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At least 1,585 records · Page 88Linked to original sources

PubMed2003

A surgical simulator for cleft lip planning and repair.

The objective of this project was to develop a computer-based surgical simulation system for cleft lip planning and repair. This system allows the user to interact with a virtual patient to perform the traditional steps of cleft-lip repair. The system interfaces to force-feedback (haptic) devices to track the user's motion and provide feedback during the procedure, while performing real-time soft-tissue simulation. An eleven-day old unilateral cleft-lip and palate patient was previously CT scanned for ancillary diagnostic purposes using standard imaging protocols and 1mm slices. High-resolution 3D meshes were automatically generated from this data using the ROVE software created in our lab. The resulting 3D meshes of bone and soft-tissue were instilled with physical properties of soft tissues for purposes of simulation. Once these preprocessing steps were completed, the patient's bone and soft-tissue data are presented on the computer screen in stereo and the user can freely view, rotate, and otherwise interact with the patient's data in real-time. The user is prompted to select anatomical landmarks on the patient data for preoperative planning purposes, then their locations are compared against that of a "gold standard" and a score, derived from their deviation from that standard and time required, is generated. The user can then move a haptic stylus and guide the motion of the virtual cutting tool. The soft tissues can thus be incised using this virtual cutting tool, moved using virtual forceps, and fused in order to perform any of the major procedures for cleft-lip repair. Real-time soft tissue deformation of the mesh realistically simulates normal tissues and haptic-rate (>1kHz) force-feedback is provided. The surgical result of the procedure can then be immediately visualized and the entire training process can be repeated at will. A short evaluation study was also performed. Two groups (nonmedical and plastic surgery residents) of six-people each performed the anatomical marking task of the simulator four times. Results showed that the plastic surgery residents scored consistently better than the people without medical background. Every person's score increased with practice, and the length of time needed to complete the eleven markings decreased. The data was compiled and showed which specific markers consistently took users the longest to identify as well as which locations were hardest to accurately mark. Our findings suggest that the simulator is a valuable training tool, giving residents a way to practice anatomical identification for cleft lip surgery without the risks associated with training on a live patient. Educators can also use the simulator to examine which markers are consistently problematic, and modify their training to address these needs.

Cleft Lip↗

PubMed2006

The use of virtual reality computer simulation in learning Port-A cath injection.

Cost-benefit management trends in Taiwan healthcare settings have led nurses to perform more invasive skills, such as Port-A cath administration of medications. Accordingly, nurses must be well-prepared prior to teaching by the mentor and supervision method. The purpose of the current study was to develop a computer-assisted protocol using virtual reality (VR) in performing Port-A cath as a training program for novice nurses. A pre-tested and post-tested control group experimental design was used in this study. Seventy-seven novice nurses were invited from one large medical center hospital in North Taiwan. Thirty-seven and forty nurses were randomly assigned to experimental and control groups. First, we designed a 40 minute port-A cath injection VR simulation. Then, the experimental group practiced this simulation two times over 3 weeks. The control group attended the traditional class. The post-test 1 was right after completion of the simulation practice. The post-test 2 was after the second simulation practice in 3 weeks. The results showed that most novice nurses lacked Port-A cath experience both in the classroom and during the period of their practice training. The knowledge score regarding the Port-A cath technique was significantly higher in the nurses that participated in the simulation training than in the control group. The novice nurses were most satisfied with the reduction in their fear of performing the Port-A cath technique and their enhanced clinical skills. VR simulation significantly reduced error rates and increased correct equipment selection, showing that nurses who participated in the simulation may be better prepared for inserting Port-A cath.

Catheterization, Central Venous↗

PubMed1993

European astronaut training in Houston.

Three European astronauts are currently training as Space Shuttle Mission Specialists at NASA's Johnson Space Center in Houston. Two of the astronauts, Maurizio Cheli and Jean-Francois Clervoy, recently became members of NASA's 'astronaut pool' and have entered the Advanced Training phase. The third one, Claude Nicollier, is now preparing for the mission to service the Hubble Space Telescope in December.

Astronauts↗

PubMed2000

Immersive virtual reality platform for medical training: a "killer-application".

