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https://www.readbyqxmd.com/read/27909673/how-to-build-your-simple-and-cost-effective-arthroscopic-skills-simulator
#1
Georgios Arealis, James Holton, Joana Bento Rodrigues, Maria Sagkrioti, Martyn Snow, Mark Hamlet, Ofer Levy
Acquisition of arthroscopic skills is not always easy and can be time-consuming. Simulation in arthroscopy improves surgical skills and can bridge the gap between reduced surgical exposure and training time and the need to reach a required level of competency. We propose a method to create a simple and cost-effective arthroscopic skills simulator using readily available materials and a low-cost Web camera available from online shops. This arthroscopic simulation device can be used to improve skills of all levels of trainees at home, in a bioskills laboratory, or in the theater...
October 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/27906472/long-term-clinical-impact-and-cost-effectiveness-of-obeticholic-acid-for-the-treatment-of-primary-biliary-cholangitis
#2
Sumeyye Samur, Matthew Klebanoff, Reiner Banken, Daniel S Pratt, Rick Chapman, Daniel A Ollendorf, Anne M Loos, Kathleen Corey, Chin Hur, Jagpreet Chhatwal
: Primary biliary cholangitis (PBC) is a chronic, progressive autoimmune liver disease that mainly affects middle-aged women. Obeticholic acid (OCA), which was recently approved by the Food and Drug Administration for PBC treatment, has demonstrated positive effects on biochemical markers of liver function. Our objective was to evaluate the long-term clinical impact and cost-effectiveness of OCA as a second-line treatment for PBC in combination with ursodeoxycholic acid (UDCA) in adults with an inadequate response to UDCA...
November 7, 2016: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/27898668/the-long-term-safety-public-health-impact-and-cost-effectiveness-of-routine-vaccination-with-a-recombinant-live-attenuated-dengue-vaccine-dengvaxia-a-model-comparison-study
#3
Stefan Flasche, Mark Jit, Isabel Rodríguez-Barraquer, Laurent Coudeville, Mario Recker, Katia Koelle, George Milne, Thomas J Hladish, T Alex Perkins, Derek A T Cummings, Ilaria Dorigatti, Daniel J Laydon, Guido España, Joel Kelso, Ira Longini, Jose Lourenco, Carl A B Pearson, Robert C Reiner, Luis Mier-Y-Terán-Romero, Kirsten Vannice, Neil Ferguson
BACKGROUND: Large Phase III trials across Asia and Latin America have recently demonstrated the efficacy of a recombinant, live-attenuated dengue vaccine (Dengvaxia) over the first 25 mo following vaccination. Subsequent data collected in the longer-term follow-up phase, however, have raised concerns about a potential increase in hospitalization risk of subsequent dengue infections, in particular among young, dengue-naïve vaccinees. We here report predictions from eight independent modelling groups on the long-term safety, public health impact, and cost-effectiveness of routine vaccination with Dengvaxia in a range of transmission settings, as characterised by seroprevalence levels among 9-y-olds (SP9)...
November 2016: PLoS Medicine
https://www.readbyqxmd.com/read/27890142/the-effects-of-a-simple-intervention-on-exposures-to-low-back-pain-risk-factors-during-traditional-posterior-load-carriage
#4
Khoirul Muslim, Maury A Nussbaum
Traditional posterior load carriage (PLC), typically performed without the use of an assistive device, is associated with a high prevalence of low back pain (LBP). However, there are few studies that have evaluated potential interventions to reduce exposures to LBP risk factors. This work examined the effects of a simple, potentially low-cost intervention using an assistive device (i.e., carrying aid) on exposures to factors related to LBP risk during PLC. Torso kinematics and kinetics, slip risk, and ratings of perceived discomfort (RPD) were obtained during simulated PLC on a walkway...
