Simulation Training for Laparoscopic Surgery Can Improve Minimally Invasive Surgical Techniques for Interns and Probationers

Objective: The clinical clerkship and practice stage plays a pivotal role in the transition of medical students from theoretical knowledge to practical application, bridging the gap between classroom learning and real-life clinical experience. In order to improve the teaching quality of interns and probationers, we try to let them practice the skills of laparoscopic surgery in the early stage, and summed up a set of evaluation methods that can be widely used in medical education. Methods: From September 2019 to December 2019, a total of 54 interns and 72 trainees were selected as research objects. They were assigned to training sessions and their proficiency was assessed before and after the training. The change in proficiency is compared to determine whether the training course is valuable. Results: Before the operation training, the interns scores were BP 17.3 3.1, CC 17.9 3.4, KT 16.4 3.4, LS 16.7 3.3. The results of probationers were BP 16.9 2.7, CC 16.8 2.8, KT 15.2 1.6, and LS 14.8 2.2. After completing the operations training, the results of interns were BP 21.1 1.9, CC 20.6 2.7, KT 19.6 3.0, and LS 20.9 1.4. The probationers scores were BP 19.3 3.2, CC 19.6 3.5, KT 19.6 2.6, and LS 20.0 2.4. After the operation training, the performance of the intern group was better than that before the training (P < 0.05). The same is true of the probationer group. The time-consuming intern examinations were BP 147.9 38.5 s, CC 123.2 28.7 s, KT 82.6 24.1 s and LS 162.5 31.1 s. The examination time of probationers were BP 179.9 46.4 s, CC 132.1 24.3 s, KT 109.3 27.5 s and LS 210.0 58.8 s. Conclusion: Simulation training for laparoscopic surgery can improve minimally invasive surgical techniques for interns and probationers.

Research on the Dual-Creation Talent Training Model of New Energy Automobile Based on Virtual Simulation

At present,as China vigorously develops new energy automobiles,the social demand for related talents has increased significantly,so the relevant institutions need to optimize and adjust the talent training mode to help the development of new energy automobiles.This paper summarizes the existing problems of China’s new energy automobile talent training mode,and analyzes the significance of the virtual simulation-based dual-creation talent training mode of new energy automobile and its specific implementation strategies,in order to provide references for the relevant personnel.

Transurethral resection of bladder tumor: A systematic review of simulator-based training courses and curricula

Objective:Transurethral resection of bladder tumor is one of the most common everyday urological procedures.This kind of surgery demands a set of skills that need training and experience.In this review,we aimed to investigate the current literature to find out if simulators,phantoms,and other training models could be used as a tool for teaching urologists.Methods:A systematic review was performed according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses statement and the recommendations of the European Association of Urology guidelines for conducting systematic reviews.Fifteen out of 932 studies met our inclusion criteria and are presented in the current review.Results:The UroTrainer(Karl Storz GmbH,Tuttlingen,Germany),a virtual reality training simulator,achieved positive feedback and an excellent face and construct validity by the participants.The inspection of bladder mucosa,blood loss,tumor resection,and procedural time was improved after the training,especially for inexperienced urologists and medical students.The construct validity of UroSim®(VirtaMed,Zurich,Switzerland)was established.SIMBLA simulator(Samed GmbH,Dresden,Germany)was found to be a realistic and useful tool by experts and urologists with intermediate experience.The test objective competency model based on SIMBLA simulator could be used for evaluating urologists.The porcine model of the Asian Urological Surgery Training and Education Group also received positive feedback by the participants that tried it.The Simulation and Technology Enhanced Learning Initiative Project had an extraordinary face and content validity,and 60%of participants would like to use the simulators in the future.The 5-day multimodal training curriculum“Boot Camp”in the United Kingdom achieved an increase of the level of confidence of the participants that lasted months after the project.Conclusion:Simulators and courses or curricula based on a simulator training could be a valuable learning tool for any surgeon,and there is no doubt that they should be a part of every urologist's technical education.

