[The anatomical model collection at the Universidade Federal de Ouro Preto's Museum of Pharmacy]. / Coleção de modelos anatômicos do Museu da Pharmacia da Universidade Federal de Ouro Preto.

The Ouro Preto School of Pharmacy was founded in 1839 and was the first pharmacy school in Latin America independent from a medical school. At the end of the nineteenth century, it had a collection of French anatomical models made by Deyrolle, Dr. Auzoux, and Vasseur-Tramod, many produced from wax or papier-mâché. This project involved recovering, identifying, cleaning, restoring, and exhibiting seventeen models found in various facilities from Universidade Federal de Ouro Preto. The models in good condition were exhibited in the Museum of Pharmacy (where this work was carried out) as part of the teaching collection for the Ouro Preto pharmacy course.

A Escola de Farmácia de Ouro Preto, fundada em 1839, foi a primeira da América Latina desvinculada de uma escola de medicina. No final do século XIX, contou com um acervo de modelos anatômicos franceses dos renomados Deyrolle, Dr. Auzoux e Vasseur-Tramod, muitos fabricados em cera ou papel machê. O presente trabalho teve como objetivo resgatar, identificar, higienizar, restaurar e expor os modelos. De unidades acadêmicas da Universidade Federal de Ouro Preto, 17 modelos anatômicos foram resgatados e transferidos para o Museu da Pharmacia, onde receberam o devido tratamento. Os modelos em melhores condições foram expostos no museu formando parte da coleção de ensino do curso de farmácia de Ouro Preto.

Coleção de modelos anatômicos do Museu da Pharmacia da Universidade Federal de Ouro Preto / The anatomical model collection at the Universidade Federal de Ouro Preto's Museum of Pharmacy

Resumo A Escola de Farmácia de Ouro Preto, fundada em 1839, foi a primeira da América Latina desvinculada de uma escola de medicina. No final do século XIX, contou com um acervo de modelos anatômicos franceses dos renomados Deyrolle, Dr. Auzoux e Vasseur-Tramod, muitos fabricados em cera ou papel machê. O presente trabalho teve como objetivo resgatar, identificar, higienizar, restaurar e expor os modelos. De unidades acadêmicas da Universidade Federal de Ouro Preto, 17 modelos anatômicos foram resgatados e transferidos para o Museu da Pharmacia, onde receberam o devido tratamento. Os modelos em melhores condições foram expostos no museu formando parte da coleção de ensino do curso de farmácia de Ouro Preto.

Abstract The Ouro Preto School of Pharmacy was founded in 1839 and was the first pharmacy school in Latin America independent from a medical school. At the end of the nineteenth century, it had a collection of French anatomical models made by Deyrolle, Dr. Auzoux, and Vasseur-Tramod, many produced from wax or papier-mâché. This project involved recovering, identifying, cleaning, restoring, and exhibiting seventeen models found in various facilities from Universidade Federal de Ouro Preto. The models in good condition were exhibited in the Museum of Pharmacy (where this work was carried out) as part of the teaching collection for the Ouro Preto pharmacy course.

In situ monitoring of photocatalyzed isomerization reactions on a microchip flow reactor by IR-MALDI ion mobility spectrometry.

The visible-light photocatalytic E/Z isomerization of olefins can be mediated by a wide spectrum of triplet sensitizers (photocatalysts). However, the search for the most efficient photocatalysts through screenings in photo batch reactors is material and time consuming. Capillary and microchip flow reactors can accelerate this screening process. Combined with a fast analytical technique for isomer differentiation, these reactors can enable high-throughput analyses. Ion mobility (IM) spectrometry is a cost-effective technique that allows simple isomer separation and detection on the millisecond timescale. This work introduces a hyphenation method consisting of a microchip reactor and an infrared matrix-assisted laser desorption ionization (IR-MALDI) ion mobility spectrometer that has the potential for high-throughput analysis. The photocatalyzed E/Z isomerization of ethyl-3-(pyridine-3-yl)but-2-enoate (E-1) as a model substrate was chosen to demonstrate the capability of this device. Classic organic triplet sensitizers as well as Ru-, Ir-, and Cu-based complexes were tested as catalysts. The ionization efficiency of the Z-isomer is much higher at atmospheric pressure which is due to a higher proton affinity. In order to suppress proton transfer reactions by limiting the number of collisions, an IM spectrometer working at reduced pressure (max. 100 mbar) was employed. This design reduced charge transfer reactions and allowed the quantitative determination of the reaction yield in real time. Among 14 catalysts tested, four catalysts could be determined as efficient sensitizers for the E/Z isomerization of ethyl cinnamate derivative E-1. Conversion rates of up to 80% were achieved in irradiation time sequences of 10 up to 180 s. With respect to current studies found in the literature, this reduces the acquisition times from several hours to only a few minutes per scan.

