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https://www.readbyqxmd.com/read/28637090/early-warning-systems-and-rapid-response-to-the-deteriorating-patient-in-hospital-a-realist-evaluation
#1
Jennifer Mcgaughey, Peter O'Halloran, Sam Porter, John Trinder, Bronagh Blackwood
AIM: To identify those contexts and mechanisms that enable or constrain the implementation of Rapid Response Systems on acute general hospital wards to recognise and respond to patient deterioration. BACKGROUND: Rapid Response Systems allow deteriorating patients to be recognised using Early Warning Systems, referred early via escalation protocols and managed at the bedside by competent staff. DESIGN: Realist Evaluation. METHODS: The research design was an embedded multiple case study approach of four wards in two hospitals in Northern Ireland which followed the principles of Realist Evaluation...
June 21, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28636811/performance-evaluation-of-gpu-parallelization-space-time-adaptive-algorithms-and-their-combination-for-simulating-cardiac-electrophysiology
#2
Rafael S Oliveira, Bernardo M Rocha, Denise Burgarelli, Wagner Meira, Christakis Constantinides, Rodrigo Weber Dos Santos
The use of computer models as a tool for the study and understanding of the complex phenomena of cardiac electrophysiology has attained increased importance nowadays. At the same time, the increased complexity of the biophysical processes translates into complex computational and mathematical models. In order to speed up cardiac simulations and to allow more precise and realistic uses, two different techniques have been traditionally exploited: parallel computing and sophisticated numerical methods. In this work, we combine a modern parallel computing technique based on multicore and graphics processing units (GPUs), and a sophisticated numerical method based on a new space-time adaptive algorithm...
June 21, 2017: International Journal for Numerical Methods in Biomedical Engineering
https://www.readbyqxmd.com/read/28635678/evaluation-of-classifier-performance-for-multiclass-phenotype-discrimination-in-untargeted-metabolomics
#3
Patrick J Trainor, Andrew P DeFilippis, Shesh N Rai
Statistical classification is a critical component of utilizing metabolomics data for examining the molecular determinants of phenotypes. Despite this, a comprehensive and rigorous evaluation of the accuracy of classification techniques for phenotype discrimination given metabolomics data has not been conducted. We conducted such an evaluation using both simulated and real metabolomics datasets, comparing Partial Least Squares-Discriminant Analysis (PLS-DA), Sparse PLS-DA, Random Forests, Support Vector Machines (SVM), Artificial Neural Network, k-Nearest Neighbors (k-NN), and Naïve Bayes classification techniques for discrimination...
June 21, 2017: Metabolites
https://www.readbyqxmd.com/read/28634114/peanut-digestome-identification-of-digestion-resistant-ige-binding-peptides
#4
Luigia Di Stasio, Gianluca Picariello, Mariantonietta Mongiello, Rita Nocerino, Roberto Berni Canani, Simona Bavaro, Linda Monaci, Pasquale Ferranti, Gianfranco Mamone
Stability to proteolytic degradation in the digestive tract is considered a general feature shared by most food allergens. Current digestibility models exclusively utilize purified allergen proteins, neglecting the relevant effects of matrix that occur for foodstuff systems. In the present study, we investigated digestion stability of the major peanut allergens directly in the natural matrix using an in vitro static model that simulates the gastrointestinal digestion including the oral, gastric, duodenal and intestinal (brush border membrane enzymes) phases...
June 17, 2017: Food and Chemical Toxicology
https://www.readbyqxmd.com/read/28633933/trajectories-of-self-evaluation-bias-in-primary-and-secondary-school-parental-antecedents-and-academic-consequences
#5
Arielle Bonneville-Roussy, Thérèse Bouffard, Carole Vezeau
Using a longitudinal approach spanning nine years of children's formal education, this study investigated the developmental trajectories of self-evaluation bias of academic competence. The study also examined how parenting styles were associated with the trajectories of bias in mid-primary school, and how those trajectories predicted academic outcomes at the end of secondary school and the beginning of college. A total of 711 children in 4th and 5th grades (mean age=10.71years old; 358 girls) participated in this study...
