Econstudentlog

Concussion and Sequelae of Minor Head Trauma

Some related links:

PECARN Pediatric Head Injury/Trauma Algorithm.
Canadian CT Head Injury/Trauma Rule.
ACEP – Traumatic Brain Injury (Mild – Adult).
AANS – concussion.
Guidelines for the Management of Severe Traumatic Brain Injury – 4th edition.
Return-to-play guidelines.
Second-impact syndrome.
Repetitive Head Injury Syndrome (medscape).
Traumatic Brain Injury & Concussion (CDC).

Advertisements

December 1, 2017 Posted by | Lectures, Medicine, Neurology | Leave a comment

Acute Coronary Syndromes

A few quotes from the lecture, as well as some links to related stuff:

“You might say: Why doesn’t coronary stenting prevent heart attacks? You got an 80 % blockage causing some angina and you stent it, why doesn’t that prevent a heart attack? And the answer is very curious. The plaques that are most likely to rupture are mild. They’re typically less than 50 %. They have a thin fibrous cap, a lot of lipid, and they rupture during stress. This has been the real confusion for my specialty over the last 30 years, starting to realize that, you know, when you get angina we find the blockage and we fix it and your angina’s better, but the lesions that were gonna cause next week’s heart attack often are not the lesion we fixed, but there’s 25 other moderate plaques in the coronary tree and one of them is heating up and it’s vulnerable. […] ACS, the whole thing here is the idea of a vulnerable plaque rupture. And it’s often not a severe narrowing.” (3-5 minutes in)

[One of the plaque rupture triggers of relevance is inflammatory cytokines…] “What’s a good example of that? Influenza. Right, influenza releases things like, IL-6 and other cytokines. What do they do? Well, they make you shake and shiver and feel like your muscles are dying. They also dissolve plaques. […] If you take a town like Ann Arbor and vaccinate everybody for influenza, we reduce heart attacks by a lot … 20-30 % during flu season.” (~11-12 minutes in)

“What happens to your systolic function as you get older? Any ideas? I’m happy to tell you it stays strong. […] What happens to diastole? […] As your myocardial cells die, a few die every day, […] those cells get replaced by fibrous tissue. So an aging heart becomes gradually stiffer [this is apparently termed ‘presbycardia’]. It beats well because the cells that are alive can overcome the fibrosis and squeeze, but it doesn’t relax as well. So left ventricular and diastolic pressure goes up. Older patients are much more likely to develop heart failure [in the ACS setting] because they already have impaired diastole from […] presbycardia.” (~1.14-1.15)

Some links to coverage of topics covered during the lecture:

Acute Coronary Syndrome.
Unstable angina.
Pathology of Acute Myocardial Infarction.
Acute Coronary Syndrome Workup.
Acute Coronary Syndrome Treatment & Management.
The GRACE risk score.
Complications of Myocardial Infarction.
Early versus Delayed Invasive Intervention in Acute Coronary Syndromes (Mehta et al. 2009).

November 3, 2017 Posted by | Cardiology, Lectures, Medicine, Studies | Leave a comment

National EM Board Review Course: Toxicology

Some links:

Flumazenil.
Naloxone.
Alcoholic Ketoacidosis.
Gastrointestinal decontamination in the acutely poisoned patient.
Chelation in Metal Intoxication.
Mudpiles – causes of high anion-gap metabolic acidosis.
Toxidromes.
Whole-bowel irrigation: Background, indications, contraindications…
Organophosphate toxicity.
Withdrawal syndromes.
Acetaminophen toxicity.
Alcohol withdrawal.
Wernicke syndrome.
Methanol toxicity.
Ethylene glycol toxicity.
Sympathomimetic toxicity.
Disulfiram toxicity.
Arsenic toxicity.
Barbiturate toxicity.
Beta-blocker toxicity.
Calcium channel blocker toxicity.
Carbon monoxide toxicity.
Caustic ingestions.
Clonidine toxicity.
Cyanide toxicity.
Digitalis toxicity.
Gamma-hydroxybutyrate toxicity.
Hydrocarbon toxicity.
CDC Facts About Hydrogen Fluoride (Hydrofluoric Acid).
Hydrogen Sulfide Toxicity.
Isoniazid toxicity.
Iron toxicity.
Lead toxicity.
Lithium toxicity.
Mercury toxicity.
Methemoglobinemia.
Mushroom toxicity.
Argyria.
Gyromitra mushroom toxicity.
Neuroleptic agent toxicity.
Neuroleptic malignant syndrome.
Oral hypoglycemic agent toxicity.
PCP toxicity.
Phenytoin toxicity.
Rodenticide toxicity.
Salicylate toxicity.
Serotonin syndrome.
TCA toxicity.