Taming Nuclear Complexity with a Committee of Multilayer Neural Networks.

We demonstrate that a committee of deep neural networks is capable of predicting the ground-state and excited energies of more than 1800 atomic nuclei with an accuracy akin to the one achieved by state-of-the-art nuclear energy density functionals (EDFs) and with significantly less computational cost. An active learning strategy is proposed to train this algorithm with a minimal set of 210 nuclei. This approach enables future fast studies of the influence of EDF parametrizations on structure properties over the whole nuclear chart and suggests that for the first time a machine learning framework successfully encoded several correlated aspects of nuclear deformation.

Polarization-independent atomic prism filter for removing amplified spontaneous emission.

We create an optical frequency, polarization-independent, narrow bandpass filter of 1.3 GHz (3 dB bandwidth), using the steep dispersion near the rubidium D1 atomic transitions within a prism-shaped vapor cell. This enables us to clean the amplified spontaneous emission from a laser by more than 3 orders of magnitude. Such a filter could find uses in fields such as quantum information processing and Raman spectroscopy.

Interpretation of androgen and anti-Mullerian hormone profiles in a Hispanic cohort of 5- to 8-year-old girls with premature adrenarche

PURPOSE: Premature adrenarche (PA) often leads to polycystic ovary syndrome (PCOS). Higher anti-mullerian hormone (AMH) levels are reported in PCOS. We studied the androgen profile and AMH profiles in Hispanic girls with PA (aged 5–8 years) and age and body mass index (BMI) matched controls. METHODS: Retrospective review of electronic medical records of girls who met the inclusion criteria for premature adrenarche were done. RESULTS: PA girls (n=76) were matched to control girls (n=12) for age (mean±standard deviation) (6.7±1 years vs. 6.2±1.3 years) and BMI (20±10 kg/m2 vs. 17.8±2.7 kg/m2). Dehydroepiandrostenedione sulfate (63.3±51.3 μg/dL vs. 29.8±17.3 μg/dL, P < 0.001) and testosterone levels (11.4±4.8 ng/dL vs. 8.2±2.9 ng/dL, P=0.001) were significantly higher in the PA group than controls. AMH values ( < 14 years: reference range, 0.49–3.15 ng/mL) were 3.2±2.2 ng/mL vs. 4.6± 3.2 ng/mL respectively in the PA and control groups and were not different (P=0.4). AMH did not show a correlation with bone age (P=0.1), and testosterone (P=0.9) in the PA group. 17-hydroxyprogesterone levels (17-OHP ng/dL) were 39.5±30.5 ng/dL vs. 36.8±19.8 ng/dL in PA versus control girls. The concentration of 17-OHP was not statistically different between the control and PA groups. CONCLUSIONS: Higher AMH was not observed in PA girls and no correlation with BA and androgen levels was observed.

Critical Points in Tumorigenesis: A Carcinogen-Initiated Phase Transition Analyzed via Single-Cell Proteomics.

A kinetic, single-cell proteomic study of chemically induced carcinogenesis is interpreted by treating the single-cell data as fluctuations of an open system transitioning between different steady states. In analogy to a first-order transition, phase coexistence and the loss of degrees of freedom are observed. The transition is detected well before the appearance of the traditional biomarker of the carcinogenic transformation.

20 MHz forward-imaging single-element beam steering with an internal rotating variable-angle reflecting surface: Wire phantom and ex vivo pilot study.

Feasibility is demonstrated for a forward-imaging beam steering system involving a single-element 20MHz angled-face acoustic transducer combined with an internal rotating variable-angle reflecting surface (VARS). Rotation of the VARS structure, for a fixed position of the transducer, generates a 2-D angular sector scan. If these VARS revolutions were to be accompanied by successive rotations of the single-element transducer, 3-D imaging would be achieved. In the design of this device, a single-element 20MHz PMN-PT press-focused angled-face transducer is focused on the circle of midpoints of a micro-machined VARS within the distal end of an endoscope. The 2-D imaging system was tested in water bath experiments with phantom wire structures at a depth of 10mm, and exhibited an axial resolution of 66µm and a lateral resolution of 520µm. Chirp coded excitation was used to enhance the signal-to-noise ratio, and to increase the depth of penetration. Images of an ex vivo cow eye were obtained. This VARS-based approach offers a novel forward-looking beam-steering method, which could be useful in intra-cavity imaging.

