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Retrospective analysis of eFAST ultrasounds performed on trauma activations at an academic level-1 trauma center

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World Journal of Emergency Medicine 2020年第1期11卷 12-17页

作者： Samantha Shwe Lauren Witchey Shadi Lahham Ethan Kunstadt Inna Shniter john c.fox School of Medicine University of CaliforniaIrvine 92697USA Department of Emergency Medicine University of CaliforniaIrvineOrangeCA 92868USA

BAcKGROUND:Point-of-care ultrasound(POcUS)has become increasingly integrated into the practice of emergency medicine.A common application is the extended focused assessment with sonography in trauma(eFAST)*** American college of Emergency Physicians has guidelines regarding the scope of ultrasound in the emergency department and the appropriate *** objective of this study was to conduct a review of performed,documented and billed eFAST ultrasounds on trauma activation ***:This was a retrospective review of all trauma activation patients during a 10-month period at an academic level-one trauma center.A list comparing all trauma activations was crossreferenced with a list of all billed eFAST *** records were reviewed to determine whether an eFAST was indicated,performed,and appropriately ***:We found that 1,507 of 1,597 trauma patients had indications for eFAST,but 396(27%)of these patients did not have a billed *** these 396 patients,87(22%)had documentation in the provider note that an eFAST was performed but there was no separate procedure *** remaining 309(78%)did not have any documentation of the eFAST in the patient’s chart although an eFAST was recorded and reviewed during ultrasound quality ***:A significant proportion of trauma patients had eFAST exams performed but were not documented or *** of documentation was *** ultrasound programs require appropriate reimbursement to support training,credentialing,equipment,quality assurance,and device *** study demonstrates a significant absence of adequate documentation leading to potential revenue loss for an emergency ultrasound program.

关键词： Point-of-care ultrasound Emergency medicine Focused assessment withsonography in trauma Trauma activation Blunt trauma

Simpli?ed point-of-care ultrasound protocol to con?rm central venous catheter placement:A prospective study

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World Journal of Emergency Medicine 2017年第1期8卷 25-28页

作者： Scan P.Wilson Samer Assaf Shadi Lahham Mohammad Subeh Alan chiem craig Anderson Samantha Shwe Ryan Nguyen john c.fox Department of Emergency Medicine University of CaliforniaIrvineOrangeCalifornia 92868USA Department of Emergency Medicine University of CaliforniaSylmarLos AngelesCalifornia 91342USA

BAcKGROUND: The current standard for con? rmation of correct supra-diaphragmatic central venous catheter(cVc) placement is with plain ? lm chest radiography(cXR). We hypothesized that a simple point-of-care ultrasound(POcUS) protocol could effectively con? rm placement and reduce time to con? ***: We prospectively enrolled a convenience sample of patients in the emergency department and intensive care unit who required cVc placement. correct positioning was considered if turbulent flow was visualized in the right atrium on sub-xiphoid, parasternal or apical cardiac ultrasound after injecting 5 cc of sterile, non-agitated, normal saline through the ***: Seventy-eight patients were enrolled. POcUS had a sensitivity of 86.8%(95%cI 77.1%–93.5%) and speci? city of 100%(95%cI 15.8%–100.0%) for identifying correct central venous catheter placement. Median POcUS and cXR completion were 16 minutes(IQR 10–29) and 32 minutes(IQR 19–45), ***: Ultrasound may be an effective tool to confirm central venous catheter placement in instances where there is a delay in obtaining a con? rmatory cXR.

关键词： Point-of-care ultrasound Emergency ultrasound central venous access

Evaluation of a point of care ultrasound curriculum for Indonesian physicians taught by fi rst-year medical students

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World Journal of Emergency Medicine 2017年第4期8卷 281-286页

作者： Jonathan B.Lee christina Tse Thomas Keown Michael Louthan christopher Gabriel Alexander Anshus Bima Hasjim Katrina Lee Esther Kim Luke Yu Allen Yu Shadi Lahham Steven Bunch Maili Alvarado Abdulatif Gari john c.fox School of Medicine University of CaliforniaIrvineUSA Department of Emergency Medicine University of CaliforniaIrvineOrangeCalifornia 92868USA

BAcKGROUND: The purpose of this study was to assess the short-term efficacy of a 4-week ultrasound curriculum taught by American first-year medical students to general practitioners working in public health care clinics, or puskesmas, in Bandung, ***: We performed a prospective, observational study of Indonesian health care practitioners from public clinics in Bandung, Indonesia. These practitioners were enrolled in a 4-week ultrasound training course taught by first-year American medical students. A total of six sessions were held comprising of 38 ultrasound milestones. A pre-course and post-course written exam and practical exam was taken by each ***: We enrolled 41 clinicians in the course. The average pre-course exam score was 35.2% with a 2.4% pass rate, whereas the average post-course exam score was 82.0% with a 92.7% pass rate. The average practical score at the completion of the course was 83.2%(SD=0.145) with 82.9% of the class passing(score above 75.0%).cONcLUSION: Our data suggests that first-year medical students can effectively teach ultrasound to physicians in Indonesia using a 4-week intensive ultrasound training course. Future studies are needed to determine the amount of training required for proficiency and to evaluate the physicians' perceptions of the student-instructors' depth of knowledge and skill in point of care ultrasound.

