The Modern Approach to Targeting Melanoma

Melanoma treatment depends largely on the clinical stage of the disease. The preferred treatment is surgical resection of the disease. The surgical margins depend on the depth of the disease. Sentinel lymph node biopsy is generally advised for all lesions greater than 1 mm depth. Complete lymphadenopathy of surrounding lymph nodes is recommended in the presence of nodal disease. There are some controversies surrounding the timing and benefit of complete lymphadenopathy in clinically occult disease. There is evidence to support the role of adjuvant therapies in the form of immunotherapy in regionally advanced disease, and there has been a significant improvement in medical therapies for advanced melanoma. BRAF inhibitors have become mainstay treatment for patients with a BRAF mutation. Immunotherapy is another cornerstone of therapy for advanced melanoma. There is ongoing research to define the optimal therapeutic regimen. Future guidelines will likely incorporate this recent research. Chemotherapy has been relegated to second-line therapy in melanoma

Is a picture worth a thousand words: an analysis of the difficulty and discrimination parameters of illustrated vs. text-alone vignettes in histology multiple choice questions.

Background Advances in cognitive load theory have led to greater understanding of how we process verbal and visual material during learning, but the evidence base with regard to the use of images within written assessments is still sparse. This study examines whether the inclusion of images within the stimulus format of multiple choice questions (MCQs) has a predictable or consistent influence on psychometric item properties, such as difficulty or discrimination. Methods Item analysis data from three consecutive years of histology multiple choice examinations were included in this study. All items were reviewed and categorised according to whether their stem, or stimulus format, was purely textual or included an associated image. Results A total of 195 MCQs were identified for inclusion and analysed using classical test theory; 95 used text alone and 100 included an image within the question stem. The number of students per examination ranged from 277 to 347, with a total of 60,850 student-question interactions. We initially examined whether the inclusion of an image within the item stem altered the item difficulty using Mann–Whitney U. The median item difficulty for images with purely textual stems was 0.77, while that for items incorporating an appropriate image was 0.80; this difference was not significant (0.77 vs. 0.80; p = 0.862, Mann–Whitney-U = 4818.5). Mean values showed that the Item Discrimination Index appeared unaffected by the inclusion of an image within the stem, and Item point biserial correlation also showed no difference in means between these two groups (Independent samples t-test; 2-tailed). Conclusion We demonstrate that the addition of illustrations within undergraduate histology Multiple Choice Question stems has no overall influence on item difficulty, or measures of item discrimination. We conclude that the use of images in this context is statistically uncritical, and suggest that their inclusion within item stems should be based upon the principles of constructive alignment. However, further research with respect to the effect of images within item stems on cognitive processing, particularly with regard to image complexity or type, would enable the development of more informed guidelines for their use

Is a picture worth a thousand words?

Background: It has previously been suggested that the use of illustrations in MCQs may have variable effects on individual items. This study examines the effect of illustrated questions, as opposed to pure text, to discern if any overall bias between the two formats is detectable. Summary of work: We reviewed 6 Histology MCQ papers from our Medical Junior Cycle. Classical test theory analysis was performed on all MCQs, which were then divided into two groups, those with associated images and those without. Summary of results: We analysed 195 single best answer MCQs; 100 with associated illustrations, 95 without. The number of students per examination ranged from 277 to 347, with a total of 60,850 student-question interactions. There was no difference in question difficulty between the two groups (0.800 vs. 0.770; p = 0.862, Mann-Whitney-U). The discriminating power of the questions, as measured by point biserial correlation, was also identical (0.315 vs. 0.300; p = 0.939; Independent t-test). Conclusions: We found no overall bias or effect on either item difficulty or discrimination resulting from the addition of illustrations. We suggest that illustrated questions, as with textual vignettes, may test a range of cognitive levels depending on how they are employed

Young adults with high autistic-like traits displayed lower food variety and diet quality in childhood

This study explored the association between autistic-like traits in young adults and dietary intake in early childhood in the Gen2 Raine Study cohort. Data were available from 811 participants at years 1, 2 and 3 for the assessment of dietary intake, and at year 20 for measurement of autistic-like traits. Results showed as autistic-like traits increased, total food variety, core food variety and dairy variety decreased (p \u3c 0.05), with a lower consumption of citrus fruits and yoghurt (both p = 0.04). As autistic-like traits increased, diet quality decreased, this trend was significant at 2 years (p = 0.024). Our results suggest that young adults with higher autistic-like traits were more likely to have had lower food variety and diet quality in early childhood

SDG 3: Good health and well-being - framing targets to maximise co-benefits for forests and people

Key Points: The achievement of SDG 3 depends on many other SDGs; some SDGs are logically inconsistent, especially in the attempt to increase conventionally defined GDP while preserving natural capital. Any short-term gains for human health from further forest conversion (e.g. food production) creates short- and long-term, direct and indirect health risks for humans, as well as for other biota. Failure to ensure universal access to sexual and reproductive healthcare services (including family planning) will increase pressure on forests at local, regional and global scales. The burning and clearing of forests cause significant harm to health via impaired quality of water, soil and air; increased exposure to infectious diseases and impacts climate regulation. Many infectious diseases are associated with forest disturbances and intrusions; some important infectious diseases have emerged from forests (notably HIV/AIDS). Greater exposure to green space, including forests, provides mental and physical health benefits for the growing global urban population

Diving into the vertical dimension of elasmobranch movement ecology

Knowledge of the three-dimensional movement patterns of elasmobranchs is vital to understand their ecological roles and exposure to anthropogenic pressures. To date, comparative studies among species at global scales have mostly focused on horizontal movements. Our study addresses the knowledge gap of vertical movements by compiling the first global synthesis of vertical habitat use by elasmobranchs from data obtained by deployment of 989 biotelemetry tags on 38 elasmobranch species. Elasmobranchs displayed high intra- and interspecific variability in vertical movement patterns. Substantial vertical overlap was observed for many epipelagic elasmobranchs, indicating an increased likelihood to display spatial overlap, biologically interact, and share similar risk to anthropogenic threats that vary on a vertical gradient. We highlight the critical next steps toward incorporating vertical movement into global management and monitoring strategies for elasmobranchs, emphasizing the need to address geographic and taxonomic biases in deployments and to concurrently consider both horizontal and vertical movements

Zoo-illogical Exhibition

Creative work by Jane O\u27Sullivan