September 29, 2017 Posted by | Lectures, Medicine, Pharmacology, Psychiatry | Leave a comment

National EM Board Review Course: Environmental Emergencies

Some links to resources on stuff covered in the lecture:

Drowning.
Diving disorders.
Henry’s law/Boyle’s law/Dalton’s law.
Nitrogen narcosis.
Decompression Sickness.
Hyperbaric Oxygen Therapy.
Blast Injuries.
Altitude sickness.
High Altitude Flatus Expulsion (HAFE).
High-Altitude Pulmonary Edema.
Hypothermia.
Cold-induced vasodilation.
Osborn Waves.
Frostbite (‘think of this as a thermal burn equivalent caused by cold’).
Trench foot.
Heat stroke.
Heat cramps.
Thermal Burns.
Parkland formula.
Escharotomy and Burns.
Electrical Injuries in Emergency Medicine.
Lightning Injuries.
Radiation exposure.
Inhalation Anthrax.
Botulism As a Bioterrorism Agent.
Chemical weapon/vessicants/nerve agent.
Bite injuries.
Cat scratch disease.
Rabies.
Rattlesnake Bite.
Snakebites: First aid.
Snake bite: coral snakes.
Black widow spider bite.
Brown recluse spider bite.
Marine envenomation.

September 22, 2017 Posted by | Lectures, Medicine | Leave a comment

Ophthalmology – National EM Board Review Course

The lecture covers a lot of different stuff. Some links:

Blepharitis.
Dacryocystitis.
Dacryoadenitis.
Chalazion.
Orbital Cellulitis.
Cranial Nerves III, IV, and VI: The Oculomotor System.
Argyll Robertson pupil.
Marcus Gunn pupil.
Horner syndrome.
Third nerve palsy.
Homonymous hemianopsia.
Central Retinal Artery Occlusion.
Central Retinal Vein Occlusion.
Optic Neuritis.
Retinal detachment.
Temporal Arteritis.
Conjunctivitis.
Epidemic Keratoconjunctivitis (EKC).
Uveitis.
Hypopyon.
Keratitis.
Herpes Zoster Ophthalmicus.
Subconjunctival Hemorrhage.
Corneal Abrasion.
Corneal Laceration.
Globe Rupture.
Acute Angle-Closure Glaucoma.
Hyphema.
Endophthalmitis.
Retrobulbar hemorrhage.

September 15, 2017 Posted by | Lectures, Medicine, Ophthalmology, Pharmacology | Leave a comment

Gastroenterology – Amal Mattu

If I hadn’t just read Horowitz & Samsom’s book I’m fairly sure this lecture would have been difficult to follow, but a lot of the stuff covered here is (naturally) closely related to the stuff covered in that book; this is mostly a revision lecture aimed at reminding you of stuff you already (supposedly?) know and/or dealing with topics closely related to stuff you already know, I don’t think it’s the right lecture for someone who knows very little about gastroenterology. I like Mattu’s approach to lecturing; this lecture was both fun and enjoyable to watch, despite (?) including a lot of information.

A few links to stuff covered/mentioned in the lecture:

Mediastinitis.
Boerhaave syndrome.
Does This Patient Have a Severe Upper Gastrointestinal Bleed? (JAMA).
Acute Liver Failure (NEJM review article).
Charcot’s cholangitis triad.
Ranson criteria.
Volvulus.
Crohn’s disease.
Ulcerative colitis.
Abdominal aortic aneurysm.
Mesenteric ischemia.
Shigella infection.
Amebiasis.
Clostridium perfringens.
Pseudomembranous colitis.

