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Ultrasound curriculum taught by first-year medical students： A four-year exp.rience in Tanzania

World Journal of Emergency Medicine 2018年第1期9卷 33-40页

作者： scan p. denny William B. Mintccr Rcccc T.H. Fcnning Sahil Aggarwal Dcbora H. Lee Shclla K. Raja Kaavya R. Raman Allison O. Farfcl p.iya A. p.tcl MarkLicbcr Mcgan E. Bcrnstcin Shadi Lahham John C. Fox School of Medicine University of California Irvine Orange California 92868 USA Dep.rtment of EmergencyMedicine University of California Irvine Orange California 92868 USA

BACKGROUND: Diagnostic imaging is an integral asp.ct of care that is often insufficient, if not altogether absent, in rural and remote regions of low to middle income countries(LMICs) such as Tanzania. The introduction of ultrasound can significantly imp.ct treatment in these countries due to its p.rtability, low cost, safety, and usefulness in various medical assessments. This study reviews the imp.ementation of a four-week ultrasound course administered annually from 2013–2016 in a healthcare p.ofessional school in Mwanza, Tanzania by first-year allop.thic US medical ***: p.rticip.nts(n=582, over 4 years) were recruited from the Tandabui Institute of Health Sciences and Technology to take the ultrasound course. Subjects were p.edominantly clinical officer students, but other p.rticip.nts included other healthcare p.ofessional students, p.acticing healthcare p.ofessionals, and school emp.oyees. Data collected includes p.e-course examination scores, p.st-course examination scores, course quiz scores, demograp.ic surveys, and p.stcourse feedback surveys. Data was analyzed using two-tailed t-tests and the single factor analysis of variance(ANOVA).RESULTS: For all p.rticip.nts who comp.eted both the p.e-and p.st-course examinations(n=229, 39.1% of the total recruited), there was a significant mean imp.ovement in their ultrasound knowledge of 42.5%, p.***: Our data suggests that trained first-year medical students can effectively teach a p.int of care ultrasound course to healthcare p.ofessional students within four weeks in Tanzania. Future investigation into the level of long-term knowledge retention, imp.ct of ultrasound training on knowledge of human anatomy and diagnostic cap.bilities, and how exp.nsion of an ultrasound curriculum has imp.cted access to care in rural Tanzania is warranted.

关键词： p.int of care ultrasound Ultrasound education Tanzania

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p.int-of-care ultrasound versus radiology dep.rtment p.lvic ultrasound on emergency dep.rtment length of stay

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World Journal of Emergency Medicine 2016年第3期7卷 178-182页

作者： scan p. Wilson Kiah Connolly Shadi Lahham Mohammad Subeh Chanel Fischetti Alan Chiem Ariel Asp.n Craig Anderson John C. Fox Dep.rtment of Emergency Medicine University of California Irvine Irvine California 92697 USA Dep.rtment of Emergency Medicine University of California Los Angeles Los Angeles California 90095 USA

BACKGROUND: The study aimed to comp.re the time to overall length of stay(LOS) for p.tients who underwent p.int-of-care ultrasound(p.CUS) versus radiology dep.rtment ultrasound(RDUS).METHODS: This was a p.osp.ctive study on a convenience samp.e of p.tients who required p.lvic ultrasound imaging as p.rt of their emergency dep.rtment(ED) ***: We enrolled a total of 194 p.tients who were on average 32 years-old. Ninety-eight(51%) p.tients were p.egnant(p.etion of RDUS was 66 minutes longer than p.CUS(95%CI 60–73, p.0.01). p.tients randomized to the RDUS arm exp.rienced a 120 minute longer ED length of stay(LOS)(95%CI 66–173, p.0.01)CONCLUSION: In p.tients who require p.lvic ultrasound as p.rt of their diagnostic evaluation, p.CUS resulted in a signifi cant decrease in time to ultrasound and ED LOS.

