A case study: exploring the impact of 3D printed models on cognitive integration during clinical skills training.

Background: Cognitive integration occurs when trainees make conceptual connections between relevant knowledges and is known to improve learning. While several experimental studies have demonstrated how text and audio-visual instruction can be designed to enhance cognitive integration, clinical skills training in real-world contexts may require alternative educational strategies. Introducing three-dimensional (3D) printed models during clinical skills instruction may offer unique learning opportunities to support cognitive integration.

Slowed Temporal and Parietal Cerebrovascular Response in Patients with Alzheimer's Disease.

Background: Recent investigations now suggest that cerebrovascular reactivity (CVR) is impaired in Alzheimer's disease (AD) and may underpin part of the disease's neurovascular component. However, our understanding of the relationship between the magnitude of CVR, the speed of cerebrovascular response, and the progression of AD is still limited. This is especially true in patients with mild cognitive impairment (MCI), which is recognized as an intermediate stage between normal aging and dementia.

Cerebrovascular Resistance in Healthy Aging and Mild Cognitive Impairment.

Measures of cerebrovascular reactivity (CVR) are used to judge the health of the brain vasculature. In this study, we report the use of several different analyses of blood oxygen dependent (BOLD) fMRI responses to CO to provide a number of metrics of CVR based on the sigmoidal resistance response to CO. To assess possible differences in these metrics with age, we compiled atlases reflecting voxel-wise means and standard deviations for four different age ranges and for a group of patients with mild cognitive impairment (MCI) and compared them.

PET/CT of Dementia.

Objective: In this article, we review the literature on PET/CT in the management of dementia, present evidence for best clinical practices, and discuss recent advances in the field.

Conclusion: Standard-of-care imaging for dementia includes CT and MRI, primarily for excluding vascular lesions or masses, detecting atrophy, and monitoring disease severity. PET/CT is a powerful functional modality that can differentiate dementia types and influence management.

2016 Year in Review: Mechanical Ventilation.

The fundamental goals of mechanical ventilation are to improve pulmonary gas exchange and relieve respiratory distress, thus permitting lung and airway healing, while at the same time lessening the risk for iatrogenic complications. This review will summarize some of the advances in mechanical ventilation in 2016, with a particular focus on ventilator-associated clinical challenges and outcomes.

Clinically Feasible Microstructural MRI to Quantify Cervical Spinal Cord Tissue Injury Using DTI, MT, and T2*-Weighted Imaging: Assessment of Normative Data and Reliability.

Background And Purpose: DTI, magnetization transfer, T2*-weighted imaging, and cross-sectional area can quantify aspects of spinal cord microstructure. However, clinical adoption remains elusive due to complex acquisitions, cumbersome analysis, limited reliability, and wide ranges of normal values. We propose a simple multiparametric protocol with automated analysis and report normative data, analysis of confounding variables, and reliability.

A Novel MRI Biomarker of Spinal Cord White Matter Injury: T2*-Weighted White Matter to Gray Matter Signal Intensity Ratio.

Background And Purpose: T2*-weighted imaging provides sharp contrast between spinal cord GM and WM, allowing their segmentation and cross-sectional area measurement. Injured WM demonstrates T2*WI hyperintensity but requires normalization for quantitative use. We introduce T2*WI WM/GM signal-intensity ratio and compare it against cross-sectional area, the DTI metric fractional anisotropy, and magnetization transfer ratio in degenerative cervical myelopathy.

Dr. Bernard Langer - inductee into the Canadian Medical Hall of Fame.

Dr. Bernard Langer's induction into the Canadian Medical Hall of Fame acknowledges his profound effect on medicine and surgery in Canada and an impact that has been truly international. In this brief biography, we highlight the major accomplishments that have made Dr.

Simulation-based training for thoracoscopy.

Introduction: An increasing proportion of thoracic procedures are performed using video-assisted thoracic surgery. This minimally invasive technique places special demands on the surgeons. Using simulation-based training on artificial models or animals has been proposed to overcome the initial part of the learning curve.

Nutritional assessment and hepatic fatty acid composition in non-alcoholic fatty liver disease (NAFLD): a cross-sectional study.

Background/aims: Low hepatic n-6 and n-3 polyunsaturated fatty acid (PUFA) may contribute to steatosis and steatohepatitis and can be affected by diet and oxidative stress.

Methods: Seventy-three patients referred for elevated liver enzymes and suspected NAFLD were assessed. Nutritional assessment, hepatic FA composition and oxidative stress were compared between these groups: simple steatosis (SS, n=18), steatohepatitis (NASH, n=38) and minimal findings on liver biopsy (MF, n=17).

Patterns of handwashing behavior and visits to patients on a general medical ward of healthcare workers.

Objective: To obtain accurate data regarding the handwashing behavior and patterns of visits to patients by healthcare workers (HCWs).

Methods: All visits by HCWs to selected patient rooms were recorded for 3 days and 2 nights. Additionally, 5 nurses were observed for 1 day each and 2 nurses were observed for 1 night each.

Violence against women in North America.

Although North America is viewed as a place where women have equal rights and status, violence against women is still rampant. Forty to 51% of women experience some type of violence in their lifetime including child abuse, physical violence, rape and domestic violence. The perpetrator is most likely to be a current or former partner.

Dissecting mechanisms of innate and acquired immunity in myocarditis.

Inflammation underlies the pathogenesis of some of the most common cardiovascular diseases. Myocarditis is a relevant clinical cause of heart failure, but also provides an excellent laboratory model to study the mechanisms of inflammation leading to heart failure. The availability of different inbred mouse strains for inducing myocarditis using viral or myosin as triggers provides an excellent platform for investigation.

Molecular cytogenetic analysis of head and neck squamous cell carcinoma: By comparative genomic hybridization, spectral karyotyping, and expression array analysis.

Background: A combination of molecular cytogenetic and expression array analysis has been performed on head and neck squamous cell carcinoma (HNSCC) of the oral cavity and supraglottis. These studies were performed to identify consensus regions of chromosomal imbalance and structural rearrangement to determine whether genes located in these genomic regions are subject to alterations in gene expression. Such combinatorial studies may help to identify recurrent patterns of altered gene expression in the context of specific chromosomal changes.

Activation of Go-coupled dopamine D2 receptors inhibits ERK1/ERK2 in pituitary cells. A key step in the transcriptional suppression of the prolactin gene.

In pituitary lactotrophs the prolactin gene is stimulated by neuropeptides and estrogen and is suppressed by dopamine via D2-type receptors. Stimulatory signals converge on activation of the mitogen-activated protein kinases ERK1/2, but dopamine regulation of this pathway is not well defined. Paradoxically, D2 agonists activate ERK1/2 in many cell types.

Production of cysteinyl-dopamine during intravenous dopamine therapy.

Background: Oxidized dopamine rapidly forms thiol-conjugates with --SH groups on cysteine, glutathione, and proteins. We used cysteinyl-dopamine production as an index of thioester production during intravenous dopamine treatment of critically ill patients.

Methods: Cysteinyl-dopamine and catecholamines were measured by high-performance liquid chromatography with electrochemical detection.

The rational clinical examination. Does this patient have aortic regurgitation?

Objective: To review evidence as to the precision and accuracy of clinical examination for aortic regurgitation (AR).

Methods: We conducted a structured MEDLINE search of English-language articles (January 1966-July 1997), manually reviewed all reference lists of potentially relevant articles, and contacted authors of relevant studies for additional information. Each study (n = 16) was independently reviewed by both authors and graded for methodological quality.