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mathematical model hemorrhage

Rajash K Handa, Paul R Territo, Philip M Blomgren, Scott A Persohn, Chen Lin, Cynthia D Johnson, Lei Jiang, Bret A Connors, Gary D Hutchins
The current accepted standard for quantifying shock wave lithotripsy (SWL)-induced tissue damage is based on morphometric detection of renal hemorrhage in serial tissue sections from fixed kidneys. This methodology is time and labor intensive and is tissue destructive. We have developed a non-destructive magnetic resonance imaging (MRI) method that permits rapid assessment of SWL-induced hemorrhagic lesion volumes in post-mortem kidneys using native tissue contrast to reduce cycle time. Kidneys of anesthetized pigs were targeted with shock waves using the Dornier Compact S lithotripter...
January 10, 2017: Urolithiasis
Kaoru Aishima, Tatsuya Shimizu, Masanori Aihara, Yuhei Yoshimoto
BACKGROUND: Recent prospective multicenter studies have shown that the probability of rupture of unruptured aneurysms with maximal diameter <7 mm is rather low. However, the overall risks and long-term impact of unruptured aneurysms on lifetime quality of life are still unknown. METHODS: A mathematical model of the natural history of intracranial aneurysms was constructed, in which the hypothetical individuals with or without unruptured aneurysm transit between discrete health states...
November 2016: World Neurosurgery
Ibrahim Diakite, Eric Q Mooring, Gustavo E Velásquez, Megan B Murray
BACKGROUND: During the 2014 Ebola virus disease (EVD) outbreak, policy-makers were confronted with difficult decisions on how best to test the efficacy of EVD vaccines. On one hand, many were reluctant to withhold a vaccine that might prevent a fatal disease from study participants randomized to a control arm. On the other, regulatory bodies called for rigorous placebo-controlled trials to permit direct measurement of vaccine efficacy prior to approval of the products. A stepped-wedge cluster study (SWCT) was proposed as an alternative to a more traditional randomized controlled vaccine trial to address these concerns...
August 2016: PLoS Neglected Tropical Diseases
Won Sup Oh, Sung-Bin Chon
Fluid resuscitation, hemostasis, and transfusion is essential in care of hemorrhagic shock. Although estimation of the residual blood volume is crucial, the standard measuring methods are impractical or unsafe. Vital signs, central venous or pulmonary artery pressures are inaccurate. We hypothesized that the residual blood volume for acute, non-ongoing hemorrhage was calculable using serial hematocrit measurements and the volume of isotonic solution infused. Blood volume is the sum of volumes of red blood cells and plasma...
May 2016: Journal of Korean Medical Science
Margo S Harrison, Jennifer B Griffin, Elizabeth M McClure, Bonnie Jones, Katelin Moran, Robert L Goldenberg
Objective The aim of the study is to evaluate clinical interventions to significantly reduce maternal mortality from prolonged labor, obstructed labor, and prolonged obstructed labor (PL/OL/POL) in sub-Saharan Africa (SSA). Methods A mathematical model-Maternal and Neonatal Directed Assessment of Technology ("MANDATE")-was created for SSA with estimated prevalence for PL/OL/POL and case fatality rates from hemorrhage, infection, and uterine rupture. Based on a literature review and expert opinion, the model was populated with estimated likelihoods of the current healthcare system ability to diagnose, transfer, and treat women with these conditions...
July 2016: American Journal of Perinatology
Sarah Thomas, Jonathan Meadows, K A Kelly McQueen
BACKGROUND: Despite global efforts to reduce the maternal mortality ratio (MMR) through the World Health Organization's (WHO) Millennium Development Goal 5 (MDG5), MMR remains unacceptably high in low-income countries (LICs). Maternal death and disability from hemorrhage, infection, and obstructed labor may be averted by timely cesarean section (CS). Most LICs have CS rates less than that recommended by the WHO. Without access to timely CS, it is unlikely that MMR in LICs will be further reduced...
July 2016: World Journal of Surgery
Laura Facchini, Alberto Bellin, Eleuterio Francisco Toro
The fiber matrix of the surface glycocalyx layer internally coating the endothelial cells and plugging the intercellular clefts is crucial for microvascular wall homeostasis. Disruption of the glycocalyx is found in clinical conditions characterized by microvascular and endothelial dysfunction such as atherosclerosis, diabetes mellitus, chronic renal failure and cerebrovascular disease. Shedding of its components may also occur during oxidative stress and systemic inflammatory states including septis. In this work, we investigate the effects of glycocalyx degradation, either due to enzymatic digestion or to agonist recruitment, on plasma filtration and solute extravasation...
