The Biology of non‐violence

This article reviews the examination of aggression in ethology. It concludes that though ethology establishes a biology of aggression, it does not conclude a biological determinism behind human violence. The article begins by examining this miscomprehension. Ethology shows a strong evolutionary tendency for aggression to be non‐violent behaviour. The human, as a higher order social animal, should conform to this. That we do not behave in this way is not a reflection of biology but that of the unique influence of culture on behaviour. Humans tend to non‐violence, biologically; it is culture that alters that tendency. How this is achieved is examined in the latter part of the article. In conclusion, ethologists, from Lorenz onwards, have argued that while aggression is rooted in human biology, violence is not, but has a cultural root. What culture has developed, it can alter, a positive optimistic message from ethology which is too often overlooked.     

Prognostic value of cardiovascular CT: Is coronary artery calcium screening enough? The added value of CCTA

Coronary artery disease (CAD) is the primary cause of death in adults in the United States. Only 50% of patients who present with a myocardial infarction have a prior history of CAD. Non-invasive cardiac imaging tests have been developed to diagnose CAD. Current guidelines and systematic reviews have tried to determine the prognostic value of the coronary artery calcium (CAC) scoring and the coronary computed tomography angiography (CCTA) for major adverse cardiovascular events. Several studies support the roles of CCTA and CAC scoring for the diagnosis of CAD in asymptomatic patients. Further studies are needed to confirm the superior role of CCTA over CAC scoring in symptomatic patients.     

The importance of imaging – Perspectives from redeployment

As the coronavirus disease 2019 (COVID-19) pandemic strains the healthcare system, radiology residents across the United States have become a vital part of the redeployed workforce. Through a series of four cases of COVID-19 patients encountered on the wards, we highlight the insight and unique set of skills redeployed radiology residents possess that are essential to patient care during this crisis. By increasing visibility through active participation on the clinical team, we demonstrate the fundamental role radiology has in the greater field of medicine.     

The DNA‐Buster: The evaluation of an alternative DNA recovery approach

Touch DNA recovery techniques can have limitations, as their effectiveness depends on the substrate on which the DNA of a person of interest can be found. In this study, an in-house dry-vacuuming device, the DNA-Buster, was compared to traditional methods for its DNA recovery performance from items typically examined in forensic casework. The aim was to evaluate whether this dry-vacuuming approach can recover DNA efficiently, potentially complementing the well-established recovery strategies. For this, the performances of swabbing, taping, wet- (M-Vac®) and dry-vacuuming (DNA-Buster) were investigated quantitatively and qualitatively for touch DNA deposited on carpet, cotton sweater, stone, tile and wood. For the sweater, both vacuuming methods outperformed the other collection tools quantitatively. While the highest DNA amounts for the carpet were yielded by swabbing and taping, dry-vacuuming was equally good in reaching full DNA profiles, whereas less complete profiles were observed for the M-Vac®. For stone and tile, swabbing was optimal, whereas dry-vacuuming clearly underperformed for these substrates. Taping was the best recovery method for wood. Despite applying single donor DNA after thoroughly cleaning the items, undesired DNA mixtures were detected for all recovery techniques and all substrates. The overall research findings show first that the novel dry-vacuuming method is suited for DNA recovery from textiles. Secondly, they indicate that more attention should be paid to the substrate-collection dependency to ensure best practices in recovering genetic material in a precise, confident and targeted manner from the variety of forensic casework material.     

The role of western non‐governmental organizations and charities

This paper looks at the general role of non‐governmental organizations in interacting with, on the one hand, governments and others in a position of power, and on the other with grass‐roots support.     

The cardiothoracic ratio—an inaccurate and outdated measurement: new data from CT

Cardiomegaly (and left ventricular size in particular) is well recognized to have cardiovascular prognostic significance. Cardiac assessment should be routinely performed when evaluating imaging studies encompassing the thorax, whether cross sectional or projectional. However, such measurements should be robust, readily available and practical. In this issue of European Radiology, Schlett et al. describe such a technique based on single level area and transverse diameter measurements on transverse CT and projection digitally acquired radiographs. This paper is significant as it makes a simple tool for left ventricular assessment readily available to all cross-sectional imagers and highlights the established limitation of cardiothoracic ratio on the chest radiograph.     

