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Pediatric simulation

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https://www.readbyqxmd.com/read/28096476/accuracy-of-oxygen-consumption-and-carbon-dioxide-elimination-measurements-in-2-breath-by-breath-devices
#1
Craig D Smallwood, John N Kheir, Brian K Walsh, Nilesh M Mehta
BACKGROUND: Although accurate quantification of oxygen consumption (V̇O2 ) and carbon dioxide elimination (V̇CO2 ) provides important insights into a patient's nutritional and hemodynamic status, few devices exist to accurately measure these parameters in children. Therefore, we assessed the accuracy and agreement of 2 devices currently on the market using a pediatric in vitro model of gas exchange. METHODS: We utilized a Huszczuk simulation model, which simulates oxygen consumption and carbon dioxide production using gas dilution, to examine the accuracy of two FDA-cleared respiratory modules (E-COVX and E-sCAiOVX-00)...
January 17, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28087087/pediatric-nurse-practitioners-effective-in-teaching-providers-the-asthma-action-plan-using-simulation
#2
Anne Borgmeyer, Patricia M Gyr, Emily Ahmad, Patrick M Ercole, Karen Balakas
Despite traditional education regarding the Asthma Action Plan (AAP), providers in the inpatient setting of a pediatric hospital reported lack of knowledge regarding the AAP and lack of confidence in teaching the AAP to patients and families. The purpose of this study was to assess the effect of a pediatric nurse practitioner (PNP)-led class incorporating simulation on resident physician knowledge of the AAP and confidence in teaching families the AAP. The study setting was a 250 bed Midwest academic pediatric hospital...
January 10, 2017: Journal of Pediatric Nursing
https://www.readbyqxmd.com/read/28079584/the-development-and-implementation-of-cognitive-aids-for-critical-events-in-pediatric-anesthesia-the-society-for-pediatric-anesthesia-critical-events-checklists
#3
Anna Clebone, Barbara K Burian, Scott C Watkins, Jorge A Gálvez, Justin L Lockman, Eugenie S Heitmiller
Cognitive aids such as checklists are commonly used in modern operating rooms for routine processes, and the use of such aids may be even more important during critical events. The Quality and Safety Committee of the Society for Pediatric Anesthesia (SPA) has developed a set of critical-event checklists and cognitive aids designed for 3 purposes: (1) as a repository of the latest evidence-based and expert opinion-based information to guide response and management of critical events, (2) as a source of just-in-time information during critical events, and (3) as a method to facilitate a shared understanding of required actions among team members during a critical event...
January 10, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28079581/assessing-the-impact-of-the-anesthesia-medication-template-on-medication-errors-during-anesthesia-a-prospective-study
#4
Eliot B Grigg, Lizabeth D Martin, Faith J Ross, Axel Roesler, Sally E Rampersad, Charles Haberkern, Daniel K W Low, Kristen Carlin, Lynn D Martin
BACKGROUND: Medication errors continue to be a significant source of patient harm in the operating room with few concrete countermeasures. The organization and identification of medication syringes may have an impact on the commission of medication errors in anesthesia, so a team of physicians and designers at the University of Washington created the Anesthesia Medication Template (AMT) to define a formal way of organizing the anesthesia workspace. The purpose of this study is to assess the ability of the AMT to reduce perioperative medication errors by anesthesia providers...
January 11, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28078552/pediatric-development-of-bosentan-facilitated-by-modeling-and-simulation
#5
Jochen Zisowsky, Martine Géhin, Andjela Kusic-Pajic, Andreas Krause, Maurice Beghetti, Jasper Dingemanse
BACKGROUND: Bosentan is approved for use in adult patients with pulmonary arterial hypertension. The primary aim of the pharmacokinetic modeling was the provision of a systematic guidance for study design and enhanced understanding of pharmacokinetics across the entire pediatric age range. METHODS: A physiologically based pharmacokinetic model was developed for the pediatric population; starting from an adult model, the effects of body weight, age, and maturation of relevant metabolizing enzymes were incorporated to extrapolate the pharmacokinetics to children...
January 11, 2017: Paediatric Drugs
https://www.readbyqxmd.com/read/28073489/cost-comparison-of-initial-lobectomy-versus-fine-needle-aspiration-for-diagnostic-workup-of-thyroid-nodules-in-children
#6
Katherine J Baxter, Heather L Short, Mitali A Thakore, Jeremy G Fisher, David H Rothstein, Kurt F Heiss, Mehul V Raval
BACKGROUND: Though uncommon in children, pediatric thyroid nodules carry a higher risk of malignancy than adult nodules. While fine-needle aspiration (FNA) has been well established as the initial diagnostic test in adults, it has been more slowly adopted in children. The purpose of this study was to examine the comparative cost of FNA versus initial diagnostic lobectomy (DL) in the pediatric patient with an ultrasound-confirmed thyroid nodule. METHODS: A decision tree model was created using an adolescent with an asymptomatic thyroid nodule as the reference case...
