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Simulated patients

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https://www.readbyqxmd.com/read/28944961/two-case-studies-on-how-study-designs-can-be-made-more-informative-using-modeling-and-simulation-approaches
#1
Philip J Lowe, Martin Fink, Mark N Milton
Drug development should extract maximum information from experiments with minimized exposure of patients or experimental animals to invasive procedures and potentially harmful effects with minimized investment of time and money. Herein, two aspects of study design are explored illustrating how information can be extracted more efficiently by investigating a range of exposures within each individual by either following responses as drug concentrations decline or by within-individual dose escalation, rather than relying on steady-state cross-sectional analyses...
September 25, 2017: Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28944759/optimization-of-an-ultralow-dose-high-resolution-pediatric-pet-scanner-design-based-on-monolithic-scintillators-with-dual-sided-digital-sipm-readout-a-simulation-study
#2
Ekaterina Mikhaylova, Valerio Tabacchini, Giacomo Borghi, Pieter Mollet, Ester D'Hoe, Dennis R Schaart, Stefaan Vandenberghe
The goal of this simulation study is the performance evaluation and comparison of six potential designs for a time-of-flight PET scanner for pediatric patients of up to about 12 years of age. It is designed to have a high sensitivity and provide high-contrast and high-resolution images. The simulated pediatric PET is a full ring scanner, consisting of 32 × 32 mm<sup>2</sup> monolithic LYSO:Ce crystals coupled to digital silicon photomultiplier (dSiPM) arrays. The six considered designs differ in axial lengths (27...
September 25, 2017: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/28944706/flexible-lateral-isocenter-a-novel-mechanical-functionality-contributing-to-dose-reduction-in-neurointerventional-procedures
#3
Ljubisa Borota, Andreas Patz
Aim of the study A new functionality that enables vertical mobility of the lateral arm of a biplane angiographic machine is referred to as the flexible lateral isocenter. The aim of this study was to analyze the impact of the flexible lateral isocenter on the air-kerma rate under experimental conditions. Material and methods An anthropomorphic head-and-chest phantom with anteroposterior (AP) diameter of the chest varying from 22 cm to 30 cm simulated human bodies of different body constitutions. The angulation of the AP arm in the sagittal plane varied from 35 degrees to 55 degrees for each AP diameter...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28944107/ensemble-molecular-dynamics-of-a-protein-ligand-complex-residual-inhibitor-entropy-enhances-drug-potency-in-butyrylcholinesterase
#4
Eric J Sorin, Walter Alvarado, Samantha Cao, Amethyst Radcliffe, Phuc La, Yi An
Butyrylcholinesterase is a key enzyme that catalyzes the hydrolysis of the neurotransmitter acetylcholine and shows an increased activity in patients suffering from Alzheimer's disease (AD), making this enzyme a primary target in treating AD. Central to this problem, and to similar scenarios involving biomolecular recognition, is our understanding of the nature of the protein-ligand complex. The butyrylcholinesterase enzyme was studied via all-atom, explicit solvent, ensemble molecular dynamics simulations sans inhibitor and in the presence of three dialkyl phenyl phosphate inhibitors of known potency to a cumulative sampling of over 40 μs...
2017: Bioenergetics: Open Access
https://www.readbyqxmd.com/read/28943699/practical-implementation-of-channelized-hotelling-observers-effect-of-roi-size
#5
Andrea Ferrero, Christopher P Favazza, Lifeng Yu, Shuai Leng, Cynthia H McCollough
Fundamental to the development and application of channelized Hotelling observer (CHO) models is the selection of the region of interest (ROI) to evaluate. For assessment of medical imaging systems, reducing the ROI size can be advantageous. Smaller ROIs enable a greater concentration of interrogable objects in a single phantom image, thereby providing more information from a set of images and reducing the overall image acquisition burden. Additionally, smaller ROIs may promote better assessment of clinical patient images as different patient anatomies present different ROI constraints...
