Personal values influencing career path in academic medicine: Perspectives of selected Canadian trainees [version 2; referees: 2 approved, 1 approved with reservations]

To pursue research, education, and health policy in one’s career, broadly defined as academic medicine, is one of the most important decisions of a trainee doctor’s career. Despite this, there is scant literature on which factors influence trainees’ choices towards clinical work or academic research. As the MD/PhD is a relatively young training path compared to the traditional PhD (Doctor of Philosophy) and MD (Doctor of Medicine) programs, it prompts the question: at the crossroads of a career, what sways the individual to select an MD, PhD, or MD/PhD program? This is a valuable question to be answered for trainees who are considering multiple career paths, for educators who want to guide undifferentiated students, and for policy makers who develop and coordinate research programs. “Intellectual stimulation” is the most consistently identified personal value which draws trainees to academic medicine. Mentorship is linked strongly to success in the field. Conversely, long training periods, a lack of autonomy, and financial considerations are deterrents from a career in academic medicine. Insight into the decision-making process is provided by recent Canadian trainees in these respective fields, in a series of short interviews

On-Line Small angle and Wide angle X-ray diffraction Studies on Melt Spinning Polyvinylidene Fluoride Using Synchrotron Radiation

On-line small-angle and wide-angle x-ray scattering experiments were performed during the melt spinning of polyvinylidene fluoride using the DESY synchrotron light source. In these studies, the melt-spinning apparatus consisting of a screw extruder, a metering pump, and a take-up motor system were assembled on two separate stepper-motor-driven platforms. To investigate the structure development during crystallization, the tape location at the desired distance from the die could be positioned at the beam level with synchronous vertical movement of extruder and take-up platforms. Small-angle and wide-angle x-ray patterns were taken simultaneously with a two-dimensional wire detector and one-dimensional wire detector. In a separate study, two-dimensional WAXS data were also taken under identical processing conditions to observe the off-equator diffraction behavior during the crystallization. The data obtained for a variety of take-up speeds generally indicate that SAXS d-spacings first appear large in the early stages of crystallization and gradually decrease along the spin-line (as the crystallization progresses). As the take-up speed increases, the crystallization onset position moves away from the die and d-spacings observed at the onset increase. In addition, the shape of the discrete scattering pattern starts as a meridional streak and converts to a teardrop shape with the tip of the pattern pointing toward the beam stop at the early stages of crystallization for high take-up speeds. This does not occur at low take-up speeds and is attributed to the differences in crystallization behavior which is spherulitic or sheaflike to row nucleated crystallites. Our studies also showed that SAXS patterns appear earlier than the wide-angle crystalline diffraction peaks indicating the SAXS technique to be more sensitive to the structural changes at these stages. An idealized model is developed to explain the observed patterns at high take-up speeds. This consists of two regimes. In regime 1, the periodic fluctuations due to the alternating crystalline and amorphous regions form along the regions where eventually the “shish” structures develop. In the second stage, a volume filling crystallization takes place between the existing crystallites along the shish structure and simultaneously radial overgrowth of crystallites (i.e., the “kebabs”) takes place. This causes the observed reduction in the average d-spacing

On-line small-angle and wide-angle x-ray scattering studies on melt-spinning poly(vinylidene fluoride) tape using synchrotron radiation

On-line small-angle and wide-angle x-ray scattering experiments were performed during the melt spinning of polyvinylidene fluoride using the DESY synchrotron light source. In these studies, the melt-spinning apparatus consisting of a screw extruder, a metering pump, and a take-up motor system were assembled on two separate stepper-motor-driven platforms. To investigate the structure development during crystallization, the tape location at the desired distance from the die could be positioned at the beam level with synchronous vertical movement of extruder and take-up platforms. Small-angle and wide-angle x-ray patterns were taken simultaneously with a two-dimensional wire detector and one-dimensional wire detector. In a separate study, two-dimensional WAXS data were also taken under identical processing conditions to observe the off-equator diffraction behavior during the crystallization. The data obtained for a variety of take-up speeds generally indicate that SAXS d-spacings first appear large in the early stages of crystallization and gradually decrease along the spin-line (as the crystallization progresses). As the take-up speed increases, the crystallization onset position moves away from the die and d-spacings observed at the onset increase. In addition, the shape of the discrete scattering pattern starts as a meridional streak and converts to a teardrop shape with the tip of the pattern pointing toward the beam stop at the early stages of crystallization for high take-up speeds. This does not occur at low take-up speeds and is attributed to the differences in crystallization behavior which is spherulitic or sheaflike to row nucleated crystallites. Our studies also showed that SAXS patterns appear earlier than the wide-angle crystalline diffraction peaks indicating the SAXS technique to be more sensitive to the structural changes at these stages. An idealized model is developed to explain the observed patterns at high take-up speeds. This consists of two regimes. In regime 1, the periodic fluctuations due to the alternating crystalline and amorphous regions form along the regions where eventually the “shish” structures develop. In the second stage, a volume filling crystallization takes place between the existing crystallites along the shish structure and simultaneously radial overgrowth of crystallites (i.e., the “kebabs”) takes place. This causes the observed reduction in the average d-spacing

A validated, automated, 3-dimensional method to reliably measure tibial torsion

Background: Tibial torsion is a twist in the tibia measured as an angle between a proximal axis line and a distal axis line. Abnormal torsion has been associated with a variety of painful clinical syndromes of the lower limb. Measurements of normal tibial torsion reported by different authors vary by 100% (ranging from 20° to 42°), making it impossible to determine normal and pathological levels. Purpose: To address the problem of unreliable measurements, this study was conducted to define an automated, validated computer method to calculate tibial torsion. Reliability was compared with current clinical methods. The difference between measurements of torsion generated from computed tomography (CT) and magnetic resonance imaging (MRI) scans of the same bone, and between males and females, was assessed. Study Design: Controlled laboratory study. Methods: Previous methods of analyzing tibial torsion were reviewed, and limitations were identified. An automated measurement method to address these limitations was defined. A total of 56 cadaveric and patient tibiae (mean ± SD age, 37 ± 15 years; range, 17-71 years; 28 female) underwent CT scanning, and 3 blinded assessors made torsion measurements by applying 2 current clinical methods and the automated method defined in the present article. Intraclass correlation coefficient (ICC) values were calculated. Further, 12 cadaveric tibiae were scanned by MRI, stripped of tissue, and measured using a structured light (SL) scanner. Differences between torsion values obtained from CT, SL, and MRI scans, and between males and females, were compared using t tests. SPSS was used for all statistical analysis. Results: When the automated method was used, the tibiae had a mean external torsion of 29°± 11° (range, 9°-65). Automated torsion assessment had excellent reliability (ICC, 1), whereas current methods had good reliability (ICC, 0.78-0.81). No significant difference was found between the torsion values calculated from SL and CT (P = .802), SL and MRI (P = .708), or MRI and CT scans (P = .826). Conclusion: The use of software to automatically perform measurements ensures consistency, time efficiency, validity, and accuracy not possible with manual measurements, which are dependent on assessor experience. Clinical Relevance: We recommend that this method be adopted in clinical practice to establish databases of normal and pathological tibial torsion reference values and ultimately guide management of related conditions