Numerical simulation of three-dimensional fracturing fracture propagation in radial wells

A fracture propagation model of radial well fracturing is established based on the finite element-meshless method.The model considers the coupling effect of fracturing fluid flow and rock matrix deformation.The fracture geometries of radial well fracturing are simulated,the induction effect of radial well on the fracture is quantitatively characterized,and the influences of azimuth,horizontal principle stress difference,and reservoir matrix permeability on the fracture geometries are revealed.The radial wells can induce the fractures to extend parallel to their axes when two radial wells in the same layer are fractured.When the radial wells are symmetrically distributed along the direction of the minimum horizontal principle stress with the azimuth greater than 15,the extrusion effect reduces the fracture length of radial wells.When the radial wells are symmetrically distributed along the direction of the maximum horizontal principal stress,the extrusion increases the fracture length of the radial wells.The fracture geometries are controlled by the rectification of radial borehole,the extrusion between radial wells in the same layer,and the deflection of the maximum horizontal principal stress.When the radial wells are distributed along the minimum horizontal principal stress symmetrically,the fracture length induced by the radial well decreases with the increase of azimuth;in contrast,when the radial wells are distributed along the maximum horizontal principal stress symmetrically,the fracture length induced by the radial well first decreases and then increases with the increase of azimuth.The fracture length induced by the radial well decreases with the increase of horizontal principal stress difference.The increase of rock matrix permeability and pore pressure of the matrix around radial wells makes the inducing effect of the radial well on fractures increase.

Three-Dimensional Simulation of Hydrodynamic Mechanism of Fluidized Bed Methanation

Organic solid waste(OSW)contains many renewable materials.The pyrolysis and gasification of OSW can realize resource utilization,and its products can be used for methanation reaction to produce synthetic natural gas in the specific reactor.In order to understand the dynamic characteristics of the reactor,a three-dimensional numerical model has been established by the method of Computational Fluid Dynamics(CFD).Along the height of the reactor,the particle distribution in the bed becomes thinner and the mean solid volume fraction decreases from 4.18%to 0.37%.Meanwhile,the pressure fluctuation range decreased from 398.76 Pa at the entrance to a much lower value of 74.47 Pa at the exit.In this simulation,three parameters of gas inlet velocity,operating temperature and solid particle diameter are changed to explore their influences on gas-solid multiphase flow.The results show that gas velocity has a great influence on particle distribution.When the gas inlet velocity decreases from 6.51 to 1.98 m/s,the minimum height that particles can reach decreases from 169 to 100 mm.Additionally,as the operating temperature increases,the particle holdup inside the reactor changes from 0.843%to 0.700%.This indicates that the particle residence time reduces,which is not conducive to the follow-up reaction.Moreover,with the increase of particle size,the fluctuation range of the pressure at the bottom of the reactor increases,and its standard deviation increases from 55.34 to 1266.37 Pa.

Training image analysis for three-dimensional reconstruction of porous media

In order to obtain a better sandstone three-dimensional （3D） reconstruction result which is more similar to the original sample, an algorithm based on stationarity for a two-dimensional （2D） training image is proposed. The second-order statistics based on texture features are analyzed to evaluate the scale stationarity of the training image. The multiple-point statistics of the training image are applied to obtain the multiple-point statistics stationarity estimation by the multi-point density function. The results show that the reconstructed 3D structures are closer to reality when the training image has better scale stationarity and multiple-point statistics stationarity by the indications of local percolation probability and two-point probability. Moreover, training images with higher multiple-point statistics stationarity and lower scale stationarity are likely to obtain closer results to the real 3D structure, and vice versa. Thus, stationarity analysis of the training image has far-reaching significance in choosing a better 2D thin section image for the 3D reconstruction of porous media. Especially, high-order statistics perform better than low-order statistics.

Dynamic simulation insights into friction weakening effect on rapid long-runout landslides:A case study of the Yigong landslide in the Tibetan Plateau,China

This study proposed a novel friction law dependent on velocity,displacement and normal stress for kinematic analysis of runout process of rapid landslides.The well-known Yigong landslide occurring in the Tibetan Plateau of China was employed as the case,and the derived dynamic friction formula was included into the numerical simulation based on Particle Flow Code.Results showed that the friction decreased quickly from 0.64(the peak)to 0.1(the stead value)during the 5s-period after the sliding initiation,which explained the behavior of rapid movement of the landslide.The monitored balls set at different sections of the mass showed similar variation characteritics regarding the velocity,namely evident increase at the initial phase of the movement,followed by a fluctuation phase and then a stopping one.The peak velocity was more than 100 m/s and most particles had low velocities at 300s after the landslide initiation.The spreading distance of the landslide was calculated at the two-dimension(profile)and three-dimension scale,respectively.Compared with the simulation result without considering friction weakening effect,our results indicated a max distance of about 10 km from the initial unstable position,which fit better with the actual situation.

