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1.
Cognition ; 248: 105810, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38733867

ABSTRACT

Human observers often exhibit remarkable consistency in remembering specific visual details, such as certain face images. This phenomenon is commonly attributed to visual memorability, a collection of stimulus attributes that enhance the long-term retention of visual information. However, the exact contributions of visual memorability to visual memory formation remain elusive as these effects could emerge anywhere from early perceptual encoding to post-perceptual memory consolidation processes. To clarify this, we tested three key predictions from the hypothesis that visual memorability facilitates early perceptual encoding that supports the formation of visual short-term memory (VSTM) and the retention of visual long-term memory (VLTM). First, we examined whether memorability benefits in VSTM encoding manifest early, even within the constraints of a brief stimulus presentation (100-200 ms; Experiment 1). We achieved this by manipulating stimulus presentation duration in a VSTM change detection task using face images with high- or low-memorability while ensuring they were equally familiar to the participants. Second, we assessed whether this early memorability benefit increases the likelihood of VSTM retention, even with post-stimulus masking designed to interrupt post-perceptual VSTM consolidation processes (Experiment 2). Last, we investigated the durability of memorability benefits by manipulating memory retention intervals from seconds to 24 h (Experiment 3). Across experiments, our data suggest that visual memorability has an early impact on VSTM formation, persisting across variable retention intervals and predicting subsequent VLTM overnight. Combined, these findings highlight that visual memorability enhances visual memory within 100-200 ms following stimulus onset, resulting in robust memory traces resistant to post-perceptual interruption and long-term forgetting.


Subject(s)
Memory, Long-Term , Memory, Short-Term , Humans , Young Adult , Adult , Male , Female , Memory, Long-Term/physiology , Memory, Short-Term/physiology , Visual Perception/physiology , Facial Recognition/physiology , Memory Consolidation/physiology , Adolescent
2.
bioRxiv ; 2023 Nov 27.
Article in English | MEDLINE | ID: mdl-38077004

ABSTRACT

The sparse and stochastic nature of reprogramming has obscured our understanding of how transcription factors drive cells to new identities. To overcome this limit, we developed a compact, portable reprogramming system that increases direct conversion of fibroblasts to motor neurons by two orders of magnitude. We show that subpopulations with different reprogramming potentials are distinguishable by proliferation history. By controlling for proliferation history and titrating each transcription factor, we find that conversion correlates with levels of the pioneer transcription factor Ngn2, whereas conversion shows a biphasic response to Lhx3. Increasing the proliferation rate of adult human fibroblasts generates morphologically mature, induced motor neurons at high rates. Using compact, optimized, polycistronic cassettes, we generate motor neurons that graft with the murine central nervous system, demonstrating the potential for in vivo therapies.

3.
Ecotoxicol Environ Saf ; 268: 115722, 2023 Dec.
Article in English | MEDLINE | ID: mdl-37992644

ABSTRACT

PFAS, or per- and polyfluoroalkyl substances, are a family of man-made chemicals found in a variety of products from non-stick cookware and food wrappers to firefighting foams. PFAS are persistent and widely distributed in the environment, including aquatic environments. In this study we examined the impact of PFAS chemicals on the physiological and behavioral endpoints of Lumbriculus variegatus (i.e., blackworms). Lumbriculus variegatus is a species of freshwater annelid worm that plays key roles in shallow freshwater ecosystems. At an environmentally relevant concentration of 1 µg/L, 12-day aqueous exposure to long chain PFAS, including PFOA, PFOS and PFDA, each markedly slowed the pulse rate of the dorsal blood vessel in L. variegatus, indicating a suppressive effect on blood circulation. The mean pulse rate was reduced from 9.6 beats/minute to 6.2 and 7.0 beats/min in PFOA and PFOS, respectively (P < 0.0001). Further, PFOA, PFOS and PFDA reduced the escape responsiveness of L. variegatus to physical stimulation. The percentage of worms showing normal escape behavior was reduced from 99.0% in control to 90.6% in the PFOS exposed group (P < 0.01). In a chronic (4 week) growth study, exposure to overlying water and sediment spiked with PFOA, PFOS or PFDA reduced the total biomass and the number of worms, indicating a suppressive effect on worm population growth. For instance, PFOA and PFDA reduced the total dry biomass by 26.3% and 28.5%, respectively, compared to the control (P < 0.05). The impact of PFAS on blackworm physiology is accompanied by an increase in lipid peroxidation. The level of malondialdehyde (MDA), an indicator of lipid peroxidation, and catalase, a major antioxidant enzyme, were markedly increased in PFOA, PFOS and PFDA exposed groups. Interestingly, exposure to PFHxA, a short chain PFAS, had no detectable effect on any of the measured endpoints. Our results demonstrate that L. variegatus is highly sensitive to the toxic impact of long chain PFAS chemicals as measured by multiple endpoints including blood circulation, behavior, and population growth. Such toxicity may have a detrimental impact on L. variegatus and the freshwater ecosystems where it resides.


