Verification on the Developmental Toxicity of Short-term Exposure to Phenol in Rats

Objective To verify the health advisory for short-term exposure to phenol.Methods The method of this validation experiment was the same as the US Environmental Protection Agency(EPA)methodology for toxicology experiments used to determine phenol drinking water equivalent level(DWEL).Pregnant female Sprague-Dawley rats were administered phenol in distilled water by gavage at daily doses of 15,30,60,120,and 240 mg/kg body weight(b.w.)from implantation(the 6 th day post-mating)to the day prior to the scheduled caesarean section(the 20th day of pregnancy).The following information was recorded:general behavior;body weight;number of corpus luteum,live birth,fetus,stillbirth,and implantation;fetal gender;body weight;body length;tail length;and abnormalities and pathomorphological changes in the dams.Results In the 60 mg/kg b.w.dose group,the mortality of pregnant rats increased with increasing doses,suggesting maternal toxicity.Fetal and placental weights decreased as phenol dose increased from30 mg/kg b.w.,and were significantly different compared those in the vehicle control group,which suggested developmental toxicity in the fetuses.However,the phenol-exposed groups showed no significant change in other parameters compared with the vehicle control group(P>0.05).Conclusion Despite using the same method as the US EPA,a different NOEAL of 15 mg/(kg·d)was obtained in this study.

The value of toxicological analysis in acute poisoning patients with uncertain exposure histories:a retrospective and descriptive study from an institute of poisoning

BACKGROUND:In clinical practice,some patients might not be able or unwilling to provide a thorough history of medication and poison exposure.The aim of this study was to use toxicological analysis to examine the clinical characteristics of patients with acute poisoning whose exposure history was uncertain from a toxicological analysis perspective.METHODS:This was a retrospective and descriptive study from an institute of poisoning.Patient registration information and test reports spanning the period from April 1,2020 to March 31,2022,were obtained.Patients with uncertain exposure histories and who underwent toxicological analysis were included.Clinical manifestations and categories of toxics were analyzed.RESULTS:Among the 195 patients with positive toxicological analysis results,the main causes of uncertain exposure history was disturbance of consciousness(62.6%),unawareness(23.6%)and unwillingness or lack of cooperation(13.8%).The predominant clinical manifestations were disturbed consciousness(62.6%),followed by vomiting and nausea(14.4%)and liver function abnormalities(8.7%).A comparison of clinical manifestations between patients with positive and negative(n=99)toxicological analyses results revealed significantly different proportions of disturbances in consciousness(63%vs.21%),dizziness(1.5%vs.5.1%),multi-organ failure(1.5%vs.7.1%),and local pain(0 vs 4%).The main categories of substances involved were psychiatric medications(23.1%),sedatives(20.5%),insecticides(13.8%),and herbicides(12.8%).CONCLUSION:The clinical manifestations of acute poisoning in patients with an uncertain exposure history are diverse and nonspecific,and toxicological analysis plays a pivotal role in the diagnosis and differential diagnosis of such patients.

Comprehensive analysis of advanced glycation end-products in commonly consumed foods:presenting a database for dietary AGEs and associated exposure assessment

Advanced glycation end-products(AGEs)are a group of heterogeneous compounds formed in heatprocessed foods and are proven to be detrimental to human health.Currently,there is no comprehensive database for AGEs in foods that covers the entire range of food categories,which limits the accurate risk assessment of dietary AGEs in human diseases.In this study,we first established an isotope dilution UHPLCQq Q-MS/MS-based method for simultaneous quantification of 10 major AGEs in foods.The contents of these AGEs were detected in 334 foods covering all main groups consumed in Western and Chinese populations.Nε-Carboxymethyllysine,methylglyoxal-derived hydroimidazolone isomers,and glyoxal-derived hydroimidazolone-1 are predominant AGEs found in most foodstuffs.Total amounts of AGEs were high in processed nuts,bakery products,and certain types of cereals and meats(>150 mg/kg),while low in dairy products,vegetables,fruits,and beverages(<40 mg/kg).Assessment of estimated daily intake implied that the contribution of food groups to daily AGE intake varied a lot under different eating patterns,and selection of high-AGE foods leads to up to a 2.7-fold higher intake of AGEs through daily meals.The presented AGE database allows accurate assessment of dietary exposure to these glycotoxins to explore their physiological impacts on human health.

