Abstract 102: Coregistration of Serial Angiograms Using Point Cloud Matching

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Fabien Scalzo ◽  
Noah Stier ◽  
Jingyu Liu ◽  
Weike Bi ◽  
David S Liebeskind
Keyword(s):  
Point Cloud ◽  
Endovascular Procedures ◽  
Care Center ◽  
Stroke Care ◽  
Patient Specific ◽  
Post Intervention ◽  
Matching Algorithm ◽  
Before And After ◽  
Real Time Visualization ◽  
Set Of Points

Introduction: Digital subtraction angiography (DSA) is the gold standard to assess reperfusion during endovascular procedures. Visualization and quantification of changes between successive runs is challenged by patient motion and variations in acquisition parameters such as zoom and pose of the x-ray receptor. Automated coregistration of successive DSA sequences would allow for the visualization of serial changes in perfusion during the procedure. The objective of this study is to develop a fully automated framework for the coregistration of patient-specific DSA acquired at different time points during an endovascular reperfusion procedure. Methods: The dataset was established retrospectively from patients admitted at a stroke care center and diagnosed with acute ischemic stroke. Included patients underwent a clot retrieval procedure. Biplane DSA was performed before and after endovascular reperfusion intervention. A neurologist manually coregistered the anterior-posterior (AP) view of successive DSA sequences from each patient using anatomical reference landmarks. The developed computer vision framework processed each DSA to extract the vasculature using a vessel detector, followed by resampling of the responses. The resulting set of points in the pre- and post-intervention DSA were then matched using a point cloud matching algorithm. In this study, we provide an experimental analysis with the conventional RANSAC algorithm. Evaluation was performed by measuring the error between the estimated affine transform, that relates the pre- to the post-intervention DSA, and the groundtruth established manually. Results: A total of 20 patients were included in the analysis. Mean age was 66.8 (range 34-91). Distribution of the TICI scores was as follows: TICI 0(3), TICI 1(0), TICI 2a(5), TICI 2b(10), TICI 3(2). Overall coregistration error was as follows: angle (8.6+- 3.1 degrees), shift (24.8 +- 19 mm), respectively. Conclusions: RANSAC point cloud matching algorithm can be used to accurately coregister serial angiograms during endovascular procedures. This could lead to near real-time visualization and quantification of revascularization.

FitFirms: A wellness option for oncology trainees.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 10537-10537
Author(s):  
Bhavana Pathak ◽  
Ann M. Eapen ◽  
Jason A. Zell
Keyword(s):  
Care Center ◽  
Gynecologic Oncology ◽  
Maslach Burnout Inventory ◽  
Surgical Oncology ◽  
Cancer Center ◽  
Johns Hopkins Hospital ◽  
Post Intervention ◽  
Social Connectivity ◽  
Social Events ◽  
Before And After

10537 Background: Burnout in oncologists has been rising over the past decade. Burnout leads to poor patient outcomes and poor physician health. Younger oncologists are at higher risk for burnout. The Firm System was designed by Victor McKusick at the Johns Hopkins hospital in 1975 to integrate faculty and trainees into clinical and psychologically supportive cohorts. Here we describe an adapted Firm System called the FitFirms, which focused on social connectivity and altruistic service as means to combat burnout in oncology trainees. Methods: We divided the Hematology and Oncology Division of an academic Comprehensive Cancer Care center into four cohorts of faculty-fellow teams called FitFirms. Each FitFirm was named after a notable local or national female leader in the field of cancer medicine—The Henrietta Lacks Firm, The Jane Wright Firm, The Padmini Iyer Firm, and The Rita Mehta Firm. The faculty and fellows interacted on an at-minimum quarterly basis in casual social events and/or community service-oriented events for 15 months. The social events included group dinners, bowling, paint and game nights. The service events included participation in 5K walk/run fundraiser for our institution’s cancer center and support of a National Cancer Survivors Day event for US Veterans. A didactic discussion series was created to explore concepts of resiliency, work-life balance, and the role of art in medicine—mentored by faculty across the spectrum of oncologic disciplines (Surgical Oncology, Gynecologic Oncology, Palliative Care, and Health Communication). The Maslach Burnout Inventory survey was used to survey the oncology trainees before and after the interventions. Results: Nine pre-intervention surveys were collected with 78% of trainees describing themselves as on the burnout spectrum of feeling either ineffective, overextended, disengaged, or burned out (22% engaged). After 15 months, 10 post-intervention surveys were collected in which 60% of trainees described themselves on the burnout spectrum (40% engaged). Conclusions: The FitFirms are a novel system using social capital to reduce the problem of burnout in oncology trainees by engaging in social connectivity and altruistic service through faculty-mentored, historically-named divisional cohorts.

