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Simulation medicine

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https://www.readbyqxmd.com/read/28430115/a-systematic-review-of-3-d-printing-in-cardiovascular-and-cerebrovascular-diseases
#1
Zhonghua Sun, Shen Yuan Lee
OBJECTIVE: The application of 3-D printing has been increasingly used in medicine, with research showing many applications in cardiovascular disease. This systematic review analyzes those studies published about the applications of 3-D printed, patient-specific models in cardiovascular and cerebrovascular diseases. METHODS: A search of PubMed/Medline and Scopus databases was performed to identify studies investigating the 3-D printing in cardiovascular and cerebrovascular diseases...
April 10, 2017: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/28427321/in-silico-assessment-of-biomedical-products-the-conundrum-of-rare-but-not-so-rare-events-in-two-case-studies
#2
Marco Viceconti, Claudio Cobelli, Tarek Haddad, Adam Himes, Boris Kovatchev, Mark Palmer
In silico clinical trials, defined as "The use of individualized computer simulation in the development or regulatory evaluation of a medicinal product, medical device, or medical intervention," have been proposed as a possible strategy to reduce the regulatory costs of innovation and the time to market for biomedical products. We review some of the the literature on this topic, focusing in particular on those applications where the current practice is recognized as inadequate, as for example, the detection of unexpected severe adverse events too rare to be detected in a clinical trial, but still likely enough to be of concern...
May 2017: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
https://www.readbyqxmd.com/read/28426147/propagation-of-error-from-parameter-constraints-in-quantitative-mri-example-application-of-multiple-spin-echo-t2-mapping
#3
Christopher L Lankford, Mark D Does
PURPOSE: Quantitative MRI may require correcting for nuisance parameters which can or must be constrained to independently measured or assumed values. The noise and/or bias in these constraints propagate to fitted parameters. For example, the case of refocusing pulse flip angle constraint in multiple spin echo T2 mapping is explored. METHODS: An analytical expression for the mean-squared error of a parameter of interest was derived as a function of the accuracy and precision of an independent estimate of a nuisance parameter...
April 20, 2017: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
https://www.readbyqxmd.com/read/28425452/estimating-the-irreversible-pressure-drop-across-a-stenosis-by-quantifying-turbulence-production-using-4d-flow-mri
#4
Hojin Ha, Jonas Lantz, Magnus Ziegler, Belen Casas, Matts Karlsson, Petter Dyverfeldt, Tino Ebbers
The pressure drop across a stenotic vessel is an important parameter in medicine, providing a commonly used and intuitive metric for evaluating the severity of the stenosis. However, non-invasive estimation of the pressure drop under pathological conditions has remained difficult. This study demonstrates a novel method to quantify the irreversible pressure drop across a stenosis using 4D Flow MRI by calculating the total turbulence production of the flow. Simulation MRI acquisitions showed that the energy lost to turbulence production can be accurately quantified with 4D Flow MRI within a range of practical spatial resolutions (1-3 mm; regression slope = 0...
April 20, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28424804/acute-medicine-finishing-school-preparing-for-the-next-step
#5
Tehmeena Khan, Nicholas Murch
The transition from registrar to consultant in medicine is one that trainees feel ill prepared for and can be extremely stressful. We devised the concept of an Acute Medicine "Finishing School" for senior trainees in London training programmes and ran sessions on CV writing, a simulated consultant interview, consultant job planning, responding to complaints and an out of hospital emergency scenario. Our feedback survey indicated that our delegates' confidence levels in all of the above aspects increased following the sessions...
2017: Acute Medicine
https://www.readbyqxmd.com/read/28420381/operations-research-in-global-health-a-scoping-review-with-a-focus-on-the-themes-of-health-equity-and-impact
#6
REVIEW
Beverly D Bradley, Tiffany Jung, Ananya Tandon-Verma, Bassem Khoury, Timothy C Y Chan, Yu-Ling Cheng
BACKGROUND: Operations research (OR) is a discipline that uses advanced analytical methods (e.g. simulation, optimisation, decision analysis) to better understand complex systems and aid in decision-making. Herein, we present a scoping review of the use of OR to analyse issues in global health, with an emphasis on health equity and research impact. A systematic search of five databases was designed to identify relevant published literature. A global overview of 1099 studies highlights the geographic distribution of OR and common OR methods used...
April 18, 2017: Health Research Policy and Systems
https://www.readbyqxmd.com/read/28419016/an-evaluation-of-a-new-debriefing-framework-reflect
#7
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/28411293/safe-and-effective-bedside-thoracentesis-a-review-of-the-evidence-for-practicing-clinicians
#8
REVIEW
Richard Schildhouse, Andrew Lai, Jeffrey H Barsuk, Michelle Mourad, Vineet Chopra
BACKGROUND: Physicians often care for patients with pleural effusion, a condition that requires thoracentesis for evaluation and treatment. We aim to identify the most recent advances related to safe and effective performance of thoracentesis. METHODS: We performed a narrative review with a systematic search of the literature. Two authors independently reviewed search results and selected studies based on relevance to thoracentesis; disagreements were resolved by consensus...