2016: Current Neurovascular Research
Ajay Malhotra, Xiao Wu, Vivek B Kalra, Joseph Schindler, Howard P Forman
OBJECTIVES: Accurate diagnosis of acute subarachnoid hemorrhage (SAH) is critical in thunderclap headache patients due to high morbidity and mortality associated with missed aneurysmal bleeds. The objective of this study was to determine the utility of computed tomography angiography (CTA) in managing patients with acute, severe headaches and negative noncontrast CT and assess the cost-effectiveness of three different screening strategies-no follow up, CTA, and lumbar puncture (LP). METHODS: A modeling-based economic evaluation was performed with a time horizon of 1 year for thunderclap headache patients in the emergency department with negative noncontrast CT for SAH...
March 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Pierre Nouvellet, Tini Garske, Harriet L Mills, Gemma Nedjati-Gilani, Wes Hinsley, Isobel M Blake, Maria D Van Kerkhove, Anne Cori, Ilaria Dorigatti, Thibaut Jombart, Steven Riley, Christophe Fraser, Christl A Donnelly, Neil M Ferguson
Ebola emerged in West Africa around December 2013 and swept through Guinea, Sierra Leone and Liberia, giving rise to 27,748 confirmed, probable and suspected cases reported by 29 July 2015. Case diagnoses during the epidemic have relied on polymerase chain reaction-based tests. Owing to limited laboratory capacity and local transport infrastructure, the delays from sample collection to test results being available have often been 2 days or more. Point-of-care rapid diagnostic tests offer the potential to substantially reduce these delays...
December 3, 2015: Nature
Sayyed Mostafa Mostafavi, Parvin Mousavi, Sean P Dukelow, Stephen H Scott
BACKGROUND: Neurological impairments following stroke impact the ability of individuals to perform daily activities, although the relative impact of individual impairments is not always clear. Recovery of sensorimotor function following stroke can vary widely, from complete recovery to modest or minimal improvements, across individuals. An important question is whether one can predict the amount of recovery based on initial examination of the individual. Robotic technologies are now being used to quantify a range of behavioral capabilities of individuals post-stroke, providing a rich set of biomarkers of sensory and motor dysfunction...
November 26, 2015: Journal of Neuroengineering and Rehabilitation
Jamal Siam, Marwa Kadan, Ron Flaishon, Ofer Barnea
The effectiveness of fluid resuscitation regimens in hemorrhagic trauma is assessed based on its ability to increase oxygen concentration in tissue. Fluid resuscitation using both crystalloids and colloids fluids, creates a dilemma due to its opposing effects on oxygen transfer. It increases blood flow thereby augmenting oxygen transport but it also dilutes the blood simultaneously and reduces oxygen concentration thereby reducing oxygen transport. In this work we have studied these two opposing effects of fluid therapy on oxygen delivery to tissue...
December 2015: Cardiovascular Engineering and Technology
Marc-Antoine de La Vega, Grazia Caleo, Jonathan Audet, Xiangguo Qiu, Robert A Kozak, James I Brooks, Steven Kern, Anja Wolz, Armand Sprecher, Jane Greig, Kamalini Lokuge, David K Kargbo, Brima Kargbo, Antonino Di Caro, Allen Grolla, Darwyn Kobasa, James E Strong, Giuseppe Ippolito, Michel Van Herp, Gary P Kobinger
BACKGROUND: Ebola virus (EBOV) causes periodic outbreaks of life-threatening EBOV disease in Africa. Historically, these outbreaks have been relatively small and geographically contained; however, the magnitude of the EBOV outbreak that began in 2014 in West Africa has been unprecedented. The aim of this study was to describe the viral kinetics of EBOV during this outbreak and identify factors that contribute to outbreak progression. METHODS: From July to December 2014, one laboratory in Sierra Leone processed over 2,700 patient samples for EBOV detection by quantitative PCR (qPCR)...
December 2015: Journal of Clinical Investigation
Emily F Hamilton, Philip A Warrick, Kathleen Collins, Samuel Smith, Thomas J Garite
BACKGROUND: New labor curves have challenged the traditional understanding of the general pattern of dilation and descent in labor. They also revealed wide variation in the time to advance in dilation. An interval of arrest such as 4 hours did not fall beyond normal limits until dilation had reached 6 cm. Thus, the American College of Obstetricians and Gynecologists/Society for Maternal-Fetal Medicine first-stage arrest criteria, based in part on these findings, are applicable only in late labor...
