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  1. Detection of P. aeruginosa harboring bla CTX-M-2, bla GES-1 and bla GES-5, bla IMP-1 and bla SPM-1 causing infections in Brazilian tertiary-care hospital

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    2012-01-01

    Background Nosocomial infections caused by Pseudomonas aeruginosa presenting resistance to beta-lactam drugs are one of the most challenging targets for antimicrobial therapy, leading to substantial increase in mortality rates in hospitals worldwide. In this context, P. aeruginosa harboring acquired mechanisms of resistance, such as production of metallo-beta-lactamase (MBLs) and extended-spectrum beta-lactamases (ESBLs) have the highest clinical impact. Hence, this study was designed to investigate the presence of genes codifying for MBLs and ESBLs among carbapenem resistant P. aeruginosa isolated in a Brazilian 720-bed teaching tertiary care hospital. Methods Fifty-six carbapenem-resistant P. aeruginosa strains were evaluated for the presence of MBL and ESBL genes. Strains presenting MBL and/or ESBL genes were submitted to pulsed-field gel electrophoresis for genetic similarity evaluation. Results Despite the carbapenem resistance, genes for MBLs (blaSPM-1 or blaIMP-1) were detected in only 26.7% of isolates. Genes encoding ESBLs were detected in 23.2% of isolates. The blaCTX-M-2 was the most prevalent ESBL gene (19.6%), followed by blaGES-1 and blaGES-5 detected in one isolate each. In all isolates presenting MBL phenotype by double-disc synergy test (DDST), the blaSPM-1 or blaIMP-1 genes were detected. In addition, blaIMP-1 was also detected in three isolates which did not display any MBL phenotype. These isolates also presented the blaCTX-M-2 gene. The co-existence of blaCTX-M-2 with blaIMP-1 is presently reported for the first time, as like as co-existence of blaGES-1 with blaIMP-1. Conclusions In this study MBLs production was not the major mechanism of resistance to carbapenems, suggesting the occurrence of multidrug efflux pumps, reduction in porin channels and production of other beta-lactamases. The detection of blaCTX-M-2,blaGES-1 and blaGES-5 reflects the recent emergence of ESBLs among antimicrobial resistant P. aeruginosa and the extraordinary

  2. Detection of P. aeruginosa harboring bla CTX-M-2, bla GES-1 and bla GES-5, bla IMP-1 and bla SPM-1 causing infections in Brazilian tertiary-care hospital

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    Polotto Milena

    2012-08-01

    Full Text Available Abstract Background Nosocomial infections caused by Pseudomonas aeruginosa presenting resistance to beta-lactam drugs are one of the most challenging targets for antimicrobial therapy, leading to substantial increase in mortality rates in hospitals worldwide. In this context, P. aeruginosa harboring acquired mechanisms of resistance, such as production of metallo-beta-lactamase (MBLs and extended-spectrum beta-lactamases (ESBLs have the highest clinical impact. Hence, this study was designed to investigate the presence of genes codifying for MBLs and ESBLs among carbapenem resistant P. aeruginosa isolated in a Brazilian 720-bed teaching tertiary care hospital. Methods Fifty-six carbapenem-resistant P. aeruginosa strains were evaluated for the presence of MBL and ESBL genes. Strains presenting MBL and/or ESBL genes were submitted to pulsed-field gel electrophoresis for genetic similarity evaluation. Results Despite the carbapenem resistance, genes for MBLs (blaSPM-1 or blaIMP-1 were detected in only 26.7% of isolates. Genes encoding ESBLs were detected in 23.2% of isolates. The blaCTX-M-2 was the most prevalent ESBL gene (19.6%, followed by blaGES-1 and blaGES-5 detected in one isolate each. In all isolates presenting MBL phenotype by double-disc synergy test (DDST, the blaSPM-1 or blaIMP-1 genes were detected. In addition, blaIMP-1 was also detected in three isolates which did not display any MBL phenotype. These isolates also presented the blaCTX-M-2 gene. The co-existence of blaCTX-M-2 with blaIMP-1 is presently reported for the first time, as like as co-existence of blaGES-1 with blaIMP-1. Conclusions In this study MBLs production was not the major mechanism of resistance to carbapenems, suggesting the occurrence of multidrug efflux pumps, reduction in porin channels and production of other beta-lactamases. The detection of blaCTX-M-2,blaGES-1 and blaGES-5 reflects the recent emergence of ESBLs among antimicrobial resistant P. aeruginosa and

  3. Abundance of carbapenemase genes (blaKPC, blaNDM and blaOXA-48) in wastewater effluents from Tunisian hospitals.

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    Nasri, Emna; Subirats, Jessica; Sànchez-Melsió, Alexandre; Mansour, Hedi Ben; Borrego, Carles M; Balcázar, José Luis

    2017-10-01

    Carbapenems are β-lactam antibiotics with a broad spectrum of activity and are usually considered the last resort for the treatment of severe infections caused by multidrug-resistant pathogens. The clinically most significant carbapenemases are KPC, NDM, and OXA-48-like enzymes, whose genes have been increasingly reported worldwide in members of the family Enterobacteriaceae. In this study, we quantified the abundance of these genes in wastewater effluents from different Tunisian hospitals. The bla NDM and bla OXA-48 -like genes were detected at similar concentrations in all hospital wastewater effluents. In contrast, the bla KPC gene was detected at lower concentration than other genes and it was only detected in three of the seven effluents analyzed. To the best of our knowledge, this study quantified for the first time the abundance of bla KPC , bla NDM , and bla OXA-48 -like genes in wastewater effluents from Tunisian hospitals, highlighting the widespread distribution of these carbapenemase genes. Copyright © 2017 Elsevier Ltd. All rights reserved.

  4. Emergence and Evolution of Multidrug-Resistant Klebsiella pneumoniae with both blaKPC and blaCTX-M Integrated in the Chromosome.

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    Huang, Weihua; Wang, Guiqing; Sebra, Robert; Zhuge, Jian; Yin, Changhong; Aguero-Rosenfeld, Maria E; Schuetz, Audrey N; Dimitrova, Nevenka; Fallon, John T

    2017-07-01

    The extended-spectrum-β-lactamase (ESBL)- and Klebsiella pneumoniae carbapenemase (KPC)-producing Enterobacteriaceae represent serious and urgent threats to public health. In a retrospective study of multidrug-resistant K. pneumoniae , we identified three clinical isolates, CN1, CR14, and NY9, carrying both bla CTX-M and bla KPC genes. The complete genomes of these three K. pneumoniae isolates were de novo assembled by using both short- and long-read whole-genome sequencing. In CR14 and NY9, bla CTX-M and bla KPC were carried on two different plasmids. In contrast, CN1 had one copy of bla KPC-2 and three copies of bla CTX-M-15 integrated in the chromosome, for which the bla CTX-M-15 genes were linked to an insertion sequence, IS Ecp1 , whereas the bla KPC-2 gene was in the context of a Tn 4401a transposition unit conjugated with a PsP3-like prophage. Intriguingly, downstream of the Tn 4401a-bla KPC-2 -prophage genomic island, CN1 also carried a clustered regularly interspaced short palindromic repeat (CRISPR)- cas array with four spacers targeting a variety of K. pneumoniae plasmids harboring antimicrobial resistance genes. Comparative genomic analysis revealed that there were two subtypes of type I-E CRISPR- cas in K. pneumoniae strains and suggested that the evolving CRISPR- cas , with its acquired novel spacer, induced the mobilization of antimicrobial resistance genes from plasmids into the chromosome. The integration and dissemination of multiple copies of bla CTX-M and bla KPC from plasmids to chromosome depicts the complex pandemic scenario of multidrug-resistant K. pneumoniae Additionally, the implications from this study also raise concerns for the application of a CRISPR- cas strategy against antimicrobial resistance. Copyright © 2017 American Society for Microbiology.

  5. Detection of multidrug-resistant Pseudomonas aeruginosa harboring bla GES-1 and bla GES-11 in Recife, Brazil

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    Valdemir Vicente da Silva Júnior

    Full Text Available Abstract INTRODUCTION: Pseudomonas aeruginosa, an important pathogen globally, presents several resistance mechanisms. This study aimed to investigate the presence of bla GES in clinical isolates of Pseudomonas aeruginosa obtained from various clinical specimens from patients admitted to three different hospitals in Recife, Brazil. The Guiana extended spectrum beta-lactamase (GES enzymes are responsible for conferring broad spectrum resistance to beta-lactam drugs, including the carbapenems. METHODS: A total of 100 carbapenem-resistant P. aeruginosa isolates underwent polymerase chain reaction (PCR testing to identify bla GES, bla KPC, bla SPM-1, bla IMP, and bla VIM. Additionally, PCR products positive for bla GES were sequenced. The clonal profiles of these same isolates were then determined by means of enterobacterial repetitive intergenic consensus (ERIC-PCR analysis. RESULTS: PCR analysis revealed that four isolates harbored bla GES; DNA sequencing showed that two harbored bla GES-1 and two bla GES-11. Beta-lactamase genes bla SPM-1, bla IMP, bla VIM, and bla KPC were investigated; none of these genes was detected. Automated susceptibility testing methods (Vitek®2, bioMérieux showed that the bla GES-1-positive isolates were only susceptible to polymyxin B. The patterns obtained with ERIC-PCR methods showed clonal relationship between the two isolates that harbored bla GES-11, whereas different clonal profiles were found in the isolates harboring bla GES-1. CONCLUSIONS: We detected the presence of bacterial isolates positive for two different variants of the enzyme GES in three different hospitals from Recife, Brazil. These enzymes have a great capacity for dissemination among Gram-negative bacteria and confer broad-spectrum resistance to beta-lactam antibiotics and to the carbapenems.

  6. Prevalence of blaTEM , blaSHV and blaCTX-M genes in clinical isolates of Escherichia coli and Klebsiella pneumoniae from Northeast India

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    Arijit Bora

    2014-01-01

    Full Text Available Aim: This study was carried out to determine the presence of blaTEM , blaSHV and blaCTX-M genes in extended-spectrum β-lactamase (ESBL producing Escherichia coli (E. coli and Klebsiella pneumoniae (K. pneumoniae at a tertiary care referral hospital in Northeast India. Materials and Methods: A total of 270 E. coli and 219 K. pneumoniae isolates were recovered during the period between August 2009 and July 2010. Kirby-Bauer disk diffusion method was performed to determine the antibiotic resistance pattern. Screening and phenotypic confirmatory test for ESBL production were performed using standard disc diffusion methods. Each of the initial ESBL screening test isolate was investigated for the presence of blaTEM , blaSHV and blaCTX-M genes via polymerase chain reaction (PCR using gene-specific primers. Results: Phenotypic confirmatory test able to detect ESBL production in 73.58% of E. coli and 67.24% of K. pneumoniae. However, PCR amplification showed the presence of one or more ESBL genes in each of the initial ESBL screening positive isolate. Among three ESBL genotypes, the most prevalent genotype was found to be blaCTX-M in E. coli (88.67% and blaTEM in K. pneumoniae (77.58% ESBL producing isolates. Majority of ESBL producing isolates possess more than one ESBL genes. Conclusion: This study constituted a primer report on high prevalence of blaTEM and blaCTX-M genes in ESBL producing isolates of E. coli and K. pneumoniae and denotes the need of more extensive studies on these antibiotic genes to determine the magnitude of the problem of antibiotic resistance exiting in this locality.

  7. Occurrence of Enterobacter hormaechei carrying blaNDM-1 and blaKPC-2 in China.

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    Yang, Biwei; Feng, Yu; McNally, Alan; Zong, Zhiyong

    2018-02-01

    Three carbapenem-resistant clinical isolates of the Enterobacter cloacae complex (ECC) were recovered from different patients in a hospital. All 3 isolates carried 2 carbapenemase genes bla KPC-2 and bla NDM-1 . A study was performed to characterize their relatedness and to investigate possible links among the patients. Whole genome sequencing revealed that the isolates were Enterobacter hormaechei and belonged to ST177 of the ECC. There were 19-142 single nucleotide polymorphisms (SNPs) between the isolates, suggesting that the isolates were likely from a central reservoir, which might have existed for some time. bla KPC-2 and bla NDM-1 were carried on 2 different IncF-type plasmids in the isolates. The 3 bla NDM-1 -carrying plasmids were almost identical and were self-transmissible, while the bla KPC-2 -carrying plasmids were only transmissible in the presence of the bla NDM-1 -carrying plasmid. The source of and direct links among them were not identified, suggesting a hospital transmission of a common multidrug resistant strain. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Characteristics of β-lactamases and their genes (blaA and blaB in Yersinia intermedia and Y. frederiksenii

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    Sharma Sachin

    2007-04-01

    Full Text Available Abstract Background The presence of β-lactamases in Y. enterocolitica has been reported to vary with serovars, biovars and geographical origin of the isolates. An understanding of the β-lactamases in other related species is important for an overall perception of antibiotic resistance in yersiniae. The objective of this work was to study the characteristics of β-lactamases and their genes in strains of Y. intermedia and Y. frederiksenii, isolated from clinical and non-clinical sources in India. Results The enzymes, Bla-A (a constitutive class A penicillinase and Bla-B (an inducible class C cephalosporinase were found to be present in all the clinical and non-clinical strains of Y. intermedia and Y. frederiksenii by double disc diffusion method. The results showed differential expression of Bla-A as indicated by presence/absence of synergy whereas expression of Bla-B was quite consistent. The presence of these enzymes was also reflected in the high minimum inhibitory concentrations, MIC50 (126–1024 mg/L and MIC90 (256–1024 mg/L of β-lactam antibiotics against these species. Restriction fragment length polymorphism (RFLP revealed heterogeneity in both blaA and blaB genes of Y. intermedia and Y. frederiksenii. The blaA gene of Y. intermedia shared significant sequence identity (87–96% with blaA of Y. enterocolitica biovars 1A, 1B and 4. The sequence identity of blaA of Y. frederiksenii with these biovars was 77–79%. The sequence identity of blaB gene of Y. intermedia and Y. frederiksenii was more (85% with that of Y. enterocolitica biovars 1A, 1B and 2 compared to other species viz., Y. bercovieri, Y. aldovae and Y. ruckeri. Isoelectric focusing data further revealed that both Y. intermedia and Y. frederiksenii produced Bla-A (pI 8.7 and "Bla-B like" (pI 5.5–7.1 enzymes. Conclusion Both Y. intermedia and Y. frederiksenii showed presence of blaA and blaB genes and unequivocal expression of the two β-lactamases. Limited heterogeneity

  9. Caracterização dos Genes de metalo-beta-lactamase blaNDM, blaSPM e blaIMP em Pseudomonas aeruginosa Resistentes a Carbapenens

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    Carolina Jahn

    2017-01-01

    Full Text Available Justificativa e objetivo: P. aeruginosa é responsável por causar grande variedade de infecções agudas e crônicas. A resistência aos carbapenêmicos está se tornando um problema terapêutico mundial e a produção de metalo-beta-lactamases (MBL tem surgido como um dos mecanismos responsáveis por esta resistência. Objetivou-se identificar as cepas produtoras de MBL e verificar a presença dos genes codificador blaNDM, blaSPM e blaIMP em isolados de P. aeruginosa resistentes aos carbapenens. Métodos: Foram analisadas 16 cepas de P. aeruginosa, isoladas de diferentes sítios de indivíduos atendidos pelo Hospital do Vale do Rio Pardo-RS, no período de março 2014 a fevereiro de 2015. A identificação bioquímica foi realizada segundo protocolo da ANVISA e o antibiograma pelo método de ágar difusão em disco. A triagem fenotípica foi feita pelo teste modificado de aproximação de discos utilizando o EDTA como inibidor e a presença dos genes através da técnica de reação em cadeia da polimerase. Resultados: O setor clínico com maior prevalência de isolamento de P. aeruginosa resistente aos carbapenens é a unidade de terapia intensiva (50%. Em relação aos espécimes clínicos, 62,5% dos isolados foram identificados no trato respiratório inferior. Através do teste fenotípico, 50% das amostras analisadas mostraram ser produtora da enzima MBL. Através da técnica de reação em cadeia da polimerase foi possível identificar a presença de um dos três genes propostos, sendo eles blaSPM. Conclusão: Os isolados de P. aeruginosa mostraram serem produtores de MBL e apresentaram o gene de resistência blaSPM nesta espécie no interior do Rio Grande do Sul. Palavras Chaves: Pseudomonas aeruginosa; metalo-beta-lactamases; blaNDM, blaIMP, e blaSPM .

  10. Yersinia enterocolitica and Photorhabdus asymbiotica β-lactamases BlaA are exported by the twin-arginine translocation pathway.

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    Schriefer, Eva-Maria; Hoffmann-Thoms, Stephanie; Schmid, Franz X; Schmid, Annika; Heesemann, Jürgen

    2013-01-01

    In general, β-lactamases of medically important Gram-negative bacteria are Sec-dependently translocated into the periplasm. In contrast, β-lactamases of Mycobacteria spp. (BlaC, BlaS) and the Gram-negative environmental bacteria Stenotrophomonas maltophilia (L2) and Xanthomonas campestris (Bla(XCC-1)) have been reported to be secreted by the twin-arginine translocation (Tat) system. Yersinia enterocolitica carries 2 distinct β-lactamase genes (blaA and blaB) encoding BlaA(Ye) and the AmpC-like β-lactamase BlaB, respectively. By using the software PRED-TAT for prediction and discrimination of Sec from Tat signal peptides, we identified a functional Tat signal sequence for Yersinia BlaA(Ye). The Tat-dependent translocation of BlaA(Ye) could be clearly demonstrated by using a Y. enterocolitica tatC-mutant and cell fractionation. Moreover, we could demonstrate a unique unusual temperature-dependent activity profile of BlaA(Ye) ranging from 15 to 60 °C and a high 'melting temperature' (T(M)=44.3°) in comparison to the related Sec-dependent β-lactamase TEM-1 (20-50°C, T(M)=34.9 °C). Strikingly, the blaA gene of Y. enterocolitica is present in diverse environmental Yersinia spp. and a blaA homolog gene could be identified in the closely related Photorhabdus asymbiotica (BlaA(Pa); 69% identity to BlaA(Ye)). For BlaA(Pa) of P. asymbiotica, we could also demonstrate Tat-dependent secretion. These results suggest that Yersinia BlaA-related β-lactamases may be the prototype of a large Tat-dependent β-lactamase family, which originated from environmental bacteria. Copyright © 2012 Elsevier GmbH. All rights reserved.

  11. Evolution of IncA/C blaCMY-₂-carrying plasmids by acquisition of the blaNDM-₁ carbapenemase gene.

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    Carattoli, Alessandra; Villa, Laura; Poirel, Laurent; Bonnin, Rémy A; Nordmann, Patrice

    2012-02-01

    The bla(NDM-1) gene has been reported to be often located on broad-host-range plasmids of the IncA/C type in clinical but also environmental bacteria recovered from the New Delhi, India, area. IncA/C-type plasmids are the main vehicles for the spread of the cephalosporinase gene bla(CMY-2), frequently identified in the United States, Canada, and Europe. In this study, we completed the sequence of IncA/C plasmid pNDM-KN carrying the bla(NDM-1) gene, recovered from a Klebsiella pneumoniae isolate from Kenya. This sequence was compared with those of three IncA/C-type reference plasmids from Escherichia coli, Yersinia ruckeri, and Photobacterium damselae. Comparative analysis showed that the bla(NDM-1) gene was located on a widely diffused plasmid scaffold known to be responsible for the spread of bla(CMY-2)-like genes and consequently for resistance to broad-spectrum cephalosporins. Considering that IncA/C plasmids possess a broad host range, this scaffold might support a large-scale diffusion of the bla(NDM-1) gene among Gram-negative rods.

  12. Predominance of carbapenem-resistant Pseudomonas aeruginosa isolates carrying blaIMP and blaVIM metallo-β-lactamases in a major hospital in Costa Rica.

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    Toval, Francisco; Guzmán-Marte, Anel; Madriz, Vivian; Somogyi, Teresita; Rodríguez, César; García, Fernando

    2015-01-01

    This study aimed to assess the molecular basis of the resistance to carbapenems in clinical isolates of Pseudomonas aeruginosa recovered from a tertiary-level health facility in San José, Costa Rica. A total of 198 non-duplicated isolates were evaluated for their susceptibility to β-lactams, aminoglycosides and fluoroquinolones. The production of metallo-β-lactamases (MBLs), the presence of MBL encoding genes (blaIMP, blaVIM and blaGIM-1) and the occurrence of these genes within class 1 integrons were investigated. In addition, an ERIC2 PCR fingerprinting method was used to elucidate the distribution of the detected MBL genes within the strain collection. Of the 198 isolates tested, 125 (63.1 %) were categorized as carbapenem-resistant. The majority (88.8 %) of the carbapemen-resistant isolates also showed resistance to ceftazidime, cefepime, aztreonam, ticarcillin/clavulanic acid, amikacin, gentamicin, tobramycin, ciprofloxacin and gatifloxacin. Among the carbapenem-resistant isolates, 102 (81.6 %) showed MBL activity. Strikingly, both blaIMP and blaVIM genes were simultaneously detected in most (94.1 %) of the 102 MBL producers. Five carbapenem-resistant MBL producers were positive only for blaIMP genes. Almost 70 % of the isolates examined harboured the intI1 gene, accompanied by the sul1 and qacEΔ1 genes in 136 (99 %) and 122 (89 %) isolates, respectively. The majority (94.4 %) of the carbapenem-resistant isolates carried the intI1 gene, in contrast to 26 % of the carbapenem-susceptible isolates. Ninety-three out of 96 (96.9 %) isolates carrying both blaIMP and blaVIM genes also harboured the intI1, sul1 and qacEΔ1 genes. Gene cassettes from carbapenem-susceptible and MBL-negative carbapenem-resistant isolates encoded aminoglycoside-resistance enzymes (aadA2, aadA4 and aadA6) as well as orfD and qacF genes. RAPD analysis distributed 126 of the isolates in 29 clusters. Eighty of the 90 blaIMP (+) blaVIM (+) isolates were sorted into 16

  13. Identification of blaOXA-51, blaOXA-58, blaDIM-1 and blaVIM carbapenemase genes in hospital enterobacteriaceae isolates from Sierra Leone

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    We describe the results of a molecular epidemiological survey of 15 carbapenemase-encoding genes from a recent collection of clinical isolates. The most salient findings revealed that (i) 60% of the isolates harbored multiple carbapenemase genes, (ii) the blaDIM-1 gene that has only been reported in...

  14. Detection of blaOXA-23-like and blaNDM-1 in Acinetobacter baumannii from the Eastern Region, Saudi Arabia.

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    El-Mahdy, Taghrid S; Al-Agamy, Mohamed H; Al-Qahtani, Ahmed A; Shibl, Atef M

    2017-01-01

    Acinetobacter baumannii is currently considered as one of the most common successful pathogens in the healthcare system due to its ability to quickly develop resistance. Ten carbapenem-resistant A. calcoaceticus-baumannii complex were isolated from the eastern region, Saudi Arabia in 2014. All isolates were resistant to ciprofloxacin, however, 8 of 10 isolates were tigecycline resistant. Susceptibility test was also carried out for three aminoglycosides, resistance to gentamicin was 80%, amikacin was 90%, and tobramycin was 50%. Colistin susceptibility was seen in all isolates. The 10 isolates harbored bla OXA-23-like and ISAba1 and 9 of them also carried bla ADC . Three isolates of 10 harbored bla NDM-1 coding for NDM metallo-β-lactamase (MBL) with coexistence of bla ADC together with either bla GES or bla TEM or both. Those three isolates exhibited negative Etest MBL screening test. Pulsed-field gel electrophoresis revealed the high clonal variability of the isolates, although two isolates were indistinguishable. The risk of dissemination of carbapenem resistance through presence of ISAba1 upstream of OXA-23-like in all isolates raises the concern about emergence of higher carbapenem prevalence rates in the future in our region. This study also demonstrated the importance of molecular surveillance to provide accurate and reliable data about the resistance rates of A. baumannii. Finally, the high incidence of NDM-1 among our isolates requires a routine surveillance to monitor the future prevalence of this enzyme in the region.

  15. Isolation, Antimicrobial Susceptibility Profile and Detection of Sul1, blaTEM, and blaSHV in Amoxicillin-Clavulanate-Resistant Bacteria Isolated From Retail Sausages in Kampar, Malaysia.

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    Tew, Lih-Shin; She, Li-Yen; Chew, Choy-Hoong

    2016-10-01

    Due to the overuse of antibiotics in livestock as a growth-promoting agent, the emergence of multi-antibiotic resistant bacteria is becoming a concern. In this study, we aimed to detect the presence and discover the molecular determinants of foodborne bacteria in retail sausages resistant towards the antibacterial agent amoxicillin-clavulanate. Two grams of sausages were chopped into small pieces and transferred into sterile Luria-Bertani (LB) enrichment broths overnight before they were plated on MacConkey agar petri dishes. The bacteria isolated were then screened for amoxicillin-clavulanate resistance, and an antimicrobial susceptibility test of each isolate was performed by using the disc diffusion method. Double synergy and phenotypic tests were carried out to detect the presence of extended spectrum β-lactamase (ESBL). API 20E kit was used to identify the Enterobacteriaceae . All isolates were further examined by polymerase chain reaction (PCR) for resistant genes bla OXA-1, bla OXA-10, plasmid-mediated AmpC ( bla CMY and bla DHA), and the chromosome-mediated AmpC, Sul 1, bla TEM, and bla SHV genes. A total of 18 amoxicillin-clavulanate resistant isolates were obtained from seven different types of retail sausages. Only half of them were identified as Enterobacteriaceae , but none were ESBL-producers. All the 18 isolated strains demonstrated resistance towards amoxicillin-clavulanate, penicillin and oxacillin (100%), cefotaxime (71.4%), cefpodoxime (66.7%), and ampicillin (83.3%). bla TEM was the most frequently detected β-lactamase gene. Both plasmid- and chromosomal-bound bla TEM genes were detected in all of the isolated Enterobacteriaceae . bla SHV and Sul 1 accounted for 22.2% and 11.1% of the amoxicillin-clavulanate resistant isolates, respectively, whereas bla AMPC, bla CMY, bla DHA, bla OXA-1, and bla OXA-10 were not found in any of the isolates. The only one ESBL-producing bacteria detected in this study was Chryseobacterium meningosepticum , which

  16. Isolation, Antimicrobial Susceptibility Profile and Detection of Sul1, blaTEM, and blaSHV in Amoxicillin-Clavulanate-Resistant Bacteria Isolated From Retail Sausages in Kampar, Malaysia

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    Tew, Lih-Shin; She, Li-Yen; Chew, Choy-Hoong

    2016-01-01

    Background Due to the overuse of antibiotics in livestock as a growth-promoting agent, the emergence of multi-antibiotic resistant bacteria is becoming a concern. Objectives In this study, we aimed to detect the presence and discover the molecular determinants of foodborne bacteria in retail sausages resistant towards the antibacterial agent amoxicillin-clavulanate. Methods Two grams of sausages were chopped into small pieces and transferred into sterile Luria-Bertani (LB) enrichment broths overnight before they were plated on MacConkey agar petri dishes. The bacteria isolated were then screened for amoxicillin-clavulanate resistance, and an antimicrobial susceptibility test of each isolate was performed by using the disc diffusion method. Double synergy and phenotypic tests were carried out to detect the presence of extended spectrum β-lactamase (ESBL). API 20E kit was used to identify the Enterobacteriaceae. All isolates were further examined by polymerase chain reaction (PCR) for resistant genes blaOXA-1, blaOXA-10, plasmid-mediated AmpC (blaCMY and blaDHA), and the chromosome-mediated AmpC, Sul1, blaTEM, and blaSHV genes. Results A total of 18 amoxicillin-clavulanate resistant isolates were obtained from seven different types of retail sausages. Only half of them were identified as Enterobacteriaceae, but none were ESBL-producers. All the 18 isolated strains demonstrated resistance towards amoxicillin-clavulanate, penicillin and oxacillin (100%), cefotaxime (71.4%), cefpodoxime (66.7%), and ampicillin (83.3%). blaTEM was the most frequently detected β-lactamase gene. Both plasmid- and chromosomal-bound blaTEM genes were detected in all of the isolated Enterobacteriaceae. blaSHV and Sul1 accounted for 22.2% and 11.1% of the amoxicillin-clavulanate resistant isolates, respectively, whereas blaAMPC, blaCMY, blaDHA, blaOXA-1, and blaOXA-10 were not found in any of the isolates. The only one ESBL-producing bacteria detected in this study was Chryseobacterium

  17. Emergence and Evolution of Multidrug-Resistant Klebsiella pneumoniae with both blaKPC and blaCTX-M Integrated in the Chromosome

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    Huang, Weihua; Wang, Guiqing; Sebra, Robert; Zhuge, Jian; Yin, Changhong; Aguero-Rosenfeld, Maria E.; Schuetz, Audrey N.; Dimitrova, Nevenka; Fallon, John T.

    2017-01-01

    The extended-spectrum-β-lactamase (ESBL)- and Klebsiella pneumoniae carbapenemase (KPC)-producing Enterobacteriaceae represent serious and urgent threats to public health. In a retrospective study of multidrug-resistant K. pneumoniae, we identified three clinical isolates, CN1, CR14, and NY9, carrying both blaCTX-M and blaKPC genes. The complete genomes of these three K. pneumoniae isolates were de novo assembled by using both short- and long-read whole-genome sequencing. In CR14 and NY9, bla...

  18. First Report of blaCTX-M-28 in Enterobacteriaceae Isolates in the United Arab Emirates

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    Mubarak Alfaresi

    2018-01-01

    Full Text Available Background. The CTX-M family of extended-spectrum beta lactamase (ESBL enzymes is comprised of over 60 blaCTX-M gene variants with the predominance of blaCTX-M-15 in many regions. In this report, we present the first description of blaCTX-M-28 in the United Arab Emirates. Methods. Forty-five non-duplicate ESBL producing isolates identified in a secondary care facility in the United Arab Emirates from June to July 2016 were studied. Gene sequencing was performed and DNA sequences were annotated using the BLAST program to identify the gene subtypes. Results. The majority of the ESBL positive isolates were E. coli (n/N=39/45; 86.6% followed by K. pneumoniae (n=5 and K. oxytoca (n=1. All isolates harboured blaCTX-M and blaTEM genes, 18 had blaSHV, and 2 were blaVIM positive. Thirty-seven isolates (82.2% were positive for blaCTX-M-28. Other blaCTX-M genes identified include blaCTX-M-167 (n=2; isolates #1 and 26 and one each for blaCTX-M-38, blaCTX-M-163, and blaCTX-M-198. No blaCTX-M-15 was identified. The predominant blaTEM subtype was blaTEM-171 (n=8 followed by one of each of blaTEM-120, blaTEM-163, and blaTEM-206. The blaSHV subtypes were blaSHV-148 and blaSHV-187. Conclusion. The findings indicate the first description of blaCTX-M-28 in a setting where blaCTX-M-15 was previously predominant.

  19. Detection of bla KPC-2 in Proteus mirabilis in Brazil

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    Adriane Borges Cabral

    2015-02-01

    Full Text Available INTRODUCTION : Infections caused by Klebsiella pneumoniae carbapenemase (KPC-producing isolates pose a major worldwide public health problem today. METHODS : A carbapenem-resistant Proteus mirabilis clinical isolate was investigated for plasmid profiles and the occurrence of β-lactamase genes. RESULTS : The isolate exhibited resistance to ertapenem and imipenem and was susceptible to meropenem, polymyxin, and tigecycline. Five plasmids were identified in this isolate. DNA sequencing analysis revealed the presence of bla KPC-2 and bla TEM-1 genes. An additional PCR using plasmid DNA confirmed that bla KPC-2 was present in one of these plasmids. Conclusions: We report the detection of bla KPC-2 in P. mirabilis in Brazil for the first time. This finding highlights the continuous transfer of bla KPC between bacterial genera, which presents a serious challenge to the prevention of infection by multidrug-resistant bacteria.

  20. Emergence of carbapenem resistant Escherichia coli isolates producing blaNDM and blaOXA-48-like carried on IncA/C and IncL/M plasmids at two Iranian university hospitals.

    Science.gov (United States)

    Solgi, Hamid; Giske, Christian G; Badmasti, Farzad; Aghamohammad, Shadi; Havaei, Seyed Asghar; Sabeti, Shahram; Mostafavizadeh, Kamyar; Shahcheraghi, Fereshteh

    2017-11-01

    The emergence of carbapenem resistance among Escherichia coli is a serious threat to public health. The objective of this study was to investigate resistance genes and clonality of carbapenem resistant E. coli in Iran. Between February 2015 and July 2016, a total of 32 non-duplicate E. coli isolates that were ertapenem resistant or intermediate (R/I-ETP) were collected from patient clinical or surveillance cultures (rectal swabs) at two university hospitals. Resistance genes were identified by PCR and sequencing. Conjugation experiments, PCR-based replicon typing, PFGE and multilocus sequence typing (MLST) were performed. PCR assays showed, among the 32 isolates, twenty-nine strains produced carbapenemase genes. The predominant carbapenemase was bla OXA-48 (82.8%), followed by bla NDM-1 (31%), bla NDM-7 (6.9%) and bla OXA-181 (3.4%). Seven of the bla NDM positive isolates co-harbored bla OXA-48 carbapenemases. The bla NDM and bla OXA-48 were found in IncA/C and IncL/M conjugative plasmids, respectively. The bla CTX-M-15 , qnrA and intI1 genes were also present in most isolates. The PFGE revealed genetic diversity among the 28 E. coli isolates, which belonged to six minor PFGE clusters and 14 isolates were singletons. The 26 isolates were distributed into 18 STs, of which two were dominant (ST648 and ST167). We identified one bla NDM-1 -positive ST131 E. coli isolates that harbor the bla CTX-M-15 and bla TEM genes. Horizontal transfer of IncA/C and IncL/M plasmids has likely facilitated the spread of the bla OXA-48 and bla NDM genes among E. coli. Their clonal diversity and the presence of faecal carriers in isolates suggest an endemic spread of OXA-48 and NDM. Therefore, it emphasizes the critical importance of monitoring and controlling the spread of carbapenem resistant E. coli. Copyright © 2017. Published by Elsevier B.V.

  1. Emergence of blaNDM-7-Producing Enterobacteriaceae in Gabon, 2016.

    Science.gov (United States)

    Moussounda, Mesmin; Diene, Seydina M; Dos Santos, Sandra; Goudeau, Alain; François, Patrice; van der Mee-Marquet, Nathalie

    2017-02-01

    Reports of carbapenemase-producing Enterobacteriaceae in Africa remain rare and assess mostly bla OXA-48 -producing isolates from Mediterranean countries and South Africa. We identified bla NDM-7 -producing Enterobacteriaceae in Gabon in 2016. The isolates contained bla NDM-7 IncX3 plasmids that were unusual and similar to the one described in a colistin-resistant Klebsiella pneumoniae SZ04 isolate from China.

  2. The spread of bla OXA-48 and bla OXA-244 carbapenemase genes among Klebsiella pneumoniae, Proteus mirabilis and Enterobacter spp. isolated in Moscow, Russia.

    Science.gov (United States)

    Fursova, Nadezhda K; Astashkin, Eugeny I; Knyazeva, Anastasia I; Kartsev, Nikolay N; Leonova, Ekaterina S; Ershova, Olga N; Alexandrova, Irina A; Kurdyumova, Natalia V; Sazikina, Svetlana Yu; Volozhantsev, Nikolay V; Svetoch, Edward A; Dyatlov, Ivan A

    2015-11-02

    The spread of carbapenemase-producing Enterobacteriaceae (CPE) is a great problem of healthcare worldwide. Study of the spread for bla OXA-48-like genes coding epidemically significant carbapenemases among hospital pathogens is important for the regional and global epidemiology of antimicrobial resistance. Antibacterial resistant isolates of Klebsiella pneumoniae (n = 95) from 54 patients, P. mirabilis (n = 32) from 20 patients, Enterobacter aerogenes (n = 6) from four patients, and Enterobacter cloacae (n = 4) from four patients were collected from January, 2013 to October, 2014 in neurosurgical intensive care unit (ICU) of the Burdenko Neurosurgery Institute, Moscow. Characteristics of the isolates were done using susceptibility tests, PCR detection of the resistance genes, genotyping, conjugation, DNA sequencing, and bioinformatic analysis. Major strains under study were multi drug resistant (MDR), resistant to three or more functional classes of drugs simultaneously-98.9 % K. pneumoniae, 100 % P. mirabilis, one E. aerogenes isolate, and one E. cloacae isolate. Molecular-genetic mechanism of MDR in K. pneumoniae and P. mirabilis isolates were based on carrying of epidemic extended-spectrum beta-lactamase bla CTX-M-15 gene (87.2 and 90.6 % accordingly), carbapenemase bla OXA-48-like gene (55.3 and 23.3 % accordingly), and class 1 (54.8 and 31.3 % accordingly) and class 2 (90.6 % P. mirabilis) integrons. The bla OXA-48-like-positive K. pneumoniae were collected during whole two-year surveillance period, while P. mirabilis and Enterobacter spp. carrying bla OXA-48-like genes were detected only after four and 18 months after the research start, respectively. The bla OXA-48-like gene acquisition was shown for P. mirabilis isolates collected from five patients and for E. cloacae isolate collected from one patient during their stay in the ICU, presumably from bla OXA-48-like-positive K. pneumoniae. The source of the bla OXA-244 gene acquired by E

  3. Decreased Fitness and Virulence in ST10 Escherichia coli Harboring blaNDM-5 and mcr-1 against a ST4981 Strain with blaNDM-5

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    Yawei Zhang

    2017-06-01

    Full Text Available Although coexistence of blaNDM-5 and mcr-1 in Escherichia coli has been reported, little is known about the fitness and virulence of such strains. Three carbapenem-resistant Escherichia coli (GZ1, GZ2, and GZ3 successively isolated from one patient in 2015 were investigated for microbiological fitness and virulence. GZ1 and GZ2 were also resistant to colistin. To verify the association between plasmids and fitness, growth kinetics of the transconjugants were performed. We also analyzed genomic sequences of GZ2 and GZ3 using PacBio sequencing. GZ1 and GZ2 (ST10 co-harbored blaNDM-5 and mcr-1, while GZ3 (ST4981 carried only blaNDM-5. GZ3 demonstrated significantly more rapid growth (P < 0.001 and overgrew GZ2 with a competitive index of 1.0157 (4 h and 2.5207 (24 h. Increased resistance to serum killing and mice mortality was also identified in GZ3. While GZ2 had four plasmids (IncI2, IncX3, IncHI2, IncFII, GZ3 possessed one plasmid (IncFII. The genetic contexts of blaNDM-5 in GZ2 and GZ3 were identical but inserted into different backbones, IncX3 (102,512 bp and IncFII (91,451 bp, respectively. The growth was not statistically different between the transconjugants with mcr-1 or blaNDM-5 plasmid and recipient (P = 0.6238. Whole genome sequence analysis revealed that 28 virulence genes were specific to GZ3, potentially contributing to increased virulence of GZ3. Decreased fitness and virulence in a mcr-1 and blaNDM-5 co-harboring ST10 E. coli was found alongside a ST4981 strain with only blaNDM-5. Acquisition of mcr-1 or blaNDM-5 plasmid did not lead to considerable fitness costs, indicating the potential for dissemination of mcr-1 and blaNDM-5 in Enterobacteriaceae.

  4. Enterobacter cloacae Complex Isolates Harboring blaNMC-A or blaIMI-Type Class A Carbapenemase Genes on Novel Chromosomal Integrative Elements and Plasmids.

    Science.gov (United States)

    Boyd, David A; Mataseje, Laura F; Davidson, Ross; Delport, Johannes A; Fuller, Jeff; Hoang, Linda; Lefebvre, Brigitte; Levett, Paul N; Roscoe, Diane L; Willey, Barbara M; Mulvey, Michael R

    2017-05-01

    Carbapenem-resistant Enterobacter cloacae complex isolates submitted to a reference laboratory from 2010 to 2015 were screened by PCR for seven common carbapenemase gene groups, namely, KPC, NDM, OXA-48, VIM, IMP, GES, and NMC-A/IMI. Nineteen of the submitted isolates (1.7%) were found to harbor Ambler class A bla NMC-A or bla IMI -type carbapenemases. All 19 isolates were resistant to at least one carbapenem but susceptible to aminoglycosides, trimethoprim-sulfamethoxazole, tigecycline, and ciprofloxacin. Most isolates (17/19) gave positive results with the Carba-NP test for phenotypic carbapenemase detection. Isolates were genetically diverse by pulsed-field gel electrophoresis macrorestriction analysis, multilocus sequence typing, and hsp60 gene analysis. The genes were found in various Enterobacter cloacae complex species; however, bla NMC-A was highly associated with Enterobacter ludwigii Whole-genome sequencing and bioinformatics analysis revealed that all NMC-A ( n = 10), IMI-1 ( n = 5), and IMI-9 ( n = 2) producers harbored the carbapenemase gene on EludIMEX-1-like integrative mobile elements (EcloIMEXs) located in the identical chromosomal locus. Two novel genes, bla IMI-5 and bla IMI-6 , were harbored on different IncFII-type plasmids. Enterobacter cloacae complex isolates harboring bla NMC-A/IMI -type carbapenemases are relatively rare in Canada. Though mostly found integrated into the chromosome, some variants are located on plasmids that may enhance their mobility potential. © Crown copyright 2017.

  5. Investigation of diversity of plasmids carrying the blaTEM-52 gene

    DEFF Research Database (Denmark)

    Bielak, Eliza Maria; Bergenholtz, Rikke D.; Jørgensen, Mikael Skaanning

    2011-01-01

    OBJECTIVES: To investigate the diversity of plasmids that carry blaTEM-52 genes among Escherichia coli and Salmonella enterica originating from animals, meat products and humans. METHODS: A collection of 22 blaTEM-52-encoding plasmids was characterized by restriction fragment length polymorphism...... of self-transfer to a plasmid-free E. coli recipient. CONCLUSIONS: The blaTEM-52 gene found in humans could have been transmitted on transferable plasmids originating from animal sources. Some of the blaTEM-52 plasmids carry replicons that differ from the classical ones. Two novel replicons were detected...

  6. Dissemination of blaOXA-58 in Proteus mirabilis isolates from Germany.

    Science.gov (United States)

    Lange, Felix; Pfennigwerth, Niels; Gerigk, Sonja; Gohlke, Frank; Oberdorfer, Klaus; Purr, Ingvill; Wohanka, Nikolaus; Roggenkamp, Andreas; Gatermann, Sören G; Kaase, Martin

    2017-05-01

    Characterization of Proteus mirabilis isolates harbouring bla OXA-58 with emphasis on the genetic environment of this resistance determinant. Strains of P. mirabilis ( n  =   37) isolated from different patients were tested for the presence of bla OXA-58 . The genetic context of bla OXA-58 was determined by WGS of two strains and Sanger sequencing. Clonality of the strains was assessed by PFGE. Susceptibility testing was performed by microdilution according to EUCAST. Four strains isolated in different geographical regions of Germany were positive for bla OXA-58 , and WGS showed that this resistance gene was harboured on a plasmid. Sanger sequencing confirmed the presence of two nearly identical plasmids, 6219 and 6208 bp in size, in all four strains. Upstream of bla OXA-58 an IS Aba 3-like transposase gene was located. The P. mirabilis strains were not clonally related according to PFGE. MICs of meropenem for three of the strains were only just above the EUCAST breakpoint and the Carba NP test was positive for only two of the strains. To our knowledge, this is the first description of bla OXA-58 in the species P. mirabilis . The resistance gene is harboured by almost identical plasmids in strains not clonally related and from different geographical regions. Apart from an IS Aba 3-like transposase gene upstream of bla OXA-58 the genetic context is different from bla OXA-58 harboured on plasmids in the genus Acinetobacter . With MICs of meropenem well below the EUCAST breakpoint or only just above it and equivocal or false negative results from the Carba NP test, bla OXA-58 can be easily overlooked in P. mirabilis . © The Author 2017. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  7. Detection of bla-IMP-1 and bla-IMP-2 Genes Among Metallo-β-lactamase-Producing Pseudomonas Aeruginosa Isolated from Burn Patients in Isfahan

    Directory of Open Access Journals (Sweden)

    M. Pourbabaee

    2016-02-01

    Full Text Available Background: Pseudomonas aeruginosa is a nosocomial pathogen which especially causes infections among burn patients. Carbapenems are extensively used for the treatment of infections caused by multidrug-resistant P. aeruginosa isolates. The emergence of carbapenemases producing isolates is an outcome of increased utilization of carbapenems. The aim of this study was to determine the bla-IMP-1 and bla-IMP-2 genes in metallo-β-lactamase (MBL -producing Pseudomonas aeruginosa isolated from burn patients in Isfahan. Material and Methods: A total of 150 P. aeruginosa were isolated from burn patients hospitalized in Imam-Mousakazem hospital in Isfahan. Antimicrobial susceptibility was determined using disk diffusion method according to the Clinical and Laboratory Standards Institute (CLSI guidelines. Double Disk Synergy Test (DDST was carried out for screening of MBL production in imipenem-resistant strains. PCR assays were used for detection of bla-IMP-1 and bla-IMP-2 genes among metallo-β-lactamase-producing Pseudomonas aeruginosa isolates. The purified PCR products were sequenced. Results: Of 150 Pseudomonas aeruginosa isolates, %100 identified as multi-drug resistant strains. The most resistance rates were seen against ciprofloxacin, tobromycin, meropenem and imipenem. All of 144 imipenem-resistant Pseudomonas aeruginosa isolates were MBL producing by DDST test. Twenty-nine (19.3% and 8(5.3% MBL producing Pseudomonas aeruginosa isolates harbored bla-IMP-1 and bla-IMP-2 genes respectively. Conclusions: According to results of this study high level resistance to imipenem and MBl genes carriage was seen among Pseudomonas aeruginosa isolated from burn patient infections in our region.

  8. Genetic characterization of blaNDM-harboring plasmids in carbapenem-resistant Escherichia coli from Myanmar.

    Directory of Open Access Journals (Sweden)

    Yo Sugawara

    Full Text Available The bacterial enzyme New Delhi metallo-β-lactamase hydrolyzes almost all β-lactam antibiotics, including carbapenems, which are drugs of last resort for severe bacterial infections. The spread of carbapenem-resistant Enterobacteriaceae that carry the New Delhi metallo-β-lactamase gene, blaNDM, poses a serious threat to public health. In this study, we genetically characterized eight carbapenem-resistant Escherichia coli isolates from a tertiary care hospital in Yangon, Myanmar. The eight isolates belonged to five multilocus-sequence types and harbored multiple antimicrobial-resistance genes, resulting in resistance against nearly all of the antimicrobial agents tested, except colistin and fosfomycin. Nine plasmids harboring blaNDM genes were identified from these isolates. Multiple blaNDM genes were found in the distinct Inc-replicon types of the following plasmids: an IncA/C2 plasmid harboring blaNDM-1 (n = 1, IncX3 plasmids harboring blaNDM-4 (n = 2 or blaNDM-7 (n = 1, IncFII plasmids harboring blaNDM-4 (n = 1 or blaNDM-5 (n = 3, and a multireplicon F plasmid harboring blaNDM-5 (n = 1. Comparative analysis highlighted the diversity of the blaNDM-harboring plasmids and their distinct characteristics, which depended on plasmid replicon types. The results indicate circulation of phylogenetically distinct strains of carbapenem-resistant E. coli with various plasmids harboring blaNDM genes in the hospital.

  9. Identificación genotípica de β-lactamasas de espectro espectro extendido (BLEE (blaTEM y blaSHV en Escherichia coli uropatógena

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    Yeffersson Grandas Franco

    2016-06-01

    Full Text Available Introducción: Las infecciones de tracto urinario (ITU son consideradas un problema de salud pública a nivel mundial debido a su incidencia y morbilidad. Entre los agentes causales que se aíslan con mayor frecuencia, se encuentra E. coli, con una prevalencia que va desde 40% al 95%. Actualmente, la problemática de las ITU ha venido en aumento, debido a la aparición de resistencia bacteriana a agentes antimicrobianos, influenciado por la presión selectiva, la preexistencia de genes de resistencia y el uso indiscriminado de antibióticos. Objetivo: Identificar molecularmente β-lactamasas de espectro extendido (blaTEM y blaSHV, en E. coli uropatógena, aislada en pacientes ambulatorios que asisten a un laboratorio clínico de tercer nivel de complejidad. Materiales y métodos: Estudio descriptivo de corte transversal. En este trabajo se estudiaron 250 cepas de las cuales 120 eran presuntivas de producir β-lactamasas de acuerdo al método de Kirby-bauer que se realizó años anteriores por el semillero de Inmunidad e Infección. Los genes de interés se amplificaron mediante PCR. Se utilizó Klebsiella pneumoniae ATCC 700603 como control positivo. Una vez amplificado el gen se llevó a cabo el corrido electroforético en gel de agarosa donde el producto amplificado fue de 470 pb en el caso de blaSHV y de 1080 pb para blaTEM. Los fenotipos compatibles con producción de β-lactamasas se analizaron por medio de distribución de frecuencia usando el software WHONET 5,6. La distribución de frecuencia de los genes analizados se calculó usando el software MedCalc versión 15.2.2 (Bélgica – Software BBVA. Resultados: De las cepas analizadas, el 52,8% portadoras del gen blaTEM y el 2,8% del gen blaSHV-2. Se encontró co-existencia de los genes blaSHV-2 y blaTEM en el 1,68% del total de las cepas. De todas las cepas presuntivas de producir BLEE (n=120, 94 fueron productoras de BLEE, lo que nos indicaría que las 21 cepas restantes, implementan

  10. Bla g 1 allergen levels in Zagreb area household dust.

    Science.gov (United States)

    Prester, Ljerka; Macan, Jelena

    2011-03-01

    Cockroach allergy is a health problem in many parts of the world. In urban environments, indoor exposure to cockroach allergens involves a risk of asthma. The aim of this study was to measure the mass fraction of Bla g 1, a major allergen of the German cockroach (Blatella germanica) in 30 house samples, collected at random from Zagreb area households, Croatia. Dust samples were collected on cellulose filters by vacuuming living rooms floors. After extraction, Bla g 1 was detected using the commercial enzyme-linked immunosorbent assay (ELISA). Only four of the thirty households had detectable Bla g 1 levels, and only in one was its concentration higher than 2.0 U g(-1), the threshold associated with sensitisation. The Bla g 1 ELISA proved highly sensitive, with the detection limit of 0.12 U g(-1). The within- and between-assay imprecision was 8.9 % and 14.4 %, respectively, and accuracy 85 % to 120 %. Low Bla g 1 levels in the household dust support previously reported low prevalence of skin sensitisation to B. germanica among Zagreb residents. Further monitoring should reveal if there are differences in cockroach allergen exposure and sensitisation between households from other geographic areas in Croatia.

  11. Dissemination of imipenem-resistant Acinetobacter baumannii with new plasmid-borne bla(OXA-72) in Taiwan.

    Science.gov (United States)

    Kuo, Shu-Chen; Yang, Su-Pen; Lee, Yi-Tzu; Chuang, Han-Chuan; Chen, Chien-Pei; Chang, Chi-Ling; Chen, Te-Li; Lu, Po-Liang; Hsueh, Po-Ren; Fung, Chang-Phone

    2013-07-13

    The systemic surveillance of imipenem-resistant Acinetobacter baumannii (IRAB) from multicenters in Taiwan revealed the emergence of isolates with bla(OXA-72). This study described their genetic makeup, mechanism of spread, and contribution to carbapenem resistance. Two hundred and ninety-one non-repetitive isolates of A. baumannii were collected from 10 teaching hospitals from different geographical regions in Taiwan from June 2007 to September 2007. Minimal inhibitory concentrations (MICs) were determined by agar dilution. Clonality was determined by pulsed-field gel electrophoresis. Plasmid was extracted and digested by restriction enzymes, and subsequently analyzed by electrophoresis and Southern blot for bla(OXA-72). The flanking regions of bla(OXA-72) were determined by inverse PCR. The contribution of bla(OXA-72) to imipenem MIC was determined by transforming plasmids carrying bla(OXA-72) into imipenem-susceptible A. baumannii. Among 142 IRAB in Taiwan, 27 harbored bla(OXA-72); 22 originated from Southern Taiwan, 5 from Central Taiwan, and none from Northern Taiwan. There were two major clones. The bla(OXA-72) was identified in the plasmids of all isolates. Two genetic structures flanking plasmid-borne bla(OXA-72) were identified and shared identical sequences in certain regions; the one described in previous literature was present in only one isolate, and the new one was present in the remaining isolates. Introduction of bla(OXA-72) resulted in an increase of imipenem MIC in the transformants. The overexpression of bla(OXA-72) mRNA in response to imipenem further supported the contribution of bla(OXA-72). In conclusion, isolates with new plasmid-borne blaOXA-72 were found to be disseminated successfully in Southern Taiwan. The spread of the resistance gene depended on clonal spread and dissemination of a new plasmid. Bla(OXA-72) in these isolates directly led to their imipenem-resistance.

  12. Transcriptional analysis of bla NDM-1 and copy number alteration under carbapenem stress

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    Deepjyoti Paul

    2017-02-01

    Full Text Available Abstract Background New Delhi metallo beta-lactamase is known to compromise carbapenem therapy and leading to treatment failure. However, their response to carbapenem stress is not clearly known. Here, we have investigated the transcriptional response of bla NDM-1 and plasmid copy number alteration under carbapenem exposure. Methods Three bla NDM-1 harboring plasmids representing three incompatibility types (IncFIC, IncA/C and IncK were inoculated in LB broth with and without imipenem, meropenem and ertapenem. After each 1 h total RNA was isolated, immediately reverse transcribed into cDNA and quantitative real time PCR was used for transcriptional expression of bla NDM-1. Horizontal transferability and stability of the plasmids encoding bla NDM-1 were also determined. Changes in copy number of bla NDM-1 harboring plasmids under the exposure of different carbapenems were determined by real time PCR. Clonal relatedness among the isolates was determined by pulsed field gel electrophoresis. Results Under carbapenem stress over an interval of time there was a sharp variation in the transcriptional expression of bla NDM-1 although it did not follow a specific pattern. All bla NDM-1 carrying plasmids were transferable by conjugation. These plasmids were highly stable and complete loss was observed between 92nd to 96th serial passages when antibiotic pressure was withdrawn. High copy number of bla NDM-1 was found for IncF type plasmids compared to the other replicon types. Conclusion This study suggests that the single dose of carbapenem pressure does not significantly influence the expression of bla NDM-1 and also focus on the stability of this gene as well as the change in copy number with respect to the incompatible type of plasmid harboring resistance determinant.

  13. Differential Binding of Co(II) and Zn(II) to Metallo-beta-Lactamase Bla2 from Bacillus anthracis

    Energy Technology Data Exchange (ETDEWEB)

    Hawk, M.; Breece, R; Hajdin, C; Bender, K; Hu, Z; Costello, A; Bennett, B; Tierney, D; Crowder, M

    2009-01-01

    In an effort to probe the structure, mechanism, and biochemical properties of metallo-{beta}-lactamase Bla2 from Bacillus anthracis, the enzyme was overexpressed, purified, and characterized. Metal analyses demonstrated that recombinant Bla2 tightly binds 1 equiv of Zn(II). Steady-state kinetic studies showed that mono-Zn(II) Bla2 (1Zn-Bla2) is active, while di-Zn(II) Bla2 (ZnZn-Bla2) was unstable. Catalytically, 1Zn-Bla2 behaves like the related enzymes CcrA and L1. In contrast, di-Co(II) Bla2 (CoCo-Bla2) is substantially more active than the mono-Co(II) analogue. Rapid kinetics and UV-vis, 1H NMR, EPR, and EXAFS spectroscopic studies show that Co(II) binding to Bla2 is distributed, while EXAFS shows that Zn(II) binding is sequential. To our knowledge, this is the first documented example of a Zn enzyme that binds Co(II) and Zn(II) via distinct mechanisms, underscoring the need to demonstrate transferability when extrapolating results on Co(II)-substituted proteins to the native Zn(II)-containing forms.

  14. Dissemination of metallo-β-lactamase in Pseudomonas aeruginosa isolates in Egypt: mutation in blaVIM-4.

    Science.gov (United States)

    Hashem, Hany; Hanora, Amro; Abdalla, Salah; Shaeky, Alaa; Saad, Alaa

    2017-05-01

    This study was designed to investigate the prevalence of metallo-β-lactamase (MBL) in Pseudomonas aeruginosa isolates collected from Suez Canal University Hospital in Ismailia, Egypt. Antibiotic susceptibility testing and phenotypic and genotypic screening for MBLs were performed on 147 isolates of P. aeruginosa. MICs were determined by agar dilution method for carbapenem that was ≥2 μg/mL for meropenem. MBL genes were detected by multiplex and monoplex PCR for P. aeruginosa-harbored plasmids. Mutation profile of sequenced MBL genes was screened using online software Clustal Omega. Out of 147 P. aeruginosa, 39 (26.5%) were carbapenem-resistant isolates and 25 (64%) were confirmed to be positive for MBLs. The susceptibility rate of P. aeruginosa toward polymyxin B and norfloxacin was 99% and 88%, respectively. Identification of collected isolates by API analysis and constructed phylogenetic tree of 16S rRNA showed that the isolates were related to P. aeruginosa species. The frequency of blaGIM-1, blaSIM-1, and blaSPM-1 was 52%, 48%, and 24%, respectively. BlaVIM and blaIMP-like genes were 20% and 4% and the sequences confirm the isolate to be blaVIM-1, blaVIM-2, blaVIM-4, and blaIMP-1. Three mutations were identified in blaVIM-4 gene. Our study emphasizes the high occurrence of multidrug-resistant P. aeruginosa-producing MBL enzymes. © 2017 APMIS. Published by John Wiley & Sons Ltd.

  15. Blaženje podnebnih sprememb z uporabo geoinženiringa

    OpenAIRE

    Horvat, Sanja

    2015-01-01

    V diplomski nalogi se osredotočamo na vrednotenje dveh znanosti, znanosti o podnebnih spremembah in znanosti o geoinženiringu, katerega osnovni namen je blaženje podnebnih sprememb. Diplomska naloga je razdeljena na dva dela. V prvem delu podrobneje razglabljamo o znanosti in politiki podnebnih sprememb ter njihovem orodju (o t.i. klimatskih modelih), s katerim operiramo in napovedujemo razvoj podnebnih sprememb, na podlagi katerih se sprejemajo radikalne družbenopolitične odločitve za blažen...

  16. Diversity and evolution of blaZ from Staphylococcus aureus and coagulase-negative staphylococci

    DEFF Research Database (Denmark)

    Olsen, John E.; Christensen, Henrik; Aarestrup, Frank Møller

    2006-01-01

    and sequences retrieved from public databases were compared. A phylogenetic tree showed that blaZ exists in three evolutionary lines: one group was of plasmid origin, one group was of chromosomal origin and one intermediate group. Sixty-nine sequence types were demonstrated. They translated into 11 BlaZ protein...... types. The major types all contained strains of both human and bovine origin, and more than one Staphylococcus species, demonstrating a shared gene pool. In a comparison of S. aureus and CoNS obtained from five Danish cattle herds, the same type of blaZ was only detected in one case. Conclusions...

  17. Prevalencia de bacterias Gram negativas portadoras del gen blaKPC en hospitales de Colombia

    Directory of Open Access Journals (Sweden)

    Robinson Pacheco

    2014-04-01

    Full Text Available Introducción. Las enzimas carbapenemasas de tipo KPC tienen gran capacidad de diseminación, son causantes de epidemias y se asocian a mayor mortalidad y estancia hospitalaria. En Colombia se han venido reportando cada vez más desde 2007, pero se desconoce la prevalencia hospitalaria. Objetivo. Estimar la prevalencia hospitalaria del gen blaKPC. Materiales y métodos. Se evaluó la presencia del gen blaKPC y su ‘clonalidad’ en aislamientos de enterobacterias y Pseudomonas aeruginosa de pacientes hospitalizados. Resultados. De los 424 aislamientos evaluados durante el periodo de estudio, 273 cumplieron con criterios de elegibilidad, 31,1 % fue positivo para el gen blaKPC y, al ajustar por ‘clonalidad’, la positividad fue de 12,8 %. El gen blaKPC se encontró con mayor frecuencia en Klebsiella pneumoniae seguido de P. aeruginosa y otras enterobacterias. A pesar de que la unidad de cuidados intensivos aportó el mayor número de aislamientos, no se encontró un patrón más prevalente del gen blaKPC en las ellas que en las otras salas. El aparato respiratorio fue el sitio anatómico de origen con la mayor prevalencia. No se presentó estacionalidad en la frecuencia de los aislamientos portadores del gen blaKPC. Conclusión. Este estudio reveló la alta prevalencia del gen blaKPC en diferentes microorganismos aislados en varias instituciones hospitalarias del país. La extraordinaria capacidad de propagación del gen blaKPC, las dificultades del diagnóstico y la limitada disponibilidad de antibióticos plantean la apremiante necesidad de fortalecer los sistemas de vigilancia epidemiológica y ajustar oportunamente las políticas institucionales de uso racional de antibióticos con el fin de contener su diseminación a otras instituciones de salud del país.

  18. First report of blaNDM-1-producing Acinetobacter baumannii isolated in Lebanon from civilians wounded during the Syrian war.

    Science.gov (United States)

    Rafei, Rayane; Dabboussi, Fouad; Hamze, Monzer; Eveillard, Matthieu; Lemarié, Carole; Mallat, Hassan; Rolain, Jean-Marc; Joly-Guillou, Marie-Laure; Kempf, Marie

    2014-04-01

    The emergence of carbapenem-resistant Acinetobacter baumannii has been observed worldwide. We describe the first detection of A. baumannii carrying the blaNDM-1 gene in Lebanon, isolated from Syrian patients wounded during the civil war. Four carbapenem-resistant A. baumannii strains isolated in 2012 in the Tripoli Government Hospital, Lebanon, from civilians wounded during the Syrian war, were analysed. Susceptibility was determined by disk diffusion testing, and resistance to carbapenems was confirmed by Etest. The presence of blaOXA-23-like, blaOXA-24-like, blaOXA-58-like, blaOXA-143-like, and blaNDM was investigated by PCR. Clonal relationships were studied by pulsed-field gel electrophoresis (PFGE), multilocus sequence typing (MLST), and blaOXA-51 sequence-based typing. All isolates harboured the blaNDM-1 gene and were negative for other tested carbapenemases. They all belonged to the sequence type 85 and formed a single cluster by PFGE. Finally, blaOXA-51-like gene sequencing revealed the presence of the blaOXA-94 variant in all four isolates. These findings show that Syria constitutes a reservoir for NDM-1-producing bacteria. These results also highlight the need for effective measures to stop the threatening spread of such strains. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  19. blaCTX-M-I group extended spectrum beta lactamase-producing Salmonella typhi from hospitalized patients in Lagos, Nigeria

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    Akinyemi KO

    2015-05-01

    Full Text Available Kabiru O Akinyemi,1 Bamidele A Iwalokun,2 Olajide O Alafe,1 Sulaiman A Mudashiru,1 Christopher Fakorede,11Department of Microbiology, Lagos State University, Ojo, Lagos, Nigeria; 2Biochemistry and Nutrition Division, Nigerian Institute of Medical Research, Yaba, Lagos, NigeriaPurpose: The global spread of blaCTX-M-I extended-spectrum beta-lactamase (ESBL-producing Salmonella spp. remains a major threat to treatment and control. Evidence of emergence and spread of this marker are lacking in Nigeria. This study investigated blaCTX-M-I ESBL production among Salmonella isolates from hospitalized patients.Methods: Patients (158 total made up of two groups were evaluated. Group A was composed of 135 patients with persistent pyrexia and group B was composed of 23 gastroenteritis patients and their stool samples. Samples were cultured, and isolates were identified and were subjected to antibiotic susceptibility testing by standard methods. Isolates were further screened for ESBL production, blaCTX-M-I genes and transferability by double disk synergy test, plasmid extraction, polymerase chain reaction, and conjugation experiment.Results: Thirty-five (25.9% Salmonella isolates were identified from group A, of which 74.3% were S. typhi, 22.9% were S. paratyphi and two (5.7% were invasive non-typhoidal S. enteritidis. Nine Plasmodium falciparum infections were recorded, four of which were identified as co-infections with typhoidal Salmonella. Only two (8.7% S. enteritidis samples were obtained from group B (P>0.05. A total of 24 isolates were ESBL-positive, eliciting resistance to five to seven antibiotics, and were multiple-drug resistant. ESBL production due to the blaCTX-M-I gene cluster was detected in eleven (45.8% Salmonella isolates. Nine (81.8% of the eleven blaCTX-M-I ESBL producers were S. typhi and two (18.2% isolates were S. enteritidis. Four of nine S. typhi blaCTX-M-I ESBL-producing strains harbored 23 kb self-transmissible plasmid that was co

  20. Incidence of blaNDM-1 gene in Escherichia coli isolates at a tertiary care referral hospital in Northeast India

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    A Bora

    2013-01-01

    Full Text Available Purpose: Increasing reports on New Delhi metallo-β-lactamase-1 (NDM-1 producing Escherichia coli constitute a serious threat to global health since it is found to be highly resistant to most of the currently available antibiotics including carbapenems. This study has been performed to find out the incidence blaNDM-1 in E. coli isolates recovered from the various clinical samples at a tertiary care referral hospital in Northeast India. Materials and Methods: A total of 270 non-duplicated E. coli isolates were recovered from the various clinical samples at a tertiary care referral hospital in Northeast India. All isolates with reduced susceptibility to meropenem or ertapenem (diameter of zones of inhibition, ≤21 mm were further phenotypically confirmed for carbapenemase production by modified Hodge test. All screened isolates were also subjected to the polymerase chain reaction detection of blaNDM-1 gene and additional bla genes coding for transmission electron microscopy, SHV, CTX-M, and AmpC. Results: Out of 270 E. coli isolates, 14 were screened for carbapenemase production on the basis of their reduced susceptibility to meropenem or ertapenem. All screened isolates were found to be positive for blaNDM-1 . Each of the blaNDM-1 possessing isolate was also positive for two or more additional bla genes, such as blaTEM , blaCTX-M and blaAmpC . Phylogenetic analysis showed very less variation in blaNDM-1 gene with respect to blaNDM-1 possessing E. coli isolates from other parts of India and abroad. Conclusions: Our findings highlight the incidence of blaNDM-1 in E. coli isolates with a reduced susceptibility to meropenem or ertapenem.

  1. Detection of New Delhi Metallo-Beta-Lactamase (Encoded by blaNDM-1 ) in Enterobacter aerogenes in China.

    Science.gov (United States)

    Shen, Yong; Xiao, Wei-Qiang; Gong, Jiao-Mei; Pan, Jun; Xu, Qing-Xia

    2017-03-01

    The increase in bla NDM -1 in Enterobacteriaceae has become a major concern worldwide. In previous study, we investigated clonal dissemination and mechanisms of resistance to carbapenem in China. We carried out retrospective surveillance for bla NDM -1 among carbapenem-resistant enterobacter strains, which were isolated from patients at our hospital by bacterial strains selection, antimicrobial susceptibility testing, species identification, and molecular detection of resistance gene. We found three bla NDM -1 -positive isolates which were identified as Enterobacter aerogenes in clinical patients in China. The bla NDM -1 -positive Enterobacter aerogenes isolates were first found. It is important to mandate prudent usage of antibiotics and implement infection control measures to control the spread of these resistant bla NDM -1 -positive strains. © 2016 Wiley Periodicals, Inc.

  2. Molecular epidemiology of outbreak-related pseudomonas aeruginosa strains carrying the novel variant blaVIM-17 metallo-beta-lactamase gene.

    Science.gov (United States)

    Siarkou, Victoria I; Vitti, Danai; Protonotariou, Efthimia; Ikonomidis, Alexandros; Sofianou, Danai

    2009-04-01

    A study was designed to investigate the molecular epidemiological characteristics of multidrug-resistant outbreak-related Pseudomonas aeruginosa isolates collected in a university hospital in northern Greece. Of 29 nonreplicate P. aeruginosa isolates resistant to carbapenems and ceftazidime, 14 were positive for metallo-beta-lactamase production. PCR analyses with primers specific for bla(VIM) and bla(IMP) revealed that 13 isolates carried a novel bla(VIM-2) gene variant, designated bla(VIM-17), and only 1 isolate carried bla(VIM-2), a gene predominant among P. aeruginosa strains in Greek hospitals. Pulsed-field gel electrophoresis of XbaI-digested genomic DNAs showed a close genetic relationship for 12 of 13 bla(VIM-17)-carrying outbreak-related isolates, which were of the O11 serotype; the clonally unrelated isolate carrying bla(VIM-17) was of the O12 serotype. PCR mapping strategies for the detection of class 1 integrons and sequencing approaches revealed the presence of integrons containing one bla(VIM) cassette flanked by two aacA29 cassettes. These integrons were similar but not identical to In59 (GenBank accession number AF263519) initially described in France. All isolates carrying bla(VIM-17), regardless of their genetic profile, had an identical integron, named In59.3, indicating that although the hospital outbreak was mainly due to clonal dissemination, the horizontal transmission of the bla(VIM-17)-containing integron among P. aeruginosa isolates should also have occurred. An outbreak-related isolate and a control strain, both of which carried the bla(VIM-2) gene but which were clonally distinct, had an identical integron, named In59.2, which differed only at the level of the bla(VIM) gene from In59.3 integrons, suggesting a common ancestry. The spread of the bla(VIM-17)-containing integron in clonally unrelated P. aeruginosa isolates without any evidence of plasmid carriage is probably associated with a transposon.

