BioGears Open Source Human Physiology Engine IMSH2014 Conference

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1 BioGearsEngine.com

28 January 2014

Open-Source Physiology Model for Simulation-Based Training

Mr. Jerry Heneghan, Director of HumanSim Product Development, Applied Research Associates, Inc. (ARA)

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Disclaimers

•  TATRC Funded Project: W81XWH-13-2-0068 •  “This work is supported by the US Army Medical Research

and Materiel Command.” •  “The views, opinions and/or findings contained in this report

are those of the author(s) and should not be construed as an official Department of the Army position, policy or decision unless so designated by other documentation.”

•  Unreal® Engine Licensing (UnrealEngine.com) •  I am the Unreal licensing manager in the government

vertical

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•  Director of Product Development for HumanSim® at ARA

•  Founder and former CEO of Virtual Heroes, Inc. acquired ’09

•  Executive Producer for America’s Army Game

•  Program manager in the Technology Assisted Learning Division of the Research Triangle Institute (RTI) - focused on the game technologies for healthcare training and education

•  Game producer at Tom Clancy’s Red Storm Entertainment •  Started his career in the military and served as a U.S. Army Aviator

(AH-64 pilot) in assignments all over the world •  Holds an M.B.A. from the Fuqua School of Business at Duke

University and a B.S. in engineering from the U.S. Military Academy

BioGears: Principal Investigator "BioGears is a project of great importance to the medical simula:on community and the advancement of immersive medical technologies. Our team looks forward to crea:ng the most comprehensive, open source mathema:cal model of human physiology available.” – Mr. Jerry Heneghan

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•  BioGears has four main parts a physiology engine, common data model, extensive documentation and BioGearsEngine.com that gives everyone access to state-of-the-art physiology modeling software.

•  Both the common data model and the physiology engine will be open source.

What is BioGears?

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•  The goals of BioGears are: •  Create a publicly available physiology research

platform that enables accurate and consistent simulated physiology across training applications

•  Lower the barrier to create medical training content

•  Engage the community to develop and extend physiology models

•  Meet the training needs of the military •  Expand the body of knowledge regarding the use

of simulated physiology for medical education

BioGears: Project Goals

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•  ARA is the prime contractor •  We have a mix of engineers, computer scientists and

biomedical personnel contributing to BioGears •  Bryan Bergeron, M.D. (www.bryanbergeron.com) •  We are identifying additional partners who have expertise

specifically in the areas of pharmacokinetics, and modeling of chronic conditions

•  We are seeking an experienced physiology modeler to join ARA’s team •  For more information please see www.careers.ara.com

BioGears: Project Team

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BioGears: Anticipated Schedule 2013

2014

2015

2016

2017

Milestone: Project Kick Off (Sept 15, 2013) Creation of Common Data Model Rearchitecture of Physiology Engine Base System Development Base System Validation

Milestone: Mini Build Release and Website Launch (Sept 2014)

Feature Development Feature Validation Community Outreach

Milestone: Beta Build Release and Users’ Group Conference (Fall 2015)

Engine Maintenance Continued Community Involvement Publications

(2017) Website Maintenance Only

Current Progress

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•  Physiology Systems: •  Blood Chemistry •  Cardiovascular •  Energy •  Fluids •  Respiratory/Gas Exchange •  Renal

•  Additional Systems •  Anesthesia Machine •  ECG •  Drug Administration

BioGears: Engine Capabilities

•  Features: •  Hemorrhage •  Smoke Inhalation •  Exercise

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•  Systems use a circuit representation or lumped parameter approach composed of compartments

•  Systems then monitor compartment information to trigger

physiological responses and feedback mechanisms •  Interface commands allow users to trigger events that the

systems reacts to

BioGears: Engine Methodology

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•  Inject Succinylcholine (muscle relaxant) •  Cardiovascular circuit transports around the body •  Appropriate compartment detects level and reduces spontaneous

respirations and heart contractility •  Endocrine system releases hormones to increase heart rate and blood

pressure once low arterial oxygen is detected •  Resistance and capacitance of the cardiovascular system compartments

is modified in an effort to compensate/stabilize the body

BioGears: Engine Methodology Example

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•  Object Oriented Design of class structures that provides a unified set of data objects for physiology simulation •  Anatomy, Circuits, Compartments, Equipment, Patient, and

Substances/Drugs

•  Implemented in an eXtensible Markup Language (XML) schema •  This representation supports the structure, relationships, and

organization of data, and provides a standard for data exchange

•  Provides the link between physiological data and the mathematics needed to accurately represent and evaluate a series of systems and events

