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Simulated practice

S M Shah, J P Crawshaw, E S Boek
In the last decade, imaging techniques capable of reconstructing three-dimensional (3-D) pore-scale model have played a pivotal role in the study of fluid flow through complex porous media. In this study, we present advances in the application of confocal laser scanning microscopy (CLSM) to image, reconstruct and characterize complex porous geological materials with hydrocarbon reservoir and CO2 storage potential. CLSM has a unique capability of producing 3-D thin optical sections of a material, with a wide field of view and submicron resolution in the lateral and axial planes...
October 25, 2016: Journal of Microscopy
D Brynn Hibbert, Pall Thordarson
Data analysis is central to understanding phenomena in host-guest chemistry. We describe here recent developments in this field starting with the revelation that the popular Job plot method is inappropriate for most problems in host-guest chemistry and that the focus should instead be on systematically fitting data and testing all reasonable binding models. We then discuss approaches for estimating uncertainties in binding studies using case studies and simulations to highlight key issues. Related to this is the need for ready access to data and transparency in the methodology or software used, and we demonstrate an example a webportal () that aims to address this issue...
October 25, 2016: Chemical Communications: Chem Comm
Heba Alhmidi, Sreelatha Koganti, Myreen E Tomas, Jennifer L Cadnum, Annette Jencson, Curtis J Donskey
BACKGROUND: Simulations using fluorescent tracers can be useful in understanding the spread of pathogens and in devising effective infection control strategies. METHODS: During simulated patient care interactions in which providers wore gloves and gowns, we evaluated environmental and personnel dissemination of fluorescent lotion and bacteriophage MS2 from a contaminated mannequin. The frequency of skin and clothing contamination after removal of personal protective equipment (PPE) was compared before versus after an intervention that included education and practice in PPE donning and doffing...
2016: Antimicrobial Resistance and Infection Control
Erin Grgurich, Cynthia Arnemann, Kim Amon, Rose Horton, Jestin N Carlson
As neonatal endotracheal intubation (ETI) is a low-frequency, high-consequence event, it is essential that providers have access to resources to aid in ETI. We sought to determine the impact of video laryngoscopy (VL) with just-in-time training on intubation outcomes over direct laryngoscopy (DL) when performed by neonatal nurses. We conducted a prospective, randomized, crossover study with neonatal nurses employed at a level 2 neonatal intensive care unit (NICU). Nurses performed both DL and VL on a neonatal mannequin using a CMAC (Karl Storz Corp, Tuttlingen, Germany) either with the assistance of the screen (VL) or without (DL)...
October 2016: Journal of Perinatal & Neonatal Nursing
Diego L Guarin, Robert E Kearney
The mechanical properties of a joint are determined by the combination of intrinsic and reflex mechanisms. However, in some situations the reflex contributions are small so that intrinsic mechanisms play the dominant role in the control of posture and movement. The intrinsic mechanisms, characterized by the joint compliance, can be described well by a second order, linear model for small perturbations around an operating point defined by mean position and torque. However, the compliance parameters depend strongly on the operating point...
October 19, 2016: IEEE Transactions on Neural Systems and Rehabilitation Engineering
Naim Al Mahi, Munni Begum
One of the primary objectives of ribonucleic acid (RNA) sequencing or RNA-Seq experiment is to identify differentially expressed (DE) genes in two or more treatment conditions. It is a common practice to assume that all read counts from RNA-Seq data follow overdispersed (OD) Poisson or negative binomial (NB) distribution, which is sometimes misleading because within each condition, some genes may have unvarying transcription levels with no overdispersion. In such a case, it is more appropriate and logical to consider two sets of genes: OD and non-overdispersed (NOD)...
September 15, 2016: Journal of Bioinformatics and Computational Biology
Yana Puckett, Benedicto C Baronia
With the recent advances in eye tracking technology, it is now possible to track surgeons' eye movements while engaged in a surgical task or when surgical residents practice their surgical skills. Several studies have compared eye movements of surgical experts and novices and developed techniques to assess surgical skill on the basis of eye movement utilizing simulators and live surgery. None have evaluated simultaneous visual tracking between an expert and a novice during live surgery. Here, we describe a successful simultaneous deployment of visual tracking of an expert and a novice during live laparoscopic cholecystectomy...