March 2017: Applied Ergonomics
https://www.readbyqxmd.com/read/27868133/ensemble-pruning-for-glaucoma-detection-in-an-unbalanced-data-set
#5
Werner Adler, Olaf Gefeller, Asma Gul, Folkert K Horn, Zardad Khan, Berthold Lausen
BACKGROUND: Random forests are successful classifier ensemble methods consisting of typically 100 to 1000 classification trees. Ensemble pruning techniques reduce the computational cost, especially the memory demand, of random forests by reducing the number of trees without relevant loss of performance or even with increased performance of the sub-ensemble. The application to the problem of an early detection of glaucoma, a severe eye disease with low prevalence, based on topographical measurements of the eye background faces specific challenges...
November 21, 2016: Methods of Information in Medicine
https://www.readbyqxmd.com/read/27859465/meta-analysis-of-aggregate-data-on-medical-events
#6
Björn Holzhauer
Meta-analyses of clinical trials often treat the number of patients experiencing a medical event as binomially distributed when individual patient data for fitting standard time-to-event models are unavailable. Assuming identical drop-out time distributions across arms, random censorship, and low proportions of patients with an event, a binomial approach results in a valid test of the null hypothesis of no treatment effect with minimal loss in efficiency compared with time-to-event methods. To deal with differences in follow-up-at the cost of assuming specific distributions for event and drop-out times-we propose a hierarchical multivariate meta-analysis model using the aggregate data likelihood based on the number of cases, fatal cases, and discontinuations in each group, as well as the planned trial duration and groups sizes...
November 18, 2016: Statistics in Medicine
https://www.readbyqxmd.com/read/27842730/surgical-skills-curricula-in-american-college-of-surgeons-accredited-education-institutes-an-international-survey
#7
Iman Ghaderi, Shimae Fitzgibbons, Yusuke Watanabe, Alexander Lachapelle, John Paige
BACKGROUND: A clear understanding of simulation-based curricula in use at American College of Surgeons Accredited Education Institutes (ACS-AEIs) is lacking. METHODS: A 25-question online survey was sent to ACS-AEIs. RESULTS: The response rate approached 60%. The most frequent specialties to use the ACS-AEIs are general surgery and obstetrics/gynecology (94%). Residents are the main target population for programming/training (96%). Elements of the ACS/Association of Program Directors in Surgery Surgical Skills Curriculum are used by 77% of responding ACS-AEIs...
September 3, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27836258/adaptive-nearly-optimal-control-for-a-class-of-continuous-time-nonaffine-nonlinear-systems-with-inequality-constraints
#8
Quan-Yong Fan, Guang-Hong Yang
The state inequality constraints have been hardly considered in the literature on solving the nonlinear optimal control problem based the adaptive dynamic programming (ADP) method. In this paper, an actor-critic (AC) algorithm is developed to solve the optimal control problem with a discounted cost function for a class of state-constrained nonaffine nonlinear systems. To overcome the difficulties resulting from the inequality constraints and the nonaffine nonlinearities of the controlled systems, a novel transformation technique with redesigned slack functions and a pre-compensator method are introduced to convert the constrained optimal control problem into an unconstrained one for affine nonlinear systems...
November 8, 2016: ISA Transactions
https://www.readbyqxmd.com/read/27832043/construct-validity-for-a-cost-effective-arthroscopic-surgery-simulator-for-resident-education
#9
Gregory Lopez, David F Martin, Rick Wright, James Jung, Peter Hahn, Nickul Jain, Daniel N Bracey, Ranjan Gupta
INTRODUCTION: Arthroscopy is one of the most challenging surgical skills to assess and teach. Although basic psychomotor arthroscopic skills, such as triangulation and object manipulation, are incorporated into many simulation exercises, they are not always individually taught or objectively evaluated. In addition, arthroscopic instruments, arthroscopy cameras, and the cadaver or joint models necessary for practice are costly. METHODS: A low-cost arthroscopic simulator was created to practice triangulation, probing, horizon changes, suture management, and object manipulation...
December 2016: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/27830490/soft-3d-printed-phantom-of-the-human-kidney-with-collecting-system
#10
Fabian Adams, Tian Qiu, Andrew Mark, Benjamin Fritz, Lena Kramer, Daniel Schlager, Ulrich Wetterauer, Arkadiusz Miernik, Peer Fischer
Organ models are used for planning and simulation of operations, developing new surgical instruments, and training purposes. There is a substantial demand for in vitro organ phantoms, especially in urological surgery. Animal models and existing simulator systems poorly mimic the detailed morphology and the physical properties of human organs. In this paper, we report a novel fabrication process to make a human kidney phantom with realistic anatomical structures and physical properties. The detailed anatomical structure was directly acquired from high resolution CT data sets of human cadaveric kidneys...
