International student mobility in diagnostic radiography: Benefits and pitfalls.

INTRODUCTION: International student mobility (ISM) is increasingly utilised in higher education to allow students the opportunity to engage authentically with cultures outside their own, providing an opportunity for self-growth. These growth opportunities often extend skills such as cultural competency, academic learning and self-efficacy, all of which are important skills for diagnostic radiography graduates. This study explores the motivations, benefits and pitfalls of an ISM program and highlights key considerations for academics considering organising a program within their own university. METHODS: This study utilised a combination of individual and small group interviews to collect data about diagnostic radiography students' motivations, perceived benefits and pitfalls of undertaking ISM. Data were analysed using reflexive thematic analysis and overarching themes were developed. RESULTS AND DISCUSSION: Three themes were developed from the data, challenges and uncertainty, personal growth, and support. Participants undertaking ISM faced challenges such as cultural differences, as well as feelings of uncertainty. Additionally, they highlighted the importance of organisation in mitigating these challenges. Despite the challenges faced, participants reported significant personal growth and success as a result of the program, integral to this success was the support of their peers and academic advisors. CONCLUSION: ISM programs may lead to enhanced employability of diagnostic radiography graduates, with integral skills such as teamwork, communication cultural competence being enhanced in participants. The role of support during ISM is integral to the success of the program. It is imperative for academics organising ISM programs at their institutions to deliberately consider the way in which radiography students are supported both before and during the program to enhance the experience and ensure outcomes are maximised.

Assessing evidence-based practice among Australian radiographers: A self-report survey.

INTRODUCTION: Evidence-based practice (EBP) is essential for ensuring the delivery of effective and efficient healthcare. Despite this, EBP is not always well implemented in the clinical environment. Evidence suggests that the application of EBP is likely impacted by healthcare workers' attitudes, knowledge and skills. While there has been a recent proliferation of international research examining diagnostic radiographers' attitudes towards, knowledge of and skills in EBP, no such research exists in an Australian context. METHODS: This study presents the results of a validated self-report survey, the evidence-based practice questionnaire (EBPQ), administered to Australian diagnostic radiographers. The data were described and aggregated means were calculated for each of the domains. Inferential statistical tests were computed, including Cronbach's alpha, Pearson's correlations and independent t-tests, and Kruskal-Wallis tests. RESULTS: The aggregated mean for the practice domain was 5.02 (SD 1.104), for the attitudes domain it was 5.41 (SD 1.169), and for the knowledge and skills domain, it was 5.20 (SD 1.177) on a seven-point scale. Significant associations were identified among these domains, with individuals holding higher qualifications and occupying leadership positions more likely to score higher. Additionally, the modality in which an individual primarily practiced appeared to also have an impact on their score. However, no significant correlation was found between any domain and the number of years an individual had been practicing. CONCLUSION: This research has established a baseline of Australian diagnostic radiographers' practices, knowledge skills and attitudes towards evidence-based practice. IMPLICATIONS FOR PRACTICE: This baseline can inform the development of interventions aimed at enhancing the role of evidence-based practice in the sampled population.

Can simulation-based education or other education interventions replace clinical placement in medical radiation sciences? A narrative review.

OBJECTIVES: In response to increasing student enrolment and workload pressures from the Covid-19 pandemic, a recent focus on health student preparation programs has been on curricula adaptations and replacement of clinical placement time with alternative education activities. The aim of the narrative review was to explore the current evidence relating to education activities in Medical Radiation Sciences (MRS) used to replace clinical placements or part of clinical placements. Medline, CINAHL and Web of Science databases were used to search for articles published between 2017 and 2022. Data from the literature was summarised into (1) planning and development of clinical replacement learning activities in MRS, (2) evaluation of clinical replacement activities, and (3) benefits and challenges of clinical replacement in MRS. KEY FINDINGS: Planning and development of clinical replacement learning activities in MRSrequires support from a wide range of stakeholders, and evidence from activities already implemented exists. Activities largely encompass an institution-specific focus. Developed clinical replacement activities use a blended approach, with simulation-based education (SBE) as a main teaching platform. Evaluation of clinical replacement activities are largely focused on students' achievement of learning objectives relating to practical and communication skills. Emerging evidence based on small student samples shows that clinical and clinical replacement activities provide similar results in terms of learning objectives. CONCLUSION: Benefits and challenges of clinical replacement in MRS are similar to those presented in the other health professions. The balance between quality and quantity of teaching and learning experiences for clinical skill development in MRS needs to be further investigated. IMPLICATIONS FOR PRACTICE: To meet the dynamic challenges of the health care environment and MRS profession, a major goal in the future will be to affirm the benefit of clinical replacement activities for MRS students.

