Mathematical Modeling of Diabetic Foot Ulcers Using Optimal Design and Mixed-Modeling Techniques

A mathematical model for the healing response of diabetic foot ulcers was developed using averaged data (Krishna et al., 2015). The model contains four major factors in the healing of wounds using four separate differential equations with 12 parameters. The four differential equations describe the interactions between matrix metalloproteinases (MMP-1), tissue inhibitors of matrix metalloproteinases (TIMP-1), the extracellular matrix (ECM) of the skin, and the fibroblasts, which produce these proteins. Recently, our research group obtained the individual patient data that comprised the averaged data. The research group has since taken several approaches to analyze the model with the individual patient data. One approach was to introduce mixed modeling techniques on certain parameters in that model. Mixed effects modeling is an analytical tool useful for the repeated measurement of data with subjects, patients, etc., that have random affects that deviate from a specified norm. This is accomplished by taking a parameter that is shared across all data sets and splitting it into a fixed variable and a random variable. Then all data sets are modeled so that the fixed variable is the same for all patients and the random variable is a unique modifier that accounts for the differences across patients. Another approach has been to use an optimal design technique to identify which times are ideal for data gathering for the model. For this project a Standard Error (SE) optimal design method was chosen with the goal of minimizing the sum of squared normalized standard errors. Our project worked to combine these techniques by first introducing mixed modeling parameter values into an SE-optimal design algorithm and then comparing the results collected to the standard algorithm. Other optimal design techniques were used with and without these mixed modeling parameters to see if a certain technique was better than the others. Finally, we worked toward improving our estimates for mixed modeling parameters by attempting to implement in MONOLIX. Our focus for this part was to develop test cases that could be implemented in MONOLIX

The Impact of a Rural School-Based Health Center on Students and Their Families in Sneedville, Tennessee: A Case Study.

The purpose of this study was to describe the impact that the school-based health center in Sneedville, Tennessee had on students who attended Hancock County High School. The study documented how the school-based health center affected students, families, and the community of Sneedville. Case study methodology was used to determine if the school-based health center impacted school attendance, mental and emotional health, sexual practices, and overall quality of life for students and their families. Data were collected through 25 interviews with health center stakeholders. The methodology included working with the staff at the school-based health center to identify the key players and key center users over the seven years of the center\u27s existence. An interview protocol was designed for each of the seven groups that were interviewed. Data were collected from current and former students, parents of current and former students, school counselors, teachers, and the school nurse. Students who attended Hancock County High School as well as their parents were impacted by their direct access to primary comprehensive health care services. Benefits to parents included a reduction of time in missed work and lower medical care costs for students without health insurance. The center promoted and improved school attendance while distributing valuable health education information to students and parents. Because the city of Sneedville has only one medical center and no hospital, the school-based health center served the rural residents well. Beginning as one of only three such centers in the United States, the school-based health center endured and evolved into a full-service, comprehensive health care provider. The center is located in an isolated region of Northeast Tennessee; the location added to the center\u27s impact on the residents. This study could provide a model for rural communities seeking ways to serve the health care needs of youth. In this time of economic instability and educational accountability, this school-based health center appeared to impact student care, thus allowing students to be more capable and ready to learn

Early Trends in Cystatin C and Outcomes in Patients with Cirrhosis and Acute Kidney Injury

Background. Acute kidney injury (AKI) is a common and severe complication in patients with cirrhosis. Progression of AKI to a higher stage associates with increased mortality. Intervening early in AKI when renal dysfunction is worsening may improve outcomes. However, serum creatinine correlates poorly with glomerular filtration in patients with cirrhosis and fluctuations may mask progression early in the course of AKI. Cystatin C, a low-molecular-weight cysteine proteinase inhibitor, is a potentially more accurate marker of glomerular filtration. Methods. We conducted a prospective multicenter study in patients with cirrhosis comparing changes in cystatin and creatinine immediately following onset of AKI as predictors of a composite endpoint of dialysis or mortality. Results. Of 106 patients, 37 (35%) met the endpoint. Cystatin demonstrated less variability between samples than creatinine. Patients were stratified into four groups reflecting changes in creatinine and cystatin: both unchanged or decreased 38 (36%) (Scr−/CysC−); only cystatin increased 25 (24%) (Scr−/CysC+); only creatinine increased 15 (14%) (Scr+/CysC−); and both increased 28 (26%) (Scr+/CysC+). With Scr−/CysC− as the reference, in both instances where cystatin rose, Scr−/CysC+ and Scr+/CysC+, the primary outcome was significantly more frequent in multivariate analysis, and , respectively. However, when only creatinine rose, outcomes were similar to the reference group. Conclusions. Changes in cystatin levels early in AKI are more closely associated with eventual dialysis or mortality than creatinine and may allow more rapid identification of patients at risk for adverse outcomes

