基于D-优化设计的那拉曲坦给药方案的建模与仿真

以那拉曲坦为例,建立药效学模型,应用D-优化设计计算相应Fisher信息矩阵,将不同给药方案下的实验结果进行量化,直观给出合理的给药方案。设计5种不同给药方案组,计算对应的Fisher信息矩阵行列式并进行组间对照,最后得出合理的给药方案。通过试验仿真结果可以对临床给药给出适当的指导。     

基于比例优势模型的那拉曲坦临床试验的建模与仿真

以那拉曲坦为例,基于比例优势模型验证了药物临床计算机模拟的可行性和实用性.对疼痛减轻的概率预测,得到的结果与那拉曲坦说明书中的曲线十分接近.在给药方案为安慰剂1、2.5、5、10、15、20mg情况下,得出头痛减轻概率的曲线,得到头痛减轻概率随给药剂量的不同而变化,从而对临床给药方案提供一定的参考.药物临床的计算机模拟是可控因素影响下定量分析的有效方法.     

急性失血的模型及计算机仿真

在作者已建立的心脏-体循环-肺循环整体模型HSP的基础上引入了压力反射控制机制,进行人体急性失血现象的建模和计算机仿真.实验结果表明符合生理和病理现象,在心率(HR)、心室弹性模量(Emax)、外周阻力(Rep)和静脉非压力容积(Vuv)等诸因素中,Vuv在心血管系统应对急性失血中起着主要作用.     

三维心电场仿真模型及计算机仿真——Ⅰ心电场仿真模型的理论基础

心电场计算机仿真是心理论研究的重要手段,也是心电理论研究的前沿课题之一。本文介绍了我们新近在IBM PC机上开发完成的心电仿真模型,其各项指标均达到了国外同类模型的水平,它能完成以往在大型机上实现的仿真模型所能完成的研究工作。     

三维心电场仿真模型及计算机仿真——Ⅱ.模型的实现原理及仿真结果

本文讨论了利用心电模型仿真心脏兴奋传播过程的方法,并给出了正常心脏的仿真结果。     

左心室局部心肌梗塞时的组分式模型及计算机仿真

为研究左心室局部心肌梗塞时心肌各部分的能量供需状况及心脏辅助装置对改善心肌能量供给的影响，我们建立了一个由左心室正常区域心肌和梗塞区域心肌两部分组成的组分式模型，我们的模型以Ｓｕｎａｇａｗａ的模型为基础，并在此基础上加以扩展，与Ｓｕｎａｇａｗａ的模型相比，我们的模型允许梗塞区域心肌的收缩性在一定范围内变化，从而可以模拟各种不同范围和不同程度的梗塞情况。用建立好的左心室组分式模型取代我们原有的狗的心     

腹膜透析中物质跨膜转运的三孔模型的研究与计算机仿真

三孔模型是描述腹膜两侧物质跨膜转运过程的一种集中参数模型,可以较准确地反映水和溶质的跨膜转运过程.本文回顾了国内外三孔模型的研究历史,并介绍了临床工作中三孔模型的计算机仿真,最后探讨了三孔模型可能存在的问题.     

新药和医疗器械临床试验设计与SAS统计分析培训班通知

<正>随着改革开放不断深入,我国的新药和医疗器械的临床试验研究正如火如荼地开展,且方兴未艾。然而,从审阅已完成的大量此类研究项目的结果来看,其试验设计质量和数据分析质量均不容乐观。有必要对有关研究单位和临床试验部门的相     

Comparison of Virtual Patient Simulation With Mannequin-Based Simulation for Improving Clinical Performances in Assessing and Managing Clinical Deterioration: Randomized Controlled Trial

Background

Virtual patient simulation has grown substantially in health care education. A virtual patient simulation was developed as a refresher training course to reinforce nursing clinical performance in assessing and managing deteriorating patients.

Objective

The objective of this study was to describe the development of the virtual patient simulation and evaluate its efficacy, by comparing with a conventional mannequin-based simulation, for improving the nursing students’ performances in assessing and managing patients with clinical deterioration.

Methods

A randomized controlled study was conducted with 57 third-year nursing students who were recruited through email. After a baseline evaluation of all participants’ clinical performance in a simulated environment, the experimental group received a 2-hour fully automated virtual patient simulation while the control group received 2-hour facilitator-led mannequin-based simulation training. All participants were then re-tested one day (first posttest) and 2.5 months (second posttest) after the intervention. The participants from the experimental group completed a survey to evaluate their learning experiences with the newly developed virtual patient simulation.

