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https://www.readbyqxmd.com/read/28092800/effect-of-venepuncture-process-design-on-efficiency-and-failure-rates-a-simulation-model-study-for-secondary-care
#1
Sean Reed, Rasa Remenyte-Prescott, Ben Rees
BACKGROUND: Healthcare aims to deliver good patient outcomes. For many clinical procedures there are multiple alternative task sequences that can be performed. These deviations can influence procedure reliability, efficiency of usage of hospital resources and risk to staff and patient safety. Venepuncture is one of the most common invasive procedures in healthcare. Literature of clinical practice shows evidence of wide variability in the procedure order and the duration of each step, which can depend on attributes, such as patient health, sampling method and staff skills...
December 29, 2016: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28092496/the-effect-of-contrast-material-on-radiation-dose-at-ct-part-i-incorporation-of-contrast-material-dynamics-in-anthropomorphic-phantoms
#2
Pooyan Sahbaee, W Paul Segars, Daniele Marin, Rendon C Nelson, Ehsan Samei
Purpose To develop a method to incorporate the propagation of contrast material into computational anthropomorphic phantoms for estimation of organ dose at computed tomography (CT). Materials and Methods A patient-specific physiologically based pharmacokinetic (PBPK) model of the human cardiovascular system was incorporated into 58 extended cardiac-torso (XCAT) patient phantoms. The PBPK model comprised compartmental models of vessels and organs unique to each XCAT model. For typical injection protocols, the dynamics of the contrast material in the body were described according to a series of patient-specific iodine mass-balance differential equations, the solutions to which provided the contrast material concentration time curves for each compartment...
January 13, 2017: Radiology
https://www.readbyqxmd.com/read/28092136/computational-fluid-dynamic-modeling-of-nose-to-ceiling-head-positioning-for-sphenoid-sinus-irrigation
#3
John R Craig, James N Palmer, Kai Zhao
BACKGROUND: After sinus surgery, patients are commonly instructed to irrigate with saline irrigations with their heads over a sink and noses directed inferiorly (nose-to-floor). Although irrigations can penetrate the sinuses in this head position, no study has assessed whether sphenoid sinus penetration can be improved by irrigating with the nose directed superiorly (nose-to-ceiling). The purpose of this study was to use a validated computational fluid dynamics (CFD) model of sinus irrigations to assess the difference in sphenoid sinus delivery of irrigations after irrigating in a nose-to-floor vs nose-to-ceiling head position...
January 16, 2017: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/28091978/patient-specific-optimisation-of-administered-activity-and-acquisition-times-for-18-f-fdg-pet-imaging
#4
Fred Wickham, Helena McMeekin, Maria Burniston, Daniel McCool, Deborah Pencharz, Annah Skillen, Thomas Wagner
BACKGROUND: The purpose of this study is to identify a method for optimising the administered activity and acquisition time for (18)F-FDG PET imaging, yielding images of consistent quality for patients with varying body sizes and compositions, while limiting radiation doses to patients and staff. Patients referred for FDG scans had bioimpedance measurements. They were injected with 3 MBq/kg of (18)F up to 370 MBq and scanned on a Siemens Biograph mCT at 3 or 4 min per bed position...
December 2017: EJNMMI Research
https://www.readbyqxmd.com/read/28091966/aortic-regurgitation-generates-a-kinematic-obstruction-which-hinders-left-ventricular-filling
#5
Ikechukwu Okafor, Vrishank Raghav, Jose F Condado, Prem A Midha, Gautam Kumar, Ajit P Yoganathan
An incompetent aortic valve (AV) results in aortic regurgitation (AR), where retrograde flow of blood into the left ventricle (LV) is observed. In this work, we parametrically characterized the detailed changes in intra-ventricular flow during diastole as a result of AR in a physiological in vitro left-heart simulator (LHS). The loss of energy within the LV as the level of AR increased was also assessed. The validated LHS consisted of an optically-clear, flexible wall LV and a modular AV holder. Two-component, planar, digital particle image velocimetry was used to visualize and quantify intra-ventricular flow...
