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Simulation medicine

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https://www.readbyqxmd.com/read/28722322/advanced-methods-for-dose-and-regimen-finding-during-drug-development-summary-of-the-ema-efpia-workshop-on-dose-finding-london-4-5-december-2014
#1
F T Musuamba, E Manolis, N Holford, Sya Cheung, L E Friberg, K Ogungbenro, M Posch, Jwt Yates, S Berry, N Thomas, S Corriol-Rohou, B Bornkamp, F Bretz, A C Hooker, P H Van der Graaf, J F Standing, J Hay, S Cole, V Gigante, K Karlsson, T Dumortier, N Benda, F Serone, S Das, A Brochot, F Ehmann, R Hemmings, I Skottheim Rusten
Inadequate dose selection for confirmatory trials is currently still one of the most challenging issues in drug development, as illustrated by high rates of late-stage attritions in clinical development and postmarketing commitments required by regulatory institutions. In an effort to shift the current paradigm in dose and regimen selection and highlight the availability and usefulness of well-established and regulatory-acceptable methods, the European Medicines Agency (EMA) in collaboration with the European Federation of Pharmaceutical Industries Association (EFPIA) hosted a multistakeholder workshop on dose finding (London 4-5 December 2014)...
July 19, 2017: CPT: Pharmacometrics & Systems Pharmacology
https://www.readbyqxmd.com/read/28722314/prospective-motion-correction-using-coil-mounted-cameras-cross-calibration-considerations
#2
Julian Maclaren, Murat Aksoy, Melvyn B Ooi, Benjamin Zahneisen, Roland Bammer
PURPOSE: Optical prospective motion correction substantially reduces sensitivity to motion in neuroimaging of human subjects. However, a major barrier to clinical deployment has been the time-consuming cross-calibration between the camera and MRI scanner reference frames. This work addresses this challenge. METHODS: A single camera was mounted onto the head coil for tracking head motion. Two new methods were developed: (1) a rapid calibration method for camera-to-scanner cross-calibration using a custom-made tool incorporating wireless active markers, and (2) a calibration adjustment method to compensate for table motion between scans...
July 19, 2017: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
https://www.readbyqxmd.com/read/28721951/recording-characteristics-of-electrical-impedance-myography-needle-electrodes
#3
Hyeuknam Kwon, Seward B Rutkove, Benjamin Sanchez
OBJECTIVE: The neurology and physiatry community need improved tools for the evaluation of skeletal muscle condition. Here, we evaluate needle electrical impedance myography (EIM), a new minimally invasive approach to determine muscle status that could ultimately become a bedside tool for the assessment of neuromuscular disorders. APPROACH: We design and study the recording characteristics of tetrapolar EIM needle electrodes combining theory and finite element model simulations...
July 19, 2017: Physiological Measurement
https://www.readbyqxmd.com/read/28721059/cost-effectiveness-analysis-of-dolutegravir-plus-backbone-compared-with-raltegravir-plus-backbone-darunavir-ritonavir-plus-backbone-and-efavirenz-tenofovir-emtricitabine-in-treatment-na%C3%A3-ve-and-experienced-hiv-positive-patients
#4
Umberto Restelli, Giuliano Rizzardini, Andrea Antinori, Adriano Lazzarin, Marzia Bonfanti, Paolo Bonfanti, Davide Croce
BACKGROUND: In January 2014, the European Medicines Agency issued a marketing authorization for dolutegravir (DTG), a second-generation integrase strand transfer inhibitor for HIV treatment. The study aimed at determining the incremental cost-effectiveness ratio (ICER) of the use of DTG+backbone compared with raltegravir (RAL)+backbone, darunavir (DRV)+ritonavir(r)+backbone and efavirenz/tenofovir/emtricitabine (EFV/TDF/FTC) in HIV-positive treatment-naïve patients and compared with RAL+backbone in treatment-experienced patients, from the Italian National Health Service's point of view...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28720284/modeling-of-plasmas-for-biomedicine
#5
REVIEW
Natalia Yu Babaeva, George V Naidis
Studies in plasma medicine, which are currently actively expanding, are of multidisciplinary character, involving physical, chemical and biological processes. Rapid progress has been achieved in this field due to synergy between experimental and theoretical/computational methods. Joint use of diagnostic tools and computations gives a better understanding of mechanisms of interaction of plasma with bio-objects. This review focuses on recent achievements in modeling of plasma for biomedical applications. Various computational approaches used in these studies are described...
