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This mixed simulation teaching tool uses augmented reality to provide training in blind and guided medical procedures. In the United States, over 250,000 deaths per year are due to medical error, making it the third leading cause of death. Many of these instances owed to substandard care and would be preventable if healthcare professionals received proper training. Many medical procedures require placing an instrument like a needle inside a target while avoiding accidental contact or puncture of surrounding organs or tissues. For procedures such as these, verbal and written instruction, while necessary and worthwhile, cannot take the place of hands-on training. Researchers at the University of Florida have developed a mixed simulation system that allows medical training instructors to visualize and consistently score trainee performance. The simulation integrates sensors and augmented reality principles with physical and virtual medical image models, enabling the students to rehearse important medical procedures and to self-debrief without endangering human lives.
Mixed simulators with anatomically correct physical and virtual components that combine real-time 3D visualization with tracked instruments, recording and playback, and automated and consistent scoring algorithms to facilitate training of clinicians in procedural skills
This mixed simulation technology collocates anatomically authentic virtual and physical 3D objects that represent the part of the human body that is of interest. The simulation has already successfully applied to three procedures: central venous access (upper torso and neck), regional anesthesia (spine) and ventriculostomy (brain). In all three applications, a sensor with six degrees of freedom that is smaller than a grain of rice secures inside the needle bore near the needle tip such that, as the trainee directly manipulates and steers the needle, the needle tip position is traceable respective to both the physical and virtual components representing the human body. Real-time 3D visualization allows trainees and instructors to observe and critique technique and strategy. Because of the needle tip tracking, metrics heretofore unavailable facilitate implementation of automated and consistent scoring algorithms. These scoring algorithms open the possibility for self-debriefing when experts are not available to provide feedback. CT and MRI scans of individual humans along with 3D files of discrete objects that represent different organs and tissues facilitate the physical and virtual imaging. 3D files fed into a 3D printer (fast prototyping machine) create the physical parts of the mixed simulation. The system integrates readily available commercial off-the-shelf components into turnkey (set up time of about seven minutes) simulation systems that are compact and lightweight (meeting airline checked luggage requirements).
This Transcatheter Aortic Valve Replacement (TAVR) extraction device enables the more efficient removal of a replaced cardiac valve. Valvular heart disease, and subsequent replacement, occurs when one or more of the four heart valves (aortic, mitral, tricuspid, or pulmonary) is damaged and not functioning properly. Many deaths attributed to valvular heart disease are due to diseases of the aortic valve. Significant valve disease is treated with mechanical or bioprosthetic valve replacement operations, in which a valve is implanted to replicate the function of the native valve. This is done via a surgical (SAVR) or transcatheter (TAVR) aortic valve replacement.
Transcatheter Aortic Valve Replacements (TAVR) became the standard intervention for high-risk patients with aortic stenosis. Traditionally, TAVRs are elected for older patients assessed as not able to reliably survive open heart surgery. TAVR usage is expanding rapidly to younger and lower-risk populations. As implant rates rise, the need for effective removal of failed TAVR valves-- after approximately 10 years-- is increasing, making explant procedures one of the fastest growing and most technically demanding areas in cardiothoracic surgery. Existing removal methods rely on manual cutting and grasping of scar tissue and the valve, creating excessive force on the valve annulus, increasing tissue damage, and prolonging operative times. Additionally, there is the ever-present risk of debris falling into the left ventricular cavity during dissection and becoming a risk to embolize if it is not all identified and removed. This highlights a major clinical need for a safer, faster, and more delicately controlled approach to remove failed TAVR valves while minimizing aortic annulus injury and stroke risk.
Researchers at the University of Florida have developed a Transcatheter Aortic Valve Replacement (TAVR) extraction and debris containment device that enables controlled, circumferential inward collapse of the implanted valve to streamline removal and preserve tissue integrity and capture dissection debris. This technology directly addresses limitations by enabling controlled, minimally traumatic extraction of failed TAVR implants.
Single-use surgical device designed to safely and efficiently collapse and enable easier removal of failed transcatheter aortic (TAVR) and other valves and capture dissection debris during open-heart procedures
The device features an outer housing and an inner shaft equipped with multiple circumferential hooks that transition between deployed and retracted positions via a ratchet-actuated handle. During use, the distal tip is inserted into the failed valve, and the hooks are deployed in an outward direction to engage the valve frame at multiple points. Ratcheting inward mechanical retraction of the hooks collapses the valve inward, enabling controlled extraction with minimal force on surrounding tissue. A debris catcher, consisting of a flexible tube, filament, and an expandable sack, is deployed distally to capture calcium and tissue fragments generated during valve compression and dissection. The entire mechanism is engineered for single-handed operation and is disposable, enabling the surgeon to efficiently remove the valve and associated debris in a streamlined, reproducible process.
This treatment for low testosterone uses a general anesthetic in low, sedative concentrations to improve long-term natural testosterone production in males. Male hypogonadism is a state of low circulating testosterone that causes many physical and mental symptoms. Certain genetic or congenital diseases, testicular injuries, and simply aging can lead to deficient levels of testosterone. Analysts expect the highly competitive global market for testosterone replacement therapy to be worth $1.4 billion in 2024. More than 80 percent of men abandon testosterone treatments after just one year. Available testosterone replacement therapies involve increasing testosterone levels exogenously through topical gels and patches, intravenous injections, or subcutaneous implants. Gels and patches require regular application and can harm women or children who might contact men wearing them. Likewise, injections and implants can be painful, invasive, and highly inconvenient.
Researchers at the University of Florida have developed an approach using a general anesthetic in low, sedative concentrations that increases endogenous testosterone production in males. The non-invasive, safe treatment may improve low testosterone conditions owing to disease or injury and relieve age-related testosterone deficiency.
Sevoflurane vapor that increases serum levels of testosterone
This low dosage of sevoflurane in vapor form increases systemic levels of testosterone. The treatment does not supplement exogenous testosterone, but rather augments the endogenous production of testosterone in a subject through inhalation of a compound containing sevoflurane, a safe and FDA-approved general anesthetic. Animal data confirms an increase in serum level of testosterone by approximately 70 percent for more than 3 months compared to controls and demonstrates no obvious effects on fertility and reproduction.
