Preference signaling in the radiology residency match: National survey of applicants.

OBJECTIVE: Two-tiered preference signaling has been implemented in the radiology residency application system to reduce congestion in the setting of high-volume applications. Signals are an indicator of strong interest that an applicant can transmit to a limited number of programs. This study assessed the impact of program signaling on interview invitations, how applicants strategically used signals based on their application's competitiveness, and applicants' attitudes toward the current signaling system. METHODS: A survey was sent to radiology residency applicants registered with TheRadRoom during the 2024 application cycle. We queried the applicant's background, applications, signal distribution, and interview outcome depending on the type of signal sent. We also asked whether respondents received an interview invitation from a hypothetical "comparator non-signaled program" if they had one additional signal to use. Group differences were assessed using nonparametric Wilcoxon signed rank test. RESULTS: A total of 202 applicants completed the survey (28% response rate). Most applied to diagnostic radiology (81%). Nearly all respondents utilized all 6 gold (98%) and 6 silver (96.5%) signals. Interview invitation rates were significantly higher for signaled programs (59.8%±27.4%) than non-signaled (8.5%±8.5%); the invitation rate at the comparator non-signaled programs was 37%. Gold signaled programs had significantly higher interview rates (67.8%±29.3) than silver (51.8%±31.3%). Respondents used 49.2%(±21.7%) of their signals for "likely to match" programs, 33.1%(±20.9%) for "aspirational" programs, and 17.6%(±15.8%) for "safety" programs. Most respondents (146;76%) supported continuing the signaling system for future cycles. CONCLUSION: Signaling programs significantly enhanced interview invitation rates, with gold signals being more effective than silver. The applicants used about 6 total signals for "likely-to-match" programs, 2 for "aspirational" programs, and about 4 for "safety" programs.

Potential strength and weakness of artificial intelligence integration in emergency radiology: a review of diagnostic utilizations and applications in patient care optimization.

Artificial intelligence (AI) and its recent increasing healthcare integration has created both new opportunities and challenges in the practice of radiology and medical imaging. Recent advancements in AI technology have allowed for more workplace efficiency, higher diagnostic accuracy, and overall improvements in patient care. Limitations of AI such as data imbalances, the unclear nature of AI algorithms, and the challenges in detecting certain diseases make it difficult for its widespread adoption. This review article presents cases involving the use of AI models to diagnose intracranial hemorrhage, spinal fractures, and rib fractures, while discussing how certain factors like, type, location, size, presence of artifacts, calcification, and post-surgical changes, affect AI model performance and accuracy. While the use of artificial intelligence has the potential to improve the practice of emergency radiology, it is important to address its limitations to maximize its advantages while ensuring the safety of patients overall.

Is older age an appropriate criterion alone for ordering cervical spine computed tomography after trauma.

BACKGROUND: Cervical spine computed tomography (CSCT) scans are frequently performed in older emergency department (ED) trauma patients based on the 65-year-old high-risk criterion of the Canadian Cervical Spine Rule (CCR). We sought to determine the positivity rate of CSCT scans in symptomatic and asymptomatic patients to assess the current applicability of age in the CCR. METHODS: We reviewed CSCT ED reports from two institutional hospitals from 2018 to 2023. The primary variable was age; however, we also recorded fracture types and sites and type of treatments. Patients were separated into symptomatic and asymptomatic cohorts. We used a Fisher's exact test to compare variables between the asymptomatic and symptomatic groups and chi-square tests for comparison between age groups. RESULTS: Of 9455 CSCTs performed in patients ≥ 65 years, 192 (2.0%) fractures were identified (113 females); 28 (0.30%) were in asymptomatic patients. The rates of fractures (1.6%) and asymptomatic fractures (0.18%) were lowest in the 65- to 70-year age group. There were no distinguishing features as to the level or part of the vertebra fractured or surgical treatment rate between asymptomatic and symptomatic patients. CONCLUSIONS: Cervical spine fractures in posttrauma patients ≥ 65 years are uncommon, with the lowest incidence in those 65 to 70 years old. Excluding asymptomatic individuals aged 65-70 from routine CSCT presents a minimal risk of missed fractures (0.18%). This prompts consideration for refining age-based screening and integrating shared decision making into the clinical protocol for this demographic, reflecting the low incidence of fractures and the changing health profile of the aging population.

Unsolicited scam invitations from predatory publications and fraudulent conferences: Radiology-in-training experience.

PURPOSE: Radiology faculty across various specialties have been reported to receive an average of 20.7 invitations to submit manuscripts to bogus journals and 4.1 invitations to speak at unsuitable events over a two-week span. Radiology trainees also receive a fair number of unsolicited invitations from unknown senders to submit manuscripts and speak at meetings. Trainees can be more vulnerable to predatory invitations due to potential naivety. We aimed to determine the prevalence of these spam invitations received by radiology trainees. MATERIAL AND METHODS: The designed survey for evaluating the experience of radiology trainees regarding phishing scams of predatory publications and conferences was sent to radiology residency and neuroradiology fellowship program leadership to redistribute amongst their trainees, and was advertised on social media platforms. The survey was first sent out on September 28, 2023, and was closed two weeks later October 12, 2023. Spearman's correlation, univariable and multivariable linear regression analyses were performed. RESULTS: Our study included 151 respondents who completed the survey. Of the survey respondents, 53 % reported receiving unsolicited emails from predatory publications (mean = 6.76 ± 7.29), and 32 % reported receiving emails from fraudulent conferences (mean = 5.61 ± 5.77). Significant positive correlation was observed between number of unsolicited email invitations with number of PubMed indexed publications, number as corresponding author, number in open access journals and number of abstract presentations. CONCLUSIONS: Trainees in radiology receive many unsolicited invitations to publish papers as well as to present at meetings that are not accredited. This could lead to wasted time and financial resources for unsuspecting trainees.

