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In this article, the development of a software system—a simulator for testing software systems using a binary protocol—is proposed. The purpose of the development is to achieve full testing of a wide class of software systems. They are directly related to the management of hardware systems, with which communication is based on a binary protocol. The developed simulator allows different types of messages to be simulated during real communication. In this way, it is possible to check how a given program system would react to correct and incorrect messages in the communication stage. This article presents a GUI system developed in the standard C++ programming language and the Qt platform, which makes it platform-independent. The system provides the ability to select preset commands via an external file or enter/correct commands in real-time. The commands may be different depending on the integration scope of the binary protocol. The connection between the developed simulator and the tested system is through RS 232 interface. Configuring settings and testing binary protocols through the developed application becomes fast and intuitive. [ABSTRACT FROM AUTHOR]

Abstract Background Robotic-assisted complete mesocolic excision is an advanced procedure mainly because of the great variability in anatomy. Phantoms can be used for simulation-based training and assessment of competency when learning new surgical procedures. However, no phantoms for robotic complete mesocolic excision have previously been described. This study aimed to develop an anatomically true-to-life phantom, which can be used for training with a robotic system situated in the clinical setting and can be used for the assessment of surgical competency. Methods Established pathology and surgical assessment tools for complete mesocolic excision and specimens were used for the phantom development. Each assessment item was translated into an engineering development task and evaluated for relevance. Anatomical realism was obtained by extracting relevant organs from preoperative patient scans and 3D printing casting moulds for each organ. Each element of the phantom was evaluated by two experienced complete mesocolic excision surgeons without influencing each other’s answers and their feedback was used in an iterative process of prototype development and testing. Results It was possible to integrate 35 out of 48 procedure-specific items from the surgical assessment tool and all elements from the pathological evaluation tool. By adding fluorophores to the mesocolic tissue, we developed an easy way to assess the integrity of the mesocolon using ultraviolet light. The phantom was built using silicone, is easy to store, and can be used in robotic systems designated for patient procedures as it does not contain animal-derived parts. Conclusions The newly developed phantom could be used for training and competency assessment for robotic-assisted complete mesocolic excision surgery in a simulated setting.

Background: Robotic-assisted complete mesocolic excision is an advanced procedure mainly because of the great variability in anatomy. Phantoms can be used for simulation-based training and assessment of competency when learning new surgical procedures. However, no phantoms for robotic complete mesocolic excision have previously been described. This study aimed to develop an anatomically true-to-life phantom, which can be used for training with a robotic system situated in the clinical setting and can be used for the assessment of surgical competency. Methods: Established pathology and surgical assessment tools for complete mesocolic excision and specimens were used for the phantom development. Each assessment item was translated into an engineering development task and evaluated for relevance. Anatomical realism was obtained by extracting relevant organs from preoperative patient scans and 3D printing casting moulds for each organ. Each element of the phantom was evaluated by two experienced complete mesocolic excision surgeons without influencing each other's answers and their feedback was used in an iterative process of prototype development and testing. Results: It was possible to integrate 35 out of 48 procedure-specific items from the surgical assessment tool and all elements from the pathological evaluation tool. By adding fluorophores to the mesocolic tissue, we developed an easy way to assess the integrity of the mesocolon using ultraviolet light. The phantom was built using silicone, is easy to store, and can be used in robotic systems designated for patient procedures as it does not contain animal-derived parts. Conclusions: The newly developed phantom could be used for training and competency assessment for robotic-assisted complete mesocolic excision surgery in a simulated setting. [ABSTRACT FROM AUTHOR]

In this article, the development of a software system—a simulator for testing software systems using a binary protocol—is proposed. The purpose of the development is to achieve full testing of a wide class of software systems. They are directly related to the management of hardware systems, with which communication is based on a binary protocol. The developed simulator allows different types of messages to be simulated during real communication. In this way, it is possible to check how a given program system would react to correct and incorrect messages in the communication stage. This article presents a GUI system developed in the standard C++ programming language and the Qt platform, which makes it platform-independent. The system provides the ability to select preset commands via an external file or enter/correct commands in real-time. The commands may be different depending on the integration scope of the binary protocol. The connection between the developed simulator and the tested system is through RS 232 interface. Configuring settings and testing binary protocols through the developed application becomes fast and intuitive.

