Toward Automation of the Supine Pressor Test for Preeclampsia

Preeclampsia leads to increased risk of morbidity and mortality for both mother and fetus. Most previous studies have largely neglected mechanical compression of the left renal vein by the gravid uterus as a potential mechanism. In this study, we first used a murine model to investigate the pathophysiology of left renal vein constriction. The results indicate that prolonged renal vein stenosis after 14 days can cause renal necrosis and an increase in blood pressure (BP) of roughly 30 mmHg. The second part of this study aimed to automate a diagnostic tool, known as the supine pressor test (SPT), to enable pregnant women to assess their preeclampsia development risk. A positive SPT has been previously defined as an increase of at least 20 mmHg in diastolic BP when switching between left lateral recumbent and supine positions. The results from this study established a baseline BP increase between the two body positions in nonpregnant women and demonstrated the feasibility of an autonomous SPT in pregnant women. Our results demonstrate that there is a baseline increase in BP of roughly 10-14 mmHg and that pregnant women can autonomously perform the SPT. Overall, this work in both rodents and humans suggests that (1) stenosis of the left renal vein in mice leads to elevation in BP and acute renal failure, (2) nonpregnant women experience a baseline increase in BP when they shift from left lateral recumbent to supine position, and (3) the SPT can be automated and used autonomously

Neurogenesis Deep Learning

Neural machine learning methods, such as deep neural networks (DNN), have achieved remarkable success in a number of complex data processing tasks. These methods have arguably had their strongest impact on tasks such as image and audio processing - data processing domains in which humans have long held clear advantages over conventional algorithms. In contrast to biological neural systems, which are capable of learning continuously, deep artificial networks have a limited ability for incorporating new information in an already trained network. As a result, methods for continuous learning are potentially highly impactful in enabling the application of deep networks to dynamic data sets. Here, inspired by the process of adult neurogenesis in the hippocampus, we explore the potential for adding new neurons to deep layers of artificial neural networks in order to facilitate their acquisition of novel information while preserving previously trained data representations. Our results on the MNIST handwritten digit dataset and the NIST SD 19 dataset, which includes lower and upper case letters and digits, demonstrate that neurogenesis is well suited for addressing the stability-plasticity dilemma that has long challenged adaptive machine learning algorithms.Comment: 8 pages, 8 figures, Accepted to 2017 International Joint Conference on Neural Networks (IJCNN 2017

Characterization of Knots and Links Arising From Site-specific Recombination on Twist Knots

We develop a model characterizing all possible knots and links arising from recombination starting with a twist knot substrate, extending previous work of Buck and Flapan. We show that all knot or link products fall into three well-understood families of knots and links, and prove that given a positive integer $n$, the number of product knots and links with minimal crossing number equal to $n$ grows proportionally to $n^5$. In the (common) case of twist knot substrates whose products have minimal crossing number one more than the substrate, we prove that the types of products are tightly prescribed. Finally, we give two simple examples to illustrate how this model can help determine previously uncharacterized experimental data.Comment: 32 pages, 7 tables, 27 figures, revised: figures re-arranged, and minor corrections. To appear in Journal of Physics