关键词： Ultrasound education Ultrasound teaching Indonesia

Procedural simulation:medical student preference and value of three task trainers for ultrasound guided regional anesthesia

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World Journal of Emergency Medicine 2017年第4期8卷 287-291页

作者： Shadi Lahham Taylaur Smith Jessa Baker Amanda Purdy Erica Frumin Bret Winners Sean P.Wilson Abdulatif Gari john c.fox Department of Emergency Medicine University of CaliforniaIrvineOrangeCalifornia 92868USA Uc Irvine School of Medicine IrvineCaliforniaUSA

BAcKGROUND: Ultrasound guided regional anesthesia is widely taught using task trainer models. commercially available models are often used; however, they can be cost prohibitive. Therefore, alternative "homemade" models with similar fidelity are often used. We hypothesize that professional task trainers will be preferred over homemade models. The purpose of this study is to determine realism, durability and cleanliness of three different task trainers for ultrasound guided nerve ***: This was a prospective observational study using a convenience sample of medical student participants in an ultrasound guided nerve block training session on January 24 th, 2015. Participants were asked to perform simulated nerve blocks on three different task trainers including, 1 commercial and 2 homemade. A questionnaire was then given to all participants to rate their experiences both with and without the knowledge on the cost of the simulator ***: Data was collected from 25 participants. The Blue Phantom model was found to have the highest fidelity. Initially, 10(40%) of the participants preferred the Blue Phantom model, while 10(40%) preferred the homemade gelatin model and 5(20%) preferred the homemade tofu model. After cost awareness, the majority, 18(72%) preferred the gelatin ***: The Blue Phantom model was thought to have the highest fidelity, but after cost consideration the homemade gelatin model was preferred.

关键词： Ultrasound guided nerve block Task trainer Regional anesthesia

Prospective evaluation of point-of-care ultrasound for pre-procedure identification of landmarks versus traditional palpation for lumbar puncture

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World Journal of Emergency Medicine 2016年第3期7卷 173-177页

作者： shadi lahham priel schmalbach sean p.wilson lori ludeman mohammad subeh jocelyn chao nadeem albadawi niki mohammadi john c.fox Emergency Medicine University of California Irvine Orange California 92868 USA

BAcKGROUND: The objective of this study is to determine if point-of-care ultrasound(POcUS) pre-procedure identification of landmarks can decrease failure rate, reduce procedural time, and decrease the number of needle redirections and reinsertions when performing a lumbar puncture(LP).METHODS: This was a prospective, randomized controlled trial comparing POcUS preprocedure identifi cation of landmarks versus traditional palpation for LP in a cohort of patients in the emergency department and intensive care ***: A total of 158 patients were enrolled. No signifi cant difference was found in time to completion, needle re-direction, or needle re-insertion when using POcUS when compared to the traditional method of ***: consistent with fi ndings of previous studies, our data indicate that there was no observed benefi t of using POcUS to identify pre-procedure landmarks when performing an LP.

关键词： Ultrasound Lumbar puncture Spinal tap

Impact of cOVID-19 pandemic on cardiovascular health in sedentary and athletes:consensus,uncertainties,and ways for mitigation

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Sports Medicine and Health Science 2024年第3期6卷 205-208页

作者： john c.Quindry Lei Xi School of Integrative Physiology and Athletic Training University of MontanaMissoulaMT59812USA Pauley Heart center Department of Internal MedicineSchool of MedicineVirginia Commonwealth UniversityRichmondVA23298-0204USA

More than 4 years has elapsed since the World Health Organization(WHO)ofﬁcially announced the coronavirus disease 2019(cOVID-19)as a pandemic outbreak in March 11,*** the ongoing investigations and political debates upon the origin,exacerbation,resurgence,andﬁnal control of cOVID-19,medical and scientiﬁc consensus indicates that the now endemic cOVID-19 virus is one of the worst public health crises in our *** every person on earth has been directly or indirectly impacted by the adverse effects of the highly contagious viral pathogen-SARS-coV-2(severe acute respiratory syndrome coronavirus 2).Indeed,the population reach of the cOVID-19 infection includes governmental response measures(e.g.,lockdowns and social distancing,mandates for masks and face coverings,vaccines,etc.)that have restricted entrenched societal routines,personal mobility,and ***,the host of health problems linked to this viral infection linger to this day,with selective groups of people experiencing a higher risk for untoward medical outcomes and/or elevated levels of vulnerability to the post-acute sequelae of cOVID-19(***-cOVID).For example,a 2021 study by Logue et *** initial evidence that 10%–30%of individuals in United States may experience prolonged symptoms following SARS-coV-2 infection,including cardiovascular abnormalities.1 Similarly,a 2021 retrospective cohort study in England suggest that the incidence of major adverse cardiovascular events(*** failure,myocardial infarction,ischemic stroke.

