Abstract: The present invention relates to a web-based platform to track medical clinical assignments and to link embedded evaluation instruments to procedure type, for the optimization and improvement of medical clinical education and performance for healthcare professions, and in particular for graduate residents, such as surgical residents. This model is the basis for the platform for physician scoring and profiling to determine physician educational and performance competency with a selected medical procedure. The invention provides methods and systems for improving or optimizing performance tracking of a medical professional.

Abstract: [Object] To more flexibly control the affinity of a spoken utterance for a background sound in accordance with the importance degree of an information notification. [Solution] There is provided an information processing apparatus including an utterance control unit that controls an output of a spoken utterance corresponding to notification information. The utterance control unit controls an output mode of the spoken utterance on the basis of an importance degree of the notification information and affinity for a background sound. In addition, there is provided an information processing method including controlling, by a processor, an output of a spoken utterance corresponding to notification information. The controlling further includes controlling an output mode of the spoken utterance on the basis of an importance degree of the notification information and affinity for a background sound.

Abstract: An AED trainer is implemented using a special purpose hardware platform and a state machine, implemented in software, which together replicate or simulate operations of a target AED device. The state machine operates the AED trainer in an efficient and effective manner to train students to correctly perform rescue procedures on patients suffering from Sudden Cardiac Arrest.

Abstract: Methods, apparatus and computer program products implement embodiments of the present invention that include receiving 3D image data with respect to a 3D region in a living body, the 3D region including a first body cavity having an opening to a second body cavity, and receiving coordinates of a seed location within the first cavity in proximity to the opening. The 3D image data is processed so as to identify, for each ray among a plurality of rays emanating from the seed location at different, respective angles, a respective distance from the seed location to a respective intersection point at which the ray intersects surface tissue in the second cavity. Among the rays, the ray for which the distance from the seed location to the respective intersection point is greatest is selected, and an image is rendered that includes the opening as seen from a location on the selected ray.

Abstract: A system and method that improves the speed and efficiency through which ultrasound practitioners acquire and develop essential basic ultrasound skills in a simulated environment without the need of actual patients or subjects. The system utilizes a simulator with an input device that manipulates a virtual transducer probe in a simulated 3D space to cut a slice through a basic shape. A 2D section of the cut plane is also displayed so that the practitioner can learn to relate 2D section with their 3D objects cut in cross-section.

Abstract: Embodiments receive images of a body area of a patient; identify abnormal tissue in the image; generate a data set with the abnormal tissue masked out; deform a model template in space so that features in the deformed model template line up with corresponding features in the data set; place data representing the abnormal tissue back into the deformed model template; generate a model of electrical properties of tissues in the body area based on the deformed and modified model template; and determine an electrode placement layout that maximizes field strength in the abnormal tissue by using the model of electrical properties to simulate electromagnetic field distributions in the body area caused by simulated electrodes placed respective to the body area. The layout can then be used as a guide for placing electrodes respective to the body area of the patient to apply TTFields to the body area.

Abstract: A rib retention training assembly that is beneficial for training and practicing chest tube insertion and other invasive rib surgical procedures is envisioned to incorporate a portion of an animal rib cage covered by a synthetic sheet of human-like skin. One embodiment contemplates an apparatus comprising three framed plates each with an aperture in the center, much like a picture frame. When assembled, the synthetic sheet of human-like skin is sandwiched between a first outer framed plate and a center framed plate such that the synthetic sheet is covering the respective apertures, and the portion of the animal rib cage is sandwiched between the center frame plate and a second outer framed plate such that the rib cage is covering the respective apertures. This assembly provides a chest prop with a realistic feel for surgical simulations.

