Medical mannequins provide the first hands-on training for nurses and doctors and help eliminate human mistakes that would otherwise take place with a real person. The closer the mannequin is to mimicking a human being, the more effective the training; thus, additional features such as movable limbs and eyes, vision processing and realistic social interaction will provide a more fulfilling learning experience. A humanoid robot with a 23 degree of freedom (DOF) hand was developed which is capable of performing complex dexterous tasks such as typing on a keyboard. A single DOF elbow and two DOF shoulder was designed and optimized to maintain human form while being able to dynamically lift common household items. A 6 DOF neck and 13 DOF face with a highly expressive silicone skin-motor arrangement has been developed. The face is capable of talking and making several expressions and is used to train the student to pick up on emotional cues such as eye contact and body language during the interview stage. A pair of 3 DOF legs and a torso were also developed which allows the humanoid to be in either the laying down or sitting up position. An algorithm was developed that only activates necessary areas of code in order to increase its cycle time which greatly increases the vision tracking capabilities of the eyes. The simulator was tested at Carilion Clinic in Roanoke VA with several of the medical staff and their feedback is provided in this document. / Master of Science

This thesis investigated the development of an EEG-based brain controlled switch and the design of a software for nerve conduction study. For EEG-based brain controlled switch, we proposed a novel paradigm for an online brain-controlled switch based on Event-Related Synchronizations (ERDs) following external sync signals. Furthermore, the ERD feature was enhanced by 3 event-related moving averages and the performance was tested online. Subjects were instructed to perform an intended motor task following an external sync signal in order to turn on a virtual switch. Meanwhile, the beta-band (16-20Hz) relative ERD power (ERD in reverse value order) of a single EEG Laplacian channel from primary motor area was calculated and filtered by 3 event-related moving average in real-time. The computer continuously monitored the filtered relative ERD power level until it exceeded a pre-set threshold selected based on the observations of ERD power range to turn on the virtual switch. Four right handed healthy volunteers participated in this study. The false positive rates encountered among the four subjects during the operation of the virtual switch were 0.8±0.4%, whereby the response time delay was 36.9±13.0s and the subjects required approximately 12.3±4.4 s of active urging time to perform repeated attempts in order to turn on the switch in the online experiments. The aim of nerve conduction simulator software design is to create software that can be used by nerve conduction simulator to serve as a medical simulator or education tool to train novice physicians for nerve conduction study test. The real response waveform of 10 different upper limb nerves in conduction studies were obtained from the equipment used in real patient studies. A waveform generation model was built to generalize the response waveform near the standard stimulus site within study interest region based on the extracted waveforms and normal reference parameters of each study and stimulus site coordinates. Finally, based on the model, a software interface was created to simulate 10 different nerve conduction studies of the upper limb with 9 pathological conditions.

La formation aux gestes en obstétrique réalisée directement auprès du patient pose des problèmes éthiques et médico-légaux. C'est pourquoi une grande partie de cette formation repose sur l'observation in-situ. Cette approche ne permet pas de prendre en charge l'ensemble des dimensions nécessaires à la formation telles que l'extraction instrumentale, l'acquisition d'un niveau de dextérité suffisant ou encore la capacité de prise de décision face à une situation à risque.Les systèmes d'entrainement par simulation consituent une réponse à ce problème de formation. Toutefois, les simulateurs haptiques actuels ne permettent qu'une évaluation qualitative du geste obstétrique et ne fournissent pas d'informations quantitatives sur les efforts subis par les différents organes pelviens. Ces informations quantitatives ne sont accessibles que par des simulation biomécaniques de la descente fœtale. Par contre, pour pouvoir être utilisées conjointement avec un simulateur haptique dans un but d'apprentissage, ces simulations doivent être interactives.Dans ce manuscrit, nous proposons tout d'abord un état de l'art des différents modèles biomécaniques existants permettant de modéliser les organes pelviens et la descente fœtale. Après avoir identifié la tête foetale comme la structure la plus susceptible de subir des dommages importants lors de l'accouchement, nous présentons un modèle de la tête foetale basé sur des éléments finis de coque CST-DKT que nous étendons avec un formulation co-rotationelle et une contrainte de volume permettant de prendre en compte la matière intra-crânienne. Une implémentation GPU de ce modèle est proposée pour permettre des simulations interactives. Ce modèle est validé sur une simulation de la pression intra-utérine subie par la tête fœtale lors de la deuxième phase de l'accouchement. Enfin, nous proposons une ébauche de modèle complet pour la simulation interactive de la descente fœtale. / The training to obstetrical gestures performed directly on the patient raise ethical and medico-legal problems. That is why most of the formation is based on in-situ observations. This approach can not handle all the necessary dimensions to the formation such as instrumental extraction, a good level of dexterity or the capacity to take decision in high risk situations.Simulation based training systems can address this formation problems. Neverteless, today's haptic simulators don't provide quantitative informations about the efforts undergone by pelvic organs. This informations are available only through biomechanical simulations of the foetal descent. To be used in conjunction with an haptic simulator, such simulations must be interactive.In this manuscript, first we propose a state of the art of the existing biomechanical models allowing to model the pelvic organs. After having identified the foetal head as the structure that can potentially undergo important damages during childbirth, we present a model of the foetal head based on shell finite elements CST-DKT that we extend to a co-rotationnal formulation and a volume constraint allowing to take in count the intra-cranial matter. A GPU implementation of this model is also porposed to allow interactive simulations. This model is validated on a simulation of intra-uterine pressure undergone by the foetal head during the second phase of childbirth. Finally, we propose a draft of a complete model intended to simulate interactively the feotal descent.

