Cardiac resynchronization therapy (CRT) is an effective treatment for heart failure (HF) patients with an electrical substrate pathology causing ventricular dyssynchrony. However 40–50% of patients do not respond to treatment. Cardiac modeling of the electrophysiology, electromechanics, and hemodynamics of the heart has been used to study mechanisms behind HF pathology and CRT response. Recently, multi-scale dyssynchronous HF models have been used to study optimal device settings and optimal lead locations, investigate the underlying cardiac pathophysiology, as well as investigate emerging technologies proposed to treat cardiac dyssynchrony. However the breadth of patient and experimental data required to create and parameterize these models and the computational resources required currently limits the use of these models to small patient numbers. In the future, once these technical challenges are overcome, biophysically based models of the heart have the potential to become a clinical tool to aid in the diagnosis and treatment of HF.
A b s t r a c tWe describe an operating theater blood transaction system (OTBTS) Blood is sometimes needed in large amounts within a short time during surgery. Ideally, unlimited amounts of blood would be available in the operating theater (OT) for immediate transfusion. However, this often cannot be achieved because of the time required for the completion of the compatibility tests and for the transportation of the blood units from the blood bank to the OT. In 1996, Cheng et al 1 proposed the use of a computer-generated list of the serial numbers of all blood units available in the blood bank inventory for "self-service" blood ordering by nursing staff in the OT. This system is basically a manual system requiring tedious matching of numbers, and there are difficulties keeping track of the blood units. Based on this concept, we developed and tested a novel computer software system that can save workforce resources, speed the availability of blood for transfusion, and ensure safety in intraoperative blood transfusion. Materials and Methods The SystemThe operating theater blood transaction system (OTBTS) is a computer software system that incorporates electronic crossmatch and the concept of a self-service blood banking system in the OT. Appropriate numbers of group A, B, AB, and O donor units are stored separately in designated compartments of a temperature-monitored refrigerator on each OT floor, and specific blood units are no longer assigned to surgical patients with a valid negative antibody screen. The software is Windows-based (Microsoft, Redmond, WA) and is developed and networked through the
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