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High fidelity simulation

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https://www.readbyqxmd.com/read/28211003/an-easy-to-build-low-budget-point-of-care-ultrasound-simulator-from-linux-to-a-web-based-solution
#1
Domagoj Damjanovic, Ulrich Goebel, Benedikt Fischer, Martin Huth, Hartmut Breger, Hartmut Buerkle, Axel Schmutz
BACKGROUND: Hands-on training in point-of-care ultrasound (POC-US) should ideally comprise bedside teaching, as well as simulated clinical scenarios. High-fidelity phantoms and portable ultrasound simulation systems are commercially available, however, at considerable costs. This limits their suitability for medical schools. A Linux-based software for Emergency Department Ultrasound Simulation (edus2TM) was developed by Kulyk and Olszynski in 2011. Its feasibility for POC-US education has been well-documented, and shows good acceptance...
December 2017: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/28199109/the-nucleotide-selectivity-at-a-pre-insertion-checkpoint-of-t7-rna-polymerase-transcription-elongation
#2
Chao E, Baogen Duan, Jin Yu
Nucleotide selection is crucial for transcription fidelity control, in particular, for viral T7 RNA polymerase (RNAP) lack of proofreading activity. It has been recognized that multiple kinetic checkpoints exist prior to full nucleotide incorporation. In this work, we implemented intensive atomistic molecular dynamics (MD) simulations to quantify how strong the nucleotide selection is at the initial checkpoint of an elongation cycle of T7 RNAP. The incoming nucleotides bind into a pre-insertion site where a critical tyrosine residue locates nearby to assist the nucleotide selection...
February 15, 2017: Journal of Physical Chemistry. B
https://www.readbyqxmd.com/read/28196566/using-high-fidelity-simulation-scenarios-in-the-classroom-to-engage-learners
#3
Stephanie Turner, Leslie G Cole
It is well known that active teaching strategies improve student learning outcomes. By using simulation scenarios as a tool to teach systematic decision making in the classroom, faculty allow a large group of students to develop abstract thinking and gain experience in a setting that has traditionally delivered information in a linear format. This article will describe the process of using a high-fidelity simulation scenario as an unfolding case study to teach students how to manage and care for a patient.
February 1, 2017: Creative Nursing
https://www.readbyqxmd.com/read/28195967/procedural-learning-perspectives-of-pulmonary-fellows-and-practitioners
#4
Hans J Lee, Briana Coleman, Andrew D Lerner, David Feller-Kopman, Roy Semaan, Bernice Frimpong, Lonny Yarmus
BACKGROUND: Procedural learning requires both didactic knowledge and motor skills. Optimal teaching styles and techniques remain to be defined for pulmonary procedural learning. We investigated the preferences of learners at 2 different points in a pulmonary career; as pulmonary fellows and as clinical practitioners. METHODS: A perception survey was conducted among pulmonary fellows and practitioners from multiple institutions throughout the United States. Fellows and practitioners were immediately surveyed on procedural learning factors after completing a procedural learning course using low/high-fidelity and/or cadaver simulators...
February 10, 2017: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/28195962/ebus-stat-subscore-analysis-to-predict-the-efficacy-and-assess-the-validity-of-virtual-reality-simulation-for-ebus-tbna-training-among-experienced-bronchoscopists
#5
Simone Scarlata, Patrizio Palermo, Piero Candoli, Ariela Tofani, Tommasangelo Petitti, Lorenzo Corbetta
BACKGROUND: Linear endobronchial ultrasound transbronchial needle aspiration (EBUS-TBNA) represents a pivotal innovation in interventional pulmonology; determining the best approach to guarantee systematic and efficient training is expected to become a main issue in the forthcoming years. Virtual reality simulators have been proposed as potential EBUS-TBNA training instruments, to avoid unskilled beginners practicing directly in real-life settings. A validated and perfected simulation program could be used before allowing beginners to practice on patients...
