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Selectable instruments with homing devices for haptic virtual reality medical simulation
Invention is apparatus for using selectable instruments in virtual medical simulations with input devices actuated by user and resembling medical instruments which transmit various identifying data to the virtual computer model from said instruments which have been selected; then, said apparatus assist in creating full immersion for the user in the virtual reality model by tracking and homing to instruments with haptic, or force feedback generating, receptacles with which said instruments dock by means of a numerical grid, creating a seamless interface of instrument selection and use in the virtual reality anatomy.
The current invention makes a range of medical simulations more realistic to the user. In virtual reality simulations, the user becomes immersed in a "world" which is artificially constructed from computer graphics in polygon frames to be a visual representation in three dimensions which changes to the user's view as he or she effects movement inside that world. In simple simulations, the user merely navigates around objects and through the virtual environment. Thus, in more complex medical simulations, the user is required to manipulate objects within the virtual environment, changing their places within that artificial, visual domain. When supplementing the virtual experience with physical medical instruments as the interface device, it is far more difficult to achieve realism, but that realism, when achieved, extends out to the very hands of the user.
In the most complex virtual reality simulations, such as medical simulations, the user can grasp and deform anatomical objects with instruments which are virtual within the computer-created world, but which--as interfaces--are handles of the instruments which might be used within that anatomy by doctors performing procedures. This obviously requires sensors of geometric position in the interface. However, in the highest level of virtual reality simulator which also senses interface position geometries, the user will experience not only instrument tactility, but force feedback from the instrument and from the organ which is seen in the virtual environment. In some cases, feedback to the hand has been effectuated through a special glove. Thus in the highest level of medical simulation, both visual and haptic displays must work in coordination.
Other technical elements in the creation of the virtual simulation include whether the user is semi-immersed, or fully immersed. In a semi-immersed situation, the user operates within the virtual world by using some sort of interface--a mouse or a touchpad, voice commands and, at times, mock instruments which electronically serve as an interfaces to the virtual reality. In this semi-immersive virtual reality, the user is watching a remote virtual world--such as one, which would normally be observed on a CRT screen in a minimally invasive surgery, or flexible scope endoscopy, or in performing an angioplasty. The essence of realism in the semi-immersive virtual reality interaction is that in a normal circumstance the user would be performing from a position remote from the event, as a physician is in minimally invasive surgeries which are performed within an enclosed cavity of the body.
In a partially immersed situation, the medical user in a simulation may be looking at a CRT screen, either in two dimensions, as is most usual, or in three dimensions with stereoscopic glasses. The instrument he or she uses is in full direct view and is used remote to the interface as a mouse or a joystick would be. On the screen the user may see the effect of navigating through the virtual reality with the instrument--if it is an simulation of a medical implement with a camera attached, such as a flexible endoscope--or if the camera is one of several implements in the real medical procedure, the user may see part or all of the implement he is manipulating offscreen as an onscreen instrument that matches his offscreen motions. Magnetic tracking devices can be used to portray the instrument in hand as the instrument onscreen, and can even use them to make simple manipulations or deformations of the computer graphics onscreen, as when virtual tissue is grasped, cut, stapled or otherwise deformed in the virtual graphic setting. In this prior art, the instrument is not able to create tactile feedback from itself--as in forming a staple--or force feedback from the virtual anatomy, as in grasping or cutting the virtual tissue. For the creation of force feedback, a resistance-creating device is necessary. If the instrument is build into this device, then the procedure is confined to those instruments which are part of resistance creating devices, which may be somewhat limiting to those surgeons who in a complex operation, may want to use several tools. In the case of the partial immersion, prior art has solved this problem by having instruments "dock" into a force-feedback-creating --or "haptic" --device.
Several of these devices are known. In all of the known devices and proposals of prior art, one of two conditions are present: (1) where the tactility and specific action of the instrument itself is necessary, that instrument in current simulators is built into the haptic device, and so no selection is possible, or (2) where a selection of instruments is possible, the instruments are usually limited to those which interact with the tissue in very basic ways, such as a scalpel cutting as opposed to scissors cutting, or a needle for sewing, or a probe moving the tissue rather than a grasp holding the tissue, and most of the more complex tactile feedback of the instrument itself is not sensed. Furthermore, in this second category of devices, the ability of the instrument to be "docked" is dependent upon direct vision by the user, and in most cases is a deterrent to the overall selection and continuum of reality in the simulation. The virtual medical simulators currently seen, then, fail to provide the surgeon in a virtual simulation an appropriately broad selection of implements that give tactile feedback in themselves, and transmit their specific actions to the simulation. In addition, current virtual medical simulators fail to provide recognition to the computer model of the types of instrument selected, and the person or persons selecting it, to be able to use that information in logic that transcends the anatomy and goes to the roles and physical position of the users themselves.
In fully immersed virtual reality some methodology is used to allow the user almost complete departure from the realistic world surrounding. This is often done by means of a mechanism that shows the visual only to the single user with small screens placed near the eyes within goggles or a head-mounted display. In certain instances, the visuals are projected upon the user's retina. However it is accomplished, in immersed virtual reality, the user has the impression of being surrounded by a completely different place than in the actual surroundings. The Head Mounted immersion may, however, become an accepted or even standard means of remote or semi-remote surgical viewing, because with the head mounted display the surgeon will--on call--be able to see many other kinds of information, such as X-rays, without looking away from his surgery.
In fully immersed virtual reality simulations which involve haptic displays, or more specifically tactile force feedback in medical simulations, the most advanced existing mechanisms both read position on a sensor which translates to a visual location in the virtual environment, and feedback a certain kind and amount of force to that interface device. In the same manner as with the partially immersive situations, watching a CRT as opposed to being surrounded with the picture in a 360 degree environment, these haptic feedback systems will either (1) require that the interfacing instrument be locked into the reader/generator mechanism, to be a part of that mechanism and not interchangeable, or (2) offer some method of reading various interchangeable interface instruments and of imparting feedback to that changeable instrument in a fixed armature, or (3) by placing the instrument (or one's finger) in a receptacle on a mullet-positional arm.
The problem of haptic simulation within a total immersion simulation is (1) that the user cannot see to insert the actual interfacing instrument, so the instrument currently must be fixed or at least pre-inserted in the haptic/reader system, or (2) though they may look down to pick up instruments, the user cannot change instruments and insert them into the receptacle except by reverting to direct view, and taking himself or herself out of the fully immersive environment. In totally immersive medical simulations, in such situations that do not admit of remote procedures that can be semi-immersive, there is currently no way of connecting a free-floating haptic arm with a selectable instrument in a totally immersive environment. Thus there continues to be a need for the haptic receptacle arm to "home" on selected instruments, and seamlessly effect their "docking."
Current virtual reality medical simulators using haptic devices have two qualities: positionality-sensing and force feedback generation. However laudatory those simulators may be, they are lacking (1) the capability for an identified user to easily select between and use two or more instruments requiring complex hand and finger movement, and (2) they lack the capability of tracking, homing, intercepting, and docking with said randomly-selected instruments within the virtual environment.
The current invention adds those two lacking functions: selectable virtual reality instruments and a homing matrix which allows those instruments to be brought into the virtual environment with the geometry-sensing haptic device homing to the instrument, intercepting its path at the point indicated by the visual display, and docking the instrument within the haptic receptacle. Thus the current invention allows the user to remain in either totally immersed virtual reality or semi-immersed virtual reality, or to operate partially in both.
One embodiment of the invention is centered on less-invasive and minimally invasive cardiac surgeries portrayed in virtual reality simulation using head-mounted displays rather than conventional CRT displays. Looking outwardly, the user will see the virtual depiction of the anatomy. The user will then select a simulated instrument with either hand by glancing straight down, and when it is lifted, said instrument and, in some cases of open surgeries, the representative hand of the user, appears within the total immersion situation. The creation of and attendance to any representative space, whether visual or tangibly physical or both, bears similar problems and can benefit similarly by this invention.
The current invention includes first several identification devices as part of the instruments used. These can be capacitance, or mere selection through a touch screen, but they will also include elements to identify which person is using which instrument, and with which hand.
The current invention includes, secondly, the construction requirement for the instruments to have their own electro-mechanical actuation sensing, for complex hand actions that require precision within an analog set of motions, including pressure at the right moments such as in cutting, grasping, or stapling. In addition, the instrument must have its own tactile characteristics apart from those of a force feedback generating device which conveys the general resistance characteristics of the anatomical tissue, and in some instances carry certain haptic feedback which is part of the instrument rather than part of the anatomical tissue. This would be true of staples that are formed just before they deform the tissue, as in ligation. The feel of forming that staple is a haptic feedback emanating from the instrument itself, rather than from the force feedback-generating device into which the instrument is placed.
Finally, the invention includes both apparatus and processes for defining a spatial grid that will be shared by the instruments and the feedback generating receptacles. The spatial grid represents a physical body in the way each of the pairings coalesces by target acquisition, homing, intercepting and docking. There will be two types of spatial grid, the bounded and the unbounded, though both may assist in the representation of spatial anatomy. In the bounded spatial grid, certain anatomy such as a rib cage made from tangible materials may exist within the spatial grid, and will at times assist in the registration of that grid. For instance, if there is a partially-open surgery exposed intra-costally through the ribs--then it may be highly desirable that the tactility the ribs themselves comes from the tangible materials, and the flesh or cartilage involved be created with virtual haptic interfaces.
