Reduce Patient Discomfort Research Articles

Laser-assisted healing: transforming periodontal and prosthodontic treatments: A narrative review

Laser technology has emerged as a transformative tool in modern dentistry, offering precision, efficiency, and enhanced healing capabilities in periodontal and prosthodontic treatments. This abstract explores the significant impact of laser-assisted therapies on the management of periodontal diseases and the fabrication of dental prostheses. Laser therapy in periodontics involves various applications, including soft tissue management, decontamination of periodontal pockets, and promotion of tissue regeneration. Similarly, in prosthodontics, lasers are utilized for precise tissue sculpting, implant site preparation, and accelerated healing around dental implants. The integration of lasers into periodontal and prosthodontic practice has led to improved treatment outcomes, reduced patient discomfort, and enhanced esthetic results. This abstract highlights the transformative potential of laser-assisted healing in periodontal and prosthodontic treatments, emphasizing the need for further research and clinical integration to maximize its benefits for patients.

Recent Advances in Local Anesthesia: A Review of Literature.

Even if local anesthetic is still the mainstay of pain management in dentistry, research will keep striving for novel and effective pain management techniques. The majority of research efforts are focused on improving anesthetic medications, delivery systems, and related methods. There are more recent technologies available that can assist the dentist in providing better pain relief with fewer unpleasant injections and fewer negative adverse effects. The purpose of the current review of the literature is to compile evidence that will convince dentists to employ modern local anesthetics, as well as other methods and techniques to reduce patient discomfort while administering anesthesia.

The effect of a live music therapy intervention on critically ill paediatric patients in the intensive care unit: A quasi-experimental pretest–posttest study

BackgroundMusic therapy as a nonpharmacological means of managing patient pain, anxiety, and discomfort is a recognised technique, although it is not widely used in the paediatric intensive care unit (PICU). AimThe aim of this study was to assess the clinical effect of a live music therapy intervention on vital signs and levels of discomfort and pain for paediatric patients in the PICU. MethodsThis was a quasi-experimental pretest–posttest study. The music therapy intervention was carried out by two music therapists who were specifically trained, each possessing a master's degree in the field of hospital music therapy. Ten minutes before the start of the music therapy session, the investigators recorded the vital signs of the patients and assessed their levels of discomfort and pain. The procedure was repeated at the start of the intervention; at 2, 5, and 10 min during the intervention; and at 10 min following the conclusion of the intervention. ResultsTwo hundred fifty-nine patients were included; 55.2% were male, with a median age of 1 year (0–21). A total of 96 (37.1%) patients suffered a chronic illness. The main reason for PICU admission was respiratory illness, at 50.2% (n = 130). Significantly lower values were observed for heart rate (p = 0.002), breathing rate (p < 0.001), and degree of discomfort (p < 0.001) during the music therapy session. ConclusionsLive music therapy results in reduced heart rates, breathing rates, and paediatric patient discomfort levels. Although music therapy is not widely used in the PICU, our results suggest that using interventions such as that used in this study could help reduce patient discomfort.

Endoscopic ultrasound-guided intervention for inaccessible papilla in advanced malignant hilar biliary obstruction.

Advanced malignant hilar biliary obstruction (MHBO) with inaccessible papilla poses a significant challenge to endoscopists, as drainage of multiple liver segments may be warranted. Transpapillary drainage may not be feasible in patients with surgically altered anatomy, duodenal stenosis, prior duodenal self-expanding metal stent, and after initial transpapillary drainage, but require re-intervention for draining separated liver segments. Endoscopic ultrasound-guided biliary drainage (EUS-BD) and percutaneous trans-hepatic biliary drainage are the feasible options in this scenario. The major advantages of EUS-BD over percutaneous trans-hepatic biliary drainage include a reduction in patient discomfort and internal drainage away from the tumor, thus reducing the possibility of tissue or tumor ingrowth. With innovations, EUS-BD is helpful not only for bilateral communicating MHBO but also for non-communicating systems with bridging hilar stents or isolated right intra-hepatic duct drainage by hepatico-duodenostomy. EUS-guided multi-stent drainage with specially designed cannulas and guidewires has become a reality. A combined approach with endoscopic retrograde cholangiopancreatography for re-intervention, interventional radiology, and intraductal tumor ablative therapies has been reported. Stent migration and bile leakage can be minimized with proper stent selection and technique, and stent blocks can be managed with EUS-guided interventions in a majority of cases. Future comparative studies are required to establish the role of EUS-guided interventions in MHBO as rescue or primary therapy.

