scholarly journals Limitations of ventilating multiple patients using single ventilator during the COVID-19 pandemic

2021 ◽  
Vol 10 (1) ◽  
pp. 165
Author(s):  
Neeraj Kumar
Keyword(s):  
Multiple Patients

scholarly journals Pooled testing with replication as a mass testing strategy for the COVID-19 pandemics

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Julius Žilinskas ◽  
Algirdas Lančinskas ◽  
Mario R. Guarracino
Keyword(s):  
Real Time ◽  
Real Time Pcr ◽  
Group Testing ◽  
Testing Strategy ◽  
Testing Technique ◽  
Testing Procedures ◽  
Pooled Testing ◽  
Replication Scheme ◽  
Speed Up ◽  
Multiple Patients

AbstractDuring the COVID-19 pandemic it is essential to test as many people as possible, in order to detect early outbreaks of the infection. Present testing solutions are based on the extraction of RNA from patients using oropharyngeal and nasopharyngeal swabs, and then testing with real-time PCR for the presence of specific RNA filaments identifying the virus. This approach is limited by the availability of reactants, trained technicians and laboratories. One of the ways to speed up the testing procedures is a group testing, where the swabs of multiple patients are grouped together and tested. In this paper we propose to use the group testing technique in conjunction with an advanced replication scheme in which each patient is allocated in two or more groups to reduce the total numbers of tests and to allow testing of even larger numbers of people. Under mild assumptions, a 13 ×  average reduction of tests can be achieved compared to individual testing without delay in time.

Regression Lines Using Multiple Measurements from Multiple Patients

1987 ◽  
Vol 66 (4) ◽  
pp. 368
Author(s):  
Steven J. Barker ◽  
Kevin K. Tremper
Keyword(s):  
Multiple Measurements ◽  
Multiple Patients

Measuring evolutionary cancer dynamics from genome sequencing, one patient at a time

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Giulio Caravagna
Keyword(s):  
Genome Sequencing ◽  
Cancer Evolution ◽  
Sequencing Data ◽  
Evolutionary Forces ◽  
Sequencing Technologies ◽  
Cancer Genome Sequencing ◽  
Multiple Resolutions ◽  
Multiple Patients ◽  
Single Tumour ◽  
Generation Sequencing

AbstractCancers progress through the accumulation of somatic mutations which accrue during tumour evolution, allowing some cells to proliferate in an uncontrolled fashion. This growth process is intimately related to latent evolutionary forces moulding the genetic and epigenetic composition of tumour subpopulations. Understanding cancer requires therefore the understanding of these selective pressures. The adoption of widespread next-generation sequencing technologies opens up for the possibility of measuring molecular profiles of cancers at multiple resolutions, across one or multiple patients. In this review we discuss how cancer genome sequencing data from a single tumour can be used to understand these evolutionary forces, overviewing mathematical models and inferential methods adopted in field of Cancer Evolution.

scholarly journals Mycobacterium talmoniae, a Potential Pulmonary Pathogen Isolated from Multiple Patients with Bronchiectasis in the United States, Including the First Case of Clinical Disease in a Patient with Cystic Fibrosis

2018 ◽  
Vol 57 (2) ◽  
Author(s):  
Ravikiran Vasireddy ◽  
Sruthi Vasireddy ◽  
Barbara A. Brown-Elliott ◽  
Alexander L. Greninger ◽  
Rebecca M. Davidson ◽  
...  
Keyword(s):  
United States ◽  
Cystic Fibrosis ◽  
16S Rrna ◽  
Type Strain ◽  
Gene Sequencing ◽  
The United States ◽  
Average Nucleotide Identity ◽  
Content Type ◽  
First Case ◽  
Multiple Patients

ABSTRACTWe characterize three respiratory isolates of the recently described speciesMycobacterium talmoniaerecovered in Texas, Louisiana, and Massachusetts, including the first case of disease in a patient with underlying cystic fibrosis. The three isolates had a 100% match toM. talmoniaeNE-TNMC-100812Tby complete 16S rRNA,rpoBregion V, andhsp65 gene sequencing. Core genomic comparisons between one isolate and the type strain revealed an average nucleotide identity of 99.8%. The isolates were susceptible to clarithromycin, amikacin, and rifabutin, while resistance was observed for tetracyclines, ciprofloxacin, and linezolid.M. talmoniaeshould be added to the list of potential pulmonary pathogens, including in the setting of cystic fibrosis.

