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https://www.readbyqxmd.com/read/28092800/effect-of-venepuncture-process-design-on-efficiency-and-failure-rates-a-simulation-model-study-for-secondary-care
#1
Sean Reed, Rasa Remenyte-Prescott, Ben Rees
BACKGROUND: Healthcare aims to deliver good patient outcomes. For many clinical procedures there are multiple alternative task sequences that can be performed. These deviations can influence procedure reliability, efficiency of usage of hospital resources and risk to staff and patient safety. Venepuncture is one of the most common invasive procedures in healthcare. Literature of clinical practice shows evidence of wide variability in the procedure order and the duration of each step, which can depend on attributes, such as patient health, sampling method and staff skills...
December 29, 2016: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28092530/feasibility-of-multi-plane-transmit-beamforming-for-real-time-volumetric-cardiac-imaging-a-simulation-study
#2
Yinran Chen, Ling Tong, Alejandra Ortega, Jianwen Luo, Jan D'hooge
Today's three-dimensional (3-D) cardiac ultrasound imaging systems suffer from relatively low spatial and temporal resolution, limiting their applicability in daily clinical practice. To address this problem, 3-D diverging wave imaging with spatial coherent compounding (DWC) as well as 3-D multi-line-transmit (MLT) imaging have recently been proposed. Currently, the former improves the temporal resolution significantly at the expense of image quality and the risk of introducing motion artifacts whereas the latter only provides a moderate gain in volume rate but mostly preserves quality...
January 10, 2017: IEEE Transactions on Ultrasonics, Ferroelectrics, and Frequency Control
https://www.readbyqxmd.com/read/28092496/the-effect-of-contrast-material-on-radiation-dose-at-ct-part-i-incorporation-of-contrast-material-dynamics-in-anthropomorphic-phantoms
#3
Pooyan Sahbaee, W Paul Segars, Daniele Marin, Rendon C Nelson, Ehsan Samei
Purpose To develop a method to incorporate the propagation of contrast material into computational anthropomorphic phantoms for estimation of organ dose at computed tomography (CT). Materials and Methods A patient-specific physiologically based pharmacokinetic (PBPK) model of the human cardiovascular system was incorporated into 58 extended cardiac-torso (XCAT) patient phantoms. The PBPK model comprised compartmental models of vessels and organs unique to each XCAT model. For typical injection protocols, the dynamics of the contrast material in the body were described according to a series of patient-specific iodine mass-balance differential equations, the solutions to which provided the contrast material concentration time curves for each compartment...
January 13, 2017: Radiology
https://www.readbyqxmd.com/read/28092318/opening-injection-pressure-is-higher-in-intraneural-compared-with-perineural-injections-during-simulated-nerve-blocks-of-the-lower-limb-in-fresh-human-cadavers
#4
Kris Vermeylen, Marlies Hermans, Filiep Soetens, Evie Vereecke, Thorsten Steinfeldt, Gerbrand Groen, Admir Hadzic, Marc Van de Velde
BACKGROUND AND OBJECTIVES: Needle-induced nerve trauma and intraneural injection can lead to neurologic injury during peripheral nerve blocks. In this study, we assessed the utility of opening injection pressure (OIP), time to OIP, and rate of rise to OIP in detecting needle-nerve contact and intraneural injection. METHODS: Five common ultrasound-guided blocks of the femoral, saphenous, subgluteal sciatic, tibial, and common peroneal nerves were simulated in 10 fresh cadavers...
January 13, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28091966/aortic-regurgitation-generates-a-kinematic-obstruction-which-hinders-left-ventricular-filling
#5
Ikechukwu Okafor, Vrishank Raghav, Jose F Condado, Prem A Midha, Gautam Kumar, Ajit P Yoganathan
An incompetent aortic valve (AV) results in aortic regurgitation (AR), where retrograde flow of blood into the left ventricle (LV) is observed. In this work, we parametrically characterized the detailed changes in intra-ventricular flow during diastole as a result of AR in a physiological in vitro left-heart simulator (LHS). The loss of energy within the LV as the level of AR increased was also assessed. The validated LHS consisted of an optically-clear, flexible wall LV and a modular AV holder. Two-component, planar, digital particle image velocimetry was used to visualize and quantify intra-ventricular flow...