The Medical Readiness Trainer (MRT) integrates fully immersive Virtual Reality (VR), highly advanced medical simulation technologies, and medical data to enable unprecedented medical education and training. The flexibility offered by the MRT environment serves as a practical teaching tool today and in the near future the will serve as an ideal vehicle for facilitating the transition to the next level of medical practice, i.e., telepresence and next generation Internet-based collaborative learning.

Computer Simulation↗

PubMed2005

Spike timing precision and neural error correction: local behavior.

The effects of spike timing precision and dynamical behavior on error correction in spiking neurons were investigated. Stationary discharges-phase locked, quasiperiodic, or chaotic-were induced in a simulated neuron by presenting pacemaker presynaptic spike trains across a model of a prototypical inhibitory synapse. Reduced timing precision was modeled by jittering presynaptic spike times. Aftereffects of errors-in this communication, missed presynaptic spikes-were determined by comparing postsynaptic spike times between simulations identical except for the presence or absence of errors. Results show that the effects of an error vary greatly depending on the ongoing dynamical behavior. In the case of phase lockings, a high degree of presynaptic spike timing precision can provide significantly faster error recovery. For nonlocked behaviors, isolated missed spikes can have little or no discernible aftereffects (or even serve to paradoxically reduce uncertainty in postsynaptic spike timing), regardless of presynaptic imprecision. This suggests two possible categories of error correction: high-precision locking with rapid recovery and low-precision nonlocked with error immunity.

Action Potentials↗

PubMed2005

[Simulation and airway management].

Despite the development of new devices and strategies to manage and secure the difficult airway, morbidity and mortality in anaesthesia due to airway problems such as difficult intubation or unrecognised failed intubation remain high. The problem seems to lie in the transfer of skills and strategies to daily clinical practice. Common methods for airway management training include theoretical instructions and hands-on sessions with manikins, animal models and cadavers. Simulation provides the opportunity to train skills and resolve specific situations embedded in a realistic scenario, facilitate the transfer of cognitive, psychomotor and affective abilities into daily clinical practice and help to improve behaviour in critical situations. This article outlines new training concepts in airway management with the help of simulation and simulators. We describe technical prerequisites and provide information on the implementation of difficult airway scenarios.

Anesthesiology↗

PubMed2006

Training model for open or laparoscopic pyeloplasty.

PURPOSE: To demonstrate the construction of a simple training model from reconfigured chicken skin to simulate open and laparoscopic reconstructive pyeloplasty. MATERIALS AND METHODS: Reconfiguring and suturing chicken skin dissected off its muscle creates a model of the ureteropelvic junction. Dismembered pyeloplasty techniques may be practiced with open or laparoscopic equipment. Students with prior training in suturing and knot-tying only used the open pyeloplasty model on three occasions. Urology trainees experienced in surgery but not laparoscopic pyeloplasty used the model laparoscopically. RESULTS: Students demonstrated a significant improvement (P < 0.05) between their first (17.00 +/- 4.44 minutes; mean +/- 95% CI) and third (11.33 +/- 2.40 minutes) attempts using the open model. Urology trainees improved their mean times from the first (18.0 minutes) to third (11.8 minutes) attempts using the laparoscopic model. CONCLUSIONS: This cheap and readily available model is reproducible and applicable to training in both open and laparoscopic pyeloplasty.

Animals↗

PubMed2005

How shall we train?

The prosecution of modern war and the competing missions of peacekeeping, humanitarian missions, and beneficiary care place great demands on the military medical system. Meeting the military medical training challenges of the new millennium requires the best trained and most experienced medical personnel possible. Various strategies for initial and sustainment (continuing) medical training are available to ensure that the medical force is ready for the next mission. Accredited programs both in and out of the military are the mainstay of training for both enlisted personnel and officers, with professional certification serving as the standard for competency. Clinical sustainment training can take place in military medical treatment facilities, civilian institutions, or a combination of the two. When direct patient care opportunities cannot provide the proper mixture of experiences to maintain certain skills, short courses, distance education, and patient simulators can play important roles. Because each training strategy offers certain advantages in different settings, it is likely that military medical departments will need to use all of them. An optimal training environment benefits from all strategies used, in combination or separately.

