Experiences of Medical Imaging Students and Clinical Learning in a Limited Resource Setting - A Qualitative Study in Rwanda

Purpose: This qualitative research aimed to explore the experiences of University of Rwanda medical imaging students during their clinical practice in the country. Methods and Materials: Focus Group Discussions (FGDs) with open-ended questions were held with twenty five medical imaging sciences students who were enrolled in their second and final year respectively of the bachelors with honors and national diploma programs. Results: Qualitative exploratory descriptive research was conducted in March 2017 through FDGs. The recorded data was transcribed, anonymized, coded, categorized and conceptualized into four themes: theory-practice gap, teaching and learning support, occupational health and safety, resources and infrastructure. Data was analyzed using content analysis. The findings indicate that there were aspects which negatively impacted clinical experiences of medical imaging students. This valuable information is important to create awareness among medical imaging academia and practicing professionals about the challenges faced by medical imaging students in clinical practice. Conclusion: Medical imaging students experienced a number of challenges during their clinical training in Rwanda. Based on these findings, specific recommendations are suggested with an aim to enhance the clinical training process of medical imaging student

PO-033 Identification and functional evaluation of monoclonal antibodies specifically targeting human carbonic anhydrase IX

Introduction Poor vascularisation of solid tumours leads to inadequate nutrient and oxygen supplies which forces tumour cells to reprogram their metabolism. As a consequence the tumour cell's environment becomes acidic and hypoxic. This, in turn, triggers signalling cascades involving for example heterodimeric hypoxia-inducible factor (HIF). Activation of this hypoxia-induced transcriptional program is crucial for the survival of tumour cells in their hostile microenvironment but also their ability to metastasize. One of the genes upregulated through the HIF pathway is carbonic anhydrase (CA)-IX (CAIX, gene G250/MN-encoded transmembrane protein). CA-IX catalyses carbon dioxide (CO2) thereby generating a proton (H+) and bicarbonate (HCO3-), the latter of which is transported back into the cell and utilised to help safeguard intracellular pH (pHi) stability. Except for the stomach and the gallbladder, CA-IX expression is negligible in normal tissues. In contrast, a broad range of tumours express high levels of CA-IX, where the protein can serve as a biomarker for the early stages of tumour development but also as tumour marker of hypoxia associated with resistance to chemotherapy and radiotherapy. Material and methods Preclinical and clinical studies have shown that CA-IX is a promising therapeutic target for detection and therapy for several cancer types. To date only a limited number of ant-CAIX monoclonal antibodies (mAbs) have been available for clinical testing as therapeutic and imaging agents. In the current study, we generated and functionally categorised a panel of 51 mouse mAbs that specifically bind to human CA-IX. Results and discussions Characterisation of the mAbs revealed that of the mAbs with the best biophysical characteristics, three3 mAbs are suitable as an antibody-drug conjugate (ADC), two2 mAbs inhibit the CA-IX enzyme activity, and one1 mAb that is suitable for CA-IX imaging purposes. Conclusion These preliminary data presented here could thus form the basis for the development of novel CA-IX targeted immunotherapies and diagnostic tools for the treatment of cancer

Synthesis and evaluation of 18F-labeled carbonic anhydrase IX inhibitors for imaging with positron emission tomography

Two carbonic anhydrase IX (CA IX) inhibitors were radiolabeled with (18)F, and evaluated for imaging CA IX expression. Despite good affinity for CA IX and excellent plasma stability, uptake of both tracers in CA IX-expressing HT-29 tumor xenografts in mice was low. (18)F-FEC accumulated predominately in the liver and nasal cavity, whereas a significant amount of (18)F-U-104 was retained in blood. Due to minimal uptake in HT-29 tumors compared to other organs/tissues, these two tracers are not suitable for use for CA IX-targeted imaging

Real-life management of neovascular age-related macular degeneration (nAMD) in France: a nationwide observational study using retrospective claims data

AIMS: Intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy is standard care for neovascular age-related macular degeneration (nAMD), but the recommended monthly injection regimen is burdensome. Evidence suggests low injection/monitoring frequencies in clinical practice and suboptimal vision outcomes. This observational cohort study uses administrative claims data from the French national healthcare system to assess anti-VEGF treatment patterns and nAMD-specific healthcare resource demands and costs. PATIENTS AND METHODS: nAMD patients ≥50 years initiating intravitreal ranibizumab, aflibercept or bevacizumab treatment (2014‒2015), and propensity score-matched non-nAMD patients (controls), were identified from the Echantillon Généraliste de Bénéficiaires database. Outcomes of interest included anti-VEGF treatment patterns, and healthcare resource utilization and associated costs of patients vis-à-vis controls over 24 months. RESULTS: Study patients (n = 355) received (mean) 5.2 and 2.4 anti-VEGF injections over 0‒12 and 12‒24 months, respectively. Most patients (79.0%) remained on their initial anti-VEGF agent; among treatment switchers the most common transition was from ranibizumab to aflibercept. During follow-up, nAMD patients were more likely than controls to require ophthalmology visits (99.7% vs 44.8%), ocular procedures (optical coherence tomography/angiography/fundoscopy) (96.9% vs 27.2%), cataract surgery (13.0% vs 6.7%), and medical transports (38.0% vs 31.9%). Mean numbers of ophthalmology visits (25.1 vs 1.2) and medical transports (6.0 vs 3.5) were higher (p<.01) among nAMD patients. Total reimbursed costs were two-fold higher for nAMD patients than controls (mean €16,799 vs €8255) due to higher treatment costs (€6847 vs €1156), medical fees (€1858 vs €295), hospital fees (€6396 vs €5235), and transport costs (€358 vs €259). Excess total healthcare cost was (mean) €5279 and €7918 over the first 12 and 24 months of treatment, respectively. CONCLUSIONS: Current intravitreal anti-VEGF treatment and monitoring requirements place considerable economic burden on the French healthcare system. New intravitreal therapies with extended dosing intervals and predictable efficacy might reduce demand on ophthalmology services