January 13, 2017: Annals of Biomedical Engineering
https://www.readbyqxmd.com/read/28091877/influence-of-enamel-dentin-thickness-on-the-toxic-and-esthetic-effects-of-experimental-in-office-bleaching-protocols
#6
C C de Oliveira Duque, D G Soares, F G Basso, J Hebling, C A de Souza Costa
OBJECTIVES: This paper aims to assess the whitening effectiveness and toxicity of tooth-bleaching protocols applied to enamel/dentin disks simulating mandibular incisors (ICs) and premolars (PMs). MATERIALS AND METHODS: A 10% hydrogen peroxide (H2O2) gel was applied for 3 × 15, 1 × 15, or 1 × 5 min to enamel/dentin disks simulating mandibular ICs and PMs, and the trans-enamel and trans-dentinal diffusion products were applied to human dental pulp cells (1 h)...
January 14, 2017: Clinical Oral Investigations
https://www.readbyqxmd.com/read/28091721/influence-of-tooth-dimension-on-the-initial-mobility-based-on-plaster-casts-and-x-ray-images-a-numerical-study
#7
Martin Hartmann, Cornelius Dirk, Susanne Reimann, Ludger Keilig, Anna Konermann, Andreas Jäger, Christoph Bourauel
AIMS: The goal was to determine the influence of different geometric parameters of the tooth on the initial tooth mobility and the position of the center of resistance employing numerical models based on scaled X-ray images and plaster casts. METHODS: The dimensions of tooth 21 were measured in 21 patients, using radiographs and dental casts. Length and mesiodistal width of the tooth were obtained from the X-ray image and the orovestibular diameter from the plaster cast...
January 13, 2017: Journal of Orofacial Orthopedics, Fortschritte der Kieferorthopädie
https://www.readbyqxmd.com/read/28091704/medical-students-medication-communication-skills-regarding-drug-prescription-a-qualitative-analysis-of-simulated-physician-patient-consultations
#8
Katarina Hauser, Jan Matthes
PURPOSE: Poor medication communication of physicians to patients is detrimental, e.g. for medication adherence. Reasons for physicians' deficits in medication communication may be unfavourable conditions in daily practice or already insufficient training during their (undergraduate) medical studies. We explored medical students' communication on new medications in simulated physician-patient conversations to identify actual deficits indicating apparent educational needs. METHODS: Fifth year medical students attending a mandatory course at the University of Cologne had simulated physician-patient consultations aiming at drug prescription...
January 14, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28090509/innovations-in-surgery-simulation-a-review-of-past-current-and-future-techniques
#9
REVIEW
Ido Badash, Karen Burtt, Carlos A Solorzano, Joseph N Carey
As a result of recent work-hours limitations and concerns for patient safety, innovations in extraclinical surgical simulation have become a desired part of residency education. Current simulation models, including cadaveric, animal, bench-top, virtual reality (VR) and robotic simulators are increasingly used in surgical training programs. Advances in telesurgery, three-dimensional (3D) printing, and the incorporation of patient-specific anatomy are paving the way for simulators to become integral components of medical training in the future...
December 2016: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28090108/a-process-for-curricular-improvement-based-on-evaluation-of-student-performance-on-milestone-examinations
#10
Marcy Hernick, Ann C Hylton, Michael Justice
Objective. To identify and address areas for curricular improvement by evaluating student achievement of expected learning outcomes and competencies on annual milestone examinations. Design. Students were tested each professional year with a comprehensive milestone examination designed to evaluate student achievement of learning outcomes and professional competencies using a combination of multiple-choice questions, standardized patient assessments (SPAs), and objective structured clinical examination (OSCE) questions...