The Influence of Aerial Exposure on Sea Anemones Aulactinia veratra Mucin Genes Expression Using the RNA Sequencing

Mucin genes are the main component of mucus. The sea anemone species, Aulactinia veratra (Phylum Cnidaria) contains different types of mucin genes. In the intertidal zone, A. veratra is found to be exposed to air during the low tide and produces large quantities of mucus as an external covering. The relation between low tide and mucus secretion is still unclear, and what is the role of mucin during arial exposure is not yet investigated. This study hypothesised that the mucin genes in A. veratra would have significantly high expression in response to aerial exposure. Therefore, the aim of current study was to examine and analyses the response of A. veratra mucins in response to an experiment involving three hours of aerial exposure. To achieve this, aim the RNA-sequencing and bioinformatics analyses were used to examine the expression profile of A. veratra mucin genes in response to aerial exposure. The generated results have shown that, Mucin4-like and mucin5B-like were up-regulated in response to the three hours of aerial exposure in A. veratra. This finding shows a significant role of mucin5B-like and mucin4-like genes in response to air stress at low tide. The data generated from this study could be used in conjunction with future mucin gene studies of sea anemones and other cnidarians to compare A. veratra mucin gene expression results across time, and to extend our understanding of mucin stress response in this phylum.

Spatial Optimization Strategies for High Temperature Heat Exposure Based on Thermally Vulnerable Populations and Case Studies

The objective of this study is to investigate the factors that contribute to brittleness and to identify strategies for mitigating these factors in populations with varying degrees of thermal vulnerability,based on the potential impact of extreme heat exposure on human survival and habitability.The physiological condition of lower adaptability to high temperature environments and the assessment of individuals who may have higher tolerance time in high temperature environments based on spatial perspectives suggest the need for targeted spatial optimization strategies for commuters and disadvantaged populations.This is demonstrated through a case study.These optimization measures encompass a variety of aspects,including the integration of transportation systems,the expansion of grey space corridors,the improvement of green space layout,and the implantation of green infrastructure.The study aims to reduce the exposure time of thermally vulnerable individuals to high temperature environments through spatial optimization strategies,to enhance the resilience of urban green spaces to heat stress,and to reduce the probability of heat-wave occurrence.

Assessment of Heavy Metal Exposure in Soils of Ihwrekreka Communities, Delta State, Nigeria

Crude oil pollution in the Niger Delta, perpetrated by both local communities and industrial actors, has brought about soil pollution with its consequent ecological, human health and food challenges. The purpose of this research was to examine the concentration and distribution of heavy metals in soil from communities contaminated by crude oil in Niger Delta, and to evaluate the potential health risks to residents from exposure to these contaminants. To achieve this, soil samples were collected from the Ihwrekreka community and analyzed for heavy metal content using inductively coupled plasma mass spectrometry (ICP-MS). The analytical results in mg/kg revealed a significant metals pollution level derived from the oil spill in the soil ranging from 4.85 - 17,078 (Cu), 1.01 - 16.1 (Cd), 0.22 - 36.8 (Cr), 8.28 - 40.9 (Ni), 7.51 - 6474 (Pb), and 8.84 - 12,851 (Zn) respectively. Most of the metals were above the permissible limits of World Health Organization, with Cu, Zn, and Pb as the most contaminating metals. Lead was found to be the main contributor to the hazard index (HI) values for both children and adults in the study area, with its concentration exceeding the permitted limits set by the WHO and the EC. The hazard index (HI) values of Pb, Cu, Zn, Cd, Ni, and Cr were significantly higher than 1. These findings suggest that the release of heavy metals from an oil-contaminated site may pose a risk to human health and the environment.