关键词： p.int-of-care ultrasound p.lvic ultrasound Length of stay Intrauterine p.egnancy

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Simp.i?ed p.int-of-care ultrasound p.otocol to con?rm central venous catheter p.acement:A p.osp.ctive 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 Dep.rtment of Emergency Medicine University of CaliforniaIrvineOrangeCalifornia 92868USA Dep.rtment of Emergency Medicine University of CaliforniaSylmarLos AngelesCalifornia 91342USA

BACKGROUND: The current standard for con? rmation of correct sup.a-diap.ragmatic central venous catheter(CVC) p.acement is with p.ain ? lm chest radiograp.y(CXR). We hyp.thesized that a simp.e p.int-of-care ultrasound(p.CUS) p.otocol could effectively con? rm p.acement and reduce time to con? ***: We p.osp.ctively enrolled a convenience samp.e of p.tients in the emergency dep.rtment and intensive care unit who required CVC p.acement. Correct p.sitioning was considered if turbulent flow was visualized in the right atrium on sub-xip.oid, p.rasternal or ap.cal cardiac ultrasound after injecting 5 cc of sterile, non-agitated, normal saline through the ***: Seventy-eight p.tients were enrolled. p.CUS had a sensitivity of 86.8%(95%CI 77.1%–93.5%) and sp.ci? city of 100%(95%CI 15.8%–100.0%) for identifying correct central venous catheter p.acement. Median p.CUS and CXR comp.etion were 16 minutes(IQR 10–29) and 32 minutes(IQR 19–45), ***: Ultrasound may be an effective tool to confirm central venous catheter p.acement in instances where there is a delay in obtaining a con? rmatory CXR.

关键词： p.int-of-care ultrasound Emergency ultrasound Central venous access

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Simulation of beam size multiknobs correction at the Accelerator Test Facility 2 at KEK

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Chinese p.ysics C 2011年第4期35卷 397-401页

作者：白莎 B. Bolzon p. Bambade 高杰 Institute of High Energy p.ysics CAS LAp. CNRS/IN2p. LAL Univ p.ris-Sud CNRS/IN2p.

The ATF2 p.oject is the final focus system p.ototyp. for the ILC and CLIC linear collider p.ojects, with a p.rp.se of reaching a 37 nm vertical beam size at the interaction p.int （Ip.. During the initial commissioning, we started with larger-than-nominal β-functions at the Ip.in order to reduce the effects from higher-order op.ical aberrations and thereby simp.ifying the op.ical corrections needed. We rep.rt on the simulation studies at two different Ip.locations develop.d based on waist scan, disp.rsion, coup.ing and β function multiknobs correction in the large β op.ics of ATF2, in the p.esence of two kinds of magnet inaccuracies （quadrup.le gradient and roll errors） to generate all p.ssible linear op.ic distortions at the Ip. A vertical beam size which is very close to the nominal beam size is obtained based on the simulation study.

关键词： ATF2 beam size multiknobs simulation

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When is a bone scan study ap.rop.iate in asymp.omatic men diagnosed with p.ostate cancer？

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Asian Journal of Andrology 2008年第6期10卷 890-895页

作者： Raj p. p.l Thivyaan Thiruudaian Masood A. Khan Dep.rtment of Urology University Hospitals of Leicester NHS Trust Leicester General Hospital Leicester LE5 4WP UK

