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Medical Simulation

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https://www.readbyqxmd.com/read/28526191/aiding-risk-information-learning-through-simulated-experience-arise-using-simulated-outcomes-to-improve-understanding-of-conditional-probabilities-in-prenatal-down-syndrome-screening
#1
Pete Wegier, Victoria A Shaffer
OBJECTIVE: To determine whether the use of simulated experiences to communicate statistical information can improve an individual's understanding of conditional probabilities-specifically the positive predictive value (PPV) of prenatal screening tests for Down syndrome. METHODS: In Experiment 1 (N=64) and Experiment 2 (N=180) participants were asked to estimate the PPV of a prenatal screening test for Down syndrome based on either (1) explicit statistics regarding the prevalence of Down syndrome and the sensitivity and specificity of a prenatal screening test for Down syndrome, or (2) experiencing up to 5000 simulated test results over a short time...
April 26, 2017: Patient Education and Counseling
https://www.readbyqxmd.com/read/28525542/semiparametric-model-and-inference-for-spontaneous-abortion-data-with-a-cured-proportion-and-biased-sampling
#2
Jin Piao, Jing Ning, Christina D Chambers, Ronghui Xu
Evaluating and understanding the risk and safety of using medications for autoimmune disease in a woman during her pregnancy will help both clinicians and pregnant women to make better treatment decisions. However, utilizing spontaneous abortion (SAB) data collected in observational studies of pregnancy to derive valid inference poses two major challenges. First, the data from the observational cohort are not random samples of the target population due to the sampling mechanism. Pregnant women with early SAB are more likely to be excluded from the cohort, and there may be substantial differences between the observed SAB time and those in the target population...
May 18, 2017: Biostatistics
https://www.readbyqxmd.com/read/28525350/comparing-four-methods-for-estimating-tree-based-treatment-regimes
#3
Aniek Sies, Iven Van Mechelen
When multiple treatment alternatives are available for a certain psychological or medical problem, an important challenge is to find an optimal treatment regime, which specifies for each patient the most effective treatment alternative given his or her pattern of pretreatment characteristics. The focus of this paper is on tree-based treatment regimes, which link an optimal treatment alternative to each leaf of a tree; as such they provide an insightful representation of the decision structure underlying the regime...
May 12, 2017: International Journal of Biostatistics
https://www.readbyqxmd.com/read/28523743/applying-lessons-from-social-psychology-to-transform-the-culture-of-error-disclosure
#4
Jason Han, Denise LaMarra, Neha Vapiwala
CONTEXT: The ability to carry out prompt and effective error disclosure has been described in the literature as an essential skill among physicians that can lead to improved patient satisfaction, staff well-being and hospital outcomes. However, few studies have addressed the social psychology principles that may influence physician behaviour. METHODS: The authors provide an overview of recent administrative measures designed to encourage physicians to disclose error, but note that deliberate practice, buttressed with lessons from social psychology, is needed to implement further productive behavioural changes...
