The nervous class holds models of the peripheral and central nervous system. Currently, on the baroreceptor reflex is modeled. More...

#include <Nervous.h>

Inheritance diagram for biogears::Nervous:

[legend]

Public Member Functions
virtual	~Nervous () override

const char *	classname () const override

size_t	hash_code () const override

void	Clear () override

void	Initialize () override
	Initializes system properties to valid homeostatic values. More...

virtual bool	Load (const CDM::BioGearsNervousSystemData &in)

virtual CDM::BioGearsNervousSystemData *	Unload () const override

SEScalar &	CalculateCentralNervousSOFA ()

void	AtSteadyState () override
	Notify systems that steady state has been achieved. More...

void	PreProcess () override
	Preprocess methods for the nervous system. More...

void	Process () override
	Nervous Process Step. More...

void	PostProcess () override
	Nervous PostProcess Step. More...

bool	CalculatePsychomotorVigilanceTask (SEPsychomotorVigilanceTask &pvt)
	Sets data on the PVT object. More...

Public Member Functions inherited from biogears::SENervousSystem
	SENervousSystem (Logger *logger)

	~SENervousSystem () override

const SEScalar *	GetScalar (const char *name) override

const SEScalar *	GetScalar (const std::string &name) override

bool	Load (const CDM::NervousSystemData &in)

Tree< const char * >	GetPhysiologyRequestGraph () const override

bool	HasComplianceScale () const

SEScalar &	GetComplianceScale ()

double	GetComplianceScale () const

bool	HasHeartRateScale () const

SEScalar &	GetHeartRateScale ()

double	GetHeartRateScale () const

bool	HasHeartElastanceScale () const

SEScalar &	GetHeartElastanceScale ()

double	GetHeartElastanceScale () const

bool	HasResistanceScaleExtrasplanchnic () const

SEScalar &	GetResistanceScaleExtrasplanchnic ()

double	GetResistanceScaleExtrasplanchnic () const

bool	HasResistanceScaleMuscle () const

SEScalar &	GetResistanceScaleMuscle ()

double	GetResistanceScaleMuscle () const

bool	HasResistanceScaleMyocardium () const

SEScalar &	GetResistanceScaleMyocardium ()

double	GetResistanceScaleMyocardium () const

bool	HasResistanceScaleSplanchnic () const

SEScalar &	GetResistanceScaleSplanchnic ()

double	GetResistanceScaleSplanchnic () const

bool	HasLeftEyePupillaryResponse () const

SEPupillaryResponse &	GetLeftEyePupillaryResponse ()

const SEPupillaryResponse *	GetLeftEyePupillaryResponse () const

void	RemoveLeftEyePupillaryResponse ()

bool	HasPainVisualAnalogueScale () const

SEScalar &	GetPainVisualAnalogueScale ()

double	GetPainVisualAnalogueScale () const

bool	HasRichmondAgitationSedationScale () const

SEScalar &	GetRichmondAgitationSedationScale ()

double	GetRichmondAgitationSedationScale () const

bool	HasRightEyePupillaryResponse () const

SEPupillaryResponse &	GetRightEyePupillaryResponse ()

const SEPupillaryResponse *	GetRightEyePupillaryResponse () const

void	RemoveRightEyePupillaryResponse ()

bool	IsAsleep () const

SEScalarTime &	GetSleepTime ()

double	GetSleepTime (const TimeUnit &unit) const

CDM::enumSleepState::value	GetSleepState () const

void	SetSleepState (CDM::enumSleepState::value sleep)

void	InvalidateSleepState ()

bool	HasSleepState () const

bool	IsAwake () const

SEScalarTime &	GetWakeTime ()

double	GetWakeTime (const TimeUnit &unit) const

bool	HasBiologicalDebt () const

SEScalar &	GetBiologicalDebt ()

double	GetBiologicalDebt () const

bool	HasReactionTime () const

SEScalarTime &	GetReactionTime ()

double	GetReactionTime (const TimeUnit &unit) const

bool	HasAttentionLapses () const

SEScalar &	GetAttentionLapses ()

double	GetAttentionLapses () const

Public Member Functions inherited from biogears::SESystem
	SESystem (Logger *logger)

virtual	~SESystem ()

bool	Load (const CDM::SystemData &in)

