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https://www.readbyqxmd.com/read/28432561/predicting-fluid-responsiveness-in-whom-a-simulated-example-of-patient-spectrum-influencing-the-receiver-operating-characteristics-curve
#1
Lars Øivind Høiseth, Jostein S Hagemo
The influence of patient spectrum on the sensitivities and specificities of diagnostic methods has been termed spectrum bias or spectrum effect. Receiver operating characteristics curves are often used to assess the ability of diagnostic methods to predict fluid responsiveness. As a receiver operating characteristics curve is a presentation of sensitivity and specificity, the purpose of the present manuscript was to explore if patient spectrum could affect areas under receiver operating characteristics curves and their gray zones...
April 21, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28432489/design-development-and-clinical-validation-of-computer-aided-surgical-simulation-system-for-streamlined-orthognathic-surgical-planning
#2
REVIEW
Peng Yuan, Huaming Mai, Jianfu Li, Dennis Chun-Yu Ho, Yingying Lai, Siting Liu, Daeseung Kim, Zixiang Xiong, David M Alfi, John F Teichgraeber, Jaime Gateno, James J Xia
PURPOSE: There are many proven problems associated with traditional surgical planning methods for orthognathic surgery. To address these problems, we developed a computer-aided surgical simulation (CASS) system, the AnatomicAligner, to plan orthognathic surgery following our streamlined clinical protocol. METHODS: The system includes six modules: image segmentation and three-dimensional (3D) reconstruction, registration and reorientation of models to neutral head posture, 3D cephalometric analysis, virtual osteotomy, surgical simulation, and surgical splint generation...
April 21, 2017: International Journal of Computer Assisted Radiology and Surgery
https://www.readbyqxmd.com/read/28432189/safety-and-efficiency-of-a-new-generic-package-labelling-a-before-and-after-study-in-a-simulated-setting
#3
Beate Hennie Garcia, Renate Elenjord, Camilla Bjornstad, Kjell Hermann Halvorsen, Sigurd Hortemo, Steinar Madsen
BACKGROUND: Medication errors are frequent and may cause harm to patients and increase healthcare expenses. AIM: To explore whether a new labelling influences time and errors when preparing medications in accordance with medication charts in an experimental setting. METHOD: We carried out an uncontrolled before and after study with 3 months inbetween experiments. Phase I used original labelling and phase II used new generic labelling. We set up an experimental medicine room, simulating a real-life setting...
April 21, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/28431980/shear-stress-alterations-in-the-celiac-trunk-of-patients-with-a-continuous-flow-left-ventricular-assist-device-as-shown-by-in-silico-and-in-vitro-flow-analyses
#4
Francesco Scardulla, Salvatore Pasta, Leonardo D'Acquisto, Sergio Sciacca, Valentina Agnese, Christian Vergara, Alfio Quarteroni, Francesco Clemenza, Diego Bellavia, Michele Pilato
BACKGROUND: The use of left ventricular assist devices (LVADs) to treat advanced cardiac heart failure is constantly increasing, although this device leads to high risk for gastrointestinal bleeding. METHODS: Using in-silico flow analysis, we quantified hemodynamic alterations due to continuous-flow LVAD (HeartWare, Inc., Framingham, MA) in the celiac trunk and major branches of the abdominal aorta, and then explored the relationship between wall shear stress (WSS) and celiac trunk orientation...
March 24, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28431936/galectin-3-mediates-the-pulmonary-arterial-hypertension-induced-right-ventricular-remodeling-through-interacting-with-nadph-oxidase-4
#5
Jingni He, Xiaohui Li, Hui Luo, Tangzhiming Li, Lin Zhao, Qiangqiang Qi, Yuwei Liu, Zaixin Yu
Pulmonary arterial hypertension (PAH) is a progressive disorder that affects both pulmonary vasculature and the heart. The response of the right ventricle (RV) to the increased afterload is an important determinant of the PAH final outcome. Galectin-3 (Gal-3), a novel biomarker in left cardiac remodeling, takes part in multiple pathophysiological processes including the inflammation, fibrosis, immunity, and oxidative stress. The levels of Gal-3 are elevated in PAH patients, although the exact mechanisms underlie the PAH-induced right ventricular structural changes remain unclear...
March 27, 2017: Journal of the American Society of Hypertension: JASH
https://www.readbyqxmd.com/read/28431428/computational-and-in-vitro-experimental-investigation-of-intrathecal-drug-distribution-parametric-study-of-the-effect-of-injection-volume-cerebrospinal-fluid-pulsatility-and-drug-uptake
#6
Kevin M Tangen, Roxanne Leval, Ankit I Mehta, Andreas A Linninger
BACKGROUND: Intrathecal drug delivery is an attractive option to circumvent the blood-brain barrier for pain management through its increased efficacy of pain relief, reduction in adverse side effects, and cost-effectiveness. Unfortunately, there are limited guidelines for physicians to choose infusion or drug pump settings to administer therapeutic doses to specific regions of the spine or the brain. Although empiric trialing of intrathecal drugs is critical to determine the sustained side effects, currently there is no inexpensive in vitro method to guide the selection of spinal drug delivery parameters...
