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

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

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Comprehensive K-Means Clustering

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Journal of Computer and Communications 2024年第3期12卷 146-159页

作者： ethan Xiao Rye Country Day School Rye USA

The k-means algorithm is a popular data clustering technique due to its speed and simplicity. However, it is susceptible to issues such as sensitivity to the chosen seeds, and inaccurate clusters due to poor initial seeds, particularly in complex datasets or datasets with non-spherical clusters. In this paper, a Comprehensive K-Means Clustering algorithm is presented, in which multiple trials of k-means are performed on a given dataset. The clustering results from each trial are transformed into a five-dimensional data point, containing the scope values of the x and y coordinates of the clusters along with the number of points within that cluster. A graph is then generated displaying the configuration of these points using Principal Component Analysis (PCA), from which we can observe and determine the common clustering patterns in the dataset. The robustness and strength of these patterns are then examined by observing the variance of the results of each trial, wherein a different subset of the data keeping a certain percentage of original data points is clustered. By aggregating information from multiple trials, we can distinguish clusters that consistently emerge across different runs from those that are more sensitive or unlikely, hence deriving more reliable conclusions about the underlying structure of complex datasets. Our experiments show that our algorithm is able to find the most common associations between different dimensions of data over multiple trials, often more accurately than other algorithms, as well as measure stability of these clusters, an ability that other k-means algorithms lack.

关键词： K-Means Clustering

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A modular microfluidic platform to study how fluid shear stress alters estrogen receptor phenotype in ER+breast cancer cells

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Microsystems & Nanoengineering 2024年第1期10卷 287-299页

作者： Braulio Andrés Ortega Quesada Jonathan Cuccia Rachael Coates Blake Nassar ethan Littlefield Elizabeth C.Martin Adam T.Melvin Cain Department of Chemical Engineering Louisiana State UniversityBaton RougeLA 70803USA Department of Chemical and Biological Engineering Clemson UniversityClemsonSC 29634USA Biological and Agricultural Engineering Louisiana State UniversityBaton RougeLA 70803USA Department Medicine Section Hematology and Medical OncologyTulane UniversityNew OrleansLA 70118USA

Metastatic breast cancer leads to poor prognoses and worse outcomes in patients due to its invasive behavior and poor response to *** is still unclear what biophysical and biochemical factors drive this more aggressive phenotype in metastatic cancer;however recent studies have suggested that exposure to fluid shear stress in the vasculature could cause *** this study a modular microfluidic platform capable of mimicking the magnitude of fluid shear stress(FSS)found in human vasculature was designed and *** device provides a platform to evaluate the effects of FSS on MCF-7 cell line,an estrogen receptor positive(ER+)breast cancer cell line,during circulation in the *** of the effects of FSS on MCF-7 cells was carried out utilizing two approaches:single cell analysis and bulk *** single cell analysis,cells were trapped in a microarray after exiting the serpentine channel and followed by immunostaining on the device(on-chip).Bulk analysis was performed after cells were collected in a microtube at the outlet of the microfluidic serpentine channel for western blotting(off-chip).It was found that cells exposed to an FSS magnitude of 10 dyn/cm^(2) with a residence time of 60 s enhanced expression of the proliferation marker Ki67 in the MCF-7 cell line at a single cell *** understand possible mechanisms for enhanced Ki67 expression,on-chip and off-chip analyses were performed for pro-growth and survival pathways ERK,AKT,and JAK/*** demonstrated that after shearing the cells phosphorylation of p-AKT,p-mTOR,and p-STAT3 were ***,there was no change in p-ERK1/*** is a mediator of ER rapid signaling,analysis of phosphorylated ERαwas carried out and no significant differences between sheared and non-sheared populations were *** together these results demonstrate that FSS can increase phosphorylation of proteins associated with a more aggressive phenotype in circulating cancer *** findin

关键词： fluid breast estrogen

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Word Puzzle

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小学生时代（大嘴英语） 2024年第9期 38-45页

作者： Celine ethan Lin 不详

剧情简介故事发生在19世纪的法国。菲丽西(Felicie)自幼失去了父母,在孤儿院长大。在那里,她和“小发明家”维克托(Victor)相识,成了好朋友。菲丽西一直有一个梦想,那就是成为一名真正的芭蕾舞者。不过,如果一直困在孤儿院的高墙之内,... 详细信息

剧情简介故事发生在19世纪的法国。菲丽西(Felicie)自幼失去了父母,在孤儿院长大。在那里,她和“小发明家”维克托(Victor)相识,成了好朋友。菲丽西一直有一个梦想,那就是成为一名真正的芭蕾舞者。不过,如果一直困在孤儿院的高墙之内,她的愿望或许将永远无法实现。

关键词： Word 孤儿院维克托发明家 19世纪

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Management of a patient with an unusual trajectory of a temporary trans-venous pacing lead

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World Journal of Cardiology 2024年第6期16卷 314-317页

