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Clinical simulation

Money Gupta, Rashi Chauhan, Yamuna Prasad, Gulshan Wadhwa, Chakresh Kumar Jain
The lack of complete treatments and appearance of multiple drug-resistance strains of Burkholderia cepacia complex (Bcc) are causing an increased risk of lung infections in cystic fibrosis patients. Bcc infection is a big risk to human health and demands an urgent need to identify new therapeutics against these bacteria. Network biology has emerged as one of the prospective hope in identifying novel drug targets and hits. We have applied protein-protein interaction methodology to identify new drug-target candidates (orthologs) in Burkhloderia cepacia GG4, which is an important strain for studying the quorum-sensing phenomena...
October 8, 2016: Computational Biology and Chemistry
Amy B Wilfert, Katherine R Chao, Madhurima Kaushal, Sanjay Jain, Sebastian Zöllner, David R Adams, Donald F Conrad
Standard techniques from genetic epidemiology are ill-suited to formally assess the significance of variants identified from a single case. We developed a statistical inference framework for identifying unusual functional variation from a single exome or genome, what we refer to as the 'n-of-one' problem. Using this approach we assessed our ability to identify the causal genotypes in over 5 million simulated cases of Mendelian disease, identifying 39% of disease genotypes as the most damaging unit in a typical exome background...
October 24, 2016: Nature Genetics
Amir Zahir, Chesahna Kindred, Brunhilde Blömeke, Carsten Goebel, Anthony A Gaspari
BACKGROUND: Allergic contact dermatitis after exposure to p-phenylenediamine (PPD)-containing hair dye products is a common and important clinical problem. Because there is a high rate of cross-elicitation of allergic contact dermatitis to other important hair dye products (such as p-toluene diamine and other aminophenol hair dyes) in PPD-allergic patients, safer alternative dyes with excellent hair coloring options are needed. OBJECTIVE: This study aimed to study tolerance to Me-PPD in a PPD-allergic cohort...
October 21, 2016: Dermatitis
Pavel B Rosnitskiy, P V Yuldashev, Oleg A Sapozhnikov, Adam Maxwell, Wayne Kreider, Michael R Bailey, Vera A Khokhlova
Various clinical applications of high intensity focused ultrasound (HIFU) have different requirements for the pressure levels and degree of nonlinear waveform distortion at the focus. The goal of this work was to determine transducer design parameters that produce either a specified shock amplitude in the focal waveform or specified peak pressures while still maintaining quasilinear conditions at the focus. Multiparametric nonlinear modeling based on the KZK equation with an equivalent source boundary condition was employed...
October 20, 2016: IEEE Transactions on Ultrasonics, Ferroelectrics, and Frequency Control
Jedrzej Kosiuk, Romina Milani, Laura Ueberham, Tobias Uhe, Clara Stegmann, Gerhard Hindricks, Andreas Bollmann
Remote ischemic preconditioning (RIPC) has been studied in models of different cardiovascular entities. Recently, a beneficial effect of RIPC on incidence of atrial fibrillation (AF) in postsurgical patients has been suggested. However, the potential impact of RIPC on electrophysiological- and thrombogenesis-related parameters in the setting of paroxysmal nonvalvular AF has not been investigated. The aim of the study is to answer the following questions: (1) Does RIPC have impact on inducibility of AF in patients with known paroxysmal AF? If yes, what are the direct electrophysiological mechanisms of this phenomenon, and could RIPC be implemented to reduce AF burden? (2) Does RIPC have the potential to minimize thrombogenic effects of simulated episodes of AF? If so, what are inhibited components of thrombogenesis and can this be used to reduce thromboembolic risk related to paroxysmal AF? The presented study is a 2-arm, randomized, placebo-controlled, double-blinded, single-center trial in a cohort of 146 patients with paroxysmal AF referred for AF ablation in sinus rhythm...
October 24, 2016: Clinical Cardiology
Wentian Guo, Yuan Ji, Daniel V T Catenacci
In precision medicine, a patient is treated with targeted therapies that are predicted to be effective based on the patient's baseline characteristics such as biomarker profiles. Oftentimes, patient subgroups are unknown and must be learned through inference using observed data. We present SCUBA, a Subgroup ClUster-based Bayesian Adaptive design aiming to fulfill two simultaneous goals in a clinical trial, 1) to treatments enrich the allocation of each subgroup of patients to their precision and desirable treatments and 2) to report multiple subgroup-treatment pairs (STPs)...
