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It became necessary to integrate alternative teaching methods having excellent results in the nursing curriculum such as high-fidelity human patient simulation. High fidelity simulation improves nu...

Streptococcus suis is one of the important emerging zoonotic pathogens. Serotype 2 is most prevalent in patients worldwide. In the present study, we first isolated one S. suis serotype 7 strain GX69 from the blood culture of a patient with septicemia complicated with pneumonia in China. In order to deepen the understanding of S. suis serotype 7 population characteristics, we investigated the phylogenetic structure, genomic features, and virulence of S. suis serotype 7 population, including 35 strains and 79 genomes. Significant diversities were revealed in S. suis serotype 7 population, which were clustered into 22 sequence types (STs), five minimum core genome (MCG) groups, and six lineages. Lineages 1, 3a, and 6 were mainly constituted by genomes from Asia. Genomes of Lineages 2, 3b, and 5a were mainly from Northern America. Most of genomes from Europe (41/48) were clustered into Lineage 5b. In addition to strain GX69, 13 of 21 S. suis serotype 7 representative strains were classified as virulent strains using the C57BL/6 mouse model. Virulence-associated genes preferentially present in highly pathogenic S. suis serotype 2 strains were not suitable as virulence indicators for S. suis serotype 7 strains. Integrative mobilizable elements were widespread and may play a critical role in disseminating antibiotic resistance genes of S. suis serotype 7 strains. Our study confirmed S. suis serotype 7 is a non-negligible pathotype and deepened the understanding of the population structure of S. suis serotype 7, which provided valuable information for the improved surveillance of this serotype.

For improved cost-effectiveness and temperature-stability, a ready to use lateral flow assay (LFA) is developed in this work for detecting inflammation/infection biomarker C-reactive protein (CRP) in human patient samples on the basis of aptamers. In prescreening investigations, an aptamer with CRP affinity was immobilized on microarray chips in forward and sandwich formats to optimize assay conditions. We suggest these microarray techniques as a resource-sparing and fast-screening instrument for evaluation of various conditions. The capability of the aptamer to detect CRP was shown. Optimized assay conditions were consequently transferred to the LFA-platform. Here we could demonstrate for the first time an aptamer-based LFA for the detection of CRP in human patient samples in pathologically relevant concentrations. The cutoff for CRP detection is set at 10 mg/L, providing a distinctive "yes" (≥10 mg/L CRP) or "no" (

This article examines the use of high-fidelity mannequins in simulation scenarios as used in nursing undergraduate education. Notwithstanding a lack of robust support in the research literature regarding outcomes, these mannequins have been broadly taken up by educators. Employing a form of posthuman inquiry, I explore how the use of high-fidelity mannequins may affect the student nurses’ relation with real living bodies, and therefore the people they eventually look after. Ways to mitigate the potential side-effects of the medium are offered, including a reframing of the simulation scenario.

Regenerative medicine is commonly used in human and equine athletes. Potential therapies include culture expanded stem cells, stromal vascular fraction of adipose tissue, platelet-rich plasma, bone marrow concentrate, or autologous conditioned serum. The purpose of this manuscript is to disseminate findings from a workshop on the development of translational regenerative medicine in the equine field. Five themes emerged: stem cell characterization and tenogenic differentiation; interactions between mesenchymal stem cells, other cells and the environment; scaffolds and cell packaging; blood- and bone marrow-based regenerative medicines; clinical use of regenerative therapies. Evidence gained through the use of regenerative medicine applications in the horse should continue to translate to the human patient, bringing novel regenerative therapies to both humans and horses.

INTRODUCTION: According to the chain of survival, chest compressions (CCs) are crucial in every cardiac arrest patient. It is very challenging to provide high-quality resuscitation in a two-paramedic team. The task of an automatic chest compression device (ACCD) is to relieve the rescuer and improve the quality of CCs. Its influence on the quality of the whole resuscitation as well as the survival of patients is still subject to discussion worldwide. This study aimed to assess the quality of CCs during resuscitation in a two-paramedic team using ACCD. MATERIAL AND METHODS: This research was designed as a prospective, randomised, cross-over, high-fidelity simulation study. Fifty-two double paramedic teams took part in the research. The role of the participants was to conduct full advanced resuscitation in a human patient’s simulator. Each team provided resuscitation twice. Once with an ACCD and once using manual compressions. Chest compression quality parameters, as well as chest compression fraction (CCF), were measured. RESULTS : Statistically significant differences were found between manual and automated compressions in: mean depth (48 ± 4 mm vs. 56 ± 3 mm, p < 0.0001), mean rate (117 ± 9 mm vs. 103 ± 1 mm, p < 0.0001), percentage of CC with correct depth (46 ± 25 vs. 87 ± 13, p < 0.0001), rate (72 ± 22 vs. 96 ± 4, p < 0.0001), and recoil (55 ± 23 vs. 89 ± 13, p < 0.0001). CCF was also higher when the ACCD was used (74 ± 7% vs. 83 ± 2%, p < 0.0001). CONCLUSIONS: The use of an ACCD increases the quality of compressions by improving CCF, chest recoil, and the percentage of compressions performed with adherence to guidelines.

