Body painting e body projection: simulação no ensino-aprendizagem em enfermagem / Body painting and body projection: simulation in nursing teaching-learning / Body painting y body projection: simulación en la enseñanza-aprendizaje de la enfermería

Objetivo: relatar a experiência da utilização das tecnologias body painting e body projectioncomo ferramentas facilitadoras do processo ensino-aprendizagem na perspectiva de docentes de Enfermagem durante o ensino do exame físico cardiovascular. Método: relato de experiência de estratégia facilitadora aplicada ao processo de ensino-aprendizagem do exame físico cardiovascular durante o curso de graduação em Enfermagem de uma universidade privada de São Paulo­Brasil. Resultados: participaram da experiência 40 estudantes, dois professores, um artista plástico e dois modelos que receberam a pintura corporal. O uso das referidas tecnologias suscitou reflexões sobre a possibilidade de utilizá-las como ferramentas para o ensino de forma lúdica e eficaz, otimizando o contexto acadêmico formal. Conclusão: as ferramentas body painting e body projection, de acordo com a percepção dos docentes, facilitam o processo de ensino-aprendizagem do exame físico cardiovascular, uma vez que aproximam a teoria da prática e permitem, aos estudantes, associações visuais que superam as tradicionais barreiras de ensino-aprendizagem.(AU)

Objective: to report the experience of using the body painting and body projection technologies as facilitating tools in the teaching-learning process from the perspective of Nursing professors during teaching of the cardiovascular physical examination. Method: an experience report of a facilitating strategy applied to the teaching-learning process corresponding to the cardiovascular physical examination in the Nursing undergraduate course at a private university from São Paulo, Brazil. Results: a total of 40 students, two professors, one plastic artist and two models on whom body painting was applied took part in the experience. Use of the aforementioned technologies raised reflections about the possibility of employing them as tools for playful and effective teaching, optimizing the formal academic context. Conclusion: according to the professors' perception, the body painting and body projection tools facilitate the teaching-learning process corresponding to the cardiovascular physical examination, as they bring the theory closer to the practice and allow students to make visual associations that overcome the traditional teaching-learning barriers.(AU)

Objetivo: informar sobre la experiencia del uso de las tecnologías de body painting y body projection como herramientas facilitadoras del proceso de enseñanza-aprendizaje desde la perspectiva de los profesores de enfermería durante la enseñanza del examen físico cardiovascular. Método: informe de experiencia de estrategia facilitadora aplicada en el proceso de enseñanza-aprendizaje del examen físico cardiovascular durante el curso de graduación en enfermería de una universidad privada de São Paulo- Brasil. Resultados: participaron en la experiencia 40 alumnos, dos profesores, un artista plástico y dos modelos que recibieron la pintura corporal. El uso de estas tecnologías suscitó reflexiones sobre la posibilidad de utilizar ambas como herramientas para la enseñanza de forma lúdica y eficaz, optimizando el contexto académico formal. Conclusión: las herramientas de body painting y body projection, según la percepción de los profesores, facilitan el proceso de enseñanza-aprendizaje del examen físico cardiovascular, ya que aproximan la teoría a la práctica y permiten a los alumnos realizar asociaciones visuales que superan las barreras tradicionales de enseñanza-aprendizaje.(AU)

Growth patterns in early childhood and cardiovascular structure and function at 4 years old: A prospective cohort study.

