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Background. Simulation-based learning (SBL) employs the synergy between technology and people to immerse learners in highly-realistic situations in order to achieve quality clinical education. Due to the ever-increasing popularity of extracorporeal membrane oxygenation (ECMO) SBL, there is a pressing need for a proper technological infrastructure that enables high-fidelity simulation to better train ECMO specialists to deal with related emergencies. In this article, we tackle the control aspect of the infrastructure by presenting and evaluating an innovative cloud-based instructor, simulator controller, and simulation operations specialist application that enables real-time remote control of full-scale immersive ECMO simulation experiences for ECMO specialists as well as creating custom simulation scenarios for standardized training of individual healthcare professionals or clinical teams. Aim. This article evaluates the intuitiveness, responsiveness, and convenience of the ECMO instructor application as a viable ECMO simulator control interface. Method. A questionnaire-based usability study was conducted following institutional ethical approval. Nineteen ECMO practitioners were given a live demonstration of the instructor application in the context of an ECMO simulator demonstration during which they also had the opportunity to interact with it. Participants then filled in a questionnaire to evaluate the ECMO instructor application as per intuitiveness, responsiveness, and convenience. Results. The collected feedback data confirmed that the presented application has an intuitive, responsive, and convenient ECMO simulator control interface. Conclusion. The present study provided evidence signifying that the ECMO instructor application is a viable ECMO simulator control interface. Next steps will comprise a pilot study evaluating the educational efficacy of the instructor application in the clinical context with further technical enhancements as per participants? This article was also made possible by an UREP grant #19-062-2-026 from the Qatar National Research Fund (a member of Qatar foundation). This article also was supported by Qatar University Internal Grant No. QUST-CENG-SPR-15/16-8. The statements made herein are solely the responsibility of the authors. Scopus

Medical simulators are advancing in technology and complexity to enhance realism and hence implementing a real-time communication system for such simulators is a challenge that engineers face. This paper follows up on the Firebase communication system solution that was employed for the modular extracorporeal membrane oxygenation (ECMO) simulator and addresses its challenges and limitations by presenting an alternative CouchDB based communication system. Testing results shows that CouchDB overcomes Firebase limitations in terms of latency, compatibility, and ongoing maintenance costs. The new approach features automatic application program interfaces (APIs), extremely low latency, and long term reliability. This paper was supported by Qatar university Internal Grant No. QUCG-CENG-2018-1. The findings achieved herein are solely the responsibility of the authors. Scopus

The sensitive domain of healthcare intensifies the shortcomings associated with internet of things (IoT) based remote health monitoring systems in terms of their high-energy consumption and big data issues such as latency and privacy, caused by, the continuous stream of raw data. Hence, in the development of their remote elderly monitoring system (REMS), the authors focus on using embedded multicore architectures as powerful IoT edge devices and energy efficient signal acquisition and processing techniques to elevate such limitations. This study addresses the design of sparsifying matrices for electroencephalogram (EEG) signals in the context of compressed sensing. These signals are known to be non-sparse in both time and standard transform domains. The designed matrices are adapted to the data and are based on the autoregressive modeling of the signal and the singular value decomposition (SVD) of the impulse response matrix of the linear predictive coding (LPC) filter. To facilitate the hardware implementation and to prolong the life of the wearable node, the measurement matrix is chosen to be binary. The proposed algorithm has been applied to the EEGLab dataset 'eeglab data set' with an average normalized mean square error of 0.068. This paper was made possible by National Priorities Research Program (NPRP) Grant No. 9-114-2-055 from the Qatar National Research Fund (a member of Qatar Foundation). Scopus

The Internet of Things (IoT) has started redesigning the paradigm of the connected health sector by leveraging the availability of low power, low-cost sensors and efficient communication protocols. Consequently, IoT based connected health platforms are expected to further enhance the patient connectivity and everyday convenience. Nevertheless, issues related to power consumption and user security limit the performance of such systems. The conventional approaches that incorporate biometric measures into the IoT design rise high concerns regarding the cost and the complexity of the implementation. This paper proposes an identification approach integrated within a patient�s heart monitoring system based on the theory of compressive sensing (CS). CS is an emerging theory that promotes both power optimization and security by transmitting random measurements with fewer samples rather than transmitting the whole raw signal. The proposed system uses the electrocardiogram (ECG) as a biometric measure to identify the patient. The advantage of such system is that it does not require any additional complexity to acquire and process the data. The obtained results showed a successful identification rate up to 98.88% by compressing the transmitted signal to only half the original one. - Springer Nature Switzerland AG 2019. Scopus

