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https://www.readbyqxmd.com/read/28324933/an-ultrasonically-powered-implantable-device-for-targeted-drug-delivery
#1
Jayant Charthad, Spyridon Baltsavias, Devleena Samanta, Ting Chia Chang, Marcus J Weber, Niloufar Hosseini-Nassab, Richard N Zare, Amin Arbabian
A wirelessly powered implantable device is proposed for fully programmable and localized drug delivery. The implant is powered using an external ultrasonic transmitter and operates at <; 5% of the FDA diagnostic ultrasound intensity limit. Drug release is achieved through electrical stimulation of drug-loaded polypyrrole nanoparticles. A design methodology for the implant electronics is presented and experimentally demonstrated to be accurate in predicting the concentration of the released drug. To the best of our knowledge, this is the first ultrasonically powered implantable device platform for targeted drug delivery using electroresponsive polymers...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28323647/clinical-complications-with-the-delivery-of-inhaled-epoprostenol-in-the-operating-room
#2
Amar M Bhatt, Erica J Stein
No abstract text is available yet for this article.
March 21, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28320042/calcium-channel-modulation-as-a-target-in-chronic-pain-control
#3
REVIEW
Ryan Patel, Carlota Montagut-Bordas, Anthony H Dickenson
Neuropathic pain remains poorly treated for large numbers of patients and little progress has been made in developing novel classes of analgesics. To redress this issue, ziconotide (Prialt(TM) ) was developed and approved as a first in class synthetic version of ω-conotoxin MVIIA, a Cav 2.2 peptide blocker. Unfortunately, the impracticalities of intrathecal delivery, low therapeutic index and severe neurological side effects associated with ziconotide has restricted its use to exceptional circumstances. Ziconotide exhibits no state or use dependent block of Cav 2...
March 20, 2017: British Journal of Pharmacology
https://www.readbyqxmd.com/read/28319990/a-decision-support-approach-for-provider-scheduling-in-a-patient-centered-medical-home
#4
Renata Konrad, Sarah Ficarra, Catherine Danko, Rachel Wallace, Cliona Archambeault
The patient-centered medical home (PCMH) has been proposed as a viable and medically effective model of primary care delivery. The fundamental principles of a PCMH address increased access and offer new ways to organize a practice. Creating provider schedules able to satisfy the operational and organizational constraints imposed by this type of delivery model is a challenging, complex, and time-consuming task.This article presents a two-step approach for scheduling providers and prospectively assessing the consequences of various schedules on patient throughput without experimenting on the real-world system...
January 2017: Journal of Healthcare Management / American College of Healthcare Executives
https://www.readbyqxmd.com/read/28317836/microscale-symmetrical-electroporator-array-as-a-versatile-molecular-delivery-system
#5
Mengxing Ouyang, Winfield Hill, Jung Hyun Lee, Soojung Claire Hur
Successful developments of new therapeutic strategies often rely on the ability to deliver exogenous molecules into cytosol. We have developed a versatile on-chip vortex-assisted electroporation system, engineered to conduct sequential intracellular delivery of multiple molecules into various cell types at low voltage in a dosage-controlled manner. Micro-patterned planar electrodes permit substantial reduction in operational voltages and seamless integration with an existing microfluidic technology. Equipped with real-time process visualization functionality, the system enables on-chip optimization of electroporation parameters for cells with varying properties...
March 20, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28316127/melatonin-pretreatment-improves-gastric-mucosal-blood-flow-and-maintains-intestinal-barrier-function-during-hemorrhagic-shock-in-dogs
#6
Christian Vollmer, Andreas P M Weber, Martin Wallenfang, Till Hoffmann, Tabea Mettler-Altmann, Richard Truse, Inge Bauer, Olaf Picker, Alexander M Mathes
OBJECTIVE: Melatonin improves hepatic perfusion after hemorrhagic shock and may reduce stress-induced gastric lesions. This study was designed to investigate whether pretreatment with melatonin may influence gastric mucosal microcirculatory perfusion (μflow), oxygenation (μHbO2 ) or intestinal barrier function during physiological and hemorrhagic conditions in dogs. METHODS: In a randomized cross-over study, five anesthetized foxhounds received melatonin 100 μg/kg or vehicle (ethanol 5%) intravenously in the absence or presence of hemorrhagic shock (60 min, -20% blood volume)...