Autonomous VR Exposure Therapy for Anxiety Disorders Using Conversational AI—Ethical and Technical Implications and Preliminary Results

The need for psychotherapy is very high and the lack of care causes a lot of suffering and high costs. This paper presents an interdisciplinary approach to creating an AI-guided exposure therapy for fear of heights in virtual reality (VR). First, ethical principles for the use of conversational AI in psychotherapy were translated into technical requirements and made measurable. Based on this, an autonomous virtual reality exposure therapy was iteratively developed with a therapist. The feasibility and implementation of the ethical principles were tested with a patient. The patient was very satisfied with the VR setup. The AI therapist was also rated positively, although there is still room for improvement regarding conversational skills. Overall, the paper shows how AI can contribute responsibly to improving the psycho-therapeutic supply. It also provides guidelines that make ethical principles tangible and measurable for developers.

Recent urbanization increases exposure to humid-heat extreme events over populated regions of China

目前对于高温的研究主要侧重于干热,针对湿热的研究相对较少,但它通常会造成更大的社会影响,尤其对人体健康的威胁.已有研究证实,当环境湿球温度超过35℃时,它会破坏人体正常生理代谢,进而威胁人体健康.本研究指出在过去四十年,中国区域日最高湿球温度几乎没有超过35℃,但部分地区日最高湿球温度超过了30℃,主要集中在中国的人口密集区,包括华东,华南和四川盆地等.进一步分析发现,中国区域近期的快速城市化加剧了极端湿热事件的社会影响,城市地区暴露于极端湿热事件的范围的增加速率明显大于其他地区,这也意味着快速城市化使得人口密集区暴露于极端湿热事件的风险明显增加.初步估算指出,自2000年以来,中国区域暴露于极端湿热事件的人口数以每年每天约3100人次的速率显著增加.

A systematic review of occupational exposure to respirable coal mine dust(RCMD)in the U.S.mining industry

Cumulative inhalation of respirable coal mine dust(RCMD)can lead to severe lung diseases,including coal worker's pneu-moconiosis(CWP),silicosis,mixed dust pneumoconiosis,dust-related diffuse fibrosis(DDF),and progressive massive fibrosis(PMF).Statistics from the number of reported cases showed a significant decrease in the progression of respiratory diseases in the 1990s.However,an unexpected increase in the number of CWP cases was reported in the late 1990s.To date,there has been no comprehensive systematic review to assess all contributing factors to the resurgence of CWP cases.This study aims to investigate the effects of various mining parameters on the prevalence of CWP in coal mines.A systematic review using the preferred reporting items for systematic reviews and meta-analysis(PRISMA)method was conducted to investigate the health effects of RCMD exposure and identify the factors that may contribute to the recent resurgence of CWP cases.The systematic review yielded a total of 401 papers,which were added to the database.The total number of 148 and 208 papers were excluded from the database in the process of screening and eligibility,respectively.Then,18 papers were considered for data selection and full-text assessment.The review revealed that factors including geographic location,mine size,mining operation type,coal-seam thickness,coal rank,changes in mining practices,technology advancement,and engi-neering dust control practices are contributing to the recent resurgence of CWP among coal workers.However,the evidence for root causes is limited owing to the methodological constraints of the studies;therefore,further detailed studies are needed.

Radiation Exposure for Patients and Staff during Different Interventional Procedures Using Anthropomorphic Phantoms:A Complete Evaluation of Different Body Regions

Interventional radiological procedures performed under the guidance of X-ray imaging tools are widely used to diagnose and treat various conditions.However,radiation exposure can result in many health problems,including cataracts,skin necrosis,radiation burns,hair loss,birth defects,and cancer^([1-2]).Patient exposure during an interventional radiology procedure involves a wide dose range and can reach a level at which deterministic effects may occur^([3]).Although knowledge of radiation safety has greatly improved over the past century,radiation exposure in the healthcare environment remains a risk to both patients and medical professionals.Recently,given the increasing number of interventions and complexity of cases,there has been growing concern about the radiation exposure of patients and surgical personnel.Therefore,a special evaluation of the exposure of patients and medical staff is necessary to ensure their protection.