Accreditation↗

PubMed2005

Photo-realistic tissue reflectance modelling for minimally invasive surgical simulation.

Computer-based simulation is an important tool for surgical skills training and assessment. In general, the degree of realism experienced by the trainees is determined by the visual and biomechanical fidelity of the simulator. In minimally invasive surgery, specular reflections provide an important visual cue for tissue deformation, depth and orientation. This paper describes a novel image-based lighting technique that is particularly suitable for modeling mucous-covered tissue surfaces. We describe how noise functions can be used to control the shape of the specular highlights, and how texture noise is generated and encoded in image-based structure at a pre-processing stage. The proposed technique can be implemented at run-time by using the graphics processor to efficiently attain pixel-level control and photo-realism. The practical value of the technique is assessed with detailed visual scoring and cross comparison experiments by two groups of observers.

Bronchoscopy↗

PubMed1989

Preferred tempo in the learning of a gross cyclical action.

Seventy-five subjects, randomly assigned to one of five training conditions, were required to learn to make large-amplitude, high-tempo, fluent movements on a so-called ski-simulator over a period of four days. Subjects trained under different tempo conditions. In four of the conditions the tempo was prescribed ("preferred", high, low, or increasing), augmented feedback being provided to enable subjects to stay on "target". "Preferred" tempo was based on the weight of the subject and was derived from a regression equation based on previous empirical research. In a fifth condition, subjects trained on "discovery learning" principles, i.e. without the tempo being prescribed. The results obtained on the three parameters (amplitude, frequency, and fluency) during the daily test sessions (in which the tempo was not prescribed) formed the data for the analyses. A learning effect was apparent on all three parameters over the four-day training period. Subjects who trained under the high or the low prescribed tempos, however, were shown to produce significantly smaller amplitude movements than subjects who trained under the other three conditions. Training under the low-tempo condition was also shown to have disadvantageous effects on the parameters tempo and fluency. It was concluded that, for these kinds of action, training at a high or a low tempo--and particularly the latter--has undesirable effects. Such disadvantageous effects, however, were shown to be avoidable if training is begun with the "preferred" tempo of the subject and increased successively by 7% over days.

Adolescent↗

PubMed2007

Using a virtual reality temporal bone simulator to assess otolaryngology trainees.

OBJECTIVE: The objective of this study is to determine the feasibility of computerized evaluation of resident performance using hand motion analysis on a virtual reality temporal bone (VR TB) simulator. We hypothesized that both computerized analysis and expert ratings would discriminate the performance of novices from experienced trainees. We also hypothesized that performance on the virtual reality temporal bone simulator (VR TB) would differentiate based on previous drilling experience. STUDY DESIGN: The authors conducted a randomized, blind assessment study. METHODS: Nineteen volunteers from the Otolaryngology-Head and Neck Surgery training program at the University of Toronto drilled both a cadaveric TB and a simulated VR TB. Expert reviewers were asked to assess operative readiness of the trainee based on a blind video review of their performance. Computerized hand motion analysis of each participant's performance was conducted. RESULTS: Expert raters were able to discriminate novices from experienced trainees (P < .05) on cadaveric temporal bones, and there was a trend toward discrimination on VR TB performance. Hand motion analysis showed that experienced trainees had better movement economy than novices (P < .05) on the VR TB. CONCLUSION: Performance, as measured by hand motion analysis on the VR TB simulator, reflects trainees' previous drilling experience. This study suggests that otolaryngology trainees could accomplish initial temporal bone training on a VR TB simulator, which can provide feedback to the trainee, and may reduce the need for constant faculty supervision and evaluation.

Cadaver↗

PubMed2001

Software and internet resources for capillary electrophoresis and micellar electrokinetic capillary chromatography.