Pain Relief in Dental Local Anaesthesia with Vibrational Devices: Much Ado about Nothing? A Scoping Review

In recent years, vibrational devices have been introduced in order to reduce patient discomfort in some situations such as orofacial pain, orthodontic therapy, and injection of local anaesthetics. This article aims to review the clinical experience given by the use of these devices in local anaesthesia. The literature search was carried out on the main scientific databases for articles up to November 2022. Eligibility criteria were established, and pertinent articles selected. The results were classified by author, year, type of study, sample size and characteristics, purpose of use, type of vibrational device used, protocol used, and outcomes. Nine relevant articles were found. These are split mouth randomized clinical trials which evaluate the reduction in pain perception with different devices and different protocols of use in children, during procedures which require local analgesia by injection, compared with traditional local anaesthesia with premedication based on anaesthetic gels. Different objective and subjective scales of pain and discomfort perception were used. Although results are promising, some data, such as those relating to vibrational intensity and frequency, are not clear. Evaluations on samples varying by age and context of use are necessary to fully define the indications for this type of aid during oral rehabilitation procedures.

Assessment of a Calibration-Free Method of Cuffless Blood Pressure Measurement: A Pilot Study.

We design an adaptive algorithm to detect the feature of the pulse wave, making it possible for two sensors to measure the local PWV in the radial artery at a short distance. Unlike the cuffless BPM that needs to use a regression model for calibration. We encapsulate the piezoelectric sensor material in a cavity and design an analog front-end circuit. This study used color ultrasound imaging equipment to measure radial arterial parameters, including the diameter and wall thickness, to aid the estimation of blood pressure (BP) using the Moens-Korteweg (MK) equation of hemodynamics. We compared the blood pressure estimated by the MK equation with the reference BP measured using an aneroid sphygmomanometer in a test group of 32 people, resulting in a mean difference of systolic BP of -0.63 mmHg, and a standard deviation of ±5.14 mmHg, a mean difference of mean arterial pressure (MAP) of 0.97 mmHg, with a standard deviation of ±3.54 mmHg, and a mean difference of diastolic BP of -1.14 mmHg, with a standard deviation of ±4.08 mmHg. This study has verified its compliance with ISO 81060-2. A new type of wearable continuous calibration-free BPM can replace the situation that requires the use of traditional ambulatory BPM and reduce patient discomfort. In this study can provide long-term continuous blood pressure monitoring in the hospital.

Combining Local PWV and Quantified Arterial Changes for Calibration-Free Cuffless Blood Pressure Estimation: A Clinical Validation

This study proposes a novel calibration-free cuffless blood pressure monitor (BPM). Unlike the cuffless BPM that requires timing correction with the traditional BPM, the calibration-free cuffless BPM can directly estimate the arterial blood pressure (BP) based on the hemodynamics mathematical model. Our proposed device integrates a pair of piezoelectric ceramics as pressure sensors to sense the pressure wave in the radial artery. It calculates the local pulse wave velocity (PWV) with our waveform detection algorithm of our proposed one. A photoplethysmogram (PPG) probe is set between the pair of pressure wave sensors. This PPG probe is used to monitor the radial artery’s PPG intensity ratio (PIR). We design PPG signal processing algorithms to quantify the PIR. We recruited 129 participants for the BP monitoring experiment. Compared with the reference sphygmomanometer, the error mean ± standard deviations (STDs) systolic BP (SBP) was 2.1 ± 3.4, and the correlation r-value was 0.97. The diastolic BP (DBP) was 0.8 ± 4.2, the correlation r-value was 0.90, and p < 0.05 is taken as statistically significant. A new type of wearable continuous calibration-free BPM can replace the situation that requires the use of traditional ambulatory BPM and reduce patient discomfort. Our proposed BP measurement passed all ANSI/AAMI/ISO 81060-2:20181_5.2.4.1.2 data analysis criterion 1 and 2 standard requirements.

