Esophageal Fistula Complicating Thyroid Lobectomy

Thyroidectomy is associated with low morbidity and mortality. Esophageal perforation following thyroidectomy has been reported only three times previously, with subsequent fistulization occurring in two of these cases. The authors present the first such case report in the English-speaking literature

A mathematical modelling study of an athlete's sprint time when towing a weighted sled

This is the author's accepted manuscript. The final publication is available at Springer via http://dx.doi.org/10.1007/s12283-013-0114-2.This study used a mathematical model to examine the effects of the sled, the running surface, and the athlete on sprint time when towing a weighted sled. Simulations showed that ratio scaling is an appropriate method of normalising the weight of the sled for athletes of different body size. The relationship between sprint time and the weight of the sled was almost linear, as long as the sled was not excessively heavy. The athlete’s sprint time and rate of increase in sprint time were greater on running surfaces with a greater coefficient of friction, and on any given running surface an athlete with a greater power-to-weight ratio had a lower rate of increase in sprint time. The angle of the tow cord did not have a substantial effect on an athlete’s sprint time. This greater understanding should help coaches set the training intensity experienced by an athlete when performing a sled-towing exercise

Assessing Medical Student’s Ability to Interpret Traumatic Injuries on Computed Tomography Before and After the Third Year Clerkships

Introduction. Exposure to radiologic images during clinical rotationsmay improve students’ skill levels. This study aimed to quantifythe improvement in radiographic interpretation of life-threateningtraumatic injuries gained during third year clinical clerkships (MS-3). Methods. We used a paired-sample prospective study design tocompare students’ accuracy in reading computed tomography (CT)images at the beginning of their third year clerkships (Phase I) andagain after completion of all of their third year clerkships (Phase II).Students were shown life-threatening injuries that included head,chest, abdomen, and pelvic injuries. Overall scores for Phase II werecompared with Phase I, as well as sub-scores for each anatomicalregion: head, chest, abdomen, and pelvis. Results. Only scores from students participating in both Phase Iand Phase II (N = 57) were used in the analysis. After completingtheir MS3 clerkship, students scored significantly better overall andin every anatomical region. Phase I and Phase II overall mean scoreswere 1.2 ± 1.1 vs. 4.6 ± 1.8 (p < 0.001). Students improved the mostwith respect to injuries of the head and chest and the area of leastimprovement was in interpreting CT scans of the abdomen. Althoughimprovements in reading radiographic images were noted after theclerkship year, students accurately diagnosed only 46% of life-threateningimages on CT scan in the trauma setting. Conclusions. These results indicated that enhanced education isneeded for medical students to interpret CT scans.Kans J Med 2018;11(4):91-94

Metabolic Profiling Reveals Biochemical Pathways Responsible for Eelgrass Response to Elevated CO\u3csub\u3e2\u3c/sub\u3e and Temperature

As CO2 levels in Earth’s atmosphere and oceans steadily rise, varying organismal responses may produce ecological losers and winners. Increased ocean CO2 can enhance seagrass productivity and thermal tolerance, providing some compensation for climate warming. However, the metabolic shifts driving the positive response to elevated CO2 by these important ecosystem engineers remain unknown. We analyzed whole-plant performance and metabolic profiles of two geographically distinct eelgrass (Zostera marina L.) populations in response to CO2 enrichment. In addition to enhancing overall plant size, growth and survival, CO2 enrichment increased the abundance of Calvin Cycle and nitrogen assimilation metabolites while suppressing the abundance of stress-related metabolites. Overall metabolome differences between populations suggest that some eelgrass phenotypes may be better suited than others to cope with an increasingly hot and sour sea. Our results suggest that seagrass populations will respond variably, but overall positively, to increasing CO2 concentrations, generating negative feedbacks to climate change