March 18, 2017: Microcirculation: the Official Journal of the Microcirculatory Society, Inc
https://www.readbyqxmd.com/read/28306518/biochemical-testing-in-a-laboratory-tent-and-semi-intensive-care-of-ebola-patients-on-site-in-a-remote-part-of-guinea-a-paradigm-shift-based-on-a-bleach-sensitive-point-of-care-device
#7
Leonid M Irenge, Jean-Michel Dindart, Jean-Luc Gala
BACKGROUND: During the West Africa Ebola virus disease (EVD) outbreak, a Belgian laboratory was deployed for supporting the Ebola treatment unit (ETU) of N'Zerekore, Guinea. Besides diagnosis of EVD and malaria, biochemical parameters were tested and used to guide supportive treatment of EVD. METHODS: To preserve analytes stability, lithium-heparin blood samples were analyzed using the i-STAT® point-of-care testing (POCT) handheld device without the viral inactivation step...
March 15, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28304318/placenta-accreta-elective-versus-emergent-delivery-as-a-major-predictor-of-blood-loss
#8
M A Seoud, R Nasr, G A Berjawi, G S Zaatari, Talal M Seoud, Afifa S Shatila, Fadi G Mirza
OBJECTIVE: To compare blood loss and the use for blood transfusion between elective (planned) and emergent cesarean hysterectomy performed for placenta accreta by a single, multidisciplinary team and to present the team's pre-operative evaluation and the surgical technique. STUDY DESIGN: Prospective cohort study at a single tertiary care center. Maternal and neonatal outcomes were compared between elective and emergent delivery of pregnancies complicated by placenta accreta...
March 16, 2017: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/28302635/financial-modelling-of-femtosecond-laser-assisted-cataract-surgery-within-the-national-health-service-using-a-hub-and-spoke-model-for-the-delivery-of-high-volume-cataract-surgery
#9
H W Roberts, M Z Ni, D P S O'Brart
AIMS: To develop financial models which offset additional costs associated with femtosecond laser (FL)-assisted cataract surgery (FLACS) against improvements in productivity and to determine important factors relating to its implementation into the National Health Service (NHS). METHODS: FL platforms are expensive, in initial purchase and running costs. The additional costs associated with FL technology might be offset by an increase in surgical efficiency. Using a 'hub and spoke' model to provide high-volume cataract surgery, we designed a financial model, comparing FLACS against conventional phacoemulsification surgery (CPS)...
March 16, 2017: BMJ Open
https://www.readbyqxmd.com/read/28302085/adaptation-of-non-technical-skills-behavioural-markers-for-delivery-room-simulation
#10
Fabrizio Bracco, Michele Masini, Gabriele De Tonetti, Francesca Brogioni, Arianna Amidani, Sara Monichino, Alessandra Maltoni, Andrea Dato, Claudia Grattarola, Massimo Cordone, Giancarlo Torre, Claudio Launo, Carlo Chiorri, Danilo Celleno
BACKGROUND: Simulation in healthcare has proved to be a useful method in improving skills and increasing the safety of clinical operations. The debriefing session, after the simulated scenario, is the core of the simulation, since it allows participants to integrate the experience with the theoretical frameworks and the procedural guidelines. There is consistent evidence for the relevance of non-technical skills (NTS) for the safe and efficient accomplishment of operations. However, the observation, assessment and feedback on these skills is particularly complex, because the process needs expert observers and the feedback is often provided in judgmental and ineffective ways...
