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Clinical simulation

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https://www.readbyqxmd.com/read/29149320/organic-scintillator-for-real-time-neutron-dosimetry
#1
Kyle A Beyer, Angela Di Fulvio, Liliana Stolarczyk, Wiktor Parol, Natalia Mojzeszek, Renata Kopéc, Shaun D Clarke, Sara A Pozzi
We developed a radiation detector based on an organic scintillator for spectrometry and dosimetry of out-of-field secondary neutrons from clinical proton beams. The detector consists of an EJ-299-34 crystalline organic scintillator, coupled by fiber optic cable to a silicon photomultiplier (SiPM). Proof of concept measurements were taken with 137Cs and 252Cf, and corresponding simulations were performed in MCNPX-PoliMi. Despite its small size, the detector is able to discriminate between neutron and gamma-rays via pulse shape discrimination...
November 15, 2017: Radiation Protection Dosimetry
https://www.readbyqxmd.com/read/29149240/z-scores-based-methods-and-their-application-to-biological-monitoring-an-example-in-professional-soccer-players
#2
Guillaume Saulière, Jérôme Dedecker, Laurie-Anne Marquet, Pierre Rochcongar, Jean-Francois Toussaint, Geoffroy Berthelot
The clinical and biological follow-up of individuals, such as the biological passport for athletes, is typically based on the individual and longitudinal monitoring of hematological or urine markers. These follow-ups aim to identify abnormal behavior by comparing the individual's biological samples to an established baseline. These comparisons may be done via different ways, but each of them requires an appropriate extra population to compute the significance levels, which is a non-trivial issue. Moreover, it is not necessarily relevant to compare the measures of a biomarker of a professional athlete to that of a reference population (even restricted to other athletes), and a reasonable alternative is to detect the abnormal values by considering only the other measurements of the same athlete...
November 15, 2017: Biostatistics
https://www.readbyqxmd.com/read/29148586/a-dynamic-ultrasound-simulation-of-a-pulsating-three-layered-cca-for-validation-of-2d-wall-motion-and-blood-velocity-estimation-algorithms
#3
Xiao Hu, Yufeng Zhang, Guanghui Cai, Kexin Zhang, Li Deng, Lian Gao, Suya Han, Jianhua Chen
PURPOSE: A dynamic ultrasound simulation model for the common carotid artery (CCA) with three arterial layers for validation of 2D wall motion and blood velocity estimation algorithms is proposed in present study. This model describes layers with not only characteristics of echo distributions conforming to clinical ones, but also varying thicknesses, axial and radial displacements with pulsatile blood pressure during a cardiac cycle. METHODS: The modeling process is as follows: first, a geometrical model according with the clinical structure size of a CCA is built based on the preset layer thicknesses and the diameter of lumen...
November 17, 2017: Medical Physics
https://www.readbyqxmd.com/read/29148432/a-singular-value-decomposition-linear-programming-svdlp-optimization-technique-for-circular-cone-based-robotic-radiotherapy
#4
Bin Liang, Yongbao Li, Wei Ran, Bin Guo, Xuang Xu, Bo Liu, Jiafeng Li, Qiuwen Wu, Fugen Zhou
With robot-controlled linac positioning, the robotic radiotherapy system such as CyberKnife significantly increases the freedom in radiation beam placement, but also imposes more challenges on treatment plan optimization. The resampling mechanism in vendor supplied treatment planning system (MultiPlan) could not fully explore the increased beam direction search space. Besides, a sparse treatment plan (using fewer beams) is desired to improve the treatment efficiency. This study proposes a singular value decomposition linear programming (SVDLP) optimization technique for circular collimator based robotic radiotherapy...
November 17, 2017: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/29148070/growth-factors-for-diabetic-foot-ulcers-mixed-treatment-comparison-analysis-of-randomized-clinical-trials
#5
Kannan Sridharan, Gowri Sivaramakrishnan
AIMS: Topical growth factors accelerate wound healing in patients with diabetic foot ulcers (DFU). Due to the absence of head to head comparisons, we carried out Bayesian network meta-analysis to compare the efficacy and safety of growth factors. METHODS: Using an appropriate search strategy, randomized controlled trials on topical growth factors compared with standard of care in patients with DFU, were included. Proportion of patients with complete healing was the primary outcome...