The purpose of the contribution is to show how software and the internet have changed the way in which we carry out research, and what additional possibilities these new resources and tools provide. The internet and e-mail broaden our horizon for cooperation. There are no borders for information exchange: our library is a virtual one, electronic databases are at our fingertips. E-mail discussion groups provide an electronic community of CE users. Such forums have provided a basis for worldwide scientific cooperation amongst scientists; the present contribution is only one of several examples. Estimation software provides us with estimates of component properties in those cases where this information is not available from literature or from experiments (an estimated value is better than no value). Several examples will illustrate the use of estimation software in capillary zone electrophoresis and micellar electrokinetic capillary chromatography. Simulation software presents visualization of experimental results to be expected, both as a training tool and as the first step in method development. Other simulations yield valuable insights into phenomena that are not readily accessible experimentally for reasons of size or time-scale.

Chromatography, Micellar Electrokinetic Capillary↗

PubMed2003

The role of differential reinforcement in predator avoidance learning.

Little is known about how predator recognition develops under natural conditions. Predispositions to respond to some stimuli preferentially are likely to interact with the effects of experience. Convergent evidence from several studies suggests that predator-nai;ve tammar wallabies (Macropus eugenii) have some ability to respond to vertebrate predators differently from non-predators and that antipredator responses can be selectively enhanced by experience. Here, we examined the effects of differential reinforcement on responses to a model fox (Vulpes vulpes), cat (Felis catus) and conspecific wallaby. During training, tammars experienced paired presentations of a model fox and a simulated capture, as well as presentations of a wallaby and a cat alone. Training enhanced responses to the fox, relative to the conspecific wallaby, but acquired responses to the two predators did not differ, despite repeated, non-reinforced presentations of the cat. Results suggest that experience interacts with the wallabies' ability to perceive predators as a natural category.

Journal Article↗

PubMed2001

Perceptibility of simulated VLF-sferics.

Sferics are weak, naturally occurring electromagnetic fields related to specific weather conditions. There are some hints that these signals might be responsible for certain complaints that are often described as "weather sensitivity syndrome." The study's purpose was to find out whether humans, when exposed to simulated sferics, can consciously perceive any kind of psychophysiological changes. 63 subjects were trained within a simple learning paradigm to discriminate between phases where simulated sferics were present or absent. They were reinforced for each correct decision out of 80 judgements by means of acoustic signals. A reward of 100 German marks was pledged to the participant who would achieve the best result of the total sample. The total number of correct judgements did not differ from a random run and no learning occurred. Subjects who reported fewer bodily complaints in their recent past had higher scores in the discrimination task.

Adult↗

PubMed2001

An evaluation of the concept of living at moderate altitude and training at sea level.

Despite equivocal findings about the benefit of altitude training, current theory dictates that the best approach is to spend several weeks living at > or =2500 m but training near sea level. This paper summarizes six studies in which we used simulated altitude (normobaric hypoxia) to examine: (i) the assumption that moderate hypoxia compromises training intensity (two studies); and (ii) the nature of physiological adaptations to sleeping in moderate hypoxia (four studies). When submaximal exercise was >55% of sea level maximum oxygen uptake (VO2max), 1800 m simulated altitude significantly increased heart rate, blood lactate and perceived exertion of skiers. In addition, cyclists self-selected lower workloads during high-intensity exercise in hypoxia (2100 m) than in normoxia. Consequently, our findings partially confirm the rationale for 'living high, training low'. In the remaining four studies, serum erythropoietin increased 80% in the early stages of hypoxic exposure, but the reticulocyte response did not significantly exceed that of control subjects. There was no significant increase in haemoglobin mass (Hb(mass)) and VO2max tended to decrease. Performance in exercise tasks lasting approximately 4 min showed a non-significant trend toward improvement (1.0+/-0.4% vs. 0.1+/-0.4% for a control group; P=0.13 for group x time interaction). We conclude that sleeping in moderate hypoxia (2650-3000 m) for up to 23 days may offer practical benefit to elite athletes, but that any effect is not likely due to increased Hb(mass) or VO2max.

Adaptation, Physiological↗

PubMed2005

A surgical simulator for planning and performing repair of cleft lips.