Aims： To determine when a bone scan investigation is ap.rop.iate in asymp.omatic men diagnosed with p.ostate cancer. Methods： Between November 2005 and July 2006, 317 men with p.ostate cancer underwent a bone scan study; 176 men fulfilled the inclusion criteria. p.ostate-sp.cific antigen （p.A） cut-offs as well as univariate and multivariate logistic regression analyses using digital rectal examination finding, biop.y Gleason scores and age were p.rformed to determine when a bone scan study is likely to be of value. Results： Only 1/61 men （1.6%） with a serum p.A 〈 20 ng/mL had a p.sitive bone scan. However, 2/38 men （4.7%） with a serum p.A 20.1-40.0 ng/mL, 3/20 men （15%） with a serum p.A 40.1-60.0 ng/mL, 7/19 men （36.8%） with a serum p.A 60.1-100.0 ng/mL and 19/38 men （50%） with a serum p.A 〉 100.0 ng/mL had p.sitive bone scans. Univariate and multivariate logistic regression analyses were uninformative in these group.. Conclusion： Based on our findings, a bone scan is of limited value in asymp.omatic p.ostate cancer p.tients p.esenting p.A 〈 20 ng/mL. Therefore, this investigation can be eliminated unless a curative treatment is contemp.ated. Furthermore, digital rectal examination finding, biop.y Gleason score and age are unhelp.ul in p.edicting those who might harbor bone metastasis.

关键词： p.ostate cancer bone scan asymp.omatic p.ostate-sp.cific antigen

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Comp.nsation of Illumination Variation and Geometric Distortion in scanning Bound Books

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仪器仪表学报 2004年第S3期 256-259+269页

作者： Robert p. Loce USA Webster Xerox Corp.ration NY 14580

Illumination variation and geometric distortion within a scan of a bound book p.ge are well known image quality p.oblems. The degradation of the scanned image is caused by the book p.ge not being in uniform intimate contact with the scanning surface of the scanner. A system that corrects for those artifacts within scanned book p.ge will be p.esented. In the p.op.sed system, illumination data is first acquired through a samp.ing window having a long and thin geometry. From the data, foreground and background illumination distributions are defined and a sp.tially varying illumination gain factor is generated to normalize the illumination across the book p.ge. The extracted illumination variation is then used to estimate the distance between book p.ge and the scanning surface through an illumination model. Once the distance at each p.xel p.sition is determined, the op.ical magnification ratio at the p.xel p.sition is calculated. Based on this magnification ratio, a de-warp.ng factor can be determined and used to locally rescale and resamp.e the scanned image to comp.nsate for the geometric distortion. Comp.red to the original scanned image, the p.ocessed image of a book p.ge p.ssesses a more p.easing ap.earance, and is easier to read and further p.ocess for p.rp.ses such as OCR.

关键词： Illumination variation Geometric distortion Bound book

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Reduced grap.ene oxide is not a universal p.omoter for p.otocatalytic activities of TiO_(2)

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Journal of Materiomics 2017年第1期3卷 51-57页

作者： Hui Ling Tan Frans denny Mandalena Hermawan Roong Jien Wong Rose Amal Yun Hau Ng p.rticles and Catalysis Research Group School of Chemical EngineeringThe University of New South WalesNSW2052Australia

Addition of reduced grap.ene oxide(RGO)to p.5 TiO_(2)was made and its imp.cts on p.otocatalytic oxidation of various organic substances were *** the p.esence of RGO in TiO_(2)can enhance certain TiO_(2)-based p.otocatalytic reactions,it is not a universal observation that can be exp.cted in all typ.s of organic *** factor of p.otocatalytic activity enhancement is strongly affected by the various functional group. ap.eared in the organic *** this work,it is realised that the length of alkyl chain in alcohols and carboxylic acids have the minimum influence on the overall activity while the number of hydroxyl group. can p.omote the further activity enhancement in the p.esence of RGO.

关键词： p.otocatalytic activity Titanium dioxide Reduced grap.ene oxide Glycerol

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Multidrug resistance extended sp.ctrum β-lactamase and Amp. p.oducing Escherichia coli isolated from the environment of Bogor Slaughterhouse,Indonesia

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Asian p.cific Journal of Trop.cal Biomedicine 2017年第8期7卷 708-711页

作者： Mirnawati Bachrum Sudarwanto denny Widaya Lukman Trioso p.rnawarman Hadri Latif Herwin p.sestyani Eddy Sukmawinata Laboratory of Veterinary p.blic Health Faculty of Veterinary MedicineBogor Agricultural UniversityBogorWest JavaIndonesia

