Endothelial barrier dysfunction in diabetic conduit arteries: a novel method to quantify filtration

The endothelial barrier plays an important role in atherosclerosis, hyperglycemia, and hypercholesterolemia. In the present study, an accurate, reproducible, and user-friendly method was used to further understand endothelial barrier function of conduit arteries. An isovolumic method was used to measure the hydraulic conductivity (Lp) of the intact vessel wall and medial-adventitial layer. Normal arterial segments with diameters from 0.2 to 5.5 mm were used to validate the method, and femoral arteries of diabetic rats were studied as an example of pathological specimens. Various arterial segments confirmed that the volume flux of water per unit surface area was linearly related to intraluminal pressure, as confirmed in microvessels. Lp of the intact wall varied from 3.5 to 22.1 × 10−7 cm·s−1·cmH2O−1 over the pressure range of 7–180 mmHg. Over the same pressure range, Lp of the endothelial barrier changed from 4.4 to 25.1 × 10−7 cm·s−1·cmH2O−1. During perfusion with albumin-free solution, Lp of rat femoral arteries increased from 6.1 to 13.2 × 10−7 cm·s−1·cmH2O−1 over the pressure range of 10–180 mmHg. Hyperglycemia increased Lp of the femoral artery in diabetic rats from 2.9 to 5.5 × 10−7 cm·s−1·cmH2O−1 over the pressure range of 20–135 mmHg. In conclusion, the Lp of a conduit artery can be accurately and reproducibly measured using a novel isovolumic method, which in diabetic rats is hyperpermeable. This is likely due to disruption of the endothelial glycocalyx

Identification of Adolescents with Adiposities and Elevated Blood Pressure and Implementation of Preventive Measures Warrants the Use of Multiple Clinical Assessment Tools.

The burden of abdominal adiposity has increased globally, which is recognized as a key condition for the development of obesity-related disorders among youth, including type 2 diabetes, cardiovascular disease, and hypertension. High blood pressure (BP) and cardiovascular diseases increase the rates of premature mortality and morbidity substantially. Aims: to investigate the relation between abdominal adiposity and elevated BP among adolescent males in Jordan. Methods: Nationally representative sample of male adolescents was selected using multi-cluster sampling technique. Study sample included 1035 adolescent males aged 12 to 17 years. Multiple indicators were used to assess adiposity including waist circumference (WC) and total body fat (TF), truncal fat (TrF), and visceral fat (VF). Systolic blood pressure was measured to assess hypertension. Results: After adjusting for age, smoking status, and physical activity, the odds of having stage two hypertension increased 6, 7, and 8 times for adolescents who were on 90th percentile or above for Trf, VF, and WC, respectively. Conclusion: Elevated BP was significantly associated with total and abdominal adiposity among adolescent males in Jordan. Use of multiple clinical assessment tools is essential to assess abdominal obesity among adolescents

Measuring medical students' professional competencies in a problem-based curriculum: A reliability study

Identification and assessment of professional competencies for medical students is challenging. We have recently developed an instrument for assessing the essential professional competencies for medical students in Problem-Based Learning (PBL) programs by PBL tutors. This study aims to evaluate the reliability and validity of professional competency scores of medical students using this instrument in PBL tutorials. Methods: Each group of seven to eight students in PBL tutorials (Year 2, n = 46) were assessed independently by two faculty members. Each tutor assessed students in his/her group every five weeks on four occasions. The instrument consists of ten items, which measure three main competency domains: interpersonal, cognitive and professional behavior. Each item is scored using a five-point Likert scale (1 = poor, 5 = exceptional). Reliability of professional competencies scores was calculated using G-theory with raters nested in occasions. Furthermore, criterion-related validity was measured by testing the correlations with students' scores in written examination. Results: The overall generalizability coefficient (G) of the professional competency scores was 0.80. Students' professional competencies scores (universe scores) accounted for 27% of the total variance across all score comparisons. The variance due to occasions accounted for 10%, while the student-occasion interaction was zero. The variance due to raters to occasions represented 8% of the total variance, and the remaining 55% of the variance was due to unexplained sources of error. The highest reliability measured was the interpersonal domain (G = 0.84) and the lowest reliability was the professional behavior domain (G = 0.76). Results from the decision (D) study suggested that an adequate dependability (G = 0.71) can be achieved by using one rater for five occasions. Furthermore, there was a positive correlation between the written examination scores and cognitive competencies scores (r = 0.46, P < 0.01), but not with the other two competency domains (interpersonal and professionalism). Conclusions: This study demonstrates that professional competency assessment scores of medical students in PBL tutorials have an acceptable reliability. Further studies for validating the instrument are required before using it for summative evaluation of students by PBL tutors.Scopu

