Comparison of sudden cardiac arrest resuscitation performance data obtained from in-hospital incident chart review and in situ high-fidelity medical simulation.

Introduction: High-fidelity medical simulation of sudden cardiac arrest (SCA) presents an opportunity for systematic probing of in-hospital resuscitation systems. Investigators developed and implemented the SimCode program to evaluate simulation's ability to generate meaningful data for system safety analysis and determine concordance of observed results with institutional quality data.

Methods: Resuscitation response performance data were collected during in situ SCA simulations on hospital medical floors.

Erythropoiesis stimulating agent administration improves survival after severe traumatic brain injury: a matched case control study.

Objective: Erythropoiesis stimulating agent (ESA) administration may reduce mortality in severe traumatic brain injury (sTBI).

Summary Background Data: It has been established that the administration of ESA in critically ill trauma victims has been associated with improved outcomes. Recent experimental and clinical data showed neuroprotective effects of ESA, however, the literature regarding impact on outcome in sTBI is lacking.

High-fidelity medical simulation as an assessment tool for radiology residents' acute contrast reaction management skills.

Purpose: The aims of this study were to use medical simulation as an assessment tool for the evaluation of radiology residents' compliance with contrast reaction treatment protocols and to gauge their perceptions of the simulation experience.

Methods: A prospective, observational study of postgraduate year 2 and 3 radiology residents' management of simulated life-threatening contrast reactions was designed. After standard didactic teaching on departmental contrast reaction protocols, residents participated individually in high-fidelity medical simulations of acute contrast reactions.

Nicotine on rat TRAM flap.

Purpose: The transverse rectus abdominis myocutaneous (TRAM) flap is one of the preferential techniques used in breast reconstruction following mastectomy. Nicotine has a detrimental effect on cutaneous flap survival; although there are no experimental studies proving this effect on musculocutaneous flaps. The aim of this study is to verify the effect of nicotine on the rat TRAM flap.

What is the significance of thrombocytosis in patients with trauma?

Background: The incidence and risk factors for the development of thrombocytosis after trauma have not been well established. Although it has been suggested that the occurrence of this sequela may be associated with adverse events, there are also limited data regarding outcomes of patients developing posttraumatic thrombocytosis. The objective of this study was to determine the incidence of, risk factors for, and sequela of posttraumatic thrombocytosis.

Providing integrity and authenticity in DICOM images: a novel approach.

The increasing adoption of information systems in healthcare has led to a scenario where patient information security is more and more being regarded as a critical issue. Allowing patient information to be in jeopardy may lead to irreparable damage, physically, morally, and socially to the patient, potentially shaking the credibility of the healthcare institution. Medical images play a crucial role in such context, given their importance in diagnosis, treatment, and research.

Solubilization of n-alkylbenzenes into decanoyl-N-methylglucamide (Mega-10) solution; temperature dependence.

Solubilization of benzene, toluene, ethylbenzene, n-propylbenzene, n-butylbenzene, n-pentylbenzene, and n-hexylbenzene into micelles of decanoyl-N-methylglucamide (Mega-10) was studied at 303.2, 308.2, 313.

A novel method of HPV genotyping using Hybrid Capture sample preparation method combined with GP5+/6+ PCR and multiplex detection on Luminex XMAP.

A novel DNA detection assay comprising Hybrid Capture sample preparation, GP5+/6+ PCR with modifications and Luminex 100 detection was developed and applied to genotyping of human papillomavirus (HPV) in cervical samples. Target-specific sample preparation was performed using magnetic beads conjugated with Hybrid Capture (HC) antibody. DNA-RNA hybrids were formed between DNA target and RNA probes and captured on HC-beads.

Advanced medical simulation applications for emergency medicine microsystems evaluation and training.

Participants in the 2008 Academic Emergency Medicine Consensus Conference "The Science of Simulation in Healthcare: Defining and Developing Clinical Expertise" morning workshop session on developing systems expertise were tasked with evaluating best applications of simulation techniques and technologies to small-scale systems in emergency medicine (EM). We collaborated to achieve several objectives: 1) describe relevant theories and terminology for discussion of health care systems and medical simulation, 2) review prior and ongoing efforts employing systems thinking and simulation programs in general medical sectors and acute care medicine, 3) develop a framework for discussion of systems thinking for EM, and 4) explore the rational application of advanced medical simulation methods to a defined framework of EM microsystems (EMMs) to promote a "quality-by-design" approach. This article details the materials compiled and questions raised during the consensus process, and the resulting simulation application framework, with proposed solutions as well as their limitations for EM systems education and improvement.

Defining systems expertise: effective simulation at the organizational level--implications for patient safety, disaster surge capacity, and facilitating the systems interface.

