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Simulation medicine

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https://www.readbyqxmd.com/read/29912085/just-in-time-training-for-intraosseous-needle-placement-and-defibrillator-use-in-a-pediatric-emergency-department
#1
Taichi Itoh, Jannet Lee-Jayaram, Rui Fang, Travis Hong, Benjamin Berg
OBJECTIVES: Just-in-time training (JITT) is a method of simulation-based training where the training occurs within the clinical environment in a concise manner. Just-in-time training has shown effects at the learner, patient, and system-wide levels. We evaluated a JITT curriculum for the procedures of intraosseous (IO) needle placement and defibrillator use in a pediatric emergency department (ED) by comparing the trainees' comfort level in performing those procedures independently (Kirkpatrick level 2a) and trainees' knowledge of the procedures/equipment (Kirkpatrick level 2b) before and after the JITT...
June 14, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29911318/generalized-information-theory-meets-human-cognition-introducing-a-unified-framework-to-model-uncertainty-and-information-search
#2
Vincenzo Crupi, Jonathan D Nelson, Björn Meder, Gustavo Cevolani, Katya Tentori
Searching for information is critical in many situations. In medicine, for instance, careful choice of a diagnostic test can help narrow down the range of plausible diseases that the patient might have. In a probabilistic framework, test selection is often modeled by assuming that people's goal is to reduce uncertainty about possible states of the world. In cognitive science, psychology, and medical decision making, Shannon entropy is the most prominent and most widely used model to formalize probabilistic uncertainty and the reduction thereof...
June 17, 2018: Cognitive Science
https://www.readbyqxmd.com/read/29911269/exploring-the-lead-compounds-for-zika-virus-ns2b-ns3-protein-an-e-pharmacophore-based-approach
#3
K Rohini, Pratika Agarwal, B Preethi, V Shanthi, K Ramanathan
The rapid spread of the Zika virus and its association with the abnormal brain development constitute a global health emergency. With a continuing spread of the mosquito vector, the exposure is expected to accelerate in the coming years. Despite number of efforts, there is still no proper vaccine or medicine to combat this virus. Of note, the NS2B-NS3 protein is proven to be the potential target for the Zika virus therapeutics. Hence, e-pharmacophore-based drug design strategy was employed to identify potent inhibitors of NS2B-NS3 protein from ASINEX database consisting of 467,802 molecules...
June 18, 2018: Applied Biochemistry and Biotechnology
https://www.readbyqxmd.com/read/29908273/integrated-study-of-the-mechanism-of-tyrosinase-inhibition-by-baicalein-using-kinetic-multispectroscopic-and-computational-simulation-analyses
#4
Nihong Guo, Cailian Wang, Chao Shang, Xue You, Liuyang Zhang, Wenbin Liu
Controlling the activity of tyrosinase, which plays an important role in melanin synthesis, is essential endeavor in the field of medicine, food, cosmetics, and agriculture. Baicalein is a widely available inhibitor of tyrosinase. The mechanism of this inhibition was studied through an integrated approach coupling enzyme kinetics, multiple types of spectroscopy and computational simulation. Baicalein conspicuously inhibited the diphenolase activity with an IC50 value of 0.11 mM. The inhibtion kinetics indicated that baicalein was a mix-type tight binding inhibitor with a Ki of 0...
June 13, 2018: International Journal of Biological Macromolecules
https://www.readbyqxmd.com/read/29907507/nrg-oncology-medical-physicists-manpower-survey-quantifying-support-demands-for-multi-institutional-clinical-trials
#5
James I Monroe, Karan Boparai, Ying Xiao, David Followill, James M Galvin, Eric E Klein, Daniel A Low, Jean M Moran, Haoyu Zhong, Jason W Sohn
PURPOSE: A survey was created by NRG to assess a medical physicists' percent full time equivalent (FTE) contribution to multi-institutional clinical trials. A 2012 American Society for Radiation Oncology report, "Safety Is No Accident," quantified medical physics staffing contributions in FTE factors for clinical departments. No quantification of FTE effort associated with clinical trials was included. METHODS: To address this lack of information, the NRG Medical Physics Subcommittee decided to obtain manpower data from the medical physics community to quantify the amount of time medical physicists spent supporting clinical trials...
