The Friday Post #7: Assorted Wildlife, An Unusual Orchestra and Boolify

• Boolify - A search engine for children that teaches them the concepts of Boolean logic.

From “About” on the Boolify website: “In our lifetimes, the quantity of information available for sifting-through has increased exponentially. Yet, the tools for “teaching how to sift” have not maintained pace with the need for sifting. With this challenge in mind, the Boolify Project offers a piece of software that helps model Boolean operators. Its primary audience is Elementary and Middle School children, but it may find relevance with others. Ultimately, its goal is to increase learners’ ability to perform effective web searches. Just how will it accomplish this? It is hypothesized that visual cues Boolify provides will help learners build a mental model of the search that they are performing. A mental model… visualized as puzzle pieces that fit together and provide real-time feedback to the learner about the efficacy of the search. Librarians, teachers and parents have told us how hard it is for students to understand web searching. Boolify makes it easier to for students to understand their web search by illustrating the logic of their search, and by showing them how each change to their search instantly changes their results. “

I did a search on pancreas AND (carcinoma OR neoplasms OR cancer). While the results weren’t as great as one would retrieve from a clinical database such as Medline, the results from Boolify were pretty good for a general search engine.

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• PLOrk is the Princeton Laptop Orchestra…. a group of humans who compose and play music using their laptops as sound instruments. Here is a sample mp3 file to listen to, entitled “Plorktree“.

• Here’s a interesting blog with great photographs of ordinary people going about their lives: English-Russia, where there was recently a fascinating post about Bear Growers in Russia. Here’s a video about a set of bad bears.
  

Next… about Frogs.

• Frog and The Journey North are fascinating educational sites by Annenberg Media. You can view maps for migratory species such as monarch butterflies, whooping cranes, robins and other species.

• The New York Times recently ran a feature article on Frogs in the Spring, interesting to me because the vernal springs behind my house supplies the yard with many frogs, salamanders and toads throughout the summer.

• Speaking of Frogs and Toads. The Latin word for toad is Bufos. Did you know that when threatened, frogs and toads can scream really loudly? Here’s one of a number of vociferous frog videos from YouTube:

Education, EBM: Back by popular demand… More Radiology Sites

A comment often heard in Problem Based Learning from medical students is: “We want more Radiology”.

Having been a visual artist in my previous career, I also find Radiology to be a fascinating subject… because therein lies the body of the patient, revealed in all its glory (or mortal flaws).

Happily, there are more high-quality clinical teaching and learning sites for Radiology available on the web for students to find these days than ever before. Most are available at no cost - although registration and log-in is commonly required before access to the full content of some of the sites is granted.

Here is the latest round of clinical radiology sites for teaching and learning in medicine.

• RadRounds describes its’ purpose as: “… a new collaborative education and professional networking tool for radiologists. Think LinkedIN, MySpace, Facebook, Orkut, but completely managed and created by radiologists FOR radiologists“. A true example of Medicine 2.0, the site is targeted at current physicians, residents and medical students interested in pursuing radiology. Clinicians from all over the world contribute hundreds of patient images for discussion. Join an interest group, start a blog, find out industry news. Blogger Dr. Steven Chan recently invited me to take a look at the site, which is where I found this beautiful image recently:

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• Learning Radiology.com^™ is a rich and multi-layered assortment of teaching/learning links for Radiology. It is the work of William Herring, MD, FACR, chair of the Radiology program at Albert Einstein Medical Center in Philadelphia, PA for more than 25 years. Dr. Herring is author of a standard radiology textbook, Learning Radiology: Recognizing the Basics (Mosby, 2007). Several of the sections which I visited on that site recently were: Case of the Week (with archives from years 2002-2008), multimedia Lectures and a section especially for Medical Students. The site is free… you could easily spend hours roaming around here!

• MedicExchange seems to me be a radiology site targeted for clinicians more than students, with lots of product directories and commercial announcements. However, click on the “Education” link to search their Case of the Week (useful for students and residents) and try out their online interactive quiz/game called Who Wants to Be an Expert Radiologist ? (screenshot below):

This librarian is a lousy simulated game-player… my virtual patient always dies.

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• A recent new blog on WordPress by radiology tech “CTDave” is The Radiology Portal… which is where I learned about the Learning Radiology site. Thank you, CTDave - who has been webmaster of Dave’s Places In Radiology since 1996. There is a Student Page there.
  