September 11, 2017 Posted by | Gastroenterology, Lectures, Medicine, Microbiology | Leave a comment

Interactive Coding with “Optimal” Round and Communication Blowup

The youtube description of this one was rather longer than usual, and I decided to quote it in full below:

“The problem of constructing error-resilient interactive protocols was introduced in the seminal works of Schulman (FOCS 1992, STOC 1993). These works show how to convert any two-party interactive protocol into one that is resilient to constant-fraction of error, while blowing up the communication by only a constant factor. Since these seminal works, there have been many follow-up works which improve the error rate, the communication rate, and the computational efficiency. All these works assume that in the underlying protocol, in each round, each party sends a *single* bit. This assumption is without loss of generality, since one can efficiently convert any protocol into one which sends one bit per round. However, this conversion may cause a substantial increase in *round* complexity, which is what we wish to minimize in this work. Moreover, all previous works assume that the communication complexity of the underlying protocol is *fixed* and a priori known, an assumption that we wish to remove. In this work, we consider protocols whose messages may be of *arbitrary* lengths, and where the length of each message and the length of the protocol may be *adaptive*, and may depend on the private inputs of the parties and on previous communication. We show how to efficiently convert any such protocol into another protocol with comparable efficiency guarantees, that is resilient to constant fraction of adversarial error, while blowing up both the *communication* complexity and the *round* complexity by at most a constant factor. Moreover, as opposed to most previous work, our error model not only allows the adversary to toggle with the corrupted bits, but also allows the adversary to *insert* and *delete* bits. In addition, our transformation preserves the computational efficiency of the protocol. Finally, we try to minimize the blowup parameters, and give evidence that our parameters are nearly optimal. This is joint work with Klim Efremenko and Elad Haramaty.”

A few links to stuff covered/mentioned in the lecture:

Coding for interactive communication correcting insertions and deletions.
Efficiently decodable insertion/deletion codes for high-noise and high-rate regimes.
Common reference string model.
Small-bias probability spaces: Efficient constructions and applications.
Interactive Channel Capacity Revisited.
Collision (computer science).
Chernoff bound.

September 6, 2017 Posted by | Computer science, Cryptography, Lectures, Mathematics | Leave a comment

Utility of Research Autopsies for Understanding the Dynamics of Cancer

A few links:
Pancreatic cancer.
Jaccard index.
Limited heterogeneity of known driver gene mutations among the metastases of individual patients with pancreatic cancer.
Epitope.
Tissue-specific mutation accumulation in human adult stem cells during life.
Epigenomic reprogramming during pancreatic cancer progression links anabolic glucose metabolism to distant metastasis.

August 25, 2017 Posted by | Cancer/oncology, Genetics, Immunology, Lectures, Medicine, Statistics | Leave a comment

Quantifying tumor evolution through spatial computational modeling

Two general remarks: 1. She talks very fast, in my opinion unpleasantly fast – the lecture would have been at least slightly easier to follow if she’d slowed down a little. 2. A few of the lectures uploaded in this lecture series (from the IAS Mathematical Methods in Cancer Evolution and Heterogeneity Workshop) seem to have some sound issues; in this lecture there are multiple 1-2 seconds long ‘chunks’ where the sound drops out and some words are lost. This is really annoying, and a similar problem (which was likely ‘the same problem’) previously lead me to quit another lecture in the series; however in this case I decided to give it a shot anyway, and I actually think it’s not a big deal; the sound-losses are very short in duration, and usually no more than one or two words are lost so you can usually figure out what was said. During this lecture there was incidentally also some issues with the monitor roughly 27 minutes in, but this isn’t a big deal as no information was lost and unlike the people who originally attended the lecture you can just skip ahead approximately one minute (that was how long it took to solve that problem).

A few relevant links to stuff she talks about in the lecture:

A Big Bang model of human colorectal tumor growth.
Approximate Bayesian computation.
Site frequency spectrum.
Identification of neutral tumor evolution across cancer types.
Using tumour phylogenetics to identify the roots of metastasis in humans.