Abstract: The present invention patent refers to a system for vascular-surgery simulation that corresponds to an equipment and system designed to produce, by means of 3D printing using a 3D printer, real images of the aorta of the patients obtained by imagined examinations such as computed tomography and/or nuclear magnetic resonance in order to enable doctors to acquire complex skills and/or to refine their operating techniques, training in a controlled environment and with suitable guidance, without putting the patient at risk, being characterized in that it comprises connectors (2) made of silicone, pulsating flow pump (3), negatoscope (4), black box (5), camera (not shown) and monitor (6) such as to reproduce, in silicone or translucent resin, the aortic arch, thoracic aorta, abdominal aorta and the iliac arteries.

Abstract: Techniques and systems are described for providing modularity, tracking and simulation features of a mixed reality simulator. A modular approach to tracking systems, tracked instruments, and interchangeable modular physical models is described. Enhanced indicators and indicator interfaces improve imaging probe and instrument orientation and alignment with respect to a physical target, including but not necessarily within a combined physical and virtual system; these include anisotropy indicators, indicators of alignment in both in-plane and out-of-plane ultrasound or other imaging techniques, and perpendicularity indicators for better placement of probes and instruments over curved surfaces. A universal needle hub is described that integrates tracking system components and simulation feedback components usably with varying needle types.

Abstract: The present disclosure relates to a medicament delivery training device comprising a body, a needle cover, a rotator that is torsionally biased, and a plunger rod. When the needle cover is moved from an extended position to a retracted position relative to the body, this linear motion is transformed into a rotational motion of the rotator which thereby releases the plunger rod. The plunger rod, which is biased, is thereby able to move axially. During axial motion of the plunger rod, the plunger rod is arranged to engage with the rotator to thereby displace the rotator axially, eventually resulting in a first angular distance rotation of the rotator. Upon release of the biased needle cover from the extended position, the rotator is allowed to rotate a second angular distance, thus obtaining a position which prevents the needle cover to move from the extended position towards the retracted position.

Abstract: Various operational mode arrangements of an electric toothbrush (10) include pre-programming a controller portion (16) of the electric toothbrush such that a single brushing event of approximately two minutes comprises automatically at least two different operating modes and specified times for each mode. Another operational mode includes the capability of operating the on/off button (20) of the toothbrush within a specified short time following termination of a normal brushing event to provide the user a specified additional time, e.g. 30 seconds of toothbrush action. A special toothbrush interface arrangement includes a display (80) which encourages children to maintain brushing for the full brushing period. This is accomplished through sequential illustration of the progress of an article from an initial state to a final desired state as the toothbrush is used for increasing portions of a full brushing time period.

Abstract: A resettable injection training device embodiment is provided. In one embodiment, the device may include an outer housing comprising locking tabs at its proximal end, a safety shield, the safety shield being slidable relative to the outer housing between a ready-to-fire position, and a fired position, wherein when the safety shield is in a fired position, the injection simulation member is retracted into the outer housing. The device may further include a plunger comprising a proximal end and a distal end, the proximal end comprising a plunger contact portion for interfacing with the locking tabs to displace the locking tabs to unlock the safety shield, and a biasing member disposed between the outer housing and the safety shield to extend the shield in a proximal direction upon release of the locking tabs, wherein retraction of the plunger and proximal movement of the outer housing resets the device.

Abstract: Systems and methods relating to placement of an ultrasound transducer for a procedure. In a non-limiting embodiment, a 3D environment including images of a body region of a patient, as well as images including a first virtual representation of an ablation needle at a first location and a second virtual representation of an ultrasound transducer at a second location is rendered on a display device. A determination may be made as to whether the first and second virtual representations collide at a first collision point. If so, at least one parameter associated with an orientation and/or position of the second virtual representation may be adjusted. A determination may then be made as to whether or not the first and second virtual representations still collide and, in response to determining that there is no collision, position data indicating the location of the second virtual representation after the adjustment, is stored.