scholarly journals Split ventilation with pressure regulators for patient-specific tidal volumes

2020 ◽  
Author(s):  
Lakshminarayan “Ram” Srinivasan ◽  
Chris A. Rishel ◽  
Barrett J. Larson ◽  
Juhwan Yoo ◽  
Ned M. Shelton
Keyword(s):  
Tidal Volume ◽  
Gas Flow ◽  
Patient Management ◽  
Patient Specific ◽  
Resource Constrained ◽  
Mechanical Ventilators ◽  
Pressure Regulator ◽  
Safety Testing ◽  
Progression Of Disease ◽  
Multiple Patients

AbstractAs a measure of last resort during the COVID-19 pandemic, single mechanical ventilators have been repurposed to support multiple patients. In existing split-ventilator configurations using FDA-approved tubing adaptors, each patient receives the same inspiratory pressure, requiring careful matching of patients to avoid barotrauma. Progression of disease may cause tidal volumes to diverge from desired targets, and routine interventions (eg. suctioning) in one patient may adversely affect other patients. To overcome these limitations, we demonstrate a split-ventilator configuration that enables individualized patient management by incorporating a commonly available pressure regulator used for gas appliances. We validate this method by achieving various combinations of tidal volume in each of two synthetic lungs using a standard ventilator machine in combination with two gas flow analyzers. With further safety testing and instrumentation, pressure regulators may represent a viable path to substantially augment the capacity for ventilation in resource-constrained settings.

scholarly journals RARE-35. MRI FINDINGS AT PROGRESSION IN ADULT PATIENTS WITH MEDULLOBLASTOMA

2019 ◽  
Vol 21 (Supplement_6) ◽  
pp. vi229-vi229
Author(s):  
Christine Cordova ◽  
Elizabeth Vera ◽  
Orwa Aboud ◽  
Ramya Antony ◽  
Lisa Boris ◽  
...  
Keyword(s):  
Sonic Hedgehog ◽  
High Specificity ◽  
Brain Parenchyma ◽  
Brain Lesions ◽  
Adult Patients ◽  
Mri Findings ◽  
Diagnostic Challenge ◽  
Natural History Study ◽  
Tumor Bed ◽  
Multiple Patients

Abstract Progression (PD) in medulloblastoma (MB) represents a diagnostic challenge due to imaging heterogeneity among/within patients. SHH (Sonic hedgehog)-MB is thought to recur mostly within the tumor bed (TB). In children, DWI restriction (DWIr) is more sensitive than contrast enhancement(CE) for first PD. Whether this is applicable to adults is unknown. METHODS Retrospective review of adults (age ≥18) with MB enrolled to Natural History study at NCI-NOB. Descriptive statistics of imaging at diagnosis and PD(CE, T2/FLAIR signal without CE, DWIr) and imaging patterns for each PD. RESULTS:14 adults with MB: 5 diagnosed in childhood (8–16 yrs), 9 as adults (18–45 yrs); Subtypes: 7 SHH, 3 non-WNT/non-SHH, 4 unknown. Eleven experienced ≥1 PD (6/7 SHH, 2/3 non-WNT/non-SHH, 3/4 unknown); median PD of 5 (range 1–9). Median age at first PD 31 years (range 10–46) with 5 first PDs >5 years after diagnosis. In 10 patients with available baseline MRI, 9 had CE, and 8 DWIr (2 without DWI sequences). Of 48 total PDs, the commonest patterns were: brain LMD alone (n=14), TB alone or distant brain parenchyma alone (each n=7), distant brain parenchyma with brain LMD (n=6), and TB with either distant brain parenchyma or LMD (n=3). Of the 82 PD lesions, 23% (n=14) of brain lesions lacked DWIr, and 37% (n=23) had T2/FLAIR signal without CE. PD tissue confirmation obtained at 18 time points:16 cases with confirmed recurrence had heterogeneous characteristics; in 12 with brain PD: CE in 5, T2/FLAIR without CE in 3 (unknown: 4). 2 CE lesions revealed meningioma (one- atypical meningioma- had DWIr). CONCLUSIONS Imaging findings in adult patients with MB are highly heterogeneous. Despite high specificity of DWIr for PD in children, it failed for 23% of brain lesions across multiple patients. Most SHH-MB had PD outside the TB, unlike what is widely accepted in the literature.

