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https://www.readbyqxmd.com/read/28325023/an-affordable-cuff-less-blood-pressure-estimation-solution
#1
Monika Jain, Niranjan Kumar, Sujay Deb
This paper presents a cuff-less hypertension pre-screening device that non-invasively monitors the Blood Pressure (BP) and Heart Rate (HR) continuously. The proposed device simultaneously records two clinically significant and highly correlated biomedical signals, viz., Electrocardiogram (ECG) and Photoplethysmogram (PPG). The device provides a common data acquisition platform that can interface with PC/laptop, Smart phone/tablet and Raspberry-pi etc. The hardware stores and processes the recorded ECG and PPG in order to extract the real-time BP and HR using kernel regression approach...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28323607/language-based-inequity-in-health-care-who-is-the-poor-historian
#2
Alexander R Green, Chijioke Nze
Patients with limited English proficiency (LEP) are among the most vulnerable populations. They experience high rates of medical errors with worse clinical outcomes than English-proficient patients and receive lower quality of care by other metrics. However, we have yet to take the issue of linguistic inequities seriously in the medical system and in medical education, tacitly accepting that substandard care is either unavoidable or not worth the cost to address. We argue that we have a moral imperative to provide high-quality care to patients with LEP and to teach our medical trainees that such care is both expected and feasible...
March 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28319551/a-contemporary-medicolegal-analysis-of-implanted-devices-for-chronic-pain-management
#3
Christopher R Abrecht, Penny Greenberg, Ellen Song, Richard D Urman, James P Rathmell
BACKGROUND: Analysis of closed malpractice claims allows the study of rare but serious complications and likely results in improved patient safety by raising awareness of such complications. Clinical studies and closed claims analyses have previously reported on the common complications associated with intrathecal drug delivery systems (IDDS) and spinal cord stimulators (SCS). This study provides a contemporary analysis of claims from within the past 10 years. METHODS: We performed a closed claims analysis for a period January 1, 2009 to December 31, 2013 for cases with pain medicine as the primary service...
April 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28319042/smartphone-application-for-mechanical-quality-assurance-of-medical-linear-accelerator
#4
Hwiyoung Kim, Hyunseok Lee, Jong In Park, Chang Heon Choi, So-Yeon Park, Hee Jung Kim, Young Suk Kim, Sung-Joon Ye
Mechanical quality assurance (QA) of medical linear accelerators consists of time consuming and human-error prone procedures. We developed a smartphone-application system for mechanical QA. The system consists of two smartphones; one attached to the gantry to obtain real-time information on mechanical parameters of medical linear accelerator, and the other to display the real-time information by bluetoothing the former. Motion sensors embedded in the smartphone were used to measure gantry and collimator rotations...
March 20, 2017: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/28318834/medical-errors-and-patient-safety-in-ophthalmology
#5
J J González-López, P Hernández-Martínez, F J Muñoz-Negrete
No abstract text is available yet for this article.
March 16, 2017: Archivos de la Sociedad Española de Oftalmología
https://www.readbyqxmd.com/read/28318505/machine-learning-in-the-prediction-of-cardiac-epicardial-and-mediastinal-fat-volumes
#6
É O Rodrigues, V H A Pinheiro, P Liatsis, A Conci
We propose a methodology to predict the cardiac epicardial and mediastinal fat volumes in computed tomography images using regression algorithms. The obtained results indicate that it is feasible to predict these fats with a high degree of correlation, thus alleviating the requirement for manual or automatic segmentation of both fat volumes. Instead, segmenting just one of them suffices, while the volume of the other may be predicted fairly precisely. The correlation coefficient obtained by the Rotation Forest algorithm using MLP Regressor for predicting the mediastinal fat based on the epicardial fat was 0...
February 24, 2017: Computers in Biology and Medicine
https://www.readbyqxmd.com/read/28316887/comparison-of-methods-of-alert-acknowledgement-by-critical-care-clinicians-in-the-icu-setting
#7
Andrew M Harrison, Charat Thongprayoon, Christopher A Aakre, Jack Y Jeng, Mikhail A Dziadzko, Ognjen Gajic, Brian W Pickering, Vitaly Herasevich
BACKGROUND: Electronic Health Record (EHR)-based sepsis alert systems have failed to demonstrate improvements in clinically meaningful endpoints. However, the effect of implementation barriers on the success of new sepsis alert systems is rarely explored. OBJECTIVE: To test the hypothesis time to severe sepsis alert acknowledgement by critical care clinicians in the ICU setting would be reduced using an EHR-based alert acknowledgement system compared to a text paging-based system...