The Role of Galactic Winds on Molecular Gas Emission from Galaxy Mergers

We assess the impact of starburst and AGN feedback-driven winds on the CO emission from galaxy mergers, and, in particular, search for signatures of these winds in the simulated CO morphologies and emission line profiles. We do so by combining a 3D non-LTE molecular line radiative transfer code with smoothed particle hydrodynamics (SPH) simulations of galaxy mergers that include prescriptions for star formation, black hole growth, a multiphase interstellar medium (ISM), and the winds associated with star formation and black hole growth. Our main results are: (1) Galactic winds can drive outflows of masses ~10^8-10^9 Msun which may be imaged via CO emission line mapping. (2) AGN feedback-driven winds are able to drive imageable CO outflows for longer periods of time than starburst-driven winds owing to the greater amount of energy imparted to the ISM by AGN feedback compared to star formation. (3) Galactic winds can control the spatial extent of the CO emission in post-merger galaxies, and may serve as a physical motivation for the sub-kiloparsec scale CO emission radii observed in local advanced mergers. (4) Secondary emission peaks at velocities greater than the circular velocity are seen in the CO emission lines in all models. In models with winds, these high velocity peaks are seen to preferentially correspond to outflowing gas entrained in winds, which is not the case in the model without winds. The high velocity peaks seen in models without winds are typically confined to velocity offsets (from the systemic) < 1.7 times the circular velocity, whereas the models with AGN feedback-driven winds can drive high velocity peaks to ~2.5 times the circular velocity.Comment: Accepted by ApJ; Minor revisions; Resolution tests include

Flinders Island spotted fever rickettsioses caused by "marmionii" strain of rickettsia honei, Eastern Australia

Australia has 4 rickettsial diseases: murine typhus, Queensland tick typhus, Flinders Island spotted fever, and scrub typhus. We describe 7 cases of a rickettsiosis with an acute onset and symptoms of fever (100%), headache (71%), arthralgia (43%), myalgia (43%), cough (43%), maculopapular/petechial rash (43%), nausea (29%), pharyngitis (29%), lymphadenopathy (29%), and eschar (29%). Cases were most prevalent in autumn and from eastern Australia, including Queensland, Tasmania, and South Australia. One patient had a history of tick bite (Haemaphysalis novaeguineae). An isolate shared 99.2%, 99.8%, 99.8%, 99.9%, and 100% homology with the 17 kDa, ompA, gltA, 16S rRNA, and Sca4 genes, respectively, of Rickettsia honei. This Australian rickettsiosis has similar symptoms to Flinders Island spotted fever, and the strain is genetically related to R. honei. It has been designated the "marmionii" strain of R. honei, in honor of Australian physician and scientist Barrie Marmion

Utilizing an Innovative Preceptor Video Mini-Series to Prepare Students for Experiential Rotations: Does it Work?

Objectives: To determine whether an innovative Mini-Series training model originally developed for preceptors could be beneficial to pharmacy students prior to and/or after beginning their introductory or advanced pharmacy practice experiences. Methods: This program consists of twelve incremental video episodes, each ranging from five to eight minutes in length. It tells the story of a young pharmacy preceptor as she guides a third and fourth year student through a challenging six-week clinical hospital rotation. Two to three reflection questions were written for each individual episode, focusing on student issues portrayed in the videos. Two-hour viewing sessions, consisting of all (12) video episodes and facilitated student reflection were held for 2nd – 4th year professional students on two campuses. At conclusion of each session, students completed a short evaluation to gauge the effectiveness and potential application of the Mini-Series program. Results: Fifty-six (56) students (22 fourth-year, 6 third-ear, and 28 second-year) participated in the voluntary viewing sessions. All students either agreed or strongly agreed that the Mini-Series program was entertaining and educational. In addition, 82% of students strongly agreed this program would be beneficial for students prior to taking their first experiential rotation, while only 47% strongly agreed it would be beneficial after they had started rotations. On a 5-point Likert scale (1=strongly disagree, 5=strongly agree), participants reported a mean of 4.6 that this medium is more effective than traditional lecture orientations held by the Office of Experiential Programs. On three open-ended questions, students provided a diversity of suggestions for enhancing the Mini-Series to make it more effective for students. Implications: The “Mini-Series” model was well received by students as a training medium to deliver educational content. As a result, more programs are being developed utilizing this innovative teaching method to help prepare students for future experiential rotations. Conflict of Interest The authors report no conflicts of interest or financial incentives to disclose related to this project. Dr. Craig D. Cox conceptualized, developed, and directed the&nbsp;Mini-Seriesprogram described in the manuscript. All funding for and all income generated by the program studied is the property of the Texas Tech University Health Sciences Center School of Pharmacy. &nbsp; Type:&nbsp;Original Researc

Does presence of a mid-ocean ridge enhance biomass and biodiversity?

