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Accurate assessment of cerebral perfusion is vital for understanding the hemodynamic processes involved in various neurological disorders and guiding clinical decision-making. This guidelines article provides a comprehensive overview of quantitative perfusion imaging of the brain using multi-timepoint arterial spin labeling (ASL), along with recommendations for its acquisition and quantification. A major benefit of acquiring ASL data with multiple label durations and/or post-labeling delays (PLDs) is being able to account for the effect of variable arterial transit time (ATT) on quantitative perfusion values and additionally visualize the spatial pattern of ATT itself, providing valuable clinical insights. Although multi-timepoint data can be acquired in the same scan time as single-PLD data with comparable perfusion measurement precision, its acquisition and postprocessing presents challenges beyond single-PLD ASL, impeding widespread adoption. Building upon the 2015 ASL consensus article, this work highlights the protocol distinctions specific to multi-timepoint ASL and provides robust recommendations for acquiring high-quality data. Additionally, we propose an extended quantification model based on the 2015 consensus model and discuss relevant postprocessing options to enhance the analysis of multi-timepoint ASL data. Furthermore, we review the potential clinical applications where multi-timepoint ASL is expected to offer significant benefits. This article is part of a series published by the International Society for Magnetic Resonance in Medicine (ISMRM) Perfusion Study Group, aiming to guide and inspire the advancement and utilization of ASL beyond the scope of the 2015 consensus article.
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Encéfalo , Circulación Cerebrovascular , Marcadores de Spin , Humanos , Encéfalo/diagnóstico por imagen , Encéfalo/irrigación sanguínea , Circulación Cerebrovascular/fisiología , Procesamiento de Imagen Asistido por Computador/métodos , Angiografía por Resonancia Magnética/métodos , Imagen por Resonancia Magnética/métodos , Imagen de PerfusiónRESUMEN
BACKGROUND: A critical unanswered question about therapeutic transcranial magnetic stimulation is what patients should do during treatment to optimize its effectiveness. Here, we address this lack of knowledge in healthy participants, testing the hypotheses that stimulating the left dorsolateral prefrontal cortex (dlPFC) while participants perform a working memory task will provide stronger effects on subsequent activation, perfusion, connectivity, and performance than stimulating resting dlPFC. METHODS: After a baseline functional magnetic resonance imaging session to localize dlPFC activation and the associated frontoparietal network (FPN) engaged by an n-back task, healthy participants (N = 40, 67.5% female) underwent 3 counterbalanced sessions, separated by several weeks, during which they received intermittent theta burst stimulation (iTBS) followed by magnetic resonance imaging scans as follows: 1) iTBS to the dlPFC while resting passively (passive), 2) iTBS to the dlPFC while performing the n-back task (active), and 3) iTBS to a vertex site, while not engaged in the n-back task and resting passively (control). RESULTS: We found no difference in n-back performance between the 3 conditions. However, FPN activation was reduced while performing the n-back task in the active condition relative to the passive and control conditions. There was no differential activity in the FPN on comparing passive with control conditions, i.e., there was no effect of the site of stimulation. We found no effects of state or site of stimulation on perfusion or connectivity with the dlPFC. CONCLUSIONS: In this study, the state of the brain while receiving iTBS affected FPN activation, possibly reflecting greater efficiency of FPN network activation when participants were stimulated while engaging the FPN.
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Corteza Prefrontal , Estimulación Magnética Transcraneal , Humanos , Femenino , Masculino , Estimulación Magnética Transcraneal/métodos , Corteza Prefrontal/fisiología , Corteza Cerebral , Imagen por Resonancia Magnética , Memoria a Corto Plazo/fisiologíaRESUMEN
The amazon forest is the habitat of a high species diversity of invertebrates and unfortunately the real richness had been underestimated. Earthworms' inventories had been poor because difficult to describe new species. This study adds new records to eastern amazon of two new species belong Rhinodrilus and Andiorrhinus genera. R. priscilae n. sp. is another rare specimen of the genre having two pair of prostatoid glands. A. (Amazonidrilus) caxiuana differ of other species in size, the intestinal origin is in XXVIII and also has only one glandular mass associated to spermatheca.