August 22, 2017 Posted by | Cancer/oncology, Evolutionary biology, Genetics, Lectures, Mathematics, Medicine, Statistics | Leave a comment

Epilepsy Diagnosis & Treatment – 5 New Things Every Physician Should Know

Links to related stuff:
i. Sudden unexpected death in epilepsy (SUDEP).
ii. Status epilepticus.
iii. Epilepsy surgery.
iv. Temporal lobe epilepsy.
v. Lesional epilepsy surgery.
vi. Nonlesional neocortical epilepsy.
vii. A Randomized, Controlled Trial of Surgery for Temporal-Lobe Epilepsy.
viii. Stereoelectroencephalography.
ix. Accuracy of intracranial electrode placement for stereoencephalography: A systematic review and meta-analysis. (The results of the review is not discussed in the lecture, for obvious reasons – lecture is a few years old, this review is brand new – but seemed relevant to me.)
x. MRI-guided laser ablation in epilepsy treatment.
xi. Laser thermal therapy: real-time MRI-guided and computer-controlled procedures for metastatic brain tumors.
xii. Critical review of the responsive neurostimulator system for epilepsy (Again, not covered but relevant).
xiii. A Multicenter, Prospective Pilot Study of Gamma Knife Radiosurgery for Mesial Temporal Lobe Epilepsy: Seizure Response, Adverse Events, and Verbal Memory.
xiv. Gamma Knife radiosurgery for recurrent or residual seizures after anterior temporal lobectomy in mesial temporal lobe epilepsy patients with hippocampal sclerosis: long-term follow-up results of more than 4 years (Not covered but relevant).

July 19, 2017 Posted by | Lectures, Medicine, Neurology, Studies | Leave a comment

Detecting Cosmic Neutrinos with IceCube at the Earth’s South Pole

I thought there were a bit too many questions/interruptions for my taste, mainly because you can’t really hear the questions posed by the members of the audience, but aside from that it’s a decent lecture. I’ve added a few links below which covers some of the topics discussed in the lecture.

Neutrino astronomy.
Antarctic Impulse Transient Antenna (ANITA).
Hydrophone.
Neutral pion decays.
IceCube Neutrino Observatory.
Evidence for High-Energy Extraterrestrial Neutrinos at the IceCube Detector (Science).
Atmospheric and astrophysical neutrinos above 1 TeV interacting in IceCube.
Notes on isotropy.
Measuring the flavor ratio of astrophysical neutrinos.
Blazar.
Supernova 1987A neutrino emissions.

July 18, 2017 Posted by | Astronomy, Lectures, Physics, Studies | Leave a comment

Probing the Early Universe through Observations of the Cosmic Microwave Background

This lecture/talk is a few years old, but it was only made public on the IAS channel last week (…along with a lot of other lectures – the IAS channel has added a lot of stuff recently, including more than 150 lectures within the last week or so; so if you’re interested you should go have a look).

Below the lecture I have added a few links with stuff (wiki-articles and a few papers) related to the topics covered in the lecture. I didn’t read those links, but I skimmed them (and a few others, which I subsequently decided not to include as their coverage did not overlap sufficiently with the stuff covered in the lecture) and decided to add them in order to remind myself what kind of stuff was included in the lecture/allow others to infer what kind of stuff might be included in the lecture. The links naturally go into a lot more detail than does the lecture, but these are the sort of topics discussed/included.

The lecture is long (90 minutes + a short Q&A), but it was interesting enough for me to watch all of it. The lecturer displays a very high level of speech disfluency throughout the lecture, in the sense that I might not be surprised if I were told that the most commonly word encountered during this lecture was ‘um’ or ‘uh’, rather than more commonly encountered mode words like ‘the’, but you get used to it (at least I managed to sort of ‘tune it out’ after a while). I should caution that there’s a short ‘jump’ very early on in the lecture (at the 2 minute mark or so) where a small amount of frames were apparently dropped, but that should not scare you away from watching the lecture; that frame drop is the only one of its kind during the lecture, aside from a similar brief ‘jump’ around the 1 hour 9 minute mark.

