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The COVID-19 (coronavirus disease) pandemic has caused a lot of damage to the social, economic and educational infrastructure of the world. The rapid change in the online learning environment calls for the development of effective learning strategies to support student learning. Principally information communication technology (ICT) emerged as a new hope in teaching-learning in streams like science and technology. Especially in the teaching-learning of a challenging subject like physics and its various streams, e.g. mechanics, wave, optics, etc., the use of ICT has increased exponentially due to its unique properties. However, some of its side effects have also been visible during this period. This study presents the feedback, experiences and recommendations of physics teachers regarding the application of ICT in the teaching-learning of physics. This article offers a comprehensive view of the impact of information and communication technology-enabled teaching-learning processes in physical sciences. To accomplish this study, an 18-question questionnaire was circulated among physics teachers across the nation and more than 100 physics teachers participated and recorded their responses. The outcomes of these responses were analysed, and corresponding conclusions with recommendations are presented. This study may be helpful for students, teachers, researchers and policymakers working in this field of ICT-enabled physics education.
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Intracranial tuberculoma is an uncommon presentation of tuberculosis, and its occurrence in an intraventricular location is very rare. It is usually confused with glioma, parasitic cyst, and craniopharyngioma. Few case reports exist in the literature on this entity. We report a case of tuberculoma at the foramen of Monro in a 7-year-old child and review the literature in terms of diagnostic dilemma.
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Ventrículos Cerebrais , Diagnóstico Diferencial , Tuberculoma Intracraniano/diagnóstico , Criança , Febre/etiologia , Cefaleia/etiologia , Humanos , Imageamento por Ressonância Magnética , Masculino , Tomografia Computadorizada por Raios X , Tuberculoma Intracraniano/diagnóstico por imagemRESUMO
INTRODUCTION: An inclusive residency program is crucial to the recruitment and retention of competitive and diverse applicants. The radiology lesbian, gay, bisexual, transgender, queer or questioning, or another diverse gender identity (LGBTQ+) inclusion audit was published in 2022, which provided a road map for assessing the inclusivity of a program's policies, facilities, culture, and engagement. In this multi-institutional trial, we detail the results of the LGBTQ+ inclusion audit for nine US radiology residency programs. METHODS: A volunteer cohort of academic radiology programs was recruited through the Radiology Residency Education Research Alliance. The LGBTQ+ inclusion audit was modified to apply to a multi-institutional study. Participating programs performed the audit from December 2023 to February 2024. Pre- and postaudit surveys were distributed to capture participants subjective assessment of inclusivity at their programs. RESULTS: Nine US radiology residency programs completed the audit. Audit scores ranged from 6 out of 10 to 9 out of 10; no program received a perfect 10 out of 10 score. Inclusive facilities and institutional culture scored highly, with eight of nine programs reporting all milestones met in these areas. The lowest-performing areas were department culture and community engagement with only three of nine and four of nine programs reporting "all milestones met." After the audit, programs overall reported improved self-perceived inclusivity, with postaudit survey scores increasing in areas related to department policy, inclusive facilities, and LGBTQ+ community outreach. DISCUSSION: Participating radiology residency programs demonstrated an overall high level of LGBTQ+ inclusivity; however, all programs identified inclusion shortcomings in department policy and practice. Intentional review of a department can be a helpful tool to promote a welcoming and healthy environment for a diverse radiology practice.
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Treatment of hepatitis C patients with direct-acting antiviral drugs involves the combination of multiple small-molecule inhibitors of distinctive mechanisms of action. ACH-806 (or GS-9132) is a novel, small-molecule inhibitor specific for hepatitis C virus (HCV). It inhibits viral RNA replication in HCV replicon cells and was active in genotype 1 HCV-infected patients in a proof-of-concept clinical trial (1). Here, we describe a potential mechanism of action (MoA) wherein ACH-806 alters viral replication complex (RC) composition and function. We found that ACH-806 did not affect HCV polyprotein translation and processing, the early events of the formation of HCV RC. Instead, ACH-806 triggered the formation of a homodimeric form of NS4A with a size of 14 kDa (p14) both in replicon cells and in Huh-7 cells where NS4A was expressed alone. p14 production was negatively regulated by NS3, and its appearance in turn was associated with reductions in NS3 and, especially, NS4A content in RCs due to their accelerated degradation. A previously described resistance substitution near the N terminus of NS3, where NS3 interacts with NS4A, attenuated the reduction of NS3 and NS4A conferred by ACH-806 treatment. Taken together, we show that the compositional changes in viral RCs are associated with the antiviral activity of ACH-806. Small molecules, including ACH-806, with this novel MoA hold promise for further development and provide unique tools for clarifying the functions of NS4A in HCV replication.
