ABSTRACT
Aims: Insufficient exposure of students to neurosurgery and neuroradiology has often been a matter of concern in medical schools across USA, Canada, UK and Europe. When taking into account the high incidence and mortality from head injuries in the form of subarachnoid and intracranial haemorrhages, it becomes evident that core knowledge in basic neurosurgical imaging and diagnoses need to be an essential part of medical training. The aim of this pilot study was to investigate the level of basic neurosurgical knowledge with regard to image interpretation in interns who were in their first postgraduate year in New Zealand. Study Design: Clinical and educational research paper. Place and Duration of Study: Wellington, New Zealand from January 2011 to January 2012. Methodology: Fifty interns in their first postgraduate year were invited to complete a neurosurgical imaging questionnaire with images of common neurosurgical findings (obvious subarachnoid and intracranial haemorrhages) randomly mixed with normal studies. Five computerized tomography (CT) scan images were required to be matched to five diagnoses. Results: All respondents agreed to participate. The mean score for the all 50 interns was 40% (95% CI 37.3 - 42.4), with a range of 0 to 80%. Thirty-six interns (72%) had a score of less than 60% and thus failed to demonstrate basic competency on the examination. None of the interns scored a full 100%. Conclusion: This study suggests that only 28% of newly qualified New Zealand doctors were able to demonstrate a basic level of competence in the evaluation of neurosurgical imaging at the start of their internship. Improvement of the undergraduate neurosurgical curriculum is strongly suggested.
ABSTRACT
Susceptibility to UV irradiation of B. cereus BIS-59 spores undergoing germination at various stages-dormant spores to vegetative cell stage and their ability to recover from radiation damage were studied. For a given dose of radiation, the number of spore photoproducts (SPP) formed in the DNA of dormant spores was about 5-times greater than that of thymine dimers (TT) formed in the DNA of vegetative cells. At intermediate stages of the germination cycle, there was a rapid decline in the UV radiation-induced SPP formed in DNA with a concomitant increase in the UV radiation-induced TT formed in DNA. Bacterial spores undergoing germination (up to 3 hr) in the low nutrient medium (0.3% yeast extract) displayed much higher resistance to UV radiation than those germinating in the rich nutrient medium, even though there was no discernible difference under the two incubation conditions in respect of the extent of germination and the time at which the outgrowth stage appeared (3 hr). This was due to the formation TT in the DNA of spores germinating in the low nutrient as compared to that of spores germinating in the rich-nutrient medium. In UV-irradiated dormant spores, SPP formed in the spore DNA did not disappear even after prolonged incubation in the non-germinating medium. However, when the UV-irradiated dormant spores were germinated in low or rich nutrient medium, a significant proportion of SPP in DNA was eliminated. The dormant spores incubated in either of the germinating media for 15 min and then UV-irradiated were capable of eliminating SPP (presumably by monomerization) even by incubation in a non-germinating medium and in the complete absence of protein synthesis (buffer holding recovery), thereby implying that spore-repair enzymes were activated in response to initial's germination. The acquisition of photo-reactivation ability appeared in spores subjected to germination only in the rich-nutrient medium at the outgrowth stage and required de novo synthesis of the required enzymes.