The Case Study Method: A Step-By-Step Approach For Analyzing Cases And Evaluating Students

The case study is an excellent method for teaching and assessing students’ knowledge and skills. Using two examples, we present a step-by-step approach for analyzing cases and evaluating students. The advantages and disadvantages of using cases are discussed and methods for identifying cases are presented

Salsalate treatment improves glycemia without altering adipose tissue in nondiabetic obese hispanics.

ObjectiveSalsalate treatment has well-known effects on improving glycemia, and the objective of this study was to examine whether the mechanism of this effect was related to changes in adipose tissue.MethodsA randomized double-blind and placebo-controlled trial in obese Hispanics (18-35 years) was conducted. The intervention consisted of 4 g day(-1) of salsalate (n = 11) versus placebo (n = 13) for 4 weeks. Outcome measures included glycemia, adiposity, ectopic fat, and adipose tissue gene expression and inflammation.ResultsIn those receiving salsalate, plasma fasting glucose decreased by 3.4% (P < 0.01), free fatty acids decreased by 42.5% (P = 0.06), and adiponectin increased by 27.7% (P < 0.01). Salsalate increased insulin AUC by 38% (P = 0.01) and HOMA-B by 47.2% (P < 0.01) while estimates of insulin sensitivity/resistance were unaffected. These metabolic improvements occurred without changes in total, abdominal, visceral, or liver fat. Plasma markers of inflammation/immune activation were unchanged following salsalate. Salsalate had no effects on adipose tissue including adipocyte size, presence of crown-like structures, or gene expression of adipokines, immune cell markers, or cytokines downstream of NF-κB with the exception of downregulation of IL-1β (P < 0.01).ConclusionsFindings suggest that metabolic improvements in response to salsalate occurred without alterations in adiposity, ectopic fat, or adipose tissue gene expression and inflammation

Chondroitin Sulfate Proteoglycans Are a Common Component of Neuronal Inclusions and Astrocytic Reaction in Neurodegenerative Diseases

Previously, we showed three differentially sulfated forms of chondroitin sulfate proteoglycans (CSPG) associated with senile plaques, astrocytes and neurofibrillary tangles in Alzheimer\u27s disease. Here, monoclonal antibodies were used to demonstrate CSPGs in other neurodegenerative diseases. CSPGs were found associated with inclusions of Parkinson\u27s, diffuse Lewy body, Pick\u27s diseases, and progressive supranuclear palsy. Reacting astrocytes in each of these neurodegenrative diseases and Huntington\u27s disease showed immunoreactivity for CSPG. CSPG distribution in a variety of neurodegenerative diseases suggests that similar mechanisms may be involved in the accumulation of proteoglycans in a number of filamentous inclusions

Relationships Between Indices of Macrovascular and Microvascular Function in Young, Black Women

Blacks (BL) exhibit an exaggerated prevalence of and mortality from cardiovascular disease (CVD) relative to other populations. Macro- and microvascular dysfunction is often a hallmark of heightened CVD risk, with both demonstrated in BL. However, data regarding this dysfunction remains sparse, particularly in BL women. Common indices of vascular function include flow-mediated dilation (FMD) and reactive hyperemia (RH) following a brief period of suprasystolic cuff occlusion and cutaneous thermal reactivity to local heating (LH). However, the relationship between these indices has not been established in BL women. PURPOSE: The present study aimed to test the relationship between indices of vascular function in BL women as assessed by FMD, RH, and LH. METHODS: To test this hypothesis, 6 white women (WW) and 6 BW (age: 22±2 vs. 21±3, respectively) were studied. FMD and RH were assessed following a period of suprasystolic cuff occlusion. Briefly, a rapid inflation cuff was secured just distal to the antecubital fossa for arterial occlusion. Blood velocity (Vmean; cm ∙ s-1) and vessel diameter (d; mm) were measured continuously via high-resolution, duplex Doppler ultrasound during a 2-min baseline, 5-min of cuff occlusion, and 3-min of recovery. FMD was determined as the percent dilation from baseline (%FMD) while RH was determined as the peak and area under the curve (AUC) responses for shear rate (8 ∙ Vmean ∙ d-1) and blood flow (Vmean ∙ π ∙ (d ∙ 20-1)2 ∙ 60). Cutaneous thermal reactivity was assessed using laser-Doppler flowmetry during a standard LH protocol and reported as cutaneous vascular conductance (CVC; red blood cell flux/mean arterial pressure). Following a baseline with local skin temperature clamped at 33°C, a 39°C heat stimulus was applied to induce cutaneous vasodilation for ~30-min. The sustained vasodilation at the end of heating is predominantly nitric oxide mediated and provides an index of microvascular function. As the LH component served as part of a larger intradermal microdialysis protocol, maximal blood flow responses were elicited via combined intradermal sodium nitroprusside (28mM) infusion and 43°C heating. CVC during the 39°C plateau was normalized to maximal CVC (%CVCmax) to account for intersite variability. Pearson correlations were then performed between the FMD, RH, and LH responses. RESULTS: Significant relationships were observed between %FMD and shear AUC (r = 0.89; P = 0.02), and blood flow AUC (r = 0.92; P = 0.01) in WW, but not in BW (r = 0.63; P = 0.18 and r = -0.24; P = 0.65, respectively). However, neither FMD nor RH correlated with the cutaneous blood flow responses to LH (P \u3e 0.05) in either WW or BW. CONCLUSION: These preliminary data suggest that FMD is highly correlated to some indices of RH in WW, but that this relationship does not hold in BW. Further, there appears to be no relationship between microvascular function as assessed by RH and LH in either population

The celebrification of farmers: celebrity and the new politics of farming

Michelle Phillipov and Michael K. Goodma