Assessing Learning Outcomes in Extracorporeal Membrane Oxygenation Simulations With a Novel Simulator and Instructor Application

Simulation plays an important part in enhancing the outcomes of clinical training worldwide. In particular, extracorporeal membrane oxygenation (ECMO) is a life-saving procedure that utilizes a cardiopulmonary bypass circuit to offer short or mid-term respiratory and circulatory assistance to seriously ill patients. After the current Coronavirus (COVID-19) pandemic hit the world, in-person simulations became quite challenging to organize, due to the precautionary physical distancing practices. Due to ECMOs reliance on hands-on training, there is a need for a physical distancing-compatible solution that does not compromise on learning fidelity. Consequently, an assessment application has been developed to assist ECMO centers in carrying out simulations while being assessed by ECMO educators remotely. In this article, we conceptually introduce a revolutionary tablet-based assessment application for convenient, yet sophisticated and structured assessment of ECMO learners as a companion to an ECMO simulator and instructor application. The proposed application allows real-time assessment of the ECMO simulation experience and creates standardized simulation assessment curricula synced with a high-realism ECMO simulator. Initial app prototype showcases basic functionality, low communication latency, and a prototype simulation system that can simulate various ECMO emergencies. IEEE

Intelligent Edge-Based Recommender System for Internet of Energy Applications

Preserving energy in households and office buildings is a significant challenge, mainly due to the recent shortage of energy resources, the uprising of the current environmental problems, and the global lack of utilizing energy-saving technologies. Not to mention, within some regions, COVID-19 social distancing measures have led to a temporary transfer of energy demand from commercial and urban centers to residential areas, causing an increased use and higher charges, and in turn, creating economic impacts on customers. Therefore, the marketplace could benefit from developing an Internet of Things ecosystem that monitors energy consumption habits and promptly recommends action to facilitate energy efficiency. This article aims to present the full integration of a proposed energy efficiency framework into the Home-Assistant platform using an edge-based architecture. End users can visualize their consumption patterns as well as ambient environmental data using the Home-Assistant user interface. More notably, explainable energy-saving recommendations are delivered to end users in the form of notifications via the mobile application to facilitate habit change. In this context, to the best of the authors’knowledge, this is the first attempt to develop and implement an energy-saving recommender system on edge devices. Thus, ensuring better privacy preservation since data are processed locally on the edge, without the need to transmit them to remote servers, as is the case with cloudlet platforms. IEEE

When High-Realism and Cost-Effectiveness Meet: Simulating Extracorporeal Membrane Oxygenation

Simulators for extracorporeal membrane oxygenation (ECMO) are generally haunted by bulky devices and low-fidelity methodologies. Ongoing efforts optimizing modern solutions for such issues, focusing on minimizing expenses and blending training with the intensive care unit. This is particularly evident, following the Coronavirus pandemic, where economical resources are extensively cut. Upon reviewing the state-ofthe- A rt and developing a strong collaboration with Hamad Medical Corporation (HMC), Qatar's leading provider of healthcare, requirements have been established for the development upon the cutting-edge. This work introduces a high-realism, cost-effective simulator for ECMO for adult patients. Specifically, the system's core relies on a thermochromic module that simulates blood color changes through an innovative reversible technology. On top, multiple simulation modules are developed, including bleeding, line chattering, air bubbles noise, and more. Furthermore, wireless technology enables teachers to orchestrate the teaching process via a custom developed tablet application. It also enables both creative and standardized simulation scenario modeling via an intuitive interface. Currently, a high-fidelity, product-level prototype is in the final stages of development (Figure 1). In a questionnaire-based study conducted in 2017 at HMC, nineteen specialists classified the efficiency of the simulator as highly realistic during an interactive demonstration. A second study is planned to be performed to assess the educational effectiveness of the simulator as a complete ECMO simulation toolbox that meets strict budget constraints and yet satisfies high pedagogical standards. Acknowledgements This paper was supported by Qatar University Internal Grant No. M-CTPCENG-2020-1. The findings achieved herein are solely the responsibility of the authors.

Enhancing ECMO blood simulation with a thermochromic color change system

Objective: With skyrocketing demand on ECMO particularly after the Coronavirus (COVID-19) pandemic, the need for properly trained staff has increased. Hence, expectations on ECMO training technology necessitate cost-effective, scalable, and yet high-realism implementations. One of the most important ECMO cues is to realistically present the blood color, and therefore an accurate and economical simulation of the blood color in ECMO is an essential and challenging endeavor. In this work, as part of an ECMO simulation initiative in collaboration with Hamad Medical Corporation, a novel thermochromic color change system is presented. Methods: To implement the system, and to simulate oxygenation and deoxygenation successfully, we are utilizing thermochromic ink, a special dye that reacts to temperature by changing color. Therefore, the system is composed of the main tank for supplying the ink, a cooling unit, and a heating unit. The components are coordinated by a control system to heat/cool the ink to simulate bright/dark blood colors respectively. Results: The system has been developed as a prototype with realistic and reversible color transitions. To achieve the oxygenation state, the ink is heated to 35°C whilst hypoxemia can be simulated by dropping the temperature below 25°C. Figure 1 shows the prototype. Conclusions: Following successful testing, the system is to be integrated with authors' ECMO simulator, allowing unpreceded cost-efficient simulation possibilities.

A High-Realism and Cost-Effective Training Simulator for Extracorporeal Membrane Oxygenation

Medical simulators, employed in extracorporeal membrane oxygenation (ECMO), are burdened with costly equipment and low-fidelity methodologies. This dichotomy necessitated a new approach that eliminates high-costs and integrates with the critical care environment. This is especially applicable after the Coronavirus pandemic, where resources and supplies are evermore scarce. After examining the state-of-the-art and establishing a close collaboration with Hamad Medical Corporation (HMC), the main healthcare provider in Qatar, several criteria were identified to advance the cutting-edge. In this article, a high-realism, cost-effective ECMO simulator is presented. It runs on a novel blood simulation technology along with simulation modules. An instructor tablet application enables instructors to orchestrate the training experience wirelessly with real-time performance. It also includes a novel scenario designer for implementing consistent simulation curricula. A product-level simulator with high-fidelity casings is in the final integration phases. Current results include developing and testing the simulated blood circuit, simulation modules for hemorrhaging, line chattering, air bubbles noise, and a replicated console along with an integrated communications system. Nineteen specialists rated the fidelity of the system as highly realistic during a questionnaire-based study. It is expected to run a second study to evaluate the educational efficacy of the simulator as a first-of-its-kind in the region. CCBYNCND