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Pulse Release 4.3

Aaron Bray requested to merge integration into stable
  • CDM API Changes
    • Blood Chemistry System Data
      • Added PlasmaOsmolality and PlasmaOsmolarity
    • Respiratory System Data
      • Added ExtrinsicPositiveEndExpiratoryPressure
      • Changed InspiratoryPulmonaryResistance to InspiratoryRespiratoryResistance
      • Changed IntrinsicPositiveEndExpiredPressure to IntrinsicPositiveEndExpiratoryPressure
      • Changed ExpiratoryPulmonaryResistance to ExpiratoryRespiratoryResistance
      • Changed PulmonaryCompliance to RespiratoryCompliance
      • Changed PulmonaryElastance to RespiratoryElastance
      • Changed PositiveEndExpiratoryPressure to TotalPositiveEndExpiratoryPressure
    • Environmental Conditions Data
      • Added MechanicalDeadSpace
    • Anesthesia Machine Data
      • Changed PositiveEndExpiredPressure to PositiveEndExpiratoryPressure
    • Bag Valve Mask Data
      • Changed ValvePositiveEndExpiredPressure to ValvePositiveEndExpiratoryPressure
    • Mechanical Ventilator Data
      • Added PeakInspiratoryFlow
      • Added ExtrinsicPositiveEndExpiratoryPressure
      • Changed PositiveEndExpiratoryPressure to TotalPositiveEndExpiratoryPressure
      • Changed DynamicPulmonaryCompliance to DynamicRespiratoryCompliance
      • Changed IntrinsicPositiveEndExpiredPressure to IntrinsicPositiveEndExpiratoryPressure
      • Changed StaticPulmonaryCompliance to StaticRespiratoryCompliance
    • Mechanical Ventilator Settings Data
      • Added ExpiratoryResistance and InspiratoryResistance
      • Changed PositiveEndExpiredPressure to PositiveEndExpiratoryPressure
    • Mechanical Ventilator Continuous Positive Airway Pressure Data
      • Changed PositiveEndExpiredPressure to PositiveEndExpiratoryPressure
    • Mechanical Ventilator Pressure Control Data
    • Changed PositiveEndExpiredPressure to PositiveEndExpiratoryPressure
    • Mechanical Ventilator Volume Control Data
      • Changed PositiveEndExpiredPressure to PositiveEndExpiratoryPressure
  • Software Architecture Improvements
    • Data Set Generation Tools
      • Initial patient set generator
        • Can create large patient sets using permutations of starting HR, RR, MAP, Age, Height, BMI, BFF and other patient properties
      • Injury set generator
        • For each patient in a patient set, will apply and run a permutation of inujuries such as (but not limited to) Hemorrhage, AirwayObstruction, Tension Pneumothorax
        • Convience modes provided to generate a set of preprogrammed TCCC injuries
    • Combined DataModelBindings, CommonDataModel and PulseEngine into a single Pulse library
      • This single library can be built as a shared/dynamic library or a static (default) library
    • Implement system/patient validation framework in Python
      • Provides access to more discrete modules in our validation pipeline for more versatile use
    • Initial architecture for automated validation
      • Currently only AirwayObstruction has been migrated
      • Created a xlsx template for automating the our validation of our models (is currently being done by hand)
      • The validation pipeline can also create a single doxygen report with a plot file and md files associated with an xlsx
      • Added the ability to create vitals monitor and ventilator monitor plots from CSV files
    • Created an Advance To Stable Action, this will run the engine until stable criteria is met
    • Threaded execution of a group of scenarios now can be provided a single json file containing all scenario to run
      • Information for every executed scenario is then updated in the provided file:
        • The locations of the: scenario file and its generated log file, and csv file
        • Various error states if encountered: Unable to initialize and why, if there were any other errors encountered
    • Post processing pipeline
      • Written in python, allows us to process a log and csv file generated from a scenario and pull out (and even generate new) data into a more machine learning friendly format
        • Unstructure Text Module looks at map of vitals to a string vector and randomly takes strings based on the vitals values to create an unstructured description of the simulation at that time. The strings and bounds are read in from a spreadsheet
    • Testing Utils
      • Add a run.cmake option to generate a config of all the failures for a quick and easy rebase (once they have been reviewed and approved of course)
      • Remove action vertical lines in our verification plots of actions that occur many many times. These actions are usually testing sensor driven inputs and make data interpretation difficult.
    • Fixed improperly mapped events
  • Physiology Model Improvements
    • Updated dyspnea implementation
      • Split single severity into a Respiration Rate severity and Tidal Volume severity
      • This allows users to define breathing impairments with more precision
      • Note any previous scenarios using Dyspnea severity should apply that value to the Tidal Volume severity
    • Mechanical Ventilator Model
      • Ventilation will immediately stop at limits for more precise targets
      • Apneic patients will no long trigger the ventilator when the model trigger is selected
      • Update naming conventions and parameter calculations to be match more widely accepted definitions
    • Respiratory Model
      • Improved handling of lung recruitment based on acinar ventilation for showing the pulmonary shunt changes due to increased ventilator PEEP
      • Calibrated respiratory diseases for mechanically ventilated patients, including ARDS and COPD
      • Added mechanoreceptor feedback that inhibits the inspiratory drive and reduces the respiratory muscle pressure during an assisted breath
    • Modifier Actions (SECardiovascularMechanicsModification, SERespiratoryMechanicsModification)
      • We now provide 2 new actions to modify the respiratory and cardiovascular model parameters
      • For example, you can provide a multipliers to modify the heart rate, respiration rate, systemic vascular and pulmonary resistances
      • This provides the end user more low level control to fine tune the physiology to their specific needs
    • The application of drug pharmacodynamics changes to the cardiovascular system now include pulse pressure as well as mean arterial pressure
      • Acute stress is more inline with validation data
    • Updated body fluid and perspiration methodology
      • Added sweat substance loss using a substance compound definition
      • Updated the sweat rate methodology to better meet validation
      • Calibrated the convective/evaporative heat loss due to sweating
      • Fixed a bug for substance tissue diffusion between the vascular and extracellular spaces
      • Added new system data outputs for total body fluid volume, plasma osmolality, and plasma osmolarity
    • Added a dehydration condition model that directly affects the Tissue, Cardiovascular and Energy systems
      • Associated new events: Hypernatremia Hyponatremia, MildDehydration, ModerateDehydration, SevereDehydration
    • Added a mechanical dead space parameter to the Environment
    • Updated the urinalysis assessment with more appropriate substance thresholds
    • Added logic for several missing events: hyperglycemia, hypoglycemia, ketoacidosis, and lactic acidosis

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