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Human patient simulators

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https://www.readbyqxmd.com/read/28441656/development-of-a-smartphone-app-for-visualizing-heart-sounds-and-murmurs
#1
Noritaka Mamorita, Naoya Arisaka, Risa Isonaka, Tadashi Kawakami, Akihiro Takeuchi
BACKGROUND: Auscultation is one of the basic techniques for the diagnosis of heart disease. However, the interpretation of heart sounds and murmurs is a highly subjective and difficult skill. OBJECTIVES: To assist the auscultation skill at the bedside, a handy phonocardiogram was developed using a smartphone (Samsung Galaxy J, Android OS 4.4.2) and an external microphone attached to a stethoscope. METHODS AND RESULTS: The Android app used Java classes, "AudioRecord," "AudioTrack," and "View," that recorded sounds, replayed sounds, and plotted sound waves, respectively...
April 26, 2017: Cardiology
https://www.readbyqxmd.com/read/28431936/galectin-3-mediates-the-pulmonary-arterial-hypertension-induced-right-ventricular-remodeling-through-interacting-with-nadph-oxidase-4
#2
Jingni He, Xiaohui Li, Hui Luo, Tangzhiming Li, Lin Zhao, Qiangqiang Qi, Yuwei Liu, Zaixin Yu
Pulmonary arterial hypertension (PAH) is a progressive disorder that affects both pulmonary vasculature and the heart. The response of the right ventricle (RV) to the increased afterload is an important determinant of the PAH final outcome. Galectin-3 (Gal-3), a novel biomarker in left cardiac remodeling, takes part in multiple pathophysiological processes including the inflammation, fibrosis, immunity, and oxidative stress. The levels of Gal-3 are elevated in PAH patients, although the exact mechanisms underlie the PAH-induced right ventricular structural changes remain unclear...
March 27, 2017: Journal of the American Society of Hypertension: JASH
https://www.readbyqxmd.com/read/28431428/computational-and-in-vitro-experimental-investigation-of-intrathecal-drug-distribution-parametric-study-of-the-effect-of-injection-volume-cerebrospinal-fluid-pulsatility-and-drug-uptake
#3
Kevin M Tangen, Roxanne Leval, Ankit I Mehta, Andreas A Linninger
BACKGROUND: Intrathecal drug delivery is an attractive option to circumvent the blood-brain barrier for pain management through its increased efficacy of pain relief, reduction in adverse side effects, and cost-effectiveness. Unfortunately, there are limited guidelines for physicians to choose infusion or drug pump settings to administer therapeutic doses to specific regions of the spine or the brain. Although empiric trialing of intrathecal drugs is critical to determine the sustained side effects, currently there is no inexpensive in vitro method to guide the selection of spinal drug delivery parameters...
May 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28428160/simulated-conversations-with-virtual-humans-to-improve-patient-provider-communication-and-reduce-unnecessary-prescriptions-for-antibiotics-a-repeated-measure-pilot-study
#4
Antoinette Schoenthaler, Glenn Albright, Judith Hibbard, Ron Goldman
BACKGROUND: Despite clear evidence that antibiotics do not cure viral infections, the problem of unnecessary prescribing of antibiotics in ambulatory care persists, and in some cases, prescribing patterns have increased. The overuse of antibiotics for treating viral infections has created numerous economic and clinical consequences including increased medical costs due to unnecessary hospitalizations, antibiotic resistance, disruption of gut bacteria, and obesity. Recent research has underscored the importance of collaborative patient-provider communication as a means to reduce the high rates of unnecessary prescriptions for antibiotics...
April 19, 2017: JMIR Medical Education
https://www.readbyqxmd.com/read/28424793/a-model-based-meta-analysis-evaluating-gender-differences-on-blood-flow-responses-to-brachial-artery-infusions-of-acetylcholine-albuterol-atp-bradykinin-estradiol-glyceryl-trinitrate-l-nmma-nevibolol-norepinephrine-sodium-nitroprusside-substance-p-and-verapamil
#5
Andy R Eugene
INTRODUCTION: Numerous studies have emerged over the course of several decades describing the properties of drugs eliciting vasodilatory or vasoconstrictor responses in the human vasculature. During drug development, decisions to move forward with testing with a new chemical entity are very costly. To fund or not to fund development, go or no-go, decisions are often limited by efficacy comparisons with the current products on the market. The primary aim of this paper is to use dose-response modeling and simulations to quantify differences in blood flow to Acetylcholine, Albuterol, ATP, Bradykinin, 17β-Estradiol, Glyceryl Trinitrate, L-NMMA, Nevibolol, Norepinephrine, Sodium Nitroprusside, Substance P, and Verapamil...
