Real-Time Ultrasound Simulation for Medical Training and Standardized Patient Assessment

With the increasing role played by ultrasound in clinical diagnostics, ultrasound training in medical education has become more and more important. The clinical routine for ultrasound training is on real patients; therefore monitored and guided examinations involving medical students are quite time-constrained. Furthermore, standardized patients (SPs), who are increasingly used in medical school for teaching and assessing medical students, need to be augmented. These SPs are typically healthy individuals who can not accurately portray the variety of abnormalities that are needed for training especially when medical examinations involve instrument interactions. To augment SPs in a realistically effective way and also address the resourced time constraints for sonography training, a computerized ultrasound simulation is essential for medical education. In this dissertation, I investigate a real-time ultrasound simulation methodology based on a virtual 3-dimentional (3-D) mesh organ. This research has developed the simulation technology to augment SPs with synthetic ultrasound images. I present this methodology and its use in simulating echocardiography. This simulated echocardiogram displays the various oriented sonographs in real time according to the placement of a mock transducer without the need of an actual patient

Extracorporeal membrane oxygenation simulation-based training: methods, drawbacks and a novel solution

Introduction: Patients under the error-prone and complication-burdened extracorporeal membrane oxygenation (ECMO) are looked after by a highly trained, multidisciplinary team. Simulation-based training (SBT) affords ECMO centers the opportunity to equip practitioners with the technical dexterity required to manage emergencies. The aim of this article is to review ECMO SBT activities and technology followed by a novel solution to current challenges. ECMO simulation: The commonly-used simulation approach is easy-to-build as it requires a functioning ECMO machine and an altered circuit. Complications are simulated through manual circuit manipulations. However, scenario diversity is limited and often lacks physiological and/or mechanical authenticity. It is also expensive to continuously operate due to the consumption of highly specialized equipment. Technological aid: Commercial extensions can be added to enable remote control and to automate circuit manipulation, but do not improve on the realism or cost-effectiveness. A modular ECMO simulator: To address those drawbacks, we are developing a standalone modular ECMO simulator that employs affordable technology for high-fidelity simulation.Peer reviewe

Aerospace Medicine and Biology: A continuing bibliography with indexes, supplement 140

This bibliography lists 306 reports, articles, and other documents introduced into the NASA scientific and technical information system in March 1975

Improving Quantification of Mitral Regurgitation Through Computational Fluid Dynamics and Ex Vivo Testing

Mitral regurgitation (MR) is a prominent cardiac disease affecting more than two million people in the United States alone. In order for patients to receive proper therapy, regurgitant volume must first be quantified. As there are an array of methods to do so, the proximal isovelocity surface area (PISA) method continues to be the most accurate and clinically used method. However, there are some difficulties obtaining the necessary measurements need for this when performing transthoracic echocardiography. This study aims to evaluate and present techniques that may be used to more accurately quantify regurgitation through ex vivo testing and computational fluid dynamic simulations. Both a steady and pulsatile flow system were created to test clinical applications used to quantify MR using the PISA method. A total of six computational fluid dynamic cases were then studied; three native mitral valves effected by MR as well as three valves enacting to have MitraClip implantation, both sets of having a MR grade of mild, moderate, and severe. All cases were effected by an eccentric ellipse orifice(s). Flow rate was evaluated in each case, comparing actual flow rate to calculated flow rate, which was found implementing the modified hemielliptic PISA model. The results of this study implicate that clinical techniques used to quantify MR need an experienced technician, as well as further developing current techniques used, which is best done through ex vivo testing. The study further implied that severity may be significantly underestimated when quantifying MR using the modified hemielliptic PISA method in the short view