February 10, 2017: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/28178963/immersive-high-fidelity-simulation-of-critically-ill-patients-to-study-cognitive-errors-a-pilot-study
#6
Shivesh Prakash, Shailesh Bihari, Penelope Need, Cyle Sprick, Lambert Schuwirth
BACKGROUND: The majority of human errors in healthcare originate from cognitive errors or biases. There is dearth of evidence around relative prevalence and significance of various cognitive errors amongst doctors in their first post-graduate year. This study was conducted with the objective of using high fidelity clinical simulation as a tool to study the relative occurrence of selected cognitive errors amongst doctors in their first post-graduate year. METHODS: Intern simulation sessions on acute clinical problems, conducted in year 2014, were reviewed by two independent assessors with expertise in critical care...
February 8, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28178332/a-hierarchical-estimator-development-for-estimation-of-tire-road-friction-coefficient
#7
Xudong Zhang, Dietmar Göhlich
The effect of vehicle active safety systems is subject to the friction force arising from the contact of tires and the road surface. Therefore, an adequate knowledge of the tire-road friction coefficient is of great importance to achieve a good performance of these control systems. This paper presents a tire-road friction coefficient estimation method for an advanced vehicle configuration, four-motorized-wheel electric vehicles, in which the longitudinal tire force is easily obtained. A hierarchical structure is adopted for the proposed estimation design...
2017: PloS One
https://www.readbyqxmd.com/read/28176890/contextualizing-the-relevance-of-basic-sciences-small-group-simulation-with-debrief-for-first-and-second-year-medical-students-in-an-integrated-curriculum
#8
Samara B Ginzburg, Judith Brenner, Michael Cassara, Thomas Kwiatkowski, Joanne M Willey
AIM: There has been a call for increased integration of basic and clinical sciences during preclinical years of undergraduate medical education. Despite the recognition that clinical simulation is an effective pedagogical tool, little has been reported on its use to demonstrate the relevance of basic science principles to the practice of clinical medicine. We hypothesized that simulation with an integrated science and clinical debrief used with early learners would illustrate the importance of basic science principles in clinical diagnosis and management of patients...
2017: Advances in Medical Education and Practice
https://www.readbyqxmd.com/read/28167584/modelling-high-reynolds-number-wall-turbulence-interactions-in-laboratory-experiments-using-large-scale-free-stream-turbulence
#9
Eda Dogan, R Jason Hearst, Bharathram Ganapathisubramani
A turbulent boundary layer subjected to free-stream turbulence is investigated in order to ascertain the scale interactions that dominate the near-wall region. The results are discussed in relation to a canonical high Reynolds number turbulent boundary layer because previous studies have reported considerable similarities between these two flows. Measurements were acquired simultaneously from four hot wires mounted to a rake which was traversed through the boundary layer. Particular focus is given to two main features of both canonical high Reynolds number boundary layers and boundary layers subjected to free-stream turbulence: (i) the footprint of the large scales in the logarithmic region on the near-wall small scales, specifically the modulating interaction between these scales, and (ii) the phase difference in amplitude modulation...
March 13, 2017: Philosophical Transactions. Series A, Mathematical, Physical, and Engineering Sciences
https://www.readbyqxmd.com/read/28167582/scaling-and-interaction-of-self-similar-modes-in-models-of-high-reynolds-number-wall-turbulence
#10
A S Sharma, R Moarref, B J McKeon
Previous work has established the usefulness of the resolvent operator that maps the terms nonlinear in the turbulent fluctuations to the fluctuations themselves. Further work has described the self-similarity of the resolvent arising from that of the mean velocity profile. The orthogonal modes provided by the resolvent analysis describe the wall-normal coherence of the motions and inherit that self-similarity. In this contribution, we present the implications of this similarity for the nonlinear interaction between modes with different scales and wall-normal locations...
March 13, 2017: Philosophical Transactions. Series A, Mathematical, Physical, and Engineering Sciences
https://www.readbyqxmd.com/read/28167580/structure-identification-in-pipe-flow-using-proper-orthogonal-decomposition
#11
Leo H O Hellström, Alexander J Smits
The energetic motions in direct numerical simulations of turbulent pipe flow at Reτ=685 are investigated using proper orthogonal decomposition. The procedure is extended such that a pressure component is identified in addition to the three-component velocity field for each mode. The pressure component of the modes is shown to align with the streamwise velocity component associated with the large-scale motions, where positive pressure coincides with positive streamwise velocity, and vice versa. The streamwise evolution of structures is then visualized using a conditional mode, which exhibit a strong similarity to the large-scale, low-momentum motions...