X‐ray regulations and room design methodology vary widely across Canada. The Canadian Organization of Medical Physicists (COMP) conducted a survey in 2016/2017 to provide a useful snapshot of existing variations in rules and methodologies for human patient medical imaging facilities. Some jurisdictions no longer have radiation safety regulatory requirements and COMP is concerned that lack of regulatory oversight might erode safe practices. Harmonized standards will facilitate oversight that will ensure continued attention is given to public safety and to control workplace exposure. COMP encourages all Canadian jurisdictions to adopt the dose limits and constraints outlined in Health Canada Safety Code 35 with the codicil that the design standards be updated to those outlined in NCRP 147 and BIR 2012.

Radiolabeled macrocyclic bisphosphonate ligands have recently been demonstrated to be highly efficacious in treatment of patients with painful bone metastases. Herein, we report a robust protocol for formulation of therapeutically relevant doses of 177Lu-labeled bisphosphonate amide of DOTA (BPAMD) using moderate specific activity 177Lu produced by direct (n,γ) route and its preliminary investigation in human patients. Doses (2.8 ± 0.2 GBq) were formulated with high radiochemical purity (98.3 ± 0.4 %) using a protocol optimized after extensive radiochemical studies. In vitro binding studies with mineralized osteosarcoma cells demonstrated specific binding of the radiotracer. Biodistribution studies in healthy Wistar rats demonstrated rapid skeletal accumulation with fast clearance from the non-target organs. In a patient administered with 555 MBq dose of 177Lu-BPAMD, intense radiotracer uptake was observed in the metastatic skeletal lesions with insignificant uptake in any other major non-targeted organs. Preliminary clinical investigations carried out after administration of 2.6 GBq of 177Lu-BPAMD revealed significant reduction in pain after 1 week without any adverse effects. The developed protocol for formulation of 177Lu-BPAMD doses using moderate specific activity carrier added 177Lu has been found to be effective and warrants wider investigations in patients with painful skeletal metastases.

The stimulus-evoked neural response is a widely explored phenomenon. Conscious awareness is associated in many cases with the corresponding selective stimulus-evoked response. For example, conscious awareness of a face stimulus is associated with or accompanied by stimulus-evoked activity in the fusiform face area (FFA). In addition to the stimulus-evoked response, spontaneous (i.e. task-unrelated) activity in the brain is also abundant. Notably, spontaneous activity is considered unconscious. For example, spontaneous activity in the FFA is not associated with conscious awareness of a face. The question is: what is the difference at the neural level between stimulus-evoked activity in a case that this activity is associated with conscious awareness of some content (e.g. activity in the FFA in response to fully visible face stimuli) and spontaneous activity in that same region of the brain? To answer this question, in the present study, we had a rare opportunity to record two face-selective multi-units in the vicinity of the FFA in a human patient. We compared multi-unit face-selective task-evoked activity with spontaneous prestimulus and a resting-state activity. We found that when activity was examined over relatively long temporal windows (e.g. 100–200 ms), face-selective stimulus-evoked firing in the recorded multi-units was much higher than the spontaneous activity. In contrast, when activity was examined over relatively short windows, we found many cases of high firing rates within the spontaneous activity that were comparable to stimulus-evoked activity. Our results thus indicate that the sustained activity is what might differentiate between stimulus-evoked activity that is associated with conscious awareness and spontaneous activity.