Some links:

Astronomical interferometer.
Polarimetry.
Bolometer.
Fourier transform.
Boomerang : A Balloon-borne Millimeter Wave Telescope and Total Power Receiver for Mapping Anisotropy in the Cosmic Microwave Background.
Observations of the Temperature and Polarization Anisotropies with Boomerang 2003.
THE COBE DIFFUSE INFRARED BACKGROUND EXPERIMENT SEARCH FOR THE COSMIC INFRARED BACKGROUND: I. LIMITS AND DETECTIONS.
Detection of the Power Spectrum of Cosmic Microwave Background Lensing by the Atacama Cosmology Telescope.
Secondary anisotropies of the CMB (review article).
Planck early results. VIII. The all-sky early Sunyaev-Zeldovich cluster sample.
Sunyaev–Zel’dovich effect.
A CMB Polarization Primer.
MEASUREMENT OF COSMIC MICROWAVE BACKGROUND POLARIZATION POWER SPECTRA FROM TWO YEARS OF BICEP DATA.
Spider: a balloon-borne CMB polarimeter for large angular scales.

July 13, 2017 Posted by | Astronomy, cosmology, Lectures, Physics | Leave a comment

Melanoma therapeutic strategies that select against resistance

A short lecture, but interesting:

If you’re not an oncologist, these two links in particular might be helpful to have a look at before you start out: BRAF (gene) & Myc. A very substantial proportion of the talk is devoted to math and stats methodology (which some people will find interesting and others …will not).

July 3, 2017 Posted by | Biology, Cancer/oncology, Genetics, Lectures, Mathematics, Medicine, Statistics | Leave a comment

Neurology Grand Rounds – Typical and Atypical Diabetic Neuropathy

The lecture is not particularly easy to follow if you’re not a neurologist, and/but I assume even neurologists might have difficulties with Liewluck’s (? the second guy’s…) contribution because that guy’s English pronunciation is not great. But if you’re the sort of person who watches neurology lectures online it’s well worth watching.

Said noted in his book on these topics that: “In general pharmacological treatments will not cause anywhere near complete pain relief: “For patients receiving pharmacological treatment, the average pain reduction is about 20-30%, and only 20-35% of patients will achieve at least a 50% pain reduction with available drugs. […] often only partial pain relief from neuropathic pain can be expected, and […] sensory deficits are unlikely to respond to treatment.” Treatment of neuropathic pain is often a trial-and-error process.”

These guys make an even stronger point than Said did: Diabetics who develop painful neuropathies do not get rid of the pain even with treatment – the pain can be managed, but it’s permanent in (…almost? …a few young type 1 diabetics, maybe? But the 60-year old neurologist had never encountered one of those, so odds are against you being one of the lucky ones…) every single case. This of course has some consequences for how patients should be managed – for example you want to devote some time and effort to managing expectations, so people don’t get/have unrealistic ideas about what the treatments which are available may actually accomplish. Another aspect related to this is which sort of treatment options to consider in such a setting, as also noted in the lecture – tolerance development is for example an easily foreseeable problem with opiate treatment which is likely to cause problems down the line if not addressed (but as I pointed out a few years ago, my impression is that: “‘it may not work particularly well in the long run, and there are a lot of side-effects’ is a better argument against [chronic opioid treatment] than the potential for addiction”).

June 23, 2017 Posted by | Diabetes, Lectures, Medicine, Neurology, Pharmacology | Leave a comment

Harnessing phenotypic heterogeneity to design better therapies

Unlike many of the IAS lectures I’ve recently blogged this one is a new lecture – it was uploaded earlier this week. I have to say that I was very surprised – and disappointed – that the treatment strategy discussed in the lecture had not already been analyzed in a lot of detail and been implemented in clinical practice for some time. Why would you not expect the composition of cancer cell subtypes in the tumour microenvironment to change when you start treatment – in any setting where a subgroup of cancer cells has a different level of responsiveness to treatment than ‘the average’, that would to me seem to be the expected outcome. And concepts such as drug holidays and dose adjustments as treatment responses to evolving drug resistance/treatment failure seem like such obvious approaches to try out here (…the immunologists dealing with HIV infection have been studying such things for decades). I guess ‘better late than never’.

