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Article ; Online: Creation of a High-Fidelity, Low-Cost, Intraosseous Line Placement Task Trainer via 3D Printing.

Markin, Nicholas W / Goergen, Nathan S / Armijo, Priscila Rodrigues / Schiller, Alicia M

Journal of visualized experiments : JoVE

2022 , Issue 186

Abstract: The description of procedural task trainers includes their use as a training tool to hone technical skills through repetition and rehearsal of procedures in a safe environment before ultimately performing the procedure on a patient. Many procedural task ... ...

Abstract	The description of procedural task trainers includes their use as a training tool to hone technical skills through repetition and rehearsal of procedures in a safe environment before ultimately performing the procedure on a patient. Many procedural task trainers available to date suffer from several drawbacks, including unrealistic anatomy and the tendency to develop user-created 'landmarks' after the trainer tissue undergoes repeated manipulations, potentially leading to inappropriate psychomotor skill development. To ameliorate these drawbacks, a process was created to produce a high-fidelity procedural task trainer, created from anatomy obtained from computed tomography (CT) scans, that utilize ubiquitous three-dimensional (3D) printing technology and off-the-shelf commodity supplies. This method includes creating a 3D printed tissue mold capturing the tissue structure surrounding the skeletal element of interest to encase the bony skeletal structure suspended within the tissue, which is also 3D printed. A tissue medium mixture, which approximates tissue in both high-fidelity geometry and tissue density, is then poured into a mold and allowed to set. After a task trainer has been used to practice a procedure, such as intraosseous line placement, the tissue media, molds, and bones are reclaimable and may be reused to create a fresh task trainer, free of puncture sites and manipulation defects, for use in subsequent training sessions.
MeSH term(s)	Humans ; Printing, Three-Dimensional
Language	English
Publishing date	2022-08-17
Publishing country	United States
Document type	Journal Article ; Video-Audio Media ; Research Support, Non-U.S. Gov't
ZDB-ID	2259946-0
ISSN	1940-087X ; 1940-087X
ISSN (online)	1940-087X
ISSN	1940-087X
DOI	10.3791/62434
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Measuring the compensatory reserve to identify shock.

Convertino, Victor A / Schiller, Alicia M

The journal of trauma and acute care surgery

2017 Volume 82, Issue 6S Suppl 1, Page(s) S57–S65

MeSH term(s)	Diagnosis, Differential ; Early Diagnosis ; Humans ; Monitoring, Physiologic/trends ; Shock, Hemorrhagic/diagnosis ; Shock, Hemorrhagic/physiopathology ; Vital Signs
Language	English
Publishing date	2017-03-23
Publishing country	United States
Document type	Journal Article
ZDB-ID	2651070-4
ISSN	2163-0763 ; 2163-0755
ISSN (online)	2163-0763
ISSN	2163-0755
DOI	10.1097/TA.0000000000001430
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Zs.A 127: Show issues

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Article ; Online: An outreach program with hands-on, physiology-based exercises generates questions about STEM career expectations.

Clarke, Martina A / Sharma, Neeru M / Schiller, Alicia M

Advances in physiology education

2019 Volume 43, Issue 2, Page(s) 175–179

Abstract: Scientific advocacy and outreach programs are encouraged to increase public understanding of scientific knowledge and generate interest in science, technology, engineering, and mathematics (STEM) careers. However, evaluation of these events' ... ...

