Radiologic Sciences Student Perceptions of Advisement.

PURPOSE: To investigate student perceptions of a structured advisement program. METHODS: Using a mixed-methods approach, 24 radiologic sciences students were surveyed in the initial and final semesters of the program to capture their perceptions of advisement practices. Quantitative data were analyzed for percentages and descriptive statistics, and qualitative responses were analyzed for emergent themes. RESULTS: Qualitative data analyses identified 3 themes: building relationships, strengthening student performance, and determining best practices for advisement. Quantitative data demonstrated that students appreciated the advisement process and acknowledged improvements in communication skills and the feedback loop. DISCUSSION: Advisement sessions can serve an important role in identifying areas where students can improve their performance. To grow and develop, students must understand their own strengths and weaknesses. Structured forms of advisement can serve as important tools to guide advisement conversations toward specific topics. CONCLUSION: The results of this study indicate that student advising is a vital component of radiologic sciences programs. Participants indicated that the advisement process helped them build relationships with faculty members and improved their overall performance.

Workplace Violence in Imaging Departments.

PURPOSE: To investigate the types and frequency of workplace violence experienced by radiologic technologists and to identify which technologists using specific imaging modalities are at increased risk. METHODS: A mixed-methods approach was employed using a research electronic data capture (REDCap; Vanderbilt University) survey designed to establish information on radiologic technologists' self-reported experiences with workplace violence. The survey was distributed to a random sample of 10 000 radiologic technologists working with various imaging disciplines. Participants (N = 193) were asked questions regarding personal and employment demographics, experiences with violence, and reporting and education practices. RESULTS: Radiologic technologists were shown to have experienced most workplace violence from patients or visitors. Among those surveyed, 50% or more reported being hit, bitten, called names, harassed, threatened, or having hair pulled by a patient. Verbal intimidation by patients, visitors, and others also was reported, with more than 50% experienced from visitors and more than 40% from patients, coworkers, radiologists, other physicians, or other health care providers. Statistical tests to evaluate a relationship between types of workplace violence and imaging modalities showed an association between name-calling by visitors and modality (P < .001). Results indicated that technologists performing computed tomography imaging, adult diagnostic imaging in the emergency department, and magnetic resonance imaging experienced the most frequent occurrences of name-calling by visitors. DISCUSSION: Workplace violence, which can affect a person mentally, physically, and emotionally, might occur in any work environment. In the health care setting, radiologic technologists might experience workplace violence originating from coworkers, other health care professionals, patients, visitors, or a combination of these sources. Therefore, a health care organization's acknowledgment of workplace violence and their resolve to prevent or reduce its occurrence is important. Providing sufficient human resources and adequate workplace violence education courses might be the first steps in eliminating workplace violence in the health care environment. CONCLUSION: Workplace violence creates an undesirable working environment, leading to negative implications for the health care worker and the patient. Education that details possible types of workplace violence and best practices for handling each type is key to protecting employees. This study provides a foundation for future quality improvement studies aimed at protecting the mental and physical health of imaging professionals.

An Investigation of MR Imaging Scanner Noise and its Effect on Technologists.

PURPOSE: To investigate the level of noise that magnetic resonance (MR) technologists are exposed to during daily tasks, and prevalence of hearing loss among MR technologists. METHODS: Decibel levels at the scanner control panel were measured and recorded at clinical facilities. A survey was distributed to MR technologists, which included questions about demographics, workplace habits, and self-reported hearing loss. RESULTS: Technologists are exposed to decibel levels higher than U.S. government recommended occupational limits; however, these are for very short periods, resulting in an average projected 8-hour noise dose of 1.68%. Statistical analysis of survey results showed no association between time spent working in an MR imaging department (P = .111); however, results did show an association between entering the scan room during image acquisition and hearing loss (P = .005). DISCUSSION: At times, technologists are exposed to decibel levels exceeding the U.S. Occupational Safety and Health Administration and the U.S. Food and Drug Administration recommended limits; however, the average findings indicate that there is a low risk of hearing damage from working at the control panel. Statistical analysis revealed an association between entering the scan room and hearing loss; therefore, individuals entering the scan room for any reason should be wearing hearing protection, even for short periods. CONCLUSION: Risks of exposure to high occupational decibel levels should be monitored continually. This study provides a foundation for future research studies, such as longitudinal analysis of hearing loss in MR technologists.

Familial Thoracic Aortic Dissection.