  3. Mechanisms Involved in Acquisition of blaNDM Genes by IncA/C2 and IncFIIY Plasmids.

    Science.gov (United States)

    Wailan, Alexander M; Sidjabat, Hanna E; Yam, Wan Keat; Alikhan, Nabil-Fareed; Petty, Nicola K; Sartor, Anna L; Williamson, Deborah A; Forde, Brian M; Schembri, Mark A; Beatson, Scott A; Paterson, David L; Walsh, Timothy R; Partridge, Sally R

    2016-07-01

    blaNDM genes confer carbapenem resistance and have been identified on transferable plasmids belonging to different incompatibility (Inc) groups. Here we present the complete sequences of four plasmids carrying a blaNDM gene, pKP1-NDM-1, pEC2-NDM-3, pECL3-NDM-1, and pEC4-NDM-6, from four clinical samples originating from four different patients. Different plasmids carry segments that align to different parts of the blaNDM region found on Acinetobacter plasmids. pKP1-NDM-1 and pEC2-NDM-3, from Klebsiella pneumoniae and Escherichia coli, respectively, were identified as type 1 IncA/C2 plasmids with almost identical backbones. Different regions carrying blaNDM are inserted in different locations in the antibiotic resistance island known as ARI-A, and ISCR1 may have been involved in the acquisition of blaNDM-3 by pEC2-NDM-3. pECL3-NDM-1 and pEC4-NDM-6, from Enterobacter cloacae and E. coli, respectively, have similar IncFIIY backbones, but different regions carrying blaNDM are found in different locations. Tn3-derived inverted-repeat transposable elements (TIME) appear to have been involved in the acquisition of blaNDM-6 by pEC4-NDM-6 and the rmtC 16S rRNA methylase gene by IncFIIY plasmids. Characterization of these plasmids further demonstrates that even very closely related plasmids may have acquired blaNDM genes by different mechanisms. These findings also illustrate the complex relationships between antimicrobial resistance genes, transposable elements, and plasmids and provide insights into the possible routes for transmission of blaNDM genes among species of the Enterobacteriaceae family. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

  4. Delayed identification of Acinetobacter baumannii during an outbreak owing to disrupted blaOXA-51-like by ISAba19.

    Science.gov (United States)

    Ahmadi, Amjad; Salimizand, Himen

    2017-07-01

    Early detection of Acinetobacter baumannii, an emerging pathogen in hospital settings, is of interest. The bla OXA-51-like family had been used as a marker to detect A. baumannii. During an infection outbreak, 14 isolates produced a 1.7-kb PCR band instead of 353 bp for this marker. This work sought the reasons behind the increased marker size. Characterisation of isolates was done by API-20NE, gyrB multiplex PCR and 16S-23S rRNA ITS sequencing. The 1.7-kb band generated and the complete bla OXA-51-like variant were sequenced to find the probable integrated element. Susceptibility testing to various antimicrobials was performed by microdilution. bla OXA-like , metallo-β-lactamases (MBLs), the ISAba1 element and the presence of ISAba1 adjacent to bla OXA-like were sought. rep-PCR, global clonal (GC) lineage determination and multilocus sequence typing (MLST) were performed to analyse the relationship among isolates. Isolates were characterised as Acinetobacter baumannii-calcoaceticus complex by API-20NE. gyrB multiplex PCR and 16S-23S ITS sequencing verified the isolates as A. baumannii. Sequencing of the 1.7-kb band revealed ISAba19 as the disrupting element. The bla OXA-51 variant was bla OXA-66 , which was elongated to 2.2 kb due to ISAba19. The bla OXA-23-like family was found in 67% of isolates. MBL genes were not detected; however, ISAba1-bla OXA-23-like was characterised in carbapenem-resistant isolates (53%; 8/15). Isolates were divided into three clusters by rep-PCR. All strains were ST2 and all but one belonged to GC II. Identification of A. baumannii based only on bla OXA-51-like is not reliable. Besides bla OXA-51-like , multiplex PCR of gyrB and rpoB could provide rapid and cost-effective results. Copyright © 2017 Elsevier B.V. and International Society of Chemotherapy. All rights reserved.

  5. Characterization of a novel plasmid type and various genetic contexts of bla OXA-58 in Acinetobacter spp. from multiple cities in China.

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    Yiqi Fu

    Full Text Available BACKGROUND/OBJECTIVE: Several studies have described the epidemiological distribution of blaOXA-58-harboring Acinetobacter baumannii in China. However, there is limited data concerning the replicon types of blaOXA-58-carrying plasmids and the genetic context surrounding blaOXA-58 in Acinetobacter spp. in China. METHODOLOGY/PRINCIPAL FINDINGS: Twelve non-duplicated blaOXA-58-harboring Acinetobacter spp. isolates were collected from six hospitals in five different cities between 2005 and 2010. The molecular epidemiology of the isolates was carried out using PFGE and multilocus sequence typing. Carbapenemase-encoding genes and plasmid replicase genes were identified by PCR. The genetic location of blaOXA-58 was analyzed using S1-nuclease method. Plasmid conjugation and electrotransformation were performed to evaluate the transferability of blaOXA-58-harboring plasmids. The genetic structure surrounding blaOXA-58 was determined by cloning experiments. The twelve isolates included two Acinetobacter pittii isolates (belong to one pulsotype, three Acinetobacter nosocomialis isolates (belong to two pulsotypes and seven Acinetobacter baumannii isolates (belong to two pulsotypes/sequence types. A. baumannii ST91 was found to be a potential multidrug resistant risk clone carrying both blaOXA-58 and blaOXA-23. blaOXA-58 located on plasmids varied from ca. 52 kb to ca. 143 kb. All plasmids can be electrotransformed to A. baumannii recipient, but were untypeable by the current replicon typing scheme. A novel plasmid replicase named repAci10 was identified in blaOXA-58-harboring plasmids of two A. pittii isolates, three A. nosocomialis isolates and two A. baumannii isolates. Four kinds of genetic contexts of blaOXA-58 were identified. The transformants of plasmids with structure of IS6 family insertion sequence (ISOur1, IS1008 or IS15-ΔISAba3-like element-blaOXA-58 displayed carbapenem nonsusceptible, while others with structure of intact ISAba3-like element-bla

  6. Isolation of Enterobacter aerogenes carrying blaTEM-1 and blaKPC-3 genes recovered from a hospital Intensive Care Unit.

    Science.gov (United States)

    Pulcrano, Giovanna; Pignanelli, Salvatore; Vollaro, Adriana; Esposito, Matilde; Iula, Vita Dora; Roscetto, Emanuela; Soriano, Amata Amy; Catania, Maria Rosaria

    2016-06-01

    Enterobacter aerogenes has recently emerged as an important hospital pathogen. In this study, we showed the emergence of E. aerogenes isolates carrying the blaKPC gene in patients colonized by carbapenem-resistant Klebsiella pneumoniae strains. Two multiresistant E. aerogenes isolates were recovered from bronchial aspirates of two patients hospitalized in the Intensive Care Unit at the "Santa Maria della Scaletta" Hospital, Imola. The antimicrobial susceptibility test showed the high resistance to carbapenems and double-disk synergy test confirmed the phenotype of KPC and AmpC production. Other investigation revealed that ESBL and blaKPC genes were carried on the conjugative pKpQIL plasmid. This is a relevant report in Italy that describes a nosocomial infection due to the production of KPC beta-lactamases by an E. aerogenes isolate in patients previously colonized by K. pneumoniae carbapenem-resistant. In conclusion, it's necessary a continuous monitoring of multidrug-resistant strains for the detection of any KPC-producing bacteria that could expand the circulation of carbapenem-resistant pathogens. © 2016 APMIS. Published by John Wiley & Sons Ltd.

  7. First Identification of a Patient Colonized With Klebsiella pneumoniae Carrying blaNDM-1 in Taiwan

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    Hua-Shin Wu

    2010-11-01

    Full Text Available New Delhi metallo-β-lactamase 1 (NDM-1 is a novel type of metallo-β-lactamase (MBL. Enterobacteriaceae carrying this NDM-1 encoding gene, blaNDM-1, have been identified worldwide. Bacteria carrying blaNDM-1 are not only resistant to carbapenem, but also highly resistant to many classes of antibiotics, which indicate the importance of prompt identification of these bacteria and implementation of strict infection control measures to prevent their transmission. Here, we report the first identification and management of a patient colonized with Klebsiella pneumoniae carrying blaNDM-1 in Taiwan, who returned from New Delhi where he had been hospitalized for a gun-shot injury.

  8. Determination of a novel integron-located variant (blaOXA -320 ) of Class D β-lactamase in Proteus mirabilis.

    Science.gov (United States)

    Cicek, Aysegul Copur; Duzgun, Azer Ozad; Saral, Aysegul; Sandalli, Cemal

    2014-10-01

    Proteus mirabilis (P. mirabilis) is one of Gram-negative pathogens encountered in clinical specimens. A clinical isolate (TRP41) of P. mirabilis was isolated from a Turkish patient in Turkey. The isolate was identified using the API 32GN system and 16S rRNA gene sequencing and it was found resistant to ampicillin/sulbactam, piperacillin, tetracycline, and trimethoprim/sulfamethoxazole. This isolate was harboring a Class 1 integron gene cassette and its DNA sequence analysis revealed a novel blaOXA variant exhibiting one amino acid substitution (Asn266Ile) from blaOXA-1 . This new variant of OXA was located on Class 1 integron together with aadA1 gene encoding aminoglycoside-modifying enzymes. According to sequence records, the new variant was named as blaOXA-320 . Cassette array and size of integron were found as blaOXA-320 -aadA1 and 2086 bp, respectively. The blaOXA-320 gene is not transferable according to conjugation experiment. In this study, we report the first identification of blaOXA-320 -aadA1 gene cassette, a novel variant of Class D β-lactamase, in P. mirabilis from Turkey. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  9. Epidemiological characteristics of blaNDM-1 in Enterobacteriaceae and the Acinetobacter calcoaceticus-Acinetobacter baumannii complex in China from 2011 to 2012.

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    Weimei Ou

    Full Text Available The study aimed to investigate the prevalence and epidemiological characteristics of blaNDM-1 (encoding New Delhi metallo-β-lactamase 1 in Enterobacteriaceae and the Acinetobacter calcoaceticus-Acinetobacter baumannii complex (ABC in China from July 2011 to June 2012.PCR was used to screen for the presence of blaNDM-1 in all organisms studied. For blaNDM-1-positive strains, 16S rRNA analysis and Analytical Profile Index (API strips were used to identify the bacterial genus and species. The ABCs were reconfirmed by PCR detection of blaOXA-51-like. Antibiotic susceptibilities of the bacteria were assessed by determining minimum inhibitory concentration (MIC of them using two-fold agar dilution test, as recommended by the Clinical and Laboratory Standards Institute (CLSI. Molecular typing was performed using pulsed-field gel electrophoresis (PFGE. S1 nuclease-pulsed-field gel electrophoresis (S1-PFGE and Southern blot hybridization were conducted to ascertain the gene location of blaNDM-1. Conjugation experiments were conducted to determine the transmission of blaNDM-1-positive strains.Among 2,170 Enterobacteriaceae and 600 ABCs, seven Enterobacteriaceae strains and two A. calcoaceticus isolates from five different cities carried the blaNDM-1 gene. The seven Enterobacteriaceae strains comprised four Klebsiella pneumoniae, one Enterobacter cloacae, one Enterobacter aerogen and one Citrobacter freundii. All seven were non-susceptible to imipenem, meropenem or ertapenem. Two A. calcoaceticus species were resistant to imipenem and meropenem. Three K. pneumoniae showed the same PFGE profiles. The blaNDM-1 genes of eight strains were localized on plasmids, while one was chromosomal.Compared with previous reports, the numbers and species containing the blaNDM-1 in Enterobacteriaceae have significantly increased in China. Most of them are able to disseminate the gene, which is cause for concern. Consecutive surveillance should be implemented and should

  10. Expansion of highly stable bla OXA-10 β-lactamase family within diverse host range among nosocomial isolates of Gram-negative bacilli within a tertiary referral hospital of Northeast India.

    Science.gov (United States)

    Maurya, Anand Prakash; Dhar, Debadatta; Basumatary, Mridul Kumar; Paul, Deepjyoti; Ingti, Birson; Choudhury, Debarati; Talukdar, Anupam Das; Chakravarty, Atanu; Mishra, Shweta; Bhattacharjee, Amitabha

    2017-04-04

    The current study reports dissemination of highly stable bla OXA-10 family of beta lactamases among diverse group of nosocomial isolates of Gram-negative bacilli within a tertiary referral hospital of the northern part of India. In the current study, a total number of 590 Gram negative isolates were selected for a period of 1 year (i.e. 1st November 2011-31st October 2012). Members of Enterobacteriaceae and non fermenting Gram negative rods were obtained from Silchar Medical College and Hospital, Silchar, India. Screening and molecular characterization of β-lactamase genes was done. Integrase gene PCR was performed for detection and characterization of integrons and cassette PCR was performed for study of the variable regions of integron gene cassettes carrying bla OXA-10 . Gene transferability, stability and replicon typing was also carried out. Isolates were typed by ERIC as well as REP PCR. Twenty-four isolates of Gram-negative bacilli that were harboring bla OXA-10 family (OXA-14, and OXA16) with fact that resistance was to the extended cephalosporins. The resistance determinant was located within class I integron in five diverse genetic contexts and horizontally transferable in Enterobacteriaceae, was carried through IncY type plasmid. MIC values were above break point for all the tested cephalosporins. Furthermore, co-carriage of bla CMY-2 was also observed. Multiple genetic environment of bla OXA-10 in this geographical region must be investigated to prevent dissemination of these gene cassettes within bacterial population within hospital settings.

  11. Medical Applications

    OpenAIRE

    Biscari, C.; Falbo, L.

    2016-01-01

    The use of accelerators for medical applications has evolved from initial experimentation to turn-key devices commonly operating in hospitals. New applications are continuously being developed around the world, and the hadrontherapy facilities of the newest generation are placed at the frontier between industrial production and advanced R&D. An introduction to the different medical application accelerators is followed by a description of the hadrontherapy facilities, with special emphasis on ...

  12. Genotypic and Antimicrobial Susceptibility of Carbapenem-Resistant Acinetobacter baumannii: Analysis of ISAba Elements and blaOXA-23-like Genes Including A New Variant

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    Abbas eBahador

    2015-11-01

    Full Text Available Carbapenem-resistant Acinetobacter baumannii (CR-AB causes serious nosocomial infections, especially in ICU wards of hospitals, worldwide. Expression of blaOXA genes is the chief mechanism of conferring carbapenem resistance among CR-AB. Although some blaOXA genes have been studied among CR-AB isolates from Iran, their blaOXA-23-like genes have not been investigated. We used a multiplex-PCR to detect Ambler class A, B, and D carbapenemases of 85 isolates, and determined that 34 harbored blaOXA-23-like genes. Amplified fragment length polymorphism (AFLP genotyping, followed by DNA sequencing of blaOXA-23-like amplicons of CR-AB from each AFLP group was used to characterize their blaOXA-23-like genes. We also assessed the antimicrobial susceptibility pattern of CR-AB isolates, and tested whether they harbored insertion sequences ISAba1 and ISAba4. Sequence comparison with reference strain A. baumannii (NCTC12156 revealed five types of mutations in blaOXA-23-like genes; including one novel variant and four mutants that were already reported from China and the USA. All of the blaOXA-23-like genes mutations were associated with increased minimum inhibitory concentrations (MICs against imipenem. ISAba1 and ISAba4 sequences were detected upstream of blaOXA-23 genes in 19% and 7% of isolates, respectively. The isolation of CR-AB with new blaOXA-23 mutations including some that have been reported from the USA and China highlights CR-AB pervasive distribution, which underscores the importance of concerted national and global efforts to control the spread of CR-AB isolates worldwide.

  13. Prevalencia de bacterias Gram negativas portadoras del gen blaKPC en hospitales de Colombia

    OpenAIRE

    Robinson Pacheco; Lyda Osorio; Adriana M. Correa; Maria Virginia Villegas

    2014-01-01

    Introducción. Las enzimas carbapenemasas de tipo KPC tienen gran capacidad de diseminación, son causantes de epidemias y se asocian a mayor mortalidad y estancia hospitalaria. En Colombia se han venido reportando cada vez más desde 2007, pero se desconoce la prevalencia hospitalaria. Objetivo. Estimar la prevalencia hospitalaria del gen blaKPC. Materiales y métodos. Se evaluó la presencia del gen blaKPC y su ‘clonalidad’ en aislamientos de enterobacterias y Pseudomonas aeruginosa de p...

  14. Functional blaKPC-2 sequences are present in United States beef cattle feces regardless of antibiotic use

    Science.gov (United States)

    Recently, using quantitative PCR (qPCR) we detected blaKPC-2 in metagenomic DNA (mgDNA) prepared from the feces of 36 lots beef cattle "raised without antibiotics" (RWA) and 36 lots raised "conventionally" (CONV). Since a small internal fragment of the blaKPC-2 gene was targeted we sought to confirm...

  15. Prevalence of bla SHV genes in clinical isolates of Klebsiella ...

    African Journals Online (AJOL)

    Five bacterial strains (4 Klebsiella pneumoniae and 1 Escherichia coli) representative of pathogenic species and resistant to β-lactam antibiotics are investigated to isolate the genes responsible of β--lactamase activity. The use of engineering techniques enables us to show the widespread of blaSHV genes particularly in ...

  16. Medical Applications

    CERN Document Server

    Biscari, C.

    2014-12-19

    The use of accelerators for medical applications has evolved from initial experimentation to turn-key devices commonly operating in hospitals. New applications are continuously being developed around the world, and the hadrontherapy facilities of the newest generation are placed at the frontier between industrial production and advanced R&D. An introduction to the different medical application accelerators is followed by a description of the hadrontherapy facilities, with special emphasis on CNAO, and the report closes with a brief outlook on the future of this field.

  17. Medical Applications

    International Nuclear Information System (INIS)

    Biscari, C; Falbo, L

    2014-01-01

    The use of accelerators for medical applications has evolved from initial experimentation to turn-key devices commonly operating in hospitals. New applications are continuously being developed around the world, and the hadrontherapy facilities of the newest generation are placed at the frontier between industrial production and advanced R&D. An introduction to the different medical application accelerators is followed by a description of the hadrontherapy facilities, with special emphasis on CNAO, and the report closes with a brief outlook on the future of this field

  18. First case of bacteraemia due to Acinetobacter schindleri harbouring blaNDM-1 in an immunocompromised patient

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    S. Montaña

    2018-01-01

    Full Text Available Clinically significant NDM-1-producing Acinetobacter schindleri has not yet been described in the literature. We report the first case of bacteraemia due to an A. schindleri strain harbouring blaNDM-1 recovered from an immunocompromised patient. Our report reinforces the fact that NDM-1 can easily be acquired by Acinetobacter species. Keywords: Acinetobacter schindleri, bacteraemia, blaNDM-1, clinically significant isolate, immunocompromised patient

  19. ZrO2/bamboo leaves ash (BLA) Catalyst in Biodiesel Conversion of Rice Bran Oil

    Science.gov (United States)

    Fatimah, Is; Taushiyah, Ana; Badriatun Najah, Fitri; Azmi, Ulil

    2018-04-01

    Preparation, characterization and catalytic activity of ZrO2/bamboo leaves ash (BLA) catalyst for conversion of rice bran oil to biodiesel have been investigated. The catalyst was prepared by impregnation method of ZrOCl2 as ZrO2 precursor with BLA at a theoretical content of 20% wt. followed by calcination. The physicochemical properties of the catalyst material were characterized by x-ray diffraction (XRD), FTIR and surface acidity measurement. Activity test of materials in biodiesel conversion of rice bran oil was used by reflux method and microwave (MW) assisted method. Reaction variables studied in the investigation were the effect of catalyst weight and time of MW irradiation compared with the use reflux method. The results showed that ZrO2/BLA catalyst exhibited competitively effective and efficient processes for the production of biodiesel. The reflux method demonstrated an higher conversion (%) compared to MW method, however MW method showed the better reusable properties.

  20. The role of the genetic elements bla oxa and IS Aba 1 in the Acinetobacter calcoaceticus-Acinetobacter baumannii complex in carbapenem resistance in the hospital setting.

    Science.gov (United States)

    Kobs, Vanessa Cristine; Ferreira, Jéssica Augustini; Bobrowicz, Thaís Alexandra; Ferreira, Leslie Ecker; Deglmann, Roseneide Campos; Westphal, Glauco Adrieno; França, Paulo Henrique Condeixa de

    2016-01-01

    Members of the Acinetobacter genus are key pathogens that cause healthcare-associated infections, and they tend to spread and develop new antibiotic resistance mechanisms. Oxacillinases are primarily responsible for resistance to carbapenem antibiotics. Higher rates of carbapenem hydrolysis might be ascribed to insertion sequences, such as the ISAba1 sequence, near bla OXA genes. The present study examined the occurrence of the genetic elements bla OXA and ISAba1 and their relationship with susceptibility to carbapenems in clinical isolates of the Acinetobacter calcoaceticus-Acinetobacter baumannii complex. Isolates identified over 6 consecutive years in a general hospital in Joinville, Southern Brazil, were evaluated. The investigation of 5 families of genes encoding oxacillinases and the ISAba1 sequence location relative to bla OXA genes was conducted using polymerase chain reaction. All isolates presented the bla OXA-51-like gene (n = 78), and 91% tested positive for the bla OXA-23-like gene (n = 71). The presence of ISAba1 was exclusively detected in isolates carrying the bla OXA-23-like gene. All isolates in which ISAba1 was found upstream of the bla OXA-23-like gene (n = 69) showed resistance to carbapenems, whereas the only isolate in which ISAba1 was not located near the bla OXA-23-like gene was susceptible to carbapenems. The ISAba1 sequence position of another bla OXA-23-like-positive isolate was inconclusive. The isolates exclusively carrying the bla OXA-51-like gene (n = 7) showed susceptibility to carbapenems. The presence of the ISAba1 sequence upstream of the bla OXA-23-like gene was strongly associated with carbapenem resistance in isolates of the A. calcoaceticus-A. baumannii complex in the hospital center studied.

  1. Survey of Antibiotic Resistance and Frequency of blaOXA-23 and blaOXA-24 Oxacillinase in Acinetobacter baumannii Isolated from Tracheal Tube Specimens of Patients Hospitalized in Intensive Care Units in Isfahan city

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    M Ghalebi

    2017-04-01

    chi-square tests. Results: All isolates were found resistant to ceftazidime, ceftriaxone, meropenem and imipenem and the lowest resistance were seen against colistin (0% and tigecycline (10%, respectively. All isolates were resistant to imipenem using Etest method with MIC ≥ 32 μg / ml. blaOXA-23 and blaOXA-24 genes were detected in 87.5% and 25% of isolates, respectively. Conclusion: Due to the results, treatment of A. baumannii isolates by carbapenems is ineffective and tigecycline or colistin could be used for treatment. Other studies for detection of other mechanisms for carbapenem resistance are recommended.

  2. A Carbapenem-Resistant Pseudomonas aeruginosa Isolate Harboring Two Copies of blaIMP-34 Encoding a Metallo-β-Lactamase.

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    Tatsuya Tada

    Full Text Available A carbapenem-resistant strain of Pseudomonas aeruginosa, NCGM1984, was isolated in 2012 from a hospitalized patient in Japan. Immunochromatographic assay showed that the isolate was positive for IMP-type metallo-β-lactamase. Complete genome sequencing revealed that NCGM1984 harbored two copies of blaIMP-34, located at different sites on the chromosome. Each blaIMP-34 was present in the same structures of the class 1 integrons, tnpA(ISPa7-intI1-qacG-blaIMP-34-aac(6'-Ib-qacEdelta1-sul1-orf5-tniBdelta-tniA. The isolate belonged to multilocus sequence typing ST235, one of the international high-risk clones. IMP-34, with an amino acid substitution (Glu126Gly compared with IMP-1, hydrolyzed all β-lactamases tested except aztreonam, and its catalytic activities were similar to IMP-1. This is the first report of a clinical isolate of an IMP-34-producing P. aeruginosa harboring two copies of blaIMP-34 on its chromosome.

  3. IncA/C Plasmid Carrying bla(NDM-1), bla(CMY-16), and fosA3 in a Salmonella enterica Serovar Corvallis Strain Isolated from a Migratory Wild Bird in Germany.

    Science.gov (United States)

    Villa, L; Guerra, B; Schmoger, S; Fischer, J; Helmuth, R; Zong, Z; García-Fernández, A; Carattoli, A

    2015-10-01

    A Salmonella enterica serovar Corvallis strain was isolated from a wild bird in Germany. This strain carried the IncA/C2 pRH-1238 plasmid. Complete sequencing of the plasmid was performed, identifying the blaNDM-1, blaCMY-16, fosA3, sul1, sul2, strA, strB, aac(6')-Ib, aadA5, aphA6, tetA(A), mphA, floR, dfrA7, and merA genes, which confer clinically relevant resistance to most of the antimicrobial classes, including β-lactams with carbapenems, fosfomycin, aminoglycosides, co-trimoxazole, tetracyclines, and macrolides. The strain likely originated from the Asiatic region and was transferred to Germany through the Milvus migrans migratory route. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

  4. The role of the genetic elements bla oxa and IS Aba 1 in the Acinetobacter calcoaceticus-Acinetobacter baumannii complex in carbapenem resistance in the hospital setting

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    Vanessa Cristine Kobs

    Full Text Available Abstract: INTRODUCTION: Members of the Acinetobacter genus are key pathogens that cause healthcare-associated infections, and they tend to spread and develop new antibiotic resistance mechanisms. Oxacillinases are primarily responsible for resistance to carbapenem antibiotics. Higher rates of carbapenem hydrolysis might be ascribed to insertion sequences, such as the ISAba1 sequence, near bla OXA genes. The present study examined the occurrence of the genetic elements bla OXA and ISAba1 and their relationship with susceptibility to carbapenems in clinical isolates of the Acinetobacter calcoaceticus-Acinetobacter baumannii complex. METHODS: Isolates identified over 6 consecutive years in a general hospital in Joinville, Southern Brazil, were evaluated. The investigation of 5 families of genes encoding oxacillinases and the ISAba1 sequence location relative to bla OXA genes was conducted using polymerase chain reaction. RESULTS: All isolates presented the bla OXA-51-like gene (n = 78, and 91% tested positive for the bla OXA-23-like gene (n = 71. The presence of ISAba1 was exclusively detected in isolates carrying the bla OXA-23-like gene. All isolates in which ISAba1 was found upstream of the bla OXA-23-like gene (n = 69 showed resistance to carbapenems, whereas the only isolate in which ISAba1 was not located near the bla OXA-23-like gene was susceptible to carbapenems. The ISAba1 sequence position of another bla OXA-23-like-positive isolate was inconclusive. The isolates exclusively carrying the bla OXA-51-like gene (n = 7 showed susceptibility to carbapenems. CONCLUSIONS: The presence of the ISAba1 sequence upstream of the bla OXA-23-like gene was strongly associated with carbapenem resistance in isolates of the A. calcoaceticus-A. baumannii complex in the hospital center studied.

  5. Identification and characterization of two novel bla(KLUC resistance genes through large-scale resistance plasmids sequencing.

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    Teng Xu

    Full Text Available Plasmids are important antibiotic resistance determinant carriers that can disseminate various drug resistance genes among species or genera. By using a high throughput sequencing approach, two groups of plasmids of Escherichia coli (named E1 and E2, each consisting of 160 clinical E. coli strains isolated from different periods of time were sequenced and analyzed. A total of 20 million reads were obtained and mapped onto the known resistance gene sequences. As a result, a total of 9 classes, including 36 types of antibiotic resistant genes, were identified. Among these genes, 25 and 27 single nucleotide polymorphisms (SNPs appeared, of which 9 and 12 SNPs are nonsynonymous substitutions in the E1 and E2 samples. It is interesting to find that a novel genotype of bla(KLUC, whose close relatives, bla(KLUC-1 and bla(KLUC-2, have been previously reported as carried on the Kluyvera cryocrescens chromosome and Enterobacter cloacae plasmid, was identified. It shares 99% and 98% amino acid identities with Kluc-1 and Kluc-2, respectively. Further PCR screening of 608 Enterobacteriaceae family isolates yielded a second variant (named bla(KLUC-4. It was interesting to find that Kluc-3 showed resistance to several cephalosporins including cefotaxime, whereas bla(KLUC-4 did not show any resistance to the antibiotics tested. This may be due to a positively charged residue, Arg, replaced by a neutral residue, Leu, at position 167, which is located within an omega-loop. This work represents large-scale studies on resistance gene distribution, diversification and genetic variation in pooled multi-drug resistance plasmids, and provides insight into the use of high throughput sequencing technology for microbial resistance gene detection.

  6. Iodometric and Molecular Detection of ESBL Production Among Clinical Isolates of E. coli Fingerprinted by ERIC-PCR: The First Egyptian Report Declares the Emergence of E. coli O25b-ST131clone Harboring blaGES.

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    El-Badawy, Mohamed F; Tawakol, Wael M; Maghrabi, Ibrahim A; Mansy, Moselhy S; Shohayeb, Mohamed M; Ashour, Mohammed S

    2017-09-01

    The extensive use of β-lactam antibiotics has led to emergence and spread of extended-spectrum β-lactamases (ESBLs). This study was conducted to investigate the prevalence of 7 different ESBL genes (bla TEM , bla SHV , bla CTX-M , bla VEB , bla PER , bla GES , and bla OXA-10 ) and O25b-ST131 high-risk clone among 61 clinical isolates of Escherichia coli. Also, one broad-spectrum β-lactamase (bla OXA-1 ) was investigated. This study was also constructed to evaluate iodometric overlay method in detection of ESBL production. Phenotypic identification of E. coli isolates using API 20E revealed 18 distinct biotypes. DNA fingerprinting using enterobacterial repetitive intergenic consensus polymerase chain reaction (ERIC-PCR) differentiated all isolates into 2 main phylogenetic groups with 60 distinct genetic profiles. Elevated values of minimal inhibitory concentration (MIC) 50 and MIC 90 for third- and fourth-generation cephalosporins were observed. Phenotypic tests revealed that 85.24% of isolates were ESBL producers. The incidence rates of bla TEM , bla SHV , bla CTX-M , bla GES , bla OXA-1 , and bla OXA-10 among E. coli ESBL producer phenotype were 69.23%, 25%, 96.15%, 3.85%, 11.54%, and 48%, respectively. On the other hand, bla VEB and bla PER were not detected. Sequencing of bla TEM and bla SHV revealed that bla TEM-214 and bla SHV-11 were the most prevalent variants. Group characterization of bla CTX-M revealed that bla CTX-M-1 was the most prevalent group of bla CTX-M family. It was found that 30.77% of E. coli ESBL producers belonged to O25b-ST131 clone harboring bla CTX-M-15 . This study concluded that iodometric overlay method was 100% sensitive in detection of ESBL production. To our knowledge, this is the first Egyptian study that declares the emergence of E. coli O25b-ST131 harboring bla GES .

  7. Inhibition of the β-Lactamase BlaMab by Avibactam Improves the In Vitro and In Vivo Efficacy of Imipenem against Mycobacterium abscessus.

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    Lefebvre, Anne-Laure; Le Moigne, Vincent; Bernut, Audrey; Veckerlé, Carole; Compain, Fabrice; Herrmann, Jean-Louis; Kremer, Laurent; Arthur, Michel; Mainardi, Jean-Luc

    2017-04-01

    Mycobacterium abscessus pulmonary infections are treated with a macrolide (clarithromycin or azithromycin), an aminoglycoside (amikacin), and a β-lactam (cefoxitin or imipenem). The triple combination is used without any β-lactamase inhibitor, even though M abscessus produces the broad-spectrum β-lactamase Bla Mab We determine whether inhibition of Bla Mab by avibactam improves the activity of imipenem against M. abscessus The bactericidal activity of drug combinations was assayed in broth and in human macrophages. The in vivo efficacy of the drugs was tested by monitoring the survival of infected zebrafish embryos. The level of Bla Mab production in broth and in macrophages was compared by quantitative reverse transcription-PCR and Western blotting. The triple combination of imipenem (8 or 32 μg/ml), amikacin (32 μg/ml), and avibactam (4 μg/ml) was bactericidal in broth (imipenem was used at 8 and 32 μg/ml, respectively. The triple combination achieved significant intracellular killing, with the bacterial survival rates being 54% and 7% with the low (8 μg/ml) and high (32 μg/ml) dosages of imipenem, respectively. In vivo inhibition of Bla Mab by avibactam improved the survival of zebrafish embryos treated with imipenem. Expression of the gene encoding Bla Mab was induced (20-fold) in the infected macrophages. Inhibition of Bla Mab by avibactam improved the efficacy of imipenem against M. abscessus in vitro , in macrophages, and in zebrafish embryos, indicating that this β-lactamase inhibitor should be clinically evaluated. The in vitro evaluation of imipenem may underestimate the impact of Bla Mab , since the production of the β-lactamase is inducible in macrophages. Copyright © 2017 American Society for Microbiology.

  8. Clonal spread of blaOXA-72-carrying Acinetobacter baumannii sequence type 512 in Taiwan.

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    Kuo, Han-Yueh; Hsu, Po-Jui; Chen, Jiann-Yuan; Liao, Po-Cheng; Lu, Chia-Wei; Chen, Chang-Hua; Liou, Ming-Li

    2016-07-01

    This is the first report to show an insidious outbreak of armA- and blaOXA-72-carrying Acinetobacter baumannii sequence type 512 (ST512) at a study hospital in northern Taiwan. Multilocus sequence typing revealed that this was a ST512 clone. All of the isolates with ST512 carried a novel 12,056-bp repGR2 in combination with a repGR12-type plasmid. This plasmid, designated pAB-ML, had one copy of the blaOXA-72 gene that was flanked by XerC/XerD-like sites and conferred resistance to carbapenems. Copyright © 2016 Elsevier B.V. and International Society of Chemotherapy. All rights reserved.

  9. Structural Variabilities in β-Lactamase (blaA of Different Biovars of Yersinia enterocolitica: Implications for β-Lactam Antibiotic and β-Lactamase Inhibitor Susceptibilities.

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    Neelja Singhal

    Full Text Available Yersiniosis caused by Yersinia enterocolitica has been reported from all continents. The bacterial species is divided into more than fifty serovars and six biovars viz. 1A, 1B, 2, 3, 4 and 5 which differ in geographical distribution, ecological niches and pathogenicity. Most Y.enterocolitica strains harbor chromosomal genes for two β-lactamases, blaA an Ambler class A penicillinase and blaB an Ambler class C inducible cephalosporinase. In the present study, susceptibility to b-lactam antibiotics and β-lactamase inhibitor was studied for Y. enterocolitica strains of biovars 1A, 1B, 2 and 4. We observed that β-lactamases were expressed differentially among strains of different biovars. To understand the molecular mechanisms underlying such differential expression, the sequences of genes and promoters of blaA were compared. Also, the variants of blaA present in different biovars were modeled and docked with amoxicillin and clavulanic acid. The mRNA secondary structures of blaA variants were also predicted in-silico. Our findings indicated that neither variations in the promoter regions, nor the secondary structures of mRNA contributed to higher/lower expression of blaA in different biovars. Analysis of H-bonding residues of blaA variants with amoxicillin and clavulanic acid revealed that if amino acid residues of a β-lactamase interacting with amoxicillin and the clavulanic acid were similar, clavulanic acid was effective in engaging the enzyme, accounting for a significant reduction in MIC of amoxicillin-clavulanate. This finding might aid in designing better β-lactamase inhibitors with improved efficiencies in future.

  10. Low Frequency of Ceftazidime-Avibactam Resistance among Enterobacteriaceae Isolates Carrying blaKPC Collected in U.S. Hospitals from 2012 to 2015.

    Science.gov (United States)

    Castanheira, Mariana; Mendes, Rodrigo E; Sader, Helio S

    2017-03-01

    Klebsiella pneumoniae carbapenemase (KPC)-producing Enterobacteriaceae isolates have been increasingly reported worldwide, and therapeutic options to treat infections caused by these organisms are limited. We evaluated the activity of ceftazidime-avibactam and comparators against 456 Enterobacteriaceae isolates carrying bla KPC collected from 79 U.S. hospitals during 2012 to 2015. Overall, ceftazidime-avibactam (MIC 50/90 , 0.5/2 μg/ml; 99.3% susceptible) and tigecycline (MIC 50/90 , 0.5/1 μg/ml; 98.9% susceptible at ≤2 μg/ml) were the most active agents. Only 80.5% and 59.0% of isolates were susceptible to colistin and amikacin, respectively. All three isolates (0.7%) displaying resistance to ceftazidime-avibactam ( K. pneumoniae ; MICs, ≥16 μg/ml) were evaluated using whole-genome sequencing analysis and relative quantification of expression levels of porins and efflux pump. Two isolates carried metallo-β-lactamase genes, bla NDM-1 or bla VIM-4 , among other β-lactam resistance mechanisms, and one displayed a premature stop codon in ompK35 and decreased expression of ompK36 Ceftazidime-avibactam was active against 100.0 and 99.3% of isolates carrying bla KPC-3 ( n = 221) and bla KPC-2 ( n = 145), respectively. Isolates carrying bla KPC were more commonly recovered from pneumonia ( n = 155), urinary tract ( n = 93), and skin/soft tissue ( n = 74) infections. Ceftazidime-avibactam (97.8 to 100.0% susceptible) was consistently active against isolates from all infection sites. K. pneumoniae (83.3% of the collection) susceptibility rates were 99.2% for ceftazidime-avibactam, 98.9% for tigecycline, and 80.1% for colistin. Ceftazidime-avibactam susceptibility did not vary substantially when comparing isolates from intensive care unit (ICU) patients to those from non-ICU patients. Ceftazidime-avibactam was active against this large collection of isolates carrying bla KPC and represents a valuable addition to the armamentarium currently available for the

  11. blaGES carrying Pseudomonas aeruginosa isolates from a public hospital in Rio de Janeiro, Brazil

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    Flávia L. P. C. Pellegrino

    Full Text Available Previous analysis of Pseudomonas aeruginosa class-1 integrons from Rio de Janeiro, Brazil, revealed the blaGES gene in one isolate. We screened isolates of two widespread PFGE genotypes, A and B, at a public hospital in Rio, for the presence of blaGES. The gene was detected in all seven P. aeruginosa isolates belonging to genotype B. Three of the seven genotype-B isolates were resistant to amikacin, aztreonam, ceftazidime, cefepime, ciprofloxacin, gentamicin, imipenem, meropenem, piperacillin-tazobactam and ticarcillin-clavulanic acid. The other four isolates were resistant to all these agents, except gentamicin, imipenem, meropenem and piperacillin-tazobactam. A synergistic effect between ceftazidime and imipenem or clavulanic acid suggested the production of GES-type ESBL.

  12. Detection of the IncX3 plasmid carrying blaKPC-3 in a Serratia marcescens strain isolated from a kidney-liver transplanted patient.

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    Gona, Floriana; Caio, Carla; Iannolo, Gioacchin; Monaco, Francesco; Di Mento, Giuseppina; Cuscino, Nicola; Fontana, Ignazio; Panarello, Giovanna; Maugeri, Gaetano; Mezzatesta, Maria Lina; Stefani, Stefania; Conaldi, Pier Giulio

    2017-10-01

    Dissemination of resistance to carbapenems among Enterobacteriaceae through plasmids is an increasingly important concern in health care worldwide. Here we report the first description of an IncX3 plasmid carrying the blaKPC-3 gene in a strain of Serratia marcescens isolated from a kidney-liver transplanted patient at the transplantation centre ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione, Palermo, Italy). To localize the transposable element containing the resistance-associated gene Next-Generation Sequencing of the bacterial DNA was performed. S. marcescens was positive for blaKPC-3 and blaSHV-11 genes. The molecular analysis demonstrated that the blaKPC-3 gene of this bacterial strain was located in one copy of the Tn-3-like element Tn4401-a carried in a plasmid that is 53 392 bp in size and showed the typical IncX3 scaffold. Our data demonstrated the presence of a new blaKPC-3 harbouring the IncX3 plasmid in S. marcescens. The possible dissemination among Enterobacteriaceae of this type of plasmid should be monitored and evaluated in terms of clinical risk.

  13. The sudden dominance of blaCTX-M harbouring plasmids in Shigella spp. Circulating in Southern Vietnam.

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    Nhu Thi Khanh Nguyen

    2010-06-01

    Full Text Available Plasmid mediated antimicrobial resistance in the Enterobacteriaceae is a global problem. The rise of CTX-M class extended spectrum beta lactamases (ESBLs has been well documented in industrialized countries. Vietnam is representative of a typical transitional middle income country where the spectrum of infectious diseases combined with the spread of drug resistance is shifting and bringing new healthcare challenges.We collected hospital admission data from the pediatric population attending the hospital for tropical diseases in Ho Chi Minh City with Shigella infections. Organisms were cultured from all enrolled patients and subjected to antimicrobial susceptibility testing. Those that were ESBL positive were subjected to further investigation. These investigations included PCR amplification for common ESBL genes, plasmid investigation, conjugation, microarray hybridization and DNA sequencing of a bla(CTX-M encoding plasmid.We show that two different bla(CTX-M genes are circulating in this bacterial population in this location. Sequence of one of the ESBL plasmids shows that rather than the gene being integrated into a preexisting MDR plasmid, the bla(CTX-M gene is located on relatively simple conjugative plasmid. The sequenced plasmid (pEG356 carried the bla(CTX-M-24 gene on an ISEcp1 element and demonstrated considerable sequence homology with other IncFI plasmids.The rapid dissemination, spread of antimicrobial resistance and changing population of Shigella spp. concurrent with economic growth are pertinent to many other countries undergoing similar development. Third generation cephalosporins are commonly used empiric antibiotics in Ho Chi Minh City. We recommend that these agents should not be considered for therapy of dysentery in this setting.

  14. Loop-mediated isothermal amplification: Rapid and sensitive detection of the antibiotic resistance gene ISAba1-blaOXA-51-like in Acinetobacter baumannii.

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    Mu, Xiaoqin; Nakano, Ryuichi; Nakano, Akiyo; Ubagai, Tsuneyuki; Kikuchi-Ueda, Takane; Tansho-Nagakawa, Shigeru; Kikuchi, Hirotoshi; Kamoshida, Go; Endo, Shiro; Yano, Hisakazu; Ono, Yasuo

    2016-02-01

    Carbapenem-resistant Acinetobacter baumannii, which are mainly induced by the production of OXA-type β-lactamases, are among the leading causes of nosocomial infections worldwide. Among the β-lactamase genes, the presence of the OXA-51-like gene carrying the upstream insertion sequence, ISAba1, was found to be one of the most prevalent carbapenem resistance mechanisms utilized by these bacteria. Consequently, it is necessary to develop a rapid detection method for ISAba1-blaOXA-51-like sequence for the timely and appropriate antibiotic treatment of A. baumannii infection. In this study, a loop-mediated isothermal amplification (LAMP) assay was optimized for ISAba1-blaOXA-51-like detection. The LAMP primer set was designed to recognize distinct sequences in the ISAba1-blaOXA-51-like gene and could amplify the gene within 25 min at an isothermal temperature of 60°C. This LAMP assay was able to detect the ISAba1-blaOXA-51-like gene with high specificity; in addition, no cross-reactivity was observed for other types of β-lactamase producers (OXA-23-like, OXA-40-like, OXA-58-like, and IMP-1), as indicated by the absence of false positive or false negative results. The detection limit for this assay was found to be 10(0)CFU per tube which was 100-fold more sensitive than a polymerase chain reaction assay for ISAba1-blaOXA-51-like detection. Furthermore, the LAMP assay provided swift detection of the ISAba1-blaOXA-51-like gene, even directly from clinical specimens. In summary, we have described a new, rapid assay for the detection of the ISAba1-blaOXA-51-like gene from A. baumannii that could be useful in a clinical setting. This method might facilitate epidemiological studies and allow monitoring of the emergence of drug resistant strains. Copyright © 2015 Elsevier B.V. All rights reserved.

  15. Bacillus licheniformis BlaR1 L3 Loop Is a Zinc Metalloprotease Activated by Self-Proteolysis

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    Sépulchre, Jérémy; Amoroso, Ana; Joris, Bernard

    2012-01-01

    In Bacillus licheniformis 749/I, BlaP β-lactamase is induced by the presence of a β-lactam antibiotic outside the cell. The first step in the induction mechanism is the detection of the antibiotic by the membrane-bound penicillin receptor BlaR1 that is composed of two functional domains: a carboxy-terminal domain exposed outside the cell, which acts as a penicillin sensor, and an amino-terminal domain anchored to the cytoplasmic membrane, which works as a transducer-transmitter. The acylation of BlaR1 sensor domain by the antibiotic generates an intramolecular signal that leads to the activation of the L3 cytoplasmic loop of the transmitter by a single-point cleavage. The exact mechanism of L3 activation and the nature of the secondary cytoplasmic signal launched by the activated transmitter remain unknown. However, these two events seem to be linked to the presence of a HEXXH zinc binding motif of neutral zinc metallopeptidases. By different experimental approaches, we demonstrated that the L3 loop binds zinc ion, belongs to Gluzincin metallopeptidase superfamily and is activated by self-proteolysis. PMID:22623956

  16. Phenotypic and molecular detection of the bla KPC gene in clinical isolates from inpatients at hospitals in São Luis, MA, Brazil.

    Science.gov (United States)

    Ribeiro, Patricia Cristina Saldanha; Monteiro, Andrea Souza; Marques, Sirlei Garcia; Monteiro, Sílvio Gomes; Monteiro-Neto, Valério; Coqueiro, Martina Márcia Melo; Marques, Ana Cláudia Garcia; de Jesus Gomes Turri, Rosimary; Santos, Simone Gonçalves; Bomfim, Maria Rosa Quaresma

    2016-12-07

    Bacteria that produce Klebsiella pneumoniae carbapenemases (KPCs) are resistant to broad-spectrum β-lactam antibiotics. The objective of this study was to phenotypically and genotypically characterize the antibiotic susceptibility to carbapenems of 297 isolates recovered from clinical samples obtained from inpatients at 16 hospitals in São Luis (Maranhão, Brazil). The study was conducted using phenotypic tests and molecular methods, including polymerase chain reaction (PCR), sequencing and enterobacterial repetitive intergenic consensus (ERIC)-PCR. The nonparametric chi-square test of independence was used to evaluate the associations between the bacterial bla KPC gene and the modified Hodge test, and the chi-square adherence test was used to assess the frequency of carbapenemases and their association with the bla KPC gene. The most frequently isolated species were Acinetobacter baumannii (n = 128; 43.0%), K. pneumoniae (n = 75; 25.2%), and Pseudomonas aeruginosa (n = 42; 14.1%). Susceptibility assays showed that polymixin B was active against 89.3% of the bacterial isolates. The Acinetobacter spp. and K. pneumoniae strains were susceptible to amikacin and tigecycline, and Pseudomonas spp. were sensitive to gentamicin and amikacin. Among the 297 isolates, 100 (33.7%) were positive for the bla KPC gene, including non-fermentative bacteria (A. baumannii) and Enterobacteriaceae species. Among the isolates positive for the bla KPC gene, K. pneumoniae isolates had the highest positivity rate of 60.0%. The bla KPC gene variants detected included KPC-2, which was found in all isolates belonging to species of the Enterobacteriaceae family. KPC-2 and KPC-3 were observed in A. baumannii isolates. Importantly, the bla KPC gene was also detected in three Raoultella isolates and one isolate of the Pantoea genus. ERIC-PCR patterns showed a high level of genetic diversity among the bacterial isolates; it was capable of distinguishing 34 clones among 100 strains

  17. Prevalence of extended-spectrum cephalosporin-resistant Escherichia coli in a farrowing farm: ST1121 clone harboring IncHI2 plasmid contributes to the dissemination of blaCMY-2

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    Hui eDeng

    2015-11-01

    Full Text Available Abstract During a regular monitoring of antimicrobial resistance in a farrowing farm in Southern China, 117 Escherichia coli isolates were obtained from sows and piglets. Compared with the isolates from piglets, the isolates from sows exhibited higher resistance rates to the tested cephalosporins. Correspondingly, the total detection rate of the blaCMY-2/blaCTX-M genes in the sow isolates (34.2% was also significantly higher than that of the piglet isolates (13.6% (p<0.05. The blaCMY-2 gene had a relatively high prevalence (11.1% in the E. coli isolates. MLST and PFGE analysis revealed the clonal spread of ST1121 E. coli in most (7/13 of the blaCMY-2-positive isolates. An indistinguishable IncHI2 plasmid harboring blaCMY-2 was also identified in each of the seven ST1121 E. coli isolates. Complete sequence analysis of this IncHI2 plasmid (pEC5207 revealed that pEC5207 may have originated through recombination of an IncHI2 plasmid with a blaCMY-2-carrying IncA/C plasmid like pCFSAN007427_01. In addtion to blaCMY-2, pEC5207 also carried other resistance determinants for aminoglycosides (aacA7, sulfonamides (sul1, as well as heavy metals ions, such as Cu and Ag. The susceptibility testing showed that the pEC5207 can mediate both antibiotic and heavy metal resistance. This highlights the role of pEC5207 in co-selection of blaCMY-2-positive isolates under the selective pressure of heavy metals, cephalosporins and other antimicrobials. In conclusion, clonal spread of an ST1121 type E. coli strain harboring an IncHI2 plasmid contributed to the dissemination of blaCMY-2 in a farrowing farm in Southern China. We also have determined the first complete sequence analysis of a blaCMY-2-carrying IncHI2 plasmid.

  18. Extracurricular activities of medical school applicants

    Directory of Open Access Journals (Sweden)

    Sang Hyun Kim

    2016-06-01

    Full Text Available Purpose: The purpose of this study was to investigate medical school applicants’ involvements in extracurricular activities including medical volunteering/community services, nonmedical community services, club activities, leadership role, and research. Methods: Extracurricular characteristics were compared for 448 applicants (223 males and 225 females who applied to Kangwon Medical School in 2013 to 2014. Frequency analysis, chi-square test, and simple correlation were conducted with the collected data. Results: The 448 applicants participated in medical volunteer/community services (15.3%, nonmedical community services (39.8%, club activities (22.9%, club officials (10%, and research (13.4%. On average, applicants from foreign universities participated in 0.9 medical volunteer/community service, 0.8 nonmedical community service, 1.7 club activities, and 0.6 research work. On the other hand, applicants from domestic universities reported 0.2 medical volunteer/community service, 1.0 nonmedical community service, 0.7 club activity, and 0.3 research. Conclusion: Involvement in extracurricular activities was extensive for medical school applicants. Participation in extracurricular activities differed between applicants from foreign and domestic universities. Females consistently reported greater participation in extracurricular activities than males. The data can be helpful for admission committees to recruit well-rounded applicants and compare between applicants with similar academic backgrounds.

  19. Norwegian patients and retail chicken meat share cephalosporin-resistant Escherichia coli and IncK/blaCMY-2 resistance plasmids.

    Science.gov (United States)

    Berg, E S; Wester, A L; Ahrenfeldt, J; Mo, S S; Slettemeås, J S; Steinbakk, M; Samuelsen, Ø; Grude, N; Simonsen, G S; Løhr, I H; Jørgensen, S B; Tofteland, S; Lund, O; Dahle, U R; Sunde, M

    2017-06-01

    In 2012 and 2014 the Norwegian monitoring programme for antimicrobial resistance in the veterinary and food production sectors (NORM-VET) showed that 124 of a total of 406 samples (31%) of Norwegian retail chicken meat were contaminated with extended-spectrum cephalosporin-resistant Escherichia coli. The aim of this study was to compare selected cephalosporin-resistant E. coli from humans and poultry to determine their genetic relatedness based on whole genome sequencing (WGS). Escherichia coli representing three prevalent cephalosporin-resistant multi-locus sequence types (STs) isolated from poultry (n=17) were selected from the NORM-VET strain collections. All strains carried an IncK plasmid with a bla CMY-2 gene. Clinical E. coli isolates (n=284) with AmpC-mediated resistance were collected at Norwegian microbiology laboratories from 2010 to 2014. PCR screening showed that 29 of the clinical isolates harboured both IncK and bla CMY-2 . All IncK/bla CMY-2 -positive isolates were analysed with WGS-based bioinformatics tools. Analysis of single nucleotide polymorphisms (SNP) in 2.5 Mbp of shared genome sequences showed close relationship, with fewer than 15 SNP differences between five clinical isolates from urinary tract infections (UTIs) and the ST38 isolates from poultry. Furthermore, all of the 29 clinical isolates harboured IncK/bla CMY-2 plasmid variants highly similar to the IncK/bla CMY-2 plasmid present in the poultry isolates. Our results provide support for the hypothesis that clonal transfer of cephalosporin-resistant E. coli from chicken meat to humans may occur, and may cause difficult-to-treat infections. Furthermore, these E. coli can be a source of AmpC-resistance plasmids for opportunistic pathogens in the human microbiota. Copyright © 2017 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  20. Serratia marcescens harbouring SME-type class A carbapenemases in Canada and the presence of blaSME on a novel genomic island, SmarGI1-1.

    Science.gov (United States)

    Mataseje, L F; Boyd, D A; Delport, J; Hoang, L; Imperial, M; Lefebvre, B; Kuhn, M; Van Caeseele, P; Willey, B M; Mulvey, M R

    2014-07-01

    An increasing prevalence since 2010 of Serratia marcescens harbouring the Ambler class A carbapenemase SME prompted us to further characterize these isolates. Isolates harbouring bla(SME) were identified by PCR and sequencing. Phenotypic analysis for carbapenemase activity was carried out by a modified Hodge test and a modified Carba NP test. Antimicrobial susceptibilities were determined by Etest and Vitek 2. Typing was by PFGE of macrorestriction digests. Whole-genome sequencing of three isolates was carried out to characterize the genomic region harbouring the bla(SME)-type genes. All S. marcescens harbouring SME-type enzymes could be detected using a modified Carba NP test. Isolates harbouring bla(SME) were resistant to penicillins and carbapenems, but remained susceptible to third-generation cephalosporins, as well as fluoroquinolones and trimethoprim/sulfamethoxazole. Isolates exhibited diverse genetic backgrounds, though 57% of isolates were found in three clusters. Analysis of whole-genome sequence data from three isolates revealed that the bla(SME) gene occurred in a novel cryptic prophage genomic island, SmarGI1-1. There has been an increasing occurrence of S. marcescens harbouring bla(SME) in Canada since 2010. The bla(SME) gene was found on a genomic island, SmarGI1-1, that can be excised and circularized, which probably contributes to its dissemination amongst S. marcescens. © The Author 2014. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  1. Complete sequence of the IncA/C1 plasmid pCf587 carrying blaPER-2 from Citrobacter freundii.

    Science.gov (United States)

    Ruggiero, Melina; Girlich, Delphine; Dabos, Laura; Power, Pablo; Naas, Thierry; Gutkind, Gabriel

    2018-02-20

    The bla PER-2 harboring plasmid pCf587 (191,541 bp) belongs to lineage IncA/C 1 and is closely related to pRA1. It contains a large resistance island including the bla PER-2 gene between two copies of IS Kox2 -like elements, the toxin-antitoxin module pemK-pemI, several other resistance genes inserted within a Tn 2 transposon, a Tn 21 -like structure, and a class 1 integron. pCf587 belongs into ST 13, a new pMLST. Copyright © 2018 American Society for Microbiology.

  2. CERN's role in medical applications

    CERN Multimedia

    Antonella Del Rosso

    2014-01-01

    Last week, CERN hosted the first meeting of the International Strategy Committee for medical applications. This Committee will help CERN establish its roadmap in the field of research and development activities for medical applications. Here the CERN Bulletin speaks with the Chair of the Committee as he shares his expectations and his vision.   Dr Michael Baumann is the Director of the Radiation Oncology department at the Carl Gustav Carus University Hospital in Dresden and of the Institute for Radiooncology of the Helmholtz-Zentrum Dresden-Rossendorf (Germany). He has recently been appointed Chair of CERN’s International Strategy Committee for medical applications – the team of experts who will advise the CERN Medical Applications Study Group led by Steve Myers. “CERN has a tremendous record in physics and basic research,” says Baumann. “I think that it has a very important role in steering some of the R&D that cannot be done at universities ...

  3. Advanced Accelerators for Medical Applications

    Science.gov (United States)

    Uesaka, Mitsuru; Koyama, Kazuyoshi

    We review advanced accelerators for medical applications with respect to the following key technologies: (i) higher RF electron linear accelerator (hereafter “linac”); (ii) optimization of alignment for the proton linac, cyclotron and synchrotron; (iii) superconducting magnet; (iv) laser technology. Advanced accelerators for medical applications are categorized into two groups. The first group consists of compact medical linacs with high RF, cyclotrons and synchrotrons downsized by optimization of alignment and superconducting magnets. The second group comprises laser-based acceleration systems aimed of medical applications in the future. Laser plasma electron/ion accelerating systems for cancer therapy and laser dielectric accelerating systems for radiation biology are mentioned. Since the second group has important potential for a compact system, the current status of the established energy and intensity and of the required stability are given.

  4. Double Copies of bla(KPC-3)::Tn4401a on an IncX3 Plasmid in Klebsiella pneumoniae Successful Clone ST512 from Italy.

    Science.gov (United States)

    Fortini, Daniela; Villa, Laura; Feudi, Claudia; Pires, João; Bonura, Celestino; Mammina, Caterina; Endimiani, Andrea; Carattoli, Alessandra

    2016-01-01

    A carbapenem-resistant sequence type 512 (ST512) Klebsiella pneumoniae carbapenemase 3 (KPC-3)-producing K. pneumoniae strain showing a novel variant plasmid content was isolated in Palermo, Italy, in 2014. ST512 is a worldwide successful clone associated with the spread of bla(KPC) genes located on the IncFIIk pKpQIL plasmid. In our ST512 strain, the bla(KPC-3) gene was unusually located on an IncX3 plasmid, whose complete sequence was determined. Two copies of bla(KPC-3)::Tn4401a caused by intramolecular transposition events were detected in the plasmid. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

  5. Complete sequencing of the bla(NDM-1)-positive IncA/C plasmid from Escherichia coli ST38 isolate suggests a possible origin from plant pathogens.

    Science.gov (United States)

    Sekizuka, Tsuyoshi; Matsui, Mari; Yamane, Kunikazu; Takeuchi, Fumihiko; Ohnishi, Makoto; Hishinuma, Akira; Arakawa, Yoshichika; Kuroda, Makoto

    2011-01-01

    The complete sequence of the plasmid pNDM-1_Dok01 carrying New Delhi metallo-β-lactamase (NDM-1) was determined by whole genome shotgun sequencing using Escherichia coli strain NDM-1_Dok01 (multilocus sequence typing type: ST38) and the transconjugant E. coli DH10B. The plasmid is an IncA/C incompatibility type composed of 225 predicted coding sequences in 195.5 kb and partially shares a sequence with bla(CMY-2)-positive IncA/C plasmids such as E. coli AR060302 pAR060302 (166.5 kb) and Salmonella enterica serovar Newport pSN254 (176.4 kb). The bla(NDM-1) gene in pNDM-1_Dok01 is terminally flanked by two IS903 elements that are distinct from those of the other characterized NDM-1 plasmids, suggesting that the bla(NDM-1) gene has been broadly transposed, together with various mobile elements, as a cassette gene. The chaperonin groES and groEL genes were identified in the bla(NDM-1)-related composite transposon, and phylogenetic analysis and guanine-cytosine content (GC) percentage showed similarities to the homologs of plant pathogens such as Pseudoxanthomonas and Xanthomonas spp., implying that plant pathogens are the potential source of the bla(NDM-1) gene. The complete sequence of pNDM-1_Dok01 suggests that the bla(NDM-1) gene was acquired by a novel composite transposon on an extensively disseminated IncA/C plasmid and transferred to the E. coli ST38 isolate.

  6. Characterization of Tn3000, a Transposon Responsible for blaNDM-1 Dissemination among Enterobacteriaceae in Brazil, Nepal, Morocco, and India.

    Science.gov (United States)

    Campos, Juliana Coutinho; da Silva, Maria José Félix; dos Santos, Paulo Roberto Nascimento; Barros, Elaine Menezes; Pereira, Mayne de Oliveira; Seco, Bruna Mara Silva; Magagnin, Cibele Massotti; Leiroz, Leonardo Kalab; de Oliveira, Théo Gremen Mimary; de Faria-Júnior, Célio; Cerdeira, Louise Teixeira; Barth, Afonso Luís; Sampaio, Suely Carlos Ferreira; Zavascki, Alexandre Prehn; Poirel, Laurent; Sampaio, Jorge Luiz Mello

    2015-12-01

    In Enterobacteriaceae, the blaNDM genes have been found in many different genetic contexts, and a wide diversity of plasmid scaffolds bearing those genes has been found. In August 2013, we identified NDM-1-producing Escherichia coli and Enterobacter hormaechei strains from a single rectal swab sample from a patient hospitalized in Rio de Janeiro, Brazil, who had no history of travel abroad. Complete DNA sequencing using the Illumina platform and annotation of the two plasmids harboring the blaNDM-1 gene, one from each strain, showed that they belonged to incompatibility groups IncFIIK and IncX3 and harbored a novel transposon named Tn3000. Similar genetic structures have been identified among other isolates in Brazil but also on plasmids from other continents. Our findings suggest that the blaNDM-1 gene may be transmitted by Tn3000 in different parts of the world. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

  7. Molecular epidemiology of carbapenem non-susceptible Acinetobacter nosocomialis in a medical center in Taiwan.

    Science.gov (United States)

    Yang, Ya-Sung; Lee, Yi-Tzu; Wang, Yung-Chih; Chiu, Chun-Hsiang; Kuo, Shu-Chen; Sun, Jun-Ren; Yin, Ti; Chen, Te-Li; Lin, Jung-Chung; Fung, Chang-Phone; Chang, Feng-Yee

    2015-04-01

    The mechanism by which carbapenem non-susceptible Acinetobacter nosocomialis (CNSAN) is disseminated is rarely described in the literature. In this study, we delineated the molecular epidemiology of CNSAN isolated from patients in a medical center in Taiwan. Fifty-four non-duplicate bloodstream isolates of CNSAN were collected at the Taipei Veterans General Hospital between 2001 and 2007. Pulsed-field gel electrophoresis (PFGE) was performed to determine their clonal relationship. Carbapenem-resistance genes and associated genetic structures were detected by polymerase chain reaction (PCR) mapping. Southern hybridization was performed to determine the plasmid location of carbapenem-resistance genes. Transmissibility of these genes to Acinetobacterbaumannii was demonstrated by conjugation tests. The overall carbapenem non-susceptibility rate among A. nosocomialis isolates during the study period was 21.6% (54/250). PFGE revealed three major pulsotypes: H (n=23), I (n=10), and K (n=8). The most common carbapenem-resistance gene was blaOXA-58 (43/54, 79.6%), containing an upstream insertion sequence IS1006 and a truncated ISAba3 (IS1006-ΔISAba3-like-blaOXA-58). All isolates belonging to the pulsotypes H, I, and K carried plasmid located IS1006-ΔISAba3-like-blaOXA-58. A common plasmid carrying ISAba1-blaOXA-82 was found in six isolates, which belonged to five pulsotypes. A type 1 integron that carried blaIMP-1 was detected in different plasmids of seven isolates, which belonged to five pulsotypes. Plasmids carrying these carbapenem-resistant determinants were transmissible from A. nosocomialis to A. baumannii via conjugation. In this medical center, CNSAN mainly emerged through clonal dissemination; propagation of plasmids and integrons carrying carbapenem-resistant determinants played a minor role. This study showed that plasmids carrying carbapenem-resistant determinants are transmissible from A. nosocomialis to A. baumannii. Copyright © 2015 Elsevier B.V. All

  8. Radiation protection in medical applications

    International Nuclear Information System (INIS)

    Maldonado M, H.

    2008-12-01

    The justification of the practices is the fundamental principle on which rests the peaceful use of ionizing radiations. They actually contain as aspirations to improve the quality of people's lives, contributing to sustainable development through environmental protection, so that the sources security and the individuals protection will be conditions which are not and should can not be operated. For medical applications is a highly illustrative example of this, since both for the diagnosis and therapy, the goal is to achieve what is sought for the white tissue, secured the least possible damage to the neighboring tissues so that in turn reduce the negative effects for the patient. As a basis for achieving the above, it is essential to have qualified personnel in all areas incidents, for example users, workers, officials and staff members. There are a variety of specialists in the field of medical applications as, nuclear chemistry, nuclear engineering, radiation protection, medical physics, radiation physics and others. Among the human resource in the country must make up the majority are medical radiologists, highlighting gaps in the number of radiotherapy and nuclear medicine but specially in the medical physics, who is in some way from a special viewpoint of the formal school, new to the country. This is true for the number of facilities which are in the country. The radiation protection responsibilities in medical applications focus primarily on two figures: the radiology safety manager, who is primarily dedicated to the protection of occupationally exposed personnel and the public, and the medical physicist whose functions are geared towards the radiological protection of the patient. The principal legislation in the medical applications area has been enacted and is monitored by the Health Secretary and National Commission on Nuclear Safety and Safeguards, entities that have reached agreements to avoid overlap and over-regulation. Medical applications in the

  9. Medical applications of cyclotrons

    International Nuclear Information System (INIS)

    Jean, R.; Fauchet, M.

    1978-01-01

    Isochronous cyclotrons used to accelerate different charged particles (protons, deuterons, alphas...) at variable energies, have important medical applications, for neutron teletherapy, in vivo or in vitro activation analysis or production of short-lived radioisotopes for nuclear medicine. The characteristics of the cyclotron presently available are described for these three applications (low energy 'compact' cyclotrons, cyclotrons of intermediate and high energies), and their advantages are discussed from the points of view of the medical requirements, the financial investments and the results obtained. (orig.) [de

  10. Chromosomal Amplification of the blaOXA-58 Carbapenemase Gene in a Proteus mirabilis Clinical Isolate.

    Science.gov (United States)

    Girlich, Delphine; Bonnin, Rémy A; Bogaerts, Pierre; De Laveleye, Morgane; Huang, Daniel T; Dortet, Laurent; Glaser, Philippe; Glupczynski, Youri; Naas, Thierry

    2017-02-01

    Horizontal gene transfer may occur between distantly related bacteria, thus leading to genetic plasticity and in some cases to acquisition of novel resistance traits. Proteus mirabilis is an enterobacterial species responsible for human infections that may express various acquired β-lactam resistance genes, including different classes of carbapenemase genes. Here we report a Proteus mirabilis clinical isolate (strain 1091) displaying resistance to penicillin, including temocillin, together with reduced susceptibility to carbapenems and susceptibility to expanded-spectrum cephalosporins. Using biochemical tests, significant carbapenem hydrolysis was detected in P. mirabilis 1091. Since PCR failed to detect acquired carbapenemase genes commonly found in Enterobacteriaceae, we used a whole-genome sequencing approach that revealed the presence of bla OXA-58 class D carbapenemase gene, so far identified only in Acinetobacter species. This gene was located on a 3.1-kb element coharboring a bla AmpC -like gene. Remarkably, these two genes were bracketed by putative XerC-XerD binding sites and inserted at a XerC-XerD site located between the terminase-like small- and large-subunit genes of a bacteriophage. Increased expression of the two bla genes resulted from a 6-time tandem amplification of the element as revealed by Southern blotting. This is the first isolation of a clinical P. mirabilis strain producing OXA-58, a class D carbapenemase, and the first description of a XerC-XerD-dependent insertion of antibiotic resistance genes within a bacteriophage. This study revealed a new role for the XerC-XerD recombinase in bacteriophage biology. Copyright © 2017 American Society for Microbiology.

  11. Occurrence of bla genes encoding carbapenem-resistant Pseudomonas aeruginosa and Acinetobacter baumannii from Intensive Care Unit in a tertiary care hospital.

    Science.gov (United States)

    Subramaniyan, Jayanthi Siva; Sundaram, Jeya Meenakshi

    2018-01-01

    ICU shows increasing incidence of infection associated with the use of invasive procedures for the diagnostic purpose as well as the indiscriminate use of antibiotics. Pseudomonas aeruginosa and Acinetobacter species are "very successful" pathogen and the emergence of the Metallo-β-Lactamases (MBL) is becoming a therapeutic challenge. To isolate the Nonfermenting Gram negative bacilli from the ICU samples. To identify the metallo betalactamase producers and to detect the bla gene presence among the Pseudomonas aeruginosa and Acinetobacter baumannii . The Nonfermenting Gram negative bacilli isolates from the ICU samples were taken over for 5 years (2009-2014) in a tertiary care hospital. The isolates of Pseudomonas species and Acinetobacter species were confirmed by API analyser and processed according to standard procedures. Detection of the MBL producers were done by E strip method and subjected for bla gene detection by PCR method. In our study a total of 195 isolates of NFGNB were obtained from various ICU. Of these MBL producers, 26 % were Pseudomonas aeruginosa and 25 % were Acinetobacter baumannii . The subtypes of bla VIM MBL producing P.aeruginosa were 26%. The predominant gene coding for MBL activity in A.baumannii were found to be bla OXA gene 11.9%. The gene accession numbers were KF975367, KF975372. We have to control the development and dissemination of these superbugs among the ICU's.

  12. Effects of Optogenetic inhibition of BLA on Sleep Brief Optogenetic Inhibition of the Basolateral Amygdala in Mice Alters Effects of Stressful Experiences on Rapid Eye Movement Sleep.

    Science.gov (United States)

    Machida, Mayumi; Wellman, Laurie L; Fitzpatrick Bs, Mairen E; Hallum Bs, Olga; Sutton Bs, Amy M; Lonart, György; Sanford, Larry D

    2017-04-01

    Stressful events can directly produce significant alterations in subsequent sleep, in particular rapid eye movement sleep (REM); however, the neural mechanisms underlying the process are not fully known. Here, we investigated the role of the basolateral nuclei of the amygdala (BLA) in regulating the effects of stressful experience on sleep. We used optogenetics to briefly inhibit glutamatergic cells in BLA during the presentation of inescapable footshock (IS) and assessed effects on sleep, the acute stress response, and fear memory. c-Fos expression was also assessed in the amygdala and the medial prefrontal cortex (mPFC), both regions involved in coping with stress, and in brain stem regions implicated in the regulation of REM. Compared to control mice, peri-shock inhibition of BLA attenuated an immediate reduction in REM after IS and produced a significant overall increase in REM. Moreover, upon exposure to the shock context alone, mice receiving peri-shock inhibition of BLA during training showed increased REM without altered freezing (an index of fear memory) or stress-induced hyperthermia (an index of acute stress response). Inhibition of BLA during REM under freely sleeping conditions enhanced REM only when body temperature was high, suggesting the effect was influenced by stress. Peri-shock inhibition of BLA also led to elevated c-Fos expression in the central nucleus of the amygdala and mPFC and differentially altered c-Fos activity in the selected brain stem regions. Glutamatergic cells in BLA can modulate the effects of stress on REM and can mediate effects of fear memory on sleep that can be independent of behavioral fear. © Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

  13. Introduction of OXA-48-producing Enterobacteriaceae to Israeli hospitals by medical tourism.

    Science.gov (United States)

    Adler, Amos; Shklyar, Maya; Schwaber, Mitchell J; Navon-Venezia, Shiri; Dhaher, Yacoub; Edgar, Rotem; Solter, Ester; Benenson, Shmuel; Masarwa, Samira; Carmeli, Yehuda

    2011-12-01

    The carbapenemase OXA-48 has been reported from different Mediterranean countries. It is mostly encoded on a single plasmid in various Enterobacteriaceae species. We characterized the epidemiological and molecular features of OXA-48-producing Enterobacteriaceae (OPE) in Israel. Epidemiological investigation was conducted by the National Center for Infection Control. Genotyping was performed using multilocus sequence typing. The bla(OXA-48)-carrying plasmids were investigated using S1 endonuclease and restriction fragment length polymorphism (RFLP). Conjugation efficiency of the bla(OXA-48)-carrying plasmids was studied in a filter mating experiment. Since 2007, four OPE-infected patients were identified, all non-Israeli (two Palestinian, one Jordanian and one Georgian). Three had prior hospitalization; two in Jordan and one in Georgia. The bla(OXA-48) gene was detected in three Escherichia coli strains belonging to different clonal complexes, one Klebsiella oxytoca and one Klebsiella pneumoniae sequence type 101, as previously reported from Tunisia and Spain. In all isolates, the bla(OXA-48) gene was located inside Tn1999.2 and was carried on a 60 kb plasmid with an identical RFLP pattern. The plasmid was able to conjugate from Klebsiella spp. to E. coli, and had a conjugation efficiency up to ~10000 times higher than that of pKpQIL. OPE, introduced mainly by medical tourism, are an emerging threat to patients from affected Mediterranean countries. The bla(OXA-48)-carrying plasmid demonstrated remarkable conjugation efficiency, which is probably important in the success of its dissemination.

