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Human patient simulators

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https://www.readbyqxmd.com/read/29333208/integrating-cadaver-needle-forces-into-a-haptic-robotic-simulator
#1
David F Pepley, Mary A Yovanoff, Katelin A Mirkin, Scarlett R Miller, David C Han, Jason Z Moore
Accurate force simulation is essential to haptic simulators for surgical training. Factors such as tissue inhomogeneity pose unique challenges for simulating needle forces. To aid in the development of haptic needle insertion simulators, a handheld force sensing syringe was created to measure the motion and forces of needle insertions. Five needle insertions were performed into the neck of a cadaver using the force sensing syringe. Based on these measurements a piecewise exponential needle force characterization, was implemented into a haptic central venous catheterization (CVC) simulator...
March 2018: Journal of Medical Devices
https://www.readbyqxmd.com/read/29332554/evaluating-the-dose-dependent-mechanism-of-action-of-trazodone-by-estimation-of-occupancies-for-different-brain-neurotransmitter-targets
#2
Luca Settimo, David Taylor
Trazodone is a drug that was introduced in the clinic almost 40 years ago. It is licensed to treat depression, but it is also commonly used off-label to treat insomnia. A recent study shows that it could be promising in preventing neurodegeneration in mice, and clinical trials to assess its possible beneficial effects on dementia and Alzheimer's disease are expected to start soon in humans. In this study, we describe the dose-dependent pharmacology of trazodone by carrying out pharmacokinetic simulations aiming to predict the brain concentrations of trazodone for different drug-dosing regimens and calculating occupancy for 28 different targets for which published trazodone-binding data are available...
January 2018: Journal of Psychopharmacology
https://www.readbyqxmd.com/read/29330341/biomechanics-of-coupled-motion-in-the-cervical-spine-during-simulated-whiplash-in-patients-with-pre-existing-cervical-or-lumbar-spinal-fusion-a-finite-element-study
#3
H Huang, R W Nightingale, A B C Dang
OBJECTIVES: Loss of motion following spine segment fusion results in increased strain in the adjacent motion segments. However, to date, studies on the biomechanics of the cervical spine have not assessed the role of coupled motions in the lumbar spine. Accordingly, we investigated the biomechanics of the cervical spine following cervical fusion and lumbar fusion during simulated whiplash using a whole-human finite element (FE) model to simulate coupled motions of the spine. METHODS: A previously validated FE model of the human body in the driver-occupant position was used to investigate cervical hyperextension injury...
January 2018: Bone & Joint Research
https://www.readbyqxmd.com/read/29324411/virtual-activities-of-daily-living-for-recovery-of-upper-extremity-motor-function
#4
Richard J Adams, Matthew D Lichter, Allison Ellington, Marga White, Kate Armstead, James T Patrie, Paul T Diamond
A study was conducted to investigate the effectiveness of virtual activities of daily living (ADL) practice using the SaeboVR software system for the recovery of upper extremity (UE) motor function following stroke. The system employs Kinect sensor-based tracking to translate human UE motion into the anatomical pose of the arm of the patient's avatar within a virtual environment, creating a virtual presence within a simulated task space. Patients gain mastery of 12 different integrated activities while traversing a metaphorical "road to recovery" that includes thematically linked levels and therapist-selected difficulty settings...
January 2018: IEEE Transactions on Neural Systems and Rehabilitation Engineering
https://www.readbyqxmd.com/read/29320790/-learning-in-protected-environment-implementation-in-continuing-medical-education
#5
Lion Sieg, Lars Friedrich, Hendrik Eismann
Actual concepts in continuing medical education in acute or emergency medicine contain skill training as well as simulation training. Methods and mechanisms to reduce crisis, like human factor training, shared mental models or closed-loop communication are incorporated. It is unknown which training method is optimal for individual departments in hospitals or for the individual level of education of the healthcare provider. A concept we provide is the so called "learning in protected environment": this environment protects the course participants and our patients from negative consequences of a conventional hands-on training...