BACKGROUND: This case report details familial aortic dissection in 2 second-degree blood relatives who experienced sudden aortic dissections. One patient underwent emergency computed tomography angiography (CTA) and the other underwent magnetic resonance angiography (MRA). These imaging examinations were instrumental in revealing each patient's condition. One patient died of dissection rupture while being prepped for surgery. The other patient underwent surgery, recovered, and undergoes continual monitoring for the condition. DISCUSSION: A positive family history of aortic dissection should be considered in patients presenting with aortic emergencies. Many genes can contribute to this condition, with most genes relating to smooth muscle and connective tissue disorders. Imaging studies for evaluating and monitoring aortic dissection include transesophageal echocardiography, CTA, and MRA. Surgical treatment is possible for aortic dissection, with the goals being to stabilize the dissection and reduce the possibility of rupture. CONCLUSION: The mortality rate for aortic dissection is high, with the main cause of death being dissection rupture. Lifelong monitoring of survivors and first-degree relatives is recommended.

Rare Orbital Metastasis Originating From a Neuroendocrine Tumor.

BACKGROUND: This case study details a rare orbital metastasis originating from the gastrointestinal tract. A patient presented with proptosis of the right eye precipitated by a slow-growing orbital tumor. A biopsy confirmed a low-grade neuroendocrine tumor. Imaging studies were completed, with magnetic resonance (MR) imaging of the orbits providing the most detailed images of the mass. Fusion software images were created from the MR images and indium In 111 pentetreotide (octreoscan) studies, which confirmed the presence of the neuroendocrine carcinoid tumor. DISCUSSION: Orbital metastases are a rare condition associated with various symptoms, most commonly proptosis and diplopia. Imaging modalities, such as MR, computed tomography, and nuclear medicine technology, are instrumental in detecting and assessing these masses. Fusion imaging software can provide additional opportunities for facilities without hybrid scanners. The treatment of choice for orbital metastases is octreotide therapy; however, radiation therapy, partial or complete surgical removal of the tumor, and chemotherapy also are used. CONCLUSION: Traditional imaging techniques and fusion imaging techniques are essential for diagnosing and treating orbital metastases.

Quantitative Systems Pharmacology Model of hUGT1A1-modRNA Encoding for the UGT1A1 Enzyme to Treat Crigler-Najjar Syndrome Type 1.

Crigler-Najjar syndrome type 1 (CN1) is an autosomal recessive disease caused by a marked decrease in uridine-diphosphate-glucuronosyltransferase (UGT1A1) enzyme activity. Delivery of hUGT1A1-modRNA (a modified messenger RNA encoding for UGT1A1) as a lipid nanoparticle is anticipated to restore hepatic expression of UGT1A1, allowing normal glucuronidation and clearance of bilirubin in patients. To support translation from preclinical to clinical studies, and first-in-human studies, a quantitative systems pharmacology (QSP) model was developed. The QSP model was calibrated to plasma and liver mRNA, and total serum bilirubin in Gunn rats, an animal model of CN1. This QSP model adequately captured the observed plasma and liver biomarker behavior across a range of doses and dose regimens in Gunn rats. First-in-human dose projections made using the translated model indicated that 0.5 mg/kg Q4W dose should provide a clinically meaningful and sustained reduction of >5 mg/dL in total bilirubin levels.

GBCAs and Risk for Nephrogenic Systemic Fibrosis: A Literature Review.

PURPOSE: To examine the risks of using of gadolinium-based contrast agents (GBCAs) in magnetic resonance (MR) imaging and explore strategies to reduce the likeliness of adverse effects in patients who might be at risk for developing nephrogenic system fibrosis (NSF). METHODS: A search of 3 scholarly databases was performed to identify articles that discuss adverse reactions to GBCAs, specifically relating to kidney function, in MR examinations. A total of 20 peer-reviewed articles were analyzed. DISCUSSION: Safety of contrast media is related to the stability of the chelate bond (ie, macrocyclic or linear). Patients who have decreased kidney function or chronic kidney disease are at higher risk for an adverse reaction to GBCAs; typically, macrocyclic contrast agents are considered safer than linear contrast agents for patients at risk for developing NSF because of their higher kinetic stability. Recommended doses of gadolinium should be adhered to carefully for all patients in conjunction with the glomerular filtration rate guidelines for contrast administration defined by the American College of Radiology. CONCLUSION: Although there are advantages to contrast use in MR examinations, technologists should work closely with referring physicians and radiologists to minimize risks for developing NSF in patients who have decreased kidney function.

Connecting the innate and adaptive immune responses in mouse choroidal neovascularization via the anaphylatoxin C5a and γδT-cells.