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Oligoquetos , Animales , Bosques , EcosistemaRESUMEN
An earthworm checklist has produced 78 nominal taxa (species/subspecies) of earthworm reported to date in Venezuela. The list of nominal taxa was obtained through literature review and the distribution maps were plotted by ecoregion. The 78 species/subspecies are divided into 24 genera and 6 families. Native earthworm species were more widely distributed than peregrine and exotic and are more associated with the conserved areas. Exotic species had been collected mainly in the north of the country in areas with at least some disturbance history. The peregrine species P. corethrurus is also widely distributed but with a preference for disturbed areas or related to its native natural grassland condition near the Guayana's shield. This is the first accurate assessment of Venezuela's earthworm species and subspecies in the last 14 years.
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Falconiformes , Oligoquetos , Animales , VenezuelaRESUMEN
Two new species of the earthworm genus Pontoscolex found in San Casimiro County, northern Venezuela are described. Because of some morphological variability, and to improve the previous description, we redescribe Onychochaeta windlei and Rhinodrilus fuenzalidae collected at La Cortada settlement, Miranda state. Pontoscolex (Mesoscolex) juanae sp. n. and Pontoscolex (Nulloscolex) hugoi subgen. n., sp. n have three pairs of tiny calciferous glands in 7th to 9th segments, with a simple tubular structure similar to that of the genus Onychochaeta; however, testes and funnels are enclosed in sacs in the 11th segment similar to the Pontoscolex. We also report the occurrences of Pontoscolex (Pontoscolex) corethrurus Müller, 1857, Metaphire houlleti (Perrier, 1872), Perionyx excavatus Perrier, 1872, Dichogaster bolaui (Michaelsen, 1891), and Eisenia fetida (Savigny, 1826).
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Oligoquetos , Animales , VenezuelaRESUMEN
Management of asymptomatic carotid artery stenosis (CAS) relies on measuring the percentage of stenosis. The aim of this study was to investigate the impact of CAS on cerebral hemodynamics using magnetic resonance imaging (MRI)-informed computational fluid dynamics (CFD) and to provide novel hemodynamic metrics that may improve the understanding of stroke risk. CFD analysis was performed in two patients with similar degrees of asymptomatic high-grade CAS. Three-dimensional anatomical-based computational models of cervical and cerebral blood flow were constructed and calibrated patient-specifically using phase-contrast MRI flow and arterial spin labeling perfusion data. Differences in cerebral hemodynamics were assessed in preoperative and postoperative models. Preoperatively, patient 1 demonstrated large flow and pressure reductions in the stenosed internal carotid artery, while patient 2 demonstrated only minor reductions. Patient 1 exhibited a large amount of flow compensation between hemispheres (80.31%), whereas patient 2 exhibited only a small amount of collateral flow (20.05%). There were significant differences in the mean pressure gradient over the stenosis between patients preoperatively (26.3 vs. 1.8 mmHg). Carotid endarterectomy resulted in only minor hemodynamic changes in patient 2. MRI-informed CFD analysis of two patients with similar clinical classifications of stenosis revealed significant differences in hemodynamics which were not apparent from anatomical assessment alone. Moreover, revascularization of CAS might not always result in hemodynamic improvements. Further studies are needed to investigate the clinical impact of hemodynamic differences and how they pertain to stroke risk and clinical management.
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PURPOSE: To evaluate pseudo-continuous arterial spin labeling (pCASL) and velocity-selective arterial spin labeling (VSASL) for quantification of spinal cord blood flow (SCBF) in the rat thoracolumbar spinal cord. METHODS: Labeling efficiency (LE) was compared between pCASL and three VSASL variants in simulations and both phantom and in vivo experiments at 9.4 T. For pCASL, the effects of label plane position and shimming were systematically evaluated. For VSASL, the effects of composite pulses and phase cycling were evaluated to reduce artifacts. Additionally, vessel suppression, respiratory, and cardiac gating were evaluated to reduce motion artifacts. pCASL and VSASL maps of spinal cord blood flow were acquired with the optimized protocols. RESULTS: LE of the descending aorta was larger in pCASL compared to VSASL variants. In pCASL, LE off-isocenter was improved by local shimming positioned at the label plane and the anatomical level of labeling for the thoracic cord was only viable at the level of the T10 vertebra. Cardiac gating was essential to reduce motion artifacts. Both pCASL and VSASL successfully demonstrated comparable SCBF values in the thoracolumbar cord. CONCLUSION: pCASL demonstrated high and consistent LE in the thoracic aorta, and VSASL was also feasible, but with reduced efficiency. A combination of cardiac gating and recording of actual post-label delays was important for accurate SCBF quantification. These results highlight the challenges and solutions to achieve sufficient ASL labeling and contrast at high field in organs prone to motion.
