Glucagon-Like Peptide 1 Receptor Activation Augments Cardiac Output and Improves Cardiac Efficiency in Obese Swine After Myocardial Infarction

This study tested the hypothesis that glucagon-like peptide 1 (GLP-1) therapies improve cardiac contractile function at rest and in response to adrenergic stimulation in obese swine after myocardial infarction. Obese Ossabaw swine were subjected to gradually developing regional coronary occlusion using an ameroid occluder placed around the left anterior descending coronary artery. Animals received subcutaneous injections of saline or liraglutide (0.005-0.015 mg/kg/day) for 30 days after ameroid placement. Cardiac performance was assessed at rest and in response to sympathomimetic challenge (dobutamine 0.3-10 μg/kg/min) using a left ventricular pressure/volume catheter. Liraglutide increased diastolic relaxation (dP/dt; Tau 1/2; Tau 1/e) during dobutamine stimulation (P < 0.01) despite having no influence on the magnitude of myocardial infarction. The slope of the end-systolic pressure volume relationship (i.e., contractility) increased with dobutamine after liraglutide (P < 0.001) but not saline administration (P = 0.63). Liraglutide enhanced the slope of the relationship between cardiac power and pressure volume area (i.e., cardiac efficiency) with dobutamine (P = 0.017). Hearts from animals treated with liraglutide demonstrated decreased β1-adrenoreceptor expression. These data support that GLP-1 agonism augments cardiac efficiency via attenuation of maladaptive sympathetic signaling in the setting of obesity and myocardial infarction

A Multidisciplinary Approach to Pancreas Cancer in 2016: A Review

In this article, we review our multidisciplinary approach for patients with pancreatic cancer. Specifically, we review the epidemiology, diagnosis and staging, biliary drainage techniques, selection of patients for surgery, chemotherapy, radiation therapy, and discuss other palliative interventions. The areas of active research investigation and where our knowledge is limited are emphasized

A RESTFUL service for aggregating state-based user performance data in simulator scenarios

Simulators often implement their own solution for aggregating and saving user performance data. Aggregating user performance data from simulators that execute on many different machines can be a pain for researchers and the data is often saved in one format that can be hard to translate to others. A framework is proposed to provide re-usable scenario initialization and user performance data aggregation functionality to simulators. A RESTful web service is proposed to aggregate and store the user performance data in the cloud for later retrieval for analysis and evaluation. Two simulator clients built with Unity3D are developed for validation of the web service. Preliminary results show that the web service offers good performance and data integrity, but is still a work in progress

Development of augmented reality training simulator systems for neurosurgery using model-driven software engineering

Neurosurgical procedures are complicated processes, providing challenges and demands ranging from medical knowledge and judgment to the neurosurgeons dexterity and perceptual capacities. Deliberate training of common neurosurgical procedures and underlying tasks is extremely important. One effective method for the training is to enhance the required surgical training tasks through the use of neurosurgical simulators. Development of neurosurgical simulators is challenging due to many reasons. In this work, we proposed to facilitate the development of new augmented reality neurosurgical simulator systems through the adoption of model-driven engineering. Our developed systems involve the interactive visualization of three-dimension brain meshes in order to train users and simulate a targeting task towards a variety of predetermined virtual targets. We present our results in a way which highlights two new design artifacts through our MDE approach

Endoscopie neurosurgery simulation: Implementation on the evolution engine

The design and evaluation of Neurosurgical simulators has heretofore emphasized the training of \u27surgical technical skills\u27. Such commercial platforms generally exercise tool use and other low level sensori-motor tasks such as targeting and navigation for training surgical residents. We report on the development of a set of modules implemented within Digital Extreme\u27s Evolution Engine, making use of game assets that are derived from pre-operative clinical scans. The simulator exercises trainees spatial reasoning skills in targeting based on ortho-planar and endoscopie views. The technical exposition presented here covers the extension of the game engine to support in-scene endoscopie cameras, and in-scene display monitors that are situated in view of the avatar, and by extension, visible to the surgical trainee while engaged in the surgical scenario

Surgical simulation workflow representation using hierarchical task analysis and statecharts: Implementation on the evolution engine

The Healthcare services providers and medical schools have only recently recognized the potential of simulation as a training tool, focusing primarily on realistic standardized-patient simulations (for problem solving and decision-making skills) and task trainers and immersive simulations (for surgical skills). We are making use of Game Engine tools for developing virtual-world scenarios for emergent events to train and evaluate the higher decision-making skills in endoscopie tasks, including situational assessment of OR displays and communications within the OR team. A critical component of this design activity is to capture the surgical workflow using a hierarchical task analysis that can provide a representation for the scenarios implemented in simulation using game engine scripting tools. We have developed a methodology based on Statecharts that shortens development time by making use of state-based patterns, extended to support task hierarchies

Metrics for assessing cytoskeletal orientational correlations and consistency.