Optimization of Design and Performance of Medical Implants using FEA

In recent years, the optimization of medical implants to enhance their safety and functionality has emerged as a paramount concern in the biomedical field. This study elucidates a comprehensive approach to optimizing the design and performance of medical implants using Finite Element Analysis (FEA). The primary objective was to discern potential areas of stress concentration and deformation, consequently proposing modifications to existing designs. Various implant materials and geometries were explored, encompassing orthopaedic, dental, and cardiovascular applications. The research successfully employed a multi-phased FEA methodology that commenced with the development of an accurate model, followed by the application of realistic boundary conditions and subsequent simulation under physiological loads. Results consistently indicated that by leveraging FEA insights, it was possible to predict potential failure points and areas of undue stress, thereby guiding design modifications. Moreover, it was observed that the iterative design process, supplemented by FEA, led to implants that exhibited enhanced biocompatibility, reduced patient discomfort, and extended longevity. This paper underscores the potency of FEA as an indispensable tool for the evolution of medical implant designs, fostering a future where implant failures become a rarity rather than a risk.

An artificial intelligence system to predict the optimal timing for mechanical ventilation weaning for intensive care unit patients: A two-stage prediction approach.

For the intensivists, accurate assessment of the ideal timing for successful weaning from the mechanical ventilation (MV) in the intensive care unit (ICU) is very challenging. Using artificial intelligence (AI) approach to build two-stage predictive models, namely, the try-weaning stage and weaning MV stage to determine the optimal timing of weaning from MV for ICU intubated patients, and implement into practice for assisting clinical decision making. AI and machine learning (ML) technologies were used to establish the predictive models in the stages. Each stage comprised 11 prediction time points with 11 prediction models. Twenty-five features were used for the first-stage models while 20 features were used for the second-stage models. The optimal models for each time point were selected for further practical implementation in a digital dashboard style. Seven machine learning algorithms including Logistic Regression (LR), Random Forest (RF), Support Vector Machines (SVM), K Nearest Neighbor (KNN), lightGBM, XGBoost, and Multilayer Perception (MLP) were used. The electronic medical records of the intubated ICU patients of Chi Mei Medical Center (CMMC) from 2016 to 2019 were included for modeling. Models with the highest area under the receiver operating characteristic curve (AUC) were regarded as optimal models and used to develop the prediction system accordingly. A total of 5,873 cases were included in machine learning modeling for Stage 1 with the AUCs of optimal models ranging from 0.843 to 0.953. Further, 4,172 cases were included for Stage 2 with the AUCs of optimal models ranging from 0.889 to 0.944. A prediction system (dashboard) with the optimal models of the two stages was developed and deployed in the ICU setting. Respiratory care members expressed high recognition of the AI dashboard assisting ventilator weaning decisions. Also, the impact analysis of with- and without-AI assistance revealed that our AI models could shorten the patients' intubation time by 21 hours, besides gaining the benefit of substantial consistency between these two decision-making strategies. We noticed that the two-stage AI prediction models could effectively and precisely predict the optimal timing to wean intubated patients in the ICU from ventilator use. This could reduce patient discomfort, improve medical quality, and lower medical costs. This AI-assisted prediction system is beneficial for clinicians to cope with a high demand for ventilators during the COVID-19 pandemic.

Development and validation of a new ICD-10-based screening colonoscopy overuse measure in a large integrated healthcare system: a retrospective observational study

BackgroundLow-value use of screening colonoscopy is wasteful and potentially harmful to patients. Decreasing low-value colonoscopy prevents procedural complications, saves patient time and reduces patient discomfort, and can improve access by...

Utility of a fulcrum for positioning support during flexion-extension radiographs for assessment of lumbar instability in patients with degenerative lumbar spondylolisthesis.

The authors investigated a new standardized technique for evaluating lumbar stability in lumbar lateral flexion-extension (LFE) radiographs. For patients with lumbar spondylolisthesis, a three-part fulcrum with a support platform that included a semiarc leaning tool with armrests, a lifting platform for height adjustment, and a base for stability were used. Standard functional radiographs were used for comparison to determine whether adequate flexion-extension was acquired through use of the fulcrum method. A total of 67 consecutive patients diagnosed with L4-5 degenerative lumbar spondylolisthesis were enrolled in the study. The authors analyzed LFE radiographs taken with the patient supported by a fulcrum (LFEF) and without a fulcrum. Sagittal translation (ST), segmental angulation (SA), posterior opening (PO), change in lumbar lordosis (CLL), and lumbar instability (LI) were measured for comparison using functional radiographs. The average value of SA was 5.76° ± 3.72° in LFE and 9.96° ± 4.00° in LFEF radiographs, with a significant difference between them (p < 0.05). ST and PO were also significantly greater in LFEF than in LFE. The detection rate of instability was 10.4% in LFE and 31.3% in LFEF, and the difference was significant. The CLL was 27.31° ± 11.96° in LFE and 37.07° ± 12.963.16° in LFEF, with a significant difference between these values (p < 0.05). Compared with traditional LFE radiographs, the LFEF radiographs significantly improved the detection rate of LI. In addition, this method may reduce patient discomfort during the process of obtaining radiographs.