In contrast to generally sparse biological communities in open-ocean settings, seamounts and ridges are perceived as areas of elevated productivity and biodiversity capable of supporting commercial fisheries. We investigated the origin of this apparent biological enhancement over a segment of the North Mid-Atlantic Ridge (MAR) using sonar, corers, trawls, traps, and a remotely operated vehicle to survey habitat, biomass, and biodiversity. Satellite remote sensing provided information on flow patterns, thermal fronts, and primary production, while sediment traps measured export flux during 2007-2010. The MAR, 3,704,404 km 2 in area, accounts for 44.7% lower bathyal habitat (800-3500 m depth) in the North Atlantic and is dominated by fine soft sediment substrate (95% of area) on a series of flat terraces with intervening slopes either side of the ridge axis contributing to habitat heterogeneity. The MAR fauna comprises mainly species known from continental margins with no evidence of greater biodiversity. Primary production and export flux over the MAR were not enhanced compared with a nearby reference station over the Porcupine Abyssal Plain. Biomasses of benthic macrofauna and megafauna were similar to global averages at the same depths totalling an estimated 258.9 kt C over the entire lower bathyal north MAR. A hypothetical flat plain at 3500 m depth in place of the MAR would contain 85.6 kt C, implying an increase of 173.3 kt C attributable to the presence of the Ridge. This is approximately equal to 167 kt C of estimated pelagic biomass displaced by the volume of the MAR. There is no enhancement of biological productivity over the MAR; oceanic bathypelagic species are replaced by benthic fauna otherwise unable to survive in the mid ocean. We propose that globally sea floor elevation has no effect on deep sea biomass; pelagic plus benthic biomass is constant within a given surface productivity regime.Peer reviewe

Use of an Innovative Interprofessional Mini-Series Movie to Train Preceptors

Objectives: To evaluate the effectiveness of the innovative “Preceptor Mini-Series: Adventures in Interprofessional Precepting” movie program in training pharmacy preceptors on interprofessional competencies and to determine pharmacy preceptors’ perceptions of the effectiveness of the Mini-Series format. Methods: Chronicled by two preceptor experts, the Mini-Series movie follows the challenges of pharmacy, nursing, and medicine students and their preceptor during six-week experiential rotations. Pharmacy preceptors were invited to events held at movie theatres or local classrooms in three different cities. Participants were asked to provide basic demographic information and answer four “pre-program” and “post-program” survey questions focused on working in an interprofessional environment on a 5 point scale, 1=strongly disagree, 5=strongly agree. The post-program survey also included six additional questions to assess participant’s attitudes toward the effectiveness of this medium. Results: Fifty-eight (58) individuals attended the movie events. The majority had more than ten years of preceptor experience (n = 21, 36.2%), were female preceptors (n = 40, 69.0%), and practiced in an interprofessional environment (n = 48, 82.8%). The participants’ scores on all four interprofessional confidence level questions were significantly increased after viewing the Mini-Series movie and the overall mean increased from 4.47 (pre-confidence level) to 4.79 (post-confidence level, p &lt; 0.001). There were no significant differences of confidence levels based on gender, location, or number of students a preceptor took on rotation each year. However, participants with fewer years of preceptor experience (0-10 years) had a significantly higher perceived learning score than those with more preceptor experience (&gt;10 years) (4.89 vs. 4.63, p = 0.020). The mean for satisfaction (4.9, 3 questions) was slightly higher than the means for perceived learning (4.8, 1 question), and instructional approach (4.87, 3 questions). Implications: After program completion, pharmacy preceptors indicated an increase in confidence level for precepting in an interprofessional environment. The Mini-Series movie program also yielded positive feedback on its delivery format and suggests the medium may be effective to use for similar future training initiatives. Conflict of Interest The authors report no conflicts of interest or financial incentives to disclose related to this project. Dr. Craig D. Cox conceptualized, developed, and directed the&nbsp;Mini-Seriesprogram described in the manuscript. All funding for and all income generated by the program studied is the property of the Texas Tech University Health Sciences Center School of Pharmacy. &nbsp; Type:&nbsp;Original Researc

