Robotic simulators for tissue examination training with multimodal sensory feedback

Tissue examination by hand remains an essential technique in clinical practice. The effective application depends on skills in sensorimotor coordination, mainly involving haptic, visual, and auditory feedback. The skills clinicians have to learn can be as subtle as regulating finger pressure with breathing, choosing palpation action, monitoring involuntary facial and vocal expressions in response to palpation, and using pain expressions both as a source of information and as a constraint on physical examination. Patient simulators can provide a safe learning platform to novice physicians before trying real patients. This paper reviews state-of-the-art medical simulators for the training for the first time with a consideration of providing multimodal feedback to learn as many manual examination techniques as possible. The study summarizes current advances in tissue examination training devices simulating different medical conditions and providing different types of feedback modalities. Opportunities with the development of pain expression, tissue modeling, actuation, and sensing are also analyzed to support the future design of effective tissue examination simulators

Sub-Nyquist Field Trial Using Time Frequency Packed DP-QPSK Super-Channel Within Fixed ITU-T Grid

Sub-Nyquist time frequency packing technique was demonstrated for the first time in a super channel field trial transmission over long-haul distances. The technique allows a limited spectral occupancy even with low order modulation formats. The transmission was successfully performed on a deployed Australian link between Sydney and Melbourne which included 995 km of uncompensated SMF with coexistent traffic. 40 and 100 Gb/s co-propagating channels were transmitted together with the super-channel in a 50 GHz ITU-T grid without additional penalty. The super-channel consisted of eight sub-channels with low-level modulation format, i.e. DP-QPSK, guaranteeing better OSNR robustness and reduced complexity with respect to higher order formats. At the receiver side, coherent detection was used together with iterative maximum-a-posteriori (MAP) detection and decoding. A 975 Gb/s DP-QPSK super-channel was successfully transmitted between Sydney and Melbourne within four 50GHz WSS channels (200 GHz). A maximum potential SE of 5.58 bit/s/Hz was achieved with an OSNR=15.8 dB, comparable to the OSNR of the installed 100 Gb/s channels. The system reliability was proven through long term measurements. In addition, by closing the link in a loop back configuration, a potential SE*d product of 9254 bit/s/Hz*km was achieved

MorphFace: a hybrid morphable face for a robopatient

Physicians use pain expressions shown in a patient’s face to regulate their palpation methods during physical examination. Training to interpret patients’ facial expressions with different genders and ethnicities still remains a challenge, taking novices a long time to learn through experience. This paper presents MorphFace: a controllable 3D physical-virtual hybrid face to represent pain expressions of patients from different ethnicity-gender backgrounds. It is also an intermediate step to expose trainee physicians to the gender and ethnic diversity of patients. We extracted four principal components from the Chicago Face Database to design a four degrees of freedom (DoF) physical face controlled via tendons to span 85% of facial variations among gender and ethnicity. Details such as skin colour, skin texture, and facial expressions are synthesized by a virtual model and projected onto the 3D physical face via a frontmounted LED projector to obtain a hybrid controllable patient face simulator. A user study revealed that certain differences in ethnicity between the observer and the MorphFace lead to different perceived pain intensity for the same pain level rendered by the MorphFace. This highlights the value of having MorphFace as a controllable hybrid simulator to quantify perceptual differences during physician training

Facial Expression Rendering in Medical Training Simulators: Current Status and Future Directions

Recent technological advances in robotic sensing and actuation methods have prompted development of a range of new medical training simulators with multiple feedback modalities. Learning to interpret facial expressions of a patient during medical examinations or procedures has been one of the key focus areas in medical training. This paper reviews facial expression rendering systems in medical training simulators that have been reported to date. Facial expression rendering approaches in other domains are also summarized to incorporate the knowledge from those works into developing systems for medical training simulators. Classifications and comparisons of medical training simulators with facial expression rendering are presented, and important design features, merits and limitations are outlined. Medical educators, students and developers are identified as the three key stakeholders involved with these systems and their considerations and needs are presented. Physical-virtual (hybrid) approaches provide multimodal feedback, present accurate facial expression rendering, and can simulate patients of different age, gender and ethnicity group; makes it more versatile than virtual and physical systems. The overall findings of this review and proposed future directions are beneficial to researchers interested in initiating or developing such facial expression rendering systems in medical training simulators.This work was supported by the Robopatient project funded by the EPSRC Grant No EP/T00519X/

Low-complexity BCH codes with optimized interleavers for DQPSK systems with laser phase noise

The presence of high phase noise in addition to additive white Gaussian noise in coherent optical systems affects the performance of forward error correction (FEC) schemes. In this paper, we propose a simple scheme for such systems, using block interleavers and binary Bose–Chaudhuri–Hocquenghem (BCH) codes. The block interleavers are specifically optimized for differential quadrature phase shift keying modulation. We propose a method for selecting BCH codes that, together with the interleavers, achieve a target post-FEC bit error rate (BER). This combination of interleavers and BCH codes has very low implementation complexity. In addition, our approach is straightforward, requiring only short pre-FEC simulations to parameterize a model, based on which we select codes analytically. We aim to correct a pre-FEC BER of around (Formula presented.). We evaluate the accuracy of our approach using numerical simulations. For a target post-FEC BER of (Formula presented.), codes selected using our method result in BERs around 3(Formula presented.) target and achieve the target with around 0.2 dB extra signal-to-noise ratio

