Laryngoscopic Image Stitching for View Enhancement and Documentation - First Experiences

One known problem within laryngoscopy is the spatially limited view onto the hypopharynx and the larynx through the endoscope. To examine the complete larynx and hypopharynx, the laryngoscope can be rotated about its main axis, and hence the physician obtains a complete view. If such examinations are captured using endoscopic video, the examination can be reviewed in detail at a later time. Nevertheless, in order to document the examination with a single representative image, a panorama image can be computed for archiving and enhanced documentation. Twenty patients with various clinical findings were examined with a 70 rigid laryngoscope, and the video sequences were digitally stored. The image sequence for each patient was then post-processed using an image stitching tool based on SIFT features, the RANSAC approach and blending. As a result, endoscopic panorama images of the larynx and pharynx were obtained for each video sequence. The proposed approach of image stitching for laryngoscopic video sequences offers a new tool for enhanced visual examination and documentation of morphologic characteristics of the larynx and the hypopharynx

Anti-inflammatory activity of Wnt signaling in enteric nervous system: in vitro preliminary evidences in rat primary cultures

Background: In the last years, Wnt signaling was demonstrated to regulate inflammatory processes. In particular, an increased expression of Wnts and Frizzled receptors was reported in inflammatory bowel disease (IBD) and ulcerative colitis to exert both anti- and pro-inflammatory functions regulating the intestinal activated nuclear factor \u3baB (NF-\u3baB), TNFa release, and IL10 expression. Methods: To investigate the role of Wnt pathway in the response of the enteric nervous system (ENS) to inflammation, neurons and glial cells from rat myenteric plexus were treated with exogenous Wnt3a and/or LPS with or without supporting neurotrophic factors such as basic fibroblast growth factor (bFGF), epithelial growth factor (EGF), and glial cell-derived neurotrophic factor (GDNF). The immunophenotypical characterization by flow cytometry and the protein and gene expression analysis by qPCR and Western blotting were carried out. Results: Flow cytometry and immunofluorescence staining evidenced that enteric neurons coexpressed Frizzled 9 and toll-like receptor 4 (TLR4) while glial cells were immunoreactive to TLR4 and Wnt3a suggesting that canonical Wnt signaling is active in ENS. Conclusions: The results of this study suggested the existence of neuronal surveillance through FZD9 and Wnt3a in enteric myenteric plexus. Moreover, experimental evidences were provided to clarify the correlation among soluble trophic factors, Wnt signaling, and anti-inflammatory protection of ENS

Predicting the Physiological Role of Circadian Metabolic Regulation in the Green Alga Chlamydomonas reinhardtii

Although the number of reconstructed metabolic networks is steadily growing, experimental data integration into these networks is still challenging. Based on elementary flux mode analysis, we combine sequence information with metabolic pathway analysis and include, as a novel aspect, circadian regulation. While minimizing the need of assumptions, we are able to predict changes in the metabolic state and can hypothesise on the physiological role of circadian control in nitrogen metabolism of the green alga Chlamydomonas reinhardtii

Fully automatic segmentation of glottis and vocal folds in endoscopic laryngeal high-speed videos using a deep Convolutional LSTM Network

