Teaching Medical Students Optimal Consulting Skills: The Challenge of Generating Better Referring Physicians.

Rationale and objectives We sought to incorporate a new teaching module into the traditional medical student radiology clerkship, to improve the necessary skills for future referring physicians. Materials and methods A new required and graded module was introduced in 2014 into the radiology clerkship in year three of medical school: the Mystery Case. Each student was provided a unique and undifferentiated case from a dedicated teaching file containing de-identified images and requisition data. Students were expected to complete three serial tasks over one week: 1) prepare a voice recognition-derived, structured radiological report utilizing appropriate and relevant vocabulary; 2) discuss pertinent additional clinical information; and 3) discuss appropriate follow-up imaging, in addition to information on how to best prepare patients for these potential patient exams (e.g., with or without contrast, bowel preparation, and length of study). Students were provided written examples and dedicated class instruction with interactive discussions covering specific cases and associated related cases through random pairing with radiology resident and attending mentors. At the close of the week, students gave brief oral presentations of their cases and submitted the tasks for a written evaluation. Upon completion of the clerkship, the students completed a Likert-type six-item survey to evaluate the perceived improvement in select skills. Results The survey was completed by 82% (54/66) of the enrolled students, with 85% finding the Mystery Case an effective use of time. Medical students perceived an improved awareness of the patient care process (77%), awareness of the medical imaging resources available (89%), ability to understand a radiology report (74%), and ability to advise patients (69%). Conclusion Introduction of the Mystery Case as a graded exercise in the medical school radiology clerkship was perceived by students as effective use of time, with an improvement in the skills essential for future referring physicians

A 850-GHz waveguide receiver employing a niobium SIS junction fabricated on a 1-μm Si_3N_4 membrane

We report on a 850-GHz superconducting-insulator-superconducting (SIS) heterodyne receiver employing an RF-tuned niobium tunnel junction with a current density of 14 kA/cm^2, fabricated on a 1-µm Si_3N_4 supporting membrane. Since the mixer is designed to be operated well above the superconducting gap frequency of niobium (2Δ/h ≈ 690 GHz), special care has been taken to minimize niobium transmission-line losses. Both Fourier transform spectrometer (FTS) measurements of the direct detection performance and calculations of the IF output noise with the mixer operating in heterodyne mode, indicate an absorption loss in the niobium film of about 6.8 dB at 822 GHz. These results are in reasonably good agreement with the loss predicted by the Mattis-Bardeen theory in the extreme anomalous limit. From 800 to 830 GHz, we report uncorrected receiver noise temperatures of 518 or 514 K when we use Callen and Welton's law to calculate the input load temperatures. Over the same frequency range, the mixer has a 4-dB conversion loss and 265 K ± 10 K noise temperature. At 890 GHz, the sensitivity of the receiver has degraded to 900 K, which is primarily the result of increased niobium film loss in the RF matching network. When the mixer was cooled from 4.2 to 1.9 K, the receiver noise temperature improved about 20% 409-K double sideband (DSB). Approximately half of the receiver noise temperature improvement can be attributed to a lower mixer conversion loss, while the remainder is due to a reduction in the niobium film absorption loss. At 982 GHz, we measured a receiver noise temperature of 1916 K

Radio Emission from SN 1994I in NGC 5194 (M 51) - The Best Studied Type Ib/c Radio Supernova

We present the results of detailed monitoring of the radio emission from the Type Ic supernova SN 1994I from 3 days after optical discovery on 1994 March 31 until eight years later at age 2927 days on 2002 April 05. The data were mainly obtained using the Very Large Array at the five wavelengths, 1.3, 2.0, 3.6, 6.2, and 21 cm, and from the Cambridge 5 km Ryle Telescope at 2.0 cm. Two additional measurements were obtained at millimeter wavelengths. This data set represents the most complete, multifrequency radio observations ever obtained for a Type Ib/c supernova. The radio emission evolves regularly in both time and frequency and is well described by established SN emission/absorption models. It is the first radio supernova with sufficient data to show that it is clearly dominated by the effects of synchrotron self-absorption at early times.Comment: 43 pages, 5 figure

Markarian 421's Unusual Satellite Galaxy

We present Hubble Space Telescope (HST) imagery and photometry of the active galaxy Markarian 421 and its companion galaxy 14 arcsec to the ENE. The HST images indicate that the companion is a morphological spiral rather than elliptical as previous ground--based imaging has concluded. The companion has a bright, compact nucleus, appearing unresolved in the HST images. This is suggestive of Seyfert activity, or possibly a highly luminous compact star cluster. We also report the results of high dynamic range long-slit spectroscopy with the slit placed to extend across both galaxies and nuclei. We detect no emission lines in the companion nucleus, though there is evidence for recent star formation. Velocities derived from a number of absorption lines visible in both galaxies indicate that the two systems are probably tidally bound and thus in close physical proximity. Using the measured relative velocities, we derive a lower limit on the MKN 421 mass within the companion orbit (R \sim 10 kpc) of 5.9 \times 10^{11} solar masses, and a mass-to-light ratio of >= 17. Our spectroscopy also shows for the first time the presence of H\alpha and [NII] emission lines from the nucleus of MKN 421, providing another example of the appearance of new emission features in the previously featureless spectrum of a classical BL Lac object. We see both broad and narrow line emission, with a velocity dispersion of several thousand km s^{-1} evident in the broad lines.Comment: LaTeX (aaspp4 style), 28 pages, 8 figures, to appear in AJ. Revised text from ref. comments; new & modified figures; new photometry included; minor corrections of typos. Color version of Fig. 1 to appear in Feb. 2000 Sky & Telescop