  14. Medical applications of accelerators

    CERN Document Server

    Rossi, Sandro

    1998-01-01

    At Present, about five thousands accelerators are devoted to biomedical applications. They are mainly used in radiotherapy, research and medical radioisotopes production. In this framework oncological hadron-therapy deserves particular attention since it represents a field in rapid evolution thanks to the joint efforts of laboratories with long experiences in particle physics. It is the case of CERN where the design of an optimised synchrotron for medical applications has been pursued. These lectures present these activities with particular attention to the new developments which are scientifically interesting and/or economically promising.

  15. Developing the Medication Reminder Mobile Application "Seeb".

    Science.gov (United States)

    Saghaeiannejad-Isfahani, Sakineh; Ehteshami, Asghar; Savari, Ebtesam; Samimi, Ali

    2017-06-01

    Today, the structure of comprehensive health care emphasizes self-care more than therapy. Medication therapy is a strong instrument for therapy received through the health setting, especially in medication area. Error in medication administration has produced different problems and they cost billions of dollars every year. Regarding mobile phone extensions, we developed a local medication reminder mobile application called "Seeb" as a suitable solution for decreasing medication errors for Iranians. We conducted a mixed methods study in three Phases: 1) Comparative study of existing mobile applications; 2) developed its object-oriented model; 3) Developed the initial version of "Seeb" that was approved for production. This application was designed for the appropriate medication administration including time and dosages through: recording patient and medication data; scheduling patients' medication; and reporting medication administration on progress. "Seeb" has been designed in compliance with Iranian health information technologists and pharmacists requirements. It is expected to reduce medication error and improve patient adherence to medical prescriptions.

  16. Coexistence of blaOXA-23 with armA in quinolone-resistant Acinetobacter baumannii from a Chinese university hospital.

    Science.gov (United States)

    Shen, Min; Luan, Guangxin; Wang, Yanhong; Chang, Yaowen; Zhang, Chi; Yang, Jingni; Deng, Shanshan; Ling, Baodong; Jia, Xu

    2016-03-01

    A total of 101 Acinetobacter baumannii isolates were collected to determine the mechanisms of quinolone resistance and investigate the occurrence of carbapenem and high-level aminoglycoside resistance genes among quinolone-resistant strains. Among 77 quinolone-resistant A. baumannii harbored mutations of gyrA and parC, 41 isolates, which belonged to European clone II, had resistance to aminoglycosides and carbapenems due to the expression of armA and acquisition of blaOXA-23. Most of sequence type belonged to clonal complex 92. These results suggested hospital dissemination of multidrug-resistant A. baumannii carrying blaOXA-23, armA, and mutations of quinolone resistance-determining regions in western China. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Australian Indigenous Students' Performance on the PIPS-BLA Reading and Mathematics Scales: 2011-2013

    Science.gov (United States)

    Styles, Irene; Wildy, Helen; Pepper, Vivienne; Faulkner, Joanne; Berman, Ye'Elah

    2014-01-01

    The assessment of literacy and numeracy skills of students as they enter school for the first time is not yet established nation-wide in Australia. However, a large proportion of primary schools have chosen to assess their starting students on the Performance Indicators in Primary Schools-Baseline Assessment (PIPS-BLA). This series of three…

  18. Accelerator development for medical applications

    International Nuclear Information System (INIS)

    Tanabe, Eiji

    2007-01-01

    Electron linear accelerators have been widely used in medical applications, especially in radiation therapy for cancer treatment. There are more than 7,000 medical electron linear accelerators in the world, treating over 250,000 patients per day. This paper reviews the current status of accelerator applications and technologies in radiation therapy, and presents the anticipated requirements for advanced radiation therapy technology in the foreseeable future. (author)

  19. Pathogenicity of pan-drug-resistant Serratia marcescens harbouring blaNDM-1.

    Science.gov (United States)

    Gruber, Teresa M; Göttig, Stephan; Mark, Laura; Christ, Sara; Kempf, Volkhard A J; Wichelhaus, Thomas A; Hamprecht, Axel

    2015-04-01

    To characterize a pan-drug-resistant Serratia marcescens clinical isolate carrying the New Delhi metallo-β-lactamase (NDM)-1. The presence of β-lactamase genes was examined by PCR and sequencing. Antibiotic susceptibility was determined by antibiotic gradient test. Transformation assays, transconjugation assays, PFGE and PCR-based replicon typing were used for plasmid analysis. Horizontal gene transfer was evaluated by liquid mating using Escherichia coli J53 as a recipient. Pathogenicity of NDM-1 expressing S. marcescens was analysed using the Galleria mellonella infection model. S. marcescens isolate SM1890 was non-susceptible to all tested antibiotics, with minocycline retaining intermediate activity. blaNDM-1 was located on a 140 kb IncA/C-type plasmid which was transferable to E. coli and Klebsiella pneumoniae by conjugation. The LD50 of the NDM-positive, SM1890 isolate was higher than that of other, NDM-1 negative, S. marcescens strains. The presence of a blaNDM-1-harbouring IncA/C plasmid resulted in marked resistance to β-lactam antibiotics, but had no significant effect on virulence of isogenic strains. Because of the intrinsic resistance of S. marcescens to colistin and reduced susceptibility to tigecycline, treatment options for infections by NDM-1-positive isolates are extremely limited in this species. © The Author 2014. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  20. Gene blaCTX-M Mutation as Risk Factor of Antibiotic Resistance

    Directory of Open Access Journals (Sweden)

    Devinna Kang

    2017-06-01

    Full Text Available Currently there are more than half from all antibiotics used in the world which is belong to β lactam group, but clinical effectiveness of the antibiotics are limited by antibiotic resistance of microorganisms as causative agents from infectious diseases. Several resistance mechanisms for Enterobacteriaceae are mostly caused by enzymatic hydrolysis of antibiotics specific enzymes, called β lactamases. β lactamases represent a large group of enzyme which is genetically and functionally different as extended‑spectrum β-lactamase (ESBL and known as greatest threat of resistence. Plasmid localization from the encoded gene and enzyme distribution among the pathogen increases every year. Most widespread and clinically relevant ESBL are class A ESBL of Temoniera (TEM, Sulphydryl variable (SHV and Cefotaxime (CTX-M types. The purpose of this review was to analyze variant of blaCTX-M gene which cause the most increase incidence of antibiotic resistance. The methods of this review were data-based searching based on Pubmed, Scopus and Google Scholar, without limitation of index factor by using the keyword “blaCTX-M”, “Extended-spectrum β-lactamase”, and “antibiotic resistance”. The conclusion of the review is CTX-M type ESBL have replaced TEM and SHV type as dominant enzyme in last decade. ESBL produced by Klebsiella pneumoniae have emerged as one of major nosocomial pathogens. Nosocomial infection caused by CTX-M-15 in Klebsiella pneumoniae dramatically increased in recent years.

  1. Application of six multiplex PCR's among 200 clinical isolates of Pseudomonas aeruginosa for the detection of 20 drug resistance encoding genes

    Directory of Open Access Journals (Sweden)

    Nandagopal Murugan

    2018-02-01

    Full Text Available Pseudomonas aeruginosa (P. aeruginosa is a menacing opportunistic, nosocomial pathogen; become a growing concern as conventional antimicrobial therapy is now futile against it. Multi-drug resistant P. aeruginosa (MDRPA has distinctive resistance mechanisms such as production of β-lactamases, repression of porin genes and over-expression of efflux pumps. The focus of this study is to standardize and application of multiplex PCR (mPCR to detect the presence of betalactamase genes encoding blaTem, blaOXA, blaCTX-M-15, blaVim, blaGes, blaVeb, blaDIM, AmpC and Efflux pump genes encoding Mex A,B-oprM, Mex C,D-oprJ, Mex X,Y-oprN, oprD, nfxB, MexR. A total of 200 clinical isolates of P. aeruginosa were tested for the presence of the above mentioned genes genotypically through mPCR and characterized by phenotypic methods for ESBL and MBL production. Out of 200 isolates, 163 (81.5% nfxB regulator gene, 102 (51% MexA, 96 (48% MexC, 93 (46.5% MexB, 86 (43% MexD, 81 (40.5% OprM, 74 (37% OprJ, 72 (36% OprD and MexR, 53 (26.5% Mex X and OprN, 49 (24.5% MexY gene. Betalactamase genes 145 (72.5% blaTem, 67 (33.5% blaOXA, 35 (17.5% blaVim, 25(12.50%, 23 (11.50% blaVeb, 21 (11.5% blaGes, 14 (7% Ctx-m and 10 (5% AmpC and 5 (2.5% blaDim-1 gene were tested positive by mPCR. Phenotypically 38 (19% and 29 (14.5% out of 200 tested positive for ESBL and MBL production. Application of this mPCR on clinical specimens is fast, accurate, specific and low-cost reliable tool for the screening, where culture negative Eubacterial PCR positive cases for an early molecular detection of drug resistance mechanism assisting the clinician to treat the disease with appropriate antibiotic selection.

  2. 21 CFR 515.10 - Medicated feed mill license applications.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Medicated feed mill license applications. 515.10... (CONTINUED) ANIMAL DRUGS, FEEDS, AND RELATED PRODUCTS MEDICATED FEED MILL LICENSE Applications § 515.10 Medicated feed mill license applications. (a) Medicated feed mill license applications (Forms FDA 3448) may...

  3. Complete sequencing of IncI1 sequence type 2 plasmid pJIE512b indicates mobilization of blaCMY-2 from an IncA/C plasmid.

    Science.gov (United States)

    Tagg, Kaitlin A; Iredell, Jonathan R; Partridge, Sally R

    2014-08-01

    Sequencing of pJIE512b, a 92.3-kb IncI1 sequence type 2 (ST2) plasmid carrying bla(CMY-2), revealed a bla(CMY-2) context that appeared to have been mobilized from an IncA/C plasmid by the insertion sequence IS1294. A comparison with published plasmids suggests that bla(CMY-2) has been mobilized from IncA/C to IncI1 plasmids more than once by IS1294-like elements. Alignment of pJIE512b with the only other available IncI1 ST2 plasmid revealed differences across the backbones, indicating variability within this sequence type. Copyright © 2014, American Society for Microbiology. All Rights Reserved.

  4. Correlation of phenotypic tests with the presence of the blaZ gene for detection of beta-lactamase.

    Science.gov (United States)

    Ferreira, Adriano Martison; Martins, Katheryne Benini; Silva, Vanessa Rocha da; Mondelli, Alessandro Lia; Cunha, Maria de Lourdes Ribeiro de Souza da

    Staphylococcus aureus and Staphylococcus saprophyticus are the most common and most important staphylococcal species associated with urinary tract infections. The objective of the present study was to compare and to evaluate the accuracy of four phenotypic methods for the detection of beta-lactamase production in Staphylococcus spp. Seventy-three strains produced a halo with a diameter ≤28mm (penicillin resistant) and all of them were positive for the blaZ gene. Among the 28 susceptible strain (halo ≥29mm), 23 carried the blaZ gene and five did not. The zone edge test was the most sensitive (90.3%), followed by MIC determination (85.5%), but the specificity of the former was low (40.0%). The nitrocefin test was the least sensitive (28.9%). However, the nitrocefin test together with the disk diffusion method showed the highest specificity (100%). The present results demonstrated that the zone edge test was the most sensitive phenotypic test for detection of beta-lactamase, although it is still not an ideal test to detect this type of resistance since its specificity was low. However, the inhibition halo diameter of the penicillin disk can be used together with the zone edge test since the same disk is employed in the two tests. Combined analysis of the two tests shows a sensitivity of 90.3% and specificity of 100%, proving better sensitivity, especially for S. saprophyticus. This is a low-cost test of easy application and interpretation that can be used in small and medium-sized laboratories where susceptibility testing is usually performed by the disk diffusion method. Copyright © 2016 Sociedade Brasileira de Microbiologia. Published by Elsevier Editora Ltda. All rights reserved.

  5. Correlation of phenotypic tests with the presence of the blaZ gene for detection of beta-lactamase

    Directory of Open Access Journals (Sweden)

    Adriano Martison Ferreira

    Full Text Available Abstract Staphylococcus aureus and Staphylococcus saprophyticus are the most common and most important staphylococcal species associated with urinary tract infections. The objective of the present study was to compare and to evaluate the accuracy of four phenotypic methods for the detection of beta-lactamase production in Staphylococcus spp. Seventy-three strains produced a halo with a diameter ≤28 mm (penicillin resistant and all of them were positive for the blaZ gene. Among the 28 susceptible strain (halo ≥29 mm, 23 carried the blaZ gene and five did not. The zone edge test was the most sensitive (90.3%, followed by MIC determination (85.5%, but the specificity of the former was low (40.0%. The nitrocefin test was the least sensitive (28.9%. However, the nitrocefin test together with the disk diffusion method showed the highest specificity (100%. The present results demonstrated that the zone edge test was the most sensitive phenotypic test for detection of beta-lactamase, although it is still not an ideal test to detect this type of resistance since its specificity was low. However, the inhibition halo diameter of the penicillin disk can be used together with the zone edge test since the same disk is employed in the two tests. Combined analysis of the two tests shows a sensitivity of 90.3% and specificity of 100%, proving better sensitivity, especially for S. saprophyticus. This is a low-cost test of easy application and interpretation that can be used in small and medium-sized laboratories where susceptibility testing is usually performed by the disk diffusion method.

  6. Current trend of robotics application in medical

    International Nuclear Information System (INIS)

    Olanrewaju, O A; Faieza, A A; Syakirah, K

    2013-01-01

    The applications of robotics in recent years has emerged beyond the field of manufacturing or industrial robots itself. Robotics applications are now widely used in medical, transport, underwater, entertainment and military sector. In medical field, these applications should be emphasized in view of the increasing challenges due to the variety of findings in the field of medicine which requires new inventions to ease work process. The objective of this review paper is to study and presents the past and on-going research in medical robotics with emphasis on rehabilitation (assistive care) and surgery robotics which are certainly the two main practical fields where robots application are commonly used presently. The study found that, rehabilitation and surgery robotics applications grow extensively with the finding of new invention, as well as research that is being undertaken and to be undertaken. The importance of medical robot in medical industry is intended to offer positive outcomes to assist human business through a complicated task that involves a long period, accuracy, focus and other routines that cannot be accomplished by human ability alone.

  7. An Evaluation of Free Medical Applications for Android Smartphones

    Directory of Open Access Journals (Sweden)

    Roxana D. CAPRAŞ

    2016-12-01

    Full Text Available ntroduction: The field of healthcare applications (apps currently holds potential to improve the daily medical practice by implementing evidence-based healthcare tools. The purpose of this study was to describe the main characteristics of Android-based healthcare applications available in Google Play and to identify those applications that are evidence-based. Methods: The study was undertaken between the 1st of July and the 30th of August 2016. An evaluation form was developed to characterize the healthcare apps available in Google Play retrieved for the following keywords: (medical apps and (evidence based medical apps respectively. Only the free apps were considered eligible for the purpose of our study. Besides the general characteristics, several criteria with regards to interactivity, functionality, esthetics, contents, benefits, as well as evidence-based aspects were considered. Results: A number of 147 healthcare apps were displayed based on the used keywords and were included in the analysis. 42 of them were excluded due to the need for payment, malfunction after installation or games/animations that used medical terms. The remaining 105 apps were then analyzed by the evaluation criteria established in the research protocol. This study shows that until this point, mobile medical applications are mostly designed for consumers or medical students and less for medical professionals. 2 medical application include evidence based medical information and 19 applications were developed in this direction. The majority of the applications were developed in USA. 60% of the analyzed applications have the capacity of improving the quality of medical care. Conclusions: We found only 2 "ideal" mobile medical applications that brought together all the requirements that every application designed for medical use should fulfill.

  8. Detection of blaCTX-M gene among Pseudomonas aeruginosa isolated from water samples in Baghdad

    Directory of Open Access Journals (Sweden)

    Saba R. Khdair

    2017-11-01

    Full Text Available A total of 50 environmental Pseudomonas aeruginosa isolates were collected from sewage and tap water in Baghdad, Iraq. The MICs of Cefotaxime and Ceftazidime were determined by using agar dilution method, The MIC ranged from 2 to 256 µg/ml.The results of antibiotic sensitivity test showed that among sewage P. aeruginosa isolates, resistance was observed most often to Ticarcillin (92%, Penicillin G (84%, Ceftazidime (12%, (8% for each of Cefotaxime and Ticarcillin. On the other hand, all tap water isolates were sensitive to Ofloxacin and Levofloxacin, Except (5% of isolates were resistant to Cefotaxime (25% to Ceftazidime and (95% to Ticarcillin. All isolates were tested for Extended-Spectrum β-Lactamase (ESBL production. Ten isolates (20% were found to be ESBL producers. All environmental P. aeruginosa isolates were screened for the presence of the blaCTX-M genes by application PCR, Only (30% of them were positive for this test.

  9. The effect of BLA GABAB receptors in anxiolytic-like effect and aversive memory deficit induced by ACPA

    Directory of Open Access Journals (Sweden)

    Katayoon Kangarlu Haghighi

    2016-07-01

    Full Text Available Background: As a psychoactive plant, Cannabis sativa (Marijuana is widely used throughout the world. Several investigations have indicated that administration of Marijuana affects various cognitive and non-cognitive behaviors. These include anxiety-like behaviors and learning and memory deficit. It has been shown that three main cannabinoid receptors [i.e. CB1, CB2 and CB3 are involved in cannabinoids’ functions. CB1 receptors are abundantly expressed in the central nervous system regions such as hippocampus, amygdala, cerebellum and the cortex. Therefore, the neuropsychological functions of endocannabinoids are thought to be more linked to CB1 receptors. Among other brain regions, CB1 is highly expressed in the amygdala which is an integral component of the limbic circuitry. The amygdala plays a major role in the control of emotional behavior, including conditioned fear and anxiety. In present study we examined the possible roles of basolateral amygdala (BLA GABAB receptors in arachydonilcyclopropylamide (ACPA-induced anxiolytic-like effect and aversive memory deficit in adult male mice. Methods: This experimental study was conducted from September 2013 to December 2014 in Institute for Studies in Theoretical Physics and Mathematics, School of Cognitive Sciences, Tehran and Male albino NMRI mice (Pasture Institute, Iran, weighting 27-30 g, were used. Bilateral guide-cannulae were implanted to allow intra BLA microinjection of the drugs. We used Elevated Plus Maze (EPM to examine memory and anxiety behavior (test-retest protocol. ACPA administrate intra-peritoneal and GABAB agonist and antagonist administrated intra-amygdala. Results: Data showed that pre-test treatment with ACPA induced anxiolytic-like and aversive memory deficit The results revealed that pre-test intra-BLA infusion of baclofen (GABAB receptor agonist impaired the aversive memory while phaclofen (GABAB receptor antagonist improved it. Interestingly, pretreatment with a sub

  10. Whole genome sequencing of Escherichia coli encoding blaNDM isolated from humans and companion animals in Egypt

    Science.gov (United States)

    Companion animals are a source of zoonotic infections and especially important considering the potential of companion animals to harbor antibiotic resistant pathogens. In this study, blaNDM positive Escherichia coli from companion animals, humans, and the environment from Mansoura, Egypt were charac...

  11. Radioisotopes for medical applications

    International Nuclear Information System (INIS)

    Carr, S.

    1998-01-01

    For more than 3 decades, the Australian Nuclear Science and Technology Organisation has been the country's main supplier of radioisotopes for medical applications. The use of radioisotopes in medicine has revolutionised the diagnosis, management and treatment of many serious diseases such as cancer, heart disease and stroke. It is also beginning to play a key role in neurological disorders such as Parkinson and Alzheimers disease and epilepsy. More recently there has been considerable growth in the application of nuclear medicine to treat sport-related injuries - especially wrist, ankle and knees where more common techniques do not always enable accurate diagnosis. Australia is a recognised leader in nuclear medicine. This can be partially attributed to the close relationship between ANSTO and the medical community in providing opportunities to develop and evaluate new agents to support more effective patient care. A list of commercial isotopes produced in the reactor or the cyclotron and used in medical applications is given. Nuclear medicine plays an important role in the clinical environment and the timely supply of radioisotopes is a key element. ANSTO will continue to be the premier supplier of currently available and developing isotopes to support the health and well being of the Australian community

  12. Radioisotopes for medical applications

    Energy Technology Data Exchange (ETDEWEB)

    Carr, S. [Australian Nuclear Science and Technology Organisation, Lucas Heights, NSW (Australia). Radiopharmaceuticals Division

    1998-03-01

    For more than 3 decades, the Australian Nuclear Science and Technology Organisation has been the country`s main supplier of radioisotopes for medical applications. The use of radioisotopes in medicine has revolutionised the diagnosis, management and treatment of many serious diseases such as cancer, heart disease and stroke. It is also beginning to play a key role in neurological disorders such as Parkinson and Alzheimers disease and epilepsy. More recently there has been considerable growth in the application of nuclear medicine to treat sport-related injuries - especially wrist, ankle and knees where more common techniques do not always enable accurate diagnosis. Australia is a recognised leader in nuclear medicine. This can be partially attributed to the close relationship between ANSTO and the medical community in providing opportunities to develop and evaluate new agents to support more effective patient care. A list of commercial isotopes produced in the reactor or the cyclotron and used in medical applications is given. Nuclear medicine plays an important role in the clinical environment and the timely supply of radioisotopes is a key element. ANSTO will continue to be the premier supplier of currently available and developing isotopes to support the health and well being of the Australian community 2 tabs., 1 fig.

  13. E. coli encoding blaNDM-5 associated with community-acquired UTI cases with unusual MIC creep like phenomenon against Imipenem.

    Science.gov (United States)

    Gajamer, Varsha Rani; Bhattacharjee, Amitabha; Paul, Deepjyoti; Deshamukhya, Chandrayee; Singh, Ashish Kr; Pradhan, Nilu; Tiwari, Hare Krishna

    2018-05-15

    Carbapenemase-producing Escherichia coli are of major clinical concern. The present study aimed to identify NDM-5 producing E.coli associated with community-acquired urinary tract infection, co-harboring ESBL genes and a pattern of imipenem MIC creep. A total of 973 urine samples were collected from females of age between 18-49 diagnosed with UTI. Isolates were identified by standard microbiological procedures. Presence of bla NDM and ESBL genes was determined by PCR assay and sequencing.PCR based replicon typing was performed. Plasmid stability of all bla producers and their transformants study were analyzed by serial passages and MIC creep phenomenon was analysed by studying revertants. Among 34 bla NDM-5 positive E.coli isolates, 21 isolates co harbored bla CTX-M-15 , followed by multiple combinations of genes. The study revealed diverse types of plasmids type viz; HI1, I1, FIA+FIB, FIA and Y. The strains showed progressive plasmid loss after 31 passages.Twenty-eight isolates mostly had MIC value of 0.5μg/ml and 1μg/ml against imipenem, ertapenem and meropenem. However, on studying the MIC creep activity; the MIC was found elevated from 0.5ug/ml to 64μg/ml and from 1μg/ml to 128μg/ml. While analyzing the revertants, MIC of most of the NDM positive isolates was reduced to 16μg/ml after the 30th serial passages. This study observed a unique phenotype of NDM producers which is not been reported earlier. In the current study, the observed phenomenon poses a global threat as these pathogens may evade phenotypic screening by routine laboratories. Copyright © 2018. Published by Elsevier Ltd.

  14. Quality assurance in medical radiation applications. The medical and dental appointment

    International Nuclear Information System (INIS)

    Ernst-Elz, Andreas

    2017-01-01

    Medical radiation applications cause averaged over the German population an annual exposure of almost 2 mSv. Medical authorities have the assignment to assure and control the diagnostic and therapeutic quality of these applications and to provide recommendations for operators with respect to dose reductions and radiation protection, including guidance for radiotherapy planning aimed to questions of dose and therapy optimization.

  15. Complete nucleotide sequence of pGA45, a 140,698-bp incFIIY plasmid encoding blaIMI-3-mediated carbapenem resistance, from river sediment

    Directory of Open Access Journals (Sweden)

    Bingjun eDang

    2016-02-01

    Full Text Available Plasmid pGA45 was isolated from the sediment of Haihe River using E. coli CV601 (gfp-tagged as recipients and indigenous bacteria from sediment as donors. This plasmid confers reduced susceptibility to imipenem which belongs to carbapenem group. Plasmid pGA45 was fully sequenced on an Illumina HiSeq 2000 sequencing system. The complete sequence of plasmid pGA45 was 140,698 bp in length with an average G+C content of 52.03%. Sequence analysis shows that pGA45 belongs to incFIIY group and harbors a backbone region shares high homology and gene synteny to several other incF plasmids including pNDM1_EC14653, pYDC644, pNDM-Ec1GN574, pRJF866, pKOX_NDM1 and pP10164-NDM. In addition to the backbone region, plasmid pGA45 harbors two notable features including one blaIMI-3-containing region and one type VI secretion system region. The blaIMI-3-containing region is responsible for bacteria carbapenem resistance and the type VI secretion system region is probably involved in bacteria virulence, respectively. Plasmid pGA45 represents the first complete nucleotide sequence of the blaIMI-harboring plasmid from environment sample and the sequencing of this plasmid provided insight into the architecture used for the dissemination of blaIMI carbapenemase genes.

  16. Seminar Pediatrics. Medical and Technical Applications

    International Nuclear Information System (INIS)

    Montivero, M.; Nespral, D.O.; Alak, Maria del Carmen

    2012-01-01

    The Association of Biology and Nuclear Medicine has organized the 'Seminar Pediatrics - Medical and Technical Applications', held in Buenos Aires in May 2012, in order to collaborate with the scientific growth of nuclear medicine in pediatrics. The main topics covered were: management of pediatric patients and medical application in childhood, dosimetry in pediatric nuclear medicine, scope of radioisotope - studies in nephrourological pathologies, PET in pediatrics, among others.

  17. Modeling Medical Services with Mobile Health Applications

    Directory of Open Access Journals (Sweden)

    Zhenfei Wang

    2018-01-01

    Full Text Available The rapid development of mobile health technology (m-Health provides unprecedented opportunities for improving health services. As the bridge between doctors and patients, mobile health applications enable patients to communicate with doctors through their smartphones, which is becoming more and more popular among people. To evaluate the influence of m-Health applications on the medical service market, we propose a medical service equilibrium model. The model can balance the supply of doctors and demand of patients and reflect possible options for both doctors and patients with or without m-Health applications in the medical service market. In the meantime, we analyze the behavior of patients and the activities of doctors to minimize patients’ full costs of healthcare and doctors’ futility. Then, we provide a resolution algorithm through mathematical reasoning. Lastly, based on artificially generated dataset, experiments are conducted to evaluate the medical services of m-Health applications.

  18. Medical isotope applications in Iceland

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1962-10-15

    About $ 12 000 worth of equipment and the services of an expert in the medical applications of radioisotopes were provided by IAEA to the Government of Iceland. The expert was primarily concerned with the establishment of a medical radioisotope laboratory at the State Hospital, Reykjavik. His specific tasks included the setting up of the equipment furnished by IAEA for radioactive measurements in medical work, the establishment of techniques for the routine uses of radioisotopes in medicine, and the training of personnel. The apparatus installed includes a well-type scintillation counter for small samples, a directional scintillation counter, and Geiger counters of different types. The laboratory is thus well equipped for nearly all the conventional applications of radioisotopes in medicine, except those involving very soft beta-ray emitting isotopes

  19. Medical applications in a nuclear research centre

    International Nuclear Information System (INIS)

    Vanhavere, F.; Eggermont, G.

    2001-01-01

    In these days of public aversion to nuclear power, it can be important to point at the medical applications of ionising radiation. Not only the general public, but also the authorities and research centres have to be aware of these medical applications, which are not without risk for public health. Now that funding for nuclear research is declining, an opening to the medical world can give new opportunities to a nuclear research centre. A lot of research could be done where the tools developed for the nuclear power world are very useful. Even new applications for the research reactors like BNCT (boron neutron capture therapy) can be envisaged for the near future. In this contribution an overview will be given of the different techniques used in the medical world with ionising radiation. The specific example of the Belgian Nuclear Research Centre will be given where the mission statement was changed to include a certain number of medical research topics. (authors)

  20. Applications of Particle Accelerators in Medical Physics

    CERN Document Server

    Cuttone, G

    2008-01-01

    Particle accelerators are often associated to high energy or nuclear physics. As well pointed out in literature [1] if we kindly analyse the number of installation worldwide we can easily note that about 50% is mainly devoted to medical applications (radiotherapy, medical radioisotopes production, biomedical research). Particle accelerators are also playing an important indirect role considering the improvement of the technical features of medical diagnostic. In fact the use of radionuclide for advanced medical imaging is strongly increasing either in conventional radiography (CT and MRI) and also in nuclear medicine for Spect an PET imaging. In this paper role of particle accelerators for medical applications will be presented together with the main solutions applied.

  1. Complete Sequence of Four Multidrug-Resistant MOBQ1 Plasmids Harboring blaGES-5 Isolated from Escherichia coli and Serratia marcescens Persisting in a Hospital in Canada.

    Science.gov (United States)

    Boyd, David; Taylor, Geoffrey; Fuller, Jeff; Bryce, Elizabeth; Embree, Joanne; Gravel, Denise; Katz, Kevin; Kibsey, Pamela; Kuhn, Magdalena; Langley, Joanne; Mataseje, Laura; Mitchell, Robyn; Roscoe, Diane; Simor, Andrew; Thomas, Eva; Turgeon, Nathalie; Mulvey, Michael

    2015-06-01

    The usefulness of carbapenems for gram-negative infections is becoming compromised by organisms harboring carbapenemases, enzymes which can hydrolyze the drug. Currently KPC (class A), NDM (class B), and OXA-48 types (class D) are the most globally widespread carbapenemases. However, among the GES-type class A extended-spectrum β-lactamases (ESBLs) there are variants that hydrolyze carbapenems, with blaGES-5 being the most common. Two Escherichia coli and two Serratia marcescens harboring blaGES-5 on plasmids were isolated by the Canadian Nosocomial Infection Surveillance Program (CNISP) from four different patients in a single hospital over a 2-year period. Complete sequencing of the blaGES-5 plasmids indicated that all four had nearly identical backbones consisting of genes for replication, partitioning, and stability, but contained variant accessory regions consisting of mobile elements and antimicrobial resistance genes. The plasmids were of a novel replicon type, but belonged to the MOBQ1 group based on relaxase sequences, and appeared to be mobilizable, but not self-transmissible. Considering the time periods of bacterial isolation, it would appear the blaGES-5 plasmid has persisted in an environmental niche for at least 2 years in the hospital. This has implications for infection control and clinical care when it is transferred to clinically relevant gram-negative organisms.

  2. Multihospital Occurrence of Pan-Resistant Klebsiella pneumoniae Sequence Type 147 with an ISEcp1-Directed blaOXA-181 Insertion in the mgrB Gene in the United Arab Emirates.

    Science.gov (United States)

    Sonnevend, Ágnes; Ghazawi, Akela; Hashmey, Rayhan; Haidermota, Aliasgher; Girgis, Safinaz; Alfaresi, Mubarak; Omar, Mohammed; Paterson, David L; Zowawi, Hosam M; Pál, Tibor

    2017-07-01

    The emergence of pan-resistant Klebsiella pneumoniae strains is an increasing concern. In the present study, we describe a cluster of 9 pan-resistant K. pneumoniae sequence type 147 (ST147) isolates encountered in 4 patients over nearly 1 year in 3 hospitals of the United Arab Emirates (UAE). The isolates exhibited highly similar genotypes. All produced chromosomally encoded OXA-181, and the majority also produced the NDM-5 carbapenemase. As with the previously described single isolate from the UAE, MS6671, the mgrB was disrupted by a functional, IS Ecp1 -driven bla OXA-181 insertion causing resistance to carbapenems. The mutation was successfully complemented with an intact mgrB gene, indicating that it was responsible for colistin resistance. bla NDM-5 was located within a resistance island of an approximately 100-kb IncFII plasmid carrying ermB , mph (A), bla TEM-1B , rmtB , bla NDM-5 , sul1 , aadA2 , and dfrA12 resistance genes. Sequencing this plasmid (pABC143-NDM) revealed that its backbone was nearly identical to that of plasmid pMS6671E from which several resistance genes, including bla NDM-5 , had been deleted. More extensive similarities of the backbone and the resistance island were found between pABC143C-NDM and the bla NDM-5 -carrying IncFII plasmids of two K. pneumoniae ST147 isolates from South Korea, one of which was colistin resistant, and both also produced OXA-181. Notably, one of these strains was isolated from a patient transferred from the UAE. Our data show that this pan-resistant clone has an alarming capacity to maintain itself over an extended period of time and is even likely to be transmitted internationally. Copyright © 2017 American Society for Microbiology.

  3. Molecular epidemiology of bla OXA-23 -producing carbapenem-resistant Acinetobacter baumannii in a single institution over a 65-month period in north China.

    Science.gov (United States)

    Ning, Nian-Zhi; Liu, Xiong; Bao, Chun-Mei; Chen, Su-Ming; Cui, En-Bo; Zhang, Ju-Ling; Huang, Jie; Chen, Fang-Hong; Li, Tao; Qu, Fen; Wang, Hui

    2017-01-05

    Carbapenem-resistant Acinetobacter baumannii poses a significant threat to hospitalized patients, as few therapeutic options remain. Thus, we investigated the molecular epidemiology and mechanism of resistance of carbapenem-resistant A.baumannii isolates in Beijing, China. Carbapenem-resistant A.baumannii isolates (n = 101) obtained between June 2009 and November 2014 were used. Multilocus sequence typing (MLST) and PCR assays for class C and D β-lactamase were performed on all isolates. S1 nuclease pulsed-field gel electrophoresis (PFGE) and Southern blot hybridization were performed to identify the resistance gene location. All 101 A.baumannii isolates were highly resistant to frequently used antimicrobials, and were considered multidrug resistant. A total of 12 sequence types (STs) were identified, including 10 reported STs and 2 novel STs. Eighty-seven isolates were classified to clonal complex 92 (CC92), among which ST191 and ST195 were the most common STs. The bla OXA-23 gene was positive in most (n = 95) of the A.baumannii isolates. Using S1-nuclease digestion PFGE and Southern blot hybridization, 3 patterns of plasmids carrying bla OXA-23 were confirmed. ST191 and ST195 (both harboring bla OXA-23 ) caused outbreaks during the study period, and this is the first report of outbreaks caused by ST191 and ST195 in north China. bla OXA-23 -producing A.baumannii ST191 and ST 195 isolates can disseminate in a hospital and are potential nosocomial outbreak strains. Surveillance of imipenem-resistant A.baumannii and antimicrobial stewardship should be strengthened.

  4. Application of stereo-imaging technology to medical field.

    Science.gov (United States)

    Nam, Kyoung Won; Park, Jeongyun; Kim, In Young; Kim, Kwang Gi

    2012-09-01

    There has been continuous development in the area of stereoscopic medical imaging devices, and many stereoscopic imaging devices have been realized and applied in the medical field. In this article, we review past and current trends pertaining to the application stereo-imaging technologies in the medical field. We describe the basic principles of stereo vision and visual issues related to it, including visual discomfort, binocular disparities, vergence-accommodation mismatch, and visual fatigue. We also present a brief history of medical applications of stereo-imaging techniques, examples of recently developed stereoscopic medical devices, and patent application trends as they pertain to stereo-imaging medical devices. Three-dimensional (3D) stereo-imaging technology can provide more realistic depth perception to the viewer than conventional two-dimensional imaging technology. Therefore, it allows for a more accurate understanding and analysis of the morphology of an object. Based on these advantages, the significance of stereoscopic imaging in the medical field increases in accordance with the increase in the number of laparoscopic surgeries, and stereo-imaging technology plays a key role in the diagnoses of the detailed morphologies of small biological specimens. The application of 3D stereo-imaging technology to the medical field will help improve surgical accuracy, reduce operation times, and enhance patient safety. Therefore, it is important to develop more enhanced stereoscopic medical devices.

  5. Attitudes of Medical Graduate and Undergraduate Students toward the Learning and Application of Medical Statistics

    Science.gov (United States)

    Wu, Yazhou; Zhang, Ling; Liu, Ling; Zhang, Yanqi; Liu, Xiaoyu; Yi, Dong

    2015-01-01

    It is clear that the teaching of medical statistics needs to be improved, yet areas for priority are unclear as medical students' learning and application of statistics at different levels is not well known. Our goal is to assess the attitudes of medical students toward the learning and application of medical statistics, and discover their…

  6. A study of RFID application impacts on medical safety.

    Science.gov (United States)

    Chang, She-I; Ou, Chin-Shyh; Ku, Cheng-Yuan; Yang, Morris

    2008-01-01

    With the international reform in medical management systems gaining ground worldwide, hospital management has gradually begun to shift its focus from providing expensive medical treatment to improving medical service quality and patient safety. In this study, we discuss the application of Radio Frequency Identification (RFID) and data integrating technology with the medical service, and examine whether or not this technology can enhance medical safety. We also discuss the possible benefits following the application of the RFID system. The findings show that the application of RFID to hospitals can actually generate benefits, which can be further divided into operational structure benefits, users' structure benefits, and organisational and environmental benefits. However, not all these benefits can achieve medical safety. Among them, only the operator and environmental benefits can play such roles. Nevertheless, the application of RFID can bring hospitals towards the integration of technology benefits and improved medical safety.

  7. Linacs for medical and industrial applications

    International Nuclear Information System (INIS)

    Hamm, R.W.

    1986-01-01

    Linear accelerators for medical and industrial applications have become an important commercial business. Microwave electron linacs for cancer radiation therapy and high-energy industrial radiography form the bulk of this market, but these, as well as induction linacs, are now being offered for radiation processing applications such as sterilization of disposable medical products, food preservation and material modifications. The radio frequency quadrupole (RFQ) linac has now made the ion linac also practical for commercial applications in medicine and industry, including radiation therapy, isotope production, neutron production, materials modification, and energy transfer processes. Ion linacs for several of these applications will soon be commercially available. The market for both ion and electron linacs is expected to significantly grow in several exciting and important areas

  8. Medical and biomedical applications of shock waves

    CERN Document Server

    Loske, Achim M

    2017-01-01

    This book provides current, comprehensive, and clear explanations of the physics behind medical and biomedical applications of shock waves. Extracorporeal shock wave lithotripsy is one of the greatest medical advances of our time, and its techniques and clinical devices are continuously evolving. Further research continues to improve the understanding of calculi fragmentation and tissue-damaging mechanisms. Shock waves are also used in orthopedics and traumatology. Possible applications in oncology, cardiology, dentistry, gene therapy, cell transfection, transformation of fungi and bacteria, as well as the inactivation of microorganisms are promising approaches for clinical treatment, industrial applications and research. Medical and Biomedical Applications of Shock Waves is useful as a guide for students, technicians and researchers working in universities and laboratories. Chemists, biologists, physicians and veterinarians, involved in research or clinical practice will find useful advice, but also engineer...

  9. Ionizing radiations: medical and industrial applications

    International Nuclear Information System (INIS)

    Vidal, H.

    1994-01-01

    Medical diagnosis with X-rays is the best known use of ionizing radiations on account of its wide diffusion (about 57 500 units in France). Other medical applications of artificial radionuclides involving a smaller number of installations are also well known, i.e. gamma teletherapy (167 units), brachytherapy (119 units) or therapy using unsealed sources (257 units). The industrial uses of ionising radiation, the diversity of which is very large, are generally less well known. The use of X- and gamma rays for non-destructive testing or food preservation and the use of tracers have some notoriety, but few people know that radioactive sources are involved in the measurement of parameters controlling industrial processes. The number of persons authorized to hold, use and/or sell artificial radionuclides amounts to about 4 800, all applications included. Approximately 650 of them are involved in therapy and 500 in medical research. The aim of this paper, which is not exhaustive, is to review a few typical applications of radionuclides both in the medical and industrial fields. It also supplies data both on the number of people authorized to use each technique and the radionuclides involved. (author). 10 tabs

  10. Use of WGS data for investigation of a long-term NDM-1-producing Citrobacter freundii outbreak and secondary in vivo spread of blaNDM-1 to Escherichia coli, Klebsiella pneumoniae and Klebsiella oxytoca

    DEFF Research Database (Denmark)

    Hammerum, Anette M; Hansen, Frank; Linde Nielsen, Hans

    2016-01-01

    Objectives An outbreak of NDM-1-producing Citrobacter freundii and possible secondary in vivo spread of blaNDM-1 to other Enterobacteriaceae were investigated. Methods From October 2012 to March 2015, meropenem-resistant Enterobacteriaceae were detected in 45 samples from seven patients at Aalborg...... of recent travel abroad and the source of the blaNDM-1 plasmid was unknown. Conclusions To our knowledge, this is the first report of an NDM-1-producing C. freundii outbreak and secondary in vivo spread of an IncA/C2 plasmid with blaNDM-1 to other Enterobacteriaceae....

  11. The regulation of mobile medical applications.

    Science.gov (United States)

    Yetisen, Ali Kemal; Martinez-Hurtado, J L; da Cruz Vasconcellos, Fernando; Simsekler, M C Emre; Akram, Muhammad Safwan; Lowe, Christopher R

    2014-03-07

    The rapidly expanding number of mobile medical applications have the potential to transform the patient-healthcare provider relationship by improving the turnaround time and reducing costs. In September 2013, the U.S. Food and Drug Administration (FDA) issued guidance to regulate these applications and protect consumers by minimising the risks associated with their unintended use. This guidance distinguishes between the subset of mobile medical apps which may be subject to regulation and those that are not. The marketing claims of the application determine the intent. Areas of concern include compliance with regular updates of the operating systems and of the mobile medical apps themselves. In this article, we explain the essence of this FDA guidance by providing examples and evaluating the impact on academia, industry and other key stakeholders, such as patients and clinicians. Our assessment indicates that awareness and incorporation of the guidelines into product development can hasten the commercialisation and market entry process. Furthermore, potential obstacles have been discussed and directions for future development suggested.

  12. High-level fluoroquinolone resistant Salmonella enterica serovar Kentucky ST198 epidemic clone with IncA/C conjugative plasmid carrying bla(CTX-M-25) gene.

    Science.gov (United States)

    Wasyl, Dariusz; Kern-Zdanowicz, Izabela; Domańska-Blicharz, Katarzyna; Zając, Magdalena; Hoszowski, Andrzej

    2015-01-30

    Multidrug resistant Salmonella Kentucky strains have been isolated from turkeys in Poland since 2009. Multiple mutations within chromosomal genes gyrA and parC were responsible for high-level ciprofloxacin resistance. One of the isolates was extended spectrum β-lactamase- (ESBL) positive: the strain 1643/2010 carried a conjugative 167,779 bps plasmid of IncA/C family. The sequence analysis revealed that it carried a blaCTX-M-25 gene and an integron with another β-lactamase encoding gene-blaOXA-21. This is the first known report of a CTX-M-25 encoding gene both in Poland and in Salmonella Kentucky world-wide, as well as in the IncA/C plasmid. Analysis of the integron showed a novel arrangement of gene cassettes-aacA4, aacC-A1 and blaOXA-21 where the latter might result from an intergeneric gene transfer. The study confirmed Salmonella Kentucky population isolated in Poland belongs to global epidemics of high level fluoroquinolone resistant clone ST198 that can carry rare β-lactamase genes. Copyright © 2014 Elsevier B.V. All rights reserved.

  13. Medical applications of colloids

    CERN Document Server

    Matijevic, Egon

    2008-01-01

    The first book of its type on the medical and biomedical applications of colloids, although there are some related titles on different topicsDiscusses the effects of uniform particles in drug formulations and releaseEvaluates particle transport and deposition in the human body.

  14. [Neurons in NAc core and BLA are activated during cocaine context-associated reward memory retrieval in mice].

    Science.gov (United States)

    Wang, Jun-Jun; Yao, Wen-Qing; Chen, Yue-Jun; Ma, Lan; Tao, Ye-Zheng

    2014-10-25

    The intense associative memories that develop between cocaine-paired contexts and rewarding stimuli make addiction hard to cure by contributing to cocaine seeking and relapse. So it's of great importance to examine the neurobiological basis of addiction memory. Cocaine conditioned place preference (CPP) used in this study is a form of Pavlovian conditioning which can establish associations between drug and contextual factors. c-Fos and Zif268 are commonly used immediate early gene (IEG) makers to identify neurons that are activated after a stimulus or behavioral conditioning. This study was designed to reveal neuronal c-Fos, Zif268 expression pattern in 10 brain regions following cocaine context-associated reward memory retrieval in mice, combining animal behavioral study and immunofluorescence method. C57BL/6 mice were randomly divided into 3 groups: Saline retrieval, Cocaine retrieval, and No retrieval of cocaine groups. Cocaine retrieval and No retrieval of cocaine underwent CPP training (one side paired with cocaine, and the other side with saline) except that No retrieval of cocaine group didn't undergo CPP test. Saline retrieval group received saline injections (i.p) on both sides. The results showed that: Neuronal c-Fos, Zif268 protein expression levels in nucleus accumbens (NAc) core both were elevated in Cocaine retrieval group compared with those in Saline retrieval (Control) group during cocaine context-associated reward memory retrieval. Zif268 protein expression level in basolateral amygdala (BLA) was also elevated in Cocaine retrieval group compared with that in control mice. Elevation was not seen in other regions such as hippocampus, prefrontal cortex (PFC). Thus, NAc core and BLA were activated during cocaine context-associated reward memory retrieval. The results suggest that neurons that are activated in NAc core and BLA are crucial basis of cocaine context-associated reward memory.

  15. Outbreak of a novel Enterobacter sp. carrying blaCTX-M-15 in a neonatal unit of a tertiary care hospital in Tanzania.

    Science.gov (United States)

    Mshana, Stephen E; Gerwing, Lisa; Minde, Mercy; Hain, Torsten; Domann, Eugen; Lyamuya, Eligius; Chakraborty, Trinad; Imirzalioglu, Can

    2011-09-01

    Enterobacter hormaechei and Cronobacter sakazakii are amongst the most important causes of outbreaks of neonatal sepsis associated with powdered milk. In this study, we report for the first time an outbreak of a novel Enterobacter sp. harbouring bla(CTX-M-15) in a neonatal unit in Tanzania. Seventeen Gram-negative enteric isolates from neonatal blood cultures were studied. Antibiotic susceptibility was assessed by disc diffusion testing, and the presence of the bla(CTX-M-15) gene was established by polymerase chain reaction (PCR) and sequencing. Isolates were typed by pulsed-field gel electrophoresis (PFGE). Identification by biochemical profiling was followed by nucleotide sequencing of 16S ribosomal DNA (rDNA), rpoB and hsp60 alleles. Environmental sampling was done and control measures were established. Isolates were initially misidentified based on their fermentation characteristics and agglutination as Salmonella enterica serotype Paratyphi. All isolates were resistant to multiple antibiotics, except for ciprofloxacin and carbapenems, and were found to harbour bla(CTX-M-15) on a 291-kb narrow-range plasmid. PFGE analysis indicated the clonal outbreak of a single strain, infecting 17 neonates with a case fatality rate of 35%. The same strain was isolated from a milk bucket. Phylogenetic analysis using 16S rDNA, rpoB and hsp60 sequences permitted no definitive identification, clustering the strains in the Enterobacter cloacae complex with similarities of 92-98.8%. The data describe an outbreak of a novel bla(CTX-M-15)-positive, multiresistant Enterobacter strain in an African neonatal unit that can easily be misidentified taxonomically. These data highlight the need for constant surveillance of bacteria harbouring extended-spectrum β-lactamases as well as improvements in hygiene measures in developing countries. Copyright © 2011 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.

  16. Characterization of ST258 Colistin-Resistant, blaKPC-Producing Klebsiella pneumoniae in a Greek Hospital.

    Science.gov (United States)

    Mavroidi, Angeliki; Katsiari, Maria; Likousi, Sofia; Palla, Eleftheria; Roussou, Zoi; Nikolaou, Charikleia; Maguina, Asimina; Platsouka, Evangelia D

    2016-07-01

    The emergence of colistin resistance may further contribute to treatment failure of infection caused by multidrug-resistant (MDR) Klebsiella pneumoniae. The colistin resistance rates were determined and colistin-resistant carbapenemase-producing K. pneumoniae (COL-R CP-Kp) were characterized over an 18-month period in a Greek hospital. Out of 135 carbapenemase producers, 19 isolates (14%) were categorized as resistant to colistin. Phenotypic and molecular characterization of the COL-R CP-Kp isolates revealed that all were MDR blaKPC producers and, excluding one isolate of MLST ST383, belonged to the international clonal lineage ST258. Furthermore, PCR amplification and sequencing of the mgrB locus revealed nucleotide sequences of different sizes and insertions of IS1- and IS5-like mobile elements. The majority (63%) of the COL-R blaKPC producers was recovered from patients in the intensive care unit (ICU) and clinical data indicated that all patients should have acquired these isolates in the ICU. The findings of the present study underscore a concerning evolution of colistin resistance in a setting of high K. pneumoniae carbapenemase (KPC)-Kp endemicity, such as Greece. Thus, continuous surveillance, molecular characterization, prudent use of antibiotics, and implementation of infection control measures for K. pneumoniae are urgent.

  17. [VR and AR Applications in Medical Practice and Education].

    Science.gov (United States)

    Hsieh, Min-Chai; Lin, Yu-Hsuan

    2017-12-01

    As technology advances, mobile devices have gradually turned into wearable devices. Furthermore, virtual reality (VR), augmented reality (AR), and mixed reality (MR) are being increasingly applied in medical fields such as medical education and training, surgical simulation, neurological rehabilitation, psychotherapy, and telemedicine. Research results demonstrate the ability of VR, AR, and MR to ameliorate the inconveniences that are often associated with traditional medical care, reduce incidents of medical malpractice caused by unskilled operations, and reduce the cost of medical education and training. What is more, the application of these technologies has enhanced the effectiveness of medical education and training, raised the level of diagnosis and treatment, improved the doctor-patient relationship, and boosted the efficiency of medical execution. The present study introduces VR, AR, and MR applications in medical practice and education with the aim of helping health professionals better understand the applications and use these technologies to improve the quality of medical care.

  18. First detection of AmpC β-lactamase bla(CMY-2) on a conjugative IncA/C plasmid in a Vibrio parahaemolyticus isolate of food origin.

    Science.gov (United States)

    Li, Ruichao; Lin, Dachuan; Chen, Kaichao; Wong, Marcus Ho Yin; Chen, Sheng

    2015-07-01

    Vibrio parahaemolyticus is an important causative agent of gastroenteritis, with the consumption of contaminated seafood being the major transmission route. Resistance to penicillin is common among V. parahaemolyticus strains, whereas cephalosporin resistance remains rare. In an attempt to assess the current prevalence and characteristics of antibiotic resistance of this pathogen in common food samples, a total of 54 (17% of the total samples) V. parahaemolyticus strains were isolated from 318 meat and seafood samples purchased from supermarkets and wet markets in Shenzhen, China, in 2013. These isolates exhibited high-level resistance to ampicillin, yet they were mostly susceptible to other antimicrobials, except for two that were resistant to extended-spectrum cephalosporins. The β-lactamase gene blaPER-1 was detectable in one strain, V. parahaemolyticus V43, which was resistant to both third- and fourth-generation cephalosporins. Compared to other blaPER-1-positive V. parahaemolyticus strains reported in our previous studies, strain V43 was found to harbor an ∼200-kb conjugative plasmid carrying genes that were different from the antimicrobial resistance genes reported from the previous studies. The β-lactamase gene blaCMY-2 was detectable for the first time in another V. parahaemolyticus isolate, V4, which was resistant to third-generation cephalosporins. This blaCMY-2 gene was shown to be located in an ∼150-kb IncA/C-type conjugative plasmid with a genetic structure consisting of traB-traV-traA-ISEcp1-blaCMY-2-blc-sugE-encR-orf1-orf2-orf3-orf4-dsbC-traC, which is identical to that of other IncA/C conjugative plasmids in Enterobacteriaceae, albeit with a different size. These findings indicate that the transmission of extended-spectrum-β-lactamase (ESBL) and AmpC β-lactamase genes via conjugative plasmids can mediate the development of extended-spectrum cephalosporin resistance in V. parahaemolyticus, thereby posing a potential threat to public health

  19. How to identify, assess and utilise mobile medical applications in clinical practice.

    Science.gov (United States)

    Aungst, T D; Clauson, K A; Misra, S; Lewis, T L; Husain, I

    2014-02-01

    There are thousands of medical applications for mobile devices targeting use by healthcare professionals. However, several factors related to the structure of the existing market for medical applications create significant barriers preventing practitioners from effectively identifying mobile medical applications for individual professional use. To define existing market factors relevant to selection of medical applications and describe a framework to empower clinicians to identify, assess and utilise mobile medical applications in their own practice. Resources available on the Internet regarding mobile medical applications, guidelines and published research on mobile medical applications. Mobile application stores (e.g. iTunes, Google Play) are not effective means of identifying mobile medical applications. Users of mobile devices that desire to implement mobile medical applications into practice need to carefully assess individual applications prior to utilisation. Searching and identifying mobile medical applications requires clinicians to utilise multiple references to determine what application is best for their individual practice methods. This can be done with a cursory exploration of mobile application stores and then moving onto other available resources published in the literature or through Internet resources (e.g. blogs, medical websites, social media). Clinicians must also take steps to ensure that an identified mobile application can be integrated into practice after carefully reviewing it themselves. Clinicians seeking to identify mobile medical application for use in their individual practice should use a combination of app stores, published literature, web-based resources, and personal review to ensure safe and appropriate use. © 2014 John Wiley & Sons Ltd.

  20. Calibration services for medical applications of radiation

    Energy Technology Data Exchange (ETDEWEB)

    DeWerd, L.A.

    1993-12-31

    Calibration services for the medical community applications of radiation involve measuring radiation precisely and having traceability to the National Institute of Standards and Technology (NIST). Radiation therapy applications involve the use of ionization chambers and electrometers for external beams and well-type ionization chamber systems as well as radioactive sources for brachytherapy. Diagnostic x-ray applications involve ionization chamber systems and devices to measure other parameters of the x-ray machine, such as non-invasive kVp meters. Calibration laboratories have been established to provide radiation calibration services while maintaining traceability to NIST. New radiation applications of the medical community spur investigation to provide the future calibration needs.

  1. Calibration services for medical applications of radiation

    International Nuclear Information System (INIS)

    DeWerd, L.A.

    1993-01-01

    Calibration services for the medical community applications of radiation involve measuring radiation precisely and having traceability to the National Institute of Standards and Technology (NIST). Radiation therapy applications involve the use of ionization chambers and electrometers for external beams and well-type ionization chamber systems as well as radioactive sources for brachytherapy. Diagnostic x-ray applications involve ionization chamber systems and devices to measure other parameters of the x-ray machine, such as non-invasive kVp meters. Calibration laboratories have been established to provide radiation calibration services while maintaining traceability to NIST. New radiation applications of the medical community spur investigation to provide the future calibration needs

  2. Present and perspective medical applications of microbial exopolysaccharides

    Directory of Open Access Journals (Sweden)

    Misu - Moscovici

    2015-09-01

    Full Text Available Microbial exopolysaccharides (EPS have found outstanding medical applications since the mid-twentieth century, with the first clinical trials on dextran solutions as plasma expanders. Other EPS entered medicine firstly as conventional pharmaceutical excipients (e.g., xanthan - as suspension stabilizer, or pullulan – in capsules and oral care products. Polysaccharides, initially obtained from plant or animal sources, became easily available for a wide range of applications, especially when they were commercially produced by microbial fermentation. Alginates are used as anti-reflux, dental impressions, or as matrix for tablets. Hyaluronic acid and derivatives are used in surgery, arthritis treatment or wound healing. Bacterial cellulose is applied in wound dressings or scaffolds for tissue engineering. The development of drug controlled-release systems and of micro- and nanoparticulated ones, has opened a new era of medical applications for biopolymers. EPS and their derivatives are well suited potentially non-toxic, biodegradable drug carriers. Such systems concern rating and targeting of controlled release. Their large area of applications is explained by the available manifold series of derivatives, whose useful properties can be thereby controlled. From matrix inclusion to conjugates, different systems have been designed to solubilize, and to assure stable transport in the body, target accumulation and variable rate-release of a drug substance. From controlled drug delivery, EPS potential applications expanded to vaccine adjuvants and diagnostic imaging systems. Other potential applications are related to the bioactive (immunomodulator, antitumor, antiviral characteristics of EPS. The numerous potential applications still wait to be developed into commercial pharmaceuticals and medical devices. Based on previous and recent results in important medical-pharmaceutical domains, one can undoubtedly state that EPS medical applications have a

  3. Microfluidics for medical applications

    NARCIS (Netherlands)

    van den Berg, Albert; van den Berg, A.; Segerink, L.I.; Segerink, Loes Irene; Unknown, [Unknown

    2015-01-01

    Lab-on-a-chip devices for point of care diagnostics have been present in clinics for several years now. Alongside their continual development, research is underway to bring the organs and tissue on-a-chip to the patient, amongst other medical applications of microfluidics. This book provides the

  4. 21 CFR 515.11 - Supplemental medicated feed mill license applications.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Supplemental medicated feed mill license... SERVICES (CONTINUED) ANIMAL DRUGS, FEEDS, AND RELATED PRODUCTS MEDICATED FEED MILL LICENSE Applications § 515.11 Supplemental medicated feed mill license applications. (a) After approval of a medicated feed...

  5. pIMP-PH114 carrying bla IMP-4 in a Klebsiella pneumoniae strain is closely related to other multidrug-resistant IncA/C2 plasmids.

    Science.gov (United States)

    Ho, Pak-Leung; Lo, Wai-U; Chan, Jane; Cheung, Yuk-Yam; Chow, Kin-Hung; Yam, Wing-Cheong; Lin, Chi-Ho; Que, Tak-Lun

    2014-02-01

    The IncA/C plasmids are broad host-range vehicles which have been associated with wide dissemination of CMY-2 among Enterobacteriaceae of human and animal origins. Acquired metallo-β-lactamases (MBLs) such as the IMP-type enzymes are increasingly reported in multidrug-resistant Gram-negative bacteria worldwide, particularly in Enterobacteriaceae. We described the complete sequence of the first IMP-4-encoding IncA/C2 plasmid, pIMP-PH114 (151,885 bp), from a sequence type 1 Klebsiella pneumoniae strain that was recovered from a patient who was hospitalized in the Philippines. pIMP-PH114 consists of a backbone from the IncA/C2 plasmids, with the insertion of a novel Tn21-like class 1 integron composite structure (containing the cassette array bla IMP-4-qacG-aacA4-catB3, followed by a class C β-lactamase bla DHA-1 and the mercury resistance operon, merRTPCADE) and a sul2-floR encoding region. Phylogenetic analysis of the IncA/C repA sequences showed that pIMP-PH114 formed a subgroup with other IncA/C plasmids involved in the international spread of CMY-2, TEM-24 and NDM-1. Identical bla IMP-4 arrays have been described among different Enterobacteriaceae and Acinetobacter spp. in China, Singapore and Australia but the genetic context is different. The broad host range of IncA/C plasmids may have facilitated dissemination of the bla IMP-4 arrays among different diverse groups of bacteria.

  6. Characterization of IncN plasmids carrying blaCTX-M-1 and qnr genes in Escherichia coli and Salmonella from animals, the environment and humans

    DEFF Research Database (Denmark)

    Dolejska, Monika; Villa, Laura; Hasman, Henrik

    2013-01-01

    were compared using restriction fragment length polymorphism (RFLP), plasmid multilocus sequence typing (pMLST) and hybridization with repN, qnrS1, qnrB19 or blaCTX-M-1 probes. Plasmids pKT58A and pHHA45 were sequenced using the 454-Genome Sequencer FLX platform on a library constructed from plasmid...... DNA purified from the respective E. coli transformants.Results Three types of IncN plasmids carrying blaCTX-M-1, qnrS1 and qnrB19 genes were identified in strains isolated from the Czech Republic, Poland, Slovakia, Denmark, Italy and the Netherlands, corresponding to pMLST sequence type (ST) 1, ST3...

  7. Mammalian synthetic biology: emerging medical applications.

    Science.gov (United States)

    Kis, Zoltán; Pereira, Hugo Sant'Ana; Homma, Takayuki; Pedrigi, Ryan M; Krams, Rob

    2015-05-06

    In this review, we discuss new emerging medical applications of the rapidly evolving field of mammalian synthetic biology. We start with simple mammalian synthetic biological components and move towards more complex and therapy-oriented gene circuits. A comprehensive list of ON-OFF switches, categorized into transcriptional, post-transcriptional, translational and post-translational, is presented in the first sections. Subsequently, Boolean logic gates, synthetic mammalian oscillators and toggle switches will be described. Several synthetic gene networks are further reviewed in the medical applications section, including cancer therapy gene circuits, immuno-regulatory networks, among others. The final sections focus on the applicability of synthetic gene networks to drug discovery, drug delivery, receptor-activating gene circuits and mammalian biomanufacturing processes. © 2015 The Author(s) Published by the Royal Society. All rights reserved.

  8. A gratuitous β-Lactamase inducer uncovers hidden active site dynamics of the Staphylococcus aureus BlaR1 sensor domain.

    Science.gov (United States)

    Frederick, Thomas E; Peng, Jeffrey W

    2018-01-01

    Increasing evidence shows that active sites of proteins have non-trivial conformational dynamics. These dynamics include active site residues sampling different local conformations that allow for multiple, and possibly novel, inhibitor binding poses. Yet, active site dynamics garner only marginal attention in most inhibitor design efforts and exert little influence on synthesis strategies. This is partly because synthesis requires a level of atomic structural detail that is frequently missing in current characterizations of conformational dynamics. In particular, while the identity of the mobile protein residues may be clear, the specific conformations they sample remain obscure. Here, we show how an appropriate choice of ligand can significantly sharpen our abilities to describe the interconverting binding poses (conformations) of protein active sites. Specifically, we show how 2-(2'-carboxyphenyl)-benzoyl-6-aminopenicillanic acid (CBAP) exposes otherwise hidden dynamics of a protein active site that binds β-lactam antibiotics. When CBAP acylates (binds) the active site serine of the β-lactam sensor domain of BlaR1 (BlaRS), it shifts the time scale of the active site dynamics to the slow exchange regime. Slow exchange enables direct characterization of inter-converting protein and bound ligand conformations using NMR methods. These methods include chemical shift analysis, 2-d exchange spectroscopy, off-resonance ROESY of the bound ligand, and reduced spectral density mapping. The active site architecture of BlaRS is shared by many β-lactamases of therapeutic interest, suggesting CBAP could expose functional motions in other β-lactam binding proteins. More broadly, CBAP highlights the utility of identifying chemical probes common to structurally homologous proteins to better expose functional motions of active sites.

  9. Virulence of Klebsiella pneumoniae isolates harboring bla KPC-2 carbapenemase gene in a Caenorhabditis elegans model.

    Directory of Open Access Journals (Sweden)

    Jean-Philippe Lavigne

    Full Text Available Klebsiella pneumoniae carbapenemase (KPC is a carbapenemase increasingly reported worldwide in Enterobacteriaceae. The aim of this study was to analyze the virulence of several KPC-2-producing K. pneumoniae isolates. The studied strains were (i five KPC-2 clinical strains from different geographical origins, belonging to different ST-types and possessing plasmids of different incompatibility groups; (ii seven transformants obtained after electroporation of either these natural KPC plasmids or a recombinant plasmid harboring only the bla KPC-2 gene into reference strains K. pneumoniae ATCC10031/CIP53153; and (iii five clinical strains cured of plasmids. The virulence of K. pneumoniae isolates was evaluated in the Caenorhabditis elegans model. The clinical KPC producers and transformants were significantly less virulent (LT50: 5.5 days than K. pneumoniae reference strain (LT50: 4.3 days (p<0.01. However, the worldwide spread KPC-2 positive K. pneumoniae ST258 strains and reference strains containing plasmids extracted from K. pneumoniae ST258 strains had a higher virulence than KPC-2 strains belonging to other ST types (LT50: 5 days vs. 6 days, p<0.01. The increased virulence observed in cured strains confirmed this trend. The bla KPC-2 gene itself was not associated to increased virulence.

  10. Persistence of Multidrug-Resistant Acinetobacter baumannii Isolates Harboring blaOXA-23 and bap for 5 Years.

    Science.gov (United States)

    Sung, Ji Youn; Koo, Sun Hoe; Kim, Semi; Kwon, Gye Cheol

    2016-08-28

    The emergence and dissemination of carbapenemase-producing Acinetobacter baumannii isolates have been reported worldwide, and A. baumannii isolates harboring blaOXA-23 are often resistant to various antimicrobial agents. Antimicrobial resistance can be particularly strong for biofilm-forming A. baumannii isolates. We investigated the genetic basis for carbapenem resistance and biofilm-forming ability of multidrug-resistant (MDR) clinical isolates. Ninety-two MDR A. baumannii isolates were collected from one university hospital located in the Chungcheong area of Korea over a 5-year period. Multiplex PCR and DNA sequencing were performed to characterize carbapenemase and bap genes. Clonal characteristics were analyzed using REP-PCR. In addition, imaging and quantification of biofilms were performed using a crystal violet assay. All 92 MDR A. baumannii isolates involved in our study contained the blaOXA-23 and bap genes. The average absorbance of biomass in Bap-producing strains was much greater than that in non-Bap-producing strains. In our study, only three REP-PCR types were found, and the isolates showing type A or type B were found more than 60 times among unique patients during the 5 years of surveillance. These results suggest that the isolates have persisted and colonized for 5 years, and biofilm formation ability has been responsible for their persistence and colonization.

  11. 78 FR 29390 - Applications; SHINE Medical Technologies, Inc.

    Science.gov (United States)

    2013-05-20

    ... NUCLEAR REGULATORY COMMISSION [Proj-0792; NRC-2013-0053] Applications; SHINE Medical Technologies... (ADAMS) Accession No. ML13088A192), SHINE Medical Technologies (SHINE) filed with the U.S. Nuclear... for a medical radioisotope production facility in Janesville, Wisconsin. An exemption from certain...

  12. Measuring emotional intelligence of medical school applicants.

    Science.gov (United States)

    Carrothers, R M; Gregory, S W; Gallagher, T J

    2000-05-01

    To discuss the development, pilot testing, and analysis of a 34-item semantic differential instrument for measuring medical school applicants' emotional intelligence (the EI instrument). The authors analyzed data from the admission interviews of 147 1997 applicants to a six-year BS/MD program that is composed of three consortium universities. They compared the applicants' scores on traditional admission criteria (e.g., GPA and traditional interview assessments) with their scores on the EI instrument (which comprised five dimensions of emotional intelligence), breaking the data out by consortium university (each of which has its own educational ethos) and gender. They assessed the EI instrument's reliability and validity for assessing noncognitive personal and interpersonal qualities of medical school applicants. The five dimensions of emotional intelligence (maturity, compassion, morality, sociability, and calm disposition) indicated fair to excellent internal consistency: reliability coefficients were .66 to .95. Emotional intelligence as measured by the instrument was related to both being female and matriculating at the consortium university that has an educational ethos that values the social sciences and humanities. Based on this pilot study, the 34-item EI instrument demonstrates the ability to measure attributes that indicate desirable personal and interpersonal skills in medical school applicants.

  13. Identification and Evaluation of Medical Translator Mobile Applications Using an Adapted APPLICATIONS Scoring System.

    Science.gov (United States)

    Khander, Amrin; Farag, Sara; Chen, Katherine T

    2017-12-22

    With an increasing number of patients requiring translator services, many providers are turning to mobile applications (apps) for assistance. However, there have been no published reviews of medical translator apps. To identify and evaluate medical translator mobile apps using an adapted APPLICATIONS scoring system. A list of apps was identified from the Apple iTunes and Google Play stores, using the search term, "medical translator." Apps not found on two different searches, not in an English-based platform, not used for translation, or not functional after purchase, were excluded. The remaining apps were evaluated using an adapted APPLICATIONS scoring system, which included both objective and subjective criteria. App comprehensiveness was a weighted score defined by the number of non-English languages included in each app relative to the proportion of non-English speakers in the United States. The Apple iTunes and Google Play stores. Medical translator apps identified using the search term "medical translator." Main Outcomes and Measures: Compilation of medical translator apps for provider usage. A total of 524 apps were initially found. After applying the exclusion criteria, 20 (8.2%) apps from the Google Play store and 26 (9.2%) apps from the Apple iTunes store remained for evaluation. The highest scoring apps, Canopy Medical Translator, Universal Doctor Speaker, and Vocre Translate, scored 13.5 out of 18.7 possible points. A large proportion of apps initially found did not function as medical translator apps. Using the APPLICATIONS scoring system, we have identified and evaluated medical translator apps for providers who care for non-English speaking patients.

  14. Optical Fibre Pressure Sensors in Medical Applications

    Directory of Open Access Journals (Sweden)

    Sven Poeggel

    2015-07-01

    Full Text Available This article is focused on reviewing the current state-of-the-art of optical fibre pressure sensors for medical applications. Optical fibres have inherent advantages due to their small size, immunity to electromagnetic interferences and their suitability for remote monitoring and multiplexing. The small dimensions of optical fibre-based pressure sensors, together with being lightweight and flexible, mean that they are minimally invasive for many medical applications and, thus, particularly suited to in vivo measurement. This means that the sensor can be placed directly inside a patient, e.g., for urodynamic and cardiovascular assessment. This paper presents an overview of the recent developments in optical fibre-based pressure measurements with particular reference to these application areas.

  15. Optical Fibre Pressure Sensors in Medical Applications.

    Science.gov (United States)

    Poeggel, Sven; Tosi, Daniele; Duraibabu, DineshBabu; Leen, Gabriel; McGrath, Deirdre; Lewis, Elfed

    2015-07-15

    This article is focused on reviewing the current state-of-the-art of optical fibre pressure sensors for medical applications. Optical fibres have inherent advantages due to their small size, immunity to electromagnetic interferences and their suitability for remote monitoring and multiplexing. The small dimensions of optical fibre-based pressure sensors, together with being lightweight and flexible, mean that they are minimally invasive for many medical applications and, thus, particularly suited to in vivo measurement. This means that the sensor can be placed directly inside a patient, e.g., for urodynamic and cardiovascular assessment. This paper presents an overview of the recent developments in optical fibre-based pressure measurements with particular reference to these application areas.