BACKGROUND AND AIMS: Childhood overweight and obesity are lifetime risk factors for cardiovascular disease but the relationship between dynamic body mass index (BMI) change and cardiovascular structure and function in early childhood remains unclear. METHODS AND RESULTS: This cohort study consisted 525 participants with 6 distinct representative growth patterns to examine the associations between BMI growth patterns and subsequent cardiovascular structure and function at age 4. BMIs were obtained at birth, 2 and 4 years old. Cardiovascular assessments were performed, including blood pressure (BP), cardiac geometric parameters, left ventricular (LV) function, speckle-tracking, integrated backscatter analysis and carotid intima-media thickness. Compared to the stable normal BMI pattern, children with the stable overweight (OW) pattern had significantly greater LV anatomic parameters in fully adjusted models. Children with the catch-up (CU) pattern revealed a uniform trend and had poorer strain. LV diameters and integrated backscatter signals were larger for those with BMI gain and lose pattern. Children with BMI lose pattern showed improved tendency involving LV mass index and BP. Both OW and CU patterns were associated with high systolic BP [odds ratio (95% CI): OW: 3.67 (1.08, 12.47); CU: 4.24 (1.75, 10.28)]. Compared to static BMI measurements at birth, 2 and 4 years old, dynamic BMI growth patterns were more predictive of cardiovascular structure and function at 4. CONCLUSIONS: Children with overweight-related BMI growth patterns in early childhood experienced undesirable cardiovascular functional or structural changes as early as 4 years old, indicating that early intervention is needed and potentially beneficial.

A simple optical tissue clearing pipeline for 3D vasculature imaging of the mediastinal organs in mice.

Optical tissue clearing (OTC) methods render tissue transparent by matching the refractive index within a sample to enable three-dimensional (3D) imaging with advanced microscopes. The application of OTC method in mediastinal organs in mice remains poorly understand. Our aim was to establish a simple protocol pipeline for 3D imaging of the mediastinal organs in mice. Trachea, oesophagus, thymus and heart were harvested from mice after retrograde perfusion via the abdominal aorta. We combined and optimized antibody labelling of thick tissue samples, OTC with cheap and non-toxic solvent ethyl cinnamate (ECi), and light-sheet fluorescence microscopy (LSFM) or laser confocal fluorescence microscopy (LCFM) to visualize the vasculature of those tissues. A high degree of optical transparency of trachea, oesophagus, thymus and heart was achieved after ECi-based OTC. With anti-CD31 antibody immunofluorescence labelling before ECi-based OTC, the vasculature of these tissues with their natural morphology, location and organizational network was imaged using LSFM or LCFM. This simple protocol pipeline provides an easy-to-setup and comprehensive way to study the vasculature of mediastinal organs in 3D without any special equipment. We anticipate that it will facilitate diverse applications in biomedical research of thoracic diseases and even other organs.

Enhancing cardiovascular research with whole-organ imaging.

PURPOSE OF REVIEW: There have been tremendous advances in the tools available for surveying blood vessels within whole organs and tissues. Here, we summarize some of the recent developments in methods for immunolabeling and imaging whole organs and provide a protocol optimized for the heart. RECENT FINDINGS: Multiple protocols have been established for chemically clearing large organs and variations are compatible with cell type-specific labeling. Heart tissue can be successfully cleared to reveal the three-dimensional structure of the entire coronary vasculature in neonatal and adult mice. Obtaining vascular reconstructions requires exceptionally large imaging files and new computational methods to process the data for accurate vascular quantifications. This is a continually advancing field that has revolutionized our ability to acquire data on larger samples as a faster rate. SUMMARY: Historically, cardiovascular research has relied heavily on histological analyses that use tissue sections, which usually sample cellular phenotypes in small regions and lack information on whole tissue-level organization. This approach can be modified to survey whole organs but image acquisition and analysis time can become unreasonable. In recent years, whole-organ immunolabeling and clearing methods have emerged as a workable solution, and new microscopy modalities, such as light-sheet microscopy, significantly improve image acquisition times. These innovations make studying the vasculature in the context of the whole organ widely available and promise to reveal fascinating new cellular behaviors in adult tissues and during repair.

Tracing the genetic footprints of vertebrate landing in non-teleost ray-finned fishes.

Rich fossil evidence suggests that many traits and functions related to terrestrial evolution were present long before the ancestor of lobe- and ray-finned fishes. Here, we present genome sequences of the bichir, paddlefish, bowfin, and alligator gar, covering all major early divergent lineages of ray-finned fishes. Our analyses show that these species exhibit many mosaic genomic features of lobe- and ray-finned fishes. In particular, many regulatory elements for limb development are present in these fishes, supporting the hypothesis that the relevant ancestral regulation networks emerged before the origin of tetrapods. Transcriptome analyses confirm the homology between the lung and swim bladder and reveal the presence of functional lung-related genes in early ray-finned fishes. Furthermore, we functionally validate the essential role of a jawed vertebrate highly conserved element for cardiovascular development. Our results imply the ancestors of jawed vertebrates already had the potential gene networks for cardio-respiratory systems supporting air breathing.