• Finally… (for students) the American College of Radiology is a good site to bookmark if you are thinking of pursuing that specialty.
  

If readers have sites to recommend for the next Radiology post… please let me know!

Education, News: Scutwork and StudentDoctor.net

Photo Credit http://www.scutwork.com - Copyright 2008 - All rights reserved

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Scutwork is a site for new residents - or soon-to-be residents - to check out!

For a different point of view, go to StudentDoctor.net which aims to cover all interests in health science education from pre-med through graduate school and residency. The StudentDoctor.net site collects anonymous remarks from students who have interviewed at U.S. or Canadian schools of medicine and makes them available on the Medical School Interview Feedback page (screenshot below):

Photo Credit: StudentDoctor Network.net - Copyright 2008 - All rights reserved

Other specialties such as dental medicine, osteopathic medicine, podiatry etc. are also covered. Also check out the SDN Interview Advice Column written by a MD/MBA.

Please note: Caveat emptor! Be certain to check the date of any posting about individual institutions before considering to take that writers’ advice, please. These are anonymous, subjective comments so they may or may not reflect verifiable or accurate information.

The Friday Post #7: World-Class Museums… Both Real and Digital

This edition of the Friday Post is about real-world museums at the forefront of making their collections available digitally.

Library of Congress is the largest library in the world with a staff of 3,600 which (according to their Facts page) answered 682,700 reference questions in 2007! The collections of Library of Congress are housed in three buildings and include: “130 million items including more than 29 million cataloged books and other print materials in 460 languages; 58 million manuscripts; the largest rare book collection in North America; and the world’s largest collection of legal materials, films, maps, sheet music and sound recordings.”

Below is a photo of the magnificent Great Hall of the Library of Congress:

Photo Source/Credit http://www.wikipedia.org/

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A good starting point of access to the mammoth collections and archives of Library of Congress is through their Digital Collections and Services webpage.

American Memory is the Library’s collection of items from American history and culture. Currently that digital archive contains 13.6 million items.

Photo Credit: Library of Congress - copyright 2008 - All rights reserved

Also check out LC Today in History… which referred me to this cool site: “Buckeroos in Paradise”, from the American Memory archive.

The Royal College of Surgeons of England has a digital catalog of museum collections online for all to search. Click here to take a virtual tour of the Royal College of Surgeons of England building.

The RCSE online catalog, called Surgicat, is the main point of entry to search this digital archive of fascinating historical material.

One example: The anatomical specimens prepared and collected by John Hunter (1728-1793), a London surgeon who’s been called “the father of scientific surgery”, are owned by the RCSE. Hunter’s 3,000 wet tissue mount specimens are displayed in the Crystal Gallery. Click here for a virtual tour of the Hunterian Museum.

Is it not amazing that Hunter’s historical record of human public health has been carefully tended, and now digitized and indexed so that in 2008: they are here for us to view online… one continent, three centuries and 3,000 miles away!

Following is one image from that collection: Hunter’s specimen of smallpox pustules on the excised face of a child who died of that disease in London (circa approx. 1760):

One picture is worth a thousand words.

Photo Credit: © 2008 The Royal College of Surgeons of England

Next… visit the National Institute of Standards & Technology Virtual Museum where you can…

• Read a history of Standardization of Women’s Clothing Sizes
• Search their list of famous inventors
• Hall of Fame - Invention Channels in Chemistry, Medical, Imaging and more
• Link to NIST Fact Sheets

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The Wellcome Library (owned by The Wellcome Trust) has a collection numbering 750,000 books, journals, manuscripts, archives or films and 250,000 paintings or drawings. To search their digital collections, click here.

Following is one example from the Wellcome archive: the work of Dr. David Furness. It is a photograph of the hairs of the inner ear of a guinea pig:

Photo Credit: http://images.wellcome.ac.uk/

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Finally… Not a museum per se, but rather one of the world’s eminent public libraries, The New York Public Library has a digital collections page worth a visit. Below is a screenshot from NYPL’s digital archive:

Photo Credit: New York Public Library - Copyright 2008 - All rights reserved

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And THANKs to the hundreds of archivists, indexers, librarians, digital experts and IT folks who’ve made these historical images and beautiful sights available to us online.

