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.

Models to Simulate Effective Coverage of Fire Station Based on Real-Time Travel Times

In recent years,frequent fire disasters have led to enormous damage in China.Effective firefighting rescues can minimize the losses caused by fires.During the rescue processes,the travel time of fire trucks can be severely affected by traffic conditions,changing the effective coverage of fire stations.However,it is still challenging to determine the effective coverage of fire stations considering dynamic traffic conditions.This paper addresses this issue by combining the traveling time calculationmodelwith the effective coverage simulationmodel.In addition,it proposes a new index of total effective coverage area(TECA)based on the time-weighted average of the effective coverage area(ECA)to evaluate the urban fire services.It also selects China as the case study to validate the feasibility of the models,a fire station(FS-JX)in Changsha.FS-JX station and its surrounding 9,117 fire risk points are selected as the fire service supply and demand points,respectively.A total of 196 simulation scenarios throughout a consecutiveweek are analyzed.Eventually,1,933,815 sets of valid sample data are obtained.The results showed that the TECA of FS-JX is 3.27 km^(2),which is far below the standard requirement of 7.00 km^(2) due to the traffic conditions.The visualization results showed that three rivers around FS-JX interrupt the continuity of its effective coverage.The proposed method can provide data support to optimize the locations of fire stations by accurately and dynamically determining the effective coverage of fire stations.

Data-based real-time petrochemical gas diffusion simulation approach on virtual reality

Background Petrochemical products possess a high risk of flammability,explosivity,and toxicity,making petrochemical accidents exceedingly destructive.Therefore,disaster analysis,prediction,and real-time simulations have become important means of controlling and reducing accident hazards.Methods This study proposes a complete real-time simulation solution of gas diffusion with coordinate and concentration data,which was mainly aimed at simulating the types of harmful gas leakage and diffusion accidents in the petrochemical industry.The rendering effect was more continuous and accurate through grid homogenization and trilinear interpolation.This study presents a data processing and rendering parallelization process to enhance simulation efficiency.Gas concentration and fragment transparency were combined to synthesize transparent pixels in a scene.To ensure the approximate accuracy of the rendering effect,improve the efficiency of real-time rendering,and meet the requirement of intuitive perception using concentration data,a weighted blended order-independent transparency(OIT)with enhanced alpha weight is presented,which can provide a more intuitive perception of the hierarchical information of concentration data while preserving depth information.This study compares and analyzes three OIT algorithms-depth peeling,weighted blended OIT,and weighted blended OIT with enhanced alpha weight-in terms of rendering image quality,rendering time,required memory,and hierarchical information.Results Using weighted blended OIT with an enhanced alpha weight technique,the rendering time was shortened by 53.2%compared with that of the depth peeling algorithm,and the texture memory required was significantly smaller than that of the depth peeling algorithm.The rendering results of weighted blended OIT with an enhanced alpha weight were approximately accurate compared with those of the depth peeling algorithm as the ground truth,and there was no popping when surfaces passed through one another.Simultaneously,compared with weighted blended OIT,weighted blended OIT with an enhanced alpha weight achieved an intuitive perception of the hierarchical information of concentration data.

A virtual reality based surgical skills training simulator for catheter ablation with real-time and robust interaction

Background Atrial fibrillation(AF)is the most common sustained cardiac arrhythmia that can cause severe heart problems.Catheter ablation is one of the most ideal procedures for the treatment of AF.Physicians qualified to perform this procedure need to be highly skilled in manipulating the relevant surgical devices.This study proposes an interactive surgical simulator with high fidelity to facilitate efficient training and low-cost medical education.Methods We used a shared centerline model to simulate the interaction between multiple surgical devices.An improved adaptive deviation-feedback approach is proposed to accelerate the convergence of each iteration.The periodical beating of the human heart was also simulated in real time using the position-based dynamics(PBD)framework to achieve higher fidelity.We then present a novel method for handling the interaction between the devices and the beating heart mesh model.Experiments were conducted in a homemade simulator prototype to evaluate the robustness,performance,and flexibility of the proposed method.Preliminary evaluation of the simulator was performed by medical students,residents,and surgeons.Results The interaction between surgical devices,static vascular meshes,and beating heart mesh was stably simulated in a frame rate suitable for interaction.Conclusion Our simulator is capable of simulating the procedure of catheter ablation with high fidelity and provides immersive visual experiences and haptic feedback.

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.

Dynamic constraint and objective generation approach for real-time train rescheduling model under human-computer interaction

Real-time train rescheduling plays a vital role in railway transportation as it is crucial for maintaining punctuality and reliability in rail operations.In this paper,we propose a rescheduling model that incorporates constraints and objectives generated through human-computer interaction.This approach ensures that the model is aligned with practical requirements and daily operational tasks while facilitating iterative train rescheduling.The dispatcher’s empirical knowledge is integrated into the train rescheduling process using a human-computer interaction framework.We introduce six interfaces to dynamically construct constraints and objectives that capture human intentions.By summarizing rescheduling rules,we devise a rule-based conflict detection-resolution heuristic algorithm to effectively solve the formulated model.A series of numerical experiments are presented,demonstrating strong performance across the entire system.Furthermore,theflexibility of rescheduling is enhanced through secondary analysis-driven solutions derived from the outcomes of humancomputer interactions in the previous step.This proposed interaction method complements existing literature on rescheduling methods involving human-computer interactions.It serves as a tool to aid dispatchers in identifying more feasible solutions in accordance with their empirical rescheduling strategies.