Subject(s)
Alkanesulfonic Acids , Fluorocarbons , Oligochaeta , Humans , Animals , Environmental Biomarkers , Ecosystem , Fresh Water , Water/pharmacology , Fluorocarbons/toxicity , Alkanesulfonic Acids/toxicity
4.
ACS Infect Dis ; 9(12): 2632-2651, 2023 Dec 08.
Article in English | MEDLINE | ID: mdl-38014670

ABSTRACT

Antimicrobial peptides (AMPs) are promising candidates to combat pathogens that are resistant to conventional antimicrobial drugs because they operate through mechanisms that involve membrane disruption. However, the use of AMPs in clinical settings has been limited, at least in part, by their susceptibility to proteolytic degradation and their lack of selectivity toward pathogenic microbes vs mammalian cells. We recently reported on the design of α- and ß-peptide oligomers structurally templated upon the naturally occurring α-helical AMP aurein 1.2. These α/ß-peptide oligomers are more proteolytically stable than aurein 1.2 and have several other attributes that render them attractive as alternatives to conventional AMPs. This study describes the influence of peptide physicochemical properties on the broad-spectrum activity of aurein 1.2-based α/ß-peptide mimics against nine bacterial, fungal, and mammalian cell lines. We used a partial least-squares regression (PLSR)-supervised machine learning model to quantify and visualize relationships between experimentally determined physicochemical properties (e.g., hydrophobicity, charge, and helicity) and experimentally measured cell-type-specific activities of 21 peptides in a 149-member α/ß-peptide library. Using this approach, we identified several peptides that were predicted to exhibit enhanced broad-spectrum selectivity, a measure that evaluates antimicrobial activity relative to mammalian cell toxicity compared to aurein 1.2. Experimental validation demonstrated high model predictive performance, and characterization of compounds with the highest broad-spectrum selectivity revealed peptide hydrophobicity, helicity, and helical rigidity to be strong predictors of broad-spectrum selectivity. The most selective peptide identified from the model prediction has more than a 13-fold improvement in broad-spectrum selectivity than that of aurein 1.2, demonstrating the ability of using PLSR models to identify quantitative structure-function relationships for nonstandard amino acid-containing peptides. Overall, this work establishes quantifiable guidelines for the rational design of helical antimicrobial α/ß-peptides and identifies promising new α/ß-peptides with significantly reduced mammalian toxicities and improved antifungal and antibacterial activities relative to aurein 1.2.


Subject(s)
Anti-Infective Agents , Antimicrobial Peptides , Animals , Amino Acids , Anti-Bacterial Agents/pharmacology , Anti-Bacterial Agents/toxicity , Anti-Infective Agents/pharmacology , Anti-Infective Agents/toxicity , Bacteria , Mammals
5.
Chemosphere ; 328: 138562, 2023 Jul.
Article in English | MEDLINE | ID: mdl-37004823

ABSTRACT

Bisphenol A (BPA) and its analogs are common environmental chemicals with many potential adverse health effects. The impact of environmentally relevant low dose BPA on human heart, including cardiac electrical properties, is not understood. Perturbation of cardiac electrical properties is a key arrhythmogenic mechanism. In particular, delay of cardiac repolarization can cause ectopic excitation of cardiomyocytes and malignant arrhythmia. This can occur as a result of genetic mutations (i.e., long QT (LQT) syndrome), or cardiotoxicity of drugs and environmental chemicals. To define the impact of low dose BPA on electrical properties of cardiomyocytes in a human-relevant model system, we examined the rapid effects of 1 nM BPA in human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) using patch-clamp and confocal fluorescence imaging. Acute exposure to BPA delayed repolarization and prolonged action potential duration (APD) in hiPSC-CMs through inhibition of the hERG K+ channel. In nodal-like hiPSC-CMs, BPA acutely increased pacing rate through stimulation of the If pacemaker channel. Existing arrhythmia susceptibility determines the response of hiPSC-CMs to BPA. BPA resulted in modest APD prolongation but no ectopic excitation in baseline condition, while rapidly promoted aberrant excitations and tachycardia-like events in myocytes that had drug-simulated LQT phenotype. In hiPSC-CM-based human cardiac organoids, the effects of BPA on APD and aberrant excitation were shared by its analog chemicals, which are often used in "BPA-free" products, with bisphenol AF having the largest effects. Our results reveal that BPA and its analogs have repolarization delay-associated pro-arrhythmic toxicity in human cardiomyocytes, particularly in myocytes that are prone to arrhythmias. The toxicity of these chemicals depends on existing pathophysiological conditions of the heart, and may be particularly pronounced in susceptible individuals. An individualized approach is needed in risk assessment and protection.