Summary Here, we describe the use of polarized patient enteroid-derived monolayers (EDMs) to assess the impact of e-cigarettes on the human gut barrier. These EDMs can be adapted to culture in a 96-well plate for high-throughput screening. We model the effect of e-cigarettes by combining pathogens, enteroids, and e-cigarette vapor-infused media and assess gut barrier integrity, bacterial internalization, and inflammatory response of the gut epithelium. This protocol can be used to assess the effects of e-cigarette components on gut functions. For complete details on the use and execution of this protocol, please refer to Sharma et al. (2021)., Graphical abstract, Highlights • Enteroid-derived monolayers (EDMs) are used for testing barrier integrity • Polarized human EDMs are adapted for high-throughput screening • E-cigarette vapor-infused media is added in the EDM model for testing • EDMs are co-cultured with pathogens to study the innate immune response, Here, we describe the use of polarized patient enteroid-derived monolayers (EDMs) to assess the impact of e-cigarettes on the human gut barrier. These EDMs can be adapted to culture in a 96-well plate for high-throughput screening. We model the effect of e-cigarettes by combining pathogens, enteroids, and e-cigarette vapor-infused media and assess gut barrier integrity, bacterial internalization, and inflammatory response of the gut epithelium. This protocol can be used to assess the effects of e-cigarette components on gut functions.

The emergence of new technologies has dramatically accelerated our understanding of the human brain function. Over the past decade, ultrasound has become a valuable tool in preclinical animal studies and clinical practice in many areas of the brain. This is because it can not only provide information about the structure and function of brain tissues but also constitute a potential treatment tool for brain disease. The recent FDA approval and success of ultrasound ablation techniques for essential tremors is an example of how ultrasound can revolutionize clinical practice. Similarly, recent brain ultrasound advances such as noninvasive blood–brain barrier (BBB) opening, ultrasound neuromodulation, and functional brain imaging have great potential to improve human patient outcomes in neurology and neurosurgery. Ultrasound is thus expected to play an increasingly important role in the diagnosis and treatment of brain disease in the upcoming years.

Dual detection of enzymatic activities enables discrimination of benign, malignant, and normal breast tissue in human patient samples.

Epithelial cancers of the upper intestinal tract in animals, in biopsied human tissue and in a human patient can be detected via a fluorescently labelled inhibitor of the DNA-repair enzyme poly(ADP-ribose) polymerase 1.

A recent addition to the treatment options in external beam therapy, so-called FLASH radiotherapy, shows remarkable healthy-tissue-sparing properties in a number of pre-clinical studies without impacting the overall treatment efficacy. Its potential in clinical applications is attracting a great deal of interest in the medical community. The use of ultra-high dose rates at extremely short irradiation times has been shown to significantly enhance the differential effects between normal and tumor tissue. This makes it possible to increase treatment doses without further harming the surrounding healthy tissue. While most studies to date have focused on the use of electron beams, X-ray and proton FLASH radiotherapy have also shown beneficial effects, although for these latter two the results still need to be independently confirmed. Furthermore, the mechanisms underlying the biological effects remain to be elucidated. Very recently, the FLASH effect has been demonstrated in the first human patient, with promising results, supporting further clinical studies. This review will present an overview of the investigations into FLASH radiotherapy to date.

Inhalation therapy is a hallmark of modern respiratory medicine. Over recent years, computational fluid-particle dynamics (CFPD) simulations of respiratory airflows and aerosol deposition in the lungs have rapidly developed into an increasingly mature research field in the biomedical engineering realm, owing, among others, to tremendous advances in computational capabilities and available resources. Despite such progress, the intrinsic anatomical and physiological complexity of the lungs prevents the straightforward implementation of ‘brute force’ simulation strategies applied across the entire pulmonary tract. Here, we discuss how knowledge gathered from recent in silico studies can be purposefully leveraged to design efficient hybrid multiscale lung models and explore quantitatively via computational fluid-particle dynamics inhalation therapy outcomes. In contrast to the efforts geared toward patient-specific applications, we argue instead that such in silico strategies hold tremendous promise for broad inter-subject variability studies that can help foster the development of clinically efficient inhalation therapies across large human patient populations. 11 130 136

Two leading causes of survivable combat deaths are hemorrhage and airway compromise. Although individual medical-training competency requirements are met using human-patient simulation (HPS), the evaluation of fidelity and HPS impact on training outcomes are not well documented. Research has documented physical fidelity concerns when comparing human anatomy to simulators, but has largely overlooked informational needs such as visual, auditory, and tactile cues for patient assessment. Training impact is often characterized by changes in confidence; however, the Dunning-Kruger effect suggests that overconfidence is pervasive. The purpose of this paper is to provide perspective on the research needs to ensure human-patient simulation meets the requirements for combat-medic training.