Public Member Functions inherited from biogears::Loggable
	Loggable ()

	Loggable (Logger *log)

virtual	~Loggable ()

virtual Logger *	GetLogger () const

Static Public Member Functions
static size_t	TypeHash ()

static constexpr char const *const	TypeTag ()

Static Public Member Functions inherited from biogears::SENervousSystem
static size_t	TypeHash ()

static constexpr char const *const	TypeTag ()

Static Public Member Functions inherited from biogears::SESystem
static const SEScalar *	GetScalar (const char name, std::vector< SESystem > *systems)

static const SEScalar *	GetScalar (const std::string &name, std::vector< SESystem * > *systems)

Protected Member Functions
	Nervous (BioGears &bg)

virtual void	Unload (CDM::BioGearsNervousSystemData &data) const

void	SetUp () override
	Initializes the nervous specific quantities. More...

void	BaroreceptorFeedback ()
	Calculates the baroreceptor feedback and sets the scaling parameters in the CDM. More...

void	CheckPainStimulus ()
	Calculates the patient pain response due to stimulus, susceptibility and drugs. More...

void	CheckNervousStatus ()
	Checks metrics in the nervous system to determine events to be thrown. Currently includes brain status and presence of fasciculation. More...

void	ChemoreceptorFeedback ()
	Calculates the chemoreceptor feedback and sets the scaling parameters in the CDM. More...

void	SetPupilEffects ()
	Sets pupil size and reactivity modifiers based on drug and TBI effects. More...

void	CalculateSleepEffects ()
	Cacluates the cumulative sleep debt burden on the patient. More...

void	UpdateSleepState ()
	Update global nervous sleep state. More...

void	AfferentResponse ()

void	CentralSignalProcess ()

void	EfferentResponse ()

void	LocalAutoregulation ()
	Calculates the cerebral autoregulation and local autoregulation of muscle and myocardium. More...

Protected Member Functions inherited from biogears::SENervousSystem
void	Unload (CDM::NervousSystemData &data) const

Protected Member Functions inherited from biogears::SESystem
void	Unload (CDM::SystemData &data) const

Protected Member Functions inherited from biogears::Loggable
virtual void	Debug (const char msg, const char origin="") const

virtual void	Debug (const std::string &msg, const std::string &origin=empty) const

virtual void	Debug (std::ostream &msg, const std::string &origin=empty) const

virtual void	Info (const char msg, const char origin="") const

virtual void	Info (const std::string &msg, const std::string &origin=empty) const

virtual void	Info (std::ostream &msg, const std::string &origin=empty) const

virtual void	Warning (const char msg, const char origin="") const

virtual void	Warning (const std::string &msg, const std::string &origin=empty) const

virtual void	Warning (std::ostream &msg, const std::string &origin=empty) const

virtual void	Error (const char msg, const char origin="") const

virtual void	Error (const std::string msg, const std::string origin=empty) const

virtual void	Error (std::ostream &msg, const std::string &origin=empty) const

virtual void	Fatal (const char msg, const char origin="") const

virtual void	Fatal (const std::string &msg, const std::string &origin=empty) const

virtual void	Fatal (std::ostream &msg, const std::string &origin=empty) const

Protected Member Functions inherited from biogears::BioGearsSystem
virtual void	LoadState ()

Static Protected Member Functions
static auto	make_unique (BioGears &bg) -> std::unique_ptr< Nervous >