June 2016: MEDtube Science
https://www.readbyqxmd.com/read/28420421/analysis-of-100-000-human-cancer-genomes-reveals-the-landscape-of-tumor-mutational-burden
#6
Zachary R Chalmers, Caitlin F Connelly, David Fabrizio, Laurie Gay, Siraj M Ali, Riley Ennis, Alexa Schrock, Brittany Campbell, Adam Shlien, Juliann Chmielecki, Franklin Huang, Yuting He, James Sun, Uri Tabori, Mark Kennedy, Daniel S Lieber, Steven Roels, Jared White, Geoffrey A Otto, Jeffrey S Ross, Levi Garraway, Vincent A Miller, Phillip J Stephens, Garrett M Frampton
BACKGROUND: High tumor mutational burden (TMB) is an emerging biomarker of sensitivity to immune checkpoint inhibitors and has been shown to be more significantly associated with response to PD-1 and PD-L1 blockade immunotherapy than PD-1 or PD-L1 expression, as measured by immunohistochemistry (IHC). The distribution of TMB and the subset of patients with high TMB has not been well characterized in the majority of cancer types. METHODS: In this study, we compare TMB measured by a targeted comprehensive genomic profiling (CGP) assay to TMB measured by exome sequencing and simulate the expected variance in TMB when sequencing less than the whole exome...
April 19, 2017: Genome Medicine
https://www.readbyqxmd.com/read/28419689/kinetic-and-structural-changes-in-hsmtphers-induced-by-pathogenic-mutations-in-human-fars2
#7
Ekaterine Kartvelishvili, Dmitry Tworowski, Hilary Vernon, Nina Moor, Jing Wang, Lee-Jun Wong, Zofia Chrzanowska-Lightowlers, Mark Safro
Mutations in the mitochondrial aminoacyl-tRNA synthetases (mtaaRSs) can cause profound clinical presentations, and have manifested as diseases with very selective tissue specificity. To date most of the mtaaRS mutations could be phenotypically recognized, such that clinicians could identify the affected mtaaRS from the symptoms alone. Among the recently reported pathogenic variants are point mutations in FARS2 gene, encoding the human mitochondrial PheRS. Patient symptoms range from spastic paraplegia to fatal infantile Alpers encephalopathy...
April 17, 2017: Protein Science: a Publication of the Protein Society
https://www.readbyqxmd.com/read/28418910/erythropoietin-drives-breast-cancer-progression-by-activation-of-its-receptor-epor
#8
Ka Kui Chan, Kyle B Matchett, Jonathan A Coulter, Hiu-Fung Yuen, Cian M McCrudden, Shu-Dong Zhang, Gareth W Irwin, Matthew A Davidson, Thomas Rülicke, Sophie Schober, Ludger Hengst, Heidelinde Jaekel, Angela Platt-Higgins, Philip S Rudland, Ken I Mills, Perry Maxwell, Mohamed El-Tanani, Terence R Lappin
Breast cancer is a leading cause of cancer-related deaths. Anemia is common in breast cancer patients and can be treated with blood transfusions or with recombinant erythropoietin (EPO) to stimulate red blood cell production. Clinical studies have indicated decreased survival in some groups of cancer patients treated with EPO. Numerous tumor cells express the EPO receptor (EPOR), posing a risk that EPO treatment would enhance tumor growth, but the mechanisms involved in breast tumor progression are poorly understood...
March 18, 2017: Oncotarget
https://www.readbyqxmd.com/read/28409029/biophysical-approaches-facilitate-computational-drug-discovery-for-atp-binding-cassette-proteins
#9
REVIEW
Steven V Molinski, Zoltán Bozóky, Surtaj H Iram, Saumel Ahmadi
Although membrane proteins represent most therapeutically relevant drug targets, the availability of atomic resolution structures for this class of proteins has been limited. Structural characterization has been hampered by the biophysical nature of these polytopic transporters, receptors, and channels, and recent innovations to in vitro techniques aim to mitigate these challenges. One such class of membrane proteins, the ATP-binding cassette (ABC) superfamily, are broadly expressed throughout the human body, required for normal physiology and disease-causing when mutated, yet lacks sufficient structural representation in the Protein Data Bank...
2017: International Journal of Medicinal Chemistry
https://www.readbyqxmd.com/read/28405409/effects-of-communication-skill-training-cst-based-on-spikes-for-insurance-covered-pharmacy-pharmacists-to-interact-with-simulated-cancer-patients
#10
Manako Hanya, Yoshitake Kanno, Junko Akasaki, Keiko Abe, Kazuhiko Fujisaki, Hiroyuki Kamei
BACKGROUND: With the development of pharmacotherapy and radiotherapy, cancer treatment is being shifted from surgical to outpatient services, consequently increasing insurance-covered pharmacies' frequency of dealing with cancer patients. As the psychology of these patients is complex, it is necessary for pharmacists to educate them in consideration of their cognitive/medical and psychosocial aspects. This study analyzed cancer patient management by pharmacists working in such pharmacies and their communication skills before and after communication skill training based on SPIKES, a six-step protocol for delivering bad news, to confirm the usefulness of such training...
