Subjects have previously been reported to show difficulties in recognising faces which are either inverted or in photographic negative. Experiments are reported in which a two-alternative forced-choice technique was used to measure sensitivity for distinguishing faces which have been modified by having the eyes moved vertically or horizontally. Subjects were less sensitive to such changes for inverted faces or negative faces, and were even less sensitive for faces that were both inverted and negative. No such effects were found for a control stimulus consisting simply of three solid circles in the same positions as the eyes and mouth of a face. When the stimuli consisted of eyes, nose, and mouth, but without a surround, no evidence of inversion or negation effects was found, which suggests that a facial surround is necessary. When the stimulus consisted of a facial surround with the eyes, nose, and mouth replaced by solid circles, effects of negation were found, but no effects of inversion. This dissociation of the effects of negation and inversion may suggest that they are the result of different underlying mechanisms.
Objectives/Hypothesis: Surgery is considered to be the mainstay of treatment for glomus jugulare tumors. A subset of patients are poor surgical candidates based on age, medical problems, tumor size, or prior treatment failure. The purpose of this study was to review our results with stereotactic radiosurgery (gamma knife treatment) in this group of patients, with particular attention to adverse reactions and symptom relief. Study Design: Retrospective review and phone survey. Methods: Charts were reviewed for size and location of tumor, history of previous treatment, symptoms before and after treatment, amount of radiation received, acute and late complications, and functional level before and after treatment. Pretreatment and posttreatment magnetic resonance imaging scans were also reviewed. Identified patients were then contacted for a phone interview. Results: Eight patients were identified. Phone interviews were conducted with four patients. Four patients had failed previous treatment. Follow‐up ranged from 7 to 104 months. One patient experienced an acute complication: intractable vertigo requiring hospitalization. No patient experienced delayed cranial neuropathies. No patient reported worsening of any of the following symptoms: pulsatile tinnitus, hearing loss, facial weakness, hoarseness, or difficulty swallowing. Three patients reported improvement in their pulsatile tinnitus. Two patients reported improvement in hearing loss, and one patient each reported improvement in vertigo and difficulty swallowing. Conclusions: Preliminary results suggest that stereotactic radiosurgery is useful to control symptoms and may be delivered safely in patients with primary or recurrent glomus jugulare tumors who are poor surgical candidates.
BackgroundEducating doctors is expensive and poor performance by future graduates can literally cost lives. Whilst the practice of medicine is highly evidence based, medical education is much less so. Research on medical school selection, undergraduate progression, Fitness to Practise (FtP) and postgraduate careers has been hampered across the globe by the challenges of uniting the data required. This paper describes the creation, structure and access arrangements for the first UK-wide attempt to do so.OverviewA collaborative approach has created a research database commencing with all entrants to UK medical schools in 2007 and 2008 (UKMED Phase 1). Here the content is outlined, governance arrangements considered, system access explained, and the potential implications of this new resource discussed. The data currently include achievements prior to medical school entry, admissions tests, graduation point information and also all subsequent data collected by the General Medical Council, including FtP, career progression, annual National Training Survey (NTS) responses, career choice and postgraduate exam performance data. UKMED has grown since the pilot phase with additional datasets; all subsequent years of students/trainees and stronger governance processes. The inclusion of future cohorts and additional information such as admissions scores or bespoke surveys or assessments is now being piloted. Thus, for instance, new scrutiny can be applied to selection techniques and the effectiveness of educational interventions. Data are available free of charge for approved studies from suitable research groups worldwide.ConclusionIt is anticipated that UKMED will continue on a rolling basis. This has the potential to radically change the volume and types of research that can be envisaged and, therefore, to improve standards, facilitate workforce planning and support the regulation of medical education and training. This paper aspires to encourage proposals to utilise this exciting resource.
Although most people are right-handed and have language in their left cerebral hemisphere, why that is so, and in particular why about ten per cent of people are left-handed, is far from clear. Multiple theories have been proposed, often with little in the way of empirical support, and sometimes indeed with strong evidence against them, and yet despite that have become modern urban myths, probably due to the symbolic power of right and left. One thinks in particular of ideas of being right-brained or left-brained, of suggestions that left-handedness is due to perinatal brain damage, of claims that left-handers die seven years earlier than right-handers, and of the unfalsifiable ramifications of the byzantine Geschwind-Behan-Galaburda theory. This article looks back over the past fifty years of research on brain asymmetries, exploring the different themes and approaches, sometimes in relation to the author's own work. Taking all of the work together it is probable that cerebral asymmetries are under genetic control, probably with multiple genetic loci, only a few of which are now beginning to be found thanks to very large databases that are becoming available. Other progress is also seen in proper meta-analyses, the use of fMRI for studying multiple functional lateralisations in large number of individuals, fetal ultra-sound for assessing handedness before birth, and fascinating studies of lateralisation in an ever widening range of animal species. With luck the next fifty years will make more progress and show fewer false directions than had much of the work in the previous fifty years.
Background-Hypertension treatment and control remain low worldwide. Strategies to improve blood pressure control have been implemented in the United States and around the world for several years. This study was designed to assess improvement in blood pressure control over a 10-year period in a large cohort of patients in the Department of Veterans Affairs.
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