Results

Compared to their baseline scores, both experimental and control groups demonstrated significant improvements (P<.001) in first and second post-test scores. While the experimental group had significantly lower (P<.05) second post-test scores compared with the first post-test scores, no significant difference (P=.94) was found between these two scores for the control group. The scores between groups did not differ significantly over time (P=.17). The virtual patient simulation was rated positively.

Conclusions

A virtual patient simulation for a refreshing training course on assessing and managing clinical deterioration was developed. Although the randomized controlled study did not show that the virtual patient simulation was superior to mannequin-based simulation, both simulations have demonstrated to be effective refresher learning strategies for improving nursing students’ clinical performance. Given the greater resource requirements of mannequin-based simulation, the virtual patient simulation provides a more promising alternative learning strategy to mitigate the decay of clinical performance over time.     

Proportional assist ventilation system based on proportional solenoid valve control

A new proportional assist ventilation (PAV) method using a proportional solenoid valve (PSV) to control air supply to patients suffering from respiratory disabilities, was studied. The outlet flow and pressure from the proportional solenoid valve at various air supply pressures were tested and proven to be suitable for pressure and flow control in a PAV system. In vitro tests using a breathing simulator, which has been proven to possess the general characteristics of human respiratory system in spontaneous breathing tests, were conducted and the results demonstrated the viability of this PAV system in normalizing the breathing patterns of patients with abnormally high resistances and elastances as well as neuromuscular weaknesses. With a back-up safety mechanism incorporated in the control program, pressure "run-away" can be effectively prevented and safe operation of the system can be guaranteed.     

Race and HIV Clinical Trial Participation

PurposeThis study was designed to examine at the role race/ethnicity plays in human immunodeficiency virus (HIV) clinical trial enrollment.BackgroundHIV clinical trials are vitally important for improving knowledge about medications and their impact on the pathogenesis of HIV/AIDS. African Americans are disproportionately underrepresented in HIV clinical trials.MethodsA 49-item survey was administered to 145 patients at an urban HIV clinic to explore race and HIV clinical trial participation.ResultsStudy participants were 56% Caucasian, 19% other, 16% African American, and 13% Hispanic. Fewer African Americans had been asked to participate in a trial compared to other groups (8% vs 24%) (p < .05). African Americans were less likely to volunteer for a trial compared to Hispanics and Caucasians, but African Americans did not differ significantly in their willingness participate in clinical trials vs other racial groups. In a regression model age, past trial participation, monetary gain, and comfort with the clinical setting predicted willingness to participate in a trial across racial groups (p < .05).DiscussionThere is a strong need to identify strategies to increase African American enrollment in trials. Such strategies need to begin with trial recruiters actively seeking out African Americans for clinical trial enrollment.     

脑组织光学模型的Monte-Carlo仿真研究

研究脑组织参数和光学特性对NIRs光谱在组织表面的分布特性的影响。本研究采用MonteCarlo方法对脑组织光学模型进行仿真,分别研究脑脊液含量、灰质和白质的光学系数对组织表面光通量值的影响。研究发现:脑组织的组织参数和光学特性影响组织表面的光通量值。组织表面的光通量与脑组织吸收系数呈负相关,与脑组织约化散射系数呈正相关。理想状态下,在1.5~3.5 cm的检测半径内,组织表面的光通量值与脑脊液含量和脑实质光学特性具有显著相关性。     

How To Successfully Design and Implement a Clinical Trial To Evaluate the Clinical Impact of New Diagnostic Assays for Testing Positive Blood Culture Bottles

New infectious disease diagnostics are being introduced into clinical practice at high rates. For tests that are better, faster, and less expensive than what came before, adoption is easy. However, many new tests, though faster than conventional diagnostics, are more expensive. Whether they will add value to patient care must be evaluated and can best be assessed by randomized controlled clinical trials (RCTs). Here, an overview of RCTs of new blood culture diagnostics is presented. Operational logistics of executing RCTs of new diagnostics are presented based on the authors' experience. For tests that facilitate appropriate use of antibiotics, involvement of an antimicrobial stewardship team in the associated clinical trial is important.     

Summary of the 2008 National Institute of Allergy and Infectious Diseases–US Food and Drug Administration Workshop on Food Allergy Clinical Trial Design

The 2008 NIAID-FDA Workshop participants identified numerous challenges to the design of clinical trials in food allergy research (Table I). The workshop participants were able to recommend several approaches to overcome these difficulties. A critical aspect of this issue brought out by the workshop participants was the need for investigators to work closely with both FDA and NIAID staff in the design of a food allergy clinical trial, especially in situation in which investigators anticipate eventually seeking licensure for their therapeutic agent.