October 24, 2016: Biometrics
Dongrae Cho, Beomjun Min, Jongin Kim, Boreom Lee
In this study, we examined the phase locking value (PLV) for seizure prediction, particularly, in the gamma frequency band. We prepared simulation data and 65 clinical cases of seizure. In addition, various filtering algorithms including bandpass filtering, empirical mode decomposition, multivariate empirical mode decomposition and noise-assisted multivariate empirical mode decomposition (NA-MEMD) were used to decompose spectral components from the data. Moreover, in the case of clinical data, the PLVs were used to classify between interictal and preictal stages using a support vector machine...
October 19, 2016: IEEE Transactions on Neural Systems and Rehabilitation Engineering
Christoph Sadee, Eugene Kashdan
In this work, we investigate chemo- thermotherapy, a recently clinically-approved post-surgery treatment of non muscle invasive urothelial bladder carcinoma. We developed a mathematical model and numerically simulated the physical processes related to this treatment. The model is based on the conductive Maxwell's equations used to simulate the therapy administration and Convection-Diffusion equation for incompressible fluid to study heat propagation through the bladder tissue. The model parameters correspond to the data provided by the thermotherapy device manufacturer...
December 1, 2016: Mathematical Biosciences and Engineering: MBE
Min Li, Stephanie C Tjen-A-Looi, Zhi-Ling Guo, John C Longhurst
Acupuncture lowers blood pressure (BP) in hypertension, but mechanisms underlying its action are unclear. To simulate clinical studies, we performed electroacupuncture (EA) in unanesthetized rats with cold-induced hypertension (CIH) induced by six weeks of cold exposure (6 °C). EA (0.1 - 0.4 mA, 2 Hz) was applied at ST36-37 acupoints overlying the deep peroneal nerve for 30 min twice weekly for five weeks while sham-EA was conducted with the same procedures as EA except for no electrical stimulation...
October 24, 2016: Scientific Reports
Kriti Mohan
BACKGROUND: Malaria is an important cause of death and illness in children worldwide. Most cases of neonatal malaria are misdiagnosed because of the lack of specific symptoms and a general lack of awareness. Nothing much is known in literature about the haematological changes during malaria infection and outcome of disease in neonates. Neonatal malaria is an underdiagnosed entity. So this hospital based observational study aims to assess diagnostic features of neonatal malaria. METHODS: From August 2004 to August 2013, information of all slide positive for malaria cases aged 0 to 28 days admitted to our pediatric hospital was collected and analysed...
October 20, 2016: Infectious Disorders Drug Targets
Ann W McMahon, Kevin Watt, Jian Wang, Dionna Green, Ram Tiwari, Gilbert J Burckart
BACKGROUND: Pediatric drug development is plagued by small sample sizes, unvalidated clinical endpoints, and limited studies. OBJECTIVES: The objective of this study was to determine whether age stratification within the pediatric population could be used to (1) assess response to a pharmacologic intervention and to (2) design future trials based upon published stratified disease data using clinical trial simulation (CTS). METHODS: Data available from the literature for Kawasaki disease (KD) was used in the model...
2016: Therapeutic Innovation & Regulatory Science
Yang Yu, Yu-Feng Zhou, Xiao Li, Mei-Ren Chen, Gui-Lin Qiao, Jian Sun, Xiao-Ping Liao, Ya-Hong Liu
This work aimed to characterize the mammary gland pharmacokinetics of cefquinome after an intramammary administration and integrate pharmacokinetic/pharmacodynamic model. The pharmacokinetic profiles of cefquinome in gland tissue were measured using high performance liquid chromatograph. Therapeutic regimens covered various dosages ranging from 25 to 800 μg/gland and multiple dosing intervals of 8, 12, and 24 h. The in vivo bacterial killing activity elevated when dosage increased or when dosing intervals were shortened...
2016: Frontiers in Microbiology
Seifollah Gholampour, Nasser Fatouraee, Amir Saeed Seddighi, Afsoun Seddighi
In the present study, the heads of 11 normal subjects and 21 patients affected by hydrocephalus due to three different causes were simulated using fluid-structure interaction (FSI). To validate the results, the calculated diagram of CSF velocity in aqueduct of Sylvius (AS) was compared with the similar velocity diagram measured using Cine PC-MRI for the same subject. After ensuring the agreement of results, other outputs such as CSF pressure were calculated non-invasively using FSI. The intracranial pressure and CSF pressure in AS and behind the optic nerve sheath were in patients 5-5...