March 2017: Proceedings of SPIE
https://www.readbyqxmd.com/read/28943681/robust-treatment-comparison-based-on-utilities-of-semi-competing-risks-in-non-small-cell-lung-cancer
#6
Thomas A Murray, Peter F Thall, Ying Yuan, Sarah McAvoy, Daniel R Gomez
A design is presented for a randomized clinical trial comparing two second-line treatments, chemotherapy versus chemotherapy plus reirradiation, for treatment of recurrent non-small-cell lung cancer. The central research question is whether the potential efficacy benefit that adding reirradiation to chemotherapy may provide justifies its potential for increasing the risk of toxicity. The design uses two co-primary outcomes: time to disease progression or death, and time to severe toxicity. Because patients may be given an active third-line treatment at disease progression that confounds second-line treatment effects on toxicity and survival following disease progression, for the purpose of this comparative study follow-up ends at disease progression or death...
2017: Journal of the American Statistical Association
https://www.readbyqxmd.com/read/28943140/hospital-to-home-a-quality-improvement-initiative-to-implement-high-fidelity-simulation-training-for-caregivers-of-children-requiring-long-term-mechanical-ventilation
#7
Jodi Thrasher, Joyce Baker, Kathleen M Ventre, Sara E Martin, Jessica Dawson, Roberta Cox, Heather M Moore, Sarah Brethouwer, Sharon Sables-Baus, Christopher D Baker
BACKGROUND: Preparing families of children requiring long-term mechanical ventilation (LTMV) to manage medical emergencies at home is challenging. Opportunities for family caregivers to rehearse crisis management in a controlled setting before discharge are limited. OBJECTIVE: We aimed to create a multimodal discharge preparedness curriculum, incorporating high-fidelity simulation training, to prepare family caregivers of children with complex medical conditions requiring long-term mechanical ventilation...
September 21, 2017: Journal of Pediatric Nursing
https://www.readbyqxmd.com/read/28943130/estimation-and-reduction-of-the-radiation-dose-to-the-fetus-from-external-beam-radiotherapy
#8
REVIEW
Michalis Mazonakis, John Damilakis
The appearance of a malignant disease during pregnancy is relatively rare. The use of external-beam radiation therapy is limited to non-pelvic tumors which are usually located above the diaphragm. However, supradiaphragmatic radiotherapy unavoidably exposes the fetus to secondary radiation due to head leakage, scatter from the machine and scatter produced inside the patient. This fetal exposure may be associated with an elevated risk for the development of deterministic harmful effects and/or carcinogenesis...
September 21, 2017: Physica Medica: PM
https://www.readbyqxmd.com/read/28942677/a-novel-device-for-intraoperative-photodynamic-therapy-dedicated-to-glioblastoma-treatment
#9
Clément Dupont, Serge Mordon, Pascal Deleporte, Nicolas Reyns, Maximilien Vermandel
AIM: Photodynamic therapy (PDT) appears to be a valuable new treatment modality for cancer therapy. Studies have reported successful application of PDT for glioblastoma. Here, we introduce a new device dedicated to intraoperative PDT delivered early after fluoro-guided resection combined with a transfer function that determines the treatment time based on the size of the surgical resection cavity. MATERIALS & METHODS: First, we describe the device, which is composed of a trocar, a balloon filled with a diffusing solution, and a fiber guide in which a cylindrical light diffuser is inserted...
September 25, 2017: Future Oncology
https://www.readbyqxmd.com/read/28942270/tracking-dynamic-tongue-motion-in-ultrasound-images-for-obstructive-sleep-apnea
#10
Chih-Yen Chien, Jeng-Wen Chen, Chun-Hsiang Chang, Chih-Chung Huang
Obstructive sleep apnea (OSA), a breathing disorder characterized by repetitive collapse of the pharyngeal airway during sleep, can cause intermittent hypoxemia and frequent arousal. The evaluation of dynamic tongue motion not only provides the biomechanics and pathophysiology for OSA diagnosis, but also helps doctors to determine treatment strategies for these patients with OSA. The purpose of this study was to develop and verify a dedicated tracking algorithm, called the modified optical flow (OF)-based method, for monitoring the dynamic motion of the tongue base in ultrasound image sequences derived from controls and patients with OSA...
