1,286 research outputs found
"Targeted disruption of the epithelial-barrier by Helicobacter pylori"
Helicobacter pylori colonizes the human gastric epithelium and induces chronic gastritis, which can lead to gastric cancer. Through cell-cell contacts the gastric epithelium forms a barrier to protect underlying tissue from pathogenic bacteria; however, H. pylori have evolved numerous strategies to perturb the integrity of the gastric barrier. In this review, we summarize recent research into the mechanisms through which H. pylori disrupts intercellular junctions and disrupts the gastric epithelial barrier
Factors Associated with the Diversification of the Gut Microbial Communities within Chimpanzees from Gombe National Park.
The gastrointestinal tract harbors large and diverse populations of bacteria that vary among individuals and within individuals over time. Numerous internal and external factors can influence the contents of these microbial communities, including diet, geography, physiology, and the extent of contact among hosts. To investigate the contributions of such factors to the variation and changes in gut microbial communities, we analyzed the distal gut microbiota of individual chimpanzees from two communities in Gombe National Park, Tanzania. These samples, which were derived from 35 chimpanzees, many of whom have been monitored for multiple years, provide an unusually comprehensive longitudinal depth for individuals of known genetic relationships. Although the composition of the great-ape microbiota has been shown to codiversify with host species, indicating that host genetics and phylogeny have played a major role in its differentiation over evolutionary timescales, the geneaological relationships of individual chimpanzees did not coincide with the similarity in their gut microbial communities. However, the inhabitants from adjacent chimpanzee communities could be distinguished based on the contents of their gut microbiota. Despite the broad similarity of community members, as would be expected from shared diet or interactions, long-term immigrants to a community often harbored the most distinctive gut microbiota, suggesting that individuals retain hallmarks of their previous gut microbial communities for extended periods. This pattern was reinforced in several chimpanzees sampled over long temporal scales, in which the major constituents of the gut microbiota were maintained for nearly a decade
Beam Propagation Through Atmospheric Turbulence Using an Altitude-Dependent Structure Profile with Non-Uniformly Distributed Phase Screens
Modeling the effects of atmospheric turbulence on optical beam propagation is a key element in the design and analysis of free-space optical communication systems. Numerical wave optics simulations provide a particularly useful technique for understanding the degradation of the optical field in the receiver plane when the analytical theory is insufficient for characterizing the atmospheric channel. Motivated by such an application, we use a split-step method modeling the turbulence along the propagation path as a series of thin random phase screens with modified von Karman refractive index statistics using the Hufnagel-Valley turbulence profile to determine the effective structure constant for each screen. In this work, we employ a space-to-ground case study to examine the irradiance and phase statistics for both uniformly and non-uniformly spaced screens along the propagation path and compare to analytical results. We find that better agreement with the analytical theory is obtained using a non-uniform spacing with the effective structure constant for each screen chosen to minimize its contribution to the scintillation in the receiver plane. We evaluate this method as a flexible alternative to other standard layered models used in astronomical imaging applications
Beam Propagation Through Atmospheric Turbulence Using an Altitude-Dependent Structure Profile with Non-Uniformly Distributed Phase Screens
For free-space optical communication systems, numerical wave optics simulations provide a useful technique for modeling turbulence-induced beam degradation when the analytical theory is insufficient for characterizing the atmospheric channel. Motivated by such applications we use a split-step method modeling the turbulence as a series of random phase screens using the Hufnagel-Valley turbulence profile. We employ a space-to-ground case study to examine the irradiance and phase statistics for uniformly and non-uniformly located screens and find better agreement with theory using a non-uniform discretization minimizing the contribution of each screen to the total scintillation. In this poster, we summarize the method and the results of the case study including a comparison to layered models used in astronomical imaging applications
Prediction and experimental evaluation of planar wing spanloads for minimum drag
Optimum wing spanloads were evaluated by comparing wing performance values from theoretical predictions and experimental wind-tunnel measurements. The optimum spanloads were found using a Lagrange multiplier optimization method. They were designed with a prescribed wing-root bending moment constraint with and without incorporating viscous representation. Wind-tunnel models were created based on the optimum spanloads and the experiments were conducted to evaluate the changes in drag as the design constraints differed. The results indicate that an optimized spanload having equal lift and wing-root bending moment to that of an elliptically-loaded wing can experience significant decreases in drag. Comparisons between the theoretical predictions and the wind-tunnel models were made using experimental 5-hole probe wake-survey measurements, which were reduced into total lift and drag, as well as spanwise lift distributions
Impact of a brief faculty training to improve patient-centered communication while using electronic health records
Objective
Despite rapid EHR adoption, few faculty receive training in how to implement patient-centered communication skills while using computers in exam rooms. We piloted a patient-centered EHR use training to address this issue.