The formation and characterization of positively surface charged TiN surfaces were investigated for improving dental implant survival. Surface nitrogen atoms of a traditional TiN implant were converted to a positive charge by a quaternization reaction which greatly increased the antibacterial efficiency. Ti, TiN, and quaternized TiN samples were incubated with human patient subgingival bacteria for 4 hours at 37°C in an anaerobic environment with an approximate 40% reduction in counts on the quaternized surface over traditional Ti and TiN. The samples were challenged with Streptococcus Mutans and fluorescent imaging confirmed significant reduction in the quaternized TiN over the traditional Ti and TiN. Contact angle measurement and X-Ray Photoelectron Spectroscopy (XPS) were utilized to confirm the surface chemistry changes. The XPS results found the charged quaternized nitrogen peak at 399.75 eV that is unique to the quaternized sample.

While considerable progress has been made in studying genetic and cellular aspects of metastasis with in vitro cell culture and in vivo animal models, the driving mechanisms of each step of metastasis are still relatively unclear due to their complexity. Moreover, little progress has been made in understanding how cellular fitness in one step of the metastatic cascade correlates with ability to survive other subsequent steps. Engineered models incorporate tools such as tailored biomaterials and microfabrication to mimic human disease progression, which when coupled with advanced quantification methods permit comparisons to human patient samples and in vivo studies. Here, we review novel tools and techniques that have been recently developed to dissect key features of the metastatic cascade using primary patient samples and highly representative microenvironments for the purposes of advancing personalized medicine and precision oncology. Although improvements are needed to increase tractability and accessibility while faithfully simulating the in vivo microenvironment, these models are powerful experimental platforms for understanding cancer biology, furthering drug screening, and facilitating development of therapeutics.

Japanese encephalitis virus (JEV) is transmitted between swine, migratory birds, and Culex mosquitoes, and has circulated indigenously in Asia for almost a century. Despite being the country with the highest JEV diversity, surveillance targeting of Indonesia’s vectors is scarce. This study collected mosquitoes from several locations in Tabanan Regency, Bali Island, Indonesia. We captured and classified 3,032 adult Culex mosquitoes into seven species, with Culex vishnui subgroup mosquitoes making up approximately 90% of the total. Japanese encephalitis virus was identified by next-generation sequencing (NGS) analysis of a Cx. vishnui mosquito pool. Genetic and phylogenetic analysis revealed the JEV as genotype (G) IV. The nucleotide identity was 99% with other JEV GIV isolates obtained from swine sera in 2017 on Bali Island and from a human patient in Australia with a travel history to Bali in 2019. This finding indicated that JEV GIV persists in restricted areas and is circulating between swine-mosquito vectors.

Summary The advancement of serial cryoFIB/SEM offers an opportunity to study large volumes of near-native, fully hydrated frozen cells and tissues at voxel sizes of 10 nm and below. We explored this capability for pathologic characterization of vitrified human patient cells by developing and optimizing a serial cryoFIB/SEM volume imaging workflow. We demonstrate profound disruption of subcellular architecture in primary fibroblasts from a Leigh syndrome patient harboring a disease-causing mutation in USMG5 protein responsible for impaired mitochondrial energy production., Graphical Abstract, Highlights • Developed and optimized a serial cryoFIB/SEM volume imaging workflow • Visualized the 3D structure of an entire cell under native conditions • Revealed a disruption of cellular structures in primary LS patient fibroblasts • Demonstrated the potential for clinical phenotyping of pathogenic tissues, Serial cryoFIB/SEM offers new opportunities for structural analysis of cells and tissues under near-native conditions. Zhu et al. developed and optimized a serial cryoFIB/SEM volume imaging workflow for visualization of entire vitreous cells in 3D, and demonstrated its potential for clinical and pathological applications with primary Leigh syndrome patient cells.

Patient-derived xenografts (PDXs) are currently promoted as new translational models in precision oncology. PDXs are immunodeficient mice with human tumors that are used as surrogate models to represent specific types of cancer. By accounting for the genetic heterogeneity of cancer tumors, PDXs are hoped to provide more clinically relevant results in preclinical research. Further, in the function of so-called “mouse avatars”, PDXs are hoped to allow for patient-specific drug testing in real-time (in parallel to treatment of the corresponding cancer patient). This paper examines the circulation of knowledge and bodily material across the species boundary of human and personalized mouse model, historically as well as in contemporary practices. PDXs raise interesting questions about the relation between animal model and human patient, and about the capacity of hybrid or interspecies models to close existing translational gaps. We highlight that the translational potential of PDXs not only depends on representational matching of model and target, but also on temporal alignment between model development and practical uses. Aside from the importance of ensuring temporal stability of human tumors in a murine body, the mouse avatar concept rests on the possibility of aligning the temporal horizons of the clinic and the lab. We examine strategies to address temporal challenges, including cryopreservation and biobanking, as well as attempts to speed up translation through modification and use of faster developing organisms. We discuss how featured model virtues change with precision oncology, and contend that temporality is a model feature that deserves more philosophical attention.

