Survey of Nutrition Education Among Medical Students

Introduction: The current literature regarding both specific interventions and the current level of nutrition education in the United States is scarce. The purpose of this paper is to provide medical student perspectives on both the degree and necessity of nutrition education during medical school. Methods: Medicine in Motion (MM) is a non-profit student-run organization founded in 2018 that aims to address burnout in medicine through physical activity, community service, and philanthropy. MM issued a survey to nine of its chapters in January 2021 to assess a range of topics including burnout, physical activity, and nutrition education. Results: Of 5500 invited students, 1182 (21.5%) responded. An average of 1.2 hours of formal nutrition education per year was reported across all participants. Students who received any degree of nutritional education reported 2.9 hours per year. Most students (57.6%) had not participated in a medical school course that provided formal education in nutrition. Of those that did participate in a nutrition course (42.4%), the course was required for 84.7% of students and the majority (80.1%) received 0-10 hours of nutrition education. Most respondents (88.7%) reported that requiring formal nutrition education should be a graduation requirement and a similar number of students (89.3%) believe medical students should receive formal training on nutrition counseling for patients. The majority (93.3%) of students either somewhat or strongly agreed that understanding the effects of nutrition/eating decisions on the human body is critical to maximizing patient care. Conclusion: Based on prior studies, physicians feel underprepared to provide nutrition counseling to their patients despite the large role poor diet plays in the burden of disease. Most medical students in this cohort believe that understanding nutrition is vital to maximize patient care. Funding and curricular changes should be allocated towards expanding the nutrition curriculum across U.S. medical schools

Comparison of front-loaded recombinant tissue-type plasminogen activator, anistreplase and combination thrombolytic therapy for acute myocardial infarction: Results of the thrombolysis in myocardial infarction (TIMI) 4 trial

AbstractObjectives. The aim of our study was to determine a superior tbrombolytic regimen from three: anistreplase (APSAC), frontloaded recombinant tissue-type plasminogen activator (rt-PA) or combination thrombolytic therapy.Background. Although thrombolytic therapy has been shown to reduce mortality and morbidity after acute myocardial infarction, it has not been clear whether more aggressive thrombolyticantithrombotic regimens could improve the outcome achieved with standard regimens.Methods. To address this issue, 382 patients with acute myocardial infection were randomized to receive in a double-blind fashion (along with intravenous heparin and aspirin) APSAC, front-loaded rt-PA or a combination of both agents. The primary end point “unsatisfactory outcome” was a composite clinical end point assessed through hospital discharge.Results. Patency of the infarct-related artery (Thrombolysis in Myocardial Infarction [TIMI] grade 2 or 3 flow) at 60 min after the start of thrombolysis was significantly higher in rt-PA-treated patients (77.8% vs. 59.5% for APSAC-treated patients and 59.3% for combination-treated patients [rt-PA vs. APSAC, p = 0.02; rt-PA vs. combination, p = 0.03]). At 90 min, the incidence of both infarct-related artery patency and TIMI grade 3 flow was significantly higher in rt-PA-treated patients (60.2% had TIMI grade 3 flow vs. 42.9% and 44.8% of APSAC- and combination-treated patients, respectively [rt-PA vs. APSAC, p < 0.01; rt-PA vs. combination, p = 0.02]). The incidence of unsatisfactory outcome was 41.3% for rt-PA compared with 49% for APSAC and 53.6% for the combination (rt-PA vs. APSAC, p = 0.19; rt-PA vs. combination, p = 0.06). The mortality rate at 6 weeks was lowest in the rt-PA-treated patients (2.2% vs. 8.8% for APSAC and 7.2% for combination thrombolytic therapy [rt-PA vs. APSAC, p = 0.02; rt-PA vs. combination, p = 0.06]).Conclusions. Front-loaded rt-PA achieved significantly higher rates of early reperfusion and was associated with trends toward better overall clinical benefit and survival than those achieved with a standard thrombolytic agent or combination thrombolytic therapy. These findings support the concept that more rapid reperfusion of the infarct-related artery is associated with improved clinical outcome