Modern ships are complex energy systems containing a large number of different elements. Each of these elements is simulated separately. Since all these models form a single system (ship), they are interdependent. The operating modes of some systems influence others, but at the same time, the work of all the systems should be aimed at fulfilling the basic functions of the ship. The work proposes a methodological approach to combining various systems of ships into a single complex model. This model allows combining models of ship systems of various levels (microlevel, macrolevel, metalevel, megalevel). The work provides examples of models of such multi-level energy systems. These are energy systems composed of an electric generator, a diesel engine, a propeller shaft, and algorithms used for operating the common parts of the ship's electric power system and a piston wear process. Analytical, structural, numerical, and object-oriented models were made for these objects. Each of these particular models describes a limited class of problems, has characteristic properties, and a mathematical structure. The work shows how particular models can be interconnected using a set-theoretic description. Particular models are combined into macrolevel models, whose output parameters are quantities that are by no means related. The macrolevel models are interrelated using control models. Control models belong to the metalevel and allow for assigning settings and response thresholds to algorithms used in automation systems. Such a model (megalevel model) allows, ultimately, investigating the dynamics of the entire system as a whole and managing it. [ABSTRACT FROM AUTHOR]

Study Design: Prospective comparative study. Objective: To quantify the educational benefit to surgical trainees of using a high-fidelity simulator to perform minimally invasive (MIS) unilateral laminotomy for bilateral decompression (ULBD) for lumbar stenosis. Methods: Twelve orthopedic and neurologic surgery residents performed three MIS ULBD procedures over 2 weeks on a simulator guided by established AO Spine metrics. Video recording of each surgery was rated by three blinded, independent experts using a global rating scale. The learning curve was evaluated with attention to technical skills, skipped steps, occurrence of errors, and timing. A knowledge gap analysis evaluating participants' current vs desired ability was performed after each trial. Results: From trial 1 to 3, there was a decrease in average procedural time by 31.7 minutes. The cumulative number of skipped steps and surgical errors decreased from 25 to 6 and 24 to 6, respectively. Overall surgical proficiency improved as indicated by video rating of efficiency and smoothness of surgical maneuvers, most notably with knowledge and handling of instruments. The greatest changes were noted in junior rather than senior residents. Average knowledge gap analysis significantly decreased by 30% from the first to last trial (P =.001), signifying trainees performed closer to their desired technical goal. Conclusion: Procedural metrics for minimally invasive ULBD in combination with a realistic surgical simulator can be used to improve the skills and confidence of trainees. Surgical simulation may offer an important educational complement to traditional methods of skill acquisition and should be explored further with other MIS techniques. [ABSTRACT FROM AUTHOR]

Serverless computing is a new way of delivering cloud services that abstracts a user from the burden of managing resources and infrastructure. Although a few serverless simulators have been developed, they do not compare to services that are offered by commercial providers. Developing a comprehensive serverless simulation framework is essential towards evaluating scenarios reliant on the serverless paradigm. This paper focuses on introducing a serverless computing model to the DIScrete event baSed Energy Consumption simulaTor for Clouds and Federations (DISSECT-CF) simulator to enable simulating realistic function-as-a-service (FaaS) solutions. This new model is capable of imitating serverless providers in terms of cost model, associating triggers, extracting performance metrics, and customising the configurations of functions. [ABSTRACT FROM AUTHOR]

Training with real patients is a critical aspect of the learning and growth of doctors in training. However, this essential step in the educational process for clinicians can potentially compromise patient safety, as they may not be adequately prepared to handle real-life situations independently. Clinical simulators help to solve this problem by providing real-world scenarios in which the physicians can train and gain confidence by safely and repeatedly practicing different techniques. In addition, obtaining objective feedback allows subsequent debriefing by analysing the situation experienced and learning from other people's mistakes. This article presents SIMUNEO, a neonatal simulator in which professionals are able to learn by practicing the management of lung ultrasound and the resolution of pneumothorax and thoracic effusions. The article also discusses in detail the hardware and software, the main components that compose the system, and the communication and implementation of these. The system was validated through both usability questionnaires filled out by neonatology residents as well as through follow-up sessions, improvement, and control of the system with specialists of the department. Results suggest that the environment is easy to use and could be used in clinical practice to improve the learning and training of students as well as the safety of patients. [ABSTRACT FROM AUTHOR]

