Performance of an Interactive Upper Extremity Peripheral Nerve Training Module Among Medical Students, Radiology Residents, and Fellows: A Multi-institutional Study

BACKGROUND AND PURPOSE

Chronic pain is a common problem and imaging is becoming increasingly utilized in the characterization of peripheral neuropathy, although this topic is not emphasized during medical training. We hypothesized that an electronic module and nerve atlas would be effective in improving comprehension among trainees.

MATERIALS AND METHODS

In this IRB-approved study, a training module was created that included a side-by-side comparison of normal upper extremity nerves on magnetic resonance imaging and ultrasound (US), with embedded questions and cases, followed by a brief hands-on US scanning session. Thirty volunteers with variable training were enrolled in 1 institution, while 14 volunteers were enrolled in another. Pre- and post-test scores were collected and compared.

RESULTS

There was a response rate of 100% at both institutions. At the first institution, subjects were divided into 2 groups: group 1 (16 medical students) and group 2 (14 residents/fellows). There was a baseline deficit of knowledge among both groups, with a mean pretest score of 37.5% and 47.5% for group 1 and group 2, respectively (P = 0.017). After module completion, both groups improved with a mean post-test score of 67.2% for group 1 and 76.1% for group 2. At the second institution, there was similar improvement even if the scanning session was not done.

CONCLUSIONS

Use of an electronic module helps trainees to become more familiar with peripheral nerve imaging, regardless of level of training. Use of the module, even in the absence of hands-on US scanning, results in an improved understanding of this topic.

B, Broussard L, Clayton S, Currie S, Dees E, Ding X, Fellers D, Fox W, Fries E, Gonzalez F, Geltenbort P, Hickerson K, Hoffbauer M, Hoffman K, Holley A, Howard D, Ito T, Komives A, Liu C, M. M, Medina J, Morley D, Morris C, O'Connor T, Penttilä S, Ramsey J, Roberts A, Salvat D, Saunders A, Seestrom S, Sharapov E, Sjue S, Snow W, Sprow A, Vanderwerp J, Vogelaar B, P.L. W, Wang Z, Weaver H, Wexler J, Womack T, Young A, Zeck B. Status of the UCN experiment

The neutron is the simplest nuclear system that can be used to probe the structure of the weak interaction and search for physics beyond the standard model. Measurements of neutron lifetime and β-decay correlation coefficients with precisions of 0.02% and 0.1%, respectively, would allow for stringent constraints on new physics. The UCNτ experiment uses an asymmetric magneto-gravitational UCN trap with in situ counting of surviving neutrons to measure the neutron lifetime, τn = 877.7s (0.7s)stat (+0.4/−0.2s)sys. We discuss the recent result from UCNτ, the status of ongoing data collection and analysis, and the path toward a 0.25 s measurement of the neutron lifetime with UCNτ.

Gravitational Redshift Test Using Eccentric Galileo Satellites

We report on a new test of the gravitational redshift and thus of local position invariance, an integral part of the Einstein equivalence principle, which is the foundation of general relativity and all metric theories of gravitation. We use data spanning 1008 days from two satellites of Galileo, Europe's global satellite navigation system, which were launched in 2014, but accidentally delivered on elliptic rather than circular orbits. The resulting modulation of the gravitational redshift of the onboard atomic clocks allows the redshift determination with high accuracy. Additionally, specific laser ranging campaigns to the two satellites have enabled a good estimation of systematic effects related to orbit uncertainties. Together with a careful conservative modeling and control of other systematic effects we measure the fractional deviation of the gravitational redshift from the prediction by general relativity to be (0.19±2.48)×10^{-5} at 1 sigma, improving the best previous test by a factor 5.6. To our knowledge, this represents the first reported improvement on one of the longest standing results in experimental gravitation, the Gravity Probe A hydrogen maser rocket experiment back in 1976.

Search for the Neutron Decay n→X+γ, Where X is a Dark Matter Particle

Fornal and Grinstein recently proposed that the discrepancy between two different methods of neutron lifetime measurements, the beam and bottle methods, can be explained by a previously unobserved dark matter decay mode, n→X+γ. We perform a search for this decay mode over the allowed range of energies of the monoenergetic γ ray for X to be dark matter. A Compton-suppressed high-purity germanium detector is used to identify γ rays from neutron decay in a nickel-phosphorous-coated stainless-steel bottle. A combination of Monte Carlo and radioactive source calibrations is used to determine the absolute efficiency for detecting γ rays arising from the dark matter decay mode. We exclude the possibility of a sufficiently strong branch to explain the lifetime discrepancy with 97% confidence.

Simultaneous Bilateral “Malignant Glaucoma” Attack in a Patient with no Antecedent Eye Surgery or Miotics

Malignant glaucoma is a term commonly used to describe a condition characterized by a sudden increase in intraocular pressure, usually occuring after eye surgery. This report describes a case of malignant glaucoma simultaneously presenting in both eyes, with no antecedent eye disease, medication or surgery. As far as we know this is the first report of spontaneous bilateral glaucoma. Both eyes were operated on according to the technique described by Chandler et al. (1), and the condition was solved. We suggest that, despite its rarity in eyes with no antecedent disease or ocular therapy, a surgeon should be aware of this condition.

Combined classical spindle cell/pleomorphic lipoma spectrum imaging and clinical data

OBJECTIVES

Compile the largest study to date on the imaging and clinical features of the classic spindle cell/pleomorphic lipoma spectrum and suggest this diagnosis be included in the differential for benign and malignant macroscopic fat-containing soft tissue masses regardless of the mass location or patient demographics.

