sensor module
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Virtuální realita představuje interaktivní uměle vytvořené prostředí izolované od reálného světa. Tato jedinečná technologie za využití imerzivity a gamifikace v posledním desetiletí vhodně doplňuje edukaci léčebných postupů a operačních technik. Náš tým se na základě pozitivních zkušeností s využitím virtuální reality v rehabilitaci rozhodl vyvinout vzdělávací model relativně nenáročné neurochirurgické operace, a to zavedení čidla intrakraniálního tlaku. Obsahem sdělení je vývoj modulu a první zkušenosti s jeho testováním ve výuce. Modul kombinuje realisticky navržené prostředí s virtuální asistencí a možností online kontroly vyučujícím. Za využití jednoduchého ovládání umožňuje bezpečný a libovolně opakovaný nácvik operace. Zdá se, že imerzivita a gamifi kace jsou klíčovým rozdílovým prvkem pro lepší zapamatování informací při nácviku, a tím zkvalitnění učebního procesu oproti jiným technikám. To nám potvrdili při testování modulu zdravotničtí pracovníci vývojového týmu a studenti lékařské fakulty a vyšší odborné zdravotnické školy. Předpokládáme, že aplikace tohoto modulu do nácviku operačních postupů by v budoucnu mohla efektivně doplnit stávající výukové metody a potenciálně urychlit vzdělávací křivku při nácviku daného výkonu.
Virtual reality represents an interactive, artificially created environment isolated from the real world. This unique technology, through immersion and gamification, has effectively complemented the education of therapeutic procedures and surgical techniques over the past decade. Based on positive experiences with the use of virtual reality in rehabilitation, our team decided to develop an educational model for a relatively straightforward neurosurgical procedure: the insertion of an intracranial pressure sensor. This report discusses the development of the module and the initial experiences with its testing in education. The module combines a realistically designed environment with virtual assistance and the possibility of online supervision by instructor. Its simple controls allow for safe and freely repeatedly practiced operations. Immersion and gamification appear to be key diff erentiators for better retention of information during training, thereby improving the educational process compared to other techniques. This has been confi rmed during module testing by healthcare professionals from the development team and students from the faculty of medicine and higher medical school. We anticipate that the application of this module in surgical training could effectively complement existing teaching methods and potentially accelerate the learning curve for the given procedure in the future.
AIMS: To explore the feasibility of subcutaneous continuous glucose monitoring (CGM) in perioperative settings and to evaluate the perioperative development of glycaemia in persons with diabetes mellitus or impaired glucose tolerance by means of CGM. METHODS: Monitoring by means of Guardian REAL-Time CGMS (Medtronic, Nortridge, USA) in 20 perioperative periods. Sensor was inserted on the day before surgery and continued for 3 days with some exceptions. RESULTS: Full implementation of the method was successful in the intensive care unit setting only. No electromagnetic interference and no side effects were found. The Wilcoxon signed-rank test revealed no significant difference between sensor and laboratory analyser values. Pearson's correlation coefficients of the values obtained by sensor and the Wellion Linus glucometer were 0.875 for the whole perioperative period, 0.866 for the intraoperative period and 0.903 for the first perioperative day. A decline in sensor accuracy on the 6(th) day was registered in one case. 16 monitored cases (80%) did not meet the criteria for safe plasma glucose range. Hypoglycaemia was found in 4 (20%) cases. There was an association between grade of the perioperative dysglycaemia and need for reoperation within the next 3 months. The most frequent perioperative glycaemic patterns are demonstrated. CONCLUSION: Subcutaneous CGM is safe offering detailed insight into glucose homeostasis in the dynamic perioperative period. Laboratory confirmation of sensor plasma glucose concentration by approved laboratory analyser is still necessary. The potentional benefits of maintaining patients within a safe glucose range should be comfirmed by future studies.