Select Metal and Metalloid Surveillance of Free-ranging Eastern Box Turtles from Illinois and Tennessee

The Eastern box turtle has been proposed as a biomonitor because it is long lived, relies on the environment for food and water, and has a small home range. To establish this designation, ISTC partnered with the Illinois Natural History Survey, the College of Veterinary Medicine at the University of Illinois, and the Clinch River Environmental Studies Organization. Plasma samples from 273 free-range box turtles were collected in 2011 and 2012 in Tennessee and Illinois. Full results reported in Allender, Matthew C., et al (2015). "Select metal and metalloid surveillance of free-ranging Eastern box turtles from Illinois and Tennessee (Terrapene carolina carolina)." Ecotoxicology 24, 1269–1278. https://doi.org/10.1007/s10646-015-1498-5Ope

The Use of Stereoscopy in a Neurosurgery Training Virtual Environment

Published in Presence: Teleoperators and Virtual EnvironmentsWe have previously investigated the effectiveness of a custom built virtual environment in assisting training of a ventriculostomy procedure, which is a commonly performed procedure by a neurosurgeon and a core task for trainee surgeons. The training tool (called VCath) was initially developed as a low fidelity app for a tablet platform to provide easy access and availability to trainees. Subsequently we have developed a high fidelity version of VCath that uses a stereoscopic display to immerse the trainee in the virtual environment. This paper reports on two studies that have been carried out to compare the low and high fidelity versions of VCath, particularly to assess the value of stereoscopy. Study 1 was conducted at the second annual boot camp organized for all year one trainees in neurosurgery in the UK. Study 2 was performed on lay people, with no surgical experience. Our hypothesis was that using stereoscopy in the training task would be beneficial. Results from Study 1 demonstrated that performance improved for both the control group and the group trained with the tablet version of VCath. The group trained on the high fidelity version of VCath with a stereoscopic display showed no performance improvement. The indication is that our hypothesis is false. In Study 2, six different conditions were investigated that covered the use of training with VCath on a tablet, a mono display at two different sizes, a stereo display at two different sizes, and a control group who received no training. Results from this study with lay people show that stereoscopy can make a significant improvement to the accuracy of needle placement. The possible reasons for these results and the apparent contradiction between the two studies are discussed

The Protein Storage Vacuole: A Unique Compound Organelle

doi: 10.1083/jcb.200107012Storage proteins are deposited into protein storage vacuoles (PSVs) during plant seed development and maturation and stably accumulate to high levels; subsequently, during germination the storage proteins are rapidly degraded to provide nutrients for use by the embryo. Here, we show that a PSV has within it a membrane-bound compartment containing crystals of phytic acid and proteins that are characteristic of a lytic vacuole. This compound organization, a vacuole within a vacuole whereby storage functions are separated from lytic functions, has not been described previously for organelles within the secretory pathway of eukaryotic cells. The partitioning of storage and lytic functions within the same vacuole may reflect the need to keep the functions separate during seed development and maturation and yet provide a ready source of digestive enzymes to initiate degradative processes early in germination.This work was supported by grants from the National Science Foundation (MCB-9974429), Department of Energy (DE-FG03-97ER20277), and Human Frontier Science Program (RG0018/2000) to J.C. Rogers, and from the Department of Energy (DE-FG02-91ER20055) to P.A. Rea. Y.M. Drozdowicz is an NSF/DOE/USDA Plant Training Grant fellow. L. Jiang is supported by a Direct Grant (project code 2030238) and a Special Grant for Conducting Research Abroad in the Summer of 2001 from the Chinese University of Hong Kong, and a grant from the Research Grants Council of the Hong Kong Special Administrative Region, China (project CUHK4156/ 01M)

Selective effects of 5-HT2C receptor modulation on performance of a novel valence-probe visual discrimination task and probabilistic reversal learning in mice.

RATIONALE: Dysregulation of the serotonin (5-HT) system is a pathophysiological component in major depressive disorder (MDD), a condition closely associated with abnormal emotional responsivity to positive and negative feedback. However, the precise mechanism through which 5-HT tone biases feedback responsivity remains unclear. 5-HT2C receptors (5-HT2CRs) are closely linked with aspects of depressive symptomatology, including abnormalities in reinforcement processes and response to stress. Thus, we aimed to determine the impact of 5-HT2CR function on response to feedback in biased reinforcement learning. METHODS: We used two touchscreen assays designed to assess the impact of positive and negative feedback on probabilistic reinforcement in mice, including a novel valence-probe visual discrimination (VPVD) and a probabilistic reversal learning procedure (PRL). Systemic administration of a 5-HT2CR agonist and antagonist resulted in selective changes in the balance of feedback sensitivity bias on these tasks. RESULTS: Specifically, on VPVD, SB 242084, the 5-HT2CR antagonist, impaired acquisition of a discrimination dependent on appropriate integration of positive and negative feedback. On PRL, SB 242084 at 1 mg/kg resulted in changes in behaviour consistent with reduced sensitivity to positive feedback. In contrast, WAY 163909, the 5-HT2CR agonist, resulted in changes associated with increased sensitivity to positive feedback and decreased sensitivity to negative feedback. CONCLUSIONS: These results suggest that 5-HT2CRs tightly regulate feedback sensitivity bias in mice with consequent effects on learning and cognitive flexibility and specify a framework for the influence of 5-HT2CRs on sensitivity to reinforcement