A realist view of the canonical EPRB experiment based on quantum theory and its consequences

A realist view of the Einstein-Podolsky-Rosen-Bohm experiment with spins based on quantum theory is presented. This view implies that there is no action at a distance. It also implies that the measurement result A (B) for particle 1 (2) depends on both magnet angles, and hence the probability of obtaining the result A (B) also depends on both magnet angles. In light of these realist implications, it is clear that what is wrong at least with local realistic theory is not the locality or no action-at-a-distance assumption itself but rather the formal implementation of that assumption.Comment: To be published in the Journal of Optics B as part of the proceeedings of the Garda 2001 Workshop on Mysteries, Puzzles and Paradoxes in Quantum Mechanic

Consistency equations in Randall-Sundrum cosmology: a test for braneworld inflation

In the context of an inflationary Randall-Sundrum Type II braneworld (RS2) we calculate spectral indices and amplitudes of cosmological scalar and tensor perturbations, up to second order in slow-roll parameters. Under very simple assumptions, extrapolating next-order formulae from first-order calculations in the case of a de Sitter brane, we see that the degeneracy between standard and braneworld lowest-order consistency equations is broken, thus giving different signatures of early-universe inflationary expansion. Using the latest results from WMAP for estimates of cosmological observables, it is shown that future data and missions can in principle discriminate between standard and braneworld scenarios.Comment: 13 pages; v3: supersedes the published version, corrected misprint

Present Status and Future Programs of the n_TOF Experiment

This is an Open Access article distributed under the terms of the Creative Commons Attribution-Noncommercial License 3.0, which permits unrestricted use, distribution, and reproduction in any noncommercial medium, provided the original work is properly citedThe neutron time-of-flight facility n_TOF at CERN, Switzerland, operational since 2001, delivers neutrons using the Proton Synchrotron (PS) 20 GeV/c proton beam impinging on a lead spallation target. The facility combines a very high instantaneous neutron flux, an excellent time of flight resolution due to the distance between the experimental area and the production target (185 meters), a low intrinsic background and a wide range of neutron energies, from thermal to GeV neutrons. These characteristics provide a unique possibility to perform neutron-induced capture and fission cross-section measurements for applications in nuclear astrophysics and in nuclear reactor technology.The most relevant measurements performed up to now and foreseen for the future will be presented in this contribution. The overall efficiency of the experimental program and the range of possible measurements achievable with the construction of a second experimental area (EAR-2), vertically located 20 m on top of the n_TOF spallation target, might offer a substantial improvement in measurement sensitivities. A feasibility study of the possible realisation of the installation extension will be also presented

Assessment of flatness and symmetry of megavoltage x-ray beam with an electronic portal imaging device (EPID)

Copyright © 2002 ACPSEM. All rights reserved. The document attached has been archived with permission from the publisher.The input/output characteristics of the Wellhofer BIS 710 electronic portal imaging device (EPID) have been investigated to establish its efficacy for periodic quality assurance (QA) applications. Calibration curves have been determined for the energy fluence incident on the detector versus the pixel values. The effect of the charge coupled device (CCD) camera sampling time and beam parameters (such as beam field size, dose rate, photon energy) on the calibration have been investigated for a region of interest (ROI) around the central beam axis. The results demonstrate that the pixel output is a linear function of the incident exposure, as expected for a video-based electronic portal imaging system. The field size effects of the BIS 710 are similar to that of an ion chamber for smaller field sizes up to 10 x 10 cm2. However, for larger field sizes the pixel value increases more rapidly. Furthermore, the system is slightly sensitive to dose rate and is also energy dependent. The BIS 710 has been used in the current study to develop a QA procedure for measurements of flatness and symmetry of a linac x-ray beam. As a two-dimensional image of the radiation field is obtained from a single exposure of the BIS 710, a technique has been developed to calculate flatness and symmetry from a defined radiation area. The flatness and symmetry values obtained are different from those calculated conventionally from major axes only (inplane, crossplane). This demonstrates that the technique can pick up the "cold" and "hot" spots in the analysed area, providing thus more information about the radiation beam. When calibrated against the water tank measurements, the BIS 710 can be used as a secondary device to monitor the x-ray beam flatness and symmetry.G. Liu, T. van Doorn and E. Beza

Paraffin-enabled graphene transfer

The transfer process of as-grown graphene limits its electrical performance and reliability. Here, the authors develop a transfer approach using paraffin as a support layer and obtain wrinkle-reduced and clean large-area graphene retaining high mobility