Análisis de los textos escolares de ciencias naturales y biología desde la perspectiva de la terminología anatómica internacional: sistema cardiovascular / Analysis of science and biology school textbooks from the perspective of the international anatomical terminology: cardiovascular system

RESUMEN: Los textos escolares en Chile siguen siendo un recurso educativo ampliamente utilizado por los profesores/as, por lo tanto, son herramientas pedagógicas que deben contar con una correcta terminología, garantizando una comunicación eficiente y precisa. En este sentido, la Terminología Anatómica Internacional aborda la organización de nombres de estructuras humanas, sin embargo, se ha observado que aún existen problemas en la correcta denominación de estructuras, generando problemas de comunicación entre profesionales y estudiantes de ciencias. En esta investigación se analizaron los términos histológicos, embriológicos y anatómicos del sistema cardiovascular humano presentes en los libros de texto escolares de 7º a 12vo grado de Ciencias Naturales y Biología, impartidos por el Ministerio de Educación de Chile. El análisis fue realizado comparando los términos utilizados en los textos con los términos oficiales del Programa Federativo Internacional de Terminologías Anatómicas y del Comité Federativo Internacional en Terminología Anatómica. Los resultados indican que el 25 % de términos analizados presentan errores y de ellos un 100 % corresponden a sinonimias. Se concluye que persisten errores en la adecuada denominación de las estructuras del cuerpo humano en los textos escolares. Al respecto, se sugiere una serie de líneas de trabajo que deberán reunir a los profesores/as y especialistas como anatomistas y biólogos para corregir los errores existentes.

SUMMARY: School textbooks in Chile remain an educational resource widely used by teachers, therefore, they are pedagogical tools that must have a correct terminology, ensuring efficient and accurate communication. In this sense, The International Anatomical Terminology addresses the organization of names of human structures. However, it has been observed that there are still problems in the correct naming of structures, creating communication problems between professionals and science students. In this research, the histological, embryological, and anatomical terms of the human cardiovascular system present in school textbooks from 7th to 12th grade of Sciences and Biology, taught by the Chilean Ministry of Education, were analyzed. The analysis was carried out by comparing the terms used in the texts with the official terms of the Federative International Programme for Anatomical Terminology and International Federative Committee for Anatomical Terminology. The results indicate that 25 % of the terms analyzed have errors and of these 100 % correspond to synonyms. It is concluded that errors persist in the proper naming of the structures of the human body in school textbooks. In this regard, a series of lines of work are suggested, that should bring together teachers and specialists such as anatomists and biologists to correct existing errors.

The circulatory system of Penaeus vannamei Boone, 1931-Lacunar function and a reconsideration of the "open vs. closed system" debate.

The morphology of hemolymph circulatory systems has been studied in many arthropod groups over the past decades. In most cases, however, the focus of these studies has been the vascular system, while its counterpart, the lacunar system, has often been neglected. To further understanding of the interrelationships between these two complementary subsystems, we investigated both, the hemolymph vascular system and the hemolymph lacunar system, of the decapod Penaeus vannamei using 3D-imaging techniques (micro-computed tomography and confocal laser scanning microscopy) in combination with 3D reconstruction. Major parts of the vascular and lacunar system are described. Our insights into their morphology are used to derive functional conclusions for a model illustrating the interrelationships between the two subsystems. The morphology of and the functional interaction between the vascular and lacunar systems are discussed in the context of the debate on "open vs. closed circulatory systems."

Recent Applications of Three Dimensional Printing in Cardiovascular Medicine.

