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Pediatric simulation

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https://www.readbyqxmd.com/read/28441181/inhaled-treprostinil-drug-delivery-during-mechanical-ventilation-and-spontaneous-breathing-using-two-different-nebulizers
#1
Donna K Parker, Shuijie Shen, Jiang Zheng, D Dunbar Ivy, Dave N Crotwell, Justin C Hotz, Robert M DiBlasi
OBJECTIVES: To determine the feasibility of delivering inhaled treprostinil during mechanical ventilation and spontaneous unassisted ventilation using the Tyvaso Inhalation System and the vibrating mesh nebulizer. We sought to compare differences in fine particle fraction, and absolute inhaled treprostinil mass delivered to neonatal, pediatric, and adult models affixed with a face mask, conventional, and high-frequency ventilation between Tyvaso Inhalation System and with different nebulizer locations between Tyvaso Inhalation System and vibrating mesh nebulizer...
April 22, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28438070/creation-of-a-novel-simulator-for-minimally-invasive-neurosurgery-fusion-of-3d-printing-and-special-effects
#2
Peter Weinstock, Roberta Rehder, Sanjay P Prabhu, Peter W Forbes, Christopher J Roussin, Alan R Cohen
OBJECTIVE Recent advances in optics and miniaturization have enabled the development of a growing number of minimally invasive procedures, yet innovative training methods for the use of these techniques remain lacking. Conventional teaching models, including cadavers and physical trainers as well as virtual reality platforms, are often expensive and ineffective. Newly developed 3D printing technologies can recreate patient-specific anatomy, but the stiffness of the materials limits fidelity to real-life surgical situations...
April 25, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28437834/elucidation-of-factor-viii-activity-pharmacokinetics-a-pooled-population-analysis-in-hemophilia-a-patients-treated-with-moroctocog-alfa
#3
João A Abrantes, Elisabet I Nielsen, Joan Korth-Bradley, Lutz Harnisch, Siv Jönsson
This study investigated the disposition of coagulation factor VIII activity in 754 moderate to severe hemophilia A patients following the administration of moroctocog alfa, a B-domain deleted recombinant factor VIII. Data analyzed included patients aged 1 day to 73 years enrolled in 13 studies conducted over a period of 20 years in 25 countries. A two-compartment population pharmacokinetic model with a baseline model described the pooled data well. Body size, age, inhibitors, race and analytical assay were identified as significant predictors of factor VIII disposition...
April 24, 2017: Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28436859/in-vivo-intracardiac-vector-velocity-imaging-using-phased-array-transducers-for-pediatric-cardiology
#4
Solveig Fadnes, Morten Wigen, Siri Ann Nyrnes, Lasse Lovstakken
Two-dimensional blood speckle tracking has shown promise for measuring complex flow patterns in neonatal hearts using linear arrays and high-frame-rate plane wave imaging. For general pediatric applications, however, the need for phased array probes emerges due to the limited intercostal acoustic window available. In this work, a clinically approved real-time duplex imaging setup with phased array probes was used to investigate the potential of blood speckle tracking for 2-D vector velocity imaging of children with congenital heart disease...
April 24, 2017: IEEE Transactions on Ultrasonics, Ferroelectrics, and Frequency Control
https://www.readbyqxmd.com/read/28436742/training-pediatric-fellows-in-palliative-care-a-pilot-comparison-of-simulation-training-and-didactic-education
#5
Katharine E Brock, Harvey J Cohen, Barbara M Sourkes, Julie J Good, Louis P Halamek
BACKGROUND: Pediatric fellows receive little palliative care (PC) education and have few opportunities to practice communication skills. OBJECTIVE: In this pilot study, we assessed (1) the relative effectiveness of simulation-based versus didactic education, (2) communication skill retention, and (3) effect on PC consultation rates. DESIGN: Thirty-five pediatric fellows in cardiology, critical care, hematology/oncology, and neonatology at two institutions enrolled: 17 in the intervention (simulation-based) group (single institution) and 18 in the control (didactic education) group (second institution)...