  16. Optical Fibre Pressure Sensors in Medical Applications

    Science.gov (United States)

    Poeggel, Sven; Tosi, Daniele; Duraibabu, DineshBabu; Leen, Gabriel; McGrath, Deirdre; Lewis, Elfed

    2015-01-01

    This article is focused on reviewing the current state-of-the-art of optical fibre pressure sensors for medical applications. Optical fibres have inherent advantages due to their small size, immunity to electromagnetic interferences and their suitability for remote monitoring and multiplexing. The small dimensions of optical fibre-based pressure sensors, together with being lightweight and flexible, mean that they are minimally invasive for many medical applications and, thus, particularly suited to in vivo measurement. This means that the sensor can be placed directly inside a patient, e.g., for urodynamic and cardiovascular assessment. This paper presents an overview of the recent developments in optical fibre-based pressure measurements with particular reference to these application areas. PMID:26184228

  17. Biomagnetics and bioimaging for medical applications

    Energy Technology Data Exchange (ETDEWEB)

    Ueno, Shoogo [Department of Biomedical Engineering, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033 (Japan)]. E-mail: ueno@medes.m.u-tokyo.ac.jp; Sekino, Masaki [Department of Biomedical Engineering, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033 (Japan)

    2006-09-15

    This paper reviews medical applications of the recently developed techniques in biomagnetics and bioimaging such as transcranial magnetic stimulation, magnetoencephalography, magnetic resonance imaging, cancer therapy based on magnetic stimulation, and magnetic control of cell orientation and cell growth. These techniques are leading medicine and biology into a new horizon through the novel applications of magnetism.

  18. Biomagnetics and bioimaging for medical applications

    International Nuclear Information System (INIS)

    Ueno, Shoogo; Sekino, Masaki

    2006-01-01

    This paper reviews medical applications of the recently developed techniques in biomagnetics and bioimaging such as transcranial magnetic stimulation, magnetoencephalography, magnetic resonance imaging, cancer therapy based on magnetic stimulation, and magnetic control of cell orientation and cell growth. These techniques are leading medicine and biology into a new horizon through the novel applications of magnetism

  19. Applications of VLSI circuits to medical imaging

    International Nuclear Information System (INIS)

    O'Donnell, M.

    1988-01-01

    In this paper the application of advanced VLSI circuits to medical imaging is explored. The relationship of both general purpose signal processing chips and custom devices to medical imaging is discussed using examples of fabricated chips. In addition, advanced CAD tools for silicon compilation are presented. Devices built with these tools represent a possible alternative to custom devices and general purpose signal processors for the next generation of medical imaging systems

  20. Polyetheretherketone (PEEK) for medical applications.

    Science.gov (United States)

    Panayotov, Ivan Vladislavov; Orti, Valérie; Cuisinier, Frédéric; Yachouh, Jacques

    2016-07-01

    Polyetheretherketone (PEEK) is a polyaromatic semi-crystalline thermoplastic polymer with mechanical properties favorable for bio-medical applications. Polyetheretherketone forms: PEEK-LT1, PEEK-LT2, and PEEK-LT3 have already been applied in different surgical fields: spine surgery, orthopedic surgery, maxillo-facial surgery etc. Synthesis of PEEK composites broadens the physicochemical and mechanical properties of PEEK materials. To improve their osteoinductive and antimicrobial capabilities, different types of functionalization of PEEK surfaces and changes in PEEK structure were proposed. PEEK based materials are becoming an important group of biomaterials used for bone and cartilage replacement as well as in a large number of diverse medical fields. The current paper describes the structural changes and the surface functionalization of PEEK materials and their most common biomedical applications. The possibility to use these materials in 3D printing process could increase the scientific interest and their future development as well.

  1. Medical applications with synchrotron radiation in Japan

    Energy Technology Data Exchange (ETDEWEB)

    Takeda, T.; Itai, Y. [Univ. of Tsukuba, Inst. of Clinical Medicine, Tsukuba (Japan); Hyodo, K.; Ando, M. [KEK, Tsukuba (Japan); Akatsuka, T. [Yamagata Univ., Faculty of Engineering, Yamagata (Japan); Uyama, C. [National Cardiovascular Centre, Suita (Japan)

    1998-05-01

    In Japan, various medical applications of synchrotron X-ray imaging, such as angiography, monochromatic X-ray computed tomography (CT), radiography and radiation therapy, are being developed. In particular, coronary arteriography (CAG) is quite an important clinical application of synchrotron radiation. Using a two-dimensional imaging method, the first human intravenous CAG was carried out at KEK in May 1996; however, further improvements of image quality are required in clinical practice. On the other hand, two-dimensional aortographic CAG revealed canine coronary arteries as clearly as those on selective CAG, and coronary arteries less than 0.2 mm in diameter. Among applications of synchrotron radiation to X-ray CT, phase-contrast X-ray CT and fluorescent X-ray CT are expected to be very interesting future applications of synchrotron radiation. For actual clinical applications of synchrotron radiation, a medical beamline and a laboratory are now being constructed at SPring-8 in Harima. 55 refs.

  2. Viewpoints on Medical Image Processing: From Science to Application

    Science.gov (United States)

    Deserno (né Lehmann), Thomas M.; Handels, Heinz; Maier-Hein (né Fritzsche), Klaus H.; Mersmann, Sven; Palm, Christoph; Tolxdorff, Thomas; Wagenknecht, Gudrun; Wittenberg, Thomas

    2013-01-01

    Medical image processing provides core innovation for medical imaging. This paper is focused on recent developments from science to applications analyzing the past fifteen years of history of the proceedings of the German annual meeting on medical image processing (BVM). Furthermore, some members of the program committee present their personal points of views: (i) multi-modality for imaging and diagnosis, (ii) analysis of diffusion-weighted imaging, (iii) model-based image analysis, (iv) registration of section images, (v) from images to information in digital endoscopy, and (vi) virtual reality and robotics. Medical imaging and medical image computing is seen as field of rapid development with clear trends to integrated applications in diagnostics, treatment planning and treatment. PMID:24078804

  3. Viewpoints on Medical Image Processing: From Science to Application.

    Science.gov (United States)

    Deserno Né Lehmann, Thomas M; Handels, Heinz; Maier-Hein Né Fritzsche, Klaus H; Mersmann, Sven; Palm, Christoph; Tolxdorff, Thomas; Wagenknecht, Gudrun; Wittenberg, Thomas

    2013-05-01

    Medical image processing provides core innovation for medical imaging. This paper is focused on recent developments from science to applications analyzing the past fifteen years of history of the proceedings of the German annual meeting on medical image processing (BVM). Furthermore, some members of the program committee present their personal points of views: (i) multi-modality for imaging and diagnosis, (ii) analysis of diffusion-weighted imaging, (iii) model-based image analysis, (iv) registration of section images, (v) from images to information in digital endoscopy, and (vi) virtual reality and robotics. Medical imaging and medical image computing is seen as field of rapid development with clear trends to integrated applications in diagnostics, treatment planning and treatment.

  4. Loop-Mediated Isothermal Amplification untuk Mendeteksi Gen blaTEM sebagai Penyandi Extended-Spectrum Beta-Lactamase pada Isolat Enterobacteriaceae

    Directory of Open Access Journals (Sweden)

    Bayu A. P. Wilopo

    2015-12-01

    Full Text Available Extended-spectrum beta-lactamase (ESBL is a beta-lactamase enzyme that is capable of hydrolyzing penicillin, cephalosporin, and monobactam, and can be inhibited by clavulanic acid. This enzyme is encoded by multiple genes, one of them is blaTEM. Polymerase chain reaction (PCR is one of the DNA amplification methods that are frequently used; however, there are other methods that can be used including, among others, loop-mediated isothermal amplification (LAMP. LAMP requires simple equipment with quicker and easy-to-read results compared to PCR. This study was a diagnostic test to explore the sensitivity and specificity of LAMP method compared to PCR in detecting blaTEM gene. Furthermore, the concordance between LAMP and PCR methods was assessed. A total of 92 Enterobacteriaceae isolates were examined by PCR and LAMP methods and compared. The result showed that the LAMP method had a sensitivity of 91.4% and a specificity of 91.2% with a concordance value (kappa of 85.4%. In conclusion, LAMP method has a good validity and a very good conformity compared to the PCR method. Therefore, LAMP method can be used as an alternative diagnostic test, especially in limited settings.

  5. Medical image informatics infrastructure design and applications.

    Science.gov (United States)

    Huang, H K; Wong, S T; Pietka, E

    1997-01-01

    Picture archiving and communication systems (PACS) is a system integration of multimodality images and health information systems designed for improving the operation of a radiology department. As it evolves, PACS becomes a hospital image document management system with a voluminous image and related data file repository. A medical image informatics infrastructure can be designed to take advantage of existing data, providing PACS with add-on value for health care service, research, and education. A medical image informatics infrastructure (MIII) consists of the following components: medical images and associated data (including PACS database), image processing, data/knowledge base management, visualization, graphic user interface, communication networking, and application oriented software. This paper describes these components and their logical connection, and illustrates some applications based on the concept of the MIII.

  6. Applications of Particle Accelerators in Medical Physics

    OpenAIRE

    Cuttone, G

    2008-01-01

    Particle accelerators are often associated to high energy or nuclear physics. As well pointed out in literature [1] if we kindly analyse the number of installation worldwide we can easily note that about 50% is mainly devoted to medical applications (radiotherapy, medical radioisotopes production, biomedical research). Particle accelerators are also playing an important indirect role considering the improvement of the technical features of medical diagnostic. In fact the use of radionuclide f...

  7. Bla-bla-bla: video chat service on the Internet, a market feasibility study

    NARCIS (Netherlands)

    Lindgreen, A.; Antioco, M.D.J.; Wetzels, M.G.M.

    2004-01-01

    The Internet is changing the way that companies carry out their business and, in fact, constitutes an entirely new application domain, which makes product innovation possible. Moreover, it is a new medium for reaching consumers, which is a central preoccupation to organisations in the current

  8. Applications of artificial neural networks in medical science.

    Science.gov (United States)

    Patel, Jigneshkumar L; Goyal, Ramesh K

    2007-09-01

    Computer technology has been advanced tremendously and the interest has been increased for the potential use of 'Artificial Intelligence (AI)' in medicine and biological research. One of the most interesting and extensively studied branches of AI is the 'Artificial Neural Networks (ANNs)'. Basically, ANNs are the mathematical algorithms, generated by computers. ANNs learn from standard data and capture the knowledge contained in the data. Trained ANNs approach the functionality of small biological neural cluster in a very fundamental manner. They are the digitized model of biological brain and can detect complex nonlinear relationships between dependent as well as independent variables in a data where human brain may fail to detect. Nowadays, ANNs are widely used for medical applications in various disciplines of medicine especially in cardiology. ANNs have been extensively applied in diagnosis, electronic signal analysis, medical image analysis and radiology. ANNs have been used by many authors for modeling in medicine and clinical research. Applications of ANNs are increasing in pharmacoepidemiology and medical data mining. In this paper, authors have summarized various applications of ANNs in medical science.

  9. mcr-1 and blaKPC-3 in Escherichia coli Sequence Type 744 after Meropenem and Colistin Therapy, Portugal.

    Science.gov (United States)

    Tacão, Marta; Tavares, Rafael Dos Santos; Teixeira, Pedro; Roxo, Inês; Ramalheira, Elmano; Ferreira, Sónia; Henriques, Isabel

    2017-08-01

    Escherichia coli Ec36 was recovered from a patient in Portugal after treatment with meropenem and colistin. Besides an IncF plasmid with Tn1441d-bla KPC-3 , already reported in clinical strains in this country, E. coli Ec36 co-harbored an IncX4::mcr-1 gene. Results highlight emerging co-resistance to carbapenems and polymyxins after therapy with drugs from both classes.

  10. Medical applications for biomaterials in Bolivia

    CERN Document Server

    Arias, Susan

    2015-01-01

    This book investigates the potential medical benefits natural biomaterials can offer in developing countries by analyzing the case of Bolivia. The book explores the medical and health related applications of Bolivian commodities: quinoa, barley, sugarcane, corn, sorghum and sunflower seeds. This book helps readers better understand some of the key health concerns facing countries like Bolivia and how naturally derived biomaterials and therapeutics could help substantially alleviate many of their problems.

  11. Appearance of β-lactam Resistance Genes in Agricultural Soils and Clinical Isolates over the 20th Century

    Science.gov (United States)

    Graham, David W.; Knapp, Charles W.; Christensen, Bent T.; McCluskey, Seánín; Dolfing, Jan

    2016-02-01

    Debate exists about whether agricultural versus medical antibiotic use drives increasing antibiotic resistance (AR) across nature. Both sectors have been inconsistent at antibiotic stewardship, but it is unclear which sector has most influenced acquired AR on broad scales. Using qPCR and soils archived since 1923 at Askov Experimental Station in Denmark, we quantified four broad-spectrum β-lactam AR genes (ARG; blaTEM, blaSHV, blaOXA and blaCTX-M) and class-1 integron genes (int1) in soils from manured (M) versus inorganic fertilised (IF) fields. “Total” β-lactam ARG levels were significantly higher in M versus IF in soils post-1940 (paired-t test; p animal manure and humans are historically interconnected. Archive data further show when non-therapeutic antibiotic use was banned in Denmark, blaCTX-M levels declined in M soils, suggesting accumulated soil ARGs can be reduced by prudent antibiotic stewardship. Conversely, int1 levels have continued to increase in M soils since 1990, implying direct manure application to soils should be scrutinized as part of future stewardship programs.

  12. Medication-use evaluation with a Web application.

    Science.gov (United States)

    Burk, Muriel; Moore, Von; Glassman, Peter; Good, Chester B; Emmendorfer, Thomas; Leadholm, Thomas C; Cunningham, Francesca

    2013-12-15

    A Web-based application for coordinating medication-use evaluation (MUE) initiatives within the Veterans Affairs (VA) health care system is described. The MUE Tracker (MUET) software program was created to improve VA's ability to conduct national medication-related interventions throughout its network of 147 medical centers. MUET initiatives are centrally coordinated by the VA Center for Medication Safety (VAMedSAFE), which monitors the agency's integrated databases for indications of suboptimal prescribing or drug therapy monitoring and adverse treatment outcomes. When a pharmacovigilance signal is detected, VAMedSAFE identifies "trigger groups" of at-risk veterans and uploads patient lists to the secure MUET application, where locally designated personnel (typically pharmacists) can access and use the data to target risk-reduction efforts. Local data on patient-specific interventions are stored in a centralized database and regularly updated to enable tracking and reporting for surveillance and quality-improvement purposes; aggregated data can be further analyzed for provider education and benchmarking. In a three-year pilot project, the MUET program was found effective in promoting improved prescribing of erythropoiesis-stimulating agents (ESAs) and enhanced laboratory monitoring of ESA-treated patients in all specified trigger groups. The MUET initiative has since been expanded to target other high-risk drugs, and efforts are underway to refine the tool for broader utility. The MUET application has enabled the increased standardization of medication safety initiatives across the VA system and may serve as a useful model for the development of pharmacovigilance tools by other large integrated health care systems.

  13. User experience integrated life-style cloud-based medical application.

    Science.gov (United States)

    Serban, Alexandru; Lupşe, Oana Sorina; Stoicu-Tivadar, Lăcrămioara

    2015-01-01

    Having a modern application capable to automatically collect and process data from users, based on information and lifestyle answers is one of current challenges for researchers and medical science. The purpose of the current study is to integrate user experience design (UXD) in a cloud-based medical application to improve patient safety, quality of care and organizational efficiency. The process consists of collecting traditional and new data from patients and users using online questionnaires. A questionnaire dynamically asks questions about the user's current diet and lifestyle. After the user will introduce the data, the application will formulate a presumptive nutritional plan and will suggest different medical recommendations regarding a healthy lifestyle, and calculates a risk factor for diseases. This software application, by design and usability will be an efficient tool dedicated for fitness, nutrition and health professionals.

  14. Medical applications of diamond particles & surfaces

    OpenAIRE

    Roger J Narayan; Ryan D. Boehm; Anirudha V. Sumant

    2011-01-01

    Diamond has been considered for use in several medical applications due to its unique mechanical, chemical, optical, and biological properties. In this paper, methods for preparing synthetic diamond surfaces and particles are described. In addition, recent developments involving the use of diamond in prostheses, sensing, imaging, and drug delivery applications are reviewed. These developments suggest that diamond-containing structures will provide significant improvements in the diagnosis and...

  15. Nano materials for Medical and Dental Applications

    International Nuclear Information System (INIS)

    Yub Kwon, T.; Oh, D.S.; Narayanan, R.

    2015-01-01

    Welcome to this special issue. Nano science and nano technology concepts are applicable across all fields of science and a more widespread application of nano materials and nano technologies is imminent or already occurring in many areas, including health care. Today is scientists take those cutting-edge technologies and concepts and apply them to medicine and dentistry. They are finding a wide variety of ways to make medical and dental materials at the nano scale to take advantage of their enhanced physical and biological properties.The purpose of this special issue is to publish high-quality research papers as well as review articles addressing recent advances in the field of nano materials for medical and dental applications. A particular interest is given to papers exploring or discussing nano materials and nano technologies related to delivery system, bonding substitutes, and surface modification techniques applicable in these areas. For this special issue, several investigators were invited to contribute original research findings that can stimulate continuing efforts to understand the cutting-edge applications of nano materials in medicine and dentistry.

  16. A special designed library for medical imaging applications

    International Nuclear Information System (INIS)

    Lymberopoulos, D.; Kotsopoulos, S.; Zoupas, V.; Yoldassis, N.; Spyropoulos, C.

    1994-01-01

    The present paper deals with a sophisticated and flexible library of medical purpose image processing routines. It contains modules for simple as well as advanced gray or colour image processing. This library offers powerful features for medical image processing and analysis applications, thus providing the physician with a means of analyzing and estimating medical images in order to accomplish their diagnostic procedures

  17. Nuclear data for medical applications

    International Nuclear Information System (INIS)

    Capote, Roberto

    2011-01-01

    Nuclear science plays an increasingly important role in medical applications, in particular the need for radioisotopes in both cancer therapy and diagnostic techniques is very well established. Over the previous thirty years, many laboratories have reported a significant body of experimental data relevant to medical radionuclide production, and international data centres have compiled most of these data. However, till late 90s no systematic effort had been devoted to their standardization and assembly. These needs are being addressed through three IAEA Coordinated Research Projects on Nuclear Data for the Production of Radionuclides that started in 1999. Monitor cross sections to be used in charged particle measurements have been also evaluated (see http://www-nds.iaea.org/medical/monitor reactions.html). A review of IAEA recommended cross sections for the production of medical radioisotopes will be presented. Theoretical modelling of nuclear reactions will be discussed both for nuclear data evaluation and validation. The role of the Recommended Input Parameter Library (RIPL) in defining the input for production codes like EMPIRE and TALYS will be highlighted. (author)

  18. 15 CFR Notes Applicable to State... - Notes applicable to State of Understanding related to Medical Equipment:

    Science.gov (United States)

    2010-01-01

    ... 15 Commerce and Foreign Trade 2 2010-01-01 2010-01-01 false Notes applicable to State of Understanding related to Medical Equipment: applicable Notes applicable to State of Understanding related to Medical Equipment: Commerce and Foreign Trade Regulations Relating to Commerce and Foreign Trade (Continued) BUREAU OF INDUSTRY AND SECURITY,...

  19. Chromosomal location of the fosA3 and blaCTX-M genes in Proteus mirabilis and clonal spread of Escherichia coli ST117 carrying fosA3-positive IncHI2/ST3 or F2:A-:B- plasmids in a chicken farm.

    Science.gov (United States)

    He, Dandan; Liu, Lanping; Guo, Baowei; Wu, Shengjun; Chen, Xiaojie; Wang, Jing; Zeng, Zhenling; Liu, Jian-Hua

    2017-04-01

    The aim of this study was to investigate the spread and location of the fosA3 gene among Enterobacteriaceae from diseased broiler chickens. Twenty-nine Escherichia coli and seven Proteus mirabilis isolates recovered from one chicken farm were screened for the presence of plasmid-mediated fosfomycin resistance genes by PCR. The clonal relatedness of fosA3-positive isolates, the transferability and location of fosA3, and the genetic context of the fosA3 gene were determined. Seven P. mirabilis isolates with three different pulsed-field gel electrophoresis (PFGE) patterns and five E. coli isolates belonging to sequence type 117 (ST117) and phylogenetic group D were positive for fosA3 and all carried the bla CTX-M gene. In E. coli, the genetic structures IS26-ISEcp1-bla CTX-M-65 -IS26-fosA3-1758 bp-IS26 and IS26-ISEcp1-bla CTX-M-3 -bla TEM-1 -IS26-fosA3-1758 bp-IS26 were present on transferable IncHI2/ST3 and F2:A-:B- plasmids, respectively. However, fosA3 was located on the chromosome of the seven P. mirabilis isolates. IS26-ISEcp1-bla CTX-M-65 -IS26-fosA3-1758 bp-IS26 and IS26-bla CTX-M-14 -611 bp-fosA3-1222 bp-IS26 were detected in three and four P. mirabilis isolates, respectively. Minicircles that contained both fosA3 and bla CTX-M-65 were shared between E. coli and P. mirabilis. This is the first report of the fosA3 gene integrated into the chromosome of P. mirabilis isolates with the bla CTX-M gene. The emergence and clonal spread of avian pathogenic E. coli ST117 with the feature of multidrug resistance and high virulence are a serious problem. Copyright © 2017 Elsevier B.V. and International Society of Chemotherapy. All rights reserved.

  20. [Standards in Medical Informatics: Fundamentals and Applications].

    Science.gov (United States)

    Suárez-Obando, Fernando; Camacho Sánchez, Jhon

    2013-09-01

    The use of computers in medical practice has enabled novel forms of communication to be developed in health care. The optimization of communication processes is achieved through the use of standards to harmonize the exchange of information and provide a common language for all those involved. This article describes the concept of a standard applied to medical informatics and its importance in the development of various applications, such as computational representation of medical knowledge, disease classification and coding systems, medical literature searches and integration of biological and clinical sciences. Copyright © 2013 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  1. Investigation of Extensively Drug-Resistant blaOXA-23-Producing Acinetobacter baumannii Spread in a Greek Hospital.

    Science.gov (United States)

    Mavroidi, Angeliki; Katsiari, Maria; Palla, Eleftheria; Likousi, Sofia; Roussou, Zoi; Nikolaou, Charikleia; Platsouka, Evangelia D

    2017-06-01

    A rapid increase was observed in the incidence of extensively drug-resistant Acinetobacter baumannii (XDR Aba) isolates in a Greek hospital during 2014. To investigate the causes of this rise, the antimicrobial resistance profiles of all carbapenem-resistant (CARB-R) Aba isolates recovered during 2014-2015 were determined. Selected XDR Aba isolates (n = 13) were characterized by molecular methods. XDR Aba (48 isolates) represented 21.4% of the 224 CARB-R Aba recovered during the study period. The 13 selected XDR Aba isolates were positive for the blaOXA-23, the intrinsic blaOXA-51, and the adeB gene of the AdeABC efflux pump, and all belonged to the 3LST ST101, corresponding to the international clone II. Three bloodstream isolates possessed two amino acid substitutions (A138T+A226V) in the deduced amino acid sequences of the pmrB gene, which may be implicated in colistin resistance. This study demonstrates that this clone still evolves by obtaining an ever-increasing arsenal of antibiotic resistance mechanisms. The clinical characteristics of the intensive care unit (ICU) patients with XDR Aba were reviewed retrospectively. Infected ICU patients with XDR Aba displayed higher death rates compared with infected ICU patients susceptible to colistin and tigecycline CARB-R Aba, although there were no statistically significant differences. Conclusively, continuous surveillance and molecular characterization of XDR Aba, combined with strict infection control measures are mandatory for combating nosocomial infections caused by this organism.

  2. Antimicrobial susceptibility and molecular epidemiology of extended-spectrum beta-lactamase-producing Enterobacteriaceae from intensive care units at Hamad Medical Corporation, Qatar.

    Science.gov (United States)

    Sid Ahmed, Mazen A; Bansal, Devendra; Acharya, Anushree; Elmi, Asha A; Hamid, Jemal M; Sid Ahmed, Abuelhassan M; Chandra, Prem; Ibrahim, Emad; Sultan, Ali A; Doiphode, Sanjay; Bilal, Naser Eldin; Deshmukh, Anand

    2016-01-01

    The emergence of extended-spectrum beta-lactamase (ESBL)-producing isolates has important clinical and therapeutic implications. High prevalence of ESBL-producing Enterobacteriaceae has been reported in the literature for clinical samples from a variety of infection sites. The present study was undertaken to evaluate the prevalence of ESBL-producing Enterobacteriaceae, and to perform molecular characterization and antimicrobial susceptibility testing of clinical isolates from patients admitted to the intensive care units at Hamad Medical Corporation, Doha, Qatar, from November 2012 to October 2013. A total of 629 Enterobacteriaceae isolates were included in the study. Identification and susceptibility testing was performed using Phoenix (Becton Dickinson) and the ESBL producers were confirmed by double-disk potentiation as recommended by the Clinical and Laboratory Standards Institute. Molecular analysis of the ESBL producers was performed by polymerase chain reaction. In total, 109 isolates (17.3 %) were confirmed as ESBL producers and all were sensitive to meropenem in routine susceptibility assays. Most of the ESBL producers (99.1 %) were resistant to amoxicillin/clavulanic acid and ceftriaxone and 93.6 % were resistant to cefepime. Among the ESBL-producing genes, bla CTX-M (66.1 %) was the most prevalent, followed by bla SHV (53.2 %) and bla TEM (40.4 %). These findings show the high prevalence of ESBL-producing Enterobacteriaceae within the intensive care units at Hamad Medical Corporation, Qatar, and emphasize the need for judicious use of antibiotics and the implementation of strict infection control measures.

  3. A special designed library for medical imaging applications

    Energy Technology Data Exchange (ETDEWEB)

    Lymberopoulos, D; Kotsopoulos, S; Zoupas, V; Yoldassis, N [Departmeent of Electrical Engineering, University of Patras, Patras 26 110 Greece (Greece); Spyropoulos, C [School of Medicine, Regional University Hospital, University of Patras, Patras 26 110 Greece (Greece)

    1994-12-31

    The present paper deals with a sophisticated and flexible library of medical purpose image processing routines. It contains modules for simple as well as advanced gray or colour image processing. This library offers powerful features for medical image processing and analysis applications, thus providing the physician with a means of analyzing and estimating medical images in order to accomplish their diagnostic procedures. 6 refs, 1 figs.

  4. Integrated medication management in mHealth applications.

    Science.gov (United States)

    Ebner, Hubert; Modre-Osprian, Robert; Kastner, Peter; Schreier, Günter

    2014-01-01

    Continuous medication monitoring is essential for successful management of heart failure patients. Experiences with the recently established heart failure network HerzMobil Tirol show that medication monitoring limited to heart failure specific drugs could be insufficient, in particular for general practitioners. Additionally, some patients are confused about monitoring only part of their prescribed drugs. Sometimes medication will be changed without informing the responsible physician. As part of the upcoming Austrian electronic health record system ELGA, the eMedication system will collect prescription and dispensing data of drugs and these data will be accessible to authorized healthcare professionals on an inter-institutional level. Therefore, we propose two concepts on integrated medication management in mHealth applications that integrate ELGA eMedication and closed-loop mHealth-based telemonitoring. As a next step, we will implement these concepts and analyze--in a feasibility study--usability and practicability as well as legal aspects with respect to automatic data transfer from the ELGA eMedication service.

  5. Medical applications of model-based dynamic thermography

    Science.gov (United States)

    Nowakowski, Antoni; Kaczmarek, Mariusz; Ruminski, Jacek; Hryciuk, Marcin; Renkielska, Alicja; Grudzinski, Jacek; Siebert, Janusz; Jagielak, Dariusz; Rogowski, Jan; Roszak, Krzysztof; Stojek, Wojciech

    2001-03-01

    The proposal to use active thermography in medical diagnostics is promising in some applications concerning investigation of directly accessible parts of the human body. The combination of dynamic thermograms with thermal models of investigated structures gives attractive possibility to make internal structure reconstruction basing on different thermal properties of biological tissues. Measurements of temperature distribution synchronized with external light excitation allow registration of dynamic changes of local temperature dependent on heat exchange conditions. Preliminary results of active thermography applications in medicine are discussed. For skin and under- skin tissues an equivalent thermal model may be determined. For the assumed model its effective parameters may be reconstructed basing on the results of transient thermal processes. For known thermal diffusivity and conductivity of specific tissues the local thickness of a two or three layer structure may be calculated. Results of some medical cases as well as reference data of in vivo study on animals are presented. The method was also applied to evaluate the state of the human heart during the open chest cardio-surgical interventions. Reference studies of evoked heart infarct in pigs are referred, too. We see the proposed new in medical applications technique as a promising diagnostic tool. It is a fully non-invasive, clean, handy, fast and affordable method giving not only qualitative view of investigated surfaces but also an objective quantitative measurement result, accurate enough for many applications including fast screening of affected tissues.

  6. Radiation protection in medical applications

    International Nuclear Information System (INIS)

    Sacc, R.A.; Rubiolo, J.; Herrero, F.

    1998-01-01

    Full text: The goal of this paper is to identify the areas in which radiation protection is actually needed and the relative importance of protection measures. A correlation between the different medical applications of the ionizing radiations and the associated risks, mainly due to ignorance, has been a constant throughout the history of mankind. At the beginning, the accidents were originated in research nuclear laboratories working on the atomic bomb, while the incidents occurred in medical areas because of virtual ignorance of the harmful effects on humans. The 60's were characterized by the oil fever, which produced innumerable accidents due to the practice of industrial radiography; in the 70's the use of radiations on medical applications was intensified, to such and extent that a new type of victim appeared: the patient. Unfortunately, during 80's and 90's the number of accidents in different medical practices has increased, projecting the occurred in Zaragoza (Spain) on 1990 with a linear accelerator for radiotherapy treatments. In some developed countries, foreseeing the probability of producing biological effects as a result of different radiology practices, more strict security rules are adopted to guarantee the application of the three principles of the radioprotection: justification, optimization and limitation of individual dose. In this way, in the U.S.A., the Joint Commission on Accreditation of Health Care Organization (JCAHO), favors a vigilance politics in the different departments of Radiodiagnostic and Nuclear Medicine to secure an effective management in security, communications and quality control, in which the medical physicists play an important role. One of the requirements for example is to attach the value of entrance exposition dose in the radiological diagnostic report. So, the doses in the different organs are compared with the tabulated doses. Basically, a quality control programme is designed to minimize the risks for patients

  7. Bla-bla-bla: video chat service on the Internet - a market feasibility study

    OpenAIRE

    Lindgreen, Adam; Antioco, Michael; Wetzels, Martin

    2004-01-01

    The Internet is changing the way that companies carry out their business and, in fact, constitutes an entirely new application domain, which makes product innovation possible. Moreover, it is a new medium for reaching consumers, which is a central preoccupation to organisations in the current business market. Here interest lies in video chatting on the Internet. This is a type of service that adds video support to chatting using a Web cam and is gradually attracting more Internet users. The p...

  8. Applications of computational tools in biosciences and medical engineering

    CERN Document Server

    Altenbach, Holm

    2015-01-01

     This book presents the latest developments and applications of computational tools related to the biosciences and medical engineering. It also reports the findings of different multi-disciplinary research projects, for example, from the areas of scaffolds and synthetic bones, implants and medical devices, and medical materials. It is also shown that the application of computational tools often requires mathematical and experimental methods. Computational tools such as the finite element methods, computer-aided design and optimization as well as visualization techniques such as computed axial tomography open up completely new research fields that combine the fields of engineering and bio/medical. Nevertheless, there are still hurdles since both directions are based on quite different ways of education. Often even the “language” can vary from discipline to discipline.

  9. Pre-Medical Preparation in Microbiology among Applicants and Matriculants in Osteopathic Medical School in the United States.

    Science.gov (United States)

    Ramos, Raddy L; Guercio, Erik; Martinez, Luis R

    2017-01-01

    It is recognized that medical school curricula contain significant microbiology-related content as part of the training of future physicians who will be responsible stewards of antimicrobials. Surprisingly, osteopathic and allopathic medical schools do not require pre-medical microbiology coursework, and the extent to which medical students have completed microbiology coursework remains poorly understood. In this report, we show that fewer than 3% of applicants and matriculants to osteopathic medical school (OMS) have completed an undergraduate major or minor in microbiology, and fewer than 17% of applicants and matriculants to OMS have completed one or more microbiology-related courses. These data demonstrate limited pre-medical microbiology-related knowledge among osteopathic medical students, which may be associated with an increase in perceived stress when learning this content or during clinical rotations as well as a potential lack of interest in pursuing a career in infectious diseases.

  10. Functionalized Nanodiamonds for Biological and Medical Applications.

    Science.gov (United States)

    Lai, Lin; Barnard, Amanda S

    2015-02-01

    Nanodiamond is a promising material for biological and medical applications, owning to its relatively inexpensive and large-scale synthesis, unique structure, and superior optical properties. However, most biomedical applications, such as drug delivery and bio-imaging, are dependent upon the precise control of the surfaces, and can be significantly affected by the type, distribution and stability of chemical funtionalisations of the nanodiamond surface. In this paper, recent studies on nanodiamonds and their biomedical applications by conjugating with different chemicals are reviewed, while highlighting the critical importance of surface chemical states for various applications.

  11. Molecular characterization of extended-spectrum β-lactamase, plasmid-mediated AmpC cephalosporinase and carbapenemase genes among Enterobacteriaceae isolates in five medical centres of East and West Azerbaijan, Iran.

    Science.gov (United States)

    Sadeghi, Mohammad Reza; Ghotaslou, Reza; Akhi, Mohammad Taghi; Asgharzadeh, Mohammad; Hasani, Alka

    2016-11-01

    Very little is known about the occurrence and various types of extended-spectrum β-lactamase (ESBL), AmpC and carbapenemase in Iran. The aims of this study were to determine the prevalence of ESBLs, AmpCs and carbapenemase genes among Enterobacteriaceae in Azerbaijan and to characterize the genetic composition of the detected genes. A total of 307 Enterobacteriaceae isolates, recovered from five medical centres, were screened for ESBL, AmpC and carbapenemase activities by the disc diffusion method and phenotypic confirmatory tests. The 162 selected strains (third-generation cephalosporins, cefoxitin- or carbapenem-resistant strains with positive or negative phenotypic confirmatory tests) were selected for multiplex PCR screening for β-lactamase genes, and detected genes were confirmed by sequencing. Of 162 isolates, 156 harboured 1 to 6 β-lactamase genes of 41 types. The most prevalent genes were blaTEM-1 (29.9 %), followed by blaCTX-M-15 (25.7 %). Plasmid-mediated AmpC was detected in 66 strains (21.5 %) alone or in combination with other genes. Carbapenemase-encoding genes were detected in 18 strains (5.8 %) of 27 carbapenem-non-susceptible isolates including 11, 7, 3 and 1 cases of blaOXA-48, blaNDM-1, blaKPC-2 and blaKPC-3 genes, respectively. Interestingly, 148 (94.8 %) of 156 strains with any β-lactamase gene were found to have a multidrug-resistant pattern. The rate of resistance to β-lactams and multidrug-resistant Enterobacteriaceae is high in Azerbaijan. All positive strains for carbapenemase genes were resistant to all β-lactams. The present study reveals the high occurrence of CTX-M-type ESBLs followed by TEM and SHV variants among Enterobacteriaceae isolates. East Azerbaijan seems to be an alarming focus for OXA-48, NDM-1 and KPC dissemination.

  12. Multilevel Modeling and Policy Development: Guidelines and Applications to Medical Travel

    Science.gov (United States)

    Garcia-Garzon, Eduardo; Zhukovsky, Peter; Haller, Elisa; Plakolm, Sara; Fink, David; Petrova, Dafina; Mahalingam, Vaishali; Menezes, Igor G.; Ruggeri, Kai

    2016-01-01

    Medical travel has expanded rapidly in recent years, resulting in new markets and increased access to medical care. Whereas several studies investigated the motives of individuals seeking healthcare abroad, the conventional analytical approach is limited by substantial caveats. Classical techniques as found in the literature cannot provide sufficient insight due to the nested nature of data generated. The application of adequate analytical techniques, specifically multilevel modeling, is scarce to non-existent in the context of medical travel. This study introduces the guidelines for application of multilevel techniques in public health research by presenting an application of multilevel modeling in analyzing the decision-making patterns of potential medical travelers. Benefits and potential limitations are discussed. PMID:27252672

  13. Multilevel Modeling and Policy Development: Guidelines and Applications to Medical Travel.

    Science.gov (United States)

    Garcia-Garzon, Eduardo; Zhukovsky, Peter; Haller, Elisa; Plakolm, Sara; Fink, David; Petrova, Dafina; Mahalingam, Vaishali; Menezes, Igor G; Ruggeri, Kai

    2016-01-01

    Medical travel has expanded rapidly in recent years, resulting in new markets and increased access to medical care. Whereas several studies investigated the motives of individuals seeking healthcare abroad, the conventional analytical approach is limited by substantial caveats. Classical techniques as found in the literature cannot provide sufficient insight due to the nested nature of data generated. The application of adequate analytical techniques, specifically multilevel modeling, is scarce to non-existent in the context of medical travel. This study introduces the guidelines for application of multilevel techniques in public health research by presenting an application of multilevel modeling in analyzing the decision-making patterns of potential medical travelers. Benefits and potential limitations are discussed.

  14. Nuclear data for medical applications: an overview

    International Nuclear Information System (INIS)

    Qaim, S.M.

    2001-01-01

    A brief introduction to nuclear data in medicine is given. The choice of a radioisotope for medical application demands an accurate knowledge of radioactive decay data. Short-lived single photon and β + -emitters are preferred for diagnostic investigations, and longer-lived corpuscular radiation emitting radioisotopes for endoradiotherapy. The nuclear reaction cross section data, on the other hand, are needed for optimising the production routes. Besides radioactive isotopes, the use of ionising radiation in therapy is discussed. External radiation therapy has achieved an important place in medicine. The role of nuclear data is briefly discussed; they are needed for radiation dose calculations. The hitherto rather neglected activation products in proton therapy are considered. The methodology of development of a nuclear data file for medical applications is outlined. (orig.)

  15. Applications of medical wireless LAN systems (MedLAN)

    OpenAIRE

    Banitsas, KA; Istepanian, RSH; Tachakra, S

    2002-01-01

    This is a post-peer-review, pre-copyedit version of an article published in Journal of Medical Marketing. The definitive publisher-authenticated version "Konstantinos A. Banitsas, R.S.H. Istepanian, Sapal Tachakra. Applications of medical Wireless LAN systems (MedLAN). Journal of Medical Marketing, Volume 2, Number 2, 1 January 2002 , pp. 136-142(7)" is available online at: http://www.ingentaconnect.com/content/pal/jomm/2002/00000002/00000002/art00008. In this paper the Wireless LAN (WLAN)...

  16. Regulatory frameworks for mobile medical applications.

    Science.gov (United States)

    Censi, Federica; Mattei, Eugenio; Triventi, Michele; Calcagnini, Giovanni

    2015-05-01

    A mobile application (app) is a software program that runs on mobile communication devices such as a smartphone. The concept of a mobile medical app has gained popularity and diffusion but its reference regulatory context has raised discussion and concerns. Theoretically, a mobile app can be developed and uploaded easily by any person or entity. Thus, if an app can have some effects on the health of the users, it is mandatory to identify its reference regulatory context and the applicable prescriptions.

  17. Preface book Microfluidics for medical applications

    NARCIS (Netherlands)

    van den Berg, Albert; Segerink, Loes Irene

    2015-01-01

    This book presents an overview of the major microfluidics techniques and platforms used for medicine and medical applications, providing the reader with an overview of the recent developments in this field. It is divided in three parts: (1) tissue and organs on-chip, (2) microfluidics for medicine

  18. Integration of the blaNDM-1 carbapenemase gene into Proteus genomic island 1 (PGI1-PmPEL) in a Proteus mirabilis clinical isolate.

    Science.gov (United States)

    Girlich, Delphine; Dortet, Laurent; Poirel, Laurent; Nordmann, Patrice

    2015-01-01

    To decipher the mechanisms and their associated genetic determinants responsible for β-lactam resistance in a Proteus mirabilis clinical isolate. The entire genetic structure surrounding the β-lactam resistance genes was characterized by PCR, gene walking and DNA sequencing. Genes encoding the carbapenemase NDM-1 and the ESBL VEB-6 were located in a 38.5 kb MDR structure, which itself was inserted into a new variant of the Proteus genomic island 1 (PGI1). This new PGI1-PmPEL variant of 64.4 kb was chromosomally located, as an external circular form in the P. mirabilis isolate, suggesting potential mobility. This is the first known description of the bla(NDM-1) gene in a genomic island structure, which might further enhance the spread of the bla(NDM-1) carbapenemase gene among enteric pathogens. © The Author 2014. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  19. Imaging requirements for medical applications of additive manufacturing.

    Science.gov (United States)

    Huotilainen, Eero; Paloheimo, Markku; Salmi, Mika; Paloheimo, Kaija-Stiina; Björkstrand, Roy; Tuomi, Jukka; Markkola, Antti; Mäkitie, Antti

    2014-02-01

    Additive manufacturing (AM), formerly known as rapid prototyping, is steadily shifting its focus from industrial prototyping to medical applications as AM processes, bioadaptive materials, and medical imaging technologies develop, and the benefits of the techniques gain wider knowledge among clinicians. This article gives an overview of the main requirements for medical imaging affected by needs of AM, as well as provides a brief literature review from existing clinical cases concentrating especially on the kind of radiology they required. As an example application, a pair of CT images of the facial skull base was turned into 3D models in order to illustrate the significance of suitable imaging parameters. Additionally, the model was printed into a preoperative medical model with a popular AM device. Successful clinical cases of AM are recognized to rely heavily on efficient collaboration between various disciplines - notably operating surgeons, radiologists, and engineers. The single main requirement separating tangible model creation from traditional imaging objectives such as diagnostics and preoperative planning is the increased need for anatomical accuracy in all three spatial dimensions, but depending on the application, other specific requirements may be present as well. This article essentially intends to narrow the potential communication gap between radiologists and engineers who work with projects involving AM by showcasing the overlap between the two disciplines.

  20. Podcasting as a novel way to communicate with medical school applicants.

    Science.gov (United States)

    Ferguson, Benjamin D; Bister, Mary K; Krapec, Joni N

    2014-09-01

    Podcasting in medical education is becoming more widely used and may be a useful tool for communicating with applicants to medical school. Given recent trends in the popularity of podcasting and mobile media, we created a podcast to communicate more effectively with applicants to our medical school as well as with the broader premedical community. The purpose of this study was to characterize the listening habits and motivations of our audience and compare the podcast's benefits to those of other resources. We additionally sought to understand patterns by which our podcast was consumed by a premedical audience. We surveyed medical school applicants who interviewed at the University of Chicago Pritzker School of Medicine for matriculation in 2013. Forty-one percent of those surveyed had listened to the podcast prior to their interview. Only 12 % of listeners accessed the podcast using a mobile device. Ninety-two percent of listeners felt that it faithfully represented the medical school, and 81 % felt that listening would encourage the decision to matriculate. A majority of listeners responded that the podcast was more helpful than other traditional resources. This is the first use of podcasting in medical school admissions and represents a novel way to communicate with prospective students. Our findings demonstrate that podcasting can be an effective tool for communicating with applicants to medical school and highlight its usefulness in recruitment. This method of communication could be adopted by other medical schools to enhance the ways in which they inform their own prospective medical students.

  1. Teleworks: a CSCW application for remote medical diagnosis support and teleconsultation.

    Science.gov (United States)

    Makris, L; Kamilatos, I; Kopsacheilis, E V; Strintzis, M G

    1998-06-01

    The present paper describes methods for the design of both synchronous and asynchronous computer-supported cooperative work (CSCW) procedures suitable for the medical application area and specifically for the purpose of medical teleconsultation and remote diagnosis support. The experimental implementation of a CSCW system built upon a PC/Windows platform is detailed as an example of a low-cost system suitable for adoption in a wide range of medical teleconsultation applications.

  2. Application essays and future performance in medical school: are they related?

    Science.gov (United States)

    Dong, Ting; Kay, Allen; Artino, Anthony R; Gilliland, William R; Waechter, Donna M; Cruess, David; DeZee, Kent J; Durning, Steven J

    2013-01-01

    There is a paucity of research on whether application essays are a valid indicator of medical students' future performance. The goal is to score medical school application essays systematically and examine the correlations between these essay scores and several indicators of student performance during medical school and internship. A journalist created a scoring rubric based on the journalism literature and scored 2 required essays of students admitted to our university in 1 year (N = 145). We picked 7 indicators of medical school and internship performance and correlated these measures with overall essay scores: preclinical medical school grade point average (GPA), clinical medical school GPA, cumulative medical school GPA, U.S. Medical Licensing Exam (USMLE) Step 1 and 2 scores, and scores on a program director's evaluation measuring intern professionalism and expertise. We then examined the Pearson and Spearman correlations between essay scores and the outcomes. Essay scores did not vary widely. American Medical College Application Service essay scores ranged from 3.3 to 4.5 (M = 4.11, SD = 0.15), and Uniformed Services University of the Health Sciences essay scores ranged from 2.9 to 4.5 (M = 4.09, SD = 0.17). None of the medical school or internship performance indicators was significantly correlated with the essay scores. These findings raise questions about the utility of matriculation essays, a resource-intensive admission requirement.

  3. Antimicrobial susceptibility, risk factors and prevalence of bla cefotaximase, temoneira, and sulfhydryl variable genes among Escherichia coli in community-acquired pediatric urinary tract infection.

    Science.gov (United States)

    Nisha, Kallyadan V; Veena, Shetty A; Rathika, Shenoy D; Vijaya, Shenoy M; Avinash, Shetty K

    2017-01-01

    The emergence of extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli has become an important challenge among pediatric patients with community-acquired urinary tract infection (UTI). The aim of this study was to assess the antimicrobial susceptibility patterns, associated risk factors and to survey the frequency of bla cefotaximase (CTX-M), bla temoneira (TEM), and bla sulfhydryl variable (SHV) genotypes in ESBL-producing E. coli isolated from children with community-acquired UTI. This was a prospective study conducted from November 2012 to March 2016 in a tertiary care center. E. coli isolated in urine cultures from children aged ≤18 years was identified and confirmed for ESBL production. ESBL-positive strains were screened for ESBL encoding genes. Chi-square test and Fisher's exact test were used to compare the difference in antibiotic susceptibility with respect to ESBL positive and negative, and binary logistic regression was used to identify the risk factors associated with ESBL production. Among 523 E. coli isolates, 196 (37.5%) were ESBL positive, >90% were resistant to cephalosporins, and 56% were resistant to fluoroquinolones. Least resistance was observed for imipenem, netilmicin, and nitrofurantoin (2%, 8.6%, 15.3%). Association between ESBL production and drug resistance was significant for ceftazidime ( P antibiotics were the common risk factors. ESBL-producing E. coli from community-acquired pediatric UTI carries more than one type of beta-lactamase coding genes correlating their increased antibiotic resistance. Aggressive infection control policy, routine screening for detecting ESBL isolates in clinical samples, and antimicrobial stewardship are the keys to prevent their dissemination in community settings.

  4. Medical applications of radioactive material

    International Nuclear Information System (INIS)

    Seidel, C.W.

    1990-01-01

    Hospitals, clinics and other medical complexes are probably the most extensive users of radioactive solutions of Tc-99m, Tl-201, Ga-67, I-123, Xe-133 and radiopharmaceuticals as diagnostic tools to evaluate the dynamic function of various organs in the body, detect cancerous tumors, sites of infection or other bodily dysfunctions. Examples of monitoring blood flow to a stressed heart and to the brain of a cocaine addict are shown. Short-lived positron emitting radionuclides (C-11, N-13, O-15 and F-18) are produced right in a hospital. Other radionuclides are used as therapeutics to reduce tumor size or kill diseased cells. Radioimmunoassay (RIA) is another medical diagnostic tool that is useful in the early detection of the AIDS virus and cancer as well as many other illnesses. Biological researchers, using radioactive biological compounds, have developed many of todays medical diagnostic procedures. Most of the recent Nobel Laureates in the life sciences have used radiolabeled compounds in their research. A brief review of these applications with several examples is presented

  5. Characterization of Acinetobacter baumannii clinical isolates carrying bla(OXA-23) carbapenemase and 16S rRNA methylase armA genes in Yemen.

    Science.gov (United States)

    Bakour, Sofiane; Alsharapy, Samer Ahmed; Touati, Abdelaziz; Rolain, Jean-Marc

    2014-12-01

    The aim of this study was to investigate the molecular support of resistance to carbapenems, aminoglycosides, and fluoroquinolones in Acinetobacter baumannii clinical isolates collected from Yemen hospital. Three A. baumannii were isolated in February 2013 from three patients hospitalized at Al-Thawra University Hospital in Sana'a, Yemen. Antibiotic susceptibility testing was performed using the disk diffusion and E-test methods. Carbapenemase production was carried out by the modified Hodge test (MHT) and imipenem-ethylenediaminetetraacetic acid (EDTA) methods. Carbapenem, aminoglycoside, and fluoroquinolone resistance determinants were studied by polymerase chain reaction and sequencing. The epidemiological relatedness of the three strains was studied using multilocus sequence typing (MLST). The isolates were resistant to almost all antibiotics tested with very high imipenem, amikacin, and ciprofloxacin minimum inhibitory concentrations (>32, >256, and >32 mg/L, respectively). The microbiological tests showed that the three A. baumannii were MHT positive, besides, the activity of β-lactamases was not inhibited by EDTA. All the three isolates contained the naturally occurring bla(OXA-51)-like gene and the bla(OXA-23)-like carbapenemase-encoding gene. The 16S rRNA methylase armA gene was detected in the three isolates. In addition, screening for genes encoding the aminoglycoside-modifying enzymes (AMEs) demonstrated that one isolate contained the acetyltransferase gene aac(6')-Ib. Fluoroquinolone resistance was associated with a single mutation Ser83Leu in the quinolone resistance determining region of the gyrA gene in all isolates. The MLST showed that the sequence type (ST) obtained corresponds to ST2 for the three strains. Here we report the first identification of multidrug-resistant A. baumannii isolates harboring the bla(OXA-23)-like gene, AMEs [aac(6')-Ib], and the 16S rRNA methylase (armA) in the Yemen hospital.

  6. Nuclear data for medical applications: an overview

    International Nuclear Information System (INIS)

    Qaim, S.M.

    2002-01-01

    A brief introduction to nuclear data in medicine is given. The choice of a radioisotope for medical application demands an accurate knowledge of radioactive decay data. Short-lived single photon and beta sup + -emitters are preferred for diagnostic investigations, and longer-lived corpuscular radiation emitting radioisotopes for endo radiotherapy. The nuclear reaction cross section data, on the other hand, are needed for optimising the production routes. Besides radioactive isotopes, the use of ionising radiation in therapy is discussed. External radiation therapy has achieved an important place in medicine. The role of nuclear data is briefly discussed; they are needed for radiation dose calculations. The hitherto rather neglected activation products in proton therapy are considered. The methodology of development of a nuclear data file for medical applications is outlined. (author)

  7. From Particle Physics to Medical Applications

    Science.gov (United States)

    Dosanjh, Manjit

    2017-06-01

    CERN is the world's largest particle physics research laboratory. Since it was established in 1954, it has made an outstanding contribution to our understanding of the fundamental particles and their interactions, and also to the technologies needed to analyse their properties and behaviour. The experimental challenges have pushed the performance of particle accelerators and detectors to the limits of our technical capabilities, and these groundbreaking technologies can also have a significant impact in applications beyond particle physics. In particular, the detectors developed for particle physics have led to improved techniques for medical imaging, while accelerator technologies lie at the heart of the irradiation methods that are widely used for treating cancer. Indeed, many important diagnostic and therapeutic techniques used by healthcare professionals are based either on basic physics principles or the technologies developed to carry out physics research. Ever since the discovery of x-rays by Roentgen in 1895, physics has been instrumental in the development of technologies in the biomedical domain, including the use of ionizing radiation for medical imaging and therapy. Some key examples that are explored in detail in this book include scanners based on positron emission tomography, as well as radiation therapy for cancer treatment. Even the collaborative model of particle physics is proving to be effective in catalysing multidisciplinary research for medical applications, ensuring that pioneering physics research is exploited for the benefit of all.

  8. Medical applications of superconducting quantum interference devices

    International Nuclear Information System (INIS)

    Uehara, Gen

    2011-01-01

    SQUIDs (Superconducting Quantum Interference Devices) are applied to clinical areas and basic medical science fields because of their potential for measuring a minute magnetic signal from the human body. Magnetoencephalography, one of their applications, is used for the functional mapping of the brain cortex before surgery and the localization of focus of epilepsy. Recently, their applications to the early-stage detection of dementia and the localization of brain ischemia are suggested. Another application of SQUIDs is magnetospinography, which detects the conduction block in spinal cord signal propagation. (author)

  9. Medical applications of synchrotron radiation

    International Nuclear Information System (INIS)

    Thomlinson, W.

    1991-10-01

    Ever since the first diagnostic x-ray was done in the United States on February 3, 1896, the application of ionizing radiation to the field of medicine has become increasingly important. Both in clinical medicine and basic research the use of x-rays for diagnostic imaging and radiotherapy is now widespread. Radiography, angiography, CAT and PETT scanning, mammography, and nuclear medicine are all examples of technologies developed to image the human anatomy. In therapeutic applications, both external and internal sources of radiation are applied to the battle against cancer. The development of dedicated synchrotron radiation sources has allowed exciting advances to take place in many of these applications. The new sources provide tunable, high-intensity monochromatic beams over a wide range of energies which can be tailored to specific programmatic needs. This paper surveys those areas of medical research in which synchrotron radiation facilities are actively involved

  10. Medical applications of synchrotron radiation

    International Nuclear Information System (INIS)

    Thomlinson, W.

    1992-01-01

    Ever since the first diagnostic X-ray was done in the United States on February 3, 1896, the application of ionizing radiation to the field of medicine has become incrasingly important. Both in clinical medicine and basic research the use of X-rays for diagnostic imaging and radiotherapy is now widespread. Radiography, angiography, CAT and PETT scanning, mammography, and nuclear medicine are all examples of technologies developed to image the human anatomy. In therapeutic applications, both external and internal sources of radiation are applied to the battle against cancer. The development of dedicated synchrotron radiation sources has allowed exciting advances to take place in many of these applications. The new sources provide tunable, high-intensity monochromatic beams over a wide range of energies which can be tailored to specific programmatic needs. This paper surveys those areas of medical research in which synchrotron radiation facilities are actively involved. (orig.)

  11. Medical applications for pharmacists using mobile devices.

    Science.gov (United States)

    Aungst, Timothy Dy

    2013-01-01

    Mobile devices (eg, smartphones, tablet computers) have become ubiquitous and subsequently there has been a growth in mobile applications (apps). Concurrently, mobile devices have been integrated into health care practice due to the availability and quality of medical apps. These mobile medical apps offer increased access to clinical references and point-of-care tools. However, there has been little identification of mobile medical apps suitable for the practice of pharmacy. To address the shortage of recommendations of mobile medical apps for pharmacists in daily practice. Mobile medical apps were identified via the iTunes and Google Play Stores via the "Medical" app categories and key word searches (eg, drug information, medical calculators). In addition, reviews provided by professional mobile medical app review websites were used to identify apps. Mobile medical apps were included if they had been updated in the previous 3 months, were available in the US, used evidence-based information or literature support, had dedicated app support, and demonstrated stability. Exclusion criteria included apps that were not available in English, had advertisement bias, used nonreferenced sources, were available only via an institution-only subscription, and were web-based portals. Twenty-seven mobile apps were identified and reviewed that involved general pharmacy practice, including apps that involved drug references, clinical references, medical calculators, laboratory references, news and continuing medical education, and productivity. Mobile medical apps have a variety of features that are beneficial to pharmacy practice. Individual clinicians should consider several characteristics of these apps to determine which are suitable to incorporate into their daily practice.

  12. An H-module linear actuator for medical equipment applications

    DEFF Research Database (Denmark)

    Liu, Xiao; Wu, Keyuan; ye, yunyue

    2012-01-01

    An H-module linear actuator (HMLA) is proposed in this paper for medical equipment applications. Compared to the existing linear actuators used in medical equipment, the proposed H-module linear actuator has much lower normal force, which makes use of an additional air-suspension system unnecessary...

  13. Resistencia a los antibióticos beta-lactámicos Carbapenems mediada por el gen blaKPC en Klebsiella pneumoniae

    Directory of Open Access Journals (Sweden)

    Aura Dayana del Carmen Falco Restrepo

    2015-12-01

    Full Text Available  Los carbapenems son antibióticos â-lactamicos de amplio espectro que se utilizan como terapia de primera línea para tratar pacientes con infecciones graves. Actualmente, la resistencia a carbapenems se asocia con la presencia de â-lactamasas capaces de hidrolizar estos antibióticos. La carbapenemasa de clase A más común es KPC, la cual es codificada por el gen blaKPC que generalmente, se encuentra ubicado en plásmidos. La selección y la rápida propagación de aislados de Klebsiella pneumoniae portadores de estas carbapenemasas se ha convertido en un problema de salud pública a nivel mundial. Esta mini-revision describe uno de los mecanismos más frecuentes de resistencia a carbapenems como lo son las enzimas carbapenemasas tipo KPC. Además se describen las variantes del gen blaKPC asi como el elemento genético móvil, el transposon Tn4401, el principal responsable de su diseminación entre géneros y especies bacterianas diferentes. Finalmente se hace una pequeña revisión cronológica de los reportes de la enzima KPC a nivel mundial.

  14. [Assessment of two applications of medication self-management in older patients. Qualitative study].

    Science.gov (United States)

    Carrillo, I; Guilabert, M; Pérez-Jover, V; Mira, J J

    2015-01-01

    The aging population and the growing use of technology are two realities of modern society. Developing tools to support medication self-management to polymedicated elderly may contribute to increase their safety. To know how patients polymedicated and older than 64 years manage dose their medication and assessment the utility of two medication self-management applications, specifically analyzing management systems, medication errors and positive and improvable aspects of each of the tools presented. Seven focal groups with 59 patients from associations and health departments were conducted. In such meetings, they received the applications and they were encouraged to use it. Then, a several group questions were asked them about their health status, how they managed their medication and their assessment about the applications. Most participants reported to use memory strategies to take correctly their medication. They assessed positively the applications although some of them showed resistance to incorporate it in their daily routine. The simple interface and ease of use were the characteristics of the applications most appreciated by patients. Is possible to foster among elderly patients the use of technological tools to support the proper administration of medications with purpose is to decrease errors and increase safety. When designing health applications is necessary to take into account the preferences of those who are targeted. Copyright © 2014 SECA. Published by Elsevier Espana. All rights reserved.

  15. Properties and medical applications of shape memory alloys.

    Science.gov (United States)

    Tarniţă, Daniela; Tarniţă, D N; Bîzdoacă, N; Mîndrilă, I; Vasilescu, Mirela

    2009-01-01

    One of the most known intelligent material is nitinol, which offers many functional advantages over conventional implantable alloys. Applications of SMA to the biomedical field have been successful because of their functional qualities, enhancing both the possibility and the execution of less invasive surgeries. The biocompatibility of these alloys is one of their most important features. Different applications exploit the shape memory effect (one-way or two-way) and the super elasticity, so that they can be employed in orthopedic and cardiovascular applications, as well as in the manufacture of new surgical tools. Therefore, one can say that smart materials, especially SMA, are becoming noticeable in the biomedical field. Super elastic NiTi has become a material of strategic importance as it allows to overcome a wide range of technical and design issues relating to the miniaturization of medical devices and the increasing trend for less invasive and therefore less traumatic procedures. This paper will consider just why the main properties of shape memory alloys hold so many opportunities for medical devices and will review a selection of current applications.

  16. Magnetic nanoparticle design for medical application

    Czech Academy of Sciences Publication Activity Database

    Mornet, S.; Vasseur, S.; Grasset, F.; Veverka, Pavel; Goglio, G.; Demourgues, A.; Portier, J.; Pollert, Emil; Duguet, E.

    2006-01-01

    Roč. 34, - (2006), s. 237-247 ISSN 0079-6786 R&D Projects: GA AV ČR(CZ) 1QS100100553; GA AV ČR(CZ) KAN200200651 Institutional research plan: CEZ:AV0Z10100521 Keywords : magnetic nanoparticles * medical applications * magnetic resonance imaging * magnetic hyperthermia Subject RIV: BM - Solid Matter Physics ; Magnetism Impact factor: 2.500, year: 2006

  17. Medical applications of atomic force microscopy and Raman spectroscopy.

    Science.gov (United States)

    Choi, Samjin; Jung, Gyeong Bok; Kim, Kyung Sook; Lee, Gi-Ja; Park, Hun-Kuk

    2014-01-01

    This paper reviews the recent research and application of atomic force microscopy (AFM) and Raman spectroscopy techniques, which are considered the multi-functional and powerful toolkits for probing the nanostructural, biomechanical and physicochemical properties of biomedical samples in medical science. We introduce briefly the basic principles of AFM and Raman spectroscopy, followed by diagnostic assessments of some selected diseases in biomedical applications using them, including mitochondria isolated from normal and ischemic hearts, hair fibers, individual cells, and human cortical bone. Finally, AFM and Raman spectroscopy applications to investigate the effects of pharmacotherapy, surgery, and medical device therapy in various medicines from cells to soft and hard tissues are discussed, including pharmacotherapy--paclitaxel on Ishikawa and HeLa cells, telmisartan on angiotensin II, mitomycin C on strabismus surgery and eye whitening surgery, and fluoride on primary teeth--and medical device therapy--collagen cross-linking treatment for the management of progressive keratoconus, radiofrequency treatment for skin rejuvenation, physical extracorporeal shockwave therapy for healing of Achilles tendinitis, orthodontic treatment, and toothbrushing time to minimize the loss of teeth after exposure to acidic drinks.

  18. Photon and electron interaction databases and their use in medical applications

    International Nuclear Information System (INIS)

    Cullen, D.E.

    1994-05-01

    This paper discusses the All Particle-Method photon and electron interaction, and atomic relaxation data bases, that were initially developed for use in medical applications. Currently these data bases are being used in both medical and industrial applications. The All Particle Method data bases are designed to allow modelling of individual collisions in as much detail as possible. Elastic scattering can be modelled as single, as opposed to multiple, scattering events. Ionization can be modelled at the atomic subshell level, to define which subshell was ionized, spectrum of the initially emitted electron, as well as the spectra of electron and photons emitted as the atom relaxes back to neutrality. These data bases are currently being used in applications involving rather small spatial regions, where detailed calculations of individual events are required. While initially designed for use in medical applications, these data bases are now being used in a variety of industrial applications, e.g., transport in microelectronics

  19. An evaluation on CT image acquisition method for medical VR applications

    Science.gov (United States)

    Jang, Seong-wook; Ko, Junho; Yoo, Yon-sik; Kim, Yoonsang

    2017-02-01

    Recent medical virtual reality (VR) applications to minimize re-operations are being studied for improvements in surgical efficiency and reduction of operation error. The CT image acquisition method considering three-dimensional (3D) modeling for medical VR applications is important, because the realistic model is required for the actual human organ. However, the research for medical VR applications has focused on 3D modeling techniques and utilized 3D models. In addition, research on a CT image acquisition method considering 3D modeling has never been reported. The conventional CT image acquisition method involves scanning a limited area of the lesion for the diagnosis of doctors once or twice. However, the medical VR application is required to acquire the CT image considering patients' various postures and a wider area than the lesion. A wider area than the lesion is required because of the necessary process of comparing bilateral sides for dyskinesia diagnosis of the shoulder, pelvis, and leg. Moreover, patients' various postures are required due to the different effects on the musculoskeletal system. Therefore, in this paper, we perform a comparative experiment on the acquired CT images considering image area (unilateral/bilateral) and patients' postures (neutral/abducted). CT images are acquired from 10 patients for the experiments, and the acquired CT images are evaluated based on the length per pixel and the morphological deviation. Finally, by comparing the experiment results, we evaluate the CT image acquisition method for medical VR applications.

  20. Systematic review on the effectiveness of augmented reality applications in medical training.

    Science.gov (United States)

    Barsom, E Z; Graafland, M; Schijven, M P

    2016-10-01

    Computer-based applications are increasingly used to support the training of medical professionals. Augmented reality applications (ARAs) render an interactive virtual layer on top of reality. The use of ARAs is of real interest to medical education because they blend digital elements with the physical learning environment. This will result in new educational opportunities. The aim of this systematic review is to investigate to which extent augmented reality applications are currently used to validly support medical professionals training. PubMed, Embase, INSPEC and PsychInfo were searched using predefined inclusion criteria for relevant articles up to August 2015. All study types were considered eligible. Articles concerning AR applications used to train or educate medical professionals were evaluated. Twenty-seven studies were found relevant, describing a total of seven augmented reality applications. Applications were assigned to three different categories. The first category is directed toward laparoscopic surgical training, the second category toward mixed reality training of neurosurgical procedures and the third category toward training echocardiography. Statistical pooling of data could not be performed due to heterogeneity of study designs. Face-, construct- and concurrent validity was proven for two applications directed at laparoscopic training, face- and construct validity for neurosurgical procedures and face-, content- and construct validity in echocardiography training. In the literature, none of the ARAs completed a full validation process for the purpose of use. Augmented reality applications that support blended learning in medical training have gained public and scientific interest. In order to be of value, applications must be able to transfer information to the user. Although promising, the literature to date is lacking to support such evidence.

  1. A clinician's artificial organ? Instant messaging applications in medical care.

    Science.gov (United States)

    Tazegul, Gokhan; Bozoglan, Humeyra; Ogut, Tahir S; Balcı, Mustafa K

    2017-09-15

    After the development of the first phone at the end of 19th century, communication technologies took a great leap forward in the 20th century. With the birth of the "smartphone" in the 21st century, communication technologies exponentially evolved and became an important part of our daily routine. Effective communications between clinicians is critical in medical care and miscommunications are a source of errors. Although telecommunication technologies have proliferated dramatically in the last decade, there is scarce evidence-based information on the use of this technology in medical care. For the purposes of medical communication, we can now consult each other about patients individually and within a group via instant messaging applications by using text messages, photos, audio messages and even videos. In this review, we examine the uses and drawbacks of instant messaging applications in medical communications.

  2. Systematic review on the effectiveness of augmented reality applications in medical training

    NARCIS (Netherlands)

    Barsom, E. Z.; Graafland, M.; Schijven, M. P.

    2016-01-01

    Computer-based applications are increasingly used to support the training of medical professionals. Augmented reality applications (ARAs) render an interactive virtual layer on top of reality. The use of ARAs is of real interest to medical education because they blend digital elements with the

  3. Medical imaging in clinical applications algorithmic and computer-based approaches

    CERN Document Server

    Bhateja, Vikrant; Hassanien, Aboul

    2016-01-01

    This volume comprises of 21 selected chapters, including two overview chapters devoted to abdominal imaging in clinical applications supported computer aided diagnosis approaches as well as different techniques for solving the pectoral muscle extraction problem in the preprocessing part of the CAD systems for detecting breast cancer in its early stage using digital mammograms. The aim of this book is to stimulate further research in medical imaging applications based algorithmic and computer based approaches and utilize them in real-world clinical applications. The book is divided into four parts, Part-I: Clinical Applications of Medical Imaging, Part-II: Classification and clustering, Part-III: Computer Aided Diagnosis (CAD) Tools and Case Studies and Part-IV: Bio-inspiring based Computer Aided diagnosis techniques. .

  4. [Impact of a software application to improve medication reconciliation at hospital discharge].

    Science.gov (United States)

    Corral Baena, S; Garabito Sánchez, M J; Ruíz Rómero, M V; Vergara Díaz, M A; Martín Chacón, E R; Fernández Moyano, A

    2014-01-01

    To assess the impact of a software application to improve the quality of information concerning current patient medications and changes on the discharge report after hospitalization. To analyze the incidence of errors and to classify them. Quasi-experimental pre / post study with non-equivalent control group study. Medical patients at hospital discharge. implementation of a software application. Percentage of reconciled patient medication on discharge, and percentage of patients with more than one unjustified discrepancy. A total of 349 patients were assessed; 199 (pre-intervention phase) and 150 (post-intervention phase). Before the implementation of the application in 157 patients (78.8%) medication reconciliation had been completed; finding reconciliation errors in 99 (63.0%). The most frequent type of error, 339 (78.5%), was a missing dose or administration frequency information. After implementation, all the patient prescriptions were reconciled when the software was used. The percentage of patients with unjustified discrepancies decreased from 63.0% to 11.8% with the use of the application (psoftware application has been shown to improve the quality of the information on patient treatment on the hospital discharge report, but it is still necessary to continue development as a strategy for improving medication reconciliation. Copyright © 2014 SECA. Published by Elsevier Espana. All rights reserved.

  5. Complete Sequence of a F33:A-:B- Conjugative Plasmid Carrying the oqxAB, fosA3 and blaCTX-M-55 Elements from a Foodborne Escherichia coli Strain

    Directory of Open Access Journals (Sweden)

    Marcus Ho-yin Wong

    2016-10-01

    Full Text Available This study reports the complete sequence of pE80, a conjugative IncFII plasmid recovered from an E. coli strain isolated from chicken meat. This plasmid harbors multiple resistance determinants including oqxAB, fosA3, blaCTX-M-55 and blaTEM-1, and is a close variant of the recently reported p42-2 element, which was recovered from E. coli of veterinary source. Recovery of pE80 constitutes evidence that evolution or genetic re-arrangement of IncFII type plasmids residing in animal-borne organisms is an active event, which involves acquisition and integration of foreign resistance elements into the plasmid backbone. Dissemination of these plasmids may further compromise the effectiveness of current antimicrobial strategies.