October 20, 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Li Huang, Bo Zhou, Huayu Wu, Li Zheng, Jinmin Zhao
Although biphasic calcium phosphate ceramic (BCP) holds promise in therapy of bone defect, surface mineralization prior to implantation may improve the bioactivity to better integrate with the host. Immersion in simulated body fluid (SBF) and bovine serum albumin-simulated body fluid (BSA-SBF) are common methods to form apatite interface layer. This study was intended to investigate the effect of SBF and BSA-SBF treatment on the bioactivity of BCP in vitro. In this study, osteoblasts were grown on BCP with or without treatment of SBF or BSA-SBF, and detected with general observation, scanning electron microscope (SEM), cell proliferation assay, morphology observation, viability assay, alkaline phosphatase (ALP) activity assay, and osteogenic specific gene expression of alkaline phosphatase (ALPL), bone gamma-carboxyglutamate (gla) protein (BGLAP), bone morphogenetic protein 2 (BMP2), bone sialoprotein (BSP), type I collagen (COLI) and runt-related transcription factor 2 (RUNX2) after culture of 2, 5 and 8days...
January 1, 2017: Materials Science & Engineering. C, Materials for Biological Applications
S D Heintze, A Eser, D Monreal, V Rousson
OBJECTIVE: Dynamic loading is a more important predictor for the clinical longevity of ceramic crowns than static loading. However, dynamic loading machines are costly and mostly have only one test station. The SD Mechatronik Chewing Simulator (formerly Willytec) may be a cost-effective alternative to evaluate the fatigue resistance of metal ceramic crowns. METHOD: Four metal ceramic materials were tested on lower first molar crowns: GC InitiaI, Creation (Willy Geller), IPS InLine (Ivoclar Vivadent) and the new low-fusion IPS Style Ceram (Ivoclar Vivadent)...
September 14, 2016: Journal of the Mechanical Behavior of Biomedical Materials
Daniel Morton, Deidre Batchelar, Michelle Hilts, Tanya Berrang, Juanita Crook
PURPOSE: Planning permanent breast seed implant (PBSI) brachytherapy using CT alone may reduce treatment accuracy because of differences in seroma visualization compared with ultrasound (US). This study evaluates dosimetric effects of seroma delineation in PBSI and the potential impact of incorporating three-dimensional (3D) US into PBSI treatment planning. METHODS AND MATERIALS: Spatially coregistered CT and 3D US images from 10 patients were retrospectively analyzed to simulate the PBSI procedure...
October 19, 2016: Brachytherapy
Jack J Olney, Paula Braitstein, Jeffrey W Eaton, Edwin Sang, Monicah Nyambura, Sylvester Kimaiyo, Ellen McRobie, Joseph W Hogan, Timothy B Hallett
BACKGROUND: With expanded access to antiretroviral therapy (ART) in sub-Saharan Africa, HIV mortality has decreased, yet life-years are still lost to AIDS. Strengthening of treatment programmes is a priority. We examined the state of an HIV care programme in Kenya and assessed interventions to improve the impact of ART programmes on population health. METHODS: We created an individual-based mathematical model to describe the HIV epidemic and the experiences of care among adults infected with HIV in Kenya...
October 19, 2016: Lancet HIV
Danny Tsai, Penelope Stewart, Rajendra Goud, Stephen Gourley, Saliya Hewagama, Sushena Krishnaswamy, Steven C Wallis, Jeffrey Lipman, Jason A Roberts
Currently there are no pharmacokinetic (PK) data to guide antibiotic dosing in critically ill Australian Indigenous patients with severe sepsis. This study aimed to determine whether the population pharmacokinetics of meropenem were different between critically ill Australian Indigenous and critically ill Caucasian patients. Serial plasma and urine samples as well as clinical and demographic data were collected over two dosing intervals from critically ill Australian Indigenous patients. Plasma meropenem concentrations were assayed by validated chromatography...
September 29, 2016: International Journal of Antimicrobial Agents
Anju Saraswat, John Bach, William D Watson, John O Elliott, Edward P Dominguez
BACKGROUND: Current surgical education relies on simulated educational experiences or didactic sessions to teach low-frequency clinical events such as abdominal compartment syndrome (ACS). The purpose of this pilot study was to evaluate if simulation would improve performance and knowledge retention of ACS better than a didactic lecture. METHODS: Nineteen general surgery residents were block randomized by postgraduate year level to a didactic or a simulation session...
August 4, 2016: American Journal of Surgery
Xiangmei Liu, H C Man
For titanium alloy implants, both surface bioactivity and antibacterial infection are the two critical factors in determining the success of clinical implantation of these metallic implants. In the present work, a novel nanocomposite layer of nano-silver-containing hydroxyapatite (Ag-HA) was prepared on the surface of biomedical Ti6Al4V by laser processing. Analysis using SEM, EDS and XRD shows the formation of an Ag-HA layer of about 200μm fusion bonded to the substrate. Mineralization tests in simulated body fluid (SBF) showed that laser fabricated Ag-HA nanocomposite layer favors the deposition of apatite on the surface of the implants...
January 1, 2017: Materials Science & Engineering. C, Materials for Biological Applications
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