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Clinical workflow

M Catarina Silva, Stephen J Haggarty
Development of effective therapeutics for neurological disorders has historically been challenging partly because of lack of accurate model systems in which to investigate disease etiology and test new therapeutics at the preclinical stage. Human stem cells, particularly patient-derived induced pluripotent stem cells (iPSCs) upon differentiation, have the ability to recapitulate aspects of disease pathophysiology and are increasingly recognized as robust scalable systems for drug discovery. We review advances in deriving cellular models of human central nervous system (CNS) disorders using iPSCs along with strategies for investigating disease-relevant phenotypes, translatable biomarkers, and therapeutic targets...
March 15, 2019: Annals of the New York Academy of Sciences
C Ranganathan, S Balaji
BACKGROUND: Despite demonstrated benefits and improved demand for telemedicine, adoption rates by U.S. ambulatory clinics remain low. There is a critical need to identify why telemedicine adoption rates remain low among ambulatory providers. INTRODUCTION: The aim of this study is to evaluate key predictors of telemedicine adoption by ambulatory clinics and assess salient differences between adopters and nonadopters. Three categories of predictors namely clinic characteristics, health information technology (HIT)-related factor, and organizational variables were examined...
March 15, 2019: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
Giulia Cappi, Diego Gabriel Dupouy, Marta Aurelia Comino, Ata Tuna Ciftlik
Multistaining of a tissue section targeting multiple markers allows to reveal complex interplays in a tumor environment. However, the resource-intensive and impractically long nature of iterative multiplexed immunostainings prohibits its practical implementation in daily routine, even when using work-flow automation systems. Here, we report a fully automated and ultra-fast multistaining using a microfluidic tissue processor (MTP) in as short as 20 minutes per marker, by immunofluorescent staining employing commercially available tyramide signal amplification polymer precipitation by horse-radish peroxidase (HRP) activation...
March 14, 2019: Scientific Reports
Emanuela Leoni, Michael Bremang, Vikram Mitra, Irene Zubiri, Stephan Jung, Ching-Hua Lu, Rocco Adiutori, Vittoria Lombardi, Claire Russell, Sasa Koncarevic, Malcolm Ward, Ian Pike, Andrea Malaspina
The lack of biomarkers for early diagnosis, clinical stratification and to monitor treatment response has hampered the development of new therapies for amyotrophic lateral sclerosis (ALS), a clinically heterogeneous neurodegenerative disorder with a variable site of disease initiation and rate of progression. To identify new biomarkers and therapeutic targets, two separate proteomic workflows were applied to study the immunological response and the plasma/brain proteome in phenotypic variants of ALS. Conventional multiplex (TMT) proteomic analysis of peripheral blood mononuclear cells (PBMCs) was performed alongside a recently introduced method to profile neuronal-derived proteins in plasma using brain tissue-enhanced isobaric tagging (TMTcalibrator)...
March 14, 2019: Scientific Reports
Shraddha Pai, Shirley Hui, Ruth Isserlin, Muhammad A Shah, Hussam Kaka, Gary D Bader
Patient classification has widespread biomedical and clinical applications, including diagnosis, prognosis, and treatment response prediction. A clinically useful prediction algorithm should be accurate, generalizable, be able to integrate diverse data types, and handle sparse data. A clinical predictor based on genomic data needs to be interpretable to drive hypothesis-driven research into new treatments. We describe netDx, a novel supervised patient classification framework based on patient similarity networks, which meets these criteria...
March 14, 2019: Molecular Systems Biology
Geoff Toner, Clark D Russell, Fiona Hamilton, Kate Templeton, Ian F Laurenson
PURPOSE: This study evaluated in-house PCR testing for local identification of bacteria carrying the major carbapenemase genes (blaOXA-48-like, blaVIM, blaNDM, blaKPC and blaIMP). METHODOLOGY: Carbapenemase-producing organisms (CPOs) isolated from patients managed in two tertiary care hospitals in Scotland from September 2014-January 2017 were investigated. A combination of chromogenic screening agar (ChromID CARBA SMART), a carbapenem hydrolysis test (Rapidec Carba NP) and in-house real-time PCR for the blaOXA-48-like, blaVIM, blaNDM, blaKPC and blaIMP genes were utilized...
