Augmenting prehospital care

2020 ◽  
pp. jramc-2019-001320
Author(s):  
Yuval Glick ◽  
B Avital ◽  
J Oppenheimer ◽  
D Nahman ◽  
L Wagnert-Avraham ◽  
...  
Keyword(s):  
Ex Vivo ◽  
Sense Of Self ◽  
Prehospital Care ◽  
Decision Time ◽  
Control Group ◽  
Full Potential ◽  
Self Confidence ◽  
Significant Prolongation ◽  
Challenging Environment ◽  
Patient Prognosis

IntroductionThe challenging environment of prehospital casualty care demands providers to make prompt decisions and to engage in lifesaving interventions, occasionally without them being adequately experienced. Telementoring based on augmented reality (AR) devices has the potential to decrease the decision time and minimise the distance gap between an experienced consultant and the first responder. The purpose of this study was to determine whether telementoring with AR glasses would affect chest thoracotomy performance and self-confidence of inexperienced trainees.MethodsTwo groups of inexperienced medical students performed a chest thoracotomy in an ex vivo pig model. While one group was mentored remotely using HoloLens AR glasses, the second performed the procedure independently. An observer assessed the trainees’ performance. In addition, trainees and mentors evaluated their own performance.ResultsQuality of performance was found to be superior with remote guidance, without significant prolongation of the procedure (492 s vs 496 s, p=0.943). Moreover, sense of self-confidence among participant was substantially improved in the telementoring group in which 100% of the participants believed the procedure was successful compared with 40% in the control group (p=0.035).ConclusionAR devices may have a role in future prehospital telementoring systems, to provide accessible consultation for first responders, and could thus positively affect the provider's confidence in decision-making, enhance procedure performance and ultimately improve patient prognosis. That being said, future studies are required to estimate full potential of this technology and additional adjustments are necessary for maximal optimisation and implementation in the field of prehospital care.

Effects of Two Different Doses of Hirudin on APTT, Determined with Eight Different Reagents

1995 ◽  
Vol 73 (02) ◽  
pp. 219-222 ◽  
Author(s):  
Manuel Monreal ◽  
Luis Monreal ◽  
Rafael Ruiz de Gopegui ◽  
Yvonne Espada ◽  
Ana Maria Angles ◽  
...  
Keyword(s):  
Ex Vivo ◽  
Anticoagulant Activity ◽  
Subcutaneous Administration ◽  
In Vitro Study ◽  
Ex Vivo Model ◽  
Suitable Candidate ◽  
Significant Prolongation ◽  
High Doses ◽  
Different Doses

SummaryThe APTT has been considered the most suitable candidate to monitor the anticoagulant activity of hirudin. However, its use is hampered by problems of standardization, which make the results heavily dependent on the responsiveness of the reagent used. Our aim was to investigate if this different responsiveness of different reagents when added in vitro is to be confirmed in an ex vivo study.Two different doses of r-hirudin (CGP 39393), 0.3 mg/kg and 1 mg/kg, were administered subcutaneously to 20 New Zealand male rabbits, and the differences in prolongation of APTT 2 and 12 h later were compared, using 8 widely used commercial reagents. All groups exhibited a significant prolongation of APTT 2 h after sc administration of hirudin, both at low and high doses. But this prolongation persisted 12 h later only when the PTTa reagent (Boehringer Mannheim) was used. In general, hirudin prolonged the APTT most with the silica- based reagents.In a further study, we compared the same APTT reagents in an in vitro study in which normal pooled plasma was mixed with increasing amount of hirudin. We failed to confirm a higher sensitivity for silica- containing reagents. Thus, we conclude that subcutaneous administration of hirudin prolongs the APTT most with the silica-based reagents, but this effect is exclusive for the ex vivo model.