March 13, 2017: Philosophical Transactions. Series A, Mathematical, Physical, and Engineering Sciences
https://www.readbyqxmd.com/read/28167578/low-dimensional-representation-of-near-wall-dynamics-in-shear-flows-with-implications-to-wall-models
#12
P J Schmid, T Sayadi
The dynamics of coherent structures near the wall of a turbulent boundary layer is investigated with the aim of a low-dimensional representation of its essential features. Based on a triple decomposition into mean, coherent and incoherent motion and a dynamic mode decomposition to recover statistical information about the incoherent part of the flow field, a driven linear system coupling first- and second-order moments of the coherent structures is derived and analysed. The transfer function for this system, evaluated for a wall-parallel plane, confirms a strong bias towards streamwise elongated structures, and is proposed as an 'impedance' boundary condition which replaces the bulk of the transport between the coherent velocity field and the coherent Reynolds stresses, thus acting as a wall model for large-eddy simulations (LES)...
March 13, 2017: Philosophical Transactions. Series A, Mathematical, Physical, and Engineering Sciences
https://www.readbyqxmd.com/read/28167577/a-statistical-state-dynamics-approach-to-wall-turbulence
#13
REVIEW
B F Farrell, D F Gayme, P J Ioannou
This paper reviews results obtained using statistical state dynamics (SSD) that demonstrate the benefits of adopting this perspective for understanding turbulence in wall-bounded shear flows. The SSD approach used in this work employs a second-order closure that retains only the interaction between the streamwise mean flow and the streamwise mean perturbation covariance. This closure restricts nonlinearity in the SSD to that explicitly retained in the streamwise constant mean flow together with nonlinear interactions between the mean flow and the perturbation covariance...
March 13, 2017: Philosophical Transactions. Series A, Mathematical, Physical, and Engineering Sciences
https://www.readbyqxmd.com/read/28165347/google-glass-for-residents-dealing-with-pediatric-cardiopulmonary-arrest-a-randomized-controlled-simulation-based-study
#14
David Drummond, Cécile Arnaud, Romain Guedj, Alexandre Duguet, Nathalie de Suremain, Arnaud Petit
OBJECTIVES: To determine whether real-time video communication between the first responder and a remote intensivist via Google Glass improves the management of a simulated in-hospital pediatric cardiopulmonary arrest before the arrival of the ICU team. DESIGN: Randomized controlled study. SETTING: Children's hospital at a tertiary care academic medical center. SUBJECTS: Forty-two first-year pediatric residents. INTERVENTIONS: Pediatric residents were evaluated during two consecutive simulated pediatric cardiopulmonary arrests with a high-fidelity manikin...
February 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28148473/a-mobile-device-app-to-reduce-time-to-drug-delivery-and-medication-errors-during-simulated-pediatric-cardiopulmonary-resuscitation-a-randomized-controlled-trial
#15
Johan N Siebert, Frederic Ehrler, Christophe Combescure, Laurence Lacroix, Kevin Haddad, Oliver Sanchez, Alain Gervaix, Christian Lovis, Sergio Manzano
BACKGROUND: During pediatric cardiopulmonary resuscitation (CPR), vasoactive drug preparation for continuous infusion is both complex and time-consuming, placing children at higher risk than adults for medication errors. Following an evidence-based ergonomic-driven approach, we developed a mobile device app called Pediatric Accurate Medication in Emergency Situations (PedAMINES), intended to guide caregivers step-by-step from preparation to delivery of drugs requiring continuous infusion...
