scholarly journals Mathematical model for treatment of neonatal hyperbilirubinemia

2021 ◽  
Vol 18 (6) ◽  
pp. 8758-8782
Author(s):  
DongMei Li ◽  
◽  
Rui-xue Zhang ◽  
Qian Xie ◽  
Qi Wang ◽  
...  
Keyword(s):  
Mathematical Model ◽  
Theoretical Basis ◽  
Numerical Approximation ◽  
Treatment Plan ◽  
Combined Treatment ◽  
Neonatal Hyperbilirubinemia ◽  
Clinical Test ◽  
Treatment Data ◽  
Coincidence Effect ◽  
Treatment Plans

<abstract> <p>Based on the mechanism of neonatal hyperbilirubinemia treatment methods (light, exchange blood and drugs), three types of neonatal hyperbilirubinemia treatment mathematical models are established, and the expressions of the model solutions are given in this paper. By applying clinical test data and numerical approximation algorithm, the relevant parameters in the model can be estimated. According to the standards of "Expert Consensus", two treatment plans are designed, which are 1) the combined transfusion and phototherapy treatment plan and 2) the combined treatment plan of drugs, transfusion and phototherapy. The results of the program operation are numerically simulated and compared with the treatment data of clinical cases. It is found that the coincidence effect is important, which verified the rationality of the model. The model results can track and predict the changes of bilirubin levels in real-time, which provides a theoretical basis for the clinical design of treatment plans.</p> </abstract>

Anomaly Detection in Healthcare: Detecting Erroneous Treatment Plans in Time Series Radiotherapy Data

2014 ◽  
Vol 08 (03) ◽  
pp. 257-278 ◽  
Author(s):  
Tamara Sipes ◽  
Steve Jiang ◽  
Kevin Moore ◽  
Nan Li ◽  
Homa Karimabadi ◽  
...  
Keyword(s):  
Anomaly Detection ◽  
Medical Errors ◽  
Predictive Analytics ◽  
Treatment Plan ◽  
Cancer Treatments ◽  
Treatment Data ◽  
Treatment Plans ◽  
New Treatment ◽  
Prostate Cancer Treatments ◽  
Radiotherapy Treatment

Adverse events in healthcare and medical errors result in thousands of accidental deaths and over one million excess injuries each year. Anomaly detection in medicine is an important task, especially in the area of radiation oncology where errors are very rare, but can be extremely dangerous, and even deadly. To avoid medical errors in radiation cancer treatment, careful attention needs to be made to ensure accurate implementation of the intended treatment plan. In this paper, we describe the work that resulted in a valuable predictive analytics tool for automatic detection of catastrophic errors in cancer radiotherapy, adding an important safeguard for patient safety. We designed a method for Dynamic Modeling and Prediction of Radiotherapy Treatment Deviations from Intended Plans (SmartTool) to automatically detect and highlight potential errors in a radiotherapy treatment plan, based on the data from several thousand prostate cancer treatments that were used to build the model. SmartTool determines if the treatment parameters are valid, against a previously built Predictive Model of a Medical Error (PMME). SmartTool communicates with a radiotherapy treatment management system, checking all the treatment parameters in the background prior to execution, and after the human expert QA is completed. Any anomalous treatment parameters are detected using an innovative intelligent algorithm in a completely automatic and unsupervised manner, and it flags the operator by highlighting the suspect parameter(s) for human intervention. Furthermore, the system is self-learning and constantly evolving, and the model is dynamically updated with the new treatment data.

scholarly journals The effects of a preoperative multidisciplinary conference on outcomes for high-risk patients with challenging surgical treatment options: a retrospective study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Masayoshi Koike ◽  
Mie Yoshimura ◽  
Yasushi Mio ◽  
Shoichi Uezono
Keyword(s):  
Patient Safety ◽  
Retrospective Study ◽  
High Risk ◽  
Treatment Plan ◽  
Treatment Options ◽  
High Risk Patients ◽  
Appropriate Treatment ◽  
Risk Patients ◽  
Treatment Plans ◽  
Multidisciplinary Conference