scholarly journals Seeing under the cover with a 3D U-Net: point cloud-based weight estimation of covered patients

2021 ◽  
Author(s):  
Alexander Bigalke ◽  
Lasse Hansen ◽  
Jasper Diesel ◽  
Mattias P. Heinrich
Keyword(s):  
Point Cloud ◽  
Drug Dosage ◽  
Sensor Data ◽  
Patient Specific ◽  
Point Cloud Data ◽  
Weight Estimation ◽  
Visual Sensor ◽  
Cloud Data ◽  
Emergency Situations ◽  
3D Cnn

Abstract Purpose Body weight is a crucial parameter for patient-specific treatments, particularly in the context of proper drug dosage. Contactless weight estimation from visual sensor data constitutes a promising approach to overcome challenges arising in emergency situations. Machine learning-based methods have recently been shown to perform accurate weight estimation from point cloud data. The proposed methods, however, are designed for controlled conditions in terms of visibility and position of the patient, which limits their practical applicability. In this work, we aim to decouple accurate weight estimation from such specific conditions by predicting the weight of covered patients from voxelized point cloud data. Methods We propose a novel deep learning framework, which comprises two 3D CNN modules solving the given task in two separate steps. First, we train a 3D U-Net to virtually uncover the patient, i.e. to predict the patient’s volumetric surface without a cover. Second, the patient’s weight is predicted from this 3D volume by means of a 3D CNN architecture, which we optimized for weight regression. Results We evaluate our approach on a lying pose dataset (SLP) under two different cover conditions. The proposed framework considerably improves on the baseline model by up to $${16}{\%}$$ 16 % and reduces the gap between the accuracy of weight estimates for covered and uncovered patients by up to $${52}{\%}$$ 52 % . Conclusion We present a novel pipeline to estimate the weight of patients, which are covered by a blanket. Our approach relaxes the specific conditions that were required for accurate weight estimates by previous contactless methods and thus constitutes an important step towards fully automatic weight estimation in clinical practice.

scholarly journals Promoting COVID-19 vaccination among healthcare personnel: a multifaceted intervention at a tertiary care center in Japan

2021 ◽  
pp. 1-26
Author(s):  
Akane Takamatsu ◽  
Hitoshi Honda ◽  
Tomoya Kojima ◽  
Kengo Murata ◽  
Hilary Babcock
Keyword(s):  
Medical Center ◽  
Care Center ◽  
Tertiary Care ◽  
Vaccination Rate ◽  
Multifaceted Intervention ◽  
Vaccine Hesitancy ◽  
Healthcare Personnel ◽  
Tertiary Care Center ◽  
Post Intervention ◽  
Post Vaccination

Abstract Objective The COVID-19 vaccine may hold the key to ending the pandemic, but vaccine hesitancy is hindering the vaccination of healthcare personnel (HCP). Design Before-after trial Participants and setting Healthcare personnel at a 790-bed tertiary care center in Tokyo, Japan. Interventions A pre-vaccination questionnaire was administered to HCP to examine their perceptions of the COVID-19 vaccine. Then, a multifaceted intervention involving (1) distribution of informational leaflets to all HCP, (2) hospital-wide announcements encouraging vaccination, (3) a mandatory lecture, (4) an educational session about the vaccine for pregnant or breastfeeding HCP, and (5) allergy testing for HCP at risk of allergic reactions to the vaccine was implemented. A post-vaccination survey was also performed. Results Of 1,575 HCP eligible for enrollment, 1,224 (77.7%) responded to the questionnaire, 43.5% (n =533) expressed willingness to be vaccinated, 48.4% (n = 593) were uncertain, and 8.0% (n=98) expressed unwillingness to be vaccinated. The latter two groups were concerned about the vaccine’s safety rather than its efficacy. Post-intervention, the overall vaccination rate reached 89.7% (1,413/1,575), with 88.9% (614/691) of the pre-vaccination survey respondents who answered “unwilling” or “unsure” eventually receiving a vaccination. In the post-vaccination questionnaire, factors contributing to increased COVID-19 vaccination included information and endorsement of vaccination at the medical center (26.4%; 274/1,037). Conclusions The present, multifaceted intervention increased COVID-19 vaccinations among HCP at a Japanese hospital. Frequent support and provision of information were crucial for increasing the vaccination rate and may be applicable to the general population as well.