Deep, noninvasive imaging and surgical guidance of submillimeter tumors using targeted M13-stabilized single-walled carbon nanotubes

Highly sensitive detection of small, deep tumors for early diagnosis and surgical interventions remains a challenge for conventional imaging modalities. Second-window near-infrared light (NIR2, 950–1,400 nm) is promising for in vivo fluorescence imaging due to deep tissue penetration and low tissue autofluorescence. With their intrinsic fluorescence in the NIR2 regime and lack of photobleaching, single-walled carbon nanotubes (SWNTs) are potentially attractive contrast agents to detect tumors. Here, targeted M13 virus-stabilized SWNTs are used to visualize deep, disseminated tumors in vivo. This targeted nanoprobe, which uses M13 to stably display both tumor-targeting peptides and an SWNT imaging probe, demonstrates excellent tumor-to-background uptake and exhibits higher signal-to-noise performance compared with visible and near-infrared (NIR1) dyes for delineating tumor nodules. Detection and excision of tumors by a gynecological surgeon improved with SWNT image guidance and led to the identification of submillimeter tumors. Collectively, these findings demonstrate the promise of targeted SWNT nanoprobes for noninvasive disease monitoring and guided surgery.National Institutes of Health (U.S.). Center for Nanotechnology Excellence (Grant U54-CA119349-04)National Institutes of Health (U.S.). Center for Nanotechnology Excellence (Grant U54-CA151884)David H. Koch Institute for Integrative Cancer Research at MIT. Frontier Research Program (Kathy and Curt Marble Cancer Research Fund)National Institute of Environmental Health Sciences (Grant P30-ES002109)Marie D. & Pierre Casimir-Lambert FundAmar G. Bose Research Gran

Original biographies from the Dictionary of African Christian Biography

A publication of the Dictionary of African Christian Biography with U.S. offices located at the Center for Global Christianity and Mission at Boston University. The editors are pleased to offer the first annual cumulative volume of the Journal of African Christian Biography, the monthly scholarly publication that was launched in June of 2016. Since then, the life stories of twelve individuals who played vital roles in and through their faith communities have been published online as free downloads. But it is important that a selection of DACB stories be more readily available to those without access to the internet. As I mentioned in the fall 2016 newsletter of the DACB, each issue of the journal is available in its e-journal, on-line version, where it is configured either as A4 or 8.5 x 11 format printable as booklets, ready for local printing and binding or stapling. Our intention is to make it easy for academics and church leaders in various parts of Africa to make print copies of the journal available to their students, colleagues or church members. And so it is with this cumulative volume.This issue focuses on: 1. "Walatta Petros and Hakalla Amale, Pious Women of Ethiopia," with commentary by Dr. Jonathan Bonk, Project Director. 2. Walatta Petros. 3. Hakalla Amale. 4. Bishop Josiah Kibira of Tanzania, Ecumenical Statesman. 5. Josiah Mutabuzi Isaya Kibira. 6. Josiah Kibira. 7. David Lonkibiri Windibiziri. 8. Abiodun Babatunde Lawrence. 9. Dominic Ignatius Ekandem. 10. William Wadé Harris, Prophet-Evangelist of West Africa: His Life, Message, Praxis, Heritage, and Legacy. 11. William Wadé Harris. 12. Michael Timneng and Jeremiah Chi Kangsen: Christianity Beyond the Missionary Presence in Cameroon. 13. Michael Timneng. 14. Jeremiah Chi Kangsen. 15. Rainisoalambo, Ravelonjanahary, and Volahavana Germaine (Nenilava): Revival Leaders of Madagascar. 16. Rainisoalambo. 17. Ravelonjanahary. 18. Volahavana Germaine (Nenilava). 19. Recent Print and Digital Resourcews Related to Christianity in Africa

Autonomous Tennis Ball Collector

Practicing tennis often involves hitting many tennis balls from one side of the court to the other without an opponent to hit the balls back. In training sessions like these, the task of collecting the balls is laborious when performed manually. The objective of this project is to develop a robotic tennis ball collector that can automatically collect the balls from one side of the court so that the player can rest rather than collect the balls manually. This document outlines the process of designing such a robot. Included in this report is background research, prototype, and concept modeling, along with a finalized design, and a complete timeline of our process. We will also detail the manufacturing process and the design verification. In the conclusion we will provide you with recommendations for future projects. Throughout our research, we discovered many similar products, but none met all of the customer’s requirements, thus opening a window for our product. After copious design consideration, we selected the strongest idea that satisfied our customers’ needs and are moving forward with structural modeling and preliminary analysis on it. After the structural prototype revealed issues in the design we went back to work and finalized a design that we felt confident with and still satisfied all the requirements. As seen in this report the final design utilizes structural framing materials to build the robot and allows for ease of attachment for all the electrical components. The final step in the design process was to test the verification prototype to ensure that it met all our specifications. Unfortunately, our design did not pass as many of the tests as we would have liked, and this is detailed in that section. While at the conclusion of this project, we did not complete as much as we hoped, there is a good foundation in place for the project to continue as our sponsor so desires