In the less-invasive cardiac surgery simulation, the actual procedure in one case is not remote, but is conducted through a small opening in the thoracic cavity. Thus it is in effect "open surgery" rather than remote surgery that is being simulated. In this medical procedure, the user may be using a gloved finger at times as a probing instrument, and at other times, or in parallel, may be using graspers, a scalpel, and a grasper with curved needle for suturing. All of these will be instruments which will be operable in the hands of the user and will been seen to do their functions upon virtual anatomy in the virtual procedure. These instruments, and the glove, will need to be placed into a receptacle arm that generates force feedback.
In the second actual cardiac surgery case, the instruments are inserted through the spaces between the ribs via small incisions or "ports" and scopes may be used to provide the internal point of view for the remote procedure. These may be residing or be placed in a number of force feedback-generating devices, as well as into a receptacle arm.
To simulate the first procedure, it will be necessary to create a virtual arena in computer graphics which includes the outside rib cage and the tissue have an essential "blind" reality of a physical shell, with the ability to create openings in a virtual manner. Within the structure will be two force feedback generating "arms," which will move into place with the "homing" feature of this invention. The "arms" must anticipate the final intersect position of instruments or gloves which are being moved by the user within the virtual space. By bringing the two elements, the force feedback "arm" and the tool into proximity, the action of "docking" will take place in the virtual environment. The position and homing matrices will be keyed to the dynamic polygon structure which provides the virtual visual reference, and so when the instrument moves toward any anatomy in the user's hand, it is "homed," intercepted, and docked by the haptic arm which will present its tactility.
The head-mounted display will be used to display both the internal arena and the area that would ordinarily be Open Surgery. In this manner, any surgery, Open or Remote can be handled in a virtual manner with virtual instruments and anatomy, and with full force feedback. The dynamic and visual boundaries become the outer limits if docking between the homing haptic arm and the freely handled selectable instrument. Thus the homing, intercepting, and docking components become an integral part of creation of a virtual experience in a manner unique to this invention.
Proposals of prior art have a great deal of force feedback generation on the shaft of such an instrument, but nothing on how to give the surgeon a selection of instruments, or how each selected instrument is recognized by the simulation system, or how the specific user is recognized. In this invention, when an simulated medical instrument is said to be selectable, the current invention provides a means of recognizing which instrument is in use, senses the internal operations of the instrument, provides the user an inherent tactility and force feedback in its operation. Moreover, proposals of prior art do not approach the subjects of target acquisition, homing and docking which are important to the virtual head-mounted display environment. With its homing matrix, the current invention allows said selected instrument to enter seamlessly into the virtual reality environment, with no stoppage for the user to insert a new instrument into the simulator under direct vision.
It is one object of this invention to provide the ability for surgeons using virtual reality medical simulations to select from a plurality of surgical implements to perform in the virtual simulation.
It is another objective of this invention to allow the virtual reality medical simulator to identify which instrument is being used in which area.
It is another objective of this invention to enable the virtual reality medical simulator to identify which person is using said selected instruments.
It is another objective of this invention to provide a virtual and/or physical model of internal or external anatomy comprised of first memory means data, and tactile input devices to create events in said virtual or physical models;
It is yet another objective of this invention to provide a plurality of sensing devices within said instruments to input data from hand and finger motions of the user on the instruments'handles.
It is another objective of this invention to provide a plurality of devices internal to the instrument to create feedback from said hand motions with said instruments.
It is another objective of this invention to provide a numerical three-dimensional grid for matching positionality of instrument and force-generating receptacle.
It is another objective of this invention to provide means for visually displaying actions of virtual implements within the virtual model.
It is another objective of this invention to provide means of electronically identifying either said selected implement or a specific user, or both, from among a plurality of users;
It is still another objective of this invention to provide a means of target acquisition for positioning force generating receptacle to dock with said implement at precise location indicated in virtual model.
FIG. 1 shows a variety of medical instruments that may be needed in a given virtual reality medical simulation, to be selected as they are needed during a given virtual procedure simulation by the medical professionals involved.
FIG. 2 shows a grasping device for a virtual surgical system, the head for which will not be on the instrument but will operate as part of the virtual reality shown on the screen. The device has sensors to detect hand actuation of the grasper, and various means to impart tactile integrity of the instrument as it is used.
FIG. 3 shows a stapling device for a virtual surgical system, the head and the staple for which will not be on the instrument but will operate as part of the virtual reality shown on the screen. The device has sensors to detect hand actuation of the stapler, and various means to impart tactile integrity of the instrument as it is used.
FIG. 4 shows one embodiment of the invention wherein a shaft of an instrument is placed in a device which generates force feedback on the shaft of the instrument.
FIG. 5 shows an embodiment of the invention that uses a capacitance method to identify an instrument that has been selected for use.
FIG. 6 shows an embodiment of the invention that uses a touch screen selection method to identify an instrument that has been selected for use.
FIG. 7 shows an embodiment of the invention that uses a key insert method for connection of the instrument to the force feedback receptacle to identify an instrument that has been selected for use.
FIG. 8 shows three embodiments of the invention in which the users wear conductive materials to allow the system to identify which user is using which instrument, or if one person has an instrument in each hand.
FIG. 9 shows an arm type force feedback device as it is seen in the virtual reality simulation, and as it is operating in actuality to generate forces from the anatomy seen on the screen.
FIG. 10 shows a user wearing a head mounted display, and in front of the user, the anatomy and instrument as the user would see them within the head mounted display.
FIG. 11 shows an embodiment of the invention in which a plurality of users participate in the same virtual procedure.
FIG. 12 shows the force feed back devices tracking a single instrument, which is approaching the barrier of virtual anatomy tissue.
FIG. 13 shows a three-dimensional numerical grid which will be use to track the target instruments and allow the force feedback devices to home on them and facilitate precise docking within the virtual space.
FIG. 14 shows two instruments as targets being acquired at the same time in relation to the same limits of homing. The force feedback receptacle that is closest when the instrument begins to penetrate the virtual anatomy at the limit of homing will move to dock that instrument.
FIG. 15 shows the two instruments as they would penetrate the three dimensional grid in the hands of the user, and the force feedback arms tracking up to the limit of homing as defined by the physics of the virtual reality anatomy.
FIG. 16 displays an overlapping view of what the user sees and what is happening during the homing and docking process within the invention.
FIG. 17 shows another embodiment of the invention, with a second type of force feedback generating device, and the substructure with two additional degrees of motion that will allow it to acquire a target and home to a precise docking.
FIG. 18 shows the previous embodiment in FIG. 17, adding a track base and a hemispherical track, to allow more latitude in this force feedback generator's tracking.
In the surgical operating room, there are many instruments available to the surgeon, and in the most realistic of virtual simulations, the surgeon would have the same instant choice of instrument. FIG. 1 shows a variety of medical instruments that a physician or surgeon would want use in various actual procedures, and in the same manner, would want them to be selectable by the medical professionals involved as those instruments are needed during a given virtual procedure simulation. Some of the more common implements to be expected by surgeons in virtual simulations, would include: Scissors, 1, graspers, 2, probe, 3, cautery, 4, flexible endoscope, 5, irrigator, 6, suction instrument, 7, retractors, 8, curved needle, 9, circular stapler, 10, cutter stapler, 11, camera, 12, and scalpel blade, 13.
In FIG. 2, one embodiment of the current invention is seen in the construction of a simulated grasper, 14, which has for the user both inherent tactility and logarithmic positionality, as well as generation of local force feedback within the range of the operation of the handle. The handle of the grasper pulls closed, 15, to grip anatomical tissue, and is also pushed open, 16, with the front fingers of the hand to release the grasp, in that way to avoid the use of a spring. In the tools that must operate at a short distance inside the body, such as this grasper, the head is driven open and closed by a push/pull rod, 17, going through the shaft, 18, of the instrument. This instrument, made for simulation, has no head as one would see in actuality. The grasper head in the drawing within the dotted lines, 19, is not on the simulator instrument, but instead is seen virtually, 20, as on a CRT screen, 21, being used with virtual anatomical tissue, 22. The implement is inherently as tactile as the actual instrument, but it also has electronics that read the push/pull rod, 17, at 23. One of several ways to read the shaft would be by opto-electronic edge detection of a pattern on the push/pull rod. The signals generated from the moving rod will be processed within the shaft, 18, by a small microprocessor, 24, which then collects this rod data and other signals and sends them to the computer by known means, 25. The data is sent in real time and makes the grasper head in the virtual image, 20, move in exactly the logarithmic positionality that the actual head would be moving, so that the user retains same eye-hand perception of velocity, 26. The selection signal local to the selected instrument and other local data are transmitted by known wire means to the first memory means in the computer, but other known means include fiber optic cable or wireless transmission by radio, sound, infrared, or other such wireless means from the instrument to the receiving device.