May 18, 2017: Medical Education
https://www.readbyqxmd.com/read/28523139/an-overview-of-the-use-of-artificial-neural-networks-in-lung-cancer-research
#5
EDITORIAL
Luca Bertolaccini, Piergiorgio Solli, Alessandro Pardolesi, Antonello Pasini
The artificial neural networks (ANNs) are statistical models where the mathematical structure reproduces the biological organisation of neural cells simulating the learning dynamics of the brain. Although definitions of the term ANN could vary, the term usually refers to a neural network used for non-linear statistical data modelling. The neural models applied today in various fields of medicine, such as oncology, do not aim to be biologically realistic in detail but just efficient models for nonlinear regression or classification...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28522975/hypoxia-and-inactivity-related-physiological-changes-constipation-inflammation-are-not-reflected-at-the-level-of-gut-metabolites-and-butyrate-producing-microbial-community-the-planhab-study
#6
Robert Šket, Nicole Treichel, Tadej Debevec, Ola Eiken, Igor Mekjavic, Michael Schloter, Marius Vital, Jenna Chandler, James M Tiedje, Boštjan Murovec, Zala Prevoršek, Blaž Stres
We explored the assembly of intestinal microbiota in healthy male participants during the run-in (5 day) and experimental phases [21-day normoxic bed rest (NBR), hypoxic bedrest (HBR)], and hypoxic ambulation (HAmb) in a strictly controlled laboratory environment, balanced fluid, and dietary intakes, controlled circadian rhythm, microbial ambiental burden, and 24/7 medical surveillance. The fraction of inspired O2 (FiO2) and partial pressure of inspired O2 (PiO2) were 0.209 and 133.1 ± 0.3 mmHg for NBR and 0...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28521646/medical-students-review-of-formative-osce-scores-checklists-and-videos-improves-with-student-faculty-debriefing-meetings
#7
Aaron W Bernard, Gabbriel Ceccolini, Richard Feinn, Jennifer Rockfeld, Ilene Rosenberg, Listy Thomas, Todd Cassese
BACKGROUND: Performance feedback is considered essential to clinical skills development. Formative objective structured clinical exams (F-OSCEs) often include immediate feedback by standardized patients. Students can also be provided access to performance metrics including scores, checklists, and video recordings after the F-OSCE to supplement this feedback. How often students choose to review this data and how review impacts future performance has not been documented. OBJECTIVE: We suspect student review of F-OSCE performance data is variable...
2017: Medical Education Online
https://www.readbyqxmd.com/read/28521380/-clinical-practical-examination-in-orthopaedic-teaching-who-is-the-ideal-examiner
#8
Peter Melcher, Andreas Roth, Mohamed Ghanem, Daisy Rotzoll
Background Medical curricula require an increasing amount of integrated clinical practical skills education. German medical faculties are increasingly implementing the OSCE (objective structured clinical examination) to test students' practical as well as communication skills. Teaching and assessment tools for practical skills include simulators and simulated patient scenarios, where peer-assisted teaching (PAT) is applied. Trained student tutors support this process. This study examines for the first time the use of PAT student tutors as examiners in an orthopaedic OSCE unit and the existence of possible differences in rating between faculty and PAT student tutors...
May 18, 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/28521277/the-spatio-temporal-mechanical-environment-of-healthy-and-injured-human-cartilage-during-sustained-activity-and-its-role-in-cartilage-damage
#9
Saeed Miramini, David W Smith, Lihai Zhang, Bruce S Gardiner
Recently we presented a computational model of articular cartilage calibrated for normal human tissue explants. This model was able to capture the transient deformation of cartilage experiencing a cyclic load. The model takes into account the tension-compression nonlinearity of the cartilage and incorporates the dependency of the compressive stiffness and fluid permeability of cartilage on the deformation-dependent aggrecan concentration in cartilage tissue. As such it represents a leading constitutive model of articular cartilage...
May 10, 2017: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/28521249/using-a-videogame-to-facilitate-nursing-and-medical-students-first-visit-to-the-operating-theatre-a-randomized-controlled-trial
#10
Ángel Del Blanco, Javier Torrente, Baltasar Fernández-Manjón, Pedro Ruiz, Manuel Giner
BACKGROUND: First experiences in the operating theatre with real patients are always stressful and intimidating for students. We hypothesized that a game-like simulation could improve perceptions and performance of novices. METHODS: A videogame was developed, combining pictures and short videos, by which students are interactively instructed on acting at the surgical block. Moreover, the game includes detailed descriptive information. After playing, students are given feedback on their performance...