Abstract Background Surgical options for patients vary with age and comorbidities, advances in medical technology and patients’ wishes. This complexity can make it difficult for surgeons to determine appropriate treatment plans independently. At our institution, final decisions regarding treatment for patients are made at multidisciplinary meetings, termed High-Risk Conferences, led by the Patient Safety Committee. Methods In this retrospective study, we assessed the reasons for convening High-Risk Conferences, the final decisions made and treatment outcomes using conference records and patient medical records for conferences conducted at our institution from April 2010 to March 2018. Results A total of 410 High-Risk Conferences were conducted for 406 patients during the study period. The department with the most conferences was cardiovascular surgery (24%), and the reasons for convening conferences included the presence of severe comorbidities (51%), highly difficult surgeries (41%) and nonmedical/personal issues (8%). Treatment changes were made for 49 patients (12%), including surgical modifications for 20 patients and surgery cancellation for 29. The most common surgical modification was procedure reduction (16 patients); 4 deaths were reported. Follow-up was available for 21 patients for whom surgery was cancelled, with 11 deaths reported. Conclusions Given that some change to the treatment plan was made for 12% of the patients discussed at the High-Risk Conferences, we conclude that participants of these conferences did not always agree with the original surgical plan and that the multidisciplinary decision-making process of the conferences served to allow for modifications. Many of the modifications involved reductions in procedures to reflect a more conservative approach, which might have decreased perioperative mortality and the incidence of complications as well as unnecessary surgeries. High-risk patients have complex issues, and it is difficult to verify statistically whether outcomes are associated with changes in course of treatment. Nevertheless, these conferences might be useful from a patient safety perspective and minimize the potential for legal disputes.

scholarly journals Multicriterial CNN based beam generation for robotic radiosurgery of the prostate

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Stefan Gerlach ◽  
Christoph Fürweger ◽  
Theresa Hofmann ◽  
Alexander Schlaefer
Keyword(s):  
Deep Learning ◽  
Treatment Planning ◽  
Treatment Plan ◽  
Plan Quality ◽  
New Approach ◽  
Beam Generation ◽  
Radiological Features ◽  
Improve Treatment ◽  
Robotic Radiosurgery ◽  
Treatment Plans

AbstractAlthough robotic radiosurgery offers a flexible arrangement of treatment beams, generating treatment plans is computationally challenging and a time consuming process for the planner. Furthermore, different clinical goals have to be considered during planning and generally different sets of beams correspond to different clinical goals. Typically, candidate beams sampled from a randomized heuristic form the basis for treatment planning. We propose a new approach to generate candidate beams based on deep learning using radiological features as well as the desired constraints. We demonstrate that candidate beams generated for specific clinical goals can improve treatment plan quality. Furthermore, we compare two approaches to include information about constraints in the prediction. Our results show that CNN generated beams can improve treatment plan quality for different clinical goals, increasing coverage from 91.2 to 96.8% for 3,000 candidate beams on average. When including the clinical goal in the training, coverage is improved by 1.1% points.

scholarly journals Outcomes of Peer Review for Radiotherapy Treatment Plans With Palliative Intent

2018 ◽  
Vol 14 (12) ◽  
pp. e794-e800
Author(s):  
Dina Thompson ◽  
Kimberly Cox ◽  
James Loudon ◽  
Ivan Yeung ◽  
Woodrow Wells
Keyword(s):  
Peer Review ◽  
Treatment Plan ◽  
Palliative Radiotherapy ◽  
Cancer Center ◽  
Palliative Intent ◽  
Treatment Plans ◽  
Important Quality ◽  
Radiation Medicine ◽  
Radiotherapy Treatment

Purpose: Peer review of a proposed treatment plan is increasingly recognized as an important quality activity in radiation medicine. Although peer review has been emphasized in the curative setting, applying peer review for treatment plans that have palliative intent is receiving increased attention. This study reports peer review outcomes for a regional cancer center that applied routine interprofessional peer review as a standard practice for palliative radiotherapy. Methods and Materials: Peer review outcomes for palliative radiotherapy plans were recorded prospectively for patients who began radiotherapy between October 1, 2015, and September 30, 2017. Recommended and implemented changes were recorded. The content of detailed discussions was recorded to gain insight into the complexities of palliative treatment plans considered during peer review. Results: Peer review outcomes were reviewed for 1,413 treatment plans with palliative intent. The proportions of detailed discussions and changes recommended were found to be 139 (9.8%) and 29 (2.1%), respectively. The content of detailed discussions and changes recommended was categorized. Major changes represented 75.9% of recommended changes, of which 84.2% were implemented clinically. Conclusion: Many complexities exist that are specific to palliative radiotherapy. Interprofessional peer review provides a forum for these complexities to be openly discussed and is an important activity to optimize the quality of care for patients with treatment plans that have palliative intent.