A few papers mentioned/discussed in the lecture:

Impact of Metabolic Heterogeneity on Tumor Growth, Invasion, and Treatment Outcomes.
Adaptive vs continuous cancer therapy: Exploiting space and trade-offs in drug scheduling.
Exploiting evolutionary principles to prolong tumor control in preclinical models of breast cancer.

June 11, 2017 Posted by | Cancer/oncology, Genetics, Immunology, Lectures, Mathematics, Medicine, Studies | Leave a comment

Cosmology: Recent Results and Future Prospects

This is another old lecture from my bookmarks. I’m reasonably certain the main reason why I did not blog this earlier is that it’s a rather general and not very detailed overview lecture, so it doesn’t actually contain a lot of new stuff. Hubble’s work, the discovery of the cosmic microwave background, properties of the early universe and how it evolved, discussion of the cosmological constant, dark matter and dark energy, some recent observational results – most of the stuff he talks about should be familiar territory to people interested in the field. Before I watched the lecture I had expected it to include a lot more ‘recent results’ and ‘future prospects’ than were actually included; a big part of the lecture is just an overview of what we’ve learned since the 1930es.

June 7, 2017 Posted by | Astronomy, Lectures, Physics | Leave a comment

Extraordinary Physics with Millisecond Pulsars

A few related links:
Nanograv.org.
Millisecond pulsar.
PSR J0348+0432.
Pulsar timing array.
Detection of Gravitational Waves using Pulsar Timing (paper).
The strong equivalence principle.
European Pulsar Timing Array.
Parkes Observatory.
Gravitational wave.
Gravitational waves from binary supermassive black holes missing in pulsar observations (paper – it’s been a long time since I watched the lecture, but in my bookmarks I noted that some of the stuff included in this publication was covered in the lecture).

May 24, 2017 Posted by | Astronomy, Lectures, Papers, Physics | Leave a comment

Imported Plant Diseases

I found myself debating whether or not I should read Lewis, Petrovskii, and Potts’ text The Mathematics Behind Biological Invasions a while back, but at the time I in the end decided that it would simply be too much work to justify the potential payoff – so instead of reading the book, I decided to just watch the above lecture and leave it at that. This lecture is definitely a very poor textbook substitute, and I was strongly debating whether or not to blog it because it just isn’t very good; the level of coverage is very low. Which is sad, because some of the diseases discussed in the lecture – like e.g. wheat leaf rust – are really important and worth knowing about. One of the important points made in the lecture is that in the context of potential epidemics, it can be difficult to know when and how to intervene because of the uncertainty involved; early action may be the more efficient choice in terms of resource use, but the earlier you intervene, the less certain will be the intervention payoff and the less you’ll know about stuff like transmission patterns (…would outbreak X ever really have spread very wide if we had not intervened? We don’t observe the counterfactual…). Such aspects of course are not only relevant to plant-diseases, and the lecture also contains other basic insights from epidemiology which apply to other types of disease – but if you’ve ever opened a basic epidemiology text you’ll know all these things already.

May 22, 2017 Posted by | Biology, Botany, Ecology, Epidemiology, Lectures | Leave a comment

Out of this World: A history of Structure in the Universe

This lecture is much less technical than were the last couple of lectures I posted, and if I remember correctly it’s aimed at a general audience (…the sort of ‘general audience’ that attends IAS lectures, but even so…). The lecture itself is quite short, only roughly 35 minutes long, but there’s a long Q&A session afterwards.

May 21, 2017 Posted by | Astronomy, Lectures, Physics | Leave a comment

The Mathematical Challenge of Large Networks

This is another one of the aforementioned lectures I watched a while ago, but had never got around to blogging:

If I had to watch this one again, I’d probably skip most of the second half; it contains highly technical coverage of topics in graph theory, and it was very difficult for me to follow (but I did watch it to the end, just out of curiosity).

The lecturer has put up a ~500 page publication on these and related topics, which is available here, so if you want to know more that’s an obvious place to go have a look. A few other relevant links to stuff mentioned/covered in the lecture:
Szemerédi regularity lemma.
Graphon.
Turán’s theorem.
Quantum graph.

May 19, 2017 Posted by | Computer science, Lectures, Mathematics, Statistics | Leave a comment