April 24, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28434554/the-simulation-based-assessment-of-pediatric-rapid-response-teams
#6
James J Fehr, Mary E McBride, John R Boulet, David J Murray
OBJECTIVE: To create scenarios of simulated decompensating pediatric patients to train pediatric rapid response teams (RRTs) and to determine whether the scenario scores provide a valid assessment of RRT performance with the hypothesis that RRTs led by intensivists-in-training would be better prepared to manage the scenarios than teams led by nurse practitioners. STUDY DESIGN: A set of 10 simulated scenarios was designed for the training and assessment of pediatric RRTs...
April 20, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28429117/a-comparison-of-mcgrath-mac%C3%A2-and-standard-direct-laryngoscopy-in-simulated-immobilized-cervical-spine-pediatric-intubation-a-manikin-study
#7
Marcin Madziala, Jacek Smereka, Marek Dabrowski, Steve Leung, Kurt Ruetzler, Lukasz Szarpak
Emergency airway management in children is generally considered to be challenging, and endotracheal intubation requires a high level of personal skills and experience. Immobilization of the cervical spine is indicated in all patients with the risk of any cervical spine injury but significantly aggravates endotracheal intubation. The best airway device in this setting has not been established yet, although the use of videolaryngoscopes is generally promising. Seventy-five moderately experienced paramedics of the Emergency Medical Service of Poland performed endotracheal intubations in a pediatric manikin in three airway scenarios: (A) normal airway, (B) manual in-line cervical immobilization, and (C) cervical immobilization using a Patriot cervical extrication collar and using two airway techniques: (1) McGrath videolaryngoscope and (2) Macintosh blade in a randomized sequence...
April 21, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28425202/examining-solutions-to-missing-data-in-longitudinal-nursing-research
#8
Mary B Roberts, Mary C Sullivan, Suzy B Winchester
PURPOSE: Longitudinal studies are highly valuable in pediatrics because they provide useful data about developmental patterns of child health and behavior over time. When data are missing, the value of the research is impacted. The study's purpose was to (1) introduce a three-step approach to assess and address missing data and (2) illustrate this approach using categorical and continuous-level variables from a longitudinal study of premature infants. METHODS: A three-step approach with simulations was followed to assess the amount and pattern of missing data and to determine the most appropriate imputation method for the missing data...
April 2017: Journal for Specialists in Pediatric Nursing: JSPN
https://www.readbyqxmd.com/read/28419486/population-pharmacokinetic-analysis-of-bortezomib-in-pediatric-leukemia-patients-model-based-support-for-body-surface-area-based-dosing-over-the-2-to-16-year-age-range
#9
Michael J Hanley, Diane R Mould, Timothy J Taylor, Neeraj Gupta, Kaveri Suryanarayan, Rachel Neuwirth, Dixie-Lee Esseltine, Terzah M Horton, Richard Aplenc, Todd A Alonzo, Xiaomin Lu, Ashley Milton, Karthik Venkatakrishnan
This population analysis described the pharmacokinetics of bortezomib after twice-weekly, repeat-dose, intravenous administration in pediatric patients participating in 2 clinical trials: the phase 2 AALL07P1 (NCT00873093) trial in relapsed acute lymphoblastic leukemia and the phase 3 AAML1031 (NCT01371981) trial in de novo acute myelogenous leukemia. The sources of variability in the pharmacokinetic parameters were characterized and quantified to support dosing recommendations. Patients received intravenous bortezomib 1...
April 18, 2017: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28419323/monte-carlo-simulation-used-to-calculate-energy-correction-factor-for-thermoluminescent-dosimeters-used-by-occupational-workers-on-pediatric-exams
#10
G Hoff, D Filipov, S Paschuk, H R Schelin, V Denyak
The main objective of this work is to simulate the X-ray scattered spectra by different pediatric phantoms (simulation of children subjected to barium meal procedures) to calculate an energy correction factor (ECF) to the reading of thermoluminescent dosimeters (TLDs). To perform this evaluation, the TLDs were positioned over three areas in two occupational workers: eyes, thyroid and hands. The Geant4 toolkit was used to define the spectra collected by TLDs, making possible to calculate the ECF. This work was developed in two stages: (1) evaluation of scattered spectra by different standard phantoms (newborn, 1, 5 and 10 years old); (2) definition of the ECF to the absorbed energy by each TLD...
