Towards the modeling of mucus draining from human lung: role of airways deformation on air-mucus interaction

Chest physiotherapy is an empirical technique used to help secretions to get out of the lung whenever stagnation occurs. Although commonly used, little is known about the inner mechanisms of chest physiotherapy and controversies about its use are coming out regularly. Thus, a scientific validation of chest physiotherapy is needed to evaluate its effects on secretions. We setup a quasi-static numerical model of chest physiotherapy based on thorax and lung physiology and on their respective biophysics. We modeled the lung with an idealized deformable symmetric bifurcating tree. Bronchi and their inner fluids mechanics are assumed axisymmetric. Static data from the literature is used to build a model for the lung's mechanics. Secretions motion is the consequence of the shear constraints apply by the air flow. The input of the model is the pressure on the chest wall at each time, and the output is the bronchi geometry and air and secretions properties. In the limit of our model, we mimicked manual and mechanical chest physiotherapy techniques. We show that for secretions to move, air flow has to be high enough to overcome secretion resistance to motion. Moreover, the higher the pressure or the quicker it is applied, the higher is the air flow and thus the mobilization of secretions. However, pressures too high are efficient up to a point where airways compressions prevents air flow to increases any further. Generally, the first effects of manipulations is a decrease of the airway tree hydrodynamic resistance, thus improving ventilation even if secretions do not get out of the lungs. Also, some secretions might be pushed deeper into the lungs; this effect is stronger for high pressures and for mechanical chest physiotherapy. Finally, we propose and tested two adimensional numbers that depend on lung properties and that allow to measure the efficiency and comfort of a manipulation

Reading Strategies: Impact on Fifth Grade African American Males’ Reading Comprehension and Motivation to Read

The purpose of this action research was to implement four close reading strategies (Aha moment, Hmm moment, B.U.R.N. strategy, and R.A.P.) and evaluate its impact on fifth grade African American male students’ reading comprehension skills and their experiences with reading at Wisteria Lane Elementary. This intervention study focused on two research questions: how does the implementation of close reading strategies impact the reading comprehension skills of fifth grade male students, and in what ways does the implementation of close reading strategies influence fifth grade male students’ motivation to read in other classes? Nationally, African American boys suffer with weak reading comprehension skills that can lead to fewer job opportunities and increased likelihood for dropping out of high school. This 11-week action research innovation had nine fifth grade African American male participants. The students were taught how to use each close reading strategy introduced and given the opportunity to practice with guided instruction, a partner, as well as independently. A pre-post Reading Comprehension assessment, formative assessments, weekly student reflection journals, a survey, and a focus group interview comprised the data sources used to measure reading comprehension skills and student perceptions about using close reading strategies on their motivation to read in other classes. Quantitative findings revealed that the posttest scores were not significantly higher than the pretest scores and partipants favored the Hmm moment strategy. Qualitative findings showed that participants saw benefits of using the close reading strategies and the close reading strategies motivated students to read. Recommendations for future research and limitations of the study are discussed

A GIS based watershed analysis system for Tillamook Bay, Oregon

Center for Research in Water Resource

More Knowledge On The Go: A Survey of Mobile Device Usage in Pharmacy

Although there are studies that explore the use of mobile devices by physicians and pharmacists, there has not been a study to date that examines the prevalence and usage patterns of mobile devices amongst pharmacy students and faculty. This is the first pan-Canadian study that examines the prevalence and patterns of use of mobile devices by pharmacy faculty and students at Anglophone and Francophone universities. Unlike previous studies, this study also included interviews with participants to collect richer data than can be gathered with an online survey alone

Applying SMT Solvers to the Test Template Framework

The Test Template Framework (TTF) is a model-based testing method for the Z notation. In the TTF, test cases are generated from test specifications, which are predicates written in Z. In turn, the Z notation is based on first-order logic with equality and Zermelo-Fraenkel set theory. In this way, a test case is a witness satisfying a formula in that theory. Satisfiability Modulo Theory (SMT) solvers are software tools that decide the satisfiability of arbitrary formulas in a large number of built-in logical theories and their combination. In this paper, we present the first results of applying two SMT solvers, Yices and CVC3, as the engines to find test cases from TTF's test specifications. In doing so, shallow embeddings of a significant portion of the Z notation into the input languages of Yices and CVC3 are provided, given that they do not directly support Zermelo-Fraenkel set theory as defined in Z. Finally, the results of applying these embeddings to a number of test specifications of eight cases studies are analysed.Comment: In Proceedings MBT 2012, arXiv:1202.582

