An integrated ultrasound curriculum (iUSC) for medical students: 4-year experience

A review of the development and implementation of a 4-year medical student integrated ultrasound curriculum is presented. Multiple teaching and assessment modalities are discussed as well as results from testing and student surveys. Lessons learned while establishing the curriculum are summarized. It is concluded that ultrasound is a well received, valuable teaching tool across all 4 years of medical school, and students learn ultrasound well, and they feel their ultrasound experience enhances their medical education

Platelet Ice Under Arctic Pack Ice in Winter

The formation of platelet ice is well known to occur under Antarctic sea ice, where subice platelet layers form from supercooled ice shelf water. In the Arctic, however, platelet ice formation has not been extensively observed, and its formation and morphology currently remain enigmatic. Here, we present the first comprehensive, long‐term in situ observations of a decimeter thick subice platelet layer under free‐drifting pack ice of the Central Arctic in winter. Observations carried out with a remotely operated underwater vehicle (ROV) during the midwinter leg of the MOSAiC drift expedition provide clear evidence of the growth of platelet ice layers from supercooled water present in the ocean mixed layer. This platelet formation takes place under all ice types present during the surveys. Oceanographic data from autonomous observing platforms lead us to the conclusion that platelet ice formation is a widespread but yet overlooked feature of Arctic winter sea ice growth

An Introduction to Gas Accretion onto Galaxies

Evidence for gas accretion onto galaxies can be found throughout the universe. In this chapter, I summarize the direct and indirect signatures of this process and discuss the primary sources. The evidence for gas accretion includes the star formation rates and metallicities of galaxies, the evolution of the cold gas content of the universe with time, numerous indirect indicators for individual galaxies, and a few direct detections of inflow. The primary sources of gas accretion are the intergalactic medium, satellite gas and feedback material. There is support for each of these sources from observations and simulations, but the methods with which the fuel ultimately settles in to form stars remain murky.Comment: 14 pages, 5 figures, Invited review to appear in Gas Accretion onto Galaxies, Astrophysics and Space Science Library, eds. A. J. Fox & R. Dav\'e, to be published by Springe

Transcriptional dysregulation of Interferome in experimental and human Multiple Sclerosis

Recent evidence indicates that single multiple sclerosis (MS) susceptibility genes involved in interferon (IFN) signaling display altered transcript levels in peripheral blood of untreated MS subjects, suggesting that responsiveness to endogenous IFN is dysregulated during neuroinflammation. To prove this hypothesis we exploited the systematic collection of IFN regulated genes (IRG) provided by the Interferome database and mapped Interferome changes in experimental and human MS. Indeed, central nervous system tissue and encephalitogenic CD4 T cells during experimental autoimmune encephalomyelitis were characterized by massive changes in Interferome transcription. Further, the analysis of almost 500 human blood transcriptomes showed that (i) several IRG changed expression at distinct MS stages with a core of 21 transcripts concordantly dysregulated in all MS forms compared with healthy subjects; (ii) 100 differentially expressed IRG were validated in independent case-control cohorts; and (iii) 53 out of 100 dysregulated IRG were targeted by IFN-beta treatment in vivo. Finally, ex vivo and in vitro experiments established that IFN-beta administration modulated expression of two IRG, ARRB1 and CHP1, in immune cells. Our study confirms the impairment of Interferome in experimental and human MS, and describes IRG signatures at distinct disease stages which can represent novel therapeutic targets in MS

Cerebrospinal fluid findings in patients with neurological manifestations in post-COVID-19 syndrome

BACKGROUND: Information on cerebrospinal fluid (CSF) findings in patients with neurological manifestations in post-COVID-19 syndrome is scarce. METHODS: Retrospective evaluation of 84 CSF samples in patients fulfilling post-COVID-19 criteria in two neurological post-COVID-19 outpatient clinics. RESULTS: In 68% of samples, all CSF parameters were normal. The most frequent pathological CSF finding was elevation of total protein (median total protein 33.3 mg/dl [total range 18.5-116.2]) in 20 of 83 (24%) samples. The second most prevalent pathological finding was a blood-CSF barrier dysfunction as measured by elevation of QAlb (median QAlb 4.65 [2.4-13.2]) in 11/84 (13%). Pleocytosis was found in only 5/84 (6%) samples and was mild in all of them. CSF-restricted oligoclonal bands were found in 5/83 (6%) samples. Anti-neuronal autoantibodies in CSF were negative in most cases, whilst 12/68 (18%) samples were positive for anti-myelin autoantibodies in serum. PCR for herpesviridae (HSV-1/-2, VZV, EBV, CMV, HHV6) showed, if at all, only weakly positive results in CSF or EDTA whole blood/plasma. CONCLUSIONS: The majority of samples did not show any pathologies. The most frequent findings were elevation of total protein and blood-CSF barrier dysfunction with no signs of intrathecal inflammation. CSF analysis still keeps its value for exclusion of differential diagnoses