March 2016: American Journal of Obstetrics and Gynecology
Adam J Kucharski, Anton Camacho, Stefan Flasche, Rebecca E Glover, W John Edmunds, Sebastian Funk
Between September 2014 and February 2015, the number of Ebola virus disease (EVD) cases reported in Sierra Leone declined in many districts. During this period, a major international response was put in place, with thousands of treatment beds introduced alongside other infection control measures. However, assessing the impact of the response is challenging, as several factors could have influenced the decline in infections, including behavior changes and other community interventions. We developed a mathematical model of EVD transmission, and measured how transmission changed over time in the 12 districts of Sierra Leone with sustained transmission between June 2014 and February 2015...
November 17, 2015: Proceedings of the National Academy of Sciences of the United States of America
Osama Ahmed, Shihao Zhang, Benjamin L Brown, Jaime Toms, Eduardo Gonzalez-Toledo, Bharat Guthikonda, Hugo Cuellar
BACKGROUND: Preoperative assessment of anterior communicating artery (AcoA) aneurysms with cerebral angiography is common, but not without risk. Computed tomography angiography (CTA) is a widely available imaging modality that provides quick acquisition, low morbidity, and low cost. One disadvantage is that it does not provide dynamic information. In this study, the authors sought to determine whether CTA alone can reliably predict the inflow dominance to an AcoA aneurysm. METHODS: Eighty-three patients with ruptured AcoA aneurysms were reviewed retrospectively...
August 2015: Neuroradiology Journal
Zhiming Li, Zhidong Teng, Xiaomei Feng, Yingke Li, Huiguo Zhang
In order to investigate the transmission mechanism of the infectious individual with Ebola virus, we establish an SEIT (susceptible, exposed in the latent period, infectious, and treated/recovery) epidemic model. The basic reproduction number is defined. The mathematical analysis on the existence and stability of the disease-free equilibrium and endemic equilibrium is given. As the applications of the model, we use the recognized infectious and death cases in Guinea to estimate parameters of the model by the least square method...
2015: Computational and Mathematical Methods in Medicine
Benny Borremans, Raphaël Vossen, Beate Becker-Ziaja, Sophie Gryseels, Nelika Hughes, Mats Van Gestel, Natalie Van Houtte, Stephan Günther, Herwig Leirs
Arenaviruses can cause mild to severe hemorrhagic fevers. Humans mainly get infected through contact with infected rodents or their excretions, yet little is known about transmission dynamics within rodent populations. Morogoro virus (MORV) is an Old World arenavirus closely related to Lassa virus with which it shares the same host species Mastomys natalensis. We injected MORV in its host, and sampled blood and excretions at frequent intervals. Infection in adults was acute; viral RNA disappeared from blood after 18 days post infection (dpi) and from excretions after 39 dpi...
2015: Scientific Reports
Folashade B Agusto, Miranda I Teboh-Ewungkem, Abba B Gumel
BACKGROUND: Ebola is one of the most virulent human viral diseases, with a case fatality ratio between 25% to 90%. The 2014 West African outbreaks are the largest and worst in history. There is no specific treatment or effective/safe vaccine against the disease. Hence, control efforts are restricted to basic public health preventive (non-pharmaceutical) measures. Such efforts are undermined by traditional/cultural belief systems and customs, characterized by general mistrust and skepticism against government efforts to combat the disease...
2015: BMC Medicine
Mahdi Mansouri, Robert F Salamonsen, Einly Lim, Rini Akmeliawati, Nigel H Lovell
In this study, we evaluate a preload-based Starling-like controller for implantable rotary blood pumps (IRBPs) using left ventricular end-diastolic pressure (PLVED) as the feedback variable. Simulations are conducted using a validated mathematical model. The controller emulates the response of the natural left ventricle (LV) to changes in PLVED. We report the performance of the preload-based Starling-like controller in comparison with our recently designed pulsatility controller and constant speed operation...
2015: PloS One
Rupert Faltermeier, Martin A Proescholdt, Sylvia Bele, Alexander Brawanski
Although multimodal monitoring sets the standard in daily practice of neurocritical care, problem-oriented analysis tools to interpret the huge amount of data are lacking. Recently a mathematical model was presented that simulates the cerebral perfusion and oxygen supply in case of a severe head trauma, predicting the appearance of distinct correlations between arterial blood pressure and intracranial pressure. In this study we present a set of mathematical tools that reliably detect the predicted correlations in data recorded at a neurocritical care unit...
2015: Computational and Mathematical Methods in Medicine
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