February 4, 2018: Practical Radiation Oncology
https://www.readbyqxmd.com/read/29904747/a-rapid-computational-approach-for-assessing-interfraction-esophageal-motion-for-use-in-stereotactic-body-radiation-therapy-planning
#6
Michael L Cardenas, Thomas R Mazur, Christina I Tsien, Olga L Green
Purpose: We present a rapid computational method for quantifying interfraction motion of the esophagus in patients undergoing stereotactic body radiation therapy on a magnetic resonance (MR) guided radiation therapy system. Methods and materials: Patients who underwent stereotactic body radiation therapy had simulation computed tomography (CT) and on-treatment MR scans performed. The esophagus was contoured on each scan. CT contours were transferred to MR volumes via rigid registration...
April 2018: Advances in Radiation Oncology
https://www.readbyqxmd.com/read/29895762/use-of-real-patients-and-patient-simulation-based-methodologies-for-teaching-gastroenterology-to-pre-clinical-medical-students
#7
Joshua DeSipio, John Gaughan, Susan Perlis, Sangita Phadtare
In recent years, there has been an increasing focus on the need to integrate formal knowledge with clinical experience in the pre-clinical years since the initial years of medical education play an important role in shaping the attitudes of medical students towards medicine and support the development of clinical reasoning. In this study, we describe approaches that involve real patients and patient-simulation-based methodologies to teach gastroenterology to second year medical students. Our goals were to (i) demonstrate bio-psychosocial aspects of clinical practice, (ii) demonstrate commonality of gastrointestinal ailments, and (iii) help understand complex gastroenterology concepts...
June 12, 2018: Healthcare (Basel, Switzerland)
https://www.readbyqxmd.com/read/29894957/spectroscopic-and-computational-evaluation-on-the-binding-of-safranal-with-human-serum-albumin-role-of-inner-filter-effect-in-fluorescence-spectral-correction
#8
Mohd Sajid Ali, Hamad A Al-Lohedan
For determining the pharmacological properties of medicinal compounds, their binding with serum albumins is very crucial. Herein, we have selected safranal, a major constituent of saffron which is known to retain a number of medicinal properties including antioxidant, anti-inflammatory, tumoricidal, anti-genotoxic, and anti-aging activities; and studied its mechanism of binding with human serum albumin at physiological pH using various spectroscopic methods along with computational approach using molecular docking...
May 29, 2018: Spectrochimica Acta. Part A, Molecular and Biomolecular Spectroscopy
https://www.readbyqxmd.com/read/29893013/online-virtual-cases-to-teach-resource-stewardship
#9
Linghong Linda Zhou, Gordon Tait, Sharron Sandhu, Amanda Steiman, Shirley Lake
BACKGROUND: As health care costs rise, medical education must focus on high-value clinical decision making. To teach and assess efficient resource use in rheumatology, online virtual interactive cases (VICs) were developed to simulate real patient encounters to increase price transparency and reinforce cost consciousness. To teach and assess efficient resource use in rheumatology, online virtual interactive cases (VICs) were developed METHODS: The VIC modules were distributed to a sample of medical students and internal medicine residents, who were required to assess patients, order appropriate investigations, develop differential diagnoses and formulate management plans...
June 11, 2018: Clinical Teacher
https://www.readbyqxmd.com/read/29891124/retention-of-cricothyrotomy-skills-by-paramedics-using-a-wire-guided-technique
#10
J A March, M J Kiemeney, J De Guzman, J D Ferguson
INTRODUCTION: Cricothyrotomy may be necessary for airway management when a patient's airway cannot be maintained through standard techniques such as oral airway placement, blind insertion airway device, or endotracheal intubation. Wire-guided cricothyrotomy is one of many techniques used to perform a cricothyrotomy. Although there is some controversy over which cricothyrotomy technique is superior, there is no published data regarding long term retention rates. The purpose of this study is to determine whether ground based paramedics can be taught and are able to retain the skills necessary to successfully perform a wire-guided cricothyrotomy...