Methods
Faculty received four hours of training at Cleveland Clinic and a condensed 90-minute version at the University of Chicago. Both included a lecture and a Group-Objective Structured Clinical Exam (GOSCE) experience. Direct observations of 10 faculty in their clinical practices were performed pre- and post-workshop.
Results
Thirty participants (94%) completed a post-workshop evaluation assessing knowledge, attitude, and skills. Faculty reported that training was important, relevant, and should be required for all providers; no differences were found between longer versus shorter training. Participants in the longer training reported higher GOSCE efficacy, however shorter workshop participants agreed more with the statement that they had gained new knowledge. Faculty improved their patient-centered EHR use skills in clinical practice on post- versus pre-workshop ratings using a validated direct-observation rating tool.
Conclusion
A brief lecture and GOSCE can be effective in training busy faculty on patient-centered EHR use skills.
Practice Implications
Faculty training on patient-centered EHR skills can enhance patient-doctor communication and promotes positive role modeling of these skills to learners
Temperature mapping above and below air film-cooled thermal barrier coatings using phosphor thermometry
Thermal barrier coatings (TBCs) are typically used in conjunction with air film cooling to maximize overall cooling effectiveness and reliability while minimizing sacrifices in engine performance. The effects of thermal barrier coating (TBC) thermal protection and air film cooling effectiveness have usually been studied separately; however, their contributions to combined cooling effectiveness are interdependent and are not simply additive. The combined cooling effectiveness is always less than the sum of the cooling effectiveness of stand-alone TBC protection and stand-alone air film cooling. These diminishing returns arise because adding the thermally insulating TBC between the cooling air and the surface to be cooled reduces the air film cooling effectiveness and because the air film cooling reduces the heat flux through the TBC and therefore reduces the temperature difference sustained across the TBC thickness. Due to these considerations, combined cooling effectiveness must be measured to achieve an optimum balance between TBC thermal protection and air film cooling. In this investigation, temperature mapping above and below air film-cooled TBCs was performed using luminescence lifetime imaging-based phosphor thermometry. Measurements were performed in the NASA GRC Mach 0.3 burner rig on a TBC-coated plate using a scaled-up cooling hole geometry where both the hot mainstream gas temperature and the blowing ratio were varied. Surface temperature maps were obtained from a Cr-doped GdAlO3 thermographic phosphor deposited on the surface of the electron-beam vapor-deposited yttria-stabilized zirconia (YSZ) TBC. From separate plates, temperature maps from the bottom of the TBC were obtained from a thin Er-doped YSZ layer integrated into the TBC below the overlying undoped YSZ. Procedures for temperature and cooling effectiveness mapping above and below the air film-cooled TBC surface are described. Most importantly, these measurements enable mapping the combined cooling effectiveness below the TBC, which is more important than surface cooling effectiveness when there is a barrier coating between the hot mainstream gas and the surface that needs thermal protection. Advantages of the luminescence lifetime imaging method over infrared thermography, as well as its limitations to steady-state conditions are discussed
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Diagnostic Performance of Ultrasonography-Based Risk Models in Differentiating Between Benign and Malignant Ovarian Tumors in a US Cohort
Importance: Ultrasonography-based risk models can help nonexpert clinicians evaluate adnexal lesions and reduce surgical interventions for benign tumors. Yet, these models have limited uptake in the US, and studies comparing their diagnostic accuracy are lacking. Objective: To evaluate, in a US cohort, the diagnostic performance of 3 ultrasonography-based risk models for differentiating between benign and malignant adnexal lesions: International Ovarian Tumor Analysis (IOTA) Simple Rules with inconclusive cases reclassified as malignant or reevaluated by an expert, IOTA Assessment of Different Neoplasias in the Adnexa (ADNEX), and Ovarian-Adnexal Reporting and Data System (O-RADS). Design, setting, and participants: This retrospective diagnostic study was conducted at a single US academic medical center and included consecutive patients aged 18 to 89 years with adnexal masses that were managed surgically or conservatively between January 2017 and October 2022. Exposure: Evaluation of adnexal lesions using the Simple Rules, ADNEX, and O-RADS. Main outcomes and measures: The main outcome was diagnostic performance, including area under the receiver operating characteristic (ROC) curve (AUC), sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios. Surgery or follow-up were reference standards. Secondary analyses evaluated the models' performances stratified by menopause