March 14, 2019: Journal of Medical Microbiology
Shinichi Kai, Yoshiyuki Matsuo, So Nakagawa, Kirill Kryukov, Shino Matsukawa, Hiromasa Tanaka, Teppei Iwai, Tadashi Imanishi, Kiichi Hirota
Rapid identification of bacterial pathogens is crucial for appropriate and adequate antibiotic treatment, which significantly improves patient outcomes. 16S ribosomal RNA (rRNA) gene amplicon sequencing has proven to be a powerful strategy for diagnosing bacterial infections. We have recently established a sequencing method and bioinformatics pipeline for 16S rRNA gene analysis utilizing the Oxford Nanopore Technologies MinION™ sequencer. In combination with our taxonomy annotation analysis pipeline, the system enabled the molecular detection of bacterial DNA in a reasonable time frame for diagnostic purposes...
March 2019: FEBS Open Bio
Paolo Cappare, Gianpaolo Sannino, Margherita Minoli, Pietro Montemezzi, Francesco Ferrini
Background : The objective of this study was to compare conventional versus digital impressions for Full-Arch maxillary rehabilitations. Methods : Patients selected for this study were treated with full-arch screw-retained rehabilitations supported by six immediately loaded dental implants. Patients have been scheduled randomly into control (conventional impression group, CIG) and test (digital impression group, DIG) groups respectively for a fully conventional workflow and a fully digital workflow. In both groups, within 24 h, temporary prostheses were delivered...
March 7, 2019: International Journal of Environmental Research and Public Health
Maria Belén Marzal-Alfaro, Vicente Escudero-Vilaplana, Carmen Guadalupe Rodríguez-González, Eva González-Haba, Aitana Calvo, Santiago Osorio, Irene Iglesias-Peinado, Ana Herranz, María Sanjurjo
OBJECTIVE: The aim of the study was to analyze both the prevalence of errors with the implementation of an image-based workflow management system during the antineoplastic compounding process, and the estimated costs associated with the negative clinical outcome if the errors had not been intercepted. METHODS: Three months after the implementation of Phocus Rx system at a hospital pharmacy department, the identification, classification (type, preparation stage, and cause), and potential severity degree (from negligible to catastrophic) of the errors intercepted were determined...
March 6, 2019: Journal of Patient Safety
Peter Androvic, Nataliya Romanyuk, Lucia Urdzikova-Machova, Eva Rohlova, Mikael Kubista, Lukas Valihrach
Circulating cell-free microRNAs are promising candidates for minimally invasive clinical biomarkers for the diagnosis, prognosis and monitoring of many human diseases. Despite substantial efforts invested in the field, the research so far has failed to deliver expected results. One of the contributing factors is general lack of agreement between various studies, partly due to the considerable technical challenges accompanying the workflow. Pre-analytical variables including sample collection, RNA isolation, and quantification are sources of bias that may hamper biological interpretation of the results...
March 12, 2019: Scientific Reports
Per Halvorsen, Nilendu Gupta, Yi Rong
No abstract text is available yet for this article.
March 12, 2019: Journal of Applied Clinical Medical Physics
J Shapey, Y Xie, E Nabavi, R Bradford, S R Saeed, S Ourselin, T Vercauteren
Multispectral and hyperspectral imaging (HSI) are emerging optical imaging techniques with the potential to transform the way surgery is performed but it is not clear whether current systems are capable of delivering real-time tissue characterisation and surgical guidance. We conducted a systematic review of surgical in vivo label-free multispectral and hyperspectral imaging systems that have been assessed intraoperatively in adult patients, published over a 10-year period to May 2018. We analysed 13 studies including 7 different HSI systems...
March 11, 2019: Journal of Biophotonics
Robert J Allen, Deana S Shenaq, Evan B Rosen, Snehal G Patel, Ian Ganly, Jay O Boyle, Jonas A Nelson, Evan Matros
Full dental rehabilitation following segmental mandibulectomy or maxillectomy for oncologic tumor ablation should be the goal for every patient. But despite advances in technology and reconstructive techniques, many patients do not achieve timely or complete oral rehabilitation. Recognizing this fault, we recently adopted an innovative workflow to increase the number of patients undergoing dental restoration, irrespective of tumor pathology or need for adjuvant radiotherapy. Preoperatively, every osseous jaw reconstruction undergoes virtual surgical planning to incorporate the placement of endosseous implants into the fibula osteocutaneous free flap...
January 2019: Plastic and Reconstructive Surgery. Global Open
Iva Bratova, Petr Paluska, Jakub Grepl, Petra Sykorova, Jan Jansa, Miroslav Hodek, Igor Sirak, Milan Vosmik, Jiri Petera
Aim: To evaluate calculation of treatment plans based on synthetic-CT (sCT) images generated from MRI. Background: Because of better soft tissue contrast, MR images are used in addition to CT images for radiotherapy planning. However, registration of CT and MR images or repositioning between scanning sessions introduce systematic errors, hence suggestions for MRI-only therapy. The lack of information on electron density necessary for dose calculation leads to sCT (synthetic CT) generation...