September 20, 2017: Ultrasound in Medicine & Biology
https://www.readbyqxmd.com/read/28942268/computational-fluid-dynamics-and-additive-manufacturing-to-diagnose-and-treat-cardiovascular-disease
#11
REVIEW
Amanda Randles, David H Frakes, Jane A Leopold
Noninvasive engineering models are now being used for diagnosing and planning the treatment of cardiovascular disease. Techniques in computational modeling and additive manufacturing have matured concurrently, and results from simulations can inform and enable the design and optimization of therapeutic devices and treatment strategies. The emerging synergy between large-scale simulations and 3D printing is having a two-fold benefit: first, 3D printing can be used to validate the complex simulations, and second, the flow models can be used to improve treatment planning for cardiovascular disease...
September 20, 2017: Trends in Biotechnology
https://www.readbyqxmd.com/read/28942199/metabolomic-findings-in-sepsis-as-a-damage-of-host-microbial-metabolism-integration
#12
REVIEW
Natalia V Beloborodova, Andrei Yu Olenin, Alisa K Pautova
Metabolomics globally evaluates the totality of the endogenous metabolites in patient's body, at the same time reflecting gene function, enzyme activity and degree of organ dysfunction in sepsis. The authors performed the analysis of the main chemical classes of low molecular weight compounds (amino acids, polyols, fatty acids, hydroxy acids, amines, nucleotides and their derivatives) that quantitatively distinguish patients with sepsis from healthy ones. The following keywords were used to find papers published in the Scopus and Web of Science databases from 2008 to 2015: (marker OR biomarker) AND (sepsis OR critical ill OR pneumonia OR hypoxia)...
September 15, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28942053/modelling-with-a-meshfree-approach-the-cornea-aqueous-humor-interaction-during-the-air-puff-test
#13
Andrea Montanino, Maurizio Angelillo, Anna Pandolfi
The air puff test is an in-vivo investigative procedure commonly utilized in ophthalmology to estimate the intraocular pressure. Potentially the test, quick and painless, could be combined with inverse analysis methods to characterize the patient-specific mechanical properties of the human cornea. A rapid localized air jet applied on the anterior surface induces the inward motion of the cornea, that interacts with aqueous humor-the fluid filling the narrow space between cornea and iris-with a strong influence on the dynamics of the cornea...
September 14, 2017: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/28941830/experimental-and-computational-study-of-the-effect-of-breath-actuated-mechanism-built-in-the-nexthaler-%C3%A2-dry-powder-inhaler
#14
Árpád Farkas, David Lewis, Tanya Church, Alan Tweedie, Francesca Mason, Allen E Haddrell, Jonathan P Reid, Alpár Horváth, Imre Balásházy
The breath-actuated mechanism (BAM) is a mechanical unit included in NEXThaler(®) with the role of delaying the emission of the drug until the inhalation flow rate of the patient is sufficiently high to detach the drug particles from their carriers. The main objective of this work was to analyse the effect of the presence of BAM on the size distribution of the emitted drug and its airway deposition efficiency and distribution. Study of the hygroscopic growth of the emitted drug particles and its effect on the deposition was another goal of this study...
September 20, 2017: International Journal of Pharmaceutics
https://www.readbyqxmd.com/read/28941736/a-prognostic-tool-to-predict-outcomes-in-children-undergoing-the-norwood-operation
#15
Punkaj Gupta, Avishek Chakraborty, Jeffrey M Gossett, Mallikarjuna Rettiganti
OBJECTIVES: To create and validate a prediction model to assess outcomes associated with the Norwood operation. METHODS: The public-use dataset from a multicenter, prospective, randomized single-ventricle reconstruction trial was used to create this novel prediction tool. A Bayesian lasso logistic regression model was used for variable selection. We used a hierarchical framework by representing discrete probability models with continuous latent variables that depended on the risk factors for a particular patient...