Protected Attributes
BioGears &	m_data

double	m_AfferentChemoreceptor_Hz

double	m_AfferentPulmonaryStretchReceptor_Hz

double	m_AorticBaroreceptorStrain

double	m_AttentionLapses

double	m_ArterialOxygenBaseline_mmHg

double	m_ArterialCarbonDioxideBaseline_mmHg

double	m_BaroreceptorOperatingPoint_mmHg

double	m_BiologicalDebt

double	m_CardiopulmonaryInputBaseline_mmHg

double	m_CardiopulmonaryInput_mmHg

double	m_CarotidBaroreceptorStrain

double	m_CentralFrequencyDelta_Per_min

double	m_CentralPressureDelta_cmH2O

std::vector< double >	m_CerebralArteriesEffectors_Large

std::vector< double >	m_CerebralArteriesEffectors_Small

double	m_CerebralOxygenSaturationBaseline

double	m_CerebralPerfusionPressureBaseline_mmHg

double	m_ChemoreceptorFiringRateSetPoint_Hz

double	m_CerebralBloodFlowBaseline_mL_Per_s

double	m_CerebralBloodFlowInput_mL_Per_s

double	m_ComplianceModifier

double	m_HeartElastanceModifier

double	m_HeartOxygenBaseline

double	m_HeartRateModifierSympathetic

double	m_HeartRateModifierVagal

double	m_HypercapniaThresholdHeart

double	m_HypercapniaThresholdPeripheral

double	m_HypoxiaThresholdHeart

double	m_HypoxiaThresholdPeripheral

double	m_MeanLungVolume_L

double	m_MuscleOxygenBaseline

double	m_OxygenAutoregulatorHeart

double	m_OxygenAutoregulatorMuscle

double	m_PeripheralBloodGasInteractionBaseline_Hz

double	m_PeripheralFrequencyDelta_Per_min

double	m_PeripheralPressureDelta_cmH2O

double	m_ReactionTime_s

double	m_ResistanceModifierExtrasplanchnic

double	m_ResistanceModifierMuscle

double	m_ResistanceModifierSplanchnic

double	m_SympatheticPeripheralSignalBaseline_Hz

double	m_SympatheticSinoatrialSignalBaseline_Hz

double	m_SympatheticPeripheralSignalFatigue

double	m_TiredTime_hr

double	m_VagalSignalBaseline_Hz

double	m_AfferentBaroreceptorAortic_Hz

double	m_AfferentBaroreceptorCarotid_Hz

double	m_AfferentCardiopulmonary_Hz

double	m_DrugRespirationEffects

bool	m_FeedbackActive

double	m_dt_s

SESubstance *	m_Succinylcholine

SESubstance *	m_Sarin

SEPatient *	m_Patient

bool	m_blockActive

double	m_painStimulusDuration_s

double	m_painVASDuration_s

double	m_painVAS

double	m_painStimulus

double	m_SympatheticSinoatrialSignal_Hz

double	m_SympatheticPeripheralSignal_Hz

double	m_VagalSignal_Hz

Protected Attributes inherited from biogears::SENervousSystem
SEScalar *	m_ComplianceScale

SEScalar *	m_HeartRateScale

SEScalar *	m_HeartElastanceScale

SEPupillaryResponse *	m_LeftEyePupillaryResponse

SEPupillaryResponse *	m_RightEyePupillaryResponse

SEScalar *	m_PainVisualAnalogueScale

SEScalar *	m_ResistanceScaleExtrasplanchnic

SEScalar *	m_ResistanceScaleMuscle

SEScalar *	m_ResistanceScaleMyocardium

SEScalar *	m_ResistanceScaleSplanchnic

SEScalarTime *	m_SleepTime

SEScalarTime *	m_WakeTime

CDM::enumSleepState::value	m_SleepState

SEScalar *	m_BiologicalDebt

SEScalarTime *	m_ReactionTime

SEScalar *	m_AttentionLapses

SEScalar *	m_RichmondAgitationSedationScale

Protected Attributes inherited from biogears::SESystem
std::stringstream	m_ss

Protected Attributes inherited from biogears::Loggable
Logger *	m_Logger

Friends
class	BioGears

class	BioGearsEngineTest

Additional Inherited Members
Static Public Attributes inherited from biogears::Loggable
static const std::string	empty

static const char *	empty_cStr

Detailed Description

The nervous class holds models of the peripheral and central nervous system. Currently, on the baroreceptor reflex is modeled.