Three dimensional (3D) printing, which consists in the conversion of digital images into a 3D physical model, is a promising and versatile field that, over the last decade, has experienced a rapid development in medicine. Cardiovascular medicine, in particular, is one of the fastest growing area for medical 3D printing. In this review, we firstly describe the major steps and the most common technologies used in the 3D printing process, then we present current applications of 3D printing with relevance to the cardiovascular field. The technology is more frequently used for the creation of anatomical 3D models useful for teaching, training, and procedural planning of complex surgical cases, as well as for facilitating communication with patients and their families. However, the most attractive and novel application of 3D printing in the last years is bioprinting, which holds the great potential to solve the ever-increasing crisis of organ shortage. In this review, we then present some of the 3D bioprinting strategies used for fabricating fully functional cardiovascular tissues, including myocardium, heart tissue patches, and heart valves. The implications of 3D bioprinting in drug discovery, development, and delivery systems are also briefly discussed, in terms of in vitro cardiovascular drug toxicity. Finally, we describe some applications of 3D printing in the development and testing of cardiovascular medical devices, and the current regulatory frameworks that apply to manufacturing and commercialization of 3D printed products.

Corrosion casting of the cardiovascular structure in adult zebrafish for analysis by scanning electron microscopy and X-ray microtomography.

Zebrafish have come to the forefront as a flexible, relevant animal model to study human disease, including cardiovascular disorders. Zebrafish are optically transparent during early developmental stages, enabling unparalleled imaging modalities to examine cardiovascular structure and function in vivo and ex vivo. At later stages, however, the options for systematic cardiovascular phenotyping are more limited. To visualise the complete vascular tree of adult zebrafish, we have optimised a vascular corrosion casting method. We present several improvements to the technique leading to increased reproducibility and accuracy. We designed a customised support system and used a combination of the commercially available Mercox II methyl methacrylate with the Batson's catalyst for optimal vascular corrosion casting of zebrafish. We also highlight different imaging approaches, with a focus on scanning electron microscopy (SEM) and X-ray microtomography (micro-CT) to obtain highly detailed, faithful three-dimensional reconstructed images of the zebrafish cardiovascular structure. This procedure can be of great value to a wide range of research lines related to cardiovascular biology in small specimens.

Cardiovascular shunting in vertebrates: a practical integration of competing hypotheses.

This review explores the long-standing question: 'Why do cardiovascular shunts occur?' An historical perspective is provided on previous research into cardiac shunts in vertebrates that continues to shape current views. Cardiac shunts and when they occur is then described for vertebrates. Nearly 20 different functional reasons have been proposed as specific causes of shunts, ranging from energy conservation to improved gas exchange, and including a plethora of functions related to thermoregulation, digestion and haemodynamics. It has even been suggested that shunts are merely an evolutionary or developmental relic. Having considered the various hypotheses involving cardiovascular shunting in vertebrates, this review then takes a non-traditional approach. Rather than attempting to identify the single 'correct' reason for the occurrence of shunts, we advance a more holistic, integrative approach that embraces multiple, non-exclusive suites of proposed causes for shunts, and indicates how these varied functions might at least co-exist, if not actually support each other as shunts serve multiple, concurrent physiological functions. It is argued that deposing the 'monolithic' view of shunting leads to a more nuanced view of vertebrate cardiovascular systems. This review concludes by suggesting new paradigms for testing the function(s) of shunts, including experimentally placing organ systems into conflict in terms of their perfusion needs, reducing sources of variation in physiological experiments, measuring possible compensatory responses to shunt ablation, moving experiments from the laboratory to the field, and using cladistics-related approaches in the choice of experimental animals.

Anatomical assessment of intrathoracic cardiovascular structures using fast spin-echo double inversion recovery and steady-state free precession magnetic resonance imaging in a normal cat.