September 20, 2016: Curēus
Phil J Peacock, Anna Woodman, Wendy McCay, Sarah E Bates
INTRODUCTION: Non-pediatric trainees working in pediatrics in the UK are expected to attend newborn deliveries and provide initial newborn life support if needed. In Swindon, new junior doctors receive a 90-minute teaching session at the start of their pediatrics rotation, but the content has not previously been standardized, and it may be several weeks before a doctor attends a newborn delivery. Thus, the confidence and competence in newborn resuscitation of doctors attending deliveries can vastly vary...
September 20, 2016: Curēus
Ling Chen, Jianguo Sun, Chengjie Xiong
Clustered interval-censored failure time data can occur when the failure time of interest is collected from several clusters and known only within certain time intervals. Regression analysis of clustered interval-censored failure time data is discussed assuming that the data arise from the semiparametric additive hazards model. A multiple imputation approach is proposed for inference. A major advantage of the approach is its simplicity because it avoids estimating the correlation within clusters by implementing a resampling-based method...
November 2016: Computational Statistics & Data Analysis
Andy Tsai, Carol E Barnewolt, Sanjay P Prahbu, Reimi Yonekura, Andrew Hosmer, Noah E Schulz, Peter H Weinstock
RATIONALE AND OBJECTIVES: Historically, skills training in performing brain ultrasonography has been limited to hours of scanning infants for lack of adequate synthetic models or alternatives. The aim of this study was to create a simulator and determine its utility as an educational tool in teaching the skills that can be used in performing brain ultrasonography on infants. MATERIALS AND METHODS: A brain ultrasonography simulator was created using a combination of multi-modality imaging, three-dimensional printing, material and acoustic engineering, and sculpting and molding...
October 20, 2016: Academic Radiology
Zhiyuan Xia, Xiandun Zhai, Beibei Liu, Yaonan Mo
Precise measurement of cadaver decomposition rate is the basis to accurate post-mortem interval (PMI) estimation. There are many approaches explored in recent years, however, it is still unsolved completely. Total volatile basic nitrogen (TVB-N), which is an important index to predict meat freshness and shelf life in food science, could serve as an indicator for measuring PMI associated decomposition rate of cadavers. The aim of this work was to establish a practical method to determine TVB-N in cadaver soft tissues (mainly skeletal muscle) for measuring decomposition rate...
October 18, 2016: Journal of Forensic and Legal Medicine
Trishal Boodhna, David P Crabb
BACKGROUND: Chronic open angle glaucoma (COAG) is an age-related eye disease causing irreversible loss of visual field (VF). Health service delivery for COAG is challenging given the large number of diagnosed patients requiring lifelong periodic monitoring by hospital eye services. Yet frequent examination better determines disease worsening and speed of VF loss under treatment. We examine the cost-effectiveness of increasing frequency of VF examinations during follow-up using a health economic model...
October 22, 2016: BMC Health Services Research
M Nikkhou, M Škarabot, S Čopar, I Muševič
We study topological defect annihilation on a glass fibre with homeotropic surface anchoring of nematic liquid crystal molecules. The fibre is set parallel to the nematic director of a planar cell with variable thickness and we create pairs of Saturn ring and Saturn anti-ring using the laser tweezers. In thick cells we observe in the whole region of defect separation a Coulomb-like pair attraction with no background force, [Formula: see text] with [Formula: see text]. In cells with thickness comparable to glass fibre diameter, we observe the Coulomb-like attraction only at small separations of the defect pair...
October 2016: European Physical Journal. E, Soft Matter
Cecilia Nilsson, Jette Led Sorensen, Lars Konge, Mikkel Westen, Morten Stadeager, Bent Ottesen, Flemming Bjerrum
BACKGROUND: Inexperienced operating assistants are often tasked with the important role of handling camera navigation during laparoscopic surgery. Incorrect handling can lead to poor visualization, increased operating time, and frustration for the operating surgeon-all of which can compromise patient safety. The objectives of this trial were to examine how to train laparoscopic camera navigation and to explore the transfer of skills to the operating room. MATERIALS AND METHODS: A randomized, single-center superiority trial with three groups: The first group practiced simulation-based camera navigation tasks (camera group), the second group practiced performing a simulation-based cholecystectomy (procedure group), and the third group received no training (control group)...
