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https://www.readbyqxmd.com/read/29552425/clinician-driven-design-of-vitalpad-an-intelligent-monitoring-and-communication-device-to-improve-patient-safety-in-the-intensive-care-unit
#1
Luisa Flohr, Shaylene Beaudry, K Taneille Johnson, Nicholas West, Catherine M Burns, J Mark Ansermino, Guy A Dumont, David Wensley, Peter Skippen, Matthias Gorges
The pediatric intensive care unit (ICU) is a complex environment, in which a multidisciplinary team of clinicians (registered nurses, respiratory therapists, and physicians) continually observe and evaluate patient information. Data are provided by multiple, and often physically separated sources, cognitive workload is high, and team communication can be challenging. Our aim is to combine information from multiple monitoring and therapeutic devices in a mobile application, the VitalPAD , to improve the efficiency of clinical decision-making, communication, and thereby patient safety...
2018: IEEE Journal of Translational Engineering in Health and Medicine
https://www.readbyqxmd.com/read/29474107/a-systematic-review-of-tools-to-measure-respiratory-rate-in-order-to-identify-childhood-pneumonia
#2
Amy Sarah Ginsburg, Jennifer L Lenahan, Rasa Izadnegahdar, J Mark Ansermino
Pneumonia is the leading infectious cause of death in children worldwide, with most deaths occurring in developing countries. Measuring respiratory rate is critical to the World Health Organization's guidelines for diagnosing childhood pneumonia in low-resource settings, yet it is difficult to accurately measure. We conducted a systematic review to landscape existing respiratory rate measurement technologies. We searched PubMed, Embase, and Compendex for studies published through September 2017 assessing the accuracy of respiratory rate measurement technologies in children...
May 1, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29464512/feasibility-of-continuous-sedation-monitoring-in-critically-ill-intensive-care-unit-patients-using-the-neurosense-wav-cns-index
#3
Nicholas West, Paul B McBeth, Sonia M Brodie, Klaske van Heusden, Sarah Sunderland, Guy A Dumont, Donald E G Griesdale, J Mark Ansermino, Matthias Görges
Sedation in the intensive care unit (ICU) is challenging, as both over- and under-sedation are detrimental. Current methods of assessment, such as the Richmond Agitation Sedation Scale (RASS), are measured intermittently and rely on patients' behavioral response to stimulation, which may interrupt sleep/rest. A non-stimulating method for continuous sedation monitoring may be beneficial and allow more frequent assessment. Processed electroencephalography (EEG) monitors have not been routinely adopted in the ICU...
February 20, 2018: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29440330/assessment-of-the-fullpiers-risk-prediction-model-in-women-with-early-onset-preeclampsia
#4
U Vivian Ukah, Beth Payne, Jennifer A Hutcheon, J Mark Ansermino, Wessel Ganzevoort, Shakila Thangaratinam, Laura A Magee, Peter von Dadelszen
Early-onset preeclampsia is associated with severe maternal and perinatal complications. The fullPIERS model (Preeclampsia Integrated Estimate of Risk) showed both internal and external validities for predicting adverse maternal outcomes within 48 hours for women admitted with preeclampsia at any gestational age. This ability to recognize women at the highest risk of complications earlier could aid in preventing these adverse outcomes through improved management. Because the majority (≈70%) of the women in the model development had late-onset preeclampsia, we assessed the performance of the fullPIERS model in women with early-onset preeclampsia to determine whether it will be useful in this subgroup of women with preeclampsia...
April 2018: Hypertension
https://www.readbyqxmd.com/read/29394109/a-multi-week-assessment-of-a-mobile-exergame-intervention-in-an-elementary-school
#5
Ainara Garde, Manil Chowdhury, Aryannah U Rollinson, Mika Johnson, Paul Prescod, Jean Pierre Chanoine, John Mark Ansermino, Guy A Dumont
BACKGROUND: Exergaming is potentially useful to promote physical activity in children; however, long-term effectiveness is unclear. MobileKids Monster Manor (MKMM) is a mobile exergame developed with the help of young advisors. The game wirelessly transmits physical activity data from an accelerometer to a mobile device. Players' steps are redeemed for in-game rewards, for example, new characters. OBJECTIVE: First, to evaluate whether increased physical activity previously observed in a 1-week intervention is sustained over a 2-week intervention and 1-week follow-up, and second, to compare impact in schools within different socioeconomic environments...
