scholarly journals Validation of a Hybrid Ex Vivo Integral Colon Simulator in Basic and Advanced Endoscopic Procedures

2019 ◽  
Vol 3 (3) ◽  
Keyword(s):  
Ex Vivo ◽  
Low Cost ◽  
Morphological Characteristics ◽  
Ileocecal Valve ◽  
Hepatic Flexure ◽  
Endoscopic Procedures ◽  
Endoscopic Techniques ◽  
Hybrid Integral ◽  
Therapeutic Procedures ◽  
Level Of Experience

Introduction: Traditionally, training in gastrointestinal endoscopy has been performed directly on the patient under expert supervision, but this practice is not free of errors and risks to the patient. With the growing development of ever more complex therapeutic endoscopic techniques, an ex vivo hybrid integral colon simulator for the teaching of basic and advanced endoscopic procedures was a necessity. It would allow for the necessary repetitions required to overcome the learning curve, with the advantages of accessibility, low cost, reproducibility and with which the use of real accessories was feasible on human-like tissues and therefore, obtain effective training and the development of endoscopic techniques with no risk to the patient. Aim: To validate the ex vivo hybrid integral colon simulator in basic and advanced procedures by experts in colonoscopy. Material and Methods: We developed a questionnaire as a measuring instrument to determine the simulator´s realism. Twentynine (29) expert endoscopists were selected and each was exposed to the simulator and performs a colonoscopy and different therapeutic procedures. The questionnaire was then applied. Statistics: The sum of skill mastery and the overall mastery was calculated, defining “close to reality” as at least, a 90% of responses in its favor. To identify the specialty effect and the level of experience (total colonoscopies) in terms of realism and the simulator´s usefulness, we used the Chi2 test and logistic regression models, considering a p<0.05 statistically significant. Results: Twenty-nine (29) experts evaluated the simulator: 15 were gastroenterologists, 14 were surgeons, with an average of 2683 total colonoscopies. From a maximum overall score of 79 (100%), 9 experts (31%) gave it 79 points (100%), and 13 experts (44%) attributed it a score of 78 points (98%). In terms of the identification of anatomical structures and the simulator´s morphological characteristics, 96.6% considered them to be close to reality. As to the mastery of basic maneuvers and the evaluation of advanced procedures, 100% of the experts considered the simulator useful in terms of reproduction and close to reality. The categorization of realism, usefulness of the simulator by specialty and the number of total colonoscopies were analyzed and no difference was detected. Discussion: Although in the overall score 100% of the experts considered the simulator experience to be close to reality and useful (cutoff point of at least 90%), the following items had greater variability: identification of the ileocecal valve and the hepatic flexure, and the mucosal appearance. We concluded that the simulator is not dependent on the physician´s level of experience nor on the specialty. Conclusion: The simulator is realistic and useful when reproducing basic and advanced procedures, using real equipment and accessories. It is therefore a valuable tool when training in different therapeutic procedures that are a technical challenge and are associated with a broad range of complications if not successfully performed. It offers the possibility of repeating the required procedure to further develop or improve the student´s psychomotor abilities with no risk to the patient.

scholarly journals Experimental Setting for Applying Mechanical Stimuli to Study the Endothelial Response of Ex Vivo Vessels under Realistic Pathophysiological Environments

Life ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 671
Author(s):  
Ana Osuna ◽  
Anna Ulldemolins ◽  
Hector Sanz-Fraile ◽  
Jorge Otero ◽  
Núria Farré ◽  
...  
Keyword(s):  
Ex Vivo ◽  
Low Cost ◽  
Technical Information ◽  
Rabbit Aorta ◽  
Pressure Waveform ◽  
Mechanical Stimuli ◽  
Experimental Setting ◽  
Endothelial Response ◽  
Flow Through ◽  
Open Source Hardware