May 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28430740/low-dose-computed-tomography-scans-with-automatic-exposure-control-for-patients-of-different-ages-undergoing-cardiac-pet-ct-and-spect-ct
#7
Ching-Ching Yang, Bang-Hung Yang, Chun-Yuan Tu, Tung-Hsin Wu, Shu-Hsin Liu
PURPOSE: This study aimed to evaluate the efficacy of automatic exposure control (AEC) in order to optimize low-dose computed tomography (CT) protocols for patients of different ages undergoing cardiac PET/CT and single-photon emission computed tomography/computed tomography (SPECT/CT). METHODS: One PET/CT and one SPECT/CT were used to acquire CT images for four anthropomorphic phantoms representative of 1-year-old, 5-year-old and 10-year-old children and an adult...
April 20, 2017: Nuclear Medicine Communications
https://www.readbyqxmd.com/read/28430590/treatment-of-esophageal-cancer-with-radiation-therapy-a-pan-chinese-survey-of-radiation-oncologists
#8
Yun Zhang, Jing Liu, Wencheng Zhang, Weiye Deng, Jinbo Yue
Lots of controversies were found about the treatment in relation to radiation therapy (RT) for esophageal squamous cell carcinoma (ESCC). We designed a questionnaire of these controversies to do a pan-Chinese survey of radiation oncologists (ROs). For operable ESCC, 53% ROs chose surgery plus postoperative chemoradiotherapy (CRT), while 40% chose preoperative CRT plus surgery. For target volume of postoperative RT, most ROs (92%) would delineate tumor bed plus involved lymph nodes region before surgery. For definitive RT, most ROs (81%) would give patients higher RT dose to 60-65Gy...
April 5, 2017: Oncotarget
https://www.readbyqxmd.com/read/28430115/a-systematic-review-of-3-d-printing-in-cardiovascular-and-cerebrovascular-diseases
#9
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/28429574/flip-angle-optimization-for-balanced-ssfp-cardiac-cine-imaging-following-the-application-of-standard-extracellular-contrast-agent-gadobutrol
#10
Daniel L R Kuetting, Darius Dabir, Julian Luetkens, Andreas Feisst, Rami Homsi, Daniel Thomas, Hans H Schild, Alois M Sprinkart
PURPOSE: To investigate the effect of the flip angle (FA) on the blood-myocardium contrast and to define the FA leading to highest image quality in contrast-enhanced balanced steady-state free precession (bSSFP) images. bSSFP images provide excellent contrast between myocardium and blood with high signal-to-noise and contrast-to-noise ratios (SNR, CNR). In clinical practice, bSSFP images are typically acquired following the injection of extracellular contrast agents (ECAs), although ECAs decrease the blood-myocardium contrast...
April 21, 2017: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/28429371/design-of-a-short-non-uniform-acquisition-protocol-for-quantitative-analysis-in-dynamic-cardiac-spect-imaging-a-retrospective-123-i-mibg-animal-study
#11
Yunlong Zan, Yong Long, Kewei Chen, Biao Li, Qiu Huang, Grant T Gullberg
PURPOSE: Our previous works have found that quantitative analysis of (123) I-MIBG kinetics in the heart with dynamic single-photon emission computed tomography (SPECT) offers the potential to quantify the innervation integrity at an early stage of left ventricular hypertrophy. However, conventional protocols involving a long acquisition time for dynamic imaging reduce the animal survival rate and thus make longitudinal analysis difficult. The goal of this work was to develop a procedure to reduce the total acquisition time by selecting non-uniform acquisition times for projection views while maintaining the accuracy and precision of estimated physiologic parameters...
April 21, 2017: Medical Physics
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
#12
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/28428738/improved-localization-of-seizure-onset-zones-using-spatiotemporal-constraints-and-time-varying-source-connectivity
#13
Juan D Martinez-Vargas, Gregor Strobbe, Kristl Vonck, Pieter van Mierlo, German Castellanos-Dominguez
Presurgical evaluation of brain neural activity is commonly carried out in refractory epilepsy patients to delineate as accurately as possible the seizure onset zone (SOZ) before epilepsy surgery. In practice, any subjective interpretation of electroencephalographic (EEG) recordings is hindered mainly because of the highly stochastic behavior of the epileptic activity. We propose a new method for dynamic source connectivity analysis that aims to accurately localize the seizure onset zones by explicitly including temporal, spectral, and spatial information of the brain neural activity extracted from EEG recordings...