On modeling approach for embedded real-time software simulation testing

Modeling technology has been introduced into software testing field. However, how to carry through the testing modeling effectively is still a difficulty. Based on combination of simulation modeling technology and embedded real-time software testing method, the process of simulation testing modeling is studied first. And then, the supporting environment of simulation testing modeling is put forward. Furthermore, an approach of embedded real-time software simulation testing modeling including modeling of cross-linked equipments of system under testing （SUT）, test case, testing scheduling, and testing system service is brought forward. Finally, the formalized description and execution system of testing models are given, with which we can realize real-time, closed loop, mad automated system testing for embedded real-time software.

Simulation of large-scale numerical substructure in real-time dynamic hybrid testing

A solution scheme is proposed in this paper for an existing RTDHT system to simulate large-scale finite element （FE） numerical substructures. The analysis of the FE numerical substructure is split into response analysis and signal generation tasks, and executed in two different target computers in real-time. One target computer implements the response analysis task, wherein a large time-step is used to solve the FE substructure, and another target computer implements the signal generation task, wherein an interpolation program is used to generate control signals in a small time-step to meet the input demand of the controller. By using this strategy, the scale of the FE numerical substructure simulation may be increased significantly. The proposed scheme is initially verified by two FE numerical substructure models with 98 and 1240 degrees of freedom （DOFs）. Thereafter, RTDHTs of a single frame-foundation structure are implemented where the foundation, considered as the numerical substructure, is simulated by the FE model with 1240 DOFs. Good agreements between the results of the RTDHT and those from the FE analysis in ABAQUS are obtained.

A Class of Fast Algorithms in Real-Time Simulation

A class of hybrid algorithms of real-time simulation based on evaluation of non-integerstep right-hand side function are presented in this paper. And some results of the convergence and stability of the algorithms are given. Using the class of algorithms, evaluation for the right-hand side function is needed once in every integration-step. Moreover, comparing with the other methods with the same amount of work, their numerical stability regions are larger and the method errors are smaller, and the numerical experiments show that the algorithms are very effective.

Model-based framework for multi-axial real-time hybrid simulation testing

Real-time hybrid simulation is an efficient and cost-effective dynamic testing technique for performance evaluation of structural systems subjected to earthquake loading with rate-dependent behavior. A loading assembly with multiple actuators is required to impose realistic boundary conditions on physical specimens. However, such a testing system is expected to exhibit significant dynamic coupling of the actuators and suffer from time lags that are associated with the dynamics of the servo-hydraulic system, as well as control-structure interaction （CSI）. One approach to reducing experimental errors considers a multi-input, multi-output （MIMO） controller design, yielding accurate reference tracking and noise rejection. In this paper, a framework for multi-axial real-time hybrid simulation （maRTHS） testing is presented. The methodology employs a real-time feedback-feedforward controller for multiple actuators commanded in Cartesian coordinates. Kinematic transformations between actuator space and Cartesian space are derived for all six-degrees-of- freedom of the moving platform. Then, a frequency domain identification technique is used to develop an accurate MIMO transfer function of the system. Further, a Cartesian-domain model-based feedforward-feedback controller is implemented for time lag compensation and to increase the robustness of the reference tracking for given model uncertainty. The framework is implemented using the 1/5th-scale Load and Boundary Condition Box （LBCB） located at the University of Illinois at Urbana- Champaign. To demonstrate the efficacy of the proposed methodology, a single-story frame subjected to earthquake loading is tested. One of the columns in the fraane is represented physically in the laboratory as a cantilevered steel column. For real- time execution, the numerical substructure, kinematic transformations, and controllers are implemented on a digital signal processor. Results show excellent performance of the maRTHS framework when six-degrees-of-freedom are controUed at the interface between substructures.

Real-Time Hybrid Simulation of Seismically Isolated Structures with Full-Scale Bearings and Large Computational Models

Hybrid simulation can be a cost effective approach for dynamic testing of structural components at full scale while capturing the system level response through interactions with a numerical model.The dynamic response of a seismically isolated structure depends on the combined characteristics of the ground motion,bearings,and superstructure.Therefore,dynamic full-scale system level tests of isolated structures under realistic dynamic loading conditions are desirable towards a holistic validation of this earthquake protection strategy.Moreover,bearing properties and their ultimate behavior have been shown to be highly dependent on rate-of-loading and scale size effects,especially under extreme loading conditions.Few laboratory facilities can test full-scale seismic isolation bearings under prescribed displacement and/or loading protocols.The adaptation of a full-scale bearing test machine for the implementation of real-time hybrid simulation is presented here with a focus on the challenges encountered in attaining reliable simulation results for large scale dynamic tests.These advanced real-time hybrid simulations of large and complex hybrid models with several thousands of degrees of freedom are some of the first to use high performance parallel computing to rapidly execute the numerical analyses.Challenges in the experimental setup included measured forces contaminated by delay and other systematic control errors in applying desired displacements.Friction and inertial forces generated by the large-scale loading apparatus can affect the accuracy of measured force feedbacks.Reliable results from real-time hybrid simulation requires implementation of compensation algorithms and correction of these various sources of errors.Overall,this research program confirms that real-time hybrid simulation is a viable testing method to experimentally assess the behavior of full-scale isolators while capturing interactions with the numerical models of the superstructure to evaluate system level and in-structure response.