2017: Journal of Pharmaceutical Health Care and Sciences
https://www.readbyqxmd.com/read/28404450/does-lying-in-the-recovery-position-increase-the-likelihood-of-not-delivering-cardiopulmonary-resuscitation
#11
Miguel Freire-Tellado, Rubén Navarro-Patón, Maria Del Pilar Pavón-Prieto, Marta Fernández-López, Javier Mateos-Lorenzo, Ivan López-Fórneas
BACKGROUND: Resuscitation guidelines endorse unconscious and normally breathing out-of-hospital victims to be placed in the recovery position to secure airway patency, but recently a debate has been opened as to whether the recovery position threatens the cardiac arrest victim's safety assessment and delays the start of cardiopulmonary resuscitation. AIM: To compare the assessment of the victim's breathing arrest while placed in the recovery position versus maintaining an open airway with the continuous head tilt and chin lift technique to know whether the recovery position delays the cardiac arrest victim's assessment and the start of cardiopulmonary resuscitation...
April 9, 2017: Resuscitation
https://www.readbyqxmd.com/read/28402925/time-delays-associated-with-vasoactive-medication-preparation-and-delivery-in-simulated-patients-at-risk-of-cardiac-arrest
#12
P G Brindley, D O'Dochartaigh, C Volney, S Ryan, M J Douma
PURPOSE: To compare, quantify, and describe the time-delays associated with four common methods of adrenaline administration in the simulated setting of impending cardiac arrest. METHODS: Using sham medication and a high-fidelity simulator, experienced Nurses prepared, then delivered, adrenaline by: i) bolus, ii) lower-concentration infusion iii) higher-concentration infusion, and iv) higher-concentration infusion plus carrier-line. We recorded medication preparation and delivery time, plus administration errors and self-reported competence...
April 7, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28401980/the-impact-of-nonadherence-to-antiseizure-drugs-on-seizure-outcomes-in-an-animal-model-of-epilepsy
#13
Kyle E Thomson, Avani C Modi, Tracy A Glauser, Joseph R Rausch, H Steve White
OBJECTIVE: Nonadherence to prescribed dosing regimens is a significant problem in the treatment of pediatric and adult chronic epilepsy, and can result in severe consequences to patient outcomes. In this first-of-kind preclinical study, the impact of nonadherence on seizure control was studied by simulating human patterns of nonadherence in an animal epilepsy model. METHODS: In study 1, three different patterns of nonadherence were modeled in newly diagnosed epileptic rats treated with carbamazepine: perfect adherence (100% of pellets contained carbamazepine), variable nonadherence (50% of pellets contained carbamazepine with different dosing patterns between animals), and complete nonadherence (0% of pellets contained carbamazepine)...
April 12, 2017: Epilepsia
https://www.readbyqxmd.com/read/28401399/intelligent-viewpoint-selection-for-efficient-ct-to-video-registration-in-laparoscopic-liver-surgery
#14
Maria R Robu, Philip Edwards, João Ramalhinho, Stephen Thompson, Brian Davidson, David Hawkes, Danail Stoyanov, Matthew J Clarkson
PURPOSE: Minimally invasive surgery offers advantages over open surgery due to a shorter recovery time, less pain and trauma for the patient. However, inherent challenges such as lack of tactile feedback and difficulty in controlling bleeding lower the percentage of suitable cases. Augmented reality can show a better visualisation of sub-surface structures and tumour locations by fusing pre-operative CT data with real-time laparoscopic video. Such augmented reality visualisation requires a fast and robust video to CT registration that minimises interruption to the surgical procedure...
April 11, 2017: International Journal of Computer Assisted Radiology and Surgery
https://www.readbyqxmd.com/read/28398628/population-pharmacokinetics-and-target-engagement-of-natalizumab-in-patients-with-multiple-sclerosis
#15
Kumar Kandadi Muralidharan, Geoffrey Kuesters, Tatiana Plavina, Meena Subramanyam, Daniel D Mikol, Sreeja Gopal, Ivan Nestorov
Natalizumab (humanized immunoglobulin G4 antibody targeting alpha-4 integrins) is a highly efficacious treatment for relapsing-remitting multiple sclerosis (RRMS) that has been in clinical use since 2006. However, natalizumab pharmacokinetic (PK) characteristics and concentration alpha-4 integrin saturation relationships have not been well described in the scientific literature. Therefore, clinical data from 11 studies were pooled and analyzed to characterize the PK and pharmacodynamic (PD) properties of natalizumab in RRMS subjects...