Ethanol Extract of Achillea fragrantissima Enhances Angiogenesis through Stimulation of VEGF Production

2020 ◽  
Vol 21 ◽  
Author(s):  
Hana M. Hammad ◽  
Amer Imraish ◽  
Maysa Al-Hussaini ◽  
Malek Zihlif ◽  
Amani A. Harb ◽  
...  
Keyword(s):  
Wound Healing ◽  
Rural Communities ◽  
Ex Vivo ◽  
Ethanol Extract ◽  
Aortic Ring ◽  
Treated Group ◽  
Control Group ◽  
Dependent Manner ◽  
Achillea Fragrantissima

Objective: Achillea fragrantissima L. (Asteraceae) is a traditionally used medicinal herb in the rural communities of Jordan. Methods: The present study evaluated the efficacy of the ethanol extract of this species on angiogenesis in both, ex vivo using rat aortic ring assay and in vivo using rat excision wound model. Results: In concentrations of 50 and 100 µg/ml, the ethanol extract showed angiogenic stimulatory effect and significantly increased length of capillary protrusions around aorta rings of about 60% in comparison to those of untreated aorta rings. In MCF-7 cells, the ethanol extract of A. fragrantissima stimulates the production of VEGF in a dose-dependent manner. 1% and 5% of ethanol extract of A. fragrantissima containing vaseline based ointment was applied on rat excision wounds for six days and was found to be effective in wound healing and maturation of the scar. Both preparations resulted in better wound healing when compared to the untreated control group and vaseline-treated group. This effect was comparable to that induced by MEBO, the positive control. Conclusion: The results indicate that A. fragrantissima has a pro-angiogenic effect, which may act through the VEGF signaling pathway.

scholarly journals Synaptic Reshaping and Neuronal Outcomes in the Temporal Lobe Epilepsy

2021 ◽  
Vol 22 (8) ◽  
pp. 3860
Author(s):  
Elisa Ren ◽  
Giulia Curia
Keyword(s):  
Animal Models ◽  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Current Knowledge ◽  
Focal Epilepsy ◽  
Ex Vivo ◽  
Hippocampal Sclerosis ◽  
Control Group ◽  
Epileptogenic Zone ◽  
Epileptiform Discharges

Temporal lobe epilepsy (TLE) is one of the most common types of focal epilepsy, characterized by recurrent spontaneous seizures originating in the temporal lobe(s), with mesial TLE (mTLE) as the worst form of TLE, often associated with hippocampal sclerosis. Abnormal epileptiform discharges are the result, among others, of altered cell-to-cell communication in both chemical and electrical transmissions. Current knowledge about the neurobiology of TLE in human patients emerges from pathological studies of biopsy specimens isolated from the epileptogenic zone or, in a few more recent investigations, from living subjects using positron emission tomography (PET). To overcome limitations related to the use of human tissue, animal models are of great help as they allow the selection of homogeneous samples still presenting a more various scenario of the epileptic syndrome, the presence of a comparable control group, and the availability of a greater amount of tissue for in vitro/ex vivo investigations. This review provides an overview of the structural and functional alterations of synaptic connections in the brain of TLE/mTLE patients and animal models.

scholarly journals The safety and efficacy of BCG encapsulated alginate particle (BEAP) against M.tb H37Rv infection in Macaca mulatta : A pilot study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ashwani Kesarwani ◽  
Parul Sahu ◽  
Kshama Jain ◽  
Prakriti Sinha ◽  
K. Varsha Mohan ◽  
...  
Keyword(s):  
T Cells ◽  
Macaca Mulatta ◽  
Ex Vivo ◽  
Protective Efficacy ◽  
Rhesus Macaques ◽  
Allergic Response ◽  
Control Group ◽  
Activated T Cells ◽  
Primate Model ◽  
Safety And Efficacy