July 15, 2017: Trends in Biotechnology
https://www.readbyqxmd.com/read/28719987/corrective-osteotomy-of-malunited-diaphyseal-fractures-of-the-forearm-simplified-using-3-dimensional-ct-data-proposal-of-our-simple-strategy-through-case-presentation
#6
Yoshitaka Hamada, Hiroyuki Gotani, Kousuke Sasaki, Yoshitaka Tanaka, Hiroshi Egawa, Thepparat Kanchanathepsak
BACKGROUND: Reconstruction of malunited diaphyseal fractures of the forearm is one of the most difficult treatments due to its complicated structure. Widespread usage of Digital Imaging and Communications in Medicine (DICOM) data of 3-dimensional (3D) computed tomography (CT) and 3D printing can make estimating the true plane of the deformity easy. METHODS: A 21-year-old man with limited supination due to left forearm nonunion deformity initially treated by locking plate fixation was referred to our hospital...
March 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28719482/teaching-incision-and-drainage-perceived-educational-value-of-abscess-models
#7
Cynthia M Adams, Lise E Nigrovic, Gavin Hayes, Peter H Weinstock, Joshua Nagler
OBJECTIVES: Incision and drainage (I&D) of skin abscesses is an important procedural skill for pediatric emergency medicine providers. Practical skills training using simulation provides an opportunity to learn and gain confidence with this invasive procedure. Our objective was to assess the perceived educational value of 2 versions of an abscess model as part of an educational workshop for teaching I&D. METHODS: A combined didactic and practical skills workshop was developed for use at 2 national conferences...
July 17, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28719062/immersive-virtual-reality-as-a-teaching-tool-for-neuroanatomy
#8
Katelyn Stepan, Joshua Zeiger, Stephanie Hanchuk, Anthony Del Signore, Raj Shrivastava, Satish Govindaraj, Alfred Iloreta
BACKGROUND: Three-dimensional (3D) computer modeling and interactive virtual reality (VR) simulation are validated teaching techniques used throughout medical disciplines. Little objective data exists supporting its use in teaching clinical anatomy. Learner motivation is thought to limit the rate of utilization of such novel technologies. The purpose of this study is to evaluate the effectiveness, satisfaction, and motivation associated with immersive VR simulation in teaching medical students neuroanatomy...
July 18, 2017: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/28717259/a-computerized-tutor-prototype-for-prostate-cryotherapy-key-building-blocks-and-system-evaluation
#9
Yoed Rabin, Kenji Shimada, Purva Joshi, Anjali Sehrawat, Robert Keelan, Dona M Wilfong, James T McCormick
This paper focuses on the evaluation of a prototype for a computer-based tutoring system for prostate cryosurgery, while reviewing its key building blocks and their benchmark performance. The tutoring system lists geometrical constraints of cryoprobe placement, displays a rendered shape of the prostate, simulates cryoprobe insertion, enables distance measurements, simulates the corresponding thermal history, and evaluates the mismatch between the target region shape and a pre-selected planning isotherm. The quality of trainee planning is measured in comparison with a computer-generated plan, created for each case study by a previously developed planning algorithm, known as bubble-packing...
January 28, 2017: Proceedings of SPIE
https://www.readbyqxmd.com/read/28717107/human-plasma-and-urinary-metabolic-profiles-of-trimethylamine-and-trimethylamine-n-oxide-extrapolated-using-a-simple-physiologically-based-pharmacokinetic-model
#10
Makiko Shimizu, Hiroshi Yamazaki
Trimethylamine, a dietary- and medicinal carnitine-derived amine, is extensively metabolized by liver to non-malodorous trimethylamine N-oxide. Although trimethylamine and trimethylamine N-oxide under daily dietary consumption or carnitine treatment are generally regarded as nontoxic, they have been, and remain, of toxicological and clinical interest because of their potential association with atherosclerosis. The aim of the current study was to model the pharmacokinetics of trimethylamine after oral administration of trimethylamine in humans and compare the results with reported measured values...