Subject(s)
Induced Pluripotent Stem Cells , Long QT Syndrome , Humans , Induced Pluripotent Stem Cells/pathology , Induced Pluripotent Stem Cells/physiology , Myocytes, Cardiac , Long QT Syndrome/genetics , Long QT Syndrome/pathology , Arrhythmias, Cardiac/chemically induced
6.
Biomed Opt Express ; 14(1): 81-88, 2023 Jan 01.
Article in English | MEDLINE | ID: mdl-36698668

ABSTRACT

Real-time intraoperative delineation of cancer and non-cancer brain tissues, especially in the eloquent cortex, is critical for thorough cancer resection, lengthening survival, and improving quality of life. Prior studies have established that thresholding optical attenuation values reveals cancer regions with high sensitivity and specificity. However, threshold of a single value disregards local information important to making more robust predictions. Hence, we propose deep convolutional neural networks (CNNs) trained on labeled OCT images and co-occurrence matrix features extracted from these images to synergize attenuation characteristics and texture features. Specifically, we adapt a deep ensemble model trained on 5,831 examples in a training dataset of 7 patients. We obtain 93.31% sensitivity and 97.04% specificity on a holdout set of 4 patients without the need for beam profile normalization using a reference phantom. The segmentation maps produced by parsing the OCT volume and tiling the outputs of our model are in excellent agreement with attenuation mapping-based methods. Our new approach for this important application has considerable implications for clinical translation.

7.
Vis Comput Ind Biomed Art ; 6(1): 2, 2023 Jan 14.
Article in English | MEDLINE | ID: mdl-36640198

ABSTRACT

Thermal ablation procedures, such as high intensity focused ultrasound and radiofrequency ablation, are often used to eliminate tumors by minimally invasively heating a focal region. For this task, real-time 3D temperature visualization is key to target the diseased tissues while minimizing damage to the surroundings. Current computed tomography (CT) thermometry is based on energy-integrated CT, tissue-specific experimental data, and linear relationships between attenuation and temperature. In this paper, we develop a novel approach using photon-counting CT for material decomposition and a neural network to predict temperature based on thermal characteristics of base materials and spectral tomographic measurements of a volume of interest. In our feasibility study, distilled water, 50 mmol/L CaCl2, and 600 mmol/L CaCl2 are chosen as the base materials. Their attenuations are measured in four discrete energy bins at various temperatures. The neural network trained on the experimental data achieves a mean absolute error of 3.97 °C and 1.80 °C on 300 mmol/L CaCl2 and a milk-based protein shake respectively. These experimental results indicate that our approach is promising for handling non-linear thermal properties for materials that are similar or dissimilar to our base materials.

8.
Toxicol Appl Pharmacol ; 447: 116057, 2022 07 15.
Article in English | MEDLINE | ID: mdl-35550884

ABSTRACT

Type II diabetes mellitus (T2DM) is characterized by insulin resistance, ß-cell dysfunction and hyperglycemia. In addition to well known risk factors such as lifestyle and genetic risk score, accumulation of environmental toxicants in organs relevant to glucose metabolism is increasingly recognized as additional risk factors for T2DM. Here, we describe the development of an in vivo oral cadmium (Cd) exposure model. It was shown that oral Cd exposure in drinking water followed by washout and high fat diet (HFD) in C57BL/6N mice results in islet Cd bioaccumulation comparable to that found in native human islets while mitigating the anorexic effects of Cd to achieve the same weight gain required to induce insulin resistance as in Cd naïve control mice. Inter individual variation in plasma glucose and insulin levels as well as islet Cd bioaccumulation was observed in both female and male mice. Regression analysis showed an inverse correlation between islet Cd level and plasma insulin following a glucose challenge in males but not in females. This finding highlights the need to account for inter individual target tissue Cd concentrations when interpreting results from in vivo Cd exposure models. No effect of Cd on insulin secretion was observed in islets ex vivo, highlighting differences between in vivo and ex vivo cadmium exposure models. In summary, our oral in vivo Cd exposure-washout with HFD model resulted in islet Cd bioaccumulation that is relevant in the context of environmental cadmium exposure in humans. Here, we showed that islet Cd bioaccumulation is associated with complex cadmium-mediated changes in glucose clearance and ß-cell function. The model described here will serve as a useful tool to further examine the relationship between Cd exposure, islet Cd bioaccumulation, dysglycemia and their underlying mechanisms.