Abstract: A resettable injection training device embodiment including an outer housing having a proximal end and a distal end, the housing defining a chamber there within, a safety shield having a proximal end and a distal end, the safety shield having a retracted, locked position, a first extended unlocked position, a second extended unlocked position, and a second extended locked position is described herein. The device embodiment including a plunger having a proximal a distal end, the plunger having a retracted and an extended position. The device may include a rotating plunger locking collar, an unlocking member coupled to the plunger, wherein rotation of the unlocking member from a first position to a second position unlocks the device and releases the safety shield from the retracted, locked position. The device may further include a resetting cap for resetting the device for a subsequent use.

Abstract: A training system for dental procedures having a training device and a self-assessment for use with the training device is described. The training device is printed with a 3D printer and includes a predetermined anatomic form of at least a portion of a human jaw structure and a predetermined anatomic form of at least one human tooth structure. Part of the printed human tooth structure is rooted in the printed human jaw structure, and both structures are designed to have at least one analogous physical property to their corresponding human structures. The self-assessment includes a pictorial array of procedural outcomes of a procedural step so that a user can identify which image in the pictorial array best represents the user's own procedural outcome of the procedural step performed by the user on the training device and at least one feedback instruction.

Abstract: In one embodiment, the invention can be an oral care system that includes a toothbrush; a user interface configured to receive a brushing goal from a user; and a programmable processor operably coupled to the user interface. The programmable processor can be configured to receive brushing goal data indicative of the brushing goal received by the user interface; and determine, based at least in part on the brushing goal data, at least one of a suggested brushing routine and a brushing evaluation for a brushing session.

Abstract: A liquid flow instructional system for presenting a proportions problem and for allowing the proportions problem to be solved comprises an input container and a plurality of output containers selectively and fluidly coupled to the input container. The system has an adjustable valve having a plurality of configurable regions. Each of the plurality of configurable regions corresponds to one of the plurality of output containers. An activable switch is provided for initiating flow of liquid from the input container to the plurality of output containers in accordance with a user configuration of the plurality of configurable regions. The proportions problem is solvable by filling each of the plurality of output containers to capacity without spillage. The correspondence between the plurality of configurable regions and the plurality of output containers is indicated by a visible indicator.

Abstract: A surgical simulator for electrosurgical training and simulation is provided. The surgical simulator includes one or more simulated tissue structures made substantially of a hydrogel comprising a dual interpenetrating network of ionically cross-linked alginate and covalently cross-linked acrylamide. Combinations of different simulated tissue structures define procedural-based models for the practice of various electrosurgical procedures including laparoscopic total mesorectal excision, transanal total mesorectal excision, cholecystectomy and transanal minimally invasive surgery. Methods of making the simulated tissue structures are also provided.

Abstract: A sensorized surgical instrument for training users laparoscopic surgical procedures is provided. The instrument includes at least one sensor selected from a group consisting of a strain gauge, accelerometer, magnetometer, and gyroscope. The sensor is attached directly to a handle of the instrument. A shaft assembly having a tool tip is interchangeably connectable to the handle. The sensor is connected to a computer configured to provide feedback useful to the user for improving the user's surgical skills. The feedback includes the time to complete a procedure, economy of motion, smoothness of motion and the force exerted at the tool tip.

Abstract: A system includes a guidance device that provides feedback to a user to compress a patient's chest at a rate of between about 90 and 110 compressions per minute and at a depth of between about 4.5 centimeters to about 6 centimeters. The system includes a pressure regulation system having a pressure-responsive valve that is configured to be coupled to a patient's airway. The pressure-responsive valve is configured to remain closed during successive chest compressions in order to permit removal at least about 200 ml from the lungs in order to lower intracranial pressure to improve survival with favorable neurological function. The pressure-responsive valve is configured to remain closed until the negative pressure within the patient's airway reaches about ?7 cm H2O, at which time the pressure-responsive valve is configured to open to provide respiratory gases to flow to the lungs through the pressure-responsive valve.

