Impact of COVID-19 pandemic on radiology education,training,and practice:A narrative review

Radiology education and training is of paramount clinical importance given the prominence of medical imaging utilization in effective clinical practice.The incorporation of basic radiology in the medical curriculum has continued to evolve,focusing on teaching image interpretation skills,the appropriate ordering of radiological investigations,judicious use of ionizing radiation,and providing exposure to interventional radiology.Advancements in radiology have been driven by the digital revolution,which has,in turn,had a positive impact on radiology education and training.Upon the advent of the corona virus disease 2019(COVID-19)pandemic,many training institutions and hospitals adhered to directives which advised rescheduling of non-urgent outpatient appointments.This inevitably impacted the workflow of the radiology department,which resulted in the reduction of clinical in-person case reviews and consultations,as well as in-person teaching sessions.Several medical schools and research centers completely suspended face-to-face academic activity.This led to challenges for medical teachers to complete the radiology syllabus while ensuring that teaching activities continued safely and effectively.As a result,online teaching platforms have virtually replaced didactic face-to-face lectures.Radiology educators also sought other strategies to incorporate interactive teaching sessions while adopting the e-learning approach,as they were cognizant of the limitations that this may have on students’clinical expertise.Migration to online methods to review live cases,journal clubs,simulation-based training,clinical interaction,and radiology examination protocolling are a few examples of successfully addressing the limitations in reduced clinical exposure.In this review paper,we discuss(1)The impact of the COVID-19 pandemic on radiology education,training,and practice;(2)Challenges and strategies involved in delivering online radiology education for undergraduates and postgraduates during the COVID-19 pandemic;and(3)Difference between the implementation of radiology education during the COVID-19 pandemic and pre-COVID-19 era.

Leptin influences estrogen metabolism and increases DNA adduct formation in breast cancer cells

Objective: The elevated incidence of obesity has been paralleled with higher risks of breast cancer. High adiposity increases leptin secretion from adipose tissue, which in turn increases cancer cell proliferation. The interplay between leptin and estrogen is one of the mechanisms through which leptin influences breast carcinogenesis. An unbalanced estrogen metabolism increases the formations of catechol estrogen quinones, DNA adducts, and cancer mutations. This study aims to investigate the effect of leptin on some estrogen metabolic enzymes and DNA adduction in breast cancer cells.Methods: High performance liquid chromatography(HPLC) was performed to analyze the DNA adducts 4-OHE1[E2]-1-N3 adenine and 4-OHE1[E2]-1-N7 guanine. Reporter gene assay, real time reverse transcription polymerase chain reaction(real time RT-PCR), and Western blot were used to assess the expression of estrogen metabolizing genes and enzymes: Cytochrome P-4501B1(CYP1B1), Nicotinamide adenine dinucleotide phosphate-quinone oxidoreductase1(NQO1), and Catechol-O-methyl transferase(COMT).Results: Leptin significantly increased the DNA adducts 4-OHE1[E2]-1-N3 adenine and 4-OHE1[E2]-1-N7 guanine.Furthermore, leptin significantly upregulated CYP1B1 promoter activity and protein expression. The luciferase promoter activities of NQO1 and m RNA levels were significantly reduced. Moreover, leptin greatly reduced the reporter activities of the COMT-P1 and COMT-P2 promoters and diminished the protein expression of COMT.Conclusions: Leptin increases DNA adduct levels in breast cancer cells partly by affecting key genes and enzymes involved in estrogen metabolism. Thus, increased focus should be directed toward leptin and its effects on the estrogen metabolic pathway as an effective approach against breast cancer.