A biópsia por agulha fina é um procedimento importante na investigação de tumores, considerado de baixo-custo, minimamente invasivo e ideal para o fornecimento de um diagnóstico preciso em casos de nódulos da glândula tireóide. Para a realização bem sucedida da biópsia por agulha, a exatidão é essencial e a prática proporciona benefícios significativos tanto na recuperação do paciente, quanto na obtenção de resultados acurados. Esta tese investigou a possibilidade do desenvolvimento de um simulador de realidade virtual para treinamento de biópsia guiada por ultrassom de nódulos da glândula tireóide. O simulador de realidade virtual proposto e desenvolvido é também uma ferramenta educativa, pois além de praticar o procedimento, o usuário pode visualizar tanto um modelo da tireóide para sentir sua textura, quanto um modelo completo do pescoço com todos os seus órgãos internos, podendo ser rotacionado. O sistema consiste de duas interfaces: uma tridimensional, apresentando os modelos virtuais com estereoscopia na mesa de visualização, cuja interação do usuário é feita através do teclado ou dispositivo háptico (Phantom OmniTM); e uma segunda que simula o exame de ultrassom, com todas as funcionalidades de um exame real, sendo manipulada pelo mouse. As duas se comunicam e todo o processo é mostrado na janela do instrutor, que substitui o supervisor orientando o usuário durante o treinamento. O simulador de realidade virtual foi avaliado experimentalmente por profissionais da área médica e tecnológica, sendo aprovado como uma ferramenta para treinamento e ensino de biópsia de nódulos da glândula tireóide. / The fine needle biopsy is an important procedure to investigations in tumors, low-cost considered, minimally invasive and ideal for supplying an accurate diagnosis in cases of thyroid gland nodules. The exactness is essential for the successful accomplishment of the needle biopsy and the practice provides significant benefits in the recovery of the patient, as well as in attainment of accurate results. This thesis investigated the possibility of the development of virtual reality simulator for the training of the ultrasound guided needle biopsy of thyroid gland nodules. The proposed and developed virtual reality simulator is also an educative tool, because besides practicing the procedure, the user can visualize thyroid model to feel its texture, as well as a complete model of the neck with all its internal organs and it can be rotated. The system consists of two interfaces: first is a three-dimensional which presents the virtual models with stereoscopy in the visualization table, whose interaction of the user is made through the keyboard or haptic device (Phantom OmniTM); and second one that simulates the ultrasound images, with all the functionalities of a real examination, manipulated by the mouse. The two interfaces communicate with each other and all the process is shown in the instructor window that substitutes the supervisor and guides the user during the training. The virtual reality simulator was experimentally evaluated by professionals of the medical and technological areas, being approved as a tool for training and education in needle biopsy of the thyroid gland nodules.

A biópsia por agulha fina é um procedimento importante na investigação de tumores, considerado de baixo-custo, minimamente invasivo e ideal para o fornecimento de um diagnóstico preciso em casos de nódulos da glândula tireóide. Para a realização bem sucedida da biópsia por agulha, a exatidão é essencial e a prática proporciona benefícios significativos tanto na recuperação do paciente, quanto na obtenção de resultados acurados. Esta tese investigou a possibilidade do desenvolvimento de um simulador de realidade virtual para treinamento de biópsia guiada por ultrassom de nódulos da glândula tireóide. O simulador de realidade virtual proposto e desenvolvido é também uma ferramenta educativa, pois além de praticar o procedimento, o usuário pode visualizar tanto um modelo da tireóide para sentir sua textura, quanto um modelo completo do pescoço com todos os seus órgãos internos, podendo ser rotacionado. O sistema consiste de duas interfaces: uma tridimensional, apresentando os modelos virtuais com estereoscopia na mesa de visualização, cuja interação do usuário é feita através do teclado ou dispositivo háptico (Phantom OmniTM); e uma segunda que simula o exame de ultrassom, com todas as funcionalidades de um exame real, sendo manipulada pelo mouse. As duas se comunicam e todo o processo é mostrado na janela do instrutor, que substitui o supervisor orientando o usuário durante o treinamento. O simulador de realidade virtual foi avaliado experimentalmente por profissionais da área médica e tecnológica, sendo aprovado como uma ferramenta para treinamento e ensino de biópsia de nódulos da glândula tireóide. / The fine needle biopsy is an important procedure to investigations in tumors, low-cost considered, minimally invasive and ideal for supplying an accurate diagnosis in cases of thyroid gland nodules. The exactness is essential for the successful accomplishment of the needle biopsy and the practice provides significant benefits in the recovery of the patient, as well as in attainment of accurate results. This thesis investigated the possibility of the development of virtual reality simulator for the training of the ultrasound guided needle biopsy of thyroid gland nodules. The proposed and developed virtual reality simulator is also an educative tool, because besides practicing the procedure, the user can visualize thyroid model to feel its texture, as well as a complete model of the neck with all its internal organs and it can be rotated. The system consists of two interfaces: first is a three-dimensional which presents the virtual models with stereoscopy in the visualization table, whose interaction of the user is made through the keyboard or haptic device (Phantom OmniTM); and second one that simulates the ultrasound images, with all the functionalities of a real examination, manipulated by the mouse. The two interfaces communicate with each other and all the process is shown in the instructor window that substitutes the supervisor and guides the user during the training. The virtual reality simulator was experimentally evaluated by professionals of the medical and technological areas, being approved as a tool for training and education in needle biopsy of the thyroid gland nodules.