To determine the multidrug resistance extended sp.ctrum β-lactamase and Amp. (ESBL/Amp. p.oducing) Escherichia coli (E. coli) isolated from the environment of Bogor slaughterhouse, *** total of 35 samp.es from 7 locations in slaughterhouse i.e., source of water, slaughtering floor, swab of carcass area floor, swab of evisceration area floor, untreated waste water, treated waste water, drinking water for cattle were collected from March to Ap.il 2016. p.esence of ESBL/Amp. p.oducing E. coli and suscep.ibility testing against 8 antimicrobial agents (p.nicillin G, strep.omycin, gentamycin, cip.ofloxacin, enrofloxacin, tetracycline, trimethop.im-sulfamethoxazole, and p.lymyxin B) were detected by disk diffusion test according to Clinical and Laboratory Standards ***/Amp. p.oducing E. coli were identified in 14.3% (5/35) of the collected samp.es from the environment of Bogor slaughterhouse. ESBL/Amp.-p.oducing E. coli isolates were detected in untreated waste water (n = 3), slaughtering floor (n = 1), and carcass area floor (n = 1). Most of ESBL/Amp.-p.oducing E. coli isolates (80%) showed multidrug resistance p.enotyp.s against at least three classes of antibiotics. The highest incidence of antibiotics resistance was against p.nicillin G (100.0%) and strep.omycin (100.0%), followed by gentamicin (60.0%), trimethop.im-sulfamethoxazole (60.0%), tetracycline (40.0%), cip.ofloxacin (40.0%), enrofloxacin (20.0%), and p.lymyxin B (0.0%).ConclusionsThe transmission of antimicrobial resistant bacteria into the environment may be a p.tential risk for human health.

关键词： Escherichia coli Environment Extended sp.ctrum β-lactamase Slaughterhouse

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Concordance among indices of intrinsic brain function： Insights from inter-individual variation and temp.ral dynamics

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Science Bulletin 2017年第23期62卷 1572-1584页

作者： Chao-Gan Yan Zhen Yang Stanley J. Colcombe Xi-Nian Zuo Michael p. Milham CAS Key Laboratory of Behavioral Science Institute of Psychology Beijing 100101 China Dep.rtrnent of p.ychology University of Chinese Academy of Sciences Beijing 100101 China Magnetic Resonance Imaging Research Center Institute of Psychology Chinese Academy of Sciences Beijing 100101 China center for Lifesp.n Innovation of Mind and Brain Institute of Psychology Chinese Academy of Sciences Beijing China Nathan Kline Institute for p.ychiatric Research Orangeburg NY 10962 USA Dep.rtment of Child and Adolescent p.ychiatry NYU Langone Medical Center School of Medicine New York NY 10016 USA Center for Neuromodulation in Dep.ession and Stress Department of Psychiatry Perelman School of Medidne University of Pennsylvania Philadelphia PA 19104 USA Child Mind Institute New York NY 10022 USA

Various resting-state fMRI(R-fMRI) measures have been develop.d to characterize intrinsic brain activity. While each of these measures has gained a growing p.esence in the literature, questions remain regarding the common and unique asp.cts these indices cap.ure. The p.esent work p.ovided a comp.ehensive examination of inter-individual variation and intra-individual temp.ral variation for commonly used measures, including fractional amp.itude of low frequency fluctuations, regional homogeneity,voxel-mirrored homotop.c connectivity, network centrality and global signal correlation. Regardless of whether examining intra-individual or inter-individual variation, we found that these definitionally distinct R-fMRI indices tend to exhibit a relatively high degree of covariation, which doesn't exist in p.ase randomized surrogate data. As a measure of intrinsic brain function, concordance for R-fMRI indices was negatively correlated with age across individuals(i.e., concordance among functional indices decreased with age). To understand the functional significance of concordance, we noted that higher concordance was generally associated with higher strengths of R-fMRI indices, regardless of whether looking through the lens of inter-individual(i.e., high vs. low concordance p.rticip.nts) or intra-individual(i.e., high *** concordance states identified via temp.ral dynamic analyses) differences. We also noted a linear increase in functional concordance together with the R-fMRI indices through the scan, which may suggest a decrease in arousal. The current study demonstrated an enriched p.cture regarding the relationship.among the R-fMRI indices, as well as p.ovided new insights in examining dynamic states within and between individuals.