Knowledge translation: Radiographers compared to other healthcare professionals.

OBJECTIVES: This narrative review examines the current status of evidence-based practice and knowledge translation in diagnostic radiography. It explores knowledge translation efforts in the allied health professions aimed at systematically implementing evidence-based practice and suggests ways that these may be applied within diagnostic radiography. KEY FINDINGS: Knowledge translation in diagnostic radiography is in its infancy with numerous examples of key findings of rigorous studies not implemented in practice. Utilising frameworks, models and theories to systematically translate knowledge into evidence-based practice has been shown to be effective in other allied health professions. Whilst few studies in diagnostic radiography report utilising these systematic approaches to implementing evidence-based practice, those that do, show promising results. Attitudes towards evidence-based practice within diagnostic radiography are becoming more positive and it is important to use this positive shift in attitudes to create real evidence-based change in the profession. CONCLUSION: The potential benefits of systematically translating knowledge into evidence-based practice in diagnostic radiography are wide reaching with positive implications for our patients, the profession and wider community. Leaders at all levels of radiography must work towards implementing evidence-based practice in their daily work. IMPLICATIONS FOR PRACTICE: Systematic approaches to knowledge translation should be adopted and reported in diagnostic radiography in order to more effectively translate knowledge into evidence-based practice.

Obstructive sleep apnea syndrome in the pediatric age: the role of the pneumologist.

OBJECTIVE: This review paper aims to summarize the current state of knowledge on the role of the pneumologist in the diagnosis and respiratory treatment of children affected by obstructive Sleep Disordered Breathing (SDB). MATERIALS AND METHODS: A literature review has been performed on the following topics: obstructive SDB and its clinical entities, indications for respiratory treatment of pediatric SDB, and Continuous Positive Airway Pressure (CPAP) and Noninvasive Positive Pressure Ventilation (NIPPV) treatment approach to obstructive SDB. RESULTS: OSDB is related to obesity, craniofacial pathologies, neuromuscular disorders and, most commonly, oadenotonsillar hypertrophy. Adenotonsillectomy is the first-choice treatment in children with obstructive apnea secondary to adenotonsillar hypertrophy. CPAP and NIPPV are recommended in cases where Obstructive Sleep Apnea (OSA) persists after surgery or when surgery is contraindicated. Treatment interventions are usually implemented gradually by separately addressing each abnormality that would predispose to obstructive SDB, then reevaluating after each intervention to detect any residual disease and to assess the need for additional treatment. CONCLUSIONS: Many pediatric patients continue to experience problems and symptoms such as hypersomnia and apnea after adenotonsillectomy and need CPAP/NIPPV treatment. Current knowledge is still incomplete, especially with regard to the mechanisms of pathogenesis of pediatric OSA, the factors affecting pediatric OSA, and the phenotypic variability of the disease. A better understanding of these aspects would contribute to the development of new therapies.

Direct measurement of DNA-mediated adhesion between lipid bilayers.

Multivalent interactions between deformable mesoscopic units are ubiquitous in biology, where membrane macromolecules mediate the interactions between neighbouring living cells and between cells and solid substrates. Lately, analogous artificial materials have been synthesised by functionalising the outer surface of compliant Brownian units, for example emulsion droplets and lipid vesicles, with selective linkers, in particular short DNA sequences. This development extended the range of applicability of DNA as a selective glue, originally applied to solid nano and colloidal particles. On very deformable lipid vesicles, the coupling between statistical effects of multivalent interactions and mechanical deformation of the membranes gives rise to complex emergent behaviours, as we recently contributed to demonstrate [Parolini et al., Nat. Commun., 2015, 6, 5948]. Several aspects of the complex phenomenology observed in these systems still lack a quantitative experimental characterisation and a fundamental understanding. Here we focus on the DNA-mediated multivalent interactions of a single liposome adhering to a flat supported bilayer. This simplified geometry enables the estimate of the membrane tension induced by the DNA-mediated adhesive forces acting on the liposome. Our experimental investigation is completed by morphological measurements and the characterisation of the DNA-melting transition, probed by in situ Förster Resonant Energy Transfer spectroscopy. Experimental results are compared with the predictions of an analytical theory that couples the deformation of the vesicle to a full description of the statistical mechanics of mobile linkers. With at most one fitting parameter, our theory is capable of semi-quantitatively matching experimental data, confirming the quality of the underlying assumptions.

Fragmentation and depolymerization of non-covalently bonded filaments.