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Antivirais/farmacologia , Proteínas de Transporte/antagonistas & inibidores , Hepacivirus/efeitos dos fármacos , Feniltioureia/análogos & derivados , Proteínas não Estruturais Virais/antagonistas & inibidores , Animais , Proteínas de Transporte/metabolismo , Linhagem Celular Tumoral , Hepacivirus/fisiologia , Humanos , Peptídeos e Proteínas de Sinalização Intracelular , Feniltioureia/farmacologia , RNA Viral/biossíntese , Proteínas não Estruturais Virais/metabolismo , Replicação Viral/efeitos dos fármacosRESUMO
OBJECTIVE: Schwannomas are typically benign tumors that occur sporadically, in neurofibromatosis type 2 (NF2), or in an entity called "schwannomatosis." Schwannomatosis patients develop multiple schwannomas without involvement of the vestibular apparatus. Geneticists, neurologists, and pathologists have recognized that schwannomatosis is distinct from NF2, but schwannomatosis remains unfamiliar to many radiologists. This article reviews the current medical literature, highlighting the similarities and differences between the schwannomatosis and NF2 phenotypes, genotypes, clinical manifestations, management considerations, and imaging findings. CONCLUSION: Imaging plays a critical role in diagnosing schwannomatosis, and a basic understanding of this syndrome is of interest to diagnostic radiologists. Moreover, it is imperative that radiologists be able to differentiate schwannomatosis from NF2 on imaging because there are significant differences in the management of these two diseases and clinical outcomes for affected patients.
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Diagnóstico por Imagem , Neurilemoma/diagnóstico , Neurofibromatoses/diagnóstico , Neoplasias Cutâneas/diagnóstico , Diagnóstico Diferencial , Humanos , Neurilemoma/epidemiologia , Neurilemoma/genética , Neurilemoma/terapia , Neurofibromatoses/epidemiologia , Neurofibromatoses/genética , Neurofibromatoses/terapia , Neurofibromatose 2/diagnóstico , Neurofibromatose 2/epidemiologia , Neurofibromatose 2/genética , Neurofibromatose 2/terapia , Fenótipo , Neoplasias Cutâneas/epidemiologia , Neoplasias Cutâneas/genética , Neoplasias Cutâneas/terapiaRESUMO
The response to pandemic-related teaching disruption has revealed dynamic levels of learning and teaching flexibility and rapid technology adoption of radiology educators and trainees. Shutdowns and distancing requirements accelerated the adoption of technology as an educational tool, in some instances supplanting in-person education entirely. Despite the limitations of remote interaction, many educational advantages were recognized that can be leveraged in developing distance learning paradigms. The specific strategies employed should match modern learning science, enabling both students and educators to mutually grow as lifelong learners. As panel members of the "COVID: Faculty perspective" Task Force of the Association of University Radiologists Radiology Research Alliance, we present a review of key learning principles which educators can use to identify techniques that enhance resident learning and present an organized framework for applying technology-aided techniques aligned with modern learning principles. Our aim is to facilitate the purposeful integration of learning tools into the training environment by matching these tools to established educational frameworks. With these frameworks in mind, radiology educators have the opportunity to re-think the balance between traditional curricular design and modern digital teaching tools and models.
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COVID-19 , Radiologia , Humanos , Radiologia/educação , Aprendizagem , Radiografia , Tecnologia , EnsinoRESUMO
Neurocysticercosis is one of the most common infections of the central nervous system in the developing world. Most often, neurocysticerci are found in the brain parenchyma, at the gray-white matter junction. A rare form of neurocysticercosis is the development of cysts at the basal subarachnoid region, termed racemose neurocysticercosis.