- MeSH
- biochemická analýza krve přístrojové vybavení MeSH
- krevní glukóza analýza MeSH
- lidé MeSH
- perioperační péče * MeSH
- pilotní projekty MeSH
- počítačové systémy MeSH
- protézy a implantáty * MeSH
- senioři MeSH
- studie proveditelnosti MeSH
- subkutánní tkáň MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- pozorovací studie MeSH
- práce podpořená grantem MeSH
AIMS: The management of congestion is one of the key treatment targets in heart failure. Assessing congestion is, however, difficult. The purpose of this study was to investigate the safety and dynamic response of a novel, passive, inferior vena cava (IVC) sensor in a chronic ovine model. METHODS AND RESULTS: A total of 20 sheep divided into three groups were studied in acute and chronic in vivo settings. Group I and Group II included 14 sheep in total with 12 sheep receiving the sensor and two sheep receiving a control device (IVC filter). Group III included an additional six animals for studying responses to volume challenges via infusion of blood and saline solutions. Deployment was 100% successful with all devices implanted; performing as expected with no device-related complications and signals were received at all observations. At similar volume states no significant differences in IVC area normalized to absolute area range were measured (55 ± 17% on day 0 and 62 ± 12% on day 120, p = 0.51). Chronically, the sensors were completely integrated with a thin, reendothelialized neointima with no loss of sensitivity to infused volume. Normalized IVC area changed significantly from 25 ± 17% to 43 ± 11% (p = 0.007) with 300 ml infused. In contrast, right atrial pressure required 1200 ml of infused volume prior to a statistically significant change from 3.1 ± 2.6 mmHg to 7.5 ± 2.0 mmHg (p = 0.02). CONCLUSION: In conclusion, IVC area can be measured remotely in real-time using a safe, accurate, wireless, and chronic implantable sensor promising to detect congestion with higher sensitivity than filling pressures.
- MeSH
- ovce MeSH
- srdeční selhání * terapie MeSH
- vena cava inferior * diagnostické zobrazování MeSH
- zvířata MeSH
- Check Tag
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
Transient receptor potential canonical 5 (TRPC5) is a polymodal, calcium-permeable, nonselective ion channel that is expressed in the brain and 75 % of human sensory neurons. Its pharmacological or genetic inhibition leads to the relief of neuropathic and inflammatory pain. The clinically approved drug duloxetine is superior to other serotonin and norepinephrine reuptake inhibitors at managing painful neuropathies, but it is not known why. Here we ask whether the TRPC5 receptor is modulated by duloxetine and may contribute to its analgesic effect. Electrophysiological measurements of heterologously expressed human TRPC5 in HEK293T cells were performed to evaluate the effect of duloxetine. The interaction site was identified by molecular docking and molecular dynamics simulations in combination with point mutagenesis. We found that duloxetine inhibits TRPC5 in a concentration-dependent manner with a high potency (IC50 = 0.54 ± 0.03 μM). Our data suggest that duloxetine binds into a voltage sensor-like domain. For the interaction, Glu418 exhibited particular importance due to putative hydrogen bond formation. Duloxetine effectively inhibits TRPC5 currents induced by cooling, voltage, direct agonists and by the stimulation of the PLC pathway. The finding that this TRPC5 inhibitor is widely used and well tolerated provides a scaffold for new pain treatment strategies.
