The cell and molecular biology of heart valve wound repair is not well understood. Valve intersti... more The cell and molecular biology of heart valve wound repair is not well understood. Valve interstitial cells (IC) are thought to play an important role in valvular wound repair. Because nitric oxide (NO) has been implicated in wound repair, we tested the hypothesis that NO promotes valvular wound repair by examining the presence of the inducible form of nitric oxide synthase (iNOS) in wounded IC monolayers, in vitro. Linear denuding wounds were made in confluent monolayers of porcine mitral valve IC plated on glass coverslips. Cultures were fixed at various times (0 to 48 h postwounding), and iNOS was localized in the cells by immunofluorescence microscopy. Cultures were also incubated with iNOS inhibitors L-N(G)-nitroarginine methyl ester (L-NAME) and N-(3-(Aminomethyl)benzyl)acetamidine (1400W), and the extent of wound closure with and without inhibitor was measured at 24, 48 and 72 h postwounding. From 6 to 24 h postwounding, iNOS localization was increased at the wound edge. At 48 h, iNOS was localized beyond the wound edge, into the monolayer, where the intensity of the signal gradually diminished until it was virtually imperceptible. At 24 and 48 h, the inhibition of iNOS with both L-NAME and 1400W resulted in a significant delay in wound closure. NO promotes valve wound repair through an effect on IC migration.
BMJ Simulation and Technology Enhanced Learning, 2019
IntroductionOne critical aspect of successful simulation facilitation is development of written s... more IntroductionOne critical aspect of successful simulation facilitation is development of written scenarios. However, there are no validated assessment tools dedicated to the evaluation of written simulation scenarios available. Our aim was to develop a tool to evaluate the quality of written simulation demonstrating content validity.MethodsA comprehensive literature search did not yield a validated assessment tool dedicated for the evaluation of written simulation scenarios. A subsequent search yielded six templates published for written simulation scenario design. From these templates, critical scenario elements were identified to create an evaluation instrument with six components of scenario quality with corresponding anchors and rating scale. Subsequently, a national group of simulation experts were engaged via survey methodology to rate the content of the proposed instrument. Ultimately, a modified two-round Delphi approach was implemented to demonstrate consensus of the final a...
Background Health care providers are often called to respond to in-flight medical emergencies, bu... more Background Health care providers are often called to respond to in-flight medical emergencies, but lack familiarity with expected supplies, interventions, and ground medical control support. Objective The objective of this study was to determine whether a mobile phone app (airRx) improves responses to simulated in-flight medical emergencies. Methods This was a randomized study of volunteer, nonemergency resident physician participants who managed simulated in-flight medical emergencies with or without the app. Simulations took place in a mock-up cabin in the simulation center. Standardized participants played the patient, family member, and flight attendant roles. Live, nonblinded rating was used with occasional video review for data clarification. Participants participated in two simulated in-flight medical emergencies (shortness of breath and syncope) and were evaluated with checklists and global rating scales (GRS). Checklist item success rates, key critical action times, GRS, an...
The cell and molecular biology of heart valve wound repair is not well understood. Valve intersti... more The cell and molecular biology of heart valve wound repair is not well understood. Valve interstitial cells (IC) are thought to play an important role in valvular wound repair. Because nitric oxide (NO) has been implicated in wound repair, we tested the hypothesis that NO promotes valvular wound repair by examining the presence of the inducible form of nitric oxide synthase (iNOS) in wounded IC monolayers, in vitro. Linear denuding wounds were made in confluent monolayers of porcine mitral valve IC plated on glass coverslips. Cultures were fixed at various times (0 to 48 h postwounding), and iNOS was localized in the cells by immunofluorescence microscopy. Cultures were also incubated with iNOS inhibitors L-N(G)-nitroarginine methyl ester (L-NAME) and N-(3-(Aminomethyl)benzyl)acetamidine (1400W), and the extent of wound closure with and without inhibitor was measured at 24, 48 and 72 h postwounding. From 6 to 24 h postwounding, iNOS localization was increased at the wound edge. At 48 h, iNOS was localized beyond the wound edge, into the monolayer, where the intensity of the signal gradually diminished until it was virtually imperceptible. At 24 and 48 h, the inhibition of iNOS with both L-NAME and 1400W resulted in a significant delay in wound closure. NO promotes valve wound repair through an effect on IC migration.
BMJ Simulation and Technology Enhanced Learning, 2019
IntroductionOne critical aspect of successful simulation facilitation is development of written s... more IntroductionOne critical aspect of successful simulation facilitation is development of written scenarios. However, there are no validated assessment tools dedicated to the evaluation of written simulation scenarios available. Our aim was to develop a tool to evaluate the quality of written simulation demonstrating content validity.MethodsA comprehensive literature search did not yield a validated assessment tool dedicated for the evaluation of written simulation scenarios. A subsequent search yielded six templates published for written simulation scenario design. From these templates, critical scenario elements were identified to create an evaluation instrument with six components of scenario quality with corresponding anchors and rating scale. Subsequently, a national group of simulation experts were engaged via survey methodology to rate the content of the proposed instrument. Ultimately, a modified two-round Delphi approach was implemented to demonstrate consensus of the final a...
Background Health care providers are often called to respond to in-flight medical emergencies, bu... more Background Health care providers are often called to respond to in-flight medical emergencies, but lack familiarity with expected supplies, interventions, and ground medical control support. Objective The objective of this study was to determine whether a mobile phone app (airRx) improves responses to simulated in-flight medical emergencies. Methods This was a randomized study of volunteer, nonemergency resident physician participants who managed simulated in-flight medical emergencies with or without the app. Simulations took place in a mock-up cabin in the simulation center. Standardized participants played the patient, family member, and flight attendant roles. Live, nonblinded rating was used with occasional video review for data clarification. Participants participated in two simulated in-flight medical emergencies (shortness of breath and syncope) and were evaluated with checklists and global rating scales (GRS). Checklist item success rates, key critical action times, GRS, an...
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Papers by Nur-Ain Nadir