August 2017: Journal of School Psychology
https://www.readbyqxmd.com/read/28633225/patient-specific-simulation-of-endovascular-thoracic-aortic-repair-initial-experience
#6
Liesbeth M Desender, Isabelle Van Herzeele, Zoran Rancic, Colin Bicknell, Ignatios Zairis, Frank E Vermassen, John H Rundback
PURPOSE: Endovascular thoracic aortic repair (TEVAR) has become the treatment modality of diverse aortic pathology. We report the use of patient-specific simulation using a dedicated PROcedure Rehearsal Studio (PRS) platform (Simbionix USA Corp, Cleveland, OH) before TEVAR and evaluate the feasibility and realism of this technology. DESCRIPTION: Virtual three-dimensional models of the patient's relevant anatomy were reconstructed from computed tomography data. PRS was used in 2 patients before TEVAR...
July 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28632593/functional-and-radiographic-outcomes-following-growth-sparing-management-of-early-onset-scoliosis
#7
Charles E Johnston, Dong-Phuong Tran, Anna McClung
BACKGROUND: In this study, we sought to evaluate radiographic, functional, and quality-of-life outcomes of patients who have completed growth-sparing management of early-onset scoliosis. METHODS: This prospective study involved patients with early-onset scoliosis who underwent growth-sparing treatment and either "final" fusion or observation for ≥2 years since the last lengthening procedure. Demographics, radiographic parameters, pulmonary function test (PFT) values, and scores of patient-reported assessments (Early-Onset Scoliosis Questionnaire [EOSQ] and Scoliosis Research Society [SRS]-30) were obtained...
June 21, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28632306/analytical-modeling-provides-new-insight-into-complex-mutual-coupling-between-surface-loops-at-ultrahigh-fields
#8
N I Avdievich, A Pfrommer, I A Giapitzakis, A Henning
Ultrahigh-field (UHF) (≥7 T) transmit (Tx) human head surface loop phased arrays improve both the Tx efficiency (B1(+) /√P) and homogeneity in comparison with single-channel quadrature Tx volume coils. For multi-channel arrays, decoupling becomes one of the major problems during the design process. Further insight into the coupling between array elements and its dependence on various factors can facilitate array development. The evaluation of the entire impedance matrix Z for an array loaded with a realistic voxel model or phantom is a time-consuming procedure when performed using electromagnetic (EM) solvers...
June 20, 2017: NMR in Biomedicine
https://www.readbyqxmd.com/read/28629409/correlation-between-knowledge-on-transmission-and-prevention-of-hiv-sti-and-proficiency-in-condom-use-among-male-migrants-from-africa-and-middle-east-evaluated-by-a-condom-use-skills-score-using-a-wooden-penile-model
#9
Fabio Zoboli, Domenico Martinelli, Mariantonietta Di Stefano, Massimo Fasano, Rosa Prato, Teresa Antonia Santantonio, Jose' Ramòn Fiore
BACKGROUND: Migrants in Italy are prevalently young adults, with a higher risk of sexual transmitted infections (STI) and HIV infection. Promoting consistent as well as correct use of condoms could reduce failure rate due to their improper use. The aim of our study was to evaluate Condom Use Skills among a migrant population recently landed in Italy, hosted in a government center for asylum seekers. METHODS: The study sample was composed of 80 male migrants. Sanitary trained interviewers submitted a questionnaire to participants to investigate age, provenience, marital status, educational level and knowledge about transmission and prevention of HIV/STI...
June 19, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28624045/a-comparison-of-a-homemade-central-line-simulator-to-commercial-models
#10
Rebecca F Brown, Christopher Tignanelli, Joanna Grudziak, Shelley Summerlin-Long, Jeffrey Laux, Andy Kiser, Sean P Montgomery
BACKGROUND: Simulation is quickly becoming vital to resident education, but commercially available central line models are costly and little information exists to evaluate their realism. This study compared an inexpensive homemade simulator to three commercially available simulators and rated model characteristics. MATERIALS AND METHODS: Seventeen physicians, all having placed >50 lines in their lifetime, completed blinded central line insertions on three commercial and one homemade model (made of silicone, tubing, and a pressurized pump system)...