December 30, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28070685/porcine-spine-finite-element-model-a-complementary-tool-to-experimental-scoliosis-fusionless-instrumentation
#7
Bahe Hachem, Carl-Eric Aubin, Stefan Parent
PURPOSE: Developing fusionless devices to treat pediatric scoliosis necessitates lengthy and expensive animal trials. The objective was to develop and validate a porcine spine numerical model as an alternative platform to assess fusionless devices. METHODS: A parametric finite element model (FEM) of an osseoligamentous porcine spine and rib cage, including the epiphyseal growth plates, was developed. A follower-type load replicated physiological and gravitational loads...
January 9, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28066887/the-effect-of-beam-purity-and-scanner-complexity-on-proton-ct-accuracy
#8
P Piersimoni, J Ramos-Méndez, T Geoghegan, V A Bashkirov, R W Schulte, B A Faddegon
PURPOSE: To determine the dependence of the accuracy in reconstruction of relative stopping power (RSP) with proton computerized tomography (pCT) scans on the purity of the proton beam and the technological complexity of the pCT scanner using standard phantoms and a digital representation of a pediatric patient. METHODS: The Monte Carlo method was applied to simulate the pCT scanner, using both a pure proton beam (uniform 200 MeV mono-energetic, parallel beam) and the Northwestern Medicine Chicago Proton Center (NMCPC) clinical beam in uniform scanning mode...
November 22, 2016: Medical Physics
https://www.readbyqxmd.com/read/28060045/dalbavancin-pharmacokinetics-and-safety-in-children-3-months-to-11-years-of-age
#9
Daniel Gonzalez, John S Bradley, Jeffrey Blumer, Ram Yogev, Kevin M Watt, Laura P James, Debra L Palazzi, Varsha Bhatt-Mehta, Janice E Sullivan, Li Zhang, Jennifer Murphy, Xilla T Ussery, Sailaja Puttagunta, Michael W Dunne, Michael Cohen-Wolkowiez
BACKGROUND: Dalbavancin is a novel lipoglycopeptide antibiotic that has potent in vitro activity against Gram-positive microorganisms. METHODS: We performed a phase 1, open-label, multi-center study to investigate the pharmacokinetics (PK) and safety of a single-dose of intravenous dalbavancin in hospitalized pediatric subjects 3 months to 11 years of age. We combined these data with previously collected adolescent PK data and performed a population PK analysis...
January 3, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28055027/interdisciplinary-onsite-team-based-simulation-training-in-the-neonatal-intensive-care-unit-a-pilot-report
#10
D J W Reed, R L Hermelin, C S Kennedy, J Sharma
OBJECTIVE: Simulation training improves individual clinician confidence, performance and self-efficacy in resuscitation and procedural training experiences. The reality of resuscitation experiences in the neonatal intensive care unit (NICU) is that they are team-accomplished events. However, limited data exist on team-based simulation training (TBST) in the NICU. We report the experience of TBST over a 4-year period. STUDY DESIGN: This is a retrospective report of 65 TBST events in a 71-bed Level IV NICU at a regional subspecialty children's hospital...
January 5, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28052886/intestinal-rehabilitation-for-children-with-intestinal-failure-is-cost-effective-a-simulation-study
#11
Henk Groen, Esther G Neelis, Marten J Poley, Joanne F Olieman, René Scheenstra, Paul Fm Krabbe, Gerard Dijkstra, Edmond Hhm Rings
BACKGROUND: Children with intestinal failure (IF) depend on parenteral nutrition (PN). The goal in the treatment of IF is to wean children off PN through intestinal rehabilitation (IR). Although the healthcare burden of IF is enormous, to our knowledge there has been no previous cost-effectiveness analysis in pediatric IF including IR. OBJECTIVE: We sought to determine the cost-effectiveness of IR in terms of costs and life-years. DESIGN: We simulated the treatment of IF in children in a discrete-event model...