scholarly journals Targeting programmed cell death in metabolic dysfunction-associated fatty liver disease (MAFLD): a promising new therapy

2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Jianan Zhao ◽  
Yiyang Hu ◽  
Jinghua Peng
Keyword(s):  
Cell Death ◽  
Liver Disease ◽  
Programmed Cell Death ◽  
Fatty Liver ◽  
Theoretical Basis ◽  
Fatty Liver Disease ◽  
Metabolic Dysfunction ◽  
Signaling Mechanisms ◽  
Treatment Plans ◽  
Diet Control

AbstractMost currently recommended therapies for metabolic dysfunction-associated fatty liver disease (MAFLD) involve diet control and exercise therapy. We searched PubMed and compiled the most recent research into possible forms of programmed cell death in MAFLD, including apoptosis, necroptosis, autophagy, pyroptosis and ferroptosis. Here, we summarize the state of knowledge on the signaling mechanisms for each type and, based on their characteristics, discuss how they might be relevant in MAFLD-related pathological mechanisms. Although significant challenges exist in the translation of fundamental science into clinical therapy, this review should provide a theoretical basis for innovative MAFLD clinical treatment plans that target programmed cell death.

Outcomes Following Surgical Treatment of Hamate Arthrosis Lunotriquetral Ligament Injuries

Hand ◽  
2021 ◽  
pp. 155894472110432
Author(s):  
Jesse Meaike ◽  
Joshua Meaike ◽  
Sanjeev Kakar
Keyword(s):  
Surgical Treatment ◽  
Treatment Group ◽  
Combined Treatment ◽  
Additional Treatment ◽  
Ligament Injuries ◽  
Interosseous Ligament ◽  
Institutional Review ◽  
Lunotriquetral Ligament ◽  
Treatment Plans ◽  
And Function

Background: An institutional review board–approved study of the functional outcomes of patients after surgical treatment of hamate arthrosis lunotriquetral ligament tear (HALT) lesions was conducted. Methods: In all, 21 wrists in 19 patients underwent arthroscopic, open, or combined treatment of HALT lesions. Seven patients underwent isolated hamate debridement and 14 had concomitant procedures to address lunotriquetral pathology. Nineteen wrists underwent procedures to address additional pathology, including triangular fibrocartilage complex, ulnotriquetral ligament split, and scapholunate ligament injuries. Results: Mayo wrist scores increased from 54 to 71. Sixteen patients had no or mild pain postoperatively, compared with none preoperatively. When stratified by lunotriquetral interosseous ligament management, 75% of the limited treatment group (none or debridement) and 78% of the additional treatment group reported improved pain. Three patients underwent additional surgeries for persistent pain. Conclusion: Resection of the proximal pole of the hamate can improve pain and function for patients with ulnar-sided wrist pain secondary to a HALT lesion. Concomitant wrist pathologies should be considered when determining treatment plans.

Willingness to Travel for Cellular Therapy: The Influence of Follow-Up Care Location, Oncologist Continuity, and Race

2021 ◽  
pp. OP.21.00312
Author(s):  
Zachary A. K. Frosch ◽  
Esin C. Namoglu ◽  
Nandita Mitra ◽  
Daniel J. Landsburg ◽  
Sunita D. Nasta ◽  
...  
Keyword(s):  
Travel Time ◽  
Cellular Therapy ◽  
Treatment Plan ◽  
Admission Rate ◽  
B Cell Lymphoma ◽  
Travel Times ◽  
Importance Weights ◽  
Follow Up Care ◽  
Treatment Plans