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Angiografía por Resonancia Magnética , Imagen por Resonancia Magnética , Ratas , Animales , Angiografía por Resonancia Magnética/métodos , Marcadores de Spin , Velocidad del Flujo Sanguíneo/fisiología , Arterias , Circulación Cerebrovascular/fisiología , Encéfalo/irrigación sanguíneaRESUMEN
Emerging in the twenty-first century, Network Science provides practical measures to interpret a system's interactions between the components and their links. Literature has focused on countries' interconnections on the final goods, but its application on the value-added from a network perspective in trade is still imitated. This paper applies network science properties and a multi-regional input-output analysis by using the UNCTAD-Eora Global Value Chain Database on the Transport Equipment value added on 2017 to unwrap the specific structural characteristics of the industry. Results show that the industry is highly centralized. The center of the network is dominated by developed countries, mainly from Europe, the United States, and Japan. Emerging countries such as China, Mexico, Thailand, and Poland also have an important position. In addition, the structure reveals two sub-hubs located in East Europe and North America. By extending to community detection, the network consists of three different communities led by Germany, the United States, and the United Kingdom, associated with more significant value-added flows. The study concludes that flows are not always consistent with the economy's geographical location as usually final goods analysis suggests, and highlight the need to continue using the complex network to reveal the world trade structure.
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Arterial spin labeling (ASL) is a non-invasive MRI technique that allows for quantitative measurement of cerebral perfusion. Incomplete or inaccurate reporting of acquisition parameters complicates quantification, analysis, and sharing of ASL data, particularly for studies across multiple sites, platforms, and ASL methods. There is a strong need for standardization of ASL data storage, including acquisition metadata. Recently, ASL-BIDS, the BIDS extension for ASL, was developed and released in BIDS 1.5.0. This manuscript provides an overview of the development and design choices of this first ASL-BIDS extension, which is mainly aimed at clinical ASL applications. Discussed are the structure of the ASL data, focussing on storage order of the ASL time series and implementation of calibration approaches, unit scaling, ASL-related BIDS fields, and storage of the labeling plane information. Additionally, an overview of ASL-BIDS compatible conversion and ASL analysis software and ASL example datasets in BIDS format is provided. We anticipate that large-scale adoption of ASL-BIDS will improve the reproducibility of ASL research.
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Encéfalo , Imagen por Resonancia Magnética , Neuroimagen , Humanos , Encéfalo/diagnóstico por imagen , Imagen por Resonancia Magnética/normas , Neuroimagen/métodos , Reproducibilidad de los Resultados , Marcadores de SpinRESUMEN
This review article provides an overview of a range of recent technical developments in advanced arterial spin labeling (ASL) methods that have been developed or adopted by the community since the publication of a previous ASL consensus paper by Alsop et al. It is part of a series of review/recommendation papers from the International Society for Magnetic Resonance in Medicine Perfusion Study Group. Here, we focus on advancements in readouts and trajectories, image reconstruction, noise reduction, partial volume correction, quantification of nonperfusion parameters, fMRI, fingerprinting, vessel selective ASL, angiography, deep learning, and ultrahigh field ASL. We aim to provide a high level of understanding of these new approaches and some guidance for their implementation, with the goal of facilitating the adoption of such advances by research groups and by MRI vendors. Topics outside the scope of this article that are reviewed at length in separate articles include velocity selective ASL, multiple-timepoint ASL, body ASL, and clinical ASL recommendations.
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Encéfalo , Imagen por Resonancia Magnética , Circulación Cerebrovascular , Procesamiento de Imagen Asistido por Computador/métodos , Angiografía por Resonancia Magnética/métodos , Imagen por Resonancia Magnética/métodos , Marcadores de SpinRESUMEN
This review article provides an overview of the current status of velocity-selective arterial spin labeling (VSASL) perfusion MRI and is part of a wider effort arising from the International Society for Magnetic Resonance in Medicine (ISMRM) Perfusion Study Group. Since publication of the 2015 consensus paper on arterial spin labeling (ASL) for cerebral perfusion imaging, important advancements have been made in the field. The ASL community has, therefore, decided to provide an extended perspective on various aspects of technical development and application. Because VSASL has the potential to become a principal ASL method because of its unique advantages over traditional approaches, an in-depth discussion was warranted. VSASL labels blood based on its velocity and creates a magnetic bolus immediately proximal to the microvasculature within the imaging volume. VSASL is, therefore, insensitive to transit delay effects, in contrast to spatially selective pulsed and (pseudo-) continuous ASL approaches. Recent technical developments have improved the robustness and the labeling efficiency of VSASL, making it a potentially more favorable ASL approach in a wide range of applications where transit delay effects are of concern. In this review article, we (1) describe the concepts and theoretical basis of VSASL; (2) describe different variants of VSASL and their implementation; (3) provide recommended parameters and practices for clinical adoption; (4) describe challenges in developing and implementing VSASL; and (5) describe its current applications. As VSASL continues to undergo rapid development, the focus of this review is to summarize the fundamental concepts of VSASL, describe existing VSASL techniques and applications, and provide recommendations to help the clinical community adopt VSASL.