Protein molecules often self-assemble by means of non-covalent physical bonds to form extended filaments, such as amyloids, F-actin, intermediate filaments, and many others. The kinetics of filament growth is limited by the disassembly rate, at which inter-protein bonds break due to the thermal motion. Existing models often assume that the thermal dissociation of subunits occurs uniformly along the filament, or even preferentially in the middle, while the well-known propensity of F-actin to depolymerize from one end is mediated by biochemical factors. Here, we show for a very general (and generic) model, using Brownian dynamics simulations and theory, that the breakup location along the filament is strongly controlled by the asymmetry of the binding force about the minimum, as well as by the bending stiffness of the filament. We provide the basic connection between the features of the interaction potential between subunits and the breakup topology. With central-force (that is, fully flexible) bonds, the breakup rate is always maximum in the middle of the chain, whereas for semiflexible or stiff filaments this rate is either a minimum in the middle or flat. The emerging framework provides a unifying understanding of biopolymer fragmentation and depolymerization and recovers earlier results in its different limits.

Aggregation dynamics, structure, and mechanical properties of bigels.

Recently we have introduced bigels, inter-penetrating gels made of two different colloidal species. Even if particles with simple short-range isotropic potential are employed, the selective interactions enable the tunability of the self-assembly, leading to the formation of complex structures. In the present paper, we explore the non-equilibrium dynamics and the phenomenology underlying the kinetic arrest under quench and the formation of bigels. We demonstrate that the peculiar bigel kinetics can be described through an arrested spinodal decomposition driven by demixing of the colloidal species. The role played by the presence of a second colloidal species on the phase diagram, as expanded to account for the increased number of parameters, is clarified both via extensive numerical simulations and experiments. We provide details on the realisation of bigels, by means of DNA-coated colloids (DNACCs), and the consequent imaging techniques. Moreover we evidence, by comparison with the usual one-component gel formation, the emergence of controllable timescales in the aggregation of the bigels, whose final stages are also experimentally studied to provide morphological details. Finally, we use numerical models to simulate the bigel response to mechanical strain, highlighting how such a new material can bear significantly higher stress compared to the usual one-component gel. We conclude by discussing possible technological uses and by providing insights on the viable research steps to undertake for more complex and yet tuneable multi-component colloidal systems.

Sarcoidosis of the breast: a rare case report and a review.

Sarcoidosis is an idiopathic systemic inflammatory granulomatous disorder comprised of epithelioid and multinucleated giant cells with little necrosis. It usually invades the lungs with fibrosis and may also involve lymph nodes, skin, liver, spleen, eyes, phalangeal bones, and parotid glands. Breast involvement is extremely rare, but, when present, it could be confused with a benign or, more important, a malignant neoplasm. We have reported a case of sarcoidosis of the breast in a 51 years old woman with systemic manifestations of sarcoidosis (arthralgias and uveitis) associated with a breast mass and with a clinical history of fibrocystic mastopathy. A chest X-ray and a Computed Tomography (CT), with raised serum levels of Angiotensin Converting Enzyme (ACE), were compatible with a diagnosis of sarcoidosis. The mammography and ultrasonogram showed a solitary little nodular lesion localized in the breast. A breast cancer in a patient with sarcoidosis? To answer this question, the patient performed breast surgery under general anaesthesia and bioptic microscopic examination showed a typical sarcoid granuloma.

[Idiopathic pulmonary hemosiderosis. Clinical and radiological assessment of re-exacerbation]. / Emosiderosi polmonare idiopatica. Valutazione clinica e radiologica della riacutizzazione.

Predominant characteristics of idiopathic pulmonary hemosiderosis (IPH), a rare pathology of unknown etiology, are recurrent alveolar hemorrhage, hemoptysis and iron deficiency anemia. No evidence of vascular disorders, infections, cancer, pulmonary embolus, veno-occlusive diseases must also be considered for the diagnosis. A case of chronic IPH with long asymptomatic periods and stages of riacutization with severe dyspnoea, high fever, cough with rusty coloured spitting, asthenia and serious respiratory insufficiency is described. The patient adds to our understanding in one of such riacutization in that she agreed to high-resolution computed tomography (HRCT) testing, in addition to common routine testing. It became possible to underline the importance of HRCT both in the diagnosis of IPH without hemoptysis, awaiting invasive investigations like fiberoptic bronchoscopy and lung biopsy, and in the clinical evaluation of the riacutization. Such analysis leads to forwarding the installment of the most appropriate therapy and to the limitation of fibrotic evolution, when possible.

[Pulmonary involvement in sclerodermia]. / Interessamento polmonare in corso di sclerodermia.

