The Audible Human Project

描述(由申请人提供)：国家医学图书馆的可见人项目(VHP)促进了先进可视化软件的发展，有助于解剖学教育，并已成为生物医学研究人员的宝贵资源。它帮助开发了许多技术，应用范围从改进成像技术到模拟手术过程。我们的长期目标是开发一个类似的“可听人项目”(AHP)。这将准确地模拟与心血管、肺和胃肠功能相关的自然产生的声音的产生、传播和非侵入性测量。它还将模拟外部引入的声音，例如通过在皮肤表面进行敲击。可听人体模型由具有特定病理和传感器的特定人类受试者的声学特征基线构建，可外推具有不同病理和解剖维度的虚拟患者的声学特征。它还模拟使用与原始记录传感器不同的声学传感器访问虚拟患者的病理。这样一个全面的工具将对医学教育和研究产生重大影响。它可以促进新的廉价、便携的听诊方法的发展，以及更先进的多模式声学成像方式的发展。从教育的角度来看，最近的研究强调了熟练听诊在医学上的持续重要性，以及这项技能在年轻医生中正在衰落的事实。AHP可以帮助提供更有效的教育体验。学生不仅会听录音，还能互动地改变解剖学和病理学，以及传感器的位置、类型和接触压力，以便(在触觉环境中)听到、“看到”和“感觉”结果，并将它们与可量化的指标联系起来。这项为期5年的R01应用程序(基于R03试点拨款，获得了126的优先分数)的目标是开发和实验验证全面的男性和女性上半身声学模型，该模型能够表示健康和特定的病理条件，包括气胸、胸腔积液、胸腔积液、粘液堵塞、肺气肿、肥胖和肺部肿块(肿瘤)。这些模型将模拟呼吸声音的产生、传输和测量，通过躯干表面的接触式和非接触式传感器。他们还将通过在声门将声音引入支气管树或通过敲击躯干表面来模拟外部引入的声音的传输和测量。为了实现这一目标，将开展以下具体目标：(1)开发AHP计算机模拟模型以模拟呼吸声的产生，特定的肺部病理如何改变声环境，以及不同接触声传感器的动力学如何改变测量结果；(2)进行机械体模模型研究以评估和改进AHP计算机模型；(3)进行犬类动物模型研究以进一步改进AHP计算机模型；以及(4)进行人体对象研究以验证AHP计算机模型。 与公共卫生相关：设想的综合可听人类项目，与可视人类项目一样，将与医学研究和教育相关。它将通过促进改进的医疗诊断技术的发展，并通过提供更有效的教育范例来教授听诊技能，从而显著影响公共卫生，最近的研究指出，听诊技能正在下降。学生不仅可以听录音，还可以互动地改变解剖学和疾病，以及听诊器的特征，并能听到、看到和感觉到结果。

DESCRIPTION (provided by applicant): The Visible Human Project (VHP) of the National Library of Medicine has catalyzed the development of advanced visualization software that has aided in anatomy education and has been an invaluable resource to biomedical researchers. It has aided in the development of numerous technologies, with applications spanning from improving imaging technology to simulating surgical procedures. Our long-term goal is to develop a comparable "Audible Human Project" (AHP). This would accurately simulate the production, transmission and noninvasive measurement of naturally-occurring sounds associated with cardiovascular, pulmonary and gastro-intestinal function. It would also model externally introduced sounds, for example via percussion at the skin surface. Constructed from a baseline of acoustic characteristics recorded for specific human subjects with specific pathologies and sensors, the Audible Human model extrapolates the acoustic characteristics for virtual patients with different pathologies and anatomical dimensions. It also simulates access to the pathologies of virtual patients using different acoustic sensors from the original recording sensor. Such a comprehensive tool would have a significant impact on medical education and research. It could catalyze the development of new inexpensive, portable auscultative methods, as well as more advanced multimode acoustic imaging modalities. From an educational perspective, recent studies have emphasized the continued importance of skilled auscultation in medicine and the fact that this skill is in decline among younger physicians. The AHP could help provide a more effective educational experience. A student would not just listen to audio recordings, but would be able to interactively vary anatomy and pathology, as well as sensor position, type and contact pressure, so as to hear, "see" and "feel" (in a haptic environment) the results and associate them with quantifiable metrics. The goal of this 5-year R01 application (which builds upon a R03 pilot grant that received a priority score of 126) is to develop and experimentally validate comprehensive male and female upper torso acoustic models capable of representing healthy and specific pathological conditions, including pneumothorax, pleural effusion, hydrothorax, mucous plugs, emphysema, obesity and masses (tumors) in the lung. These models will simulate breath sound generation, transmission and measurement via contact and non-contact sensors on the torso surface. They will also simulate the transmission and measurement of externally introduced sound via introduction of sound at the glottis into the bronchial airway tree or via percussion on the torso surface. In order to achieve this goal, the following specific aims will be undertaken: (1) Develop the AHP computer simulation model to simulate breath sound generation, how specific lung pathologies alter the acoustic environment, and how different contact acoustic sensor dynamics alter measurements; (2) Perform mechanical phantom model studies to evaluate and refine the AHP computer model; (3) Perform canine animal model studies to further refine the AHP computer model; and (4) Perform human subject studies to validate the AHP computer model. PUBLIC HEALTH RELEVANCE: The envisioned comprehensive Audible Human Project, like the Visible Human Project, will be relevant to both medical research and education. It would significantly impact public health by catalyzing the development of improved medical diagnostic techniques and by providing a more effective educational paradigm for teaching stethoscopic skills, which are in decline as noted in recent studies. The student would not just listen to audio recordings but would be able to interactively vary anatomy and disease, as well as stethoscope characteristics and hear, "see" and "feel" the results.