August 30, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28941280/optimizing-the-amount-of-simulation-training-used-to-teach-vaginal-delivery-skills-to-medical-students
#16
Joshua F Nitsche, Timberly Butler, Alison Shew, Sha Jin, Brian C Brost
OBJECTIVE: To determine the amount of simulation training required for students to attain minimal competence and mastery of a vaginal delivery. METHODS: An observational study was conducted at a US medical school between May 11, 2015, and May 8, 2016. Using a modified Angoff method, 10 members of the Obstetrics and Gynecology faculty evaluated a vaginal delivery procedural checklist and established cutoff scores for minimal competence and mastery. During a 5-week period, all third-year students received between two and five 45-minute vaginal delivery simulation sessions; performance was assessed at week 6...
September 23, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28941247/wear-testing-of-a-canine-hip-resurfacing-implant-using-highly-cross-linked-polyethylene
#17
Kevin J Warburton, John B Everingham, Jillian L Helms, Andrew J Kazanovicz, Katherine A Hollar, Jeff D Brourman, Steven M Fox, Trevor J Lujan
Hip resurfacing offers advantages for young active patients afflicted with hip osteoarthritis, and may also be a beneficial treatment for adult canines. Conventional hip resurfacing uses metal-on-metal bearings to preserve bone stock, but it may be feasible to use metal-on-polyethylene bearings to reduce metal wear debris, while still preserving bone. This study characterized the short-term wear behavior of a novel hip resurfacing implant for canines that uses a 1.5 mm thick liner of highly cross-linked polyethylene in the acetabular component...
September 23, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/28941232/engineering-cardiovascular-implant-surfaces-to-create-a-vascular-endothelial-growth-microenvironment
#18
Jingan Li, Kun Zhang, Nan Huang
Cardiovascular disease is generally accepted as the leading cause of morbidity and mortality worldwide, and an increasing number of patients suffer from atherosclerosis and thrombosis annually. To treat these disorders and prolong the sufferers' life, several cardiovascular implants have been developed and applied clinically. Nevertheless, thrombosis and hyperplasia at the site of cardiovascular implants are recognized as long-term problems in the practice of interventional cardiology. Here, we start this review from the clinical requirement of the implants, such as anti-hyperplasia, anti-thrombosis and pro-endothelialization, wherein particularly focus on the natural factors which influence functional endothelialization in situ, including the healthy smooth muscle cells (SMCs) environment, blood flow shear stress (BFSS) and the extracellular matrix (ECM) microenvironment...
September 23, 2017: Biotechnology Journal
https://www.readbyqxmd.com/read/28941221/how-well-do-rheumatology-fellows-manage-acute-infusion-reactions-a-pilot-curricular-intervention
#19
Jason J Weiner, Amanda M Eudy, Lisa G Criscione-Schreiber
BACKGROUND: Infusible DMARDs are commonly prescribed in rheumatology and other fields. There are no published formal educational curricula rheumatology fellowship programs can use to teach infusion reaction management skills to fellows. We aimed to better understand this educational gap, and implement and assess the effectiveness of an experiential curriculum on acute infusion reaction management. METHODS: We included current rheumatology fellows and recent graduates from five fellowship programs...
September 21, 2017: Arthritis Care & Research
https://www.readbyqxmd.com/read/28940776/influence-of-collars-on-the-primary-stability-of-cementless-femoral-stems-a-finite-element-study-using-a-diverse-patient-cohort
#20
Rami M A Al-Dirini
For cementless femoral stems, there is debate as to whether a collar enhances primary stability and load transfer compared to collarless designs. Finite Element (FE) analysis has the potential to compare stem designs within the same cohort, allowing for subtle performance differences to be identified, if present. Subject-specific FE models of intact and implanted femora were run for a diverse cohort (21 males, 20 females; BMI 16.4-41.2 kg.m(-2) , age 50-80yrs). Collared and collarless versions of Corail® (DePuy Synthes) were sized and positioned using an automated algorithm that aligns the femoral/stem axes, preserves the head-centre location and maximises metaphyseal fit...
September 21, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
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