May 31, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29890316/effects-of-a-homogeneous-polysaccharide-from-sijunzi-decoction-on-human-intestinal-microbes-including-structures-and-metabolites-in-vitro
#11
Beibei Gao, Ruijun Wang, Ying Peng, Xiaobo Li
ETHNOPHARMACOLOGICAL RELEVANCE: Sijunzi decoction (SJZD) is a classic recipe in traditional Chinese medicine (TCM) to strengthen the spleen and replenish Qi, and the immune-enhancement activity of a homogeneous polysaccharide, S-3-1, purified from SJZD has been proven. AIM OF THE STUDY: The present study aimed to understand the immunomodulatory mechanism of S-3-1 by investigating its effects on human intestinal microbes, including structures and metabolites. MATERIALS AND METHODS: S-3-1 was incubated with simulated gastric juice, intestinal juice, and human fecal microflora independently and sequentially...
June 8, 2018: Journal of Ethnopharmacology
https://www.readbyqxmd.com/read/29889745/simulation-in-obstetrics
#12
Andrew J Satin
Simulation in obstetrics is a widely accepted and valuable tool that benefits all levels of learners from medical students to maternal-fetal medicine subspecialists. What began as an adjunct to medical education now has a rapidly expanding role in acquisition of new and innovative procedures, team and unit training, and safety and quality initiatives. The number of obstetric simulation peer-reviewed reports has increased exponentially in recent years, yet only a small percentage of reports primarily addresses clinical outcomes...
June 6, 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29888689/describing-ccfp-em-programs-in-canada-a-national-survey-of-program-directors
#13
Avik Nath, Krishan Yadav, Jeffrey J Perry
CLINICIAN'S CAPSULE What is known about the topic? Little has been published on the structure and curricula of the Canadian College of Family Physicians Emergency Medicine [CCFP(EM)] programs across Canada. What did this study ask? Describe the major components of CCFP(EM) programs and how they are incorporated into curricula. What did this study find? Programs have similar clinical rotations, ultrasound, and simulation requirements. Variation exists in administrative structures, financial resources, academic projects, and competency-based curricula...
June 11, 2018: CJEM
https://www.readbyqxmd.com/read/29888651/robustness-of-testing-procedures-for-confirmatory-subpopulation-analyses-based-on-a-continuous-biomarker
#14
Alexandra Christine Graf, Gernot Wassmer, Tim Friede, Roland Gerard Gera, Martin Posch
With the advent of personalized medicine, clinical trials studying treatment effects in subpopulations are receiving increasing attention. The objectives of such studies are, besides demonstrating a treatment effect in the overall population, to identify subpopulations, based on biomarkers, where the treatment has a beneficial effect. Continuous biomarkers are often dichotomized using a threshold to define two subpopulations with low and high biomarker levels. If there is insufficient information on the dependence structure of the outcome on the biomarker, several thresholds may be investigated...
January 1, 2018: Statistical Methods in Medical Research
https://www.readbyqxmd.com/read/29888477/a-bayesian-finite-mixture-of-bivariate-regression-model-for-causal-mediation-analyses
#15
Geneviève Lefebvre, Mariia Samoilenko, Isabelle Boucoiran, Lucie Blais
Building on the work of Schwartz et al, Joint Bayesian analysis of birthweight and censored gestational age using finite mixture models in Statistics in Medicine, we propose a Bayesian finite mixture of bivariate regression model for causal mediation analyses. Using an identifiability condition within each component of the mixture, we express the natural direct and indirect effects of the exposure on the outcome as functions of the component-specific regression coefficients. On the basis of simulated data, we examine the behavior of the model for estimating these effects in situations where the associations between exposure, mediator, and outcome are confounded or not...
