Radiology for medical students (1925-2018): an overview

Objective: Radiology has been espoused as an excellent tool for educating medical students since 1925. Advances in technology and PACS mean it has never been easier to demonstrate living anatomy and clinical pathology in exquisite detail to students. The aim of this study was to provide an overview of radiologic publications related to teaching medical students and its evolution through time. Methods: A literature search was performed from inception to November 2018. The search strategies used both text words and relevant indexing related to “radiology”, “medical students” and “curriculum”. Results: 3589 records were identified of which 377 were included. There was a 100 fold increase in rate of publication over time—most were expository or surveys (60%), with few truly experimental articles. Radiology was used in clinical teaching (67%) and anatomy (33%). Almost half of radiologic anatomy teaching was conducted without the input of a Radiologist. Compulsory clinical clerkships/blocks in radiology was offered infrequently (35%). Female first authorship had increased in the last decade (47%). Conclusion: There is a significant increase in articles published on the role of radiology in medical student teaching in the last decade. Research in this area is required in order to investigate the role of radiology in improving the modern medical students’ education

Changes in the Seasonal Cycle in the Circumpolar Arctic, 1976-95: Temperature and Precipitation

The Arctic is one region where the effects of global climate change are expected to be easy to observe. This study identifies regions in the circumpolar Arctic that have experienced similar changes in the seasonal cycle of temperature and precipitation over recent decades. Data from Arctic and northern nations have been compiled to form a new data set of over 1200 circumpolar Arctic climate stations. Changes in the seasonal cycle between two decades (1976-85 and 1986-95) are examined for the 247 temperature and 555 precipitation stations that meet specific completeness criteria. Inter-decadal shifts are analyzed using 11-day averages of daily mean temperature and 5-day averages of total daily precipitation. Examined at time-steps finer than annual or monthly means, climatic variations in the region are not consistent either through the seasons or across space. Some areas have demonstrated recent increases in temperature or precipitation, while others have displayed decreases in these elements. Many areas reveal climatic shifts in specific periods of the year that contrast markedly with the trends observed in other periods and other places.L'Arctique est une région où il devrait être relativement facile d'observer les effets du changement climatique mondial. Cette étude inventorie les régions de l'Arctique circumpolaire qui ont connu des changements similaires dans le cycle saisonnier de température et de précipitation au cours des dernières décennies. Des données provenant de nations de l'Arctique et du Nord ont été compilées en vue de créer un nouvel ensemble de données issues de plus de 1200 stations climatiques de l'Arctique circumpolaire. On examine les changements dans le cycle saisonnier entre deux décennies (1976-1985 et 1986-1995) pour les 247 stations de température et les 555 stations hyétométriques qui répondent aux critères spécifiques d'intégralité. On analyse les décalages entre les deux décennies en utilisant les moyennes sur 11 jours de la température quotidienne moyenne, ainsi que les moyennes sur cinq jours de la précipitation quotidienne totale. Si on les examine à des pas de temps plus petits que les moyennes annuelles ou mensuelles, les variations climatiques dans la région ne sont pas cohérentes, que ce soit en fonction des saisons ou de l'espace. Certaines zones ont affiché de récentes hausses de température ou de précipitation, tandis que d'autres ont enregistré des baisses de ces mêmes paramètres. Un grand nombre de régions montrent des changements de climat durant des périodes spécifiques de l'année, changements qui contrastent de façon très nette avec les tendances observées à d'autres moments et en d'autres lieux

Assessing the role of slab rheology in coupled plate-mantle convection models

International audienceAssessing the role of slab rheology in coupled plate-mantle convection models. Earth and Planetary Science Letters 430, 191-201. Abstract Reconstructing the 3D structure of the Earth's mantle has been a challenge for geodynamicists for about 40 years. Although numerical models and computational capabilities have substantially progressed, parameterizations used for modeling convection forced by plate motions are far from being Earth-like. Among the set of parameters, rheology is fundamental because it defines in a non-linear way the dynamics of slabs and plumes, and the organization of lithosphere deformation. In this study, we evaluate the role of the temperature dependence of viscosity (variations up to 6 orders of magnitude) and the importance of pseudo-plasticity on reconstructing slab evolution in 3D spherical models of convection driven by plate history models. Pseudo-plasticity, which produces plate-like behavior in convection models, allows a consistent coupling between imposed plate motions and global convection, which is not possible with temperature-dependent viscosity alone. Using test case models, we show that increasing temperature dependence of viscosity enhances vertical and lateral coherence of slabs, but leads to unrealistic slab morphologies for large viscosity contrasts. Introducing pseudo-plasticity partially solves this issue, producing thin laterally and vertically more continuous slabs, and flat subduction where trench retreat is fast. We evaluate the differences between convection reconstructions employing different viscosity laws to be very large, and similar to the differences between two models with the same rheology but using two different plate histories or initial conditions

Application of radio tomographic imaging to HF oblique incidence ray tracing

Radio tomography is a technique for generating images of the spatial structure of ionospheric electron density over a wide area. This paper assesses the potential use of radio tomography in HF oblique propagation and ray tracing applications. Synthetic ionograms produced by ray tracing through tomographic images and ionospheric models have been compared with experimental oblique ionograms from six paths lying close to the image plane in the United Kingdom. In particular, study has been made of the effects of various types of input information used to constrain the vertical electron density structure in the tomographic reconstructions. It was found that use of a fine height resolution (5 km) and incorporation of information from one vertical ionosonde in the reconstruction process makes significant improvements to the overall reliability of the tomographic image. As expected, E layer propagation is better defined using a climatological model than by tomography. However, in comparison with three ionospheric models, use of tomographic images can significantly reduce the RMS error in the determination of the F2 layer maximum usable frequency