Control performance comparison between tuned liquid damper and tuned liquid column damper using real-time hybrid simulation

Tuned liquid damper (TLD) and tuned liquid column damper (TLCD) are two types of passive control devices that are widely used in structural control. In this study, a real-time hybrid simulation (RTHS) technique is employed to investigate the diff erence in control performance between TLD and TLCD. A series of RTHSs is presented with the premise of the same liquid length, mass ratio, and structural parameters. Herein, TLD and TLCD are physically experimented, and controlled structures are numerically simulated. Then, parametric studies are performed to further evaluate the diff erent performance between TLD and TLCD. Experimental results demonstrate that TLD is more eff ective than TLCD under diff erent amplitude excitations.

A Class of Parallel Algorithms of Real-TimeNumerical Simulation for Stiff Dynamic System

In this paper a class of real-time parallel modified Rosenbrock methods of numerical simulation is constructed for stiff dynamic systems on a multiprocessor system, and convergence and numerical stability of these methods are discussed. A-stable real-time parallel formula of two-stage third-order and A(α)-stable real-time parallel formula with o ≈ 89.96° of three-stage fourth-order are particularly given. The numerical simulation experiments in parallel environment show that the class of algorithms is efficient and applicable, with greater speedup.

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.

Analysis of actuator delay and its effect on uncertainty quantification for real-time hybrid simulation

Uncertainties in structure properties can result in different responses in hybrid simulations. Quantification of the effect of these tmcertainties would enable researchers to estimate the variances of structural responses observed from experiments. This poses challenges for real-time hybrid simulation （RTHS） due to the existence of actuator delay. Polynomial chaos expansion （PCE） projects the model outputs on a basis of orthogonal stochastic polynomials to account for influences of model uncertainties. In this paper, PCE is utilized to evaluate effect of actuator delay on the maximum displacement from real-time hybrid simulation of a single degree of freedom （SDOF） structure when accounting for uncertainties in structural properties. The PCE is first applied for RTHS without delay to determine the order of PCE, the number of sample points as well as the method for coefficients calculation. The PCE is then applied to RTHS with actuator delay. The mean, variance and Sobol indices are compared and discussed to evaluate the effects of actuator delay on uncertainty quantification for RTHS. Results show that the mean and the variance of the maximum displacement increase linearly and exponentially with respect to actuator delay, respectively. Sensitivity analysis through Sobol indices also indicates the influence of the single random variable decreases while the coupling effect increases with the increase of actuator delay.

Restoring force correction based on online discrete tangent stiffness estimation method for real-time hybrid simulation

In real-time hybrid simulation（RTHS）, it is difficult if not impossible to completely erase the error in restoring force due to actuator response delay using existing displacement-based compensation methods. This paper proposes a new force correction method based on online discrete tangent stiffness estimation（online DTSE） to provide accurate online estimation of the instantaneous stiffness of the physical substructure. Following the discrete curve parameter recognition theory, the online DTSE method estimates the instantaneous stiffness mainly through adaptively building a fuzzy segment with the latest measurements, constructing several strict bounding lines of the segment and calculating the slope of the strict bounding lines, which significantly improves the calculation efficiency and accuracy for the instantaneous stiffness estimation. The results of both computational simulation and real-time hybrid simulation show that：（1） the online DTSE method has high calculation efficiency, of which the relatively short computation time will not interrupt RTHS; and（2） the online DTSE method provides better estimation for the instantaneous stiffness, compared with other existing estimation methods. Due to the quick and accurate estimation of instantaneous stiffness, the online DTSE method therefore provides a promising technique to correct restoring forces in RTHS.

SPACEBORNE SAR REAL-TIME ECHO SIMULATION PLATFORM BASED ON VPX

To perform the ground test of a spaceborne Synthetic Aperture Radar(SAR) system, an echo simulator with the characteristics of multimode, multi-assemblage, and real time is proposed in this paper. A hardware platform of the real-time echo simulator based on the VPX bus is designed. With this platform, real-time multi-point echo generation and scenario targets echo generation can be achieved by the real-time signal processing in Field Programmable Gate Array(FPGA), utilizing the parameters calculated by the industry computers. Furthermore, this platform can output different signals if it is expanded to multi-channels, making it possible for the assignment of echo generation and test in different spaceborne SAR modes. The test results with the actual SAR system show that this platform can satisfy the system requirements and is now used in practice.