Role of virtual reality simulation in endoscopy training

Recent advancements in virtual reality graphics and models have allowed virtual reality simulators to be incorporated into a variety of endoscopic training programmes. Use of virtual reality simulators in training programmes is thought to improve skill acquisition amongst trainees which is reflected in improved patient comfort and safety. Several studies have already been carried out to ascertain the impact that usage of virtual reality simulators may have upon trainee learning curves and how this may translate to patient comfort. This article reviews the available literature in this area of medical education which is particularly relevant to all parties involved in endoscopy training and curriculum development. Assessment of the available evidence for an optimal exposure time with virtual reality simula-tors and the long-term benefits of their use are also discussed.     

Using high-level models for modeling industrial machines in a virtual environment

The work presented in this paper deals with a platform independent model formalism for designing virtual reality applications. In our approach, we focused on industrial machine simulators design. The structure of an industrial machine model is composed by “Virtual Components” which corresponds to the physical industrial components of the machine and a control part which corresponds to the functional specification of the machine. Each virtual component is modeled by VRML model for geometry and by hybrid automata (HA) for behavior. The control part is modeled by Sequential Function Charts (SFC), as it is the case in the majority of industrial machines. Those SFC are translated to HA and composed with the virtual components HA. The whole HA model of the machine is then implemented in the generic virtual environment “OpenMASK” by specific software translation tools which was developed previously. This method makes virtual prototyping accessible by the specialists in the domain of industrial machine design domain In this paper, we describe the high level modeling method putting the accent on the coupling between the control part and the process and then we apply it in the case of an assembly machine.     

New directions in virtual environments and gaming to address obesity and diabetes: industry perspective

Virtual reality is increasingly used for education and treatment in the fields of health and medicine. What is the health potential of virtual reality technology from the software development industry perspective? This article presents interviews with Ben Sawyer of Games for Health, Dr. Walter Greenleaf of InWorld Solutions, and Dr. Ernie Medina of MedPlay Technologies. Games for Health brings together researchers, medical professionals, and game developers to share information on the impact that game technologies can have on health, health care, and policy. InWorld is an Internet-based virtual environment designed specifically for behavioral health care. MedPlay Technologies develops wellness training programs that include exergaming technology. The interviewees share their views on software development and other issues that must be addressed to advance the field of virtual reality for health applications.     

Turning virtual reality into reality: a checklist to ensure virtual reality studies of eating behavior and physical activity parallel the real world

Virtual reality (VR) provides a potentially powerful tool for researchers seeking to investigate eating and physical activity. Some unique conditions are necessary to ensure that the psychological processes that influence real eating behavior also influence behavior in VR environments. Accounting for these conditions is critical if VR-assisted research is to accurately reflect real-world situations. The current work discusses key considerations VR researchers must take into account to ensure similar psychological functioning in virtual and actual reality and does so by focusing on the process of spontaneous mental simulation. Spontaneous mental simulation is prevalent under real-world conditions but may be absent under VR conditions, potentially leading to differences in judgment and behavior between virtual and actual reality. For simulation to occur, the virtual environment must be perceived as being available for action. A useful chart is supplied as a reference to help researchers to investigate eating and physical activity more effectively.     

脊柱疾病虚拟手术系统的初步研究

目的 建立基于64排CT图像数据的计算机辅助三维立体脊柱手术模拟系统,为术前进行精确设计手术方案及达到术后良好效果提供真实可靠依据.方法 对人体64排CT切片数据进行感兴趣区域图像分割和边缘提取,采用面绘制技术对提取的轮廓序列进行三维数据生成,建立适用于虚拟手术的脊柱三维重建模型,采用Freeform虚拟手术软件和Phantom力反馈系统,初步以腰椎间盘突出后路减压椎间盘摘除术为例,进行虚拟手术,并且以动态动画形式演示.结果 初步建立了脊柱疾病虚拟手术系统,完成了腰椎后路椎间盘摘除虚拟手术模型,以动态形式成功演示了椎间盘突出手术仿真模拟,手术过程真实逼真,立体可视化效果好,并可进行反复演练,预测手术效果.结论 腰椎三维立体可视化模拟手术系统的建立,为腰椎术前手术方案制定提供实用有效的技术手段和全新的科学方法 .     

Virtual reality aided design of parts and assemblies

Current virtual reality (VR) systems provide an enormous potential for enhancing the visualization of 3D-design drafts. Based on new navigation techniques the designer is able to interact, model in a more intuitive and efficient way. In our contribution we present a novel interaction metaphor that facilitates the synthesis of efficient virtual reality interaction and visualization techniques with modern feature based CAD systems. We present “NAVIMODE”, an alternative approach for navigation, manipulation and selection, to combine the advantages of VR and CAD systems. The design engineer has the chance to design in his/her habitual environment using the advantage of virtual reality concurrently.     