Spallation reactions. A successful interplay between modeling and applications

The spallation reactions are a type of nuclear reaction which occur in space by interaction of the cosmic rays with interstellar bodies. The first spallation reactions induced with an accelerator took place in 1947 at the Berkeley cyclotron (University of California) with 200 MeV deuterons and 400 MeV alpha beams. They highlighted the multiple emission of neutrons and charged particles and the production of a large number of residual nuclei far different from the target nuclei. The same year R. Serber describes the reaction in two steps: a first and fast one with high-energy particle emission leading to an excited remnant nucleus, and a second one, much slower, the de-excitation of the remnant. In 2010 IAEA organized a worskhop to present the results of the most widely used spallation codes within a benchmark of spallation models. If one of the goals was to understand the deficiencies, if any, in each code, one remarkable outcome points out the overall high-quality level of some models and so the great improvements achieved since Serber. Particle transport codes can then rely on such spallation models to treat the reactions between a light particle and an atomic nucleus with energies spanning from few tens of MeV up to some GeV. An overview of the spallation reactions modeling is presented in order to point out the incomparable contribution of models based on basic physics to numerous applications where such reactions occur. Validations or benchmarks, which are necessary steps in the improvement process, are also addressed, as well as the potential future domains of development. Spallation reactions modeling is a representative case of continuous studies aiming at understanding a reaction mechanism and which end up in a powerful tool.Comment: 59 pages, 54 figures, Revie

Limits of Life and the Habitability of Mars: The ESA Space Experiment BIOMEX on the ISS

BIOMEX (BIOlogy and Mars EXperiment) is an ESA/Roscosmos space exposure experiment housed within the exposure facility EXPOSE-R2 outside the Zvezda module on the International Space Station (ISS). The design of the multiuser facility supports—among others—the BIOMEX investigations into the stability and level of degradation of space-exposed biosignatures such as pigments, secondary metabolites, and cell surfaces in contact with a terrestrial and Mars analog mineral environment. In parallel, analysis on the viability of the investigated organisms has provided relevant data for evaluation of the habitability of Mars, for the limits of life, and for the likelihood of an interplanetary transfer of life (theory of lithopanspermia). In this project, lichens, archaea, bacteria, cyanobacteria, snow/permafrost algae, meristematic black fungi, and bryophytes from alpine and polar habitats were embedded, grown, and cultured on a mixture of martian and lunar regolith analogs or other terrestrial minerals. The organisms and regolith analogs and terrestrial mineral mixtures were then exposed to space and to simulated Mars-like conditions by way of the EXPOSE-R2 facility. In this special issue, we present the first set of data obtained in reference to our investigation into the habitability of Mars and limits of life. This project was initiated and implemented by the BIOMEX group, an international and interdisciplinary consortium of 30 institutes in 12 countries on 3 continents. Preflight tests for sample selection, results from ground-based simulation experiments, and the space experiments themselves are presented and include a complete overview of the scientific processes required for this space experiment and postflight analysis. The presented BIOMEX concept could be scaled up to future exposure experiments on the Moon and will serve as a pretest in low Earth orbit