Abstract	Scientific advocacy and outreach programs are encouraged to increase public understanding of scientific knowledge and generate interest in science, technology, engineering, and mathematics (STEM) careers. However, evaluation of these events' effectiveness is difficult and somewhat rare. This study's purpose was to better understand how effective an established physiology-based outreach program was in generating interest in STEM careers, while simultaneously providing information that can be used to increase the effectiveness of future events. We partnered with a private school located in Omaha, Nebraska, where 64-80 students participated in 3 h of physiology-based activities presented by volunteers from the University of Nebraska Medical Center. The event included a brief presentation of the eye, sensory, heart, and lung systems, followed by hands-on demonstrations and activities. Each session concluded with 15 min of questions and answers (Q&A), where students were encouraged to engage the volunteers in inquiries about what they just learned, career-related questions, or any topic of their choosing. Each Q&A session was audio recorded and evaluated using thematic analysis to identify patterns in the Q&A data. Two major themes of questions were identified:
MeSH term(s)	Career Choice ; Community-Institutional Relations ; Humans ; Mathematics/education ; Mathematics/methods ; Motivation ; Physiology/education ; Physiology/methods ; Students/psychology
Language	English
Publishing date	2019-04-17
Publishing country	United States
Document type	Journal Article
ZDB-ID	1024917-5
ISSN	1522-1229 ; 1043-4046
ISSN (online)	1522-1229
ISSN	1043-4046
DOI	10.1152/advan.00013.2019
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Zs.A 5611: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
Uc I Zs.89: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular ab Jg. 2022: Lesesaal (EG)

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Article ; Online: Increased Brain-Derived Neurotrophic Factor in Lumbar Dorsal Root Ganglia Contributes to the Enhanced Exercise Pressor Reflex in Heart Failure.

Schiller, Alicia M / Hong, Juan / Xia, Zhiqiu / Wang, Han-Jun

International journal of molecular sciences

2019 Volume 20, Issue 6

Abstract: An exaggerated exercise pressor reflex (EPR) is associated with excessive sympatho-excitation and exercise intolerance in the chronic heart failure (CHF) state. We hypothesized that brain-derived neurotrophic factor (BDNF) causes the exaggerated EPR via ... ...

Abstract	An exaggerated exercise pressor reflex (EPR) is associated with excessive sympatho-excitation and exercise intolerance in the chronic heart failure (CHF) state. We hypothesized that brain-derived neurotrophic factor (BDNF) causes the exaggerated EPR via sensitizing muscle mechanosensitive afferents in CHF. Increased BDNF expression was observed in lumbar dorsal root ganglia (DRGs) from CHF rats compared to sham rats. Immunofluorescence data showed a greater increase in the number of BDNF-positive neurons in medium and large-sized DRG subpopulations from CHF rats. Patch clamp data showed that incubation with BDNF for 4⁻6 h, significantly decreased the current threshold-inducing action potential (AP), threshold potential and the number of APs during current injection in Dil-labeled isolectin B4 (IB4)-negative medium-sized DRG neurons (mainly mechano-sensitive) from sham rats. Compared to sham rats, CHF rats exhibited an increased number of APs during current injection in the same DRG subpopulation, which was significantly attenuated by 4-h incubation with anti-BDNF. Finally, chronic epidural delivery of anti-BDNF attenuated the exaggerated pressor response to either static contraction or passive stretch in CHF rats whereas this intervention had no effect on the pressor response to hindlimb arterial injection of capsaicin. These data suggest that increased BDNF in lumbar DRGs contributes to the exaggerated EPR in CHF.
MeSH term(s)	Animals ; Antibodies, Monoclonal/pharmacology ; Body Weight ; Brain-Derived Neurotrophic Factor/antagonists & inhibitors ; Brain-Derived Neurotrophic Factor/genetics ; Brain-Derived Neurotrophic Factor/metabolism ; Disease Models, Animal ; Ganglia, Spinal/metabolism ; Heart Failure/diagnosis ; Heart Failure/etiology ; Heart Failure/physiopathology ; Hemodynamics ; Immunohistochemistry ; Lumbosacral Region ; Male ; Organ Size ; Physical Conditioning, Animal ; Rats ; Reflex/drug effects ; Sensory Receptor Cells/metabolism
Chemical Substances	Antibodies, Monoclonal ; Brain-Derived Neurotrophic Factor
Language	English
Publishing date	2019-03-24
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2019364-6
ISSN	1422-0067 ; 1422-0067 ; 1661-6596
ISSN (online)	1422-0067
ISSN	1422-0067 ; 1661-6596
DOI	10.3390/ijms20061480
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Letter to the editor: Does low-frequency power of heart rate variability correlate with cardiac sympathetic tone in normal sheep?

