Utility of a bespoke 3-dimensional printed model in complex transposition.
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ABSTRACT:
SUBMITTER: Contreras JR
PROVIDER: S-EPMC8311502 | biostudies-literature | 2021 Jun
REPOSITORIES: biostudies-literature
Publications
Utility of a bespoke 3-dimensional printed model in complex transposition.
Contreras Juan R JR Villemain Olivier O Marini Davide D Dragulescu Andreea A Yoo Shi-Joon SJ Barron David J DJ
JTCVS techniques 20210119
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Project description:3D printing is a rapidly growing area of interest within pharmaceutical science thanks to its versatility in creating different dose form geometries and drug doses to enable the personalisation of medicines. Research in this area has been dominated by polymer-based materials; however, for poorly water-soluble lipophilic drugs, lipid formulations present advantages in improving bioavailability. This study progresses the area of 3D-printed solid lipid formulations by providing a 3D-printed dissolvable polymer scaffold to compartmentalise solid lipid formulations within a single dosage form. This allows the versatility of different drugs in different lipid formulations, loaded into different compartments to generate wide versatility in drug release, and specific control over release geometry to tune release rates. Application to a range of drug molecules was demonstrated by incorporating the model lipophilic drugs; halofantrine, lumefantrine and clofazimine into the multicompartmental scaffolded tablets. Fenofibrate was used as the model drug in the single compartment scaffolded tablets for comparison with previous studies. The formulation-laden scaffolds were characterised using X-ray CT and dispersion of the formulation was studied using nephelometry, while release of a range of poorly water-soluble drugs into different gastrointestinal media was studied using HPLC. The studies show that dispersion and drug release are predictably dependent on the exposed surface area-to-volume ratio (SA:V) and independent of the drug. At the extremes of SA:V studied here, within 20 min of dissolution time, formulations with an SA:V of 0.8 had dispersed to between 90 and 110%, and completely released the drug, where as an SA:V of 0 yielded 0% dispersion and drug release. Therefore, this study presents opportunities to develop new dose forms with advantages in a polypharmacy context.
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Project description:BackgroundMediastinoscopy remains an important component of lung cancer staging. The development of endobronchial ultrasonography has meant residents perform fewer mediastinoscopies. We hypothesized that a 3-dimensional printed model of the mediastinum would be an effective tool for teaching residents the anatomy and techniques for mediastinoscopy.MethodsA color model of the mediastinum was 3-dimensionally printed based on segmented computed tomographic images. For 2 years, residents and attendings were asked to provide a skills assessment after every mediastinoscopy. During the second year, all residents received standardized instruction for mediastinoscopy using the 3-dimensional model. Skills assessments were compared between the residents taught with and without the 3-dimensional model.ResultsThere were 49 resident and 65 attending surveys completed. Residents taught with the 3-dimensional model were more likely to answer that they could identify normal anatomy "well"/"very well" compared with residents taught without the model (86% vs 52%, P = .015). Residents taught with the 3-dimensional model more frequently answered they were able to perform an uncomplicated mediastinoscopy "well"/ "very well" (59% vs 31%, P = .079) compared with residents taught without the 3-dimensional model, although this was not significant. Attendings were equally likely to answer "well"/"very well" that residents taught with the 3-dimensional model could identify normal anatomy (52% vs 55%, P > .99) and perform an uncomplicated mediastinoscopy (48% vs 43%, P = .79) compared with those taught without the model.ConclusionsA 3-dimensional printed model of the mediastinum may be an effective tool for teaching mediastinoscopy.
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Project description:BackgroundPeripheral pulmonary lesion (PPL) incidence is rising because of increased chest imaging sensitivity and frequency. For PPLs suspicious for lung cancer, current clinical guidelines recommend tissue diagnosis. Radial endobronchial ultrasound (R-EBUS) is a bronchoscopic technique used for this purpose. It has been observed that diagnostic yield is impacted by the ability to accurately manipulate the radial probe. However, such skills can be acquired, in part, from simulation training. Three-dimensional (3D) printing has been used to produce training simulators for standard bronchoscopy but has not been specifically used to develop similar tools for R-EBUS.ObjectiveWe report the development of a novel ultrasound-compatible, anatomically accurate 3D-printed R-EBUS simulator and evaluation of its utility as a training tool.MethodsComputed tomography images were used to develop 3D-printed airway models with ultrasound-compatible PPLs of "low" and "high" technical difficulty. Twenty-one participants were allocated to two groups matched for prior R-EBUS experience. The intervention group received 15 minutes to pretrain R-EBUS using a 3D-printed model, whereas the nonintervention group did not. Both groups then performed R-EBUS on 3D-printed models and were evaluated using a specifically developed assessment tool.ResultsFor the "low-difficulty" model, the intervention group achieved a higher score (21.5 ± 2.02) than the nonintervention group (17.1 ± 5.7), reflecting 26% improvement in performance (P = 0.03). For the "high-difficulty" model, the intervention group scored 20.2 ± 4.21 versus 13.3 ± 7.36, corresponding to 52% improvement in performance (P = 0.02). Participants derived benefit from pretraining with the 3D-printed model, regardless of prior experience level.Conclusion3D-printing can be used to develop simulators for R-EBUS education. Training using these models significantly improves procedural performance and is effective in both novice and experienced trainees.
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Project description:To assess the improvement in patient understanding with use of a three-dimensional printed vestibular model as a teaching tool and to evaluate the effects of educational approach on dizziness-related disabilities. Single center randomized controlled trial set in the Otolaryngology ambulatory care clinic located at a tertiary care, teaching institution in Shreveport, Louisiana. Patients with a current or suspected diagnosis of benign paroxysmal positional vertigo who met inclusion criteria were randomized to either the three-dimensional model group or the control group. Each group received the same education session about dizziness, with the three-dimensional model being used as a visual aid in the experimental group. The control group received only verbal education. Outcome measures included patient understanding of benign paroxysmal positional vertigo etiology, comfort level with symptom prevention, anxiety related to vertigo symptoms, and how likely the patient was to recommend the teaching session to another individual suffering from vertigo. Pre-session and post-session surveys were administered to all patients to assess outcome measures. Eight patients were enrolled in the experimental group, and eight patients were enrolled in the control group. On post-survey data, the experimental group reported increased understanding of symptom etiology (p = 0.0289), increased comfort level with preventing symptoms (p = 0.2999), a larger decrease in symptom related anxiety (p = 0.0453) and were more likely to recommend the education session (p = 0.2807) compared to the control group. Three-dimensional printed vestibular model demonstrates promise for patient education and reducing related anxiety.Supplementary informationThe online version contains supplementary material available at 10.1007/s12070-022-03325-5.
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