Incidence and survival after acute myocardial infarction in indigenous and non-indigenous people in the Northern Territory, 1992-2004

Objective: To estimate the incidence and survival rates of acute myocardial infarction (AMI) for Northern Territory Indigenous and non-Indigenous populations.Design and participants: Retrospective cohort study for all new AMI cases recorded in hospital inpatient data or registered as an ischaemic heart disease (IHD) death between 1992 and 2004.Main outcome measures: Population-based incidence and survival rates by age, sex, Indigenous status, remoteness of residence and year of diagnosis.Results: Over the 13-year study period, the incidence of AMI increased 60% in the NT Indigenous population (incidence rate ratio [IRR], 1.04; 95% CI, 1.02–1.06), but decreased 20% in the non-Indigenous population (IRR, 0.98; 95% CI, 0.97–1.00). Over the same period, there was an improvement in all-cases survival (ie, survival with and without hospital admission) for the NT Indigenous population due to a reduction in deaths both pre-hospital and after hospital admission (death rates reduced by 56% and 50%, respectively). The non-Indigenous all-cases death rate was reduced by 29% as a consequence of improved survival after hospital admission; there was no significant change in pre-hospital survival in this population. Important factors that affected outcome in all people after AMI were sex (better survival for women), age (survival declined with increasing age), remoteness (worse outcomes for non-Indigenous residents of remote areas), year of diagnosis and Indigenous status (hazard ratio, 1.44; 95% CI, 1.21–1.70).Conclusions: Our results show that the increasing IHD mortality in the NT Indigenous population is a consequence of a rise in AMI incidence, while at the same time there has been some improvement in Indigenous AMI survival rates. The simultaneous decrease in IHD mortality in NT non-Indigenous people was a result of reduced AMI incidence and improved survival after AMI in those admitted to hospital. Our results inform population-specific strategies for a systemwide response to AMI management

Protein kinase activity of phosphoinositide 3-kinase regulates cytokine-dependent cell survival

Extent: 14 p.The dual specificity protein/lipid kinase, phosphoinositide 3-kinase (PI3K), promotes growth factor-mediated cell survival and is frequently deregulated in cancer. However, in contrast to canonical lipid-kinase functions, the role of PI3K protein kinase activity in regulating cell survival is unknown. We have employed a novel approach to purify and pharmacologically profile protein kinases from primary human acute myeloid leukemia (AML) cells that phosphorylate serine residues in the cytoplasmic portion of cytokine receptors to promote hemopoietic cell survival. We have isolated a kinase activity that is able to directly phosphorylate Ser585 in the cytoplasmic domain of the interleukin 3 (IL-3) and granulocyte macrophage colony stimulating factor (GM-CSF) receptors and shown it to be PI3K. Physiological concentrations of cytokine in the picomolar range were sufficient for activating the protein kinase activity of PI3K leading to Ser585 phosphorylation and hemopoietic cell survival but did not activate PI3K lipid kinase signaling or promote proliferation. Blockade of PI3K lipid signaling by expression of the pleckstrin homology of Akt1 had no significant impact on the ability of picomolar concentrations of cytokine to promote hemopoietic cell survival. Furthermore, inducible expression of a mutant form of PI3K that is defective in lipid kinase activity but retains protein kinase activity was able to promote Ser585 phosphorylation and hemopoietic cell survival in the absence of cytokine. Blockade of p110α by RNA interference or multiple independent PI3K inhibitors not only blocked Ser585 phosphorylation in cytokine-dependent cells and primary human AML blasts, but also resulted in a block in survival signaling and cell death. Our findings demonstrate a new role for the protein kinase activity of PI3K in phosphorylating the cytoplasmic tail of the GM-CSF and IL-3 receptors to selectively regulate cell survival highlighting the importance of targeting such pathways in cancer.Daniel Thomas, Jason A. Powell, Benjamin D. Green, Emma F. Barry, Yuefang Ma, Joanna Woodcock, Stephen Fitter, Andrew C.W. Zannettino, Stuart M. Pitson, Timothy P. Hughes, Angel F. Lopez, Peter R. Shepherd, Andrew H. Wei, Paul G. Ekert and Mark A. Guthridg

Evaluating the Impact of Nonconcurrent Flight Laboratory and Ground Course Progress on the Academic Outcomes of Collegiate Aviation Students

Flight training is often conducted as a two-part model, where a student completes an academic ground course to learn the knowledge and also enrolls in a flight laboratory course to apply the knowledge and skills required to earn a new certificate or rating. Often, these two parts are offered as separate courses to provide flexibility to students in the training environment. The intent is that the ground course and flight laboratory are conducted concurrently, so the students apply knowledge from the ground course during their flight training. However, external factors may delay the flight training progress in the laboratory environment, causing the student to disconnect their flight training and ground course into a nonconcurrent status. This study aims to assess the impact of concurrent versus nonconcurrent flight lab enrollment on the academic outcomes of collegiate aviation students in the classroom. The study will determine whether a student conducting flight training in their current course of study (concurrent training) performs significantly better academically than a student conducting training in a previous flight lab to their current course of study (nonconcurrent training). Quantitative data was collected in the form of academic scores on classroom block exams to evaluate the impact of students in concurrent versus nonconcurrent training environments. A series of independent sample t-tests were used to find consistent evidence that students in a concurrent flight laboratory perform better on block exams in their academic ground course than students enrolled in a nonconcurrent flight laboratory. The results of this research will be used to inform both educational practices within flight training departments and will assist in providing clarity to external parties interested in evaluating the impact of students completing a lab course that is nonconcurrent to their current ground course of study

Using AI for Diagnosis and Treatment Plan

This assignment is to be used for Undergraduate Medical Education Training to consider the role of AI by patients and aspiring physicians. Students will comparing and contrast three self-diagnostic tools WebMD, ChatGPT, and Bard with a case study to determine a diagnosis and treatment plan. Additionally, students will consider concerns, benefits, privacy and accuracy, and how this will impact their practice as physicians