News, Medical Education, Patient/Consumer Health: Actual Surgical Procedures from OR-Live… and Patients, too

The prospect of undergoing invasive surgery, post-op recovery, the risk of infection or negative sequelae has a real psychological impact for potential patients or family members. It is only human to be apprehensive of major surgery… Watching a video of a procedure is a powerful means of gaining an overview for a future patient, as it illustrates in a dispassionate, clinical manner what the treatment will involve.

OR-Live.com provides just that type of specific surgical information, as it is an archive of webcasts or videos showing surgery or procedures involving actual patients in real time.

Medical institutions on OR-Live are fully identified, the physicians or surgical team generally introduce themselves on camera, and the patients may (or may not) speak or identify themselves. For example, recently I watched a webcast of an elective caesarean section, and the mother and father both spoke on camera after the baby was born. Cool!  The site is, in a way, a type of ‘library’ for anyone who is seeking to learn more about treatments or operations which have been suggested to them by their own physicians, or for learning needs of medical students, nurses, residents or other health professionals.

Here is an excerpt from the OR-Live Inc. About page:

” Medical Information provided on OR-Live is presented for educational purposes. It is intended to support, not replace, the relationship that exists between a patient/site visitor and his/her existing physician.

This website is owned and operated by OR-Live, Inc. OR-Live, Inc. is not a health care provider and does not provide medical diagnosis or treatment. OR-Live, Inc. only provides visitors to the site with referrals to medical facilities and health care providers that may be able to assist them in their medical needs. OR-Live, Inc. has not conducted an independent investigation or performed other due diligence functions with regard to the health care providers or medical facilities to which the referrals are made. “

“ Live audiences on OR-Live usually average around 1,000 viewers…“.

Source/Credit: http://www.or-live.com/about/

During surgical procedures, one doctor (or team of physicians) provides commentary - usually outside of the surgical suite - to explain to the viewer what is happening in the operating room.

Because OR-Live is a commercial - and for profit - venture, the live or taped broadcasts will provide subtle (or not so subtle) cues aimed towards promotion and marketing the health care institution or facility where the surgery took place. As an example, following is a screenshot of an announcement of a transnasal endoscopic procedure scheduled to take place on Thursday May 8 2008:

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Photo Source/Credit: http://www.or-live.com/

(Note: The identifying name and location of the medical facility hosting the session has been deliberately obscured in order to avoid any appearance of ‘advertising’ or conflicts of interest).

OR-Live segments also provide brief videos of actual patients speaking about their diagnosis, surgical and/or treatment experience. This is useful information for potential patients (or medical or nursing students) who can watch and listen to real patients describe their symptoms, diagnosis, selection of treatments, surgery, post-op recovery and outcome.

To gain full access to the contents of OR-Live, you must first register with the company, then log-in. Access to the contents is free of charge. Users will need to connect via a computer which has media-player software (which is available to download for free… click here for a FAQ) and a high speed Internet connection is recommended.

For a list of procedures by Surgical Specialty on OR-Live, click here. For a list of Podcasts on OR-Live: click here.

News, Academic Medicine, Medical Education: Check out these Comments

A recent article written by Jacob Goldstein* for the Wall Street Journal Health Blog entitled “Why More Medical Students Won’t Mean More Doctors” was noted, in which he cites an April 2008 report from the Association of American Medical Colleges, predicting a 21% increase in enrollment in medical schools over the next few decade.

Following is an excerpt from this 13-page report (available at no cost online from AAMC):

” Based on the fall 2007 survey of U.S. medical schools and an appraisal of future enrollment at new medical schools under discussion or development, the AAMC estimates that first-year U.S.M.D. enrollment will grow to nearly 19,909 in the 2012 academic year from 16,488 in 2002—an increase of nearly twenty one percent. The projected increase in enrollment primarily reflects growth at existing medical schools, with over 86 percent of existing schools indicating a current or planned increase in first-year enrollment. This growth would push the average class size at existing medical schools from 132 students in 2002 to 152 students by 2012. In addition, several new medical schools hope to enroll their first classes in the coming years. “

Quote - from AAMC Report ( April 2008 )

Quite entertaining to read are the lengthening list of comments engendered by this article. Senior physicians, clinical faculty in academic-medical institutions, medical students, baby boomers and more have added their free-ranging thoughts about this topic. I recommend them to you.