February 2018: Games for Health
https://www.readbyqxmd.com/read/29210791/design-and-evaluation-of-a-closed-loop-anesthesia-system-with-robust-control-and-safety-system
#6
Nicholas West, Klaske van Heusden, Matthias Görges, Sonia Brodie, Aryannah Rollinson, Christian L Petersen, Guy A Dumont, J Mark Ansermino, Richard N Merchant
BACKGROUND: Closed-loop control of anesthesia involves continual adjustment of drug infusion rates according to measured clinical effect. The NeuroSENSE monitor provides an electroencephalographic measure of depth of hypnosis (wavelet-based anesthetic value for central nervous system monitoring [WAVCNS]). It has previously been used as feedback for closed-loop control of propofol, in a system designed using robust control engineering principles, which implements features specifically designed to ensure patient safety...
November 22, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29198742/prediction-of-adverse-maternal-outcomes-from-pre-eclampsia-and-other-hypertensive-disorders-of-pregnancy-a-systematic-review
#7
REVIEW
U Vivian Ukah, Dane A De Silva, Beth Payne, Laura A Magee, Jennifer A Hutcheon, Helen Brown, J Mark Ansermino, Tang Lee, Peter von Dadelszen
BACKGROUND: The hypertensive disorders of pregnancy are a leading cause of maternal and perinatal mortality and morbidity. The ability to predict these complications using simple tests could aid in management and improve outcomes. We aimed to systematically review studies that reported on potential predictors of adverse maternal outcomes among women with a hypertensive disorder of pregnancy. METHODS: We searched MEDLINE, Embase and CINAHL (inception - December 2016) for studies of predictors of severe maternal complications among women with a hypertensive disorder of pregnancy...
January 2018: Pregnancy Hypertension
https://www.readbyqxmd.com/read/29060715/detecting-obstructive-sleep-apnea-in-children-by-self-affine-visualization-of-oximetry
#8
Ainara Garde, Parastoo Dekhordi, Christian L Petersen, J Mark Ansermino, Guy A Dumont
Obstructive sleep apnea (OSA), characterized by cessations of breathing during sleep due to upper airway collapse, can affect the healthy growth and development of children. The gold standard for OSA diagnosis, polysomnography(PSG), is expensive and resource intensive, resulting in long waiting lists to perform a PSG. Previously, we investigated the time-frequency analysis of blood oxygen saturation (SpO2 ) to screen for OSA. We used overnight pulse oximetry from 146 children, collected using a smartphone-based pulse oximeter (Phone Oximeter), simultaneously with standard PSG...
July 2017: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28719383/closed-loop-control-of-total-intravenous-anesthesia-during-significant-intraoperative-blood-loss-a-case-report
#9
Sonia M Brodie, Matthias Görges, J Mark Ansermino, Guy A Dumont, Richard N Merchant
Closed-loop control of anesthesia based on continuous feedback from processed electroencephalography adjusts drug dosing to target a desired depth of hypnosis during dynamic clinical circumstances, freeing the anesthesiologist to focus on more complex tasks. We describe a case of closed-loop control of total intravenous anesthesia in which a sudden loss of blood required immediate intervention. This case illustrates that closed-loop control of drug delivery maintained an appropriate depth of hypnosis during a rapidly changing surgical situation, and that processed electroencephalography may be a useful adjunct indicator for cerebral hypoperfusion...
October 15, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28479878/pediatric-out-of-hospital-deaths-following-hospital-discharge-a-mixed-methods-study
#10
Lacey English, Elias Kumbakumba, Charles P Larson, Jerome Kabakyenga, Joel Singer, Niranjan Kissoon, J Mark Ansermino, Hubert Wong, Julius Kiwanuka, M O Wiens
BACKGROUND: Out-of-hospital death among children living in resource poor settings occurs frequently. Little is known about the location and circumstances of child death following a hospital discharge. OBJECTIVES: This study aimed to understand the context surrounding out-of-hospital deaths and the barriers to accessing timely care for Ugandan children recently discharged from the hospital. METHODS: This was a mixed-methods sub-study within a larger cohort study of post-discharge mortality conducted in the Southwestern region of Uganda...