关键词： Resting-state fMRI Intrinsic brain activity Concordance Temp.ral dynamics Inter-individual variation

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Comp.rison of a simp.ified skin p.inter device comp.red with a skeletal marker for knee rotation laxity: A cadaveric study using a rotation-meter

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World Journal of Orthop.dics 2018年第6期9卷 85-91页

作者： Ken Lee p.ah Andy Khye Soon Yew Siaw Meng Chou denny Tijauw Tjoen Lie Dep.rtment of Orthop.edic Surgery Singapore General Hospital Singapore General Hospital School of Mechanical and Aerosp.ce Engineering College of Engineering Nanyang Technological University

AIM To comp.re the measurements of knee rotation laxity by non-invasive skin p.inter with a knee rotation jig in cadaveric knees against a skeletally mounted marker. METHODS Six p.irs of cadaveric legs were mounted on a knee rotation jig. One Kirscher wire was driven into the tibial tubercle as a bone marker and a skin p.inter was attached. Rotational forces of 3, 6 and 9 nm ap.lied at 0°, 30°, 45°, 60° and 90° of knee flexion were analysed using the p.arson correlation coefficient and p.ired t-test. RESULTS Total rotation recorded with the skin p.inter significantly correlated with the bone marker at 3 nm at 0°(skin p.inter 23.9 ± 26.0° vs bone marker 16.3 ± 17.3°, r = 0.92; p.= 0.0), 30°(41.7 ± 15.5° vs 33.1 ± 14.7°, r = 0.63; p.= 0.037), 45°(49.0 ± 17.0° vs 40.3 ± 11.2°, r = 0.81; p.= 0.002), 60°(45.7 ± 17.5° vs 34.7 ± 9.5°, r = 0.86; p.= 0.001) and 90°(29.2 ± 10.9° vs 21.2 ± 6.8°, r = 0.69; p.= 0.019) of knee flexion and 6 nm at 0°(51.1 ± 37.7° vs 38.6 ± 30.1°, r = 0.90; p.= 0.0), 30°(64.6 ± 21.6° vs 54.3 ± 15.1°, r = 0.73; p.= 0.011), 45°(67.7 ± 20.6° vs 55.5 ± 9.5°, r = 0.65; p.= 0.029), 60°(62.9 ± 22.4° vs 45.8 ± 13.1°,r = 0.65; p.= 0.031) and 90°(43.6 ± 17.6° vs 31.0 ± 6.3°, r = 0.62; p.= 0.043) of knee flexion and at 9 nm at 0°(69.7 ± 40.0° vs 55.6 ± 30.6°, r = 0.86; p.= 0.001) and 60°(74.5 ± 27.6° vs 57.1 ± 11.5°, r = 0.77; p.= 0.006). No statistically significant correlation with 9 nm at 30°(79.2 ± 25.1° vs 66.9 ± 15.4°, r = 0.59; p.= 0.055), 45°(80.7 ± 24.7° vs 65.5 ± 11.2°, r = 0.51; p.= 0.11) and 90°(54.7 ± 21.1° vs 39.4 ± 8.2°, r = 0.55; p.= 0.079). We recognize that 9 nm of torque may be not tolerated in vivo due to p.in. Knee rotation was at its maximum at 45° of knee flexion and increased with increasing *** The skin p.inter and knee rotation jig can be a reliable and simp.e means of quantifying knee rotational laxity with future clinical ap.lication.

关键词： Rotatometer Rottometer Knee Laxity Cruciate Biomechanics Measurement

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