This paper describes the design, construction and testing of an experimental setting, making it possible to study the endothelium under different pathophysiological conditions. This novel experimental approach allows the application of the following stimuli to an ex vivo vessel in a physiological bath: (a) a realistic intravascular pressure waveform defined by the user; (b) shear stress in the endothelial layer since, in addition to the pressure waveform, the flow through the vessel can be independently controlled by the user; (c) conditions of hypo/hyperoxia and hypo/hypercapnia in an intravascular circulating medium. These stimuli can be applied alone or in different combinations to study possible synergistic or antagonistic effects. The setting performance is illustrated by a proof of concept in an ex vivo rabbit aorta. The experimental setting is easy to build by using very low-cost materials widely available. Online Supplement files provide all the technical information (e.g., circuits, codes, 3D printer drivers) following an open-source hardware approach for free replication.

scholarly journals Electrochemical treatment of ex vivo human abdominal skin and potential use in scar management: A pilot study

2021 ◽  
Vol 7 ◽  
pp. 205951312098853
Author(s):  
Dana M Hutchison ◽  
Amir A Hakimi ◽  
Avin Wijayaweera ◽  
Soohong Seo ◽  
Ellen M Hong ◽  
...  
Keyword(s):  
Color Change ◽  
Ex Vivo ◽  
Low Cost ◽  
Histological Evaluation ◽  
Ph Change ◽  
Level Of Evidence ◽  
Abdominal Skin ◽  
Electrochemical Therapy ◽  
Mean Width ◽  
Scar Management

Introduction: Scar treatments aim to address pathologic collagen deposition; however, they can be expensive or difficult to control. Electrochemical therapy (ECT) offers a simple alternative treatment. The purpose of this study is to examine the acid-base and histological changes in ex vivo human abdominal skin following ECT. Methods: Forty-two ex vivo human panniculus tissue sections collected from six individuals were tumesced with normal saline. ECT was performed by inserting two platinum needle electrodes connected to a DC power supply into each specimen. Voltage was varied (3–6 V) and applied for 5 minutes. Each specimen was sectioned across both electrode insertion sites and immediately stained with pH sensitive dye. The width of dye color change for each dosimetry pair was calculated. Hematoxylin and eosin staining was used to evaluate samples. Results and Discussion: ECT caused a spatially localised and dose-dependent increased area of acidic and basic pH around the anode and cathode, respectively. A significantly greater mean width of pH change was generated at the cathode compared to the anode in all treatment groups. Histological evaluation displayed broad condensation and hyalinisation of dermal collagen. Conclusion: ECT triggered dermal pH alterations and changed the underlying structural framework of the specimen. This technology may serve as a low-cost, minimally invasive local soft-tissue remodeling technique with potential application in scar management. Level of Evidence: 5 Lay Summary Electrochemical therapy is a novel treatment that causes spatially selective dermal injury in areas of interest. This study measures the effects of electrochemical therapy when applied to abdominal skin. Electrochemical therapy appears to have beneficial effects by causing a highly localised reduction in collagen content or local softening of tissue, which is consistent with other studies on scar therapies, including chemexfoliation, radiofrequency technologies, and lasers. However, electrochemical therapy can be performed at a fraction of the costs of these aforementioned modalities.

scholarly journals SpheroidPicker for automated 3D cell culture manipulation using deep learning

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Istvan Grexa ◽  
Akos Diosdi ◽  
Maria Harmati ◽  
Andras Kriston ◽  
Nikita Moshkov ◽  
...  
Keyword(s):  
Cell Culture ◽  
Precision Medicine ◽  
High Throughput Screening ◽  
Standard Sample ◽  
Ex Vivo ◽  
Low Cost ◽  
3D Cell Culture ◽  
Syringe Pump ◽  
Experimental Conditions ◽  
The Past

AbstractRecent statistics report that more than 3.7 million new cases of cancer occur in Europe yearly, and the disease accounts for approximately 20% of all deaths. High-throughput screening of cancer cell cultures has dominated the search for novel, effective anticancer therapies in the past decades. Recently, functional assays with patient-derived ex vivo 3D cell culture have gained importance for drug discovery and precision medicine. We recently evaluated the major advancements and needs for the 3D cell culture screening, and concluded that strictly standardized and robust sample preparation is the most desired development. Here we propose an artificial intelligence-guided low-cost 3D cell culture delivery system. It consists of a light microscope, a micromanipulator, a syringe pump, and a controller computer. The system performs morphology-based feature analysis on spheroids and can select uniform sized or shaped spheroids to transfer them between various sample holders. It can select the samples from standard sample holders, including Petri dishes and microwell plates, and then transfer them to a variety of holders up to 384 well plates. The device performs reliable semi- and fully automated spheroid transfer. This results in highly controlled experimental conditions and eliminates non-trivial side effects of sample variability that is a key aspect towards next-generation precision medicine.