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Circulación Cerebrovascular , Angiografía por Resonancia Magnética , Angiografía por Resonancia Magnética/métodos , Imagen por Resonancia Magnética , Perfusión , Marcadores de SpinRESUMEN
ABSTRACT Greek yogurt (GY) has gained popularity in recent years for its marked texture, taste, and nutritional characteristics compared to traditional yogurt (TY). The objective of this work was to analyze the physicochemical, sensory, and lipid profile of GY and TY with blueberry flavor, both manufactured by a local industry in the state of Rio Grande do Sul, Brazil. Protein and lipid content, as well as humidity, ash, and fatty acid profile were quantified and a sensory evaluation was completed using the affective method. The physicochemical results showed 1.5% and 2.3% more proteins and lipids, respectively, for GY compared to TY. The humidity in TY was 10% lower than in GY. Eighteen types of polyunsaturated, saturated, monounsaturated fatty acids were identified, with a high proportion of C14, C16, and C18. Sensory analysis showed a preference for GY over TY (64% versus 36%, p0.05). Both the protein and lipid content, associated with creaminess, likely influence better acceptance of GY.
RESUMEN El yogur griego (YG) ha ganado popularidad durante los últimos años por su marcada textura, sabor y características nutricionales en comparación con el yogur tradicional (YT). El objetivo de este trabajo fue analizar el perfil fisicoquímico, sensorial y lipídico de YG y YT con sabor a arándano, ambos fabricados por una industria ubicada en el estado de Rio Grande do Sul, Brasil. Fueron cuantificados el contenido de proteínas, lípidos, humedad y cenizas, así como también el perfil de ácidos grasos y la evaluación sensorial por método afectivo. Los resultados fisicoquímicos mostraron que YG contiene 1,5% y 2,3% más de proteínas y lípidos, respectivamente, en comparación con YT (p0,05) en relación a la aceptación de los atributos color, olor, sabor y acidez. Los atributos cuerpo, apariencia y textura presentaron mejores scores de aceptación para el YG. Tanto el contenido de proteínas y lípidos, asociados a la cremosidad, probablemente hayan influenciado una mejor aceptación del YG.
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Arterial spin labeling (ASL) is a non-invasive and cost-effective MRI technique for brain perfusion measurements. While it has developed into a robust technique for scientific and clinical use, its image processing can still be daunting. The 2019 Ann Arbor ISMRM ASL working group established that education is one of the main areas that can accelerate the use of ASL in research and clinical practice. Specifically, the post-acquisition processing of ASL images and their preparation for region-of-interest or voxel-wise statistical analyses is a topic that has not yet received much educational attention. This educational review is aimed at those with an interest in ASL image processing and analysis. We provide summaries of all typical ASL processing steps on both single-subject and group levels. The readers are assumed to have a basic understanding of cerebral perfusion (patho) physiology; a basic level of programming or image analysis is not required. Starting with an introduction of the physiology and MRI technique behind ASL, and how they interact with the image processing, we present an overview of processing pipelines and explain the specific ASL processing steps. Example video and image illustrations of ASL studies of different cases, as well as model calculations, help the reader develop an understanding of which processing steps to check for their own analyses. Some of the educational content can be extrapolated to the processing of other MRI data. We anticipate that this educational review will help accelerate the application of ASL MRI for clinical brain research.