In human medicine, non-contrast cardiac magnetic resonance imaging (CMRI) is routinely used to assess the cardiovascular system. In this study, using non-contrast CMRI, we provide a thorough description of the normal appearance of the intrathoracic cardiovascular structures in one healthy cat using a magnet operating at a field of 1.5-Tesla. The CMRI protocol was based on the use of fast spin-echo double inversion recovery and steady-state free precession pulse sequences in oblique short-axis, vertical long-axis, and horizontal long-axis imaging planes. After imaging the feline heart, four cadaver cats injected with latex substance into their arterial and venous systems were sectioned to facilitate interpretation of the intrathoracic cardiovascular structures to the corresponding CMRI. The fast spin-echo double inversion recovery images showed the best evaluation of gross intrathoracic anatomy, giving excellent contrast of the myocardium and vessels walls as they appeared with intermediate signal intensity compared to the lumen that appeared with low signal intensity. By contrast, steady-state free precession images showed details of the heart cavities and vascular lumen due to the high signal intensity of fast-flowing blood. The results of this study provide some anatomic detail for the heart and associated vessels as seen by non-contrast CMRI in the domestic cat.

Core/Shell Piezoelectric Nanofibers with Spatial Self-Orientated ß-Phase Nanocrystals for Real-Time Micropressure Monitoring of Cardiovascular Walls.

Implantable pressure biosensors show great potential for assessment and diagnostics of pressure-related diseases. Here, we present a structural design strategy to fabricate core/shell polyvinylidene difluoride (PVDF)/hydroxylamine hydrochloride (HHE) organic piezoelectric nanofibers (OPNs) with well-controlled and self-orientated nanocrystals in the spatial uniaxial orientation (SUO) of ß-phase-rich fibers, which significantly enhance piezoelectric performance, fatigue resistance, stability, and biocompatibility. Then PVDF/HHE OPNs soft sensors are developed and used to monitor subtle pressure changes in vivo. Upon implanting into pig, PVDF/HHE OPNs sensors demonstrate their ultrahigh detecting sensitivity and accuracy to capture micropressure changes at the outside of cardiovascular walls, and output piezoelectric signals can real-time and synchronously reflect and distinguish changes of cardiovascular elasticity and occurrence of atrioventricular heart-block and formation of thrombus. Such biological information can provide a diagnostic basis for early assessment and diagnosis of thrombosis and atherosclerosis, especially for postoperative recrudescence of thrombus deep within the human body.

Getting to the heart of cardiovascular evolution in humans.

Differences in the response of cardiomyocytes to oxygen deprivation in humans and chimpanzees may explain why humans are more prone to certain heart diseases.

INVESTIGATION INTO CARDIOVASCULAR ASSESSMENT OF CAPTIVE ADULT SCARLET IBIS (EUDOCIMUS RUBER).

Cardiovascular lesions are commonly diagnosed postmortem in scarlet ibis (Eudocimus ruber), but antemortem diagnosis is rare. The aim of this study was to evaluate the cardiovascular health of a zoo population (n = 44) of apparently healthy, adult, scarlet ibis. A cross-sectional study design was employed whereby each animal was manually restrained for physical examination, phlebotomy, and echocardiographic examination performed with a 12-MHz transducer and a ventromedial approach, and observed intervals were calculated for 12 parameters. Seven individuals from the study population had high left-sided mid-ventricular velocities (2.59-5.89 m/sec) compared with values in other species. Follow-up examination suggested that these mid-ventricular obstructive lesions were dynamic and transient in nature rather than caused by fixed lesions within the outflow tract and may therefore be associated with stress. Conscious echocardiography proved to be feasible, although, unsurprisingly, the stress response in nonhabituated birds appeared to increase blood flow velocities. Handling protocols likely have a significant effect on echocardiographic parameters and should be taken into consideration when interpreting findings. Serum cholesterol concentrations were generally high (7.4-13.0 mmol/L), and further work is required to investigate the relationship between circulating cholesterol and the development of atherosclerosis in scarlet ibis. Serum cardiac troponin I concentrations were measured, and four animals were identified with suspected elevated levels, likely indicative of myocardial damage.

Impact of cardiovascular embryology animations on short-term learning.