The objective investigation of the dynamic properties of vocal fold vibrations demands the recording and further quantitative analysis of laryngeal high-speed video (HSV). Quantification of the vocal fold vibration patterns requires as a first step the segmentation of the glottal area within each video frame from which the vibrating edges of the vocal folds are usually derived. Consequently, the outcome of any further vibration analysis depends on the quality of this initial segmentation process. In this work we propose for the first time a procedure to fully automatically segment not only the time-varying glottal area but also the vocal fold tissue directly from laryngeal high-speed video (HSV) using a deep Convolutional Neural Network (CNN) approach. Eighteen different Convolutional Neural Network (CNN) network configurations were trained and evaluated on totally 13,000 high-speed video (HSV) frames obtained from 56 healthy and 74 pathologic subjects. The segmentation quality of the best performing Convolutional Neural Network (CNN) model, which uses Long Short-Term Memory (LSTM) cells to take also the temporal context into account, was intensely investigated on 15 test video sequences comprising 100 consecutive images each. As performance measures the Dice Coefficient (DC) as well as the precisions of four anatomical landmark positions were used. Over all test data a mean Dice Coefficient (DC) of 0.85 was obtained for the glottis and 0.91 and 0.90 for the right and left vocal fold (VF) respectively. The grand average precision of the identified landmarks amounts 2.2 pixels and is in the same range as comparable manual expert segmentations which can be regarded as Gold Standard. The method proposed here requires no user interaction and overcomes the limitations of current semiautomatic or computational expensive approaches. Thus, it allows also for the analysis of long high-speed video (HSV)-sequences and holds the promise to facilitate the objective analysis of vocal fold vibrations in clinical routine. The here used dataset including the ground truth will be provided freely for all scientific groups to allow a quantitative benchmarking of segmentation approaches in future

Isolation and in vitro cultivation of adrenal cells from mice

The adrenal gland consists of two tissues, cortex and medulla, united under one capsule. Adrenal stem/progenitor cells play a key role in development and homeostasis. Here, we describe a protocol for generating primary cultures of adrenal cells from mice. We describe techniques for separating the cortex and medulla, generating spheroid cultures containing stem- and progenitor cells, and for the differentiation into steroidogenic and chromaffin cells, respectively. This protocol enables analysis of various treatments before, during, or after differentiation. For complete details on the use and execution of this protocol, please refer to Rubin de Celis et al. (2015), Steenblock et al. (2018), and Werdermann et al. (2021)

Umsorgt werden und umsorgen - Leben mit mehreren Langzeiterkrankungen (Leila) : eine qualitative Studie zum Beitrag von APN in integrierter Versorgung

Hintergrund: Das Leben mit mehreren chronischen Krankheiten ist komplex und führt zu einer erhöhten Pflege- und Betreuungsbedürftigkeit. Zur Förderung der integrierten Versorgung wurde ein dreijähriges Projekt namens «Leben mit Langzeiterkrankung» (Leila) initiiert. Ziel: Das Projekt hatte zum Ziel, Leistungen von Pflegeexpertinnen in Advanced Practice Nursing (APN) für chronisch erkrankte Menschen in Zusammenarbeit mit Hausarztpraxen zu entwickeln. Folgende Fragestellungen wurden untersucht: 1. Wie erleben Patient(inn)en, Zuweisende und Pflegeexpertinnen APN das Leila-Dienstleistungsangebot? 2. Wie gestalten sich Zuweisungsprozesse? 3. Wie erleben die Beteiligten die Zusammenarbeit und die APN-Rollenausübung? Methode: Es wurde ein qualitativer Ansatz gemäß Grounded Theory nach Corbin und Strauss gewählt, um Erfahrungen mit Leila und Interaktionen der an Leila beteiligten Personen zu untersuchen. Dabei wurden 38 Interviews mit Patient(inn)en, die mit multiplen chronischen Krankheiten leben, deren betreuende Pflegeexpertinnen APN und zuweisenden Ärzt(inn)en durchgeführt und evaluiert. Ergebnisse: «Umsorgt werden und umsorgen» zeigte sich als zentrale Kategorie. Diese beschreibt wie auf die Patient(inn)en eingegangen wurde, sie einbezogen und ernst genommen wurden. Die Hauptkategorie «Den Alltag gestalten» zeigt, dass die Patient(inn)en lernten, mit den Folgen chronischer Erkrankungen im Alltag umzugehen. «Alle Ressourcen nutzen» legt dar, wie Potenziale und Stärken eingesetzt wurden. Schlussfolgerungen: Die Ergebnisse zu Zuweisungs- und Kooperationsprozessen ergaben, dass die APN-Rollenanerkennung und -ausübung noch ausgehandelt werden muss. Zukünftige APN-Angebote für diese Patient(inn)engruppe sollten nebst Ärztenetzwerken in weitere Dienstleistungen und die Spitex integriert werden. Background: Living with multiple chronic diseases is complex and leads to enhanced care needs. To foster integrated care a project called “Living with chronic disease” (Leila) was initiated. Aim: The aim was to develop an Advanced Practice Nursing (APN) service in collaboration with medical centers for persons who are living with multiple chronic diseases. The following research questions were addressed: 1. What are patients' experiences, referring physicians and APNs with the Leila-Service? 2. How are referral processes performed? 3. How do the involved groups experience collaboration and APN role development? Methods: A qualitative approach according grounded theory of Corbin and Strauss was used to explore the experiences with the Leila project and the interaction of the persons involved. 38 interviews were conducted with patients who are living with multiple chronic diseases, their APN's and the referring physicians. Results: The findings revealed “Being cared for and caring” as main category. The data demonstrated how patients responded to their involvement into care and that they were taken as serious partners in the care process. The category “organizing everyday life” describes how patients learned to cope with the consequences of living with multiple chronic diseases. “Using all resources” as another category demonstrates how capabilities and strengths were adopted. Conclusions: The results of the cooperation- and allocation processes showed that the APN recognition and APN role performance have to be negotiated. Prospective APN-services for this patient population should be integrated along with physician networks and other service providers including community health nursing