January 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29317750/exhaled-air-dispersion-during-bag-mask-ventilation-and-sputum-suctioning-implications-for-infection-control
#6
Matthew T V Chan, Benny K Chow, Thomas Lo, Fanny W Ko, Susanna S Ng, Tony Gin, David S Hui
Mask ventilation and coughing during oro-tracheal suctioning produce aerosols that enhance nosocomial transmission of respiratory infections. We examined the extent of exhaled air dispersion from a human-patient-simulator during mask ventilation by different groups of healthcare workers and coughing bouts. The simulator was programmed to mimic varying severity of lung injury. Exhaled airflow was marked with tiny smoke particles, and highlighted by laser light-sheet. We determined the normalized exhaled air concentration in the leakage jet plume from the light scattered by smoke particles...
January 9, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29309250/cost-effectiveness-of-gene-expression-profile-testing-in-community-practice
#7
Young Chandler, Clyde B Schechter, Jinani Jayasekera, Aimee Near, Suzanne C O'Neill, Claudine Isaacs, Charles E Phelps, G Thomas Ray, Tracy A Lieu, Scott Ramsey, Jeanne S Mandelblatt
Purpose Gene expression profile (GEP) testing can support chemotherapy decision making for patients with early-stage, estrogen receptor-positive, human epidermal growth factor 2-negative breast cancers. This study evaluated the cost effectiveness of one GEP test, Onco type DX (Genomic Health, Redwood City, CA), in community practice with test-eligible patients age 40 to 79 years. Methods A simulation model compared 25-year societal incremental costs and quality-adjusted life-years (QALYs) of community Onco type DX use from 2005 to 2012 versus usual care in the pretesting era (2000 to 2004)...
January 8, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/29301059/objective-validation-of-perfusion-based-human-cadaveric-simulation-training-model-for-management-of-internal-carotid-artery-injury-in-endoscopic-endonasal-sinus-and-skull-base-surgery
#8
Jasper Shen, Kevin Hur, Zhipeng Zhang, Michael Minneti, Martin Pham, Bozena Wrobel, Gabriel Zada
BACKGROUND: The emergence of minimally invasive endoscopic endonasal skull base surgery has necessitated reproducible and realistic simulators of rare vascular injuries. OBJECTIVE: To assess the face and content validity of an innovative perfusion-based cadaveric model developed to simulate internal carotid artery (ICA) injury during endoscopic surgery. METHODS: Otolaryngology and neurosurgery trainees attempted 3 consecutive trials of endoscopic control of a parasellar ICA injury, with standardized technical feedback...
December 29, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29298994/cost-effectiveness-of-hla-dqb1-hla-b-pharmacogenetic-guided-treatment-and-blood-monitoring-in-us-patients-taking-clozapine
#9
François R Girardin, Antoine Poncet, Arnaud Perrier, Nathalie Vernaz, Mark Pletscher, Caroline F Samer, Jeffrey A Lieberman, Jean Villard
Less than 1% of adult patients with schizophrenia taking clozapine develop agranulocytosis, and most of these cases occur within the first weeks of treatment. The human leukocyte antigen (HLA) region has been associated with genetic susceptibility to clozapine-induced agranulocytosis (single amino acid changes in HLA-DQB1 (126Q) and HLA-B (158T)). The current study aimed to evaluate the cost-effectiveness, from a healthcare provider's perspective, of an HLA genotype-guided approach in patients with treatment-resistant schizophrenia who were taking clozapine and to compare the results with the current absolute neutrophil count monitoring (ANCM) schemes used in the USA...
January 3, 2018: Pharmacogenomics Journal
https://www.readbyqxmd.com/read/29285342/a-study-on-the-predictability-of-acute-lymphoblastic-leukaemia-response-to-treatment-using-a-hybrid-oncosimulator
#10
Eleftherios Ouzounoglou, Eleni Kolokotroni, Martin Stanulla, Georgios S Stamatakos
Efficient use of Virtual Physiological Human (VPH)-type models for personalized treatment response prediction purposes requires a precise model parameterization. In the case where the available personalized data are not sufficient to fully determine the parameter values, an appropriate prediction task may be followed. This study, a hybrid combination of computational optimization and machine learning methods with an already developed mechanistic model called the acute lymphoblastic leukaemia (ALL) Oncosimulator which simulates ALL progression and treatment response is presented...