November 17, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29146508/biomechanical-analysis-of-palmar-midcarpal-instability-and-treatment-by-partial-wrist-arthrodesis
#6
Sarah A Shiga, Frederick W Werner, Marc Garcia-Elias, Brian J Harley
PURPOSE: To create a biomechanical model of palmar midcarpal instability by selective ligament sectioning and to analyze treatment by simulated partial wrist arthrodesis. METHODS: Nine fresh-frozen cadaver arms were moved through 3 servohydraulic actuated motions and 2 passive wrist mobilizations. The dorsal radiocarpal, triquetrohamate, scaphocapitate, and scaphotrapeziotrapezoid ligaments were sectioned to replicate palmar midcarpal instability. Kinematic data for the scaphoid, lunate, and triquetrum were recorded before and after ligament sectioning and again after simulated triquetrohamate arthrodesis (TqHA) and radiolunate arthrodesis (RLA)...
November 14, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29146168/bone-marrow-derived-mesenchymal-stromal-cells-enhanced-by-platelet-rich-plasma-maintain-adhesion-to-scaffolds-in-arthroscopic-simulation
#7
Alexander R Hoberman, Carl Cirino, Mary Beth McCarthy, Mark P Cote, Leo Pauzenberger, Knut Beitzel, Augustus D Mazzocca, Felix Dyrna
PURPOSE: To assess the response of bone marrow-derived mesenchymal stromal cells (bMSCs) enhanced by platelet-rich plasma (PRP) in the setting of a normal human tendon (NHT), a demineralized bone matrix (DBM), and a fibrin scaffold (FS) with simulated arthroscopic mechanical washout stress. METHODS: Bone marrow was aspirated from the humeral head and concentrated. BMSCs were counted, plated, and grown to confluence. Cells were seeded onto 3 different scaffolds: (1) NHT, (2) DBM, and (3) FS...
November 13, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29146107/cardiovascular-anatomy-in-children-with-bidirectional-glenn-anastomosis-regarding-the-transcatheter-fontan-completion
#8
Aleksander Sizarov, Francesca Raimondi, Damien Bonnet, Younes Boudjemline
BACKGROUND: Transcatheter stent-secured completion of total cavopulmonary connection (TCPC) after surgical preparations during the Glenn anastomosis procedure has been reported, but complications from this approach have precluded its clinical acceptance. AIMS: To analyse cardiovascular morphology and dimensions in children with bidirectional Glenn anastomosis, regarding the optimal device design for transcatheter Fontan completion without special surgical "preconditionings"...
November 13, 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/29145886/are-mice-good-models-for-human-neuromuscular-disease-comparing-muscle-excursions-in-walking-between-mice-and-humans
#9
Xiao Hu, James P Charles, Turgay Akay, John R Hutchinson, Silvia S Blemker
BACKGROUND: The mouse is one of the most widely used animal models to study neuromuscular diseases and test new therapeutic strategies. However, findings from successful pre-clinical studies using mouse models frequently fail to translate to humans due to various factors. Differences in muscle function between the two species could be crucial but often have been overlooked. The purpose of this study was to evaluate and compare muscle excursions in walking between mice and humans. METHODS: Recently published musculoskeletal models of the mouse hindlimb and human lower limb were used to simulate muscle-tendon dynamics during mouse and human walking, a key daily activity...
November 16, 2017: Skeletal Muscle
https://www.readbyqxmd.com/read/29145878/improving-readiness-for-recruitment-through-simulated-trial-activation-the-adjuvant-steroids-in-adults-with-pandemic-influenza-asap-trial
#10
Wei Shen Lim, Garry Meakin, Clare Brittain, Thomas Bewick, Lelia Duley
BACKGROUND: Research in public health emergencies requires trials to be set up in readiness for activation at short notice and in anticipation of limited timelines for patient recruitment. We conducted a simulated activation of a hibernating pandemic influenza clinical trial in order to test trial processes and to determine the value of such simulation in maintaining trial readiness. METHODS: The simulation involved the Nottingham Clinical Trials Unit, one participating hospital, one manufacturing unit and the Investigational Medicinal Product (IMP) supplier...
November 16, 2017: Trials
https://www.readbyqxmd.com/read/29145786/cephalexin-susceptibility-breakpoint-for-veterinary-isolates-clinical-laboratory-standards-institute-revision
#11
Mark G Papich, Cindy Lindeman
The Clinical and Laboratory Standards Institute (CLSI) uses cephalothin as the class representative for testing veterinary isolates for susceptibility to other first-generation cephalosporins, including cephalexin. We examined replacing cephalothin with cephalexin because cephalexin is used more often clinically. Bacterial isolates were obtained from dogs and cats from a national surveillance program. CLSI testing methods were used to determine the MIC for 4 cephalosporins used in veterinary medicine. Cephalexin clinical breakpoints for canine isolates were established by using published pharmacokinetic data and Monte Carlo simulations to calculate the probability of target attainment (PTA)...