Implementation of a patient-specific tapering protocol at discharge decreases total opioid dose prescribed for 6 weeks after elective primary spine surgery

2020 ◽  
Vol 45 (6) ◽  
pp. 474-478
Author(s):  
Sarah S Joo ◽  
Oluwatobi O Hunter ◽  
Mallika Tamboli ◽  
Jody C Leng ◽  
T Kyle Harrison ◽  
...  
Keyword(s):  
Spine Surgery ◽  
Joint Replacement ◽  
Oral Morphine ◽  
Hospital Length ◽  
Opioid Consumption ◽  
Hospital Length Of Stay ◽  
Patient Specific ◽  
Opioid Dose ◽  
Before And After ◽  
Primary Spine

Background and objectivesAt our institution, we developed an individualized discharge opioid prescribing and tapering protocol for joint replacement patients and implemented the same protocol for neurosurgical spine patients. We then tested the hypothesis that this protocol will decrease the oral morphine milligram equivalent (MME) dose of opioid prescribed postdischarge after elective primary spine surgery.MethodsIn this retrospective cohort study, we identified all consecutive elective primary spine surgery cases 1 year before and after introduction of the protocol. This protocol used the patient’s prior 24-hour inpatient opioid consumption to determine discharge opioid pill count and tapering schedule. The primary outcome was total opioid dose prescribed in oral MME from discharge through 6 weeks. Secondary outcomes included in-hospital opioid consumption in MME, hospital length of stay, MME prescribed at discharge, opioid refills, and rates of minor and major adverse events.ResultsEighty-three cases comprised the final sample (45 preintervention and 38 postintervention). There were no differences in baseline characteristics. The total oral MME (median (IQR)) from discharge through 6 weeks postoperatively was 900 (420–1440) preintervention compared with 300 (112–806) postintervention (p<0.01, Mann-Whitney U test), and opioid refill rates were not different between groups. There were no differences in other outcomes.ConclusionsThis patient-specific prescribing and tapering protocol effectively decreases the total opioid dose prescribed for 6 weeks postdischarge after elective primary spine surgery. Our experience also demonstrates the potential generalizability of this protocol, which was originally designed for joint replacement patients, to other surgical populations.

scholarly journals Prediction of 3D Cardiovascular hemodynamics before and after coronary artery bypass surgery via deep learning

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Gaoyang Li ◽  
Haoran Wang ◽  
Mingzi Zhang ◽  
Simon Tupin ◽  
Aike Qiao ◽  
...  
Keyword(s):  
Deep Learning ◽  
Artery Bypass ◽  
Computational Cost ◽  
Specific Model ◽  
Arterial System ◽  
Patient Specific ◽  
Cardiovascular Hemodynamics ◽  
Before And After ◽  
Deep Learning Network ◽  
Cfd Method

AbstractThe clinical treatment planning of coronary heart disease requires hemodynamic parameters to provide proper guidance. Computational fluid dynamics (CFD) is gradually used in the simulation of cardiovascular hemodynamics. However, for the patient-specific model, the complex operation and high computational cost of CFD hinder its clinical application. To deal with these problems, we develop cardiovascular hemodynamic point datasets and a dual sampling channel deep learning network, which can analyze and reproduce the relationship between the cardiovascular geometry and internal hemodynamics. The statistical analysis shows that the hemodynamic prediction results of deep learning are in agreement with the conventional CFD method, but the calculation time is reduced 600-fold. In terms of over 2 million nodes, prediction accuracy of around 90%, computational efficiency to predict cardiovascular hemodynamics within 1 second, and universality for evaluating complex arterial system, our deep learning method can meet the needs of most situations.

scholarly journals 600. Decreased Hospital Readmission After Programmatic Strengthening of an Outpatient Parenteral Antimicrobial Therapy (OPAT) Program

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S362-S363
Author(s):  
Gaurav Agnihotri ◽  
Alan E Gross ◽  
Minji Seok ◽  
Cheng Yu Yen ◽  
Farah Khan ◽  
...  
Keyword(s):  
Hospital Readmission ◽  
Multinomial Logistic Regression ◽  
Univariate Analysis ◽  
Tertiary Care ◽  
Intervention Group ◽  
Care Hospital ◽  
Full Time ◽  
Post Intervention ◽  
Before And After ◽  
The Impact