May 9, 2017: Nurse Education Today
https://www.readbyqxmd.com/read/28513733/polylactic-acid-nano-and-microchamber-arrays-for-encapsulation-of-small-hydrophilic-molecules-featuring-drug-release-via-high-intensity-focused-ultrasound
#11
Meiyu Gai, Johannes Frueh, Tianyi Tao, Arseniy V Petrov, Vladimir V Petrov, Evgeniy V Shesterikov, Sergei I Tverdokhlebov, Gleb B Sukhorukov
Long term encapsulation combined with spatiotemporal release for a precisely defined quantity of small hydrophilic molecules on demand remains a challenge in various fields ranging from medical drug delivery, controlled release of catalysts to industrial anti-corrosion systems. Free-standing individually sealed polylactic acid (PLA) nano- and microchamber arrays were produced by one-step dip-coating a PDMS stamp into PLA solution for 5 s followed by drying under ambient conditions. The wall thickness of these hydrophobic nano-microchambers is tunable from 150 nm to 7 μm by varying the PLA solution concentration...
May 17, 2017: Nanoscale
https://www.readbyqxmd.com/read/28511893/assessment-of-the-effectiveness-of-attenuation-of-pb-aprons-by-using-tld-dosimetry-and-monte-carlo-calculations
#12
H Olaya Dávila, J A Díaz Merchán, H R Vega Carrillo, S A Martínez Ovalle
We developed an experimental set-up by using a continuous emission X-ray (Pantak DXT-3000) and three types of Pb aprons, with thicknesses of 0.25, 0.5, and 0.75mm, coated with Mylar fiber on their surface. Aprons were placed at a distance of 2.5m from the focus. Aluminum filtration was performed at the beam output to reproduce the qualities of narrow beams, N40 (Eeffective =33keV), N80 (Eeffective =65keV), and N100 (Eeffective =83keV), according to the ISO standard 4037 (1-3). Each apron was fixed with 10 thermoluminescent dosimeters (TLDs) over its surface, five dosimeters before and five dosimeters after irradiation with X-rays...
May 10, 2017: Applied Radiation and Isotopes
https://www.readbyqxmd.com/read/28511730/simulation-in-canadian-postgraduate-emergency-medicine-training-a-national-survey
#13
Evan Russell, Andrew Koch Hall, Carly Hagel, Andrew Petrosoniak, Jeffrey Damon Dagnone, Daniel Howes
OBJECTIVES: Simulation-based education (SBE) is an important training strategy in emergency medicine (EM) postgraduate programs. This study sought to characterize the use of simulation in FRCPC-EM residency programs across Canada. METHODS: A national survey was administered to residents and knowledgeable program representatives (PRs) at all Canadian FRCPC-EM programs. Survey question themes included simulation program characteristics, the frequency of resident participation, the location and administration of SBE, institutional barriers, interprofessional involvement, content, assessment strategies, and attitudes about SBE...
May 17, 2017: CJEM
https://www.readbyqxmd.com/read/28509849/low-duty-cycling-mac-protocol-for-low-data-rate-medical-wireless-body-area-networks
#14
Chongqing Zhang, Yinglong Wang, Yongquan Liang, Minglei Shu, Jinquan Zhang, Lina Ni
Wireless body area networks (WBANs) are severely energy constrained, and how to improve the energy efficiency so as to prolong the network lifetime as long as possible is one of the most important goals of WBAN research. Low data-rate WBANs are promising to cut down the energy consumption and extend the network lifetime. Considering the characteristics and demands of low data-rate WBANs, a low duty-cycling medium access control (MAC) protocol is specially designed for this kind of WBAN in this paper. Longer superframes are exploited to cut down the energy consumed on the transmissions and receptions of redundant beacon frames...
May 16, 2017: Sensors
https://www.readbyqxmd.com/read/28508836/tabulated-square-shaped-source-model-for-linear-accelerator-electron-beam-simulation
#15
Navid Khaledi, Mahmood Reza Aghamiri, Hossein Aslian, Ahmad Ameri
CONTEXT: Using this source model, the Monte Carlo (MC) computation becomes much faster for electron beams. AIMS: The aim of this study was to present a source model that makes linear accelerator (LINAC) electron beam geometry simulation less complex. SETTINGS AND DESIGN: In this study, a tabulated square-shaped source with transversal and axial distribution biasing and semi-Gaussian spectrum was investigated. SUBJECTS AND METHODS: A low energy photon spectrum was added to the semi-Gaussian beam to correct the bremsstrahlung X-ray contamination...