Constructor & Destructor Documentation

biogears::Nervous::Nervous ( BioGears & bg )

protected

biogears::Nervous::~Nervous ( )

overridevirtual

Member Function Documentation

void biogears::Nervous::AfferentResponse ( )

protected

void biogears::Nervous::AtSteadyState ( )

overridevirtual

Notify systems that steady state has been achieved.

Reimplemented from biogears::BioGearsSystem.

void biogears::Nervous::BaroreceptorFeedback ( )

protected

Calculates the baroreceptor feedback and sets the scaling parameters in the CDM.

The baroreceptor feedback function uses the current mean arterial pressure relative to the mean arterial pressure set-point in order to calculate the sympathetic and parasympathetic response fractions. These fractions are used to update the scaling parameters of heart rate, heart elastance, resistance and compliance for each time step.

Todo:: Add decompensation. Perhaps a reduction in the effect that is a function of blood volume below a threshold... and maybe time.

SEScalar & biogears::Nervous::CalculateCentralNervousSOFA ( )

bool biogears::Nervous::CalculatePsychomotorVigilanceTask ( SEPsychomotorVigilanceTask & pvt )

Sets data on the PVT object.

Uses information from calculatesleepeffects routine (see nervous-assessments)

void biogears::Nervous::CalculateSleepEffects ( )

protected

Cacluates the cumulative sleep debt burden on the patient.

Models for metabolic changes, vigilance and awareness changes are computed here. These models effect physiology data requests and the tissue system

void biogears::Nervous::CentralSignalProcess ( )

protected

void biogears::Nervous::CheckNervousStatus ( )

protected

Checks metrics in the nervous system to determine events to be thrown. Currently includes brain status and presence of fasciculation.

Intracranial pressure is checked to determine if the patient has Intracranial Hyper/hypotension Fasciculation can occur as a result of calcium/magnesium deficiency (or other electrolyte imbalances),succinylcholine, nerve agents, ALS Currently, only fasciculations due to the nerve agent Sarin are active. Other causes are a subject of model improvement

Event:: Patient: Intracranial Hypertension. The intracranial pressure has risen above 25 mmHg.

Event:: Patient: End Intracranial Hypertension. The intracranial pressure has fallen below 24 mmHg.

Event:: Patient: Intracranial Hypotension. The intracranial pressure has fallen below 7 mmHg.

Event:: Patient: End Intracranial Hypotension. The intracranial pressure has risen above 7.5 mmHg.

[nambda1971cholinesterase]

[11], [214]

void biogears::Nervous::CheckPainStimulus ( )

protected

Calculates the patient pain response due to stimulus, susceptibility and drugs.

A patient reacts to a noxious stimulus in a certain way. Generally this is reported as a VAS scale value. This value is generally reported by the patient after the nervous system has already parsed the stimulus. For a robotic manikin trainer we need to determine the nervous system and systemic responses related to that stimulus

void biogears::Nervous::ChemoreceptorFeedback ( )

protected

Calculates the chemoreceptor feedback and sets the scaling parameters in the CDM.