Pellegrino, Peter R / Schiller, Alicia M

American journal of physiology. Heart and circulatory physiology

2014 Volume 308, Issue 2, Page(s) H146–7

MeSH term(s)	Animals ; Baroreflex ; Female ; Heart/physiology ; Heart Rate ; Sympathetic Nervous System/physiology
Language	English
Publishing date	2014-12-31
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	603838-4
ISSN	1522-1539 ; 0363-6135
ISSN (online)	1522-1539
ISSN	0363-6135
DOI	10.1152/ajpheart.00798.2014
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Article ; Online: Quantification of Renal Sympathetic Vasomotion as a Novel End Point for Renal Denervation.

Pellegrino, Peter Ricci / Zucker, Irving H / Chatzizisis, Yiannis S / Wang, Han-Jun / Schiller, Alicia M

Hypertension (Dallas, Tex. : 1979)

2020 Volume 76, Issue 4, Page(s) 1247–1255

Abstract: Renal sympathetic denervation, a potentially revolutionary interventional treatment for hypertension, faces an existential problem due to the inability to confirm successful ablation of the targeted renal sympathetic nerves. Based on the observation that ...

Abstract	Renal sympathetic denervation, a potentially revolutionary interventional treatment for hypertension, faces an existential problem due to the inability to confirm successful ablation of the targeted renal sympathetic nerves. Based on the observation that renal sympathetic nerve activity exerts rhythmic, baroreflex-driven, and vasoconstrictive control of the renal vasculature, we developed a novel technique for identifying rhythmic sympathetic vascular control using a time-varying, 2-component Windkessel model of the renal circulation. This technology was tested in 2 different animal models of renal denervation; 10 rabbits underwent chronic, surgical renal denervation, and 9 pigs underwent acute, functional renal denervation via intrathecal administration of ropivacaine. Both methods of renal denervation reduced negative admittance gain, negative phase shift renal vascular control at known sympathetic vasomotor frequencies, consistent with a reduction in vasoconstrictive, baroreflex-driven renal sympathetic vasomotion. Classic measures like mean renal blood flow and mean renal vascular resistance were not significantly affected in either model of renal denervation. Renal sympathetic vasomotion monitoring could provide intraprocedural feedback for interventionists performing renal denervation and serve more broadly as a platform technology for the evaluation and treatment of diseases affecting the sympathetic nervous system.
MeSH term(s)	Animals ; Baroreflex/physiology ; Denervation/methods ; Disease Models, Animal ; Heart Rate/physiology ; Hypertension/physiopathology ; Hypertension/surgery ; Kidney/innervation ; Rabbits ; Swine ; Sympathectomy/methods ; Sympathetic Nervous System/physiopathology
Language	English
Publishing date	2020-08-24
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	423736-5
ISSN	1524-4563 ; 0194-911X ; 0362-4323
ISSN (online)	1524-4563
ISSN	0194-911X ; 0362-4323
DOI	10.1161/HYPERTENSIONAHA.120.15325
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Zs.A 1488: Show issues

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Article ; Online: Increased Brain-Derived Neurotrophic Factor in Lumbar Dorsal Root Ganglia Contributes to the Enhanced Exercise Pressor Reflex in Heart Failure

Alicia M. Schiller / Juan Hong / Zhiqiu Xia / Han-Jun Wang

International Journal of Molecular Sciences, Vol 20, Iss 6, p

2019 Volume 1480

Abstract	An exaggerated exercise pressor reflex (EPR) is associated with excessive sympatho-excitation and exercise intolerance in the chronic heart failure (CHF) state. We hypothesized that brain-derived neurotrophic factor (BDNF) causes the exaggerated EPR via sensitizing muscle mechanosensitive afferents in CHF. Increased BDNF expression was observed in lumbar dorsal root ganglia (DRGs) from CHF rats compared to sham rats. Immunofluorescence data showed a greater increase in the number of BDNF-positive neurons in medium and large-sized DRG subpopulations from CHF rats. Patch clamp data showed that incubation with BDNF for 4–6 h, significantly decreased the current threshold-inducing action potential (AP), threshold potential and the number of APs during current injection in Dil-labeled isolectin B4 (IB4)-negative medium-sized DRG neurons (mainly mechano-sensitive) from sham rats. Compared to sham rats, CHF rats exhibited an increased number of APs during current injection in the same DRG subpopulation, which was significantly attenuated by 4-h incubation with anti-BDNF. Finally, chronic epidural delivery of anti-BDNF attenuated the exaggerated pressor response to either static contraction or passive stretch in CHF rats whereas this intervention had no effect on the pressor response to hindlimb arterial injection of capsaicin. These data suggest that increased BDNF in lumbar DRGs contributes to the exaggerated EPR in CHF.
Keywords	exercise ; mechanoreflex ; cardiovascular reflexes ; neurotrophic factors ; Biology (General) ; QH301-705.5 ; Chemistry ; QD1-999
Language	English
Publishing date	2019-03-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Eppur Si Muove: The dynamic nature of physiological control of renal blood flow by the renal sympathetic nerves.