Objective To develop a low-cost simulator model and a colonoscope with materials that are easily accessible to offer training on colonoscopy skills during undergraduate studies. Since this is the procedure of choice for colorectal cancer screening, the general practitioner must be able to recognize its main indications, preparation, and complications. Methods Using materials such as a mannequin, a vehicle inspection camera, a conduit, polyvinyl chloride (PVC) pipe, acrylic, wood, and red paint, we built a simulator and a 150-cm long and 20-to-25-mm thick colonoscope. The colonoscope's handle and handhold were made of acrylic, the colonoscope's mobile end was made with articulated PVC rings, and the up and down movements were performed according to the traction of the steel cables. The camera attached to its distal end enables connection to a smartphone to view the image. In the simulator, the conduit was inserted into the mannequin to simulate the curvatures of the colon. Red spray paint was used to simulate the staining of the colonic mucosa in the inner region of the mannequin and the adventitial layer in the outer region. Results We were able to build a simulator and a colonoscope with a total amount of R$ 182.82 (roughly US$ 36.50). Both were tested and proved to be useful in the acquisition of psychomotor and cognitive skills in colonoscopy. Conclusion The simulator and colonoscope developed by us are cost-effective, useful in the acquisition of psychomotor and cognitive skills in colonoscopy, and can facilitate the structuring of a training program for undergraduate students.

Purpose: Simulators for pedicle screws placement range from basic sawbones to virtual reality. Yet, they remain expensive and often require specific devices. No free online virtual simulator has yet been developed. The goal was to design a freely accessible Web-based simulator. Methods: The computer simulator consisted of a lumbar spine, a red box hiding the pedicles and five pairs of screws. After inserting the screws, the red box was removed to assess their position. A validation study was conducted with 24 medical students randomized into a simulation and a control group. All had a basic course on pedicle screws. The 12 simulation group students performed two sessions on computer. All 24 students then conducted a final common step on sawbones. The number of misplaced screws, types of breaches, and simulation times were analyzed. Results: In the final sawbones simulation, 96 real screws were studied. Control group misplaced 50% of their screws compared with only 20.8% in the simulation group (p < 0.05). More careful, simulation group students were slower to insert their real screws. Over the two computer simulations, the rate of misplaced screws decreased (12.5% vs. 38.3%), showing a good handling of the simulator. Students were able to analyze and correct their pedicle breaches. Conclusion: This tool is the first free online lumbar pedicle screws simulator. Simulation helped students to better position the final real screws on sawbones. This project showed it was possible to create a free educational tool with no special equipment. Level of evidence: Level 3. [ABSTRACT FROM AUTHOR]

Modern ships are complex energy systems containing a large number of different elements. Each of these elements is simulated separately. Since all these models form a single system (ship), they are interdependent. The operating modes of some systems influence others, but at the same time, the work of all the systems should be aimed at fulfilling the basic functions of the ship. The work proposes a methodological approach to combining various systems of ships into a single complex model. This model allows combining models of ship systems of various levels (microlevel, macrolevel, metalevel, megalevel). The work provides examples of models of such multi-level energy systems. These are energy systems composed of an electric generator, a diesel engine, a propeller shaft, and algorithms used for operating the common parts of the ship’s electric power system and a piston wear process. Analytical, structural, numerical, and object-oriented models were made for these objects. Each of these particular models describes a limited class of problems, has characteristic properties, and a mathematical structure. The work shows how particular models can be interconnected using a set-theoretic description. Particular models are combined into macrolevel models, whose output parameters are quantities that are by no means related. The macrolevel models are interrelated using control models. Control models belong to the metalevel and allow for assigning settings and response thresholds to algorithms used in automation systems. Such a model (megalevel model) allows, ultimately, investigating the dynamics of the entire system as a whole and managing it.