RF-Net: Unsupervised Low-Light Image Enhancement Based on Retinex and Exposure Fusion

Low-light image enhancement methods have limitations in addressing issues such as color distortion,lack of vibrancy,and uneven light distribution and often require paired training data.To address these issues,we propose a two-stage unsupervised low-light image enhancement algorithm called Retinex and Exposure Fusion Network(RFNet),which can overcome the problems of over-enhancement of the high dynamic range and under-enhancement of the low dynamic range in existing enhancement algorithms.This algorithm can better manage the challenges brought about by complex environments in real-world scenarios by training with unpaired low-light images and regular-light images.In the first stage,we design a multi-scale feature extraction module based on Retinex theory,capable of extracting details and structural information at different scales to generate high-quality illumination and reflection images.In the second stage,an exposure image generator is designed through the camera response mechanism function to acquire exposure images containing more dark features,and the generated images are fused with the original input images to complete the low-light image enhancement.Experiments show the effectiveness and rationality of each module designed in this paper.And the method reconstructs the details of contrast and color distribution,outperforms the current state-of-the-art methods in both qualitative and quantitative metrics,and shows excellent performance in the real world.

Assessment of Asbestos Exposure Associated with a Brake Grinder

The wear patterns for drum-style automotive brakes tend to enlarge internal drum diameters. Such enlargement is most profound when used brake drums are machined to restore the metal friction surfaces. Specialized arc grinding machinery has been used to match replacement shoe-style brake friction materials to enlarged drums. The process of arc grinding removes friction material, thereby producing dust. When organic-style friction materials contained asbestos, use of arc grinding machinery posed an asbestos fiber exposure risk to operators and proximate personnel. The manufacturers of arc grinding machinery have incorporated local exhaust ventilation systems designed to capture and remove this dust at the point of grinding contact and propel this dust into collection bags or other systems. This research was designed to evaluate the dust capture and retention characteristics of a specific arc grinder product, when used to custom grind asbestos-containing brake friction materials. A Bear Model 1420 automotive brake shoe arc grinder was the subject of this study. During two separate but consecutive test sessions, newly relined sets of shoe-style automobile brake friction materials were precision ground. Both area and personal air samples were collected throughout each testing session. This work took place within a closed and unventilated metal building, with total interior volume of 2500 m3. Collected air samples were analyzed using phase contrast microscopy (PCM) and transmission electron microscopy (TEM). The results of analysis using PCM for personal samples (n = 6) ranged from <0.044 to 0.055 fibers per cc (f/cc) (mean 0.05). Follow-up analysis of these personal samples using TEM indicated asbestos-adjusted PCM exposures ranging from <0.0074 to 0.055 f/cc (mean ≤ 0.041). Area air samples, taken at distances ranging from 1.5 to 9 meters from the arc grinder (n = 12), showed asbestos-adjusted PCM concentrations ranging from <0.0075 to 0.041 f/cc (mean ≤ 0.017). The process of custom arc grinding shoe-style, asbestos-containing brake friction materials can cause exposure to airborne asbestos fibers. However, when done using properly equipped arc grinding machines, such exposures are not expected to exceed the current occupational exposure limits for asbestos of 0.1 f/cc 8-hour time-weighted average (TWA) or 1.0 f/cc 30-minute average.

Repeated methamphetamine exposure decreases plasma brain-derived neurotrophic factor levels in rhesus monkeys

Background Brain-derived neurotrophic factor(BDNF)is known to prevent methamphetamine(METH)-induced neurotoxicity and plays a role in various stages of METH addiction.However,there is a lack of research with longitudinal design on changes in plasma BDNF levels in active METH-dependent individuals.Aims The aim of the study was to investigate changes in BDNF levels during METH self-administration in monkeys.Methods This study measured plasma BDNF levels in three male rhesus monkeys with continuous METH exposure and four male control rhesus monkeys without METH exposure.Changes in plasma BDNF levels were then assessed longitudinally during 40 sessions of METH self-administration in the three monkeys.Results Repeated METH exposure decreased plasma BDNF levels.Additionally,plasma BDNF decreased with long-term rather than short-term accumulation of METH during METH self-administration.Conclusions These findings may indicate that the changes in peripheral BDNF may reflect the quantity of accumulative METH intake during a frequent drug use period.