Research on the Design and Application of Virtual and Real Integrated Training Platform Based on Intelligent Manufacturing

In this paper,we built a robot training platform using virtual simulation software,and the robot assembly,handling,and palletizing were realized.The workstation includes an industrial robot,gas control unit,track function module,assembly function module,palletizing function module,vision module,etc.,and robot movement is achieved through language programming.The platform provides conditions for the practical ability training of application-oriented talents.

Virtual reality tools for training in gastrointestinal endoscopy:A systematic review

BACKGROUND Virtual reality(VR)has emerged as an innovative technology in endoscopy training,providing a simulated environment that closely resembles real-life scenarios and offering trainees a valuable platform to acquire and enhance their endoscopic skills.This systematic review will critically evaluate the effectiveness and feasibility of VR-based training compared to traditional methods.AIM To evaluate the effectiveness and feasibility of VR-based training compared to traditional methods.By examining the current state of the field,this review seeks to identify gaps,challenges,and opportunities for further research and implementation of VR in endoscopic training.METHODS The study is a systematic review,following the guidelines for reporting systematic reviews set out by the PRISMA statement.A comprehensive search command was designed and implemented and run in September 2023 to identify relevant studies available,from electronic databases such as PubMed,Scopus,Cochrane,and Google Scholar.The results were systematically reviewed.RESULTS Sixteen articles were included in the final analysis.The total number of participants was 523.Five studies focused on both upper endoscopy and colonoscopy training,two on upper endoscopy training only,eight on colonoscopy training only,and one on sigmoidoscopy training only.Gastrointestinal Mentor virtual endoscopy simulator was commonly used.Fifteen reported positive results,indicating that VR-based training was feasible and acceptable for endoscopy learners.VR technology helped the trainees enhance their skills in manipulating the endoscope,reducing the procedure time or increasing the technical accuracy,in VR scenarios and real patients.Some studies show that the patient discomfort level decreased significantly.However,some studies show there were no significant differences in patient discomfort and pain scores between VR group and other groups.CONCLUSION VR training is effective for endoscopy training.There are several well-designed randomized controlled trials with large sample sizes,proving the potential of this innovative tool.Thus,VR should be more widely adopted in endoscopy training.Furthermore,combining VR training with conventional methods could be a promising approach that should be implemented in training.

Three-Dimensional and Cross-sectional Characteristics of Normal Grain Growth Based on Monte Carlo Simulation

An appropriate Monte Carlo method was developed to simulate the three-dimensional normal grain growth more completely. Comparative investigation on the three-dimensional and the cross-sectional characteristics of normal grain growth was done. It was found that the time exponent of grain growth determined from cross-section exhibits the same rule of increasing slowly with time and approaching the theoretical value n = 0.5 of steadygrain growth as the three-dimensional (3-D) system. From change of the number of grains per unit area with timemeasured in cross-section, the state of 3-D normal grain growth may be predicted. The gtain size distribution incross-section is different from that in 3-D system and can not express the evolution characteristic of the 3-D distribution. Furthermore, there exists statistical connection between the topological parameters in cross-section and thosein three-dimensions.

Interactive plant simulation modeling for developing an operator training system in a natural gas pressure-regulating station

This study proposes a method of interactive plant simulation modeling which delivers the online simulated results to the field operators and induces them to take proper actions in the case of pre-identified accident scenarios in a chemical plant. The developed model integrates the real-time process dynamic simulation with 3DCFD accident simulation in a designed interface using object linking and embedding technology so that it can convey to trainees the online information of the accident which is not available in existing operator training systems.The model encompasses the whole process of data transfer till the end of the training at which a trainee operates an emergency shutdown system in a programmed model. In this work, an overall scenario is simulated which is from an abnormal increase in the main valve discharge（second）pressure due to valve malfunction to accidental gas release through the crack of a pressure recorder, and the magnitude of the accident with respect to the lead time of each trainee＇s emergency response is analyzed. The model can improve the effectiveness of the operator training system through interactively linking the trainee actions with the simulation model resulting in different accident scenarios with respect to each trainee＇s competence when facing an accident.