Life with a hemodialysis machine

The aim of the present study was to describe the experience of patients undergoing haemodialysis starting from their own perception. A qualitative perspective using Merleau Ponty's Existential Phenomenology was considered to be the most appropriate methodology for this study. Fifteen patients were interviewed in a haemodialysis unit at a Brazilian teaching hospital. Interviews were based on the question 'What does the experience of living with a haemodialysis machine mean?' Convergences in speeches were grouped into three categories: the machine, improvement in quality of life, reflection on patients' experience. These findings show the existential reality patients experience. A haemodialysis machine dictates their lives: they have to accept strict rules controlled by a team of healthcare providers. They realize it has to be so and there is no way out. It is the only way to get some relief from the symptoms of the disease. The feeling is mostly acceptance of the condition. Healthcare providers' dedication is recognized. Some participants complain bout painful procedures, others deny them, others fantasize the reality. An essential piece of information is the lack of future perspectives; few patients mentioned the possibility of a transplant or the possibility of carrying out their own care. The study may contribute in outlining new perspectives for nurses to understand the needs of patients undergoing haemodialysis. An approach accepting patients' views will probably bring awareness to patients as to the possibilities of helping with their own treatment.     

Uses of a dedicated 3D reconstruction software with augmented and mixed reality in planning and performing advanced liver surgery and living donor liver transplantation (with videos)

The development of digital intelligent diagnostic and treatment technology has opened countless new opportunities for liver surgery from the era of digital anatomy to a new era of digital diagnostics, virtual surgery simulation and using the created scenarios in real-time surgery using mixed reality. In this article, we described our experience on developing a dedicated 3 dimensional visualization and reconstruction software for surgeons to be used in advanced liver surgery and living donor liver transplantation. Furthermore, we shared the recent developments in the field by explaining the outreach of the software from virtual reality to augmented reality and mixed reality.     

虚拟现实技术辅助胸部战创伤分级救治模式

基于现代战争胸部外伤伤情特点和战伤分级救治理论,本文提出利用虚拟现实技术(virtual reality,VR)辅助建立胸部战伤分级救治模式.VR具有提供沉浸式和交互式体验、规避安全风险等优势,利用VR设计个性化胸部战伤案例,在分级救治不同的阶段对伤情评估、诊断和处置进行培训和考核,更有利于提高野战条件下战士及卫生人员...     

From virtual reality to web-based multimedia maintenance manuals

This paper focuses on a structured methodology that uses virtual reality (VR) and digital human modeling (DHM) to study maintenance procedures of industrial products. VR technologies help to highlight the most critical aspects of maintenance operations, while DHM tools allow detailing working sequences. Data coming from these analyses are then used to draw up a multimedia maintenance manual based on digital video animations, audio comments, explanatory images and written recommendations. Information is available to maintenance personnel directly on the working site through portable electronic devices. Further, web-based multimedia manuals can be updated on-line and help to shorten learning time and maintenance downtimes.     

Illusory ownership of a virtual child body causes overestimation of object sizes and implicit attitude changes

An illusory sensation of ownership over a surrogate limb or whole body can be induced through specific forms of multisensory stimulation, such as synchronous visuotactile tapping on the hidden real and visible rubber hand in the rubber hand illusion. Such methods have been used to induce ownership over a manikin and a virtual body that substitute the real body, as seen from first-person perspective, through a head-mounted display. However, the perceptual and behavioral consequences of such transformed body ownership have hardly been explored. In Exp. 1, immersive virtual reality was used to embody 30 adults as a 4-y-old child (condition C), and as an adult body scaled to the same height as the child (condition A), experienced from the first-person perspective, and with virtual and real body movements synchronized. The result was a strong body-ownership illusion equally for C and A. Moreover there was an overestimation of the sizes of objects compared with a nonembodied baseline, which was significantly greater for C compared with A. An implicit association test showed that C resulted in significantly faster reaction times for the classification of self with child-like compared with adult-like attributes. Exp. 2 with an additional 16 participants extinguished the ownership illusion by using visuomotor asynchrony, with all else equal. The size-estimation and implicit association test differences between C and A were also extinguished. We conclude that there are perceptual and probably behavioral correlates of body-ownership illusions that occur as a function of the type of body in which embodiment occurs.     

LIVING WITH A HAEMODIALYSIS MACHINE

The aim of the present study was to describe the experience of patients undergoing haemodialysis starting from their own perception. A qualitative perspective using Merleau Ponty's Existential Phenomenology was considered to be the most appropriate methodology for this study. Fifteen patients were interviewed in a haemodialysis unit at a Brazilian teaching hospital. Interviews were based on the question ‘What does the experience of living with a haemodialysis machine mean?’ Convergences in speeches were grouped into three categories: the machine, improvement in quality of life, reflection on patients' experience. These findings show the existential reality patients experience. A haemodialysis machine dictates their lives: they have to accept strict rules controlled by a team of healthcare providers. They realize it has to be so and there is no way out. It is the only way to get some relief from the symptoms of the disease. The feeling is mostly acceptance of the condition. Healthcare providers' dedication is recognized. Some participants complain about painful procedures, others deny them, others fantasize the reality. An essential piece of information is the lack of future perspectives; few patients mentioned the possibility of a transplant or the possibility of carrying out their own care. The study may contribute in outlining new perspectives for nurses to understand the needs of patients undergoing haemodialysis. An approach accepting patients' views will probably bring awareness to patients as to the possibilities of helping with their own treatment.     