Neovascular age-related macular degeneration (AMD) is characterized by choroidal neovascularization (CNV). An overactive complement system is associated with AMD pathogenesis, and serum pro-inflammatory cytokines, including IL-17, are elevated in AMD patients. IL-17 is produced by complement C5a-receptor-expressing T-cells. In murine CNV, infiltrating γδT- rather than Th17-cells produce the IL-17 measurable in lesioned eyes. Here we asked whether C5a generated locally in response to CNV recruits IL-17-producing T-cells to the eye. CNV lesions were generated using laser photocoagulation and quantified by imaging; T-lymphocytes were characterized by QRT-PCR. CNV resulted in an increase in splenic IL-17-producing γδT- and Th17-cells; yet in the CNV eye, only elevated levels of γδT-cells were observed. Systemic administration of anti-C5- or anti-C5a-blocking antibodies blunted the CNV-induced production of splenic Th17- and γδT-cells, reduced CNV size and eliminated ocular γδT-cell infiltration. In ARPE-19 cell monolayers, IL-17 triggered a pro-inflammatory state; and splenocyte proliferation was elevated in response to ocular proteins. Thus, we demonstrated that CNV lesions trigger a systemic immune response, augmenting local ocular inflammation via the infiltration of IL-17-producing γδT-cells, which are presumably recruited to the eye in a C5a-dependent manner. Understanding the complexity of complement-mediated pathological mechanisms will aid in the development of an AMD treatment.

Intrapopulation genome size variation in D. melanogaster reflects life history variation and plasticity.

We determined female genome sizes using flow cytometry for 211 Drosophila melanogaster sequenced inbred strains from the Drosophila Genetic Reference Panel, and found significant conspecific and intrapopulation variation in genome size. We also compared several life history traits for 25 lines with large and 25 lines with small genomes in three thermal environments, and found that genome size as well as genome size by temperature interactions significantly correlated with survival to pupation and adulthood, time to pupation, female pupal mass, and female eclosion rates. Genome size accounted for up to 23% of the variation in developmental phenotypes, but the contribution of genome size to variation in life history traits was plastic and varied according to the thermal environment. Expression data implicate differences in metabolism that correspond to genome size variation. These results indicate that significant genome size variation exists within D. melanogaster and this variation may impact the evolutionary ecology of the species. Genome size variation accounts for a significant portion of life history variation in an environmentally dependent manner, suggesting that potential fitness effects associated with genome size variation also depend on environmental conditions.

Data from 11 years of molecular typing infectious bronchitis virus field isolates.

In 1993, a new molecular typing method for infectious bronchitis virus (IBV) was introduced. This method uses reverse transcriptase-polymerase chain reaction (RT-PCR) and restriction fragment length polymorphism (RFLP) analysis of the spike gene to obtain RFLP patterns that correlate with serotype. Using that test at the Poultry Diagnostic and Research Center (PDRC, University of Georgia, Athens, GA), we have identified a total of 1523 IBV isolates in the past 11 yr. The data were obtained from clinical samples submitted to our laboratory from birds with clinical signs characteristic of IBV infection. The samples are primarily from the southeastern United States but are also from many other states as well as from outside the United States. Most of the isolations occurred during July, followed by May, April, November, October, and January. The fewest number of isolates identified on an annual basis was 20 in 2003. An unusually high number of isolations occurred in 1997 (318 isolations) and 1999 (246 isolations), which coincided with the GAV variant virus and GA98 variant virus outbreaks respectively. By far, the Ark-DPI strain was the most frequently identified type of IBV and ranged from 23% to 65% of total isolations per year. Ark-like isolates, defined as having a similar but unique RFLP pattern from the Ark-DPI vaccine strain were identified every year of the study except in 1996. In addition, new Ark-like isolates continued to emerge each year (except in the year 2000) beginning in 1997, reflecting the ability of that IBV type to undergo genetic drift. Eighty-two different variant viruses were identified although only two (GAV and GA98) became persistent and caused widespread disease. Some viruses tended to be geographically restricted to a given area (CAV in California and MX97-8147 in Mexico), whereas others were widespread (Ark-DPI, Conn, DE072, and Mass). The Florida, Gray, Holte, Iowa, and JMK types were not detected during the 11-yr period, and no foreign virus types were detected in the United States. These data show that IBV variant viruses are consistently circulating in commercial poultry and are capable of causing disease outbreaks. Our observations highlight the importance of constantly monitoring IBV as well as other coronaviruses like severe acute respiratory syndrome-coronavirus that have the ability to change and emerge to cause disease in a susceptible host.