Schiller, Alicia M / Pellegrino, Peter Ricci / Zucker, Irving H

Autonomic neuroscience : basic & clinical

2017 Volume 204, Page(s) 17–24

Abstract: Tubuloglomerular feedback and the myogenic response are widely appreciated as important regulators of renal blood flow, but the role of the sympathetic nervous system in physiological renal blood flow control remains controversial. Where classic studies ... ...

Abstract	Tubuloglomerular feedback and the myogenic response are widely appreciated as important regulators of renal blood flow, but the role of the sympathetic nervous system in physiological renal blood flow control remains controversial. Where classic studies using static measures of renal blood flow failed, dynamic approaches have succeeded in demonstrating sympathetic control of renal blood flow under normal physiological conditions. This review focuses on transfer function analysis of renal pressure-flow, which leverages the physical relationship between blood pressure and flow to assess the underlying vascular control mechanisms. Studies using this approach indicate that the renal nerves are important in the rapid regulation of the renal vasculature. Animals with intact renal innervation show a sympathetic signature in the frequency range associated with sympathetic vasomotion that is eliminated by renal denervation. In conscious rabbits, this sympathetic signature exerts vasoconstrictive, baroreflex control of renal vascular conductance, matching well with the rhythmic, baroreflex-influenced control of renal sympathetic nerve activity and complementing findings from other studies employing dynamic approaches to study renal sympathetic vascular control. In this light, classic studies reporting that nerve stimulation and renal denervation do not affect static measures of renal blood flow provide evidence for the strength of renal autoregulation rather than evidence against physiological renal sympathetic control of renal blood flow. Thus, alongside tubuloglomerular feedback and the myogenic response, renal sympathetic outflow should be considered an important physiological regulator of renal blood flow. Clinically, renal sympathetic vasomotion may be important for solving the problems facing the field of therapeutic renal denervation.
MeSH term(s)	Animals ; Kidney/blood supply ; Kidney/innervation ; Kidney/physiology ; Renal Circulation/physiology ; Sympathetic Nervous System/physiology
Language	English
Publishing date	2017-05
Publishing country	Netherlands
Document type	Journal Article ; Review
ZDB-ID	2020105-9
ISSN	1872-7484 ; 1566-0702
ISSN (online)	1872-7484
ISSN	1566-0702
DOI	10.1016/j.autneu.2016.08.003
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Article ; Online: The physiology of blood loss and shock: New insights from a human laboratory model of hemorrhage.

Schiller, Alicia M / Howard, Jeffrey T / Convertino, Victor A

Experimental biology and medicine (Maywood, N.J.)

2017 Volume 242, Issue 8, Page(s) 874–883

Abstract: The ability to quickly diagnose hemorrhagic shock is critical for favorable patient outcomes. Therefore, it is important to understand the time course and involvement of the various physiological mechanisms that are active during volume loss and that ... ...