In FIG. 3, another instrument in the invention is shown, a stapler, 27, that is used to ligate, or seal off, blood vessels before they are cut during the surgical procedure, as in the virtual image. The stapler normally has a feeder for staples, but because this simulator is virtual, the only staples, 28, will be those that appear in the visual representation, 29, acting upon the anatomy, 30. As in FIG. 2, the area with dotted lines, 31, will not be part of the instrument, 27, but the instrument must act and feel as if that stapler head were there. The simulated stapler must give the resistance of a metal staple feeding into the head, 32, and being formed, 33, and the handle, 34, will click and release when the staple's sides would pressed together with precision. The staple-forming tactility will be accomplished with a cam arrangement, 35, in the handle of the mock instrument, but as in FIG. 1, the stapler will have sensors for hand movements. The action of the push/pull rod will be read at 36 by opto-electronic edge detection of a pattern on the rod, or by other means to sense the analog movement electronically. Also as in FIG. 1, a microprocessor, 37, will modify the signal for transmission to the first memory means of the computer.
FIG. 4 shows one device, 38, for general force feedback generation upon the shaft, 39, of the instrument and thus mostly to the wrist and arm of the user, 40, as opposed to that force feedback as occurs in the instruments in FIGS. 2 and 3, which is generated locally in the instrument to the user's hands and fingers for the tactile integrity of the simulator instrument itself, by mechanical or electronic means in the handle or working upon the handle. In this more general device, of which there are known variations extant, the headless shaft, 39, is inserted into hole, 41, in the force feedback generator. Certain sensors read geometric positionality, including depth of insertion,42, and rotation, 43. At the direction of a first memory means in the computer, motors will drive the shaft backward, 44, rotate it, 45, or move it a few degrees sideways in keeping with the visual deformation and resistance of the virtual anatomy in the visual representation.
FIG. 5 shows one method for the computer to identify the instrument selected, 46, by capacitance cause by the touch, 47, of a user. In the instrument shown, the data gathered by its microprocessor is transmitted over wire, 48.
FIG. 6 displays a more conventional method for the user to select an instrument. This method is useful if there are certain handle groups, and the touch screen, 49, allows user's to re-use the same handle of a handle group that has the same analog positionality and the same tactile integrity, as a different instrument which acts as the selected instrument on the virtual anatomy in the simulation. In this embodiment, the user selects from icons, 50, with the touch of a finger at 51. There are many other known methodologies and apparatus for this type of selection.
FIG. 7 shows yet another embodiment of the selection identification, wherein the tip, 52, on the end of instrument shaft, 53, has an electro-mechanical key code, 54. The force feedback receptacle, 55, into which the selected instrument fits, 56, makes one of several possible combinations of connections, 57, with electronic contacts on the force feedback generator receptacle. An addition benefit to this methodology is that it offers a means of solid connection from which a motor can generate rotational force feedback to that shaft.
FIG. 8 displays an embodiment of the identification function of the invention that uniquely identifies not only the individual who is holding the instrument, but with which hand he or she holds the instrument, or two instruments. This may be accomplished by a special capacitance garment, sleeve, or band, to be worn on a specified hand, which will contact the instrument when it is in use. At 58, a finger sleeve with electronically sensitive mesh contacts the instrument handle. At 59, a better connection might be made with a palm band. An even better connection, at 60, would be the full mesh glove with a code that identified which hand of which user holds the instrument, and relays that information to the computer.
In FIG. 9, another known force feedback generating device is shown. On the screen, the virtual anatomy shows the deformation caused by the instrument. This is the result of a shaft positionality at 61, and a localized instrument positionality, at 62, which senses the opening and closing of the instrument as the user's hand moves. This localized instrument positionality provides the data for the deformation of virtual anatomical tissue at 63, in what is a specific collision of the instrument head as opposed to a general movement of tissue, 64, by the shaft, 61. In parallel, but also in contrast, the general force feedback device, 65, both senses the positionality of the instrument shaft in relation to the virtual tissue, and gives a general force feedback to the shaft, 66, as the general anatomical tissue reacts to general position intrusion and manipulation by the shaft at 64. In this known force feedback device, 65, the tip, 67, of the simulated instrument is inserted by direct view into a receptacle, 68. From that point the force feedback arm senses X and Y, 2-dimensional axes of positionality, at 69, and also a Z-axis which reflects depth, at 70. However, unless the receptacle has a locking integration methodology such as shown in FIG. 7, that known force feedback arm will not sense rotation of the shaft, 71. FIG. 7 then, is in itself an improvement on prior art. To generate force feedback at, the force feedback arm uses small electric motors to move one segment or another of the arm providing counter-positional force at 72, and at 73 and other points of the device. A new set of forces such as might occur with respiratory movement in a patient, 74, may be introduced for realism in a virtual anatomy. It is this proposed ability of force feedback-generating devices to create original position and force for the purposes of realistic virtual display, rather than as reactive force and position, which is one of the foundations of core claims in the current invention dealing with target acquisition and homing methodologies.
The force feedback in FIG. 9 is a general force feedback on the shaft as seen in the X-Y axes at 75, and the Z-axis at 76, and affects the wrist, 77, and arm, 78, of the user. None of the force feedback generated by this device or other known generalized force feedback-generating devices for use with medical instruments gives a localized force feedback within the instrument itself, to the fingers and hand of the user. The cathode ray screen, 79, in this embodiment of the invention is one of many known display technologies for visual representation of a virtual model, including liquid crystal display screens and head mounted displays which may use any of a plurality of known technologies to allow a virtual model to surround the eyes in what is known as "full immersion" virtual reality.
FIG. 10 portrays an embodiment of the invention wherein the user, 80, is "fully immersed" in the virtual model, 81, by means of a head mounted display, 82, which allows only a narrow area of downward vision, 83, that allows the user to select an instrument, 84, from among a plurality of instruments, 85, within his or her vision and immediate reach, 86. In FIG. 10, the user is already holding an instrument in the right hand, 87, which is seen and felt only in relation to the virtual model in which the user is "fully immersed" at 88.
FIG. 11 demonstrates an embodiment of the invention in which a plurality of users, 89 and 90, may participate in a virtual procedure, 91, and in which the selection and identification of instruments at, 92 and 93, and the identification of the participant, 89 and 90, as well as which hand of the participant, 94, 95, 96, and 97, is using each selected instrument, are relevant to the first memory means control of the virtual experience. Each participant, 89 and 90, is not only seeing the results of this selection of and actions with multiple instruments, but he or she is also feeling the tactility of each instrument locally with the hands and fingers, and the general force feedback of the anatomical mass up wrists and arms as generated by a force feedback generator. However, because the head mounted displays at 98 and 99 cause each user to be almost fully immersed in the virtual environment, the participants can see neither the force feedback generators nor the receptacles into which the tips of the instruments must be inserted.
In FIG. 12, an embodiment of the invention is shown wherein the user cannot see the force feedback-generating receptacle, as in FIG. 11. This part of the invention requires a new methodology wherein the tip of the instrument, being tracked in free space by known magnetic, sound, or other technology, becomes a moving target for target acquisition and interception by the appropriate receptacle of appropriate force feedback generator. User selects probe instrument, 100, and moves it toward anatomy surface, 101, in virtual physics model. Closest force feedback generator, 102, has target acquisition on probe, mirrors as it approaches anatomy surface, 101 for potential docking at 103. User moves probe horizontally, 104, to another point on anatomy surface, 105 before inserting. Second force feedback generator, 106, takes over as closest receptacle, 107, moves, 108, to meet probe in potential docking. FIG. 13 shows the numerical grid, 109, which in this embodiment of the invention tracks the approaching instrument, 110, by known means of magnetic tracking, 111, and uses those numerical coordinates to allow the force feedback arm,112, to acquire the target instrument and "home" toward the approaching instrument by proactive actuation of the arm. Also resident in the first memory means is the positional knowledge of the surface of the virtual anatomy.
FIG. 14 portrays an embodiment of the invention that uses a plurality of instruments, 113 and 114, to be acquired targets and to dock with force feedback generators, 115 and 116, which are "homing" with the target instruments to the surface of the virtual anatomy, 117. This allows the full interaction of selected instruments with the virtual anatomy, with appropriate force feedback on each which docks precisely into the appropriate receptacle, 118 and 119, at the point they will meet the surface of the anatomy, 120 and 121.
In FIG. 15, the same instruments, 113 and 114, are shown, with the same haptic, or force feedback, generators, 115 and 116. The surface of the virtual anatomy, 117 has numerical coordinates on the grid, as do the haptic devices. The instruments are placed on the grid by their proximity to the magnetic tracking devices at 122 and 123, and the same receptacles, 118 and 119 are moved in mirror fashion as the instrument targets are acquired and tracked, and the haptic devices "home" to the points it is predicted that the instruments will meet the virtual anatomy at 120 and 121.
FIG. 16 shows a rendering of the virtual reality mode, 124, in which eyes of the user, 125, are almost totally occupied by small, close screens,126, which fit over the eyes like goggles. This gives the user the visual impression of being inside an artificial world, 127, which moves as the head or body tilt up or rotate, as well as having a breadth that allows eyes to see a wide range in any direction with what seems to be a surrounding screen. The surface of the virtual anatomy seen by the user visually, 128, corresponds to the limit of homing for the haptic devices at 117. The one instrument, 129, that is interacting with virtual anatomy, corresponds with the tactile instrument, 130, which is just docking with the receptacle, 131, of a haptic device at 132. The other instrument, 133, which is just entering the user's field of view, is the tactile instrument, 134, which is being acquired as a target for homing and docking by the second haptic device, 135.
FIG. 17 shows the haptic device, 136, from FIG. 4 in an embodiment for homing and docking in a dedicated area. The force feedback generator in this embodiment can move to an angle, 137, and rotate on its base, 138.