November 9, 2016: Annals of Biomedical Engineering
https://www.readbyqxmd.com/read/27798056/computational-modelling-for-congenital-heart-disease-how-far-are-we-from-clinical-translation
#11
REVIEW
Giovanni Biglino, Claudio Capelli, Jan Bruse, Giorgia M Bosi, Andrew M Taylor, Silvia Schievano
Computational models of congenital heart disease (CHD) have become increasingly sophisticated over the last 20 years. They can provide an insight into complex flow phenomena, allow for testing devices into patient-specific anatomies (pre-CHD or post-CHD repair) and generate predictive data. This has been applied to different CHD scenarios, including patients with single ventricle, tetralogy of Fallot, aortic coarctation and transposition of the great arteries. Patient-specific simulations have been shown to be informative for preprocedural planning in complex cases, allowing for virtual stent deployment...
October 25, 2016: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/27787234/interaction-of-a-relativistic-dense-electron-beam-with-a-laser-wiggler-in-a-vacuum-self-field-effects-on-the-electron-orbits-and-free-electron-laser-gain
#12
E Abbasi, S Jafari, R Hedayati
Employing laser wigglers and accelerators provides the potential to dramatically cut the size and cost of X-ray light sources. Owing to recent technological developments in the production of high-brilliance electron beams and high-power laser pulses, it is now conceivable to make steps toward the practical realisation of laser-pumped X-ray free-electron lasers (FELs). In this regard, here the head-on collision of a relativistic dense electron beam with a linearly polarized laser pulse as a wiggler is studied, in which the laser wiggler can be realised using a conventional quantum laser...
November 1, 2016: Journal of Synchrotron Radiation
https://www.readbyqxmd.com/read/27782633/dimensional-reduction-of-markov-state-models-from-renormalization-group-theory
#13
S Orioli, P Faccioli
Renormalization Group (RG) theory provides the theoretical framework to define rigorous effective theories, i.e., systematic low-resolution approximations of arbitrary microscopic models. Markov state models are shown to be rigorous effective theories for Molecular Dynamics (MD). Based on this fact, we use real space RG to vary the resolution of the stochastic model and define an algorithm for clustering microstates into macrostates. The result is a lower dimensional stochastic model which, by construction, provides the optimal coarse-grained Markovian representation of the system's relaxation kinetics...
September 28, 2016: Journal of Chemical Physics
https://www.readbyqxmd.com/read/27781203/real-life-treatment-paradigms-show-adalimumab-is-cost-effective-for-the-management-of-ulcerative-colitis
#14
Candace L Beilman, Nguyen Xuan Thanh, Victoria Ung, Christopher Ma, Karen Wong, Karen I Kroeker, Thomas Lee, Haili Wang, Arto Ohinmaa, Phil Jacobs, Brendan P Halloran, Richard N Fedorak
Background. Adalimumab is effective for the maintenance of remission in patients with moderate-to-severe ulcerative colitis (UC). Currently, biologic therapies are used in cases where patients fail conventional medical therapies. If biologic therapies are not available, patients often choose to remain in an unwell state rather than undergo colectomy. Objective. The aim of the study was to evaluate the cost-effectiveness of adalimumab in patients with UC where adalimumab was readily available compared to not available...
2016: Canadian Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27774923/development-and-validation-of-a-low-cost-microsurgery-ear-trainer-for-low-resource-settings
#15
M P A Clark, B D Westerberg, J E Mitchell
OBJECTIVE: Chronic suppurative otitis media is a neglected condition affecting up to 330 million people worldwide, with the burden of the disease in impoverished countries. The need for non-governmental organisations to hardwire training into their programmes has been highlighted. An ear surgery simulator appropriate for training in resource-poor settings was developed, and its effectiveness in facilitating the acquisition of headlight and microsurgical skills necessary to safely perform procedures via the ear canal was investigated...