作者： Metesh Acharya ethan Kavanagh Sheena Garg Davorin Sef Fabio De Robertis Department of Cardiac Surgery University Hospitals of Leicester NHS TrustLeicester LE39QPUnited Kingdom Department of Cardiac Surgery King’s College LondonLondon WC2R 2LSUnited Kingdom Department of Cardiac Surgery Royal Brompton and Harefield HospitalsLondon UB96JHUnited Kingdom

Perforation of the right ventricle during placement of pacing wires is a welldocumented complication and can be potentially *** of temporary pacemaker,helical screw leads and steroids use prior to implant are recognised as risk factors for development of post-permanent pacemaker *** reported an unusual case of pacing wire perforating interventricular septum into the left ventricle that occurred during the implant procedure performed in another *** the preoperative work-up and transfer to our tertiary cardiothoracic centre,the patient underwent successful surgical *** conclusion,early recognition and timely diagnosis using advanced multimodality imaging can guide surgical intervention and prevent unfavourable consequences of device-related complications.

关键词： Ventricular perforation Lead perforation Pacing

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Physiological phenotypes differ among color morphs in introduced common wall lizards(Podarcis muralis)

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Integrative Zoology 2024年第3期19卷 505-523页

作者： Ali AMER Sierra SPEARS Princeton L.VAUGHN Cece COLWELL ethan H.LIVINGSTON Wyatt MCQUEEN Anna SCHILL Dustin G.REICHARD Eric J.GANGLOFF Kinsey M.BROCK Department of Biological Sciences Ohio Wesleyan UniversityDelawareOhioUSA Department of Ecology and Evolutionary Biology Princeton UniversityPrincetonNew JerseyUSA Department of Biology Idaho State UniversityPocatelloIdahoUSA Department of Environmental Science Policyand ManagementCollege of Natural ResourcesUniversity of CaliforniaBerkeleyUSA Museum of Vertebrate Zoology University of CaliforniaBerkeleyUSA

Many species exhibit color polymorphisms which have distinct physiological and behavioral ***,the consistency of morph trait covariation patterns across species,time,and ecological contexts remains *** trait covariation is especially relevant in the context of invasion biology and urban ***,physiological traits pertaining to energy maintenance are crucial to fitness,given their immediate ties to individual reproduction,growth,and population *** investigated the physiological traits of Podarcis muralis,a versatile color polymorphic species that thrives in urban environments(including invasive populations in Ohio,USA).We measured five physiological traits(plasma corticosterone and triglycerides,hematocrit,body condition,and field body temperature),which compose an integrated multivariate *** then tested variation among co-occurring color morphs in the context of establishment in an urban *** found that the traits describing physiological status and strategy shifted across the active season in a morph-dependent manner—the white and yellow morphs exhibited clearly different multivariate physiological phenotypes,characterized primarily by differences in plasma *** suggests that morphs have different strategies in physiological regulation,the flexibility of which is crucial to urban *** white-yellow morph exhibited an intermediate phenotype,suggesting an intermediary energy maintenance *** morphs also exhibited distinct phenotypes,but the low prevalence of this morph in our study populations precludes clear *** work provides insight into how differences among stable polymorphisms exist across axes of the phenotype and how this variation may aid in establishment within novel environments.

关键词： color polymorphism physiological status seasonal variation thermoregulation urban habitat

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Efficient Vision Transformers for Autonomous Off-Road Perception Systems

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Journal of Computer and Communications 2024年第9期12卷 188-207页

作者： Max H. Faykus III Adam Pickeral ethan Marquez Melissa C. Smith Jon C. Calhoun Holcombe Department of Electrical and Computer Engineering Clemson University Clemson SC USA

The development of autonomous vehicles has become one of the greatest research endeavors in recent years. These vehicles rely on many complex systems working in tandem to make decisions. For practical use and safety reasons, these systems must not only be accurate, but also quickly detect changes in the surrounding environment. In autonomous vehicle research, the environment perception system is one of the key components of development. Environment perception systems allow the vehicle to understand its surroundings. This is done by using cameras, light detection and ranging (LiDAR), with other sensor systems and modalities. Deep learning computer vision algorithms have been shown to be the strongest tool for translating camera data into accurate and safe traversability decisions regarding the environment surrounding a vehicle. In order for a vehicle to safely traverse an area in real time, these computer vision algorithms must be accurate and have low latency. While much research has studied autonomous driving for traversing well-structured urban environments, limited research exists evaluating perception system improvements in off-road settings. This research aims to investigate the adaptability of several existing deep-learning architectures for semantic segmentation in off-road environments. Previous studies of two Convolutional Neural Network (CNN) architectures are included for comparison with new evaluation of Vision Transformer (ViT) architectures for semantic segmentation. Our results demonstrate viability of ViT architectures for off-road perception systems, having a strong segmentation accuracy, lower inference speed and memory footprint compared to previous results with CNN architectures.