FIG. 18 shows another embodiment of this variation on the haptic device, 136, shown in FIG. 17. In this case it can home to a larger area because of a circular base track at 139 and a semi-circular rail at 140. Combined with the localized mechanisms, this haptic device now has 4 degrees of tracking motion.
It can be seen that this invention adds to the efficacy of the surgical simulation by providing unseen linkage between the selection and usage of the instrument locally in the user's hand, and its fill use in the virtual model, docking seamlessly and unseen to the user, and providing the real time haptic response to virtual anatomical tissue that transfers more quickly to actual experience.
1. An apparatus for using selectable instruments in virtual reality medical simulations comprising:
- (a) a virtual model of anatomy comprised of first memory means, a plurality of data generator and receptor means and at least one input device partially resembling a medical instrument for manual operation to create events in said virtual model;
- (b) means for transmitting a plurality of signals between said at least one input device and said first memory means, said means for transmitting signals optionally comprising second memory means locally at said at least one input device;
- (c) means for visually displaying actions of virtual medical instruments within said virtual model;
- (d) means for electronically identifying at least one of (1) a selected input device in use, (2) a specific user of said at least one input device from among a plurality of users, and (3) the specific hand said specific user is using with said at least one input device;
- (e) a plurality of force generating receptacles;
- (f) a numerical three-dimensional grid for establishing the physical position of said at least one input device and of said plurality of force generating receptacles; and
- (g) at least one means of target acquisition for homing on said input device and for positioning at least one of said plurality of force generating receptacles to dock with said at least one input device at a precise location derived from said virtual model and said numerical grid.
2. Apparatus as defined in claim 1 wherein said means for transmitting a plurality of signals include means for transmitting local actuation data signals from said at least one input device to said first memory means.
3. Apparatus as defined in claim 1 wherein said at least one input device partially resembles instruments selected from a group consisting of scissors, irrigator, stapler, cutter-stapler, grasper, suction device, circular stapler, flexible endoscope, injection catheter, biopsy catheter, cautery snare catheter, balloon catheter, stent-placement catheter, rotating-blade catheter, drill, routing tool, cutting laser, sealing laser, mechanical sewing tool, bridling tool, probe, camera, needle and thread, scalpel, and cannula.
4. Apparatus as defined in claim 1 wherein said virtual model is of internal anatomy.
5. Apparatus as defined in claim 1 wherein said virtual model is of external anatomy.
6. Apparatus as defined in claim 1 wherein said means for identifying a selected input device is capacitance means.
7. Apparatus as defined in claim 1 wherein said means for identifying a selected input device is electrical-mechanical key-code means.
8. Apparatus as defined in claim 1 wherein said means for identifying a specific user is capacitance means.
9. Apparatus as defined in claim 1 wherein the specific hand said user is using is identified by capacitance means.
10. Apparatus as defined in claim 1 wherein at least one of said plurality of force generating receptacles is of the haptic-arm type.
11. Apparatus as defined in claim 1 wherein at least one of said plurality of force generating receptacles is of the cylinder-receptacle type.
12. An apparatus as defined in claim 1 wherein said at least one input device comprises a plurality of input devices partially resembling a plurality of different medical instruments.
13. Apparatus as defined in claim 1 further comprising at least one sensing device within said at least one input device to detect hand motions of a user.
14. Apparatus as defined in claim 13 wherein said at least one sensing device within said at least one input device generates a feedback signal indicative of said hand motions.
15. Apparatus as defined in claim 1 wherein said means for visually displaying comprises at least one means viewable by more than one user simultaneously.
16. Apparatus as defined in claim 1 wherein said means for visually displaying comprises at least one head mounted means for individual viewing by the wearer of said head mounted means.
Referenced Cited
Patent History
Type: Grant
Filed: Aug 18, 1998
Date of Patent: Sep 5, 2000
Inventor: David C. Hon (Seattle, WA)
Primary Examiner: Kien T. Nguyen
Assistant Examiner: John Edmund Rovnak
Attorney: Crutsinger & Booth
Application Number: 9/136,441
International Classification: G09B 2328;


text:
Poll: Most Americans Not Concerned About Swine Flu
Wednesday, August 19, 2009; 10:16 AM
Most Americans are either "not too" or "not at all" worried about the swine flu hitting home and broad majorities have confidence the government and local health providers will be able to effectively deal with an outbreak, according to a new Washington Post-ABC News poll.
Eager to stem the spread of the H1N1 virus, several federal agencies joined forces today to release new guidelines for businesses to use in the upcoming flu season.
A key component in the federal response is the swine flu vaccine currently in production, and in the poll, 55 percent of Americans say they are apt to get the vaccine for themselves or someone in their household. Stipulating a doctor's recommendation, that percentage jumps to 65 percent.
But the government has to battle some complacency: Only about one in eight Americans is very worried that swine flu will affect his or her family, with more than twice as many "not at all" concerned. Overall, more than six in 10 are not worried.
The limited concern does not appear related to the general confidence in the federal government and local hospitals and health agencies to handle the virus, as those who expect high performance are no more or less worried than others.
In general, nearly three-quarters have confidence the government can respond effectively to a swine flu outbreak in this country; more than eight in 10 say so about their local health agencies.

subset: commoncrawl


text:
All ye lovers of gore and explosions...
The War has kicked back into gear! The GAAF (Green Army Air Force) flew 2 missions early this morning, and O-Town is considering an investment in Surface-to-Air Missiles.
Quick summary: 2 GAAF F16's against 2 TAF (Tan Air Force, Tan being color of O-Town) J35's. 2 J35's shot down; 1 F16 shot down. Rumor that shot-down pilot was listening to Billy Idol and thus distracted.
4 GAAF F105's against a radar/AAA emplacement next to the piano. Both targets destroyed; no casualties.
The TAF promises to make the GAAF sorry they dared. More later.
(Can't understand this? Read this link.)


text:
Hi cuties thank you all for ur comments and sry couldn't reply to ur comments as I was busy here with some family function and I hope u will get the answers for the questions one by one and this plot will not bore u I guess……with no further delay let's get into the plot……..
Kindly ignore typos and grammatical errors..
Do comment and share ur thoughts……
It was a very pleasant morning and all the birds were chriping the cool breeze the sun rays and the lawn which was decorated beautifully for the two people of the day….. The dhols sound made everyone dance along with that the smell of the flowers that were spread on the carpet which was for the bride and the groom of the day…..the groom was already sitting near the fire with his face covered with flower (hanging from the sherwani cap he was wearing) and the pandit was chanting the mantras…..
All the members of the Oberoi Family was present around the mandap and they were waiting for the bride to come…..
Soon the bride also came down with her face covered with veil…..she was wearing red color lehenga and she was looking damn pretty even with her face covered…. Matching to her the groom was wearing a light red color sherwani……
The marriage rituals started and the couple were instructed to exchange the garlands….. Followed by seven rounds around the fire…….next moment he made her wear mangalsutra and filled her hairline with Sindoor (with her face covered)….. The pandit announced that the marriage is over and now they are pathi patni and asked them to remove their veils……. They obliged him and removed their veils…… Their face is reviled and by now it has turned into dark red as both of them were blushing and standing in front oof elders and all wished them together as…..
No………(the voice echoed the whole room) nahi nahi aise kaesi ho saktha??????? Saumya weds chulbul what the wuck.???????
It was ofcourse a dream sequence of the great Rudy the lady killer…but soon he'll become chulbul killer…..
Rudra: Chulbul …………(in an irritated voice) first my long hair creature and now my sumo……… No never ever I will allow you near my sumo……. she's mine only my sumo….. RUDY'S SUMO AND NOT CHUL'S SUMO….(saying so he made an crybaby face and with a jerk he got down from the bed and rushed outside…..
But for real he became an crybaby by the visual he had seen……
Saumya was pestering chulbul/Gauri to accompany her till the temple holding his..sry sry her hands……seeing this rudra's blood boiled in jealous and that red blood might burn anyone who comes in front of him……
Rudra: chulbul first you tried to become my bhabha and now you planning to become my sautan…… Very bad mistake chulbul I underestimated you……..but not anymore you'll have to pay for this………(in anger hit his legs on to the near by wall but again it backfired him and his legs got hurt and soon he ran into his room hopping)
But chulbul denied Saumya with a shy face and now Saumya turned to an crybaby but she pulled chulbuls cheeks and went from there coz her mom and her bhabi was already waiting for her……..
Rudra who was in great relief went to his room and fell on the bed with a thud….and again he closed his eyes but the same nightmare of chulya's Marriage haunted him and he ran inside the washroom to wash himself and his nightmare …..
Dadi excited about her best friends visit after long years was kneely observing the preparation and arrangements and all food each and everything was checked throughly coz she doesn't want anything to be compromised……….
Om who was figuring out all the possible ways of regaining the deal and trying to crack the answers for his brother's question….
Rudra who came down list in his own stupid nightmare came and sat near om and questioned about the day's work…..
Shivay as ordered by dadi came with dhushyant,Sahil along with the little devil…….pinky doesn't like Shivay caring for someone's child and that too she was the one who cheated her and made oh my Mataa of her……….. But Jhanvi adorned her in her arms and soon she found her more comfortable started to play with her heavy jewelleries……. dhushyant felt really uncomfortable by the way pinky behaving but Shivay assured him and they both went to meet Tej who was busy in his own thoughts….