Abstract: Methods and training programs for improving the level of quality of care within a healthcare plan. The methods include obtaining medical data from a population of patients within the plan, storing such data in electronic medical records embodied on a computer readable medium, evaluating at least one metric within the data via a computer capable of interpreting said electronic medical records, and presenting a notification if the metric is found to be below a standard for the metric. The training includes evaluating the healthcare plan's current practices, training the healthcare provider in improved practices, providing a system for recording medical documents, and training the healthcare provider in use of the system.

Abstract: Systems and methods enabling a personalized solution for allowing more efficient access to the carotid artery (or vertebral arteries) m patients needing endovascular/neurointervention procedures using catheter systems.

Abstract: A medicament-free device (e.g., a smartphone device) for simulating a medicament dispenser may include a sensing device and a processor. The sensing device may sense a user action performed upon the medicament-free device and may output sense data. The processor may receive the sense data, compare the sense data with predefined data, and provide feedback based on how the sense data compares to the predefined data. The predefined data may be indicative of a model user action associated with the medicament dispenser.

Abstract: A method and a system of alerting patient with sleep disorder are provided. The method includes: detecting a change in a parameter(s), and if the change is detected, sounding an alarm, wherein the parameter(s) includes sound, motion, heartbeat, blood pressure, breathing frequency, magnitude and/or frequency of movement. The system includes a detector for detecting a change in a parameter(s) and an output device for sounding an alarm, wherein the parameter(s) comprise(s) sound, motion, heartbeat, blood pressure, breathing frequency, and/or magnitude and/or frequency of movement.

Abstract: Systems and methods for simulating fluid injection procedures are disclosed. According to some embodiments, a fluid injection simulation system comprises a processing unit coupled to a variable flow resistance module. The processing unit determines a fluid flow resistance that corresponds to a predetermined level of resistance for tactilely simulating a fluid injection procedure. The processing unit controls the variable flow resistance module to achieve the fluid flow resistance that corresponds to the predetermined level of resistance for tactilely simulating a fluid injection procedure.

Abstract: Methods, systems, and devices for creating a model of a medical device for use in an extended reality (XR) system are described. The method may include receiving a three-dimensional model of the medical device, where the three-dimensional model is represented by a plurality of vectors. The method may further include reducing a number of the plurality of vectors to at least below a maximum vector count threshold while maintaining at least a minimum model resolution threshold. In some cases, the method may include assigning one or more components to the reduced number of the plurality of vectors. The method may further include configuring a software-executable file for displaying an XR version of the three-dimensional model of the medical device.

Abstract: A system and method for converting static/still medical images of a particular patient into dynamic and interactive images interacting with medical tools including medical devices by coupling a model of tissue dynamics and tool characteristics to the patient specific imagery for simulating a medical procedure in an accurate and dynamic manner by coupling a model of tissue dynamics to patient specific imagery for simulating surgery on the particular patient. The method includes a tool to add and/or to adjust the dynamic image of tissues and ability to draw any geometric shape on the dynamic image of tissues and to add the shape into the modeling system.

Abstract: The present disclosure relates to a tool used to producing anatomical phantoms. The tool includes an inner flexible mold which sits inside a rigid, thermally conductive outer shell. The rigid shell may be made out of aluminum. The silicone mold and thermally conductive shell both include at least two interlocking components. The shell is held together by a locking mechanism which can expand upon internal pressure. An anatomical phantom is produced from polyvinyl alcohol hydrogel by freezing and thawing a PVA liquid precursor in the silicone mold and demolding it.

Abstract: Systems, methods, and tangibly-implemented software instructions for supporting a teleoperated surgical system (TSS). A surgical input that includes monitored events of the TSS, is received. A current stage of the surgical procedure is autonomously determined based on the surgical input. A call for surgeon assistance may be detected, in response to which context-relevant assistance may be provided to a surgeon console of the TSS, the context-relevant assistance being stage-synchronized with the surgical procedure.