November 1, 2017: Journal of Veterinary Diagnostic Investigation
https://www.readbyqxmd.com/read/29145437/assessment-of-the-suitability-of-biodegradable-rods-for-use-in-posterior-lumbar-fusion-an-in-vitro-biomechanical-evaluation-and-finite-element-analysis
#12
Fon-Yih Tsuang, Yueh-Ying Hsieh, Yi-Jie Kuo, Chia-Hsien Chen, Feng-Huei Lin, Chen-Sheng Chen, Chang-Jung Chiang
Interbody fusion with posterior instrumentation is a common method for treating lumbar degenerative disc diseases. However, the high rigidity of the fusion construct may produce abnormal stresses at the adjacent segment and lead to adjacent segment degeneration (ASD). As such, biodegradable implants are becoming more popular for use in orthopaedic surgery. These implants offer sufficient stability for fusion but at a reduced stiffness. Tailored to degrade over a specific timeframe, biodegradable implants could potentially mitigate the drawbacks of conventional stiff constructs and reduce the loading on adjacent segments...
2017: PloS One
https://www.readbyqxmd.com/read/29144999/communicating-out-loud-midwifery-students-experiences-of-a-simulation-exercise-for-neonatal-resuscitation
#13
Mary Carolan-Olah, Gina Kruger, Vera Brown, Felicity Lawton, Melissa Mazzarino, Vidanka Vasilevski
Midwifery students feel unprepared to deal with commonly encountered emergencies, such as neonatal resuscitation. Clinical simulation of emergencies may provide a safe forum for students to develop necessary skills. A simulation exercise, for neonatal resuscitation, was developed and evaluated using qualitative methods. Pre and post-simulation questions focussed on student confidence and knowledge of resuscitation. Data were analysed using a thematic analysis approach. Pre-simulation questions revealed that most students considered themselves not very confident/unsure about their level of confidence in undertaking neonatal resuscitation...
October 23, 2017: Nurse Education in Practice
https://www.readbyqxmd.com/read/29144569/-11-c-arachidonic-acid-incorporation-measurement-in-human-brain-optimization-for-clinical-use
#14
Francesca Zanderigo, Yeona Kang, Dileep Kumar, Anastasia Nikolopoulou, P David Mozley, Paresh J Kothari, Bin He, David Schlyer, Stanley I Rapoport, Maria A Oquendo, Shankar Vallabhajosula, J John Mann, M Elizabeth Sublette
Arachidonic acid (AA) is involved in signal transduction, neuroinflammation, and production of eicosanoid metabolites. The AA brain incorporation coefficient (K*) is quantifiable in vivo using [(11) C]AA positron emission tomography, although repeatability remains undetermined. We evaluated K* estimates obtained with population-based metabolite correction (PBMC) and image-derived input function (IDIF) in comparison to arterial blood-based estimates, and compared repeatability. Eleven healthy volunteers underwent a [(11) C]AA scan; five repeated the scan 6 weeks later, simulating a pre- and post-treatment study design...
November 16, 2017: Synapse
https://www.readbyqxmd.com/read/29144380/a-passive-and-wireless-sensor-for-bone-plate-strain-monitoring
#15
Yisong Tan, Jiale Hu, Limin Ren, Jianhua Zhu, Jiaqi Yang, Di Liu
This paper reports on a sensor for monitoring bone plate strain in real time. The detected bone plate strain could be used for judging the healing state of fractures in patients. The sensor consists of a magnetoelastic material, which can be wirelessly connected and passively embedded. In order to verify the effectiveness of the sensor, a tibia-bone plate-screw (TBS) model was established using the finite element analysis method. A variation of the bone plate strain was obtained via this model. A goat hindquarter tibia was selected as the bone fracture model in the experiment...