April 11, 2017: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28392018/comprehensive-simulation-enhanced-training-curriculum-for-an-advanced-minimally-invasive-procedure-a-randomized-controlled-trial
#16
Boris Zevin, Nicolas J Dedy, Esther M Bonrath, Teodor P Grantcharov
BACKGROUND: There is no comprehensive simulation-enhanced training curriculum to address cognitive, psychomotor, and nontechnical skills for an advanced minimally invasive procedure. OBJECTIVES: 1) To develop and provide evidence of validity for a comprehensive simulation-enhanced training (SET) curriculum for an advanced minimally invasive procedure; (2) to demonstrate transfer of acquired psychomotor skills from a simulation laboratory to live porcine model; and (3) to compare training outcomes of SET curriculum group and chief resident group...
December 2, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28389068/bone-mineral-density-measurements-around-osseointegrated-implants-a-precision-study-and-validation-of-scan-protocol-for-transfemoral-amputees
#17
Rehne Lessmann Hansen, Bente Lomholt Langdahl, Peter Holmberg Jørgensen, Klaus Kjær Petersen, Kjeld Søballe, Maiken Stilling
Visual evaluation of bone changes around an osseointegration (OI) implant in femoral amputees examined on plain radiographs shows that periprosthetic bone resorption takes place during the first years after OI surgery, but the bone mineral density (BMD) change has not been previously quantified by dual-energy X-ray absorptiometry (DXA). Precision is vital when monitoring BMD changes around implants, and thus the aim of this study was to evaluate the precision and feasibility of a scan protocol for BMD measurements in proximity of OI implants...
April 4, 2017: Journal of Clinical Densitometry
https://www.readbyqxmd.com/read/28385615/identification-and-characterisation-of-a-salt-form-of-danirixin-with-reduced-pharmacokinetic-variability-in-patient-populations
#18
Jackie C Bloomer, Claire Ambery, Bruce E Miller, Paul Connolly, Helen Garden, Nick Henley, Neil Hodnett, Sarah Keel, James L Kreindler, Richard S Lloyd, Wayne Matthews, John Yonchuk, Aili L Lazaar
The natural variability of gastric pH or gastric acid reducing medications can result in lower and more variable clinical pharmacokinetics for basic compounds in patient populations. Progressing alternative salt forms with improved solubility and dissolution properties can minimise this concern. This manuscript outlines a nonclinical approach comprising multiple biopharmaceutical, in vitro and physiologically based pharmacokinetic model (PBPK) modelling studies to enable selection of an alternative salt form for danirixin (DNX, GSK1325756), a pharmaceutical agent being developed for chronic obstructive pulmonary disease (COPD)...
April 3, 2017: European Journal of Pharmaceutics and Biopharmaceutics
https://www.readbyqxmd.com/read/28380196/an-agent-based-simulation-combined-with-group-decision-making-technique-for-improving-the-performance-of-an-emergency-department
#19
M Yousefi, R P M Ferreira
This study presents an agent-based simulation modeling in an emergency department. In a traditional approach, a supervisor (or a manager) allocates the resources (receptionist, nurses, doctors, etc.) to different sections based on personal experience or by using decision-support tools. In this study, each staff agent took part in the process of allocating resources based on their observation in their respective sections, which gave the system the advantage of utilizing all the available human resources during the workday by being allocated to a different section...
March 30, 2017: Brazilian Journal of Medical and Biological Research, Revista Brasileira de Pesquisas Médicas e Biológicas
https://www.readbyqxmd.com/read/28373266/global-proteomic-analysis-of-human-liver-microsomes-rapid-characterization-and-quantification-of-hepatic-drug-metabolizing-enzymes
#20
Brahim Achour, Hajar Al-Feteisi, Francesco Lanucara, Amin Rostami-Hodjegan, Jill Barber
Many genetic and environmental factors lead to inter-individual variations in metabolism and transport of drugs, profoundly affecting efficacy and toxicity. Precision dosing, targeting drug dose to a well-characterised sub-population, is dependent on quantitative models of the profiles of drug-metabolizing enzymes and transporters within that sub-population, informed by quantitative proteomics. We report the first use of ion mobility-mass spectrometry for this purpose, allowing rapid, robust, label-free quantification of human liver microsomal (HLM) proteins from distinct individuals...
April 3, 2017: Drug Metabolism and Disposition: the Biological Fate of Chemicals
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