The outlook of building information modeling for sustainable development

As human needs evolve, information technologies and natural environments require a wider perspective of sustainable development, especially when examining the built environment that impacts the central of social-ecological systems. The objectives of the paper are (a) to review the status and development of building information modeling (BIM) in regards to the sustainable development in the built environment, and (b) to develop a future outlook framework that promotes BIM in sustainable development. Seven areas of sustainability were classified to analyze forty-four BIM guidelines and standards. This review examines the use of BIM in sustainable development, focusing primarily on certain areas of sustainability, such as project development, design, and construction. The developed framework describes the need for collaboration with the multiple disciplines for the future adoption and use of BIM for the sustainable development. It also considers the integration between “BIM and green assessment criteria”; and “BIM and renewable energy” to address the shortcomings of the standards and guidelines

Wind redistribution of snow impacts the Ka- and Ku-band radar signatures of Arctic sea ice

Wind-driven redistribution of snow on sea ice alters its topography and microstructure, yet the impact of these processes on radar signatures is poorly understood. Here, we examine the effects of snow redistribution over Arctic sea ice on radar waveforms and backscatter signatures obtained from a surface-based, fully polarimetric Ka- and Ku-band radar at incidence angles between 0∘ (nadir) and 50∘. Two wind events in November 2019 during the Multidisciplinary drifting Observatory for the Study of Arctic Climate (MOSAiC) expedition are evaluated. During both events, changes in Ka- and Ku-band radar waveforms and backscatter coefficients at nadir are observed, coincident with surface topography changes measured by a terrestrial laser scanner. At both frequencies, redistribution caused snow densification at the surface and the uppermost layers, increasing the scattering at the air–snow interface at nadir and its prevalence as the dominant radar scattering surface. The waveform data also detected the presence of previous air–snow interfaces, buried beneath newly deposited snow. The additional scattering from previous air–snow interfaces could therefore affect the range retrieved from Ka- and Ku-band satellite altimeters. With increasing incidence angles, the relative scattering contribution of the air–snow interface decreases, and the snow–sea ice interface scattering increases. Relative to pre-wind event conditions, azimuthally averaged backscatter at nadir during the wind events increases by up to 8 dB (Ka-band) and 5 dB (Ku-band). Results show substantial backscatter variability within the scan area at all incidence angles and polarizations, in response to increasing wind speed and changes in wind direction. Our results show that snow redistribution and wind compaction need to be accounted for to interpret airborne and satellite radar measurements of snow-covered sea ice.</p

Epigenome-wide association study of serum urate reveals insights into urate co-regulation and the SLC2A9 locus

Elevated serum urate levels, a complex trait and major risk factor for incident gout, are correlated with cardiometabolic traits via incompletely understood mechanisms. DNA methylation in whole blood captures genetic and environmental influences and is assessed in transethnic meta-analysis of epigenome-wide association studies (EWAS) of serum urate (discovery, n = 12,474, replication, n = 5522). The 100 replicated, epigenome-wide significant (p &lt; 1.1E–7) CpGs explain 11.6% of the serum urate variance. At SLC2A9, the serum urate locus with the largest effect in genome-wide association studies (GWAS), five CpGs are associated with SLC2A9 gene expression. Four CpGs at SLC2A9 have significant causal effects on serum urate levels and/or gout, and two of these partly mediate the effects of urate-associated GWAS variants. In other genes, including SLC7A11 and PHGDH, 17 urate-associated CpGs are associated with conditions defining metabolic syndrome, suggesting that these CpGs may represent a blood DNA methylation signature of cardiometabolic risk factors. This study demonstrates that EWAS can provide new insights into GWAS loci and the correlation of serum urate with other complex traits

Meta-analyses identify DNA methylation associated with kidney function and damage

Chronic kidney disease is a major public health burden. Elevated urinary albumin-to-creatinine ratio is a measure of kidney damage, and used to diagnose and stage chronic kidney disease. To extend the knowledge on regulatory mechanisms related to kidney function and disease, we conducted a blood-based epigenome-wide association study for estimated glomerular filtration rate (n = 33,605) and urinary albumin-to-creatinine ratio (n = 15,068) and detected 69 and seven CpG sites where DNA methylation was associated with the respective trait. The majority of these findings showed directionally consistent associations with the respective clinical outcomes chronic kidney disease and moderately increased albuminuria. Associations of DNA methylation with kidney function, such as CpGs at JAZF1, PELI1 and CHD2 were validated in kidney tissue. Methylation at PHRF1, LDB2, CSRNP1 and IRF5 indicated causal effects on kidney function. Enrichment analyses revealed pathways related to hemostasis and blood cell migration for estimated glomerular filtration rate, and immune cell activation and response for urinary albumin-to-creatinineratio-associated CpGs