January 4, 2017: American Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28048849/su-f-j-174-a-series-of-computational-human-phantoms-in-dicom-rt-format-for-normal-tissue-dose-reconstruction-in-epidemiological-studies
#12
A Pyakuryal, B Moroz, C Lee, C Pelletier, J Jung, C Lee
PURPOSE: Epidemiological studies of second cancer risk in radiotherapy patients often require individualized dose estimates of normal tissues. Prior to 3D conformal radiation therapy planning, patient anatomy information was mostly limited to 2D radiological images or not even available. Generic patient CT images are often used in commercial radiotherapy treatment planning system (TPS) to reconstruct normal tissue doses. The objective of the current work was to develop a series of reference size computational human phantoms in DICOM-RT format for direct use in dose reconstruction in TPS...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048825/su-f-t-50-evaluation-of-monte-carlo-simulations-performance-for-pediatric-brachytherapy-dosimetry
#13
C Chatzipapas, P Papadimitroulas, G Loudos, N Papanikolaou, G Kagadis
PURPOSE: Pediatric tumors are generally treated with multi-modal procedures. Brachytherapy can be used with pediatric tumors, especially given that in this patient population low toxicity on normal tissues is critical as is the suppression of the probability for late malignancies. Our goal is to validate the GATE toolkit on realistic brachytherapy applications, and evaluate brachytherapy plans on pediatrics for accurate dosimetry on sensitive and critical organs of interest. METHODS: The GATE Monte Carlo (MC) toolkit was used...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048753/su-f-i-32-organ-doses-from-pediatric-head-ct-scan
#14
H Liu, Q Liu, J Qiu, M Majer, Z Knezevic, S Miljanic, H Hrsak, W Zhuo
PURPOSE: To evaluate the organ doses of pediatric patients who undergoing head CT scan using Monte Carlo (MC) simulation and compare it with measurements in anthropomorphic child phantom.. METHODS: A ten years old children voxel phantom was developed from CT images, the voxel size of the phantom was 2mm*2mm*2mm. Organ doses from head CT scan were simulated using MCNPX software, 180 detectors were placed in the voxel phantom to tally the doses of the represented tissues or organs...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048636/tu-fg-brb-04-a-new-optimization-method-for-pre-treatment-patient-specific-stopping-power-by-combining-proton-radiography-and-x-ray-ct
#15
C Collins-Fekete, R Schulte, L Beaulieu, J Seco
PURPOSE: The relative stopping power (RSP) uncertainty is the largest contributor to the range uncertainty in proton therapy. The purpose of this work is to develop a robust and systematic method that yields accurate patient specific RSPs by combining pre-treatment X-ray CT and daily proton radiography. METHODS: The method is formulated as a penalized least squares optimization (PLSO) problem min(|Ax-B|). The matrix A represents the cumulative path-length crossed in each material computed by calculating proton trajectories through the X-ray CT...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048468/su-d-209-06-study-on-the-dose-conversion-coefficients-in-pediatric-radiography-with-the-development-of-children-voxel-phantoms
#16
Q Liu, W Zhuo, H Liu, Y Liu, T Chen
PURPOSE: Conversion coefficients of organ dose normalized to entrance skin dose (ESD) are widely used to evaluate the organ doses directly using ESD without time-consuming dose measurement, this work aims to investigate the dose conversion coefficients in pediatric chest and abdomen radiography with the development of 5 years and 10 years old children voxel phantoms. METHODS: After segmentation of organs and tissues from CT slice images of ATOM tissue-equivalent phantoms, a 5-year-old and a 10-year-old children computational voxel phantoms were developed for Monte Carlo simulation...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048321/su-g-206-08-how-should-focal-spot-be-chosen-for-optimized-ct-imaging-with-dose-modulation
#17
S Bache, X Liu, J Rong
PURPOSE: To choose the preferred focal spot for achieving optimized CT image quality with balanced tube heating considerations. METHODS: An anthropomorphic pelvic phantom was scanned using a GE Discovery CT750 HD at 120 and 140kVp, 0.8s rotation time, and pitch of 0.984. "Smart mA" was enabled to simulate a routine abdomen-pelvis CT scan. Permissible mA values at 120 and 140 kVp were obtained from the Serial Load Rating table (for mimicking a busy CT clinical operation) in the scanner Technical Reference Manual...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047939/tu-h-campus-iep1-03-comparison-of-monte-carlo-simulation-and-conversion-factor-based-method-on-estimation-of-effective-dose-in-pediatric-patients-undergoing-interventional-cardiac-procedures
#18
K Leung, M Wong, Y Ng, S Lee, R Ming Chun Chau, F Lee
PURPOSE: Interventional cardiac procedures utilize frequent fluoroscopy and cineangiography, which impose considerable radiation risk to patients, especially pediatric patients. Accurate calculation of effective dose is important in order to estimate cancer risk over the rest of their lifetime. This study evaluates the difference in effective dose calculated by Monte Carlo simulation with those estimated by locally-derived conversion factors (CF-local) and by commonly quoted conversion factors from Karambatsakidou et al (CF-K)...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047857/su-c-207a-01-a-novel-maximum-likelihood-method-for-high-resolution-proton-radiography-proton-ct
#19
C Collins-Fekete, R Schulte, L Beaulieu, J Seco
PURPOSE: Multiple Coulomb scattering is the largest contributor to blurring in proton imaging. Here we tested a maximum likelihood least squares estimator (MLLSE) to improve the spatial resolution of proton radiography (pRad) and proton computed tomography (pCT). METHODS: The object is discretized into voxels and the average relative stopping power through voxel columns defined from the source to the detector pixels is optimized such that it maximizes the likelihood of the proton energy loss...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047794/su-g-iep3-09-investigating-the-interplay-of-antiscatter-grids-with-modern-detectors-and-image-processing-in-digital-radiography
#20
A Sanchez, K Little, M Baad, I Reiser, Z F Lu, K Feinstein
PURPOSE: To use phantom and simulation experiments to relate technique factors, patient size and antiscatter grid use to image quality in portable digital radiography (DR), in light of advancements in detector design and image processing. METHODS: Image contrast-to-noise ratio (CNR) on a portable DR system (MobileDaRt Evolution, Shimadzu) was measured by imaging four aluminum inserts of varying thickness, superimposed on a Lucite slab phantom using a pediatric abdominal protocol...
June 2016: Medical Physics
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