2017: Frontiers in Neuroscience
https://www.readbyqxmd.com/read/28428160/simulated-conversations-with-virtual-humans-to-improve-patient-provider-communication-and-reduce-unnecessary-prescriptions-for-antibiotics-a-repeated-measure-pilot-study
#14
Antoinette Schoenthaler, Glenn Albright, Judith Hibbard, Ron Goldman
BACKGROUND: Despite clear evidence that antibiotics do not cure viral infections, the problem of unnecessary prescribing of antibiotics in ambulatory care persists, and in some cases, prescribing patterns have increased. The overuse of antibiotics for treating viral infections has created numerous economic and clinical consequences including increased medical costs due to unnecessary hospitalizations, antibiotic resistance, disruption of gut bacteria, and obesity. Recent research has underscored the importance of collaborative patient-provider communication as a means to reduce the high rates of unnecessary prescriptions for antibiotics...
April 19, 2017: JMIR Medical Education
https://www.readbyqxmd.com/read/28428149/local-control-and-toxicity-of-adaptive-radiotherapy-using-weekly-ct-imaging-results-from-the-lartia-trial-in-stage-iii-nsclc
#15
Sara Ramella, Michele Fiore, Sonia Silipigni, Maria Cristina Zappa, Massimo Jaus, Antonio Maria Alberti, Paolo Matteucci, Elisabetta Molfese, Patrizia Cornacchione, Carlo Greco, Lucio Trodella, Edy Ippolito, Rolando Maria D'Angelillo
INTRODUCTION: Anatomical change of tumor during radiotherapy contributes to target missing. However, in case of tumor shrinkage adaptation of volume could results in an increased incidence of recurrences in the area of target reduction. This study aims to investigate the incidence of failure of adaptive approach and in particular the risk of local recurrence in the area excluded after replanning. METHODS: In this prospective study, LA-NSCLC patients treated with concomitant chemoradiation underwent weekly chest-CT simulation during treatment...
April 17, 2017: Journal of Thoracic Oncology
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
#16
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/28427290/a-real-time-method-for-decoding-the-neural-drive-to-muscles-using-single-channel-intra-muscular-emg-recordings
#17
Saeed Karimimehr, Hamid Reza Marateb, Silvia Muceli, Marjan Mansourian, Miguel Angel Mañanas, Dario Farina
The neural command from motor neurons to muscles - sometimes referred to as the neural drive to muscle - can be identified by decomposition of electromyographic (EMG) signals. This approach can be used for inferring the voluntary commands in neural interfaces in patients with limb amputations. This paper proposes for the first time an innovative method for fully automatic and real-time intramuscular EMG (iEMG) decomposition. The method is based on online single-pass density-based clustering and adaptive classification of bivariate features, using the concept of potential measure...
March 20, 2017: International Journal of Neural Systems
https://www.readbyqxmd.com/read/28427173/circumvent-the-uncertainty-in-the-applications-of-transcriptional-signatures-to-tumor-tissues-sampled-from-different-tumor-sites
#18
Jun Cheng, You Guo, Qiao Gao, Hongdong Li, Haidan Yan, Mengyao Li, Hao Cai, Weicheng Zheng, Xiangyu Li, Weizhong Jiang, Zheng Guo
The expression measurements of thousands of genes are correlated with the proportions of tumor epithelial cell (PTEC) in clinical samples. Thus, for a tumor diagnostic or prognostic signature based on a summarization of expression levels of the signature genes, the risk score for a patient may dependent on the tumor tissues sampled from different tumor sites with diverse PTEC for the same patient. Here, we proposed that the within-samples relative expression orderings (REOs) based gene pairs signatures should be insensitive to PTEC variations...
February 27, 2017: Oncotarget
https://www.readbyqxmd.com/read/28426432/surface-as-a-motion-surrogate-for-gated-re-scanned-pencil-beam-proton-therapy
#19
Ye Zhang, Isabel Huth, Martin Wegner, Damien C Weber, Antony J Lomax
This simulation study investigated the dosimetric effectiveness and treatment efficiency of surface motion guided gating of pencil beam scanning (PBS) proton therapy for liver tumour treatments. Dedicated 4D dose calculations were performed for simulating gated treatments using 4DCT data for six patients derived from 4DMRI (4DCT(MRI)). Surface motion as a surrogate for tumour motion was extracted from the 4DMRI images and a linear internal-external correlation model applied to derive amplitude-based gating windows (GWs) of 10 and 5 mm...
April 20, 2017: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/28425890/biomedical-simulation-evolution-concepts-challenges-and-future-trends
#20
Carla Sá-Couto, Luís Patrão, Francisco Maio-Matos, José Miguel Pêgo
Biomedical simulation is an effective educational complement for healthcare training, both at undergraduate and postgraduate level. It enables knowledge, skills and attitudes to be acquired in a safe, educationally orientated and efficient manner. In this context, simulation provides skills and experience that facilitate the transfer of cognitive, psychomotor and proper communication competences, thus changing behavior and attitudes, and ultimately improving patient safety. Beyond the impact on individual and team performance, simulation provides an opportunity to study organizational failures and improve system performance...
December 30, 2016: Acta Médica Portuguesa
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