And also to consider: why blogs - as one example of productive social networking tools - are here to stay. The traditional model of writing opinion pieces, submitting them to an editor who then decides (or not) to publish them in a (paper) journal, waiting months for comments or rebuttals to be published in a subsequent (paper) issue… both the model and the cycle have been changed, forever.

Finally, writer M. Mitchell Waldrop recently wrote an article of interest for Scientific American on Open Access, Networks and Science 2.0 (online - April 21 2008 ).

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* A previous item written by Mr. Goldstein in April 2008 was the impetus for writing an a post on this blog about a new medical school in the planning stages at Hofstra University, to open in 2011.

Education, Instruction: One Heck of an Exam - The USMLE

American medical students who are nearing the end of their second year of graduate medical education face the prospect of preparing for one of the most important examinations of their career thus far : Step 1 of the United States Medical Licensing Exam (or USMLE).

There are three examinations in the USMLE process (Steps 1 through 3) and students must progress through each step at carefully defined points in their medical education. A passing score from the Step 1 exam must be reported for each student by USMLE to their institution prior to the start of the clinical clerkship year, which commences on July 1 2008.

To view a list of clinical subjects and areas covered by USMLE, click here. Following is an excerpt from the USMLE website, explaining the three examinations:

The Three Steps of the USMLE

” Step 1 assesses whether you understand and can apply important concepts of the sciences basic to the practice of medicine, with special emphasis on principles and mechanisms underlying health, disease, and modes of therapy. Step 1 ensures mastery of not only the sciences that provide a foundation for the safe and competent practice of medicine in the present, but also the scientific principles required for maintenance of competence through lifelong learning.

Step 2 assesses whether you can apply medical knowledge, skills, and understanding of clinical science essential for the provision of patient care under supervision and includes emphasis on health promotion and disease prevention. Step 2 ensures that due attention is devoted to principles of clinical sciences and basic patient-centered skills that provide the foundation for the safe and competent practice of medicine.

Step 3 assesses whether you can apply medical knowledge and understanding of biomedical and clinical science essential for the unsupervised practice of medicine, with emphasis on patient management in ambulatory settings. Step 3 provides a final assessment of physicians assuming independent responsibility for delivering general medical care. “

Source: http://USMLE.org - Copyright 2008 - All rights reserved

The USMLE is sponsored by the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME).

ExamMaster is a subscription test-prep resource available to UCHC students as they prepare for this important test. On-site registration and log-in to ExamMaster is required. Students can design their own tests, use standardized tests, save their scores and review results. Online tutorials are also available.

Here is a screenshot of the Start page, after I logged in to ExamMaster:

Photo Credit/Source: ExamMaster Inc. - Copyright 2008 - All rights reserved

Note: Just to get a feel for the real test, I completed the ExamMaster test-bank for Psychiatry last week. My score? 70% correct… Wow!

Friday Post #6: Creating Better Presentations, Health-Blogs and More Stuff on Cephalopods

Creating effective presentations - and advice on blogging - start off the Friday Post #6 for this week.

Are there any of us who haven’t dozed off in the middle of an overly-long Powerpoint presentation? You know: it’s after lunch, you stayed up late the night before… the room is very warm, the lights are low and suddenly you’re face down on the table making little snicking sounds. Embarrassing, but very common.

However, if you’re the person presenting rather than listening, you definitely want to avoid putting your boss and colleagues to sleep. Thanks to Clinical Cases and Images for posting about this excellent tutorial by Alexei Kapterev on how to create more effective presentations called Death by Powerpoint (and How to Avoid It).

Three faculty members from North Carolina State University have made their tutorial on creating effective poster presentations available at this link: http://www.ncsu.edu/project/posters/NewSite/index.html

Thinking about starting a Blog? Read the 10 points to consider that Trisha Okubo has given in her presentation, “Blog Your Brand“. You might want to reconsider the blog. But hers is an example of a great presentation. It is entertaining, crisp, her points are clear, the slides are uncluttered, she uses thought-provoking headlines, her key points do not cause members of the audience to get stuck in that dreaded “stop-and-ponder” loop… as in, missing the content of the next 7 slides because you’re still trying to figure out what the speaker said four minutes ago.