In biology, organization at multiple scales potentiates biological function. Current advances in staining and imaging of biological tissues provide a wealth of data, but there are few metrics to quantitatively describe these findings. In particular there is a need for a metric that would characterize the correlation and consistency of orientation of different biological constructs within a tissue. We aimed to create such a metric and to demonstrate its use with images of cardiac tissues. The co-orientational order parameter (COOP) was based on the mathematical framework of a classical parameter, the orientational order parameter (OOP). Theorems were proven to illustrate the properties and boundaries of the COOP, which was then applied to both synthetic and experimental data. We showed the COOP to be useful for quantifying the correlation of orientation of constructs such as actin filaments and sarcomeric Z-lines. As expected, cardiac tissues showed perfect correlation between actin filaments and Z-lines. We also demonstrated the use of COOP to quantify the consistency of construct orientation within cells of the same shape. The COOP provides a quantitative tool to characterize tissues beyond co-localization or single construct orientation distribution. In the future, this new parameter could be used to represent the quantitative changes during maturation of cardiac tissue, pathological malformation, and other processes

Metrics for assessing cytoskeletal orientational correlations and consistency.

In biology, organization at multiple scales potentiates biological function. Current advances in staining and imaging of biological tissues provide a wealth of data, but there are few metrics to quantitatively describe these findings. In particular there is a need for a metric that would characterize the correlation and consistency of orientation of different biological constructs within a tissue. We aimed to create such a metric and to demonstrate its use with images of cardiac tissues. The co-orientational order parameter (COOP) was based on the mathematical framework of a classical parameter, the orientational order parameter (OOP). Theorems were proven to illustrate the properties and boundaries of the COOP, which was then applied to both synthetic and experimental data. We showed the COOP to be useful for quantifying the correlation of orientation of constructs such as actin filaments and sarcomeric Z-lines. As expected, cardiac tissues showed perfect correlation between actin filaments and Z-lines. We also demonstrated the use of COOP to quantify the consistency of construct orientation within cells of the same shape. The COOP provides a quantitative tool to characterize tissues beyond co-localization or single construct orientation distribution. In the future, this new parameter could be used to represent the quantitative changes during maturation of cardiac tissue, pathological malformation, and other processes

Metrics for Assessing Cytoskeletal Orientational Correlations and Consistency

In biology, organization at multiple scales potentiates biological function. Current advances in staining and imaging of biological tissues provide a wealth of data, but there are few metrics to quantitatively describe these findings. In particular there is a need for a metric that would characterize the correlation and consistency of orientation of different biological constructs within a tissue. We aimed to create such a metric and to demonstrate its use with images of cardiac tissues. The co-orientational order parameter (COOP) was based on the mathematical framework of a classical parameter, the orientational order parameter (OOP). Theorems were proven to illustrate the properties and boundaries of the COOP, which was then applied to both synthetic and experimental data. We showed the COOP to be useful for quantifying the correlation of orientation of constructs such as actin filaments and sarcomeric Z-lines. As expected, cardiac tissues showed perfect correlation between actin filaments and Z-lines. We also demonstrated the use of COOP to quantify the consistency of construct orientation within cells of the same shape. The COOP provides a quantitative tool to characterize tissues beyond co-localization or single construct orientation distribution. In the future, this new parameter could be used to represent the quantitative changes during maturation of cardiac tissue, pathological malformation, and other processes

In vitro and in vivo activity of voriconazole and benznidazole combination on trypanosoma cruzi infection models

Combination therapy has been proposed as an ideal strategy to reduce drug toxicity and improve treatment efficacy in Chagas disease. Previously, we demonstrated potent in vivo anti-Trypanosoma cruzi activity of voriconazole. In this work, we aimed to study the synergistic effect of voriconazole (VCZ) and benznidazole (BZ) both in vitro and in vivo models of T. cruzi infection using the Tulahuen strain. Combining VCZ and BZ at fixed concentrations, the inhibitory concentration 50% (I