January 2017: Journal of Cancer Research and Therapeutics
https://www.readbyqxmd.com/read/28507840/cadaver-based-necrotizing-fasciitis-model-for-medical-training
#16
Kurt M Mohty, Matthew G Cravens, William J Adamas-Rappaport, Bahareh Amini-Shervin, Steven C Irving, Nicholas Stea, Srikar Adhikari, Richard Amini
Necrotizing fasciitis is a devastating infectious disease process that is characterized by extensive soft tissue necrosis along deep fascial planes, systemic toxicity, and high mortality. Ultrasound imaging is a rapid and non-invasive tool that can be used to help make the diagnosis of necrotizing fasciitis by identifying several distinctive sonographic findings. The purpose of this study is to describe the construction of a realistic diagnostic training model for necrotizing fasciitis using fresh frozen cadavers and common, affordable materials...
April 14, 2017: Curēus
https://www.readbyqxmd.com/read/28507421/orthopaedic-tumors-what-problems-are-we-solving-and-are-universities-and-major-medical-centers-doing-enough
#17
Mohamed Mediouni, Daniel R Schlatterer
Little has been published about the complexity of orthopaedic tumors compared to others tumors. The current study in the literature treated this problem in terms of classification, surgical intervention and impact on the patient. In this article, factors risks of tumors will be we identified. A strategy based on three dimensional simulations will be explained in order to improve the clinical trials.
June 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/28505682/-implementation-of-a-laparoscopic-simulation-training-in-undergraduate-medical-education-the-l%C3%A3-beck-toolbox-curriculum
#18
Tilman Laubert, Michael Thomaschewski, Paul Auerswald, Markus Zimmermann, Linda Brüheim, Tobias Keck, Claudia Benecke
Background Simulation-based training has become increasingly relevant in minimally invasive surgery (MIS). It is unclear whether or not the established Lübeck Toolbox (LTB) Curriculum for the acquisition of basic MIS skills can be implemented to supplement standard undergraduate education in surgery and how it would be accepted. Materials und Methods Since 04/2015, students at the medical school of the University of Lübeck have had the option to complete the highly standardized and validated LTB Curriculum...
May 15, 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/28505240/incidence-of-gonorrhea-and-chlamydia-following-hiv-preexposure-prophylaxis-among-men-who-have-sex-with-men-a-modeling-study
#19
Samuel M Jenness, Kevin M Weiss, Steven M Goodreau, Thomas Gift, Harrell Chesson, Karen W Hoover, Dawn K Smith, Albert Y Liu, Patrick S Sullivan, Eli S Rosenberg
Background: Preexposure prophylaxis (PrEP) is highly effective for preventing HIV, but risk compensation (RC) in men who have sex with men (MSM) raises concerns about increased sexually transmitted infections (STIs). CDC's PrEP guidelines recommend biannual STI screening, which may reduce incidence by treating STIs that would otherwise remain undiagnosed. We investigated the impact of these two potentially counteracting phenomena. Methods: With a stochastic network-based mathematical model of HIV and rectal/urogenital Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) transmission dynamics among MSM in the United States, we simulated PrEP uptake following the prescription indications and HIV/STI screening recommendations in the CDC guidelines...
May 13, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28505041/the-potential-return-on-public-investment-in-detecting-adverse-drug-effects
#20
Krista F Huybrechts, Rishi J Desai, Moa Park, Joshua J Gagne, Mehdi Najafzadeh, Jerry Avorn
BACKGROUND: Many countries lack fully functional pharmacovigilance programs, and public budgets allocated to pharmacovigilance in industrialized countries remain low due to resource constraints and competing priorities. OBJECTIVE: Using 3 case examples, we sought to estimate the public health and economic benefits resulting from public investment in active pharmacovigilance programs to detect adverse drug effects. RESEARCH DESIGN: We assessed 3 examples in which early signals of safety hazards were not adequately recognized, resulting in continued exposure of a large number of patients to these drugs when safer and effective alternative treatments were available...
June 2017: Medical Care
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