RPG that has won praise for its revolutionary level generation tech.

Nintendo Switch – Open Beta

Dragon Ball FighterZ (Bandai Namco) Open Beta – Go head to head in VS Online with no fewer than 23 characters and 13 stages. Don’t forget to also stop by the Battle Tutorial to sharpen your skills and master all kinds of devastating techniques. The Open Beta servers are scheduled to be on between 9 p.m. PT on Aug. 9 and 11:59 p.m. PT on Aug. 11.

Switch eShop – Demo

Nintendo eShop sales:

Great deals this week! Check out the full list of deals available this week here.

Activities

Calling All Nintendo Labo Fans! – In less than two weeks, the latest Nintendo Labo Creators Contest No. 2 ends! Have you started on your entry? A team of Nintendo Labo judges will select four winners in two categories: Best Toy-Con Musical Instrument and Best Gaming Experience using Toy-Con Garage. The contest ends at 10:59 a.m. PT on Aug. 20. You can also check out other submissions here – and don’t forget to give a “like” to your favorites! The prizes include a specially designed, collectible cardboard-inspired Nintendo Switch system, Nintendo Labo Creators jackets and more. For more info, please visit the official contest site here. 

So that’s your lot for this week’s North American Nintendo Download. Go on, be a sport and drop a vote in the poll above, and a comment below with your hot picks!