Abstract	The ability to quickly diagnose hemorrhagic shock is critical for favorable patient outcomes. Therefore, it is important to understand the time course and involvement of the various physiological mechanisms that are active during volume loss and that have the ability to stave off hemodynamic collapse. This review provides new insights about the physiology that underlies blood loss and shock in humans through the development of a simulated model of hemorrhage using lower body negative pressure. In this review, we present controlled experimental results through utilization of the lower body negative pressure human hemorrhage model that provide novel insights on the integration of physiological mechanisms critical to the compensation for volume loss. We provide data obtained from more than 250 human experiments to classify human subjects into two distinct groups: those who have a high tolerance and can compensate well for reduced central blood volume (e.g. hemorrhage) and those with low tolerance with poor capacity to compensate.We include the conceptual introduction of arterial pressure and cerebral blood flow oscillations, reflex-mediated autonomic and neuroendocrine responses, and respiration that function to protect adequate tissue oxygenation through adjustments in cardiac output and peripheral vascular resistance. Finally, unique time course data are presented that describe mechanistic events associated with the rapid onset of hemodynamic failure (i.e. decompensatory shock). Impact Statement Hemorrhage is the leading cause of death in both civilian and military trauma. The work submitted in this review is important because it advances the understanding of mechanisms that contribute to the total integrated physiological compensations for inadequate tissue oxygenation (i.e. shock) that arise from hemorrhage. Unlike an animal model, we introduce the utilization of lower body negative pressure as a noninvasive model that allows for the study of progressive reductions in central blood volume similar to those reported during actual hemorrhage in conscious humans to the onset of hemodynamic decompensation (i.e. early phase of decompensatory shock), and is repeatable in the same subject. Understanding the fundamental underlying physiology of human hemorrhage helps to test paradigms of critical care medicine, and identify and develop novel clinical practices and technologies for advanced diagnostics and therapeutics in patients with life-threatening blood loss.
MeSH term(s)	Arterial Pressure ; Blood Volume ; Hemodynamics ; Humans ; Models, Cardiovascular ; Oxygen/metabolism ; Shock, Hemorrhagic/physiopathology
Chemical Substances	Oxygen (S88TT14065)
Language	English
Publishing date	2017-04
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	4015-0
ISSN	1535-3699 ; 1525-1373 ; 0037-9727
ISSN (online)	1535-3699 ; 1525-1373
ISSN	0037-9727
DOI	10.1177/1535370217694099
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Ua VI Zs.111: Show issues

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Article ; Online: Retrospective analysis of a STEM outreach event reveals positive influences on student attitudes toward STEM careers but not scientific methodology.

Crawford, A J / Hays, Cassandra L / Schlichte, Sarah L / Greer, Sydney E / Mallard, Halle J / Singh, Ryan M / Clarke, Martina A / Schiller, Alicia M

Advances in physiology education

2021 Volume 45, Issue 3, Page(s) 427–436

Abstract: Substantial, involved, and expensive efforts to promote the dissemination of scientific knowledge and career interest in Science, Technology, Engineering, and Mathematics (STEM) are enthusiastically supported by many scientific, federal, and local ... ...

Abstract	Substantial, involved, and expensive efforts to promote the dissemination of scientific knowledge and career interest in Science, Technology, Engineering, and Mathematics (STEM) are enthusiastically supported by many scientific, federal, and local organizations. The articulated underlying goals for these efforts include an enhanced public understanding of science and science-related policy, an increased diversity in STEM careers, and an increase in the future STEM workforce. This effort is primarily driven by an underperformance of the United States that includes poor test performance and limited number of students pursuing STEM degrees. Despite this investment, attitudes toward STEM have not notably changed. The goal of this project was to determine students' attitudes toward STEM in response to a previously established scientific outreach event. This event was used to address three common goals in STEM outreach: STEM literacy, diversity and inclusion, and career preparedness. We found there was a notable difference in the attitudes toward scientific activities and interest in pursuing a "Science Career" after participation in this event. Strikingly, interest in hypothesis development, the keystone of all STEM disciplines, was the least liked of all the activities offered during the event. Our data suggest that events designed to enhance interest in pursuing a STEM career may benefit from different elements compared with events designed to increase understanding of STEM literacy concepts, such as hypothesis development.
MeSH term(s)	Attitude ; Career Choice ; Humans ; Mathematics ; Retrospective Studies ; Students ; Technology
Language	English
Publishing date	2021-06-19
Publishing country	United States
Document type	Journal Article
ZDB-ID	1024917-5
ISSN	1522-1229 ; 1043-4046
ISSN (online)	1522-1229
ISSN	1043-4046
DOI	10.1152/advan.00118.2020
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