Abstract: A medication management system is described that is operable to determine whether a user is actually following a protocol, provide additional assistance to a user, starting with instructions, video instructions, and the like, and moving up to contact from a medication administrator if it is determined that the user would need such assistance in any medical adherence situation, including clinical trial settings, home care settings, healthcare administration locations, such as nursing homes, clinics, hospitals and the like. Suspicious activity on the part of a patient or other user of the system is identified and can be noted to a healthcare provider or other service provider where appropriate.

Abstract: Systems and methods related to the field of cardiac resuscitation, and in particular to devices for assisting rescuers in performing cardio-pulmonary resuscitation (CPR), are described herein. In one aspect, a method for managing cardiopulmonary resuscitation (CPR) treatment to a person in need of emergency assistance includes monitoring a parameter that indicates a fatigue level of a rescuer and providing an indication that a different person should perform the CPR component if the rescuer is exhibiting fatigue.

Abstract: An interactive mixed reality simulator is provided that includes a virtual 3D model of internal or hidden features of an object; a physical model or object being interacted with; and a tracked instrument used to interact with the physical object. The tracked instrument can be used to simulate or visualize interactions with internal features of the physical object represented by the physical model. In certain embodiments, one or more of the internal features can be present in the physical model. In another embodiment, some internal features do not have a physical presence within the physical model.

Abstract: A neck assembly for an anthropomorphic test device (ATD) includes a plurality of vertebra discs, a plurality of ligament joints each having a joint element disposed between the vertebra discs, and a torsion assembly coupled to one of the vertebra discs to allow rotation about an axis of the one of the vertebra discs to simulate torsion response of a human neck.

Abstract: A computer implemented method and system for generating a hybrid test construct, and for simulating and recording events, to test and simulate a virtual environment of connected devices. A plurality of real devices and virtual devices are provided and their behavior parameters are provided. A hybrid test construct of virtual and real devices is created by connecting the plurality of real devices and instantiating the virtual devices and external influencers. At least one container is specified to represent the virtual environment. A spatial relationship of the real devices, the virtual devices, and the external influencers are specified. Then at least one event is specified. A simulation is run where real data is received from the real devices that are then combined with a behavioral simulation of the virtual devices and external influencers. The results of the simulation are then compared to forecasted behavior.

Abstract: An exemplary system may include an augmented reality device with a user interface, a processor and memory having a program communicatively connected to the processor. A transceiver may be communicatively connected to a practitioner device for real-time practitioner guidance. The system may include a plurality of sensors and a feedback device in communication with the processor. The system may display initial and updated guidance objects in a real-time environment of the user and in response to sensor outputs of the plurality of sensors. The feedback device may provide at least one of audio, visual, and tactile feedback in response to the sensors outputs. The system may condition the user to provide a desired reaction by guiding the real-time user reactions in the real-time environment using the feedback in response to the sensor outputs.

Abstract: A system for and method of reconstituting post mortem circulation is provided. Certain methods include simulating natural clotting cascades at wound sites while preventing clotting in reservoirs and within the cadaver. Clot prevention in the reservoir and the cadaver are accomplished with an anticoagulant and a dispersant, respectively. Simulation of clotting at the wound site is accomplished by diluting cadaver fluid with reservoir fluid, thereby diluting the dispersant. The cadaver fluid contains excess calcium for resisting the anticoagulant of the reservoir fluid. Certain methods of the present invention also include reanimating a heart, attaching foreign cadaveric circulatory branches to other cadaveric tissue, enabling mobile cadaveric perfusion, and utilizing a water bath with gravity-feed perfusion.