November 25, 2016: American Journal of Pharmaceutical Education
https://www.readbyqxmd.com/read/28090107/developing-a-framework-for-objective-structured-clinical-examinations-using-the-nominal-group-technique
#11
Safeera Y Hussainy, Matthew F Crum, Paul J White, Ian Larson, Daniel T Malone, David T Manallack, Joseph A Nicolazzo, Jennifer McDowell, Angelina S Lim, Carl M Kirkpatrick
Objective. To use the nominal group technique to develop a framework to improve existing and develop new objective structured clinical examinations (OSCEs) within a four-year bachelor of pharmacy course. Design. Using the nominal group technique, a unique method of group interview that combines qualitative and quantitative data collection, focus groups were conducted with faculty members, practicing pharmacists, and undergraduate pharmacy students. Five draft OSCEs frameworks were suggested and participants were asked to generate new framework ideas...
November 25, 2016: American Journal of Pharmaceutical Education
https://www.readbyqxmd.com/read/28090106/an-interprofessional-simulation-using-the-sbar-communication-tool
#12
Matthew Kostoff, Crystal Burkhardt, Abigail Winter, Sarah Shrader
Objective. To determine the impact of an interprofessional simulation using the SBAR (situation-background-assessment-recommendation/request) communication tool on pharmacy students' self-perception of interprofessional competence and reactions towards interprofessional collaboration. Design. Ninety-six pharmacy students participated in an interprofessional simulation within a required applications-based capstone course. Pharmacy students collaborated with nursing students on multiple patient cases in various settings using the SBAR communication tool over the telephone...
November 25, 2016: American Journal of Pharmaceutical Education
https://www.readbyqxmd.com/read/28090102/virtual-patient-case-sharing-across-two-schools-of-pharmacy
#13
Michael A Smith, Laura A Siemianowski, Neal Benedict
Objective. To expand the use of virtual patients at 2 schools of pharmacy through virtual patient case sharing. Design. Faculty members at two schools of pharmacy collaborated to expand the use of virtual patients. Two simulation programs, vpSim and DecisionSim (Decision Simulation, LLC, Chadsford, PA), were used to create interactive patient cases for a required course and an elective course at the different schools. Each school developed cases for their own use and then shared the cases with the other school...
November 25, 2016: American Journal of Pharmaceutical Education
https://www.readbyqxmd.com/read/28089874/mathematical-modelling-of-cell-layer-growth-in-a-hollow-fibre-bioreactor
#14
Lloyd A C Chapman, Jonathan P Whiteley, Helen M Byrne, Sarah L Waters, Rebecca J Shipley
Generating autologous tissue grafts of a clinically useful volume requires efficient and controlled expansion of cell populations harvested from patients. Hollow fibre bioreactors show promise as cell expansion devices, owing to their potential for scale-up. However, further research is required to establish how to specify appropriate hollow fibre bioreactor operating conditions for expanding different cell types. In this study we develop a simple model for the growth of a cell layer seeded on the outer surface of a single fibre in a perfused hollow fibre bioreactor...
January 12, 2017: Journal of Theoretical Biology
https://www.readbyqxmd.com/read/28089763/comparison-of-multi-arm-multi-stage-design-and-adaptive-randomization-in-platform-clinical-trials
#15
REVIEW
Jianchang Lin, Veronica Bunn
Platforms trials are clinical trials that allow for concurrent evaluations of multiple treatments, thus allowing for more efficient and ethical studies compared to traditional two-arm trials. Conventional group-sequential multi-arm multi-stage (MAMS) designs use pre-specified stopping boundaries and treatment selection rules to determine if experimental treatments should be dropped. Flexible MAMS designs allow for interim modifications to the design plan without compromising error rates. Bayesian response adaptive randomization (BRAR) designs increase patient allocation to treatment arms that are performing well during the course of the trial...