2017: Journal of Toxicological Sciences
https://www.readbyqxmd.com/read/28715105/a-simulation-based-approach-to-measuring-team-situational-awareness-in-emergency-medicine-a-multicenter-observational-study
#11
Elizabeth D Rosenman, Aurora J Dixon, Jessica M Webb, Sarah Brolliar, Simon J Golden, Kerin A Jones, Sachita Shah, James A Grand, Steve W J Kozlowski, Georgia T Chao, Rosemarie Fernandez
OBJECTIVES: Team situational awareness (TSA) is critical for effective teamwork and supports dynamic decision-making in unpredictable, time-pressured situations. Simulation provides a platform for developing and assessing TSA; but these efforts are limited by suboptimal measurement approaches. The objective of this study was to develop and evaluate a novel approach to TSA measurement in interprofessional emergency medicine teams. METHODS: We performed a multicenter, prospective, simulation-based observational study to evaluate an approach to TSA measurement...
July 17, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28714282/variability-of-4d-flow-parameters-when-subjected-to-changes-in-mri-acquisition-parameters-using-a-realistic-thoracic-aortic-phantom
#12
Cristian Montalba, Jesus Urbina, Julio Sotelo, Marcelo E Andia, Cristian Tejos, Pablo Irarrazaval, Daniel E Hurtado, Israel Valverde, Sergio Uribe
PURPOSE: To assess the variability of peak flow, mean velocity, stroke volume, and wall shear stress measurements derived from 3D cine phase contrast (4D flow) sequences under different conditions of spatial and temporal resolutions. METHODS: We performed controlled experiments using a thoracic aortic phantom. The phantom was connected to a pulsatile flow pump, which simulated nine physiological conditions. For each condition, 4D flow data were acquired with different spatial and temporal resolutions...
July 16, 2017: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
https://www.readbyqxmd.com/read/28714249/simultaneous-magnetic-resonance-diffusion-and-pseudo-diffusion-tensor-imaging
#13
Meghdoot Mozumder, Leandro Beltrachini, Quinten Collier, Jose M Pozo, Alejandro F Frangi
PURPOSE: An emerging topic in diffusion magnetic resonance is imaging blood microcirculation alongside water diffusion using the intravoxel incoherent motion (IVIM) model. Recently, a combined IVIM diffusion tensor imaging (IVIM-DTI) model was proposed, which accounts for both anisotropic pseudo-diffusion due to blood microcirculation and anisotropic diffusion due to tissue microstructures. In this article, we propose a robust IVIM-DTI approach for simultaneous diffusion and pseudo-diffusion tensor imaging...
July 16, 2017: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
https://www.readbyqxmd.com/read/28714169/reliable-quantification-of-marrow-fat-content-and-unsaturation-level-using-in-vivo-mr-spectroscopy
#14
Kaipin Xu, Sigurdur Sigurdsson, Vilmundur Gudnason, Trisha Hue, Ann Schwartz, Xiaojuan Li
PURPOSE: To develop a novel technique for reliable quantification of bone marrow fat content and composition using in vivo MR spectroscopy (MRS). METHODS: An MRS quantification method combining both advantages of Voigt line shape model and time-domain analysis was developed. The proposed method was tested using computer-simulated data and in vivo data acquired at lumbar vertebral bodies of 23 subjects (age, 83.8 ± 3.7 y; male, n = 13; female, n = 10) from L1 to L4...
July 16, 2017: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
https://www.readbyqxmd.com/read/28714064/assessing-the-validity-of-the-approximation-of-diffusion-weighted-mri-signals-from-crossing-fascicles-by-sums-of-signals-from-single-fascicles
#15
Gaëtan Rensonnet, Benoît Scherrer, Simon K Warfield, Benoît Macq, Maxime Taquet
PURPOSE: To assess the validity of the superposition approximation for crossing fascicles, i.e., the assumption that the total diffusion-weighted MRI signal is the sum of the signals arising from each fascicle independently, even when the fascicles intermingle in a voxel. METHODS: Monte Carlo simulations were used to study the impact of the approximation on the diffusion-weighted MRI signal and to assess whether this approximate model allows microstructural features of interwoven fascicles to be accurately estimated, despite signal differences...