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In this study, chitosan was chemically modified with 2-methylpyridine. Subsequently, the modified chitosan was cross-linked to cellulose using succinic anhydride. Additionally, the capacity of cellulose derivatives to adsorb Pb(II) ions in an aqueous solution was studied through the determination of Pb(II) ions concentration in water, using microwave plasma atomic emission spectroscopy (MP-AES). A maximum adsorption capacity of 6.62, 43.14, 60.6, and 80.26 mg/g was found for cellulose, cellulose-succinic acid, cellulose-chitosan, and cellulose-chitosan-pyridine, respectively. The kinetic data analysis of the adsorption process showed a pseudo-second-order behavior. The increase in metal removal from water is possibly due to metal chelation with the carbonyl group of succinic acid, and the pyridine groups incorporated into chitosan.
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Cerebral hemodynamics in the presence of cerebrovascular occlusive disease (CVOD) are influenced by the anatomy of the intracranial arteries, the degree of stenosis, the patency of collateral pathways, and the condition of the cerebral microvasculature. Accurate characterization of cerebral hemodynamics is a challenging problem. In this work, we present a strategy to quantify cerebral hemodynamics using computational fluid dynamics (CFD) in combination with arterial spin labeling MRI (ASL). First, we calibrated patient-specific CFD outflow boundary conditions using ASL-derived flow splits in the Circle of Willis. Following, we validated the calibrated CFD model by evaluating the fractional blood supply from the main neck arteries to the vascular territories using Lagrangian particle tracking and comparing the results against vessel-selective ASL (VS-ASL). Finally, the feasibility and capability of our proposed method were demonstrated in two patients with CVOD and a healthy control subject. We showed that the calibrated CFD model accurately reproduced the fractional blood supply to the vascular territories, as obtained from VS-ASL. The two patients revealed significant differences in pressure drop over the stenosis, collateral flow, and resistance of the distal vasculature, despite similar degrees of clinical stenosis severity. Our results demonstrated the advantages of a patient-specific CFD analysis for assessing the hemodynamic impact of stenosis.
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Heavy metals in water are a serious environmental problem due to their accumulation and toxicity; there are several processes we can use to address this issue, but adsorption is the most popular due to its simplicity and efficiency. Polysaccharides such as cellulose have received attention as adsorbents for heavy metals, and cotton-chitosan composites (CCs) were developed here with nontoxic reagents such as carboxylic acids as crosslinkers and NaH2PO4 as a catalyst to achieve chitosan covalent crosslinkage into oxidized cotton textiles with H2O2. The composites were characterized by fourier-transform infrared spectroscopy (FTIR), elemental analysis (EA), X-ray photoelectron spectroscopy (XPS), atomic-force and scanning electron microscopy (AFM and SEM), and tensile strength; the adsorption of lead ions (Pb) was evaluated with cotton-chitosan composites and quantified by microwave plasma atomic emission spectroscopy (MP-AES). The composites showed a maximum incorporation of chitosan of 27.62 mg per gram of cotton textile. A tensile strength analysis of the composite showed a Young's modulus approximately 1 MPa higher than that of cotton textile. The adsorption of lead ions with composites in an aqueous solution at pH 5 and 25 °C was circa 74% after 6 h of contact, as determined by MP-AES. This work is an approach to demonstrate the potential of these polysaccharides, modified by "green" procedures to remove pollutants from water.