Use of an Innovative Interprofessional Mini-Series Movie to Train Preceptors

Objectives: To evaluate the effectiveness of the innovative “Preceptor Mini-Series: Adventures in Interprofessional Precepting” movie program in training pharmacy preceptors on interprofessional competencies and to determine pharmacy preceptors’ perceptions of the effectiveness of the Mini-Series format. Methods: Chronicled by two preceptor experts, the Mini-Series movie follows the challenges of pharmacy, nursing, and medicine students and their preceptor during six-week experiential rotations. Pharmacy preceptors were invited to events held at movie theatres or local classrooms in three different cities. Participants were asked to provide basic demographic information and answer four “pre-program” and “post-program” survey questions focused on working in an interprofessional environment on a 5 point scale, 1=strongly disagree, 5=strongly agree. The post-program survey also included six additional questions to assess participant’s attitudes toward the effectiveness of this medium. Results: Fifty-eight (58) individuals attended the movie events. The majority had more than ten years of preceptor experience (n = 21, 36.2%), were female preceptors (n = 40, 69.0%), and practiced in an interprofessional environment (n = 48, 82.8%). The participants’ scores on all four interprofessional confidence level questions were significantly increased after viewing the Mini-Series movie and the overall mean increased from 4.47 (pre-confidence level) to 4.79 (post-confidence level, p 10 years) (4.89 vs. 4.63, p = 0.020). The mean for satisfaction (4.9, 3 questions) was slightly higher than the means for perceived learning (4.8, 1 question), and instructional approach (4.87, 3 questions). Implications: After program completion, pharmacy preceptors indicated an increase in confidence level for precepting in an interprofessional environment. The Mini-Series movie program also yielded positive feedback on its delivery format and suggests the medium may be effective to use for similar future training initiatives. Conflict of Interest The authors report no conflicts of interest or financial incentives to disclose related to this project. Dr. Craig D. Cox conceptualized, developed, and directed the Mini-Seriesprogram described in the manuscript. All funding for and all income generated by the program studied is the property of the Texas Tech University Health Sciences Center School of Pharmacy.   Type: Original Researc

Walks4work: Rationale and study design to investigate walking at lunchtime in the workplace setting

Background: Following recruitment of a private sector company, an 8week lunchtime walking intervention was implemented to examine the effect of the intervention on modifiable cardiovascular disease risk factors, and further to see if walking environment had any further effect on the cardiovascular disease risk factors. Methods. For phase 1 of the study participants were divided into three groups, two lunchtime walking intervention groups to walk around either an urban or natural environment twice a week during their lunch break over an 8week period. The third group was a waiting-list control who would be invited to join the walking groups after phase 1. In phase 2 all participants were encouraged to walk during their lunch break on self-selecting routes. Health checks were completed at baseline, end of phase 1 and end of phase 2 in order to measure the impact of the intervention on cardiovascular disease risk. The primary outcome variables of heart rate and heart rate variability were measured to assess autonomic function associated with cardiovascular disease. Secondary outcome variables (Body mass index, blood pressure, fitness, autonomic response to a stressor) related to cardiovascular disease were also measured. The efficacy of the intervention in increasing physical activity was objectively monitored throughout the 8-weeks using an accelerometer device. Discussion. The results of this study will help in developing interventions with low researcher input with high participant output that may be implemented in the workplace. If effective, this study will highlight the contribution that natural environments can make in the reduction of modifiable cardiovascular disease risk factors within the workplace. © 2012 Brown et al.; licensee BioMed Central Ltd