Three-dimensional visualization and virtual reality simulation role in hepatic surgery:Further research warranted

Artificial intelligence(AI)is the study of algorithms that enable machines to analyze and execute cognitive activities including problem solving,object and word recognition,reduce the inevitable errors to improve the diagnostic accuracy,and decision-making.Hepatobiliary procedures are technically complex and the use of AI in perioperative management can improve patient outcomes as discussed below.Three-dimensional(3D)reconstruction of images obtained via ultrasound,computed tomography scan or magnetic resonance imaging,can help surgeons better visualize the surgical sites with added depth perception.Preoperative 3D planning is associated with lesser operative time and intraoperative complications.Also,a more accurate assessment is noted,which leads to fewer operative complications.Images can be converted into physical models with 3D printing technology,which can be of educational value to students and trainees.3D images can be combined to provide 3D visualization,which is used for preoperative navigation,allowing for more precise localization of tumors and vessels.Nevertheless,AI enables surgeons to provide better,personalized care for each patient.

Three-Dimensional Finite Element Numerical Simulation and Physical Experiment for Magnetism-Stress Detecting in Oil Casing

The casing damage has been a big problem in oilfield production. The current detection methods mostly are used after casing damage, which is not very effective. With the rapid development of China's offshore oil industry, the number of offshore oil wells is becoming larger and larger. Because the cost of offshore oil well is very high, the casing damage will cause huge economic losses. What's more, it can also bring serious pollution to marine environment. So the effective methods of detecting casing damage are required badly. The accumulation of stress is the main reason for the casing damage. Magnetic anisotropy technique based on counter magnetostriction effect can detect the stress of casing in real time and help us to find out the hidden dangers in time. It is essential for us to prevent the casing damage from occurring. However, such technique is still in the development stage. Previous studies mostly got the relationship between stress and magnetic signals by physical experiment, and the study of physical mechanism in relative magnetic permeability connecting the stress and magnetic signals is rarely reported. The present paper uses the ANSYS to do the three-dimensional finite element numerical simulation to study how the relative magnetic permeability works for the oil casing model. We find that the quantitative relationship between the stress' s variation and magnetic induction intensity's variation is: Δδ =K* ΔB, K = 8.04×109, which is proved correct by physical experiment.

The Research and Development of Integrated Operation-Maintenance Simulation Training System

With deep development of state grid’s system of "Three Sets of Five [1]", China is in urgent need of establishing an appropriate type of simulation system to rapidly improve operation efficiency and the level of maintainers, which aim at the integrated operation of substation operation and maintenance service. This article gives an introduction of a simulation training system which is designed for operation-skills training in electrical systems. By the composition of the multiple subjects and skills training for operations staff, this system can provide human guarantee and intellectual support for the "Big-Centralized Overhal".

Three-dimensional discrete element numerical simulation of Paleogene salt structures in the western Kuqa foreland thrust belt

Taking the Paleogene salt strata in the west of Kuqa foreland thrust belt as study object, the deformation features of salt structure in the compression direction and perpendicular to the compression direction were examined to find out the control factors and formation mechanisms of the salt structures. By using the three-dimensional discrete element numerical simulation method, the formation mechanisms of typical salt structures of western Kuqa foreland thrust belt in Keshen and Dabei work areas were comprehensively analyzed. The simulation results show that the salt deformation in Keshen and Dabei work areas is of forward spread type, with deformation concentrated in the piedmont zone;the salt deformation is affected by the early uplift near the compression end, pre-existing basement faults, synsedimentary process and the initial salt depocenter;in the direction perpendicular to the compression direction, salt rocks near the compression end have strong lateral mobility with the velocity component moving towards the middle part, and the closer to the middle, the larger the velocity will be, so that salt rocks will aggregate towards the middle and deform intensely, forming complex folds and separation of salt structures from salt source, and local outcrop with thrust faults. Compared with 2 D simulation, 3 D simulation can analyze salt structures in the principal stress direction and direction perpendicular to the principal stress, give us a full view of the formation mechanisms of salt structures, and guide the exploration of oil and gas reservoirs related to salt structures.

Understanding the effects of structured self-assessment in directed,self-regulated simulation-based training of mastoidectomy:A mixed methods study

Objective:Self-directed training represents a challenge in simulation-based training as low cognitive effort can occur when learners overrate their own level of performance.This study aims to explore the mechanisms underlying the positive effects of a structured self-assessment intervention during simulation-based training of mastoidectomy.Methods:A prospective,educational cohort study of a novice training program consisting of directed,self-regulated learning with distributed practice(5x3 procedures)in a virtual reality temporal bone simulator.The intervention consisted of structured self-assessment after each procedure using a rating form supported by small videos.Semi-structured telephone interviews upon completion of training were conducted with 13 out of 15 participants.Interviews were analysed using directed content analysis and triangulated with quantitative data on secondary task reaction time for cognitive load estimation and participants’self-assessment scores.Results:Six major themes were identified in the interviews:goal-directed behaviour,use of learning supports for scaffolding of the training,cognitive engagement,motivation from self-assessment,selfassessment bias,and feedback on self-assessment(validation).Participants seemed to self-regulate their learning by forming individual sub-goals and strategies within the overall goal of the procedure.They scaffolded their learning through the available learning supports.Finally,structured self-assessment was reported to increase the participants’cognitive engagement,which was further supported by a quantitative increase in cognitive load.Conclusions:Structured self-assessment in simulation-based surgical training of mastoidectomy seems to promote cognitive engagement and motivation in the learning task and to facilitate self-regulated learning.