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Introducción: El proceso de mejora continua constituye hoy la piedra angular de los esfuerzos para gestionar la calidad en la formación de los profesionales. Objetivo : Evaluar el estado actual de la Facultad "Manuel Fajardo" para el desarrollo del proceso de autoevaluación de la carrera de Medicina con fines de mejora continua. Métodos: El grupo de estudio estuvo integrado por 57 profesores y 143 estudiantes de primero hasta sexto años en el período enero-marzo de 2020. Se seleccionó, para los estudiantes, una muestra estratificada por conglomerado; y para los profesores, una estratificada simple. Además, se realizó una investigación observacional, descriptiva, de corte transversal. Resultados: La calidad del proceso de formación tuvo una percepción diferente entre profesores y estudiantes. Más del 20 por ciento de los encuestados consideró como no satisfactoria la preparación del personal no docente y administrativo, y su incidencia en la formación del profesional; acerca de la organización docente, estos la valoraron en más del 30 por ciento como no satisfactoria. Casi el 30 por ciento de los profesores manifestó como medianamente satisfactoria o insatisfactoria la actividad investigativa y laboral de los estudiantes; y más del 20 por ciento de los estudiantes estimó que había dificultades en la aplicación de las estrategias curriculares. Conclusiones: Se constataron insuficiencias que limitaban el continuo desarrollo del proceso de formación(AU)
Introduction: The continuous improvement process is nowadays the cornerstone of efforts made to manage quality in the training of professionals. Objective: To assess the current state of Manuel Fajardo School of Medical Sciences regarding the development of the self-evaluation process in the medical major for the purpose of continuous improvement. Methods: The study group consisted of 57 professors and 143 students from first to sixth academic years, in the period from January to March 2020. A sample stratified by cluster was selected for the students; while, for teachers, the sample was chosen by simple stratification. In addition, an observational, descriptive and cross-sectional research was carried out. Results: The quality of the training process had a different perception between professors and students. More than 20 percent of the respondents considered as unsatisfactory the preparation of nonteaching and administrative personnel and its impact on professional training. Regarding organization of teaching, more than 30 percent rated it as unsatisfactory. Almost 30 percent of the professors stated that research and work activity of the students was moderately satisfactory or unsatisfactory, while more than 20 percent of the students estimated that there were difficulties in the application of curricular strategies. Conclusions: Insufficiencies were found that limited the continuous development of the training process(AU)
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Humanos , Educación Médica/métodos , Capacitación Profesional , AutoevaluaciónRESUMEN
Introducción: La educación se define como el campo pedagógico que trata los procedimientos, las técnicas y los modos requeridos para lograr con efectividad el proceso de aprendizaje en el estudiante. Objetivo: Evaluar la preparación pedagógica de los estudiantes de sexto año de la carrera de medicina del curso 2019-2020 en la Facultad de Ciencias Médicas Manuel Fajardo. Métodos: El universo quedó constituido por 27 estudiantes de sexto año de la carrera de medicina, durante su rotación por Pediatría, en el Hospital Pediátrico Borrás-Marfán. Se trabajó con todo el universo. Se realizó una investigación observacional, descriptiva y de corte transversal en el período desde enero hasta abril de 2019. Se definió como variable principal la formación pedagógica, de la cual se derivaron varias dimensiones. Resultados: Las habilidades de lectura, escritura y redacción estuvieron garantizadas en la mayoría de los estudiantes. El 44 por ciento se sintió totalmente capacitado para aplicar las tecnologías de la información y las comunicaciones, y un amplio porcentaje refirió dificultades para comunicarse en una segunda lengua. La mitad de los estudiantes tuvo buen dominio teórico de los conceptos pedagógicos, aunque solo el 33 por ciento podría siempre elaborar materiales didácticos. El 62 porciento dominaba el conocimiento médico y el 78 por ciento el método clínico. La formación pedagógica en los estudiantes encuestados resultó deficiente, en lo que influyen negativamente los aspectos de conocimiento general; más de la mitad de los estudiantes manifestaron dificultades para comunicarse en una segunda lengua y aplicar las tecnologías de la información y las comunicaciones. Pocos estuvieron preparados para evaluar los resultados investigativos. Conclusiones: En sentido general, los conceptos pedagógicos son conocidos, pero pocos estudiantes manifiestan dominio acerca de la elaboración de materiales didácticos, la educación continua y el aprendizaje autónomo(AU)
Introduction: Education is defined as the pedagogical sphere that deals with the procedures, techniques and modes required for the student to achieve learning effectively. Objective: To assess the pedagogical preparation of sixth-year medical students in the 2019-2020 academic year at Manuel Fajardo School of Medical Sciences. Methods: The universe was made up of 27 sixth-year medical students, during their Pediatrics rotation at Borrás-Marfán Pediatric Hospital. The entire universe was used. An observational, descriptive and cross-sectional research was carried out in the period from January to April 2019. Pedagogical training was defined as the main variable, from which several dimensions were derived. Results: Reading and writing skills were guaranteed in most of the students. 44 percent felt themselves fully trained to apply information and communication technologies, while a large percentage reported difficulties in communicating using a second language. Half of the students had a good theoretical command of pedagogical concepts, although only 33 percent could always prepare teaching materials. 62 percent dominated the medical knowledge, while 78 percent dominated the clinical method. Pedagogical training in the surveyed students was deficient, a situation influenced negatively by general knowledge aspects. More than half of the students reported difficulties for communicating using a second language and for applying information and communication technologies. Few students were prepared to assess research results. Conclusions: Generally speaking, pedagogical concepts are known, but only few students show mastery of the development of didactic materials, continuous education and autonomous learning(AU)