Transitoriness in cancer patients: a cross-sectional survey of lung and gastrointestinal cancer patients

Objective: Despite earlier diagnosis and advancements in treatment, cancer remains a leading cause of death in the world (13% of all deaths according to the World Health Organization) among men and women. Cancer accounts for approximately 20% of the deaths in the USA every year. Here, we report the findings from a cross-sectional survey of psychosocial factors in lung and gastrointestinal cancer patients. The aim of the study was to explore the associations among transitoriness, uncertainty, and locus of control (LOC) with quality of life. Transitoriness is defined as a person's confrontation with life's finitude due to a cancer diagnosis. Methods: A total of 126 patients with lung or gastrointestinal cancer completed eight self-reporting questionnaires addressing demographics, spiritual perspective, symptom burden, transitoriness, uncertainty, LOC, and quality of life. Results: Transitoriness, uncertainty, and LOC were significantly associated with one another (r = 0.3267, p = 0.0002/r = 0.1994, p = 0.0252, respectively). LOC/belief in chance has a significant inverse relationship with patients' quality of life (r = −0.2505, p = 0.0047). Transitoriness, uncertainty, and LOC were found to have a significant inverse relationship with patients' quality of life (transitoriness state: r = −0.5363, p = 0.0000/trait: r = −0.4629, p = 0.0000/uncertainty: r = −0.4929, p = 0.0000/internal LOC: r = 0.1759, p = 0.0489/chance LOC: r = −0.2505, p = 0.0047). Conclusion: Transitoriness, uncertainty, and LOC are important concepts as they adversely influence patients' quality of life. Incorporating this finding into the care of cancer patients may provide them with the support they need to cope with treatment and maintenance of a positive quality of lif

Biocultural Practices during the Transition to History at the Vat Komnou Cemetery, Angkor Borei, Cambodia

Mainland Southeast Asia underwent dramatic changes after the mid-first millennium B.C.E., as its populations embraced new metallurgical and agricultural technologies. Southeast Asians transformed their physical and social environments further through their participation in international maritime trade networks. Early state formation characterized much of the mainland by the mid-first millennium C.E. We examined a protohistoric (200 B.C.E.–200 C.E.) skeletal sample from the Vat Komnou cemetery at Angkor Borei in the Mekong Delta (southern Cambodia) to understand the health impacts of this changing environment. Degenerative joint disease patterns indicate a distinct sexual division of labor. Although intentional dental filing was practiced, its impact on oral-dental health could not be determined. Dental pathologies suggest a mixed diet with more fibrous foods and a lower reliance on soft, processed agricultural foods. A broad-spectrum diet and varied use of the local environment are inferred from the faunal evidence. Stable isotope ratios indicate a relatively greater reliance on fish and estuarine dietary resources than on terrestrial protein. Affinities with other groups in the region are suggested by the cultural practices of the relatively tall, healthy inhabitants from Vat Komnou

Evolution of oceanic near surface stratification in response to an autumn storm

Understanding the processes that control the evolution of the ocean surface boundary layer (OSBL) is a prerequisite for obtaining accurate simulations of air-sea fluxes of heat and trace gases. Observations of the rate of dissipation of turbulent kinetic energy (ɛ), temperature, salinity, current structure and wave-field over a period of 9.5 days in the NE Atlantic during the Ocean Surface Mixing, Ocean Submesoscale Interaction Study (OSMOSIS), are presented. The focus of this study is a storm which passed over the observational area during this period. The profiles of ɛ in the OSBL are consistent with profiles from large eddy simulation (LES) of Langmuir turbulence. In the transition layer (TL), at the base of the OSBL, ɛ was found to vary periodically at the local inertial frequency. A simple bulk model of the OSBL and a parametrisation of shear driven turbulence in the TL are developed. The parametrisation of ɛ is based on assumptions about the momentum balance of the OSBL and shear across the TL. The predicted rate of deepening, heat budget and the inertial currents in the OSBL were in good agreement with the observations, as is the agreement between the observed value of ɛ and that predicted using the parametrisation. A previous study reported spikes of elevated dissipation related to enhanced wind-shear alignment at the base of the OSBL after this storm. The spikes in dissipation are not predicted by this new parametrisation, implying that they are not an important source of dissipation during the storm