June 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28621882/exercise-capacity-and-functional-performance-in-heart-failure-patients-supported-by-a-left-ventricular-assist-device-at-discharge-from-inpatient-rehabilitation
#11
Thomas Schmidt, Birna Bjarnason-Wehrens, Petra Bartsch, Ezin Deniz, Jan Schmitto, Sebastian Schulte-Eistrup, Detlev Willemsen, Nils Reiss
Adequate physical and functional performance is an important prerequisite for renewed participation and integration in self-determined private and (where appropriate) professional lives following left ventricular assist device (LVAD) implantation. During cardiac rehabilitation (CR), individually adapted exercise programs aim to increase exercise capacity and functional performance. A retrospective analysis of cardiopulmonary exercise capacity and functional performance in LVAD patients at discharge from a cardiac rehabilitation program was conducted...
June 16, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28619459/reflections-on-experiential-learning-in-evaluation-capacity-building-with-a-community-organization-dancing-with-parkinson-s
#12
April Nakaima, Sanjeev Sridharan
This paper discusses what was learned about evaluation capacity building with community organizations who deliver services to individuals with neurological disorders. Evaluation specialists engaged by the Ontario Brain Institute Evaluation Support Program were paired with community organizations, such as Dancing With Parkinson's. Some of the learning included: relationship building is key for this model of capacity building; community organizations often have had negative experiences with evaluation and the idea that evaluations can be friendly tools in implementing meaningful programs is one key mechanism by which such an initiative can work; community organizations often need evaluation most to be able to demonstrate their value; a strength of this initiative was that the focus was not just on creating products but mostly on developing a learning process in which capacities would remain; evaluation tools and skills that organizations found useful were developing a theory of change and the concept of heterogeneous mechanisms (informed by a realist evaluation lens)...
May 8, 2017: Evaluation and Program Planning
https://www.readbyqxmd.com/read/28610631/simulation-of-complex-data-structures-for-planning-of-studies-with-focus-on-biomarker-comparison
#13
Andreas Schulz, Daniela Zöller, Stefan Nickels, Manfred E Beutel, Maria Blettner, Philipp S Wild, Harald Binder
BACKGROUND: There are a growing number of observational studies that do not only focus on single biomarkers for predicting an outcome event, but address questions in a multivariable setting. For example, when quantifying the added value of new biomarkers in addition to established risk factors, the aim might be to rank several new markers with respect to their prediction performance. This makes it important to consider the marker correlation structure for planning such a study. Because of the complexity, a simulation approach may be required to adequately assess sample size or other aspects, such as the choice of a performance measure...
June 13, 2017: BMC Medical Research Methodology
https://www.readbyqxmd.com/read/28609643/training-techniques-for-visual-search-in-complex-task-environments
#14
Svyatoslav Guznov, Gerald Matthews, Joel S Warm, Marc Pfahler
OBJECTIVE: The goal for this study was to evaluate several visual search training techniques in an unmanned aerial vehicle (UAV) simulated task environment. BACKGROUND: Operators controlling remote unmanned vehicles often must perform complex visual search tasks (e.g., target search). These tasks may pose substantial demands on the operator due to various environmental factors. Visual search training may reduce errors and mitigate stress, but the most effective form of training has not been determined...
June 1, 2017: Human Factors
https://www.readbyqxmd.com/read/28608361/using-poisson-gamma-model-to-evaluate-the-duration-of-recruitment-process-when-historical-trials-are-available
#15
Nathan Minois, Valérie Lauwers-Cances, Stéphanie Savy, Michel Attal, Sandrine Andrieu, Vladimir Anisimov, Nicolas Savy
At the design of clinical trial operation, a question of a paramount interest is how long it takes to recruit a given number of patients. Modelling the recruitment dynamics is the necessary step to answer this question. Poisson-gamma model provides very convenient, flexible and realistic approach. This model allows predicting the trial duration using data collected at an interim time with very good accuracy. A natural question arises: how to evaluate the parameters of recruitment model before the trial begins? The question is harder to handle as there are no recruitment data available for this trial...
June 12, 2017: Statistics in Medicine
https://www.readbyqxmd.com/read/28607506/cost-effectiveness-of-pharmacogenetic-guided-treatment-are-we-there-yet
#16
REVIEW
M Verbelen, M E Weale, C M Lewis
Pharmacogenetics (PGx) has the potential to personalize pharmaceutical treatments. Many relevant gene-drug associations have been discovered, but PGx-guided treatment needs to be cost-effective as well as clinically beneficial to be incorporated into standard health-care. We reviewed economic evaluations for PGx associations listed in the US Food and Drug Administration (FDA) Table of Pharmacogenomic Biomarkers in Drug Labeling. We determined the proportion of evaluations that found PGx-guided treatment to be cost-effective or dominant over the alternative strategies, and estimated the impact on this proportion of removing the cost of genetic testing...