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Encéfalo/patologia , Neurocisticercose/diagnóstico , Neurocisticercose/terapia , Cistos/patologia , Humanos , Masculino , Neurocisticercose/epidemiologia , Tomografia Computadorizada por Raios X , Adulto JovemRESUMO
PURPOSE: The purpose was to create and analyze a competency-based model of educating medical students in a radiology clerkship that can be used to guide curricular reform. METHODS: During the 2019 to 2020 academic year, 326 fourth-year medical students were enrolled in a 2-week required clerkship. An online testing platform, ExamSoft (Dallas, Texas), was used to test pre- and postinstruction knowledge on "must see" diagnoses, as outlined in the National Medical Student Curriculum in Radiology. Assessment analysis was used to compare the frequency with which the correct diagnosis was identified on the pretest to that on the posttest. At the end of the academic year, in addition to statistical analysis, categorical analysis was used to classify the degree of this change to uncover topics that students found most challenging. RESULTS: For 23 of the 27 topics (85%), there was a significant improvement in diagnostic accuracy after instruction in the test curriculum. Categorical analysis further demonstrated that the clerkship had a high impact in teaching 13 of the 27 topics (48%), had a lower impact for 6 topics (22%), and identified the remaining 8 topics (30%) as gaps in teaching and learning. CONCLUSIONS: For medical students, our instructional program significantly increased competency for most critical radiologic diagnoses. Categorical analysis adds value beyond statistical analysis and allows dynamic tailoring of teaching to address gaps in student learning.
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Estágio Clínico , Radiologia , Estudantes de Medicina , Currículo , Humanos , Radiologia/educação , TexasRESUMO
CONTEXT AND AIMS: Our aim was to assess the postoperative analgesia after ultrasound-guided "Adductor canal block" (ACB) and "Intraarticular Analgesia" (IAA) in arthroscopic knee surgeries postoperatively. SETTINGS AND DESIGN: This experimental, randomized prospective study was conducted in the Department of Anesthesia, Himalayan Institute of Medical Sciences, Dehradun. SUBJECTS AND METHODS: Sixty patients, who underwent arthroscopic knee surgeries were divided into two groups, with 30 patients each. Each group was given spinal anesthesia using 3 ml of 0.5% hyperbaric Bupivacaine. After completion of surgery, Group I patients were given ultrasound-guided ACB, Group II patients were given IAA. Postoperatively, pain was assessed using the Numeric Rating Scale (NRS). Time of first analgesic requirement and total postoperative tramadol consumption in the 1st 24 h were recorded. RESULTS: No significant difference was seen between both groups pertaining to patient's demographic data, type, and duration of surgery. The difference in the median NRS score between both the groups at different time intervals was statistically insignificant (P > 0.05). Total tramadol consumption in Group I (172.85 ± 82.59) mg was more than Group II (157.85 ± 33.83) mg. The duration of first analgesic requirement was 351.43 min, 342.86 min for Group I and II, respectively. CONCLUSION: To conclude, both ACB and IAA provide good postoperative pain control in arthroscopic knee surgeries with no significant difference in pain scores and postoperative analgesic requirement.
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OBJECTIVE: Indocyanine green video angiography (ICG-VA) is a routine while performing vascular surgery to assess patency of perforators, completeness of clipping and/or to assess patency of anastomosis. Its usefulness in assessing cerebral blood flow and perfusion is not well studied. This study is aimed to assess the cerebral blood flow and perfusion after temporary clipping and to correlate with the risk of ischemia. METHODS: Prospective analysis of intra-operative ICG-VA performed during temporary arterial occlusion in 38 patients from January 2014 to December 2018 was conducted. Co-relation with post-operative MR diffusion weighted imaging (MR DWI) in terms of vascular territory of interest within 48 hours of surgery was performed. Clinical outcome was assessed using modified Rankin Scale (mRS) score 1-month post-surgery. RESULTS: 43 aneurysms in 38 patients clipped using ICG-VA were included in this study. No side effect of ICG dye was seen in any patients. The number of times temporary clips applied had a direct relationship to the delay in appearance of ICG in the surgical field which became statistically significant after application of 3rd temporary clip. Nine (23.7%) patients developed ischemia following the procedure confirmed by post-operative MR DWI and all the ischemic cases had visible decrease in ICG fluorescence post-temporary clipping. CONCLUSIONS: No previous study had tried to assess the intraoperative cerebral blood flow and perfusion during temporary clipping of parent vessels during aneurysm surgery. The use of ICG-VA can be extended to assess perfusion in desired territory by merely assessing the degree of opacification.