UNLABELLED: The objective of this project was to develop a computer-based surgical simulation system for planning and performing cleft lip repair. This system allows the user to interact with a virtual patient to perform the traditional steps of cleft-lip repair (rotation-advancement technique). MATERIALS AND METHODS: The system interfaces to force-feedback (haptic) devices to track the user's motion and provide feedback during the procedure, while performing real-time soft-tissue simulation. An 11-day-old unilateral cleft lip, alveolus and palate patient was previously CT scanned for ancillary diagnostic purposes using standard imaging protocols and 1mm slices. High-resolution 3D meshes were automatically generated from this data using the ROVE software developed in-house. The resulting 3D meshes of bone and soft tissue were instilled with physical properties of soft tissues for purposes of simulation. Once these preprocessing steps were completed, the patient's bone and soft tissue data are presented on the computer screen in stereo and the user can freely view, rotate, and otherwise interact with the patient's data in real time. The user is prompted to select anatomical landmarks on the patient's data for preoperative planning purposes, then their locations are compared against that of a 'gold standard' and a score, derived from their deviation from that standard and time required, is generated. The user can then move a haptic stylus and guide the motion of the virtual cutting tool. The soft tissues can thus be incised using this virtual cutting tool, moved using virtual forceps, and fused in order to perform any of the major procedures for cleft lip repair. Real-time soft tissue deformation of the mesh realistically simulates normal tissues and haptic-rate (>1 kHz) force-feedback is provided. The surgical result of the procedure can then be immediately visualized and the entire training process can be repeated at will. A short evaluation study was also performed. Two groups (non-medical and plastic surgery residents) of six persons each performed the anatomical marking task of the simulator four times. RESULTS: Results showed that the plastic surgery residents scored consistently better than the persons without medical background. Every person's score increased with practice, and the length of time needed to complete the 11 markings decreased. The data was compiled and showed which specific markers consistently took users the longest to identify as well as which locations were hardest to accurately mark. CONCLUSION: These findings suggest that the simulator is a valuable training tool, giving residents a way to practice anatomical identification for cleft lip surgery without the risks associated with training on a live patient. Educators can also use the simulator to examine which markers are consistently problematic, and modify their training to address these needs.

Cleft Lip↗

PubMed2006

SEBINI: Software Environment for BIological Network Inference.

UNLABELLED: The Software Environment for BIological Network Inference (SEBINI) has been created to provide an interactive environment for the deployment and evaluation of algorithms used to reconstruct the structure of biological regulatory and interaction networks. SEBINI can be used to compare and train network inference methods on artificial networks and simulated gene expression perturbation data. It also allows the analysis within the same framework of experimental high-throughput expression data using the suite of (trained) inference methods; hence SEBINI should be useful to software developers wishing to evaluate, compare, refine or combine inference techniques, and to bioinformaticians analyzing experimental data. SEBINI provides a platform that aids in more accurate reconstruction of biological networks, with less effort, in less time. AVAILABILITY: A demonstration website is located at https://www.emsl.pnl.gov/NIT/NIT.html. The Java source code and PostgreSQL database schema are available freely for non-commercial use.

Algorithms↗

PubMed2002

A new haptic interface for VR medical training.

Successful applications of haptic displays are limited to tool-based interfaces that simulate haptic effects on surgical and other medical instruments. However, no satisfactory haptic display exist so far, that enable the simulation of high fidelity palpation of human tissue or body segments. Existing approaches developed for medical training fail due to unrealistic haptic effects, time-consuming donning and doffing, and inconvenient use (e.g., mechatronic tactile and kinesthetic displays) or due to restricted function and adjustability (e.g., passive mannequins). The key idea of the new haptic interface is to attach artificial organs or segments (e.g. a plastic leg) to a force actuating mechatronic unit (e.g. robot). A set of different materials combined in certain layers yield components that look and feel like real objects. When the user touches the artificial object the contact forces and position changes are measured and fed into a model-based controller. Thus, the actuator moves the object so that the user gets the impression that he had induced the movement. The new haptic display has been verified with a setup developed for the training of functional joint evaluation after knee injuries. Compared to classical approaches, this display is convenient to use, provides realistic tactile properties and can be partly adjusted to different system properties (e.g. pathological joint properties). This kind of new interface can be applied to many different medical applications, where the clinician directly touches human limbs or tissue, such as in obstetrics, reanimation, organ palpation, etc.

Artificial Organs↗