Virtual Reality applied to biomedical engineering

Actualment, la realitat virtual esta sent tendència i s'està expandint a l'àmbit mèdic, fent possible l'aparició de nombroses aplicacions dissenyades per entrenar metges i tractar pacients de forma més eficient, així com optimitzar els processos de planificació quirúrgica. La necessitat mèdica i objectiu d'aquest projecte és fer òptim el procés de planificació quirúrgica per a cardiopaties congènites, que compren la reconstrucció en 3D del cor del pacient i la seva integració en una aplicació de realitat virtual. Seguint aquesta línia s’ha combinat un procés de modelat 3D d’imatges de cors obtinguts gracies al Hospital Sant Joan de Déu i el disseny de l’aplicació mitjançant el software Unity 3D gracies a l’empresa VISYON. S'han aconseguit millores en quant al software emprat per a la segmentació i reconstrucció, i s’han assolit funcionalitats bàsiques a l’aplicació com importar, moure, rotar i fer captures de pantalla en 3D de l'òrgan cardíac i així, entendre millor la cardiopatia que s’ha de tractar. El resultat ha estat la creació d'un procés òptim, en el que la reconstrucció en 3D ha aconseguit ser ràpida i precisa, el mètode d’importació a l’app dissenyada molt senzill, i una aplicació que permet una interacció atractiva i intuïtiva, gracies a una experiència immersiva i realista per ajustar-se als requeriments d'eficiència i precisió exigits en el camp mèdic

Assessing mechanical properties of the cardiovascular system

The elasticity of wall of the arteries plays a significant role in cardiovascular system. Capacitance of the aorta is predicative of cardiovascular events[1]. To get better understanding the function of the cardiovascular system, special attention should be paid to digest the traditional two-element Windkessel model. Because the Windkessel model provides information of cardiovascular function and which may be useful for prevention and diagnosis of hypertension. Our research presents a series of in vitro experimental studies of compliance, peripheral resistance, and pulse waves. In this thesis, several studies have been achieved: 1) a mathematical model for the capacitance of the aorta is derived based upon the conservation of mass, and a specialized test device provided by BDC Laboratories is used to simulate the aorta by employing an arched silicone-rubber tube with a known capacitance. 2) applied and compared arterial compliance determined from blood pressure, arterial compliance determined from PWV, and mechanical capacitance in flexible tubes and animal calf aortae. 3) investigated using sensitivity analysis as the analytical technique to determine parameters which. 4) develop a new technique which based on blood pressure diagram of flexible tubes and animal aortas. In the first study corresponding to chapter five, that the entire blood-pressure state may be plotted on a single blood-pressure diagram using three nondimensional groups. This diagram illustrates the impact of altering the capacitance and ejection period on the pulse pressure that exists within the aorta. In the second study corresponding to chapter six, the sensitivity analysis that has been used to figure out sensitivity coefficients with the largest magnitude is based on the most sensitive parameter that can be adjusted if we want to alter a pressure. In the third study corresponding to chapter seven, arterial compliance determined from blood pressure is more straightforward approach than arterial compliance determined from PWV to measuring the arterial stiffness. By that allowing hypertension to be managed. In the last study corresponding to chapter seven, it is figured out that total cardiovascular capacitance plays a significant role in determining the risk factors for cardiovascular disease, and the systolic and diastolic pressures during the cardiac cycle. In addition to cardiovascular capacitance other parameters that contribute to creating blood pressure include total peripheral resistance, stroke volume, ejection period, and heartrate. In conclusion, this research, combined with additional support may permit the realization for measuring arterial stiffness in the home setting. This research may make significant paradigm changes in prognosis and diagnosis of arterial stiffness and other cardiovascular events.Includes bibliographical references (pages 188-194)

Towards a Low-Cost Monitor-Based Augmented Reality Training Platform for At-Home Ultrasound Skill Development

Ultrasound education traditionally involves theoretical and practical training on patients or on simulators; however, difficulty accessing training equipment during the COVID-19 pandemic has highlighted the need for home-based training systems. Due to the prohibitive cost of ultrasound probes, few medical students have access to the equipment required for at home training. Our proof of concept study focused on the development and assessment of the technical feasibility and training performance of an at-home training solution to teach the basics of interpreting and generating ultrasound data. The training solution relies on monitor-based augmented reality for displaying virtual content and requires only a marker printed on paper and a computer with webcam. With input webcam video, we performed body pose estimation to track the student's limbs and used surface tracking of printed fiducials to track the position of a simulated ultrasound probe. The novelty of our work is in its combination of printed markers with marker-free body pose tracking. In a small user study, four ultrasound lecturers evaluated the training quality with a questionnaire and indicated the potential of our system. The strength of our method is that it allows students to learn the manipulation of an ultrasound probe through the simulated probe combined with the tracking system and to learn how to read ultrasounds in B-mode and Doppler mode