Nifurtimox plus Eflornithine for Late-Stage Sleeping Sickness in Uganda: A Case Series

African sleeping sickness (Human African Trypanosomiasis, or HAT), due to the parasite Trypanosoma brucei gambiense, threatens millions across remote and conflict-affected regions of sub-Saharan Africa, and causes about 15 000 reported cases every year. Untreated HAT progresses from stage 1 (infection of the blood and lymph) to stage 2 (invasion of the central nervous system), and ultimately death. Drugs for stage 2 are few. The historical mainstay, melarsoprol, is highly toxic and inefficacious in some areas due to parasite resistance. Eflornithine is the only viable alternative, already established as safe and efficacious, but difficult to administer and at risk of resistance if used in monotherapy. This paper reports on a series of 48 Ugandan patients treated with a novel combination of nifurtimox (a drug registered for Chagas disease) and eflornithine, 17 as part of a terminated trial, and 31 in a subsequent case series study. Despite the low sample size, findings are promising: no cases of treatment failure, no treatment terminations, and no HAT- or treatment-related deaths. Nifurtimox plus eflornithine may be the best treatment hope for stage 2 HAT patients in the next decade, while new drugs are developed. A larger, multi-centric trial of the combination is ongoing

Point-of-Care Technologies for Precision Cardiovascular Care and Clinical Research

Point-of-care technologies (POC or POCT) are enabling innovative cardiovascular diagnostics that promise to improve patient care across diverse clinical settings. The National Heart, Lung, and Blood Institute convened a working group to discuss POCT in cardiovascular medicine. The multidisciplinary working group, which included clinicians, scientists, engineers, device manufacturers, regulatory officials, and program staff, reviewed the state of the POCT field; discussed opportunities for POCT to improve cardiovascular care, realize the promise of precision medicine, and advance the clinical research enterprise; and identified barriers facing translation and integration of POCT with existing clinical systems. A POCT development roadmap emerged to guide multidisciplinary teams of biomarker scientists, technologists, health care providers, and clinical trialists as they: 1) formulate needs assessments; 2) define device design specifications; 3) develop component technologies and integrated systems; 4) perform iterative pilot testing; and 5) conduct rigorous prospective clinical testing to ensure that POCT solutions have substantial effects on cardiovascular care

Taxonomy based on science is necessary for global conservation

Peer reviewe

Sex difference and intra-operative tidal volume: Insights from the LAS VEGAS study

BACKGROUND: One key element of lung-protective ventilation is the use of a low tidal volume (VT). A sex difference in use of low tidal volume ventilation (LTVV) has been described in critically ill ICU patients.OBJECTIVES: The aim of this study was to determine whether a sex difference in use of LTVV also exists in operating room patients, and if present what factors drive this difference.DESIGN, PATIENTS AND SETTING: This is a posthoc analysis of LAS VEGAS, a 1-week worldwide observational study in adults requiring intra-operative ventilation during general anaesthesia for surgery in 146 hospitals in 29 countries.MAIN OUTCOME MEASURES: Women and men were compared with respect to use of LTVV, defined as VT of 8 ml kg-1 or less predicted bodyweight (PBW). A VT was deemed 'default' if the set VT was a round number. A mediation analysis assessed which factors may explain the sex difference in use of LTVV during intra-operative ventilation.RESULTS: This analysis includes 9864 patients, of whom 5425 (55%) were women. A default VT was often set, both in women and men; mode VT was 500 ml. Median [IQR] VT was higher in women than in men (8.6 [7.7 to 9.6] vs. 7.6 [6.8 to 8.4] ml kg-1 PBW, P < 0.001). Compared with men, women were twice as likely not to receive LTVV [68.8 vs. 36.0%; relative risk ratio 2.1 (95% CI 1.9 to 2.1), P < 0.001]. In the mediation analysis, patients' height and actual body weight (ABW) explained 81 and 18% of the sex difference in use of LTVV, respectively; it was not explained by the use of a default VT.CONCLUSION: In this worldwide cohort of patients receiving intra-operative ventilation during general anaesthesia for surgery, women received a higher VT than men during intra-operative ventilation. The risk for a female not to receive LTVV during surgery was double that of males. Height and ABW were the two mediators of the sex difference in use of LTVV.TRIAL REGISTRATION: The study was registered at Clinicaltrials.gov, NCT01601223