AbstractDue to the limited utility of Bacillus Calmette–Guérin (BCG), the only approved vaccine available for tuberculosis, there is a need to develop a more effective and safe vaccine. We evaluated the safety and efficacy of a dry powder aerosol (DPA) formulation of BCG encapsulated alginate particle (BEAP) and the conventional intradermal BCG immunization in infant rhesus macaques (Macaca mulatta). The infant macaques were immunized intratracheally with DPA of BEAP into the lungs. Animals were monitored for their growth, behaviour, any adverse and allergic response. The protective efficacy of BEAP was estimated by the ex-vivo H37Rv infection method. Post-immunization with BEAP, granulocytes count, weight gain, chest radiography, levels of liver secreted enzymes, cytokines associated with inflammation like TNF and IL-6 established that BEAP is non-toxic and it does not elicit an allergic response. The T cells isolated from BEAP immunized animals’ blood, upon stimulation with M.tb antigen, secreted high levels of IFN-γ, TNF, IL-6 and IL-2. The activated T cells from BEAP group, when co-cultured with M.tb infected macrophages, eliminated largest number of infected macrophages compared to the BCG and control group. This study suggests the safety and efficacy of BEAP in Non-human primate model.

Reduced Jumping to Conclusion Bias after Experimentally Induced Enhancement of Subjective Body Boundaries in Psychosis

2021 ◽  
Vol 54 (2) ◽  
pp. 92-97
Author(s):  
Naomi Lyons ◽  
Detlef E. Dietrich ◽  
Johannes Graser ◽  
Georg Juckel ◽  
Christian Koßmann ◽  
...  
Keyword(s):  
Sense Of Self ◽  
Psychotic Symptoms ◽  
Control Group ◽  
Implicit Measure ◽  
Relevant Factor ◽  
The Core ◽  
Significant Difference ◽  
Explicit Measure ◽  
Experimental Group ◽  
Core Features

<b><i>Introduction:</i></b> A disturbed sense of self is frequently discussed as an etiological factor for delusion symptoms in psychosis. Phenomenological approaches to psychopathology posit that lacking the sense that the self is localized within one’s bodily boundaries (disembodiment) is one of the core features of the disturbed self in psychosis. The present study examines this idea by experimentally manipulating the sense of bodily boundaries. <b><i>Methods:</i></b> Seventy-three patients with psychosis were randomly assigned to either a 10-min, guided self-massage in the experimental group (EG) to enhance the sense of bodily boundaries or a control group (CG), which massaged a fabric ring. Effects on an implicit measure (jumping to conclusion bias; JTC) and an explicit measure (Brief State Paranoia Checklist; BSPC) of delusion processes were assessed. The JTC measures the tendency to make a decision with little evidence available, and the BSPC explicitly measures the approval of paranoid beliefs. <b><i>Results:</i></b> Patients in the EG showed a lower JTC (<i>M</i> = 4.11 draws before decision) than the CG (<i>M</i> = 2.43; Cohen’s <i>d</i> = 0.64). No significant difference in the BSPC was observed. <b><i>Discussion/Conclusion:</i></b> Our results indicate that enhancing the sense of body boundaries through a self-massage can reduce an implicit bias associated with delusional ideation and correspondingly support the idea that disembodiment might be a relevant factor in the formation of psychotic symptoms.

scholarly journals Moving beyond Limitations: Designing the Helpdys App for Children with Dyslexia in Rural Areas

2021 ◽  
Vol 13 (13) ◽  
pp. 7081
Author(s):  
Andres Larco ◽  
Jorge Carrillo ◽  
Nelson Chicaiza ◽  
Cesar Yanez ◽  
Sergio Luján-Mora
Keyword(s):  
Rural Communities ◽  
Rural Areas ◽  
Rating Scale ◽  
Language Disorder ◽  
Educational Games ◽  
Mobile App ◽  
Literacy Skills ◽  
Full Potential ◽  
Positive Contribution ◽  
Self Confidence

