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A pathologically formed blood clot or thrombus is central to major cardiovascular diseases like heart attack and stroke. Detailed quantitative evaluation of flow and flow-mediated transport processes in the thrombus neighborhood within large artery hemodynamics is crucial for understanding disease progression and assessing treatment efficacy. This, however, remains a challenging task owing to the complexity of pulsatile viscous flow interactions with arbitrary shape and heterogeneous microstructure of realistic thrombi. Here, we address this challenge by conducting a systematic parametric simulation-based study on characterizing unsteady hemodynamics and flow-mediated transport in the neighborhood of an arterial thrombus. We use a hybrid particle-continuum-based finite element approach to handle arbitrary thrombus shape and microstructural variations. Results from a cohort of 50 different unsteady flow scenarios are presented, including unsteady vortical structures, pressure gradient across the thrombus boundary, finite time Lyapunov exponents, and dynamic coherent structures that organize advective transport. We clearly illustrate the combined influence of three key parameters-thrombus shape, microstructure, and extent of wall disease-in terms of (a) determining hemodynamic features in the thrombus neighborhood and (b) governing the balance between advection, permeation, and diffusion to regulate transport processes in the thrombus neighborhood.<br /><br /> To show some preliminary results about the possibility to exploit a cardiovascular mathematical model-made patient-specific by noninvasive data routinely measured during ordinary clinical examinations-in order to obtain sufficiently accurate central blood pressure (BP) estimates.<br /><br /> A closed-loop multiscale (0D and 1D) model of the cardiovascular system is made patient-specific by using as model inputs the individual mean heart rate and left-ventricular contraction time, weight, height, age, sex and mean/pulse brachial BPs. The resulting framework is used to determine central systolic, diastolic, mean and pulse pressures, which are compared with the beat-averaged invasive pressures of 12 patients aged 72 ± 6.61 years.<br /><br /> Errors in central systolic, diastolic, mean and pulse pressures by the model are 4.26 ± 2.81, 5.86 ± 4.38, 4.98 ± 3.95 and 3.51±2.38 mmHg, respectively.<br /><br /> The proposed modeling approach shows a good patient-specific response and appears to be potentially useful in clinical practice. However, this approach needs to be evaluated in a larger cohort of patients and could possibly be improved through more accurate oscillometric BP measurement methods.<br /><br />The proposed modeling approach shows a good patient-specific response and appears to be potentially useful in clinical practice. However, this approach needs to be evaluated in a larger cohort of patients and could possibly be improved through more accurate oscillometric BP measurement methods.<br /><br /> Cardiac auscultation skills have proven difficult to train and maintain. The authors investigated whether using phonocardiograms as visual adjuncts to audio cases improved first-year medical students' cardiac auscultation performance.<br /><br /> The authors randomized 135 first-year medical students using an email referral link in 2018 and 2019 to train using audio-only cases (audio group) or audio with phonocardiogram tracings (combined group). Training included 7cases with normal and abnormal auscultation findings. The assessment included feature identification and diagnostic accuracy using 14audio-only cases, 7presented during training, and 7alternate versions of the same diagnoses. The assessment-administered immediately after training and repeated 7days later-prompted participants to identify the key features and diagnoses for 14audio-only cases. Key feature scores and diagnostic accuracy were compared between groups using repeated measures ANOVA.<br /><br /> Mean key feature scores were statistically significantly higher in the combined group (70%, 95% CI 67-75%) compared to the audio group (61%, 95% CI 56-66%) (F(1,116) = 6.144, p = 0.015, d<br /><br />  = 0.45). Similarly, mean diagnostic accuracy in the combined group (68%, 95% CI 62-73%) was significantly higher than the audio group, although with small effect size (59%, 95% CI 54-65%) (F(1,116) = 4.548, p = 0.035, d<br /><br />  = 0.40). Time on task for the assessment and prior auscultation experience did not significantly impact performance on either measure.<br /><br /> The addition of phonocardiograms to supplement cardiac auscultation training improves diagnostic accuracy and heart sound feature identification amongst novice students compared to training with audio alone.<br /><br />The addition of phonocardiograms to supplement cardiac auscultation training improves diagnostic accuracy and heart sound feature identification amongst novice students compared to training with audio alone.The number of cancer survivors is expected to rise to up to 20 million by 2026. It is of utmost importance that nurses who provide survivorship care enhance their knowledge and skills to meet the needs of cancer survivors. The purpose of this project is to propose a pilot evidence-based educational project to incorporate the concept and framework of the survivorship care plan for nursing students. [https://www.selleckchem.com/products/pf-06826647.html PF-06826647 chemical structure] We evaluated feedback from nursing students for their knowledge and attitude on cancer survivorship care. A pilot educational project was given to 38 undergraduate students and 17 graduate students. Pre- and post-test feedback were collected from these students. Content analysis was used to analyze the data. At least 60% of both undergraduate and graduate nursing students had experience in either adult or pediatric oncology units. Only 11% of undergraduate and 18% of graduate students reported awareness of survivorship care plans. However, all of the students believed the survivorship care plan will be helpful for cancer patients. We recommend that it is imperative to incorporate the concept of cancer survivorship in the early stage of nursing education.<br /><br /> Hyperinsulinaemia and insulin resistance (IR) are strongly associated with obesity and are forerunners of type 2 diabetes. Little is known about metabolic alterations separately associated with obesity, hyperinsulinaemia/IR and impaired glucose tolerance (IGT) in adolescents.<br /><br /> To identify metabolic alterations associated with obesity, hyperinsulinaemia/IR and hyperinsulinaemia/IR combined with IGT in obese adolescents.<br /><br /> 81 adolescents were stratified into four groups based on body mass index (lean vs. obese), insulin responses (normal insulin (NI) vs. high insulin (HI)) and glucose responses (normal glucose tolerance (NGT) vs. IGT) after an oral glucose tolerance test (OGTT). The groups comprised (1) healthy lean with NI and NGT, (2) obese with NI and NGT, (3) obese with HI and NGT, and (4) obese with HI and IGT. Targeted nuclear magnetic resonance-based metabolomics analysis was performed on fasting and seven post-OGTT plasma samples, followed by univariate and multivariate statistical analyses.<br /><br /> Two groups of metabolites were identified (1) Metabolites associated with insulin response level adolescents with HI (groups 3-4) had higher concentrations of branched-chain amino acids and tyrosine, and lower concentrations of serine, glycine, myo-inositol and dimethylsulfone, than adolescents with NI (groups 1-2).