April 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28408233/securing-a-chest-tube-properly-a-simple-framework-for-teaching-emergency-medicine-residents-and-assessing-their-technical-abilities
#9
Raaj K Ruparel, Torrey A Laack, Rushin D Brahmbhatt, Phillip G Rowse, Johnathon M Aho, Yazan N AlJamal, Brian D Kim, David S Morris, David R Farley, Ronna L Campbell
BACKGROUND: Quality-improvement efforts at our institution have identified chest tube dislodgement as a preventable complication of tube thoracostomy. Because proper fixation techniques are not well described in the literature and are seldom formally taught, techniques vary among residents. OBJECTIVE: Our aim was to develop and test a framework for teaching and assessing chest tube securement. METHODS: A repeated-measures study design was used...
April 10, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28404708/practice-simulated-office-orals-as-a-predictor-of-certification-examination-performance-in-family-medicine
#10
Kendall Noel, Douglas Archibald, Carlos Brailovsky
OBJECTIVE: To determine if performance on practice simulated office orals (SOOs) conducted during residency training could predict residents' performance on the SOO component of the College of Family Physicians of Canada's (CFPC's) final Certification examination. DESIGN: Prospective cohort study. SETTING: University of Ottawa in Ontario. PARTICIPANTS: Family medicine residents enrolled in the University of Ottawa's Family Medicine Residency program between July 1, 2012, and June 30, 2014, who were eligible to write the CFPC Certification examination in the spring of 2014 and who had participated in all 4 practice SOO examination sessions; 23 residents met these criteria...
April 2017: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/28403924/-parental-project-of-general-medicine-residents-from-aix-marseille-university-theoretical-knowledge-in-reproduction-and-behavior-towards-parenting
#11
A Fabregue, B Moheng, A Laynet, A Agostini, L Boubli, B Courbiere
OBJECTIVES: Analyze residents' intentions about parenting and knowledge about fertility, as well as their alleged behavior towards a diagnosis of diminished ovarian reserve. MATERIALS AND METHODS: Prospective study with distribution of self-administered questionnaire to residents of Aix-Marseille university from June to September 2015. The questionnaire was composed of a first descriptive part including generic and personal informations about the residents and their intentions towards parenting...
March 2017: J Gynecol Obstet Hum Reprod
https://www.readbyqxmd.com/read/28398905/an-integrated-model-of-scintillator-reflector-properties-for-advanced-simulations-of-optical-transport
#12
Emilie Roncali, Mariele Stockhoff, Simon Cherry
Accurately modeling the light transport in scintillation detectors is essential to design new detectors for nuclear medicine or high energy physics. Optical models implemented in software such as Geant4 and GATE suffer from important limitations that we addressed by implementing a new approach in which the crystal reflectance was computed from 3D surface measurements. The reflectance was saved in a look-up-table (LUT) then used in Monte Carlo simulation to determine the fate of optical photons. Our previous work using this approach demonstrated excellent agreement with experimental characterization of crystal light output in a limited configuration, i...
April 11, 2017: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/28394080/parallel-transmit-capability-of-various-rf-transmit-elements-and-arrays-at-7t-mri
#13
Stefan H G Rietsch, Stephan Orzada, Andreas K Bitz, Marcel Gratz, Mark E Ladd, Harald H Quick
PURPOSE: In this work, 22 configurations for remote radiofrequency (RF) coil arrays consisting of different transmit element designs for 7 Tesla (T) ultrahigh-field MRI are compared by numerical simulations. METHODS: Investigated transmit RF element types are rectangular loops, micro striplines, micro striplines with meanders, 250-mm shielded dipoles with meanders, and lambda over two dipoles with and without shield. These elements are combined in four different configurations of circumferential RF body arrays with four or eight transmit elements each...
April 10, 2017: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
https://www.readbyqxmd.com/read/28394030/the-effect-of-realistic-geometries-on-the-susceptibility-weighted-mr-signal-in-white-matter
#14
Tianyou Xu, Sean Foxley, Michiel Kleinnijenhuis, Way Cherng Chen, Karla L Miller
PURPOSE: To investigate the effect of realistic microstructural geometry on the susceptibility-weighted MR signal in white matter (WM), with application to demyelination. METHODS: Previous work has modeled susceptibility-weighted signals under the assumption that axons are cylindrical. In this study, we explored the implications of this assumption by considering the effect of more realistic geometries. A three-compartment WM model incorporating relevant properties based on the literature was used to predict the MR signal...