March 17, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28300169/double-flow-focused-liquid-injector-for-efficient-serial-femtosecond-crystallography
#11
Dominik Oberthuer, Juraj Knoška, Max O Wiedorn, Kenneth R Beyerlein, David A Bushnell, Elena G Kovaleva, Michael Heymann, Lars Gumprecht, Richard A Kirian, Anton Barty, Valerio Mariani, Aleksandra Tolstikova, Luigi Adriano, Salah Awel, Miriam Barthelmess, Katerina Dörner, P Lourdu Xavier, Oleksandr Yefanov, Daniel R James, Garrett Nelson, Dingjie Wang, George Calvey, Yujie Chen, Andrea Schmidt, Michael Szczepek, Stefan Frielingsdorf, Oliver Lenz, Edward Snell, Philip J Robinson, Božidar Šarler, Grega Belšak, Marjan Maček, Fabian Wilde, Andrew Aquila, Sébastien Boutet, Mengning Liang, Mark S Hunter, Patrick Scheerer, John D Lipscomb, Uwe Weierstall, Roger D Kornberg, John C H Spence, Lois Pollack, Henry N Chapman, Saša Bajt
Serial femtosecond crystallography requires reliable and efficient delivery of fresh crystals across the beam of an X-ray free-electron laser over the course of an experiment. We introduce a double-flow focusing nozzle to meet this challenge, with significantly reduced sample consumption, while improving jet stability over previous generations of nozzles. We demonstrate its use to determine the first room-temperature structure of RNA polymerase II at high resolution, revealing new structural details. Moreover, the double flow-focusing nozzles were successfully tested with three other protein samples and the first room temperature structure of an extradiol ring-cleaving dioxygenase was solved by utilizing the improved operation and characteristics of these devices...
March 16, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28298660/hyperlactatemia-and-cardiac-surgery
#12
REVIEW
Jonathon Minton, David A Sidebotham
The normal blood lactate level is 0-2 mmol/L, and a value above 3-5 mmol/L is variably used to define hyperlactatemia. In cardiac surgical patients, hyperlactatemia can arise from both hypoxic and non-hypoxic mechanisms. The major non-hypoxic mechanism is likely stress-induced accelerated aerobic metabolism, in which elevated lactate results from a mass effect on the lactate/pyruvate equilibrium. The lactate/pyruvate ratio is normal (<20) in this circumstance. Hyperlactatemia can also result from impaired global or regional oxygen delivery, in which case the lactate/pyruvate ratio is typically elevated (>20)...
March 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/28298362/negative-regulation-of-smad1-pathway-and-collagen-iv-expression-by-store-operated-ca2-entry-in-glomerular-mesangial-cells
#13
Peiwen Wu, Yuezhong Ren, Yuhong Ma, Yanxia Wang, Hui Jiang, Sarika Chaudhari, Mark E Davis, Jonathan E Zuckerman, Rong Ma
Collagen IV (Col IV) is a major component of expanded glomerular extracellular matrix in diabetic nephropathy and Smad1 is a key molecule regulating Col IV expression in mesangial cells (MCs). The present study was conducted to determine if Smad1 pathway and Col IV protein abundance were regulated by store-operated Ca2+ entry (SOCE). In cultured human MCs, pharmacological inhibition of SOCE significantly increased the total amount of Smad1 protein. Activation of SOCE blunted high glucose-increased Smad1 protein content...
March 15, 2017: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/28297462/surface-dose-variations-in-6-and-10-mv-flattened-and-flattening-filter-free-fff-photon-beams
#14
Jason Cashmore
As the use of linear accelerators operating in flattening filter-free (FFF) modes becomes more widespread, it is important to have an understanding of the surface doses delivered to patients with these beams. Flattening filter removal alters the beam quality and relative contributions of low-energy X-rays and contamination electrons in the beam. Having dosimetric data to describe the surface dose and buildup regions under a range of conditions for FFF beams is important if clinical decisions are to be made...
September 2016: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/28297446/initial-clinical-experience-with-arccheck-for-imrt-vmat-qa
#15
Michalis Aristophanous, Yelin Suh, Pai C Chi, Luke J Whittlesey, Scott LaNeave, Mary K Martel
Many devices designed for the purpose of performing patient-specific IMRT/VMAT QA are commercially available. In this work we report our experience and initial clinical results with the ArcCHECK. The ArcCHECK consists of a cylindrical array of diode detectors measuring entry and exit doses. The measured result is a cumulative dose displayed as a 2D matrix. The detector array requires both an absolute dose calibration, and a calibration of the detector response, relative to each other. In addition to the calibrations suggested by the manufacturer, various tests were performed in order to assess its stability and performance prior to clinical introduction...