January 13, 2017: Annals of Biomedical Engineering
https://www.readbyqxmd.com/read/28090108/a-process-for-curricular-improvement-based-on-evaluation-of-student-performance-on-milestone-examinations
#6
Marcy Hernick, Ann C Hylton, Michael Justice
Objective. To identify and address areas for curricular improvement by evaluating student achievement of expected learning outcomes and competencies on annual milestone examinations. Design. Students were tested each professional year with a comprehensive milestone examination designed to evaluate student achievement of learning outcomes and professional competencies using a combination of multiple-choice questions, standardized patient assessments (SPAs), and objective structured clinical examination (OSCE) questions...
November 25, 2016: American Journal of Pharmaceutical Education
https://www.readbyqxmd.com/read/28090107/developing-a-framework-for-objective-structured-clinical-examinations-using-the-nominal-group-technique
#7
Safeera Y Hussainy, Matthew F Crum, Paul J White, Ian Larson, Daniel T Malone, David T Manallack, Joseph A Nicolazzo, Jennifer McDowell, Angelina S Lim, Carl M Kirkpatrick
Objective. To use the nominal group technique to develop a framework to improve existing and develop new objective structured clinical examinations (OSCEs) within a four-year bachelor of pharmacy course. Design. Using the nominal group technique, a unique method of group interview that combines qualitative and quantitative data collection, focus groups were conducted with faculty members, practicing pharmacists, and undergraduate pharmacy students. Five draft OSCEs frameworks were suggested and participants were asked to generate new framework ideas...
November 25, 2016: American Journal of Pharmaceutical Education
https://www.readbyqxmd.com/read/28089874/mathematical-modelling-of-cell-layer-growth-in-a-hollow-fibre-bioreactor
#8
Lloyd A C Chapman, Jonathan P Whiteley, Helen M Byrne, Sarah L Waters, Rebecca J Shipley
Generating autologous tissue grafts of a clinically useful volume requires efficient and controlled expansion of cell populations harvested from patients. Hollow fibre bioreactors show promise as cell expansion devices, owing to their potential for scale-up. However, further research is required to establish how to specify appropriate hollow fibre bioreactor operating conditions for expanding different cell types. In this study we develop a simple model for the growth of a cell layer seeded on the outer surface of a single fibre in a perfused hollow fibre bioreactor...
January 12, 2017: Journal of Theoretical Biology
https://www.readbyqxmd.com/read/28089763/comparison-of-multi-arm-multi-stage-design-and-adaptive-randomization-in-platform-clinical-trials
#9
REVIEW
Jianchang Lin, Veronica Bunn
Platforms trials are clinical trials that allow for concurrent evaluations of multiple treatments, thus allowing for more efficient and ethical studies compared to traditional two-arm trials. Conventional group-sequential multi-arm multi-stage (MAMS) designs use pre-specified stopping boundaries and treatment selection rules to determine if experimental treatments should be dropped. Flexible MAMS designs allow for interim modifications to the design plan without compromising error rates. Bayesian response adaptive randomization (BRAR) designs increase patient allocation to treatment arms that are performing well during the course of the trial...
January 12, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28089723/cost-effectiveness-of-the-decipher-genomic-classifier-to-guide-individualized-decisions-for-early-radiation-therapy-after-prostatectomy-for-prostate-cancer
#10
Jennifer M Lobo, Daniel M Trifiletti, Vanessa N Sturz, Adam P Dicker, Christine Buerki, Elai Davicioni, Matthew R Cooperberg, R Jeffrey Karnes, Robert B Jenkins, Robert B Den, Timothy N Showalter
BACKGROUND: Controversy exists regarding the effectiveness of early adjuvant versus salvage radiation therapy after prostatectomy for prostate cancer. Estimates of prostate cancer progression from the Decipher genomic classifier (GC) could guide informed decision-making and improve the outcomes for patients. MATERIALS AND METHODS: We developed a Markov model to compare the costs and quality-adjusted life years (QALYs) associated with GC-based treatment decisions regarding adjuvant therapy after prostatectomy with those of 2 control strategies: usual care (determined from patterns of care studies) and the alternative of 100% adjuvant radiation therapy...