Background: Embodiment through a virtual avatar is a key element for people to feel that they are in the virtual world. Objective: This study aimed to elucidate the interaction between 2 methods of eliciting embodiment through a virtual avatar: motion synchronization and appearance similarity between a human and avatar, to understand embodiment (agency, body ownership, and self-location) and subjective experience (presence, simulator sickness, and emotion) in virtual reality. Methods: Using a full-body motion capture system, 24 participants experienced their virtual avatars with a 3D-scanned face and size-matched body from a first-person perspective. This study used a 2 (motion; sync and async) x 2 (appearance; personalized and generic) within-subject design. Results: The results indicated that agency and body ownership increased when motion and appearance were matched, whereas self-location, presence, and emotion were affected by motion only. Interestingly, if the avatar's appearance was similar to the participants (personalized avatar), they formed an agency toward the avatar's motion that was not performed by themselves. Conclusions: Our findings would be applicable in the field of behavioral therapy, rehabilitation, and entertainment applications, by eliciting higher agency with a personalized avatar. [ABSTRACT FROM AUTHOR]

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In earlier work, a driver model incorporating sensory dynamics was identified from driving simulator experiments involving random disturbances, random target paths and linear vehicle dynamics. In the present paper, the driver model and experiments are extended to include transient disturbances, discrete target paths and nonlinear vehicle dynamics. The predictions of the model are compared with measurements from the experiments. Simulator motion is found to have a significant beneficial effect on drivers' responses, giving faster driver reaction times and more successful disturbance rejection and path following. The driver model predicts the measured responses well. The model suggests that drivers are unable to develop an accurate internal model of motion cueing filters, perceiving phase and gain distortions introduced by filtering as disturbances. Drivers are found able to account for the time-varying operating point of a nonlinear vehicle. The driver model is also able to match the behaviour of experienced drivers near the friction limit of the tyres, however, further work is necessary to understand how an inaccurate internal model impedes the performance of less experienced drivers. The findings contribute new knowledge to the fields of driver simulation and motion cueing. [ABSTRACT FROM AUTHOR]

Mastering coronary angiography requires practice. Cadavers and animals do not accurately represent the human anatomical body, and practicing with actual patients has medical safety issues. Simulation offers safe and realistic conditions for cardiology intervention training. In this study, we propose a novel 3D printed simulator that contains physically realistic anatomy and has four access points. It increases safety for patients and students, and production is low-cost. We aimed to make and validate this simulator design as a prototype for coronary cannulation training. It was designed using computed tomography (CT) scan data of aorta, coronary, and heart models, and was printed by 3D printing with resin materials consisting of 75% or 85% clear resin and 25% or 15% flexible resin additive. The simulator was constructed with a camera above the simulator with a degree of LAO of 30°/0°, a display table, and an acrylic box. Twelve validators were interviewed for their expert opinions and analyzed by a qualitative method. They scored the simulator's suitability on a four-point Likert scale questionnaire. They described the simulator as having admirable values for all aspects (85.8%), curriculum suitability (92%), educational importance (94%), accuracy (83%), efficiency (78%), safety (87.5%), endurance (81.2%), aesthetics (80.7%), storage (85.4%), and affordability (85.8%). [ABSTRACT FROM AUTHOR]

Training with real patients is a critical aspect of the learning and growth of doctors in training. However, this essential step in the educational process for clinicians can potentially compromise patient safety, as they may not be adequately prepared to handle real-life situations independently. Clinical simulators help to solve this problem by providing real-world scenarios in which the physicians can train and gain confidence by safely and repeatedly practicing different techniques. In addition, obtaining objective feedback allows subsequent debriefing by analysing the situation experienced and learning from other people’s mistakes. This article presents SIMUNEO, a neonatal simulator in which professionals are able to learn by practicing the management of lung ultrasound and the resolution of pneumothorax and thoracic effusions. The article also discusses in detail the hardware and software, the main components that compose the system, and the communication and implementation of these. The system was validated through both usability questionnaires filled out by neonatology residents as well as through follow-up sessions, improvement, and control of the system with specialists of the department. Results suggest that the environment is easy to use and could be used in clinical practice to improve the learning and training of students as well as the safety of patients.