Devolution's policy impact on non-emergency medical transportation in State Children's Health Insurance Programs.

Proponents of devolution often maintain that the transfer of power and authority of programs enables local officials to craft policy solutions that better align with the needs of their constituents. This article provides one of the first empirical evaluations of this assumption as it relates to non-emergency medical transportation (NEMT) in the State Children's Health Insurance Program (SCHIP). NEMT programs meet a critical need in the areas in which they serve, directly targeting this single key access barrier to care. Yet states have great latitude in making such services available. The authors utilize data from 32 states to provide a preliminary assessment of devolution's consequences and policy impact on transportation-related access to care. Their findings provide mixed evidence on devolution's impact on policy outcomes. Proponents of devolution can find solace in the fact that several states have gone beyond federally mandated minimum requirements to offer innovative programs to remove transportation barriers to care. Detractors of devolution will find continued pause on several key issues, as a number of states do not offer NEMT to their SCHIP populations while cutting services and leaving over $7 billion in federal matching funding unspent.

Proof of concept: In vitro measurement of correlation between radiodensity and ultrasound echo response of ovine vertebral bodies.

An acoustic guidance method for pedicle screw placement during spine fixation surgery was recently investigated, with a view toward preventing complications such as injury to the spinal cord, thecal sac, and spinal nerve roots due to screw misplacement. The method relies upon the change in the ultrasound amplitude reflected at different sites-from the outer posterior cortex, through the pedicle, and towards the distal ventral cortex. The amplitude change was empirically observed through in vitro measurement of ultrasound amplitude at the different sites by inserting a 2.5-MHz single element transducer into a vertebral body through insertion pathway created by an advancing screw. This paper provides a theoretical and experimental rationale behind these empirical findings and distance-dependent correlation coefficients between amplitude and bone mineral density within the vertebral body, which approached 97%.

A-Mode ultrasound guidance for pedicle screw advancement in ovine vertebral bodies.

BACKGROUND CONTEXT: In pedicle screw fixation surgery, rigid instruments are inserted into a vertebral body. When the instruments are misdirected within the pedicle or advanced too far beyond it, perforations of the inner or outer cortex can cause damage to the spinal nerve roots and spinal cord. These complications can occur despite the use of imaging modalities, such as radiographs, fluoroscopy, and computerized axial tomography (CAT) scans. A-Mode ultrasound (US), a nonionizing modality, merits study for its possible use in such a type of surgery. PURPOSE: The purpose of the study was to determine the utility of A-mode US during pedicle screw placement, to characterize the approach to the marrow-cortex interface, and to obtain the signature profiles of cortex perforations. STUDY DESIGN: A-Mode data were generated on insertion of a forward-viewing transducer (FVT) and a side-viewing transducer (SVT) to successively greater drilled depths along the insertion pathway. A-Mode broadband US backscatter (BUB) pedicle screw emulation experiments were conducted with transducers inserted into drilled sheep vertebral bodies. BUB amplitude patterns were observed and analyzed. Descriptive statistics were used. METHODS: In vitro acoustic experiments on vertebral bodies in a water bath were performed with two 1-MHz unfocused transducers to measure sound speed, broadband US attenuation, and backscatter coefficients. Micro-CAT scan three-dimensional (3-D) images of 10 disarticulated vertebral bodies were obtained pre- and postdrilling done in 5-mm depth increments with a flat-bottom drill. BUB patterns were noted of transducers inserted through rostral outer cortex, through the pedicle, and advanced to the ventral marrow-cortex interface. 2.5-MHz FVT and SVT were co-advanced in successive 5-mm increments along the insertion pathway, with BUBs measured at each point and the echoes composited into a single figure. Deliberate perforations of ventral cortex were made. RESULTS: Evident patterns or measures indicating the proximity of the ventral marrow-cortex interface were: 1) marrow BUB values increasing in amplitude over three distal peaks in most FVT cases (7 out of 10) and SVT cases (9 out of 10); 2) BUB ratio of marrow-cortex interface to the smallest marrow value greater than 2, in all FVT cases (10 out of 10) with FVT mean of 4.00+/-1.82 (2.25-8.33); and 3) a ratio of distal BUB value to starting cortex BUB in the 0. 82 to 1.62 range (mean, 0.98+/-0.30) in 80% of FVT cases. Ventral FVT perforations resulted in a major drop in the BUB value. CONCLUSIONS: The increase in the BUB amplitudes in the distal insertion pathway suggests that, at least with a 2.5-MHz transducer, an approximate 1.5-cm US window exists in most cases, by which close approach of the ventral marrow-cortex interface could be anticipated. Other ratios may serve as stop criteria to prevent further drilling. A precipitous drop in BUB amplitude may be an indication of a cortex perforation.