February 6, 2018: Interface Focus
https://www.readbyqxmd.com/read/29285341/simulating-a-virtual-population-s-sensitivity-to-salt-and-uninephrectomy
#11
John S Clemmer, Robert L Hester, W Andrew Pruett
Salt sensitivity, with or without concomitant hypertension, is associated with increased mortality. Reduced functional renal mass plays an important role in causing salt-sensitive hypertension for many individuals. Factors that are important in the condition of decreased renal mass and how they affect blood pressure (BP) or salt sensitivity are unclear. We used HumMod, an integrative mathematical model of human physiology, to create a heterogeneous population of 1000 virtual patients by randomly varying physiological parameters...
February 6, 2018: Interface Focus
https://www.readbyqxmd.com/read/29281626/integrated-rare-variant-based-risk-gene-prioritization-in-disease-case-control-sequencing-studies
#12
Jhih-Rong Lin, Quanwei Zhang, Ying Cai, Bernice E Morrow, Zhengdong D Zhang
Rare variants of major effect play an important role in human complex diseases and can be discovered by sequencing-based genome-wide association studies. Here, we introduce an integrated approach that combines the rare variant association test with gene network and phenotype information to identify risk genes implicated by rare variants for human complex diseases. Our data integration method follows a 'discovery-driven' strategy without relying on prior knowledge about the disease and thus maintains the unbiased character of genome-wide association studies...
December 27, 2017: PLoS Genetics
https://www.readbyqxmd.com/read/29259395/cervical-spine-mechanism-for-reproduction-of-the-biomechanical-behaviours-of-the-human-neck-during-rotation-traction-manipulation
#13
Yuancan Huang, Shuai Li, Minshan Feng, Liguo Zhu
Rotation-traction (RT) manipulation is a commonly used physical therapy procedure in TCM (traditional Chinese medicine) for cervical spondylosis. This procedure temporarily separates the C3 and C4 cervical vertebrae from each other when a physician applies a jerky action while the neck is voluntarily turned by the patient to a specific position as instructed by the physician, where the cervical vertebrae are twisted and locked. However, a high rate of cervical injury occurs due to inexperienced physician interns who lack sufficient training...
2017: Applied Bionics and Biomechanics
https://www.readbyqxmd.com/read/29250903/effects-of-ambient-conditions-on-the-risk-of-pressure-injuries-in-bedridden-patients-multi-physics-modelling-of-microclimate
#14
Tal Zeevi, Ayelet Levy, Neima Brauner, Amit Gefen
Scientific evidence regarding microclimate and its effects on the risk of pressure ulcers (PU) remains sparse. It is known that elevated skin temperatures and moisture may affect metabolic demand as well as the mechanical behaviour of the tissue. In this study, we incorporated these microclimate factors into a novel, 3-dimensional multi-physics coupled model of the human buttocks, which simultaneously determines the biothermal and biomechanical behaviours of the buttocks in supine lying on different support surfaces...
December 17, 2017: International Wound Journal
https://www.readbyqxmd.com/read/29250209/spine-on-a-chip-human-annulus-fibrosus-degeneration-model-for-simulating-the-severity-of-intervertebral-disc%C3%A2-degeneration
#15
Min Ho Hwang, Dong Hyun Cho, Seung Min Baek, Jae Won Lee, Jeong Hun Park, Chang Min Yoo, Jae Hee Shin, Hyo Geun Nam, Hyeong Guk Son, Hyun Jung Lim, Han Sang Cho, Hong Joo Moon, Joo Han Kim, Jong Kwang Lee, Hyuk Choi
The aetiology of intervertebral disc (IVD) degeneration accompanied by low back pain (LBP) is largely unknown, and there are no effective fundamental therapies. Symptomatic IVD is known to be associated with nerve root compression. However, even in the absence of nerve compression, LBP occurs in patients with IVD degeneration. We hypothesize that this phenomenon is associated with a concentration of pro-inflammatory cytokines such as interleukin (IL)-1β and tumour necrosis factor-alpha (TNF-α), which can lead to altered histologic features and cellular phenotypes observed during IVD degeneration...
