Facilitating the transition from physiology to hospital wards through an interdisciplinary case study of septic shock

BACKGROUND: In order to develop clinical reasoning, medical students must be able to integrate knowledge across traditional subject boundaries and multiple disciplines. At least two dimensions of integration have been identified: horizontal integration, bringing together different disciplines in considering a topic; and vertical integration, bridging basic science and clinical practice. Much attention has been focused on curriculum overhauls, but our approach is to facilitate horizontal and vertical integration on a smaller scale through an interdisciplinary case study discussion and then to assess its utility. METHODS: An interdisciplinary case study discussion about a critically ill patient was implemented at the end of an organ system-based, basic sciences module at New York University School of Medicine. Three clinical specialists—a cardiologist, a pulmonologist, and a nephrologist—jointly led a discussion about a complex patient in the intensive care unit with multiple medical problems secondary to septic shock. The discussion emphasized the physiologic underpinnings behind the patient’s presentation and the physiologic considerations across the various systems in determining proper treatment. The discussion also highlighted the interdependence between the cardiovascular, respiratory, and renal systems, which were initially presented in separate units. After the session students were given a brief, anonymous three-question free-response questionnaire in which they were asked to evaluate and freely comment on the exercise. RESULTS: Students not only took away physiological principles but also gained an appreciation for various thematic lessons for bringing basic science to the bedside, especially horizontal and vertical integration. The response of the participants was overwhelmingly positive with many indicating that the exercise integrated the material across organ systems, and strengthened their appreciation of the role of physiology in understanding disease presentations and guiding appropriate therapy. CONCLUSIONS: Horizontal and vertical integration can be presented effectively through a single-session case study, with complex patient cases involving multiple organ systems providing students opportunities to integrate their knowledge across organ systems while emphasizing the importance of physiology in clinical reasoning. Furthermore, having several clinicians from different specialties discuss the case together can reinforce the matter of integration across multiple organ systems and disciplines in students’ minds

Magnetism and the Weiss Exchange Field - A Theoretical Analysis Inspired by Recent Experiments

The huge spin precession frequency observed in recent experiments with spin-polarized beams of hot electrons shot through magnetized films is interpreted as being caused by Zeeman coupling of the electron spins to the so-called Weiss exchange field in the film. A "Stern-Gerlach experiment" for electrons moving through an inhomogeneous exchange field is proposed. The microscopic origin of exchange interactions and of large mean exchange fields, leading to different types of magnetic order, is elucidated. A microscopic derivation of the equations of motion of the Weiss exchange field is presented. Novel proofs of the existence of phase transitions in quantum XY-models and antiferromagnets, based on an analysis of the statistical distribution of the exchange field, are outlined.Comment: 36 pages, 3 figure

Microwave Oscillations of a Nanomagnet Driven by a Spin-Polarized Current

We describe direct electrical measurements of microwave-frequency dynamics in individual nanomagnets that are driven by spin transfer from a DC spin-polarized current. We map out the dynamical stability diagram as a function of current and magnetic field, and we show that spin transfer can produce several different types of magnetic excitations, including small-angle precession, a more complicated large-angle motion, and a high-current state that generates little microwave signal. The large-angle mode can produce a significant emission of microwave energy, as large as 40 times the Johnson-noise background.Comment: 12 pages, 3 figure

Diameters in preferential attachment models

In this paper, we investigate the diameter in preferential attachment (PA-) models, thus quantifying the statement that these models are small worlds. The models studied here are such that edges are attached to older vertices proportional to the degree plus a constant, i.e., we consider affine PA-models. There is a substantial amount of literature proving that, quite generally, PA-graphs possess power-law degree sequences with a power-law exponent \tau>2. We prove that the diameter of the PA-model is bounded above by a constant times \log{t}, where t is the size of the graph. When the power-law exponent \tau exceeds 3, then we prove that \log{t} is the right order, by proving a lower bound of this order, both for the diameter as well as for the typical distance. This shows that, for \tau>3, distances are of the order \log{t}. For \tau\in (2,3), we improve the upper bound to a constant times \log\log{t}, and prove a lower bound of the same order for the diameter. Unfortunately, this proof does not extend to typical distances. These results do show that the diameter is of order \log\log{t}. These bounds partially prove predictions by physicists that the typical distance in PA-graphs are similar to the ones in other scale-free random graphs, such as the configuration model and various inhomogeneous random graph models, where typical distances have been shown to be of order \log\log{t} when \tau\in (2,3), and of order \log{t} when \tau>3