Role of hypothalamic-pituitary adrenal-axis, toll-like receptors, and macrophage polarization in pre-atherosclerotic changes induced by social isolation stress in mice.

It has been well documented that chronic stress can induce atherosclerotic changes, however, the underlying mechanisms is yet to be established. In this regard, this study aimed to elucidate the relation between hypothalamic-pituitary adrenal-axis (HPA-axis), toll-like receptors (TLRs), as well as M1/M2 macrophage ratio and pre-atherosclerotic changes in social isolation stress (SIS) in mice. We used small interfering RNA against the glucocorticoid receptor (GR) to evaluate the relation between HPA-axis and TLRs. C57BL/6J mice were subjected to SIS and RT-PCR, ELISA, flow cytometry, and immunohistochemistry were used to assess the relations between pre-atherosclerotic changes and TLRs, macrophage polarization, pro-inflammatory cytokines, and cell adhesion molecules in aortic tissue. We used TAK-242 (0.3 mg/kg, intraperitoneally), a selective antagonist of TLR4, as a possible prophylactic treatment for atherosclerotic changes induced by SIS. We observed that isolated animals had higher serum concentration of corticosterone and higher body weight in comparison to normal animals. In isolated animals, results of in vitro study showed that knocking-down of the GR in bone marrow-derived monocytes significantly decreased the expression of TLR4. In vivo study suggested higher expression of TLR4 on circulating monocytes and higher M1/M2 ratio in aortic samples. Pathological study showed a mild pre-atherosclerotic change in isolated animals. Finally, we observed that treating animals with TAK-242 could significantly inhibit the pre-atherosclerotic changes. SIS can possibly increase the risk of atherosclerosis through inducing abnormal HPA-axis activity and subsequently lead to TLR4 up-regulation, vascular inflammation, high M1/M2 ratio in intima. Thus, TLR4 inhibitors might be a novel treatment to decrease the risk of atherosclerosis induced by chronic stress.

The possible role of nitric oxide in anti-convulsant effects of Naltrindole in seizure-induced by social isolation stress in male mice.

Social isolation stress (SIS) as a chronic model of early-life stress could induce proconvulsant effects in mice. In the current study, we evaluated the role of opioid receptors (OPRs) agonists and antagonists in pro-conversant effects of SIS and the common pathway between delta-opioid receptors (DORs) and nitric oxide (NO) in stress-induced seizure. For reaching to this goal, we used pentylenetetrazol (PTZ) model of clonic-seizure to measure seizure threshold and administrated selective and non-selective OPRs agonists and antagonists in both social condition (SC) and isolated condition (IC) animals. In the next step, we administrated sub effective dose of naltrindole (NLT, 0.3 mg/kg) with sub-effective doses of nitric oxide synthesis (NOS) inhibitors including L-NAME (10 mg/kg), aminoguanidine (50 mg/kg) and 7-NI (15 mg/kg). Also, we co-administrated sub-effective dose of SNC80 (0.5 mg/kg) with sub-effective dose of l-arg (25 mg/kg) to assess the seizure threshold. In addition, we measured nitrite levels of hippocampus following administration of mentioned drugs in both SC and IC mice. Our findings showed that L-NAME and 7-NI (but not AG) increased anti-convulsant activity of NLT and l-arg increased proconvulsant effects of SNC80 in IC animals. Nitrite assay showed that co-administration of NLT plus sub-effective doses of L-NAME and 7-NI (but not AG) decreased and co-administration of SNC80 with sub-effective dose of l-arg increased nitrite levels of hippocampus in IC mice. This study suggests the role of n-NOS in anti-convulsant effects of NLT and pro-convulsant effects of SNC80 in stress-induced seizure.

Protective effect of minocycline on LPS-induced mitochondrial dysfunction and decreased seizure threshold through nitric oxide pathway.

Lipopolysaccharide (LPS) increases inflammatory cytokines of the brain and deregulates the mitochondrial function, thus could increase the seizure susceptibility. Studies have shown that minocycline has neuroprotective and antioxidant properties. In this study, we aimed to evaluate the anticonvulsant properties of minocycline in LPS-treated animals and the possible involvement of nitric oxide and mitochondrial pathways. In a PTZ model of seizure in mice, minocycline was administrated to LPS-treated mice. Then followed by co-injection of its sub-effective dose and NOS inhibitors including 7-Nitroindazole (7-NI), aminoguanidine (AG) and L-NG-Nitroarginine methyl ester (L-NAME) to evaluate the changes in seizure threshold and the possible involvement of nitrergic system. Molecular assessments were used to evaluate the effects of each treatment on inflammation and mitochondrial function in the brain. LPS-treated animals had lower seizure threshold compared to intact animals; injection of minocycline (80 mg/kg) to LPS-treated mice reversed this effect. Co-injection of sub-effective doses of minocycline (40 mg/kg) and L-NAME to LPS-treated animals significantly increased seizure threshold. We observed that co-treatment of minocycline and AG dissimilar to 7-NI could increase the seizure threshold of LPS-treated animals. L-arginine reversed the anticonvulsant effect of minocycline. Also, molecular evaluations showed that LPS could increase the ATP levels, GSH levels, and reactive oxygen species formation. However, minocycline at both doses significantly reversed the effect of LPS. Minocycline counteracts the proconvulsant effects of LPS through regulating of mitochondrial function and decreasing of neuro-inflammation. Also, co-administration of minocycline and i-NOS inhibitors could intensify anticonvulsant effects of minocycline.