November 2017: Biomicrofluidics
https://www.readbyqxmd.com/read/29248596/the-wonderland-of-neuronal-nicotinic-acetylcholine-receptors
#16
REVIEW
Daniel Bertrand, A V Terry
Nearly 30 years of experimental evidence supports the argument that ligands of nicotinic acetylcholine receptors (nAChRs) have potential as therapeutic agents. However, as in the famous Lewis Carroll novel "Alice in Wonderland", there have been many unexpected adventures along the pathway of development, and few nAChR ligands have been approved for any clinical condition to date with the exception of nicotine dependence. The recent failures of nAChR ligands in AD and schizophrenia clinical trials have reduced enthusiasm for this therapeutic strategy and many pharmaceutical companies have now abandoned this field of research...
December 14, 2017: Biochemical Pharmacology
https://www.readbyqxmd.com/read/29243665/anthropomorphic-thorax-phantom-for-cardio-respiratory-motion-simulation-in-tomographic-imaging
#17
Konstantin Bolwin, Björn Czekalla, Lynn Johann Frohwein, Florian Buther, Klaus P Schäfers
Patient motion during medical imaging using techniques such as computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET), or single emission computed tomography (SPECT) is well known to degrade images leading to blurring effects or severe artifacts. Motion correction methods try to overcome this degrading effects. However, they need to be validated under realistic conditions. In the present work, a sophisticated anthropomorphic thorax phantom is presented that combines several aspects of a simulator for cardio-respiratory motion...
December 15, 2017: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/29240567/theoretical-evaluation-and-experimental-validation-of-localized-therapeutic-hypothermia-application-to-preserve-residual-hearing-after-cochlear-implantation
#18
Ilmar Tamames, Curtis King, Chin-Yuh Huang, Fred F Telischi, Michael E Hoffer, Suhrud M Rajguru
OBJECTIVES: Cochlear implantation surgery has been shown to result in trauma to inner ear sensory structures, resulting in loss of residual hearing. Localized therapeutic hypothermia has been shown in clinical care to be a neuroprotective intervention. Previously, we have shown in an experimental model that localized hypothermia protects cochlear hair cells and residual hearing function against surgical and cochlear implantation trauma. Using experimental temperature measurements carried out in human cadaver temporal bones and a finite element model of the inner ear, the present study examined the temperature distribution of a custom-designed hypothermia delivery system in the human inner ear organs...
December 13, 2017: Ear and Hearing
https://www.readbyqxmd.com/read/29238755/spatiotemporal-progression-of-early-human-ventricular-fibrillation
#19
David Vidmar, David E Krummen, Justin Hayase, Sanjiv M Narayan, Gordon Ho, Wouter-Jan Rappel
Objectives: The objective of this study was to evaluate the spatio-temporal organization and progression of human ventricular fibrillation (VF) in the left (LV) and right (RV) ventricles. Background: Studies suggest that localized sources contribute to VF maintenance, but the evolution of VF episodes has not been quantified. Methods: Synchrony between electrograms recorded from 25 patients with induced VF is computed and used to define the Asynchronous Index (ASI), indicating regions which are out-of-step with surrounding tissue...
December 11, 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29232300/three-dimensional-printing-of-life-like-models-for-simulation-and-training-of-minimally-invasive-cardiac-surgery
#20
Toshiyuki Yamada, Motohiko Osako, Tomoya Uchimuro, Ryogen Yoon, Toshiaki Morikawa, Maki Sugimoto, Hisao Suda, Hideyuki Shimizu
OBJECTIVE: As the use of minimally invasive surgery in cardiothoracic surgery increases, so does the need for simulation and training. We developed a heart model for simulation and training of minimally invasive cardiac surgery, particularly minimally invasive mitral valve repair using our new three-dimensional printing system. METHODS: Digital imaging and communication in medicine data from patient computed tomography, three-dimensional computer-aided design, and three-dimensional printing helped create replicas of the heart and thoracic cavity...
November 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
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