Introduction:
Multi-modality imaging is a crucial component of cardiovascular (CV) fellowship training and requires knowledge of CV anatomy for interpretation. We hypothesized that hands-on anatomy ...education would improve the imaging interpretation skills of CV fellows.
Methods:
The first-year CV fellowship class completed a hands-on cadaveric anatomy session correlated with clinical imaging. Fellows’ ability to identify CV structures on cardiac imaging was assessed using a 30-question assessment tool administered at baseline and 1 week and 6 months post intervention. Advanced CV fellows (second or third year) who had not attended the session were also tested. Scores were expressed as median interquartile range.
Results:
Among 9 first-year fellows, the majority reported no formal anatomy training since medical school (N = 7) and rated their knowledge of CV anatomy as fair or poor (N = 7) prior to the intervention. The median assessment score was higher 1 week after intervention vs baseline (24 23-25 vs 19 17-21; P = .013) and remained higher than baseline at 6 months (26 26-28 vs 19 17-21; P = .009). The 6-month post-intervention score for first-year fellows was not significantly different than that of senior fellows (n = 10) not exposed to the intervention (26 26-28 vs 26 23-27; P = .434).
Conclusions:
Gross anatomy instruction improved first-year CV fellows’ interpretation of CV imaging. Anatomic instruction may be a useful adjunct to multi-modality imaging education.
Seeds identified as Gossypium barbadense, South American cotton, have been recovered from the Real Alto site on the Coast of Ecuador in contexts14C dated 3500-3000 B.C. The oldest date previously ...reported is 2500 B.C. for coastal Peru.
The introduction of maize agriculture into the Southwest and onto the Colorado Plateau was accompanied by irrigation techniques. Twenty-six radiocarbon dates at two sites, K'yana Chabina and ...K'yawa:na'a Deyatchinanne, in the Zuni area of New Mexico, establish the use of irrigation canals to between 3,000 and 1,000 years ago. Associated features and the presence of nearby habitation sites independently corroborate the chronology of canal building. The geomorphology of the Zuni landscape and the morphology of the irrigation canals are consistent with the artificial construction of the canals. Pollen evidence points to an agricultural landscape and the cultivation of maize.
To cope with the enhanced luminosity at the Large Hadron Collider (LHC) in 2021, the ATLAS collaboration is planning a major detector upgrade. As a part of this, the Level 1 trigger based on ...calorimeter data will be upgraded to exploit the fine granularity readout using a new system of Feature EXtractors (FEX), which each reconstruct different physics objects for the trigger selection. The jet FEX (jFEX) system is conceived to provide jet identification (including large area jets) and measurements of global variables within a latency budget of less then 400ns. It consists of 6 modules. A single jFEX module is an ATCA board with 4 large FPGAs of the Xilinx Ultrascale+ family, that can digest a total input data rate of ~3.6 Tb/s using up to 120 Multi Gigabit Transceiver (MGT), 24 electrical optical devices, board control and power on the mezzanines to allow flexibility in upgrading controls functions and components without affecting the main board. The 24-layers stack-up was carefully designed to preserve the signal integrity in a very densely populated high speed signal board selecting MEGTRON6 as the most suitable PCB material. This contribution reports on the design challenges and the test results of the jFEX prototypes. In particular the fully assembled final prototype has been tested up to 12.8 Gb/s in house and in integrated tests at CERN. The full jFEX system will be produced by the end of 2018 to allow for installation and commissioning to be completed before LHC restarts in March 2021.
Beans for Valdivia Damp, Jonathan E.; Pearsall, Deborah M.; Kaplan, Lawrence T.
Science (American Association for the Advancement of Science),
1981-May-15, Letnik:
212, Številka:
4496
Journal Article
Recenzirano
Carbonized remains of Canavalia beans were recovered from archaeological deposits excavated at Real Alto (OGCh-12), southwestern Ecuador. The identification, context and dating of the earliest beans ...from Real Alto demonstrate their use from the beginning of Valdivia (about 3300 B.C.) and the Early Formative in coastal Ecuador.
The architecture of early Valdivia (3300–2300 B.C.) communities provides information about the structure of early village life on the Ecuadorian Pacific coastal lowland. Household units from the ...sites of Real Alto and Loma Alta seem to exhibit domestic patterning in sleeping areas, cooking, tool working, cotton spinning, garbage disposal, and burial of the dead. The village layout provides a plan for settlement in the shape of a letter U. The Valdivia U-shaped village is briefly examined in its prehistoric context. Together, house and village patterns at Real Alto and Loma Alta reflect the beginnings of settled life in the context of an agricultural economy.
Identification of baicalein as a ferroptosis inhibitor by natural product library screening Xie, Yangchun; Xinxin SongauthorThe Center for DAMP Biology, Department of Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USA; Xiaofang SunauthorThe Center for DAMP Biology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510510, China ...
2015
Journal Article
Peripartum cardiomyopathy (PPCM) occurs in ≈1:2000 deliveries in the United States and worldwide. The genetic underpinnings of PPCM remain poorly defined. Approximately 10% of women with PPCM harbor ...truncating variants in
(TTNtvs). Whether mutations in other genes can predispose to PPCM is not known. It is also not known if the presence of TTNtvs predicts clinical presentation or outcomes. Nor is it known if the prevalence of TTNtvs differs in women with PPCM and preeclampsia, the strongest risk factor for PPCM.
Women with PPCM were retrospectively identified from several US and international academic centers, and clinical information and DNA samples were acquired. Next-generation sequencing was performed on 67 genes, including
, and evaluated for burden of truncating and missense variants. The impact of TTNtvs on the severity of clinical presentation, and on clinical outcomes, was evaluated.
Four hundred sixty-nine women met inclusion criteria. Of the women with PPCM, 10.4% bore TTNtvs (odds ratio=9.4 compared with 1.2% in the reference population; Bonferroni-corrected
*=1.2×10
). We additionally identified overrepresentation of truncating variants in FLNC (odds ratio=24.8,
*=7.0×10
), DSP (odds ratio=14.9,
*=1.0×10
), and BAG3 (odds ratio=53.1,
*=0.02), genes not previously associated with PPCM. This profile is highly similar to that found in nonischemic dilated cardiomyopathy. Women with TTNtvs had lower left ventricular ejection fraction on presentation than did women without TTNtvs (23.5% versus 29%,
=2.5×10
), but did not differ significantly in timing of presentation after delivery, in prevalence of preeclampsia, or in rates of clinical recovery.
This study provides the first extensive genetic and phenotypic landscape of PPCM and demonstrates that predisposition to heart failure is an important risk factor for PPCM. The work reveals a degree of genetic similarity between PPCM and dilated cardiomyopathy, suggesting that gene-specific therapeutic approaches being developed for dilated cardiomyopathy may also apply to PPCM, and that approaches to genetic testing in PPCM should mirror those taken in dilated cardiomyopathy. Last, the clarification of genotype/phenotype associations has important implications for genetic counseling.
The United States has the highest maternal mortality in the developed world with cardiovascular disease as the leading cause of pregnancy-related deaths. In response to this, the emerging ...subspecialty of cardio-obstetrics has been growing over the past decade. Cardiologists with training and expertise in caring for patients with cardiovascular disease in pregnancy are essential to provide effective, comprehensive, multidisciplinary, and high-quality care for this vulnerable population. This document provides a blueprint on incorporation of cardio-obstetrics training into cardiovascular disease fellowship programs to improve knowledge, skill, and expertise among cardiologists caring for these patients, with the goal of improving maternal and fetal outcomes.
PDF