June 11, 2018: Statistics in Medicine
https://www.readbyqxmd.com/read/29883948/simulation-of-a-complete-x-ray-digital-radiographic-system-for-industrial-applications
#16
E Nazemi, B Rokrok, A Movafeghi, M H Choopan Dastjerdi
Simulating X-ray images is of great importance in industry and medicine. Using such simulation permits us to optimize parameters which affect image's quality without the limitations of an experimental procedure. This study revolves around a novel methodology to simulate a complete industrial X-ray digital radiographic system composed of an X-ray tube and a computed radiography (CR) image plate using Monte Carlo N Particle eXtended (MCNPX) code. In the process of our research, an industrial X-ray tube with maximum voltage of 300 kV and current of 5 mA was simulated...
May 19, 2018: Applied Radiation and Isotopes
https://www.readbyqxmd.com/read/29883946/indirubin-a-bis-indole-alkaloid-binds-to-tubulin-and-exhibits-antimitotic-activity-against-hela-cells-in-synergism-with-vinblastine
#17
Lakshmi Mohan, Darpan Raghav, Shabeeba M Ashraf, Jomon Sebastian, Krishnan Rathinasamy
Indirubin, a bis-indole alkaloid used in traditional Chinese medicine has shown remarkable anticancer activity against chronic myelocytic leukemia. The present work was aimed to decipher the underlying molecular mechanisms responsible for its anticancer attributes. Our findings suggest that indirubin inhibited the proliferation of HeLa cells with an IC50 of 40 μM and induced a mitotic block. At concentrations higher than its IC50 , indirubin exerted a moderate depolymerizing effect on the interphase microtubular network and spindle microtubules in HeLa cells...
June 5, 2018: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/29882064/touching-proteins-with-virtual-bare-hands-visualizing-protein-drug-complexes-and-their-dynamics-in-self-made-virtual-reality-using-gaming-hardware
#18
Erick Martins Ratamero, Dom Bellini, Christopher G Dowson, Rudolf A Römer
The ability to precisely visualize the atomic geometry of the interactions between a drug and its protein target in structural models is critical in predicting the correct modifications in previously identified inhibitors to create more effective next generation drugs. It is currently common practice among medicinal chemists while attempting the above to access the information contained in three-dimensional structures by using two-dimensional projections, which can preclude disclosure of useful features. A more accessible and intuitive visualization of the three-dimensional configuration of the atomic geometry in the models can be achieved through the implementation of immersive virtual reality (VR)...
June 7, 2018: Journal of Computer-aided Molecular Design
https://www.readbyqxmd.com/read/29881768/face-and-construct-validity-of-a-novel-mechanical-ercp-simulator
#19
Sophia E van der Wiel, Arjun D Koch, Marco J Bruno
Background and study aims:  Simulation-based training has become an important pillar in competence-based medicine. However, limited data are available on use of simulators in training for endoscopic retrograde cholangiopancreatography (ERCP). We aimed to determine the face and construct validity of the Boškoski-Costamagna mechanical ERCP Trainer, and to assess its didactic value, as judged by experts. Methods:  Participants were divided into four groups based on ERCP lifetime experience: novices, intermediate, experienced, and experts...
June 2018: Endoscopy International Open
https://www.readbyqxmd.com/read/29881185/electromagnetic-simulation-of-non-invasive-approach-for-the-diagnosis-of-diabetic-foot-ulcers
#20
Roshen Borkar, James Rizkalla, Youngmin Kwon, Paul Salama, Maher Rizkalla
Diabetic foot ulcers are systemic diseases that affect all blood vessels within the human body. From major blood vessels to microvasculature, hardening, thickening, and narrowing of blood vessels ultimately results to diminished blood flow to end organs. The detrimental effects of peripheral vascular disease are well recognized across medicine, particularly with regards to diabetic foot ulcers. Diabetic foot ulcers (DFU) are common across all fields of medicine, including but not limited to: orthopedics, vascular surgery, podiatry, general internal medicine, and infectious disease...
June 2018: Journal of Orthopaedics
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