Vibrio navarrensis is a rare human pathogen. Strains of Vibrio navarrensis biotype pommerensis were isolated from seawater of the Baltic Sea. Recently, a strain of this biotype was recovered from a human patient. The isolate contains two circular chromosomes and a large plasmid with a size of 180 kb.

Human patient simulation uses technology to add advancements to learning that traditional learning methods cannot. Many programs are fast-paced and do not provide students with many hands-on experiences before clinical experiences. The literature notes the benefits of human patient simulation in other healthcare programs, yet limited studies exist in occupational therapy. This study examined student perspectives on the use of human patient simulators in occupational therapy curriculum. 146 first year master of occupational therapy students completed an open-ended survey after an evaluation experience with a physiologically based human patient simulator. Responses were collected during four consecutive years. Transcripts were analyzed using qualitative content analysis. Four themes emerged and centered on the value of hands-on learning, team and family dynamics, the human experience, and relevance of clinically applicable skills. Findings indicate that students perceive this type of learning as beneficial before taking the next step towards fieldwork, and programs should consider offering a variety of simulated patient cases throughout the curriculum.

There is an important need to develop a transcatheter/trans-septal-like model which will allow deliverability of mitral valve devices at the right angulation and height above the mitral annulus similar to the human patient. A ministernotomy allowing for TEE probe to be introduced transpericardially was performed in seven animals. In three, a standard trans-septal approach was used to attempt to deliver a device to the level of the mitral plane with a human delivery system. In four cases, a Dacron tube was connected to the RPV and the device introduced to the LA. Under TEE equivalent imaging, the device was then successfully steered to the mitral plane in all cases, having failed in all trans-septal attempts. A combination of transpericardial echocardiographic imaging (TPE) and RPV approach to the LA facilitated successful human-like mitral valve device implantation.

The biological effects of radiation dose to organs at risk surrounding tumor target volumes are a major dose-limiting constraint in radiotherapy. This can mean that the tumor cannot be completely destroyed, and the efficacy of radiotherapy will be decreased. Thus, ways to reduce damage to healthy tissue has always been a topic of particular interest in radiotherapy research. Modern radiotherapy technologies such as helical tomotherapy (HT), intensity-modulated radiation therapy (IMRT), and proton radiotherapy can reduce radiation damage to healthy tissues. Recent outcomes of animal experiments show that FLASH radiotherapy (FLASH-RT) can reduce radiation-induced damage in healthy tissue without decreasing antitumor effectiveness. The very short radiotherapy time compared to that of conventional dose-rate radiotherapy is another advantage of FLASH-RT. The first human patient received FLASH-RT in Switzerland in 2018. FLASH-RT may become one of the main radiotherapy technologies in clinical applications in the future. We summarize the history of the development of FLASH-RT, its mechanisms, its influence on radiotherapy, and its future.

The collection contains proceedings of IX International scientific-practical іnternet conference "Food Аdditives. Healthy Man and Human Patient Diet", the topics of which contain a wide range of issues related to the development of technologies for special and functional products. The materials cover the areas and problems of using food supplements to ensure a healthy lifestyle, in medicine, sports, agriculture, ensuring their quality and safety.

Blood is a liquid that transports oxygen and supplements to cells and diverts carbon dioxide and other byproducts. Red blood cells principally carry oxygen and gather carbon dioxide using hemoglobin. Hereditary disease of the blood comprises hemoglobinopathies, which is a significant common health issue in Bangladesh. Sickle cell disorder alludes to the gathering of hereditary issues described by the presence of sickle hemoglobin, sickliness, schistocytes, intense and ongoing tissue injury and blockage of the bloodstream by anomalously formed red cells. Schistocytes are additionally a critical marker of a perilous condition affecting a human patient. In the cutting-edge setting, only the most modern computerized cell counters flag their administrators if a schistocyte is identified and few of them can provide a schistocyte tally. By analyzing these issues, in this paper, we propose to create an automatic system that will allow blood cells to be separated very quickly, and with this, blood diseases can be also identified.