Images of spinal nerves and adjacent structures with optical coherence tomography: preliminary animal studies.

UNLABELLED: Multiple complications have been reported with spinal intervertebral transforaminal injection procedures, despite the use of fluoroscopic needle-positioning measures. We explored an imaging technology (optical coherence tomography, or OCT) for its possible use in spine interventional procedures as a means of providing needle tip vision at the neuroforamen. Optical coherence tomography is the B-mode optical analog of ultrasound. With the use of 2 different (time- and frequency-domain) OCT systems, we obtained high-resolution (approximately 10 microm) images of ex vivo and in situ paraspinal structures (spinal nerves, radicular artery, dura, cauda equina) in different animals. An OCT forward-looking, needle-shaped endoscope in development is presented, with a discussion of its possible method of use, safety, efficacy, technical problems, and future prospects. Further studies are needed to determine whether such OCT technology has a potential niche in the performance of spine pain procedures. PERSPECTIVE: This article presents preliminary high-resolution images obtained with an optical imaging approach (optical coherence tomography) of neurovascular and other structures within the spinal neuroforamen. Advances in this technology may provide effective needle tip vision for pain interventionalists and may help to reduce complications from spine needle injection procedures.

Pediatric airway and esophageal profiles with acoustic reflectometry.

Acoustic reflectometry is a technique by which the dimensions of a cavity can be estimated in the form of an area-distance profile. We conducted a pilot study to obtain the acoustic reflectometry (AR) images associated with breathing tube (endotracheal tube, ETT) placement (inner diameter 4.5-6 mm) and positioning in 21 (n = 21) children, aged 2-12 yr. Characteristic AR profiles, as previously noted in adults, were obtained for tracheal and esophageal intubations in children. Both types of profiles showed constant area throughout the ETT length, followed distally by either a rapid area increase (tracheal) or an area decrease to a near zero value (esophageal). Relative to a tracheal profile, a bronchial intubation exhibits a decrease in area distal to the carina position. With deeper ETT insertion, abutment of the ETT against the bronchial wall can occur, with a possible profound area decrease. The occurrence of ETT abutment in children and neonates, and its possible AR detection and treatment, is discussed.

Frontal slab composite magnetic resonance neurography of the brachial plexus: implications for infraclavicular block approaches.

BACKGROUND: Magnetic resonance neurography (MRN) is an imaging method by which nerves can be selectively highlighted. Using commercial software, the authors explored a variety of approaches to develop a three-dimensional volume-rendered MRN image of the entire brachial plexus and used it to evaluate the accuracy of infraclavicular block approaches. METHODS: With institutional review board approval, MRN of the brachial plexus was performed in 10 volunteer subjects. MRN imaging was performed on a GE 1.5-tesla magnetic resonance scanner (General Electric Healthcare Technologies, Waukesha, WI) using a phased array torso coil. Coronal STIR and T1 oblique sagittal sequences of the brachial plexus were obtained. Multiple software programs were explored for enhanced display and manipulation of the composite magnetic resonance images. The authors developed a frontal slab composite approach that allows single-frame reconstruction of a three-dimensional volume-rendered image of the entire brachial plexus. Automatic segmentation was supplemented by manual segmentation in nearly all cases. For each of three infraclavicular approaches (posteriorly directed needle below midclavicle, infracoracoid, or caudomedial to coracoid), the targeting error was measured as the distance from the MRN plexus midpoint to the approach-targeted site. RESULTS: Composite frontal slabs (coronal views), which are single-frame three-dimensional volume renderings from image-enhanced two-dimensional frontal view projections of the underlying coronal slices, were created. The targeting errors (mean +/- SD) for the approaches-midclavicle, infracoracoid, caudomedial to coracoid-were 0.43 +/- 0.67, 0.99 +/- 1.22, and 0.65 +/- 1.14 cm, respectively. CONCLUSION: Image-processed three-dimensional volume-rendered MNR scans, which allow visualization of the entire brachial plexus within a single composite image, have educational value in illustrating the complexity and individual variation of the plexus. Suggestions for improved guidance during infraclavicular block procedures are presented.