Dyslexia is a relatively common language disorder which is generally ignored in rural communities. It hinders children’s learning processes and, in some cases, is the cause of dropouts or violence in schools. The present work strives to create a web and mobile app as a preliminary step towards the diagnosis and treatment of dyslexic children. Apps providing didactic educational games and activities improve literacy skills for students with reading disabilities. The current work incorporates user experience and prototyping to fulfill app requirements. The authors evaluated the apps with the Mobile App Rating Scale (MARS) tool to assess engagement, functionality, aesthetics, and information. The app’s improvements were immediately implemented and tested in the “Escuela Linea Equinoccial” (Ecuador) school, proving its utility for future use in the education system. The app can be a valuable tool for children with dyslexia to progress successfully through school, raising their self-confidence and, thereby, helping them reach their full potential as adults able to make a positive contribution to society.

scholarly journals Effectiveness and cost-effectiveness of an optimized process of providing assistive technology for impaired upper extremity function: Protocol of a prospective, quasi-experimental non-randomized study (OMARM)

2021 ◽  
pp. 1-14
Author(s):  
Uta Roentgen ◽  
Loek van der Heide ◽  
Ingrid E.H. Kremer ◽  
Huub Creemers ◽  
Merel A. Brehm ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Assistive Technology ◽  
Upper Extremity ◽  
Randomized Study ◽  
Intervention Group ◽  
Control Group ◽  
Full Potential ◽  
Extremity Function ◽  
Quasi Experimental ◽  
Upper Extremity Function

BACKGROUND: Impaired upper extremity function due to muscle paresis or paralysis has a major impact on independent living and quality of life (QoL). Assistive technology (AT) for upper extremity function (i.e. dynamic arm supports and robotic arms) can increase a client’s independence. Previous studies revealed that clients often use AT not to their full potential, due to suboptimal provision of these devices in usual care. OBJECTIVE: To optimize the process of providing AT for impaired upper extremity function and to evaluate its (cost-) effectiveness compared with care as usual. METHODS: Development of a protocol to guide the AT provision process in an optimized way according to generic Dutch guidelines; a quasi-experimental study with non-randomized, consecutive inclusion of a control group (n= 48) receiving care as usual and of an intervention group (optimized provision process) (n= 48); and a cost-effectiveness and cost-utility analysis from societal perspective will be performed. The primary outcome is clients’ satisfaction with the AT and related services, measured with the Quebec User Evaluation of Satisfaction with AT (Dutch version; D-QUEST). Secondary outcomes comprise complaints of the upper extremity, restrictions in activities, QoL, medical consumption and societal cost. Measurements are taken at baseline and at 3, 6 and 9 months follow-up.

Developing a sense of self-reliance: caregivers of infants with single-ventricle heart disease during the interstage period

2021 ◽  
pp. 1-7
Author(s):  
Flerida Imperial-Perez ◽  
MarySue V. Heilemann ◽  
Lynn V. Doering ◽  
Jo-Ann Eastwood ◽  
Nancy A. Pike
Keyword(s):  
Heart Disease ◽  
Grounded Theory ◽  
Single Ventricle ◽  
Sense Of Self ◽  
Home Monitoring ◽  
Palliative Surgery ◽  
Constructivist Grounded Theory ◽  
Self Confidence ◽  
Self Reliance ◽  
Second Surgery

Abstract Background: Caring for infants after the first-stage palliative surgery for single-ventricle heart disease bring challenges beyond the usual parenting responsibilities. Current studies fail to capture the nuances of caregivers’ experiences during the most critical “interstage” period between the first and second surgery. Objectives: To explore the perceptions of caregivers about their experiences while transitioning to caregiver roles, including the successes and challenges associated with caregiving during the interstage period. Methods: Constructivist Grounded Theory methodology guided the collection and analysis of data from in person or telephonic interviews with caregivers after their infants underwent the first-stage palliative surgery for single-ventricle heart disease, and were sent to home for 2–4 months before returning for their second surgery. Symbolic interactionism informed data analyses and interpretation. Results: Our sample included 14 parents, who were interviewed 1–2 times between November, 2019 and July, 2020. Most patients were mothers (71%), Latinx (64%), with household incomes <$30K (42%). Data analysis led to the development of a Grounded Theory called Developing a Sense of Self-Reliance with three categories: (1) Owning caregiving responsibilities despite grave fears, (2) Figuring out how “to make it work” in the interstage period, and (3) Gaining a sense of self-reliance. Conclusions: Parents transitioned to caregiver roles by developing a sense of self-reliance and, in the process, gained self-confidence and decision-making skills. Our study responded to the key research priority from the AHA Scientific Statement to address the knowledge gap in home monitoring for interstage infants through qualitative research design.