The educational value of disaster victim identification (DVI) missions—transfer of knowledge

Transfer of knowledge is the cornerstone of any educational organisation, with senior staff expected to participate in the training of less experienced colleagues and students. Teaching in the field is, however, slightly different, and a less theoretical approach is usually recommended. In terms of Disaster Victim Identification (DVI) activities, practical work under supervision of a field team stimulates tactile memory. A more practical approach is also useful when multiple organizations from a variety of countries are involved, as language barriers make it easier to manually show someone how to solve a problem, instead of attempting to explain complex concepts verbally. “See one, do one, teach one” is an approach that can be used to ensure that teaching is undertaken with the teacher grasping the essentials of a situation before passing on the information to someone else. The key principles of adult learning that need to be applied to DVI situations include the following: participants need to know why they are learning and to be motivated to learn by the need to solve problems; previous experience must be respected and built upon and learning approaches should match participants’ background and diversity; and finally participants need to be actively involved in the learning process. Active learning involves the active acquisition of knowledge and/or skills during the performance of a task and characterizes DVI activities. Learning about DVI structure, activities and responsibilities incorporates both the learning of facts (“declarative knowledge”) and practical skills (“procedural knowledge”). A fundamental requirement of all DVI exercises should be succession planning with involvement of less experienced colleagues at every opportunity so that essential teaching and learning opportunities are maximized. DVI missions provide excellent teaching opportunities and international agencies have a responsibility to teach less experienced colleagues and local staff during deployment.     

The value of quantitative MRI using 1.5 T magnet in diagnosis of carpal tunnel syndrome

Objective

The aim of this study was to assess the efficacy of quantitative MRI parameters using 1.5 T magnet in evaluation of MN in CTS.

Deciding for others: The ethics of surrogate decision‐making

Buarachanan A. E. & Brock D. W. (Cambridge University Press, New York, NY, 1990), 368 pages, $49.50 hardback; $16.95 paperback.     

War‐wounded refugees: The types of injury and influence of disability on well‐being and social integration

The aim of this study is to describe the war injuries and investigate the influence of physical disability on well‐being and social integration in a group of war‐wounded refugees after two years in Sweden. A culturally heterogenous sample of 54 war‐wounded refugees was investigated during hospitalization shortly after arrival, and after two years. Quantitative data were covered by physical examinations, interviews and questionnaires. In addition, qualitative data were collected within semi‐structured interviews on both occasions. The major types of war injuries were: fractures (22%), traumatic amputations (17%), spinal cord injuries (17%), nerve injuries (11%), combinations of fractures and nerve injuries (9%), bilateral eye injuries (9%), brain injuries (7%), other injuries (7%). Regarding the type of injuries and medical complications, the group studied was representative of small unit operations of war with low access to early medical care. The degree of physical disability was not a salient factor for well‐being and social integration after two years in Sweden. The losses and desires to be repatriated were apparent from the qualitative findings, as exemplified by three case reports. The findings of this study are in accordance with previous research on refugees and war‐injured ex‐combatants, but further multidisciplinary research is needed. The results also imply that resettlement countries should pay continuous attention to the broad needs of their war‐wounded refugees.     

Core body temperatures during final stages of life—an evaluation of data from in-hospital decedents

International Journal of Legal Medicine - Temperature-based methods are widely accepted as the gold standard for death time estimation. In the absence of any other information, the nomogram method...     

The role of specialist neuroradiology second opinion reporting: is there added value?