Genomic Instability Is a Mechanism for Diminished Male Fertility Following Chronic Dichlorvos Exposure

Background and Objectives: Chronic low-dose exposure to dichlorvos occurs in communities in Africa where the substance is used indiscriminately for a variety of purposes. This experiment used an animal model to evaluate genomic instability induced by this pattern of chronic exposure and its relationship with some measures of fertility in males. Methods: Seventy-five male Rattus norvegicus rats obtained for this experiment, were randomly allotted into five groups. Dichlorvos was given by oral gavage at doses of 0.28 mg/kg, 0.56 mg/kg and, 1.68 mg/kg, respectively, to three of the groups, on alternate days for 50 weeks. The remaining two groups received plain drinking water and cyclophosphamide as negative and positive controls, respectively. Samples were collected at 17, 34, and 50 weeks. Sperm count, sperm morphology and serum levels of follicle-stimulating hormone, luteinizing hormone, dihydrotestosterone, oestrogen and progesterone were determined. Furthermore, the frequency of micronucleated polychromatic erythrocytes was determined in bone marrow cells obtained from the femur. Results: The mean ranks of micronuclei frequency had an increasing trend. The frequency of micronucleated polychromatic erythrocytes (MnPCE) had a significant negative correlation with oestrogen (rs = -0.47, p = 0.00, n = 50), follicle-stimulating hormone (rs = -0.41, p = 0.00, n = 50) and progesterone (rs = -0.37, p = 0.01, n = 50) serum levels. A positive monotonic relationship also existed between micronuclei frequency and those of tubular necrosis, tubular vacuolation, and residual bodies. A positive significant moderate correlation was found between MnPCE and the proportion of immotile sperms (rs = 0.41, p = 0.00, n = 50). Conclusion: The nature of the correlations between micronuclei frequency and the proportion of immotile sperms, adverse histological changes and serum hormone levels found in this study suggest genomic instability as the possible mechanism for diminished fertility in males chronically exposed to dichlorvos.

Short-term Exposure to Fine Particles and Risk of Cause-Specific Mortality--China,2013-2018

What is already known about this topic?Short-term exposure to PM2.5 has been associated with population excess death.This issue is of critical concern in China given its high level of exposure to PM2.5 compared to that of the rest of the world.What is added by this report?Existing studies were conducted from 2013-2015 and have failed to capture the full effects of China’s actions towards cleaner air in recent years,such as the first Action Plan for Air Pollution Prevention and Control issued in 2013.This study uses the longest time series data to date from 2013-2018,provides the latest evidence on PM2.5 and cause-specific death nationwide,and identifies regional patterns of PM2.5-related effects as well as PM2.5-related susceptible populations.What are the implications for public health practice?This study suggests that the development of standards and the implementation of actions to clean the air and protect public health should be tailored to PM2.5-related sensitive diseases,susceptible populations,and regional patterns.

Impact of Non-Compliance of Exposure Classes in Reinforced Concrete Structures

From the National Agency for the Organization and Construction of Infrastructures (ANOCI) program to the Emerging Senegal Plan (PSE), construction in Senegal has improved considerably. However, deficiencies remain in the specification of materials used mainly in hydraulic concrete. They are generally related to the specification of aggregates for alkali reactivity and the choice of exposure classes specified in NF EN 206-1. The purpose of this article is to study the incidence of non-compliance with exposure classes in reinforced concrete structures. To carry out this study, surveys were carried out at several sites (districts) in Dakar (Cité Avion, Touba Ouakam, Cité Asecna, Cité Batrain, Cité Comico, Cité Assemblée and Terme Sud) in order to collect information on the formulation and implementation methods used. The comparison of the various readings carried out made it possible to deduce conclusions and to give recommendations when using standard NF EN 206-1.