MATERIALS AND METHODS

An institutional search was performed to identify all available classic-type spindle cell/pleomorphic lipomas with available demographic and imaging data. Images and reports were analyzed by one MSK-trained radiologist and radiographic, anatomic and clinical data were recorded. Additionally, a literature search was performed to identify studies describing the spindle cell lipoma spectrum imaging features and were combined with institutional data.

RESULTS

Forty-two institutional cases were identified, 37 of which had MRIs performed among which 21 had images available (T1- and T2-weighted pulse sequences) for review while the remainder had outside reports detailing the mass imaging features. There was a mean age of 57 with 79% of cases occurring in males. Contrary to prior reports, 57% of masses were subcutaneous, and the neck and back region accounted for 26% of cases. When the institutional cases were combined with available data in the literature, there was a new sample size of 91 masses, 74 of which had MRI and/or CT data. Eighty-seven percent of masses were heterogeneous, 51% were composed of less than 75% fat, 65% were in the back, neck or shoulder region, 27% of masses were deep and 91% demonstrated enhancement. Eighty-two percent of patients were males with a mean age of 58 at excision.

CONCLUSION

Imaging features, patient demographics and tumor location alone are not enough to differentiate tumors of the spindle cell lipoma spectrum from other macroscopic fat-containing benign and malignant tumors, and these entities should be included in the same imaging differential diagnosis.

The glenoid track: a review of the clinical relevance, method of calculation and current evidence behind this method

In the setting of bipolar bone injury, orthopedic surgeons are currently making use of the glenoid track method to guide surgical management. Using preoperative CT or MR imaging, this method allows the identification of patients who are more likely to fail a primary capsuloligamentous Bankart repair. As the glenoid track method becomes increasingly used in preoperative planning, it is important for the radiologist to become familiar with its concept and method of calculation. This review article aims to concisely summarize the current literature and the clinical implications of the glenoid track method.

Immature and mature sperm morphometry in fresh and frozen-thawed falcon ejaculates

Sperm morphometry is one characteristic which may be useful in prediction of fertility and sperm freezability in a species. Knowledge of the sperm characteristics of the ejaculate and the morphometric descriptors is necessary to effectively develop sperm cryopreservation. The aim of the current study was to provide a general description of the sperm from two falcon species (Peregrine falcon Falco peregrinus peregrinus/brookei and Gyrfalcon Falco rusticolus) including immature sperm, sperm head morphometric descriptors, and the existence of mature sperm subpopulations. Semen samples were collected by massage and voluntary false copulation and diluted with Lake and Ravie medium. Smears were prepared of the diluted samples, stained with Hemacolor^®, and subjected to: 1) morphological analysis (bright field optical microscopy), and 2) computerised morphometric analysis; each sperm head was measured for length, width, area and perimeter. In addition, in the Gyrfalcon, pooled semen was frozen in pellets using DMA as a cryoprotectant and the analyses repeated after thawing. The mean percentage of immature sperm (spermatocytes and spermatids) was similarly high in all species/subspecies: Brookei Peregrine falcon (F. p. brookei) 55.5%, European Peregrine falcon (F. p. peregrinus) 65.5% and Gyrfalcon 64.7%. Clustering analyses identified four subpopulations of mature spermatozoa with different morphometric characteristics (P < 0.001). The relative proportions of these subpopulations were similar in all three species. The mean values recorded for the morphometric variables of the four subpopulations were, however, lower (P < 0.001) in the thawed Gyrfalcon samples than in fresh samples. The results support the idea of pleiomorphy as a characteristic of raptor mature sperm. This finding, plus that of the existence of four sperm subpopulations with different morphometric characteristics, may be important in the future development of cryopreservation protocols for falcon sperm.

Performance of Metal and Polymeric O-Ring Seals during Beyond-Design-Basis Thermal Conditions

This paper summarizes the small scale thermal exposure test results of the performance of metallic and polymeric O-ring seals typically used in radioactive material transportation packages. Five different O-ring materials were evaluated: Inconel/silver, ethylene-propylene diene monomer (EPDM), polytetrafluoroethylene (PTFE), silicone, butyl, and Viton. The overall objective of this study is to provide test data and insights to the performance of these Oring seals when exposed to beyond-design-basis temperature conditions due to a severe fire. Tests were conducted using a small-scale stainless steel pressure vessel pressurized with helium to 2 bar or 5 bar at room temperature. The vessel was then heated in an electric furnace to temperatures up to 900 °C for a pre-determined period (typically 8 h to 9 h). The pressure drop technique was used to determine if leakage occurred during thermal exposure. Out of a total of 46 tests performed, leakage (loss of vessel pressure) was detected in 13 tests.

Spatial Frequency Components of Images Modulate Neuronal Activity in Monkey Amygdala

Processing the spatial frequency components of an image is a crucial feature for visual perception, especially in recognition of faces. Here, we study the correlation between spatial frequency components of images of faces and neuronal activity in monkey amygdala while performing a visual recognition task. The frequency components of the images were analyzed using a fast Fourier transform for 40 spatial frequency ranges. We recorded 65 neurons showing statistically significant responses to at least one of the images used as a stimulus. A total of 37 of these neurons (n = 37) showed significant responses to at least three images, and in eight of them (8/37, 22%), we found a statistically significant correlation between neuron response and the modulus amplitude of at least one frequency range present in the images. Our results indicate that high spatial frequency and low spatial frequency components of images influence the activity of amygdala neurons.

A development scenario connecting the ternary symmetric horseshoe with the binary horseshoe

It is explained in which way the ternary symmetric horseshoe can be obtained along a development scenario starting with a binary horseshoe. We explain the case of a complete ternary horseshoe in all detail and then give briefly some further incomplete cases. The key idea is to start with a three degrees of freedom system with a rotational symmetry, reduce the system with the help of the conserved angular momentum to one with two degrees of freedom where the value of the conserved angular momentum acts as a parameter and then let its value go to zero.