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https://www.readbyqxmd.com/read/29334569/assessment-of-prehospital-hemorrhage-and-airway-care-using-a-simulation-model
#1
Mariya E Skube, Seth Witthuhn, Kristine Mulier, Bonnie Boucher, Elizabeth Lusczek, Greg J Beilman
BACKGROUND: The quality of prehospital care impacts patient outcomes. Military efforts have focused on training revision and the creation of high fidelity simulation models to address potentially survivable injuries. We sought to investigate the applicability of models emphasizing hemorrhage control and airway management to a civilian population. METHODS: Prehospital healthcare providers (PHPs) undergoing their annual training were enrolled. A trauma scenario was simulated with two modules: hemorrhage control and airway management...
January 12, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29333761/simulated-patients-uncovered
#2
Mohsin F Butt
No abstract text is available yet for this article.
February 2018: Clinical Teacher
https://www.readbyqxmd.com/read/29333659/acute-renal-replacement-therapy-during-hospitalization-is-training-adequate
#3
Paul M Palevsky
Acute renal replacement therapy is one of the most common interventions provided by nephrologists, however, data on the quality of training provided to nephrology fellows is limited. Extensive curricula for acute renal replacement therapy and the management of poisonings and intoxications have been published, but personal experience suggests that there are significant opportunities to improve training. Particular areas to be considered include the use of novel technologies for assessment of volume status, greater emphasis on the dosing of medications during acute renal replacement therapy, greater training in assessing and tailoring treatment to the goals of care of the individual patient, incorporation of continuous quality improvement tools into the management of acute renal replacement therapy programs and development of robust simulation training to augment training...
January 14, 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29333474/saccades-in-progressive-supranuclear-palsy-maladapted-irregular-curved-and-slow
#4
Aasef G Shaikh, Stewart A Factor, Jorge Juncos
Background and objectives: Slowed and curved rapid eye movements, saccades, are the well-known features of progressive supranuclear palsy (PSP). We hypothesized that the saccades in PSP are not only slow and curved, but they are also irregular and have timing deficits. Methods: We tested this hypothesis in 12 patients with PSP by measuring vertical and horizontal visually guided saccades using a limbus tracker. Results: Both, horizontal and vertical saccades were slow and had irregular trajectory and velocity profiles, but deficits were much more robust in vertical saccades...
September 2017: Movement Disorders Clinical Practice
https://www.readbyqxmd.com/read/29333208/integrating-cadaver-needle-forces-into-a-haptic-robotic-simulator
#5
David F Pepley, Mary A Yovanoff, Katelin A Mirkin, Scarlett R Miller, David C Han, Jason Z Moore
Accurate force simulation is essential to haptic simulators for surgical training. Factors such as tissue inhomogeneity pose unique challenges for simulating needle forces. To aid in the development of haptic needle insertion simulators, a handheld force sensing syringe was created to measure the motion and forces of needle insertions. Five needle insertions were performed into the neck of a cadaver using the force sensing syringe. Based on these measurements a piecewise exponential needle force characterization, was implemented into a haptic central venous catheterization (CVC) simulator...
March 2018: Journal of Medical Devices
https://www.readbyqxmd.com/read/29333113/grating-oriented-line-wise-filtration-golf-for-dual-energy-x-ray-ct
#6
Yan Xi, Wenxiang Cong, Daniel Harrison, Ge Wang
In medical X-ray Computed Tomography (CT), the use of two distinct X-ray source spectra (energies) allows dose-reduction and material discrimination relative to that achieved with only one source spectrum. Existing dual-energy CT methods include source kVp-switching, double-layer detection, dual-source gantry, and two-pass scanning. Each method suffers either from strong spectral correlation or patient-motion artifacts. To simultaneously address these problems, we propose to improve CT data acquisition with the Grating Oriented Line-wise Filtration (GOLF) method, a novel X-ray filter that is placed between the source and patient...