To diet or not if you have inflammatory bowel disease

Liver surgery remains a difficult challenge in which preoperative data analysis and strategy definition may play a significant role in the success of the procedure. Medical image processing led to a major improvement of patient care by guiding the surgical gesture. From this initial data, new technologies of virtual reality and augmented reality can increase the potential of such images. The 3D modeling of the liver of patients from their CT scan or MRI thus allows an improved surgical planning. Simulation allows the procedure to be simulated preoperatively and offers the opportunity to train the surgical gesture before carrying it out. These three preoperative steps can be used intraoperatively thanks to the development of augmented reality, which consists of superimposing the preoperative 3D modeling of the patient onto the real intraoperative view of the patient and his/her organs. Augmented reality provides surgeons with a transparent view of the patient. This facilitated the intraoperative identification of the vascular anatomy and the control of the segmental arteries and veins in liver surgery, thus preventing intraoperative bleeding. It can also offer guidance due to the virtual improvement of their real surgical tools, which are tracked in real-time during the procedure. During the surgical procedure, augmented reality, therefore, offers surgeons a transparent view of their patient, which will lead to the automation of the most complex maneuvers. The new ways of processing and analyzing liver images have dramatically changed the approach to liver surgery.     

Contribution of virtual reality to neuropsychology of memory: study in aging

The principal interest of virtual reality is its potential to create experiments close to daily life with a perfect experimental control. In a first time, we review the studies illustrating the contribution of virtual reality for neuropsychology, mainly for memory study. In a second time, we present the results of an experiment in which the subjects were driving in a virtual town, that tested all the episodic memory components, i.e. the memories of what, where and when events happened. Young and elderly adults performed the virtual test, either with intentional or incidental encoding, and either in active (they drove a virtual car) or passive exploration of the town (they were passengers). The results showed that older subjects recalled the spatiotemporal context and the details of the events in a lower proportion than younger, as well in active as in passive condition. Subject's memory complaints were correlated with the virtual scores, but not with usual verbal episodic memory tests. Therefore, virtual tests seem to allow a better assessment of episodic memory than the usual ones, especially because of their spatiotemporal memory assessment, and appear to be a hopeful tool for a neuropsychology closer to patient's daily life than the usual tests.     

The Importance of Measurement Precision and Behavioral Homologies in Evaluating the Behavioral Consequences of Fetal‐Ethanol Exposure: Commentary on Williams and Colleagues (“Sensory‐Motor Deficits in Children with Fetal Alcohol Spectrum Disorder Assessed Using a Robotic Virtual Reality Platform”)

The recent study by Willams and colleagues utilized a novel robotic virtual reality measurement system to measure sensory‐motor processing deficits in children with fetal alcohol spectrum disorders (FASDs). This system and the precise quantitation of distinct constituent behavioral processes may hold considerable utility and importance for the study of FASD‐related motor deficits, their neural bases, and translational research efforts using homologous behavioral approaches in animal and human studies..     

仿真内镜在消化道的临床应用进展

结合近年国外相关文献,介绍仿真内镜在消化道的临床应用情况。通过与传统内窥镜进行比较,指出仿真内镜的优点和缺点,并展望仿真内镜的应用前景。     

The Effect of Virtual Reality on Pain and Anxiety During Colonoscopy: A Randomized Controlled Trial

Background The aim of the study is to evaluate the effect of virtual reality application during a colonoscopy on the pain and anxiety experienced by patients.Methods The study was conducted as experimental, randomized, controlled research. The study was carried out between October 15, 2017 and May 20, 2018 in the Endoscopy Unit of a Public Hospital in northern Turkey. The study sample consisted of 60 patients who underwent colonoscopy. The patients were divided into 2 groups by using simple randomization. The patients in the experimental group watched virtual reality applications during colonoscopy, whereas the patients in the control group underwent standard colonoscopy protocol. Colonoscopy was performed on patients in both groups by the same gastroenterologist without the use of anesthesia. The demographic data of both groups, pain levels during and after the procedure, before and after the procedure anxiety levels were evaluated.Results The mean age of the patients in the experimental group was 56.33 ± 11.81, the mean age of the patients in the control group was 56.20 ± 15.62. There was no statistically significant difference between the pre- and post-operative state anxiety score averages of the patients in the experimental and control groups. There was a statistically significant difference between the trait anxiety scores (P < .000) and pain scores (P < .03) during the procedure between both groups.Conclusion The virtual reality application was found to reduce patients’ pain during the colonoscopy procedure. The virtual reality application, an easily available, inexpensive, and non-invasive method, can be used by nurses in pain management during colonoscopy.