Identificación de parvovirus canino tipo 2C en cachorros de Nicaragua

Objetivo. Identificar los genotipos de parvovirus canino-circulantes en cachorros en dos municipios de Nicaragua. Materiales y métodos. Se recolectaron muestras por hisopado rectal de 45 cachorros con y sin antecedentes de vacunación, con menos 6 meses de edad, con y sin sintomatología compatible con parvovirosis. Las muestras y dos de las vacunas que se comercializan en Nicaragua (vacuna nº1 y vacuna nº2) fueron analizadas por Reacción en Cadena de la Polimerasa (PCR) convencional para un producto de ˜ 630 pb del gen VP2. Además, se secuenciaron en sentido inverso cuatro muestras de campo elegidas al azar y ambas cepas de vacunas. Resultados. El 28.9% (13/45) de las muestras analizadas fueron positivas en PCR. No se encontraron diferencias significativas en la detección por PCR del fragmento de VP2, respecto al estado de vacunación de los animales (p=0.05). Las cuatro muestras de campo secuenciadas fueron identificadas como genotipo CPV-2C y las dos cepas vacunales se identificaron como genotipo CPV-2A. Conclusiones. La inferencia evolutiva de las secuencias alineadas de cepas vacunales mostró alta divergencia evolutiva respecto a las cepas de campo. Este hallazgo lleva a replantear el tema sobre la eficacia de las vacunas analizadas en este trabajo y que son aplicadas en Nicaragua. Objective. To identify genotypes of canine parvovirus circulating in puppies in two municipalities of Nicaragua. Materials and methods. Rectal swab samples from 45 puppies less under 6 months of age were collected and processed for presence of parvovirus bur conventional PCR technique. Puppies might or not have been vaccinated and with or without parvovirus infection symptoms. Two commercially available parvovirus vaccines in Nicaragua (vaccine no1 and vaccine no2) were also analyzed by conventional Polymerase Chain Reaction (PCR) resulting in a product of approximate to 630 bp of the VP2 gene. In addition, Sanger sequences of four randomly chosen field samples and both vaccine strains were obtained. Results. 28.9% (13/45) of the analyzed samples were positive by PCR, for CPV VP2 gene. No statistically significant differences (p >= 0.05) were obtained in PCR detection between dogs with or without vaccination history. The four sequenced field samples were identified as CPV-2C genotype while both vaccine strains were identified as CPV-2A genotype. Conclusions. The aligned sequences showed high evolutionary divergence of filed strains with respect to vaccines strains, leading us to reconsider the efficacy of the analyzed vaccines commercially available in Nicaragua nowadays

Geometry of River Networks II: Distributions of Component Size and Number

The structure of a river network may be seen as a discrete set of nested sub-networks built out of individual stream segments. These network components are assigned an integral stream order via a hierarchical and discrete ordering method. Exponential relationships, known as Horton's laws, between stream order and ensemble-averaged quantities pertaining to network components are observed. We extend these observations to incorporate fluctuations and all higher moments by developing functional relationships between distributions. The relationships determined are drawn from a combination of theoretical analysis, analysis of real river networks including the Mississippi, Amazon and Nile, and numerical simulations on a model of directed, random networks. Underlying distributions of stream segment lengths are identified as exponential. Combinations of these distributions form single-humped distributions with exponential tails, the sums of which are in turn shown to give power law distributions of stream lengths. Distributions of basin area and stream segment frequency are also addressed. The calculations identify a single length-scale as a measure of size fluctuations in network components. This article is the second in a series of three addressing the geometry of river networks.Comment: 16 pages, 13 figures, 4 tables, Revtex4, submitted to PR

A Fast Sequential Learning Technique for Real Circuits with Application to Enhancing ATPG Performance

This paper presents an efficient and novel method for sequential learning of implications, invalid states, and tied gates. It can handle real industrial circuits, with multiple clock domains and partial set/reset. The application of this method to improve the efficiency of sequential ATPG is also demonstrated by achieving higher fault coverages and lower test generation times

Comparison of bacterial maxillary sinus cultures between odontogenic sinusitis and chronic rhinosinusitis

BACKGROUND: Bacterial odontogenic sinusitis (ODS) is distinct from other forms of rhinosinusitis. Diagnosing ODS can be challenging because of nonspecific clinical presentations and underrepresentation in the literature. The purpose of this study was to compare maxillary sinus bacterial cultures between patients with ODS and chronic rhinosinusitis (CRS), to determine whether certain bacteria are associated with ODS. METHODS: This was a retrospective case-control study of 276 consecutive patients from August 2015 to August 2019 who underwent endoscopic sinus surgery (ESS) for bacterial ODS, CRS without nasal polyps (CRSsNP), or CRS with nasal polyps (CRSwNP). When present, pus was sterilely cultured from maxillary sinuses after maxillary antrostomy, and aerobic and anaerobic cultures were immediately sent for processing. Demographics and culture results were compared between ODS and CRS patients, and then separately between ODS and CRSsNP, and ODS and CRSwNP. ODS culture results were also compared between different dental pathologies (endodontic vs oroantral fistula). RESULTS: The following bacteria were significantly more likely in ODS compared to CRS: mixed anaerobes, Fusobacterium spp., Eikenella corrodens, Streptococcus intermedius, Streptococcus anginosus, and Streptococcus constellatus. Staphylococcus aureus and Pseudomonas aeruginosa were inversely related to ODS. There were no significant differences in cultures between the different dental pathologies. CONCLUSION: Certain bacteria were more likely to be associated with ODS compared to CRS when purulence was cultured from the maxillary sinus. Physicians should evaluate for an odontogenic source of sinusitis when these ODS-associated bacteria are identified in maxillary sinus cultures