Abstract: The invention relates generally to a system and methods by which a microbiome-based action component may be developed that is useful in order to establish, restore, promote, or maintain patient health. More specifically, the system and methods of the present invention may be used to develop a microbiome-based action component that efficiently summarizes the state of a patient's microbiome and whether and to what extent inflammation exists in the patient's intestines. Such an efficient summary may be used to render more immediate health care to the patient. Certain specific embodiments of the present invention may be used to facilitate the development a microbiome-based action component that provides, in addition to the efficient summary, a patient-specific, personalized microbiome health plan that includes options that may be followed in order that the patient may achieve personal health, growth, and development goals given the state of the patient's microbiome and intestinal inflammation.

Abstract: Embodiments provided herein include a resettable injection training device having a body, a plunger slidable relative thereto, an injection simulation member and retractable and extendable shield, wherein the shield releasably locks in a retracted position prior to use. After use of the training device, the shield extends over the injection simulation member to prevent contact with the injection simulation member. Resetting of the slidable shield occurs by applying a force onto a distal end of the shield to retract the shield until a shield locking surface interacts with a locking surface on the body to maintain the shield in a retracted position. Release of the shield from a retracted position to an extended position may occur by moving the plunger toward a distal end of the body until a contact region at a proximal end of the plunger releases the shield locking surface from the body locking surface to release the shield.

Abstract: A surgical implement training process that includes teaching an identity of a plurality of first surgical implements in a first surgical implement tray, a location of the plurality of first surgical implements in the first surgical implement tray and an actual order in which each of the first surgical implements are used when performing a surgical procedure. A surgical implement selection system includes a display portion and an input portion. The first surgical implement tray is played on a first display region of the display portion. First images of the first surgical implements in the first display region are selected which causes the first images of the selected first surgical implements to appear in a second display region of the display portion. Each of the first images includes one of the first surgical implements. The first images are organized in the second display region in a testing order based upon when the first surgical implements are used when performing the surgical procedure.

Abstract: A computer-implemented method for medical device modeling includes accessing an electronic definition for a model of a three-dimensional item and an electronic definition of a three-dimensional spline relating to an internal anatomical volume; determining, with a computer-based finite element analysis system and using the electronic definitions, stresses created by the three-dimensional item along the three-dimensional spline, for different points along the three-dimensional spline; and displaying stress data generated by the finite element analysis system with a visualization system, the display of the stress data indicating levels of stress on portions of the three-dimensional item at particular locations along the three-dimensional spline.

Abstract: A simulated tissue structure for surgical training is provided. The simulated tissue structure includes a first layer made of silicone and a second layer made of silicone interconnected by a third layer made of polyester fiber that is embedded in part in the first layer and in part in the second layer to create a mechanical linkage between the first layer and the second layer. Part of the third layer that is adjacent to the first layer and part of the third layer that is adjacent to the second layer includes fiber strands coated in silicone. An inclusion that mimics an anatomical structure is located between the first layer and the second layer. The third layer of polyester fibers provides a realistic dissection plane for the practice of the surgical excision of the inclusion.

Abstract: An ultrasound imaging apparatus includes an image generator configured to scan an object to obtain an ultrasound image; a neural network configured to generate a virtual ultrasound image based on matching medical images of different modalities; an image converting part configured to convert a medical image of a different modality, previously obtained by scanning the object, into the virtual ultrasound image by using the neural network; and a matching part configured to determine a position of a virtual probe based on the ultrasound image and the virtual ultrasound image, and configured to match the ultrasound image with the medical image that corresponds to the determined position of the virtual probe.

Abstract: A surgical simulator for surgical training is provided. The simulator includes a frame defining an enclosure and a simulated tissue model located inside an enclosure. The simulated tissue model is adapted for practicing hysterectomies and includes at least a simulated uterus and a simulated vagina. The simulated tissue model is suspending inside the enclosure with two planar sheets of silicone such that the tissue model is located between the two sheets each of which form a fold and are in turn connected to the frame. The frame may be shaped like a cylinder and located inside a cavity of a larger laparoscopic trainer having a penetrable simulated abdominal wall. The tissue model is interchangeable and accessible laterally through an aperture provided in a support leg of the trainer.