April 10, 2017: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
https://www.readbyqxmd.com/read/28393677/in-silico-high-throughput-virtual-screening-and-molecular-dynamics-simulation-study-to-identify-inhibitor-for-adeabc-efflux-pump-of-acinetobacter-baumannii
#15
Privita Verma, Monalisa Tiwari, Vishvanath Tiwari
Emergence of multi-drug resistant strains of Acinetobacter baumannii has caused significant health problems and is responsible for high morbidity and mortality. Overexpression of AdeABC efflux system is one of the major mechanisms. In this study, we have focused on overcoming the drug resistance by identifying inhibitors that can effectively bind and inhibit integral membrane protein, AdeB of this efflux pump. We performed homology modeling to generate structure of AdeB using MODELLER v9.16 followed by model refinement using 3D-Refine tool and validated using PSVS, ProsaWeb, ERRAT etc...
April 10, 2017: Journal of Biomolecular Structure & Dynamics
https://www.readbyqxmd.com/read/28388301/procalcitonin-biomarker-algorithm-reduces-antibiotic-prescriptions-duration-of-therapy-and-costs-in-chronic-obstructive-pulmonary-disease-a-comparison-in-the-netherlands-germany-and-the-united-kingdom
#16
Marloes E van der Maas, Gertjan Mantjes, Lotte M G Steuten
Antibiotics are often recommended as treatment for patients with chronic obstructive pulmonary disease (COPD) exacerbations. However, not all COPD exacerbations are caused by bacterial infections and there is consequently considerable misuse and overuse of antibiotics among patients with COPD. This poses a severe burden on healthcare resources such as increased risk of developing antibiotic resistance. The biomarker procalcitonin (PCT) displays specificity to distinguish bacterial inflammations from nonbacterial inflammations and may therefore help to rationalize antibiotic prescriptions...
April 2017: Omics: a Journal of Integrative Biology
https://www.readbyqxmd.com/read/28386099/participatory-simulation-modelling-to-inform-public-health-policy-and-practice-rethinking-the-evidence-hierarchies
#17
Eloise O'Donnell, Jo-An Atkinson, Louise Freebairn, Lucie Rychetnik
Drawing on the long tradition of evidence-based medicine that aims to improve the efficiency and effectiveness of clinical practice, the field of public health has sought to apply 'hierarchies of evidence' to appraise and synthesise public health research. Various critiques of this approach led to the development of synthesis methods that include broader evidence typologies and more 'fit for purpose' privileging of methodological designs. While such adaptations offer great utility for evidence-informed public health policy and practice, this paper offers an alternative perspective on the synthesis of evidence that necessitates a yet more egalitarian approach...
April 6, 2017: Journal of Public Health Policy
https://www.readbyqxmd.com/read/28382769/the-blindfolded-code-training-exercise
#18
Rami Ahmed, Kate Hughes, Patrick Hughes
BACKGROUND: Communication errors are the leading cause of preventable patient harm in medicine. There is little description in the literature of advanced techniques to teach crisis resource management (CRM) communication strategies, or how to improve real-time ineffective behaviour or habits that may persist despite appropriate behaviour and leadership witnessed in the simulation lab. CONTEXT: This article presents an advanced teaching technique to force the adoption of closed-loop communication strategies...
April 5, 2017: Clinical Teacher
https://www.readbyqxmd.com/read/28382726/improved-dark-blood-late-gadolinium-enhancement-db-lge-imaging-using-an-optimized-joint-inversion-preparation-and-t2-magnetization-preparation
#19
Tamer A Basha, Maxine C Tang, Connie Tsao, Cory M Tschabrunn, Elad Anter, Warren J Manning, Reza Nezafat
PURPOSE: To develop a dark blood-late gadolinium enhancement (DB-LGE) sequence that improves scar-blood contrast and delineation of scar region. METHODS: The DB-LGE sequence uses an inversion pulse followed by T2 magnetization preparation to suppress blood and normal myocardium. Time delays inserted after preparation pulses and T2 -magnetization-prep duration are used to adjust tissue contrast. Selection of these parameters was optimized using numerical simulations and phantom experiments...
April 5, 2017: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
https://www.readbyqxmd.com/read/28379080/interprofessional-collaborative-reasoning-by-residents-and-nurses-in-internal-medicine-evidence-from-a-simulation-study
#20
K S Blondon, F Maître, V Muller-Juge, N Bochatay, S Cullati, P Hudelson, N V Vu, G L Savoldelli, M R Nendaz
Clinical reasoning has been studied in residents or nurses, using interviews or patient-provider encounters. Despite a growing interest in interprofessional collaboration, the notion of collaborative reasoning has not been well studied in clinical settings. Our study aims at exploring resident-nurse collaborative reasoning in a simulation setting. We enrolled 14 resident-nurse teams from a general internal medicine division in a mixed methods study. Teams each managed one of four acute case scenarios, followed by a stimulated-recall session...
April 2017: Medical Teacher
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