scholarly journals Use of Ultrasound Microscopy for Ex Vivo Analysis of Acoustic Impedance in Mouse Liver with Steatohepatitis

Acoustics ◽  
2020 ◽  
Vol 3 (1) ◽  
pp. 3-10
Author(s):  
Hideki Kumagai ◽  
Kazuto Kobayashi ◽  
Sachiko Yoshida ◽  
Koji Yokoyama ◽  
Norio Hirota ◽  
...  
Keyword(s):  
Acoustic Impedance ◽  
Ex Vivo ◽  
Acoustic Microscopy ◽  
Control Group ◽  
Scanning Acoustic Microscopy ◽  
Central Frequency ◽  
Deficient Diet ◽  
Acoustic Images ◽  
Ultrasound Microscopy

Scanning acoustic microscopy reveals information on histology and acoustic impedance through tissues. The objective of the present study was to investigate whether acoustic impedance values in the liver over time reflect the progression of steatohepatitis through different grades and stages, and whether this approach can visualize histologic features of the disease. Mice were divided into two groups: a control group and a steatohepatitis group prepared by keeping the mice on a methionine and choline-deficient diet for 56 weeks. The hepatic lobe was excised for measurement of impedance and observation of microscopic structure using a commercially available scanning acoustic microscopy system with a central frequency of 320 MHz. Scanning acoustic microscopy revealed that acoustic impedance through liver tissue with steatohepatitis temporarily decreased with the degree of fat deposition and then increased in parallel with the progression of inflammation and fibrosis. However, the acoustic images obtained did not allow discrimination of detailed microstructures from those seen using light microscopy. In conclusion, estimation of acoustic impedance appears to have potential clinical applications, such as for monitoring or follow-up studies.

Extent of Specific to Nonspecific Resistance in Mice: Parenteral Versus Aerosol Challenge

1970 ◽  
Vol 1 (3) ◽  
pp. 274-278
Author(s):  
Roberta J. Hackett ◽  
Stanley Marcus
Keyword(s):  
Klebsiella Pneumoniae ◽  
Salmonella Typhimurium ◽  
Survival Time ◽  
Intraperitoneal Injection ◽  
Quantitative Data ◽  
Control Group ◽  
Type I ◽  
Nonspecific Resistance ◽  
Significant Prolongation

Quantitative data were gathered concerning the extent of resistance induced in mice immunized by specific and nonspecific means and subsequently challenged both parenterally and by aerosol. Animals were immunized specifically by subcutaneous or intraperitoneal injection of Formalin-killed Klebsiella pneumoniae type I, which was also employed as a challenge organism. The intraperitoneal ld 50 was 30 bacilli. Nonspecific resistance was induced by injection of a Boivin preparation of Salmonella typhimurium endotoxin. Nonspecific resistance was highest 24 hr after injection of 10 μg of endotoxin. At this time, more than half of the mice survived challenge with 10 2 but not with 10 3 ld 50 . Specifically immunized mice were resistant to as much as 10 5 ld 50 , depending upon the route of immunization. Potency ratios for parenteral challenge were: nonspecific to normal, 100; specific to normal, 10 4 to 10 5 ; specific to nonspecific, 10 2 to 10 3 . Employing aerosol challenge, specific immunization protected in the ld 100 range; nonspecifically immunized animals showed significant prolongation of survival time, but the 30-day mortality was similar to the control group.

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