Using Pharmacokinetic Modeling and Electronic Health Record Data to Predict Clinical and Safety Outcomes after Methylprednisolone Exposure during Cardiopulmonary Bypass in Neonates

Background:Infants undergoing cardiac surgery with cardiopulmonary bypass(CPB)frequently receive intraoperative methylprednisolone(MP)to suppress CPB-related inflammation;however,the optimal dosing strategy and efficacy of MP remain unclear.Methods:We retrospectively analyzed all infants under 90 days-old who received intra-operative MP for cardiac surgery with CPB from 2014–2017 at our institution.We combined real-world dosing data from the electronic health record(EHR)and two previously developed population pharmacokinetic/pharmacodynamic models to simulate peak concentration(Cmax)and area under the concentration-time curve for 24 h(AUC24)for MP and the inflammatory cytokines interleukin-6(IL-6)and interleukin-10(IL-10).We evaluated the relationships between post-operative,safety,and other clinical outcomes obtained from the EHR with each predicted exposure using non-parametric tests.Results:A total of 142 infants with median post-natal age 8(interquartile range[IQR]:5,37)days received a total dose of 30(19,49)mg/kg of MP.Twelve(8%)died,37(26%)met the composite post-operative outcome,114(80%)met the composite safety outcome,and 23(16%)had a major complication.Predicted median Cmax and AUC24 IL-6 exposure was significantly higher for infants meeting the composite post-operative outcome and those with major complications.Predicted median Cmax and AUC24 MP exposure was significantly higher for infants requiring insulin.No exposure was associated with death or other safety outcomes.Conclusions:Pro-inflammatory IL-6,but not MP exposure,was associated with post-operative organ dysfunction,suggesting current MP dosing may not adequately suppress IL-6 or increase IL-10 to impact clinical outcomes.Prospective study will be required to define the optimal exposure-efficacy and exposure-safety profiles in these infants.

Artificial dermis combined with skin grafting for the treatment of hand skin and soft tissue defects and exposure of bone and tendon

BACKGROUND The recovery time of hand wounds is long,which can easily result in chronic and refractory wounds,making the wounds unable to be properly repaired.The treatment cycle is long,the cost is high,and it is prone to recurrence and disability.Double layer artificial dermis combined with autologous skin transplantation has been used to repair hypertrophic scars,deep burn wounds,exposed bone and tendon wounds,and post tumor wounds.AIM To investigate the therapeutic efficacy of autologous skin graft transplantation in conjunction with double-layer artificial dermis in treating finger skin wounds that are chronically refractory and soft tissue defects that expose bone and tendon.METHODS Sixty-eight chronic refractory patients with finger skin and soft tissue defects accompanied by bone and tendon exposure who were admitted from July 2021 to June 2022 were included in this study.The observation group was treated with double layer artificial dermis combined with autologous skin graft transplantation(n=49),while the control group was treated with pedicle skin flap transplantation(n=17).The treatment status of the two groups of patients was compared,including the time between surgeries and hospital stay.The survival rate of skin grafts/flaps and postoperative wound infections were evaluated using the Vancouver Scar Scale(VSS)for scar scoring at 6 mo after surgery,as well as the sensory injury grading method and two-point resolution test to assess the recovery of skin sensation at 6 mo.The satisfaction of the two groups of patients was also compared.RESULTS Wound healing time in the observation group was significantly longer than that in the control group(P<0.05,27.92±3.25 d vs 19.68±6.91 d);there was no significant difference in the survival rate of skin grafts/flaps between the two patient groups(P>0.05,95.1±5.0 vs 96.3±5.6).The interval between two surgeries(20.0±4.3 d)and hospital stay(21.0±10.1 d)in the observation group were both significantly shorter than those in the control group(27.5±9.3 d)and(28.4±17.7 d),respectively(P<0.05).In comparison to postoperative infection(23.5%)and subcutaneous hematoma(11.8%)in the control group,these were considerably lower at(10.2%)and(6.1%)in the observation group.When comparing the two patient groups at six months post-surgery,the excellent and good rate of sensory recovery(91.8%)was significantly higher in the observation group than in the control group(76.5%)(P<0.05).There was also no statistically significant difference in two point resolution(P>0.05).The VSS score in the observation group(2.91±1.36)was significantly lower than that in the control group(5.96±1.51),and group satisfaction was significantly higher(P<0.05,90.1±6.3 vs 76.3±5.2).CONCLUSION The combination of artificial dermis and autologous skin grafting for the treatment of hand tendon exposure wounds has a satisfactory therapeutic effect.It is a safe,effective,and easy to operate treatment method,which is worthy of clinical promotion.