Progressive systemic sclerosis (PSS) is a connective tissue disease characterized by fibrosis and thickness of cutis and subcutis (scleroderma) and deterioration of small arteries and capillary vessels, with changeable visceral renal, cardiac, intestinal and pulmonary involvements. The disease is characterized by cutaneous sclerosis, that is to say by the increase of consistence and thickness of cutis that lose her usual elasticity. The sclerosis can be limited to the fingers (sclerodactyly) or can involve otherwise (acrosclerosis); many other time is diffuse also to upper limbs and to thorax (diffuse scleroderma). The disease is rare and its incidence is variable from 2 to 10 x 10(6); more frequently hits women than men in the ratio of 3 to 1 or 8 to 1 (according to certain Authors). In the elderly is more frequently represented by the CREST syndrome (calcinosis, Raynaud's phenomenon, oesophageal dismotility, sclerodactyly, teleangiectasia). The authors have considered nine patients with pulmonary involvement of progressive systemic sclerosis: five with CREST syndrome and four with diffuse scleroderma. In addition to the common routine examinations, we performed chest radiography (CXR), pulmonary function tests, fiberoptic bronchoscopy and bronchoalveolar lavage (BAL), Gallium 67 scanning and high resolution computed tomography (HRCT) with the purpose to consider the role of these medical examinations in diagnosis and the follow-up of pulmonary involvement in scleroderma. From the results we have observed that: 1) in early disease chest radiography may be silent even if the patient shows a restrictive syndrome and reduction of diffusion capacity of carbon monoxide (DLCO); 2) chest radiography, pulmonary function tests and Gallium 67 scanning have traditionally been used to measure the degree of lung involvement in SSP but unfortunately, none of these reliably predicts disease activity or future course; 3) bronchoalveolar lavage shows the degree of lung inflammation (alveolitis) characterized by the increase of total BAL cell counts and by higher neutrophil cells in the initial stage of the disease; 4) even HRCT shows in this stage, the typical aspect of higher endoalveolar cellularity with ground glass appearance. With the progression of anatomical damage, there can be found even appearance of complete destruction of pulmonary architecture with the typical alteration of honeycomb. These findings support the hypothesis that a ground glass appearance on HRCT is the radiographic equivalent of alveolitis found in BAL. Furthermore HRCT shows itself useful in the follow-up the disease and in detecting of its activity condition.(ABSTRACT TRUNCATED AT 400 WORDS)

Effects of lacidipine and nifedipine on lower limb veins in nonphlebopathic patients.

The aim of this study was to evaluate the effect of lacidipine and nifedipine on lower limb veins. Forty hypertensive patients, aged 30-50 years, with no deep venous thrombosis, venous insufficiency, or hypothyroidism underwent double-blind treatment with placebo (1 week), lacidipine 4 mg once daily (1 week), and slow-release nifedipine 20 mg twice daily (1 week) in randomized sequence. Echo-color Doppler examination of superficial, deep, communicating, and perforating veins of the legs was performed. The results showed venous insufficiency and hypertension after 1-week administration of lacidipine (5 and 15%, respectively) and nifedipine (10 and 25%, respectively) and only two cases (5%) of venous hypertension during placebo administration. Lower limb edema was observed in two patients (5%) during treatment with nifedipine slow-release (SR). The hemodynamic effects of lacidipine and nifedipine were reversible but may contribute to the mechanism of lower limb edema.

Determination of arterial diameters, length and mass of the plaque, and theoretical volume in the internal carotid artery by quantitative vascular echography.

To study the evolution of atherosclerosis, the consensual changes that occur in the arterial wall, lumen, and atheroma must be evaluated. The authors propose a new, noninvasive method of obtaining arterial diameters, length and mass of plaque, and theoretical volume in the internal carotid artery. The study was performed in 37 patients with different degrees of atherosclerosis (from 20% to 50%). All patients underwent echo examination. Long-axis tomographic planes were recorded with the same angle of incidence by placing a goniometer around the neck. Furthermore, the arterial diameters and the plaque length were measured from photorecordings, and theoretical arterial volume (sum of two bitruncated semiellipsoids), residual volume (Simpson's integral rule), and plaque mass (difference between theoretical vascular volume and residual volume) were calculated. Intraobserver and interobserver variability and reproducibility were tested in all the measurements and calculations. Intraobserver/interobserver variability and reproducibility were found to be less than 8% according to all measurements and calculations. These results indicate that the method is reproducible and allows noninvasive, quantitative assessments of vascular geometry in evolving atherosclerosis.

The incidence of asymptomatic extracoronary atherosclerosis in patients with coronary atherosclerosis.