scholarly journals Cueing Attention to a Matrix of Values on a Head-Worn Display: Four Studies with a Multiple Patient Monitoring Task

2019 ◽  
Vol 63 (1) ◽  
pp. 1771-1771
Author(s):  
Isaac S. Salisbury ◽  
Tsz-Lok Tang ◽  
Caitlin Browning ◽  
Paul D. Schlosser ◽  
Ismail Mohamed ◽  
...  
Keyword(s):  
Patient Monitoring ◽  
Vital Signs ◽  
High Contrast ◽  
Design Features ◽  
Visual Cue ◽  
Monitoring Task ◽  
Patient Deterioration ◽  
Auditory Alerts ◽  
Multiple Patients

Head-worn displays (HWDs) can help clinicians monitor multiple patients by displaying multiple patients’ vital signs. We conducted four experiments exploring design features that affect how a HWD can quickly and reliably cue attention to patient deterioration. In a series of lab-based experiments, we found that a HWD could quickly and reliably cue participants’ attention with high-contrast visual highlights with two distinct levels, or with a short white flash. However, visual alerts on a HWD did not cue attention as quickly as similar alerts on a conventional screen or auditory alerts. We conclude that HWDs can quickly notify clinicians of patient deterioration when paired with a strong visual cue, but there are perceptual challenges unique to HWDs.

scholarly journals Identification and Validation of Nebulized Aerosol Devices for Sputum Induction

2014 ◽  
Vol 21 (2) ◽  
pp. 101-106 ◽  
Author(s):  
Warren J Davidson ◽  
John Dennis ◽  
Stephanie The ◽  
Belinda Litoski ◽  
Cora Pieron ◽  
...  
Keyword(s):  
Induced Sputum ◽  
Infection Prevention And Control ◽  
Sputum Induction ◽  
Induction Program ◽  
Cell Counts ◽  
Significant Difference ◽  
Scientific Testing ◽  
Patient Use ◽  
And Control ◽  
Multiple Patients

BACKGROUND: Induced sputum cell counts are a noninvasive and reliable method for evaluating the presence, type and degree of airway inflammation in patients with asthma. Currently, standard nebulizer devices used for sputum induction in multiple patients are labelled as single-patient devices by the manufacturer, which conflicts with infection prevention and control requirements. As such, these devices cannot feasibly be used in a clinical sputum induction program. Therefore, there is a need to identify alternative nebulizer devices that are either disposable or labelled for multi-patient use.OBJECTIVE: To apply validated rigorous, scientific testing methods to identify and validate commercially available nebulizer devices appropriate for use in a clinical sputum induction program.METHODS: Measurement of nebulized aerosol output and size for the selected nebulizer designs followed robust International Organization for Standardization methods. Sputum induction using two of these nebulizers was successfully performed on 10 healthy adult subjects. The cytotechnologist performing sputum cell counts was blinded to the type of nebulizer used.RESULTS: The studied nebulizers had variable aerosol outputs. The AeroNeb Solo (Aerogen, Ireland), Omron NE-U17 (Omron, Japan) and EASYneb II (Flaem Nuova, Italy) systems were found to have similar measurements of aerosol size. There was no significant difference in induced sputum cell results between the AeroNeb Solo and EASYneb II devices.DISCUSSION: There is a need for rigorous, scientific evaluation of nebulizer devices for clinical applications, including sputum induction, for measurement of cell counts.CONCLUSION: The present study was the most comprehensive analysis of different nebulizer devices for sputum induction to measure cell counts, and provides a framework for appropriate evaluation of nebulizer devices for induced sputum testing.

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