January 12, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28089723/cost-effectiveness-of-the-decipher-genomic-classifier-to-guide-individualized-decisions-for-early-radiation-therapy-after-prostatectomy-for-prostate-cancer
#16
Jennifer M Lobo, Daniel M Trifiletti, Vanessa N Sturz, Adam P Dicker, Christine Buerki, Elai Davicioni, Matthew R Cooperberg, R Jeffrey Karnes, Robert B Jenkins, Robert B Den, Timothy N Showalter
BACKGROUND: Controversy exists regarding the effectiveness of early adjuvant versus salvage radiation therapy after prostatectomy for prostate cancer. Estimates of prostate cancer progression from the Decipher genomic classifier (GC) could guide informed decision-making and improve the outcomes for patients. MATERIALS AND METHODS: We developed a Markov model to compare the costs and quality-adjusted life years (QALYs) associated with GC-based treatment decisions regarding adjuvant therapy after prostatectomy with those of 2 control strategies: usual care (determined from patterns of care studies) and the alternative of 100% adjuvant radiation therapy...
August 17, 2016: Clinical Genitourinary Cancer
https://www.readbyqxmd.com/read/28089607/estimates-of-nasal-airflow-at-the-nasal-cycle-mid-point-improve-the-correlation-between-objective-and-subjective-measures-of-nasal-patency
#17
Courtney Gaberino, John S Rhee, Guilherme J M Garcia
INTRODUCTION: The nasal cycle represents a significant challenge when comparing pre- and post-surgery objective measures of nasal airflow. METHODS: Computational fluid dynamics (CFD) simulations of nasal airflow were conducted in 12 nasal airway obstruction patients showing significant nasal cycling between pre- and post-surgery computed tomography scans. To correct for the nasal cycle, mid-cycle models were created virtually. Subjective scores of nasal patency were obtained via the Nasal Obstruction Symptom Evaluation (NOSE) and unilateral visual analog scale (VAS)...
January 9, 2017: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/28089562/sequential-multiple-assignment-randomized-trials-an-opportunity-for-improved-design-of-stroke-reperfusion-trials
#18
William J Meurer, Nicholas J Seewald, Kelley Kidwell
BACKGROUND: Modern clinical trials in stroke reperfusion fall into 2 categories: alternative systemic pharmacological regimens to alteplase and "rescue" endovascular approaches using targeted thrombectomy devices and/or medications delivered directly for persistently occluded vessels. Clinical trials in stroke have not evaluated how initial pharmacological thrombolytic management might influence subsequent rescue strategy. A sequential multiple assignment randomized trial (SMART) is a novel trial design that can test these dynamic treatment regimens and lead to treatment guidelines that more closely mimic practice...
January 12, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28089485/perceptual-error-analysis-of-human-and-synthesized-voices
#19
Marina Englert, Glaucya Madazio, Ingrid Gielow, Jorge Lucero, Mara Behlau
OBJECTIVE/HYPOTHESIS: To assess the quality of synthesized voices through listeners' skills in discriminating human and synthesized voices. STUDY DESIGN: Prospective study. METHODS: Eighteen human voices with different types and degrees of deviation (roughness, breathiness, and strain, with three degrees of deviation: mild, moderate, and severe) were selected by three voice specialists. Synthesized samples with the same deviations of human voices were produced by the VoiceSim system...
January 12, 2017: Journal of Voice: Official Journal of the Voice Foundation
https://www.readbyqxmd.com/read/28089362/clinical-pharmacokinetics-of-oral-levofloxacin-and-sitafloxacin-in%C3%A2-epididymal-tissue
#20
Takuya Sadahira, Koichiro Wada, Kazuro Ikawa, Norifumi Morikawa, Hiroaki Kurahashi, Takashi Yoshioka, Yuichi Ariyoshi, Yasuyuki Kobayashi, Motoo Araki, Ayano Ishii, Masami Watanabe, Shinya Uehara, Toyohiko Watanabe, Yasutomo Nasu
OBJECTIVES: This study aimed to investigate the penetration of fluoroquinolones into human epididymal tissue. METHODS: The penetration of levofloxacin (LVFX) 500 mg or sitafloxacin (STFX) 100 mg into epididymal tissue was examined. Patients with prostate cancer who were referred for orchiectomy were included. LVFX 500 mg (n = 9) or STFX 100 mg (n = 9) was administered orally 1 h before orchiectomy, and 0.5 g of epididymal tissue and blood samples were collected simultaneously during surgery...
January 11, 2017: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
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