April 13, 2017: Radiation Protection Dosimetry
https://www.readbyqxmd.com/read/28419016/an-evaluation-of-a-new-debriefing-framework-reflect
#11
Lauren E Zinns, Paul C Mullan, Karen J OʼConnell, Leticia M Ryan, Angela T Wratney
BACKGROUND: Postresuscitation debriefing (PRD) is recommended by the American Heart Association guidelines but is infrequently performed. Prior studies have identified barriers for pediatric emergency medicine (PEM) fellows including lack of a standardized curriculum. OBJECTIVE: Our objective was to create and assess the feasibility of a time-limited, structured PRD framework entitled REFLECT: Review the event, Encourage team participation, Focused feedback, Listen to each other, Emphasize key points, Communicate clearly, and Transform the future...
April 18, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28418271/use-of-a-novel-airway-kit-and-simulation-in-resident-training-on-emergent-pediatric-airways
#12
Jonathan M Melzer, Erin R S Hamersley, Thomas Q Gallagher
Objective Development of a novel pediatric airway kit and implementation with simulation to improve resident response to emergencies with the goal of improving patient safety. Methods Prospective study with 9 otolaryngology residents (postgraduate years 1-5) from our tertiary care institution. Nine simulated pediatric emergency airway drills were carried out with the existing system and a novel portable airway kit. Response times and time to successful airway control were noted with both the extant airway system and the new handheld kit...
April 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28410277/use-of-population-pharmacokinetics-and-electronic-health-records-to-assess-piperacillin-tazobactam-safety-in-infants
#13
Sara Salerno, Christoph P Hornik, Michael Cohen-Wolkowiez, P Brian Smith, Lawrence C Ku, Matthew S Kelly, Reese Clark, Daniel Gonzalez
BACKGROUND: Piperacillin, in combination with tazobactam, is frequently used in infants for treating nosocomial infections, although safety data in this population are limited. Electronic health record (EHR) data can be used to evaluate drug safety in infants, but measures of drug exposure are lacking. METHODS: To relate simulated piperacillin exposure with adverse events (AEs) in infants using EHR data, we identified infants discharged from 333 neonatal intensive care units managed by the Pediatrix Medical Group between 1997 and 2012...
April 13, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28407218/incorporating-covariates-into-integrated-factor-analysis-of-multi-view-data
#14
Gen Li, Sungkyu Jung
In modern biomedical research, it is ubiquitous to have multiple data sets measured on the same set of samples from different views (i.e., multi-view data). For example, in genetic studies, multiple genomic data sets at different molecular levels or from different cell types are measured for a common set of individuals to investigate genetic regulation. Integration and reduction of multi-view data have the potential to leverage information in different data sets, and to reduce the magnitude and complexity of data for further statistical analysis and interpretation...
April 13, 2017: Biometrics
https://www.readbyqxmd.com/read/28406438/u-s-trends-of-ed-visits-for-pediatric-traumatic-brain-injuries-implications-for-clinical-trials
#15
Cheng Chen, Junxin Shi, Rachel M Stanley, Eric A Sribnick, Jonathan I Groner, Henry Xiang
Our goal in this paper was to use the 2006-2013 Nationwide Emergency Department Sample (NEDS) database to describe trends of annual patient number, patient demographics and hospital characteristics of pediatric traumatic brain injuries (TBI) treated in U.S. emergency departments (EDs); and to use the same database to estimate the available sample sizes for various clinical trials of pediatric TBI cases. National estimates of patient demographics and hospital characteristics were calculated for pediatric TBI...