August 17, 2016: Clinical Genitourinary Cancer
https://www.readbyqxmd.com/read/28089685/evaluation-of-drug-drug-interaction-potential-between-sacubitril-valsartan-lcz696-and-statins-using-a-physiologically-based-pharmacokinetic-model
#11
Wen Lin, Tao Ji, Heidi Einolf, Surya Ayalasomayajula, Tsu-Han Lin, Imad Hanna, Tycho Heimbach, Christopher Breen, Venkateswar Jarugula, Handan He
Sacubitril/valsartan (LCZ696) has been approved for the treatment of heart failure. Sacubitril is an in vitro inhibitor of OATPs. In clinical studies, LCZ696 increased atorvastatin Cmax by 1.7-fold and AUC by 1.3-fold, but had little or no effect on simvastatin or simvastatin acid exposure. A PBPK modelling approach was applied to explore the underlying mechanisms behind the statin-specific LCZ696 drug interaction observations. The model incorporated OATP-mediated clearance (CLint,T) for simvastatin and simvastatin acid to successfully describe the PK profiles of either analyte in the absence or presence of LCZ696...
January 12, 2017: Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28089562/sequential-multiple-assignment-randomized-trials-an-opportunity-for-improved-design-of-stroke-reperfusion-trials
#12
William J Meurer, Nicholas J Seewald, Kelley Kidwell
BACKGROUND: Modern clinical trials in stroke reperfusion fall into 2 categories: alternative systemic pharmacological regimens to alteplase and "rescue" endovascular approaches using targeted thrombectomy devices and/or medications delivered directly for persistently occluded vessels. Clinical trials in stroke have not evaluated how initial pharmacological thrombolytic management might influence subsequent rescue strategy. A sequential multiple assignment randomized trial (SMART) is a novel trial design that can test these dynamic treatment regimens and lead to treatment guidelines that more closely mimic practice...
January 12, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28089362/clinical-pharmacokinetics-of-oral-levofloxacin-and-sitafloxacin-in%C3%A2-epididymal-tissue
#13
Takuya Sadahira, Koichiro Wada, Kazuro Ikawa, Norifumi Morikawa, Hiroaki Kurahashi, Takashi Yoshioka, Yuichi Ariyoshi, Yasuyuki Kobayashi, Motoo Araki, Ayano Ishii, Masami Watanabe, Shinya Uehara, Toyohiko Watanabe, Yasutomo Nasu
OBJECTIVES: This study aimed to investigate the penetration of fluoroquinolones into human epididymal tissue. METHODS: The penetration of levofloxacin (LVFX) 500 mg or sitafloxacin (STFX) 100 mg into epididymal tissue was examined. Patients with prostate cancer who were referred for orchiectomy were included. LVFX 500 mg (n = 9) or STFX 100 mg (n = 9) was administered orally 1 h before orchiectomy, and 0.5 g of epididymal tissue and blood samples were collected simultaneously during surgery...
January 11, 2017: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/28088840/evaluation-of-a-short-term-training-program-in-bedside-emergency-ultrasound-in-southwestern-tanzania
#14
Mark Shaffer, Heather A Brown, Chloé McCoy, Prosper Bashaka
OBJECTIVES: To evaluate the effect of a short-term training program in emergency ultrasound on physician skills and attitudes in southwestern Tanzania. METHODS: Eight registrar physicians at Mbeya Zonal Referral Hospital (Mbeya, Tanzania) underwent a 5-day course in bedside emergency ultrasound, focusing primarily on the focused assessment with sonography for trauma examination, including didactic sessions, practical sessions, and on-job training. The impact on ultrasound knowledge was assessed by pretest and posttest evaluations...
January 15, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28087598/bayesian-network-inference-modeling-identifies-trib1-as-a-novel-regulator-of-cell-cycle-progression-and-survival-in-cancer-cells
#15
Rina Gendelman, Heming Xing, Olga K Mirzoeva, Preeti Sarde, Christina Curtis, Heidi Feiler, Paul McDonagh, Joe W Gray, Iya Khalil, W Michael Korn
Molecular networks governing cellular responses to targeted therapies are complex dynamic systems with non-intuitive behaviors. Here we applied a novel computational strategy to infer probabilistic causal relationships between network components based on gene expression. We constructed a model comprised of an ensemble of networks using multidimensional data from cell line models of cell cycle arrest caused by inhibition of MEK1/2. Through simulation of reverse-engineered Bayesian network modeling, we generated predictions of G1-S transition...