Subject(s)
Cadmium Poisoning , Diabetes Mellitus, Type 2 , Insulin Resistance , Insulins , Islets of Langerhans , Animals , Cadmium/metabolism , Cadmium/toxicity , Diabetes Mellitus, Type 2/metabolism , Diet, High-Fat/adverse effects , Female , Glucose/metabolism , Insulin/metabolism , Insulins/metabolism , Insulins/pharmacology , Male , Mice , Mice, Inbred C57BL
9.
Cell Syst ; 12(11): 1023-1025, 2021 11 17.
Article in English | MEDLINE | ID: mdl-34793700

ABSTRACT

One snapshot of the peer review process for "Mapping the dynamic transfer functions of eukaryotic gene regulation" (Lee et al., 2021) appears below.


Subject(s)
Gene Expression Regulation , Promoter Regions, Genetic/genetics
10.
Oral Maxillofac Surg ; 25(3): 367-371, 2021 Sep.
Article in English | MEDLINE | ID: mdl-33237435

ABSTRACT

BACKGROUND: Accurate placement of TMJ implant components may be facilitated by virtual surgical planning (VSP) technologies. The aim of this study was to assess the accuracy of a typical VSP protocol and describe the pattern of surgical error associated with total alloplastic TMJ replacement. METHODS: A retrospective analysis was undertaken on 40 adult patients who were implanted with a fully customised, 3D printed TMJ prosthesis due to end-stage TMJ disease. Planned TMJ implant position based on preoperative CBCT images was compared with final position on postoperative OPGs using a previously validated linear rescaling method. Translational discrepancy was described in the anterior-posterior direction and superior-inferior direction. Rotational discrepancy was described as anterior or posterior. RESULTS: Lin's concordance between preoperative and postoperative position was 0.97, with no significant differences (p > 0.05). The Bland-Altman analysis showed a 95% limit of agreement between planned and final position of - 5.9 to 5.4 mm. Overall, final implant position was more anterior (0.4 mm), superior (0.4 mm) and posteriorly rotated (2.4°) compared with planned position. CONCLUSION: The use of VSP in TMJ replacement surgery results in accurate implant placement with good agreement between planned and final implant position. Discrepancies in planned and final implant position tended to result in the mandibular component of the implant being translated anterior superiorly and rotated posteriorly, with potential implications for the biomechanical performance of the implant and overall device longevity. These results should be used to assist TMJ surgeons pre- and intraoperatively to facilitating accurate implant positioning and optimal surgical rehabilitation.


Subject(s)
Joint Prosthesis , Temporomandibular Joint , Adult , Humans , Mandible , Radiography, Panoramic , Retrospective Studies , Temporomandibular Joint/diagnostic imaging , Temporomandibular Joint/surgery
11.
Cell Syst ; 11(5): 424-448, 2020 11 18.
Article in English | MEDLINE | ID: mdl-33212016

ABSTRACT

Connecting the molecular structure and function of chromatin across length and timescales remains a grand challenge to understanding and engineering cellular behaviors. Across five orders of magnitude, dynamic processes constantly reshape chromatin structures, driving spaciotemporal patterns of gene expression and cell fate. Through the interplay of structure and function, the genome operates as a highly dynamic feedback control system. Recent experimental techniques have provided increasingly detailed data that revise and augment the relatively static, hierarchical view of genomic architecture with an understanding of how dynamic processes drive organization. Here, we review how novel technologies from sequencing, imaging, and synthetic biology refine our understanding of chromatin structure and function and enable chromatin engineering. Finally, we discuss opportunities to use these tools to enhance understanding of the dynamic interrelationship of chromatin structure and function.