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Artificial intelligence (AI) systems play an increasingly important role in all parts of the imaging chain, from image creation to image interpretation to report generation. In order to responsibly manage radiology AI systems and make informed purchase decisions about them, radiologists must understand the underlying principles of AI. Our task force was formed by the Radiology Research Alliance (RRA) of the Association of University Radiologists to identify and summarize a curated list of current educational materials available for radiologists.
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Inteligência Artificial , Radiologia , Humanos , Radiografia , RadiologistasRESUMO
Several non-neoplastic processes, including infection, inflammation, demyelination, vasculitis, autoimmune disease, and post-treatment changes (radiation therapy or chemoradiation) can result in a mass-like, space-occupying lesion on conventional computed tomography (CT) or magnetic resonance (MR) imaging of the brain. Additionally, non-neoplastic processes can produce imaging findings that mimic nontumoral neoplastic involvement of the central nervous system. Such instances pose a substantial diagnostic dilemma for interpreting radiologists, as well as clinicians tasked with determining the appropriate diagnostic tests and therapeutic strategies for these patients. Nuclear medicine studies, including single positron emission computed tomography (SPECT) and positron emission tomography (PET), as well as hybrid SPECT/CT, PET/CT, and PET/MRI may offer important diagnostic insights into these challenging cases, often helping to differentiate these mimics from true brain neoplasms. In this review, we detail common and uncommon brain tumor mimics in specific context of PET and SPECT imaging of the brain, including the multimodality imaging appearance of tumor mimics and the potential roles these modalities may play in providing diagnostic clarity.
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Encefalopatias/diagnóstico por imagem , Tomografia por Emissão de Pósitrons/métodos , Tomografia Computadorizada de Emissão de Fóton Único/métodos , Encéfalo/diagnóstico por imagem , Neoplasias Encefálicas/diagnóstico por imagem , Diagnóstico Diferencial , HumanosRESUMO
We have discovered a novel class of compounds active against hepatitis C virus (HCV), using a surrogate cellular system, HCV replicon cells. The leading compound in the series, ACH-806 (GS-9132), is a potent and specific inhibitor of HCV. The selection of resistance replicon variants against ACH-806 was performed to map the mutations conferring resistance to ACH-806 and to determine cross-resistance profiles with other classes of HCV inhibitors. Several clones emerged after the addition of ACH-806 to HCV replicon cells at frequencies and durations similar to that observed with NS3 protease inhibitors and NS5B polymerase inhibitors. Phenotypic analyses of these clones revealed that they are resistant to ACH-806 but remain sensitive to other classes of HCV inhibitors. Moreover, no significant change in the susceptibility to ACH-806 was found when the replicon cellular clones resistant to NS3 protease inhibitors and NS5B polymerase inhibitors were examined. Sequencing of the entire coding region of ACH-806-resistant replicon variants yielded several consensus mutations. Reverse genetics identified two single mutations in NS3, a cysteine-to-serine mutation at amino acid 16 and an alanine-to-valine mutation at amino acid 39, that are responsible for the resistance of the replicon variants to ACH-806. Both mutations are located at the N terminus of NS3 where extensive interactions with the central hydrophobic region of NS4A exist. These data provide evidence that ACH-806 inhibits HCV replication by a novel mechanism.