  6. Radioprotection in the medical applications of the ionizing radiations

    International Nuclear Information System (INIS)

    2001-01-01

    This publication presents information about of the radiological safety in the medical application of the ionizing radiation compiled in 11 chapter and 1 annex. The first four chapters are principally dedicated to technical uses in radioprotection, the external and internal irradiation and the biological radiation effects. The radioprotection principles, the individual monitoring techniques, and the radioprotection systems are developed afterwards in the followings three chapters. The second half of the document is dedicated entirely to the medical practices using ionizing radiations, specially to the radioprotection aspects in radiodiagnosis, nuclear medicine and radiotherapy. The final chapter is dedicated to radiological accidents happened worldwide in the field of the medical applications of the ionizing radiations. The annex, about of the regulatory area, established a set of standards, laws, decrees and other force regulations in radiological safety, related in radiodiagnosis, nuclear medicine and radiotherapy

  7. Generation of high brightness x-ray source and its medical applications

    International Nuclear Information System (INIS)

    Fujii, Sadao; Muro, Mikio; Oku, Yasunari; Daido, Hiroyuki; Takahashi, Kenjiro

    2001-01-01

    Laser produced plasmas are one of the most feasible sources to be used for industrial applications, especially medical applications: Angiography, Protein crystallography, X-ray microscopy and XAFS. In the present paper, laser requirements are clarified for the medical and life science fields and then we estimate both the photon energy spectra and the number of photons based on Monte-Carlo simulation. (author)

  8. A clean bill of health for CERN’s medical applications office

    CERN Multimedia

    2014-01-01

    Many of you will have had the opportunity to follow the seminar on medical applications given by two members of our new International Strategy Committee for medical applications on 20 November. This occasion gives me a good opportunity to take stock of what’s been achieved since we set up our office for medical applications under Steve Myers almost a year ago.   It’s already an impressive list of achievements, and one that’s poised to grow. The International Strategy Committee is perhaps the most visible part of it. Meeting for the first time last week, the Committee will help us focus and prioritise our efforts so we can extract the maximum benefit. The existence of the office itself is already a major step in this direction: today, instead of having seven separate medical initiatives at CERN, we have a single coordinated approach and each component benefits. Let’s take a look at the current state of progress. The study to develop LEIR into the OPENM...

  9. Procedures for the medical application of research reactors (Appendix)

    International Nuclear Information System (INIS)

    Nishihara, H.; Kanda, K.

    2004-01-01

    The Kyoto University Reactor (KUR) is one of the four research reactors in Japan that are currently licensed for medical application, in addition to other research purposes. Taking the KUR as an example, legal and other procedures for using research reactors for boron neutron capture therapy (BNCT) are described, which are practiced in accordance with the 'Provisional Guideline Pertaining to Medical Irradiation by Accelerators and/or Reactors, other than defined by the Medical Service Act' of the Science Council of Japan

  10. Curve Matching with Applications in Medical Imaging

    DEFF Research Database (Denmark)

    Bauer, Martin; Bruveris, Martins; Harms, Philipp

    2015-01-01

    In the recent years, Riemannian shape analysis of curves and surfaces has found several applications in medical image analysis. In this paper we present a numerical discretization of second order Sobolev metrics on the space of regular curves in Euclidean space. This class of metrics has several...

  11. Responsibility structure in medical radiation applications

    International Nuclear Information System (INIS)

    Beekman, Z.M.

    1989-01-01

    The author discusses the various aspects of the responsibilities of physicians and clinical physicists with regard to radiation protection in medical applications of ionizing radiation. It becomes still clearer that the physician, who carries out the examination or the treatment, also has to bear the responsibility. this holds for the indication assessment as well as for optimization of the quality of the examination or treatment versus radiation burden of the patient, radiologic worker and thirds. Further it is clear that the physician in these will have to delegate specific tasks and responsibilities, whether or not in the elongated-arm construction. The clinical physicist is responsible in particular for the applications of the physical methods and watches the quality of the apparatus and methods used. As such he also is responsible for the technical workers, who take care of the preventive and corrective maintenance. The principal responsibility of the clinical physicist however lies in the field of standardization and calibration of medical-physical instruments. Besides this investigation into and development of new techniques, methods and apparatus come up, while also education and training of various profession groups involved need attention. (author). 6 refs.; 1 tab

  12. Industrial and medical applications of accelerators with energies less than 20 MeV

    International Nuclear Information System (INIS)

    Duggan, J.L.

    1983-01-01

    In this paper the medical and industrial application of small accelerators is reviewed. Most of the material is taken from the Seventh Conference on the Application of Accelerators in Research and Industry, which was held in Denton, Texas in November of 1982. The areas covered include medical linacs, cyclotron design and production of medical radioisotopes, radiation processing, ion implantation for the metallurgical and semiconductor industries, oil and mineral exploration, trace, surface and bulk analysis, and unique accelerators for all of the above applications

  13. The national institute of radiation hygiene and the medical application of radiation

    International Nuclear Information System (INIS)

    Baarli, J.

    1988-01-01

    This paper gives a review of the rules and regulations concerning medical application of radiation in Norway. It discusses the intention of the regulations, the way in which the regulations is applied and how the National Institute of Radiation Hygiene as the competent authority assures the application of the regulations. The paper furthermore gives an indication of the areas of radiation application in medicine and the number of location of X-ray equipment, nuclear medical laboratories, radiation therapy equipment, etc. The number of X-ray examinations in Norway per year are also given, together with their distribution among the various types of examinations. Summary results of a quality assurance investigation of nuclear medical laboratories are given, as well as the results of inspections of the various types of equipment used in medical diagnostics

  14. Applications of Novel Techniques to Health Foods, Medical and Agricultural Biotechnology

    OpenAIRE

    Baianu, I. C.; Lozano, P. R.; Prisecaru, V. I.; Lin, H. C.

    2004-01-01

    Selected applications of novel techniques in Agricultural Biotechnology, Health Food formulations and Medical Biotechnology are being reviewed with the aim of unraveling future developments and policy changes that are likely to open new niches for Biotechnology and prevent the shrinking or closing the existing ones. Amongst the selected novel techniques with applications to both Agricultural and Medical Biotechnology are: immobilized bacterial cells and enzymes, microencapsulation and liposom...

  15. Radiation hazards from medical applications

    International Nuclear Information System (INIS)

    Beekman, Z.M.

    1981-01-01

    An introduction is presented on the radiation hazards connected with biomedical radiography and nuclear medicine. The frequency of radiodiagnostic efforts was rather high in the Netherlands. This was reduced considerably by abolishing the thorax screening of the population. About diagnostic nuclear medicine less can be said because far fewer numerical data are available. An exposition of genetically and somatically significant doses and how to compute them is given. The drawing up of a profit versus risk evaluation for medical applications of ionizing radiations is recommended. (Auth.)

  16. 21 CFR 515.20 - Approval of medicated feed mill license applications.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Approval of medicated feed mill license... SERVICES (CONTINUED) ANIMAL DRUGS, FEEDS, AND RELATED PRODUCTS MEDICATED FEED MILL LICENSE Administrative Actions on Licenses § 515.20 Approval of medicated feed mill license applications. Within 90 days after an...

  17. Research on medical applications of radioisotopes and radiation in Australia

    International Nuclear Information System (INIS)

    Hardy, C.J.

    1987-01-01

    The Australian Atomic Energy Commission (AAEC) produces and distributes commercially in Australia and abroad a range of radioisotopes and radiopharmaceuticals for medical applications. The AAEC carries out research and development on new and improved processes and procucts is collaboration with medical specialists in hospitals and research workers in other organisations. Examples of these processes and products are: a gel generator for production of 99m Tc; radiopharmaceuticals for diagnosis of tumours and brain disease and therapy for arthritis; 64 Cu for study of copper metabolism; and monoclonal antibodies for tumour diagnosis and therapy. New medical applications in Australia of neutron irradiation include the measurement of total body nitrogen and neutron capture in boron-labelled compounds in vivo for melanoma therapy. (author)

  18. Sovereign immunity: Principles and application in medical malpractice.

    Science.gov (United States)

    Suk, Michael

    2012-05-01

    Tort law seeks accountability when parties engage in negligent conduct, and aims to compensate the victims of such conduct. An exception to this general rule governing medical negligence is the doctrine of sovereign immunity. Historically, individuals acting under the authority of the government or other sovereign entity had almost complete protection against tort liability. This article addressed the following: (1) the development of sovereign immunity in law, (2) the lasting impact of the Federal Tort Claims Act on sovereign immunity, and (3) the contemporary application of sovereign immunity to medical malpractice, using case examples from Virginia and Florida. I performed an Internet search to identify sources that addressed the concept of sovereign immunity, followed by a focused search for relevant articles in PubMed and LexisNexis, literature databases for medical and legal professionals, respectively. Historically, sovereign liability conferred absolute immunity from lawsuits in favor of the sovereign (ie, the government). Practical considerations in our democratic system have contributed to an evolution of this doctrine. Understanding sovereign immunity and its contemporary application are of value for any physician interested in the debate concerning medical malpractice in the United States. Under certain circumstances, physicians working as employees of the federal or state government may be protected against individual liability if the government is substituted as the defendant.

  19. User Interface Design in Medical Distributed Web Applications.

    Science.gov (United States)

    Serban, Alexandru; Crisan-Vida, Mihaela; Mada, Leonard; Stoicu-Tivadar, Lacramioara

    2016-01-01

    User interfaces are important to facilitate easy learning and operating with an IT application especially in the medical world. An easy to use interface has to be simple and to customize the user needs and mode of operation. The technology in the background is an important tool to accomplish this. The present work aims to creating a web interface using specific technology (HTML table design combined with CSS3) to provide an optimized responsive interface for a complex web application. In the first phase, the current icMED web medical application layout is analyzed, and its structure is designed using specific tools, on source files. In the second phase, a new graphic adaptable interface to different mobile terminals is proposed, (using HTML table design (TD) and CSS3 method) that uses no source files, just lines of code for layout design, improving the interaction in terms of speed and simplicity. For a complex medical software application a new prototype layout was designed and developed using HTML tables. The method uses a CSS code with only CSS classes applied to one or multiple HTML table elements, instead of CSS styles that can be applied to just one DIV tag at once. The technique has the advantage of a simplified CSS code, and a better adaptability to different media resolutions compared to DIV-CSS style method. The presented work is a proof that adaptive web interfaces can be developed just using and combining different types of design methods and technologies, using HTML table design, resulting in a simpler to learn and use interface, suitable for healthcare services.

  20. Profiles of phenotype resistance to antibiotic other than β-lactams in Klebsiella pneumoniae ESBLs-producers, carrying blaSHV genes

    Directory of Open Access Journals (Sweden)

    Pawel Sacha

    2010-04-01

    Full Text Available Extended spectrum β-lactamases production is one of the most common mechanism of resistance to extendedspectrum β-lactam antibiotics is increasing worldwide. Twenty five strains of Klebsiella pneumoniae isolated from clinicalspecimens were tested. Based on the phenotypic confirmatory test all these strains were defined as ESBL producers namedESBL(+. The plasmid DNA from each strains was used to investigate the presence of blaSHV genes responsible for extendedspectrum β-lactamases production. Moreover, susceptibility of these strains to antibiotic other than β-lactams in was tested.

  1. Whole-genome typing and characterization of blaVIM19-harbouring ST383 Klebsiella pneumoniae by PFGE, whole-genome mapping and WGS.

    Science.gov (United States)

    Sabirova, Julia S; Xavier, Basil Britto; Coppens, Jasmine; Zarkotou, Olympia; Lammens, Christine; Janssens, Lore; Burggrave, Ronald; Wagner, Trevor; Goossens, Herman; Malhotra-Kumar, Surbhi

    2016-06-01

    We utilized whole-genome mapping (WGM) and WGS to characterize 12 clinical carbapenem-resistant Klebsiella pneumoniae strains (TGH1-TGH12). All strains were screened for carbapenemase genes by PCR, and typed by MLST, PFGE (XbaI) and WGM (AflII) (OpGen, USA). WGS (Illumina) was performed on TGH8 and TGH10. Reads were de novo assembled and annotated [SPAdes, Rapid Annotation Subsystem Technology (RAST)]. Contigs were aligned directly, and after in silico AflII restriction, with corresponding WGMs (MapSolver, OpGen; BioNumerics, Applied Maths). All 12 strains were ST383. Of the 12 strains, 11 were carbapenem resistant, 7 harboured blaKPC-2 and 11 harboured blaVIM-19. Varying the parameters for assigning WGM clusters showed that these were comparable to STs and to the eight PFGE types or subtypes (difference of three or more bands). A 95% similarity coefficient assigned all 12 WGMs to a single cluster, whereas a 99% similarity coefficient (or ≥10 unmatched-fragment difference) assigned the 12 WGMs to eight (sub)clusters. Based on a difference of three or more bands between PFGE profiles, the Simpson's diversity indices (SDIs) of WGM (0.94, Jackknife pseudo-values CI: 0.883-0.996) and PFGE (0.93, Jackknife pseudo-values CI: 0.828-1.000) were similar (P = 0.649). However, the discriminatory power of WGM was significantly higher (SDI: 0.94, Jackknife pseudo-values CI: 0.883-0.996) than that of PFGE profiles typed on a difference of seven or more bands (SDI: 0.53, Jackknife pseudo-values CI: 0.212-0.849) (P = 0.007). This study demonstrates the application of WGM to understanding the epidemiology of hospital-associated K. pneumoniae. Utilizing a combination of WGM and WGS, we also present here the first longitudinal genomic characterization of the highly dynamic carbapenem-resistant ST383 K. pneumoniae clone that is rapidly gaining importance in Europe. © The Author 2016. Published by Oxford University Press on behalf of the British Society for Antimicrobial

  2. The application of digital medical 3D printing technology on tumor operation

    Science.gov (United States)

    Chen, Jimin; Jiang, Yijian; Li, Yangsheng

    2016-04-01

    Digital medical 3D printing technology is a new hi-tech which combines traditional medical and digital design, computer science, bio technology and 3D print technology. At the present time there are four levels application: The printed 3D model is the first and simple application. The surgery makes use of the model to plan the processing before operation. The second is customized operation tools such as implant guide. It helps doctor to operate with special tools rather than the normal medical tools. The third level application of 3D printing in medical area is to print artificial bones or teeth to implant into human body. The big challenge is the fourth level which is to print organs with 3D printing technology. In this paper we introduced an application of 3D printing technology in tumor operation. We use 3D printing to print guide for invasion operation. Puncture needles were guided by printed guide in face tumors operation. It is concluded that this new type guide is dominantly advantageous.

  3. [Non-medical applications for brain MRI: Ethical considerations].

    Science.gov (United States)

    Sarrazin, S; Fagot-Largeault, A; Leboyer, M; Houenou, J

    2015-04-01

    The recent neuroimaging techniques offer the possibility to better understand complex cognitive processes that are involved in mental disorders and thus have become cornerstone tools for research in psychiatry. The performances of functional magnetic resonance imaging are not limited to medical research and are used in non-medical fields. These recent applications represent new challenges for bioethics. In this article we aim at discussing the new ethical issues raised by the applications of the latest neuroimaging technologies to non-medical fields. We included a selection of peer-reviewed English medical articles after a search on NCBI Pubmed database and Google scholar from 2000 to 2013. We screened bibliographical tables for supplementary references. Websites of governmental French institutions implicated in ethical questions were also screened for governmental reports. Findings of brain areas supporting emotional responses and regulation have been used for marketing research, also called neuromarketing. The discovery of different brain activation patterns in antisocial disorder has led to changes in forensic psychiatry with the use of imaging techniques with unproven validity. Automated classification algorithms and multivariate statistical analyses of brain images have been applied to brain-reading techniques, aiming at predicting unconscious neural processes in humans. We finally report the current position of the French legislation recently revised and discuss the technical limits of such techniques. In the near future, brain imaging could find clinical applications in psychiatry as diagnostic or predictive tools. However, the latest advances in brain imaging are also used in non-scientific fields raising key ethical questions. Involvement of neuroscientists, psychiatrists, physicians but also of citizens in neuroethics discussions is crucial to challenge the risk of unregulated uses of brain imaging. Copyright © 2014 L’Encéphale, Paris. Published by

  4. [Investigation of OXA type beta-lactamases and PFGE patterns in Acinetobacter baumannii strains resistant to carbapenems].

    Science.gov (United States)

    Keyik, Serafettin; Arslan, Uğur; Türk Dağı, Hatice; Seyhan, Tuba; Fındık, Duygu

    2014-10-01

    Acinetobacter baumannii is an important opportunistic and multidrug-resistant pathogen leading to nosocomial infections. Over the last 10 years, a significant and threatening increase in resistance to carbapenems, mainly due to the dissemination of class D beta-lactamases, has been reported in A.baumannii worldwide. The most common types of beta-lactamases causing carbapenem resistance in A.baumannii are the OXA-23, OXA-24, OXA-40, OXA-58 and OXA-143 type serine beta-lactamases. The aim of this study was to investigate the presence of OXA type beta-lactamases in carbapenem-resistant A.baumannii strains and the clonal relationship between the strains. A total of 105 non-duplicate carbapenem-resistant A.baumannii strains isolated from various clinical samples (68 blood, 18 bronchoalveolar lavage, 13 drainage, 3 urine, 2 cerebrospinal fluid and 1 catheter samples) in the Microbiology Laboratories of Selcuk University, Meram (2009-2012) and Selcuklu (2007-2008) Medical School Hospitals, were included in the study. The isolates were identified by conventional methods and Phoenix 100 BD (BD Diagnostic, USA) and Vitek II (bioMerieux, France) automated systems. Carbapenem susceptibility test was performed by Kirby-Bauer disk diffusion method according to the CLSI standards. bla(OXA 23-like), bla(OXA 24-like), bla(OXA 58-like) and bla(OXA 51-like) genes were amplified by multiplex PCR assay and clonal relatedness was investigated by pulsed-field gel electrophoresis (PFGE) using ApaI enzyme. The bla(OXA 51-like) gene was determined in all carbapenem-resistant A.baumannii isolates, while the bla(OXA 23-like) and bla(OXA 58-like) genes were detected in 46.6% and 53.3% of isolates, respectively. However bla(OXA 24-like) gene was not demonstrated in any isolates. bla(OXA 23-like) gene was determined in both Meram and Selcuklu Medical School hospitals, but bla(OXA 58-like) gene was detected only in Meram Medical School hospital. PFGE analysis of the isolates revealed 32 different

  5. Iso-Surface Volume Rendering : speed and accuracy for medical applications

    NARCIS (Netherlands)

    Bosma, Marco

    2000-01-01

    This thesis describes the research on the accuracy and speed of different methods for the visualization of three-dimensional (3D)sets of (measured) data. In medical environments, these 3D datasets are generated by for instance CT and MRI scanners. The medical application makes special demands on the

  6. Perception Towards the Use of Smartphone Application (Apps to Enhance Medication Adherence Among Saudi Pediatrics

    Directory of Open Access Journals (Sweden)

    Renad Alsalamah

    2018-03-01

    Full Text Available Objectives: The aim of this study was to measure the importance of smartphone applications (Apps in medication adherence in children to help parents and caregivers in giving medication to children to maintain a good health and quality of life, and to improve current clinical practices in adherence to medications among Saudi pediatrics. Methodology: Cross sectional survey to Saudi Arabia population was conducted from March to April 2017(n=405. Data were collected, tabulated and analyzed using Survey Monkey. We present design requirements for building medication reminders that support the routine aspect of medication-taking by linking children’s concerns, (such as games on taking medications at time. Results: Of the 405 survey participants, the majority of participants 72.5% were not aware by applications of smart device that make easier to take medicines regularly. Eighty percent of participants preferred a mobile app to help their children take the medicine easily and regularly, and 39.8% of them thought that the child will interact with this game, the majority of them 88.6% don’t have any obstacle hinders the use of these updated applications. Fifty percent of them will encourage young patients, to use such applications (App to help them in their medication adherence. Conclusion: Nonadherence to medication is still represents a fundamental health care challenge. The presence of an application makes it easier for parents to give medication to their sick children. Most children love playing games, there is a high probability of their attachment to this application (App and it will promote children’s medication adherence. Key words: Patient adherence, Pediatric, Smartphone, Applications, Apps.

  7. Optical polymers for laser medical applications

    Science.gov (United States)

    Sultanova, Nina G.; Kasarova, Stefka N.; Nikolov, Ivan D.

    2016-01-01

    In medicine, optical polymers are used not only in ophthalmology but in many laser surgical, diagnostic and therapeutic systems. The application in lens design is determined by their refractive and dispersive properties in the considered spectral region. We have used different measuring techniques to obtain precise refractometric data in the visible and near-infrared spectral regions. Dispersive, thermal and other important optical characteristics of polymers have been studied. Design of a plastic achromatic objective, used in a surgical stereo-microscope at 1064 nm laser wavelength, is accomplished. Geometrical and wavefront aberrations are calculated. Another example of application of polymers is the designed all-mirror apochromatic micro-lens, intended for superluminescent diode fiber coupling in medical systems.

  8. RF linear accelerators for medical and industrial applications

    CERN Document Server

    Hanna, Samy

    2012-01-01

    This unique resource offers you a clear overview of medical and industrial accelerators. Using minimal mathematics, this book focuses on offering thorough explanations of basic concepts surrounding the operation of accelerators. you find well illustrated discussions designed to help you use accelerator-based systems in a safer, more productive, and more reliable manner.This practical book details the manufacturing process for producing accelerators for medical and industrial applications. You become knowledgeable about the commonly encountered real-world manufacturing issues and potential sources of defects which help you avoid costly production problems. From principles of operation and the role of accelerators in cancer radiation therapy, to manufacturing techniques and future trends in accelerator design and applications, this easy-to-comprehend volume quickly brings you up-to-speed with the critical concepts you need to understand for your work in the field.

  9. Silver nanoparticles: mechanism of antimicrobial action, synthesis, medical applications, and toxicity effects

    Science.gov (United States)

    Prabhu, Sukumaran; Poulose, Eldho K.

    2012-10-01

    Silver nanoparticles are nanoparticles of silver which are in the range of 1 and 100 nm in size. Silver nanoparticles have unique properties which help in molecular diagnostics, in therapies, as well as in devices that are used in several medical procedures. The major methods used for silver nanoparticle synthesis are the physical and chemical methods. The problem with the chemical and physical methods is that the synthesis is expensive and can also have toxic substances absorbed onto them. To overcome this, the biological method provides a feasible alternative. The major biological systems involved in this are bacteria, fungi, and plant extracts. The major applications of silver nanoparticles in the medical field include diagnostic applications and therapeutic applications. In most of the therapeutic applications, it is the antimicrobial property that is being majorly explored, though the anti-inflammatory property has its fair share of applications. Though silver nanoparticles are rampantly used in many medical procedures and devices as well as in various biological fields, they have their drawbacks due to nanotoxicity. This review provides a comprehensive view on the mechanism of action, production, applications in the medical field, and the health and environmental concerns that are allegedly caused due to these nanoparticles. The focus is on effective and efficient synthesis of silver nanoparticles while exploring their various prospective applications besides trying to understand the current scenario in the debates on the toxicity concerns these nanoparticles pose.

  10. Trusted data management for Grid-based medical applications

    NARCIS (Netherlands)

    van 't Noordende, G.J.; Olabarriaga, S.D.; Koot, M.R.; de Laat, C.T.A.M.; Udoh, E.

    2011-01-01

    Existing Grid technology has been foremost designed with performance and scalability in mind. When using Grid infrastructure for medical applications, privacy and security considerations become paramount. Privacy aspects require a re-thinking of the design and implementation of common Grid

  11. Quality assurance in medical radiation applications. The medical and dental appointment; Qualitaetssicherung bei medizinischen Strahlenanwendungen. Die aerztlichen und zahnaerztlichen Stellen

    Energy Technology Data Exchange (ETDEWEB)

    Ernst-Elz, Andreas [Ministerium fuer Energiewende, Landwirtschaft, Umwelt, Natur und Digitalisierung des Landes Schleswig-Holstein, Kiel (Germany)

    2017-07-01

    Medical radiation applications cause averaged over the German population an annual exposure of almost 2 mSv. Medical authorities have the assignment to assure and control the diagnostic and therapeutic quality of these applications and to provide recommendations for operators with respect to dose reductions and radiation protection, including guidance for radiotherapy planning aimed to questions of dose and therapy optimization.

  12. Medical students' recognition and application of geriatrics principles in a new curriculum.

    Science.gov (United States)

    Nanda, Aman; Farrell, Timothy W; Shield, Renée R; Tomas, Maria; Campbell, Susan E; Wetle, Terrie

    2013-03-01

    Given the aging U.S. population, it is imperative that medical students recognize and apply geriatrics principles. To address this need, in 2006, the Warren Alpert Medical School of Brown University integrated geriatrics content into a new medical school curriculum. Preclinical and clinical medical students submitted written reflective journals in response to prompts regarding the geriatrics content of the new medical school curriculum, including their didactic and clinical experiences. An interdisciplinary team used a structured qualitative approach to identify themes, including the recognition and application of geriatrics principles. Thirty medical student journalers submitted 405 journal entries. Themes regarding students' emerging understanding of geriatrics principles included a growing understanding of geriatrics principles, recognition of the importance of psychosocial factors and patient preferences in caring for older adults, recognition of the complexities of treating older adults and application of geriatric principles to clinical situations, and understanding of physicians' roles in managing the care of older adults. Medical student reflective journaling allows medical educators to obtain timely feedback on curricular innovations and helps illuminate the process by which medical students learn to recognize and apply core geriatrics principles. © 2013, Copyright the Authors Journal compilation © 2013, The American Geriatrics Society.

  13. Medical Device Integrated Vital Signs Monitoring Application with Real-Time Clinical Decision Support.

    Science.gov (United States)

    Moqeem, Aasia; Baig, Mirza; Gholamhosseini, Hamid; Mirza, Farhaan; Lindén, Maria

    2018-01-01

    This research involves the design and development of a novel Android smartphone application for real-time vital signs monitoring and decision support. The proposed application integrates market available, wireless and Bluetooth connected medical devices for collecting vital signs. The medical device data collected by the app includes heart rate, oxygen saturation and electrocardiograph (ECG). The collated data is streamed/displayed on the smartphone in real-time. This application was designed by adopting six screens approach (6S) mobile development framework and focused on user-centered approach and considered clinicians-as-a-user. The clinical engagement, consultations, feedback and usability of the application in the everyday practices were considered critical from the initial phase of the design and development. Furthermore, the proposed application is capable to deliver rich clinical decision support in real-time using the integrated medical device data.

  14. Polymer Based Biosensors for Medical Applications

    DEFF Research Database (Denmark)

    Cherré, Solène; Rozlosnik, Noemi

    2015-01-01

    , environmental monitoring and food safety. The detected element varies from a single molecule (such as glucose), a biopolymer (such as DNA or a protein) to a whole organism (such as bacteria). Due to their easy use and possible miniaturization, biosensors have a high potential to come out of the lab...... and be available for use by everybody. To fulfil these purposes, polymers represent very appropriate materials. Many nano- and microfabrication methods for polymers are available, allowing a fast and cheap production of devices. This chapter will present the general concept of a biosensor in a first part......The objective of this chapter is to give an overview about the newest developments in biosensors made of polymers for medical applications. Biosensors are devices that can recognize and detect a target with high selectivity. They are widely used in many fields such as medical diagnostic...

  15. Synchrotron radiation applications in medical research

    International Nuclear Information System (INIS)

    Thomlinson, W.

    1995-01-01

    The medical projects employing synchrotron radiation as discussed in this paper are, for the most part, still in their infancies and no one can predict the direction in which they will develop. Both the basic research and applied medical programs are sure to be advanced at the new facilities coming on line, especially the ESRF and Spring- 8. However, success is not guaranteed. There is a lot of competition from advances in conventional imaging with the development of digital angiography, computed tomography, functional magnetic resonance imaging and ultrasound. The synchrotron programs will have to provide significant advantages over these modalities in order to be accepted by the medical profession. Advances in image processing and potentially the development of compact sources will be required in order to move the synchrotron developed imaging technologies into the clinical world. In any event, it can be expected that the images produced by the synchrotron technologies will establish ''gold standards'' to be targeted by conventional modalities. A lot more work needs to be done in order to bring synchrotron radiation therapy and surgery to the level of human studies and, subsequently, to clinical applications

  16. 78 FR 59038 - Mobile Medical Applications; Guidance for Industry and Food and Drug Administration Staff...

    Science.gov (United States)

    2013-09-25

    ... FDA intends to apply its regulatory oversight to only those mobile apps that are medical devices and...] Mobile Medical Applications; Guidance for Industry and Food and Drug Administration Staff; Availability...) is announcing the availability of the guidance entitled ``Mobile Medical Applications.'' The FDA is...

  17. Public Use of Mobile Medical Applications: A Case Study on Cloud-Based Medical Service of Taiwan.

    Science.gov (United States)

    Lu, Chen-Luan; Yan, Yu-Hua

    2016-01-01

    The use of smart mobile devices has been getting increasingly popular. The focus of this study is an attempt to explore the development of mobile medical App by medical centers and regional hospitals of Taiwan and the function of the App for comparison. The results show indicated that many hospitals developed Apps for the public for mobile medical service, of which 26 medical centers (100%) and 72 regional hospitals (84.7%) availed appointment making service via Apps. The result indicated variance at significant level (p < 0.01). There are 23 medical centers (88.5%) and 74 regional hospitals (87.1%) availed Apps for checking service progress. The result indicated insignificant variance level (p > 0.01). We can see that mobile medical service is gradually emerging as a vital issue. Yet, this is a new domain in medical service. With the mushrooming of medical applications in smart mobile devices, the medical service system is expected to be installed in these devices to enhance interactive mode of operation and inquiry services, such as medication and inquiries into physical examination results. By then, people can learn the status of their health with this system.

  18. The Most Common Smartphone Applications Used By Medical Students and Barriers of Using Them.

    Science.gov (United States)

    Jebraeily, Mohamad; Fazlollahi, Zahra Zare; Rahimi, Bahlol

    2017-12-01

    Medical knowledge is rapidly expanding and updating. It is very important that students can timely access to information and the latest scientific evidence without any time and place limitation. The smartphone is one of ICT tools that adopted greatly by healthcare professionals. Today, the most medical sciences universities have provided smartphone as an educational aid tool and acquisition licenses for medical apps resources in training of their students. This research was conducted to determine common smartphone applications among medical students of Urmia University of medical sciences and to identify barriers in using them. This research was a descriptive type of study carried out in 2016. Population of the study included 530 medical students completing the clinical course in Urmia University of Medical Sciences. Data were collected using researcher-developed questionnaire. The validity of it determined based on the view of experts and the reliability of it obtained by calculating the value of Cronbach's alpha (α = 0.82). 82.3% of the students had smartphone, which in terms of operating system the highest was related Andriod (53%) and iPhone (32%). The most common applications used often by medical students included Up to date, PubSearch, Calculate by QxMD, Epocrates and OMnio. Lack of accreditation of medical apps by valid health institutions (4.63), lack of support and update of applications by their developers (4.44), lack of adequate skill to use applications (4.25) are the most important barriers in using these applications among students. To assurance quality of medical apps, it seems very important that academic and healthcare organizations should be involved to develop and update the apps and also provided guidelines for accreditation of apps. It is recommended that for promotion of knowledge and skill of students provide essential educations.

  19. Real-time image mosaicing for medical applications.

    Science.gov (United States)

    Loewke, Kevin E; Camarillo, David B; Jobst, Christopher A; Salisbury, J Kenneth

    2007-01-01

    In this paper we describe the development of a robotically-assisted image mosaicing system for medical applications. The processing occurs in real-time due to a fast initial image alignment provided by robotic position sensing. Near-field imaging, defined by relatively large camera motion, requires translations as well as pan and tilt orientations to be measured. To capture these measurements we use 5-d.o.f. sensing along with a hand-eye calibration to account for sensor offset. This sensor-based approach speeds up the mosaicing, eliminates cumulative errors, and readily handles arbitrary camera motions. Our results have produced visually satisfactory mosaics on a dental model but can be extended to other medical images.

  20. Summaries of fiscal year 1994 projects in medical applications and biophysical research

    International Nuclear Information System (INIS)

    1995-04-01

    This report provides information on the research supported in Fiscal Year 1994 by the Medical Applications and Biophysical Research Division of the Office of Health and Environmental Research. A brief statement of the scope of the following areas is presented: dosimetry; measurement science; radiological and chemical physics; structural biology; human genome; and medical applications. Summaries of the research projects in these categories are presented

  1. Aliphatic polyesters for medical imaging and theranostic applications.

    Science.gov (United States)

    Nottelet, Benjamin; Darcos, Vincent; Coudane, Jean

    2015-11-01

    Medical imaging is a cornerstone of modern medicine. In that context the development of innovative imaging systems combining biomaterials and contrast agents (CAs)/imaging probes (IPs) for improved diagnostic and theranostic applications focuses intense research efforts. In particular, the classical aliphatic (co)polyesters poly(lactide) (PLA), poly(lactide-co-glycolide) (PLGA) and poly(ɛ-caprolactone) (PCL), attract much attention due to their long track record in the medical field. This review aims therefore at providing a state-of-the-art of polyester-based imaging systems. In a first section a rapid description of the various imaging modalities, including magnetic resonance imaging (MRI), optical imaging, computed tomography (CT), ultrasound (US) and radionuclide imaging (SPECT, PET) will be given. Then, the two main strategies used to combine the CAs/IPs and the polyesters will be discussed. In more detail we will first present the strategies relying on CAs/IPs encapsulation in nanoparticles, micelles, dendrimers or capsules. We will then present chemical modifications of polyesters backbones and/or polyester surfaces to yield macromolecular imaging agents. Finally, opportunities offered by these innovative systems will be illustrated with some recent examples in the fields of cell labeling, diagnostic or theranostic applications and medical devices. Copyright © 2015 Elsevier B.V. All rights reserved.

  2. Near-infrared spectroscopic tissue imaging for medical applications

    Science.gov (United States)

    Demos, Stavros [Livermore, CA; Staggs, Michael C [Tracy, CA

    2006-12-12

    Near infrared imaging using elastic light scattering and tissue autofluorescence are explored for medical applications. The approach involves imaging using cross-polarized elastic light scattering and tissue autofluorescence in the Near Infra-Red (NIR) coupled with image processing and inter-image operations to differentiate human tissue components.

  3. Radiotracers for medical applications

    International Nuclear Information System (INIS)

    Rayudu, G.A.S.

    1983-01-01

    This book discusses the medical applications of radiotracers. Diagnostic uses and pharmacokinetics of isotopes and radiopharmaceuticals is emphasized. The volume one covers the following topics: Radiohalogenated compounds, including radioiodine; Tc-labeled compounds; and in-house prepared radiopharmaceuticals. The charge particle range vs. energy in every element is tabulated for protons for cyclotrons users. Discussions are also provided on nonimaging radiotracer methods; /sup 11/C, /sup 13/N, /sup 15/O, /sup 67/Ga. /sup 111/In, /sup 75/Se, /sup 123m/Te compounds; radioactive noble gases; and miscellaneous radiotracers for imaging. Vol. II: Pertinent nuclear science data such as radiation dosimetry, radionuclide production modes, radionuclides for therapy, human experimentation regulations and consent forms, and radiotracer laboratory designs are presented. 272 pp., 7 x 10, 1983, ISBN-0-8493-6016-1

  4. Characterisation of IncA/C2 plasmids carrying an In416-like integron with the blaVIM-19 gene from Klebsiella pneumoniae ST383 of Greek origin.

    Science.gov (United States)

    Papagiannitsis, Costas C; Dolejska, Monika; Izdebski, Radosław; Giakkoupi, Panagiota; Skálová, Anna; Chudějová, Kateřina; Dobiasova, Hana; Vatopoulos, Alkiviadis C; Derde, Lennie P G; Bonten, Marc J M; Gniadkowski, Marek; Hrabák, Jaroslav

    2016-02-01

    The complete nucleotide sequences of three multidrug resistance (MDR) IncA/C-like plasmids from Enterobacteriaceae isolates carrying the VIM-type carbapenemase-encoding integrons In4863 (blaVIM-19-aacA7-dfrA1-ΔaadA1-smr2) or In4873 (blaVIM-1-aacA7-dfrA1-ΔaadA1-smr2) were determined, which are the first In416-like elements identified in Greece. Plasmids pKP-Gr642 and pKP-Gr8143 were from Klebsiella pneumoniae ST383 isolates, whereas plasmid pEcl-Gr4873 was from an Enterobacter cloacae ST88 isolate. Sequencing showed that pKP-Gr642 (162787bp) and pKP-Gr8143 (154395bp) consisted of the type 1 IncA/C2 conserved backbone, the blaCMY-2-like gene-containing region, and the ARI-B (with the sul2 gene) and ARI-A (with a class 1 integron) resistance islands, like the plasmid pUMNK88_161 from the USA. The third plasmid, pEcl-Gr4873 (153958bp), exhibited extensive similarity with the type 2 IncA/C2 plasmid pR55 from France. pEcl-Gr4873 carried only one resistance island of a hybrid transposon structure inserted in a different location to ARI-A in type 1 A/C2 plasmids. In all three plasmids, the In416-like integrons In4863 or In4873 were identified within non-identical class II transposon structures. All three In416-like-carrying regions presented significant similarities with the MDR region of the IncA/C2 plasmid pCC416 from Italy, carrying the prototype In416 integron (blaVIM-4-aacA7-dfrA1-ΔaadA1-smr2). These findings provided the basis for speculations regarding the evolution of IncA/C2 plasmids with In416-like integrons, and confirmed the rapid evolution of some IncA/C2 plasmid lineages. Considering the broad host range of IncA/C2 molecules, it seems that pKP-Gr642, pKP-Gr8143 and pEcl-Gr4873 plasmids might support the diffusion of In416-like integrons among Enterobacteriaceae. Copyright © 2015 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.

  5. Field-testing the new DECtalk PC system for medical applications

    Science.gov (United States)

    Grams, R. R.; Smillov, A.; Li, B.

    1992-01-01

    Synthesized human speech has now reached a new level of performance. With the introduction of DEC's new DECtalk PC, the small system developer will have a very powerful tool for creative design. It has been our privilege to be involved in the beta-testing of this new device and to add a medical dictionary which covers a wide range of medical terminology. With the inherent board level understanding of speech synthesis and the medical dictionary, it is now possible to provide full digital speech output for all medical files and terms. The application of these tools will cover a wide range of options for the future and allow a new dimension in dealing with the complex user interface experienced in medical practice.

  6. Utilization of smart phones related medical applications among medical students at King Abdulaziz University, Jeddah: A cross-sectional study.

    Science.gov (United States)

    Sayedalamin, Zaid; Alshuaibi, Abdulaziz; Almutairi, Osama; Baghaffar, Mariam; Jameel, Tahir; Baig, Mukhtiar

    The present study explored the utility, attitude, and trends regarding Smartphone related Medical Applications (Apps) among medical students of King Abdulaziz University (KAU) Jeddah, Saudi Arabia (SA) and their perceptions of the impact of Medical Apps in their training activities. This survey was conducted at the Faculty of Medicine, Jeddah, and Rabigh campuses, KAU, Jeddah, SA. All participants were medical students of 2nd to 6th year. The data was collected by using an anonymous questionnaire regarding the perception of medical students about Medical Apps on the smart devices and the purpose of installation of the Apps. Additionally examined was the use of different Medical Apps by the students to investigate the impact of Medical Apps on the clinical training/practice. Data was analyzed on SPSS 21. The opinion of 330/460 medical students from all academic years was included in the study with a response rate of 72%. There were 170 (51.5%) males and 160 (48.5%) females with a mean age of 21.26±1.86 years. Almost all participating students 320 (97%) were well aware of Medical Apps for smart devices and 89.1% had installed different applications on their smart devices. The main usage was for either revision of courses (62.4%) or for looking up of medical information (67.3%), followed by preparing for a presentation (34.5%) and getting the medical news (32.1%). Regarding the impact of Medical Apps, most of the students considered these helpful in clinical decision-making, assisting in differential diagnosis, allowing faster access to Evidence-Based Medical practice, saving time and others. The practical use of these Apps was found to be minimal in medical students. Around 73% were occasional users of Medical Apps, and only 27% were using Medical Apps at least once a day. The regular use of Medical Apps on mobile devices is not common among medical students of KAU. Copyright © 2016 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd

  7. Multimedia Security System for Security and Medical Applications

    Science.gov (United States)

    Zhou, Yicong

    2010-01-01

    This dissertation introduces a new multimedia security system for the performance of object recognition and multimedia encryption in security and medical applications. The system embeds an enhancement and multimedia encryption process into the traditional recognition system in order to improve the efficiency and accuracy of object detection and…

  8. Medical imaging technology reviews and computational applications

    CERN Document Server

    Dewi, Dyah

    2015-01-01

    This book presents the latest research findings and reviews in the field of medical imaging technology, covering ultrasound diagnostics approaches for detecting osteoarthritis, breast carcinoma and cardiovascular conditions, image guided biopsy and segmentation techniques for detecting lung cancer, image fusion, and simulating fluid flows for cardiovascular applications. It offers a useful guide for students, lecturers and professional researchers in the fields of biomedical engineering and image processing.

  9. 76 FR 50231 - Mobile Medical Applications Draft Guidance; Public Workshop

    Science.gov (United States)

    2011-08-12

    ... workshop discussion, a ``mobile medical app'' is a mobile application that meets the definition of ``device... applications are subject to regulation as devices when they meet the definition of a device in section 201(h... man * * * '' or ``* * * intended to affect the structure or any function of the body of man or other...

  10. Some advances in medical applications of low energy accelerators

    Science.gov (United States)

    Valković, V.; Moschini, G.

    1991-05-01

    Medical applications of low energy accelerators include: the use of nuclear analytical methods and procedures for laboratory studies and routine measurements; material productions and modifications to meet special requirements; radioisotope productions and their applications in radiopharmaceuticals as well as in positron emission tomography; and radiotherapy with ions, based on improved understanding of the interaction of charged particles with living tissue. Some of the recent advances in these fields are critically summarized. The plan for an improved charged particle facility in a hospital environment dedicated to applications in biology and medicine is presented.

  11. Prevalence of blaZ gene types and the cefazolin inoculum effect among methicillin-susceptible Staphylococcus aureus blood isolates and their association with multilocus sequence types and clinical outcome.

    Science.gov (United States)

    Chong, Y P; Park, S-J; Kim, E S; Bang, K-M; Kim, M-N; Kim, S-H; Lee, S-O; Choi, S-H; Jeong, J-Y; Woo, J H; Kim, Y S

    2015-02-01

    Cefazolin treatment failures have been described for bacteraemia caused by methicillin-susceptible Staphylococcus aureus (MSSA) with type A β-lactamase and inoculum effect (InE). We investigated the prevalence of blaZ (β-lactamase) gene types and a cefazolin InE among MSSA blood isolates in South Korea and evaluated their association with specific genotypes. The clinical impact of the cefazolin InE was also evaluated. A total of 220 MSSA isolates were collected from a prospective cohort study of S. aureus bacteraemia. A pronounced InE with cefazolin was defined as a ≥4-fold increase in the minimum inhibitory concentration (MIC) between a standard and high inoculum, resulting in a non-susceptible MIC. Sequencing of blaZ and multilocus sequence typing (MLST) were performed. Clinical outcomes were assessed in 77 patients treated with cefazolin. The blaZ gene was detected in 92 % of the 220 MSSA isolates. Type C β-lactamase was the most common (53 %), followed by type B (20 %) and type A (17 %). Certain genotypes were significantly associated with specific β-lactamase types (notably, ST30 and type A β-lactamase). A pronounced cefazolin InE was observed in 13 % of isolates. Most of these (79 %) expressed type A β-lactamase and ST30 was the predominant (55 %) clone amongst them. Cefazolin treatment failure was not observed in patients infected with strains exhibiting a pronounced InE. These strains had no impact on other clinical outcomes. In conclusion, the prevalence of a pronounced InE with cefazolin could be dependent upon distributions of MSSA genotypes. Cefazolin can likely be used for the treatment of MSSA bacteraemia (except endocarditis), without consideration of an InE.

  12. Datenschutz- und Medizinprodukterecht bei Ubiquitous Computing-Anwendungen im Gesundheitssektor / Data protection and medical product law with respect to medical ubiquitous computing applications

    Directory of Open Access Journals (Sweden)

    Skistims, Hendrik

    2011-01-01

    Full Text Available With respect to ubiquitous computing there is a great potential of application, particularly in medicine and health care. This work deals with the legal problems which ubiquitous computing is facing in these areas. At the beginning, issues with respect to data protection and professional secrecy are treated. Afterwards the problem of applicability of medical product law for medical ubiquitous computing applications as well as the resulting requirements for manufactures, operators and users will be discussed.

  13. Application of Learning Theories on Medical Imaging Education

    Directory of Open Access Journals (Sweden)

    Osama A. Mabrouk Kheiralla

    2018-05-01

    Full Text Available The main objective of the education process is that student must learn well rather than the educators to teach well. If radiologists get involved in the process of medical education, it is important for them to do it through sound knowledge of how students learn. Researches have proved that most of the teachers in the field of medical education including diagnostic imaging are actually doctors or technicians, who didn’t have an opportunity to study the basics of learning. Mostly they have gained their knowledge through watching other educators, and they mostly rely on their personal skills and experience in doing their job. This will hinder them from conveying knowledge in an effective and scientific way, and they will find themselves lagging away behind the latest advances in the field of medical education and educational research, which will lead to negative cognitive outcomes among learners. This article presents an overview of three of the most influential basic theories of learning, upon which many teachers rely in their practical applications, which must be considered by radiologist who act as medical educators.

  14. Open-source software platform for medical image segmentation applications

    Science.gov (United States)

    Namías, R.; D'Amato, J. P.; del Fresno, M.

    2017-11-01

    Segmenting 2D and 3D images is a crucial and challenging problem in medical image analysis. Although several image segmentation algorithms have been proposed for different applications, no universal method currently exists. Moreover, their use is usually limited when detection of complex and multiple adjacent objects of interest is needed. In addition, the continually increasing volumes of medical imaging scans require more efficient segmentation software design and highly usable applications. In this context, we present an extension of our previous segmentation framework which allows the combination of existing explicit deformable models in an efficient and transparent way, handling simultaneously different segmentation strategies and interacting with a graphic user interface (GUI). We present the object-oriented design and the general architecture which consist of two layers: the GUI at the top layer, and the processing core filters at the bottom layer. We apply the framework for segmenting different real-case medical image scenarios on public available datasets including bladder and prostate segmentation from 2D MRI, and heart segmentation in 3D CT. Our experiments on these concrete problems show that this framework facilitates complex and multi-object segmentation goals while providing a fast prototyping open-source segmentation tool.

  15. NASA technology utilization applications. [transfer of medical sciences

    Science.gov (United States)

    1973-01-01

    The work is reported from September 1972 through August 1973 by the Technology Applications Group of the Science Communication Division (SCD), formerly the Biological Sciences Communication Project (BSCP) in the Department of Medical and Public Affairs of the George Washington University. The work was supportive of many aspects of the NASA Technology Utilization program but in particular those dealing with Biomedical and Technology Application Teams, Applications Engineering projects, new technology reporting and documentation and transfer activities. Of particular interest are detailed reports on the progress of various hardware projects, and suggestions and criteria for the evaluation of candidate hardware projects. Finally some observations about the future expansion of the TU program are offered.

  16. Virtual Reality in Psychological, Medical and Pedagogical Applications

    Science.gov (United States)

    Eichenberg, Christiane, Ed.

    2012-01-01

    This book has an aim to present latest applications, trends and developments of virtual reality technologies in three humanities disciplines: in medicine, psychology and pedagogy. Studies show that people in both educational as well as in the medical therapeutic range expect more and more that modern media are included in the corresponding demand…

  17. Three-Dimensional Printing and Medical Imaging: A Review of the Methods and Applications.

    Science.gov (United States)

    Marro, Alessandro; Bandukwala, Taha; Mak, Walter

    2016-01-01

    The purpose of this article is to review recent innovations on the process and application of 3-dimensional (3D) printed objects from medical imaging data. Data for 3D printed medical models can be obtained from computed tomography, magnetic resonance imaging, and ultrasound using the Data Imaging and Communications in Medicine (DICOM) software. The data images are processed using segmentation and mesh generation tools and converted to a standard tessellation language (STL) file for printing. 3D printing technologies include stereolithography, selective laser sintering, inkjet, and fused-deposition modeling . 3D printed models have been used for preoperative planning of complex surgeries, the creation of custom prosthesis, and in the education and training of physicians. The application of medical imaging and 3D printers has been successful in providing solutions to many complex medical problems. As technology advances, its applications continue to grow in the future. Copyright © 2015 Mosby, Inc. All rights reserved.

  18. Medical Applications at CERN and the ENLIGHT Network.

    Science.gov (United States)

    Dosanjh, Manjit; Cirilli, Manuela; Myers, Steve; Navin, Sparsh

    2016-01-01

    State-of-the-art techniques derived from particle accelerators, detectors, and physics computing are routinely used in clinical practice and medical research centers: from imaging technologies to dedicated accelerators for cancer therapy and nuclear medicine, simulations, and data analytics. Principles of particle physics themselves are the foundation of a cutting edge radiotherapy technique for cancer treatment: hadron therapy. This article is an overview of the involvement of CERN, the European Organization for Nuclear Research, in medical applications, with specific focus on hadron therapy. It also presents the history, achievements, and future scientific goals of the European Network for Light Ion Hadron Therapy, whose co-ordination office is at CERN.

  19. Genetic and biochemical characterization of an acquired subgroup B3 metallo-β-lactamase gene, blaAIM-1, and its unique genetic context in Pseudomonas aeruginosa from Australia.

    Science.gov (United States)

    Yong, Dongeun; Toleman, Mark A; Bell, Jan; Ritchie, Brett; Pratt, Rachael; Ryley, Henry; Walsh, Timothy R

    2012-12-01

    Three clinical Pseudomonas aeruginosa isolates (WCH2677, WCH2813, and WCH2837) isolated from the Women's and Children's Hospital, Adelaide, Australia, produced a metallo-β-lactamase (MBL)-positive Etest result. All isolates were PCR negative for known MBL genes. A gene bank was created, and an MBL gene, designated bla(AIM-1), was cloned and fully characterized. The encoded enzyme, AIM-1, is a group B3 MBL that has the highest level of identity to THIN-B and L1. It is chromosomal and flanked by two copies (one intact and one truncated) of an ISCR element, ISCR15. Southern hybridization studies indicated the movement of both ISCR15 and bla(AIM-1) within the three different clinical isolates. AIM-1 hydrolyzes most β-lactams, with the exception of aztreonam and, to a lesser extent, ceftazidime; however, it possesses significantly higher k(cat) values for cefepime and carbapenems than most other MBLs. AIM-1 was the first mobile group B3 enzyme detected and signals further problems for already beleaguered antimicrobial regimes to treat serious P. aeruginosa and other Gram-negative infections.

  20. Design and Evaluation of a Medication Adherence Application with Communication for Seniors in Independent Living Communities.

    Science.gov (United States)

    Dasgupta, Dipanwita; Johnson, Reid A; Chaudhry, Beenish; Reeves, Kimberly G; Willaert, Patty; Chawla, Nitesh V

    2016-01-01

    Medication non-adherence is a pressing concern among seniors, leading to a lower quality of life and higher healthcare costs. While mobile applications provide a viable medium for medication management, their utility can be limited without tackling the specific needs of seniors and facilitating the active involvement of care providers. To address these limitations, we are developing a tablet-based application designed specifically for seniors to track their medications and a web portal for their care providers to track medication adherence. In collaboration with a local Aging in Place program, we conducted a three-month study with sixteen participants from an independent living facility. Our study found that the application helped participants to effectively track their medications and improved their sense of wellbeing. Our findings highlight the importance of catering to the needs of seniors and of involving care providers in this process, with specific recommendations for the development of future medication management applications.

  1. The influence of labor market changes on first-time medical school applicant pools.

    Science.gov (United States)

    Cort, David A; Morrison, Emory

    2014-12-01

    To explore whether the number and composition of first-time applicants to U.S. MD-granting medical schools, which have fluctuated over the past 30 years, are related to changes in labor market strength, specifically the unemployment rate and wages. The authors merged time series data from 1980 through 2010 (inclusive) from five sources and used multivariate time series models to determine whether changes in labor market strength (and several other macro-level factors) were related to the number of the medical school applicants as reported by the American Medical College Application Service. Analyses were replicated across specific sex and race/ethnicity applicant pools. Two results surfaced in the analyses. First, the strength of the labor market was not influential in explaining changes in applicant pool sizes for all applicants, but was strongly influential in explaining changes for black and Hispanic males. Increases of $1,000 in prevailing median wages produced a 1.6% decrease in the white male applicant pool, while 1% increases in the unemployment rate were associated with 4.5% and 3.1% increases in, respectively, the black and Hispanic male applicant pools. Second, labor market strength was a more important determinant in applications from males than in applications from females. Although stakeholders cannot directly influence the overall economic market, they can plan and prepare for fewer applications from males, especially those who are black and Hispanic, when the labor market is strong.

  2. Usability Evaluation of An Electronic Medication Administration Record (eMAR) Application

    Science.gov (United States)

    Guo, J.; Iribarren, S.; Kapsandoy, S.; Perri, S.; Staggers, N.

    2011-01-01

    Background Electronic medication administration records (eMARs) have been widely used in recent years. However, formal usability evaluations are not yet available for these vendor applications, especially from the perspective of nurses, the largest group of eMAR users. Objective To conduct a formal usability evaluation of an implemented eMAR. Methods Four evaluators examined a commercial vendor eMAR using heuristic evaluation techniques. The evaluators defined seven tasks typical of eMAR use and independently evaluated the application. Consensus techniques were used to obtain 100% agreement of identified usability problems and severity ratings. Findings were reviewed with 5 clinical staff nurses and the Director of Clinical Informatics who verified findings with a small group of clinical nurses. Results Evaluators found 60 usability problems categorized into 233 heuristic violations. Match, Error, and Visibility heuristics were the most frequently violated. Administer Medication and Order and Modify Medications tasks had the highest number of heuristic violations and usability problems rated as major or catastrophic. Conclusion The high number of usability problems could impact the effectiveness, efficiency and satisfaction of nurses’ medication administration activities and may include concerns about patient safety. Usability is a joint responsibility between sites and vendors. We offer a call to action for usability evaluations at all sites and eMAR application redesign as necessary to improve the user experience and promote patient safety. PMID:23616871

  3. Unusual events in the use of radioactive material at medical applications

    International Nuclear Information System (INIS)

    Czarwinski, R.

    2002-01-01

    In the Federal Republic of Germany unusual events in the use of radioactive materials and in the operation of accelerators outside the nuclear sector are evaluated centrally and published annually. At that evaluation it can be distinguished between the medical and non-medical application of ionising radiation. Around 3000 user of radioactive materials are registered in medicine including research and teaching. That means approximately 25% of all users in Germany. Firstly an overview on the number of unusual events in the last ten years is given for medical applications like afterloading, gamma irradiation, nuclear medicine, radiation sources and accelerators. The analysis of the incidents in the considered medical areas resulted in two categories-human error and technical break down. The main causes for the incidents which could be analysed are presented in the paper. Additionally the radiation exposures resulting from the incidents are considered. The analysis of these unusual events enables in dependence of the known information lessons learned to avoid similar errors. This feedback will be offered. (Author)

  4. Application of EGS and ETRAN to Problems in Medical Physics and Dosimetry

    CERN Document Server

    Nelson, W R

    1980-01-01

    The author looks at a few applications of Monte Carlo programs to problems of interest in medical physics and dosimetry. In particular, two areas are considered: 1) bremsstrahlung production from medical accelerators; 2) photon dosimetry at medium to low energies. (16 refs) .

  5. Ethics of emergent information and communication technology applications in humanitarian medical assistance.

    Science.gov (United States)

    Hunt, Matthew; Pringle, John; Christen, Markus; Eckenwiler, Lisa; Schwartz, Lisa; Davé, Anushree

    2016-07-01

    New applications of information and communication technology (ICT) are shaping the way we understand and provide humanitarian medical assistance in situations of disaster, disease outbreak or conflict. Each new crisis appears to be accompanied by advancements in humanitarian technology, leading to significant improvements in the humanitarian aid sector. However, ICTs raise ethical questions that warrant attention. Focusing on the context of humanitarian medical assistance, we review key domains of ICT innovation. We then discuss ethical challenges and uncertainties associated with the development and application of new ICTs in humanitarian medical assistance, including avoiding harm, ensuring privacy and security, responding to inequalities, demonstrating respect, protecting relationships, and addressing expectations. In doing so, we emphasize the centrality of ethics in humanitarian ICT design, application and evaluation. © The Author 2016. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  6. Mobile-Based Medical Health Application - Medi-Chat App

    Directory of Open Access Journals (Sweden)

    Mustapha Adamu Mohammed

    2017-05-01

    Full Text Available The aftermath of the development and implementation of the Android operating system and its associated Application Programming InterfacesAPI by Google culminated in the development more mobile device-enabled applications designed for our day-to-day businesses and personal use however in recent times we are experiencing a massive revolution in the use of mobile technology in the health sectors of our economy and this revolution is termed as Mobile Health Technology MHT.This new technological breakthrough has enabled the development of powerful android applications that enabled people tract and monitor the treat of heart and kidney related diseases as well as the monitoring and evaluation certain drug prescriptions. It has also changed the way we communicate with our specialist doctors from phone text to mobile-based communication. All these interventions provided by MHT have drastically increased the efficient and effective provision of health care delivery on one side and providing a common platform for prospective patients to easily interact with health professionals for medical advice and subsequent treatment of their diseases. Moreover In Ghana It would provide a much efficient and cost effective way of improving health-care methodologies in this 21st century which is characterized by information and communication technology. In this paper the main goal is to develop a mobile health application that provides common platform prospective patients and specialist doctors give free consultation and health tips on health related conditions thereby reducing the difficulty and challenges uncounted in accessing free medical health care at the already overburdened hospitals polyclinics and health centers in Ghana.

  7. 21 CFR 515.21 - Refusal to approve a medicated feed mill license application.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Refusal to approve a medicated feed mill license... SERVICES (CONTINUED) ANIMAL DRUGS, FEEDS, AND RELATED PRODUCTS MEDICATED FEED MILL LICENSE Administrative Actions on Licenses § 515.21 Refusal to approve a medicated feed mill license application. (a) The...

  8. 42. Science week: Laser Science and applications, Aleppo (SY), 2-4 Nov 2002, Book two: Laser science and medical laser applications

    International Nuclear Information System (INIS)

    2005-01-01

    This publication includes the papers presented at the 42nd science week of the Supreme Council of Sciences, held in Aleppo (Syria) from 2-4 November 2002. This proceedings is published in three books covering laser science and applications and in particular on material studies and medical uses. Part two covers medical applications, Part three on applications of laser in material sciences, while Part one is for contents and the proceedings program

  9. Contemporary vascular smartphone medical applications.

    Science.gov (United States)

    Carter, Thomas; O'Neill, Stephen; Johns, Neil; Brady, Richard R W

    2013-08-01

    Use of smartphones and medical mHealth applications (apps) within the clinical environment provides a potential means for delivering elements of vascular care. This article reviews the contemporary availability of apps specifically themed to major vascular diseases and the opportunities and concerns regarding their integration into practice. Smartphone apps relating to major vascular diseases were identified from the app stores for the 6 most popular smartphone platforms, including iPhone, Android, Blackberry, Nokia, Windows, and Samsung. Search terms included peripheral artery (arterial) disease, varicose veins, aortic aneurysm, carotid artery disease, amputation, ulcers, hyperhydrosis, thoracic outlet syndrome, vascular malformation, and lymphatic disorders. Forty-nine vascular-themed apps were identified. Sixteen (33%) were free of charge. Fifteen apps (31%) had customer satisfaction ratings, but only 3 (6%) had greater than 100. Only 13 apps (27%) had documented medical professional involvement in their design or content. The integration of apps into the delivery of care has the potential to benefit vascular health care workers and patients. However, high-quality apps designed by clinicians with vascular expertise are currently lacking and represent an area of concern in the mHealth market. Improvement in the quality and reliability of these apps will require the development of robust regulation. Copyright © 2013 Elsevier Inc. All rights reserved.

  10. Integrated Medical Model Project - Overview and Summary of Historical Application

    Science.gov (United States)

    Myers, J.; Boley, L.; Butler, D.; Foy, M.; Goodenow, D.; Griffin, D.; Keenan, A.; Kerstman, E.; Melton, S.; McGuire, K.; hide

    2015-01-01

    Introduction: The Integrated Medical Model (IMM) Project represents one aspect of NASA's Human Research Program (HRP) to quantitatively assess medical risks to astronauts for existing operational missions as well as missions associated with future exploration and commercial space flight ventures. The IMM takes a probabilistic approach to assessing the likelihood and specific outcomes of one hundred medical conditions within the envelope of accepted space flight standards of care over a selectable range of mission capabilities. A specially developed Integrated Medical Evidence Database (iMED) maintains evidence-based, organizational knowledge across a variety of data sources. Since becoming operational in 2011, version 3.0 of the IMM, the supporting iMED, and the expertise of the IMM project team have contributed to a wide range of decision and informational processes for the space medical and human research community. This presentation provides an overview of the IMM conceptual architecture and range of application through examples of actual space flight community questions posed to the IMM project. Methods: Figure 1 [see document] illustrates the IMM modeling system and scenario process. As illustrated, the IMM computational architecture is based on Probabilistic Risk Assessment techniques. Nineteen assumptions and limitations define the IMM application domain. Scenario definitions include crew medical attributes and mission specific details. The IMM forecasts probabilities of loss of crew life (LOCL), evacuation (EVAC), quality time lost during the mission, number of medical resources utilized and the number and type of medical events by combining scenario information with in-flight, analog, and terrestrial medical information stored in the iMED. In addition, the metrics provide the integrated information necessary to estimate optimized in-flight medical kit contents under constraints of mass and volume or acceptable level of mission risk. Results and Conclusions

  11. Colistin- and Carbapenem-Resistant Escherichia coli Harboring mcr-1 and blaNDM-5, Causing a Complicated Urinary Tract Infection in a Patient from the United States

    Directory of Open Access Journals (Sweden)

    José R. Mediavilla

    2016-08-01

    Full Text Available Colistin is increasingly used as an antibiotic of last resort for the treatment of carbapenem-resistant Gram-negative infections. The plasmid-borne colistin resistance gene mcr-1 was initially identified in animal and clinical samples from China and subsequently reported worldwide, including in the United States. Of particular concern is the spread of mcr-1 into carbapenem-resistant bacteria, thereby creating strains that approach pan-resistance. While several reports of mcr-1 have involved carbapenem-resistant strains, no such isolates have been described in the United States. Here, we report the isolation and identification of an Escherichia coli strain harboring both mcr-1 and carbapenemase gene blaNDM-5 from a urine sample in a patient without recent travel outside the United States. The isolate exhibited resistance to both colistin and carbapenems, but was susceptible to amikacin, aztreonam, gentamicin, nitrofurantoin, tigecycline, and trimethoprim-sulfamethoxazole. The mcr-1- and blaNDM-5-harboring plasmids were completely sequenced and shown to be highly similar to plasmids previously reported from China. The strain in this report was first isolated in August 2014, highlighting an earlier presence of mcr-1 within the United States than previously recognized.

  12. [Mobile phone-computer wireless interactive graphics transmission technology and its medical application].

    Science.gov (United States)

    Huang, Shuo; Liu, Jing

    2010-05-01

    Application of clinical digital medical imaging has raised many tough issues to tackle, such as data storage, management, and information sharing. Here we investigated a mobile phone based medical image management system which is capable of achieving personal medical imaging information storage, management and comprehensive health information analysis. The technologies related to the management system spanning the wireless transmission technology, the technical capabilities of phone in mobile health care and management of mobile medical database were discussed. Taking medical infrared images transmission between phone and computer as an example, the working principle of the present system was demonstrated.

  13. Spread of ISCR1 Elements Containing blaDHA-1 and Multiple Antimicrobial Resistance Genes Leading to Increase of Flomoxef Resistance in Extended-Spectrum-β-Lactamase-Producing Klebsiella pneumoniae▿

    Science.gov (United States)

    Lee, Chen-Hsiang; Liu, Jien-Wei; Li, Chia-Chin; Chien, Chun-Chih; Tang, Ya-Fen; Su, Lin-Hui

    2011-01-01

    Increasing resistance to quinolones, aminoglycosides, and/or cephamycins in extended-spectrum-β-lactamase (ESBL)-producing Enterobacteriaceae exacerbates the already limited antibiotic treatment options for infections due to these microbes. In this study, the presence of resistance determinants for these antimicrobial agents was examined by PCR among ESBL-producing Klebsiella pneumoniae (ESBL-KP) isolates that caused bacteremia. Pulsed-field gel electrophoresis was used to differentiate the clonal relationship among the isolates studied. Transferability and the location of the resistance genes were analyzed by conjugation experiments, followed by DNA-DNA hybridization. Among the 94 ESBL-KP isolates studied, 20 isolates of flomoxef-resistant ESBL-KP were identified. They all carried a DHA-1 gene and were genetically diverse. CTX-M genes were found in 18 of the isolates. Among these DHA-1/CTX-M-producing K. pneumoniae isolates, ISCR1 was detected in 13 (72%) isolates, qnr genes (1 qnrA and 17 qnrB genes) were detected in 18 (100%), aac(6′)-Ib-cr was detected in 11 (61%), and 16S rRNA methylase (all armA genes) was detected in 14 (78%). Four transconjugants were available for further analysis, and qnrB4, aac(6′)-Ib-cr, armA, and blaDHA-1 were all identified on these self-transferable blaCTX-M-carrying plasmids. The genetic environments of ISCR1 associated with armA, blaDHA-1, and qnrB4 genes in the four transconjugants were identical. Replicon-type analysis revealed a FIIA plasmid among the four self-transferable plasmids, although the other three were nontypeable. The cotransfer of multiple resistance genes with the ISCR1 element-carrying plasmids has a clinical impact and warrants close monitoring and further study. PMID:21746945

  14. Spread of ISCR1 elements containing blaDHA-₁ and multiple antimicrobial resistance genes leading to increase of flomoxef resistance in extended-spectrum-beta-lactamase-producing Klebsiella pneumoniae.

    Science.gov (United States)

    Lee, Chen-Hsiang; Liu, Jien-Wei; Li, Chia-Chin; Chien, Chun-Chih; Tang, Ya-Fen; Su, Lin-Hui

    2011-09-01

    Increasing resistance to quinolones, aminoglycosides, and/or cephamycins in extended-spectrum-β-lactamase (ESBL)-producing Enterobacteriaceae exacerbates the already limited antibiotic treatment options for infections due to these microbes. In this study, the presence of resistance determinants for these antimicrobial agents was examined by PCR among ESBL-producing Klebsiella pneumoniae (ESBL-KP) isolates that caused bacteremia. Pulsed-field gel electrophoresis was used to differentiate the clonal relationship among the isolates studied. Transferability and the location of the resistance genes were analyzed by conjugation experiments, followed by DNA-DNA hybridization. Among the 94 ESBL-KP isolates studied, 20 isolates of flomoxef-resistant ESBL-KP were identified. They all carried a DHA-1 gene and were genetically diverse. CTX-M genes were found in 18 of the isolates. Among these DHA-1/CTX-M-producing K. pneumoniae isolates, ISCR1 was detected in 13 (72%) isolates, qnr genes (1 qnrA and 17 qnrB genes) were detected in 18 (100%), aac(6')-Ib-cr was detected in 11 (61%), and 16S rRNA methylase (all armA genes) was detected in 14 (78%). Four transconjugants were available for further analysis, and qnrB4, aac(6')-Ib-cr, armA, and bla(DHA-1) were all identified on these self-transferable bla(CTX-M)-carrying plasmids. The genetic environments of ISCR1 associated with armA, bla(DHA-1), and qnrB4 genes in the four transconjugants were identical. Replicon-type analysis revealed a FIIA plasmid among the four self-transferable plasmids, although the other three were nontypeable. The cotransfer of multiple resistance genes with the ISCR1 element-carrying plasmids has a clinical impact and warrants close monitoring and further study.

  15. The application of wiki technology in medical education.

    Science.gov (United States)

    Rasmussen, Andrew; Lewis, Melanie; White, Jonathan

    2013-01-01

    BACKGROUND, AIMS AND METHODS: Recent years have seen the introduction of web-based technologies such as the 'wiki', which is a webpage whose content can be edited in real time using a web browser. This article reviews the current state of knowledge about the use of wikis in education, and considers whether wiki technology has features that might prove useful in medical education. Advantages and challenges of the technology are discussed, and recommendations for use are provided. We believe that wiki technology offers a number of potential benefits for administrators, students and instructors, including the ability to share information online, to construct knowledge together, to facilitate collaboration and to enable social learning and peer feedback. We believe that with proper planning and instructional design, wiki technology can be usefully employed in medical education. We intend to continue to study the impact of wiki technology in our own programme, and we encourage others to evaluate the application of wiki technology in other areas of medical education.

  16. Portable mini gamma camera for medical applications

    CERN Document Server

    Porras, E; Benlloch, J M; El-Djalil-Kadi-Hanifi, M; López, S; Pavon, N; Ruiz, J A; Sánchez, F; Sebastiá, A

    2002-01-01

    A small, portable and low-cost gamma camera for medical applications has been developed and clinically tested. This camera, based on a scintillator crystal and a Position Sensitive Photo-Multiplier Tube, has a useful field of view of 4.6 cm diameter and provides 2.2 mm of intrinsic spatial resolution. Its mobility and light weight allow to reach the patient from any desired direction. This camera images small organs with high efficiency and so addresses the demand for devices of specific clinical applications. In this paper, we present the camera and briefly describe the procedures that have led us to choose its configuration and the image reconstruction method. The clinical tests and diagnostic capability are also presented and discussed.

  17. [Study of the Application of Mobile Medical Technology in Construction of Grading Diagnosis and Treatment System].

    Science.gov (United States)

    Zhu, Wenwu; Shen, Yihong; Zhen, Hui; Yang, Xiaohe; Hu, Kai

    2018-02-08

    The combination of mobile medical technology and the grading diagnosis and treatment system (GDTS) can stimulate the allocation of medical resources, reduce medical cost and improve public health significantly. Firstly we summarize development features of mobile medical technology in foreign and domestic market, then we study the application model of mobile medical application in GDTS with field research data and analyzes its advantage and shortage. Finally, we propose four measures for further developing mobile medical application in the GDTS:the government departments should formulate policies and industry standards of products as soon as possible to meet requirement of market; service providers should take the hospitals as core role to achieve mutual benefit and win-win situation; take the daily monitoring of chronic diseases as an entry point to build profitable business model; enhance publicity to promote public health awareness.