Introduction: Patients under the error-prone and complication-burdened extracorporeal membrane oxygenation (ECMO) are looked after by a highly trained, multidisciplinary team. Simulation-based training (SBT) affords ECMO centers the opportunity to equip practitioners with the technical dexterity required to manage emergencies. The aim of this article is to review ECMO SBT activities and technology followed by a novel solution to current challenges. ECMO simulation: The commonly-used simulation approach is easy-to-build as it requires a functioning ECMO machine and an altered circuit. Complications are simulated through manual circuit manipulations. However, scenario diversity is limited and often lacks physiological and/or mechanical authenticity. It is also expensive to continuously operate due to the consumption of highly specialized equipment. Technological aid: Commercial extensions can be added to enable remote control and to automate circuit manipulation, but do not improve on the realism or cost-effectiveness. A modular ECMO simulator: To address those drawbacks, we are developing a standalone modular ECMO simulator that employs affordable technology for high-fidelity simulation.

Introduction: Extracorporeal membrane oxygenation (ECMO) training programs employ real ECMO components, causing them to be extremely expensive while offering little realism in terms of blood oxygenation and pressure. To overcome those limitations, we are developing a standalone modular ECMO simulator that reproduces ECMO’s visual, audio and haptic cues using affordable mechanisms. We present a central component of this simulator, capable of visually reproducing blood oxygenation color change using thermochromism. Methods: Our simulated ECMO circuit consists of two physically distant modules, responsible for adding and withdrawing heat from a thermochromic fluid. This manipulation of heat creates a temperature difference between the fluid in the drainage line and the fluid in the return line of the circuit and, hence, a color difference. Results: Thermochromic ink mixed with concentrated dyes was used to create a recipe for a realistic and affordable blood-colored fluid. The implemented “ECMO circuit” reproduced blood’s oxygenation and deoxygenation color difference or lack thereof. The heat control circuit costs 300 USD to build and the thermochromic fluid costs 40 USD/L. During a ten-hour in situ demonstration, nineteen ECMO specialists rated the fidelity of the oxygenated and deoxygenated “blood” and the color contrast between them as highly realistic. Conclusions: Using low-cost yet high-fidelity simulation mechanisms, we implemented the central subsystem of our modular ECMO simulator, which creates the look and feel of an ECMO circuit without using an actual one.

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 over-reliance 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.

Despite the progressive development and adoption of simulation-based training (SBT), the current practices do not match the ever-increasing international demand. This statement is especially applicable to extracorporeal membrane oxygenation (ECMO); a sophisticated life-saving technique that demands a highly-trained, multidisciplinary team. ECMO SBT mostly employs rudimentary and impractical techniques for simulation. Despite the availability of several simulators, the procedure remains highly costly to simulate and technical limitations impede scaled adoption and effective instruction. This paper proposes a novel modular approach to ECMO simulator design. By compartmentalizing the system into cost-effective, reusable, and extensible modules; physical fidelity can be achieved while keeping costs to a minimum. 2017 IEEE. This publication was made possible by an internal Qatar University grant and UREP grant #19-062-2-026 from the Qatar National Research Fund (a member of Qatar foundation). The statements made herein are solely the responsibility of the authors. Scopus

This document is the Accepted Manuscript version of the following article: Mohammed Al Disi, Abdullah Alsalemi, Yahya Alhomsi, Faycal Bensaali, Abbes Amira, and Guillaume Alinier, ‘Revolutionizing ECMO simulation with affordable yet high-Fidelity technology’, The American Journal of Emergency Medicine, Vol. 36 (7): 1310-1312, July 2018. Under embargo until 15 November 2018. The final, definitive version is available online via doi: https://doi.org/10.1016/j.ajem.2017.11.036.

Extracorporeal membrane oxygenation (ECMO) is a high-complexity life-saving procedure where quick and coordinated interventions are required to avoid mortality. ECMO perfusionists and nurses must be well trained to respond to time-critical emergencies, using simulation-based education, which currently rely on rudimental ECMO simulation processes. Implementing a simulation system for such complex medical procedure necessitates a robust, well-coordinated underlying architecture. In this paper, the use of Internet of Things (IoT) service Firebase is presented in the case study of an ECMO simulator. Features of the proposed solution are discussed and justified in the given use case including latency, hardware compatibility, and data management. For the used case of ECMO simulation system, Firebase proved to be a proper communication solution that satisfied the urgent nature of medical training. 2017 IEEE. This publication was made possible by an internal Qatar University grant and UREP grant #19-062-2-026 from the Qatar National Research Fund (a member of Qatar foundation). The statements made herein are solely the responsibility of the authors. Scopus