December 2016: African Health Sciences
https://www.readbyqxmd.com/read/28319512/in-response
#11
LETTER
Christian Leth Petersen, Matthias Görges, Roslyn Massey, Guy Albert Dumont, J Mark Ansermino
No abstract text is available yet for this article.
May 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28268987/identifying-individual-sleep-apnea-hypoapnea-epochs-using-smartphone-based-pulse-oximetry
#12
Ainara Garde, Parastoo Dekhordi, J Mark Ansermino, Guy A Dumont
Sleep apnea, characterized by frequent pauses in breathing during sleep, poses a serious threat to the healthy growth and development of children. Polysomnography (PSG), the gold standard for sleep apnea diagnosis, is resource intensive and confined to sleep laboratories, thus reducing its accessibility. Pulse oximetry alone, providing blood oxygen saturation (SpO2) and blood volume changes in tissue (PPG), has the potential to identify children with sleep apnea. Thus, we aim to develop a tool for at-home sleep apnea screening that provides a detailed and automated 30 sec epoch-by-epoch sleep apnea analysis...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28227197/identifying-individual-sleep-apnea-hypoapnea-epochs-using-smartphone-based-pulse-oximetry
#13
Ainara Garde, Parastoo Dekhordi, J Mark Ansermino, Guy A Dumont, Ainara Garde, Parastoo Dekhordi, J Mark Ansermino, Guy A Dumont, J Mark Ansermino, Parastoo Dekhordi, Guy A Dumont, Ainara Garde
Sleep apnea, characterized by frequent pauses in breathing during sleep, poses a serious threat to the healthy growth and development of children. Polysomnography (PSG), the gold standard for sleep apnea diagnosis, is resource intensive and confined to sleep laboratories, thus reducing its accessibility. Pulse oximetry alone, providing blood oxygen saturation (SpO2) and blood volume changes in tissue (PPG), has the potential to identify children with sleep apnea. Thus, we aim to develop a tool for at-home sleep apnea screening that provides a detailed and automated 30 sec epoch-by-epoch sleep apnea analysis...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28211193/sequential-allocation-trial-design-in-anesthesia-an-introduction-to-methods-modeling-and-clinical-applications
#14
REVIEW
Matthias Görges, Guohai Zhou, Rollin Brant, J Mark Ansermino
Estimation of the dose-response curve for new anesthetic protocols typically focuses on identifying minimum effective doses. The application of a sequential experimental method is appropriate, as it minimizes sample size requirements by updating dose assignments based on information accrued from successive subjects. One approach is the up-and-down method for estimating the median effective dose in a patient population (ED50 ). Designs better suited for achieving greater than 50% effectiveness, include the biased coin approach, and continual reassessment method...
March 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27726840/-growth-and-dental-implants-assessment-and-prevention-of-the-long-term-aesthetic-risk
#15
Philippe Bousquet, Hélène Ansermino, Pierre Canal, Matthieu Renaud, Christèle Artz
Using implant to replace a tooth is a well known treatment. However, the practitioner must keep in mind that osteointegrated implants behave like ankylosed teeth, and their evolution does not follow the alveolar processes of the adjacent teeth during growth. This growth decreases after 20 years, but remains present. This can lead to infraposition functionally and aesthetically failure for the implant therapy. Risk factors, like patient's age, sex and shape of the face must be evaluated. Most palatal implant positioning and use of screwed prosthetic tooth can permit the infraposition treatment during years of aging...