March 2019: Reports of Practical Oncology and Radiotherapy
Brent van der Heyden, Patrick Wohlfahrt, Daniëlle B P Eekers, Christian Richter, Karin Terhaag, Esther G C Troost, Frank Verhaegen
In radiotherapy, computed tomography (CT) datasets are mostly used for radiation treatment planning to achieve a high-conformal tumor coverage while optimally sparing healthy tissue surrounding the tumor, referred to as organs-at-risk (OARs). Based on CT scan and/or magnetic resonance images, OARs have to be manually delineated by clinicians, which is one of the most time-consuming tasks in the clinical workflow. Recent multi-atlas (MA) or deep-learning (DL) based methods aim to improve the clinical routine by an automatic segmentation of OARs on a CT dataset...
March 11, 2019: Scientific Reports
Oyediran Akinrinade, Tiina Heliö, Ronald H Lekanne Deprez, Jan D H Jongbloed, Ludolf G Boven, Maarten P van den Berg, Yigal M Pinto, Tero-Pekka Alastalo, Samuel Myllykangas, Karin van Spaendonck-Zwarts, J Peter van Tintelen, Paul A van der Zwaag, Juha Koskenvuo
Recent advancements in next generation sequencing (NGS) technology have led to the identification of the giant sarcomere gene, titin (TTN), as a major human disease gene. Truncating variants of TTN (TTNtv) especially in the A-band region account for 20% of dilated cardiomyopathy (DCM) cases. Much attention has been focused on assessment and interpretation of TTNtv in human disease; however, missense and non-frameshifting insertions/deletions (NFS-INDELs) are difficult to assess and interpret in clinical diagnostic workflow...
March 11, 2019: Scientific Reports
Paul Hamelmann, Massimo Mischi, Alexander F Kolen, Judith O E H van Laar, Rik Vullings, Jan W M Bergmans
Fetal heart rate (fHR) monitoring using Doppler Ultrasound (US) is a standard method to assess fetal health before and during labor. Typically, an US transducer is positioned on the maternal abdomen and directed towards the fetal heart. Due to fetal movement or displacement of the transducer, the relative fetal heart location (fHL) with respect to the US transducer can change, leading to frequent periods of signal loss. Consequently, frequent repositioning of the US transducer is required, which is a cumbersome task affecting clinical workflow...
March 8, 2019: Sensors
Hao Yang, Xiaotao Guo, Lawrence H Schwartz, Binsheng Zhao
Quantitative imaging biomarkers are increasingly used in oncology clinical trials to assist the evaluation of tumor responses to novel therapies. To identify these biomarkers and ensure smooth clinical translation once they have been validated, it is critical to develop a reliable workflow-efficient imaging platform for integration in clinical settings. Here we will present a web-based volumetric response-assessment system that we developed based on an open-source image viewing platform (WEASIS) and a DICOM image archive (DCM4CHEE)...
March 2019: Tomography: a Journal for Imaging Research
Saumya Gurbani, Brent Weinberg, Lee Cooper, Eric Mellon, Eduard Schreibmann, Sulaiman Sheriff, Andrew Maudsley, Mohammed Goryawala, Hui-Kuo Shu, Hyunsuk Shim
Glioblastoma has poor prognosis with inevitable local recurrence despite aggressive treatment with surgery and chemoradiation. Radiation therapy (RT) is typically guided by contrast-enhanced T1-weighted magnetic resonance imaging (MRI) for defining the high-dose target and T2-weighted fluid-attenuation inversion recovery MRI for defining the moderate-dose target. There is an urgent need for improved imaging methods to better delineate tumors for focal RT. Spectroscopic MRI (sMRI) is a quantitative imaging technique that enables whole-brain analysis of endogenous metabolite levels, such as the ratio of choline-to-N-acetylaspartate...
March 2019: Tomography: a Journal for Imaging Research
Daniel L Rubin, Mete Ugur Akdogan, Cavit Altindag, Emel Alkim
Medical imaging is critical for assessing the response of patients to new cancer therapies. Quantitative lesion assessment on images is time-consuming, and adopting new promising quantitative imaging biomarkers of response in clinical trials is challenging. The electronic Physician Annotation Device (ePAD) is a freely available web-based zero-footprint software application for viewing, annotation, and quantitative analysis of radiology images designed to meet the challenges of quantitative evaluation of cancer lesions...
March 2019: Tomography: a Journal for Imaging Research
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