Atherosclerosis is a systemic vascular disease that can produce pathologies in any organ. The aim of this study was to evaluate the incidence of asymptomatic peripheral atherosclerosis (PA) in patients symptomatic for angina and myocardial infarction affected by coronary atherosclerosis (CAD). 315 patients (268 male and 47 female) aged between 36 and 69 years, asymptomatic for claudicatio and cerebral ischaemic disease, underwent selective coronary angiography to detect coronary stenosis > or = 50% and Echo-Color-Doppler examination of the epiaortic trunks and upper and lower limb arteries to detect peripheral stenosis > or = 30%. In the total population the incidence of PA in patients with CAD was 23% but in patients with trivascular CAD it was 32%. These data suggest that in patients with trivascular CAD it is necessary to investigate peripheral circulation as, also in asymptomatic patients, polydistrictual atherosclerosis was frequent.

Solid-phase time-resolved fluorescence detection of human immunodeficiency virus polymerase chain reaction amplification products.

A new assay system for the detection of polymerase chain reaction (PCR) amplification products is presented. This single-pot sandwich assay system employs solid-support oligonucleotide-coated capture beads, a rare earth metal chelate-labeled probe, and a time-resolved fluorescence detection. The new assay system was evaluated for various reaction conditions including, DNA denaturation time, hybridization salt concentration, probe concentration, and hybridization time, all of which are important in designing an assay with a high level of sensitivity for the detection of duplex DNA. This nonisotopic assay system was applied to the detection of purified human immunodeficiency virus (HIV) DNA and sensitivity was compared with agarose gel electrophoresis and slot blot hybridization using a 32P-labeled probe. We were able to detect the amplified product from one copy of HIV DNA after 35 cycles of PCR amplification in less than 30 min using this assay, which compared with one copy by gel electrophoresis after 40 cycles of PCR amplification and one copy by slot blot hybridization after 35 cycles of PCR amplification and an overnight exposure of the autoradiogram. Thus, this assay is rapid, sensitive, and easy to use.

[Echo-Doppler evaluation of the internal mammary artery bypass on the left coronary artery: a 4-year follow-up]. / Valutazione eco-Doppler del bypass di arteria mammaria interna su coronaria sinistra: 4 anni di follow-up.

In this study ultrasonographic techniques are suggested to monitor internal mammary artery bypass graft on the anterior descending coronary artery. One hundred and fourty patients were studied using 3 different ultrasonographic methods: zero-crossing continuous wave Doppler, fast Fourier transform (FFT) continuous wave Doppler and high resolution echo-Doppler. The patients underwent the ultrasonographic examinations 3 times a year for 4 years. By means of FFT Doppler analysis and echo-Doppler it was possible to perform the study in 138 patients and by zero-crossing system in 127 patients. Ultrasonographic techniques showed pathologies of the graft in 17 (13%) patients: 15 with obstructive pathologies and 2 with haemodetournament of the second intercostal artery.

[Blood acceleration is the principal factor in coronary flow increase during exercise test]. / L'accelerazione ematica è il principale fattore di aumento del flusso coronarico durante test da sforzo.

Continuous wave Doppler evaluation of the blood flow velocity in the internal mammary artery anastomosed to the left anterior descending coronary artery is a technique for assessing human coronary flow that shows a good reproducibility and lower change in Doppler angle between resting and supine exercise conditions. In this study the reciprocal changes which occur in coronary blood flow, coronary stroke volume, coronary resistance and blood pressure have been studied. During supine exercise coronary stroke volume remains constant and the increase of blood cells acceleration is necessary to have the shortening of cardiac cycle. This parameter is inversely dependent on the coronary resistances and directly dependent on blood pressure. As a consequence it plays the main role in increasing coronary blood flow during exercise.

Doppler continuous-wave analysis of grafted mammary artery as a non-invasive technique for static and dynamic assessment of coronary flow in man.

In this paper, Doppler continuous-wave analysis of blood velocity in the internal mammary artery, anastomosed to the left coronary vascular bed in humans who have undergone myocardial revascularization, is proposed as a non-invasive technique to study coronary blood flow during physiological procedures which cause it to change. Blood velocity curves obtained in normal and anastomosed internal mammary arteries were compared during hyperventilation and the Valsalva manoeuvre. During hyperventilation, blood velocity increased in the normal mammary but not in the anastomosed artery. During the expiratory effort of the Valsalva manoeuvre, the mean blood velocity decreased in the normal mammary artery but it did not change significantly in the anastomosed artery. Variations in the mean velocity were largely prevented by simultaneous and well-balanced increases and decreases in the diastolic and systolic velocities, respectively.