2017: PeerJ
https://www.readbyqxmd.com/read/28314101/a-dielectrophoresis-system-for-testing-antimicrobial-susceptibility-of-gram-negative-bacteria-to-beta-lactam-antibiotics
#8
I-Hsiu Su, Wen-Chien Ko, Chung-Hsin Shih, Fang-Hao Yeh, Yung-Nien Sun, Jung-Chih Chen, Po-Lin Chen, Hsien-Chang Chang
Gram-negative bacteria (GNBs) are common pathogens causing severe sepsis. Rapid evaluation of drug susceptibility would guide effective antibiotic treatment, and promote life-saving. A total of 78 clinical isolates of 13 gram-negative species collected between April 2013 and November 2013 from two medical centers in Tainan were tested. Bacterial morphology changes in different concentrations of antibiotics were observed under the electric field of a quadruple electrode array using light microscopy. The minimal inhibitory concentrations (MICs) of four antimicrobial agents, namely cefazolin, ceftazidime, cefepime, and doripenem, were determined by the dielectrophoretic antimicrobial susceptibility testing (dAST) and by the conventional broth dilution testing (BDT)...
March 17, 2017: Analytical Chemistry
https://www.readbyqxmd.com/read/28306610/30-day-potentially-avoidable-readmissions-due-to-adverse-drug-events
#9
Olivia Dalleur, Patrick E Beeler, Jeffrey L Schnipper, Jacques Donzé
OBJECTIVE: To analyze the patterns of potentially avoidable readmissions due to adverse drug events (ADEs) to identify the most appropriate risk reduction interventions. METHODS: In this observational study, we analyzed a random sample of 534 potentially avoidable 30-day readmissions from 10,275 consecutive discharges from the medical department of an academic hospital. Readmissions due to ADEs were reviewed to identify the causative drugs and the severity and interventions to prevent them...
March 17, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28306589/older-adult-kidney-function-assessment-and-rounding-creatinine-led-to-medication-dosing-error
#10
Timothy Nguyen, Yanique Foster, Shpres Cekaj
BACKGROUND/AREAS OF UNCERTAINTY: Kidney function assessment in older adults can be unreliable because of many factors, and inaccurate assessment can lead to medication dosing error. Practitioners may have adopted the method of rounding creatinine to an arbitrary number 1.0 because of change in muscle mass and age-related change. This has in fact proven to cause more harm than good, potentially leading to underdosing of many medications. DATA SOURCES: A literature search performed using PubMed with the following key words (rounding serum creatinine, rounding serum creatinine AND pharmacist or pharmacy, rounding serum creatinine AND doctor or physician or healthcare, rounding serum creatinine AND kidney function) with no restrictions (dates or any other requirement)...
March 1, 2017: American Journal of Therapeutics
https://www.readbyqxmd.com/read/28302461/data-quality-in-institutional-arthroplasty-registries-description-of-a-model-of-validation-and-report-of-preliminary-results
#11
Maria P Bautista, Guillermo A Bonilla, Klaus W Mieth, Adolfo M Llinás, Fernanda Rodríguez, Laura L Cárdenas
BACKGROUND: Arthroplasty registries are a relevant source of information for research and quality improvement in patient care and its value depends on the quality of the recorded data. The purpose of this study is to describe a model of validation and present the findings of validation of an Institutional Arthroplasty Registry (IAR). METHODS: Information from 209 primary arthroplasties and revision surgeries of the hip, knee, and shoulder recorded in the IAR between March and September 2015 were analyzed in the following domains...
February 20, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28302112/automation-bias-in-electronic-prescribing
#12
David Lyell, Farah Magrabi, Magdalena Z Raban, L G Pont, Melissa T Baysari, Richard O Day, Enrico Coiera
BACKGROUND: Clinical decision support (CDS) in e-prescribing can improve safety by alerting potential errors, but introduces new sources of risk. Automation bias (AB) occurs when users over-rely on CDS, reducing vigilance in information seeking and processing. Evidence of AB has been found in other clinical tasks, but has not yet been tested with e-prescribing. This study tests for the presence of AB in e-prescribing and the impact of task complexity and interruptions on AB. METHODS: One hundred and twenty students in the final two years of a medical degree prescribed medicines for nine clinical scenarios using a simulated e-prescribing system...
March 16, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28298662/the-teg-%C3%A2-6s-on-shaky-ground-a-novel-assessment-of-the-teg-%C3%A2-6s-performance-under-a-challenging-condition
#13
Martin Gill
Thromboelastography(®) (TEG(®)) is used to guide clinical decision-making across many medical and surgical subspecialties. Advances in this field have resulted in analyzers becoming increasingly user friendly, and have led to a reduction in the possibility of user error. The new TEG(®)6s does not come with the warnings of vibration and movement avoidance of its predecessor. It was decided to test the capability of this device while being subject to motion. TEG(®)6s machine 1 was placed in an environment free from motion...