Subject(s)
Chromatin Assembly and Disassembly/physiology , Chromatin/physiology , Chromosomes/genetics , Chromosomes/physiology , Gene Expression/genetics , Gene Expression Regulation/genetics , Genome/genetics , Genomics/methods , Structure-Activity Relationship , Time Factors
13.
Oral Maxillofac Surg ; 24(2): 203-209, 2020 Jun.
Article in English | MEDLINE | ID: mdl-32306164

ABSTRACT

PURPOSE: The aim of this study was to determine the accuracy of orthopantomograms (OPGs) when assessing post-operative temporomandibular joint (TMJ) implant position, compared with cone beam computerized tomography (CBCT). METHODS: A retrospective analysis was undertaken on six adult patients who were implanted with a custom TMJ prosthesis due to end-stage TMJ disease. Post-operative CBCT was compared with post-operative OPGs. Overall magnification of each OPG was calculated and used to linearly rescale each image. Implant position was assessed by measuring the gonion angle and the distance between each surgical screw and the mandibular gonion (SG length). RESULTS: Mean magnification for OPGs was 24.2%. There were no significant differences (p > 0.05) in the gonion angle on OPGs compared with CBCT images. There was a mean decrease in SG lengths of 0.02 mm on OPGs, corresponding to error level of 5.31%. The 95% limits of agreement between OPGs and CBCT images for SG lengths were 1.65 mm and - 1.73 mm. CONCLUSION: This study presents a clinically applicable and accurate first-line radiographic screening tool to assess TMJ implant position. When combined with clinical assessment, OPGs can help reduce the need for further imaging and radiation exposure post-operatively.


Subject(s)
Dental Implants , Temporomandibular Joint Disorders , Adult , Cone-Beam Computed Tomography , Humans , Radiography, Panoramic , Retrospective Studies , Temporomandibular Joint
14.
Curr Opin Syst Biol ; 24: 18-31, 2020 Dec.
Article in English | MEDLINE | ID: mdl-36330198

ABSTRACT

Cellular reprogramming drives cells from one stable identity to a new cell fate. By generating a diversity of previously inaccessible cell types from diverse genetic backgrounds, cellular reprogramming is rapidly transforming how we study disease. However, low efficiency and limited maturity have limited the adoption of in vitro-derived cellular models. To overcome these limitations and improve mechanistic understanding of cellular reprogramming, a host of synthetic biology tools have been deployed. Recent synthetic biology approaches have advanced reprogramming by tackling three significant challenges to reprogramming: delivery of reprogramming factors, epigenetic roadblocks, and latent donor identity. In addition, emerging insight from the molecular systems biology of reprogramming reveal how systems-level drivers of reprogramming can be harnessed to further advance reprogramming technologies. Furthermore, recently developed synthetic biology tools offer new modes for engineering cell fate.

15.
Sci Adv ; 5(11): eaav3097, 2019 11.
Article in English | MEDLINE | ID: mdl-31723597

ABSTRACT

Skin-like sensory devices should be stretchable and self-healable to meet the demands for future electronic skin applications. Despite recent notable advances in skin-inspired electronic materials, it remains challenging to confer these desired functionalities to an active semiconductor. Here, we report a strain-sensitive, stretchable, and autonomously self-healable semiconducting film achieved through blending of a polymer semiconductor and a self-healable elastomer, both of which are dynamically cross-linked by metal coordination. We observed that by controlling the percolation threshold of the polymer semiconductor, the blend film became strain sensitive, with a gauge factor of 5.75 × 105 at 100% strain in a stretchable transistor. The blend film is also highly stretchable (fracture strain, >1300%) and autonomously self-healable at room temperature. We proceed to demonstrate a fully integrated 5 × 5 stretchable active-matrix transistor sensor array capable of detecting strain distribution through surface deformation.

16.
J Pharm Sci ; 108(11): 3582-3591, 2019 11.
Article in English | MEDLINE | ID: mdl-31278916

ABSTRACT

Mathematical modeling of drug release can aid in the design and development of sustained delivery systems, but the parameter estimation of such models is challenging owing to the nonlinear mathematical structure and complexity and interdependency of the physical processes considered. Highly parameterized models often lead to overfitting, strong parameter correlations, and as a consequence, inaccurate model predictions for systems not explicitly part of the fitting database. Here, we show that an efficient stochastic optimization algorithm can be used not only to find robust estimates of global minima to such complex problems but also to generate metadata that allow quantitative evaluation of parameter sensitivity and correlation, which can be used for further model refinement and development. A practical methodology is described through the analysis of a predictive drug release model on published experimental data sets. The model is then used to design a zeroth-order release profile in an experimental system consisting of an antibody fragment in a poly(lactic-co-glycolic acid) solvent depot, which is validated experimentally. This approach allows rational decision-making when developing new models, selecting models for a specific application, or designing formulations for experimental trials.