October 2016: Journal of Laryngology and Otology
https://www.readbyqxmd.com/read/27765677/blood-collection-tubes-as-medical-devices-the-potential-to-affect-assays-and-proposed-verification-and-validation-processes-for-the-clinical-laboratory
#16
REVIEW
Raffick A R Bowen, Dorothy M Adcock
Blood collection tubes (BCTs) are an often under-recognized variable in the preanalytical phase of clinical laboratory testing. Unfortunately, even the best-designed and manufactured BCTs may not work well in all clinical settings. Clinical laboratories, in collaboration with healthcare providers, should carefully evaluate BCTs prior to putting them into clinical use to determine their limitations and ensure that patients are not placed at risk because of inaccuracies due to poor tube performance. Selection of the best BCTs can be achieved through comparing advertising materials, reviewing the literature, observing the device at a scientific meeting, receiving a demonstration, evaluating the device under simulated conditions, or testing the device with patient samples...
December 2016: Clinical Biochemistry
https://www.readbyqxmd.com/read/27764098/the-spatial-dynamics-of-predators-and-the-benefits-and-costs-of-sharing-information
#17
Matthieu Barbier, James R Watson
Predators of all kinds, be they lions hunting in the Serengeti or fishermen searching for their catch, display various collective strategies. A common strategy is to share information about the location of prey. However, depending on the spatial characteristics and mobility of predators and prey, information sharing can either improve or hinder individual success. Here, our goal is to investigate the interacting effects of space and information sharing on predation efficiency, represented by the expected rate at which prey are found and consumed...
October 2016: PLoS Computational Biology
https://www.readbyqxmd.com/read/27755739/inferring-invasive-species-abundance-using-removal-data-from-management-actions
#18
Amy J Davis, Mevin B Hooten, Ryan S Miller, Matthew L Farnsworth, Jesse Lewis, Michael Moxcey, Kim M Pepin
Evaluation of the progress of management programs for invasive species is crucial for demonstrating impacts to stakeholders and strategic planning of resource allocation. Estimates of abundance before and after management activities can serve as a useful metric of population management programs. However, many methods of estimating population size are too labor intensive and costly to implement, posing restrictive levels of burden on operational programs. Removal models are a reliable method for estimating abundance before and after management using data from the removal activities exclusively, thus requiring no work in addition to management...
October 2016: Ecological Applications: a Publication of the Ecological Society of America
https://www.readbyqxmd.com/read/27730649/pediatric-laryngeal-simulator-using-3d-printed-models-a-novel-technique
#19
Katherine R Kavanagh, Valerie Cote, Yvonne Tsui, Simon Kudernatsch, Donald R Peterson, Tulio A Valdez
OBJECTIVE: Simulation to acquire and test technical skills is an essential component of medical education and residency training in both surgical and nonsurgical specialties. High-quality simulation education relies on the availability, accessibility, and reliability of models. The objective of this work was to describe a practical pediatric laryngeal model for use in otolaryngology residency training. Ideally, this model would be low-cost, have tactile properties resembling human tissue, and be reliably reproducible...
October 12, 2016: Laryngoscope
https://www.readbyqxmd.com/read/27712708/patient-heterogeneity-in-health-economic-decision-models-for-chronic-obstructive-pulmonary-disease-are-current-models-suitable-to-evaluate-personalized-medicine
#20
Martine Hoogendoorn, Talitha L Feenstra, Yumi Asukai, Andrew H Briggs, Sixten Borg, Roberto W Dal Negro, Ryan N Hansen, Sven-Arne Jansson, Reiner Leidl, Nancy Risebrough, Yevgeniy Samyshkin, Margarethe E Wacker, Maureen P M H Rutten-van Mölken
OBJECTIVES: To assess how suitable current chronic obstructive pulmonary disease (COPD) cost-effectiveness models are to evaluate personalized treatment options for COPD by exploring the type of heterogeneity included in current models and by validating outcomes for subgroups of patients. METHODS: A consortium of COPD modeling groups completed three tasks. First, they reported all patient characteristics included in the model and provided the level of detail in which the input parameters were specified...
September 2016: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
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