November 16, 2017: Sensors
https://www.readbyqxmd.com/read/29143400/pharmacokinetics-of-concentrated-naloxone-nasal-spray-for-opioid-overdose-reversal-phase-i-healthy-volunteer-study
#16
Rebecca McDonald, Ulrike Lorch, Jo Woodward, Björn Bosse, Helen Dooner, Gill Mundin, Kevin Smith, John Strang
BACKGROUND AND AIMS: Take-home naloxone can prevent death from heroin/opioid overdose, but pre-provision is difficult because naloxone is usually given by injection. Non-injectable alternatives, including naloxone nasal sprays, are currently being developed. To be effective, the intranasal (i.n.) spray dose must be adequate but not excessive, and early absorption must be comparable to intramuscular (i.m.) injection. We report on the pharmacokinetics (PK) of a specially produced concentrated novel nasal spray...
November 16, 2017: Addiction
https://www.readbyqxmd.com/read/29143283/evaluation-of-sequential-spect-and-ct-for-targeted-radionuclide-therapy-dosimetry
#17
Tiantian Li, Nien-Yun Wu, Na Song, Greta S P Mok
PURPOSE: In targeted radionuclide therapy (TRT), a prior knowledge of the absorbed dose biodistribution is essential for pre-therapy treatment planning. Previously, we showed that non-rigid organ-by-organ registration in sequential quantitative SPECT images improved dose estimation. This study aims to investigate if sequential CT can further improve TRT dosimetric accuracy. METHODS: We simulated SPECT/CT acquisitions at 1, 12, 24, 72 and 144 h In-111 Zevalin post-injection using an analytical MEGP projector, modeling attenuation, scatter and collimator-detector response...
November 15, 2017: Annals of Nuclear Medicine
https://www.readbyqxmd.com/read/29143119/infectious-and-non-infectious-diseases-causing-the-air-crescent-sign-a-state-of-the-art-review
#18
REVIEW
Joyce Betta Sevilha, Rosana Souza Rodrigues, Miriam Menna Barreto, Gláucia Zanetti, Bruno Hochhegger, Edson Marchiori
Aspergilloma, also known as mycetoma or fungus ball, is characterized by a round or oval mass with soft-tissue attenuation within a preexisting lung cavity. The typical computed tomography (CT) aspect of an aspergilloma is a mass separated from the wall of the cavity by an airspace of variable size and shape, resulting in the air crescent sign, also known as the meniscus sign. This CT feature is non-specific and can be simulated by several other entities that result in intracavitary masses. This review describes the main clinical and imaging aspects of the infectious and non-infectious diseases that may present with fungus-ball appearance, including pulmonary hydatid cyst, Rasmussen aneurysm, pulmonary gangrene, intracavitary clot, textiloma, lung cancer, metastasis, and teratoma, focusing on the differential diagnosis...
November 15, 2017: Lung
https://www.readbyqxmd.com/read/29143085/clinical-significance-of-new-magnetic-resonance-thoracic-ductography-before-thoracoscopic-esophagectomy-for-esophageal-cancer
#19
Junya Oguma, Soji Ozawa, Akihito Kazuno, Miho Nitta, Yamato Ninomiya, Kentaro Yatabe, Tetsu Niwa, Takakiyo Nomura
BACKGROUND: Preoperative simulation of the thoracic duct using magnetic resonance thoracic ductography (MRTD) would enable a safe lymph node dissection near the thoracic duct and the prevention of chylothorax after an esophagectomy. The aim of this study was to determine whether MRTD is useful for preventing injury to the thoracic duct during surgery and for reducing the incidence of chylothorax after surgery. METHODS: We evaluated 130 patients who underwent preoperative MRTD followed by a thoracoscopic esophagectomy for the treatment of thoracic esophageal cancer between August 2014 and April 2017 (MRTD group)...
November 15, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29142396/antioxidant-and-cholinesterase-inhibitory-activities-of-ethyl-acetate-extract-of-terminalia-chebula-cell-free-in-vitro-and-in-silico-studies
#20
Mohamed Asik Rajmohamed, Suganthy Natarajan, Premkumar Palanisamy, Akbarsha Mohammad Abdulkader, Archunan Govindaraju
Background: Alzheimer's disease (AD) is a progressive neurodegenerative disorder clinically characterized by memory loss and impaired cognitive function. Cholinergic enzyme deficiency and oxidative stress are the two major factors implicated in the pathogenesis of AD. The symptomatic treatment, as of now, is the use of cholinesterase inhibitors toward cholinergic "downturn." Therefore, there is a search for compounds that will be useful in focused therapies. There has been suggestion that Terminalia chebula fruit would be a potential source...
October 2017: Pharmacognosy Magazine
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