Best clinical practice guidance for treating deep carious lesions in primary teeth: an EAPD policy document

PurposeThe European Academy of Paediatric Dentistry (EAPD) has developed this best clinical practice guidance to help clinicians manage deep carious lesions in primary teeth.MethodsThree expert groups conducted systematic reviews of the relevant literature. The topics were: (1) conventional techniques (2) Minimal Intervention Dentistry (MID) and (3) materials. Workshops were held during the corresponding EAPD interim seminar in Oslo in April 2021. Several clinical based recommendations and statements were agreed upon, and gaps in our knowledge were identified.ResultsThere is strong evidence that indirect pulp capping and pulpotomy techniques, and 38% Silver Diamine Fluoride are shown to be effective for the management of caries in the primary dentition. Due to the strict criteria, it is not possible to give clear recommendations on which materials are most appropriate for restoring primary teeth with deep carious lesions. Atraumatic Restorative Technique (ART) is not suitable for multi-surface caries, and Pre-formed Metal Crowns (PMCs) using the Hall technique reduce patient discomfort. GIC and RMGIC seem to be more favourable given the lower annual failure rate compared to HVGIC and MRGIC. Glass carbomer cannot be recommended due to inferior marginal adaptation and fractures. Compomers, hybrid composite resins and bulk-fill composite resins demonstrated similar values for annual failure rates.ConclusionThe management of deep carious lesions in primary teeth can be challenging and must consider the patient’s compliance, operator skills, materials and costs. There is a clear need to increase the use of MID techniques in managing carious primary teeth as a mainstream rather than a compromise option.

Ultrasound Guided Injections in Shoulder as Compared to Direct Injections

Ultrasound, also known as sonography, is an imaging method that uses high-frequency sound waves to produce real-time and dynamic images of the body. Ultrasound is increasingly being used to assist Sports Medicine Physicians, Rheumatologists, Orthopedists, and Primary Care. Procedural planning prior to any procedure increases efficiency in the operative field and reduces patient discomfort. Ultrasound is commonly utilized in regenerative medicine techniques due to the ability to visualize soft tissue targets with high resolution. Ultrasound is beneficial in both diagnostic purposes and image-guidance for procedures. Understanding how to quickly optimize the ultrasound image and ergonomics for the procedure will greatly improve your procedure workflow.

Oral pregnancy tumor and its exigent medicament for expecting mothers using combination treatment modality: A clinical case series

To emphasize the incidence of pyogenic granuloma in expecting mothers and a combined treatment of conventional method and diode laser. A pregnancy tumor is a pyogenic granuloma occurring on the gingiva during the gestation period. However, the term pyogenic granuloma is deceptive, because the lesion is distinct from infection. In this case series, 2 clinical reports are discussed in detail, unfolding the clinical appearance of the particular lesion. The histopathological correlation has been established and an apposite treatment modality is described, focusing on the minute considerations. We observed a challenging incidence of overgrowth that was disturbing for the subjects, affecting their health along with the fetus'. There was no adverse effect while treating them during the 2 trimester of gestation. We were also efficient in achieving instantaneous coagulation with lasers preceded by comprehensive removal of the lesion using blades, making it a suitable and safe tool.The dilemma of the clinician was resolved confirming that surgical excision is the gold standard for the complete removal of the lesion along with added benefits of lasers to reduce patient discomfort and accelerate healing.

Janus mucosal dressing with a tough and adhesive hydrogel based on synergistic effects of gelatin, polydopamine, and nano-clay