September 2016: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/28297270/the-feasibility-of-using-microsoft-kinect-v2-sensors-during-radiotherapy-delivery
#16
David M Edmunds, Sophie E Bashforth, Fatemeh Tahavori, Kevin Wells, Ellen M Donovan
Consumer-grade distance sensors, such as the Microsoft Kinect devices (v1 and v2), have been investigated for use as marker-free motion monitoring systems for radiotherapy. The radiotherapy delivery environment is challenging for such sensors because of the proximity to electromagnetic interference (EMI) from the pulse forming network which fires the magnetron and electron gun of a linear accelerator (linac) during radiation delivery, as well as the requirement to operate them from the control area. This work investigated whether using Kinect v2 sensors as motion monitors was feasible during radiation delivery...
November 2016: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/28296771/a-randomized-comparison-of-video-demonstration-versus-hands-on-training-of-medical-students-for-vacuum-delivery-using-objective-structured-assessment-of-technical-skills-osats
#17
Ziad Hilal, Anne K Kumpernatz, Günther A Rezniczek, Cem Cetin, Eva-Katrin Tempfer-Bentz, Clemens B Tempfer
BACKGROUND: To compare medical students' skills for vaginal operative delivery by vacuum extraction (VE) after hands-on training versus video demonstration. METHODS: We randomized medical students to an expert demonstration (group 1) or a hands-on (group 2) training using a standardized VE algorithm on a pelvic training model. Students were tested with a 40-item Objective Structured Assessment of Technical Skills (OSATS) scoring system after training and 4 days later...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28296670/intraoperative-feeding-improves-calorie-and-protein-delivery-in-acute-burn-patients
#18
David E Varon, Gil Freitas, Neha Goel, Jennifer Wall, Deepak Bharadia, Erin Sisk, Joshua C Vacanti, Bohdan Pomahac, Indranil Sinha, Vihas M Patel
Enteral nutrition support is a critical component of modern burn care for severely burned patients. However, tube feeds are frequently withheld during the perioperative period because of aspiration concerns. As a result, patients requiring multiple operative procedures risk accumulating significant protein-calorie deficits. The objective of this study was to describe our American Burn Association-certified burn center's experience implementing an intraoperative feeding protocol in severely burned patients defined as a cutaneous burn ≥20% TBSA...
March 6, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28296322/predicting-deliverability-of-volumetric-modulated-arc-therapy-vmat-plans-using-aperture-complexity-analysis
#19
Kelly C Younge, Don Roberts, Lindsay A Janes, Carlos Anderson, Jean M Moran, Martha M Matuszak
The purpose of this study was to evaluate the ability of an aperture complexity metric for volumetric-modulated arc therapy (VMAT) plans to predict plan delivery accuracy. We developed a complexity analysis tool as a plug-in script to Varian's Eclipse treatment planning system. This script reports the modulation of plans, arcs, and individual control points for VMAT plans using a previously developed complexity metric. The calculated complexities are compared to that of 649 VMAT plans previously treated at our institution from 2013 to mid-2015...
July 2016: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/28296018/assembly-and-transport-of-microscopic-cargos-via-reconfigurable-photoactivated-magnetic-microdockers
#20
Fernando Martinez-Pedrero, Helena Massana-Cid, Pietro Tierno
The realization of micromotors able to dock and transport microscopic objects in a fluid medium has direct applications toward the delivery of drugs and chemicals in small channels and pores, and the realization of functional wireless microrobots in lab-on-a-chip technology. A simple and general method to tow microscopic particles in water by using remotely controllable light-activated hematite microdockers is demonstrated. These anisotropic ferromagnetic particles can be synthesized in bulk and present the remarkable ability to be activated by light while independently manipulated via external fields...
March 15, 2017: Small
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