Development of student simulated patient training and evaluation indicators in a high-fidelity nursing simulation:a Delphi consensus study

Objective:This study is aimed to develop student simulated patient(SSP)training content and evaluation indicators,and further explores their validity and reliabilities.Methods:Delphi consultations with 20 nursing exper ts were conducted.The weights of indicators were calculated through the analytic hierarchy process.SSP training was conducted with a high-fidelity nursing simulation.Results:The expert positive coefficients were 0.952 in the first round consultation and 1.00 in the second round consultation.The expert authority coefficient was reported as 0.87.The training included role and responsibility of simulated patient(SP),script interpretation,plot performance,and training for a rater,with a total of 17 indicators.SSP evaluation consisted of disease knowledge,role portrayal,and performance fidelity and since being a rater,it consists of 20 indicators in total.The coordination coefficients of two rounds of consultation ranged from 0.530 to 0.918.The content validity of SSP evaluation indicators was 0.95.The inter-rater reliability was repor ted as 0.866,and the internal consistency established using Cronbach’sαwas 0.727.Conclusions:Students as SPs should have first-hand knowledge and experience within the simulated scenarios.SSP training content and evaluation indicators were determined through the Delphi consensus combined with analytic hierarchy process.The evaluation indicators were valid and reliable,and provided the objective and quantifiable measurements for SSP training in nursing。

THE SYSTEM SIMULATION OF THREE-DIMENSIONAL RADAR

To provide a test platform for Electronic Warfare (EW) system, it is needed to simulate the radar received Intermediate Frequency (IF) signals and radar system functions.This letter gives a description of a radar system simulation software developed for frequencyphase scanning three-dimensional (3-D) radar. Experimental results prove that the software could be used for system evaluation and for training purposes as an attractive alternative to real EW system.

Three-Dimensional Simulations of RESET Operation in Phase-Change Random Access Memory with Blade-Type Like Phase Change Layer by Finite Element Modeling

An optimized device structure for reducing the RESET current of phase-change random access memory （PCRAM） with blade-type like （BTL） phase change layer is proposed. The electrical thermal analysis of the BTL cell and the blade heater contactor structure by three-dimensional finite element modeling are compared with each other during RESET operation. The simulation results show that the programming region of the phase change layer in the BTL cell is much smaller, and thermal electrical distributions of the BTL cell are more concentrated on the TiN/GST interface. The results indicate that the BTL cell has the superiorities of increasing the heating efficiency, decreasing the power consumption and reducing the RESET current from 0.67mA to 0.32mA. Therefore, the BTL cell will be appropriate for high performance PCRAM device with lower power consumption and lower RESET current.

Virtual reality simulation in training endoscopic skills: A systematic review

Objective:Training young physicians in gastrointestinal endoscopy through virtual reality(VR)simulators has become popular.It is important to evaluate the benefits and usefulness of this technology for teaching endoscopic skills.The objective of this literature review is to understand the benefits of VR technology through quantitative and qualitative examination of learning outcomes.Methods:A literature search of 7 databases was conducted.Studies which compared the effects of learning through VR simulation and another method of learning were included.In addition,studies were included if they evaluated learning outcomes on clinical patients.Participants could be medical residents,fellows,physicians,or nurses.Common outcomes measured across studies included subjective overall performance scores,total procedure times,rate of successful procedure completion,error rates,patient pain or discomfort,and measures of independence.Results:A total of 22 studies were included.Overall,VR simulation training was seen to be comparable or significantly better than clinical training,no training,other types of simulation,and another form of VR training.Many authors reported increasing patient safety,reducing stress and time constraints,and shortening the learning curve as advantages of VR simulation training.However,this form of training is also expensive and may result in the learning of bad habits.Conclusion:VR simulation technology can be a valuable form of educating endoscopy novices if properly supervised during training,and if there is also integration of clinical training.