Shivay and dhushyant entered Tej's study oly to find him lost somewhere but their voices brought back his thoughts and he composed himself…..
Shivay: bade papa aap teek hain na???? Any problem?????
Tej: no…. nothing as such was…was….just thinking about how to sort out this deal issues….
Shivay: bade papa Shekars are coming today and you can ask them and then back to normal stocks, deals that's it…
Dhushyant : Shivay Mohit Shekar???? The one with whom we planned to sign a deal right????
Tej: what??? Shivay is this for real??? Coz you doesn't make any deals with big industries then how come with Shekar???
Shivay: you are right…. But he himself came forward and we couldn't deny it and I jus accepted it oly whn I was convinced and assured that the other small industries invested their shares with us will be Benefitted….
Tej: why is that you want to deal oly with small and budding firms…..
Shivay: it's because they are being underestimated by big industries and so their exposure and their survival in the business market is less that's y….
Dhushyant: so once when small firms like mine get to collaborate with other firms like mine then the shares and the stock levels of the small corporates or firms ll be increased and this will pave way for other collaborations too…..
Tej: fine great that's interesting and even I ll think about it and sure ll try to imply it….
Shivay: sure bade papa coz there are so much of graduates who are interested in business have no way to prove themselves and this small group collaborations ll pave way for them to showcase their talents and again there ll be an increase in small companies stocks and shares……
Tej: well……. Quiet impressed Shivay……and a very all the best to both of you and best wishes…..
Saying so they headed outside oly to find the devil's mischief all over the living room…..
But a voice caught everyone's attention from the entrance…
Dadi who was overwhelmed by seeing them opened her arms and walked towards them….. And she hugged them tight and pulled them inside…..
Dadi: on time huh……..as usual……dint change a bit…..(spoke with them while walking and took them to the living room were all others were remained silent an surprised…….
Dadi: arre khothiya what are you staring at(closing the opened mouth of Rudra who was bit shocked by his dadis gesture towards them) they are my best friends……… Leela and vidhya….(both smiled at him and blessed him as he bent down and touched their feet)
Now all the three ladies sat on the couch and all others too sat and dadi started the introduction section….
He is my elder son Tej and his wife Jhanvi…..
He is my younger son Shakthi and his wife pinky….
Turning to shivomru…..
He is Shivay the eldest grandson and son of Shakthi and pinky
This is Omkara the second eldest grandson, son of Tej and Jhanvi
This is Rudra third eldest grandson, son of Tej and Jhanvi
And where is Prinku????
Rudra: dadi she went to mandir along with bhabhi…..
Dadi: accha….I ll Introduce them after they come from temple…… woh vidhya,Leela bhaisab kaha hai???
Vidhya: both of them discussing about something blah blah blah..
A voice: it is not blah blah blah actually it is called as conference call…..
All turned to see who it was and there stood four people and came to the living room….
Leela: haan Haan conference call with your secretary rosy right????
Karan Singh Shekar (kss) Leela meri maa..not with rosy as you think and for ur kind information it was you who fired her
Leela: Haan Haan I know I know just checked whether you are lying or not…..
Vidhya: bhaisab ignore her and Kalyani woh meri pati hei Raj Singh Rathore(rsr) and he is my son Kailash and Dil Parvathi…..
Leela: yeh meri pathi the great Shri Shri shri Karan Singh Shekar Maharaj ji……. and my son and Dil shifted to Canada fifteen years back and oly our grandson came back now to see us and he took over the business in India…..
Jhanvi: Parvathi ji what about your children they dint come and what they are doing???
Listening to this her face became sad and tears flowing down her cheeks
Parvathi: we lost our children in an accident…….two daughters and one son……..
After listening to this they felt very bad to scratch the burnt wounds of their past……
Sahil who came with shivika and dhushyant there shocked to see Kailash there and without his own knowledge he questioned him
Sahil: aap Mr.Kailash Rathore na????
Tej who understood why he asked him stood immediately from his place and went near Sahil and singed him no through his eyes and answered him yes told sahil to take shivika along with him to Om's room……
Shivay who witnessed the sign language between them felt something is fishy and decided to ask Tej but before that he turned to the guest and Introduced him as shivay's brother in law….
But suddenly from nowhere a bucket full of black color water was splashed on Mr and Mrs. Kailash…..
All stood with a jerk and meantime chulbul who brought tea for the guests dropped the plate and made all the galsses to break into peices……..he/she was shocked to see the scenario and the people in front of her……
ANIKA!!!!!!!!!!!!!(Shivay shouted at his top voice) yes it is Anika who poured water on them….but Anika dint respond instead directly went near Kailash and held his collar and started to yell at him…
Anika(holding his collar and shaking him) why the hell you came back??? What is now left with me???? You snachted everything from me and now again you came back for what????(all were shocked to see Anika shouting and none witnessed her anger and this behaviour was new to all of them and even for Shivay)
Tej who was standing immediately went near Anika and pulled her towards him and she like a kid hugged him and cried telling him to get out of her life and nothing is left with her…..
Anika: looked at Tej and aksed him to send them away as she doesn't want to see them and they are really such an 2rs people who wud do anything for their business…..ask them to leave bade papa (said crying and folded her hands and pleaded him )
Tej( hugged Anika and who couldn't tolerate it shouted at his top voice) MR.KAILASH OUT NOW……….. FOR GOD DAMN SAKE OUT NOW……
Shivay:babe papa what is happening and are you sure what you are telling???
Tej(again shouting) I KNOW WHAT AM DOING AND WHAT AM SAYING AND I MEAN IT……
Shivay who went near Tej to take Anika with him but she pushed his hands away to his surprise and continued uttering the same and soon she fainted…..
Tej immediately picked her in his arms and took her to his room and shivay was literally shocked first by his wife's behaviour and now she is unconscious and followed Tej along with omru…….while they informed the doctor to him fast……
Chulbul just ran to his room and he was trembling with fear and whose eyes were filled with tears only indicating the pain of her's…..
Saumya who witnessed all this called her mom to come back from her frnds house and she rushed towards Anika along with prinku and Tia……
The others were left numb as to how to react………….
So to find the answers stay tuned and wait for next update….
Untill then take care
Love you all


text:
Neil and Chantrelle
When Neil Gaiman was on tour for American Gods last year, I caught up with him at TechTV in San Francisco. We made a "date" to have sushi when he returned to the Bay Area. On July 2nd this year, Neil read his new book, Coraline, to a captivated Berkeley audience, all of whom regressed to being eight years old (at least I did!) while listening to the reading and it was fantastic. He kept his date with me and we met at Yoshi's in Oakland for a lovely lunch.
We chatted a while about food, drink and the sort and then the "official" interview began. Join our lunch already in progress…
neil: I was passing through Gatwick Airport and saw a whiskey on the shelves that I'd never seen before for a price that I'd never seen before in Gatwick Airport. It was £169, which was $250, a lot more than you normally see whiskies. And it was in this really ugly box: plastic-cellophane and cardboard and looked like it had been made in the 1970s. And the label looked really weird too. It was a Strathisla whiskey, which I'd never heard of. And it went into its casks in 1955, had been decanted and bottled in about 1999 and here it was up on the shelves. And I thought, "Well, I've never paid that much but I'll get it." I took it home and it completely ruined me for whiskies. That particular Strathisla [did]. And I assumed that this was something you could always get at Gatwick airport and, ever since then, I've gone back, and I've sent people back, and people have gone and checked and they can't find it. [Someone] found one site that had one bottle for about $500 and [this was the '57] it wasn't even the '55. And [the '55] did all these things. I still have some left in the bottle because it's one of those things that you can drink in very, very small amounts. And it's like one of those sweets, I don't know what they're called in America, but when I was a kid in England they were called Gobstoppers.
chantrelle: They're the same here.
neil: Do you still have those? With the sequence of flavors? And it's like that sequence of flavors. You put it in your mouth and taste one thing and then you taste 2 or 3 more things and then slowly it sort of evaporates in your mouth and it's gone and you start getting this sequence of aftertastes and it runs through 5 or 6 completely separate, completely distinct tastes like a chromatic scale of whiskies.
chantrelle: I can't do scotch. I've tried. My husband is really into scotch and we were going to go to Scotland last year and I was going to drive and he would get to do a distillery tour and we would hike around the hillsides. We were a week away from going when foot-and-mouth happened.
neil: And you couldn't hike anywhere anymore
chantrelle: Right, so we went to France and Italy. We ended up having a wonderful food trip because of the change in plans though—probably a better food trip than we would have had in Scotland especially since we don't eat meat.
neil: Did I tell you about the salad I tried to eat in Argentina? In Argentina, I have no voice. I'm completely silent. I did the Rio de Janeiro book fair and did the signing and had to make myself heard over the book fair. And then did a signing for 1200 people. And by the end of the 1200 people signing, I did not have a voice. I was completely silent. So, I'm without a voice and Andres is my guide and escort around the wonderful, wacky world of Buenos Aires. At the time I was pretty much completely vegetarian, I've now drifted again. I've always been a kind of lazy fish-eating vegetarian…
|…glad to know it's eggplant and not some strange undersea beastie
chantrelle: Pescatarian
neil: Ya, but these days I'm being much less picky about, "Ok, fine, I'll eat meat." But at the time I was really being rather strict. And so it was probably Argentina that killed that because there's nothing to eat. So I go into this restaurant, which I go to because it has this amazing salad section on the window including macrobiotic salads and things and I said, "We have to go here." We go into the restaurant. It's like any of those wonderful old Argentinean restaurants, it's not been decorated since 1922, they've expanded it and given it a couple of coats of paint but it's still got the same ceiling and it's obviously a tango dance floor on Saturday nights but right now it's a restaurant. The waiter comes over and I say, "Ah, I'll have this" but only I don't say that because I don't have any voice so I'm sort of pointing and nudging Andres. The waiter looks at me and says, "No." Andres says, "No, they don't have that." So I say, "Ok, that one"…"No." And then the man runs his finger down the entire list of salads until he finds the "tomato, and salad cream and tinned peas salad," points to that with his thumb and says, "It's very good, it's very very good" [in a low gruff voice] which I think is probably Argentinean for "We have some in the fridge in the back." And I gave up and had the meat. It was very strange, Andres would actually get weirded out by the quantity of vegetables. I would watch vegetarian friends of mine, Alan and Sue Grahams, trying to explain to the Argentineans that a ham sandwich does not become a vegetarian sandwich by adding lettuce.