  18. Radiation protection and dosimetry issues in the medical applications of ionizing radiation

    International Nuclear Information System (INIS)

    Vaz, Pedro

    2014-01-01

    The technological advances that occurred during the last few decades paved the way to the dissemination of CT-based procedures in radiology, to an increasing number of procedures in interventional radiology and cardiology as well as to new techniques and hybrid modalities in nuclear medicine and in radiotherapy. These technological advances encompass the exposure of patients and medical staff to unprecedentedly high dose values that are a cause for concern due to the potential detrimental effects of ionizing radiation to the human health. As a consequence, new issues and challenges in radiological protection and dosimetry in the medical applications of ionizing radiation have emerged. The scientific knowledge of the radiosensitivity of individuals as a function of age, gender and other factors has also contributed to raising the awareness of scientists, medical staff, regulators, decision makers and other stakeholders (including the patients and the public) for the need to correctly and accurately assess the radiation induced long-term health effects after medical exposure. Pediatric exposures and their late effects became a cause of great concern. The scientific communities of experts involved in the study of the biological effects of ionizing radiation have made a strong case about the need to undertake low dose radiation research and the International System of Radiological Protection is being challenged to address and incorporate issues such as the individual sensitivities, the shape of dose–response relationship and tissue sensitivity for cancer and non-cancer effects. Some of the answers to the radiation protection and dosimetry issues and challenges in the medical applications of ionizing radiation lie in computational studies using Monte Carlo or hybrid methods to model and simulate particle transport in the organs and tissues of the human body. The development of sophisticated Monte Carlo computer programs and voxel phantoms paves the way to an accurate

  19. State of the art in medical applications using non-thermal atmospheric pressure plasma

    Science.gov (United States)

    Tanaka, Hiromasa; Ishikawa, Kenji; Mizuno, Masaaki; Toyokuni, Shinya; Kajiyama, Hiroaki; Kikkawa, Fumitaka; Metelmann, Hans-Robert; Hori, Masaru

    2017-12-01

    Plasma medical science is a novel interdisciplinary field that combines studies on plasma science and medical science, with the anticipation that understanding the scientific principles governing plasma medical science will lead to innovations in the field. Non-thermal atmospheric pressure plasma has been used for medical treatments, such as for cancer, blood coagulation, and wound healing. The interactions that occur between plasma and cells/tissues have been analyzed extensively. Direct and indirect treatment of cells with plasma has broadened the applications of non-thermal atmospheric pressure plasma in medicine. Examples of indirect treatment include plasma-assisted immune-therapy and plasma-activated medium. Controlling intracellular redox balance may be key in plasma cancer treatment. Animal studies are required to test the effectiveness and safety of these treatments for future clinical applications.

  20. The role of electromagnetic separators in the production of radiotracers for bio-medical research and nuclear medical application

    CERN Document Server

    Beyer, Gerd-Jürgen

    2003-01-01

    With the growing complexity of positron emission tomography/single photon emission computed tomography imaging and the new developments in systemic radionuclide therapy there is a growing need for radioisotope preparations with higher radiochemical and radionuclidic purity that has not been achievable before. Especially important for the new applications is the specific activity of the radiotracer. Conventional methods in medical isotope production have reached their technical limitations. The role of isotope separators is discussed with examples of typical production and characterization experiments conducted at the ISOLDE and TRIUMF facilities. These preliminary experiments indicate that isotope separators have a definite role to play in the future for the production of radioisotopes for biomedical research and medical application.

  1. Organic transistors with high thermal stability for medical applications.

    Science.gov (United States)

    Kuribara, Kazunori; Wang, He; Uchiyama, Naoya; Fukuda, Kenjiro; Yokota, Tomoyuki; Zschieschang, Ute; Jaye, Cherno; Fischer, Daniel; Klauk, Hagen; Yamamoto, Tatsuya; Takimiya, Kazuo; Ikeda, Masaaki; Kuwabara, Hirokazu; Sekitani, Tsuyoshi; Loo, Yueh-Lin; Someya, Takao

    2012-03-06

    The excellent mechanical flexibility of organic electronic devices is expected to open up a range of new application opportunities in electronics, such as flexible displays, robotic sensors, and biological and medical electronic applications. However, one of the major remaining issues for organic devices is their instability, especially their thermal instability, because low melting temperatures and large thermal expansion coefficients of organic materials cause thermal degradation. Here we demonstrate the fabrication of flexible thin-film transistors with excellent thermal stability and their viability for biomedical sterilization processes. The organic thin-film transistors comprise a high-mobility organic semiconductor, dinaphtho[2,3-b:2',3'-f]thieno[3,2-b]thiophene, and thin gate dielectrics comprising a 2-nm-thick self-assembled monolayer and a 4-nm-thick aluminium oxide layer. The transistors exhibit a mobility of 1.2 cm(2) V(-1)s(-1) within a 2 V operation and are stable even after exposure to conditions typically used for medical sterilization.

  2. Image-based electronic patient records for secured collaborative medical applications.

    Science.gov (United States)

    Zhang, Jianguo; Sun, Jianyong; Yang, Yuanyuan; Liang, Chenwen; Yao, Yihong; Cai, Weihua; Jin, Jin; Zhang, Guozhen; Sun, Kun

    2005-01-01

    We developed a Web-based system to interactively display image-based electronic patient records (EPR) for secured intranet and Internet collaborative medical applications. The system consists of four major components: EPR DICOM gateway (EPR-GW), Image-based EPR repository server (EPR-Server), Web Server and EPR DICOM viewer (EPR-Viewer). In the EPR-GW and EPR-Viewer, the security modules of Digital Signature and Authentication are integrated to perform the security processing on the EPR data with integrity and authenticity. The privacy of EPR in data communication and exchanging is provided by SSL/TLS-based secure communication. This presentation gave a new approach to create and manage image-based EPR from actual patient records, and also presented a way to use Web technology and DICOM standard to build an open architecture for collaborative medical applications.

  3. [Medical school admission test at the University of Goettingen - which applicants will benefit?].

    Science.gov (United States)

    Simmenroth-Nayda, Anne; Meskauskas, Erik; Burckhardt, Gerhard; Görlich, Yvonne

    2014-01-01

    Medical schools in Germany may select 60% of the student applicants through their own admission tests. The influence of the school-leaving examination grades (EGs) in each of the procedural steps is controversial. At Goettingen Medical School, we combine a structured interview and a communicative skills assessment. We analysed how many applicants succeeded in our admission test, compared to a model which only takes EGs into account. Admission scores were transferred into SPSS-21. Sociodemographic data were submitted by the Stiftung Hochschulstart. Besides descriptive statistics, we used Pearson-correlation and means comparisons (t-test, analysis of variance). 221 applicants (EGs 1.0-1.9) were invited in the winter semester 2013/14 and 222 applicants (EGs 1.1-1.8) in the summer semester 2014. The proportion of women was 68% (winter) and 74% (summer). Sixteen and 37 applicants had a medical vocational training and performed slightly better. The analysis showed that our test was gender neutral. EGs did not correlate with interviews or skills assessment. Despite a two-fold impact of EGs, 26 (winter) and 44 (summer) of the overall 181 applicants had EGs of 1.4 -1.9, which would have been too low for admission otherwise. If EGs were only considered once, 40 (winter) and 59 (summer) applicants would have succeeded. Copyright © 2014. Published by Elsevier GmbH.

  4. An overview on extremity dosimetry in medical applications

    International Nuclear Information System (INIS)

    Vanhavere, F.; Carinou, E.; Donadille, L.; Ginjaume, M.; Jankowski, J.; Rimpler, A.; Sans Merce, M.

    2008-01-01

    Some activities of EURADOS Working Group 9 (WG9) are presently funded by the European Commission (CONRAD project). The objective of WG9 is to promote and co-ordinate research activities for the assessment of occupational exposures to staff at workplaces in interventional radiology (IR) and nuclear medicine. For some of these applications, the skin of the fingers is the limiting organ for individual monitoring of external radiation. Therefore, sub-group 1 of WG9 deals with the use of extremity dosemeters in medical radiation fields. The wide variety of radiation field characteristics present in a medical environment together with the difficulties in measuring a local dose that is representative for the maximum skin dose, usually with one single detector, makes it difficult to perform accurate extremity dosimetry. Sub-group 1 worked out a thorough literature review on extremity dosimetry issues in diagnostic and therapeutic nuclear medicine and positron emission tomography, interventional radiology and interventional cardiology and brachytherapy. Some studies showed that the annual dose limits could be exceeded if the required protection measures are not taken, especially in nuclear medicine. The continuous progress in new applications and techniques requires an important effort in radiation protection and training. (authors)

  5. Application countermeasures of non-incineration technologies for medical waste treatment in China.

    Science.gov (United States)

    Chen, Yang; Ding, Qiong; Yang, Xiaoling; Peng, Zhengyou; Xu, Diandou; Feng, Qinzhong

    2013-12-01

    By the end of 2012, there were 272 modern, high-standard, centralized medical waste disposal facilities operating in various cities in China. Among these facilities nearly 50% are non-incineration treatment facilities, including the technologies of high temperature steam, chemical disinfection and microwave. Each of the non-incineration technologies has its advantages and disadvantages, and any single technology cannot offer a panacea because of the complexity of medical waste disposal. Although non-incineration treatment of medical waste can avoid the release of polychlorinated dibenzo-p-dioxins/dibenzofurans, it is still necessary to decide how to best meet the local waste management needs while minimizing the impact on the environment and public health. There is still a long way to go to establish the sustainable application and management mode of non-incineration technologies. Based on the analysis of typical non-incineration process, pollutant release, and the current tendency for technology application and development at home and abroad, this article recommends the application countermeasures of non-incineration technologies as the best available techniques and best environmental practices in China.

  6. 28 CFR 552.26 - Medical attention in use of force and application of restraints incidents.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Medical attention in use of force and application of restraints incidents. 552.26 Section 552.26 Judicial Administration BUREAU OF PRISONS... § 552.26 Medical attention in use of force and application of restraints incidents. (a) In immediate use...

  7. [Research on the Application of Lean Management in Medical Consumables Material Logistics Management].

    Science.gov (United States)

    Yang, Chai; Zhang, Wei; Gu, Wei; Shen, Aizong

    2016-11-01

    Solve the problems of high cost, low utilization rate of resources, low medical care quality problem in medical consumables material logistics management for scientific of medical consumables management. Analysis of the problems existing in the domestic medical consumables material logistics management in hospital, based on lean management method, SPD(Supply, Processing, Distribution) for specific applications, combined HBOS(Hospital Business Operation System), HIS (Hospital Information System) system for medical consumables material management. Achieve the lean management in medical consumables material purchase, warehouse construction, push, clinical use and retrospect. Lean management in medical consumables material can effectively control the cost in logistics management, optimize the alocation of resources, liberate unnecessary time of medical staff, improve the quality of medical care. It is a scientific management method.

  8. Report on Workshop 'Radiation protection of the 'consumer' of medical irradiation applications'

    International Nuclear Information System (INIS)

    Geus, W.W.A.A.

    1989-01-01

    The Main division Radioactivity and Applications of Radiation of the Dutch Department of Welfare, Public Health and Culture has organized a 'workshop' on the protection of the patient ( or consumer) in medical applications of radiation. The EG guideline of september 3rd 1984 'In behalf of assessment of fundamental measures with regard to radiation protection of persons who are examined or treated medically' and the advice of the National Council for Public Health brought out thereabout in april 1988, served as background of the contributions and discussions presented in this collection. (H.W.). Refs.; figs.; tabs

  9. [Application Progress of Three-dimensional Laser Scanning Technology in Medical Surface Mapping].

    Science.gov (United States)

    Zhang, Yonghong; Hou, He; Han, Yuchuan; Wang, Ning; Zhang, Ying; Zhu, Xianfeng; Wang, Mingshi

    2016-04-01

    The booming three-dimensional laser scanning technology can efficiently and effectively get spatial three-dimensional coordinates of the detected object surface and reconstruct the image at high speed,high precision and large capacity of information.Non-radiation,non-contact and the ability of visualization make it increasingly popular in three-dimensional surface medical mapping.This paper reviews the applications and developments of three-dimensional laser scanning technology in medical field,especially in stomatology,plastic surgery and orthopedics.Furthermore,the paper also discusses the application prospects in the future as well as the biomedical engineering problems it would encounter with.

  10. A review on the application of medical infrared thermal imaging in hands

    Science.gov (United States)

    Sousa, Elsa; Vardasca, Ricardo; Teixeira, Sérgio; Seixas, Adérito; Mendes, Joaquim; Costa-Ferreira, António

    2017-09-01

    Infrared Thermal (IRT) imaging is a medical imaging modality to study skin temperature in real time, providing physiological information about the underlining structures. One of the most accessible body sites to be investigated using such imaging method is the hands, which can reflect valuable information about conditions affecting the upper limbs. The aim of this review is to acquaint the successful applications of IRT in the hands with a medical scope, opening horizons for future applications based in the achieved results. A systematic literature review was performed in order to assess in which applications medical IRT imaging was applied to the hands. The literature search was conducted in the reference databases: PubMed, Scopus and ISI Web of Science, making use of keywords (hand, thermography, infrared imaging, thermal imaging) combination that were present at the title and abstract. No temporal restriction was made. As a result, 4260 articles were identified, after removal of duplicates, 3224 articles remained and from first title and abstract filtering, a total of 388 articles were considered. After application of exclusion criteria (non-availability, non-clinical applications, reviews, case studies, written in other languages than English and using liquid crystal thermography), 146 articles were considered for this review. It can be verified that thermography provides useful diagnostic and monitoring information of conditions that directly or indirectly related to hands, as well as aiding in the treatment assessment. Trends and future challenges for IRT applications on hands are provided to stimulate researchers and clinicians to explore and address them.

  11. Discussions in symposium 'neutron dosimetry in neutron fields - from detection techniques to medical applications'

    International Nuclear Information System (INIS)

    Tanimura, Y.; Sato, T.; Kumada, H.; Terunuma, T.; Sakae, T.; Harano, H.; Matsumoto, T.; Suzuki, T.; Matsufuji, N.

    2008-01-01

    Recently the traceability system (JCSS) of neutron standard based on the Japanese law 'Measurement Act' has been instituted. In addition, importance of the neutron dose evaluation has been increasing in not only the neutron capture medical treatment but also the proton or heavy particle therapy. Against such a background, a symposium 'Neutron dosimetry in neutron fields - From detection techniques to medical applications-' was held on March 29, 2008 and recent topics on the measuring instruments and their calibration, the traceability system, the simulation technique and the medical applications were introduced. This article summarizes the key points in the discussion at the symposium. (author)

  12. The evolution of cognitive load theory and its application to medical education

    NARCIS (Netherlands)

    Leppink, Jimmie; van den Heuvel, Angelique

    Cognitive Load Theory (CLT) has started to find more applications in medical education research. Unfortunately, misconceptions such as lower cognitive load always being beneficial to learning and the continued use of dated concepts and methods can result in improper applications of CLT principles in

  13. 78 FR 15974 - Importer of Controlled Substances, Notice of Application; Meridian Medical Technologies

    Science.gov (United States)

    2013-03-13

    ... DEPARTMENT OF JUSTICE Drug Enforcement Administration Importer of Controlled Substances, Notice of Application; Meridian Medical Technologies Pursuant to Title 21 Code of Federal Regulations 1301.34 (a), this is notice that on January 8, 2013, Meridian Medical Technologies, 2555 Hermelin Drive, St. Louis...

  14. HTC Vive MeVisLab integration via OpenVR for medical applications.

    Science.gov (United States)

    Egger, Jan; Gall, Markus; Wallner, Jürgen; Boechat, Pedro; Hann, Alexander; Li, Xing; Chen, Xiaojun; Schmalstieg, Dieter

    2017-01-01

    Virtual Reality, an immersive technology that replicates an environment via computer-simulated reality, gets a lot of attention in the entertainment industry. However, VR has also great potential in other areas, like the medical domain, Examples are intervention planning, training and simulation. This is especially of use in medical operations, where an aesthetic outcome is important, like for facial surgeries. Alas, importing medical data into Virtual Reality devices is not necessarily trivial, in particular, when a direct connection to a proprietary application is desired. Moreover, most researcher do not build their medical applications from scratch, but rather leverage platforms like MeVisLab, MITK, OsiriX or 3D Slicer. These platforms have in common that they use libraries like ITK and VTK, and provide a convenient graphical interface. However, ITK and VTK do not support Virtual Reality directly. In this study, the usage of a Virtual Reality device for medical data under the MeVisLab platform is presented. The OpenVR library is integrated into the MeVisLab platform, allowing a direct and uncomplicated usage of the head mounted display HTC Vive inside the MeVisLab platform. Medical data coming from other MeVisLab modules can directly be connected per drag-and-drop to the Virtual Reality module, rendering the data inside the HTC Vive for immersive virtual reality inspection.

  15. HTC Vive MeVisLab integration via OpenVR for medical applications.

    Directory of Open Access Journals (Sweden)

    Jan Egger

    Full Text Available Virtual Reality, an immersive technology that replicates an environment via computer-simulated reality, gets a lot of attention in the entertainment industry. However, VR has also great potential in other areas, like the medical domain, Examples are intervention planning, training and simulation. This is especially of use in medical operations, where an aesthetic outcome is important, like for facial surgeries. Alas, importing medical data into Virtual Reality devices is not necessarily trivial, in particular, when a direct connection to a proprietary application is desired. Moreover, most researcher do not build their medical applications from scratch, but rather leverage platforms like MeVisLab, MITK, OsiriX or 3D Slicer. These platforms have in common that they use libraries like ITK and VTK, and provide a convenient graphical interface. However, ITK and VTK do not support Virtual Reality directly. In this study, the usage of a Virtual Reality device for medical data under the MeVisLab platform is presented. The OpenVR library is integrated into the MeVisLab platform, allowing a direct and uncomplicated usage of the head mounted display HTC Vive inside the MeVisLab platform. Medical data coming from other MeVisLab modules can directly be connected per drag-and-drop to the Virtual Reality module, rendering the data inside the HTC Vive for immersive virtual reality inspection.

  16. The FLUKA Code: Developments and Challenges for High Energy and Medical Applications

    CERN Document Server

    Böhlen, T T; Chin, M P W; Fassò, A; Ferrari, A; Ortega, P G; Mairani, A; Sala, P R; Smirnov, G; Vlachoudis, V

    2014-01-01

    The FLUKA Monte Carlo code is used extensively at CERN for all beam-machine interactions, radioprotection calculations and facility design of forthcoming projects. Such needs require the code to be consistently reliable over the entire energy range (from MeV to TeV) for all projectiles (full suite of elementary particles and heavy ions). Outside CERN, among various applications worldwide, FLUKA serves as a core tool for the HIT and CNAO hadron-therapy facilities in Europe. Therefore, medical applications further impose stringent requirements in terms of reliability and predictive power, which demands constant refinement of sophisticated nuclear models and continuous code improvement. Some of the latest developments implemented in FLUKA are presented in this paper, with particular emphasis on issues and concerns pertaining to CERN and medical applications.

  17. Impact of medicated feed along with clay mineral supplementation on Escherichia coli resistance to antimicrobial agents in pigs after weaning in field conditions.

    Science.gov (United States)

    Jahanbakhsh, Seyedehameneh; Kabore, Kiswendsida Paul; Fravalo, Philippe; Letellier, Ann; Fairbrother, John Morris

    2015-10-01

    The aim of this study was to examine changes in antimicrobial resistance (AMR) phenotype and virulence and AMR gene profiles in Escherichia coli from pigs receiving in-feed antimicrobial medication following weaning and the effect of feed supplementation with a clay mineral, clinoptilolite, on this dynamic. Eighty E. coli strains isolated from fecal samples of pigs receiving a diet containing chlortetracycline and penicillin, with or without 2% clinoptilolite, were examined for antimicrobial resistance to 15 antimicrobial agents. Overall, an increased resistance to 10 antimicrobials was observed with time. Supplementation with clinoptilolite was associated with an early increase but later decrease in blaCMY-2, in isolates, as shown by DNA probe. Concurrently, a later increase in the frequency of blaCMY-2 and the virulence genes iucD and tsh was observed in the control pig isolates, being significantly greater than in the supplemented pigs at day 28. Our results suggest that, in the long term, supplementation with clinoptilolite could decrease the prevalence of E. coli carrying certain antimicrobial resistance and virulence genes. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. Machine learning for epigenetics and future medical applications

    OpenAIRE

    Holder, Lawrence B.; Haque, M. Muksitul; Skinner, Michael K.

    2017-01-01

    ABSTRACT Understanding epigenetic processes holds immense promise for medical applications. Advances in Machine Learning (ML) are critical to realize this promise. Previous studies used epigenetic data sets associated with the germline transmission of epigenetic transgenerational inheritance of disease and novel ML approaches to predict genome-wide locations of critical epimutations. A combination of Active Learning (ACL) and Imbalanced Class Learning (ICL) was used to address past problems w...

  19. Liquid Marbles: From Industrial to Medical Applications

    Directory of Open Access Journals (Sweden)

    Roxana-Elena Avrămescu

    2018-05-01

    Full Text Available Liquid marbles are versatile structures demonstrating a pseudo-Leidenfrost wetting regime formed by encapsulating microscale volumes of liquid in a particle shell. The liquid core is completely separated from the exterior through air pockets. The external phase consists of hydrophobic particles, in most cases, or hydrophilic ones distributed as aggregates. Their interesting features arise from the double solid-fluid character. Thus, these interesting formations, also known as “dry waters”, have gained attention in surface science. This review paper summarizes a series of proposed formulations, fabrication techniques and properties, in correlation with already discovered and emerging applications. A short general review of the surface properties of powders (contact angle, superficial tension is proposed, followed by a presentation of liquid marbles’ properties (superficial characteristics, elasticity, self-propulsion etc.. Finally, applications of liquid marbles are discussed, mainly as helpful and yet to be exploited structures in the pharmaceutical and medical field. Innovative pharmaceutical forms (Pickering emulsions are also means of use taken into account as applications which need further investigation.

  20. Dissemination of medical applications of nuclear energy with virtual reality technology

    International Nuclear Information System (INIS)

    Botelho, Felipe M.; Oliveira, Beatriz A.R.

    2007-01-01

    This work makes use of Virtual Reality technology to disseminate medical applications of nuclear energy, with educational purposes. Virtual Reality is an effective learning tool, since navigation and interaction in virtual worlds can improve motivation in the learning process. With this technology, learning can be achieved in a clearer, joyful and more objective way. Among the existing medical applications of nuclear energy, this work focuses on the use of radiopharmaceuticals. The goal is to simulate this application in a virtual environment, for educational purposes, and to show the absorption of a radiopharmaceutical by the human body, during a diagnostics or treatment procedure. An example has been chosen, for Iodine radiopharmaceutical, which has affinity with the thyroid, and then concentrates in this organ. During the simulation, the concentration of the radioactive Iodine in the thyroid can be emphasized, and in the sequence, the virtual patient can be shown during the imaging procedure. (author)

  1. A qualitative analysis of statements on motivation of applicants for medical school.

    Science.gov (United States)

    Wouters, Anouk; Bakker, Anneke H; van Wijk, Inge J; Croiset, Gerda; Kusurkar, Rashmi A

    2014-09-23

    Selection committees try to ascertain that motivated students are selected for medical school. Self-determination theory stresses that the type of motivation is more important than the quantity of motivation. Autonomous motivation, compared to controlled motivation, in students leads to better learning outcomes. Applicants can express their motivation in written statements, a selection tool which has been found to elicit heterogeneous responses, hampering the comparison of applicants. This study investigates the content of applicants' statements on motivation for medical school in particular, the possibility to distinguish the type of motivation and the differences between selected and non-selected applicants. A thematic analysis was conducted on written statements on motivation (n = 96), collected as a part of the selection procedure for the graduate entry program for medicine and research at our institution. Themes were identified as motivation-related and motivation-unrelated (additional). The motivation-related themes were further classified as autonomous and controlled types of motivation. Group percentages for each theme were compared between selected and non-selected applicants using Chi-square test and Fisher exact test. Applicants mainly described reasons belonging to autonomous type of motivation and fewer reasons belonging to controlled type of motivation. Additional themes in the statements included previous work experience and academic qualifications, ambitions, expectations and descriptions of the program and profession, personal qualities, and personal history. Applicants used strong words to support their stories. The selected and non-selected applicants did not differ in their types of motivation. Non-selected applicants provided more descriptions of personal history than selected applicants (p motivation does not appear to distinguish between applicants in selection for medical school. Both selected and non-selected applicants reported

  2. Medical and surgical applications of space biosensor technology

    Science.gov (United States)

    Hines, J. W.

    1996-01-01

    Researchers in space life sciences are rapidly approaching a technology impasse. Many of the critical questions on the impact of spaceflight on living systems simply cannot be answered with the limited available technologies. Research subjects, particularly small animal models like the rat, must be allowed to function relatively untended and unrestrained for long periods to fully reflect the impact of microgravity and spaceflight on their behavior and physiology. These requirements preclude the use of present hard-wired instrumentation techniques and limited data acquisition systems. Implantable sensors and miniaturized biotelemetry are the only means of capturing the fundamental and critical data. This same biosensor and biotelemetry technology has direct application to Earth-based medicine and surgery. Continuous, on-line data acquisition and improved measurement capabilities combined with the ease and flexibility offered by automated, wireless, and portable instruments and data systems, should provide a boon to the health care industry. Playing a key role in this technology revolution is the Sensors 2000! (S2K!) Program at NASA Ames Research Center. S2K!, in collaboration with space life sciences researchers and managers, provides an integrated capability for sensor technology development and applications, including advanced biosensor technology development, spaceflight hardware development, and technology transfer and commercialization. S2K! is presently collaborating on several spaceflight projects with dual-use medical applications. One prime example is a collaboration with the Fetal Treatment Center (FTC) at the University of California at San Francisco. The goal is to develop and apply implantable chemical sensor and biotelemetry technology to continuously monitor fetal patients during extra-uterine surgery, replacement into the womb, through birth and beyond. Once validated for ground use, the method will be transitioned to spaceflight applications to

  3. Medical and surgical applications of space biosensor technology

    Science.gov (United States)

    Hines, John W.

    1996-02-01

    Researchers in space life sciences are rapidly approaching a technology impasse. Many of the critical questions on the impact of spaceflight on living systems simply cannot be answered with the limited available technologies. Research subjects, particularly small animal models like the rat, must be allowed to function relatively untended and unrestrained for long periods to fully reflect the impact of microgravity and spaceflight on their behavior and physiology. These requirements preclude the use of present hard-wired instrumentation techniques and limited data acquisition systems. Implantable sensors and miniaturized biotelemetry are the only means of capturing the fundamental and critical data. This same biosensor and biotelemetry technology has direct application to Earth-based medicine and surgery. Continuous, on-line data acquisition and improved measurement capabilities combined with the ease and flexibility offered by automated, wireless, and portable instruments and data systems, should provide a boon to the health care industry. Playing a key role in this technology revolution is the Sensors 2000! (S2K!) Program at NASA Ames Research Center. S2K!, in collaboration with space life sciences researchers and managers, provides an integrated capability for sensor technology development and applications, including advanced biosensor technology development, spaceflight hardware development, and technology transfer and commercialization. S2K! is presently collaborating on several spaceflight projects with dual-use medical applications. One prime example is a collaboration with the Fetal Treatment Center (FTC) at the University of California at San Francisco. The goal is to develop and apply implantable chemical sensor and biotelemetry technology to continuously monitor fetal patients during extra-uterine surgery, replacement into the womb, through birth and beyond. Once validated for ground use, the method will be transitioned to spaceflight applications to

  4. 77 FR 19716 - Importer of Controlled Substances; Notice of Application Meridian Medical Technologies

    Science.gov (United States)

    2012-04-02

    ... DEPARTMENT OF JUSTICE Drug Enforcement Administration Importer of Controlled Substances; Notice of Application Meridian Medical Technologies Pursuant to 21 U.S.C. 958(i), the Attorney General shall, prior to... is notice that on January 4, 2012, Meridian Medical Technologies, 2555 Hermelin Drive, St. Louis...

  5. Energy minimization in medical image analysis: Methodologies and applications.

    Science.gov (United States)

    Zhao, Feng; Xie, Xianghua

    2016-02-01

    Energy minimization is of particular interest in medical image analysis. In the past two decades, a variety of optimization schemes have been developed. In this paper, we present a comprehensive survey of the state-of-the-art optimization approaches. These algorithms are mainly classified into two categories: continuous method and discrete method. The former includes Newton-Raphson method, gradient descent method, conjugate gradient method, proximal gradient method, coordinate descent method, and genetic algorithm-based method, while the latter covers graph cuts method, belief propagation method, tree-reweighted message passing method, linear programming method, maximum margin learning method, simulated annealing method, and iterated conditional modes method. We also discuss the minimal surface method, primal-dual method, and the multi-objective optimization method. In addition, we review several comparative studies that evaluate the performance of different minimization techniques in terms of accuracy, efficiency, or complexity. These optimization techniques are widely used in many medical applications, for example, image segmentation, registration, reconstruction, motion tracking, and compressed sensing. We thus give an overview on those applications as well. Copyright © 2015 John Wiley & Sons, Ltd.

  6. Rough-fuzzy pattern recognition applications in bioinformatics and medical imaging

    CERN Document Server

    Maji, Pradipta

    2012-01-01

    Learn how to apply rough-fuzzy computing techniques to solve problems in bioinformatics and medical image processing Emphasizing applications in bioinformatics and medical image processing, this text offers a clear framework that enables readers to take advantage of the latest rough-fuzzy computing techniques to build working pattern recognition models. The authors explain step by step how to integrate rough sets with fuzzy sets in order to best manage the uncertainties in mining large data sets. Chapters are logically organized according to the major phases of pattern recognition systems dev

  7. Graphical User Interfaces for Volume Rendering Applications in Medical Imaging

    OpenAIRE

    Lindfors, Lisa; Lindmark, Hanna

    2002-01-01

    Volume rendering applications are used in medical imaging in order to facilitate the analysis of three-dimensional image data. This study focuses on how to improve the usability of graphical user interfaces of these systems, by gathering user requirements. This is achieved by evaluations of existing systems, together with interviews and observations at clinics in Sweden that use volume rendering to some extent. The usability of the applications of today is not sufficient, according to the use...

  8. Security issues in healthcare applications using wireless medical sensor networks: a survey.

    Science.gov (United States)

    Kumar, Pardeep; Lee, Hoon-Jae

    2012-01-01

    Healthcare applications are considered as promising fields for wireless sensor networks, where patients can be monitored using wireless medical sensor networks (WMSNs). Current WMSN healthcare research trends focus on patient reliable communication, patient mobility, and energy-efficient routing, as a few examples. However, deploying new technologies in healthcare applications without considering security makes patient privacy vulnerable. Moreover, the physiological data of an individual are highly sensitive. Therefore, security is a paramount requirement of healthcare applications, especially in the case of patient privacy, if the patient has an embarrassing disease. This paper discusses the security and privacy issues in healthcare application using WMSNs. We highlight some popular healthcare projects using wireless medical sensor networks, and discuss their security. Our aim is to instigate discussion on these critical issues since the success of healthcare application depends directly on patient security and privacy, for ethic as well as legal reasons. In addition, we discuss the issues with existing security mechanisms, and sketch out the important security requirements for such applications. In addition, the paper reviews existing schemes that have been recently proposed to provide security solutions in wireless healthcare scenarios. Finally, the paper ends up with a summary of open security research issues that need to be explored for future healthcare applications using WMSNs.

  9. Security Issues in Healthcare Applications Using Wireless Medical Sensor Networks: A Survey

    Directory of Open Access Journals (Sweden)

    Hoon-Jae Lee

    2011-12-01

    Full Text Available Healthcare applications are considered as promising fields for wireless sensor networks, where patients can be monitored using wireless medical sensor networks (WMSNs. Current WMSN healthcare research trends focus on patient reliable communication, patient mobility, and energy-efficient routing, as a few examples. However, deploying new technologies in healthcare applications without considering security makes patient privacy vulnerable. Moreover, the physiological data of an individual are highly sensitive. Therefore, security is a paramount requirement of healthcare applications, especially in the case of patient privacy, if the patient has an embarrassing disease. This paper discusses the security and privacy issues in healthcare application using WMSNs. We highlight some popular healthcare projects using wireless medical sensor networks, and discuss their security. Our aim is to instigate discussion on these critical issues since the success of healthcare application depends directly on patient security and privacy, for ethic as well as legal reasons. In addition, we discuss the issues with existing security mechanisms, and sketch out the important security requirements for such applications. In addition, the paper reviews existing schemes that have been recently proposed to provide security solutions in wireless healthcare scenarios. Finally, the paper ends up with a summary of open security research issues that need to be explored for future healthcare applications using WMSNs.

  10. Medical application and its promotion of X-band linacs

    International Nuclear Information System (INIS)

    Uesaka, Mitsuru; Dobashi, Katsuhiro; Kaneyasu, Tatsuo

    2005-01-01

    This article presents the current status of the development of the monochromatic tunable hard X-ray source by the X-band linac and YAG leasers. New medical applications such as 2 colors CT and Drug Delivery System (DDS) are planned. Finally, the virtual laboratory for the distribution of the system to the society is discussed. (author)

  11. Scanning Micromirror Platform Based on MEMS Technology for Medical Application

    Directory of Open Access Journals (Sweden)

    Eakkachai Pengwang

    2016-02-01

    Full Text Available This topical review discusses recent development and trends on scanning micromirrors for biomedical applications. This also includes a biomedical micro robot for precise manipulations in a limited volume. The characteristics of medical scanning micromirror are explained in general with the fundamental of microelectromechanical systems (MEMS for fabrication processes. Along with the explanations of mechanism and design, the principle of actuation are provided for general readers. In this review, several testing methodology and examples are described based on many types of actuators, such as, electrothermal actuators, electrostatic actuators, electromagnetic actuators, pneumatic actuators, and shape memory alloy. Moreover, this review provides description of the key fabrication processes and common materials in order to be a basic guideline for selecting micro-actuators. With recent developments on scanning micromirrors, performances of biomedical application are enhanced for higher resolution, high accuracy, and high dexterity. With further developments on integrations and control schemes, MEMS-based scanning micromirrors would be able to achieve a better performance for medical applications due to small size, ease in microfabrication, mass production, high scanning speed, low power consumption, mechanical stable, and integration compatibility.

  12. MediFrame: A Tablet Application to Plan, Inform, Remind and Sustain Older Adults Medication Intake

    DEFF Research Database (Denmark)

    Dalgaard, Lea Gulstav; Grönvall, Erik; Verdezoto, Nervo

    2013-01-01

    treatment or a specific condition. In this paper, we discuss experiences from designing the tablet-based application MediFrame. MediFrame is a personal medication management system to support older adults in non-clinical settings such as the home. The paper describes the user-centered design process...... and the resulting tablet application. We show how MediFrame can be used to support adherence in medical treatments through fieldwork informed use scenarios. Based on early qualitative feedback, we also discuss lessons learned and how designers can support a holistic medication experience for an older adult...

  13. Review of Cyclotrons for the Production of Radioactive Isotopes for Medical and Industrial Applications

    Science.gov (United States)

    Schmor, Paul

    2011-02-01

    Radioactive isotopes are used in a wide range of medical, biological, environmental and industrial applications. Cyclotrons are the primary tool for producing the shorter-lived, proton-rich radioisotopes currently used in a variety of medical applications. Although the primary use of the cyclotron-produced short-lived radioisotopes is in PET/CT (positron emission tomography/computed tomography) and SPECT (single photon emission computed tomography) diagnostic medical procedures, cyclotrons are also producing longer-lived isotopes for therapeutic procedures as well as for other industrial and applied science applications. Commercial suppliers of cyclotrons are responding by providing a range of cyclotrons in the energy range of 3-70MeV for the differing needs of the various applications. These cyclotrons generally have multiple beams servicing multiple targets. This review article presents some of the applications of the radioisotopes and provides a comparison of some of the capabilities of the various current cyclotrons. The use of nuclear medicine and the number of cyclotrons supplying the needed isotopes are increasing. It is expected that there will soon be a new generation of small "tabletop" cyclotrons providing patient doses on demand.

  14. ``Low Power Wireless Technologies: An Approach to Medical Applications''

    Science.gov (United States)

    Bellido O., Francisco J.; González R., Miguel; Moreno M., Antonio; de La Cruz F, José Luis

    Wireless communication supposed a great both -quantitative and qualitative, jump in the management of the information, allowing the access and interchange of it without the need of a physical cable connection. The wireless transmission of voice and information has remained in constant evolution, arising new standards like BluetoothTM, WibreeTM or ZigbeeTM developed under the IEEE 802.15 norm. These newest wireless technologies are oriented to systems of communication of short-medium distance and optimized for a low cost and minor consume, becoming recognized as a flexible and reliable medium for data communications across a broad range of applications due to the potential that the wireless networks presents to operate in demanding environments providing clear advantages in cost, size, power, flexibility, and distributed intelligence. About the medical applications, the remote health or telecare (also called eHealth) is getting a bigger place into the manufacturers and medical companies, in order to incorporate products for assisted living and remote monitoring of health parameteres. At this point, the IEEE 1073, Personal Health Devices Working Group, stablish the framework for these kind of applications. Particularly, the 1073.3.X describes the physical and transport layers, where the new ultra low power short range wireless technologies can play a big role, providing solutions that allow the design of products which are particularly appropriate for monitor people’s health with interoperability requirements.

  15. Applications of Monte Carlo method in Medical Physics

    International Nuclear Information System (INIS)

    Diez Rios, A.; Labajos, M.

    1989-01-01

    The basic ideas of Monte Carlo techniques are presented. Random numbers and their generation by congruential methods, which underlie Monte Carlo calculations are shown. Monte Carlo techniques to solve integrals are discussed. The evaluation of a simple monodimensional integral with a known answer, by means of two different Monte Carlo approaches are discussed. The basic principles to simualate on a computer photon histories reduce variance and the current applications in Medical Physics are commented. (Author)

  16. High-performance floating-point image computing workstation for medical applications

    Science.gov (United States)

    Mills, Karl S.; Wong, Gilman K.; Kim, Yongmin

    1990-07-01

    The medical imaging field relies increasingly on imaging and graphics techniques in diverse applications with needs similar to (or more stringent than) those of the military, industrial and scientific communities. However, most image processing and graphics systems available for use in medical imaging today are either expensive, specialized, or in most cases both. High performance imaging and graphics workstations which can provide real-time results for a number of applications, while maintaining affordability and flexibility, can facilitate the application of digital image computing techniques in many different areas. This paper describes the hardware and software architecture of a medium-cost floating-point image processing and display subsystem for the NeXT computer, and its applications as a medical imaging workstation. Medical imaging applications of the workstation include use in a Picture Archiving and Communications System (PACS), in multimodal image processing and 3-D graphics workstation for a broad range of imaging modalities, and as an electronic alternator utilizing its multiple monitor display capability and large and fast frame buffer. The subsystem provides a 2048 x 2048 x 32-bit frame buffer (16 Mbytes of image storage) and supports both 8-bit gray scale and 32-bit true color images. When used to display 8-bit gray scale images, up to four different 256-color palettes may be used for each of four 2K x 2K x 8-bit image frames. Three of these image frames can be used simultaneously to provide pixel selectable region of interest display. A 1280 x 1024 pixel screen with 1: 1 aspect ratio can be windowed into the frame buffer for display of any portion of the processed image or images. In addition, the system provides hardware support for integer zoom and an 82-color cursor. This subsystem is implemented on an add-in board occupying a single slot in the NeXT computer. Up to three boards may be added to the NeXT for multiple display capability (e

  17. Synchrotrons and their applications in medical imaging and therapy

    International Nuclear Information System (INIS)

    Lewis, R.

    2004-01-01

    Full text: Australasia's first synchrotron is being built on the campus of Monash University near Melbourne. Is it of any relevance to the medical imaging and radiation therapy communities? The answer is an unequivocal yes. Synchrotrons overcome many of the problems with conventional X-ray sources and as a result make it possible to demonstrate extraordinary advances in both X-ray imaging and indeed in radio-therapy. Synchrotron imaging offers us a window into what is possible and the results are spectacular. Specific examples include lung images that reveal alveolar structure and computed tomography of single cells. For therapy treatments are being pioneered that seem to be effective on high grade gliomas. An overview of the status of medical applications using synchrotrons will be given and the proposed Australian medical imaging and therapy facilities will be described and some of the proposed research highlighted. Copyright (2004) Australasian College of Physical Scientists and Engineers in Medicine

  18. Complete Sequence of pSAM7, an IncX4 Plasmid Carrying a Novel blaCTX-M-14b Transposition Unit Isolated from Escherichia coli and Enterobacter cloacae from Cattle

    NARCIS (Netherlands)

    Stokes, M.O.; Abuoun, M.; Umur, S.; Wu, G.; Partridge, S.R.; Mevius, D.J.; Coldham, N.G.; Fielder, M.D.

    2013-01-01

    The same plasmid carrying blaCTX-M-14b was identified from an Escherichia coli isolate and an Enterobacter cloacae isolate collected from cattle in the United Kingdom by complete plasmid sequencing. This 35,341-bp plasmid, pSAM7, had an IncX4 backbone that is 99% identical to that of pJIE143 from a

  19. 21 CFR 515.25 - Revocation of order refusing to approve a medicated feed mill license application or suspending...

    Science.gov (United States)

    2010-04-01

    ... medicated feed mill license application or suspending or revoking a license. 515.25 Section 515.25 Food and..., FEEDS, AND RELATED PRODUCTS MEDICATED FEED MILL LICENSE Administrative Actions on Licenses § 515.25 Revocation of order refusing to approve a medicated feed mill license application or suspending or revoking a...

  20. The Application of Use Case Modeling in Designing Medical Imaging Information Systems

    International Nuclear Information System (INIS)

    Safdari, Reza; Farzi, Jebraeil; Ghazisaeidi, Marjan; Mirzaee, Mahboobeh; Goodini, Azadeh

    2013-01-01

    Introduction. The essay at hand is aimed at examining the application of use case modeling in analyzing and designing information systems to support Medical Imaging services. Methods. The application of use case modeling in analyzing and designing health information systems was examined using electronic databases (Pubmed, Google scholar) resources and the characteristics of the modeling system and its effect on the development and design of the health information systems were analyzed. Results. Analyzing the subject indicated that Provident modeling of health information systems should provide for quick access to many health data resources in a way that patients' data can be used in order to expand distant services and comprehensive Medical Imaging advices. Also these experiences show that progress in the infrastructure development stages through gradual and repeated evolution process of user requirements is stronger and this can lead to a decline in the cycle of requirements engineering process in the design of Medical Imaging information systems. Conclusion. Use case modeling approach can be effective in directing the problems of health and Medical Imaging information systems towards understanding, focusing on the start and analysis, better planning, repetition, and control

  1. Emergence of serine carbapenemases (KPC and SME) among clinical strains of Enterobacteriaceae isolated in the United States Medical Centers: report from the MYSTIC Program (1999-2005).

    Science.gov (United States)

    Deshpande, Lalitagauri M; Rhomberg, Paul R; Sader, Helio S; Jones, Ronald N

    2006-12-01

    Among 8885 Enterobacteriaceae tested in the 1999 to 2005 period as part of the USA Meropenem Yearly Susceptibility Test Information Collection (MYSTIC) Program, 51 strains with increased imipenem and meropenem MIC values (> or =2 microg/mL) were detected. bla(KPC) was identified from 28 Klebsiella pneumoniae from 3 medical centers in the New York City area (8 ribotypes), 2 Klebsiella oxytoca from Arkansas (same ribotype), 7 Citrobacter freundii (6 from New York [5 ribotypes] and 1 from Delaware), 4 Enterobacter spp. from New York (2 species, different ribotypes), 3 Escherichia coli (2 from New York and 1 from Ohio, same ribotype), and 1 Serratia marcescens (New York). Sequencing confirmed KPC-2 or -3 in all of the strains. S. marcescens strains harboring SME-1 (2 isolates, same ribotype) and SME-2 (1 isolate) were identified from medical centers in Illinois and Washington state, respectively. Our results indicate that bla(KPC-2/3) has emerged widely (New York City area, Arkansas, Delaware, and Ohio) among Enterobacteriaceae isolated in the MYSTIC Program participant sites (2000-2005) and continues to be isolated from multiple species, as a result of clonal expansion and horizontal gene transfer. The escalating occurrence (0.35%) of serine carbapenemases could compromise the role of carbapenems and other beta-lactams in USA clinical practice although observed in only a few locations to date.

  2. Emergence of multidrug-resistant Acinetobacter baumannii producing OXA-23 Carbapenemase in Qatar

    Directory of Open Access Journals (Sweden)

    J.-M. Rolain

    2016-05-01

    Full Text Available The objective of our study was to describe the molecular support of carbapenem resistance from randomly selected clinical isolates of multidrug-resistant (MDR Acinetobacter baumannii as a pilot study from the Hamad Medical Corporation (HMC, Qatar. Results of our report will be used to study carbapenemases using molecular techniques in all isolated MDR A. baumannii. Forty-eight MDR A. baumannii were randomly selected from isolates preserved at HMC. Identification of all isolates was confirmed by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Antibiotic resistance was tested phenotypically by Phoenix and confirmed by Etest. The molecular support of carbapenemases (blaOXA-23, blaOXA-24, blaOXA-58, blaNDM was investigated by real-time PCR. The epidemiologic relatedness of the isolates was verified by phylogenetic analysis based on partial sequences of CsuE and blaOXA-51 genes. All 48 isolates were identified as A. baumannii and were confirmed to be resistant to most antibiotics, especially meropenem, imipenems, ciprofloxacin, levofloxacin, amikacin, gentamicin and most of the β-lactams; they were sensitive to colistin. All the isolates were positive for blaOXA-23 and negative for the other tested carbapenemase genes. Clonality analysis demonstrated that different lineages were actually circulating in Qatar; and we suggest that an outbreak occurred in the medical intensive care unit of HMC between 2011 and 2012. Here we report the emergence of MDR A. baumannii producing the carbapenemase OXA-23 in Qatar.

  3. Application of a latent variables model for the medical images analysis

    International Nuclear Information System (INIS)

    Campos S, Y.; Ruiz C, S.

    2008-01-01

    In recent years the technological advance has allowed the significant advance in diverse research fields, the medicine has not been exempt of this technology and the use of this technology has allowed a significant advance in the equipment that are used to obtain medical images. The quantity of information that is generated with this equipment has grown in exponential form and it is a difficult task to carry out a quantitative analysis of the data also the manipulation of big quantities of information makes the medical images analysis a complicated task. It is in fact this complexity what motivates this work where one of the main objectives is the analysis of techniques that allow to work with the complexity of the data generated with medical equipment. Likewise, it is wanted to illustrate an application of the peaceful uses of the nuclear energy to treat a medical problem where the diagnostic it depends essentially on the current medical equipment to give an appropriate treatment to the patients. (Author)

  4. Fiber optic temperature sensors for medical applications

    Science.gov (United States)

    Schaafsma, David T.; Palmer, Gail; Bechtel, James H.

    2003-07-01

    Recent developments in fiber-optic sensor technology have demonstrated the utility of fiber-optic sensors for both medical and industrial applications. Fiber sensors based on fluorescent decay of rare earth doped materials allow rapid and accurate temperature measurement in challenging environments. Here we review the principles of operation of these sensors with a rare earth doped probe material and demonstrate why this material is an excellent choice for these types of sensors. The decay time technique allows accurate temperature determination from two measurements of the fluorescence intensity at a well-defined time interval. With this method, all instrumental and extraneous environmental effect will cancel, thus providing an accurate temperature measurement. Stability data will be presented for the fiber-optic probes. For medical applications, new breakthroughs in RF ablation technology and electro-surgical procedures are being introduced as alternative, less invasive treatment for removal of small tumors and for removal of plaque within arteries as a preventive treatment that avoids open heart surgery. The availability of small diameter temperature probes (230 microns or 450 microns in diameter) offers a whole new scope to temperature measurement. Accurate and reliable temperature monitoring during any laser treatment procedure or RF ablation at the surgical site is critical. Precise, NIST traceable reliable results are needed to prevent overheating or underheating during treatment. In addition, how interventional catheters are used in hyperthermia studies and the advantages to having flexible cables and multiple sensors are discussed. Preliminary data is given from an animal study where temperature was monitored in a pig during an RF study.

  5. Assessment of CHF characteristics at subcooled conditions for the CANFLEX bundle

    International Nuclear Information System (INIS)

    Onder, E.N.; Leung, L.K.H.

    2013-01-01

    Boiling-Length-Average (BLA) Critical Heat Flux (CHF) values for the CANFLEX bundle at cross-sectional average subcooled conditions have been evaluated using the ASSERT-PV subchannel code. The predicted BLA CHF values supplement experimental BLA CHF values obtained with full-scale bundle simulators at saturated conditions in developing a BLA CHF correlation applicable over the interested range of cross-sectional average thermodynamic quality in regional overpower protection (ROP) trip and safety analyses. The BLA CHF correlation exhibits similar characteristics to those observed in tubes at subcooled and saturated conditions. Applying this correlation has led to similar prediction accuracy in dryout power to that using the BLA CHF-data-based correlation at saturated conditions. However, it provides improved prediction accuracy in dryout power at dryout conditions near saturation compared to the BLA CHF-data-based correlation (which tends to underpredict the dryout power)

  6. Differential barometric-based positioning technique for indoor elevation measurement in IoT medical applications.

    Science.gov (United States)

    Wang, Hua; Wen, Yingyou; Zhao, Dazhe

    2017-07-20

    Medical applications have begun to benefit from Internet of Things (IoT) technology through the introduction of wearable devices. Several medical applications require accurate patient location as various changes affect pressure parameters inside the body. This study aims to develop a system to measure indoor altitude for IoT medical applications. We propose a differential barometric-based positioning system to estimate the altitude between a reference sensor and a localizing sensor connected to the human body. The differential barometric altimetry model is introduced to estimate indoor elevations and eliminate environmental artifacts. In addition, a Gaussian filter processing is adopted to remove noise from the elevation measurements. The proposed system is then investigated through extensive experiments, using various evaluation criteria. The results indicate that the proposed system yielded good accuracy with reduced implementation complexity and fewer costs. The proposed system is resilient compared to other indoor localization approaches, even when numerous environmental artifacts in indoor environments are present.

  7. Medical applications of nuclear physics and heavy-ion beams

    International Nuclear Information System (INIS)

    Alonso, Jose R.

    2000-01-01

    Isotopes and accelerators, hallmarks of nuclear physics, are finding increasingly sophisticated and effective applications in the medical field. Diagnostic and therapeutic uses of radioisotopes are now a $10B/yr business worldwide, with over 10 million procedures and patient studies performed every year. This paper will discuss the use of isotopes for these applications. In addition, beams of protons and heavy ions are being more and more widely used clinically for treatment of malignancies. To be discussed here as well will be the rationale and techniques associated with charged-particle therapy, and the progress in implementation and optimization of these technologies for clinical use

  8. Plasma treatment: A Novel Medical Application

    International Nuclear Information System (INIS)

    Boonyawan, Dheerawan

    2015-01-01

    Cold atmospheric plasma (CAP) for the medical treatment is a new field in plasma application, called plasma medicine. CAP contrains mix of excited atoms and molecules, UV photons, charged particles as well as reactive oxygen species (ROS) and reactive nitrogen species (RNS). Typical species in air CAPs are O 3 , OH, N x , and HNO x . Two cold atomospheric plasma devices were utiized (either in an indirect or a direct way) for the treatment of physiologically healthy volunterrs, The results show that CAP is effective againts chronic wound infections and/ or for skin treatment in clinical trials. The current developments in this field have fuelled the hope that CAP could be, and interesting new therapeutic apptoach in the treatment of cancer.

  9. Early-career researchers in medical applications @ CERN | 6 June | Main Auditorium

    CERN Multimedia

    2016-01-01

      Discover how technological advances for high-energy physics have become essential tools for modern medicine. CERN seeks to answer fundamental questions about the Universe, and this mission naturally contributes to advancing the frontiers of technology. State-of-the-art techniques developed for particle accelerators, detectors, and physics computing have applications beyond the high-energy physics community in the medical field. These applications now have an essential role in clinical practices and medical research centres: from imaging devices, accelerator-technology dedicated to cancer therapy, to simulations and data science tools. This knowledge transfer from the high energy physics community to innovation in other fields is an inherent component of CERN’s mission and culture. It fuels scientific collaboration and technological advances, and drives innovation. In addition, it motivates future generations of scientists, and contributes to the public awareness of the impact of fu...

  10. Ionizing radiation sources used in medical applications in Brazil

    International Nuclear Information System (INIS)

    Araujo, A.M.C.; Carlos, M.T.; Cruz, L.R.F.; Domingues, C.; Farias, J.T.; Ferreira, R.; Figueiredo, L.; Peixoto, J.E.; Oliveira, S.M.V.; Drexler, G.

    1991-02-01

    Preliminary data about ionizing radiation sources used in medical applications and obtained through a national programme by IRD/CNEN together with Brazilian health authorities are presented. The data presentation follows, as close as possible, recommendations given by the United Nations Scientific Committee on Effects of Atomic Radiation (UNSCEAR). This programme has two main aims: First: to contribute for research in the field of ionizing radiation effects and risks including information about equipment quality control and procedures adopted by professionals working in Radiation Medicine. Second: to investigate the radiation protection status in Brazil, in order to give assistance to Brazilian health authorities for planning regional radiation programmes and training programmes for medical staffs. (F.E.). 13 refs, 19 figs, 34 tabs

  11. Medical image registration algorithms assesment Bronze Standard application enactment on grids using the MOTEUR workflow engine

    CERN Document Server

    Glatard, T; Pennec, X

    2006-01-01

    Medical image registration is pre-processing needed for many medical image analysis procedures. A very large number of registration algorithms are available today, but their performance is often not known and very difficult to assess due to the lack of gold standard. The Bronze Standard algorithm is a very data and compute intensive statistical approach for quantifying registration algorithms accuracy. In this paper, we describe the Bronze Standard application and we discuss the need for grids to tackle such computations on medical image databases. We demonstrate MOTEUR, a service-based workflow engine optimized for dealing with data intensive applications. MOTEUR eases the enactment of the Bronze Standard and similar applications on the EGEE production grid infrastructure. It is a generic workflow engine, based on current standards and freely available, that can be used to instrument legacy application code at low cost.

  12. Data bank applications of a nuclear medical computer system

    International Nuclear Information System (INIS)

    Hale, T.I.; Jucker, A.; Haering, W.; Schmid, B.

    1980-01-01

    Computer systems in nuclear medicine are normally not used for data bank applications. A concept for a PDP-11-34 with RK 05 disc is presented, which serves the needs of data manipulations of a medium sized hospital including management of patient data, pharma stock control etc. besides specific use for nuclear medical work with absolute priority. The program is available upon request. (orig.) [de

  13. Applications of nuclear technique in environmental and medical science

    International Nuclear Information System (INIS)

    Shi Xianfeng; Shen Hao; Liu Bo; Sun Minde; Yao Huiying; Zhou Shijun; Mi Yong

    2001-01-01

    The serious environmental pollution problem and application of the nuclear technique in environmental and medical sciences were discussed. The analysed results of the elemental distribution of particles in automobile exhaust, the aerosol particle of different size and the effect of Rare Earth on cells were reported. The authors can obtain some information related to element concentration. It offers a convenient method in inspecting the environmental pollution

  14. Proceedings of the tenth annual symposium on computer applications in medical care

    International Nuclear Information System (INIS)

    Orthner, H.F.

    1988-01-01

    This book covers the proceedings of the tenth annual symposium on Computer Applications in Medical Care. The papers include: Image processing in cardiovascular radiology and radiologic automated diagnosis (RAD)

  15. Detection of Ampicillin Resistance Genes (bla in Clinical Isolates of Escherichia coli with Polymerase Chain Reaction Method

    Directory of Open Access Journals (Sweden)

    Tiana Milanda

    2014-09-01

    Full Text Available Escherichia coli is a rod negative Gram which could be pathogenic, if its value increases or located in outer gastrointestinal tract. Pathogenic E. coli will produce enterotoxin which will cause diarrhoea or infection in urine tract. Ampicilin was one of particular antibiotics to overcome infection. Ampicilin nowadays is no longer used as primary medicine, because of its resistance case. The aim of this research is to detect the presence of gene which is responsible to ampicilin resistant E. coli. We used isolated midstream urine from cystitis object in Hasan Sadikin Hospital (RSHS as samples. Polymerase Chain Reaction (PCR method (colony-PCR and DNA-PCR were done to invenstigate the antibiotic resistency. Based on the result of antibiotic susceptibility testing to ampicillin, E. coli samples were resistant to ampicilin. Elektroforegram products of colony-PCR and DNA-PCR showed that the resistance case of ampicilin caused by bla gene (199 bp. Selective and rational antibiotic treatment is required to prevent ampicillin resistance in patients with symptoms

  16. 78 FR 31563 - Ryan White HIV/AIDS Program Core Medical Services Waiver; Application Requirements

    Science.gov (United States)

    2013-05-24

    ... HIV/AIDS Program Core Medical Services Waiver; Application Requirements AGENCY: Health Resources and... Public Health Service Act, as amended by the Ryan White HIV/AIDS Treatment Extension Act of 2009 (Ryan... medical services, including antiretroviral drugs, for individuals with HIV/AIDS identified and eligible...

  17. An approach for access differentiation design in medical distributed applications built on databases.

    Science.gov (United States)

    Shoukourian, S K; Vasilyan, A M; Avagyan, A A; Shukurian, A K

    1999-01-01

    A formalized "top to bottom" design approach was described in [1] for distributed applications built on databases, which were considered as a medium between virtual and real user environments for a specific medical application. Merging different components within a unified distributed application posits new essential problems for software. Particularly protection tools, which are sufficient separately, become deficient during the integration due to specific additional links and relationships not considered formerly. E.g., it is impossible to protect a shared object in the virtual operating room using only DBMS protection tools, if the object is stored as a record in DB tables. The solution of the problem should be found only within the more general application framework. Appropriate tools are absent or unavailable. The present paper suggests a detailed outline of a design and testing toolset for access differentiation systems (ADS) in distributed medical applications which use databases. The appropriate formal model as well as tools for its mapping to a DMBS are suggested. Remote users connected via global networks are considered too.

  18. Visual servoing in medical robotics: a survey. Part II: tomographic imaging modalities--techniques and applications.

    Science.gov (United States)

    Azizian, Mahdi; Najmaei, Nima; Khoshnam, Mahta; Patel, Rajni

    2015-03-01

    Intraoperative application of tomographic imaging techniques provides a means of visual servoing for objects beneath the surface of organs. The focus of this survey is on therapeutic and diagnostic medical applications where tomographic imaging is used in visual servoing. To this end, a comprehensive search of the electronic databases was completed for the period 2000-2013. Existing techniques and products are categorized and studied, based on the imaging modality and their medical applications. This part complements Part I of the survey, which covers visual servoing techniques using endoscopic imaging and direct vision. The main challenges in using visual servoing based on tomographic images have been identified. 'Supervised automation of medical robotics' is found to be a major trend in this field and ultrasound is the most commonly used tomographic modality for visual servoing. Copyright © 2014 John Wiley & Sons, Ltd.

  19. Application of Irradiation. Application to polymer processing, exhaust gas treatment, sterilization of medical instruments and food

    Energy Technology Data Exchange (ETDEWEB)

    Sawai, Takeshi; Sawai, Teruko

    2000-03-01

    Many fields such as industry, agriculture, medical treatment and environment use radiation. This report explained some examples of irradiation applications. Radiation source is {sup 60}Co {gamma}-ray. Polymer industry use radiation for radiation curing (thermally stable polymer), tire, expanded polymer, radiation induced graft copolymerization and electron beam curing. On environmental conservation, radiation is used for elimination of NOx and SOx in exhaust combustion gas. In the medical treatment, radiation is applied to sterilization of medical instruments, that occupied about 50% volume, and blood for transfusion, which is only one method to prevent GVHD after transfusion. On agriculture, irradiation to spice, dry vegetable, frozen kitchen, potato and garlic are carried out in 30 countries. However, potato is only a kind food in Japan. Radiation breeding and pest control are put in practice. (S.Y.)

  20. USSTRIDE program is associated with competitive Black and Latino student applicants to medical school

    OpenAIRE

    Campbell, Kendall M.; Berne-Anderson, Thesla; Wang, Aihua; Dormeus, Guy; Rodríguez, José E.

    2014-01-01

    Purpose: We compared MCAT scores, grade point averages (GPAs), and medical school acceptance rates of Black and Latino students in an outreach program called Undergraduate Science Students Together Reaching Instructional Diversity and Excellence (USSTRIDE) to non-USSTRIDE students. We hypothesized that Black and Latino participants in USSTRIDE had higher acceptance rates to medical school, higher MCAT scores, and college GPAs when compared to other Black and Latino medical school applicants f...

  1. ELIMED, MEDical and multidisciplinary applications at ELI-Beamlines

    International Nuclear Information System (INIS)

    Schillaci, F; Anzalone, A; Cirrone, G A P; Cuttone, G; Musumarra, A; Pisciotta, P; Romano, F; Romano, F P; Carpinelli, M; Cutroneo, M; De Martinis, C; Giove, D; Korn, G; Maggiore, M; Margarone, D; Manti, L; Perozziello, F M; Petrovic, I; Ristic-Fira, A; Renis, M

    2014-01-01

    ELI-Beamlines is one of the pillars of the pan-European project ELI (Extreme Light Infrastructure). It will be an ultra high-intensity, high repetition-rate, femtosecond laser facility whose main goal is generation and applications of high-brightness X-ray sources and accelerated charged particles in different fields. Particular care will be devoted to the potential applicability of laser-driven ion beams for medical treatments of tumors. Indeed, such kind of beams show very interesting peculiarities and, moreover, laser-driven based accelerators can really represent a competitive alternative to conventional machines since they are expected to be more compact in size and less expensive. The ELIMED project was launched thanks to a collaboration established between FZU-ASCR (ELI-Beamlines) and INFN-LNS researchers. Several European institutes have already shown a great interest in the project aiming to explore the possibility to use laser-driven ion (mostly proton) beams for several applications with a particular regard for medical ones. To reach the project goal several tasks need to be fulfilled, starting from the optimization of laser-target interaction to dosimetric studies at the irradiation point at the end of a proper designed transport beam-line. Researchers from LNS have already developed and successfully tested a high-dispersive power Thomson Parabola Spectrometer, which is the first prototype of a more performing device to be used within the ELIMED project. Also a Magnetic Selection System able to produce a small pencil beam out of a wide energy distribution of ions produced in laser-target interaction has been realized and some preliminary work for its testing and characterization is in progress. In this contribution the status of the project will be reported together with a short description of the of the features of device recently developed.

  2. Smartphone application for mechanical quality assurance of medical linear accelerators

    Science.gov (United States)

    Kim, Hwiyoung; Lee, Hyunseok; In Park, Jong; Choi, Chang Heon; Park, So-Yeon; Kim, Hee Jung; Kim, Young Suk; Ye, Sung-Joon

    2017-06-01

    Mechanical quality assurance (QA) of medical linear accelerators consists of time-consuming and human-error-prone procedures. We developed a smartphone application system for mechanical QA. The system consists of two smartphones: one attached to a gantry for obtaining real-time information on the mechanical parameters of the medical linear accelerator, and another displaying real-time information via a Bluetooth connection with the former. Motion sensors embedded in the smartphone were used to measure gantry and collimator rotations. Images taken by the smartphone’s high-resolution camera were processed to evaluate accuracies of jaw-positioning, crosshair centering and source-to-surface distance (SSD). The application was developed using Android software development kit and OpenCV library. The accuracy and precision of the system was validated against an optical rotation stage and digital calipers, prior to routine QA measurements of five medical linear accelerators. The system accuracy and precision in measuring angles and lengths were determined to be 0.05  ±  0.05° and 0.25  ±  0.14 mm, respectively. The mean absolute errors (MAEs) in QA measurements of gantry and collimator rotation were 0.05  ±  0.04° and 0.05  ±  0.04°, respectively. The MAE in QA measurements of light field was 0.39  ±  0.36 mm. The MAEs in QA measurements of crosshair centering and SSD were 0.40  ±  0.35 mm and 0.41  ±  0.32 mm, respectively. In conclusion, most routine mechanical QA procedures could be performed using the smartphone application system with improved precision and within a shorter time-frame, while eliminating potential human errors.

  3. Smartphone application for mechanical quality assurance of medical linear accelerators.

    Science.gov (United States)

    Kim, Hwiyoung; Lee, Hyunseok; Park, Jong In; Choi, Chang Heon; Park, So-Yeon; Kim, Hee Jung; Kim, Young Suk; Ye, Sung-Joon

    2017-06-07

    Mechanical quality assurance (QA) of medical linear accelerators consists of time-consuming and human-error-prone procedures. We developed a smartphone application system for mechanical QA. The system consists of two smartphones: one attached to a gantry for obtaining real-time information on the mechanical parameters of the medical linear accelerator, and another displaying real-time information via a Bluetooth connection with the former. Motion sensors embedded in the smartphone were used to measure gantry and collimator rotations. Images taken by the smartphone's high-resolution camera were processed to evaluate accuracies of jaw-positioning, crosshair centering and source-to-surface distance (SSD). The application was developed using Android software development kit and OpenCV library. The accuracy and precision of the system was validated against an optical rotation stage and digital calipers, prior to routine QA measurements of five medical linear accelerators. The system accuracy and precision in measuring angles and lengths were determined to be 0.05  ±  0.05° and 0.25  ±  0.14 mm, respectively. The mean absolute errors (MAEs) in QA measurements of gantry and collimator rotation were 0.05  ±  0.04° and 0.05  ±  0.04°, respectively. The MAE in QA measurements of light field was 0.39  ±  0.36 mm. The MAEs in QA measurements of crosshair centering and SSD were 0.40  ±  0.35 mm and 0.41  ±  0.32 mm, respectively. In conclusion, most routine mechanical QA procedures could be performed using the smartphone application system with improved precision and within a shorter time-frame, while eliminating potential human errors.

  4. A Review on the 3D Printing of Functional Structures for Medical Phantoms and Regenerated Tissue and Organ Applications

    Directory of Open Access Journals (Sweden)

    Kan Wang

    2017-10-01

    Full Text Available Medical models, or “phantoms,” have been widely used for medical training and for doctor-patient interactions. They are increasingly used for surgical planning, medical computational models, algorithm verification and validation, and medical devices development. Such new applications demand high-fidelity, patient-specific, tissue-mimicking medical phantoms that can not only closely emulate the geometric structures of human organs, but also possess the properties and functions of the organ structure. With the rapid advancement of three-dimensional (3D printing and 3D bioprinting technologies, many researchers have explored the use of these additive manufacturing techniques to fabricate functional medical phantoms for various applications. This paper reviews the applications of these 3D printing and 3D bioprinting technologies for the fabrication of functional medical phantoms and bio-structures. This review specifically discusses the state of the art along with new developments and trends in 3D printed functional medical phantoms (i.e., tissue-mimicking medical phantoms, radiologically relevant medical phantoms, and physiological medical phantoms and 3D bio-printed structures (i.e., hybrid scaffolding materials, convertible scaffolds, and integrated sensors for regenerated tissues and organs.

  5. Application of the ICRP recommendations in medical radiation practice and in medical monitoring of workers

    International Nuclear Information System (INIS)

    Lafontaine, A.

    1979-01-01

    Medical exposure in connection with an existing or suspected illness may be made subject to the ICRP principles, but it must be realized that the dose limitation system cannot necessarily be applied when the individual at risk is the one benefiting from examination or treatment. Justification is the responsibility of the doctor prescribing the examination or treatment and/or of the person carrying it out. Optimization will be achieved by virtue of the rules imposed on doctors and by the requirements applicable to equipment and techniques. The same rules and requirements apply mutatis mutandis to check-ups, routine medical examinations, examinations for professional purposes, medico-legal examinations and medical research. In the last case ethical rules and criteria for the validity of the proposed research also need to be applied. Medical monitoring of workers must take the ICRP principles into account, but a qualified doctor should nevertheless be able to form his own judgement on the basis of his knowledge of different types of exposure (both to radiation and to other agents), to intervene in cases of accidental or planned exposure, and to gather data in order to evaluate the long-term effects and the consequences of occupational exposure in terms of doses to the public. Moreover, the doctor should inform the worker of his conclusions and recommendations. (author)

  6. Radiation environmental impact assessment of the radioisotope's application on nuclear medical science

    International Nuclear Information System (INIS)

    Liu Hongshi

    2004-01-01

    The radiation environmental impact assessment of the radioisotope's application on nuclear medical science is introduced, including the assessment criteria, the assessment methods and the environmental impact assessment of three wastes emission. (authors)

  7. Medical Cyclotrons

    Science.gov (United States)

    Friesel, D. L.; Antaya, T. A.

    Particle accelerators were initially developed to address specific scientific research goals, yet they were used for practical applications, particularly medical applications, within a few years of their invention. The cyclotron's potential for producing beams for cancer therapy and medical radioisotope production was realized with the early Lawrence cyclotrons and has continued with their more technically advanced successors — synchrocyclotrons, sector-focused cyclotrons and superconducting cyclotrons. While a variety of other accelerator technologies were developed to achieve today's high energy particles, this article will chronicle the development of one type of accelerator — the cyclotron, and its medical applications. These medical and industrial applications eventually led to the commercial manufacture of both small and large cyclotrons and facilities specifically designed for applications other than scientific research.

  8. Medical Applications of Laser Induced Breakdown Spectroscopy

    International Nuclear Information System (INIS)

    Pathak, A K; Rai, N K; Singh, Ankita; Rai, A K; Rai, Pradeep K; Rai, Pramod K

    2014-01-01

    Sedentary lifestyle of human beings has resulted in various diseases and in turn we require a potential tool that can be used to address various issues related to human health. Laser Induced Breakdown Spectroscopy (LIBS) is one such potential optical analytical tool that has become quite popular because of its distinctive features that include applicability to any type/phase of samples with almost no sample preparation. Several reports are available that discusses the capabilities of LIBS, suitable for various applications in different branches of science which cannot be addressed by traditional analytical methods but only few reports are available for the medical applications of LIBS. In the present work, LIBS has been implemented to understand the role of various elements in the formation of gallstones (formed under the empyema and mucocele state of gallbladder) samples along with patient history that were collected from Purvancal region of Uttar Pradesh, India. The occurrence statistics of gallstones under the present study reveal higher occurrence of gallstones in female patients. The gallstone occurrence was found more prevalent for those male patients who were having the habit of either tobacco chewing, smoking or drinking alcohols. This work further reports in-situ LIBS study of deciduous tooth and in-vivo LIBS study of human nail

  9. Study on the Application Mode and Legal Protection of Green Materials in Medical-Nursing Combined Building

    Science.gov (United States)

    Zhiyong, Xian

    2017-09-01

    In the context of green development, green materials are the future trend of Medical-Nursing Combined building. This paper summarizes the concept and types of green building materials. Then, on the basis of existing research, it constructs the green material system framework of Medical-Nursing Combined building, puts forward the application mode of green building materials, and studies the policy and legal protection of green material application.

  10. Medical applications of membranes: Drug delivery, artificial organs and tissue engineering

    NARCIS (Netherlands)

    Stamatialis, Dimitrios; Papenburg, B.J.; Girones nogue, Miriam; Saiful, S.; Bettahalli Narasimha, M.S.; Schmitmeier, Stephanie; Wessling, Matthias

    2008-01-01

    This paper covers the main medical applications of artificial membranes. Specific attention is given to drug delivery systems, artificial organs and tissue engineering which seem to dominate the interest of the membrane community this period. In all cases, the materials, methods and the current

  11. [Development and evaluation of the medical imaging distribution system with dynamic web application and clustering technology].

