Intimate Partner Violence and the Role of Child Maltreatment and Neighborhood Violence: A Retrospective Study of African American and US Caribbean Black Women.

Background: Research suggests that intimate partner violence (IPV) is associated with childhood maltreatment and violence exposure within the neighborhood context. This study examined the role of child maltreatment and violence exposure on intimate partner violence, with the moderating effects of mental disorders (IPV) among US Black women. Methods: Data from the National Survey of American Life (NSAL), the largest and most complete sample on the mental health of US Blacks, and the first representative sample of Caribbean Blacks residing in the United States was used to address the study objectives. Descriptive statistics, chi-square test of independence, t-test, and logistic regression procedures were used to analyze the data. Results: Bivariate results indicate an association between child abuse and intimate partner victimization among US Black women. Witnessing violence as a child as well as neighborhood violence exposure was also related to IPV but shown to differ between African American and Caribbean Black women. Multivariate findings confirmed the influence of mental disorders and social conditions on US Black women's risk for IPV. Moderating effects of child maltreatment and mental disorders in association with adult IPV were not found. Conclusions: The study addressed the short and long-term impact of child maltreatment and the contribution to the cycle of intimate violence among US Black women including African American and Caribbean Blacks. The study suggests the need for prevention and intervention efforts to improve structural conditions for at-risk populations and communities predisposed to violence and other negative outcomes. Possibilities for future research are also discussed.

Machine Learning-Based A Priori Chemotherapy Response Prediction in Breast Cancer Patients using Textural CT Biomarkers.

Early prediction of cancer response to neoadjuvant chemotherapy (NAC) could permit personalized treatment adjustments for patients, which would improve treatment outcomes and patient survival. For the first time, the efficiency of quantitative computed tomography (qCT) textural and second derivative of textural (SDT) features were investigated and compared in this study. It was demonstrated that intra-tumour heterogeneity can be probed through these biomarkers and used as chemotherapy tumour response predictors in breast cancer patients prior to the start of treatment. These features were used to develop a machine learning approach which provided promising results with cross-validated AUC0.632+, accuracy, sensitivity and specificity of 0.86, 81%, 74% and 88%, respectively.Clinical Relevance- The results obtained in this study demonstrate the potential of textural CT biomarkers as response predictors of standard NAC before treatment initiation.

SU-E-J-155: Evaluate a Stepped TE Segmented EPI Sequence for 3D Dose Monitoring Using Gel Dosimetry.

PROBLEM: Gel based MR relaxometry provides accurate 3D dosimetric mapping. The routinely used multi spin echo (MSE) sequence has limitations. Our aim was to evaluate a stepped TE segmented EPI sequence for 3D dose monitoring at 1.5T and 3T. METHODS: The polymer gel (BANG KIT, MGS Research) was prepared under normoxic conditions and stored in glass vials. Calibration was performed under dose range of 3-18 Gy with irradiation using the True Beam. Segmented Echo Planar Imaging Sequence was evaluated for T2 relaxometry at 1.5T and 3T (GE medical systems). The parameters of the stepped TE segmented Echo Planar Imaging Sequence were kept identical at both 1.5 and 3T: TE=15.6,27,39,51,63,75,87,99 ms; TR= 4000ms; FOV=22*22;Slice thk/gap: 3/3; # Shots=14; Scan time=8 min. The MSE sequence parameters were set close to the EPI sequence on both scanners (scan time: 18 mins). RESULTS: The EPI image quality at 1.5 T was comparable to MSE sequence; at 3T ghosting artifacts could be seen in EPI images. The log linear plot of signal intensities of the segmented EPI sequence for irradiation in the range 0-20 Gy is shown at 1.5 and 3T (fig 1 & 2). The T2 values agreed with that of corresponding MSE sequences at both 1.5 and 3Tand the fit was much better using the segmented EPI sequence than the MSE sequences. The dose calibration factor,a, was similar for all the sequences (fig. 3- 3T a: MSE=0.93, EPI=0.99; fig.4- 1.5T a: MSE=0.79, EPI=0.95) Conclusions: The EPI image quality at 1.5T was comparable to MSE. The dose calibration factor evaluated with the EPI sequences was comparable at 1.5T and 3T and close to the MSE sequence. Acquisition time of EPI is less than half of MSE sequence with more flexibility in choice of TEs .The study establishes EPI as a novel sequence for dose mapping.