BioGears: Software Common Data Model (CDM)

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•  BioGears will be open source all code under the BSD 3 license •  Includes the CDM and Engine, plus other framework support

•  BSD 3 license is a GPL-compatible software license that allows unlimited modification and/or redistribution of code and/or derived products for any purpose as long as its copyright notices and the license's disclaimers of warranty are maintained

•  While it is encouraged that any modification or extension to the BioGears code base be made available to the community, under BSD 3, it is not required for modifications to be released to the community

BioGears: Envisioned Users

Adds systems to the engine Extends func:onality Replaces systems with other models

BioGears Contributor

Use the engine as is via the API Ex. Game Developers

Engine Integrator

Uses/extends CDM to drive their model Runs BioGears engine and other engine(s) in tandem

External Model/ Engine Developer

Creates customer files (pa:ents, drugs, command lists, etc) as input to BioGears engine for research purposes

Researcher/ Educator

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•  Software Development Kit (SDK) (Targets: Integrator) •  Built Binaries and Headers •  Front facing Interface only access point •  Code Examples •  Doxygen style documentation for every interface/function •  Datasets: Patient, Drug, configuration files, etc

•  Source Code (Targets: Integrator, Contributor, Model Developer, Researcher) •  Header, Code, and project files (makefiles, msvc projects, etc.) •  Full Doxygen style documentation inline for entire engine code

base including functionality, references, assumptions etc. •  System Level Documents (Targets: Researcher,

Contributor, Model Developer) •  Word Documents for each system •  Methodology of the system, good background information for

papers and researchers •  Does not cover the workings of every subroutine in the code

base

BioGears: Software Deliverables

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•  Male, 25 y/o, high level of physical conditioning •  Actions/Interventions: Performing strenuous

exercise at high altitude. Results in heat stroke •  Assessments: Core temperature, sweat rate,

pallor, heart rate •  Female, with Asthma, 12 hrs NPO, OR

•  Actions/Interventions: Administer drugs, intubate

•  Assessments: Blood panel, respiration rate, ETCO2, Heart rate, BP, SPO2, PFT

•  Male 60 y/o, hypertensive, diabetic, obese: •  Actions/Interventions: Drug administration •  Assessments: Blood Panel, Urine Panel,

EKG, Retina Assessment

BioGears: Showcase Scenarios

Sedation & Airway Images Project funded by TATRC

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•  Female, 17 y/o, exposure elements •  Actions/Interventions: Environment

customization for heat loss and body insulation; variation of nutritional/hydration state

•  Assessments: Core /Peripheral temperature, Heart Rate, Respiration Rate

•  Male 22 y/o, massive trauma resulting in hemorrhage, tension pneumothorax •  Actions/Interventions: Tourniquet

Application, Needle Decompression, drug and fluid administration

•  Assessments: Bleeding rate, heart rate, blood pressure, distal pulse, respiration rate

BioGears: Showcase Scenarios contd.

Combat Medic Images Project funded by Army RDECOM

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•  Under Development •  Learn about the engine and

the BioGears project •  Download the engine (mini

build 2014, beta build 2015) •  Connect with community

members via forums •  Share scenario files, see

how others are using the engine

BioGearsEngine.com

•  Sign Up for conference and project news

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•  Source Code: •  Primary trunk and contributor branches available via Google Code •  Link to source provided at BioGearsEngine.com (first build available

Fall 2014) •  Configuration and Data Files:

•  Scenario files, patient files, drug files, etc, can be accessed and posted on BioGearsEngine.com

•  Analysis: •  Forum discussions, uploaded publication and other documents that

discuss the use, validation, and extensions of the BioGears engine •  Example:

•  A user can create a branch to model a new feature. Then discuss their contributions and provide configuration and analysis information via the website forums.

BioGears: How to Contribute

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•  In Fall 2015 the BioGears team will hold a conference in the Raleigh/Durham area.

•  The conference will coincide with our BioGears Engine Beta Build release and will focus on: •  How to use BioGears in your application •  How you can contribute to the ongoing body of knowledge •  Demonstrating how BioGears is working in a medical training tool

ARA is developing for the Army

•  We are looking for interested parties to sign up to participate, speak and display.

•  Please ‘sign up’ via BioGearsEngine.com to keep up with news about the project and the conference!

BioGears: Conference 2015

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QUESTIONS