BACKGROUND Radiotherapy, combined with surgical resection and chemotherapy, remains a first-line treatment for infiltrative gliomas. However, these tumors are not surgically curable, and often recur, even within the prior radiation field, and may demonstrate a more aggressive phenotype. Importantly, high grade gliomas display diverse molecular phenotypes, and whether this genetic variability leads to divergent behaviour in the radiated tumor microenvironment is unknown. Herein, we characterize the effects of the irradiated brain microenvinroment on nine additional unique GBM cell lines to better understand the nuances of how tumor molecular phenotypes influence cellular dynamics. METHODS Female athymic nude mice were randomly divided into cranial radiation (15 Gy) and non-radiated groups. Mice then underwent intracranial implantation with one of the selected patient-derived xenograft (PDX) GBM cell lines (GBM 6, 10, 12, 39, 46, 76, 123, 164, 196; total n=8-15, per group, per line). Kaplan-Meyer (K-M) and log-rank tests were performed to compare the survival between irradiated and non-irradiated groups. RESULT Of nine previously untested human GBM lines, we found that five demonstrated shorter survival in the pre-radiated brain (GBM 6, 46, 76, 164, 196). However, two lines yielded prolonged survival in the pre-radiated brain (GBM 10, 12); GBM 39, 123 whose rate of growth was not impacted by the radiated brain. CONCLUSION These results highlight the likely critical impact of the irradiated microenvironment on tumor behaviour, yet illustrate that different tumors may exhibit opposing responses. Although further evaluation will be needed to understand mechanisms of divergent behavior, our data suggest the increased rate of growth in the radiated microenvironment may not apply to the fastest-growing tumor lines, which could instead demonstrate a paradoxical response.

In this paper, we present an exploratory work towards the recognition of activities and performing real-time objective assessment in human patient simulation (HPS). Although HPS has been pervasively used in medical and nursing programs in developed countries, there is a huge need in providing consistent and objective assessment on student performance during HPS. Current methods all depend on instructor subjective observation, which not only could lead to inconsistency in evaluation across different students and different instructors, but also are very time and resource intensive. Recognizing complex human activities in the context of HPS is very challenging because it involves the recognition of human actions, gestures, as well as human-object and human-mannequin interactions. Hence, we study the feasibility of developing such a system for a particular simulation where a student is required to first identify the patient and then place a neck brace on the patient’s neck. The system we that we have developed identifies the actions and activities in the simulation and provides qualitative assessment on the student performance using computer vision, OpenPose, and TensorFlow. The system also consists of a debriefing mobile app that the student and instructor could use to view an automatically generated report with supporting key frames captured and annotated by our system.

For the past century, experimental data obtained from animal studies have been required by reviewers of scientific articles and grant applications to validate the physiological relevance of in vitro results. At the same time, pharmaceutical researchers and regulatory agencies recognize that results from preclinical animal models frequently fail to predict drug responses in humans. This Progress Report reviews recent advances in human organ‐on‐a‐chip (Organ Chip) microfluidic culture technology, both with single Organ Chips and fluidically coupled human “Body‐on‐Chips” platforms, which demonstrate their ability to recapitulate human physiology and disease states, as well as human patient responses to clinically relevant drug pharmacokinetic exposures, with higher fidelity than other in vitro models or animal studies. These findings raise the question of whether continuing to require results of animal testing for publication or grant funding still makes scientific or ethical sense, and if more physiologically relevant human Organ Chip models might better serve this purpose. This issue is addressed in this article in context of the history of the field, and advantages and disadvantages of Organ Chip approaches versus animal models are discussed that should be considered by the wider research community., This article reviews recent advances with human Organ Chip microfluidic culture technology showing that it can mimic human physiology, disease states, and responses to drugs with higher accuracy than some animal models. This raises the question whether it might be time for reviewers of publications and grants to consider requesting human Organ Chip studies in lieu of animal testing.