January 13, 2017: Cancer Research
https://www.readbyqxmd.com/read/28087265/myocardial-relaxation-is-accelerated-by-fast-stretch-not-reduced-afterload
#16
Charles S Chung, Charles W Hoopes, Kenneth S Campbell
Fast relaxation of cross-bridge generated force in the myocardium facilitates efficient diastolic function. Recently published research studying mechanisms that modulate the relaxation rate has focused on molecular factors. Mechanical factors have received less attention since the 1980s when seminal work established the theory that reducing afterload accelerates the relaxation rate. Clinical trials using afterload reducing drugs, partially based on this theory, have thus far failed to improve outcomes for patients with diastolic dysfunction...
January 10, 2017: Journal of Molecular and Cellular Cardiology
https://www.readbyqxmd.com/read/28086973/gaussian-diffusion-sinogram-inpainting-for-x-ray-ct-metal-artifact-reduction
#17
Chengtao Peng, Bensheng Qiu, Ming Li, Yihui Guan, Cheng Zhang, Zhongyi Wu, Jian Zheng
BACKGROUND: Metal objects implanted in the bodies of patients usually generate severe streaking artifacts in reconstructed images of X-ray computed tomography, which degrade the image quality and affect the diagnosis of disease. Therefore, it is essential to reduce these artifacts to meet the clinical demands. METHODS: In this work, we propose a Gaussian diffusion sinogram inpainting metal artifact reduction algorithm based on prior images to reduce these artifacts for fan-beam computed tomography reconstruction...
January 5, 2017: Biomedical Engineering Online
https://www.readbyqxmd.com/read/28086901/gpu-accelerated-voxel-driven-forward-projection-for-iterative-reconstruction-of-cone-beam-ct
#18
Yi Du, Gongyi Yu, Xincheng Xiang, Xiangang Wang
BACKGROUND: For cone-beam computed tomography (CBCT), which has been playing an important role in clinical applications, iterative reconstruction algorithms are able to provide advantageous image qualities over the classical FDK. However, the computational speed of iterative reconstruction is a notable issue for CBCT, of which the forward projection calculation is one of the most time-consuming components. METHOD AND RESULTS: In this study, the cone-beam forward projection problem using the voxel-driven model is analysed, and a GPU-based acceleration method for CBCT forward projection is proposed with the method rationale and implementation workflow detailed as well...
January 5, 2017: Biomedical Engineering Online
https://www.readbyqxmd.com/read/28086879/validity-evidence-for-two-objective-structured-clinical-examination-stations-to-evaluate-core-skills-of-the-shoulder-and-knee-assessment
#19
Michael J Battistone, Andrea M Barker, J Peter Beck, Robert Z Tashjian, Grant W Cannon
BACKGROUND: We developed two objective structured clinical examinations (OSCEs) to educate and evaluate trainees in the evaluation and management of shoulder and knee pain. Our objective was to examine the evidence for validity of these OSCEs. METHODS: A multidisciplinary team of content experts developed checklists of exam maneuvers and criteria to guide rater observations. Content was proposed by faculty, supplemented by literature review, and finalized using a Delphi process...
January 13, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28086779/the-effect-of-electrical-conductivity-of-myocardium-on-cardiac-pumping-efficacy-a-computational-study
#20
Ana Rahma Yuniarti, Ki Moo Lim
BACKGROUND AND AIMS: The existence of non-excitable cells in the myocardium leads to the increasing conduction non-uniformity and decreasing myocardial electrical conductivity. Slowed myocardial conduction velocity (MCV) believed to enhance the probability of cardiac arryhthmia and alter the cardiac mechanical pumping efficacy, even in sinus rhythm. Though several studies on the correlation between MCV and cardiac electrical instabilities exist, there has been no study concerning correlation or causality between MCV and cardiac mechanical pumping efficacy, due to the limitation in clinical methods to document and evaluate cardiac mechanical responses directly...
January 10, 2017: Biomedical Engineering Online
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