June 13, 2017: Pharmacogenomics Journal
https://www.readbyqxmd.com/read/28603907/a-randomised-controlled-trial-evaluating-a-low-cost-3d-printed-bronchoscopy-simulator
#17
T H Pedersen, J Gysin, A Wegmann, M Osswald, S R Ott, L Theiler, R Greif
Low-fidelity, simulation-based psychomotor skills training is a valuable first step in the educational approach to mastering complex procedural skills. We developed a cost-effective bronchial tree simulator based on a human thorax computed tomography scan using rapid-prototyping (3D-print) technology. This randomised, single-blind study evaluated how realistic our 3D-printed simulator would mimic human anatomy compared with commercially available bronchial tree simulators (Laerdal(®) Airway Management Trainer with Bronchial Tree and AirSim Advance Bronchi, Stavanger, Norway)...
June 12, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28603876/patients-and-family-caregivers-understanding-of-the-cancer-stage-treatment-goal-and-chance-of-cure-a-study-with-patient-caregiver-physician-triad
#18
Dong Wook Shin, Juhee Cho, So Young Kim, Hyung Kook Yang, Keeho Park, Sun-Seog Kweon, Dai Ha Koh, Hae-Sung Nam, Jong-Hyock Park
BACKGROUND: Accurate understanding of the extent of disease, treatment goal, and prognosis is a prerequisite for the patients with cancer and their caregivers to make informed decision. We sought to evaluate patients' and family caregivers' understanding of the cancer stage, treatment goal, and chance of cure taking their own physician's evaluation as reference. METHODS: A national survey was performed with 750 patient-caregiver dyads (75.5% participation rate) recruited by 134 oncologists in 13 cancer centers (93% participation rate) in Korea...
June 11, 2017: Psycho-oncology
https://www.readbyqxmd.com/read/28600460/standard-operating-procedures-improve-acute-neurologic-care-in-a-sub-saharan-african-setting
#19
Lamin E S Jaiteh, Stefan A Helwig, Abubacarr Jagne, Andreas Ragoschke-Schumm, Catherine Sarr, Silke Walter, Martin Lesmeister, Matthias Manitz, Sebastian Blaß, Sarah Weis, Verena Schlund, Neneh Bah, Jil Kauffmann, Mathias Fousse, Sabina Kangankan, Asmell Ramos Cabrera, Kai Kronfeld, Christian Ruckes, Yang Liu, Ousman Nyan, Klaus Fassbender
OBJECTIVE: Quality of neurologic emergency management in an under-resourced country may be improved by standard operating procedures (SOPs). METHODS: Neurologic SOPs were implemented in a large urban (Banjul) and a small rural (Brikama) hospital in the Gambia. As quality indicators of neurologic emergency management, performance of key procedures was assessed at baseline and in the first and second implementation years. RESULTS: At Banjul, 100 patients of the first-year intervention group exhibited higher rates of general procedures of emergency management than 105 control patients, such as neurologic examination (99...
June 9, 2017: Neurology
https://www.readbyqxmd.com/read/28600370/substituting-physicians-with-nurse-practitioners-physician-assistants-or-nurses-in-nursing-homes-protocol-for-a-realist-evaluation-case-study
#20
Marleen Hermien Lovink, Anke Persoon, Anneke Jah van Vught, Lisette Schoonhoven, Raymond Tcm Koopmans, Miranda Gh Laurant
INTRODUCTION: In developed countries, substituting physicians with nurse practitioners, physician assistants and nurses (physician substitution) occurs in nursing homes as an answer to the challenges related to the ageing population and the shortage of staff, as well as to guarantee the quality of nursing home care. However, there is great diversity in how physician substitution in nursing homes is modelled and it is unknown how it can best contribute to the quality of healthcare. This study aims to gain insight into how physician substitution is modelled and whether it contributes to perceived quality of healthcare...
June 8, 2017: BMJ Open
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