December 2017: Sensing and Imaging
https://www.readbyqxmd.com/read/29332992/experiment-design-for-early-molecular-events-in-hiv-infection
#7
Aditya Jagarapu, LaMont Cannon, Ryan Zurakowski
The recent introduction of integrase inhibitors to the HIV antiviral repertoire permits us to create in vitro experiments that reliably terminate HIV infection at the point of chromosomal integration. This allows us to isolate the dynamics of a single round of infection, without needing to account for the influence of multiple overlapping rounds of infection. By measuring the various nucleic acid concentrations in a population of infected target cells at multiple time points, we can infer the rates of these molecular events with great accuracy, which allows us to compare the rates between target cells with different functional phenotypes...
May 2017: Proceedings of the ... American Control Conference
https://www.readbyqxmd.com/read/29332910/successful-infant-pneumonectomy-with-unilateral-pulmonary-artery-occlusion-test
#8
Koji Kato, Taichi Kato, Satoshi Hayano, Yoshie Fukasawa, Atsushi Numaguchi, Tetsuo Hattori, Akiko Saito, Yoshiaki Sato, Masahiro Hayakawa
The use of unilateral pulmonary artery occlusion (UPAO) test for the preoperative evaluation of pneumonectomy was reported in adult patients. On the contrary, in infants, no strategies have yet been recommended to predict hemodynamics after pneumonectomy, nor has use of the UPAO test been reported. We describe the first case of infant with abnormal pulmonary circulation in whom successful pneumonectomy was performed after preoperative evaluation using UPAO test. Right pneumonectomy was planned for an 8-month-old girl, because of decreased right pulmonary function, high risk of pneumothorax, and impaired left lung expansion due to overexpansion caused by severe left bronchial stenosis and bronchomalacia...
January 15, 2018: International Heart Journal
https://www.readbyqxmd.com/read/29332776/compliance-with-a-national-standard-by-norwegian-helicopter-emergency-physicians
#9
Lars Petter Bjørnsen, Andrea Marie Solheim, Oddvar Uleberg, Eirik Skogvoll
OBJECTIVE: The "National Standard Requirements for Helicopter Emergency Medicine Services Physicians" gives recommendations on medical requirements for flight physicians. This study describes the level of formal competence, experience, and guideline compliance of Norwegian helicopter emergency medical service (HEMS) physicians. METHODS: In May 2013, all HEMS physicians with full-time engagement at Norwegian HEMS bases were invited to participate in a cross-sectional survey using a structured, Web-based questionnaire...
January 2018: Air Medical Journal
https://www.readbyqxmd.com/read/29332554/evaluating-the-dose-dependent-mechanism-of-action-of-trazodone-by-estimation-of-occupancies-for-different-brain-neurotransmitter-targets
#10
Luca Settimo, David Taylor
Trazodone is a drug that was introduced in the clinic almost 40 years ago. It is licensed to treat depression, but it is also commonly used off-label to treat insomnia. A recent study shows that it could be promising in preventing neurodegeneration in mice, and clinical trials to assess its possible beneficial effects on dementia and Alzheimer's disease are expected to start soon in humans. In this study, we describe the dose-dependent pharmacology of trazodone by carrying out pharmacokinetic simulations aiming to predict the brain concentrations of trazodone for different drug-dosing regimens and calculating occupancy for 28 different targets for which published trazodone-binding data are available...
January 2018: Journal of Psychopharmacology
https://www.readbyqxmd.com/read/29332468/local-radiotherapy-affects-drug-pharmacokinetics-exploration-of-a-neglected-but-significant-uncertainty-of-cancer-therapy
#11
Yu-Jen Chen, Tung-Hu Tsai, Li-Ying Wang, Chen-Hsi Hsieh
PURPOSE: Concurrent chemoradiation therapy is the mainstay of treatment for many types of malignancies. However, concurrent chemoradiation therapy is associated with a greater number of systemic adverse effects than radiotherapy or chemotherapy alone. SUMMARY: Pharmacokinetics is the study of a drug and/or its metabolite kinetics in the body, including absorption, distribution, metabolism, and elimination. The incidences of adverse effects are markedly higher in patients who receive concurrent chemoradiation therapy than in those who receive either radiotherapy or chemotherapy alone...