Neil and his eggplant sushi
I always forget how much I like eating good sushi in the bay area. Until I get out here and eat good sushi and go "Yes!"
[Neil eats the eggplant nigiri]
That is great! The eggplant. I've never had eggplant sushi before and decided to.
chantrelle: And you probably couldn't get it anywhere else but around here.
[Neither of us had ever had eggplant sushi before. It is strange-looking, somewhat unagi-ish but not quite like unagi. Neil is "glad to know it's eggplant and not some strange undersea beastie."]
chantrelle: It's awesome to come here and see good jazz and eat sushi served to your table during the show. I had this "foodporn" moment during a show. I take a bite of salmon and it was one of the best pieces of salmon I'd ever had, right as the bass solo starts. So it's completely quiet and I can't make a sound. It was like having sex in your parent's house. I just couldn't say anything. It was almost painful!
neil: I really hope your microphone is working
chantrelle: That's not going on the site. My mom reads it!
neil: You have to put it! That is one of those perfect descriptions of something.
chantrelle: I'm married now, I guess it's ok.
neil: I was going to say. They've probably figured it out.
[There you go Neil…it's there :)]
neil: So what would you like to know foodporn-wise? Apart from the fact that I just discovered that I actuallylike eggplant sushi.
chantrelle: The first question is Coraline-related. What inspired the dishes that Coraline's dad prepared?
neil: The entire inspiration for that kind of thing came from my son, Michael, who, when he was 8 or 9, would look at me in horror, I was cooking at the time. My wife was working and, one day, I realized that it would make so much more sense if I cooked than if she did. So I started cooking and I cooked for several years. I'd cook something and Mike would look at me in horror, and he would say, "Dad, you've made a recipe haven't you?" And I would plead guilty to having made a recipe. He would just sigh and shake his head, go to the freezer and take out a little box of microwavable french fries and a microwave mini-pizza and he would go and put it in and sit down and that would be his dinner.
He was like so many kids, one of the most conservative eaters. I remember when we moved to America, so between the ages of 9 and 14 or 15, we'd go to our favorite restaurant and he would eat a peanut butter and jelly sandwich or if he were feeling adventurous he would have the grilled cheese sandwich. One day, the waiter there, who he got on with, said, "You know Mike? I always bring you the grilled cheese or peanut butter and jelly sandwich. Have you thought of trying something else from somewhere on the menu? This is really good." And I forget what "this" was but whatever it was Mike went, "Oh, ok." And he ordered it and he loved it. And at that point the menu became this map to adventure. And he was very happy. These days he's a bizarre and wonderfully adventurous eater.
So I really stole that from there.
Then I stole the dishes from various people. There is a very very dear friend of mine who I shall not name because people would read the web site and say "Haha, did you really do this?" When I first went to his house for dinner, he very proudly prepared a pizza. It was basically a tinned apricot pizza. It was apricot halves in syrup on the pizza along with the onions and stuff and it was one of those things where I could not go there. I could not reach that place. I live in a universe in which tinned apricots and pizza are things that must remain forever [apart].
And that's why I put the pineapple pizza. That was a little tribute to my friend. And I'd never quite been one of those people who had ever really been able to get into the idea, for example, stuffing a chicken with prunes. I know that there are people who do this.
chantrelle: Stewing it in wine however is very good.
neil: Stewing it in wine is wonderful, yes. Absolutely, you make a wonderful Coq au Vin. But it's also the kind of thing, which, as a kid, you go, "Why would you do that?" I didn't want to make fun of her dad, which is why it was pineapple rather than tinned apricots. It would be very easy to make his recipes really silly and they weren't. I just wanted him to be somebody who was cooking things that an 8-yr-old girl simply is not going to respond to. And, as he says, it's quite possible that if she tried some of them she might like them but he's never making anything that she's ever going to go "Hey, I could try that!" He is the kind of person who would see a squid in the fishmongers and go, "I know lots of great squid recipes" and would buy the squid and she's just going to look at it.
Holly, who is now 17 as of a couple of days ago, her favorite food growing up was smoked salmon and seeing that we weren't very rich at the time, I discovered that I could go to my local fishmonger and get smoked salmon bits, the little off-cuts. Just get a bag of them incredibly cheaply because what they sold expensively was the beautiful strips of smoked salmon but I'd buy her bags [of the bits] and she'd sit there and eat them as if it were candy.
|…the happiest moment in terms of "happy in your mouth."
chantrelle: My friend's daughter, who is 6, likes smoked salmon but she prefers gravlax. If you put "regular" salmon in front of her, she'll say, "I like this, but I would rather have gravlax."
neil: The best of all of those that I've ever had was in a hotel in Gottenburg, Sweden…whatever the hotel is that dominates the bay, and I've forgotten the name of it. They have a marinated salmon dish that is not actually a gravlax and is not a smoked salmon it's something else. It's their own marinated salmon thing, which is probably the happiest moment in terms of "happy in your mouth." If I was sent to a desert island and told, "Well, you can only eat one thing, what would it be?" I'd say, "Well, I'll have that."
[The conversation then turns to Reykjavik and an interesting discovery of Neil's]
neil: I was in Reykjavik on a Sunday and the restaurant was not open. [I] walked down to the Japanese restaurant got to the bottom of the [menu] and there's "pony sushi." Which makes a kind of sense because that is the only animal they have too many of.
[The waitress returns with a menu for Neil to order more food. He goes with albacore toro, the Yoshi roll, which is salmon and asparagus, and a 2nd order of the eggplant so that he can share his discovery]
chantrelle: What's your favorite comfort food?
neil: Sushi
chantrelle: I knew you were going to say that.
neil: No, I mean it really really is. It has to be reasonably good sushi. There is nothing more depressing in the world than being far from home, like in an airport or somewhere, and going, "Oh look, they have a sushi counter" and ordering the sushi and eating this sad fishy stuff on sort of rice pudding strips and going "Why am I doing this?"
Something I have been guilty of in the past.
So, my comfort food is sushi. Every now and then I will use sushi to reward myself and I'll use it to keep me going through things like signing tours [which] can be absolutely hellish. People thought I was kidding or thought I was lunatic when I posted the American Gods signing tour journal, "Ok I had sushi here, sushi there, good sushi here, bad sushi here."
chantrelle: I didn't see a problem with it.
neil: No, as far as I was concerned I was like, "Ok, this is my tour…"
chantrelle: I would eat sushi every day if I could afford it.
neil: That was the joy of being on tour with somebody else paying. And surprisingly I think the best sushi of the entire tour was in Victoria, British Columbia. It was amazingly fresh. It was quite wonderful.
Although the place I recommended on the journal, who's name I've now forgotten, in Chicago, at world horror time. Check the journal back in the beginning of May, and I actually posted the address and everything of this place in Chicago [Katsu – 2651 W. Peterson Ave, Chicago 60659]. Every now and then things come in from the Frequently Asked Question line just going, "I ate there, it was amazing." It really was world-class sushi…in Chicago. It was this one place that was really up there, as far as preparation and inspiration, and originality and coolness, up there with the Nobu's.
chantrelle: I ate at Nobu in London.
neil: I've never done Nobu in London but I have not heard nice things about it.
chantrelle: No, really? It was fantastic. All I really ate was salmon, I ordered other things but don't remember those well, I just had order after order of the fresh salmon…Salmon for dessert. I would have had more if they wouldn't have brought the check because they were closing.
neil: I love Nobu Next Door in New York.
But I had a strange experience at Nobu [in New York] where they accidentally nearly killed one member of our party. Which is just bizarre because one of the things they do at the beginning is that they come around saying "Do you have any allergies, blah blah blah?" It was this Comic Book Legal Defense Fund meal where these people had paid $2000 to have a meal with me for the Legal Defense Fund. When I'd said to the Legal Defense Fund, "Let's just auction off dinner," they'd been looking at doing sandwiches and then suddenly it's $2000 and we're going, "Well maybe we go somewhere worthwhile." Then DC Comics said they'd pick up the bill and we went to Nobu.