July 16, 2017: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
https://www.readbyqxmd.com/read/28713276/structure-activity-relationships-of-pentacyclic-triterpenoids-as-potent-and-selective-inhibitors-against-human-carboxylesterase-1
#16
Li-Wei Zou, Tong-Yi Dou, Ping Wang, Wei Lei, Zi-Miao Weng, Jie Hou, Dan-Dan Wang, Yi-Ming Fan, Wei-Dong Zhang, Guang-Bo Ge, Ling Yang
Human carboxylesterase 1 (hCE1), one of the most important serine hydrolases distributed in liver and adipocytes, plays key roles in endobiotic homeostasis and xenobiotic metabolism. This study aimed to find potent and selective inhibitors against hCE1 from phytochemicals and their derivatives. To this end, a series of natural triterpenoids were collected and their inhibitory effects against human carboxylesterases (hCEs) were assayed using D-Luciferin methyl ester (DME) and 6,8-dichloro-9,9-dimethyl-7-oxo-7,9-dihydroacridin-2-yl benzoate (DDAB) as specific optical substrate for hCE1, and hCE2, respectively...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28712105/evaluation-of-a-low-cost-3d-printed-model-for-bronchoscopy-training
#17
Matteo Parotto, Joshua Qua Jiansen, Ahmed AboTaiban, Svetlana Ioukhova, Alisher Agzamov, Richard Cooper, Gerald O'Leary, Massimiliano Meineri
BACKGROUND: Flexible bronchoscopy is a fundamental procedure in anesthesia and critical care medicine. Learning this procedure is a complex task, but the use of simulation-based training provides significant advantages like enhanced patient safety. Access to bronchoscopy simulators may be limited in low resources settings. We developed a low-cost 3D printed bronchoscopy training model. METHODS: A parametric airway model was obtained from an online medical model repository and fabricated using a low-cost 3D printer...
July 16, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28706765/trauma-and-hypothermia-in-antarctica-an-emergency-medicine-marine-simulation-scenario
#18
Chrystal Horwood, Kerry-Lynn Williams, Tate Skinner, Robert Brown, Tia Renouf, Adam Dubrowski
Simulation has been shown to improve both learner knowledge and patient outcomes. Many emergency medicine training programs incorporate simulation into their curricula to provide learners with experiences that are rare to encounter in practice, yet performance with a high degree of competence is critical. One rare encounter, which is depicted in the report, is the management of a trauma patient who was hypothermic after falling from an expedition vessel into the cold Southern Ocean. The unique scenario presented in this technical report incorporates CanMEDS learning objectives including the communicator, health advocate, and collaborator roles...
June 12, 2017: Curēus
https://www.readbyqxmd.com/read/28705402/-development-of-an-objective-structured-clinical-examination-osce-for-evaluating-clinical-competence-in-vascular-medicine
#19
J Risse, T Busato, V Dufrost, M Perri, S Zuily, D Wahl
OBJECTIVES: Vascular medicine is now a clinical specialty in France. During their studies, students will acquire clinical reasoning in addition to technical skills. An Objective Structured Clinical Examination (OSCE) is considered as the gold standard for evaluating clinical competence. Our main objective was to evaluate the feasibility and acceptability of OSCE for the evaluation of students, secondarily their performance. METHODS: Three representative clinical cases of the specialty were developed...
May 2017: J Med Vasc
https://www.readbyqxmd.com/read/28704580/efficient-discovery-and-capture-of-new-neuronal-nitric-oxide-synthase-postsynaptic-density-protein-95-uncouplers-from-herbal-medicines-using-magnetic-molecularly-imprinted-polymers-as-artificial-antibodies
#20
Xiaoli Gu, Jiaojiao Huang, Lei Zhang, Yu Zhang, Chong-Zhi Wang, Chenghong Sun, Dandan Yao, Fei Li, Lina Chen, Chun-Su Yuan
In the scope of stroke treatment, new neuronal nitric oxide synthase-postsynaptic density protein-95 uncouplers from herbal medicines were discovered and captured. To do so, highly selective magnetic molecularly imprinted polymers with a core-shell structure were prepared as artificial antibodies. According to the results of computational simulations, we designed and synthesized various polymers with varying amounts and types of template, functional monomer, cross-linker and solvent. Characterization and performance tests revealed that the most appropriate artificial antibodies showed uniform spherical morphologies, large adsorption capacities, fast binding kinetics, high selectivity and quick separation...
July 13, 2017: Journal of Separation Science
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