    Science.gov (United States)

    Yokohama, Noriya; Tsuchimoto, Tadashi; Oishi, Masamichi; Itou, Katsuya

    2007-01-20

    It has been noted that the downtime of medical informatics systems is often long. Many systems encounter downtimes of hours or even days, which can have a critical effect on daily operations. Such systems remain especially weak in the areas of database and medical imaging data. The scheme design shows the three-layer architecture of the system: application, database, and storage layers. The application layer uses the DICOM protocol (Digital Imaging and Communication in Medicine) and HTTP (Hyper Text Transport Protocol) with AJAX (Asynchronous JavaScript+XML). The database is designed to decentralize in parallel using cluster technology. Consequently, restoration of the database can be done not only with ease but also with improved retrieval speed. In the storage layer, a network RAID (Redundant Array of Independent Disks) system, it is possible to construct exabyte-scale parallel file systems that exploit storage spread. Development and evaluation of the test-bed has been successful in medical information data backup and recovery in a network environment. This paper presents a schematic design of the new medical informatics system that can be accommodated from a recovery and the dynamic Web application for medical imaging distribution using AJAX.

  12. An Overview of Mechanical Properties and Material Modeling of Polylactide (PLA) for Medical Applications.

    Science.gov (United States)

    Bergström, Jörgen S; Hayman, Danika

    2016-02-01

    This article provides an overview of the connection between the microstructural state and the mechanical response of various bioresorbable polylactide (PLA) devices for medical applications. PLLA is currently the most commonly used material for bioresorbable stents and sutures, and its use is increasing in many other medical applications. The non-linear mechanical response of PLLA, due in part to its low glass transition temperature (T g ≈ 60 °C), is highly sensitive to the molecular weight and molecular orientation field, the degree of crystallinity, and the physical aging time. These microstructural parameters can be tailored for specific applications using different resin formulations and processing conditions. The stress-strain, deformation, and degradation response of a bioresorbable medical device is also strongly dependent on the time history of applied loads and boundary conditions. All of these factors can be incorporated into a suitable constitutive model that captures the multiple physics that are involved in the device response. Currently developed constitutive models already provide powerful computations simulation tools, and more progress in this area is expected to occur in the coming years.

  13. Security Issues in Healthcare Applications Using Wireless Medical Sensor Networks: A Survey

    OpenAIRE

    Hoon-Jae Lee; Pardeep Kumar

    2011-01-01

    Healthcare applications are considered as promising fields for wireless sensor networks, where patients can be monitored using wireless medical sensor networks (WMSNs). Current WMSN healthcare research trends focus on patient reliable communication, patient mobility, and energy-efficient routing, as a few examples. However, deploying new technologies in healthcare applications without considering security makes patient privacy vulnerable. Moreover, the physiological data of an individual are ...

  14. Country status of application, manufacturing and sterilization of single-use medical products

    International Nuclear Information System (INIS)

    Norimah Yusof

    1986-01-01

    The paper reviews the current status of application of single-use medical products in Malaysia. The status of their manufacturing and sterilization is also discussed. The increasing production of such items calls for a more reliable and efficient sterilization technique in particular, radiation sterilization. In line with the demand and the effort to increase local production of medical products, UTN would be providing irradiation service together with research and development in this particular field by 1988. (author)

  15. Update on Research and Application of Problem-Based Learning in Medical Science Education

    Science.gov (United States)

    Fan, Chuifeng; Jiang, Biying; Shi, Xiuying; Wang, Enhua; Li, Qingchang

    2018-01-01

    Problem-based learning (PBL) is a unique form of pedagogy dedicated to developing students' self-learning and clinical practice skills. After several decades of development, although applications vary, PBL has been recognized all over the world and implemented by many medical schools. This review summarizes and updates the application and study of…

  16. Radiation processed hydrogels (wound dressings) for medical applications

    International Nuclear Information System (INIS)

    Varshney, Lalit

    2004-01-01

    Thermal analysis plays an important role in study and development of hydrogel materials for medical applications. Thermal stability of the ingredients which is important from the point of manufacturing, rate of evaporation for shelf life evaluation, determination of gelation and temperature responsive temperatures, cooling behaviour, gel elasticity, radiation effects etc. can be studied using thermal analysis equipment like Differential scanning calorimetry (DSC), Thermo-gravimetric analysis (TGA) and thermo-mechanical analysis (TMA). In this use of these techniques in development, evaluation and quality control of hydrogel wound dressing is discussed

  17. Modeling of bubble dynamics in relation to medical applications

    Energy Technology Data Exchange (ETDEWEB)

    Amendt, P.A.; London, R.A. [Lawrence Livermore National Lab., CA (United States); Strauss, M. [California Univ., Davis, CA (United States)]|[Israel Atomic Energy Commission, Beersheba (Israel). Nuclear Research Center-Negev] [and others

    1997-03-12

    In various pulsed-laser medical applications, strong stress transients can be generated in advance of vapor bubble formation. To better understand the evolution of stress transients and subsequent formation of vapor bubbles, two-dimensional simulations are presented in channel or cylindrical geometry with the LATIS (LAser TISsue) computer code. Differences with one-dimensional modeling are explored, and simulated experimental conditions for vapor bubble generation are presented and compared with data. 22 refs., 8 figs.

  18. Modeling of bubble dynamics in relation to medical applications

    International Nuclear Information System (INIS)

    Amendt, P.A.; London, R.A.; Strauss, M.; Israel Atomic Energy Commission, Beersheba

    1997-01-01

    In various pulsed-laser medical applications, strong stress transients can be generated in advance of vapor bubble formation. To better understand the evolution of stress transients and subsequent formation of vapor bubbles, two-dimensional simulations are presented in channel or cylindrical geometry with the LATIS (LAser TISsue) computer code. Differences with one-dimensional modeling are explored, and simulated experimental conditions for vapor bubble generation are presented and compared with data. 22 refs., 8 figs

  19. Calibration and application of medical particle accelerators to space radiation experiments

    International Nuclear Information System (INIS)

    Ryu, Kwangsun; Park, Miyoung; Chae, Jangsoo; Yoon, Sangpil; Shin, Dongho

    2012-01-01

    In this paper, we introduce radioisotope facilities and medical particle accelerators that can be applied to space radiation experiments and the experimental conditions required by the space radiation experiments. Space radiation experiments on the ground are critical in determining the lifetimes of satellites and in choosing or preparing the appropriate electrical parts to assure the designated mission lifetime. Before the completion of building the 100-MeV proton linear accelerator in Gyeongju, or even after the completion, the currently existing proton accelerators for medical purposes could suggest an alternative plan. We have performed experiments to calibrate medical proton beam accelerators to investigate whether the beam conditions are suitable for applications to space radiation experiments. Based on the calibration results, we propose reference beam operation conditions for space radiation experiments.

  20. Affective computing and medical informatics: state of the art in emotion-aware medical applications.

    Science.gov (United States)

    Luneski, Andrej; Bamidis, Panagiotis D; Hitoglou-Antoniadou, Madga

    2008-01-01

    The area of affective computing has received significant attention by the research community over the last few years. In this paper we review the underlying principles in the field, in an effort to draw threads for possible future development within medical informatics. The approach is lead by considering the three main affective channels, namely, visual, audio/speech, and physiological in relation to e-health, emotional intelligence and e-learning. A discussion on the importance of past and present applications together with a prediction on future literature output is also provided.

  1. Design Investigation on Applicable Mesh Structures for Medical Stent Applications

    Science.gov (United States)

    Asano, Shoji; He, Jianmei

    2017-11-01

    In recent years, utilization of medical stents is one of effective treatments for stenosis and occlusion occurring in a living body’s lumen indispensable for maintenance of human life such as superficial femoral artery (SFA) occlusion. However, there are concerns about the occurrence of fatigue fractures caused by stress concentrations, neointimal hyperplasia and the like due to the shape structure and the manufacturing method in the conventional stents, and a stent having high strength and high flexibility is required. Therefore, in this research, applicable mesh structures for medical stents based on the design concepts of high strength, high flexibility are interested to solve various problem of conventional stent. According to the shape and dimensions of SFA occlusion therapy stent and indwelling delivery catheter, shape design of the meshed stent are performed using 3-dimensional CAD software Solid Works first. Then analytical examination on storage characteristics and compression characteristics of such mesh structure applied stent models were carried out through finite element analysis software ANSYS Workbench. Meshed stent models with higher strength and higher flexibility with integral molding are investigated analytically. It was found that the storage characteristics and compression characteristics of meshed stent modles are highly dependent on the basic mesh shapes with same surface void ratio. Trade-off relationship between flexibility and storage characteristics is found exited, it is required to provide appropriate curvatures during basic mesh shape design.

  2. Peculiarities of medical sociology: application of social theories in analyzing health and medicine.

    Science.gov (United States)

    Kaminskas, Raimundas; Darulis, Zilvinas

    2007-01-01

    To reveal the peculiarities of medical sociology introducing the application of social theories in analyzing public health and medicine. Comparative and descriptive analysis of scientific references found and current situation. During the last decade of the 20th century, the discussions about the sociology of health and medicine as separate discipline and its practical applications became more active. Main factors determined the growing importance of discipline were institutionalization of medicine and health care, changing patterns in doctor-patient relationships, different health perceptions, understanding of the influence of social factors on health, cardinal changes in the area of health technologies, consumeristic attitude towards health, appearance of market relationships within health care, and other global phenomena. In sociology, usual social theories such as structural functionalism, conflict, symbolic interaction, poststructuralism, feminist often attempt to explain the changes within health care. There is a relation of medical sociology and other types of sociology having common areas with medicine and health being analyzed in the article; social theories and their application in the field of health and medicine are being introduced attempting to explain the ongoing social changes in both Lithuania and the world. More and more attention in various areas of medical activities is being paid to the social aspects (both individual and society levels) of these activities, and there is a shift from applied sociology towards medical one. Despite the cessations of the development of medical sociology as separate branch of sciences, the researches of recent years are demonstrating obvious approaching modern research issues and methods, which do exist in contemporary world. Such tendencies show the prompt approaching of the academic community of Lithuania the general scientific standards which are dominating in the globalization-effected world.

  3. Evaluation of critical thinking application in medical ultrasound practice among sonographers in south-eastern Nigeria

    International Nuclear Information System (INIS)

    Agwu, K.K.; Ogbu, S.O.I.; Okpara, E.

    2007-01-01

    Purpose: To investigate the application of critical thinking (CT) in medical ultrasound by sonographers in south-eastern Nigeria as a measure of the quality of practice. Methods: A semi-structured questionnaire based on six elements of CT was distributed to 82 sonographers selected through a simple random sampling. The questionnaire investigated the application of the elements of interpretation, analysis, evaluation, inference, explanation and self-regulation involved in CT by medical sonographers. The data for each respondent were categorized into age, experience and the elements of CT. Statistical analyses were done using mean and Spearman's Rank correlation. Results: The overall mean score of the practitioners on all the elements of CT application was 8.65 ± 6.76 against a total of 60. The application of CT did not show any correlation with age or clinical experience using Spearman's Rank correlation (r = -0.017; p > 0.05 and r = -0.086; p > 0.05, respectively). Conclusions: The results show that there is poor application of CT by medical sonographers in the locality which may impact negatively on the outcome of this diagnostic process. Increase in the number of formal training programmes in sonography and inclusion of CT skills in the curriculum are recommended

  4. Presence of quinolone resistance to qnrB1 genes and blaOXA-48 carbapenemase in clinical isolates of Klebsiella pneumoniae in Spain.

    Science.gov (United States)

    Rodríguez Martínez, J M; Díaz-de Alba, P; Lopez-Cerero; Ruiz-Carrascoso, G; Gomez-Gil, R; Pascual, A

    2014-01-01

    A study is presented on the presence of quinolone resistance qnrB1 genes in clinical isolates belonging to the largest series of infections caused by OXA-48-producing Klebsiella pneumoniae in a single-centre outbreak in Spain. Evidence is also provided, according to in vitro results, that there is a possibility of co-transfer of plasmid harbouring blaOXA-48 with an other plasmid harbouring qnrB1 in presence of low antibiotic concentrations of fluoroquinolones, showing the risk of multi-resistance screening. Copyright © 2013 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  5. 77 FR 5213 - Medicare Program; Emergency Medical Treatment and Labor Act (EMTALA): Applicability to Hospital...

    Science.gov (United States)

    2012-02-02

    ... [CMS-1350-NC] RIN 0938-AQ51 Medicare Program; Emergency Medical Treatment and Labor Act (EMTALA... the applicability of the Emergency Medical Treatment and Labor Act (EMTALA) to hospital inpatients... available to persons without Federal government identification, commenters are encouraged to leave their...

  6. Colistin- and Carbapenem-Resistant Escherichia coli Harboring mcr-1 and blaNDM-5, Causing a Complicated Urinary Tract Infection in a Patient from the United States.

    Science.gov (United States)

    Mediavilla, José R; Patrawalla, Amee; Chen, Liang; Chavda, Kalyan D; Mathema, Barun; Vinnard, Christopher; Dever, Lisa L; Kreiswirth, Barry N

    2016-08-30

    Colistin is increasingly used as an antibiotic of last resort for the treatment of carbapenem-resistant Gram-negative infections. The plasmid-borne colistin resistance gene mcr-1 was initially identified in animal and clinical samples from China and subsequently reported worldwide, including in the United States. Of particular concern is the spread of mcr-1 into carbapenem-resistant bacteria, thereby creating strains that approach pan-resistance. While several reports of mcr-1 have involved carbapenem-resistant strains, no such isolates have been described in the United States. Here, we report the isolation and identification of an Escherichia coli strain harboring both mcr-1 and carbapenemase gene blaNDM-5 from a urine sample in a patient without recent travel outside the United States. The isolate exhibited resistance to both colistin and carbapenems, but was susceptible to amikacin, aztreonam, gentamicin, nitrofurantoin, tigecycline, and trimethoprim-sulfamethoxazole. The mcr-1- and blaNDM-5-harboring plasmids were completely sequenced and shown to be highly similar to plasmids previously reported from China. The strain in this report was first isolated in August 2014, highlighting an earlier presence of mcr-1 within the United States than previously recognized. Colistin has become the last line of defense for the treatment of infections caused by Gram-negative bacteria resistant to multiple classes of antibiotics, in particular carbapenem-resistant Enterobacteriaceae (CRE). Resistance to colistin, encoded by the plasmid-borne gene mcr-1, was first identified in animal and clinical samples from China in November 2015 and has subsequently been reported from numerous other countries. In April 2016, mcr-1 was identified in a carbapenem-susceptible Escherichia coli strain from a clinical sample in the United States, followed by a second report from a carbapenem-susceptible E. coli strain originally isolated in May 2015. We report the isolation and identification of

  7. Applications for approval to market a new drug; complete response letter; amendments to unapproved applications. Final rule.

    Science.gov (United States)

    2008-07-10

    The Food and Drug Administration (FDA) is amending its regulations on new drug applications (NDAs) and abbreviated new drug applications (ANDAs) for approval to market new drugs and generic drugs (drugs for which approval is sought in an ANDA). The final rule discontinues FDA's use of approvable letters and not approvable letters when taking action on marketing applications. Instead, we will send applicants a complete response letter to indicate that the review cycle for an application is complete and that the application is not ready for approval. We are also revising the regulations on extending the review cycle due to the submission of an amendment to an unapproved application and starting a new review cycle after the resubmission of an application following receipt of a complete response letter. In addition, we are adding to the regulations on biologics license applications (BLAs) provisions on the issuance of complete response letters to BLA applicants. We are taking these actions to implement the user fee performance goals referenced in the Prescription Drug User Fee Amendments of 2002 (PDUFA III) that address procedures and establish target timeframes for reviewing human drug applications.

  8. MCNP6 simulation of reactions of interest to FRIB, medical, and space applications

    International Nuclear Information System (INIS)

    Mashnik, Stepan G.

    2015-01-01

    The latest production-version of the Los Alamos Monte Carlo N-Particle transport code MCNP6 has been used to simulate a variety of particle-nucleus and nucleus-nucleus reactions of academic and applied interest to research subjects at the Facility for Rare Isotope Beams (FRIB), medical isotope production, space-radiation shielding, cosmic-ray propagation, and accelerator applications, including several reactions induced by radioactive isotopes, analyzing production of both stable and radioactive residual nuclei. Here, we discuss examples of validation and verification of MCNP6 by comparing with recent neutron spectra measured at the Heavy Ion Medical Accelerator in Chiba, Japan; spectra of light fragments from several reactions measured recently at GANIL, France; INFN Laboratori Nazionali del Sud, Catania, Italy; COSY of the Jülich Research Center, Germany; and cross sections of products from several reactions measured lately at GSI, Darmstadt, Germany; ITEP, Moscow, Russia; and, LANSCE, LANL, Los Alamos, U.S.A. As a rule, MCNP6 provides quite good predictions for most of the reactions we analyzed so far, allowing us to conclude that it can be used as a reliable and useful simulation tool for various applications for FRIB, medical, and space applications involving stable and radioactive isotopes. (author)

  9. Nanodiamonds for Medical Applications: Interaction with Blood in Vitro and in Vivo.

    Science.gov (United States)

    Tsai, Lin-Wei; Lin, Yu-Chung; Perevedentseva, Elena; Lugovtsov, Andrei; Priezzhev, Alexander; Cheng, Chia-Liang

    2016-07-12

    Nanodiamonds (ND) have emerged to be a widely-discussed nanomaterial for their applications in biological studies and for medical diagnostics and treatment. The potentials have been successfully demonstrated in cellular and tissue models in vitro. For medical applications, further in vivo studies on various applications become important. One of the most challenging possibilities of ND biomedical application is controllable drug delivery and tracing. That usually assumes ND interaction with the blood system. In this work, we study ND interaction with rat blood and analyze how the ND surface modification and coating can optimize the ND interaction with the blood. It was found that adsorption of a low concentration of ND does not affect the oxygenation state of red blood cells (RBC). The obtained in vivo results are compared to the results of in vitro studies of nanodiamond interaction with rat and human blood and blood components, such as red blood cells and blood plasma. An in vivo animal model shows ND injected in blood attach to the RBC membrane and circulate with blood for more than 30 min; and ND do not stimulate an immune response by measurement of proinflammatory cytokine TNF-α with ND injected into mice via the caudal vein. The results further confirm nanodiamonds' safety in organisms, as well as the possibility of their application without complicating the blood's physiological conditions.

  10. Nanodiamonds for Medical Applications: Interaction with Blood in Vitro and in Vivo

    Directory of Open Access Journals (Sweden)

    Lin-Wei Tsai

    2016-07-01

    Full Text Available Nanodiamonds (ND have emerged to be a widely-discussed nanomaterial for their applications in biological studies and for medical diagnostics and treatment. The potentials have been successfully demonstrated in cellular and tissue models in vitro. For medical applications, further in vivo studies on various applications become important. One of the most challenging possibilities of ND biomedical application is controllable drug delivery and tracing. That usually assumes ND interaction with the blood system. In this work, we study ND interaction with rat blood and analyze how the ND surface modification and coating can optimize the ND interaction with the blood. It was found that adsorption of a low concentration of ND does not affect the oxygenation state of red blood cells (RBC. The obtained in vivo results are compared to the results of in vitro studies of nanodiamond interaction with rat and human blood and blood components, such as red blood cells and blood plasma. An in vivo animal model shows ND injected in blood attach to the RBC membrane and circulate with blood for more than 30 min; and ND do not stimulate an immune response by measurement of proinflammatory cytokine TNF-α with ND injected into mice via the caudal vein. The results further confirm nanodiamonds’ safety in organisms, as well as the possibility of their application without complicating the blood’s physiological conditions.

  11. Examining the application of Web 2.0 in medical-related organisations.

    Science.gov (United States)

    Chu, Samuel Kai Wah; Woo, Matsuko; King, Ronnel B; Choi, Stephen; Cheng, Miffy; Koo, Peggy

    2012-03-01

    This study surveyed Web 2.0 application in three types of selected health or medical-related organisations such as university medical libraries, hospitals and non-profit medical-related organisations. Thirty organisations participated in an online survey on the perceived purposes, benefits and difficulties in using Web 2.0. A phone interview was further conducted with eight organisations (26.7%) to collect information on the use of Web 2.0. Data were analysed using both quantitative and qualitative approaches. Results showed that knowledge and information sharing and the provision of a better communication platform were rated as the main purposes of using Web 2.0. Time constraints and low staff engagement were the most highly rated difficulties. In addition, most participants found Web 2.0 to be beneficial to their organisations. Medical-related organisations that adopted Web 2.0 technologies have found them useful, with benefits outweighing the difficulties in the long run. The implications of this study are discussed to help medical-related organisations make decisions regarding the use of Web 2.0 technologies. © 2011 The authors. Health Information and Libraries Journal © 2011 Health Libraries Group.

  12. Advances in solid state laser technology for space and medical applications

    Science.gov (United States)

    Byvik, C. E.; Buoncristiani, A. M.

    1988-01-01

    Recent developments in laser technology and their potential for medical applications are discussed. Gas discharge lasers, dye lasers, excimer lasers, Nd:YAG lasers, HF and DF lasers, and other commonly used lasers are briefly addressed. Emerging laser technology is examined, including diode-pumped lasers and other solid state lasers.

  13. Sub-typing of extended-spectrum-β-lactamase-producing isolates from a nosocomial outbreak: application of a 10-loci generic Escherichia coli multi-locus variable number tandem repeat analysis.

    Directory of Open Access Journals (Sweden)

    Nahid Karami

    Full Text Available Extended-spectrum β-lactamase producing Escherichia coli (ESBL-E. coli were isolated from infants hospitalized in a neonatal, post-surgery ward during a four-month-long nosocomial outbreak and six-month follow-up period. A multi-locus variable number tandem repeat analysis (MLVA, using 10 loci (GECM-10, for 'generic' (i.e., non-STEC E. coli was applied for sub-species-level (i.e., sub-typing delineation and characterization of the bacterial isolates. Ten distinct GECM-10 types were detected among 50 isolates, correlating with the types defined by pulsed-field gel electrophoresis (PFGE, which is recognized to be the 'gold-standard' method for clinical epidemiological analyses. Multi-locus sequence typing (MLST, multiplex PCR genotyping of bla CTX-M, bla TEM, bla OXA and bla SHV genes and antibiotic resistance profiling, as well as a PCR assay specific for detecting isolates of the pandemic O25b-ST131 strain, further characterized the outbreak isolates. Two clusters of isolates with distinct GECM-10 types (G06-04 and G07-02, corresponding to two major PFGE types and the MLST-based sequence types (STs 131 and 1444, respectively, were confirmed to be responsible for the outbreak. The application of GECM-10 sub-typing provided reliable, rapid and cost-effective epidemiological characterizations of the ESBL-producing isolates from a nosocomial outbreak that correlated with and may be used to replace the laborious PFGE protocol for analyzing generic E. coli.

  14. Ultra Wideband Wireless Body Area Network for Medical Applications

    Science.gov (United States)

    2010-04-01

    Medical Applications RTO-MP-HFM-182 42 - 11 z x y Tumour Fat Skin Chest Figure 8: A Simple Hemispherical Brest Model. Table 2...x y Tumour Fat Skin Chest wall  Glands Nipple Figure 9: A Comprehensive Hemispherical Brest Model. The base diameter of the breast is...34 in Proc. 2nd European Radar Conference (EuRAD), Paris , France, October 6–7, 2005, pp. 97–100. [38] M. Sugawara, K. Niki, H. Furuhata, S. Ohnishi

  15. Predictors of students' self-reported adoption of a smartphone application for medical education in general practice.

    Science.gov (United States)

    Sandholzer, Maximilian; Deutsch, Tobias; Frese, Thomas; Winter, Alfred

    2015-05-21

    Smartphones and related applications are increasingly gaining relevance in the healthcare domain. We previously assessed the demands and preferences of medical students towards an application accompanying them during a course on general practice. The current study aims to elucidate the factors associated with adoption of such a technology. Therefore we provided students with a prototype of an application specifically related to their studies in general practice. A total estimation among students participating in a general practice examination at the Leipzig Medical School was conducted in May 2014. Students were asked to answer a structured self-designed questionnaire. Univariable comparisons were made to identify significant differences between those students who reported to have used the application frequently and those who did not. Multivariable binary logistic regression was used to reveal independent predictors of frequent application usage. The response rate was 99.3 % (n = 305/307). The majority (59 %, n = 180/305) were female students. The mean age was 24.5 years and 79.9 % (n = 243/304) owned a smartphone or tablet computer. Regarding the usage of the provided application, 2.3 % (n = 7/303) did not use the app while 68.0 % (n = 206/303) replied to have used it more than five times. Frequent users significantly differed from non-frequent users with regard to being female rather than male, higher mobile device ownership, more frequent exchange about obtaining the course certificate, higher personal interest in new technologies, larger enjoyment of the technology, lower intention to not use smartphone applications in the future, better opinion towards smartphone applications for the profession of a doctor, higher perceived importance of medical applications on the job, higher compatibility of smartphone applications with personal work style, higher perceived relevance of university support and personal benefit of use. Multivariable

  16. The electronic residency application service application can predict accreditation council for graduate medical education competency-based surgical resident performance.

    Science.gov (United States)

    Tolan, Amy M; Kaji, Amy H; Quach, Chi; Hines, O Joe; de Virgilio, Christian

    2010-01-01

    Program directors often struggle to determine which factors in the Electronic Residency Application Service (ERAS) application are important in the residency selection process. With the establishment of the Accreditation Council for Graduate Medical Education (ACGME) competencies, it would be important to know whether information available in the ERAS application can predict subsequent competency-based performance of general surgery residents. This study is a retrospective correlation of data points found in the ERAS application with core competency-based clinical rotation evaluations. ACGME competency-based evaluations as well as technical skills assessment from all rotations during residency were collected. The overall competency score was defined as an average of all 6 competencies and technical skills. A total of77 residents from two (one university and one community based university-affiliate) general surgery residency programs were included in the analysis. Receiving honors for many of the third year clerkships and AOA membership were associated with a number of the individual competencies. USMLE scores were predictive only of Medical Knowledge (p = 0.004). Factors associated with higher overall competency were female gender (p = 0.02), AOA (p = 0.06), overall number of honors received (p = 0.04), and honors in Ob/Gyn (p = 0.03) and Pediatrics (p = 0.05). Multivariable analysis showed honors in Ob/Gyn, female gender, older age, and total number of honors to be predictive of a number of individual core competencies. USMLE scores were only predictive of Medical Knowledge. The ERAS application is useful for predicting subsequent competency based performance in surgical residents. Receiving honors in the surgery clerkship, which has traditionally carried weight when evaluating a potential surgery resident, may not be as strong a predictor of future success. Copyright © 2010 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights

  17. Development of optical FBG force measurement system for the medical application

    Science.gov (United States)

    Song, Hoseok; Kim, Kiyoung; Suh, Jungwook; Lee, Jungju

    2010-03-01

    Haptic feedback plays a very important role in medical surgery. In minimally invasive surgery (MIS), however, very long and stiff bar of instruments take haptic feeling away from the surgeon. In minimally invasive robotic surgery (MIRS), moreover, haptic feelings are totally eliminated. Previous researchers have reported that the absence of force feedback increased the average force magnitude applied to the tissue by at least 50%, and increased the peakforce magnitude by at least a factor of two. Therefore, it is very important to provide haptic information in MIRS. Recently, many sensors are being developed for MIS or MIRS, but they have some obstacles in their application to real situations of medical surgery. The most critical problems are size limit and sterilizability. Optical fiber sensors are one of the most suitable sensors for this environment. Especially, optical fiber Bragg grating (FBG) sensor has one additional advantage than the other optical fiber sensors. FBG sensor is not influenced by intensity of light source. In this paper, we would like to present the initial results of study on the application of the FBG sensor to measure reflected forces in MIRS environments and then suggest the possibility of successful application to the MIRS systems.

  18. Visual servoing in medical robotics: a survey. Part I: endoscopic and direct vision imaging - techniques and applications.

    Science.gov (United States)

    Azizian, Mahdi; Khoshnam, Mahta; Najmaei, Nima; Patel, Rajni V

    2014-09-01

    Intra-operative imaging is widely used to provide visual feedback to a clinician when he/she performs a procedure. In visual servoing, surgical instruments and parts of tissue/body are tracked by processing the acquired images. This information is then used within a control loop to manoeuvre a robotic manipulator during a procedure. A comprehensive search of electronic databases was completed for the period 2000-2013 to provide a survey of the visual servoing applications in medical robotics. The focus is on medical applications where image-based tracking is used for closed-loop control of a robotic system. Detailed classification and comparative study of various contributions in visual servoing using endoscopic or direct visual images are presented and summarized in tables and diagrams. The main challenges in using visual servoing for medical robotic applications are identified and potential future directions are suggested. 'Supervised automation of medical robotics' is found to be a major trend in this field. Copyright © 2013 John Wiley & Sons, Ltd.

  19. Access control based on attribute certificates for medical intranet applications.

    Science.gov (United States)

    Mavridis, I; Georgiadis, C; Pangalos, G; Khair, M

    2001-01-01

    Clinical information systems frequently use intranet and Internet technologies. However these technologies have emphasized sharing and not security, despite the sensitive and private nature of much health information. Digital certificates (electronic documents which recognize an entity or its attributes) can be used to control access in clinical intranet applications. To outline the need for access control in distributed clinical database systems, to describe the use of digital certificates and security policies, and to propose the architecture for a system using digital certificates, cryptography and security policy to control access to clinical intranet applications. We have previously developed a security policy, DIMEDAC (Distributed Medical Database Access Control), which is compatible with emerging public key and privilege management infrastructure. In our implementation approach we propose the use of digital certificates, to be used in conjunction with DIMEDAC. Our proposed access control system consists of two phases: the ways users gain their security credentials; and how these credentials are used to access medical data. Three types of digital certificates are used: identity certificates for authentication; attribute certificates for authorization; and access-rule certificates for propagation of access control policy. Once a user is identified and authenticated, subsequent access decisions are based on a combination of identity and attribute certificates, with access-rule certificates providing the policy framework. Access control in clinical intranet applications can be successfully and securely managed through the use of digital certificates and the DIMEDAC security policy.

  20. Medical robots in cardiac surgery - application and perspectives.

    Science.gov (United States)

    Kroczek, Karolina; Kroczek, Piotr; Nawrat, Zbigniew

    2017-03-01

    Medical robots offer new standards and opportunities for treatment. This paper presents a review of the literature and market information on the current situation and future perspectives for the applications of robots in cardiac surgery. Currently in the United States, only 10% of thoracic surgical procedures are conducted using robots, while globally this value remains below 1%. Cardiac and thoracic surgeons use robotic surgical systems increasingly often. The goal is to perform more than one hundred thousand minimally invasive robotic surgical procedures every year. A surgical robot can be used by surgical teams on a rotational basis. The market of surgical robots used for cardiovascular and lung surgery was worth 72.2 million dollars in 2014 and is anticipated to reach 2.2 billion dollars by 2021. The analysis shows that Poland should have more than 30 surgical robots. Moreover, Polish medical teams are ready for the introduction of several robots into the field of cardiac surgery. We hope that this market will accommodate the Polish Robin Heart robots as well.

  1. BOOK REVIEW: Light, Visible and Invisible and its Medical Applications

    Science.gov (United States)

    Newing, Angela

    2000-09-01

    This book is based on various lectures given by Professor Newing over the last few years covering the centenaries of the discovery of x-rays, radioactivity, the electron and radium. It is a splendid follow-up read after studying the more formal presentations in A-level textbooks. The theory of each technique is touched on and the reader is provided with a full list of references for deeper analysis. Intermittently within the text are paragraphs of historical and developmental details, illustrated by contemporary drawings and photographs. These passages, which appear in a different typeface, add greatly to the enjoyment of the book, but could be skipped by an impatient reader seeking to gain an appropriate review knowledge of the subject of medical radiation physics. The areas of physiological measurement and medical engineering are not covered, neither is medical computing. Chapters discuss the diagnostic and therapeutic applications of x-rays. Different methods of scanning are outlined and the appropriateness of techniques brought up-to-date. Treatment with ionizing radiations is expanded to touch on electron radiotherapy, neutron therapy and brachytherapy. Phototherapy and photochemotherapy are considered in the section on treatments using non-ionizing radiations. The story starts with evidence from the ancient worlds of Egypt and Greece, accelerating through the nineteenth and twentieth centuries to the many treatments around today. The laser is shown to be a versatile and exact tool, available in a complete range of wavelengths for different surgical uses. The scientific principles and current applications of nuclear medicine, ultrasound and MRI are described. For each type of procedure, the author includes comments on advantages, disadvantages and operational safety. Dosimetry and quality assurance are touched upon. The book reflects Professor Newing's enthusiasm for her role as a medical physicist both as practitioner and teacher. To any students studying

  2. Medical applications of infrared thermography: A review

    Science.gov (United States)

    Lahiri, B. B.; Bagavathiappan, S.; Jayakumar, T.; Philip, John

    2012-07-01

    Abnormal body temperature is a natural indicator of illness. Infrared thermography (IRT) is a fast, passive, non-contact and non-invasive alternative to conventional clinical thermometers for monitoring body temperature. Besides, IRT can also map body surface temperature remotely. Last five decades witnessed a steady increase in the utility of thermal imaging cameras to obtain correlations between the thermal physiology and skin temperature. IRT has been successfully used in diagnosis of breast cancer, diabetes neuropathy and peripheral vascular disorders. It has also been used to detect problems associated with gynecology, kidney transplantation, dermatology, heart, neonatal physiology, fever screening and brain imaging. With the advent of modern infrared cameras, data acquisition and processing techniques, it is now possible to have real time high resolution thermographic images, which is likely to surge further research in this field. The present efforts are focused on automatic analysis of temperature distribution of regions of interest and their statistical analysis for detection of abnormalities. This critical review focuses on advances in the area of medical IRT. The basics of IRT, essential theoretical background, the procedures adopted for various measurements and applications of IRT in various medical fields are discussed in this review. Besides background information is provided for beginners for better understanding of the subject.

  3. The application of accelerator for medical therapy in Indonesia

    International Nuclear Information System (INIS)

    Yunasfi; Mudjiono; Irwati, Dwi; Hanifa

    2003-01-01

    The study of the application of accelerator for medical therapy in Indonesia was carried out. Accelerator that used for therapy is an electron lintier accelerator (Linac) which can radiate electron beam and X-ray. This study shows that there are 8 unit of Linac distributed at 6 big hospitals in Indonesia, especially in Jakarta. This study also shows that radiotherapy facilities in Indonesia is un sufficient of. Therefore, providing radiotherapy facilities for hospitals, especially the big hospitals in Indonesia is necessary

  4. Medical applications of artificial intelligence

    CERN Document Server

    Agah, Arvin

    2013-01-01

    Enhanced, more reliable, and better understood than in the past, artificial intelligence (AI) systems can make providing healthcare more accurate, affordable, accessible, consistent, and efficient. However, AI technologies have not been as well integrated into medicine as predicted. In order to succeed, medical and computational scientists must develop hybrid systems that can effectively and efficiently integrate the experience of medical care professionals with capabilities of AI systems. After providing a general overview of artificial intelligence concepts, tools, and techniques, Medical Ap

  5. From particle physics to medical applications

    CERN Document Server

    Dosanjh, Manjit

    2017-01-01

    CERN is the world's largest particle physics research laboratory. Since it was established in 1954, it has made an outstanding contribution to our understanding of the fundamental particles and their interactions, and also to the technologies needed to analyse their properties and behaviour. The experimental challenges have pushed the performance of particle accelerators and detectors to the limits of our technical capabilities, and these groundbreaking technologies can also have a significant impact in applications beyond particle physics. In particular, the detectors developed for particle physics have led to improved techniques for medical imaging, while accelerator technologies lie at the heart of the irradiation methods that are widely used for treating cancer. Indeed, many important diagnostic and therapeutic techniques used by healthcare professionals are based either on basic physics principles or the technologies developed to carry out physics research. Ever since the discovery of x-rays by Roentgen...

  6. Radiotracers in medical applications, vols 1-2

    International Nuclear Information System (INIS)

    Rayudu, G.V.S.

    1983-01-01

    These volumes will serve as a basis for instruction and reference for professionals such as radiopharmaceutical chemists, radiopharmacologists, radiopharmacists, radiobiochemists, and others involved in the medical applications of radiotracers. Vol. I: Topics include radiohalogenated compounds, including radioiodine; Tc-labeled compounds; and in-house prepared radiopharmaceuticals. The charge particle range vs. energy in every element is tabulated for protons for cyclotrons users. Discussions are also provided on nonimaging radiotracer methods; 11 C, 13 N, 15 O, 67 Ga. 111 In, 75 Se, /SUP 123m/ Te compounds; radioactive noble gases; and miscellaneous radiotracers for imaging. Vol. II: Pertinent nuclear science data such as radiation dosimetry, radionuclide production modes, radionuclides for therapy, human experimentation regulations and consent forms, and radiotracer laboratory designs are presented

  7. Medical Application of Free Electron Laser Trasmittance using Hollow Optical Fiber

    CERN Document Server

    Suzuki, Sachiko; Ishii, Katsonuri

    2004-01-01

    Mid-infrared Free Electron Laser (FEL) is expected as new application for biomedical surgery. However, delivery of MIR-FEL into the body is difficult because the common glass optical fibers have strong absorption at MIR region. A good operational and flexible line for FEL is required at medical field. A Hollow optical fiber is developed for IR laser and high-power laser delivery. We evaluated the fiber for FEL transmission line. This fiber is coated with cyclic olefin polymer (COP) and silver thin film on the inside of glass capillary tube. It is 700 μm-bore and 1m in lengths. The fiber transmission loss of the measured wavelength region of 5.5 μm to 12 μm is less than 1dB/m when the fiber is straight and 1.2 dB/m when bent to radius of 20 cm. Additionally, the output beam profile and the pulse structure is not so different form incidence beam. In conclusion, the fiber is suitable for delivery of the FEL energy for applications in medical and laser surgery.

  8. Simulation training for medical emergencies in the dental setting using an inexpensive software application.

    Science.gov (United States)

    Kishimoto, N; Mukai, N; Honda, Y; Hirata, Y; Tanaka, M; Momota, Y

    2017-11-09

    Every dental provider needs to be educated about medical emergencies to provide safe dental care. Simulation training is available with simulators such as advanced life support manikins and robot patients. However, the purchase and development costs of these simulators are high. We have developed a simulation training course on medical emergencies using an inexpensive software application. The purpose of this study was to evaluate the educational effectiveness of this course. Fifty-one dental providers participated in this study from December 2014 to March 2015. Medical simulation software was used to simulate a patient's vital signs. We evaluated participants' ability to diagnose and treat vasovagal syncope or anaphylaxis with an evaluation sheet and conducted a questionnaire before and after the scenario-based simulation training. The median evaluation sheet score for vasovagal syncope increased significantly from 7/9 before to 9/9 after simulation training. The median score for anaphylaxis also increased significantly from 8/12 to 12/12 (P simulation training. This simulation course improved participants' ability to diagnose and treat medical emergencies and improved their confidence. This course can be offered inexpensively using a software application. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  9. Medical applications of multi-wire proportional chambers

    International Nuclear Information System (INIS)

    Reading, D.H.

    1976-05-01

    The adaption of Multi-Wire Proportional Chambers (MWPC) for medical applications has necessitated bi-dimensional readout. This is achieved by analysing signals induced onto the cathode planes. At a useful X-ray energy of 40 to 45 keV, just above the K absorption edge in Xenon, the efficiency and resolution are both optimized. Poor resolution events due to K shell fluorescent capture and Auger emission, or L shell photo-electron emission, may be rejected by using energy discrimination - resulting in approximately halving the efficiency to 8% for a 1.6 cm thick atmospheric pressure chamber, but with sub millimeter inherent resolution. This is still far inferior to film resolution, but the MWPC is useful when numbers are required for computation or retrieval. Short descriptions of the MWPC applications to bone density measurements and tomography are given. Its use when pressurized as a gamma camera is discussed, and it is concluded that it may prove useful as a portable special purpose camera, or as one with a very large area thus compensating for low efficiency. Developments with liquid filled chambers are given and also the promising positron imaging hybrid MWPC. (author)

  10. Nanotechnology in medical applications: state-of-the-art in materials and devices

    NARCIS (Netherlands)

    Roszek B; Jong WH de; Geertsma RE; BMT

    2005-01-01

    Nanotechnology is an extremely powerful emerging technology, which is expected to have a substantial impact on medical technology now and in the future. The potential impact of novel nanomedical applications on disease diagnosis, therapy, and prevention is foreseen to change health care in a

  11. Proceedings of the ninth annual symposium on computer applications in medical care

    International Nuclear Information System (INIS)

    Ackerman, M.J.

    1985-01-01

    This book covers the proceedings of the ninth annual symposium on computer applications in medical care. Some topics covered are: Development of a portable report writer for radiology; A new CT - aided robotic stereotaxis system; and a local-area-network based oncology microcomputer system

  12. 77 FR 13967 - Notice of Intent To Discontinue Use of Paper Applications for Airman Medical Certification

    Science.gov (United States)

    2012-03-08

    ... also in terms of the complex logistics and use of Agency resources involved. This burden becomes all... to record the results of the applicant's medical examination on the reverse side of application form...

  13. USSTRIDE program is associated with competitive Black and Latino student applicants to medical school.

    Science.gov (United States)

    Campbell, Kendall M; Berne-Anderson, Thesla; Wang, Aihua; Dormeus, Guy; Rodríguez, José E

    2014-01-01

    We compared MCAT scores, grade point averages (GPAs), and medical school acceptance rates of Black and Latino students in an outreach program called Undergraduate Science Students Together Reaching Instructional Diversity and Excellence (USSTRIDE) to non-USSTRIDE students. We hypothesized that Black and Latino participants in USSTRIDE had higher acceptance rates to medical school, higher MCAT scores, and college GPAs when compared to other Black and Latino medical school applicants from our institution. The academic performance (GPAs and MCAT scores) and acceptance and matriculation rate data on all Black and Latino Florida State University applicants to any medical school from 2008 to 2012 were collected from the AIS/AMCAS database and separated into two comparison groups (USSTRIDE vs. Non-USSTRIDE). Independent sample T-tests and chi-square analysis, Cohen's D test, and odds ratios were determined. Average science GPA was 3.47 for USSTRIDE students (n=55) and 3.45 for non-USSTRIDE students (n=137, p=0.68, d=0.0652). Average cumulative GPA was 3.57 for USSTRIDE students and 3.54 for non-USSTRIDE students (p=0.45, d=0.121). Average MCAT score was 23 for USSTRIDE students and 25 for non-USSTRIDE students (p=0.02, d=0.378). Twenty-three percent of accepted USSTRIDE students and 29% of accepted non-USSTRIDE students had multiple acceptances (p=0.483, OR 1.38, 95% CI 0.52-3.88). Forty-nine percent of non-USSTRIDE students and 75% of USSTRIDE students matriculated in medical school (p=0.001, OR 3.13 95% CI 1.51-6.74). About 78.6% of USSTRIDE students matriculated at FSU's medical school compared to 36.2% of non-USSTRIDE students (pLatino students to our medical school. This finding is true for other medical schools as USSTRIDE students are as likely as non-USSTRIDE students to have multiple acceptances.

  14. Nye oplysninger om bl.a. miljømæssig risikovurdering af PAT-protein og glufosinatammonium herbicider. Zea mays (Bt11). Supplerende materiale om Bt11. Modtaget 21-02-2005, deadline 29-03-2005, svar 07-03-2005

    DEFF Research Database (Denmark)

    Strandberg, Morten Tune

    2005-01-01

    Mail: Det tilsendte supplerende materiale om Bt-11 majsen (mail pr. 21-02-2005) omhandler bl.a. eventuelle uønskede konsekvenser ved ulovlig anvendelse af glufosinat ammonium herbicider i forbindelse med dyrkningen. Vi har allerede indraget dette aspekt i forbindelse med den økologiske risikovurd...

  15. Antimicrobial resistance and detection of mecA and blaZ genes in coagulase-negative Staphylococcus isolated from bovine mastitis

    Directory of Open Access Journals (Sweden)

    Lidiane C. Soares

    2012-08-01

    Full Text Available The present study evaluated the pheno- and genotypical antimicrobial resistance profile of coagulase-negative Staphylococcus (CNS species isolated from dairy cows milk, specially concerning to oxacillin. Of 100 CNS isolates, the S. xylosus was the prevalent species, followed by S. cohnii, S. hominis, S. capitis and S. haemolyticus. Only 6% were phenotypically susceptible to the antimicrobial agents tested in disk diffusion assay. Penicillin and ampicillin resistance rates were significantly higher than others antimicrobials. Four isolates were positive to mecA gene (4%, all represented by the S. xylosus species. The blaZ gene was detected in 16% of the isolates (16/100. It was noticed that all mecA + were also positive to this gene and the presence of both genes was correlated to phenotypic beta-lactamic resistance. We conclude that CNS species from bovine milk presented significantly distinct antimicrobial resistance profiles, evaluated by phenotypic and genotypic tests, which has implications for treatment and management decisions.

  16. Marijuana: modern medical chimaera.

    Science.gov (United States)

    Lamarine, Roland J

    2012-01-01

    Marijuana has been used medically since antiquity. In recent years there has been a resurgence of interest in medical applications of various cannabis preparations. These drugs have been cited in the medical literature as potential secondary treatment agents for severe pain, muscle spasticity, anorexia, nausea, sleep disturbances, and numerous other uses. This article reviews the research literature related to medical applications of various forms of cannabis. Benefits related to medical use of cannabinoids are examined and a number of potential risks associated with cannabis use, both medical and recreational, are considered. There is a clearly identified need for further research to isolate significant benefits from the medical application of cannabinoids and to establish dosage levels, appropriate delivery mechanisms and formulations, and to determine what role, if any, cannabinoids might play in legitimate medical applications. It is also imperative to determine if reported dangers pose a significant health risks to users.

  17. Effectiveness, tolerability and practical application of the newer generation anti-obesity medications

    Directory of Open Access Journals (Sweden)

    Jeffrey S MacDaniels

    2016-03-01

    Full Text Available Objective: Comparison of the efficacy and tolerability of five newer anti-obesity medications to guide clinical decision making, examining bupropion–naltrexone combination, liraglutide, lorcaserin, orlistat, and phentermine–topiramate combination. Methods: A brief literature review and internet search for high-powered, randomized and placebo-controlled drug trials was conducted. Drug trial information was established for five currently approved anti-obesity medications. Secondarily, a statistical comparison of medications through Number Needed to Treat (NNT and Number Needed to Harm (NNH analyses were attempted as a way to provide a clinical analysis across these varied medications. Finally, a commentary about clinical application is issued for each agent accounting for typical side-effects, serious side-effects, mechanism of action and ease of use. Results: All five agents are currently approved oral medications to lower weight. The NNT range was 3–12, and NNH range was 4–17. The agent with the best NNT is phentermine–topiramate combination (NNT=3 and the agent with the best NNH is bupropion–naltrexone combination (NNH=17. Conclusion: When considering each patient’s clinical presentation, knowledge of each drug’s mechanism of action, side-effect profile, efficacy, and NNT and NNH values can help in selecting an anti-obesity medication to augment his or her weight loss efforts.

  18. Nuclear Data for Medical Applications – Recent Developments and Future Requirements

    International Nuclear Information System (INIS)

    Nichols, A.L.; Capote, R.

    2014-01-01

    Cancer treatment represents a major economic and medical issue because of the extensive incidence of the disease worldwide, with a particularly large rate of increase to be found in developing countries. Over the previous twenty years, the International Atomic Energy Agency (IAEA) has dedicated a series of investigations towards identifying and quantifying the production routes and decay characteristics of radioisotopes judged to be of existing and emerging importance in nuclear medicine and radiotherapy. Both the recommendations formulated during the course of these technical debates and the results of recently completed and on-going IAEA coordinated research projects are focused towards the successful evolution of improvements in nuclear data for medical applications throughout the early 21 st century

  19. Frontier of Advanced Accelerator Applications and Medical Treatments Using Nuclear Techniques. Abstract

    International Nuclear Information System (INIS)

    2015-01-01

    To address the challenges of research-based practice, developing advanced accelerator applications, and medical treatments using nuclear tecniqoes, researchers from Rajamakala University of Technology Lanna, Office of Atoms for Peace, and Chiang Mai University have joined in hosting this conference. Nuclear medicine, amedical specialty, diagnoses and treats diseases in a safe and painless way. Nuclear techniques can determine medical information that may otherwise be unavailable, require surgery, or necessitate more expensive and invasive diagnostic tests. Advance in nuclear techniques also offer the potential to detect abnormalities at earlier stages, leasding to earlier treatment and a more successful prognosis.

  20. Radiation protection requirements for medical application of ionizing radiation in the Republic of Macedonia

    International Nuclear Information System (INIS)

    Nestoroska, Svetlana; Angelovski, Goran; Shahin, Nuzi

    2010-01-01

    In this paper, the regulatory infrastructure in radiation protection in the Republic of Macedonia is presented. The national radiation protection requirements for the medical application of ionizing radiation are reviewed for both occupational exposed persons and patients undergoing a medical treatment with ionizing radiation and their compliance with the international standards is considered. The gaps identified on the national level are presented and steps for overcoming such gaps are analyzed.(Author)

  1. High-quality laser-accelerated ion beams for medical applications

    Energy Technology Data Exchange (ETDEWEB)

    Harman, Zoltan; Keitel, Christoph H. [Max-Planck-Institut fuer Kernphysik, Heidelberg (Germany); Salamin, Yousef I. [Max-Planck-Institut fuer Kernphysik, Heidelberg (Germany); American University of Sharjah (United Arab Emirates)

    2009-07-01

    Cancer radiation therapy requires accelerated ion beams of high energy sharpness and a narrow spatial profile. As shown recently, linearly and radially polarized, tightly focused and thus extremely strong laser beams should permit the direct acceleration of light atomic nuclei up to energies that may offer the potentiality for medical applications. Radially polarized beams have better emittance than their linearly polarized counterparts. We put forward the direct laser acceleration of ions, once the refocusing of ion beams by external fields is solved or radially polarized laser pulses of sufficient power can be generated.

  2. Formation and Development of the Pre-Professional Training System of Foreign Medical Applicants in Ukraine (Historical and Educational Aspect)

    Science.gov (United States)

    Proskurkina, Iana

    2014-01-01

    The growing number of foreign applicants looking forward to getting education in Ukrainian medical universities makes us find the ways how to improve and make effective the pre-professional training system of foreign medical applicants for further education. The article deals with the issues of the history of formation and development of the…

  3. Medical judgement analogue studies with applications to spaceflight crew medical officer.

    Science.gov (United States)

    McCarroll, Michele L; Ahmed, Rami A; Schwartz, Alan; Gothard, Michael David; Atkinson, Steven Scott; Hughes, Patrick; Brito, Jose Cepeda; Assad, Lori; Myers, Jerry; George, Richard L

    2017-10-01

    The National Aeronautics and Space Administration (NASA) developed plans for potential emergency conditions from the Exploration Medical Conditions List. In an effort to mitigate conditions on the Exploration Medical Conditions List, NASA implemented a crew medical officer (CMO) designation for eligible astronauts. This pilot study aims to add knowledge that could be used in the Integrated Medical Model. An analogue population was recruited for two categories: administrative physicians (AP) representing the physician CMOs and technical professionals (TP) representing the non-physician CMOs. Participants completed four medical simulations focused on abdominal pain: cholecystitis (CH) and renal colic (RC) and chest pain: cardiac ischaemia (STEMI; ST-segment elevation myocardial infarction) and pneumothorax (PX). The Medical Judgment Metric (MJM) was used to evaluate medical decision making. There were no significant differences between the AP and TP groups in age, gender, race, ethnicity, education and baseline heart rate. Significant differences were noted in MJM average rater scores in AP versus TP in CH: 13.0 (±2.25), 4.5 (±0.48), p=<0.001; RC: 12.3 (±2.66), 4.8 (±0.94); STEMI: 12.1 (±3.33), 4.9 (±0.56); and PX: 13.5 (±2.53), 5.3 (±1.01), respectively. There could be a positive effect on crew health risk by having a physician CMO. The MJM demonstrated the ability to quantify medical judgement between the two analogue groups of spaceflight CMOs. Future studies should incorporate the MJM in a larger analogue population study to assess the medical risk for spaceflight crewmembers.

  4. E-SAP: efficient-strong authentication protocol for healthcare applications using wireless medical sensor networks.

    Science.gov (United States)

    Kumar, Pardeep; Lee, Sang-Gon; Lee, Hoon-Jae

    2012-01-01

    A wireless medical sensor network (WMSN) can sense humans' physiological signs without sacrificing patient comfort and transmit patient vital signs to health professionals' hand-held devices. The patient physiological data are highly sensitive and WMSNs are extremely vulnerable to many attacks. Therefore, it must be ensured that patients' medical signs are not exposed to unauthorized users. Consequently, strong user authentication is the main concern for the success and large scale deployment of WMSNs. In this regard, this paper presents an efficient, strong authentication protocol, named E-SAP, for healthcare application using WMSNs. The proposed E-SAP includes: (1) a two-factor (i.e., password and smartcard) professional authentication; (2) mutual authentication between the professional and the medical sensor; (3) symmetric encryption/decryption for providing message confidentiality; (4) establishment of a secure session key at the end of authentication; and (5) professionals can change their password. Further, the proposed protocol requires three message exchanges between the professional, medical sensor node and gateway node, and achieves efficiency (i.e., low computation and communication cost). Through the formal analysis, security analysis and performance analysis, we demonstrate that E-SAP is more secure against many practical attacks, and allows a tradeoff between the security and the performance cost for healthcare application using WMSNs.

  5. E-SAP: Efficient-Strong Authentication Protocol for Healthcare Applications Using Wireless Medical Sensor Networks

    Directory of Open Access Journals (Sweden)

    Hoon-Jae Lee

    2012-02-01

    Full Text Available A wireless medical sensor network (WMSN can sense humans’ physiological signs without sacrificing patient comfort and transmit patient vital signs to health professionals’ hand-held devices. The patient physiological data are highly sensitive and WMSNs are extremely vulnerable to many attacks. Therefore, it must be ensured that patients’ medical signs are not exposed to unauthorized users. Consequently, strong user authentication is the main concern for the success and large scale deployment of WMSNs. In this regard, this paper presents an efficient, strong authentication protocol, named E-SAP, for healthcare application using WMSNs. The proposed E-SAP includes: (1 a two-factor (i.e., password and smartcard professional authentication; (2 mutual authentication between the professional and the medical sensor; (3 symmetric encryption/decryption for providing message confidentiality; (4 establishment of a secure session key at the end of authentication; and (5 professionals can change their password. Further, the proposed protocol requires three message exchanges between the professional, medical sensor node and gateway node, and achieves efficiency (i.e., low computation and communication cost. Through the formal analysis, security analysis and performance analysis, we demonstrate that E-SAP is more secure against many practical attacks, and allows a tradeoff between the security and the performance cost for healthcare application using WMSNs.

  6. The medically examined applicant for private insurance and his/her right to informed consent: a comparative analysis.

    Science.gov (United States)

    Defloor, Sarah

    2011-05-01

    Within the context of health and insurance law, an important question that arises is "to what extent is an applicant for private insurance truly capable of giving his/her 'free' and informed consent for a medical examination?". It should be borne in mind that it is the private insurer who requires a medical examination in order to gather medical information, and, moreover, that the insurer will not be inclined to conclude or carry out an insurance contract without this medical information. A distinction has to be made between not being free by legal coercion and not being (completely) free by factual circumstances. Exercising the right to informed consent involves exactly weighing up the consequences of the decision. Hence the applicant must be put in a position of being able to weigh up the consequences and take them into consideration.

  7. The medical examination in United States immigration applications: the potential use of genetic testing leads to heightened privacy concerns.

    Science.gov (United States)

    Burroughs, A Maxwell

    2005-01-01

    The medical examination has been an integral part of the immigration application process since the passing of the Immigration Act of 1891. Failing the medical examination can result in denial of the application. Over the years the medical examination has been expanded to include questioning about diseases that are scientifically shown to be rooted in an individual's genetic makeup. Recent advances in the fields of genomics and bioinformatics are making accurate and precise screening for these conditions a reality. Government policymakers will soon be faced with decisions regarding whether or not to sanction the use of these newly-developed genetic tests in the immigration application procedure. The terror threat currently facing the United States may ultimately bolster the argument in favor of genetic testing and/or DNA collection of applicants. However, the possibility of a government mandate requiring genetic testing raises a host of ethical issues; including the threat of eugenics and privacy concerns. Genetic testing has the ability to uncover a wealth of sensitive medical information about an individual and currently there are no medical information privacy protections afforded to immigration applicants. This article examines the potential for genetic testing in the immigration application process and the ethical issues surrounding this testing. In particular, this article explores the existing framework of privacy protections afforded to individuals living in the United States and how this and newly-erected standards like those released by the Health and Human Services (HHS) might apply to individuals seeking to immigrate to the United States.

  8. Machine learning for epigenetics and future medical applications.

    Science.gov (United States)

    Holder, Lawrence B; Haque, M Muksitul; Skinner, Michael K

    2017-07-03

    Understanding epigenetic processes holds immense promise for medical applications. Advances in Machine Learning (ML) are critical to realize this promise. Previous studies used epigenetic data sets associated with the germline transmission of epigenetic transgenerational inheritance of disease and novel ML approaches to predict genome-wide locations of critical epimutations. A combination of Active Learning (ACL) and Imbalanced Class Learning (ICL) was used to address past problems with ML to develop a more efficient feature selection process and address the imbalance problem in all genomic data sets. The power of this novel ML approach and our ability to predict epigenetic phenomena and associated disease is suggested. The current approach requires extensive computation of features over the genome. A promising new approach is to introduce Deep Learning (DL) for the generation and simultaneous computation of novel genomic features tuned to the classification task. This approach can be used with any genomic or biological data set applied to medicine. The application of molecular epigenetic data in advanced machine learning analysis to medicine is the focus of this review.

  9. Features and application of wearable biosensors in medical care

    Directory of Open Access Journals (Sweden)

    Sima Ajami

    2015-01-01

    Full Text Available One of the new technologies in the field of health is wearable biosensor, which provides vital signs monitoring of patients, athletes, premature infants, children, psychiatric patients, people who need long-term care, elderly, and people in impassable regions far from health and medical services. The aim of this study was to explain features and applications of wearable biosensors in medical services. This was a narrative review study that done in 2015. Search conducted with the help of libraries, books, conference proceedings, through databases of Science Direct, PubMed, Proquest, Springer, and SID (Scientific Information Database. In our searches, we employed the following keywords and their combinations; vital sign monitoring, medical smart shirt, smart clothing, wearable biosensors, physiological monitoring system, remote detection systems, remote control health, and bio-monitoring system. The preliminary search resulted in 54 articles, which published between 2002 and 2015. After a careful analysis of the content of each paper, 41 sources selected based on their relevancy. Although the use of wearable in healthcare is still in an infant stage, it could have a magic effect on healthcare. Smart wearable in the technology industry for 2015 is one that is looking to be a big and profitable market. Wearable biosensors capable of continuous vital signs monitoring and feedback to the user will be significantly effective in timely prevention, diagnosis, treatment, and control of diseases.

  10. Complete Sequence of p07-406, a 24,179-base-pair plasmid harboring the blaVIM-7 metallo-beta-lactamase gene in a Pseudomonas aeruginosa isolate from the United States.

    Science.gov (United States)

    Li, Hongyang; Toleman, Mark A; Bennett, Peter M; Jones, Ronald N; Walsh, Timothy R

    2008-09-01

    An outbreak involving a Pseudomonas aeruginosa strain that was resistant to all tested antimicrobials except polymyxin B occurred in a hospital in Houston, TX. Previous studies on this strain showed that it possesses a novel mobile metallo-beta-lactamase (MBL) gene, designated bla(VIM-7), located on a plasmid (p07-406). Here, we report the complete sequence, annotation, and functional characterization of this plasmid. p07-406 is 24,179 bp in length, and 29 open reading frames were identified related to known or putatively recognized proteins. Analysis of this plasmid showed it to be comprised of four distinct regions: (i) a region of 5,200 bp having a Tn501-like mercuric resistance (mer) transposon upstream of the replication region; (ii) a Tn3-like transposon carrying a truncated integron with a bla(VIM-7) gene and an insertion sequence inserted at the other end of this transposon; (iii) a region of four genes, upstream of the Tn3-like transposon, possessing very high similarity to plasmid pXcB from Xanthomonas campestris pv. citri commonly associated with plants; (iv) a backbone sequence similar to the backbone structure of the IncP group plasmid Rms149, pB10, and R751. This is the first plasmid to be sequenced carrying an MBL gene and highlights the amelioration of DNA segments from disparate origins, most noticeably from plant pathogens.

  11. Are the results of questionnaires measuring non-cognitive characteristics during the selection procedure for medical school application biased by social desirability?

    Science.gov (United States)

    Obst, Katrin U; Brüheim, Linda; Westermann, Jürgen; Katalinic, Alexander; Kötter, Thomas

    2016-01-01

    Introduction: A stronger consideration of non-cognitive characteristics in Medical School application procedures is desirable. Psychometric tests could be used as an economic supplement to face-to-face interviews which are frequently conducted during university internal procedures for Medical School applications (AdH, Auswahlverfahren der Hochschulen). This study investigates whether the results of psychometric questionnaires measuring non-cognitive characteristics such as personality traits, empathy, and resilience towards stress are vulnerable to distortions of social desirability when used in the context of selection procedures at Medical Schools. Methods: This study took place during the AdH of Lübeck University in August 2015. The following questionnaires have been included: NEO-FFI, SPF, and AVEM. In a 2x1 between-subject experiment we compared the answers from an alleged application condition and a control condition. In the alleged application condition we told applicants that these questionnaires were part of the application procedure. In the control condition applicants were informed about the study prior to completing the questionnaires. Results: All included questionnaires showed differences which can be regarded as social-desirability effects. These differences did not affect the entire scales but, rather, single subscales. Conclusion: These results challenge the informative value of these questionnaires when used for Medical School application procedures. Future studies may investigate the extent to which the differences influence the actual selection of applicants and what implications can be drawn from them for the use of psychometric questionnaires as part of study-place allocation procedures at Medical Schools.

  12. Are the results of questionnaires measuring non-cognitive characteristics during the selection procedure for medical school application biased by social desirability?

    Directory of Open Access Journals (Sweden)

    Obst, Katrin U.

    2016-11-01

    Full Text Available Introduction: A stronger consideration of non-cognitive characteristics in Medical School application procedures is desirable. Psychometric tests could be used as an economic supplement to face-to-face interviews which are frequently conducted during university internal procedures for Medical School applications (AdH, Auswahlverfahren der Hochschulen. This study investigates whether the results of psychometric questionnaires measuring non-cognitive characteristics such as personality traits, empathy, and resilience towards stress are vulnerable to distortions of social desirability when used in the context of selection procedures at Medical Schools.Methods: This study took place during the AdH of Lübeck University in August 2015. The following questionnaires have been included: NEO-FFI, SPF, and AVEM. In a 2x1 between-subject experiment we compared the answers from an alleged application condition and a control condition. In the alleged application condition we told applicants that these questionnaires were part of the application procedure. In the control condition applicants were informed about the study prior to completing the questionnaires.Results: All included questionnaires showed differences which can be regarded as social-desirability effects. These differences did not affect the entire scales but, rather, single subscales.Conclusion: These results challenge the informative value of these questionnaires when used for Medical School application procedures. Future studies may investigate the extent to which the differences influence the actual selection of applicants and what implications can be drawn from them for the use of psychometric questionnaires as part of study-place allocation procedures at Medical Schools.

  13. Polysaccharide-Based Materials Associated with or Coordinated to Gold Nanoparticles: Synthesis and Medical Application.

    Science.gov (United States)

    Facchi, Débora P; da Cruz, Joziel A; Bonafé, Elton G; Pereira, Antonio G B; Fajardo, André R; Venter, Sandro A S; Monteiro, Johny P; Muniz, Edvani C; Martins, Alessandro F

    2017-01-01

    Gold nanoparticles (AuNPs) have enormous potential for application in imaging, diagnosis, and therapies in the medical field. AuNPs are renowned for their localized surface plasmon resonance (LSPR) properties, large surface area, and biocompatibility with body fluids. Further, AuNPs have featured prominently in new methodologies for cancer treatments, like photothermal and imaging therapies. Although AuNPs present enormous potential for application in the medical field, their instability under physiological conditions prevents further uses. However, this limitation may be overcome by associating AuNPs with biopolymers. To the best of our knowledge, a revision paper rationalizing the structure/property relationship and applications of AuNPspolysaccharide composites in the medical field has not been published yet. This manuscript discusses the most relevant aspects and state-of-art concepts surrounding the synthesis of AuNPs based on green chemistry and their association with polysaccharides that can efficiently function both as stabilizing and reducing agents of Au nanoparticles. Even more, polysaccharide devices may inhibit non-specific interactions between AuNPs and biological macromolecules, suppressing unsuitable "protein corona" formations on AuNP surfaces, thereby increasing the potential of AuNP composites of being employing as drug delivery matrices and wound-healing devices as well as in photothermal/ imaging purposes for cancer treatments and biosensors. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  14. Interoperability of medical device information and the clinical applications: an HL7 RMIM based on the ISO/IEEE 11073 DIM.

    Science.gov (United States)

    Yuksel, Mustafa; Dogac, Asuman

    2011-07-01

    Medical devices are essential to the practice of modern healthcare services. Their benefits will increase if clinical software applications can seamlessly acquire the medical device data. The need to represent medical device observations in a format that can be consumable by clinical applications has already been recognized by the industry. Yet, the solutions proposed involve bilateral mappings from the ISO/IEEE 11073 Domain Information Model (DIM) to specific message or document standards. Considering that there are many different types of clinical applications such as the electronic health record and the personal health record systems, the clinical workflows, and the clinical decision support systems each conforming to different standard interfaces, detailing a mapping mechanism for every one of them introduces significant work and, thus, limits the potential health benefits of medical devices. In this paper, to facilitate the interoperability of clinical applications and the medical device data, we use the ISO/IEEE 11073 DIM to derive an HL7 v3 Refined Message Information Model (RMIM) of the medical device domain from the HL7 v3 Reference Information Mode (RIM). This makes it possible to trace the medical device data back to a standard common denominator, that is, HL7 v3 RIM from which all the other medical domains under HL7 v3 are derived. Hence, once the medical device data are obtained in the RMIM format, it can easily be transformed into HL7-based standard interfaces through XML transformations because these interfaces all have their building blocks from the same RIM. To demonstrate this, we provide the mappings from the developed RMIM to some of the widely used HL7 v3-based standard interfaces.

  15. Collateral damage of flomoxef therapy: in vivo development of porin deficiency and acquisition of blaDHA-1 leading to ertapenem resistance in a clinical isolate of Klebsiella pneumoniae producing CTX-M-3 and SHV-5 beta-lactamases.

    Science.gov (United States)

    Lee, Chen-Hsiang; Chu, Chishih; Liu, Jien-Wei; Chen, Yi-Shung; Chiu, Chiung-Jung; Su, Lin-Hui

    2007-08-01

    The study aimed to characterize the genetic basis of flomoxef and collateral ertapenem resistance in a clinical isolate of extended-spectrum beta-lactamase-producing Klebsiella pneumoniae (ESBL-KP) after flomoxef exposure. Four ESBL-KP isolates (Lkp11-14) were recovered sequentially from four episodes of bacteraemia in an elderly patient. Laboratory investigations included genotyping by PFGE, resistance gene analysis by PCR and sequencing, and outer membrane protein analysis by SDS-PAGE. Plasmid analysis by DNA-DNA hybridization, electroporation and conjugation was also performed. Lkp14 was recovered after 21 days of flomoxef therapy. It demonstrated an indistinguishable PFGE pattern when compared with those produced by Lkp11-13. However, resistance to both flomoxef and ertapenem emerged in Lkp14. Molecular characterization revealed that, in addition to the pre-existing ESBL production (CTX-M-3 and SHV-5) and OmpK35 deficiency found in Lkp11-13, Lkp14 had acquired an extra plasmid-mediated AmpC beta-lactamase gene (blaDHA-1) and failed to express OmpK36, because of insertional inactivation by an insertion sequence IS5. Other resistance mechanisms, such as production of carbapenem-hydrolysing enzymes or expression of chromosomal efflux, were apparently not involved. Conjugational transfer of the plasmid-mediated blaDHA-1 gene into Lkp11 resulted in a significant increase in the MICs of cephamycins and beta-lactamase inhibitors, but not in those of carbapenems. Lkp14 was apparently derived from the previously flomoxef-susceptible isolates, Lkp11-13. After flomoxef exposure, the in vivo acquisition of the plasmid-mediated blaDHA-1 gene has led to flomoxef resistance in Lkp14, and the concomitant depletion of OmpK36 expression has resulted in a collateral effect of ertapenem resistance and diminished susceptibilities to imipenem and meropenem.

  16. Molecular characterization of carbapenem-resistant Acinetobacter ...

    African Journals Online (AJOL)

    Medical Sciences, 7Department of Microbiology, School of Medicine, Iran University of Medical Sciences, International ... The results also indicate that 62.3, 30.4, and 4.3 % of the isolates were positive for ..... The coexistence of blaIMP and.

  17. Response Distortion on Personality Tests in Applicants: Comparing High-Stakes to Low-Stakes Medical Settings

    Science.gov (United States)

    Anglim, Jeromy; Bozic, Stefan; Little, Jonathon; Lievens, Filip

    2018-01-01

    The current study examined the degree to which applicants applying for medical internships distort their responses to personality tests and assessed whether this response distortion led to reduced predictive validity. The applicant sample (n = 530) completed the NEO Personality Inventory whilst applying for one of 60 positions as first-year…

  18. [The Application of the Fault Tree Analysis Method in Medical Equipment Maintenance].

    Science.gov (United States)

    Liu, Hongbin

    2015-11-01

    In this paper, the traditional fault tree analysis method is presented, detailed instructions for its application characteristics in medical instrument maintenance is made. It is made significant changes when the traditional fault tree analysis method is introduced into the medical instrument maintenance: gave up the logic symbolic, logic analysis and calculation, gave up its complicated programs, and only keep its image and practical fault tree diagram, and the fault tree diagram there are also differences: the fault tree is no longer a logical tree but the thinking tree in troubleshooting, the definition of the fault tree's nodes is different, the composition of the fault tree's branches is also different.