scholarly journals Compact Miniaturized Bioluminescence Sensor Based on Continuous Air-Segmented Flow for Real-Time Monitoring: Application to Bile Salt Hydrolase (BSH) Activity and ATP Detection in Biological Fluids

Chemosensors ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 122
Author(s):  
Aldo Roda ◽  
Pierpaolo Greco ◽  
Patrizia Simoni ◽  
Valentina Marassi ◽  
Giada Moroni ◽  
...  
Keyword(s):  
Bile Salt ◽  
Light Emission ◽  
Ex Vivo ◽  
Biological Fluids ◽  
Low Cost ◽  
Bile Salt Hydrolase ◽  
Segmented Flow ◽  
Active Substrate ◽  
Flat Spiral ◽  
Bsh Activity

A simple and versatile continuous air-segmented flow sensor using immobilized luciferase was designed as a general miniaturized platform based on sensitive biochemiluminescence detection. The device uses miniaturized microperistaltic pumps to deliver flows and compact sensitive light imaging detectors based on BI-CMOS (smartphone camera) or CCD technology. The low-cost components and power supply make it suitable as out-lab device at point of need to monitor kinetic-related processes or ex vivo dynamic events. A nylon6 flat spiral carrying immobilized luciferase was placed in front of the detector in lensless mode using a fiber optic tapered faceplate. ATP was measured in samples collected by microdialysis from rat brain with detecting levels as low as 0.4 fmoles. The same immobilized luciferase was also used for the evaluation of bile salt hydrolase (BSH) activity in intestinal microbiota. An aminoluciferin was conjugatated with chenodeoxycholic acid forming the amide derivative aLuc-CDCA. The hydrolysis of the aLuc-CDCA probe by BSH releases free uncaged aminoluciferin which is the active substrate for luciferase leading to light emission. This method can detect as low as 0.5 mM of aLuc-CDCA, so it can be used on real faecal human samples to study BSH activity and its modulation by diseases and drugs.

Cost-Effective Directional Drilling and Logging-While-Drilling Operational/Maintenance Model Aids an East Africa Operator to Deliver Its Remote Location Exploration Campaign

2016 ◽  
Author(s):  
Iain Lunney
Keyword(s):  
Low Cost ◽  
Commodity Prices ◽  
Cost Effective ◽  
Directional Drilling ◽  
Remote Maintenance ◽  
Support Team ◽  
High Level ◽  
Remote Assistance ◽  
Level Of Experience ◽  
Maintenance Model

ABSTRACT In a cost-sensitive market driven by depressed commodity prices, significant capital challenges exist for operators interested in pursuing exploration activities in remote environments to define their producible reserves. This paper explores the organizational and operational model developed by a service company over several remote area mobilizations; this model resulted in an optimized low-cost service delivery model characterized by top quartile operational key performance indicators (KPIs). The model centralizes critical functions of an operational organization into discrete service units that are located near the operational location or that provide remote assistance with communication and reporting lines in place to function effectively. Top quartile operational performance and tool availability is a result of placing a remote repair and maintenance facility that includes containerized specialty modules near the operational area. The upfront bottomhole assembly engineering, 24/7 monitoring, and proactive feedback of logged data, drillstring dynamics, and wellbore hydraulics are performed by a core team of subject matter experts in their respective disciplines from an established centralized operating center. The operational KPIs over the course of the six well exploration campaign provided substantial evidence to support the reliability of the model and the high level of experience used in both the remote maintenance facility and the operations center support team.