April 13, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28402385/does-choice-of-influenza-vaccine-type-change-disease-burden-and-cost-effectiveness-in-the-united-states-an-agent-based-modeling-study
#16
Jay V DePasse, Kenneth J Smith, Jonathan M Raviotta, Eunha Shim, Mary Patricia Nowalk, Richard K Zimmerman, Shawn T Brown
Offering a choice of influenza vaccine type may increase vaccine coverage and reduce disease burden, but it is more costly. This study calculated the public health impact and cost-effectiveness of 4 strategies: no choice, pediatric choice, adult choice, or choice for both age groups. Using agent-based modeling, individuals were simulated as they interacted with others, and influenza was tracked as it spread through a population in Washington, DC. Influenza vaccination coverage derived from data from the Centers for Disease Control and Prevention was increased by 6...
April 10, 2017: American Journal of Epidemiology
https://www.readbyqxmd.com/read/28401980/the-impact-of-nonadherence-to-antiseizure-drugs-on-seizure-outcomes-in-an-animal-model-of-epilepsy
#17
Kyle E Thomson, Avani C Modi, Tracy A Glauser, Joseph R Rausch, H Steve White
OBJECTIVE: Nonadherence to prescribed dosing regimens is a significant problem in the treatment of pediatric and adult chronic epilepsy, and can result in severe consequences to patient outcomes. In this first-of-kind preclinical study, the impact of nonadherence on seizure control was studied by simulating human patterns of nonadherence in an animal epilepsy model. METHODS: In study 1, three different patterns of nonadherence were modeled in newly diagnosed epileptic rats treated with carbamazepine: perfect adherence (100% of pellets contained carbamazepine), variable nonadherence (50% of pellets contained carbamazepine with different dosing patterns between animals), and complete nonadherence (0% of pellets contained carbamazepine)...
April 12, 2017: Epilepsia
https://www.readbyqxmd.com/read/28401674/placebo-like-response-in-absence-of-treatment-in-children-with-autism
#18
Rebecca M Jones, Caroline Carberry, Amarelle Hamo, Catherine Lord
Caregiver report is the most common measure of change in pediatric psychiatry. Yet, placebo response rates pose significant challenges to reliably detect a treatment response. The present study simulated an eight-week clinical trial protocol for Autism Spectrum Disorder (ASD) for the purpose of testing the feasibility and validity of several outcome measures. Twenty caregivers answered questions about their child's behavior on their smartphone each week and completed a battery of paper questionnaires during weeks one and eight...
April 12, 2017: Autism Research: Official Journal of the International Society for Autism Research
https://www.readbyqxmd.com/read/28390466/a-nomogram-for-calculation-of-maximum-recommended-dose-by-volume-of-local-anesthetic-in-pediatric-dentistry
#19
David Williams, Theodore Splaver, Jason Walker
PURPOSE: Calculation of maximum recommended doses for local anesthetic agents and added vasopressors is complex and error-prone with potentially fatal consequences. The purpose of this investigation was to develop a nomogram to calculate the maximum recommended doses, expressed as volumes (number of cartridges or ml) of local anesthetic for healthy U.S. pediatric dental patients based on body weight, and test its accuracy and reproducibility. METHODS: Standard mathematical techniques were used to draft the nomogram...
March 15, 2017: Pediatric Dentistry
https://www.readbyqxmd.com/read/28383854/-high-fidelity-simulation-a-new-tool-for-learning-and-research-in-pediatrics
#20
REVIEW
I Bragard, N Farhat, M-C Seghaye, K Schumacher
Caring for a sick child represents a high risk activity that requires technical and non-technical skills related to several factors such as the rarity of certain events or the stress of caring for a child. As regard these conditions, medi¬cal simulation provides a learning environment without risk, the control of variables, the reproducibility of situations, and the confrontation with rare events. In this article, we des¬cribe the steps of a simulation session and outline the current knowledge of the use of simulation in paediatrics...
October 2016: Revue Médicale de Liège
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