October 21, 2016: Surgical Endoscopy
Katherine A Guthrie, Hilary S Gammill, Mads Kamper-Jørgensen, Anne Tjønneland, Vijayakrishna K Gadi, J Lee Nelson, Wendy Leisenring
Natural acquisition of small amounts of foreign cells or DNA, referred to as microchimerism, occurs primarily through maternal-fetal exchange during pregnancy. Microchimerism can persist long-term and has been associated with both beneficial and adverse human health outcomes. Quantitative microchimerism data present challenges for statistical analysis, including a skewed distribution, excess zero values, and occasional large values. Methods for comparing microchimerism levels across groups while controlling for covariates are not well established...
October 21, 2016: American Journal of Epidemiology
Alexis K Huynh, Martin L Lee, Melissa M Farmer, Lisa V Rubenstein
BACKGROUND: Stepped wedge designs have gained recognition as a method for rigorously assessing implementation of evidence-based quality improvement interventions (QIIs) across multiple healthcare sites. In theory, this design uses random assignment of sites to successive QII implementation start dates based on a timeline determined by evaluators. However, in practice, QII timing is often controlled more by site readiness. We propose an alternate version of the stepped wedge design that does not assume the randomized timing of implementation while retaining the method's analytic advantages and applying to a broader set of evaluations...
October 21, 2016: BMC Medical Research Methodology
Marit Hegg Reime, Tone Johnsgaard, Fred Ivan Kvam, Morten Aarflot, Marit Breivik, Janecke Merethe Engeberg, Guttorm Brattebø
Poor teamwork is an important factor in the occurrence of critical incidents because of a lack of non-technical skills. Team training can be a key to prevent these incidents. The purpose of this study was to explore the experience of nursing and medical students after a simulation-based interprofessional team training (SBITT) course and its impact on professional and patient safety practices, using a concurrent mixed-method design. The participants (n = 262) were organized into 44 interprofessional teams...
October 13, 2016: Nurse Education in Practice
Geir K Hanssen, Yngve Dahl
Purpose: Our purpose is to provide insight into the added value of applying a participatory design approach in the design of an interactive sound environment simulator to facilitate communication and understanding between patients and audiologists in consultation situations. Method: We have applied a qualitative approach, presenting results and discussion in the form of a story, following 3 consecutive steps: problem investigation, design, and evaluation. Results: We provide an overview of lessons learned, emphasizing how patients and audiologists took roles and responsibilities in the design process and the effects of this involvement...
October 1, 2016: American Journal of Audiology
Baohua Yue, Ron Brendel, Amelia Lukitsch, Thomas Prentice, Brian Doty
BACKGROUND: Commercial baclofen formulations used with infusion pumps are available at therapeutic concentrations of 0.5-2.0 mg/mL. However, patients who receive higher daily doses of baclofen may benefit from products with greater baclofen concentrations since their refill frequency would be reduced (up to a maximum of 180 days). We evaluated baclofen solubility, baclofen 3 mg/mL intrathecal (IT) formulation stability, and chemical and physical compatibility with Medtronic SynchroMed(®) II and Codman Medstream(®) programmable IT infusion pumps...
October 21, 2016: Neuromodulation: Journal of the International Neuromodulation Society
Artak E Kostanyan
The closed-loop recycling counter-current chromatography (CLR CCC) is performed in several consecutive separation stages. First, the loop is opened, and within a specified time the solution of solutes in the mobile phase is continuously fed to the column. After the solutes loading is finished, the loop is closed, and the first separation stage starts. After a certain number of cycles the first fraction of solutes is eluted, the loop is closed, and the second separation stage starts, and so on. In this study, simple equations are presented allowing the simulation of such separation processes...
October 14, 2016: Journal of Chromatography. A
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