So one of the party is saying, "I can't eat shellfish, I will stop breathing." They go "Ok, not a problem." The misos come and the miso is course number 4 or 5, we'd eaten several things first. The misos come in and at the same moment two things happen: First of which is we get half way down the miso and I notice there are little clams. Little shellfish shells in the miso. The second thing I notice is, coming from the seat next door to me, the noise sort of [gasssp, gasssp] as someone slowly stops being able to breathe.
|…there are tastes that one cannot go back to.
Chris Oarr from the Legal Defense Fund ended up running over, grabbing this lady, putting her in a taxi, and heading off to find a hospital or something.
neil: Here we go, ask another question.
chantrelle: What is your favorite childhood food memory?
neil: Favorite childhood food memory? Well, there are tastes that one cannot go back to. There are tastes that do not exist.
One brand of ice cream that they no longer make and no longer tastes like that when they do called Verrechia's. It was just the local ice cream when I was a kid in Portsmouth.
Ribena gum, Ribena pastels. Which were these blackcurrant-flavored sweets. They still make something with that name in Hong Kong because a fan in Hong Kong heard me complain that this was a taste from my youth you could not get. She found me some and actually sent them. Unfortunately, it's a completely different foodstuff. It's not the same thing. But they were these sort of wonderful hard gums which were basically just sugar and blackcurrant essence. But they made me incredibly happy and they no longer exist. And I still get blackcurrant flavored sweets when I'm in England and blackcurrant-flavored glycerin throat drops because sometimes, if you suck one, you can sort of find something that reminds you enough of that taste. So, those would be, in terms of the tastes I still remember [my favorite].
[waitress returns with the second order]
neil: It looks wonderful.
waitress: You dug in huh?
neil: [to Chantrelle] So can I get you [to try] one of [the eggplants]? This is foodporn, I mean, you have to be experimental.
[FYI, go to Yoshi's…get the eggplant!]
What else would you like to know?
chantrelle: Well, this one is obvious too I think. If you were forced to eat food from just one region for the rest of your life what region would you choose?
neil: Oh, I'd definitely take sushi again.
Although, having said that, I have an enormous fondness…one reason why I garden is I love fresh vegetables. I love growing fresh vegetables and having fresh vegetables around.
chantrelle: By the way, the eggplant was fantastic
neil: That was why I wanted to make you guys try some. It was really good. Sometimes I love occasional counter-intuitive foods. Seeing eggplant sushi on the list and going, "Well, ok, it's certainly worth trying" even if it's awful and it actually was lovely. It's got that lovely sweetness of well-grilled eggplant. And I love the color too, there's a magical, sort of, bluish sheen to it.
chantrelle: it's the closest thing to blue food that exists I think.
neil: [picking the parsley up from his plate] There was a while when my kids had read the Penn & Teller'sHow to Play with Your Food and we really got into the concept of "pass the parsley." Have you ever readHow to Play with Your Food by Penn & Teller?
chantrelle: No.
neil: Ok, Penn & Teller, one of their books is "Penn & Teller's How to Play with Your Food," an amazing and wonderful book. And it includes, when they were on the road, none of them ate parsley and wherever they ate, food would come with parsley. So they developed this game of "pass the parsley," the object of which [is to get your parsley onto someone else's plate] but there's a "but" on there which is that the other person cannot see you. They are into misdirection and so on and so forth and the object is to get your parsley onto the other guy's plate without him or her ever noticing. They have to look down and go "Oh my god, there's the parsley." And I remember one point in the Penn & Teller book where they talk about that there was actually a major car accident immediately outside the window and a car crashed into the window of their restaurant and they sat there with their heads glued [looks intently down at the plate] to their plates.
chantrelle: I can see them doing that.
OK, two more FoodPorn questions.
neil: Ask
chantrelle: It's your turn to cook dinner, what do you make? What's your favorite thing to prepare? You can do it seasonally if you'd like.
neil: Ok…Well, my favorite thing to cook is not what I would make for dinner. It's my favorite thing to cook and it's been my favorite thing to cook every since I was a little kid. Which I actually put in, on a sort of foodporn level, into Coraline: Omelettes. When I was a kid, I would have been about 11 or 12, I watched this British quiz show. They had this quiz show called The Generation Game, which was pretty dreadful. The idea is, two representatives from families, father and son or uncle and nephew or mother and daughter or whatever, are taken apart and a specialist would come out and make a pot. And do something that if you were a practiced expert you could do in 2 minutes and do well. So you throw your pot, you do your thing, it's simple, it's beautiful and the guy takes a couple of minutes, he's got a beautifully thrown pot and they say, "And now father and daughter here are your lumps of clay!" And they'd sit down and they produce things that would not have done duty as an ashtray and everybody laughs and the potter comes out and says, "Ah, I'll give this one 3 and this one has originality, I'll give it 5." So that's very much the way it went. They had this boozy old English cook who was actually before my time, she was a Julia Child-like character called Fanny Craddock and her husband Johnny. They actually were TV cooks before my generation but they got them out, they rolled them out for the generation game and Fanny Craddock comes out and she made an omelette. And I was absolutely fascinated watching how she made the omelette. And immediately as a kid got into making omlettes using the one piece of information that I learned from her first. Which is you begin by melting some butter in a pan and then you stir that butter back into whatever your mix is.
chantrelle: I noticed that in the book. I'd never done that before.
neil: It's stirring that little bit, it doesn't have to be a lot of butter, but it's stirring that melted butter back into the mix and then adding…These days I've now discovered that plain yogurt is actually my favorite thing to then add to the egg mix. And you wind up with this amazing, amazing texture and amazing taste omelette. So actually my favorite thing to cook…If someone said you can cook one thing forever what would you cook, I'd cook omlettes. I take pleasure in making a perfect omelette and folding it and flipping it.
In terms of doing a dinner, I go through phases where this is my favorite thing to cook. I went through my major curry phase for a while. I just found all of these strange Indian books and just cooked. The house just smelled like garam masala for a while. But I think probably my favorite thing just to cook is really, really simply grilled fish.
My most embarrassing cooking admission at this point is when I actually stayed at a friend's house in Florida….this isn't my friend Tori, because normally when I say I stay at a friend's house in Florida everyone goes, "Ahh it's Tori," but this wasn't actually. This was my friends Jonathan and Jane who are very famous in England but completely unknown over here. And I was staying at their place in Florida and doing some writing and they had this George Foreman Lean Mean Grilling Machine thing which I laughed at. I went "Hahaha" and then I started experimenting with it because I was out there and they really didn't have a working grill and this was the only thing I could grill anything on and I went "This is great!" And I discovered that in terms of cooking fish it was just absolutely magnificent.
|And they just sort of go into your mouth and they do things.
So, when I got home I said to my wife, "This is really embarrassing but I want to buy one." I love the sheer efficiency of cooking perfectly grilled fish every time. So that's my most embarrassing cooking admission but I love cooking fish.
I love doing interesting things with fish. My favorite bizarre and unusual recipe with fish is a trout recipe, which is "Trout in Newspaper." You need black and white newspaper, which is harder and harder to find these days as they get more and more into color printing and color printing inks are poisonous, but you need black and white newspaper. And you take a whole trout and you slit it down the middle and you stick some herbs and maybe some sliced lemon into the middle of it. You fold it up in several layers of newspaper, make a sort of package essentially, a tight package of your trout wrapped in the newspaper. Then you hold it under a tap until it is completely soggy and wet. And you put it into a hot oven for about 25 minutes. And the outer newspaper will dry out. The inside ends up steaming it. The heat of the water will steam the trout. All cooking smells are kept inside that newspaper package.
chantrelle: Like parchment.
neil: Except it's much thicker. And the other cool thing that happens is then when you come with your scissors at the end and you cut the trout out of the newspaper, the skin and everything sticks to the newspaper and you get this perfect, absolutely perfect, pink trout. It takes the head and the tail and the skin and you just get this perfectly cooked and perfectly done fish onto the plate. And it's something I learned watching a TV episode of "Floyd on Fish" many, many years ago. [Keith] Floyd, another magnificently boozy English cooking show host. He went off to a trout farm and said, "What is your favorite recipe?" and they said, "Trout Newspaper." Then he put it into his book, Floyd on Fish, and I seem to remember he got something wrong. I always love that, misprints in cooking books are always interesting. At that point I think they said you cook it for, like, 10 minutes or something. We tried it and it doesn't work. You need about 1/2 an hour.
chantrelle: Ok, last one. Since this is for FoodPorn, what do you think is the sexiest food?
neil: Oh, that's a good one. In terms of sheer sensual fun, I love sushi. And sushi I love because you have this whole combination of textures and tastes and things that you can do with it and you're dipping it and your putting the thing on and there's something deeply sexual…or sensual.
In terms of sex, it's probably a really, really good red wine. But at that point you're into those sorts of red wines that cost an awful lot and I tend to only drink if other people are paying for them. And you go "That's how much and that could feed a family of how many?"
chantrelle: But "Oh my god it's good!"
neil: Yes. And normally those red wines that are magically that tawny color. They're not even red anymore. It's hit that sort of reddish-amber in color. And they just sort of go into your mouth and they do things. And it's the nearest thing there is to sex. So that's it.


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Blardy hell.
I can clock up to about 350km per week on average with ease.
That's just so blardy expensive.