First bounds on the high-energy emission from isolated Wolf-Rayet binary systems

High-energy gamma-ray emission is theoretically expected to arise in tight binary star systems (with high mass loss and high velocity winds), although the evidence of this relationship has proven to be elusive so far. Here we present the first bounds on this putative emission from isolated Wolf-Rayet (WR) star binaries, WR 147 and WR 146, obtained from observations with the MAGIC telescope.Comment: (Authors are the MAGIC Collaboration.) Manuscript in press at The Astrophysical Journal Letter

Implementation of the Random Forest Method for the Imaging Atmospheric Cherenkov Telescope MAGIC

The paper describes an application of the tree classification method Random Forest (RF), as used in the analysis of data from the ground-based gamma telescope MAGIC. In such telescopes, cosmic gamma-rays are observed and have to be discriminated against a dominating background of hadronic cosmic-ray particles. We describe the application of RF for this gamma/hadron separation. The RF method often shows superior performance in comparison with traditional semi-empirical techniques. Critical issues of the method and its implementation are discussed. An application of the RF method for estimation of a continuous parameter from related variables, rather than discrete classes, is also discussed.Comment: 16 pages, 8 figure

Simultaneous multi-frequency observation of the unknown redshift blazar PG 1553+113 in March-April 2008

The blazar PG 1553+113 is a well known TeV gamma-ray emitter. In this paper, we determine its spectral energy distribution using simultaneous multi-frequency data in order to study its emission processes. An extensive campaign was carried out between March and April 2008, where optical, X-ray, high-energy (HE) gamma-ray, and very-high-energy (VHE) gamma-ray data were obtained with the KVA, Abastumani, REM, RossiXTE/ASM, AGILE and MAGIC telescopes, respectively. This is the first simultaneous broad-band (i.e., HE+VHE) gamma-ray observation, though AGILE did not detect the source. We combine data to derive source's spectral energy distribution and interpret its double peaked shape within the framework of a synchrotron self compton modelComment: 5 pages, 2 figures, publishe

Spintronics: Fundamentals and applications

Spintronics, or spin electronics, involves the study of active control and manipulation of spin degrees of freedom in solid-state systems. This article reviews the current status of this subject, including both recent advances and well-established results. The primary focus is on the basic physical principles underlying the generation of carrier spin polarization, spin dynamics, and spin-polarized transport in semiconductors and metals. Spin transport differs from charge transport in that spin is a nonconserved quantity in solids due to spin-orbit and hyperfine coupling. The authors discuss in detail spin decoherence mechanisms in metals and semiconductors. Various theories of spin injection and spin-polarized transport are applied to hybrid structures relevant to spin-based devices and fundamental studies of materials properties. Experimental work is reviewed with the emphasis on projected applications, in which external electric and magnetic fields and illumination by light will be used to control spin and charge dynamics to create new functionalities not feasible or ineffective with conventional electronics.Comment: invited review, 36 figures, 900+ references; minor stylistic changes from the published versio

MAGIC Upper Limits for two Milagro-detected, Bright Fermi Sources in the Region of SNR G65.1+0.6

We report on the observation of the region around supernova remnant G65.1+0.6 with the stand-alone MAGIC-I telescope. This region hosts the two bright GeV gamma-ray sources 1FGL J1954.3+2836 and 1FGL J1958.6+2845. They are identified as GeV pulsars and both have a possible counterpart detected at about 35 TeV by the Milagro observatory. MAGIC collected 25.5 hours of good quality data, and found no significant emission in the range around 1 TeV. We therefore report differential flux upper limits, assuming the emission to be point-like (<0.1 deg) or within a radius of 0.3 deg. In the point-like scenario, the flux limits around 1 TeV are at the level of 3 % and 2 % of the Crab Nebula flux, for the two sources respectively. This implies that the Milagro emission is either extended over a much larger area than our point spread function, or it must be peaked at energies beyond 1 TeV, resulting in a photon index harder than 2.2 in the TeV band.Comment: 8 pages, 3 figures, 1 tabl