Lower Gastrointestinal Bleeding

2020 ◽  
Author(s):  
Jennifer Nayor ◽  
John R. Saltzman
Keyword(s):  
Differential Diagnosis ◽  
Ischemic Colitis ◽  
Ileocecal Valve ◽  
Radiation Proctitis ◽  
Gi Bleeding ◽  
Older Individuals ◽  
Diverticular Bleeding ◽  
Endoscopic Techniques ◽  
Internal Hemorrhoids ◽  
Lower Gi Bleeding

Of patients who present with major gastrointestinal (GI) bleeding, 20 to 30% will ultimately be diagnosed with bleeding originating from a lower GI source. Lower GI bleeding has traditionally been defined as bleeding originating from a source distal to the ligament of Treitz; however, with the advent of capsule endoscopy and deep enteroscopy allowing for visualization of the entire small bowel, the definition has been updated to GI bleeding originating from a source distal to the ileocecal valve. Lower GI bleeding can range from occult blood loss to massive bleeding with hemodynamic instability and predominantly affects older individuals, with a mean age at presentation of 63 to 77 years. Comorbid illness, which is a risk factor for mortality from GI bleeding, is also more common with increasing age. Most deaths related to GI bleeding are not due to uncontrolled hemorrhage but exacerbation of underlying comorbidities or nosocomial complications. This review covers the following areas: evaluation of lower GI bleeding (including physical examination and diagnostic tests), initial management, and differential diagnosis. Disorders addressed in the differential diagnosis include diverticulosis, arteriovenous malformations (AVMs), ischemic colitis, anorectal disorders, radiation proctitis, postpolypectomy bleeding, and colorectal neoplasms. Figures show an algorithm for management of patients with suspected lower GI bleeding, tagged red blood cell scans, diverticular bleeding, colonic AVM, ischemic colitis, bleeding hemorrhoid, chronic radiation proctitis, and ileocolonic valve polyp. Tables list descriptive terms for rectal bleeding and suggested location of bleeding, imaging modalities and differential diagnosis for lower GI bleeding, endoscopic techniques for hemostasis, and an internal hemorrhoids grading system. This review contains 9 figures, 8 tables, and 103 references.

Emergency surgical obstetrics simulation training: an ex vivo low-cost model using bovine uterus and porcine bladder for haemostatic uterine brace suture techniques

2020 ◽  
Vol 7 (1) ◽  
pp. 26-30 ◽  
Author(s):  
Amy Sinclair ◽  
Mohamed Sayed Allam ◽  
Evelyn Jean Ferguson ◽  
Mohamed Khairy Mehasseb
Keyword(s):  
Postpartum Haemorrhage ◽  
Ex Vivo ◽  
Cost Model ◽  
Low Cost ◽  
Broad Ligament ◽  
Training Model ◽  
Mortality And Morbidity ◽  
Emergency Situations ◽  
Healthcare Settings

Postpartum haemorrhage remains a leading cause of maternal mortality and morbidity. While conventional obstetrics training curricula describe at length the management of postpartum haemorrhage, obstetrics trainees rarely have exposure to surgical management of postpartum haemorrhage in emergency situations due to reduced hours of training. Procedures such as the transverse or longitudinal haemostatic uterine brace sutures are recognised to be safe, simple and allow for the preservation of the uterus. Training during emergency situations is rarely practical or ideal. We describe a simple model that simulates the atonic postnatal uterus and allows trainees to practise the safe placement of the brace sutures. We use a bovine uterus model with attached broad ligament, bladder and ureters for the transverse haemostatic suture. For the longitudinal brace suture, we use a porcine bladder to simulate the uterus, with the ureters and bladder mesentery simulating the tubes and broad ligaments. The placement of the sutures can be practised with the uterus/bladder closed, or open akin to a caesarean section. Tissue dissection and feedback is almost similar to in vivo conditions. The sutures are inserted and driven using the material and correct placement used during real surgery. Our wet lab training model allows the acquisition, maintenance and enhancement of the required technical skills in a controlled environment, using inexpensive, reproducible and widely available specimens. The model has proved successful in both high and low-resource healthcare settings.