Nurses\u27 Alumnae Association Bulletin - Volume 18 Number 1

Alumnae Notes Central Dressing Room Committee Reports Digest of Alumnae Association Meetings Graduation Awards - 1952 Greetings from Miss Childs Greetings from the President Marriages Modern Trends in Orthopaedic Surgery Necrology New Arrivals Physical Advances at Jefferson Hospital - 1953 Staff Activities - 1952-1953 Student Activities The Artificial Heart Lung Machin

Absolute quantitation of coronary steal induced by intravenous dipyridamole

AbstractOBJECTIVESThe study was done to determine whether coronary steal (defined as an absolute decrease in perfusion from resting blood flow) is induced by intravenous (IV) dipyridamole in patients with severe coronary artery disease (CAD).BACKGROUNDMyocardial ischemia during coronary vasodilation is usually attributed to coronary steal. However, there is limited data on the absolute magnitude of coronary steal in humans.METHODSEighteen patients with multivessel CAD underwent dynamic positron emission tomography (PET) imaging with 13NH3at rest and after infusion of IV dipyridamole. Eight myocardial sectors were analyzed per short axis slice and myocardial blood flow calculated with a two-compartment model in absolute terms.RESULTSCoronary steal occurred in 8 of the 18 patients. In the 8 patients with coronary steal, myocardial blood flow decreased from 90 ± 18 ml/100 g/min at rest to 68 ± 27 ml/100 g/min following dipyridamole in the segments with steal, and increased from 87 ± 19 to 138 ± 16 ml/100 g/min following dipyridamole in the segments without steal. Significant clinical correlates of coronary steal were either ST elevation or the combination of ST depression and angina.CONCLUSIONSCoronary vasodilation with IV dipyridamole is associated with significant reductions in blood flow to collateral-dependent myocardium consistent with coronary steal in about 45% of patients with severe CAD

Return to employment following critical illness and its association with psychosocial outcomes: a systematic review and meta-analysis

Background: Patients who survive critical illness have well-defined physical, cognitive, emotional, and familial problems. However, the impact of these problems on survivors’ ability to return to work and other financial outcomes are less clear. Objective: To determine the financial and employment consequences of an intensive care stay, we performed a systematic review and meta-analysis. Data Source We searched MEDLINE, Embase, and CINAHL (1970-2018). All study designs except narrative reviews, case reports, case control studies, and editorials were included. Included studies assessed financial outcomes in patients admitted to critical care, and their caregivers. Data Extraction: Two reviewers independently applied eligibility criteria, assessed quality and extracted data. The primary outcome reported was return to employment among those previously employed. We also examined financial stress and the impact financial outcomes had on quality of life and psychosocial health. Data Synthesis: From 5765 eligible abstracts, 51 studies were included, which provided data on 858 caregivers/family members and 7267 patients. Forty-two papers reported on patient outcomes and 11 papers on caregiver/family members. Two papers included data from both patients and caregivers/family members. Return to employment was the most commonly reported financial outcome for critical care survivors. The pooled estimate for return to employment—among those who were employed prior to critical illness—was 33% (95% CI: 21%-48%), 55% (95% CI: 45%-64%) and 56% (95% CI: 45%-66%) at 3, 6, and 12 months, respectively. Across the studies included in this review, there was a positive association with psychosocial health if patients returned to employment. This included improved health related quality of life and fewer depressive symptoms. With caregivers/family members, six studies reported changes to employment such as reduced hours and lost earnings. Conclusions: Following critical illness, many patients who were previously employed do not return to work, even one year later. This new job loss is associated with worse health related quality of life amongst survivors and worse psychological function amongst survivors and caregivers/family members. More interventional research is required to understand how best to support employability after critical illness

The Polycomb protein, Bmi1, regulates insulin sensitivity

Objective: The Polycomb Repressive Complexes (PRC) 1 and 2 function to epigenetically repress target genes. The PRC1 component, Bmi1, plays a crucial role in maintenance of glucose homeostasis and beta cell mass through repression of the Ink4a/Arf locus. Here we have explored the role of Bmi1 in regulating glucose homeostasis in the adult animal, which had not been previously reported due to poor postnatal survival of Bmi1−/− mice. Methods: The metabolic phenotype of Bmi1+/− mice was characterized, both in vivo and ex vivo. Glucose and insulin tolerance tests and hyperinsulinemic-euglycemic clamps were performed. The insulin signaling pathway was assessed at the protein and transcript level. Results: Here we report a negative correlation between Bmi1 levels and insulin sensitivity in two models of insulin resistance, aging and liver-specific insulin receptor deficiency. Further, heterozygous loss of Bmi1 results in increased insulin sensitivity in adult mice, with no impact on body weight or composition. Hyperinsulinemic-euglycemic clamp reveals increased suppression of hepatic glucose production and increased glucose disposal rate, indicating elevated glucose uptake to peripheral tissues, in Bmi1+/− mice. Enhancement of insulin signaling, specifically an increase in Akt phosphorylation, in liver and, to a lesser extent, in muscle appears to contribute to this phenotype. Conclusions: Together, these data define a new role for Bmi1 in regulating insulin sensitivity via enhancement of Akt phosphorylation