Subject(s)
Delayed-Action Preparations/chemistry , Pharmaceutical Preparations/chemistry , Drug Delivery Systems/methods , Drug Liberation/drug effects , Models, Theoretical , Polylactic Acid-Polyglycolic Acid Copolymer/chemistry , Solvents/chemistry
17.
Article in English | MEDLINE | ID: mdl-31209011

ABSTRACT

Candida albicans is an opportunistic fungal pathogen responsible for mucosal candidiasis and systemic candidemia in humans. Often, these infections are associated with the formation of drug-resistant biofilms on the surfaces of tissues or medical devices. Increased incidence of C. albicans resistance to current antifungals has heightened the need for new strategies to prevent or eliminate biofilm-related fungal infections. In prior studies, we designed 14-helical ß-peptides to mimic the structural properties of natural antimicrobial α-peptides (AMPs) in an effort to develop active and selective antifungal compounds. These amphiphilic, cationic, helical ß-peptides exhibited antifungal activity against planktonic C. albicans cells and inhibited biofilm formation in vitro and in vivo Recent studies have suggested the use of antivirulence agents in combination with antifungals. In this study, we investigated the use of compounds that target C. albicans polymorphism, such as 1-dodecanol, isoamyl alcohol, and farnesol, to attempt to improve ß-peptide efficacy for preventing C. albicans biofilms. Isoamyl alcohol, which prevents hyphal formation, reduced the minimum biofilm prevention concentrations (MBPCs) of ß-peptides by up to 128-fold. Combinations of isoamyl alcohol and antifungal ß-peptides resulted in less than 10% hemolysis at the antifungal MBPCs. Overall, our results suggest potential benefits of combination therapies comprised of morphogenesis modulators and antifungal AMP peptidomimetics for preventing C. albicans biofilm formation.


Subject(s)
Antifungal Agents/pharmacology , Biofilms/drug effects , Candida albicans/drug effects , Peptides/pharmacology , Antifungal Agents/chemistry , Antimicrobial Cationic Peptides/chemistry , Antimicrobial Cationic Peptides/pharmacology , Candida albicans/growth & development , Hyphae/drug effects , Hyphae/growth & development , Pentanols , Peptides/chemistry
19.
Surg Infect (Larchmt) ; 5(4): 343-8, 2004.
Article in English | MEDLINE | ID: mdl-15744125

ABSTRACT

BACKGROUND: Historically, medical schools have taught principles of hemodynamic shock using large animal models. Such exercises are infrequent today due to the increasing aversion of students and the wider community to the use of large animals in teaching. Herein, we describe two alternative exercises that communicated basic science and clinical principles of shock effectively. METHODS: We developed two complementary, distinct single-afternoon laboratory exercises for third-year medical students. The first exercise (lab) demonstrated three principles: (1) in vitro cytokine-induced apoptosis (illustrating mechanisms and consequences of sepsis), (2) the hemodynamic manifestations of hypovolemia and septic shock in rats, and (3) the effects of fluid resuscitation or vasopressor administration in these same rat models. In the second exercise, students managed the diagnosis, initial resuscitation, surgical treatment, and ICU care of a "patient" with abdominal sepsis, using a manikin-based patient simulator and actual patient test data. Current basic science and clinical literature were incorporated. RESULTS: Efficacy was evaluated by polling students in one of four rotations (n = 25). Educational value of the lab exercise was rated 3.70 (1, worst rating; 5, best rating), whereas its applicability to clinical care was rated 4.35. Educational value and clinical applicability of the patient simulator were rated 4.52 and 4.76, respectively. CONCLUSIONS: These exercises combining laboratory demonstrations of the pathophysiologic mechanisms and manifestations of shock with simulation were judged effective and clinically relevant while fulfilling the National Institutes of Health (NIH) mandate to reduce use of experimental animals.


Subject(s)
Education, Medical, Undergraduate/methods , Shock, Septic/physiopathology , Shock/physiopathology , Animals , Apoptosis/physiology , Curriculum , Cytokines/adverse effects , Hemodynamics , Laboratories , Manikins , Models, Animal , Models, Biological , Rats , Shock/diagnosis , Shock/therapy , Shock, Septic/diagnosis , Shock, Septic/etiology , Shock, Septic/therapy
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