In a way to help doctors and medical students train on performing difficult surgeries before entering the stressful operating room, DevinSense is developing a generic hardware platform for medical simulation. The system is used together with specific simulation software derived from real patient data and optimized towards the user specifications. The hardware platform will enable training for the operator to develop basic surgical skills effectively without the risk of losing the patients and avoiding the hospital daily contrails. The trainee on the simulator sees the scene displayed in real 3D-stereoscopic mode through a semi-transparent mirror and controls the surgery tools with a 6-DOF force feedback device. Thus, the simulated procedure becomes nearly identical to the real surgery. This project aims to develop a conceptual hardware platform for the medical simulator. The proposed solution should be height adjustable to different users. It must also include additional ergonomic functions such as mobility and suitable for use within the working environment. Accordingly, two conceptual prototypes are manufactured and evaluated. The first conceptual prototype is developed to check if the setup provides a good experience for the users, and to dimension the size of the components and to determine their location to set targets for the second prototype. The resulting product of the second prototype is one leg-lifting column with aluminum profile mounted on the top of it. The semi-transparent mirror, secondary monitor, haptic device and additional components are mounted on the setup to deliver the desired functions. The mechanical development is done using Autodesk Inventor. ANSYS is used to simulate the setups’ stresses and vibrational response to ensure that the system will perform optimally. MATLAB is used for mathematical modeling. The test results of the second prototype were promising where the height can be adjusted for users between 155 cm and 200 cm. Furthermore, the prototype provides stable and stiff design while operating on the simulator as well as transporting it. / För att hjälpa läkare och läkarstudenter att träna på att utföra svåra operationer, utvecklar DevinSense en generisk hårdvaruplattform för medicinska kirurgi-simulatorer. Systemet används för specifika simuleringsprogram som kommer ifrån verkliga patientdata och är optimerad med avseende på användarens specifikation. Hårdvaruplattformen möjliggör utbildning för operatören att utveckla grundläggande kirurgiska färdigheter effektivt utan risk för patienterna. Den som utbildas på simulatorn ser operationssimuleringen som en verkligt 3D-stereoskopisk bild genom en halvgenomskinlig spegel och styr kirurgiverktyget med en 6-DOF haptisk-enhet. Simuleringen kommer att kännas som en riktig operation. Syftet med projektet är att utveckla en prototyp av en haptisk plattform för en medicinsk simulator. Prototypen bör vara justerbar i höjdled för att passa olika användare. Den måste också innefatta ytterligare ergonomiska funktioner som till exempel att vara lätt att transportera. Följaktligen har två prototyper tillverkats och utvärderats. Den första prototypen utvecklades för att kontrollera om den ger en bra upplevelse för användaren, för att dimensionera komponenterna och för att bestämma deras platser. Detta för att sätta upp mål för den slutgiltiga prototypen. Den slutgiltiga prototypen har en linjärenhet som är monterad på en bottenplatta och en aluminiumprofil som är monterad ovanpå linjärenheten. Den halvgenomskinliga spegeln, sekundära bildskärmen, haptiska enheten och ytterligare funktionsenheter har även monterats på aluminiumprofilen. Autodesk Inventor användes för att designa prototypen. ANSYS användes för att analysera spänningar och vibrationsbeteende hos prototypen för att säkerställa att systemet kommer att fungera tillfredställande. MATLAB användes för matematisk modellering. Testresultaten för den andra prototypen blev lovande. Höjden kan justeras för användaren, som är mellan 155 och 200 cm lång, den är stabil när användaren använder haptikenheten och den är även stabil när användaren ska förflytta prototypen till ett annat rum.