There are many problems and challenges related to the treatment of highly prevalent oral mucosal diseases and oral drug delivery because of a large amount of saliva present in the oral cavity, the accompanying oral movements, and unconscious swallowing in the mouth. Therefore, an ideal oral dressing should possess stable adhesion and superior tough strength in the oral cavity. However, this fundamental requirement greatly limits the use of synthetic adhesive dressings for oral dressings. Here, we developed a mussel-inspired Janus gelatin-polydopamine-nano-clay (GPC) hydrogel with controlled adhesion and toughness through the synergistic physical and chemical interaction of gelatin (Gel), nano-clay, and dopamine (DA). The hydrogel not only exhibits strong wet adhesion force (63 kPa) but also has high toughness (1026 ± 100 J m−3). Interfacial adhesion of hydrogels is achieved by modulating the interaction of catechol groups of the hydrogel with specific functional groups (e.g., NH2, SH, OH, and COOH) on the tissue surface. The matrix dissipation of the hydrogel is regulated by physical crosslinking of gelatin, chemical crosslinking of gelatin with polydopamine (Michael addition and Schiff base formation), and nano-clay-induced constraint of the molecular chain. In addition, the GPC hydrogel shows high cell affinity and favors cell adhesion and proliferation. The hydrogel's instant and strong mucoadhesive properties provide a long-lasting therapeutic effect of the drug, thereby enhancing the healing of oral ulcers. Therefore, mussel-inspired wet-adhesion Janus GPC hydrogels can be used as a platform for mucosal dressing and drug delivery systems. Statement of significanceIt is a great challenge to treat oral mucosal diseases due to the large amount of saliva present in the oral cavity, the accompanying oral movements, unconscious swallowing, and flushing of drugs in the mouth. To overcome the significant limitations of clinical bioadhesives, such as weakness, toxicity, and poor usage, in the present study, we developed a simple method through the synergistic effects of gelatin, polydopamine, and nano-clay to prepare an optimal mucosal dressing (Janus GPC) that integrates Janus, adhesion, toughness, and drug release property. It fits effectively in the mouth, resists saliva flushing and oral movements, provides oral drug delivery, and reduces patient discomfort. The Janus GPC adhesive hydrogels have great commercial potential to support further the development of innovative therapies for oral mucosal diseases.

Interventional Pulmonology and Esophagus: Combined Endobronchial Ultrasound and Endoscopic Ultrasound for Mediastinal Staging.

Endoscopic ultrasound (EUS) techniques in addition to endobronchial ultrasound (EBUS) can lead to diagnosis and complete accurate staging of the mediastinum in a single session. This allows for decreased health care costs, less delay in diagnosis and treatment, reduced patient discomfort, and decreased morbidity compared with invasive surgical staging techniques. In comparison to conventional mediastinoscopy, the cost-effectiveness and reduced complication profile of the endoscopic approach has made this a superior initial step in the staging and diagnosis of lung cancer. Moreover, compared with EBUS alone, combined EUS and EBUS has significantly increased yield, as well as diagnostic sensitivity making a combined approach preferable as the emerging gold-standard technique for initial minimally invasive mediastinal staging. We discuss the advantage of using EUS in combination with EBUS and highlight techniques, lymph node landmarks, utility in staging and restaging of the mediastinum, roles in diagnosing mediastinal infections and granulomatous lesions, and future directions in endosonography.

MP32-09 PATIENT CONTROLLED URETHRAL HYDRODISTENTION REDUCES PAIN DURING MALE FLEXIBLE CYSTOSCOPY

You have accessJournal of UrologyCME1 May 2022MP32-09 PATIENT CONTROLLED URETHRAL HYDRODISTENTION REDUCES PAIN DURING MALE FLEXIBLE CYSTOSCOPY Daniel Wagner, and William Lin Daniel WagnerDaniel Wagner More articles by this author , and William LinWilliam Lin More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002581.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Flexible cystoscopy is typically performed under local anesthesia with intraurethral insertion of aqueous lidocaine gel. Male patients often experience significant discomfort as the cystoscope is negotiated past the membranous and prostatic urethra. The objective of this study is to determine whether patient controlled urethral hydrodistention can reduce patient discomfort during male flexible cystoscopy. METHODS: Flexible cystoscopy was performed using Karl Storz 15 F flexible cystoscope by a single urologist in cystoscopy naive male patients, with or without patient controlled urethral hydrodistention. 10 cc of 2% aqueous lidocaine gel was introduced into the urethra and left in place for 10 minutes prior to initiation of the procedure. Urethral hydrodistention was achieved by having the patients forcibly compress 250 ml flexible polyvinyl chloride container of sterile sale as the flexible cystoscope was negotiated past the urethra. clinical outcomes were assessed using analog pain scale post procedure to assess pain associated with the procedure. RESULTS: A total of 63 cystoscopy naive men underwent flexible cystoscopy. 32 patients were in the urethral hydrodistention group with median age of 47. 31 patients were in the control group with median age of 50. Analog pain score was 1.96 in the urethral hydrodistention group and 5.68 in the control group (p <0.01). CONCLUSIONS: In our study, patient controlled urethral hydrodistention significantly reduces pain associated with flexible cystoscopy in cystoscopy naive male patients. It is reasonable to incorporate this technique as part of the male flexible cystoscopy procedure. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e535 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Daniel Wagner More articles by this author William Lin More articles by this author Expand All Advertisement PDF DownloadLoading ...