Acoustic reflectometry esophageal profiles minimally affected by massive gas ventilation.

Acoustic reflectometry can be used to distinguish between breathing tube placement in an esophagus vs the trachea via characteristic area-distance profiles for both cavities. In the cardiopulmonary resuscitation setting, capnography may be useless because the patient has little or no pulmonary circulation. With the breathing tube in the esophagus, can massive ventilation with a manual resuscitation bag, as might occur in the cardiopulmonary resuscitation setting, markedly alter the form of the obtained esophageal reflectometry profile? Nine hounds were induced, endotracheally intubated, mechanically ventilated, and anesthetized. Area-distance profiles were obtained with a 2-microphone acoustic reflectometer customized to measure areas up to 50 cm. Acoustic reflectometer profiles were obtained in intubated esophagi as follows: (1) baseline nonventilated state, (2) after aggressive 2-handed manual ventilation with high inspiratory pressures, rapid respiratory rates, and large tidal volumes for periods of 0.5, 1, and 1.5 minutes, upon detachment of the resuscitation bag, and (3) after esophagogastric decompression. We hypothesized that massive gas ventilation has no effect on the esophageal peak areas (null hypothesis), and used a paired t test for statistical significance (P < .05). For times of 0.5, 1.0, and 1.5 minutes, the ventilation volumes (mean +/- SD) were 25 +/- 7, 49 +/- 8, and 70 +/- 18 L. Massive gas ventilation caused minimal broadening and slight distal spread of the basal "hump". The mean peak area change was 0.18 +/- 0.35 cm2. For a paired t test (n = 9, df = 8), the corresponding t value was 1.54, with a P value of .16, which was incompatible with the null hypothesis. The experimental observations indicate a minimal effect of massive gas ventilation on the acoustic reflectometry esophageal profile. Hence, operator recognition of the altered canine acoustic reflectometer profile as that of an esophageal cavity is maintained, indicating that acoustic reflectometry may be useful in correctly identifying the site of breathing tube placement in out-of-hospital cardiac arrest situations despite massive esophageal ventilation.

Acoustic reflectometry detection of an endobronchial intubation in a patient with equal breath sounds.

Acoustic reflectometry can be used to distinguish between a tracheal and an esophageal intubation based on an area-distance profile. In a patient undergoing laparoscopic surgery, acoustic reflectometry was used to detect a bronchoscopically confirmed endobronchial intubation in the presence of equal bilateral breath sounds. An in vitro simulation suggests that in an endobronchial intubation, in the presence of a space leak between the tube cuff and the bronchus, an acoustic pressure disturbance can be transmitted to the opposite lung (causing equal breath sounds), without significant bulk airway flow (causing inadequate ventilation of the opposite lung).

Validation study of two-microphone acoustic reflectometry for determination of breathing tube placement in 200 adult patients.

BACKGROUND: Acoustic reflectometry allows the construction of a one-dimensional image of a cavity, such as the airway or the esophagus. The reflectometric area-distance profile consists of a constant cross-sectional area segment (length of endotracheal tube), followed either by a rapid increase in the area beyond the carina (tracheal intubation) or by an immediate decrease in the area (esophageal intubation). METHODS: Two hundred adult patients were induced and intubated, without restrictions on anesthetic agents or airway adjunct devices. A two-microphone acoustic reflectometer was used to determine whether the breathing tube was placed in the trachea or esophagus. A blinded reflectometer operator, seated a distance away from the patient, interpreted the acoustic area-distance profile alone to decide where the tube was placed. Capnography was used as the gold standard. RESULTS: Of 200 tracheal intubations confirmed by capnography, the reflectometer operator correctly identified 198 (99% correct tracheal intubation identification rate). In two patients there were false-negative results, patients with a tracheal intubation were interpreted as having an esophageal intubation. A total of 14 esophageal intubations resulted, all correctly identified by reflectometry, for a 100% esophageal intubation identification rate. CONCLUSIONS: Acoustic reflectometry is a rapid, noninvasive method by which to determine whether breathing tube placement is correct (tracheal) or incorrect (esophageal). Reflectometry determination of tube placement may be useful in airway emergencies, particularly in cases where visualization of the glottic area is not possible and capnography may fail, as in patients with cardiac arrest.