Medical education in Maharashtra: the student perspective.

BACKGROUND: There is hardly any structured study reporting the perspective of medical students, with regard to the medical education system in Maharashtra, which is facing challenges. AIM: A perception study of students was conducted to explore the situation, challenges, and consequent solutions of medical education in Maharashtra. SETTINGS AND DESIGN: A descriptive perception study. MATERIALS AND METHODS: A structured questionnaire was e-mailed to 92 students, and interviews with seven key-informants comprising of faculty, administrators, and policy makers were conducted, to gather qualitative insights. RESULTS: Thirty-seven student replies were received and analyzed. The satisfaction level of student respondents for various factors was as follows: infrastructure 18/37 (48.6%), quality of teaching 14/37 (37.8%), patient population 22/37 (59.5%), and administration 8/37 (21.6%). Ninety-two percent (34/37) of the students stated that the fundamental problem was the inability of the system to attract good, quality teachers. The reasons stated were low salaries, low level of job satisfaction, high level of bureaucracy, and high work load. CONCLUSIONS: The medical education system in Maharashtra is viewed as being stagnant. The respondents emphasized an urgent need for educational reforms, which should include better compensation for teachers, sharing of facilities between government and private medical colleges, and improved efficiency of the Medical Council of India. In the long run a public-private mix with sharing of resources may be a plausible solution.

Familial mitochondrial encephalomyopathy with stroke-like episodes and episodic disturbances of consciousness: a study of pedigree including three generations with multisystemic abnormalities.

We report here two cases in a family with pleomorphic clinical features which include mitochondrial myopathy, encephalopathy, stroke-like episodes, episodic disturbances of consciousness and other multisystemic abnormalities. The other signs observed in multisystemic abnormalities were ophthalmoplegia, short stature, diabetes mellitus, diabetes insipidus, renal dysfunction, optic atrophy, retinal degeneration, impairment of hearing and mental retardation or deterioration. A symptomatological variation was observed in cases in the same family. It is suggested that these widely varying symptoms may be expressions caused by a common biochemical defect which involves different tissues in different individuals in the family. The syndromes observed in the present cases were compared with other possibly-related mitochondrial encephalomyopathies.

Early congenital syphilis: clinico-radiologic features in 202 patients.

Venereal syphilis is highly prevalent among women of child-bearing age in Zambia. It is estimated to contribute 25-30% of the perinatal mortality rate of 50 per 1,000 births at the University Teaching Hospital in Lusaka. Because of multisystem involvement, early congenital syphilis, the offshoot of maternal syphilis, has varied criteria for its diagnosis. Therefore, in an attempt to draw guidelines for an easier and more reliable diagnosis, the authors analyzed the clinico-radiologic features of congenital syphilis in 202 patients. Although all infants were under the age of six months, there were several significant differences in the manifestations of the disease among neonates and the postneonates. The younger infants had a higher incidence of jaundice and mortality, whereas joint swellings, skin rash, snuffles, anemia, and periosteal reaction visible in x-rays of long bones were typical findings among the older group. The radiologic changes were seen in greater than 95% of patients in both groups. About 84% of mothers had attended prenatal clinics, but less than 20% of the women had been tested for syphilis. Since early congenital syphilis is common in many parts of the world and since all serologic tests have limitations, awareness of appropriate diagnostic criteria is recommended for all medical personnel.

Parotitis with secondary syphilis: a case report.

Painless swelling of the parotid salivary gland was observed in a patient presenting with secondary syphilis. This case is of special interest to venereologists and surgeons as parotitis associated with syphilis may be mistaken for common tumours of the parotid glands. A diagnosis of syphilitic parotitis should be considered in patients presenting with swollen parotid salivary glands in countries where syphilis is prevalent.