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Antivirais/farmacologia , Farmacorresistência Viral/genética , Inibidores Enzimáticos/farmacologia , Variação Genética , Hepacivirus/efeitos dos fármacos , Replicon/efeitos dos fármacos , Linhagem Celular Tumoral , Hepacivirus/enzimologia , Hepacivirus/genética , Humanos , Modelos Moleculares , Inibidores de Proteases/farmacologia , Seleção Genética , Proteínas não Estruturais Virais/antagonistas & inibidores , Proteínas não Estruturais Virais/química , Proteínas não Estruturais Virais/genéticaRESUMO
Beta-lactamases are serine- and metal-dependent hydrolases, produced by the bacteria as defense against beta-lactam antibiotics. Commercially available inhibitors such as clavulanic acid, sulbactam, and tazobactam, which are currently used in the hospital settings, have reduced activity against newly emerging beta-lactamases. Bacterial production of diverse beta-lactamases including class-A, class-C, and ESBLs has motivated several research groups to search for inhibitors with a broader spectrum of activity. Previously, several novel 6-methylidene penems bearing, [5,5] [5,6] and [5,5,5] heterocycles have been synthesized in our laboratory and were shown to be potent and broad-spectrum beta-lactamase inhibitors. As a continuation of our previous work and in order to extend the structure-activity relationships, in this paper, we describe herein the synthesis and in vitro, in vivo activities of several novel 5,5,6-fused tricyclic heterocycles attached to the 6-methylidene penem core. The compounds presented in the current paper are potent and broad-spectrum inhibitors of the TEM-1 and AmpC beta-lactamases. In combination with piperacillin, their in vitro activities showed enhanced susceptibility to class A- and C-resistant strains studied in various bacteria. Some of the newly synthesized compounds such as 12a-c were shown to have in vivo activity in the acute lethal infection model against TEM-1 producing organisms. The 5,5,6-fused heterocyclic ring cores such as 21, 25, and 35 reported here are hitherto unknown in the literature.
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Antibacterianos/química , Compostos Heterocíclicos com 3 Anéis/farmacologia , Lactamas/farmacologia , Inibidores de beta-Lactamases , Antibacterianos/farmacologia , Proteínas de Bactérias/antagonistas & inibidores , Compostos Heterocíclicos com 3 Anéis/química , Imidazóis/química , Imidazóis/farmacologia , Lactamas/química , Testes de Sensibilidade Microbiana , Pirazóis/química , Pirazóis/farmacologia , Relação Estrutura-Atividade , beta-LactamasesRESUMO
A series of potent anthranilic acid-based inhibitors of the hepatitis C NS5B polymerase has been identified. The inhibitors bind to a site on NS5B between the thumb and palm regions adjacent to the active site as determined by X-ray crystallography of the enzyme-inhibitor complex. Guided by both molecular modeling and traditional SAR, the enzyme activity of the initial hit was improved by approximately 100-fold, yielding a series of potent and selective NS5B inhibitors with IC50 values as low as 10 nM. These compounds were also inhibitors of the HCV replicon in cultured HUH7 cells.
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Antivirais/síntese química , Hepacivirus/efeitos dos fármacos , Proteínas não Estruturais Virais/antagonistas & inibidores , ortoaminobenzoatos/síntese química , Regulação Alostérica , Antivirais/química , Antivirais/farmacologia , Sítios de Ligação , Linhagem Celular , Cristalografia por Raios X , Hepacivirus/enzimologia , Hepacivirus/genética , Humanos , Modelos Moleculares , Replicon , Relação Estrutura-Atividade , Proteínas não Estruturais Virais/química , Replicação Viral/efeitos dos fármacos , ortoaminobenzoatos/química , ortoaminobenzoatos/farmacologiaRESUMO
We report an unusual case of neurobrucellosis who presented with headache, vision loss, confusional state, retrobulbar neuritis and left hemiparesis. Neuroimaging studies showed features of ischemic infarct and white matter abnormalities. Pulmonary involvement in form of lobar pneumonia of left basal lobe was another unusual manifestation. Diagnosis was based on the rising titers of antibrucella antibody. Patient showed remarkable improvement on triple drug therapy in form of doxycycline, rifampicin and streptomycin.
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Brucelose/complicações , Infecções do Sistema Nervoso Central/complicações , Meningoencefalite/etiologia , Neurite Óptica/etiologia , Anticorpos Antibacterianos/análise , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Pneumonia Bacteriana/complicações , Pneumonia Bacteriana/diagnóstico por imagem , Tomografia Computadorizada por Raios XRESUMO
Through high throughput screening, substituted proline sulfonamide 6 was identified as HCV NS5b RNA-dependent RNA polymerase inhibitor. Optimization of various regions of the lead molecule resulted in compounds that displayed good potency and selectivity. The crystal structure of 6 and NS5b polymerase complex confirmed the binding near the active site region. The optimization approach and SAR are discussed in detail.