F-18-Fluorodeoxyglucose Positron Emission Tomography Imaging-Assisted Management of Patients With Severe Left Ventricular Dysfunction and Suspected Coronary Disease A Randomized, Controlled Trial (PARR-2)

ObjectivesWe conducted a randomized trial to assess the effectiveness of F-18-fluorodeoxyglucose (FDG) positron emission tomography (PET)-assisted management in patients with severe ventricular dysfunction and suspected coronary disease.BackgroundSuch patients may benefit from revascularization, but have significant perioperative morbidity and mortality. F-18-fluorodeoxyglucose PET can detect viable myocardium that might recover after revascularization.MethodsIncluded were patients with severe left ventricular (LV) dysfunction and suspected coronary disease being considered for revascularization, heart failure, or transplantation work-ups or in whom PET was considered potentially useful. Patients were stratified according to recent angiography or not, then randomized to management assisted by FDG PET (n = 218) or standard care (n = 212). The primary outcome was the composite of cardiac death, myocardial infarction, or recurrent hospital stay for cardiac cause, within 1 year.ResultsAt 1 year, the cumulative proportion of patients who had experienced the composite event was 30% (PET arm) versus 36% (standard arm) (relative risk 0.82, 95% confidence interval [CI] 0.59 to 1.14; p = 0.16). The hazard ratio (HR) for the composite outcome, PET versus standard care, was 0.78 (95% CI 0.58 to 1.1; p = 0.15); for patients that adhered to PET recommendations for revascularization, revascularization work-up, or neither, HR = 0.62 (95% CI 0.42 to 0.93; p = 0.019); in those without recent angiography, for cardiac death, HR = 0.4 (95% CI 0.17 to 0.96; p = 0.035).ConclusionsThis study did not demonstrate a significant reduction in cardiac events in patients with LV dysfunction and suspected coronary disease for FDG PET-assisted management versus standard care. In those who adhered to PET recommendations and in patients without recent angiography, significant benefits were observed. The utility of FDG PET is best realized in this subpopulation and when adherence to recommendations can be achieved

Machine Learning in the Nuclear Medicine: Part 2-Neural Networks and Clinical Aspects

COPYRIGHT © 2021 by the Society of Nuclear Medicine and Molecular Imaging.This article is the second part in our machine learning series. Part 1 provided a general overview of machine learning in nuclear medicine. Part 2 focuses on neural networks. We start with an example illustrating how neural networks work and a discussion of potential applications. Recognizing that there is a spectrum of applications, we focus on recent publications in the areas of image reconstruction, low-dose PET, disease detection, and models used for diagnosis and outcome prediction. Finally, since the way machine learning algo- rithms are reported in the literature is extremely variable, we conclude with a call to arms regarding the need for standardized reporting of design and outcome metrics and we propose a basic checklist our community might follow going forward

Transition numérique et pratiques de recherche et d’enseignement supérieur en agronomie, environnement, alimentation et sciences vétérinaires à l’horizon 2040.

Pour citer ce document:Barzman M. (Coord.), Gerphagnon M. (Coord.), Mora O. (Coord.),Aubin-Houzelstein G., Bénard A., Martin C., Baron G.L, Bouchet F., Dibie-Barthélémy J., Gibrat J.F., Hodson S., Lhoste E., Moulier-Boutang Y., Perrot S., Phung F., Pichot C., Siné M., Venin T. 2019. Transition numérique et pratiques de recherche et d’enseignement supérieur en agronomie, environnement, alimentation et sciences vétérinaires à l’horizon 2040.INRA, France, 161pagesTransition numérique et pratiques de recherche et d’enseignement supérieur en agronomie, environnement, alimentation et sciences vétérinaires à l’horizon 2040

Liquid facets-Related (lqfR) Is Required for Egg Chamber Morphogenesis during Drosophila Oogenesis

Clathrin interactor 1 [CLINT1] (also called enthoprotin/EpsinR) is an Epsin N-terminal homology (ENTH) domain-containing adaptor protein that functions in anterograde and retrograde clathrin-mediated trafficking between the trans-Golgi network and the endosome. Removal of both Saccharomyces cerevisiae homologs, Ent3p and Ent5p, result in yeast that are viable, but that display a cold-sensitive growth phenotype and mistrafficking of various vacuolar proteins. Similarly, either knock-down or overexpression of vertebrate CLINT1 in cell culture causes mistrafficking of proteins. Here, we have characterized Drosophila CLINT1, liquid-facets Related (lqfR). LqfR is ubiquitously expressed throughout development and is localized to the Golgi and endosome. Strong hypomorphic mutants generated by imprecise P-element excision exhibit extra macrochaetae, rough eyes and are female sterile. Although essentially no eggs are laid, the ovaries do contain late-stage egg chambers that exhibit abnormal morphology. Germline clones reveal that LqfR expression in the somatic follicle cells is sufficient to rescue the oogenesis defects. Clones of mutant lqfR follicle cells have a decreased cell size consistent with a downregulation of Akt1. We find that while total Akt1 levels are increased there is also a significant decrease in activated phosphorylated Akt1. Taken together, these results show that LqfR function is required to regulate follicle cell size and signaling during Drosophila oogenesis