Abstract: A monitoring device operates on a pressure signal from a blood processing apparatus which has an extracorporeal blood circuit for pumping blood through a dialyzer, and a treatment fluid supply system for pumping a treatment fluid through the dialyzer. The monitoring device has a first input block for obtaining a first pressure signal, and a second input block for obtaining a second pressure signal. An emulation block generates, as a function of the second pressure signal, an emulated first pressure signal which emulates a concurrent signal response of the first pressure sensor, and a filtering block generates a filtered signal as a function of the first pressure signal and the emulated first pressure signal, so as to suppress, in the filtered signal compared to the first pressure signal, signal interferences originating from the treatment fluid supply system. A pulse detection block processes the filtered signal for detection of subject pulses.

Abstract: Devices, systems, and methods appropriate for use in medical training are disclosed. In some instances, a patient simulator system is provided that includes a maternal patient simulator and a fetal patient simulator. The maternal patient simulator includes an internal chamber sized to receive the fetal patient simulator and a birthing mechanism disposed within the internal chamber configured to translate and rotate the fetal patient simulator with respect to the maternal patient simulator to simulate a birth. In some instances, the maternal patient simulator includes a structural framework and a sub-layer engaged with the structural framework to provide structural support and alignment features for one or more soft silicon outer layers defining a realistic skin of the maternal patient simulator.

Abstract: Systems, methods and techniques for providing sensory input to a subject through non-invasive brain stimulation are generally described. In some examples, an input signal related to an environment may be received. In various further examples, a communication to the subject may be determined in response to the input signal. In some examples, an output signal corresponding to the determined communication may be generated. Some further examples may comprise non-invasively stimulating a portion of the subject's brain with the output signal with a stimulation subsystem positioned outside of the subject's scalp. In various examples, the stimulation of the portion of the subject's brain may be effective in producing a sensory response perceivable by the subject.

Abstract: Disclosed herein are systems, methods, and software for providing a virtual environment with enhanced visual and haptic detail. In some embodiments, the haptic tool and haptic target are assigned affordance and susceptibility values, respectively, that are used to determine visual and haptic feedback.

Abstract: A method and apparatus for an augmented reality simulator for professional and educational training is provided. The simulator provides a training environment spanning one or more physical locations in which one or more virtual avatars representing purely virtual objects or persons or real physical objects or persons which are located at a different physical location are projected into the physical space. The avatars are interactive with other avatars and real objects or persons and update over time or in response to actions taken by other real or virtual elements, or based on predefined instructions. Sensors and devices are used to detect the locations of and actions taken by real persons or real objects and this sensed data is used to evolve the state of the simulation and avatars based on predefined instructions and programs and update the view of all participants.

Abstract: A simulated abdominal wall model that is ideal for practicing laparoscopic first entry surgical techniques is provided. The model includes a simulated abdominal wall portion captured between two frame elements of a support. The support is connectable to a surgical trainer. When connected to the trainer, the model provides a penetrable abdominal tissue portion for accessing an internal cavity of the trainer. The simulated abdominal wall includes a plurality of layers including a skin layer, a fabric posterior rectus sheath layer, a simulated fat layer of low-resilience polyurethane foam and at least two layers that provide distinctive haptic feedback upon penetration of the simulated transversalis fascia and muscle layers. The simulated abdominal wall includes a simulated umbilicus across several layers of simulated tissue.

Abstract: A training device simulating ablation of a disc space between adjacent vertebral bodies. A heating apparatus includes an upper surface. A lower plate is provided on the upper surface of the heating apparatus. An upper substantially transparent plate is fixed by a frame above the lower plate. The upper plate is etched with an outline of a vertebral body. Fixed in position proximate the lower frame, the upper plate holds a biological material compressed between the plates. Tool-holding clamps, attached to the frame, are positioned to insert a surgical tool, in a proper location and orientation, into the biological material between the upper and lower plates.