AIM: To assess the impact on patient management of formal neuroradiology "second reading" of computed tomography (CT) and magnetic resonance imaging (MRI) images initially interpreted by general radiologists. MATERIALS AND METHODS: Second opinion reports during the calendar year 2004 were compared with the original report and assessed for major or minor discrepancies. A major discrepancy was separated from a minor discrepancy whereby a change in opinion significantly affected patient management. RESULTS: There were 506 second opinions during 2004 given by three consultant neuroradiologists. Incomplete data were found in 141. Forty-one percent were CT images and the remainder MRI. The majority of second opinions were requested by neurologists. Most of the remaining referrals were from neurosurgeons or the primary radiologist. There was a 13% major and a 21% minor discrepancy rate. The remaining 66% were in complete agreement. There was a mixture of overcalls, misinterpretation, and undercalls. There were similar rates of minor and major discrepancies in both CT and MRI. CONCLUSION: There is a significant major discrepancy rate between specialist neuroradiology second opinion and general radiologists. The benefit of a formal specialist second opinion service is clearly demonstrated; however, it is time-consuming.     

The Withers Archive: online availability of H. Rodney Withers’ data

We have collected lab notebooks from Rod Wither’s many years of experimentation, from laboratories in Houston and Los Angeles, as well as from several of his collaborators in the USA and overseas. The contents have been digitized, and in this note we explain the mechanism that has been set up to make the ‘Withers Archive’ available online.     

Long‐term persistence of translocations in stable lymphocytes from victims of a radiological accident

Purpose: To investigate whether translocations in ‘stable’ lymphocytes, i.e. those not containing unstable aberrations in any chromosome including counterstained ones, would have a longer persistence with time compared with those measured in all cells.

Materials and methods: The time‐course of chromosomal aberrations in the three most highly exposed radiation victims of an Estonian accident in November 1994 was followed for 7 post‐accident years encompassing 15 samples. Chromosome painting was performed using probes for chromosomes 1, 2 and 4 with a pan‐centromeric probe, and chromosomal aberrations involving the painted chromosomes were scored using a developed version of the Protocol for Aberration Identification and Nomenclature Terminology (PAINT) nomenclature. Metaphases containing aberrations were captured with an image analyser and stored on a computer. An earlier analysis of aberrations in the painted portion of the genome was performed in all cells, irrespective of the possible aberrations in the unpainted part of the genome. The present analysis has taken into account the ‘stable/unstable’ nature of the complete cell. Evaluation was performed on images, counting all chromosomes and checking the counterstained chromosomes for unstable aberrations, i.e. dicentrics, acentrics or ring chromosomes.

Results: In the original analyses of all cells, a decrease in translocation frequency in the early samples was observed. In the present study of stable cells, the results showed that the yield of translocations is constant with time.

Conclusions: The results show that translocations observed in stable cells are persistent with time. This implies that retrospective dosimetry and calibration should be performed using stable cells. To obtain more information on this issue, the stability status of all cells in any future fluorescence in situ hybridization follow‐up of a radiation accident should be noted.     

The prognostic value of cardiac SPECT performed at the primary care physician’s office

Background

The prognostic value of single-photon emission computed-tomography (SPECT)-myocardial perfusion imaging (MPI) is well documented. However, the utility of SPECT-MPI when performed at a low-volume primary care physician’s (PCP's) office is unknown.

Methods

We conducted a prospective cohort study of consecutive patients referred by their PCP to undergo a stress-MPI at the PCP's office using a mobile laboratory. Major adverse cardiovascular events (MACE) of death, myocardial infarction (MI), and coronary revascularization were prospectively tabulated using mail and telephone interviews, chart review, and social security death index.

Results

One thousand three hundred ninety subjects [mean age 58 ± 13 years; 44% women] were followed for 27 ± 9 months, with a 99% complete follow-up rate. Subjects with abnormal MPI [174 (12.5%)] had significantly higher rates of all-cause mortality [5.2% vs 1.0%, P < .001], death, or MI [5.7% vs 1.5%, P = .001], and the composite of death, MI, or late revascularization (>60 days post-MPI) [12.6 vs 2.7%, P < .001]. Overall MACE risk was associated with the total perfusion abnormality burden, while the revascularization rate was related to the reversible perfusion abnormality burden.

Conclusion

Contemporary SPECT-MPI performed in the setting of a PCP's office carries a robust prognostic value, similar to that reported in tertiary or large-volume practice settings.