Objective(s): To create and validate a synthetic simulator for teaching tracheostomy and laryngotracheal reconstruction (LTR) using anterior costal cartilage and thyroid ala cartilage grafts. Methods: A late adolescent/adult neck and airway simulator was constructed based on CT scans from a cadaver and a live patient. Images were segmented to create three‐dimensional printed molds from which anatomical parts were casted. To evaluate the simulator, expert otolaryngologists ‐ head and neck surgeons performed tracheostomy and LTR using anterior costal cartilage and thyroid ala cartilage grafts on a live anesthetized porcine model (gold standard) followed by the synthetic simulator. They evaluated each model for face validity (realism and anatomical accuracy) and content validity (perceived effectiveness as a training tool) using a five‐point Likert scale. For each expert, differences for each item on each simulator were compared using Wilcoxon Signed‐Rank tests with Sidak correction. Results: Nine expert faculty surgeons completed the study. Experts rated face and content validity of the synthetic simulator an overall median of 4 and 5, respectively. There was no difference in scores between the synthetic model and the live porcine model for any of the steps of any of the surgical procedures. Conclusion: The synthetic simulator created for this study has high face and content validity for tracheostomy and LTR with anterior costal cartilage and thyroid ala cartilage grafts and was not found to be different than the live porcine model for these procedures. Level of Evidence: 5 Laryngoscope, 131:E2378–E2386, 2021 [ABSTRACT FROM AUTHOR]

Mastering coronary angiography requires practice. Cadavers and animals do not accurately represent the human anatomical body, and practicing with actual patients has medical safety issues. Simulation offers safe and realistic conditions for cardiology intervention training. In this study, we propose a novel 3D printed simulator that contains physically realistic anatomy and has four access points. It increases safety for patients and students, and production is low-cost. We aimed to make and validate this simulator design as a prototype for coronary cannulation training. It was designed using computed tomography (CT) scan data of aorta, coronary, and heart models, and was printed by 3D printing with resin materials consisting of 75% or 85% clear resin and 25% or 15% flexible resin additive. The simulator was constructed with a camera above the simulator with a degree of LAO of 30°/0°, a display table, and an acrylic box. Twelve validators were interviewed for their expert opinions and analyzed by a qualitative method. They scored the simulator’s suitability on a four-point Likert scale questionnaire. They described the simulator as having admirable values for all aspects (85.8%), curriculum suitability (92%), educational importance (94%), accuracy (83%), efficiency (78%), safety (87.5%), endurance (81.2%), aesthetics (80.7%), storage (85.4%), and affordability (85.8%).

Objective: To review the current status of robotic training and the impact of various training platforms on the performance of robotic surgical trainees.Data Sources: Literature review of Google Scholar and PubMed. The search terms included a combination of the following: "robotic training," "simulation," "robotic curriculum," "obgyn residency robotic training," "virtual reality robotic training," "DaVinci training," "surgical simulation," "gyn surgical training." The sources considered for inclusion included peer-reviewed articles, literature reviews, textbook chapters, and statements from various institutions involved in resident training.Methods Of Study Selection: A literature search of Google Scholar and PubMed using terms related to robotic surgery and robotics training, as mentioned in the "Data Sources" section.Results: Multiple novel platforms that use machine learning and real-time video feedback to teach and evaluate robotic surgical skills have been developed over recent years. Various training curricula, virtual reality simulators, and other robotic training tools have been shown to enhance robotic surgical education and improve surgical skills. The integration of didactic learning, simulation, and intraoperative teaching into more comprehensive training curricula shows positive effects on robotic skills proficiency. Few robotic surgery training curricula have been validated through peer-reviewed study, and there is more work to be completed in this area. In addition, there is a lack of information about how the skills obtained through robotics curricula and simulation translate into operating room performance and patient outcomes.Conclusion: Data collected to date show promising advances in the training of robotic surgeons. A diverse array of curricula for training robotic surgeons continue to emerge, and existing teaching modalities are evolving to keep up with the rapidly growing demand for proficient robotic surgeons. Futures areas of growth include establishing competency benchmarks for existing training tools, validating existing curricula, and determining how to translate the acquired skills in simulation into performance in the operating room and patient outcomes. Many surgical training platforms are beginning to expand beyond discrete robotic skills training to procedure-specific and team training. There is still a wealth of research to be done to understand how to create an effective training experience for gynecologic surgical trainees and robotics teams. [ABSTRACT FROM AUTHOR]