December 2017: Technology in Cancer Research & Treatment
https://www.readbyqxmd.com/read/29332447/a-projection-quality-driven-tube-current-modulation-method-in-cone-beam-ct-for-igrt-proof-of-concept
#12
Kuo Men, Jianrong Dai
PURPOSE: To develop a projection quality-driven tube current modulation method in cone-beam computed tomography for image-guided radiotherapy based on the prior attenuation information obtained by the planning computed tomography and then evaluate its effect on a reduction in the imaging dose. MATERIALS AND METHODS: The QCKV-1 phantom with different thicknesses (0-400 mm) of solid water upon it was used to simulate different attenuation (μ). Projections were acquired with a series of tube current-exposure time product (mAs) settings, and a 2-dimensional contrast to noise ratio was analyzed for each projection to create a lookup table of mAs versus 2-dimensional contrast to noise ratio, μ...
December 2017: Technology in Cancer Research & Treatment
https://www.readbyqxmd.com/read/29332121/pattern-onset-ergs-and-veps-produced-by-patterns-arising-from-light-increment-and-decrement
#13
Dennis M Fritsch, Jane C Sowden, Dorothy A Thompson
Purpose: Our aim was to elaborate how on and off signals contribute to pattern ERGs and pattern visual evoked potentials (VEPs) by using pedestal patterns arising from incremental and decremental onset stimulation. Methods: Pattern onset/offset ERGs and VEPs were produced by black and white checks of 60' side length and 88% spatial contrast appearing in a 16° field for 200 ms from white (110 cd/m2), black (7 cd/m2), and gray (48 cd/m2) backgrounds and disappeared for 1000 ms...
January 1, 2018: Investigative Ophthalmology & Visual Science
https://www.readbyqxmd.com/read/29330837/computer-simulated-modeling-of-healthy-and-diseased-right-ventricular-and-pulmonary-circulation
#14
Jody Chou, Joseph B Rinehart
We have previously developed a simulated cardiovascular physiology model for in-silico testing and validation of novel closed-loop controllers. To date, a detailed model of the right heart and pulmonary circulation was not needed, as previous controllers were not intended for use in patients with cardiac or pulmonary pathology. With new development of controllers for vasopressors, and looking forward, for combined vasopressor-fluid controllers, modeling of right-sided and pulmonary pathology is now relevant to further in-silico validation, so we aimed to expand our existing simulation platform to include these elements...
January 12, 2018: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29330437/a-computational-assay-of-estrogen-receptor-%C3%AE-antagonists-reveals-the-key-common-structural-traits-of-drugs-effectively-fighting-refractory-breast-cancers
#15
Matic Pavlin, Angelo Spinello, Marzia Pennati, Nadia Zaffaroni, Silvia Gobbi, Alessandra Bisi, Giorgio Colombo, Alessandra Magistrato
Somatic mutations of the Estrogen Receptor α (ERα) occur with an up to 40% incidence in ER sensitive breast cancer (BC) patients undergoing prolonged endocrine treatments. These polymorphisms are implicated in acquired resistance, disease relapse, and increased mortality rates, hence representing a current major clinical challenge. Here, multi-microseconds (12.5 µs) molecular dynamics simulations revealed that recurrent ERα polymorphisms (i. e. L536Q, Y537S, Y537N, D538G) (mERα) are constitutively active in their apo form and that they prompt the selection of an agonist (active)-like conformation even upon antagonists binding...
January 12, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29330341/biomechanics-of-coupled-motion-in-the-cervical-spine-during-simulated-whiplash-in-patients-with-pre-existing-cervical-or-lumbar-spinal-fusion-a-finite-element-study
#16
H Huang, R W Nightingale, A B C Dang
OBJECTIVES: Loss of motion following spine segment fusion results in increased strain in the adjacent motion segments. However, to date, studies on the biomechanics of the cervical spine have not assessed the role of coupled motions in the lumbar spine. Accordingly, we investigated the biomechanics of the cervical spine following cervical fusion and lumbar fusion during simulated whiplash using a whole-human finite element (FE) model to simulate coupled motions of the spine. METHODS: A previously validated FE model of the human body in the driver-occupant position was used to investigate cervical hyperextension injury...