March 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/28298063/long-term-correction-in-sleep-disturbance-is-sustained-after-arthroscopic-rotator-cuff-repair
#14
John G Horneff, Fotios Tjoumakaris, Charles Wowkanech, Matthew Pepe, Bradford Tucker, Luke Austin
BACKGROUND: Sleep disturbance is a major complaint of patients with rotator cuff disease that often leads them to seek treatment. The authors previously reported a prospective analysis of patients who underwent rotator cuff repair and found that sleep disturbance significantly improved at 3 months after surgery. That improvement in sleep was maintained at 6 months. HYPOTHESIS: In the current study, the authors sought to gain medium-term data on this same population at greater than 2 years...
February 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28297451/radshield-semiautomated-shielding-design-using-a-floor-plan-driven-graphical-user-interface
#15
Matthew C DeLorenzo, Dee H Wu, Kai Yang, Isaac B Rutel
The purpose of this study was to introduce and describe the development of RadShield, a Java-based graphical user interface (GUI), which provides a base design that uniquely performs thorough, spatially distributed calculations at many points and reports the maximum air-kerma rate and barrier thickness for each barrier pursuant to NCRP Report 147 methodology. Semiautomated shielding design calculations are validated by two approaches: a geometry-based approach and a manual approach. A series of geometry-based equations were derived giving the maximum air-kerma rate magnitude and location through a first derivative root finding approach...
September 2016: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/28296002/game-of-hospitals
#16
Ruvini Vithanage, Benita Knox, Anna Ryan
BACKGROUND: Systems of health care is a key learning area in medical curricula. An understanding of the health care system with regards to reducing medical errors, improving efficiency in the provision of care and cost containment is recognised as being difficult to teach. CONTEXT: A game-based session was designed and executed as part of a medical student conference. This session incorporated numerous aspects of systems of health care, including teamwork, the efficient and equitable allocation of resources, safety, quality, medical errors, structure of health care systems and political influences in the delivery of health care...
March 13, 2017: Clinical Teacher
https://www.readbyqxmd.com/read/28295821/economic-impact-of-medication-error-a-systematic-review
#17
Elaine K Walsh, Christina Raae Hansen, Laura J Sahm, Patricia M Kearney, Edel Doherty, Colin P Bradley
PURPOSE: Medication error is a significant source of morbidity and mortality among patients. Clinical and cost-effectiveness evidence are required for the implementation of quality of care interventions. Reduction of error-related cost is a key potential benefit of interventions addressing medication error. The aim of this review was to describe and quantify the economic burden associated with medication error. METHODS: PubMed, Cochrane, Embase, CINAHL, EconLit, ABI/INFORM, Business Source Complete were searched...
March 13, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/28295413/using-a-handheld-stereo-depth-camera-to-overcome-limited-field-of-view-in-simulation-imaging-for-radiation-therapy-treatment-planning
#18
Cesare Jenkins, Lei Xing, Amy Yu
PURPOSE: A correct body contour is essential for reliable treatment planning in radiation therapy. While modern medical imaging technologies provide highly accurate patient modeling, there are times when a patient's anatomy cannot be fully captured or there is a lack of easy access to computed tomography (CT) simulation. Here we provide a practical solution to the surface contour truncation problem by using a handheld stereo depth camera (HSDC) to obtain the missing surface anatomy and a surface-surface image registration to stich the surface data into the CT dataset for treatment planning...
March 11, 2017: Medical Physics
https://www.readbyqxmd.com/read/28295324/effect-of-fetal-presentation-on-sonographic-estimation-of-fetal-weight-according-to-different-formulas
#19
Anat Shmueli, Amir Aviram, Ron Bardin, Arnon Wiznitzer, Rony Chen, Rinat Gabbay-Benziv
OBJECTIVE: To compare the accuracy of various sonographic estimation of fetal weight (sEFW) formulas for breech-presenting fetuses. METHODS: A retrospective analysis of sEFW performed within 3 days of delivery in a tertiary medical center in Israel between July 2007 and December 2014 was conducted. Breech-presenting singleton fetuses were matched by sex and birth weight to vertex-presenting fetuses. sEFW was calculated using 21 formulas. Systematic and random errors, proportion of estimates (POE) within 10% of actual birth weight, and reliability analysis were used to compare sonographic accuracy...
March 13, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28294462/disruption-of-white-matter-structural-integrity-and-connectivity-in-posttraumatic-stress-disorder-a-tbss-and-tractography-study
#20
Elizabeth A Olson, Jiaolong Cui, Rena Fukunaga, Lisa D Nickerson, Scott L Rauch, Isabelle M Rosso
BACKGROUND: Most studies of brain white matter (WM) in posttraumatic stress disorder (PTSD) have focused on combat trauma, and often were confounded by neurological and substance dependence comorbidity. This study used tract-based spatial statistics (TBSS) and probabilistic tractography to characterize WM microstructure in a mixed-sex community sample of PTSD patients exposed to diverse and multiple traumas, and in trauma-exposed normal comparison (TENC) subjects. METHODS: TBSS compared diffusion measures between 20 adults with DSM-IV PTSD and 17 TENC, using a whole-brain voxel-wise approach...
March 15, 2017: Depression and Anxiety
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