Experiences of Early and Enhanced Clinical Exposure for Postgraduate Neonatal Nursing Students at the University of Zambia, School of Nursing Sciences: Lessons and Implications for the Future

Background and Objectives: Early and Enhanced Clinical Exposure immediately places postgraduate students in a clinical setting and incorporates continual hands-on instruction throughout their studies. It aims to motivate students by strengthening their academics, improving clinical and communication skills, and increasing their confidence. The underlying principles are to provide a clinical context and to ensure that the patient remains the centre of learning. The School of Nursing Sciences implemented this model in 2021 to produce hands-on Masters-level neonatal practitioners who can work in multidisciplinary clinical contexts. Therefore, this study explored the experiences of postgraduate nursing students on the Early and Enhanced Clinical Exposure model and draw implications for the future. Methods: A phenomenological study design was utilized at the University of Zambia, School of Nursing Sciences and comprised of eight Master of Science Neonatal Nursing students in their second year. Convenience sampling was used to select the study site and participants. Data was collected between 15th January 2023 and 31st January 2023 using an in-depth interview guide. Audio recording and notes were transcribed immediately after data collection. Data analysis was conducted using thematic analysis and codes and themes were constructed from the coded data. Ethical clearance and permission were sought before conducting the study. Results: Four major themes emerged from the study: identity and role confusion, challenging and hectic experiences, positive educational experiences, and personal and professional growth. These themes contributed to the promotion of evidence-based practice by helping students to assess, diagnose, and treat various conditions, as well as gain interest, experience, knowledge, and exposure. Conclusion: The model has a significant impact on motivation to learn, as evidenced by reported increased skill level with potential for use in clinical practice. It is recommended that it be implemented in all postgraduate programs for full-time students.

Knowledge of radiation exposure associated with common trauma imaging modalities among orthopaedic surgeons,emergency medicine physicians,and general surgeons in the United States

BACKGROUND:Few contemporary studies have assessed physicians’knowledge of radiation exposure associated with common imaging studies,especially in trauma care.The purpose of this study was to assess the knowledge of physicians involved in caring for trauma patients regarding the effective radiation doses of musculoskeletal(MSK)imaging studies routinely utilized in the trauma setting.METHODS:An electronic survey was distributed to United States orthopaedic surgery,general surgery,and emergency medicine(EM)residency programs.Participants were asked to estimate the radiation dose for common imaging modalities of the pelvis,lumbar spine,and lower extremity,in terms of chest X-ray(CXR)equivalents.Physician estimates were compared to the true effective radiation doses.Additionally,participants were asked to report the frequency of discussing radiation risk with patients.RESULTS:A total of 218 physicians completed the survey;102(46.8%)were EM physicians,88(40.4%)wereorthopaedicsurgeons,and28(12.8%)weregeneralsurgeons.Physicians underestimated the effective radiation doses of nearly all imaging modalities,most notably for pelvic computed tomaography(CT)(median 50 CXR estimation vs.162 CXR actual)and lumbar CT(median 50 CXR estimation vs.638 CXR actual).There was no difference between physician specialties regarding estimation accuracy(P=0.133).Physicians who regularly discussed radiation risks with patients more accurately estimated radiation exposure(P=0.007).CONCLUSION:The knowledge among orthopaedic and general surgeons and EM physicians regarding the radiation exposure associated with common MSK trauma imaging is lacking.Further investigation with larger scale studies is warranted,and additional education in this area may improve care.