January 2018: Bone & Joint Research
https://www.readbyqxmd.com/read/29330332/identification-and-characterization-of-sites-where-persistent-atrial-fibrillation-is-terminated-by-localized-ablation
#17
Junaid A B Zaman, William H Sauer, Mahmood I Alhusseini, Tina Baykaner, Ryan T Borne, Christopher A B Kowalewski, Sonia Busch, Paul C Zei, Shirley Park, Mohan N Viswanathan, Paul J Wang, Johannes Brachmann, David E Krummen, John M Miller, Wouter Jan Rappel, Sanjiv M Narayan, Nicholas S Peters
BACKGROUND: The mechanisms by which persistent atrial fibrillation (AF) terminates via localized ablation are not well understood. To address the hypothesis that sites where localized ablation terminates persistent AF have characteristics identifiable with activation mapping during AF, we systematically examined activation patterns acquired only in cases of unequivocal termination by ablation. METHODS AND RESULTS: We recruited 57 patients with persistent AF undergoing ablation, in whom localized ablation terminated AF to sinus rhythm or organized tachycardia...
January 2018: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/29330204/pazopanib-exposure-relationship-with-clinical-efficacy-and-safety-in-the-adjuvant-treatment-of-advanced-renal-cell-carcinoma
#18
Cora Sternberg, Frede Donskov, Naomi B Haas, Christian Doehn, Paul Russo, Mohamed A Elmeliegy, Guillaume Baneyx, Hiya Banerjee, Paola Aimone, Robert J Motzer
PURPOSE: PROTECT, a phase III randomized placebo-controlled study, evaluated pazopanib efficacy and safety in the adjuvant RCC setting. The relationship between pazopanib exposure (Ctrough) and efficacy and safety was evaluated. EXPERIMENTAL DESIGN: Evaluable steady-state blood trough concentrations were collected from 311 patients at week 3 or 5 (early Ctrough), and 250 patients at week 16 or 20 (late Ctrough). Pazopanib pharmacokinetic (PK) data was analyzed via a population model approach...
January 12, 2018: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
https://www.readbyqxmd.com/read/29329996/to-prep-or-not-to-prep-that-is-the-question-a-randomized-trial-on-the-use-of-antiflatulent-medication-as-part-of-bowel-preparation-for-patients-having-image-guided-external-beam-radiation-therapy-to-the-prostate
#19
Merrylee McGuffin, Naila Devji, Lyann Kehoe, Anne Carty, Steve Russell, Lisa Di Prospero, Carlo DeAngelis, Alex Kiss, Danny Vesprini, Andrew Loblaw, Laura D'Alimonte
INTRODUCTION: Radiation therapy is a standard treatment option for prostate cancer. With growing use of escalated doses and tighter margins, procedures to limit rectal size variation are needed to reduce prostate motion, increase treatment accuracy, and minimize rectal toxicity. This prospective study was done to determine whether the introduction of an antiflatulent medication would decrease rectal distention at computed tomography (CT) simulation and throughout a course of radiation therapy...
November 4, 2017: Practical Radiation Oncology
https://www.readbyqxmd.com/read/29329915/observed-variation-in-n95-respirator-use-by-nurses-demonstrating-isolation-care
#20
Elizabeth L Beam, Elizabeth L Hotchkiss, Shawn G Gibbs, Angela L Hewlett, Peter C Iwen, Suzanne L Nuss, Philip W Smith
Video review and scoring was used to evaluate the behaviors of nurses wearing N95 filtering face piece respirators while providing isolation care in a simulated patient care environment. This study yielded a detailed description of behaviors related to N95 respirator use in a health care setting. Developing a more robust and systematic behavior analysis tool for use in demonstration, simulation, and clinical care would allow for improved respiratory protection of health care workers.
January 9, 2018: American Journal of Infection Control
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