PURPOSE Patients weigh competing priorities when deciding whether to travel to a cellular therapy center for treatment. We conducted a choice-based conjoint analysis to determine the relative value they place on clinical factors, oncologist continuity, and travel time under different post-treatment follow-up arrangements. We also evaluated for differences in preferences by sociodemographic factors. METHODS We administered a survey in which patients with diffuse large B-cell lymphoma selected treatment plans between pairs of hypothetical options that varied in travel time, follow-up arrangement, oncologist continuity, 2-year overall survival, and intensive care unit admission rate. We determined importance weights (which represent attributes' value to participants) using generalized estimating equations. RESULTS Three hundred and two patients (62%) responded. When all follow-up care was at the center providing treatment, plans requiring longer travel times were less attractive ( v 30 minutes, importance weights [95% CI] of –0.54 [–0.80 to –0.27], –0.57 [–0.84 to –0.29], and –0.17 [–0.49 to 0.14] for 60, 90, and 120 minutes). However, the negative impact of travel on treatment plan choice was mitigated by offering shared follow-up (importance weights [95% CI] of 0.63 [0.33 to 0.93], 0.32 [0.08 to 0.57], and 0.26 [0.04 to 0.47] at 60, 90, and 120 minutes). Black participants were less likely to choose plans requiring longer travel, regardless of follow-up arrangement, as indicated by lower value importance weights for longer travel times. CONCLUSION Reducing travel burden through shared follow-up may increase patients' willingness to travel to receive cellular therapies, but additional measures are required to facilitate equitable access.

Mathematical study of a single leukocyte in microchannel flow

2018 ◽  
Vol 13 (5) ◽  
pp. 43 ◽  
Author(s):  
S. Boujena ◽  
O. Kafi ◽  
A. Sequeira
Keyword(s):  
Mathematical Model ◽  
Numerical Approximation ◽  
Stokes Equations ◽  
Navier Stokes ◽  
Microchannel Flow ◽  
Navier Stokes Equations ◽  
Coupled Problem ◽  
Inflammatory Drugs ◽  
The Mathematical Model ◽  
Rate Type

The recruitment of leukocytes and subsequent rolling, activation, adhesion and transmigration are essential stages of an inflammatory response. Chronic inflammation may entail atherosclerosis, one of the most devastating cardiovascular diseases. Understanding this mechanism is of crucial importance in immunology and in the development of anti-inflammatory drugs. Micropipette aspiration experiments show that leukocytes behave as viscoelastic drops during suction. The flow of non-Newtonian viscoelastic fluids can be described by differential, integral and rate-type constitutive equations. In this study, the rate-type Oldroyd-B model is used to capture the viscoelasticity of the leukocyte which is considered as a drop. Our main goal is to analyze a mathematical model describing the deformation and flow of an individual leukocyte in a microchannel flow. In this model we consider a coupled problem between a simplified Oldroyd-B system and a transport equation which describes the density considered as non constant in the Navier–Stokes equations. First we present the mathematical model and we prove the existence of solution, then we describe its numerical approximation using the level set method. Through the numerical simulations we analyze the hemodynamic effects of three inlet velocity values. We note that the hydrodynamic forces pushing the cell become higher with increasing inlet velocities.

scholarly journals A Creature Called CIH: From a Quantum Explanation of Psychological Disorders to a Classical Limit of Behavior

2017 ◽  
Author(s):  
Saeideh Mohseni Nezhad
Keyword(s):  
Impulse Control ◽  
Classical Limit ◽  
Treatment Plan ◽  
Psychological Disorders ◽  
Conduct Disorders ◽  
Quantum Limit ◽  
Quantum Model ◽  
Quantum Field Theories ◽  
Treatment Plans ◽  
Suitable Treatment

The objective of this study is to present a Quantum Model for designing and predicting suitable treatment plans for different psychological disorders. The theory has been extracted from Quantum Field Theories and is modeled on a Conceptual Isolated Human (CIH), which is a totally abstract idea. The Quantum limit of the model explains the way disorders are formed, and its classical limit forecasts the observable CIH behavior. Then, a pattern has been presented for treatment plans based on the CIH Quantum Model, which is named ‘Systematic Balancing’. Finally, Systematic Balancing is presented in this article in order to explain and predict the treatment plan for the category of 'Disruptive, Impulse-Control, and Conduct Disorders in DSM-5'.

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