• This program is a computer-based simulator that reproduces the local anesthetic training items used in student training at Matsumoto Dental University.
• You can install it on your PC or tablet because this is created as a Progressive Web App (PWA).

1. Access this page.
2. For Windows PC (opens in Edge or Chrome) and Android, a notification will be displayed to install it. (no need to install).
   • Once installed, you can use the application even when you are not connected to the Internet.
   • For iPhone or iPad, select "Add to Home Screen" from the menu.

1. Shave the hair on the back of the guinea pig
2. Inject 0.1 mL of the following drugs intradermally, and each injection site papule is enclosed in a circle marked by a magic marker.
   • Saline
   • Pro: Procaine hydrochloride (1%)
   • Lid: Lidocaine hydrochloride (1%)
   • Mep: Mepivacaine hydrochloride (1%)
   • Bup: Bupivacaine hydrochloride (1%)
   • Lid + Adr: Lidocaine hydrochloride (1%) with adrenaline (1/100,000)
3. Stimulate 6 times at each papule with needle, with the number of the skin contractions counted, defining this number as the score (minimum is 0, and maximum is 6).
   • Stimulate at 5 min interval up to 120 min
4. When a score of 6 is obtained three times in a row, finish the stimulation and define that time as the duration.
   • No need to stimulate after completion
5. Compare the sum of score values and duration of action for each drug.

1. Press Start button to start measurement
2. When you click inside the circle, "Response" or "No response" will be displayed at the bottom left of the screen. If there is a response, the circle will temporarily turn red.
3. You can change the speed (times) of time passing with the slider.
   • Values can be changed both while running and stopped.
4. Press the Pause button to stop time passing, and press the Restart button to resume time passing
5. You can run the experiment from the beginning with new parameter values by pressing the New Exp. button.
   • This means conducting experiments using different animals.
6. Press the Quit button and then exit the program.
   • Please perform this operation to delete the parameter information because this remains in the browser,

• This simulator is modeled based on actual training results, but it may not necessarily yield the same results as animal experiments.
  • Because drug parameter values are set with random numbers, the duration of drug action may differ from the original drug order.
    • I think this frequency has decreased because v1.0.0 has changed to using random numbers that follow a multivariate normal distribution
  • Because the presence or absence of a response when stimulated is determined by random numbers, the number of responses repeats up and down and does not necessarily increase over time.

A paper on the model formula and parameter values used in this simulator.

• Toshiaki Ara and Hiroyuki Kitamura: Development of a Predictive Statistical Pharmacological Model for Local Anesthetic Agent Effects with Bayesian Hierarchical Model Parameter Estimation. Medicines 2023, 10(11), 61 (https://doi.org/10.3390/medicines10110061)

• Since it is released under the MIT License, it can be used and modified for both commercial and non-commercial purposes.
• Build the environment using one of the following methods.
  1. Access the page published on GitHub
     • https://toshi-ara.github.io/simla-ts/sim_local_anesthetics.html
     • This is the easiest, and I think it would be a good idea to post this link on a page that is easy for students to access (such as a classroom-specific page).
  2. Installing on student computers
     • When you click the Code button on this page, Download ZIP will be displayed, so click it. A file named simla-ts-main.zip will be saved.
     • After unzipping the file, copy the contents of the docs folder to your computer (Please change the folder name as appropriate).
     • Double-click sim_local_anesthetics.html in the folder to start the browser and use the simulator.
  3. Install on your own web server (Please consult an expert)
     • Place the contents of the above docs folder in the appropriate location on the web server (Please change the folder name as appropriate).
     • You can use the simulator by visiting sim_local_anesthetics.html

• If you want to modify program, please edit the LICENSE file. Please add the copyright holder after Copyright (c) 2022 ARA Toshiaki and include this LICENSE file in the source code.

• Requires npm (JavaScript package management system)
• Run the following command with npm installed

git clone https://github.com/toshi-ara/simla-ts.git
# git clone [email protected]:toshi-ara/simla-ts.git  # when ssh is used
cd simla-ts

npm install
npm run build

It is also possible to use code from another repository on GitHub.

• There is no need for npm in this case (works only in the browser).

• Disable pinch-in in canvas area

• Update the correlation coefficients among drug parameter values

• Change the timer text color to red when there is a response

• Fix failure to start after installing as a PWA application

• use "multivariate-normal" package to generate random numbers that follow a multivariate normal distribution
  • drop R script

• update contents in README.md (this page)
  • added environment construction and reference items
• change to English (original contents in Japanese are moved to README-ja.md)

• change directory location of source code
  • changed to publish below docs
• change the public URL accordingly
  • https://toshi-ara.github.io/simla-ts/sim_local_anesthetics.html

• change the method to set drug parameter values in simulation
  • use the random numbers that follow a multivariate normal distribution (the correlation coefficient between each drug is 0.8)

• Author: Matsumoto Dental University, Department of Pharmacology, Toshiaki Ara
• Year:2022
• License: MIT License