February 1, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28146452/validation-of-a-high-fidelity-electrophysiology-simulator-and-development-of-a-proficiency-based-simulator-training-program
#16
Waqas Ullah, Ross J Hunter, Malcolm Finlay, Mark J Earley, Ailsa McLean, Raffaella Marazzi, Roberto De Ponti, Richard J Schilling
INTRODUCTION: Simulator training can potentially provide high-intensity training in electrophysiology (EP) without compromising patient safety. We assessed the construct validity of a novel EP simulator (ANGIO Mentor; Simbionix) and developed proficiency-based scores for clinical EP simulator training. METHODS: Two European training centers participated. Participants were grouped on the basis of years of EP experience and (for a subset) subjectively scored clinical catheter manipulation skills...
February 2017: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
https://www.readbyqxmd.com/read/28146449/a-taxonomy-of-delivery-and-documentation-deviations-during-delivery-of-high-fidelity-simulations
#17
William R McIvor, Arna Banerjee, John R Boulet, Tanja Bekhuis, Eugene Tseytlin, Laurence Torsher, Samuel DeMaria, John P Rask, Matthew S Shotwell, Amanda Burden, Jeffrey B Cooper, David M Gaba, Adam Levine, Christine Park, Elizabeth Sinz, Randolph H Steadman, Matthew B Weinger
INTRODUCTION: We developed a taxonomy of simulation delivery and documentation deviations noted during a multicenter, high-fidelity simulation trial that was conducted to assess practicing physicians' performance. Eight simulation centers sought to implement standardized scenarios over 2 years. Rules, guidelines, and detailed scenario scripts were established to facilitate reproducible scenario delivery; however, pilot trials revealed deviations from those rubrics. A taxonomy with hierarchically arranged terms that define a lack of standardization of simulation scenario delivery was then created to aid educators and researchers in assessing and describing their ability to reproducibly conduct simulations...
February 2017: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
https://www.readbyqxmd.com/read/28144746/a-multispecialty-evaluation-of-thiel-cadavers-for-surgical-training
#18
Marina Yiasemidou, David Roberts, Daniel Glassman, James Tomlinson, Shekhar Biyani, Danilo Miskovic
BACKGROUND: Changes in UK legislation allow for surgical procedures to be performed on cadavers. The aim of this study was to assess Thiel cadavers as high-fidelity simulators and to examine their suitability for surgical training. METHODS: Surgeons from various specialties were invited to attend a 1 day dissection workshop using Thiel cadavers. The surgeons completed a baseline questionnaire on cadaveric simulation. At the end of the workshop, they completed a similar questionnaire based on their experience with Thiel cadavers...
January 31, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28137782/diagnostic-accuracy-of-gps-when-using-an-early-intervention-decision-support-system-a-high-fidelity-simulation
#19
Olga Kostopoulou, Talya Porat, Derek Corrigan, Samhar Mahmoud, Brendan C Delaney
BACKGROUND: Observational and experimental studies of the diagnostic task have demonstrated the importance of the first hypotheses that come to mind for accurate diagnosis. A prototype decision support system (DSS) designed to support GPs' first impressions has been integrated with a commercial electronic health record (EHR) system. AIM: To evaluate the prototype DSS in a high-fidelity simulation. DESIGN AND SETTING: Within-participant design: 34 GPs consulted with six standardised patients (actors) using their usual EHR...
January 30, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28125995/analysis-of-spatiotemporal-fidelity-in-quantitative-3d-first-pass-perfusion-cardiovascular-magnetic-resonance
#20
Lukas Wissmann, Alexander Gotschy, Claudio Santelli, Kerem Can Tezcan, Sandra Hamada, Robert Manka, Sebastian Kozerke
BACKGROUND: Whole-heart first-pass perfusion cardiovascular magnetic resonance (CMR) relies on highly accelerated image acquisition. The influence of undersampling on myocardial blood flow (MBF) quantification has not been systematically investigated yet. In the present work, the effect of spatiotemporal scan acceleration on image reconstruction accuracy and MBF error was studied using a numerical phantom and validated in-vivo. METHODS: Up to 10-fold scan acceleration using k-t PCA and k-t SPARSE-SENSE was simulated using the MRXCAT CMR numerical phantom framework...
January 27, 2017: Journal of Cardiovascular Magnetic Resonance
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