The chemoreceptor feedback function uses the current arterial partial pressure of oxygen and carbon dioxide relative to the partial pressure set-points in order to calculate response signal. The affected systems identify the signal and adjust accordingly. Note that chemoreception is currently built into the respiratory driver; therefore, the chemoreceptor feedback only sets CV modifiers.

const char* biogears::Nervous::classname ( ) const

inlineoverridevirtual

Reimplemented from biogears::SENervousSystem.

void biogears::Nervous::Clear ( )

overridevirtual

Reimplemented from biogears::SENervousSystem.

void biogears::Nervous::EfferentResponse ( )

protected

size_t biogears::Nervous::hash_code ( ) const

inlineoverridevirtual

Reimplemented from biogears::SENervousSystem.

void biogears::Nervous::Initialize ( )

overridevirtual

Initializes system properties to valid homeostatic values.

Reimplemented from biogears::BioGearsSystem.

bool biogears::Nervous::Load ( const CDM::BioGearsNervousSystemData & in )

virtual

void biogears::Nervous::LocalAutoregulation ( )

protected

Calculates the cerebral autoregulation and local autoregulation of muscle and myocardium.

auto biogears::Nervous::make_unique ( BioGears & bg ) -> std::unique_ptr<Nervous>

staticprotected

void biogears::Nervous::PostProcess ( )

overridevirtual

Nervous PostProcess Step.

Currently no nervous postprocess methods.

Implements biogears::BioGearsSystem.

void biogears::Nervous::PreProcess ( )

overridevirtual

Preprocess methods for the nervous system.

Computes nervous system regulation of the body. Baroreceptor and chemoreceptor feedback is computed and modifiers set in preparation for systems processing.

Implements biogears::BioGearsSystem.

void biogears::Nervous::Process ( )

overridevirtual

Nervous Process Step.

The only current Process-specific function checks the brain status to set events.

Implements biogears::BioGearsSystem.

void biogears::Nervous::SetPupilEffects ( )

protected

Sets pupil size and reactivity modifiers based on drug and TBI effects.

Modifiers are on a scale between -1 (for reduction in size/reactivity) and 1 (for increase) TBI effects are applied to the eye on the same side of the injury if localized or both if diffuse Drug and TBI pupil effects are simply summed together

void biogears::Nervous::SetUp ( )

overrideprotectedvirtual

Initializes the nervous specific quantities.

Initializes the nervous system.

Implements biogears::BioGearsSystem.

static size_t biogears::Nervous::TypeHash ( )

inlinestatic

static constexpr char const* const biogears::Nervous::TypeTag ( )

inlinestatic

CDM::BioGearsNervousSystemData * biogears::Nervous::Unload ( ) const

overridevirtual

Reimplemented from biogears::SENervousSystem.

void biogears::Nervous::Unload ( CDM::BioGearsNervousSystemData & data ) const

protectedvirtual

void biogears::Nervous::UpdateSleepState ( )

protected

Update global nervous sleep state.

Update sleep state when action is used.