An understanding of human embryology is essential for students to better understand the subjects of human anatomy and physiology. However, human embryology is a challenging subject for many, since they must learn how anatomic structures and physiological processes develop over a period of time. Embryology texts typically use static, two-dimensional images to illustrate the dynamic three-dimensional developmental processes, making it difficult for a student to understand spatial relationships and sequential steps. To help students conceptualize these series of complex dynamic developmental events that occur over time, two of the authors and a graphic artist developed six web-based cardiovascular embryology animations and housed them on an Indiana University website. This research study examines knowledge gains and user satisfaction of students, faculty, and laypeople around the world who accessed these six website animations. Data collection spanned 6 yr, and pretest/posttest assessments (ranging from 4 to 7 multiple-choice questions each) were used to determine immediate knowledge gains of cardiovascular embryology. The total number of completed pretest/posttest assessments ranged from 555 to 1,449 per animation. The number of correct posttest scores was significantly improved over matched pretest scores (confidence interval range 1.3-3.2, depending on the animation, P < 0.001), suggesting the animations are useful for embryology learning (at least in the short term). Demographic and user satisfaction information was gathered with an anonymous survey at the end of each animation. Survey data from all animations indicated participants found the animations easy to use and very effective for their learning. This research highlights the positive impacts of web-based animations on learning complicated events of cardiovascular embryology.

Generative retrieval results in positive academic emotions and long-term retention of cardiovascular anatomy using transthoracic echocardiography.

With increasing medical knowledge, procedural, and diagnostic skills to learn, it is vital for educators to make the limited amount of teaching time available to students effective and efficient. Generative retrieval is an effective and efficient learning tool, improving long-term retention through the practice of retrieval from memory. Forty medical students were randomized to learn normal cardiovascular anatomy using transthoracic echocardiography video clips in a generative retrieval (GR) or standard practice (SP) group. GR participants were required to verbally identify each unlabeled cardiovascular structure after viewing the video. After answering, participants viewed the correctly labeled video. SP participants viewed the same video clips labeled with the correct cardiovascular structure for the same amount of total time without verbally generating an answer. All participants were tested for intermediate (1-wk), late (1-mo), and long-term (6- to 9-mo) retention of cardiovascular anatomy. Additionally, a three-question survey was incorporated to assess perceptions of the learning method. There was no difference in pretest scores. The GR group demonstrated a trend toward improvement in recall at 1 wk [GR = 74.3 (SD 12.3); SP = 65.4 (SD 16.7); P = 0.10] and 1 mo [GR = 69.9 (SD15.6); SP = 64.3 (SD 15.4); P = 0.33]. At the 6- to 9-mo time point, there was a statistically significant difference in scores [GR = 74.3 (SD 9.9); SP = 65.0 (SD 14.1); P = 0.042]. At nearly every time point, learners had a statistically significantly higher perception of effectiveness, enjoyment, and satisfaction with GR. In addition to improved recall, GR is associated with increased perceptions of effectiveness, enjoyment, and satisfaction, which may lead to increased engagement, time spent studying, and improved retention.

A Low Power Cardiovascular Healthcare System With Cross-Layer Optimization From Sensing Patch to Cloud Platform.

Nowadays, cardiovascular disease is still one of the primary diseases that limit life expectation of humans. To address this challenge, this work reports an Internet of Medical Things (IoMT)-based cardiovascular healthcare system with cross-layer optimization from sensing patch to cloud platform. A wearable ECG patch with a custom System-on-Chip (SoC) features a miniaturized footprint, low power consumption, and embedded signal processing capability. The patch also integrates wireless connectivity with mobile devices and cloud platform for optimizing the complete system. On the big picture, a "wearable patch-mobile-cloud" hybrid computing framework is proposed with cross-layer optimization for performance-power trade-off in embedded-computing. The measurement results demonstrate that the on-patch compression ratio of the raw ECG signal can reach 12.07 yielding a percentage root mean square variation of 2.29%. In the test with the MIT-BIH database, the average improvement of signal to noise ratio and mean square error are 12.63 dB and 94.47%, respectively. The average accuracy of disease prediction operation executed in cloud platform is 97%.