Abstract Background Although it is recommended that an OPAT program should be managed by a formal OPAT team that supports the treating physician, many OPAT programs face challenges in obtaining necessary program staff (i.e nurses or pharmacists) due to limited data examining the impact of a dedicated OPAT team on patient outcomes. Our objective was to compare OPAT-related readmission rates among patients receiving OPAT before and after the implementation of a strengthened OPAT program. Methods This retrospective quasi-experiment compared adult patients discharged on intravenous (IV) antibiotics from the University of Illinois Hospital before and after implementation of programmatic changes to strengthen the OPAT program. Data from our previous study were used as the pre-intervention group (1/1/2012 to 8/1/2013), where only individual infectious disease (ID) physicians coordinated OPAT. Post-intervention (10/1/2017 to 1/1/2019), a dedicated OPAT nurse provided full time support to the treating ID physicians through care coordination, utilization of protocols for lab monitoring and management, and enhanced documentation. Factors associated with readmission for OPAT-related problems at a significance level of p&lt; 0.1 in univariate analysis were eligible for testing in a forward stepwise multinomial logistic regression to identify independent predictors of readmission. Results Demographics, antimicrobial indications, and OPAT administration location of the 428 patients pre- and post-intervention are listed in Table 1. After implementation of the strengthened OPAT program, the readmission rate due to OPAT-related complications decreased from 17.8% (13/73) to 6.5% (23/355) (p=0.001). OPAT-related readmission reasons included: infection recurrence/progression (56%), adverse drug reaction (28%), or line-associated issues (17%). Independent predictors of hospital readmission due to OPAT-related problems are listed in Table 2. Table 1. OPAT Patient Demographics and Factors Pre- and Post-intervention Table 2. Factors independently associated with hospital readmission in OPAT patients Conclusion An OPAT program with dedicated staff at a large academic tertiary care hospital was independently associated with decreased risk for readmission, which provides critical evidence to substantiate additional resources being dedicated to OPAT by health systems in the future. Disclosures All Authors: No reported disclosures

scholarly journals A method for evaluation of patient-specific lean body mass from limited-coverage CT images and its application in PERCIST: comparison with predictive equation

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Jingjie Shang ◽  
Zhiqiang Tan ◽  
Yong Cheng ◽  
Yongjin Tang ◽  
Bin Guo ◽  
...  
Keyword(s):  
Lean Body Mass ◽  
Body Mass ◽  
Whole Body ◽  
Patient Specific ◽  
Predictive Equation ◽  
Reference Standard ◽  
Pet Ct ◽  
Before And After ◽  
Percist 1.0 ◽  
Limited Coverage

Abstract Background Standardized uptake value (SUV) normalized by lean body mass ([LBM] SUL) is recommended as metric by PERCIST 1.0. The James predictive equation (PE) is a frequently used formula for LBM estimation, but may cause substantial error for an individual. The purpose of this study was to introduce a novel and reliable method for estimating LBM by limited-coverage (LC) CT images from PET/CT examinations and test its validity, then to analyse whether SUV normalised by LC-based LBM could change the PERCIST 1.0 response classifications, based on LBM estimated by the James PE. Methods First, 199 patients who received whole-body PET/CT examinations were retrospectively retrieved. A patient-specific LBM equation was developed based on the relationship between LC fat volumes (FVLC) and whole-body fat mass (FMWB). This equation was cross-validated with an independent sample of 97 patients who also received whole-body PET/CT examinations. Its results were compared with the measurement of LBM from whole-body CT (reference standard) and the results of the James PE. Then, 241 patients with solid tumours who underwent PET/CT examinations before and after treatment were retrospectively retrieved. The treatment responses were evaluated according to the PE-based and LC-based PERCIST 1.0. Concordance between them was assessed using Cohen’s κ coefficient and Wilcoxon’s signed-ranks test. The impact of differing LBM algorithms on PERCIST 1.0 classification was evaluated. Results The FVLC were significantly correlated with the FMWB (r=0.977). Furthermore, the results of LBM measurement evaluated with LC images were much closer to the reference standard than those obtained by the James PE. The PE-based and LC-based PERCIST 1.0 classifications were discordant in 27 patients (11.2%; κ = 0.823, P=0.837). These discordant patients’ percentage changes of peak SUL (SULpeak) were all in the interval above or below 10% from the threshold (±30%), accounting for 43.5% (27/62) of total patients in this region. The degree of variability is related to changes in LBM before and after treatment. Conclusions LBM algorithm-dependent variability in PERCIST 1.0 classification is a notable issue. SUV normalised by LC-based LBM could change PERCIST 1.0 response classifications based on LBM estimated by the James PE, especially for patients with a percentage variation of SULpeak close to the threshold.