Friends And Related Function Documentation

friend class BioGears

friend

friend class BioGearsEngineTest

friend

Member Data Documentation

double biogears::Nervous::m_AfferentBaroreceptorAortic_Hz

protected

double biogears::Nervous::m_AfferentBaroreceptorCarotid_Hz

protected

double biogears::Nervous::m_AfferentCardiopulmonary_Hz

protected

double biogears::Nervous::m_AfferentChemoreceptor_Hz

protected

double biogears::Nervous::m_AfferentPulmonaryStretchReceptor_Hz

protected

double biogears::Nervous::m_AorticBaroreceptorStrain

protected

double biogears::Nervous::m_ArterialCarbonDioxideBaseline_mmHg

protected

double biogears::Nervous::m_ArterialOxygenBaseline_mmHg

protected

double biogears::Nervous::m_AttentionLapses

protected

double biogears::Nervous::m_BaroreceptorOperatingPoint_mmHg

protected

double biogears::Nervous::m_BiologicalDebt

protected

bool biogears::Nervous::m_blockActive

protected

double biogears::Nervous::m_CardiopulmonaryInput_mmHg

protected

double biogears::Nervous::m_CardiopulmonaryInputBaseline_mmHg

protected

double biogears::Nervous::m_CarotidBaroreceptorStrain

protected

double biogears::Nervous::m_CentralFrequencyDelta_Per_min

protected

double biogears::Nervous::m_CentralPressureDelta_cmH2O

protected

std::vector<double> biogears::Nervous::m_CerebralArteriesEffectors_Large

protected

std::vector<double> biogears::Nervous::m_CerebralArteriesEffectors_Small

protected

double biogears::Nervous::m_CerebralBloodFlowBaseline_mL_Per_s

protected

double biogears::Nervous::m_CerebralBloodFlowInput_mL_Per_s

protected

double biogears::Nervous::m_CerebralOxygenSaturationBaseline

protected

double biogears::Nervous::m_CerebralPerfusionPressureBaseline_mmHg

protected

double biogears::Nervous::m_ChemoreceptorFiringRateSetPoint_Hz

protected

double biogears::Nervous::m_ComplianceModifier

protected

BioGears& biogears::Nervous::m_data

protected

double biogears::Nervous::m_DrugRespirationEffects

protected

double biogears::Nervous::m_dt_s

protected

bool biogears::Nervous::m_FeedbackActive

protected

double biogears::Nervous::m_HeartElastanceModifier

protected

double biogears::Nervous::m_HeartOxygenBaseline

protected

double biogears::Nervous::m_HeartRateModifierSympathetic

protected

double biogears::Nervous::m_HeartRateModifierVagal

protected

double biogears::Nervous::m_HypercapniaThresholdHeart

protected

double biogears::Nervous::m_HypercapniaThresholdPeripheral

protected

double biogears::Nervous::m_HypoxiaThresholdHeart

protected

double biogears::Nervous::m_HypoxiaThresholdPeripheral

protected

double biogears::Nervous::m_MeanLungVolume_L

protected

double biogears::Nervous::m_MuscleOxygenBaseline

protected

double biogears::Nervous::m_OxygenAutoregulatorHeart

protected

double biogears::Nervous::m_OxygenAutoregulatorMuscle

protected

double biogears::Nervous::m_painStimulus

protected

double biogears::Nervous::m_painStimulusDuration_s

protected

double biogears::Nervous::m_painVAS

protected

double biogears::Nervous::m_painVASDuration_s

protected

SEPatient* biogears::Nervous::m_Patient

protected

double biogears::Nervous::m_PeripheralBloodGasInteractionBaseline_Hz

protected

double biogears::Nervous::m_PeripheralFrequencyDelta_Per_min

protected

double biogears::Nervous::m_PeripheralPressureDelta_cmH2O

protected

double biogears::Nervous::m_ReactionTime_s

protected

double biogears::Nervous::m_ResistanceModifierExtrasplanchnic

protected

double biogears::Nervous::m_ResistanceModifierMuscle

protected

double biogears::Nervous::m_ResistanceModifierSplanchnic

protected

SESubstance* biogears::Nervous::m_Sarin

protected

SESubstance* biogears::Nervous::m_Succinylcholine

protected

double biogears::Nervous::m_SympatheticPeripheralSignal_Hz

protected

double biogears::Nervous::m_SympatheticPeripheralSignalBaseline_Hz

protected

double biogears::Nervous::m_SympatheticPeripheralSignalFatigue

protected

double biogears::Nervous::m_SympatheticSinoatrialSignal_Hz

protected

double biogears::Nervous::m_SympatheticSinoatrialSignalBaseline_Hz

protected

double biogears::Nervous::m_TiredTime_hr

protected

double biogears::Nervous::m_VagalSignal_Hz

protected

double biogears::Nervous::m_VagalSignalBaseline_Hz

protected

Public Member Functions

Static Public Member Functions

Protected Member Functions

Static Protected Member Functions

Protected Attributes

Friends

Additional Inherited Members

Detailed Description

Constructor & Destructor Documentation

Member Function Documentation

Friends And Related Function Documentation

Member Data Documentation