关键词： cardiovascular routine Impact

Review of Networked Microgrid Protection:Architectures,challenges,Solutions,and Future Trends

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cSEE Journal of Power and Energy Systems 2024年第2期10卷 448-467页

作者： Jorge de la cruz Ying Wu john E.candelo-Becerra Juan c.Vasquez Josep M.Guerrero center for Research on Microgrids(cROM) Department of Energy TechnologyAalborg University9220 AalborgDenmark Facultad de Minas Departamento de Energia Eléctrica y AutomaticaUniversidad Nacional de ColombiaSede MedellinCarrera 80 No.65-223RobledoMedellin 050041Colombia. center for Research on Microgrids at UPc(UPc cROM) Department of Electronic EngineeringTechnical University of Catalonia(UPC)08019 Barcelona Spain IcREA Pg.Lluis Companys 2308010 BarcelonaSpain center for Research on Microgrids at AAU(AAU cROM) AAU EnergyAalborg University(AAU)9220 Aalborg EastDenmark

Design and selection of advanced protection schemes have become essential for reliable and secure operation of networked *** protection schemes that allow correct operation of microgrids have been proposed for individual systems in different topologies and ***,protection schemes for networked microgrids are still in devel-opment,and further research is required to design and operate advanced protection in interconnected *** of these microgrids in different nodes with various intercon-nection technologies increases fault occurrence and complicates protection *** paper aims to point out challenges in developing protection for networked microgrids,potential solutions,and research areas that need to be addressed for their ***,this article presents a systematic analysis of different microgrid clusters proposed since 2016,including several architectures of networked microgrids,operation modes,components,and utilization of renewable sources,which have not been widely explored in previous review ***,the paper presents a discussion on protection systems currently available for microgrid clusters,current challenges,and solutions that have been proposed for these ***,it discusses the trend of protection schemes in networked microgrids and presents some conclusions related to ***—Adaptive eprotection,microgrid cluster,microgrid,multiple microgrid,networked microgrid,real-time simulation,smart grid.

关键词： Adaptive eprotection microgrid cluster microgrid multiple microgrid networked microgrid real-time simulation smart grid

Assessment of clinical depression metrics in cardiac patients using the patient health Questionnaire-9 before and after phase-II cardiac rehabilitation

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Sports Medicine and Health Science 2024年第3期6卷 240-245页

作者： john c.Quindry Michael McNamara carrie Oser crystelle Fogle Integrative Physiology and Athletic Training University of MontanaMissoulaMTUSA St.Patrick's Hospital MissoulaMTUSA cardiovascular Health Program–Montana Department of Public Health and Human Services HelenaMTUSA

cardiovascular disease remains a leading cause of morbidity and mortality,a fact that is commonly associated with co-morbidities such as clinical *** phase II cardiac rehabilitation is an established intervention for those with cardiovascular disease,its effect on patients who also suffer from depression are under ***:To quantify Pre-and Post-cardiac rehabilitation questionnaire scores collected from a large patient data *** this investigation,27670 patients completed Patient Health Questionnaire-9 questionnaires both Pre-and Post-rehabilitation(averaging[28.08.7]phase II sessions).Findings reveal that questionnaire scores decreased by 40%–48%across all groups,a finding that was independent of assigned sex,race,and ***,when data were stratified for questionnaire scores that may indicate major and minor depressive disorder,phase II cardiac rehabilitation outcomes were lower by 61%and 49%*** all groups exhibited lower questionnaire scores following cardiac rehabilitation participation,numerical differences at Preand Post-rehabilitation time points indicate that males and White patients have more favorable *** latter observation,while not confirmed currently,appears to be linked to referral rates to phase II cardiac rehabilitation,which remain poor for females,racial and ethnic minorities.

关键词： clinical depression Exercise Psychological health

Boron neutron capture therapy of cancer:where do we stand now?

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cancer communications 2024年第8期44卷 889-892页

作者： Rolf F.Barth Gong Wu Maria da Graca H.Vicente john c Grecula Nilendu Gupta Department of Pathology The Ohio State UniversityColumbusOhioUSA Mass Spectrometry and Proteomics Facility The Ohio State UniversityColumbusOhioUSA Department of chemistry Louisiana State UniversityBaton RougeLouisianaUSA Department of Radiation Oncology The Ohio State UniversityColumbusOhioUSA

1 INTRODUcTION,This is the third Editorial/commentary that one of us(***)has written relating to boron neutron capture therapy(BNcT)[1,2].For those readers who are unfamiliar with BNcT we would refer them to several recent comprehensive reviews[3–5].The second Editorial ended on a hopeful note that with the introduction of acceleratorbased neutron sources(ABNSs),BNcT would enter into the mainstream of radiation therapy[2].

关键词： boron 1,2 neutron