Stem Cell Harvest From Adipose Tissue

Background: Differentiation, self-renewal, immunomodulation, and angiogenesis are all capabilities of stem cells that can help improve tissue structure (Bacakova et al, 2018). In adipose tissue, there is a stromal vascular fraction (SVF) that contains a variety of cell types that can transdifferentiate between endothelial and adipogenic cell lineages. (Schreml et al., 2009). The procedure used to harvest adipose tissue, such as liposuction or excision, has an impact on the quality of SVF and ADSC recovered from it. Barzelay et al., 2015). Literature review: The two most common locations for stem cell harvest are bone marrow and fat tissue. Taking stem cells can be done in a variety of ways, depending on the source of the cells. Isolating stem cells from preimplantation embryos is how embryonic stem cell retrieval is done. Liposuction is the removal of subcutaneous tissue with the help of a suction pump and an aspiration cannula introduced through a skin incision. Suction-assisted lipectomy, suction lipoplasty, and liposculpture are other synonyms for liposuction. The advantage of liposuction over resection for obtaining stem cells is that it is less intrusive and can preserve neurovascular structures. In addition, liposuction preserves fluid balance and reduces patient discomfort. A high-speed cannula is used in liposuction to disrupt adipocytes. This procedure has the potential to cause cellular harm. Adipocyte viability and transplant survival will be improved by using less stressful adipose tissue extraction procedures. (Simonacci et al., 2017). Under general anaesthesia, the resected tissue was removed whole. In order to separate ADSC, fibrous tissue and visible blood vessels were removed from the retrieved adipose tissue. Resection of adipose tissue produced more SVF and ADSC cells than liposuction, according to Iyyanki et al and Faustini et al. This differs from the findings of a prior study by Schreml et al. Conclusion: Liposuction and resection both have advantages and downsides when it comes to extracting stem cells from fat tissue. There was no discernible difference in the removal of stem cells from adipose tissue by liposuction versus excision.

Design and Evaluation of a Handheld Robotic Device for Peripheral Catheterization.

Medical robots provide enhanced dexterity, vision, and safety for a broad range of procedures. In this article, we present a handheld, robotic device capable of performing peripheral catheter insertions with high accuracy and repeatability. The device utilizes a combination of ultrasound imaging, miniaturized robotics, and machine learning to safely and efficiently introduce a catheter sheath into a peripheral blood vessel. Here, we present the mechanical design and experimental validation of the device, known as VeniBot. Additionally, we present results on our ultrasound deep learning algorithm for vessel segmentation, and performance on tissue-mimicking phantom models that simulate difficult peripheral catheter placement. Overall, the device achieved first-attempt success rates of 97 ± 4% for vessel punctures and 89 ± 7% for sheath cannulations on the tissue mimicking models (n = 240). The results from these studies demonstrate the viability of a handheld device for performing semi-automated peripheral catheterization. In the future, the use of this device has the potential to improve clinical workflow and reduce patient discomfort by assuring a safe and efficient procedure.

Isotropic multichannel total variation framework for joint reconstruction of multicontrast parallel MRI.

Purpose: To develop a synergistic image reconstruction framework that exploits multicontrast (MC), multicoil, and compressed sensing (CS) redundancies in magnetic resonance imaging (MRI). Approach: CS, MC acquisition, and parallel imaging (PI) have been individually well developed, but the combination of the three has not been equally well studied, much less the potential benefits of isotropy within such a setting. Inspired by total variation theory, we introduce an isotropic MC image regularizer and attain its full potential by integrating it into compressed MC multicoil MRI. A convex optimization problem is posed to model the new variational framework and a first-order algorithm is developed to solve the problem. Results: It turns out that the proposed isotropic regularizer outperforms many of the state-of-the-art reconstruction methods not only in terms of rotation-invariance preservation of symmetrical features, but also in suppressing noise or streaking artifacts, which are normally encountered in PI methods at aggressive undersampling rates. Moreover, the new framework significantly prevents intercontrast leakage of contrast-specific details, which seems to be a difficult situation to handle for some variational and low-rank MC reconstruction approaches. Conclusions: The new framework is a viable option for image reconstruction in fast protocols of MC parallel MRI, potentially reducing patient discomfort in otherwise long and time-consuming scans.