status and race. Results: The cohort included 511 female patients with a 15.9% malignant tumor prevalence (81 patients). Mean (SD) ages of patients with benign and malignant adnexal lesions were 44.1 (14.4) and 52.5 (15.2) years, respectively, and 200 (39.1%) were postmenopausal. In the ROC analysis, the AUCs for discriminative performance of the ADNEX and O-RADS models were 0.96 (95% CI, 0.93-0.98) and 0.92 (95% CI, 0.90-0.95), respectively. After converting the ADNEX continuous individualized risk into the discrete ordinal categories of O-RADS, the ADNEX performance was reduced to an AUC of 0.93 (95% CI, 0.90-0.96), which was similar to that for O-RADS. The Simple Rules combined with expert reevaluation had 93.8% sensitivity (95% CI, 86.2%-98.0%) and 91.9% specificity (95% CI, 88.9%-94.3%), and the Simple Rules combined with malignant classification had 93.8% sensitivity (95% CI, 86.2%-98.0%) and 88.1% specificity (95% CI, 84.7%-91.0%). At a 10% risk threshold, ADNEX had 91.4% sensitivity (95% CI, 83.0%-96.5%) and 86.3% specificity (95% CI, 82.7%-89.4%) and O-RADS had 98.8% sensitivity (95% CI, 93.3%-100%) and 74.4% specificity (95% CI, 70.0%-78.5%). The specificities of all models were significantly lower in the postmenopausal group. Subgroup analysis revealed high performances independent of race. Conclusions and relevance: In this diagnostic study of a US cohort, the Simple Rules, ADNEX, and O-RADS models performed well in differentiating between benign and malignant adnexal lesions; this outcome has been previously reported primarily in European populations. Risk stratification models can lead to more accurate and consistent evaluations of adnexal masses, especially when used by nonexpert clinicians, and may reduce unnecessary surgeries.</p
Two to Tango: Co-evolution of Hominid Natural Killer Cell Receptors and MHC
Natural killer (NK) cells have diverse roles in hominid immunity and reproduction. Modulating these functions are the interactions between major histocompatibility complex (MHC) class I molecules that are ligands for two NK cell surface receptor types. Diverse killer cell immunoglobulin-like receptors (KIR) bind specific motifs encoded within the polymorphic MHC class I cell surface glycoproteins, while, in more conserved interactions, CD94:NKG2A receptors recognize MHC-E with bound peptides derived from MHC class I leader sequences. The hominid lineage presents a choreographed co-evolution of KIR with their MHC class I ligands. MHC-A, -B, and -C are present in all great apes with species-specific haplotypic variation in gene content. The Bw4 epitope recognized by lineage II KIR is restricted to MHC-B but also present on some gorilla and human MHC-A. Common to great apes, but rare in humans, are MHC-B possessing a C1 epitope recognized by lineage III KIR. MHC-C arose from duplication of MHC-B and is fixed in all great apes except orangutan, where it exists on approximately 50% of haplotypes and all allotypes are C1-bearing. Recent study showed that gorillas possess yet another intermediate MHC organization compared to humans. Like orangutans, but unlike the Pan-Homo species, duplication of MHC-B occurred. However, MHC-C is fixed, and the MHC-C C2 epitope (absent in orangutans) emerges. The evolution of MHC-C drove expansion of its cognate lineage III KIR. Recently, position −21 of the MHC-B leader sequence has been shown to be critical in determining NK cell educational outcome. In humans, methionine (−21M) results in CD94:NKG2A-focused education whereas threonine (−21T) produces KIR-focused education. This is another dynamic position among hominids. Orangutans have exclusively −21M, consistent with their intermediate stage in lineage III KIR-focused evolution. Gorillas have both −21M and −21T, like humans, but they are unequally encoded by their duplicated B genes. Chimpanzees have near-fixed −21T, indicative of KIR-focused NK education. Harmonious with this observation, chimpanzee KIR exhibit strong binding and, compared to humans, smaller differences between binding levels of activating and inhibitory KIR. Consistent between these MHC-NK cell receptor systems over the course of hominid evolution is the evolution of polymorphism favoring the more novel and dynamic KIR system
Demonstration Advanced Avionics System (DAAS) function description
The Demonstration Advanced Avionics System, DAAS, is an integrated avionics system utilizing microprocessor technologies, data busing, and shared displays for demonstrating the potential of these technologies in improving the safety and utility of general aviation operations in the late 1980's and beyond. Major hardware elements of the DAAS include a functionally distributed microcomputer complex, an integrated data control center, an electronic horizontal situation indicator, and a radio adaptor unit. All processing and display resources are interconnected by an IEEE-488 bus in order to enhance the overall system effectiveness, reliability, modularity and maintainability. A detail description of the DAAS architecture, the DAAS hardware, and the DAAS functions is presented. The system is designed for installation and flight test in a NASA Cessna 402-B aircraft
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