- MeSH
- bolest * MeSH
- duloxetinum hydrochlorid farmakologie MeSH
- HEK293 buňky MeSH
- kationtové kanály TRPC * genetika metabolismus MeSH
- lidé MeSH
- simulace molekulového dockingu MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
Stormorken syndrome is a multiorgan hereditary disease caused by dysfunction of the endoplasmic reticulum (ER) Ca2+ sensor protein STIM1, which forms the Ca2+ release-activated Ca2+ (CRAC) channel together with the plasma membrane channel Orai1. ER Ca2+ store depletion activates STIM1 by releasing the intramolecular "clamp" formed between the coiled coil 1 (CC1) and CC3 domains of the protein, enabling the C terminus to extend and interact with Orai1. The most frequently occurring mutation in patients with Stormorken syndrome is R304W, which destabilizes and extends the STIM1 C terminus independently of ER Ca2+ store depletion, causing constitutive binding to Orai1 and CRAC channel activation. We found that in cis deletion of one amino acid residue, Glu296 (which we called E296del) reversed the pathological effects of R304W. Homozygous Stim1 E296del+R304W mice were viable and phenotypically indistinguishable from wild-type mice. NMR spectroscopy, molecular dynamics simulations, and cellular experiments revealed that although the R304W mutation prevented CC1 from interacting with CC3, the additional deletion of Glu296 opposed this effect by enabling CC1-CC3 binding and restoring the CC domain interactions within STIM1 that are critical for proper CRAC channel function. Our results provide insight into the activation mechanism of STIM1 by clarifying the molecular basis of mutation-elicited protein dysfunction and pathophysiology.
- MeSH
- aminokyseliny metabolismus MeSH
- endoplazmatické retikulum metabolismus MeSH
- kanály aktivované uvolněním vápníku * genetika MeSH
- membránové proteiny * metabolismus MeSH
- mutace MeSH
- myši MeSH
- protein ORAI1 metabolismus MeSH
- protein STIM1 genetika MeSH
- vápník metabolismus MeSH
- vápníkové kanály metabolismus MeSH
- zvířata MeSH
- Check Tag
- myši MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
PURPOSE: To develop an assumption-free methodology for aligning the geometry of on-board imagers with the geometry of medical linear accelerators applied in image-guided radiotherapy (IGRT). MATERIAL: Alignment of the on-board imaging (OBI) system with respect to the accelerator system is achieved using a multi-modular phantom described elsewhere (Tabor et al., 2017), enabling the geometry of the linear accelerator to be specified without any pre-assumptions. METHODS: The placement of two isocentres (of the on-board imager and of the therapeutic system) and of three frames of reference (those of the on-board imager, of the therapeutic system, and of the treatment table) is formulated as an optimization problem. It is solved by analysing the images of fiducial points positioned in 3D space in phantom modules attached to the treatment table and to the collimator of the accelerator. Fiducials are projected onto an imaging plane of unknown characteristics from a virtual source of unknown coordinates. CONCLUSIONS: An analytical framework exploiting projection images of the proposed multi-modular phantom has been developed, enabling precise alignment of the reference frame related to the on-board imager with the reference frame related to the therapeutic system. Within the proposed framework, the necessary corrections of treatment table positioning prior to patient irradiation, are delivered in the treatment table coordinates.
The most important dosimetry quantity that is determined at radiotherapy centers is the absorbed dose to water for external beams. Fixed tolerances for absorbed doses measured under reference conditions with an ionization chamber for high-energy photon and electron beams are usually 2 and 3%, respectively, regardless of uncertainties of the input variables and other conditions during evaluation. In reality, this agreement should be evaluated considering the uncertainties of the input variables because they affect the size of the random deviations of the measurements from their true values. The aim of this work was to develop a new approach to evaluate the agreement between measured and reported values based on statistical interference rather than to use fixed tolerance levels. The proposed method considers different scenarios that can occur during the evaluation of agreement. Because the method is described in general, it can be used in all similar situations when partial uncertainties can be established.
- MeSH
- celková dávka radioterapie MeSH
- kalibrace MeSH
- lidé MeSH
- nádory radioterapie MeSH
- nejistota MeSH
- plánování radioterapie pomocí počítače metody normy MeSH
- radioterapie s modulovanou intenzitou metody normy MeSH
- statistické modely * MeSH
- vysokoenergetická radioterapie normy MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
In radiotherapy, radiochromic films can be used for verification of delivery of dose distributions calculated by treatment planning systems. The main objective of this work was to compare three different techniques for evaluation of dose distributions for prostate cancer treatment plans using radiochromic EBT3 films. These techniques are: red channel evaluation taking into account only a response of irradiated film (R), red channel evaluation taking into account a response of unirradiated and irradiated film (Rcor) and multichannel evaluation in FilmQA software (RGB). Also comparison between film and MatriXX measurement was performed. Comparison showed that gamma analysis passing rates strongly depend on evaluation technique and on a model of scanner for digitizing films. The highest gamma passing rates were obtained with red channel evaluation taking into account a response of unirradiated and irradiated film using Epson V750 scanner (Rcor) and multichannel evaluation in FilmQA using Epson 11000XL scanner.