ESTRESSE, DOR E LESÕES MÚSCULO-ESQUELÉTICAS EM PROFESSORES DE CASCAVEL – PR

Esta pesquisa aborda o adoecimento de professores com o objetivo de identificar as doenças que têm causado seus afastamentos do trabalho na Rede Municipal de Educação de Cascavel, PR. Foram realizados levantamentos em atestados médicos cadastrados no ano de 2014 junto à Divisão de Medicina e Segurança do trabalho da Prefeitura Municipal de Cascavel para uma análise quanti-qualitativa, por meio da técnica de análise de conteúdo de Laurence Bardin (2011). A análise dos atestados cadastrados evidenciou que dos 394 atestados averiguados 96 % eram de professoras, a idade média foi de 41,83 anos e as doenças mais recorrentes foram Transtornos Mentais ou Emocionais (25,38%), Traumas e Contusões (22,84%) e Distúrbios Músculo Esqueléticos (13,95%)

Modelagem matemática nos anos iniciais do Ensino Fundamental: uma proposta para o 5º ano

Este artigo relata algumas ações de uma pesquisa intervenção que teve como foco a Modelagem Matemática nos Anos Iniciais do Ensino Fundamental. A questão de pesquisa - Quais as possibilidades e limitações de uma prática pedagógica investigativa efetivada em uma turma de 5º ano do Ensino Fundamental tendo como aportes teóricos estudos do campo da Modelagem Matemática? – delineou os objetivos que se constituem em avaliar as contribuições da prática pedagógica na reflexão crítica do aluno frente a questões sociais; promover nos discentes a capacidade de fazer uso de conhecimentos vinculados à disciplina de Matemática em outras áreas do conhecimento e em situações cotidianas, bem como contribuir para a disseminação de conhecimentos relativos à Modelagem Matemática nos Anos Iniciais do Ensino Fundamental. O referencial teórico está alicerçado em conceitos e contribuições de Biembengut e Hein (2005), Burak e Aragão (2012), Barbosa (2001, 2004), Silva e Barbosa (2011) e Silva, Barbosa e Oliveira (2013). Os conteúdos matemáticos abordados emergiram de temas de interesse dos estudantes, evidenciados por meio de diálogos efetivados no início da referida prática, que ocorreu nos meses de março, abril e maio de 2015, em uma escola pública da Região do Vale do Taquari, RS. Os resultados provenientes da pesquisa apontam olhares para a escrita dos alunos; uso de diferentes formas de pensar matematicamente e crescimento da turma frente às questões sociais discutidas ao longo dos encontros