scholarly journals Daily Bathing with Chlorhexidine-Based Soap and the Prevention of Staphylococcus aureus Transmission and Infection

2014 ◽  
Vol 35 (3) ◽  
pp. 243-250 ◽  
Author(s):  
Melissa A. Viray ◽  
James C. Morley ◽  
Craig M. Coopersmith ◽  
Marin H. Kollef ◽  
Victoria J. Fraser ◽  
...  
Keyword(s):  
At Risk ◽  
Staphylococcus Aureus ◽  
Tertiary Care ◽  
Control Unit ◽  
Post Intervention ◽  
Icu Patients ◽  
Chlorhexidine Bathing ◽  
Before And After ◽  
Surgical Icu ◽  
Time Series Methodology

Objective.Determine whether daily bathing with chlorhexidine-based soap decreased methicillin-resistant Staphylococcus aureus (MRSA) transmission and intensive care unit (ICU)-acquired S. aureus infection among ICU patients.Design.Prospective pre-post-intervention study with control unit.Setting.A 1,250-bed tertiary care teaching hospital.Patients.Medical and surgical ICU patients.Methods.Active surveillance for MRSA colonization was performed in both ICUs. In June 2005, a chlorhexidine bathing protocol was implemented in the surgical ICU. Changes in S. aureus transmission and infection rate before and after implementation were analyzed using time-series methodology.Results.The intervention unit had a 20.68% decrease in MRSA acquisition after institution of the bathing protocol (12.64 cases per 1,000 patient-days at risk before the intervention vs 10.03 cases per 1,000 patient-days at risk after the intervention; β, −2.62 [95% confidence interval (CI), −5.19 to −0.04]; P = .046). There was no significant change in MRSA acquisition in the control ICU during the study period (10.97 cases per 1,000 patient-days at risk before June 2005 vs 11.33 cases per 1,000 patient-days at risk after June 2005; β, −11.10 [95% CI, −37.40 to 15.19]; P = .40). There was a 20.77% decrease in all S. aureus (including MRSA) acquisition in the intervention ICU from 2002 through 2007 (19.73 cases per 1,000 patient-days at risk before the intervention to 15.63 cases per 1,000 patient-days at risk after the intervention [95% CI, −7.25 to −0.95]; P = .012)]. The incidence of ICU-acquired MRSA infections decreased by 41.37% in the intervention ICU (1.96 infections per 1,000 patient-days at risk before the intervention vs 1.15 infections per 1,000 patient-days at risk after the intervention; P = .001).Conclusions.Institution of daily chlorhexidine bathing in an ICU resulted in a decrease in the transmission of S. aureus, including MRSA. These data support the use of routine daily chlorhexidine baths to decrease rates of S. aureus transmission and infection.

scholarly journals Management of Symphysis Pubis Dysfunction During Pregnancy Using Exercise and Pelvic Support Belts

2005 ◽  
Vol 85 (12) ◽  
pp. 1290-1300 ◽  
Author(s):  
Jill Depledge ◽  
Peter J McNair ◽  
Cheryl Keal-Smith ◽  
Maynard Williams
Keyword(s):  
Pregnant Women ◽  
Scale Score ◽  
Symphysis Pubis ◽  
Patient Specific ◽  
Functional Scale ◽  
Muscle Strengthening ◽  
Questionnaire Score ◽  
Before And After ◽  
Average Pain ◽  
Pelvic Support

Abstract Background and Purpose. Symphysis pubis pain is a significant problem for some pregnant women. The purpose of this study was to investigate the effects of exercise, advice, and pelvic support belts on the management of symphysis pubis dysfunction during pregnancy. Subjects. Ninety pregnant women with symphysis pubis dysfunction were randomly assigned to 3 treatment groups. Methods. A randomized masked prospective experimental clinical trial was conducted. Specific muscle strengthening exercises and advice concerning appropriate methods for performing activities of daily living were given to the 3 groups, and 2 of the groups were given either a rigid pelvic support belt or a nonrigid pelvic support belt. The dependent variables, which were measured before and after the intervention, were a Roland-Morris Questionnaire score, a Patient-Specific Functional Scale score, and a pain score (101-point numerical rating score). Results. After the intervention, there was a significant reduction in the Roland-Morris Questionnaire score, the Patient-Specific Functional Scale score, and the average and worst pain scores in all groups. With the exception of average pain, there were no significant differences between groups for the other measures. Discussion and Conclusion. The findings indicate that the use of either a rigid or a nonrigid pelvic support belt did not add to the effects provided by exercise and advice.

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