The Institute of Medicine's report "To Err is Human" identified simulation as a means to enhance safety in the medical field, just as flight simulation is used to improve the aviation industry. Yet, while there is evidence that simulation may improve task performance, there is little evidence that simulation actually improves patient outcome. Similarly, simulation is currently used to model teamwork-communication skills for disaster management and critical events, but little research or evidence exists to show that simulation improves disaster response or facilitates intersystem or interagency communication.

Educational and research implications of portable human patient simulation in acute care medicine.

Advanced medical simulation has become widespread. One development, the adaptation of simulation techniques and manikin technologies for portable operation, is starting to impact the training of personnel in acute care fields such as emergency medicine (EM) and trauma surgery. Unencumbered by cables and wires, portable simulation programs mitigate several limitations of traditional (nonportable) simulation and introduce new approaches to acute care education and research.

Proposal for DICOM multiframe medical image integrity and authenticity.

This paper presents a novel algorithm to successfully achieve viable integrity and authenticity addition and verification of n-frame DICOM medical images using cryptographic mechanisms. The aim of this work is the enhancement of DICOM security measures, especially for multiframe images. Current approaches have limitations that should be properly addressed for improved security.

Solubilization of n-alkylbenzenes into decanoyl-N-methylglucamide (Mega-10) solution.

Solubilization of benzene, toluene, ethylbenzene, n-propylbenzene, n-butylbenzene, n-pentylbenzene, and n-hexylbenzene into micelles of decanoyl-N-methylglucamide (Mega-10) was studied, where equilibrium concentrations of the above solubilizates were determined spectrophotometrically at 303.2 K. The concentration of the above solubilizates remained constant below the critical micelle concentration (cmc) and increased linearly with an increase in Mega-10 concentration above the cmc.

Multiple encounter simulation for high-acuity multipatient environment training.

Patient safety interventions for multitasking, multipatient, error-prone work settings such as the emergency department (ED) must improve assorted clinical abilities, specific cognitive strategies, and teamwork functions of the staff to be effective. Multiple encounter simulation scenarios explore and convey this specialized mental work-set through use of multiple high-fidelity medical simulation (SIM) manikins in realistic surroundings. Multipatient scenarios reflect the work situations being targeted yet have the benefit of scripted control and instructor guidance to advance specific educational objectives.

Effect of sample aliquot size on the limit of detection and reproducibility of clinical assays.

Background: Nucleic acid amplification technologies significantly improved the limit of detection (LOD) for diagnostic assays. The ability of these assays to amplify fewer than 10 target copies of DNA or RNA imposes new requirements on the preparation of clinical samples. We report a statistical method to determine how large of an aliquot is necessary to reproducibly provide a detectable number of cells.

Intraocular pressure change during hemodialysis.

Purpose: To evaluate intraocular pressure (IOP) change through hemodialysis and examine other factors to affect IOP change in patients treated with hemodialysis.

Design: Prospective, observational case series.

Methods: IOP, blood pressure, and plasma colloid osmotic pressure (COP) were measured in 188 eyes of 95 patients receiving hemodialysis in Nantan General Hospital.

Portable advanced medical simulation for new emergency department testing and orientation.

Objectives: Efforts to mitigate unexpected problems during transition of an active emergency department (ED) to a new physical plant are imperative to ensure effective health care delivery and patient safety. The authors used advanced medical simulation (SIM) to evaluate the capacity of a new ED for emergent resuscitative processes and assist facility orientation before opening day.

Methods: Operational readiness testing and orientation to the new ED of a large academic center were arranged through a Transportable Enhanced Simulation Technologies for Pre-Implementation Limited Operations Testing (TESTPILOT) project.

Antibacterial activity of plants used in cooking for aroma and taste.

Thirty-three plants used in cooking for aroma and taste were examined for antibacterial activity against pathogens causing foodborne infections. Vibrio parahaemolyticus and Staphylococcus aureus were sensitive to many kinds of plant extracts, whereas Listeria monocytogenes, Escherichia coli O157:H7, and Salmonella Enteritidis populations decreased in only six, one, and three plant extracts, respectively. The polyphenol content in the plants was significantly different between the antibacterial plants and nonantibacterial plants, indicating that the polyphenols were related to the antibacterial action of these plants.

Hepatic acute phase induction of murine beta-galactoside alpha 2,6 sialyltransferase (ST6Gal I) is IL-6 dependent and mediated by elevation of exon H-containing class of transcripts.

Hepatic expression of CMP-NeuAc:Gal beta 1,4GlcNAc alpha 2,6-sialyltransferase (ST6Gal I) is induced as part of the acute phase response in mammals by mechanisms that remain poorly understood. Previous work suggests that murine liver ST6Gal I mRNA contains an additional and novel region that is not found on ST6Gal I mRNA from human HepG2 hepatoma cells and from rat liver. This novel region, residing 5' of the common Exon I sequence, is encoded by a discrete upstream exon, Exon H.