Simple Summary To develop new medical treatments, animal studies are used. However, there are questions and concerns about the usefulness of preclinical animal research. These so-called translational success rates vary between 0 and 100% and no clear relationship has been established with possible predictive factors such as animal species or field of research. This paper presents the main results of a conference that was organised in November 2019 as part of a research project that focuses on ways to improve predictability of translation from preclinical research to clinical studies. Based on the conference results and the findings from the research project, we define four points of attention that are crucial in the search for improved translational success rates: (a) optimising the methods and design of studies; (b) incorporation of the complexity of the human patient in research; (c) start with the patient rather than existing animal models as the gold standard; and (d) more and better collaboration within the chain from funding to pharmacy. We conclude that this requires improved organization and use of procedures, as well as a change of attitude and culture in research. Abstract Preclinical animal studies are performed to analyse the safety and efficacy of new treatments, with the aim to protect humans. However, there are questions and concerns about the quality and usefulness of preclinical animal research. Translational success rates vary between 0 and 100%, and no clear relationship has been found with possible predictive factors such as animal species or field of research. Therefore, it is not yet possible to indicate what factors predict successful translation. Translational strategies were therefore discussed at an international conference held in the Netherlands in November 2019, aiming to develop practical guidelines for more robust animal-to-human translation. The conference was organised during the course of a research project funded by the Dutch Research Council (313-99-310), addressing possible solutions for the low translational values that had been published for a multitude of animal studies in human health care. This article provides an overview of the project and the conference discussions. Based on the conference results and the findings from the research project, we define four points of attention that are crucial in the search for improved translational success rates: (a) optimising the methods and design of studies; (b) incorporation of the complexity of the human patient in research; (c) start with the patient rather than existing animal models as the gold standard; and (d) more and better collaboration within the chain from funding to pharmacy. We conclude that this requires improved organization and use of procedures, as well as a change of attitude and culture in research, including a consideration of the translational value of animal-free innovations and human-relevant science.

The advancement of serial cryo-FIB/SEM offers a new opportunity to study large volumes of near-native, fully hydrated frozen cells and tissues at voxel sizes of 10 nm and below. We explored this capability for pathologic characterization of vitrified human patient cells. We demonstrate profound disruption of subcellular architecture in primary fibroblasts from a Leigh syndrome patient harboring a disease-causing mutation in USMG5 protein responsible for impaired mitochondrial energy production.

To diagnose peripheral lung tumors, bronchoscopy is recommended for tissue sampling. Because most peripheral target regions of interest reside outside the airways, during bronchoscopy radial probe endobronchial ultrasound (RP-EBUS) is often used to provide extraluminal information and assist in locating biopsy sites. RP-EBUSguided transbronchial needle aspiration (TBNA) has demonstrated its potential over conventional TBNA to improve the diagnostic yield of peripheral pulmonary nodule biopsy. Meanwhile, image-guided bronchoscopy systems have been introduced to enable better planning and navigation. Currently, the physician has to deal with two disconnected imaging domains during live bronchoscopy; i.e., an image-guided system and RP-EBUS. The state-of-the-art image-guided bronchoscopy systems provide no guidance for RP-EBUS and biopsy targeting during live bronchoscopy, which is needed for accurate diagnosis of peripheral pulmonary nodules. To fill this gap, we expand the concept of virtual bronchoscopy (VB) in image-guided bronchoscopy systems and build a virtual RP-EBUS model to simulate the RP-EBUS probe in the computed-tomography (CT)-based virtual chest space. Results with human patient data illustrate the synchronized visualization of the virtual RP-EBUS model with the 3D chest model.

Epithelial tissues mechanically deform the surrounding extracellular matrix during embryonic development, wound repair, and tumor invasion. Ex vivo measurements of such multicellular tractions within three-dimensional (3D) biomaterials could elucidate collective dissemination during disease progression, and enable preclinical testing of targeted anti-migration therapies. However, past 3D traction measurements have been low throughput due to the challenges of imaging and analyzing information-rich 3D material deformations. Here, we demonstrate a method to profile multicellular clusters in a 96-well plate format based on spatially heterogeneous contractile, protrusive, and circumferential tractions. As a case study, we profile multicellular clusters across varying states of the epithelial-mesenchymal transition, revealing a successive loss of protrusive and circumferential tractions, as well as the formation of localized contractile tractions with elongated cluster morphologies. These cluster phenotypes were biochemically perturbed using drugs, biasing towards traction signatures of different epithelial or mesenchymal states. This higher-throughput analysis is promising to systematically interrogate and perturb aberrant mechanobiology, which could be utilized with human patient samples to guide personalized therapies.