Measuring medical students' professional competencies in a problem-based curriculum: A reliability study

Background: Identification and assessment of professional competencies for medical students is challenging. We have recently developed an instrument for assessing the essential professional competencies for medical students in Problem-Based Learning (PBL) programs by PBL tutors. This study aims to evaluate the reliability and validity of professional competency scores of medical students using this instrument in PBL tutorials. Methods: Each group of seven to eight students in PBL tutorials (Year 2, n = 46) were assessed independently by two faculty members. Each tutor assessed students in his/her group every five weeks on four occasions. The instrument consists of ten items, which measure three main competency domains: interpersonal, cognitive and professional behavior. Each item is scored using a five-point Likert scale (1 = poor, 5 = exceptional). Reliability of professional competencies scores was calculated using G-theory with raters nested in occasions. Furthermore, criterion-related validity was measured by testing the correlations with students’ scores in written examination. Results: The overall generalizability coefficient (G) of the professional competency scores was 0.80. Students’ professional competencies scores (universe scores) accounted for 27% of the total variance across all score comparisons. The variance due to occasions accounted for 10%, while the student-occasion interaction was zero. The variance due to raters to occasions represented 8% of the total variance, and the remaining 55% of the variance was due to unexplained sources of error. The highest reliability measured was the interpersonal domain (G = 0.84) and the lowest reliability was the professional behavior domain (G = 0.76). Results from the decision (D) study suggested that an adequate dependability (G = 0.71) can be achieved by using one rater for five occasions. Furthermore, there was a positive correlation between the written examination scores and cognitive competencies scores (r = 0.46, P < 0.01), but not with the other two competency domains (interpersonal and professionalism). Conclusions: This study demonstrates that professional competency assessment scores of medical students in PBL tutorials have an acceptable reliability. Further studies for validating the instrument are required before using it for summative evaluation of students by PBL tutors

Inverse VoF Meshless method for efficient non-destructive thermographic evaluation

Paper presented to the 10th International Conference on Heat Transfer, Fluid Mechanics and Thermodynamics, Florida, 14-16 July 2014.A novel computational tool based on the Localized Radial-basis Function (RBF) Collocation (LRC) Meshless method coupled with a Volume-of-Fluid (VoF) scheme capable of accurately and efficiently solving transient multi-dimensional heat conduction problems in composite and heterogeneous media is formulated and implemented. While the LRC Meshless method lends its inherent advantages of spectral convergence and ease of automation, the VoF scheme allows to effectively and efficiently simulate the location, size, and shape of cavities, voids, inclusions, defects, or de-attachments in the conducting media without the need to regenerate point distributions, boundaries, or interpolation matrices. To this end, the Inverse Geometric problem of Cavity Detection can be formulated as an optimization problem that minimizes an objective function that computes the deviation of measured temperatures at accessible locations to those generated by the LRC-VoF Meshless method. The LRC-VoF Meshless algorithms will be driven by an optimization code based on the Simplex Linear Programming algorithm which can efficiently search for the optimal set of design parameters (location, size, shape, etc.) within a predefined design space. Initial guesses to the search algorithm will be provided by the classical 1D semi-infinite composite analytical solution which can predict the approximate location of the cavity. The LRC-VoF formulation is tested and validated through a series of controlled numerical experiments. The proposed approach will allow solving the onerous computational inverse geometric problem in a very efficient and robust manner while affording its implementation in modest computational platforms, thereby realizing the disruptive potential of the proposed multidimensional high-fidelity non-destructive evaluation (NDE) method.cf201

Comparison of four mathematical models to analyze indicator-dilution curves in the coronary circulation

While several models have proven to result in accurate estimations when measuring cardiac output using indicator dilution, the mono-exponential model has primarily been chosen for deriving coronary blood/plasma volume. In this study, we compared four models to derive coronary plasma volume using indicator dilution; the mono-exponential, power-law, gamma-variate, and local density random walk (LDRW) model. In anesthetized goats (N = 14), we determined the distribution volume of high molecular weight (2,000 kDa) dextrans. A bolus injection (1.0 ml, 0.65 mg/ml) was given intracoronary and coronary venous blood samples were taken every 0.5–1.0 s; outflow curves were analyzed using the four aforementioned models. Measurements were done at baseline and during adenosine infusion. Absolute coronary plasma volume estimates varied by ~25% between models, while the relative volume increase during adenosine infusion was similar for all models. The gamma-variate, LDRW, and mono-exponential model resulted in volumes corresponding with literature, whereas the power-model seemed to overestimate the coronary plasma volume. The gamma-variate and LDRW model appear to be suitable alternative models to the mono-exponential model to analyze coronary indicator-dilution curves, particularly since these models are minimally influenced by outliers and do not depend on data of the descending slope of the curve only