Next: A blog for journalists and public relations specialists, Bulldog Reporter, offers up a lengthy List of Health Related Blogs. If you are looking for new content to connect with, try this comprehensive international list. It is very l-o-n-g. (Thanks to David Rothman for the link).

Next item. Weird marine animals… cephalopods in particular. I like ‘em. (See a previous posting about the work of Roger Hanlon here). Following are two videos of scientists investigating the carcass of a giant squid found in New Zealand in April 2008 (links and video - courtesy of BBC News):

• Technicians in New Zealand are shown defrosting the body of a rare colossal squid (Apr 28 2008 )
• Giant squid is examined prior to dissection (Apr 30 2008 )

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Finally… Octopus Tossing? Not being a hockey fan, I’m out of the loop but… Holy Cow! Is this any way to treat a cephalopod?!

News, Academic Medicine: Uncertain Times for New Scientists

” Many early career scientists are trapped in a research “Catch 22”. They can’t get the NIH R01 funding they need to establish a lab and launch an independent career because NIH reviewers say they don’t have the data to support their grant applications. Yet the preliminary data and proof that experiments will succeed is hard to come by without that very funding. Many of these young scientists are pursuing radically new approaches to medical challenges. Some of them, like Harvard University’s Rachelle Gaudet, are creating whole new fields of science. The data they need cannot be taken off the shelf. “

” Really exciting science is harder, takes more effort, and comes with more risk. Yet limited resources are forcing NIH review committees to be more conservative in their funding decisions…. The reviewers want to see proposals that are highly likely to succeed. They don’t want you to chase outlying ideas. “

– Text (p. 15) from: ” A Broken Pipeline? Flat Funding of the NIH Puts a Generation of Science at Risk: A Follow-Up Statement by a Group of Concerned Universities and Research Institutions ” (March 2008 )

A recent research report entitled A Broken Pipeline? Flat Funding of the NIH Puts a Generation of Science at Risk is highly critical of falling NIH research grant funding levels, and the subsequent impact this will have on scientific research, drug discovery and the careers of young and talented scientists.

Faculty and staff from the following academic-medical institutions of Brown University, Duke University, Harvard University, Ohio State University, Partners Healthcare, University of California-Los Angeles and Vanderbilt University wrote the 24-page document, available online, at no cost, from this website: http://www.brokenpipeline.org.

The 2008 report provides interviews of 12 young scientists and their current medical research projects, concluding that “scientific advances may be lost if NIH funding is not quickly restored to levels that overcome inflation”.

Read the press release describing the 2008 report here.

This report is a follow-up to one published in March 2007 entitled Within Our Grasp—Or Slipping Away? Assuring a New Era of Scientific and Medical Progress.

Here is a press release describing the 2007 report.

Also available on the BrokenPipeline site are transcripts of several authors on video and testimony from March 2008 Congressional hearings, which you can view by clicking here.

News, Consumer Health: Public Service Announcement… Real Men wear Gowns

Here are some facts that are not amusing:

” Men are 25 percent less likely than women to have visited the doctor within the past year and are 38 percent more likely than women to have neglected their cholesterol tests. (Source: AHRQ Medical Expenditure Panel Survey, 2005). Furthermore, men are 1.5 times more likely than women to die from heart disease, cancer and chronic lower respiratory diseases (Source: Centers for Disease Control and Prevention, 2005). “

” The new campaign encourages men over 40 to learn which preventive screening tests they need to get and when they need to get them. This campaign complements AHRQ’s existing efforts toward improving the safety and quality of health care and promoting patient involvement in their own health care, including the “Questions are the Answer” campaign launched with the Ad Council in March 2007 and the “Superheroes” Spanish-language campaign launched in March 2008. “

Quote from The Ad Council website - Press Release dated April 21 2008, announcing new national ad campaign designed to raise awareness among middle-aged men about the importance of preventive medical testing.

Watch these two very brief public service announcements from Agency for Health Care Research & Quality and the Ad Council about How Real Men Wear Gowns.

What a great idea to raise public health awareness of the importance of regular health screening. If humor will get you into the doctor’s office for an annual physical - go with it. Funny!

http://www.ahrq.gov/realmen/videos/MenInGowns_15_captions.wmv

http://www.ahrq.gov/realmen/videos/MenInGowns_30_captions.wmv