Wireless Sensor Network (WSN) is a developing area of research. In sensor network applications, monitoring of the detected amount of data, monitoring the status of a wireless touch terminal, processing and displaying data have become key components of sensor networks. Wireless Sensor Networks (WSNs), which comprise of spatially distributed self-configurable sensors, impeccably meet the prerequisite. Since running real experiments is expensive and tedious, recreation is basic to contemplate WSNs, being the normal method to test new applications and conventions in the field. It requires a reasonable model dependent on strong suppositions and a suitable system to ease usage. Moreover, the results of recovery depend on the specific situation under investigation (environment), equipment and suspicions at the physical layer, which, as a rule, are not accurate enough to track the real behavior of the WSN, thus risking the reliability of the results. In any case, the detailed models take into account scalability and execution issues as there are a huge number of hubs that rely on the application to replicate. The goal of this study is to conduct a survey on various simulator uses for WSNs. [ABSTRACT FROM AUTHOR]

The aim of this research for was to measure the user acceptance of simulator application which was built as a tool for student in learning of supply chain, particularly in bullwhip effect problem. The measurements used for the acceptance of supply chain simulator application in this research was the Technology Acceptance Model from 162 samples which were analyzed with Confirmatory Factor Analysis and Structural Equation Modelling. The result of this research indicated that the user acceptance (shown by customer participation) of supply chain simulator was directly influence by perceived usefulness of supply chain simulator application used (positive and significant); the user acceptance of supply chain simulator was indirectly influenced by perceived ease of use in using supply chain simulator application (positive but not significant); the user acceptance of supply chain simulator was indirectly influenced by perceived enjoyment when the supply chain simulator application was used. The research would give a better understanding about a bullwhip effect and better experience for students, which would not be obtained through conventional learning, when the tools were not used.

The primary aim of this review was to synthesize the literature for studies investigating the use of computer simulation (CS) and virtual reality (VR) in undergraduate dental education in operative and restorative dentistry. The secondary aim was to list best practices that maximize the simulation experience in dental education. A literature review of the PubMed and ERIC databases was conducted using the search terms "Dental AND Simulator," "Dental AND Virtual reality," and "Simulation AND Dental education." Studies in English language were categorized into 1 of 5 themes: Manual dexterity and cavity preparation, light curing skills, simulation perception and experience, predictability, and simulation model development. Main practices of simulation education indicated in the McGaghie et al. critical review published in 2010 were used as a reference to identify common practices for dental simulation. Thirty nine of 579 identified abstracts met the inclusion criteria. Skill acquisition and feedback were the two most frequently investigated parameters found in the review. CS was efficient in teaching cavity preparation and light curing skills. Feedback and deliberate practice were among the best practices that should be emphasized in order to enhance the efficiency of the CS and VR simulation exercises. The use of CS is effective in teaching operative skills (such as light curing and cavity preparation) reliably; whereas, the use of VR in undergraduate curricula is debatable. To achieve the maximum benefits of the simulation exercises, emphasis must be given to the timely feedback and deliberate practice approaches. [ABSTRACT FROM AUTHOR]

In many manufacturing processes, sensor agents specifically adapt to explore pipes and other constrained environments filled with fluid are usually needed for monitoring purposes. However, in some of these environments only miniaturized agents can be used. Furthermore, these agents might be kinetically passive, due to limited resources and size. Therefore, designing and using these agents can be difficult. One possible solution to this problem is to change the agents' morphology, such that optimally shaped agents reach target destinations simply by passively moving through the fluid. Here, we propose an evolutionary scheme for evolving the agent's morphology to reach a predefined desired point in a fluid environment. This scheme includes a genotype-phenotype mapping based on Lindenmayer-Systems, as well as custom reproduction operators, selection criterion, and fitness function. In order to allow the simulation of irregularly shaped bodies underwater, we develop a simulation framework based on the Robot Operating System and the Unmanned Underwater Vehicle package. We test the proposed method on a set of 10 target points in a pipe inspection scenario. Results show that the evolved agents reach the target points with a distance error smaller than 5% in the worst case, and a standard deviation of 1.1% over 10 repeated experiments. [ABSTRACT FROM AUTHOR]