  19. Design and Implementation of a Laser-Based Ammonia Breath Sensor for Medical Applications

    KAUST Repository

    Owen, Kyle

    2012-06-01

    Laser-based sensors can be used as non-invasive monitoring tools to measure parts per billion (ppb) levels of trace gases. Ammonia sensors are useful for applications in environmental pollutant monitoring, atmospheric and combustion kinetic studies, and medical diagnostics. This sensor was specifically designed to measure ammonia in exhaled breath to be used as a medical diagnostic and monitoring tool, however, it can also be extended for use in other applications. Although ammonia is a naturally occurring species in exhaled breath, abnormally elevated levels can be an indication of adverse medical conditions. Laser-based breath diagnostics have many benefits since they are cost effective, non-invasive, painless, real time monitors. They have the potential to improve the quality of medical care by replacing currently used blood tests and providing immediate feedback to physicians. This sensor utilizes a Quantum Cascade Laser and Wavelength Modulation Spectroscopy with second harmonic normalized by first harmonic detection in a 76 m multi-pass absorption cell to measure ppb levels of ammonia with improved sensitivity over previous sensors. Initial measurements to determine the ammonia absorption line parameters were performed using direct absorption spectroscopy. This is the first experimental study of the ammonia absorption line transitions near 1103.46 cm1 with absorption spectroscopy. The linestrengths were measured with uncertainties less than 10%. The collisional broadening coefficients for each of the ammonia lines with nitrogen, oxygen, water vapor, and carbon dioxide were also measured, many of which had uncertainties less than 5%. The sensor was characterized to show a detectability limit of 10 ppb with an uncertainty of less than 5% at typical breath ammonia levels. Initial breath test results showed that some of the patients with chronic kidney disease had elevated ammonia levels while others had ammonia levels in the same range as expected for healthy

  20. [Medical technology and medical education].

    Science.gov (United States)

    von Mallek, D; Biersack, H-J; Mull, R; Wilhelm, K; Heinz, B; Mellert, F

    2010-08-01

    The education of medical professionals is divided into medical studies, postgraduate training leading to the qualification as a specialist, and continuing professional development. During education, all scientific knowledge and practical skills are to be acquired, which enable the physician to practice responsibly in a specialized medical area. In the present article, relevant curricula are analyzed regarding the consideration of medical device-related topics, as the clinical application of medical technology has reached a central position in modern patient care. Due to the enormous scientific and technical progress, this area has become as important as pharmacotherapy. Our evaluation shows that medical device-related topics are currently underrepresented in the course of medical education and training and should be given greater consideration in all areas of medical education. Possible solutions are presented.

  1. Laser Isotope Enrichment for Medical and Industrial Applications

    Energy Technology Data Exchange (ETDEWEB)

    Leonard Bond

    2006-07-01

    Laser Isotope Enrichment for Medical and Industrial Applications by Jeff Eerkens (University of Missouri), Jay Kunze (Idaho State University), and Leonard Bond (Idaho National Laboratory) The principal isotope enrichment business in the world is the enrichment of uranium for commercial power reactor fuels. However, there are a number of other needs for separated isotopes. Some examples are: 1) Pure isotopic targets for irradiation to produce medical radioisotopes. 2) Pure isotopes for semiconductors. 3) Low neutron capture isotopes for various uses in nuclear reactors. 4) Isotopes for industrial tracer/identification applications. Examples of interest to medicine are targets to produce radio-isotopes such as S-33, Mo-98, Mo-100, W-186, Sn-112; while for MRI diagnostics, the non-radioactive Xe-129 isotope is wanted. For super-semiconductor applications some desired industrial isotopes are Si-28, Ga-69, Ge-74, Se-80, Te-128, etc. An example of a low cross section isotope for use in reactors is Zn-68 as a corrosion inhibitor material in nuclear reactor primary systems. Neutron activation of Ar isotopes is of interest in industrial tracer and diagnostic applications (e.g. oil-logging). . In the past few years there has been a sufficient supply of isotopes in common demand, because of huge Russian stockpiles produced with old electromagnetic and centrifuge separators previously used for uranium enrichment. Production of specialized isotopes in the USA has been largely accomplished using old ”calutrons” (electromagnetic separators) at Oak Ridge National Laboratory. These methods of separating isotopes are rather energy inefficient. Use of lasers for isotope separation has been considered for many decades. None of the proposed methods have attained sufficient proof of principal status to be economically attractive to pursue commercially. Some of the authors have succeeded in separating sulfur isotopes using a rather new and different method, known as condensation

  2. Laser Isotope Enrichment for Medical and Industrial Applications

    International Nuclear Information System (INIS)

    Leonard Bond

    2006-01-01

    Laser Isotope Enrichment for Medical and Industrial Applications by Jeff Eerkens (University of Missouri), Jay Kunze (Idaho State University), and Leonard Bond (Idaho National Laboratory) The principal isotope enrichment business in the world is the enrichment of uranium for commercial power reactor fuels. However, there are a number of other needs for separated isotopes. Some examples are: (1) Pure isotopic targets for irradiation to produce medical radioisotopes. (2) Pure isotopes for semiconductors. (3) Low neutron capture isotopes for various uses in nuclear reactors. (4) Isotopes for industrial tracer/identification applications. Examples of interest to medicine are targets to produce radio-isotopes such as S-33, Mo-98, Mo-100, W-186, Sn-112; while for MRI diagnostics, the non-radioactive Xe-129 isotope is wanted. For super-semiconductor applications some desired industrial isotopes are Si-28, Ga-69, Ge-74, Se-80, Te-128, etc. An example of a low cross section isotope for use in reactors is Zn-68 as a corrosion inhibitor material in nuclear reactor primary systems. Neutron activation of Ar isotopes is of interest in industrial tracer and diagnostic applications (e.g. oil-logging). . In the past few years there has been a sufficient supply of isotopes in common demand, because of huge Russian stockpiles produced with old electromagnetic and centrifuge separators previously used for uranium enrichment. Production of specialized isotopes in the USA has been largely accomplished using old ''calutrons'' (electromagnetic separators) at Oak Ridge National Laboratory. These methods of separating isotopes are rather energy inefficient. Use of lasers for isotope separation has been considered for many decades. None of the proposed methods have attained sufficient proof of principal status to be economically attractive to pursue commercially. Some of the authors have succeeded in separating sulfur isotopes using a rather new and different method, known as condensation

  3. Development of a high resolution voxelised head phantom for medical physics applications.

    Science.gov (United States)

    Giacometti, V; Guatelli, S; Bazalova-Carter, M; Rosenfeld, A B; Schulte, R W

    2017-01-01

    Computational anthropomorphic phantoms have become an important investigation tool for medical imaging and dosimetry for radiotherapy and radiation protection. The development of computational phantoms with realistic anatomical features contribute significantly to the development of novel methods in medical physics. For many applications, it is desirable that such computational phantoms have a real-world physical counterpart in order to verify the obtained results. In this work, we report the development of a voxelised phantom, the HIGH_RES_HEAD, modelling a paediatric head based on the commercial phantom 715-HN (CIRS). HIGH_RES_HEAD is unique for its anatomical details and high spatial resolution (0.18×0.18mm 2 pixel size). The development of such a phantom was required to investigate the performance of a new proton computed tomography (pCT) system, in terms of detector technology and image reconstruction algorithms. The HIGH_RES_HEAD was used in an ad-hoc Geant4 simulation modelling the pCT system. The simulation application was previously validated with respect to experimental results. When compared to a standard spatial resolution voxelised phantom of the same paediatric head, it was shown that in pCT reconstruction studies, the use of the HIGH_RES_HEAD translates into a reduction from 2% to 0.7% of the average relative stopping power difference between experimental and simulated results thus improving the overall quality of the head phantom simulation. The HIGH_RES_HEAD can also be used for other medical physics applications such as treatment planning studies. A second version of the voxelised phantom was created that contains a prototypic base of skull tumour and surrounding organs at risk. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  4. A medical application integrating remote 3D visualization tools to access picture archiving and communication system on mobile devices.

    Science.gov (United States)

    He, Longjun; Ming, Xing; Liu, Qian

    2014-04-01

    With computing capability and display size growing, the mobile device has been used as a tool to help clinicians view patient information and medical images anywhere and anytime. However, for direct interactive 3D visualization, which plays an important role in radiological diagnosis, the mobile device cannot provide a satisfactory quality of experience for radiologists. This paper developed a medical system that can get medical images from the picture archiving and communication system on the mobile device over the wireless network. In the proposed application, the mobile device got patient information and medical images through a proxy server connecting to the PACS server. Meanwhile, the proxy server integrated a range of 3D visualization techniques, including maximum intensity projection, multi-planar reconstruction and direct volume rendering, to providing shape, brightness, depth and location information generated from the original sectional images for radiologists. Furthermore, an algorithm that changes remote render parameters automatically to adapt to the network status was employed to improve the quality of experience. Finally, performance issues regarding the remote 3D visualization of the medical images over the wireless network of the proposed application were also discussed. The results demonstrated that this proposed medical application could provide a smooth interactive experience in the WLAN and 3G networks.

  5. Review of CdTe medical applications

    Energy Technology Data Exchange (ETDEWEB)

    Entine, G; Garcia, D A; Tow, D E

    1977-02-01

    CdTe sensors are now being used in several areas of nuclear medicine. CdTe probe technics, originally developed to study dental pathology in dog models, are being used clinically to diagnose venous thrombosis of the legs and to detect occult dental infections in patients scheduled for prosthetic cardiovascular and orthopedic surgery. Similar instrumentation is in use in animal research of myocardial infarction and synthetic tooth substitutes. Transmission technics have also been developed to diagnose pulmonary edema and to measure bone mineral changes in space flight. Investigations are also underway in the use of linear or two-dimensional arrays of CdTe gamma sensors for medical imaging. Economic considerations have slowed this work, but the technology appears to be available. Development of photoconductive CdTe X-ray detectors for scintigraphic scanners has also begun. Rapid detector improvement will be needed for success in this field, but the potential usefulness is very great. Together, the present application results are encouraging and wide use of CdTe detectors should occur within only a few years.

  6. Spatial molecular epidemiology of carbapenem-resistant and New Delhi metallo beta-lactamase (blaNDM)-producing Escherichia coli in the piglets of organized farms in India.

    Science.gov (United States)

    Pruthvishree, B S; Vinodh Kumar, O R; Sinha, D K; Malik, Y P S; Dubal, Z B; Desingu, P A; Shivakumar, M; Krishnaswamy, N; Singh, B R

    2017-06-01

    A cross-sectional study was conducted in 10 government-organized pig farms between 2014 and 2016 representing seven states of India to understand the epidemiology of carbapenem resistance in the Escherichia coli. In this study, fecal sample (n = 673) from non-diarrheic (n = 501) and diarrheic (n = 172) piglets were processed for isolation of carbapenem resistant E. coli. Of 673, E. coli isolate (n = 112) was genotyped for confirming the carbapenem resistance and associated virulence factors. Of the 112 isolates, 23 were phenotypically resistant to carbapenem and 8 were carrying the New Delhi metallo beta-lactamase (blaNDM) gene. The carbapenem-resistant isolates also produced extended spectrum beta-lactamases and were multidrug resistant. The PCR-based pathotyping revealed the presence of stx1, stx2, eae and hlyA genes. The enterobacterial repetitive intergenic consensus PCR dendrogram analysis of the isolates yielded three distinct clusters. The statistical analysis revealed no association between carriages of carbapenem-resistant E. coli in different breed of piglets however, location, sex, health status of piglets and age showed significant difference. The spatial analysis with SaTScan helped in identification of carbapenem-resistant clusters. The presence of carbapenem resistant E. coli isolates with virulence genes in the piglet poses a potential public health risk through possible access and spread via the food chain and environment. Efflux pump may also play an important role in carbapenem resistance in piglet E. coli isolates. Furthermore, identification of risk factors in relation to spatial clusters will help in designing preventive strategies for reducing the risk of spread of carbapenem resistant bacteria. 1. Piglets harbor carbapenem resistant E. coli and have great public health significance. 2. Apart from carbapenemase, efflux pump is also important for carbapenem resistance. 3. This is the first report of blaNDM in the piglets from India. © 2017

  7. USSTRIDE program is associated with competitive Black and Latino student applicants to medical school

    Directory of Open Access Journals (Sweden)

    Kendall M. Campbell

    2014-05-01

    Full Text Available Purpose: We compared MCAT scores, grade point averages (GPAs, and medical school acceptance rates of Black and Latino students in an outreach program called Undergraduate Science Students Together Reaching Instructional Diversity and Excellence (USSTRIDE to non-USSTRIDE students. We hypothesized that Black and Latino participants in USSTRIDE had higher acceptance rates to medical school, higher MCAT scores, and college GPAs when compared to other Black and Latino medical school applicants from our institution. Methods: The academic performance (GPAs and MCAT scores and acceptance and matriculation rate data on all Black and Latino Florida State University applicants to any medical school from 2008 to 2012 were collected from the AIS/AMCAS database and separated into two comparison groups (USSTRIDE vs. Non-USSTRIDE. Independent sample T-tests and chi-square analysis, Cohen's D test, and odds ratios were determined. Results: Average science GPA was 3.47 for USSTRIDE students (n=55 and 3.45 for non-USSTRIDE students (n=137, p=0.68, d=0.0652. Average cumulative GPA was 3.57 for USSTRIDE students and 3.54 for non-USSTRIDE students (p=0.45, d=0.121. Average MCAT score was 23 for USSTRIDE students and 25 for non-USSTRIDE students (p=0.02, d=0.378. Twenty-three percent of accepted USSTRIDE students and 29% of accepted non-USSTRIDE students had multiple acceptances (p=0.483, OR 1.38, 95% CI 0.52–3.88. Forty-nine percent of non-USSTRIDE students and 75% of USSTRIDE students matriculated in medical school (p=0.001, OR 3.13 95% CI 1.51–6.74. About 78.6% of USSTRIDE students matriculated at FSU's medical school compared to 36.2% of non-USSTRIDE students (p<0.01. Conclusions: USSTRIDE and non-USSTRIDE students had similar science and cumulative GPAs. USSTRIDE students' MCAT scores were lower but acceptance rates to medical school were higher. Participation in USSTRIDE is associated with increased acceptance rates for Black and Latino students to our

  8. Electrical aspects of argon micro-cell plasma with applications in bio-medical technology

    NARCIS (Netherlands)

    Horiuchi, Y.; Dijk, van J.; Makabe, T.

    2003-01-01

    Argon micro-cell plasma (MCP) is believed to be a viable tool for performing micro-surgery. The non-thermal nature of the discharge allows an effective treatment of pathological tissue without causing thermal damage to its surroundings. This bio-medical application imposes a number of design

  9. Complete Genome Sequence of a Human-Invasive Salmonella enterica Serovar Typhimurium Strain of the Emerging Sequence Type 213 Harboring a Multidrug Resistance IncA/C Plasmid and a blaCMY-2-Carrying IncF Plasmid.

    Science.gov (United States)

    Silva, Claudia; Calva, Edmundo; Calva, Juan J; Wiesner, Magdalena; Fernández-Mora, Marcos; Puente, José L; Vinuesa, Pablo

    2015-11-12

    Salmonella enterica subsp. enterica serovar Typhimurium strain 33676 was isolated in Mexico City, Mexico, from a patient with a systemic infection, and its complete genome sequence was determined using PacBio single-molecule real-time technology. Strain 33676 harbors an IncF plasmid carrying the extended-spectrum cephalosporin gene blaCMY-2 and a multidrug resistance IncA/C plasmid. Copyright © 2015 Silva et al.

  10. Tunable white light source for medical applications

    Science.gov (United States)

    Blaszczak, Urszula J.; Gryko, Lukasz; Zajac, Andrzej

    2017-08-01

    Development of light-emitting diodes has brought new possibilities in many applications, especially in terms of flexible adjustment of light spectra. This feature is very useful in construction of many devices, for example for medical diagnosis and treatment. It was proved, that in some cases LEDs can easily replace lasers during therapy of cancer without reduction of efficiency of this process. On the other hand during diagnosis process LED-based constructions can provide unique ability to adjust the color temperature of the output light while maintaining high color rendering. It allows for optimum surface contrast and enhanced tissue differentiation at the operator site. In the paper we describe the construction of the tunable LED-based source designed for application in endoscopy. It was optimized from the point of view of the color rendition for 5 different correlated color temperatures (illuminant A, D55, D65, 3500K and 4500K) with the restriction of very high (>90) values of general and specific color rendering indexes (according to Ra method). The source is composed of 13 light-emitting diodes from visible region mounted on the common radiator and controlled by dedicated system. Spectra of the components are mixed and the spectra of output light is analyzed. On the basis of obtained spectra colorimetric parameters are calculated and compared with the results of theoretical analysis.

  11. Digitization of medical documents: an X-Windows application for fast scanning.

    Science.gov (United States)

    Muñoz, A; Salvador, C H; Gonzalez, M A; Dueñas, A

    1992-01-01

    This paper deals with digitization, using a commercial scanner, of medical documents as still images for introduction into a computer-based Information System. Document management involves storing, editing and transmission. This task has usually been approached from the perspective of the difficulties posed by radiologic images because of their indisputable qualitative and quantitative significance. However, healthcare activities require the management of many other types of documents and involve the requirements of numerous users. One key to document management will be the availability of a digitizer to deal with the greatest possible number of different types of documents. This paper describes the relevant aspects of documents and the technical specifications that digitizers must fulfill. The concept of document type is introduced as the ideal set of digitizing parameters for a given document. The use of document type parameters can drastically reduce the time the user spends in scanning sessions. Presentation is made of an application based on Unix, X-Windows and OSF/Motif, with a GPIB interface, implemented around the document type concept. Finally, the results of the evaluation of the application are presented, focusing on the user interface, as well as on the viewing of color images in an X-Windows environment and the use of lossy algorithms in the compression of medical images.

  12. 医疗移动应用程序评价%Evaluation on medical mobile applications

    Institute of Scientific and Technical Information of China (English)

    李骁; 方振威; 林阳

    2015-01-01

    目的:评价市场上主流医疗移动应用程序的功能,分析其易用性及可能存在的问题。方法检索中国区ITunes Store和Google Play Store,将纳入的移动应用程序按功能进行分析。结果共纳入6款移动应用程序,其中3款为集成功能类(用药助手,用药参考,集博),3款为单一功能类(临床指南,医学计算公式,检验助手)。功能包含药品信息、医学计算、药物相互作用、临床用药指南、药品资讯、患者指导及化验值标准范围。单一功能类应用程序在数据信息的数量、文献资料的广度及内容的深度上优于集成功能类。集成功能类应用程序中,用药助手具备全面的药物信息解读;用药参考可定制本院处方集,使处方信息个性化,并提供快捷的药物审查;集博从药品说明书的角度出发,突出其法律地位。结论医疗移动程序功能全面、使用便捷,可以为医务工作者提供一定的参考;但各软件数据来源各异,缺乏统一的标准,其权威性和准确性尚需进一步验证。%Objective To evaluate the functions of medical mobile applications in market, and analyze the availability and potential pro-blems, and to provide reference for medical practitioners.Methods The search for medical applications was conducted in China region of iTunes Store and Google Play Store, and the eligible applications were analyzed in the light of their functions.Results Six medical applications were concluded after screening in terms of the criteria of inclusion and exclusion, in which three of them belong to the category of integrated functions and the rest single function.Functions of the medical applica-tions involved at least one of the following elements:medicine informa-tion, medicine calculation, medicine interactions, clinical guide, medi-cine advertisement, patient′s guidance and standard range of laboratory values.Applications with single

  13. Introduction to the simulation with MCNP Monte Carlo code and its applications in Medical Physics

    International Nuclear Information System (INIS)

    Parreno Z, F.; Paucar J, R.; Picon C, C.

    1998-01-01

    The simulation by Monte Carlo is tool which Medical Physics counts with it for the development of its research, the interest by this tool is growing, as we may observe in the main scientific journals for the years 1995-1997 where more than 27 % of the papers treat over Monte Carlo and/or its applications in the radiation transport.In the Peruvian Institute of Nuclear Energy we are implementing and making use of the MCNP4 and EGS4 codes. In this work are presented the general features of the Monte Carlo method and its more useful applications in Medical Physics. Likewise, it is made a simulation of the calculation of isodose curves in an interstitial treatment with Ir-192 wires in a mammary gland carcinoma. (Author)

  14. Acute Stress Suppresses Synaptic Inhibition and Increases Anxiety via Endocannabinoid Release in the Basolateral Amygdala.

    Science.gov (United States)

    Di, Shi; Itoga, Christy A; Fisher, Marc O; Solomonow, Jonathan; Roltsch, Emily A; Gilpin, Nicholas W; Tasker, Jeffrey G

    2016-08-10

    Stress and glucocorticoids stimulate the rapid mobilization of endocannabinoids in the basolateral amygdala (BLA). Cannabinoid receptors in the BLA contribute to anxiogenesis and fear-memory formation. We tested for rapid glucocorticoid-induced endocannabinoid regulation of synaptic inhibition in the rat BLA. Glucocorticoid application to amygdala slices elicited a rapid, nonreversible suppression of spontaneous, but not evoked, GABAergic synaptic currents in BLA principal neurons; the effect was also seen with a membrane-impermeant glucocorticoid, but not with intracellular glucocorticoid application, implicating a membrane-associated glucocorticoid receptor. The glucocorticoid suppression of GABA currents was not blocked by antagonists of nuclear corticosteroid receptors, or by inhibitors of gene transcription or protein synthesis, but was blocked by inhibiting postsynaptic G-protein activity, suggesting a postsynaptic nongenomic steroid signaling mechanism that stimulates the release of a retrograde messenger. The rapid glucocorticoid-induced suppression of inhibition was prevented by blocking CB1 receptors and 2-arachidonoylglycerol (2-AG) synthesis, and it was mimicked and occluded by CB1 receptor agonists, indicating it was mediated by the retrograde release of the endocannabinoid 2-AG. The rapid glucocorticoid effect in BLA neurons in vitro was occluded by prior in vivo acute stress-induced, or prior in vitro glucocorticoid-induced, release of endocannabinoid. Acute stress also caused an increase in anxiety-like behavior that was attenuated by blocking CB1 receptor activation and inhibiting 2-AG synthesis in the BLA. Together, these findings suggest that acute stress causes a long-lasting suppression of synaptic inhibition in BLA neurons via a membrane glucocorticoid receptor-induced release of 2-AG at GABA synapses, which contributes to stress-induced anxiogenesis. We provide a cellular mechanism in the basolateral amygdala (BLA) for the rapid stress

  15. Nuclear energy and its medical application

    International Nuclear Information System (INIS)

    Jain, S.K.

    2010-01-01

    Ionising radiation is used in radiotherapy to treat cancer and to sterilise medical equipment because it destroys cells. Radioactive tracers are used in nuclear medicine because the ionising radiation it emits is easy to detect. There are three main uses of ionising radiation in medicine: treatment, diagnosis and sterilisation. Radiotherapy is used to treat cancers by irradiating them with ionising radiation. Radioactive tracers are used to diagnose and investigate several medical conditions. Ionising radiation is used to sterilise medical equipment as it kills germs and/or bacteria

  16. Medical Applications and Toxicities of Gallium Compounds

    Directory of Open Access Journals (Sweden)

    Christopher R. Chitambar

    2010-05-01

    Full Text Available Over the past two to three decades, gallium compounds have gained importance in the fields of medicine and electronics. In clinical medicine, radioactive gallium and stable gallium nitrate are used as diagnostic and therapeutic agents in cancer and disorders of calcium and bone metabolism. In addition, gallium compounds have displayed anti-inflammatory and immunosuppressive activity in animal models of human disease while more recent studies have shown that gallium compounds may function as antimicrobial agents against certain pathogens. In a totally different realm, the chemical properties of gallium arsenide have led to its use in the semiconductor industry. Gallium compounds, whether used medically or in the electronics field, have toxicities. Patients receiving gallium nitrate for the treatment of various diseases may benefit from such therapy, but knowledge of the therapeutic index of this drug is necessary to avoid clinical toxicities. Animals exposed to gallium arsenide display toxicities in certain organ systems suggesting that environmental risks may exist for individuals exposed to this compound in the workplace. Although the arsenic moiety of gallium arsenide appears to be mainly responsible for its pulmonary toxicity, gallium may contribute to some of the detrimental effects in other organs. The use of older and newer gallium compounds in clinical medicine may be advanced by a better understanding of their mechanisms of action, drug resistance, pharmacology, and side-effects. This review will discuss the medical applications of gallium and its mechanisms of action, the newer gallium compounds and future directions for development, and the toxicities of gallium compounds in current use.

  17. Shape memory polymer cellular solid design for medical applications

    International Nuclear Information System (INIS)

    De Nardo, L; Bertoldi, S; Tanzi, M C; Farè, S; Haugen, H J

    2011-01-01

    Shape memory polymers (SMPs) are an emerging class of active materials whose response can be easily tailored via modifications of the molecular parameters and optimization of the transformation processes. In this work, we originally demonstrated that a correct coupling of polymer transformation processes (co-extrusion with chemical blowing agents, salt co-extrusion/particulate leaching, solvent casting/particulate leaching) and SMPs allows one to obtain porous structures with a broad spectrum of morphological properties resulting in tunable thermo-mechanical and shape recovery properties. Such a wide range of properties could fulfil the specifications of medical applications in which the use of SMP-based foams can be envisaged

  18. Positron emitting radionuclides: manufacturing, labelling and examples of medical applications

    International Nuclear Information System (INIS)

    Comar, D.; Maziere, M.; Berger, G.; Crouzel, C.; Soussaline, F.; Kellershohn, C.

    1979-01-01

    The only radioisotopes of carbon, oxygen and nitrogen which can be used in medicine are positrons emitters. They may be incorporated in organic molecules and detected in vivo by quantitative emission tomography. The manufacture of these short lived radioisotopes need a cyclotron to be set up in a hospital. The main procedures for making these radioisotopes are described so as their incorporation in complex molecules. Some medical applications in the field of the brain blood-flow, and oxygen consumption, the cerebral amino-acids metabolism and the brain distribution of psychoactive drugs are described [fr

  19. Unique identification code for medical fundus images using blood vessel pattern for tele-ophthalmology applications.

    Science.gov (United States)

    Singh, Anushikha; Dutta, Malay Kishore; Sharma, Dilip Kumar

    2016-10-01

    Identification of fundus images during transmission and storage in database for tele-ophthalmology applications is an important issue in modern era. The proposed work presents a novel accurate method for generation of unique identification code for identification of fundus images for tele-ophthalmology applications and storage in databases. Unlike existing methods of steganography and watermarking, this method does not tamper the medical image as nothing is embedded in this approach and there is no loss of medical information. Strategic combination of unique blood vessel pattern and patient ID is considered for generation of unique identification code for the digital fundus images. Segmented blood vessel pattern near the optic disc is strategically combined with patient ID for generation of a unique identification code for the image. The proposed method of medical image identification is tested on the publically available DRIVE and MESSIDOR database of fundus image and results are encouraging. Experimental results indicate the uniqueness of identification code and lossless recovery of patient identity from unique identification code for integrity verification of fundus images. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  20. Low-dosage helical CT applications for chest medical checkup and lung cancer screening

    International Nuclear Information System (INIS)

    Wang Ping; Cui Fa; Liang Huanqing; Zheng Minfei

    2005-01-01

    Objective: A discussion on low-dosage helical CT applications on chest medical checkup and lung cancer screening. Methods: On the 100 chest medical check up with three different of protocols, including standard-dosage (the tube current was 230 mAs) were compared with low-dose (tube current was 50 mAs or 30 mAs). Results: Low-dosage helical CT scan provides excellent images. In 100 chest medical checkup, 39 nodules or masses were revealed, enlarged lymph node was noted in 1 case; emphysema or bullae was demonstrated in 3 segments; thickening of bronchial wall was shown in 2 cases; and localized pleural thickening was found in 1 case. Conclusion: In chest checkup or lung cancer screening low-dosage helical CT (tube current 30 mAs) will not only guarantee image quality but also reduce the radiation dose during the examination. (authors)

  1. Bioadhesives for internal medical applications: A review.

    Science.gov (United States)

    Zhu, Wenzhen; Chuah, Yon Jin; Wang, Dong-An

    2018-04-22

    Bioadhesives such as tissue adhesives, hemostatic agents, and tissue sealants have gained increasing popularity in different areas of clinical operations during the last three decades. Bioadhesives can be categorized into internal and external ones according to their application conditions. External bioadhesives are generally applied in topical medications such as wound closure and epidermal grafting. Internal bioadhesives are mainly used in intracorporal conditions with direct contact to internal environment including tissues, organs and body fluids, such as chronic organ leak repair and bleeding complication reduction. This review focuses on internal bioadhesives that, in contrast with external bioadhesives, emphasize much more on biocompatibility and adhesive ability to wet surfaces rather than on gluing time and intensity. The crosslinking mechanisms of present internal bioadhesives can be generally classified as follows: 1) chemical conjugation between reactive groups; 2) free radical polymerization by light or redox initiation; 3) biological or biochemical coupling with specificity; and 4) biomimetic adhesion inspired from natural phenomena. In this review, bioadhesive products of each class are summarized and discussed by comparing their designs, features, and applications as well as their prospects for future development. Despite the emergence of numerous novel bioadhesive formulations in recent years, thus far, the classification of internal and external bioadhesives has not been well defined and universally acknowledged. Many of the formulations have been proposed for treatment of several diseases even though they are not applicable for such conditions. This is because of the lack of a systematic standard or evaluation protocol during the development of a new adhesive product. In this review, the definition of internal and external bioadhesives is given for the first time, and with a focus on internal bioadhesives, the criteria of an ideal internal

  2. Can We Trust Computational Modeling for Medical Applications?

    Science.gov (United States)

    Mulugeta, Lealem; Walton, Marlei; Nelson, Emily; Myers, Jerry

    2015-01-01

    Operations in extreme environments such as spaceflight pose human health risks that are currently not well understood and potentially unanticipated. In addition, there are limited clinical and research data to inform development and implementation of therapeutics for these unique health risks. In this light, NASA's Human Research Program (HRP) is leveraging biomedical computational models and simulations (M&S) to help inform, predict, assess and mitigate spaceflight health and performance risks, and enhance countermeasure development. To ensure that these M&S can be applied with confidence to the space environment, it is imperative to incorporate a rigorous verification, validation and credibility assessment (VV&C) processes to ensure that the computational tools are sufficiently reliable to answer questions within their intended use domain. In this presentation, we will discuss how NASA's Integrated Medical Model (IMM) and Digital Astronaut Project (DAP) have successfully adapted NASA's Standard for Models and Simulations, NASA-STD-7009 (7009) to achieve this goal. These VV&C methods are also being leveraged by organization such as the Food and Drug Administration (FDA), National Institute of Health (NIH) and the American Society of Mechanical Engineers (ASME) to establish new M&S VV&C standards and guidelines for healthcare applications. Similarly, we hope to provide some insight to the greater aerospace medicine community on how to develop and implement M&S with sufficient confidence to augment medical research and operations.

  3. Smart Medical Systems with Application to Nutrition and Fitness in Space

    Science.gov (United States)

    Soller, Babs R.; Cabrera, Marco; Smith, Scott M.; Sutton, Jeffrey P.

    2002-01-01

    Smart medical systems are being developed to allow medical treatments to address alterations in chemical and physiological status in real time. In a smart medical system sensor arrays assess subject status, which are interpreted by computer processors which analyze multiple inputs and recommend treatment interventions. The response of the subject to the treatment is again assessed by the sensor arrays, closing the loop. An early form of "smart medicine" has been practiced in space to assess nutrition. Nutrient levels are assessed with food frequency questionnaires, which are interpreted by flight surgeons to recommend in-flight alterations in diet. In the future, sensor arrays will directly probe body chemistry. Near infrared spectroscopy can be used to noninvasively measure several blood and tissue parameters which are important in the assessment of nutrition and fitness. In particular, this technology can be used to measure blood hematocrit and interstitial fluid pH. The noninvasive measurement of interstitial pH is discussed as a surrogate for blood lactate measurement for the development and real-time assessment of exercise protocols in space. Earth-based application of these sensors are also described.

  4. [What medical students want - evaluation of medical recruitment ads by future physicians].

    Science.gov (United States)

    Renkawitz, T; Schuster, T; Benditz, A; Craiovan, B; Grifka, J; Lechler, P

    2013-10-01

    Three-quarters of all hospitals in Germany are now struggling to fill open positions for doctors. The medical job ad is a vital tool for human resources marketing and an important image factor. The present study examines the importance of information and offers in medical recruitment ads on application decisions by medical students. A total of 184 future physicians from clinical semesters participated voluntarily in an anonymous cross-sectional survey. Using a standardised questionnaire, the importance of 49 -individual items extracted from medical recruitment ads were rated with the help of a 4-point Likert Scale. Finally, the study participants prioritised their reasons for an application as a physician. Primary influence on the application decision on medical recruitment ads by medical students had offers/information in relation to education and training aspects and work-life balance. Payment rates for physicians and work load played an important role for the application motivation. Additional earnings for, e. g., emergency calls, providing of medical expertise and assistance with housing, relocation and reimbursement of interview expenses were less crucial. In prioritising key reasons for selecting a prospective employer "regular working hours," an "individual training concept" and an "attractive work-life balance" scored the highest priority. The "opportunity for scientific work" was assigned only a small significance. High importance for the application decision by future physicians on medical recruitment ads is placed on jobs with an opportunity for personal development and aspects that contribute to work-life balance. © Georg Thieme Verlag KG Stuttgart · New York.

  5. Aerosol generation and delivery in medical applications

    International Nuclear Information System (INIS)

    Soni, P.S.; Raghunath, B.

    1998-01-01

    It is well established that radioaerosol lung technique by inhalation is a very versatile technique in the evaluation of health effects and medical diagnostic applications, especially to detect chronic obstructive pulmonary diseases, their defence mechanism permeability and many others. Most important part of aerosol technology is to generate reproducibly stable diagnostic radioaerosols of known characteristics. Many compressed air atomisers are commercially available for generating aerosols but they have limited utility in aerosol inhalation, either because of large droplet size, low aerosol output or high airflow rates. There is clearly a need for a versatile and economical aerosol generation/inhalation system that can produce dry labelled aerosol particles with high deep lung delivery efficiency suitable for clinical studies. BARC (Bhabha Atomic Research Centre) has developed a dry aerosol generation/delivery system which operates on compressed air and generates dry polydisperse aerosols. This system is described along with an assessment of the aerosol characteristics and efficiency for diagnosis of various respiratory disorders

  6. Hard X-Ray Phase-Contrast Imaging for Medical Applications - Physicist's Dream or Radiologist's Mainstream?

    International Nuclear Information System (INIS)

    Wilkins, S. W.; Gureyev, T. E.; Mayo, S. C.; Nesterets, Ya. I.; Pogany, A.; Stevenson, A. W.; Paganin, D. M.

    2007-01-01

    We briefly review currently practiced methods of X-ray phase contrast imaging and consider some of their relative features, especially in regard to applicability to clinical medical studies. Various related technological issues and promising future areas of development are also briefly discussed

  7. Access database application in medical treatment management platform

    International Nuclear Information System (INIS)

    Wu Qingming

    2014-01-01

    For timely, accurate and flexible access to medical expenses data, we applied Microsoft Access 2003 database management software, and we finished the establishment of a management platform for medical expenses. By developing management platform for medical expenses, overall hospital costs for medical expenses can be controlled to achieve a real-time monitoring of medical expenses. Using the Access database management platform for medical expenses not only changes the management model, but also promotes a sound management system for medical expenses. (authors)

  8. An Overview of Recent Application of Medical Infrared Thermography in Sports Medicine in Austria

    Directory of Open Access Journals (Sweden)

    Carolin Hildebrandt

    2010-05-01

    Full Text Available Medical infrared thermography (MIT is used for analyzing physiological functions related to skin temperature. Technological advances have made MIT a reliable medical measurement tool. This paper provides an overview of MIT´s technical requirements and usefulness in sports medicine, with a special focus on overuse and traumatic knee injuries. Case studies are used to illustrate the clinical applicability and limitations of MIT. It is concluded that MIT is a non-invasive, non-radiating, low cost detection tool which should be applied for pre-scanning athletes in sports medicine.

  9. A flexible mobile-device biosensing instrumentation platform for point-of-care medical diagnostics applications

    DEFF Research Database (Denmark)

    Patou, François; Pfreundt, Andrea; Zulfiqar, Azeem

    2014-01-01

    helping to address this challenge. Specifically, Lab-on-Chip (LoC) devices have a key role to play in the advent of Point-of-Care (PoC) medical applications, driving a shift of the medical diagnostics paradigm and the transition from a centralized, technical, high-throughput biological sample analysis...... programmable electrical readout from LoCs potentially comprehending varied transducers addressing different targeted biological markers. A smart-phone/tablet docking-station embeds the hardware interface necessary for the implementation of a smart-phone digital lock-in amplifier. The platform is tested...

  10. Unhappiness and dissatisfaction in doctors cannot be predicted by selectors from medical school application forms: A prospective, longitudinal study

    Directory of Open Access Journals (Sweden)

    Ferguson E

    2005-12-01

    Full Text Available Abstract Background Personal statements and referees' reports are widely used on medical school application forms, particularly in the UK, to assess the suitability of candidates for a career in medicine. However there are few studies which assess the validity of such information for predicting unhappiness or dissatisfaction with a career in medicine. Here we combine data from a long-term prospective study of medical student selection and training, with an experimental approach in which a large number of assessors used a paired comparison technique to predict outcome. Methods Data from a large-scale prospective study of students applying to UK medical schools in 1990 were used to identify 40 pairs of doctors, matched by sex, for whom personal statements and referees' reports were available, and who in a 2002/3 follow-up study, one pair member was very satisfied and the other very dissatisfied with medicine as a career. In 2005, 96 assessors, who were experienced medical school selectors, doctors, medical students or psychology students, used information from the doctors' original applications to judge which member of each pair of doctors was the happier, more satisfied doctor. Results None of the groups of assessors were significantly different from chance expectations in using applicants' personal statements and the referees' reports to predict actual future satisfaction or dissatisfaction, the distribution being similar to binomial expectations. However judgements of pairs of application forms from pairs of doctors showed a non-binomial distribution, indicating consensus among assessors as to which doctor would be the happy doctor (although the consensus was wrong in half the cases. Assessors taking longer to do the task concurred more. Consensus judgements seem mainly to be based on referees' predictions of academic achievement (even though academic achievement is not actually a valid predictor of happiness or satisfaction. Conclusion

  11. Light ion linacs for medical applications

    International Nuclear Information System (INIS)

    Bradbury, J.N.; Knapp, E.A.; Nagle, D.E.

    1975-01-01

    Recent advances in linear accelerator technology point to the feasibility of designing and developing practical medical linacs for producing protons, neutrons, or π mesons for the radiation therapy of cancer. Additional uses of such linacs could include radioisotope production and charged particle radiography. For widespread utilization medical linacs must exhibit reasonable cost, compactness, reliability, and simplicity of operation. Possible extensions of current accelerator technology which might provide these characteristics are discussed in connection with linac design, fabrication techniques, materials, power sources, injectors, and particle collection and delivery systems. Parameters for a medical proton linac for producing pions are listed. (U.S.)

  12. BR2 reactor: medical and industrial applications

    International Nuclear Information System (INIS)

    Ponsard, B.

    2005-01-01

    The radioisotopes are produced for various applications in the nuclear medicine (diagnostic, therapy, palliation of metastatic bone pain), industry (radiography of welds, ...), agriculture (radiotracers, ...) and basic research. Due to the availability of high neutron fluxes (thermal neutron flux up to 10 15 n/cm 2 .s), the BR2 reactor is considered as a major facility through its contribution for a continuous supply of products such 99 Mo ( 99 mTc), 131 I, 133 Xe, 192 Ir, 186 Re, 153 Sm, 90 Y, 32 P, 188 W ( 188 Re), 203 Hg, 82 Br, 41 Ar, 125 I, 177 Lu, 89 Sr, 60 Co, 169 Yb, 147 Nd, and others. Neutron Transmutation Doped (NTD) silicon is produced for the semiconductor industry in the SIDONIE (Silicon Doping by Neutron Irradiation Experiment) facility, which is designed to continuously rotate and traverse the silicon through the neutron flux. These combined movements produce exceptional dopant homogeneity in batches of silicon measuring 4 and 5-inches in diameter by up to 750 mm in length. The main objectives of work performed were to provide a reliable and qualitative supply of radioisotopes and NTD-silicon to the customers in accordance with a quality system that has been certified to the requirements of the EN ISO 9001: 2000. This new Quality System Certificate has been obtained in November 2003 for the Production of radioisotopes for medical and industrial applications and the Production of Neutron Transmutation Doped (NTD) Silicon in the BR2 reactor

  13. Phenotypic and molecular detection of BLACTX-M gene extended-spectrum beta-lactamases in escherichia coli and klebsiella pneumoniae of north sumatera isolates

    Science.gov (United States)

    Hasibuan, Mirzan; Suryanto, Dwi; Lia Kusumawati, R.

    2018-03-01

    The application of antibiotics expanded-spectrum third-generation cephalosporin for the treatment of infectious diseases in hospitals is known contribute to increasing resistance due to the presence of the blaCTX-M gene in the bacteria producing ESBLs. This study was aimed to detect ESBLs, isolate phenotype and blaCTX-M genes on Escherichia coli and Klebsiella pneumoniae collected from H. Adam Malik Central Hospital. Phenotypes of the bacterial were detection using Vitek two compact, while the blaCTX-M genes were detection using polymerase chain reaction technique. The results showed that 85 (100%) isolates were ESBLs consisted of 41(48%) of Escherichia coli, and 44 (52%) of Klebsiella pneumoniae, respectively. blaCTX-M genes were detection in 62 (72.94%) of the isolates which 31 (36.47%) were Escherichia coli, and 31 (36.47%) of the isolates were Klebsiella pneumoniae, respectively. This study indicates the high prevalence of blaCTX-M genes in Escherichia coli and Klebsiella pneumoniea causing bacterial antibiotic resistance.

  14. Handling limited datasets with neural networks in medical applications: A small-data approach.

    Science.gov (United States)

    Shaikhina, Torgyn; Khovanova, Natalia A

    2017-01-01

    Single-centre studies in medical domain are often characterised by limited samples due to the complexity and high costs of patient data collection. Machine learning methods for regression modelling of small datasets (less than 10 observations per predictor variable) remain scarce. Our work bridges this gap by developing a novel framework for application of artificial neural networks (NNs) for regression tasks involving small medical datasets. In order to address the sporadic fluctuations and validation issues that appear in regression NNs trained on small datasets, the method of multiple runs and surrogate data analysis were proposed in this work. The approach was compared to the state-of-the-art ensemble NNs; the effect of dataset size on NN performance was also investigated. The proposed framework was applied for the prediction of compressive strength (CS) of femoral trabecular bone in patients suffering from severe osteoarthritis. The NN model was able to estimate the CS of osteoarthritic trabecular bone from its structural and biological properties with a standard error of 0.85MPa. When evaluated on independent test samples, the NN achieved accuracy of 98.3%, outperforming an ensemble NN model by 11%. We reproduce this result on CS data of another porous solid (concrete) and demonstrate that the proposed framework allows for an NN modelled with as few as 56 samples to generalise on 300 independent test samples with 86.5% accuracy, which is comparable to the performance of an NN developed with 18 times larger dataset (1030 samples). The significance of this work is two-fold: the practical application allows for non-destructive prediction of bone fracture risk, while the novel methodology extends beyond the task considered in this study and provides a general framework for application of regression NNs to medical problems characterised by limited dataset sizes. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  15. Embedded Control in Wearable Medical Devices: Application to the Artificial Pancreas

    Directory of Open Access Journals (Sweden)

    Stamatina Zavitsanou

    2016-09-01

    Full Text Available Significant increases in processing power, coupled with the miniaturization of processing units operating at low power levels, has motivated the embedding of modern control systems into medical devices. The design of such embedded decision-making strategies for medical applications is driven by multiple crucial factors, such as: (i guaranteed safety in the presence of exogenous disturbances and unexpected system failures; (ii constraints on computing resources; (iii portability and longevity in terms of size and power consumption; and (iv constraints on manufacturing and maintenance costs. Embedded control systems are especially compelling in the context of modern artificial pancreas systems (AP used in glucose regulation for patients with type 1 diabetes mellitus (T1DM. Herein, a review of potential embedded control strategies that can be leveraged in a fully-automated and portable AP is presented. Amongst competing controllers, emphasis is provided on model predictive control (MPC, since it has been established as a very promising control strategy for glucose regulation using the AP. Challenges involved in the design, implementation and validation of safety-critical embedded model predictive controllers for the AP application are discussed in detail. Additionally, the computational expenditure inherent to MPC strategies is investigated, and a comparative study of runtime performances and storage requirements among modern quadratic programming solvers is reported for a desktop environment and a prototype hardware platform.

  16. Do US Medical Licensing Applications Treat Mental and Physical Illness Equivalently?

    Science.gov (United States)

    Gold, Katherine J; Shih, Elizabeth R; Goldman, Edward B; Schwenk, Thomas L

    2017-06-01

    State medical licensing boards are responsible for evaluating physician impairment. Given the stigma generated by mental health issues among physicians and in the medical training culture, we were interested in whether states asked about mental and physical health conditions differently and whether questions focused on current impairment. Two authors reviewed physician medical licensing applications for US physicians seeking first-time licensing in 2013 in the 50 states and the District of Columbia. Questions about physical and mental health, as well as substance abuse, were identified and coded as to whether or not they asked about diagnosis and/or treatment or limited the questions to conditions causing physician impairment. Forty-three (84%) states asked questions about mental health conditions, 43 (84%) about physical health conditions, and 47 (92%) about substance use. States were more likely to ask for history of treatment and prior hospitalization for mental health and substance use, compared with physical health disorders. Among states asking about mental health, just 23 (53%) limited all questions to disorders causing functional impairment and just 6 (14%) limited to current problems. While most state medical licensing boards ask about mental health conditions or treatment, only half limited queries to disorders causing impairment. Differences in how state licensing boards assess mental health raise important ethical and legal questions about assessing physician ability to practice and may discourage treatment for physicians who might otherwise benefit from appropriate care.

  17. Smart sensors and systems innovations for medical, environmental, and IoT applications

    CERN Document Server

    Yasuura, Hiroto; Liu, Yongpan; Lin, Youn-Long

    2017-01-01

    This book describes the technology used for effective sensing of our physical world and intelligent processing techniques for sensed information, which are essential to the success of Internet of Things (IoT). The authors provide a multidisciplinary view of sensor technology from materials, process, circuits, and big data domains and showcase smart sensor systems in real applications including smart home, transportation, medical, environmental, agricultural, etc. Unlike earlier books on sensors, this book provides a “global” view on smart sensors covering abstraction levels from device, circuit, systems, and algorithms. Profiles active research on smart sensors based on CMOS microelectronics; Describes applications of sensors and sensor systems in cyber physical systems, the social information infrastructure in our modern world; Includes coverage of a variety of related information technologies supporting the application of sensors; Discusses the integration of computation, networking, actuation, database...

  18. Medical Information & Technology: Rapidly Expanding Vast Horizons

    Science.gov (United States)

    Sahni, Anil K.

    2012-12-01

    During ÑMedical Council Of India?, Platinum Jubilee Year (1933-2008) Celebrations, In Year 2008, Several Scientific Meeting/Seminar/Symposium, On Various Topics Of Contemporary Importance And Relevance In The Field Of ÑMedical Education And Ethics?, Were Organized, By Different Medical Colleges At Various Local, State, National Levels. The Present Discussion, Is An Comprehensive Summary Of Various Different Aspects of ìMedical Information Communication Technologyî, Especially UseFul For The Audience Stratum Group Of Those Amateur Medical & Paramedical Staff, With No Previous Work Experience Knowledge Of Computronics Applications. Outlining The, i.Administration Applications: Medical Records Etc, ii. Clinical Applications: Pros pective Scope Of TeleMedicine Applicabilities Etc iii. Other Applications: Efforts To Augment Improvement Of Medical Education, Medical Presentations, Medical Education And Research Etc. ÑMedical Trancription? & Related Recent Study Fields e.g ÑModern Pharmaceuticals?,ÑBio-Engineering?, ÑBio-Mechanics?, ÑBio-Technology? Etc., Along With Important Aspects Of Computers-General Considerations, Computer Ergonomics Assembled To Summarize, The AwareNess Regarding Basic Fundamentals Of Medical Computronics & Its Practically SuccessFul Utilities.

  19. Katharsis of the skin: Peeling applications and agents of chemical peelings in Greek medical textbooks of Graeco-Roman antiquity.

    Science.gov (United States)

    Ursin, F; Steger, F; Borelli, C

    2018-04-28

    Recipes for peelings date back to medical texts of old Egypt. The oldest medical papyri contain recipes for "improving beauty of the skin" and "removing wrinkles" by use of agents like salt and soda. The Egyptian Queen Cleopatra (69-30 BC) is said to have taken bathes in donkey's milk in order to improve the beauty of her skin. However, little is known about other agents and peeling applications in later Greek medical textbooks. We will discover new agents and describe ancient peeling applications. First, we will have to identify ancient Greek medical terms for the modern terms "peeling" and "chemical peeling". Second, based on the identified terms we will perform a systematic fulltext search for agents in original sources. Third, we will categorize the results into three peeling applications: (1) cleansing, (2) aesthetical improvement of the skin, and (3) therapy of dermatological diseases. We performed a full systematic keyword search with the identified Greek terms in databases of ancient Greek texts. Our keywords for peeling and chemical peeling are "smēxis" and "trīpsis". Our keywords for agents of peeling and chemical peeling are "smégmata", "rhýmmata", "kathartiká", and "trímmata". Diocles (4 th century BC) was the first one who mentioned "smēxis" and "trīpsis" as parts of daily cleansing routine. Criton (2 nd century AD) wrote about peeling applications, but any reference to the agents is lost. Antyllos (2 nd century AD) composed three lists of peeling applications including agents. Greek medical textbooks of Graeco-Roman antiquity report several peeling applications like cleansing, brightening, darkening, softening, and aesthetical improvement of the skin by use of peeling and chemical peeling, as well as therapy of dermatological diseases. There are 27 ancient agents for what is contemporarily called peeling and chemical peeling. We discovered more specific agents than hitherto known to research. This article is protected by copyright. All rights

  20. Fluorine-18-labelled molecules: synthesis and application in medical imaging

    International Nuclear Information System (INIS)

    Dolle, F.; Perrio, C.; Barre, L.; Lasne, M.C.; Le Bars, D.

    2006-01-01

    Positron emission tomography (PET) is one of the more powerful available techniques for medical imaging. It relies on the use of molecules labelled with a positron emitter (β + ). Among those emitters, fluorine-18, available from a cyclotron, is a radionuclide of choice because of its relatively long-half-life (109.8 min) and the relatively low energy of the emitted-positron. The electrophilic form of fluorine-18 ([ 18 F]F 2 or reagents derived from [ 18 F]F 2 ) is mainly used for hydrogen or metal substitutions on aromatic or vinylic carbons. The presence of the stable isotope (fluorine-19) in the radiotracers limits their use in medical imaging. The nucleophilic form of fluorine-18 (alkaline mono-fluoride, K[ 18 F]F, the most used), obtained from irradiation of enriched water, is widely used in aliphatic and (hetero)aromatic substitutions for the synthesis of radiotracers with high specific radioactivity. Some examples of radio-fluorinated tracers used in PET are presented, as well as some of their in vivo applications in human. (authors)

  1. Development and examination of a rubric for evaluating point-of-care medical applications for mobile devices.

    Science.gov (United States)

    Butcher, Robyn; MacKinnon, Martin; Gadd, Kathleen; LeBlanc-Duchin, Denise

    2015-01-01

    The rapid development and updates of mobile medical resource applications (apps) highlight the need for an evaluation tool to assess the content of these resources. The purpose of the study was to develop and test a new evaluation rubric for medical resource apps. The evaluation rubric was designed using existing literature and through a collaborative effort between a hospital and an academic librarian. Testing found scores ranging from 23% to 88% for the apps. The evaluation rubric proved able to distinguish levels of quality within each content component of the apps, demonstrating potential for standardization of medical resource app evaluations.

  2. Medical imaging education in biomedical engineering curriculum: courseware development and application through a hybrid teaching model.

    Science.gov (United States)

    Zhao, Weizhao; Li, Xiping; Chen, Hairong; Manns, Fabrice

    2012-01-01

    Medical Imaging is a key training component in Biomedical Engineering programs. Medical imaging education is interdisciplinary training, involving physics, mathematics, chemistry, electrical engineering, computer engineering, and applications in biology and medicine. Seeking an efficient teaching method for instructors and an effective learning environment for students has long been a goal for medical imaging education. By the support of NSF grants, we developed the medical imaging teaching software (MITS) and associated dynamic assessment tracking system (DATS). The MITS/DATS system has been applied to junior and senior medical imaging classes through a hybrid teaching model. The results show that student's learning gain improved, particularly in concept understanding and simulation project completion. The results also indicate disparities in subjective perception between junior and senior classes. Three institutions are collaborating to expand the courseware system and plan to apply it to different class settings.

  3. A qualitative analysis of statements on motivation of applicants for medical school

    OpenAIRE

    Wouters, Anouk; Bakker, Anneke H; van Wijk, Inge J; Croiset, Gerda; Kusurkar, Rashmi A

    2014-01-01

    Background Selection committees try to ascertain that motivated students are selected for medical school. Self-determination theory stresses that the type of motivation is more important than the quantity of motivation. Autonomous motivation, compared to controlled motivation, in students leads to better learning outcomes. Applicants can express their motivation in written statements, a selection tool which has been found to elicit heterogeneous responses, hampering the comparison of applican...

  4. A collaborative institutional model for integrating computer applications in the medical curriculum.

    OpenAIRE

    Friedman, C. P.; Oxford, G. S.; Juliano, E. L.

    1991-01-01

    The introduction and promotion of information technology in an established medical curriculum with existing academic and technical support structures poses a number of challenges. The UNC School of Medicine has developed the Taskforce on Educational Applications in Medicine (TEAM), to coordinate this effort. TEAM works as a confederation of existing research and support units with interests in computers and education, along with a core of interested faculty with curricular responsibilities. C...

  5. European union legislation in medical application of ionizing radiation and radiation protection

    International Nuclear Information System (INIS)

    Vanlic-Razumenic, N.; Pavlovic, R.; Plecas, I.

    1999-01-01

    The most important aspects of the latest EU legislation concerning medical application of ionizing radiation, with the special emphasis on nuclear medicine are presented in this paper. The EU member countries will start to apply this regulation on 13 th May 2000. Our legislation is already adjusted to IAEA standards and ICRP Recommendation. Those regulations are of special concerns in the Radioisotope Laboratory of The Vinca Institute of Nuclear Sciences. (author)

  6. Persistent phosphors for painting, medical and biological applications

    International Nuclear Information System (INIS)

    Nazarov, M.

    2013-01-01

    Multiphase micro and nanoparticle persistent phosphors are synthesized and applied for different fields including painting, medical and biological investigations. A lot of examples show a broad range of applications of persistent luminescence from bulk materials to high tech products, especially in medicine. The development of high efficiency nanosized phosphor makes it possible to propose persistent materials as very good candidates for photodynamic therapy of cancer. An artificial block from slag, concrete, and sand covered with SrAl 2 O 4 :Eu 2+ , Dy 3+ based phosphor is prepared, and a new direction in biology for algae cultivation and artificial reef is discussed. For the first time, underwater luminescence is experimentally studied under real sea conditions. Bright blue-green long-lasting afterglow is registered at a depth of 5 m. The fishes are attracted by the light of the artificial reef. (author)

  7. A triple GEM gamma camera for medical application

    Energy Technology Data Exchange (ETDEWEB)

    Anulli, F. [Laboratori Nazionali di Frascati INFN, Frascati (Italy); Balla, A. [Laboratori Nazionali di Frascati INFN, Frascati (Italy); Bencivenni, G. [Laboratori Nazionali di Frascati INFN, Frascati (Italy); Corradi, G. [Laboratori Nazionali di Frascati INFN, Frascati (Italy); D' Ambrosio, C. [Laboratori Nazionali di Frascati INFN, Frascati (Italy); Domenici, D. [Laboratori Nazionali di Frascati INFN, Frascati (Italy); Felici, G. [Laboratori Nazionali di Frascati INFN, Frascati (Italy); Gatta, M. [Laboratori Nazionali di Frascati INFN, Frascati (Italy); Morone, M.C. [Dipartimento di Biopatologia e Diagnostica per immagini, Universita di Roma Tor Vergata (Italy); INFN - Sezione di Roma Tor Vergata (Italy); Murtas, F. [Laboratori Nazionali di Frascati INFN, Frascati (Italy)]. E-mail: fabrizio.murtas@lnf.infn.it; Schillaci, O. [Dipartimento di Biopatologia e Diagnostica per immagini, Universita di Roma Tor Vergata (Italy)

    2007-03-01

    A Gamma Camera for medical applications 10x10cm{sup 2} has been built using a triple GEM chamber prototype. The photon converters placed in front of the three GEM foils, has been realized with different technologies. The chamber, High Voltage supplied with a new active divider made in Frascati, is readout through 64 pads, 1mm{sup 2} wide, organized in a row of 8cm long, with LHCb ASDQ chip. This Gamma Camera can be used both for X-ray movie and PET-SPECT imaging; this chamber prototype is placed in a scanner system, creating images of 8x8cm{sup 2}. Several measurements have been performed using phantom and radioactive sources of Tc99m(140keV) and Na22(511keV). Results on spatial resolution and image reconstruction are presented.

  8. Summaries of research projects for fiscal years 1996 and 1997, medical applications and biophysical research

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-02-01

    The Medical Applications and Biophysical Research Division of the Office of Biological and Environmental Research supports and manages research in several distinct areas of science and technology. The projects described in this book are grouped by the main budgetary areas: General Life Sciences (structural molecular biology), Medical Applications (primarily nuclear medicine) and Measurement Science (analytical chemistry instrumentation), Environmental Management Science Program, and the Small Business Innovation Research Program. The research funded by this division complements that of the other two divisions in the Office of Biological and Environmental Research (OBER): Health Effects and Life Sciences Research, and Environmental Sciences. Most of the OBER programs are planned and administered jointly by the staff of two or all three of the divisions. This summary book provides information on research supported in these program areas during Fiscal Years 1996 and 1997.

  9. Distinguishing the Effects of Bond-Length Alternation versus Bond-Order Alternation on the Nonlinear Optical Properties of π-Conjugated Chromophores

    KAUST Repository

    Gieseking, Rebecca L.; Risko, Chad; Bredas, Jean-Luc

    2015-01-01

    Understanding the relationships between the molecular nonlinear optical (NLO) properties and the bond-length alternation (BLA) or π-bond-order alternation (BOA) along the molecular backbone of linear π-conjugated systems has proven widely useful in the development of NLO organic chromophores and materials. Here, we examine model polymethines to elucidate the reliability of these relationships. While BLA is solely a measure of molecular geometric structure, BOA includes information pertaining to the electronic structure. As a result, BLA is found to be a good predictor of NLO properties only when optimized geometries are considered, whereas BOA is more broadly applicable. Proper understanding of the distinction between BLA and BOA is critical when designing computational studies of NLO properties, especially for molecules in complex environments or in nonequilibrium geometries. © 2015 American Chemical Society.

  10. Distinguishing the Effects of Bond-Length Alternation versus Bond-Order Alternation on the Nonlinear Optical Properties of π-Conjugated Chromophores

    KAUST Repository

    Gieseking, Rebecca L.

    2015-06-18

    Understanding the relationships between the molecular nonlinear optical (NLO) properties and the bond-length alternation (BLA) or π-bond-order alternation (BOA) along the molecular backbone of linear π-conjugated systems has proven widely useful in the development of NLO organic chromophores and materials. Here, we examine model polymethines to elucidate the reliability of these relationships. While BLA is solely a measure of molecular geometric structure, BOA includes information pertaining to the electronic structure. As a result, BLA is found to be a good predictor of NLO properties only when optimized geometries are considered, whereas BOA is more broadly applicable. Proper understanding of the distinction between BLA and BOA is critical when designing computational studies of NLO properties, especially for molecules in complex environments or in nonequilibrium geometries. © 2015 American Chemical Society.

  11. Medical Applications of the PHITS Code (3): User Assistance Program for Medical Physics Computation.

    Science.gov (United States)

    Furuta, Takuya; Hashimoto, Shintaro; Sato, Tatsuhiko

    2016-01-01

    DICOM2PHITS and PSFC4PHITS are user assistance programs for medical physics PHITS applications. DICOM2PHITS is a program to construct the voxel PHITS simulation geometry from patient CT DICOM image data by using a conversion table from CT number to material composition. PSFC4PHITS is a program to convert the IAEA phase-space file data to PHITS format to be used as a simulation source of PHITS. Both of the programs are useful for users who want to apply PHITS simulation to verification of the treatment planning of radiation therapy. We are now developing a program to convert dose distribution obtained by PHITS to DICOM RT-dose format. We also want to develop a program which is able to implement treatment information included in other DICOM files (RT-plan and RT-structure) as a future plan.

  12. MO-A-9A-01: Innovation in Medical Physics Practice: 3D Printing Applications

    International Nuclear Information System (INIS)

    Ehler, E; Perks, J; Rasmussen, K; Bakic, P

    2014-01-01

    3D printing, also called additive manufacturing, has great potential to advance the field of medicine. Many medical uses have been exhibited from facial reconstruction to the repair of pulmonary obstructions. The strength of 3D printing is to quickly convert a 3D computer model into a physical object. Medical use of 3D models is already ubiquitous with technologies such as computed tomography and magnetic resonance imaging. Thus tailoring 3D printing technology to medical functions has the potential to impact patient care. This session will discuss applications to the field of Medical Physics. Topics discussed will include introduction to 3D printing methods as well as examples of real-world uses of 3D printing spanning clinical and research practice in diagnostic imaging and radiation therapy. The session will also compare 3D printing to other manufacturing processes and discuss a variety of uses of 3D printing technology outside the field of Medical Physics. Learning Objectives: Understand the technologies available for 3D Printing Understand methods to generate 3D models Identify the benefits and drawbacks to rapid prototyping / 3D Printing Understand the potential issues related to clinical use of 3D Printing

  13. MO-A-9A-01: Innovation in Medical Physics Practice: 3D Printing Applications

    Energy Technology Data Exchange (ETDEWEB)

    Ehler, E [University of Minnesota, Minneapolis, MN (United States); Perks, J [UC Davis Medical Center, Sacramento, CA (United States); Rasmussen, K [East Carolina University, Greenville, NC (United States); Bakic, P [University of Pennsylvania, Philadelphia, PA (United States)

    2014-06-15

    3D printing, also called additive manufacturing, has great potential to advance the field of medicine. Many medical uses have been exhibited from facial reconstruction to the repair of pulmonary obstructions. The strength of 3D printing is to quickly convert a 3D computer model into a physical object. Medical use of 3D models is already ubiquitous with technologies such as computed tomography and magnetic resonance imaging. Thus tailoring 3D printing technology to medical functions has the potential to impact patient care. This session will discuss applications to the field of Medical Physics. Topics discussed will include introduction to 3D printing methods as well as examples of real-world uses of 3D printing spanning clinical and research practice in diagnostic imaging and radiation therapy. The session will also compare 3D printing to other manufacturing processes and discuss a variety of uses of 3D printing technology outside the field of Medical Physics. Learning Objectives: Understand the technologies available for 3D Printing Understand methods to generate 3D models Identify the benefits and drawbacks to rapid prototyping / 3D Printing Understand the potential issues related to clinical use of 3D Printing.

  14. The origins of scientific cinematography and early medical applications.

    Science.gov (United States)

    Barboi, Alexandru C; Goetz, Christopher G; Musetoiu, Radu

    2004-06-08

    To examine the neurologic cinematographic contributions of Gheorghe Marinescu. Near the end of the 19th century, cinematography developed and was immediately recognized as a new technique applicable to medical documentation. After studying with several prominent European neurologists and deeply influenced by Jean-Martin Charcot, Marinescu returned to Bucharest in 1897 and applied moving picture techniques to the study of neurologic patients. The Romanian State Archives were researched for original Marinescu films, and related publications were translated from Romanian and French. Between 1899 and 1902, Marinescu perfected the use of cinematography as a research method in neurosciences and published five articles based on cinematographic documents. He focused his studies particularly on organic gait disorders, locomotor ataxia, and hysteria. He adapted Charcot's method of lining up several patients with the same disorder and showing them together to permit appreciation of archetypes and formes frustes. He decomposed the moving pictures into sequential tracings for publication. He documented treatment results with cases filmed before and after therapy. Processed and digitized excerpts of these films accompany this manuscript. Marinescu's cinematographic studies led to several original contributions in clinical neurology. Remaining film archives include examples of many neurologic diseases, his examination techniques, and the working medical environment of the young founder of the Romanian school of neurology.

  15. THz waves: biological effects, industrial and medical; Les ondes THz: effets biologiques, applications industrielles et medicales

    Energy Technology Data Exchange (ETDEWEB)

    Coutaz, J.L.; Garet, F. [Universite de Savoie au Bourget du Lac, IMEP-LAHC, UMR CNRS 5130, 73 (France); Le Drean, Y.; Zhadobov, M. [Institut d' Electronique et des Telecommunications de Rennes, 35 (France); Veyret, B. [I.M.S., 33 - Pessac (France); Mounaix, P. [Laboratoire Ondes et Matiere d' Aquitaine, Universite de Bordeaux, 1 UMR 5798, 33 - Talence (France); Caumes, J.P. [ALPhANOV, 33 - Bordeaux (France); Gallot, G. [Ecole Polytechnique, Laboratoire d' Optique et Biosciences, CNRS UMR 7645, INSERM U696, 91 - Palaiseau (France); Gian Piero, Gallerano [ENEA, Frascati (Italy); Mouret, G. [Universite du Littoral Cote d' Opale - ULCO, 59 - Dunkerque (France); Guilpin, J.C. [Direction Generale de l' Aviation Civile, 94 - Bonneuil sur Marne (France)

    2011-07-01

    Following the debates about body scanners installed in airports for passengers security control, the non-ionizing radiations (NIR) section of the French radiation protection society (SFR) has organized a conference day to take stock of the present day knowledge about the physical aspects and the biological effects of this frequency range as well as about their medical, and industrial applications (both civil and military). This document gathers the slides of the available presentations: 1 - introduction and general considerations about THz waves, the THz physical phenomenon among NIR (J.L. Coutaz); 2 - interaction of millimeter waves with living material: from dosimetry to biological impacts (Y. Le Drean and M. Zhadobov); 3 - Tera-Hertz: standards and recommendations (B. Veyret); 4 - THz spectro-imaging technique: status and perspectives (P. Mounaix); 5 - THz technology: seeing the invisible? (J.P. Caumes); 6 - Tera-Hertz: biological and medical applications (G. Gallot); 7 - Biological applications of THz radiation: a review of events and a glance to the future (G.P. Gallerano); 8 - Industrial and military applications - liquids and solids detection in the THz domain (F. Garet); 9 - THz radiation and its civil and military applications - gas detection and quantifying (G. Mouret); 10 - Body scanners and civil aviation security (J.C. Guilpin, presentation not available). (J.S.)

  16. Summary Report of Consultants' Meeting on Auger Electron Emission Data Needs for Medical Applications

    International Nuclear Information System (INIS)

    Noy, Roberto Capote; Chung, Hyun Kyung; Bartschat, Klaus; Dong, Chenzhong; Jonsson, Per; Kibedi, Tibor; Kondev, Filip G.; Nikjoo, Hooshang; Palffy, Adriana

    2013-11-01

    A summary is given of a Consultants' Meeting on 'Auger Electron Emission Data Needs for Medical Applications'. Participants assessed and reviewed detailed atomic and nuclear data needs for a number of Auger emitters deemed as potentially suitable for applications in nuclear medicine and radiotherapy. Technical discussions are described in this report, along with recommendations for future work, along with recommendations for future work. Presentations by the consultants at the meeting are available at http://www-nds.iaea.org/index-meeting-crp/CM-Auger-2013/. (author)

  17. ANALYSIS OF ELASTIC DEFORMATION OF BRAIDED TUBULAR STRUCTURES FOR MEDICAL APPLICATIONS

    Directory of Open Access Journals (Sweden)

    Mehmet Emin YÜKSEKKAYA

    2001-02-01

    Full Text Available In this study, self-expanding stents were fabricated and analyzed. These stents are in the form of 3-D tubular braided structures made of polymeric materials. This type of structures is used in medicine to open clogged artheries and veins by exerting radial force. The amount of radial force exerted into the membrane should not give any damage to the veins. Therefore, the geometry of the three dimensional tubular braided fabric is analyzed to give an optimum radial force for medical applications.

  18. New trends in medical and service robots theory and integrated applications

    CERN Document Server

    Bleuler, Hannes; Rodic, Aleksandar; Vaida, Calin; Pisla, Adrian; First International Workshop on Medical and Service Robots

    2014-01-01

    This book contains mainly the selected papers of the First International Workshop on Medical and Service Robots, held in Cluj-Napoca, Romania, in 2012. The high quality of the scientific contributions is the result of a rigorous selection and improvement based on the participants’ exchange of opinions and extensive peer-review. This process has led to the publishing of the present collection of 16 independent valuable contributions and points of view and not as standard symposium or conference proceedings.  The addressed issues are: Computational Kinematics, Mechanism Design, Linkages and Manipulators, Mechanisms for Biomechanics, Mechanics of Robots, Control Issues for Mechanical Systems, Novel Designs, Teaching Methods, all of these being concentrated around robotic systems for medical and service applications.  The results are of interest to researchers and professional practitioners as well as to Ph.D. students in the field of mechanical and electrical engineering.  This volume marks the start of a s...

  19. New non-cognitive procedures for medical applicant selection: a qualitative analysis in one school.

    Science.gov (United States)

    Katz, Sara; Vinker, Shlomo

    2014-11-07

    Recent data have called into question the reliability and predictive validity of standard admission procedures to medical schools. Eliciting non-cognitive attributes of medical school applicants using qualitative tools and methods has thus become a major challenge. 299 applicants aged 18-25 formed the research group. A set of six research tools was developed in addition to the two existing ones. These included: a portfolio task, an intuitive task, a cognitive task, a personal task, an open self-efficacy questionnaire and field-notes. The criteria-based methodology design used constant comparative analysis and grounded theory techniques to produce a personal attributes profile per participant, scored on a 5-point scale holistic rubric. Qualitative validity of data gathering was checked by comparing the profiles elicited from the existing interview against the profiles elicited from the other tools, and by comparing two profiles of each of the applicants who handed in two portfolio tasks. Qualitative validity of data analysis was checked by comparing researcher results with those of an external rater (n =10). Differences between aggregated profile groups were checked by the Npar Wilcoxon Signed Ranks Test and by Spearman Rank Order Correlation Test. All subjects gave written informed consent to their participation. Privacy was protected by using code numbers. A concept map of 12 personal attributes emerged, the core constructs of which were motivation, sociability and cognition. A personal profile was elicited. Inter-rater agreement was 83.3%. Differences between groups by aggregated profiles were found significant (p < .05, p < .01, p < .001).A random sample of sixth year students (n = 12) underwent the same admission procedure as the research group. Rank order was different; and arrogance was a new construct elicited in the sixth year group. This study suggests a broadening of the methodology for selecting medical school applicants. This methodology

  20. 22 CFR 41.108 - Medical examination.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Medical examination. 41.108 Section 41.108... AND NATIONALITY ACT, AS AMENDED Application for Nonimmigrant Visa § 41.108 Medical examination. (a) Requirements for medical examination. An applicant for a nonimmigrant visa shall be required to take a medical...