XPS Jensen Lung as a Low-Cost, High-Fidelity Training Adjunct to Ex-Vivo Lung Perfusion

2018 ◽  
Vol 37 (4) ◽  
pp. S243-S244
Author(s):  
B. Shukrallah ◽  
C. Eggeman ◽  
D. Mast ◽  
D. Igoe ◽  
J. Ralston ◽  
...  
Keyword(s):  
Ex Vivo ◽  
Low Cost ◽  
Lung Perfusion ◽  
High Fidelity ◽  
Ex Vivo Lung Perfusion

scholarly journals Energy-Saving Electrospinning with a Concentric Teflon-Core Rod Spinneret to Create Medicated Nanofibers

Polymers ◽  
2020 ◽  
Vol 12 (10) ◽  
pp. 2421 ◽  
Author(s):  
Shixiong Kang ◽  
Shicong Hou ◽  
Xunwei Chen ◽  
Deng-Guang Yu ◽  
Lin Wang ◽  
...  
Keyword(s):  
Energy Saving ◽  
Energy Savings ◽  
Ex Vivo ◽  
Low Cost ◽  
Electrospun Nanofibers ◽  
Electrospinning Process ◽  
Water Soluble ◽  
Drug Dissolution ◽  
Core Rod

Although electrospun nanofibers are expanding their potential commercial applications in various fields, the issue of energy savings, which are important for cost reduction and technological feasibility, has received little attention to date. In this study, a concentric spinneret with a solid Teflon-core rod was developed to implement an energy-saving electrospinning process. Ketoprofen and polyvinylpyrrolidone (PVP) were used as a model of a poorly water-soluble drug and a filament-forming matrix, respectively, to obtain nanofibrous films via traditional tube-based electrospinning and the proposed solid rod-based electrospinning method. The functional performances of the films were compared through in vitro drug dissolution experiments and ex vivo sublingual drug permeation tests. Results demonstrated that both types of nanofibrous films do not significantly differ in terms of medical applications. However, the new process required only 53.9% of the energy consumed by the traditional method. This achievement was realized by the introduction of several engineering improvements based on applied surface modifications, such as a less energy dispersive air-epoxy resin surface of the spinneret, a free liquid guiding without backward capillary force of the Teflon-core rod, and a smaller fluid–Teflon adhesive force. Other non-conductive materials could be explored to develop new spinnerets offering good engineering control and energy savings to obtain low-cost electrospun polymeric nanofibers.

scholarly journals Electrochemical degradation and saponification of porcine adipose tissue

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Tiffany T. Pham ◽  
Anna M. Stokolosa ◽  
Pamela A. Borden ◽  
Kyle D. Hansen ◽  
Ellen M. Hong ◽  
...  
Keyword(s):  
Adipose Tissue ◽  
Subcutaneous Adipose Tissue ◽  
Ex Vivo ◽  
Imaging Techniques ◽  
Low Cost ◽  
Electrical Potential ◽  
Body Contouring ◽  
Past Century ◽  
Ph Gradients ◽  
Subcutaneous Adipose

AbstractBody contouring achieved via subcutaneous adipose tissue reduction has notably advanced over the past century, from suction assisted lipectomy to techniques with reduced degrees of invasiveness including laser, radiofrequency, high frequency focused ultrasound, cryolipolysis, and drug-based injection approaches. These costly techniques have focused on damaging adipocyte cell membranes, hydrolyzing triglycerides (TGs), or inducing apoptosis. Here, we present a simple, low-cost technique, termed electrochemical lipolysis (ECLL). During ECLL, saline is injected into the subcutaneous adipose tissue, followed by insertion of needle electrodes and application of an electrical potential. Electrolysis of saline creates localized pH gradients that drive adipocyte death and saponification of TGs. Using pH mapping, various optical imaging techniques, and biochemical assays, we demonstrate the ability of ECLL to induce acid and base injury, cell death, and the saponification of triglycerides in ex vivo porcine adipose tissue. We define ECLL’s potential role as a minimally-invasive, ultra-low-cost technology for reducing and contouring adipose tissue, and present ECLL as a potential new application of an emerging electrochemical redox based treatment modality.

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