Most existing models of driver steering control do not consider the driver's sensory dynamics, despite many aspects of human sensory perception having been researched extensively. The authors recently reported the development of a driver model that incorporates sensory transfer functions, noise and delays. The present paper reports the experimental identification and validation of this model. An experiment was carried out with five test subjects in a driving simulator, aiming to replicate a real-world driving scenario with no motion scaling. The results of this experiment are used to identify parameter values for the driver model, and the model is found to describe the results of the experiment well. Predicted steering angles match the linear component of measured results with an average 'variance accounted for' of 98% using separate parameter sets for each trial, and 93% with a single fixed parameter set. The identified parameter values are compared with results from the literature and are found to be physically plausible, supporting the hypothesis that driver steering control can be predicted using models of human perception and control mechanisms. [ABSTRACT FROM AUTHOR]

Narrowband-Internet of Things (NB-IoT) displays high-quality connectivity underpinned by fifth-generation (5G) networks to cover a wide array of IoT applications. The devices’ development and integration into different smart systems require permanent control, supervision, and the study of power consumption models to determine the performance of the network topology and allow for the measurement of the efficiency of the network topology’s application. This paper reports on an architecture and open-sourced simulation that was developed to study NB-IoT in Device-to-Device (D2D) mode, which includes the Physical (PHY), network, and application layers, as well as a queuing model, the model for uplink and downlink delays, the throughput, the overall NB-IoT D2D network performance, and the energy consumption based on the Low Energy Adaptive Clustering Hierarchy (LEACH) protocol. Our results prove that the suggested framework contributes to a reduction in power consumption, a minimization of queuing delays, a decrease in communication cost, a reduction in inter-cluster collisions, and the prevention of attacks from malicious nodes. Consequently, the framework manages the battery’s State of Charge (SOC), improves the battery’s State of Health (SOH), and maximizes the whole network lifetime. The proposed framework, the code of which has been open-sourced, can be effectively used for scientific research and development purposes to evaluate different parameters and improve the planning of NB-IoT networks.

Purpose Of the Study: Feedback devices and dispatcher assistance increase CPR quality in bystander resuscitation. Yet, there is no data comparing both approaches with uninstructed CPR. The present prospective, randomized, controlled, manikin trial aims to determine the effects of the use of a smartphone application (PocketCPR) on CPR quality in a bystander CPR scenario compared to dispatcher-assisted telephone CPR and uninstructed CPR.Methods: 100 laypersons were included to perform 8-min CPR on a manikin. Volunteers were randomly assigned to one of four groups: (1) uninstructed CPR (uninstructed group), (2) dispatcher-assisted telephone CPR (telephone-group), (3) guidance and feedback through a smartphone application (app-group) and (4) dispatcher-assisted telephone CPR combined with the smartphone-app (telephone + app-group).Results and Discussion: There was no significant difference in the time to first compression between the uninstructed and the app-group (p = 0.052), likewise between the telephone- and the telephone + app-group (p = 0.193). The no-flow-time of the uninstructed group was significantly longer compared to all other groups (p < 0.001). Median compression rate was significantly higher and within the recommended range in the app- and the telephone + app-group. There was no significant difference regarding correct compression depth between the four groups. Correct hand position and complete thorax release was found significantly more frequently in groups with smartphone-app support.Conclusions: Feedback by a smartphone application can improve bystander CPR quality in terms of no-flow-time, compression rate, correct hand position, thorax release and does not delay CPR onset. However, the use of a smartphone application does not improve compression depth significantly. [ABSTRACT FROM AUTHOR]