关键词： Semantic Segmentation Off-Road Vision Transformers CNNs Autonomous Driving

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以色列正走向又一个失去的十年?

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商业周刊（中文版） 2024年第9期 26-27页

作者： Galit Altstein ethan Bronner 不详

历史教训表明,军费开支的增加将带来经济成本,虽然目前还没有人能说出成本有多高。当时主要源于情报方面的失误:整个安全部门都认为,隔壁的敌人被吓住了。是的,有人看到它在进行军事演习,但它不敢进攻。然后,当敌方的武装分子涌入以色列... 详细信息

历史教训表明,军费开支的增加将带来经济成本,虽然目前还没有人能说出成本有多高。当时主要源于情报方面的失误:整个安全部门都认为,隔壁的敌人被吓住了。是的,有人看到它在进行军事演习,但它不敢进攻。然后,当敌方的武装分子涌入以色列时,士兵们正在因犹太节日休假,死亡和破坏迅速增加。以色列不得不依赖美国的装备和弹药。领导人说,这是一个教训,这个国家需要大幅增加军事准备和支出。

关键词：武装分子安全部门军费开支军事演习历史教训以色列

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粒子物理学终于规划出一条健康的前进之路

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世界科学 2024年第6期 13-18页

作者：刘牛伊森·西格尔

许多宇宙学难题仍有待解决。通过采用广泛且多样的方法，粒子物理学正朝着光明的未来前进。就在十年前，粒子物理学领域看起来还处于混乱之中。大型强子对撞机刚刚启动，虽然他们发现了希格斯玻色子——标准模型预言的最后一种未被发现...

许多宇宙学难题仍有待解决。通过采用广泛且多样的方法，粒子物理学正朝着光明的未来前进。就在十年前，粒子物理学领域看起来还处于混乱之中。大型强子对撞机刚刚启动，虽然他们发现了希格斯玻色子——标准模型预言的最后一种未被发现的粒子——但他们未能找到任何证据来支持任何一种能够带领我们超越标准模型的其他主流理论。费米实验室，能量前沿领域的先驱，永久性地关闭了其主加速器，而对像中微子质量起源、暗物质性质以及物质-反物质不对称起源等难题的研究似乎陷入了停滞，无论是在实验还是理论方面都进展缓慢。

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Competing-risks model for predicting the prognosis of patients with regressive melanoma based on the SEER database

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Malignancy Spectrum 2024年第2期1卷 123-135页

作者： Chaodi Huang Liying Huang Jianguo Huang Xinkai Zheng Congjun Jiang Kong Ching Tom UTim Wu WenHsien ethan Huang Yunfei Gao Fangmin Situ Hai Yu Liehua Deng Jun Lyu Department of Dermatology The First Affiliated Hospital of Jinan University and Jinan University Institute of DermatologyGuangzhouGuangdongChina Department of Clinical Research The First Affiliated Hospital of Jinan UniversityGuangzhouGuangdongChina Department of Dermatology Huadu District People's Hospital of GuangzhouGuangzhouGuangdongChina Department of Dermatology The First Affiliated Hospital of Bengbu Medical CollegeBengbuAnhuiChina Primax Biotech Company Hong KongChina Meng Yi Centre Limited MacaoChina GeneHope Clinic TaipeiTaiwanChina Guangdong Provincial Key Laboratory of Tumor Interventional Diagnosis and Treatment Zhuhai Institute of Translational MedicineZhuhai People's Hospital Affiliated with Jinan UniversityZhuhaiGuangdongChina The Biomedical Translational Research Institute Faculty of Medical ScienceJinan UniversityGuangzhouGuangdongChina Department of Dermatology The Fifth Affiliated Hospital of Jinan UniversityHeyuanGuangdongChina Guangdong Provincial Key Laboratory of Traditional Chinese Medicine Informatization GuangzhouGuangdongChina

Background:The relationship between the regression and prognosis of melanoma has been debated for *** competing-risk events are present,using traditional survival analysis methods may induce bias in the identified prognostic factors that affect patients with regressive ***:Data on patients diagnosed with regressive melanoma were extracted from the Surveillance,Epidemiology,and End Results(SEER)database during *** incidence function and Gray's test were used for the univariate analysis,and the Cox proportional-hazards model and the Fine-Gray model were used for the multivariate ***:A total of 1442 eligible patients were diagnosed with regressive melanoma,including 529 patients who died:109 from regressive melanoma and 420 from other *** multivariate analysis using the Fine-Gray model revealed that SEER stage,surgery status,and marital status were important factors that affected the prognosis of regressive *** to the existence of competing-risk events,the Cox model may have induced biases in estimating the effect values,and the competing-risks model was more advantageous in the analysis of multipleendpoint clinical survival ***:The findings of this study may help clinicians to better understand regressive melanoma and provide reference data for clinical decisions.

关键词： competing-risks model prognosis regressive melanoma SEER Cox model

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