The weak-line T Tauri star V410Tau I. A multi-wavelength study of variability

We present the results of an intensive coordinated monitoring campaign in the optical and X-ray wavelength ranges of the low-mass, pre-main sequence star V410Tau carried out with the aim to study the relation between various indicators for magnetic activity that probe emission from different atmospheric layers: optical photometric star spot (rotation) cycle, chromospheric Halpha emission, and coronal X-rays. Two X-ray pointings were carried out with the Chandra satellite simultaneously with the optical observations, and centered near the maximum and minimum levels of the optical lightcurve. A relation of their different count levels to the rotation period of the dominating spot is not confirmed by a third Chandra observation carried out some months later, during another minimum of the 1.87d cycle. Similarly we find no indications for a correlation of the Halpha emission with the spots' rotational phase. The extraordinary stability of the largest spot is confirmed by long-term photometric and radial velocity measurements. Joining our optical photometry with previous data we provide a new estimate for the dominant periodicity of V410Tau. This updated value removes systematic offsets of the time of minimum observed in data taken over the last decade. Furthermore, the combination of the new data with published measurements taken during the last decade allows us to examine long-term changes in the mean light level of the photometry of V410Tau. A variation on the timescale of 5.4yr is suggested. Assuming that this behavior is truely cyclic V410Tau is the first pre-main sequence star on which an activity cycle is detected.Comment: 16 pages, accepted for publication in A&

BIOLEX – The Biology and Lunar experiment and the LOGOS Cubes

BIOLEX is a concept designed for in situ science on the Moon or in its orbit. As heritage of the polar and space experiment BIOMEX (Biology and Mars Experiment) on the ISS it is a more developed concept. Measurement operations on an exposure platform as well as within a micro-greenhouse device are part of this concept. The goal is to investigate the use of lunar resources as well as to analyse the stability of biomolecules as potential biosignatures serving as reference for future space exploration missions to Mars and the icy ocean moons in the outer solar system. Astrobiological exploration of the solar system is a priority research area such as emphasized by the European Astrobiology Roadmap (AstRoMap). It is focusing on several research topics, such as "Habitability" and on "Biomarkers for the detection of life". Therefore, "space platforms and laboratories", such as the EXPOSE setup installed outside the ISS, are essential to gain more knowledge on space- and planetary environments, which might be an essential basis for improvement of the robotic and human interplanetary exploration (Moon, Mars, Encedalus, Titan and Europa). In reference to these exposure platforms a new generation of hardware is needed to be installed in the lunar orbit or directly on the Moon. The BIOLEX is representing by its LOGOS (Lunar Organisms, Geo-microbiology and Organics Space Experiment) cubes such a concept combining the life detection topics with topics relevant to autonomous life supporting systems. A combination of a sample exposure device and a microhabitat for plants and microorganisms could address a tremendous number of questions from astrobiology and life sciences. The main scientific objectives for the use of BIOLEX-LOGOS cubes are: (i) in situ measurements by spectroscopy methods (such as Raman, IR, UV/VISspectroscopy) for analysis of biosignatures and their stability what is relevant for support of future life detection missions on Mars and the icy moons in the outer solar system); (ii) in situ measurements of environmental conditions (radiation, pressure/vacuum, temperature, pH, humidity) in micro-modules or compartments in reference to planned micro-habitat experiments placed on the Moon or incorporated on an exposure facility in orbit; (iii) in situ measurements of microorganisms’ activity in micro-modules / compartments in reference to planned microhabitat experiments placed on the moon or incorporated in the exposure facility in orbit. In reference to these scientific ideas the Moon is an excellent platform to operate different space experiments which will be of relevance for astrobiology, life sciences and human space missions. BIOLEX tries to fulfil a large number of scientific investigations in reference to these disciplines. The lunar environment is much harsher compared to Mars; and tests on biomolecules in this environment could provide information on their stability and therefore on the value to be used as reference for future space missions to Mars or the icy ocean moons in the outer solar system. Resources of the Moon such as the regolith or the freely available radiation on the surface could be tested by using them in a micro-greenhouse. Within this greenhouse different filters could test the optimal spectra range of the radiation

Treatment of unprotected left main coronary artery stenosis with a drug eluting stent in a heart transplant patient with allograft vasculopathy

High risk angioplasty with drug eluting stent placement into an unprotected left main coronary artery in a heart transplant recipient with allograft vasculopathy is reported. Ten month angiographic follow up is reported. The literature is reviewed and current methods of revascularisation are described in detail. This is the first report of drug eluting stent use in this clinical situation