Introduction/Aim: The patient's condition and high-risk nature of extracorporeal membrane oxygenation (ECMO) therapy force clinical services to ensure clinicians are properly trained and always ready to deal effectively with critical situations. Simulation-based education (SBE), from the simplest approaches to the most immersive modalities, helps promote optimum individual and team performance. The risks of SBE are negative learning, inauthenticity in learning and overreliance on the participants' suspension of disbelief. This is especially relevant to ECMO SBE as circuit/patient interactions are difficult to fully simulate without confusing circuit alterations. Methods: Our efforts concentrate on making ECMO simulation easier and more realistic in order to reduce the current gap there is between SBE and real ECMO patient care. Issues to be overcome include controlling the circuit pressures, system failures, patient issues, blood colour and cost factors. Key to our developments are the hospital-university collaboration and research funding. Results: A prototype ECMO simulator has been developed that allows for realistic ECMO SBE. The system emulates the ECMO machine interface with remotely controllable pressure parameters, haemorrhaging, line chattering, air bubble noise and simulated blood colour change. Conclusion: The prototype simulator allows the simulation of common ECMO emergencies through innovative solutions that enhance the fidelity of ECMO SBE and reduce the requirement for suspension of disbelief from participants. Future developments will encompass the patient cannulation aspect. [ABSTRACT FROM AUTHOR]

Abstract: Magnetic Resonance Imaging (MRI) simulation differs from diagnostic MRI in purpose, technical requirements, and implementation. We propose a semiautomatic method for image acceptance and commissioning for the scanner, the radiofrequency (RF) coils, and pulse sequences for an MRI simulator. The ACR MRI accreditation large phantom was used for image quality analysis with seven parameters. Standard ACR sequences with a split head coil were adopted to examine the scanner's basic performance. The performance of simulation RF coils were measured and compared using the standard sequence with different clinical diagnostic coils. We used simulation sequences with simulation coils to test the quality of image and advanced performance of the scanner. Codes and procedures were developed for semiautomatic image quality analysis. When using standard ACR sequences with a split head coil, image quality passed all ACR recommended criteria. The image intensity uniformity with a simulation RF coil decreased about 34% compared with the eight‐channel diagnostic head coil, while the other six image quality parameters were acceptable. Those two image quality parameters could be improved to more than 85% by built‐in intensity calibration methods. In the simulation sequences test, the contrast resolution was sensitive to the FOV and matrix settings. The geometric distortion of simulation sequences such as T1‐weighted and T2‐weighted images was well‐controlled in the isocenter and 10 cm off‐center within a range of ±1% (2 mm). We developed a semiautomatic image quality analysis method for quantitative evaluation of images and commissioning of an MRI simulator. The baseline performances of simulation RF coils and pulse sequences have been established for routine QA. [ABSTRACT FROM AUTHOR]

Background: Bilateral axillo-breast approach robotic thyroidectomy (BABA RT) is an excellent surgical method, being oncologically safe and with anatomic views similar to those of open surgery. BABA RT, however, requires training and a learning curve for proficiency. We evaluated the educational effectiveness of a surgical training model for BABA RT, comparing objective BABA scores with scores on the da Vinci Skills Simulator (dVSS).Methods: Medical students, surgical residents, and surgical fellows performed structured tasks with the BABA training model and dVSS under the same conditions. All tasks were videotaped. BABA scores were compared with dVSS scores and with objective evaluation scores (GEARS and OSATS).Results: Eight medical students, ten surgical residents, and eight surgical fellows participated in this study. The educational effect of BABA training improved from one to two (p < 0.001), two to three (p = 0.003), and one to three (p < 0.001) procedures. Statistically significant differences were found when students were compared with residents (p = 0.025) and fellows (p < 0.001) in the BABA training model, and between students and fellows (p = 0.004) in dVSS. BABA scores showed similar distribution patterns in the three groups to GEARS and OSATS scores (p < 0.001 each).Conclusions: The BABA training model is an excellent educational tool for surgical residents and surgical fellows to learn and practice BABA RT. Assessment by BABA score yielded objective results comparable to those of traditional scoring methodologies. [ABSTRACT FROM AUTHOR]