- MeSH
- algoritmy MeSH
- celková dávka radioterapie MeSH
- fantomy radiodiagnostické * MeSH
- filmová dozimetrie přístrojové vybavení metody MeSH
- kalibrace MeSH
- lidé MeSH
- nádory prostaty radioterapie MeSH
- plánování radioterapie pomocí počítače metody MeSH
- radioterapie s modulovanou intenzitou metody MeSH
- záření gama MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- hodnotící studie MeSH
- srovnávací studie MeSH
Transient receptor potential ankyrin 1 channel (TRPA1) serves as a key sensor for reactive electrophilic compounds across all species. Its sensitivity to temperature, however, differs among species, a variability that has been attributed to an evolutionary divergence. Mouse TRPA1 was implicated in noxious cold detection but was later also identified as one of the prime noxious heat sensors. Moreover, human TRPA1, originally considered to be temperature-insensitive, turned out to act as an intrinsic bidirectional thermosensor that is capable of sensing both cold and heat. Using electrophysiology and modeling, we compare the properties of human and mouse TRPA1, and we demonstrate that both orthologues are activated by heat, and their kinetically distinct components of voltage-dependent gating are differentially modulated by heat and cold. Furthermore, we show that both orthologues can be strongly activated by cold after the concurrent application of voltage and heat. We propose an allosteric mechanism that could account for the variability in TRPA1 temperature responsiveness.
- MeSH
- biologické modely MeSH
- druhová specificita MeSH
- elektrofyziologie metody MeSH
- HEK293 buňky MeSH
- kationtový kanál TRPA1 metabolismus MeSH
- lidé MeSH
- myši MeSH
- napětím ovládané aniontové kanály metabolismus fyziologie MeSH
- nízká teplota MeSH
- sekvence aminokyselin MeSH
- vysoká teplota MeSH
- zvířata MeSH
- Check Tag
- lidé MeSH
- myši MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
This paper presents a newly-designed and realized Invasive Blood Pressure (IBP) device for the simulation on patient's monitors. This device shows improvements and presents extended features with respect to a first prototype presented by the authors and similar systems available in the state-of-the-art. A peculiarity of the presented device is that all implemented features can be customized from the developer and from the point of view of the end user. The realized device has been tested, and its performances in terms of accuracy and of the back-loop measurement of the output for the blood pressure regulation utilization have been described. In particular, an accuracy of ±1 mmHg at 25 °C, on a range from -30 to 300 mmHg, was evaluated under different test conditions. The designed device is an ideal tool for testing IBP modules, for zero setting, and for calibrations. The implemented extended features, like the generation of custom waveforms and the Universal Serial Bus (USB) connectivity, allow use of this device in a wide range of applications, from research to equipment maintenance in clinical environments to educational purposes. Moreover, the presented device represents an innovation, both in terms of technology and methodologies: It allows quick and efficient tests to verify the proper functioning of IBP module of patients' monitors. With this innovative device, tests can be performed directly in the field and faster procedures can be implemented by the clinical maintenance personnel. This device is an open source project and all materials, hardware, and software are fully available for interested developers or researchers.
- MeSH
- design vybavení MeSH
- kalibrace MeSH
- krevní tlak fyziologie MeSH
- lidé MeSH
- měření krevního tlaku přístrojové vybavení metody MeSH
- monitorování fyziologických funkcí přístrojové vybavení metody MeSH
- monitory krevního tlaku * MeSH
- software MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