Objective The Advanced Burn Life Support (ABLS) program is a burn-education curriculum nearly 30 years in the making, focusing on the unique challenges of the first 24 h of care after burn injury. Our team applied high fidelity human patient simulation (HFHPS) to the established ABLS curriculum. Our hypothesis was that HFHPS would be a feasible, easily replicable, and valuable adjunct to the current curriculum that would enhance learner experience. Methods This prospective, evidenced-based practice project was conducted in a single simulation center employing the American Burn Association’s ABLS curriculum using HFHPS. Participants managed 7 separate simulated polytrauma and burn scenarios with resultant clinical complications. After training, participants completed written and practical examinations as well as satisfaction surveys. Results From 2012 to 2013, 71 students participated in this training. Simulation (ABLS-Sim) participants demonstrated a 2.5% increase in written post-test scores compared to traditional ABLS Provider Course (ABLS Live) (p = 0.0016). There was no difference in the practical examination when comparing ABLS-Sim versus ABLS Live. Subjectively, 60 (85%) participants completed surveys. The Educational Practice Questionnaire showed best practices rating of 4.5 ± 0.7; with importance of learning rated at 4.4 ± 0.8. The Simulation Design Scale rating for design was 4.6 ± 0.6 with an importance rating of 4.4 ± 0.8. Overall Satisfaction and Self-Confidence with Learning were 4.4 ± 0.7 and 4.5 ± 0.7, respectfully. Conclusions Integrating HFHPS with the current ABLS curriculum led to higher written exam scores, high levels of confidence, satisfaction, and active learning, and presented an evidenced-based model for education that is easily employable for other facilities nationwide.

Background Emergency general surgery (EGS) is characterized by high rates of morbidity and mortality. Though checklists and associated communication-based huddle strategies have improved outcomes, these tools have never been specifically examined in EGS. We hypothesized that use of an evidence-based communication tool aimed to trigger intraoperative discussion could improve communication in the EGS operating room (OR). Materials and methods We designed a set of discussion prompts based on modifiable factors identified from previously published studies aimed to encourage all team members to speak up and to centralize awareness of patient disposition and intraoperative transfusion practices. This tool was pilot-tested using OR human patient simulators and was then rolled out to EGS ORs at an academic medical center. The perceived effect of our tool's implementation was evaluated through mixed-methodologic presurvey and postsurvey analysis. Results Preimplementation and postimplementation survey-based data revealed that providers reported the EGS-focused discussion prompts as improving team communication in EGS. A trend toward shared awareness of intraoperative events was observed; however, nurses described cultural impedance of discussion initiation. Providers described a need for further reinforcement of the tool and its indications during implementation. Conclusions Use of a discussion-based communication tool is perceived as supporting team communication in the EGS OR and led to a trend toward improving a shared understanding of intraoperative events. Analyses suggest the need for enhanced reinforcement of use during implementation and improvement of team-based education regarding EGS. Furthermore work is needed to understand the full impact of this evidence-based tool on OR team dynamics and EGS patient outcomes.

Background and objectives: Educational technology is widely used in all parts of medical education. The use and application of common educational technologies and adoption of educational design patterns in medical sciences education can greatly help in medical simulations, training, and improving of clinical skills of nurses and medical students. The aim of this research was to study computer-assisted instruction, virtual patients, and human patient simulation in medical science education based on Gagne’s educational design pattern. Methods: The research methodology in this paper was a review-article of applied type, which helps the education designer in the field of medical education to choose the most suitable educational technologies in medical science education to achieve their desired goals by considering the advantages and disadvantages of computer-assisted instruction, virtual patients, and human patient simulation. Results: In this article, we first reviewed the educational technology and common technologies in medical education and its advantages and disadvantages as well as the most appropriate educational technology to achieve the needed goals. We then described two multimedia (Computer-Assisted Instruction and Virtual Patients) and educational models for virtual patients as well as two simulators (virtual patient and human patient simulation). Subsequently, we explored the educational design and its patterns (including Ganja, Watson, Merrill, Reigeluth, Asher, Camp, and Siemens) and selected the best pattern (Gagne’s pattern) according to the learning theories and research background. Finally, the three approaches mentioned in this article (computer-assisted instruction, virtual patients, human patient simulation) were designed based on the Gagne’s model. Conclusion: Based on the results, one can conclude that the computer-assisted instruction, virtual patients, and human patient simulation based on the Gagne’s educational design model can help medical education instructors in training communication skills, clinical skills, and skills of obtaining medical history from the patient as well as problem-solving skills, knowledge acquisition, and critical thinking. They can also help the educational designer in the field of medical education to select the most suitable educational technologies in medical science education due to the best educational model of virtual patients and the Meyer educational media principles and simulation-based learning-educational theories tailored to the goals and content of medical education courses. Therapies for autoimmune disorders such as SLE.