September 2016: L' Orthodontie Française
https://www.readbyqxmd.com/read/27720089/the-usefulness-of-the-apache-ii-score-in-obstetric-critical-care-a-structured-review
#16
REVIEW
Helen M Ryan, Sumedha Sharma, Laura A Magee, J Mark Ansermino, Karen MacDonell, Beth A Payne, Keith R Walley, Peter von Dadelszen
OBJECTIVE: To assess the performance of the Acute Physiology and Chronic Health Evaluation II (APACHE II) mortality prediction model in pregnant and recently pregnant women receiving critical care in low-, middle-, and high-income countries during the study period (1985-2015), using a structured literature review. DATA SOURCES: Ovid MEDLINE, Embase, Web of Science, and Evidence-Based Medicine Reviews, searched for articles published between 1985 and 2015. STUDY SELECTION: Twenty-five studies (24 publications), of which two were prospective, were included in the analyses...
October 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/27628107/scheduled-follow-up-referrals-and-simple-prevention-kits-including-counseling-to-improve-post-discharge-outcomes-among-children-in-uganda-a-proof-of-concept-study
#17
Matthew O Wiens, Elias Kumbakumba, Charles P Larson, Peter P Moschovis, Celestine Barigye, Jerome Kabakyenga, Andrew Ndamira, Lacey English, Niranjan Kissoon, Guohai Zhou, J Mark Ansermino
BACKGROUND: Recurrent illness following hospital discharge is a major contributor to childhood mortality in resource-poor countries. Yet post-discharge care is largely ignored by health care workers and policy makers due to a lack of resources to identify children with recurrent illness and a lack of cohesive systems to provide care. The purpose of this proof-of-concept study was to evaluate the effectiveness of a bundle of interventions at discharge to improve health outcomes during the vulnerable post-discharge period...
September 28, 2016: Global Health, Science and Practice
https://www.readbyqxmd.com/read/27558533/developing-an-objective-method-for-analyzing-vital-signs-changes-in-neonates-during-general-anesthesia
#18
Matthias Görges, Nicholas C West, Edda Karlsdóttir, J Mark Ansermino, Myles Cassidy, Gillian R Lauder
BACKGROUND: Commonly used general anesthetics are considered to be neurotoxic to the developing rodent brain, leading to poor long-term outcome. However, it is unclear whether these rodent studies can be extrapolated to the human neonate. Given that anesthesia for urgent neonatal surgery cannot be avoided, it is vitally important to assess other factors that may impact neurological outcome following anesthesia and surgery. OBJECTIVE: The purpose of this study is to identify thresholds for detecting vital sign deviations, which may have the potential for affecting neurological outcome following anesthesia and surgery in neonates...
November 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27534987/respiratory-rate-and-pulse-oximetry-derived-information-as-predictors-of-hospital-admission-in-young-children-in-bangladesh-a-prospective-observational-study
#19
Ainara Garde, Guohai Zhou, Shahreen Raihana, Dustin Dunsmuir, Walter Karlen, Parastoo Dekhordi, Tanvir Huda, Shams El Arifeen, Charles Larson, Niranjan Kissoon, Guy A Dumont, J Mark Ansermino
OBJECTIVE: Hypoxaemia is a strong predictor of mortality in children. Early detection of deteriorating condition is vital to timely intervention. We hypothesise that measures of pulse oximetry dynamics may identify children requiring hospitalisation. Our aim was to develop a predictive tool using only objective data derived from pulse oximetry and observed respiratory rate to identify children at increased risk of hospital admission. SETTING: Tertiary-level hospital emergency department in Bangladesh...
August 17, 2016: BMJ Open
https://www.readbyqxmd.com/read/27464979/a-procedural-electroencephalogram-simulator-for-evaluation-of-anesthesia-monitors
#20
Christian Leth Petersen, Matthias Görges, Roslyn Massey, Guy Albert Dumont, J Mark Ansermino
BACKGROUND: Recent research and advances in the automation of anesthesia are driving the need to better understand electroencephalogram (EEG)-based anesthesia end points and to test the performance of anesthesia monitors. This effort is currently limited by the need to collect raw EEG data directly from patients. METHODS: A procedural method to synthesize EEG signals was implemented in a mobile software application. The application is capable of sending the simulated signal to an anesthesia depth of hypnosis monitor...
November 2016: Anesthesia and Analgesia
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