By the way, I queued and got my subsidy today during lunch with LadyCow. In less than 24 hours, the RM625 was equally distributed. 70% went to car installment and the $50 to feed the car, and the rest? Concert ticket -_____-
In a long run, i dont see the subsidy will help us in any way at all.
"Change your lifestyle!!" – Urge from the orang atasan.
Sure, we will try to change our lifestyle as best as we could, not because we want to, is cos we have no other choice. but you will also have to help us because you are suppose to be. We pay for your expensive mansions, yacht and wheels remember?
The lump sum of money you receive monthly is not charity, its salary.
You will need to help us by improving the rubbish public transportation that we have so that we can secure our job by turning up for work. Why not improve the safety too because we will need to walk around more and leave the safety of our car as we could no longer afford to use them ?
But i forget that everything has become more expensive, and thus pushing the desperate to do what desperate people will do in order to survive this cruel world -> Crime.
You will need to help maintain the food price. Especially the staple food of Asians, Rice. The price for it had skyrocketed like nobody's business and now I think we will all eventually have to grow our own and eat potatoes to survive.
Changing lifestyle will mean going out less, staying home more. Economy will slump as buying power slow down, inflation increase, everyone will be stingy like hell. Who will benefit at this?
Remember when you stay home, you will have to keep yourself entertained..via TV, astro, internet, computers, aircon and fans = electricity = tnb = price will increase in lieu.
This had been mentioned time over time and I'm getting so sick of it already but yet!! If you want to compare our lifestyle, please compare it dollar to dollar. Come on la, our living standard is freaking low yet living expense is sky high! Why not compare that instead of oil prices with non oil producing countries?
I believe in UK, with a steady income of 2.2k, you could live comfortably in a studio flat, drive a car(CHEAP) and eat out once in awhile, take a walk in a park, enjoy life, be young!
Over here, we are struggling to breathe. Walk in a park, hahahaha, kena rompak got la. Pay petrol to get there, pay illegal parking attendants that does nothing but stare threateningly at you. Actually we wont have the time to go also, as we will be working past working hrs.
Worse is when people tell me, hey, be grateful when u get a job that pays you 1.8. I say, you people are the ones that spoil the whole employing market. Accept so much lesser than what you know you are worth. And this is the kind of attitude we get throughout asia.
i say, no more friend. Enough. change la…Malaysians are no longer so naive and eat watever words you have on the media.


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I have to share some thoughts about how we are being manipulated into repeating the falsehood that our military men and women are "fighting
Tag: media
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|Welcome to the ISIPS Newsletter
|May 20, 2016
|Safety Watch: Micotil injections can be lethal
|Commentary: We can do better in protecting our frontline caregivers
|B. Braun Focused on Helping Educate Nurses About USP < 800 > and Improving Vascular Access at INS 2016
|People with HIV are far less likely to get cancer treatment, study shows
|HIV Vaccine Design Should Adapt as HIV Virus Mutates
|New HIV vaccine trial aims to build on earlier modest success
|One step closer to a cure for HIV: Cutting the virus's DNA out of living animal cells eradicates the disease
|Large HIV vaccine study planned in South Africa this fall
|I'm Celebrating HIV Vaccine Awareness Day Because There's Exciting Science Happening
|Holy Name Medical Center only NJ Hospital to Receive Hepatitis Testing Award at White House
|'Hepatitis C virus can control liver cancer' claims Mumbai based homeopath
|Hepatitis C efficient against Cancer
|National Viral Hepatitis Testing Day
|Hepatitis C Is Killing Americans in Record Numbers While Patients Cannot Access Life Saving Medicine
|Ninety percent of Colorado residents with hepatitis C going untreated
|How I Overcame Hepatitis C Stigma for a Cure
Prevention of needle-stick injuries in healthcare facilities: a meta-analysis
OBJECTIVE To estimate the summary effectiveness of different needle-stick injury (NSI)-prevention interventions.
9 Tips for Preventing Infection in the Hospital
We can prevent infections in the hospital. With a few simple tips to cut back on nosocomial infections like C Diff (Clostridium difficile) and antibiotic resistant infections like MRSA.
VanishPoint® Blood Collection Set
The VanishPoint® Blood Collection Set, from Retractable Technologies, Inc., features automated in-vein retraction that effectively reduces the risk of needlestick injuries and blood exposure. The safety mechanism is activated by depressing a retraction trigger that is located near the finger-grip area. This allows for easy one-handed activation, without changes in hand position, while reducing the risk of inadvertent activation. The needle is retracted directly from the patient, virtually eliminating exposure to the contaminated needle.
|End the mosquito cycle in your backyard
|Rid your backyard of mosquitoes
|El Paso reports human West Nile virus case, 1st in Texas
|First case of West Nile virus in El Paso; TX Department of State Health Services warns public
|Season's first West Nile case reported in area
|Dallas County Reports First West Nile-Positive Traps of 2016
|Infected O.C. mosquitoes signal start of West Nile virus season
|West Nile Virus Fast Facts
WHO Issues Guidance on Zika Virus and the Olympic and Paralympic Games in Brazil
The World Health Organization (WHO) and the Pan American Health Organization (PAHO) recognize that athletes and visitors are seeking more information on the risks of Zika and ways to prevent infection while attending the Olympic and Paralympic..
WHO Confirms Zika Virus Strain Imported From the Americas to Africa
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|Rep. DiZoglio Secures $20,000 for Valley Anti-Drug Program
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|Sex, Breast Milk May Have Helped Spread Ebola in Africa
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|Mobile Money payments to Ebola response workers saved lives and $10 million – UN study finds
Fighting Ebola with 21st Century Biotech
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To gain a more complete picture of the impact of Zika virus infection during pregnancy, the Centers for Disease Control and Prevention (CDC) today will begin reporting the total number of pregnant women with Zika virus infection from two newly...
Tulip Safety Fistula Needle
Features of the clear, patented TULIP safety needle protector:
Controlling liquid infectious waste continues to present multiple challenges. As regulations tighten and operating costs rise, it's important to find a safe,
cost-effective solution that's affordable and provides minimal environmental impact. The QUICK-DRAIN™ Systems from Bemis simply and effectively address your challenges, from staff safety to regulatory compliance to cost-effective disposal of liquid infectious waste.
The VACUETTE® VISIO PLUS Blood Collection Needle with optical venipuncture control is a great help for phlebotomy personnel. The latest innovation from Greiner Bio-One at last brings vision to blood collection. When venipuncture has been carried out successfully, blood flow is visible in the view window in the transparent plastic hub of the needle.
The VISIO PLUS also has advantages for the patient. Movement in the vein during penetration whilst searching for the vein lumen is sometimes painful for the patient: Due to the visible blood flow in the view window, this movement is avoided. The special cut of the needle tip makes penetration of the tissue a lot easier. The new VACUETTE® VISIO PLUS needle thus guarantees pain-free, stress-free venipuncture.
Qlicksmart BladeSINGLE provides a simply safer way to remove and contain used scalpel blades in sterile operating environments. This world-first single-handed scalpel blade remover prevents the dangerous injuries commonly caused by removing blades with fingers, forceps or re-sheathing techniques.
BladeSINGLE enables single-handed "passive" activation - keeping hands out of harm's way. The clear casing of the cartridge allows easy and accurate counting.
Packaging your drug in a prefillable syringe with a safety feature will provide protection for health care workers and patients against accidental needlestick injuries. The NovaGuard SA (Staked-needle Automatic) syringe system can be deployed using a single-handed technique to shield the exposed needle.
System Benefits
· Mitigates glass flange breakage
· Bulk packaging enables automated assembly
· Designed to prevent pre-activation
· Uses standard plunger rods
· Tamper resistant
To learn more about using the NovaGuard SA syringe system for your drug product, or for information on any of West's injectable drug packaging or delivery system technologies, click here.
*For investigational use only by our pharmaceutical and biotechnology development partners. West markets the NovaGuard SA technology as an integrated system. Final assembly is completed by the pharmaceutical company.
West and the diamond logo and NovaGuard™ are trademarks or registered s of West Pharmaceutical Services, Inc. in the United States and other jurisdictions.
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Pranav Ainavolu
Programmer • Blogger • Technology Evangelist
A Software Engineer by profession and a Geek at heart. I love exploring new technologies and working on algorithmic problems. As of now, I write code for bread, butter and satisfaction. I like to develop applications, specifically that involves much more than writing code. It's not just about slinging code, but producing something meaningful that has a measurable and positive impact, helps others and solves intriguing problems.
"When it rains, all the birds fly towards the shelter. But eagle alone avoids the rain by flying above the clouds. Problem is common to all, but ATTITUDE makes the difference"


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Over 10,000 Expats Deported Within One Week in Saudi Arabia
The number of violators arrested in Saudi Arabia since November 15, 2017 has reached 1,483,009. (Pixabay)
In the past week, more than 10,000 people were deported in an ongoing crackdown on residency and labour law violators.
The number of violators arrested in Saudi Arabia since November 15, 2017 has reached 1,483,009.
Saudi Press Agency shared that the number of violators deported to their home countries as part of the 'Nation Free of Illegal Expats' campaign reached 377,572.
19 ministries and government departments are participating in the campaign, Saudi Gazette reported.
Read More
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Officials told Saudi Gazette that 11,844 violators are being held at various detention centers awaiting deportation.
Flight bookings for as many as 255,932 are being finalised for their final departure from the country.
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